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Sample records for feeding tube insertion

  1. Feeding tube insertion - gastrostomy

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002937.htm Feeding tube insertion - gastrostomy To use the sharing features on this page, please enable JavaScript. A gastrostomy feeding tube insertion is the placement of a feeding ...

  2. Laparoscopic insertion of the Moss feeding tube.

    Science.gov (United States)

    Albrink, M H; Hagan, K; Rosemurgy, A S

    1993-12-01

    Placement of enteral feeding tubes is an important part of a surgeon's skill base. Surgical insertion of feeding tubes has been performed safely for many years with very few modifications. With the recent surge in interest and applicability of other laparoscopic procedures, it is well within the skills of the average laparoscopic surgeon to insert feeding tubes. We describe herein a simple technique for the insertion of the Moss feeding tube. The procedure described has a minimum of invasion, along with simplicity, safety, and accuracy.

  3. Blind bedside insertion of small bowel feeding tubes.

    LENUS (Irish Health Repository)

    Duggan, SN

    2009-12-01

    The use of Naso-Jejunal (NJ) feeding is limited by difficulty in feeding tube placement. Patients have traditionally required transfer to Endoscopy or Radiology for insertion of small bowel feeding tubes, with clear resource implications. We hypothesised that the adoption of a simple bedside procedure would be effective and reduce cost. Clinical nutrition and nurse specialist personnel were trained in the 10\\/10\\/10 method of blind bedside NJ insertion.

  4. Chest tube insertion

    Science.gov (United States)

    Chest drainage tube insertion; Insertion of tube into chest; Tube thoracostomy; Pericardial drain ... Be careful there are no kinks in your tube. The drainage system should always sit upright and be placed ...

  5. Feeding Tubes

    Science.gov (United States)

    ... feeding therapies have been exhausted. Please review product brand and method of placement carefully with your physician ... Total Parenteral Nutrition. Resources: Oley Foundation Feeding Tube Awareness Foundation Children’s Medical Nutrition Alliance APFED’s Educational Webinar ...

  6. Multicentre survey of radiologically inserted gastrostomy feeding tube (RIG) in the UK

    International Nuclear Information System (INIS)

    Lowe, A.S.; Laasch, H.U.; Stephenson, S.; Butterfield, C.; Goodwin, M.; Kay, C.L.; Glancy, S.; Jackson, S.; Brown, D.; McLean, P.; Keanie, J.; Thrower, A.; Briggs, R.; Punekar, S.; Krishnan, S.; Thomas, B.; Yap, K.; Mullan, D.; Maskell, G.; Hancock, J.

    2012-01-01

    Aims: To evaluate the variance in current UK clinical practice and clinical outcomes for direct percutaneous radiologically inserted gastrostomy (RIG). Materials and methods: A prospective UK multicentre survey of RIG performed between October 2008 and August 2010 was performed through the British Society of Gastrointestinal and Abdominal Radiology (BSGAR). Results: Data from 684 patients were provided by 45 radiologists working at 17 UK centres. Two hundred and sixty-three cases (40%) were performed with loop-retained catheters, and 346 (53%) with balloon-retained devices. Sixty percent of all patients experienced pain in the first 24 h, but settled in the majority thereafter. Early complications, defined as occurring in the first 24 h, included minor bleeding (1%), wound infection (3%), peritonism (2%), and tube misplacement (1%). Late complications, defined as occurring between day 2 and day 30 post-procedure, included mild pain (30%), persisting peritonism (2%), and 30 day mortality of 1% (5/665). Pre-procedural antibiotics or anti-methicillin-resistant Staphylococcus aureus (MRSA) prophylaxis did not affect the rate of wound infection, peritonitis, post-procedural pain, or mortality. Ninety-three percent of cases were performed using gastropexy. Gastropexy decreased post-procedural pain (p < 0.001), but gastropexy-related complications occurred in 5% of patients. However, post-procedure pain increased with the number of gastropexy sutures used (p < 0.001). The use of gastropexy did not affect the overall complication rate or mortality. Post-procedure pain increased significantly as tube size increased (p < 0.001). The use of balloon-retention feeding tubes was associated with more pain than the deployment of loop-retention devices (p < 0.001). Conclusion: RIG is a relatively safe procedure with a mortality of 1%, with or without gastropexy. Pain is the commonest complication. The use of gastropexy, fixation dressing or skin sutures, smaller tube sizes, and

  7. Chest tube insertion - series (image)

    Science.gov (United States)

    Chest tubes are inserted to drain blood, fluid, or air and allow full expansion of the lungs. The tube is placed in the pleural space. The area where the tube will be inserted is numbed (local anesthesia). The patient may also be sedated. The chest ...

  8. Feeding tube - infants

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007235.htm Feeding tube - infants To use the sharing features on this page, please enable JavaScript. A feeding tube is a small, soft, plastic tube placed ...

  9. Nasogastric feeding tubes from a neonatal department yield high concentrations of potentially pathogenic bacteria- even 1 d after insertion

    DEFF Research Database (Denmark)

    Meinich Petersen, Sandra; Greisen, Gorm; Krogfelt, Karen Angeliki

    2016-01-01

    probiotic administration through the tube. RESULTS: Out of the 94 NG-tubes, 89% yielded more than 1,000 colony-forming units (CFU)/ml bacteria, and 55% yielded the potentially pathogenic Enterobacteriaceae and/or Staphylococcus aureus. The mean concentration in the yield was 5.3 (SD: 2.1, maximum 9.4) log10......BACKGROUND: Preterm infants are vulnerable to pathogens and at risk of developing necrotizing enterocolitis (NEC) or sepsis. Nasogastric feeding tubes (NG-tubes) might contaminate feeds given through them due to biofilm formation. We wanted to determine if there is a rationale in replacing NG......-tubes more often to reduce contamination. METHODS: We conducted an observational study of used NG-tubes from a tertiary neonatal department. After removal, we flushed a 1-ml saline solution through the tube, determined the density of bacteria by culture, and related it to the duration of use and any...

  10. Gastrostomy feeding tube - bolus

    Science.gov (United States)

    Feeding - gastrostomy tube - bolus; G-tube - bolus; Gastrostomy button - bolus; Bard Button - bolus; MIC-KEY - bolus ... KEY, 3 to 8 weeks after surgery. These feedings will help your child grow strong and healthy. ...

  11. Pneumothorax Following Feeding Tube Placement: Precaution and Treatment

    Directory of Open Access Journals (Sweden)

    Morteza Zahmatkesh

    2012-05-01

    Full Text Available Nasojejunal feeding tubes are being used at an increased frequency, but it is not without complications that could be life-threatening. We report two cases of pneumothorax following small-bore feeding tube insertion into the pleural cavity, resulting in pneumothorax. We further discuss the potential measures that can be taken to prevent and treat this serious complication.

  12. Gastrostomy feeding tube - pump

    Science.gov (United States)

    ... button, close the clamp on the feeding set, disconnect the extension set from the button, and close ... Copyright Privacy Accessibility Quality Guidelines Viewers & Players MedlinePlus Connect for EHRs For Developers U.S. National Library of ...

  13. Deadly pressure pneumothorax after withdrawal of misplaced feeding tube

    DEFF Research Database (Denmark)

    Andresen, Erik Nygaard; Frydland, Martin; Usinger, Lotte

    2016-01-01

    BACKGROUND: Many patients have a nasogastric feeding tube inserted during admission; however, misplacement is not uncommon. In this case report we present, to the best of our knowledge, the first documented fatality from pressure pneumothorax following nasogastric tube withdrawal. CASE PRESENTATION......, but our patient died less than an hour after withdrawal. The autopsy report stated that cause of death was tension pneumothorax, which developed following withdrawal of the misplaced feeding tube. CONCLUSIONS: The indications for insertion of nasogastric feeding tubes are many and the procedure...... is considered harmless; however, if the tube is misplaced there is good reason to be cautious on removal as this can unmask puncture of the pleura eliciting pneumothorax and, as this case report shows, result in an ultimately deadly tension pneumothorax....

  14. Gastroenteric tube feeding: Techniques, problems and solutions

    Science.gov (United States)

    Blumenstein, Irina; Shastri, Yogesh M; Stein, Jürgen

    2014-01-01

    Gastroenteric tube feeding plays a major role in the management of patients with poor voluntary intake, chronic neurological or mechanical dysphagia or gut dysfunction, and patients who are critically ill. However, despite the benefits and widespread use of enteral tube feeding, some patients experience complications. This review aims to discuss and compare current knowledge regarding the clinical application of enteral tube feeding, together with associated complications and special aspects. We conducted an extensive literature search on PubMed, Embase and Medline using index terms relating to enteral access, enteral feeding/nutrition, tube feeding, percutaneous endoscopic gastrostomy/jejunostomy, endoscopic nasoenteric tube, nasogastric tube, and refeeding syndrome. The literature showed common routes of enteral access to include nasoenteral tube, gastrostomy and jejunostomy, while complications fall into four major categories: mechanical, e.g., tube blockage or removal; gastrointestinal, e.g., diarrhea; infectious e.g., aspiration pneumonia, tube site infection; and metabolic, e.g., refeeding syndrome, hyperglycemia. Although the type and frequency of complications arising from tube feeding vary considerably according to the chosen access route, gastrointestinal complications are without doubt the most common. Complications associated with enteral tube feeding can be reduced by careful observance of guidelines, including those related to food composition, administration rate, portion size, food temperature and patient supervision. PMID:25024606

  15. Tension Pneumothorax and Subcutaneous Emphysema Complicating Insertion of Nasogastric Tube

    Directory of Open Access Journals (Sweden)

    Narjis AL Saif

    2015-01-01

    Full Text Available Nasogastric tube has a key role in the management of substantial number of hospitalized patients particularly the critically ill. In spite of the apparent simple insertion technique, nasogastric tube placement has its serious perhaps fatal complications which need to be carefully assessed. Pulmonary misplacement and associated complications are commonplace during nasogastric tube procedure. We present a case of tension pneumothorax and massive surgical emphysema in critically ill ventilated patient due to inadvertent nasogastric tube insertion and also discussed the risk factors, complication list, and arrays of techniques for safer tube placement.

  16. Is tube feeding futile in advanced dementia?

    Science.gov (United States)

    Lynch, Matthew C.

    2016-01-01

    It is controversial whether tube feeding in people with dementia improves nutritional status or prolongs survival. Guidelines published by several professional societies cite observational studies that have shown no benefit and conclude that tube feeding in patients with advanced dementia should be avoided. However, all studies on tube feeding in dementia have major methodological flaws that invalidate their findings. The present evidence is not sufficient to justify general guidelines. Patients with advanced dementia represent a very heterogeneous group, and evidence demonstrates that some patients with dementia benefit from tube feeding. However, presently available guidelines make a single recommendation against tube feeding for all patients. Clinicians, patients, and surrogates should be aware that the guidelines and prior commentary on this topic tend both to overestimate the strength of evidence for futility and to exaggerate the burdens of tube feeding. Shared decision making requires accurate information tailored to the individual patient's particular situation, not blanket guidelines based on flawed data. Lay Summary: Many doctors believe that tube feeding does not help people with advanced dementia. Scientific studies suggest that people with dementia who have feeding tubes do not live longer or gain weight compared with those who are carefully hand fed. However, these studies are not very helpful because of flaws in design, which are discussed in this article. Guidelines from professional societies make a blanket recommendation against feeding tubes for anyone with dementia, but an individual approach that takes each person's situation into account seems more appropriate. Patients and surrogates should be aware that the guidelines on this topic tend both to underestimate the benefit and exaggerate the burdens of tube feeding. PMID:27833208

  17. Advanced Illness: Feeding Tubes and Ventilators

    Science.gov (United States)

    ... example), that are easier to swallow, and by avoiding thin liquids and things that require chewing. Some ... feeding tubes actually extend life in end-stage Alzheimer's disease. For many, this is a quality of ...

  18. Guide tube insert assembly for use in a nuclear reactor

    International Nuclear Information System (INIS)

    Hopkins, R.J.; Land, J.T.

    1992-01-01

    This patent describes an internals assembly for a nuclear reactor of the type including an upper support plate and an upper core plate, each having apertures for conducting control rod assemblies into an out of fuel assemblies with the apertures of the upper support plate being aligned with the apertures of the upper core plate, a guide tube insert assembly comprising: an elongated tubular body extending between at least one of the aligned apertures formed in the upper support plate and the upper core plate; guide plates within the elongated tubular body, each of the guide plates having a planar surface extending substantially perpendicular to an axial direction of the tubular body; at least one interconnecting means for interconnecting the guide plates into a guide tube insert assembly such that the guide plates are simultaneously mountable within and removable from the elongated body, and the periphery of each of the guide plates is spaced apart from the inner walls of the elongated tubular body at every point when the insert assembly is mounted within the tubular body, and a stabilizing means for securing the lowermost guide plate of the guide tube insert assembly within the elongated tubular body to prevent rotational and lateral movement between the guide tube insert assembly and the tubular body

  19. Survival period after tube feeding in bedridden older patients.

    Science.gov (United States)

    Kosaka, Yoichi; Nakagawa-Satoh, Takuma; Ohrui, Takashi; Fujii, Masahiko; Arai, Hiroyuki; Sasaki, Hidetada

    2012-04-01

    We prospectively studied survival periods after tube feeding. Participants were 163 bedridden older patients suffering from dysphagia. A wide range of survival periods after tube feeding were observed within half a year without tube feeding after being bedridden. After this initial period, survival periods after tube feeding were limited to approximately half a year. Survival periods after tube feeding were positively proportional to the length of time patients were free from pneumonia after tube feeding. After tube feeding, patients died from pneumonia within half a year, and the frequency of pneumonia was 3.1 ± 2.7 times (mean ± SD) before death. Survival periods after tube feeding for less than 1 year were primarily determined by being bedridden for more than half a year without tube feeding and once pneumonia occurred; patients who were tube fed did not survive for more than half a year. © 2012 Japan Geriatrics Society.

  20. Otological Findings Ten Years after Myringotomy with Tympanostomy Tube Insertion

    Directory of Open Access Journals (Sweden)

    Ali Goljanian Tabrizi

    2011-01-01

    Full Text Available Introduction: To study the long-term complications of tympanostomy tube insertion in young children 10 years after surgery.   Materials and Methods: In September 2011, the medical records of all patients who had undergone myringotomy with tympanostomy tube insertion between February 2000 and March 2001 at the two general hospitals of Isfahan University of Medical Sciences were studied. Of the 98 patients who fulfilled the inclusion criteria, 82 patients agreed to participate and were enrolled in the study. The complications of the operation were evaluated in these patients.   Results: Of the 164 ears that were operated on, myringosclerosis was found in 17.1%, atrophy of the tympanic membrane in 1.2%, permanent perforation of the tympanic membrane in 0.6% and tympanic membrane atelectasis in 0.6%. None of the patients developed cholesteatoma as a complication of tympanostomy tube insertion.   Conclusion:  Considering the low risk of serious complications after 10 years, tympanostomy tube insertion is a safe and effective treatment option in the treatment of otitis media with effusion.

  1. Intravesical knotting of feeding tube used as urinary catheter in an infant

    Directory of Open Access Journals (Sweden)

    Mamatha Basavaraju

    2016-09-01

    Full Text Available Infant feeding tube is commonly used to temporarily drain the bladder in pediatric population. A case is described where the tube got knotted inside the bladder probably due to over insertion or bladder spasm caused by irritation of catheter.

  2. Compounded Apixaban Suspensions for Enteral Feeding Tubes.

    Science.gov (United States)

    Caraballo, Maria L; Donmez, Seda; Nathan, Kobi; Zhao, Fang

    2017-07-01

    Objective: There is limited information on compounded apixaban formulations for administration via enteral feeding tubes. This study was designed to identify a suitable apixaban suspension formulation that is easy to prepare in a pharmacy setting, is compatible with commonly used feeding tubes, and has a beyond-use date of 7 days. Methods: Apixaban suspensions were prepared from commercially available 5-mg Eliquis tablets. Several vehicles and compounding methods were screened for ease of preparation, dosage accuracy, and tube compatibility. Two tubing types, polyurethane and polyvinyl chloride, with varying lengths and diameters, were included in the study. They were mounted on a peg board during evaluation to mimic the patient body position. A 7-day stability study of the selected formulation was also conducted. Results: Vehicles containing 40% to 60% Ora-Plus in water all exhibited satisfactory flowability through the tubes. The mortar/pestle compounding method was found to produce more accurate and consistent apixaban suspensions than the pill crusher or crushing syringe method. The selected formulation, 0.25 mg/mL apixaban in 50:50 Ora-Plus:water, was compatible with both tubing types, retaining >98% drug in posttube samples. The stability study also confirmed that this formulation was stable physically and chemically over 7 days of storage at room temperature. Conclusions: A suitable apixaban suspension formulation was identified for administration via enteral feeding tubes. The formulation consisted of 0.25 mg/mL apixaban in 50:50 Ora-Plus:water. The stability study results supported a beyond-use date of 7 days at room temperature.

  3. Heat transfer behaviors in round tube with conical ring inserts

    International Nuclear Information System (INIS)

    Promvonge, P.

    2008-01-01

    To increase convection heat transfer in a uniform heat flux tube by a passive method, several conical rings used as turbulators are mounted over the test tube. The effects of the conical ring turbulator inserts on the heat transfer rate and friction factor are experimentally investigated in the present work. Conical rings with three different diameter ratios of the ring to tube diameter (d/D = 0.5, 0.6, 0.7) are introduced in the tests, and for each ratio, the rings are placed with three different arrangements (converging conical ring, referred to as CR array, diverging conical ring, DR array and converging-diverging conical ring, CDR array). In the experiment, cold air at ambient condition for Reynolds numbers in a range of 6000-26,000 is passed through the uniform heat flux circular tube. It is found that the ring to tube diameter ratio and the ring arrays provide a significant effect on the thermal performance of the test tube. The experimental results demonstrate that the use of conical ring inserts leads to a higher heat transfer rate than that of the plain surface tube, and the DR array yields a better heat transfer than the others. The results are also correlated in the form of Nusselt number as a function of Reynolds number, Prandtl number and diameter ratio. An augmentation of up to 197%, 333%, and 237% in Nusselt number is obtained in the turbulent flow for the CR, DR and CDR arrays, respectively, although the effect of using the conical ring causes a substantial increase in friction factor

  4. Gastrostomy tube feeding of children with cerebral palsy

    DEFF Research Database (Denmark)

    Dahlseng, Magnus O; Andersen, Guro L; DA Graca Andrada, Maria

    2012-01-01

    To compare the prevalence of gastrostomy tube feeding (GTF) of children with cerebral palsy (CP) in six European countries.......To compare the prevalence of gastrostomy tube feeding (GTF) of children with cerebral palsy (CP) in six European countries....

  5. Factors related to persisting perforations after ventilation tube insertion.

    Science.gov (United States)

    O'Connell Ferster, Ashley P; Tanner, April Michelle; Karikari, Kodjo; Roberts, Christopher; Wiltz, Derek; Carr, Michele M

    2016-02-01

    Over a million ventilation tubes are placed annually in the United States, making this one of the most commonly performed procedures in the field of medicine. Certain factors increase the risk of persistent tympanic membrane perforation following the extrusion of short term ventilation tubes. Persistent perforations may fail to heal on their own, necessitating surgical closure to avoid conductive hearing loss. It is important to detect factors that may predict children who are at increased risk for persistent perforations. This study was a retrospective chart review that involved 757 patients between 2003 and 2008. The patients studied were within the age of 2 months-17 years, and all had short term tubes placed. The chart data also included demographic information, comorbidities, and information related to tube insertion and follow-up care. Chi-square, t-test, and multivariate logistic regression were conducted to compare variables between patients with perforations and those without. Data from 757 patients was analyzed, showing that perforation rate is associated with rhinorrhea, operative tube removal, aural polyps, and otorrhea (OR 1.72, 8.16, 4.69, and 1.72 respectively). The absence of otorrhea decreased the likelihood of TM perforations and no significant differences were found in gender, total number of sets of tubes, type of tube, use of nasal steroids, adenoidectomy, or nasal congestion. Our findings suggest that children with rhinorrhea, otorrhea, aural polyps, or prolonged intubation requiring operative tube removal should be identified clinically as children at risk of persisting perforation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Research on temperature control and influence of the vacuum tubes with inserted tubes solar heater

    Science.gov (United States)

    Xiao, L. X.; He, Y. T.; Hua, J. Q.

    2017-11-01

    A novel snake-shape vacuum tube with inserted tubes solar collector is designed in this paper, the heat transfer characteristics of the collector are analyzed according to its structural characteristics, and the influence of different working temperature on thermal characteristics of the collector is studied. The solar water heater prototype consisting of 14 vacuum tubes with inserted tubes is prepared, and the hot water storage control subsystem is designed by hysteresis comparison algorithm. The heat characteristic of the prototype was experimentally studied under hot water output temperature of 40-45°C, 50-55°C and 60-65°C. The daily thermal efficiency was 64%, 50% and 46%, respectively. The experimental results are basically consistent with the theoretical analysis.

  7. Erythromycin for Promoting the Postpyloric Placement of Feeding Tubes: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Qing-Jun Jiang

    2018-01-01

    Full Text Available Background. Critically ill patients can benefit from enteral nutrition with postpyloric feeding tubes, but the low success rate limits its wide use. Erythromycin could elevate the success rate of tube insertion, but its clinical efficiency still remains controversial. Methods. Included studies must be RCTs which assessed the success rate of postpyloric feeding tube insertion using erythromycin. Results. 284 patients were enrolled in six studies. Meta-analysis showed that erythromycin significantly increases the rate of successful postpyloric feeding tube placement (RR 1.45, 95% CI (1.12, 1.86 and did not increase the risk of adverse effects (RR 2.15, 95% CI (0.20, 22.82. Subgroup analysis showed that unweighted feeding tubes (RR 1.47, 95% CI (1.03, 2.11 could significantly increase the success rate. Country of study, intravenous route of erythromycin, and year of participant enrollment did not influence these results. Conclusions. Erythromycin significantly increases the success rate of postpyloric feeding tube placement. This suggests that erythromycin can be used as an auxiliary method to improve the success rate of bedside insertion.

  8. Development, prevention, and treatment of feeding tube dependency.

    Science.gov (United States)

    Krom, Hilde; de Winter, J Peter; Kindermann, Angelika

    2017-06-01

    Enteral nutrition is effective in ensuring nutritional requirements and growth. However, when tube feeding lasts for a longer period, it can lead to tube dependency in the absence of medical reasons for continuation of tube feeding. Tube-dependent children are unable or refuse to start oral activities and they lack oral skills. Tube dependency has health-, psychosocial-, and economy-related consequences. Therefore, the transition to oral feeding is of great importance. However, this transition can be very difficult and needs a multidisciplinary approach. Most studies for treatment of tube dependency are based on behavioral interventions, such as family therapy, individual behavior therapy, neuro-linguistic programming, and parental anxiety reduction. Furthermore, oral motor therapy and nutritional adjustments can be helpful in tube weaning. The use of medication has been described in the literature. Although mostly chosen as the last resort, hunger-inducing methods, such as the Graz-model and the Dutch clinical hunger provocation program, are also successful in weaning children off tube feeding. The transition from tube to oral feeding is important in tube-dependent children but can be difficult. We present an overview for the prevention and treatment of tube dependency. What is known: • Longer periods of tube feeding can lead to tube dependency. • Tube weaning can be very difficult. What is new: • Weaning as soon as possible and therefore referral to a multidisciplinary team are recommended. • An overview of treatment options for tube dependency is presented in this article.

  9. Pediatric Enteric Feeding Techniques: Insertion, Maintenance, and Management of Problems

    International Nuclear Information System (INIS)

    Nijs, Els L. F.; Cahill, Anne Marie

    2010-01-01

    Enteral feeding is considered a widespread, well-accepted means of delivering nutrition to adults and children who are unable to consume food by mouth or who need support in maintaining adequate nutrition for a variety of reasons, including acute and chronic disease states. Delivery of enteral feeding to nutritionally deprived patients may be achieved by several means. In this article, the indications and insertion of enteral access in children will be reviewed. In addition, common complications and management of problems will be discussed.

  10. Do financial incentives of introducing case mix reimbursement increase feeding tube use in nursing home residents?

    Science.gov (United States)

    Teno, Joan M; Feng, Zhanlian; Mitchell, Susan L; Kuo, Sylvia; Intrator, Orna; Mor, Vincent

    2008-05-01

    To determine whether adoption of Medicaid case mix reimbursement is associated with greater prevalence of feeding tube use in nursing home (NH) residents. Secondary analysis of longitudinal administrative data about the prevalence of feeding tube insertion and surveys of states' adoption of case mix reimbursement. NHs in the United States. NH residents at the time of NH inspection between 1993 and 2004. Facility prevalence of feeding tubes reported at the state inspection of NHs reported in the Online Survey, Certification and Reporting database and interviews with state policy makers regarding the adoption of case mix reimbursement. Between 1993 and 2004, 16 states adopted Resource Utilization Group case mix reimbursement. States varied in the prevalence of feeding tubes in their NHs. Although the use of feeding tube increased substantially over the years of the study, once temporal trends and facility fixed effects were accounted for, case mix reimbursement was not associated with greater prevalence of feeding tube use. The adoption of Medicaid case mix reimbursement was not associated with an increase in the prevalence of feeding tube use.

  11. [Effects of slow twisting needle insertion and tubing needle insertion at Neiguan (PC 6) on cardiovascular function: a comparative study].

    Science.gov (United States)

    Ning, Shaoli; Zhao, Lihua; Xu, Lingjun; Huang, Yu; Pang, Yong; Huang, Dingjian

    2016-01-01

    To compare the effects between slow twisting needle insertion and tubing needle insertion. With cross-over design, 100 healthy young subjects (half male and half female) aged from 19 to 23 years were randomly divided into two groups by random digital table, 50 cases in each one. At the first stage, subjects in the group A were treated with slow twisting needle insertion while, subjects in,the group B were treated with tubing needle insertion. One week later, the procedure of second stage was performed alternately. The needle was inserted into Neiguan (PC 6) with two methods by one acupuncturist. The needle was retained for 5 min before removal. Five min before needle insertion as well as needle withdrawal and 30 min after needle withdrawal, ZXG-E automatic cardiovascular diagnostic apparatus was used to test cardiovascular function. At the tim of needle withdrawal, slow twisting needle insertion could improve effect work of kinetics (EWK), effective blood volume (BV) and reduce elastic expansion coefficient of blood vessel (FEK) and left ventricular spray blood impedance (VER), which was significantly different from tubing needle insertion (all P 0.05). The slow twisting needle insertion is significantly superior to tubing needle insertion on lowering vascular tension and VER, improving EWK and BV.

  12. Current microbiology of percutaneous endoscopic gastrostomy tube (PEG tube) insertion site infections in patients with cancer.

    Science.gov (United States)

    Rolston, Kenneth V I; Mihu, Coralia; Tarrand, Jeffrey J

    2011-08-01

    Percutaneous endoscopic gastrostomy (PEG) is frequently used to provide enteral access in cancer patients who are unable to swallow. Infection is an important complication in this setting. Current microbiological data are needed to guide infection prevention and treatment strategies. The microbiological records of our institution (a 550-bed comprehensive cancer center) were retrospectively reviewed over an 8-month study period in order to identify patients who developed PEG tube insertion site infections, and review their microbiological details and susceptibility/resistance data. Fifty-eight episodes of PEG tube insertion site infections were identified. Of these, 31 (53%) were monomicrobial, and the rest were polymicrobial. The most common organisms isolated were Candida species, Staphylococcus aureus, and Pseudomonas aeruginosa. All infections were local (cellulitis, complicated skin, and skin structure infections including abdominal wall abscess) with no cases of concomitant bacteremia being documented. Most of the organisms isolated were susceptible to commonly used antimicrobial agents, although some quinolone-resistant and some multidrug-resistant organisms were isolated. This retrospective study provides descriptive data regarding PEG tube insertion site infections. These data have helped us update institutional guidelines for infection prevention and treatment as part of our focus on antimicrobial stewardship.

  13. Feeding tube-related complications and problems in patients receiving long-term home enteral nutrition

    Directory of Open Access Journals (Sweden)

    Vasileios Alivizatos

    2015-04-01

    Full Text Available Aim: The aim of this study was to evaluate the long-term complications and problems related to gastrostomy and jejunostomy feeding tubes used for home enteral nutrition support and the effect these have on health care use. Materials and Methods: The medical records of 31 patients having gastrostomy (27 patients and jejunostomy (4 feeding tubes inserted in our Department were retrospectively studied. All were discharged on long-term (>3 months enteral nutrition and followed up at regular intervals by a dedicated nurse. Any problem or complication associated with tube feeding as well as the intervention, if any, that occurred, was recorded. Data were collected and analyzed. Results: All the patients were followed up for a mean of 17.5 months (4-78. The most frequent tube-related complications included inadvertent removal of the tube (broken tube, plugged tube; 45.1%, tube leakage (6.4%, dermatitis of the stoma (6.4%, and diarrhea (6.4%. There were 92 unscheduled health care contacts, with an average rate of such 2.9 contacts over the mean follow-up time of 17.5 months. Conclusion: In patients receiving long-term home enteral nutrition, feeding tube-related complications and problems are frequent and result in significant health care use. Further studies are needed to address their optimal prevention modalities and management.

  14. An anthology of advances in enteral tube feeding formulations.

    Science.gov (United States)

    Campbell, Sheila M

    2006-08-01

    This article summarizes several major advances in tube feeding formulas marketed in the United States. It traces the progress in tube feeding formulas, starting with blenderized formulas to commercially available intact-nutrient formulas and culminating in the introduction of the concept of immunonutrition. The impact of packaging is also described.

  15. Testing Placement of Gastric Feeding Tubes in Infants.

    Science.gov (United States)

    Metheny, Norma A; Pawluszka, Ann; Lulic, Melanie; Hinyard, Leslie J; Meert, Kathleen L

    2017-11-01

    Inadvertent positioning of a nasogastric tube in the lung can cause serious complications, so identifying methods to detect improperly inserted tubes is imperative. To compare the sensitivity, specificity, and negative and positive predictive values of 4 pH cut points (< 4.0, < 4.5, < 5.0, and < 5.5) in differentiating gastric and tracheal aspirates under various treatment conditions and to explore the utility of a pepsin assay for distinguishing between gastric and tracheal aspirates. Gastric and tracheal aspirates were collected from critically ill infants undergoing mechanical ventilation who had nasogastric or orogastric feeding tubes. Aspirates were tested with colorimetric pH indicators and a rapid pepsin assay. Information about treatment conditions was obtained from medical records. Two hundred twelve gastric aspirates and 60 tracheal aspirates were collected from 212 patients. Sensitivity was highest and specificity was lowest at the gastric aspirate pH cut point of less than 5.5. Positive predictive values were 100% at all pH cut points less than 5.0. Negative predictive values were higher at the pH cut point of less than 5.0 than at cut points less than 4.5. A higher percentage of pepsin-positive readings was found in gastric aspirates (88.3%) than in tracheal aspirates (5.4%). For a desired positive predictive value of 100%, a pH cut point of less than 5.0 provides the best negative predictive values, regardless of gastric acid inhibitor administration and feeding status. The pepsin assay is promising as an additional marker to distinguish gastric from tracheal aspirates. ©2017 American Association of Critical-Care Nurses.

  16. Clinical application of transnasal feeding tube placement under fluoroscopic guidance

    International Nuclear Information System (INIS)

    Ge Kunyuan; Ni Caifang; Liu Yizhi; Zhu Xiaoli; Zou Jianwei; Jin Yonghai; Chen Long; Sun Ge; Sun Lingfang; Zhang Dong

    2008-01-01

    Objective: To evaluate the feasibility and effectiveness of duodenal feeding tube placement under fluoroscopic guidance and its clinical application. Methods: The transnasal duodenal nutriment tubes placement under fluoroscopic guidance were performed in 59 patients from June 3th, 2003 to August 17th, 2007. The successful placement of the feeding tube was defined as that of the tube tip was fixed at or distal to the duodenojejunal junction. Results: 57 out of 59 patients were successfully managed by feeding tube placement, with primary successful rate of 96.6% (57/59). The remaining two failures were due to overdistention of the stomach and were further managed after gastrointestinal decompression thoroughly. The mean fluoroscopy time of the procedure was 17.8 minutes with no severe immediate or delayed complications. Conclusion: The transnasal duodenal nutrient feeding tube placement under fluoroscopic guidance is a safe,economic, and effective management for enteral nutrition, providing extensive clinical utilization. (authors)

  17. Peritonitis following percutaneous gastrostomy tube insertions in children

    International Nuclear Information System (INIS)

    Dookhoo, Leema; Mahant, Sanjay; Parra, Dimitri A.; John, Philip R.; Amaral, Joao G.; Connolly, Bairbre L.

    2016-01-01

    Percutaneous retrograde gastrostomy has a high success rate, low morbidity, and can be performed under different levels of sedation or local anesthesia in children. Despite its favourable safety profile, major complications can occur. Few studies have examined peritonitis following percutaneous retrograde gastrostomy in children. To identify potential risk factors and variables influencing the development and early diagnosis of peritonitis following percutaneous retrograde gastrostomy. We conducted a retrospective case-control study of children who developed peritonitis within 7 days of percutaneous retrograde gastrostomy between 2003 and 2012. From the 1,504 patients who underwent percutaneous retrograde gastrostomy, patients who developed peritonitis (group 1) were matched by closest date of procedure to those without peritonitis (group 2). Peritonitis was defined according to recognized clinical criteria. Demographic, clinical, procedural, management and outcomes data were collected. Thirty-eight of 1,504 children (2.5%; 95% confidence interval, 1.8-3.5) who underwent percutaneous retrograde gastrostomy developed peritonitis ≤7 days post procedure (group 1). Fever (89%), irritability (63%) and abdominal pain (55%) occurred on presentation of peritonitis. Group 1 patients were all treated with antibiotics; 41% underwent additional interventions: tube readjustments (8%), aspiration of pneumoperitoneum (23%), laparotomy (10%) and intensive care unit admission (10%). In group 1, enteral feeds started on average 3 days later and patients were discharged 5 days later than patients in group 2. There were two deaths not directly related to peritonitis. Neither age, gender, weight, underlying diagnoses nor operator was identified as a risk factor. Peritonitis following percutaneous retrograde gastrostomy in children occurs in approximately 2.5% of cases. No risk factors for its development were identified. Medical management is usually sufficient for a good outcome

  18. Peritonitis following percutaneous gastrostomy tube insertions in children.

    Science.gov (United States)

    Dookhoo, Leema; Mahant, Sanjay; Parra, Dimitri A; John, Philip R; Amaral, Joao G; Connolly, Bairbre L

    2016-09-01

    Percutaneous retrograde gastrostomy has a high success rate, low morbidity, and can be performed under different levels of sedation or local anesthesia in children. Despite its favourable safety profile, major complications can occur. Few studies have examined peritonitis following percutaneous retrograde gastrostomy in children. To identify potential risk factors and variables influencing the development and early diagnosis of peritonitis following percutaneous retrograde gastrostomy. We conducted a retrospective case-control study of children who developed peritonitis within 7 days of percutaneous retrograde gastrostomy between 2003 and 2012. From the 1,504 patients who underwent percutaneous retrograde gastrostomy, patients who developed peritonitis (group 1) were matched by closest date of procedure to those without peritonitis (group 2). Peritonitis was defined according to recognized clinical criteria. Demographic, clinical, procedural, management and outcomes data were collected. Thirty-eight of 1,504 children (2.5%; 95% confidence interval, 1.8-3.5) who underwent percutaneous retrograde gastrostomy developed peritonitis ≤7 days post procedure (group 1). Fever (89%), irritability (63%) and abdominal pain (55%) occurred on presentation of peritonitis. Group 1 patients were all treated with antibiotics; 41% underwent additional interventions: tube readjustments (8%), aspiration of pneumoperitoneum (23%), laparotomy (10%) and intensive care unit admission (10%). In group 1, enteral feeds started on average 3 days later and patients were discharged 5 days later than patients in group 2. There were two deaths not directly related to peritonitis. Neither age, gender, weight, underlying diagnoses nor operator was identified as a risk factor. Peritonitis following percutaneous retrograde gastrostomy in children occurs in approximately 2.5% of cases. No risk factors for its development were identified. Medical management is usually sufficient for a good outcome

  19. Peritonitis following percutaneous gastrostomy tube insertions in children

    Energy Technology Data Exchange (ETDEWEB)

    Dookhoo, Leema [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada); University of Toronto, Faculty of Medicine, Toronto, ON (Canada); Mahant, Sanjay [The Hospital for Sick Children, Department of Pediatrics, Toronto, ON (Canada); Parra, Dimitri A.; John, Philip R.; Amaral, Joao G.; Connolly, Bairbre L. [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada)

    2016-09-15

    Percutaneous retrograde gastrostomy has a high success rate, low morbidity, and can be performed under different levels of sedation or local anesthesia in children. Despite its favourable safety profile, major complications can occur. Few studies have examined peritonitis following percutaneous retrograde gastrostomy in children. To identify potential risk factors and variables influencing the development and early diagnosis of peritonitis following percutaneous retrograde gastrostomy. We conducted a retrospective case-control study of children who developed peritonitis within 7 days of percutaneous retrograde gastrostomy between 2003 and 2012. From the 1,504 patients who underwent percutaneous retrograde gastrostomy, patients who developed peritonitis (group 1) were matched by closest date of procedure to those without peritonitis (group 2). Peritonitis was defined according to recognized clinical criteria. Demographic, clinical, procedural, management and outcomes data were collected. Thirty-eight of 1,504 children (2.5%; 95% confidence interval, 1.8-3.5) who underwent percutaneous retrograde gastrostomy developed peritonitis ≤7 days post procedure (group 1). Fever (89%), irritability (63%) and abdominal pain (55%) occurred on presentation of peritonitis. Group 1 patients were all treated with antibiotics; 41% underwent additional interventions: tube readjustments (8%), aspiration of pneumoperitoneum (23%), laparotomy (10%) and intensive care unit admission (10%). In group 1, enteral feeds started on average 3 days later and patients were discharged 5 days later than patients in group 2. There were two deaths not directly related to peritonitis. Neither age, gender, weight, underlying diagnoses nor operator was identified as a risk factor. Peritonitis following percutaneous retrograde gastrostomy in children occurs in approximately 2.5% of cases. No risk factors for its development were identified. Medical management is usually sufficient for a good outcome

  20. A Novel Device for Accurate Chest Tube Insertion

    DEFF Research Database (Denmark)

    Katballe, Niels; Moeller, Lars B; Olesen, Winnie H

    2016-01-01

    BACKGROUND: Optimal positioning of a large-bore chest tube is in the part of the pleural cavity that needs drainage. It is recommended that the chest tube be positioned apically in pneumothorax and basally for fluids. However, targeted chest tube positioning to a specific part of the pleural cavity...... can be a challenge. METHODS: A new medical device, the KatGuide, was developed for accurate guiding of a chest tube (28F) to an intended part of the pleural cavity. The primary end point of this randomized, controlled trial was optimal position of the chest tube. The optimal position in pneumothorax...

  1. Development and Technology Transfer of the Syncro Blue Tube (Gabriel) Magnetically Guided Feeding Tube

    Science.gov (United States)

    2017-06-01

    suggestions for reducing this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188...the tube to the 110 cm mark. At the 110 cm mark, secure the tube with medical tape and remove the stylet completely allowing enough tube slack ...and it provides slack that allows tube to advance distally by the effect of natural peristalsis on the bolus-sized balloon. Results: Most feeding

  2. [Long-term follow-up after tympanostomy tube insertion in children with serous otitis media].

    Science.gov (United States)

    Fekete-Szabó, Gabriella; Kiss, Fekete; Rovó, László

    2015-11-15

    The authors report about the efficacy of inserted tympanostomy tube in children with serous otitis media. The aim of the authors was to assess the status of eardrum, the function of Eustachian tube and hearing level 10 years after the use of tympanostomy tube. Patients filled out a questionnaire and microscopic examination of tympanic membrane, tympanometry, Eustachian tube function examination, and audiometry tests were performed. In the period of 2003-2004, ventilation tube insertion was performed in 711 patients in the ENT Department of Pediatric Health Center of University of Szeged. In 349 patients adenotomy and tympanostomy tube insertion, in 18 cases tonsillectomy and grommet insertion and in 344 patients only typmanostomy tube insertion were performed. Due to objective difficulties (address change, no phone number) 453 patients were asked for control test and 312 persons accepted the invitation. Normal hearing level was found in 84.6% of patients and normal tympanometry result occurred in 82%. Tympanic ventilation disorder, perforation of tympanic membrane, sensorineural hearing loss and sensorineural hearing loss due to noise exposure were diagnosed. Application of tympanostomy tube is effective in the treatment of serous otitis media resulting from ventilation disorder. The authors draw attention to the importance of tympanometry examination to prevent the adhesive processes and cholesteatoma in chronic ventilation disorder of the middle ear.

  3. Thermohydraulic performance comparision of compound inserts for a turbulent flow through a circular tube

    Directory of Open Access Journals (Sweden)

    Kapse Arvind A.

    2017-01-01

    Full Text Available Heat transfer and pressure drop characteristics of three different passive inserts are experimentally investigated for individual and compound insertion. Insert cross-section is altered along the length of test section for compound insertion. Test runs were conducted in a concentric circular tube in tube heat exchanger in the Reynolds number range of 8000 to 32000 with water as a working fluid. Enhancements in Nusselt number and friction factors are reported to be in the range of 38-234% and 55-524%, respectively, over plain tube. The average performance ratios based on equal pumping power are also reported and found in the range of 0.63-1.53. Based on experimental results, optimum combination for compound insertion is proposed.

  4. The feeding tube of cyst nematodes: characterisation of protein exclusion.

    Directory of Open Access Journals (Sweden)

    Sebastian Eves-van den Akker

    Full Text Available Plant parasitic nematodes comprise several groups; the most economically damaging of these are the sedentary endoparasites. Sedentary endoparasitic nematodes are obligate biotrophs and modify host root tissue, using a suite of effector proteins, to create a feeding site that is their sole source of nutrition. They feed by withdrawing host cell assimilate from the feeding site though a structure known as the feeding tube. The function, composition and molecular characteristics of feeding tubes are poorly characterised. It is hypothesised that the feeding tube facilitates uptake of host cell assimilate by acting as a molecular sieve. Several studies, using molecular mass as the sole indicator of protein size, have given contradictory results about the exclusion limits of the cyst nematode feeding tube. In this study we propose a method to predict protein size, based on protein database coordinates in silico. We tested the validity of these predictions using travelling wave ion mobility spectrometry--mass spectrometry, where predictions and measured values were within approximately 6%. We used the predictions, coupled with mass spectrometry, analytical ultracentrifugation and protein electrophoresis, to resolve previous conflicts and define the exclusion characteristics of the cyst nematode feeding tube. Heterogeneity was tested in the liquid, solid and gas phase to provide a comprehensive evaluation of three proteins of particular interest to feeding tube size exclusion, GFP, mRFP and Dual PI. The data and procedures described here could be applied to the design of plant expressed defence compounds intended for uptake into cyst nematodes. We also highlight the need to assess protein heterogeneity when creating novel fusion proteins.

  5. The feeding tube of cyst nematodes: characterisation of protein exclusion.

    Science.gov (United States)

    Eves-van den Akker, Sebastian; Lilley, Catherine J; Ault, James R; Ashcroft, Alison E; Jones, John T; Urwin, Peter E

    2014-01-01

    Plant parasitic nematodes comprise several groups; the most economically damaging of these are the sedentary endoparasites. Sedentary endoparasitic nematodes are obligate biotrophs and modify host root tissue, using a suite of effector proteins, to create a feeding site that is their sole source of nutrition. They feed by withdrawing host cell assimilate from the feeding site though a structure known as the feeding tube. The function, composition and molecular characteristics of feeding tubes are poorly characterised. It is hypothesised that the feeding tube facilitates uptake of host cell assimilate by acting as a molecular sieve. Several studies, using molecular mass as the sole indicator of protein size, have given contradictory results about the exclusion limits of the cyst nematode feeding tube. In this study we propose a method to predict protein size, based on protein database coordinates in silico. We tested the validity of these predictions using travelling wave ion mobility spectrometry--mass spectrometry, where predictions and measured values were within approximately 6%. We used the predictions, coupled with mass spectrometry, analytical ultracentrifugation and protein electrophoresis, to resolve previous conflicts and define the exclusion characteristics of the cyst nematode feeding tube. Heterogeneity was tested in the liquid, solid and gas phase to provide a comprehensive evaluation of three proteins of particular interest to feeding tube size exclusion, GFP, mRFP and Dual PI. The data and procedures described here could be applied to the design of plant expressed defence compounds intended for uptake into cyst nematodes. We also highlight the need to assess protein heterogeneity when creating novel fusion proteins.

  6. How do You Select an Anesthesia Method Prior to Tympanostomy Tube Insertion for a Child?

    OpenAIRE

    Lee, Dong-Hee

    2016-01-01

    The use of general (face-mask inhalation and intravenous) anesthesia has been the method of choice for tympanostomy tube insertion in children. However, there is no exact guideline for the choice of anesthesia method and there is no evidence to support the use of one anesthesia method over another. Clinically, the anesthesia method used to be decided by old customs and the surgeon's blind faith that children cannot bear tympanostomy tube insertion under local anesthesia. Clinicians should kee...

  7. Percutaneous Endoscopic Gastrostomy Tube Insertion in Neurodegenerative Disease: A Retrospective Study and Literature Review

    Directory of Open Access Journals (Sweden)

    Pamela Sarkar

    2017-05-01

    Full Text Available Background/Aims With the notable exceptions of dementia, stroke, and motor neuron disease, relatively little is known about the safety and utility of percutaneous endoscopic gastrostomy (PEG tube insertion in patients with neurodegenerative disease. We aimed to determine the safety and utility of PEG feeding in the context of neurodegenerative disease and to complete a literature review in order to identify whether particular factors need to be considered to improve safety and outcome. Methods A retrospective case note review of patients referred for PEG insertion by neurologists in a single neuroscience center was conducted according to a pre-determined set of standards. For the literature review, we identified references from searches of PubMed, mainly with the search items “percutaneous endoscopic gastrostomy” and “neurology” or “neurodegenerative disease.” Results Short-term mortality and morbidity associated with PEG in patients with neurological disease were significant. Age greater than 75 years was associated with poor outcome, and a trend toward adverse outcome was observed in patients with low serum albumin. Conclusions This study highlights the relatively high risk of PEG in patients with neurodegenerative disease. We present points for consideration to improve outcome in this particularly vulnerable group of patients.

  8. The impact of HPV status on weight loss and feeding tube use in oropharyngeal carcinoma.

    Science.gov (United States)

    Vangelov, Belinda; Kotevski, Damian P; Williams, Janet R; Smee, Robert I

    2018-04-01

    It has been well established that patients with oropharyngeal carcinoma are at high nutritional risk, with significant weight loss and tube feeding common. Human papillomavirus (HPV)-associated disease has led to a change in the "typical" presentation and nutritional profile of this population. The aim of our study was to determine whether the need for a feeding tube, and weight loss during radiotherapy (RT) in patients with oropharyngeal carcinoma differed with HPV status. Patients who received curative RT ± chemotherapy from January 2011 to January 2016 were included (n = 100). We retrospectively evaluated feeding tube use and timing of insertion (prophylactic vs reactive), percentage weight loss during RT and the prevalence of critical weight loss (CWL) ≥5%. HPV-positive patients had significantly higher weight loss during RT compared to the rest of the cohort (8.4% vs 6.1%, 95%CI 0.8-3.9, p = 0.003). CWL was observed in 86% and in a higher proportion with HPV-positive disease (93%, p = 0.011). Conditional probability modelling analysis revealed, with 74% accuracy, concurrent chemoradiotherapy and HPV-positive status were predictors of CWL when comparing HPV-positive patients to HPV-negative (96%, p = 0.001 and 98%, p = 0.012 respectively). More HPV-positive patients required feeding tubes (n = 43, 63%, p = 0.05), most being reactive (n = 27, 63%). All patients with reactive tubes experienced CWL. The high incidence of CWL in patients with HPV-positive oropharyngeal carcinoma is of concern. Tube feeding continues to be a necessary nutritional intervention in this population and predicting who will require a tube is challenging. Larger, prospective cohort studies are required. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Alternative method for predicting optimal insertion depth of the laryngeal tube in children.

    Science.gov (United States)

    Kim, J T; Jeon, S Y; Kim, C S; Kim, S D; Kim, H S

    2007-11-01

    Little information is available about the accuracy of the teeth mark on the laryngeal tube (LT) as a guide to correct placement in children. The aim of this crossover study was to evaluate three methods for optimal insertion depth of the size (#) 2 tube in children weighing 12-25 kg. In 24 children, the LT #2 was consecutively inserted by three different methods: (A) until the thick teeth mark on the tube was aligned with the upper incisors, (B) until resistance was felt, and (C) by inserting to a depth, previously measured, of the curved distance between the cricoid cartilage and the upper incisor. In each case, the depth of insertion, the degree of effective ventilation, the presence of leakage, and the fibreoptic view were assessed. Insertion based on the teeth mark led to a shorter insertion depth and a greater incidence of inadequate ventilation compared with the other two methods. There was no difference in the adequacy of ventilation between methods B and C. The vocal cords were more easily identified with methods B (62.5%) and C (75%) than with method A (12.5%). Insertion of the LT #2 aligned with the teeth mark can result in a shallow insertion depth and inadequate ventilation. The measured distance from the cricoid cartilage to the upper incisor offers alternative guidance for correct LT insertion.

  10. Pre-radiotherapy feeding tube identifies a poor prognostic subset of postoperative p16 positive oropharyngeal carcinoma patients.

    Science.gov (United States)

    Verma, Vivek; Liu, Jingxia; Eschen, Laura; Danieley, Jonathan; Spencer, Christopher; Lewis, James S; Diaz, Jason; Piccirillo, Jay F; Adkins, Douglas R; Nussenbaum, Brian; Thorstad, Wade L; Gay, Hiram A

    2015-01-09

    This study explores variables associated with poor prognosis in postoperative p16 positive oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing adjuvant radiotherapy or chemoradiotherapy. Specifically, analysis was done related to timing of feeding tube insertion relative to radiotherapy. From 1997-2009, of 376 consecutive patients with OPSCC, 220 received adjuvant IMRT, and 97 were p16 positive and eligible. Of these, 23 had feeding tube placement before IMRT (B-FT), 32 during/after IMRT (DA-FT), and 42 had no feeding tube (NO-FT). Feeding tubes were not placed prophylactically. These three groups were analyzed for differential tumor, patient, treatment, and feeding tube characteristics, as well as differences in overall survival (OS), disease free survival (DFS), and distant metastasis free survival (DMFS). Pre-RT FT insertion was associated with higher tumor size and depth, T (but not N) and overall stage, comorbidities, presence of chemotherapy, and less use of transoral laser microsurgery/transoral bovie. Additionally, time from surgery to IMRT completion was also statistically longer in the B-FT group. The feeding tube was permanent in 52% of patients in the B-FT group versus 16% in the DA-FT group (p = 0.0075). The 5-year OS for the NO-FT, DA-FT, and B-FT groups was 90%, 86%, and 50%, respectively. The 5-year DFS for the NO-FT, DA-FT, and B-FT groups was 87.6%, 83.6%, and 42.7%, respectively. Multivariate analysis showed that for OS and DFS, feeding tube placement timing and smoking history were statistically significant. Due to the poor prognosis of early FT insertion, the presence of FTs at time of radiotherapy consultation can be used as an alternate marker to identify a subset of p16 positive OPSCC patients that have a poor prognosis.

  11. Pre-radiotherapy feeding tube identifies a poor prognostic subset of postoperative p16 positive oropharyngeal carcinoma patients

    International Nuclear Information System (INIS)

    Verma, Vivek; Liu, Jingxia; Eschen, Laura; Danieley, Jonathan; Spencer, Christopher; Lewis, James S Jr; Diaz, Jason; Piccirillo, Jay F; Adkins, Douglas R; Nussenbaum, Brian; Thorstad, Wade L; Gay, Hiram A

    2015-01-01

    This study explores variables associated with poor prognosis in postoperative p16 positive oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing adjuvant radiotherapy or chemoradiotherapy. Specifically, analysis was done related to timing of feeding tube insertion relative to radiotherapy. From 1997–2009, of 376 consecutive patients with OPSCC, 220 received adjuvant IMRT, and 97 were p16 positive and eligible. Of these, 23 had feeding tube placement before IMRT (B-FT), 32 during/after IMRT (DA-FT), and 42 had no feeding tube (NO-FT). Feeding tubes were not placed prophylactically. These three groups were analyzed for differential tumor, patient, treatment, and feeding tube characteristics, as well as differences in overall survival (OS), disease free survival (DFS), and distant metastasis free survival (DMFS). Pre-RT FT insertion was associated with higher tumor size and depth, T (but not N) and overall stage, comorbidities, presence of chemotherapy, and less use of transoral laser microsurgery/transoral bovie. Additionally, time from surgery to IMRT completion was also statistically longer in the B-FT group. The feeding tube was permanent in 52% of patients in the B-FT group versus 16% in the DA-FT group (p = 0.0075). The 5-year OS for the NO-FT, DA-FT, and B-FT groups was 90%, 86%, and 50%, respectively. The 5-year DFS for the NO-FT, DA-FT, and B-FT groups was 87.6%, 83.6%, and 42.7%, respectively. Multivariate analysis showed that for OS and DFS, feeding tube placement timing and smoking history were statistically significant. Due to the poor prognosis of early FT insertion, the presence of FTs at time of radiotherapy consultation can be used as an alternate marker to identify a subset of p16 positive OPSCC patients that have a poor prognosis

  12. Transition from tube feeding to oral feeding: experience in a tertiary care paediatric cardiology unit.

    Science.gov (United States)

    Shine, Anne Marie; Finn, Daragh Gerard; Allen, Noeleen; McMahon, Colin J

    2018-05-02

    Home enteral tube feeding (HETF) is imperative for many infants and children with congenital heart disease (CHD). Tube weaning (TW) facilitates the progression from tube feeding to oral diet. There is limited literature on TW practices, protocols and success for children with CHD that have been tube fed. The objective of this study is to assess the process of weaning HETF in a tertiary referral centre for paediatric CHD. Specifically, we aimed to assess the duration of HETF, duration of TW and the interventions involved. We retrospectively reviewed the medical and dietetic records of all infants and children that were successfully weaned off HETF over a 12-month period from January 2015 to December 2015. There were 30 children included in the study, 9 boys and 21 girls. The diagnoses included 15 septal defects, 8 univentricular diagnosis and other diagnoses in 7 children. The median age at initiation of enteral tube feeding was 45 days (range 2-169). The median duration to wean from enteral tube feeding was 52 days (range 2-359). Number of dietetic consults required for successful TW varied among patients, median 5 (range 2-23). The number of days required for successful TW was associated with age and duration on HETF. Dietetic interventions included discontinuation of nutrient dense feeds, altering feed schedule and reduction of feed volume. Weaning HETF is possible in the outpatient setting. Early and frequent dietetic intervention is recommended to ensure prompt discontinuation of HETF when appropriate.

  13. Repairing a steam generator tube by inserting a sheath

    International Nuclear Information System (INIS)

    Gaudin, J.P.

    1986-01-01

    According to the invention, the mechanical deformation of the sheath, realized by expansion in its end part opposite to the expanded end within the tube plate, is situated along a limited height, and the parameters of the said mechanical deformation are calculated according to the welding parameters applied consecutively. Besides, the said welding parameters are determined according to the initial mechanical deformation to obtain stress relaxation more particularly in the singular zones of the mechanical deformation. The present invention applies to the repair of PWR steam generator tubes [fr

  14. In Vitro Evaluation of Eslicarbazepine Delivery via Enteral Feeding Tubes.

    Science.gov (United States)

    Reindel, Kristin; Zhao, Fang; Hughes, Susan; Dave, Vivek S

    2017-12-01

    Purpose: The feasibility of preparing an eslicarbazepine acetate suspension using Aptiom tablets for administration via enteral feeding tubes was evaluated. Methods: Eslicarbazepine acetate suspension (40 mg/mL) was prepared using Aptiom tablets after optimizing the tablet crushing methods and the vehicle composition. A stability-indicating high-performance liquid chromatography (HPLC) method was developed to monitor the eslicarbazepine stability in the prepared suspension. Three enteric feeding tubes of various composition and dimensions were evaluated for the delivery of the suspensions. The suspension was evaluated for the physical and chemical stability for 48 hours. Results: The reproducibility and consistency of particle size reduction was found to be best with standard mortar/pestle. The viscosity analysis and physical stability studies showed that ORA-Plus:water (50:50 v/v) was optimal for suspending ability and flowability of suspension through the tubes. The developed HPLC method was found to be stability indicating and suitable for the assay of eslicarbazepine acetate in the prepared suspension. The eslicarbazepine concentrations in separately prepared suspensions were within acceptable range (±3%), indicating accuracy and reproducibility of the procedure. The eslicarbazepine concentrations in suspensions before and after delivery through the enteric feeding tubes were within acceptable range (±4%), indicating absence of any physical/chemical interactions of eslicarbazepine with the tubes and a successful delivery of eslicarbazepine dosage via enteric feeding tubes. The stability study results showed that eslicarbazepine concentration in the suspension remained unchanged when stored at room temperature for 48 hours. Conclusion: The study presents a convenient procedure for the preparation of a stable suspension of eslicarbazepine acetate (40 mg/mL) using Aptiom tablets, for administration via enteral feeding tubes.

  15. Retortable Laminate/Polymeric Food Tubes for Specialized Feeding

    Science.gov (United States)

    2012-06-01

    Report STP #3010 Results and Accomplishments (June 2010 – June 2012) Report No: FTR 303 CDRL Sequence: A003 June 2012 CORANET CONTRACT #: SP4701-08-D...June 2010 - June 2012 Retortable Laminate/Polymeric Food Tubes for Specialized Feeding - STP # 3010 SP4701-08-D-0004 MANTECH (0708011S) CORANET A003...on commercial off-the-shelf materials and not military unique. A market survey of commercially available laminated tubes revealed that they are all

  16. A novel method for improving chest tube insertion skills among medical interns

    Science.gov (United States)

    Tatli, Ozgur; Turkmen, Suha; Imamoglu, Melih; Karaca, Yunus; Cicek, Mustafa; Yadigaroglu, Metin; Bayrak, Selen T.; Asik, Olgun; Topbas, Murat; Turedi, Suleyman

    2017-01-01

    Objectives: To develop a low-cost biomaterial-covered chest tube simulation model and assess its possible usefulness for developing the chest tube insertion skills among medical interns. Methods: This mannequin-based interventional study was performed in a University hospital setting. We included 63 physicians performing emergency medicine internship at the Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey, between January 2015 and March 2015. A dummy was prepared for training simulation using a display mannequin. Medical interns received instruction concerning pneumothorax and the chest tube procedure. A total of 63 medical interns participating in this interventional study were asked to insert a chest tube in a biomaterial-covered mannequin. A senior trainee scored their performance using a check list and the mean of the total scores was calculated (21 items; total score, 42). Results: The mean procedural score was 40.9 ± 1.3 of a possible 42. The maximum score of 42 was achieved by 39.7% of the medical interns, while another 33.3% achieved a score of 41. Of the participants, 85% succeeded in inserting the tube via an appropriate technique, achieving a score of 40 or more. Conclusion: Our results indicated that this model could be useful for effective training of medical interns for chest tube insertion, which is an important skill in emergency medicine. This biomaterial-covered model is inexpensive and its use can potentially be widened to improve training methods without significant financial demand. PMID:28917064

  17. Swirl flow analysis in a helical wire inserted tube using CFD code

    International Nuclear Information System (INIS)

    Park, Yusun; Chang, Soon Heung

    2010-01-01

    An analysis on the two-phase flow in a helical wire inserted tube using commercial CFD code, CFX11.0, was performed in bubbly flow and annular flow regions. The analysis method was validated with the experimental results of Takeshima. Bubbly and annular flows in a 10 mm inner diameter tube with varying pitch lengths and inserted wire diameters were simulated using the same analysis methods after validation. The geometry range of p/D was 1-4 and e/D was 0.08-0.12. The results show that the inserted wire with a larger diameter increased swirl flow generation. An increasing swirl flow was seen as the pitch length increased. Regarding pressure loss, smaller pitch lengths and inserted wires with larger diameters resulted in larger pressure loss. The average liquid film thickness increased as the pitch length and the diameter of the inserted wire increased in the annular flow region. Both in the bubbly flow and annular flow regions, the effect of pitch length on swirl flow generation and pressure loss was more significant than that of the inserted wire diameters. Pitch length is a more dominant factor than inserted wire diameter for the design of the swirl flow generator in small diameter tubes.

  18. Development of a nasogastric tube insertion simulator: a collaborative interdisciplinary effort.

    Science.gov (United States)

    Summer, Lindsay; Gonzalez, Laura; Jimeno, Miguel; Christensen, Ken

    2009-01-01

    The nursing faculty shortage has created the need for more innovative and effective ways to better stimulate nursing students. Simulation technology is one way to increase the effectiveness of teaching faculty. In this article, a collaborative project between the College of Nursing and College of Engineering at the University of South Florida to develop and evaluate a PC-based software simulator based on videogame technologies for nursing skill acquisition is discussed. A software simulator for teaching and assessing mastery of the procedure for nasogastric tube insertion is described. The purpose of the simulator is to complement the standard training of nasogastric tube insertion that uses static mannequins and instruction/assessment by nursing instructors. The simulator was used in a fundamentals of nursing class at the University of South Florida, with 75 students enrolled. Evaluation showed that the simulator significantly increased the confidence of the students in their ability to perform nasogastric tube insertion.

  19. Reusable locking tube insertion and removal fixture and method in a reconstitutable fuel assembly

    International Nuclear Information System (INIS)

    Shallenberger, J.M.; Ferlan, S.J.

    1987-01-01

    This patent describes a locking tube insertion and removal fixture for use with a reconstitutable fuel assembly. The process includes a top nozzle with an adapter plate having at least one passageway, at least one guide thimble with an upper end portion, and an attaching structure having a hollow locking tube insertable and removable into and from a locking position in the upper end portion of the guide thimble for releasably locking the upper end portion of the guide thimble within the passageway of the top nozzle and adapter plate

  20. Disc-retained tubes for radiologically inserted gastrostomy (RIG): Not up to the job?

    International Nuclear Information System (INIS)

    Kibriya, N.; Wilbraham, L.; Mullan, D.; Puro, P.; Vasileuskaya, S.; Edwards, D.W.; Laasch, H.-U.

