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Sample records for extracardiac conduit fontan

  1. An international multicenter study comparing arrhythmia prevalence between the intracardiac lateral tunnel and the extracardiac conduit type of Fontan operations.

    Science.gov (United States)

    Balaji, Seshadri; Daga, Ankana; Bradley, David J; Etheridge, Susan P; Law, Ian H; Batra, Anjan S; Sanatani, Shubayan; Singh, Anoop K; Gajewski, Kelly K; Tsao, Sabrina; Singh, Harinder R; Tisma-Dupanovic, Svjetlana; Tateno, Shigeru; Takamuro, Motoki; Nakajima, Hiromichi; Roos-Hesselink, Jolien W; Shah, Maully

    2014-08-01

    The study objective was to determine whether the extracardiac conduit Fontan confers an arrhythmia advantage over the intracardiac lateral tunnel Fontan. This multicenter study of 1271 patients compared bradyarrhythmia (defined as need for pacing) and tachyarrhythmia (defined as needing antiarrhythmic therapy) between 602 patients undergoing the intracardiac Fontan and 669 patients undergoing the extracardiac Fontan. The median age at the time of the Fontan procedure was 2.1 years (interquartile range, 1.6-3.2 years) for the intracardiac group and 3.0 years (interquartile range, 2.4-3.9) for the extracardiac group (P 30 days) bradyarrhythmia occurred in 105 patients (18%) in the intracardiac group and 63 patients (9%) in the extracardiac group (P 30 days) tachyarrhythmia occurred in 58 patients (10%) in the intracardiac group and 23 patients (3%) in the extracardiac group (P factoring time since surgery, more patients in the extracardiac group had early bradycardia (odds ratio, 2.9; 95% confidence interval, 1.8-4.6), with no difference in early tachycardia, late bradycardia, or late tachycardia. Overall arrhythmia burden is similar between the 2 groups, but the extracardiac Fontan group had a higher incidence of early bradyarrhythmias. There was no difference in the incidence of late tachyarrhythmias over time between the 2 operations. Therefore, the type of Fontan performed should be based on factors other than an anticipated reduction in arrhythmia burden from the extracardiac conduit. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  2. Percutaneous transthoracic computed tomography-guided AICD insertion in a patient with extracardiac Fontan conduit.

    LENUS (Irish Health Repository)

    Murphy, Darra T

    2011-02-01

    Percutaneous pulmonary venous atrial puncture was performed under computed tomography guidance to successfully place an automated implantable cardiac defibrillator into a 26-year-old patient with extracardiac Fontan conduit who had presented with two out-of-hospital cardiac arrests. The procedure avoided the need for lead placement at thoracotomy.

  3. Towards a Tissue-Engineered Contractile Fontan-Conduit: The Fate of Cardiac Myocytes in the Subpulmonary Circulation.

    Directory of Open Access Journals (Sweden)

    Daniel Biermann

    Full Text Available The long-term outcome of patients with single ventricles improved over time, but remains poor compared to other congenital heart lesions with biventricular circulation. Main cause for this unfavourable outcome is the unphysiological hemodynamic of the Fontan circulation, such as subnormal systemic cardiac output and increased systemic-venous pressure. To overcome this limitation, we are developing the concept of a contractile extracardiac Fontan-tunnel. In this study, we evaluated the survival and structural development of a tissue-engineered conduit under in vivo conditions. Engineered heart tissue was generated from ventricular heart cells of neonatal Wistar rats, fibrinogen and thrombin. Engineered heart tissues started beating around day 8 in vitro and remained contractile in vivo throughout the experiment. After culture for 14 days constructs were implanted around the right superior vena cava of Wistar rats (n = 12. Animals were euthanized after 7, 14, 28 and 56 days postoperatively. Hematoxylin and eosin staining showed cardiomyocytes arranged in thick bundles within the engineered heart tissue-conduit. Immunostaining of sarcomeric actin, alpha-actin and connexin 43 revealed a well -developed cardiac myocyte structure. Magnetic resonance imaging (d14, n = 3 revealed no constriction or stenosis of the superior vena cava by the constructs. Engineered heart tissues survive and contract for extended periods after implantation around the superior vena cava of rats. Generation of larger constructs is warranted to evaluate functional benefits of a contractile Fontan-conduit.

  4. Computational modeling of Fontan physiology: at the crossroads of pediatric cardiology and biomedical engineering.

    Science.gov (United States)

    Slesnick, Timothy C; Yoganathan, Ajit P

    2014-08-01

    The Fontan operation has evolved over the last four and a half decades and is now widely applied to patients with various forms of "single ventricle" congenital heart disease. Survival has greatly improved since the early years, but long-term morbidity and mortality continue to occur. Modeling of Fontan geometries, both in vitro and using computational fluid dynamics, has been instrumental in designing novel changes to Fontan's operation, including the application of staged surgical procedures leading to a total cavopulmonary anastomosis, lateral tunnel, extracardiac conduit, and most recently bifurcated Y-graft modifications. In this review, the history of modeling of Fontan physiologies, current state-of-the-art methodologies, and future directions are explored. The application of these techniques to cardiac magnetic resonance imaging to construct patient specific anatomies offers the possibility of individualized surgical planning to optimize hemodynamics, including minimizing power loss, balancing hepatic factor distribution, and ultimately improving patient outcomes.

  5. Utilização de valvas homólogas e heterólogas em condutos extracardíacos The use of homograph and heterograph valves in extracardiac conduits

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    Rui Siqueira de Almeida

    1988-08-01

    Full Text Available O conceito do uso de um conduto extracardíaco para estabelecer uma via de saída, conectando o ventrículo direito com o tronco pulmonar, ou seus ramos, foi desenvolvido na década de 60. Entre 1971 e 1986, 335 pacientes receberam, no The Hospital for Sick Children, de Londres, condutos extracardíacos para o lado direito do coração; 176 destes foram homoenxertos aórticos, preservados em solução antibióticonutriente; 140 heteroenxertos (Hancock, Ross, Carpentier-Edwards, lonescu-Shiley e 19 tubos não valvulados. Estes condutos foram usados na correção de defeitos cardíacos complexos. A idade média foi de 6,34 anos e o peso médio, de 17,8 kg. O diâmetro interno dos condutos variou de 8 a 30 mm. A mortalidade hospitalar foi de 29,2% e o seguimento dos sobrevivente teve uma duração máxima de 14,3 anos, sendo que apenas 40% delas foram relacionadas ao conduto extracardíaco. A curva atuarial, livre de obstrução, dos condutos extracardíacos foi significativa, quando se analisaram os homoenxertos, face a cada grupo de heteroenxertos (p The concept of using extracardiac conduits, to establish an outflow tract between the right ventricle and the pulmonary artery was developed on the sixties. Between 1971 and 1986, 335 patients received extracardiac conduits for the right heart, at The Hospital for Sick Children, London; 176 were antibiotic preserved aortic homografts (Hancock, Ross, Carpentier-Edwards, lonescu-Shiley and 19 non-valved tubes. These conduits were used for the repair of complex congenital heart defects. The mean age of these groups was 6.34 ± 4.6 years and the mean weight 17.8 ± 10.8 kg. The internal diameter of the conduits varied from 8 to 30 mm. The hospital mortality was 29.2% and long-term follow-up of the survivals had a maximum period of 14,39 years. Sixty patients (17.9% were submited to 60 reoperations, being only 40% conduit related. The actuarial survival cun/e of freedom from obstruction was significant

  6. The Fontan pathway: What's down the road?

    International Nuclear Information System (INIS)

    Khambadkone, Sachin

    2008-01-01

    The Fontan circulation results from routing of the systemic venous blood to the pulmonary circulation without a hydraulic source of a ventricle. Although a hypertrophied right atrium was thought to be essential for this circulation, the current form of the operation has neither the right atrium nor any valves in the venous circulation that is connected to the pulmonary arteries directly. Modifications in the operative model was one of the early steps in improving outcome. Use of fenestration, staging of Fontan completion and better perioperative management have led to a significant drop in mortality rates in the current era. Despite this, there is late attrition of patients with complications such as arrhythmias, ventricular dysfunction, and unusual clinical syndromes of protein-losing enteropathy (PLE) and plastic bronchitis. Management of failing Fontan includes a detailed hemodynamic and imaging assessment to treat any correctable lesions such as obstruction within the Fontan circuit, early control of arrhythmia and maintenance of sinus rhythm, symptomatic treatment for PLE and plastic bronchitis, manipulation of systemic and pulmonary vascular resistance, and Fontan conversion of less favorable atriopulmonary connection to extra-cardiac total cavopulmonary connection with arrythmia surgery. Cardiac transplantation remains the only successful definitive palliation in the failing Fontan patients

  7. Quantification of hepatic flow distribution using particle tracking for patient specific virtual Fontan surgery

    Science.gov (United States)

    Yang, Weiguang; Vignon-Clementel, Irene; Troianowski, Guillaume; Shadden, Shawn; Mohhan Reddy, V.; Feinstein, Jeffrey; Marsden, Alison

    2010-11-01

    The Fontan surgery is the third and final stage in a palliative series to treat children with single ventricle heart defects. In the extracardiac Fontan procedure, the inferior vena cava (IVC) is connected to the pulmonary arteries via a tube-shaped Gore-tex graft. Clinical observations have shown that the absence of a hepatic factor, carried in the IVC flow, can cause pulmonary arteriovenous malformations. Although it is clear that hepatic flow distribution is an important determinant of Fontan performance, few studies have quantified its relation to Fontan design. In this study, we virtually implanted three types of grafts (T-junction, offset and Y-graft) into 5 patient specific models of the Glenn (stage 2) anatomy. We then performed 3D time-dependent simulations and systematically compared the IVC flow distribution, energy loss, and pressure levels in different surgical designs. A robustness test is performed to evaluate the sensitivity of hepatic distribution to pulmonary flow split. Results show that the Y-graft design effectively improves the IVC flow distribution, compared to traditional designs and that surgical designs could be customized on a patient-by-patient basis.

  8. Surgical options after Fontan failure

    DEFF Research Database (Denmark)

    van Melle, Joost P; Wolff, Djoeke; Hörer, Jürgen

    2016-01-01

    by the European Congenital Heart Surgeons Association among 22 member centres. Outcome of surgery to address failing Fontan was collected in 225 patients among which were patients with Fontan takedown (n=38; 17%), Fontan conversion (n=137; 61%) or HTX (n=50; 22%). RESULTS: The most prevalent indication...... for failing Fontan surgery was arrhythmia (43.6%), but indications differed across the surgical groups (p...OBJECTIVE: The objective of this European multicenter study was to report surgical outcomes of Fontan takedown, Fontan conversion and heart transplantation (HTX) for failing Fontan patients in terms of all-cause mortality and (re-)HTX. METHODS: A retrospective international study was conducted...

  9. Congenital heart defects and extracardiac malformations.

    Science.gov (United States)

    Rosa, Rosana Cardoso M; Rosa, Rafael Fabiano M; Zen, Paulo Ricardo G; Paskulin, Giorgio Adriano

    2013-06-01

    To review the association between congenital heart defects and extracardiac malformations. Scientific articles were searched in the Medline, Lilacs, and SciELO databases, using the descriptors "congenital heart disease," "congenital heart defects," "congenital cardiac malformations," "extracardiac defects," and "extracardiac malformations." All case series that specifically explored the association between congenital heart defects and extracardiac malformations were included. Congenital heart diseases are responsible for about 40% of birth defects, being one of the most common and severe malformations. Extracardiac malformations are observed in 7 to 50% of the patients with congenital heart disease, bringing a greater risk of comorbidity and mortality and increasing the risks related to heart surgery. Different studies have attempted to assess the presence of extracardiac abnormalities in patients with congenital heart disease. Among the changes described, those of the urinary tract are more often reported. However, no study has evaluated all patients in the same way. Extracardiac abnormalities are frequent among patients with congenital heart disease, and patients with these alterations may present an increased risk of morbimortality. Therefore, some authors have been discussing the importance and cost-effectiveness of screening these children for other malformations by complementary exams.

  10. Non-invasive Investigations for the Diagnosis of Fontan-Associated Liver Disease in Pediatric and Adult Fontan Patients

    Directory of Open Access Journals (Sweden)

    Amyna Fidai

    2017-03-01

    Full Text Available Fontan-associated liver disease (FALD is a serious complication related to the chronically elevated venous pressure and low cardiac output of this abnormal circulation. However, diagnostic markers for this condition are limited. We hypothesized that specific tests for fibrosis developed for other chronic liver diseases would identify a higher prevalence of FALD than ultrasound and standard laboratory tests and that identified abnormalities would correlate with time post-Fontan. In this cross-sectional study, we assessed 19 children (average age 8.4 ± 4.3 and 5.4 ± 4.1 years post-Fontan and 8 adults (average age 31.5 ± 8.9 and 21.1 ± 4 years post-Fontan using standard serum laboratory investigations assessing hepatic integrity and function, the FibroTest, liver ultrasound, and transient elastography (FibroScan. In adult Fontan patients, hemoglobin, C-reactive protein, and gamma-glutamyl transpeptidase were significantly increased, and white blood cell and platelet counts were significantly decreased in comparison to the pediatric cohort. International normalized ratio was mildly elevated in both children and adults. FibroTest results were suggestive of fibrosis regardless of time post-Fontan. FibroScan measurements were significantly correlated with time post-Fontan, but the incidence of ultrasound-detected liver abnormalities was variable. No cases of hepatocellular carcinoma were identified. Abnormalities suggestive of FALD occur in both children and adults post-Fontan. Select laboratory tests, and possibly ultrasound and FibroScan in some patients, appear to have the most promise for the non-invasive detection of FALD.

  11. An Early Glenn Operation May be Associated with the Later Occurrence of Protein-Losing Enteropathy in Fontan Patients : Association of Early Glenn and Failing Fontan.

    Science.gov (United States)

    Unseld, Bettina; Stiller, Brigitte; Borth-Bruhns, Thomas; du Bois, Florian; Kroll, Johannes; Grohmann, Jochen; Fleck, Thilo

    2017-08-01

    Protein-losing enteropathy (PLE) and plastic bronchitis (PB) are major causes of long-term mortality after Fontan operation. The objective of this study was to determine early clinical risk factors before the onset of PLE and PB. In a cohort study, 106 Fontan patients between 2005 and 2013 were examined. A median of 5.3 (1.5-8.5) years later, follow-up questionnaires were used to group the patients in a PLE or PB group (n = 14) and a non-PLE/PB group (n = 92). Prevalence of PLE was 9.4% (n = 10) and of PB 3.8% (n = 4). At follow-up, five patients (4.7%) died of PLE or PB. Median age at death was 6.2 years (IQR 10.5, 95% CI 5.3-23.4). We observed no significant group differences in gender distribution (p = 0.73), ventricular morphology (p = 0.87), surgical technique (p = 0.64), conduit fenestration (p = 0.34), age at Fontan operation (p = 0.54), and need for diuretics (p = 0.56). Hypoplastic left heart syndrome was more frequent in the PLE/PB group 50 vs. 22.8% (p = 0.03) OR 3.4 (95% CI 1.1-10.8). The modified Glenn procedure was performed at a median age of 4 months (IQR 4.0) in the PLE/PB group versus 8 months (IQR 8.0) in the non-PLE/PB group (p = 0.01). The early Glenn procedure and hypoplastic left heart syndrome may be associated with the development of PLE and PB.

  12. Hemodynamic causes of exercise intolerance in Fontan patients

    DEFF Research Database (Denmark)

    Hebert, Anders; Jensen, Annette S; Mikkelsen, Ulla Ramer

    2014-01-01

    BACKGROUND: Exercise intolerance is frequent among Fontan patients and an important determinant for quality of life. This study investigated the hemodynamic causes of impaired exercise capacity in Fontan patients with particular focus on the influence of stroke volume index (SVI) and heart rate (HR...... patients and controls respectively. CONCLUSION: SVI decreased significantly in Fontan patients near the end of maximal effort exercise. The low SVI at maximal exercise was the most important hemodynamic factor limiting exercise capacity in Fontan patients, whereas chronotropic impairment had a smaller...

  13. Assessment of Liver Stiffness in Pediatric Fontan Patients Using Transient Elastography

    Directory of Open Access Journals (Sweden)

    Becky Chen

    2016-01-01

    Full Text Available Background. Hepatic fibrosis is a potential complication following Fontan surgery and heralds long-term risk for cirrhosis. Transient elastography (TE is a rapid, noninvasive method to assess liver fibrosis by measuring liver stiffness. Objectives. To compare liver stiffness and liver biochemistries in pediatric Fontan patients with age- and sex-matched controls and to determine patients’ acceptance of TE. Methods. Patients were recruited from British Columbia Children’s Hospital. Twenty-two Fontan patients (15 males were identified. Demographic information and cardiac data were collected. TE was measured using size-appropriate probes. Results. The median age of the Fontan cohort was 13.7 (5.9–16.8 years. Time from Fontan surgery to TE was 9.6 (1.0–12.9 years. The median Fontan circuit pressure was 13 (11–14 mmHg. TE values were higher in Fontan patients versus controls (18.6 versus 4.7 kPa, p<0.001. There was no association between TE values and patient age (r=0.41, p=0.058, time since Fontan surgery (r=0.40, p=0.062, or median Fontan circuit pressure (CVP (r=0.35, p=0.111. Patients found TE to be nonpainful, convenient, and safe. Conclusions. TE is feasible to assess liver stiffness in children following Fontan surgery. Pediatric Fontan patients have markedly elevated liver stiffness values. TE may have important utility in liver care follow-up of pediatric Fontan patients.

  14. Thromboembolism and anticoagulation after Fontan surgery

    OpenAIRE

    Viswanathan, Sangeetha

    2016-01-01

    This review attempts to answer the common questions faced by a clinician regarding thromboembolism and thromboprophylaxis in patients following Fontan surgery. The review is in an easy to understand question and answer format and discusses the currently available literature on the subject in an attempt to arrive at practical clinically relevant solutions. Patients who have undergone the Fontan operation are at a high risk for thromboembolism. Based on available evidence, there is a strong rat...

  15. Heart transplantation in Fontan patients across Australia and New Zealand.

    Science.gov (United States)

    Shi, William Y; Yong, Matthew S; McGiffin, David C; Jain, Pankaj; Ruygrok, Peter N; Marasco, Silvana F; Finucane, Kirsten; Keogh, Anne; d'Udekem, Yves; Weintraub, Robert G; Konstantinov, Igor E

    2016-07-15

    Patients with Fontan physiology may eventually require heart transplantation (HT). We determined the rates and outcomes of HT in a national, population-based multicentre study. From 1990 to 2015, 1369 patients underwent the Fontan procedure as recorded in the Australia and New Zealand Fontan Registry. We identified those who underwent HT and analysed their outcomes. We compared rates of HT between two catchment areas. In area 1 (n=721), patients were referred to the national paediatric HT programme or its associated adult programme. In area 2 (n=648), patients were referred to the national paediatric HT programme or one of the other adult HT programmes. Mean follow-up time post-Fontan was 11±8 years. Freedom from Fontan failure was 74%±3.9% at 20 years. HT was performed in 34 patients. Patients living in area 1 were more likely to have HT (4.0%, 29/721 vs 0.8%, 5/648, p<0.001) with a cumulative proportion of 3.4% vs 0.7% at 10 years and 6.8% vs 1.2% at 20 years (p=0.002). Area 1 patients were more likely to undergo HT (hazard ratio 4.7, 95% CI 1.7 to 13.5, p=0.003) on multivariable regression. Post-HT survival at 1, 5 and 10 years was 91%, 78% and 71%, respectively. Compared with other patients with congenital heart disease (n=87), Fontan patients had similar in-hospital outcomes and long-term survival. Although HT after the Fontan procedure can be achieved with excellent outcomes, most patients with Fontan failure do not undergo HT. Significant regional differences in rates of HT in Fontan patients exist. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  16. Immune Abnormalities in Fontan Protein-Losing Enteropathy: A Case-Control Study.

    Science.gov (United States)

    Magdo, H Sonali; Stillwell, Terri L; Greenhawt, Matthew J; Stringer, Kathleen A; Yu, Sunkyung; Fifer, Carlen G; Russell, Mark W; Schumacher, Kurt R

    2015-08-01

    To comprehensively characterize the immunologic characteristics of patients with protein-losing enteropathy (PLE) post-Fontan and compare them with patients without PLE post-Fontan. Patients with PLE post-Fontan and age-matched controls post-Fontan were prospectively studied with laboratory markers of immune function. Infectious history was obtained by interview and chart review. The groups' demographics, cardiac history, immune characteristics, and infection history were compared using appropriate 2-group statistics. A total of 16 patients enrolled (8 patients with PLE and 8 controls). All patients with PLE had lymphopenia compared with 25% of controls (P = .01). All patients with PLE had markedly depressed CD4 T cell counts (median 58 cells/μL) compared with controls (median 450 cells/μL, P = .0002); CD4% was also low in the PLE group (12.3%) and normal in control (36.9%, P = .004). Both groups had mildly depressed CD8 T cells and normal to slightly elevated natural killer and B-cell subsets. A majority of patients with PLE (62.5%) had negative titers to measles, mumps, and rubella vaccination, compared with no control Fontan with a negative titer (P = .03). Despite profoundly low CD4 counts, the frequency of infection was not different between groups with no reported opportunistic infections. Patients with Fontan-associated PLE have extensive quantitative immune abnormalities, particularly CD4 deficiency. These immune abnormalities are similar to those found in non-Fontan patients with PLE caused by intestinal lymphangiectasia. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Quality of life and cognitive function in Fontan patients, a population-based study

    DEFF Research Database (Denmark)

    Idorn, Lars; Jensen, Annette S; Juul, Klaus

    2013-01-01

    BACKGROUND: After the Fontan procedure patients are at risk for reduced quality of life (QoL) and cognitive function. We aimed to assess these important factors in Danish Fontan patients and to compare the results with a group of healthy controls. METHODS: All Fontan patients living in Denmark we...

  18. The Use of Fecal Calprotectin Levels in the Fontan population.

    Science.gov (United States)

    Miranda, Carlos; Taqatqa, Anas; Chapa-Rodriguez, Adrian; Holton, Jacob P; Awad, Sawsan M

    2018-03-01

    The Fontan procedure was first performed in the seventies as a palliation for patients with single ventricle physiology. A feared complication after a Fontan procedure is the development of protein losing enteropathy (PLE). Systemic inflammation has a negative effect on the intestinal barrier integrity, which has supported the use of steroids in this setting. To the best of our knowledge there are no studies linking intestinal inflammation in patients with PLE after Fontan. The objective of this study was to identify the presence of intestinal inflammation measured by FC in patients with PLE after a Fontan procedure. A cross-sectional analysis was performed examining 23 stool samples from 23 Fontan patients for both Fecal alpha-1-antitrypsin (FA1AT) and FC with and without PLE. The median FC was 21 mcg/gm of stool (IQR: 15.7-241 mcg/gm of stool), and the median FA1AT was 40 mg/dL (IQR: 30-220 mg/dL). The median FC and FA1AT were significantly higher in the PLE group than in the Non-PLE group (p = 0.002 and p PLE, which correlated with the elevated levels of FA1AT. Inversely, levels of FC in Fontan patients without suspected PLE were within the normal range. To our knowledge, this is the first study to demonstrate intestinal inflammation using FC in the setting of PLE within this cohort, and may prove to be useful as a diagnostic tool in its treatment.

  19. Extracardiac findings detected by cardiac magnetic resonance imaging

    International Nuclear Information System (INIS)

    Wyttenbach, Rolf; Medioni, Nathalie; Santini, Paolo; Vock, Peter; Szucs-Farkas, Zsolt

    2012-01-01

    To determine the prevalence and importance of extracardiac findings (ECF) in patients undergoing clinical CMR and to test the hypothesis that the original CMR reading focusing on the heart may underestimate extracardiac abnormalities. 401 consecutive patients (mean age 53 years) underwent CMR at 1.5 T. Main indications were ischaemic heart disease (n = 183) and cardiomyopathy (n = 164). All CMR sequences, including scout images, were reviewed with specific attention to ECF in a second reading by the same radiologist who performed the first clinical reading. Potentially significant findings were defined as abnormalities requiring additional clinical or radiological follow-up. 250 incidental ECF were detected, of which 84 (34%) had potentially significant ECF including bronchial carcinoma (n = 1), lung consolidation (n = 7) and abdominal abnormalities. In 166 CMR studies (41%) non-significant ECF were detected. The number of ECF identified at second versus first reading was higher for significant (84 vs. 47) and non-significant (166 vs. 36) findings (P < 0.00001). About one fifth of patients undergoing CMR were found to have potentially significant ECF requiring additional work-up. The second dedicated reading detected significantly more ECF compared with the first clinical reading emphasising the importance of active search for extracardiac abnormalities when evaluating CMR studies. circle Many patients undergoing cardiac MR have significant extracardiac findings (ECF) circle These impact on management and require additional work-up. circle Wide review of scout and cine sequences will detect most ECFs. circle Education of radiologists is important to identify ECFs on CMR studies. (orig.)

  20. Surgical outcome of Fontan conversion and arrhythmia surgery: Need a pacemaker?

    Science.gov (United States)

    Terada, Takafumi; Sakurai, Hajime; Nonaka, Toshimichi; Sakurai, Takahisa; Sugiura, Junya; Taneichi, Tetsuyoshi; Ohtsuka, Ryohei

    2014-07-01

    Atrial tachyarrhythmias are frequent complications in the late period after the Fontan procedure, and important risk factors for a poor prognosis. The impact of Fontan conversion and arrhythmia surgery in failed Fontan patients has been described in many reports. We evaluated our experience with Fontan conversion procedures, concomitant arrhythmia surgery, and pacemaker implantation. We reviewed the hospital records of 25 consecutive patients who underwent a Fontan conversion procedure from January 2004 to March 2012. Twenty-four patients had arrhythmia surgery using cryoablation and radiofrequency ablation at the time of conversion. A bilateral atrial maze procedure was performed in 6 patients, right-side maze in 15, and isthmus block in 3. Three patients with a diagnosis of corrected transposition of the great arteries underwent simultaneous pacemaker implantation electively. There was no early death and one late death during a mean follow-up period of 21.2 months. Three tachyarrhythmia recurrences developed, and there were 4 occurrences of sinus bradycardia. Five of these patients required postoperative pacemaker implantation. The mid-term results of Fontan conversion and arrhythmia surgery in our institute were satisfactory. The occurrence of unexpected postoperative pacemaker requirement was high in the patients who underwent a right atrial or bilateral atrial maze procedure. Pacemaker or lead implantation is recommended for patients planned to undergo a right-side or full maze procedure. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  1. Skeletal muscle abnormalities and exercise capacity in adults with a Fontan circulation.

    Science.gov (United States)

    Cordina, Rachael; O'Meagher, Shamus; Gould, Haslinda; Rae, Caroline; Kemp, Graham; Pasco, Julie A; Celermajer, David S; Singh, Nalin

    2013-10-01

    The peripheral muscle pump is key in promoting cardiac filling during exercise, especially in subjects who lack a subpulmonary ventricle (the Fontan circulation). A muscle-wasting syndrome exists in acquired heart failure but has not been assessed in Fontan subjects. We sought to investigate whether adults with the Fontan circulation exhibit reduced skeletal muscle mass and/or metabolic abnormalities. Sixteen New York Heart Association Class I/II Fontan adults (30±2 years) underwent cardiopulmonary exercise testing and lean mass quantification with dual x-ray absorptiometry (DXA); eight had calf muscle (31)P magnetic resonance spectroscopy as did eight healthy age-matched and sex-matched controls. DXA results were compared with Australian reference data. Single tertiary referral centre. Peak VO2 was 1.9±0.1 L/min (66±3% of predicted values). Skeletal muscle mass assessed by relative appendicular lean mass index was significantly reduced compared with age-matched and sex-matched reference values (Z-score -1.46±0.22, pskeletal muscle mass correlated with poorer VO2 max (r=0.67, p=0.004). Overall, skeletal muscle mass T-score (derived from comparison with young normal reference mean) was -1.47±0.21; 4/16 Fontan subjects had sarcopenic range muscle wasting (T-score Muscle aerobic capacity, measured by the rate constant (k) of postexercise phosphocreatine resynthesis, was significantly impaired in Fontan adults versus controls (1.48±0.13 vs 2.40±0.33 min(-1), p=0.02). Fontan adults have reduced skeletal muscle mass and intrinsic muscle metabolic abnormalities.

  2. Contractility-afterload mismatch in patients with protein-losing enteropathy after the Fontan operation.

    Science.gov (United States)

    Ozawa, Hideto; Ueno, Takayoshi; Iwai, Shigemitsu; Kawata, Hiroaki; Nishigaki, Kyouichi; Kishimoto, Hidefumi; Sawa, Yoshiki

    2014-10-01

    This study aimed to clarify the relationship between onset of protein-losing enteropathy (PLE) and Fontan circulation, with special reference to the development of contractility-afterload mismatch. The PLE group comprised 9 patients who experienced PLE after undergoing the Fontan operation, and the control group consisted of 32 patients had did not experienced PLE more than 10 years after the Fontan operation. The study compared the pre- and postoperative values of arterial elastance (Ea), end-systolic elastance (Ees), and contractility-afterload mismatch (Ea/Ees). Furthermore, the variations in the values were examined during the preoperative, postoperative, and midterm postoperative periods in seven PLE patients who underwent cardiac catheterization at the onset of PLE and during the pre- and postintervention periods in three PLE patients who underwent surgical intervention to improve the Fontan circulation after the onset of PLE. Comparison of the values obtained before and after Fontan operations showed that the Ea values increased significantly in the PLE group. However, the pre- and postoperative Ees values did not differ in the two groups. During the postoperative period, Ea/Ees increased significantly, and the Ea and Ea/Ees values increased continuously until the onset of PLE in the PLE group. In the patients who underwent surgical intervention to improve the Fontan circulation after the onset of PLE, the Ea/Ees decreased significantly, and the serum albumin levels improved after the intervention. Contractility-afterload mismatch, mainly caused by the increase in the afterload of the systemic ventricle, may have an important role in the development of PLE after the Fontan operation.

  3. The Direct Effect of Flexible Walls on Fontan Connection Fluid Dynamics

    Science.gov (United States)

    Tree, Mike; Fagan, Kiley; Yoganathan, Ajit

    2014-11-01

    The current standard treatment for sufferers of congenital heart defects is the palliative Fontan procedure. The Fontan procedure results in an anastomosis of major veins directly to the branched pulmonary arteries bypassing the dysfunctional ventricle. This total cavopulmonary connection (TCPC) extends life past birth, but Fontan patients still suffer long-term complications like decreased exercise capacity, protein-losing enteropathy, and pulmonary arteriovenous malformations (PAVM). These complications have direct ties to fluid dynamics within the connection. Previous experimental and computation studies of Fontan connection fluid dynamics employed rigid vessel models. More recent studies utilize flexible models, but a direct comparison of the fundamental fluid dynamics between rigid and flexible vessels only exists for a computational model, without a direct experimental validation. Thus, this study was a direct comparison of fluid dynamics within a rigid and two compliant idealized TCPCs. 2D particle image velocimetry measurements were collected at the connection center plane. Results include power loss, hepatic flow distribution, fluid shear stress, and flow structure recognition. The effect of flexible walls on these values and clinical impact will be discussed.

  4. Bosentan Improves Exercise Capacity in Adolescents and Adults After Fontan Operation

    DEFF Research Database (Denmark)

    Hebert, Anders; Mikkelsen, Ulla Ramer; Thilen, Ulf

    2014-01-01

    a crucial role. Elevated pulmonary vascular resistance has been associated with raised levels of endothelin-1, which are common both before and after Fontan operations. Treatment with endothelin-1 receptor antagonists could theoretically improve cardiopulmonary hemodynamics and exercise capacity. The aim......BACKGROUND: The Fontan procedure has improved survival in children with functionally univentricular hearts. With time, however, complications such as reduced exercise capacity are seen more frequently. Exercise intolerance is multifactorial, but pulmonary vascular resistance probably plays...... of this study was therefore to examine the efficacy and safety of bosentan in Fontan patients. METHODS AND RESULTS: Seventy-five adolescents and adults were randomized 1:1 to 14 weeks of treatment with bosentan or placebo. Cardiopulmonary exercise test, functional class, blood samples, and quality...

  5. O conduto valvulado bovino contegra, um biomaterial para o tratamento cirúrgico de cardiopatias congênitas The contegra valved bovine conduit: a biomaterial for the surgical treatment of congenital heart defects

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2012-01-01

    congenital heart defects, especially as a conduit for the right ventricular outflow tract reconstruction. This article aims to make a comprehensive review on the clinical outcomes of Contegra. Reports of Contegra published since 2002 were comprehensively retrieved, collected and analyzed. There were 1718 Contegra, applied in 1705 patients. The sizes of the conduits were 8-22 mm. The patients aged from newborn to 74.5 years, prevailed by pediatrics. The primary diagnosis was congenital heart defects in all cases, with Tetralogy of Fallot, truncus arteriosus and pulmonary atresia being the first three diagnoses, representing 25.6%, 16.7%, and 13.1%, respectively. Contegra was used as a tube graft in the pulmonary position in 1635 (95.9% patients, as a monocuspid patch in 12 (0.7%, as a graft in the position of the pulmonary valve or a monocusps in 40 (2.3%, and as an inferior vena cava-pulmonary artery conduit in the Fontan procedure in 18 (1.1% patients, respectively. Conduit reimplantation was performed in 141 (8.3% patients 33.8 ± 37 (8.6-106.8 months after the initial conduit insertion. Conduit plasty was necessary in 6 (0.4%, and reintervention in 83 (4.9% patients. Indications for conduit reimplantation included severe stenosis of the distal anastomosis, pseudoaneurysm of the proximal anastomosis and severe conduit regurgitation. As for the good performance, availability and longevity, Contegra is a biomaterial suitable for the right ventricular outflow tract reconstruction and for patch repair for ventricular septal defect, but not apt for Fontan procedure.

  6. O conduto valvulado bovino contegra, um biomaterial para o tratamento cirúrgico de cardiopatias congênitas The contegra valved bovine conduit: a biomaterial for the surgical treatment of congenital heart defects

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2012-12-01

    congenital heart defects, especially as a conduit for the right ventricular outflow tract reconstruction. This article aims to make a comprehensive review on the clinical outcomes of Contegra. Reports of Contegra published since 2002 were comprehensively retrieved, collected and analyzed. There were 1718 Contegra, applied in 1705 patients. The sizes of the conduits were 8-22 mm. The patients aged from newborn to 74.5 years, prevailed by pediatrics. The primary diagnosis was congenital heart defects in all cases, with Tetralogy of Fallot, truncus arteriosus and pulmonary atresia being the first three diagnoses, representing 25.6%, 16.7%, and 13.1%, respectively. Contegra was used as a tube graft in the pulmonary position in 1635 (95.9% patients, as a monocuspid patch in 12 (0.7%, as a graft in the position of the pulmonary valve or a monocusps in 40 (2.3%, and as an inferior vena cava-pulmonary artery conduit in the Fontan procedure in 18 (1.1% patients, respectively. Conduit reimplantation was performed in 141 (8.3% patients 33.8 ± 37 (8.6-106.8 months after the initial conduit insertion. Conduit plasty was necessary in 6 (0.4%, and reintervention in 83 (4.9% patients. Indications for conduit reimplantation included severe stenosis of the distal anastomosis, pseudoaneurysm of the proximal anastomosis and severe conduit regurgitation. As for the good performance, availability and longevity, Contegra is a biomaterial suitable for the right ventricular outflow tract reconstruction and for patch repair for ventricular septal defect, but not apt for Fontan procedure.

  7. Arrhythmia and exercise intolerance in Fontan patients

    DEFF Research Database (Denmark)

    Idorn, L; Juul, K; Jensen, A S

    2013-01-01

    BACKGROUND: Long-term survival after the Fontan procedure shows excellent results but is associated with a persistent risk of arrhythmias and exercise intolerance. We aimed to analyze the current burden of clinically relevant arrhythmia and severe exercise intolerance in Danish Fontan patients...... and estimated to 99.1% per year. Prevalence of clinically relevant arrhythmia and severe exercise intolerance increased significantly with age and was found in 32% and 85% of patients ≥20years, respectively. Thus, from survival data and logistic regression models the future prevalence of patients, clinically...... relevant arrhythmia and severe exercise intolerance were estimated, revealing a considerable augmentation. Furthermore, resting and maximum cardiac index, resting stroke volume index and pulmonary diffusing capacity decreased significantly with age while diastolic and systolic ventricular function...

  8. CT findings of plastic bronchitis in children after a Fontan operation

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea); Jhang, Won Kyoung; Kim, Young Hwee; Ko, Jae Kon; Park, In Sook [University of Ulsan College of Medicine, Department of Pediatric Cardiology, Asan Medical Center, Seoul (Korea); Park, Jeong-Jun; Yun, Tae-Jin; Seo, Dong-Man [University of Ulsan College of Medicine, Department of Pediatric Cardiac Surgery, Asan Medical Center, Seoul (Korea)

    2008-09-15

    Plastic bronchitis is a rare cause of acute obstructive respiratory failure in children. Life-threatening events are much more frequent in patients with repaired cyanotic congenital heart disease, and most frequent following a Fontan operation. Commonly, the diagnosis is not made until bronchial casts are expectorated. Detailed CT findings in plastic bronchitis have not been described. To describe the CT findings in plastic bronchitis in children after a Fontan operation. Three children with plastic bronchitis after a Fontan operation were evaluated by chest CT. Bronchial casts were spontaneously expectorated and/or extracted by bronchoscopy. Airway and lung abnormalities seen on CT were analyzed in the three children. CT demonstrated bronchial casts in the central airways with associated atelectasis and consolidation in all children. The affected airways were completely or partially obstructed by the bronchial casts without associated bronchiectasis. The airway and lung abnormalities rapidly improved after removal of the bronchial casts. CT can identify airway and lung abnormalities in children with plastic bronchitis after a Fontan operation. In addition, CT can be used to guide bronchoscopy and to monitor treatment responses, and thereby may improve clinical outcomes. (orig.)

  9. Fontan-associated protein-losing enteropathy and plastic bronchitis.

    Science.gov (United States)

    Schumacher, Kurt R; Stringer, Kathleen A; Donohue, Janet E; Yu, Sunkyung; Shaver, Ashley; Caruthers, Regine L; Zikmund-Fisher, Brian J; Fifer, Carlen; Goldberg, Caren; Russell, Mark W

    2015-04-01

    To characterize the medical history, disease progression, and treatment of current-era patients with the rare diseases Fontan-associated protein-losing enteropathy (PLE) and plastic bronchitis. A novel survey that queried demographics, medical details, and treatment information was piloted and placed online via a Facebook portal, allowing social media to power the study. Participation regardless of PLE or plastic bronchitis diagnosis was allowed. Case control analyses compared patients with PLE and plastic bronchitis with uncomplicated control patients receiving the Fontan procedure. The survey was completed by 671 subjects, including 76 with PLE, 46 with plastic bronchitis, and 7 with both. Median PLE diagnosis was 2.5 years post-Fontan. Hospitalization for PLE occurred in 71% with 41% hospitalized ≥ 3 times. Therapy varied significantly. Patients with PLE more commonly had hypoplastic left ventricle (62% vs 44% control; OR 2.81, 95% CI 1.43-5.53), chylothorax (66% vs 41%; OR 2.96, CI 1.65-5.31), and cardiothoracic surgery in addition to staged palliation (17% vs 5%; OR 4.27, CI 1.63-11.20). Median plastic bronchitis diagnosis was 2 years post-Fontan. Hospitalization for plastic bronchitis occurred in 91% with 61% hospitalized ≥ 3 times. Therapy was very diverse. Patients with plastic bronchitis more commonly had chylothorax at any surgery (72% vs 51%; OR 2.47, CI 1.20-5.08) and seasonal allergies (52% vs 36%; OR 1.98, CI 1.01-3.89). Patient-specific factors are associated with diagnoses of PLE or plastic bronchitis. Treatment strategies are diverse without clear patterns. These results provide a foundation upon which to design future therapeutic studies and identify a clear need for forming consensus approaches to treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Optimizing CT angiography in patients with Fontan physiology: single-center experience of dual-site power injection

    International Nuclear Information System (INIS)

    Sandler, K.L.; Markham, L.W.; Mah, M.L.; Byrum, E.P.; Williams, J.R.

    2014-01-01

    Aim: To identify adult patients with single-ventricle congenital heart disease and Fontan procedure palliation who have been misdiagnosed with or incompletely evaluated for pulmonary embolism. Additionally, this study was designed to demonstrate that simultaneous, dual-injection of contrast medium into an upper and lower extremity vein is superior to single-injection protocols for CT angiography (CTA) of the chest in this population. Materials and methods: Patients included in the study were retrospectively selected from the Adult Congenital Heart Disease (ACHD) database. Search criteria included history of Fontan palliation and available chest CT examination. Patients were evaluated for (1) type of congenital heart disease and prior operations;(2) indication for initial CT evaluation;(3) route of contrast medium administration for the initial CT examination and resulting diagnosis;(4) whether or not anticoagulation therapy was initiated; and (5) final diagnosis and treatment plan. Results: The query of the ACHD database resulted in 28 individuals or patients with Fontan palliation (superior and inferior venae cavae anastomosed to the pulmonary arteries). Of these, 19 patients with Fontan physiology underwent CTA of the pulmonary circulation, and 17 had suboptimal imaging studies. Unfortunately, seven of these 17 patients (41%) were started on anticoagulation therapy due to a diagnosis of pulmonary embolism that was later excluded. Conclusion: Patients with single-ventricle/Fontan physiology are at risk of thromboembolic disease. Therefore, studies evaluating their complex anatomy must be performed with the optimal imaging protocol to ensure diagnostic accuracy, which is best achieved with dual-injection of an upper and lower extremity central vein. - Highlights: • The adult congenital heart disease population is growing. • Many of these patients have single ventricle/Fontan physiology. • Patients with Fontan physiology are at increased risk for

  11. The enhancement of hemodynamic performance in Fontan circulation using pain free spontaneous ventilation.

    Science.gov (United States)

    Lofland, G K

    2001-07-01

    Positive pressure ventilation is known to have a deleterious effect on pulmonary blood flow in patients with Fontan physiology. We evaluated the hemodynamic effects of pain free, spontaneous, non-positive pressure ventilation in patients undergoing Fontan staging procedures or completion. Fontan procedures, with creation of low pressure passive pulmonary circulation. Between May 1997 and May 1999 50 consecutive patients undergoing either bi-directional Glenn (BDG, n=23) or completion Fontan (n=27), were managed with early extubation. Anaesthetic management included continuous narcotics, caudal block, epidural block, or hyperbaric spinal. Post-operative management included low dose dopamine (3 mcg/kg per min), nitro-glycerine (0.3 mcg/kg per min) and nitroprusside (0.3 mcg/kg per min). Post-operative management was identical for all patients. Twelve patients were randomly selected to undergo continuous cardiac output and cardiac index (CI) determinations utilizing extra vascular Doppler probes placed on the ascending aorta, allowing for continuous aortic diameter and Doppler wave form velocity recordings. All patients were extubated either in the operating room or within one hour post-operatively. There were no deaths and no complications in the series. Mean length of stay (LOS) for BDG was 4.3+/-0.5 days. Mean LOS for Fontan patients was 11+/-4 days. Mean pulmonary artery pressure (MPAP) fell from 19+/-3.464 pre-extubation to 14+/-3.271 immediately post-extubation, 13.2+/-2.261 6 h post-extubation, and 11.7+/-2.146 12 h post-extubation. All decreases in MPAP post-extubation were significant (P=post-extubation 5.05+/-1.297, 12 h post-extubation 6.225+/-1.19. All increases in CI post-extubation were significant (P=pain free, spontaneous, non-positive pressure ventilation enhances hemodynamic performance in patients with Fontan circulation and clearly improves outcome.

  12. Usefulness of peripheral vascular function to predict functional health status in patients with Fontan circulation.

    Science.gov (United States)

    Goldstein, Bryan H; Golbus, Jessica R; Sandelin, Angela M; Warnke, Nicole; Gooding, Lindsay; King, Karen K; Donohue, Janet E; Gurney, James G; Goldberg, Caren S; Rocchini, Albert P; Charpie, John R

    2011-08-01

    After the Fontan operation, patients are at a substantial risk of the development of impaired functional health status. Few early markers of suboptimal outcomes have been identified. We sought to assess the association between peripheral vascular function and functional health status in Fontan-palliated patients. Asymptomatic Fontan patients (n = 51) and age- and gender-matched healthy controls (n = 22) underwent endothelial pulse amplitude testing using a noninvasive fingertip peripheral arterial tonometry (PAT) device. Raw data were transformed into the PAT ratio, an established marker of vascular function. Cardiopulmonary exercise testing was performed using the Bruce protocol. In the Fontan cohort, 94% of patients were New York Heart Association functional class I and 88% had a B-type natriuretic peptide level of interquartile range 1.96 to 4.13 vs median 1.86, interquartile range 1.14 to 2.79, p = 0.03). The PAT ratio, a measure of reactive hyperemia, was lower in Fontan patients (median 0.17, interquartile range -0.04 to 0.44, vs median 0.50, interquartile range 0.27 to 0.74, p = 0.002). The key parameters of exercise performance, including peak oxygen consumption (median 28.8 ml/kg/min, interquartile range 25.6 to 33.2 vs median 45.5 ml/kg/min, interquartile range 41.7 to 49.9, p interquartile range 150 to 246 vs median 330, interquartile range 209 to 402 W, p <0.0001), were lower in Fontan patients than in the controls. The PAT ratio correlated with the peak oxygen consumption (r = 0.28, p = 0.02) and peak work (r = 0.26, p = 0.03). In conclusion, in an asymptomatic Fontan population, there is evidence of reduced basal peripheral arterial tone and vasodilator response, suggesting dysfunction of the endothelium-derived nitric oxide pathway. Vasodilator function appears to correlate with exercise performance. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Creating a Fontan fenestration in a child with dextrocardia and interrupted inferior vena cava

    Directory of Open Access Journals (Sweden)

    Pradeepkumar Charlagorla

    2016-01-01

    Full Text Available Plastic bronchitis is a rare life-threatening complication of the Fontan operation. Transcatheter Fontan fenestration can ameliorate symptoms by decompressing elevated venous pressures. Transcatheter creation of a fenestration can be technically challenging in cases with complex venous anatomy. We report a case of a 5-year-old boy with heterotaxy, dextrocardia with unbalanced atrioventricular canal (AVC, atrial and visceral situs inversus, left-sided superior vena cava (SVC, and left-sided interrupted inferior vena cava (IVC with azygos continuation. With few modifications to the equipment, a successful Fontan fenestration with stent implantation was performed via transjugular approach. At 2-year follow-up, his symptoms of plastic bronchitis improved significantly.

  14. An extracardiac unruptured right sinus of valsalva aneurysm complicated with atherothrombosis

    Directory of Open Access Journals (Sweden)

    Jun Zhang

    2016-04-01

    Full Text Available We present quite a rare case of extracardiac unruptured right sinus of valsalva aneurysm (SVA complicated with atherothrombosis in a young adult man. A 35-year-old male with a giant unruptured SVA arising from the right coronary sinus (RCS with extracardiac protrusion was diagnosed by echocardiography. Contrast-enhanced computed tomography (CT revealed a huge calcified aneurysm with mural thrombi originating from the aortic root, and about 80% stenosis at the initial segment of the right coronary artery (RCA. Intraoperative exploration demonstrated a giant unruptured aneurysm arising from the RCS. Different from other SVAs reported before, this aneurismal wall appeared thick and atheromatous-like. In this aneurysm, there was a small localized intima tearing and mural thrombosis, and the orifice of the RCA was almost blocked. This patient underwent surgical patch repair to prevent aneurysm rupture and coronary artery bypass grafting for RCA revascularization. In conclusion, the pathological examination demonstrated marked foam cells, inflammatory cells, and thrombosis in the aneurismal wall. Learning points: • Echocardiographic characteristics of sinus of valsalva aneurysm (SVA. • Diagnostic evaluation of extracardiac unruptured SVA. • Pathology of rare SVA.

  15. MDCT evaluation of pulmonary embolism in children and young adults following a lateral tunnel Fontan procedure: optimizing contrast-enhancement techniques

    International Nuclear Information System (INIS)

    Prabhu, Sanjay P.; Mahmood, Soran; Sena, Laureen; Lee, Edward Y.

    2009-01-01

    Pulmonary embolism (PE) is a life-threatening thromboembolic complication in patients who have undergone a Fontan procedure for augmenting pulmonary blood flow in the setting of single-ventricle physiology. In patients following a Fontan procedure, lack of proper contrast agent mixing in the right atrium and sluggish, low-velocity blood flow within the Fontan circulation often results in suboptimal contrast enhancement within the pulmonary artery for evaluating PE. Unfortunately, there is a paucity of information describing the optimal contrast-enhancement technique with multidetector CT (MDCT) for evaluating PE in children and young adults following a Fontan procedure. We illustrate the MDCT imaging findings of suboptimal contrast enhancement within the pulmonary artery, which can be mistaken for PE, in patients following a lateral Fontan procedure, and we discuss MDCT techniques to optimize contrast enhancement within the pulmonary artery in these patients for evaluating PE. The MDCT imaging findings in pediatric and young adult patients following a lateral Fontan procedure and with clinically suspected PE are illustrated. We describe intravenous contrast agent injection techniques that can be used to optimize the contrast enhancement in the pulmonary artery in patients following a lateral Fontan procedure. The use of a suboptimal contrast-enhancement technique led to initial misdiagnosis and incomplete evaluation of PE in the three patients following a lateral Fontan procedure. Imaging in two patients showed that optimal evaluation of thrombosis in the Fontan pathway and PE in the pulmonary arteries can be successfully achieved with simultaneous upper- and lower-limb injections of contrast agent. This series demonstrates that suboptimal contrast enhancement can result in misdiagnosis or incomplete evaluation of PE in children and young adults following a lateral Fontan procedure. Careful attention to optimizing contrast enhancement during MDCT examination for

  16. Contribution of cardiac and extra-cardiac disease burden to risk of cardiovascular outcomes varies by ejection fraction in heart failure

    DEFF Research Database (Denmark)

    Wolsk, Emil; Claggett, Brian; Køber, Lars

    2018-01-01

    AIMS: Patients with heart failure (HF) often have multiple co-morbidities that contribute to the risk of adverse cardiovascular (CV) and non-CV outcomes. We assessed the relative contribution of cardiac and extra-cardiac disease burden and demographic factors to CV outcomes in HF patients...... Association class, systolic blood pressure, time since HF diagnosis, HF medication use), extra-cardiac (body mass index, creatinine, diabetes mellitus, chronic obstructive pulmonary disease, smoker), and demographic (age, gender) categories, and calculated subscores for each patient representing the burden......EF patients (PAR: 76% cardiac disease vs. 58% extra-cardiac disease, P vs. 49% extra-cardiac disease, P

  17. Cardiac magnetic resonance and the need for routine cardiac catheterization in single ventricle patients prior to Fontan: a comparison of 3 groups: pre-Fontan CMR versus cath evaluation.

    Science.gov (United States)

    Fogel, Mark A; Pawlowski, Thomas W; Whitehead, Kevin K; Harris, Matthew A; Keller, Marc S; Glatz, Andrew C; Zhu, Winnie; Shore, David; Diaz, Laura K; Rome, Jonathan J

    2012-09-18

    This study investigated whether cardiac magnetic resonance (CMR) and echocardiography (echo) can replace catheterization (cath) for routine evaluation prior to Fontan and under what circumstances CMR and cath are used together. Routine cath prior to Fontan has been utilized for years; noninvasive methods, however, may be sufficient. This study reviews clinical data in 119 consecutive patients investigating 3 groups: those who underwent CMR alone (MR; n = 41), cath alone (C; n = 41), or both cath and CMR (C+M; n = 37) prior to Fontan. No clinically significant differences were noted in patient characteristics, hemodynamics, or clinical status prior to or after surgery between the C and MR groups. CMR added information in 82%. There were no discrepant findings between CMR and cath data in the C+M group. Diagnostic success was ≥95% in all groups. Of those undergoing Fontan completion, the C+M group had similar outcomes to C and MR; C and CMR were utilized in combination to assess aortopulmonary collaterals or the need for an intervention or evaluate its success. Echo could not delineate pulmonary arterial anatomy in 46% to 53% of patients. The C+M and C groups were exposed to 6.8 ± 4.1 mSv of radiation. Single ventricle patients not requiring an intervention can undergo successful Fontan completion with CMR and echo alone with similar short-term outcomes to C, which was used as a control, preventing an invasive test and exposure to radiation. CMR can add information in a significant number of patients. Cath and CMR are utilized together for interventions and assessment of aortopulmonary collaterals. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  18. “Will she live a long happy life?” Parents' concerns for their children with Fontan circulation

    Directory of Open Access Journals (Sweden)

    Karin du Plessis

    2018-03-01

    Full Text Available Background: Families of children at the worst end of the congenital heart disease endure a significant burden which is often not clearly delineated in the clinical literature. We examined the greatest concerns of parents whose children have a Fontan circulation. Methods: Parents (N = 107 of children in the Australian and New Zealand Fontan Registry completed online surveys with open-ended and closed questions. A qualitative method approach incorporating thematic analyses was used. Results: The greatest concerns for parents of a child with a Fontan circulation were centered on fear of death for their child and psychosocial well-being, followed by lesser themes around anti-coagulation use, pregnancy and financial burdens. Conclusions: Fear of death and the psychological well-being of their children were the main parental concerns. It highlights the need to clearly communicate information on outcomes to families, and the need for family-focused psychological interventions to improve the psychosocial functioning of both parents and young people. Keywords: Congenital heart disease, Fontan, Parents of children with a Fontan circulation, Qualitative research

  19. Radiologic manifestations of extra-cardiac complications of infective endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Colen, Teran W.; Gunn, Martin; Cook, Erin; Dubinsky, Theodore [University of Washington Medical Center, Department of Radiology, 1959 NE Pacific Ave, Box 357115, Seattle, WA (United States)

    2008-11-15

    Infective endocarditis (IE) is a disease with high morbidity and a mortality rate of 9-30%, even with appropriate diagnosis and therapy. Septic emboli, caused by IE, can affect any organ or tissue in the body with an arterial supply and occur in 12-40% of IE cases. The most common extra-cardiac organ system involved in IE is the central nervous system. Other organs frequently involved are the lungs (especially in right-sided IE), spleen, kidneys, liver, and the musculoskeletal system. In addition, the arterial system itself is susceptible to the development of potentially fatal mycotic aneurysms. As extra-cardiac complications often antedate the clinical diagnosis of IE, it is important that the diagnosis is suggested when characteristic findings are encountered during imaging. In addition, imaging is often used to monitor the extent of complications in patients with a known diagnosis of IE. (orig.)

  20. Extracardiac manifestations of infective endocarditis and their historical descriptions.

    Science.gov (United States)

    Silverman, Mark E; Upshaw, Charles B

    2007-12-15

    In his landmark "Gulstonian Lectures on Malignant Endocarditis," published in 1885, William Osler commented, "Few diseases present greater difficulties in the way of diagnosis than malignant endocarditis, difficulties which in many cases are practically insurmountable." At that time, the fields of microbiology and blood cultures were in their infancy, and the diagnosis was made premortem in just half the patients with the condition. After Osler's report, extracardiac physical findings became essential clues to earlier diagnosis. Today, infective endocarditis is most commonly suggested from the history and often clinched by an echocardiogram and blood cultures. Although prized physical manifestations are much less frequent now, they still do occur and may be an invaluable clue that leads to earlier, more effective treatment. The investigators review these extracardiac findings along with their historical descriptions: splinter hemorrhages, emboli, Osler's nodes, Janeway and Bowman lesions of the eye, Roth spots, petechiae, and clubbing.

  1. Radiologic manifestations of extra-cardiac complications of infective endocarditis

    International Nuclear Information System (INIS)

    Colen, Teran W.; Gunn, Martin; Cook, Erin; Dubinsky, Theodore

    2008-01-01

    Infective endocarditis (IE) is a disease with high morbidity and a mortality rate of 9-30%, even with appropriate diagnosis and therapy. Septic emboli, caused by IE, can affect any organ or tissue in the body with an arterial supply and occur in 12-40% of IE cases. The most common extra-cardiac organ system involved in IE is the central nervous system. Other organs frequently involved are the lungs (especially in right-sided IE), spleen, kidneys, liver, and the musculoskeletal system. In addition, the arterial system itself is susceptible to the development of potentially fatal mycotic aneurysms. As extra-cardiac complications often antedate the clinical diagnosis of IE, it is important that the diagnosis is suggested when characteristic findings are encountered during imaging. In addition, imaging is often used to monitor the extent of complications in patients with a known diagnosis of IE. (orig.)

  2. 18F-FDG PET/CT diagnosis of unexpected extracardiac septic embolisms in patients with suspected cardiac endocarditis

    International Nuclear Information System (INIS)

    Bonfiglioli, Rachele; Nanni, Cristina; Morigi, Joshua James; Ambrosini, Valentina; Fanti, Stefano; Graziosi, Maddalena; Rapezzi, Claudio; Trapani, Filippo; Bartoletti, Michele; Tumietto, Fabio; Viale, Pier Luigi; Ferretti, Alice; Rubello, Domenico

    2013-01-01

    Acute infective endocarditis is a potentially life-threatening disease. Its outcome strongly depends on systemic embolization and extracardiac infections. When present, these conditions usually lead to a more aggressive therapeutic approach. However, the diagnosis of peripheral septic embolism is very challenging. 18 F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT has proven to be accurate for the detection of inflammatory diseases and occult infections. The aim of this study was to assess the added value of 18 F-FDG PET/CT in the detection of extracardiac embolisms in the evaluation of patients with suspected valvular endocarditis (VE). Seventy-one patients with suspected infective endocarditis, enrolled between June 2010 and December 2012, underwent 18 F-FDG PET/CT with the standard procedure on a dedicated PET/CT scanner. Extracardiac findings were subsequently evaluated with other imaging procedures. Of the 71 patients with suspicion of infective endocarditis, we found unexpected extracardiac findings in 17 patients (24 %) without any clinical suspicion. Extracardiac findings were subsequently evaluated with other imaging procedures. PET/CT detected unexpected extra sites of infection in 24 % of cases, leading to changes in therapeutic management in a very relevant percentage of patients. These findings may have important therapeutic implications. (orig.)

  3. Can endurance training improve physical capacity and quality of life in young Fontan patients?

    Science.gov (United States)

    Hedlund, Eva R; Lundell, Bo; Söderström, Liselott; Sjöberg, Gunnar

    2018-03-01

    Children after Fontan palliation have reduced exercise capacity and quality of life. Our aim was to study whether endurance training could improve physical capacity and quality of life in Fontan patients. Fontan patients (n=30) and healthy age- and gender-matched control subjects (n=25) performed a 6-minute walk test at submaximal capacity and a maximal cycle ergometer test. Quality of life was assessed with Pediatric Quality of Life Inventory Version 4.0 questionnaires for children and parents. All tests were repeated after a 12-week endurance training programme and after 1 year. Patients had decreased submaximal and maximal exercise capacity (maximal oxygen uptake 35.0±5.1 ml/minute per·kg versus 43.7±8.4 ml/minute·per·kg, pquality of life score (70.9±9.9 versus 85.7±8.0, pimproved their submaximal exercise capacity in a 6-minute walk test (from 590.7±65.5 m to 611.8±70.9 m, pquality of life (pimprove maximal exercise capacity. At follow-up, submaximal exercise capacity had increased further and improved quality of life was sustained. The controls improved their maximal exercise capacity (pquality of life after training. At follow-up, improvement of maximal exercise capacity was sustained. We believe that an individualised endurance training programme for Fontan patients improves submaximal exercise capacity and quality of life in Fontan patients and the effect on quality of life appears to be long-lasting.

  4. The Cost Differential Between Warfarin Versus Aspirin Treatment After a Fontan Procedure.

    Science.gov (United States)

    Schilling, Chris; Dalziel, Kim; Iyengar, Ajay J; d'Udekem, Yves

    2017-08-01

    The use of aspirin versus warfarin for treatment of patients after a Fontan procedure remains contentious. Current preference-based models of treatment across Australia and New Zealand show variation in care that is unlikely to reflect patient differences and/or clinical risk. We combine data from the Australian and New Zealand Fontan Registry and a home INR (International Normalised Ratio) monitoring program (HINRMP) from the Royal Children's Hospital (RCH) Melbourne, to estimate the cost difference for Fontan recipients receiving aspirin versus warfarin for 2015. We adopt a societal perspective to costing which includes cost to the health system (e.g. medical consults, pathology tests) and costs to patients and carers (e.g. travel and time), but excludes costs of adverse events. Costs are presented in Australian 2015 dollars; any costs from previous years have been inflated using appropriate rates from the Australian Bureau of Statistics. We find that warfarin patients face additional costs of $825 per annum, with the majority ($584 or 71%) of those borne by the patient or family. If aspirin is as clinically as effective as warfarin, Fontan recipients could be enjoying far less costly, invasive and time-consuming treatment. While achieving such clinical consensus can be difficult, economics shows us that there are large costs associated with a failure to achieve it. Copyright © 2017. Published by Elsevier B.V.

  5. Hemodynamic Effects of Ventricular Assist Device Implantation on Norwood, Glenn, and Fontan Circulation: A Simulation Study.

    Science.gov (United States)

    Di Molfetta, Arianna; Amodeo, Antonio; Gagliardi, Maria G; Trivella, Maria G; Fresiello, Libera; Filippelli, Sergio; Toscano, Alessandra; Ferrari, Gianfranco

    2016-01-01

    The growing population of failing single-ventricle (SV) patients might benefit from ventricular assist device (VAD) support as a bridge to heart transplantation. However, the documented experience is limited to isolated case reports. Considering the complex and different physiopathology of Norwood, Glenn, and Fontan patients and the lack of established experience, the aim of this work is to realize and test a lumped parameter model of the cardiovascular system able to simulate SV hemodynamics and VAD implantation effects to support clinical decision. Hemodynamic and echocardiographic 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. Simulation results suggest that the implantation of VAD: (i) increases the cardiac output and the mean arterial systemic pressure in all the three palliation conditions (Norwood 77.2 and 19.7%, Glenn 38.6 and 32.2%, and Fontan 17.2 and 14.2%); (ii) decreases the SV external work (Norwood 55%, Glenn 35.6%, and Fontan 41%); (iii) decreases the pressure pulsatility index (Norwood 65.2%, Glenn 81.3%, and Fontan 64.8%); (iv) increases the pulmonary arterial pressure in particular in the Norwood circulation (Norwood 39.7%, Glenn 12.1% and Fontan 3%); and (v) decreases the atrial pressure (Norwood 2%, Glenn 10.6%, and Fontan 8.6%). Finally, the VAD work is lower in the Norwood circulation (30.4 mL·mm Hg) in comparison with Fontan (40.3 mL·mm Hg) and to Glenn (64.5 mL·mm Hg) circulations. The use of VAD in SV physiology could be helpful to bridge patients to heart transplantations by increasing the CO and unloading the SV with a decrement of the atrial pressure and the SV external work. The regulation of the pulmonary flow is challenging because the Pap is increased by the presence of VAD. The hemodynamic changes are different in the different SV palliation step. The use of numerical models

  6. The role of cardiovascular magnetic resonance in candidates for Fontan operation: Proposal of a new Algorithm

    Directory of Open Access Journals (Sweden)

    Ait-Ali Lamia

    2011-11-01

    Full Text Available Abstract Background To propose a new diagnostic algorithm for candidates for Fontan and identify those who can skip cardiac catheterization (CC. Methods Forty-four candidates for Fontan (median age 4.8 years, range: 2-29 years were prospectively evaluated by trans-thoracic echocardiography (TTE, Cardiovascular magnetic resonance (CMR and CC. Before CC, according to clinical, echo and CMR findings, patients were divided in two groups: Group I comprised 18 patients deemed suitable for Fontan without requiring CC; group II comprised 26 patients indicated for CC either in order to detect more details, or for interventional procedures. Results In Group I ("CC not required" no unexpected new information affecting surgical planning was provided by CC. Conversely, in Group II new information was provided by CC in three patients (0 vs 11.5%, p = 0.35 and in six an interventional procedure was performed. During CC, minor complications occurred in one patient from Group I and in three from Group II (6 vs 14%, p = 0.7. Radiation Dose-Area product was similar in the two groups (Median 20 Gycm2, range: 5-40 vs 26.5 Gycm2, range: 9-270 p = 0.37. All 18 Group I patients and 19 Group II patients underwent a total cavo-pulmonary anastomosis; in the remaining seven group II patients, four were excluded from Fontan; two are awaiting Fontan; one refused the intervention. Conclusion In this paper we propose a new diagnostic algorithm in a pre-Fontan setting. An accurate non-invasive evaluation comprising TTE and CMR could select patients who can skip CC.

  7. Renal abscess after the Fontan procedure: a case report

    Directory of Open Access Journals (Sweden)

    Kumar Suresh

    2011-02-01

    Full Text Available Abstract Introduction The Fontan procedure is an intervention that helps to correct single ventricle physiology. There are many known long-term complications of 'Fontan physiology'. However, the occurrence of renal abscess in such patients has not yet been reported in the literature. The first generation of adults has now undergone the procedure and it is necessary to be aware of the long-term outcomes and complications associated with it. Case presentation We report the case of a 22-year-old South Indian man who had developed a staphylococcal renal abscess against a background of xanthogranulomatous pyelonephritis, nine years after Fontan surgery. He presented to our hospital with a high-grade fever of 25-days duration but with no other symptoms. Physical examination identified costovertebral angle tenderness and pedal edema. An ultrasound scan revealed a mass in his left kidney. The results of a computed tomography scan were consistent with a renal abscess. Despite treatment with the appropriate parenteral antibiotics, there was no change in the size of the abscess and a left nephrectomy was performed as a curative procedure. Conclusions The learning points here are manifold. It is important to be aware of the possibility of renal abscess in a post-procedural patient. The early diagnosis of a septic focus in the kidneymay help to prevent the rare outcome of nephrectomy.

  8. Gastrointestinal haemorrhage due to lymphangiectasia caused by protein-losing enteropathy in the Fontan circulation.

    Science.gov (United States)

    Gras, Pauline; Gottrand, Frédéric; Godart, François

    2017-10-01

    We report the case of a 14-year-old boy with severe protein-losing enteropathy after Fontan surgery that led to lymphangiectasia, which caused gastrointestinal haemorrhage and required invasive treatment to stop the bleeding. Through this case and a review of the literature on protein-losing enteropathy after Fontan surgery, we highlight a rare and serious presentation of the disease and the difficulties of diagnosis and management.

  9. Transhepatic approach for extracardiac inferior cavopulmonary connection stent fenestration.

    LENUS (Irish Health Repository)

    Kenny, Damien

    2012-02-01

    We report on a 3-year-old male who underwent transcatheter stent fenestration of the inferior portion of an extracardiac total cavopulmonary connection in the setting of hypoplastic left heart syndrome. Transhepatic approach, following an unsuccessful attempt from the femoral vein facilitated delivery of a diabolo-shaped stent.

  10. {sup 18}F-FDG PET/CT diagnosis of unexpected extracardiac septic embolisms in patients with suspected cardiac endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Bonfiglioli, Rachele; Nanni, Cristina; Morigi, Joshua James; Ambrosini, Valentina; Fanti, Stefano [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Nuclear Medicine, Bologna (Italy); Graziosi, Maddalena; Rapezzi, Claudio [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Cardiology, Bologna (Italy); Trapani, Filippo; Bartoletti, Michele; Tumietto, Fabio; Viale, Pier Luigi [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Infective Diseases, Bologna (Italy); Ferretti, Alice; Rubello, Domenico [Azienda Ospedaliera S. Maria della Misericordia, Nuclear Medicine, Radiology, Neuroradiology, Medical Physics, Rovigo (Italy)

    2013-08-15

    Acute infective endocarditis is a potentially life-threatening disease. Its outcome strongly depends on systemic embolization and extracardiac infections. When present, these conditions usually lead to a more aggressive therapeutic approach. However, the diagnosis of peripheral septic embolism is very challenging. {sup 18}F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT has proven to be accurate for the detection of inflammatory diseases and occult infections. The aim of this study was to assess the added value of {sup 18}F-FDG PET/CT in the detection of extracardiac embolisms in the evaluation of patients with suspected valvular endocarditis (VE). Seventy-one patients with suspected infective endocarditis, enrolled between June 2010 and December 2012, underwent {sup 18}F-FDG PET/CT with the standard procedure on a dedicated PET/CT scanner. Extracardiac findings were subsequently evaluated with other imaging procedures. Of the 71 patients with suspicion of infective endocarditis, we found unexpected extracardiac findings in 17 patients (24 %) without any clinical suspicion. Extracardiac findings were subsequently evaluated with other imaging procedures. PET/CT detected unexpected extra sites of infection in 24 % of cases, leading to changes in therapeutic management in a very relevant percentage of patients. These findings may have important therapeutic implications. (orig.)

  11. Fontan fenestration closure and event-free survival.

    Science.gov (United States)

    Imielski, Bartlomiej R; Woods, Ronald K; Mussatto, Kathleen A; Cao, Yumei; Simpson, Pippa M; Tweddell, James S

    2013-01-01

    The purpose of the present study was to evaluate the association of open and closed Fontan fenestration status with event-free survival. All patients who underwent a fenestrated Fontan procedure at our institution from January 1994 through June 2007 were reviewed. Patient information was obtained from the medical records. The patients were assigned to 1 of 2 study groups, open or closed, according to their most recent fenestration status. Clinically relevant morbid events were tabulated, and Kaplan-Meier event analysis was used to create event-free probability curves with log-rank comparisons. A total of 161 patients were classified as open and 51 as closed. The median interval to an event was 1.1 years (interquartile range, 0.1-3.3 years) after the Fontan procedure. The median interval to closure was 1.2 years (interquartile range, 0.7-3.3 years). The median interval to an event was 1.5 years (interquartile range, 0.1-4.6 years) in the closed group and 1.1 years (interquartile range, 0.1-3.3 years) in the open group. Event-free probability analysis revealed no significant difference between the 2 groups (P = .15). The median follow-up arterial oxygen saturation was greater in the closed group (96.0%; interquartile range, 94.0%-97.0%) than in the open group (91.0%; interquartile range, 86.0%-95.0%; P < .0001). Fenestration closure was associated with greater arterial oxygen saturation but not greater event-free survival. The interval to an event was slightly less than the interval to fenestration closure, suggesting potential merit in the evaluation of earlier fenestration closure. Adoption of specific fenestration management guidelines might help improve the overall outcomes and enhance the quality of future studies. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  12. When is reacquisition necessary due to high extra-cardiac uptake in myocardial perfusion scintigraphy?

    DEFF Research Database (Denmark)

    Johansen, Allan; Lomsky, Milan; Gerke, Oke

    2013-01-01

    Technetium-labeled agents, which are most often used for assessing myocardial perfusion in myocardial perfusion scintigraphy (MPS), are cleared by the liver and excreted by the biliary system. Spillover from extra-cardiac activity into the myocardium, especially the inferior wall, might conceal d...... defects and lower the diagnostic accuracy of the study. The objective was to determine rules of thumb for when reacquisition is useful due to high extra-cardiac uptake, i.e., when interpretation of the studies was affected by poor image quality....

  13. Predicting long-term mortality after Fontan procedures: A risk score based on 6707 patients from 28 studies

    NARCIS (Netherlands)

    Alsaied, Tarek; Bokma, Jouke P.; Engel, Mark E.; Kuijpers, Joey M.; Hanke, Samuel P.; Zuhlke, Liesl; Zhang, Bin; Veldtman, Gruschen R.

    2017-01-01

    Reported long-term outcome measures vary greatly between studies in Fontan patients making comprehensive appraisal of mortality hazard challenging. We sought to create a clinical risk score to assist monitoring of Fontan patients in the outpatient setting. A systematic review was conducted to

  14. Current role of cardiac and extra-cardiac pathologies in clinically indicated cardiac computed tomography with emphasis on status before pulmonary vein isolation

    Energy Technology Data Exchange (ETDEWEB)

    Sohns, J.M.; Lotz, J. [Goettingen University Medical Center (Germany). Inst. for Diagnostic and Interventional Radiology; German Center for Cardiovascular Research (DZHK), Goettingen (Germany); Menke, J.; Staab, W.; Fasshauer, M.; Kowallick, J.T.; Zwaka, P.A.; Schwarz, A. [Goettingen University Medical Center (Germany). Inst. for Diagnostic and Interventional Radiology; Spiro, J. [Koeln University Hospital (Germany). Radiology; Bergau, L.; Unterberg-Buchwald, C. [Goettingen University Medical Center (Germany). Cardiology and Pneumology

    2014-09-15

    Purpose: The aim of this study was to assess the incidence of cardiac and significant extra-cardiac findings in clinical computed tomography of the heart in patients with atrial fibrillation before pulmonary vein isolation (PVI). Materials and Methods: 224 patients (64 ± 10 years; male 63%) with atrial fibrillation were examined by cardiac 64-slice multidetector CT before PVI. Extra-cardiac findings were classified as 'significant' if they were recommended to additional diagnostics or therapy, and otherwise as 'non-significant'. Additionally, cardiac findings were documented in detail. Results: A total of 724 cardiac findings were identified in 203 patients (91% of patients). Additionally, a total of 619 extra-cardiac findings were identified in 179 patients (80% of patients). Among these extra-cardiac findings 196 (32%) were 'significant', and 423 (68%) were 'non-significant'. In 2 patients (1%) a previously unknown malignancy was detected (esophageal cancer and lung cancer, local stage, no metastasis). 203 additional imaging diagnostics followed to clarify the 'significant' findings (124 additional CT, costs 38,314.69 US dollars). Overall, there were 3.2 cardiac and 2.8 extra-cardiac findings per patient. Extra-cardiac findings appear significantly more frequently in patients over 60 years old, in smokers and in patients with a history of cardiac findings (p < 0.05). Conclusion: Cardiac CT scans before PVI should be screened for extracardiac incidental findings that could have important clinical implications for each patient. (orig.)

  15. Endothelin receptor antagonism in single ventricle physiology with fontan palliation: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Gwendolyn Derk

    2015-04-01

    Conclusions: Bosentan was found to be a safe and well tolerated endothelin receptor antagonist in Fontan patients over 3–6 months of therapy. Bosentan use was associated with improved functional capacity. Future studies with larger sample size and longer duration are warranted to examine the long-term safety and efficacy of endothelin blockade in Fontan physiology.

  16. Comparison of particle image velocimetry and phase contrast MRI in a patient-specific extracardiac total cavopulmonary connection.

    Science.gov (United States)

    Kitajima, Hiroumi D; Sundareswaran, Kartik S; Teisseyre, Thomas Z; Astary, Garrett W; Parks, W James; Skrinjar, Oskar; Oshinski, John N; Yoganathan, Ajit P

    2008-08-01

    Particle image velocimetry (PIV) and phase contrast magnetic resonance imaging (PC-MRI) have not been compared in complex biofluid environments. Such analysis is particularly useful to investigate flow structures in the correction of single ventricle congenital heart defects, where fluid dynamic efficiency is essential. A stereolithographic replica of an extracardiac total cavopulmonary connection (TCPC) is studied using PIV and PC-MRI in a steady flow loop. Volumetric two-component PIV is compared to volumetric three-component PC-MRI at various flow conditions. Similar flow structures are observed in both PIV and PC-MRI, where smooth flow dominates the extracardiac TCPC, and superior vena cava flow is preferential to the right pulmonary artery, while inferior vena cava flow is preferential to the left pulmonary artery. Where three-component velocity is available in PC-MRI studies, some helical flow in the extracardiac TCPC is observed. Vessel cross sections provide an effective means of validation for both experiments, and velocity magnitudes are of the same order. The results highlight similarities to validate flow in a complex patient-specific extracardiac TCPC. Additional information obtained by velocity in three components further describes the complexity of the flow in anatomic structures.

  17. Fontan Surgical Planning: Previous Accomplishments, Current Challenges, and Future Directions.

    Science.gov (United States)

    Trusty, Phillip M; Slesnick, Timothy C; Wei, Zhenglun Alan; Rossignac, Jarek; Kanter, Kirk R; Fogel, Mark A; Yoganathan, Ajit P

    2018-04-01

    The ultimate goal of Fontan surgical planning is to provide additional insights into the clinical decision-making process. In its current state, surgical planning offers an accurate hemodynamic assessment of the pre-operative condition, provides anatomical constraints for potential surgical options, and produces decent post-operative predictions if boundary conditions are similar enough between the pre-operative and post-operative states. Moving forward, validation with post-operative data is a necessary step in order to assess the accuracy of surgical planning and determine which methodological improvements are needed. Future efforts to automate the surgical planning process will reduce the individual expertise needed and encourage use in the clinic by clinicians. As post-operative physiologic predictions improve, Fontan surgical planning will become an more effective tool to accurately model patient-specific hemodynamics.

  18. Trasplante después del Fontan. Aspectos quirúrgicos

    Directory of Open Access Journals (Sweden)

    Juan-Miguel Gil-Jaurena

    2016-09-01

    Conclusiones: Trasplantar a pacientes con Fontan previo es un reto. Podemos anticipar variantes en cada una de las 5 anastomosis previstas. Es recomendable obtener tejido extra del donante (aorta y arco, vena cava superior e innominada, pericardio. Los resultados pueden superponerse a otras series de trasplante cardiaco.

  19. Long-term survival, modes of death, and predictors of mortality in patients with Fontan surgery.

    Science.gov (United States)

    Khairy, Paul; Fernandes, Susan M; Mayer, John E; Triedman, John K; Walsh, Edward P; Lock, James E; Landzberg, Michael J

    2008-01-01

    To better define determinants of mortality in patients with univentricular physiology, a database registry was created of patients born in 1985 or earlier with Fontan surgery who were followed up at Children's Hospital Boston. A total of 261 patients, 121 of whom (46.4%) were women, had a first Fontan surgery at a median age of 7.9 years: right atrium-to-pulmonary artery connection in 135 (51.7%); right atrium to right ventricle in 25 (9.6%); and total cavopulmonary connection in 101 (38.7%). Over a median of 12.2 years, 76 (29.1%) died, 5 (1.9%) had cardiac transplantation, 5 (1.9%) had Fontan revision, and 21 (8.0%) had Fontan conversion. Perioperative mortality decreased steadily over time and accounted for 68.4% of all deaths. In early survivors, actuarial freedom from death or transplantation was 93.7%, 89.9%, 87.3%, and 82.6% at 5, 10, 15, and 20 years, respectively, with no significant difference between right atrium to pulmonary artery versus total cavopulmonary connection. Late deaths were classified as sudden in 7 patients (9.2%), thromboembolic in 6 (7.9%), heart failure-related in 5 (6.7%), sepsis in 2 (2.6%), and other in 4 (5.2%). Most sudden deaths were of presumed arrhythmic origin with no identifiable predictor. Independent risk factors for thromboembolic death were lack of antiplatelet or anticoagulant therapy (hazard ratio [HR], 91.6; P=0.0041) and clinically diagnosed intracardiac thrombus (HR, 22.7; P=0.0002). Independent predictors of heart failure death were protein-losing enteropathy (HR, 7.1; P=0.0043), single morphologically right ventricle (HR, 10.5; P=0.0429), and higher right atrial pressure (HR, 1.3 per 1 mm Hg; P=0.0016). In perioperative survivors of Fontan surgery, gradual attrition occurs predominantly from thromboembolic, heart failure-related, and sudden deaths.

  20. Fetal and neonatal mortality in patients with isolated congenital heart diseases and heart conditions associated with extracardiac abnormalities.

    Science.gov (United States)

    Marantz, Pablo; Sáenz Tejeira, M Mercedes; Peña, Gabriela; Segovia, Alejandra; Fustiñana, Carlos

    2013-10-01

    Congenital malformations are a known cause of intrauterine death; of them, congenital heart diseases (CHDs) are accountable for the highest fetal and neonatal mortality rates. They are strongly associated with other extracardiac malformations and an early fetal mortality. Two hundred and twenty fves cases of CHDs are presented. Of them, 155 were isolated CHDs (group A) and 70 were associated with extracardiac malformations, chromosomal disorders, or genetic syndromes (group B). The overall mortality in group B was higher than that observed in group A (p Heart diseases associated with extracardiac abnormalities had a higher mortality rate than isolated congenital heart diseases in the period up to 60 weeks of postmenstrual age (140 days post-term). No differences were observed between both groups of patients in terms of prenatal mortality.

  1. 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

  2. Dorsal spinal cord stimulation obtunds the capacity of intrathoracic extracardiac neurons to transduce myocardial ischemia.

    Science.gov (United States)

    Ardell, Jeffrey L; Cardinal, René; Vermeulen, Michel; Armour, J Andrew

    2009-08-01

    Populations of intrathoracic extracardiac neurons transduce myocardial ischemia, thereby contributing to sympathetic control of regional cardiac indices during such pathology. Our objective was to determine whether electrical neuromodulation using spinal cord stimulation (SCS) modulates such local reflex control. In 10 anesthetized canines, middle cervical ganglion neurons were identified that transduce the ventricular milieu. Their capacity to transduce a global (rapid ventricular pacing) vs. regional (transient regional ischemia) ventricular stress was tested before and during SCS (50 Hz, 0.2 ms duration at 90% MT) applied to the dorsal aspect of the T1 to T4 spinal cord. Rapid ventricular pacing and transient myocardial ischemia both activated cardiac-related middle cervical ganglion neurons. SCS obtunded their capacity to reflexly respond to the regional ventricular ischemia, but not rapid ventricular pacing. In conclusion, spinal cord inputs to the intrathoracic extracardiac nervous system obtund the latter's capacity to transduce regional ventricular ischemia, but not global cardiac stress. Given the substantial body of literature indicating the adverse consequences of excessive adrenergic neuronal excitation on cardiac function, these data delineate the intrathoracic extracardiac nervous system as a potential target for neuromodulation therapy in minimizing such effects.

  3. [Failed transcatheter creation of fenestration in a Fontan patient with original fenestration closed by AngelWings septal occluder: a case report].

    Science.gov (United States)

    Ohno, Atsuko; Hirotaka, Ishido; Kobayashi, Toshiki; Asano, Haruhiko; Kyo, Shunei; Senzaki, Hideaki

    2007-10-01

    The fenestrated Fontan procedure has helped to reduce the mortality and morbidity of pediatric patients who underwent the Fontan operation. We treated a patient (7-year-old, female) who had developed heart failure 1 year after fenestration closure using an AngelWings device, although the patient met the proposed criteria for test occlusion. Hemodynamic evaluation using the ventricular pressure-area relationship revealed that the patient had both systolic and diastolic dysfunction, which were difficult to recognize by conventional hemodynamic indices. We then tried to percutaneously create a fenestration using a Brockenbrough needle, but this procedure failed. The AngelWings device, which may have been covered by pseudointima (composed of fibroelastic tissue), was hard enough to break the Brockenbrough needle. Re-creating a fenestration after device closure in patients after the fenestrated Fontan operation appears to be difficult, so more accurate methods to predict Fontan physiology after fenestration closure are needed.

  4. The Role of Routine Whole Volume SPECT Reconstruction in Comparison to Cine Raw Data in the Detection of Extracardiac Uptake on Myocardial Perfusion Scans

    International Nuclear Information System (INIS)

    Maharaj, M.; Korowlay, N.A.

