Treitl, Karla Maria; Woerner, Benedikt; Schinner, Regina; Czihal, Michael; Notohamiprodjo, Susan; Hoffmann, Ulrich; Treitl, Marcus
2017-09-01
To analyse the patency rates of femoro-popliteal stenting with different self-expandable Nitinol stent-designs. Two hundred and twenty-two patients (142 (64%) male; age 72.4 ± 11.6 years) with symptomatic femoro-popliteal peripheral arterial occlusive disease (PAOD) underwent percutaneous transluminal angioplasty (PTA) and stenting with three different Nitinol stents (interwoven IW: n = 70; closed-cell CC: n = 85; open-cell OC: n = 67). One-year post-procedural target lesion revascularization (TLR_12M) rates were investigated with regard to co-morbidities: diabetes (DBM), hyperlipidaemia (HLP), hypertension (RR), coronary artery disease (CAD) and degree of calcification. Twelve-month follow-up data were available for 60, 69 and 50 patients in the IW, OC and CC groups (179 patients in total). The cumulative patency (IW: 52 (86.7%); OC: 50 (72.5%); CC: 23 (46.0%); P stent and the highest TLR_12M for the CC stent. The interwoven stent-design was superior to the standard open- and closed-cell stent-designs in endovascular treatment of femoro-popliteal PAOD in a follow-up period of 12 months. • Results of femoro-popliteal stenting are still unsatisfactory. • Comparative studies for currently available different Nitinol stent-designs are lacking. • This is a first comparative study on long-term patency of different Nitinol stent-designs. • Interwoven stent-design leads to improved long-term patency. • Interwoven stent-design leads to lower TLR than other stent-designs.
DEFF Research Database (Denmark)
Tønnesen, K H; Holstein, P; Andersen, E
1991-01-01
dilatation of femoro-popliteal occlusions, the balloons were inflated on both sides of the lesion. The dilated segment was then isolated from the circulation. Through a sideport between the balloons 5 mg of tissue type plasminogen activator and 1000 IU of heparin were installed within the segment for 30 min...
Vascular endoprostheses for femoro-popliteal occlusive disease
Energy Technology Data Exchange (ETDEWEB)
Triller, J; Mahler, F; Do, D; Thalmann, R
1989-03-01
A self-expanding vascular endoprothesis (wall stent) was implanted in 26 patients with femoro-popliteal occlusive disease following recurrent stenosis or occlusion after percutaneous angioplasty. Implantation was successful in all cases and there were no complications. Five of the 26 patients developped a thrombosis in the first nine days; in four of these, thrombolysis was successful. Patency rate after one month was 96%, after three months 95%, after six months 85% and after nine months 87%. In order to prevent thrombosis after implantation, anticoagulant therapy is indicated. Poor distal flow encourages intimal hyperplasia and therefore recurrences.
Vascular endoprostheses for femoro-popliteal occlusive disease
International Nuclear Information System (INIS)
Triller, J.; Mahler, F.; Do, D.; Thalmann, R.
1989-01-01
A self-expanding vascular endoprothesis (wall stent) was implanted in 26 patients with femoro-popliteal occlusive disease following recurrent stenosis or occlusion after percutaneous angioplasty. Implantation was successful in all cases and there were no complications. Five of the 26 patients developped a thrombosis in the first nine days; in four of these, thrombolysis was successful. Patency rate after one month was 96%, after three months 95%, after six months 85% and after nine months 87%. In order to prevent thrombosis after implantation, anticoagulant therapy is indicated. Poor distal flow encourages intimal hyperplasia and therefore recurrences. (orig.) [de
Graft type for femoro-popliteal bypass surgery.
Ambler, Graeme K; Twine, Christopher P
2018-02-11
Femoro-popliteal bypass is implemented to save limbs that might otherwise require amputation, in patients with ischaemic rest pain or tissue loss; and to improve walking distance in patients with severe life-limiting claudication. Contemporary practice involves grafts using autologous vein, polytetrafluoroethylene (PTFE) or Dacron as a bypass conduit. This is the second update of a Cochrane review first published in 1999 and last updated in 2010. To assess the effects of bypass graft type in the treatment of stenosis or occlusion of the femoro-popliteal arterial segment, for above- and below-knee femoro-popliteal bypass grafts. For this update, the Cochrane Vascular Information Specialist searched the Vascular Specialised Register (13 March 2017) and CENTRAL (2017, Issue 2). Trial registries were also searched. We included randomised trials comparing at least two different types of femoro-popliteal grafts for arterial reconstruction in patients with femoro-popliteal ischaemia. Randomised controlled trials comparing bypass grafting to angioplasty or to other interventions were not included. Both review authors (GKA and CPT) independently screened studies, extracted data, assessed trials for risk of bias and graded the quality of the evidence using GRADE criteria. We included nineteen randomised controlled trials, with a total of 3123 patients (2547 above-knee, 576 below-knee bypass surgery). In total, nine graft types were compared (autologous vein, polytetrafluoroethylene (PTFE) with and without vein cuff, human umbilical vein (HUV), polyurethane (PUR), Dacron and heparin bonded Dacron (HBD); FUSION BIOLINE and Dacron with external support). Studies differed in which graft types they compared and follow-up ranged from six months to 10 years.Above-knee bypassFor above-knee bypass, there was moderate-quality evidence that autologous vein grafts improve primary patency compared to prosthetic grafts by 60 months (Peto odds ratio (OR) 0.47, 95% confidence interval (CI
Dirven, M.; Scharn, D.M.; Blankensteijn, J.D.; Vliet, J.A. van der
2008-01-01
PURPOSE: To investigate the usefulness of greater saphenous vein preservation for future vascular reconstructions during femoro-popliteal bypass surgery. DESIGN: Post-hoc analysis of data acquired in a randomized multi-centre clinical trial comparing two different vascular prostheses
Energy Technology Data Exchange (ETDEWEB)
Strecker, Ernst-Peter K.; Boos, Irene B.L.; Goettmann, Dieter; Vetter, Sylvia [Department of Imaging, Interventional Radiology, and Nuclear Medicine, Diakonissen Hospital, Diakonissenstrasse 28, 76199, Karlsruhe (Germany)
2004-02-01
The aim of this study was to determine the patency rate after femoro-popliteal stenting followed by oral clopidogrel plus long-term aspirin. In a prospective trial, 31 patients with a total of 33 femoro-popliteal artery lesions (21 stenoses, 12 occlusions; 24 femoral, 9 popliteal) were treated with flexible tantalum stents after unsuccessful percutaneous transluminal angioplasty (PTA) preceded by local fibrinolysis in 5 of 12 patients with total occlusion. Post-interventionally, oral aspirin 100 mg was started simultaneously for the long term and was combined with an oral loading dose of 300 mg clopidogrel, followed by 75 mg clopidogrel daily for 28 days. Patients were followed for at least 12 months (maximum 34 months) by clinical examination, Doppler pressure measurement, color and duplex sonography, and angiography in case of suspicion of restenosis. In a retrospective analysis, the results were compared with those of historical groups of patients having received aspirin only (41 patients) or a long-term high-dose low molecular weight heparin (LMWH)+aspirin treatment (42 patients). Three small puncture aneurysms were treated successfully by conservative means and were categorized as minor bleeding complication. Cumulative primary patency rate (PPR) was 76{+-}7.5% (1 year), and 70{+-}9.6% (2 years) in the clopidogrel+aspirin group, thus being tendentiously better than in the aspirin-only group showing 75{+-}4.6% (1 year), and 50{+-}8.1% (2 years). Long-term high-dose LMWH+aspirin treatment showed 87{+-}5.8% (1 year), and 72{+-}9.1% (2 years), thus being superior to the other treatment regimes, with a statistically significant difference (p<0.05) between the LMWH+aspirin and the aspirin group. Clopidogrel plus aspirin is a safe medication regimen and may be effective in the prevention of early stent thrombosis. Mid- and long-term patency rate seems to be intermediate as compared with other therapeutic regimens. The LMWH+aspirin seems to be superior compared with
International Nuclear Information System (INIS)
Strecker, Ernst-Peter K.; Boos, Irene B.L.; Goettmann, Dieter; Vetter, Sylvia
2004-01-01
The aim of this study was to determine the patency rate after femoro-popliteal stenting followed by oral clopidogrel plus long-term aspirin. In a prospective trial, 31 patients with a total of 33 femoro-popliteal artery lesions (21 stenoses, 12 occlusions; 24 femoral, 9 popliteal) were treated with flexible tantalum stents after unsuccessful percutaneous transluminal angioplasty (PTA) preceded by local fibrinolysis in 5 of 12 patients with total occlusion. Post-interventionally, oral aspirin 100 mg was started simultaneously for the long term and was combined with an oral loading dose of 300 mg clopidogrel, followed by 75 mg clopidogrel daily for 28 days. Patients were followed for at least 12 months (maximum 34 months) by clinical examination, Doppler pressure measurement, color and duplex sonography, and angiography in case of suspicion of restenosis. In a retrospective analysis, the results were compared with those of historical groups of patients having received aspirin only (41 patients) or a long-term high-dose low molecular weight heparin (LMWH)+aspirin treatment (42 patients). Three small puncture aneurysms were treated successfully by conservative means and were categorized as minor bleeding complication. Cumulative primary patency rate (PPR) was 76±7.5% (1 year), and 70±9.6% (2 years) in the clopidogrel+aspirin group, thus being tendentiously better than in the aspirin-only group showing 75±4.6% (1 year), and 50±8.1% (2 years). Long-term high-dose LMWH+aspirin treatment showed 87±5.8% (1 year), and 72±9.1% (2 years), thus being superior to the other treatment regimes, with a statistically significant difference (p<0.05) between the LMWH+aspirin and the aspirin group. Clopidogrel plus aspirin is a safe medication regimen and may be effective in the prevention of early stent thrombosis. Mid- and long-term patency rate seems to be intermediate as compared with other therapeutic regimens. The LMWH+aspirin seems to be superior compared with CLAFS
Viswanath, Y K; Rogers, I M
1999-09-01
Complete knee dislocation is a rare injury and an associated incidence of popliteal artery damage ranges from 16-60% of cases. It occurs commonly in road traffic accidents and in high velocity trauma where significant contact remains as the usual mode of injury. We describe a rare case of non-contact knee dislocation with popliteal artery injury sustained while practising Aikido, a type of martial art. This patient successfully underwent closed reduction of the knee with an emergency vein bypass graft. Similar injury in association with Aikido has not been described in the English literature previously. Various martial art injuries are briefly discussed and safety recommendations made.
A non-contact complete knee dislocation with popliteal artery disruption, a rare martial arts injury
Viswanath, Y; Rogers, I
1999-01-01
Complete knee dislocation is a rare injury and an associated incidence of popliteal artery damage ranges from 16-60% of cases. It occurs commonly in road traffic accidents and in high velocity trauma where significant contact remains as the usual mode of injury. We describe a rare case of non-contact knee dislocation with popliteal artery injury sustained while practising Aikido, a type of martial art. This patient successfully underwent closed reduction of the knee with an emergency vein byp...
Popliteal artery entrapment syndrome.
LENUS (Irish Health Repository)
O'Leary, D P
2010-01-01
Popliteal artery entrapment syndrome is a rare abnormality of the anatomical relationship between the popliteal artery and adjacent muscles or fibrous bands in the popliteal fossa. The following is a case report of a 19 year old female, in whom popliteal artery entrapment syndrome was diagnosed, and successfully treated surgically. A review of literature is also presented and provides details on how PAES is classified, diagnosed both clinically and radiologically, and treated surgically.
Energy Technology Data Exchange (ETDEWEB)
Brechtel, Klaus [Universitaetsklinikum Tuebingen (Germany). Abt. fuer Diagnostische und Interventionelle Radiologie
2010-09-15
The endovascular treatment of femoro-popliteal PAD is still challenging. The number of endovascular procedures in this vessel segment has increased over the past years. Despite new technologies, the outcome of endovascular therapy in terms of durability is still weak. In the meantime, the latest developments are progressing, such as the combination of mechanical angioplasty and drug delivery. Additionally, there are former techniques, such as debulking by atherectomy, which have been technically improved and now contribute to modern concepts of endovascular treatment. This article provides an overview on treatment indications and technical options including the latest technical developments. (orig.)
Directory of Open Access Journals (Sweden)
Joung Hun Byun
2017-10-01
Full Text Available Background: Lesions in distal target arteries hinder surgical bypass procedures in patients with peripheral arterial occlusive disease. Methods: Between April 2012 and October 2015, 16 patients (18 limbs with lifestyle- limiting claudication (n=12 or chronic critical limb ischemia (n=6 underwent femoral–above-knee (AK polytetrafluoroethylene (PTFE bypass grafts with a bridging stent graft placement between the distal target popliteal artery and the PTFE graft. Ring-supported PTFE grafts were used in all patients with no available vein for graft material. Follow-up evaluations assessed clinical symptoms, the ankle-brachial index, ultrasonographic imaging and/or computed tomography angiography, the primary patency rate, and complications. Results: All procedures were successful. The mean follow-up was 12.6 months (range, 11 to 14 months, and there were no major complications. The median baseline ankle-brachial index of 0.4 (range, 0.2 to 0.55 significantly increased to 0.8 (range, 0.5 to 1.0 at 12 months (p<0.01. The primary patency rate at 12 months was 83.3%. The presenting symptoms resolved within 2 weeks. Conclusion: In AK bypasses with a diffusely diseased distal target popliteal artery or when below-knee (BK bypass surgery is impossible, this procedure could be clinically effective and safe when used as an alternative to femoral-BK bypass surgery.
Recanalization of superficial femoral artery by retrograde approach via popliteal artery
International Nuclear Information System (INIS)
Kim, Jae Kyu; Kim, Hyung Kil; Yun, Ung; Seo, Jeong Jin; Kang, Heoung Keun
1995-01-01
To recanalize the occlusive lesion of superficial femoral artery at origin site by retrograde approach via popliteal artery. 15 patients, who were poor surgical candidates due to coronary artery disease and who had severe occlusive lesion of superficial femoral artery close to its origin with good distal runoffs to popliteal artery, were selected. Patients were all men and range of age were from 53 years to 66 years (mean age: 63 years). Range of lesion length were from 15 cm to 30 cm (mean length: 22.4 cm). Localization of popliteal artery was done with Doppler stethoscope or 'road-map' DSA. The method of recanalization were transluminal endarterectomy catheter (TEC), TEC and angioplasty, thrombolysoangioplasty (TLA). Retrograde puncture of popliteal artery was done in 15 patients successfully. TEC and PTA was performed in 9 patients, TEC only in 2 patients, and TLA and PTA in 2 patients. During the follow-up period of 5 months to 2 years reocclusion did not occur in 10 patients except for 1 patient with poor cardiac output in whom it occurred 1 day later. Remained 4 patients were lost in follow up. Any neurologic or vascular complication did not occur. Retrograde approach of superficial femoral artery via popliteal artery in patients with difficult vascular intervention by common method provides a useful, alternative recanalization method
Recanalization of superficial femoral artery by retrograde approach via popliteal artery
Energy Technology Data Exchange (ETDEWEB)
Kim, Jae Kyu; Kim, Hyung Kil; Yun, Ung; Seo, Jeong Jin; Kang, Heoung Keun [Chonnam University Medical School, Kwangju (Korea, Republic of)
1995-09-15
To recanalize the occlusive lesion of superficial femoral artery at origin site by retrograde approach via popliteal artery. 15 patients, who were poor surgical candidates due to coronary artery disease and who had severe occlusive lesion of superficial femoral artery close to its origin with good distal runoffs to popliteal artery, were selected. Patients were all men and range of age were from 53 years to 66 years (mean age: 63 years). Range of lesion length were from 15 cm to 30 cm (mean length: 22.4 cm). Localization of popliteal artery was done with Doppler stethoscope or 'road-map' DSA. The method of recanalization were transluminal endarterectomy catheter (TEC), TEC and angioplasty, thrombolysoangioplasty (TLA). Retrograde puncture of popliteal artery was done in 15 patients successfully. TEC and PTA was performed in 9 patients, TEC only in 2 patients, and TLA and PTA in 2 patients. During the follow-up period of 5 months to 2 years reocclusion did not occur in 10 patients except for 1 patient with poor cardiac output in whom it occurred 1 day later. Remained 4 patients were lost in follow up. Any neurologic or vascular complication did not occur. Retrograde approach of superficial femoral artery via popliteal artery in patients with difficult vascular intervention by common method provides a useful, alternative recanalization method.