    2013-01-01

    Aim: To assess the insertion procedure and performance of disc-retained gastrostomy tubes, recording complications and accidental displacements by prospective audit, and to determine whether primary placement of the tube off-licence was feasible. Materials and methods: Disc-retained 12 F single-lumen Monarch gastrostomy tubes (Enteral UK, Selby, UK) were inserted by three gastrointestinal interventional radiologists in a supra-regional cancer centre. The 12 F tubes required a 20 F peel-away sheath with four-point gastropexy fixation and were placed under conscious sedation, using electrocardiogram (EEG) bispectral index monitoring. Follow-up was performed in an in-house gastrostomy drop-in clinic at 1 week and 1 month, supplemented with weekly telephone follow-up. Patients also had open access to the gastrostomy drop-in clinic for immediate advice and complication management. Results: Eighteen patients underwent primary insertion of a Monarch gastrostomy tube over 5 months. A total of 6/18 (33%) tubes displaced; 4/18 (22%) completely, 2/18 (11%) occult into the peritoneum. Four of 18 (22%) patients developed infection at the stoma site. Due to the unexpectedly poor performance of the tube, the study was terminated early. Conclusion: Initial experience with the Monarch disc-retained gastrostomy tube demonstrates it unsuitable for primary placement with current protocols. In view of the potentially serious complications, the Medicines and Healthcare Products Regulatory Agency (MHRA) has been informed. A request has been made to the distributer to reassess the tube design and/or review the procedure promoted for primary placement

  1. Refining low protein modular feeds for children on low protein tube feeds with organic acidaemias.

    Science.gov (United States)

    Daly, A; Evans, S; Ashmore, C; Chahal, S; Santra, S; MacDonald, A

    2017-12-01

    Children with inherited metabolic disorders (IMD) who are dependent on tube feeding and require a protein restriction are commonly fed by 'modular tube feeds' consisting of several ingredients. A longitudinal, prospective two-phase study, conducted over 18 months assessed the long-term efficacy of a pre-measured protein-free composite feed. This was specifically designed to meet the non-protein nutritional requirements of children (aged over 1 year) with organic acidaemias on low protein enteral feeds and to be used as a supplement with an enteral feeding protein source. All non-protein individual feed ingredients were replaced with one protein-free composite feed supplying fat, carbohydrate, and micronutrients. Thirteen subjects, median age 7.4y (3-15.5y), all nutritionally tube dependent (supplying nutritional intake: ≥ 90%, n = 12; 75%, n = 1), and diagnosed with organic acidaemias (Propionic acidaemia, n = 6; Vitamin B 12 non-responsive methyl malonic acidaemia, n = 4; Isovaleric acidaemia, n = 2; Glutaric aciduria type1, n = 1); were studied. Nutritional intake, biochemistry and anthropometry were monitored at week - 8, 0, 12, 26 and 79. Energy intake remained unchanged, providing 76% of estimated energy requirements. Dietary intakes of vitamins, minerals and essential fatty acids significantly increased from week 0 to week 79, but sodium, potassium, magnesium, decosahexanoic acid and fibre did not meet suggested requirements. Plasma zinc, selenium, haemoglobin and MCV significantly improved, and growth remained satisfactory. Natural protein intake met WHO/FAO/UNU 2007 recommendations. A protein-free composite feed formulated to meet the non-protein nutritional requirements of children aged over 1 year improved nutritional intake, biochemical nutritional status, and simplified enteral tube feeding regimens in children with organic acidaemias.

  2. Conservative use of chest-tube insertion in children with pleural effusion.

    Science.gov (United States)

    Epaud, R; Aubertin, G; Larroquet, M; Pointe, H Ducou-le; Helardot, P; Clement, A; Fauroux, B

    2006-04-01

    The aim of this work was to evaluate the effect of a more conservative use of chest-tube insertion on the short-term and long-term outcome of pleural infection. Sixty-five patients with pleural infection, aged 1 month to 16 years were each treated according to one of the two protocols: classical management with chest-tube insertion (classical group, n = 33), or conservative use of chest-tube insertion (conservative group, n = 32), with drainage indicated only in the case of voluminous pleural effusion defined by a mediastinal shift and respiratory distress and/or an uncontrolled septic situation. The two groups were comparable with regard to age, baseline C-reactive protein (CRP) value and white blood cell counts, pleural thickness, identified bacteria, and antibiotic treatment. Chest-tube insertion was performed in 17 patients (52%) of the classical group compared to eight patients (25%) of the conservative group (P = 0.03). Duration of temperature above 39 degrees C was shorter in the conservative group (10 +/- 1 vs. 14 +/- 1 days, P = 0.01), as was the normalization of CRP (13 +/- 1 vs. 17 +/- 1 days, P = 0.03). Duration of hospitalization and intravenous (IV) antibiotherapy as well as the delay of chest-radiograph normalization was not significantly different between the two groups. A more conservative use of chest-tube insertion did not change short- and long-term outcome of the pleural infection in children. Drainage could be restricted to the most severely affected patients with pleural empyema causing a mediastinal shift and respiratory distress and/or presenting with an uncontrolled septic situation.

  3. Nasoenteral feeding tube placement by nurses using an electromagnetic guidance system (with video)

    NARCIS (Netherlands)

    Mathus-Vliegen, Elisabeth M. H.; Duflou, Ann; Spanier, Marcel B. W.; Fockens, Paul

    2010-01-01

    BACKGROUND: The early institution of feeding in patients who need postpyloric feeding tubes is often hampered by a limited availability of endoscopists experienced in safe tube positioning. OBJECTIVE: To test the feasibility of having nurses place postpyloric feeding tubes by using a universal path

  4. Colojejunal Fistula Resulting from a D-PEJ Feeding Tube

    Directory of Open Access Journals (Sweden)

    Martin D. Zielinski

    2008-06-01

    Full Text Available Numerous procedures have been developed to provide adequate enteral nutrition to patients with gastrointestinal disorders. Previously, operative placement of a feeding gastrostomy or jejunostomy tube was the accepted means of gaining chronic enteral access. However, improved technology and experience with endoscopic techniques have quickly replaced primary operative placement of enteral access. Direct percutaneous endoscopic jejunostomy (D-PEJ is a procedure that was designed to deliver enteral feeding solutions for patients with proximal disease after unsatisfactory results from percutaneous endoscopic gastrostomy tubes with jejunal extensions (PEG-J. As with any procedure, it is associated with complications. We present the first reported case of a colojejunal fistula resulting from a D-PEJ placement. While D-PEJ has been shown to be relatively safe, complications related to the inherent limitations of the procedure need to be considered when the patient experiences unusual post-procedure symptoms and worked up appropriately.

  5. Ahmed glaucoma valve implantation with tube insertion through the ciliary sulcus in pseudophakic/aphakic eyes.

    Science.gov (United States)

    Eslami, Yadolla; Mohammadi, Massood; Fakhraie, Ghasem; Zarei, Reza; Moghimi, Sasan

    2014-02-01

    To report the efficacy and safety of Ahmed glaucoma valve (AGV) insertion into the ciliary sulcus in pseudophakic/aphakic patients. A chart review was done on patients with uncontrolled glaucoma, who underwent AGV implantation with tube inserted into the ciliary sulcus. Baseline intraocular pressure (IOP) and number of medications were compared with that of postoperative follow-up visits. Surgical success was defined as last IOP glaucoma control, and without loss of light perception. Postoperative complications were recorded. Twenty-three eyes of 23 patients were recruited with the mean follow-up of 9 months (range, 3 to 24 mo). The mean (SD) age of patients was 49.9 (16.9) years (range, 22 to 80 years). The mean (SD) IOP (mm Hg) was reduced from 37.9 (12.4) before surgery to 16.2 (3.6) at the last follow-up visit (P<0.001). The mean (SD) number of medications was reduced from 3.3 (0.9) preoperatively to 1 (1.1) at the last follow-up (P<0.001). Success rate was 18/23 (78.6%). Complications included endophthalmitis in 1 eye, tube exposure in 1 diabetic patient, and vitreous tube occlusion in 1 eye. No case of corneal decompensation or graft failure was seen during follow-up. Ciliary sulcus placement of the tube of AGV effectively reduces IOP and medication use in short term. It has the potential to lower corneal complications of anterior chamber tube insertion and avoids the need for pars plana vitrectomy and tube insertion in patients at higher risk of corneal decompensation.

  6. Application of nasointestinal feeding tube in treatment of acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Li Tian

    2016-12-01

    Full Text Available Objective: To observe the clinical effect of nasointestinal feeding tube for enteral nutrition in the treatment of acute pancreatitis. Methods: A total of 128 patients with acute pancreatitis who were admitted in our hospital were included in the study and randomized into the treatment group and the control group with 64 cases in each group. Routine pancreatitis treatments after admission in the two groups were performed. On the basis, nasointestinal feeding tube was indwelled in patients in the treatment group for nutrition support. The changes of biochemical and nutritional indicators before and after treatment in the two groups were compared. Results: LC, TP, ALB, and Hb after treatment in the two groups were significantly elevated, while AMY and Lipase were significantly reduced when compared with before treatment (P0.05. Conclusions: Adoption of nasointestinal feeding tube for enteral nutrition in the treatment of acute pancreatitis can significantly improve the nutritional status; therefore, it deserves to be widely recommended in the clinic.

  7. Dilemmas for guardians of advanced dementia patients regarding tube feeding.

    Science.gov (United States)

    Gil, Efrat; Agmon, Maayan; Hirsch, Ayal; Ziv, Miriam; Zisberg, Anna

    2018-01-01

    advanced dementia is an incurable illness, its last stage marked by inability to eat. Tube feeding was deemed a helpful solution at this stage, but in recent years its inefficiency has been proved, and it is no longer practiced in many countries around the world. In Israel, however, the procedure is still accepted. In the gastroenterology department at the Bnai Zion Medical Center, a serious interaction is ongoing with patients' legal guardians, where detailed information is given about the inefficiency of the tube procedure. Nevertheless, the great majority of guardians choose to have it performed. to probe the considerations underlying the decision for gastrostomy, despite the data and the recommendations. qualitative research, including participant observation at the clinic and in-depth interviews with guardians. the families of most patients did not discuss end-of-life issues with them. The overwhelming preference for using the technology was interpreted as life-saving, in contrast to comfort feeding, which was deemed euthanasia. The reasons given for the decision to tube feed were drawn from a range of outlooks: religion, the patient's earlier survival capacity, and pragmatic considerations involving relations with nursing home staff. study of the decision-making process of advanced dementia patients' guardians sheds light on the layers of meaning of the Israeli discourse regarding end-of-life issues. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

  8. Esophagojejunostomy Feeding Tube Placement in 5 Dogs with Pancreatitis and Anorexia

    Directory of Open Access Journals (Sweden)

    Forrest Cummings

    2014-01-01

    Full Text Available Enteral feeding tube placement has been described in veterinary medicine for several years. Indications include oral, esophageal, gastrointestinal, pancreatic, hepatic, and neurologic diseases. In this paper, endoscopically assisted placement of an esophagojejunostomy (EJ feeding tube in dogs with pancreatitis and prolonged anorexia is described. To the author’s knowledge there are no published reports of this procedure. Esophagojejunostomy feeding tubes provide an alternative to other forms of postgastric feeding tube placement (e.g., nasojejunal, gastrojejunostomy, and jejunostomy tubes without the associated complications of patient discomfort, sneezing, epistaxis, and peritonitis. Tube occlusion, transient vomiting and loose stool were the most commonly reported complications.

  9. Flow pattern assessment in tubes with wire coil inserts in laminar and transition regimes

    International Nuclear Information System (INIS)

    Garcia, A.; Solano, J.P.; Vicente, P.G.; Viedma, A.

    2007-01-01

    The paper presents an analysis of the flow mechanisms in tubes with wire coils using hydrogen bubble visualization and PIV techniques. Results have been contrasted with experimental data on pressure drop. The relation between the observed flow patterns and the friction factor has been analysed. The experimental analysis that has been carried out allows one to state that at low Reynolds numbers (Re < 400) the flow in tubes with wire coils is basically similar to the flow in smooth tubes. At Reynolds numbers between 500 and 700 and in short pitch wire coils a recirculating flow appears. The insertion of wires coils in a smooth tube accelerates significantly the transition to turbulence. This is produced at Reynolds numbers between 700 and 1000 depending on the wire pitch

  10. Heat Transfer Enhancement Studies in a Circular Tube Fitted with Right-Left Helical Inserts with Spacer

    OpenAIRE

    P. K. Nagarajan; P. Sivashanmugam

    2011-01-01

    Experimental investigation of heat transfer and friction factor characteristics of circular tube fitted with 300 right-left helical screw inserts with 100 mm spacer of different twist ratio has been presented for laminar and turbulent flow.. The experimental data obtained were compared with those obtained from plain tube published data. The heat transfer coefficient enhancement for 300 RL inserts with 100 mm spacer is quite comparable with for 300 R-L inserts. Performance evalu...

  11. Comparison of four techniques of nasogastric tube insertion in anaesthetised, intubated patients: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Mohan Chandra Mandal

    2014-01-01

    Full Text Available Background and Aims: Insertion of nasogastric tubes (NGTs in anaesthetised, intubated patients with a conventional method is sometimes difficult. Different techniques of NGT insertion have been tried with varying degree of success. The aim of this prospective, randomised, open-label study was to evaluate three modified techniques of NGT insertion comparing with the conventional method in respect of success rate, time taken for insertion and the adverse events. Methods: In the operation theatre of general surgery, the patients were randomly allocated into four groups: Group C (control group, n = 54, Group W (ureteral guide wire group, n = 54, Group F (neck flexion with lateral pressure, n = 54 and Group R (reverse Sellick′s manoeuvre, n = 54. The number of attempts for successful NGT insertion, time taken for insertion and adverse events were noted. Results: All the three modified techniques were found more successful than the conventional method on the first attempt. The least time taken for insertion was noted in the reverse Sellick′s method. However, on intergroup analysis, neck flexion and reverse Sellick′s methods were comparable but significantly faster than the other two methods with respect to time taken for insertion. Conclusion: Reverse Sellick′s manoeuver, neck flexion with lateral neck pressure and guide wire-assisted techniques are all better alternatives to the conventional method for successful, quick and reliable NGT insertion with permissible adverse events in anaesthetised, intubated adult patients. Further studies after eliminating major limitations of the present study are warranted to establish the superiority of any one of these modified techniques.

  12. Deaths associated with insertion of nasogastric tubes for enteral nutrition in the medical intensive care unit: Clinical and autopsy findings

    Science.gov (United States)

    Smith, Avery L.; Santa Ana, Carol A.; Fordtran, John S.; Guileyardo, Joseph M.

    2018-01-01

    ABSTRACT It is generally assumed that blind insertion of nasogastric tubes for enteral nutrition in patients admitted to medical intensive care units is safe; that is, does not result in life-threatening injury. If death occurs in temporal association with insertion of a nasogastric tube, caregivers typically attribute it to underlying diseases, with little or no consideration of iatrogenic death due to tube insertion. The clinical and autopsy results in three recent cases at Baylor University Medical Center challenge the validity of these notions. PMID:29904295

  13. Hemlock woolly adelgid (Homoptera: Adelgidae): stylet bundle insertion and feeding sites

    Science.gov (United States)

    Rebecca F. Young; Kathleen S. Shields; Graeme P. Berlyn

    1995-01-01

    Stylet bundle insertion site, path traveled, and feeding site were examined for the hemlock woolly adelgid, Adelges tsugae Annand, on needles from current and previous years of eastern hemlock, Tsuga canadensis Carriere. The stylet bundle is composed of 4 individual stylets--2 outer mandibular stylets and 2 inner maxillary stylets...

  14. Cuff depth and continuous chest auscultation method for determination of tracheal tube insertion depth in nasal intubation: observational study.

    Science.gov (United States)

    Ouchi, Kentaro; Sugiyama, Kazuna

    2016-04-01

    Incorrect endobronchial placement of the tracheal tube can lead to serious complications. Hence, it is necessary to determine the accuracy of tracheal tube positioning. Markers are included on tracheal tubes, in the process of their manufacture, as indicators of approximate intubation depth. In addition, continuous chest auscultation has been used for determining the proper position of the tube. We examined insertion depth using the cuff depth and continuous chest auscultation method (CC method), compared with insertion depth determined by the marker method, to assess the accuracy of these methods. After induction of anesthesia, tracheal intubation was performed in each patient. In the CC method, the depth of tube insertion was measured when the cuff had passed through the glottis, and again when breath sounds changed in quality; the depth of tube insertion was determined from these values. In the marker method, the depth of tube insertion was measured and determined when the marker of the tube had reached the glottis, using insertion depth according to the marker as an index. Insertion depth by the marker method was 26.6 ± 1.2 cm and by the CC method was 28.0 ± 1.2 cm (P < 0.0001). The CC method indicated a significantly greater depth than the marker method. This study determined the safe range of tracheal tube placement. Tube positions determined by the CC method were about 1 cm deeper than those determined by the marker. This information is important to prevent accidental one-lung ventilation and accidental extubation. UMIN No. UMIN000011375.

  15. Fluoroscopy-guided insertion of nasojejunal tubes in children - setting local diagnostic reference levels

    International Nuclear Information System (INIS)

    Vitta, Lavanya; Raghavan, Ashok; Sprigg, Alan; Morrell, Rachel

    2009-01-01

    Little is known about the radiation burden from fluoroscopy-guided insertions of nasojejunal tubes (NJTs) in children. There are no recommended or published standards of diagnostic reference levels (DRLs) available. To establish reference dose area product (DAP) levels for the fluoroscopy-guided insertion of nasojejunal tubes as a basis for setting DRLs for children. In addition, we wanted to assess our local practice and determine the success and complication rates associated with this procedure. Children who had NJT insertion procedures were identified retrospectively from the fluoroscopy database. The age of the child at the time of the procedure, DAP, screening time, outcome of the procedure, and any complications were recorded for each procedure. As the radiation dose depends on the size of the child, the children were assigned to three different age groups. The sample size, mean, median and third-quartile DAPs were calculated for each group. The third-quartile values were used to establish the DRLs. Of 186 procedures performed, 172 were successful on the first attempt. These were performed in a total of 43 children with 60% having multiple insertions over time. The third-quartile DAPs were as follows for each age group: 0-12 months, 2.6 cGy cm 2 ; 1-7 years, 2.45 cGy cm 2 ; >8 years, 14.6 cGy cm 2 . High DAP readings were obtained in the 0-12 months (n = 4) and >8 years (n = 2) age groups. No immediate complications were recorded. Fluoroscopy-guided insertion of NJTs is a highly successful procedure in a selected population of children and is associated with a low complication rate. The radiation dose per procedure is relatively low. (orig.)

  16. A very feasible alternative in patients with feeding difficulties from gastrostomy: Jejunal tube advanced through the gastrostomy

    Directory of Open Access Journals (Sweden)

    Ramazan Karabulut

    2015-01-01

    Full Text Available Background: Our aim is to share our experiences regarding patients who cannot be fed effectively through the gastrostomy tube, but were inserted feeding jejunostomy through the gastrostomy orifice using scopic fluoroscopic techniques utilised by the interventional radiology. Patients and Methods: Between January 2010 and May 2013 the patients that were inserted jejunostomy tube through the gastrostomy orifice using fluoroscopic techniques were retrospectively analysed. Data including primary indication for gastrostomy, sex, concomitant disease and the requirement for gastroesophageal reflux disease (GERD were all recorded. Results: There were five patients with these criteria. They all received either medical or surgical GERD therapy; nevertheless enteral feeding failed to reach an effective level, they all had vomiting and did not gain any weight. Following conversion, all the patients gained minimum 2 kg in 2-5 months; all the patients tolerated enteral feeding and were discharged in the early period. There were neither procedure related complications such as perforation, bleeding nor sedation related complications. Procedure took no more than 30 min as a whole. There was no need for surgical intervention. However in one patient re-intervention was required due to accidental removal of the catheter. Conclusions: In case of feeding difficulties following the gastrostomy; instead of an invasive surgical intervention; physicians should consider jejunal feeding that is advanced through the gastrostomy, which does not require any anaesthesia.

  17. Radiology responsibilities post NPSA guidelines for nasogastric tube insertion: A single centre review

    International Nuclear Information System (INIS)

    Snaith, Beverly; Flintham, Kevin

    2015-01-01

    Background: There are well-recognised complications associated with malposition of nasogastric (NG) tubes. In 2011 the UK National Patient Safety Agency (NPSA) published an alert regarding their insertion and position confirmation. This alert also identified the expected radiology standards for both image acquisition and reporting. Method: This was a retrospective review of referrals over a six-month period within a multi-site NHS Trust. A consecutive sampling approach was used and radiology reports where the text included the terms “NG tube”, “nasogastric” or “feeding” were included. Data were collected from the radiology information system and NG tube visibility and image quality were confirmed by two independent reviewers. Results: 1137 examinations demonstrated an NG tube, of which 68.3% were performed to check tube position. There was statistically significant correlation between lower radiation exposure and non-visualisation (Fishers exact test, p < 0.001). The number of examinations with higher exposure index (EI) in the NG check cohort suggests that the radiographer increased the exposure to improve visualization (x 2  = 2.846; 95% CI; p = 0.046), although the utility of this is unproven. Malplaced tubes were demonstrated either in the respiratory tract (1.8%) or proximal gastrointestinal tract (8.6%) as a result of insufficient length introduced. Conclusion: The prompt acquisition and reporting of radiographs is essential to reduce the risk of NG tube complications. Respiratory tract misplacement rates were in line with the published literature, but this study does raise concern regarding the number of tubes located in the proximal GI tract. Radiology's responsibility in accurate and effective reporting of medical interventions is significant

  18. A Study on Thermal Performance of a Novel All-Glass Evacuated Tube Solar Collector Manifold Header with an Inserted Tube

    Directory of Open Access Journals (Sweden)

    Jichun Yang

    2015-01-01

    Full Text Available A novel all-glass evacuated tube collector manifold header with an inserted tube is proposed in this paper which makes water in all-glass evacuated solar collector tube be forced circulated to improve the performance of solar collector. And a dynamic numerical model was presented for the novel all-glass evacuated tube collector manifold header water heater system. Also, a test rig was built for model validation and comparison with traditional all-glass evacuated tube collector. The experiment results show that the efficiency of solar water heater with a novel collector manifold header is higher than traditional all-glass evacuated tube collector by about 5% and the heat transfer model of water heater system is valid. Based on the model, the relationship between the average temperature of water tank and inserted tube diameter (water mass flow has been studied. The results show that the optimized diameter of inserted tube is 32 mm for the inner glass with the diameter of 47 mm and the water flow mass should be less than 1.6 Kg/s.

  19. Increasing rate of middle ear ventilation tube insertion in children in denmark

    DEFF Research Database (Denmark)

    Djurhuus, Bjarki Ditlev; Skytthe, Axel; Christensen, Kaare

    2014-01-01

    ventilation tube insertions distributed among 269,459 different children were identified. From 1997 to 2010 the age standardized incidence rate in 0-15-year-olds increased from 26 to 40 per 1000 person years with an estimated annual increase of 2.0% (95% confidence interval 1.9-2.1%). The largest increase...... in incidence rate was found in 1-year-olds with an annual increase of 4.5% (95% confidence interval 4.4-4.6%). Age-specific incidence rates remained at maximum around the age of 14 months throughout the period. The cumulative incidence proportion for the 2010 birth cohort by the time they reach the age of 5......OBJECTIVE: To study the incidence rates of middle ear ventilation tube insertion in children aged 0 to 15 years in Denmark from 1997 to 2010. METHODS: Using two national registers, the Danish National Health Service Register and the Danish National Patient Register, practically all cases of middle...

  20. The Feasibility and Outcome of Oro-esophageal Tube Feeding in Patients with Various Etiologies.

    Science.gov (United States)

    Kim, Juyong; Seo, Han Gil; Lee, Goo Joo; Han, Tai Ryoon; Oh, Byung-Mo

    2015-12-01

    The oro-esophageal tube (OE tube) is widely used in dysphagia patients although its success rate for transition to oral feeding is reported only in stroke patients. The aim of this study was to evaluate the feasibility and outcome of OE tube feeding for patients with dysphagia resulting from various etiologies. The authors reviewed the medical records of 1995 dysphagic patients that had undergone videofluoroscopic swallowing study (VFSS) in a tertiary hospital from April 2002 through December 2009. Of these, 97 patients were recommended to use OE tube feeding based on the VFSS findings. Follow-up VFSS were performed on 54 patients. The mean duration of tube use at the time of follow-up VFSS was 274 days. We evaluated clinical information including age, sex, diet, etiology of dysphagia, location of lesions, duration of intervention, and complications of OE tube feeding. Initially, all 54 patients were fed using the OE tube. After their last follow-up evaluation, 19 patients (35.2 %) resumed full oral feeding without the OE tube, 12 patients (22.2 %) used partial OE tube feeding, and 23 patients (42.6 %) continued OE tube feeding only. Full oral feeding was achieved again most often in brain tumor, stroke, and head and neck cancer patients (54.5, 27.3, and 20.0 %, respectively). Mild adverse events, such as blood-tinged sputum, nausea, dyspepsia, and regurgitation of food, were reported in 4 patients. OE tube feeding is a feasible feeding method also in conditions other than stroke such as brain tumors, and head and neck cancers.

  1. Improved Safety and Efficacy of Small-Bore Feeding Tube Confirmation Using an Electromagnetic Placement Device.

    Science.gov (United States)

    Powers, Jan; Luebbehusen, Michael; Aguirre, Lillian; Cluff, Julia; David, Mary Ann; Holly, Vince; Linford, Lorraine; Park, Nancy; Brunelle, Rocco

    2018-04-01

    Early enteral nutrition has been shown to decrease complications and improve patient outcomes. Post pyloric feeding is recommended for patients with gastric intolerance or at high risk for aspiration. Feeding tube placement can be challenging and pose risk of pulmonary complications. Reliance on radiographic confirmation for feeding tube placement exposes the patient to radiation. Electromagnetic placement device (EMPD) may offer a method to minimize pulmonary complications, increase successful placement, and decrease radiation exposure to the patient. The purpose of this study was to evaluate the safety and efficacy of using EMPD verification, instead of routine abdominal radiographic confirmation, for small-bore feeding tube placement. Variables evaluated were adverse events, utilization of radiographs for confirmation, and success rate of feeding tube placement in the ordered location. Two time frames were reviewed. In a 1-year period, 3754 small-bore feeding tubes were placed using EMPD, with zero adverse events noted. Radiographic confirmation was utilized in 0%-29.2% of the EMPD placed tubes. Successful placement of feeding tubes using EMPD ranged from 94%-99.6%. During a 5-year period, 7081 EMPD feeding tubes were evaluated. One adverse event, pneumothorax, occurred during the placement of these 7081 tubes, for a rate of 0.014%. Feeding tube placement confirmation is safe and efficacious via EMPD providing an effective method of feeding tube placement with a success rate >94% into the desired location. EMPD is an accurate verification method of distal tip location, eliminating the need for routine abdominal radiographic confirmation. © 2018 American Society for Parenteral and Enteral Nutrition.

  2. Use of Noninvasive Ventilation During Feeding Tube Placement.

    Science.gov (United States)

    Banfi, Paolo; Volpato, Eleonora; Valota, Chiara; D'Ascenzo, Salvatore; Alunno, Chiara Bani; Lax, Agata; Nicolini, Antonello; Ticozzi, Nicola; Silani, Vincenzo; Bach, John R

    2017-11-01

    Parenteral nutrition is indicated in amyotrophic lateral sclerosis (ALS) when dysphagia, loss of appetite, and difficulty protecting the airways cause malnutrition, severe weight loss, dehydration, and increased risk of aspiration pneumonia. The aim of this review is to compare percutaneous endoscopic gastrostomy (PEG), radiologically inserted G-tube (RIG), and percutaneous radiologic gastrostomy (PRG) in patients with ALS, performed with or without noninvasive ventilation (NIV). We searched PubMed, MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), the EBSCO Online Research Database, and Scopus up to December 2015. A priori selection included all randomized controlled trials (RCTs), quasi-randomized trials, and prospective and retrospective studies. The primary outcome was 30-d survival. We found no RCTs or quasi-RCTs. Seven studies about the implementation of the PEG/RIG procedure during the use of NIV and 5 studies without NIV were included. In another study of 59 subjects undergoing open gastrostomy, all with vital capacity NIV at full ventilatory support settings, there were no respiratory complications. Thus, the use of NIV during the implementation of these procedures, especially when used at full ventilatory support settings of pressure preset 18-25 cm H 2 O, can support alveolar ventilation before, during, and after the procedures and prevent respiratory complications. The procedures investigated appear equivalent, but the methodological quality of the studies could be improved. Possible benefits with regard to nutrition parameters, quality of life, and psychological features need to be further investigated. Copyright © 2017 by Daedalus Enterprises.

  3. Oral dextrose for analgesia in neonates during nasogastric tube insertion: a randomised controlled trial.

    Science.gov (United States)

    Ravishankar, Arjun; Thawani, Rajat; Dewan, Pooja; Das, Saurabhi; Kashyap, Archana; Batra, Prerna; Faridi, Moonis Mohammed Akbar

    2014-02-01

    This study aims to determine if oral dextrose solution can mitigate the pain response to nasogastric tube (NGT) insertion in neonates. The study was a double-blinded, placebo-controlled, randomised controlled trial. One hundred and fifty consecutive neonates were randomised into three groups to receive 25% dextrose (D25), or 10% dextrose (D10) or placebo (distilled water). An NGT was inserted after giving 2 mL of one of the solutions orally. Pain response was assessed using the Premature Infant Pain Profile (PIPP), and the duration of cry was noted within 60 s of the intervention. Total PIPP score, duration of cry, change in heart rate and oxygen saturation (SpO2 ) were compared among the three groups. Neonates who received D25 had significantly lesser pain response to NGT insertion in terms of lower PIPP score (P < 0.05) and duration of cry (P = 0.001) compared to D10. There was a significantly smaller increase in heart rate and decrease in SpO2 (P < 0.05). In comparison with placebo, D10 significantly decreased duration of cry (P < 0.05) but not PIPP score. Oral D25 was effective in reducing the pain response during NGT insertion in neonates when compared with oral D10 and placebo. Oral D10 was not found to have a potent analgesic effect for the same. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  4. Survival times with and without tube feeding in patients with dementia or psychiatric diseases in Japan.

    Science.gov (United States)

    Takayama, Keiko; Hirayama, Keisuke; Hirao, Akihiko; Kondo, Keiko; Hayashi, Hideki; Kadota, Koichi; Asaba, Hiroyuki; Ishizu, Hideki; Nakata, Kenji; Kurisu, Kairi; Oshima, Etsuko; Yokota, Osamu; Yamada, Norihito; Terada, Seishi

    2017-11-01

    It is widely supposed that there has been no evidence of increased survival in patients with advanced dementia receiving enteral tube feeding. However, more than a few studies have reported no harmful outcome from tube feeding in dementia patients compared to in patients without dementia. This was a retrospective study. Nine psychiatric hospitals in Okayama Prefecture participated in this survey. All inpatients fulfilling the entry criteria were evaluated. All subjects suffered from difficulty with oral intake. Attending physicians thought that the patients could not live without long-term artificial nutrition. The physicians decided whether to make use of long-term artificial nutrition between January 2012 and December 2014. We evaluated 185 patients. Their mean age was 76.6 ± 11.4 years. Of all subjects, patients with probable Alzheimer's disease (n = 78) formed the biggest group, schizophrenia patients (n = 44) the second, and those with vascular dementia (n = 30) the third. The median survival times were 711 days for patients with tube feeding and 61 days for patients without tube feeding. In a comparison different types of tube feeding, median survival times were 611 days for patients with a nasogastric tube and more than 1000 days for those with a percutaneous endoscopic gastrostomy tube. Patients with tube feeding survived longer than those without tube feeding, even among dementia patients. This study suggests that enteral nutrition for patients with dementia prolongs survival. Additionally, percutaneous endoscopic gastrostomy tube feeding may be safer than nasogastric tube feeding among patients in psychiatric hospitals. © 2017 Japanese Psychogeriatric Society.

  5. A novel method for improving chest tube insertion skills among medical interns. Using biomaterial-covered mannequin

    Directory of Open Access Journals (Sweden)

    Ozgur Tatli

    2017-10-01

    Full Text Available Objectives: To develop a low-cost biomaterial-covered chest tube simulation model and assess its possible usefulness for developing the chest tube insertion skills among medical interns. Methods: This mannequin-based interventional study was performed in a University hospital setting. We included 63 physicians performing emergency medicine internship at the Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey, between January 2015 and March 2015. A dummy was prepared for training simulation using a display mannequin. Medical interns received instruction concerning pneumothorax and the chest tube procedure. A total of 63 medical interns participating in this interventional study were asked to insert a chest tube in a biomaterial-covered mannequin. A senior trainee scored their performance using a check list and the mean of the total scores was calculated (21 items; total score, 42. Results: The mean procedural score was 40.9 ± 1.3 of a possible 42. The maximum score of 42 was achieved by 39.7% of the medical interns, while another 33.3% achieved a score of 41. Of the participants, 85% succeeded in inserting the tube via an appropriate technique, achieving a score of 40 or more. Conclusion: Our results indicated that this model could be useful for effective training of medical interns for chest tube insertion, which is an important skill in emergency medicine. This biomaterial-covered model is inexpensive and its use can potentially be widened to improve training methods without significant financial demand.

  6. A novel method for improving chest tube insertion skills among medical interns. Using biomaterial-covered mannequin.

    Science.gov (United States)

    Tatli, Ozgur; Turkmen, Suha; Imamoglu, Melih; Karaca, Yunus; Cicek, Mustafa; Yadigaroglu, Metin; Bayrak, Selen T; Asik, Olgun; Topbas, Murat; Turedi, Suleyman

    2017-10-01

    To develop a low-cost biomaterial-covered chest tube simulation model and assess its possible usefulness for developing the chest tube insertion skills among medical interns. Methods: This mannequin-based interventional study was performed in a University hospital setting. We included 63 physicians performing emergency medicine internship at the Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey, between January 2015 and March 2015. A dummy was prepared for training simulation using a display mannequin. Medical interns received instruction concerning pneumothorax and the chest tube procedure. A total of 63 medical interns participating in this interventional study were asked to insert a chest tube in a biomaterial-covered mannequin. A senior trainee scored their performance using a check list and the mean of the total scores was calculated (21 items; total score, 42). Results: The mean procedural score was 40.9 ± 1.3 of a possible 42. The maximum score of 42 was achieved by 39.7% of the medical interns, while another 33.3% achieved a score of 41. Of the participants, 85% succeeded in inserting the tube via an appropriate technique, achieving a score of 40 or more. Conclusion: Our results indicated that this model could be useful for effective training of medical interns for chest tube insertion, which is an important skill in emergency medicine. This biomaterial-covered model is inexpensive and its use can potentially be widened to improve training methods without significant financial demand.

  7. Procedure and device for extracting the end of a tube inserted into a hole in a tube plate

    International Nuclear Information System (INIS)

    1980-01-01

    When constructing heat exchangers and steam generators, particularly in the construction of steam generators for nuclear power stations, many small diameter tubes have to be secured into a very thick tube plate for instance 600 mm thick. This crimping or expanding of the tube is generally performed by rolling the internal surface of the tube inside a hole drilled right through the tube plate and slightly greater in diameter than the external diameter of the tube before the tube is rolled. To check the tubes for defects, it is necessary to extract certain tubes from the tube plate in order to move the tube to a testing and inspection point and examine the part of it that was secured in the plate hole. The invention concerns the uncrimping of these tubes [fr

  8. Cooperative learning using simulation to achieve mastery of nasogastric tube insertion.

    Science.gov (United States)

    Cason, Melanie Leigh; Gilbert, Gregory E; Schmoll, Heidi H; Dolinar, Susan M; Anderson, Jane; Nickles, Barbara Marshburn; Pufpaff, Laurie A; Henderson, Ruth; Lee, Frances Wickham; Schaefer, John J

    2015-03-01

    Traditionally, psychomotor skills training for nursing students involves didactic instruction followed by procedural review and practice with a task trainer, manikin, or classmates. This article describes a novel method of teaching psychomotor skills to associate degree and baccalaureate nursing students, Cooperative Learning Simulation Skills Training (CLSST), in the context of nasogastric tube insertion using a deliberate practice-to-mastery learning model. Student dyads served as operator and student learner. Automatic scoring was recorded in the debriefing log. Student pairs alternated roles until they achieved mastery, after which they were assessed individually. Median checklist scores of 100% were achieved by students in both programs after one practice session and through evaluation. Students and faculty provided positive feedback regarding this educational innovation. CLSST in a deliberate practice-to-mastery learning paradigm offers a novel way to teach psychomotor skills in nursing curricula and decreases the instructor-to-student ratio. Copyright 2015, SLACK Incorporated.

  9. Predictors of Enteral Tube Feeding in Hospitalized Older Adults.

    Science.gov (United States)

    Crenitte, Milton Roberto Furst; Avelino-Silva, Thiago Junqueira; Apolinario, Daniel; Curiati, Jose Antonio Esper; Campora, Flavia; Jacob-Filho, Wilson

    2017-11-01

    Despite general recognition that enteral tube feeding (ETF) is frequently employed in long-term care facilities and patients with dementia, remarkably little research has determined which factors are associated with its use in acutely ill older adults. In this study, we aimed to investigate determinants of ETF introduction in hospitalized older adults. We examined a retrospective cohort of acutely ill patients, aged 60 years and older, admitted to a university hospital's geriatric ward from 2014-2015, in São Paulo, Brazil. The main outcome was the introduction of ETF during hospitalization. Predictors of interest included age, sex, referring unit, comorbidity burden, functional status, malnutrition, depression, dementia severity, and delirium. Multivariate analysis was performed using backward stepwise logistic regression. A total of 214 cases were included. Mean age was 81 years, and 63% were women. Malnutrition was detected in 47% of the cases, dementia in 46%, and delirium in 36%. ETF was initiated in 44 (21%) admissions. Independent predictors of ETF were delirium (odds ratio [OR], 4.83; 95% CI, 2.12-11.01; P ETF. One in five acutely ill older adults used ETF while hospitalized. Delirium and functional dependency were independent predictors of its introduction. Risks and benefits of enteral nutrition in this particular context need to be further explored.

  10. The Challenges of Home Enteral Tube Feeding: A Global Perspective

    Directory of Open Access Journals (Sweden)

    Omorogieva Ojo

    2015-04-01

    Full Text Available The aim of this review is to provide a global perspective of Home Enteral Tube Feeding (HETF and to outline some of the challenges of home enteral nutrition (HEN provisions. It is well established that the number of patients on HETF is on the increase worldwide due to advances in technology, development of percutaneous endoscopic gastrostomy techniques, and the shift in care provisions from acute to community settings. While the significance of home enteral nutrition in meeting the nutritional requirements of patients with poor swallowing reflexes and those with poor nutritional status is not in doubt, differences exist in terms of funding, standards, management approaches and the level of infrastructural development across the world. Strategies for alleviating some of the challenges militating against the effective delivery of HETF including the development of national and international standards, guidelines and policies for HETF, increased awareness and funding by government at all levels were discussed. Others, including development of HEN services, which should create the enabling environment for multidisciplinary team work, clinical audit and research, recruitment and retention of specialist staff, and improvement in patient outcomes have been outlined. However, more research is required to fully establish the cost effectiveness of the HEN service especially in developing countries and to compare the organization of HEN service between developing and developed countries.

  11. [Intraoperative placement of transnasal small intestinal feeding tube during the surgery in 5 cases with high position intestinal obstruction and postoperative feeding].

    Science.gov (United States)

    Duan, Guang-qi; Zhang, Min; Guan, Xiao-hao; Yin, Zhi-qing

    2012-09-01

    To explore the value of employing the small intestinal feeding tube in treating high position intestinal obstruction of newborn infant. Five newborn infants (3 males and 2 females; 1 premature infant and 4 fully-mature infants; 2 had membranous atresia of duodenum, 1 had annular pancreas, and 2 had proximal small intestine atresia; 1 infant had malrotation). The duodenal membrane-like atresia and the blind-end of small intestine were removed and intestinal anastomosis was performed, which was combined with intestinal malrotation removal. Before the intestinal anastomosis surgery, the anesthetist inserted via nose a 6Fr small intestinal ED tube, made by CREATE MEDIC CO LTD of Japan[ the State Food and Drug Administration-instrument (Im.) 2007-NO.2661620]. Twenty-four hours after surgery, abdominal X-ray plain film was taken and patients were fed with syrup; 48 hours later, formula milk was pumped or lactose-free milk amino acids were given by intravenous injection pump through the feeding tube. The amount of milk and fluids was gradually increased to normal amount according to the condition. In initial 3 days the intravenous nutrition was given and one week after operation, the infants were fed through mouth in addition to pumping milk through the tube and stopped infusion. Ten to 22 days after operation, the tube was removed and the infant patients were discharged. All the five infants showed that the feeding through the nutrition tube was accomplished and the time of venous nutrition was reduced and fistula operation was avoided. None of the infants on question was off the tube and no jaundice exacerbation was found and the liver function was also found normal. At the very beginning, the tube was occasionally blocked by milk vale in one infant and after 0.9% sodium chloride solution flushing patency restored. After that, the feeding tube was washed once with warm water after feeding. In one infant vomiting occurred due to enough oral milk. The photograph of upper

  12. Inadvertent chest tube insertion in congenital cystic adenomatoid malformation and congenital lobar emphysema-highlighting an important problem

    International Nuclear Information System (INIS)

    Prabhu, Shailesh M; Choudhury, Subhasis Roy; Solanki, Ravi S; Shetty, Gurucharan S; Agarwala, Surenderkumar

    2013-01-01

    Chest tube insertion in congenital cystic lung lesions is an important problem in children with acute respiratory distress having a cystic lucent lesion on chest radiograph. To evaluate the imaging findings and complications in cases of congenital cystic lung lesions with chest tube insertion and suggest the role of appropriate imaging for management of these patients. Chest radiographs and CT scans of children with congenital cystic lung lesions who had inadvertent chest tube insertion preoperatively were retrospectively reviewed for imaging appearances and complications. Fifteen patients comprising 10 cases of congenital cystic adenomatoid malformation (CCAM) and 5 cases of congenital lobar emphysema (CLE) were included. Majority of the cases were infants. CCAM was misdiagnosed as complicated pneumatocele (n = 5) and pneumothorax (n = 5), while CLE was misdiagnosed as tension pneumothorax (n = 5) on the chest radiograph findings. Final diagnosis was made on CT and operative findings with histopathology. Complications noted were pneumothorax, hydropneumothorax, and infection in cases of CCAM, and change in imaging appearance and pneumothorax in cases of CLE. Chest tube insertion in congenital cystic lesions increases the rate of associated complications. Chest CT has a definite role in early diagnosis and deciding appropriate management in these cases

  13. The usefulness of levin tube inserted drip infusion spiral CT: comparison with conventional method in subtotal gastrectomy patients

    International Nuclear Information System (INIS)

    Park, Young Jin; Kim, Young Hwan; Yoon, Jung Hee; Cha, Soon Joo; Kim, Jeong Sook; Kim, Sung Rok; Hur, Gham; Rhim, Hyun Chul

    1998-01-01

    The purpose of this study is to access the usefulness of newly designed Levin tube inserted drip infusion spiral CT for the evaluation of remnant stomach and anastomosis site in patients who have undergone subtotal gastrectomy for stomach cancer. A new technique named Levin tube inserted drip infusion spiral CT was used to prospectively study 23 patients. A 16Fr Levin tube was inserted into the remnant stomach; 500 ml of tap water was drip infused just before CT scanning and an additional 500 ml of water was infused during IV contrast injection. Water was infused by gravity, using a water bottle suspended at a height of 90 cm (Group A). The 31 patients who underwent conventional spiral CT scanning immediately after the divided ingestion of 900 ml diluted gastrografin were selected as a control group (Group B). The anatomic delineation of the anastomosis site was graded by two radiologists as excellent (3), good(2), fair (1) or poor (0). To evaluate the degree of distension, the maximal diameters of remnant stomach and the anastomosis site, and the thickness of the stomach wall, were also measured. In patients who had undergone subtobal gastrectomy, Levin tube inserted drip infusion spiral CT showed excellent anatomic delineation of the site of anastomosis and remnant stomach. We found that because it increases the distension of remnant stomach and the anastomosis site, this technique is effective for the evaluation of postoperative stomach. (author). 10 refs., 2 tabs., 3 figs

  14. Early discharge with tube feeding at home for preterm infants is associated with longer duration of breast feeding.

    Science.gov (United States)

    Meerlo-Habing, Z E; Kosters-Boes, E A; Klip, H; Brand, P L P

    2009-07-01

    Mothers of preterm infants are more likely to discontinue breast feeding early than mothers of term infants. We evaluated the effect of early discharge with tube feeding of preterm infants under close supervision by paediatric nurse specialists on the duration of breast feeding. Case-control study. Medium/high-care neonatal unit of a large district general hospital. Preterm infants (paediatric nurse specialists or regular follow-up of preterm infants discharged with oral feeding. Duration of breast feeding assessed by telephone interview 6 months after birth. There were 50 preterm infants in the early discharge group and 78 in the control group. Mothers in the early discharge group continued to breast feed longer than mothers in the control group (log rank test, p = 0.028). Four months after discharge, 63% of preterm infants in the control group were fed formula compared to 36% in the early discharge group (95% CI for difference 9% to 43%, p = 0.04). The relative risk of breast feeding cessation 6 months after birth in the early discharge group compared to the control group was 0.63 (95% CI 0.41 to 0.96). After adjustment for smoking, gestational age and birth weight, this relative risk was 0.67 (95% CI 0.43 to 1.05). Close supervision and follow-up by paediatric nurse specialists of preterm infants discharged early with tube feeding appears to increase duration of breast feeding. A randomised controlled trial to confirm these findings is warranted.

  15. The Effectiveness of Self-Expandable Metallic Stent Insertion in Treating Right-Sided Colonic Obstruction: A Comparison between SEMS and Decompression Tube Placement and an Investigation of the Safety and Difficulties of SEMS Insertion in Right Colons

    Directory of Open Access Journals (Sweden)

    Rintaro Moroi

    2014-01-01

    Full Text Available Objectives. Self-expandable metallic stent (SEMS is widely used to treat malignant colonic obstruction. However, most reports about SEMS insertion have concentrated on the left colon. This study aimed to (1 investigate the effectiveness of SEMS insertion compared with conventional decompression tube for right-sided colonic obstruction and (2 compare the safety and technical success of SEMS insertion between left- and right-sided colonic obstructions. Methods. The data from thirty-seven patients who underwent SEMS or conventional decompression tube placement for malignant colonic obstruction in our hospital were analyzed retrospectively. Technical and clinical success, complications, and technical difficulties were analyzed. We compared the results between SEMS insertion and decompression tube placement in right colons and the outcomes of SEMS insertion between right- and left-sided colonic obstructions. Results. For right colons, the clinical success rate of SEMS insertion (100% was significantly higher than that of decompression tube placement (55.9%. Concerning SEMS insertion, the technical difficulty and safety of SEMS insertion were similar between right- and left-sided colonic obstructions. Conclusion. SEMS insertion for right-sided colon is significantly more effective than conventional decompression tube placement, and this procedure was safer and less technically challenging than expected. SEMS insertion should be considered for treating right-sided malignant colonic obstruction.

  16. Percutaneous transesophageal gastro-tubing (PTEG) as an alternative long-term tube feeding procedure when gastrostomy is not feasible.

    Science.gov (United States)

    Toh Yoon, Ezekiel Wong; Nishihara, Kazuki

    2017-12-01

    Percutaneous transesophageal gastro-tubing (PTEG) is a minimally invasive technique to access the gut via an esophagostomy. However, this procedure is not well known and the literature available is still fairly limited. This observational study was conducted to evaluate our experience using this method as an alternative long-term tube feeding procedure when gastrostomy is not suitable. A total of 15 patients (10 males and 5 females) who underwent PTEG at our institution from 2012 to 2016 were observed and analyzed in this study. The average age was 80.1 (71-93) years. Underlying conditions that required PTEG were previous gastric resection in 11 patients, left diaphragm disorder in 2 patients, interposing transverse colon between the abdominal wall and anterior gastric wall in 1 patient, and severe gastrostomy site leakage in 1 patient. Tube placement was successful in all patients by approaching the left side of the neck, using a 15 Fr size tube. The mean postoperative length of stay was 22 (8-48) days. Postoperative adverse events included accidental tube dislodgement in three patients, tracheoesophageal fistula in one patient, inferior thyroid artery injury in one patient and thyroid gland mispuncture in one patient. There was no procedure-related mortality nor mortality at 30 days. Eight patients were discharged with some oral intake. PTEG is feasible in patients requiring long-term tube feeding for whom gastrostomy is unsuitable. It is an effective long-term tube feeding procedure and should be offered as a more comfortable alternative to nasogastric tubing.

  17. Neonatal enteral feeding tubes as loci for colonisation by members of the Enterobacteriaceae

    Directory of Open Access Journals (Sweden)

    Smith Craig

    2009-09-01

    Full Text Available Abstract Background The objective of this study was to determine whether neonatal nasogastric enteral feeding tubes are colonised by the opportunistic pathogen Cronobacter spp. (Enterobacter sakazakii and other Enterobacteriaceae, and whether their presence was influenced by the feeding regime. Methods One hundred and twenty-nine tubes were collected from two neonatal intensive care units (NICU. A questionnaire on feeding regime was completed with each sample. Enterobacteriaceae present in the tubes were identified using conventional and molecular methods, and their antibiograms determined. Results The neonates were fed breast milk (16%, fortified breast milk (28%, ready to feed formula (20%, reconstituted powdered infant formula (PIF, 6%, or a mixture of these (21%. Eight percent of tubes were received from neonates who were 'nil by mouth'. Organisms were isolated from 76% of enteral feeding tubes as a biofilm (up to 107 cfu/tube from neonates fed fortified breast milk and reconstituted PIF and in the residual lumen liquid (up to 107 Enterobacteriaceae cfu/ml, average volume 250 μl. The most common isolates were Enterobacter cancerogenus (41%, Serratia marcescens (36%, E. hormaechei (33%, Escherichia coli (29%, Klebsiella pneumoniae (25%, Raoultella terrigena (10%, and S. liquefaciens (12%. Other organisms isolated included C. sakazakii (2%,Yersinia enterocolitica (1%,Citrobacter freundii (1%, E. vulneris (1%, Pseudomonas fluorescens (1%, and P. luteola (1%. The enteral feeding tubes were in place between 48 h (13%. All the S. marcescens isolates from the enteral feeding tubes were resistant to amoxicillin and co-amoxiclav. Of additional importance was that a quarter of E. hormaechei isolates were resistant to the 3rd generation cephalosporins ceftazidime and cefotaxime. During the period of the study, K. pneumoniae and S. marcescens caused infections in the two NICUs. Conclusion This study shows that neonatal enteral feeding tubes

  18. Heat transfer experiments in a wire-inserted tube at supercritical pressures

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Yoon Yeong; Kim, Hwan Yeol; Yoo, Tae Ho

    2009-07-15

    The hydraulic diameter of a subchannel in a core concept developed at KAERI is 6.5 mm. The sub-channel is much smaller than that of the conventional PWR, and naturally a helical wire was considered as one of the candidates for a spacer. For simplicity the subchannel is simulated by a commercially available Inconel 625 tube of 6.32 mm ID with a helically-coiled spring steel wire insert of 1.3 mm OD. The medium is CO{sub 2}. The test pressures are 7.75 and 8.12 MPa corresponding to 1.05 and 1.1 times the critical pressure of CO{sub 2}, respectively. The mass flux and heat flux, which were in the range of 400 {approx} 1200 kg/m{sup 2}s and 30 {approx} 90 kW/m{sup 2} respectively, were varied at a given system pressure. The corresponding Reynolds numbers at the inlet spans between 2.5 x 10{sup 4} and 7.5 x 10{sup 4}. It was observed that the heat transfer was enhanced by almost twice in most of the tested enthalpy range except for in the the region far from the pseudocritical point. The test results revealed that the wire effect was sustained in the downstream up to 40-60 times the wire diameter. The temperature decreased in the first half of the span between contact points and it increased in the second half of the span.

  19. Graft-free Ahmed tube insertion: a modified method at 5 mm from limbus

    Directory of Open Access Journals (Sweden)

    Juan Carlos Mesa-Gutiérrez

    2010-04-01

    Full Text Available Juan Carlos Mesa-Gutiérrez, Juan Lillo-Sopena, Anna Monés-Llivina, Silvia Sanz-Moreno, Jorge Arruga-GinebredaDepartment of Ophthalmology, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, SpainObjective: To determine the medium-term outcome of Ahmed implants inserted through a needle tract at 5 mm from limbus that eliminates the need for a donor scleral graft.Methods: A retrospective case series of 19 patients undergoing Ahmed implant surgery for refractory glaucoma with a mean follow-up of 12 months. Primary outcome measures included control of intraocular pressure after surgery. Secondary outcome measure included the frequency of intraoperative and postoperative complications.Results: Intraocular pressure was maintained between 6 and 21 mmHg throughout the study. There was no postoperative hypotony. There were no complications related to this modified technique.Conclusion: Needle tract at 5 mm from limbus maintains implant’s ability to control intraocular pressure and eliminates the need for a donor scleral graft or heterologous material.Keywords: surgical technique, Ahmed implant, refractory glaucoma, donor scleral graft, tube shunt device

  20. Fluoroscopically-guided transnasal insertion of ileus tube intestinal decompression in patients with inoperable malignant bowel obstruction

    International Nuclear Information System (INIS)

    Fang Shiming; Li Haili; Lin Qing; Mao Aiwu; Wu Shaoqiu; Jiang Haosheng; Cao Yan; Wang Zhenlei

    2011-01-01

    Objective: To assess the technical feasibility and effectiveness of fluoroscopically-guided transnasal insertion of ileus tube for intestinal decompression in the treatment of inoperable malignant bowel obstruction. Methods: A total of 211 patients with inoperable malignant bowel obstruction were enrolled in this study. The median KPS scale was 40 (ranged from 20 to 60). Under fluoroscopic guidance, transnasal insertion of ileus tube by using conventional technique or guidewire-catheter exchange technique was performed in all patients. The technical success rate, the clinical effective rate, the curative rate and adverse reactions as well as complications were documented. The correlation among the obstructive sites, obstruction causes and therapeutic effectiveness was analyzed. The ileus tube used in this study was a four-cavity and double-balloon catheter with a diameter of 16 F/18 f, which is produced by Cliny Company. Results: Transnasal drainage tube was successfully inserted into the proximal jejunum in all 211 patients with malignant bowel obstruction, and the total technical success rate was 100%. The initial technical success rate of the traditional technique and the catheter-guidewire exchange method was 85.5% (65/76) and 100% (135/135) respectively, the difference between the two was significant (P<0.05). After 24 hours, the clinical remission rate in the patients with high-level intestinal obstruction, lower-level intestinal obstruction and colorectal obstruction was 95.8% (46/48), 92.9% (117/126) and 83.8% (31/37), respectively. A follow-up of 4-245 days (mean 138 days) was conducted, and the total clinical cure rate was 27.5% (58/211). The clinical cure rate in small intestine obstruction and colorectal obstruction caused by primary tumor or recurrence was 12.7% (20/157) and 59.5% (22/37), respectively (P<0.05). The adverse reactions and complications included uncomfortable pharynx feeling or pain (99.1%, 199/221), the tube obstruction (23.2%, 49

  1. Peristaltic pumping in an elastic tube: feeding the hungry python

    Science.gov (United States)

    Takagi, Daisuke; Balmforth, Neil

    2010-11-01

    Biological ducts convey contents like food in the digestive system by peristaltic action, propagating waves of muscular contraction and relaxation. The motion is investigated theoretically by considering a radial force of sinusoidal or Gaussian form moving steadily down a fluid-filled axisymmetric tube. Effects of the prescribed force on the resultant fluid flow and elastic deformation of the tube wall are presented. The flow can induce a rigid object suspended in the fluid to propel in different ways, as demonstrated in numerous examples.

  2. Limited utility of plain abdominal radiographs in evaluating intussusceptions secondary to long indwelling feeding tubes

    Directory of Open Access Journals (Sweden)

    Albert Yang

    2013-01-01

    Full Text Available Adult intussusception (AI is relatively rare and can be a difficult clinical diagnosis, often requiring cross-sectional imaging for confirmation. Unfortunately, intussusceptions in the setting of indwelling long enteral feeding tubes have been predominantly characterized in the pediatric population with minimal investigation in adults. We report three cases of AI in patients with long feeding catheters serving as anatomic lead points leading to intussusception diagnosed on cross-sectional imaging. We highlight the limited utility of the supine plain films for detection of AI, and it behooves the radiologist to hold a high index of suspicion if the patient has a long enteral catheter. Since the majority of these patients tend to be fairly ill and unable to stand for upright abdominal radiographs, in the setting of percutaneous feeding tubes, decubitus abdominal radiographs should always be obtained. These cases also highlight the importance of having a high clinical suspicion of intussusceptions in a patient presenting with abdominal pain in the setting of an enteral feeding tube. In post-operative patients, other factors can predispose the patient to intussusception, including adhesions. Another interesting feature in tube related AI is the reverse intussusception that may be seen with indwelling enteral tubes. Reverse intussusception is where the distal bowel telescopes into the proximal segment over the tube.

  3. Successful use of a bulk laxative to control the diarrhea of tube feeding.

    Science.gov (United States)

    Frank, H A; Green, L C

    1979-01-01

    The greatly increased nutritional demands of the severely burned patient frequently require the use of tube feeding for enternal hyperalimentation. At a time when general patient morale is low and motivation needs to be maximally maintained, there is nothing so dispiriting as the distress of a painful perianal region and uncontrollable liquid stools. Attempts to control the diarrhea which frequently accompanies tube feeding by changing the formula or the method of administration or a wide variety of constipating drugs have all met with very limited success. Based on the clinical observation of a noted gastroenterologist (Bockus), we have administered a mucilagenous hydrophilic colloid bulk laxative (Metamucil) to patients on tube feeding formulae. The dosage and frequency are adjusted to individual patient needs, but average 7 g per liter of liquid formula. The results have been dramatic; namely, the virtual elimination of the diarrhea problem in our burn patients on enteral hyperalimentation by gastric tube feeding. Colonic transit time increases. The stools become formed but soft, cohesive but not adhesive. Perianal irritation does not occur. Neither does soilage of wound, dressings, or bed. No rebound constipation or obstructive symptoms have been encountered. We attribute this response to the same water binding mechanism that allows these colloids to prevent chronic constipation. Our patients may be given as much as 5,000 to 6,000 calories of tube feeding per day. Our patients are not distressed by diarrhea. Our nursing staff is relieved of the burden that entails.

  4. ''Push-pull'' gastrostomy: a new technique for percutaneous gastrostomy tube insertion in the neonate and young infant

    International Nuclear Information System (INIS)

    Cahill, A.M.; Kaye, R.D.; Fitz, C.R.; Towbin, R.B.

    2001-01-01

    Objective. To evaluate a newly developed method combining antegrade and retrograde techniques for percutaneous gastrostomy tube (PGT) insertion in the neonate and young infant. Materials and methods. From January 1994 to December 2000, 85 children (47 male, 38 female), mean age 4.5 months (range 0.44-9.13 months) underwent PGT insertion using the ''push-pull'' technique. With the addition, 57 children had a jejunostomy tube placed as well at or within 24 h of the PGT procedure. The mean weight was 3.74 kg, range 1.5-7.0 kg. The indications for the procedure included failure to thrive in 40 patients (25 %), static encephalopathy in 21 (25 %), neurological/congenital abnormalities in 12 (14 %), aspiration in 7 (8 %), and cardiac problems in 5 (6 %). Results. Eighty-five PGTs were successfully inserted in 85 children. One procedure was initially unsuccessful due to failed conscious sedation and was completed under general anesthesia. Four of 85 patients initially had attempted antegrade placement that failed, and the procedure was successfully completed using the ''push-pull'' method. One major complication occurred: a gastrocolic fistula at day 5 post-procedure, which was surgically repaired without sequelae. Tube-related problems included; tube dislodgement (n = 1) and procedure-related stomal infection (n = 3). Conclusion. The ''push-pull'' gastrostomy technique is a safe, effective method of percutaneous gastrostomy tube placement in neonates. It facilitates successful placement of the PGT in patients in whom the classic antegrade method is not possible. It has become the procedure of choice in this group. (orig.)

  5. Process to repair a steam generator tube by inserting a tubular sleeve and the associated sleeve

    International Nuclear Information System (INIS)

    Gaudin, J.P.

    1986-01-01

    The tubular sleeve is introduced in the tube and is mechanically expanded inside the tube plate, and is diametrally expanded at its upper part within the tube and outside the tube plate. Tightness is ensured by brazing the end part of the sleeve within the tube. The end part of the sleeve is brazed by melting of brazing metal previously applied to the outer surface of the sleeve of its end region. The invention applies more particularly to steam generators of pressurized water nuclear reactors [fr

  6. Advantages of Direct Insertion of a Straight Probe Without a Guide Tube During Anterior Odontoid Screw Fixation of Odontoid Fractures.

    Science.gov (United States)

    Park, Jin Hoon; Kang, Dong-Ho; Lee, Moon Kyu; Yoo, Byoungwoo; Jung, Sang Ku; Hwang, Soo-Hyun; Kim, Jeoung Hee; Oh, Sunkyu; Lee, Eun Jung; Jeon, Sang Ryong; Roh, Sung Woo; Rhim, Seung Chul

    2016-05-01

    A retrospective cohort study. The aim of this study was to compare the anterior odontoid screw fixation (AOSF) with a guide tube or with a straight probe. AOSF associates with several complications, including malpositioning, fixation loss, and screw breakage. Screw pull-out from the C2 body is the most common complication. All consecutive patients with type II or rostral shallow type III odontoid fractures who underwent AOSFs during the study period were enrolled retrospectively. The guide-tube AOSF method followed the standard published method except C3 body and C2-3 disc annulus rimming was omitted to prevent disc injury; instead, the guide tube was anchored at the anterior inferior C2 vertebra corner. After 2 screw pull-outs, the guide-tube cohort was analyzed to identify the cause of instrument failure. Thereafter, the straight-probe method was developed. A guide tube was not used. A small pilot hole was made on the most anterior side of the inferior endplate, followed by insertion of a 2.5 mm straight probe through the C2 body. Non-union and instrument failure rates and screw-direction angles of the guide-tube and straight-probe groups were recorded. The guide-tube group (n = 13) had 2 screw pull-outs and 1 non-union. The straight-probe group (n = 8) had no complications and significantly larger screw-direction angles than the guide-tube group (60.5 ± 4.63 vs. 54.8 ± 3.82 degrees; P = 0.047). Straight-probe AOSF yielded larger direction angles without injuring bone and disc. Complications were absent. The procedure was easier than guide-tube AOSF and assured sufficient engagement, even in horizontal fracture orientation cases. 3.

  7. Endobronchial intubation detected by insertion depth of endotracheal tube, bilateral auscultation, or observation of chest movements: randomised trial.

    Science.gov (United States)

    Sitzwohl, Christian; Langheinrich, Angelika; Schober, Andreas; Krafft, Peter; Sessler, Daniel I; Herkner, Harald; Gonano, Christopher; Weinstabl, Christian; Kettner, Stephan C

    2010-11-09

    To determine which bedside method of detecting inadvertent endobronchial intubation in adults has the highest sensitivity and specificity. Prospective randomised blinded study. Department of anaesthesia in tertiary academic hospital. 160 consecutive patients (American Society of Anesthesiologists category I or II) aged 19-75 scheduled for elective gynaecological or urological surgery. Patients were randomly assigned to eight study groups. In four groups, an endotracheal tube was fibreoptically positioned 2.5-4.0 cm above the carina, whereas in the other four groups the tube was positioned in the right mainstem bronchus. The four groups differed in the bedside test used to verify the position of the endotracheal tube. To determine whether the tube was properly positioned in the trachea, in each patient first year residents and experienced anaesthetists were randomly assigned to independently perform bilateral auscultation of the chest (auscultation); observation and palpation of symmetrical chest movements (observation); estimation of the position of the tube by the insertion depth (tube depth); or a combination of all three (all three). Correct and incorrect judgments of endotracheal tube position. 160 patients underwent 320 observations by experienced and inexperienced anaesthetists. First year residents missed endobronchial intubation by auscultation in 55% of cases and performed significantly worse than experienced anaesthetists with this bedside test (odds ratio 10.0, 95% confidence interval 1.4 to 434). With a sensitivity of 88% (95% confidence interval 75% to 100%) and 100%, respectively, tube depth and the three tests combined were significantly more sensitive for detecting endobronchial intubation than auscultation (65%, 49% to 81%) or observation(43%, 25% to 60%) (Pauscultation to detect inadvertent endobronchial intubation. But even experienced physicians will benefit from inserting tubes to 20-21 cm in women and 22-23 cm in men, especially when high

  8. The placement of naso-jejunal feeding tube under DSA guidance: its technology and skills

    International Nuclear Information System (INIS)

    Song Laichang; Wang Wenhui; Li Fenqiang; Su Dongjun; Li Bo

    2009-01-01

    Objective: To retrospectively analyze and summarize the manipulation and skills of the placement of naso-jejunal feeding tube under DSA guidance. Methods: After performing the spraying anesthesia of nasopharynx, the naso-jejunal feeding tube, with the help of guide wire and under DSA guidance, was placed into the proximal jejunum by passing it through the nose, pharynx, esophagus, stomach, pylorus and duodenum in order. The procedure was employed in 441 cases. Results: The mean time for performing the procedure was within five minutes. The procedure was successfully accomplished in all 441 cases and no complications occurred in this series. Conclusion: Under DSA guidance the placement of naso- jejunal feeding tube can be safely and quickly carried out with high successful rate and less sufferings to patient. It is worth popularizing this technique in clinical practice. (authors)

  9. The effects of oral sucrose on pain due to nasogastric tube insertion in premature infants: A crossover clinical trial

    Directory of Open Access Journals (Sweden)

    Jebreili M

    2014-11-01

    Full Text Available Background and Objective: Pain in neonates may have adverse impacts. Therefore, relieving pain through harmless, simple, and applicable methods, in order to prevent its dangerous consequences, is of great importance. The aim of the present study is to determine the impact of oral sucrose on relieving nasogastric tube insertion pain in premature neonates. Materials and Method: The present study is a crossover clinical trial on 38 preterm infants (gestational age between 28-34 weeks hospitalized in Bistonoh-e-Bahman Hospital, Tabriz, Iran, in 2013. The subjects were selected by convenience sampling and divided into two groups using randomized block design. In the first group, nasogastric tube insertion was carried out in the routine way for the first time, and for the second time, by administration of oral sucrose. In the second group, the procedure was performed in the reverse order of that in the first group. In both groups the emerging pain was measured by the Premature Infant Pain Profile (PIPP tool 2 minutes before, during, and 5 minutes after the procedure. Data were analyzed using, chi-square t-test, Students' independent test, paired t-test, and repeated measures ANOVA in SPSS version 18 to examine the trend of change in pain in time. P values of less than 0.05 were considered statistically significant. Results: The results showed that oral sucrose reduces the pain response of infants. The mean pain score during the insertion of nasogastric tube and administration of oral sucrose was 5.95 ± 2.35 and during routine procedures was 9.93 ± 2.89 (P < 0.001. The mean pain score 5 minutes after insertion of nasogastric tube with administration of oral sucrose was 3.66 ± 0.57 and routine procedure was 6.38 ± 0.83 (P = 0.017. Conclusion: It was revealed that oral sucrose can relieve pain caused by nasogastric tube insertion. Therefore, its implementation as a harmless and simple method can reduce pain in preterm infants.