    2011-01-01

    The objective of this study was to determine the role of routine whole volume reconstructed single-photon emission tomography (rSPECT) compared to cine raw data to detect extracardiac uptake of Sestamibi (MIBI). In a retrospective study, the myocardial perfusion studies of 426 patients were inspected separately for extracardiac uptake on cine raw data and rSPECT. The acquisition parameters for all the images were done according to departmental protocol. The whole volume SPECT data was selected and processed by HOSEM iterative reconstruction using the HERMES computer software system. The images were assessed by two observers, a student in training and a senior consultant nuclear medicine physician. The overall mean age and standard deviation of the 426 patients at the time of the study was 60 ± 12 years. Statistical analysis was performed using the Kappa and McNemars tests. The clinical significance of the extracardiac uptake was evaluated using hospital folders and /or laboratory results after viewing images. rSPECT detected 25 patients (5.9%) and cine raw data identified 18 patients (4.2%) with extracardiac uptake. All the areas of extracardiac uptake noted on cine raw data were seen on the rSPECT images. Only 21 of the 25 patients had complete 5-year clinical follow-up. The value of the clinical significance of the extracardiac uptake was limited due to the study being retrospective. The proportion of positives identified by rSPECT was significantly larger than those identified by cine raw data (P = 0.0082). Although our study demonstrates that rSPECT is more sensitive than cine raw data in detecting extracardiac uptake, it also shows that there is no benefit in routine whole volume rSPECT in daily clinical practice

  5. Fontan-associated protein-losing enteropathy and heart transplant: A Pediatric Heart Transplant Study analysis.

    Science.gov (United States)

    Schumacher, Kurt R; Gossett, Jeffrey; Guleserian, Kristine; Naftel, David C; Pruitt, Elizabeth; Dodd, Debra; Carboni, Michael; Lamour, Jacqueline; Pophal, Stephen; Zamberlan, Mary; Gajarski, Robert J

    2015-09-01

    Post-Fontan protein-losing enteropathy (PLE) is associated with significant morbidity and mortality. Although heart transplantation (HTx) can be curative, PLE may increase the risk of morbidity before and after HTx. This study analyzed the influence of PLE influence on waiting list and post-HTx outcomes in a pediatric cohort. Fontan patients listed for HTx and enrolled in the Pediatric Heart Transplant Study from 1999 to 2012 were stratified by a diagnosis of PLE, and the association of PLE with waiting list and post-HTx mortality, rejection, and infection was analyzed. Compared with non-PLE Fontan patients (n = 260), PLE patients listed for HTx (n = 96) were older (11.9 years vs 7.6 years; p = 0.003), had a larger body surface area (1.1 m(2) vs 0.9 m(2); p = 0.0001), had lower serum bilirubin (0.5 vs 0.9 mg/dl; p = 0.01), lower B-type natriuretic peptide (59 vs 227 pg/ml; p = 0.006), and were less likely to be on a ventilator (3% vs 13%; p = 0.006). PLE patients had lower waiting list mortality than non-PLE Fontan patients (p PLE was not independently associated with increased post-HTx mortality at any time point. In this multicenter cohort, the diagnosis of PLE alone was not associated with increased waiting list mortality or post-HTx morbidity or mortality. Given the limitations of our data, this analysis suggests that PLE patients in the pediatric age group have outcomes similar to their non-PLE counterparts. Additional multicenter studies of PLE patients with targeted collection of PLE-specific information will be necessary to fully delineate the risks conferred by PLE for HTx. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  6. What Limits Cardiac Performance during Exercise in Normal Subjects and in Healthy Fontan Patients?

    Directory of Open Access Journals (Sweden)

    André La Gerche

    2010-01-01

    Full Text Available Exercise is an important determinant of health but is significantly reduced in the patient with a univentricular circulation. Normal exercise physiology mandates an increase in pulmonary artery pressures which places an increased work demand on the right ventricle (RV. In a biventricular circulation with pathological increases in pulmonary vascular resistance and/or reductions in RV function, exercise-induced augmentation of cardiac output is limited. Left ventricular preload reserve is dependent upon flow through the pulmonary circulation and this requires adequate RV performance. In the Fontan patient, the reasons for exercise intolerance are complex. In those patients with myocardial dysfunction or other pathologies of the circulatory components, it is likely that these abnormalities serve as a limitation to cardiac performance during exercise. However, in the healthy Fontan patient, it may be the absence of a sub-pulmonary pump which limits normal increases in pulmonary pressures, trans-pulmonary flow requirements and cardiac output. If so, performance will be exquisitely dependent on pulmonary vascular resistance. This provides a potential explanation as to why pulmonary vasodilators may improve exercise tolerance. As has recently been demonstrated, these agents may offer an important new treatment strategy which directly addresses the physiological limitations in the Fontan patient.

  7. Extra-cardiac manifestations of adult congenital heart disease.

    Science.gov (United States)

    Gaeta, Stephen A; Ward, Cary; Krasuski, Richard A

    2016-10-01

    Advancement in correction or palliation of congenital cardiac lesions has greatly improved the lifespan of congenital heart disease patients, resulting in a rapidly growing adult congenital heart disease (ACHD) population. As this group has increased in number and age, emerging science has highlighted the systemic nature of ACHD. Providers caring for these patients are tasked with long-term management of multiple neurologic, pulmonary, hepatic, renal, and endocrine manifestations that arise as syndromic associations with congenital heart defects or as sequelae of primary structural or hemodynamic abnormalities. In this review, we outline the current understanding and recent research into these extra-cardiac manifestations. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Effect of race on the timing of the Glenn and Fontan procedures for single-ventricle congenital heart disease.

    Science.gov (United States)

    Ingaramo, Oscar A; Khemani, Robinder G; Markovitz, Barry P; Epstein, David

    2012-03-01

    Disparities in health care have been documented between different racial groups in the United States. We hypothesize that there will be racial variance in the timing of the Glenn and Fontan procedures for children with single-ventricle physiology. We performed a retrospective review of a national pediatric intensive care unit database (Virtual PICU Performance System, LLC). Children with hypoplastic left heart syndrome, tricuspid atresia, and common ventricle, admitted from January 2006 to July 2008, were included. Data included race, weight, age, medical length of stay, Paediatric Index of Mortality 2 score, and survival. None. There were 423 patients from 29 hospitals. The study population was 7.6% black, 13.0% Hispanic, 59.8% white, 9.2% "other," and 11.6% had missing racial/ethnic information. Diagnoses included 255 patients with hypoplastic left heart syndrome, 91 with tricuspid atresia, and 77 with common ventricle. The median age for the Glenn procedure (n = 205) was 5.5 months (interquartile range, 4.6-7.0 months) and 39.7 months (interquartile range, 32.4-50.6 months) for the Fontan procedure (n = 218). There was no difference between the median age at the time of the Glenn or Fontan procedures between the different racial/ethnic groups (p = .65 and p = .16, respectively). The medical length of intensive care unit stay for patients receiving the Glenn and Fontan procedures was 3.7 days (interquartile range, 1.9-6.1 days) and 3.7 days (interquartile range, 1.9-6.8 days), respectively. There were no differences in medical length of intensive care unit stay for the Glenn procedure between the different racial/ethnic groups (p = .21). Hispanic patients had a longer medical length of intensive care unit stay (6.3 days; interquartile range, 3.1-9.9 days) than white patients (2.9 days; interquartile range, 1.8-5.3 days) for the Fontan procedure (p = .008). The timing of single-ventricle palliative procedures was not affected by race/ethnicity.

  9. Fontan-associated protein-losing enteropathy and plastic bronchitis: characterizing current-era risk factors, course, and progression

    Science.gov (United States)

    Schumacher, Kurt R.; Stringer, Kathleen A.; Donohue, Janet E.; Yu, Sunkyung; Shaver, Ashley; Caruthers, Regine L.; Zikmund-Fisher, Brian J.; Fifer, Carlen; Goldberg, Caren; Russell, Mark W.

    2015-01-01

    Objective Characterize the medical history, disease progression, and treatment of current-era patients with the rare diseases Fontan-associated protein losing enteropathy (PLE) and plastic bronchitis (PB). Study Design A novel survey that queried demographics, medical details, and treatment information was piloted and placed online via a Facebook portal allowing social media to power the study. Participation regardless of PLE or PB diagnosis was allowed. Case control analyses compared patients with PLE and PB to uncomplicated control Fontan patients. Results The survey was completed by 671 subjects including 76 with PLE, 46 with PB, and 7 with both. Median PLE diagnosis was 2.5 years post-Fontan. Hospitalization for PLE occurred in 71% with 41% hospitalized ≥ 3 times. Therapy varied significantly. PLE patients more commonly had hypoplastic left ventricle (62% vs 44% control; OR 2.8, 95% CI 1.4–5.5), chylothorax (66% vs 41%; OR 3.0, CI 1.6–5.3), and cardiothoracic surgery in addition to staged palliation (17% vs 5%; OR 4.3, CI 1.6, 11.2). Median PB diagnosis was 2 years post-Fontan. Hospitalization for PB occurred in 91% with 61% hospitalized ≥3 times. Therapy was very diverse. PB patients more commonly had chylothorax at any surgery (72% vs 51%; OR 2.5, CI 1.2–5.1) and seasonal allergies (52% vs 36%; OR 2.0, CI 1.0–3.9). Conclusions Patient-specific factors are associated with diagnoses of PLE or PB. Treatment strategies are diverse without clear patterns. These results provide a foundation upon which to design future therapeutic studies and identify a clear need for forming consensus approaches to treatment. PMID:25661406

  10. Anestesia en la operación de Fontan

    Directory of Open Access Journals (Sweden)

    Lincoln de la Parte Pérez

    2002-12-01

    Full Text Available La técnica de Fontan ofrece la primera operación fisiológica para la atresia tricuspídea (AT mediante la separación completa de las circulaciones sistémicas y pulmonar. Este proceder se basa en el principio de que la presión en la aurícula derecha es suficiente para garantizar un flujo sanguíneo adecuado a los pulmones, lo que hace innecesaria la función del ventrículo derecho. A partir de su introducción, existe una esperanza para los pacientes con un solo ventrículo y es un procedimiento cada vez más frecuente en el Servicio de Anestesia Cardiovascular. Esta realidad fue el motivo para presentar una revisión bibliográfica actualizada sobre la técnica anestésica que se debe emplear en este procedimiento quirúrgico.Fontan´s technique offers the first physiological operation for tricuspid atresia by complete separation of systemic and pulmonary circulation. This procedure is based on the principle that the right atrium pressure is enough to assure an adequate blood flow to the lungs, which makes the function of right ventricle unnecessary. After the introduction of this procedure, there is a hope for those patients with only one ventricle, therefore, this is an increasingly frequent technique applied in the cardiovascular anesthesia service. Such a reality was the main reason for presenting an updated literature review of the anesthetic technique that should be used in this surgical procedure.

  11. Hepatic blood flow distribution and performance in conventional and novel Y-graft Fontan geometries: a case series computational fluid dynamics study.

    Science.gov (United States)

    Yang, Weiguang; Vignon-Clementel, Irene E; Troianowski, Guillaume; Reddy, V Mohan; Feinstein, Jeffrey A; Marsden, Alison L

    2012-05-01

    A novel Y-shaped baffle has been proposed for the Fontan operation with promising initial results. However, previous studies have relied either on idealized models or a single patient-specific model. The objective of this study is to comprehensively compare the hemodynamic performance and hepatic blood flow distribution of the Y-graft Fontan baffle with 2 current designs using multiple patient-specific models. Y-shaped and tube-shaped grafts were virtually implanted into 5 patient-specific Glenn models forming 3 types of Fontan geometries: Y-graft, T-junction, and offset. Unsteady flow simulations were performed at rest and at varying exercise conditions. The hepatic flow distribution between the right and left lungs was carefully quantified using a particle tracking method. Other physiologically relevant parameters such as energy dissipation, superior vena cava pressure, and wall shear stress were evaluated. The Fontan geometry significantly influences the hepatic flow distribution. The Y-graft design improves the hepatic flow distribution effectively in 4 of 5 patients, whereas the T-junction and offset designs may skew as much as 97% of hepatic flow to 1 lung in 2 cases. Sensitivity studies show that changes in pulmonary flow split can affect the hepatic flow distribution dramatically but that some Y-graft and T-junction designs are relatively less sensitive than offset designs. The Y-graft design offers moderate improvements over the traditional designs in power loss and superior vena cava pressure in all patients. The Y-graft Fontan design achieves overall superior hemodynamic performance compared with traditional designs. However, the results emphasize that no one-size-fits-all solution is available that will universally benefit all patients and that designs should be customized for individual patients before clinical application. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  12. New insights into the aspects of pulmonary diffusing capacity in Fontan patients

    DEFF Research Database (Denmark)

    Idorn, Lars; Hanel, Birgitte; Jensen, Annette S

    2014-01-01

    by 48.3 ± 17.4% in the Fontan group and by 20.2 ± 13.9% in the control group (p = 0.001). In a multiple linear regression analysis including the explanatory variables of surgical data and exercise data at rest and peak exercise, the resting cardiac index was an independent predictor of the diffusing...

  13. Critical congenital heart disease--utility of routine screening for chromosomal and other extracardiac malformations.

    Science.gov (United States)

    Baker, Kimberly; Sanchez-de-Toledo, Joan; Munoz, Ricardo; Orr, Richard; Kiray, Shareen; Shiderly, Dana; Clemens, Michele; Wearden, Peter; Morell, Victor O; Chrysostomou, Constantinos

    2012-01-01

    Objective.  Infants with critical congenital heart disease (CHD) can have genetic and other extracardiac malformations, which add to the short- and long-term risk of morbidity and perhaps mortality. We sought to examine our center's practice of screening for extracardiac anomalies and to determine the yield of these tests among specific cardiac diagnostic categories. Design.  Retrospective review of infants admitted to the cardiac intensive care unit with a new diagnosis of CHD. Subjects were categorized into six groups: septal defects (SD), conotruncal defects (CTD), single-ventricle physiology (SV), left-sided obstructive lesions (LSO), right-sided obstructive lesions (RSO), and "other" (anomalous pulmonary venous return, Ebstein's anomaly). Screening modalities included genetic testing (karyotype and fluorescent in situ hybridization for 22q11.2 deletion), renal ultrasound (RUS), and head ultrasound (HUS). Results.  One hundred forty-one patients were identified. The incidence of cardiac anomalies was: CTD (36%), SD (18%), SV (18%), LSO (14%), RSO (3%), and "other" (8%). Overall 14% had an abnormal karyotype, 5% had a deletion for 22q11.2, 28% had an abnormal RUS and 22% had abnormal HUS. Patients in SD and SV had the highest incidence of abnormal karyotype (36% and 17%); 22q11.2 deletion was present only in CTD and LSO groups (9% and 7%, respectively); abnormal RUS and HUS were seen relatively uniformly in all categories. Premature infants had significantly higher incidence of renal 43% vs. 24%, and intracranial abnormalities 46% vs. 16%. Conclusion.  Infants with critical CHD and particularly premature infants have high incidence of genetic and other extracardiac anomalies. Universal screening for these abnormalities with ultrasonographic and genetic testing maybe warranted because early detection could impact short and long-term outcomes. © 2011 Wiley Periodicals, Inc.

  14. Evaluation of blood flow distribution asymmetry and vascular geometry in patients with Fontan circulation using 4-D flow MRI

    International Nuclear Information System (INIS)

    Jarvis, Kelly; Markl, Michael; Schnell, Susanne; Barker, Alex J.; Garcia, Julio; Chowdhary, Varun; Carr, James; Lorenz, Ramona; Rose, Michael; Robinson, Joshua D.; Rigsby, Cynthia K.

    2016-01-01

    Asymmetrical caval to pulmonary blood flow is suspected to cause complications in patients with Fontan circulation. The aim of this study was to test the feasibility of 4-D flow MRI for characterizing the relationship between 3-D blood flow distribution and vascular geometry. We hypothesized that both flow distribution and geometry can be calculated with low interobserver variability and will detect a direct relationship between flow distribution and Fontan geometry. Four-dimensional flow MRI was acquired in 10 Fontan patients (age: 16 ± 4 years [mean ± standard deviation], range: 9-21 years). The Fontan connection was isolated by 3-D segmentation to evaluate flow distribution from the inferior vena cava (IVC) and superior vena cava (SVC) to the left and right pulmonary arteries (LPA, RPA) and to characterize geometry (cross-sectional area, caval offset, vessel angle). Flow distribution results indicated SVC flow tended toward the RPA while IVC flow was more evenly distributed (SVC to RPA: 78% ± 28 [9-100], IVC to LPA: 54% ± 28 [4-98]). There was a significant relationship between pulmonary artery cross-sectional area and flow distribution (IVC to RPA: R"2=0.50, P=0.02; SVC to LPA: R"2=0.81, P=0.0004). Good agreement was found between observers and for flow distribution when compared to net flow values. Four-dimensional flow MRI was able to detect relationships between flow distribution and vessel geometry. Future studies are warranted to investigate the potential of patient specific hemodynamic analysis to improve diagnostic capability. (orig.)

  15. Evaluation of blood flow distribution asymmetry and vascular geometry in patients with Fontan circulation using 4-D flow MRI

    Energy Technology Data Exchange (ETDEWEB)

    Jarvis, Kelly; Markl, Michael [Northwestern University, Department of Radiology, Feinberg School of Medicine, Chicago, IL (United States); Northwestern University, Department of Biomedical Engineering, McCormick School of Engineering, Chicago, IL (United States); Schnell, Susanne; Barker, Alex J.; Garcia, Julio; Chowdhary, Varun; Carr, James [Northwestern University, Department of Radiology, Feinberg School of Medicine, Chicago, IL (United States); Lorenz, Ramona [University Medical Center Freiburg, Department of Radiology, Freiburg (Germany); Rose, Michael [Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Medical Imaging, Chicago, IL (United States); Robinson, Joshua D. [Northwestern University, Department of Pediatrics, Feinberg School of Medicine, Chicago, IL (United States); Ann and Robert H. Lurie Children' s Hospital of Chicago, Division of Cardiology, Chicago, IL (United States); Rigsby, Cynthia K. [Northwestern University, Department of Radiology, Feinberg School of Medicine, Chicago, IL (United States); Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Medical Imaging, Chicago, IL (United States)

    2016-10-15

    Asymmetrical caval to pulmonary blood flow is suspected to cause complications in patients with Fontan circulation. The aim of this study was to test the feasibility of 4-D flow MRI for characterizing the relationship between 3-D blood flow distribution and vascular geometry. We hypothesized that both flow distribution and geometry can be calculated with low interobserver variability and will detect a direct relationship between flow distribution and Fontan geometry. Four-dimensional flow MRI was acquired in 10 Fontan patients (age: 16 ± 4 years [mean ± standard deviation], range: 9-21 years). The Fontan connection was isolated by 3-D segmentation to evaluate flow distribution from the inferior vena cava (IVC) and superior vena cava (SVC) to the left and right pulmonary arteries (LPA, RPA) and to characterize geometry (cross-sectional area, caval offset, vessel angle). Flow distribution results indicated SVC flow tended toward the RPA while IVC flow was more evenly distributed (SVC to RPA: 78% ± 28 [9-100], IVC to LPA: 54% ± 28 [4-98]). There was a significant relationship between pulmonary artery cross-sectional area and flow distribution (IVC to RPA: R{sup 2}=0.50, P=0.02; SVC to LPA: R{sup 2}=0.81, P=0.0004). Good agreement was found between observers and for flow distribution when compared to net flow values. Four-dimensional flow MRI was able to detect relationships between flow distribution and vessel geometry. Future studies are warranted to investigate the potential of patient specific hemodynamic analysis to improve diagnostic capability. (orig.)

  16. Oral budesonide treatment for protein-losing enteropathy in Fontan-palliated patients.

    Science.gov (United States)

    Schumacher, Kurt R; Cools, Michael; Goldstein, Bryan H; Ioffe-Dahan, Viktoriya; King, Karen; Gaffney, Diane; Russell, Mark W

    2011-10-01

    Protein-losing enteropathy (PLE) is a rare complication of Fontan palliation associated with significant morbidity and mortality. It is characterized by the loss of serum proteins into the intestinal lumen, and its pathophysiology likely involves enteral inflammation. Budesonide, an oral steroid, is an attractive treatment option because of its potent enteral activity and minimal systemic side effects. A single-center, retrospective review of Fontan-palliated PLE patients treated with oral budesonide for 6 months or longer was performed. The patient characteristics reviewed were demographics, anatomic diagnosis, budesonide treatment (dose and duration), other medications and therapeutic interventions, hospitalizations, serum albumin levels, medical complications, and patient status at the time of follow-up assessment. The study enrolled 10 patients representing 228 patient-months of on-therapy follow-up evaluation. Serum albumin levels increased after initiation of budesonide for 90% of the patients, and clinical evidence of fluid overload improved for 60% of them. Symptomatic improvement was reported in 80% of the cases. During the treatment period, 50% of the patients met the primary end point of death or cardiac transplantation. In this series of PLE patients, oral budesonide therapy was associated with significant symptomatic improvement and sustained increases in serum albumin. However, budesonide therapy may not alter the long-term outcome for patients with advanced PLE.

  17. Prevalence of extra-cardiac findings on studies of noninvasive coronary angiography multidetector computed tomography 64 rows

    International Nuclear Information System (INIS)

    Carrascosa, Patricia M.; Capunay, Carlos M.; Deviggiano, A.; Melendez, F.; Carrascosa, Jorge M.; Garcia, M.

    2007-01-01

    The aim of this paper is to show the importance of evaluating in a full form images obtained from a studio of noninvasive coronary angiography by multidetector computed tomography (AC-TCMD). 90 users of AC-TCMD were evaluated retrospectively conducted between October 2006 and April 2007 with a multidetector tomography of 64-rows(Phillips Medical Systems) . The images were reprocessed with a maximum field of vision and determined the presence of extra-cardiac findings, which were classified according to their impact on the management and treatment of patient at 3 degrees: low, medium and high grade. The studies were assessed jointly by a cardiologist and a radiologist qualified for cardiac and corporal evaluation. Extra-cardiac findings were identified in 58 patients. There were 38 patients with findings of low grade, 31 medium grade and 1 high grade. It was recommended to 16 patients its monitoring by images on reasonable period of time [es

  18. Quantification of ventricular unloading by 3D echocardiography in single ventricle of left ventricular morphology following superior cavo-pulmonary anastomosis and Fontan completion – a feasibility study

    Directory of Open Access Journals (Sweden)

    Deepa Sasikumar

    2017-01-01

    Conclusions: We provide preliminary information on 3DE volume data of single ventricle of LV morphology and the pattern of unloading after SCPA and Fontan operation. Immediate significant volume unloading occurred after SCPA which tended to catch-up after 3 months, whereas continued fall in ventricular volume with time was noted after Fontan.

  19. Conduit Stability and Collapse in Explosive Volcanic Eruptions: Coupling Conduit Flow and Failure Models

    Science.gov (United States)

    Mullet, B.; Segall, P.

    2017-12-01

    Explosive volcanic eruptions can exhibit abrupt changes in physical behavior. In the most extreme cases, high rates of mass discharge are interspaced by dramatic drops in activity and periods of quiescence. Simple models predict exponential decay in magma chamber pressure, leading to a gradual tapering of eruptive flux. Abrupt changes in eruptive flux therefore indicate that relief of chamber pressure cannot be the only control of the evolution of such eruptions. We present a simplified physics-based model of conduit flow during an explosive volcanic eruption that attempts to predict stress-induced conduit collapse linked to co-eruptive pressure loss. The model couples a simple two phase (gas-melt) 1-D conduit solution of the continuity and momentum equations with a Mohr-Coulomb failure condition for the conduit wall rock. First order models of volatile exsolution (i.e. phase mass transfer) and fragmentation are incorporated. The interphase interaction force changes dramatically between flow regimes, so smoothing of this force is critical for realistic results. Reductions in the interphase force lead to significant relative phase velocities, highlighting the deficiency of homogenous flow models. Lateral gas loss through conduit walls is incorporated using a membrane-diffusion model with depth dependent wall rock permeability. Rapid eruptive flux results in a decrease of chamber and conduit pressure, which leads to a critical deviatoric stress condition at the conduit wall. Analogous stress distributions have been analyzed for wellbores, where much work has been directed at determining conditions that lead to wellbore failure using Mohr-Coulomb failure theory. We extend this framework to cylindrical volcanic conduits, where large deviatoric stresses can develop co-eruptively leading to multiple distinct failure regimes depending on principal stress orientations. These failure regimes are categorized and possible implications for conduit flow are discussed, including

  20. Técnica para correção de truncus arteriosus tipos I e II sem condutos extracardíacos Technique for correction of truncus arteriosus type I and II without extracardiac conduits

    Directory of Open Access Journals (Sweden)

    Miguel Barbero-Marcial

    1989-04-01

    Full Text Available Uma nova técnica para correção cirúrgica do truncus arteriosus (TA sem o uso de conduto extracardíaco foi realizada em 7 pacientes, senão 6 do tipo I, e do tipo II em 1 paciente; a idade variou de 2 a 9 meses. O tronco comum foi septado com retalho, dividindo-o em uma posição aórtica e outra pulmonar; a comunicação interventricular (CIV foi fechada através de ventriculotomia; anastomose direta entre as artérias pulmonares e o ventrículo direito foi realizada, sendo a parede anterior construída com retalho de pericárdio bovino com válvula monocúspide. Houve apenas 1 óbito no pós-operatório. Nos 6 pacientes restantes, a relação entre as pressões sistólicas ventrículo direito/ventrículo esquerdo (VD/VE foi menor que 0,51 em 5 pacientes; em 1 paciente, essa relação foi de 0,60, associada a CIV residual. Todos os pacientes encontram-se em classe funcional I (NYHA, em um período de 1 a 14 meses de pós-operatório. Baseados nestes resultados, propomos esta técnica para pacientes com TA tipo I ou II, no primeiro ano de vida.A new corrective surgery for truncus arteriosus (TA without the use of extracardiac conduit was employed in 7 patients with truncus (TA type I in 6 cases and type II in 1 case, aged from two to nine months. The common TA was septated with a patch into aortic and pulmonary segments and the ventricular septal defect was closed through ventriculotomy; a direct anastomosis between the pulmonary arteries and the right ventricle was performed, the anterior wall of this, being contructed with a patch with a monocusp valve. There was one imediate postoperative death. In the surviving six patients the RV/LV postoperative peak systolic was less than 0.51 in five and 0.60 in one with residual VSD; all are in functional class I, in postoperative period between one and fourteen months. Based in these results we propose this technique for patients with type I or II, in the first year of life.

  1. Roentgenologic findings of non-penetrating extracardiac chest injuries

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Duck; Ra, Woo Youn [Presbyterian Medical Center, Jeonju (Korea, Republic of)

    1975-06-15

    Of the conventional P-A and A-P chest films which have been studied, many roentgenologic signs suggested for chest trauma. In the present study, an effort was designated to further clarify the x-ray findings of the nonpenetrating extracardiac chest injuries and to observe the x-ray findings being a leading maneuver of surgical procedure. Fat embolism and shock lung must be kept in mind on follow up films. The results thus obtained are summarized as follows; 1. Most of cases are visualized between the age of 10 and 50 and more common in male. 2. The denoting rib fracture, hemopneumothorax, and lung contusion are direct roentgenologic signs. 3. In case of serious result which showed pulmonary edema pattern on conventional chest films, we thought fat embolism or shock lung to be the cause of death.

  2. Detection and severity classification of extracardiac interference in {sup 82}Rb PET myocardial perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Orton, Elizabeth J., E-mail: eorton@physics.carleton.ca; Kemp, Robert A. de; Glenn Wells, R. [Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 (Canada); Department of Physics, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario K1S 5B6 (Canada); Al Harbi, Ibraheem [Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 (Canada); Department of Medicine (Cardiology), King Fahad Hospital, Medina 42351 (Saudi Arabia); Klein, Ran [Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 (Canada); Department of Biomedical Engineering, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario K1S 5B6 (Canada); Beanlands, Rob S. B. [Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 (Canada)

    2014-10-15

    Purpose: Myocardial perfusion imaging (MPI) is used for diagnosis and prognosis of coronary artery disease. When MPI studies are performed with positron emission tomography (PET) and the radioactive tracer rubidium-82 chloride ({sup 82}Rb), a small but non-negligible fraction of studies (∼10%) suffer from extracardiac interference: high levels of tracer uptake in structures adjacent to the heart which mask the true cardiac tracer uptake. At present, there are no clinically available options for automated detection or correction of this problem. This work presents an algorithm that detects and classifies the severity of extracardiac interference in {sup 82}Rb PET MPI images and reports the accuracy and failure rate of the method. Methods: A set of 200 {sup 82}Rb PET MPI images were reviewed by a trained nuclear cardiologist and interference severity reported on a four-class scale, from absent to severe. An automated algorithm was developed that compares uptake at the external border of the myocardium to three thresholds, separating the four interference severity classes. A minimum area of interference was required, and the search region was limited to that facing the stomach wall and spleen. Maximizing concordance (Cohen’s Kappa) and minimizing failure rate for the set of 200 clinician-read images were used to find the optimal population-based constants defining search limit and minimum area parameters and the thresholds for the algorithm. Tenfold stratified cross-validation was used to find optimal thresholds and report accuracy measures (sensitivity, specificity, and Kappa). Results: The algorithm was capable of detecting interference with a mean [95% confidence interval] sensitivity/specificity/Kappa of 0.97 [0.94, 1.00]/0.82 [0.66, 0.98]/0.79 [0.65, 0.92], and a failure rate of 1.0% ± 0.2%. The four-class overall Kappa was 0.72 [0.64, 0.81]. Separation of mild versus moderate-or-greater interference was performed with good accuracy (sensitivity

  3. Echocardiographic characteristics in Fontan patients before the onset of protein-losing enteropathy or plastic bronchitis.

    Science.gov (United States)

    Du Bois, Florian; Stiller, Brigitte; Borth-Bruhns, Thomas; Unseld, Bettina; Kubicki, Rouven; Hoehn, René; Reineker, Katja; Grohmann, Jochen; Fleck, Thilo

    2018-01-01

    It was this study's objective to evaluate the echocardiographic characteristics and flow patterns in abdominal arteries of Fontan patients before the onset of protein-losing enteropathy (PLE) or plastic bronchitis (PB). In this retrospective cohort investigation, we examined 170 Fontan patients from 32 different centers who had undergone echocardiographic and Doppler ultrasound examinations between June 2006 and May 2013. Follow-up questionnaires were completed by 105 patients a median of 5.3 (1.5-8.5) years later to evaluate whether one of the complications had occurred since the examinations. A total of 91 patients never developed PLE or PB ("non-PLE/PB"); they were compared to 14 affected patients. Eight of the 14 patients had already been diagnosed with "present PLE/PB" when examined. Six "future PLE/PB" patients developed those complications later on and were identified on follow-up. The "future PLE/PB" patients presented significantly slower diastolic flow velocities in the celiac artery (0.1 (0.1-0.5) m/s vs 0.3 (0.1-1.0) m/s (P = .04) and in the superior mesenteric artery (0.0 (0.0-0.2) m/s vs 0.2 (0.0-0.6) m/s, P = .02) than the "non-PLE/PB" group. Median resistance indices in the celiac artery were significantly higher (0.9 (0.8-0.9) m/s vs 0.8 (0.6-0.9) m/s, (P = .01)) even before the onset of PLE or PB. An elevated flow resistance in the celiac artery may prevail in Fontan patients before the clinical manifestation of PLE or PB. © 2017 Wiley Periodicals, Inc.

  4. Stochastic simulation of karst conduit networks

    Science.gov (United States)

    Pardo-Igúzquiza, Eulogio; Dowd, Peter A.; Xu, Chaoshui; Durán-Valsero, Juan José

    2012-01-01

    Karst aquifers have very high spatial heterogeneity. Essentially, they comprise a system of pipes (i.e., the network of conduits) superimposed on rock porosity and on a network of stratigraphic surfaces and fractures. This heterogeneity strongly influences the hydraulic behavior of the karst and it must be reproduced in any realistic numerical model of the karst system that is used as input to flow and transport modeling. However, the directly observed karst conduits are only a small part of the complete karst conduit system and knowledge of the complete conduit geometry and topology remains spatially limited and uncertain. Thus, there is a special interest in the stochastic simulation of networks of conduits that can be combined with fracture and rock porosity models to provide a realistic numerical model of the karst system. Furthermore, the simulated model may be of interest per se and other uses could be envisaged. The purpose of this paper is to present an efficient method for conditional and non-conditional stochastic simulation of karst conduit networks. The method comprises two stages: generation of conduit geometry and generation of topology. The approach adopted is a combination of a resampling method for generating conduit geometries from templates and a modified diffusion-limited aggregation method for generating the network topology. The authors show that the 3D karst conduit networks generated by the proposed method are statistically similar to observed karst conduit networks or to a hypothesized network model. The statistical similarity is in the sense of reproducing the tortuosity index of conduits, the fractal dimension of the network, the direction rose of directions, the Z-histogram and Ripley's K-function of the bifurcation points (which differs from a random allocation of those bifurcation points). The proposed method (1) is very flexible, (2) incorporates any experimental data (conditioning information) and (3) can easily be modified when

  5. Clinical utility of (18)F-FDG positron emission tomography/computed tomography scan vs. (99m)Tc-HMPAO white blood cell single-photon emission computed tomography in extra-cardiac work-up of infective endocarditis

    DEFF Research Database (Denmark)

    Lauridsen, Trine K; Iversen, Kasper K; Ihlemann, Nikolaj

    2017-01-01

    The extra-cardiac work-up in infective endocarditis (IE) comprises a search for primary and secondary infective foci. Whether18FDG-PET/CT or WBC-SPECT/CT is superior in detection of clinically relevant extra-cardiac manifestations in IE is unexplored. The objectives of this study were to identify...

  6. Cross-sectional imaging of the Fontan circuit in adult congenital heart disease

    International Nuclear Information System (INIS)

    Lewis, G.; Thorne, S.; Clift, P.; Holloway, B.

    2015-01-01

    The Fontan circuit is the result of a palliative surgical procedure that is performed in patients with a functionally single ventricle cardiac anomaly. The success of this operation has resulted in an increasing population of adults with this anatomy and physiology. The purpose of this article is to familiarize the general radiologist with the expected anatomy and cross-sectional imaging findings, highlight special imaging considerations, and examine the common complications that are encountered in this group of patients

  7. Three cases of hepatocellular carcinoma in Fontan patients: Review of the literature and suggestions for hepatic screening

    NARCIS (Netherlands)

    Josephus Jitta, Djike; Wagenaar, Lodewijk J.; Mulder, Barbara J. M.; Guichelaar, Maureen; Bouman, Donald; van Melle, Joost P.

    2016-01-01

    The Fontan procedure has been used since 1971 as a palliative treatment for various (functionally) univentricular hearts. The systemic venous blood flows passively to the pulmonary arteries, without passing through a functional ventricle. This results in chronic systemic venous congestion, which may

  8. Three cases of hepatocellular carcinoma in Fontan patients : Review of the literature and suggestions for hepatic screening

    NARCIS (Netherlands)

    Jitta, Djike Josephus; Wagenaar, Lodewijk J.; Mulder, Barbara J. M.; Guichelaar, Maureen; Bouman, Donald; Melle, van Joost P.

    2016-01-01

    The Fontan procedure has been used since 1971 as a palliative treatment for various (functionally) univentricular hearts. The systemic venous blood flows passively to the pulmonary arteries, without passing through a functional ventricle. This results in chronic systemic venous congestion, which may

  9. Optimization of Design of Steam Turbine Exhaust Conduits

    Directory of Open Access Journals (Sweden)

    A. S. Goldin

    2014-01-01

    Full Text Available Improving effectiveness turbine was and remains a key issue for today. In order to improve the efficiency of the turbine is necessary to reduce losses in the steam turbine exhaust conduit.This paper presents the design optimization exhaust conduit steam turbine K-27-2.9 produced by JSC «KTW» at the design stage. The aims of optimizing the design were: decreasing hydraulic resistance of the conduit, reduction of non-uniformity of the flow at the outlet of the conduit, equalizing steam flow ahead of the condenser tube bundle.The conduit models were made and flows in it were simulated in environment of the Solid Works and its application COSMOS Flo Works.As the initial conduit model was selected exhaust conduit of turbine PT-25/34-3.4 produced by JSC «KTW». Was obtained by the calculated velocity field at the outlet of the conduit. The analysis of the calculation results revealed the necessity of changes to the initial design of the conduit. The changes were accompanied by calculating currents flow in the conduit, and assessed the impact of design changes on the nature of the course. Further transformation of the construction of the conduit was held on the results of these calculations. Construction changes are not touched by the outer geometry of the conduit, and were introduced to meet technological.According to calculation results, conclusions were drawn and selected three versions of the conduit.Given are the research results for the initial conduit model and modified design versions. In order to evaluate the flow degree of irregularity the momentum factor (Bussinesku factor for outlet crosssection of the selected conduit design version. Analysis of the research results made it possible to determine optimum design of the exhaust conduit.Introducing the suggested alterations in the conduit design will result in improvement of heat exchange in the condenser, an increase in reliability of the tube bundle operation, a decrease in noise and

  10. Conduit enlargement in an eogenetic karst aquifer

    Science.gov (United States)

    Moore, Paul J.; Martin, Jonathan B.; Screaton, Elizabeth J.; Neuhoff, Philip S.

    2010-11-01

    SummaryMost concepts of conduit development have focused on telogenetic karst aquifers, where low matrix permeability focuses flow and dissolution along joints, fractures, and bedding planes. However, conduits also exist in eogenetic karst aquifers, despite high matrix permeability which accounts for a significant component of flow. This study investigates dissolution within a 6-km long conduit system in the eogenetic Upper Floridan aquifer of north-central Florida that begins with a continuous source of allogenic recharge at the Santa Fe River Sink and discharges from a first-magnitude spring at the Santa Fe River Rise. Three sources of water to the conduit include the allogenic recharge, diffuse recharge through epikarst, and mineralized water upwelling from depth. Results of sampling and inverse modeling using PHREEQC suggest that dissolution within the conduit is episodic, occurring only during 30% of 16 sampling times between March 2003 and April 2007. During low flow conditions, carbonate saturated water flows from the matrix to the conduit, restricting contact between undersaturated allogenic water with the conduit wall. When gradients reverse during high flow conditions, undersaturated allogenic recharge enters the matrix. During these limited periods, estimates of dissolution within the conduit suggest wall retreat averages about 4 × 10 -6 m/day, in agreement with upper estimates of maximum wall retreat for telogenetic karst. Because dissolution is episodic, time-averaged dissolution rates in the sink-rise system results in a wall retreat rate of about 7 × 10 -7 m/day, which is at the lower end of wall retreat for telogenetic karst. Because of the high permeability matrix, conduits in eogenetic karst thus enlarge not just at the walls of fractures or pre-existing conduits such as those in telogenetic karst, but also may produce a friable halo surrounding the conduits that may be removed by additional mechanical processes. These observations stress the

  11. The corrosion effect on the conduit systems

    International Nuclear Information System (INIS)

    Laaidi, Naouar; Belattar, Sougratti

    2009-01-01

    The conduits in the buildings require a regular and permanent control, in order to avoid the risks of deterioration caused by the corrosion or the escape of water. In this work, we present a thermal nondestructive testing method of concrete structures containing water conduits, based on numerical modeling in three dimensions. The goal is to study the detectability of these conduits in different situations and to give a thermal characterization of the rust behaviour in the steel conduits. (author)

  12. Bentall Operation with Valved Homograft Conduit

    Science.gov (United States)

    Choudhary, Shiv K.; Talwar, Sachin; Kumar, A. Sampath

    2000-01-01

    Lesions of the ascending aorta associated with aortic valve disease are usually treated by implanting a prosthetic valved conduit (Bentall procedure). In this report, we present our experience in which a valved homograft conduit was used for the procedure. Six patients underwent a Bentall procedure with the use of a cryopreserved valved homograft conduit. Two of the patients had annuloaortic ectasia, 2 had Marfan syndrome, and 1 had an atherosclerotic aneurysm of the aorta. One patient had severe aortic stenosis due to a bicuspid aortic valve, along with an aneurysm and localized dissection of the ascending aorta. In all of the patients, the aortic annulus was substantially dilated, with accompanying moderate-to-severe aortic regurgitation. A standard procedure was performed with moderate hypothermia, cardiopulmonary bypass, and aortic and bicaval cannulation. The ascending aorta and the aortic valve were replaced with a cryopreserved valved homograft conduit (aortic in 5 patients and pulmonary in 1). The native coronary ostia were anastomosed directly to the homograft. Echocardiography, which was performed intraoperatively, before discharge from the hospital, and at follow-up visits (1 to 36 months), revealed good valve function without dilatation of the homograft conduits. There was 1 late death due to Aspergillus fumigatus endocarditis, 6 months postoperatively. In 1 patient, magnetic resonance imaging performed at 24 months revealed normal caliber of the homograft conduit. We conclude that the Bentall procedure can be performed, safely and with excellent results, using cryopreserved homograft conduits. PMID:11198310

  13. Coronary dual source multi detector computed tomography in patients suspected of coronary artery disease: Prevalence of incidental extra-cardiac findings

    International Nuclear Information System (INIS)

    Bendix, K.; Jensen, J.M.; Poulsen, S.; Mygind, N.; Norgaard, B.L.

    2011-01-01

    Objectives: (1) To establish the prevalence of incidental extra-cardiac findings (ECFs) in coronary multi detector computed tomography (CCT) performed in a large, homogeneous cohort of patients suspected of coronary artery disease (CAD). (2) To examine whether any association can be established between ECFs and pretest risk as determined by conventional risk factors for CAD, the Diamond-Forrester risk model or coronary artery calcium scores. (3) To assess cost related to extra-cardiac examinations. Design: Retrospective study of consecutive patients who had CCT performed. A large field of view was recreated from the non-enhanced CT scan and evaluated by a radiologist for incidental ECFs. Subjects: Patients with chest pain referred to CTA by a cardiologist. Results: In 1383 patients a total of 481 ECFs were indentified, 378 minor (meaning no follow-up was needed) and 103 major ECFs (ECF followed up clinically and/or with additional imaging), in a total of 393 (28%) patients. 85 (6%) patients had one major ECF and 9 (0.7%) patients had two major ECFs. In 19 (4 cases of malignancy) patients the major ECF had therapeutic consequences. Significant positive associations were found between age and smoking, respectively and the presence of ECFs. The cost estimate of saving one life from malignant disease based on ECF examinations is 40,190 Euro . Conclusion: Incidental extra-cardiac findings are common, sometimes revealing serious, even malignant disease. Diagnostic follow-up of major ECFs seems to be cost-effective in a Danish clinical setting. We recommend investigating a large field of view for incidental ECFs following CCT.

  14. Quantitative echocardiographic measures in the assessment of single ventricle function post-Fontan: Incorporation into routine clinical practice.

    Science.gov (United States)

    Rios, Rodrigo; Ginde, Salil; Saudek, David; Loomba, Rohit S; Stelter, Jessica; Frommelt, Peter

    2017-01-01

    Quantitative echocardiographic measurements of single ventricular (SV) function have not been incorporated into routine clinical practice. A clinical protocol, which included quantitative measurements of SV deformation (global circumferential and longitudinal strain and strain rate), standard deviation of time to peak systolic strain, myocardial performance index (MPI), dP/dT from an atrioventricular valve regurgitant jet, and superior mesenteric artery resistance index, was instituted for all patients with a history of Fontan procedure undergoing echocardiography. All measures were performed real time during clinically indicated studies and were included in clinical reports. A total of 100 consecutive patients (mean age = 11.95±6.8 years, range 17 months-31.3 years) completed the protocol between September 1, 2014 to April 29, 2015. Deformation measures were completed in 100% of the studies, MPI in 93%, dP/dT in 55%, and superior mesenteric artery Doppler in 82%. The studies were reviewed to assess for efficiency in completing the protocol. The average time for image acquisition was 27.4±8.8 (range 10-62 minutes). The average time to perform deformation measures was 10.8±5.5 minutes (range 5-35 minutes) and time from beginning of imaging to report completion was 53.4±13.7 minutes (range 27-107 minutes). There was excellent inter-observer reliability when deformation indices were blindly repeated. Patients with a single left ventricle had significantly higher circumferential strain and strain rate, longitudinal strain and strain rate, and dP/dT compared to a single right ventricle. There were no differences in quantitative indices of ventricular function between patients 10 years post-Fontan. Advanced quantitative assessment of SV function post-Fontan can be consistently and efficiently performed real time during clinically indicated echocardiograms with excellent reliability. © 2016, Wiley Periodicals, Inc.

  15. Biological conduit small gap sleeve bridging method for peripheral nerve injury: regeneration law of nerve fibers in the conduit

    Directory of Open Access Journals (Sweden)

    Pei-xun Zhang

    2015-01-01

    Full Text Available The clinical effects of 2-mm small gap sleeve bridging of the biological conduit to repair peripheral nerve injury are better than in the traditional epineurium suture, so it is possible to replace the epineurium suture in the treatment of peripheral nerve injury. This study sought to identify the regeneration law of nerve fibers in the biological conduit. A nerve regeneration chamber was constructed in models of sciatic nerve injury using 2-mm small gap sleeve bridging of a biodegradable biological conduit. The results showed that the biological conduit had good histocompatibility. Tissue and cell apoptosis in the conduit apparently lessened, and regenerating nerve fibers were common. The degeneration regeneration law of Schwann cells and axons in the conduit was quite different from that in traditional epineurium suture. During the prime period for nerve fiber regeneration (2-8 weeks, the number of Schwann cells and nerve fibers was higher in both proximal and distal ends, and the effects of the small gap sleeve bridging method were better than those of the traditional epineurium suture. The above results provide an objective and reliable theoretical basis for the clinical application of the biological conduit small gap sleeve bridging method to repair peripheral nerve injury.

  16. Drill pipes and casings utilizing multi-conduit tubulars

    Energy Technology Data Exchange (ETDEWEB)

    Curlett, H.B.

    1989-01-24

    A seal adapted for use with a multi-conduit well tubular, or the like, is described which consists of: a plate with fluid passages, each passage corresponding to an opening of a conduit of the multiconduit tubular, and a groove on the plate around each passage; and elastomer means partially embeddable into each groove for sealing each conduit of a tubular to a corresponding conduit of another similar tubular.

  17. Design of barrier coatings on kink-resistant peripheral nerve conduits

    Directory of Open Access Journals (Sweden)

    Basak Acan Clements

    2016-02-01

    Full Text Available Here, we report on the design of braided peripheral nerve conduits with barrier coatings. Braiding of extruded polymer fibers generates nerve conduits with excellent mechanical properties, high flexibility, and significant kink-resistance. However, braiding also results in variable levels of porosity in the conduit wall, which can lead to the infiltration of fibrous tissue into the interior of the conduit. This problem can be controlled by the application of secondary barrier coatings. Using a critical size defect in a rat sciatic nerve model, the importance of controlling the porosity of the nerve conduit walls was explored. Braided conduits without barrier coatings allowed cellular infiltration that limited nerve recovery. Several types of secondary barrier coatings were tested in animal studies, including (1 electrospinning a layer of polymer fibers onto the surface of the conduit and (2 coating the conduit with a cross-linked hyaluronic acid-based hydrogel. Sixteen weeks after implantation, hyaluronic acid-coated conduits had higher axonal density, displayed higher muscle weight, and better electrophysiological signal recovery than uncoated conduits or conduits having an electrospun layer of polymer fibers. This study indicates that braiding is a promising method of fabrication to improve the mechanical properties of peripheral nerve conduits and demonstrates the need to control the porosity of the conduit wall to optimize functional nerve recovery.

  18. 47 CFR 32.2441 - Conduit systems.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Conduit systems. 32.2441 Section 32.2441 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions for Balance Sheet Accounts § 32.2441 Conduit systems. (a...

  19. Peripheral nerve conduits: technology update

    Science.gov (United States)

    Arslantunali, D; Dursun, T; Yucel, D; Hasirci, N; Hasirci, V

    2014-01-01

    Peripheral nerve injury is a worldwide clinical problem which could lead to loss of neuronal communication along sensory and motor nerves between the central nervous system (CNS) and the peripheral organs and impairs the quality of life of a patient. The primary requirement for the treatment of complete lesions is a tension-free, end-to-end repair. When end-to-end repair is not possible, peripheral nerve grafts or nerve conduits are used. The limited availability of autografts, and drawbacks of the allografts and xenografts like immunological reactions, forced the researchers to investigate and develop alternative approaches, mainly nerve conduits. In this review, recent information on the various types of conduit materials (made of biological and synthetic polymers) and designs (tubular, fibrous, and matrix type) are being presented. PMID:25489251

  20. Artificial urinary conduit construction using tissue engineering methods.

    Science.gov (United States)

    Kloskowski, Tomasz; Pokrywczyńska, Marta; Drewa, Tomasz

    2015-01-01

    Incontinent urinary diversion using an ileal conduit is the most popular method used by urologists after bladder cystectomy resulting from muscle invasive bladder cancer. The use of gastrointestinal tissue is related to a series of complications with the necessity of surgical procedure extension which increases the time of surgery. Regenerative medicine together with tissue engineering techniques gives hope for artificial urinary conduit construction de novo without affecting the ileum. In this review we analyzed history of urinary diversion together with current attempts in urinary conduit construction using tissue engineering methods. Based on literature and our own experience we presented future perspectives related to the artificial urinary conduit construction. A small number of papers in the field of tissue engineered urinary conduit construction indicates that this topic requires more attention. Three main factors can be distinguished to resolve this topic: proper scaffold construction along with proper regeneration of both the urothelium and smooth muscle layers. Artificial urinary conduit has a great chance to become the first commercially available product in urology constructed by regenerative medicine methods.

  1. Flexible cryogenic conduit

    International Nuclear Information System (INIS)

    Brindza, P.D.; Wines, R.R.; Takacs, J.J.

    1999-01-01

    A flexible and relatively low cost cryogenic conduit is described. The flexible cryogenic conduit of the present invention comprises a first inner corrugated tube with single braided serving, a second outer corrugated tube with single braided serving concentric with the inner corrugated tube, and arranged outwardly about the periphery of the inner corrugated tube and between the inner and outer corrugated tubes: a superinsulation layer; a one half lap layer of polyester ribbon; a one half lap layer of copper ribbon; a spirally wound refrigeration tube; a second one half lap layer of copper ribbon; a second one half lap layer of polyester ribbon; a second superinsulation layer; a third one half lap layer of polyester ribbon; and a spirally wound stretchable and compressible filament

  2. Conduit for regeneration of biological material

    DEFF Research Database (Denmark)

    2016-01-01

    The present invention relates to a conduit comprising a first material, having 1) a through-going hole, 2) fibers aligned along the long-axis in the through-going hole, each fiber having a diameter in the range 200-2000 nm. The conduit is preferably for regeneration of biological material, even...

  3. Comparing Pre- and Post-Operative Fontan Hemodynamic Simulations: Implications for the Reliability of Surgical Planning

    Science.gov (United States)

    Haggerty, Christopher M.; de Zélicourt, Diane A.; Restrepo, Maria; Rossignac, Jarek; Spray, Thomas L.; Kanter, Kirk R.; Fogel, Mark A.; Yoganathan, Ajit P.

    2012-01-01

    Background Virtual modeling of cardiothoracic surgery is a new paradigm that allows for systematic exploration of various operative strategies and uses engineering principles to predict the optimal patient-specific plan. This study investigates the predictive accuracy of such methods for the surgical palliation of single ventricle heart defects. Methods Computational fluid dynamics (CFD)-based surgical planning was used to model the Fontan procedure for four patients prior to surgery. The objective for each was to identify the operative strategy that best distributed hepatic blood flow to the pulmonary arteries. Post-operative magnetic resonance data were acquired to compare (via CFD) the post-operative hemodynamics with predictions. Results Despite variations in physiologic boundary conditions (e.g., cardiac output, venous flows) and the exact geometry of the surgical baffle, sufficient agreement was observed with respect to hepatic flow distribution (90% confidence interval-14 ± 4.3% difference). There was also good agreement of flow-normalized energetic efficiency predictions (19 ± 4.8% error). Conclusions The hemodynamic outcomes of prospective patient-specific surgical planning of the Fontan procedure are described for the first time with good quantitative comparisons between preoperatively predicted and postoperative simulations. These results demonstrate that surgical planning can be a useful tool for single ventricle cardiothoracic surgery with the ability to deliver significant clinical impact. PMID:22777126

  4. Experimental investigation of the effects of inserting a bovine venous valve in the inferior vena cava of Fontan circulation

    Science.gov (United States)

    Santhanakrishnan, Arvind; Johnson, Jacob; Kotz, Monica; Tang, Elaine; Khiabani, Reza; Yoganathan, Ajit; Maher, Kevin

    2012-11-01

    The Fontan procedure is a palliative surgery performed on patients with single ventricle (SV) congenital heart defects. The SV is used for systemic circulation and the venous return from the inferior vena cava (IVC) and superior vena cava (SVC) is routed to the pulmonary arteries (PA), resulting in a total cavopulmonary connection (TCPC). Hepatic venous hypertension is commonly manifested in the Fontan circulation, leading to long-term complications including liver congestion and cirrhosis. Respiratory intrathoracic pressure changes affect the venous return from the IVC to the PA. Using a physical model of an idealized TCPC, we examine placement of a unidirectional bovine venous valve within the IVC as a method of alleviating hepatic venous hypertension. A piston pump is used to provide pulsatility in the internal flow through the TCPC, while intrathoracic pressure fluctuations are imposed on the external walls of the model using a pair of linear actuators. When implanted in the extrathoracic position, the hepatic venous pressure is lowered from baseline condition. The effects of changing caval flow distribution and intrathoracic pressure on TCPC hemodynamics will be examined.

  5. Value of multislice computed tomography angiography of the thorax in preparation for catheter ablation for the treatment of atrial fibrillation: The impact of unexpected cardiac and extracardiac findings on patient care

    Energy Technology Data Exchange (ETDEWEB)

    Wissner, Erik; Wellnitz, Clinton V.; Srivathsan, Komandoor; Scott, Luis R. [Mayo Clinic Arizona - Mayo Clinic Hospital, Cardiovascular Diseases, 5777 East Mayo Boulevard, Phoenix, AZ 85054 (United States); Altemose, Gregory T. [Mayo Clinic Arizona - Mayo Clinic Hospital, Cardiovascular Diseases, 5777 East Mayo Boulevard, Phoenix, AZ 85054 (United States)], E-mail: altemose.gregory@mayo.edu

    2009-11-15

    Objective: In patients referred for catheter ablation for the treatment of atrial fibrillation, multislice computed tomography angiography of the thorax is routinely performed to assess pulmonary vein anatomy. We sought to investigate the incidence of unexpected cardiac and extracardiac findings in this select patient population and to establish how these findings influence subsequent patient care. Methods: Ninety-five patients (mean age 62 {+-} 10 years, 35% female) referred to our institution for ablation therapy for atrial fibrillation between July 2003 and October 2007 underwent multislice computed tomography angiography of the thorax. Radiologists interpreted all images. Need for additional testing, consultation and eventual diagnosis were assessed by electronic record review. Results: A total of 83 (5 cardiac, 78 extracardiac) unexpected findings were observed in 50/95 (53%) of patients. The findings prompted 23 additional tests (5 cardiac, 18 noncardiac) in 15/95 (16%) of patients and 8 subsequent referrals in 7/95 (7%) patients. In 6 patients the findings significantly altered future patient care and resulted in postponement of ablation therapy in 4 patients. In 2 patients, extracardiac findings (pulmonary emboli and adenocarcinoma of the lung) were of potentially life-saving consequence. Conclusions: In patients undergoing multislice computed tomography angiography of the thorax in anticipation of planned catheter ablation therapy for the treatment of atrial fibrillation, unexpected findings are common and of potentially significant value. In comparison, there is a higher prevalence of unexpected extracardiac, rather than cardiac findings. Further investigation of these findings may lead to postponement of ablation therapy, but may also be of potentially lifesaving consequence.

  6. Value of multislice computed tomography angiography of the thorax in preparation for catheter ablation for the treatment of atrial fibrillation: The impact of unexpected cardiac and extracardiac findings on patient care

    International Nuclear Information System (INIS)

    Wissner, Erik; Wellnitz, Clinton V.; Srivathsan, Komandoor; Scott, Luis R.; Altemose, Gregory T.

    2009-01-01

    Objective: In patients referred for catheter ablation for the treatment of atrial fibrillation, multislice computed tomography angiography of the thorax is routinely performed to assess pulmonary vein anatomy. We sought to investigate the incidence of unexpected cardiac and extracardiac findings in this select patient population and to establish how these findings influence subsequent patient care. Methods: Ninety-five patients (mean age 62 ± 10 years, 35% female) referred to our institution for ablation therapy for atrial fibrillation between July 2003 and October 2007 underwent multislice computed tomography angiography of the thorax. Radiologists interpreted all images. Need for additional testing, consultation and eventual diagnosis were assessed by electronic record review. Results: A total of 83 (5 cardiac, 78 extracardiac) unexpected findings were observed in 50/95 (53%) of patients. The findings prompted 23 additional tests (5 cardiac, 18 noncardiac) in 15/95 (16%) of patients and 8 subsequent referrals in 7/95 (7%) patients. In 6 patients the findings significantly altered future patient care and resulted in postponement of ablation therapy in 4 patients. In 2 patients, extracardiac findings (pulmonary emboli and adenocarcinoma of the lung) were of potentially life-saving consequence. Conclusions: In patients undergoing multislice computed tomography angiography of the thorax in anticipation of planned catheter ablation therapy for the treatment of atrial fibrillation, unexpected findings are common and of potentially significant value. In comparison, there is a higher prevalence of unexpected extracardiac, rather than cardiac findings. Further investigation of these findings may lead to postponement of ablation therapy, but may also be of potentially lifesaving consequence.

  7. Drill pipes and casings utilizing multi-conduit tubular; Flerkanals roerstreng

    Energy Technology Data Exchange (ETDEWEB)

    Curlett, H.B.

    1997-04-23

    The invention relates to a multi-conduit tubular having fluid conduits and electrical conduits, with associated surface fluid and electrical commutators, and downhole sensors for providing surface monitors with instantaneous formation data. Each tubular includes a plurality of uniform linear conduits there through, with a gasket seal plate interposed between joined tubular for assuring a high pressure seal between joined conduits. the seal plate includes an intermediate electrical connector for connecting electrical conduit connectors of one tubular to another. A coupling collar with uniform diameter internal coarse and fine threads joins the tubular ends having similar threads by differential thread action without respective tubular rotation. Each tubular end includes an inter-engaging index recess and index lug, and drive recesses and lugs for maintaining angular registry of the tubular string and for driving one drill tubular with another. A fluid commutator includes a rotating shaft with passages connected to the tubular conduits, and rotating in a manifold having annular grooves in communication with the shaft passages and external fluid sources. An adaptor couples each commutator shaft passage to one or more tubular conduits. Slip rings on a quill shaft and stationary brush means provide electrical continuity from the electrical conduit wires to surface equipment. A cross-over sub includes formation parameter sensors and telemetry equipment in a blocked off portion of a fluid conduit. An annular accumulator connected with the well bore annulus applies a pressure thereto in response to downhole sensors to change the effective density of the drill mud. The multi-conduit tubular is further adapted for use as a well casing to provide downhole access of a plurality of fluids and electrical parameter sensors. 28 figs.

  8. Water Flow in Karst Aquifer Considering Dynamically Variable Saturation Conduit

    Science.gov (United States)

    Tan, Chaoqun; Hu, Bill X.

    2017-04-01

    The karst system is generally conceptualized as dual-porosity system, which is characterized by low conductivity and high storage continuum matrix and high conductivity and quick flow conduit networks. And so far, a common numerical model for simulating flow in karst aquifer is MODFLOW2005-CFP, which is released by USGS in 2008. However, the steady-state approach for conduit flow in CFP is physically impractical when simulating very dynamic hydraulics with variable saturation conduit. So, we adopt the method proposed by Reimann et al. (2011) to improve current model, in which Saint-Venant equations are used to model the flow in conduit. Considering the actual background that the conduit is very big and varies along flow path and the Dirichlet boundary varies with rainfall in our study area in Southwest China, we further investigate the influence of conduit diameter and outflow boundary on numerical model. And we also analyze the hydraulic process in multi-precipitation events. We find that the numerical model here corresponds well with CFP for saturated conduit, and it could depict the interaction between matrix and conduit during very dynamic hydraulics pretty well compare with CFP.

  9. 3D-engineering of Cellularized Conduits for Peripheral Nerve Regeneration

    Science.gov (United States)

    Hu, Yu; Wu, Yao; Gou, Zhiyuan; Tao, Jie; Zhang, Jiumeng; Liu, Qianqi; Kang, Tianyi; Jiang, Shu; Huang, Siqing; He, Jiankang; Chen, Shaochen; Du, Yanan; Gou, Maling

    2016-08-01

    Tissue engineered conduits have great promise for bridging peripheral nerve defects by providing physical guiding and biological cues. A flexible method for integrating support cells into a conduit with desired architectures is wanted. Here, a 3D-printing technology is adopted to prepare a bio-conduit with designer structures for peripheral nerve regeneration. This bio-conduit is consisted of a cryopolymerized gelatin methacryloyl (cryoGelMA) gel cellularized with adipose-derived stem cells (ASCs). By modeling using 3D-printed “lock and key” moulds, the cryoGelMA gel is structured into conduits with different geometries, such as the designed multichannel or bifurcating and the personalized structures. The cryoGelMA conduit is degradable and could be completely degraded in 2-4 months in vivo. The cryoGelMA scaffold supports the attachment, proliferation and survival of the seeded ASCs, and up-regulates the expression of their neurotrophic factors mRNA in vitro. After implanted in a rat model, the bio-conduit is capable of supporting the re-innervation across a 10 mm sciatic nerve gap, with results close to that of the autografts in terms of functional and histological assessments. The study describes an indirect 3D-printing technology for fabricating cellularized designer conduits for peripheral nerve regeneration, and could lead to the development of future nerve bio-conduits for clinical use.

  10. Impact of empiric nesiritide or milrinone infusion on early postoperative recovery after Fontan surgery: a randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Costello, John M; Dunbar-Masterson, Carolyn; Allan, Catherine K; Gauvreau, Kimberlee; Newburger, Jane W; McGowan, Francis X; Wessel, David L; Mayer, John E; Salvin, Joshua W; Dionne, Roger E; Laussen, Peter C

    2014-07-01

    We sought to determine whether empirical nesiritide or milrinone would improve the early postoperative course after Fontan surgery. We hypothesized that compared with milrinone or placebo, patients assigned to receive nesiritide would have improved early postoperative outcomes. In a single-center, randomized, double-blinded, placebo-controlled, multi-arm parallel-group clinical trial, patients undergoing primary Fontan surgery were assigned to receive nesiritide, milrinone, or placebo. A loading dose of study drug was administered on cardiopulmonary bypass followed by a continuous infusion for ≥12 hours and ≤5 days after cardiac intensive care unit admission. The primary outcome was days alive and out of the hospital within 30 days of surgery. Secondary outcomes included measures of cardiovascular function, renal function, resource use, and adverse events. Among 106 enrolled subjects, 35, 36, and 35 were randomized to the nesiritide, milrinone, and placebo groups, respectively, and all were analyzed based on intention to treat. Demographics, patient characteristics, and operative factors were similar among treatment groups. No significant treatment group differences were found for median days alive and out of the hospital within 30 days of surgery (nesiritide, 20 [minimum to maximum, 0-24]; milrinone, 18 [0-23]; placebo, 20 [0-23]; P=0.38). Treatment groups did not significantly differ in cardiac index, arrhythmias, peak lactate, inotropic scores, urine output, duration of mechanical ventilation, intensive care or chest tube drainage, or adverse events. Compared with placebo, empirical perioperative nesiritide or milrinone infusions are not associated with improved early clinical outcomes after Fontan surgery. http://www.clinicaltrials.gov. Unique identifier: NCT00543309. © 2014 American Heart Association, Inc.

  11. A novel conduit-based coaptation device for primary nerve repair.

    Science.gov (United States)

    Bamba, Ravinder; Riley, D Colton; Kelm, Nathaniel D; Cardwell, Nancy; Pollins, Alonda C; Afshari, Ashkan; Nguyen, Lyly; Dortch, Richard D; Thayer, Wesley P

    2018-06-01

    Conduit-based nerve repairs are commonly used for small nerve gaps, whereas primary repair may be performed if there is no tension on nerve endings. We hypothesize that a conduit-based nerve coaptation device will improve nerve repair outcomes by avoiding sutures at the nerve repair site and utilizing the advantages of a conduit-based repair. The left sciatic nerves of female Sprague-Dawley rats were transected and repaired using a novel conduit-based device. The conduit-based device group was compared to a control group of rats that underwent a standard end-to-end microsurgical repair of the sciatic nerve. Animals underwent behavioral assessments at weekly intervals post-operatively using the sciatic functional index (SFI) test. Animals were sacrificed at four weeks to obtain motor axon counts from immunohistochemistry. A sub-group of animals were sacrificed immediately post repair to obtain MRI images. SFI scores were superior in rats which received conduit-based repairs compared to the control group. Motor axon counts distal to the injury in the device group at four weeks were statistically superior to the control group. MRI tractography was used to demonstrate repair of two nerves using the novel conduit device. A conduit-based nerve coaptation device avoids sutures at the nerve repair site and leads to improved outcomes in a rat model. Conduit-based nerve repair devices have the potential to standardize nerve repairs while improving outcomes.

  12. In vitro evaluation of carbon-nanotube-reinforced bioprintable vascular conduits

    International Nuclear Information System (INIS)

    Dolati, Farzaneh; Yu, Yin; Zhang, Yahui; Ozbolat, Ibrahim T; Jesus, Aribet M De; Sander, Edward A

    2014-01-01

    Vascularization of thick engineered tissue and organ constructs like the heart, liver, pancreas or kidney remains a major challenge in tissue engineering. Vascularization is needed to supply oxygen and nutrients and remove waste in living tissues and organs through a network that should possess high perfusion ability and significant mechanical strength and elasticity. In this paper, we introduce a fabrication process to print vascular conduits directly, where conduits were reinforced with carbon nanotubes (CNTs) to enhance their mechanical properties and bioprintability. In vitro evaluation of printed conduits encapsulated in human coronary artery smooth muscle cells was performed to characterize the effects of CNT reinforcement on the mechanical, perfusion and biological performance of the conduits. Perfusion and permeability, cell viability, extracellular matrix formation and tissue histology were assessed and discussed, and it was concluded that CNT-reinforced vascular conduits provided a foundation for mechanically appealing constructs where CNTs could be replaced with natural protein nanofibers for further integration of these conduits in large-scale tissue fabrication. (paper)

  13. Aortopulmonary collateral flow is related to pulmonary artery size and affects ventricular dimensions in patients after the fontan procedure.

    Directory of Open Access Journals (Sweden)

    Heiner Latus

    Full Text Available BACKGROUND: Aortopulmonary collaterals (APCs are frequently found in patients with a single-ventricle (SV circulation. However, knowledge about the clinical significance of the systemic-to-pulmonary shunt flow in patients after the modified Fontan procedure and its potential causes is limited. Accordingly, the aim of our study was to detect and quantify APC flow using cardiovascular magnetic resonance (CMR and assess its impact on SV volume and function as well as to evaluate the role of the size of the pulmonary arteries in regard to the development of APCs. METHODS: 60 patients (mean age 13.3 ± 6.8 years after the Fontan procedure without patent tunnel fenestration underwent CMR as part of their routine clinical assessment that included ventricular functional analysis and flow measurements in the inferior vena cava (IVC, superior vena cava (SVC and ascending aorta (Ao. APC flow was quantified using the systemic flow estimator: (Ao - (IVC + SVC. Pulmonary artery index (Nakata index was calculated as RPA + LPA area/body surface area using contrast enhanced MR angiography. The patient cohort was divided into two groups according to the median APC flow: group 1 0.495 l/min/m(2. RESULTS: Group 1 patients had significant smaller SV enddiastolic (71 ± 16 vs 87 ± 25 ml/m(2; p=0.004 and endsystolic volumes (29 ± 11 vs 40 ± 21 ml/m(2; p=0.02 whereas ejection fraction (59 ± 9 vs 56 ± 13%; p=0.38 differed not significantly. Interestingly, pulmonary artery size showed a significant inverse correlation with APC flow (r=-0.50, p=0.002. CONCLUSIONS: Volume load due to APC flow in Fontan patients affected SV dimensions, but did not result in an impairment of SV function. APC flow was related to small pulmonary artery size, suggesting that small pulmonary arteries represent a potential stimulus for the development of APCs.

  14. Spectrum of congenital heart defects and extracardiac malformations associated with chromosomal abnormalities: results of a seven year necropsy study

    OpenAIRE

    Tennstedt, C; Chaoui, R; Korner, H; Dietel, M

    1999-01-01

    OBJECTIVE—To analyse the spectrum of congenital heart malformations, the frequency of extracardiac malformations, and the proportion of chromosome aberrations among fetuses sent for necropsy.
MATERIAL—Necropsies were performed on 815 fetuses—448 induced abortions (55%), 220 spontaneous abortions (27%), and 147 stillbirths (18%)—during a seven year period (1991-97) in the department of pathology of the Charité Medical Centre in Berlin. A congenital heart defect was identified in 129 cases (16%...

  15. In Vitro Study of Directly Bioprinted Perfusable Vasculature Conduits.

    Science.gov (United States)

    Zhang, Yahui; Yu, Yin; Akkouch, Adil; Dababneh, Amer; Dolati, Farzaneh; Ozbolat, Ibrahim T

    2015-01-01

    The ability to create three dimensional (3D) thick tissues is still a major tissue engineering challenge. It requires the development of a suitable vascular supply for an efficient media exchange. An integrated vasculature network is particularly needed when building thick functional tissues and/or organs with high metabolic activities, such as the heart, liver and pancreas. In this work, human umbilical vein smooth muscle cells (HUVSMCs) were encapsulated in sodium alginate and printed in the form of vasculature conduits using a coaxial deposition system. Detailed investigations were performed to understand the dehydration, swelling and degradation characteristics of printed conduits. In addition, because perfusional, permeable and mechanical properties are unique characteristics of natural blood vessels, for printed conduits these properties were also explored in this work. The results show that cells encapsulated in conduits had good proliferation activities and that their viability increased during prolonged in vitro culture. Deposition of smooth muscle matrix and collagen was observed around the peripheral and luminal surface in long-term cultured cellular vascular conduit through histology studies.

  16. Pumped Storage and Potential Hydropower from Conduits

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2015-02-25

    Th is Congressional Report, Pumped Storage Hydropower and Potential Hydropower from Conduits, addresses the technical flexibility that existing pumped storage facilities can provide to support intermittent renewable energy generation. This study considered potential upgrades or retrofit of these facilities, the technical potential of existing and new pumped storage facilities to provide grid reliability benefits, and the range of conduit hydropower opportunities available in the United States.

  17. Engineering a multimodal nerve conduit for repair of injured peripheral nerve

    Science.gov (United States)

    Quigley, A. F.; Bulluss, K. J.; Kyratzis, I. L. B.; Gilmore, K.; Mysore, T.; Schirmer, K. S. U.; Kennedy, E. L.; O'Shea, M.; Truong, Y. B.; Edwards, S. L.; Peeters, G.; Herwig, P.; Razal, J. M.; Campbell, T. E.; Lowes, K. N.; Higgins, M. J.; Moulton, S. E.; Murphy, M. A.; Cook, M. J.; Clark, G. M.; Wallace, G. G.; Kapsa, R. M. I.

    2013-02-01

    Injury to nerve tissue in the peripheral nervous system (PNS) results in long-term impairment of limb function, dysaesthesia and pain, often with associated psychological effects. Whilst minor injuries can be left to regenerate without intervention and short gaps up to 2 cm can be sutured, larger or more severe injuries commonly require autogenous nerve grafts harvested from elsewhere in the body (usually sensory nerves). Functional recovery is often suboptimal and associated with loss of sensation from the tissue innervated by the harvested nerve. The challenges that persist with nerve repair have resulted in development of nerve guides or conduits from non-neural biological tissues and various polymers to improve the prognosis for the repair of damaged nerves in the PNS. This study describes the design and fabrication of a multimodal controlled pore size nerve regeneration conduit using polylactic acid (PLA) and (PLA):poly(lactic-co-glycolic) acid (PLGA) fibers within a neurotrophin-enriched alginate hydrogel. The nerve repair conduit design consists of two types of PLGA fibers selected specifically for promotion of axonal outgrowth and Schwann cell growth (75:25 for axons; 85:15 for Schwann cells). These aligned fibers are contained within the lumen of a knitted PLA sheath coated with electrospun PLA nanofibers to control pore size. The PLGA guidance fibers within the nerve repair conduit lumen are supported within an alginate hydrogel impregnated with neurotrophic factors (NT-3 or BDNF with LIF, SMDF and MGF-1) to provide neuroprotection, stimulation of axonal growth and Schwann cell migration. The conduit was used to promote repair of transected sciatic nerve in rats over a period of 4 weeks. Over this period, it was observed that over-grooming and self-mutilation (autotomy) of the limb implanted with the conduit was significantly reduced in rats implanted with the full-configuration conduit compared to rats implanted with conduits containing only an alginate

  18. Degradation properties of the electrostatic assembly PDLLA/CS/CHS nerve conduit

    Energy Technology Data Exchange (ETDEWEB)

    Xu Haixing [School of Chemical Engineering, Wuhan University of Technology, Wuhan 430070 (China); Yan Yuhua; Wan Tao; Li Shipu, E-mail: yanyuhua8@126.co [Biomedical Materials and Engineering Research Center, Wuhan University of Technology, Wuhan 430070 (China)

    2009-08-15

    A poly(d,l-lactic acid)/chondroitin sulfate/chitosan (PDLLA/CS/CHS) nerve conduit for repairing nerve defects was prepared by electrostatic assembly and the thermally induced phase separation technique. The hydrophilic characteristics of the PDLLA/CS/CHS assembly nerve conduits were improved markedly. The degradation behavior of the nerve conduit with various assembly layers was evaluated by a pH change, weight loss rate and molecular weight change. The pH of the solution of the nerve conduit could be effectively adjusted by varying the layer numbers and overcoming the acidity-caused auto-acceleration of PDLLA; the nerve conduit can retain its integrity in a phosphate buffer solution after being degraded for 3 months. After such a conduit was implanted in the rat for 3 months, obvious degradation occurred, but the regenerated nerve was integrated and it grew successfully from the proximal to distal nerve stump. All these results implied that the degradation rate of the prepared conduit can adapt to the regeneration of the peripheral nerve, which might be a new derivative of PDLLA-based biodegradable materials for repairing nerve injuries without acidity-caused irritations and acidity-induced auto-accelerating degradation behavior as shown by PDLLA.

  19. Extreme loads seismic testing of conduit systems

    International Nuclear Information System (INIS)

    Howard, G.E.; Ibanez, P.; Harrison, S.; Shi, Z.T.

    1991-01-01

    Rigid steel conduit (thin-wall tubes with threaded connections) containing electrical cabling are a common feature in nuclear power plants. Conduit systems are in many cases classified in U.S.A. practice as Seismic Category I structures. this paper summarizes results and others aspects of a dynamic test program conducted to investigate conduit systems seismic performance under three-axis excitation for designs representative at a nuclear power plant sited near Ft. Worth, Texas (a moderate seismic zone), with a Safe Shutdown Earthquake (SSE) of 0.12 g. Test specimens where subjected to postulated seismic events, including excitation well in excess of Safe Shutdown Earthquake events typical for U.S.A. nuclear power stations. A total of 18 conduit systems of 9-meter nominal lengths were shake table mounted and subjected to a variety of tests. None of the specimens suffered loss of load capacity when subjected to a site-enveloping Safe Shutdown Earthquake (SSE). Clamp/attachment hardware failures only began to occur when earthquake input motion was scaled upward to minimum values of 2.3-4.6 times site enveloping SSE response spectra. Tensile and/or shear failure of clamp attachment bolts or studs was the failure mode in all case in which failure was induced. (author)

  20. LOAD ON BURIED PRESSURE CONDUITS WITH REFERENCE TO ...

    African Journals Online (AJOL)

    width of conduit or trench; the shearing forces on the plane between the backfill and adjacent earth; for embankment condition, the amounL of relative settlement between the backfill and adjacent earth; the rigidity of the conduit support under embankment loading. Table 3. Selected values of c'' for use in Eq. 8. Sand and.

  1. Small-sized conduits in the right ventricular outflow tract in young children: bicuspidalized homografts are a good alternative to standard conduits.

    Science.gov (United States)

    François, Katrien; De Groote, Katya; Vandekerckhove, Kristof; De Wilde, Hans; De Wolf, Daniel; Bové, Thierry

    2017-10-03

    Downsizing a homograft (HG) through bicuspidalization has been used for more than 2 decades to overcome the shortage of small-sized conduits for reconstruction of the right ventricular outflow tract (RVOT) in young children. Our goal was to investigate the durability of bicuspidalized HGs compared with other small HGs. A retrospective analysis of 93 conduits ≤20 mm, implanted over 23 years, was performed. The end-points were survival, structural valve degeneration and conduit replacement. The conduits comprised 40 pulmonary HGs, 12 aortic HGs, 17 bicuspidalized HGs and 24 xenografts. The median age, mean conduit diameter and z-value at implantation were 1.4 (interquartile range 0.3-3) years, 16.5 ± 2.7 mm and 2.8 ± 1.3, respectively. Valve position was heterotopic in 59 patients and orthotopic in 34 patients. At a mean follow-up period of 7.6 ± 5.9 years, the hospital survival rate was 89%. Freedom from explant at 5 and 10 years was 83 ± 5% and 52 ± 6%, respectively. Freedom from structural valve degeneration was 79 ± 5% at 5 years and 47 ± 6% at 10 years [68 ± 8% for pulmonary HG, 42 ± 16% for bicuspidalized HG, 31 ± 15% for aortic HG and 20 ± 9% for xenografts (log rank P right ventricular outflow tract conduit in young children. However, when a small pulmonary HG is unavailable, bicuspidalization offers a valid alternative, preferable to xenograft conduits, at mid-term follow-up. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  2. Twenty years of cable-in-conduit conductors: 1975-1995

    International Nuclear Information System (INIS)

    Dresner, L.

    1995-01-01

    This paper reviews our progress during the last two decades in understanding cable-in-conduit conductors. The emphasis is on the physical principles governing the behavior of cable-in-conduit conductors, and no detailed mathematics is presented. The paper is constructed as a historical narrative

  3. Extracardiac 18F-florbetapir imaging in patients with systemic amyloidosis: more than hearts and minds.

    Science.gov (United States)

    Wagner, T; Page, J; Burniston, M; Skillen, A; Ross, J C; Manwani, R; McCool, D; Hawkins, P N; Wechalekar, Ashutosh D

    2018-07-01

    18 F-Florbetapir has been reported to show cardiac uptake in patients with systemic light-chain amyloidosis (AL). This study systematically assessed uptake of 18 F-florbetapir in patients with proven systemic amyloidosis at sites outside the heart. Seventeen patients with proven cardiac amyloidosis underwent 18 F-florbetapir PET/CT imaging, 15 with AL and 2 with transthyretin amyloidosis (ATTR). Three patients had repeat scans. All patients had protocolized assessment at the UK National Amyloidosis Centre including imaging with 123 I-serum amyloid P component (SAP). 18 F-Florbetapir images were assessed for areas of increased tracer accumulation and time-uptake curves in terms of standardized uptake values (SUV mean ) were produced. All 17 patients showed 18 F-florbetapir uptake at one or more extracardiac sites. Uptake was seen in the spleen in 6 patients (35%; 6 of 9, 67%, with splenic involvement on 123 I-SAP scintigraphy), in the fat in 11 (65%), in the tongue in 8 (47%), in the parotids in 8 (47%), in the masticatory muscles in 7 (41%), in the lungs in 3 (18%), and in the kidney in 2 (12%) on the late half-body images. The 18 F-florbetapir spleen retention index (SRI) was calculated. SRI >0.045 had 100% sensitivity/sensitivity (in relation to 123 I-SAP splenic uptake, the current standard) in detecting splenic amyloid on dynamic imaging and a sensitivity of 66.7% and a specificity of 100% on the late half-body images. Intense lung uptake was seen in three patients, one of whom had lung interstitial infiltration suggestive of amyloid deposition on previous high-resolution CT. Repeat imaging showed a stable appearance in all three patients suggesting no early impact of treatment response. 18 F-Florbetapir PET/CT is a promising tool for the detection of extracardiac sites of amyloid deposition. The combination of uptake in the heart and uptake in the spleen on 18 F-florbetapir PET/CT, a hallmark of AL, suggests that this tracer holds promise as a screening tool

  4. Extracardiac findings at cardiac MR imaging: a single-centre retrospective study over 14 years.

    Science.gov (United States)

    Sokolowski, Felix C; Karius, Philipp; Rodríguez, Alejandra; Lembcke, Alexander; Wagner, Moritz; Hamm, Bernd; Dewey, Marc

    2018-04-30

    To determine the prevalence and significance of extracardiac findings (ECF) in a large set of cardiac magnetic resonance (MR) imaging examinations. The institutional review board (IRB) of the Charité approved this retrospective, single-centre study. A total of 4376 cardiac MR imaging reports of 3553 patients (age 37.4 ± 20 years, 60.8 % male) examined from 2000 to 2014 were included. Findings with a recommendation for follow-up were considered "major ECF". To analyse the association of indication, age and gender with ECF, Poisson regression and computed incidence rate ratios (IRR) were evaluated. The overall prevalence of ECF was 34% (95% confidence interval [CI] 32.5-35.6%). Major ECF were present in 3.4% (95% CI 2.9-4.1%) while findings that changed patient management were found in 0.9% (95% CI 0.7-1.3%). In the cases of congenital heart disease, ECF prevalence was higher compared to myocarditis (IRR, 6.0; 95% CI 5.1-7.1%; p < 0.001), while the prevalence of major ECF was lower (IRR, 0.2; 95% CI 0.02-0.51%; p < 0.05). Older patient age was associated with more nonvascular ECF (p < 0.001). Female patients had the same probability of having an ECF as male patients (IRR, 1.04; 95% CI 0.95-1.1%; p = 0.43). ECF in cardiac MR imaging are present in about every third patient while relevant ECF that change patient management can be found in about one out of 100 patients. Our data suggest that it is important to involve well-trained radiologists in reading cardiac MR images, which often reveal ECF if congenital heart disease is the clinical indication. • Extracardiac findings are present in about every third patient. • Relevant ECF changing patient management are found in one out of 100 findings. • Chance of ECF is high in patients with CHD and vascular indications.

  5. Short-term outcomes after incontinent conduit for gynecologic cancer: comparison of ileal, sigmoid, and transverse colon.

    Science.gov (United States)

    Tabbaa, Zaid M; Janco, Jo Marie T; Mariani, Andrea; Dowdy, Sean C; McGree, Michaela E; Weaver, Amy L; Cliby, William A

    2014-06-01

    The aim of this study is to estimate the overall rates of significant incontinent conduit-related complications and compare rates between conduit types. This was a retrospective review of 166 patients who underwent incontinent urinary diversion from April 1993 through April 2013. Patients were categorized by conduit type-ileal, sigmoid colon, and transverse colon. Significant conduit-related complications were assessed at 30 and 90days after surgery. Significant conduit-related complication was defined as any of the following: ureteral stricture, conduit leak, conduit obstruction, conduit ischemia, ureteral anastomotic leak, stent obstruction requiring intervention via interventional radiology procedure or reoperation, and renal failure. A total of 166 patients underwent formation of an incontinent urinary conduit, most commonly during exenteration for gynecologic malignancy. There were 129 ileal, 11 transverse colon, and 26 sigmoid conduits. The overall significant conduit-related complication rate within 30days was 15.1%. Complication rates for ileal, transverse and sigmoid conduits were 14.7%, 0%, and 23.1%, respectively (Fisher's exact test, p=0.24). By 90days, the Kaplan-Meier estimated rates of significant complications were 21.8% overall, and 22.3%, 0%, and 28.9%, respectively, by conduit type (log-rank test, p=0.19). The most common significant conduit-related complications were conduit or ureteral anastomotic leaks and conduit obstructions. By 1 and 2years following surgery, the Kaplan-Meier estimated overall rate of significant conduit-related complication increased to 26.5% and 30.1%, respectively. Our study suggests that there are multiple appropriate tissue sites for use in incontinent conduit formation, and surgical approach should be individualized. Most significant conduit-related complications occur within 90days after surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Novel technique for airless connection of artificial heart to vascular conduits.