Directory of Open Access Journals (Sweden)
Marcelo Bettega
2011-12-01
Full Text Available A síndrome do aprisionamento da artéria poplítea caracteriza-se pela compressão desta artéria sendo a principal causa de claudicação intermitente em jovens. Homem, 18 anos, branco, apresentava parestesia, frialdade e palidez do pé direito, iniciada 24 horas após exercício físico. Em membro inferior direito, ausência de pulsos tibial posterior e dorsal do pé. À flexão dorsal e flexão plantar forçadas, houve diminuição dos pulsos tibial posterior e dorsal do pé à esquerda. Tratado cirurgicamente, o paciente apresentou pulso em ambas as artérias. A síndrome é mais frequente em homens e a prevalência varia entre 0,16 e 3,5%. O aprisionamento da artéria poplítea tipo III é mais comum. A falta de tratamento pode levar à embolia, trombose e aneurismas pós-estenóticos. Esta síndrome deve ser lembrada como causa de dor na perna, especialmente em homens jovens e de prática esportiva intensa.Popliteal artery entrapment syndrome is the compression of the popliteal artery and is the main cause of intermittent claudication in young patients. An 18-year-old man was admitted at our service complaining of right foot paresthesia, coldness, and pallor that appeared 24 hours after physical activity. Posterior tibial and dorsal artery of foot pulses were not present in right lower limb. Diminished posterior tibial and dorsal artery of the foot pulses were found in left lower limb at dorsal flexion and forced plantar flexion. After surgery, both pulses were present. This syndrome is more frequent in men and its prevalence varies between 0.16 and 3.5%. Popliteal artery entrapment type III is most common. Non-treated entrapment can lead to embolism, thrombosis and post-stenotic aneurysms. The syndrome must be considered as a cause of lower limb pain specially in young men with intense sport practice history.
Directory of Open Access Journals (Sweden)
Koki Takizawa
2017-01-01
Full Text Available We report a rare case of cystic adventitial disease of popliteal artery with venous aneurysm of popliteal vein. A 46-year-old woman had sudden-onset intermittent claudication and coldness in her right leg. The right-sided ankle-brachial pressure index (ABI was 1.01, but peripheral arterial pulsation was decreased at knee venting position. Computed tomography revealed simple cystic lesion of the popliteal artery and stenosis of the arterial lumen in this lesion. The patient was treated by complete resection of the cystic adventitial layer of popliteal artery. A venous aneurysm of popliteal vein was revealed by intraoperative echo and was simply ligated. The patient had uneventful postoperative course and no symptoms of relevance during the two years of follow-up.
Cystic adventitial disease of popliteal artery with significant stenosis
International Nuclear Information System (INIS)
Gupta, Ranjana; Mittal, Puneet; Gupta, Praveen; Jindal, Nancy
2013-01-01
Cystic adventitial disease of popliteal artery is a rare condition of unknown etiology which usually presents in middle-aged men. We present Doppler and computed tomography angiography findings in a case of cystic adventitial disease with significant obstruction of popliteal artery, with secondary narrowing of popliteal vein
Endovascular repair of blunt popliteal arterial injuries
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Zhong, Shan; Zhang, Xiquan; Chen, Zhong; Zhu, Wei; Pan, Xiaolin [Dept. of nterventional Vascular, The 148th Hospital of Chinese People' s Liberation Army, Zibo (China); Dong, Peng; Sun, Yequan [Dept. of Medical Imaging, Weifang Medical University, Weifang (China); Qi, Deming [Dept. of Medical Imaging, Qilu Medical University, Zibo (China)
2016-09-15
To evaluate the feasibility and effectiveness of endovascular repair for blunt popliteal arterial injuries. A retrospective analysis of seven patients with clinical suspicion of popliteal arterial injuries that were confirmed by arteriography was performed from September 2009 to July 2014. Clinical data included demographics, mechanism of injury, type of injury, location of injury, concomitant injuries, time of endovascular procedures, time interval from trauma to blood flow restoration, instrument utilized, and follow-up. All patients were male (mean age of 35.9 ± 10.3 years). The type of lesion involved intimal injury (n = 1), partial transection (n = 2), complete transection (n = 2), arteriovenous fistula (n = 1), and pseudoaneurysm (n = 1). All patients underwent endovascular repair of blunt popliteal arterial injuries. Technical success rate was 100%. Intimal injury was treated with a bare-metal stent. Pseudoaneurysm and popliteal artery transections were treated with bare-metal stents. Arteriovenous fistula was treated with bare-metal stent and coils. No perioperative death and procedure-related complication occurred. The average follow-up was 20.9 ± 2.3 months (range 18–24 months). One patient underwent intra-arterial thrombolysis due to stent thrombosis at 18 months after the procedure. All limbs were salvaged. Stent migration, deformation, or fracture was not found during the follow-up. Endovascular repair seems to be a viable approach for patients with blunt popliteal arterial injuries, especially on an emergency basis. Endovascular repair may be effective in the short-term. Further studies are required to evaluate the long-term efficacy of endovascular repair.
Uncommon Diseases of The Popliteal Artery: A Pictorial Review
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Mohamed Jarraya
2016-08-01
Full Text Available Abstract Uncommon diseases of the popliteal artery include cystic adventitial disease, popliteal artery entrapment syndrome (PAES and popliteal artery aneurysm (PAA. Because all of these conditions may present with pain or intermittent claudication, imaging is crucial for differentiating them and directing management. Delayed diagnosis can lead to major complications, including acute limb ischemia. Our aim is to provide an illustrative overview of these conditions in order to make radiologists aware of them and avoid misdiagnosis for timely appropriate management. Teaching Points • Cystic adventitial disease diagnosis is based on evidence of cysts within artery walls. • A variety of anatomic variations may result in PAES. • PAES may be bilateral. • PAA is most commonly encountered in men. • Acute complications of PAA include acute thrombosis and distal embolization.
Magnetic resonance imaging of popliteal artery pathologies
International Nuclear Information System (INIS)
Holden, Andrew; Merrilees, Stephen; Mitchell, Nicola; Hill, Andrew
2008-01-01
This paper illustrates examples of popliteal artery pathologies imaged with contrast enhanced magnetic resonance angiography (CE-MRA) and magnetic resonance imaging (MRI) at a single tertiary referral centre. Popliteal artery pathologies were identified in 1710 patients referred over a 6-year period with symptoms suggesting lower limb arterial occlusive disease. Common pathologies such as atherosclerotic occlusive disease, thromboemboli and aneurysm disease are discussed as well as unusual pathologies such as cystic adventitial disease, mycotic aneurysm and arterial entrapment. The combination of CE-MRA and the excellent soft tissue resolution of MRI allow detailed evaluation of arterial and peri-arterial pathologies, and facilitate appropriate management decisions
Magnetic resonance imaging of popliteal artery pathologies
Energy Technology Data Exchange (ETDEWEB)
Holden, Andrew [Department of Radiology, Auckland City Hospital, Park Road, Grafton, Auckland 9 (New Zealand)], E-mail: andrewh@adhb.govt.nz; Merrilees, Stephen [Department of Radiology, Auckland City Hospital, Park Road, Grafton, Auckland 9 (New Zealand)], E-mail: smerrilees@adhb.govt.nz; Mitchell, Nicola [Department of Radiology, Auckland City Hospital, Park Road, Grafton, Auckland 9 (New Zealand)], E-mail: nmit010@ec.auckland.ac.nz; Hill, Andrew [Department of Vascular Surgery, Auckland City Hospital, Park Road, Grafton, Auckland 9 (New Zealand)], E-mail: ahill@adhb.govt.nz
2008-07-15
This paper illustrates examples of popliteal artery pathologies imaged with contrast enhanced magnetic resonance angiography (CE-MRA) and magnetic resonance imaging (MRI) at a single tertiary referral centre. Popliteal artery pathologies were identified in 1710 patients referred over a 6-year period with symptoms suggesting lower limb arterial occlusive disease. Common pathologies such as atherosclerotic occlusive disease, thromboemboli and aneurysm disease are discussed as well as unusual pathologies such as cystic adventitial disease, mycotic aneurysm and arterial entrapment. The combination of CE-MRA and the excellent soft tissue resolution of MRI allow detailed evaluation of arterial and peri-arterial pathologies, and facilitate appropriate management decisions.
Bou, Steven; Day, Carly
2014-11-01
Popliteal artery entrapment syndrome (PAES) is a rare condition that should be suspected in a young patient with exertional lower extremity pain. We report the case of an 18-year-old female volleyball player with bilateral exertional lower extremity pain who had been previously diagnosed with tendinitis and periostitis. Diagnostic studies showed entrapment of the left popliteal artery and the left anterior tibial artery. To our knowledge, there has only been 1 previous report of anterior tibial artery involvement in PAES. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
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Palena, Luis Mariano, E-mail: marianopalena@hotmail.com; Manzi, Marco
2013-07-15
Purpose: To evaluate the efficacy and safety of “Direct Stent Puncture” technique for intraluminal stent recanalization in the femoro-popliteal segments. Methods and Materials: A cohort of diabetics who had symptomatic in-stent occlusion of the superficial femoral or popliteal arteries underwent endovascular recanalization. After antegrade failure, direct stent puncture technique was performed. The primary end-point was to efficacy assessment, intended as technical success and clinical improvement. The secondary end-point was safety assessment, intended as free of complication rate. Results: Fifty-four patients (37 men; 73.6 ± 8.5 years) underwent direct stent puncture technique, after several unsuccessful antegrade attempts to cross the occluded stent. Technical success for intraluminal stent recanalization was achieved in 53/54 (98.2%) of cases and failed in 1/54 (1.8%). Clinical improvement was obtained in 51/54 (94.4%) of cases, with regression of the clinical symptoms and improvement of the TcPO{sub 2}, from 3 ± 18 mmHg to 43 ± 11 mmHg after 15 days (p < 0.001). Free of complications rate was 92.5%. In 2/54 (3.7%) of cases distal embolization occurred, in 1/54 (1.9%) case a sudden vessel thrombosis was diagnosed after 12 hours and in 1/54 (1.9%) case hematoma at the stent puncture site was observed. Conclusions: Direct Stent Puncture technique is an efficacy and safety option for intraluminal stent recanalization in the femoro-popliteal segment in-stent occlusion.
Thrombosed Popliteal Artery Pseudoaneurysm as Herald of Tibial Osteochondroma
Directory of Open Access Journals (Sweden)
A.M. Ruales Romero
Full Text Available Background: Osteochondroma is the most common non-malignant tumour of bone, accounting for approximately one third of benign lesions in the skeleton. They often develop around the knee in the distal femur and in the proximal tibia and fibula. They present as a painless slow growing mass during adolescence and have been reported to cause damage to adjacent structures such as blood vessels; arterial damage is more common than venous injury and is usually a result of compression, stretching, and rubbing of the arterial wall. Such lesions include stenosis, thrombosis, and pseudoaneurysm formation possibly causing lower limb claudication or acute limb ischemia. Methods: An 18 year old male patient with a 4 week history of pain, hematoma, and oedema of the left calf without previous trauma is reported. A computed tomography scan (CT revealed a large popliteal artery pseudoaneurysm and its close relationship to a protrusion of the proximal tibia. Results: The popliteal artery was repaired by an external saphenous patch and the exostosis was removed. The patient had palpable popliteal and distal pulses after surgery and during the first year follow-up. Conclusions: Tibial osteochondroma should be considered in the differential diagnosis in young patients, among the potential causes of pseudoaneurysm of the femoral or popliteal artery. Surgical repair should be performed to restore normal blood flow with resection of the exostosis to prevent recurrence. Keywords: Popliteal artery, Pseudoaneurysm, Tibial exostosis, Osteochondroma
Popliteal artery entrapment syndrome in a young girl
International Nuclear Information System (INIS)
Haidar, Salwa; Thomas, Karen; Miller, Stephen
2005-01-01
Popliteal artery entrapment syndrome (PAES) is well-described in adults, but is an uncommon cause of lower-limb pain in children. We present an 11.5-year-old girl with thrombosed aneurysm of the right popliteal artery, subsequently diagnosed with bilateral type I PAES. Multimodality illustration of the radiological findings is presented. (orig.)
Onishi, Tadanobu; Shimizu, Takamasa; Omokawa, Shohei; Sananpanich, Kanit; Kido, Akira; Mahakkanukrauh, Pasuk; Tanaka, Yasuhito
2018-05-30
There is lack of anatomical information regarding cutaneous perforator of the popliteal artery and its connections with the descending branch of the inferior gluteal and profunda femoris arteries. We aimed to evaluate the anatomical basis of popliteal artery perforator-based propeller flap from the posterior thigh region and to demonstrate our experience utilizing this flap. Ten fresh cadaveric lower extremities were dissected following injection of a silicone compound into the femoral artery. We investigated the number, location, length, and diameter of cutaneous perforators of the popliteal artery. Based on the results, we treated three cases with a large soft tissue defect around the knee using popliteal artery perforator-based propeller flap. We found a mean of 1.9 cutaneous perforators arising from the popliteal artery with a mean pedicle length of 6 cm and a mean arterial internal diameter of 0.9 mm, which were located at an average of 4 cm proximal to the bicondylar line. The most distal perforator consistently arose along the small saphenous vein and connected proximally with concomitant artery of the posterior femoral cutaneous nerve, forming a connection with perforating arteries of the profunda femoris artery. A mean of 4.5 cutaneous perforators branched from the arterial connection sites. All clinical cases healed without any complications. The popliteal artery perforator-based propeller flap is reliable for reconstruction of soft tissue defects around the knee. The flap should include the deep fascia and concomitant artery along with the posterior femoral cutaneous nerve for maintaining the blood supply.
Endovascular Management of the Popliteal Artery: Comparison of Atherectomy and Angioplasty
Semaan, Elie; Hamburg, Naomi; Nasr, Wael; Shaw, Palma; Eberhardt, Robert; Woodson, Jonathan; Doros, Gheorghe; Rybin, Denis; Farber, Alik
2013-01-01
Purpose Symptomatic atherosclerotic disease of the popliteal artery presents challenges for endovascular therapy. We evaluated the technical success, complications and midterm outcomes of atherectomy and angioplasty involving the popliteal segment. Methods We conducted a retrospective review of outcomes of popliteal artery intervention using atherectomy or angioplasty performed between 2003 and 2008. Results A total of 56 patients (36% women, age 72.8±12.2 years, 77% critical limb ischemia) underwent popliteal atherectomy (n=18) or angioplasty (n=38). These patients had similar clinical characteristics, TASC/TASC II classification, mean lesion length, and run-off scores. We observed a trend toward higher rates of technical success defined as atherectomy compared to angioplasty (94% vs. 71%, p=0.08). While angioplasty was associated with a higher frequency of arterial dissection (23% vs. 0%, p=0.003), atherectomy was associated with a higher rate of thromboembolic events (22% vs 0%, p=0.01). Adjunctive stenting was used more frequently following angioplasty compared to atherectomy (45% vs. 6%, p=0.005). Thrombolysis was used to treat embolization in 4 patients in the atherectomy group. The improvement in the ankle-brachial index was similar between the two treatment groups. Primary patency of the popliteal artery at 3, 6, and 12 months was 94%, 88%, and 75% in the atherectomy group and 89%, 82%, and 73% in the angioplasty group (p=NS). There were no significant differences in limb salvage and freedom from reintervention at 1 year between the atherectomy and angioplasty groups. Conclusions Our experience with popliteal artery endovascular therapy indicates a distinct pattern of procedural complications with atherectomy compared to angioplasty but similar midterm patency, limb salvage and freedom from intervention. PMID:19942598
Imaging popliteal artery disease in young adults with claudication: self-assessment module.