  10. Competence in confirming correct placement of nasogastric feeding tubes amongst FY1 doctors

    OpenAIRE

    Lee, Sindy; Mason, Eleanor

    2013-01-01

    Foundation year one (FY1) doctors are required to confirm correct placement of nasogastric (NG) feeding tubes on chest radiography on a regular basis. Many FY1s do not receive formal training during medical school or during the FY1 year. Multiple incidents of harm to patients, including death, resulting from incorrect placement of an NG feeding tube have been reported to the National Patient Safety Agency (NPSA) since 2005. Our audit assessed the confidence and knowledge of FY1 doctors in cor...

  11. Enteral Tube Feeding Alters the Oral Indigenous Microbiota in Elderly Adults ▿ †

    OpenAIRE

    Takeshita, Toru; Yasui, Masaki; Tomioka, Mikiko; Nakano, Yoshio; Shimazaki, Yoshihiro; Yamashita, Yoshihisa

    2011-01-01

    Enteral tube feeding is widely used to maintain nutrition for elderly adults with eating difficulties, but its long-term use alters the environment of the oral ecosystem. This study characterized the tongue microbiota of tube-fed elderly adults by analyzing the 16S rRNA gene. The terminal restriction fragment length polymorphism (T-RFLP) profiles of 44 tube-fed subjects were compared with those of 54 subjects fed orally (average age, 86.4 ± 6.9 years). Bar-coded pyrosequencing data were also ...

  12. Enteral tube feeding alters the oral indigenous microbiota in elderly adults.

    Science.gov (United States)

    Takeshita, Toru; Yasui, Masaki; Tomioka, Mikiko; Nakano, Yoshio; Shimazaki, Yoshihiro; Yamashita, Yoshihisa

    2011-10-01

    Enteral tube feeding is widely used to maintain nutrition for elderly adults with eating difficulties, but its long-term use alters the environment of the oral ecosystem. This study characterized the tongue microbiota of tube-fed elderly adults by analyzing the 16S rRNA gene. The terminal restriction fragment length polymorphism (T-RFLP) profiles of 44 tube-fed subjects were compared with those of 54 subjects fed orally (average age, 86.4 ± 6.9 years). Bar-coded pyrosequencing data were also obtained for a subset of the subjects from each group (15 tube-fed subjects and 16 subjects fed orally). The T-RFLP profiles demonstrated that the microbiota of the tube-fed subjects was distinct from that of the subjects fed orally (permutational multivariate analysis of variance [perMANOVA], P < 0.001). The pyrosequencing data revealed that 22 bacterial genera, including Corynebacterium, Peptostreptococcus, and Fusobacterium, were significantly more predominant in tube-fed subjects, whereas the dominant genera in the subjects fed orally, such as Streptococcus and Veillonella, were present in much lower proportions. Opportunistic pathogens rarely detected in the normal oral microbiota, such as Corynebacterium striatum and Streptococcus agalactiae, were often found in high proportions in tube-fed subjects. The oral indigenous microbiota is disrupted by the use of enteral feeding, allowing health-threatening bacteria to thrive.

  13. Metabolic assessment and enteral tube feeding usage in children with acute neurological diseases

    Directory of Open Access Journals (Sweden)

    Heitor Pons Leite

    Full Text Available OBJECTIVE: To report on acquired experience of metabolic support for children with acute neurological diseases, emphasizing enteral tube feeding usage and metabolic assessment, and also to recommend policies aimed towards improving its implementation. DESIGN: Retrospective analysis. SETTING: Pediatric Intensive Care Unit of Hospital do Servidor Público Estadual de São Paulo. SUBJECTS: 44 patients consecutively admitted to the Pediatric ICU over a period of 3 years who were given nutrition and metabolic support for at least 72 hours. Head trauma, CNS infections and craniotomy post-operative period following tumor exeresis were the main diagnoses. MEASUREMENTS: Records of protein-energy intake, nutrient supply route, nitrogen balance and length of therapy. RESULTS: From a total of 527 days of therapy, single parenteral nutrition was utilized for 34.3% and single enteral tube feeding for 79.1% of that period. 61.4% of the children were fed exclusively via enteral tube feeding, 9.1% via parenteral and 39.5 % by both routes. The enteral tube feeding was introduced upon admission and transpyloric placement was successful in 90% of the cases. Feeding was started 48 hours after ICU admission. The caloric goal was achieved on the 7th day after admission, and thereafter parenteral nutrition was interrupted. The maximum energy supply was 104.2 ± 23.15 kcal/kg. The median length of therapy was 11 days (range 4-38. None of the patients on tube feeding developed GI tract bleeding, pneumonia or bronchoaspiration episodes and, of the 4 patients who were given exclusive TPN, 2 developed peptic ulcer. The initial urinary urea nitrogen was 7.11 g/m2 and at discharge 6.44 g/m2. The protein supply increased from 1.49 g/kg to 3.65 g/kg (p< 0.01. The nitrogen balance increased from -7.05 to 2.2 g (p< 0.01. CONCLUSIONS: Children with acute neurological diseases are hypercatabolic and have high urinary nitrogen losses. The initial negative nitrogen balance can be

  14. Implementation of an electromagnetic imaging system to facilitate nasogastric and post-pyloric feeding tube placement in patients with and without critical illness.

    Science.gov (United States)

    Windle, E M; Beddow, D; Hall, E; Wright, J; Sundar, N

    2010-02-01

    Artificial nutrition support is required to optimise nutritional status in many patients. Traditional methods of placing feeding tubes may incur clinical risk and financial costs. A technique facilitating placement of nasogastric and post-pyloric tubes via electromagnetic visual guidance may reduce the need for X-ray exposure, endoscopy time and the use of parenteral nutrition. The present study aimed to audit use of such a system at initial implementation in patients within an acute NHS Trust. A retrospective review was undertaken of dietetic and medical records for the first 14 months of using the Cortrak system. Data were collected on referral origin, preparation of the patient prior to insertion, placement success rates and need for X-ray. Cost analysis was also performed. Referrals were received from primary consultants or consultant intensivists, often on the advice of the dietitian. Fifty-nine percent of patients received prokinetic therapy at the time of placement. Thirty-nine tube placements were attempted. Sixty-nine percent of referrals for post-pyloric tube placement resulted in successful placement. X-ray films were requested for 22% of all attempted post-pyloric placements. Less than half of nasogastric tubes were successfully passed, although none of these required X-ray confirmation. The mean cost per tube insertion attempt was 111 pounds. This system confers advantages, particularly in terms of post-pyloric tube placement, even at this early stage of implementation. A reduction in clinical risk and cost avoidance related to X-ray exposure, the need for endoscopic tube placement and parenteral nutrition have been achieved. The implementation of this system should be considered in other centres.

  15. Influences of the wavy surface inserted in the middle of a circular tube heat exchanger on thermal performance

    Energy Technology Data Exchange (ETDEWEB)

    Jedsadaratanancai, Withada [King Mongkut' s Institute of Technology Ladkrabang, Bangkok (Thailand); Boonloi, Amnart [King Mongkut' s University of Technology North Bangkok, Bangkok (Thailand)

    2015-09-15

    Numerical investigations on flow topology, heat transfer behavior and performance evaluation in a circular tube inserted with various configurations of wavy surfaces, Inclined wavy surface (IWS), V-downstream wavy surface (VDWS), V-Upstream wavy surface (VUWS) are presented. The effects of the flow attack angles; 20 .deg., 30 .deg., 45.deg. and 60.deg. are studied for the Reynolds numbers, Re = 100-2000. The numerical results are compared with the smooth circular tube with no wavy surface and the previous works. It is found that the IWS, VDWS and VUWS can produce longitudinal vortex flow and impinging jet of the fluid flow like inclined baffle, V-downstream baffle and V-Upstream baffle, respectively, but give lower friction loss. The flow phenomena created by the wavy surfaces help to augment the heat transfer rate and thermal performance in the test tube. In the range studied, the order of enhancement for heat transfer rate is around 1.40-3.75, 1.60-6.25 and 1.30-5.80 times higher than the smooth tube for IWS, VDWS and VUWS, respectively. Moreover, the maximum thermal performance, presented in terms of the Thermal enhancement factor (TEF), is found to be about 1.60, 2.40 and 2.10, respectively, for IWS, VUWS and VDWS.

  16. Comparison between gastrostomy feeding and self-expandable metal stent insertion for patients with esophageal cancer and dysphagia.

    Science.gov (United States)

    Min, Yang Won; Jang, Eun Young; Jung, Ji Hey; Lee, Hyuk; Min, Byung-Hoon; Lee, Jun Haeng; Rhee, Poong-Lyul; Kim, Jae J

    2017-01-01

    Self-expandable metal stent (SEMS) insertion and percutaneous gastrostomy (PG) feeding are commonly used for patients with esophageal cancer and dysphagia. This study aimed to compare outcomes between SEMS insertion and PG feeding for them. We retrospectively analyzed 308 patients with esophageal cancer who underwent fully covered SEMS insertion (stent group) or PG (gastrostomy group) for dysphagia due to tumor. Patients with other causes of dysphagia, such as radiation-induced or postoperative stricture, were excluded from the study. Clinical outcomes were compared between the two groups, including overall survival and need for additional intervention and postprocedural nutritional status. At baseline, the stent group (n = 169) had more stage IV patients, less cervical cancers, and received radiotherapy and esophagectomy less often than the gastrostomy group (n = 64). The Kaplan-Meier curves showed higher overall survival in the gastrostomy group than in the stent group. Multivariate analysis revealed that PG was associated with better survival compared with SEMS insertion (hazard ratio 0.541, 95% confidence interval 0.346-0.848, p = 0.007). In addition, the gastrostomy group needed additional intervention less often (3.1% vs. 21.9%, p esophageal cancer and dysphagia. Stabilized nutritional status by PG may play a role in improving patient survival.

  17. Heat transfer intensification within tube recuperator by inserting secondary emitters inside air channels

    International Nuclear Information System (INIS)

    Sandor, P.; Soroka, B.; Kudryavtsev, V.; Zgurskyy, V.

    2009-01-01

    The research program was stipulated by reduction the service life of the tube recuperators of reheating furnaces at DUNAFERR metallurgical works in Dunaujvaros (Hungary) while replacement the natural gas by coke - oven gas as a furnace fuel took place and air preheating temperature was increased. The tests procedure consists in comparison of temperature and pressure distributions by air flows preheating under air moving inside the tube loops. Advantages of new recuperator design compared to ordinary one have been proven by validation of concept for adequacy to the testing results. The first tests have demonstrated enhancement of local specific and total heat fluxes transferred from flue gases to air flow within the MD tube loops in comparison with those for BD loops by 25 to 45% - dependence on temperature level within the heating (furnace) chamber and on preheated air flow rate. (author)

  18. Interventions for children with ear discharge occurring at least two weeks following grommet (ventilation tube) insertion

    NARCIS (Netherlands)

    Venekamp, Roderick P; Javed, Faisal; van Dongen, Thijs Ma; Waddell, Angus; Schilder, Anne Gm

    2016-01-01

    BACKGROUND: Ear discharge (otorrhoea) is common in children with grommets (ventilation/tympanostomy tubes); the proportion of children developing discharge ranges from 25% to 75%. The most common treatment strategies include oral broad-spectrum antibiotics, antibiotic eardrops or those containing a

  19. Family Experiences With Feeding Tubes in Neurologic Impairment: A Systematic Review.

    Science.gov (United States)

    Nelson, Katherine E; Lacombe-Duncan, Ashley; Cohen, Eyal; Nicholas, David B; Rosella, Laura C; Guttmann, Astrid; Mahant, Sanjay

    2015-07-01

    Gastrostomy tubes (G-tubes) are frequently used to provide enteral nutrition for children who have neurologic impairment. Understanding the impact of G-tubes from the family's perspective will inform decision-making and improve support from health care providers. This study explored the experiences of families after G-tube placement in children with neurologic impairment. We conducted a systematic review of English-language qualitative primary research studies describing family experiences after G-tube placement. Six electronic databases were searched from inception to June 2014. Two authors independently screened and identified relevant studies, evaluated quality of reporting by using the Consolidated Criteria for Reporting Qualitative Research tool, and extracted data. Overarching concepts were developed by using thematic analysis. From 2674 screened abstracts, 84 texts were reviewed, and 13 studies met the inclusion criteria. G-tubes affect the lives of children, parents, and the family unit in many ways, both positive and negative. Improvements and challenges were described for children's health and happiness, for parental caregiving and stress, and for logistics and bonding within the family. G-tube feeding also changed relationships within the family, between the family and the medical system, and between the family and the outside world. Furthermore, experiences varied, with different families framing similar concepts as positive and negative. G-tube placement has diverse effects on daily life for children with neurologic impairment and their families. Clinicians may use the themes identified in this study to guide conversations with families about their values, experiences, and expectations before and after G-tube placement. Copyright © 2015 by the American Academy of Pediatrics.

  20. Comparative Study of Esophageal Self-expandable Metallic Stent Insertion and Gastrostomy Feeding for Dysphagia Caused by Lung Cancer.

    Science.gov (United States)

    Kim, Jihye; Min, Yang Won; Lee, Hyuk; Min, Byung Hoon; Lee, Joon Haeng; Rhee, Poong Lyul; Kim, Jae J

    2018-03-25

    Dysphagia is encountered in a large proportion of patients with lung cancer and is associated with malnutrition and a poor quality of life. This study compared the clinical outcomes of self-expandable metallic stent (SEMS) insertion and percutaneous gastrostomy (PG) feeding for patients with lung cancer and dysphagia. A total of 261 patients with lung cancer, who underwent either SEMS insertion (stent group) or PG (gastrostomy group) as an initial treatment procedure for dysphagia between July 1997 and July 2015 at the Samsung Medical Center, were reviewed retrospectively, and 84 patients with esophageal obstruction were identified. The clinical outcomes, including the overall survival, additional intervention, complications, and post-procedural nutritional status in the two groups, were compared. Among the 84 patients finally analyzed, 68 patients received SEMS insertion and 16 had PG. The stent group had less cervical obstruction and more mid-esophageal obstruction than the gastrostomy group. The Kaplan-Meier curves revealed similar overall survival in the two groups. Multivariate analysis showed that the two modalities had similar survival rates (PG compared with SEMS insertion, hazard ratio 0.682, p=0.219). Fifteen patients (22.1%) in the stent group received additional intervention, whereas there was no case in the gastrostomy group (p=0.063). The decrease in the serum albumin level after the procedure was lower in the gastrostomy group than in the stent group (-0.20±0.54 g/dL vs. -0.65±0.57 g/dL, p=0.013). SEMS insertion and PG feeding for relieving dysphagia by lung cancer had a comparable survival outcome. On the other hand, PG was associated with a better nutritional status.

  1. Comparison between gastrostomy feeding and self-expandable metal stent insertion for patients with esophageal cancer and dysphagia.

    Directory of Open Access Journals (Sweden)

    Yang Won Min

    Full Text Available Self-expandable metal stent (SEMS insertion and percutaneous gastrostomy (PG feeding are commonly used for patients with esophageal cancer and dysphagia. This study aimed to compare outcomes between SEMS insertion and PG feeding for them.We retrospectively analyzed 308 patients with esophageal cancer who underwent fully covered SEMS insertion (stent group or PG (gastrostomy group for dysphagia due to tumor. Patients with other causes of dysphagia, such as radiation-induced or postoperative stricture, were excluded from the study. Clinical outcomes were compared between the two groups, including overall survival and need for additional intervention and postprocedural nutritional status.At baseline, the stent group (n = 169 had more stage IV patients, less cervical cancers, and received radiotherapy and esophagectomy less often than the gastrostomy group (n = 64. The Kaplan-Meier curves showed higher overall survival in the gastrostomy group than in the stent group. Multivariate analysis revealed that PG was associated with better survival compared with SEMS insertion (hazard ratio 0.541, 95% confidence interval 0.346-0.848, p = 0.007. In addition, the gastrostomy group needed additional intervention less often (3.1% vs. 21.9%, p < 0.001 and experienced less decrease in serum albumin levels (-0.15 ± 0.56 g/dL vs. -0.39 ± 0.58 g/dL, p = 0.011 than the stent group after procedure.Our data suggested that, compared with SEMS insertion, PG is associated with better overall survival in patients with esophageal cancer and dysphagia. Stabilized nutritional status by PG may play a role in improving patient survival.

  2. Experimental and numerical investigation on heat transfer augmentation in a circular tube under forced convection with annular differential blockages/inserts

    Science.gov (United States)

    Waghole, D. R.

    2018-01-01

    Investigation on heat transfer by generating turbulence in the fluid stream inside the circular tube is an innovative area of research for researchers. Hence, many techniques are been investigated and adopted for enhancement of heat transfer rate to reduce the size and the cost of the heat exchanger/circular tube. In the present study the effect of differential solid ring inserts /turbulators on heat transfer, friction factor of heat exchanger/circular tube was evaluated through experimentally and numerically. The experiments were conducted in range of 3000 ≤Re≤ 6500 and annular blockages 0 ≤ɸ≤50 %. The heat transfer rate was higher for differential combination of inserts as compared to tube fitted with uniform inserts. The maximum heat transfer was obtained by the use of differential metal circular ring inserts/blockages. From this study, Nusselt number, friction factor and enhancement factor are found as 2.5-3.5 times, 12% - 50.5% and 155% - 195%, respectively with water. Finally new possible correlations for predicting heat transfer and friction factor in the flow of water through the circular tube with differential blockages/inserts are proposed.

  3. Heat transfer and pressure drop studies of TiO2/DI water nanofluids in helically corrugated tubes using spiraled rod inserts

    Science.gov (United States)

    Anbu, S.; Venkatachalapathy, S.; Suresh, S.

    2018-05-01

    An experimental study on the convective heat transfer and friction factor characteristics of TiO2/DI water nanofluids in uniformly heated plain and helically corrugated tubes (HCT) with and without spiraled rod inserts (SRI) under laminar flow regime is presented in this paper. TiO2 nanoparticles with an average size of 32 nm are dispersed in deionized (DI) water to form stable suspensions containing 0.1, 0.15, 0.2, and 0.25% volume concentrations of nanoparticles. It is found that the inclusion of nanoparticles to DI water ameliorated Nusselt number which increased with nanoparticles concentration upto 0.2%. Two spiraled rod inserts made of copper with different pitches (pi = 50 mm and 30 mm) are inserted in both plain and corrugated tubes and it is found that the addition of these inserts increased the Nusselt number substantially. For Helically corrugated tube with lower pitch and maximum height of corrugation (pc = 8 mm, hc = 1 mm) with 0.2% volume concentration of nanoparticles, a maximum enhancement of 15% in Nusselt number is found without insert and with insert having lower pitch (pi = 30 mm) the enhancement is 34% when compared to DI water in plain tube. The results on friction factor show a maximum penalty of about 53.56% for the above HCT.

  4. Loss of feed flow, steam generator tube rupture and steam line break thermohydraulic experiments

    Energy Technology Data Exchange (ETDEWEB)

    Mendler, O J; Takeuchi, K; Young, M Y

    1986-10-01

    The Westinghouse Model Boiler No. 2 (MB-2) steam generator test model at the Engineering Test Facility in Tampa, Florida, was reinstrumented and modified for performing a series of tests simulating steam generator accident transients. The transients simulated were: loss of feed flow, steam generator tube rupture, and steam line break events. This document presents a description of (1) the model boiler and the associated test facility, (2) the tests performed, and (3) the analyses of the test results.

  5. Evaluation of the benefits of gastric tube feeding in an elderly population.

    Science.gov (United States)

    Weaver, J P; Odell, P; Nelson, C

    1993-09-01

    To assess the benefits of gastric tube feeding in an elderly community hospital population. One hundred consecutive patients who required feeding gastrostomies from July 1984 through June 1987. Durham (NC) Regional Hospital, a 380-bed community hospital. Patients were evaluated using a quality of life scale (QL scale) adapted from Spitzer's QL Index. The evaluation was based on hospital records at the time of tube placement and interviews with patients or family members at follow-up between June 1991 and March 1992. Subjective evaluation of the benefits of gastric tube feeding were obtained in interviews with patients or their families at follow-up. Overall there was no significant change in the objective evaluation of quality of life at follow-up. Men, patients over 76 years of age, and patients with chronic illnesses such as multiple strokes or dementia showed the poorest response on the QL scale. Subjective evaluation by patients or their family members was positively correlated with objective evaluation on the QL scale. Family members of patients who showed the poorest response on the QL scale were more likely than other family members to respond no to the question, "Would you want this done to you if you were in his/her situation?" Our QL scale provides a good indication of patients' and family members' subjective evaluation of the benefits of gastrostomy tube feeding after 4 to 8 years. Thus, the scale should be helpful to physicians who must consult with patients and their families and make decisions about the use of this procedure. The significant discrepancy between family members' evaluations of the benefit of the procedure to the patient and their refusal of the procedure for themselves if they were in the patient's situation confirms the need for advance directives and the importance of conscientious implementation of the Patient Self Determination Act of 1990.

  6. Loss of feed flow, steam generator tube rupture and steam line break thermohydraulic experiments

    International Nuclear Information System (INIS)

    Mendler, O.J.; Takeuchi, K.; Young, M.Y.

    1986-10-01

    The Westinghouse Model Boiler No. 2 (MB-2) steam generator test model at the Engineering Test Facility in Tampa, Florida, was reinstrumented and modified for performing a series of tests simulating steam generator accident transients. The transients simulated were: loss of feed flow, steam generator tube rupture, and steam line break events. This document presents a description of (1) the model boiler and the associated test facility, (2) the tests performed, and (3) the analyses of the test results

  7. Complications of ventilation tube insertion in children with and without cleft palate: a nested case-control comparison.

    Science.gov (United States)

    Smillie, Ian; Robertson, Sophie; Yule, Anna; Wynne, David M; Russell, Craig J H

    2014-10-01

    Optimizing hearing in patients with cleft lip and/or palate (CLP) by early recognition and management of otitis media with effusion is essential for speech development. Some evidence has suggested higher complication rates from ventilation tube (VT) insertion in patients with CLP and has led to a trend not to treat these patients surgically. However, studies have failed to match comparison groups for age and sex. To compare complication rates from VT insertion in pediatric patients with and without CLP. The study used a nested case-control design to evaluate 60 pediatric patients with CLP who underwent VT insertion at a children's hospital. The control group of age- and sex-matched patients was selected from a database of 2943 VT insertions. All patients were administered general anesthesia and underwent VT insertion by a pediatric otorhinolaryngology (ENT) team. The primary outcomes were numbers of otorrhea complications. Secondarily, rates of attendance at an ENT clinic specifically for complications were evaluated. Finally, numbers of complications other than otorrhea were assessed but not statistically analyzed owing to the varied types and low numbers in each group. The control cohort had 151 documented cases of otorrhea compared with 121 in the CLP group (ratio 1.25:1); the difference between groups was not statistically significant (P = .52). There was no significant difference in mean ENT clinic visits per patient for complications between groups (0.80 in the CLP group, 0.78 for controls) (P = .66). Regarding complications other than otorrhea, the control group reported more than the CLP group (43 vs 25; ratio, 1.7:1). Complication rates of VT placement among patients with CLP were not higher than those among patients without CLP. Therefore, treatment with VT insertion should be administered to patients with CLP under the same guidelines as for those without CLP. Indeed, there could be an argument for a shift in practice toward more aggressive

  8. Incidence of Complications Developed after the Insertion of Ventilation Tube in Children under 6 years old in 2008-2009

    Directory of Open Access Journals (Sweden)

    Nader Saki

    2012-01-01

    Full Text Available Introduction: One of the main treatments of chronic otitis media with effusion is ventilation of the middle ear with a ventilation tube (VT. The objective of this study was to determine the incidence and the types of VT complications in children with otitis media with effusion in Ahwaz. Materials and Methods: In this prospective study, the medical records of 208 children (52 male and 35 female in Imam Khomeini and Apadana hospitals were reviewed. The children were between 10 months and 6 years old. The patients were followed up 12-18 months after ventilation tube insertion. We reviewed age, sex, postoperative otorrhea, eardrum atrophy, tympanosclerosis and persistent perforation. In all these patients, the indication for surgery was chronic middle ear effusion. The data were analyzed and presented as numbers and percentages using SPSS17.0. Results: Transient otorrhea occurred in 12.5% and delayed otorrhea in 8.2%. Otorrhea non-responsive to medical treatment was seen in 1.9%. Complications after tympanostomy tube extrusion included atrophy (27.8% myringosclerosis (37.9%, and persistent perforation (2.4%.The average extrusion time was 10.5 ±5 months (ranging between 3-22 months. Conclusion: After extrusion of the ventilation tube, patients should be followed up regularly for recurrence of OME. Myringosclerosis, tympanic membrane atrophy and otorrhea are the most common complications of otitis media with effusion. However, they are generally insignificant. Consequently, in the majority of these complications, there is no need for any treatment.

  9. Endoscopically placed guide wire assisted nasogastric tube insertion for palliation of absolute dysphagia in patients with incurable esophageal cancer

    Directory of Open Access Journals (Sweden)

    Purkayastha Joydeep

    2006-01-01

    Full Text Available Carcinoma of the esophagus is a dreadful disease because it causes a lot of distress to the patient due to its adverse effects on swallowing. Many patients present with large incurable disease or undergo disease progression and become incurable. Such patients are advised palliative and symptomatic care. The most distressing symptom that requires palliation in such patients is dysphagia. Many procedures are available for relief of dysphagia, but these are not readily available or are costly. We describe a simple, safe, cost effective and easy to do procedure for palliation of malignant dysphagia by insertion of Ryle′s tube over a endoscopically placed guide wire especially suitable for patients of the poor socio-economic strata.

  10. Shaping oral feeding in a gastronomy tube-dependent child in natural settings.

    Science.gov (United States)

    Gutentag, S; Hammer, D

    2000-07-01

    A 3-year-old medically fragile girl who refused to eat after prolonged and frequent hospitalizations was started on a feeding program in the home and school settings. She exhibited food aversions and received all nourishment via a gastronomy tube. Preevaluation observations of her feeding behavior revealed that she refused all presented drinks and foods. Treatment was two-fold. First, food acceptance was followed by social praise and access to preferred toy play, and second, food refusal and disruptive behaviors were ignored. Gagging, vomiting, and crying occurred periodically during initial feedings. In addition, there were medical complications during the course of treatment necessitating continuous modifications of the program. Results of a multiple-phase design showed marked increases in the amount of food consumed at home, which then generalized to the school setting.

  11. Estimation of cobalt release from feed water heater tubes of BWRs

    International Nuclear Information System (INIS)

    Uchida, S.; Kitamura, M.; Ozawa, Y.

    1983-01-01

    To evaluate the release source of cobalt from heater tubes of the feed water line, release rate measurements were carried out by detecting 60 Co released from irradiated stainless steel in contact with neutral water at an oxygen concentration of 20 ppb. The dependences of cobalt release rate on temperature, flow velocity and exposure time were studied after 670 hours of release experiments, and an empirical equation (which is presented) was obtained in the temperature range from 150 to 240 deg C. A decrease in the cobalt release rate above 250 deg C was considered due to the formation of a protective oxide layer. From these data, the amount of cobalt released from individual feed water heaters was evaluated. It was demonstrated that low cobalt containing stainless steel was economically applied only in the higher temperature region of the heater (20% of the total surface) to reduce cobalt feed rate into the reactor (to approx. 1/2). (author)

  12. Gastrostomy versus nasogastric tube feeding for chemoradiation patients with head and neck cancer: the TUBE pilot RCT.

    Science.gov (United States)

    Paleri, Vinidh; Patterson, Joanne; Rousseau, Nikki; Moloney, Eoin; Craig, Dawn; Tzelis, Dimitrios; Wilkinson, Nina; Franks, Jeremy; Hynes, Ann Marie; Heaven, Ben; Hamilton, David; Guerrero-Urbano, Teresa; Donnelly, Rachael; Barclay, Stewart; Rapley, Tim; Stocken, Deborah

    2018-04-01

    Approximately 9000 new cases of head and neck squamous cell cancers (HNSCCs) are treated by the NHS each year. Chemoradiation therapy (CRT) is a commonly used treatment for advanced HNSCC. Approximately 90% of patients undergoing CRT require nutritional support via gastrostomy or nasogastric tube feeding. Long-term dysphagia following CRT is a primary concern for patients. The effect of enteral feeding routes on swallowing function is not well understood, and the two feeding methods have, to date (at the time of writing), not been compared. The aim of this pilot randomised controlled trial (RCT) was to compare these two options. This was a mixed-methods multicentre study to establish the feasibility of a RCT comparing oral feeding plus pre-treatment gastrostomy with oral feeding plus as-required nasogastric tube feeding in patients with HNSCC. Patients were recruited from four tertiary centres treating cancer and randomised to the two arms of the study (using a 1 : 1 ratio). The eligibility criteria were patients with advanced-staged HNSCC who were suitable for primary CRT with curative intent and who presented with no swallowing problems. The primary outcome was the willingness to be randomised. A qualitative process evaluation was conducted alongside an economic modelling exercise. The criteria for progression to a Phase III trial were based on a hypothesised recruitment rate of at least 50%, collection of outcome measures in at least 80% of those recruited and an economic value-of-information analysis for cost-effectiveness. Of the 75 patients approached about the trial, only 17 consented to be randomised [0.23, 95% confidence interval (CI) 0.13 to 0.32]. Among those who were randomised, the compliance rate was high (0.94, 95% CI 0.83 to 1.05). Retention rates were high at completion of treatment (0.94, 95% CI 0.83 to 1.05), at the 3-month follow-up (0.88, 95% CI 0.73 to 1.04) and at the 6-month follow-up (0.88, 95% CI 0.73 to 1.04). No serious adverse

  13. Definition of the minimum longitude of insert in the rebuilding of Charpy test tubes for surveillance and life extension of vessels in Mexico

    International Nuclear Information System (INIS)

    Romero C, J.; Hernandez C, R.; Rocamontes A, M.

    2011-11-01

    In the National Institute of Nuclear Research (Mexico) a welding system for the rebuilding of Charpy test tubes has been developed, automated, qualified and used for the surveillance of the mechanical properties (mainly embrittlement) of the vessel. This system uses the halves of the rehearsed Charpy test tubes of the surveillance capsules extracted of the reactors, to obtain, of a rehearsed test tube, two reconstituted test tubes. This rebuilding process is used so much in the surveillance program like in the potential extension of the operation license of the vessel. To the halves of Charpy test tubes that have been removed the deformed part by machine are called -insert- and in a very general way the rebuilding consists in weld with the welding process -Stud Welding- two metallic implants in the ends of the insert, to obtain a reconstituted test tube. The main characteristic of this welding are the achieved small dimensions, so much of the areas welded as of the areas affected by the heat. The applicable normative settles down that the minim longitude of the insert for the welding process by Stud Welding it should be of 18 mm, however according to the same normative this longitude can diminish if is demonstrated analytic or experimentally that the central volume of 1 cm 3 in the insert is not affected. In this work the measurement of the temperature profiles to different distances of the welding interface is presented, defining an equation for the maximum temperatures reached in function of the distance, on the other hand the real longitude affected in the test tube by means of metallography is determined and this way the minimum longitude of the insert for this developed rebuilding system was determined. (Author)

  14. Evaluation of App-Based Serious Gaming as a Training Method in Teaching Chest Tube Insertion to Medical Students: Randomized Controlled Trial.

    Science.gov (United States)

    Haubruck, Patrick; Nickel, Felix; Ober, Julian; Walker, Tilman; Bergdolt, Christian; Friedrich, Mirco; Müller-Stich, Beat Peter; Forchheim, Franziska; Fischer, Christian; Schmidmaier, Gerhard; Tanner, Michael C

    2018-05-21

    The insertion of a chest tube should be as quick and accurate as possible to maximize the benefit and minimize possible complications for the patient. Therefore, comprehensive training and assessment before an emergency situation are essential for proficiency in chest tube insertion. Serious games have become more prevalent in surgical training because they enable students to study and train a procedure independently, and errors made have no effect on patients. However, up-to-date evidence regarding the effect of serious games on performance in procedures in emergency medicine remains scarce. The aim of this study was to investigate the serious gaming approach in teaching medical students an emergency procedure (chest tube insertion) using the app Touch Surgery and a modified objective structural assessment of technical skills (OSATS). In a prospective, rater-blinded, randomized controlled trial, medical students were randomized into two groups: intervention group or control group. Touch Surgery has been established as an innovative and cost-free app for mobile devices. The fully automatic software enables users to train medical procedures and afterwards self-assess their training effort. The module chest tube insertion teaches each key step in the insertion of a chest tube and enables users the meticulous application of a chest tube. In contrast, the module "Thoracocentesis" discusses a basic thoracocentesis. All students attended a lecture regarding chest tube insertion (regular curriculum) and afterwards received a Touch Surgery training lesson: intervention group used the module chest tube insertion and the control group used Thoracocentesis as control training. Participants' performance in chest tube insertion on a porcine model was rated on-site via blinded face-to-face rating and via video recordings using a modified OSATS tool. Afterwards, every participant received an individual questionnaire for self-evaluation. Here, trainees gave information about their

  15. Evaluation of App-Based Serious Gaming as a Training Method in Teaching Chest Tube Insertion to Medical Students: Randomized Controlled Trial

    Science.gov (United States)

    Ober, Julian; Walker, Tilman; Bergdolt, Christian; Friedrich, Mirco; Müller-Stich, Beat Peter; Forchheim, Franziska; Fischer, Christian; Schmidmaier, Gerhard; Tanner, Michael C

    2018-01-01

    Background The insertion of a chest tube should be as quick and accurate as possible to maximize the benefit and minimize possible complications for the patient. Therefore, comprehensive training and assessment before an emergency situation are essential for proficiency in chest tube insertion. Serious games have become more prevalent in surgical training because they enable students to study and train a procedure independently, and errors made have no effect on patients. However, up-to-date evidence regarding the effect of serious games on performance in procedures in emergency medicine remains scarce. Objective The aim of this study was to investigate the serious gaming approach in teaching medical students an emergency procedure (chest tube insertion) using the app Touch Surgery and a modified objective structural assessment of technical skills (OSATS). Methods In a prospective, rater-blinded, randomized controlled trial, medical students were randomized into two groups: intervention group or control group. Touch Surgery has been established as an innovative and cost-free app for mobile devices. The fully automatic software enables users to train medical procedures and afterwards self-assess their training effort. The module chest tube insertion teaches each key step in the insertion of a chest tube and enables users the meticulous application of a chest tube. In contrast, the module “Thoracocentesis” discusses a basic thoracocentesis. All students attended a lecture regarding chest tube insertion (regular curriculum) and afterwards received a Touch Surgery training lesson: intervention group used the module chest tube insertion and the control group used Thoracocentesis as control training. Participants’ performance in chest tube insertion on a porcine model was rated on-site via blinded face-to-face rating and via video recordings using a modified OSATS tool. Afterwards, every participant received an individual questionnaire for self-evaluation. Here

  16. Attachment of and biofilm formation by Enterobacter sakazakii on stainless steel and enteral feeding tubes.

    Science.gov (United States)

    Kim, Hoikyung; Ryu, Jee-Hoon; Beuchat, Larry R

    2006-09-01

    Enterobacter sakazakii has been reported to form biofilms, but environmental conditions affecting attachment to and biofilm formation on abiotic surfaces have not been described. We did a study to determine the effects of temperature and nutrient availability on attachment and biofilm formation by E. sakazakii on stainless steel and enteral feeding tubes. Five strains grown to stationary phase in tryptic soy broth (TSB), infant formula broth (IFB), or lettuce juice broth (LJB) at 12 and 25 degrees C were examined for the extent to which they attach to these materials. Higher populations attached at 25 degrees C than at 12 degrees C. Stainless steel coupons and enteral feeding tubes were immersed for 24 h at 4 degrees C in phosphate-buffered saline suspensions (7 log CFU/ml) to facilitate the attachment of 5.33 to 5.51 and 5.03 to 5.12 log CFU/cm(2), respectively, before they were immersed in TSB, IFB, or LJB, followed by incubation at 12 or 25 degrees C for up to 10 days. Biofilms were not produced at 12 degrees C. The number of cells of test strains increased by 1.42 to 1.67 log CFU/cm(2) and 1.16 to 1.31 log CFU/cm(2) in biofilms formed on stainless steel and feeding tubes, respectively, immersed in IFB at 25 degrees C; biofilms were not formed on TSB and LJB at 25 degrees C, indicating that nutrient availability plays a major role in processes leading to biofilm formation on the surfaces of these inert materials. These observations emphasize the importance of temperature control in reconstituted infant formula preparation and storage areas in preventing attachment and biofilm formation by E. sakazakii.

  17. Conversion of choledochojejunostomy stents to jejunal feeding tubes for postoperative enteral alimentation.

    Science.gov (United States)

    Burke, D R; Torosian, M H; McLean, G K; Meranze, S G; Rosato, E F

    1988-01-01

    The problem of protein calorie malnutrition following major gastrointestinal surgery can be treated with central venous or enteric alimentation, with the latter being preferred. The authors describe a simple technique for the conversion of biliary stents placed after pancreaticoduodenal surgery into jejunal feeding tubes when the stenting function is no longer needed. Three illustrative cases are presented. In each case, the procedure took less than 30 min and had no associated morbidity. This technique allows early conversion from central venous to enteric alimentation without the need to create a second surgical enterostomy.

  18. How ticks get under your skin: insertion mechanics of the feeding apparatus of Ixodes ricinus ticks

    Science.gov (United States)

    Richter, Dania; Matuschka, Franz-Rainer; Spielman, Andrew; Mahadevan, L.

    2013-01-01

    The tick Ixodes ricinus uses its mouthparts to penetrate the skin of its host and to remain attached for about a week, during which time Lyme disease spirochaetes may pass from the tick to the host. To understand how the tick achieves both tasks, penetration and attachment, with the same set of implements, we recorded the insertion events by cinematography, interpreted the mouthparts’ function by scanning electron microscopy and identified their points of articulation by confocal microscopy. Our structural dynamic observations suggest that the process of insertion and attachment occurs via a ratchet-like mechanism with two distinct stages. Initially, the two telescoping chelicerae pierce the skin and, by moving alternately, generate a toehold. Subsequently, a breaststroke-like motion, effected by simultaneous flexure and retraction of both chelicerae, pulls in the barbed hypostome. This combination of a flexible, dynamic mechanical ratchet and a static holdfast thus allows the tick to solve the problem of how to penetrate skin and also remain stuck for long periods of time. PMID:24174106

  19. Development and validation of a prediction model for tube feeding dependence after curative (chemo- radiation in head and neck cancer.

    Directory of Open Access Journals (Sweden)

    Kim Wopken

    Full Text Available BACKGROUND: Curative radiotherapy or chemoradiation for head and neck cancer (HNC may result in severe acute and late side effects, including tube feeding dependence. The purpose of this prospective cohort study was to develop a prediction model for tube feeding dependence 6 months (TUBEM6 after curative (chemo- radiotherapy in HNC patients. PATIENTS AND METHODS: Tube feeding dependence was scored prospectively. To develop the multivariable model, a group LASSO analysis was carried out, with TUBEM6 as the primary endpoint (n = 427. The model was then validated in a test cohort (n = 183. The training cohort was divided into three groups based on the risk of TUBEM6 to test whether the model could be extrapolated to later time points (12, 18 and 24 months. RESULTS: Most important predictors for TUBEM6 were weight loss prior to treatment, advanced T-stage, positive N-stage, bilateral neck irradiation, accelerated radiotherapy and chemoradiation. Model performance was good, with an Area under the Curve of 0.86 in the training cohort and 0.82 in the test cohort. The TUBEM6-based risk groups were significantly associated with tube feeding dependence at later time points (p<0.001. CONCLUSION: We established an externally validated predictive model for tube feeding dependence after curative radiotherapy or chemoradiation, which can be used to predict TUBEM6.

  20. Compounding rifampin suspensions with improved injectability for nasogastric enteral feeding tube administration.

    Science.gov (United States)

    de Villiers, Melgardt M; Vogel, Laura; Bogenschutz, Monica C; Fingerhut, Bonnie J; D'Silva, Joseph B; Moore, Anne

    2010-01-01

    Often medications that have to be administered to patients via a nasogastric enteral feeding tubes are only available as tablets and capsules with no suitable commercial liquid alternatives. In such situations, pharmacists and nurses have to compound the tablets and capsule contents into liquid suspension formulations for dosing. The risk of occlusion of the enteral tubes during administration is reduced by employing liquid suspensions that are composed of small and uniform particles, not subject to rapid rates of settling, resistant to caking, and easily and uniformly re-suspended upon agitation. Present techniques often employ a manual process, such as a mortar and pestle, to accomplish the particle size reduction and subsequent incorporation into a suitable liquid diluent. A new compounding device has been invented that employs an automated wet-milling process in a single-use disposable plastic container to compound the suspensions. The two processes were compared using Rifampin capsules and various liquid diluents. A prototype version of the new device was employed in the experiments. The physical characteristics of the compounded suspensions were evaluated by determining sedimentation rate, sedimentation volume, and particle size and shape using laser light scattering, optical microscopy, and scanning electron microscopy techniques. The use characteristic of the compounded suspensions was evaluated using a nasogastric tube inject ability test. The results indicated that suspensions prepared using the new device were more resistant to sedimentation and caking and were easier to re-disperse into a uniform mixture by gentle shaking. The results were a consequence of the particles generated by the new device which were found to be smaller and more uniform in shape and size. The suspensions prepared using the new device did not cause blockage of the enteral feeding tubes in comparison to those prepared using a mortar and pastle. In conclusion, the results indicate

  1. Nasogastric feeding tube located in the lung. SENSAR case of the trimester.

    Science.gov (United States)

    2017-01-01

    A clinical case is presented that was communicated to Spanish Notification System on Safety in Anaesthesia and Recovery (SENSAR). Using this communication and its analysis, a strategy is obtained in order to reduce the risks associated with the insertion of a nasogastric tube (NST) for enteral nutrition in adult patients in the post-surgical recovery unit. A description of the incident is presented, an analysis of its causes, and the measures that were introduced in order to avoid similar incidents in the future, as well as to promote a safety culture in the organisation. A description of associated incidents registered in SENSAR is also given. The aim of this work is to describe, analyse and introduce safety measures arising from incidents notified to SENSAR, associated with the insertion and checking of the nutrition NST in adult patients in the post-surgical recovery unit. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Patient and Family Caregivers’ Experiences of Living With a Jejunostomy Feeding Tube After Surgery for Esophagogastric Cancer

    OpenAIRE

    Halliday, V.; Baker, M.; Thomas, A.L.; Bowrey, D.

    2017-01-01

    BACKGROUND: Jejunostomy feeding tubes (JFTs) can be used to provide nutrition support to patients who have had surgery for esophagogastric cancer. Although previous research reports how patients cope with a gastrostomy tube, little is known about the impact of having a JFT. The aim of this qualitative study was to explore how patients and their informal caregivers experience living with a JFT in the first months following surgery. METHODS: Participants were purposively sampled from a cohort o...

  3. Experimental Analysis of the Thermo-Hydraulic Performance on a Cylindrical Parabolic Concentrating Solar Water Heater with Twisted Tape Inserts in an Absorber Tube

    Science.gov (United States)

    Kumar, Birendra; Nayak, Rajen Kumar; Singh, S. N.

    2018-05-01

    A twisted tape inserted in an absorber tube may be an excellent option to enhance the performance of a cylindrical parabolic concentrating solar collector (CPC). The present work is an experimental study of the flow and heat transfer with and without twisted tape inserts in the absorber tube of a CPC. Results are presented for mass flow rates of water, ṁ=0.0198-0.0525 kg/s, twist ratio, y=5-10 and Reynolds number, Re=2577.46-6785.55. In the present study, we found that the outlet water temperature, collector efficiency and Nusselt number (Nu) are higher in the twisted tapes as compared to those without the twisted tape inserts in the absorber tube of the CPC. For fixed mass flow rate of water ṁ, the To and η increased with the decrease in twist ratio, y, and is higher in lower twist ratio, y=5, of the twisted tapes. The whole experiment was performed at the Indian Institute of Technology (ISM) in Dhanbad, India during the months of March-April 2017. Based on the experimental data, the correlations for the Nu and friction factor were also developed.

  4. Continuous versus bolus intragastric tube feeding for preterm and low birth weight infants with gastro-oesophageal reflux disease.

    Science.gov (United States)

    Richards, Robyn; Foster, Jann P; Psaila, Kim

    2014-07-17

    Gastro-oesophageal reflux disease is a particularly common condition in preterm and low birth weight infants. These infants are also more likely to have excessive regurgitation, as they do not have a fully developed antireflux mechanism. Preterm and low birth weight infants who are unable to suck oral feeds are required to be fed via an intragastric tube for varying lengths of time. Intragastric tube feeding can be delivered by the intermittent bolus or continuous feeding method. Use of continuous or intermittent bolus intragastric feeding may have a positive or negative effect on the incidence or severity of gastro-oesophageal reflux disease. To determine whether continuous or intermittent bolus intragastric tube feeding reduces the number of episodes and the duration of gastro-oesophageal reflux disease (GORD) in preterm and low birth weight infants.We intended to perform subgroup analyses for gestational age; birth weight; age in days from birth at full enteral feeding via intragastric tube (breast vs bottle); frequency of intermittent bolus feed; and type of medication for treatment of GORD (only if medication prescribed and given similarly to both intervention groups). We used the standard search strategy of the Cochrane Neonatal Group as described in The Cochrane Library (www.thecochranelibrary.com) to search for randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 9), MEDLINE (1966 to September 2013), EMBASE (1980 to September 2013) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to September 2013). We also searched previous reviews, including cross-references, abstracts and conference and symposia proceedings of the Perinatal Society of Australia and New Zealand and the Pediatric Academic Societies (American Pediatric Society/Society for Pediatric Research and European Society for Paediatric Research) from 1990 to 2012. Published and unpublished RCTs and quasi

  5. Plugging of feed inlet tube upstands with Ni/Ti shape memory alloy plugs - Heysham 1 power station

    International Nuclear Information System (INIS)

    Mathews, A.J.

    1988-01-01

    The paper contains a description of a new approach for Plugging feed inlet tubes of Gas-Cooled Reactors. Instead of utilizing the original explosive method plugging by fitting a shape memory alloy plug into the upstand is being described. (author)

  6. Quality of Life Issues for Families Who Make the Decision to Use a Feeding Tube for Their Child with Disabilities.

    Science.gov (United States)

    Brotherson, Mary Jane; And Others

    1995-01-01

    Eight families deciding to use a feeding tube to meet the nutrition needs of their children with disabilities were interviewed over a two-year period. Family decision making in the context of quality of life was examined using a theoretical family systems model. Implications for future interventions are addressed. (Author/SW)

  7. Enteral Feeding Tube Clogging: What Are the Causes and What Are the Answers? A Bench Top Analysis.

    Science.gov (United States)

    Garrison, Christopher M

    2018-02-01

    Clogged enteral feeding tubes remain a significant barrier to the delivery of nutrition, hydration, and medications to patients who cannot tolerate oral intake. There is limited research that compares the relative efficacy of different methods used to clear a clogged feeding tube. The objectives of this study were to better understand the factors that contribute to enteral feeding tube clogging and to test the efficacy of 3 methods for clearing clogged feeding tubes. Three formulations of clogs were artificially created and tested in vitro and composed of various quantities of crushed medication (ie, aspirin) and 0.15 g coagulated protein (ie, tofu). The following 3 clog clearing strategies were tested on all clog types (n = 5 clogs/formulation/treatment): warm water flushes, an enzyme treatment, and an actuated mechanical occlusion clearing device. The variable among the clog types that appears most responsible for decreased clearing success is the state of the coagulated protein. Dried-out protein appears to makes a greater difference than increasing the medication quantity. The actuated mechanical occlusion clearing device was significantly more successful (93%) when compared with warm water flushes (20%) and the commercially available enzyme treatment (33%; P Nutrition.

  8. Crashworthiness of Aluminium Tubes; Part 1: Hydroforming at Different Corner-Fill Radii and End Feeding Levels

    International Nuclear Information System (INIS)

    D'Amours, Guillaume; Rahem, Ahmed; Williams, Bruce; Worswick, Michael; Mayer, Robert

    2007-01-01

    The automotive industry, with an increasing demand to reduce vehicle weight through the adoption of lightweight materials, requires a search of efficient methods that suit these materials. One attractive concept is to use hydroforming of aluminium tubes. By using FE simulations, the process can be optimized to reduce the risk for failure while maintaining energy absorption and component integrity under crash conditions. It is important to capture the level of residual ductility after forming to allow proper design for crashworthiness. This paper presents numerical and experimental studies that have been carried out for high pressure hydroforming operations to study the influence of the tube corner radius, end feeding, material thinning, and work hardening in 76.2 mm diameter, 3 mm wall thickness AA5754 aluminium alloy tube. End feeding was used to increase the formability of the tubes. The influence of the end feed displacement versus tube forming pressure schedule was studied to optimize the forming process operation to reduce thinning. Validation of the numerical simulations was performed by comparison of the predicted strain distributions and thinning, with measured quantities. The effect of element formulation (thin shell versus solid elements) was also considered in the models

  9. Crashworthiness of Aluminium Tubes; Part 1: Hydroforming at Different Corner-Fill Radii and End Feeding Levels

    Science.gov (United States)

    D'Amours, Guillaume; Rahem, Ahmed; Williams, Bruce; Worswick, Michael; Mayer, Robert

    2007-05-01

    The automotive industry, with an increasing demand to reduce vehicle weight through the adoption of lightweight materials, requires a search of efficient methods that suit these materials. One attractive concept is to use hydroforming of aluminium tubes. By using FE simulations, the process can be optimized to reduce the risk for failure while maintaining energy absorption and component integrity under crash conditions. It is important to capture the level of residual ductility after forming to allow proper design for crashworthiness. This paper presents numerical and experimental studies that have been carried out for high pressure hydroforming operations to study the influence of the tube corner radius, end feeding, material thinning, and work hardening in 76.2 mm diameter, 3 mm wall thickness AA5754 aluminium alloy tube. End feeding was used to increase the formability of the tubes. The influence of the end feed displacement versus tube forming pressure schedule was studied to optimize the forming process operation to reduce thinning. Validation of the numerical simulations was performed by comparison of the predicted strain distributions and thinning, with measured quantities. The effect of element formulation (thin shell versus solid elements) was also considered in the models.

  10. Proposed examination of defect detection of magnetic tube where alternating probe in type of insertion is used

    International Nuclear Information System (INIS)

    Kiya, Atsushi; Gotoh, Yuji; Sakurai, Kenta

    2008-01-01

    In various plants in the thermal power plant and the nuclear plant, a lot of steel tubes are used for various places such as heat exchangers, and these steel tubes should inspect regular for a healthy securing of the plant. Then, the outer side defect inspection of the magnetic substance steel tube using an electromagnetic phenomenon was examined in this research. It is shown that the inspection of the outer side defect on a steel tube with baffle is possible using the proposed method. (author)

  11. Feed rate affecting surface roughness and tool wear in dry hard turning of AISI 4140 steel automotive parts using TiN+AlCrN coated inserts

    Science.gov (United States)

    Paengchit, Phacharadit; Saikaew, Charnnarong

    2018-02-01

    This work aims to investigate the effects of feed rate on surface roughness (Ra) and tool wear (VB) and to obtain the optimal operating condition of the feed rate in dry hard turning of AISI 4140 chromium molybdenum steel for automotive industry applications using TiN+AlCrN coated inserts. AISI 4140 steel bars were employed in order to carry out the dry hard turning experiments by varying the feed rates of 0.06, 0.08 and 0.1 mm/rev based on experimental design technique that can be analyzed by analysis of variance (ANOVA). In addition, the cutting tool inserts were examined after machining experiments by SEM to evaluate the effect of turning operations on tool wear. The results showed that averages Ra and VB were significantly affected by the feed rate at the level of significance of 0.05. Averages Ra and VB values at the feed rate of 0.06 mm/rev were lowest compared to average values at the feed rates of 0.08 and 0.1 mm/rev, based on the main effect plot.

  12. Continuous nasogastric tube feeding: monitoring by combined use of refractometry and traditional gastric residual volumes.

    Science.gov (United States)

    Chang, W-K; McClave, S-A; Chao, Y-C

    2004-02-01

    Traditional use of gastric residual volumes (GRVs) is insensitive and cannot distinguish retained enteral formula from the large volume of endogenous secretions. We designed this prospective study to determine whether refractometry and Brix value (BV) measurements could be used to monitor gastric emptying and tolerance in patients receiving continuous enteral feeding. Thirty-six patients on continuous nasogastric tube feeding were divided into two groups; patients with lower GRVs (75 ml) in Group 2. Upon entry, all gastric contents were aspirated, the volume was recorded (Asp GRV), BV measurements were made by refractometry, and then the contents were reinstilled but diluted with 30 ml additional water. Finally, a small amount was reaspirated and repeat BV measurements were made. Three hours later, the entire procedure was repeated a second time. The BV ratio, calculated (Cal) GRV, and volume of formula remaining were calculated by derived equations. Mean BV ratios were significantly higher for those patients in Group 2 compared to those in Group 1. All but one of the 22 patients (95%) in Group 1 had a volume of formula remaining in the stomach estimated on both measurements to be less than the hourly infusion rate (all these patients had BV ratios 70%). Three of the Group 2 patients (21%) whose initial measurement showed evidence for retention of formula, improved on repeat follow-up measurement assuring adequate gastric emptying. The remaining five patients from Group 2 (35%) had a volume of formula remaining that was less than the hourly infusion rate on both measurements. The pattern of Asp GRVs and serial pre- and post-dilution BVs failed to differentiate these patients in Group 2 with potential emptying problems from those with sufficient gastric emptying. Refractometry and measurement of the BV may improve the clinical utilization of GRVs, by its ability to identify the component of formula within gastric contents and track changes in that component related

  13. The effect of a natural food based tube feeding in minimizing diarrhea in critically ill neurological patients.

    Science.gov (United States)

    Schmidt, Simone B; Kulig, Willibald; Winter, Ralph; Vasold, Antje S; Knoll, Anette E; Rollnik, Jens D

    2018-01-09

    Diarrhea has negative consequences for patients, health care staff and health care costs when neurological patients are fed enterally over long periods. We examined the effect of tube feeding with natural foods in reducing the number of fluid stool evacuations and diarrhea in critically ill neurological patients. A multicenter, prospective, open-label and randomized controlled trial (RCT) was conducted at facilities in Germany specializing in early rehabilitation after neurological damage. Patients of the INTERVENTION group were fed by tube using a commercially available product based on real foods such as milk, meat, carrots, whereas CONTROL patients received a standard tube-feed made of powdered raw materials. All received enteral nutrition over a maximum of 30 days. The number of defecations and the consistency of each stool according to the Bristol Stool Chart (BSC) were monitored. In addition, daily calories, liquids and antibiotic-use were recorded. 118 Patients who had suffered ischemic stroke, intracerebral hemorrhage, traumatic brain injury or hypoxic brain damage and requiring enteral nutrition were enrolled; 59 were randomized to receive the intervention and 59 control feed. There were no significant differences in clinical screening data, age, sex, observation period or days under enteral nutrition between the groups. Patients in both groups received equivalent amount of calories and fluids. In both groups antibiotics were frequently prescribed (69.5% in the INTERVENTION group and 75.7% in the CONTROL group) for 10-11 days on average. In comparison to the CONTROL group, patients in the INTERVENTION group had a significant reduction of the number of watery stool evacuations (type 7 BSC) (minus 61%, IRR = 0.39, p natural based food was effective in reducing the number of watery defecations and diarrhea in long term tube-fed critically ill neurological patients, compared to those fed with standard tube feeding. Copyright © 2018 The Authors. Published

  14. The effect of enteral tube feeding in cystic fibrosis: A registry based study.

    Science.gov (United States)

    Libeert, Denis; Declercq, Dimitri; Wanyama, Simeon; Thomas, Muriel; Van Daele, Sabine; De Baets, Frans; Van Biervliet, Stephanie

    2018-03-01

    Long-term effect of enteral tube feeding (ETF) in cystic fibrosis (CF) remains equivocal. A Belgian CF registry based, retrospective, longitudinal study, evaluated the pre- and post- ETF (n = 113) clinical evolution and compared each patient with 2 age, gender, pancreatic status and genotype class-matched controls. At baseline ETF had a worse BMI z-score (p ETF, had already a significant worse nutritional status and pulmonary function at first entry in the registry. Both parameters displayed a significant decline before ETF-introduction. ETF had more hospitalization and intravenous antibiotic (IVAB) treatment days (p ETF introduction hospitalizations and IVAB decreased significantly. After ETF-introduction BMI z-score recuperated towards the original curve before the decline, but remained below the controls. Starting ETF had no effect on rate of height gain in children. The pre-index FEV1 decline (-1.52%/year (p = 0.002)) stabilized to +0.39%/year afterwards. Controls displayed decline of -0.48%/year (p ETF introduction improved BMI z-score and stabilized FEV1, associated with less hospitalizations and IVAB treatments. Higher mortality and transplantation in the ETF cases, leading to drop-outs, made determination of the effect size difficult. Copyright © 2018 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  15. [Nasogastric tube feeding in bulimia. Controlled study with follow-up at 3 months].

    Science.gov (United States)

    Rigaud, Daniel; Brayer, Véronique; Biton-Jélic, Violaine; Païs, Vanessa; Pennacchio, Hélène; Brun, Jean-Marcel

    2007-10-01

    Few effective treatments are available for severe forms of bulimia nervosa, which are accompanied by malnutrition, anxiety, and depressive mood. We previously showed in an open study that nasogastric tube feeding (TF) reduced binges and purging in patients with anorexia nervosa. This prospective randomized trial compared bulimia patients in two treatment groups: one group received TF at home, together with psychotherapy, nutritional counseling and a support group while the control group received only psychotherapy, nutritional counseling, and a support group. Patients in the first group underwent TF for 8 weeks (exclusively for 10 days and associated with meals thereafter). Assessment was based on clinical examination, laboratory results, and a variety of questionnaires (our in-house instrument for measuring binge and vomiting episodes, eating disorder inventory, Beck's depression inventory and the Hamilton rating scale for anxiety), all performed at the onset of treatment and at 8 days, 8 weeks (i.e., the end of TF), and 3 months after treatment began. Binges and vomiting disappeared faster and more frequently in TF patients than in the control group: 65% versus 29% (pbulimia nervosa, reducing the number of binge and vomiting episodes and improving nutritional status and mood.

  16. Medication Errors in Patients with Enteral Feeding Tubes in the Intensive Care Unit.

    Science.gov (United States)

    Sohrevardi, Seyed Mojtaba; Jarahzadeh, Mohammad Hossein; Mirzaei, Ehsan; Mirjalili, Mahtabalsadat; Tafti, Arefeh Dehghani; Heydari, Behrooz

    2017-01-01

    Most patients admitted to Intensive Care Units (ICU) have problems in using oral medication or ingesting solid forms of drugs. Selecting the most suitable dosage form in such patients is a challenge. The current study was conducted to assess the frequency and types of errors of oral medication administration in patients with enteral feeding tubes or suffering swallowing problems. A cross-sectional study was performed in the ICU of Shahid Sadoughi Hospital, Yazd, Iran. Patients were assessed for the incidence and types of medication errors occurring in the process of preparation and administration of oral medicines. Ninety-four patients were involved in this study and 10,250 administrations were observed. Totally, 4753 errors occurred among the studied patients. The most commonly used drugs were pantoprazole tablet, piracetam syrup, and losartan tablet. A total of 128 different types of drugs and nine different oral pharmaceutical preparations were prescribed for the patients. Forty-one (35.34%) out of 116 different solid drugs (except effervescent tablets and powders) could be substituted by liquid or injectable forms. The most common error was the wrong time of administration. Errors of wrong dose preparation and administration accounted for 24.04% and 25.31% of all errors, respectively. In this study, at least three-fourth of the patients experienced medication errors. The occurrence of these errors can greatly impair the quality of the patients' pharmacotherapy, and more attention should be paid to this issue.

  17. Enteral Tube Feeding Nutritional Protein Hydrolysate Production Under Different Factors By Enzymatic Hydrolysis

    Directory of Open Access Journals (Sweden)

    Nguyen ThiQuynhHoa

    2015-01-01

    Full Text Available Abstract Hydrolysis of proteins involves the cleavage of peptide bonds to give peptides of varying sizes and amino acid composition. There are a number of types of hydrolysis enzymatic acid or alkali hydrolysis. Chemical hydrolysis is difficult to control and reduces the nutritional quality of products destroying L-form amino acids and producing toxic substances such as lysino-alanine. Enzymatic hydrolysis works without destructing amino acids and by avoiding the extreme temperatures and pH levels required for chemical hydrolysis the nutritional properties of the protein hydrolysates remain largely unaffected. In this research we investigate the fat removal and protein hydrolysis from pork meat to produce the enteral tube feeding nutritional protein hydrolysate for patient. Our results are as follows meat moisture 75.1 protein 22.6 lipid 1.71 ash 0.5 vitamin B1 1.384mg100g n hexantreatment at 80oCin 45 minutes and drying 30 minutes in 90oC.Viscosity of the hydrolysate is very low 2.240 0.092 cPand high degree of hydrolysis 31.390 0.138 . The final protein powder has balance nutritional components and acid amines low microorganisms which are safety for human consumption.

  18. Comparison of intraoperative versus delayed enteral feeding tube placement in patients undergoing a Whipple procedure.

    Science.gov (United States)

    Scaife, Courtney L; Hewitt, Kelly C; Mone, Mary C; Hansen, Heidi J; Nelson, Edward T; Mulvihill, Sean J

    2014-01-01

    The intraoperative placement of an enteral feeding tube (FT) during pancreaticoduodenectomy (PD) is based on the surgeon's perception of need for postoperative nutrition. Published preoperative risk factors predicting postoperative morbidity may be used to predict FT need and associated intraoperative placement. A retrospective review of patients who underwent PD during 2005-2011 was performed by querying the National Surgical Quality Improvement Program (NSQIP) database with specific procedure codes. Patients were categorized based on how many of 10 possible preoperative risk factors they demonstrated. Groups of patients with scores of ≤ 1 (low) and ≥ 2 (high), respectively, were compared for FT need, length of stay (LoS) and organ space surgical site infections (SSIs). Of 138 PD patients, 82 did not have an FT placed intraoperatively, and, of those, 16 (19.5%) required delayed FT placement. High-risk patients were more likely to require a delayed FT (29.3%) compared with low-risk patients (9.8%) (P = 0.026). The 16 patients who required a delayed FT had a median LoS of 15.5 days, whereas the 66 patients who did not require an FT had a median LoS of 8 days (P < 0.001). In this analysis, subjects considered as high-risk patients were more likely to require an FT than low-risk patients. Assessment of preoperative risk factors may improve decision making for selective intraoperative FT placement. © 2013 International Hepato-Pancreato-Biliary Association.