    Science.gov (United States)

    Karimov, Jamshid H; Gao, Shengqiang; Dessoffy, Raymond; Sunagawa, Gengo; Sinkewich, Martin; Grady, Patrick; Sale, Shiva; Moazami, Nader; Fukamachi, Kiyotaka

    2017-12-01

    Successful implantation of a total artificial heart relies on multiple standardized procedures, primarily the resection of the native heart, and exacting preparation of the atrial and vascular conduits for pump implant and activation. Achieving secure pump connections to inflow/outflow conduits is critical to a successful outcome. During the connection process, however, air may be introduced into the circulation, traveling to the brain and multiple organs. Such air emboli block blood flow to these areas and are detrimental to long-term survival. A correctly managed pump-to-conduit connection prevents air from collecting in the pump and conduits. To further optimize pump-connection techniques, we have developed a novel connecting sleeve that enables airless connection of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) to the conduits. In this brief report, we describe the connecting sleeve design and our initial results from two acute in vivo implantations using a scaled-down version of the CFTAH.

  7. Generation of Complex Karstic Conduit Networks with a Hydro-chemical Model

    Science.gov (United States)

    De Rooij, R.; Graham, W. D.

    2016-12-01

    The discrete-continuum approach is very well suited to simulate flow and solute transport within karst aquifers. Using this approach, discrete one-dimensional conduits are embedded within a three-dimensional continuum representative of the porous limestone matrix. Typically, however, little is known about the geometry of the karstic conduit network. As such the discrete-continuum approach is rarely used for practical applications. It may be argued, however, that the uncertainty associated with the geometry of the network could be handled by modeling an ensemble of possible karst conduit networks within a stochastic framework. We propose to generate stochastically realistic karst conduit networks by simulating the widening of conduits as caused by the dissolution of limestone over geological relevant timescales. We illustrate that advanced numerical techniques permit to solve the non-linear and coupled hydro-chemical processes efficiently, such that relatively large and complex networks can be generated in acceptable time frames. Instead of specifying flow boundary conditions on conduit cells to recharge the network as is typically done in classical speleogenesis models, we specify an effective rainfall rate over the land surface and let model physics determine the amount of water entering the network. This is advantageous since the amount of water entering the network is extremely difficult to reconstruct, whereas the effective rainfall rate may be quantified using paleoclimatic data. Furthermore, we show that poorly known flow conditions may be constrained by requiring a realistic flow field. Using our speleogenesis model we have investigated factors that influence the geometry of simulated conduit networks. We illustrate that our model generates typical branchwork, network and anastomotic conduit systems. Flow, solute transport and water ages in karst aquifers are simulated using a few illustrative networks.

  8. A polymer foam conduit seeded with Schwann cells promotes guided peripheral nerve regeneration.

    Science.gov (United States)

    Hadlock, T; Sundback, C; Hunter, D; Cheney, M; Vacanti, J P

    2000-04-01

    Alternatives to autografts have long been sought for use in bridging neural gaps. Many entubulation materials have been studied, although with generally disappointing results in comparison with autografts. The purpose of this study was to design a more effective neural guidance conduit, to introduce Schwann cells into the conduit, and to determine regenerative capability through it in an in vivo model. A novel, fully biodegradable polymer conduit was designed and fabricated for use in peripheral nerve repair, which approximates the macro- and microarchitecture of native peripheral nerves. It comprised a series of longitudinally aligned channels, with diameters ranging from 60 to 550 microns. The lumenal surfaces promoted the adherence of Schwann cells, whose presence is known to play a key role in nerve regeneration. This unique channel architecture increased the surface area available for Schwann cell adherence up to five-fold over that available through a simple hollow conduit. The conduit was composed of a high-molecular-weight copolymer of lactic and glycolic acids (PLGA) (MW 130,000) in an 85:15 monomer ratio. A novel foam-processing technique, employing low-pressure injection molding, was used to create highly porous conduits (approximately 90% pore volume) with continuous longitudinal channels. Using this technique, conduits were constructed containing 1, 5, 16, 45, or more longitudinally aligned channels. Prior to cellular seeding of these conduits, the foams were prewet with 50% ethanol, flushed with physiologic saline, and coated with laminin solution (10 microg/mL). A Schwann cell suspension was dynamically introduced into these processed foams at a concentration of 5 X 10(5) cells/mL, using a simple bioreactor flow loop. In vivo regeneration studies were carried out in which cell-laden five-channel polymer conduits (individual channel ID 500 microm, total conduit OD 2.3 mm) were implanted across a 7-mm gap in the rat sciatic nerve (n = 4), and midgraft

  9. Reverse Saphenous Conduit Flap in 19 Dogs and 1 Cat.

    Science.gov (United States)

    Cavalcanti, Jacqueline V J; Barry, Sabrina L; Lanz, Otto I; Barnes, Katherine; Coutin, Julia V

    2018-05-14

    The purpose of this retrospective study was to report the outcomes of 19 dogs and 1 cat undergoing reverse saphenous conduit flap between 1999 and 2016. Reverse saphenous conduit flap was used to treat traumatic wounds and wounds resulting from tumor excision in the hind limb; the majority of cases had medial shearing injuries. All animals had complete flap survival. In five animals (20%), minor donor site dehiscence occurred, which did not require surgery. Other postoperative complications included signs of severe venous congestion in one dog. Reverse saphenous conduit flap is a useful technique to repair skin defects of the distal hind limb.

  10. Ash production by attrition in volcanic conduits and plumes.

    Science.gov (United States)

    Jones, T J; Russell, J K

    2017-07-17

    Tephra deposits result from explosive volcanic eruption and serve as indirect probes into fragmentation processes operating in subsurface volcanic conduits. Primary magmatic fragmentation creates a population of pyroclasts through volatile-driven decompression during conduit ascent. In this study, we explore the role that secondary fragmentation, specifically attrition, has in transforming primary pyroclasts upon transport in volcanic conduits and plumes. We utilize total grain size distributions from a suite of natural and experimentally produced tephra to show that attrition is likely to occur in all explosive volcanic eruptions. Our experimental results indicate that fine ash production and surface area generation is fast (eruption column stability, tephra dispersal, aggregation, volcanic lightening generation, and has concomitant effects on aviation safety and Earth's climate.

  11. Silk fibroin enhances peripheral nerve regeneration by improving vascularization within nerve conduits.

    Science.gov (United States)

    Wang, Chunyang; Jia, Yachao; Yang, Weichao; Zhang, Cheng; Zhang, Kuihua; Chai, Yimin

    2018-07-01

    Silk fibroin (SF)-based nerve conduits have been widely used to bridge peripheral nerve defects. Our previous study showed that nerve regeneration in a SF-blended poly (l-lactide-co-ɛ-caprolactone) [P(LLA-CL)] nerve conduit is better than that in a P(LLA-CL) conduit. However, the involved mechanisms remain unclarified. Because angiogenesis within a nerve conduit plays an important role in nerve regeneration, vascularization of SF/P(LLA-CL) and P(LLA-CL) conduits was compared both in vitro and in vivo. In the present study, we observed that SF/P(LLA-CL) nanofibers significantly promoted fibroblast proliferation, and vascular endothelial growth factor secreted by fibroblasts seeded in SF/P(LLA-CL) nanofibers was more than seven-fold higher than that in P(LLA-CL) nanofibers. Conditioned medium of fibroblasts in the SF/P(LLA-CL) group stimulated more human umbilical vein endothelial cells (HUVEC) to form capillary-like networks and promoted faster HUVEC migration. The two kinds of nerve conduits were used to bridge 10-mm-length nerve defects in rats. At 3 weeks of reparation, the blood vessel area in the SF/P(LLA-CL) group was significantly larger than that in the P(LLA-CL) group. More regenerated axons and Schwann cells were also observed in the SF/P(LLA-CL) group, which was consistent with the results of blood vessels. Collectively, our data revealed that the SF/P(LLA-CL) nerve conduit enhances peripheral nerve regeneration by improving angiogenesis within the conduit. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 2070-2077, 2018. © 2018 Wiley Periodicals, Inc.

  12. Regenerative potential of silk conduits in repair of peripheral nerve injury in adult rats.

    Science.gov (United States)

    Huang, W; Begum, R; Barber, T; Ibba, V; Tee, N C H; Hussain, M; Arastoo, M; Yang, Q; Robson, L G; Lesage, S; Gheysens, T; Skaer, Nicholas J V; Knight, D P; Priestley, J V

    2012-01-01

    Various attempts have been made to develop artificial conduits for nerve repair, but with limited success. We describe here conduits made from Bombyx mori regenerated silk protein, and containing luminal fibres of Spidrex(®), a silk-based biomaterial with properties similar to those of spider silk. Assessment in vitro demonstrated that Spidrex(®) fibres support neurite outgrowth. For evaluation in vivo, silk conduits 10 mm in length and containing 0, 100, 200 or 300 luminal Spidrex(®) fibres, were implanted to bridge an 8 mm gap in the rat sciatic nerve. At 4 weeks, conduits containing 200 luminal Spidrex(®) fibres (PN200) supported 62% and 59% as much axon growth as autologous nerve graft controls at mid-conduit and distal nerve respectively. Furthermore, Spidrex(®) conduits displayed similar Schwann cell support and macrophage response to controls. At 12 weeks, animals implanted with PN200 conduits showed similar numbers of myelinated axons (81%) to controls, similar gastrocnemius muscle innervation, and similar hindpaw stance assessed by Catwalk footprint analysis. Plantar skin innervation was 73% of that of controls. PN200 Spidrex(®) conduits were also effective at bridging longer (11 and 13 mm) gaps. Our results show that Spidrex(®) conduits promote excellent axonal regeneration and function recovery, and may have potential for clinical application. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Peripheral nerve conduits: technology update

    Directory of Open Access Journals (Sweden)

    Arslantunali D

    2014-12-01

    Full Text Available D Arslantunali,1–3,* T Dursun,1,2,* D Yucel,1,4,5 N Hasirci,1,2,6 V Hasirci,1,2,7 1BIOMATEN, Center of Excellence in Biomaterials and Tissue Engineering, Middle East Technical University (METU, Ankara, Turkey; 2Department of Biotechnology, METU, Ankara, Turkey; 3Department of Bioengineering, Gumushane University, Gumushane, Turkey; 4Faculty of Engineering, Department of Medical Engineering, Acibadem University, Istanbul, Turkey; 5School of Medicine, Department of Histology and Embryology, Acibadem University, Istanbul, Turkey; 6Department of Chemistry, Faculty of Arts and Sciences, METU, Ankara, Turkey; 7Department of Biological Sciences, Faculty of Arts and Sciences, METU, Ankara, Turkey *These authors have contributed equally to this work Abstract: Peripheral nerve injury is a worldwide clinical problem which could lead to loss of neuronal communication along sensory and motor nerves between the central nervous system (CNS and the peripheral organs and impairs the quality of life of a patient. The primary requirement for the treatment of complete lesions is a tension-free, end-to-end repair. When end-to-end repair is not possible, peripheral nerve grafts or nerve conduits are used. The limited availability of autografts, and drawbacks of the allografts and xenografts like immunological reactions, forced the researchers to investigate and develop alternative approaches, mainly nerve conduits. In this review, recent information on the various types of conduit materials (made of biological and synthetic polymers and designs (tubular, fibrous, and matrix type are being presented. Keywords: peripheral nerve injury, natural biomaterials, synthetic biomaterials

  14. Measurement of pulmonary vascular resistance of Fontan candidates with pulmonary arterial distortion by means of pulmonary perfusion imaging

    International Nuclear Information System (INIS)

    Park, In-Sam; Mizukami, Ayumi; Tomimatsu, Hirofumi; Kondou, Chisato; Nakanishi, Toshio; Nakazawa, Makoto; Momma, Kazuo

    1998-01-01

    We measured the distribution of blood flow to the right (R) and left lung (L) by means of pulmonary perfusion imaging and calculated pulmonary vascular resistance (Rp) in 13 patients, whose right and left pulmonary artery pressures were different by 2 to 9 mmHg due to pulmonary arterial distortion (5 interruption, 8 stenosis). The right lung/left lung blood flow ratio was determined and from the ratio and the total pulmonary blood flow, which was determined using the Fick's principle, the absolute values of right and left pulmonary blood flow were calculated. Using the right and left pulmonary blood flow and the right and left pulmonary arterial pressures, right and left pulmonary vascular resistance were calculated, separately. Vascular resistance of the whole lung (Rp) was then calculated using the following equation. 1/(Rp of total lung)=1/(Rp of right lung)+1/(Rp of left lung). Rp calculated from this equation was 1.8+/-0.8 U·m 2 and all values were less than 3 U·m 2 (range 0.3-2.8). Rp estimated from the conventional method using the total pulmonary blood flow and pulmonary arterial pressures, without using the right/left blood flow ratio, ranging from 0.4 to 3.8 U·m 2 and 5 of 13 patients showed Rp>3 U·m 2 . All patients underwent Fontan operation successfully. These data indicated that this method is useful to estimate Rp and to determine the indication of Fontan operation in patients with pulmonary arterial distortions. (author)

  15. POROSITY OF THE WALL OF A NEUROLAC (R) NERVE CONDUIT HAMPERS NERVE REGENERATION

    NARCIS (Netherlands)

    Meek, Marcel F.; Den Dunnen, Wilfred F. A.

    2009-01-01

    One way to improve nerve regeneration and bridge longer nerve gaps may be the use of semipermeable/porous conduits. With porosity less biomaterial is used for the nerve conduit. We evaluated the short-term effects of porous Neurolac (R) nerve conduits for in vivo peripheral nerve regeneration. In 10

  16. Intracardiac foreign body resulting from a transmediastinal gunshot mimics an extracardiac foreign body: An image presentation

    Directory of Open Access Journals (Sweden)

    Hsun-Yi Fu

    2017-10-01

    Full Text Available A transmediastinal gunshot wound (TMGW is one of the most severe traumatic injuries, with a high mortality rate. Prompt diagnosis and emergency surgical intervention with or without cardiopulmonary bypass are usually required to save lives. We report a particular case of TMGW in which the computed tomography imaging findings indicated an extracardiac foreign body. However, intraoperative findings revealed an intracardiac foreign body, and urgent cardiopulmonary bypass was performed to remove the foreign body. We suggest that cardiopulmonary bypass should be on standby during an exploratory sternotomy for TMGW, when the trajectory of the bullet hints at a cardiac-penetrating injury according to imaging studies and the location of the bullet remains unaffected by the patient's postural changes.

  17. Frictional melting and stick-slip behavior in volcanic conduits

    Science.gov (United States)

    Kendrick, Jackie Evan; Lavallee, Yan; Hirose, Takehiro; di Toro, Giulio; Hornby, Adrian Jakob; Hess, Kai-Uwe; Dingwell, Donald Bruce

    2013-04-01

    Dome-building eruptions have catastrophic potential, with dome collapse leading to devastating pyroclastic flows with almost no precursory warning. During dome growth, the driving forces of the buoyant magma may be superseded by controls along conduit margins; where brittle fracture and sliding can lead to formation of lubricating cataclasite and gouge. Under extreme friction, pseudotachylyte may form at the conduit margin. Understanding the conduit margin processes is vital to understanding the continuation of an eruption and we postulate that pseudotachylyte generation could be the underlying cause of stick-slip motion and associated seismic "drumbeats", which are so commonly observed at dome-building volcanoes. This view is supported by field evidence in the form of pseudotachylytes identified in lava dome products at Soufrière Hills (Montserrat) and Mount St. Helens (USA). Both eruptions were characterised by repetitive, periodic seismicity and lava spine extrusion of highly viscous magma. High velocity rotary shear (HVR) experiments demonstrate the propensity for melting of the andesitic and dacitic material (from Soufrière Hills and Mount St. Helens respectively) at upper conduit stress conditions (HVR experiments which mimic rapid velocity fluctuations in stick-slip behavior demonstrate velocity-weakening behavior of melt, with a tendency for unstable slip. During ascent, magma may slip and undergo melting along the conduit margin. In the process the shear resistance of the slip zone is increased, acting as a viscous brake halting slip (the "stick" of stick-slip motion). Sufficient buoyancy-driven pressures from ascending magma below eventually overcome resistance to produce a rapid slip event (the "slip") along the melt-bearing slip zone, which is temporarily lubricated due to velocity-weakening. New magma below experiences the same slip event more slowly (as the magma decompresses) to produce a viscous brake and the process is repeated. This allows a

  18. Polymeric Nerve Conduits with Contact Guidance Cues Used in Nerve Repair

    Institute of Scientific and Technical Information of China (English)

    G DAI; X NIU; J YIN

    2016-01-01

    In the modern life, the nerve injury frequently happens due to mechanical, chemical or thermal accidents. In the trivial injuries, the peripheral nerves can regenerate on their own; however, in most of the cases the clinical treatments are required, where relatively large nerve injury gaps are formed. Currently, the nerve repair can be accomplished by direct suture when the injury gap is not too large;while the autologous nerve graft working as the gold standard of peripheral nerve injury treatment for nerve injuries with larger gaps. However, the direct suture is limited by heavy tension at the suture sites, and the autologous nerve graft also has the drawbacks of donor site morbidity and insufifcient donor tissue. Recently, artiifcial nerve conduits have been developed as an alternative for clinical nerve repair to overcome the limitations associated with the above treatments. In order to further improve the efifciency of nerve conduits, various guidance cues are incorporated, including physical cues, biochemical signals, as well as support cells. First, this paper reviewed the contact guidance cues applied in nerve conduits, such as lumen ifllers, multi-channels and micro-patterns on the inner surface. Then, the paper focused on the polymeric nerve conduits with micro inner grooves. The polymeric nerve conduits were fabricated using the phase inversion-based ifber spinning techniques. The smart spinneret with grooved die was designed in the spinning platform, while different spinning conditions, including flow rates, air-gap distances, and polymer concentrations, were adjusted to investigate the inlfuence of fabrication conditions on the geometry of nerve conduits. The inner groove size in the nerve conduits can be precisely controlled in our hollow ifber spinning process, which can work as the efifcient contact guidance cue for nerve regeneration.

  19. Fabrication and Optimization of Gelatin/ Nano Bioglass Conduits for Peripheral Nerve Regeneration

    Directory of Open Access Journals (Sweden)

    M. Foroutan Koudehi

    2014-07-01

    Full Text Available Introduction & Objective: Peripheral nerve injury is common in trauma patients and 4.5% of all soft-tissue injuries are accompanied by defects of peripheral nerve. Peripheral nerve injuries can lead to lifetime loss of function and permanent disfigurement. Designed conduits com-prised of natural and synthetic materials are now widely used in the construction of damaged tissues. The aim of this project was to prepare nanocomposite conduits from gelatin and bioglass for damaged peripheral nerve reconstruction. Materials & Methods: In this experimental study,compound water solution of gelatin and nano bioglass synthesized through sol gel method, was made. After preparing the solution, special mandrels were dipped in solution several times and freeze dried in order to be emptied of wa-ter via sublimation. The conduits had the following dimensions: internal diameter: 1.6 mm, outside diameter: 2.2 mm and length about 12 mm. In order to evaluate the biocompatibility of conduits we used cytotoxicity test by Chinese ovary cells and MTT assay by Miapaca-2 (pancreatic cancer cell line. Results: The prepared nano bioglass and conduits were characterized using transmission elec-tron microscopy, scanning electron microscopy, fourier transformed infrared spectroscopy and X-ray diffraction. Results of biocompatibility test showed no sign of cytotoxicity and cells were found to be attached to the pore walls offered by the conduits. Conclusion: According to the results, nano bioglass conduits could be a good candidate for peripheral nerve regeneration. (Sci J Hamadan Univ Med Sci 2014; 21 (2:152-160

  20. Midterm performance of a novel restorative pulmonary valved conduit: preclinical results

    NARCIS (Netherlands)

    Soliman, Osama I.; Miyazaki, Yosuke; Abdelghani, Mohammad; Brugmans, Marieke; Witsenburg, Maarten; Onuma, Yoshinobu; Cox, Martijn; Serruys, Patrick W.

    2017-01-01

    Aims: The Xeltis bioabsorbable pulmonary valved conduit (XPV), designed to guide functional restoration of patients' own tissue, is potentially more durable than current pulmonary bioprosthetic valves/valved conduits. The aim of this study was to assess the haemodynamic performance of the novel XPV

  1. Treatment of right ventricle to pulmonary artery conduit stenosis in infants with hypoplastic left heart syndrome.

    Science.gov (United States)

    Münsterer, Andrea; Kasnar-Samprec, Jelena; Hörer, Jürgen; Cleuziou, Julie; Eicken, Andreas; Malcic, Ivan; Lange, Rüdiger; Schreiber, Christian

    2013-09-01

    To determine the incidence of right ventricle-to-pulmonary artery (RV-PA) conduit stenosis after the Norwood I operation in patients with hypoplastic left heart syndrome (HLHS), and to determine whether the treatment strategy of RV-PA conduit stenosis has an influence on interstage and overall survival. Ninety-six patients had a Norwood operation with RV-PA conduit between 2002 and 2011. Details of reoperations/interventions due to conduit obstruction prior to bidirectional superior cavopulmonary anastomosis (BSCPA) were collected. Overall pre-BSCPA mortality was 17%, early mortality after Norwood, 6%. Early angiography was performed in 34 patients due to desaturation at a median of 8 days after the Norwood operation. Fifteen patients (16%) were diagnosed with RV-PA conduit stenosis that required treatment. The location of the conduit stenosis was significantly different in the patients with non-ringed (proximal) and the patients with ring-enforced conduit (distal), P = 0.004. In 6 patients, a surgical revision of the conduit was performed; 3 of them died prior to BSCPA. Another 6 patients had a stent implantation and 3 were treated with balloon dilatation followed by a BSCPA in the subsequent 2 weeks. All patients who were treated interventionally for RV-PA conduit obstruction had a successful BSCPA. Patients who received a surgical RV-PA conduit revision had a significantly higher interstage (P = 0.044) and overall mortality (P = 0.011) than those who received a stent or balloon dilatation of the stenosis followed by an early BSCPA. RV-PA conduit obstruction after Norwood I procedure in patients with HLHS can be safely and effectively treated by stent implantation, balloon dilatation and early BSCPA. Surgical revision of the RV-PA conduit can be reserved for patients in whom an interventional approach fails, and an early BSCPA is not an option.

  2. Collagen-coated polylactic-glycolic acid (PLGA) seeded with neural-differentiated human mesenchymal stem cells as a potential nerve conduit.

    Science.gov (United States)

    Sulong, Ahmad Fadzli; Hassan, Nur Hidayah; Hwei, Ng Min; Lokanathan, Yogeswaran; Naicker, Amaramalar Selvi; Abdullah, Shalimar; Yusof, Mohd Reusmaazran; Htwe, Ohnmar; Idrus, Ruszymah Bt Hj; Haflah, Nor Hazla Mohamed

    2014-01-01

    Autologous nerve grafts to bridge nerve gaps pose various drawbacks. Nerve tissue engineering to promote nerve regeneration using artificial neural conduits has emerged as a promising alternative. To develop an artificial nerve conduit using collagen-coated polylactic-glycolic acid (PLGA) and to analyse the survivability and propagating ability of the neuro-differentiated human mesenchymal stem cells in this conduit. The PLGA conduit was constructed by dip-molding method and coated with collagen by immersing the conduit in collagen bath. The ultra structure of the conduits were examined before they were seeded with neural-differentiated human mesenchymal stem cells (nMSC) and implanted sub-muscularly on nude mice thighs. The non-collagen-coated PLGA conduit seeded with nMSC and non-seeded non-collagen-coated PLGA conduit were also implanted for comparison purposes. The survivability and propagation ability of nMSC was studied by histological and immunohistochemical analysis. The collagen-coated conduits had a smooth inner wall and a highly porous outer wall. Conduits coated with collagen and seeded with nMSCs produced the most number of cells after 3 weeks. The best conduit based on the number of cells contained within it after 3 weeks was the collagen-coated PLGA conduit seeded with neuro-transdifferentiated cells. The collagen-coated PLGA conduit found to be suitable for attachment, survival and proliferation of the nMSC. Minimal cell infiltration was found in the implanted conduits where nearly all of the cells found in the cell seeded conduits are non-mouse origin and have neural cell markers, which exhibit the biocompatibility of the conduits. The collagen-coated PLGA conduit is biocompatible, non-cytotoxic and suitable for use as artificial nerve conduits.

  3. Development of a comprehensive inventory management system for underground fiber optic conduits.

    Science.gov (United States)

    2013-03-01

    Major State Departments of Transportation operate and maintain networks of thousands of miles of conduits, many : carrying fiber optic cables that are vital to State communication systems. These conduits are located alongside or : across highways and...

  4. Coronary atherosclerosis burden is not advanced in patients with β-thalassemia despite premature extracardiac atherosclerosis: a coronary artery calcium score and carotid intima-media thickness study.

    Science.gov (United States)

    Hahalis, George; Zacharioglou, Evangelia; Xanthopoulou, Ioanna; Koniari, Ioanna; Kalogeropoulou, Chistina; Tsota, Irene; Rigopoulou, Aspasia; Diamantopoulos, Athanasios; Gkizas, Vasilios; Davlouros, Periklis; Akinosoglou, Karolina; Leopoulou, Marianna; Gogos, Charalampos; Alexopoulos, Dimitrios

    2016-02-01

    Thalassemic patients demonstrate an increased rate of extracardiac vascular complications and increased carotid wall intima-media thickness (cIMT), but very low prevalence of coronary artery disease (CAD). We investigated the atheroma burden by assessing the coronary artery calcium (CAC) and cIMT in these patients. We examined 37 patients with β-thalassemia and 150 healthy control volunteers with multi-detector computer tomography (CT) and ultrasonography to determine CAC score and cIMT, respectively. Propensity score matching (C-statistic: 0.88; 95% CI: 0.83-0.93) resulted in 27 pairs of patients; severe CAC was observed in 2 (7.4%) and 0 of β-thalassemia patients and healthy volunteers respectively (P = 0.5). Median calcium score was 0 (0-0) in β-thalassemia patients and 0 (0-4) in healthy volunteers (P = 0.8). Median intima-media thickness was higher in β-thalassemia patients compared to control group [0.45 (0.06-0.65) vs. 0.062 (0.054-0.086); P = 0.04]. Patients with β-thalassemia in comparison with healthy control subjects exhibit similar CAC score and increased cIMT. Our findings indicate a disparate rate of progression of atherosclerosis between coronary and extracardiac arteries in these patients lending support to the epidemiological evidence.

  5. Treatment of Children with Protein – Losing Enteropathy After Fontan and Other Complex Congenital Heart Disease Procedures in Condition with Limited Human and Technical Resources

    OpenAIRE

    Bejiqi, Ramush; Retkoceri, Ragip; Zeka, Naim; Bejiqi, Hana; Vuqiterna, Armend; Maloku, Arlinda

    2014-01-01

    Background Protein-losing enteropathy (PLE) is a disorder characterized by abnormal and often profound enteric protein loss. It’s relatively uncommon complication of Fontan and other complex congenital heart disease (CCHD) procedures. Because of the complexity and rarity of this disease process, the pathogenesis and pathophysiology of protein-losing enteropathy remain poorly understood, and attempts at treatment seldom yield long-term success. Aim of presentation is to describe single centre ...

  6. In vivo visualization of microneedle conduits in human skin using laser scanning microscopy

    International Nuclear Information System (INIS)

    Bal, S; Kruithof, A C; Bouwstra, J; Liebl, H; Tomerius, M; Lademann, J; Meinke, M

    2010-01-01

    Solid microneedles enhance the penetration of drugs into the viable skin but little is known about the geometry of the conduits in vivo. Therefore, laser scanning microscopy was used to visualize the conduits of a microneedle system with needles at a length of 300 μm in 6 healthy subjects over a period of time. The model drug, a fluorescent dye was applied before and after piercing. Laser scanning microscopy was evaluated as being an excellent method to monitor the geometry and closure of the conduits over time. The used microneedle system was evaluated as suitable to enhance the transport of model drugs into the viable epidermis without bleeding and a short closure time of the conduits at the skin surface

  7. In vivo visualization of microneedle conduits in human skin using laser scanning microscopy

    Science.gov (United States)

    Bal, S.; Kruithof, A. C.; Liebl, H.; Tomerius, M.; Bouwstra, J.; Lademann, J.; Meinke, M.

    2010-03-01

    Solid microneedles enhance the penetration of drugs into the viable skin but little is known about the geometry of the conduits in vivo. Therefore, laser scanning microscopy was used to visualize the conduits of a microneedle system with needles at a length of 300 μm in 6 healthy subjects over a period of time. The model drug, a fluorescent dye was applied before and after piercing. Laser scanning microscopy was evaluated as being an excellent method to monitor the geometry and closure of the conduits over time. The used microneedle system was evaluated as suitable to enhance the transport of model drugs into the viable epidermis without bleeding and a short closure time of the conduits at the skin surface.

  8. Visualization of conduit-matrix conductivity differences in a karst aquifer using time-lapse electrical resistivity

    Science.gov (United States)

    Meyerhoff, Steven B.; Karaoulis, Marios; Fiebig, Florian; Maxwell, Reed M.; Revil, André; Martin, Jonathan B.; Graham, Wendy D.

    2012-12-01

    In the karstic upper Floridan aquifer, surface water flows into conduits of the groundwater system and may exchange with water in the aquifer matrix. This exchange has been hypothesized to occur based on differences in discharge at the Santa Fe River Sink-Rise system, north central Florida, but has yet to be visualized using any geophysical techniques. Using electrical resistivity tomography, we conducted a time-lapse study at two locations with mapped conduits connecting the Santa Fe River Sink to the Santa Fe River Rise to study changes of electrical conductivity during times of varying discharge over a six-week period. Our results show conductivity differences between matrix, conduit changes in resistivity occurring through time at the locations of mapped karst conduits, and changes in electrical conductivity during rainfall infiltration. These observations provide insight into time scales and matrix conduit conductivity differences, illustrating how surface water flow recharged to conduits may flow in a groundwater system in a karst aquifer.

  9. Scientific Results of Conduit Drilling in the Unzen Scientific Drilling Project (USDP

    Directory of Open Access Journals (Sweden)

    Kozo Uto

    2005-09-01

    Full Text Available Abstract Directional drilling at Unzen Volcano in Japan duringmid of 2004 penetrated the magma conduit and successfullyrecovered samples of the lava dike that is believed to havefed the 1991–1995 eruption. The dike was sampled about1.3 km below the volcano’s summit vent and is intrudedinto a broader conduit zone that is 0.5 km wide. This zoneconsists of multiple older lava dikes and pyroclastic veinsand has cooled to less than 200˚C. The lava dike sample wasunexpectedly altered, suggesting that circulation of hydrothermalfluids rapidly cools the conduit region of even veryactive volcanoes. It is likely that seismic signals monitoredprior to emergence of the lava dome reflected fracturing ofthe country rocks, caused by veining as volatiles escapedpredominantly upward, not outward, from the rising magma.Geophysical and geological investigation of cuttings andcore samples from the conduit and of bore-hole logging datacontinues.

  10. AngioVac Aspiration for Paradoxical Emboli Protection through a Fenestrated Fontan During Central Venous Thrombus Manipulation

    Energy Technology Data Exchange (ETDEWEB)

    Al-Hakim, Ramsey, E-mail: ralhakim@mednet.ucla.edu [University of California, Department of Radiology, Division of Interventional Radiology (United States); Patel, Komal, E-mail: kdpatel@mednet.ucla.edu [University of California, Department of Anesthesiology, Division of Cardiothoracic Anesthesiology (United States); Moriarty, John M., E-mail: jmoriarty@mednet.ucla.edu [University of California, Department of Radiology, Division of Interventional Radiology (United States)

    2015-06-15

    This case reports describes a 39-year-old female with a history of surgically repaired hypoplastic left heart syndrome who presented with a left peripherally inserted central catheter (PICC) with associated large volume subclavian and brachiocephalic vein thrombus. Due to the presence of a right-to-left shunt via a fenestrated Fontan, there was clinical concern for a paradoxical embolism during removal of the PICC. The AngioVac aspiration system was successfully utilized to aspirate thromboemboli from the level of the proximal Glenn shunt during manipulation and removal of the PICC. This is the first reported case to demonstrate the safe and effective use of the AngioVac aspiration system for protection of paradoxical emboli through a cardiac right-to-left shunt during a procedure at high risk for thromboembolism.

  11. Explosive device of conduit using Ti Ni alloy

    Directory of Open Access Journals (Sweden)

    A. Yu. Kolobov

    2014-01-01

    Full Text Available Presently, materials have been developed which are capable at changing temperate to return significant inelastic deformations, exhibit rubber-like elasticity, convert heat into mechanical work, etc. The aggregate of these effects is usually called the shape memory effect.At present a great number of compounds and alloys with a shape memory effect has been known.These are alloys based on titanium nickelide (TiNi, copper-based alloys (Cu-Al, Cu-Sn, Cu-Al-Ni, Cu-Zn-Si, etc., gold and silver (Ag-Cd, Au-Ag-Cd, Au-Cd-Cu, Au-Zn-Cu, etc., manganese (Mn-Cr, Fe-Cu, Mn-Cu-Ni, Mn-Cu-Zr, Mn-Ni, etc., iron (Fe-Mn, Fe-Ni, Fe-Al, etc., and other compounds.The alloys based on titanium nickelide (nitinol are the most widely used.Alloys with shape memory effect find various applications in engineering and medicine, namely connecting devices, actuators, transformable design, multipurpose medical implants, etc.There is a task of breaking fuel conduit during separating the spacecraft from the rocket in space technology.The paper examines the procedure for design calculation of the separating device of conduit with the use of Ti-Ni alloy. This device can be used instead of the pyro-knives.The device contains two semi-rings from Ti-Ni alloy. In the place of break on the conduit an annular radius groove is made.At a temperature of martensite passage the semi-rings undergo deformation and in the strained state are set in the device. With heating to the temperature of the austenitic passage of bushing macro-deformation the energy stored by the nitinol bushing is great enough to break the conduit on the neck.The procedures of design calculation and response time of device are given.

  12. Peripheral nerve regeneration with conduits: use of vein tubes.

    Science.gov (United States)

    Sabongi, Rodrigo Guerra; Fernandes, Marcela; Dos Santos, João Baptista Gomes

    2015-04-01

    Treatment of peripheral nerve injuries remains a challenge to modern medicine due to the complexity of the neurobiological nerve regenerating process. There is a greater challenge when the transected nerve ends are not amenable to primary end-to-end tensionless neurorraphy. When facing a segmental nerve defect, great effort has been made to develop an alternative to the autologous nerve graft in order to circumvent morbidity at donor site, such as neuroma formation, scarring and permanent loss of function. Tubolization techniques have been developed to bridge nerve gaps and have been extensively studied in numerous experimental and clinical trials. The use of a conduit intends to act as a vehicle for moderation and modulation of the cellular and molecular ambience for nerve regeneration. Among several conduits, vein tubes were validated for clinical application with improving outcomes over the years. This article aims to address the investigation and treatment of segmental nerve injury and draw the current panorama on the use of vein tubes as an autogenous nerve conduit.

  13. Peripheral nerve regeneration with conduits: use of vein tubes

    Directory of Open Access Journals (Sweden)

    Rodrigo Guerra Sabongi

    2015-01-01

    Full Text Available Treatment of peripheral nerve injuries remains a challenge to modern medicine due to the complexity of the neurobiological nerve regenerating process. There is a greater challenge when the transected nerve ends are not amenable to primary end-to-end tensionless neurorraphy. When facing a segmental nerve defect, great effort has been made to develop an alternative to the autologous nerve graft in order to circumvent morbidity at donor site, such as neuroma formation, scarring and permanent loss of function. Tubolization techniques have been developed to bridge nerve gaps and have been extensively studied in numerous experimental and clinical trials. The use of a conduit intends to act as a vehicle for moderation and modulation of the cellular and molecular ambience for nerve regeneration. Among several conduits, vein tubes were validated for clinical application with improving outcomes over the years. This article aims to address the investigation and treatment of segmental nerve injury and draw the current panorama on the use of vein tubes as an autogenous nerve conduit.

  14. The grain-size distribution of pyroclasts: Primary fragmentation, conduit sorting or abrasion?

    Science.gov (United States)

    Kueppers, U.; Schauroth, J.; Taddeucci, J.

    2013-12-01

    Explosive volcanic eruptions expel a mixture of pyroclasts and lithics. Pyroclasts, fragments of the juvenile magma, record the state of the magma at fragmentation in terms of porosity and crystallinity. The grain size distribution of pyroclasts is generally considered to be a direct consequence of the conditions at magma fragmentation that is mainly driven by gas overpressure in bubbles, high shear rates, contact with external water or a combination of these factors. Stress exerted by any of these processes will lead to brittle fragmentation by overcoming the magma's relaxation timescale. As a consequence, most pyroclasts exhibit angular shapes. Upon magma fragmentation, the gas pyroclast mixture is accelerated upwards and eventually ejected from the vent. The total grain size distribution deposited is a function of fragmentation conditions and transport related sorting. Porous pyroclasts are very susceptible to abrasion by particle-particle or particle-conduit wall interaction. Accordingly, pyroclastic fall deposits with angular clasts should proof a low particle abrasion upon contact to other surfaces. In an attempt to constrain the degree of particle interaction during conduit flow, monomodal batches of washed pyroclasts have been accelerated upwards by rapid decompression and subsequently investigated for their grain size distribution. In our set-up, we used a vertical cylindrical tube without surface roughness as conduit. We varied grain size (0.125-0.25; 0.5-1; 1-2 mm), porosity (0; 10; 30 %), gas-particle ratio (10 and 40%), conduit length (10 and 28 cm) and conduit diameter (2.5 and 6 cm). All ejected particles were collected after settling at the base of a 3.3 m high tank and sieved at one sieve size below starting size (half-Φ). Grain size reduction showed a positive correlation with starting grain size, porosity and overpressure at the vent. Although milling in a volcanic conduit may take place, porous pyroclasts are very likely to be a primary product

  15. Free-boundary models of a meltwater conduit

    KAUST Repository

    Dallaston, Michael C.

    2014-08-01

    © 2014 AIP Publishing LLC. We analyse the cross-sectional evolution of an englacial meltwater conduit that contracts due to inward creep of the surrounding ice and expands due to melting. Making use of theoretical methods from free-boundary problems in Stokes flow and Hele-Shaw squeeze flow we construct an exact solution to the coupled problem of external viscous creep and internal heating, in which we adopt a Newtonian approximation for ice flow and an idealized uniform heat source in the conduit. This problem provides an interesting variant on standard free-boundary problems, coupling different internal and external problems through the kinematic condition at the interface. The boundary in the exact solution takes the form of an ellipse that may contract or expand (depending on the magnitudes of effective pressure and heating rate) around fixed focal points. Linear stability analysis reveals that without the melting this solution is unstable to perturbations in the shape. Melting can stabilize the interface unless the aspect ratio is too small; in that case, instabilities grow largest at the thin ends of the ellipse. The predictions are corroborated with numerical solutions using boundary integral techniques. Finally, a number of extensions to the idealized model are considered, showing that a contracting circular conduit is unstable to all modes of perturbation if melting occurs at a uniform rate around the boundary, or if the ice is modelled as a shear-thinning fluid.

  16. Improved axonal regeneration of transected spinal cord mediated by multichannel collagen conduits functionalized with neurotrophin-3 gene.

    Science.gov (United States)

    Yao, L; Daly, W; Newland, B; Yao, S; Wang, W; Chen, B K K; Madigan, N; Windebank, A; Pandit, A

    2013-12-01

    Functionalized biomaterial scaffolds targeted at improving axonal regeneration by enhancing guided axonal growth provide a promising approach for the repair of spinal cord injury. Collagen neural conduits provide structural guidance for neural tissue regeneration, and in this study it is shown that these conduits can also act as a reservoir for sustained gene delivery. Either a G-luciferase marker gene or a neurotrophin-3-encoding gene, complexed to a non-viral, cyclized, PEGylated transfection vector, was loaded within a multichannel collagen conduit. The complexed genes were then released in a controlled fashion using a dual release system both in vitro and in vivo. For evaluation of their biological performance, the loaded conduits were implanted into the completely transected rat thoracic spinal cord (T8-T10). Aligned axon regeneration through the channels of conduits was observed one month post-surgery. The conduits delivering neurotrophin-3 polyplexes resulted in significantly increased neurotrophin-3 levels in the surrounding tissue and a statistically higher number of regenerated axons versus the control conduits (P<0.05). This study suggests that collagen neural conduits delivering a highly effective non-viral therapeutic gene may hold promise for repair of the injured spinal cord.

  17. A novel balloon assisted two-stents telescoping technique for repositioning an embolized stent in the pulmonary conduit.

    Science.gov (United States)

    Kobayashi, Daisuke; Gowda, Srinath T; Forbes, Thomas J

    2014-08-01

    A 9-year-old male, with history of pulmonary atresia and ventricular septal defect, status post complete repair with a 16 mm pulmonary homograft in the right ventricular outflow tract (RVOT) underwent 3110 Palmaz stent placement for conduit stenosis. Following deployment the stent embolized proximally into the right ventricle (RV). We undertook the choice of repositioning the embolized stent into the conduit with a transcatheter approach. Using a second venous access, the embolized stent was carefully maneuvered into the proximal part of conduit with an inflated Tyshak balloon catheter. A second Palmaz 4010 stent was deployed in the distal conduit telescoping through the embolized stent. The Tyshak balloon catheter was kept inflated in the RV to stabilize the embolized stent in the proximal conduit until it was successfully latched up against the conduit with the deployment of the overlapping second stent. One year later, he underwent Melody valve implantation in the pre-stented conduit relieving conduit insufficiency. This novel balloon assisted two-stents telescoping technique is a feasible transcatheter option to secure an embolized stent from the RV to the RVOT. © 2014 Wiley Periodicals, Inc.

  18. Treatment of Children with Protein – Losing Enteropathy After Fontan and Other Complex Congenital Heart Disease Procedures in Condition with Limited Human and Technical Resources

    Science.gov (United States)

    Bejiqi, Ramush; Retkoceri, Ragip; Zeka, Naim; Bejiqi, Hana; Vuqiterna, Armend; Maloku, Arlinda

    2014-01-01

    Background Protein-losing enteropathy (PLE) is a disorder characterized by abnormal and often profound enteric protein loss. It’s relatively uncommon complication of Fontan and other complex congenital heart disease (CCHD) procedures. Because of the complexity and rarity of this disease process, the pathogenesis and pathophysiology of protein-losing enteropathy remain poorly understood, and attempts at treatment seldom yield long-term success. Aim of presentation is to describe single centre experience in diagnosis, evaluation, management and treatment of children with protein-losing enteropathy after Fontan and other CCHD procedures in the current era and in centre with limited human and technical resources, follows with a comprehensive review of protein-losing enteropathy publications, and concludes with suggestions for prevention and treatment. Material and methodology Retrospectively we analyzed patients with CCHD and protein-losing enteropathy in our institution, starting from January 2000 to December 2012. The including criteria were age between two and 17 years, to have a complex congenital heart disease and available complete documentation of cardiac surgery under cardiopulmonary bypass. Results Of all patients we evaluated 18 cases with protein-losing enteropathy, aged 6 to 19 years (mean 14±9); there were three children who had undergone screening procedure for D-transposition, one Tetralogy of Fallot, and remaining 14 patients had undergone Fontan procedures; (anatomic diagnosis are: six with tricuspid atresia, seven with d-transposition, double outlet right ventricle and pulmonary atresia and two with hypoplastic left heart syndrome). The diagnosis of protein-losing enteropathy was made at median age of 5.6 years, ranging from 13 months to 15 years. Diagnosis was made using alpha 1-antitrypsin as a gold marker in stool. By physical examination in 14 patients edema was found, in three ascites, and six patients had pleural effusion. Laboratory findings

  19. Free-boundary models of a meltwater conduit

    KAUST Repository

    Dallaston, Michael C.; Hewitt, Ian J.

    2014-01-01

    © 2014 AIP Publishing LLC. We analyse the cross-sectional evolution of an englacial meltwater conduit that contracts due to inward creep of the surrounding ice and expands due to melting. Making use of theoretical methods from free-boundary problems

  20. Phase separation phenomena in branching conduits. Topical report Dec 78-Dec 81

    International Nuclear Information System (INIS)

    Saba, N.; Lahey, R.T. Jr.

    1982-03-01

    The analysis of Light Water Reactor (LWR) Loss-of-Coolant Accidents (LOCA's) requires that one be able to accurately calculate the two-phase flow splits in complex, branching conduits. The purpose of this study is to provide a general method for calculating the phase separation in a branching conduit. The degree of phase separation of a two-phase (air/water) mixture flowing through a plexiglas tee test section was measured. In addition, flow visualization, using high speed photography, was performed. The experimental design considerations, error analysis and the dependence of the observed phase separation on global parameters, such as inlet quality, mass flux and separation angle, are discussed. The pressure gradients were measured along the various conduits and the differential pressure was obtained at the tee junction by extrapolation. It was found that the degree of phase separation was quite pronounced, with the vapor phase preferentially separating into the branch. Using these data, a physically-based empirical model was developed with which to calculate the phasic distribution of a subsonic two-phase mixture in the downstream branches of a branching conduit

  1. Biocarbon urinary conduit: laboratory experience and clinical applications.

    Science.gov (United States)

    Kobashi, L I; Raible, D A

    1980-07-01

    A new urinary conduit utilizing pure vitreous carbon has been used successfully in dogs. Pure carbon appears to be inert with respect to urine and urothelium. Lack of urinary salt encrustation on the exposed surface provides a well-functioning urinary conduit for vesical drainage. Twenty-one vesicostomies were performed in dogs. Careful follow-up and histologic studies of removed specimens were done to establish the biocompatibility of pure carbon. All vesicostomies functioned well. A description of the device, protocol, and results of laboratory experimentation are outlined. The surgical procedure is explained in detail. Results encourage the clinical trial of these devices in humans. Indications include patients with neurogenic vesicla dysfunction and those with total urinary incontinence, both of which require permanent indwelling catheters.

  2. Pregnancy in complex CHD: focus on patients with Fontan circulation and patients with a systemic right ventricle.

    Science.gov (United States)

    Khan, Abigail; Kim, Yuli Y

    2015-12-01

    The majority of children with congenital heart disease (CHD) now survive into adulthood, and many women with CHD want to pursue pregnancy. Pregnancy represents a complex issue for the CHD care provider. It requires balancing the interests of the woman against the risk to her health during pregnancy, while also factoring in the long-term risks to her health and the risk to her fetus. Our knowledge about this subject has been historically limited by lack of data regarding the outcome of pregnancy in CHD; however, in recent years, more data have begun to emerge. In this review, we will summarise what is known about risk assessment in pregnant CHD patients. We provide a framework for healthcare providers managing pregnancy in this population, with focus on the systemic right ventricle and the Fontan operation.

  3. Uncovering Offshore Financial Centers: Conduits and Sinks in the Global Corporate Ownership Network.

    Science.gov (United States)

    Garcia-Bernardo, Javier; Fichtner, Jan; Takes, Frank W; Heemskerk, Eelke M

    2017-07-24

    Multinational corporations use highly complex structures of parents and subsidiaries to organize their operations and ownership. Offshore Financial Centers (OFCs) facilitate these structures through low taxation and lenient regulation, but are increasingly under scrutiny, for instance for enabling tax avoidance. Therefore, the identification of OFC jurisdictions has become a politicized and contested issue. We introduce a novel data-driven approach for identifying OFCs based on the global corporate ownership network, in which over 98 million firms (nodes) are connected through 71 million ownership relations. This granular firm-level network data uniquely allows identifying both sink-OFCs and conduit-OFCs. Sink-OFCs attract and retain foreign capital while conduit-OFCs are attractive intermediate destinations in the routing of international investments and enable the transfer of capital without taxation. We identify 24 sink-OFCs. In addition, a small set of five countries - the Netherlands, the United Kingdom, Ireland, Singapore and Switzerland - canalize the majority of corporate offshore investment as conduit-OFCs. Each conduit jurisdiction is specialized in a geographical area and there is significant specialization based on industrial sectors. Against the idea of OFCs as exotic small islands that cannot be regulated, we show that many sink and conduit-OFCs are highly developed countries.

  4. Novel drug delivering conduit for peripheral nerve regeneration

    Science.gov (United States)

    Labroo, Pratima; Shea, Jill; Edwards, Kyle; Ho, Scott; Davis, Brett; Sant, Himanshu; Goodwin, Isak; Gale, Bruce; Agarwal, Jay

    2017-12-01

    Objective. This paper describes the design of a novel drug delivery apparatus integrated with a poly lactic-co-glycolic acid (PLGA) based nerve guide conduit for controlled local delivery of nerve growth factor (NGF) and application in peripheral nerve gap injury. Approach. An NGF dosage curve was acquired to determine the minimum in vitro concentration for optimal neurite outgrowth of dorsal root ganglion (DRG) cells; PLGA based drug delivery devices were then designed and tested in vitro and in vivo across 15 mm rat sciatic nerve gap injury model. Main results. The drug delivery nerve guide was able to release NGF for 28 d at concentrations (0.1-10 ng ml-1) that were shown to enhance DRG neurite growth. Furthermore, the released NGF was bioactive and able to enhance DRG neurite growth. Following these tests, optimized NGF-releasing nerve conduits were implanted across 15 mm sciatic nerve gaps in a rat model, where they demonstrated significant myelination and muscle innervation in vivo as compared to empty nerve conduits (p  design process and provides increased versatility for releasing a variety of different growth factors. This innovative device has the potential for broad applicability and allows for easier customization to change the type of drugs and dosage of individual drugs without devising a completely new biomaterial-drug conjugate each time.

  5. Havery Mudd 2014-2015 Computer Science Conduit Clinic Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Aspesi, G [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Bai, J [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Deese, R [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Shin, L [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2015-05-12

    Conduit, a new open-source library developed at Lawrence Livermore National Laboratories, provides a C++ application programming interface (API) to describe and access scientific data. Conduit’s primary use is for inmemory data exchange in high performance computing (HPC) applications. Our team tested and improved Conduit to make it more appealing to potential adopters in the HPC community. We extended Conduit’s capabilities by prototyping four libraries: one for parallel communication using MPI, one for I/O functionality, one for aggregating performance data, and one for data visualization.

  6. SQUG cable tray and conduit evaluation procedure

    International Nuclear Information System (INIS)

    Smith, P.D.; Eder, S.J.; Conoscente, J.P.

    1990-01-01

    Cable tray and conduit systems for electrical cables are a common feature and industrial facilities. They have an excellent performance history in past strong earthquake, even though they are rarely designed for earthquakes. Considerable data have been gathered on their performance in earthquakes and in shake table testing. The data have been used to develop a procedure for the verification of the seismic adequacy of cable tray and conduit systems in operating nuclear plants. The procedure is discussed in this paper. It will result in substantial savings, such as reduced engineering effort, fewer modifications of existing hardware, and simpler documentation, relative to alternate procedures like dynamic analysis of shake table testing. The procedure ensures safety-function in a unique manner since the methodology used to develop it (1) is based on a large body of historical data and (2) uses a relative approach of ensuring that nuclear plant systems will perform at least as well as systems that performed well in past earthquakes. (orig.)

  7. Structures and lithofacies of inferred silicic conduits in the Paraná-Etendeka LIP, southernmost Brazil

    Science.gov (United States)

    Simões, M. S.; Lima, E. F.; Sommer, C. A.; Rossetti, L. M. M.

    2018-04-01

    Extensive silicic units in the Paraná-Etendeka LIP have been long interpreted as pyroclastic density currents (rheomorphic ignimbrites) derived from the Messum Complex in Namibia. In recent literature, however, they have been characterized as effusive lava flows and domes. In this paper we describe structures and lithofacies related to postulated silicic lava feeder conduits at Mato Perso, São Marcos and Jaquirana-Cambará do Sul areas in southern Brazil. Inferred conduits are at least 15-25 m in width and the lithofacies include variably vesicular monomictic welded and non-welded breccias in the margins to poorly vesicular, banded, spherulitic and microfractured vitrophyres in the central parts. Flat-lying coherent vitrophyres and massive obsidian are considered to be the subaerial equivalents of the conduits. Large-scale, regional tectonic structures in southern Brazil include the NE-SW aligned Porto Alegre Suture, Leão and Açotea faults besides the Antas Lineament, a curved tectonic feature accompanying the bed of Antas river. South of the Antas Lineament smaller-scale, NW-SE lineaments limit the exposure areas of the inferred conduits. NE-SW and subordinate NW-SE structures within this smaller-scale lineaments are represented by the main postulated conduit outcrops and are parallel to the dominant sub-vertical banding in the widespread banded vitrophyre lithofacies. Upper lava flows display flat-lying foliation, pipe-like and spherical vesicles and have better developed microlites. Petrographic characteristics of the silicic vitrophyres indicate that crystal-poor magmas underwent distinct cooling paths for each inferred conduit area. The vitrophyre chemical composition is defined by the evolution of trachydacitic/dacitic vitrophyres with 62-65 wt% SiO2 to rhyodacite and rhyolite with 66-68 wt% SiO2. The more evolved rocks are assigned to the latest intrusive grey vitrophyre outcropping in the center of the conduits. Degassing pathways formed during

  8. Investigation of entrance length in circular and noncircular conduits by computational fluid dynamics simulation

    Directory of Open Access Journals (Sweden)

    Pimpun Tongpun

    2014-08-01

    Full Text Available This study estimated entrance length of circular and noncircular conduits, including circle, triangle, square and hexagon cross-sectional conduit, by using computational fluid dynamics (CFD. For simulation condition, the length of noncircular conduit was 10 m and the hydraulic diameter was 0.2 m. The laminar flow with Reynolds number of 500 and turbulent flow with Reynolds number of 50,000 were applied to investigate water flow in conduits. The governing equations were solved iteratively by using ANSYS FLUENT 14.0. For turbulent flow simulation, standard k-epsilon and RNG k-epsilon model were employed to simulate turbulence. The preliminary results were validated by comparison with theoretical data. At first, grid independency was evaluated to optimize the model. Norm* was employed to investigate the entrance length, which is related to velocity. The simulated results revealed that the entrance length for laminar flow was longer than turbulent flow.

  9. A biosynthetic nerve guide conduit based on silk/SWNT/fibronectin nanocomposite for peripheral nerve regeneration.

    Directory of Open Access Journals (Sweden)

    Fatemeh Mottaghitalab

    Full Text Available As a contribution to the functionality of nerve guide conduits (NGCs in nerve tissue engineering, here we report a conduit processing technique through introduction and evaluation of topographical, physical and chemical cues. Porous structure of NGCs based on freeze-dried silk/single walled carbon nanotubes (SF/SWNTs has shown a uniform chemical and physical structure with suitable electrical conductivity. Moreover, fibronectin (FN containing nanofibers within the structure of SF/SWNT conduits produced through electrospinning process have shown aligned fashion with appropriate porosity and diameter. Moreover, fibronectin remained its bioactivity and influenced the adhesion and growth of U373 cell lines. The conduits were then implanted to 10 mm left sciatic nerve defects in rats. The histological assessment has shown that nerve regeneration has taken places in proximal region of implanted nerve after 5 weeks following surgery. Furthermore, nerve conduction velocities (NCV and more myelinated axons were observed in SF/SWNT and SF/SWNT/FN groups after 5 weeks post implantation, indicating a functional recovery for the injured nerves. With immunohistochemistry, the higher S-100 expression of Schwann cells in SF/SWNT/FN conduits in comparison to other groups was confirmed. In conclusion, an oriented conduit of biocompatible SF/SWNT/FN has been fabricated with acceptable structure that is particularly applicable in nerve grafts.

  10. The influence of a static, homogenous magnetic field (B=320mT) on extracardiac pulsations of Tenebrio molitor pupae (Coleoptera: Tenebrionidae).

    Science.gov (United States)

    Vácha, M

    1997-10-01

    While investigating and describing interactions among living organisms and magnetic fields (MFs) it is imperative to lay great emphasis on independent reproducibility of published experimental results. Mutual confrontation of existing theoretical models with reliable data obtained under comparable conditions can aid gradual mapping of this hitherto badly organized and understood discipline of biology. The objective of our experiment, based on analysing extracardiac pulsations of the pupae of Tenebrio molitor under the influence of a MF, was to verify published data on allegedly accelerated development induced by a MF employing a different procedure. The obtained data are in agreement with a hypothesis of increased pupal metabolism during the period of MF activity. Furthermore, some dependence on the age of the pupae cannot be ruled out.

  11. VLP seismicity from resonant modes of acoustic-gravity waves in a conduit-crack system filled with multiphase magma

    Science.gov (United States)

    Liang, C.; Prochnow, B. N.; OReilly, O. J.; Dunham, E. M.; Karlstrom, L.

    2016-12-01

    Oscillation of magma in volcanic conduits connected to cracks (dikes and sills) has been suggested as an explanation for very long period (VLP) seismic signals recorded at active basaltic volcanoes such as. Kilauea, Hawaii, and Erebus, Antarctica. We investigate the VLP seismicity using a linearized model for waves in and associated eigenmodes of a coupled conduit-crack system filled with multiphase magma, an extension of the Karlstrom and Dunham (2016) model for acoustic-gravity waves in volcanic conduits. We find that the long period surface displacement (as recorded on broadband seismometers) is dominated by opening/closing of the crack rather than the deformation of the conduit conduit walls. While the fundamental eigenmode is sensitive to the fluid properties and the geometry of the magma plumbing system, a closer scrutiny of various resonant modes reveals that the surface displacement is often more sensitive to higher modes. Here we present a systematic analysis of various long period acoustic-gravity wave resonant modes of a coupled conduit-crack system that the surface displacement is most sensitive to. We extend our previous work on a quasi-one-dimensional conduit model with inviscid magma to a more general axisymmetric conduit model that properly accounts for viscous boundary layers near the conduit walls, based on the numerical method developed by Prochnow et al. (submitted to Computers and Fluids, 2016). The surface displacement is dominated by either the fundamental or higher eigenmodes, depending on magma properties and the geometry of conduit and crack. An examination of the energetics of these modes reveals the complex interplay of different restoring forces (magma compressibility in the conduit, gravity, and elasticity of the crack) driving the VLP oscillations. Both nonequilibrium bubble growth and resorption and viscosity contribute to the damping of VLP signals. Our models thus provide a means to infer properties of open-vent basaltic volcanoes

  12. Biological conduits combining bone marrow mesenchymal stem cells and extracellular matrix to treat long-segment sciatic nerve defects

    Directory of Open Access Journals (Sweden)

    Yang Wang

    2015-01-01

    Full Text Available The transplantation of polylactic glycolic acid conduits combining bone marrow mesenchymal stem cells and extracellular matrix gel for the repair of sciatic nerve injury is effective in some respects, but few data comparing the biomechanical factors related to the sciatic nerve are available. In the present study, rabbit models of 10-mm sciatic nerve defects were prepared. The rabbit models were repaired with autologous nerve, a polylactic glycolic acid conduit + bone marrow mesenchymal stem cells, or a polylactic glycolic acid conduit + bone marrow mesenchymal stem cells + extracellular matrix gel. After 24 weeks, mechanical testing was performed to determine the stress relaxation and creep parameters. Following sciatic nerve injury, the magnitudes of the stress decrease and strain increase at 7,200 seconds were largest in the polylactic glycolic acid conduit + bone marrow mesenchymal stem cells + extracellular matrix gel group, followed by the polylactic glycolic acid conduit + bone marrow mesenchymal stem cells group, and then the autologous nerve group. Hematoxylin-eosin staining demonstrated that compared with the polylactic glycolic acid conduit + bone marrow mesenchymal stem cells group and the autologous nerve group, a more complete sciatic nerve regeneration was found, including good myelination, regularly arranged nerve fibers, and a completely degraded and resorbed conduit, in the polylactic glycolic acid conduit + bone marrow mesenchymal stem cells + extracellular matrix gel group. These results indicate that bridging 10-mm sciatic nerve defects with a polylactic glycolic acid conduit + bone marrow mesenchymal stem cells + extracellular matrix gel construct increases the stress relaxation under a constant strain, reducing anastomotic tension. Large elongations under a constant physiological load can limit the anastomotic opening and shift, which is beneficial for the regeneration and functional reconstruction of sciatic nerve. Better

  13. Transcatheter Pulmonary Valve Replacement for Right Ventricular Outflow Tract Conduit Dysfunction After the Ross Procedure

    DEFF Research Database (Denmark)

    Gillespie, Matthew J; McElhinney, Doff B; Kreutzer, Jacqueline

    2015-01-01

    BACKGROUND: Right ventricular outflow tract (RVOT) conduit dysfunction is a limitation of the Ross procedure. Transcatheter pulmonary valve replacement (TPVR) could alter the impact of conduit dysfunction and the risk-benefit balance for the Ross procedure. METHODS: Retrospective review of databa......BACKGROUND: Right ventricular outflow tract (RVOT) conduit dysfunction is a limitation of the Ross procedure. Transcatheter pulmonary valve replacement (TPVR) could alter the impact of conduit dysfunction and the risk-benefit balance for the Ross procedure. METHODS: Retrospective review....... Of these, 56 (84%) received a Melody valve; in 5 of the 11 patients who did not, the implant was aborted due to concern for coronary artery compression, and 1 implanted patient required emergent surgery for left coronary compression. The RVOT gradient decreased from a median 38 mm Hg to 13.5 mm Hg (p

  14. 26 CFR 1.58-2 - General rules for conduit entities; partnerships and partners.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 1 2010-04-01 2010-04-01 true General rules for conduit entities; partnerships...; partnerships and partners. (a) General rules for conduit entities. Sections 1.58-3 through 1.58-6 provide rules... example, if a trust has $100,000 of capital gains for the taxable year, all of which are distributed to A...

  15. Polyurethane/Gelatin Nanofibrils Neural Guidance Conduit Containing Platelet-Rich Plasma and Melatonin for Transplantation of Schwann Cells.

    Science.gov (United States)

    Salehi, Majid; Naseri-Nosar, Mahdi; Ebrahimi-Barough, Somayeh; Nourani, Mohammdreza; Khojasteh, Arash; Farzamfar, Saeed; Mansouri, Korosh; Ai, Jafar

    2018-04-01

    The current study aimed to enhance the efficacy of peripheral nerve regeneration using a biodegradable porous neural guidance conduit as a carrier to transplant allogeneic Schwann cells (SCs). The conduit was prepared from polyurethane (PU) and gelatin nanofibrils (GNFs) using thermally induced phase separation technique and filled with melatonin (MLT) and platelet-rich plasma (PRP). The prepared conduit had the porosity of 87.17 ± 1.89%, the contact angle of 78.17 ± 5.30° and the ultimate tensile strength and Young's modulus of 5.40 ± 0.98 MPa and 3.13 ± 0.65 GPa, respectively. The conduit lost about 14% of its weight after 60 days in distilled water. The produced conduit enhanced the proliferation of SCs demonstrated by a tetrazolium salt-based assay. For functional analysis, the conduit was seeded with 1.50 × 10 4 SCs (PU/GNFs/PRP/MLT/SCs) and implanted into a 10-mm sciatic nerve defect of Wistar rat. Three control groups were used: (1) PU/GNFs/SCs, (2) PU/GNFs/PRP/SCs, and (3) Autograft. The results of sciatic functional index, hot plate latency, compound muscle action potential amplitude and latency, weight-loss percentage of wet gastrocnemius muscle and histopathological examination using hematoxylin-eosin and Luxol fast blue staining, demonstrated that using the PU/GNFs/PRP/MLT conduit to transplant SCs to the sciatic nerve defect resulted in a higher regenerative outcome than the PU/GNFs and PU/GNFs/PRP conduits.

  16. Prevalence of associated extracardiac malformations in the congenital heart disease population.

    Science.gov (United States)

    Egbe, Alexander; Uppu, Santosh; Lee, Simon; Ho, Deborah; Srivastava, Shubhika

    2014-10-01

    The authors hypothesized that changes in prenatal factors such as termination of pregnancy for fetal anomalies and prenatal vitamin supplementation have altered the epidemiology of patients with multiple congenital anomalies and may have had an impact on their prevalence in the current era. This study reviewed the Nationwide Inpatient Sample database from 1998 to 2008 and compared the prevalence of ECM among live births with a CHD diagnosis (case) and that among live births without a CHD diagnosis (control). For this study, 42 ECM and 10 CHD diagnoses were selected for subanalysis. Longitudinal analysis also was performed to determine temporal variation of ECM prevalence in the CHD population during the 11-year study period. The cohort in this study consisted of 97,154 patients in the case group and 12,078,482 subjects in the control group. The prevalences in the CHD population were 11.4 % for nonsyndromic congenital malformation (NSCM), 2.2 % for genetic syndrome (GS), and 13.6 % for overall extracardiac congenital malformation (ECM). The prevalences in the control group were 6.7 % for NSCM, 0.3 % for GS, and 7.0 % for ECM. The findings showed a strong association of NSCM [odds ratio (OR) 1.88; 95 % confidence interval (CI) 1.73-1.94], GS (OR 2.52; 95 % CI 2.44-2.61), and overall ECM (OR 2.01; 95 % CI 1.97-2.14) with CHD. The prevalences of GS and multiple organ system CM decreased significantly during the study period. This study was the largest and most comprehensive population-based study to evaluate the association between CHD and ECM in newborns.

  17. Mechanical cleaning of oil spills in seawater using circular conduits

    Energy Technology Data Exchange (ETDEWEB)

    Shedid, S.; Abou Kassem, J.; Zekri, A. [United Arab Emirates Univ., Al Ain City (United Arab Emirates). Dept. of Chemical and Petroleum Engineering

    2005-10-15

    Treatment of the crude oil pollution in seawater has attracted global attention during the last two decades. This study was undertaken using circular conduits as a mechanical means to clean oil spills in seawater under different conditions of temperature, oil gravity, shaking frequency, conduit diameter, and initial thickness of oil layer. An experimental model was designed and built to achieve the study. It consists of shaking water bath (to represent sea waves) fitted with temperature controller and glass tubes of different inside diameters of 0.3 cm, 0.5 cm, and 0.7 cm. Three crude oils of different oil gravity of 35{sup o}API, 38{sup o}API, and 47{sup o}API were investigated under different shaking frequencies of 20, 40, and 60 stroke/minute with different tube diameters. The results proved that application of mechanical cleaning of oil spills using circular conduits is a practical technique. The cleaning of black oil spills is more efficient than one of volatile oil. Furthermore, the results indicated that the increase of shaking frequency and/or water temperature provide(s) faster cleaning of oil spills while temperature increase recovers the maximum oil. (Author)

  18. Geometry and Hydraulics of Englacial Conduits, Storglaciaren, Sweden

    Science.gov (United States)

    Fountain, A. G.; Schlichting, R.; Frodin, S.; Jacobel, R. W.

    2001-12-01

    Englacial conduits are the primary structure responsible for transporting surface water to the base of a glacier, where it supplies the subglacial hydraulic system and, in turn, affects glacier movement. Despite the well-known theoretical descriptions of englacial conduits, little direct evidence exists about their geometry and hydraulics. In July 2001, we initiated a field effort on Storglaciären, Sweden, to intersect englacial conduits by drilling into the glacier using a hot water drill. A companion project (Jacobel et al., this session) attempted to detect the englacial conduits using ground-penetrating radar. In a typical borehole, the water level remained at the surface while drilling through the impermeable ice. Once a connection was made, the water level dropped roughly 10 m and remained low despite continued water pumping. A small video camera was lowered, with attachments, to measure the geometry of the opening, and water flow speed. The water level in the hole provided a piezometric measure of the pressure. We drilled 22 holes at 3 separate locations and 17 (77%) connected englacially, the remaining 5 reached the bed without englacial connection, of which 2 drained at the bed. The geometry of the connections was highly irregular in cross-section with 1-2 cm openings, reminiscent of crevasse-like features rather than circular cross-sections as anticipated from the theoretical literature. Flow behavior was observed by tracking particle motion. The flow was complicated, in part by the inferred tangential intersection between the borehole and structure, and by the observed surging behavior. Flow speeds were low, on the order of 1 cm sec-1. Water level records from 3 different holes over several days exhibited highly correlated variations and large diurnal excursions. In contrast, records from holes drilled to the bed showed little variation. Based on these measurements, our conceptual picture of the englacial system is that of a sluggish flow system

  19. Tension layer winding of cable-in-conduit conductor

    International Nuclear Information System (INIS)

    Devernoe, A.; Ciancetta, G.; King, M.; Parizh, M.; Painter, T.; Miller, J.

    1996-01-01

    A 710 mm i.d. by 440 mm long, 6 layer Cable-in-Conduit (CIC) coil was precision tension layer wound with Incoloy 908 jacketed conductor to model winding technology that will be used for the Nb 3 Sn outsert coils of the 45 Tesla Hybrid Magnet Project at the US National High Magnetic Field Laboratory. This paper reports on the set up of a new winding facility with unique capabilities for insulating and winding long length CIC conductor and on special procedures which were developed to wind and support layer to layer transitions and to safely form conductor into and out of the winding. Analytical methods used to predict conduit keystoning, springback and back tensioning requirements before winding are reported in comparison to results obtained during winding and actual winding build-up dimensions on a layer by layer basis in comparison to design requirements

  20. Delineating saturated conduit patterns and dimensions in the upper Floridan aquifer through numerical groundwater flow modeling (Invited)

    Science.gov (United States)

    Kincaid, T. R.; Meyer, B. A.

    2009-12-01

    In groundwater flow modeling, aquifer permeability is typically defined through model calibration. Since the pattern and size of conduits are part of a karstic permeability framework, those parameters should be constrainable through the same process given a sufficient density of measured conditions. H2H Associates has completed a dual-permeability steady-state model of groundwater flow through the western Santa Fe River Basin, Florida from which a 380.9 km network of saturated conduits was delineated through model calibration to heads and spring discharges. Two calibration datasets were compiled describing average high-water and average low-water conditions based on heads at 145 wells and discharge from 18 springs for the high-water scenario and heads at 188 wells and discharge from 9 springs for the low-water scenario. An initial conduit network was defined by assigning paths along mapped conduits and inferring paths along potentiometric troughs between springs and swallets that had been connected by groundwater tracing. These initial conduit assignments accounted for only 13.75 and 34.1 km of the final conduit network respectively. The model was setup using FEFLOW™ where conduits were described as discrete features embedded in a porous matrix. Flow in the conduits was described by the Manning-Strickler equation where variables for conduit area and roughness were used to adjust the volume and velocity of spring flows. Matrix flow was described by Darcy’s law where hydraulic conductivity variations were limited to three geologically defined internally homogeneous zones that ranged from ~2E-6 m/s to ~4E-3 m/s. Recharge for both the high-water and low-water periods was determined through a water budget analysis where variations were restricted to nine zones defined by land-use. All remaining variations in observed head were then assumed to be due to conduits. The model was iteratively calibrated to the high-water and low-water datasets wherein the location, size

  1. 26 CFR 1.7701(l)-1 - Conduit financing arrangements.

    Science.gov (United States)

    2010-04-01

    ... determines that such recharacterization is appropriate to prevent avoidance of any tax imposed by title 26 of...) INCOME TAX (CONTINUED) INCOME TAXES General Actuarial Valuations § 1.7701(l)-1 Conduit financing...

  2. Cardiopulmonary Exercise Testing in Fontan Patients With and Without Isomerism (Heterotaxy) as Compared to Patients With Primary Ciliary Dyskinesia and Subjects With Structurally Normal Hearts

    DEFF Research Database (Denmark)

    Loomba, Rohit S; Danduran, Michael; Nielsen, Kim G

    2017-01-01

    with and without isomerism. We have now compared these finding with those from patients with primary ciliary dyskinesia, as many patients with isomerism have ciliary dyskinesia. We identified patients having the Fontan circulation with and without isomerism who had undergone cardiopulmonary exercise testing......, comparing the findings from healthy individuals undergoing exercise, and a comparable number of individuals with primary ciliary dyskinesia but no congenital heart disease. We were able to include a total of 68 patients in our study, with 17 in each of the four groups. Cardiopulmonary exercise testing...

  3. Interstage evaluation of homograft-valved right ventricle to pulmonary artery conduits for palliation of hypoplastic left heart syndrome.

    Science.gov (United States)

    Sandeep, Nefthi; Punn, Rajesh; Balasubramanian, Sowmya; Smith, Shea N; Reinhartz, Olaf; Zhang, Yulin; Wright, Gail E; Peng, Lynn F; Wise-Faberowski, Lisa; Hanley, Frank L; McElhinney, Doff B

    2018-04-01

    Palliation of hypoplastic left heart syndrome with a standard nonvalved right ventricle to pulmonary artery conduit results in an inefficient circulation in part due to diastolic regurgitation. A composite right ventricle pulmonary artery conduit with a homograft valve has a hypothetical advantage of reducing regurgitation, but may differ in the propensity for stenosis because of valve remodeling. This retrospective cohort study included 130 patients with hypoplastic left heart syndrome who underwent a modified stage 1 procedure with a right ventricle to pulmonary artery conduit from 2002 to 2015. A composite valved conduit (cryopreserved homograft valve anastomosed to a polytetrafluoroethylene tube) was placed in 100 patients (47 aortic, 32 pulmonary, 13 femoral/saphenous vein, 8 unknown), and a nonvalved conduit was used in 30 patients. Echocardiographic functional parameters were evaluated before and after stage 1 palliation and before the bidirectional Glenn procedure, and interstage interventions were assessed. On competing risk analysis, survival over time was better in the valved conduit group (P = .040), but this difference was no longer significant after adjustment for surgical era. There was no significant difference between groups in the cumulative incidence of bidirectional Glenn completion (P = .15). Patients with a valved conduit underwent more interventions for conduit obstruction in the interstage period, but this difference did not reach significance (P = .16). There were no differences between groups in echocardiographic parameters of right ventricle function at baseline or pre-Glenn. In this cohort of patients with hypoplastic left heart syndrome, inclusion of a valved right ventricle to pulmonary artery conduit was not associated with any difference in survival on adjusted analysis and did not confer an identifiable benefit on right ventricle function. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier

  4. Challenges of using electrical resistivity method to locate karst conduits-A field case in the Inner Bluegrass Region, Kentucky

    Science.gov (United States)

    Zhu, J.; Currens, J.C.; Dinger, J.S.

    2011-01-01

    Conduits serve as major pathways for groundwater flow in karst aquifers. Locating them from the surface, however, is one of the most challenging tasks in karst research. Geophysical methods are often deployed to help locate voids by mapping variations of physical properties of the subsurface. Conduits can cause significant contrasts of some physical properties that can be detected; other subsurface features such as water-bearing fractures often yield similar contrasts, which are difficult to distinguish from the effects of the conduits. This study used electrical resistivity method to search for an unmapped karst conduit that recharges Royal Spring in the Inner Bluegrass karst region, Kentucky, USA. Three types of resistivity techniques (surface 2D survey, quasi-3D survey, and time-lapse survey) were used to map and characterize resistivity anomalies. Some of the major anomalies were selected as drilling targets to verify the existence of the conduits. Drilling near an anomaly identified by an electrical resistivity profile resulted in successful penetration of a major water-filled conduit. The drilling results also suggest that, in this study area, low resistivity anomalies in general are associated with water-bearing features. However, differences in the anomaly signals between the water-filled conduit and other water-bearing features such as water-filled fracture zones were undistinguishable. The electrical resistivity method is useful in conduit detection by providing potential drilling targets. Knowledge of geology and hydrogeology about the site and professional judgment also played important roles in locating the major conduit. ?? 2011 Elsevier B.V.

  5. 3D Bioprinting of Heterogeneous Aortic Valve Conduits with Alginate/Gelatin Hydrogels

    Science.gov (United States)

    Duan, Bin; Hockaday, Laura A.; Kang, Kevin H.; Butcher, Jonathan T.

    2013-01-01

    Heart valve disease is a serious and growing public health problem for which prosthetic replacement is most commonly indicated. Current prosthetic devices are inadequate for younger adults and growing children. Tissue engineered living aortic valve conduits have potential for remodeling, regeneration, and growth, but fabricating natural anatomical complexity with cellular heterogeneity remain challenging. In the current study, we implement 3D bioprinting to fabricate living alginate/gelatin hydrogel valve conduits with anatomical architecture and direct incorporation of dual cell types in a regionally constrained manner. Encapsulated aortic root sinus smooth muscle cells (SMC) and aortic valve leaflet interstitial cells (VIC) were viable within alginate/gelatin hydrogel discs over 7 days in culture. Acellular 3D printed hydrogels exhibited reduced modulus, ultimate strength, and peak strain reducing slightly over 7-day culture, while the tensile biomechanics of cell-laden hydrogels were maintained. Aortic valve conduits were successfully bioprinted with direct encapsulation of SMC in the valve root and VIC in the leaflets. Both cell types were viable (81.4±3.4% for SMC and 83.2±4.0% for VIC) within 3D printed tissues. Encapsulated SMC expressed elevated alpha-smooth muscle actin when printed in stiff matrix, while VIC expressed elevated vimentin in soft matrix. These results demonstrate that anatomically complex, heterogeneously encapsulated aortic valve hydrogel conduits can be fabricated with 3D bioprinting. PMID:23015540

  6. Genipin-Cross-Linked Chitosan Nerve Conduits Containing TNF-α Inhibitors for Peripheral Nerve Repair.

    Science.gov (United States)

    Zhang, Li; Zhao, Weijia; Niu, Changmei; Zhou, Yujie; Shi, Haiyan; Wang, Yalin; Yang, Yumin; Tang, Xin

    2018-07-01

    Tissue engineered nerve grafts (TENGs) are considered a promising alternative to autologous nerve grafting, which is considered the "gold standard" clinical strategy for peripheral nerve repair. Here, we immobilized tumor necrosis factor-α (TNF-α) inhibitors onto a nerve conduit, which was introduced into a chitosan (CS) matrix scaffold utilizing genipin (GP) as the crosslinking agent, to fabricate CS-GP-TNF-α inhibitor nerve conduits. The in vitro release kinetics of TNF-α inhibitors from the CS-GP-TNF-α inhibitor nerve conduits were investigated using high-performance liquid chromatography. The in vivo continuous release profile of the TNF-α inhibitors released from the CS-GP-TNF-α inhibitor nerve conduits was measured using an enzyme-linked immunosorbent assay over 14 days. We found that the amount of TNF-α inhibitors released decreased with time after the bridging of the sciatic nerve defects in rats. Moreover, 4 and 12 weeks after surgery, histological analyses and functional evaluations were carried out to assess the influence of the TENG on regeneration. Immunochemistry performed 4 weeks after grafting to assess early regeneration outcomes revealed that the TENG strikingly promoted axonal outgrowth. Twelve weeks after grafting, the TENG accelerated myelin sheath formation, as well as functional restoration. In general, the regenerative outcomes following TENG more closely paralleled findings observed with autologous grafting than the use of the CS matrix scaffold. Collectively, our data indicate that the CS-GP-TNF-α inhibitor nerve conduits comprised an elaborate system for sustained release of TNF-α inhibitors in vitro, while studies in vivo demonstrated that the TENG could accelerate regenerating axonal outgrowth and functional restoration. The introduction of CS-GP-TNF-α-inhibitor nerve conduits into a scaffold may contribute to an efficient and adaptive immune microenvironment that can be used to facilitate peripheral nerve repair.

  7. 78 FR 61987 - Corbett Water District; Notice of Preliminary Determination of a Qualifying Conduit Hydropower...

    Science.gov (United States)

    2013-10-09

    ... District; Notice of Preliminary Determination of a Qualifying Conduit Hydropower Facility and Soliciting... construct a qualifying conduit hydropower facility, pursuant to section 30 of the Federal Power Act, as amended by section 4 of the Hydropower Regulatory Efficiency Act of 2013 (HREA). The Corbett Hydroelectric...

  8. Ileal-conduit following cystectomy, single-institution revision of indications and outcome

    International Nuclear Information System (INIS)

    Abol-Enein, Hassan A.; Abdul-Muhsin, Ausama S.; Alhallaq, Yousuf M.

    2008-01-01

    Objective was to revise indications, case fatality ratio, and postoperative early and late complications of ileal conduit as a method of urinary diversion. This is a retrospective study in which 200 patients underwent an ileal conduit from August 1994 to December 2000 in Mansoura Urology and Nephrology Center, Mansoura, Egypt. Preoperative criteria of patient selection, preoperative findings and postoperative follow-up data were reviewed. In 200 patients aged 29-75 years, with a mean age of 55.84-/+ 8.91 years, the ileal conduit was chosen as a method of urinary diversion, due to one of the following patient or surgical factors; 50 (25%) cardiopulmonary co-morbidities, 27(13.5%) liver cirrhosis, 20 (10%) impaired renal function, 18 (9%) poorly controlled diabetes mellitus and 3 (1.5%) morbid obesity. Frozen section pathological examination showed carcinoma invasion of the urethra in 26 (13%) and prostate stroma in 16 (8%) male patients. Severe adhesions and difficulty cystectomy were encountered in 25 (12.5%) patients. Tumor was found at or close to the bladder neck in 13 (6.5%) female patients and 2 (1%) patients were found to have short mesentery. The mean follow up period was 90.02 -/+ 22.63 months. Fatality rate was 2%. Twenty-three (11.5%) patients had early complications, while 36 (23.7%) patients had late complications. Ileal conduit is still the best urinary diversion method in many patients who have bladder cancer with associated chronic medical disease or certain surgical factors that render other urinary diversion methods more difficult carry more postoperative morbidity and mortality or both. (author)

  9. Exploring Ultimate Water Capillary Evaporation in Nanoscale Conduits.

    Science.gov (United States)

    Li, Yinxiao; Alibakhshi, Mohammad Amin; Zhao, Yihong; Duan, Chuanhua

    2017-08-09

    Capillary evaporation in nanoscale conduits is an efficient heat/mass transfer strategy that has been widely utilized by both nature and mankind. Despite its broad impact, the ultimate transport limits of capillary evaporation in nanoscale conduits, governed by the evaporation/condensation kinetics at the liquid-vapor interface, have remained poorly understood. Here we report experimental study of the kinetic limits of water capillary evaporation in two dimensional nanochannels using a novel hybrid channel design. Our results show that the kinetic-limited evaporation fluxes break down the limits predicated by the classical Hertz-Knudsen equation by an order of magnitude, reaching values up to 37.5 mm/s with corresponding heat fluxes up to 8500 W/cm 2 . The measured evaporation flux increases with decreasing channel height and relative humidity but decreases as the channel temperature decreases. Our findings have implications for further understanding evaporation at the nanoscale and developing capillary evaporation-based technologies for both energy- and bio-related applications.

  10. 78 FR 63176 - Notice of Preliminary Determination of a Qualifying Conduit Hydropower Facility and Soliciting...

    Science.gov (United States)

    2013-10-23

    ... Preliminary Determination of a Qualifying Conduit Hydropower Facility and Soliciting Comments and Motions To... of intent to construct a qualifying conduit hydropower facility, pursuant to section 30 of the Federal Power Act, as amended by section 4 of the Hydropower Regulatory Efficiency Act of 2013 (HREA). The...

  11. MR and CT imaging of pulmonary valved conduits in children and adolescents: normal appearance and complications

    Energy Technology Data Exchange (ETDEWEB)

    Tenisch, Estelle V.; Alamo, Leonor T.; Gudinchet, Francois [Lausanne University Hospital, Department of Medical Imaging, Lausanne (Switzerland); Sekarski, Nicole [Lausanne University Hospital, Department of Pediatrics, Lausanne (Switzerland); Hurni, Michel [Lausanne University Hospital, Department of Cardiovascular Surgery, Lausanne (Switzerland)

    2014-12-15

    The Contegra registered is a conduit made from the bovine jugular vein and then interposed between the right ventricle and the pulmonary artery. It is used for cardiac malformations in the reconstruction of right ventricular outflow tract. To describe both normal and pathological appearances of the Contegra registered in radiological imaging, to describe imaging of complications and to define the role of CT and MRI in postoperative follow-up. Forty-three examinations of 24 patients (17 boys and 7 girls; mean age: 10.8 years old) with Contegra registered conduits were reviewed. Anatomical description and measurements of the conduits were performed. Pathological items examined included stenosis, dilatation, plicature or twist, thrombus or vegetations, calcifications and valvular regurgitation. Findings were correlated to the echographic gradient through the conduit when available. CT and MR work-up showed Contegra registered stenosis (n = 12), dilatation (n = 9) and plicature or twist (n = 7). CT displayed thrombus or vegetations in the Contegra registered in three clinically infected patients. Calcifications of the conduit were present at CT in 12 patients and valvular regurgitation in three patients. The comparison between CT and/or MR results showed a good correlation between the echographic gradient and the presence of stenosis in the Contegra registered. CT and MR bring additional information about permeability and postoperative anatomy especially when echocardiography is inconclusive. Both techniques depict the normal appearance of the conduit, and allow comparison and precise evaluation of changes in the postoperative follow-up. (orig.)