Chew, Felix S; Bui-Mansfield, Liem T
2007-09-01
The educational objectives of this self-assessment module on imaging popliteal artery disease in young adults with intermittent claudication are for the participant to exercise, self-assess, and improve his or her knowledge of the imaging and clinical features of popliteal artery entrapment syndrome, cystic adventitial disease,and masses associated with popliteal artery obstruction.
RARE PRESENTATION OF SYMPTOMATIC BILATERAL PROXIMAL POPLITEAL ARTERY ANEURYSM
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Thulasikumar Ganapathy
2016-07-01
Full Text Available True Popliteal artery aneurysm is the most common of all the peripheral artery aneurysms. We present a case of proximal popliteal artery aneurysm involvement both lower limb presented with gangrene in one lower limb and incapacitating claudication pain on the other lower limb. We have successfully repaired both sides aneurysm in the same sitting with Poly Tetra Fluro Ethylene (PTFE graft, as the patient also had multiple venous perforators’ involvement on both sides, which left us only with synthetic graft repair option rather than venous graft repair.
International Nuclear Information System (INIS)
Yilmaz, Saim; Sindel, Timur; Ceken, Kagan; Alimoglu, Emel; Lueleci, Ersin
2001-01-01
Purpose: To investigate the value of the retrograde popliteal artery approach for the percutaneous intentional extraluminal recanalization (PIER) of long superficial femoral artery (SFA) occlusions.Methods: During a period of 17 months, PIER through ultrasound-guided retrograde popliteal artery puncture was performed for 39 long SFA occlusions in 37 patients. In six patients, six additional iliac artery stenoses were also treated via the popliteal approach.Results: The procedure was technically successful in 32 (82%) of 39 SFA occlusions; in 29, lesions were treated with balloon angioplasty alone, and in three, stents were also used. Cumulative patency rate was 66% at 6 months, 62% at 1 year, and 59% at 18 months. Additional iliac artery stenoses were successfully treated in the same session. Complications included two minor hematomas and two SFA ruptures, which required no treatment.Conclusion: PIER through retrograde popliteal puncture is a safe and effective method in the treatment of long femoropopliteal occlusions, with a high technical success, low complication rate and a reasonable short-term patency rate. The technique offers an alternative in cases where standard PIER is unsuccessful or contraindicated
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Marcelo Ferreira
2008-03-01
Full Text Available O aneurisma de artéria poplítea é relativamente raro, porém representa cerca de 85% de todos os aneurismas arteriais periféricos. Apresenta-se geralmente com um quadro de complicação isquêmica e elevado risco de perda do membro acometido. Em função disso, preconiza-se seu tratamento eletivo, atualmente realizado com resultados satisfatórios pela técnica endovascular. Relatamos nossa experiência com a utilização do stent de nitinol auto-expansível revestido com PTFEe - Fluency (Bard, Alemanha, reforçado internamente com o stent de nitinol auto-expansível Zilver (Cook, EUA no tratamento de um aneurisma de artéria poplítea.Popliteal artery aneurysm is relatively rare, but represents around 85% of all peripheral arterial aneurysms. It is usually presented with ischemic complication and high risk of limb loss. For that reason, its elective treatment is indicated and currently carried through with satisfactory results using endovascular techniques. We describe our experience with the use of an ePTFE-covered nitinol self-expandable stent graft - Fluency (Bard, Germany, reinforced internally with the nitinol self-expandable Zilver stent (Cook, USA for the treatment of a popliteal artery aneurism.
International Nuclear Information System (INIS)
Pokrajac, Boris; Schmid, Rainer; Kirisits, Christian; Mock, Ulrike; Fellner, Claudia; Wambersie, Andre; Poetter, Richard; Minar, Erich
2002-01-01
Purpose: Endovascular brachytherapy (EVBT) has been proven to significantly reduce restenosis after percutaneous transluminal angioplasty (PTA). The object of this analysis was to assess the possible correlation between iridium-192 source non-centering and angiographic-determined restenosis. Materials and methods: A total of 113 patients with long-segment lesions of the superficial femoro-popliteal artery (SFA) were randomized to receive either PTA alone or PTA followed by EVBT in the Vienna-2 study. This analysis was performed on a subgroup of 34 out of 57 patients, who received PTA+EVBT. Angiographic restenosis was defined as lumen reduction of more than 50%. Angiograms taken immediately after PTA (34 patients) and at follow-up (25 patients) were analyzed. The distance between the vessel wall and the actual position of the source at the time of EVBT was measured (in mm) and correlated with the follow-up vessel lumen diameter. Measurements were performed at points at a distance of 10 mm from each other. The dose was determined at the luminal surface and at the reference depth of 2 mm into the vessel wall for different distances from the source. Results: Among the 622 measured points, 62 (10.0%) were within restenotic areas; 560 (90.0%) were in arterial segments without proven angiographic restenosis. As far as source centering is concerned, 7.9% of restenotic points were observed when the maximum distance to the arterial wall was 5 mm. Conclusions: The proportion of restenotic points significantly increased with source non-centering. This observation was interpreted as being related to a decrease in dose at the target. When the maximum distance between the source and the vessel surface was >5 mm, the dose at the reference depth (2 mm into the vessel wall) decreased to values lower than 5 Gy
Popliteal artery puncture in the assessment of patients with severe leg ischemia
DEFF Research Database (Denmark)
Agerskov, K; Faris, I; Tønnesen, K H
1983-01-01
Two-plane angiography and direct segmental pressure measurements in the femoral and popliteal arteries and indirectly on the arm and ankle were performed in 101 limbs seeking to establish a relationship between angiographic assessment of the patency of the popliteal artery and the trifurcation...... vessels and the popliteal ankle pressure difference. When the tiberoperoneal trunk or the trifurcation vessels were occluded or more than 50% of the lumen was stenosed, the pressure difference exceeded 10 mmHg in 30/40 limbs (75%). When three, two, or only one of the tibial vessels were patent......, the pressure difference exceeded 10 mmHg in 2/58 limbs (3%). One month following above knee femoropopliteal bypass (48 limbs), patients with a popliteal-ankle difference less than 10 mmHg obtained a significantly higher ankle pressure index (PI 0.86, range 0.56-1.20) (p less than 0.01) than those...
International Nuclear Information System (INIS)
Zeller, T.; Frank, U.; Buergelin, K.; Schwarzwaelder, U.; Neumann, F.J.; Reimers, B.
2004-01-01
Background: Evaluation of the efficacy and safety of a new 7F-atherectomy device (30-day endpoint) for the treatment of short and mid-length arterial lesions with a reference diameter of 2.5-7 mm. Material and Methods: Fifty-eight femoto-popliteal stenoses in 46 patients (67% male, mean age 66± 9 years) with chronic peripheral occlusive disease of the lower limbs [Rutherford stage 2: n = 13 (28%); stage 3: n = 29 (63%); stage 4: 2 (4%), stage 5: n = 2 (4%]), were treated with directional atherectomy. Target lesion characteristics: Common femoral artery: n = 1 (2%), superficial femoral artery: n = 47 (81%); popliteal artery, n = 10 (17%); instent n = 3 (5%). Thirty (65%) of the interventions were performed using an antegrade approach, 16 (35%) interventions in cross-over technique. Mean degree of stenosis was 83 ± 11 mm, mean length of lesion was 37 ± 37 mm. Results: 6.5 ± 2 (4-10) passes of the lesion were performed with the catheter. Three lesions were treated after predilatation, 55 (95%) interventions as primary atherectomy. In 31/58 lesions (53%) additional balloon angioplasty was performed, in 1 lesion (2%) additional stent placement was needed. The mean degree of stenosis after atherectomy was reduced to 29 ± 20% (0-60%) after additional balloon angioplasty, it was 11 ± 10% (0-30%). A residual stenosis of [de
Popliteal artery entrapment syndrome
International Nuclear Information System (INIS)
Klooster, N.J.J.; Janevski, B.K.; Kitslaar, P.
1988-01-01
Two patients with unilateral popliteal artery entrapment syndrome (PAES) are reported. The importance of diligence in angiographic diagnosis and recognition of the so-called 'functional' PAES group as a separate entity are stressed. It is inferred from our material that a surgical approach for PAES is to be advocated since surgical release of the entrapment can lead to complete resolution of symptoms regardless of aetiology. (orig.) [de
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Nakaya, Yasuhiro, E-mail: y-nakaya@radiol.med.osaka-u.ac.jp [Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka 565-0871 (Japan); Kim, Tonsok; Hori, Masatoshi; Onishi, Hiromitsu; Nakamoto, Atsushi; Tsuboyama, Takahiro; Maeda, Noboru; Higashihara, Hiroki; Tomoda, Kaname; Nakamura, Hironobu [Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka 565-0871 (Japan)
2011-08-15
Purpose: The purpose of this study was to investigate correlations between the aorto-popliteal bolus transit speed and aortic and popliteal bolus transit time in order to evaluate the possibility for prediction of bolus transit speed by single test injection technique. Materials and methods: Approval was obtained from our institutional review board for this study, which included 42 patients, from all of whom written informed consent was obtained. Low-dose serial CT scanning after injection of 12 ml contrast material (300 mg/ml) at a rate of 3 ml/s followed by saline flush was performed twice, first at the level of the upper abdomen and second at the level of the knee joint. The times needed to reach peak enhancement of the upper abdominal aorta (T-aorta) and bilateral popliteal arteries (T-popliteal) were obtained, and aorto-popliteal bolus transit speeds between the abdominal aorta and popliteal arteries were calculated. ABI was recorded for the bilateral feet. The Pearson's product-moment correlation coefficient was used to investigate the correlation between the bolus transit speed and T-aorta, T-popliteal, ABI, and patient age. Result: The respective correlation coefficients for bolus transit speed on the one hand and T-aorta, T-popliteal, ABI, patient age on the other were -0.50, -0.84, 0.36, and -0.52. Conclusion: The time to peak enhancement for popliteal arteries showed the strongest correlation with aorto-popliteal bolus transit speeds, and was considered to be the most accurate predictor for aorto-popliteal bolus transit speeds.
DEFF Research Database (Denmark)
Tønnesen, K H; Sager, P; Karle, A
1988-01-01
We report the results of 50 angioplasty procedures via the popliteal artery. A 3-year follow-up including control of blood pressures at ankle and toe levels show results comparable to reports in the literature. This new approach for angioplasty of the superficial femoral artery and eventually of ...
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Zeller, T.; Frank, U.; Buergelin, K.; Schwarzwaelder, U.; Neumann, F.J. [Herz-Zentrum Bad Krozingen (Germany). Abt. Angiologie; Krankenberg, H. [Kardiologische Gemeinschaftspraxis Mathey, Schofer u. Partner, Hamburg (Germany); Reimers, B. [Centro Civile Mirano (Italy)
2004-01-01
Background: Evaluation of the efficacy and safety of a new 7F-atherectomy device (30-day endpoint) for the treatment of short and mid-length arterial lesions with a reference diameter of 2.5-7 mm. Material and Methods: Fifty-eight femoto-popliteal stenoses in 46 patients (67% male, mean age 66{+-} 9 years) with chronic peripheral occlusive disease of the lower limbs [Rutherford stage 2: n = 13 (28%); stage 3: n = 29 (63%); stage 4: 2 (4%), stage 5: n = 2 (4%]), were treated with directional atherectomy. Target lesion characteristics: Common femoral artery: n = 1 (2%), superficial femoral artery: n = 47 (81%); popliteal artery, n = 10 (17%); instent n = 3 (5%). Thirty (65%) of the interventions were performed using an antegrade approach, 16 (35%) interventions in cross-over technique. Mean degree of stenosis was 83 {+-} 11 mm, mean length of lesion was 37 {+-} 37 mm. Results: 6.5 {+-} 2 (4-10) passes of the lesion were performed with the catheter. Three lesions were treated after predilatation, 55 (95%) interventions as primary atherectomy. In 31/58 lesions (53%) additional balloon angioplasty was performed, in 1 lesion (2%) additional stent placement was needed. The mean degree of stenosis after atherectomy was reduced to 29 {+-} 20% (0-60%) after additional balloon angioplasty, it was 11 {+-} 10% (0-30%). A residual stenosis of < 50% after plain atherectomy was achieved in 55 (95%) lesions, of < 30% in 49 (84%). Complications: 3 (6,5%) cases of embolism of debris were detected and treated successfully by aspiration. The mean ankle-brachial index increased from 0.62 {+-} 0.12 to 0.92 {+-} 0.36 before discharge, and to 0.86 {+-} 0.17 after 30 days. Rutherford stage after 30 days: stage 0: n = 038 (83%); Stage 1: n = 4 (8%); Stage 2: n = 3 (6%); Stage 5: n = 1 (2%). (orig.) [German] Ziel der Arbeit: Multizentrische Anwendungs- und Sicherheits-Studie (30 Tage Follow-up) eines neuen 7F-Atherektomiekatheters zur Behandlung peripherer kurzer und mittellanger Stenosen mit
Straight configuration saphenous vein transposition to popliteal artery for vascular access.
Caco, Gentian; Golemi, Dhurata; Likaj, Eriola
2017-03-21
The saphenous vein is commonly used as a vascular graft in peripheral artery surgery but rarely used for vascular access. The literature on straight configuration saphenous vein transposition to the popliteal artery is scarce. Here we present two cases of straight configuration saphenous vein transposition to the popliteal artery for vascular access, the surgical technique and respective follow-up. Two young men, aged 29 and 36 years, were chosen for lower-limb vascular access for hemodialysis. The first patient was paraplegic since birth. He used his arms to move so upper extremity vascular access was avoided. The second patient presented with an infected upper extremity arteriovenous graft (AVG) and after multiple closed AVFs he had no more available arm veins. Both patients received autologous lower extremity straight configuration saphenous vein transpositions to the popliteal artery under spinal anesthesia in May and October 2012, respectively. Cannulation of the fistula was allowed after one month. There were no early complications. Slight swelling on the leg appeared in one of the patients. Both fistulas were still functional after 36 and 32 months, respectively. The straight configuration saphenous vein transposition to popliteal artery is simple to perform, offers a long and straight segment for cannulation and may be a suitable autologous vascular access in selected patients.
Computer tomographic demonstration of the popliteal artery entrapment syndrome
International Nuclear Information System (INIS)
Alder, W.; Zwicker, H.
1979-01-01
The popliteal artery entrapment syndrome can be diagnosed by computer tomography with a greater degree of certainty than by angiography. The advantage of computer tomography depends on the simultaneous demonstration of the position of the vessel and of the surrounding muscles and their abnormal situation. (orig.) [de
MR imaging and MR angiography in popliteal artery entrapment syndrome
International Nuclear Information System (INIS)
Atilla, S.; Akpek, S.; Yuecel, C.; Tali, E.T.; Isik, S.; Ilgit, E.T.