  19. Combination of helical ferritic-steel inserts and flux-tube-expansion divertor for the heat control in tokamak DEMO reactor

    International Nuclear Information System (INIS)

    Takizuka, T.; Tokunaga, S.; Hoshino, K.; Shimizu, K.; Asakura, N.

    2015-01-01

    Edge localized modes (ELMs) in the H-mode operation of tokamak reactors may be suppressed/mitigated by the resonant magnetic perturbation (RMP), but RMP coils are considered incompatible with DEMO reactors under the strong neutron flux. We propose an innovative concept of the RMP without installing coils but inserting ferritic steels of the helical configuration. Helically perturbed field is naturally formed in the axisymmetric toroidal field through the helical ferritic steel inserts (FSIs). When ELMs are avoided, large stationary heat load on divertor plates can be reduced by adopting a flux-tube-expansion (FTE) divertor like an X divertor. Separatrix shape and divertor-plate inclination are similar to those of a simple long-leg divertor configuration. Combination of the helical FSIs and the FTE divertor is a suitable method for the heat control to avoid transient ELM heat pulse and to reduce stationary divertor heat load in a tokamak DEMO reactor

  20. Observation of double loop insertion of silicone rubber tube anastomosis method combined with "Z" flap repair in the treatment of lacrimal ductule laceration

    Directory of Open Access Journals (Sweden)

    Rui Hou

    2017-03-01

    Full Text Available AIM: To investigate the clinical curative effect of double loop insertion of silicone rubber tube combined with "Z" flap repair in the treatment of laceration of eyelid with canaliculus laceration. METHODS: The paper reviewed 45 cases of laceration of eyelid with laceration canaliculus, caused by trauma, which were treated in my hospital from January 2014 to January 2016. In the process of anastomosis of lacrimal duct and suture of eyelid laceration, either the method of single spinal anesthesia tube placement on skin contraposition suture or the method of dual annular silicone tube placement combined with the word "Z" flap repair was used. We compared the two methods and studied the possible complications like eyelid varus and valgus, lacrimal point valgus, eyelid scar, anastomotic dehiscence again. RESULTS: Out of the 22 cases in which the patients chose the single spinal anesthesia tube implantation on skin suture, 21 cases succeeded and patients received lacrimal duct patency results after extubation; and 1 case anastomosis failed. Complications: 20 cases had different degree of complications and the impact on their appearances were significant. Out of the 23 cases in which the patients chose double passage annular silicone tube joint prosthesis implantation Z flap, 23 received extubation results lacrimal patency or almost patency, the anastomosis of patients was successful. Complications: in two cases, patients had mild eyelid entropion and pomatum varus. Both eyelid deformity and severe wound tear did not occur in all cases again. Scar was not obvious. The success rate of anastomosis between the two groups was not significantly different(P=0.4889. To compare the rate of complications, there were significant differences(χ2=30.42, PCONCLUSION: The application of dual ring implantation silicon tube combined with the word "Z" flap repair in the treatment of lacrimal canaliculi laceration of eyelid laceration ensured the success rate of

  1. Risk of bleeding in patients undergoing percutaneous endoscopic gastrotrostomy (PEG tube insertion under antiplatelet therapy: a systematic review with a meta-analysis

    Directory of Open Access Journals (Sweden)

    Alfredo J. Lucendo

    2015-03-01

    Full Text Available Background and aim: Patients undergoing percutaneous endoscopic gastrostomy (PEG tube placement often are under antiplatelet therapy with a potential thromboembolic risk if these medications are discontinued. This systematic review aims to assess if maintaining aspirin and/or clopidogrel treatment increases the risk of bleeding following PEG placement. Methods: A systematic search of the MEDLINE, EMBASE, and SCOPUS databases was developed for studies investigating the risk of bleeding in patients on antiplatelet therapy undergoing PEG tube insertion. Summary estimates, including 95 % confidence intervals (CI, were calculated. A fixed or random effects model was used depending on heterogeneity (I². Publication bias risks were assessed by means of funnel plot analysis. Results: Eleven studies with a total of 6,233 patients (among whom 3,665 were undergoing antiplatelet treatment, met the inclusion criteria and were included in the quantitative summary. Any PEG tube placement-related bleeding was found in 2.67 % (95 % CI 1.66 %, 3.91 % of the entire population and in 2.7 % (95 % CI 1.5 %, 4.1 % of patients not receiving antiplatelet therapy. Pooled relative risk (RR for bleeding in patients under aspirin, when compared to controls, was 1.43 (95 % CI 0.89, 2.29; I² = 0 %; pooled RR for clopidogrel was 1.21 (95 % CI 0.48, 3.04; I² = 0 % and for dual antiplatelet therapy, 2.13; (95 % CI 0.77, 5.91; I² = 47 %. No significant publication bias was evident for the different medications analyzed. Conclusion: Antiplatelet therapy was safe among patients undergoing PEG tube insertion. Future prospective and randomized studies with larger sample sizes are required to confirm the results of this study.

  2. A protocol of early aggressive acceleration of tube feeding increases ileus without perceptible benefit in severely burned patients.

    Science.gov (United States)

    Kesey, Jennifer; Dissanaike, Sharmila

    2013-01-01

    Optimal nutrition is essential to the recovery of burned patients. The authors evaluated the efficacy of an aggressive nutrition delivery protocol. The following protocol was implemented: initiation of tube feeds within 4 hours, acceleration to goal rate within 8 hours, and tolerance of gastric residual volumes of 400 ml. Patients on the protocol formed the study group whereas patients admitted immediately before implementation served as controls for a study period of 7 days after admission. Outcome variables included ileus, prokinetic medication use, intensive care unit and overall length of stay, ventilator days and mortality. Variables were compared using bivariate analysis. The 42 study subjects and 34 controls were similar at baseline. Time to initiation was similar (6.8 vs 9.4 hours; P = .226), however, goal rate was achieved much sooner in the study group (11.2 vs 20.9 hours; P protocol was successfully implemented and resulted in early achievement of goal tube feed rates. However, this resulted in tube feed intolerance as manifested by more cases of clinical ileus.

  3. Enteral Feeding Tubes in Patients Undergoing Definitive Chemoradiation Therapy for Head-and-Neck Cancer: A Critical Review

    Energy Technology Data Exchange (ETDEWEB)

    Koyfman, Shlomo A., E-mail: koyfmas@ccf.org [Departments of Radiation and Solid Tumor Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Adelstein, David J. [Departments of Radiation and Solid Tumor Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States)

    2012-11-01

    Definitive chemoradiation therapy has evolved as the preferred organ preservation strategy in the treatment of locally advanced head-and-neck cancer (LA-HNC). Dry mouth and dysphagia are among the most common and most debilitating treatment-related toxicities that frequently necessitate the placement of enteral feeding tubes (FT) in these patients to help them meet their nutritional requirements. The use of either a percutaneous endoscopic gastrostomy tube or a nasogastric tube, the choice of using a prophylactic vs a reactive approach, and the effects of FTs on weight loss, hospitalization, quality of life, and long-term functional outcomes are areas of continued controversy. Considerable variations in practice patterns exist in the United States and abroad. This critical review synthesizes the current data for the use of enteral FTs in this patient population and clarifies the relative advantages of different types of FTs and the timing of their use. Recent developments in the biologic understanding and treatment approaches for LA-HNC appear to be favorably impacting the frequency and severity of treatment-related dysphagia and may reduce the need for enteral tube feeding in the future.

  4. A simple in vitro test tube method for estimating the bioavailability of phosphorus in feed ingredients for swine.

    Science.gov (United States)

    Bollinger, David W; Tsunoda, Atsushi; Ledoux, David R; Ellersieck, Mark R; Veum, Trygve L

    2004-04-07

    A simplified in vitro test tube (TT) method was developed to estimate the percentage of available P in feed ingredients for swine. The entire digestion procedure with the TT method consists of three consecutive enzymatic digestions carried out in a 50-mL conical test tube: (1) Pre-digestion with endo-xylanase and beta-glucanase for 1 h, (2) peptic digestion for 2 h, and (3) pancreatic digestion for 2 or 4 h. The TT method is simpler and much easier to perform compared to the dialysis tubing (DT) method, because dialysis tubing is not used. Reducing sample size from 1.0 to 0.25 g for the TT method improved results. In conclusion, the accuracy and validity of the TT method is equal to that of our more complicated DT method (r = 0.97, P < 0.001), designed to mimic the digestive system of swine, for estimating the availability of P in plant-origin feed ingredients.

  5. Therapeutic amnioinfusion for intrapartum fetal distress using a pediatric feeding tube.

    Science.gov (United States)

    Abdel-Aleem, H; Amin, A F; Shokry, M; Radwan, R A

    2005-08-01

    To evaluate the role of therapeutic amnioinfusion using a pediatric feeding tube in cases of intrapartum fetal distress. A randomized clinical trial including 438 women admitted in labor at Assiut University Hospital with nonreassuring fetal heart rate tracing. Using sealed opaque envelopes, the women were randomized to 2 groups. In the amnioinfusion group they underwent transcervical amnioinfusion (1000 mL of warmed sterile saline solution) in addition to conventional treatment. In the control group they received conventional treatment only. The primary outcome was cesarean section rate for fetal distress. The secondary outcomes were neonatal and maternal complications. The amnioinfusion group showed a significant reduction in the rate of cesarean section for fetal distress (relative risk [RR], 0.7; 95% confidence interval [CI], 0.6-0.83), and a 30% reduction in abnormal fetal heart rate patterns (RR, 0.7; 95% CI, 0.6-0.83). Significantly fewer newborns had Apgar scores less than 7 at 1 and 5 min in the amnioinfusion group than in the control group (RR, 0.38; 95% CI, 0.26-0.55 and RR, 0.31; 95% CI, 0.15-0.64, respectively). Significantly fewer newborns had meconium below the vocal cords in the amnioinfusion group than in the control group (RR, 0.36; 95% CI, 0.13-0.97). Moreover, 14 newborns in the amnioinfusion group needed admission to the intensive care unit vs. 31 newborns in the control group. There were no significant differences between the 2 groups regarding the incidence rates of uterine hypertonus and maternal temperature higher than 38 degrees C. Therapeutic amnioinfusion is a simple and effective intervention that reduces the rates of cesarean section for intrapartum nonreassuring fetal heart tracing. In under-resourced settings, it can be performed using inexpensive catheters.

  6. Evaluating Factors for Prophylactic Feeding Tube Placement in Gastroesophageal Cancer Patients Undergoing Chemoradiotherapy

    Directory of Open Access Journals (Sweden)

    Vivek Verma

    2017-09-01

    Full Text Available PurposeThough better studied in head/neck cancers, there are currently no studies on timing of feeding tube (FT placement in patients with gastroesophageal cancer. This study sought to discern characteristics of patients who used versus did not use a prophylactic FT (pFT, and also analyzed factors associated with placement of FTs during chemoradiotherapy (CRT.Methods/materialsFrom 1998 to 2013, 1,329 patients underwent neoadjuvant CRT, of which 323 received an FT. Patients for whom FTs were placed prior to treatment due to tumor occlusion or substantial weight loss (n = 130, and those with FTs placed following treatment (n = 43 were excluded. One hundred patients had pFTs placed, and 50 underwent placement during CRT. The following was collected for each patient: demographic/patient information, oncologic/treatment characteristics, and CRT tolerance.ResultsNo significant differences were found in any parameter between cohorts that used (n = 66 versus did not use a pFT (n = 34; on univariate and multivariate analyses, no pretreatment characteristic associated with using a pFT. When compared with patients who used a pFT (n = 66, those who required an FT during CRT (n = 50 had lower body mass index (p = 0.045, underwent higher-dose radiotherapy (p = 0.003, and received induction chemotherapy (p = 0.031. On multivariate analysis, receipt of induction chemotherapy and greater weight loss and esophagitis during treatment were associated with placement of FTs during CRT (p < 0.05.ConclusionOf our cohort who received pFTs, there were no clinical factors that predicted for their use. Patients must be closely monitored for weight loss and esophagitis when receiving CRT in order to intervene prior to further worsening of toxicities.

  7. Development of a multivariable normal tissue complication probability (NTCP) model for tube feeding dependence after curative radiotherapy/chemo-radiotherapy in head and neck cancer

    International Nuclear Information System (INIS)

    Wopken, Kim; Bijl, Hendrik P.; Schaaf, Arjen van der; Laan, Hans Paul van der; Chouvalova, Olga; Steenbakkers, Roel J.H.M.; Doornaert, Patricia; Slotman, Ben J.; Oosting, Sjoukje F.; Christianen, Miranda E.M.C.; Laan, Bernard F.A.M. van der; Roodenburg, Jan L.N.; René Leemans, C.; Verdonck-de Leeuw, Irma M.; Langendijk, Johannes A.

    2014-01-01

    Background and purpose: Curative radiotherapy/chemo-radiotherapy for head and neck cancer (HNC) may result in severe acute and late side effects, including tube feeding dependence. The purpose of this prospective cohort study was to develop a multivariable normal tissue complication probability (NTCP) model for tube feeding dependence 6 months (TUBE M6 ) after definitive radiotherapy, radiotherapy plus cetuximab or concurrent chemoradiation based on pre-treatment and treatment characteristics. Materials and methods: The study included 355 patients with HNC. TUBE M6 was scored prospectively in a standard follow-up program. To design the prediction model, the penalized learning method LASSO was used, with TUBE M6 as the endpoint. Results: The prevalence of TUBE M6 was 10.7%. The multivariable model with the best performance consisted of the variables: advanced T-stage, moderate to severe weight loss at baseline, accelerated radiotherapy, chemoradiation, radiotherapy plus cetuximab, the mean dose to the superior and inferior pharyngeal constrictor muscle, to the contralateral parotid gland and to the cricopharyngeal muscle. Conclusions: We developed a multivariable NTCP model for TUBE M6 to identify patients at risk for tube feeding dependence. The dosimetric variables can be used to optimize radiotherapy treatment planning aiming at prevention of tube feeding dependence and to estimate the benefit of new radiation technologies

  8. Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for patients with head and neck cancer. A systematic review

    International Nuclear Information System (INIS)

    Wang Jinfeng; Liu Minjie; Ye Yun; Liu Chao; Huang Guanhong

    2014-01-01

    There are two main enteral feeding strategies—namely nasogastric (NG) tube feeding and percutaneous gastrostomy—used to improve the nutritional status of patients with head and neck cancer (HNC). But up till now there has been no consistent evidence about which method of enteral feeding is the optimal method for this patient group. To compare the effectiveness of percutaneous gastrostomy and NGT feeding in patients with HNC, relevant literature was identified through Medline, Embase, Pubmed, Cochrane, Wiley and manual searches. We included randomized controlled trials (RCTs) and non-experimental studies comparing percutaneous gastrostomy—including percutaneous endoscopic gastrostomy (PEG) and percutaneous fluoroscopic gastrostomy (PFG)—with NG for HNC patients. Data extraction recorded characteristics of intervention, type of study and factors that contributed to the methodological quality of the individual studies. Data were then compared with respect to nutritional status, duration of feeding, complications, radiotherapy delays, disease-free survival and overall survival. Methodological quality of RCTs and non-experimental studies were assessed with separate standard grading scales. It became apparent from our studies that both feeding strategies have advantages and disadvantages. (author)

  9. Association of a Proactive Swallowing Rehabilitation Program With Feeding Tube Placement in Patients Treated for Pharyngeal Cancer.

    Science.gov (United States)

    Ajmani, Gaurav S; Nocon, Cheryl C; Brockstein, Bruce E; Campbell, Nicholas P; Kelly, Amy B; Allison, Jamie; Bhayani, Mihir K

    2018-04-19

    A proactive speech and language pathology (SLP) program is an important component of the multidisciplinary care of patients with head and neck squamous cell carcinoma (HNSCC). Swallowing rehabilitation can reduce the rate of feeding tube placement, thereby significantly improving quality of life. To evaluate the initiation of a proactive SLP rehabilitation program at a single institution and its association with rates of feeding tube placement and dietary intake in patients with HNSCC. Cohort study at a tertiary care and referral center for patients with HNSCC serving the northern Chicago region. Patients were treated for squamous cell carcinomas of the hypopharynx, oropharynx, and nasopharynx from 2004 to 2015 with radiation or chemoradiation therapy in the definitive or adjuvant setting. Patients who received less than 5000 cGy radiation or underwent reirradiation were excluded. A proactive SLP program for patients with HNSCC was initiated in 2011. Study cohorts were divided into 2 groups: 2004 through 2010 and 2011 through 2015. Primary outcome variables were SLP referral placement and timing of the referral. Secondary outcomes were feeding tube placement and ability to tolerate any oral intake. A total of 254 patients met inclusion criteria (135 before and 119 after implementation of SLP program; median age, 60 years [range, 14-94 years]; 77% male). With the initiation of a proactive SLP program, pretreatment evaluations increased from 29 (21.5%) to 70 (58.8%; risk ratio [RR], 2.74; 95% CI, 1.92-3.91), and rate of referral overall at any time increased from 60.0% to 79.8% (RR, 1.33; 95% CI, 1.13-1.57). Feeding tube placement rates decreased from 45.9% (n = 62) to 29.4% (n = 35; RR, 0.64; 95% CI, 0.46-0.89). Among patients receiving a swallow evaluation, feeding tube requirements were less frequent for those receiving a pretreatment evaluation (31 of 99 [31%]) than for those referred during (11 of 18 [61%]) or after (38 of 59 [64%]) treatment. The rate

  10. Numerical investigation of heat transfer and friction factor characteristics in a circular tube fitted with V-cut twisted tape inserts.

    Science.gov (United States)

    Salman, Sami D; Kadhum, Abdul Amir H; Takriff, Mohd S; Mohamad, Abu Bakar

    2013-01-01

    Numerical investigation of the heat transfer and friction factor characteristics of a circular fitted with V-cut twisted tape (VCT) insert with twist ratio (y = 2.93) and different cut depths (w = 0.5, 1, and 1.5 cm) were studied for laminar flow using CFD package (FLUENT-6.3.26). The data obtained from plain tube were verified with the literature correlation to ensure the validation of simulation results. Classical twisted tape (CTT) with different twist ratios (y = 2.93, 3.91, 4.89) were also studied for comparison. The results show that the enhancement of heat transfer rate induced by the classical and V-cut twisted tape inserts increases with the Reynolds number and decreases with twist ratio. The results also revealed that the V-cut twisted tape with twist ratio y = 2.93 and cut depth w = 0.5 cm offered higher heat transfer rate with significant increases in friction factor than other tapes. In addition the results of V-cut twist tape compared with experimental and simulated data of right-left helical tape inserts (RLT), it is found that the V-cut twist tape offered better thermal contact between the surface and the fluid which ultimately leads to a high heat transfer coefficient. Consequently, 107% of maximum heat transfer was obtained by using this configuration.

  11. A comparison of the test tube and the dialysis tubing in vitro methods for estimating the bioavailability of phosphorus in feed ingredients for swine.

    Science.gov (United States)

    Bollinger, David W; Tsunoda, Atsushi; Ledoux, David R; Ellersieck, Mark R; Veum, Trygve L

    2005-05-04

    The validity of a simplified in vitro test tube (TT) method was compared with a more complicated dialysis tubing (DT) method to estimate the percentage of available phosphorus (P) in 41 plant origin and five animal origin feed ingredients for swine. The TT method using 1.0 or 0.25 g samples was compared with the DT method using 1.0 g samples at two pancreatic incubation times (2 vs 4 h) in a 3 x 2 factorial arrangement of treatments. Each DT and TT method treatment was replicated three and six times, respectively. Both methods utilize three enzymatic digestions: (i) predigestion with endoxylanase and beta-glucanase for 1 h, (ii) pepsin digestion for 2 h, and (iii) pancreatin digestion for 2 or 4 h. For the TT method, the entire procedure was conducted in a 50 mL conical centrifuge tube and replicated six times. For the DT method, the first two digestions were conducted in a 10 mL plastic syringe before the contents were quantitatively transferred into a segment of DT for the pancreatic digestion. The percentages of hydrolyzed P for plant origin ingredients measured by the DT method using 1.0 g samples and the TT method using 0.25 g samples were highly correlated (r = 0.94-0.97, P or = 0.4) with published in vivo available P values. In conclusion, the accuracy and validity of the TT method using 0.25 g samples with a 2 h pancreatic digestion time was equal to or superior to the DT method using 1.0 g samples with a 4 h pancreatic digestion time for estimating P availability in plant origin feed ingredients.

  12. Outcomes of percutaneous endoscopic gastrostomy tube insertion in respiratory impaired amyotrophic lateral sclerosis patients under noninvasive ventilation.

    Science.gov (United States)

    Czell, David; Bauer, Matthias; Binek, Janek; Schoch, Otto D; Weber, Markus

    2013-05-01

    Percutaneous endoscopic gastrostomy (PEG) tube placement in amyotrophic lateral sclerosis (ALS) patients with impaired respiratory function is associated with an increased risk of peri-procedural and post-interventional complications. It was the aim of the study to analyze peri- and post-interventional complications and survival after PEG tube placement under noninvasive ventilation (NIV) in ALS patients with various degrees of respiratory impairment. Twenty-six subjects were included in this retrospective case study. Prior to PEG tube placement, training with ventilatory support via an oronasal mask was performed with ALS subjects on the pneumology ward. PEG placement was then performed under continuous NIV. FVC, sniff nasal inspiratory pressure, and demographic data were assessed. Complication rates and 1-month and overall survival rates were analyzed. There were no deaths within 24 hours after PEG placement. One subject died within the first month. The mean survival rate after PEG was 12 ± 10 months (range 0.6-42 months). There was no difference in post-PEG survival between subjects with moderately (> 50%) and severely (NIV in ALS subjects.

  13. A Peer-Reviewed Instructional Video is as Effective as a Standard Recorded Didactic Lecture in Medical Trainees Performing Chest Tube Insertion: A Randomized Control Trial.

    Science.gov (United States)

    Saun, Tomas J; Odorizzi, Scott; Yeung, Celine; Johnson, Marjorie; Bandiera, Glen; Dev, Shelly P

    Online medical education resources are becoming an increasingly used modality and many studies have demonstrated their efficacy in procedural instruction. This study sought to determine whether a standardized online procedural video is as effective as a standard recorded didactic teaching session for chest tube insertion. A randomized control trial was conducted. Participants were taught how to insert a chest tube with either a recorded didactic teaching session, or a New England Journal of Medicine (NEJM) video. Participants filled out a questionnaire before and after performing the procedure on a cadaver, which was filmed and assessed by 2 blinded evaluators using a standardized tool. Western University, London, Ontario. Level of clinical care: institutional. A total of 30 fourth-year medical students from 2 graduating classes at the Schulich School of Medicine & Dentistry were screened for eligibility. Two students did not complete the study and were excluded. There were 13 students in the NEJM group, and 15 students in the didactic group. The NEJM group׳s average score was 45.2% (±9.56) on the prequestionnaire, 67.7% (±12.9) for the procedure, and 60.1% (±7.65) on the postquestionnaire. The didactic group׳s average score was 42.8% (±10.9) on the prequestionnaire, 73.7% (±9.90) for the procedure, and 46.5% (±7.46) on the postquestionnaire. There was no difference between the groups on the prequestionnaire (Δ + 2.4%; 95% CI: -5.16 to 9.99), or the procedure (Δ -6.0%; 95% CI: -14.6 to 2.65). The NEJM group had better scores on the postquestionnaire (Δ + 11.15%; 95% CI: 3.74-18.6). The NEJM video was as effective as video-recorded didactic training for teaching the knowledge and technical skills essential for chest tube insertion. Participants expressed high satisfaction with this modality. It may prove to be a helpful adjunct to standard instruction on the topic. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc

  14. [Quality of Life of Children with Otitis Media and Impact of Insertion of Transtympanic Ventilation Tubes in a Portuguese Population].

    Science.gov (United States)

    Lameiras, Ana Rita; Silva, Deodato; O Neill, Assunção; Escada, Pedro

    2018-01-31

    Quality of life is an important measure for health-outcome evaluation. Although otitis media is one of the most common childhood diseases, its impact on Portuguese children's quality of life is unknown. The aim of this study is to determine the quality of life of Portuguese children with chronic otitis media with effusion and/or recurrent acute otitis media and the short-term impact of transtympanic ventilation tubes, using the Portuguese version of the OM-6 questionnaire, a valid, reliable and sensitive instrument to evaluate the health-related quality of life in children with otitis media. This study was conducted in a tertiary referral center, to where children are referred from primary care and hospital pediatric consultations. The Portuguese version of the OM-6 questionnaire was applied to children with chronic otitis media with effusion and/or recurrent acute otitis media. The instrument was re-administered at two months postoperatively to a group of children who underwent tympanostomy tube placement, to evaluate the change in quality of life with the surgical procedure. The study involved a sample of 169 children, aged between 6 months and 12 years (mean: 4.20 ± 2.05 years). The average score in the survey was 3.3 ± 1.47, of a maximum of 7 (worst quality of life). The domains 'caregiver concerns', 'hearing loss' and 'physical suffering' had the highest scores. The domain 'hearing loss' was correlated with the domain 'speech impairment' (rs = 0.41; p Portuguese children quality of life. Tympanostomy tubes improve quality of life related to the middle ear in most children. The application of validated disease-specific questionnaires allows an enhanced understanding of the impact of otitis media on Portuguese children quality of life and of the success of therapeutic measures.

  15. A nationwide study on the impact of pneumococcal conjugate vaccination on antibiotic use and ventilation tube insertion in Denmark 2000-2014

    DEFF Research Database (Denmark)

    Howitz, Michael Frantz; Harboe, Zitta Barrella; Ingels, Helene

    2017-01-01

    Introduction of Pneumococcal Conjugated Vaccines (PCV) in national immunization programs have been successful in reducing the number of invasive and lower respiratory pneumococcal infections. The impact of the vaccines on upper respiratory infections caused by pneumococci is less clear although...... these account for most pneumococcal infections. In this study, we used likely proxies for respiratory infections in children, such as antibiotic use and ventilation tube insertions (VTI), to estimate the impact of the vaccine on a national level. The study was designed as a population-based retrospective...... reversed to near year 2000 levels after the introduction of PCV. This indicates that implementation of pneumococcal vaccines in the Childhood Vaccination Programme has likely reduced the incidence of upper respiratory diseases due to pneumococci in Denmark....

  16. Use of proton pump inhibitors is associated with increased mortality due to nosocomial pneumonia in bedridden patients receiving tube feeding.

    Science.gov (United States)

    Hamai, Kosuke; Iwamoto, Hiroshi; Ohshimo, Shinichiro; Wakabayashi, Yu; Ihara, Daisuke; Fujitaka, Kazunori; Hamada, Hironobu; Ono, Koichi; Hattori, Noboru

    2018-05-22

    To investigate the association between the use of proton pump inhibitors (PPI) and nosocomial pneumonia and gastrointestinal bleeding in bedridden patients receiving tube feeding. A total of 116 bedridden hospitalized patients receiving tube feeding, of which 80 were supported by percutaneous endoscopic gastrostomy and 36 by nasogastric tube, were included in the present study. The patients were divided into two groups: 62 patients treated with PPI (PPI group) and 54 patients without PPI (non-PPI group). Mortality due to nosocomial pneumonia was evaluated using the Kaplan-Meier approach and the log-rank test. A total of 36 patients (31%) died of nosocomial pneumonia during the observation period; the mortality rate due to nosocomial pneumonia was significantly higher in the PPI group than in the non-PPI group (P = 0.0395). Cox proportional hazard analysis showed that the use of PPI and lower levels of serum albumin were independent predictors of 2-year mortality due to nosocomial pneumonia. Gastrointestinal bleeding was observed in four patients in the non-PPI group (7.7%) and in one patient in the PPI group (1.6%); there was no significant difference between the two groups. The use of PPI in bedridden tube-fed patients was independently associated with mortality due to nosocomial pneumonia, and the PPI group had a non-significant lower incidence of gastrointestinal bleeding than the non-PPI group. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 The Authors Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

  17. Study on heat transfer and friction factor characteristics of γ-Al2O3/water through circular tube with twisted tape inserts with different thicknesses

    International Nuclear Information System (INIS)

    Esmaeilzadeh, E.; Almohammadi, H.; Nokhosteen, A.; Motezaker, A.; Omrani, A.N.

    2014-01-01

    An experimental study was carried out to investigate heat transfer and friction factor characteristics of γ-Al 2 O 3 /water nano-fluid through circular tube with twisted tape inserts with various thicknesses at constant heat flux. In this work, γ-Al 2 O 3 /water nano-fluids with two volume concentrations of 0.5% and 1% were used as the working fluid. The twist ratio of twisted tape remained constant at 3.21, while the thicknesses were changed through three values of 0.5 mm, 1 mm and 2 mm. The experiments were performed in laminar flow regime from 150 to 1600 Reynolds numbers. Results indicated that twisted tape inserts enhanced the average convective heat transfer coefficient, and also more the thickness of twisted tape is more the enhancement of convective heat transfer coefficient is. Also, the highest enhancement was achieved at maximum volume concentration. Results showed that nano-fluids have better heat transfer performance when utilized with thicker twisted tapes. At the same time, the increase in twisted tape thickness leads to an increase in friction factor. In the end, the combined results of these two phenomena result in enhanced convective heat transfer coefficient and thermal performance. Finally, two new correlations were offered for Nusselt number and thermal performance based on our experimental observation. (authors)

  18. A retrospective matched cohort study evaluating the effects of percutaneous endoscopic gastrostomy feeding tubes on nutritional status and survival in patients with advanced gastroesophageal malignancies undergoing systemic anti-cancer therapy.

    Science.gov (United States)

    Mitchell, Scott; Williams, John P; Bhatti, Harsimrandeep; Kachaamy, Toufic; Weber, Jeffrey; Weiss, Glen J

    2017-01-01

    Many patients with cancer or other systemic illnesses can experience malnutrition. One way to mitigate malnutrition is by insertion of a percutaneous endoscopic gastrostomy feeding tube (PEG tube). The goal of this retrospective matched cohort study is to evaluate if PEG tube placement improved nutritional status and overall survival (OS) in advanced gastroesophageal (GE) cancer patients who are undergoing anti-neoplastic therapy. GE cancer patients who were treated and evaluated by a nutritionist and had at least 2 nutritionist follow-up visits were identified. Patients with PEG tube were matched to patients that did not undergo PEG placement (non-PEG). Clinical characteristics, GE symptoms reported at nutrition follow-up visits, and OS were recorded. 20 PEG and 18 non-PEG cases met criteria for further analyses. After correction for multiple testing, there were no OS differences between PEG and non-PEG, treatment naive and previously treated. However, PEG esophageal carcinoma has statistically significant inferior OS compared with non-PEG esophageal carcinoma. PEG placement did not significantly reduce the proportion of patients with weight loss between the initial nutrition assessment and 12-week follow-up. In this small study, PEG placement had inferior OS outcome for GE esophageal carcinoma, no improvement in OS for other evaluated groups, and did not reduce weight loss between baseline and 12-week follow-up. Unless there is prospective randomized trial that can show superiority of PEG placement in this population, PEG placement in this group cannot be endorsed.

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

    Science.gov (United States)

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

    2015-09-01

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

  20. Tube plug

    International Nuclear Information System (INIS)

    Zafred, P. R.

    1985-01-01

    The tube plug comprises a one piece mechanical plug having one open end and one closed end which is capable of being inserted in a heat exchange tube and internally expanded into contact with the inside surface of the heat exchange tube for preventing flow of a coolant through the heat exchange tube. The tube plug also comprises a groove extending around the outside circumference thereof which has an elastomeric material disposed in the groove for enhancing the seal between the tube plug and the tube

  1. Human factors related to time-dependent infection control measures: "Scrub the hub" for venous catheters and feeding tubes.

    Science.gov (United States)

    Caspari, Lindsay; Epstein, Elizabeth; Blackman, Amy; Jin, Li; Kaufman, David A

    2017-06-01

    The use of catheter hub decontamination protocols is a common practice to reduce central line-associated bloodstream infections. However, few data exist on the most effective disinfection procedure prior to hub access accounting for human factors and time-dependent practices in real time in the clinical setting. An observational design with a multimodal intervention was used in this study in a neonatal intensive care unit. Direct observations on nurse compliance of scrub times with decontamination when accessing of venous catheter and feeding tube hubs were conducted during 3 phases: (1) baseline period prior to any interventions; (2) during an educational intervention phase; and (3) during a timer intervention period when using a timing device, either an actual timer or music button. Overall, both education and the timing device interventions increased the mean scrub time ± SD of venous catheter hubs. Mean baseline scrub times of 10 ± 5 seconds were lower compared with 23 ± 12 seconds after educational intervention (P music button use (P observed with scrub times of feeding tubes. Time-based infection control measures, such as scrubbing the hub, must be implemented with aids that qualify specific times to account for human factors, to ensure adherence to time-dependent measures aimed at decreasing nosocomial infections. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  2. Otopathogens Detected in Middle Ear Fluid Obtained during Tympanostomy Tube Insertion: Contrasting Purulent and Non-Purulent Effusions

    Science.gov (United States)

    Holder, Robert C.; Kirse, Daniel J.; Evans, Adele K.; Whigham, Amy S.; Peters, Timothy R.; Poehling, Katherine A.; Swords, William E.; Reid, Sean D.

    2015-01-01

    Otitis media is a prominent disease among children. Previous literature indicates that otitis media is a polymicrobial disease, with Haemophilus influenzae, Streptococcus pneumoniae, Alloiococcus otitidis and Moraxella catarrhalis being the most commonly associated bacterial pathogens. Recent literature suggests that introduction of pneumococcal conjugate vaccines has had an effect on the etiology of otitis media. Using a multiplex PCR procedure, we sought to investigate the presence of the aforementioned bacterial pathogens in middle ear fluid collected from children undergoing routine tympanostomy tube placement at Wake Forest Baptist Medical Center during the period between January 2011 and March 2014. In purulent effusions, one or more bacterial organisms were detected in ~90% of samples. Most often the presence of H. influenzae alone was detected in purulent effusions (32%; 10 of 31). In non-purulent effusions, the most prevalent organism detected was A. otitidis (26%; 63 of 245). Half of the non-purulent effusions had none of these otopathogens detected. In purulent and non-purulent effusions, the overall presence of S. pneumoniae was lower (19%; 6 of 31, and 4%; 9 of 245, respectively) than that of the other pathogens being identified. The ratio of the percentage of each otopathogen identified in purulent vs. non-purulent effusions was >1 for the classic otopathogens but not for A. otitidis. PMID:26039250

  3. Attachment of iron corrosion products on steam generator tube and feed-water pump in PWRs secondary system

    International Nuclear Information System (INIS)

    Shoda, Y.; Ishihara, N.; Miyata, H.; Ohira, T.; Watanabe, Y.; Nonaka, Y.

    2010-01-01

    Operating experience of the secondary systems in PWRs indicates that scale attachment distinctly have an effect on the performance of water-steam cycle. Attached scale on outer surface of steam generator (SG) tube could induce many problems such as decrease heat efficiency of plant, corrosion of tube by intergranular attack (IGA), and choke of flow channel. Scale attached on rotor blade of feed water pump increases the driving steam consumption to keep the constant flow rate, and results in the thermal efficiency decrease of the plant. In this study, two types of test about scale deposition on equipment were executed in the conditions simulating the secondary system of PWR. One is SG model test, which simulated the circulating boiler composed of single SG tube and blow down line. The deposition rate under AVT condition was equivalent to plants revealed with extended period. High-AVT test provided useful reference, because the deposition rate of power plant is too small to measure in a short period after the beginning of High-AVT operation in Japan. The other is feed water pump model test. The mock-up pump is composed of a rotating stainless steel disk. As a result, it is confirmed that the deposition rate depends mostly on iron concentration in water and the exfoliation rate depends mainly on pH. Applying this information, the scale deposition-growth behavior on the equipment is quantitatively expressed by the model combined of scale deposition behavior and exfoliation behavior couples with the former. These results bring effective estimation for suppressing deposition-growth by the selection of water chemistry management and/or equipment improvement in the PWR secondary system. (author)

  4. Prevalence, Outcomes, and Management of Enteral Tube Feeding Intolerance: A Retrospective Cohort Study in a Tertiary Center.

    Science.gov (United States)

    Wang, Kailun; McIlroy, Kerry; Plank, Lindsay D; Petrov, Max S; Windsor, John A

    2017-08-01

    Enteral tube feeding (ETF) is the most common form of artificial feeding in hospitalized patients, and the development of intolerance (ETFI) is the most common complication. This study aimed to determine the prevalence of ETFI, the clinical consequences, and the current management approach to ETFI in hospitalized adult patients. Adult patients receiving ETF were identified from a prospective database in the Nutrition Services at Auckland City Hospital. Further information was obtained by the review of clinical records for a 12-month period, up to December 2014. The prevalence of ETFI was 33% among 754 patients. ETFI more frequently occurred in the intensive care unit ( P ETF were also frequently attempted. ETFI is a frequent problem in adult hospitalized patients receiving ETF, and it is associated with poor clinical outcomes such as inadequate nutrition and complications of feeding. While the pathophysiology is poorly understood, there also appears to be no standard evidence-based treatment. Studies investigating the mechanisms and optimized management are therefore indicated.

  5. Performance Study of a Cylindrical Parabolic Concentrating Solar Water Heater with Nail Type Twisted Tape Inserts in the Copper Absorber Tube

    Directory of Open Access Journals (Sweden)

    Amit K. Bhakta

    2018-01-01

    Full Text Available This paper reports the overall thermal performance of a cylindrical parabolic concentrating solar water heater (CPCSWH with inserting nail type twisted tape (NTT in the copper absorber tube for the nail twist pitch ratios, 4.787, 6.914 and 9.042, respectively. The experiments are conducted for a constant volumetric water flow rate and during the time period 9:00 a.m. to 15:00 p.m. The useful heat gain, hourly solar energy collected and hourly solar energy stored in this solar water heater were found to be higher for the nail twist pitch ratio 4.787. The above said parameters were found to be at a peak at noon and observed to follow the path of variation of solar intensity. At the start of the experiment, the value of charging efficiency was observed to be maximum, whereas the maximum values of instantaneous efficiency and overall thermal efficiency were observed at noon. The key finding is that the nail twist pitch ratio enhances the overall thermal performance of the CPCSWH.

  6. Measurement of impulse peak insertion loss from two acoustic test fixtures and four hearing protector conditions with an acoustic shock tube

    Science.gov (United States)

    Murphy, William J.; Fackler, Cameron J.; Berger, Elliott H.; Shaw, Peter B.; Stergar, Mike

    2015-01-01

    Impulse peak insertion loss (IPIL) was studied with two acoustic test fixtures and four hearing protector conditions at the E-A-RCAL Laboratory. IPIL is the difference between the maximum estimated pressure for the open-ear condition and the maximum pressure measured when a hearing protector is placed on an acoustic test fixture (ATF). Two models of an ATF manufactured by the French-German Research Institute of Saint-Louis (ISL) were evaluated with high-level acoustic impulses created by an acoustic shock tube at levels of 134 decibels (dB), 150 dB, and 168 dB. The fixtures were identical except that the E-A-RCAL ISL fixture had ear canals that were 3 mm longer than the National Institute for Occupational Safety and Health (NIOSH) ISL fixture. Four hearing protection conditions were tested: Combat Arms earplug with the valve open, ETYPlugs® earplug, TacticalPro headset, and a dual-protector ETYPlugs earplug with TacticalPro earmuff. The IPILs measured for the E-A-RCAL fixture were 1.4 dB greater than the National Institute for Occupational Safety and Health (NIOSH) ISL ATF. For the E-A-RCAL ISL ATF, the left ear IPIL was 2.0 dB greater than the right ear IPIL. For the NIOSH ATF, the right ear IPIL was 0.3 dB greater than the left ear IPIL. PMID:26356380

  7. Conductive sub-layer of twisted-tape-induced swirl-flow heat transfer in vertical circular tubes with various twisted-tape inserts

    Science.gov (United States)

    Hata, K.; Fukuda, K.; Masuzaki, S.

    2018-04-01

    conductive sub-layer δ CSL and the nondimensional thickness of the conductive sub-layer y + CSL on the circular tubes with various twisted-tape inserts were determined on the basis of numerical solutions for the swirl velocities u sw ranging from 5.23 to 21.18 m/s. Correlations between the conductive sub-layer thickness δ CSL and the nondimensional thickness of the conductive sub-layer y + CSL for twisted-tape-induced swirl-flow heat transfer in a vertical circular tube were derived.

  8. Body Weight and Body Mass Index in Patients with End-Stage Cystic Fibrosis Stabilize After the Start of Enteral Tube Feeding

    NARCIS (Netherlands)

    Kraaijeveld, FM; de Roos, N.M.; Belle-van Meerkerk, Gerdien; Teding van Berkhout, F; Heijerman, HGM; van de Graaf, EA

    2017-01-01

    Abstract BACKGROUND: Enteral tube feeding (ETF) is widely used in patients with cystic fibrosis (CF) and end-stage lung disease, but previous studies have been limited to investigating whether ETF improves outcomes in patients with moderately or mildly impaired pulmonary function. OBJECTIVE: This

  9. Body Weight and Body Mass Index in Patients with End-Stage Cystic Fibrosis Stabilize After the Start of Enteral Tube Feeding

    NARCIS (Netherlands)

    Hollander, Francis M.; Roos, de Nicole M.; Belle-Van Meerkerk, Gerdien; Teding van Berkhout, Ferdinand; Heijerman, Harry G.M.; Graaf, van de Ed A.

    2017-01-01

    Background: Enteral tube feeding (ETF) is widely used in patients with cystic fibrosis (CF) and end-stage lung disease, but previous studies have been limited to investigating whether ETF improves outcomes in patients with moderately or mildly impaired pulmonary function. Objective: This study

  10. The Effect of an Intervention Aimed at Reducing Errors when Administering Medication through Enteral Feeding Tubes in an Institution for Individuals with Intellectual Disability

    Science.gov (United States)

    Idzinga, J. C.; de Jong, A. L.; van den Bemt, P. M. L. A.

    2009-01-01

    Background: Previous studies, both in hospitals and in institutions for clients with an intellectual disability (ID), have shown that medication errors at the administration stage are frequent, especially when medication has to be administered through an enteral feeding tube. In hospitals a specially designed intervention programme has proven to…

  11. Tacrolimus Aggravated Tube Feeding Syndrome with Acute Renal Failure in a Pediatric Liver Transplant Recipient

    Directory of Open Access Journals (Sweden)

    R. Kula

    2017-01-01

    Full Text Available Acute renal failure can be caused by calcineurin inhibitors (CNIs, due to arteriolopathy and altered tubular function. Within this context, we present the case of a 14-month-old liver transplant recipient who suffered an acute polyuric renal failure during a short episode of hypercaloric feeding. In our case, CNI-induced distal RTA led to nephrocalcinosis and therefore to secondary nephrogenic diabetes insipidus. The diet with high renal solute load consequently resulted in an acute polyuric renal failure with severe hypernatremic dehydration. In conclusion, a hypercaloric diet in children with potentially impaired renal function due to therapy with CNIs requires precise calculation of the potential renal solute load and the associated fluid requirements.

  12. Gastrointestinal tolerance and plasma status of carotenoids, EPA and DHA with a fiber-enriched tube feed in hospitalized patients initiated on tube nutrition: Randomized controlled trial.

    Science.gov (United States)

    Jakobsen, L H; Wirth, R; Smoliner, C; Klebach, M; Hofman, Z; Kondrup, J

    2017-04-01

    During the first days of tube feeding (TF) gastrointestinal (GI) complications are common and administration of sufficient nutrition is a challenge. Not all standard nutritionally complete formulas contain dietary fiber, fish oil or carotenoids, key dietary nutrients for health and wellbeing. The aim of this study was to investigate the effects of a fiber, fish oil and carotenoid enriched TF formula on diarrhea, constipation and nutrient bioavailability. A multi-center randomized, double-blind, controlled, parallel trial compared the effects of a dietary fiber, fish oil and carotenoid-enriched TF formula (test) with an isocaloric non-enriched formula (control) in 51 patients requiring initiation of TF. Incidence of diarrhea and constipation (based on stool frequency and consistency) was recorded daily. Plasma status of EPA, DHA and carotenoids was measured after 7 days. The incidence of diarrhea was lower in patients receiving the test formula compared with the control group (19% vs. 48%, p = 0.034). EPA and DHA status (% of total plasma phospholipids) was higher after 7 days in test compared with control group (EPA: p = 0.002, DHA: p = 0.082). Plasma carotenoid levels were higher after 7 days in the test group compared with control group (lutein: p = 0.024, α-carotene: p = 0.005, lycopene: p = 0.020, β-carotene: p = 0.054). This study suggests that the nutrient-enriched TF formula tested might have a positive effect on GI tolerance with less diarrhea incidence and significantly improved EPA, DHA and carotenoid plasma levels during the initiation of TF in hospitalized patients who are at risk of diarrhea and low nutrient status. This trial was registered at trialregister.nl; registration number 2924. Copyright © 2016. Published by Elsevier Ltd.

  13. Testing of self-repairing composite airplane components by use of CAI and the release of the repair chemicals from carefully inserted small tubes

    Science.gov (United States)

    Dry, Carolyn

    2007-04-01

    The research on self repair of airplane components, under an SBIR phase II with Wright Patterson Air Force Base, has investigated the attributes and best end use applications for such a technology. These attributes include issues related to manufacturability, cost, potential benefits such as weight reduction, and cost reduction. The goal of our research has been to develop self-repairing composites with unique strength for air vehicles. Our revolutionary approach involves the autonomous release of repair chemicals from within the composite matrix itself. The repair agents are contained in hollow, structural fibers that are embedded within the matrix. Under stress, the composite senses external environmental factors and reacts by releasing the repair agents from within the hollow vessels. This autonomous response occurs wherever and whenever cracking, debonding or other matrix damage transpires. Superior performance over the life of the composite is achieved through this self-repairing mechanism. The advantages to the military would be safely executed missions, fewer repairs and eventually lighter vehicles. In particular the research has addressed the issues by correlating the impact of the various factors, such as 1) delivery vessel placement, shape/size and effect on composite strength, chemicals released and their effect on the matrix, release trigger and efficacy and any impact on matrix properties 2) impact of composite processing methods that involve heat and pressure on the repair vessels. Our self repairing system can be processed at temperatures of 300-350F, repairs in less than 30 seconds and does not damage the composite by repair fiber insertion or chemical release. Scaling up and manufacture of components has revealed that anticipating potential problems allowed us to avoid those associated with processing temperatures and pressures. The presentation will focus on compression after impact testing and the placement of repair fibers/tubes into prepreg

  14. Effect of kinetic parameters on simultaneous ramp reactivity insertion plus beam tube flooding accident in a typical low enriched U{sub 3}Si{sub 2}-Al fuel-based material testing reactor-type research reactor

    Energy Technology Data Exchange (ETDEWEB)

    Nasir, Rubina; Mirza, Nasir M. [Dept. of, Physics, Air University, Islamabad (Pakistan); Mirza, Sikander M. [Dept. of, Physics and Applied Mathematics, Pakistan Institute of Engineering and Applied Sciences, Post Office Nilore, Islamabad (Pakistan)

    2017-06-15

    This work looks at the effect of changes in kinetic parameters on simultaneous reactivity insertions and beam tube flooding in a typical material testing reactor-type research reactor with low enriched high density (U{sub 3}Si{sub 2}-Al) fuel. Using a modified PARET code, various ramp reactivity insertions (from $0.1/0.5 s to $1.3/0.5 s) plus beam tube flooding ($0.5/0.25 s) accidents under uncontrolled conditions were analyzed to find their effects on peak power, net reactivity, and temperature. Then, the effects of changes in kinetic parameters including the Doppler coefficient, prompt neutron lifetime, and delayed neutron fractions on simultaneous reactivity insertion and beam tube flooding accidents were analyzed. Results show that the power peak values are significantly sensitive to the Doppler coefficient of the system in coupled accidents. The material testing reactor-type system under such a coupled accident is not very sensitive to changes in the prompt neutron life time; the core under such a coupled transient is not very sensitive to changes in the effective delayed neutron fraction.

  15. Heat transfer analysis and effects of feeding tubes arrangement, falling film behavior and backsplash on ice formation around horizontal tubes bundles

    International Nuclear Information System (INIS)

    Sait, Hani Hussain

    2013-01-01

    Highlights: • Ice shape around the tubes. • Effects of accumulation of ice around the tubes. • Effects of parallel and series tubes arrangements. • Effects of ice accumulated around the tube surfaces. • Effects of backsplash on ice formation. - Abstract: Excessive electrical load has recently get a lot of attention from electric companies specially in hot countries like Saudi Arabia, where air-conditioning load represents about 75% from the total electrical load. Energy storage by freezing is one of the methods that used to tackle this issue. Ice is formed around horizontal cold tubes that are subjected to falling film of water. Ice quantity is measured, photographed and studied. In this studied the coolant inside the tubes flows in series tube arrangement. The results are compared with previous study in which parallel arrangement was used. In addition the falling film behavior and the resulted backsplash are also investigated. A mathematical model to predict ice formation around the tube is proposed. Comparison of the results of the model with that of the experiments showed that the agreement between the two is acceptable. The results also show a quite reasonable quantity of ice is formed in a short time and the series arrangement is more efficient than parallel one. The falling film shapes and its backsplash has also affected the ice formation

  16. Duodenal and ileal glucose infusions differentially alter gastrointestinal peptides, appetite response, and food intake: a tube feeding study.

    Science.gov (United States)

    Poppitt, Sally D; Shin, Hyun Sang; McGill, Anne-Thea; Budgett, Stephanie C; Lo, Kim; Pahl, Malcolm; Duxfield, Janice; Lane, Mark; Ingram, John R

    2017-09-01

    Background: Activation of the ileal brake through the delivery of nutrients into the distal small intestine to promote satiety and suppress food intake provides a new target for weight loss. Evidence is limited, with support from naso-ileal lipid infusion studies. Objective: The objective of the study was to investigate whether glucose infused into the duodenum and ileum differentially alters appetite response, food intake, and secretion of satiety-related gastrointestinal peptides. Design: Fourteen healthy male participants were randomly assigned to a blinded 4-treatment crossover, with each treatment of single-day duration. On the day before the intervention (day 0), a 380-cm multilumen tube (1.75-mm diameter) with independent port access to the duodenum and ileum was inserted, and position was confirmed by X-ray. Subsequently (days 1-4), a standardized breakfast meal was followed midmorning by a 90-min infusion of isotonic glucose (15 g, 235 kJ) or saline to the duodenum or ileum. Appetite ratings were assessed with the use of visual analog scales (VASs), blood samples collected, and ad libitum energy intake (EI) measured at lunch, afternoon snack, and dinner. Results: Thirteen participants completed the 4 infusion days. There was a significant effect of nutrient infused and site (treatment × time, P appetite, and decreased ad libitum EI at a subsequent meal. Although glucose to the duodenum also suppressed appetite ratings, eating behavior was not altered. This trial was registered at www.anzctr.org.au as ACTRN12612000429853. © 2017 American Society for Nutrition.

  17. An experimental investigation on heat transfer enhancement in the laminar flow of water/TiO2 nanofluid through a tube heat exchanger fitted with modified butterfly inserts

    Science.gov (United States)

    Venkitaraj, K. P.; Suresh, S.; Alwin Mathew, T.; Bibin, B. S.; Abraham, Jisa

    2018-03-01

    Nanofluids are advanced heat transfer fluids that exhibit thermal properties superior than that of the conventional fluids such as water, oil etc. This paper reports the experimental study on convective heat transfer characteristics of water based titanium dioxide nanofluids in fully developed flow through a uniformly heated pipe heat exchanger fitted with modified butterfly inserts. Nanofluids are prepared by dispersing TiO2 nanoparticles of average particle size 29 nm in deionized water. The heat transfer experiments are performed in laminar regime using nanofluids prepared with 0.1% and 0.3% volume fractions of TiO2 nanoparticles. The thermal performance characteristics of conventional butterfly inserts and modified butterfly inserts are also compared using TiO2 nanofluid. The inserts with different pitches 6 cm, 9 cm and 12 cm are tested to determine the effect of pitch distance of inserts in the heat transfer and friction. The experimental results showed that the modification made in the butterfly inserts were able to produce higher heat transfer than conventional butterfly inserts.

  18. Carnitine deficiency presenting with a decreased mental state in a patient with amyotrophic lateral sclerosis receiving long-term tube feeding: a case report.

    Science.gov (United States)

    Isse, Naohi; Miura, Yoh; Obata, Toshiyuki; Takahara, Noriko

    2013-12-30

    L-carnitine is an important metabolic mediator involved in fatty acid transport. It is obtained from the diet, particularly from animal products, such as red meat. Previous reports have revealed that long-term tube feeding with a commercial product containing no or low levels of carnitine can lead to an altered mental state caused by hyperammonemia. A 72-year-old Japanese man had a 12-year history of amyotrophic lateral sclerosis. He was bedridden and had required mechanical ventilation and enteral tube feeding for 10 years at home. His main enteral solution was a commercial product that contained low carnitine levels, and he sometimes received coffee and homemade products such as miso soup. Our patient's ability to communicate gradually deteriorated over a period of one year. His serum total carnitine level was abnormally low, at 26.7μmol/L (normal range, 45 to 91μmol/L), but his ammonium level was normal. His mental state improved dramatically after starting L-carnitine supplementation (600mg twice daily). This case highlights the importance of avoiding carnitine deficiency in patients with amyotrophic lateral sclerosis undergoing long-term tube feeding. These patients experience progressive muscle atrophy that might cause impaired carnitine storage and might manifest as communication difficulties. Carnitine deficiency can be misdiagnosed as a progression of systemic muscle atrophy. Clinicians should be aware of this disorder and should consider periodically measuring carnitine levels, regardless of the patient's serum ammonium levels.

  19. A virtual reality based simulator for learning nasogastric tube placement.

    Science.gov (United States)

    Choi, Kup-Sze; He, Xuejian; Chiang, Vico Chung-Lim; Deng, Zhaohong

    2015-02-01

    Nasogastric tube (NGT) placement is a common clinical procedure where a plastic tube is inserted into the stomach through the nostril for feeding or drainage. However, the placement is a blind process in which the tube may be mistakenly inserted into other locations, leading to unexpected complications or fatal incidents. The placement techniques are conventionally acquired by practising on unrealistic rubber mannequins or on humans. In this paper, a virtual reality based training simulation system is proposed to facilitate the training of NGT placement. It focuses on the simulation of tube insertion and the rendering of the feedback forces with a haptic device. A hybrid force model is developed to compute the forces analytically or numerically under different conditions, including the situations when the patient is swallowing or when the tube is buckled at the nostril. To ensure real-time interactive simulations, an offline simulation approach is adopted to obtain the relationship between the insertion depth and insertion force using a non-linear finite element method. The offline dataset is then used to generate real-time feedback forces by interpolation. The virtual training process is logged quantitatively with metrics that can be used for assessing objective performance and tracking progress. The system has been evaluated by nursing professionals. They found that the haptic feeling produced by the simulated forces is similar to their experience during real NGT insertion. The proposed system provides a new educational tool to enhance conventional training in NGT placement. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Jejunostomy feeding tube

    Science.gov (United States)

    ... DJ, Martin BC, Gonzalez L, Aebersold M. Nutritional management and enteral intubation. In: Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M, eds. Clinical Nursing Skills: Basic to Advanced Skills . 9th ed. New York, NY: Pearson; 2016:chap 16. Ziegler TR. Malnutrition, nutritional assessment, ...

  1. Nasogastric feeding tube

    Science.gov (United States)

    ... to Advanced Skills . 9th ed. New York, NY: Pearson; 2016:chap 16. Ziegler TR. Malnutrition, nutritional assessment, ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: ...

  2. Tube Feeding Troubleshooting Guide

    Science.gov (United States)

    ... around the rectum Black, tarry stool or diarrhea Black/brown blood in vomit (looks like coffee grounds) Vomiting ... your doc tor. Black, tarry stool or diarrhea; black/brown blood in vomit; or >1 Tablespoon bright red ...

  3. Gastrostomy Tube Feeding in Children With Developmental or Acquired Disorders: A Longitudinal Comparison on Healthcare Provision and Eating Outcomes 4 Years After Gastrostomy.

    Science.gov (United States)

    Backman, Ellen; Karlsson, Ann-Kristin; Sjögreen, Lotta

    2018-03-30

    Studies on long-term feeding and eating outcomes in children requiring gastrostomy tube feeding (GT) are scarce. The aim of this study was to describe children with developmental or acquired disorders receiving GT and to compare longitudinal eating and feeding outcomes. A secondary aim was to explore healthcare provision related to eating and feeding. This retrospective cohort study reviewed medical records of children in 1 administrative region of Sweden with GT placement between 2005 and 2012. Patient demographics, primary diagnoses, age at GT placement, and professional healthcare contacts prior to and after GT placement were recorded and compared. Feeding and eating outcomes were assessed 4 years after GT placement. The medical records of 51 children, 28 boys and 23 girls, were analyzed and grouped according to "acquired" (n = 13) or "developmental" (n = 38) primary diagnoses. At 4 years after GT placement, 67% were still using GT. Only 6 of 37 (16%) children with developmental disorders transferred to eating all orally, as opposed to 10 of 11 (91%) children with acquired disorders. Children with developmental disorders were younger at the time of GT placement and displayed a longer duration of GT activity when compared with children with acquired disorders. This study demonstrates a clear difference between children with developmental or acquired disorders in duration of GT activity and age at GT placement. The study further shows that healthcare provided to children with GT is in some cases multidisciplinary, but primarily focuses on feeding rather than eating. © 2018 American Society for Parenteral and Enteral Nutrition.

  4. The rendezvous technique involving insertion of a guidewire in a percutaneous transhepatic gallbladder drainage tube for biliary access in a case of difficult biliary cannulation.

    Science.gov (United States)

    Sunada, Fumiko; Morimoto, Naoki; Tsukui, Mamiko; Kurata, Hidekazu

    2017-05-01

    Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic method and treatment approach for biliary diseases. However, biliary cannulation can be difficult in some cases. We performed ERCP in a 97-year-old woman with abdominal pain resulting from acute cholangitis caused by choledocholithiasis and observed difficult biliary cannulation. Eventually, the patient was successfully treated with the rendezvous technique. We could not cannulate the biliary duct during ERCP twice. Therefore, we placed a percutaneous transhepatic gallbladder drainage (PTGBD) tube without intrahepatic dilation. The rendezvous technique was performed using the PTGBD tube. The patient did not experience pancreatitis or perforation.

  5. Nutritional status and feeding-tube placement in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy-based larynx preservation program.

    Science.gov (United States)

    Bozec, Alexandre; Benezery, Karen; Chamorey, Emmanuel; Ettaiche, Marc; Vandersteen, Clair; Dassonville, Olivier; Poissonnet, Gilles; Riss, Jean-Christophe; Hannoun-Lévi, Jean-Michel; Chand, Marie-Eve; Leysalle, Axel; Saada, Esma; Sudaka, Anne; Haudebourg, Juliette; Hebert, Christophe; Falewee, Marie-Noelle; Demard, François; Santini, José; Peyrade, Frédéric

    2016-09-01

    The objective of the study is to evaluate the nutritional status and determine its impact on clinical outcomes in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy (ICT)-based larynx preservation program without prophylactic feeding-tube placement. All patients with locally advanced (T3/4, N0-3, M0) hypopharyngeal squamous cell carcinoma, technically suitable for total pharyngolaryngectomy, treated by docetaxel, cisplatin and 5-fluorouracil (TPF)-ICT for larynx preservation at our institution between 2004 and 2013, were included in this retrospective study. Patients' nutritional status was closely monitored. Enteral nutrition was used if and when a patient was unable to sustain per-oral nutrition and hydration. The impact of nutritional status on clinical outcomes was investigated in univariate and multivariate analysis. A total of 53 patients (42 men and 11 women, mean age = 58.6 ± 8.2 years) were included in this study. Six (11.3 %) patients had lost more than 10 % of their usual body weight before therapy. Compared with patients' usual weight, the mean maximum patient weight loss during therapeutic management was 8.7 ± 4.5 kg. Enteral nutrition was required in 17 patients (32 %). We found no influence of the tested nutritional status-related factors on response to ICT, toxicity of ICT, overall, cause-specific and recurrence-free survival, and on post-therapeutic swallowing outcome. Maximum weight loss was significantly associated with a higher risk of enteral tube feeding during therapy (p = 0.03) and of complications (grade ≥3, p = 0.006) during RT. Without prophylactic feeding-tube placement, approximately one-third of the patients required enteral nutrition. There was no significant impact of nutritional status on oncologic or functional outcomes.

  6. Limitations of Routine Verification of Nasogastric Tube Insertion Using X-Ray and Auscultation: Two Case Reports of Life-Threatening Complications.

    Science.gov (United States)

    Nejo, Takahide; Oya, Soichi; Tsukasa, Tsuchiya; Yamaguchi, Naomi; Matsui, Toru

    2016-12-01

    Several bedside approaches used in combination with thoracoabdominal X-ray are widely used to avoid severe complications that have been reported during nasogastric tube management. Although confirmation by X-ray is considered the gold standard, it is not yet perfect. We present 2 cases of rare complications in which the routine verification methods could not detect all the complications related to the nasogastric tube placement. Case 1 was a 17-year-old male who presented with a brain tumor and repeatedly required nasogastric tube placement. Despite normal auscultatory and X-ray findings, the patient's condition deteriorated rapidly after resuming the enteral nutrition (EN). Computed tomography images showed the presence of hepatic portal venous gas (HPVG). Urgent upper gastrointestinal endoscopy showed esophagogastric submucosal tunneling of the tube that required an emergency open total gastrectomy. Case 2 was a 76-year-old man with long-term EN after stroke. While the last auscultatory verification was normal, he suddenly developed extensive HPVG due to gastric mucosal injury following EN, which resulted in progressive intestinal necrosis, general peritonitis, and death. These 2 cases indicated that routine verification methods consisting of auscultation and X-ray may not be completely reliable, and the awareness of the limitations of these methods should be reaffirmed because expeditious examinations and necessary interventions are critical in preventing life-threatening complications.

  7. Catalytic combustion of propane in a membrane reactor with separate feed of reactants—I. Operation in absence of trans-membrane pressure gradients

    NARCIS (Netherlands)

    Saracco, Guido; Veldsink, Jan Willem; Versteeg, Geert F.; Swaaij, Wim P.M. van

    1995-01-01

    A pilot plant study on propane catalytic combustion in a membrane reactor with separate reactant feeds is presented. The membrane consisted of a porous alumina tube activated by insertion into its pores of a Pt/γ-Al2O3 catalyst. The role of reactants concentration and of the feed flow rates were

  8. Acute effects of continuous nasogastric tube-feeding on gastric function - comparison of a polymeric and a nonpolymeric formula

    NARCIS (Netherlands)

    Kleibeuker, J. H.; Boersma-van Ek, W.

    1991-01-01

    The acute effects of continuous intragastric administration of 1500 ml (4200 kJ/liter) of a polymeric and of a nonpolymeric formula on gastric function were studied in 15 healthy subjects. During 450 min 1500 ml, containing 6300 kJ (1500 kcal), was given through a nasogastric tube. At regular

  9. Intercostal drainage tube or intracardiac drainage tube?

    Directory of Open Access Journals (Sweden)

    N Anitha

    2016-01-01

    Full Text Available Although insertion of chest drain tubes is a common medical practice, there are risks associated with this procedure, especially when inexperienced physicians perform it. Wrong insertion of the tube has been known to cause morbidity and occasional mortality. We report a case where the left ventricle was accidentally punctured leading to near-exsanguination. This report is to highlight the need for experienced physicians to supervise the procedure and train the younger physician in the safe performance of the procedure.