  12. A Physicochemically Optimized and Neuroconductive Biphasic Nerve Guidance Conduit for Peripheral Nerve Repair.

    Science.gov (United States)

    Ryan, Alan J; Lackington, William A; Hibbitts, Alan J; Matheson, Austyn; Alekseeva, Tijna; Stejskalova, Anna; Roche, Phoebe; O'Brien, Fergal J

    2017-12-01

    Clinically available hollow nerve guidance conduits (NGCs) have had limited success in treating large peripheral nerve injuries. This study aims to develop a biphasic NGC combining a physicochemically optimized collagen outer conduit to bridge the transected nerve, and a neuroconductive hyaluronic acid-based luminal filler to support regeneration. The outer conduit is mechanically optimized by manipulating crosslinking and collagen density, allowing the engineering of a high wall permeability to mitigate the risk of neuroma formation, while also maintaining physiologically relevant stiffness and enzymatic degradation tuned to coincide with regeneration rates. Freeze-drying is used to seamlessly integrate the luminal filler into the conduit, creating a longitudinally aligned pore microarchitecture. The luminal stiffness is modulated to support Schwann cells, with laminin incorporation further enhancing bioactivity by improving cell attachment and metabolic activity. Additionally, this biphasic NGC is shown to support neurogenesis and gliogenesis of neural progenitor cells and axonal outgrowth from dorsal root ganglia. These findings highlight the paradigm that a successful NGC requires the concerted optimization of both a mechanical support phase capable of bridging a nerve defect and a neuroconductive phase with an architecture capable of supporting both Schwann cells and neurons in order to achieve functional regenerative outcome. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. Resource Utilization Associated with Extracardiac Co-morbid Conditions Following Congenital Heart Surgery in Infancy.

    Science.gov (United States)

    Tuomela, Krista E; Gordon, John B; Cassidy, Laura D; Johaningsmeir, Sarah; Ghanayem, Nancy S

    2017-06-01

    Congenital heart disease (CHD) is often associated with chronic extracardiac co-morbid conditions (ECC). The presence of ECC has been associated with greater resource utilization during the operative period; however, the impact beyond hospital discharge has not been described. This study sought to understand the scope of chronic ECC in infants with CHD as well as to describe the impact of ECC on resource utilization after discharge from the index cardiac procedure. IRB approved this retrospective study of infants Whitney Rank Sum Test with p < 0.05 considered significant. ECC occurred in 55% (481/876) of infants. Median STAT score was higher in the group with ECC (3 vs. 2, p < 0.001). Resource utilization after discharge from the index procedure as defined by median hospital charges (78 vs. 10 K, p < 0.001 and unplanned hospital days 4 vs. 0, p < 0.001) was higher in those with ECC, and increased with the greater number of ECC, even after accounting for surgical complexity. STAT score and the presence of multiple ECC were associated with higher resource utilization following the index cardiac surgical procedure. These data may be helpful in deciding which children might benefit from a cardiac complex care program that partners families and providers to improve health and decrease healthcare costs.

  14. Ureteric catheterization via an ileal conduit: technique and retrieval of a JJ stent.

    Science.gov (United States)

    Wah, T M; Kellett, M J

    2004-11-01

    Retrograde ureteric catheterization of a patient with an ileal conduit is difficult, because guide wires and catheters coil in the conduit. A modified loopogram, using a Foley catheter as a fulcrum through which catheters can be advanced to the ureteric anastomosis, is described. This technique was used to remove a JJ stent, which had been inserted previously across a stricture in one ureter, the stent crossing from one kidney to the other.

  15. Continent catheterizable conduit for urinary diversion in children: Applicability and acceptability

    Directory of Open Access Journals (Sweden)

    Shailesh Solanki

    2015-01-01

    Full Text Available Background: Continent catheterizable conduit (CCC has made clean intermittent catheterization (CIC painless and easy. It is applicable in diverse clinical conditions. Nonetheless, convincing the parents for the need of conduit procedure is still difficult. Materials and Methods: A prospective study, included children who underwent CCC procedure from March 2008 to February 2013. The data were assessed for; diagnosis, type of conduit, number of preoperative counselling sessions before acceptance, role of "self-help group" in decision making, parental concern and satisfaction for the procedure. Results: Twenty-nine patients (males; 24, females; 5 underwent CCC procedure for various clinical conditions. The multiple preoperative counselling sessions and creation of "self-help groups" were helped them for decision making. The main concerns among parents were: (1 Impact of procedure on future fertility and sexual life. (2 Patency of native urethral channel. (3 Permanent urinary stoma over the abdomen. Conclusion: CCC procedures are applicable to a wide array of clinical situations with a good outcome. The acceptability of the CCC procedure improves with preoperative counselling of parent/child, initiation of preoperative per urethral CIC and creation of self-help groups.

  16. Combined use of decellularized allogeneic artery conduits with autologous transdifferentiated adipose-derived stem cells for facial nerve regeneration in rats.

    Science.gov (United States)

    Sun, Fei; Zhou, Ke; Mi, Wen-juan; Qiu, Jian-hua

    2011-11-01

    Natural biological conduits containing seed cells have been widely used as an alternative strategy for nerve gap reconstruction to replace traditional nerve autograft techniques. The purpose of this study was to investigate the effects of a decellularized allogeneic artery conduit containing autologous transdifferentiated adipose-derived stem cells (dADSCs) on an 8-mm facial nerve branch lesion in a rat model. After 8 weeks, functional evaluation of vibrissae movements and electrophysiological assessment, retrograde labeling of facial motoneurons and morphological analysis of regenerated nerves were performed to assess nerve regeneration. The transected nerves reconstructed with dADSC-seeded artery conduits achieved satisfying regenerative outcomes associated with morphological and functional improvements which approached those achieved with Schwann cell (SC)-seeded artery conduits, and superior to those achieved with artery conduits alone or ADSC-seeded artery conduits, but inferior to those achieved with nerve autografts. Besides, numerous transplanted PKH26-labeled dADSCs maintained their acquired SC-phenotype and myelin sheath-forming capacity inside decellularized artery conduits and were involved in the process of axonal regeneration and remyelination. Collectively, our combined use of decellularized allogeneic artery conduits with autologous dADSCs certainly showed beneficial effects on nerve regeneration and functional restoration, and thus represents an alternative approach for the reconstruction of peripheral facial nerve defects. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Development and Implementation of a Segment/Junction Box Level Database for the ITS Fiber Optic Conduit Network

    Science.gov (United States)

    2012-03-01

    This project initiated the development of a computerized database of ITS facilities, including conduits, junction : boxes, cameras, connections, etc. The current system consists of a database of conduit sections of various lengths. : Over the length ...

  18. The Norwood procedure: in favor of the RV-PA conduit.

    Science.gov (United States)

    Barron, David J

    2013-01-01

    Evolution of the Norwood procedure has culminated in there currently being three treatment strategies available for initial management: the 'classical' Norwood (utilizing a Blalock-Taussig shunt), the Norwood with right-ventricle to pulmonary artery (RV-PA) conduit, and the 'hybrid' Norwood procedure utilizing bilateral pulmonary artery banding and ductal stenting. Each variant has its potential advantages and disadvantages, and this paper looks to examine the evidence in favor of each strategy, with emphasis on the supportive data for the RV-PA conduit. The 'classical' procedure has the benefit of the greatest accumulated surgical experience and avoids any incision into the ventricle. However, the diastolic run-off of the Blalock-Taussig shunt can cause hemodynamic instability and unpredictable coronary steal phenomenon. The RV-PA conduit has the advantage of maintaining diastolic pressure with a more stable postoperative course, but at the cost of a ventriculotomy that may have detrimental long-term sequelae. The 'hybrid' procedure has the advantage of avoiding cardiopulmonary bypass, but does not always secure coronary blood flow and has a high inter-stage morbidity and reintervention rate. The evidence shows that each technique may have its place in future management, and that treatment algorithms could emerge that direct the choice of procedure for specific patient groups. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Parastomal hernias after radical cystectomy and ileal conduit diversion

    Directory of Open Access Journals (Sweden)

    Timothy F. Donahue

    2016-07-01

    Full Text Available Parastomal hernia, defined as an “incisional hernia related to an abdominal wall stoma”, is a frequent complication after conduit urinary diversion that can negatively impact quality of life and present a clinically significant problem for many patients. Parastomal hernia (PH rates may be as high as 65% and while many patients are asymptomatic, in some series up to 30% of patients require surgical intervention due to pain, leakage, ostomy appliance problems, urinary obstruction, and rarely bowel obstruction or strangulation. Local tissue repair, stoma relocation, and mesh repairs have been performed to correct PH, however, long-term results have been disappointing with recurrence rates of 30%–76% reported after these techniques. Due to high recurrence rates and the potential morbidity of PH repair, efforts have been made to prevent PH development at the time of the initial surgery. Randomized trials of circumstomal prophylactic mesh placement at the time of colostomy and ileostomy stoma formation have shown significant reductions in PH rates with acceptably low complication profiles. We have placed prophylactic mesh at the time of ileal conduit creation in patients at high risk for PH development and found it to be safe and effective in reducing the PH rates over the short-term. In this review, we describe the clinical and radiographic definitions of PH, the clinical impact and risk factors associated with its development, and the use of prophylactic mesh placement for patients undergoing ileal conduit urinary diversion with the intent of reducing PH rates.

  20. 78 FR 66355 - Pleasant Grove City, UT; Notice of Preliminary Determination of a Qualifying Conduit Hydropower...

    Science.gov (United States)

    2013-11-05

    ... City, UT; Notice of Preliminary Determination of a Qualifying Conduit Hydropower Facility and... Grove City, Utah (Pleasant Grove) filed a notice of intent to construct a qualifying conduit hydropower facility, pursuant to section 30 of the Federal Power Act, as amended by section 4 of the Hydropower...

  1. 78 FR 53752 - City of Sandpoint, Idaho; Notice of Preliminary Determination of a Qualifying Conduit Hydropower...

    Science.gov (United States)

    2013-08-30

    ... Sandpoint, Idaho; Notice of Preliminary Determination of a Qualifying Conduit Hydropower Facility and... intent to construct a qualifying conduit hydropower facility, pursuant to section 30 of the Federal Power Act, as amended by section 4 of the Hydropower Regulatory Efficiency Act of 2013 (HREA). The Little...

  2. 78 FR 61985 - City of Astoria, Oregon; Notice of Preliminary Determination of a Qualifying Conduit Hydropower...

    Science.gov (United States)

    2013-10-09

    ..., Oregon; Notice of Preliminary Determination of a Qualifying Conduit Hydropower Facility and Soliciting... of intent to construct a qualifying conduit hydropower facility, pursuant to section 30 of the Federal Power Act, as amended by section 4 of the Hydropower Regulatory Efficiency Act of 2013 (HREA). The...

  3. Evidence for Arbovirus Dissemination Conduits from the Mosquito (Diptera: Culicidae) Midgut

    National Research Council Canada - National Science Library

    Romoser, William

    2004-01-01

    .... Experiments using Venezuelan equine encephalitis viral replicon particles, which express the green fluorescent protein gene in cells, indicate the operation of tissue conduits, possibly involving...

  4. AC losses and stability on large cable-in-conduit superconductors

    Science.gov (United States)

    Bruzzone, Pierluigi

    1998-12-01

    The cable-in-conduit superconductors are preferred for applications where the AC losses and stability are a major concern, e.g., fusion magnets and SMES. A review of coupling currents loss results for both NbTi and Nb 3Sn cable-in-conduit conductors (CICC) is presented and the AC loss relevant features are listed, with special emphasis for the role of the interstrand resistance and strand coating. The transient stability approach for CICCs is discussed and the analytical models are quoted as well as the relevant experimental database. The likely spectrum of transient disturbance in CICC is reviewed and the need to account for interstrand current sharing in the design is outlined. Eventually a practical criterion for the interstrand resistance is proposed to link the stability and AC loss design.

  5. CIBLAGE D'INFLATION ET CONDUITE DE LA POLITIQUE ...

    African Journals Online (AJOL)

    Administrateur

    de l'amendement de la loi relative à la monnaie et au crédit, l'Algérie a explicitement ... la Banque d'Algérie, très importante pour la conduite de la politique monétaire. ..... matière de contrainte budgétaire entre les secteurs public et privé. En.

  6. Design and production of stopper made of concrete foam composite used for open channel conduit cover and parking bumper

    Science.gov (United States)

    Syam, Bustami; Sebayang, Alexander; Sebayang, Septian; Muttaqin, Maraghi; Darmadi, Harry; Basuki, WS; Sabri, M.; Abda, S.

    2018-03-01

    Open channel conduit is designed and produced with the aims to reduce excess water, whether from rain, seepage, or excess irrigation water in an area. It is also included in one of the important components of urban infrastructure in tackling the problem of flooding and waterlogging. On the roadway, e.g. housing complex the open channel conduits should function the same, however conduit covers are needed. The covers should be also designed to function as parking bumper. This paper discusses the design and production of the stoppers using our newly invented materials; the stoppers are structurally tested under static, dynamic, and bump test. Response of the conduit cover are found from structural analysis using finite element software ANSYS MECHANICAL version 17.5. Two types of stoppers are introduced: flat and curvy configuration. It was obtained that both types are suitable for open channel conduit cover and parking bumper.

  7. 78 FR 56872 - City of Barre, Vermont; Notice of Preliminary Determination of a Qualifying Conduit Hydropower...

    Science.gov (United States)

    2013-09-16

    ..., Vermont; Notice of Preliminary Determination of a Qualifying Conduit Hydropower Facility and Soliciting... construct a qualifying conduit hydropower facility, pursuant to section 30 of the Federal Power Act, as amended by section 4 of the Hydropower Regulatory Efficiency Act of 2013 (HREA). The Nelson Street 17 kW...

  8. Sealing a conduit end

    International Nuclear Information System (INIS)

    Mentz, R.M.

    1993-01-01

    An apparatus for sealing or blocking conduits, such as the primary nozzles of a nuclear steam generator is described. It includes an annular bracket sealingly attached to the open end of the nozzle, the bracket having a plurality of threaded holes therein. Mounted atop the bracket is a generally circular nozzle dam for covering the opening. Interposed between the nozzle dam and the bracket is an extrusion-resistant seal member having a plurality of apertures therethrough for receiving each bolt. The seal member is configured to resist extrusion by having laminated layers of differing hardnesses, so that the seal member will not laterally extrude away from each bolt in a manner that enlarges the aperture surrounding each bolt as the nozzle dam is bolted to the bracket. (author)

  9. Nitric oxide permits hypoxia-induced lymphatic perfusion by controlling arterial-lymphatic conduits in zebrafish and glass catfish

    DEFF Research Database (Denmark)

    Dahl Ejby Jensen, Lasse; Cao, Renhai; Hedlund, Eva-Maria

    2009-01-01

    and lymphatic perfusion. Here we show in the adult zebrafish and glass catfish (Kryptopterus bicirrhis) that blood-lymphatic conduits directly connect arterial vessels to the lymphatic system. Under hypoxic conditions, arterial-lymphatic conduits (ALCs) became highly dilated and linearized by NO...

  10. The Use of Degradable Nerve Conduits for Human Nerve Repair: A Review of the Literature

    Directory of Open Access Journals (Sweden)

    M. F. Meek

    2005-01-01

    Full Text Available The management of peripheral nerve injury continues to be a major clinical challenge. The most widely used technique for bridging defects in peripheral nerves is the use of autologous nerve grafts. This technique, however, has some disadvantages. Many alternative experimental techniques have thus been developed, such as degradable nerve conduits. Degradable nerve guides have been extensively studied in animal experimental studies. However, the repair of human nerves by degradable nerve conduits has been limited to only a few clinical studies. In this paper, an overview of the available international published literature on degradable nerve conduits for bridging human peripheral nerve defects is presented for literature available until 2004. Also, the philosophy on the use of nerve guides and nerve grafts is given.

  11. Sciatic nerve regeneration in rats by a promising electrospun collagen/poly(ε-caprolactone nerve conduit with tailored degradation rate

    Directory of Open Access Journals (Sweden)

    Jiang Xinquan

    2011-07-01

    Full Text Available Abstract Background To cope with the limitations faced by autograft acquisitions particularly for multiple nerve injuries, artificial nerve conduit has been introduced by researchers as a substitute for autologous nerve graft for the easy specification and availability for mass production. In order to best mimic the structures and components of autologous nerve, great efforts have been made to improve the designation of nerve conduits either from materials or fabrication techniques. Electrospinning is an easy and versatile technique that has recently been used to fabricate fibrous tissue-engineered scaffolds which have great similarity to the extracellular matrix on fiber structure. Results In this study we fabricated a collagen/poly(ε-caprolactone (collagen/PCL fibrous scaffold by electrospinning and explored its application as nerve guide substrate or conduit in vitro and in vivo. Material characterizations showed this electrospun composite material which was made of submicron fibers possessed good hydrophilicity and flexibility. In vitro study indicated electrospun collagen/PCL fibrous meshes promoted Schwann cell adhesion, elongation and proliferation. In vivo test showed electrospun collagen/PCL porous nerve conduits successfully supported nerve regeneration through an 8 mm sciatic nerve gap in adult rats, achieving similar electrophysiological and muscle reinnervation results as autografts. Although regenerated nerve fibers were still in a pre-mature stage 4 months postoperatively, the implanted collagen/PCL nerve conduits facilitated more axons regenerating through the conduit lumen and gradually degraded which well matched the nerve regeneration rate. Conclusions All the results demonstrated this collagen/PCL nerve conduit with tailored degradation rate fabricated by electrospinning could be an efficient alternative to autograft for peripheral nerve regeneration research. Due to its advantage of high surface area for cell attachment, it

  12. Long-Term Regeneration and Functional Recovery of a 15 mm Critical Nerve Gap Bridged by Tremella fuciformis Polysaccharide-Immobilized Polylactide Conduits

    Directory of Open Access Journals (Sweden)

    Shan-hui Hsu

    2013-01-01

    Full Text Available Novel peripheral nerve conduits containing the negatively charged Tremella fuciformis polysaccharide (TF were prepared, and their efficacy in bridging a critical nerve gap was evaluated. The conduits were made of poly(D,L-lactide (PLA with asymmetric microporous structure. TF was immobilized on the lumen surface of the nerve conduits after open air plasma activation. The TF-modified surface was characterized by the attenuated total reflection Fourier-transformed infrared spectroscopy and the scanning electron microscopy. TF modification was found to enhance the neurotrophic gene expression of C6 glioma cells in vitro. TF-modified PLA nerve conduits were tested for their ability to bridge a 15 mm gap of rat sciatic nerve. Nerve regeneration was monitored by the magnetic resonance imaging. Results showed that TF immobilization promoted the nerve connection in 6 weeks. The functional recovery in animals receiving TF-immobilized conduits was greater than in those receiving the bare conduits during an 8-month period. The degree of functional recovery reached ~90% after 8 months in the group of TF-immobilized conduits.

  13. Analytical studies on hotspot temperature of cable-in-conduit conductors

    International Nuclear Information System (INIS)

    Yoshida, Kiyoshi; Takigami, Hiroyoshi; Kubo, Hiroatsu

    2001-01-01

    This paper describes an analytical study to review the hotspot temperature design criteria of the cable-in-conduit conductors for the ITER magnet system. The ITER magnet system uses three kinds of cable-in-conduit conductors for the Toroidal Field (TF) coils, the Central Solenoid (CS) and the Poloidal Field (PF) coils. The amount of copper in the superconducting cable has been defined by using the classical hotspot temperature design criteria that is based on the adiabatic condition. In the current design, ITER superconducting cables include a large amount of pure copper strands to satisfy the classical criteria. However, temperature and stress in the conduit and insulations after quench can be simulated with the quench simulation program and stress analysis program using the latest analysis tools. This analysis shows that the strand temperature is dominated by the conduction along strands and the heat capacity of other conductor materials and coolant. The hotspot temperature depends strongly on the delay time for quench detection. This analysis provides an estimation of delay times for quench detection. The thermal and stress analysis can provide the maximum allowable temperature after quench by determination of a failure or a functional disorder condition of the jacket material and turn insulation. In conclusion, it is found that the current density of the cable space can be increased, by reducing the extra copper strand, thereby, allowing a reduction of the coil radial build. (author)

  14. A rare case of prosthetic endocarditis and dehiscence in a mechanical valved conduit.

    Science.gov (United States)

    Kannan, Arun; Smith, Cristy; Subramanian, Sreekumar; Janardhanan, Rajesh

    2014-02-07

    A middle-aged adult patient with a history of aortic root replacement with a mechanical valved conduit and remote chest trauma was referred to our institution with prosthetic endocarditis. Transoesophageal echocardiogram at our institution confirmed a near-complete dehiscence of the prosthetic aortic valve from the conduit, with significant perivalvular flow forming a pseudoaneurysm. The patient underwent a high-risk re-operation, involving redo aortic root replacement with a homograft after extensive debridement of the infected tissue. The patient was discharged to an outside facility after an uncomplicated hospital course, and remains stable.

  15. Tile drainage as karst: Conduit flow and diffuse flow in a tile-drained watershed

    Science.gov (United States)

    Schilling, K.E.; Helmers, M.

    2008-01-01

    The similarity of tiled-drained watersheds to karst drainage basins can be used to improve understanding of watershed-scale nutrient losses from subsurface tile drainage networks. In this study, short-term variations in discharge and chemistry were examined from a tile outlet collecting subsurface tile flow from a 963 ha agricultural watershed. Study objectives were to apply analytical techniques from karst springs to tile discharge to evaluate water sources and estimate the loads of agricultural pollutants discharged from the tile with conduit, intermediate and diffuse flow regimes. A two-member mixing model using nitrate, chloride and specific conductance was used to distinguish rainwater versus groundwater inputs. Results indicated that groundwater comprised 75% of the discharge for a three-day storm period and rainwater was primarily concentrated during the hydrograph peak. A contrasting pattern of solute concentrations and export loads was observed in tile flow. During base flow periods, tile flow consisted of diffuse flow from groundwater sources and contained elevated levels of nitrate, chloride and specific conductance. During storm events, suspended solids and pollutants adhered to soil surfaces (phosphorus, ammonium and organic nitrogen) were concentrated and discharged during the rapid, conduit flow portion of the hydrograph. During a three-day period, conduit flow occurred for 5.6% of the time but accounted for 16.5% of the total flow. Nitrate and chloride were delivered primarily with diffuse flow (more than 70%), whereas 80-94% of total suspended sediment, phosphorus and ammonium were exported with conduit and intermediate flow regimes. Understanding the water sources contributing to tile drainage and the manner by which pollutant discharge occurs from these systems (conduit, intermediate or diffuse flow) may be useful for designing, implementing and evaluating non-point source reduction strategies in tile-drained landscapes. ?? 2007 Elsevier B.V. All

  16. Thoracoscopic management of volvulus of the gastric conduit following minimally invasive Ivor-Lewis esophagectomy.

    Science.gov (United States)

    Linson, Jeremy; Latzko, Michael; Ahmed, Bestoun; Awad, Ziad

    2016-07-01

    We present a case of emergent thoracoscopic management of volvulus of the gastric conduit following minimally invasive Ivor-Lewis esophagectomy. The patient is a 69-year-old Caucasian male with a history of adenocarcinoma of the lower third of the esophagus. Initial presentation was dysphagia with solid foods, which progressed in severity until he was unable to swallow anything. EUS demonstrated a partially obstructing mass at 33 cm; biopsy revealed poorly differentiated adenocarcinoma, stage T3N2Mx. PET scan did not reveal any metastatic disease. Preoperative management included neo-adjuvant chemoradiation therapy (5-FU and cisplatin) and early placement of a jejunal feeding tube. Intra-operative leak test was performed as a matter of routine following completion of the esophagogastric anastomosis. A nasogastric tube was placed intra-operatively and removed on POD2 according to our standard pathway. Postoperatively, the patient progressed without difficulty to POD4, when we routinely obtain an upper GI swallow study. This demonstrated a lack of transit of contrast through the distal neo-esophagus. Follow-up endoscopy revealed volvulus of the gastric conduit with obliteration of the lumen. We immediately took the patient to the OR for thoracoscopic detorsion, which we accomplished successfully by entering the existing trochar sites and using blunt dissection.␣Upon entering the thoracic cavity, the staple line that had been oriented anteriorly was now posterior. Attachments were gently teased away from the chest wall and the conduit was detorsed and anchored to the chest wall in the correct orientation with silk suture. Intra-operative endoscopy demonstrated a patent conduit. Postoperative upper GI fluoroscopy now showed good transit of contrast. The patient continued to improve and was eventually advanced to mechanical soft diet and discharged on postoperative day 9. Early intervention is indicated in cases of volvulus of the gastric conduit following Ivor

  17. Application of near real-time radial semblance to locate the shallow magmatic conduit at Kilauea Volcano, Hawaii

    Science.gov (United States)

    Dawson, P.; Whilldin, D.; Chouet, B.

    2004-01-01

    Radial Semblance is applied to broadband seismic network data to provide source locations of Very-Long-Period (VLP) seismic energy in near real time. With an efficient algorithm and adequate network coverage, accurate source locations of VLP energy are derived to quickly locate the shallow magmatic conduit system at Kilauea Volcano, Hawaii. During a restart in magma flow following a brief pause in the current eruption, the shallow magmatic conduit is pressurized, resulting in elastic radiation from various parts of the conduit system. A steeply dipping distribution of VLP hypocenters outlines a region extending from sea level to about 550 m elevation below and just east of the Halemaumau Pit Crater. The distinct hypocenters suggest the shallow plumbing system beneath Halemaumau consists of a complex plexus of sills and dikes. An unconstrained location for a section of the conduit is also observed beneath the region between Kilauea Caldera and Kilauea Iki Crater.

  18. Numerical modeling and sensitivity analysis of seawater intrusion in a dual-permeability coastal karst aquifer with conduit networks

    Directory of Open Access Journals (Sweden)

    Z. Xu

    2018-01-01

    Full Text Available Long-distance seawater intrusion has been widely observed through the subsurface conduit system in coastal karst aquifers as a source of groundwater contaminant. In this study, seawater intrusion in a dual-permeability karst aquifer with conduit networks is studied by the two-dimensional density-dependent flow and transport SEAWAT model. Local and global sensitivity analyses are used to evaluate the impacts of boundary conditions and hydrological characteristics on modeling seawater intrusion in a karst aquifer, including hydraulic conductivity, effective porosity, specific storage, and dispersivity of the conduit network and of the porous medium. The local sensitivity analysis evaluates the parameters' sensitivities for modeling seawater intrusion, specifically in the Woodville Karst Plain (WKP. A more comprehensive interpretation of parameter sensitivities, including the nonlinear relationship between simulations and parameters, and/or parameter interactions, is addressed in the global sensitivity analysis. The conduit parameters and boundary conditions are important to the simulations in the porous medium because of the dynamical exchanges between the two systems. The sensitivity study indicates that salinity and head simulations in the karst features, such as the conduit system and submarine springs, are critical for understanding seawater intrusion in a coastal karst aquifer. The evaluation of hydraulic conductivity sensitivity in the continuum SEAWAT model may be biased since the conduit flow velocity is not accurately calculated by Darcy's equation as a function of head difference and hydraulic conductivity. In addition, dispersivity is no longer an important parameter in an advection-dominated karst aquifer with a conduit system, compared to the sensitivity results in a porous medium aquifer. In the end, the extents of seawater intrusion are quantitatively evaluated and measured under different scenarios with the variabilities of

  19. Silicic magma differentiation in ascent conduits. Experimental constraints

    Science.gov (United States)

    Rodríguez, Carmen; Castro, Antonio

    2017-02-01

    Crystallization of water-bearing silicic magmas in a dynamic thermal boundary layer is reproduced experimentally by using the intrinsic thermal gradient of piston-cylinder assemblies. The standard AGV2 andesite under water-undersaturated conditions is set to crystallize in a dynamic thermal gradient of about 35 °C/mm in 10 mm length capsules. In the hotter area of the capsule, the temperature is initially set at 1200 °C and decreases by programmed cooling at two distinct rates of 0.6 and 9.6 °C/h. Experiments are conducted in horizontally arranged assemblies in a piston cylinder apparatus to avoid any effect of gravity settling and compaction of crystals in long duration runs. The results are conclusive about the effect of water-rich fluids that are expelled out the crystal-rich zone (mush), where water saturation is reached by second boiling in the interstitial liquid. Expelled fluids migrate to the magma ahead of the solidification front contributing to a progressive enrichment in the fluxed components SiO2, K2O and H2O. The composition of water-rich fluids is modelled by mass balance using the chemical composition of glasses (quenched melt). The results are the basis for a model of granite magma differentiation in thermally-zoned conduits with application of in-situ crystallization equations. The intriguing textural and compositional features of the typical autoliths, accompanying granodiorite-tonalite batholiths, can be explained following the results of this study, by critical phenomena leading to splitting of an initially homogeneous magma into two magma systems with sharp boundaries. Magma splitting in thermal boundary layers, formed at the margins of ascent conduits, may operate for several km distances during magma transport from deep sources at the lower crust or upper mantle. Accordingly, conduits may work as chromatographic columns contributing to increase the silica content of ascending magmas and, at the same time, leave behind residual mushes that

  20. Transverse colon conduit urinary diversion in patients treated with very high dose pelvic irradiation

    International Nuclear Information System (INIS)

    Ravi, R.; Dewan, A.K.; Pandey, K.K.

    1994-01-01

    Urinary diversion may be required in patients receiving pelvic irradiation for gynaecological or genitourinary cancers either as part of a planned or salvage surgical procedure or for urological complications of irradiation. Records were reviewed for 30 such patients who underwent transverse colon conduit as a primary form of urinary diversion. Most of the conduits were constructed using refluxing ureterocolic anastomoses with stents. The results showed no operative mortality. Although the procedure was associated with a complication rate of 37% and a re-operation rate of 20%, there were no bowel or urinary anastomotic leaks. The operation could be safely performed on patients with renal failure, with 83% of such patients showing normal or improved serum creatinine levels post operatively. The advantages of transverse colon conduit urinary diversion are the use of non-irradiated bowel and ureters for diversion. It is recommended as a primary form of urinary diversion in these high risk cases. (Author)

  1. Selective reinnervation: a comparison of recovery following microsuture and conduit nerve repair.

    Science.gov (United States)

    Evans, P J; Bain, J R; Mackinnon, S E; Makino, A P; Hunter, D A

    1991-09-20

    Selective reinnervation was studied by comparing the regeneration across a conventional neurorraphy versus a conduit nerve repair. Lewis rats underwent right sciatic nerve transection followed by one of four different nerve repairs (n = 8/group). In groups I and II a conventional neurorraphy was performed and in groups III and IV the proximal and distal stumps were coapted by use of a silicone conduit with an interstump gap of 5 mm. The proximal and distal stumps in groups I and III were aligned anatomically correct and the proximal stump was rotated 180 degrees in groups II and IV (i.e. proximal peroneal nerve opposite the distal tibial nerve and the proximal tibial nerve opposite the distal peroneal nerve). By 14 weeks, there was an equivalent, but incomplete return in sciatic function index (SFI) in groups I, III, and IV as measured by walking track analysis. However, the SFI became unmeasurable by 6 weeks in all group II animals. At 14 weeks, the percent innervation of the tibialis anterior and medial gastronemius muscles by the peroneal and tibial nerves respectively was estimated by selective compound muscle action potential amplitude recordings. When fascicular alignment was reversed, there was greater tibial (P = 0.02) and lesser peroneal (P = 0.005) innervation of the gastrocnemius muscle in the conduit (group IV) versus the neurorraphy (group II) group. This suggests that the gastrocnemius muscle may be selectively reinnervated by the tibial nerve. However, there was no evidence of selective reinnervation of the tibialis anterior muscle. Despite these differences, the functional recovery in both conduit repair groups (III and IV) was equivalent to a correctly aligned microsuture repair (group I) and superior to that in the incorrectly aligned microsuture repair (group II).

  2. Pericardial tissue valves and Gore-Tex conduits as an alternative for right ventricular outflow tract replacement in children.

    Science.gov (United States)

    Allen, Bradley S; El-Zein, Chawki; Cuneo, Betina; Cava, Joseph P; Barth, Mary Jane; Ilbawi, Michel N

    2002-09-01

    There is still no perfect conduit for reconstruction of the right ventricular outflow tract (RVOT) in children. Homografts are not always available in the appropriate size, and degenerate in a few years. This study evaluates the pericardial valve with Gore-Tex conduit as an alternative for RVOT construction. From January 1, 1993, to September 30, 1999, a pericardial tissue valve was inserted in all patients undergoing RVOT reconstruction or pulmonary valve replacement (PVR) who were large enough to accommodate a tissue valve. In patients without a native main pulmonary artery, a new technique was used to construct an RV-PA conduit out of a flat sheet of Gore-Tex, as Dacron frequently leads to stenosis. Data were collected by retrospective review, follow-up echocardiograms, and assessment by a single cardiologist. There were 48 patients, 22 undergoing a PVR alone and 26 a RV-PA valved Gore-Tex conduit. Diagnosis included tetralogy of Fallot (n = 25); truncus arteriosis (n = 9); ventricular septal defect with PA (n = 5); DORV (n = 4); D-TGA with PS (n = 2); and 1 each IAA with sub AS, VSD with PI, and PS s/p Ross procedure. Patient age ranged from 3 to 33 years and 98% were reoperations. The valve sizes ranged from 19 to 33 mm and the median hospital length of stay was 4 days. There were 2 (4.2%) perioperative and 1 (2.1%) late deaths, none related to the valve or Gore-Tex conduit. At a follow-up of 15 to 86 months (mean 43 +/- 16 months), all remaining 45 patients are New York Heart Association class I, all valves are functional, and no patient has required valve or conduit replacement or revision; more importantly, echocardiogram revealed no significant valve or conduit stenosis (mean gradient 16 +/- 8 mm Hg) and no evidence of regurgitation or structural degeneration. A pericardial tissue valve and Gore-Tex conduit provides a reliable alternative for RVOT reconstruction in pediatric patients. It is readily available, molds in the limited retrosternal space, and

  3. Long distance seawater intrusion through a karst conduit network in the Woodville Karst Plain, Florida

    OpenAIRE

    Zexuan Xu; Seth Willis Bassett; Bill Hu; Scott Barrett Dyer

    2016-01-01

    Five periods of increased electrical conductivity have been found in the karst conduits supplying one of the largest first magnitude springs in Florida with water. Numerous well-developed conduit networks are distributed in the Woodville Karst Plain (WKP), Florida and connected to the Gulf of Mexico. A composite analysis of precipitation and electrical conductivity data provides strong evidence that the increases in conductivity are directly tied to seawater intrusion moving inland and travel...

  4. Lorentz force effect on mixed convection micropolar flow in a vertical conduit

    Science.gov (United States)

    Abdel-wahed, Mohamed S.

    2017-05-01

    The present work provides a simulation of control and filtration process of hydromagnetic blood flow with Hall current under the effect of heat source or sink through a vertical conduit (pipe). This work meets other engineering applications, such as nuclear reactors cooled during emergency shutdown, geophysical transport in electrically conducting and heat exchangers at low velocity conditions. The problem is modeled by a system of partial differential equations taking the effect of viscous dissipation, and these equations are simplified and solved analytically as a series solution using the Differential Transformation Method (DTM). The velocities and temperature profiles of the flow are plotted and discussed. Moreover, the conduit wall shear stress and heat flux are deduced and explained.

  5. Electromagnetic nondestructive testing at high lift-off using a magnetic image conduit

    International Nuclear Information System (INIS)

    Lee, Jin Yi; Jun, Jong Woo; Kim, Jung Min; Le, Min Hhuy

    2013-01-01

    To protect sensors from the extreme environments, such as, heat, moisture, pollution and radiation, cracks must be inspected for; this can be done by measuring the distribution of magnetic fields at high lift-off through nondestructive electro-magnetic testing. However, as the intensity of an electro-magnetic field is inversely proportional to the square of the lift-off, it becomes increasingly difficult to effective inspect a crack as the lift-off increases. In this paper, a magnetic image conduit to minimize the intensity loss of an electro-magnetic field at high lift-off is proposed, and the effectiveness of a conduit for magnetic imaging is verified by means of both theoretical and experimental approaches.

  6. Using MODFLOW with CFP to understand conduit-matrix exchange in a karst aquifer during flooding

    Science.gov (United States)

    Spellman, P.; Screaton, E.; Martin, J. B.; Gulley, J.; Brown, A.

    2011-12-01

    Karst springs may reverse flow when allogenic runoff increases river stage faster than groundwater heads and may exchange of surface water with groundwater in the surrounding aquifer matrix. Recharged flood water is rich in nutrients, metals, and organic matter and is undersaturated with respect to calcite. Understanding the physical processes controlling this exchange of water is critical to understanding metal cycling, redox chemistry and dissolution in the subsurface. Ultimately the magnitude of conduit-matrix exchange should be governed by head gradients between the conduit and the aquifer which are affected by the hydraulic conductivity of the matrix, conduit properties and antecedent groundwater heads. These parameters are interrelated and it is unknown which ones exert the greatest control over the magnitude of exchange. This study uses MODFLOW-2005 coupled with the Conduit Flow Processes (CFP) package to determine how physical properties of conduits and aquifers influence the magnitude of surface water-groundwater exchange. We use hydraulic data collected during spring reversals in a mapped underwater cave that sources Madison Blue Spring in north-central Florida to explore which factors are most important in governing exchange. The simulation focused on a major flood in 2009, when river stage increased by about 10 meters over 9 days. In a series of simulations, we varied hydraulic conductivity, conduit diameter, roughness height and tortuosity in addition to antecedent groundwater heads to estimate the relative effects of each parameter on the magnitude of conduit-matrix exchange. Each parameter was varied across plausible ranges for karst aquifers. Antecedent groundwater heads were varied using well data recorded through wet and dry seasons throughout the spring shed. We found hydraulic conductivity was the most important factor governing exchange. The volume of exchange increased by about 61% from the lowest value (1.8x10-6 m/d) to the highest value (6 m

  7. Challenges of management and therapy in patients with a functionally single ventricle after Fontan operation.

    Science.gov (United States)

    Trojnarska, Olga; Ciepłucha, Aleksandra

    2011-01-01

    Forty years ago, Fontan and Baudet performed the first life-saving operation on a patient with a functionally single ventricle. This multi-stage procedure established the connection between systemic venous circulation and pulmonary arteries. As a consequence, the pulmonary circulation is supplied in a passive way, whereas the single ventricle pumps the blood into the systemic circulation only. Over the years, the technique of creating the abovementioned vascular connections has undergone several modifications. Due to the fundamental non-physiological hemodynamic relations between arterial pulmonary and systemic venous pressures, numerous complications can be observed in these patients including: supraventricular arrhythmias, thromboemboli, hepatic dysfunction, protein-losing enteropathy, heart failure, worsening cyanosis, systemic venous collateralization, and pulmonary arteriovenous malformations, as well as connective tissue lesions in bronchi. Although based on an ingenious concept, the operation remains of a palliative character. Occasionally, heart transplantation is the ultimate resolution. Pharmacological therapy, and surgical conversion, often appear to be ineffective. However, this procedure has enabled many patients to reach adulthood and enjoy their lives to the full. This fact poses a great challenge for cardiologists wishing to become more knowledgeable and experienced as regards such patients, if we are not to waste such fabulous surgical achievements.

  8. Impact of pacing modality and biventricular pacing on cardiac output and coronary conduit flow in the post-cardiotomy patient.

    LENUS (Irish Health Repository)

    Healy, David G

    2012-02-03

    We have previously demonstrated the role of univentricular pacing modalities in influencing coronary conduit flow in the immediate post-operative period in the cardiac surgery patient. We wanted to determine the mechanism of this improved coronary conduit and, in addition, to explore the possible benefits with biventricular pacing. Sixteen patients undergoing first time elective coronary artery bypass grafting who required pacing following surgery were recruited. Comparison of cardiac output and coronary conduit flow was performed between VVI and DDD pacing with a single right ventricular lead and biventricular pacing lead placement. Cardiac output was measured using arterial pulse waveform analysis while conduit flow was measured using ultrasonic transit time methodology. Cardiac output was greatest with DDD pacing using right ventricular lead placement only [DDD-univentricular 5.42 l (0.7), DDD-biventricular 5.33 l (0.8), VVI-univentricular 4.71 l (0.8), VVI-biventricular 4.68 l (0.6)]. DDD-univentricular pacing was significantly better than VVI-univentricular (P=0.023) and VVI-biventricular pacing (P=0.001) but there was no significant advantage to DDD-biventricular pacing (P=0.45). In relation to coronary conduit flow, DDD pacing again had the highest flow [DDD-univentricular 55 ml\\/min (24), DDD-biventricular 52 ml\\/min (25), VVI-univentricular 47 ml\\/min (23), VVI-biventricular 50 ml\\/min (26)]. DDD-univentricular pacing was significantly better than VVI-univentricular (P=0.006) pacing but not significantly different to VVI-biventricular pacing (P=0.109) or DDD-biventricular pacing (P=0.171). Pacing with a DDD modality offers the optimal coronary conduit flow by maximising cardiac output. Biventricular lead placement offered no significant benefit to coronary conduit flow or cardiac output.

  9. Natural Occurring Silks and Their Analogues as Materials for Nerve Conduits

    Directory of Open Access Journals (Sweden)

    Christine Radtke

    2016-10-01

    Full Text Available Spider silk and its synthetic derivatives have a light weight in combination with good strength and elasticity. Their high cytocompatibility and low immunogenicity make them well suited for biomaterial products such as nerve conduits. Silk proteins slowly degrade enzymatically in vivo, thus allowing for an initial therapeutic effect such as in nerve scaffolding to facilitate endogenous repair processes, and then are removed. Silks are biopolymers naturally produced by many species of arthropods including spiders, caterpillars and mites. The silk fibers are secreted by the labial gland of the larvae of some orders of Holometabola (insects with pupa or the spinnerets of spiders. The majority of studies using silks for biomedical applications use materials from silkworms or spiders, mostly of the genus Nephila clavipes. Silk is one of the most promising biomaterials with effects not only in nerve regeneration, but in a number of regenerative applications. The development of silks for human biomedical applications is of high scientific and clinical interest. Biomaterials in use for biomedical applications have to meet a number of requirements such as biocompatibility and elicitation of no more than a minor inflammatory response, biodegradability in a reasonable time and specific structural properties. Here we present the current status in the field of silk-based conduit development for nerve repair and discuss current advances with regard to potential clinical transfer of an implantable nerve conduit for enhancement of nerve regeneration.

  10. Water exchange and pressure transfer between conduits and matrix and their influence on hydrodynamics of two karst aquifers with sinking streams

    Science.gov (United States)

    Bailly-Comte, Vincent; Martin, Jonathan B.; Jourde, Hervé; Screaton, Elizabeth J.; Pistre, Séverin; Langston, Abigail

    2010-05-01

    SummaryKarst aquifers are heterogeneous media where conduits usually drain water from lower permeability volumes (matrix and fractures). For more than a century, various approaches have used flood recession curves, which integrate all hydrodynamic processes in a karst aquifer, to infer physical properties of the movement and storage of groundwater. These investigations typically only consider flow to the conduits and thus have lacked quantitative observations of how pressure transfer and water exchange between matrix and conduit during flooding could influence recession curves. We present analyses of simultaneous discharge and water level time series of two distinctly different karst systems, one with low porosity and permeability matrix rocks in southern France, and one with high porosity and permeability matrix rocks in north-central Florida (USA). We apply simple mathematical models of flood recession using time series representations of recharge, storage, and discharge processes in the karst aquifer. We show that karst spring hydrographs can be interpreted according to pressure transfer between two distinct components of the aquifer, conduit and matrix porosity, which induce two distinct responses at the spring. Water exchange between conduits and matrix porosity successively control the flow regime at the spring. This exchange is governed by hydraulic head differences between conduits and matrix, head gradients within conduits, and the contrast of permeability between conduits and matrix. These observations have consequences for physical interpretations of recession curves and modeling of karst spring flows, particularly for the relative magnitudes of base flow and quick flow from karst springs. Finally, these results suggest that similar analyses of recession curves can be applied to karst aquifers with distinct physical characteristics utilizing well and spring hydrograph data, but information must be known about the hydrodynamics and physical properties of

  11. Conduit dynamics in transitional rhyolitic activity recorded by tuffisite vein textures from the 2008-2009 Chaitén eruption

    Directory of Open Access Journals (Sweden)

    Elodie eSaubin

    2016-05-01

    Full Text Available The mechanisms of hazardous silicic eruptions are controlled by complex, poorly-understood conduit processes. Observations of recent Chilean rhyolite eruptions have revealed the importance of hybrid activity, involving simultaneous explosive and effusive emissions from a common vent. Such behaviour hinges upon the ability of gas to decouple from magma in the shallow conduit. Tuffisite veins are increasingly suspected to be a key facilitator of outgassing, as they repeatedly provide a transient permeable escape route for volcanic gases. Intersection of foam domains by tuffisite veins appears critical to efficient outgassing. However, knowledge is currently lacking into textural heterogeneities within shallow conduits, their relationship with tuffisite vein propagation, and the implications for fragmentation and degassing processes. Similarly, the magmatic vesiculation response to upper conduit pressure perturbations, such as those related to the slip of dense magma plugs, remains largely undefined. Here we provide a detailed characterization of an exceptionally large tuffisite vein within a rhyolitic obsidian bomb ejected during transitional explosive-effusive activity at Chaitén, Chile in May 2008. Vein textures and chemistry provide a time-integrated record of the invasion of a dense upper conduit plug by deeper fragmented magma. Quantitative textural analysis reveals diverse vesiculation histories of various juvenile clast types.Using vesicle size distributions, bubble number densities, zones of diffusive water depletion, and glass H2O concentrations, we propose a multi-step degassing/fragmentation history, spanning deep degassing to explosive bomb ejection. Rapid decompression events of ~3-4 MPa are associated with fragmentation of foam and dense magma at ~200-350 metres depth in the conduit, permitting vertical gas and pyroclast mobility over hundreds of metres. Permeable pathway occlusion in the dense conduit plug by pyroclast accumulation

  12. Comparative analysis of the pressure profilometry of vesicocutaneous continent catheterizable conduits between patients with and without rectus abdominis neosphincter (Yachia principle).

    Science.gov (United States)

    Rondon, Atila; Leslie, Bruno; Arcuri, Leonardo Javier; Ortiz, Valdemar; Macedo, Antonio

    2015-09-01

    To assess whether crossing rectus abdominis muscle strips, as proposed by Yachia, would change urinary catheterizable conduit's pressure profilometry, in static and dynamic conditions. Non-randomized selection of 20 continent patients that underwent Macedo's ileum-based reservoir, 10 including Yachia's technique (Study Group) and 10 without this mechanism of continence (Control Group). Demographics and cystometric data were assessed. Conduit's pressure profilometry was obtained by infusing saline through a multichannel catheter, at rest and during Valsalva maneuver. We assessed the pressure: (a) in the bladder; (b) in conduit's proximal segment; and (c) in conduit's distal segment, which is presumably the abdominal wall and crossed muscle strips site. Mean age at surgery was 6.1 years in the Control Group and 7.7 years in the Study Group. There was no statistically significant difference between groups regarding maximum cystometric bladder capacity and leakage point pressure. At rest, the pressure profilometry showed similar results between groups in all segments analyzed. During Valsalva maneuver, pressure profilometry showed similar results between groups in bladder and conduit's proximal segment pressure. In this condition, conduit's distal segment pressure in the Study Group (Mean = 72.9 and Peak = 128.7 cmH2 O) was significantly greater (P continence. © 2014 Wiley Periodicals, Inc.

  13. A new venous conduit utilizing the recipient portal vein branches for segment V in adult partial liver transplantation.

    Science.gov (United States)

    Moon, I S; Kim, D G; Lee, M D; Hong, S K; Park, S C; Oh, D Y; Ahn, S T; Lee, Y J

    2005-03-01

    Right anterior-medial lobe congestion due to temporary clamping of segment V and/or VIII is common in the operative theater during adult donor right lobe liver transplantation, the most common procedure in our institute. We have used an autogenous saphenous vein conduit to recipient portal vein tributaries in 15 cases, as a "Y-to-I venoplasty" since January 2004. The recipient portal vein is transected 5 mm proximal to its bifurcation and extended to both sides with partial hepatic dissection. The "Y-to-I venoplasty" is made by suture closure of the portal vein transversely to form a tube. The average length is 7.5 cm with a 1.3 cm width. One end of "Y-to-I venoplasty" conduit is anastomosed to the donor segment V branch on the back table. And the other end is anastomosed directly to the IVC via a new window or the middle hepatic vein stump in recipient. The phase distension of the conduit with respiration is noted in the operative field. A 6/15 (40%) patency rate, was observed by CT angiography at the second postoperative week. All-patient conduits showed good flow on serial examinations at the 60th postoperative day. This new venous graft, made of recipient portal vein is a good conduit for segment V decongestion in adult right lobe partial liver transplantation.

  14. Erosion of cohesive soil layers above underground conduits

    Science.gov (United States)

    Luu, Li-Hua; Philippe, Pierre; Noury, Gildas; Perrin, Jérôme; Brivois, Olivier

    2017-06-01

    Using a recently developed 2D numerical modelling that combines Discrete Element (DEM) and Lattice Boltzmann methods (LBM), we simulate the destabilisation by an hydraulic gradient of a cohesive granular soil clogging the top of an underground conduit. We aim to perform a multi-scale study that relates the grain scale behavior to the macroscopic erosion process. In particular, we study the influence of the flow conditions and the inter-particle contact forces intensity on the erosion kinetic.

  15. Documentation of a Conduit Flow Process (CFP) for MODFLOW-2005

    Science.gov (United States)

    Shoemaker, W. Barclay; Kuniansky, Eve L.; Birk, Steffen; Bauer, Sebastian; Swain, Eric D.

    2007-01-01

    This report documents the Conduit Flow Process (CFP) for the modular finite-difference ground-water flow model, MODFLOW-2005. The CFP has the ability to simulate turbulent ground-water flow conditions by: (1) coupling the traditional ground-water flow equation with formulations for a discrete network of cylindrical pipes (Mode 1), (2) inserting a high-conductivity flow layer that can switch between laminar and turbulent flow (Mode 2), or (3) simultaneously coupling a discrete pipe network while inserting a high-conductivity flow layer that can switch between laminar and turbulent flow (Mode 3). Conduit flow pipes (Mode 1) may represent dissolution or biological burrowing features in carbonate aquifers, voids in fractured rock, and (or) lava tubes in basaltic aquifers and can be fully or partially saturated under laminar or turbulent flow conditions. Preferential flow layers (Mode 2) may represent: (1) a porous media where turbulent flow is suspected to occur under the observed hydraulic gradients; (2) a single secondary porosity subsurface feature, such as a well-defined laterally extensive underground cave; or (3) a horizontal preferential flow layer consisting of many interconnected voids. In this second case, the input data are effective parameters, such as a very high hydraulic conductivity, representing multiple features. Data preparation is more complex for CFP Mode 1 (CFPM1) than for CFP Mode 2 (CFPM2). Specifically for CFPM1, conduit pipe locations, lengths, diameters, tortuosity, internal roughness, critical Reynolds numbers (NRe), and exchange conductances are required. CFPM1, however, solves the pipe network equations in a matrix that is independent of the porous media equation matrix, which may mitigate numerical instability associated with solution of dual flow components within the same matrix. CFPM2 requires less hydraulic information and knowledge about the specific location and hydraulic properties of conduits, and turbulent flow is approximated by

  16. Convection in a volcanic conduit recorded by bubbles

    Science.gov (United States)

    Carey, Rebecca J.; Manga, Michael; Degruyter, Wim; Gonnermann, Helge M.; Swanson, Donald; Houghton, Bruce F.; Orr, Tim R.; Patrick, Matthew R.

    2013-01-01

    Microtextures of juvenile pyroclasts from Kīlauea’s (Hawai‘i) early A.D. 2008 explosive activity record the velocity and depth of convection within the basaltic magma-filled conduit. We use X-ray microtomography (μXRT) to document the spatial distribution of bubbles. We find small bubbles (radii from 5 μm to 70 μm) in a halo surrounding larger millimeter-size bubbles. This suggests that dissolved water was enriched around the larger bubbles—the opposite of what is expected if bubbles grow as water diffuses into the bubble. Such volatile enrichment implies that the volatiles within the large bubbles were redissolving into the melt as they descended into the conduit by the downward motion of convecting magma within the lava lake. The thickness of the small bubble halo is ∼100–150 μm, consistent with water diffusing into the melt on time scales on the order of 103 s. Eruptions, triggered by rockfall, rapidly exposed this magma to lower pressures, and the haloes of melt with re-dissolved water became sufficiently supersaturated to cause nucleation of the population of smaller bubbles. The required supersaturation pressures are consistent with a depth of a few hundred meters and convection velocities of the order of 0.1 m s−1, similar to the circulation velocity observed on the surface of the Halema‘uma‘u lava lake.

  17. Conduit for high temperature transfer of molten semiconductor crystalline material

    Science.gov (United States)

    Fiegl, George (Inventor); Torbet, Walter (Inventor)

    1983-01-01

    A conduit for high temperature transfer of molten semiconductor crystalline material consists of a composite structure incorporating a quartz transfer tube as the innermost member, with an outer thermally insulating layer designed to serve the dual purposes of minimizing heat losses from the quartz tube and maintaining mechanical strength and rigidity of the conduit at the elevated temperatures encountered. The composite structure ensures that the molten semiconductor material only comes in contact with a material (quartz) with which it is compatible, while the outer layer structure reinforces the quartz tube, which becomes somewhat soft at molten semiconductor temperatures. To further aid in preventing cooling of the molten semiconductor, a distributed, electric resistance heater is in contact with the surface of the quartz tube over most of its length. The quartz tube has short end portions which extend through the surface of the semiconductor melt and which are lef bare of the thermal insulation. The heater is designed to provide an increased heat input per unit area in the region adjacent these end portions.

  18. Fabrication of bioactive conduits containing the fibroblast growth factor 1 and neural stem cells for peripheral nerve regeneration across a 15 mm critical gap

    International Nuclear Information System (INIS)

    Ni, Hsiao-Chiang; Tseng, Ting-Chen; Hsu, Shan-hui; Chen, Jeng-Rung; Chiu, Ing-Ming

    2013-01-01

    Nerve conduits are often used in combination with bioactive molecules and stem cells to enhance peripheral nerve regeneration. In this study, the acidic fibroblast growth factor 1 (FGF1) was immobilized onto the microporous/micropatterned poly (D, L-lactic acid) (PLA) nerve conduits after open air plasma treatment. PLA substrates grafted with chitosan in the presence of a small amount of gold nanoparticles (nano Au) showed a protective effect on the activity of the immobilized FGF1 in vitro. Different conduits were tested for their ability to bridge a 15 mm critical gap defect in a rat sciatic nerve injury model. Axon regeneration and functional recovery were evaluated by histology, walking track analysis and electrophysiology. Among different conduits, PLA conduits grafted with chitosan–nano Au and the FGF1 after plasma activation had the greatest regeneration capacity and functional recovery in the experimental animals. When the above conduit was seeded with aligned neural stem cells, the efficacy was further enhanced and it approached that of the autograft group. This work suggested that microporous/micropatterned nerve conduits containing bioactive growth factors may be successfully fabricated by micropatterning techniques, open plasma activation, and immobilization, which, combined with aligned stem cells, may synergistically contribute to the regeneration of the severely damaged peripheral nerve. (paper)

  19. Erosion of cohesive soil layers above underground conduits

    Directory of Open Access Journals (Sweden)

    Luu Li-Hua

    2017-01-01

    Full Text Available Using a recently developed 2D numerical modelling that combines Discrete Element (DEM and Lattice Boltzmann methods (LBM, we simulate the destabilisation by an hydraulic gradient of a cohesive granular soil clogging the top of an underground conduit. We aim to perform a multi-scale study that relates the grain scale behavior to the macroscopic erosion process. In particular, we study the influence of the flow conditions and the inter-particle contact forces intensity on the erosion kinetic.

  20. Comparison of echocardiographic and cardiac magnetic resonance imaging measurements of functional single ventricular volumes, mass, and ejection fraction (from the Pediatric Heart Network Fontan Cross-Sectional Study).

    Science.gov (United States)

    Margossian, Renee; Schwartz, Marcy L; Prakash, Ashwin; Wruck, Lisa; Colan, Steven D; Atz, Andrew M; Bradley, Timothy J; Fogel, Mark A; Hurwitz, Lynne M; Marcus, Edward; Powell, Andrew J; Printz, Beth F; Puchalski, Michael D; Rychik, Jack; Shirali, Girish; Williams, Richard; Yoo, Shi-Joon; Geva, Tal

    2009-08-01

    Assessment of the size and function of a functional single ventricle (FSV) is a key element in the management of patients after the Fontan procedure. Measurement variability of ventricular mass, volume, and ejection fraction (EF) among observers by echocardiography and cardiac magnetic resonance imaging (CMR) and their reproducibility among readers in these patients have not been described. From the 546 patients enrolled in the Pediatric Heart Network Fontan Cross-Sectional Study (mean age 11.9 +/- 3.4 years), 100 echocardiograms and 50 CMR studies were assessed for measurement reproducibility; 124 subjects with paired studies were selected for comparison between modalities. Interobserver agreement for qualitative grading of ventricular function by echocardiography was modest for left ventricular (LV) morphology (kappa = 0.42) and weak for right ventricular (RV) morphology (kappa = 0.12). For quantitative assessment, high intraclass correlation coefficients were found for echocardiographic interobserver agreement (LV 0.87 to 0.92, RV 0.82 to 0.85) of systolic and diastolic volumes, respectively. In contrast, intraclass correlation coefficients for LV and RV mass were moderate (LV 0.78, RV 0.72). The corresponding intraclass correlation coefficients by CMR were high (LV 0.96, RV 0.85). Volumes by echocardiography averaged 70% of CMR values. Interobserver reproducibility for the EF was similar for the 2 modalities. Although the absolute mean difference between modalities for the EF was small (<2%), 95% limits of agreement were wide. In conclusion, agreement between observers of qualitative FSV function by echocardiography is modest. Measurements of FSV volume by 2-dimensional echocardiography underestimate CMR measurements, but their reproducibility is high. Echocardiographic and CMR measurements of FSV EF demonstrate similar interobserver reproducibility, whereas measurements of FSV mass and LV diastolic volume are more reproducible by CMR.

  1. The Railway and the River: Conduits of Dickens’s Imaginary City

    NARCIS (Netherlands)

    Moore, B.; Murail, E.; Thornton, S.

    2017-01-01

    This chapter analyses the railway and the river as two key conduits of Dickens’ imaginary city, arguing that each simultaneously connects and fractures the modern urban world that he depicts. Focusing on Dombey and Son and Our Mutual Friend, the chapter explores how railway and river combine

  2. Three-layer microfibrous peripheral nerve guide conduit composed of elastin-laminin mimetic artificial protein and poly(L-lactic acid

    Directory of Open Access Journals (Sweden)

    Sachiro eKakinoki

    2014-07-01

    Full Text Available We developed a microfibrous poly(L-lactic acid (PLLA nerve conduit with a three-layered structure to simultaneously enhance nerve regeneration and prevent adhesion of surrounding tissue. The inner layer was composed of PLLA microfiber containing 25% elastin-laminin mimetic protein (AG73-(VPGIG30 that promotes neurite outgrowth. The thickest middle layer was constructed of pure PLLA microfibers that impart the large mechanical stremgth to the conduit. A 10% poly(ethylene glycol was added to the outer layer to prevent the adhesion with the surrounding tissue. The AG73-(VPGIG30 composisting of an elastin-like repetitive sequence (VPGIG30 and a laminin-derived sequence (RKRLQVQLSIRT: AG73 was biosynthesized using Escherichia coli. The PLLA microfibrous conduits were fabricated using an electrospinning procedure. AG73-(VPGIG30 was successfully mixed in the PLLA microfibers, and the PLLA/AG73-(VPGIG30 microfibers were stable under physiological conditions. The PLLA/AG73-(VPGIG30 microfibers enhanced adhesion and neurite outgrowth of PC12 cells. The electrospun microfibrous conduit with a three-layered structure was implanted for bridging a 2.0-cm gap in the tibial nerve of a rabbit. Two months after implantation, no adhesion of surrounding tissue was observed, and the action potential was slightly improved in the nerve conduit with the PLLA/AG73-(VPGIG30 inner layer.

  3. Three-layer microfibrous peripheral nerve guide conduit composed of elastin-laminin mimetic artificial protein and poly(L-lactic acid)

    Science.gov (United States)

    Kakinoki, Sachiro; Nakayama, Midori; Moritan, Toshiyuki; Yamaoka, Tetsuji

    2014-07-01

    We developed a microfibrous poly(L-lactic acid) (PLLA) nerve conduit with a three-layered structure to simultaneously enhance nerve regeneration and prevent adhesion of surrounding tissue. The inner layer was composed of PLLA microfiber containing 25% elastin-laminin mimetic protein (AG73-(VPGIG)30) that promotes neurite outgrowth. The thickest middle layer was constructed of pure PLLA microfibers that impart the large mechanical stremgth to the conduit. A 10% poly(ethylene glycol) was added to the outer layer to prevent the adhesion with the surrounding tissue. The AG73-(VPGIG)30 composisting of an elastin-like repetitive sequence (VPGIG)30 and a laminin-derived sequence (RKRLQVQLSIRT: AG73) was biosynthesized using Escherichia coli. The PLLA microfibrous conduits were fabricated using an electrospinning procedure. AG73-(VPGIG)30 was successfully mixed in the PLLA microfibers, and the PLLA/AG73-(VPGIG)30 microfibers were stable under physiological conditions. The PLLA/AG73-(VPGIG)30 microfibers enhanced adhesion and neurite outgrowth of PC12 cells. The electrospun microfibrous conduit with a three-layered structure was implanted for bridging a 2.0-cm gap in the tibial nerve of a rabbit. Two months after implantation, no adhesion of surrounding tissue was observed, and the action potential was slightly improved in the nerve conduit with the PLLA/AG73-(VPGIG)30 inner layer.

  4. FDG-PET identification of infected pulmonary artery conduit following tetralogy of fallot (TOF) repair

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yu Yang; Williams, Hadyn; Pucar, Darko [Dept. of Radiology, Medical College of Georgia, Augusta (United States)

    2017-03-15

    Tetralogy of Fallot (TOF) is one of the most common forms of cyanotic congenital heart disease usually managed by serial surgical repairs. The repaired prosthetic valve or conduit is susceptible to life-threatening infection. FDG-PET is an effective alternative to evaluate the source of infection when other examinations are inconclusive. We report an unusual case of an infected pulmonary artery conduit after TOF repair although the echocardiogram was negative for vegetation, which was later confirmed by surgery and pathology. The case highlights the role of FDG-PET as a problem-solving tool for potential endocarditis and cardiac device infection cases after complex cardiac surgery.

  5. FDG-PET identification of infected pulmonary artery conduit following tetralogy of fallot (TOF) repair

    International Nuclear Information System (INIS)

    Zhang, Yu Yang; Williams, Hadyn; Pucar, Darko

    2017-01-01

    Tetralogy of Fallot (TOF) is one of the most common forms of cyanotic congenital heart disease usually managed by serial surgical repairs. The repaired prosthetic valve or conduit is susceptible to life-threatening infection. FDG-PET is an effective alternative to evaluate the source of infection when other examinations are inconclusive. We report an unusual case of an infected pulmonary artery conduit after TOF repair although the echocardiogram was negative for vegetation, which was later confirmed by surgery and pathology. The case highlights the role of FDG-PET as a problem-solving tool for potential endocarditis and cardiac device infection cases after complex cardiac surgery

  6. Long distance seawater intrusion through a karst conduit network in the Woodville Karst Plain, Florida

    Science.gov (United States)

    Xu, Zexuan; Bassett, Seth Willis; Hu, Bill; Dyer, Scott Barrett

    2016-08-01

    Five periods of increased electrical conductivity have been found in the karst conduits supplying one of the largest first magnitude springs in Florida with water. Numerous well-developed conduit networks are distributed in the Woodville Karst Plain (WKP), Florida and connected to the Gulf of Mexico. A composite analysis of precipitation and electrical conductivity data provides strong evidence that the increases in conductivity are directly tied to seawater intrusion moving inland and traveling 11 miles against the prevailing regional hydraulic gradient from from Spring Creek Spring Complex (SCSC), a group of submarine springs at the Gulf Coast. A geochemical analysis of samples from the spring vent rules out anthropogenic contamination and upwelling regional recharge from the deep aquifer as sources of the rising conductivity. The interpretation is supported by the conceptual model established by prior researchers working to characterize the study area. This paper documents the first and longest case of seawater intrusion in the WKP, and also indicates significant possibility of seawater contamination through subsurface conduit networks in a coastal karst aquifer.

  7. Dual-Component Gelatinous Peptide/Reactive Oligomer Formulations as Conduit Material and Luminal Filler for Peripheral Nerve Regeneration.

    Science.gov (United States)

    Kohn-Polster, Caroline; Bhatnagar, Divya; Woloszyn, Derek J; Richtmyer, Matthew; Starke, Annett; Springwald, Alexandra H; Franz, Sandra; Schulz-Siegmund, Michaela; Kaplan, Hilton M; Kohn, Joachim; Hacker, Michael C

    2017-05-21

    Toward the next generation of nerve guidance conduits (NGCs), novel biomaterials and functionalization concepts are required to address clinical demands in peripheral nerve regeneration (PNR). As a biological polymer with bioactive motifs, gelatinous peptides are promising building blocks. In combination with an anhydride-containing oligomer, a dual-component hydrogel system (cGEL) was established. First, hollow cGEL tubes were fabricated by a continuous dosing and templating process. Conduits were characterized concerning their mechanical strength, in vitro and in vivo degradation and biocompatibility. Second, cGEL was reformulated as injectable shear thinning filler for established NGCs, here tyrosine-derived polycarbonate-based braided conduits. Thereby, the formulation contained the small molecule LM11A-31. The biofunctionalized cGEL filler was assessed regarding building block integration, mechanical properties, in vitro cytotoxicity, and growth permissive effects on human adipose tissue-derived stem cells. A positive in vitro evaluation motivated further application of the filler material in a sciatic nerve defect. Compared to the empty conduit and pristine cGEL, the functionalization performed superior, though the autologous nerve graft remains the gold standard. In conclusion, LM11A-31 functionalized cGEL filler with extracellular matrix (ECM)-like characteristics and specific biochemical cues holds great potential to support PNR.

  8. Sciatic nerve regeneration by transplantation of Schwann cells via erythropoietin controlled-releasing polylactic acid/multiwalled carbon nanotubes/gelatin nanofibrils neural guidance conduit.

    Science.gov (United States)

    Salehi, Majid; Naseri-Nosar, Mahdi; Ebrahimi-Barough, Somayeh; Nourani, Mohammdreza; Khojasteh, Arash; Hamidieh, Amir-Ali; Amani, Amir; Farzamfar, Saeed; Ai, Jafar

    2018-05-01

    The current study aimed to enhance the efficacy of peripheral nerve regeneration using an electrically conductive biodegradable porous neural guidance conduit for transplantation of allogeneic Schwann cells (SCs). The conduit was produced from polylactic acid (PLA), multiwalled carbon nanotubes (MWCNTs), and gelatin nanofibrils (GNFs) coated with the recombinant human erythropoietin-loaded chitosan nanoparticles (rhEpo-CNPs). The PLA/MWCNTs/GNFs/rhEpo-CNPs conduit had the porosity of 85.78 ± 0.70%, the contact angle of 77.65 ± 1.91° and the ultimate tensile strength and compressive modulus of 5.51 ± 0.13 MPa and 2.66 ± 0.34 MPa, respectively. The conduit showed the electrical conductivity of 0.32 S cm -1 and lost about 11% of its weight after 60 days in normal saline. The produced conduit was able to release the rhEpo for at least 2 weeks and exhibited favorable cytocompatibility towards SCs. For functional analysis, the conduit was seeded with 1.5 × 10 4 SCs and implanted into a 10 mm sciatic nerve defect of Wistar rat. After 14 weeks, the results of sciatic functional index, hot plate latency, compound muscle action potential amplitude, weight-loss percentage of wet gastrocnemius muscle and Histopathological examination using hematoxylin-eosin and Luxol fast blue staining demonstrated that the produced conduit had comparable nerve regeneration to the autograft, as the gold standard to bridge the nerve gaps. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1463-1476, 2018. © 2017 Wiley Periodicals, Inc.

  9. Magma wagging and whirling in volcanic conduits

    Science.gov (United States)

    Liao, Yang; Bercovici, David; Jellinek, Mark

    2018-02-01

    Seismic tremor characterized by 0.5-7 Hz ground oscillations commonly occur before and during eruptions at silicic volcanoes with widely ranging vent geometries and edifice structures. The ubiquitous characteristics of this tremor imply that its causes are potentially common to silicic volcanoes. Here we revisit and extend to three dimensions the magma-wagging model for tremor (Jellinek and Bercovici, 2011; Bercovici et al., 2013), wherein a stiff magma column rising in a vertical conduit oscillates against a surrounding foamy annulus of bubbly magma, giving rise to tremor. While prior studies were restricted to two-dimensional lateral oscillations, here we explore three-dimensional motion and additional modes of oscillations. In the absence of viscous damping, the magma column undergoes 'whirling' motion: the center of each horizontal section of the column traces an elliptical trajectory. In the presence of viscous effect we identify new 'coiling' and 'uncoiling' column bending shapes with relatively higher and comparable rates of dissipation to the original two-dimensional magma wagging model. We also calculate the seismic P-wave response of the crustal material around the volcanic conduit to the new whirling motions and propose seismic diagnostics for different wagging patterns using the time-lag between seismic stations. We test our model by analyzing pre-eruptive seismic data from the 2009 eruption of Redoubt Volcano. In addition to suggesting that the occurrence of elliptical whirling motion more than 1 week before the eruption, our analysis of seismic time-lags also implies that the 2009 eruption was accompanied by qualitative changes in the magma wagging behavior including fluctuations in eccentricity and a reversal in the direction of elliptical whirling motion when the eruption was immediately impending.

  10. Vulcanian explosions at Volcán de Colima, Mexico: modelling the conduit processes

    Science.gov (United States)

    Varley, N. R.; Stevenson, J.; Johnson, J.; Reyes, G.; Weber, K.; Sanderson, R.

    2006-12-01

    Activity at Volcán de Colima has increased over the past 8 years, and is possibly building towards a significant eruption. Monitoring its current activity is therefore critical, with recent expansion of the network providing new types of data which need to be understood. Recent activity has consisted of 3 effusive episodes lasting up to 22 months, separated by periods characterised by daily Vulcanian eruptions of small to moderate size; the largest producing pyroclastic flows reaching over 5 km, representing the most significant since the last Plinian event (1913). A model has been proposed to explain the mechanism of the Vulcanian explosions, derived through integrating different data including seismicity, SO2 flux and the ascent velocity and thermal emission of the eruption column. Infrasound measurements have helped to demonstrate the variability in the distribution of energy produced by the events. Swarms of low frequency seismic events were associated with the largest magnitude explosions and have been examined statistically with variations observed in the magnitude-frequency relationship of each swarm and their distribution. Seismic evidence of migration of the source has been identified, maybe explained by brittle fracturing associated with an increasing pressure differential within the conduit system. Volcán de Colima has a complex edifice structure with explosions switching between multiple vents and showing pulsing. Variation in remotely monitored fumarole temperatures has also been related to the explosive activity. It is clear that small variations of certain critical factors within the conduit system can lead to a transition between effusive and explosive activity. Frequent transitions at Volcán de Colima provide an ideal opportunity to analyse variations in the observable signals and deduce relationships with changes within the conduit that influence magma ascent and degassing, such as its volatile contents or ascent velocity. One goal of this

  11. Inactive supply wells as conduits for flow and contaminant migration: conditions of occurrence and suggestions for management

    Science.gov (United States)

    Gailey, Robert M.

    2017-11-01

    Water supply wells can act as conduits for vertical flow and contaminant migration between water-bearing strata under common hydrogeologic and well construction conditions. While recognized by some for decades, there is little published data on the magnitude of flows and extent of resulting water quality impacts. Consequently, the issue may not be acknowledged widely enough and the need for better management persists. This is especially true for unconsolidated alluvial groundwater basins that are hydrologically stressed by agricultural activities. Theoretical and practical considerations indicate that significant water volumes can migrate vertically through wells. The flow is often downward, with shallow groundwater, usually poorer in quality, migrating through conduit wells to degrade deeper water quality. Field data from locations in California, USA, are presented in combination with modeling results to illustrate both the prevalence of conditions conducive to intraborehole flow and the resulting impacts to water quality. Suggestions for management of planned wells include better enforcement of current regulations and more detailed consideration of hydrogeologic conditions during design and installation. A potentially greater management challenge is presented by the large number of existing wells. Monitoring for evidence of conduit flow and solute transport in areas of high well density is recommended to identify wells that pose greater risks to water quality. Conduit wells that are discovered may be addressed through approaches that include structural modification and changes in operations.

  12. Incorporation of cooling-induced crystallization into a 2-dimensional axisymmetric conduit heat flow model

    Science.gov (United States)

    Heptinstall, David; Bouvet de Maisonneuve, Caroline; Neuberg, Jurgen; Taisne, Benoit; Collinson, Amy

    2016-04-01

    Heat flow models can bring new insights into the thermal and rheological evolution of volcanic 3 systems. We shall investigate the thermal processes and timescales in a crystallizing, static 4 magma column, with a heat flow model of Soufriere Hills Volcano (SHV), Montserrat. The latent heat of crystallization is initially computed with MELTS, as a function of pressure and temperature for an andesitic melt (SHV groundmass starting composition). Three fractional crystallization simulations are performed; two with initial pressures of 34MPa (runs 1 & 2) and one of 25MPa (run 3). Decompression rate was varied between 0.1MPa/° C (runs 1 & 3) and 0.2MPa/° C (run 2). Natural and experimental matrix glass compositions are accurately reproduced by all MELTS runs. The cumulative latent heat released for runs 1, 2 and 3 differs by less than 9% (8.69E5 J/kg*K, 9.32E5 J/kg*K, and 9.49E5 J/kg*K respectively). The 2D axisymmetric conductive cooling simulations consider a 30m-diameter conduit that extends from the surface to a depth of 1500m (34MPa). The temporal evolution of temperature is closely tracked at depths of 10m, 750m and 1400m in the centre of the conduit, at the conduit walls, and 20m from the walls into the host rock. Following initial cooling by 7-15oC at 10m depth inside the conduit, the magma temperature rebounds through latent heat release by 32-35oC over 85-123 days to a maximum temperature of 1002-1005oC. At 10m depth, it takes 4.1-9.2 years for the magma column to cool by 108-131oC and crystallize to 75wt%, at which point it cannot be easily remobilized. It takes 11-31.5 years to reach the same crystallinity at 750-1400m depth. We find a wide range in cooling timescales, particularly at depths of 750m or greater, attributed to the initial run pressure and the dominant latent heat producing crystallizing phase, Albite-rich Plagioclase Feldspar. Run 1 is shown to cool fastest and run 3 cool the slowest, with surface emissivity having the strongest cooling

  13. Associated genetic syndromes and extracardiac malformations strongly influence outcomes of fetuses with congenital heart diseases.

    Science.gov (United States)

    Bensemlali, Myriam; Bajolle, Fanny; Ladouceur, Magalie; Fermont, Laurent; Lévy, Marilyne; Le Bidois, Jérôme; Salomon, Laurent J; Bonnet, Damien

    2016-05-01

    Congenital heart disease (CHD) is often associated with extracardiac malformations (ECMs) and genetic syndromes. To determine the effect of cytogenetic anomalies and/or ECMs associated with CHD on parental decision to choose termination of pregnancy (TOP) or compassionate care (CC), as well as on the outcome of children born alive. This 10-year retrospective study included all prenatally diagnosed cases of CHD in a single tertiary referral centre. From January 2002 to December 2011, 2036 consecutive cases of fetal CHD (798 TOPs and 1238 live births, including 59 with postnatal CC) were included. CHD was associated with a known cytogenetic anomaly in 9.8% of cases and a major ECM in 11.7% of cases. The proportion of prenatally identified associated cytogenetic anomalies was significantly lower in the live-birth group than in the TOP plus CC group (4.2% vs 17.5%; P<0.001); this was also true for ECMs (8.1% vs 16.7%; P<0.001). The mortality rate was higher in the group with an associated cytogenetic anomaly or ECM (29.1%) than in cases with isolated CHD; a 2.4-fold increase in the death rate was observed (95% confidence interval 1.34-4.38; P=0.003). These associations remained significant after multivariable analysis, including the severity of the CHD (uni- or biventricular physiology). Prenatal diagnosis of a known cytogenetic anomaly or major ECM strongly influences parental decision to choose TOP or postnatal CC. Genetic syndromes and ECMs are associated with a higher mortality rate, independent of the complexity of the CHD. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  14. Characterization and Schwann Cell Seeding of up to 15.0 cm Long Spider Silk Nerve Conduits for Reconstruction of Peripheral Nerve Defects

    Directory of Open Access Journals (Sweden)

    Tim Kornfeld

    2016-11-01

    Full Text Available Nerve reconstruction of extended nerve defect injuries still remains challenging with respect to therapeutic options. The gold standard in nerve surgery is the autologous nerve graft. Due to the limitation of adequate donor nerves, surgical alternatives are needed. Nerve grafts made out of either natural or artificial materials represent this alternative. Several biomaterials are being explored and preclinical and clinical applications are ongoing. Unfortunately, nerve conduits with successful enhancement of axonal regeneration for nerve defects measuring over 4.0 cm are sparse and no conduits are available for nerve defects extending to 10.0 cm. In this study, spider silk nerve conduits seeded with Schwann cells were investigated for in vitro regeneration on defects measuring 4.0 cm, 10.0 cm and 15.0 cm in length. Schwann cells (SCs were isolated, cultured and purified. Cell purity was determined by immunofluorescence. Nerve grafts were constructed out of spider silk from Nephila edulis and decellularized ovine vessels. Finally, spider silk implants were seeded with purified Schwann cells. Cell attachment was observed within the first hour. After 7 and 21 days of culture, immunofluorescence for viability and determination of Schwann cell proliferation and migration throughout the conduits was performed. Analyses revealed that SCs maintained viable (>95% throughout the conduits independent of construct length. SC proliferation on the spider silk was determined from day 7 to day 21 with a proliferation index of 49.42% arithmetically averaged over all conduits. This indicates that spider silk nerve conduits represent a favorable environment for SC attachment, proliferation and distribution over a distance of least 15.0 cm in vitro. Thus spider silk nerve implants are a highly adequate biomaterial for nerve reconstruction.

  15. Influence of conduit flow mechanics on magma rheology and the growth style of lava domes

    Science.gov (United States)

    Husain, Taha; Elsworth, Derek; Voight, Barry; Mattioli, Glen; Jansma, Pamela

    2018-06-01

    We develop a 2-D particle-mechanics model to explore different lava-dome growth styles. These range from endogenous lava dome growth comprising expansion of a ductile dome core to the exogenous extrusion of a degassed lava plug resulting in generation of a lava spine. We couple conduit flow dynamics with surface growth of the evolving lava dome, fuelled by an open-system magma chamber undergoing continuous replenishment. The conduit flow model accounts for the variation in rheology of ascending magma that results from degassing-induced crystallization. A period of reduced effusive flow rates promote enhanced degassing-induced crystallization. A degassed lava plug extrudes exogenously for magmas with crystal contents (ϕ) of 78 per cent, yield strength >1.62 MPa, and at flow rates of 3 m3 s-1) for magma with lower relative yield strengths (p = 3 MPa) at the conduit exit is forced out by the high discharge rate pulse (2 process, which has been observed at Mount St. Helens and other locations, largely reflects gravitational loading of dome with a viscous core, with retardation by yield strength and talus friction.

  16. A 40 kA NbTi cable in conduit conductor for the large poloidal field coils of net

    International Nuclear Information System (INIS)

    Torossian, A.; Bessette, D.; Turck, B.; Kazimierzak, B.

    1990-01-01

    The main feature of this cable in conduit design is to separate the manufacture of the full length of the steel conduit (400 m) and of the cable in order to minimize the industrial risk and consequently the cost. A circular cross section for that cable seems to be the most suitable for that purpose: - axisymmetric cabling with full transposition of strands, - cable behaviour independent of the field orientation, - less deformation of subcables, - cross section remains circular when the cable is under tension and makes the slippage of the cable in the conduit easier, - butt welding of 8 m long tubes forming the conduit becomes simpler. The square external shape allows to minimize the amount of insulating material and consequently improves the overall current density of the coil. This conductor is aimed to large poloidal field coils for NET which do not require high field and in that case NbTi seems to be the best choice with regard to reliability and cost but Nb 3 Sn could be used as well. Stainless steel ribbons are inserted between subcables in order to reduce losses induced by the rapid field changes and also to improve the mechanical behaviour of the cable

  17. NRC Information No. 90-23: Improper installation of Patel conduit seals

    International Nuclear Information System (INIS)

    Rossi, C.E.

    1992-01-01

    On November 6, 1989, the staff at the H.B. Robinson plant notified the NRC that they had discovered that some of the conduit seal grommets used to seal insulated wire conductors entering environmentally qualified instrument housings were oversized for the application. The seals are used to prevent moisture from entering safety-related electrical components following loss-of-coolant accidents. The problem was attributed to inadequate installation instructions that were used when the seals were installed in 1986 and 1987. These instructions listed the grommets by wire gauge size and gave maximum wire insulation diameters for each wire size. In accordance with these instructions, the seals were selected based on wire gauge alone. However, since the insulation thickness for a given wire gauge the correct grommet size would have been the minimum wire insulation diameter for which a particular grommet will achieve an effective seal. The selection of grommet size based only on wire gauge size resulted in the installation of some grommets that were too large to provide an effective seal. As a result, some of the seals failed pressure tests that were designed to simulate post-LOCA pressures. During the investigation of the grommet leakage problem, the Robinson staff also checked the torque on the conduit seal union nuts that are used to compress the seals. EGS Corporation recommends that the union nuts be torqued to 50 ft-lb. On approximately half of the 90 seals inspected, the union nut moved about 1/4 inch when this torque was applied. EGS Corporation reports that 1/4 inch of movement does not necessarily indicate a degraded seal but recommends that the correct torque be verified on a representative sample of installed conduit seals

  18. Pseudotachylyte formation in volcanic conduits: Montserrat vs. Mount St. Helens

    Science.gov (United States)

    Kendrick, J. E.; Lavallee, Y.; Petrakova, L.; Ferk, A.; Di Toro, G.; Hess, K.; Ferri, F.; Dingwell, D. B.