1998-01-01
Popliteal artery entrapment (PAE) syndrome is an uncommon congenital anomaly seen in young adults causing ischemic symptoms in the lower extremities. It is the result of various types of anomalous relationships between the popliteal artery and the neighboring muscular structures. The purpose of this study was to define the role of MR imaging combined with MR angiography in the diagnosis of PAE cases. Four cases with segmental occlusion and medial displacement of popliteal artery in digital subtraction angiography (DSA) examinations were diagnosed as PAE syndrome by MR imaging and MR angiography. The DSA and MRA images are compared. All of the cases showed various degrees of abnormal intercondylar insertion of the medial head of the gastrocnemius muscle. The MR images showed detailed anatomy of the region revealing the cause of the arterial entrapment. Subclassification of the cases were done and fat tissue filling the normal localization of the muscle was evaluated. The DSA and MRA images demonstrated the length and localization of the occluded segment and collateral vascular developments equally. It is concluded that angiographic evaluation alone in PAE syndrome might result in overlooking the underlying cause of the arterial occlusion, which in turn leads to unsuccessful therapy procedures such as balloon angioplasty. Magnetic resonance imaging combined with MR angiography demonstrates both the vascular anatomy and the variations in the muscular structures in the popliteal fossa successfully, and this combination seems to be the most effective way of evaluating young adults with ischemic symptoms suggesting PAE syndrome. (orig.)
DEFF Research Database (Denmark)
Vogt, K C; Rasmussen, J G; Schroeder, T V
2000-01-01
to evaluate the clinical significance of the steal phenomenon following femoro-femoral bypass, and whether the addition of intravascular ultrasound (IVUS) to the established examinations of the donor iliac artery can improve the prediction of patients who will develop steal.......to evaluate the clinical significance of the steal phenomenon following femoro-femoral bypass, and whether the addition of intravascular ultrasound (IVUS) to the established examinations of the donor iliac artery can improve the prediction of patients who will develop steal....
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Rogério Franco de Araujo Goes
2015-08-01
Full Text Available ABSTRACTOBJECTIVE: To analyze and describe the distance from the popliteal artery to three specific areas of the proximal region of the tibia, with the knee extended, by means of magnetic resonance. METHODS: Images of 100 knees of patients who underwent magnetic resonance examinations were analyzed. The location of the popliteal artery was measured in three different areas of the posterior proximal region of the tibia. The first measurement was made at the level of the knee joint (tibial plateau. The second was 9 mm distally to the tibial plateau. The third was at the level of the anterior tuberosity of the tibia (ATT. RESULTS: The distances between the popliteal artery and the tibial plateau and ATT region were significantly greater in males than in females. The distances between the popliteal artery and the regions 9 mm distally to the tibial plateau and the ATT were significantly greater in the age group over 36 years than in the group ≤36 years. CONCLUSION: Knowledge of the anatomical position of the popliteal artery, as demonstrated through magnetic resonance studies, is of great relevance in planning surgical procedures that involve the knee joint. In this manner, devastating iatrogenic injuries can be avoided, particularly in regions that are proximal to the tibial plateau and in young patients.
Popliteal artery aneurysms. Clinical relevance of dynamics and vulnerability
Kropman, R.H.J.
2013-01-01
Knowledge of anatomic variations of the popliteal artery is essential for the management of peripheral vascular disease. It influences the success of femoropopliteal and crural reconstructions and may also be important in orthopedic surgery. Variations may increase the risk of bleeding, dissections,
Popliteal artery injury during posterior cruciate ligament reconstruction
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Marcos Henrique Frauendorf Cenni
2015-06-01
Full Text Available This study reports a case of popliteal artery injury during arthroscopic reconstruction of the posterior cruciate ligament. The evolution of the injury is described and comments are made regarding the anatomy of this artery and potential risks of this surgical technique. This study had the aims of alerting the medical community, especially knee surgeons, regarding a severe surgical complication and discussing the ways of preventing it.
Angiographic imaging of the branching of the popliteal artery into the arteries of the lower leg
International Nuclear Information System (INIS)
Prayer, L.; Karnel, F.; Schurawitzki, H.
1990-01-01
For the anatomic analysis of the branching of the popliteal artery into the lower leg arteries, 414 intra-arterial DSA images of the lower extremity (obtained in 223 patients) were available. In 90.1% of the material examined, a 'normal' branching was found. If one leg of a patient showed 'normal' branching, there was a probability of 6.9% to find a different branching of the artery in the other leg. In 9.9% of the examined legs deviations from standard branching were observed. If there was a deviation from standard observed in one leg, the probability of finding a variant of branching in the other leg as well was 4.4%. (orig./MG) [de
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Anna E. Boniakowski, MD
2017-06-01
Full Text Available Functional popliteal artery entrapment syndrome can be difficult to diagnose, as the imaging modalities presently employed are designed to detect anatomic entrapment. We describe a novel imaging technique to aid in diagnosis in this cohort. A 22-year-old cyclist presented with exercise-limiting claudication. Magnetic resonance angiography with provocative maneuvers was nondiagnostic. Digital subtraction angiography revealed long-segment occlusion of the popliteal artery with plantar flexion; however, the specific site of compression remained unclear. Intravascular ultrasound allowed specific localization of compression and further confirmed the diagnosis. Thus, we report this as an adjunctive imaging modality to definitively diagnose functional popliteal artery entrapment syndrome and to assist in operative planning.
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Cvetković Slobodan
2014-01-01
Full Text Available Introduction. Posterior knee joint dislocation associated with injury of the popliteal artery in children is an extremely rare condition. Rapid diagnosis and treatment are essential for limb salvage and function. Case report. We reported a 14-year-old boy who suffered traumatic displacement of the right knee and contusion of the popliteal artery during motorcycle accident. The diagnosis was confirmed using Doppler and duplex ultrasonography and digital substraction transfemoral arteriography. The urgent surgical procedure was performed using posterior approach to the popliteal artery. During the surgical exploration, rupture of the posterior cruciate ligament associated with thrombosed popliteal artery have been found. The damaged popliteal artery was resected and replaced with autologous saphenous vein graft. The last stage of the procedure was a transosseous femoral fixation of posterior circuate ligament. A 3-year-follow-up after the surgery demonstrated intact arterial perfusion and very good function of the knee with a minimal difference as compared with the contralateral knee. Conclusion. Combined orthopedic and vascular injuries are very rare in children. They require combined treatment. [Projekat Ministarstva nauke Republike Srbije, br. 175008
A new diagnostic approach to popliteal artery entrapment syndrome
Energy Technology Data Exchange (ETDEWEB)
Williams, Charles; Kennedy, Dominic; Bastian-Jordan, Matthew; Hislop, Matthew; Cramp, Brendan; Dhupelia, Sanjay [Queensland X-Ray, Sunnybank, Queensland, 4109 (Australia)
2015-09-15
A new method of diagnosing and defining functional popliteal artery entrapment syndrome is described. By combining ultrasonography and magnetic resonance imaging techniques with dynamic plantarflexion of the ankle against resistance, functional entrapment can be demonstrated and the location of the arterial occlusion identified. This combination of imaging modalities will also define muscular anatomy for guiding intervention such as surgery or Botox injection.
A new diagnostic approach to popliteal artery entrapment syndrome
International Nuclear Information System (INIS)
Williams, Charles; Kennedy, Dominic; Bastian-Jordan, Matthew; Hislop, Matthew; Cramp, Brendan; Dhupelia, Sanjay
2015-01-01
A new method of diagnosing and defining functional popliteal artery entrapment syndrome is described. By combining ultrasonography and magnetic resonance imaging techniques with dynamic plantarflexion of the ankle against resistance, functional entrapment can be demonstrated and the location of the arterial occlusion identified. This combination of imaging modalities will also define muscular anatomy for guiding intervention such as surgery or Botox injection
Diagnosis and surgical approach of popliteal artery entrapment syndrome: a retrospective study
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Stavros Gourgiotis
2008-02-01
Full Text Available Stavros Gourgiotis1, John Aggelakas1, Nikolaos Salemis1, Charalabos Elias2, Charalabos Georgiou11Second Surgical Department, 401 General Army Hospital of Athens, Greece; 2Second Surgical Department, 417 NIMTS Veterans General Hospital of Athens, GreeceBackground: Popliteal artery entrapment syndrome (PAES is a rare but potentially limb threatening peripheral vascular disease occurring predominantly in young adults. This study is a retrospective review of 49 limbs in 38 patients with PAES treated surgically over an 8-year period.Patients and methods: From 1995 to 2002, 38 patients with a mean age of 21 years (range, 18–29 years underwent surgery for PAES at a single institution. The patients’ demographic data and clinical features are recorded. The preoperative diagnosis of PAES was made based on various combinations of investigations including positional stress test, duplex ultrasonography, computed tomography, computed tomographic angiography, and angiography. Results: Nine, 33, and 7 patients had Delaney’s type I, II, and III PAES respectively. The surgical procedures consisted of simple release of the popliteal artery in 33 limbs (67.3%, autogenous saphenous vein (ASV patch angioplasty with or without thromboendarterectomy (TEA in 5 limbs (10.2% and ASV graft interposition or bypass in 11 limbs (22.5%. At a median follow up of 34 months (range, 8–42 months, there were no postoperative complications and all the patients were cured of their symptoms.Conclusions: PAES is an unusual but important cause of peripheral vascular insufficiency especially in young patients. Early diagnosis through a combined approach is necessary for exact diagnosis. Popliteal artery release alone or with vein bypass is the treatment of choice when intervention is indicated for good operative outcome and to prevent limb loss.Keywords: popliteal artery, entrapment syndrome, diagnosis, surgery, treatment
International Nuclear Information System (INIS)
Kim, Youn Kil; Hahn, Seong Tae; Baek, Jee Hee; Kim, Choon Yul; Shinn, Kyung Sub
1996-01-01
To evaluate the effectiveness and safety of the modified pulse-spray method using Urokinase(UK) in subacute and chronic thrombotic arterial occlusion. Modified pulse-spray methods using UK were performed in seven patients with subacute (1 week-1month) to chronic (1month-5years) occlusive symptoms such as limb pain, claudication and impotence. Angiographic examination revealed thrombotic occlusion of the aorta, common iliac arteries, brachial arterio-venous hemodialysis graft and femoro-popliteal bypass graft. The patients underwent thrombolysis using modified pulse-spray and additional constant infusion of UK. In the presence of underlying stenosis or organized clots, balloon angioplasty or stent placement was performed. Complete lysis was obtained in five of seven patients. For initial lysis, the mean dose of UK was 420,000 units, and the mean modified pulse-spray time was 50 minutes. Mean total dose of UK and mean total time for complete lysis were 800,000 units and 161 minutes, respectively. Thrombolysis of the femoro-popliteal bypass graft failed due to severe occlusion of the distal anastomosis. Partial lysis was achieved in one patient with aorto-illac occlusion, but further thrombolysis was stopped due to bleeding at the puncture site. The modified pulse-spray method using UK is effective in treating subacute and chronic arterial thrombotic occlusion. It augments the speed, safety and efficacy of thrombolysis. When underlying stenosis or organized clots remain after thrombolysis, ballon angioplasty or stent placement would be helpful
International Nuclear Information System (INIS)
He Xu; Gu Jianping; Lou Wensheng; Chen Liang; Chen Guoping; Su Haobo; Song Jinhua; Wang Tao; Xu Ke
2011-01-01
Objective: To discuss the application of retrograde popliteal artery puncturing under X-ray guidance in the interventional therapy for superficial femoral artery occlusion. Methods: Retrograde popliteal artery puncturing under X-ray guidance was carried out in nine patients with long-segment occlusion of superficial femoral artery as antegrade recanalization via femoral artery approach had failed in them. After retrograde route was successfully established, the balloon dilation and subsequent stent placement for occluded vessel were performed. Results: The technical success was obtained in all patients. The occluded superficial femoral arteries were reopened and the symptoms of intermittent claudication disappeared. No serious complications such as injuries of adjacent nerves or vessels occurred. The ankle-brachial index (ABI) increased from preoperative (0.38±0.13) to postoperative (0.92±0.11) with the difference being statistically significant (P<0.01). A follow-up period lasting for 2-16 months was conducted. Eleven months after the treatment, intermittent claudication recurred in one case, and CT angiography showed that the distal part of the stent was narrowed. The symptoms were improved after percutaneous transcatheter angioplasty was performed again. Conclusion: Retrograde popliteal artery puncturing under X-ray guidance is an effective and safe technique for the treatment of superficial femoral artery long-segment occlusion with stent placement, especially for patients in whom antegrade recanalization via femoral artery approach fails. (authors)
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Ligia Jackeline Iorio Pires
2011-09-01
Full Text Available O aneurisma da artéria poplítea é o mais frequente dos aneurismas periféricos verdadeiros. Embora seja assintomático, apresenta complicações isquêmicas por embolia ou trombose. A correção deste aneurisma pode ser cirúrgica convencional, com técnica e prognóstico bem estabelecidos, ou endovascular, técnica inovadora e menos invasiva. A reperfusão do saco aneurismático excluído, apesar de rara, está relacionada à intensa circulação colateral. Relatamos um caso de aneurisma de poplítea, que após dois anos de exclusão apresentou fluxo no saco aneurismático com sintomatologia, sendo tratado por técnica endovacular alternativa.The popliteal artery aneurysm is the most frequent of the peripheral aneurysms. Although asymptomatic, it can complicate with severe limb ischemia due to embolization or thrombosis. The surgical correction presents well-established techniques and results, while the less invasive endovascular therapy is still evolving. The recurrence is very rare and can be related to collateral artery refilling. We report a recurrent popliteal artery aneurysm after two years of conventional ligation and bypass surgery, in which an alternative endovascular strategy was successfully applied.
Peiper, C; Heye, K; Ktenidis, K; Horsch, S
1997-01-01
Additional therapy of symptomatic popliteal artery aneurysm includes intraoperative lysis for the treatment of the descending thrombosis and spinal cord stimulation for cases of chronic deterioration of the peripheral perfusion state. Between 1989 and 1996, we treated 50 patients with 55 symptomatic aneurysms using this concept, 18 of them as emergency cases. We reached a postoperative amputation rate of 12.7% and good long-term functional results in 34 of 37 patients.
Surgical treatment of chronic occlusive in peripheral arteries (Review of 100 cases
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H. AHRARI
1977-01-01
slight deterioration during follow up, after femoro-popliteal operations the rate of early success rapidly declined. Aotrto-iliac stenosis is a more promising situation for reconstruction. Either grafting or endarterectomy is available. We abondon endarterectomy in small arteres below the popliteal arteries to avoid reobstruction due to thrombosis. We agree that sympathectomy should be performed at the time of trophic changes in the skin of the foot, and for early gangrene, we remove the third and fourth lumbar ganglia. This operation should increase the circulation to the skin below the knee. We do not recommend sympathectomy as the treatment for claudication. 3- Apart from the data derived from our group, patients gave us the following information. a - many patients come from the northern part of Iran which has a Medite ranean climate . . b - None of them had a hight cholesterol level. c - Only one patient had high blood pressure. d - Half of the patients had occlusion below the popliteal arteries Cmostely Buerger type in character and femoro popliteal obstruction which were segmental occlusion or iliac arteries.