  10. Intercostal drainage tube or intracardiac drainage tube?

    Science.gov (United States)

    Anitha, N; Kamath, S Ganesh; Khymdeit, Edison; Prabhu, Manjunath

    2016-01-01

    Although insertion of chest drain tubes is a common medical practice, there are risks associated with this procedure, especially when inexperienced physicians perform it. Wrong insertion of the tube has been known to cause morbidity and occasional mortality. We report a case where the left ventricle was accidentally punctured leading to near-exsanguination. This report is to highlight the need for experienced physicians to supervise the procedure and train the younger physician in the safe performance of the procedure.

  11. Experimental insertions

    International Nuclear Information System (INIS)

    Sandweiss, J.; Kycia, T.F.

    1975-01-01

    A discussion is given of the eight identical experimental insertions for the planned ISABELLE storage rings. Four sets of quadrupole doublets are used to match the β functions in the insertions to the values in the cells, and the total free space available at the crossing point is 40 meters. An asymmetric beam energy operation is planned, which will be useful in a number of experiments

  12. Technique for joining metal tubing

    Science.gov (United States)

    Wright, H. W.

    1976-01-01

    Uniform wall thickness and uninterrupted heat transfer is achieved by using shaped metal insert as wall material for joint. Insert acts as support during brazing, after which excess material is ground away to bring joint to original tubing size.

  13. Definition of the minimum longitude of insert in the rebuilding of Charpy test tubes for surveillance and life extension of vessels in Mexico; Definicion de la longitud minima de inserto en la reconstitucion de probetas Charpy para vigilancia y extension de vida de vasijas en Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Romero C, J.; Hernandez C, R.; Rocamontes A, M., E-mail: jesus.romero@inin.gob.mx [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico)

    2011-11-15

    In the National Institute of Nuclear Research (Mexico) a welding system for the rebuilding of Charpy test tubes has been developed, automated, qualified and used for the surveillance of the mechanical properties (mainly embrittlement) of the vessel. This system uses the halves of the rehearsed Charpy test tubes of the surveillance capsules extracted of the reactors, to obtain, of a rehearsed test tube, two reconstituted test tubes. This rebuilding process is used so much in the surveillance program like in the potential extension of the operation license of the vessel. To the halves of Charpy test tubes that have been removed the deformed part by machine are called -insert- and in a very general way the rebuilding consists in weld with the welding process -Stud Welding- two metallic implants in the ends of the insert, to obtain a reconstituted test tube. The main characteristic of this welding are the achieved small dimensions, so much of the areas welded as of the areas affected by the heat. The applicable normative settles down that the minim longitude of the insert for the welding process by Stud Welding it should be of 18 mm, however according to the same normative this longitude can diminish if is demonstrated analytic or experimentally that the central volume of 1 cm{sup 3} in the insert is not affected. In this work the measurement of the temperature profiles to different distances of the welding interface is presented, defining an equation for the maximum temperatures reached in function of the distance, on the other hand the real longitude affected in the test tube by means of metallography is determined and this way the minimum longitude of the insert for this developed rebuilding system was determined. (Author)

  14. Development of laser cladding system to repair wall thinning of 1-inch heat exchanger tube

    International Nuclear Information System (INIS)

    Terada, Takaya

    2013-01-01

    We developed a laser cladding system to repair the inner wall wastage of heat exchanger tubes. Our system, which is designed to repair thinning tube walls within 100 mm from the edge of a heat exchanger tube, consists of a fiber laser, a composite-type optical fiberscope, a coupling device, a laser processing head, and a wire-feeding device. All of these components were reconfigured from the technologies of FBR maintenance. The laser processing head, which has a 15-mm outer diameter, was designed to be inserted into a 1-inch heat exchanger tube. We mounted a heatproof broadband mirror for laser cladding and fiberscope observation with visible light inside the laser processing head. The wire-feeding device continuously supplied 0.4-mm wire to the laser irradiation spot with variable feeding speeds from 0.5 to 20 mm/s. We are planning to apply our proposed system to the maintenance of aging industrial plants. (author)

  15. Vacuum guidelines for ISA insertions

    International Nuclear Information System (INIS)

    Edwards, D. Jr.

    1976-01-01

    Vacuum requirements place design restrictions on the ISA insertions. The vacuum tube diameter, given a distance L between pumps, is determined by the desorption of molecules from the wall under the impact of ions created by the beam, whereas the thickness of the tube must be sufficient to prevent collapse. In addition, the entire vacuum chamber must be able to be baked out at approximately 200 0 C

  16. Glytube: a conical tube and parafilm M-based method as a simplified device to artificially blood-feed the dengue vector mosquito, Aedes aegypti.

    Directory of Open Access Journals (Sweden)

    André Luis Costa-da-Silva

    Full Text Available Aedes aegypti, the main vector of dengue virus, requires a blood meal to produce eggs. Although live animals are still the main blood source for laboratory colonies, many artificial feeders are available. These feeders are also the best method for experimental oral infection of Ae. aegypti with Dengue viruses. However, most of them are expensive or laborious to construct. Based on principle of Rutledge-type feeder, a conventional conical tube, glycerol and Parafilm-M were used to develop a simple in-house feeder device. The blood feeding efficiency of this apparatus was compared to a live blood source, mice, and no significant differences (p = 0.1189 were observed between artificial-fed (51.3% of engorgement and mice-fed groups (40.6%. Thus, an easy to assemble and cost-effective artificial feeder, designated "Glytube" was developed in this report. This simple and efficient feeding device can be built with common laboratory materials for research on Ae. aegypti.

  17. Heat exchanger tube tool

    International Nuclear Information System (INIS)

    Gugel, G.

    1976-01-01

    Certain types of heat-exchangers have tubes opening through a tube sheet to a manifold having an access opening offset from alignment with the tube ends. A tool for inserting a device, such as for inspection or repair, is provided for use in such instances. The tool is formed by a flexible guide tube insertable through the access opening and having an inner end provided with a connector for connection with the opening of the tube in which the device is to be inserted, and an outer end which remains outside of the chamber, the guide tube having adequate length for this arrangement. A flexible transport hose for internally transporting the device slides inside of the guide tube. This hose is long enough to slide through the guide tube, into the heat-exchanger tube, and through the latter to the extent required for the use of the device. The guide tube must be bent to reach the end of the heat-exchanger tube and the latter may be constructed with a bend, the hose carrying anit-friction elements at interspaced locations along its length to make it possible for the hose to negotiate such bends while sliding to the location where the use of the device is required

  18. Mortality after nasogastric tube feeding initiation in long-term care elderly with oropharyngeal dysphagia--the contribution of refeeding syndrome.

    Science.gov (United States)

    Lubart, Emilia; Leibovitz, Arthur; Dror, Yosef; Katz, Elena; Segal, Refael

    2009-01-01

    The refeeding syndrome (RS) is an underappreciated but clinically important entity characterized by acute electrolyte abnormalities, mainly hypophosphatemia, fluid retention and dysfunction of various organs and systems, which can result in significant morbidity and occasionally death. To examine the incidence of death cases and death causes following nasogastric tube (NGT) feeding initiation in frail elderly with particular reference to RS. Forty patients with feeding problems for at least 72 h before restarting of alimentation by NGT were included. Excluded were those in any critical clinical situation. Clinical parameters and nutritional assessment were recorded before and after refeeding. Blood samples were taken before, daily for the first 3 days and 1 week after refeeding initiation. During the 1st week of refeeding, 9 patients (22.5%) died and within 1 month 10 more, summing to 47.5%. Most deaths were due to infectious causes [15 out of 19, (79%)]; some were due to no obvious reason [4 out of 19, (21%)]. Significant electrolyte changes were observed in the 2-3 days following refeeding. Significant were the decreases in phosphorus and elevations in potassium and lymphocytes (day 7). We found no correlations between the severity of decreases in levels of phosphorus and mortality. Mortality after NGT feeding initiation was high, mainly due to infectious complications. However, in a considerable number of patients hypophosphatemia was noted, suggesting that RS could be a contributory factor of mortality. Since this is a treatable condition, more attention should be paid to detecting and coping with this problem. Copyright 2009 S. Karger AG, Basel.

  19. Population-based comparison of two feeding tube approaches for head and neck cancer patients receiving concurrent systemic-radiation therapy: is a prophylactic feeding tube approach harmful or helpful?

    Science.gov (United States)

    Olson, Robert; Karam, Irene; Wilson, Gavin; Bowman, Angela; Lee, Christopher; Wong, Frances

    2013-12-01

    The purpose of this study is to compare patient outcomes between a therapeutic versus a prophylactic gastrostomy tube (GT) placement approach in patients treated with concurrent systemic and radiation (SRT) therapy for head and neck cancer (HNC). Outcomes were compared between all HNC patients treated with concurrent SRT from January 2001 to June 2009 from a center that only places GTs therapeutically when clinically necessary (center A) versus a center that generally places them prophylactically (center B). A total of 445 patients with HNC were identified, with 63 % from center A. As anticipated, GTs were placed less commonly in center A compared to B (31 versus 88 %; p approach results in exposing higher number of patients to GT complications. The higher rate of hospitalizations using a therapeutic approach suggests that patients are sicker when GTs are required. Given the similar weight loss and survival, a therapeutic approach at an earlier stage of need may be a preferable approach, when access to prompt GT placement is available.

  20. Replacement of Mushroom Cage Gastrostomy Tube Using a Modified Technique to Allow Percutaneous Replacement with an Endoscopic Tube in Patients with Amyotrophic Lateral Sclerosis

    International Nuclear Information System (INIS)

    Ammar, Thoraya; Rio, Alan; Ampong, Mary Ann; Sidhu, Paul S.

    2010-01-01

    Radiologic inserted gastrostomy (RIG) is the preferred method in our institution for enteral feeding in amyotrophic lateral sclerosis (ALS). Skin-level primary-placed mushroom cage gastrostomy tubes become tight with weight gain. We describe a minimally invasive radiologic technique for replacing mushroom gastrostomy tubes with endoscopic mushroom cage tubes in ALS. All patients with ALS who underwent replacement of a RIG tube were included. Patients were selected for a modified replacement when the tube length of the primary placed RIG tube was insufficient to allow like-for-like replacement. Replacement was performed under local anesthetic and fluoroscopic guidance according to a preset technique, with modification of an endoscopic mushroom cage gastrostomy tube to allow percutaneous placement. Assessment of the success, safety, and durability of the modified technique was undertaken. Over a 60-month period, 104 primary placement mushroom cage tubes in ALS were performed. A total of 20 (19.2%) of 104 patients had a replacement tube positioned, 10 (9.6%) of 104 with the modified technique (male n = 4, female n = 6, mean age 65.5 years, range 48-85 years). All tubes were successfully replaced using this modified technique, with two minor complications (superficial wound infection and minor hemorrhage). The mean length of time of tube durability was 158.5 days (range 6-471 days), with all but one patient dying with a functional tube in place. We have devised a modification to allow percutaneous replacement of mushroom cage gastrostomy feeding tubes with minimal compromise to ALS patients. This technique allows tube replacement under local anesthetic, without the need for sedation, an important consideration in ALS.

  1. High aspect ratio catalytic reactor and catalyst inserts therefor

    Science.gov (United States)

    Lin, Jiefeng; Kelly, Sean M.

    2018-04-10

    The present invention relates to high efficient tubular catalytic steam reforming reactor configured from about 0.2 inch to about 2 inch inside diameter high temperature metal alloy tube or pipe and loaded with a plurality of rolled catalyst inserts comprising metallic monoliths. The catalyst insert substrate is formed from a single metal foil without a central supporting structure in the form of a spiral monolith. The single metal foil is treated to have 3-dimensional surface features that provide mechanical support and establish open gas channels between each of the rolled layers. This unique geometry accelerates gas mixing and heat transfer and provides a high catalytic active surface area. The small diameter, high aspect ratio tubular catalytic steam reforming reactors loaded with rolled catalyst inserts can be arranged in a multi-pass non-vertical parallel configuration thermally coupled with a heat source to carry out steam reforming of hydrocarbon-containing feeds. The rolled catalyst inserts are self-supported on the reactor wall and enable efficient heat transfer from the reactor wall to the reactor interior, and lower pressure drop than known particulate catalysts. The heat source can be oxygen transport membrane reactors.

  2. Evaluation of the educational technology "Caring for dependent people" by family caregivers in changes and transfers of patients and tube feeding

    Directory of Open Access Journals (Sweden)

    Maria José Lumini Landeiro

    Full Text Available ABSTRACT Objective: to assess the contributions of interactive educational technology "Caring for Dependent People" in the development of knowledge to family caregivers of dependent people in a household context and their satisfaction in its use. Method: quasi-experimental study, not randomized, of the before and after type, with a convenience sample of 65 family caregivers, from two Medicine services of a hospital in Porto, Portugal. The Control Group consisted of 33 family caregivers and the Experimental Group of 32, identified by consecutive sampling. The experimental group had access to educational technology at home. Data were collected by socio-demographic, satisfaction and evaluation of knowledge questionnaire, about how to feed by nasogastric tube, positioning and transferring the dependent person. The assessment in both groups had two moments: initial, during hospitalization and one month after discharge. Results: the experimental group had a larger increase in knowledge related to the use of the educational technology. In the control group the knowledge did not differ in the two evaluation time points. Conclusion: these results confirm the improvement of interactive educational technologies and in the training of family caregivers to care for dependents. This technology successfully met the technical quality and learning needs of caregivers, and was considered easy and stimulating.

  3. Bradycardia after Tube Thoracostomy for Spontaneous Pneumothorax

    Directory of Open Access Journals (Sweden)

    Yomi Fashola

    2018-01-01

    Full Text Available We present the case of an elderly patient who became bradycardic after chest tube insertion for spontaneous pneumothorax. Arrhythmia is a rare complication of tube thoracostomy. Unlike other reported cases of chest tube induced arrhythmias, the bradycardia in our patient responded to resuscitative measures without removal or repositioning of the tube. Our patient, who had COPD, presented with shortness of breath due to spontaneous pneumothorax. Moments after tube insertion, patient developed severe bradycardia that responded to Atropine. In patients requiring chest tube insertion, it is important to be prepared to provide cardiopulmonary resuscitative therapy in case the patient develops a life-threatening arrhythmia.

  4. Leakproof Swaged Joints in Thin-Wall Tubing

    Science.gov (United States)

    Stuckenberg, F. H.; Crockett, L. K.; Snyder, W. E.

    1986-01-01

    Tubular inserts reinforce joints, reducing incidence of leaks. In new swaging technique, tubular inserts placed inside ends of both tubes to be joined. Made from thicker-wall tubing with outside diameter that matches inside diameter of thin tubing swaged, inserts support tube ends at joint. They ensure more uniform contact between swage fitting and tubing. New swaging technique developed for Al/Ti/V-alloy hydraulic supply lines.

  5. Spring/dimple instrument tube restraint

    International Nuclear Information System (INIS)

    DeMario, E.E.; Lawson, C.N.

    1993-01-01

    A nuclear fuel assembly for a pressurized water nuclear reactor has a spring and dimple structure formed in a non-radioactive insert tube placed in the top of a sensor receiving instrumentation tube thimble disposed in the fuel assembly and attached at a top nozzle, a bottom nozzle, and intermediate grids. The instrumentation tube thimble is open at the top, where the sensor or its connection extends through the cooling water for coupling to a sensor signal processor. The spring and dimple insert tube is mounted within the instrumentation tube thimble and extends downwardly adjacent the top. The springs and dimples restrain the sensor and its connections against lateral displacement causing impact with the instrumentation tube thimble due to the strong axial flow of cooling water. The instrumentation tube has a stainless steel outer sleeve and a zirconium alloy inner sleeve below the insert tube adjacent the top. The insert tube is relatively non-radioactivated inconel alloy. The opposed springs and dimples are formed on diametrically opposite inner walls of the insert tube, the springs being formed as spaced axial cuts in the insert tube, with a web of the insert tube between the cuts bowed radially inwardly for forming the spring, and the dimples being formed as radially inward protrusions opposed to the springs. 7 figures

  6. Managing a chest tube and drainage system.

    Science.gov (United States)

    Durai, Rajaraman; Hoque, Happy; Davies, Tony W

    2010-02-01

    Intercostal drainage tubes (ie, chest tubes) are inserted to drain the pleural cavity of air, blood, pus, or lymph. The water-seal container connected to the chest tube allows one-way movement of air and liquid from the pleural cavity. The container should not be changed unless it is full, and the chest tube should not be clamped unnecessarily. After a chest tube is inserted, a nurse trained in chest-tube management is responsible for managing the chest tube and drainage system. This entails monitoring the chest-tube position, controlling fluid evacuation, identifying when to change or empty the containers, and caring for the tube and drainage system during patient transport. This article provides an overview of indications, insertion techniques, and management of chest tubes. Copyright 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  7. Randomized study of percutaneous endoscopic gastrostomy versus nasogastric tubes for enteral feeding in head and neck cancer patients treated with (chemo)radiation

    International Nuclear Information System (INIS)

    Corry, J.; Poon, W.; McPhee, N.; Milner, A. D.; Cruickshank, D.; Rischin, D.; Peters, L. J.

    2008-01-01

    Full text: Percutaneous endoscopic gastrostomy (PEG) tubes have largely replaced nasogastric tubes (NGT) for nutritional support of patients with head and neck cancer undergoing curative (chemo)radiotherapy without any good scientific basis. A randomized trial was conducted to compare PEG tubes and NGT in terms of nutritional outcomes, complications, patient satisfaction and cost. The study was closed early because of poor accrual, predominantly due to patients' reluctance to be randomized. There were 33 patients eligible for analysis. Nutritional support with both tubes was good. There were no significant differences in overall complication rates, chest infection rates or in patients' assessment of their overall quality of life. The cost of a PEG tube was 10 times that of an NGT. The duration of use of PEG tubes was significantly longer, a median 139 days compared with a median 66 days for NGT. We found no evidence to support the routine use of PEG tubes over NGT in this patient group

  8. Body Weight and Body Mass Index in Patients with End-Stage Cystic Fibrosis Stabilize After the Start of Enteral Tube Feeding.

    Science.gov (United States)

    Hollander, Francis M; de Roos, Nicole M; Belle van Meerkerk, Gerdien; Teding van Berkhout, Ferdinand; Heijerman, Harry G M; van de Graaf, Ed A

    2017-11-01

    Enteral tube feeding (ETF) is widely used in patients with cystic fibrosis (CF) and end-stage lung disease, but previous studies have been limited to investigating whether ETF improves outcomes in patients with moderately or mildly impaired pulmonary function. This study investigated body weight, body mass index (BMI; calculated as kg/m 2 ), pulmonary function, and the presence of CF-related diabetes before and after the start of ETF. This was a retrospective observational study. Data from 26 adult patients in an outpatient setting who had end-stage CF (19 women) and had been using ETF for at least 6 months between 2000 and 2014 were analyzed. Body weight, BMI, pulmonary function (forced expiratory volume in 1 second as percent of predicted) and incidence of CF-related diabetes from 6 months before to 6 months after starting ETF. Time effects were tested with one-way analysis of variance for data that were normally distributed and the Friedman test for non-parametric data. Correlations were tested with Pearson's r or Spearman's ρ, depending on the distribution of the data. Mean body weight increased by 3.5 kg (95% CI 2.2 to 4.8 kg) after patients started ETF. In women, mean BMI decreased by 0.7 in the 6 months before the start of ETF (PETF to 25% after 6 months (P=0.0013), with similar trends in women and men. There was no correlation between changes in weight and lung function. CF-related diabetes was already present in 12 patients and developed in 1 more patient after the start of ETF. ETF improved body weight and BMI but not pulmonary function in 26 patients with end-stage CF. Clinical outcomes were similar in women and men, but the sample size of men was too small to determine statistical significance. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  9. Comparison the effect of two ways of tube feeding including bolus and continuous infusion on gastric residual volume and diarrhea in patients hospitalized in Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Shahriari M

    2015-05-01

    Full Text Available Background and Objective: Proper nutritional support is one of the important caring aspects in patients who were hospitalized in Intensive Care Unit. Although the several studies have been done concerning the selection of proper nutrition method for patients, but there is no agreement on this issue. The aim of current study was the compare the effect of two ways of tube feeding including bolus and continuous infusion on gastric residual volume and diarrhea in patients hospitalized in Intensive Care Unit.  Materials and Method: The current clinical trial was conducted on patients who were hospitalized in intensive care unit in Alzahra hospital in Isfahan, 2013. Fifty patients were selected through convenient sampling and were randomly assigned into two groups of 25 people of intervention and control. Nutrition was done through infusion pump in intervention group and by bolus in control group. Gastric residual volume and diarrhea was assessed each four hours for four days. Data were gathered through checklist and were analyzed by SPSS18 using descriptive and inferential statistics including independent T-test, Fisher's exact test and repeated measures ANOVA.  Results: The results showed that the mean of gastric residual volume in control group was more than the intervention group on the third day (p=0.04. Also, the mean of gastric residual volume did not show significant difference at different times in intervention group, but the mean of gastric residual volume was significantly increased in control group at different times (p=0.04. Fisher's exact test showed no significant difference between two groups concerning the diarrhea frequency.  Conclusion: In nutritional support with continuous infusion method, gastric residual volume was not increased and gastric emptying rate was not diminished. Therefore, this method can be used as an appropriate nutritional support in intensive care unit.

  10. Enhancement of heat transfer using varying width twisted tape inserts

    African Journals Online (AJOL)

    user

    enhancement of heat transfer with twisted tape inserts as compared to plain ... studies for heat transfer and pressure drop of laminar flow in horizontal tubes ... flow in rectangular and square plain ducts and ducts with twisted-tape inserts .... presence of the insert in the pipe causes resistance to flow and increases turbulence.

  11. Apparatus for securing structural tubes in nuclear reactor fuel assemblies

    International Nuclear Information System (INIS)

    Kerry, J.S.

    1987-01-01

    This patent describes a nuclear reactor fuel assembly having a structural tube with a predetermined inside diameter, a generally cylindrical insert of an axial length substantially smaller than the axial length of the structural tube and having a generally cylindrical passageway of a predetermined diameter smaller than the predetermined inside diameter for providing an effectively reduced inside diameter for the structural tube. The insert comprises: means, having an outside diameter approximately equal to the predetermined inside diameter, for coaxially centering the insert within the structural tube; forming lobes, operable when expanded to locally deform against the structural tube thereby locking the insert within the structural tube

  12. Pump element for a tube pump

    DEFF Research Database (Denmark)

    2011-01-01

    The invention relates to a tube pump comprising a tube and a pump element inserted in the tube, where the pump element comprises a rod element and a first and a second non-return valve member positioned a distance apart on the rod element. The valve members are oriented in the same direction...... relative to the rod element so as to allow for a fluid flow in the tube through the first valve member, along the rod element, and through the second valve member. The tube comprises an at least partly flexible tube portion between the valve members such that a repeated deformation of the flexible tube...... portion acts to alternately close and open the valve members thereby generating a fluid flow through the tube. The invention further relates to a pump element comprising at least two non-return valve members connected by a rod element, and for insertion in an at least partly flexible tube in such tube...

  13. Vertical steam generator with slab-type tube-plate with even tube bundle washing

    International Nuclear Information System (INIS)

    Manek, O.; Masek, V.; Motejl, V.; Quitta, R.

    1980-01-01

    A shielding plate supporting the tubes attached to the tube plate of a vertical steam generator is mounted above the tube plate. Tube sleeves are designed with a dimensional tolerance relative to the heat transfer tubes and the sleeve end and the tube plate end. A separate space is thus formed above the tube plate in which circulation or feed water is introduced to flow between the branch and the heat transfer tube. This provides intensive washing of heat transfer tubes at a critical point and prevents deposit formation, thus excluding heat transfer tube failures. (J.B.)

  14. Hydrogen water intake via tube-feeding for patients with pressure ulcer and its reconstructive effects on normal human skin cells in vitro

    Science.gov (United States)

    2013-01-01

    Background Pressure ulcer (PU) is common in immobile elderly patients, and there are some research works to investigate a preventive and curative method, but not to find sufficient effectiveness. The aim of this study is to clarify the clinical effectiveness on wound healing in patients with PU by hydrogen-dissolved water (HW) intake via tube-feeding (TF). Furthermore, normal human dermal fibroblasts OUMS-36 and normal human epidermis-derived cell line HaCaT keratinocytes were examined in vitro to explore the mechanisms relating to whether hydrogen plays a role in wound-healing at the cellular level. Methods Twenty-two severely hospitalized elderly Japanese patients with PU were recruited in the present study, and their ages ranged from 71.0 to 101.0 (86.7 ± 8.2) years old, 12 male and 10 female patients, all suffering from eating disorder and bedridden syndrome as the secondary results of various underlying diseases. All patients received routine care treatments for PU in combination with HW intake via TF for 600 mL per day, in place of partial moisture replenishment. On the other hand, HW was prepared with a hydrogen-bubbling apparatus which produces HW with 0.8-1.3 ppm of dissolved hydrogen concentration (DH) and −602 mV to −583 mV of oxidation-reduction potential (ORP), in contrast to reversed osmotic ultra-pure water (RW), as the reference, with DH of < 0.018 ppm and ORP of +184 mV for use in the in vitro experimental research. In in vitro experiments, OUMS-36 fibroblasts and HaCaT keratinocytes were respectively cultured in medium prepared with HW and/or RW. Immunostain was used for detecting type-I collagen reconstruction in OUMS-36 cells. And intracellular reactive oxygen species (ROS) were quantified by NBT assay, and cell viability of HaCaT cells was examined by WST-1 assay, respectively. Results Twenty-two patients were retrospectively divided into an effective group (EG, n = 12) and a less effective group (LG, n = 10) according to

  15. Realistic thermal transient margin analysis of 'MONJU' based on plant performance measurements. Reactor vessel outlet nozzle and evaporator feed water inlet tube sheet of the manual reactor plant trip

    International Nuclear Information System (INIS)

    Yamada, Fumiaki; Mori, Takero

    2005-01-01

    In order to develop technologies and achieve safe and stable operation of Monju' as well as realize optimized design and construction of safe and economically competitive fast breeder reactors, the authors are evaluating design approach applied to 'Monju' based on actually measured behavioral data during plant operations. This report uses actual measured characteristic data of 'Monju' during a plant trip test obtained at a commissioning stage with up to 40% power output and introduces plant thermal hydraulic behavior analysis in a representative thermal transient event, i.e. a manual plant trip. Thermal transient driven loads incurred by the reactor vessel outlet nozzle and by the evaporator feed water inlet tube sheet were further derived by structural analyses and were compared with the previously derived values in the design stage and with the limit values. Though the reactor vessel outlet nozzle was exposed to larger temperature change in the trip test than the analytical prediction, the newly calculated mechanical load was about 50% of the previous evaluation in the design stage. Also, the newly analyzed mechanical load incurred by the evaporator feed water inlet tube sheet in this event had a large margin against the limit value of cumulative damage cycle fraction, although the observed temperature disturbance in a steam blow test was wilder than the analytical prediction. Thus we concluded that the Monju' plant has an assured safety margin against thermal transient in plant trip events. (author)

  16. Compression device for feeding a waste material to a reactor

    Science.gov (United States)

    Williams, Paul M.; Faller, Kenneth M.; Bauer, Edward J.

    2001-08-21

    A compression device for feeding a waste material to a reactor includes a waste material feed assembly having a hopper, a supply tube and a compression tube. Each of the supply and compression tubes includes feed-inlet and feed-outlet ends. A feed-discharge valve assembly is located between the feed-outlet end of the compression tube and the reactor. A feed auger-screw extends axially in the supply tube between the feed-inlet and feed-outlet ends thereof. A compression auger-screw extends axially in the compression tube between the feed-inlet and feed-outlet ends thereof. The compression tube is sloped downwardly towards the reactor to drain fluid from the waste material to the reactor and is oriented at generally right angle to the supply tube such that the feed-outlet end of the supply tube is adjacent to the feed-inlet end of the compression tube. A programmable logic controller is provided for controlling the rotational speed of the feed and compression auger-screws for selectively varying the compression of the waste material and for overcoming jamming conditions within either the supply tube or the compression tube.

  17. Lattice insertions for POPAE

    International Nuclear Information System (INIS)

    Cho, Y.; Crosbie, E.A.; Diebold, R.; Johnson, D.E.; Ohnuma, S.; Ruggiero, A.G.; Teng, L.C.

    1977-01-01

    Four types of insertions are described for the six 200-m straight sections of POPAE. All have dispersion matched to zero. (1) Injection-ejection insertion--This has proper high-β values and phase advances for horizontal injection and vertical ejection. (2) Phase-adjust insertion--The phase advance in this insertion is adjustable over a range of approximately 100 0 . (3) General-purpose insertion--The β* is adjustable from 2.5. to 200 m and the crossing angle is adjustable from 0 to 11 mrad. (4) High-luminosity insertion--This gives an even lower β + of meter

  18. Enhancement of heat transfer using varying width twisted tape inserts

    African Journals Online (AJOL)

    International Journal of Engineering, Science and Technology ... experimental investigations of the augmentation of turbulent flow heat transfer in a horizontal tube by means of varying width twisted tape inserts with air as the working fluid.

  19. Evaluation of the educational technology "Caring for dependent people" by family caregivers in changes and transfers of patients and tube feeding.

    Science.gov (United States)

    Landeiro, Maria José Lumini; Peres, Heloísa Helena Ciqueto; Martins, Teresa Vieira

    2016-08-18

    to assess the contributions of interactive educational technology "Caring for Dependent People" in the development of knowledge to family caregivers of dependent people in a household context and their satisfaction in its use. quasi-experimental study, not randomized, of the before and after type, with a convenience sample of 65 family caregivers, from two Medicine services of a hospital in Porto, Portugal. The Control Group consisted of 33 family caregivers and the Experimental Group of 32, identified by consecutive sampling. The experimental group had access to educational technology at home. Data were collected by socio-demographic, satisfaction and evaluation of knowledge questionnaire, about how to feed by nasogastric tube, positioning and transferring the dependent person. The assessment in both groups had two moments: initial, during hospitalization and one month after discharge. the experimental group had a larger increase in knowledge related to the use of the educational technology. In the control group the knowledge did not differ in the two evaluation time points. these results confirm the improvement of interactive educational technologies and in the training of family caregivers to care for dependents. This technology successfully met the technical quality and learning needs of caregivers, and was considered easy and stimulating. avaliar os contributos da tecnologia educacional interativa "Cuidar de Pessoas Dependentes" no desenvolvimento de conhecimentos aos familiares cuidadores de pessoas dependentes, no contexto domiciliário e a satisfação no seu uso. estudo quasi-experimental, não randomizado, do tipo antes e depois, com amostra de conveniência constituída por 65 familiares cuidadores, de dois Serviços de Medicina de um hospital do Porto, Portugal. O Grupo Controle foi constituído por 33 familiares cuidadores e o Grupo Experimental por 32, identificados por amostragem consecutiva. O grupo experimental teve Acesso à tecnologia educacional

  20. Technique employed to seal a tube leaking in a heat exchanger of the tube type by explosives with supporting means for the adjacent tubes

    International Nuclear Information System (INIS)

    Larson, G.C.

    1978-01-01

    This invention concerns the technique employed to seal a tube leaking in a heat exchanger of the tube and tube plate type by detonating metal plugs activated by an explosive and inserted in both ends of the tube. It refers in particular to an apparatus and process in which the deformation or distortion of the adjacent tubes and tube plate ties under the effect of the explosive forces is significantly reduced [fr

  1. Enteral feeding without pancreatic stimulation

    DEFF Research Database (Denmark)

    Kaushik, Neeraj; Pietraszewski, Marie; Holst, Jens Juul

    2005-01-01

    OBJECTIVE: All forms of commonly practiced enteral feeding techniques stimulate pancreatic secretion, and only intravenous feeding avoids it. In this study, we explored the possibility of more distal enteral infusions of tube feeds to see whether activation of the ileal brake mechanism can result...

  2. Hand-actuated spring clip insertion tool

    International Nuclear Information System (INIS)

    Cuba, G.W.

    1993-01-01

    A hand-actuated insertion tool includes a handle assembly, an elongated hollow tubular outer support tube, an elongated inner pull rod, and a coupling arrangement. The handle assembly has a first handle member and a second handle member pivoted to a member for movement between unactuated and actuated positions. The tube is attached in a fixed relation to a handle member. The rod is mounted within the tube for sliding movement relative thereto between home and retracted positions. The coupling arrangement pivotally connects the rod to the second handle member such that the rod will undergo sliding movement from the home position to the retracted positions relative to the tube as the second handle member is moved from the unactuated position to the actuated position adjacent to the first handle member. (author)

  3. 21 CFR 888.4230 - Cement ventilation tube.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cement ventilation tube. 888.4230 Section 888.4230...) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4230 Cement ventilation tube. (a) Identification. A cement ventilation tube is a tube-like device usually made of plastic intended to be inserted into...

  4. The use of radioactive inserts in the study of metal deformation during tube-making processes; Emploi de fils metalliques radioactifs pour l'etude des deformations des metaux pendant la fabrication de tubes; Ispol'zovanie radioaktivnykh vtulok dlya izucheniya deformatsii metallov pri protsesse izgotovleniya trub; Empleo de insertos radiactivos en el estudio de la deformacion de los metales durante la fabricacion de tubos

    Energy Technology Data Exchange (ETDEWEB)

    Davison, W H.T. [Tube Investments Research Laboratories, Cambridge (United Kingdom)

    1962-01-15

    This paper reports on the use of radioactive inserts in studying the deformation of steel in hot rotary piercing for tube making. Iron or steel wires are activated in the pile, inserted in tubes drilled in iron or steel billets, which are then processed under normal production conditions. Careful monitoring shows that the radiation exposures and contamination of the plant are quite negligible. On cooling, the billets are scanned in the laboratory, using a collimated scintillationcounter mounted normal to the surface of the pierced billet, and isodose curves show the shape of the deformed insert normal to the tube surface. A similar scan of a section normal to the axis of the tube gives a second plot; from a combination of the two plots, a three-dimensional picture is obtained. Some results are quoted, but the main emphasis of the paper is on the experimental technique, which has quite general applicability to metal deformation studies. The insert must be located within a millimeter or thereabouts, for which a higher resolution is required than is normal in medical scanning techniques. The problems of achieving this are discussed in terms of {gamma}-energy, collimator design and energy discrimination. (author) [French] Le present memoire traite de l'emploi de fils metalliques radioactifs pour l'etude de la deformation de l'acier durant le forage rotatif a chaud en vue de la fabrication des tubes. Des fils de fer ou d'acier sont actives dans un reacteur et places dans des cavites tabulaires menagees a l'interieur de billettes de fer ou d'acier que l'on transforme ensuite dans les conditions de fabrication normales. Un controle radiologique minutieux montre que les dangers d'irradiation et de contamination dans l'usine sont pratiquement negligeables. Apres refroidissement, les billettes sont examinees en laboratoire au moyen d'un compteur a scintillations avec collimateur de faible ouverture, monte de facon que l'axe soit perpendiculaire a la surface de la billette

  5. Gastrostomy Tube (G-Tube)

    Science.gov (United States)

    ... any of these problems: a dislodged tube a blocked or clogged tube any signs of infection (including redness, swelling, or warmth at the tube site; discharge that's yellow, green, or foul-smelling; fever) excessive bleeding or drainage from the tube site severe abdominal pain lasting ...

  6. Pressure tube reactor

    International Nuclear Information System (INIS)

    Seki, Osamu; Kumasaka, Katsuyuki.

    1988-01-01

    Purpose: To remove the heat of reactor core using a great amount of moderators at the periphery of the reactor core as coolants. Constitution: Heat of a reactor core is removed by disposing a spontaneous recycling cooling device for cooling moderators in a moderator tank, without using additional power driven equipments. That is, a spontaneous recycling cooling device for cooling the moderators in the moderator tank is disposed. Further, the gap between the inner wall of a pressure tube guide pipe disposed through the vertical direction of a moderator tank and the outer wall of a pressure tube inserted through the guide pipe is made smaller than the rupture distortion caused by the thermal expansion upon overheating of the pressure tube and greater than the minimum gap required for heat shiels between the pressure tube and the pressure tube guide pipe during usual operation. In this way, even if such an accident as can not using a coolant cooling device comprising power driven equipment should occur in the pressure tube type reactor, the rise in the temperature of the reactor core can be retarded to obtain a margin with time. (Kamimura, M.)

  7. Insertion Modeling and Its Applications

    OpenAIRE

    Alexander Letichevsky; Oleksandr Letychevskyi; Vladimir Peschanenko

    2016-01-01

    The paper relates to the theoretical and practical aspects of insertion modeling. Insertion modeling is a theory of agents and environments interaction where an environment is considered as agent with a special insertion function. The main notions of insertion modeling are presented. Insertion Modeling System is described as a tool for development of different kinds of insertion machines. The research and industrial applications of Insertion Modeling System are presented.

  8. Percutaneous Ureteral stent insertion

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Yup; Sung, Dong Wook; Choi, Woo Suk; Lee, Dong Ho; Ko, Young Tae; Lee, Sun Wha; Lim, Jae Hoon [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1990-10-15

    Percutaneous ureteral stent insertion is a treatment of permanent or temporary urinary diversion to maintain continuity and function of the obstructed and injured ureter. We performed 31 cases of percutaneous double pig tall ureteral stent insertion in 21 patients, included 13 patients with malignant ureteral obstruction and eight patients with injured ureter as well as benign inflammatory stricture. Satisfactory resulted was obtained in all patients but one, who need percutaneous nephrostomy on week later for urinary diversion. No significant complication was encountered. The authors concluded that percutaneous ureteral stent insertion, an interventional procedure alternative to urologic retrograde method, is an effective method for urinary diversion.

  9. Tube-in-shell heat exchangers

    International Nuclear Information System (INIS)

    Richardson, J.

    1976-01-01

    Tube-in-shell heat exchangers normally comprise a bundle of parallel tubes within a shell container, with a fluid arranged to flow through the tubes in heat exchange with a second fluid flowing through the shell. The tubes are usually end supported by the tube plates that separate the two fluids, and in use the tube attachments to the tube plates and the tube plates can be subject to severe stress by thermal shock and frequent inspection and servicing are required. Where the heat exchangers are immersed in a coolant such as liquid Na such inspection is difficult. In the arrangement described a longitudinally extending central tube is provided incorporating axially spaced cylindrical tube plates to which the opposite ends of the tubes are attached. Within this tube there is a tubular baffle that slidably seals against the wall of the tube between the cylindrical tube plates to define two co-axial flow ducts. These ducts are interconnected at the closed end of the tube by the heat exchange tubes and the baffle comprises inner and outer spaced walls with the interspace containing Ar. The baffle is easily removable and can be withdrawn to enable insertion of equipment for inspecting the wall of the tube and tube attachments and to facilitate plugging of defective tubes. Cylindrical tube plates are believed to be superior for carrying pressure loads and resisting the effects of thermal shock. Some protection against thermal shock can be effected by arranging that the secondary heat exchange fluid is on the tube side, and by providing a thermal baffle to prevent direct impingement of hot primary fluid on to the cylindrical tube plates. The inner wall of the tubular baffle may have flexible expansible region. Some nuclear reactor constructions incorporating such an arrangement are described, including liquid metal reactors. (U.K.)

  10. Effect of occlusal calculus utilized as a potential "biological sealant" in special needs patients with gastric feeding tubes: a qualitative in vitro contrast to pit and fissure sealant restorations.

    Science.gov (United States)

    Owens, Barry M; Sharp, Harry K; Fourmy, Emily E; Phebus, Jeffrey G

    2016-01-01

    The aim of this case report and in vitro investigation was to evaluate the marginal microleakage of intact occlusal calculus of primary molars extracted from a special needs patient who received nutrition via a gastric feeding tube. An adolescent with a history of developmental disturbance presented for routine dental care in a hospital facility. Prophylaxis was performed, and 2 mandibular permanent molars were restored. Five primary molars were extracted due to mobility and delayed retention. Heavy deposits of intact calculus were present on the occlusal surfaces of the primary teeth. The extracted teeth were immersed in methylene blue dye solution, invested in acrylic resin, sectioned into blocks, and photographed at 20× and 40× magnification. Previously photographed calculus-free molars with pit and fissure sealants were reviewed and served as contrasting "restorations." The occlusal calculus on the primary teeth extracted from the patient absorbed the dye, while the comparison teeth containing pit and fissure sealants exhibited varying degrees of marginal dye penetration (microleakage). No marginal microleakage was noted in the calculus specimens, indicating that this substrate may serve as a "natural" occlusal surface sealant and that its removal from occlusal surfaces during routine oral prophylaxis may be unnecessary.

  11. Tubing misconnections: normalization of deviance.

    Science.gov (United States)

    Simmons, Debora; Symes, Lene; Guenter, Peggi; Graves, Krisanne

    2011-06-01

    Accidental connection of an enteral system to an intravenous (IV) system frequently results in the death of the patient. Misconnections are commonly attributed to the presence of universal connectors found in the majority of patient care tubing systems. Universal connectors allow for tubing misconnections between physiologically incompatible systems. The purpose of this review of case studies of tubing misconnections and of current expert recommendations for safe tubing connections was to answer the following questions: In tubing connections that have the potential for misconnections between enteral and IV tubing, what are the threats to safety? What are patient outcomes following misconnections between enteral and IV tubing? What are the current recommendations for preventing misconnections between enteral and IV tubing? Following an extensive literature search and guided by 2 models of threats and errors, the authors analyzed case studies and expert opinions to identify technical, organizational, and human errors; patient-related threats; patient outcomes; and recommendations. A total of 116 case studies were found in 34 publications. Each involved misconnections of tubes carrying feedings, intended for enteral routes, to IV lines. Overwhelmingly, the recommendations were for redesign to eliminate universal connectors and prevent misconnections. Other recommendations were made, but the analysis indicates they would not prevent all misconnections. This review of the published case studies and current expert recommendations supports a redesign of connectors to ensure incompatibility between enteral and IV systems. Despite the cumulative evidence, little progress has been made to safeguard patients from tubing misconnections.

  12. ALS insertion devices

    International Nuclear Information System (INIS)

    Hoyer, E.; Chin, J.; Halbach, K.; Hassenzahl, W.V.; Humphries, D.; Kincaid, B.; Lancaster, H.; Plate, D.

    1990-11-01

    The Advanced Light Source (ALS), the first US third generation synchrotron radiation source, is currently under construction at the Lawrence Berkeley Laboratory. The low-emittance, 1.5 GeV electron storage ring and the insertion devices are specifically designed to produce high brightness beams in the UV to soft X-Ray range. The planned initial complement of insertion devices includes four 4.6 m long undulators, with period lengths of 3.9 cm, 5.0 cm (2) and 8.0 cm, and a 2.9 m long wiggler of 16 cm period length. Undulator design is well advanced and fabrication has begun on the 5.0 cm and 8.0 cm period length undulators. This paper discusses ALS insertion device requirements; general design philosophy; and design of the magnetic structure, support structure/drive systems, control system and vacuum system. 18 refs., 9 figs., 5 tabs

  13. Reactivity insertion accident analysis

    International Nuclear Information System (INIS)

    Moreira, J.M.L.; Nakata, H.; Yorihaz, H.

    1990-04-01

    The correct prediction of postulated accidents is the fundamental requirement for the reactor licensing procedures. Accident sequences and severity of their consequences depend upon the analysis which rely on analytical tools which must be validated against known experimental results. Present work presents a systematic approach to analyse and estimate the reactivity insertion accident sequences. The methodology is based on the CINETHICA code which solves the point-kinetics/thermohydraulic coupled equations with weighted temperature feedback. Comparison against SPERT experimental results shows good agreement for the step insertion accidents. (author) [pt

  14. ISABELLE insertion quadrupoles

    International Nuclear Information System (INIS)

    Kaugerts, J.; Polk, I.; Sampson, W.; Dahl, P.F.

    1979-01-01

    Beam focussing and control at the beam intersection regions of ISABELLE is accomplished by a number of superconducting insertion quadrupoles. These magnets differ from the standard ISABELLE quadrupoles in various ways. In particular, the requirements of limited space near the intersections and aperture for beam extraction impose constraints on their configuration. To achieve optimum beam focussing and provide tuning flexibility calls for stronger quadrupole trim windings than those in the standard quadrupoles. The magnetic and mechanical design of the insertion quadrupoles and their associated correction and steering windings to accomplish the above tasks is presented

  15. Disc-Donut-Tube wear test report, Phase I

    International Nuclear Information System (INIS)

    Kowal, K.; Knaus, S.E.

    1976-06-01

    The report describes a test program which simulated the wear-inducing conditions in the AI Prototype CRBR Steam Generator. This was accomplished by simulating the wear inducing loading and motion of a steam tube against ''disc-donut'' tube spacer plates. It was found that 2- 1 / 4 Cr-1 Mo tubes, wearing against 2- 1 / 4 Cr-l Mo tube spacer plates, seized and galled as deep as .017 inches. Inconel 718 tube spacer plates uniformly wore the tubes as deep as .012 in. Aluminum bronze inserts wore as deep as .003 inches into the tube

  16. PEG tubes: dealing with complications.

    Science.gov (United States)

    Malhi, Hardip; Thompson, Rosie

    A percutaneous endoscopic gastronomy tube can be used to deliver nutrition, hydration and medicines directly into the patient's stomach. Patients will require a tube if they are unable to swallow safely, putting them at risk of aspiration of food, drink and medicines into their lungs. It is vital that nurses are aware of the complications that may arise when caring for a patient with a PEG tube. It is equally important that nurses know how to deal with these complications or from where tc seek advice. This article provides a quick troubleshooting guide to help nurses deal with complications that can arise with PEG feeding.

  17. Method of inserting fuel rod

    International Nuclear Information System (INIS)

    Kamimoto, Shuji; Imoo, Makoto; Tsuchida, Kenji.

    1991-01-01

    The present invention concerns a method of inserting a fuel rod upon automatic assembling, automatic dismantling and reassembling of a fuel assembly in a light water moderated reactor, as well as a device and components used therefor. That is, a fuel rod is inserted reliably to an aimed point of insertion by surrounding the periphery of the fuel rod to be inserted with guide rods, and thereby suppressing the movement of the fuel rod during insertion. Alternatively, a fuel rod is inserted reliably to a point of insertion by inserting guide rods at the periphery of the point of insertion for the fuel rod to be inserted thereby surrounding the point of insertion with the guide rods or fuel rods. By utilizing fuel rods already present in the fuel assembly as the guide rods described above, the fuel rod can be inserted reliably to the point of insertion with no additional devices. Dummy fuel rods are previously inserted in a fuel assembly which are then utilized as the above-mentioned guide rods to accurately insert the fuel rod to the point of insertion. (I.S.)

  18. Insertion in Persian

    Science.gov (United States)

    Kambuziya, Aliyeh Kord-e Zafaranlu; Dehghan, Masoud

    2011-01-01

    This paper investigates epenthesis process in Persian to catch some results in relating to vowel and consonant insertion in Persian lexicon. This survey has a close relationship to the description of epenthetic consonants and the conditions in which these consonants are used. Since no word in Persian may begin with a vowel, so that hiatus can't be…

  19. The Composite Insertion Electrode

    DEFF Research Database (Denmark)

    Atlung, Sven; Zachau-Christiansen, Birgit; West, Keld

    1984-01-01

    The specific energy obtainable by discharge of porous insertion electrodes is limited by electrolyte depletion in thepores. This can be overcome using a solid ion conductor as electrolyte. The term "composite" is used to distinguishthese electrodes from porous electrodes with liquid electrolyte...

  20. Failure analysis of boiler tube

    International Nuclear Information System (INIS)

    Mehmood, K.; Siddiqui, A.R.

    2007-01-01

    Boiler tubes are energy conversion components where heat energy is used to convert water into high pressure superheated steam, which is then delivered to a turbine for electric power generation in thermal power plants or to run plant and machineries in a process or manufacturing industry. It was reported that one of the tubes of a fire-tube boiler used in a local industry had leakage after the formation of pits at the external surface of the tube. The inner side of the fire tube was working with hot flue gasses with a pressure of 10 Kg/cm/sup 2/ and temperature 225 degree C. The outside of the tube was surrounded by feed water. The purpose of this study was to determine the cause of pits developed at the external surface of the failed boiler tube sample. In the present work boiler tube samples of steel grade ASTM AI61/ASTM A192 were analyzed using metallographic analysis, chemical analysis, and mechanical testing. It was concluded that the appearance of defects on the boiler tube sample indicates cavitation type corrosion failure. Cavitation damage superficially resembled pitting, but surface appeared considerably rougher and had many closely spaced pits. (author)

  1. Horizontal beam tubes in FRM-II

    International Nuclear Information System (INIS)

    Coors, D.; Vanvor, D.

    2001-01-01

    The new research reactor in Garching FRM-II is equipped with 10 leak tight horizontal beam tubes (BT1 - BT10), each of them consisting of a beam tube structure taking an insert with neutron channels. The design of all beam tube structures is similar whereas the inserts are adapted to the special requirements of the using of each beam tube. Inside the reflector tank the beam tube structures are shaped by the inner cones which are made of Al-alloy with circular and rectangular cross sections. They are located in the region of maximum neutron flux (exception BT10), they are directly connected to the flanges of the reflector tank, their lengths are about 1.5 m (exception BT10) and their axes are directed tagentially to the core centre thus contributing to a low γ-noise at the experiments. (orig.)

  2. Tests of compressed geometry NEC acceleration tubes

    International Nuclear Information System (INIS)

    Raatz, J.E.; Rathmell, R.D.; Stelson, P.H.; Ziegler, N.F.

    1985-01-01

    Tests have been performed in the 3 MV Pelletron test machine at NEC on a compressed geometry tube which increases the insulating length of the tube by eliminating the heated electrode assemblies (approx.2.5 cm thick) at the end of each tube section. Some insert electrodes are changed to provide some trapping of secondary ions. The geometry tested provided an 18% increase in live ceramic in the tube. The compressed geometry tube allowed a terminal voltage of 3.55 MV on the 3 MV column at normal gradients of 30.3 kv/tube gap. The tube was also conditioned to more than 4 MV and remained stable in voltage with few sparks and with low x-ray levels for days at about 4 MV. This same performance could be achieved with or without arc discharge cleaning. 4 refs., 4 figs

  3. Fuel insert shuffler

    International Nuclear Information System (INIS)

    Naser, J.; Colley, R.; Gaiser, J.; Brookmire, T.; Engle, S.

    1987-01-01

    The potential for the use of expert systems in the nuclear power industry is widely recognized. The benefits of such systems include consistency of reasoning during off-normal situations when humans are under great stress, the reduction of time required to perform certain functions and the retention of human expertise in performing specialized functions. As the potential benefits are more and more demonstrated and realized, the development of expert systems becomes a necessary part of the nuclear power industry. The development of the fuel insert shuffle expert system is used as a case study. In fact, it shows that the potential benefits are realizable. Currently, the development of the insert shuffle plan requires three to four man-weeks of effort. Further modifications to this plan are sometimes required dur to either changes in the desired core load pattern or damaged fuel assemblies or inserts. These changes generally require two to four man-days of effort and could be stressful if they are critical path items on the outage schedule

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

    OpenAIRE

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

    2006-01-01

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

  5. [Lung abscess and necrotizing pneumonia: chest tube insertion or surgery?].

    Science.gov (United States)

    Pagès, P-B; Bernard, A

    2012-04-01

    Lung abscesses and necrotizing pneumonia are rare complications of community-acquired pneumonia since the advent of antibiotics. Their management leans first of all on the antibiotic treatment adapted on the informed germs. However, in 11 to 20% of the cases of lung abscesses, this treatment is insufficient, and drainage, either endoscopic or percutaneous, must be envisaged. In first intention, we shall go to less invasive techniques: endoscopic or percutaneous radio-controlled. In case of failure of these techniques, a percutaneous surgical drainage by minithoracotomy will be performed. In the necrotizing pneumonia, because of the joint obstruction of the bronchus and blood vessels corresponding to a lung segment, the systemic antibiotic treatment will be poor effective. In case of failure of this one we shall propose, a percutaneous surgical drainage, especially if the necrosis limits itself to a single lobe. The surgical treatment will be reserved: in the failures of the strategy of surgical drainage, in the necroses extending in several lobes. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  6. SVC obstruction and stridor relieved by nasogastric tube insertion.

    Science.gov (United States)

    Molena, Emma J; Krishnamoorthy, Ashwin; Praveen, Coimbatore

    2016-03-01

    Achalasia is an idiopathic motility disorder of the oesophagus of increasing incidence. It is characterized by aperistalsis of the lower oesophagus and failure of relaxation of the lower oesophageal sphincter. Patients classically present with chronic symptoms of dysphagia, chest pain, weight loss and regurgitation, and they commonly suffer pulmonary complications such as recurrent microaspiration of static, retained food contents of the upper oesophagus. However, it has also been described, uncommonly, to present with megaoesophagus and secondary tracheal compression. We present a case of megaoesophagus secondary to achalasia which presented with stridor and signs of acute superior vena caval obstruction. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2016.

  7. Fuel assembly insertion system

    International Nuclear Information System (INIS)

    Barkhurst, D.J.

    1987-01-01

    This patent describes a nuclear reactor facility having fuel bundles: a system for the insertion of a fuel bundle into a position where vertically arranged fuel bundles surround and are adjacent the system comprising, in combination, separate and individual centering devices secured to and disposed on top of each fuel bundle adjacent the position. Each such centering device has a generally box-like cap configuration on the upper end of each fuel bundle and includes: a top wall; first and second side walls, each secured along and upper edge to the top wall; a rear plate attached along opposite vertical edges to the first and second side walls; a front inclined wall joined along an upper edge to the top to the wall and attached along opposite vertical edges first and second side walls; pad means secured to the lower edge of the first and second side walls, the front inclined wall and the rear plate for mounting each centering device on top of an associated fuel bundle; pin means carried by at least two of the pad means engageable with an associated aperature for locating and laterally fixing each centering device on top of its respective fuel bundle. Each front inclined wall of each of the centering devices is orientated on top of its respective fuel bundle to slope upwardly and away from the position where upon downward insertion of a fuel bundle any contact between the lower end of the fuel bundle inserted with a front inclined wall of a centering device will laterally deflect the fuel bundle. Each centering device further includes a central socket means secured to the top wall, and an elongated handling pole pivotally attached to the socket

  8. Apparatus for inspecting and repairing a pressurized-water reactor's steam generator heat exchanger tubes

    International Nuclear Information System (INIS)

    Mueller, O.; Roettger, H.; Kasti, H.; Hagen, H.G.

    1976-01-01

    Described is an apparatus provided for use with a pressurized-water reactor' steam generator having a manifold chamber enclosing the bottom side of a horizontal tube sheet having holes therethrough in which are mounted the tubes of a heat exchanger tube bundle. The manifold chamber has a manhole giving access to the tube's bottom side to permit internal inspection or repair of the tubes by registration of an end of a flexible guide conduit with the tube sheet holes and through which a flexible carrier can be guided for insertion via these holes in the tube sheet and through the tubes extending from the tube sheet's other side

  9. Sleeve type repair of degraded nuclear steam generator tubes

    International Nuclear Information System (INIS)

    Ayres, P.S.; Stark, L.E.; Feldstein, J.G.; Fu, T.

    1986-01-01

    A sealable sleeve is described for insertion into the repair of a degraded tube which consists of: a hollow core inner member of the same material as the degraded tube; a thinner outer member of substantially pure nickel and resistant to corrosive attack, the outer member being metallurgically bonded with the inner member; an expanded portion of the sleeve at one end for positioning in the tube within a tube sheet; a multiplicity of grooves formed in and adjacent to the other end of the sleeve which extends into the free-standing portion of the tube beyond the tube sheet, and a noble metal braze material contained in the grooves

  10. Data Insertion in Bitcoin's Blockchain

    Directory of Open Access Journals (Sweden)

    Andrew Sward

    2018-04-01

    Full Text Available This paper provides the first comprehensive survey of methods for inserting arbitrary data into Bitcoin’s blockchain. Historical methods of data insertion are described, along with lesser-known techniques that are optimized for efficiency. Insertion methods are compared on the basis of efficiency, cost, convenience of data reconstruction, permanence, and potentially negative impact on the Bitcoin ecosystem.

  11. Steam generator tube extraction

    International Nuclear Information System (INIS)

    Delorme, H.

    1985-05-01

    To enable tube examination on steam generators in service, Framatome has now developed a process for removing sections of steam generator tubes. Tube sections can be removed without being damaged for treating the tube section expanded in the tube sheet

  12. [How to do - the chest tube drainage].

    Science.gov (United States)

    Klopp, Michael; Hoffmann, Hans; Dienemann, Hendrik

    2015-03-01

    A chest tube is used to drain the contents of the pleural space to reconstitute the physiologic pressures within the pleural space and to allow the lungs to fully expand. Indications for chest tube placement include pneumothorax, hemothorax, pleural effusion, pleural empyema, and major thoracic surgery. The most appropriate site for chest tube placement is the 4th or 5th intercostal space in the mid- or anterior- axillary line. Attention to technique in placing the chest tube is vital to avoid complications from the procedure. Applying the step-by-step technique presented, placement of a chest tube is a quick and safe procedure. Complications - frequently occurring when the tube is inserted with a steel trocar - include hemothorax, dislocation, lung lacerations, and injury to organs in the thoracic or abdominal cavity." © Georg Thieme Verlag KG Stuttgart · New York.

  13. Implementation of the evidence review on best practice for confirming the correct placement of nasogastric tube in patients in an acute care hospital.

    Science.gov (United States)

    Tho, Poh Chi; Mordiffi, Siti; Ang, Emily; Chen, Helen

    2011-03-01

    Nasogastric (NG) tube is a device passed through the gastrointestinal tract of patients for the purpose of feeding, gastric decompression and medication administration. However, a small risk involved in the process is that the tube may be misplaced into the trachea during insertion or may get displaced at a later stage, leading to disastrous results. Recent adverse incidences arising out of the misplacement of NG tube raised concerns among the nursing and medical community and the Patient Safety Officer of the hospital. The Evidence Based Nursing Unit, in collaboration with some of the key nursing leaders in nursing administration, was tasked to explore and institute the current best practice in confirming the correct placement of NG tube. The aim of this project was to institute the best practice to confirm the correct placement of NG tube in patients in an acute care hospital setting. The project comprised of a few stages. The first stage involved reviewing the existing recommendations and guidelines on the methods for checking correct NG tube placement. The second stage involved incorporation of the change of practice into the clinical setting. The final stage was to monitor and evaluate the impact of the new practice on the patients, nurses and other healthcare professionals. Evidence search from guidelines and journals supported the test that used pH indicator instead of the litmus test. There is no evidence that supports the method of auscultation and bubbling to confirm correct NG tube placement in the absence of aspirate. Radiology remains the 'gold standard' for checking correct NG tube placement. The revised method of NG tube placement and workflow was incorporated in the revised Standard Operating Procedures. A total of 17 roadshows were conducted to create awareness regarding the new method amongst the nurses, and the implementation of the revised method and workflow was commenced on 3 November 2008. The initial audit conducted 1 month after the

  14. Improved drainage with active chest tube clearance.

    Science.gov (United States)

    Shiose, Akira; Takaseya, Tohru; Fumoto, Hideyuki; Arakawa, Yoko; Horai, Tetsuya; Boyle, Edward M; Gillinov, A Marc; Fukamachi, Kiyotaka

    2010-05-01

    This study was performed to evaluate the efficacy of a novel chest drainage system. This system employs guide wire-based active chest tube clearance to improve drainage and maintain patency. A 32 Fr chest tube was inserted into pleural cavities of five pigs. On the left, a tube was connected to the chest canister, and on the right, the new system was inserted between the chest tube and chest canister. Acute bleeding was mimicked by periodic infusion of blood. The amount of blood drained from each chest cavity was recorded every 15 min for 2 h. After completion of the procedure, all residual blood and clots in each chest cavity were assessed. The new system remained widely patent, and the amount of drainage achieved with this system (670+/-105 ml) was significantly (P=0.01) higher than that with the standard tube (239+/-131 ml). The amount of retained pleural blood and clots with this system (150+/-107 ml) was significantly (P=0.04) lower than that with the standard tube (571+/-248 ml). In conclusion, a novel chest drainage system with active tube clearance significantly improved drainage without tube manipulations. 2010 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.

  15. Tube pancreatico-duodenostomy for management of a severe penetrating pancreaticoduodenal injury.

    Science.gov (United States)

    Hatzigeorgiadis, Anestis; Boulas, Konstantinos A; Barettas, Nikolaos; Papageorgiou, Irene; Blouhos, Konstantinos

    2014-05-27

    Optimal management of penetrating pancreaticoduodenal injuries and better outcomes are associated with simple, fast damage control surgery and shorter operative time. The performance of pyloric exclusion and tube duodenostomy has markedly decreased. However, there is still a trend toward their performance in cases of delay duodenal repair or severe pancreaticoduodenal injury. The present report describes a case of a hemodynamically stable patient with a single penetrating gunshot trauma causing an AAST-OIS grade III pancreatic head injury and grade IV injury of the second portion of the duodenum. The patient was treated in our Level IV rural trauma center and submitted to primary closure of the posterolateral duodenal wall (the laceration of the contralateral inner medial duodenal wall could not be repaired), external duodenal and pancreatic drainage, and duodenal decompression by tube pancreatico-duodenostomy (insertion of a 18 Fr Foley catheter through the laceration of the pancreatic head toward the duodenal lumen), tube cholangiostomy, and pyloric exclusion accompanied with a feeding jejunostomy. Tube pancreatico-duodenostomy, which is described for the first time in the literature, turned out to be effective and can be considered as an option in pancreaticoduodenal trauma when the inner medial duodenal wall cannot be repaired.

  16. Ear Tubes

    Science.gov (United States)

    ... of the ear drum or eustachian tube, Down Syndrome, cleft palate, and barotrauma (injury to the middle ear caused by a reduction of air pressure, ... specialist) may be warranted if you or your child has experienced repeated ... fluid in the middle ear, barotrauma, or have an anatomic abnormality that ...

  17. Facility target insert shielding assessment

    Energy Technology Data Exchange (ETDEWEB)

    Mocko, Michal [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-10-06

    Main objective of this report is to assess the basic shielding requirements for the vertical target insert and retrieval port. We used the baseline design for the vertical target insert in our calculations. The insert sits in the 12”-diameter cylindrical shaft extending from the service alley in the top floor of the facility all the way down to the target location. The target retrieval mechanism is a long rod with the target assembly attached and running the entire length of the vertical shaft. The insert also houses the helium cooling supply and return lines each with 2” diameter. In the present study we focused on calculating the neutron and photon dose rate fields on top of the target insert/retrieval mechanism in the service alley. Additionally, we studied a few prototypical configurations of the shielding layers in the vertical insert as well as on the top.

  18. [Prehospital airway management of laryngeal tubes. Should the laryngeal tube S with gastric drain tube be preferred in emergency medicine?].

    Science.gov (United States)

    Dengler, V; Wilde, P; Byhahn, C; Mack, M G; Schalk, R

    2011-02-01

    Laryngeal tubes (LT) are increasingly being used for emergency airway management. This article reports on two patients in whom out-of-hospital intubation with a single-lumen LT was associated with massive pulmonary aspiration in one patient and gastric overinflation in the other. In both cases peak inspiratory pressures exceeded the LT leak pressure of approximately 35 mbar. This resulted in gastric inflation and decreased pulmonary compliance and increased inspiratory pressure further, thereby creating a vicious circle. It is therefore recommended that laryngeal tube suction (LTS) should be used in all cases of emergency airway management and a gastric drain tube be inserted through the dedicated second lumen. Apart from gastric overinflation, incorrect LT/LTS placement must be detected and immediately corrected, e.g. in cases of difficult or impossible gastric tube placement, permanent drainage of air from the gastric tube, decreasing minute ventilation or an ascending capnography curve.

  19. Insertion device and method for accurate and repeatable target insertion

    Science.gov (United States)

    Gubeli, III, Joseph F.; Shinn, Michelle D.; Bevins, Michael E.; Dillon-Townes, Lawrence; Neil, George R.

    2017-07-04

    The present invention discloses a device and a method for inserting and positioning a target within a free electron laser, particle accelerator, or other such device that generates or utilizes a beam of energy or particles. The system includes a three-point registration mechanism that insures angular and translational accuracy and repeatability of positioning upon multiple insertions within the same structure.