    2012-12-01

    Seismogenic fracture and faulting may result in non-equilibrium frictional melting of rock, which upon cooling and recrystallisation forms pseudotachylyte. In volcanic environments, the transition from endogenous to exogenous growth can be attributed to a shift in magma rheology into the brittle regime, and thus the ascent of high-viscosity magma can form discrete shear zones, comparable to tectonic faults, along conduit margins. Pseudotachylytes have, until now, rarely been noted in exogenous volcanic materials and seldom in active volcanic environments. This is despite the simultaneous occurrence of high pressures and differential stresses, which make high-viscosity magmas ideal candidates for the occurrence of frictional melting. Here, we compare the chemical, thermal, magnetic and structural properties of two candidate volcanic pseudotachylytes; one from Soufriere Hills (Montserrat) and one from Mount St. Helens (USA). Additionally, we present data from a set of high-velocity rotary shear experiments on the host materials of these natural pseudotachylytes in which melting was induced after just 10's of centimeters of slip at realistic extrusion velocities (0.4 - 1.6 ms-1) and low normal stresses (0.5-2 MPa). After 1-2 meters of slip a continuous melt layer formed, at which point friction decreased and the fault zone displayed slip-weakening behaviour. For volcanic conduits, this would facilitate temporarily elevated slip rates, or an increase in extrusion rate, and could cause transitions in dome morphology and eruption style. This study demonstrates that shear fracturing in magma or sliding along conduit margins can readily result in frictional melting. The conspicuous absence of pseudotachylytes in active volcanic environments is likely the result of exceptionally high background temperatures which precipitate near-equilibrium melting, thereby obviating one of the characteristic signatures of pseudotachylyte - glassy protomelts formed by selective melting of

  19. Right ventricular to pulmonary artery conduit instead of modified Blalock-Taussig shunt improves postoperative hemodynamics in newborns after the Norwood operation.

    Science.gov (United States)

    Mair, Rudolf; Tulzer, Gerald; Sames, Eva; Gitter, Roland; Lechner, Evelyn; Steiner, Jürgen; Hofer, Anna; Geiselseder, Gertraud; Gross, Christoph

    2003-11-01

    Perioperative mortality, prolonged postoperative recovery after the Norwood procedure, and mortality between stage I and stage II might be related to shunt physiology. A right ventricular to pulmonary artery conduit offers a banded physiology in contrast to a Blalock-Taussig shunt. The purpose of this study was to assess the hemodynamic differences and their consequences in the postoperative course between Norwood patients with a Blalock-Taussig shunt and those with a right ventricular to pulmonary artery conduit. From October 1999 until May 2002, 32 unselected consecutive patients underwent a Norwood procedure at the General Hospital Linz. The first 18 patients received a Blalock-Taussig shunt. In the remaining 14 patients we performed a right ventricular to pulmonary artery conduit. Both groups were compared. The diastolic blood pressure was significantly higher in the right ventricular to pulmonary artery conduit group (P <.001). Despite a higher FIO(2), PO(2) levels tended to be lower in the first 5 postoperative days. At the age of 3 months, catheterization laboratory data showed a lower Qp/Qs ratio in the same group (0.86 [0.78; 1] versus 1.55 [1.15; 1.6]; P =.005) and a higher dp/dt (955 [773; 1110] vs 776 [615; 907]; P =.018). (Descriptive data reflect medians and quartiles [in brackets].) Hospital survival was 72% in the Blalock-Taussig shunt group versus 93% in the right ventricular to pulmonary artery conduit group. Mortality between stage I and stage II was 23% in the Blalock-Taussig shunt group versus 0% in the right ventricular to pulmonary artery conduit group. A higher diastolic blood pressure and a lower Qp/Qs ratio were associated with a more stable and efficient circulation in patients with a right ventricular to pulmonary artery conduit. More intensive ventilatory support was necessary during the first postoperative days. We did not note any adverse effects of the ventriculotomy on ventricular performance.

  20. Impact of bed rest on conduit artery remodeling: effect of exercise countermeasures.

    NARCIS (Netherlands)

    Duijnhoven, N.T.L. van; Green, D.J.; Felsenberg, D.; Belavy, D.L.; Hopman, M.T.E.; Thijssen, D.H.J.

    2010-01-01

    Physical inactivity is a potent stimulus for vascular remodeling, leading to a marked decrease in conduit artery diameter. However, little is known about the impact of physical inactivity on artery wall thickness or wall:lumen ratio or the potential of exercise countermeasures to modify artery wall

  1. Enhancing Peripheral Nerve Regeneration with a Novel Drug-Delivering Nerve Conduit

    Science.gov (United States)

    2015-10-01

    our novel nerve conduit. 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE...growth in dorsal root ganglion ( DRG ) cell culture Tasks/Subtasks: 1. In Vitro NGF/GNDF release kinetics experiments.......................... (Gale...Axonal growth of DRGs ................................................................ (Terry, Shea) (11-18months) Progress: We have started these

  2. Permeability Measurements of Rock Samples from Conduit Drilling at Unzen Volcano, Japan

    Science.gov (United States)

    Watanabe, T.; Shimizu, Y.; Noguchi, S.; Nakada, S.

    2006-12-01

    The last eruption of Unzen Volcano (1990-1995) was effusive to form lava domes, though magmas at depths are estimated to have contained volatile materials enough to cause explosive eruptions [e.g., Sato et al., 1995]. Most of volatile materials should have escaped from ascending magmas. The escape of gas is controlled by permeability of magmas and country rocks. Unzen Scientific Drilling Project sampled both the latest conduit and its country rock (USDP-4). In order to understand degassing processes, we have measured the permeability of these rock samples. Four cube samples with edges of 25 mm were cut from USDP-4 cores C1, C12 (country rock), C13 and C14 (conduit). Sample C1 is considered as Old Unzen Lava, and Sample C12 volcanic breccia. The transient pulse method was employed to measure the permeability. It applies a step of the fluid pressure difference across a specimen, and measures the decay rate of the fluid pressure difference. This method can be applied to samples with very low permeability, since it determines the permeability without measuring the fluid flux. Nitrogen gas was used as a pore fluid. Our permeametry system is built in a pressure vessel, and the confining pressure and the pore fluid pressure can be controlled independently. The temperature of the measurement system is kept constant within 0.1 degree. The temperature control and the background leak rate limit the measurable permeability to be higher than 10^{-20} m2. Measurements were first conducted under the atmospheric pressure. The permeability in a rock sample varies with the direction by a factor less than 5. Sample C1 has the lowest permeability (10^{-19} m2), and Sample C12 the highest value (10^{-17 m2). The permeability of C13 and C14 is of the order of 10^{- 18} m2. Though only a trace of vesicles can be seen in conduit samples, the interconnection is still maintained. The pressure dependence of the permeability is now investigated up to 50 MPa. The permeability of C13 and C14

  3. Terrestrial analogs to lunar sinuous rilles - Kauhako Crater and channel, Kalaupapa, Molokai, and other Hawaiian lava conduit systems

    International Nuclear Information System (INIS)

    Coombs, C.R.; Hawke, B.R.; Wilson, L.

    1990-01-01

    Two source vents, one explosive and one effusive erupted to form a cinder cone and low lava shield that together compose the Kalaupapa peninsula of Molokai, Hawaii, A 50-100-m-wide channel/tube system extends 2.3 km northward from kauhako crater in the center of the shield. Based on modeling, a volume of up to about 0.2 cu km of lava erupted at a rate of 260 cu m/sec to flow through the Kauhako conduit system in one of the last eruptive episodes on the peninsula. Channel downcutting by thermal erosion occurred at a rate of about 10 micron/sec to help form the 30-m-deep conduit. Two smaller, secondary tube systems formed east of the main lava channel/tube. Several other lava conduit systems on the islands of Oahu and Hawaii were also compared to the Kauhako and lunar sinuous rille systems. These other lava conduits include Whittington, Kupaianaha, and Mauna Ulu lava tubes. Morphologically, the Hawaiian tube systems studied are very similar to lunar sinuous rilles in that they have deep head craters, sinuous channels, and gentle slopes. Thermal erosion is postulated to be an important factor in the formation of these terrestrial channel systems and by analogy is inferred to be an important process involved in the formation of lunar sinuous rilles. 28 refs

  4. FATIGUE PROPERTIES OF MODIFIED 316LN STAINLESS STEEL AT 4 K FOR HIGH FIELD CABLE-IN-CONDUIT APPLICATIONS

    International Nuclear Information System (INIS)

    Toplosky, V. J.; Walsh, R. P.; Han, K.

    2010-01-01

    Cable-In-Conduit-Conductor (CICC) alloys, exposed to Nb 3 Sn reaction heat-treatments, such as modified 316LN require a design specific database. A lack of fatigue life data (S-n curves) that could be applied in the design of the ITER CS and the NHMFL Series Connected Hybrid magnets is the impetus for the research presented here. The modified 316LN is distinguished by a lower carbon content and higher nitrogen content when compared to conventional 316LN. Because the interstitial alloying elements affect the mechanical properties significantly, it is necessary to characterize this alloy in a systematic way. In conjunction, to ensure magnet reliability and performance, several criteria and expectations must be met, including: high fatigue life at the operating stresses, optimal stress management at cryogenic temperatures and thin walled conduit to reduce coil mass. Tension-tension load control axial fatigue tests have good applicability to CICC solenoid magnet design, thus a series of 4 K strength versus fatigue life curves have been generated. In-situ samples of 316LN base metal, seam welded, butt welded and seam plus butt welded are removed directly from the conduit in order to address base and weld material fatigue life variability. The more than 30 fatigue tests show good grouping on the fatigue life curve and allow discretionary 4 K fatigue life predictions for conduit made with modified 316LN.

  5. On magma fragmentation by conduit shear stress: Evidence from the Kos Plateau Tuff, Aegean Volcanic Arc

    Science.gov (United States)

    Palladino, Danilo M.; Simei, Silvia; Kyriakopoulos, Konstantinos

    2008-12-01

    Large silicic explosive eruptions are the most catastrophic volcanic events. Yet, the intratelluric mechanisms underlying are not fully understood. Here we report a field and laboratory study of the Kos Plateau Tuff (KPT, 161 ka, Aegean Volcanic Arc), which provides an excellent geological example of conduit processes that control magma vesiculation and fragmentation during intermediate- to large-scale caldera-forming eruptions. A prominent feature of the KPT is the occurrence of quite unusual platy-shaped tube pumice clasts in pyroclastic fall and current deposits from the early eruption phases preceding caldera collapse. On macroscopic and SEM observations, flat clast faces are elongated parallel to tube vesicles, while transverse surfaces often occur at ~ 45° to vesicle elongation. This peculiar pumice texture provides evidence of high shear stresses related to strong velocity gradients normal to conduit walls, which induced vesiculation and fragmentation of the ascending magma. Either an increasing mass discharge rate without adequate enlargement of a narrow central feeder conduit or a developing fissure-like feeder system related to incipient caldera collapse provided suitable conditions for the generation of plate tube pumice within magma volumes under high shear during the pre-climactic KPT eruption phases. This mechanism implies that the closer to the conduit walls (where the stronger are the velocity gradients) the larger was the proportion of plate vs. conventional (lensoid) juvenile fragments in the ascending gas-pyroclast mixture. Consequently, plate pumice clasts were mainly entrained in the outer portions of the jet and convecting regions of a sustained, Plinian-type, eruption column, as well as in occasional lateral blast currents generated at the vent. As a whole, plate pumice clasts in the peripheral portions of the column were transported at lower altitudes and deposited by fallout or partial collapse closer to the vent relative to lensoid ones

  6. Neurodevelopmental Outcome and Health-related Quality of Life in Children With Single-ventricle Heart Disease Before Fontan Procedure.

    Science.gov (United States)

    Reich, Bettina; Heye, Kristina; Tuura, Ruth; Beck, Ingrid; Wetterling, Kristina; Hahn, Andreas; Hofmann, Karoline; Schranz, Dietmar; Akintürk, Hakan; Latal, Beatrice; Knirsch, Walter

    2017-12-05

    Neurodevelopmental impairment and impaired quality of life constitute a major source of morbidity among children with complex congenital heart disease, in particular for single-ventricle (SV) morphologies. Risk factors and quality of life determining clinical and neurodevelopmental outcome at 2 years of age are examined. In a 2-center cohort study, 48 patients with SV morphology (26 hypoplastic left heart syndrome and 22 other types of univentricular heart defect) have been examined before Fontan procedure between 2010 and 2015. Patients were assessed with the Bayley Scales of Infant and Toddler Development, Third Version (Bayley-III), and the Preschool Children Quality of Life (TAPQOL) questionnaire. A total of 44 patients underwent hybrid procedure (n = 25), Norwood procedure (n = 7), or shunt or banding procedure (n = 12) as first surgery before subsequent bidirectional cavopulmonary anastomosis (n = 48). Median cognitive, language, and motor composite scores on the Bayley-III were 100 (range 65-120), 97 (68-124), and 97 (55-124), respectively. The language composite score was significantly below the norm (P = 0.025). Risk factors for poorer neurodevelopmental outcome were prolonged mechanical ventilation, longer days of hospital stay, and more reinterventions (all P neurodevelopmental outcome of this high-risk patient population. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. What goes up might come down: Backflow in the conduits of persistently degassing volcanoes and ramifications for melt-inclusion analysis

    Science.gov (United States)

    Suckale, J.; Qin, Z.; Picchi, D.; Keller, T.

    2017-12-01

    Many active volcanoes erupt significantly less magma than they degas, implying that large quantities of magma must descend back into the plumbing system after degassing. The resulting bidirectional flow field in the volcanic conduit is fundamentally unstable. These instabilities are important to understand, because they likely control the episodicity of eruptive behavior observed at persistently degassing volcanoes. Laboratory experiments have provided invaluable insights into the flow regimes that may arise in volcanic conduits, but are not straightforward to scale up to volcanic systems. The goal of this study is to use direct numerical simulations to virtually reproduce the analogue experiments by Stevenson and Blake, 1998, compare them to simple analytical models and gain insights into the different flow regimes and interface instabilities observed in actual volcanic conduits. Direct numerical simulations provide a compelling complement to analogue experiments, because they are not constrained by the scales or flow properties achievable in a laboratory setting. By linking virtual and analogue experiments, we show that the interface between ascending and descending fluid is not usually stationary in volcanic conduits (see fig). The intuition that buoyant, volatile-rich magma moves up while heavy, degassed magma moves down is hence not generally true in bidirectional conduit flow. Instead, our results show that a potentially significant portion of the volatile-rich magma flows downwards despite its positive buoyancy - a process commonly referred to as backflow. The existence of backflow in volcanic conduits has potentially important ramifications for understanding melt-inclusion trends, because it affects exsolved and dissolved volatile components differently. Our preliminary results suggest that carbon dioxide bubbles exsolved at depth tend to decouple from the backflow and escape into the upward moving portion of the fluid, while dissolved water is recycled

  8. Comparison of Fiber Optic and Conduit Attenuated Total Reflection (ATR) Fourier Transform Infrared (FT-IR) Setup for In-Line Fermentation Monitoring.

    Science.gov (United States)

    Koch, Cosima; Posch, Andreas E; Herwig, Christoph; Lendl, Bernhard

    2016-12-01

    The performance of a fiber optic and an optical conduit in-line attenuated total reflection mid-infrared (IR) probe during in situ monitoring of Penicillium chrysogenum fermentation were compared. The fiber optic probe was connected to a sealed, portable, Fourier transform infrared (FT-IR) process spectrometer via a plug-and-play interface. The optical conduit, on the other hand, was connected to a FT-IR process spectrometer via a knuckled probe with mirrors that had to be adjusted prior to each fermentation, which were purged with dry air. Penicillin V (PenV) and its precursor phenoxyacetic acid (POX) concentrations were determined by online high-performance liquid chromatography and the obtained concentrations were used as reference to build partial least squares regression models. Cross-validated root-mean-square errors of prediction were found to be 0.2 g L -1 (POX) and 0.19 g L -1 (PenV) for the fiber optic setup and 0.17 g L -1 (both POX and PenV) for the conduit setup. Higher noise-levels and spectrum-to-spectrum variations of the fiber optic setup lead to higher noise of estimated (i.e., unknown) POX and PenV concentrations than was found for the conduit setup. It seems that trade-off has to be made between ease of handling (fiber optic setup) and measurement accuracy (optical conduit setup) when choosing one of these systems for bioprocess monitoring. © The Author(s) 2016.

  9. Postoperative evaluation of surgical procedures in congenital heart disease with MR imaging

    International Nuclear Information System (INIS)

    Seelos, K.C.; Kersting-Sommerhoff, B.; Higgins, C.B.

    1989-01-01

    This paper reports on a study in which electrocardiographically gated spin-echo MR imaging was used to evaluate 23 patients with congenital heart disease who had undergone Waterston (n = 3), Potts (n = 2), Senning (n = 3), Fontan (n = 3), Rastelli (n = 4), Damus (n = 1) and Jatene (n = 7) procedures. Surgical shunts, conduits, or baffles were identified correctly in all patients. Patency, atresia and hypoplasia of central pulmonary arteries (PAs) as well as postoperative complications (focal stenosis of PAs, thrombosed pseudoaneurysm, intramural abscess) were diagnosed. MR findings were corroborated with angiography, echocardiography, and surgery. Narrowing of the right ventricular outflow tract and focal compression of the proximal PAs were recognized as specific complications of the Jatene procedure. MR imaging appears to be effective for the postoperative evaluation of surgical procedures used for congenital heart disease

  10. Cardiovascular effects of right ventricle-pulmonary artery valved conduit implantation in experimental pulmonic stenosis

    International Nuclear Information System (INIS)

    Saida, Y.; Tanaka, R.; Fukushima, R.; Hoshi, K.; Hira, S.; Soda, A.; Iizuka, T.; Ishikawa, T.; Nishimura, T.; Yamane, Y.

    2009-01-01

    Right ventricle (RV)-pulmonary artery (PA) valved conduit (RPVC) implantation decreases RV systolic pressure in pulmonic stenosis (PS) by forming a bypass route between the RV and the PA. The present study evaluates valved conduits derived from canine aortae in a canine model of PS produced by pulmonary artery banding (PAB). Pulmonary stenosis was elicited using PAB in 10 conditioned beagles aged 8 months. Twelve weeks after PAB, the dogs were assigned to one group that did not undergo surgical intervention and another that underwent RPVC using denacol-treated canine aortic valved grafts (PAB+RPVC). Twelve weeks later, the rate of change in the RV-PA systolic pressure gradient was significantly decreased in the PAB+RPVC, compared with the PAB group (60.5+-16.7% vs. 108.9+-22.9%; p0.01). In addition, the end-diastolic RV free wall thickness (RVFWd) was significantly reduced in the PAB+RPVC, compared with the PAB group (8.2+-0.2 vs. 9.4+-0.7 mm; p0.05). Thereafter, regurgitation was not evident beyond the conduit valve and the decrease in RV pressure overload induced by RPVC was confirmed. The present results indicate that RPVC can be performed under a beating heart without cardiopulmonary bypass and adapted to dogs with various types of PS, including 'supra valvular' PS or PS accompanied by dysplasia of the pulmonary valve. Therefore, we consider that this method is useful for treating PS in small animals

  11. Sexual Function after Non-Nerve-Sparing Radical Cystoprostatectomy: A Comparison between Ileal Conduit Urinary Diversion and Orthotopic Ileal Neobladder Substitution

    Directory of Open Access Journals (Sweden)

    M.A Asgari

    2013-07-01

    Full Text Available Objective To compare the erectile function (EF and sexual desire (SD in men after radical cystoprostatectomy (RCP who had either an ileal conduit urinary diversion or orthotropic ileal neobladder substitution. Materials and Methods Eighty one sexually active men with bladder cancer were enrolled in this prospective study. After RCP according to patients' preferences they underwent either ileal conduit urinary diversion (n = 41 or orthotropic ileal neobladder substitution (n = 40. EF and SD were assessed using International Index of Erectile Function (IIEF questionnaire. Patients were assessed at 4-week before surgery and were followed up at 1, 6, and 12-month postoperatively using the same questionnaire. Results Postoperatively the EF and SD domains deteriorated significantly in both groups, but in a small proportion of the patients submitted to ileal neobladder they gradually improved with time (P = 0.006. At 12-month postoperative period, 4 (9.8% and 14 (35.0% patients in ileal conduit and ileal neobladder groups were able to achieve erections hard enough for vaginal penetration and maintained their erection to completion of intercourse, respectively (P = 0.006. Among patients in the ileal conduit and ileal neobladder groups, additional 4 (9.8% and 7 (17.1% patients were able to get some erection, but were unable to maintain their erection to completion of intercourse (P = 0.02. At 12-month follow up period 24.4% of the ileal conduit and 45.0% of the ileal neobladder patients rated their sexual desire very high or high (P = 0.01. Conclusion When performed properly, orthotopic ileal neobladder substitution after RCP offers better long-term results in terms of EF and SD.

  12. 76 FR 53678 - Calleguas Municipal Water District Notice of Surrender of Exemption (Conduit)

    Science.gov (United States)

    2011-08-29

    ... Municipal Water District Notice of Surrender of Exemption (Conduit) Pursuant to section 4.95(a) of the Commission's regulations,\\1\\ Calleguas Municipal Water District filed with the Commission a petition to... Municipal Water District, 87 FERC ] 62,256 (1999). \\3\\ See filing of July 11, 2011 by Calleguas Municipal...

  13. Incorporation of cooling-induced crystallisation into a 2-dimensional axisymmetric conduit heat flow model

    Science.gov (United States)

    Heptinstall, D. A.; Neuberg, J. W.; Bouvet de Maisonneuve, C.; Collinson, A.; Taisne, B.; Morgan, D. J.

    2015-12-01

    Heat flow models can bring new insights into the thermal and rheological evolution of volcanic systems. We shall investigate the thermal processes and timescales in a crystallizing, static magma column, with a heat flow model of Soufriere Hills Volcano (SHV), Montserrat. The latent heat of crystallization is initially computed with MELTS, as a function of pressure and temperature for an andesitic melt (SHV groundmass starting composition). Three fractional crystallization simulations are performed; two with initial pressures of 34MPa (runs 1 & 2) and one of 25MPa (run 3). Decompression rate was varied between 0.1MPa/°C (runs 1 & 3) and 0.2MPa/°C (run 2). Natural and experimental matrix glass compositions are accurately reproduced by all MELTS runs. The cumulative latent heat released for runs 1, 2 and 3 differs by less than 9% (8.69e5 J/kg*K, 9.32e5 J/kg*K, and 9.49e5 J/kg*K respectively). The 2D axisymmetric conductive cooling simulations consider a 30m-diameter conduit that extends from the surface to a depth of 1500m (34MPa). The temporal evolution of temperature is closely tracked at depths of 10m, 750m and 1400m in the center of the conduit, at the conduit walls, and 20m from the walls into the host rock. Following initial cooling by 7-15oC at 10m depth inside the conduit, the magma temperature rebounds through latent heat release by 32-35oC over 85-123 days to a maximum temperature of 1002-1005oC. At 10 m depth, it takes 4.1-9.2 years for the magma column to cool over 108-130oC and crystallize to 75wt%, at which point it cannot be easily remobilized. It takes 11-31.5 years to reach the same crystallinity at 750-1400m depth. We find a wide range in cooling timescales, particularly at depths of 750m or greater, attributed to the initial run pressure and dominant latent heat producing crystallizing phases (Quartz), where run 1 cools fastest and run 3 cools slowest. Surface cooling by comparison has the strongest influence on the upper tens of meters in all

  14. Construction of nerve guide conduits from cellulose/soy protein composite membranes combined with Schwann cells and pyrroloquinoline quinone for the repair of peripheral nerve defect

    Energy Technology Data Exchange (ETDEWEB)

    Luo, Lihua [Department of Biomedical Engineering, School of Basic Medical Sciences, Wuhan University, Wuhan 430071 (China); Center of Molecular Medicine, School of Medicine, Hubei University of Arts and Sciences, Xiangyang 441053 (China); Gan, Li; Liu, Yongming; Tian, Weiqun; Tong, Zan [Department of Biomedical Engineering, School of Basic Medical Sciences, Wuhan University, Wuhan 430071 (China); Wang, Xiong; Huselstein, Celine [Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), UMR 7365 CNRS – Université de Lorraine, Biopôle, 54500 Vandoeuvre-lès-Nancy (France); Chen, Yun, E-mail: yunchen@whu.edu.cn [Department of Biomedical Engineering, School of Basic Medical Sciences, Wuhan University, Wuhan 430071 (China)

    2015-02-20

    Regeneration and functional reconstruction of peripheral nerve defects remained a significant clinical challenge. Nerve guide conduits, with seed cells or neurotrophic factors (NTFs), had been widely used to improve the repair and regeneration of injured peripheral nerve. Pyrroloquinoline quinone (PQQ) was an antioxidant that can stimulate nerve growth factors (NGFs) synthesis and accelerate the Schwann cells (SCs) proliferation and growth. In present study, three kinds of nerve guide conduits were constructed: one from cellulose/SPI hollow tube (CSC), another from CSC combined with SCs (CSSC), and the third one from CSSC combined with PQQ (CSSPC), respectively. And then they were applied to bridge and repair the sciatic nerve defect in rats, using autograft as control. Effects of different nerve guide conduits on the nerve regeneration were comparatively evaluated by general analysis, sciatic function index (SFI) and histological analysis (HE and TEM). Newly-formed regenerative nerve fibers were observed and running through the transparent nerve guide conduits 12 weeks after surgery. SFI results indicated that the reconstruction of motor function in CSSPC group was better than that in CSSC and CSC groups. HE images from the cross-sections and longitudinal-sections of the harvested regenerative nerve indicated that regenerative nerve fibers had been formed and accompanied with new blood vessels and matrix materials in the conduits. TEM images also showed that lots of fresh myelinated and non-myelinated nerve fibers had been formed. Parts of vacuolar, swollen and abnormal axons occurred in CSC and CSSC groups, while the vacuolization and swell of axons was the least serious in CSSPC group. These results indicated that CSSPC group had the most ability to repair and reconstruct the nerve structure and functions due to the comprehensive contributions from hollow CSC tube, SCs and PQQ. As a result, the CSSPC may have the potential for the applications as nerve guide

  15. The Malnutrition-Related Increase in Early Visceralization of Leishmania donovani Is Associated with a Reduced Number of Lymph Node Phagocytes and Altered Conduit System Flow

    Science.gov (United States)

    Ibrahim, Marwa K.; Barnes, Jeffrey L.; Anstead, Gregory M.; Jimenez, Fabio; Travi, Bruno L.; Peniche, Alex G.; Osorio, E. Yaneth; Ahuja, Seema S.; Melby, Peter C.

    2013-01-01

    In a murine model of moderate childhood malnutrition we found that polynutrient deficiency led to a 4–5-fold increase in early visceralization of L. donovani (3 days post-infection) following cutaneous infection and a 16-fold decrease in lymph node barrier function (pmalnutrition-related parasite dissemination we analyzed the cellularity, architecture, and function of the skin-draining lymph node. There was no difference in the localization of multiple cell populations in the lymph node of polynutrient deficient (PND) mice, but there was reduced cellularity with fewer CD11c+dendritic cells (DCs), fibroblastic reticular cells (FRCs), MOMA-2+ macrophages, and CD169+ subcapsular sinus macrophage (p<0.05 for all) compared to the well-nourished (WN) mice. The parasites were equally co-localized with DCs associated with the lymph node conduit network in the WN and PND mice, and were found in the high endothelial venule into which the conduits drain. When a fluorescent low molecular weight (10 kD) dextran was delivered in the skin, there was greater efflux of the marker from the lymph node conduit system to the spleens of PND mice (p<0.04), indicating that flow through the conduit system was altered. There was no evidence of disruption of the conduit or subcapsular sinus architecture, indicating that the movement of parasites into the subcortical conduit region was due to an active process and not from passive movement through a leaking barrier. These results indicate that the impaired capacity of the lymph node to act as a barrier to dissemination of L. donovani infection is associated with a reduced number of lymph node phagocytes, which most likely leads to reduced capture of parasites as they transit through the sinuses and conduit system. PMID:23967356

  16. How to quantify conduits in wood?

    Science.gov (United States)

    Scholz, Alexander; Klepsch, Matthias; Karimi, Zohreh; Jansen, Steven

    2013-01-01

    Vessels and tracheids represent the most important xylem cells with respect to long distance water transport in plants. Wood anatomical studies frequently provide several quantitative details of these cells, such as vessel diameter, vessel density, vessel element length, and tracheid length, while important information on the three dimensional structure of the hydraulic network is not considered. This paper aims to provide an overview of various techniques, although there is no standard protocol to quantify conduits due to high anatomical variation and a wide range of techniques available. Despite recent progress in image analysis programs and automated methods for measuring cell dimensions, density, and spatial distribution, various characters remain time-consuming and tedious. Quantification of vessels and tracheids is not only important to better understand functional adaptations of tracheary elements to environment parameters, but will also be essential for linking wood anatomy with other fields such as wood development, xylem physiology, palaeobotany, and dendrochronology.

  17. Usefulness of the Guglielmi detachable coil for embolization of a systemic venous collateral after Fontan operation: A case report.

    Science.gov (United States)

    Sonomura, Tetsuo; Ikoma, Akira; Kawai, Nobuyuki; Suenaga, Tomohiro; Takeuchi, Takashi; Suzuki, Hiroyuki; Uchita, Shunji; Nakai, Motoki; Minamiguchi, Hiroki; Kishi, Kazushi; Sato, Morio

    2012-09-28

    Embolization of collateral veins is often treated with rigid coils (Gianturco and interlocking detachable coils type). However, when dealing with tortuous and dilated collateral veins, there is a high risk for technical failure and coil migration due to inflexibility of the coils. To safely and successfully solve this problem, Guglielmi detachable coils (GDC) can be used for embolization. Their flexibility allows for easy navigation in tortuous veins, low risk of unintended coil release or coil migration, and safe deployment. A 12-year-old girl with a single ventricle had severe cyanosis and a low exercise tolerance 5 years after Fontan procedure. The symptoms were caused by a tortuous and dilated collateral from the left phrenic vein into the left pulmonary vein, forming a right-to-left shunt. The collateral, which had a large diameter and high flow, and therefore a high risk of coil migration, was successfully embolized with 8 GDC. There were no complications such as coil migration or cerebral infarction. Transcatheter embolization increased her systemic oxygen saturation from 81%-84% to 94%-95%, and increased her ability to exercise. The embolization procedure using flexible GDC was low risk compared with other rigid coil embolization techniques when performing embolization of tortuous and dilated collateral veins.

  18. Characterization of molecule and particle transport through nanoscale conduits

    Science.gov (United States)

    Alibakhshi, Mohammad Amin

    Nanofluidic devices have been of great interest due to their applications in variety of fields, including energy conversion and storage, water desalination, biological and chemical separations, and lab-on-a-chip devices. Although these applications cross the boundaries of many different disciplines, they all share the demand for understanding transport in nanoscale conduits. In this thesis, different elusive aspects of molecule and particle transport through nanofluidic conduits are investigated, including liquid and ion transport in nanochannels, diffusion- and reaction-governed enzyme transport in nanofluidic channels, and finally translocation of nanobeads through nanopores. Liquid or solvent transport through nanoconfinements is an essential yet barely characterized component of any nanofluidic systems. In the first chapter, water transport through single hydrophilic nanochannels with heights down to 7 nm is experimentally investigated using a new measurement technique. This technique has been developed based on the capillary flow and a novel hybrid nanochannel design and is capable of characterizing flow in both single nanoconduits as well as nanoporous media. The presence of a 0.7 nm thick hydration layer on hydrophilic surfaces and its effect on increasing the hydraulic resistance of the nanochannels is verified. Next, ion transport in a new class of nanofluidic rectifiers is theoretically and experimentally investigated. These so called nanofluidic diodes are nanochannels with asymmetric geometries which preferentially allow ion transport in one direction. A nondimensional number as a function of electrolyte concentration, nanochannel dimensions, and surface charge is derived that summarizes the rectification behavior of this system. In the fourth chapter, diffusion- and reaction-governed enzyme transport in nanofluidic channels is studied and the theoretical background necessary for understanding enzymatic activity in nanofluidic channels is presented. A

  19. Purinergic modulation of adult guinea pig cardiomyocytes in long term cultures and co-cultures with extracardiac or intrinsic cardiac neurones.

    Science.gov (United States)

    Horackova, M; Huang, M H; Armour, J A

    1994-05-01

    To determine the capacity of ATP to modify cardiomyocytes directly or indirectly via peripheral autonomic neurones, the effects of various purinergic agents were studied on long term cultures of adult guinea pig ventricular myocytes and their co-cultures with extracardiac (stellate ganglion) or intrinsic cardiac neurones. Ventricular myocytes and cardiac neurones were enzymatically dissociated and plated together or alone (myocytes only). Myocyte cultures were used for experiments after three to six weeks. The electrical and contractile properties of cultured myocytes and myocyte-neuronal networks were investigated. The spontaneous beating frequency of ventricular myocytes co-cultured with stellate ganglion neurones increased by approximately 140% (p under control conditions, but when beta adrenergic receptors of tetrodotoxin sensitive neural responses were blocked, ATP induced greater augmentation (> 100%). In contrast, ATP induced much smaller effects in non-innervated myocyte cultures (approximately 26%, p UTP > MSATP > beta gamma ATP > alpha beta ATP. Adenosine (10(-4) M) attenuated the beating frequency of myocytes in both types of co-culture, while not significantly affecting non-innervated myocyte cultures. The experimental model used in this study showed that extrinsic and intrinsic cardiac neurones which possess P2 receptors can greatly enhance cardiac myocyte contractile rate when activated by ATP. Since adenosine reduced contractile rate in both types of co-cultures while not affecting non-innervated myocytes, it is concluded that some of these neurones possess P1 receptors.

  20. Vortex Flow in the Right Atrium Surrogates Supraventricular Arrhythmia and Thrombus After Atriopulmonary Connection-Type Fontan Operation: Vortex Flow Analysis Using Conventional Cine Magnetic Resonance Imaging.

    Science.gov (United States)

    Shiina, Yumi; Inai, Kei; Takahashi, Tatsunori; Shimomiya, Yamato; Ishizaki, Umiko; Fukushima, Kenji; Nagao, Michinobu

    2018-02-01

    We developed a novel imaging technique, designated as vortex flow (VF) mapping, which presents a vortex flow visually on conventional two-dimensional (2D) cine MRI. Using it, we assessed circumferential VF patterns and influences on RA thrombus and supraventricular tachycardia (SVT) in AP connection-type Fontan circulation. Retrospectively, we enrolled 27 consecutive patients (25.1 ± 9.2 years) and 7 age-matched controls who underwent cardiac MRI. Conventional cine images acquired using a 1.5-Tesla scanner were scanned for axial and coronal cross section of the RA. We developed "vortex flow mapping" to demonstrate the ratio of the circumferential voxel movement at each phase to the total movement throughout a cardiac cycle towards the RA center. The maximum ratio was used as a magnitude of vortex flow (MVF%) in RA cine imaging. We also measured percentages of strong and weak VF areas (VFA%). Furthermore, in 10 out of 27, we compared VF between previous CMR (3.8 ± 1.5 years ago) and latest CMR. Of the patients, 15 had cardiovascular complications (Group A); 12 did not (Group B). A transaxial image showed that strong VFA% in Group A was significantly smaller than that in Group B or controls. A coronal view revealed that strong VFA% was also smaller, and weak VFA% was larger in Group A than in Group B or controls (P < 0.05, and P < 0.05). Maximum MVF% in Group A was significantly smaller than in other groups (P < 0.001). Univariate logistic analyses revealed weak VFA% on a coronal image, and serum total bilirubin level as factors affecting cardiovascular complications (Odds ratio 1.14 and 66.1, 95% CI 1.004-1.30 and 1.59-2755.6, P values < 0.05 and < 0.05, respectively). Compared to the previous CMR, smaller maximum VMF%, smaller strong VFA%, and larger weak VFA% were identified in the latest CMR. Circumferentially weak VFA% on a coronal image can be one surrogate marker of SVT and thrombus in AP connection-type Fontan circulation. This simple VF

  1. Natural Occurring Silks and Their Analogues as Materials for Nerve Conduits

    OpenAIRE

    Christine Radtke

    2016-01-01

    Spider silk and its synthetic derivatives have a light weight in combination with good strength and elasticity. Their high cytocompatibility and low immunogenicity make them well suited for biomaterial products such as nerve conduits. Silk proteins slowly degrade enzymatically in vivo, thus allowing for an initial therapeutic effect such as in nerve scaffolding to facilitate endogenous repair processes, and then are removed. Silks are biopolymers naturally produced by many species of arthropo...

  2. Analysis of aortic root surgery with composite mechanical aortic valve conduit and valve-sparing reconstruction.

    Science.gov (United States)

    Dias, Ricardo Ribeiro; Mejia, Omar Asdrubal Vilca; Fiorelli, Alfredo Inácio; Pomerantzeff, Pablo Maria Alberto; Dias, Altamiro Ribeiro; Mady, Charles; Stolf, Noedir Antonio Groppo

    2010-01-01

    Comparative analysis of early and late results of aortic root reconstruction with aortic valve sparing operations and the composite mechanical valve conduit replacement. From November 2002 to September 2009, 164 consecutive patients with mean age 54 ± 15 years, 115 male, underwent the aortic root reconstruction (125 mechanical valve conduit replacements and 39 valve sparing operations). Sixteen percent of patients had Marfan syndrome and 4.3% had bicuspid aortic valve. One hundred and forty-four patients (88%) were followed for a mean period of 41.1 ± 20.8 months. The hospital mortality was 4.9%, 5.6% in operations with valved conduits and 2.6% in the valve sparing procedures (P valve sparing operations, respectively (95% CI = 70% - 95%, P = 0.001), (95% CI = 82% - 95% P = 0.03) and (95% CI = 81% - 95%, P = 0.03). Multivariate analysis showed that creatinine greater than 1.4 mg/dl, Cabrol operation and renal dialysis were predictors of mortality, respectively, with occurrence chance of 6 (95% CI = 1.8 - 19.5, P = 0.003), 12 (95% CI = 3 - 49.7, P = 0.0004) and 16 (95% CI = 3.6 - 71.3, P = 0.0002). The aortic root reconstruction has a low early and late mortality, high survival free of complications and low need for reoperation. During the late follow-up, valve sparing aortic root reconstructions presented fewer incidences of bleeding, thromboembolic events and endocarditis.

  3. Experimental study on scale removal from special-shaped conduits through underwater electrical discharge

    International Nuclear Information System (INIS)

    Cao, Y; Wang, Z Q; Li, G F; Wu, Y; Zhou, J J

    2013-01-01

    Underwater electrical discharge technology is an innovative technique that can be used to enhance the stress intensity of water and improve the load addition. The technique enlarges the section area and compresses the surrounding water using a high-powered shock wave, which is induced by an underwater electrical discharge. This paper investigates the effectiveness of scale removal for special-shaped conduits employing underwater electrical discharge. Experimental results show that the pressure wave generated by underwater electrical discharge is capable of eliminating scale in special-shaped conduits. The data indicates that when the capacitance of the parallel-pulsed capacitors was 4 μF, the high pulsed power voltage was 33 kV and the primary discharge gap was 48 mm, the result of scale removal was remarkable. In laboratory tests, the scale of special equipment was removed to a great extent by this method. Because of its effectiveness and low cost, this method improves the practice and extends the lifetime of such equipment, and thus has potential application and economic value.

  4. Rapid prototyping of a double-layer polyurethane-collagen conduit for peripheral nerve regeneration.

    Science.gov (United States)

    Cui, Tongkui; Yan, Yongnian; Zhang, Renji; Liu, Li; Xu, Wei; Wang, Xiaohong

    2009-03-01

    A new technique for preparing double-layer polyurethane (PU)-collagen nerve conduits for peripheral nerve repair via a double-nozzle, low-temperature, deposition manufacturing (DLDM) system has been developed. The DLDM system is based on a digital prototyping approach, and uses a combination of thermally induced phase separation and freeze-drying. With this system, two kinds of biomaterials with different properties can be combined to produce scaffold structures with good biocompatibility in the inner layer and with the desired mechanical strength protruded by the outer. The forming precision is high, the wall thickness can be controlled, and a tight connection between the two layers can be achieved. The effects of changing the processing parameters and the material temperature on the structure of the scaffolds have been investigated. Additionally, the effect of material concentration on the mechanical strength and hydrophilic properties of the scaffolds has also been studied. Ideal peripheral nerve repair conduits, comprising an outer microporous layer of PU and internal oriented filaments of collagen, have been manufactured through optimizing the processing parameters and the biomaterial concentrations.

  5. Opportunities for Energy Development in Water Conduits: A Report Prepared in Response to Section 7 of the Hydropower Regulatory Efficiency Act of 2013

    Energy Technology Data Exchange (ETDEWEB)

    Sale, Michael J. [BCS, Incorporated, Laurel, MD (United States); Bishop, Norman A. [Knight Piesold, Chicago, IL (United States); Reiser, Sonya L. [Knight Piesold, Chicago, IL (United States); Johnson, Kurt [Telluride Energy LLC, Grand Junction, CO (United States); Bailey, Andrea C. [BCS, Incorporated, Laurel, MD (United States); Frank, Anthony [BCS, Incorporated, Laurel, MD (United States); Smith, Brennan T. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Environmental Sciences Division

    2014-09-01

    In Section 7 of the Hydropower Regulatory Efficiency Act (HREA) of 2013 (P.L. 113-23), Congress directed the U.S. Department of Energy (DOE) to prepare an analysis of conduit hydropower opportunities available in the United States and to present case studies that describe the potential energy generation from these types of hydropower projects. Those analyses have been included in a new DOE report to Congress, and this ORNL/TM provides additional technical details supporting that report. Conduit hydropower offers important new ways to enhance renewable energy portfolios in the United States, as well as to increase the energy efficiency of water delivery systems. Conduit hydropower projects are constructed on existing water-conveyance structures, such as irrigation canals or pressurized pipelines that deliver water to municipalities, industry, or agricultural water users. Although water conveyance infrastructures are usually designed for non-power purposes, new renewable energy can often be harvested from them without affecting their original purpose and without the need to construct new dams or diversions. Conduit hydropower differs from more conventional hydropower development in that it is generally not located on natural rivers or waterways and therefore does not involve the types of environmental impacts that are associated with hydropower. The addition of hydropower to existing water conduits can provide valuable new revenue sources from clean, renewable energy. The new energy can be used within the existing water distribution systems to offset other energy demands, or it can be sold into regional transmission systems.

  6. Numerical simulation of freshwater/seawater interaction in a dual-permeability karst system with conduits: the development of discrete-continuum VDFST-CFP model

    Science.gov (United States)

    Xu, Zexuan; Hu, Bill

    2016-04-01

    Dual-permeability karst aquifers of porous media and conduit networks with significant different hydrological characteristics are widely distributed in the world. Discrete-continuum numerical models, such as MODFLOW-CFP and CFPv2, have been verified as appropriate approaches to simulate groundwater flow and solute transport in numerical modeling of karst hydrogeology. On the other hand, seawater intrusion associated with fresh groundwater resources contamination has been observed and investigated in numbers of coastal aquifers, especially under conditions of sea level rise. Density-dependent numerical models including SEAWAT are able to quantitatively evaluate the seawater/freshwater interaction processes. A numerical model of variable-density flow and solute transport - conduit flow process (VDFST-CFP) is developed to provide a better description of seawater intrusion and submarine groundwater discharge in a coastal karst aquifer with conduits. The coupling discrete-continuum VDFST-CFP model applies Darcy-Weisbach equation to simulate non-laminar groundwater flow in the conduit system in which is conceptualized and discretized as pipes, while Darcy equation is still used in continuum porous media. Density-dependent groundwater flow and solute transport equations with appropriate density terms in both conduit and porous media systems are derived and numerically solved using standard finite difference method with an implicit iteration procedure. Synthetic horizontal and vertical benchmarks are created to validate the newly developed VDFST-CFP model by comparing with other numerical models such as variable density SEAWAT, couplings of constant density groundwater flow and solute transport MODFLOW/MT3DMS and discrete-continuum CFPv2/UMT3D models. VDFST-CFP model improves the simulation of density dependent seawater/freshwater mixing processes and exchanges between conduit and matrix. Continuum numerical models greatly overestimated the flow rate under turbulent flow

  7. Aptitude visuelle à la conduite automobile: exemple des candidats au permis de conduire à Libreville

    Science.gov (United States)

    Souhail, Hassane; Assoumou, Prudence; Birinda, Hilda; Mengome, Emmanuel Mve

    2015-01-01

    L'objectif était d’évaluer l'aptitude visuelle à la conduite automobile des candidats au permis de conduire à Libreville. Il s'agissait d'une étude transversale, descriptive et analytique, qui s'est déroulée à Libreville pendant la période du 4 avril 2012 au 14 juillet 2012 (soit 4 mois et 10 jours). La population d’étude concernait les candidats soumis aux épreuves d'obtention du permis de conduire. Nous avons inclus dans notre travail, les candidats, ayant donné leur consentement par écrit et exclus ceux refusant d'adhérer à l'enquête. Les variables étudiées concernaient l’âge, le sexe, la population d’étude, l'activité professionnelle, l'acuité visuelle de loin et de près, la vision des couleurs, la catégorie du permis de conduire, et l'aptitude visuelle à la conduite automobile. La saisie et l'analyse des données ont été collectées au moyen d'une fiche d'enquête standardisée; après vérification et validation, elles ont été saisies sur le logiciel Excel Windows et analysées sur le logiciel Epi Info version 3.5.1. L’âge moyen des 406 candidats était de 29 ans ± 6,65 ans avec des extrêmes allant de 17 ans à 52 ans. Les hommes représentaient 283 (69,7%) et les femmes 123 (30,3%), soit un ratio de 2,3. Les fonctionnaires étaient retrouvés dans 39,4 % des cas, suivi des élèves-étudiants dans 33,5%. Dans notre population d’étude, 71 sur 406 candidats avaient une baisse de l'acuité visuelle de loin, soit 17,5%. Dans notre série, nous avons retrouvés 34 candidats âgés de 40 ans et plus, et seulement 14 candidats (41,2%) avaient une baisse de l'acuité visuelle de près. La quasi-totalité des patients avaient une vision de couleurs normale (99,5%), cependant 2 candidats avaient une vision de couleurs anormale, soit une prévalence de 0,5%. Dans notre échantillon, 403 (99,3%) sollicitaient un permis de conduire de catégorie léger (perms A, A1, B, F) et 3 (0,7%) sollicitaient un permis de conduire de type

  8. Visualized Evaluation of Blood Flow to the Gastric Conduit and Complications in Esophageal Reconstruction.

    Science.gov (United States)

    Noma, Kazuhiro; Shirakawa, Yasuhiro; Kanaya, Nobuhiko; Okada, Tsuyoshi; Maeda, Naoaki; Ninomiya, Takayuki; Tanabe, Shunsuke; Sakurama, Kazufumi; Fujiwara, Toshiyoshi

    2018-03-01

    Evaluation of the blood supply to gastric conduits is critically important to avoid complications after esophagectomy. We began visual evaluation of blood flow using indocyanine green (ICG) fluorescent imaging in July 2015, to reduce reconstructive complications. In this study, we aimed to statistically verify the efficacy of blood flow evaluation using our simplified ICG method. A total of 285 consecutive patients who underwent esophagectomy and gastric conduit reconstruction were reviewed and divided into 2 groups: before and after introduction of ICG evaluation. The entire cohort and 68 patient pairs after propensity score matching (PS-M) were evaluated for clinical outcomes and the effect of visualized evaluation on reducing the risk of complication. The leakage rate in the ICG group was significantly lower than in the non-ICG group for each severity grade, both in the entire cohort (285 subjects) and after PS-M; the rates of other major complications, including recurrent laryngeal nerve palsy and pneumonia, were not different. The duration of postoperative ICU stay was approximately 1 day shorter in the ICG group than in the non-ICG group in the entire cohort, and approximately 2 days shorter after PS-M. Visualized evaluation of blood flow with ICG methods significantly reduced the rate of anastomotic complications of all Clavien-Dindo (CD) grades. Odds ratios for ICG evaluation decreased with CD grade (0.3419 for CD ≥ 1; 0.241 for CD ≥ 2; and 0.2153 for CD ≥ 3). Objective evaluation of blood supply to the reconstructed conduit using ICG fluorescent imaging reduces the risk and degree of anastomotic complication. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Robotic Assisted Radical Cystoprostatectomy and Intracorporeal Ileal Conduit Urinary Diversion for a Kidney Transplant Recipient

    Directory of Open Access Journals (Sweden)

    Peter A. Caputo

    Full Text Available ABSTRACT Introduction and Objectives: Robotic assisted radical cystectomy (RARC is an alternative to open radical cystectomy. As experience is gained with the RARC approach the technique is being applied to more complex surgical cases. We describe here our technique for RARC with intracorporeal ileal conduit urinary diversion for a renal transplant recipient. Materials and Methods: The patient is a 60-year old man with high-grade muscle invasive bladder cancer. He has a history of renal failure due to polycystic kidney disease and received a deceased donor renal transplant in 2008. His hospital course at time of transplant was complicated by low-level BK virus viremia. Interestingly his trans-urethral bladder tumor resection specimen at time of bladder cancer diagnosis stained positive for SV40. His native kidneys were anuric so bilateral laparoscopic nephrectomy was performed in a staged fashion 2 weeks prior to RARC. Our surgical technique utilizes 6 trocars, of note a 12-mm assistant trocar is placed 1 cm superior to the pubic symphysis, and this trocar is solely used to pass a laparoscopic stapler to facilitate the excision of the ileal segment and the stapled enteric anastomosis. Surgical steps include: identification of native ureters bilaterally (removed en bloc with the bladder specimen; identification of the transplanted ureter at the right bladder dome; posterior bladder and prostate dissection along Denonvilliers’ fascia; development of the space of Retzius; ligation and transection of the bladder and prostate vascular bundles; apical prostate dissection and transection of urethra; left pelvic lymphadenectomy; ilium resection for creation of the ileal conduit; stapled enteric anastomosis; ureteroileal anastomosis; maturation of the ileal conduit stoma. Results: The surgery had no intraoperative complications. Operative time was 443 minutes (7.4 hours. Estimated blood loss was 250 cc. Length of hospital stay was 5 days. The patient

  10. Engineering based assessment for a shape design of a pediatric ePTFE pulmonary conduit valve.

    Science.gov (United States)

    Tsuboko, Yusuke; Shiraishi, Yasuyuki; Yamada, Akihiro; Yambe, Tomoyuki; Miura, Hidekazu; Mura, Seitaro; Yamagishi, Masaaki

    2016-08-01

    The authors examined the hemodynamic characteristics of expanded polytetrafluoroethylene (ePTFE) pulmonary valved conduits quantitatively by our originally developed pediatric pulmonary mechanical circulatory system, in order to suggest the optimal shape design. The system consisted of pneumatically driven right atrium and ventricle model, a pulmonary valve chamber, and elastic pulmonary compliance model with peripheral vascular resistance units, a venous reservoir. We employed two different types of ePTFE valve and evaluated the relationship between the leaflets motion and hemodynamic characteristics by using a high-speed video camera. As a result, we successfully reproduced hemodynamic simulations in our pediatric pulmonary mock system. We confirmed that the presence of bulging sinuses in the pulmonary valved conduit reduced the transvalvular energy loss and increased the valve opening area during systolic period. Our engineering-based in vitro analysis could be useful for proposing a shape design optimization of sophisticated pediatric ePTFE pulmonary valve.

  11. Practice Variation in Single-Ventricle Patients Undergoing Elective Cardiac Catheterization: A Report from the Congenital Cardiac Catheterization Project on Outcomes (C3PO).

    Science.gov (United States)

    Goldstein, Bryan H; Holzer, Ralf J; Trucco, Sara M; Porras, Diego; Murphy, Joshua; Foerster, Susan R; El-Said, Howaida G; Beekman, Robert H; Bergersen, Lisa

    2016-01-01

    The objective of this study was to investigate variation in practice surrounding elective cardiac catheterization in patients with single-ventricle (SV) congenital heart disease. Patient and procedural characteristics and outcomes during SV catheterization were collected prospectively from eight centers using a web-based registry (Congenital Cardiac Catheterization Project on Outcomes). We attempted to identify a population of elective procedures by limiting the cohort in case type and timing. Cases were then stratified by stage of SV palliation (pre-bidirectional cavopulmonary anastomosis [pre-BCPA], pre-Fontan and post-Fontan) and limited by age. Subcohort analysis was performed by mode of airway management (assisted vs. spontaneous ventilation). Institutional variation was assessed. Between 2/2007 and 6/2010, 1459 (10.1%) of 14 467 cases in the registry met the inclusion and exclusion criteria, including 326 pre-BCPA, 571 pre-Fontan and 562 post-Fontan procedures. Median patient age was 0.4 (interquartile range 0.3, 0.5), 2.6 (1.0, 3.4) and 9.6 (5.2, 15.4) years and weight was 5.6 (4.8, 6.4), 12.2 (10.5, 14), and 26.3 (16.6, 51.8) kg in the pre-BCPA, pre-Fontan and post-Fontan cohorts, respectively. Cases were more commonly diagnostic in the pre-BCPA cohort (57%) whereas they were more commonly interventional in the pre-Fontan (69%) and post-Fontan (77%) cohorts. At least one adverse event (AE) occurred in 210 cases (14.4%) overall, including 20% of pre-BCPA, 11% of pre-Fontan and 14% of post-Fontan catheterizations. Mode of airway management was associated with statistically significant, but clinically small differences in hemodynamic measures in the pre- and post-Fontan cohorts, but not in the pre-BCPA group. Considerable practice variation exists across centers with variability in airway management, AE rate, case type, interventions performed and fluoroscopy time, in all SV cohorts. Elective catheterization in SV patients, frequently performed with

  12. Ceramic fiber blanket wrap for fire protection of cable trays and conduits

    International Nuclear Information System (INIS)

    Chaille, C.E.; Reiman, R.J.

    1980-01-01

    In some areas of nuclear power plants, cables of redundant electrical systems, which are necessary for the safe shutdown of the reactor, are in close proximity. If a fire should occur in one of these areas, both electrical systems could be destroyed before the fire is extinguished and control of the reactor may be lost. A ceramic fiber blanket was evaluated as a fire protective wrap around cable trays and conduits. 2 refs

  13. Adult Stem Cell Based Enhancement of Nerve Conduit for Peripheral Nerve Repair

    Science.gov (United States)

    2016-10-01

    accompanied by injuries to peripheral nerves; if not repaired, the trauma can lead to significant dysfunction and disability . While nerves have the ability to...recovery, minimized disability , and increased quality of life for our wounded warriors. 2. KEYWORDS: Stem Cell, Nerve Conduit, Peripheral Nerve...would be a paradigm shift away from ordering X-rays at 10-12 weeks and only ordering a CT scan. It has the potential to change the standard of care

  14. Age-related changes in biomechanical properties of transgenic porcine pulmonary and aortic conduits

    International Nuclear Information System (INIS)

    Wilczek, Piotr; Malota, Zbigniew; Lesiak, Anna; Niemiec-Cyganek, Aleksandra; Kubin, Barbara; Nozynski, Jerzy; Mzyk, Aldona; Gramatyka, Michalina; Slomski, Ryszard; Wilczek, Grazyna; Opiela, Jolanta

    2014-01-01

    The limitations associated with conventional valve prosthesis have led to a search for alternatives. One potential approach is tissue engineering. Most tissue engineering studies have described the biomechanical properties of heart valves derived from adult pigs. However, because one of the factors affecting the function of valve prosthesis after implantation is appropriate sizing for a given patient, it is important to evaluate the usefulness of a heart valve given the donor animal’s weight and age. The aim of this study was to evaluate how the age of a pig can influence the biomechanical and hemodynamical properties of porcine heart valve prosthesis after acellularization. Acellular porcine aortic and pulmonary valve conduits were used. Hearts were harvested from animals differing in weight and age. The biomechanical properties of the valves were then characterized using a uniaxial tensile test. Moreover, computer simulations based on the finite element method (FEM) were used to study the influence of biomechanical properties on the hemodynamic conditions. Studying biomechanical and morphological changes in porcine heart valve conduits according to the weight and age of the animals can be valuable for developing age-targeted therapy using tissue engineering techniques. (paper)

  15. Field observations of extended seawater intrusion through subsurface karst conduit networks at Wakulla Spring in the Woodville Karst Plain, Florida

    Science.gov (United States)

    Xu, Z.; Bassett, S.; Hu, B. X.; Dyer, S.

    2016-12-01

    Five periods of increased electrical conductivity have been found in the karst conduits supplying one of the largest first magnitude springs in Florida with water. Numerous well-developed conduit networks are distributed in the Woodville Karst Plain (WKP), Florida and connected to the Gulf of Mexico. A composite analysis of precipitation and electric conductivity data provides strong evidence that the increases in conductivity are directly tied to seawater intrusion moving inland and traveling 14 miles against the prevailing regional hydraulic gradient from from Spring Creek Spring Complex (SCSC), a group of submarine springs at the Gulf Coast. A geochemical analysis of samples from the spring vent rules out anthropogenic contamination and upwelling regional recharge from the deep aquifer as sources of the rising conductivity. The interpretation is supported by the conceptual model established by prior researchers working to characterize the study area. This abstract documented the first and longest case of seawater intrusion in the WKP, and also indicates significant possibility of seawater contamination through subsurface conduit networks in a coastal karst aquifer.

  16. Faulting within the Mount St. Helens conduit and implications for volcanic earthquakes

    Science.gov (United States)

    Pallister, John S.; Cashman, Katharine V.; Hagstrum, Jonathan T.; Beeler, Nicholas M.; Moran, Seth C.; Denlinger, Roger P.

    2013-01-01

    The 2004–2008 eruption of Mount St. Helens produced seven dacite spines mantled by cataclastic fault rocks, comprising an outer fault core and an inner damage zone. These fault rocks provide remarkable insights into the mechanical processes that accompany extrusion of degassed magma, insights that are useful in forecasting dome-forming eruptions. The outermost part of the fault core consists of finely comminuted fault gouge that is host to 1- to 3-mm-thick layers of extremely fine-grained slickenside-bearing ultracataclasite. Interior to the fault core, there is an ∼2-m-thick damage zone composed of cataclastic breccia and sheared dacite, and interior to the damage zone, there is massive to flow-banded dacite lava of the spine interior. Structures and microtextures indicate entirely brittle deformation, including rock breakage, tensional dilation, shearing, grain flow, and microfaulting, as well as gas and fluid migration through intergranular pores and fractures in the damage zone. Slickenside lineations and consistent orientations of Riedel shears indicate upward shear of the extruding spines against adjacent conduit wall rocks.Paleomagnetic directions, demagnetization paths, oxide mineralogy, and petrology indicate that cataclasis took place within dacite in a solidified steeply dipping volcanic conduit at temperatures above 500 °C. Low water content of matrix glass is consistent with brittle behavior at these relatively high temperatures, and the presence of tridymite indicates solidification depths of <1 km. Cataclasis was coincident with the eruption’s seismogenic zone at <1.5 km.More than a million small and low-frequency “drumbeat” earthquakes with coda magnitudes (Md) <2.0 and frequencies <5 Hz occurred during the 2004–2008 eruption. Our field data provide a means with which to estimate slip-patch dimensions for shear planes and to compare these with estimates of slip patches based on seismic moments and shear moduli for dacite rock and

  17. Numerical study of groundwater flow cycling controlled by seawater/freshwater interaction in a coastal karst aquifer through conduit network using CFPv2

    Science.gov (United States)

    Xu, Zexuan; Hu, Bill X.; Davis, Hal; Kish, Stephen

    2015-11-01

    In this study, a groundwater flow cycling in a karst springshed and an interaction between two springs, Spring Creek Springs and Wakulla Springs, through a subground conduit network are numerically simulated using CFPv2, the latest research version of MODFLOW-CFP (Conduit Flow Process). The Spring Creek Springs and Wakulla Springs, located in a marine estuary and 11 miles inland, respectively, are two major groundwater discharge spots in the Woodville Karst Plain (WKP), North Florida, USA. A three-phase conceptual model of groundwater flow cycling between the two springs and surface water recharge from a major surface creek (Lost Creek) was proposed in various rainfall conditions. A high permeable subground karst conduit network connecting the two springs was found by tracer tests and cave diving. Flow rate of discharge, salinity, sea level and tide height at Spring Creek Springs could significantly affect groundwater discharge and water stage at Wakulla Springs simultaneously. Based on the conceptual model, a numerical hybrid discrete-continuum groundwater flow model is developed using CFPv2 and calibrated by field measurements. Non-laminar flows in conduits and flow exchange between conduits and porous medium are implemented in the hybrid coupling numerical model. Time-variable salinity and equivalent freshwater head boundary conditions at the submarine spring as well as changing recharges have significant impacts on seawater/freshwater interaction and springs' discharges. The developed numerical model is used to simulate the dynamic hydrological process and quantitatively represent the three-phase conceptual model from June 2007 to June 2010. Simulated results of two springs' discharges match reasonably well to measurements with correlation coefficients 0.891 and 0.866 at Spring Creeks Springs and Wakulla Springs, respectively. The impacts of sea level rise on regional groundwater flow field and relationship between the inland springs and submarine springs are

  18. A pilot muon radiography to image the shallow conduit of the Stromboli volcano: results and future prospects

    Science.gov (United States)

    Miyamoto, Seigo; Tioukov, Valeri; Sirignano, Chiara; Bozza, Cristiano; Morishima, Kunihiro

    2017-04-01

    The test result of imaging the shallow part of the Stromboli crater zone by using cosmic-ray muons in 2012 and possible performance of the future muon observation will be presented. It is well known that the behavior of volcanic eruptions strongly depends on the shape of the conduit. Stromboli is one of the most known and studied active volcanoes in the world, nevertheless the details of its internal structure are not well defined yet. Geophysical exploration method which use high energy cosmic-ray muons and makes the density image of the object like X-ray radiography for the human body is called "muon radiography " or "muography". A pilot muography was done for the shallow part of Stromboli in 2012. We succeeded to clarify that there is a less density part at the North-East cone in the crater zone. It is considered that the stack of volcanic ashes. On the other hand, we also confirmed that the contamination of the physical background particles and they makes the noisy density image especially about 50 meter below from the top of the crater. In another observation, Nishiyama et al (2014) revealed the contents of background particles and the way to remove them were presented. They showed that the main contents of the background particles is low kinetic energy charged particles and also showed that it is possible to remove them by using multi-layerd muon film detector. We can plan the future muography observation to see the deeper part of the conduit( at least until 100 meter from the top of crater) by their backgroundless method. Therefore we estimated possible performance of the future observation by multi-layer muon films. The result suggests that we might get the image of shallow conduit from the surface to the depth of e.g. 55 meter with 20 meter spatial resolution or 100 meter with 27 meter resolution in case the density in the conduit is 0.0 g/cm3 and with 71 percent statistical confidence level.

  19. Brachial artery repair using the basilic vein as a reliable conduit in a 3-year-old child

    Directory of Open Access Journals (Sweden)

    Hyunyoung G. Kim

    2017-04-01

    Full Text Available A supracondylar fracture of the humerus is the most common upper extremity fracture in children with concurrent neurovascular complications. However, bypass grafting in the management of a pediatric open elbow dislocation with an arterial injury has rarely been reported in the literature. Hence, an adequate conduit for a vessel graft interposition remains questionable when a primary anastomosis is limited in an arterial reconstruction. The purpose of this study is to present a brachial artery reconstruction in a 3-year-old patient with an open supracondylar fracture of the humerus. In the clinical and surgical examination of the patient, an open wound in the left antecubital fossa presented with accompanying brachial artery injury. To repair the artery, a reverse end-to-end anastomosis was conducted using basilic vein graft from the ipsilateral arm under general anesthesia. The patient had palpable radial pulses in the postoperative clinical examination and was discharged without complications. The great saphenous vein (GSV has proven to be the most common and the best conduit for arterial reconstruction of the upper extremity in the adult patients. However, the GSV graft is known to have the propensity for becoming aneurysmal in pediatric patients. Some studies have demonstrated the basilic vein as a suitable conduit in pediatric patients, in that it has durable patency, fewer branches, size compatibility for anastomosis, and proximity to the brachial artery. Our case confirms the safety of using this autogenous vein from within the zone of injury for arterial reconstruction, after a supracondylar humeral fracture. The management of pediatric elbow fractures accompanying vascular injuries can be technically demanding due to relatively small, delicate structures and concurrent neurovascular network. Nonetheless, a vascular injury should be treated with high level of suspicion and immediate intervention to avoid any limb ischemia or loss. In

  20. Modified conduit preparation creates a pseudosinus in an aortic valve-sparing procedure for aneurysm of the ascending aorta.

    Science.gov (United States)

    Cochran, R P; Kunzelman, K S; Eddy, A C; Hofer, B O; Verrier, E D

    1995-06-01

    Mechanical valved conduit replacement of the aortic root is a durable and appropriate procedure for many diseases of the ascending aorta, but may sacrifice an anatomically salvageable aortic valve. For young active patients and for patients with "systemic" arterial disease (atherosclerosis, Marfan's syndrome) who may require future operations, life-long anticoagulation with its attendant thromboembolic versus hemorrhagic risks is not ideal. Several techniques have been suggested as aortic valve-sparing options. Recently, a procedure was described that combines the freehand homograft techniques with the standard Bentall techniques (David procedure). This innovative technique replaces the ascending aorta with a Dacron cylinder, spares the aortic valve, and restores competence and thus offers an excellent alternative. The durability of this procedure that places the aortic valve inside a cylindrical conduit without sinuses of Valsalva is unknown. In selected patients, we have used this technique to spare the aortic valve. On the basis of experimental data and preliminary computer modeling, with the hope of improving the durability, we have modified the conduit to create a "pseudosinus" in our most recent nine patients. We have done the David procedure in 10 patients. The pseudosinus modification was done in the most recent nine patients. Patients' ages ranged from 37 to 71 years (mean 49.9 years). There were five female and five male patients. Five patients had Marfan's syndrome and five patients had annuloaortic ectasia. There has been no mortality and all patients have had both early and late follow-up echocardiography. Five patients have zero to trace aortic insufficiency, four patients have trace to mild aortic insufficiency, and one patient has mild or "1+" aortic insufficiency. Aortic insufficiency has not progressed in any patient during the 18 months of follow-up. The patient with 1+ aortic insufficiency has no activity limits, good ventricular function, and

  1. Permeability and 3-D melt geometry in shear-induced high melt fraction conduits

    Science.gov (United States)

    Zhu, W.; Cordonnier, B.; Qi, C.; Kohlstedt, D. L.

    2017-12-01

    Observations of dunite channels in ophiolites and uranium-series disequilibria in mid-ocean ridge basalt suggest that melt transport in the upper mantle beneath mid-ocean ridges is strongly channelized. Formation of high melt fraction conduits could result from mechanical shear, pyroxene dissolution, and lithological partitioning. Deformation experiments (e.g. Holtzman et al., 2003) demonstrate that shear stress causes initially homogeneously distributed melt to segregate into an array of melt-rich bands, flanked by melt-depleted regions. At the same average melt fraction, the permeability of high melt fraction conduits could be orders of magnitude higher than that of their homogenous counterparts. However, it is difficult to determine the permeability of melt-rich bands. Using X-ray synchrotron microtomography, we obtained high-resolution images of 3-dimensional (3-D) melt distribution in a partially molten rock containing shear-induced high melt fraction conduits. Sample CQ0705, an olivine-alkali basalt aggregate with a nominal melt fraction of 4%, was deformed in torsion at a temperature of 1473 K and a confining pressure of 300 MPa to a shear strain of 13.3. A sub-volume of CQ0705 encompassing 3-4 melt-rich bands was imaged. Microtomography data were reduced to binary form so that solid olivine is distinguishable from basalt glass. At a spatial resolution of 160 nm, the 3-D images reveal the shape and connectedness of melt pockets in the melt-rich bands. Thin melt channels formed at grain edges are connected at large melt nodes at grain corners. Initial data analysis shows a clear preferred orientation of melt pockets alignment subparallel to the melt-rich band. We use the experimentally determined geometrical parameters of melt topology to create a digital rock with identical 3-D microstructures. Stokes flow simulations are conducted on the digital rock to obtain the permeability tensor. Using this digital rock physics approach, we determine how deformation

  2. Hot upwelling conduit beneath the Atlas Mountains, Morocco

    Science.gov (United States)

    Sun, Daoyuan; Miller, Meghan S.; Holt, Adam F.; Becker, Thorsten W.

    2014-11-01

    The Atlas Mountains of Morocco display high topography, no deep crustal root, and regions of localized Cenozoic alkaline volcanism. Previous seismic imaging and geophysical studies have implied a hot mantle upwelling as the source of the volcanism and high elevation. However, the existence, shape, and physical properties of an associated mantle anomaly are debated. Here we use seismic waveform analysis from a broadband deployment and geodynamic modeling to define the physical properties and morphology of the anomaly. The imaged low-velocity structure extends to ~200 km beneath the Atlas and appears ~350 K hotter than the ambient mantle with possible partial melting. It includes a lateral conduit, which suggests that the Quaternary volcanism arises from the upper mantle. Moreover, the shape and temperature of the imaged anomaly indicate that the unusually high topography of the Atlas Mountains is due to active mantle support.

  3. Thermal Expansivity Between 150 and 800°C of Hydrothermally Altered Conduit Dyke Samples from USDP-4 Drill Core (Mt Unzen, Shimabara, Japan)

    Science.gov (United States)

    Yilmaz, T. I.; Hess, K. U.; Vasseur, J.; Wadsworth, F. B.; Gilg, H. A.; Nakada, S.; Dingwell, D. B.

    2017-12-01

    When hot magma intrudes the crust, the surrounding rocks expand. Similarly, the cooling magma contracts. The expansion and contraction of these multiphase materials is not simple and often requires empirical constraint. Therefore, we constrained the thermal expansivity of Unzen dome and conduit samples using a NETZSCH® DIL 402C. Following experiments, those samples were scanned using a Phoenix v|tome|x m to observe the cracks that may have developed during the heating and cooling. The dome samples do not show petrological or chemical signs of alteration. However, the alteration of the conduit dykes is represented by the occurrence of the main secondary phases such as chlorite, sulfides, carbonates, R1 (Reichweite parameter) illite-smectite, and kaolinite. These alteration products indicate an (I) early weak to moderate argillic magmatic alteration, and a (II) second stage weak to moderate propylitic hydrothermal alteration. The linear thermal expansion coefficient aL of the dome material is K-1 between 150° and 800°C and shows a sharp peak of up to K-1 around the alpha-beta-quartz-transition ( 573°C). In contrast, aL of the hydrothermally altered conduit samples starts to increase around 180° and reaches K-1 at 400°C. We interpret this effect as being due to the water content of the kaolinite and the R1 illite-smectite, which induces larger expansions per degree temperature change. Furthermore, the altered conduit samples show a more pronounced increases of aL between 500 and 650°C of up to peaks at K-1, which is generated by the breakdown of chlorite, iron-rich dolomite solid solutions, calcite, and pyrite. We use a 1D conductive model of heat transfer to explore how the country rock around the Unzen conduit zone would heat up after intrusion. In turn, we convert these temperature profiles to thermal stress profiles, assuming the edifice is largely undeformable. We show that these high linear thermal expansion coefficients of the hydrothermally altered

  4. Cable-in-conduit conductor optimization for fusion magnet applications

    International Nuclear Information System (INIS)

    Miller, J.R.; Kerns, J.A.

    1987-01-01

    Careful design of the toroidal-field (TF) and poloidal-field (PF) coils in a tokamak machine using cable-in-conduit conductors (CICC) can result in quite high overall winding-pack current densities - even with the high nuclear heat loads that may be imposed in operating a fusion reactor - and thereby help reduce the overall machine size. In our design process, we systematically examined the operational environment of a magnet, e.g., mechanical stresses, current, field, heat load, coolant temperature, and cooldown stresses, to determine the optimum amounts of copper, superconductor, helium, and sheath material for the CICC. This process is being used to design the superconducting magnet systems that comprise the Tokamak Ignition/Burn Experimental Reactor (TIBER II). 13 refs., 2 figs

  5. Hawaiian fissure fountains: Quantifying vent and shallow conduit geometry, episode 1 of the 1969-1974 Mauna Ulu eruption: Chapter 17

    Science.gov (United States)

    Parcheta, Carolyn; Fagents, Sarah; Swanson, Donald A.; Houghton, Bruce F.; Ericksen, Todd; Carey, Rebecca; Cayol, Valérie; Poland, Michael P.; Weis, Dominique

    2015-01-01

    Geometries of shallow magmatic pathways feeding volcanic eruptions are poorly constrained, yet many key interpretations about eruption dynamics depend on knowledge of these geometries. Direct quantification is difficult because vents typically become blocked with lava at the end of eruptions. Indirect geophysical techniques have shed light on some volcanic conduit geometries, but the scales are too coarse to resolve narrow fissures (widths typically 1 m). Kīlauea's Mauna Ulu eruption, which started with 30 m. Direct measurements at the ground surface were augmented by tripod-mounted lidar measurements to quantify the shallow conduit geometry for three vents at a resolution eruptive behavior, especially if incorporated into computer models.

  6. Construction of nerve guide conduits from cellulose/soy protein composite membranes combined with Schwann cells and pyrroloquinoline quinone for the repair of peripheral nerve defect.

    Science.gov (United States)

    Luo, Lihua; Gan, Li; Liu, Yongming; Tian, Weiqun; Tong, Zan; Wang, Xiong; Huselstein, Celine; Chen, Yun

    2015-02-20

    Regeneration and functional reconstruction of peripheral nerve defects remained a significant clinical challenge. Nerve guide conduits, with seed cells or neurotrophic factors (NTFs), had been widely used to improve the repair and regeneration of injured peripheral nerve. Pyrroloquinoline quinone (PQQ) was an antioxidant that can stimulate nerve growth factors (NGFs) synthesis and accelerate the Schwann cells (SCs) proliferation and growth. In present study, three kinds of nerve guide conduits were constructed: one from cellulose/SPI hollow tube (CSC), another from CSC combined with SCs (CSSC), and the third one from CSSC combined with PQQ (CSSPC), respectively. And then they were applied to bridge and repair the sciatic nerve defect in rats, using autograft as control. Effects of different nerve guide conduits on the nerve regeneration were comparatively evaluated by general analysis, sciatic function index (SFI) and histological analysis (HE and TEM). Newly-formed regenerative nerve fibers were observed and running through the transparent nerve guide conduits 12 weeks after surgery. SFI results indicated that the reconstruction of motor function in CSSPC group was better than that in CSSC and CSC groups. HE images from the cross-sections and longitudinal-sections of the harvested regenerative nerve indicated that regenerative nerve fibers had been formed and accompanied with new blood vessels and matrix materials in the conduits. TEM images also showed that lots of fresh myelinated and non-myelinated nerve fibers had been formed. Parts of vacuolar, swollen and abnormal axons occurred in CSC and CSSC groups, while the vacuolization and swell of axons was the least serious in CSSPC group. These results indicated that CSSPC group had the most ability to repair and reconstruct the nerve structure and functions due to the comprehensive contributions from hollow CSC tube, SCs and PQQ. As a result, the CSSPC may have the potential for the applications as nerve guide

  7. Simulation of Microdamage and Evaluation of Remaining Life of Steam Conduit Components from New-Generation Refractory Steel 10Kh9MF-Sh

    Science.gov (United States)

    Gladshtein, V. I.

    2018-03-01

    The effects of microdamage on the remaining life of high-temperature components of steam conduits from high-chromium steel 10Kh9MF-Sh and low-alloy steel 12Kh1M1F are compared. To simulate the microdamage, specimens with a circular notch and different relative diameters are fabricated. Specimens with a notch simulating the highest degree of microdamage and smooth specimens are tested for long-term strength. The coefficient of the remaining life of a conduit is computed for the range of relative damage presenting practical interest.

  8. Numerical study of groundwater flow cycling controlled by seawater/freshwater interaction in a coastal karst aquifer through conduit network using CFPv2.

    Science.gov (United States)

    Xu, Zexuan; Hu, Bill X; Davis, Hal; Kish, Stephen

    2015-11-01

    In this study, a groundwater flow cycling in a karst springshed and an interaction between two springs, Spring Creek Springs and Wakulla Springs, through a subground conduit network are numerically simulated using CFPv2, the latest research version of MODFLOW-CFP (Conduit Flow Process). The Spring Creek Springs and Wakulla Springs, located in a marine estuary and 11 miles inland, respectively, are two major groundwater discharge spots in the Woodville Karst Plain (WKP), North Florida, USA. A three-phase conceptual model of groundwater flow cycling between the two springs and surface water recharge from a major surface creek (Lost Creek) was proposed in various rainfall conditions. A high permeable subground karst conduit network connecting the two springs was found by tracer tests and cave diving. Flow rate of discharge, salinity, sea level and tide height at Spring Creek Springs could significantly affect groundwater discharge and water stage at Wakulla Springs simultaneously. Based on the conceptual model, a numerical hybrid discrete-continuum groundwater flow model is developed using CFPv2 and calibrated by field measurements. Non-laminar flows in conduits and flow exchange between conduits and porous medium are implemented in the hybrid coupling numerical model. Time-variable salinity and equivalent freshwater head boundary conditions at the submarine spring as well as changing recharges have significant impacts on seawater/freshwater interaction and springs' discharges. The developed numerical model is used to simulate the dynamic hydrological process and quantitatively represent the three-phase conceptual model from June 2007 to June 2010. Simulated results of two springs' discharges match reasonably well to measurements with correlation coefficients 0.891 and 0.866 at Spring Creeks Springs and Wakulla Springs, respectively. The impacts of sea level rise on regional groundwater flow field and relationship between the inland springs and submarine springs are

  9. Functional and regenerative effects of local administration of autologous mononuclear bone marrow cells combined with silicone conduit on transected femoral nerve of rabbits.

    Science.gov (United States)

    Trindade, Anelise Bonilla; Schestatsky, Pedro; Torres, Vítor Félix; Gomes, Cristiano; Gianotti, Giordano Cabral; Paz, Ana Helena da Rosa; Terraciano, Paula Barros; Marques, Janete Maria Volpato; Guimarães, Karina Magano; Graça, Dominguita Lühers; Cirne-Lima, Elizabeth Obino; Contesini, Emerson Antonio

    2015-10-01

    The inoculation of cells into injury sites can accelerate and improve the quality of nerve regeneration. This study aimed to evaluate the functional and regenerative effects of mononuclear autologous bone marrow cells (MABMC) combined with silicon conduit grafting in rabbit femoral nerves. Twenty-eight animals were allocated to one of two groups: treatment group (TG) or control group (CG), divided according to the time of evaluation, at either 50 or 75 days. After neurotmesis of the femoral nerve, surgical repair was performed with nerve autografts in silicon conduits, leaving a 5mm gap in both groups. The TG received MABMC in silicon conduits, and CG received a sham saline inoculum. Histological, clinical and electrophysiological analyses detected no differences between groups, but analysis of leg diameter showed that TG diameters were larger. This cell therapy did not improve regeneration of the femoral nerve, but there was a tendency for better functional recovery. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Hydrothermal Alteration of the Mt Unzen Conduit (Shimabara/Japan)

    Science.gov (United States)

    Yilmaz, T. I.; Mayer, K.; Hess, K. U.; Janots, E.; Gilg, H. A.; Dingwell, D. B.

    2016-12-01

    Investigations were carried out on hydrothermally altered coherent dacitic dykes samples from (USDP-4) drill core at Mt Unzen stratovolcano (Shimabara/Japan). XRF, XRD, EMPA, and C-O-isotope analysis led to insights concerning chemistry, mineralogy, and intensity of alteration as well as the origin of carbonate-precipitating fluids. Additionally a textural characterization of the occurring replacement features in the magma conduit zone was performed. The occurrence of the main secondary phases such as chlorite, pyrite, carbonates, and R1 (Reichweite parameter) illite-smectite indicate a weak to moderate propylitic to phyllic hydrothermal alteration. The dacitic samples of the dykes show different hydrothermal alteration features: (i) carbonate pseudomorphs after hornblende as well as core and zonal textures due to replacement of plagioclase by R1 illite-smectite, (ii) colloform banded fracture fillings and fillings in dissolution vugs, and (iii) chlorite and R1 illite-smectite in the groundmass. Carbonates in fractures comprise iron-rich dolomite solid solutions ("ankerite") and calcite. Isotopic values of d13Cvpdb = -4.59 ± 0.6‰ and d18Ovpdb = -21.73 ± 0.5‰ indicate a hydrothermal-magmatic origin for the carbonate formation. The chlorite-carbonate-pyrite index (CCPI) and the Ishikawa alteration index (AI), applied to the investigated samples show significant differences (CCPI=52.7-57.8; AI=36.1-40.6) indicating their different degree of alteration. According to Nakada et al., 2005, the C13 to C16 dykes represent the feeder dyke from the latest eruption (1991-1995) whereas C8 represents an earlier dyke feeder dyke from an older eruption. Weakest conduit alteration, which was obtained in samples C16-1-5 and C13-2-5, correlates with the alteration degree of the pristine dome rocks. Highest CCPI value was determined for sample C14-1-5 and the highest AI value was determined for sample C15-2-6. The degrees of alteration do not indicate highest alteration of the

  11. Magnetic losses and reactance change by the use of metallic conduit in electrical installations; Perdidas magneticas y cambio de reactancia por la tuberia metalica en instalaciones electricas

    Energy Technology Data Exchange (ETDEWEB)

    Campero Littlewood, Eduardo; Castaneda D, Miguel; Castulo A, Roberto; Bratu Serban, Neagu [Universidad Autonoma Metropolitana-Azcapotzalco, Mexico, D. F. (Mexico)

    1996-12-31

    In this paper are presented the results obtained in the measurement of magnetic losses in metallic conduits in electric installations. The losses for parasitic currents and by hysteresis were obtained in different conditions of magnetic density, caused by the net current resulting from the sum of all the currents of all the conductors that travel along the conduit. These currents are named differential currents, and the conditions in which they appear in the electric installations are described. The magnetic induction phenomenon that occurs in metallic conduit is briefly described and the basic concepts that describe it. A theoretical-experimental methodology is offered to quantify the energy losses by parasitic currents and by the metal magnetization in these metallic conduits. At the same time, the impact of these differential currents impact in the reactance of the electric installation is quantified. The obtained results for twelve conduits of different diameters and different wall thickness are shown. A comparison analysis is made with the reported results in a previous article, where the losses were estimated by means of the temperature rise measurement of the metallic wall. [Espanol] En este articulo se presentan los resultados obtenidos en la medicion de perdidas magneticas en tuberias conduit (metalicas) en instalaciones electricas. Las perdidas por corrientes parasitas y por histeresis se obtuvieron para diferentes condiciones de densidad magnetica, provocada por la corriente neta resultante de la suma de las corrientes de todos los conductores que viajan por la tuberia. A estas corrientes se les designa corrientes diferenciales y se describen las condiciones en las que estas aparecen en las instalaciones electricas. Se explica brevemente el fenomeno de induccion magnetica que se presenta en las tuberias metalicas y los conceptos basicos que la describen. Se plantea una metodologia teorico-experiemental para cuantificar las perdidas de energia, por

  12. Magnetic losses and reactance change by the use of metallic conduit in electrical installations; Perdidas magneticas y cambio de reactancia por la tuberia metalica en instalaciones electricas

    Energy Technology Data Exchange (ETDEWEB)

    Campero Littlewood, Eduardo; Castaneda D, Miguel; Castulo A, Roberto; Bratu Serban, Neagu [Universidad Autonoma Metropolitana-Azcapotzalco, Mexico, D. F. (Mexico)

    1997-12-31

    In this paper are presented the results obtained in the measurement of magnetic losses in metallic conduits in electric installations. The losses for parasitic currents and by hysteresis were obtained in different conditions of magnetic density, caused by the net current resulting from the sum of all the currents of all the conductors that travel along the conduit. These currents are named differential currents, and the conditions in which they appear in the electric installations are described. The magnetic induction phenomenon that occurs in metallic conduit is briefly described and the basic concepts that describe it. A theoretical-experimental methodology is offered to quantify the energy losses by parasitic currents and by the metal magnetization in these metallic conduits. At the same time, the impact of these differential currents impact in the reactance of the electric installation is quantified. The obtained results for twelve conduits of different diameters and different wall thickness are shown. A comparison analysis is made with the reported results in a previous article, where the losses were estimated by means of the temperature rise measurement of the metallic wall. [Espanol] En este articulo se presentan los resultados obtenidos en la medicion de perdidas magneticas en tuberias conduit (metalicas) en instalaciones electricas. Las perdidas por corrientes parasitas y por histeresis se obtuvieron para diferentes condiciones de densidad magnetica, provocada por la corriente neta resultante de la suma de las corrientes de todos los conductores que viajan por la tuberia. A estas corrientes se les designa corrientes diferenciales y se describen las condiciones en las que estas aparecen en las instalaciones electricas. Se explica brevemente el fenomeno de induccion magnetica que se presenta en las tuberias metalicas y los conceptos basicos que la describen. Se plantea una metodologia teorico-experiemental para cuantificar las perdidas de energia, por

  13. Injunctions against mere conduit of information protected by copyright

    DEFF Research Database (Denmark)

    Sandfeld Jakobsen, Søren; Petersen, Clement Salung

    2011-01-01

    This paper includes an in-depth analysis of EU law and Scandinavian law on injunctions against internet access providers (IAPs) performing as mere conduit of information protected by copyright. In recent Scandinavian case law, courts have granted preliminary injunctions which have caused IAPs...... to either shut down specific internet connections allegedly used to infringe copyright or to block access to internet content, which allegedly infringed applicable copyright rules. This paper considers some significant legal challenges, which are emerging in the wake of this case law, and which should...... requires rules, which take into due consideration the special aspects related to enforcement of copyright on the internet through IAPs. Secondly, it is shown that the termination of internet connections and the blocking of access to internet content may not support the public policies behind copyright law...