Stavroulakis, Konstantinos; Schwindt, Arne; Torsello, Giovanni; Stachmann, Arne; Hericks, Christiane; Bosiers, Michel J; Beropoulis, Efthymios; Stahlhoff, Stefan; Bisdas, Theodosios
2017-04-01
To report a single-center study comparing drug-coated balloon (DCB) angioplasty vs directional atherectomy with antirestenotic therapy (DAART) for isolated lesions of the popliteal artery. Seventy-two patients were treated with either DCB angioplasty alone (n=31) or with DAART (n=41) for isolated popliteal artery stenotic disease between October 2009 and December 2015. The majority of patients presented with lifestyle-limiting claudication (74% vs 86%, respectively). Vessel calcification (29% vs 29%, respectively), mean lesion length (47 vs 42 mm, respectively), and number of runoff vessels were comparable between the groups. The primary outcome measure was primary patency; secondary outcomes were technical success (<30% residual stenosis or bailout stenting), secondary patency, and freedom from clinically driven target lesion revascularization (TLR). The technical success rate following DCB was 84% vs 93% (p=0.24) after DAART. The 12-month primary patency rate was significantly higher in the DAART group (65% vs 82%; hazard ratio 2.64, 95% confidence interval 1.09 to 6.37, p=0.021), while freedom from TLR did not differ between the 2 treatment strategies (82% vs 94%, p=0.072). Secondary patency at 12 months was identical for both groups (96% vs 96%). Although not statistically significant, bailout stenting was more common after DCB angioplasty (16% vs 5% for DAART, p=0.13) and aneurysmal degeneration of the popliteal artery was seen more often after DAART (7% vs 0% for DCB alone, p=0.25). Popliteal artery injury was observed in 2 patients treated using DAART (5% vs 0% for DCB alone, p=0.5), whereas distal embolization rates were comparable between the groups (3% for DCB alone vs 5% for DAART, p=0.99). In this study, the use of DAART was associated with a higher primary patency rate compared with DCB angioplasty for isolated popliteal lesions. Nonetheless, both treatment options were associated with excellent 12-month secondary patency. Aneurysmal degeneration of
Hua, W R; Yi, M Q; Min, T L; Feng, S N; Xuan, L Z; Xing, J
2013-08-01
This study aimed to ascertain differences in benefit and effectiveness of popliteal versus tibial retrograde access in subintimal arterial flossing with the antegrade-retrograde intervention (SAFARI) technique. This was a retrospective study of SAFARI-assisted stenting for long chronic total occlusion (CTO) of TASC C and D superficial femoral lesions. 38 cases had superficial femoral artery lesions (23 TASC C and 15 TASC D). All 38 cases underwent SAFARI-assisted stenting. The ipsilateral popliteal artery was retrogradely punctured in 17 patients. A distal posterior tibial (PT) or dorsalis pedis (DP) artery was retrogradely punctured in 21 patients, and 16 of them were punctured after open surgical exposure. SAFARI technical success was achieved in all cases. There was no significant difference in 1-year primary patency (75% vs. 78.9%, p = .86), secondary patency (81.2% vs. 84.2%, p = .91) and access complications (p = 1.00) between popliteal and tibial retrograde access. There was statistical difference in operation time between popliteal (140.1 ± 28.4 min) and tibial retrograde access with PT/DP punctures after surgical vessel exposure (120.4 ± 23.0 min, p = .04). The SAFARI technique is a safe and feasible option for patients with infrainguinal CTO (TASC II C and D). The PT or DP as the retrograde access after surgical vessel exposure is a good choice when using the SAFARI technique. Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
Percutaneous angioplasty of carotid artery stenoses
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Freitag, G.; Freitag, J.; Koch, R.D.; Wagemann, W.
1986-03-01
Percutaneous transluminal angioplasty (PTA) is a well-established method to remedy stenoses and short occlusions in the femoro-popliteal region and has also proved worthwhile in dilating stenoses of pelvic, renal and coronary arteries. Following successful experiments in animals, Mathias et al. employed angioplasty to treat carotid artery stenoses in the same way. To date, successful treatment of carotid artery stenoses has been described only in isolated recent reports. For fear of embolism, angioplasty has not yet become standard practice in this region. Because of the limited number of carotid artery stenoses treated so far, the risk involved cannot be reliably assessed. It is remarkable that no embolism has been reported for the greater number of dilated stenoses of the subclavian artery. Moreover, the report by Mathias et al. indicated that for 350 angioplasties of pelvifemoral arteries 1.1% embolisms occured after artery occlusions only, while no embolism was observed after stenoses. Having gained experience of applying PTA to the treatment of vascular obstructions of extremities, we have adopted this technique in the carotid area as well.
Stavroulakis, Konstantinos; Bisdas, Theodosios; Torsello, Giovanni; Stachmann, Arne; Schwindt, Arne
2015-12-01
To evaluate the midterm results of combined directional atherectomy (DA) and drug-eluting balloon (DEB) angioplasty for atherosclerotic lesions of the popliteal artery. In a single-arm, prospective study, 21 patients (mean age 63±16 years; 16 men) with isolated popliteal artery lesions were enrolled and underwent treatment with combined DA and DEB angioplasty under filter protection between October 2009 and February 2014. The majority (18, 86%) presented with lifestyle-limiting intermittent claudication and 3 with critical limb ischemia. Fifteen (71%) target sites were de novo lesions; 4 were occlusions. The main outcome was primary patency; secondary outcomes were technical success, secondary patency, and early and midterm morbidity and mortality. The TurboHawk atherectomy device was used in 15 (71%) patients and the SilverHawk peripheral plaque excision system in the remaining 6 patients. The In.Pact Admiral/Pacific DEB was used in the majority of cases (15, 71%). The technical success rate was 90% (n=19). One flow-limiting dissection was treated with bailout stenting. Complications included a perforation of the popliteal artery and 2 puncture site hematomas; there was no distal embolic event. The mean follow-up was 18±12 months. Two restenoses were retreated successfully. Kaplan-Meier estimates of primary patency at 12 and 18 months were 95% and 90%, respectively; the secondary patency was 100%. One (5%) patient died in follow-up. None of the patients had an amputation. In this prospective single-arm study, the combined therapy of DA and DEB angioplasty for popliteal artery lesions showed promising midterm performance. The combination of DA and DEB may, in highly selected patients, overcome the challenges presented by the mobility of the knee joint. © The Author(s) 2015.
Directory of Open Access Journals (Sweden)
Mohit Gupta
2016-01-01
Full Text Available Literature suggests that vascular damage occurring with orthopedic injury of the lower extremity is rare and uncommon. We present a case of a young adult male who presented to the emergency room with a history of road traffic accident with complaints of pain in the right ankle diagnosed as medial malleolus fracture and pain in the left knee diagnosed as undisplaced lateral tibial condyle fracture. At the time of presentation, the left leg appeared normal and was stabilized with a knee brace, which on the next day developed severe swelling with absence of distal pulses. Doppler revealed no blood flow distal to popliteal artery with severe soft tissue edema. The patient was posted for emergency basis vascular exploration where popliteal artery was surprisingly found transected and was repaired followed by timely fasciotomy. This case report has also been prepared to stress the importance of secondary survey in patients after high energy trauma as it can prevent the important injuries from being missed.
Emergency and elective implantation of covered stent systems in iatrogenic arterial injuries
International Nuclear Information System (INIS)
Goltz, J.P.; Kickuth, R.; Bastuerk, P.; Hoppe, H.; Triller, J.
2011-01-01
Purpose: To evaluate the effectiveness and safety of covered stents for the management of iatrogenic arterial injury. Materials and Methods: Between 03/1998 and 12/2009, 31 patients underwent selective covered stent implantation after iatrogenic arterial injury. 12/31 of these patients (38.7 %) were hemodynamically unstable. Six different endovascular covered stent types were utilized. The primary endpoints of this study were technical and clinical success and rates of minor and major complications. Results: Initial angiograms demonstrated active extravasation in 19 (61.3 %) patients and pseudoaneurysms in 12 (38.7 %) patients. The following sites of bleeding origin were detected: axillary artery, subclavian artery, common iliac artery, external iliac artery, internal iliac artery, common femoral artery, superficial femoral artery, popliteal and fibular artery, femoro-popliteal and popliteo-crural bypasses, common hepatic artery, aberrant hepatic artery, cystic and gastroduodenal artery. In all patients bleeding was effectively controlled by covered stent implantation resulting in an immediate technical success of 100 %. Clinical success attributed to covered stent implantation was documented in 30 of the 31 patients (96.8 %). Major complications included death in four patients (11.1 %), acute thrombosis with arm ischemia in one patient (2.8 %) and stent fracture with associated pseudoaneurysm in another patient (2.8 %). In 2/31 patients (6.5 %) covered stent failure was detected and successfully treated by implantation of a second covered stent. Conclusion: Emergency and elective implantation of covered stents may be used for minimally invasive and effective management of iatrogenic arterial injury. (orig.)
Thakar, Tejal; Chaudhuri, Arindam
2013-06-01
To present a preliminary experience using a multilayer flow-modulating stent for trans/infragenicular popliteal endovascular aneurysm repair. Five men (mean age 76 years, range 62-86) with 6 popliteal artery aneurysms (PAAs) measuring 22 to 39 mm in diameter (mean 30) underwent endovascular repair using the Cardiatis Multilayer Aneurysm Repair System (MARS) between June and August 2011. Radiological assessments post procedure using duplex ultrasonography and biplanar knee radiographs (additional contrast studies as necessary) sought evidence of aneurysm exclusion, graft patency, and preservation of branches and runoff vessels. Technical success was achieved in each case. There was one symptomatic stent occlusion requiring thrombectomy at 4 days, with reocclusion, and one leak via the stent struts into the sac with no branch outflow identified. Two further symptomatic stent occlusions were identified within a 6-week follow-up period, totaling 3 occlusions among the 6 devices deployed. No firm conclusion can be reached on the efficacy of the MARS in PAAs due to the inherent limitations of this small series, although a 50% thrombosis rate is a poor outcome. The risk of early thrombosis in flow-modulating stents deployed in the popliteal artery exists, as it does with earlier generation stent-grafts. Larger prospective trials and the influence of more aggressive antithrombotic/anticoagulant therapy should be considered to enable accurate evaluation of this device in popliteal artery aneurysms.
Zwiers, I; Hoogland, C M T; Mackaay, A J C
2016-03-01
In this study the intra- and inter-observer variability of ultrasound measurements of the diameter of the popliteal artery were tested in a group of patients under surveillance for a small (diameter 10-20 mm), asymptomatic popliteal artery aneurysm (PAA). From a group of patients under ultrasound surveillance for bilateral, asymptomatic PAAs, 13 consecutive patients agreed to participate in the study and provided informed consent. The maximum diameter of the popliteal arteries was assessed by a vascular technologist. The same assessment was repeated by a second vascular technologist, unaware of the results of the first measurement. After a week, this protocol was repeated. The intra- and inter-observer reliability of this measurement was calculated using intra-class correlation coefficients (ICCs) and Bland and Altman plots. Of the 10 patients with bilateral and three patients with unilateral PAA, 12 completed the 2 week protocol. A total of 86 measurements were analyzed. The mean diameter of the popliteal arteries was 13.5 ± 3.4 mm. The ICC for the intra-observer reliability of observer 1 was 0.96 (95% CI 0.92-0.99), p .47. The absolute magnitude of the systematic error of both observers was less than 0.135 mm (median 0.00). Ultrasound measurement of the maximum diameter of the popliteal artery is reproducible; hence, it is suitable for making a clinical treatment decision. Its use for surveillance of small, asymptomatic PAAs is justified. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
The diabetic foot - modern possibilities of vascular reconstruction
International Nuclear Information System (INIS)
Arlart, I.P.
1992-01-01
Arterial vascular disease in diabetic patients includes both microangiopathy and macroangiopathy. Macroangiopathy, i.e. stenoses of occlusions of the ilio-femoro-popliteal arteries and crural arteries, can be treated by surgical vascular reconstructions and radiological procedures such as recanalisation via catheter and CT-guided lumbar sympathetic trunk, neurolysis. In this paper the different therapeutic techniques are presented in respect of indications and results particularly in the diabetic patients. (orig.) [de
A Matched Case-Control Study on Open and Endovascular Treatment of Popliteal Artery Aneurysms.
Dorigo, W; Fargion, A; Masciello, F; Piffaretti, G; Pratesi, G; Giacomelli, E; Pratesi, C
2018-01-01
To compare early and late results of open and endovascular management of popliteal artery aneurysm in a retrospective single-center matched case-control study Methods: From 1981 to 2015, 309 consecutive interventions for popliteal artery aneurysm were performed in our institution, in 59 cases with endovascular repair and in 250 cases with open repair. Endovascular repair was preferred in older asymptomatic patients, while open repair was offered more frequently to patients with a thrombosed popliteal artery aneurysm and a poor run-off status. A one-to-one coarsened exact matching on the basis of the baseline demographic, clinical, and anatomical covariates significantly different between the two treatment options was performed and two equivalent groups of 56 endovascular repairs and open repairs were generated. The two groups were compared in terms of perioperative results with χ 2 test and of follow-up outcomes with the Kaplan-Meier curves and log-rank test. There were no differences between the two groups in terms of perioperative outcomes. Median duration of follow-up was 38 months. Five-year survival rates were 94% in endovascular repair group and 89.5% in open repair group (p = 0.4, log-rank 0.6). Primary patency rates at 1, 3, and 5 years were 81%, 78%, and 72% in endovascular repair group and 82.5%, 80%, and 64% in open repair group (p = 0.8, log-rank 0.01). Freedom from reintervention at 5 years was 65.5% in endovascular repair group and 76% in open repair group (p = 0.2, log-rank 1.2). Secondary patency at 1, 3, and 5 years was 94%, 86%, and 74% in endovascular repair group, and 94%, 89%, and 71% in open repair group, respectively (p = 0.9, log-rank 0.01). The rates of limb preservation at 5 years were 94% in endovascular repair group and 86.4% in open repair group (p = 0.3, log-rank 0.8). Open repair and endovascular repair of popliteal artery aneurysms provided in this retrospective single-center experience similar perioperative and follow-up results in
Rastan, Aljoscha; McKinsey, James F.; Garcia, Lawrence A.; Rocha-Singh, Krishna J.; Jaff, Michael R.; Harlin, Stuart; Kamat, Suraj; Janzer, Sean; Zeller, Thomas
2017-01-01
Purpose: To report the effectiveness of directional atherectomy for the treatment of popliteal artery occlusive disease. Methods: This subset of the prospective, multicenter, single-arm DEFINITIVE LE trial included 158 patients (mean age 72.0±10.9 years; 82 men) who underwent directional atherectomy in 162 popliteal artery lesions between 2009 and 2011. Forty-eight (30.4%) patients were suffering from critical limb ischemia (CLI). The mean lesion length was 5.8±3.9 cm; 38 (23.5%) arteries were occluded. The primary outcome measure for patients with intermittent claudication (IC) was duplex ultrasound–defined primary patency at 1 year; the outcome for subjects with CLI was freedom from major amputation of the target limb at 1 year. Outcomes and adverse events were independently assessed. Results: Procedure success (≤30% residual stenosis) was achieved in 84.4% of treated lesions; adjunctive stenting was required in 6 (3.7%) of the 162 lesions. The 1-year primary patency rate was 75.0% (IC patients 78.2% and CLI patients 67.5%, p=0.118). The freedom from major amputation in both cohorts was 100%. In both IC and CLI patients, significant improvements were demonstrated at 1 year in the Rutherford category, walking distance, and quality of life in comparison to baseline. Conclusion: This study indicates that directional atherectomy in popliteal arteries leads to favorable technical and clinical results at 1 year for claudicant as well as CLI patients. PMID:29117818
Iatrogenic popliteal artery injury in non arthroplasty knee surgery.