  20. Electron tube

    Science.gov (United States)

    Suyama, Motohiro [Hamamatsu, JP; Fukasawa, Atsuhito [Hamamatsu, JP; Arisaka, Katsushi [Los Angeles, CA; Wang, Hanguo [North Hills, CA

    2011-12-20

    An electron tube of the present invention includes: a vacuum vessel including a face plate portion made of synthetic silica and having a surface on which a photoelectric surface is provided, a stem portion arranged facing the photoelectric surface and made of synthetic silica, and a side tube portion having one end connected to the face plate portion and the other end connected to the stem portion and made of synthetic silica; a projection portion arranged in the vacuum vessel, extending from the stem portion toward the photoelectric surface, and made of synthetic silica; and an electron detector arranged on the projection portion, for detecting electrons from the photoelectric surface, and made of silicon.

  1. Backflushable filter insert

    International Nuclear Information System (INIS)

    Keith, R.C.; Vandenberg, T.; Randolph, M.C.; Lewis, T.B.; Gillis, P.J. Jr.

    1988-01-01

    Filter elements are mounted on a tube plate beneath an accumulator chamber whose wall is extended by skirt and flange to form a closure for the top of pressure vessel. The accumulator chamber is annular around a central pipe which serves as the outlet for filtered water passing from the filter elements. The chamber contains filtered compressed air from supply. Periodically the filtration of water is stopped and vessel is drained. Then a valve is opened, allowing the accumulated air to flow from chamber up a pipe and down pipe, pushing the filtered water from pipe back through the filter elements to clean them. The accumulator chamber is so proportioned, relative to the volume of the system communicating therewith during backflushing, that the equilibrium pressure during backflushing cannot exceed the pressure rating of the vessel. However a line monitors the pressure at the top of the vessel, and if it rises too far a bleed valve is automatically opened to depressurise the system. The chamber is intended to replace the lid of an existing vessel to convert a filter using filter aid to one using permanent filter elements. (author)

  2. Laparoscopic feeding jejunostomy: also a simple technique.

    Science.gov (United States)

    Albrink, M H; Foster, J; Rosemurgy, A S; Carey, L C

    1992-01-01

    Placement of feeding tubes is a common procedure for general surgeons. While the advent of percutaneous endoscopic gastrostomy has changed and improved surgical practice, this technique is contraindicated in many circumstances. In some patients placement of feeding tubes in the stomach may be contraindicated due to the risks of aspiration, gastric paresis, or gastric dysmotility. We describe a technique of laparoscopic jejunostomy tube placement which is easy and effective. It is noteworthy that this method may be used in patients who have had previous abdominal operations, and it has the added advantage of a direct peritoneal view of the viscera. We suggest that qualified laparoscopic surgeons learn the technique of laparoscopic jejunostomy.

  3. Support tube of in-core instruments

    International Nuclear Information System (INIS)

    Suzumura, Takeshi; Saito, Shozo; Yasuda, Tetsuo; Shirosaki, Kiyotaka.

    1975-01-01

    Object: To permit satisfactory output measurement by preventing the bending of a in-core instrument tube within a reactor due to vibrations by means of a spring and thereby preventing mechanical damage of an adjacent fuel channel box. Structure: At a corner of a channel box of a fuel assembly, a in-core instrument tube is arranged along a channel box and has its surface provided with a plurality of removable leaf springs arranged in the direction of axis of the in-core instrument tube and each having an arcular tip. Thus, when the in-core instrument tube is inserted into the reactor, the arcular tip portions of the leaf springs are brought into plane contact with the corner of the channel box so that the in-core instrument tube is elastically supported on the channel box. Thus, there is no possibility of causing damage to the adjacent fuel channel box. (Kamimura, M.)

  4. Lithium insertion in nanostructured titanates

    NARCIS (Netherlands)

    Borghols, W.J.H.

    2010-01-01

    Upon nano-sizing of insertion compounds several significant changes in Li-insertion behavior have been observed for sizes below approximately 50 nm. Although the origins of the phenomena are interrelated, the changes can be divided in three main observations. (1) The formation of new phases, leading

  5. Metallographic study of reconstitution welding in inserts of 1 cm3

    International Nuclear Information System (INIS)

    Romero C, J.; Garcia R, R.; Fernandez T, F.; Perez R, N.; Rocamontes A, M.

    2007-01-01

    In this article, the welding metallographic study carried out in Charpy test tubes reconstituted with notch in 'V', used in the surveillance programs of the vessel in nucleo electric plants is described. Inserts of 1 cm 3 are used, where the inserts are usually rectangular of minimum 18 millimeters of length. The importance of using inserts of 1 cm 3 is that the mechanical properties can be measured in another direction of the vessel steel, when changing the direction or sense of the notch in 'V' or the face where this notch is made in the insert. (Author)

  6. Test manufacturing of copper canisters with cast inserts. Assessment report

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, C.G

    1998-08-01

    The current design of canisters for the deep repository for spent nuclear fuel consists of an outer corrosion-protective copper casing in the form of a tubular section with lid and bottom and an inner pressure-resistant insert. The insert is designed to be manufactured by casting and inside are channels in which the fuel assemblies are to be placed. Over the last years, a number of full-scale manufacturing tests of all canister components have been carried out. The purpose has been to determine and develop the best manufacturing technique and to establish long-term contacts with the best suppliers of material and technology. Part of the work has involved the developing and implementing of a quality assurance system in accordance with ISO 9001, covering the whole chain from suppliers of material up to and including the delivery of assembled canisters. This report consists of a description of the design of the canister together with current drawings and complementary technical specifications stipulating, among other things, requirements placed on different materials. The different manufacturing methods that have been used are also described and commented on in both text and illustrations. For the manufacturing of copper tubes, the roll-forming of rolled plate to tube halves and longitudinal welding is a method that has been tested on a relatively large number of tubes by now, and that probably can be developed into a functioning production method. However, the very promising outcome of performed tests on seamless tube manufacturing, has resulted in a change in direction in tube manufacturing, focusing on continued testing of extrusion as well as pierce and draw processing in the immediate future. In connection with ongoing operations, new manufacturing tests of tubes with less material thickness will be carried out. Test manufacturing of cast inserts has resulted in the choice of nodular iron as material in the continued work. This improvement in design has resulted

  7. Test manufacturing of copper canisters with cast inserts. Assessment report

    International Nuclear Information System (INIS)

    Andersson, C.G.

    1998-08-01

    The current design of canisters for the deep repository for spent nuclear fuel consists of an outer corrosion-protective copper casing in the form of a tubular section with lid and bottom and an inner pressure-resistant insert. The insert is designed to be manufactured by casting and inside are channels in which the fuel assemblies are to be placed. Over the last years, a number of full-scale manufacturing tests of all canister components have been carried out. The purpose has been to determine and develop the best manufacturing technique and to establish long-term contacts with the best suppliers of material and technology. Part of the work has involved the developing and implementing of a quality assurance system in accordance with ISO 9001, covering the whole chain from suppliers of material up to and including the delivery of assembled canisters. This report consists of a description of the design of the canister together with current drawings and complementary technical specifications stipulating, among other things, requirements placed on different materials. The different manufacturing methods that have been used are also described and commented on in both text and illustrations. For the manufacturing of copper tubes, the roll-forming of rolled plate to tube halves and longitudinal welding is a method that has been tested on a relatively large number of tubes by now, and that probably can be developed into a functioning production method. However, the very promising outcome of performed tests on seamless tube manufacturing, has resulted in a change in direction in tube manufacturing, focusing on continued testing of extrusion as well as pierce and draw processing in the immediate future. In connection with ongoing operations, new manufacturing tests of tubes with less material thickness will be carried out. Test manufacturing of cast inserts has resulted in the choice of nodular iron as material in the continued work. This improvement in design has resulted

  8. Fuel assembly and fuel cladding tube

    International Nuclear Information System (INIS)

    Tsutsumi, Shinro; Ito, Ken-ichi; Inagaki, Masatoshi; Nakajima, Junjiro.

    1996-01-01

    A fuel cladding tube is a zirconium liner tube formed by lining a pure zirconium layer on the inner side of a zirconium alloy tube. The fuel cladding tube is formed by extrusion molding of a composite billet formed by inserting a pure zirconium billet into a zirconium alloy billet. Accordingly, the pure zirconium layer and the zirconium alloy tube are strongly joined by metal bond. The fuel cladding tube has an external oxide film on the outer surface of the zirconium alloy tube and an internal oxide film on the inner side of the pure zirconium layer. The external oxide film has a thickness preferably of about 1μm. The internal oxide film has a thickness of not more than 10μm, preferably, from 1 to 5μm. With such a constitution, flaws to be formed on both inner and outer surfaces of the cladding tube upon assembling a fuel assembly can be reduced thereby enabling to reduce the amount of hydrogen absorbed to the cladding tube. (I.N.)

  9. Method of repairing pressure tube type reactors

    International Nuclear Information System (INIS)

    Asada, Takashi.

    1983-01-01

    Purpose: To enable to re-start the reactor operation in a short time, upon occurrence of failures in a pressure tube, as well as directly examine the cause for the failures in the pressure tube. Method: The pressure tube reactor main body comprises a calandria tank of a briquette form, pressure tubes, fuel assemblies and an iron-water shielding body. If failure is resulted to a pressure tube, the reactor operation is at first shutdown and nuclear fuel assemblies are extracted to withdraw from the pressure tube. Then, to an inlet pipe way and an outlet pipeway connected to the failed pressure tube, are attached plugs by means of welding or the like at the appropriate position where the radiation exposure dose is lower and the repairing work can be performed with ease. The pressure tube is disconnected to withdraw from the inlet pipeway and the outlet pipeway and, instead, radiation shielding plug tube is inserted and shield cooling device is actuated if required, wherein the reactor is actuated to re-start the operation. (Yoshino, Y.)

  10. Long-term follow-up of otitis media with effusion in children: comparisons between a ventilation tube group and a non-ventilation tube group.

    Science.gov (United States)

    Hong, Hye Ran; Kim, Tae Su; Chung, Jong Woo

    2014-06-01

    The objective of this study was to investigate the long-term outcomes in children with otitis media with effusion who received either medical treatment or ventilation tubes. We retrospectively analyzed the medical records of 89 bilateral cases of otitis media with effusion in children who were recommended to receive ventilation tube insertion and were followed up for more than 5 years. Tympanic membrane was inspected by otoscopic examination. Hearing was evaluated with pure tone audiometry. The mean duration of follow-up was 8.4 years (range, 5.2-15.7 years). Twenty-three children were treated without surgery, while 22 were treated once by ventilation tube insertion and 44 were treated more than once by ventilation tube insertion. At the fifth year of follow-up, both groups of children who underwent ventilation tube insertion had more frequent tympanic membrane abnormalities than the medication group (8.7% in those treated without surgery, 72.7% in those treated once by ventilation tube insertion, and 88.6% in those treated more than once by ventilation tube insertion). Common tympanic membrane abnormalities were retraction (27.0%) and tympanosclerotic plaque (23.6%), regardless of the treatment modality. At the fifth year follow-up, the average air-conduction threshold was 10.0 dB (± 6.5 dB) in patients treated without surgery, 15.9 dB (± 11.2dB) in patients treated once by ventilation tube insertion, and 17.8 dB (± 7.6 dB) in those treated more than once by ventilation tube insertion. The audiological difference was significant when we compared the hearing level of children treated by medication without surgery to the two ventilation tube groups. Though ventilation tube insertion can resolve hearing loss quickly, there were more tympanic membrane abnormalities and a decline in hearing levels in our ventilation tube insertion group vs. the observation group measured 5 years later. Physicians should therefore be cautious when applying a ventilation tube in

  11. photomultiplier tubes

    CERN Multimedia

    photomultiplier tubes. A device to convert light into an electric signal (the name is often abbreviated to PM). Photomultipliers are used in all detectors based on scintillating material (i.e. based on large numbers of fibres which produce scintillation light at the passage of a charged particle). A photomultiplier consists of 3 main parts: firstly, a photocathode where photons are converted into electrons by the photoelectric effect; secondly, a multiplier chain consisting of a serie of dynodes which multiply the number of electron; finally, an anode, which collects the resulting current.

  12. photomultiplier tube

    CERN Multimedia

    photomultiplier tubes. A device to convert light into an electric signal (the name is often abbreviated to PM). Photomultipliers are used in all detectors based on scintillating material (i.e. based on large numbers of fibres which produce scintillation light at the passage of a charged particle). A photomultiplier consists of 3 main parts: firstly, a photocathode where photons are converted into electrons by the photoelectric effect; secondly, a multiplier chain consisting of a serie of dynodes which multiply the number of electron; finally, an anode, which collects the resulting current.

  13. Myringotomy versus ventilation tubes in secretory otitis media: eardrum pathology, hearing, and eustachian tube function 25 years after treatment

    DEFF Research Database (Denmark)

    Caye-Thomasen, P.; Stangerup, S.E.; Jorgensen, G.

    2008-01-01

    OBJECTIVE: This report documents the dynamics of eardrum pathology, hearing acuity, and eustachian tube function during 25 years after treatment of bilateral secretory otitis media. The included children were treated by myringotomy on the left ear and ventilation tube insertion on the right ear....... MATERIALS AND METHODS: Two hundred twenty-four children with bilateral secretory otitis media were treated by bilateral myringotomy and insertion of a ventilation tube on the right side only. The children were reexamined by otomicroscopy, tympanometry, and pure tone audiometry after 3, 7, and 25 years...

  14. Root cause of incomplete control rod insertions at Westinghouse reactors

    International Nuclear Information System (INIS)

    Ray, S.

    1997-01-01

    Within the past year, incomplete RCCA insertions have been observed on high burnup fuel assemblies at two Westinghouse PWRs. Initial tests at the Wolf Creek site indicated that the direct cause of the incomplete insertions observed at Wolf Creek was excessive fuel assembly thimble tube distortion. Westinghouse committed to the NRC to perform a root cause analysis by the end of August, 1996. The root cause analysis process used by Westinghouse included testing at ten sites to obtain drag, growth and other characteristics of high burnup fuel assemblies. It also included testing at the Westinghouse hot cell of two of the Wolf Creek incomplete insertion assemblies. A mechanical model was developed to calculate the response of fuel assemblies when subjected to compressive loads. Detailed manufacturing reviews were conducted to determine if this was a manufacturing related issue. In addition, a review of available worldwide experience was performed. Based on the above, it was concluded that the thimble tube distortion observed on the Wolf Creek incomplete insertion assemblies was caused by unusual fuel assembly growth over and above what would typically be expected as a result of irradiation exposure. It was determined that the unusual growth component is a combination of growth due to oxide accumulation and accelerated growth, and would only be expected in high temperature plants on fuel assemblies that see long residence times and high power duties

  15. Kinked and retained nasogastric tube in polytrauma patient; a case report

    Directory of Open Access Journals (Sweden)

    Kumar Ashok

    2017-06-01

    Full Text Available Enteral feeding is an important and preferred technique of feeding in head injury patient to provide nutrition. As inadequate nutrition causes decrease in physical ability, neurological impairment and takes a long time for improvement or delayed deterioratation. With our best knowledge kinked and retained nasogastric tube in stomach is a very rare complication of feeding in head injuries patients. Predisposing factors that can cause kinking is excess tube length, tube in situ for long time and small bore tube. We are reporting one such case of kinked and retained nasogastric tube in the stomach of a polytrauma patient which was retrieved by upper GI endoscope.

  16. Pressure tube reactor

    International Nuclear Information System (INIS)

    Matsumoto, Tomoyuki; Fujino, Michihira.

    1980-01-01

    Purpose: To equalize heavy water flow distribution by providing a nozzle for externally injecting heavy water from a vibration preventive plate to the upper portion to feed the heavy water in a pressure tube reactor and swallowing up heavy water in a calandria tank to supply the heavy water to the reactor core above the vibration preventive plate. Constitution: A moderator injection nozzle is mounted on the inner wall of a calandria tank. Heavy water is externally injected above the vibration preventive plate, and heavy water in the calandria tank is swallowed up to supply the heavy water to the core reactor above the vibration preventive plate. Therefore, the heavy water flow distribution can be equalized over the entire reactor core, and the distribution of neutron absorber dissolved in the heavy water is equalized. (Yoshihara, H.)

  17. Method of fabricating a poision tube for reactor control rods

    Energy Technology Data Exchange (ETDEWEB)

    Mori, Yasuhiko; Yoshida, Toshimi; Masaoka, Isao; Naruse, Akisuke

    1983-04-28

    A method to unify the neutron absorbing performance, enhance the workability in the insertion of neutron absorber tube and further decrease the stresses acting on the neutron absorber coating tube is described. The neutron absorber coated rod comprising neutron absorbing substance and a metal pipe is fabricated by compressing a metal pipe filled with the neutron absorber. Specifically, neutron absorbing substance such as boron carbide powder or the like is filled in a metal pipe such as made of stainless steel tube by way of vibration packing or the like. Then, after heating the metal pipe, it is applied with compression working such as swaging into a fine tube to increase the packing density of the absorbing substance filled in the pipe to greater than 60% of the theoretical density and completely contacted closely to the inner wall of the pipe. The neutron absorber coated rod thus fabricated can be inserted to an external coating tube with ease at a predetermined gap.

  18. Computation and measurement of calandria tube sag in PHWR

    International Nuclear Information System (INIS)

    Kim, Tae Ryong; Sohn, Seok Man

    2003-01-01

    Calandria tubes and liquid injection shutdown system (LISS) tubes in a pressurized heavy water reactor (PHWR) is known to sag due to irradiation creep and growth during plant operation. When the sag of calandria tube becomes bigger, the calandria tube possibly comes in contact with LISS tube crossing beneath and calandria tube. The contact subsequently may cause the damage on the calandria tube resulting in unpredicted outage of the plant. It is therefore necessary to check the gap between the two tubes in order to periodically confirm no contact by using a proper measure during the plant life. An ultrasonic gap measuring probe assembly which can be inserted into two viewing ports of the calandria was developed in Korea and utilized to measure the sags of both tubes in the PHWR. It was found that the centerlines of calandria tubes and liquid injection shutdown system tubes can be precisely detected by ultrasonic wave. The gaps between two tubes were easily obtained from the relative distance of the measured centerline elevations of the tubes. Based on the irradiation creep equation and the measurement data, a computer program to calculate the sags was also developed. With the computer program, the sag at the end of plant life was predicted. (author)

  19. Occam paradox? A variation of tapia syndrome and an unreported complication of guidewire-assisted pedicle screw insertion.

    Science.gov (United States)

    Emohare, Osa; Peterson, Erik; Slinkard, Nathaniel; Janus, Seth; Morgan, Robert

    2013-10-01

    Study Design Case report. Clinical Question The clinical aim is to report on a previously unknown association between guidewire-assisted pedicle screw insertion and neuropraxia of the recurrent laryngeal nerve (RLN), and how this may overlap with the signs of Tapia syndrome; we also report our approach to the clinical management of this patient. Methods A 17-year-old male patient with idiopathic scoliosis experienced Tapia syndrome after posterior instrumentation and arthrodesis at the level of T1-L1. After extubation, the patient had a hoarse voice and difficulty in swallowing. Imaging showed a breach in the cortex of the anterior body of T1 corresponding to the RLN on the right. Results Otolaryngological examination noted right vocal fold immobility, decreased sensation of the endolarynx, and pooling of secretions on flexible laryngoscopy that indicated right-sided cranial nerve X injury and left-sided tongue deviation. Aspiration during a modified barium swallow prompted insertion of a percutaneous endoscopic gastrostomy tube before the patient was sent home. On postoperative day 20, a barium swallow demonstrated reduced aspiration, and the patient reported complete resolution of symptoms. The feeding tube was removed, and the patient resumed a normal diet 1 month later. Tapia syndrome, or persistent unilateral laryngeal and hypoglossal paralysis, is an uncommon neuropraxia, which has previously not been observed in association with a breached vertebral body at T1 along the course of the RLN. Conclusion Tapia syndrome should be a differential diagnostic consideration whenever these symptoms persist postoperatively and spine surgeons should be aware of this as a potential complication of guidewires in spinal instrumentation.

  20. Stress analysis of HTR-10 steam generator heat exchanging tubes

    International Nuclear Information System (INIS)

    Dong Jianling; Zhang Xiaohang; Yin Dejian; Fu Jiyang

    2001-01-01

    Steam Generator (SG) heat exchanging tubes of 10 MW High Temperature Gas Cooled Reactor (HTR-10) are protective screens between the primary loop of helium with radioactivity and the secondary loop of feeding water and steam without radioactivity. Water and steam will enter into the primary loop when rupture of the heat exchanging tubes occurs, which lead to increase of the primary loop pressure and discharge of radioactive materials. Therefore it is important to guarantee the integrity of the tubes. The tube structure is spiral tube with small bending radius, which make it impossible to test with volumetric in-service detection. For such kind of spiral tube, using LBB concept to guarantee the integrity of the tubes is an important option. The author conducts stress analysis and calculation of HTR-10 SG heat exchanging tubes using the FEM code of piping stress analysis, PIPESTRESS. The maximum stress and the dangerous positions are obtained

  1. Eustachian tube patency

    Science.gov (United States)

    Eustachian tube patency refers to how much the eustachian tube is open. The eustachian tube runs between the middle ear and the throat. It controls the pressure behind the eardrum and middle ear space. This helps keep ...

  2. Process and device for locating a defective tube, particularly in the tube bundle of a steam generator

    International Nuclear Information System (INIS)

    Denis, Jean.

    1977-01-01

    A process is described for locating a defective tube, particularly in the tube bundle of a steam generator of the reversed U tube kind with the ends connected to a tube plate, marking with the bottom of the generator casing a space separated into two adjacent collectors, respectively for the inlet and outlet of a primary fluid flowing inside the tubes of the bundle, these being externally washed by a secondary vaporizing fluid. In this process a television camera that can be inserted into the casing is used. This process consists in transmitting to a display system outside the generator an image of the tube plate in each collector by means of a directional television camera and then to place over this image a luminous marker to locate the end or the faulty tube [fr

  3. Tube holding system

    International Nuclear Information System (INIS)

    Cunningham, R.C.

    1978-01-01

    A tube holding rig is described for the lateral support of tubes arranged in tight parcels in a heat exchanger. This tube holding rig includes not less than two tube supporting assemblies, with a space between them, located crosswise with respect to the tubes, each supporting assembly comprising a first set of parallel components in contact with the tubes, whilst a second set of components is also in contact with the tubes. These two sets of parts together define apertures through which the tubes pass [fr

  4. LOFT voltage insertion calibaration program

    International Nuclear Information System (INIS)

    Tillitt, D.N.; Miyasaki, F.S.

    1975-08-01

    The Loss-of-Fluid Test (LOFT) Facility is an experimental facility built around a ''scaled'' version of a large pressurized water reactor (LPWR). Part of this facility is the Data Acquisition and Visual Display System (DAVDS) as defined by the LOFT System Design Document SDD 1.4.2C. The DAVDS has a 702 data channel recording capability of which 548 are recorded digitally. The DAVDS also contains a Voltage Insertion Calibration Subsystem used to inject precise and known voltage steps into the recording systems. The computer program that controls the Voltage Insertion Calibration Subsystem is presented. 7 references. (auth)

  5. Tube Thoracostomy: Complications and Its Management

    Directory of Open Access Journals (Sweden)

    Emeka B. Kesieme

    2012-01-01

    Full Text Available Background. Tube thoracostomy is widely used throughout the medical, surgical, and critical care specialities. It is generally used to drain pleural collections either as elective or emergency. Complications resulting from tube thoracostomy can occasionally be life threatening. Aim. To present an update on the complications and management of complications of tube thoracostomy. Methods. A review of the publications obtained from Medline search, medical libraries, and Google on tube thoracostomy and its complications was done. Results. Tube thoracostomy is a common surgical procedure which can be performed by either the blunt dissection technique or the trocar technique. Complication rates are increased by the trocar technique. These complications have been broadly classified as either technical or infective. Technical causes include tube malposition, blocked drain, chest drain dislodgement, reexpansion pulmonary edema, subcutaneous emphysema, nerve injuries, cardiac and vascular injuries, oesophageal injuries, residual/postextubation pneumothorax, fistulae, tumor recurrence at insertion site, herniation through the site of thoracostomy, chylothorax, and cardiac dysrhythmias. Infective complications include empyema and surgical site infection. Conclusion. Tube thoracostomy, though commonly performed is not without risk. Blunt dissection technique has lower risk of complications and is hence recommended.

  6. Tube Thoracostomy: Complications and Its Management

    Science.gov (United States)

    Kesieme, Emeka B.; Dongo, Andrew; Ezemba, Ndubueze; Irekpita, Eshiobo; Jebbin, Nze; Kesieme, Chinenye

    2012-01-01

    Background. Tube thoracostomy is widely used throughout the medical, surgical, and critical care specialities. It is generally used to drain pleural collections either as elective or emergency. Complications resulting from tube thoracostomy can occasionally be life threatening. Aim. To present an update on the complications and management of complications of tube thoracostomy. Methods. A review of the publications obtained from Medline search, medical libraries, and Google on tube thoracostomy and its complications was done. Results. Tube thoracostomy is a common surgical procedure which can be performed by either the blunt dissection technique or the trocar technique. Complication rates are increased by the trocar technique. These complications have been broadly classified as either technical or infective. Technical causes include tube malposition, blocked drain, chest drain dislodgement, reexpansion pulmonary edema, subcutaneous emphysema, nerve injuries, cardiac and vascular injuries, oesophageal injuries, residual/postextubation pneumothorax, fistulae, tumor recurrence at insertion site, herniation through the site of thoracostomy, chylothorax, and cardiac dysrhythmias. Infective complications include empyema and surgical site infection. Conclusion. Tube thoracostomy, though commonly performed is not without risk. Blunt dissection technique has lower risk of complications and is hence recommended. PMID:22028963

  7. Clinical tube weaning supported by hunger provocation in fully-tube-fed children.

    Science.gov (United States)

    Hartdorff, Caroline M; Kneepkens, C M Frank; Stok-Akerboom, Anita M; van Dijk-Lokkart, Elisabeth M; Engels, Michelle A H; Kindermann, Angelika

    2015-04-01

    Children with congenital malformations, mental retardation, and complex early medical history frequently have feeding problems. Although tube feeding is effective in providing the necessary energy and nutrients, it decreases the child's motivation to eat and may lead to oral aversion. In this study, we sought to confirm our previous results, showing that a multidisciplinary clinical hunger provocation program may lead to quick resumption of oral feeding. In a crossover study, 22 children of 9 to 24 months of age who were fully dependent on tube feeding were randomly assigned to one of two groups: group A, intervention group (2-week multidisciplinary clinical hunger provocation program); and group B, control group (4-week outpatient treatment by the same multidisciplinary team). Patients failing one treatment were reassigned to the other treatment group. Primary outcome measures were at least 75% orally fed at the conclusion of the intervention and fully orally fed and gaining weight 6 months after the intervention. In group A, 9/11 patients were successfully weaned from tube feeding (2 failures: 1 developed ulcerative colitis, 1 drop-out). In group B, only 1 patient was weaned successfully; 10/11 were reassigned to the clinical hunger provocation program, all being weaned successfully. Six months after the intervention, 1 patient had to resume tube feeding. In total, in the control group, 1/11 (9%) was weaned successfully as compared with 18/21 (86%) in the hunger provocation group (P hunger provocation is an effective short-term intervention for weaning young children from tube feeding.

  8. Optimizing the Thermoacoustic Pulse Tube Refrigerator Performances

    Directory of Open Access Journals (Sweden)

    E. V. Blagin

    2014-01-01

    Full Text Available The article deals with research and optimization of the thermoacoustic pulse tube refrigerator to reach a cryogenic temperature level. The refrigerator is considered as a thermoacoustic converter based on the modified Stirling cycle with helium working fluid. A sound pressure generator runs as a compressor. Plant model comprises an inner heat exchanger, a regenerative heat exchanger, a pulse tube, hot and cold heat exchangers at its ends, an inertial tube with the throttle, and a reservoir. A model to calculate the pulse tube thermoacoustic refrigerator using the DeltaEC software package has been developed to be a basis for calculation techniques of the pulse tube refrigerator. Momentum, continuity, and energy equations for helium refrigerant are solved according to calculation algorithm taking into account the porosity of regenerator and heat exchangers. Optimization of the main geometric parameters resulted in decreasing temperature of cold heat exchanger by 41,7 K. After optimization this value became equal to 115,01 K. The following parameters have been optimized: diameters of the feeding and pulse tube and heat exchangers, regenerator, lengths of the regenerator and pulse and inertial tubes, as well as initial pressure. Besides, global minimum of temperatures has been searched at a point of local minima corresponding to the optimal values of abovementioned parameters. A global-local minima difference is 0,1%. Optimized geometric and working parameters of the thermoacoustic pulse tube refrigerator are presented.

  9. Fixed mask assembly research for APS insertion devices

    International Nuclear Information System (INIS)

    Kuzay, T.M.

    1992-01-01

    The Fixed Mask Assembly (FMA) is the first component to interact with the photon beam. Two sets of a pair of FMA channels, vertically and horizontally disposed, contain the beam rather than define it. They are subject to very large heat fluxes during containment. In current practice, the FMA channels are made of heavy, seamless copper, have rectangular cross-sections, and are cooled internally with water. Channels are set at grazing angles ranging from I to 6 degrees with respect to the beam, depending on the type of insertion device. APS insertion devices will impose higher heat fluxes on FMAS. Therefore, a need exists to improve the FMA engineering, keeping in mind the current design criteria and philosophy of FMAS. Preliminary analysis of current heat transfer practice indicates that the major resistance to heat transfer is on the coolant side. Therefore, FMA cooling would benefit from enhanced heat transfer on the coolant side. With this principle in mind, an experimental program has been undertaken to explore the feasibility of using high-performance copper tube configurations which are expected to yield heat transfer coefficients, open-quotes hclose quotes, in single phase flow systems 2 to 5(?) times higher than equivalent plain tubes. In this report, the experimental scope and a preliminary analysis of high-performance copper tube configurations are described

  10. Summary of experimental insertions workshop

    International Nuclear Information System (INIS)

    Sandweiss, J.; Month, M.

    1976-01-01

    An ISABELLE workshop of the summer 1976 series, which was held at Brookhaven August 16--20, focused on the design and utilization of the experimental insertions. The goals of the workshop are outlined, and a few general remarks about the results are presented

  11. Concepts for stereoselective acrylate insertion

    KAUST Repository

    Neuwald, Boris

    2013-01-23

    Various phosphinesulfonato ligands and the corresponding palladium complexes [{((PaO)PdMeCl)-μ-M}n] ([{( X1-Cl)-μ-M}n], (PaO) = κ2- P,O-Ar2PC6H4SO2O) with symmetric (Ar = 2-MeOC6H4, 2-CF3C6H4, 2,6-(MeO)2C6H3, 2,6-(iPrO)2C 6H3, 2-(2′,6′-(MeO)2C 6H3)C6H4) and asymmetric substituted phosphorus atoms (Ar1 = 2,6-(MeO)2C6H 3, Ar2 = 2′-(2,6-(MeO)2C 6H3)C6H4; Ar1 = 2,6-(MeO)2C6H3, Ar2 = 2-cHexOC 6H4) were synthesized. Analyses of molecular motions and dynamics by variable temperature NMR studies and line shape analysis were performed for the free ligands and the complexes. The highest barriers of ΔGa = 44-64 kJ/mol were assigned to an aryl rotation process, and the flexibility of the ligand framework was found to be a key obstacle to a more effective stereocontrol. An increase of steric bulk at the aryl substituents raises the motional barriers but diminishes insertion rates and regioselectivity. The stereoselectivity of the first and the second methyl acrylate (MA) insertion into the Pd-Me bond of in situ generated complexes X1 was investigated by NMR and DFT methods. The substitution pattern of the ligand clearly affects the first MA insertion, resulting in a stereoselectivity of up to 6:1 for complexes with an asymmetric substituted phosphorus. In the consecutive insertion, the stereoselectivity is diminished in all cases. DFT analysis of the corresponding insertion transition states revealed that a selectivity for the first insertion with asymmetric (P aO) complexes is diminished in the consecutive insertions due to uncooperatively working enantiomorphic and chain end stereocontrol. From these observations, further concepts are developed. © 2012 American Chemical Society.

  12. Bender/Coiler for Tubing

    Science.gov (United States)

    Stoltzfus, J. M.

    1983-01-01

    Easy-to-use tool makes coils of tubing. Tubing to be bend clamped with stop post. Die positioned snugly against tubing. Operator turns handle to slide die along tubing, pushing tubing into spiral groove on mandrel.

  13. Remotised sliver sample removal from irradiated pressure tube

    Energy Technology Data Exchange (ETDEWEB)

    Rupani, B B; Sharma, B S.V.G.; Shyam, T V; Sinha, R K [Bhabha Atomic Research Centre, Bombay (India). Reactor Engineering Div.

    1994-12-31

    The life of irradiated pressure tubes of Pressurised Heavy Water Reactor (PHWR) can be assessed by analysing hydrogen content in sliver samples of pressure tube material. The sample can be obtained in the form of small slivers by scraping at any specified locations within the bore of the pressure tube of operating reactor. A tool namely Hydride Scraping Tool (HST) has been developed to obtain very thin slivers of hydride bearing samples from irradiated pressure tube. In order to save man-rem consumption during scraping operation, a feeding mechanism has also been designed and developed for axial positioning of scraping tool in the channel remotely. This paper covers general details about constructional features of the scraping tool, feeding mechanism and their control system. It also highlights the operational salient features and capabilities of the system. Possible applications of the feeding mechanism in other fields are also indicated. (author). 4 figs.

  14. Remotised sliver sample removal from irradiated pressure tube

    International Nuclear Information System (INIS)

    Rupani, B.B.; Sharma, B.S.V.G.; Shyam, T.V.; Sinha, R.K.

    1994-01-01

    The life of irradiated pressure tubes of Pressurised Heavy Water Reactor (PHWR) can be assessed by analysing hydrogen content in sliver samples of pressure tube material. The sample can be obtained in the form of small slivers by scraping at any specified locations within the bore of the pressure tube of operating reactor. A tool namely Hydride Scraping Tool (HST) has been developed to obtain very thin slivers of hydride bearing samples from irradiated pressure tube. In order to save man-rem consumption during scraping operation, a feeding mechanism has also been designed and developed for axial positioning of scraping tool in the channel remotely. This paper covers general details about constructional features of the scraping tool, feeding mechanism and their control system. It also highlights the operational salient features and capabilities of the system. Possible applications of the feeding mechanism in other fields are also indicated. (author). 4 figs

  15. The first LHC insertion quadrupole

    CERN Multimedia

    2004-01-01

    An important milestone was reached in December 2003 at the CERN Magnet Assembly Facility. The team from the Accelerator Technology - Magnet and Electrical Systems group, AT-MEL, completed the first special superconducting quadrupole for the LHC insertions which house the experiments and major collider systems. The magnet is 8 metres long and contains two matching quadrupole magnets and an orbit corrector, a dipole magnet, used to correct errors in quadrupole alignment. All were tested in liquid helium and reached the ultimate performance criteria required for the LHC. After insertion in the cryostat, the superconducting magnet will be installed as the Q9 quadrupole in sector 7-8, the first sector of the LHC to be put in place in 2004. Members of the quadrupole team, from the AT-MEL group, gathered around the Q9 quadrupole at its inauguration on 12 December 2003 in building 181.

  16. Insertion device calculations with mathematica

    Energy Technology Data Exchange (ETDEWEB)

    Carr, R. [Stanford Synchrotron Radiation Lab., CA (United States); Lidia, S. [Univ. of California, Davis, CA (United States)

    1995-02-01

    The design of accelerator insertion devices such as wigglers and undulators has usually been aided by numerical modeling on digital computers, using code in high level languages like Fortran. In the present era, there are higher level programming environments like IDL{reg_sign}, MatLab{reg_sign}, and Mathematica{reg_sign} in which these calculations may be performed by writing much less code, and in which standard mathematical techniques are very easily used. The authors present a suite of standard insertion device modeling routines in Mathematica to illustrate the new techniques. These routines include a simple way to generate magnetic fields using blocks of CSEM materials, trajectory solutions from the Lorentz force equations for given magnetic fields, Bessel function calculations of radiation for wigglers and undulators and general radiation calculations for undulators.

  17. Ring insertions as light sources

    International Nuclear Information System (INIS)

    Green, G.K.

    1975-01-01

    Bending magnets can be inserted in the long straight sections of electron storage rings to produce synchrotron radiation. If the design is carefully proportioned, the bending magnets create only a small perturbation of the properties of the ring. The resulting spectra have favorable optical properties as sources for spectroscopy and diffraction studies. The characteristics of the source are discussed, and the geometrical requirements of the magnets are presented

  18. Inserts for nuclear fuel elements

    International Nuclear Information System (INIS)

    Cragg, P.J.

    1982-01-01

    An insert for a nuclear fuel pin which comprises a strip. The strip carries notches, which enable a coding arrangement to be carried on the strip. The notches may be of differing sizes and the coding on the strip includes identification and identification checking data. Each notch on the strip may give rise to a signal pulse which is counted by a detector to avoid errors. (author)

  19. ATLAS insertable B-layer

    Czech Academy of Sciences Publication Activity Database

    Marčišovský, Michal

    2011-01-01

    Roč. 633, č. 1 (2011), "S224"-"S225" ISSN 0168-9002. [International workshop on radiation imaging detectors /11./. Praha, 26.06.2009-02.07.2009] R&D Projects: GA MŠk LA08015; GA MŠk LA08032 Institutional research plan: CEZ:AV0Z10100502 Keywords : ATLAS * pixel detector * insertable B-layer Subject RIV: BF - Elementary Particles and High Energy Physics Impact factor: 1.207, year: 2011

  20. Tube sheet design for PFBR steam generator

    International Nuclear Information System (INIS)

    Chellapandi, P.; Chetal, S.C.; Bhoje, S.B.

    1991-01-01

    Top and bottom tube sheets of PFBR Steam Generators have been analysed with 3D and axisymmetric models using CASTEM Programs. Analysis indicates that the effects of piping reactions at the inlet/outlet nozzles on the primary stresses in the tube sheets are negligible and the asymmetricity of the deformation pattern introduced in the tube sheet by the presence of inlet/outlet and manhole nozzles is insignificant. The minimum tube sheet thicknesses for evaporator and reheater are 135 mm and 75 mm respectively. Further analysis has indicated the minimum fillet radius at the junction of tube sheet and dished end should be 20 mm. Simplified methodology has been developed to arrive at the number of thermal baffles required to protect the tube sheet against fatigue damage due to thermal transient. This method has been applied to PFBR steam generators to determine the required number of thermal baffles. For protecting the bottom tube sheet of evaporator against the thermal shock due to feed water and secondary pump trip, one thermal shield is found to be sufficient. Further analysis is required to decide upon the actual number to take care of the severe thermal transient, following the event of sudden dumping of water/steam, immediately after the sodium-water reaction. (author)

  1. HTS Insert Magnet Design Study

    CERN Document Server

    Devaux, M; Fleiter, J; Fazilleau, P; Lécrevisse, T; Pes, C; Rey, J-M; Rifflet, J-M; Sorbi, M; Stenvall, A; Tixador, P; Volpini, G

    2011-01-01

    Future accelerator magnets will need to reach higher field in the range of 20 T. This field level is very difficult to reach using only Low Temperature Superconductor materials whereas High Temperature Superconductors (HTS) provide interesting opportunities. High current densities and stress levels are needed to design such magnets. YBCO superconductor indeed carries large current densities under high magnetic field and provides good mechanical properties especially when produced using the IBAD approach. The HFM EUCARD program studies the design and the realization of an HTS insert of 6 T inside a Nb$_{3}$Sn dipole of 13T at 4.2 K. In the2HTS insert, engineering current densities higher than 250 MA/m under 19 T are required to fulfill the specifications. The stress level is also very severe. YBCO IBAD tapes theoretically meet these challenges from presented measurements. The insert protection is also a critical because HTS materials show low quench propagation velocities and the coupling with the Nb$_{3}$Sn m...

  2. Device for facilitating the insertion and withdrawal of fuel assemblies from a nuclear reactor

    International Nuclear Information System (INIS)

    Andrea, C.; Siegel, E.A.

    1976-01-01

    A device is provided which is installed in a reactor prior to carrying out refueling operations and which accurately locates and isolates a selected core location to permit rapid withdrawal and insertion of fuel subassemblies at that location. A shielded plug designed to cooperate with the refueling apparatus is inserted into an access port in the reactor head. A structural shroud extends down from the plug and carries at its lower end a radially floating, hexagonal spreader tube with mechanisms to rotate it for angular alignment purposes and a linear drive for inserting it into the core. The upper end of the spreader tube serves as a guide for leading the fuel handling apparatus into alignment with the chosen subassembly

  3. Pressure vessels and methods of sealing leaky tubes disposed in pressure vessels

    International Nuclear Information System (INIS)

    Larson, G.C.

    1980-01-01

    This invention relates to pressure vessels and to methods of sealing leaky tubes in them and is especially applicable to pressure vessels in the form of sheet-and-tube type heat exchangers constructed with a large number of relatively small diameter tubes grouped in a bundle. To seal off a leaky tube in such a heat exchanger an explosive activated plug in the form of a hollow metal body is used, inserted at each end of the tube to be sealed. Using the arrangement of pressure vessel and associated tube sheets and the explosive activated plug method of sealing a leaky tube as described in this invention it is claimed that distortion of the adjacent tubes and the tube sheets is reduced when the explosive activated plugs are detonated. (U.K.)

  4. Difficulty with cuff deflation of reinforced tracheal tube caused by inflation line occlusion with silk thread ligation and fixation.

    Science.gov (United States)

    Gotoh, Sayoko; Sugiyama, Daisuke; Imai, Eriko; Kawamata, Mikito

    2015-03-05

    A reinforced tracheal tube, ligated with silk threads, was inserted into a tracheostomy orifice and fixed to the skin. The cuff inflation line of the reinforced tracheal tube became occluded. Reinforced 'armoured' tracheal tubes have a spiral of wire embedded into the wall of the tube to give strength and flexibility, and may be sharply bent without compromising the tube lumen. The tracheal cuff attached to the tube is inflated by injecting air through a narrow-diameter tube welded to the outside of the tracheal tube. When a reinforced tracheal tube is ligated and fixed with silk threads, it should be confirmed whether the tracheal tube cuff can be deflated and inflated after fixation. Moreover, because occlusion can be eliminated by removing all silk threads used to ligate a tracheal tube, they should be removed before extubation. 2015 BMJ Publishing Group Ltd.

  5. Field errors in hybrid insertion devices

    International Nuclear Information System (INIS)

    Schlueter, R.D.

    1995-02-01

    Hybrid magnet theory as applied to the error analyses used in the design of Advanced Light Source (ALS) insertion devices is reviewed. Sources of field errors in hybrid insertion devices are discussed

  6. Field errors in hybrid insertion devices

    Energy Technology Data Exchange (ETDEWEB)

    Schlueter, R.D. [Lawrence Berkeley Lab., CA (United States)

    1995-02-01

    Hybrid magnet theory as applied to the error analyses used in the design of Advanced Light Source (ALS) insertion devices is reviewed. Sources of field errors in hybrid insertion devices are discussed.

  7. Visual beam tube inspection at the TRIGA reactor Vienna

    International Nuclear Information System (INIS)

    Boeck, H.; Musilek, A.; Villa, M.

    2006-01-01

    Of the four TRIGA beam tubes two have been visually inspected in 1985. Prior to the inspection the reactor was shut down for 3 weeks. The fuel elements around the beam tubes were removed. Stainless steel dummy elements were inserted in the fuel positions to shield the core radiation. The active part of the Fast Rabbit Tube was removed into the beam tube loading device and transferred to an interim storage: Front dose rate was ∼ 50 mSv/h. Generally the beam tube was very clean, after the last inspection about 30 years ago. A1 cm cut was observed at the beam tube front end. A rigid endoscope was used to check the beam tube's inner surface using a 90 degree deflection objective and photo- and video equipment. The direct dose rate in front of the beam tube was about 30 mSv/h. The beam tube was vacuum cleaned. A corroded shielding tank containing boric acid has leaked. A wooden collimator partially disintegrating due to extreme temperature was removed from beam tube D. Documentation of the inspection for visible defects is produced for later comparison

  8. Use of an esophagostomy tube as a method of nutritional management in raptors: a case series.

    Science.gov (United States)

    Huynh, Minh; Sabater, Mikel; Brandão, João; Forbes, Neil A

    2014-03-01

    We determined if esophagostomy tube placement is feasible for nutritional support in raptors. The clinical data were reviewed from 18 raptors admitted between 2006 and 2012, and in which esophagostomy tubes were placed. Indications for tube placement, complications associated with its placement and management, duration of treatment, and changes in patient body weight were evaluated. The most common indication was nutritional and medical support in stressed hospitalized animals, and intensive care cases. Complications were regurgitation, unexpected removal, and misplacement of the tube. The esophagostomy tube was well tolerated in all but 2 cases. A tube was replaced once in 2 patients. Five birds died during the treatment course. Mortality was not associated with the placement of the tube. Average duration of tube placement was 6.1 +/- 3.7 days. Most birds did not gain any weight with use of the feeding tubes. Esophagostomy tubes are well tolerated in raptors, but further studies are needed to demonstrate their efficiency.

  9. X-ray tubes

    International Nuclear Information System (INIS)

    Young, R.W.

    1979-01-01

    A form of x-ray tube is described which provides satisfactory focussing of the electron beam when the beam extends for several feet from gun to target. Such a tube can be used for computerised tomographic scanning. (UK)

  10. Pressure tube type reactors

    International Nuclear Information System (INIS)

    Komada, Masaoki.

    1981-01-01

    Purpose: To increase the safety of pressure tube type reactors by providing an additional ECCS system to an ordinary ECCS system and injecting heavy water in the reactor core tank into pressure tubes upon fractures of the tubes. Constitution: Upon fractures of pressure tubes, reduction of the pressure in the fractured tubes to the atmospheric pressure in confirmed and the electromagnetic valve is operated to completely isolate the pressure tubes from the fractured portion. Then, the heavy water in the reactor core tank flows into and spontaneously recycles through the pressure tubes to cool the fuels in the tube to prevent their meltdown. By additionally providing the separate ECCS system to the ordinary ECCS system, fuels can be cooled upon loss of coolant accidents to improve the safety of the reactors. (Moriyama, K.)

  11. Neural Tube Defects

    Science.gov (United States)

    Neural tube defects are birth defects of the brain, spine, or spinal cord. They happen in the ... that she is pregnant. The two most common neural tube defects are spina bifida and anencephaly. In ...

  12. Regional insertion: an emergent approach

    International Nuclear Information System (INIS)

    Serra, M.T.F.; Nascimento Teixeira, P. do

    1989-01-01

    The Brazilian Electrical Sector incorporates new variables that expressing the extensive spectrum of environmental impacts in the take of decisions, referring to the viability of realizing a electrical undertaking, attends the several restrictions that are important by the sector and by the society in the environment area and promotes the adequate generation of liquid benefits, consequential of the electrical undertaking. Due to these factors, the Electrical Sector is improving the concept of regional insertion, with the sectorial expansion in long-dated and the created demand in the environmental and social area, focalizing the solution for these questions. (C.G.C.). 1 fig, 2 tabs

  13. Recent advances in insertion devices

    International Nuclear Information System (INIS)

    Gluskin, E.; Moog, E.R.

    1995-01-01

    Demand for more and better insertion devices (IDs) at new third-generation synchrotron radiation facilities has led to significant advances in ID technology at different laboratories around the world. In this overview of this progress, focus is on those results that apply to IDs in general rather than one specific ID or laboratory. The advances fall into two general categories: those that reduce the net effect that the ID has on the particle beam, and those that enhance the quality of the emitted light spectrum. The need for these advances, factors that are most important inaachieving them, and the current state of the art are discussed

  14. Summary of experimental insertions workshop

    International Nuclear Information System (INIS)

    Sandweiss, J.; Month, M.

    1976-01-01

    The last ISABELLE workshop of the summer 1976 series, which was held at Brookhaven, August 16-20, focused on the design and utilization of the experimental insertions. The goals of the workshop, which were somewhat more general than might be suggested by the title, are: (1) review the ISABELLE proposal from the point of view of experimental use; (2) contribute useful information on the ''open questions'' in the ISABELLE design; (3) develop data for experimental equipment and operating cost estimates; and (4) project a first approximation to ISABELLE operating modes

  15. Insertion and crossing region design

    International Nuclear Information System (INIS)

    Wienands, U.; Beloshitsky, P.

    2001-01-01

    This article is the summary of the 5-afternoon tutorial on insertions for circular machines. Roughly half the course (Part 1) was spent discussing interaction regions, We start by recapitulating basic beam optics including building blocks. This provides the tools to analyze the basic structure of interaction regions and explore the parameter space. This simple example is then successively refined and made more realistic. Examples of realized interaction regions for both hadron and electron machines are shown and their salient features and differences explained. A brief discussion of solenoid-decoupling brings Part 1 to a close. In Part 2 we discussed various utility sections. Dispersion suppressors are presented in detail discussing the principles as well as the practical implementation of flexible suppressors using LEP as an example. Injection schemes, both single-turn and multi-turn stacking, are presented in depth. The matching of wiggler and undulator insertions and a discussion of the impact of these devices on beam parameters closes out Part 2

  16. Percutaneous Endoscopic Gastrostomy in the Enteral Feeding of the Elderly

    Directory of Open Access Journals (Sweden)

    Huan-Lin Chen

    2011-09-01

    Full Text Available Today we are faced with an aging society that may develop malnutrition because of dysphagia related to dementia, stroke, and malignancy seen often in the elderly. The preferred form of nutritional supplementation for this group is enteral nutrition, and the most appropriate long-term method is by use of a gastrostomy. Percutaneous endoscopic gastrostomy (PEG was first introduced in 1980 as an alternative to the traditional operative procedure and rapidly became the preferred procedure. In geriatric patients, the principal indications are neurological dysphagia and malnutrition, related to an underlying disease or anorexia-cachexia in very elderly. PEG is contraindicated in the presence of respiratory distress, previous gastric resection, total esophageal obstruction, coagulation disorders and sepsis in the elderly. Common complications include wound infection, leakage, hemorrhage, and fistula in the general population, but aspiration pneumonia is the major case of death in this group. Risks and complications of PEG must be discussed with patients and their families; and the decision for percutaneous endoscopic gastrostomy insertion should only be made after careful consideration and discussion between managing physicians, allied health professionals, and the patient and/or family. Four ethical principles may help make feeding decisions: beneficence, non-maleficence, autonomy and justice. Attentive long-term care after tube replacement is mandatory. Acceptance of percutaneous endoscopic gastrostomy placement by patients and their families tends to increase once favorable outcomes are offered.

  17. 21 CFR 868.5800 - Tracheostomy tube and tube cuff.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Tracheostomy tube and tube cuff. 868.5800 Section... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5800 Tracheostomy tube and tube cuff. (a) Identification. A tracheostomy tube and tube cuff is a device intended to be placed into a...

  18. The kinetics of porous insertion electrodes

    Energy Technology Data Exchange (ETDEWEB)

    Atlung, S; West, K [British Columbia Univ., Vancouver (Canada)

    1989-05-01

    The principles of porous electrodes are discussed as well as the discharge of the insertion compound, the working potential, transport in the electrolyte, the time dependence of the electrolyte concentration, and modeling of the porous electrode. The simulation of a TiS2 porous electrode and the composite insertion electrode are considered as well. The influence of electrode thickness and porosity in a typical porous TiS2 electrode is revealed. It is shown that the use of insertion compounds as battery electrodes is limited by the requirement that the inserted ion must be distributed in the interior of the insertion compound particle. 15 refs.

  19. [Use of the Pentax-AWS videolaryngoscope for bougie-assisted exchange of tracheal tubes].

    Science.gov (United States)

    Kishii, Miki; Asai, Takashi; Nagata, Atsushi; Shingu, Koh

    2009-06-01

    A gum elastic bougie can be useful for tube exchange. One major problem with this technique is that it may not possible to pass a new tube over the bougie into the trachea, because the tip of the tube can collide with tissues around the glottis. We report a case in which tube exchange using the bougie was difficult, but the Pentax-AWS videolaryngoscope enabled tracheal intubation. In a 62-year-old trauma patient with head and neck stabilized using a Halo vest, was scheduled for emergency fixation of the neck. Exchange of a polyvinylchloride tube to a reinforced tube was planned. A bougie was passed through the old tube, removing the tube, and a new tube was advanced over the bougie, but it was impossible to advance the tube into the trachea. Insertion of a Macintosh laryngoscope did not enable intubation. The new tube was removed from the bougie, attached to the Pentax-AWS videolaryngoscope, and the tube (with the Pentax-AWS) was passed over the bougie. Although it was not possible to see the glottis with the Pentax-AWS, the tube was easily advanced over the bougie into the trachea. Operation went on uneventfully. We believe that, when it is difficult to advance a tracheal tube over a tube exchanger, the use of the Pentax-AWS may facilitate intubation.

  20. The impact of a chest tube management protocol on the outcome of trauma patients with tube thoracostomy.

    Science.gov (United States)

    de Abreu, Emanuelle Maria Sávio; Machado, Carla Jorge; Pastore Neto, Mario; de Rezende Neto, João Baptista; Sanches, Marcelo Dias

    2015-01-01

    to investigate the effect of standardized interventions in the management of tube thoracostomy patients and to assess the independent effect of each intervention. A chest tube management protocol was assessed in a retrospective cohort study. The tube thoracostomy protocol (TTP) was implemented in August 2012, and consisted of: antimicrobial prophylaxis, chest tube insertion in the operating room (OR), admission post chest tube thoracostomy (CTT) in a hospital floor separate from the emergency department (ED), and daily respiratory therapy (RT) sessions post-CTT. The inclusion criteria were, hemodynamic stability, patients between the ages of 15 and 59 years, and injury severity score (ISS) chest wall, lung, and pleura. During the study period 92 patients were managed according to the standardized protocol. The outcomes of those patients were compared to 99 patients treated before the TTP. Multivariate logistic regression analysis was performed to assess the independent effect of each variable of the protocol on selected outcomes. Demographics, injury severity, and trauma mechanisms were similar among the groups. As expected, protocol compliance increased after the implementation of the TTP. There was a significant reduction (pchest tube days. Respiratory therapy was independently linked to significant reduction (pchest tube insertion was associated with significant (ptrauma patients.

  1. Comparison of bougie-guided insertion of Proseal tm laryngeal mask airway with digital technique in adults

    Directory of Open Access Journals (Sweden)

    Anand Kuppusamy

    2010-01-01

    Full Text Available The Proseal TM laryngeal mask airway (PLMA TM , Laryngeal Mask Company, UK was designed to improve ventilatory characteristics and offer protection against regurgitation and gastric insufflation. The PLMA is a modified laryngeal mask airway with large ventral cuff, dorsal cuff and a drain tube. These modifications improve seal around glottis and enable better ventilatory characteristics. The drain tube prevents gastric distension and offers protection against aspiration. There were occasional problems, like failed insertion and inadequate ventilation, in placing PLMA TM using the classical digital technique. To overcome these problems, newer placement techniques like thumb insertion technique, introducer tool placement and gum elastic bougie (GEB-aided placement were devised. We compared classical digital placement of PLMA TM with gum elastic bougie-aided technique in 60 anaesthetised adult patients (with 30 patients in each group with respect to number of attempts to successful placement, effective airway time, airway trauma during insertion, postoperative airway morbidity and haemodynamic response to insertion. The number of attempts to successful placement, airway trauma during insertion and haemodynamic response to insertion were comparable among the two groups, while effective airway time and oropharyngeal leak pressure were significantly higher in bougie- guided insertion of PLMA. Postoperatively, sore throat was more frequent with digital technique while dysphagia was more frequent with bougie-guided technique. Hence gum elastic bougie guided, laryngoscope aided insertion of PLMA is an excellent alternate to classical digital technique.

  2. Wear plates control rod guide tubes top internal reactor vessel C. N. VANDELLOS II

    International Nuclear Information System (INIS)

    2010-01-01

    The guide tubes for control rods forming part of the upper internals of the reactor vessel, its function is to guide the control rod to permit its insertion in the reactor core. These guide tubes are suspended from the upper support plate which are fixed by bolts and extending to the upper core plate which is fastened by clamping bolts (split pin) to prevent lateral displacement of the guide tubes, while allowing axial expansion.

  3. Randomized clinical trial of pigtail catheter versus chest tube in injured patients with uncomplicated traumatic pneumothorax.

    Science.gov (United States)

    Kulvatunyou, N; Erickson, L; Vijayasekaran, A; Gries, L; Joseph, B; Friese, R F; O'Keeffe, T; Tang, A L; Wynne, J L; Rhee, P

    2014-01-01

    Small pigtail catheters appear to work as well as the traditional large-bore chest tubes in patients with traumatic pneumothorax, but it is not known whether the smaller pigtail catheters are associated with less tube-site pain. This study was conducted to compare tube-site pain following pigtail catheter or chest tube insertion in patients with uncomplicated traumatic pneumothorax. This prospective randomized trial compared 14-Fr pigtail catheters and 28-Fr chest tubes in patients with traumatic pneumothorax presenting to a level I trauma centre from July 2010 to February 2012. Patients who required emergency tube placement, those who refused and those who could not respond to pain assessment were excluded. Primary outcomes were tube-site pain, as assessed by a numerical rating scale, and total pain medication use. Secondary outcomes included the success rate of pneumothorax resolution and insertion-related complications. Forty patients were enrolled. Baseline characteristics of 20 patients in the pigtail catheter group were similar to those of 20 patients in the chest tube group. No patient had a flail chest or haemothorax. Pain scores related to chest wall trauma were similar in the two groups. Patients with a pigtail catheter had significantly lower mean(s.d.) tube-site pain scores than those with a chest tube, at baseline after tube insertion (3.2(0.6) versus 7.7(0.6); P pneumothorax, use of a 14-Fr pigtail catheter is associated with reduced pain at the site of insertion, with no other clinically important differences noted compared with chest tubes. NCT01537289 (http://clinicaltrials.gov). © 2013 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  4. NEI You Tube Videos: Amblyopia

    Medline Plus

    Full Text Available ... YouTube Videos » NEI YouTube Videos: Amblyopia Listen NEI YouTube Videos YouTube Videos Home Age-Related Macular Degeneration ... Retinopathy of Prematurity Science Spanish Videos Webinars NEI YouTube Videos: Amblyopia Embedded video for NEI YouTube Videos: ...

  5. Chest tube drainage of pleural effusions--an audit of current practice and complications at Hutt Hospital.

    Science.gov (United States)

    Epstein, Erica; Jayathissa, Sisira; Dee, Stephen

    2012-05-11

    The aims of the study were to review small-bore chest tube insertion practices for drainage of pleural fluid at Hutt Valley District Health Board (HVDHB), to assess complications, and compare the findings with international data. Retrospective analysis of clinical records was completed on all chest tube insertions for drainage of pleural fluid at HVDHB from December 2008 to November 2009. Descriptive statistics were used to present demographics and tube-associated complications. Comparison was made to available similar international data. Small-bore tubes comprised 59/65 (91%) chest tube insertions and 23/25 (92%) complications. Available comparative data was limited. Ultrasound was used in 36% of insertions. Nearly half of chest drains placed for empyema required subsequent cardiothoracic surgical intervention. Chest drain complication rates at HVDHB were comparable to those seen internationally. Referral rates to cardiothoracic surgery for empyema were within described ranges. The importance of procedural training for junior medical staff, optimising safety of drain insertions with ultrasound guidance, and clear clinical governance for chest tube insertions are important in minimising harm from this procedure. Specialist societies need to take a leadership in providing guidance on chest drain insertions to secondary and tertiary hospitals in Australia and New Zealand.

  6. Chest tube placement in thorax trauma - comparison chest X-ray and computed tomography (CT)

    International Nuclear Information System (INIS)

    Heim, P.; Maas, R.; Buecheler, E.; Tesch, C.

    1998-01-01

    Estimation of chest tube placement in patients with thoracic trauma with regard to chest tube malposition in chest radiography in the supine position compared to additional computed tomography of the thorax. Material and methods: Apart from compulsory chest radiography after one or multiple chest tube insertions, 31 severely injured patients with thoracic trauma underwent a CT scan of the thorax. These 31 patients with 40 chest tubes constituted the basis for the present analysis. Results: In chest radiography in the supine position there were no chest tube malpositions (n=40); In the CT scans 25 correct positions, 7 pseudo-malpositions, 6 intrafissural and 2 intrapulmonary malpositions were identified. Moreover 16 sufficient, 18 insufficient and 6 indifferent functions of the chest tubes were seen. Conclusion: In case of lasting clinical problems and questionable function of the chest tube, chest radiography should be supplemented by a CT scan of the thorax in order to estimate the position of the chest tube. (orig.) [de

  7. Laryngeal tube use in out-of-hospital cardiac arrest by paramedics in Norway

    Directory of Open Access Journals (Sweden)

    Sunde Geir A

    2012-12-01

    Full Text Available Abstract Background Although there are numerous supraglottic airway alternatives to endotracheal intubation, it remains unclear which airway technique is optimal for use in prehospital cardiac arrests. We evaluated the use of the laryngeal tube (LT as an airway management tool among adult out-of-hospital cardiac arrest (OHCA patients treated by our ambulance services in the Haukeland and Innlandet hospital districts. Methods Post-resuscitation forms and data concerning airway management in 347 adult OHCA victims were retrospectively assessed with regard to LT insertion success rates, ease and speed of insertion and insertion-related problems. Results A total of 402 insertions were performed on 347 OHCA patients. Overall, LT insertion was successful in 85.3% of the patients, with a 74.4% first-attempt success rate. In the minority of patients (n = 46, 13.3%, the LT insertion time exceeded 30 seconds. Insertion-related problems were recorded in 52.7% of the patients. Lack of respiratory sounds on auscultation (n = 100, 28.8%, problematic initial tube positioning (n = 85, 24.5%, air leakage (n = 61, 17.6%, vomitus/aspiration (n = 44, 12.7%, and tube dislocation (n = 17, 4.9% were the most common problems reported. Insertion difficulty was graded and documented for 95.4% of the patients, with the majority of insertions assessed as being “Easy” (62.5% or “Intermediate” (24.8%. Only 8.1% of the insertions were considered to be “Difficult”. Conclusions We found a high number of insertion related problems, indicating that supraglottic airway devices offering promising results in manikin studies may be less reliable in real-life resuscitations. Still, we consider the laryngeal tube to be an important alternative for airway management in prehospital cardiac arrest victims.

  8. Pediatric cuffed endotracheal tubes

    Directory of Open Access Journals (Sweden)

    Neerja Bhardwaj

    2013-01-01

    Full Text Available Endotracheal intubation in children is usually performed utilizing uncuffed endotracheal tubes for conduct of anesthesia as well as for prolonged ventilation in critical care units. However, uncuffed tubes may require multiple changes to avoid excessive air leak, with subsequent environmental pollution making the technique uneconomical. In addition, monitoring of ventilatory parameters, exhaled volumes, and end-expiratory gases may be unreliable. All these problems can be avoided by use of cuffed endotracheal tubes. Besides, cuffed endotracheal tubes may be of advantage in special situations like laparoscopic surgery and in surgical conditions at risk of aspiration. Magnetic resonance imaging (MRI scans in children have found the narrowest portion of larynx at rima glottides. Cuffed endotracheal tubes, therefore, will form a complete seal with low cuff pressure of <15 cm H 2 O without any increase in airway complications. Till recently, the use of cuffed endotracheal tubes was limited by variations in the tube design marketed by different manufacturers. The introduction of a new cuffed endotracheal tube in the market with improved tracheal sealing characteristics may encourage increased safe use of these tubes in clinical practice. A literature search using search words "cuffed endotracheal tube" and "children" from 1980 to January 2012 in PUBMED was conducted. Based on the search, the advantages and potential benefits of cuffed ETT are reviewed in this article.

  9. Establishing Decision Trees for Predicting Successful Postpyloric Nasoenteric Tube Placement in Critically Ill Patients.