  14. Studying the causes for corrosive destruction of water conduits

    Energy Technology Data Exchange (ETDEWEB)

    Azamatova, F I; Kulinichev, G P; Porubov, I S

    1979-01-01

    Pipes from different oil and gas production administrations were selected for X-ray and metallographic studies of the cause of corrosive destruction. The chemical composition and mechanical properties of the pipe material are presented in tables. The phase composition of the corrosion products was studied by X-rays. The complex structure of the layer made up of the corrosion products was taken into consideration. The studies were conducted in an X-ray diffraction chamber. The obtained results are presented in a table. The metallographic studies showed that a significant corrosive damage of the materials of water conduits occurs as a result of the development of local corrosion processes, caused by the substantive heterogeneity of the structure of the metal, related to the nonuniform distribution of the pearlite because of carbon liquidation.

  15. NECL1 coated PLGA as favorable conduits for repair of injured peripheral nerve

    International Nuclear Information System (INIS)

    Xu, Fuben; Zhang, Kun; Lv, Peizhen; Lu, Rongbin; Zheng, Li; Zhao, Jinmin

    2017-01-01

    Restoration of normal neurological function of transected peripheral nerve challenged regenerative medicine and surgery. Previous studies showed that Nectin-like molecule 1 (NECL1) is one of the important adhesion molecules on the axons and Schwann cells is located along the internodes in direct apposition to NECL1. In this study, we fabricated PLGA membrane pre-coated with NECL1, mimicking the natural axons to enhance the adhesion of Schwann cells. Investigation of the cellular response in vitro was performed by detecting cytotoxicity, proliferation, morphology, viability, specific markers and Scanning Electron Microscopy (SEM) of Schwann cells cultured in PLGA. Further, the NECL1-coated PLGA conduits were used for peripheral nerve repair after sciatic nerve defect was constructed. Results showed that PLGA-coated NECL1 enhanced cell proliferation compared with PLGA, as evidenced by MTT analysis, cell viability assay and histological evaluation. RT-PCR results showed that GDNF (glial cell line-derived neurotrophic factor), BDNF (brain-derived neurotrophic factor), CNTF (ciliary neurotrophic factor) and neurotrophic factors of axonal regeneration were highly expressed in PLGA/NECL1 group. S100, which is Schwann cell marker, was also elevated in PLGA-NCEL1 in both mRNA and protein expression as demonstrated by PCR and immunohistochemical examination. Moreover, in vivo study showed that implantation of PLGA/NCEL1 tubes in bridging the nerve defect can significantly improve Schwann cell aggregation and attachment and greatly enhance the functional recovery of nerve regeneration as compared with control and PLGA groups. Therefore, the novel blend of PLGA/NECL1 conduits proved to be promising candidate for tissue engineering scaffold. - Highlights: • A fabricated PLGA tubes pre-coated with Nectin-like molecule 1 (NECL1) strategy for sciatic nerve regeneration is proposed. • The NECL1 coated PLGA can promote Schwann cells adhesion and growth meanwhile maintain the

  16. The efficacy of a scaffold-free Bio 3D conduit developed from human fibroblasts on peripheral nerve regeneration in a rat sciatic nerve model.

    Directory of Open Access Journals (Sweden)

    Hirofumi Yurie

    Full Text Available Although autologous nerve grafting is the gold standard treatment of peripheral nerve injuries, several alternative methods have been developed, including nerve conduits that use supportive cells. However, the seeding efficacy and viability of supportive cells injected in nerve grafts remain unclear. Here, we focused on a novel completely biological, tissue-engineered, scaffold-free conduit.We developed six scaffold-free conduits from human normal dermal fibroblasts using a Bio 3D Printer. Twelve adult male rats with immune deficiency underwent mid-thigh-level transection of the right sciatic nerve. The resulting 5-mm nerve gap was bridged using 8-mm Bio 3D conduits (Bio 3D group, n = 6 and silicone tube (silicone group, n = 6. Several assessments were conducted to examine nerve regeneration eight weeks post-surgery.Kinematic analysis revealed that the toe angle to the metatarsal bone at the final segment of the swing phase was significantly higher in the Bio 3D group than the silicone group (-35.78 ± 10.68 versus -62.48 ± 6.15, respectively; p < 0.01. Electrophysiological studies revealed significantly higher compound muscle action potential in the Bio 3D group than the silicone group (53.60 ± 26.36% versus 2.93 ± 1.84%; p < 0.01. Histological and morphological studies revealed neural cell expression in all regions of the regenerated nerves and the presence of many well-myelinated axons in the Bio 3D group. The wet muscle weight of the tibialis anterior muscle was significantly higher in the Bio 3D group than the silicone group (0.544 ± 0.063 versus 0.396 ± 0.031, respectively; p < 0.01.We confirmed that scaffold-free Bio 3D conduits composed entirely of fibroblast cells promote nerve regeneration in a rat sciatic nerve model.

  17. Large-area irradiated low-level laser effect in a biodegradable nerve guide conduit on neural regeneration of peripheral nerve injury in rats.

    Science.gov (United States)

    Shen, Chiung-Chyi; Yang, Yi-Chin; Liu, Bai-Shuan

    2011-08-01

    This study used a biodegradable composite containing genipin-cross-linked gelatin annexed with β-tricalcium phosphate ceramic particles (genipin-gelatin-tricalcium phosphate, GGT), developed in a previous study, as a nerve guide conduit. The aim of this study was to analyse the influence of a large-area irradiated aluminium-gallium-indium phosphide (AlGaInP) diode laser (660 nm) on the neural regeneration of the transected sciatic nerve after bridging the GGT nerve guide conduit in rats. The animals were divided into two groups: group 1 comprised sham-irradiated controls and group 2 rats underwent low-level laser (LLL) therapy. A compact multi-cluster laser system with 20 AlGaInP laser diodes (output power, 50mW) was applied transcutaneously to the injured peripheral nerve immediately after closing the wound, which was repeated daily for 5 min for 21 consecutive days. Eight weeks after implantation, walking track analysis showed a significantly higher sciatic function index (SFI) score (Pguide conduit in rats. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Conduit degassing and thermal controls on eruption styles at Mount St. Helens

    Science.gov (United States)

    Schneider, Andrew; Rempel, Alan W.; Cashman, Katharine V.

    2012-12-01

    The explosivity of silicic eruptions depends on the interplay between magma rheology, exsolution kinetics, and degassing. Magma degassing is governed by the competing effects of vertical transport within the conduit and the lateral flux of gas out of the conduit (Diller et al., 2006; Jaupart and Allegre, 1991). We combine a simplified treatment of these degassing processes with thermodynamic modeling to examine the conditions present at Mount St. Helens during the spine extruding eruption from 2004 to 2008. We find that two parameters are primarily responsible for controlling the eruptive style: the magma chamber temperature, and a dimensionless parameter that gauges the efficiency of lateral degassing. Together, these parameters determine whether and where magma can solidify at depth to form a dense solid plug that is gradually extruded as a volcanic spine. We show that the small (50 oC) decrease in magma chamber temperature between eruptive activity in the 1980s and that of 2004-2008, combined with a modest increase in degassing efficiency associated with lower volumetric flux, can explain the observed change in erupted material from viscous lava flows to solidified spines. More generally, we suggest that similar threshold behavior may explain observed abrupt transitions in effusive eruptive styles at other intermediate composition volcanoes. Finally, we extrapolate our results to suggest that the increase in degassing efficiency accompanying decreasing magma supply rates may have caused the transition from explosive to effusive activity in late 1980.

  19. Flow-rate measurements in closed-conduits by tracer techniques

    International Nuclear Information System (INIS)

    Lund Plantat, C.

    1982-01-01

    This paper presents the study of the precision obtained measuring flow-rates in closed-conduits by tracer techniques. The flow-rates analyzed were in the range of 10 to 20 l/s and Reynolds numbers from 10 5 to 2 x 10 5 . Tracer used were fluoresceine and In-113 m; and the measurements were performed with the dilution method (punctual and continuous injection) and the Allen method. Precisions for the method of punctual and continuous injections were 6.25% and 9.45% for fluoresceine and 9.3% and 3% for In-113, respectively. For Allen method with In-113 m a precision of 5% was obtained; probably this value was affected by the short distance between detectors. In all cases the error corresponds with the expected value except in one measurement at a 68.3% confidence level. (I.V.)

  20. Bronchovascular reconstruction with a bovine pericardial conduit and surgical reintervention due to thrombosis with revascularisation.

    Science.gov (United States)

    Peña, Emilio; Blanco, Montserrat; Otero, Teresa

    2014-01-01

    We present the case of a 57-year-old male with left hilar squamous cell carcinoma infiltrating the pulmonary artery and in whom a sleeve bronchoplasty and angioplasty were performed using a bovine pericardial conduit. Three days post-operatively, graft thrombosis was detected; thrombectomy and graft reconstruction were performed with revascularisation of the graft. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  1. [Electrophysiological study on rat conduit pulmonary artery smooth muscle cells under normoxia and acute hypoxia].

    Science.gov (United States)

    Hu, Ying; Zou, Fei; Cai, Chun-Qing; Wu, Hang-Yu; Yun, Hai-Xia; Chen, Yun-Tian; Jin, Guo-En; Ge, Ri-Li

    2006-10-25

    The present study was designed to investigate the electrophysiological characteristics of rat conduit pulmonary artery smooth muscle cells (PASMCs) and the response to acute hypoxia. PASMCs of the 1st to 2nd order branches in the conduit pulmonary arteries were obtained by enzymatic isolation. The PASMCs were divided into acute hypoxia preconditioned group and normoxia group. Hypoxia solutions were achieved by bubbling with 5% CO2 plus 95% N2 for at least 30 min before cell perfusion. Potassium currents were compared between these two groups using whole-cell patch clamp technique. The total outward current of PASMCs was measured under normoxia condition when iBTX [specific blocking agent of large conductance Ca-activated K(+) (BK(Ca)) channel] and 4-AP [specific blocking agent of delayed rectifier K(+) (K(DR)) channel] were added consequently into bath solution. PASMCs were classified into three types according to their size, shape and electrophysiological characteristics. Type I cells are the smallest with spindle shape, smooth surface and discrete perinuclear bulge. Type II cells show the biggest size with banana-like appearance. Type III cells have the similar size with type I, and present intermediary shape between type I and type II. iBTX had little effect on the total outward current in type I cells, while 4-AP almost completely blocked it. Most of the total outward current in type II cells was inhibited by iBTX, and the remaining was sensitive to 4-AP. In type III cells, the total outward current was sensitive to both iBTX and 4-AP. Acute hypoxia reduced the current in all three types of cells: (1614.8+/-62.5) pA to (892.4+/-33.6) pA for type I cells (Ppotassium current and improves the E(m) in PASMCs. These effects may be involved in the modulation of constriction/relaxation of conduit artery under acute hypoxia. Different distribution of K(DR) and BK(Ca) channels in these three types of PASMCs might account for their different constriction

  2. Recurrent protein-losing enteropathy and tricuspid valve insufficiency in a transplanted heart: a causal relationship?

    Science.gov (United States)

    Aggarwal, Sanjeev; Delius, Ralph E; Walters, Henry L; L'Ecuyer, Thomas J

    2012-01-01

    This case report describes a toddler who developed a protein-losing enteropathy (PLE) 4 years after orthotopic heart transplantation (OHT). He was born with a hypoplastic left heart syndrome for which he underwent a successful Norwood procedure, a Hemi-Fontan palliation, and a Fontan palliation at 18 months of age. Fifteen months following the Fontan operation, he developed a PLE and Fontan failure requiring OHT. Four years after OHT, he developed a severe tricuspid regurgitation and a PLE. His PLE improved after tricuspid valve replacement. It is now 2 years since his tricuspid valve replacement and he remains clinically free of ascites and peripheral edema with a normal serum albumin level. His prosthetic tricuspid valve is functioning normally. © 2011 Wiley Periodicals, Inc.

  3. Le projet de recherche: définition, conduite et réalisation

    OpenAIRE

    Stockinger , Peter

    2013-01-01

    Master; Ce support de séminaire développe brièvement les quatre points suivants: 1) Définition d’un projet de recherche – présentation générale et recommandations. 2) La conduite d’un projet de recherche – présentation générale et recommandations. 3) La réalisation d’un projet de recherche sous forme d’un mémoire - présentation générale et recommandations. 4) Des ressources pour conduire un projet de recherche : ressources enligne et références bibliographiques.

  4. Biodegradable chitin conduit tubulation combined with bone marrow mesenchymal stem cell transplantation for treatment of spinal cord injury by reducing glial scar and cavity formation

    Directory of Open Access Journals (Sweden)

    Feng Xue

    2015-01-01

    Full Text Available We examined the restorative effect of modified biodegradable chitin conduits in combination with bone marrow mesenchymal stem cell transplantation after right spinal cord hemisection injury. Immunohistochemical staining revealed that biological conduit sleeve bridging reduced glial scar formation and spinal muscular atrophy after spinal cord hemisection. Bone marrow mesenchymal stem cells survived and proliferated after transplantation in vivo, and differentiated into cells double-positive for S100 (Schwann cell marker and glial fibrillary acidic protein (glial cell marker at 8 weeks. Retrograde tracing showed that more nerve fibers had grown through the injured spinal cord at 14 weeks after combination therapy than either treatment alone. Our findings indicate that a biological conduit combined with bone marrow mesenchymal stem cell transplantation effectively prevented scar formation and provided a favorable local microenvironment for the proliferation, migration and differentiation of bone marrow mesenchymal stem cells in the spinal cord, thus promoting restoration following spinal cord hemisection injury.

  5. Biodegradable chitin conduit tubulation combined with bone marrow mesenchymal stem cell transplantation for treatment of spinal cord injury by reducing glial scar and cavity formation

    Science.gov (United States)

    Xue, Feng; Wu, Er-jun; Zhang, Pei-xun; Li-ya, A; Kou, Yu-hui; Yin, Xiao-feng; Han, Na

    2015-01-01

    We examined the restorative effect of modified biodegradable chitin conduits in combination with bone marrow mesenchymal stem cell transplantation after right spinal cord hemisection injury. Immunohistochemical staining revealed that biological conduit sleeve bridging reduced glial scar formation and spinal muscular atrophy after spinal cord hemisection. Bone marrow mesenchymal stem cells survived and proliferated after transplantation in vivo, and differentiated into cells double-positive for S100 (Schwann cell marker) and glial fibrillary acidic protein (glial cell marker) at 8 weeks. Retrograde tracing showed that more nerve fibers had grown through the injured spinal cord at 14 weeks after combination therapy than either treatment alone. Our findings indicate that a biological conduit combined with bone marrow mesenchymal stem cell transplantation effectively prevented scar formation and provided a favorable local microenvironment for the proliferation, migration and differentiation of bone marrow mesenchymal stem cells in the spinal cord, thus promoting restoration following spinal cord hemisection injury. PMID:25788929

  6. Experimental sintering of ash at conduit conditions and implications for the longevity of tuffisites

    Science.gov (United States)

    Gardner, James E.; Wadsworth, Fabian B.; Llewellin, Edward W.; Watkins, James M.; Coumans, Jason P.

    2018-03-01

    Escape of gas from magma in the conduit plays a crucial role in mitigating explosivity. Tuffisite veins—ash-filled cracks that form in and around volcanic conduits—represent important gas escape pathways. Sintering of the ash infill decreases its porosity, eventually forming dense glass that is impermeable to gas. We present an experimental investigation of surface tension-driven sintering and associated densification of rhyolitic ash under shallow conduit conditions. Suites of isothermal (700-800 °C) and isobaric H2O pressure (20 and 40 MPa) experiments were run for durations of 5-90 min. Obsidian powders with two different size distributions were used: 1-1600 μm (mean size = 89 μm), and 63-400 μm (mean size = 185 μm). All samples evolved similarly through four textural phases: phase 1—loose and cohesion-less particles; phase 2—particles sintered at contacts and surrounded by fully connected tortuous pore space of up to 40% porosity; phase 3—continuous matrix of partially coalesced particles that contain both isolated spherical vesicles and connected networks of larger, contorted vesicles; phase 4—dense glass with 2-5% fully isolated vesicles that are mainly spherical. Textures evolve faster at higher temperature and higher H2O pressure. Coarse samples sinter more slowly and contain fewer, larger vesicles when fully sintered. We quantify the sintering progress by measuring porosity as a function of experimental run-time, and find an excellent collapse of data when run-time is normalized by the sintering timescale {λ}_s=η \\overline{R}/σ , where η is melt viscosity, \\overline{R} is mean particle radius, and σ is melt-gas surface tension. Because timescales of diffusive H2O equilibration are generally fast compared to those of sintering, the relevant melt viscosity is calculated from the solubility H2O content at experimental temperature and pressure. We use our results to develop a framework for estimating ash sintering rates under shallow

  7. Theory and modelling of quench in cable-in-conduit superconducting magnets

    International Nuclear Information System (INIS)

    Shajii, A.

    1994-04-01

    A new simple, self consistent theoretical model is presented that describes the phenomena of quench propagation in Cable-In-Conduit superconducting magnets. The model (Quencher) circumvents many of the difficulties associated with obtaining numerical solutions in more general existing models. Specifically, a factor of 30-50 is gained in CPU time over the general, explicit time dependent codes used to study typical quench events. The corresponding numerical implementation of the new model is described and the numerical results are shown to agree very well with those of the more general models, as well as with experimental data. Further, well justified approximations lead to the MacQuench model that is shown to be very accurate and considerably more efficient than the Quencher model. The MacQuench code is suitable for performing quench studies on a personal computer, requiring only several minutes of CPU time. In order to perform parametric studies on new conductor designs it is required to utilize a model such as MacQuench because of the high computational efficiency of this model. Finally, a set of analytic solutions for the problem of quench propagation in Cable-In-Conduit Conductors is presented. These analytic solutions represent the first such results that remain valid for the long time scales of interest during a quench process. The assumptions and the resulting simplifications that lead to the analytic solutions are discussed, and the regimes of validity of the various approximations are specified. The predictions of the analytic results are shown to be in very good agreement with numerical as well as experimental results. Important analytic scaling relations are verified by such comparisons, and the consequences of some of these scalings on currently designed superconducting magnets are discussed

  8. Tissue-engineered spiral nerve guidance conduit for peripheral nerve regeneration.

    Science.gov (United States)

    Chang, Wei; Shah, Munish B; Lee, Paul; Yu, Xiaojun

    2018-06-01

    Recently in peripheral nerve regeneration, preclinical studies have shown that the use of nerve guidance conduits (NGCs) with multiple longitudinally channels and intra-luminal topography enhance the functional outcomes when bridging a nerve gap caused by traumatic injury. These features not only provide guidance cues for regenerating nerve, but also become the essential approaches for developing a novel NGC. In this study, a novel spiral NGC with aligned nanofibers and wrapped with an outer nanofibrous tube was first developed and investigated. Using the common rat sciatic 10-mm nerve defect model, the in vivo study showed that a novel spiral NGC (with and without inner nanofibers) increased the successful rate of nerve regeneration after 6 weeks recovery. Substantial improvements in nerve regeneration were achieved by combining the spiral NGC with inner nanofibers and outer nanofibrous tube, based on the results of walking track analysis, electrophysiology, nerve histological assessment, and gastrocnemius muscle measurement. This demonstrated that the novel spiral NGC with inner aligned nanofibers and wrapped with an outer nanofibrous tube provided a better environment for peripheral nerve regeneration than standard tubular NGCs. Results from this study will benefit for future NGC design to optimize tissue-engineering strategies for peripheral nerve regeneration. We developed a novel spiral nerve guidance conduit (NGC) with coated aligned nanofibers. The spiral structure increases surface area by 4.5 fold relative to a tubular NGC. Furthermore, the aligned nanofibers was coated on the spiral walls, providing cues for guiding neurite extension. Finally, the outside of spiral NGC was wrapped with randomly nanofibers to enhance mechanical strength that can stabilize the spiral NGC. Our nerve histological data have shown that the spiral NGC had 50% more myelinated axons than a tubular structure for nerve regeneration across a 10 mm gap in a rat sciatic nerve

  9. Investigating the influence of conduit residues on polyurethane plates

    Directory of Open Access Journals (Sweden)

    Rachel Faverzani Magnago

    Full Text Available Abstract Converting waste into a product similar to the original one or into another useful product is to save energy, protect natural resources, and bring back to the production cycle what was discarded. In that direction, new polyurethane-based composites have been developed by incorporating 5%, 10%, 15%, and 20% PVC conduit discarded by the construction industry. The objective of this study was to investigate the interaction between the phases of waste incorporation and the effect upon the new material properties. The samples were produced by the polycondensation process. Microstructural analysis revealed a reduction in pore size across the polymer matrix. However, there were no changes in thermal insulation, water absorption, compressive strength, and burning rate tests and in the thermogravimetric analysis and differential scanning calorimetry. The results from this study showed that the replacement of raw material by waste did not affect its properties.

  10. The effect on stability and thermal hydraulic quenchback of perforating the jacket of a cable-in-conduit conductor

    International Nuclear Information System (INIS)

    Dresner, L.

    1994-01-01

    This Paper continues earlier work on the reduction of the quench pressure in a doubler cable-in-conduit conductor achieved by perforating the inner jacket. The present study examines the effect of the perforations on the stability margin and on the ononset of thermal hydraulic quenchback

  11. Fast evolving conduits in clay-bonded sandstone: Characterization, erosion processes and significance for the origin of sandstone landforms

    Czech Academy of Sciences Publication Activity Database

    Bruthans, J.; Svetlik, D.; Soukup, J.; Schweigstillová, Jana; Válek, Jan; Sedláčková, M.; Mayo, A.L.

    2012-01-01

    Roč. 177, December (2012), s. 178-193 ISSN 0169-555X R&D Projects: GA AV ČR IAA300130806 Institutional support: RVO:67985891 ; RVO:68378297 Keywords : sandstone * erosion * piping * tensile strength * conduit * landform Subject RIV: DA - Hydrology ; Limnology Impact factor: 2.552, year: 2012

  12. Impact of asymmetric lamp positioning on the performance of a closed-conduit UV reactor

    Directory of Open Access Journals (Sweden)

    Tipu Sultan

    2017-06-01

    Full Text Available Computational fluid dynamics (CFD analyses for the performance improvement of a closed-conduit ultraviolet (UV reactor were performed by changing the lamp positions from symmetric to asymmetric. The asymmetric lamp positioning can be useful for UV reactor design and optimization. This goal was achieved by incorporating the two performance factors, namely reduction equivalent dose (RED and system dose performance. Four cases were carried out for asymmetric lamp positioning within the UV reactor chamber and each case consisted of four UV lamps that were simulated once symmetrically and four times asymmetrically. The results of the four asymmetric cases were compared with the symmetric one. Moreover, these results were evaluated by using CFD simulations of a closed-conduit UV reactor. The fluence rate model, UVCalc3D was employed to validate the simulations results. The simulation results provide detailed information about the dose distribution, pathogen track modeling and RED. The RED value was increased by approximately 15% by using UVCalc3D fluence rate model. Additionally, the asymmetric lamp positioning of the UV lamps had more than 50% of the pathogens received a better and a higher UV dose than in the symmetric case. Consequently, the system dose performance was improved by asymmetric lamp positioning. It was concluded that the performance parameters (higher RED and system dose performance were improved by using asymmetric lamp positioning.

  13. Pulmonary artery reconstruction with a tailor-made bovine pericardial conduit following sleeve resection of a long segmental pulmonary artery for the treatment of lung cancer: technical details of the dog-ear method for adjusting diameter during vascular anastomosis.

    Science.gov (United States)

    Shimizu, Kimihiro; Nagashima, Toshiteru; Ohtaki, Yoichi; Takahashi, Toru; Mogi, Akira; Kuwano, Hiroyuki

    2017-05-01

    Sleeve resection of the pulmonary artery (PA) is always required for lung-sparing operations in which half or more of the vessel circumference is infiltrated by the primary tumor or metastatic hilar nodes. Following sleeve resection, conduit reconstruction may be indicated if there is excessive distance between the two vascular stumps, because there is a high degree of tension when repaired by direct anastomosis. We herein present a case of PA reconstruction using a tailor-made bovine pericardial conduit after sleeve resection of PA during lung cancer surgery. The length of resection was longer than 3 cm, and the difference in diameter between the conduit and peripheral PA stump was larger than 0.5 cm. We describe the surgical and oncological merits of a bovine pericardial conduit, and provide details of our reconstruction technique, focusing on adjustment of diameter between the conduit and peripheral PA (dog-ear method).

  14. Development and fabrication of superconducting hybrid Cable-In-Conduit-Conductor (CICC) for indigenous fusion programme

    International Nuclear Information System (INIS)

    Singh, A.K.; Hussain, M.M.; Abdulla, K.K.; Singh, R.P.

    2011-01-01

    The Atomic Fuels Division has initiated development and fabrication of Cable-In-Conduit-Conductor (CICC) of various configurations, for superconducting fusion grade magnets required for their indigenous Fusion Programme. The process involves development of high grade superconducting multifilamentary wire, multi stage cabling of superconducting as well as copper wires and, finally, jacketing of the cables in SS316LN tubes. The overview of the development and fabrication of CICC is presented in this article. (author)

  15. Distilling allometric and environmental information from time series of conduit size: the standardization issue and its relationship to tree hydraulic architecture.

    Science.gov (United States)

    Carrer, Marco; von Arx, Georg; Castagneri, Daniele; Petit, Giai

    2015-01-01

    Trees are among the best natural archives of past environmental information. Xylem anatomy preserves information related to tree allometry and ecophysiological performance, which is not available from the more customary ring-width or wood-density proxy parameters. Recent technological advances make tree-ring anatomy very attractive because time frames of many centuries can now be covered. This calls for the proper treatment of time series of xylem anatomical attributes. In this article, we synthesize current knowledge on the biophysical and physiological mechanisms influencing the short- to long-term variation in the most widely used wood-anatomical feature, namely conduit size. We also clarify the strong mechanistic link between conduit-lumen size, tree hydraulic architecture and height growth. Among the key consequences of these biophysical constraints is the pervasive, increasing trend of conduit size during ontogeny. Such knowledge is required to process time series of anatomical parameters correctly in order to obtain the information of interest. An appropriate standardization procedure is fundamental when analysing long tree-ring-related chronologies. When dealing with wood-anatomical parameters, this is even more critical. Only an interdisciplinary approach involving ecophysiology, wood anatomy and dendrochronology will help to distill the valuable information about tree height growth and past environmental variability correctly. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Hydraulic analysis of harmonic pumping tests in frequency and time domains for identifying the conduits networks in a karstic aquifer

    Science.gov (United States)

    Fischer, P.; Jardani, A.; Cardiff, M.; Lecoq, N.; Jourde, H.

    2018-04-01

    In a karstic field, the flow paths are very complex as they globally follow the conduit network. The responses generated from an investigation in this type of aquifer can be spatially highly variable. Therefore, the aim of the investigation in this case is to define a degree of connectivity between points of the field, in order to understand these flow paths. Harmonic pumping tests represent a possible investigation method for characterizing the subsurface flow of groundwater. They have several advantages compared to a constant-rate pumping (more signal possibilities, ease of extracting the signal in the responses and possibility of closed loop investigation). We show in this work that interpreting the responses from a harmonic pumping test is very useful for delineating a degree of connectivity between measurement points. We have firstly studied the amplitude and phase offset of responses from a harmonic pumping test in a theoretical synthetic modeling case in order to define a qualitative interpretation method in the time and frequency domains. Three different type of responses have been separated: a conduit connectivity response, a matrix connectivity, and a dual connectivity (response of a point in the matrix, but close to a conduit). We have then applied this method to measured responses at a field research site. Our interpretation method permits a quick and easy reconstruction of the main flow paths, and the whole set of field responses appear to give a similar range of responses to those seen in the theoretical synthetic case.

  17. Quench detection by fluid dynamic means in cable-in-conduit superconductors

    International Nuclear Information System (INIS)

    Dresner, L.

    1988-01-01

    The tight confinement of the helium in cable-in-conduit superconductors creates protection problems because of the pressure rise that can occur during a quench. But the same pressure rise offers the possibility of a non-electrical means of detecting incipient quenches by monitoring the outflow from the various hydraulic paths of the magnet. If the method is to work, the signal must be large enough to be detected unambiguously at an early time, and must not depend too strongly on the length, Joule power density, or rate of growth of the initial normal zone. This paper explores by calculation the degree to which these conditions can be met. The Westinghouse Large Coil Task coil is used as an example

  18. Assessing lateral flows and solute transport during floods in a conduit-flow-dominated karst system using the inverse problem for the advection-diffusion equation

    Science.gov (United States)

    Cholet, Cybèle; Charlier, Jean-Baptiste; Moussa, Roger; Steinmann, Marc; Denimal, Sophie

    2017-07-01

    The aim of this study is to present a framework that provides new ways to characterize the spatio-temporal variability of lateral exchanges for water flow and solute transport in a karst conduit network during flood events, treating both the diffusive wave equation and the advection-diffusion equation with the same mathematical approach, assuming uniform lateral flow and solute transport. A solution to the inverse problem for the advection-diffusion equations is then applied to data from two successive gauging stations to simulate flows and solute exchange dynamics after recharge. The study site is the karst conduit network of the Fourbanne aquifer in the French Jura Mountains, which includes two reaches characterizing the network from sinkhole to cave stream to the spring. The model is applied, after separation of the base from the flood components, on discharge and total dissolved solids (TDSs) in order to assess lateral flows and solute concentrations and compare them to help identify water origin. The results showed various lateral contributions in space - between the two reaches located in the unsaturated zone (R1), and in the zone that is both unsaturated and saturated (R2) - as well as in time, according to hydrological conditions. Globally, the two reaches show a distinct response to flood routing, with important lateral inflows on R1 and large outflows on R2. By combining these results with solute exchanges and the analysis of flood routing parameters distribution, we showed that lateral inflows on R1 are the addition of diffuse infiltration (observed whatever the hydrological conditions) and localized infiltration in the secondary conduit network (tributaries) in the unsaturated zone, except in extreme dry periods. On R2, despite inflows on the base component, lateral outflows are observed during floods. This pattern was attributed to the concept of reversal flows of conduit-matrix exchanges, inducing a complex water mixing effect in the saturated zone

  19. Measurement of nanosize etched pits in SiO2 optical fiber conduit using AFM

    International Nuclear Information System (INIS)

    Espinosa, G.; Golzarri, J.I.; Vazquez, C.; Fragoso, R.

    2003-01-01

    Fission fragment tracks from 252 Cf have been observed in SiO 2 optical fiber, using an atomic force microscope (AFM), after a very short chemical etching in hydrofluoric acid solution at normal temperature. The nuclear track starting and evolution process is followed by the AFM direct measurements on the material surface and beyond a fine layer of the surface material. The images of the scanned cones were determined observing the two predominant energies from 252 Cf fission fragments and the development of the tracks in the 150 μm diameter optical fiber conduit

  20. Clinical experience with an alloplastic stoma prosthesis (Biocarbon) for urinary conduits and cutaneous ureterostomy.

    Science.gov (United States)

    Månsson, W; Harzmann, R

    1988-01-01

    An alloplastic stoma prosthesis, Biocarbon, composed of 99.9% pure carbon in vitreous form, was used in six patients with conduit urinary diversion and in seven with cutaneous ureterostomy. The patients were thereafter observed for 2-86 months. Complications were subcutaneous infection, urinary fistula and ureteral stenosis, which necessitated removal of the prosthesis in most cases. The permanent stoma, without need for adhesive collecting device, was appreciated by the patients. Problems relating to biocompatibility remain to be solved before the place of the stoma prosthesis in urinary diversion can be determined.

  1. Functional collagen conduits combined with human mesenchymal stem cells promote regeneration after sciatic nerve transection in dogs.

    Science.gov (United States)

    Cui, Yi; Yao, Yao; Zhao, Yannan; Xiao, Zhifeng; Cao, Zongfu; Han, Sufang; Li, Xing; Huan, Yong; Pan, Juli; Dai, Jianwu

    2018-05-01

    Numerous studies have focused on the development of novel and innovative approaches for the treatment of peripheral nerve injury using artificial nerve guide conduits. In this study, we attempted to bridge 3.5-cm defects of the sciatic nerve with a longitudinally oriented collagen conduit (LOCC) loaded with human umbilical cord mesenchymal stem cells (hUC-MSCs). The LOCC contains a bundle of longitudinally aligned collagenous fibres enclosed in a hollow collagen tube. Our previous studies showed that an LOCC combined with neurotrophic factors enhances peripheral nerve regeneration. However, it remained unknown whether an LOCC seeded with hUC-MSCs could also promote regeneration. In this study, using various histological and electrophysiological analyses, we found that an LOCC provides mechanical support to newly growing nerves and functions as a structural scaffold for cells, thereby stimulating sciatic nerve regeneration. The LOCC and hUC-MSCs synergistically promoted regeneration and improved the functional recovery in a dog model of sciatic nerve injury. Therefore, the combined use of an LOCC and hUC-MSCs might have therapeutic potential for the treatment of peripheral nerve injury. Copyright © 2018 John Wiley & Sons, Ltd.

  2. Magma shearing and friction in the volcanic conduit: A crystal constraint

    Science.gov (United States)

    Wallace, P. A.; Kendrick, J. E.; Henton De Angelis, S.; Ashworth, J. D.; Coats, R.; Miwa, T.; Mariani, E.; Lavallée, Y.

    2017-12-01

    Magma shearing and friction processes in the shallow volcanic conduit are typical manifestations of strain localisation, which in turn can have an influential role on magma ascent dynamics. The thermal consequences of such events could drive the destabilisation of magma and thus dictate the style of activity at the surface. Shear heating and fault friction are prime candidates for the generation of significant quantities of heat. Here we use a combination of field and experimental evidence to investigate how crystals can act as sensitive recorders of both physical and chemical processes occurring in the shallow volcanic conduit. Spine extrusion during the closing of the 1991-95 eruption at Unzen volcano, Japan, provided the unique opportunity to investigate marginal shear zone formation, which preserves a relic of the deformation during magma ascent. Our results show that crystals can effectively act as a deformation marker during magma ascent through the viscous-brittle transition by accommodating strain in the form of crystal plasticity before fracturing (comminution). Electron backscatter diffraction (EBSD) reveals up to 40° lattice distortion of biotite phenocrysts in zones of high shear, with negligible plasticity further away. Plagioclase microlites display a systematic plastic response to an increase in shear intensity, as recorded by an increase in lattice distortion towards the spine margin of up to 9°. This localisation of strain within the shear zone is also accompanied by the destabilisation of hydrous mineral phases (i.e. amphibole), compaction of pores (23-13% Φ), glass devitrification and magnetic anomalies. The narrow zone of disequilibrium textures suggests the likely effect of a thermal input due to strain localisation being the contributing factor. These observations are complimented by high-temperature high-velocity rotary shear experiments which simulate the deformation evolution during shear. Hence, understanding these shallow volcanic

  3. Norwood with right ventricle-to-pulmonary artery conduit is more effective than Norwood with Blalock-Taussig shunt for hypoplastic left heart syndrome: mathematic modeling of hemodynamics.

    Science.gov (United States)

    Mroczek, Tomasz; Małota, Zbigniew; Wójcik, Elżbieta; Nawrat, Zbigniew; Skalski, Janusz

    2011-12-01

    The introduction of right ventricle to pulmonary artery (RV-PA) conduit in the Norwood procedure for hypoplastic left heart syndrome resulted in a higher survival rate in many centers. A higher diastolic aortic pressure and a higher mean coronary perfusion pressure were suggested as the hemodynamic advantage of this source of pulmonary blood flow. The main objective of this study was the comparison of two models of Norwood physiology with different types of pulmonary blood flow sources and their hemodynamics. Based on anatomic details obtained from echocardiographic assessment and angiographic studies, two three-dimensional computer models of post-Norwood physiology were developed. The finite-element method was applied for computational hemodynamic simulations. Norwood physiology with RV-PA 5-mm conduit and Blalock-Taussig shunt (BTS) 3.5-mm shunt were compared. Right ventricle work, wall stress, flow velocity, shear rate stress, energy loss and turbulence eddy dissipation were analyzed in both models. The total work of the right ventricle after Norwood procedure with the 5-mm RV-PA conduit was lower in comparison to the 3.5-mm BTS while establishing an identical systemic blood flow. The Qp/Qs ratio was higher in the BTS group. Hemodynamic performance after Norwood with the RV-PA conduit is more effective than after Norwood with BTS. Computer simulations of complicated hemodynamics after the Norwood procedure could be helpful in establishing optimal post-Norwood physiology. Copyright © 2011 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

  4. In vitro efficacy of a gene-activated nerve guidance conduit incorporating non-viral PEI-pDNA nanoparticles carrying genes encoding for NGF, GDNF and c-Jun.

    Science.gov (United States)

    Lackington, William A; Raftery, Rosanne M; O'Brien, Fergal J

    2018-06-07

    Despite the success of tissue engineered nerve guidance conduits (NGCs) for the treatment of small peripheral nerve injuries, autografts remain the clinical gold standard for larger injuries. The delivery of neurotrophic factors from conduits might enhance repair for more effective treatment of larger injuries but the efficacy of such systems is dependent on a safe, effective platform for controlled and localised therapeutic delivery. Gene therapy might offer an innovative approach to control the timing, release and level of neurotrophic factor production by directing cells to transiently sustain therapeutic protein production in situ. In this study, a gene-activated NGC was developed by incorporating non-viral polyethyleneimine-plasmid DNA (PEI-pDNA) nanoparticles (N/P 7 ratio, 2μg dose) with the pDNA encoding for nerve growth factor (NGF), glial derived neurotrophic factor (GDNF) or the transcription factor c-Jun. The physicochemical properties of PEI-pDNA nanoparticles, morphology, size and charge, were shown to be suitable for gene delivery and demonstrated high Schwann cell transfection efficiency (60±13%) in vitro. While all three genes showed therapeutic potential in terms of enhancing neurotrophic cytokine production while promoting neurite outgrowth, delivery of the gene encoding for c-Jun showed the greatest capacity to enhance regenerative cellular processes in vitro. Ultimately, this gene-activated NGC construct was shown to be capable of transfecting both Schwann cells (S42 cells) and neuronal cells (PC12 and dorsal root ganglia) in vitro, demonstrating potential for future therapeutic applications in vivo. The basic requirements of biomaterial-based nerve guidance conduits have now been well established and include being able to bridge a nerve injury to support macroscopic guidance between nerve stumps, while being strong enough to withstand longitudinal tension and circumferential compression, in addition to being mechanically sound to facilitate

  5. Autologous alternative veins may not provide better outcomes than prosthetic conduits for below-knee bypass when great saphenous vein is unavailable.

    Science.gov (United States)

    Avgerinos, Efthymios D; Sachdev, Ulka; Naddaf, Abdallah; Doucet, Dannielle R; Mohapatra, Abhisekh; Leers, Steven A; Chaer, Rabih A; Makaroun, Michel S

    2015-08-01

    There is a need to better define the role of alternative autologous vein (AAV) segments over contemporary prosthetic conduits in patients with critical limb ischemia when great saphenous vein (GSV) is not available for use as the bypass conduit. Consecutive patients who underwent bypass to infrageniculate targets between 2007 and 2011 were categorized in three groups: GSV, AAV, and prosthetic. The primary outcome was graft patency. The secondary outcome was limb salvage. Cox proportional hazards regression was used to adjust for baseline confounding variables. A total of 407 infrainguinal bypasses to below-knee targets were analyzed; 255 patients (63%) received a single-segment GSV, 106 patients (26%) received an AAV, and 46 patients (11%) received a prosthetic conduit. Baseline characteristics were similar among groups, with the exception of popliteal targets and anticoagulation use being more frequent in the prosthetic group. Primary patency at 2 and 5 years was estimated at 47% and 32%, respectively, for the GSV group; 24% and 23% for the AAV group; and 43% and 38% for the prosthetic group. Primary assisted patency at 2 and 5 years was estimated at 71% and 55%, respectively, for the GSV group; 53% and 51% for the AAV group; and 45% and 40% for the prosthetic group. Secondary patency at 2 and 5 years was estimated at 75% and 60%, respectively, for the GSV group; 57% and 55% for the AAV group; and 46% and 41% for the prosthetic group. In Cox analysis, primary patency (hazard ratio [HR], 0.55; P < .001; 95% confidence interval [CI], 0.404-0.758), primary assisted patency (HR, 0.57; P = .004; 95% CI, 0.388-0.831), and secondary patency (HR, 0.56; P = .005; 95% CI, 0.372-0.840) were predicted by GSV compared with AAV, but there was no difference between AAV and prosthetic grafts except for the primary patency, for which prosthetic was protective (HR, 0.38; P < .001; 95% CI, 0.224-0.629). Limb salvage was similar among groups. AAV conduits may not offer a significant

  6. A new cable-in-conduit conductor magnet with insulated strands

    International Nuclear Information System (INIS)

    Yamaguchi, Satarou; Yamamoto, Junya; Motojima, Osamu.

    1995-09-01

    Many studies have used cable-in-conduit conductor (CICC) coils in trying to develop an AC superconducting magnet because of its enormous potential if AC losses were low and insulation voltage was high. The strands in the most recent CICC magnets are coated with chromium or another metal with high electrical resistance to order to induce current re-distribution among the strands and to avoid a quench caused by a current imbalance. Current re-distribution is highly complex and very difficult to analyze because the conditions of the strand surfaces and the contact areas vary greatly with the operation of the conductor. If, however, the cable currents were well-balanced, insulating the strands would be the best way to reduce AC losses. We propose a new CICC magnet structure featuring a current lead that balances the strand currents via its resistance. Having calculated current balances, we find that strand currents are well within the present parameters for nuclear fusion experiments and superconducting magnet energy storages. (author)

  7. Myectomy and LA-to-LV Conduit for Severe Calcific Mitral Stenosis and Hypertrophic Cardiomyopathy.

    Science.gov (United States)

    Meghji, Zahara; Nguyen, Anita; Geske, Jeffrey B; Schaff, Hartzell V

    2018-02-26

    Severe calcific mitral valve stenosis can rarely occur concomitantly with obstructive hypertrophic cardiomyopathy. In these patients, surgical decalcification of the stenotic mitral valve followed by mitral valve replacement carries significant operative risk and may result in paravalvular leakage, atrioventricular groove disruption, and excessive bleeding. We report the first 2 cases of obstructive hypertrophic cardiomyopathy with severe calcific mitral valve stenosis successfully treated with concomitant transaortic septal myectomy and bypass of the stenotic mitral valve using a valved left atrium to left ventricular conduit. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Laparoscopic ischemic conditioning of the stomach increases neovascularization of the gastric conduit in patients undergoing esophagectomy for cancer.

    Science.gov (United States)

    Pham, Thai H; Melton, Shelby D; McLaren, Patrick J; Mokdad, Ali A; Huerta, Sergio; Wang, David H; Perry, Kyle A; Hardaker, Hope L; Dolan, James P

    2017-09-01

    Gastric ischemic preconditioning has been proposed to improve blood flow and reduce the incidence of anastomotic complications following esophagectomy with gastric pull-up. This study aimed to evaluate the effect of prolonged ischemic preconditioning on the degree of neovascularization in the distal gastric conduit at the time of esophagectomy. A retrospective review of a prospectively maintained database identified 30 patients who underwent esophagectomy. The patients were divided into three groups: control (no preconditioning, n = 9), partial (short gastric vessel ligation only, n = 8), and complete ischemic preconditioning (left and short gastric vessel ligation, n = 13). Microvessel counts were assessed, using immunohistologic analysis to determine the degree of neovascularization at the distal gastric margin. The groups did not differ in age, gender, BMI, pathologic stage, or cancer subtype. Ischemic preconditioning durations were 163 ± 156 days for partial ischemic preconditioning, compared to 95 ± 50 days for complete ischemic preconditioning (P = 0.2). Immunohistologic analysis demonstrated an increase in microvessel counts of 29% following partial ischemic preconditioning (P = 0.3) and 67% after complete ischemic preconditioning (P gastric conduit. © 2017 Wiley Periodicals, Inc.

  9. Enhancement of Median Nerve Regeneration by Mesenchymal Stem Cells Engraftment in an Absorbable Conduit: Improvement of Peripheral Nerve Morphology with Enlargement of Somatosensory Cortical Representation.

    Directory of Open Access Journals (Sweden)

    Julia Teixeira Oliveira

    2014-10-01

    Full Text Available We studied the morphology and the cortical representation of the median nerve (MN, 10 weeks after a transection immediately followed by treatment with tubulization using a polycaprolactone (PCL conduit with or without bone marrow-derived mesenchymal stem cell (MSC transplant. In order to characterize the cutaneous representation of MN inputs in primary somatosensory cortex (S1, electrophysiological cortical mapping of the somatosensory representation of the forepaw and adjacent body parts was performed after acute lesion of all brachial plexus nerves, except for the MN. This was performed in ten adult male Wistar rats randomly assigned in 3 groups: MN Intact (n=4, PCL-Only (n=3 and PCL+MSC (n=3. Ten weeks before mapping procedures in animals from PCL-Only and PCL+MSC groups, animal were subjected to MN transection with removal of a 4-mm-long segment, immediately followed by suturing a PCL conduit to the nerve stumps with (PCL+MSC group or without (PCL-Only group injection of MSC into the conduit. After mapping the representation of the MN in S1, animals had a segment of the regenerated nerve processed for light and transmission electron microscopy. For histomorphometric analysis of the nerve segment, sample size was increased to 5 animals per experimental group. The PCL+MSC group presented a higher number of myelinated fibers and a larger cortical representation of MN inputs in S1 (3,383±390 fibers; 2.3 mm2, respectively than the PCL-Only group (2,226±575 fibers; 1.6 mm2. In conclusion, MSC-based therapy associated with PCL conduits can improve MN regeneration. This treatment seems to rescue the nerve representation in S1, thus minimizing the stabilization of new representations of adjacent body parts in regions previously responsive to the MN.

  10. Histological study of right ventricle-pulmonary artery valved conduit implantation (RPVC) in dogs with pulmonic stenosis.

    Science.gov (United States)

    Saida, Yuuto; Tanaka, Ryou; Fukushima, Ryuji; Hira, Satoshi; Hoshi, Katsuichiro; Soda, Aiko; Iizuka, Tomoya; Ishikawa, Taisuke; Nishimura, Taiki; Yamane, Yoshihisa

    2009-04-01

    We examined whether right ventricle-pulmonary artery valved conduit (RPVC) implantation can overcome the disadvantages of current procedures for pulmonic stenosis (PS). We histologically evaluated the feasibility of RPVC using a homograft in PS model dogs. Eight dogs underwent pulmonary artery banding (PAB) and then 12 weeks later were assigned to PAB (n=4) or PAB+RPVC (n=4) groups. Dogs in the PAB group received no treatment throughout the experimental period, whereas the PAB+RPVC group underwent RPVC. At 1 year after PAB, hearts and conduits were explanted from euthanized dogs and histologically evaluated. The ratios (%) of myocardial fibrosis on right ventricle (RV) epicardial, median and endocardial layers were significantly lower in the PAB+RPVC, than in the PAB group. The ratio of myocardial fibrosis on left ventricular (LV) epicardial and endocardial layers were significantly lower in the PAB+RPVC, than in the PAB group. Neo-intimal thickness in the anastomosis areas of the Denacol and PAB+RPVC groups was 42.77 +/- 30.19 and 88.30 +/- 27.24 microm, respectively, with no significant differences between the groups. Calcification and neo- intima hypertrophy were not obvious in the valve area. Immunohistological staining showed that the internal surface of the anastomosis and intermediate areas were positive for endothelial cells. We concluded that RPVC using a bioprosthetic graft can apparently overcome the disadvantages of current procedures for pulmonic stenosis.

  11. Impact of Age and Aerobic Exercise Training on Conduit Artery Wall Thickness: Role of the Shear Pattern.

    Science.gov (United States)

    Tanahashi, Koichiro; Kosaki, Keisei; Sawano, Yuriko; Yoshikawa, Toru; Tagawa, Kaname; Kumagai, Hiroshi; Akazawa, Nobuhiko; Maeda, Seiji

    2017-01-01

    Hemodynamic shear stress is the frictional force of blood on the arterial wall. The shear pattern in the conduit artery affects the endothelium and may participate in the development and progression of atherosclerosis. We investigated the role of the shear pattern in age- and aerobic exercise-induced changes in conduit artery wall thickness via cross-sectional and interventional studies. In a cross-sectional study, we found that brachial shear rate patterns and brachial artery intima-media thickness (IMT) correlated with age. Additionally, brachial artery shear rate patterns were associated with brachial artery IMT in 102 middle-aged and older individuals. In an interventional study, 39 middle-aged and older subjects were divided into 2 groups: control and exercise. The exercise group completed 12 weeks of aerobic exercise training. Aerobic exercise training significantly increased the antegrade shear rate and decreased the retrograde shear rate and brachial artery IMT. Moreover, changes in the brachial artery antegrade shear rate and the retrograde shear rate correlated with the change in brachial artery IMT. The results of the present study indicate that changes in brachial artery shear rate patterns may contribute to age- and aerobic exercise training-induced changes in brachial artery wall thickness. © 2017 S. Karger AG, Basel.

  12. Radial Artery as a Coronary Artery Bypass Conduit: 20-Year Results.

    Science.gov (United States)

    Gaudino, Mario; Tondi, Paolo; Benedetto, Umberto; Milazzo, Valentina; Flore, Roberto; Glieca, Franco; Ponziani, Francesca Romana; Luciani, Nicola; Girardi, Leonard N; Crea, Filippo; Massetti, Massimo

    2016-08-09

    There is a lack of evidence for the choice of the second conduit in coronary surgery. The radial artery (RA) is a possible option, but few data on very-long-term outcomes exist. This study describes 20-year results of RA grafts used for coronary artery bypass grafting and the effects of RA removal on forearm circulation. We report the results of the prospective 20-year follow-up of the first 100 consecutive patients who received the RA as a coronary bypass conduit at our institution. Follow-up was 100% complete. There were 64 deaths, 23 (35.9%) from cardiovascular causes. Kaplan-Meier 20-year survival was 31%. Of the 36 survivors, 33 (91.6%) underwent RA graft control at a mean of 19.0 ± 2.5 years after surgery. The RA was found to be patent in 24 cases (84.8% patency). In the overall population, probability of graft failure at 20 years was 19.0 ± 0.2% for the left internal thoracic artery (ITA), 25.0 ± 0.2% for the RA, and 55.0 ± 0.2% for the saphenous vein (p = 0.002 for RA vs. saphenous vein, 0.11 for RA vs. ITA, and p 90%, but not location of distal anastomosis, significantly influenced long-term RA graft patency. No patients reported hand or forearm symptoms. The ulnar artery diameter was increased in the operated arm (2.44 ± 0.43 mm vs. 2.01 ± 0.47 mm; p 90% stenosis. RA harvesting does not lead to hand or forearm symptoms, even at a very-long-term follow-up. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  13. Neural network based inspection of voids and karst conduits in hydro-electric power station tunnels using GPR

    Science.gov (United States)

    Kilic, Gokhan; Eren, Levent

    2018-04-01

    This paper reports on the fundamental role played by Ground Penetrating Radar (GPR), alongside advanced processing and presentation methods, during the tunnel boring project at a Dam and Hydro-Electric Power Station. It identifies from collected GPR data such issues as incomplete grouting and the presence of karst conduits and voids and provides full details of the procedures adopted. In particular, the application of collected GPR data to the Neural Network (NN) method is discussed.

  14. Three-dimensional fluid mechanics of particulate two-phase flows in U-bend and helical conduits

    Science.gov (United States)

    Tiwari, Prashant; Antal, Steven P.; Podowski, Michael Z.

    2006-04-01

    The results of numerous studies performed to date have shown that the performance of various hydraulic systems can be significantly improved by using curved conduit geometries instead of straight tubes. In particular, the formation of Dean vortices, which enhance the development of centrifugal instabilities, has been identified as a factor behind reducing the near-wall concentration buildup in particulate flow devices (e.g., in membrane filtration modules). Still, several issues regarding the effect of conduit curvature on local multidimensional phenomena governing fluid flow still remain open. A related issue is concerned with the impact that conduit geometry makes on the concentration distribution of a dispersed phase in two-phase flows in general, and in particulate flows (solid/liquid or solid/gas suspensions) in particular. It turns out that only very limited efforts have been made in the past to understand the fluid mechanics of such flows via advanced computer simulations. The purpose of this paper is to present the results of full three-dimensional (3D) theoretical and numerical analyses of single- and two-phase dilute particle/liquid flows in U-bend and helical curved conduits. The numerical analysis is based on computational fluid dynamics (CFD) simulations performed using a state-of-the-art multiphase flow computer code, NPHASE. The major issues discussed in the first part of the paper are concerned with the effect of curved/coiled geometry on the evolution of flow field and the associated wall shear. It has been demonstrated that the primary curvature (a common factor for both the U-bend and helix geometries) may cause a substantial asymmetry in the radial distribution of the main flow velocity. This, in turn, leads to a significant, albeit highly nonuniform, increase in the wall shear stress. Specifically, the wall shear around the outer half of tube circumference may become twice the corresponding value for a straight tube, and gradually decrease to

  15. Detection of the normal zone with cowound sensors in cable-in conduit conductors

    International Nuclear Information System (INIS)

    Martovetsky, N.N.; Chaplin, M.R.

    1996-01-01

    Tokamaks in the future will use superconducting cable-in-conduit- conductors (CICC) in all poloidal field (PF) and toroidal field (TF) magnets. Conventional quench detection, the measurement of small resistive normal zone voltages ( 4 kV). In the quench detection design for TPX, we have considered several different locations for internal co-wound voltage sensors in the cable cross-section as the primary mechanism to cancel this inductive noise. The Noise Rejection Experiment (NRE) at LLNL has been designed to evaluate which internal locations will produce the best inductive- noise cancellation, and provide us with experimental data for comparison with previously developed theory. The details of the experiments and resulting data are presented and analyzed

  16. C3 toxin and poly-DL-lactide-ε-caprolactone conduits in the critically damaged peripheral nervous system: a combined therapeutic approach.

    Science.gov (United States)

    Leibig, Nico; Boyle, Veronika; Kraus, Daniel; Stark, Gerhard Bjoern; Penna, Vincenzo

    2015-03-01

    Peripheral nerve regeneration over longer distances through conduits is limited. In the presented study, critical size nerve gap bridging with a poly-DL-lactide-ε-caprolactone (PLC) conduit was combined with application of C3 toxin to facilitate axonal sprouting. The PLC filled with fibrin (n = 10) and fibrin gel loaded with 1-μg C3-C2I and 2-μg C2II (n = 10) were compared to autologous nerve grafts (n = 10) in a 15-mm sciatic nerve gap lesion model of the rat. Functional and electrophysiological analyses were performed before histological evaluation. Evaluation of motor function and nerve conduction velocity at 16 weeks revealed no differences between the groups. All histological parameters and muscle weight were significantly elevated in nerve graft group. No differences were observed in both PLC groups. The PLCs are permissive for nerve regeneration over a 15-mm defect in rats. Intraluminal application of C3 toxin did not lead to significant enhancement of nerve sprouting.

  17. Aerodynamic improvement of the assembly through which gas conduits are taken into a smoke stack by simulating gas flow on a computer

    Science.gov (United States)

    Prokhorov, V. B.; Fomenko, M. V.; Grigor'ev, I. V.

    2012-06-01

    Results from computer simulation of gas flow motion for gas conduits taken on one and two sides into the gas-removal shaft of a smoke stack with a constant cross section carried out using the SolidWorks and FlowVision application software packages are presented.

  18. 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

  19. Neurologic Injury and Cerebral Blood Flow In Single Ventricles Throughout Staged Surgical Reconstruction

    Science.gov (United States)

    Fogel, Mark A.; Li, Christine; Elci, Okan U.; Pawlowski, Tom; Schwab, Peter J.; Wilson, Felice; Nicolson, Susan C.; Montenegro, Lisa M.; Diaz, Laura; Spray, Thomas L.; Gaynor, J William; Fuller, Stephanie; Mascio, Christopher; Keller, Marc S.; Harris, Matthew A.; Whitehead, Kevin K.; Bethel, Jim; Vossough, Arastoo; Licht, Daniel J.

    2017-01-01

    Background Single ventricle patients experience a high rate of brain injury and adverse neurodevelopmental outcome, however, the incidence of brain abnormalities throughout surgical reconstruction and its relationship with cerebral blood flow, oxygen delivery and carbon dioxide reactivity remains unknown. Methods Single ventricle patients were studied with MRI scans immediately prior to bidirectional Glenn (pre-BDG), prior to Fontan and then 3–9 months after Fontan reconstruction. Results One hundred and sixty eight consecutive subjects recruited into the project underwent 235 scans: 63 pre-BDG (mean age 4.8+1.7 months), 118 BDG (2.9+1.4 years) and 54 after Fontan (2.4+1.0 years). Non-acute ischemic white matter changes on T2 weighted imaging, focal tissue loss, and ventriculomegaly were all more commonly detected in BDG and Fontans compared to pre-BDG (P<0.05). BDG patients has significantly higher CBF than Fontan patients. The odds of discovering brain injury adjusting for surgical stage as well as 2 or more co-existing lesions within a patient all decreased (63–75% and 44% respectively) with increasing amount of cerebral blood flow (P<0.05). In general, there was no association of oxygen delivery (with the exception of ventriculomegaly in the BDG group) or carbon dioxide reactivity with neurological injury. Conclusion Significant brain abnormalities are commonly present in single ventricle patients and detection of these lesions increase as children progress through staged surgical reconstruction with multiple co-existing lesions more common earlier than later. In addition, this study demonstrated that BDG patients had greater CBF than Fontan patients and that there exists an inverse association of various indices of CBF with these brain lesions, however, CO2 reactivity, oxygen delivery (with one exception) were not associated with brain lesion development. PMID:28031423

  20. Relaxation of microparticles exposed to hydrodynamic forces in microfluidic conduits.

    Science.gov (United States)

    Janča, Josef; Halabalová, Věra; Polášek, Vladimír; Vašina, Martin; Menshikova, Anastasia Yu

    2011-02-01

    The behavior of microparticles exposed to gravitational and lift forces and to the velocity gradient in flow velocity profile formed in microfluidic conduits is studied from the viewpoint of the transient period (the relaxation) between the moment at which a particle starts to be transported by the hydrodynamic flow and the time at which it reaches an equilibrium position, characterized by a balance of all active forces. The theoretical model allowing the calculation of the relaxation time is proposed. The numerical calculus based on the proposed model is compared with the experimental data obtained under different experimental conditions, namely, for different lengths of microfluidic channels, different average linear velocities of the carrier liquid, and different sizes and densities of the particles used in the study. The results are important for the optimization of microfluidic separation units such as microthermal field-flow fractionation channels in which the separation or manipulation of the microparticles of various origin, synthetic, natural, biological, etc., is performed under similar experimental conditions but by applying an additional thermodynamic force.

  1. Hypoglossal-Facial Nerve Reconstruction Using a Y-Tube-Conduit Reduces Aberrant Synkinetic Movements of the Orbicularis Oculi and Vibrissal Muscles in Rats

    Directory of Open Access Journals (Sweden)

    Yasemin Kaya

    2014-01-01

    Full Text Available The facial nerve is the most frequently damaged nerve in head and neck trauma. Patients undergoing facial nerve reconstruction often complain about disturbing abnormal synkinetic movements of the facial muscles (mass movements, synkinesis which are thought to result from misguided collateral branching of regenerating motor axons and reinnervation of inappropriate muscles. Here, we examined whether use of an aorta Y-tube conduit during reconstructive surgery after facial nerve injury reduces synkinesis of orbicularis oris (blink reflex and vibrissal (whisking musculature. The abdominal aorta plus its bifurcation was harvested (N = 12 for Y-tube conduits. Animal groups comprised intact animals (Group 1, those receiving hypoglossal-facial nerve end-to-end coaptation alone (HFA; Group 2, and those receiving hypoglossal-facial nerve reconstruction using a Y-tube (HFA-Y-tube, Group 3. Videotape motion analysis at 4 months showed that HFA-Y-tube group showed a reduced synkinesis of eyelid and whisker movements compared to HFA alone.

  2. Hypoglossal-facial nerve reconstruction using a Y-tube-conduit reduces aberrant synkinetic movements of the orbicularis oculi and vibrissal muscles in rats.

    Science.gov (United States)

    Kaya, Yasemin; Ozsoy, Umut; Turhan, Murat; Angelov, Doychin N; Sarikcioglu, Levent

    2014-01-01

    The facial nerve is the most frequently damaged nerve in head and neck trauma. Patients undergoing facial nerve reconstruction often complain about disturbing abnormal synkinetic movements of the facial muscles (mass movements, synkinesis) which are thought to result from misguided collateral branching of regenerating motor axons and reinnervation of inappropriate muscles. Here, we examined whether use of an aorta Y-tube conduit during reconstructive surgery after facial nerve injury reduces synkinesis of orbicularis oris (blink reflex) and vibrissal (whisking) musculature. The abdominal aorta plus its bifurcation was harvested (N = 12) for Y-tube conduits. Animal groups comprised intact animals (Group 1), those receiving hypoglossal-facial nerve end-to-end coaptation alone (HFA; Group 2), and those receiving hypoglossal-facial nerve reconstruction using a Y-tube (HFA-Y-tube, Group 3). Videotape motion analysis at 4 months showed that HFA-Y-tube group showed a reduced synkinesis of eyelid and whisker movements compared to HFA alone.

  3. Current distribution in Cable-In-Conduit Conductors

    International Nuclear Information System (INIS)

    Ferri, M.A.

    1994-05-01

    A numerical study of the current distribution in Cable-In-Conduit Conductors (CICC's) experiencing linearly ramping transport currents and transverse magnetic fields was conducted for both infinitely long, periodic cables and finite length cables terminated in low resistance joints. The goal of the study was to gain insight into the phenomenon known as Ramp Rate Limitation, an as yet unexplained correspondence between maximum attainable current and the ramp time taken to reach that current in CICC superconducting magnets. A discrete geometric model of a 27 strand multiply twisted CICC was developed to effectively represent the flux linkages, mutual inductances, and resistive contact points between the strands of an experimentally tested cable. The results of the numerical study showed that for fully periodic cables, the current imbalances due to ramping magnetic fields and ramping transport currents are negligible in the range of experimentally explored operating conditions. For finite length, joint terminated cables, however, significant imbalances can exist. Unfortunately, quantitative results are limited by a lack of knowledge of the transverse resistance between strands in the joints. Nonetheless, general results are presented showing the dependency of the imbalance on cable length, ramp time, and joint resistance for both ramping transverse magnet fields and ramping transport currents. At the conclusion of the study, it is suggested that calculated current imbalances in a finite length cable could cause certain strands to prematurely ''quench'' -- become non-superconducting --thus leading to an instability for the entire cable. This numerically predicted ''current imbalance instability'' is compared to the experimentally observed Ramp Rate Limitation for the 27 strand CICC sample

  4. Assessing lateral flows and solute transport during floods in a conduit-flow-dominated karst system using the inverse problem for the advection–diffusion equation

    Directory of Open Access Journals (Sweden)

    C. Cholet

    2017-07-01

    Full Text Available The aim of this study is to present a framework that provides new ways to characterize the spatio-temporal variability of lateral exchanges for water flow and solute transport in a karst conduit network during flood events, treating both the diffusive wave equation and the advection–diffusion equation with the same mathematical approach, assuming uniform lateral flow and solute transport. A solution to the inverse problem for the advection–diffusion equations is then applied to data from two successive gauging stations to simulate flows and solute exchange dynamics after recharge. The study site is the karst conduit network of the Fourbanne aquifer in the French Jura Mountains, which includes two reaches characterizing the network from sinkhole to cave stream to the spring. The model is applied, after separation of the base from the flood components, on discharge and total dissolved solids (TDSs in order to assess lateral flows and solute concentrations and compare them to help identify water origin. The results showed various lateral contributions in space – between the two reaches located in the unsaturated zone (R1, and in the zone that is both unsaturated and saturated (R2 – as well as in time, according to hydrological conditions. Globally, the two reaches show a distinct response to flood routing, with important lateral inflows on R1 and large outflows on R2. By combining these results with solute exchanges and the analysis of flood routing parameters distribution, we showed that lateral inflows on R1 are the addition of diffuse infiltration (observed whatever the hydrological conditions and localized infiltration in the secondary conduit network (tributaries in the unsaturated zone, except in extreme dry periods. On R2, despite inflows on the base component, lateral outflows are observed during floods. This pattern was attributed to the concept of reversal flows of conduit–matrix exchanges, inducing a complex water mixing effect

  5. Hydraulic tomography of discrete networks of conduits and fractures in a karstic aquifer by using a deterministic inversion algorithm

    Science.gov (United States)

    Fischer, P.; Jardani, A.; Lecoq, N.

    2018-02-01

    In this paper, we present a novel inverse modeling method called Discrete Network Deterministic Inversion (DNDI) for mapping the geometry and property of the discrete network of conduits and fractures in the karstified aquifers. The DNDI algorithm is based on a coupled discrete-continuum concept to simulate numerically water flows in a model and a deterministic optimization algorithm to invert a set of observed piezometric data recorded during multiple pumping tests. In this method, the model is partioned in subspaces piloted by a set of parameters (matrix transmissivity, and geometry and equivalent transmissivity of the conduits) that are considered as unknown. In this way, the deterministic optimization process can iteratively correct the geometry of the network and the values of the properties, until it converges to a global network geometry in a solution model able to reproduce the set of data. An uncertainty analysis of this result can be performed from the maps of posterior uncertainties on the network geometry or on the property values. This method has been successfully tested for three different theoretical and simplified study cases with hydraulic responses data generated from hypothetical karstic models with an increasing complexity of the network geometry, and of the matrix heterogeneity.

  6. Neural-differentiated mesenchymal stem cells incorporated into muscle stuffed vein scaffold forms a stable living nerve conduit.

    Science.gov (United States)

    Hassan, Nur Hidayah; Sulong, Ahmad Fadzli; Ng, Min-Hwei; Htwe, Ohnmar; Idrus, Ruszymah B H; Roohi, Sharifah; Naicker, Amaramalar S; Abdullah, Shalimar

    2012-10-01

    Autologous nerve grafts to bridge nerve gaps have donor site morbidity and possible neuroma formation resulting in development of various methods of bridging nerve gaps without using autologous nerve grafts. We have fabricated an acellular muscle stuffed vein seeded with differentiated mesenchymal stem cells (MSCs) as a substitute for nerve autografts. Human vein and muscle were both decellularized by liquid nitrogen immersion with subsequent hydrolysis in hydrochloric acid. Human MSCs were subjected to a series of treatments with a reducing agent, retinoic acid, and a combination of trophic factors. The differentiated MSCs were seeded on the surface of acellular muscle tissue and then stuffed into the vein. Our study showed that 35-75% of the cells expressed neural markers such as S100b, glial fibrillary acidic protein (GFAP), p75 NGF receptor, and Nestin after differentiation. Histological and ultra structural analyses of muscle stuffed veins showed attachment of cells onto the surface of the acellular muscle and penetration of the cells into the hydrolyzed fraction of muscle fibers. We implanted these muscle stuffed veins into athymic mice and at 8 weeks post-implantation, the acellular muscle tissue had fully degraded and replaced with new matrix produced by the seeded cells. The vein was still intact and no inflammatory reactions were observed proving the biocompatibility and biodegradability of the conduit. In conclusion, we have successfully formed a stable living nerve conduit which may serve as a substitute for autologous nerves. Copyright © 2012 Orthopaedic Research Society.

  7. Comparison of the air-Q intubating laryngeal airway and the cobra perilaryngeal airway as conduits for fiber optic-guided intubation in pediatric patients.

    Science.gov (United States)

    Girgis, Karim K; Youssef, Maha M I; ElZayyat, Nashwa S

    2014-10-01

    One of the methods proposed in cases of difficult airway management in children is using a supraglottic airway device as a conduit for tracheal intubation. The aim of this study was to compare the efficacy of the Air-Q Intubating Laryngeal Airway (Air-Q) and the Cobra Perilaryngeal Airway (CobraPLA) to function as a conduit for fiber optic-guided tracheal intubation in pediatric patients. A total of 60 children with ages ranging from 1 to 6 years, undergoing elective surgery, were randomized to have their airway managed with either an Air-Q or CobraPLA. Outcomes recorded were the success rate, time and number of attempts required for fiber optic-guided intubation and the time required for device removal after intubation. We also recorded airway leak pressure (ALP), fiber optic grade of glottic view and occurrence of complications. Both devices were successfully inserted in all patients. The intubation success rate was comparable with the Air-Q and the CobraPLA (96.7% vs. 90%), as was the first attempt success rate (90% vs. 80%). The intubation time was significantly longer with the CobraPLA (29.5 ± 10.9 s vs. 23.2 ± 9.8 s; P fiber optic grade of glottic view was comparable with the two devices. The CobraPLA was associated with a significantly higher incidence of blood staining of the device on removal and post-operative sore throat. Both the Air-Q and CobraPLA can be used effectively as a conduit for fiber optic-guided tracheal intubation in children. However, the Air-Q proved to be superior due to a shorter intubation time and less airway morbidity compared with the CobraPLA.

  8. Frictional melting dynamics in the upper conduit: A chemical answer to a complex physical question

    Science.gov (United States)

    Henton De Angelis, S.; Lavallee, Y.; Kendrick, J. E.; Hornby, A.; von Aulock, F. W.; Clesham, S.; Hirose, T.; Perugini, D.

    2013-12-01

    During volcanic eruptions the generation of frictional heat along the walls of the shallow conduit leads to melting of the rocks along the slip interface. Frictional melting has previously been described as a process out of thermodynamic equilibrium, but upon slip and mingling of the melt batches, homogeneity can be achieved, and may have an h important rheological control on the dynamics of slip. To test melt homogenization in the frictional melt zones of volcanic conduits we performed constant-rate slip experiments under controlled stress conditions using a high-velocity rotary shear apparatus. Volcanic dome samples from three different volcanoes (Volcán De Colima, Soufrière Hills Volcano and Santiaguito Volcano) were investigated. Each sample was subjected to a stress of 1 MPa and slip rate of 1 m/s. For each sample set 5 experiments were conducted: 1) experiment stopped at the onset of melting; 2) experiment stopped on the formation of a full melt layer; 3) experiment stopped after 5m of slip at steady state conditions; 4) experiment stopped after 10m of slip at steady state conditions; 5) experiment stopped after 15m of slip at steady state conditions. We analyzed the resulting proto-melt zones using micron sized X-ray spectroscopy in the high-brightness synchrotron beamline I18 (at Diamond Light Source UK). Particular focus was given to the concentration variance analysis of Rare Earth Elements as their mobilities can be used to precisely quantify the degree and timescale of homogenisation involved during frictional melting. This study refines our understanding of the chemical process of melting and mixing which carry important consequences for the rheological control on the physical dynamics of slip.

  9. Reverse saphenous conduit flap in small animals: Clinical applications and outcomes

    Directory of Open Access Journals (Sweden)

    Ross C. Elliott

    2014-08-01

    Full Text Available Due to the lack of skin elasticity defects of the distal hind limb can be a challenge to close. This article assesses a well-described, but completely under-used technique for closure of wounds on the distal tarsus. The technique was used with good success in six cases presenting to the Bryanston Veterinary Hospital with a wide range of underlying pathology ranging from trauma to neoplastic disease of the tarsus. All six cases were treated with a reverse saphenous conduit flap and two of them underwent radiation therapy with no adverse side effects. All cases showed excellent results with a very low degree of flap necrosis that never exceeded 15% of the total flap area. This skin flap provides an excellent treatment method that is reliable in closure of defects of the distal tarsus with few adverse effects. To the author’s knowledge there has been only one previously published report on the clinical use of this type of skin flap,even though the flap is well described in most texts.

  10. Troubles des conduites alimentaires et tempérament cyclothymique: étude transversale à propos de 107 étudiants Tunisiens

    Science.gov (United States)

    Jaweher, Masmoudi; Sonda, Trabelsi; Uta, Ouali; Inès, Feki; Rim, Sallemi; Imene, Baati; Abdelaziz, Jaoua

    2014-01-01

    Introduction Les objectifs de notre étude ont été d'estimer la prévalence des troubles des conduites alimentaires (TCA) chez les jeunes tunisiens et étudier la relation entre le tempérament cyclothymique et les TCA. Méthodes Nous avons ainsi mené une étude transversale descriptive et analytique. Elle a concerné 107 étudiants de l'Institut de Presse et des Sciences de l'Information de la Manouba, Tunisie. Pour l’évaluation des TCA, nous avons procédé par la passation de l'auto questionnaire EAT 40, dans sa version validée en Tunisie. C'est l'outil le plus utilisé pour le dépistage des TCA dans le monde. Pour l’évaluation du tempérament cyclothymique, nous avons utilisé le TEMPS A dans sa version arabe validée. Une fiche épidémiologique associée a permis de recueillir quelques facteurs sociodémographiques et hygiéno-diététiques. Résultats La prévalence des troubles de conduites alimentaires a été de 24,3%. Le pourcentage des étudiants ayant un score de tempérament cyclothymique ≥14 a été de 37,4%. Une association a été trouvée entre les troubles de conduites alimentaires et le tempérament affectif cyclothymique que ce soit selon l'approche dimensionnelle (p=0,005) ou selon celle catégorielle (p=0,046). Le tempérament cyclothymique multiplie par deux le risque de développer un TCA chez les étudiants de sexe féminin (p=0,04). Conclusion Es TCA sont fréquents chez nos étudiants particulièrement de sexe féminin. De plus, la présence d'un tempérament cyclothymique associé permettrait de suspecter doublement une appartenance au spectre bipolaire et devrait conduire à une attention particulière de la part du clinicien pour définir au mieux les stratégies thérapeutiques. PMID:25404977

  11. Neurological Injury and Cerebral Blood Flow in Single Ventricles Throughout Staged Surgical Reconstruction.

    Science.gov (United States)

    Fogel, Mark A; Li, Christine; Elci, Okan U; Pawlowski, Tom; Schwab, Peter J; Wilson, Felice; Nicolson, Susan C; Montenegro, Lisa M; Diaz, Laura; Spray, Thomas L; Gaynor, J William; Fuller, Stephanie; Mascio, Christopher; Keller, Marc S; Harris, Matthew A; Whitehead, Kevin K; Bethel, Jim; Vossough, Arastoo; Licht, Daniel J

    2017-02-14

    Patients with a single ventricle experience a high rate of brain injury and adverse neurodevelopmental outcome; however, the incidence of brain abnormalities throughout surgical reconstruction and their relationship with cerebral blood flow, oxygen delivery, and carbon dioxide reactivity remain unknown. Patients with a single ventricle were studied with magnetic resonance imaging scans immediately prior to bidirectional Glenn (pre-BDG), before Fontan (BDG), and then 3 to 9 months after Fontan reconstruction. One hundred sixty-eight consecutive subjects recruited into the project underwent 235 scans: 63 pre-BDG (mean age, 4.8±1.7 months), 118 BDG (2.9±1.4 years), and 54 after Fontan (2.4±1.0 years). Nonacute ischemic white matter changes on T2-weighted imaging, focal tissue loss, and ventriculomegaly were all more commonly detected in BDG and Fontan compared with pre-BDG patients ( P <0.05). BDG patients had significantly higher cerebral blood flow than did Fontan patients. The odds of discovering brain injury with adjustment for surgical stage as well as ≥2 coexisting lesions within a patient decreased (63%-75% and 44%, respectively) with increasing amount of cerebral blood flow ( P <0.05). In general, there was no association of oxygen delivery (except for ventriculomegaly in the BDG group) or carbon dioxide reactivity with neurological injury. Significant brain abnormalities are commonly present in patients with a single ventricle, and detection of these lesions increases as children progress through staged surgical reconstruction, with multiple coexisting lesions more common earlier than later. In addition, this study demonstrated that BDG patients had greater cerebral blood flow than did Fontan patients and that an inverse association exists of various indexes of cerebral blood flow with these brain lesions. However, CO 2 reactivity and oxygen delivery (with 1 exception) were not associated with brain lesion development. URL: http

  12. Prenatal Diagnosis of Persistent Left Superior Vena Cava and its Clinical Significance

    Directory of Open Access Journals (Sweden)

    Aytül Çorbacıoğlu Esmer

    2014-03-01

    Full Text Available Background: Persistent left superior vena cava (PLSVC is a variant of systemic venous return which is observed in 0.3% of autopsies in the general population and in 4-8% of patients with congenital heart disease. Aims: To evaluate associated cardiac, extracardiac and chromosomal anomalies in prenatally diagnosed cases of PLSVC and to review their outcome. Study Design: Retrospective comparative study. Methods: The data of patients with a prenatal diagnosis of PLSVC between May 2008 and January 2013 were reviewed retrospectively. Results: Data of 31 cases were reviewed. Fifteen (48.4% cases were associated with cardiac defects and 17 (54.8% cases had associated extracardiac sonographic or postpartum findings. Two fetuses had karyotype anomalies. Outcome was significantly more favorable in cases not associated with cardiac defects in comparison to those associated with cardiac anomalies (84.6% vs. 33.3%, p=0.009. All cases with isolated PLSVC survived, while among the cases associated with extracardiac anomalies, with cardiac anomalies and with both extracardiac and cardiac anomalies, the survival rate was 75%, 50% and 22.2%, respectively. The most frequent group of cardiac anomalies associated with PLSVC was septal defects and VSD was the most common heart defect individually, being observed in nine fetuses. Conclusion: Prenatally diagnosed PLSVC is associated with cardiac and extracardiac anomalies in the majority of cases. Outcome is significantly worse if PLSVC is associated with a cardiac defect, and the prognosis is excellent in isolated cases.

  13. Design and synthesis of elastin-like polypeptides for an ideal nerve conduit in peripheral nerve regeneration

    International Nuclear Information System (INIS)

    Hsueh, Yu-Sheng; Savitha, S.; Sadhasivam, S.; Lin, Feng-Huei; Shieh, Ming-Jium

    2014-01-01

    The study involves design and synthesis of three different elastin like polypeptide (ELP) gene monomers namely ELP1, ELP2 and ELP3 that encode for ELP proteins. The formed ELPs were assessed as an ideal nerve conduit for peripheral nerve regeneration. ELP1 was constructed with a small elongated pentapeptide carrying VPGVG sequence to mimic the natural polypeptide ELP. The ELP2 was designed by the incorporation of 4-penta peptide chains to improve the biocompatibility and mechanical strength. Thus, the third position in unique VPGVG was replaced with alanine to VPAVG and in a similar way modified to VPGKG, VPGEG and VPGIG with the substitution of lysine, glutamic acid and isoleucine. In ELP3, fibronectin C5 domain endowed with REDV sequence was introduced to improve the cell attachment. The ELP1, ELP2 and ELP3 proteins expressed by Escherichia coli were purified by inverse transition cycling (ITC). The purified ELPs were confirmed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and western blotting. The Schwann cell (SC) morphology and cell adhesion were assessed by fabrication of ELP membrane cross-linked with glutaraledhyde. The Schwann cell proliferation was measured by WST-1 assay. Immunofluorostaining of Schwann cells was accomplished with SC specific phenotypic marker, S100. - Highlights: • Design and synthesis of three gene monomers of elastin like polypeptides (ELP1, 2 and 3) were reported. • Molecular weight of ITC purified ELP1, ELP2 and ELP3 was in the range of 37–38 kDa. • Schwann cell adhesion was found to be prominent in ELP3 and could be used as nerve conduit for peripheral nerve regeneration

  14. Design and synthesis of elastin-like polypeptides for an ideal nerve conduit in peripheral nerve regeneration

    Energy Technology Data Exchange (ETDEWEB)

    Hsueh, Yu-Sheng [Institute of Biomedical Engineering, College of Engineering, National Taiwan University, Taipei 100, Taiwan (China); Institute of Biomedical Engineering, College of Medicine, National Taiwan University, Taipei 100, Taiwan (China); Savitha, S. [Institute of Biomedical Engineering, College of Engineering, National Taiwan University, Taipei 100, Taiwan (China); Department of Biotechnology, Sree Sastha Institute of Engineering and Technology, Chennai (India); Institute of Biomedical Engineering, College of Medicine, National Taiwan University, Taipei 100, Taiwan (China); Sadhasivam, S. [Division of Biomedical Engineering and Nanomedicine Research, National Health Research Institutes, Miaoli 350, Taiwan (China); Lin, Feng-Huei, E-mail: double@ntu.edu.tw [Institute of Biomedical Engineering, College of Engineering, National Taiwan University, Taipei 100, Taiwan (China); Division of Biomedical Engineering and Nanomedicine Research, National Health Research Institutes, Miaoli 350, Taiwan (China); Institute of Biomedical Engineering, College of Medicine, National Taiwan University, Taipei 100, Taiwan (China); Shieh, Ming-Jium [Institute of Biomedical Engineering, College of Engineering, National Taiwan University, Taipei 100, Taiwan (China); College of Medicine, National Taiwan University Hospital, Taipei 100, Taiwan (China); Institute of Biomedical Engineering, College of Medicine, National Taiwan University, Taipei 100, Taiwan (China)

    2014-05-01

    The study involves design and synthesis of three different elastin like polypeptide (ELP) gene monomers namely ELP1, ELP2 and ELP3 that encode for ELP proteins. The formed ELPs were assessed as an ideal nerve conduit for peripheral nerve regeneration. ELP1 was constructed with a small elongated pentapeptide carrying VPGVG sequence to mimic the natural polypeptide ELP. The ELP2 was designed by the incorporation of 4-penta peptide chains to improve the biocompatibility and mechanical strength. Thus, the third position in unique VPGVG was replaced with alanine to VPAVG and in a similar way modified to VPGKG, VPGEG and VPGIG with the substitution of lysine, glutamic acid and isoleucine. In ELP3, fibronectin C5 domain endowed with REDV sequence was introduced to improve the cell attachment. The ELP1, ELP2 and ELP3 proteins expressed by Escherichia coli were purified by inverse transition cycling (ITC). The purified ELPs were confirmed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and western blotting. The Schwann cell (SC) morphology and cell adhesion were assessed by fabrication of ELP membrane cross-linked with glutaraledhyde. The Schwann cell proliferation was measured by WST-1 assay. Immunofluorostaining of Schwann cells was accomplished with SC specific phenotypic marker, S100. - Highlights: • Design and synthesis of three gene monomers of elastin like polypeptides (ELP1, 2 and 3) were reported. • Molecular weight of ITC purified ELP1, ELP2 and ELP3 was in the range of 37–38 kDa. • Schwann cell adhesion was found to be prominent in ELP3 and could be used as nerve conduit for peripheral nerve regeneration.