Bernhoff, K; Björck, M
2015-02-01
We have investigated iatrogenic popliteal artery injuries (PAI) during non arthroplasty knee surgery regarding mechanism of injury, treatment and outcomes, and to identify successful strategies when injury occurs. In all, 21 iatrogenic popliteal artery injuries in 21 patients during knee surgery other than knee arthroplasty were identified from the Swedish Vascular Registry (Swedvasc) between 1987 and 2011. Prospective registry data were supplemented with case-records, including long-term follow-up. In total, 13 patients suffered PAI during elective surgery and eight during urgent surgery such as fracture fixation or tumour resection. Nine injuries were detected intra-operatively, five within 12 to 48 hours and seven > 48 hours post-operatively (two days to 23 years). There were 19 open vascular and two endovascular surgical repairs. Two patients died within six months of surgery. One patient required amputation. Only six patients had a complete recovery of whom had the vascular injury detected at time of injury and repaired by a vascular surgeon. Patients sustaining vascular injury during elective procedures are more likely to litigate (p = 0.029). We conclude that outcomes are poorer when there is a delay of diagnosis and treatment, and that orthopaedic surgeons should develop strategies to detect PAI early and ensure rapid access to vascular surgical support. ©2015 The British Editorial Society of Bone & Joint Surgery.
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Alexei L. Charyshkin
2017-06-01
Full Text Available The aim of our study was to evaluate the results of the surgical treatment for patients with critical limb ischemia (CLI and stenotic lesions of the brachiocephalic arteries. Methods and Results: We examined 72 patients (68/87.2% men and 4/7.3% women aged from 46 to 78 years (mean age, 62.2±4.3 years with CLI and stenotic lesions of the brachiocephalic arteries. Conservative treatment was performed in 17(23.6% patients and surgical treatment in 55(76.4%. It has been carried out 73 surgical operations: femoral popliteal bypass (5/6.8%, lumbar sympathectomy (4/5.5%, thrombectomy of occluded aortofemoral graft (2/2.7%, limb amputation (4/5.5%, iliofemoral bypass (4/5.5%, aortofemoral bifurcation bypass (10/13.1%, endovascular surgery (1/1.6%, limb amputation at thigh level - 4(5.5%, thrombectomy of occluded distal arteries (4/5.5%, femoro-femoral cross-over bypass (1/1.6%, resection of popliteal artery aneurysm and prosthesis of the popliteal artery (1/1.6%, semi-closed loop endarterectomy of occluded arteries of the lower limbs (8/10.9%, carotid endarterectomy (23/31.5%, and carotid-subclavian bypass (2/2.7%. After the surgical intervention, we observed the disappearance or reduction of pain, restoration of sensitivity and motor activity, and healing of trophic ulcers in 75% of patients. In the late postoperative period, we detected the progression of limb ischemia in 4(5.5% patients; in connection with that, we performed limb amputation at thigh level. Ischemic stroke with a lethal outcome developed in one patient (1.4%. Conclusion: In patients with multifocal atherosclerosis, multilevel reconstructive surgical interventions must be performed in stages, due to the high operational risk, and risk of complications, secondary amputations and lethality in the postoperative period.
Popliteal Artery Aneurysm in Women
DEFF Research Database (Denmark)
Ravn, Hans; Pansell-Fawcett, Karin; Björck, Martin
2017-01-01
OBJECTIVES: Ninety-five per cent of those operated on for popliteal artery aneurysm (PA) are men. Thus, PAs in women are difficult to investigate. The aim was to study the disease in women. METHODS: Women treated for PA in 1987-2012, prospectively registered in the Swedish vascular registry......, Swedvasc, supplemented by case records, were compared with the larger male cohort. Survival was determined through cross linkage with the National Population Registry. RESULTS: 1509 patients (men and women), 1872 legs, were identified; of these 74 patients (4.9%) were women, 81 legs (4.3%). The median age...... was 70 years in women versus 69 in men. Twenty-nine centres operated on women (range 1-7 women/centre). There were no time trends in the proportion of women operated on (p=.5). Bilateral PA occurred in 9.5% of women and 27.0% of men (p=.002). For symptomatic aneurysms, there was a larger proportion...
Energy Technology Data Exchange (ETDEWEB)
Arlart, I.P. (Katharinenhospital, Stuttgart (Germany). Radiologisches Inst.)
1992-05-01
Arterial vascular disease in diabetic patients includes both microangiopathy and macroangiopathy. Macroangiopathy, i.e. stenoses of occlusions of the ilio-femoro-popliteal arteries and crural arteries, can be treated by surgical vascular reconstructions and radiological procedures such as recanalisation via catheter and CT-guided lumbar sympathetic trunk, neurolysis. In this paper the different therapeutic techniques are presented in respect of indications and results particularly in the diabetic patients. (orig.).
[Trampoline accident with anterior knee dislocation caused popliteal artery disruption].
Pedersen, Peter Heide; Høgh, Annette Langager
2011-10-17
Only a few reports describe the risk of neurovascular damage following knee dislocation while trampolining. A 16 year-old male in a trampoline accident, sustained multi-ligament damage and occlusion of the popliteal artery. The occlusion did not show clinically until 24 hours after the trauma. He underwent vascular surgery (short saphenous bypass). We recommend implementing algorithms, for the management of suspected knee dislocation and possible accompanying neurovascular injuries in all trauma centers.
International Nuclear Information System (INIS)
Liu, Patrick T.; Moyer, Adrian C.; Huettl, Eric A.; Fowl, Richard J.; Stone, William M.
2005-01-01
Popliteal vascular entrapment syndrome can result in calf claudication, aneurysm formation, distal arterial emboli, or popliteal vessel thrombosis. The most commonly reported causes of this syndrome have been anomalies of the medial head of the gastrocnemius muscle as it relates to the course of the popliteal artery. We report two cases of rare anomalous slips of the lateral head of the gastrocnemius muscle causing popliteal vascular entrapment syndrome. (orig.)
LENUS (Irish Health Repository)
Killeen, Shane D
2009-01-01
Cases of true mycotic popliteal artery aneurysm are rare. Presentation is variable but invasive and non-invasive investigations collectively facilitate diagnosis and guide operative procedures. Definitive treatment generally utilizes surgical intervention with excision and reconstruction using autologous vein graft. Prolonged targeted antibiotic therapy is an important adjuvant.
Fox, Charles J; Perkins, Jeremy G; Kragh, John F; Singh, Niten N; Patel, Bhavin; Ficke, James R
2010-07-01
Popliteal artery war wounds can bleed severely and historically have high rates of amputation associated with ligation (72%) and repair (32%). More than before, casualties are now surviving the initial medical evacuation and presenting with severely injured limbs that prompt immediate limb salvage decisions in the midst of life-saving maneuvers. A modern analysis of current results may show important changes because previous limb salvage strategies were limited by the resuscitation and surgical techniques of their eras. Because exact comparisons between wars are difficult, the objective of this study was to calculate a worst-case (a pulseless, fractured limb with massive hemorrhage from popliteal artery injury) amputation-free survival rate for the most severely wounded soldiers undergoing immediate reconstruction to save both life and limb. We performed a retrospective study of trauma casualties admitted to the combat support hospital at Ibn Sina Hospital in Baghdad, Iraq, between 2003 and 2007. US military casualties requiring a massive transfusion (> or = 10 blood units transfused within 24 hours of injury) were identified. We extracted data on the subset of casualties with a penetrating supra or infrageniculate popliteal arterial vascular injury. Demographics, injury mechanism, Injury Severity Score, tourniquet use, physiologic parameters, damage control adjuncts, surgical repair techniques, operative time, and outcomes (all-cause 30-day mortality, amputation rates, limb salvage failure, and graft patency) were investigated. Forty-six massively transfused male casualties, median age 24 years (range, 19-54 years; mean Injury Severity Score, 19 +/- 8.0), underwent immediate orthopedic stabilization and vascular reconstruction. There was one early death. The median operative time for the vascular repairs was 217 minutes (range, 94-630 minutes) and included all damage control procedures. Combined arterial and venous injuries occurred in 17 (37%). Ligation was
International Nuclear Information System (INIS)
Kornaat, Peter R.; Sharma, Ruby; Geest, Rob J. van der; Lamb, Hildo J.; Bloem, Johan L.; Watt, Iain; Kloppenburg, Margreet; Hellio le Graverand, Marie-Pierre
2009-01-01
The purpose of the study was to determine if a positive association exists between arterial vessel wall thickness and generalized osteoarthritis (OA). Our hypothesis is that generalized OA is another facet of the metabolic syndrome. The medical ethical review board of our institution approved the study. Written informed consent was obtained from each patient prior to the study. Magnetic resonance (MR) images of the knee were obtained in 42 patients who had been diagnosed with generalized OA at multiple joint sites. Another 27 MR images of the knee were obtained from a matched normal (non-OA) reference population. Vessel wall thickness of the popliteal artery was quantitatively measured by dedicated software. Linear regression models were used to investigate the association between vessel wall thickness and generalized OA. Adjustments were made for age, sex, and body mass index (BMI). Confidence intervals (CI) were computed at the 95% level and a significance level of α = 0.05 was used. Patients in the generalized OA population had a significant higher average vessel wall thickness than persons from the normal reference population (p ≤ α), even when correction was made for sex, age, and BMI. The average vessel wall thickness of the popliteal artery was 1.09 mm in patients with generalized OA, and 0.96 mm in the matched normal reference population. The association found between increased popliteal artery vessel wall thickness and generalized osteoarthritis suggests that generalized OA might be another facet of the metabolic syndrome. (orig.)
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Kornaat, Peter R.; Sharma, Ruby; Geest, Rob J. van der; Lamb, Hildo J.; Bloem, Johan L.; Watt, Iain [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Kloppenburg, Margreet [Leiden University Medical Center, Department of Rheumatology, Leiden (Netherlands); Hellio le Graverand, Marie-Pierre [Pfizer Global Research and Development, New London, CT (United States)
2009-12-15
The purpose of the study was to determine if a positive association exists between arterial vessel wall thickness and generalized osteoarthritis (OA). Our hypothesis is that generalized OA is another facet of the metabolic syndrome. The medical ethical review board of our institution approved the study. Written informed consent was obtained from each patient prior to the study. Magnetic resonance (MR) images of the knee were obtained in 42 patients who had been diagnosed with generalized OA at multiple joint sites. Another 27 MR images of the knee were obtained from a matched normal (non-OA) reference population. Vessel wall thickness of the popliteal artery was quantitatively measured by dedicated software. Linear regression models were used to investigate the association between vessel wall thickness and generalized OA. Adjustments were made for age, sex, and body mass index (BMI). Confidence intervals (CI) were computed at the 95% level and a significance level of {alpha} = 0.05 was used. Patients in the generalized OA population had a significant higher average vessel wall thickness than persons from the normal reference population (p {<=} {alpha}), even when correction was made for sex, age, and BMI. The average vessel wall thickness of the popliteal artery was 1.09 mm in patients with generalized OA, and 0.96 mm in the matched normal reference population. The association found between increased popliteal artery vessel wall thickness and generalized osteoarthritis suggests that generalized OA might be another facet of the metabolic syndrome. (orig.)
Harb, Z; Harb, A; Kammoona, Ishan; Huber, C
2011-04-01
In lower extremity trauma, it is routine to check the neurovascular status of the affected limb. Failure to recognise a vascular injury can have catastrophic consequences for the patient. The frequent observation of the distal pulses at regular intervals after a traumatic knee dislocation is absolutely mandatory for the early recognition and management of popliteal artery thrombosis. A limb-threatening complication of popliteal artery thrombosis occurring in association with a palpable dorsalis pedis pulse after a trampoline-related knee dislocation is reported here to emphasise some important teaching points. These lessons are a learning tool to help in the early recognition of the potential complications associated with such injuries and thus minimise their occurrence.
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Pranit N. Chotai
2015-12-01
Full Text Available Constellation of ipsilateral posterior hip dislocation, intertrochanteric- and proximal tibial fracture with popliteal artery injury is rare. Management of this presentation is challenging. A motor vehicle accident victim presented with these injuries, but without any initial signs of vascular compromise. Popliteal artery injury was diagnosed intra-operatively and repaired. This was followed by external fixation of tibial fracture, open reduction of dislocated hip and internal fixation of intertrochanteric fracture. Patient regained bilateral complete weight bearing and returned to pre-accident activity level. Apt surgical management including early repair of vascular injury in such a trauma mélange allows for a positive postoperative outcome.
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Weiwei Wu
Full Text Available OBJECTIVE: Percutaneous transluminal angioplasty and stenting (PTA + stent has gained acceptance as a primary treatment modality for the superficial femoral artery (SFA diseases. Popliteal artery embolization (PAE is a severe complication in SFA interventions. The purpose of this study was to evaluate the incidence, risk factors, treatment and prognosis of PAE in primary SFA PTA + stent. METHODS: Chronic SFA arteriosclerosis cases that underwent primary PTA + stent were reviewed from a retrospectively maintained database. Runoff vessels were evaluated in all cases before and after the interventions for PAE detection. The primary patency, secondary patency and limb salvage rates were calculated using Kaplan-Meier analysis and compared using log-rank analysis. Cox multivariate regression was performed to evaluate predictors of patency and limb salvage rates. RESULTS: There were 436 lesions treated in 388 patients with 10 PAE events (2.3% in total. PAE rate was significantly higher in Transatlantic Inter-Society Consensus (TASC C/D group compared with TASC A/B group (OR = 8.91, P = .002, in chronic total occlusion (CTO lesions compared with stenotic lesions (P<.0001, and in group with history of cerebral ischemic stroke (OR = 6.11, P = .007. PAE rates were not significantly affected by age, sex, smoking, hypertension, diabetes, hyperlipidemia and runoff status. The binary logistic regression showed that only the TASC C/D was an independent predictor of PAE (P = .031. The 12-month and 24-month primary patency, secondary patency and limb salvage rates in PAE group showed no significant differences comparing with non-PAE group. CONCLUSIONS: PAE is a rare event in primary SFA PTA + stent. TASC C/D lesion, CTO and cerebral ischemic stroke history are risk factors for PAE. PAE is typically reversible by comprehensive techniques. If the popliteal flow is restored in time, PAE has no significant effect on long-term patency and limb
African Journals Online (AJOL)
Nicky
Arteriotomy revealed an area of fractured intima with overlying thrombus. The area was debrided and ... the ankle (and not the posterior tibial artery). On exploration five lateral tears to the femoro-popliteal ... transverse intimal fracture with overlying thrombus (Fig. 3). Passage of a Fogarty embolectomy catheter returned a ...
Surveillance Duplex Ultrasonography of Stent Grafts for Popliteal Aneurysms.
Pineda, Danielle M; Troutman, Douglas A; Dougherty, Matthew J; Calligaro, Keith D
2016-05-01
Stent grafts, also known as covered stents, have become an increasingly acceptable treatment for popliteal artery aneurysms. However, endovascular exclusion confers lower primary patency compared to traditional open bypass and exclusion. The purpose of this study was to evaluate whether duplex ultrasonography (DU) can reliably diagnose failing stent grafts placed for popliteal artery aneurysms prior to occlusion. Between June 5, 2007, and March 11, 2014, 21 stent grafts (Viabahn; Gore, Flagstaff, Arizona) were placed in 19 patients for popliteal artery aneurysms. All patients had at least 1 follow-up duplex scan postoperatively. Mean follow-up was 28.9 months (9-93 months). Postoperative DU surveillance was performed in our Intersocietal Accreditation Commission noninvasive vascular laboratory at 1 week postprocedure and every 6 months thereafter. Duplex ultrasonography measured peak systolic velocities (PSVs) and ratio of adjacent PSVs (Vr) every 5 cm within the stent graft and adjacent arteries. We retrospectively classified the following factors as "abnormal DU findings": focal PSV > 300 cm/s, uniform PSVs 3.0. These DU criteria were derived from laboratory-specific data that we previously published on failing stent grafts placed for lower extremity occlusive disease. Four of the 21 stent grafts presented with symptomatic graft thrombosis within 6 months of a normal DU. Three of these 4 patients presented with rest pain and underwent thrombectomy (2) or vein bypass (1), and 1 elected for nonintervention for claudication. Our results suggest that surveillance DU using criteria established for grafts placed for occlusive disease may not be useful for predicting stent graft failure in popliteal artery aneurysms. © The Author(s) 2016.