    Science.gov (United States)

    Chen, Weisheng; Sun, Cheng; Wei, Ru; Zhang, Yanlin; Ye, Heng; Chi, Ruibin; Zhang, Yichen; Hu, Bei; Lv, Bo; Chen, Lifang; Zhang, Xiunong; Lan, Huilan; Chen, Chunbo

    2018-01-01

    Despite the use of prokinetic agents, the overall success rate for postpyloric placement via a self-propelled spiral nasoenteric tube is quite low. This retrospective study was conducted in the intensive care units of 11 university hospitals from 2006 to 2016 among adult patients who underwent self-propelled spiral nasoenteric tube insertion. Success was defined as postpyloric nasoenteric tube placement confirmed by abdominal x-ray scan 24 hours after tube insertion. Chi-square automatic interaction detection (CHAID), simple classification and regression trees (SimpleCart), and J48 methodologies were used to develop decision tree models, and multiple logistic regression (LR) methodology was used to develop an LR model for predicting successful postpyloric nasoenteric tube placement. The area under the receiver operating characteristic curve (AUC) was used to evaluate the performance of these models. Successful postpyloric nasoenteric tube placement was confirmed in 427 of 939 patients enrolled. For predicting successful postpyloric nasoenteric tube placement, the performance of the 3 decision trees was similar in terms of the AUCs: 0.715 for the CHAID model, 0.682 for the SimpleCart model, and 0.671 for the J48 model. The AUC of the LR model was 0.729, which outperformed the J48 model. Both the CHAID and LR models achieved an acceptable discrimination for predicting successful postpyloric nasoenteric tube placement and were useful for intensivists in the setting of self-propelled spiral nasoenteric tube insertion. © 2016 American Society for Parenteral and Enteral Nutrition.

  10. Tracheostomy: from insertion to decannulation

    Science.gov (United States)

    Engels, Paul T.; Bagshaw, Sean M.; Meier, Michael; Brindley, Peter G.

    2009-01-01

    Tracheostomy is a common surgical procedure, and is increasingly performed in the intensive care unit (ICU) as opposed to the operating room. Procedural knowledge is essential and is therefore outlined in this review. We also review several high-quality studies comparing percutaneous dilational tracheostomy and open surgical tracheostomy. The percutaneous method has a comparable, if not superior, safety profile and lower cost compared with the open surgical approach; therefore the percutaneous method is increasingly chosen. Studies comparing early versus late tracheostomy suggest morbidity benefits that include less nosocomial pneumonia, shorter mechanical ventilation and shorter stay in the ICU. However, we discuss the questions that remain regarding the optimal timing of tracheostomy. We outline the potential acute and chronic complications of tracheostomy and their management, and we review the different tracheostomy tubes, their indications and when to remove them. PMID:19865580

  11. Leucine pulses enhance skeletal muscle protein synthesis during continuous feeding in neonatal pigs

    Science.gov (United States)

    Infants unable to maintain oral feeding can be nourished by orogastric tube. We have shown that orogastric continuous feeding restricts muscle protein synthesis compared with intermittent bolus feeding in neonatal pigs. To determine whether leucine leu infusion can be used to enhance protein synthes...

  12. Attitudes of Health Care Professionals Towards Gastrostomy Feeding in Older Adults in Malaysia

    Directory of Open Access Journals (Sweden)

    Mohamad Hasif Jaafar

    2015-03-01

    Conclusion: This survey indicated that most HCPs involved in the care of geriatric patients would advocate PEG feeding. Important factors inhibiting the use of PEG tube feeding in Malaysia were identified. Future studies should explore the barriers to acceptance in order to identify potential solutions to improving PEG feeding use in Malaysia.

  13. Process and device for detecting and localizing leaks in a tube bundle heat exchanger when it is stopped

    International Nuclear Information System (INIS)

    Germain, J.L.; Jeanneteau, E.; Loisy, F.

    1986-01-01

    The device can be used to detect the tubes presenting leaks in a tube bundle exchanger of a light water reactor. This device comprises a feeding point to fill the secondary part of the exchanger, in which the tubes are immersed, with a pressure mixture of vector gas (air) and helium. It has also a feeding point to establish in the tube a sweeping air flow. An analysis apparatus, such as a spectrograph, measures the helium content of air at the outlet of each tube [fr

  14. Lunar Lava Tube Sensing

    Science.gov (United States)

    York, Cheryl Lynn; Walden, Bryce; Billings, Thomas L.; Reeder, P. Douglas

    1992-01-01

    Large (greater than 300 m diameter) lava tube caverns appear to exist on the Moon and could provide substantial safety and cost benefits for lunar bases. Over 40 m of basalt and regolith constitute the lava tube roof and would protect both construction and operations. Constant temperatures of -20 C reduce thermal stress on structures and machines. Base designs need not incorporate heavy shielding, so lightweight materials can be used and construction can be expedited. Identification and characterization of lava tube caverns can be incorporated into current precursor lunar mission plans. Some searches can even be done from Earth. Specific recommendations for lunar lava tube search and exploration are (1) an Earth-based radar interferometer, (2) an Earth-penetrating radar (EPR) orbiter, (3) kinetic penetrators for lunar lava tube confirmation, (4) a 'Moon Bat' hovering rocket vehicle, and (5) the use of other proposed landers and orbiters to help find lunar lava tubes.

  15. Categorising YouTube

    DEFF Research Database (Denmark)

    Simonsen, Thomas Mosebo

    2011-01-01

    This article provides a genre analytical approach to creating a typology of the User Generated Content (UGC) of YouTube. The article investigates the construction of navigation processes on the YouTube website. It suggests a pragmatic genre approach that is expanded through a focus on YouTube......’s technological affordances. Through an analysis of the different pragmatic contexts of YouTube, it is argued that a taxonomic understanding of YouTube must be analysed in regards to the vacillation of a user-driven bottom-up folksonomy and a hierarchical browsing system that emphasises a culture of competition...... and which favours the already popular content of YouTube. With this taxonomic approach, the UGC videos are registered and analysed in terms of empirically based observations. The article identifies various UGC categories and their principal characteristics. Furthermore, general tendencies of the UGC within...

  16. Steam generator tube performance

    International Nuclear Information System (INIS)

    Tatone, O.S.; Pathania, R.S.

    1983-08-01

    A review of the performance of steam generator tubes in 110 water-cooled nuclear power reactors showed that tubes were plugged at 46 (42 percent) of the reactors. The number of tubes removed from service increased from 1900 (0.14 percent) in 1980 to 4692 (0.30 percent) in 1981. The leading causes of tube failures were stress corrosion cracking from the primary side, stress corrosion cracking (or intergranular attack) from the secondary side and pitting corrosion. The lowest incidence of corrosion-induced defects from the secondary side occurred in reactors that used all-volatile treatment since start-up. At one reactor a large number of degraded tubes were repaired by sleeving which is expected to become an important method of tube repair in the future

  17. Sequential cooling insert for turbine stator vane

    Science.gov (United States)

    Jones, Russel B

    2017-04-04

    A sequential flow cooling insert for a turbine stator vane of a small gas turbine engine, where the impingement cooling insert is formed as a single piece from a metal additive manufacturing process such as 3D metal printing, and where the insert includes a plurality of rows of radial extending impingement cooling air holes alternating with rows of radial extending return air holes on a pressure side wall, and where the insert includes a plurality of rows of chordwise extending second impingement cooling air holes on a suction side wall. The insert includes alternating rows of radial extending cooling air supply channels and return air channels that form a series of impingement cooling on the pressure side followed by the suction side of the insert.

  18. Development of fabrication technology for copper canisters with cast inserts. Status report in August 2001

    International Nuclear Information System (INIS)

    Andersson, Claes-Goeran

    2002-04-01

    This report contains an account of the results of trial fabrication of copper canisters with cast inserts carried out during the period 1998 - 2001. The work of testing of fabrication methods is being focused on a copper thickness of 50 mm. Occasional canisters with 30 mm copper thickness are being fabricated for the purpose of gaining experience and evaluating fabrication and inspection methods for such canisters. For the fabrication of copper tubes, SKB has concentrated its efforts on seamless tubes made by extrusion and pierce and draw processing. Five tubes have been extruded and two have been pierced and drawn during the period. Materials testing has shown that the resultant structure and mechanical properties of these tubes are good. Despite certain problems with dimensional accuracy, it can be concluded that both of these methods can be developed for use in the serial production of SKB' copper tubes. No new trial fabrication with roll forming of copper plate and longitudinal welding has been done. This method is nevertheless regarded as a potential alternative. Copper lids and bottoms are made by forging of continuous-cast bars. The forged blanks are machined to the desired dimensions. Due to the Canister Laboratory's need for lids to develop the technique for sealing welding, a relatively large number of forged blanks have been fabricated. It is noted in the report that the grain size obtained in lids and bottoms is much coarser than in fabricated copper tubes. Development work has been commenced for the purpose of optimizing the forging process. Nine cast inserts have been cast during the three-year period. The results of completed material testing of test pieces taken at different places along the length of the inserts have in several cases shown an unacceptable range of variation in strength properties and structure. In the continued work, insert fabrication will be developed in terms of both casting technique and iron composition. Development work on

  19. Rectangular drift tube characteristics

    International Nuclear Information System (INIS)

    Denisov, D.S.; Musienko, Yu.V.

    1985-01-01

    Results on the study of the characteristics of a 50 x 100 mm aluminium drift tube are presented. The tube was filled with argon-methane and argon-isobutane mixtures. With 16 per cent methane concentration the largest deviation from a linear relation between the drift time and the drift path over 50 mm is less than 2 mm. The tube filled with argon-isobutane mixture is capable of operating in a limited streamer mode

  20. Insertion devices at the advanced photon source

    International Nuclear Information System (INIS)

    Moog, E.R.

    1996-01-01

    The insertion devices being installed at the Advanced Photon Source cause the stored particle beam to wiggle, emitting x-rays with each wiggle. These x-rays combine to make an intense beam of radiation. Both wiggler and undulator types of insertion devices are being installed; the characteristics of the radiation produced by these two types of insertion devices are discussed, along with the reasons for those characteristics

  1. Node insertion in Coalescence Fractal Interpolation Function

    International Nuclear Information System (INIS)

    Prasad, Srijanani Anurag

    2013-01-01

    The Iterated Function System (IFS) used in the construction of Coalescence Hidden-variable Fractal Interpolation Function (CHFIF) depends on the interpolation data. The insertion of a new point in a given set of interpolation data is called the problem of node insertion. In this paper, the effect of insertion of new point on the related IFS and the Coalescence Fractal Interpolation Function is studied. Smoothness and Fractal Dimension of a CHFIF obtained with a node are also discussed

  2. Categorising YouTube

    OpenAIRE

    Simonsen, Thomas Mosebo

    2011-01-01

    This article provides a genre analytical approach to creating a typology of the User Generated Content (UGC) of YouTube. The article investigates the construction of navigation processes on the YouTube website. It suggests a pragmatic genre approach that is expanded through a focus on YouTube’s technological affordances. Through an analysis of the different pragmatic contexts of YouTube, it is argued that a taxonomic understanding of YouTube must be analysed in regards to the vacillation of a...

  3. Pressure tube reactor

    International Nuclear Information System (INIS)

    Susuki, Akira; Murata, Shigeto; Minato, Akihiko.

    1993-01-01

    In a pressure tube reactor, a reactor core is constituted by arranging more than two units of a minimum unit combination of a moderator sealing pipe containing a calandria tube having moderators there between and a calandria tube and moderators. The upper header and a lower header of the calandria tank containing moderators are communicated by way of the moderator sealing tube. Further, a gravitationally dropping mechanism is disposed for injecting neutron absorbing liquid to a calandria gas injection portion. A ratio between a moderator volume and a fuel volume is defined as a function of the inner diameter of the moderator sealing tube, the outer diameter of the calandria tube and the diameter of fuel pellets, and has no influence to intervals of a pressure tube lattice. The interval of the pressure tube lattice is enlarged without increasing the size of the pressure tube, to improve production efficiency of the reactor and set a coolant void coefficient more negative, thereby enabling to improve self controllability and safety. Further, the reactor scram can be conducted by injecting neutron absorbing liquid. (N.H.)

  4. Heated Tube Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Heated Tube Facility at NASA GRC investigates cooling issues by simulating conditions characteristic of rocket engine thrust chambers and high speed airbreathing...

  5. Steam generator tube performance

    International Nuclear Information System (INIS)

    Tatone, O.S.; Pathania, R.S.

    1984-10-01

    A review of the performance of steam generator tubes in 116 water-cooled nuclear power reactors showed that tubes were plugged at 54 (46 percent) of the reactors. The number of tubes removed from service decreased from 4 692 (0.30 percent) in 1981 to 3 222 (0.20 percent) in 1982. The leading causes of tube failures were stress corrosion cracking from the primary side, stress corrosion cracking (or intergranular attack) from the secondary side and pitting corrosion. The lowest incidence of corrosion-induced defects from the secondary side occurred in reactors that have used only volatile treatment, with or without condensate demineralization

  6. Steam generator tube performance

    International Nuclear Information System (INIS)

    Tatone, O.S.; Tapping, R.L.; Stipan, L.

    1992-03-01

    A survey of steam generator operating experience for 1986 has been carried out for 184 pressurized water and pressurized heavy-water reactors, and 1 water-cooled, graphite-moderated reactor. Tubes were plugged at 75 of the reactors (40.5%). In 1986, 3737 tubes were plugged (0.14% of those in service) and 3148 tubes were repaired by sleeving. A small number of reactors accounted for the bulk of the plugged tubes, a phenomenon consistent with previous years. For 1986, the available tubesheet sludge data for 38 reactors has been compiled into tabular form, and sludge/deposit data will be incorporated into all future surveys

  7. Antroduodenal motility in neurologically handicapped children with feeding intolerance

    Directory of Open Access Journals (Sweden)

    Werlin Steven L

    2004-09-01

    Full Text Available Abstract Background Dysphagia and feeding intolerance are common in neurologically handicapped children. The aim is to determine the etiologies of feeding intolerance in neurologically handicapped children who are intolerant of tube feedings. Methods Eighteen neurologically handicapped children, followed in the Tube Feeding Clinic at the Children's Hospital of Wisconsin who were intolerant of gastrostomy feedings. The charts of these 18 patients were reviewed. Past medical history, diagnoses, history of fundoplication and results of various tests of gastrointestinal function including barium contrast radiography, endoscopy and antroduodenal manometry were documented. Results Five of 11 children had abnormal barium upper gastrointestinal series. Seven of 14 had abnormal liquid phase gastric emptying tests. Two of 16 had esophagitis on endoscopy. All 18 children had abnormal antroduodenal motility. Conclusions In neurologically handicapped children foregut dysmotility may be more common than is generally recognized and can explain many of the upper gastrointestinal symptoms in neurologically handicapped children.

  8. Insertion material for controlling reactivity

    International Nuclear Information System (INIS)

    Baba, Iwao.

    1994-01-01

    Moderators and a group of suspended materials having substantially the same density as the moderator are sealed in a hollow rod vertically inserted to a fuel assembly. Specifically, the group of suspended materials is adapted to have a density changing stepwise from density of the moderator at the exit temperature of the reactor core to that at the inlet temperature of the reactor core. Reactivity is selectively controlled for a portion of high power and a portion of high reactivity by utilizing the density of the moderator and the distribution of the density. That is, if the power distribution is flat, the density of the moderators changes at a constant rate over the vertical direction of the reactor core and the suspended materials stay at a portion of the same density, to form a uniform distribution. Further, upon reactor shutdown, since the liquid temperature of the moderators is lowered and the density is increased, all of beads are collected at the upper portion to remove water at the upper portion of the reactor core of low burnup degree thereby selectively controlling the reactivity at a portion of high power and a portion of high reactivity. (N.H.)

  9. [Rare problem with the insertion of a Supreme™ laryngeal mask airway device. Case of the trimester].

    Science.gov (United States)

    2014-03-01

    A breast tumor was resected under general anesthesia. After induction, the airway was managed with a Supreme™ laryngeal mask airway device. The insertion of the laryngeal mask airway device, the insertion of the orogastric tube through the drain tube, as well as the mechanical ventilation, were very difficult from the beginning. On removing the laryngeal mask airway device to solve the problem, it was observed that the drain tube was broken, and the orogastric tube had passed into the anterior, laryngeal part of the device through the split. It was later found out that the laryngeal mask airway device, as well as the whole manufacturing batch, had suffered a design modification: the cuff was constructed with a softer material without reinforcement in the tip, and the drain tube had a heat-sealing defect that facilitated the break. The incident was reported to the local supplier and the manufacturer, and the defective batch of laryngeal mask airway devices was recalled. The incident was also reported to other hospitals via SENSAR, to warn other users of the potential dangers of the design modification in the Supreme™ laryngeal mask airway. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  10. Feeding Your Baby

    Medline Plus

    Full Text Available ... care Is it safe? Labor & birth Postpartum care Baby Caring for your baby Feeding your baby Family ... community Home > Baby > Feeding your baby Feeding your baby E-mail to a friend Please fill in ...

  11. Feeding Your Baby

    Medline Plus

    Full Text Available ... our online community Home > Baby > Feeding your baby Feeding your baby E-mail to a friend Please ... been added to your dashboard . Time to eat! Feeding your baby helps her grow healthy and strong. ...

  12. Breastfeeding vs. Formula Feeding

    Science.gov (United States)

    ... for Educators Search English Español Breastfeeding vs. Formula Feeding KidsHealth / For Parents / Breastfeeding vs. Formula Feeding What's ... work with a lactation specialist. All About Formula Feeding Commercially prepared infant formulas are a nutritious alternative ...

  13. Animal Feeding Operations

    Science.gov (United States)

    ... type=”submit” value=”Submit” /> Healthy Water Home Animal Feeding Operations Recommend on Facebook Tweet Share Compartir ... of Concentrated Animal Feeding Operations (CAFOs) What are Animal Feeding Operations (AFOs)? According to the United States ...

  14. Steam generator tube failures

    International Nuclear Information System (INIS)

    MacDonald, P.E.; Shah, V.N.; Ward, L.W.; Ellison, P.G.

    1996-04-01

    A review and summary of the available information on steam generator tubing failures and the impact of these failures on plant safety is presented. The following topics are covered: pressurized water reactor (PWR), Canadian deuterium uranium (CANDU) reactor, and Russian water moderated, water cooled energy reactor (VVER) steam generator degradation, PWR steam generator tube ruptures, the thermal-hydraulic response of a PWR plant with a faulted steam generator, the risk significance of steam generator tube rupture accidents, tubing inspection requirements and fitness-for-service criteria in various countries, and defect detection reliability and sizing accuracy. A significant number of steam generator tubes are defective and are removed from service or repaired each year. This wide spread damage has been caused by many diverse degradation mechanisms, some of which are difficult to detect and predict. In addition, spontaneous tube ruptures have occurred at the rate of about one every 2 years over the last 20 years, and incipient tube ruptures (tube failures usually identified with leak detection monitors just before rupture) have been occurring at the rate of about one per year. These ruptures have caused complex plant transients which have not always been easy for the reactor operators to control. Our analysis shows that if more than 15 tubes rupture during a main steam line break, the system response could lead to core melting. Although spontaneous and induced steam generator tube ruptures are small contributors to the total core damage frequency calculated in probabilistic risk assessments, they are risk significant because the radionuclides are likely to bypass the reactor containment building. The frequency of steam generator tube ruptures can be significantly reduced through appropriate and timely inspections and repairs or removal from service

  15. Cotton transformation via pollen tube pathway.

    Science.gov (United States)

    Wang, Min; Zhang, Baohong; Wang, Qinglian

    2013-01-01

    Although many gene transfer methods have been employed for successfully obtaining transgenic cotton, the major constraint in cotton improvement is the limitation of genotype because the majority of transgenic methods require plant regeneration from a single transformed cell which is limited by cotton tissue culture. Comparing with other plant species, it is difficult to induce plant regeneration from cotton; currently, only a limited number of cotton cultivars can be cultured for obtaining regenerated plants. Thus, development of a simple and genotype-independent genetic transformation method is particularly important for cotton community. In this chapter, we present a simple, cost-efficient, and genotype-independent cotton transformation method-pollen tube pathway-mediated transformation. This method uses pollen tube pathway to deliver transgene into cotton embryo sacs and then insert foreign genes into cotton genome. There are three major steps for pollen tube pathway-mediated genetic transformation, which include injection of -foreign genes into pollen tube, integration of foreign genes into plant genome, and selection of transgenic plants.

  16. Avaliação da estimulação sensório-motora-oral na transição da alimentação enteral para a via oral plena em recém-nascidos pré-termo Evaluation of sensory-motor-oral stimulation in the transition from gastric tube to full oral feeding in preterm newborns

    Directory of Open Access Journals (Sweden)

    Magda Aline Bauer

    2009-12-01

    Full Text Available OBJETIVOS: avaliar a influência da estimulação sensório-motora-oral (SMO sobre o ganho de peso, tempo para realizar a transição da sonda para a via oral e, indiretamente, sobre a alta hospitalar de pré-termos. MÉTODOS: estudo de intervenção, do tipo ensaio clínico controlado, que incluiu 24 pré-termos, internados na UTI Neonatal do Hospital Universitário de Santa Maria, Rio Grande do Sul, Brasil, entre maio de 2007 e março de 2008, alocados, por sorteio, em grupo estimulado (GE e controle (GC. A análise das diferenças entre os grupos foi testada utilizando o teste t-Student independente e exato de Fisher (valor de pOBJECTIVES: to evaluate the influence of sensory-motor-oral (SMO stimulation on weight gain, the time taken to make the transition from tube-to oral feeding and, indirectly, on the duration of hospitalization of preterm infants. METHODS: a controlled clinical intervention study was carried out with 24 preterm infants hospitalized in the Neonatal ICU of the Santa Maria University Hospital in the State of Rio Grande do Sul, Brazil, between May 2007 and March 2008, divided randomly into a treatment (TG and control group (CG. The analysis of the differences between the groups was tested using Student's independent t-test and Fisher's exact test (with a p value <0.05. RESULTS: there was no statistical difference in terms of anthropometrical measurements, although the daily weight gain was higher in the TG (p=0.16. The TG group made a full transition from tube-to oral feeding on average 1.6 days earlier than the CG, 83.3% of the children in the TG making the transition within seven days, compared to only 38.9% of the control group. There was no difference in terms of the length of stay in hospital between the two groups (p=0.48. CONCLUSIONS: SMO stimulation was likely to lead to a swifter transition from tube-to oral feeding, without any adverse effect on weight gain in preterm newborns. No influence on the length of stay in

  17. Abdominal Plain Film Before Gastrostomy Tube Placement to Predict Success of Percutaneous Endoscopic Procedure

    NARCIS (Netherlands)

    Pruijsen, J. M.; de Bruin, A.; Sekema, G.; Koetse, H. A.; van Rheenen, P. F.

    Objectives: Percutaneous endoscopic gastrostomy (PEG) tube feeding is a convenient method for children requiring long-term enteral nutrition. Preoperative fitness of the majority of pediatric PEG candidates is graded as American Society of Anesthesiologists physical status >= III, indicating

  18. Feeding outcomes in infants after supraglottoplasty.

    Science.gov (United States)

    Eustaquio, Marcia; Lee, Erika Nevin; Digoy, G Paul

    2011-11-01

    Review the impact of bilateral supraglottoplasty on feeding and compare the risk of postoperative feeding difficulties between infants with and without additional comorbidities. Case series with chart review. Children's hospital. The medical records of all patients between birth and 12 months of age treated for laryngomalacia with bilateral supraglottoplasty by a single surgeon (GPD) between December 2005 and September 2009 and followed for a minimum of 1 month were reviewed. Infants with significant comorbidities were evaluated separately. Nutritional intake before and after surgery, as well as speech and language pathology reports, was reviewed to qualify any feeding difficulties. Age at the time of surgery, additional surgical interventions, medical comorbidities, and length of follow-up were also noted during chart review. Of 81 infants who underwent bilateral supraglottoplasty, 75 were eligible for this review. In the cohort of infants without comorbidities, 46 of 48 (96%) had no change or an improvement in their oral intake after surgery. Of the 2 patients with initial worsening of feeding, all resumed oral intake within 2 months. In the group of patients with additional medical comorbidities, 22% required further interventions such as nasogastric tube, dietary modification, or gastrostomy tube placement. Supraglottoplasty in infants has a low incidence of persistent postoperative dysphagia. Infants with additional comorbidities are at a higher risk of feeding difficulty than otherwise healthy infants.

  19. Method for shaping polyethylene tubing

    Science.gov (United States)

    Kramer, R. C.

    1981-01-01

    Method forms polyethylene plastic tubing into configurations previously only possible with metal tubing. By using polyethylene in place of copper or stain less steel tubing inlow pressure systems, fabrication costs are significantly reduced. Polyethylene tubing can be used whenever low pressure tubing is needed in oil operations, aircraft and space applications, powerplants, and testing laboratories.

  20. Pyrotechnic Tubing Connector

    Science.gov (United States)

    Graves, Thomas J.; Yang, Robert A.

    1988-01-01

    Tool forms mechanical seal at joint without levers or hydraulic apparatus. Proposed tool intended for use in outer space used on Earth by heavily garbed workers to join tubing in difficult environments. Called Pyrotool, used with Lokring (or equivalent) fittings. Piston slides in cylinder when pushed by gas from detonating pyrotechnic charge. Impulse of piston compresses fittings, sealing around butting ends of tubes.

  1. Numerical simulation of fluid flow and heat transfer in a concentric tube heat exchanger

    International Nuclear Information System (INIS)

    Mokamati, S.V.; Prasad, R.C.

    2003-01-01

    In this paper, numerical simulation of a concentric tube heat exchanger is presented to determine the convective heat transfer coefficient and friction factor in a smooth tube. Increasing the convective heat transfer coefficient can increase heat transfer rate in a concentric tube heat exchanger from a given tubular surface area. This can be achieved by using heat transfer augmentation devices. This work constitutes the initial phase of the numerical simulation of heat transfer from tubes employing augmentation devices, such as twisted tapes, wire-coil inserts, for heat transfer enhancement. A computational fluid dynamics (CFD) simulation tool was developed with CFX software and the results obtained from the simulations are validated with the empirical correlations for a smooth tube heat exchanger. The difficulties associated with the simulation of a heat exchanger augmented with wire-coil inserts are discussed. (author)

  2. Molybdenum Tube Characterization report

    Energy Technology Data Exchange (ETDEWEB)

    Beaux II, Miles Frank [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Usov, Igor Olegovich [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-02-07

    Chemical vapor deposition (CVD) techniques have been utilized to produce free-standing molybdenum tubes with the end goal of nuclear fuel clad applications. In order to produce tubes with properties desirable for this application, deposition rates were lowered requiring long deposition durations on the order of 50 hours. Standard CVD methods as well as fluidized-bed CVD (FBCVD) methods were applied towards these objectives. Characterization of the tubes produced in this manner revealed material suitable for fuel clad applications, but lacking necessary uniformity across the length of the tubes. The production of freestanding Mo tubes that possess the desired properties across their entire length represents an engineering challenge that can be overcome in a next iteration of the deposition system.

  3. Measurement and computation for sag of calandria tube due to irradiation creep in PHWR

    International Nuclear Information System (INIS)

    Son, S. M.; Lee, W. R.; Lee, S. K.; Lee, J. S.; Kim, T. R.; Na, B. K.; Namgung I.

    2003-01-01

    Calandria tubes and Liquid Injection Shutdown System(LISS) tubes in a Pressurized Heavy Water Reactor(PHWR) are to sag due to irradiation creep and growth during plant operation. When the sag of calandria tube becomes bigger, the calandria tube possibly comes in contact with LISS tube crossing beneath the calandria tube. The contact subsequently may cause the damage on the calandria tube resulting in unpredicted outage of the plant. It is therefore necessary to check the gap between the two tubes in order to periodically confirm no contact by using a proper measure during the plant life. An ultrasonic gap measuring probe assembly which can be inserted into two viewing ports of the calandria was developed in Korea and utilized to measure the sags of both tubes in the PHWR. It was found that the centerlines of calandria tubes and liquid injection shutdown system tubes can be precisely detected by ultrasonic wave. The gaps between two tubes were easily obtained from the relative distance of the measured centerline elevations of the tubes. Based on the irradiation creep equation and the measurement data, a computer program to calculate the sags was also developed. With the computer program, the sag at the end of plant life was predicted

  4. Experiments on vibration of heat exchanger tube arrays in cross flow

    International Nuclear Information System (INIS)

    Blevins, R.D.; Gibert, R.J.; Villard, B.

    1981-08-01

    A series of tests have been made at the Commissariat a l'Energie Atomique, in cooperation with General Atomic Company, SAN DIEGO (U.S.A.) on the flow-induced vibration of heat exchanger tube bundles in cross flow. These tests were made in air on tube bundles which simulated heat exchangers in the high temperature gas cooled reactors. The tests were of two types. In the first type, an instrumented tube was inserted at various locations into a tube bundle. Measurements were made of pressure at a number of points along the tube and about the circumference of the tube. These measurements were processed to obtain the spectra of turbulent pressure fluctuations on the tube, the spanwise correlation and the lift force. The second set of tests was made on tube bundles with flexible tubes. As the flow velocity was increased, these tests clearly show an instability. Nine tube configurations were tested with both plastic and metallic tubes and the effect of tube-to-tube difference in natural frequency was investigated

  5. A Comparative study of early postpartum IUCD insertion to interval IUCD insertion at Tertiary Care Centre

    OpenAIRE

    Roopal, Dr.; Bisht, Vandana

    2018-01-01

    Background: A Comparative study of early postpartum IUCD insertion to interval IUCD insertion at Tertiary Care Centre.Methods: This prospective study was conducted among 100 women at tertiary care centre, Haldwani, Nainital. Patients were divided in to two groups. Group A (n=50)-post placental insertion within 10 minutes of delivery of placenta. Group B (n=50)-Interval insertion after 6 weeks of delivery. Both groups were compared in terms of pain abdomen, bleeding, missing thread, expulsion,...

  6. Metallographic study of reconstitution welding in inserts of 1 cm{sup 3}; Estudio metalografico de soldaduras de reconstitucion en insertos de 1 cm{sup 3}

    Energy Technology Data Exchange (ETDEWEB)

    Romero C, J.; Garcia R, R.; Fernandez T, F.; Perez R, N.; Rocamontes A, M. [ININ, 52750 La Marquesa, Estado de Mexico (Mexico)

    2007-07-01

    In this article, the welding metallographic study carried out in Charpy test tubes reconstituted with notch in 'V', used in the surveillance programs of the vessel in nucleo electric plants is described. Inserts of 1 cm{sup 3} are used, where the inserts are usually rectangular of minimum 18 millimeters of length. The importance of using inserts of 1 cm{sup 3} is that the mechanical properties can be measured in another direction of the vessel steel, when changing the direction or sense of the notch in 'V' or the face where this notch is made in the insert. (Author)

  7. Laser Myringotomy Versus Ventilation Tubes In Otitis Media With Effusion.

    Science.gov (United States)

    Yousaf, Mohammad; Malik, Suhail Ahmad; Haroon, Tahir

    2016-01-01

    Otitis media with effusion (OME) is a leading cause of difficulty in hearing in paediatric population. Otitis media with effusion must be detected and managed early to prevent conductive hearing loss in children. It was aimed to compare results of laser myringotomy and ventilation tube insertion, in terms of hearing improvement and recurrence of Middle ear effusion (MEE). This randomized controlled trial was conducted from February 2012 to January 2015. Children of 4- 12 years of age with decreased hearing due to OME were included in the study. These children were investigated with pure tone audiometry (PTA) and tympanometry to confirm conductive hearing loss. Patients were put in 2 groups, group one comprised of patients treated with laser myringotomy and group 2, treated with ventilation tube insertion. The objective was to evaluate and compare results of the two procedures in terms of resolution of middle ear effusion (MEE) and improvement of hearing. The two procedures were also compared in terms of complications like otorrhea, persistence of perforation, hypertrophic scar and thinning of tympanic membrane (TM). Middle ear effusion cleared in 35 out of 68 ears with laser myringotomy (LM) as compared to 52 out of 62 ears with ventilation tubes (VT). The myringotomy was still patent in 21 ears treated with LM while tube was in site in 50 years with VT after 3 months. The hearing level improved with LM by 10-15 dB after first 3 months. The aim in Otitis media with effusion is ventilation of tympanic cavity. Laser myringotomy can be substitute to ventilation tube insertion (VT). But it remains patent for shorter time and less effective than VT. The ears with refractory or recurrent MEE should have VT insertion.

  8. A Note regarding Problems with Interaction and Varying Block Sizes in a Comparison of Endotracheal Tubes

    Directory of Open Access Journals (Sweden)

    Richard L. Einsporn

    2014-01-01

    Full Text Available A randomized clinical experiment to compare two types of endotracheal tubes utilized a block design where each of the six participating anesthesiologists performed tube insertions for an equal number of patients for each type of tube. Five anesthesiologists intubated at least three patients with each tube type, but one anesthesiologist intubated only one patient per tube type. Overall, one type of tube outperformed the other on all three effectiveness measures. However, analysis of the data using an interaction model gave conflicting and misleading results, making the tube with the better performance appear to perform worse. This surprising result was caused by the undue influence of the data for the anesthesiologist who intubated only two patients. We therefore urge caution in interpreting results from interaction models with designs containing small blocks.

  9. Infant feeding tube as urinary tract stent | Ekeke | Port Harcourt ...

    African Journals Online (AJOL)

    Methods: Data from the hospital records of patients who required stents at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria were obtained from their case notes from May 2003 to May 2006. Information extracted from these case notes included: age and sex of patient, indications for stenting, ...

  10. Central Solenoid Insert Technical Specification

    Energy Technology Data Exchange (ETDEWEB)

    Martovetsky, Nicolai N [ORNL; Smirnov, Alexandre [ORNL

    2011-09-01

    The US ITER Project Office (USIPO) is responsible for the ITER central solenoid (CS) contribution to the ITER project. The Central Solenoid Insert (CSI) project will allow ITER validation the appropriate lengths of the conductors to be used in the full-scale CS coils under relevant conditions. The ITER Program plans to build and test a CSI to verify the performance of the CS conductor. The CSI is a one-layer solenoid with an inner diameter of 1.48 m and a height of 4.45 m between electric terminal ends. The coil weight with the terminals is approximately 820 kg without insulation. The major goal of the CSI is to measure the temperature margin of the CS under the ITER direct current (DC) operating conditions, including determining sensitivity to load cycles. Performance of the joints, ramp rate sensitivity, and stability against thermal or electromagnetic disturbances, electrical insulation, losses, and instrumentation are addressed separately and therefore are not major goals in this project. However, losses and joint performance will be tested during the CSI testing campaign. The USIPO will build the CSI that will be tested at the Central Solenoid Model Coil (CSMC) Test Facility at the Japan Atomic Energy Agency (JAEA), Naka, Japan. The industrial vendors (the Suppliers) will report to the USIPO (the Company). All approvals to proceed will be issued by the Company, which in some cases, as specified in this document, will also require the approval of the ITER Organization. Responsibilities and obligations will be covered by respective contracts between the USIPO, called Company interchangeably, and the industrial Prime Contractors, called Suppliers. Different stages of work may be performed by more than one Prime Contractor, as described in this specification. Technical requirements of the contract between the Company and the Prime Contractor will be covered by the Fabrication Specifications developed by the Prime Contractor based on this document and approved by

  11. INFLUENCE OF THE TYPE OF INSERTS ON DIMENSIONAL ACCURACY IN TURNING PROCESS

    Directory of Open Access Journals (Sweden)

    Pavel POLÁK

    2015-07-01

    Full Text Available This article is aimed to demonstrate the effect of cutting material and geometry of inserts chip breaker for dimensional accuracy in turning. The experiment is aimed on measuring compliance with dimensional accuracy in turning of samples from steel 11 523 at a constant feed rate and depth of cut, with varying spindle speeds. Machining was performed by using a different types of replaceable inserts. The measurement results will be evaluated in terms of the impact of differ-ent geometry characteristics and changing speeds spindle.

  12. The computational design of junctions by carbon nanotube insertion into a graphene matrix

    International Nuclear Information System (INIS)

    Mao Yuliang; Zhong Jianxin

    2009-01-01

    Using first-principles density functional theory calculations, two types of junction models constructed from armchair and zigzag carbon nanotube (CNT) insertion into a graphene matrix have been envisioned. It has been found that the insertion of the CNT into the graphene matrix leads to the formation of C-C covalent bonds between graphene and the CNT that distort the CNT geometry. However, the hydrogenation of the suspended carbon bonds on the graphene resumes the graphene-like structure of the pristine tube. The calculated band structure of armchair CNT insertion into graphene or hydrogenation graphene opens up a band gap and converts the metallic CNT into a semiconductor. For the zigzag CNT, the sp 3 hybridization between the graphene and nanotube alters the band structure of the tube significantly, whereas saturating the dangling bonds of terminal carbon atoms of graphene makes the CNT almost keep the same character of the bands as that in the pristine tube. The synthesis of our designed hybrid structures must be increasingly driven by an interest in molecules that not only have intriguing structures but also have special functions such as hydrogen storage.

  13. Automation in tube finishing bay

    International Nuclear Information System (INIS)

    Bhatnagar, Prateek; Satyadev, B.; Raghuraman, S.; Syama Sundara Rao, B.

    1997-01-01

    Automation concept in tube finishing bay, introduced after the final pass annealing of PHWR tubes resulted in integration of number of sub-systems in synchronisation with each other to produce final cut fuel tubes of specified length, tube finish etc. The tube finishing bay which was physically segregated into four distinct areas: 1. tube spreader and stacking area, 2. I.D. sand blasting area, 3. end conditioning, wad blowing, end capping and O.D. wet grinding area, 4. tube inspection, tube cutting and stacking area has been studied

  14. TJC: plan and prepare for the transition to new tubing connectors to minimize the risk of dangerous misconnections, clinician frustration.

    Science.gov (United States)

    2014-12-01

    To reduce the risk of dangerous tubing misconnections, the ISO is rolling out new tubing connector standards that will eventually make it nearly impossible for tubing associated with one delivery system to be connected to a delivery system that serves a different purpose. Experts welcome the change, noting that tubing misconnections that cause injury and even death have been happening for years. However, TJC has issued a Sentinel Event Alert, warning that health care organizations need to be vigilant in managing the risk posed by these misconnections during the phased-in transition to the new connectors. Experts explain that tubing misconnections occur because many different types of tubing utilize the same Leur connector, making it possible for a clinician to mistakenly connect a tube to the wrong delivery system. The most common type of tubing misconnection reported to the ISMP is when a clinician wants to administer something to a patient through a feeding tube, but accidently administers the substance through an IV tube instead. The first new connector, called the ENFit, is going to be for enteral feeding tubes. It will not connect to IV tubing, making that type of misconnection unlikely. The new connector should be available early next year. Since hospitals will continue to use older tubing until their supplies are exhausted, manufacturers will temporarily provide adapters capable of making new administration sets compatible with older tubing.

  15. Insertion profiles of 4 headless compression screws.

    Science.gov (United States)

    Hart, Adam; Harvey, Edward J; Lefebvre, Louis-Philippe; Barthelat, Francois; Rabiei, Reza; Martineau, Paul A

    2013-09-01

    In practice, the surgeon must rely on screw position (insertion depth) and tactile feedback from the screwdriver (insertion torque) to gauge compression. In this study, we identified the relationship between interfragmentary compression and these 2 factors. The Acutrak Standard, Acutrak Mini, Synthes 3.0, and Herbert-Whipple implants were tested using a polyurethane foam scaphoid model. A specialized testing jig simultaneously measured compression force, insertion torque, and insertion depth at half-screw-turn intervals until failure occurred. The peak compression occurs at an insertion depth of -3.1 mm, -2.8 mm, 0.9 mm, and 1.5 mm for the Acutrak Mini, Acutrak Standard, Herbert-Whipple, and Synthes screws respectively (insertion depth is positive when the screw is proud above the bone and negative when buried). The compression and insertion torque at a depth of -2 mm were found to be 113 ± 18 N and 0.348 ± 0.052 Nm for the Acutrak Standard, 104 ± 15 N and 0.175 ± 0.008 Nm for the Acutrak Mini, 78 ± 9 N and 0.245 ± 0.006 Nm for the Herbert-Whipple, and 67 ± 2N, 0.233 ± 0.010 Nm for the Synthes headless compression screws. All 4 screws generated a sizable amount of compression (> 60 N) over a wide range of insertion depths. The compression at the commonly recommended insertion depth of -2 mm was not significantly different between screws; thus, implant selection should not be based on compression profile alone. Conically shaped screws (Acutrak) generated their peak compression when they were fully buried in the foam whereas the shanked screws (Synthes and Herbert-Whipple) reached peak compression before they were fully inserted. Because insertion torque correlated poorly with compression, surgeons should avoid using tactile judgment of torque as a proxy for compression. Knowledge of the insertion profile may improve our understanding of the implants, provide a better basis for comparing screws, and enable the surgeon to optimize compression. Copyright

  16. Tube thoracostomy in the management of pleural fluid collections.

    Science.gov (United States)

    Nwofor, A M E; Ekwunife, C N

    2006-06-01

    To determine the demographic pattern, indications and complications associated with tube thoracostomy in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi. A 5-year review of case records of patients who underwent tube thoracostomy at NAUTH Nnewi between January 1999 and December 2003. Demographic data, clinical features, duration of drainage, complications and outcomes were analyzed. A total of 65 cases were studied, male: female ratio was 2.4:1. Eighteen patients (27.7%) were below 10 years of age. Infective cases accounted for 63.1% (41) of the cases that had tube thoracostomy. Forty-one patients (63.1%) had tube drainage for 10 days or less. Complication rate was 41.5% (27), mostly mild, with dislodgement of the tube accounting for about half. Failure rate of 13.7% (9) was recorded for the procedure. A mortality of 6.2% (4) was recorded but there was no procedure related death. Seven patients (10.8%) required further surgery. Tube thoracostomy is a simple and efficacious procedure for the treatment of pleural space collections. The safety of the procedure can be improved upon by adequate training in the insertion procedure, while proper selection of cases will reduce failure rate and unnecessary morbidity. Early resort to thoracoscopic or open surgery when tube thoracostomy is considered inappropriate or has failed will improve the success rate in the overall management of pleural fluid collections.

  17. Chest tube care in critically ill patient: A comprehensive review

    Directory of Open Access Journals (Sweden)

    Hanan Mohammed Mohammed

    2015-10-01

    Full Text Available Breathing is automatic. We don’t usually think too much about it unless we develop a problem. Lack of adequate ventilation and impairment of our respiratory system can quickly become life-threatening. There are many clinical conditions that may necessitate the use of chest tubes. When there is an accumulation of positive pressure in the chest cavity (where it should normally be negative pressure between pleurae, a patient will require chest drainage. Chest tubes may be inserted to drain body fluids or to facilitate the re-expansion of a lung. It is important for the clinician to determine the most appropriate tube size to use prior to intubation. The position of the chest tube is related to the function that the chest tube performs. When managing the care of patients who have chest tubes it is important to fully understand what to do in case problems arise. It is also important to be able to assess when the chest tube is ready to be discontinued. Nurses and other healthcare professionals who are responsible for the safe delivery of care should be knowledgeable about respiratory pathophysiology, signs of respiratory compromise, and the care and management of interventions that may be utilized to ensure adequate respiration.

  18. Treatment of Snoring with a Nasopharyngeal Airway Tube

    Directory of Open Access Journals (Sweden)

    Macario Camacho

    2016-01-01

    Full Text Available Objective. To study the feasibility of a standard nasopharyngeal airway tube (NPAT as treatment for snoring. Methods. An obese 35-year-old man, who is a chronic, heroic snorer, used NPATs while (1 the patient’s bedpartner scored the snoring and (2 the patient recorded himself with the smartphone snoring app “Quit Snoring.” Baseline snoring was 8–10/10 (10 = snoring that could be heard through a closed door and interrupted the bedpartner’s sleep to the point where they would sometimes have to sleep separately and 60–200 snores/hr. Several standard NPATs were tested, consisting of soft polyvinyl chloride material raging between 24- and 36-French (Fr tubes. Results. The 24 Fr tube did not abate snoring. The 26 Fr tube was able to abate the snoring sound most of the night (smartphone app: 11.4 snores/hr, bedpartner VAS = 2/10. The 28 and 30 Fr tubes abated the snoring sound the entire time worn (smartphone app: 0 snores, bedpartner VAS 0/10 but could not be tolerated more than 2.5 hours. The tube of 36 Fr size could not be inserted, despite several attempts bilaterally. Conclusion. Appropriately sized nasopharyngeal airway tubes may abate the snoring sound; however, as in this patient, they may be too painful and intolerable for daily use.

  19. Device for the selective positioning of a component on a tube plate

    International Nuclear Information System (INIS)

    1974-01-01

    The invention relates to a device for the selective positioning of a component on a tube plate. It particularly applies to the positioning of a guide tube head successively opposite all the tubes of the tube bundle of a nuclear reactor steam generator. The large number of tubes in the tube bundle of the steam generator in a pressure water nuclear power station must be checked periodically for any likely corrosion. This check is effected with a Foucault current probe which is inserted in each tube in turn and is connected to a probe signal processing unit. The probe is placed in a flexible guide tube brought in turn in front of each tube of the bundle to be checked. The invention concerns a device to move the opening of a tube guide for a Foucault current detector over the entire surface of the tube plate, thereby providing access to all the tubes whilst limiting the interventions to a single positioning and a single withdrawal of the apparatus for testing all the bundle. Between the two interventions at the beginning and end of the operation, all displacements are remote controlled from outside the dangerous radioacive area [fr

  20. Feed water pre-heater with two steam spaces

    International Nuclear Information System (INIS)

    Tratz, H.; Kelp, F.; Netsch, E.

    1976-01-01

    A feed water pre-heater for the two stage heating of feed water by condensing steam, having a low installed height is described, which can be installed in the steam ducts of turbines of large output, as in LWRs in nuclear power stations. The inner steam space is closed on one side by the water vessel, while the tubes of the inner steam space go straight from the water vessel, and the tubes of the outer steam space are bent into a U shape and open out into the water vessel. The two-stage preheater is thus surrounded by feedwater in two ways. (UWI) [de

  1. Helically coiled tube heat exchanger

    International Nuclear Information System (INIS)

    Harris, A.M.

    1981-01-01

    In a heat exchanger such as a steam generator for a nuclear reactor, two or more bundles of helically coiled tubes are arranged in series with the tubes in each bundle integrally continuing through the tube bundles arranged in series therewith. Pitch values for the tubing in any pair of tube bundles, taken transverse to the path of the reactor coolant flow about the tubes, are selected as a ratio of two unequal integers to permit efficient operation of each tube bundle while maintaining the various tube bundles of the heat exchanger within a compact envelope. Preferably, the helix angle and tube pitch parallel to the path of coolant flow are constant for all tubes in a single bundle so that the tubes are of approximately the same length within each bundle

  2. Steam generator tube performance

    International Nuclear Information System (INIS)

    Tatone, O.S.; Pathania, R.S.

    1982-04-01

    The performance of steam generator tubes in water-cooled nuclear power reactors has been reviewed for 1980. Tube defects occurred at 38% of the 97 reactors surveyed. This is a marginal improvement over 1979 when defects occurred at 41% of the reactors. The number of failed tubes was also lower, 0.14% of the tubes in service in 1980 compared with 0.20% of those in service in 1979. Analysis of the causes of these failures indicates that stress corrosion cracking was the leading failure mechanism. Reactors that used all-volatile treatment of secondary water, with or without full-flow condensate demineralization since start-up showed the lowest incidence of corrosion-related defects

  3. X-ray tube

    International Nuclear Information System (INIS)

    Webley, R.S.

    1975-01-01

    The object of the invention described is to provide an X-ray tube providing a scanned X-ray output which does not require a scanned electron beam. This is obtained by an X-ray tube including an anode which is rotatable about an axis, and a source of a beam of energy, for example an electron beam, arranged to impinge on a surface of the anode to generate X-radiation substantially at the region of incidence on the anode surface. The anode is rotatable about the axis to move the region of incidence over the surface. The anode is so shaped that the rotation causes the region of incidence to move in a predetermined manner relative to fixed parts of the tube so that the generated X-radiation is scanned in a predetermined manner relative to the tube. (UK)

  4. Fuel assembly guide tube

    International Nuclear Information System (INIS)

    Jabsen, F.S.

    1979-01-01

    This invention is directed toward a nuclear fuel assembly guide tube arrangement which restrains spacer grid movement due to coolant flow and which offers secondary means for supporting a fuel assembly during handling and transfer operations

  5. Bull Moose Tube Company

    Science.gov (United States)

    The EPA is providing notice of a proposed Administrative Penalty Assessment against the Bull Moose Tube Company, a business located at 1819 Clarkson Road, Chesterfield, MO, 63017, for alleged violations at the facility located at 406 East Industrial Drive,

  6. Tracheostomy tube - eating

    Science.gov (United States)

    Trach - eating ... take your first bites. Certain factors may make eating or swallowing harder, such as: Changes in the ... easier to swallow. Suction the tracheostomy tube before eating. This will keep you from coughing while eating, ...

  7. Flow induced vibrations in gas tube assembly of centrifuge

    International Nuclear Information System (INIS)

    Alam, M.; Atta, M.A.; Mirza, J.A.; Khan, A.Q.

    1986-01-01

    A centrifuge essentially consists of a rotor rotating at very high speed. Gas tube assembly, located at the center of the rotor, is used to introduce feed gas into the rotor and remove product and waste streams from it. The gas tube assembly is thus a static component, the product and waste scoops of which are lying in the high pressure region of a fluid rotating at very high speed. This can cause flow induced vibrations in the gas tube assembly. Such vibrations affect not only the mechanical stability of the gas tube assembly but may also reduce the separative power of the centrifuge. In a cascade, if some of the centrifuges have gas tube vibration, then cascade performance will be affected. A theoretical analysis of the effect of waste tube vibrations on product and waste flow rates and pressures in the centrifuge is presented. A simple stage consisting of two centrifuges, in which one has tube vibration, is considered for this purpose. The results are compared with experiment. It is shown that waste tube vibration generates oscillations in waste and product flow rates that are observable outside the centrifuge. (author)

  8. Estimation of optimal nasotracheal tube depth in adult patients.

    Science.gov (United States)

    Ji, Sung-Mi

    2017-12-01

    The aim of this study was to estimate the optimal depth of nasotracheal tube placement. We enrolled 110 patients scheduled to undergo oral and maxillofacial surgery, requiring nasotracheal intubation. After intubation, the depth of tube insertion was measured. The neck circumference and distances from nares to tragus, tragus to angle of the mandible, and angle of the mandible to sternal notch were measured. To estimate optimal tube depth, correlation and regression analyses were performed using clinical and anthropometric parameters. The mean tube depth was 28.9 ± 1.3 cm in men (n = 62), and 26.6 ± 1.5 cm in women (n = 48). Tube depth significantly correlated with height (r = 0.735, P < 0.001). Distances from nares to tragus, tragus to angle of the mandible, and angle of the mandible to sternal notch correlated with depth of the endotracheal tube (r = 0.363, r = 0.362, and r = 0.546, P < 0.05). The tube depth also correlated with the sum of these distances (r = 0.646, P < 0.001). We devised the following formula for estimating tube depth: 19.856 + 0.267 × sum of the three distances (R 2 = 0.432, P < 0.001). The optimal tube depth for nasotracheally intubated adult patients correlated with height and sum of the distances from nares to tragus, tragus to angle of the mandible, and angle of the mandible to sternal notch. The proposed equation would be a useful guide to determine optimal nasotracheal tube placement.

  9. Streak tube development

    International Nuclear Information System (INIS)

    Hinrichs, C.K.; Estrella, R.M.

    1979-01-01

    A research program for the development of a high-speed, high-resolution streak image tube is described. This is one task in the development of a streak camera system with digital electronic readout, whose primary application is for diagnostics in underground nuclear testing. This program is concerned with the development of a high-resolution streak image tube compatible with x-ray input and electronic digital output. The tube must be capable of time resolution down to 100 psec and spatial resolution to provide greater than 1000 resolution elements across the cathode (much greater than presently available). Another objective is to develop the capability to make design changes in tube configurations to meet different experimental requirements. A demountable prototype streak tube was constructed, mounted on an optical bench, and placed in a vacuum system. Initial measurements of the tube resolution with an undeflected image show a resolution of 32 line pairs per millimeter over a cathode diameter of one inch, which is consistent with the predictions of the computer simulations. With the initial set of unoptmized deflection plates, the resolution pattern appeared to remain unchanged for static deflections of +- 1/2-inch, a total streak length of one inch, also consistent with the computer simulations. A passively mode-locked frequency-doubled dye laser is being developed as an ultraviolet pulsed light source to measure dynamic tube resolution during streaking. A sweep circuit to provide the deflection voltage in the prototype tube has been designed and constructed and provides a relatively linear ramp voltage with ramp durations adjustable between 10 and 1000 nsec

  10. Researching YouTube

    OpenAIRE

    Arthurs, Jane; Drakopoulou, Sophia; Gandini, Alessandro

    2018-01-01

    ‘Researching YouTube’ introduces the special issue of Convergence which arose out of an international academic conference on YouTube that was held in London at Middlesex University in September 2016. The conference aimed to generate a robust overview of YouTube’s changing character and significance after its first ten years of development by creating a productive dialogue between speakers from different disciplines and cultures, and between YouTube-specific research and wider debates in media...

  11. Tubing crimping pliers

    Science.gov (United States)

    Lindholm, G.T.

    1981-02-27

    The disclosure relates to pliers and more particularly to pliers for crimping two or more pieces of copper tubing together prior to their being permanently joined by brazing, soldering or the like. A die containing spring-loaded pins rotates within a cammed ring in the head of the pliers. As the die rotates, the pins force a crimp on tubing held within the pliers.

  12. Characterization of Friction Stir Welded Tubes by Means of Tube Bulge Test

    International Nuclear Information System (INIS)

    D'Urso, G.; Longo, M.; Giardini, C.

    2011-01-01

    Mechanical properties of friction stir welded joints are generally evaluated by means of conventional tensile test. This testing method might provide insufficient information because maximum strain obtained in tensile test before necking is small; moreover, the application of tensile test is limited when the joint path is not linear or even when the welds are executed on curved surfaces. Therefore, in some cases, it would be preferable to obtain the joints properties from other testing methods. Tube bulge test can be a valid solution for testing circumferential or longitudinal welds executed on tubular workpieces. The present work investigates the mechanical properties and the formability of friction stir welded tubes by means of tube bulge tests. The experimental campaign was performed on tubular specimens having a thickness of 3 mm and an external diameter of 40 mm, obtained starting from two semi-tubes longitudinally friction stir welded. The first step, regarding the fabrication of tubes, was performed combining a conventional forming process and friction stir welding. Sheets in Al-Mg-Si-Cu alloy AA6060 T6 were adopted for this purpose. Plates having a dimension of 225x60 mm were bent (with a bending axis parallel to the main dimension) in order to obtain semi-tubes. A particular care was devoted to the fabrication of forming devices (punch and die) in order to minimize the springback effects. Semi-tubes were then friction stir welded by means of a CNC machine tool. Some preliminary tests were carried out by varying the welding parameters, namely feed rate and rotational speed. A very simple tool having flat shoulder and cylindrical pin was used. The second step of the research was based on testing the welded tubes by means of tube bulge test. A specific equipment having axial actuators with a conical shape was adopted for this study. Some analyses were carried out on the tubes bulged up to a certain pressure level. In particular, the burst pressure and the

  13. Tube spacer grid for a heat-exchanger tube bundle

    International Nuclear Information System (INIS)

    Scheidl, H.

    1976-01-01

    A tube spacer grid for a heat-exchanger tube bundle is formed by an annular grid frame having a groove formed in its inner surface in which the interspaced grid bars have their ends positioned and held in interspaced relationship by short sections of tubes passed through holes axially formed in the grid frame so that the tubes are positioned between the ends of the grid bars in the grooves. The tube sections may be cut from the same tubes used to form the tube bundle. 5 claims, 3 drawing figures

  14. Speaking Tracheostomy Tube and Modified Mouthstick Stylus in a Ventilator-Dependent Patient with Spinal Cord Injury

    OpenAIRE

    Mitate, Eiji; Kubota, Kensuke; Ueki, Kenji; Inoue, Rumi; Inoue, Ryosuke; Momii, Kenta; Sugimori, Hiroshi; Maehara, Yoshihiko; Nakamura, Seiji

    2015-01-01

    Communication is a serious problem for patients with ventilator-dependent tetraplegia. A 73-year-old man was presented at the emergency room in cardiopulmonary arrest after falling from a height of 2 m. After successful resuscitation, fractures of the cervical spine and cervical spinal cord injury were found. Due to paralysis of the respiratory muscles, a mechanical ventilator with a tracheostomy tube was required. First, a cuffed tracheostomy tube and a speaking tracheostomy tube were insert...

  15. Insertable fluid flow passage bridgepiece and method

    Science.gov (United States)

    Jones, Daniel O.

    2000-01-01

    A fluid flow passage bridgepiece for insertion into an open-face fluid flow channel of a fluid flow plate is provided. The bridgepiece provides a sealed passage from a columnar fluid flow manifold to the flow channel, thereby preventing undesirable leakage into and out of the columnar fluid flow manifold. When deployed in the various fluid flow plates that are used in a Proton Exchange Membrane (PEM) fuel cell, bridgepieces of this invention prevent mixing of reactant gases, leakage of coolant or humidification water, and occlusion of the fluid flow channel by gasket material. The invention also provides a fluid flow plate assembly including an insertable bridgepiece, a fluid flow plate adapted for use with an insertable bridgepiece, and a method of manufacturing a fluid flow plate with an insertable fluid flow passage bridgepiece.

  16. Utility Bill Insert for Wastewater Services

    Science.gov (United States)

    Intended for use by wastewater and water supply utilities, one side of the utility bill insert has information for customers that discharge to sanitary sewer systems; the other side is for customers with septic systems.

  17. HB+ inserted into the CMS Solenoid

    CERN Multimedia

    Tejinder S. Virdee, CERN

    2006-01-01

    The first half of the barrel hadron calorimeter (HB+) has been inserted into the superconducting solenoid of CMS, in preparation for the magnet test and cosmic challenge. The operation went smoothly, lasting a couple of days.

  18. Bulkhead insert for an internal combustion engine

    Science.gov (United States)

    Maki, Clifford E.; Chottiner, Jeffrey Eliot; Williams, Rick L.; Thibault, Mark W.; Ervin, James Douglas; Boileau, James Maurice; McKeough, Bryan

    2017-08-01

    An engine includes a cylinder block defining at least one main bearing bulkhead adjacent to a cylinder, and a crankshaft rotatably housed within the block by a main bearing. A bulkhead insert has a cap portion, and an insert portion provided within the bulkhead. The insert portion has having first and second end regions connected by first and second straps. Each strap having a flanged beam cross section. The first and second ends of the insert portion are configured to connect a main bearing cap column to a cylinder head column. Each of the first and second end regions define at least one protrusion having a surface substantially normal to engine combustion and reactive loads. The cap portion is configured to mate with the first end region at the main bearing cap column and support the main bearing.

  19. Chronic insertional Achilles tendinopathy: surgical outcomes

    OpenAIRE

    Oshri, Yael; Palmanovich, Ezequiel; Brin, Yaron Shagra; Karpf, Ronen; Massarwe, Sabri; Kish, Benny; Nyska, Meir

    2012-01-01

    Background and objective: insertional Achilles tendinopathy is a common condition among athletes and joggers. One fifth of the injuries involves the insertion of the tendon. The etiology is either due to mechanical overuse related to sports activity, or a systemic inflammatory disease. The clinical appearance includes pain and movement restriction. The primary treatment is conservative. The surgery referred to in this study (Calcaneal Osteotomy) is performed by decompression of the posterior ...

  20. Z-2 Threaded Insert Design and Testing

    Science.gov (United States)

    Ross, Amy; Rhodes, Richard; Jones, Robert J.; Graziosi, David; Ferl, Jinny; Sweeny, Mitch; Scarborough, Stephen

    2016-01-01

    NASA's Z-2 prototype space suit contains several components fabricated from an advanced hybrid composite laminate consisting of IM10 carbon fiber and fiber glass. One requirement was to have removable, replaceable helicoil inserts to which other suit components would be fastened. An approach utilizing bonded in inserts with helicoils inside of them was implemented. During initial assembly, cracking sounds were heard followed by the lifting of one of the blind inserts out of its hole when the screws were torqued. A failure investigation was initiated to understand the mechanism of the failure. Ultimately, it was determined that the pre-tension caused by torqueing the fasteners is a much larger force than induced from the pressure loads of the suit which was not considered in the insert design. Bolt tension is determined by dividing the torque on the screw by a k value multiplied by the thread diameter of the bolt. The k value is a factor that accounts for friction in the system. A common value used for k for a non-lubricated screw is 0.2. The k value can go down by as much as 0.1 if the screw is lubricated which means for the same torque, a much larger tension could be placed on the bolt and insert. This paper summarizes the failure investigation that was performed to identify the root cause of the suit failure and details how the insert design was modified to resist a higher pull out tension.

  1. NEI You Tube Videos: Amblyopia

    Medline Plus

    Full Text Available ... search for current job openings visit HHS USAJobs Home >> NEI YouTube Videos >> NEI YouTube Videos: Amblyopia Listen NEI YouTube Videos YouTube Videos Home Age-Related Macular Degeneration Amblyopia Animations Blindness Cataract ...

  2. NEI You Tube Videos: Amblyopia

    Medline Plus

    Full Text Available ... search for current job openings visit HHS USAJobs Home » NEI YouTube Videos » NEI YouTube Videos: Amblyopia Listen NEI YouTube Videos YouTube Videos Home Age-Related Macular Degeneration Amblyopia Animations Blindness Cataract ...

  3. Comparison of three methods of feeding colostrum to dairy calves.

    Science.gov (United States)

    Besser, T E; Gay, C C; Pritchett, L

    1991-02-01

    Absorption of colostral immunoglobulins by Holstein calves was studied in 3 herds in which 3 methods of colostrum feeding were used. Failure of passive transfer, as determined by calf serum immunoglobulin G1 (IgG1) concentration less than 10 mg/ml at 48 hours of age, was diagnosed in 61.4% of calves from a dairy in which calves were nursed by their dams, 19.3% of calves from a dairy using nipple-bottle feeding, and 10.8% of calves from a dairy using tube feeding. The management factor determined to have the greatest influence on the probability of failure of passive transfer in the herds using artificial methods of colostrum feeding (bottle feeding or tube feeding) was the volume of colostrum fed as it affected the amount of IgG1 received by the calf. In dairies that used artificial feeding methods, failure of passive transfer was infrequent in calves fed greater than or equal to 100 g IgG1 in the first colostrum feeding. In the dairy that allowed calves to suckle, prevalence of failure of passive transfer was greater than 50% even among calves nursed by cows with above-average colostral IgG1 concentration. Analysis of the effect of other management factors on calf immunoglobulin absorption revealed small negative effects associated with the use of previously frozen colostrum and the use of colostrum from cows with long nonlactating intervals.

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

    OpenAIRE

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

    2012-01-01

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

  5. Simplified feeding appliance for an infant with cleft palate

    Directory of Open Access Journals (Sweden)

    Shaila Masih

    2014-01-01

    Full Text Available A child born with cleft palate may experience difficulties while feeding. Early surgical treatment may need to be postponed until certain age and weight gain of the infant. The case presented here is of a 1-month-old neonate born with cleft palate, assisted with a new feeding appliance made with ethylene vinyl acetate using pressure molding technique to aid in proper feeding. The patient′s weight and health significantly improved after the insertion of obturator. The advantages of this material included being lightweight, moldability, good palatal fit and decreased soft tissue injury.

  6. Comparative Assessment of Cutting Inserts and Optimization during Hard Turning: Taguchi-Based Grey Relational Analysis

    Science.gov (United States)

    Venkata Subbaiah, K.; Raju, Ch.; Suresh, Ch.