  15. Controls on magma permeability in the volcanic conduit during the climactic phase of the Kos Plateau Tuff eruption (Aegean Arc)

    Science.gov (United States)

    Degruyter, W.; Bachmann, O.; Burgisser, A.

    2010-01-01

    X-ray computed microtomography (µCT) was applied to pumices from the largest Quaternary explosive eruption of the active South Aegean Arc (the Kos Plateau Tuff; KPT) in order to better understand magma permeability within volcanic conduits. Two different types of pumices (one with highly elongated bubbles, tube pumice; and the other with near spherical bubbles, frothy pumice) produced synchronously and with identical chemical composition were selected for µCT imaging to obtain porosity, tortuosity, bubble size and throat size distributions. Tortuosity drops on average from 2.2 in frothy pumice to 1.5 in tube pumice. Bubble size and throat size distributions provide estimates for mean bubble size (~93-98 μm) and mean throat size (~23-29 μm). Using a modified Kozeny-Carman equation, variations in porosity, tortuosity, and throat size observed in KPT pumices explain the spread found in laboratory measurements of the Darcian permeability. Measured difference in inertial permeability between tube and frothy pumices can also be partly explained by the same variables but require an additional parameter related to the internal roughness of the porous medium (friction factor f 0 ). Constitutive equations for both types of permeability allow the quantification of laminar and turbulent gas escape during ascent of rhyolitic magma in volcanic conduits.

  16. Chilling of dormant buds hyperinduces FLOWERING LOCUS T and recruits GA-inducible 1,3-beta-glucanases to reopen signal conduits and release dormancy in Populus.

    Science.gov (United States)

    Rinne, Päivi L H; Welling, Annikki; Vahala, Jorma; Ripel, Linda; Ruonala, Raili; Kangasjärvi, Jaakko; van der Schoot, Christiaan

    2011-01-01

    In trees, production of intercellular signals and accessibility of signal conduits jointly govern dormancy cycling at the shoot apex. We identified 10 putative cell wall 1,3-β-glucanase genes (glucan hydrolase family 17 [GH17]) in Populus that could turn over 1,3-β-glucan (callose) at pores and plasmodesmata (PD) and investigated their regulation in relation to FT and CENL1 expression. The 10 genes encode orthologs of Arabidopsis thaliana BG_ppap, a PD-associated glycosylphosphatidylinositol (GPI) lipid-anchored protein, the Arabidopsis PD callose binding protein PDCB, and a birch (Betula pendula) putative lipid body (LB) protein. We found that these genes were differentially regulated by photoperiod, by chilling (5°C), and by feeding of gibberellins GA(3) and GA(4). GA(3) feeding upregulated all LB-associated GH17s, whereas GA(4) upregulated most GH17s with a GPI anchor and/or callose binding motif, but only GA(4) induced true bud burst. Chilling upregulated a number of GA biosynthesis and signaling genes as well as FT, but not CENL1, while the reverse was true for both GA(3) and GA(4). Collectively, the results suggest a model for dormancy release in which chilling induces FT and both GPI lipid-anchored and GA(3)-inducible GH17s to reopen signaling conduits in the embryonic shoot. When temperatures rise, the reopened conduits enable movement of FT and CENL1 to their targets, where they drive bud burst, shoot elongation, and morphogenesis.

  17. Fabrication of nerve guidance conduit with luminal filler as scaffold for peripheral nerve repair

    International Nuclear Information System (INIS)

    Aranilla, Charito T.; Wach, Rodoslaw; Ulanski, Piotr

    2015-01-01

    Peripheral nerve injury is a serious health concern for society, affecting trauma patients, many of whom acquire life-long disability. The gold standard of treatment for peripheral nerve injury is the use of nerve grafts, wherein nerve autograft or allograft is used to bridge the gap in the damaged nerve. Nerve guidance conduits (NGCs) are an attractive alternative to nerve autografts for aiding in the regeneration of peripheral nerve tissue. NGCs are small cylinders or tubes composed of either natural or synthetic biomaterials that are used to axon regeneration. The ends of the damaged nerve are inserted into either end of the cylinder and the NGC acts both as a connecting bridge for the severed nerve ends as well as a protective shelter for the regenerating nerve. This study aims at fabricating nerve guidance conduits with luminal structure based on synthetic biodegradable and biocompatible polymers such as poly (trimethylene carbonate ) (PTMC), poly (lactic acid) (PLA) and poly (caprolactone) (PCL). Initial base materials for fabrication were PLA acid tubes compared to PCL tubes when prepared by spray and dip-coating methods. The morphology of the tubes where examined by SEM and results showed better porosity of PLA acid tubes compared to PCL tubes when prepared by spraying technique. Poly(lactic acid) was then blended with poly(trimethylene carbonate) at a ratio of 1:4 (5% total polymer content) for further fabrication. Electron beam radiation (25 and 50 kGy) was employed for sterilization and the changes in properties induced by irradiation in comprising polymers were evaluated. The wettability, mechanical thermal properties were not significantly changed by irradiation.In a separate experiment, synthesis of carboxymethyl chitosan hydrogel crosslinked by electron beam radiation was studied to create a luminal filler for PTMC-PLA tubes. Based on proper viscosity of solution before crosslinking, sufficient gel fraction and swelling, 10% w/v concentration of

  18. Scaffoldless tissue-engineered nerve conduit promotes peripheral nerve regeneration and functional recovery after tibial nerve injury in rats

    Institute of Scientific and Technical Information of China (English)

    Aaron M. Adams; Keith W. VanDusen; Tatiana Y. Kostrominova; Jacob P. Mertens; Lisa M. Larkin

    2017-01-01

    Damage to peripheral nerve tissue may cause loss of function in both the nerve and the targeted muscles it innervates. This study compared the repair capability of engineered nerve conduit (ENC), engineered fibroblast conduit (EFC), and autograft in a 10-mm tibial nerve gap. ENCs were fabricated utilizing primary fibroblasts and the nerve cells of rats on embryonic day 15 (E15). EFCs were fabricated utilizing primary fi-broblasts only. Following a 12-week recovery, nerve repair was assessed by measuring contractile properties in the medial gastrocnemius muscle, distal motor nerve conduction velocity in the lateral gastrocnemius, and histology of muscle and nerve. The autografts, ENCs and EFCs reestablished 96%, 87% and 84% of native distal motor nerve conduction velocity in the lateral gastrocnemius, 100%, 44% and 44% of native specific force of medical gastrocnemius, and 63%, 61% and 67% of native medial gastrocnemius mass, re-spectively. Histology of the repaired nerve revealed large axons in the autograft, larger but fewer axons in the ENC repair, and many smaller axons in the EFC repair. Muscle histology revealed similar muscle fiber cross-sectional areas among autograft, ENC and EFC repairs. In conclusion, both ENCs and EFCs promot-ed nerve regeneration in a 10-mm tibial nerve gap repair, suggesting that the E15 rat nerve cells may not be necessary for nerve regeneration, and EFC alone can suffice for peripheral nerve injury repair.

  19. Experimental composite guidance conduits for peripheral nerve repair: An evaluation of ion release

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, X.F. [Department of Biological Sciences and Medical Engineering Design and Innovation Centre, Cork Institute of Technology, Cork (Ireland); Coughlan, A. [Inamori School of Engineering, Alfred University, Alfred, NY. 14802 (United States); O' Shea, H. [Department of Biological Sciences and Medical Engineering Design and Innovation Centre, Cork Institute of Technology, Cork (Ireland); Towler, M.R. [Inamori School of Engineering, Alfred University, Alfred, NY. 14802 (United States); Kehoe, S., E-mail: sharonkehoe@dal.ca [Department of Applied Oral Sciences, Dalhousie University, Halifax, NS, B3H 4R2 (Canada); School of Biomedical Engineering, Dalhousie University, Halifax, NS, B3H 4R2 (Canada); Boyd, D., E-mail: d.boyd@dal.ca [Department of Applied Oral Sciences, Dalhousie University, Halifax, NS, B3H 4R2 (Canada); School of Biomedical Engineering, Dalhousie University, Halifax, NS, B3H 4R2 (Canada)

    2012-08-01

    Poly (lactide-co-glycolide) (PLGA) - Pluronic F127 - glass composites have demonstrated excellent potential, from the perspective of controlled mechanical properties and cytocompatibility, for peripheral nerve regeneration. In addition to controlling the mechanical properties and cytotoxicity for such composite devices, the glass component may mediate specific responses upon implantation via degradation in the physiological environment and release of constituent elements. However, research focused on quantifying the release levels of such therapeutic ions from these experimental medical devices has been limited. To redress the balance, this paper explores the ion release profiles for Si{sup 4+}, Ca{sup 2+}, Na{sup +}, Zn{sup 2+}, and Ce{sup 4+} from experimental composite nerve guidance conduits (CNGC) comprising PLGA (at 12.5, and 20 wt.%), F127 (at 0, 2.5 and 5 wt.%) and various loadings of Si-Ca-Na-Zn-Ce glass (at 20 and 40 wt.%) for incubation periods of up to 28 days. The concentration of each ion, at various time points, was determined using Inductively Coupled Plasma-Atomic Emission Spectrometry (Perkin Elmer Optima 3000). It was observed that the Si{sup 4+}, Na{sup +}, Ca{sup 2+}, Zn{sup 2+} release from CNGCs in this study ranged from 0.22 to 6.477 ppm, 2.307 to 3.277 ppm, 40 to 119 ppm, and 45 to 51 ppm, respectively. The Ce{sup 4+} concentrations were under the minimum detection limits for the ICP instrument utilized. The results indicate that the ion release levels may be appropriate to mediate therapeutic effects with respect to peripheral nerve regeneration. The data generated in this paper provides requisite evidence to optimize composition for pre-clinical evaluation of the experimental composite. - Graphical abstract: Highlights: Black-Right-Pointing-Pointer Time-dependent degradation studies of PLGA/glass composite nerve guidance conduits (NGCs). Black-Right-Pointing-Pointer Si{sup 4+}, Na{sup +}, Ca{sup 2+} and Zn{sup 2+} release levels for the

  20. Experience de conduite, alcool et environnement monotone. In Sandrine Gaymard et Teodor Tiplica (Eds.) Sécurité routière : un défi à l'aube du XXIème siècle

    OpenAIRE

    BERTHELON, Catherine; GALY, Edith

    2017-01-01

    L'hypothèse est faite que la prise d'une faible dose d'alcool en début d'après-midi, au moment de la baisse physiologique du niveau de vigilance (creux post prandial), pourrait entraîner un assoupissement précoce, notamment chez les jeunes conducteurs novices, ayant des répercussions sur la performance. La baisse de performance devrait s'amplifier au fur et à mesure de la conduite, de par la monotonie et la longueur de la séance de conduite. Seize jeunes conducteurs de 18 ans venant d'obtenir...

  1. Pockets, conduits, channels, and plumes: links to volcanism and orogeny in the rollback dominated western Mediterranean

    Science.gov (United States)

    Miller, Meghan S.; Sun, Daoyuan; O'Driscoll, Leland; Becker, Thorsten W.; Holt, Adam; Diaz, Jordi; Thomas, Christine

    2015-04-01

    Detailed mantle and lithospheric structure from the Canary Islands to Iberia have been imaged with data from recent temporary deployments and select permanent stations from over 300 broadband seismometers. The stations extended across Morocco and Spain as part of the PICASSO, IberArray, and Morocco-Münster experiments. We present results from S receiver functions (SRF), shear wave splitting, waveform modeling, and geodynamic models that help constrain the tectonic evolution of the westernmost Mediterranean, including orogenesis of the Atlas Mountains and occurrence of localized alkaline volcanism. Our receiver function images, in agreement with previous geophysical modeling, show that the lithosphere is thin (~65 km) beneath the Atlas, but thickens (~100 km) over a very short length scale at the flanks of the mountains. We find that these dramatic changes in lithospheric thickness also correspond to dramatic decreases in delay times inferred from S and SKS splitting observations of seismic anisotropy. Pockets and conduits of low seismic velocity material below the lithosphere extend along much of the Atlas to Southern Spain and correlate with the locations of Pliocene-Quaternary magmatism. Waveform analysis from the USC linear seismic array across the Atlas Mountains constrains the position, shape, and physical characteristics of one localized, low velocity conduit that extends from the uppermost mantle (~200 km depth) up to the volcanoes in the Middle Atlas. The shape, position and temperature of these seismically imaged low velocity anomalies, topography of the base of the lithosphere, morphology of the subducted slab beneath the Alboran Sea, position of the West African Craton and correlation with mantle flow inferred from shear wave splitting suggest that the unusually high topography of the Atlas Mountains and isolated recent volcanics are due to active mantle support that may be from material channeled from the Canary Island plume.

  2. Solid-cryogen-stabilized, cable-in-conduit (CIC) superconducting cables

    Science.gov (United States)

    Voccio, J. P.; Michael, P. C.; Bromberg, L.; Hahn, S.

    2015-12-01

    This paper considers the use of a solid cryogen as a means to stabilize, both mechanically and thermally, magnesium diboride (MgB2) superconducting strands within a dual-channel cable-in-conduit (CIC) cable for use in AC applications, such as a generator stator winding. The cable consists of two separate channels; the outer channel contains the superconducting strands and is filled with a fluid (liquid or gas) that becomes solid at the device operating temperature. Several options for fluid will be presented, such as liquid nitrogen, hydrocarbons and other chlorofluorocarbons (CFCs) that have a range of melting temperatures and volumetric expansions (from solid at operating temperature to fixed volume at room temperature). Implications for quench protection and conductor stability, enhanced through direct contact with the solid cryogen, which has high heat capacity and thermal conductivity (compared with helium gas), will be presented. Depending on the cryogen, the conductor will be filled initially either with liquid at atmospheric conditions or a gas at high pressure (∼100 atm). After cooldown, the cryogen in the stranded-channel will be solid, essentially locking the strands in place, preventing strand motion and degradation due to mechanical deformation while providing enhanced thermal capacity for stability and protection. The effect of cryogen porosity is also considered. The relatively high heat capacity of solid cryogens at these lower temperatures (compared to gaseous helium) enhances the thermal stability of the winding. During operation, coolant flow through the open inner channel will minimize pressure drop.

  3. The Himalayas: barrier and conduit for gene flow.

    Science.gov (United States)

    Gayden, Tenzin; Perez, Annabel; Persad, Patrice J; Bukhari, Areej; Chennakrishnaiah, Shilpa; Simms, Tanya; Maloney, Trisha; Rodriguez, Kristina; Herrera, Rene J

    2013-06-01

    The Himalayan mountain range is strategically located at the crossroads of the major cultural centers in Asia, the Middle East and Europe. Although previous Y-chromosome studies indicate that the Himalayas served as a natural barrier for gene flow from the south to the Tibetan plateau, this region is believed to have played an important role as a corridor for human migrations between East and West Eurasia along the ancient Silk Road. To evaluate the effects of the Himalayan mountain range in shaping the maternal lineages of populations residing on either side of the cordillera, we analyzed mitochondrial DNA variation in 344 samples from three Nepalese collections (Newar, Kathmandu and Tamang) and a general population of Tibet. Our results revealed a predominantly East Asian-specific component in Tibet and Tamang, whereas Newar and Kathmandu are both characterized by a combination of East and South Central Asian lineages. Interestingly, Newar and Kathmandu harbor several deep-rooted Indian lineages, including M2, R5, and U2, whose coalescent times from this study (U2, >40 kya) and previous reports (M2 and R5, >50 kya) suggest that Nepal was inhabited during the initial peopling of South Central Asia. Comparisons with our previous Y-chromosome data indicate sex-biased migrations in Tamang and a founder effect and/or genetic drift in Tamang and Newar. Altogether, our results confirm that while the Himalayas acted as a geographic barrier for human movement from the Indian subcontinent to the Tibetan highland, it also served as a conduit for gene flow between Central and East Asia. Copyright © 2013 Wiley Periodicals, Inc.

  4. Chilling of Dormant Buds Hyperinduces FLOWERING LOCUS T and Recruits GA-Inducible 1,3-β-Glucanases to Reopen Signal Conduits and Release Dormancy in Populus[W][OA

    Science.gov (United States)

    Rinne, Päivi L.H.; Welling, Annikki; Vahala, Jorma; Ripel, Linda; Ruonala, Raili; Kangasjärvi, Jaakko; van der Schoot, Christiaan

    2011-01-01

    In trees, production of intercellular signals and accessibility of signal conduits jointly govern dormancy cycling at the shoot apex. We identified 10 putative cell wall 1,3-β-glucanase genes (glucan hydrolase family 17 [GH17]) in Populus that could turn over 1,3-β-glucan (callose) at pores and plasmodesmata (PD) and investigated their regulation in relation to FT and CENL1 expression. The 10 genes encode orthologs of Arabidopsis thaliana BG_ppap, a PD-associated glycosylphosphatidylinositol (GPI) lipid-anchored protein, the Arabidopsis PD callose binding protein PDCB, and a birch (Betula pendula) putative lipid body (LB) protein. We found that these genes were differentially regulated by photoperiod, by chilling (5°C), and by feeding of gibberellins GA3 and GA4. GA3 feeding upregulated all LB-associated GH17s, whereas GA4 upregulated most GH17s with a GPI anchor and/or callose binding motif, but only GA4 induced true bud burst. Chilling upregulated a number of GA biosynthesis and signaling genes as well as FT, but not CENL1, while the reverse was true for both GA3 and GA4. Collectively, the results suggest a model for dormancy release in which chilling induces FT and both GPI lipid-anchored and GA3-inducible GH17s to reopen signaling conduits in the embryonic shoot. When temperatures rise, the reopened conduits enable movement of FT and CENL1 to their targets, where they drive bud burst, shoot elongation, and morphogenesis. PMID:21282527

  5. Conduits to care: call lights and patients’ perceptions of communication

    Science.gov (United States)

    Montie, Mary; Shuman, Clayton; Galinato, Jose; Patak, Lance; Anderson, Christine A; Titler, Marita G

    2017-01-01

    Background Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of literature discussing patient communication with their health care providers, few studies have explored patients’ perceptions concerning call light use and communication. The specific aim of this study was to solicit patients’ perceptions regarding their call light use and communication with nursing staff. Methods Patients invited to this study met the following inclusion criteria: proficient in English, been hospitalized for at least 24 hours, aged ≥21 years, and able to communicate verbally (eg, not intubated). Thirty participants provided written informed consent, were enrolled in the study, and completed interviews. Results Using qualitative descriptive methods, five major themes emerged from patients’ perceptions (namely; establishing connectivity, participant safety concerns, no separation: health care and the call light device, issues with the current call light, and participants’ perceptions of “nurse work”). Multiple minor themes supported these major themes. Data analysis utilized the constant comparative methods of Glaser and Strauss. Discussion Findings from this study extend the knowledge of patients’ understanding of not only why inconsistencies occur between the call light and their nurses, but also why the call light is more than merely a device to initiate communication; rather, it is a direct conduit to their health care and its delivery. PMID:29075125

  6. Conduits to care: call lights and patients' perceptions of communication.

    Science.gov (United States)

    Montie, Mary; Shuman, Clayton; Galinato, Jose; Patak, Lance; Anderson, Christine A; Titler, Marita G

    2017-01-01

    Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of literature discussing patient communication with their health care providers, few studies have explored patients' perceptions concerning call light use and communication. The specific aim of this study was to solicit patients' perceptions regarding their call light use and communication with nursing staff. Patients invited to this study met the following inclusion criteria: proficient in English, been hospitalized for at least 24 hours, aged ≥21 years, and able to communicate verbally (eg, not intubated). Thirty participants provided written informed consent, were enrolled in the study, and completed interviews. Using qualitative descriptive methods, five major themes emerged from patients' perceptions (namely; establishing connectivity, participant safety concerns, no separation: health care and the call light device, issues with the current call light, and participants' perceptions of "nurse work"). Multiple minor themes supported these major themes. Data analysis utilized the constant comparative methods of Glaser and Strauss. Findings from this study extend the knowledge of patients' understanding of not only why inconsistencies occur between the call light and their nurses, but also why the call light is more than merely a device to initiate communication; rather, it is a direct conduit to their health care and its delivery.

  7. Structure Of Conduits Of The Acidic Volcanism And Related Deposits In The Paraná-Etendeka Magmatic Province, São Marcos Region, South Brazil

    Science.gov (United States)

    Guimarães, L. F.; De Campos, C. P.; Lima, E. F. D.; Janasi, V. A.

    2015-12-01

    Voluminous acidic volcanics from the Paraná-Etendeka Magmatic Province crop out in the southern part of Brazil. The conduits responsible for the feeding of this intermediate/acid volcanism are preserved and well exposed in the São Marcos region (Lima et al. 2012; Geologia USP 12:49-64). Conduits are aligned along a NW-SE trend and have thicknesses up to 1 km. These structures are often characterized by mixing between dacitic and rhyodacitic magmas, with intercalation between two major zones: 1) reddish or grayish vitrophiricdacite/rhyodacite, sub-divided in massive or vesiculated; 2) reddish or grayish vitrophiric fragmented dacite/rhyodacite composed of bubble-rich angular to rounded blocks. Such fragments commonly deform coeval to the flow. A third zone dominated by filaments depicts a chaotic stretching-and-folding process from the mixture of the acid magmas. We used classical field measurements of flow structures and recognized main flow directions in these feeder-dikes. They follow two preferential directions: NW, ranging from N272° to N 355°, and NE, varying from N20° to N85°. These directions are indicative of a transtensive fissural system, which seems to be related to conjugated fractures. Evidence of an important fragmentation process in the conduits point towards the presence of related products in this region, thus rheomorphic deposits such as those observed elsewhere (e.g. Uruguay and Namibia) are expected to occur. Possible vestiges of these deposits could be represented by restricted outcrops of lens-shaped and banded hipohyaline, occasionally bubble-rich, dacites. The presence of continuous pseudotachylitic levels, tightly folded bands with horizontal axial planes together with local deformed bubble-rich pumice-like lens could be indicative of remelting and rheomorphism of previous vulcanoclastic material. Coulees and compound (lobed) dacitic lava flows, reaching up to 5-8 meters length, occur as the uppermost deposits and correspond to the

  8. [Laparoscopic cystectomy and ileal conduit urinary diversion for neurogenic bladders and related conditions. Morbidity and better quality of life].

    Science.gov (United States)

    Sakhri, R; Seigle-Murandi, F; Jacqmin, D; Lang, H; Saussine, C

    2015-05-01

    To assess morbidity and functional consequences of laparoscopic cystectomy with ileal conduit urinary diversion: in neurologic patients. We reviewed the records of forty-two patients (ten men and thirty-two women) who underwent surgery between August 2007 and October 2013. The median age of the patient was 54 years old (range between 21-79 years). A laparoscopic cystectomy was performed followed by a short laparotomy to perform the ileal conduit urinary diversion. Records were reviewed to retrieve the indications and describe the postoperative and functional course. Patients and GPs were interviewed during phone calls to appreciate the quality of life by the PGII scale in order to assess the functional outcome. The operation was performed on 42 patients, of whom 18 had multiple sclerosis, nine a post-traumatic neurogenic bladder. Among the total population, 10 patients (23.81%) required a transfusion of at least one packed red blood cells (1-7). The overall rate of early complications was 35.71%. Belated complications were seen in 52.38% of the population. The median duration of hospital stay was 16 days (range between 9-70 days). The median follow up was 34 months (range between 1-76 months). For patients, the PGII scale rating had a median value of 6 (2-7). All referring physicians described a better functional status. The laparoscopic cystectomy can make postoperative course smoother for the neurological patients. However, the surgeon must weigh individually the benefit of performing the operation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  9. A novel approach to estimate the eruptive potential and probability in open conduit volcanoes.

    Science.gov (United States)

    De Gregorio, Sofia; Camarda, Marco

    2016-07-26

    In open conduit volcanoes, volatile-rich magma continuously enters into the feeding system nevertheless the eruptive activity occurs intermittently. From a practical perspective, the continuous steady input of magma in the feeding system is not able to produce eruptive events alone, but rather surplus of magma inputs are required to trigger the eruptive activity. The greater the amount of surplus of magma within the feeding system, the higher is the eruptive probability.Despite this observation, eruptive potential evaluations are commonly based on the regular magma supply, and in eruptive probability evaluations, generally any magma input has the same weight. Conversely, herein we present a novel approach based on the quantification of surplus of magma progressively intruded in the feeding system. To quantify the surplus of magma, we suggest to process temporal series of measurable parameters linked to the magma supply. We successfully performed a practical application on Mt Etna using the soil CO2 flux recorded over ten years.

  10. Normal zone propagation and Thermal Hydraulic Quenchback in a cable-in-conduit superconductor

    International Nuclear Information System (INIS)

    Lue, J.W.; Dresner, L.

    1993-01-01

    When a local normal zone appears in a cable-in-conduit superconductor, a slug of hot helium is produced. The pressure rises and the hot helium expands. Thus the normal zone propagation in such a conductor can be governed by the hot helium expansion, rather than the heat conduction along the conductor. The expansion of the hot helium compresses the cold helium outside of the normal zone. This raises th at sign temperature of the cold helium. When the temperature rise reaches the current sharing limit, the superconductor in contact goes normal. Thus a rapid increase in normal zone propagation occur. This phenomenon is termed Thermal Hydraulic Quenchback (THQ). An experiment was performed to investigate this process. The existence of THQ was verified. Thresholds of THQ were also observed by varying the conductor current, the magnetic field, the temperature, and the initial normal zone length. When THQ occurred, normal zone propagation approaching the velocity of sound was observed. A better picture of THQ is obtained by a careful comparison of the data with analytical studies

  11. Contention between supply of hydrothermal fluid and conduit obstruction: inferences from numerical simulations

    Science.gov (United States)

    Tanaka, Ryo; Hashimoto, Takeshi; Matsushima, Nobuo; Ishido, Tsuneo

    2018-05-01

    We investigate a volcanic hydrothermal system using numerical simulations, focusing on change in crater temperature. Both increases and decreases in crater temperature have been observed before phreatic eruptions. We follow the system's response for up to a decade after hydrothermal fluid flux from the deep part of the system is increased and permeability is reduced at a certain depth in a conduit. Our numerical simulations demonstrate that: (1) changes in crater temperature are controlled by the magnitude of the increase in hydrothermal fluid flux and the degree of permeability reduction; (2) significant increases in hydrothermal flux with decreases in permeability induce substantial pressure changes in shallow depths in the edifice and decreases in crater temperature; (3) the location of maximum pressure change differs between the mechanisms. The results of this study imply that it is difficult to predict eruptions by crater temperature change alone. One should be as wary of large eruptions when crater temperature decreases as when crater temperature increases. It is possible to clarify the implications of changes in crater temperature with simultaneous observation of ground deformation.

  12. Prenatal detection of structural cardiac defects and presence of associated anomalies: a retrospective observational study of 1262 fetal echocardiograms.

    Science.gov (United States)

    Mone, Fionnuala; Walsh, Colin; Mulcahy, Cecelia; McMahon, Colin J; Farrell, Sinead; MacTiernan, Aoife; Segurado, Ricardo; Mahony, Rhona; Higgins, Shane; Carroll, Stephen; McParland, Peter; McAuliffe, Fionnuala M

    2015-06-01

    The aim of this study is to document the detection of fetal congenital heart defect (CHD) in relation to the following: (1) indication for referral, (2) chromosomal and (3) extracardiac abnormalities. All fetal echocardiograms performed in our institution from 2007 to 2011 were reviewed retrospectively. Indication for referral, cardiac diagnosis based on the World Health Organization International Classification of Diseases tenth revision criteria and the presence of chromosomal and extracardiac defects were recorded. Of 1262 echocardiograms, 287 (22.7%) had CHD. Abnormal anatomy scan in pregnancies originally considered to be at low risk of CHD was the best indicator for detecting CHD (91.2% of positive cardiac diagnoses), compared with other indications of family history (5.6%) or maternal medical disorder (3.1%). Congenital anomalies of the cardiac septa comprised the largest category (n = 89), within which atrioventricular septal defects were the most common anomaly (n = 36). Invasive prenatal testing was performed for 126 of 287 cases, of which 44% (n = 55) had a chromosomal abnormality. Of 232 fetuses without chromosomal abnormalities, 31% had an extracardiac defect (n = 76). Most CHDs occur in pregnancies regarded to be at low risk, highlighting the importance of a routine midtrimester fetal anatomy scan. Frequent association of fetal CHD and chromosomal and extracardiac pathology emphasises the importance of thorough evaluation of any fetus with CHD. © 2015 John Wiley & Sons, Ltd.

  13. 58. Actitud frente al flujo sanguíneo pulmonar adicional en la operación de glenn

    Directory of Open Access Journals (Sweden)

    F. Serrano Martínez

    2010-01-01

    Conclusiones: El mantenimiento de FPAC no incrementa la morbimortalidad post-Glenn ni altera la conservación funcional del ventrículo único, permitiendo llegar a la fase pre-Fontan con mayor SaO2 y mejor tamaño de ramas pulmonares. La existencia o ausencia de FPAC no influyó en los resultados del Fontan posterior, aunque consideramos interesante mantenerlo, especialmente en casos con ramas pulmonares pequeñas. La paliación pre-Glenn tipo banding pulmonar se asoció a mayor imposibilidad de conservar un FPAC.

  14. Exploring the role of lipids in intercellular conduits: breakthroughs in the pipeline

    Directory of Open Access Journals (Sweden)

    Elise eDelage

    2013-12-01

    Full Text Available It has been known for more than a century that most of the plant cells are connected to their neighbors through membranous pores perforating the cell wall, namely plasmodesmata (PDs. The recent discovery of tunneling nanotubes (TNTs, thin membrane bridges established between distant mammalian cells, suggests that intercellular communication mediated through cytoplasmic continuity could be a conserved feature of eukaryotic organisms. Although TNTs differ from PDs in their formation and architecture, both are characterized by a continuity of the plasma membrane between two cells, delimiting a nanotubular channel supported by actin-based cytoskeleton. Due to this unusual membrane organization, lipids are likely to play critical roles in the formation and stability of intercellular conduits like TNTs and PDs, but also in regulating the transfer through these structures. While it is crucial for a better understanding of those fascinating communication highways, the study of TNT lipid composition and dynamics turned out to be extremely challenging. The present review aims to give an overview of the recent findings in this context. We will also discuss some of the promising imaging approaches, which might be the key for future breakthroughs in the field and could also benefit the research on PDs.

  15. The side-to-side fashion for individual distal coronary anastomosis using venous conduit.

    Science.gov (United States)

    Kato, Takayoshi; Tsunekawa, Tomohiro; Motoji, Yusuke; Hirakawa, Akihiro; Okawa, Yasuhide; Tomita, Shinji

    2017-04-01

    Regarding to coronary artery bypass grafting (CABG), the end-to-side anastomosis (ESA) has been performed as a gold standard. Recently, the effectiveness of the distal side-to-side anastomosis (SSA) in CABG using internal mammary artery has been reported. The benefit of SSA comparing to ESA also has been disclosed by computing simulation. However, use of SSA by venous conduit for individual CABG has not been reported. In this study, we investigated feasibility of SSA. From January 2013 to October 2014, we conducted 114 CABGs. There were 92 venous distal anastomoses without sequential anastomotic site (61 SSA and 31 ESA). The anastomosis was evaluated before discharge and at 1 year after the procedure by angiography or multi-detector row computed tomographic coronary angiography. The median values for time to anastomosis were 13 min in the two group (p = 0.89). There was no revision of anastomosis in both groups. Additional stitches for hemostasis were required significantly less in SSA than ESA (18.0 vs 45.2 %, respectively, p fashion is easy to perform and maybe beneficial in blood flow pattern.

  16. Multicriteria Gain Tuning for Rotorcraft Flight Controls (also entitled The Development of the Conduit Advanced Control System Design and Evaluation Interface with a Case Study Application Fly by Wire Helicopter Design)

    Science.gov (United States)

    Biezad, Daniel

    1997-01-01

    Handling qualities analysis and control law design would seem to be naturally complimenting components of aircraft flight control system design, however these two closely coupled disciplines are often not well integrated in practice. Handling qualities engineers and control system engineers may work in separate groups within an aircraft company. Flight control system engineers and handling quality specialists may come from different backgrounds and schooling and are often not aware of the other group's research. Thus while the handling qualities specifications represent desired aircraft response characteristics, these are rarely incorporated directly in the control system design process. Instead modem control system design techniques are based on servo-loop robustness specifications, and simple representations of the desired control response. Comprehensive handling qualities analysis is often left until the end of the design cycle and performed as a check of the completed design for satisfactory performance. This can lead to costly redesign or less than satisfactory aircraft handling qualities when the flight testing phase is reached. The desire to integrate the fields of handling qualities and flight,control systems led to the development of the CONDUIT system. This tool facilitates control system designs that achieve desired handling quality requirements and servo-loop specifications in a single design process. With CONDUIT, the control system engineer is now able to directly design and control systems to meet the complete handling specifications. CONDUIT allows the designer to retain a preferred control law structure, but then tunes the system parameters to meet the handling quality requirements.

  17. Ecoulements intermittents de gaz et de liquide en conduite verticale Intermittent Gas and Liquid Flows in a Vertical Pipe.

    Directory of Open Access Journals (Sweden)

    Line A.

    2006-11-01

    Full Text Available Le modèle présenté ici permet la pré-détermination du gradient de pression, du taux global de gaz, et de grandeurs caractéristiques de l'intermittence, dans un écoulement à poches et bouchons en conduite verticale. L'écriture des lois de conservation en moyenne phasique conditionnelle conduit à la définition d'une cellule moyenne équivalente. La fermeture du modèle est assurée par des lois de contrainte de cisaillement film-paroi, film-poche, bouchon-paroi, par une loi d'arrachage du gaz au culot de la poche, une loi de glissement du gaz dans les bouchons et par une loi de la vitesse moyenne de propagation des fronts de poches. Le calibrage et la qualification du modèle s'appuient sur deux banques de données, dont l'une a été obtenue avec des fluides pétroliers dans des conditions proches des situations industrielles (boucle diphasique de Boussens. The model described here can be used to predetermine the pressure gradient, the overall gas rate and the characteristic intermittence magnitudes in pocket and slug flow in a vertical pipe. The way governing equations in the conditional phase average are written defines an equivalent average cell. The model is closed by film/wall, film/pocket and slug/wall shear-stress laws, by a pulloff law for the gas at the bottom of the pocket, a slippage law for the gas in the slugs, and a mean propagation velocity law for the pocket fronts. The calibration and qualification of the model are based on two data banks, one of which contains data on petroleum fluids under conditions close to industrial situations (two-phase loop at Boussens.

  18. Social media methods for studying rare diseases.

    Science.gov (United States)

    Schumacher, Kurt R; Stringer, Kathleen A; Donohue, Janet E; Yu, Sunkyung; Shaver, Ashley; Caruthers, Regine L; Zikmund-Fisher, Brian J; Fifer, Carlen; Goldberg, Caren; Russell, Mark W

    2014-05-01

    For pediatric rare diseases, the number of patients available to support traditional research methods is often inadequate. However, patients who have similar diseases cluster "virtually" online via social media. This study aimed to (1) determine whether patients who have the rare diseases Fontan-associated protein losing enteropathy (PLE) and plastic bronchitis (PB) would participate in online research, and (2) explore response patterns to examine social media's role in participation compared with other referral modalities. A novel, internet-based survey querying details of potential pathogenesis, course, and treatment of PLE and PB was created. The study was available online via web and Facebook portals for 1 year. Apart from 2 study-initiated posts on patient-run Facebook pages at the study initiation, all recruitment was driven by study respondents only. Response patterns and referral sources were tracked. A total of 671 respondents with a Fontan palliation completed a valid survey, including 76 who had PLE and 46 who had PB. Responses over time demonstrated periodic, marked increases as new online populations of Fontan patients were reached. Of the responses, 574 (86%) were from the United States and 97 (14%) were international. The leading referral sources were Facebook, internet forums, and traditional websites. Overall, social media outlets referred 84% of all responses, making it the dominant modality for recruiting the largest reported contemporary cohort of Fontan patients and patients who have PLE and PB. The methodology and response patterns from this study can be used to design research applications for other rare diseases. Copyright © 2014 by the American Academy of Pediatrics.

  19. Successful diuretics treatment of protein-losing enteropathy in Noonan syndrome.

    Science.gov (United States)

    Mizuochi, Tatsuki; Suda, Kenji; Seki, Yoshitaka; Yanagi, Tadahiro; Yoshimoto, Hironaga; Kudo, Yoshiyuki; Iemura, Motofumi; Tanikawa, Ken; Matsuishi, Toyojiro

    2015-04-01

    There are few reports on successful high-dose spironolactone treatment of refractory protein-losing enteropathy (PLE) caused by Fontan procedure. We report successful diuretics treatment with spironolactone and furosemide at standard dose, of refractory PLE in a patient with Noonan syndrome and repaired congenital heart disease. This is the first successful application of diuretics treatment in a patient with refractory PLE without Fontan procedure. This case illustrates that diuretics treatment can be the first-line treatment of PLE regardless of the causative physiology, and can be effective in refractory PLE with Noonan syndrome. © 2015 Japan Pediatric Society.

  20. A Decaheme Cytochrome as a Molecular Electron Conduit in Dye-Sensitized Photoanodes

    Science.gov (United States)

    Hwang, Ee Taek; Sheikh, Khizar; Orchard, Katherine L; Hojo, Daisuke; Radu, Valentin; Lee, Chong-Yong; Ainsworth, Emma; Lockwood, Colin; Gross, Manuela A; Adschiri, Tadafumi; Reisner, Erwin; Butt, Julea N; Jeuken, Lars J C

    2015-01-01

    In nature, charge recombination in light-harvesting reaction centers is minimized by efficient charge separation. Here, it is aimed to mimic this by coupling dye-sensitized TiO2 nanocrystals to a decaheme protein, MtrC from Shewanella oneidensis MR-1, where the 10 hemes of MtrC form a ≈7-nm-long molecular wire between the TiO2 and the underlying electrode. The system is assembled by forming a densely packed MtrC film on an ultra-flat gold electrode, followed by the adsorption of approximately 7 nm TiO2 nanocrystals that are modified with a phosphonated bipyridine Ru(II) dye (RuP). The step-by-step construction of the MtrC/TiO2 system is monitored with (photo)electrochemistry, quartz-crystal microbalance with dissipation (QCM-D), and atomic force microscopy (AFM). Photocurrents are dependent on the redox state of the MtrC, confirming that electrons are transferred from the TiO2 nanocrystals to the surface via the MtrC conduit. In other words, in these TiO2/MtrC hybrid photodiodes, MtrC traps the conduction-band electrons from TiO2 before transferring them to the electrode, creating a photobioelectrochemical system in which a redox protein is used to mimic the efficient charge separation found in biological photosystems. PMID:26180522

  1. Thermo-Hydraulic behaviour of dual-channel superconducting Cable-In-Conduit Conductors for ITER

    International Nuclear Information System (INIS)

    Renard, B.

    2006-09-01

    In an effort to optimise the cryogenics of large superconducting coils for fusion applications (ITER), dual channel Cable-In-Conduit Conductors (CICC) are designed with a central channel spiral to provide low hydraulic resistance and faster helium circulation. The qualitative and economic rationale of the conductor central channel is here justified to limit the superconductor temperature increase, but brings more complexity to the conductor cooling characteristics. The pressure drop of spirals is experimentally evaluated in nitrogen and water and an explicit hydraulic friction model is proposed. Temperatures in the cable must be quantified to guarantee superconductor margin during coil operation under heat disturbance and set adequate inlet temperature. Analytical one-dimensional thermal models, in steady state and in transient, allow to better understand the thermal coupling of CICC central and annular channels. The measurement of a heat transfer characteristic space and time constants provides cross-checking experimental estimations of the internal thermal homogenization. A simple explicit model of global inter-channel heat exchange coefficient is proposed. The risk of thermosyphon between the two channels is considered since vertical portions of fusion coils are subject to gravity. The new hydraulic model, heat exchange model and gravitational risk ratio allow the thermohydraulic improvement of CICC central spirals. (author)

  2. Study on the dynamic behavior of a current in cable-in-conduit conductors by using self magnetic field measurements

    Energy Technology Data Exchange (ETDEWEB)

    Obana, Tetsuhiro, E-mail: obana.tetsuhiro@LHD.nifs.ac.jp [National Institute for Fusion Science, 322-6 Oroshi, Toki 509-5292, Gifu (Japan); Takahata, Kazuya; Hamaguchi, Shinji; Imagawa, Shinsaku; Mito, Toshiyuki [National Institute for Fusion Science, 322-6 Oroshi, Toki 509-5292, Gifu (Japan); Kizu, Kaname; Murakami, Haruyuki; Yoshida, Kiyoshi [Japan Atomic Energy Agency, Ibaraki (Japan)

    2011-10-15

    In order to understand the current behavior inside a cable-in-conduit conductor (CICC), self magnetic field measurements on the CICC were conducted. A prototype NbTi CICC, the configuration of which is a racket shape, for JT-60SA EF coil was used as a short conductor sample. By using Hall sensors arranged around the short conductor sample, the variation in the self magnetic field was measured. Taking into account the measurements, the current behavior inside the CICC was analyzed by using analytical models consisting of line currents. The analytical results indicate that the current distribution in the cross-section of the CICC would be non-uniform before a normal propagation, and the current distribution would be improved after the normal propagation.

  3. Literature Review: Double-Barrelled Wet Colostomy (One Stoma) versus Ileal Conduit with Colostomy (Two Stomas).

    Science.gov (United States)

    Gan, Jason; Hamid, Rizwan

    2017-01-01

    The aim of this literature review was to analyse the advantages and disadvantages of a traditional ileal conduit (IC) with separate colostomy technique compared to the outcomes of a double-barrelled wet colostomy (DBWC) technique. The former technique results in the formation of two stomas, and the latter results in the formation of one stoma. PubMed was searched electronically for articles on DBWC. Fifteen articles were retrieved and of them 13 were included in the literature review (350 patients). Of the articles, 3 directly compared DBWC to IC with colostomy. Review of 13 DBWC articles demonstrated perioperative mortality ranging between 0 and 11.1% and postoperative complications ranging from 0 to 100%. Three of the studies directly compared DBWC to IC with colostomy; median operating times and length of stay were shorter in DBWC patients (p colostomy technique, as it requires only one stoma. This literature review supports the use of the technically less challenging DBWC technique as a viable alternative to the traditional IC with colostomy technique. © 2016 S. Karger AG, Basel.

  4. Glacier surge mechanism based on linked cavity configuration of the basal water conduit system

    Science.gov (United States)

    Kamb, Barclay

    1987-08-01

    Based on observations of the 1982-1983 surge of Variegated Glacier, Alaska, a model of the surge mechanism is developed in terms of a transition from the normal tunnel configuration of the basal water conduit system to a linked cavity configuration that tends to restrict the flow of water, resulting in increased basal water pressures that cause rapid basal sliding. The linked cavity system consists of basal cavities formed by ice-bedrock separation (cavitation), ˜1 m high and ˜10 m in horizontal dimensions, widely scattered over the glacier bed, and hydraulically linked by narrow connections where separation is minimal (separation gap ≲ 0.1 m). The narrow connections, called orifices, control the water flow through the conduit system; by throttling the flow through the large cavities, the orifices keep the water flux transmitted by the basal water system at normal levels even though the total cavity cross-sectional area (˜200 m2) is much larger than that of a tunnel system (˜10 m2). A physical model of the linked cavity system is formulated in terms of the dimensions of the "typical" cavity and orifice and the numbers of these across the glacier width. The model concentrates on the detailed configuration of the typical orifice and its response to basal water pressure and basal sliding, which determines the water flux carried by the system under given conditions. Configurations are worked out for two idealized orifice types, step orifices that form in the lee of downglacier-facing bedrock steps, and wave orifices that form on the lee slopes of quasisinusoidal bedrock waves and are similar to transverse "N channels." The orifice configurations are obtained from the results of solutions of the basal-sliding-with-separation problem for an ice mass constituting of linear half-space of linear rheology, with nonlinearity introduced by making the viscosity stress-dependent on an intuitive basis. Modification of the orifice shapes by melting of the ice roof due to

  5. Conduits to care: call lights and patients’ perceptions of communication

    Directory of Open Access Journals (Sweden)

    Montie M

    2017-09-01

    Full Text Available Mary Montie,1 Clayton Shuman,1 Jose Galinato,1 Lance Patak,2 Christine A Anderson,1 Marita G Titler1 1Department of Systems, Populations, and Leadership, School of Nursing, University of Michigan, Ann Arbor, MI, 2Department of Anesthesiology and Pain Medicine, Seattle Children’s Hospital, Seattle, WA, USA Background: Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of literature discussing patient communication with their health care providers, few studies have explored patients’ perceptions concerning call light use and communication. The specific aim of this study was to solicit patients’ perceptions regarding their call light use and communication with nursing staff. Methods: Patients invited to this study met the following inclusion criteria: proficient in English, been hospitalized for at least 24 hours, aged ≥21 years, and able to communicate verbally (eg, not intubated. Thirty participants provided written informed consent, were enrolled in the study, and completed interviews. Results: Using qualitative descriptive methods, five major themes emerged from patients’ perceptions (namely; establishing connectivity, participant safety concerns, no separation: health care and the call light device, issues with the current call light, and participants’ perceptions of “nurse work”. Multiple minor themes supported these major themes. Data analysis utilized the constant comparative methods of Glaser and Strauss. Discussion: Findings from this study extend the knowledge of patients’ understanding of not only why inconsistencies occur between the call light and their nurses, but also why the call light is more than merely a device to initiate communication; rather, it is a direct conduit to their health care and its delivery. Keywords: nurse–patient communication, medical technology, quality of care, qualitative research

  6. Results of a Seven-Year, Single-Centre Experience of the Long-Term Outcomes of Bovine Ureter Grafts Used as Novel Conduits for Haemodialysis Fistulas

    International Nuclear Information System (INIS)

    Das, Neelan; Bratby, Mark J.; Shrivastava, Vivek; Cornall, Alison J.; Darby, Christopher R.; Boardman, Philip; Anthony, Susan; Uberoi, Raman

    2011-01-01

    Purpose: To report the long-term outcomes of bovine ureter grafts as novel conduits for haemodialysis fistulas. Materials and Methods: Thirty-five patients underwent placement of a total of 40 SynerGraft 100 (SG100; CryoLife Europa ® , Guildford, UK) bovine ureter grafts between April 2002 and February 2009. Prospective data were collected on all patients, including active surveillance with blood flow studies and 6-monthly duplex ultrasound studies. Main outcome measures were primary and secondary patency rates. Results: Mean follow-up time was 97 weeks (range 4–270). Thirteen patients died from unrelated causes during the study period; 12 of these patients had a functioning graft at the time of death. Five patients underwent transplantation, and all had a functioning graft at transplantation. Twelve patients had a functioning graft at the end of the study period. One hundred and ten stenoses were detected, and 97 venoplasty procedures were performed. Of the stenoses, 41.8% were located at the venous anastomosis, 12.7% within the graft, 17.3% in the outflow veins, and 28.1% in central veins. No arterial stenoses were detected. Primary patency rates were 53% at 6 months and 14% at 1 year. Secondary patency rates were 81% at 6 months, 75% at 1 year, and 56% at 2 years. Conclusions: Active surveillance and intervention was able to achieve satisfactory long-term secondary patency for these novel conduits compared with those made of PTFE seen in other studies.

  7. Comportement comparé de conduites rigides et flexibles ensouillées au voisinage de sols gelés Comparative Behavior of Rigid and Flexible Pipes Buried in the Vicinity of Frozen Ground

    Directory of Open Access Journals (Sweden)

    Putot C.

    2006-11-01

    Full Text Available Au cours des dernières années, les activités pétrolières à terre comme en mer, tant en Alaska qu'au Canada, se sont maintenues à un niveau raisonnable. En octobre 1987, le premier champ pétrolier offshore a été mis en exploitation en mer de Beaufort (Endicott. Bien que l'industrie soit principalement dans une phase d'exploration, des besoins vont progressivement se manifester en matière de lignes de collecte et d'injection. La détermination du tracé de conduites en offshore arctique ainsi que leur dimensionnement nécessite la prise en compte de facteurs très spécifiques : le raclage des glaces dérivantes impose une profondeur minimum d'ensouillage, ce qui accroît, malgré l'isolation des conduites, la proportion de chaleur communiquée au pergélisol (ou permafrost en dégel : les tassements différentiels résultant de la variabilité de composition des sols peuvent provoquer des déformations, voire des instabilités des conduites tout à fait inacceptables. Il est assez intuitif de penser que les conduites flexibles accommoderont plus facilement les mouvements de sol que les rigides. L'objet de cet article est de proposer une méthode d'analyse assez souple permettant de jauger facilement cet avantage. In recent years, onshore and offshore petroleum activities, in both Alaska and Canada, have continued on a reasonable level. In October 1987 the first offshore oil field began production in the Beaufort Sea (Endicott. Although the industry is mainly in an exploration phase, needs will steadily appear with regard to gathering and injection line. . The determination to lay flowlines in offshore arctic areas as well as their sizing require that very specific factors be taken into consideration. Scouring by drifting ice requires a minimum depth of burial. Despite the insulation of pipes, this burial increases the proportion of heat communicated to melting permafrost. The differential compaction resulting from the variability of

  8. Ecoulements diphasiques gaz-liquide à poches et à bouchons en conduites Two-Phase Gas-Liquid Slug Flow in Pipes

    Directory of Open Access Journals (Sweden)

    Ferschneider G.

    2006-11-01

    Full Text Available Les écoulements diphasiques gaz-liquide ont été étudiés afin de contribuer à développer des modèles de calculs prédictifs des pertes de charge dans les conduites de production des bruts pétroliers. Les expériences nécessaires ont été réalisées sur la boucle diphasique de Boussens dans les conditions suivantes représentatives des conditions industrielles : diamètre 6 , longueur 120 m, disposition de la conduite horizontale ou faiblement ascendante, couple de fluide gaz naturel-huile légère. Le gradient de pression, le contenu global, et la distribution locale des phases ont été mesurés. Le traitement des équations de conservation phasique intégrées sur la section par différents types de moyennes a permis de développer un modèle cellulaire qui inclue un nombre limité d'équations constitutives nécessaires à sa fermeture. Ce modèle prédétermine convenablement le gradient de pression, le contenu gaz global et la longueur des poches et des bouchons. Two-phase gas-liquid flows were analyzed so as to develop models for prediction of pressure drops in crude-oil production lines. The experiments were performed on the two-phase loop at Boussens under the following representative industrial conditions: 6 diameter, 120 m length, horizontal or slightly rising pipe, couple of fluids natural gas and light oil. The pressure gradient, average content and local phase distribution were measured. Conservation phase equations integrated along the cross-section were processed by different time-averaged operators so as to develop a cellular model including a limited number of constitutive equations required for its closure. This model suitably predetermines the pressure gradient, the average gas content and the length of gas and liquid slug.

  9. Protein losing enteropathy secondary to a pulmonary artery stent

    Directory of Open Access Journals (Sweden)

    Narayanswami Sreeram

    2012-01-01

    Full Text Available A 2-year-old patient with hypoplastic left heart syndrome presented 6 months following Fontan completion with protein-losing enteropathy (PLE. He had undergone stent implantation in the left pulmonary artery after the Norwood procedure, followed by redilation of the stent prior to Fontan completion. Combined bronchoscopic and catheterization studies during spontaneous breathing confirmed left bronchial stenosis behind the stent, and diastolic systemic ventricular pressure during expiration of 25 mm Hg. We postulate that the stent acts as a valve, against which the patient generates high expiratory pressures, which are reflected in the ventricular diastolic pressure. This may be the cause of PLE.

  10. Churn-annular flow pattern transition in a vertical upward gas-liquid two-phase flow in various conduits

    International Nuclear Information System (INIS)

    Takenaka, Nobuyuki; Ueda, Tadanobu; Asano, Hitoshi

    2008-01-01

    Void fraction was measured by neutron radiography for a vertical upward gas-water two-phase flow in a concentric annular tube with and with out a spacer, 4x4 rod bundle with and without a spacer and a tight rod bundle with and without a wrapping wire for various gas and liquid flow rates. The flow patterns of these two-phase flows were determined by the Mishima-Ishii flow pattern map and void fraction was calculated by the Ishii's drift flux model. The predicted values were compared with the experimental results. The void fraction was well predicted by the Mishima-Ishii flow pattern map and the Ishii's drift flux model except the annular flow region with void fraction lower than 0.8 for conduits with small equivalent diameter. A new churn-annular flow pattern transition condition of the void fraction equal to 0.8 was added. The void fraction for the present experimental condition was successful predicted with the new transition model. (author)

  11. Helium flow dynamics and heat transfer in a cable in conduit conductor of superconducting magnets: a review

    International Nuclear Information System (INIS)

    Vaghela, Hitensinh; Sarkar, Biswanath; Lakhera, Vikas

    2016-01-01

    Superconducting (SC) magnets with Cable in Conduit Conductor (CICC) winding, cooled by helium at 4 K temperature are employed for many applications which require high magnetic field and high current densities. The construction of CICC aims to maintain superconductivity state by optimization of various parameters, i.e., thermal stability, ratio of normal conductor to superconductor material, mechanical strength, low hydraulic impedance, current density, magnetic field, etc. The cryogenic thermal stability of the CICC is of prime importance for the safe, stable and reliable operation of SC magnets. The prediction of thermal and hydraulic behaviour of CICC in large SC magnets is difficult due to the complex geometry, variation of fluid properties, various heat in-flux incidences over the long length of CICC and a complex heat transport phenomenon. A systematic review of the thermal and hydraulic studies of CICC has been presented in the paper highlighting the challenges and opportunities for further improvement in its design and performance. (author)

  12. Kinking and Torsion Can Significantly Improve the Efficiency of Valveless Pumping in Periodically Compressed Tubular Conduits. Implications for Understanding of the Form-Function Relationship of Embryonic Heart Tubes

    Directory of Open Access Journals (Sweden)

    Florian Hiermeier

    2017-11-01

    Full Text Available Valveless pumping phenomena (peristalsis, Liebau-effect can generate unidirectional fluid flow in periodically compressed tubular conduits. Early embryonic hearts are tubular conduits acting as valveless pumps. It is unclear whether such hearts work as peristaltic or Liebau-effect pumps. During the initial phase of its pumping activity, the originally straight embryonic heart is subjected to deforming forces that produce bending, twisting, kinking, and coiling. This deformation process is called cardiac looping. Its function is traditionally seen as generating a configuration needed for establishment of correct alignments of pulmonary and systemic flow pathways in the mature heart of lung-breathing vertebrates. This idea conflicts with the fact that cardiac looping occurs in all vertebrates, including gill-breathing fishes. We speculate that looping morphogenesis may improve the efficiency of valveless pumping. To test the physical plausibility of this hypothesis, we analyzed the pumping performance of a Liebau-effect pump in straight and looped (kinked configurations. Compared to the straight configuration, the looped configuration significantly improved the pumping performance of our pump. This shows that looping can improve the efficiency of valveless pumping driven by the Liebau-effect. Further studies are needed to clarify whether this finding may have implications for understanding of the form-function relationship of embryonic hearts.

  13. The 2006 Eruption of Raoul Volcano (Kermadecs): A Phreato-magmatic Event From a Hydrothermally-Sealed Volcanic Conduit System.

    Science.gov (United States)

    Christenson, B. W.; Reyes, A. G.; Werner, C. A.

    2006-12-01

    The March 17, 2006 eruption from Raoul volcano (Kermadec Islands, NZ), which tragically claimed the life of NZ Department of Conservation staff member Mark Kearney, is being interpreted as a magmatic-hydrothermal event triggered by shaking associated with regional earthquake swarm activity. Although the eruption released ca. 200 T of SO2, thus confirming its magmatic nature, it occurred without significant precursory volcanic seismicity, and without any of the precursory responses of the volcanic hydrothermal system which were observed prior to the last eruption in 1964. Raoul Island has a long and varied eruption history dating back > 1.4 ma, and has been hydrothermally active throughout historic time. Present day fumarolic and hotspring discharges within Raoul caldera point to the existence of a small but well established, mixed meteoric - seawater hydrothermal system within the volcano. Magmatic signatures are apparent in fumarolic gas discharges, but are heavily masked by their interaction with hydrothermal system fluids (eg. near complete scrubbing of sulphur and halogen gases from the boiling point fumarolic discharges). A diffuse degassing study conducted in 2004 revealed that ca. 80 T/d CO2 is passively discharged from the volcano, suggesting that ongoing (albeit low level) convective degassing of magma occurs at depth. Interestingly, vent locations from the 2006 eruption correspond to areas of relatively low CO2 discharge on the crater floor in 2004. This, in conjunction with the preliminary findings of abundant hydrothermal mineralisation (calcite, anhydrite, quartz) in eruption ejecta, suggests that the main volcanic conduits had become effectively sealed during the interval since the last eruption. Calcite-hosted fluid inclusions are CO2 clathrate-bearing, and have relatively low homogenisation temperatures (165-180 °C), suggesting that the seal environment was both gas-charged and shallowly seated (< 200 m). Shaking associated with the regional

  14. Minimizing coupling loss by selection of twist pitch lengths in multi-stage cable-in-conduit conductors

    International Nuclear Information System (INIS)

    Rolando, G; Nijhuis, A; Devred, A

    2014-01-01

    The numerical code JackPot-ACDC (van Lanen et al 2010 Cryogenics 50 139–48, van Lanen et al 2011 IEEE Trans. Appl. Supercond. 21 1926–9, van Lanen et al 2012 Supercond. Sci. Technol. 25 025012) allows fast parametric studies of the electro-magnetic performance of cable-in-conduit conductors (CICCs). In this paper the code is applied to the analysis of the relation between twist pitch length sequence and coupling loss in multi-stage ITER-type CICCs. The code shows that in the analysed conductors the coupling loss is at its minimum when the twist pitches of the successive cabling stages have a length ratio close to one. It is also predicted that by careful selection of the stage-to-stage twist pitch ratio, CICCs cabled according to long twist schemes in the initial stages can achieve lower coupling loss than conductors with shorter pitches. The result is validated by AC loss measurements performed on prototype conductors for the ITER Central Solenoid featuring different twist pitch sequences. (paper)

  15. Right atrium and superior vena cava pressure measurements in a novel animal model to study one and a half ventricle repair as compared to Fontan type procedure

    Directory of Open Access Journals (Sweden)

    Anil Bhattarai

    2017-01-01

    ventricle repair, as compared to Fontan type procedure.

  16. Enhanced peripheral nerve regeneration through asymmetrically porous nerve guide conduit with nerve growth factor gradient.

    Science.gov (United States)

    Oh, Se Heang; Kang, Jun Goo; Kim, Tae Ho; Namgung, Uk; Song, Kyu Sang; Jeon, Byeong Hwa; Lee, Jin Ho

    2018-01-01

    In this study, we fabricated a nerve guide conduit (NGC) with nerve growth factor (NGF) gradient along the longitudinal direction by rolling a porous polycaprolactone membrane with NGF concentration gradient. The NGF immobilized on the membrane was continuously released for up to 35 days, and the released amount of the NGF from the membrane gradually increased from the proximal to distal NGF ends, which may allow a neurotrophic factor gradient in the tubular NGC for a sufficient period. From the in vitro cell culture experiment, it was observed that the PC12 cells sense the NGF concentration gradient on the membrane for the cell proliferation and differentiation. From the in vivo animal experiment using a long gap (20 mm) sciatic nerve defect model of rats, the NGC with NGF concentration gradient allowed more rapid nerve regeneration through the NGC than the NGC itself and NGC immobilized with uniformly distributed NGF. The NGC with NGF concentration gradient seems to be a promising strategy for the peripheral nerve regeneration. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 52-64, 2018. © 2017 Wiley Periodicals, Inc.

  17. Time scales of foam stability in shallow conduits: Insights from analogue experiments

    Science.gov (United States)

    Spina, L.; Scheu, B.; Cimarelli, C.; Arciniega-Ceballos, A.; Dingwell, D. B.

    2016-10-01

    Volcanic systems can exhibit periodical trends in degassing activity, characterized by a wide range of time scales. Understanding the dynamics that control such periodic behavior can provide a picture of the processes occurring in the feeding system. Toward this end, we analyzed the periodicity of outgassing in a series of decompression experiments performed on analogue material (argon-saturated silicone oil plus glass beads/fibers) scaled to serve as models of basaltic magma. To define the effects of liquid viscosity and crystal content on the time scale of outgassing, we investigated both: (1) pure liquid systems, at differing viscosities (100 and 1000 Pa s), and (2) particle-bearing suspensions (diluted and semidiluted). The results indicate that under dynamic conditions (e.g., decompressive bubble growth and fluid ascent within the conduit), the periodicity of foam disruption may be up to several orders of magnitude less than estimates based on the analysis of static conditions. This difference in foam disruption time scale is inferred to result from the contribution of bubble shear and bubble growth to inter-bubble film thinning. The presence of particles in the semidiluted regime is further linked to shorter bubble bursting times, likely resulting from contributions of the presence of a solid network and coalescence processes to the relative increase in bubble breakup rates. Finally, it is argued that these experiments represent a good analogue of gas-piston activity (i.e., the periodical rise-and-fall of a basaltic lava lake surface), implying a dominant role for shallow foam accumulation as a source process for these phenomena.

  18. Computational modeling of lava domes using particle dynamics to investigate the effect of conduit flow mechanics on flow patterns

    Science.gov (United States)

    Husain, Taha Murtuza

    Large (1--4 x 106 m3) to major (> 4 x 106 m3) dome collapses for andesitic lava domes such as Soufriere Hills Volcano, Montserrat are observed for elevated magma discharge rates (6--13 m3/s). The gas rich magma pulses lead to pressure build up in the lava dome that result in structural failure of the over steepened canyon-like walls which may lead to rockfall or pyroclastic flow. This indicates that dome collapse intimately related to magma extrusion rate. Variation in magma extrusion rate for open-system magma chambers is observed to follow alternating periods of high and low activity. Periodic behavior of magma exhibits a rich diversity in the nature of its eruptive history due to variation in magma chamber size, total crystal content, linear crystal growth rate and magma replenishment rate. Distinguished patterns of growth were observed at different magma flow rates ranging from endogenous to exogenous dome growth for magma with varying strengths. Determining the key parameters that control the transition in flow pattern of the magma during its lava dome building eruption is the main focus. This dissertation examines the mechanical effects on the morphology of the evolving lava dome on the extrusion of magma from a central vent using a 2D particle dynamics model. The particle dynamics model is coupled with a conduit flow model that incorporates the kinetics of crystallization and rheological stiffening to investigate important mechanisms during lava dome building eruptions. Chapter I of this dissertation explores lava dome growth and failure mechanics using a two-dimensional particle-dynamics model. The model follows the evolution of fractured lava, with solidification driven by degassing induced crystallization of magma. The particle-dynamics model emulates the natural development of dome growth and rearrangement of the lava dome which is difficult in mesh-based analyses due to mesh entanglement effects. The deformable talus evolves naturally as a frictional

  19. Experimental and theoretical fracture mechanics applied to volcanic conduits and domes

    Science.gov (United States)

    Sammonds, P.; Matthews, C.; Kilburn, C.; Smith, R.; Tuffen, H.; Meredith, P.

    2008-12-01

    We present an integrated modelling and experimental approach to magma deformation and fracture, which we attempt to validate against field observations of seismicity. The importance of fracture processes in magma ascent dynamics and lava dome growth and collapse are apparent from the associated seismicity. Our laboratory experiments have shown that brittle fracture of magma can occur at high temperature and stress conditions prevalent in the shallow volcanic system. Here, we use a fracture mechanics approach to model seismicity preceding volcanic eruptions. Starting with the fracture mechanics concept of a crack in an elastic body, we model crack growth around the volcanic conduit through the processes of crack interactions, leading either to the propagation and linkage of cracks, or crack avoidance and the inhibition of crack propagation. The nature of that interaction is governed by the temperature and plasticity of the magma. We find that fracture mechanics rules can account for the style of seismicity preceding eruptions. We have derived the changes in seismic b-value predicted by the model and interpret these in terms of the style of fracturing, fluid flow and heat transport. We compare our model with results from our laboratory experiments where we have deformed lava at high temperatures under triaxial stresses. These experiments were conducted in dry and water saturated conditions at effective pressures up to 10 MPa, temperatures up to 1000°C and strain rates from 10-4 s-1 to 10-6 s-1. The behaviour of these magmas was largely brittle under these conditions. We monitored the acoustic emission emitted and calculate the change in micro-seismic b-value with deformation. These we find are in accord with volcano seismicity and our fracture mechanics model.

  20. Planning of vessel grafts for reconstructive surgery in congenital heart diseases

    Science.gov (United States)

    Rietdorf, U.; Riesenkampff, E.; Schwarz, T.; Kuehne, T.; Meinzer, H.-P.; Wolf, I.

    2010-02-01

    The Fontan operation is a surgical treatment for patients with severe congenital heart diseases, where a biventricular correction of the heart can't be achieved. In these cases, a uni-ventricular system is established. During the last step of surgery a tunnel segment is placed to connect the inferior caval vein directly with the pulmonary artery, bypassing the right atrium and ventricle. Thus, the existing ventricle works for the body circulation, while the venous blood is passively directed to the pulmonary arteries. Fontan tunnels can be placed intra- and extracardially. The location, length and shape of the tunnel must be planned accurately. Furthermore, if the tunnel is placed extracardially, it must be positioned between other anatomical structures without constraining them. We developed a software system to support planning of the tunnel location, shape, and size, making pre-operative preparation of the tunnel material possible. The system allows for interactive placement and adjustment of the tunnel, affords a three-dimensional visualization of the virtual Fontan tunnel inside the thorax, and provides a quantification of the length, circumferences and diameters of the tunnel segments. The visualization and quantification can be used to plan and prepare the tunnel material for surgery in order to reduce the intra-operative time and to improve the fit of the tunnel patch.

  1. Effect of Surface Pore Structure of Nerve Guide Conduit on Peripheral Nerve Regeneration

    Science.gov (United States)

    Oh, Se Heang; Kim, Jin Rae; Kwon, Gu Birm; Namgung, Uk; Song, Kyu Sang

    2013-01-01

    Polycaprolactone (PCL)/Pluronic F127 nerve guide conduits (NGCs) with different surface pore structures (nano-porous inner surface vs. micro-porous inner surface) but similar physical and chemical properties were fabricated by rolling the opposite side of asymmetrically porous PCL/F127 membranes. The effect of the pore structure on peripheral nerve regeneration through the NGCs was investigated using a sciatic nerve defect model of rats. The nerve fibers and tissues were shown to have regenerated along the longitudinal direction through the NGC with a nano-porous inner surface (Nanopore NGC), while they grew toward the porous wall of the NGC with a micro-porous inner surface (Micropore NGC) and, thus, their growth was restricted when compared with the Nanopore NGC, as investigated by immunohistochemical evaluations (by fluorescence microscopy with anti-neurofilament staining and Hoechst staining for growth pattern of nerve fibers), histological evaluations (by light microscopy with Meyer's modified trichrome staining and Toluidine blue staining and transmission electron microscopy for the regeneration of axon and myelin sheath), and FluoroGold retrograde tracing (for reconnection between proximal and distal stumps). The effect of nerve growth factor (NGF) immobilized on the pore surfaces of the NGCs on nerve regeneration was not so significant when compared with NGCs not containing immobilized NGF. The NGC system with different surface pore structures but the same chemical/physical properties seems to be a good tool that is used for elucidating the surface pore effect of NGCs on nerve regeneration. PMID:22871377

  2. The dynamics of slug trains in volcanic conduits: Evidence for expansion driven slug coalescence

    Science.gov (United States)

    Pering, T. D.; McGonigle, A. J. S.; James, M. R.; Capponi, A.; Lane, S. J.; Tamburello, G.; Aiuppa, A.

    2017-12-01

    Strombolian volcanism is a ubiquitous form of activity, driven by the ascent and bursting of bubbles of slug morphology. Whilst considerable attention has been devoted to understanding the behaviour of individual slugs in this regime, relatively little is known about how inter-slug interactions modify flow conditions. Recently, we reported on high temporal frequency strombolian activity on Etna, in which the larger erupted slug masses were followed by longer intervals before the following explosion than the smaller bursts (Pering et al., 2015). We hypothesised that this behaviour arose from the coalescence of ascending slugs causing a prolonged lag before arrival of the next distinct bubble. Here we consider the potential importance of inter-slug interactions for the dynamics of strombolian volcanism, by reporting on the first study into the behaviour of trains of ascending gas slugs, scaled to the expansion rates in volcanic conduits. This laboratory analogue study illustrates that slugs in trains rise faster than individual slugs, and can be associated with aspects of co-current flow. The work also highlights that coalescence and inter-slug interactions play an important role in modulating slug train behaviour. We also report, for the first time, on slug coalescence driven by vertical expansion of the trailing slug, a process which can occur, even where the leading slug base ascent velocity is greater than that of the trailing slug.

  3. Evasion of CO2 from streams - the dominant component of the carbon export through the aquatic conduit in a boreal landscape.

    Science.gov (United States)

    Wallin, Marcus B; Grabs, Thomas; Buffam, Ishi; Laudon, Hjalmar; Agren, Ånneli; Öquist, Mats G; Bishop, Kevin

    2013-03-01

    Evasion of gaseous carbon (C) from streams is often poorly quantified in landscape C budgets. Even though the potential importance of the capillary network of streams as C conduits across the land-water-atmosphere interfaces is sometimes mentioned, low-order streams are often left out of budget estimates due to being poorly characterized in terms of gas exchange and even areal surface coverage. We show that evasion of C is greater than all the total dissolved C (both organic and inorganic) exported downstream in the waters of a boreal landscape. In this study evasion of carbon dioxide (CO2 ) from running waters within a 67 km(2) boreal catchment was studied. During a 4 year period (2006-2009) 13 streams were sampled on 104 different occasions for dissolved inorganic carbon (DIC) and dissolved organic carbon (DOC). From a locally determined model of gas exchange properties, we estimated the daily CO2 evasion with a high-resolution (5 × 5 m) grid-based stream evasion model comprising the entire ~100 km stream network. Despite the low areal coverage of stream surface, the evasion of CO2 from the stream network constituted 53% (5.0 (±1.8) g C m(-2)  yr(-1) ) of the entire stream C flux (9.6 (±2.4) g C m(-2)  yr(-1) ) (lateral as DIC, DOC, and vertical as CO2 ). In addition, 72% of the total CO2 loss took place already in the first- and second-order streams. This study demonstrates the importance of including CO2 evasion from low-order boreal streams into landscape C budgets as it more than doubled the magnitude of the aquatic conduit for C from this landscape. Neglecting this term will consequently result in an overestimation of the terrestrial C sink strength in the boreal landscape. © 2012 Blackwell Publishing Ltd.

  4. Effect of Concomitant Birth Defects and Genetic Anomalies on Infant Mortality in Tetralogy of Fallot.

    Science.gov (United States)

    Jernigan, Eric G; Strassle, Paula D; Stebbins, Rebecca C; Meyer, Robert E; Nelson, Jennifer S

    2017-08-15

    A substantial proportion of infants born with tetralogy of Fallot (TOF) die in infancy. A better understanding of the heterogeneity associated with TOF, including extracardiac malformations and chromosomal anomalies is vital to stratifying risk and optimizing outcomes during infancy. Using the North Carolina Birth Defects Monitoring Program, infants diagnosed with TOF and born between 2003 and 2012 were included. Kaplan-Meier survival curves were used to estimate cumulative 1-year mortality, stratified by the presence of concomitant birth defects (BDs) and chromosomal anomalies. Multivariable logistic regression was used to estimate the direct effect of each concomitant BD, after adjusting for all others. A total of 496 infants with TOF were included, and 15% (n = 76) died. The number of concomitant BD systems was significantly associated with the risk of death at 1-year, p < 0.0001. Specifically, the risk of mortality was 8% among infants with TOF with or without additional cardiac defects, 16% among infants with TOF and 1 extracardiac BD system, 19% among infants with 2 extracardiac BD systems, and 39% among infants with ≥ 3 extracardiac BD systems. After adjustment, concomitant eye and gastrointestinal defects were significantly associated increased with 1-year mortality, odds ratio 2.83 (95% confidence interval, 1.08-7.32) and odds ratio 4.43 (95% confidence interval, 1.57, 12.45), respectively. Infants with trisomy 13 or trisomy 18 were also significantly more likely to die, p < 0.0001. Both concomitant BDs and genetic anomalies increase the risk of mortality among infants with TOF. Future studies are needed to identify the underlying genetic and socioeconomic risk factors for high-risk TOF infants. Birth Defects Research 109:1154-1165, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  5. Surgical Anatomy and Microvascular Surgical Technique Relevant to Experimental Renal Transplant in Rat Employing Aortic and Inferior Venacaval Conduits.

    Science.gov (United States)

    Shrestha, Badri Man; Haylor, John

    2017-11-15

    Rat models of renal transplant are used to investigate immunologic processes and responses to therapeutic agents before their translation into routine clinical practice. In this study, we have described details of rat surgical anatomy and our experiences with the microvascular surgical technique relevant to renal transplant by employing donor inferior vena cava and aortic conduits. For this study, 175 rats (151 Lewis and 24 Fisher) were used to establish the Fisher-Lewis rat model of chronic allograft injury at our institution. Anatomic and technical details were recorded during the period of training and establishment of the model. A final group of 12 transplanted rats were studied for an average duration of 51 weeks for the Lewis-to-Lewis isografts (5 rats) and 42 weeks for the Fisher-to-Lewis allografts (7 rats). Functional measurements and histology confirmed the diagnosis of chronic allograft injury. Mastering the anatomic details and microvascular surgical techniques can lead to the successful establishment of an experimental renal transplant model.

  6. Electromagnetic analysis of a superconducting transformer for high current characterization of cable in conduit conductors in background magnetic field

    Science.gov (United States)

    Wu, Xiangyang; Tan, Yunfei; Fang, Zhen; Jiang, Donghui; Chen, Zhiyou; Chen, Wenge; Kuang, Guangli

    2017-10-01

    A large cable-in-conduit-conductor (CICC) test facility has been designed and fabricated at the High Magnetic Field Laboratory of the Chinese Academy of Sciences (CHMFL) in order to meet the test requirement of the conductors which are applied to the future fusion reactor. The critical component of the test facility is an 80 kA superconducting transformer which consists of a multi-turn primary coil and a minor-turn secondary coil. As the current source of the conductor samples, the electromagnetic performance of the superconducting transformer determines the stability and safety of the test facility. In this paper, the key factors and parameters, which have much impact on the performance of the transformer, are analyzed in detail. The conceptual design and optimizing principles of the transformer are discussed. An Electromagnetic-Circuit coupled model built in ANSYS Multiphysics is successfully used to investigate the electromagnetic characterization of the transformer under the dynamic operation condition.

  7. Calcite veining and feeding conduits in a hydrothermal system: Insights from a natural section across the Pleistocene Gölemezli travertine depositional system (western Anatolia, Turkey)

    Science.gov (United States)

    Capezzuoli, Enrico; Ruggieri, Giovanni; Rimondi, Valentina; Brogi, Andrea; Liotta, Domenico; Alçiçek, Mehmet Cihat; Alçiçek, Hülya; Bülbül, Ali; Gandin, Anna; Meccheri, Marco; Shen, Chuan-Chou; Baykara, Mehmet Oruç

    2018-02-01

    Linking the architecture of structural conduits with the hydrothermal fluids migrating from the reservoir up to the surface is a key-factor in geothermal research. A contribution to this achievement derives from the study of spring-related travertine deposits, but although travertine depositional systems occur widely, their feeding conduits are only rarely exposed. The integrated study carried out in the geothermal Gölemezli area, nearby the well-known Pamukkale area (Denizli Basin, western Anatolia, Turkey), focused on onyx-like calcite veins (banded travertine) and bedded travertine well exposed in a natural cross-section allowing the reconstruction of the shallower part of a geothermal system. The onyx-like veins represent the thickest vein network (> 150 m) so far known. New field mapping and structural/kinematic analyses allowed to document a partially dismantled travertine complex (bedded travertine) formed by proximal fissure ridges and distal terraced/pools depositional systems. The banded calcite veins, WNW-trending and up to 12 m thick, developed within a > 200 m thick damaged rock volume produced by parallel fault zones. Th/U dating indicates a long lasting (middle-late Pleistocene) fluids circulation in a palaeo-geothermal system that, due to its location and chemical characteristics, can be considered the analogue of the nearby, still active, Pamukkale system. The isotopic characteristics of the calcite veins together with data from fluid inclusions analyses, allow the reconstruction of some properties (i.e. temperature, salinity and isotopic composition) and processes (i.e. temperature variation and intensity of degassing) that characterized the parent fluids and the relation between degassing intensity and specific microfabric of calcite crystals (elongated/microsparite-micrite bands), controlled by changes/fluctuations of the physico-chemical fluid characteristics.

  8. The Miracle Baby Grows Up: Hypoplastic Left Heart Syndrome in the Adult.

    Science.gov (United States)

    Lewis, Matthew; Rosenbaum, Marlon

    2017-08-01

    Hypoplastic left heart syndrome (HLHS) is characterized by underdevelopment of the mitral valve, left ventricle, and aorta and is ultimately palliated with a single-ventricle repair. Universally fatal in infancy prior to the advent of modern surgical techniques, the majority of HLHS patients will now reach adulthood. However, despite improvements in early survival, the HLHS population continues to face significant morbidity and early mortality. This review delineates common sources of patient morbidity and highlights areas in need of additional research for this growing segment of the adult congenital heart disease population. It has become increasingly clear that palliated adult single ventricle patients, like those with HLHS, face significant life-long morbidity from elevated systemic venous pressures as a consequence of the Fontan procedure. Downstream organ dysfunction secondary to elevated Fontan pressures has the potential to significantly impact long-term management decisions, including strategies of organ allocation. Because of the presence of a morphologic systemic right ventricle, HLHS patients may be at even higher risk than other adult patients with a Fontan. Because the adult HLHS population continues to grow, recognition of common sources of patient morbidity and mortality is becoming increasingly important. A coordinated effort between patients and providers is necessary to address the many remaining areas of clinical uncertainty to help ensure continued improvement in patient prognosis and quality of life.

  9. Nanopatterned acellular valve conduits drive the commitment of blood-derived multipotent cells

    Directory of Open Access Journals (Sweden)

    Di Liddo R

    2016-10-01

    Full Text Available Rosa Di Liddo,1,2 Paola Aguiari,3 Silvia Barbon,1,2 Thomas Bertalot,1 Amit Mandoli,1 Alessia Tasso,1 Sandra Schrenk,1 Laura Iop,3 Alessandro Gandaglia,3 Pier Paolo Parnigotto,2 Maria Teresa Conconi,1,2 Gino Gerosa31Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 2Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling ONLUS, 3Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy Abstract: Considerable progress has been made in recent years toward elucidating the correlation among nanoscale topography, mechanical properties, and biological behavior of cardiac valve substitutes. Porcine TriCol scaffolds are promising valve tissue engineering matrices with demonstrated self-repopulation potentiality. In order to define an in vitro model for investigating the influence of extracellular matrix signaling on the growth pattern of colonizing blood-derived cells, we cultured circulating multipotent cells (CMC on acellular aortic (AVL and pulmonary (PVL valve conduits prepared with TriCol method and under no-flow condition. Isolated by our group from Vietnamese pigs before heart valve prosthetic implantation, porcine CMC revealed high proliferative abilities, three-lineage differentiative potential, and distinct hematopoietic/endothelial and mesenchymal properties. Their interaction with valve extracellular matrix nanostructures boosted differential messenger RNA expression pattern and morphologic features on AVL compared to PVL, while promoting on both matrices the commitment to valvular and endothelial cell-like phenotypes. Based on their origin from peripheral blood, porcine CMC are hypothesized in vivo to exert a pivotal role to homeostatically replenish valve cells and contribute to hetero- or allograft colonization. Furthermore, due to their high responsivity to extracellular matrix nanostructure signaling, porcine CMC could be useful for a preliminary

  10. The effects of fenoldopam on coronary conduit blood flow after coronary artery bypass graft surgery.

    LENUS (Irish Health Repository)

    Halpenny, M

    2012-02-03

    OBJECTIVE: To quantify the effects of fenoldopam, 0.1 microg\\/kg\\/min, on left internal mammary artery (LIMA) and saphenous vein blood flow after coronary anastomosis. DESIGN: Prospective, randomized, double-blind, placebo-controlled trial. SETTING: University teaching hospital, single institution. PARTICIPANTS: Thirty-one American Society of Anesthesiologists III patients undergoing elective coronary revascularization. INTERVENTIONS: A perivascular ultrasonic flow probe (Linton Instrumentation, Norfolk, UK) was placed around the LIMA and saphenous vein graft after coronary anastomosis. MEASUREMENTS AND MAIN RESULTS: Immediately before and at 5-minute intervals for 15 minutes after starting the infusion, blood flow was measured in the LIMA and one saphenous vein graft using a transit time ultrasonic flow probe. Heart rate, blood pressure, and central venous pressure were documented at these time points. Administration of fenoldopam, 0.1 microg\\/kg\\/min, did not alter heart rate or blood pressure. A small, nonsignificant increase in LIMA blood flow occurred during the 15-minute study period (30 +\\/- 12 to 35 +\\/- 10 mL\\/min) in patients who received fenoldopam. No significant changes occurred in the placebo group. CONCLUSIONS: The findings indicate that fenoldopam, 0.1 microg\\/kg\\/min, did not influence coronary conduit blood flow to a clinically significant extent. The small increase in LIMA blood flow may be of greater importance in high-risk patients or in the prevention of coronary arterial spasm.

  11. Operação de Rastelli utilizando-se conduto valvulado de pericárdio bovino: experiência inicial Rastelli operation with bovine pericardium valved conduit: early experience

    Directory of Open Access Journals (Sweden)

    Carlos R Moraes

    1988-08-01

    of the great arteries, VSD and subpulmonic stenosis, one had pulmonary atresia, VSD and a previous Waterston shunt, and one had a type II truncus arteriosus. Two patients died of causes unrelated to the type of the conduit used. The valved conduit of preserved bovine pericardium is easy to handle due to its excellent flexibility, allowing perfect adaptability inside the pericardial sac. The absence of a supporting ring abolish gradient across the conduit and turbulence which are recognized causes of calcification.

  12. Shallow conduit processes of the 1991 Hekla eruption, Iceland

    Science.gov (United States)

    Gudnason, J.; Thordarson, T.; Houghton, B. F.

    2013-12-01

    On January 17, 1991 at 17:00 hrs, the 17th eruption of Hekla since 1104AD began. Lasting for almost two months, it produced 0.02 km3 of icelandite tephra and ~0.15km3 of icelandite lava. This eruption was the third of four eruptions since 1980 with a recurrence period of approximately 10 years, as opposed to a recurrence interval of c. 55 years for the eruptions in the period 1104AD to 1947AD. [1] The last four Hekla eruptions are typified by a 0.5-2 hour-long initial phase of subplinian intensity and discharge ranging from 2900-6700 m3/s [2]. In all 4 events the inital phase was followed by a sustained and relatively low-discharge(sorted tephra fall covering >20,000 km2. Here we examine the first phase of the Hekla 1991 eruption with focus on vesiculation and fragmentation processes in the shallow conduit and ash production. Samples of the tephra fall were collected on snow immediately after the initial phase at multiple sites providing a representative spatial coverage within the 0.1mm isopach [3]. This set was augmented by samples collected in 2012 to provide tighter coverage of near vent region. Grain size of all samples has been measured down to 1 micron. Density measurements have been conducted on 4 near-vent pumice samples (100 clasts each) and the pumice vesicle size distribution has been determined in a selected subset of clasts. The reconstructed whole deposit grain size distribution exhibits a unimodal, log-normal distribution peaking at -3 phi, typical of dry, magmatic fragmentation. Pumice densities range from 520-880 kg/m3 and exhibit a tight unimodal and log-normal distribution indicating a mean vesicularity of 77% to 79% for the magma erupted during the initial phase. Along with preliminary results for bubble number density and vesicle size distribution this implies a single late-stage homogeneous bubble nucleation and very uniform conditions of magma fragmentation during this short-lived initial phase of the Hekla 1991 eruption. 1. Gudmundsson, A

  13. Effect of current imbalance on stability of a cable-in-conduit conductor consisting of chrome-plated strands

    International Nuclear Information System (INIS)

    Koizumi, Norikiyo; Takahashi, Yoshikazu; Nishi, Masataka; Isono, Takaaki; Tsuji, Hiroshi; Ono, Michitaka; Hamajima, Takataro; Fujioka, Tsutomu.