The current role of vascular stents.
Busquet, J
1993-09-01
The limitations of percutaneous balloon angioplasty have favoured the development and the use of vascular endoprostheses or stents. These thin-walled metal devices maintain after expansion, an optimal and constant diameter for the vascular lumen. Restenosis, dissection, abrupt closure, residual stenosis or re-opened total occlusion represent appropriate indications for stenting. A large experience with non-coronary application of stents is currently available in iliac, femoro-popliteal and renal arteries, aorta, large veins.
Popliteal amyloidoma presenting with leg ischemia in a chronic dialysis patient
International Nuclear Information System (INIS)
Aoki, Y.; Kaneda, Kiyoshi; Miyagi, Noboru; Itoh, Manabu; Ohmoto, Hirofumi
2000-01-01
The authors report a case of bilateral popliteal amyloidoma causing stenosis of the popliteal artery and vein. This patient had been treated with hemodialysis for 26 years. The diagnosis was made with MR angiography. A popliteal tumor of the right knee was resected surgically and the histologic examination showed deposition of amyloid. After resecting the popliteal tumor, the severe leg pain and intermittent claudication improved. This report suggests that popliteal amyloid tumors should be considered in a patient undergoing long-term hemodialysis who complains of leg pain and intermittent claudication. (orig.)
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Parthipun, Aneeta; Diamantopoulos, Athanasios; Kitrou, Panagiotis; Padayachee, Soundrie; Karunanithy, Narayan; Ahmed, Irfan; Zayed, Hany; Katsanos, Konstantinos
2015-01-01
PurposeTo report the immediate and mid-term clinical and anatomical outcomes of a novel, hybrid, heparin-bonded, nitinol ring stent (TIGRIS; Gore Medical) when used for the treatment of lesions located in the popliteal artery.Materials and MethodsThis was a prospective single-centre registry. Patients eligible for inclusion were individuals suffering from symptomatic popliteal arterial occlusive disease (Rutherford–Becker stage 3–6; P1–P3 segments) and treated with placement of the TIGRIS stent(s). Patients were prospectively scheduled for clinical review and duplex ultrasound follow-up after 6 and 12 months. Outcome measures included immediate technical success, primary vessel patency, in-stent binary restenosis (evaluable by Duplex at 50 % threshold; PSVR > 2.0), freedom from target lesion revascularization (TLR) and amputation-free survival (AFS) estimated by Kaplan–Meier (K–M) survival analysis. Cox proportional-hazards regression analysis was also performed to adjust for confounders and search for independent predictors of outcomes.ResultsFrom August 2012 to March 2014, a total of 54 popliteal TIGRIS stents were implanted in 50 limbs of 48 patients (27 men and 21 women; mean age 76.0 ± 1.7 years). Median Rutherford–Becker stage was five at baseline and 37/50 (74.0 %) were chronic total occlusions. Technical success was achieved in all cases (100 %). Stented lesion length was 114.2 ± 36.9 mm (range 6–20 cm). Median follow-up was 11.8 ± 0.8 months. After 12 months, primary patency of the TIGRIS stent was 69.5 ± 10.2 % with an 86.1 ± 5.9 % freedom from TLR and 87 ± 5.0 % AFS (K–M estimates).ConclusionThe TIGRIS hybrid heparin-bonded nitinol ring stent is a safe and effective endovascular option for complex occlusive disease of the popliteal artery
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Parthipun, Aneeta; Diamantopoulos, Athanasios; Kitrou, Panagiotis [King’s Health Partners, Department of Interventional Radiology, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Padayachee, Soundrie [King’s Health Partners, Department of Ultrasonic Angiology, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Karunanithy, Narayan; Ahmed, Irfan [King’s Health Partners, Department of Interventional Radiology, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Zayed, Hany [King’s Health Partners, Department of Vascular Surgery, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Katsanos, Konstantinos, E-mail: konstantinos.katsanos@gstt.nhs.uk, E-mail: katsanos@med.upatras.gr [King’s Health Partners, Department of Interventional Radiology, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom)
2015-08-15
PurposeTo report the immediate and mid-term clinical and anatomical outcomes of a novel, hybrid, heparin-bonded, nitinol ring stent (TIGRIS; Gore Medical) when used for the treatment of lesions located in the popliteal artery.Materials and MethodsThis was a prospective single-centre registry. Patients eligible for inclusion were individuals suffering from symptomatic popliteal arterial occlusive disease (Rutherford–Becker stage 3–6; P1–P3 segments) and treated with placement of the TIGRIS stent(s). Patients were prospectively scheduled for clinical review and duplex ultrasound follow-up after 6 and 12 months. Outcome measures included immediate technical success, primary vessel patency, in-stent binary restenosis (evaluable by Duplex at 50 % threshold; PSVR > 2.0), freedom from target lesion revascularization (TLR) and amputation-free survival (AFS) estimated by Kaplan–Meier (K–M) survival analysis. Cox proportional-hazards regression analysis was also performed to adjust for confounders and search for independent predictors of outcomes.ResultsFrom August 2012 to March 2014, a total of 54 popliteal TIGRIS stents were implanted in 50 limbs of 48 patients (27 men and 21 women; mean age 76.0 ± 1.7 years). Median Rutherford–Becker stage was five at baseline and 37/50 (74.0 %) were chronic total occlusions. Technical success was achieved in all cases (100 %). Stented lesion length was 114.2 ± 36.9 mm (range 6–20 cm). Median follow-up was 11.8 ± 0.8 months. After 12 months, primary patency of the TIGRIS stent was 69.5 ± 10.2 % with an 86.1 ± 5.9 % freedom from TLR and 87 ± 5.0 % AFS (K–M estimates).ConclusionThe TIGRIS hybrid heparin-bonded nitinol ring stent is a safe and effective endovascular option for complex occlusive disease of the popliteal artery.
Zhang, Z; Marois, Y; Guidoin, R G; Bull, P; Marois, M; How, T; Laroche, G; King, M W
1997-01-01
Following positive results obtained in in vitro studies and in vivo implantations in animals, a clinical trial using the Vascugraft polyurethane arterial prosthesis as a below-knee substitute was undertaken in 15 patients. Eight grafts became occluded during the first year, and segments from four of them were explanted and made available for pathological, structural and chemical investigations. The implantation periods ranged from 21 to 358 days. Failures were associated with kinking (one case), possible anastomotic mismatch between the graft and the artery (one case), and poor run-off (two cases). No organized collagenous internal encapsulation was noted; however, endothelial-like cells were observed at the anastomotic site of one graft. No significant structural degradation of the prostheses was observed in those grafts implanted for 21, 38 and 46 days. Some deteriorations in the fibrous structure were observed on the external surface of the prosthesis implanted for 358 days. High-resolution carbon C1s analysis by ESCA demonstrated a 60 to 80% decrease in carbonate content on the surface of all explanted prostheses. Chemical analyses of each polyurethane graft by IR, SEC and DSC revealed no significant chemical changes. The clinical performance of the Vascugraft prosthesis for below-knee implantation proved to be no more impressive than that of expanded polytetrafluorethylene, the currently accepted reference. The decision by B. Braun Melsungen AG to end this program is therefore to be regarded as highly professional.
Ucci, Alessandro; Curci, Ruggiero; Azzarone, Matteo; Bianchini Massoni, Claudio; Bozzani, Antonio; Marcato, Carla; Marone, Enrico Maria; Perini, Paolo; Tecchio, Tiziano; Freyrie, Antonio; Argenteri, Angelo
2018-01-01
Background The endovascular approach became an alternative to open surgical treatment of popliteal artery aneurysm over the last few years. Heparin-bonded stent-grafts have been employed for endovascular popliteal artery aneurysm repair, showing good and stable results. Only few reports about the use of multilayer flow modulator are available in literature, providing small patient series and short follow-up. The aim of this study is to report the outcomes of patients with popliteal artery aneurysm treated with the multilayer flow modulator in three Italian centres. Methods We retrospectively analysed a series of both symptomatic and asymptomatic patients with popliteal artery aneurysm treated with the multilayer flow modulator from 2009 to 2015. Follow-up was undertaken with clinical and contrast-enhanced ultrasound examinations at 1, 6 and 12 months, and yearly thereafter. Computed tomography angiography was performed in selected cases. Primary endpoints were aneurysm sac thrombosis; freedom from sac enlargement and primary, primary-assisted and secondary patency during follow-up. Secondary endpoints were technical success, collateral vessels patency, limb salvage and aneurysm-related complications. Results Twenty-three consecutive patients (19 males, age 72 ± 11) with 25 popliteal artery aneurysms (mean diameter 23 mm ± 1, 3 symptomatic patients) were treated with 40 multilayer flow modulators during the period of the study. Median follow-up was 22.6 ± 16.7 months. Complete aneurysm thrombosis occurred in 92.9% of cases (23/25 cases) at 18 months. Freedom from sac enlargement was 100% (25/25 cases) with 17 cases of aneurysm sac shrinkage (68%). At 1, 6, 12 and 24 months, estimated primary patency was 95.7%, 87.3%, 77% and 70.1%, respectively. At the same intervals, primary-assisted patency was 95.7%, 91.3%, 86% and 86%, respectively, and secondary patency was 100%, 95.7%, 90.3% and 90.3%, respectively. Technical success was 100%. The collateral
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Serdar Yilmaz
2014-01-01
Full Text Available Hematomas caused by surgery or trauma that persist and expand slowly for more than a month are defined as chronic expanding hematomas (CEH. Magnetic resonance imaging (MRI is useful for the diagnosis. Total excision with the pseudocapsule is the treatment method. Pseudoaneurysms result from arterial wall disruptions and can be mistaken for CEH. We present a rare case report of a 45-year-old man with a large, painful swelling in his left popliteal fossa. He had a puncture wound by a nail 11 years ago and a gradually expanding mass occurred in his popliteal fossa. A pseudoaneurysm was detected and operated a year later. After surgery, a gradually expanding mass recurred in his popliteal fossa. On the arteriography, the popliteal artery was occluded and the blood flow was maintained with collateral vessels. On MRI, an enormous swelling of 115 × 107 × 196 cm in diameter was seen. It was diagnosed as CEH and was excised completely protecting the collateral vessels and there was no recurrence after a year from the surgery.
International Nuclear Information System (INIS)
Bastug, Demir E.; Dominic, Anthony; Ortiz, Orlando; DiBartolomeo, Anthony G.; Kotzan, Jeffrey M.; Abraham, F. Matthew
1997-01-01
A 31-year-old woman with Cogan syndrome (a rare form of systemic vasculitis) was evaluated for a cold, painful left foot with diminished pulses. Arteriography demonstrated thrombosis of the left popliteal artery with evidence of vasculitis. Thrombolytic therapy was begun with initial success but eventual rethrombosis. After reinitiating thrombolytic therapy combined with intraarterial vasodilator therapy, successful angioplasty was performed with sustained results, at 6-month follow-up
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Chang, Il Soo; Chee, Hyun Keun; Park, Sang Woo; Yun, Ik Jin; Hwang, Jae Joon; Lee, Song Am; Kim, Jun Seok; Chang, Seong Hwan; Jung, Hong Geun [Konkuk University Hospital, Seoul (Korea, Republic of)
2011-04-15
We wanted to evaluate the status of self-expandable nitinol stents implanted in the P2 and P3 segments of the popliteal artery in Korean patients. We retrospectively analyzed 189 consecutive patients who underwent endovascular treatment for steno occlusive lesions in the femoropopliteal artery from July 2003 to March 2009, and 18 patients who underwent stent placement in popliteal arterial P2 and P3 segments were finally enrolled. Lesion patency was evaluated by ultrasound or CT angiography, and stent fracture was assessed by plain X-rays at 1, 3, 6 and 12 months and annually thereafter. At the 1-month follow-up, stent fracture (Type 2) was seen in one limb (up to P3, 1 of 18, 6%) and it was identified in seven limbs at the 3-month follow-up (Type 2, Type 3, Type 4) (n = 1: up to P2: n = 6: P3). At the 6-month follow-up, one more fracture (Type 1) (up to P3) was noted. At the 1-year follow-up, there were no additional stent fractures. Just four limbs (up to P2) at the 2-year follow-up did not have stent fracture. The primary patency was 94%, 61% and 44% at 1, 3 and 6 months, respectively, and the group with stent implantation up to P3 had a higher fracture rate than that of the group that underwent stenting up to P2 (p < 0.05). We suggest that stent placement up to the popliteal arterial P3 segment and over P2 in an Asian population can worsen the stent patency owing to stent fracture. It may be necessary to develop a stent design and structure for the Asian population that can resist the bending force in the knee joint
Spiridonov, A A; Satmari, V V; Zaporozhan, A A; Grozovskiĭ, Iu A; Il'ina, M B; Novikova, S P; Shekhter, A B; Dobrova, N B
1989-01-01
The experimental and clinical data on the use of new native grafts with increased thromboresistance--the Vitlan and heparinized ones are presented. In all the acute and chronic experiments, the increased thromboresistance of both types of the grafts versus the common Fluorlon-Lavsan ones, and well-formed neointima with sufficient vascularization by the year 1 and 5 of follow-up were revealed. Complete organization of the external and internal capsules of the grafts was noted 5 mos later, no tissue reaction to Vitlan and heparinized grafts was revealed. The Vitlan grafts were used in 19 patients. Good immediate and long-term results were obtained in reconstruction of the aorto-femoral, aorto-pulmonary and femoro-popliteal segments with the grafts of 10 and 8 mm in diameter. All the Vitlan shunts of the femoro-popliteal segment with 6 mm diameter were thrombosed 1-6 mos after the operation. The heparinized grafts with 8 mm diameter at the femoro-popliteal position were used in 28 patients, good long-term results were noted in 27.
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Damjanović Miodrag
2014-01-01
Full Text Available Introduction. Entrapment and fracture of diagnostic or therapeutic devices within the coronary circulatory system are a rare, but increasing problem. Case report. A 70-yearold man was admitted in our clinic for coronary angiography before the planned aortic valve replacement. An arterial sheath was inserted in the right common femoral artery. After introducing a J-tip diagnostic coronary guidewire into the aorta and advancing a left Judkins diagnostic catheter over it, suddenly occured peeling off of the wire´s hydrophilic coating at the aortic arch level. Very soon, this outer coating of guidewire carried by the blood stream was entered into the left femoral artery, then into the left popliteal artery. This stripped part of guidewire was successfully caught and extracted out by using a goose-neck snare catheter. Conclusion. A sudden stripping of outer coating of a J-tip diagnostic hydrophilic coronary guidewire during coronary angiography is possible to manage quickly and successfully by the use of a simple cathether.