    2017-08-01

    The present study aims to compare the conventional cutting inserts with wiper cutting inserts during the hard turning of AISI 4340 steel at different workpiece hardness. Type of insert, hardness, cutting speed, feed, and depth of cut are taken as process parameters. Taguchi’s L18 orthogonal array was used to conduct the experimental tests. Parametric analysis carried in order to know the influence of each process parameter on the three important Surface Roughness Characteristics (Ra, Rz, and Rt) and Material Removal Rate. Taguchi based Grey Relational Analysis (GRA) used to optimize the process parameters for individual response and multi-response outputs. Additionally, the analysis of variance (ANOVA) is also applied to identify the most significant factor.

  7. Medical image of the week: Dobhoff tube placement with Roux-en-Y gastric bypass

    Directory of Open Access Journals (Sweden)

    Ali H

    2018-04-01

    Full Text Available No abstract available. Article truncated after 150 words. Roux-en-Y gastric bypass is one of the most commonly performed bariatric operations in the United States. It involves partitioning a small gastric pouch off the proximal stomach and attaching that pouch directly to the intestine, thereby bypassing the large remainder of the stomach (1,2. Placing a Dobhoff tube (DHT and confirming its placement can be challenging due to the change in anatomy after the procedure. Here, we have a 65-year-old woman who presented to the hospital with acute encephalopathy and acute hypoxic respiratory failure due to multifocal pneumonia requiring intubation and prolonged ICU stay. A DHT was inserted after intubation for feeding purposes. An abdominal X-ray was obtained to confirm placement of the DHT (Figure 1. Normally the DHT tip should be placed in the 2nd to 3rd portion of the duodenum and would create a C-shaped tracing on the X-ray. However, in our patient who had history of Roux-en-Y …

  8. Insertion of Balloon Retained Gastrostomy Buttons: A 5-Year Retrospective Review of 260 Patients

    International Nuclear Information System (INIS)

    Power, Sarah; Kavanagh, Liam N.; Shields, Mary C.; Given, Mark F.; Keeling, Aoife N.; McGrath, Frank P.; Lee, Michael J.

    2013-01-01

    Radiologically inserted gastrostomy (RIG) is an established way of maintaining enteral nutrition in patients who cannot maintain nutrition orally. The purpose of this study was to evaluate the safety and efficacy of primary placement of a wide bore button gastrostomy in a large, varied patient population through retrospective review. All patients who underwent gastrostomy placement from January 1, 2004 to January 1, 2009 were identified. 18-Fr gastrostomy buttons (MIC-Key G) were inserted in the majority. Follow-up ranged from 6 months to 4.5 years. A total of 260 patients (M:F 140:120, average age 59.2 years) underwent gastrostomy during the study period. Overall success rate for RIG placement was 99.6 %, with success rate of 95.3 % for primary button insertion. Indications included neurological disorders (70 %), esophageal/head and neck malignancy (21 %), and other indications (9 %). Major and minor complication rates were 1.2 and 12.8 %, respectively. Thirty-day mortality rate was 6.8 %. One third of patients underwent gastrostomy reinsertion during the study period, the main indication for which was inadvertent catheter removal. Patency rate was high at 99.5 %. The maximum number of procedures in any patient was 8 (n = 2), and the average tube dwell time was 125 days. Primary radiological insertion of a wide bore button gastrostomy is a safe technique, with high success rate, high patency rate, and low major complication rate. We believe that it is feasible to attempt button gastrostomy placement in all patients, once tract length is within limits of tube length. If difficulty is encountered, then a standard tube may simply be placed instead.

  9. Insertion of Balloon Retained Gastrostomy Buttons: A 5-Year Retrospective Review of 260 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Power, Sarah, E-mail: sarahpower28@yahoo.co.uk; Kavanagh, Liam N.; Shields, Mary C.; Given, Mark F.; Keeling, Aoife N.; McGrath, Frank P.; Lee, Michael J., E-mail: mlee@rcsi.ie [Beaumont Hospital, Department of Radiology (Ireland)

    2013-04-15

    Radiologically inserted gastrostomy (RIG) is an established way of maintaining enteral nutrition in patients who cannot maintain nutrition orally. The purpose of this study was to evaluate the safety and efficacy of primary placement of a wide bore button gastrostomy in a large, varied patient population through retrospective review. All patients who underwent gastrostomy placement from January 1, 2004 to January 1, 2009 were identified. 18-Fr gastrostomy buttons (MIC-Key G) were inserted in the majority. Follow-up ranged from 6 months to 4.5 years. A total of 260 patients (M:F 140:120, average age 59.2 years) underwent gastrostomy during the study period. Overall success rate for RIG placement was 99.6 %, with success rate of 95.3 % for primary button insertion. Indications included neurological disorders (70 %), esophageal/head and neck malignancy (21 %), and other indications (9 %). Major and minor complication rates were 1.2 and 12.8 %, respectively. Thirty-day mortality rate was 6.8 %. One third of patients underwent gastrostomy reinsertion during the study period, the main indication for which was inadvertent catheter removal. Patency rate was high at 99.5 %. The maximum number of procedures in any patient was 8 (n = 2), and the average tube dwell time was 125 days. Primary radiological insertion of a wide bore button gastrostomy is a safe technique, with high success rate, high patency rate, and low major complication rate. We believe that it is feasible to attempt button gastrostomy placement in all patients, once tract length is within limits of tube length. If difficulty is encountered, then a standard tube may simply be placed instead.

  10. The effects of an inserted linear carbon chain on the vibration of a carbon nanotube

    International Nuclear Information System (INIS)

    Hu, Z L; Guo, X M; Ru, C Q

    2007-01-01

    An elastic string-elastic shell model is developed to study the coupled vibration of a carbon nanowire made of a linear carbon chain (C-chain) inserted inside a carbon nanotube (CNT). It is shown that the vibration of the inserted C-chain is coupled with vibration of the CNT only for vibration modes with circumferential wavenumber n = 1. In other cases, such as axisymmetric modes (n = 0) or higher-order vibration modes with n≥2, total resultant van der Waals (vdW) force acting on the C-chain due to the innermost tube always vanishes, and therefore vibration of the CNT does not cause vibration of the inserted C-chain, although the existence of the C-chain does have an effect on the vibration of the CNT through the chain-CNT vdW forces acting on the innermost tube. The present model predicts that non-coaxial vibration between the C-chain and the innermost tube does not occur due to negligible bending rigidity of the C-chain. In addition, it is found that the C-chain has most significant effect on the lowest frequency associated with the radial vibration mode for circumferential wavenumber 2 (n = 2). In particular, the effect of the C-chain on the axisymmetric radial breathing frequencies (n = 0) predicted by the present model is found to be in reasonable agreement with known experimental and modeling results available in the literature. The present work offers systematic modeling results on the effects of an inserted C-chain on the vibration of CNTs

  11. Application of small intestine decompression combined with oral feeding in middle and late period of malignant small bowel obstruction.

    Science.gov (United States)

    Li, Dechun; Du, Hongtao; Shao, Guoqing; Guo, Yongtuan; Lu, Wan; Li, Ruihong

    2017-07-01

    The application value of small intestine decompression combined with oral feeding in the middle and late period of malignant small bowel obstruction was examined. A total of 22 patients with advanced malignant small bowel obstruction were included in the present study. An ileus tube was inserted via the nose under fluoroscopy into the obstructed small intestine of each patient. At the same time, the insertion depth the of the catheter was adjusted. When the catheter was blocked, small bowel selective angiography was performed to determine the location and cause of the obstruction and the extent of the obstruction, and to determine the length of the small intestine in the site of obstruction, and to select the variety and tolerance of enteral nutrition. We observed the decompression tube flow and ease of intestinal obstruction. In total, 20 patients were treated with oral enteral nutrition after abdominal distension, and 22 cases were treated by the nose to observe the drainage and the relief of intestinal obstruction. The distal end of the catheter was placed in a predetermined position. The symptoms of intestinal obstruction were relieved 1-4 days after decompression. The 22 patients with selective angiography of the small intestine showed positive X-ray signs: 18 patients with oral enteral nutrition therapy had improved the nutritional situation 2 weeks later. In 12 cases, where there was anal defecation exhaust, 2 had transient removal of intestinal obstruction catheter. In conclusion, this comprehensive treatment based on small intestine decompression combined with enteral nutrition is expected to become a new therapeutic approach and method for the treatment of patients with advanced tumor small bowel obstruction.

  12. SOLVENTLESS MIGRATORY-INSERTION REACTIONS OF ...

    African Journals Online (AJOL)

    Preferred Customer

    The product formed by reaction of an alkyl or aryl cyclopentadienyl metal carbonyl .... (as also observed from the NMR tube experiments) that the solventless reaction between ... As can be seen from Figure 3, the reaction rate in the melt.

  13. Treating mediastinoesophageal fistula with covered stent through nasal esophagus drainage tube

    International Nuclear Information System (INIS)

    Han Xinwei; Wu Gang; Li Yongdong; Ma Nan; Wang Yanli; Gao Xuemei

    2005-01-01

    Objective: To investigate the value of treating mediastinoesophageal fistula with covered stent through nasal esophagus drainage tube. Methods: Ten patients with mediastinoesophageal fistula were treated by 5F catheter inserting into the abscess cavities through nasal esophageal fistula, with stent placement in the esophagus. The abscess cavities were washed and angiograghied through drainage tube and the sites of the drainage tube were adjusted in time until withdrawal of the tube. Results: The drainage tubes were pulled out within 10-25 days with disappearance of the abscess cavities and normal diet intake without difficulty. Conclusions: Treating mediastinoesophageal fistula with covered stent through nasal esophagus drainage tube is safe, microinvasive economic and acceptable, worth to be recommended. (authors)

  14. Feeding Your Baby

    Medline Plus

    Full Text Available ... for your baby Feeding your baby Family health & safety Complications & Loss Pregnancy complications Preterm labor & premature birth ... for your baby Feeding your baby Family health & safety Complications & Loss Pregnancy complications Preterm labor & premature birth ...

  15. Feeding Your Baby

    Medline Plus

    Full Text Available ... questions Email sign up Join our online community Home > Baby > Feeding your baby Feeding your baby E- ... We're working to radically improve the health care they receive. We're pioneering research to find ...

  16. Feeding Your Baby

    Medline Plus

    Full Text Available ... fitness Prenatal care Is it safe? Labor & birth Postpartum care Baby Caring for your baby Feeding your ... fitness Prenatal care Is it safe? Labor & birth Postpartum care Baby Caring for your baby Feeding your ...

  17. Feeding Your Baby

    Medline Plus

    Full Text Available ... Home > Baby > Feeding your baby Feeding your baby E-mail to a friend Please fill in all fields. Please enter a valid e-mail address. Your information: Your recipient's information: Your ...

  18. Feeding Your Baby

    Medline Plus

    Full Text Available ... Frequently asked questions Email sign up Join our online community Home > Baby > Feeding your baby Feeding your baby E-mail to a friend Please fill in all fields. Please enter a ...

  19. Feeding Your Baby

    Medline Plus

    Full Text Available ... Frequently asked questions Email sign up Join our online community March for Babies Nacersano Share Your Story ... Frequently asked questions Email sign up Join our online community Home > Baby > Feeding your baby Feeding your ...

  20. Tube plug removal machine

    International Nuclear Information System (INIS)

    Hawkins, P.J.

    1987-01-01

    In a nuclear steam generator wherein some faulty tubes have been isolated by mechanical plugging, to remove a selected plug without damaging the associated tube, a plug removal machine is used. The machine drills into a plug portion with a tap drill bit having a drill portion a tap portion and a threaded portion, engaging that plug portion with the threaded portion after the drilled hole has been threaded by the tap portion thereof, and removing a portion of the plug in the tube with a counterbore drill bit mounted concentrically about the tap drill bit. A trip pin and trip spline disengage the tap drill bit from the motor. The counterbore drill bit is thereafter self-centered with respect to the tube and plug about the now stationary tap drill bit. After a portion of the plug has been removed by the counterbore drill bit, pulling on the top drill bit by grippers on slots will remove the remaining plug portion from the tube. (author)

  1. Categorising YouTube

    Directory of Open Access Journals (Sweden)

    Thomas Mosebo Simonsen

    2011-09-01

    Full Text Available This article provides a genre analytical approach to creating a typology of the User Generated Content (UGC of YouTube. The article investigates the construction of navigationprocesses on the YouTube website. It suggests a pragmatic genre approach that is expanded through a focus on YouTube’s technological affordances. Through an analysis of the different pragmatic contexts of YouTube, it is argued that a taxonomic understanding of YouTube must be analysed in regards to the vacillation of a user-driven bottom-up folksonomy and a hierarchical browsing system that emphasises a culture of competition and which favours the already popular content of YouTube. With this taxonomic approach, the UGC videos are registered and analysed in terms of empirically based observations. The article identifies various UGC categories and their principal characteristics. Furthermore, general tendencies of the UGC within the interacting relationship of new and old genres are discussed. It is argued that the utility of a conventional categorical system is primarily of analytical and theoretical interest rather than as a practical instrument.

  2. Measuring of tube expansion

    International Nuclear Information System (INIS)

    Vogeleer, J. P.

    1985-01-01

    The expansion of the primary tubes or sleeves of the steam generator of a nuclear reactor plant are measured while the tubes or sleeves are being expanded. A primary tube or sleeve is expanded by high pressure of water which flows through a channel in an expander body. The water is supplied through an elongated conductor and is introduced through a connector on the shank connected to the conductor at its outer end. A wire extends through the mandrel and through the conductor to the end of the connector. At its inner end the wire is connected to a tapered pin which is subject to counteracting forces produced by the pressure of the water. The force on the side where the wire is connected to the conductor is smaller than on the opposite side. The tapered pin is moved in the direction of the higher force and extrudes the wire outwardly of the conductor. The tapered surface of the tapered pin engages transverse captive plungers which are maintained in engagement with the expanding tube or sleeve as they are moved outwardly by the tapered pin. The wire and the connector extend out of the generator and, at its outer end, the wire is connected to an indicator which measures the extent to which the wire is moved by the tapered pin, thus measuring the expansion of the tube or sleeve as it progresses

  3. Enhancement of acoustical performance of hollow tube sound absorber

    International Nuclear Information System (INIS)

    Putra, Azma; Khair, Fazlin Abd; Nor, Mohd Jailani Mohd

    2016-01-01

    This paper presents acoustical performance of hollow structures utilizing the recycled lollipop sticks as acoustic absorbers. The hollow cross section of the structures is arranged facing the sound incidence. The effects of different length of the sticks and air gap on the acoustical performance are studied. The absorption coefficient was measured using impedance tube method. Here it is found that improvement on the sound absorption performance is achieved by introducing natural kapok fiber inserted into the void between the hollow structures. Results reveal that by inserting the kapok fibers, both the absorption bandwidth and the absorption coefficient increase. For test sample backed by a rigid surface, best performance of sound absorption is obtained for fibers inserted at the front and back sides of the absorber. And for the case of test sample with air gap, this is achieved for fibers introduced only at the back side of the absorber.

  4. Enhancement of acoustical performance of hollow tube sound absorber

    Energy Technology Data Exchange (ETDEWEB)

    Putra, Azma, E-mail: azma.putra@utem.edu.my; Khair, Fazlin Abd, E-mail: fazlinabdkhair@student.utem.edu.my; Nor, Mohd Jailani Mohd, E-mail: jai@utem.edu.my [Centre for Advanced Research on Energy, Universiti Teknikal Malaysia Melaka, Hang Tuah Jaya, Durian Tunggal Melaka 76100 Malaysia (Malaysia)

    2016-03-29

    This paper presents acoustical performance of hollow structures utilizing the recycled lollipop sticks as acoustic absorbers. The hollow cross section of the structures is arranged facing the sound incidence. The effects of different length of the sticks and air gap on the acoustical performance are studied. The absorption coefficient was measured using impedance tube method. Here it is found that improvement on the sound absorption performance is achieved by introducing natural kapok fiber inserted into the void between the hollow structures. Results reveal that by inserting the kapok fibers, both the absorption bandwidth and the absorption coefficient increase. For test sample backed by a rigid surface, best performance of sound absorption is obtained for fibers inserted at the front and back sides of the absorber. And for the case of test sample with air gap, this is achieved for fibers introduced only at the back side of the absorber.

  5. Comparison of endoscopic Nd:YAG laser therapy and oesophageal tube in palliation of oesophagogastric malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Hahl, J.; Salo, T.; Ovaska, J.; Haapiainen, R.; Kalima, T.; Schroeder, T. (Helsinki Univ. Central Hospital (Finland). Meilahti Clinic)

    1991-01-01

    The clinical results of 96 patients with upper gastrointestinal malignancy have been evaluated retrospectively. 69 patients with a mean age of 72 years (35 men and 34 women) were treated with endoscopic laser therapy, and 27 patients with a mean age of 67 years (16 men and 11 women) with insertion of an oesophageal tube. After laser therapy the bulk of the tumour was reduced in 87%, and in 55% clear signs of relieved dysphagia were seen. The insertion of an esophageal tube was successful in 89%. In the laser group no fatal complications occurred, and the overall complication risk was 8.7%. The first-year survival in all laser patients was 12%, and in patients with impassable tumour stenosis the survival was 6%. The mortality related to the insertion of an oesophageal tube was 11%, and complications occurred in 48% of the patients. The first-year survival of the tube group was nil. It is concluded that endoscopic laser therapy and insertion of oesophageal tube are both effective methods in palliation of oesophagogastric malignancy, but the mortality and risk for complications were markedly lower after laser therapy. 20 refs., 1 fig., 3 tabs.

  6. Method and apparatus for testing closed-end tubes in heat exchangers of nuclear reactors and the like

    International Nuclear Information System (INIS)

    Seyd, G.; Bergbauer, A.; Paulsen, U.

    1975-01-01

    A description is given of a test stopper which is insertable into a tube closed at one end for testing the tightness of the tube with a fluid under pressure, the tube being in a heat exchanger of a nuclear reactor or the like. The test stopper includes a tubular outer jacket that is expandable outwardly to tightly seat the stopper in the tube. The stopper also has front and back end-face members joined to the ends of the outer jacket to define a closed space within the jacket. With the stopper inserted into the tube, the front end-face member and the closed end portion of the tube define a closed inner region of the tube. An inner tubular member, disposed within the outer jacket, partitions the closed space within the jacket into an annular outer chamber and a cylindrical inner chamber. A pressure-fluid supply selectively supplies fluid to the chambers. The outer jacket expands in response to fluid admitted to the annular chamber and the front end-face member has a through bore to admit fluid under pressure to the inner region of the tube. A method of testing of such a tube with a fluid under pressure includes inserting the test stopper into the tube and then expanding the outer jacket of the stopper to seat the stopper firmly in the tube. A fluid under pressure is directed through the stopper and into the closed region defined by the front end-face member of the stopper and the closed end portion of the tube. The pressure of the fluid introduced into this closed region is monitored for detecting a leak in the closed-end tube

  7. Effects of hunger level and tube diameter on thefeeding behavior of teat-fed dairy calves

    DEFF Research Database (Denmark)

    Herskin, Mette S; Skjøth, Flemming; Jensen, Margit Bak

    2010-01-01

    Behavioral changes caused by variation in hunger have a great potential in health monitoring in dairy cattle. The present experiment used 48 Danish Holstein bull calves with a median age of 33 d. We examined the effect of different levels of hunger (reduced, in which calves were fed 1.5 L of milk...... via esophageal tube before feeding; increased, in which calves were fed half milk ration at the previous feeding, or control, in which calves were fed normal ration at the previous feeding) on feeding behavior of calves fed via different tube diameters (6.0, 3.0, or 1.5 mm). Behavior observed during...... levels. The present results show that only a rather high reduction in tube diameter led to reduced drinking rate. Neither reduced nor increased hunger levels led to changes in drinking rate, but calves showed reduced nonnutritive sucking and butting when they were less hungry and increased nonnutritive...

  8. DWPF Sample Vial Insert Study-Statistical Analysis of DWPF Mock-Up Test Data

    Energy Technology Data Exchange (ETDEWEB)

    Harris, S.P. [Westinghouse Savannah River Company, AIKEN, SC (United States)

    1997-09-18

    This report is prepared as part of Technical/QA Task Plan WSRC-RP-97-351 which was issued in response to Technical Task Request HLW/DWPF/TTR-970132 submitted by DWPF. Presented in this report is a statistical analysis of DWPF Mock-up test data for evaluation of two new analytical methods which use insert samples from the existing HydragardTM sampler. The first is a new hydrofluoric acid based method called the Cold Chemical Method (Cold Chem) and the second is a modified fusion method.Either new DWPF analytical method could result in a two to three fold improvement in sample analysis time.Both new methods use the existing HydragardTM sampler to collect a smaller insert sample from the process sampling system. The insert testing methodology applies to the DWPF Slurry Mix Evaporator (SME) and the Melter Feed Tank (MFT) samples.The insert sample is named after the initial trials which placed the container inside the sample (peanut) vials. Samples in small 3 ml containers (Inserts) are analyzed by either the cold chemical method or a modified fusion method. The current analytical method uses a HydragardTM sample station to obtain nearly full 15 ml peanut vials. The samples are prepared by a multi-step process for Inductively Coupled Plasma (ICP) analysis by drying, vitrification, grinding and finally dissolution by either mixed acid or fusion. In contrast, the insert sample is placed directly in the dissolution vessel, thus eliminating the drying, vitrification and grinding operations for the Cold chem method. Although the modified fusion still requires drying and calcine conversion, the process is rapid due to the decreased sample size and that no vitrification step is required.A slurry feed simulant material was acquired from the TNX pilot facility from the test run designated as PX-7.The Mock-up test data were gathered on the basis of a statistical design presented in SRT-SCS-97004 (Rev. 0). Simulant PX-7 samples were taken in the DWPF Analytical Cell Mock

  9. Advanced evacuated tube collectors

    Science.gov (United States)

    Schertz, W. W.; Hull, J. R.; Winston, R.; Ogallagher, J.

    1985-04-01

    The essence of the design concept for these new collectors is the integration of moderate levels of nonimaging concentration inside the evacuated tube itself. This permanently protects the reflection surfaces and allows the use of highly reflecting front surface mirrors with reflectances greater than 95%. Previous fabrication and long term testing of a proof-of-concept prototype has established the technical success of the concept. Present work is directed toward the development of a manufacturable unit that will be suitable for the widest possible range of applications. Design alternatives include scaling up the original prototype's tube diameter from 5 cm to 10 cm, using an internal shaped metal concentrating reflector, using a variety of profile shapes to minimize so-called gap losses and accommodate both single ended and double-ended flow geometries, and allowing the use of heat pipes for the absorber tube.

  10. Square through tube

    International Nuclear Information System (INIS)

    Akita, Junji; Honma, Toei.

    1975-01-01

    Object: To provide a square through tube involving thermal movement in pipelines such as water supply pump driving turbine exhaust pipe (square-shaped), which is wide in freedom with respect to shape and dimension thereof for efficient installation at site. Structure: In a through tube to be airtightly retained for purpose of decontamination in an atomic power plant, comprising a seal rubber plate, a band and a bolt and a nut for securing said plate, the seal rubber plate being worked into the desired shape so that it may be placed in intimate contact with the concrete floor surface by utilization of elasticity of rubber, thereby providing airtightness at a corner portion of the square tube. (Kamimura, M.)

  11. SG tube identification

    International Nuclear Information System (INIS)

    Hoogstraten, P. van

    1994-01-01

    A ''Tracker'' system is described which is designed to identify any tube in a reactor steam generator quickly and safely. Occupational radiation doses to maintenance workers are reduced by using a Tracker and emergency down times are shortened. The system employs a television camera and light source in a stainless steel box with a large window. Both the camera and spotlight can be panned and tilted to reach any point on the tubesheet and are remotely controlled. An operator at a safe working distance can identify any tube visible on a real time video by comparison with the tubesheet pattern stored earlier in the computer memory. The identified tube can then be spotlighted and dealt with quickly by a maintenance worker inside the channel head. (UK)

  12. Test manufacture of the canister insert 135

    International Nuclear Information System (INIS)

    Raiko, H.

    2005-10-01

    This report describes the insert-manufacturing test of a disposal canister for spent nuclear fuel that was made by Metso Foundries Jyvaeskylae Oy, in June 2004 on contract for Posiva Oy. The test manufacture was a part of the co-operation development programme of encapsulation technology between SKB AB and Posiva Oy. Insert casting was specified according to the current manufacturing specifications of SKB. The canister insert was of BWR-type with integral bottom. This was the second trial manufacture of this type of insert in Finland and, in total, the third test manufacture of insert by Metso Foundries Jyvaeskylae Oy. The result fulfilled all the requirements but the material mechanical properties of the cast material. The measured ultimate strength and elongation at rupture were lower than specified in the upper part of the cast. The reason for this was revealed in the metallurgical investigation of the cast material. The cast contained slag (dross). Avoiding the dross formation will be the most demanding challenge of the forthcoming development of the cast procedure. (orig.)

  13. Test manufacture of a canister insert

    International Nuclear Information System (INIS)

    Raiko, H.

    2004-11-01

    This report describes the insert-manufacturing test of a disposal canister for spent nuclear fuel that was made by Metso Paper Oy, Jyvaeskylae Foundry, in 2003 on contract for Posiva Oy. The test manufacture was a part of the co-operation development programme of encapsulation technology between SKB AB and Posiva Oy. Insert casting was specified according to the current manufacturing specifications of SKB. The canister insert was of BWR-type with integral bottom. This was the first trial manufacture of this type of insert in Finland and, in total, the second test manufacture of insert by Metso Paper. The result fulfilled all the requirements but the material mechanical properties and metallurgical structure of the cast material. The measured tensile strength, ultimate strength and elongation at rupture were lower than specified. The reason for this was revealed in the metallurgical investigation of the cast material. The nodulizing of the graphite was not occurred during the casting process according to the requirements. (orig.)

  14. TRACY transient experiment databook. 3) Ramp feed experiment

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, Ken; Yamane, Yuichi; Ogawa, Kazuhiko; Aizawa, Eiju; Yanagisawa, Hiroshi; Miyoshi, Yoshinori [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    2002-03-01

    This is a databook of TRACY ''ramp feed'' experiments. TRACY is a reactor to perform supercritical experiments using low-enriched uranyl nitrate aqueous solution. The excess reactivity of TRACY is 3$ at maximum, and it is inserted by feeding the solution to a core tank or by withdrawing a control rod, which is called as the transient rod, from the core. In the ramp feed experiment, the supercritical experiment is initiated by feeding the fuel solution to the core tank in a constant feed rate. The data in the present databook consist of datasheets and graphs. Experimental conditions and typical values of measured parameters are tabulated in the datasheet. In the graph, power and temperature profiles are plotted. Those data are useful for the investigation of criticality accidents with fissile solutions, and for validation of criticality accident analysis codes. (author)

  15. Methods for batch fabrication of cold cathode vacuum switch tubes

    Science.gov (United States)

    Walker, Charles A [Albuquerque, NM; Trowbridge, Frank R [Albuquerque, NM

    2011-05-10

    Methods are disclosed for batch fabrication of vacuum switch tubes that reduce manufacturing costs and improve tube to tube uniformity. The disclosed methods comprise creating a stacked assembly of layers containing a plurality of adjacently spaced switch tube sub-assemblies aligned and registered through common layers. The layers include trigger electrode layer, cathode layer including a metallic support/contact with graphite cathode inserts, trigger probe sub-assembly layer, ceramic (e.g. tube body) insulator layer, and metallic anode sub-assembly layer. Braze alloy layers are incorporated into the stacked assembly of layers, and can include active metal braze alloys or direct braze alloys, to eliminate costs associated with traditional metallization of the ceramic insulator layers. The entire stacked assembly is then heated to braze/join/bond the stack-up into a cohesive body, after which individual switch tubes are singulated by methods such as sawing. The inventive methods provide for simultaneously fabricating a plurality of devices as opposed to traditional methods that rely on skilled craftsman to essentially hand build individual devices.

  16. Sampling of high molecular weight hydrocarbons with adsorbent tubes

    International Nuclear Information System (INIS)

    Stroemberg, B.

    1996-12-01

    Adsorption tubes have been used to determine the content of hydrocarbons in gas samples from small scale combustion and gasification of biomass. Compounds from benzene (mw 78) to indeno (1,2,3-cd) pyrene (mw 276) have been examined. The results show that it is possible to analyze polyaromatic hydrocarbons (PAH) with 4 aromatic rings (mw 202). Detection limits for these compounds are 3 . PAH with higher molecule weight can be identified and quantified in samples with high amounts of PAH e.g. at gasification of biomass. Sampling on adsorption tubes is extremely quick and easy. The tube is inserted in the gas of interest and the sample is sucked through the tube with a pump. Sampling times of 2-10 minutes are often sufficient. High moisture content in the gas may result in losses of the most volatile compounds, when drying. Even very low concentrations of water in the tube may cause ice formation in the cold-trap and the sample will be destroyed. The analysis is unfortunately time-consuming because the desorption oven must be cooled between every analysis. This will reduce the number of samples which can be analyzed per day. The tubes can be stored for several weeks before analysis without deterioration. 4 refs, 5 figs, 3 tabs

  17. PRODUCTION OF URANIUM TUBING

    Science.gov (United States)

    Creutz, E.C.

    1958-04-15

    The manufacture of thin-walled uranium tubing by the hot-piercing techique is described. Uranium billets are preheated to a temperature above 780 d C. The heated billet is fed to a station where it is engaged on its external surface by three convex-surfaced rotating rollers which are set at an angle to the axis of the billet to produce a surface friction force in one direction to force the billet over a piercing mandrel. While being formed around the mandrel and before losing the desired shape, the tube thus formed is cooled by a water spray.

  18. Guide tube sleeve

    International Nuclear Information System (INIS)

    Attix, D.J.

    1983-01-01

    The invention increases the operating capacity of a nuclear reactor by causing a modification in the flow pattern of the coolant which enhances the coolant's effectiveness. The apparatus provides a thin-walled tubular sleeve closely surrounding but not attached to the exterior surface of a guide tube in a fuel assembly. The wall of the sleeve has tabs projecting outwardly into adjacent flow channels. The sleeve is attached to the wall of a cellular void through which passes the guide tube associated with said sleeve. The tabs increase the flow of water in the channel and thus increase the heat transfer

  19. Pressure tube type research reactor

    International Nuclear Information System (INIS)

    Ueda, Hiroshi.

    1976-01-01

    Object: To prevent excessive heat generation due to radiation of a pressure tube vessel. Structure: A pressure tube encasing therein a core comprises a dual construction comprising inner and outer tubes coaxially disposed. High speed cooling water is passed through the inner tube for cooling. In addition, in the outer periphery of said outer tube there is provided a forced cooling tube disposed coaxially thereto, into which cooling fluid, for example, such as moderator or reflector is forcibly passed. This forced cooling tube has its outer periphery surrounded by the vessel into which moderator or reflector is fed. By the provision of the dual construction of the pressure tube and the forced cooling tube, the vessel may be prevented from heat generation. (Ikeda, J.)

  20. Responsive versus scheduled feeding for preterm infants.

    Science.gov (United States)

    Watson, Julie; McGuire, William

    2015-10-13

    Feeding preterm infants in response to their hunger and satiation cues (responsive, cue-based, or infant-led feeding) rather than at scheduled intervals might enhance infants' and parents' experience and satisfaction, help in the establishment of independent oral feeding, increase nutrient intake and growth rates, and allow earlier hospital discharge. To assess the effect of feeding preterm infants on a responsive basis versus feeding prescribed volumes at scheduled intervals on growth, duration of hospital stay, and parental satisfaction. We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 9, 2015), MEDLINE (1966 to September 2015), EMBASE (1980 to September 2015), and CINAHL (1982 to September 2015), conference proceedings, previous reviews, and trial registries. Randomised controlled trials (RCTs) or quasi-RCTs that compared a policy of feeding preterm infants on a responsive basis versus feeding at scheduled intervals. Two review authors assessed trial eligibility and risk of bias and undertook data extraction independently. We analysed the treatment effects in the individual trials and reported the risk ratio and risk difference for dichotomous data and mean difference (MD) for continuous data, with respective 95% confidence intervals (CIs). We used a fixed-effect model in meta-analyses and explored the potential causes of heterogeneity in sensitivity analyses. We found nine eligible RCTs including 593 infants in total. These trials compared responsive with scheduled interval regimens in preterm infants in the transition phase from intragastric tube to oral feeding. The trials were generally small and contained various methodological weaknesses including lack of blinding and incomplete assessment of all randomised participants. Meta-analyses, although limited by data quality and availability, suggest that responsive feeding

  1. Thoracostomy tubes: A comprehensive review of complications and related topics

    Science.gov (United States)

    Kwiatt, Michael; Tarbox, Abigail; Seamon, Mark J.; Swaroop, Mamta; Cipolla, James; Allen, Charles; Hallenbeck, Stacinoel; Davido, H. Tracy; Lindsey, David E.; Doraiswamy, Vijay A.; Galwankar, Sagar; Tulman, David; Latchana, Nicholas; Papadimos, Thomas J.; Cook, Charles H.; Stawicki, Stanislaw P.

    2014-01-01

    Tube thoracostomy (TT) placement belongs among the most commonly performed procedures. Despite many benefits of TT drainage, potential for significant morbidity and mortality exists. Abdominal or thoracic injury, fistula formation and vascular trauma are among the most serious, but more common complications such as recurrent pneumothorax, insertion site infection and nonfunctioning or malpositioned TT also represent a significant source of morbidity and treatment cost. Awareness of potential complications and familiarity with associated preventive, diagnostic and treatment strategies are fundamental to satisfactory patient outcomes. This review focuses on chest tube complications and related topics, with emphasis on prevention and problem-oriented approaches to diagnosis and treatment. The authors hope that this manuscript will serve as a valuable foundation for those who wish to become adept at the management of chest tubes. PMID:25024942

  2. Gastric Outlet Obstruction Caused by Foley Catheter: A Complication when Substituting for Commercial Gastrostomy Tubes

    Directory of Open Access Journals (Sweden)

    Amanda B. Lewis

    2018-01-01

    Full Text Available The technique of using percutaneous endoscopic gastrostomy (PEG for long-term enteral feeding is well established and commonly used. While the technique is relatively safe and simple, the gastrostomy tube itself may deteriorate or malfunction, requiring a replacement tube. We present a case of a 58-year-old woman who was found to have gastric outlet obstruction from the inflated balloon of a Foley catheter being used as a replacement for her PEG tube. This case illustrates a potential complication of using a Foley catheter in place of commercially available gastrostomy tubes.

  3. Breast-Feeding Twins: Making Feedings Manageable

    Science.gov (United States)

    ... Department of Health and Human Services Office on Women's Health. http://www.womenshealth.gov/publications/our-publications/breastfeeding-guide. Accessed March 11, 2015. Shelov SP, et al. Feeding your ...

  4. Feed safety in the feed supply chain

    Directory of Open Access Journals (Sweden)

    Pinotti, L.

    2011-01-01

    Full Text Available A number of issues have weakened the public's confidence in the quality and wholesomeness of foods of animal origin. As a result farmers, nutritionists, industry and governments have been forced to pay serious attention to animal feedstuff production processes, thereby acknowledging that animal feed safety is an essential prerequisite for human food safety. Concerns about these issues have produced a number of important effects including the ban on the use of processed animal proteins, the ban on the addition of most antimicrobials to farm animals diets for growth‐promotion purposes, and the implementation of feed contaminant regulations in the EU. In this context it is essential to integrate knowledge on feed safety and feed supply. Consequently, purchase of new and more economic sources of energy and protein in animal diets, which is expected to conform to adequate quality, traceability, environmental sustainability and safety standards, is an emerging issue in livestock production system.

  5. Blenderized feeding formulas with nutritious and inexpensive foods

    Directory of Open Access Journals (Sweden)

    Ana Paula Lança BENTO

    Full Text Available ABSTRACT Objective: To propose an inexpensive blenderized tube feeding formula consisting of foods with standard nutritional composition that meets the nutritional requirements of individuals aged more than 51 years. Methods: The enteral diets were formulated mainly with fresh foods and tested for their physical (homogeneity, stability, osmolality, pH, and flow rate and chemical (moisture, ash, protein, lipids, energy, crude fiber, vitamin C, calcium, iron, magnesium, and zinc characteristics. The cost was determined by surveying item prices in supermarkets and stores that specialize in nutritional support. Results: The blenderized tube feeding formula was stable and homogeneous, and had slightly acidic pH, hypertonic osmolality (603mOsm/kg, and flow rate comparable with gravity drip (21 minutes. Proximate composition analysis indicated appropriate levels of proteins, lipids, vitamin C, and zinc. The mean cost of 2000kcal of the standard blenderized tube feeding formula was R$ 12.3±1.4, which is 70% cheaper than the mean cost of similar commercial enteral formulas. Conclusion: The planned diet can be an excellent choice for patients using blenderized tube feeding formulas as it consisted of habitual food items, had physical and nutritional quality, and was inexpensive.

  6. Double wall steam generator tubing

    International Nuclear Information System (INIS)

    Padden, T.R.; Uber, C.F.

    1983-01-01

    Double-walled steam generator tubing for the steam generators of a liquid metal cooled fast breeder reactor prevents sliding between the surfaces due to a mechanical interlock. Forces resulting from differential thermal expansion between the outer tube and the inner tube are insufficient in magnitude to cause shearing of base metal. The interlock is formed by jointly drawing the tubing, with the inside wall of the outer tube being already formed with grooves. The drawing causes the outer wall of the inner tube to form corrugations locking with the grooves. (author)

  7. RERTR-12 Insertion 1 Irradiation Summary Report

    International Nuclear Information System (INIS)

    Perez, D.M.; Lillo, M.A.; Chang, G.S.; Woolstenhulme, N.E.; Roth, G.A.; Wachs, D.M.

    2012-01-01

    The Reduced Enrichment for Research and Test Reactor (RERTR) experiment RERTR-12 was designed to provide comprehensive information on the performance of uranium-molybdenum (U-Mo) based monolithic fuels for research reactor applications. RERTR-12 insertion 1 includes the capsules irradiated during the first two irradiation cycles. These capsules include Z, X1, X2 and X3 capsules. The following report summarizes the life of the RERTR-12 insertion 1 experiment through end of irradiation, including as-run neutronic analysis results, thermal analysis results and hydraulic testing results.

  8. RERTR-12 Insertion 2 Irradiation Summary Report

    International Nuclear Information System (INIS)

    Perez, D.M.; Chang, G.S.; Wachs, D.M.; Roth, G.A.; Woolstenhulme, N.E.

    2012-01-01

    The Reduced Enrichment for Research and Test Reactor (RERTR) experiment RERTR-12 was designed to provide comprehensive information on the performance of uranium-molybdenum (U-Mo) based monolithic fuels for research reactor applications.1 RERTR-12 insertion 2 includes the capsules irradiated during the last three irradiation cycles. These capsules include Z, Y1, Y2 and Y3 type capsules. The following report summarizes the life of the RERTR-12 insertion 2 experiment through end of irradiation, including as-run neutronic analysis results, thermal analysis results and hydraulic testing results.

  9. Installation of the LHC experimental insertions

    CERN Document Server

    Bartolome-Jimenez, S

    2004-01-01

    The installation of the LHC experimental insertions, and particularly the installation of the low-beta quadrupoles, raises many technical challenges due to the stringent alignment specifications and to the difficulty of access in very confined areas. The compact layout with many lattice elements, vacuum components, beam control instrumentation and the presence of shielding does not allow for any improvisation in the installation procedure. This paper reviews all the constraints that need to be taken into account when installing the experimental insertions. It describes the chronological sequence of installation and discusses the technical solutions that have been adopted.

  10. INSTALLATION OF THE LHC EXPERIMENTAL INSERTIONS

    CERN Document Server

    Bartolome-Jimenez, S

    2004-01-01

    The installation of the LHC experimental insertions, and particularly the installation of the Low-Beta quadrupoles, raises many technical challenges due to the stringent alignment specifications and to the difficulty of access in very confined areas. The compact layout with many lattice elements, vacuum components, beam control instrumentation and the presence of shielding does not allow for any improvisation in the installation procedure. This paper reviews all the constraints that need to be taken into account when installing the experimental insertions. It describes the chronological sequence of installation and discusses the technical solutions that have been adopted.

  11. Compact insert design for cryogenic pressure vessels

    Energy Technology Data Exchange (ETDEWEB)

    Aceves, Salvador M.; Ledesma-Orozco, Elias Rigoberto; Espinosa-Loza, Francisco; Petitpas, Guillaume; Switzer, Vernon A.

    2017-06-14

    A pressure vessel apparatus for cryogenic capable storage of hydrogen or other cryogenic gases at high pressure includes an insert with a parallel inlet duct, a perpendicular inlet duct connected to the parallel inlet. The perpendicular inlet duct and the parallel inlet duct connect the interior cavity with the external components. The insert also includes a parallel outlet duct and a perpendicular outlet duct connected to the parallel outlet duct. The perpendicular outlet duct and the parallel outlet duct connect the interior cavity with the external components.

  12. ALS insertion device block measurement and inspection

    International Nuclear Information System (INIS)

    Marks, S.; Carrieri, J.; Cook, C.; Hassenzahl, W.V.; Hoyer, E.; Plate, D.

    1991-05-01

    The performance specifications for ALS insertion devices require detailed knowledge and strict control of the Nd-Fe-B permanent magnet blocks incorporated in these devices. This paper describes the measurement and inspection apparatus and the procedures designed to qualify and characterize these blocks. A detailed description of a new, automated Helmholtz coil facility for measurement of the three components of magnetic moment is included. Physical block inspection and magnetic moment measurement procedures are described. Together they provide a basis for qualifying blocks and for specifying placement of blocks within an insertion devices' magnetic structures. 1 ref., 4 figs

  13. A longitudinal evaluation of hearing and ventilation tube insertion in patients with primary ciliary dyskinesia

    DEFF Research Database (Denmark)

    Andersen, Tobias Nicolai; Alanin, Mikkel Christian; von Buchwald, Christian

    2016-01-01

    INTRODUCTION: Primary ciliary dyskinesia (PCD) is an autosomal recessive genetic disease, which primarily manifests with oto-sino-pulmonary symptoms. Otitis media with effusion (OME) is common from early childhood. The existing literature on OME management in PCD is conflicting. The goals of the ...

  14. Tube-dwelling invertebrates

    NARCIS (Netherlands)

    Hölker, Franz; Vanni, Michael J.; Kuiper, Jan J.; Meile, Christof; Grossart, Hans Peter; Stief, Peter; Adrian, Rita; Lorke, Andreas; Dellwig, Olaf; Brand, Andreas; Hupfer, Michael; Mooij, Wolf M.; Nützmann, Gunnar; Lewandowski, Jörg

    2015-01-01

    There is ample evidence that tube-dwelling invertebrates such as chironomids significantly alter multiple important ecosystem functions, particularly in shallow lakes. Chironomids pump large water volumes, and associated suspended and dissolved substances, through the sediment and thereby compete

  15. Cladding tube manufacturing technology

    International Nuclear Information System (INIS)

    Hahn, R.; Jeong, Y. H.; Baek, B. J.; Kim, K. H.; Kim, S. J.; Choi, B. K.; Kim, J. M.

    1999-04-01

    This report gives an overview of the manufacturing routine of PWR cladding tubes. The routine essentially consists of a series of deformation and annealing processes which are necessary to transform the ingot geometry to tube dimensions. By changing shape, microstructure and structure-related properties are altered simultaneously. First, a short overview of the basics of that part of deformation geometry is given which is related to tube reducing operations. Then those processes of the manufacturing routine which change the microstructure are depicted, and the influence of certain process parameters on microstructure and material properties are shown. The influence of the resulting microstructure on material properties is not discussed in detail, since it is described in my previous report A lloy Development for High Burnup Cladding . Because of their paramount importance still up to now, and because manufacturing data and their influence on properties for other alloys are not so well established or published, the descriptions are mostly related to Zry4 tube manufacturing, and are only in short for other alloys. (author). 9 refs., 46 figs

  16. Thoughts on accelerator tubes

    International Nuclear Information System (INIS)

    Larson, J.D.

    1978-01-01

    A brief, subjective review is given of mechanisms that may be limiting electrostatic accelerator tubes to present levels of performance. Suggestions are made for attacking these limitations with the purpose of stimulating the thinking of designers and users of electrostatic accelerators

  17. Tracheostomy tube - speaking

    Science.gov (United States)

    ... with others. However, you can learn how to speak with a tracheostomy tube. It just takes practice. There ... If it is hard to speak with a trach in place, special devices can help you learn to create sounds. One-way valves, called speaking valves, are placed ...

  18. Thoughts of accelerator tubes

    International Nuclear Information System (INIS)

    Larson, J.D.

    1977-01-01

    A brief, subjective review is given of mechanisms that may be limiting electrostatic accelerator tubes to present levels of performance. Suggestions are made for attacking these limitations with the purpose of stimulating the thinking of designers and users of electrostatic accelerators

  19. Cladding tube manufacturing technology

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, R. [Kraftwerk Union AG, Mulheim (Germany); Jeong, Y.H.; Baek, B.J.; Kim, K.H.; Kim, S.J.; Choi, B.K.; Kim, J.M. [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1999-04-01

    This report gives an overview of the manufacturing routine of PWR cladding tubes. The routine essentially consists of a series of deformation and annealing processes which are necessary to transform the ingot geometry to tube dimensions. By changing shape, microstructure and structure-related properties are altered simultaneously. First, a short overview of the basics of that part of deformation geometry is given which is related to tube reducing operations. Then those processes of the manufacturing routine which change the microstructure are depicted, and the influence of certain process parameters on microstructure and material properties are shown. The influence of the resulting microstructure on material properties is not discussed in detail, since it is described in my previous report 'Alloy Development for High Burnup Cladding.' Because of their paramount importance still up to now, and because manufacturing data and their influence on properties for other alloys are not so well established or published, the descriptions are mostly related to Zry4 tube manufacturing, and are only in short for other alloys. (author). 9 refs., 46 figs.

  20. Per-operative vibration analysis: a valuable tool for defining correct stem insertion: preliminary report.

    Science.gov (United States)

    Mulier, Michiel; Pastrav, Cesar; Van der Perre, Georges

    2008-01-01

    Defining the stem insertion end point during total hip replacement still relies on the surgeon's feeling. When a custom-made stem prosthesis with an optimal fit into the femoral canal is used, the risk of per-operative fractures is even greater than with standard prostheses. Vibration analysis is used in other clinical settings and has been tested as a means to detect optimal stem insertion in the laboratory. The first per-operative use of vibration analysis during non-cemented custom-made stem insertion in 30 patients is reported here. Thirty patients eligible for total hip replacement with uncemented stem prosthesis were included. The neck of the stem was connected with a shaker that emitted white noise as excitation signal and an impedance head that measured the frequency response. The response signal was sent to a computer that analyzed the frequency response function after each insertion phase. A technician present in the operating theatre but outside the laminated airflow provided feed-back to the surgeon. The correlation index between the frequency response function measured during the last two insertion hammering sessions was >0.99 in 86.7% of the cases. In four cases the surgeon stopped the insertion procedure because of a perceived risk of fracture. Two special cases illustrating the potential benefit of per-operative vibration analysis are described. The results of intra-operative vibration analysis indicate that this technique may be a useful tool assisting the orthopaedic surgeon in defining the insertion endpoint of the stem. The development of a more user-friendly device is therefore warranted.

  1. Neutron absorber inserts for 55-gal drums

    International Nuclear Information System (INIS)

    Wilson, R.E.; Kim, Y.S.; Toffer, H.

    2000-01-01

    Transport and temporary storage of more than 200 g of fissile material in 55-gal drums at the Rocky Flats Environmental Technology Site (RFETS) have received significant attention during the cleanup mission. This paper discusses successful applications and results of extensive computer studies. Interim storage and movement of fissile material in excess of standard drum limits (200 g) in a safe configuration have been accomplished using special drum inserts. Such inserts have constrained the contents of a drum to two 4-ell bottles. The content of the bottles was limited to 600 g Pu or U in solution or a total of 1200 g for the entire drum. The inserts were a simple design constructed of stainless steel, forming a vertical cylindrical pipe into which two bottles, one on top of the other, could be centered in the drum. The remaining drum volume was configured to preclude any additional bottle placement external to the vertical cylinder. Such inserts in drums were successfully used in moving high-concentration solution from one building to another for chemical processing. Concern about the knowledge of fissile material concentration in bottles prompted another study for drum inserts. The past practice had been to load up to fourteen 4-ell bottles into 55-gal drums, provided the fissile material concentration was < 6 g fissile/ell, and the total drum contents of 200 g fissile was not exceeded. Only one determination of the solution concentration was needed. An extensive safety analysis concluded that a single measurement of bottle content could not ensure compliance with double-contingency-criterion requirements. A second determination of the bottle contents was required before bottles could be placed in a 55-gal drum. Al alternative to a dual-measurement protocol, which is for bolstering administrative control, was to develop an engineered safety feature that would eliminate expensive tests and administrative decisions. A drum insert design was evaluated that would

  2. Performance of Silicon carbide whisker reinforced ceramic inserts on Inconel 718 in end milling process

    International Nuclear Information System (INIS)

    Reddy, M M; Joshua, C X H

    2016-01-01

    An experimental investigation is planned in order to study the machinability of Inconel 718 with silicon carbide whisker reinforced ceramic inserts in end milling process. The relationship between the cutting speed, feed rate, and depth of cut against the response factors are studied to show the level of significance of each parameter. The cutting parameters are optimized by using Taguchi method. Implementing analysis of variance, the parameter which influences the surface roughness the most is determined to be the cutting speed, followed by the feed rate and depth of cut. Meanwhile, the optimal cutting condition is determined to have high cutting speed, low feed rate, and high depth of cut in the range of selected parameters. (paper)

  3. Face and content validity of a virtual-reality simulator for myringotomy with tube placement.

    Science.gov (United States)

    Huang, Caiwen; Cheng, Horace; Bureau, Yves; Agrawal, Sumit K; Ladak, Hanif M

    2015-10-20

    Myringotomy with tube insertion can be challenging for junior Otolaryngology residents as it is one of the first microscopic procedures they encounter. The Western myringotomy simulator was developed to allow trainees to practice microscope positioning, myringotomy, and tube placement. This virtual-reality simulator is viewed in stereoscopic 3D, and a haptic device is used to manipulate the digital ear model and surgical tools. To assess the face and content validity of the Western myringotomy simulator. The myringotomy simulator was integrated with new modules to allow speculum placement, manipulation of an operative microscope, and insertion of the ventilation tube through a deformable tympanic membrane. A questionnaire was developed in consultation with instructing surgeons. Fourteen face validity questions focused on the anatomy of the ear, simulation of the operative microscope, appearance and movement of the surgical instruments, deformation and cutting of the eardrum, and myringotomy tube insertion. Six content validity questions focused on training potential on surgical tasks such as speculum placement, microscope positioning, tool navigation, ear anatomy, myringotomy creation and tube insertion. A total of 12 participants from the Department of Otolaryngology-Head and Neck Surgery were recruited for the study. Prior to completing the questionnaire, participants were oriented to the simulator and given unlimited time to practice until they were comfortable with all of its aspects. Responses to 12 of the 14 questions on face validity were predominantly positive. One issue of concern was with contact modeling related to tube insertion into the eardrum, and the second was with the movement of the blade and forceps. The former could be resolved by using a higher resolution digital model for the eardrum to improve contact localization. The latter could be resolved by using a higher fidelity haptic device. With regard to content validity, 64% of the responses

  4. Radioactivity transport following steam generator tube rupture

    International Nuclear Information System (INIS)

    Hopenfeld, J.

    1985-03-01

    A review of the capabilities of the CITADEL computer code as well as plant experience to project radioactivity releases following a steam generator tube rupture in PWR's shows that certain experimental data are needed for reliable off-site dose predictions. This article defines five parameters which are the key for such predictions and discusses the functional dependence of these parameters on various operational variables. The above parameters can be used in conjunction with CITADEL or they can be inserted in the appropriate equations which then conveniently can be programmed as a subroutine in thermal-hydraulic system codes. A joint Westinghouse, Electric Power Research Institute and Nuclear Regulatory Commission Program aimed at obtaining the five parameters empirically is described

  5. An in vitro comparison of tracheostomy tube cuffs

    Directory of Open Access Journals (Sweden)

    Maguire S

    2015-04-01

    Full Text Available Seamus Maguire,1 Frances Haury,2 Korinne Jew2 1Research and Development, Covidien Respiratory and Monitoring Solutions, Athlone, Ireland; 2Medical Affairs, Covidien Respiratory and Monitoring Solutions, Boulder, CO, USA Introduction: The Shiley™ Flexible adult tracheostomy tube with TaperGuard™ cuff has been designed through its geometry, materials, diameter, and wall thickness to minimize micro-aspiration of fluids past the cuff and to provide an effective air seal in the trachea while also minimizing the risk of excessive contact pressure on the tracheal mucosa. The cuff also has a deflated profile that may allow for easier insertion through the stoma site. This unique design is known as the TaperGuard™ cuff. The purpose of the observational, in vitro study reported here was to compare the TaperGuard™ taper-shaped cuff to a conventional high-volume low-pressure cylindrical-shaped cuff (Shiley™ Disposable Inner Cannula Tracheostomy Tube [DCT] with respect to applied tracheal wall pressure, air and fluid sealing efficacy, and insertion force.Methods: Three sizes of tracheostomy tubes with the two cuff types were placed in appropriately sized tracheal models and lateral wall pressure was measured via pressure-sensing elements on the inner surface. Fluid sealing performance was assessed by inflating the cuffs within the tracheal models (25 cmH2O, instilling water above the cuff, and measuring fluid leakage past the cuff. To measure air leak, tubes were attached to a test lung and ventilator, and leak was calculated by subtracting the average exhaled tidal volume from the average delivered tidal volume. A tensile test machine was used to measure insertion force for each tube with the cuff deflated to simulate clinical insertion through a stoma site.Results: The average pressure exerted on the lateral wall of the model trachea was lower for the taper-shaped cuff than for the cylindrical cuff under all test conditions (P<0.05. The taper

  6. Direct random insertion mutagenesis of Helicobacter pylori.

    NARCIS (Netherlands)

    Jonge, de R.; Bakker, D.; Vliet, van AH; Kuipers, E.J.; Vandenbroucke-Grauls, C.M.J.E.; Kusters, J.G.

    2003-01-01

    Random insertion mutagenesis is a widely used technique for the identification of bacterial virulence genes. Most strategies for random mutagenesis involve cloning in Escherichia coli for passage of plasmids or for phenotypic selection. This can result in biased selection due to restriction or

  7. Direct random insertion mutagenesis of Helicobacter pylori

    NARCIS (Netherlands)

    de Jonge, Ramon; Bakker, Dennis; van Vliet, Arnoud H. M.; Kuipers, Ernst J.; Vandenbroucke-Grauls, Christina M. J. E.; Kusters, Johannes G.

    2003-01-01

    Random insertion mutagenesis is a widely used technique for the identification of bacterial virulence genes. Most strategies for random mutagenesis involve cloning in Escherichia coli for passage of plasmids or for phenotypic selection. This can result in biased selection due to restriction or

  8. Angiotensin Converting Enzyme Insertion/Deletion Gene ...

    African Journals Online (AJOL)

    Angiotensin Converting Enzyme Insertion/Deletion Gene Polymorphism: An Observational Study among Diabetic Hypertensive Subjects in Malaysia. ... Methods: The pharmacological effect of ACE inhibition on mean arterial pressure (MAP) and glomerular filtration rate (GFR) were observed among a total of 62 subjects for ...

  9. Insertion Loss of Personal Protective Clothing

    International Nuclear Information System (INIS)

    Shull, D.J.

    1999-01-01

    The use of personal protective clothing that covers the head is a common practice in many industries. Such personal protective clothing will impact the sound pressure level and the frequency content of sounds to which the wearer will be exposed. The use of such clothing, then, may impact speech and alarm audibility. A measure of the impact of such clothing is its insertion loss. Insertion loss measurements were performed on four types of personal protective clothing in use by Westinghouse Savannah River Company personnel which utilize cloth and plastic hood configurations to protect the head. All clothing configurations tested at least partially cover the ears. The measurements revealed that insertion loss of the items tested was notable at frequencies above 1000 Hz only and was a function of material stiffness and acoustic flanking paths to the ear. Further, an estimate of the clothing's noise reduction rating reveals poor performance in that regard, even though the insertion loss of the test articles was significant at frequencies at and above 1000 Hz.'

  10. Aspects of insertion in random trees

    NARCIS (Netherlands)

    Bagchi, Arunabha; Reingold, E.M.

    1982-01-01

    A method formulated by Yao and used by Brown has yielded bounds on the fraction of nodes with specified properties in trees bult by a sequence of random internal nodes in a random tree built by binary search and insertion, and show that in such a tree about bounds better than those now known. We

  11. Patients Comprehension of Pharmaceutical Package Inserts ...

    African Journals Online (AJOL)

    Tropical Journal of Pharmaceutical Research December 2015; 14 (12): ... Available online at http://www.tjpr.org ... patients/consumers about PPI. ... the perception of outpatients of Karachi about ... Do you store the medication at the temperature specified in the package insert ... drugs available in local market of Pakistan was.

  12. Drift tubes of Linac 2

    CERN Multimedia

    Photographic Service

    1977-01-01

    Being redied for installation, those at the right are for tank 1, those on the left for tank 2. Contrary to Linac 1, which had drift-tubes supported on stems, here the tubes are suspended, for better mechanical stability.

  13. NEI You Tube Videos: Amblyopia

    Medline Plus

    Full Text Available ... YouTube Videos: Amblyopia Embedded video for NEI YouTube Videos: Amblyopia ... *PDF files require the free Adobe® Reader® software for viewing. This website is maintained by the ...

  14. Tubing For Sampling Hydrazine Vapor

    Science.gov (United States)

    Travis, Josh; Taffe, Patricia S.; Rose-Pehrsson, Susan L.; Wyatt, Jeffrey R.

    1993-01-01

    Report evaluates flexible tubing used for transporting such hypergolic vapors as those of hydrazines for quantitative analysis. Describes experiments in which variety of tubing materials, chosen for their known compatibility with hydrazine, flexibility, and resistance to heat.

  15. Prospects for stronger calandria tubes

    International Nuclear Information System (INIS)

    Ells, C.E.; Coleman, C.E.; Hosbons, R.R.; Ibrahim, E.F.; Doubt, G.L.

    1990-12-01

    The CANDU calandria tubes, made of seam welded and annealed Zircaloy-2, have given exemplary service in-reactor. Although not designed as a system pressure containment, calandria tubes may remain intact even in the face of pressure tube rupture. One such incident at Pickering Unit 2 demonstrated the economic advantage of such an outcome, and a case can be made for increasing the probability that other calandria tubes would perform in a similar fashion. Various methods of obtaining stronger calandria tubes are available, and reviewed here. When the tubes are internally pressurized, the weld is the weak section of the tube. Increasing the oxygen concentration in the starting sheet, and thickening the weld, are promising routes to a stronger tube

  16. DWPF Sample Vial Insert Study-Statistical Analysis of DWPF Mock-Up Test Data

    International Nuclear Information System (INIS)

    Harris, S.P.

    1997-01-01

    This report is prepared as part of Technical/QA Task Plan WSRC-RP-97-351 which was issued in response to Technical Task Request HLW/DWPF/TTR-970132 submitted by DWPF. Presented in this report is a statistical analysis of DWPF Mock-up test data for evaluation of two new analytical methods which use insert samples from the existing HydragardTM sampler. The first is a new hydrofluoric acid based method called the Cold Chemical Method (Cold Chem) and the second is a modified fusion method.Both new methods use the existing HydragardTM sampler to collect a smaller insert sample from the process sampling system. The insert testing methodology applies to the DWPF Slurry Mix Evaporator (SME) and the Melter Feed Tank (MFT) samples. Samples in small 3 ml containers (Inserts) are analyzed by either the cold chemical method or a modified fusion method. The current analytical method uses a HydragardTM sample station to obtain nearly full 15 ml peanut vials. The samples are prepared by a multi-step process for Inductively Coupled Plasma (ICP) analysis by drying, vitrification, grinding and finally dissolution by either mixed acid or fusion. In contrast, the insert sample is placed directly in the dissolution vessel, thus eliminating the drying, vitrification and grinding operations for the Cold chem method. Although the modified fusion still requires drying and calcine conversion, the process is rapid due to the decreased sample size and that no vitrification step is required.A slurry feed simulant material was acquired from the TNX pilot facility from the test run designated as PX-7.The Mock-up test data were gathered on the basis of a statistical design presented in SRT-SCS-97004 (Rev. 0). Simulant PX-7 samples were taken in the DWPF Analytical Cell Mock-up Facility using 3 ml inserts and 15 ml peanut vials. A number of the insert samples were analyzed by Cold Chem and compared with full peanut vial samples analyzed by the current methods. The remaining inserts were analyzed by

  17. Expansion lyre-shaped tube

    International Nuclear Information System (INIS)

    Andro, Jean.

    1973-01-01

    The invention relates the expansion lyre-shaped tube portions formed in dudgeoned tubular bundles between two bottom plates. An expansion lyre comprises at least two sets of tubes of unequal lengths coplanar and symmetrical with respect to the main tube axis, with connecting portions between the tubes forming said sets. The invention applies to apparatus such as heat exchangers, heaters, superheaters or breeders [fr

  18. Acute diaphragmatic paralysis caused by chest-tube trauma to phrenic nerve

    Energy Technology Data Exchange (ETDEWEB)

    Nahum, E.; Ben-Ari, J.; Schonfeld, T. [Pediatric Intensive Care Unit, Schneider Children' s Medical Center of Israel, Petah Tiqva (Israel); Horev, G. [Dept. of Diagnostic Radiology, Schneider Children' s Medical Center of Israel, Petah Tiqva (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel)

    2001-06-01

    A 3{sup 1}/{sub 2}-year-old child developed unilateral diaphragmatic paralysis after chest drain insertion. Plain chest X-ray demonstrated paravertebral positioning of the chest-tube tip, and magnetic resonance imaging revealed hematomas in the region of the chest-tube tip and the phrenic nerve fibers. The trauma to the phrenic nerve was apparently secondary to malposition of the chest tube. This is a rare complication and has been reported mainly in neonates. Radiologists should notify the treating physicians that the correct position of a chest drain tip is at least 2 cm distant from the vertebrae. (orig.)

  19. Acute diaphragmatic paralysis caused by chest-tube trauma to phrenic nerve

    International Nuclear Information System (INIS)

    Nahum, E.; Ben-Ari, J.; Schonfeld, T.; Horev, G.

    2001-01-01

    A 3 1 / 2 -year-old child developed unilateral diaphragmatic paralysis after chest drain insertion. Plain chest X-ray demonstrated paravertebral positioning of the chest-tube tip, and magnetic resonance imaging revealed hematomas in the region of the chest-tube tip and the phrenic nerve fibers. The trauma to the phrenic nerve was apparently secondary to malposition of the chest tube. This is a rare complication and has been reported mainly in neonates. Radiologists should notify the treating physicians that the correct position of a chest drain tip is at least 2 cm distant from the vertebrae. (orig.)

  20. Frequency of changing enteral alimentation bags and tubing, and adverse clinical outcomes in patients in a long term care facility.

    Science.gov (United States)

    Graham, S; McIntyre, M; Chicoine, J; Gerard, B; Laughren, R; Cowley, G; Morrison, J; Aoki, F Y; Nicolle, L E

    1993-01-01

    Enteral alimentation, given via nasogastric or gastrostomy tubes, is a well established practice to provide nutrition for patients with significant neurological injury. The frequency with which enteral feeding bags and tubes require change and potential adverse effects associated with bacterial contamination of tube feeds remain controversial. The authors studied different times between enteral feeding bag and tube changes, and the effect on adverse clinical outcomes in residents of a long term care facility. In the first study, residents were randomized to 24 h (n = 2), 48 h (n = 3) or 72 h (n = 6) tube feeding and bag changes with clinical status monitored in a standardized fashion for six months. In the second study, patients were randomized to 24 h (n = 6) or 72 h (n = 6) changes. Patient-days of follow-up were 382, 574 and 1000 for the three arms of the first study period and 556 and 496 for the two arms of the second study. No differences in potential clinical adverse events--including fever, gastrointestinal symptoms or pneumonia--were observed with different durations of tubing change. This study suggests it is appropriate to change alimentation tube and feeding bags every 72 h (rather than every 24 h). The less frequent changes will decrease supply costs and free nursing time for other activities.