    1997-02-01

    The effect of an unbalanced current distribution in a conductor consisting of chrome plated strands on stability was investigated using a cable-in-conduit conductor (CICC) consisting of 27 NbTi chrome-plated strands. In addition, the quench behavior when a non-uniform current distribution was produced in the conductor was studied from the experimental results. Moreover, impedance of the chrome-plated strands was measured using the sample conductor. The results show that the stability is determined by the largest strand current when it is sufficiently large otherwise by the transport current when it is not high enough. It was found that it took a long time to make the conductor quench from the onset of the normal transition of the strand carrying the large current. This is explained by the good diffusivity of the coolant temperature in the conductor's cross section. Since the ramp-rate limitation cannot probably take place if the coolant temperature is diffused well in the conductor's cross section, it is expected the ramp-rate limitation can be prevented using this effect. It is also shown that the chrome-plated strands come into contact with one another with uniform transverse conductance on the order of 10 3 S/m. (author)

  14. submitter Design and Manufacturing of a 45 kA at 10 T REBCO-CORC Cable-in-Conduit Conductor for Large-Scale Magnets

    CERN Document Server

    Mulder, Tim; Mentink, Matthias; Silva, Helder; van der Laan, Danko; Dhalle, Marc; ten Kate, Herman

    2016-01-01

    The European Organization for Nuclear Research (CERN) is developing high-current ReBCO-CORC strand-based cables for use in future large-scale detector magnets. A six-around-one, forced flow gas-cooled ReBCO-CORC cable-in-conduit conductor (CICC) is envisioned for application in magnets operating in the 20-40 K temperature range. A CICC, rated for 45 kA at 4.2 K and 10 T, is designed and in production. The CICC comprises a cable of six CORC strands helically wound around a tube. The cable has an expected current density of 105 $A/mm^2$ at 10 T/4.2 K, which corresponds to an overall current density of 53 $A/mm^2$. A cable current density of 110 $A/mm^2$ can be reached when increasing the temperature to 20 K and operating in a magnetic field of 5 T.

  15. [Whipple's disease endocarditis: report of 5 cases and review of the literature].

    Science.gov (United States)

    Aïouaz, H; Célard, M; Puget, M; Vandenesch, F; Mercusot, A; Fenollar, F; Delahaye, F; Obadia, J F; Tebib, J; Rousset, H

    2005-10-01

    Endocarditic lesions (infectious endocarditis) associated with Whipple's disease are exceptional. We report five cases from the cardiovascular and pneumologic hospital Louis Pradel in Lyon. We have collected all cases of Tropheryma whipplei endocarditis diagnosed between 1995 and 2004. Five men with a mean age of 53 years at time of diagnosis. The symptoms were essentially cardiovascular: murmur, embolism in 3 cases, and heart failure secondary to valvular insufficiency in 2 cases. The valvular involvement, double in 3 cases, was more often aortic. Vegetations were present in all patients and valvular destruction sometimes very important. A low grade fever was present in 4 cases, associated with weight loss in 2 cases. The only extra-cardiac symptoms were arthralgias or arthritis in all cases, considered in 3 patients as seronegative rheumatoid arthritis, B27+ spondylarthritis, and psoriasic arthritis. Their was no other clinical manifestations of Whipple's disease, particularly digestive, ocular, neurologic or adenopathy, and duodenal biopsies secondarily performed in 4 cases were non contributive. This differs from literature as an extra-cardiac location was identified in 11 out of 17 cases. The diagnosis was obtained by histology and PCR on the cardiac valves, as all the patients underwent surgery. The evolution was favourable with a prolonged antibiotic therapy. These report confirms the existence of endocarditic forms of the Whipple's disease, in which the single extra-cardiac manifestation is rheumatologic, and reminds us the usefulness of histology and PCR on the cardiac valves at the time of valvular surgery.

  16. The Medial Temporal Lobe – Conduit of Parallel Connectivity: A model for Attention, Memory, and Perception.

    Directory of Open Access Journals (Sweden)

    Brian B. Mozaffari

    2014-11-01

    Full Text Available Based on the notion that the brain is equipped with a hierarchical organization, which embodies environmental contingencies across many time scales, this paper suggests that the medial temporal lobe (MTL – located deep in the hierarchy – serves as a bridge connecting supra to infra – MTL levels. Bridging the upper and lower regions of the hierarchy provides a parallel architecture that optimizes information flow between upper and lower regions to aid attention, encoding, and processing of quick complex visual phenomenon. Bypassing intermediate hierarchy levels, information conveyed through the MTL ‘bridge’ allows upper levels to make educated predictions about the prevailing context and accordingly select lower representations to increase the efficiency of predictive coding throughout the hierarchy. This selection or activation/deactivation is associated with endogenous attention. In the event that these ‘bridge’ predictions are inaccurate, this architecture enables the rapid encoding of novel contingencies. A review of hierarchical models in relation to memory is provided along with a new theory, Medial-temporal-lobe Conduit for Parallel Connectivity (MCPC. In this scheme, consolidation is considered as a secondary process, occurring after a MTL-bridged connection, which eventually allows upper and lower levels to access each other directly. With repeated reactivations, as contingencies become consolidated, less MTL activity is predicted. Finally, MTL bridging may aid processing transient but structured perceptual events, by allowing communication between upper and lower levels without calling on intermediate levels of representation.

  17. Recurrent late cardiac tamponade following cardiac surgery : a deceiving and potentially lethal complication

    NARCIS (Netherlands)

    Harskamp, Ralf E.; Meuzelaar, Jacobus J.

    2010-01-01

    Background - Cardiac tamponade, characterized by inflow obstruction of the heart chambers by extracardiac compression, is a potentially lethal complication following cardiac surgery. Case report - We present a case of recurrent cardiac tamponade following valve surgery. At first presentation,

  18. Assessment of a magnet system combining the advantages of cable-in-conduit forced-flow and pool-boiling magnets

    International Nuclear Information System (INIS)

    Slack, D.; Hassenzahl, W.; Felker, B.; Chaplin, M.

    1993-01-01

    This paper presents an idea for a magnet system that could be used to advantage in tokamaks and other fusion engineering devices. Higher performance designs, specifically newer tokamaks such as those for the international Tokamak Engineering Reactor (ITER) and Tokamak Physics Experiment (TPX) use Cable in Conduit Conductor (CICC) forced flow coils to advantage to meet field and current density requirements. Pool boiling magnets lack structural integrity to resist high magnetic forces since helium cooling areas must surround each conductor. A second problem is that any leak can threaten the voltage standoff integrity of the magnet system. This is because a leak can result in low-pressure helium gas becoming trapped by limited conductance in the magnet bundle and low-pressure helium has poor dielectric strength. The system proposed here is basically a CICC system, with it's inherent advantages, but bathed in higher pressure supercritical helium to eliminate the leak and voltage break-down problems. Schemes to simplify helium coolant plumbing with the proposed system are discussed. A brief historical review of related magnet systems is included. The advantages and disadvantages of using higher pressure, supercritical helium in combination with solid electrical insulation in a CICC system are discussed. Related electrical data from some previous works are compiled and discussed

  19. Pulmonary hypertension in children with congenital heart disease (PAH-CHD, PPHVD-CHD). Expert consensus statement on the diagnosis and treatment of paediatric pulmonary hypertension. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and DGPK.

    Science.gov (United States)

    Kozlik-Feldmann, Rainer; Hansmann, Georg; Bonnet, Damien; Schranz, Dietmar; Apitz, Christian; Michel-Behnke, Ina

    2016-05-01

    Pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) is a complex disease that presents with a broad spectrum of morphological and haemodynamic findings of varying severity. Recently, the aspect of paediatric pulmonary hypertensive vascular disease (PPHVD) has been introduced to expand the understanding of the full spectrum of pulmonary hypertension and increased pulmonary vascular resistance. Evaluation and treatment of PAH-CHD/PPHVD-CHD can be divided into in different topics. First, defining criteria for operability and initiation of advanced therapies preoperatively and postoperatively is an unresolved issue. Second, management of Eisenmenger syndrome is still an important question, with recent evidence on the severity of the disease and a more rapidly progressive course than previously described. Third, the Fontan circulation with no subpulmonary ventricle requires a distinct discussion, definition and classification since even a mild rise in pulmonary vascular resistance may lead to the so-called failing Fontan situation. Patients with CHD and single-ventricle physiology (Fontan/total cavopulmonary anastomosis) require a particularly stepwise and individualised approach. This consensus statement is on the current evidence for the most accurate evaluation and treatment of increased pulmonary artery pressure and resistance, as well as ventricular dysfunction, in children with congenital heart defects, and provides according practical recommendations. To optimise preoperative and postoperative management in patients with PAH-CHD, diagnostic and treatment algorithms are provided. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. Speleogenesis, geometry, and topology of caves: A quantitative study of 3D karst conduits

    Science.gov (United States)

    Jouves, Johan; Viseur, Sophie; Arfib, Bruno; Baudement, Cécile; Camus, Hubert; Collon, Pauline; Guglielmi, Yves

    2017-12-01

    Karst systems are hierarchically spatially organized three-dimensional (3D) networks of conduits behaving as drains for groundwater flow. Recently, geostatistical approaches proposed to generate karst networks from data and parameters stemming from analogous observed karst features. Other studies have qualitatively highlighted relationships between speleogenetic processes and cave patterns. However, few studies have been performed to quantitatively define these relationships. This paper reports a quantitative study of cave geometries and topologies that takes the underlying speleogenetic processes into account. In order to study the spatial organization of caves, a 3D numerical database was built from 26 caves, corresponding to 621 km of cumulative cave passages representative of the variety of karst network patterns. The database includes 3D speleological surveys for which the speleogenetic context is known, allowing the polygenic karst networks to be divided into 48 monogenic cave samples and classified into four cave patterns: vadose branchwork (VB), water-table cave (WTC), looping cave (LC), and angular maze (AM). Eight morphometric cave descriptors were calculated, four geometrical parameters (width-height ratio, tortuosity, curvature, and vertical index) and four topological ones (degree of node connectivity, α and γ graph indices, and ramification index) respectively. The results were validated by statistical analyses (Kruskal-Wallis test and PCA). The VB patterns are clearly distinct from AM ones and from a third group including WTC and LC. A quantitative database of cave morphology characteristics is provided, depending on their speleogenetic processes. These characteristics can be used to constrain and/or validate 3D geostatistical simulations. This study shows how important it is to relate the geometry and connectivity of cave networks to recharge and flow processes. Conversely, the approach developed here provides proxies to estimate the evolution of

  1. Parental mental health moderates the efficacy of exercise training on health-related quality of life in adolescents with congenital heart disease

    NARCIS (Netherlands)

    Dulfer, Karolijn; Duppen, Nienke; van Dijk, Arie P. J.; Kuipers, Irene M.; van Domburg, Ron T.; Verhulst, Frank C.; van der Ende, Jan; Helbing, Willem A.; Utens, Elisabeth M. W. J.

    2015-01-01

    To evaluate the moderating influence of parental variables on changes in health-related quality of life (HRQoL) in adolescents with Tetralogy of Fallot (ToF) or a Fontan circulation after participation in standardized exercise training. A multicenter randomized controlled trail in which 56 patients,

  2. Aortic root surgery in Marfan syndrome: Bentall procedure with the composite mechanical valved conduit versus aortic valve reimplantation with Valsalva graft.

    Science.gov (United States)

    Nardi, Paolo; Pellegrino, Antonio; Versaci, Francesco; Mantione, Ludmilla; Polisca, Patrizio; Iorio, Fiore S; Chiariello, Luigi

    2010-09-01

    The aim of the study is to compare mid-term results of Bentall aortic root replacement with composite mechanical valved conduit and aortic valve reimplantation procedure using the Valsalva graft for the treatment of aortic root aneurysm in patients with Marfan syndrome. We retrospectively compared data of 23 patients (mean age 38 + or - 14 years) who had undergone the Bentall procedure (group B) to those of 24 patients (mean age 36 + or - 12 years) who had undergone aortic valve reimplantation (group R) during a 14-year period. Follow-up (mean duration 65 + or - 44 months) was 100% complete. There were no operative deaths in either group. In group B, as compared with group R, preoperative aortic insufficiency (3.2 + or - 1.1/4 vs. 1.7 + or - 1.4/4, P Marfan patients, the Bentall procedure is associated with excellent mid-term outcome. The reimplantation technique, adopted for less dilated aortas, provides similarly satisfactory results. The Valsalva graft seems, with time, to allow a stable aortic valve function.

  3. Recurrent late cardiac tamponade following cardiac surgery: a deceiving and potentially lethal complication

    NARCIS (Netherlands)

    Harskamp, Ralf E.; Meuzelaar, Jacobus J.

    2010-01-01

    Cardiac tamponade, characterized by inflow obstruction of the heart chambers by extracardiac compression, is a potentially lethal complication following cardiac surgery. We present a case of recurrent cardiac tamponade following valve surgery. At first presentation, diagnosis was delayed because of

  4. Magmas in motion: Degassing in volcanic conduits and fabrics of pyroclastic density current

    Science.gov (United States)

    Burgisser, Alain

    Volcanoes are caused by the transport of magma batches from the Earth's crust to the surface. These magmas in motion undergo drastic changes of rheologic properties during their journey to the surface and this work explores how these changes affect volcanic eruptions. The first part of this study is devoted to the dynamic aspects of degassing and permeability in magmas with high pressure, high temperature experiments on natural volcanic rocks. Degassing is measured by the influence of decompression rate on the growth of the bubbles present in the magma while permeability is deduced from the temporal evolution of these bubbles. The parameterization of our results in a numerical model of volcanic conduit flow show that previous models based on equilibrium degassing overestimate the acceleration and the decompression rate of the magma. Assessing permeability effects derived form our results show that the transition between explosive and effusive eruptions is a strong function of the magma initial ascent rate. The second part of this work is a unification of two end-members of pyroclastic currents (highly concentrated pyroclastic flows and dilute, turbulent pyroclastic surges) using theoretical scaling arguments based on multiphase physics. Starting from the dynamics of the particle interactions with a fundamental eddy, we consider the full spectrum of eddies generated within a turbulent current. We demonstrate that the presence of particles with various sizes induces a density stratification of the current, leading to its segregation into a basal concentrated part overlain by a dilute cloud. To verify our predictions on the interactions of such a segregated pyroclastic current with its surroundings (hills and sea), we studied the products of the 2050 BP caldera-forming eruption of Okmok Volcano (Alaska). This field study allowed us to reconstruct the eruptive sequence and to validate the main aspects of our theoretical model, such as the superposition of a dense and

  5. Use of modified Harvard step test for the evaluation of exercise tolerance in patients with a functional single ventricle after total cavopulmonary connection

    Directory of Open Access Journals (Sweden)

    A. A. Tupikina

    2016-01-01

    Full Text Available According to the literature, nearly one-third of patients with congenital heart diseases have signs of heart failure. Objective: to assess the possibility and results of using a modified Harvard step test (MHST for the evaluation of exercise tolerance in children with a functional single ventricle. The investigation covered 110 healthy children aged 6 to 16 years and 29 patients aged 3 to 16 years with a functional single ventricle after total cavopulmonary connection with an extracardiac conduit a year after surgery and fenestration closure. MHST using a complete protocol was carried out in 44,8% of the patients. In the other examinees, the reason for stopping the test was premature muscle weakness and dyspnea. This could establish Functional Class (FC II heart failure in 55,2% of the sick children. In the examinees, the MHST index (MHSTI characterizing exercise tolerance ranged from 22,4 to 111. The median MHSTI scores significantly differed between the groups of patients with FC I and II heart failure (p=0,021. Exercise tolerance was lower in 17,2% of the patients with a functional single ventricle; in the others it was average and above average (41,5 and 41,3%, respectively, which was suggestive of good hemodynamic adaptation in patients after surgery. The findings prove the safety and efficiency of using the above test in the evaluation of exercise tolerance in children 3 years of age and older.

  6. Fibulin-4 is essential for maintaining arterial wall integrity in conduit but not muscular arteries.

    Science.gov (United States)

    Halabi, Carmen M; Broekelmann, Thomas J; Lin, Michelle; Lee, Vivian S; Chu, Mon-Li; Mecham, Robert P

    2017-05-01

    Homozygous or compound heterozygous mutations in fibulin-4 ( FBLN4 ) lead to autosomal recessive cutis laxa type 1B (ARCL1B), a multisystem disorder characterized by significant cardiovascular abnormalities, including abnormal elastin assembly, arterial tortuosity, and aortic aneurysms. We sought to determine the consequences of a human disease-causing mutation in FBLN4 (E57K) on the cardiovascular system and vascular elastic fibers in a mouse model of ARCL1B. Fbln4 E57K/E57K mice were hypertensive and developed arterial elongation, tortuosity, and ascending aortic aneurysms. Smooth muscle cell organization within the arterial wall of large conducting vessels was abnormal, and elastic fibers were fragmented and had a moth-eaten appearance. In contrast, vessel wall structure and elastic fiber integrity were normal in resistance/muscular arteries (renal, mesenteric, and saphenous). Elastin cross-linking and total elastin content were unchanged in large or small arteries, whereas elastic fiber architecture was abnormal in large vessels. While the E57K mutation did not affect Fbln4 mRNA levels, FBLN4 protein was lower in the ascending aorta of mutant animals compared to wild-type arteries but equivalent in mesenteric arteries. We found a differential role of FBLN4 in elastic fiber assembly, where it functions mainly in large conduit arteries. These results suggest that elastin assembly has different requirements depending on vessel type. Normal levels of elastin cross-links in mutant tissue call into question FBLN4's suggested role in mediating lysyl oxidase-elastin interactions. Future studies investigating tissue-specific elastic fiber assembly may lead to novel therapeutic interventions for ARCL1B and other disorders of elastic fiber assembly.

  7. Challenges of univentricular physiology in heterotaxy.

    Science.gov (United States)

    Jacobs, Marshall L; Mavroudis, Constantine

    2011-04-01

    Patients with heterotaxy syndrome exhibit an extensive constellation of congenital cardiac malformations, making these patients a challenging group to manage surgically. Many of these patients' hearts do not lend themselves to separation of the pulmonary and systemic circulations except by some modification of the Fontan procedure. Palliative procedures early in life are directed at creating a satisfactory balance of pulmonary and systemic blood flow and at the same time ensuring unobstructed pulmonary venous return. Early conversion from parallel pulmonary and systemic circulations to superior cavopulmonary connections is important, to reduce volume work of the systemic ventricle. Heterotaxy patients are generally considered a high-risk population with respect to eventual Fontan procedure. It is important to appreciate the unique and variable anatomy of the sinus node and conduction system and the potential for occult pulmonary venous obstruction, atrioventricular valve regurgitation, and recurrent cyanosis, which may be related to the development of pulmonary arteriovenous malformations.

  8. Spatial resolution of transport parameters in a subtropical karst conduit system during dry and wet seasons

    Science.gov (United States)

    Ender, Anna; Goeppert, Nadine; Goldscheider, Nico

    2018-04-01

    Karst aquifers are characterized by a high degree of hydrologic variability and spatial heterogeneity of transport parameters. Tracer tests allow the quantification of these parameters, but conventional point-to-point experiments fail to capture spatiotemporal variations of flow and transport. The goal of this study was to elucidate the spatial distribution of transport parameters in a karst conduit system at different flow conditions. Therefore, six tracer tests were conducted in an active and accessible cave system in Vietnam during dry and wet seasons. Injections and monitoring were done at five sites along the flow system: a swallow hole, two sites inside the cave, and two springs draining the system. Breakthrough curves (BTCs) were modeled with CXTFIT software using the one-dimensional advection-dispersion model and the two-region nonequilibrium model. In order to obtain transport parameters in the individual sections of the system, a multi-pulse injection approach was used, which was realized by using the BTCs from one section as input functions for the next section. Major findings include: (1) In the entire system, mean flow velocities increase from 183 to 1,043 m/h with increasing discharge, while (2) the proportion of immobile fluid regions decrease; (3) the lowest dispersivity was found at intermediate discharge; (4) in the individual cave sections, flow velocities decrease along the flow direction, related to decreasing gradients, while (5) dispersivity is highest in the middle section of the cave. The obtained results provide a valuable basis for the development of an adapted water management strategy for a projected water-supply system.

  9. The value of FDG-PET/CT in the diagnostic work-up of extra cardiac infectious manifestations in infectious endocarditis

    DEFF Research Database (Denmark)

    Ozcan, C; Asmar, A; Gill, S

    2013-01-01

    Infectious endocarditis (IE) is a serious condition with a high morbidity and mortality. The optimal management of IE depends not only on correct antibiotic therapy and surgery when needed, but involves identification of the portal of entry and detection of extracardiac infectious manifestations...

  10. Performance of cable-in-conduit conductors in ITER [International Thermonuclear Experimental Reactor] toroidal field coils with varying heat loads

    International Nuclear Information System (INIS)

    Kerns, J.A.; Wong, R.L.

    1989-01-01

    The toroidal field (TF) coils in the International Thermonuclear Experimental Reactor (ITER) will operate with varying heat loads generated by ac losses and nuclear heating. The total heat load is estimated to be 2 kW per TF coil under normal operation and can be higher for different operating scenarios. Ac losses are caused by ramping the poloidal field (PF) for plasma initiation, burn, and shutdown; nuclear heating results from neutrons that penetrate into the coil past the shield. Present methods to reduce or eliminate these losses lead to larger and more expensive machines, which are unacceptable with today's budget constraints. A suitable solution is to design superconductors that operate with high heat loads. The cable-in-conduit conductor (CICC) can operate with high heat loads. One CICC design is analyzed for its thermal performance using two computer codes developed at LLNL. One code calculates the steady state flow conditions along the flow path, while the other calculates the transient conditions in the flow. We have used these codes to analyze the superconductor performance during the burn phase of the ITER plasma. The results of these analyses give insight to the choice of flow rate on superconductor performance. 4 refs., 5 figs

  11. Comparaison des conduites discursives de mères et d’enseignants dans la co-construction de récits avec des enfants

    Directory of Open Access Journals (Sweden)

    Vinel Elise

    2014-07-01

    Full Text Available Cette communication s’intéresse aux conduites discursives produites par des mères et des enseignants au cours de deux lectures conjointes d’album avec des enfants. Elle s’inscrit dans une approche dialogique et interactionniste du langage. Dans la suite des travaux de Florin (1991, Grossmann (1996, analysant les styles d’interaction des enseignants et de réception des enfants en cours de lecture, mais aussi de ceux de Vygotski (1984, Bruner (1994 ou encore Salazar Orvig et De Weck (2014, nous cherchons à comprendre de quelles manières les adultes racontent des histoires aux enfants et à quelles expériences spécifiques des récits ceux-ci sont confrontés. Dix enfants âgés de 3 à 5 ans ont été filmés au cours de ces séances de lectures d’albums, sans texte et avec texte, avec un de leur parent à leur domicile et avec des pairs et des enseignants à l’école.

  12. Brain Magnetic Resonance Immediately Prior To Surgery In Single Ventricles and Surgical Postponement

    Science.gov (United States)

    Fogel, Mark A.; Pawlowski, Tom; Schwab, Peter J.; Nicolson, Susan C.; Montenegro, Lisa M.; Berenstein, Laura Diaz; Spray, Thomas L.; Gaynor, J William; Fuller, Stephanie; Keller, Marc S.; Harris, Matthew A.; Whitehead, Kevin K.; Vossough, Arastoo; Licht, Daniel J.

    2014-01-01

    Background Single ventricle patients undergoing surgical reconstruction experience a high rate of brain injury; incidental findings on pre-operative brain scans may result in safety considerations involving hemorrhage extension during cardiopulmonary bypass that result in surgical postponement. Methods Single ventricle patients were studied with brain scans immediately preoperatively as part of a National Institute of Health study and were reviewed by neuroradiology immediately prior to cardiopulmonary bypass. Results One hundred and thirty four consecutive subjects recruited into the project were studied: 33 prior to stage I (3.7±1.8 days), 34 prior to bidirectional Glenn (5.8±3.5 months) and 67 prior to Fontan (3.3±1.1 years). Six (4.5%) surgeries were postponed because of concerning imaging findings on brain MRI; 2 prior to stage I, 3 prior to bidirectional Glenn and 1 prior to Fontan. Five were due to unexpected incidental findings of acute intracranial hemorrhage and one due to diffuse cerebellar cytotoxic edema; none who proceeded to surgery had these lesions. Prematurity as well as genetic syndromes were not present in any with postponed surgery. Four of 4 prior to bidirectional Glenn/Fontan with surgical delays had hypoplastic left heart syndrome compared with 44/97 who did not (P=0.048). After observation and follow up, all eventually had successful surgeries with bypass. Conclusion Preoperative brain MRI performed in children with single ventricles disclosed injuries in 4.5% leading to surgical delay; hemorrhagic lesions were most common and raised concerns for extension during surgery. The true risk of progression and need for delay of surgery due to heparinization associated with these lesions remains uncertain. PMID:25149046

  13. Troponinforhøjelse--differentialdiagnostiske overvejelser samt prognostisk betydning

    DEFF Research Database (Denmark)

    Jensen, Jesper Khedri; Mickley, Hans

    2003-01-01

    It has become increasingly evident that elevation of troponins can be demonstrated in other diseases than acute myocardial infarction. In this review we wanted to assess the prevalence and the clinical importance of troponin elevations in patients with mainly extra-cardiac organ manifestations. O...

  14. Quantitative Analysis of Karst Conduit Structure Parameters and Hydraulic Parameters Based on Tracer Test

    Science.gov (United States)

    Qiang, Z.; Zhiqiang, Z.; Xu, M.; Jinyu, S.; Jihong, Q.

    2017-12-01

    The Old Town of Lijiang is famous as the world cultural heritage since 1997, while characterized by its ancient buildings and natural scenery, water is the soul of the town. Around Heilongtan Springs, there are a large quantity of springs at the Old Town of Lijiang , which is an important part of the World Cultural Heritage. Heilongtan Springs is 2420m above the sea level, the annual variation of the flow rate varies greatly (0 8042 x 104 m3 / year). Recharge area Jiuzihai depressions is 6km long, 3km wide and 2800m above sea level, as main karst water recharge area karst funnel and the sink hole are developing on this planation surface, in the research area medium to thick layers of limestone made up Beiya formation (T2b) of Triassic system distributed widely, karst is strongly developed and the fissure caves water occurrence. In order to exploring the application of tracer test in karst hydrogeology, a tracer test was conducted from Jiuzihai depressions to Ganze Spring. Based on the hydrogeological conditions in the study area, tracer test was used for analysis of groundwater connectivity and flow field characteristics, quantitative analysis of Tracer Breakthrough Curves (BTC) with code Qtracer2. The results demonstated that there are hydraulic connection between Jiuzihai depressions with Ganze Spring, and there are other karst conduits in this area. The longitudinal dispersivity coefficient is 0.24 m2/s, longitudinal dispersivity is 12.06m, flow-channel volume is 3.08×104 m3, flow-channel surface area is 3.27×107m2, mean diameter is 1.42m, Reynolds number is 25187, Froude number is 0.0061, respectively. The groundwater in this area is in a slow turbulent state. The results are of great significance to understand the law of groundwater migration, establish groundwater quality prediction model and exploit karst water resources effectively.

  15. 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.

  16. Outcome for Fetuses with Prenatally Detected Congenital Heart Disease and Cardiac Arrhythmias in Taiwan

    Directory of Open Access Journals (Sweden)

    Sheng-Mou Hsiao

    2007-01-01

    Conclusion: Outcome for fetuses with prenatally detected CHD remains poor, with the prognosis negatively influenced by the presence of complex heart defects as well as extracardiac and chromosomal anomalies. However, prognosis is good for fetuses with cardiac arrhythmia, except with long QT syndrome or hydrops fetalis.

  17. Formation of obsidian pyroclasts by sintering of ash particles in the volcanic conduit

    Science.gov (United States)

    Gardner, James E.; Llewellin, Edward W.; Watkins, James M.; Befus, Kenneth S.

    2017-02-01

    The ranges in intensity and style of volcanic eruptions, from highly explosive Plinian eruptions to quiescent lava extrusions, depend on the style and efficiency of gas loss from ascending magma. Obsidian pyroclasts - small, glassy pieces of quenched magma found in some volcanic tephra beds - may preserve valuable information about magma degassing in their vesicle textures and volatile contents. Accurate interpretation of their textures and volatiles, however, requires understanding the mechanism of formation of the pyroclasts. Obsidian pyroclasts from the ca. 1325-1350 C.E. North Mono eruption of Mono Craters (CA, USA) were analyzed and found to have H2O and CO2 contents indicating that they were formed at pressures in the approximate range of 3-40 MPa. Many also contain domains with differing vesicle textures, separated by boundaries containing xenocrystic material, indicating that they are composed of smaller fragments that have sutured together. More than half of the pyroclasts analyzed contained small (∼10 μm), highly distorted vesicles, with multi-cuspate morphology, interpreted as the remnants of interstitial gas trapped amongst sintered fragments of melt/glass. Rounded vesicles are also common and are interpreted to result from surface tension-driven relaxation of the distorted vesicles. Calculated timescales of sintering and relaxation are consistent with timescales for pyroclast formation indicated by H2O re-equilibration within the heterogeneous pyroclasts. This sintering model for the origin of obsidian pyroclasts is further supported by the observation that spherical vesicles are found mainly in H2O-rich pyroclasts, and distorted vesicles mainly in H2O-poor pyroclasts. We conclude that obsidian pyroclasts generated during the North Mono eruption were formed by cycles of fragmentation, sintering/suturing, and relaxation, over a very wide range of depths within the conduit; we find no evidence to support pumice (foam) collapse as the formation

  18. Perioperative management of a patient with Dandy Walker malformation with tetralogy of Fallot undergoing total correction and fresh homologous pericardial pulmonary valve conduit implantation: Report of a rare case

    Directory of Open Access Journals (Sweden)

    Vishnu Datt

    2015-01-01

    Full Text Available Perioperative management of a patient with Dandy-Walker malformation (DWM with tetralogy of Fallot (TOF, patent ductus arteriosus, and pulmonary artery stenosis is a great challenge to the anesthesiologist. Anesthetic management in such patients can trigger tet spells that might rapidly increase intracranial pressure (ICP, conning and even death. The increase in ICP can precipitate tet spells and further brain hypoxia. To avoid an increase in ICP during TOF corrective surgery ventriculo-peritoneal (VP shunt should be performed before cardiac surgery. We present the first case report of a 11-month-old male baby afflicted with DWM and TOF who underwent successful TOF total corrective surgery and fresh autologous pericardial pulmonary valve conduit implantation under cardiopulmonary bypass after 1 week of VP shunt insertion.

  19. Cardiac pathologies incidentally detected with non-gated chest CT; Inzidentelle Pathologien des Herzens im Thorax-CT

    Energy Technology Data Exchange (ETDEWEB)

    Scherer, Axel; Kroepil, P.; Lanzman, R.S.; Moedder, U. [Inst. fuer Radiologie, Universitaetsklinikum Duesseldorf, Heinrich-Heine-Univ. (Germany); Choy, G.; Abbara, S. [Cardiovascular Imaging Section, Massachusetts General Hospital, Harvard Medical School (United States)

    2009-12-15

    Cardiac imaging using electrocardiogram-gated multi-detector computed tomography (MDCT) permits noninvasive diagnosis of congenital and acquired cardiac pathologies and has thus become increasingly important in the last years. Several studies investigated the incidence and relevance of incidental extracardiac structures within the lungs, mediastinum, chest wall, and abdomen with gated coronary CT. This resulted in the general acceptance of the review of extracardiac structures as a routine component of coronary CT interpretation. On the other hand radiologists tend to neglect pericardial and cardiac pathologies in non-gated chest CT, which is primarily performed for the evaluation of the respiratory system or for tumor staging. Since the introduction of multi-detector spiral CT technology, the incidental detection of cardiac and pericardial findings has become possible using non-gated chest CT. This article reviews the imaging appearances and differential diagnostic considerations of incidental cardiac entities that may be encountered in non-gated chest CT. (orig.)

  20. Reimplantation valve-sparing aortic root replacement in Marfan syndrome using the Valsalva conduit: an intercontinental multicenter study.

    Science.gov (United States)

    Settepani, Fabrizio; Szeto, Wilson Y; Pacini, Davide; De Paulis, Ruggero; Chiariello, Luigi; Di Bartolomeo, Roberto; Gallotti, Roberto; Bavaria, Joseph E

    2007-02-01

    Introduced by DePaulis in 2000, the Gelweave Valsalva graft (Sulzer Vascutek, Refrewshire, Scotland) is a modified Dacron conduit (DuPont, Wilmington, DE), with prefashioned sinuses of Valsalva. The aim of this study was to evaluate the mid-term results of the reimplantation valve-sparing aortic root replacement using the Gelweave Valsalva prosthesis in Marfan syndrome patients. A retrospective review was performed of 35 patients with Marfan syndrome in four centers who underwent the reimplantation valve-sparing aortic root replacement using the Gelweave Valsalva prosthesis. The patients were predominantly men, with a mean age of 36.5 +/- 12.6 years (range, 14 to 62 years). Two patients presented with acute type A dissections and underwent emergent operations. Elective hemiarch reconstruction using hypothermic circulatory arrest was required in 11 patients. Aortic valve cusp repair was performed in 2 patients. There were no operative or hospital deaths, and no patients died during follow-up. The mean follow-up was 19 months (range, 1 to 60 months). Significant (>2+) aortic insufficiency (AI), requiring aortic valve replacement, developed in 3 patients during follow-up that requiring aortic valve replacement. The 5-year freedom from reoperation owing to structural valve deterioration was 88.9% +/- 8.1%. There were no episodes of clinically significant thromboembolism. Reimplantation valve-sparing aortic root replacement with the Gelweave Valsalva prosthesis in Marfan patients provides satisfactory mid-term results, thus encouraging further use of this type of repair. However, long-term results are needed in order to define the durability of this technique.

  1. Multi-ported, internally recuperated burners for direct flame impingement heating applications

    Energy Technology Data Exchange (ETDEWEB)

    Abbasi, Hamid A. (Naperville, IL); Kurek, Harry (Dyer, IN); Chudnovsky, Yaroslav (Skokie, IL); Lisienko, Vladimir G. (Ekaterinburg, RU); Malikov, German K. (Ekaterinburg, RU)

    2010-08-03

    A direct flame impingement method and apparatus employing at least one multi-ported, internally recuperated burner. The burner includes an innermost coaxial conduit having a first fluid inlet end and a first fluid outlet end, an outermost coaxial conduit disposed around the innermost coaxial conduit and having a combustion products outlet end proximate the first fluid inlet end of the innermost coaxial conduit and a combustion products inlet end proximate the first fluid outlet end of the innermost coaxial conduit, and a coaxial intermediate conduit disposed between the innermost coaxial conduit and the outermost coaxial conduit, whereby a second fluid annular region is formed between the innermost coaxial conduit and the intermediate coaxial conduit and a combustion products annular region is formed between the intermediate coaxial conduit and the outermost coaxial conduit. The intermediate coaxial conduit has a second fluid inlet end proximate the first fluid inlet end of the innermost coaxial conduit and a second fluid outlet end proximate the combustion products inlet end of the outermost coaxial conduit.

  2. Author Details

    African Journals Online (AJOL)

    Ekure, E.N. Vol 28, No 1 (2009) - Articles Congenital Heart Diseases associated with Identified Syndromes and Other Extra-Cardiac Congenital Malformations in Children in Lagos Abstract PDF · Vol 28, No 1 (2009) - Articles Marfan Syndrome: A Study of a Nigerian Family and Review of Current Cardiovascular ...

  3. Identification of TBX5 mutations in a series of 94 patients with Tetralogy of Fallot

    NARCIS (Netherlands)

    Baban, Anwar; Postma, Alex Vincent; Marini, Monica; Trocchio, Gianluca; Santilli, Antonella; Pelegrini, Monica; Sirleto, Pietro; Lerone, Margherita; Albanese, Sonia Bernadette; Barnett, Phil; Boogerd, Cornelis Job; Dallapiccola, Bruno; Digilio, Maria Cristina; Ravazzolo, Roberto; Pongiglione, Giacomo

    2014-01-01

    Tetralogy of Fallot (TOF) (OMIM #187500) is the most frequent conotruncal congenital heart defect (CHD) with a range of intra- and extracardiac phenotypes. TBX5 is a transcription factor with well-defined roles in heart and forelimb development, and mutations in TBX5 are associated with Holt-Oram

  4. Successful performances of the EU-AltTF sample, a large size Nb{sub 3}Sn cable-in-conduit conductor with rectangular geometry

    Energy Technology Data Exchange (ETDEWEB)

    Della Corte, A; Corato, V; Di Zenobio, A; Fiamozzi Zignani, C; Muzzi, L; Polli, G M; Reccia, L; Turtu, S [Associazione EURATOM-ENEA sulla Fusione, Via E Fermi 45, 00044 Frascati, Rome (Italy); Bruzzone, P [EPFL-CRPP, Fusion Technology, 5232 Villigen PSI (Switzerland); Salpietro, E [European Fusion Development Agreement, Close Support Unit, Boltzmannstrasse 2, 85748 Garching (Germany); Vostner, A, E-mail: antonio.dellacorte@enea.i [Fusion for Energy, c/ Josep Pla 2, Edificio B3, 08019 Barcelona (Spain)

    2010-04-15

    One of the design features which yet offers interesting margins for performance optimization of cable-in-conduit conductors (CICCs), is their geometry. For relatively small size Nb{sub 3}Sn CICCs, operating at high electromagnetic pressure, such as those for the EDIPO project, it has been experimentally shown that a design based on a rectangular layout with higher aspect ratio leads to the best performance, especially in terms of degradation with electromagnetic loads. To extend this analysis to larger size Nb{sub 3}Sn CICCs, we manufactured and tested, in the SULTAN facility, an ITER toroidal field (TF) cable, inserted into a thick stainless steel tube and then compacted to a high aspect ratio rectangular shape. Besides establishing a new record in Nb{sub 3}Sn CICC performances for ITER TF type cables, the very good test results confirmed that the conductor properties improve not only by lowering the void fraction and raising the cable twist pitch, as already shown during the ITER TFPRO and the EDIPO test campaigns, but also by the proper optimization of the conductor shape with respect to the electromagnetic force distribution. The sample manufacturing steps, along with the main test results, are presented here.

  5. Moderate persistent asthma and dextrocardia

    International Nuclear Information System (INIS)

    Guimaraes, Maira de Lucca; Ferreira, Marcela Goncalves; Beraldo, Claudinei Leoncio; Magalhaes, Eugenio Fernandes de; Beraldo, Bruno Leoncio de Moraes

    2011-01-01

    Dextrocardia is a rare disorder that develops specially in adults. It is frequently associated with situs inversus, not necessarily implying cardiac and/or extracardiac malformations. The case herein reported is uncommon, because it is a case of dextrocardia situs solitus (the second most common) that does not present such malformations. (author)

  6. Moderate persistent asthma and dextrocardia; Asma persistente moderada e dextrocardia

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Maira de Lucca; Ferreira, Marcela Goncalves [Medicina da Universidade do Vale do Sapucai (UNIVAS), Pouso Alegre, MG (Brazil); Beraldo, Claudinei Leoncio; Magalhaes, Eugenio Fernandes de [Pneumologia da Universidade do Vale do Sapucai (UNIVAS), Pouso Alegre, MG (Brazil); Beraldo, Bruno Leoncio de Moraes [Clinica Medica do Hospital das Clinicas Samuel Libanio, Pouso Alegre, MG (Brazil)

    2011-10-15

    Dextrocardia is a rare disorder that develops specially in adults. It is frequently associated with situs inversus, not necessarily implying cardiac and/or extracardiac malformations. The case herein reported is uncommon, because it is a case of dextrocardia situs solitus (the second most common) that does not present such malformations. (author)

  7. Magma dynamics within a basaltic conduit revealed by textural and compositional features of erupted ash: the December 2015 Mt. Etna paroxysms.

    Science.gov (United States)

    Pompilio, Massimo; Bertagnini, Antonella; Del Carlo, Paola; Di Roberto, Alessio

    2017-07-06

    In December 2015, four violent explosive episodes from Mt. Etna's oldest summit crater, the Voragine, produced eruptive columns extending up to 15 km a.s.l. and significant fallout of tephra up to a hundred km from the vent. A combined textural and compositional study was carried out on pyroclasts from three of the four tephra deposits sampled on the volcano at 6 to 14 km from the crater. Ash fractions (Φ = 1-2) were investigated because these grain sizes preserve the magma properties unmodified by post- emplacement processes. Results were used to identify processes occurring in the conduit during each single paroxysm and to understand how they evolve throughout the eruptive period. Results indicate that the magmatic column is strongly heterogeneous, mainly with respect to microlite, vescicle content and melt composition. During each episode, the heterogeneities can develop at time scales as short as a few tens of hours, and differences between distinct episodes indicate that the time scale for completely refilling the system and renewing magma is in the same order of magnitude. Our data also confirm that the number and shape of microlites, together with melt composition, have a strong control on rheological properties and fragmentation style.

  8. Dependence of the ac loss on the aspect ratio in a cable in conduit conductor

    International Nuclear Information System (INIS)

    Cau, F; Bruzzone, P

    2010-01-01

    The coupling current loss in rectangular superconducting cables is strictly dependent on their aspect ratio, which has an impact on the area linked by the field variation and consequently on the currents induced between strands. The relation between the ac loss and aspect ratio is studied with reference to the testing of three short cable in conduit conductor (CICC) samples at the SULTAN test facility. The first conductor is a 25 kA NbTi cable for the JT60-SA tokamak; the second is a 20 kA Nb 3 Sn cable for the HZB hybrid magnet. The last CICC is a 68 kA Nb 3 Sn cable with layout similar to that of the ITER toroidal field (TF) conductor (called the 'European toroidal field (EUTF) alternate'). All the samples are assembled with two conductor sections differing only in their orientation with respect to the external variable field. In the first and third samples, the cable of one leg is rotated by 90 0 , while in the HZB sample it is rotated by 45 0 with respect to the other leg. The ac loss is measured at the SULTAN test facility using a gas flow calorimetric method. A sample length of 39 cm is exposed to a sinusoidal field with an amplitude of ± 0.3 or ± 0.2 T (depending on the superconductor) and frequency variable in the range 0.1-0.8 Hz. A background field of 2 T perpendicular both to the sinusoidal field and to the sample axis is also applied. The ac loss is assessed by measuring the variation of the He enthalpy, assuming the metal enthalpy to be negligible. The loss curve for both legs is discussed in terms of the respective aspect ratios and the results, including data from former test campaigns, are compared with the aim of finding an analytical relation between the loss and the conductor dimensions.

  9. Chemistry, mineralogy and alteration intensity of hydrothermal altered Mt Unzen conduit rocks (Shimabara/Japan)

    Science.gov (United States)

    Hess, Kai-Uwe; Yilmaz, Tim; Gilg, H. Albert; Janots, Emilie; Mayer, Klaus; Nakada, Setsuya; Dingwell, Donald

    2017-04-01

    Investigations were carried out on hydrothermally altered coherent dacitic dykes samples from (USDP-4) drill core at Mt Unzen stratovolcano (Shimabara/Japan). XRF, XRD, EMPA, C-O-isotope, hot-cathode CL and SEM analysis led to insights concerning chemistry, mineralogy, and intensity and type of alteration as well as the origin of carbonate-precipitating fluids. Additionally a textural characterization of the occurring replacement features in the volcanic conduit rocks was performed. The occurrence of the main secondary phases such as chlorite, pyrite, carbonates, and R1 (Reichweite parameter) illite-smectite and kaolinite group minerals indicate a weak to moderate propylitic to phyllic hydrothermal alteration. The dacitic samples of the dykes show different hydrothermal alteration features: (i) carbonate and chlorite pseudomorphs after hornblende as well as core and zonal textures due to replacement of plagioclase by R1 illite-smectite as well as kaolinite group minerals, (ii) colloform banded fracture fillings and fillings in dissolution vugs, and (iii) chlorite, R1 illite-smectite as well as kaolinite group minerals in the groundmass. Late chlorite veins crosscut precipitates of R1 illite-smectite as well as kaolinite group minerals. Carbonates in fractures and in pseudomorphs after hornblende comprise iron-rich dolomite solid solutions ("ankerite") and calcite. Isotopic values indicate a hydrothermal-magmatic origin for the carbonate formation. The chlorite-carbonate-pyrite index (CCPI) and the Ishikawa alteration index (AI), applied to the investigated samples show significant differences (CCPI=52.7-57.8; AI=36.1-40.6) indicating their different degree of alteration. According to Nakada et al., 2005, the C13 to C16 dykes represent the feeder dyke from the latest eruption (1991-1995) whereas C8 represents an earlier dyke feeder dyke from an older eruption. Weakest alteration, which was obtained in samples C16-1-5 and C13-2-5, correlates with the alteration

  10. Energy Management Strategies for a Pneumatic-Hybrid Engine Based on Sliding Window Pattern Recognition Stratégies de gestion de l’énergie pour un moteur hybride pneumatique basées sur la reconnaissance du cycle de conduite

    Directory of Open Access Journals (Sweden)

    Ivanco A.

    2009-11-01

    recognition method is based on a correlation function. To improve analysis, all the results obtained with different energy management strategies are compared with a Dynamic Programming approach (DP considered as the optimal solution. Results show that about 40% of fuel saving can be achieved by DP. The VPC and DPR strategies give better results than the CPC strategy, not so far from the results obtained with DP. Cet article présente comparativement des stratégies de gestion de l’énergie pour un nouveau concept de moteur hybride : l’hybride pneumatique. Dans cette configuration spécifique, c’est le moteur lui-même qui est hybridé (et non le véhicule. Plusieurs stratégies de gestion d’énergie sont proposées dans cet article. La première est dite Causale (CS car basée sur des principes heuristiques de décision. La deuxième est basée sur la minimisation d’un critère d’équivalence et est appelée stratégie à Coefficient de Pénalité Constant (CPC. Dans ce cas, les flux d’énergie (depuis chaque source chimique ou pneumatique sont décrits dans des unités identiques. Ainsi, pour un même travail à produire, il est possible de faire une « balance » entre la consommation nécessaire selon chacune des deux sources d’énergie, et ceci avec un coefficient de pondération constant. La troisième stratégie utilise un coefficient de pondération variable selon la quantité d’air disponible dans le réservoir (i.e. état de charge et est appelée stratégie à Coefficient de Pénalité Variable (VPC. Dans ce cas, le coefficient de pénalité est une fonction non-linéaire de la pression dans le réservoir. Un autre raisonnement consiste à considérer qu’il est nécessaire d’adapter également le coefficient à la situation de conduite (embouteillage, urbain, routier, autoroutier..., pour cela il est impératif de reconnaître la situation de conduite. Le coefficient peut alors être adapté, selon la situation reconnue à la valeur optimale pr

  11. Volcanic risk metrics at Mt Ruapehu, New Zealand: some background to a probabilistic eruption forecasting scheme and a cost/benefit analysis at an open conduit volcano

    Science.gov (United States)

    Jolly, Gill; Sandri, Laura; Lindsay, Jan; Scott, Brad; Sherburn, Steve; Jolly, Art; Fournier, Nico; Keys, Harry; Marzocchi, Warner

    2010-05-01

    The Bayesian Event Tree for Eruption Forecasting software (BET_EF) is a probabilistic model based on an event tree scheme that was created specifically to compute long- and short-term probabilities of different outcomes (volcanic unrest, magmatic unrest, eruption, vent location and eruption size) at long-time dormant and routinely monitored volcanoes. It is based on the assumption that upward movements of magma in a closed conduit volcano will produce detectable changes in the monitored parameters at the surface. In this perspective, the goal of BET_EF is to compute probabilities by merging information from geology, models, past data and present monitoring measurements, through a Bayesian inferential method. In the present study, we attempt to apply BET_EF to Mt Ruapehu, a very active and well-monitored volcano exhibiting the typical features of open conduit volcanoes. In such conditions, current monitoring at the surface is not necessarily able to detect short term changes at depth that may occur only seconds to minutes before an eruption. This results in so-called "blue sky eruptions" of Mt Ruapehu (for example in September 2007), that are volcanic eruptions apparently not preceded by any presently detectable signal in the current monitoring. A further complication at Mt Ruapehu arises from the well-developed hydrothermal system and the permanent crater lake sitting on top of the magmatic conduit. Both the hydrothermal system and crater lake may act to mask or change monitoring signals (if present) that magma produces deeper in the edifice. Notwithstanding these potential drawbacks, we think that an attempt to apply BET_EF at Ruapehu is worthwhile, for several reasons. First, with the exception of a few "blue sky" events, monitoring data at Mt Ruapehu can be helpful in forecasting major events, especially if a large amount of magma is intruded into the edifice and becomes available for phreatomagmatic or magmatic eruptions, as for example in 1995-96. Secondly, in

  12. Robotic cardiac surgery: an anaesthetic challenge.

    Science.gov (United States)

    Wang, Gang; Gao, Changqing

    2014-08-01

    Robotic cardiac surgery with the da Vinci robotic surgical system offers the benefits of a minimally invasive procedure, including a smaller incision and scar, reduced risk of infection, less pain and trauma, less bleeding and blood transfusion requirements, shorter hospital stay and decreased recovery time. Robotic cardiac surgery includes extracardiac and intracardiac procedures. Extracardiac procedures are often performed on a beating heart. Intracardiac procedures require the aid of peripheral cardiopulmonary bypass via a minithoracotomy. Robotic cardiac surgery, however, poses challenges to the anaesthetist, as the obligatory one-lung ventilation (OLV) and CO2 insufflation may reduce cardiac output and increase pulmonary vascular resistance, potentially resulting in hypoxaemia and haemodynamic compromise. In addition, surgery requires appropriate positioning of specialised cannulae such as an endopulmonary vent, endocoronary sinus catheter, and endoaortic clamp catheter under the guidance of transoesophageal echocardiography. Therefore, cardiac anaesthetists should have a working knowledge of these systems, OLV and haemodynamic support. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Can nerve regeneration on an artificial nerve conduit be enhanced by ethanol-induced cervical sympathetic ganglion block?

    Directory of Open Access Journals (Sweden)

    Yoshiki Shionoya

    Full Text Available This study aimed to determine whether nerve regeneration by means of an artificial nerve conduit is promoted by ethanol-induced cervical sympathetic ganglion block (CSGB in a canine model. This study involved two experiments-in part I, the authors examined the effect of CSGB by ethanol injection on long-term blood flow to the orofacial region; part II involved evaluation of the effect of CSGB by ethanol injection on inferior alveolar nerve (IAN repair using polyglycolic acid-collagen tubes. In part I, seven Beagles were administered left CSGB by injection of 99.5% ethanol under direct visualization by means of thoracotomy, and changes in oral mucosal blood flow in the mental region and nasal skin temperature were evaluated. The increase in blood flow on the left side lasted for 7 weeks, while the increase in average skin temperature lasted 10 weeks on the left side and 3 weeks on the right. In part II, fourteen Beagles were each implanted with a polyglycolic acid-collagen tube across a 10-mm gap in the left IAN. A week after surgery, seven of these dogs were administered CSGB by injection of ethanol. Electrophysiological findings at 3 months after surgery revealed significantly higher sensory nerve conduction velocity and recovery index (ratio of left and right IAN peak amplitudes after nerve regeneration in the reconstruction+CSGB group than in the reconstruction-only group. Myelinated axons in the reconstruction+CSGB group were greater in diameter than those in the reconstruction-only group. Administration of CSGB with ethanol resulted in improved nerve regeneration in some IAN defects. However, CSGB has several physiological effects, one of which could possibly be the long-term increase in adjacent blood flow.

  14. Can nerve regeneration on an artificial nerve conduit be enhanced by ethanol-induced cervical sympathetic ganglion block?

    Science.gov (United States)

    Sunada, Katsuhisa; Shigeno, Keiji; Nakada, Akira; Honda, Michitaka; Nakamura, Tatsuo

    2017-01-01

    This study aimed to determine whether nerve regeneration by means of an artificial nerve conduit is promoted by ethanol-induced cervical sympathetic ganglion block (CSGB) in a canine model. This study involved two experiments—in part I, the authors examined the effect of CSGB by ethanol injection on long-term blood flow to the orofacial region; part II involved evaluation of the effect of CSGB by ethanol injection on inferior alveolar nerve (IAN) repair using polyglycolic acid-collagen tubes. In part I, seven Beagles were administered left CSGB by injection of 99.5% ethanol under direct visualization by means of thoracotomy, and changes in oral mucosal blood flow in the mental region and nasal skin temperature were evaluated. The increase in blood flow on the left side lasted for 7 weeks, while the increase in average skin temperature lasted 10 weeks on the left side and 3 weeks on the right. In part II, fourteen Beagles were each implanted with a polyglycolic acid-collagen tube across a 10-mm gap in the left IAN. A week after surgery, seven of these dogs were administered CSGB by injection of ethanol. Electrophysiological findings at 3 months after surgery revealed significantly higher sensory nerve conduction velocity and recovery index (ratio of left and right IAN peak amplitudes) after nerve regeneration in the reconstruction+CSGB group than in the reconstruction-only group. Myelinated axons in the reconstruction+CSGB group were greater in diameter than those in the reconstruction-only group. Administration of CSGB with ethanol resulted in improved nerve regeneration in some IAN defects. However, CSGB has several physiological effects, one of which could possibly be the long-term increase in adjacent blood flow. PMID:29220373

  15. AC loss performance of cable-in-conduit conductor. Influence of cable mechanical property on coupling loss reduction

    International Nuclear Information System (INIS)

    Matsui, Kunihiro; Koizumi, Norikiyo; Isono, Takaaki; Hamada, Kazuya; Nunoya, Yoshihiko

    2003-01-01

    The ITER Central Solenoid (CS) model coil, CS Insert and Nb 3 Al Insert were developed and tested from 2000 to 2002. The AC loss performances of these coils were investigated in various experiments. In addition, the AC losses of the CS and Nb 3 Al Insert conductors were measured using short CS and Nb 3 Al Insert conductors before the coil tests. The coupling time constants of these conductors were estimated to be 30 and 120 ms, respectively. On the other hand, the test results of the CS and Nb 3 Al Inserts show that the coupling currents induced in these conductors had multiple decay time constants. In fact, the existence of the coupling currents with long decay time constants, the order of which was in the thousands of seconds, was directly observed with hall sensors and voltage taps. Moreover, the AC loss test results show that electromagnetic force decreases coupling losses with exponential decay constants. This is because the weak sinter among the strands, which originated during heat treatment, was broken due to the electromagnetic force, and then the contact resistance among strands increased. It was found that this exponential decay constant was the function of a gap (i.e., a mechanical property of the cable) created between the cable and conduit due to electromagnetic force. The gap can be estimated by pressure drop, measured under the electromagnetic force. The pressure drop can easily be measured at an initial trial charge, and then it is possible to estimate the exponential decay constant before normal coil operation. Accordingly, it is possible to predict promptly how many times the trial operations are necessary to decrease the coupling losses to the designed value by measuring the coupling losses and the pressure drop during the initial coil operation trial. (author)

  16. Lossless droplet transfer of droplet-based microfluidic analysis

    Science.gov (United States)

    Kelly, Ryan T [West Richland, WA; Tang, Keqi [Richland, WA; Page, Jason S [Kennewick, WA; Smith, Richard D [Richland, WA

    2011-11-22

    A transfer structure for droplet-based microfluidic analysis is characterized by a first conduit containing a first stream having at least one immiscible droplet of aqueous material and a second conduit containing a second stream comprising an aqueous fluid. The interface between the first conduit and the second conduit can define a plurality of apertures, wherein the apertures are sized to prevent exchange of the first and second streams between conduits while allowing lossless transfer of droplets from the first conduit to the second conduit through contact between the first and second streams.

  17. Experience with intravenous digital subtraction angiography following shunting in 4 cases of congenital heart diseases

    International Nuclear Information System (INIS)

    Higashidate, Masafumi; Konno, Susumu; Sumitomo, Naokata; Ito, Sango; Kobayashi, Hiroshi

    1985-01-01

    Intravenous digital subtraction angiography (IV-DSA) was performed in two patients with Fallot's tetralogy who underwent Blalock-Taussing operation, a patient with coarctation of the aortic arch who underwent extra-anastomic bypass between the ascending aorta and the descending aorta, and a patient with stenosis of the tricuspid valve who underwent Fontan type operation (anastomosis between the right atrium and the pulmonary artery). The conventional cardiac angiography was also performed for the comparison with IV-DSA in all patients. IV-DSA revealed the thickness of the subclavian artery anastomosed by Blaloch-Taussing operation, but failed to determine the accurate thickness of the pulmonary artery required for PA-index for radical surgery in cases of Fallot's tetralogy. Bypass from the ascending aorta to the descending aorta was well visualized by IV-DSA because the heart did not overlap on the image. In cases of Fontan type operation, IV-DSA permitted the visualization of blood flow from the right atrium to the pulmonary artery and the shape of the pulmonary artery. It is concluded that IV-DSA is a less invasive, simple technique to evaluate patients' condition following shunting for congenital heart diseases, as compared to the conventional method. (Namekawa, K.)

  18. Wärme- und Stoffaustauschreaktor

    OpenAIRE

    Laevemann, E.; Kessling, W.; Heinzl, W.; Jung, D.; Sitzmann, R.

    1994-01-01

    The description refers to a heat and mass transfer reactor comprising two conduit systems separated from one another by mass, of which one conduit system (heat exchange conduit system) is swept by a fluid or gaseous heating or cooling medium A and the other conduit system (mass transfer conduit system) is swept by a gaseous medium B and another fluid medium C. The reactor according to the invention is characterized by the fact that the heat exchange conduit system is arranged horizontally and...

  19. Multiple-port valve

    International Nuclear Information System (INIS)

    Doody, T.J.

    1978-01-01

    A multiple-port valve assembly is designed to direct flow from a primary conduit into any one of a plurality of secondary conduits as well as to direct a reverse flow. The valve includes two mating hemispherical sockets that rotatably receive a spherical valve plug. The valve plug is attached to the primary conduit and includes diverging passageways from that conduit to a plurality of ports. Each of the ports is alignable with one or more of a plurality of secondary conduits fitting into one of the hemispherical sockets. The other hemispherical socket includes a slot for the primary conduit such that the conduit's motion along that slot with rotation of the spherical plug about various axes will position the valve-plug ports in respect to the secondary conduits

  20. Use of a Y-tube conduit after facial nerve injury reduces collateral axonal branching at the lesion site but neither reduces polyinnervation of motor endplates nor improves functional recovery.

    Science.gov (United States)

    Hizay, Arzu; Ozsoy, Umut; Demirel, Bahadir Murat; Ozsoy, Ozlem; Angelova, Srebrina K; Ankerne, Janina; Sarikcioglu, Sureyya Bilmen; Dunlop, Sarah A; Angelov, Doychin N; Sarikcioglu, Levent

    2012-06-01

    Despite increased understanding of peripheral nerve regeneration, functional recovery after surgical repair remains disappointing. A major contributing factor is the extensive collateral branching at the lesion site, which leads to inaccurate axonal navigation and aberrant reinnervation of targets. To determine whether the Y tube reconstruction improved axonal regrowth and whether this was associated with improved function. We used a Y-tube conduit with the aim of improving navigation of regenerating axons after facial nerve transection in rats. Retrograde labeling from the zygomatic and buccal branches showed a halving in the number of double-labeled facial motor neurons (15% vs 8%; P facial-facial anastomosis coaptation. However, in both surgical groups, the proportion of polyinnervated motor endplates was similar (≈ 30%; P > .05), and video-based motion analysis of whisking revealed similarly poor function. Although Y-tube reconstruction decreases axonal branching at the lesion site and improves axonal navigation compared with facial-facial anastomosis coaptation, it fails to promote monoinnervation of motor endplates and confers no functional benefit.

  1. Advanced data processing of airborne electromagnetic data for imaging hidden conduit networks in the coastal karst plain of Tulum (Mexico)

    International Nuclear Information System (INIS)

    Schiller, A.; Schattauer, I.; Ottowitz, D.

    2016-01-01

    This study is part of a series of international research cooperations which commenced in 2007 and are still ongoing. The study area is located on the east coast of the Yucatan Peninsula, Mexico, and comprises the northern most part of the Sian Kaan biosphere reserve, a coastal wetland of international importance, as well as the city of Tulum in the state of Quintana Roo, and part of the second largest barrier reef in the world some 300 metres to one kilometre off shore. Two airborne surveys, conducted in 2007 and 2008 by the Geological Survey of Austria, covered an area of some 200 square kilometres, including the well-known Ox Bel Ha cave system, already mapped by exploration divers. In order to get additional ground truth data and input for the hydrological model, extended ground geophysical campaigns have been conducted an - nually. The first processing of the airborne electromagnetic (AEM) data revealed not only a clear signature from known caves but also the image of a vast, unexplored, hidden conduit network. However, lateral and depth resolution was limited due to measurement drift and noise as well the specific behaviour of the ap - plied inversion technique. Newly developed algorithms for processing AEM data and inversion results have improved the signal-to-noise ratio significantly and enabled the imaging of well defined structures in the underground. Therefore, the AEM method is now capable of quickly deliver crucial structural information of karst-water regimes in difficult accessible areas with unique depth information compared to previous studies. (Author)

  2. Molten salt as a heat transfer fluid for heating a subsurface formation

    Science.gov (United States)

    Nguyen, Scott Vinh; Vinegar, Harold J.

    2010-11-16

    A heating system for a subsurface formation includes a conduit located in an opening in the subsurface formation. An insulated conductor is located in the conduit. A material is in the conduit between a portion of the insulated conductor and a portion of the conduit. The material may be a salt. The material is a fluid at operating temperature of the heating system. Heat transfers from the insulated conductor to the fluid, from the fluid to the conduit, and from the conduit to the subsurface formation.

  3. submitter Development of Joint Terminals for a New Six-Around-One ReBCO-CORC Cable-in-Conduit Conductor Rated 45 kA at 10T/4K

    CERN Document Server

    Mulder, Tim; Mentink, Matthias; Dhalle, Marc; Ten Kate, Herman

    2016-01-01

    The European Organization for Nuclear Research (CERN) is developing a six-around-one conductor on round core (CORC)-strand-based cable-in-conduit conductor (CICC) for use in detector and other large magnet systems. The CICC comprises six ReBCO-CORC strands helically wound around a central tube or rod and inserted in a square aluminum jacket. A major design challenge is finding a simple yet low-resistive method of injecting current homogeneously into the CORC strands of the CICC. In the production of joints for single-CORC cables, we are currently pursuing a method in which the different ReBCO layers at both ends of the CORC cable are trimmed into a staircase-like geometry. A similar trimming method is developed for joint terminals for the ReBCO-CORC-based CICC. A demonstration joint terminal is made to test the various steps of the trimming and manufacturing process before fabricating a joint terminal with real CORC strands. This paper presents an overview of CIC-joint terminal design, simulation results, and...

  4. International tax planning & prevention of abuse under domestic tax law, tax treaties & EC-law

    OpenAIRE

    De Broe, Luc

    2007-01-01

    PART ONE:THE USE OF CONDUIT & BASE COMPANIES IN INTERNATIONAL TAX PLANNING 1 1. CONDUIT COMPANIES 1 1.1. Treaty shopping 1 1.1.1. Description of the term “Treaty shopping” in relation to conduit companies 1 1.1.2. Basic features of “Treaty Shopping” in relation to conduit companies 6 1.1.2.1. Form of the conduit: company or partnership ? 6 1.1.2.2. Tax considerations in setting up the conduit 8 1.2. Directive shopping 11 1.2.1. Description of the term ...

  5. Heating systems for heating subsurface formations

    Science.gov (United States)

    Nguyen, Scott Vinh [Houston, TX; Vinegar, Harold J [Bellaire, TX

    2011-04-26

    Methods and systems for heating a subsurface formation are described herein. A heating system for a subsurface formation includes a sealed conduit positioned in an opening in the formation and a heat source. The sealed conduit includes a heat transfer fluid. The heat source provides heat to a portion of the sealed conduit to change phase of the heat transfer fluid from a liquid to a vapor. The vapor in the sealed conduit rises in the sealed conduit, condenses to transfer heat to the formation and returns to the conduit portion as a liquid.

  6. Possible extracardiac predictors of aortic dissection in Marfan syndrome

    Science.gov (United States)

    2014-01-01

    Background According to previous studies, aortic diameter alone seems to be insufficient to predict the event of aortic dissection in Marfan syndrome (MFS). Determining the optimal schedule for preventive aortic root replacement (ARR) aortic growth rate is of importance, as well as family history, however, none of them appear to be decisive. Thus, the aim of this study was to search for potential predictors of aortic dissection in MFS. Methods A Marfan Biobank consisting of 79 MFS patients was established. Thirty-nine MFS patients who underwent ARR were assigned into three groups based on the indication for surgery (dissection, annuloaortic ectasia and prophylactic surgery). The prophylactic surgery group was excluded from the study. Transforming growth factor-β (TGF-β) serum levels were measured by ELISA, relative expression of c-Fos, matrix metalloproteinase 3 and 9 (MMP-3 and −9) were assessed by RT-PCR. Clinical parameters, including anthropometric variables - based on the original Ghent criteria were also analyzed. Results Among patients with aortic dissection, TGF-β serum level was elevated (43.78 ± 6.51 vs. 31.64 ± 4.99 ng/l, p < 0.0001), MMP-3 was up-regulated (Ln2α = 1.87, p = 0.062) and striae atrophicae were more common (92% vs. 41% p = 0.027) compared to the annuloaortic ectasia group. Conclusions We found three easily measurable parameters (striae atrophicae, TGF-β serum level, MMP-3) that may help to predict the risk of aortic dissection in MFS. Based on these findings a new classification of MFS, that is benign or malignant is also proposed, which could be taken into consideration in determining the timing of prophylactic ARR. PMID:24720641

  7. A hyaluronan-based nerve guide : in vitro cytotoxicity, subcutaneous tissue reactions, and degradation in the rat

    NARCIS (Netherlands)

    Jansen, K; van Wachem, PB; Nicolai, JPA; de Leij, LFMH; van Luyn, MJA; van der Werf, J.F.A.

    We investigated possible cytotoxic effects, biocompatibility, and degradation of a hyaluronan-based conduit for peripheral nerve repair. We subjected the conduits to an in vitro fibroblast cytotoxicity test and concluded that the conduits were not cytotoxic. Subsequently, we implanted the conduits

  8. Apparatus and method for maintaining multi-component sample gas constituents in vapor phase during sample extraction and cooling

    Science.gov (United States)

    Felix, Larry Gordon; Farthing, William Earl; Irvin, James Hodges; Snyder, Todd Robert

    2010-05-11

    A dilution apparatus for diluting a gas sample. The apparatus includes a sample gas conduit having a sample gas inlet end and a diluted sample gas outlet end, and a sample gas flow restricting orifice disposed proximate the sample gas inlet end connected with the sample gas conduit and providing fluid communication between the exterior and the interior of the sample gas conduit. A diluted sample gas conduit is provided within the sample gas conduit having a mixing end with a mixing space inlet opening disposed proximate the sample gas inlet end, thereby forming an annular space between the sample gas conduit and the diluted sample gas conduit. The mixing end of the diluted sample gas conduit is disposed at a distance from the sample gas flow restricting orifice. A dilution gas source connected with the sample gas inlet end of the sample gas conduit is provided for introducing a dilution gas into the annular space, and a filter is provided for filtering the sample gas. The apparatus is particularly suited for diluting heated sample gases containing one or more condensable components.

  9. Catalytic reactor for low-Btu fuels

    Science.gov (United States)

    Smith, Lance; Etemad, Shahrokh; Karim, Hasan; Pfefferle, William C.

    2009-04-21

    An improved catalytic reactor includes a housing having a plate positioned therein defining a first zone and a second zone, and a plurality of conduits fabricated from a heat conducting material and adapted for conducting a fluid therethrough. The conduits are positioned within the housing such that the conduit exterior surfaces and the housing interior surface within the second zone define a first flow path while the conduit interior surfaces define a second flow path through the second zone and not in fluid communication with the first flow path. The conduit exits define a second flow path exit, the conduit exits and the first flow path exit being proximately located and interspersed. The conduits define at least one expanded section that contacts adjacent conduits thereby spacing the conduits within the second zone and forming first flow path exit flow orifices having an aggregate exit area greater than a defined percent of the housing exit plane area. Lastly, at least a portion of the first flow path defines a catalytically active surface.

  10. Improved severe hepatopulmonary syndrome after liver transplantation in an adolescent with end-stage liver disease secondary to biliary atresia

    Directory of Open Access Journals (Sweden)

    Tae Jun Park

    2014-03-01

    Full Text Available Hepatopulmonary syndrome (HPS is a serious complication of end-stage liver disease, which is characterized by hypoxia, intrapulmonary vascular dilatation, and liver cirrhosis. Liver transplantation (LT is the only curative treatment modality for patients with HPS. However, morbidity and mortality after LT, especially in cases of severe HPS, remain high. This case report describes a patient with typical findings of an extracardiac pulmonary arteriovenous shunt on contrast-enhanced transesophageal echocardiography (TEE, and clubbing fingers, who had complete correction of HPS by deceased donor LT. The patient was a 16-year-old female who was born with biliary atresia and underwent porto-enterostomy on the 55th day after birth. She had been suffered from progressive liver failure with dyspnea, clubbing fingers, and cyanosis. Preoperative arterial blood gas analysis revealed severe hypoxia (arterial O2 tension of 54.5 mmHg and O2 saturation of 84.2%. Contrast-enhanced TEE revealed an extracardiac right-to-left shunt, which suggested an intrapulmonary arteriovenous shunt. The patient recovered successfully after LT, not only with respect to physical parameters but also for pychosocial activity, including school performance, during the 30-month follow-up period.

  11. The QBO as potential amplifier and conduit to lower altitudes of solar cycle influence

    Directory of Open Access Journals (Sweden)

    H. G. Mayr

    2007-06-01

    tapping the momentum from the upward propagating gravity waves. Influenced and amplified by wave processes, the QBO thus acts as conduit to transfer to lower altitudes the larger SC variations in the UV absorbed in the mesosphere. Our model produces in the temperature variations of the QBO and EAO measurable SC modulations at polar latitudes near the tropopause. The effects are apparently generated by the meridional circulation, and planetary waves presumably, which redistribute the energy from the equatorial region where the waves are very effective in amplifying the SC influence.

  12. A systematic method for using 3D echocardiography to evaluate tricuspid valve insufficiency in hypoplastic left heart syndrome

    OpenAIRE

    Mart, Christopher Robin; Eckhauser, Aaron Wesley; Murri, Michael; Su, Jason Thomas

    2014-01-01

    With surgical palliation of hypoplastic left heart syndrome (HLHS), the tricuspid valve (TV) becomes the systemic atrioventricular valve and moderate/severe TV insufficiency (TVI), an adverse risk factor for survival to Fontan, has been reported in up to 35% of patients prior to stage I palliation. Precise echocardiographic identification of the mechanism of TVI cannot be determined by two-dimensional echocardiography. Three-dimensional echocardiography (3DE) can provide significant insight i...

  13. Clean Sampling of an Englacial Conduit at Blood Falls, Antarctica - Some Experimental and Numerical Results

    Science.gov (United States)

    Kowalski, Julia; Francke, Gero; Feldmann, Marco; Espe, Clemens; Heinen, Dirk; Digel, Ilya; Clemens, Joachim; Schüller, Kai; Mikucki, Jill; Tulaczyk, Slawek M.; Pettit, Erin; Berry Lyons, W.; Dachwald, Bernd

    2017-04-01

    results of its deployment at Blood Falls. In contrast to conventional melting-probe applications, which can only melt vertically, the IceMole realized an oblique melting path to penetrate the englacial conduit. Experimental and numerical results on melting at oblique angles are rare. Besides reporting on the IceMole technology and the field deployment itself, we will compare and discuss the observed melting behavior with re-analysis results in the context of a recently developed numerical model. Finally, we will present our first steps in utilizing the model to infer on the ambient cryo-environment.

  14. Kinetic energy absorbing pad

    International Nuclear Information System (INIS)

    Bricmont, R.J.; Hamilton, P.A.; Ming Long Ting, R.

    1981-01-01

    Reactors, fuel processing plants etc incorporate pipes and conduits for fluids under high pressure. Fractures, particularly adjacent to conduit elbows, produce a jet of liquid which whips the broken conduit at an extremely high velocity. An enormous impact load would be applied to any stationary object in the conduit's path. The design of cellular, corrugated metal impact pads to absorb the kinetic energy of the high velocity conduits is given. (U.K.)

  15. Radionuclide Angiocardiographic Evaluation of Left-to-Right Cardiac Shunts: Analysis of Time-Active Curves

    International Nuclear Information System (INIS)

    Kim, Ok Hwa; Bahk, Yong Whee; Kim, Chi Kyung

    1987-01-01

    The noninvasive nature of the radionuclide angiocardiography provided a useful approach for the evaluation of left-to-right cardiac shunts (LRCS). While the qualitative information can be obtained by inspection of serial radionuclide angiocardiograms, the quantitative information of radionuclide angiocardiography can be obtained by the analysis of time-activity curves using advanced computer system. The count ratios method and pulmonary-to-systemic flow ratio (QP/QS) by gamma variate fit method were used to evaluate the accuracy of detection and localization of LRCS. One hundred and ten time-activity curves were analyzed. There were 46 LRCS (atrial septal defects 11, ventricular septal defects 22, patent ductus arteriosus 13) and 64 normal subjects. By computer analysis of time-activity curves of the right atriurn, ventricle and the lungs separately, the count ratios modified by adding the mean cardiac transit time were calculated in each anatomic site. In normal subjects the mean count ratios in the right atrium, ventricle and lungs were 0.24 on average. In atrial septal defects, the count ratios were high in the right atrium, ventricle and lungs, whereas in ventricular septal defects the count ratios were higher only in the right ventricle and lungs. Patent ductus arteriosus showed normal count ratios in the heart but high count ratios were obtained in the lungs. Thus, this count ratios method could be separated normal from those with intracardiac or extracardiac shunts, and moreover, with this method the localization of the shunt level was possible in LRCS. Another method that could differentiate the intracardiac shunts from extracardiac shunts was measuring QP/QS in the left and right lungs. In patent ductus arteriosus, the left lung QP/QS was higher than those of the right lung, whereas in atrial septal defects and ventricular septal defects QP/ QS ratios were equal in both lungs. From this study, it was found that by measuring QP/QS separately in the lungs

  16. Determinants and improvement of electrocardiographic diagnosis of left ventricular hypertrophy in a black African population.

    Directory of Open Access Journals (Sweden)

    Ahmadou M Jingi

    Full Text Available BACKGROUND: Left ventricular hypertrophy (LVH is a major cardiovascular risk factor. The electrocardiogram (ECG has been shown to be a poor tool in detecting LVH due to cardiac and extracardiac factors. We studied the determinants and possibility of improving the test performance of the ECG in a group of Black Africans. METHODS: We studied echocardiograms and electrocardiograms of 182 Cameroonian patients among whom 113 (62.1% were having an echocardiographic LVH. Echocardiographic LVH was defined as Left Ventricular Mass Indexed to height 2.7(LVMI>48 g/m2.7 in men, and >44 g/m 2.7 in women or Body Surface Area ≥116 g/m2 in men, and ≥96 g/m2 in women. Test performances were calculated for 6 classic ECG criteria Sokolow-Lyon, Cornell, Cornell product, Gubner-Ungerleiger, amplitudes of R in aVL, V5 and V6. RESULTS: The most sensitive criteria were Cornell (37.2% and Sokolow-Lyon index (26.5%. The most specific criteria were Gubner (98.6%, RaVL (97.1%, RV5/V6 (95.7% and Cornell product (94.2%. The performance of the ECG in diagnosing LVH significantly increased with the severity of LVH for Cornell index (r = 0.420, p<0.0001 and Sokolow index (r = 0.212, p = 0.002. It decreased with body habitus (r = -0.248, p = 0.001 for Sokolow-Lyon index. Cornell index was less affected (age p = 0.766; body habitus: p = 0.209. After sex-specific adjustment for BMI, Cornell BMI sensitivity increased from 37.2% to 69% (r = 0.472, p<0.0001, and Sokolow-Lyon BMI sensitivity increased from 26.5% to 58.4% (r = 0.270, p<0.001. CONCLUSION: The test performance of the ECG in diagnosing LVH is low in this Black African population, due to extracardiac factors such as age, sex, body habitus, and cardiac factors such as LVH severity and geometry. However, this performance is improved after adjustment for extracardiac factors.

  17. Harmonic scalpel versus electrocautery for harvest of radial artery conduits: Reduced risk of spasm and intimal injury on optical coherence tomography

    Science.gov (United States)

    Brazio, Philip S.; Laird, Patrick C.; Xu, Chenyang; Gu, Junyan; Burris, Nicholas S.; Brown, Emile N.; Kon, Zachary N.; Poston, Robert S.

    2009-01-01

    Objective Vasospasm is the primary obstacle to widespread adoption of the radial artery as a conduit in coronary artery bypass grafting. We used optical coherence tomography, a catheter-based intravascular imaging modality, to measure the degree of radial artery spasm induced by means of harvest with electrocautery or a harmonic scalpel in patients undergoing coronary artery bypass grafting. Methods Radial arteries were harvested from 44 consecutive patients with a harmonic scalpel (n = 15) or electrocautery (n = 29). Vessels were imaged before harvesting and after removal from the arm, with saphenous vein tracts serving as internal controls. Optical coherence tomographic findings for the degree of harvesting-induced injury were validated against histologic measures. Results Optical coherence tomographic measures of endovascular dimensions and injury correlated strongly with histologic findings. Mean luminal volume, a measure of vasospasm, decreased significantly less after harvesting with a harmonic scalpel (9% ± 7%) than with electrocautery (35% ± 6%, P = .015). Completely intact intima was present in 11 (73%) of 15 radial arteries harvested with a harmonic scalpel (73%) compared with 9 of 29 arteries harvested by means of electrocautery (31%, P = .011). Intraoperative flow measurements and patency rates at 5 days postoperatively were not significantly different among groups. Conclusions Optical coherence tomography provides a level of speed and accuracy for quantifying endothelial injury and vasospasm that has not been described for any other modality, suggesting potential as an intraoperative quality assurance tool. Our optical coherence tomographic findings suggest that the harmonic scalpel induces less spasm and intimal injury compared with electrocautery. PMID:19026820

  18. Experience with intravenous digital subtraction angiography following shunting in 4 cases of congenital heart diseases

    Energy Technology Data Exchange (ETDEWEB)

    Higashidate, Masafumi; Konno, Susumu; Sumitomo, Naokata; Ito, Sango; Kobayashi, Hiroshi

    1985-01-01

    Intravenous digital subtraction angiography (IV-DSA) was performed in two patients with Fallot's tetralogy who underwent Blalock-Taussing operation, a patient with coarctation of the aortic arch who underwent extra-anastomic bypass between the ascending aorta and the descending aorta, and a patient with stenosis of the tricuspid valve who underwent Fontan type operation (anastomosis between the right atrium and the pulmonary artery). The conventional cardiac angiography was also performed for the comparison with IV-DSA in all patients. IV-DSA revealed the thickness of the subclavian artery anastomosed by Blaloch-Taussing operation, but failed to determine the accurate thickness of the pulmonary artery required for PA-index for radical surgery in cases of Fallot's tetralogy. Bypass from the ascending aorta to the descending aorta was well visualized by IV-DSA because the heart did not overlap on the image. In cases of Fontan type operation, IV-DSA permitted the visualization of blood flow from the right atrium to the pulmonary artery and the shape of the pulmonary artery. It is concluded that IV-DSA is a less invasive, simple technique to evaluate patients' condition following shunting for congenital heart diseases, as compared to the conventional method. (Namekawa, K.).

  19. Impact of evolving strategy on clinical outcomes and central pulmonary artery growth in patients with bilateral superior vena cava undergoing a bilateral bidirectional cavopulmonary shunt.

    Science.gov (United States)

    Honjo, Osami; Tran, Kim-Chi D; Hua, Zhongdong; Sapra, Priya; Alghamdi, Abdullah A; Russell, Jennifer L; Caldarone, Christopher A; Van Arsdell, Glen S

    2010-09-01

    We reported a high incidence of thrombosis, central pulmonary artery hypoplasia, and mortality for bilateral bidirectional cavopulmonary shunts. We hypothesized that technical modifications in the cavopulmonary anastomosis and anticoagulation would limit thrombus and central pulmonary artery hypoplasia, and thereby improve outcomes. Sixty-one patients (median age, 8.4 months; weight, 6.6 kg) underwent bilateral bidirectional cavopulmonary shunt from 1990 to 2007. The cohort was divided into 2 groups: 1) the conventional group (1990-1999, n = 37) and 2) the V-shaped group, with a hemi-Fontan or modification in which the cavae were anastomosed to the pulmonary artery adjacent to each other so they formed the appearance of a V (1999-2007, n = 24). Central and branch pulmonary artery growth, survival, and reinterventions were determined. The pre-Fontan study showed equivalent superior venae cavae and Nakata indices. The central pulmonary artery index and central pulmonary artery/Nakata index ratio were significantly higher in the V-shaped group (P analysis showed anastomotic strategy, low saturation, and thrombosis were predictors for death. Anastomotic strategy, lack of anticoagulation, thrombosis, and small superior venae cavae were predictors for reintervention (P strategy affected reintervention. Anastomotic strategy and postoperative thrombus affected mortality. 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  20. ProSeal laryngeal mask airway improves oxygenation when used as a conduit prior to laryngoscope guided intubation in bariatric patients

    Directory of Open Access Journals (Sweden)

    Aparna Sinha

    2013-01-01

    Full Text Available Background: The primary objective of this study was to compare the effect of ventilation using the ProSeal TM laryngeal mask airway (PLMA with facemask and oropharyngeal airway (FM, prior to laryngoscopy, on arterial oxygenation in morbidly obese patients undergoing bariatric surgery. Methods: Forty morbidly obese patients were randomly recruited to either PLMA or FM. After pre-oxygenation (FiO 2 1.0 in the ramp position with continuous positive airway pressure of 10 cm H 2 O for 5 min, anaesthesia was induced. Following loss of jaw thrust oropharyngeal airway, the FM and PLMA were inserted. On achieving paralysis, volume control ventilation with PEEP (5 cm H 2 O was initiated. The difficulty in mask ventilation (DMV in FM, number of attempts at PLMA and laryngoscopy were graded (Cormack and Lehane in all patients. Time from onset of laryngoscopy to endotracheal tube confirmation was recorded. Hypoxia was defined as mild (SpO 2 ≤95%, moderate (SpO 2 ≤90% and severe (SpO 2 ≤85%. Results: Significant rise in pO 2 was observed within both groups ( P=0.001, and this was significantly higher in the PLMA ( P=0.0001 when compared between the groups. SpO 2 ≥ 90% ( P=0.018 was seen in 19/20 (95% patients in PLMA and 13/20 (65% in FM at confirmation of tracheal tube. A strong association was found between DMV and Cormack Lehane in the FM group and with number of attempts in the PLMA group. No adverse events were observed. Conclusion: ProSeal TM laryngeal mask airway as conduit prior to laryngoscopy in morbidly obese patients seems effective in increasing oxygen reserves, and can be suggested as a routine airway management technique when managing the airway in the morbidly obese.