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André Hideo Motoki
2008-12-01
Full Text Available Aneurismas de artéria femoral são raros, porém são o segundo tipo mais freqüente de aneurismas periféricos, sendo o aneurisma de artéria poplítea o mais comum. Normalmente, são de etiologia aterosclerótica. As complicações deste aneurisma são representadas por embolia, trombose e, mais raramente, a rotura. O objetivo deste trabalho é relatar um caso de um paciente com 59 anos, masculino, com queixa de dor súbita em membro inferior esquerdo associado à frialdade, palidez e ausência de pulsos. O ecocolordoppler evidenciou a presença de aneurisma trombosado da artéria femoral comum. O paciente foi submetido, com sucesso, à ressecção do aneurisma, com reconstrução do leito arterial.Common femoral artery aneurysms are rare; however, they are the second most frequent type of peripheral aneurysm, popliteal artery aneurysms being the most common. They usually have atherosclerotic ethiology. The complications of this aneurysm are thromboembolism and, more rarely, rupture. This article aimed at reporting the case of a 59-year-old male patient with complaint of sudden pain in his left leg associated with coldness, paleness and absence of pulses. Color Doppler ultrasound showed a thrombosed aneurysm of the common femoral artery. The patient was successfully submitted to aneurysm resection with reconstruction of the arterial bed.
International Nuclear Information System (INIS)
Kau, Thomas; Eicher, Wolfgang; Reiterer, Christian; Niedermayer, Martin; Rabitsch, Egon; Hausegger, Klaus A.; Senft, Birgit
2011-01-01
To evaluate the accuracy of dual-energy CT angiography (DE-CTA) maximum intensity projections (MIPs) in symptomatic peripheral arterial occlusive disease (PAOD). In 58 patients, DE-CTA of the lower extremities was performed on dual-source CT. In a maximum of 35 arterial segments, severity of the most stenotic lesion was graded (<10%, 10-49% and 50-99% luminal narrowing or occlusion) independently by two radiologists, with DSA serving as the reference standard. In DSA, 52.3% of segments were significantly stenosed or occluded. Agreement of DE-CTA MIPs with DSA was good in the aorto-iliac and femoro-popliteal regions (κ = 0.72; κ = 0.66), moderate in the crural region (κ = 0.55), slight in pedal arteries (κ = 0.10) and very good in bypass segments (κ = 0.81). Accuracy was 88%, 78%, 74%, 55% and 82% for the respective territories and moderate (75%) overall, with good sensitivity (84%) and moderate specificity (67%). Sensitivity and specificity was 82% and 76% in claudicants and 84% and 61% in patients with critical limb ischaemia. While correlating well with DSA above the knee, accuracy of DE-CTA MIPs appeared to be moderate in the calf and largely insufficient in calcified pedal arteries, especially in patients with critical limb ischaemia. (orig.)
Bacteria of leg atheromatous arteries responsible for inflammation.
Olszewski, Waldemar Lech; Rutkowska, Joanna; Moscicka-Wesolowska, Maria; Swoboda-Kopec, Ewa; Stelmach, Ewa; Zaleska, Marzanna; Zagozda, Malgorzata
2016-09-01
Ischaemia of the lower limbs is frequently followed by inflammation and, in advanced cases, necrosis of peripheral tissues. Whether this is caused by arterial hypoperfusion only or by the presence of bacteria in the arterial walI as well remains unclear. The aim of the study was to prove the presence and source of bacteria in arterial specimens and evaluate their chemotactic properties resulting in the formation of periarterial cellular infiltrates. Bacterial culture and testing for 16sRNA were performed in fragments of popliteal artery harvested from amputated limbs. Carotid artery plaques served as controls. Fragments of arteries were transplanted into scid mice to evaluate their chemotactic activity for macrophages. a) higher prevalence of isolates and 16sRNA in atherosclerotic popliteal than carotid arteries, b) high density of plaque and periarterial infiltrates and mRNA level for pro-inflammatory cytokines in popliteal arteries, c) prevalent microbes were Staphylococcus aureus, S. epidermidis and Enterococci, d) foot skin and arterial bacterial phenotypes and DNA revealed evident similarities, and e) more intensive mouse macrophage accumulation in popliteal than carotid implants into scid mice. The presence of bacteria in the lower limb arterial wall was documented. They may predispose to inflammation secondary to ischaemic changes.
Rupture of popliteal arterial aneurysm due to salmonella infection
International Nuclear Information System (INIS)
Kim, Dong Hun; Oh, Hyung Woo; Kim, Dong Hyun; Byun, Joo Nam
2006-01-01
We report here on a case of popliteal aneurysm and rupture that occurred over a 10-day period and this was all secondary to salmonella infection. Computed tomography (CT) angiography of the extremity that was performed before and after aneurysmal rupture showed the aneurysm's rapid evolution to rupture over a short period of time. We also review the pathogenesis, clinical presentation, diagnostic approach and management of salmonella aneurysms
DEFF Research Database (Denmark)
Agerskov, K; Henriksen, O; Tønnesen, K H
1981-01-01
The effect of head-up tilt on leg blood flow and segmental arterial blood pressures was studied in 21 patients with occlusion or severe stenosis of the common or superficial femoral artery. Arterial pressure was measured directly in the brachial artery, common femoral artery and popliteal artery....... Relative change in blood flow in the leg during tilt was estimated by changes in arterio-venous oxygen differences and by the indicator dilution technique in nine patients. Head-up tilt caused a decrease in leg blood flow of 36% corresponding to an increase in total vascular resistance of 57%. Tilt did...... not change the pressure gradient from femoral to popliteal artery in the patients with occlusion of the superficial femoral artery, indicating that the flow resistance offered by the collateral arteries had increased. In a bilateral sympathectomised patient the increase in collateral resistance was almost...
Stent fractures in the Hemobahn/Viabahn stent graft after endovascular popliteal aneurysm repair
Tielliu, Ignace F. J.; Zeebregts, Clark J.; Vourliotakis, George; Bekkema, Foppe; van den Dungen, Jan J. A. M.; Prins, Ted R.; Verhoeven, Eric L. G.
Objective: During the last decade, endovascular repair of popliteal artery aneurysms (PAAs) has become a valid alternative to open repair. This study analyzes the incidence and origin of stein graft fractures after endovascular repair, its impact on patency, and strategies to prevent fractures.
Balloon angioplasty of popliteal and crural arteries in elderly with critical chronic limb ischemia
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Atar, Eli; Siegel, Yoel; Avrahami, Ram; Bartal, Gabriel; Bachar, Gil N.; Belenky, Alexander
2005-02-01
Objective: Elderly patients with extensive infrainguinal peripheral vascular disease and critical chronic limb ischemia (CCLI) are poor surgical candidates. Our purpose was to evaluate angiographic and clinical results of popliteal, infrapopliteal, and multi-level disease percutaneous transluminal angioplasty (PTA) in such patients. Design: Retrospective study of angiographic and clinical files in selected group. Materials and methods: Between 1996 and 2002, 38 elderly patients aged 80-94 years old (mean age 83.3) with critical leg ischemia were treated with PTA. All patients were at high surgical risk. 31/38 (81.5%) patients had chronic non-healing wounds, and 14/38 (37%) had multi-level disease of superficial femoral, popliteal and crural arteries. One hundred and two lesions were treated by angioplasty. Immediate angiographic and 1 year clinical results were retrospectively analyzed. Results: The overall procedural success rate was 32/38 (84.2%). There were three major complications (7.9%), but no deaths, and three technical failures, all were of infrapopliteal lesions. After 1 year, 27 patients could be followed, five patients died during the first year of unrelated causes. Twenty-three patients (85.2%), were clinically re-occluded within 1 year, but complete and partial wound healing was achieved in 80% (16/20) and rest pain improvement in 57% (4/7), so that overall limb salvage was 74% (20/27). Conclusions: Elderly patients with multi-level CCLI have a short patency term following angioplasty of 14.8% after 1 year. Nevertheless, this temporary vascular patency enables wound healing or improvement in 74% of these patients, thus such endovascular interventions are recommended in this age group.
Balloon angioplasty of popliteal and crural arteries in elderly with critical chronic limb ischemia
International Nuclear Information System (INIS)
Atar, Eli; Siegel, Yoel; Avrahami, Ram; Bartal, Gabriel; Bachar, Gil N.; Belenky, Alexander
2005-01-01
Objective: Elderly patients with extensive infrainguinal peripheral vascular disease and critical chronic limb ischemia (CCLI) are poor surgical candidates. Our purpose was to evaluate angiographic and clinical results of popliteal, infrapopliteal, and multi-level disease percutaneous transluminal angioplasty (PTA) in such patients. Design: Retrospective study of angiographic and clinical files in selected group. Materials and methods: Between 1996 and 2002, 38 elderly patients aged 80-94 years old (mean age 83.3) with critical leg ischemia were treated with PTA. All patients were at high surgical risk. 31/38 (81.5%) patients had chronic non-healing wounds, and 14/38 (37%) had multi-level disease of superficial femoral, popliteal and crural arteries. One hundred and two lesions were treated by angioplasty. Immediate angiographic and 1 year clinical results were retrospectively analyzed. Results: The overall procedural success rate was 32/38 (84.2%). There were three major complications (7.9%), but no deaths, and three technical failures, all were of infrapopliteal lesions. After 1 year, 27 patients could be followed, five patients died during the first year of unrelated causes. Twenty-three patients (85.2%), were clinically re-occluded within 1 year, but complete and partial wound healing was achieved in 80% (16/20) and rest pain improvement in 57% (4/7), so that overall limb salvage was 74% (20/27). Conclusions: Elderly patients with multi-level CCLI have a short patency term following angioplasty of 14.8% after 1 year. Nevertheless, this temporary vascular patency enables wound healing or improvement in 74% of these patients, thus such endovascular interventions are recommended in this age group
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João Antonio Corrêa
2007-06-01
Full Text Available Os autores relatam um caso de aneurisma de artéria poplítea trombosado em que se realizou fibrinólise com sucesso na fase aguda. Foram utilizadas veias de braço para realização do enxerto e exclusão do aneurisma, pois o paciente havia sido previamente submetido à safenectomia bilateral e revascularização do miocárdio com as veias do outro braço. Apesar das dificuldades, o salvamento do membro foi alcançado.The authors report a case of a thrombosed popliteal artery aneurysm successfully treated by fibrinolysis in its acute stage. Arm veins were used to perform a bypass and aneurysm exclusion, since the patient had previously been submitted to bilateral saphenous vein stripping and myocardial revascularization using the veins of the other arm. Despite the difficulties, limb salvage was achieved.
Pseudoaneurysms of large arteries associated with AIDS
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Carlos Eli Piccinato
Full Text Available BACKGROUND: Several vascular complications are known to occur in association with the acquired immunodeficiency syndrome (AIDS and recent publications have called attention to the development of pseudoaneurysms of large arteries in patients with AIDS. CASE REPORT: We report on 2 patients with AIDS aged 23 and 31 years with pseudoaneurysms of the abdominal aorta and common iliac arteries. After clinical and radiological evaluation by arteriography and computed tomography, the patients were submitted to aneurysmectomy, with the placement of a patch of dacron in the first case and the interposition of a right aorto-iliac and left femoral prosthesis in the second. The second patient developed new aneurysms of the right subclavian and left popliteal arteries 2 months after surgery. Proximal ligation of the right subclavian artery was performed to treat the first aneurysm and resection and interposition of a reversed saphenous vein was carried out to treat the pseudoaneurysm of the popliteal artery. Histopathological examination of the popliteal artery revealed necrotizing arteritis.
The edema of the lower limb: investigations by dynamic and static lymphoscintigraphy
International Nuclear Information System (INIS)
Fritz, P.; Wildeshaus, K.H.; Winkel, K. zum.
1986-01-01
24 patients with edema of the lower limb after femoro-popliteal or femoro-crural bypass surgery were investigated by dynamic and static lymphoscintigraphy. In 20 patients contrast phlebography was also done. Venous drainage disturbences were not demonstrable. Legs with edema had a statistically significant lower drainage capacity for sup(99m)Tc sulfur microcolloid than contralateral legs. Velocity of prefascial lymphatic transport of radioactivity showed no significant differences between edematous and contralateral legs. Static lymphoscintigraphy demonstrated typical lymphedema associated-soft tissue findings in 83%. Diffuse retention of radiocolloid in the region of the edema and iatrogenic lesions of lymph vessels (dermal back flow) in the region of the surgical scar were found in 45% and 41% of cases, respectively. Based on the criteria of dynamic and static lymphoscintigraphy and the pathogenetic classification of lymphedema according to FOELDI, a dynamic insufficiency of lymph drainage must be assumed to be the cause of lymphedema after arterial reconstructions. Iatrogenic lymph vessel lesions also play a causative role. Dynamic and static lymphoscintigraphy gives valuable information for the differentiation between postreconstructive lymphedema of mechanical and functional origin. (Author)
Femoropopliteal laser recanalization - a multicenterstudy
International Nuclear Information System (INIS)
Lammer, J.; Pilger, E.; Karnel, F.; Schurawitzki, H.; Horvath, W.; Oertl, M.; Riedl, M.; Umek, H.; Klein, G.E.; Schreyer, H.; Neumayer, K.; Einspieler, R.; Olbert, F.; Polterauer, P.; Haidinger, D.; Partsch, H.; Graz Univ.; Vienna Univ.; Vienna Univ.; Krankenhaus der Barmherzigen Brueder, Linz; Wilhelminenspital, Vienna
1990-01-01
Laser-assisted angioplasty was performed in four different hospitalcenters, following the same treatment protocol and using a Nd-YAG laser with a sapphire-probe catheter. The initial recanalization rate of 259 femoro-popliteal occlusions with a mean length of 7.5 cm was 84%. Dissections or perforations were observed in 10%. An emergency surgical intervention was required in 1.1%. The long-term patency rate of the successfully recanalized arteries was 74% after 2 years. The cumulative cure rate of all 259 patients was 62%. (orig.) [de
African Journals Online (AJOL)
plication was acute arterial occlusion caused by thrombo- embolism. The reasons for ... Total. 43. 55. TABLE 11. CONCOMITANT DISEASE IN 38 PATIENTS .... Dacron prosthesis in 4. .... genous saphenous vein and the type of anastomosis.
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Šarac Momir
2011-01-01
Full Text Available Background. Traumatic arteriovenous (AV fistula is considered to be a pathologic communication between the arterial and venous systems following injury caused mostly by firearms, sharp objects or blasting agents. Almost 50% of all traumatic AV fistulas are localized in the extremities. In making diagnosis, besides injury anamnesis data, clinical image is dominated by palpable thrill and auscultator continual sounds at the site of fistula, extremities edemas, ischemia distally of fistula, pronounced varicose syndrome, and any signs of the right heart load in high-flow fistulas. Case report. We presented a male 32-year-old patient self-injured the region of the right lower and upper leg by shotgun during hunting in 2005. The same day the patient was operated on in a tertiary traumatology health care institution under the diagnosis of vulnus sclopetarium femoris et cruris dex; AV fistula reg popliteae dex; fractura cruris dex. The performed surgery was ligatura AV fistulae; reconstructio a. popliteae cum T-T anastomosis; fasciotomia cruris dex. Postoperatively, in the patient developed a multiple AV fistula of the femoral and popliteal artery and neighboring veins. The patient was two more times operated on for closing the fistula but with no success. Three years later the patient was referred to the Clinic for Vascular Surgery, Military Medical Academy, Belgrade, Serbia. A physical examination on admission showed the right upper leg edema, pronounced varicosities and high thrill, signs of the skin induration and initial ischemia with ulceration in the right lower leg, as well as numerous scars in the inner side of the leg from the previously performed operations. Due to the right heart load there were also present easy getting tired, tachypnoea and tachycardia. CT and contrast angiography verified the presence of multiple traumatic AV fistulas in the surface femoral and popliteal artery and neighboring veins of the highest diameter being 1 cm
The Infrapopliteal Arterial Occlusions Similar to Buerger Disease: Report of Two Cases
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Kimihiro Igari
2014-01-01
Full Text Available We herein present two cases that required the differential diagnosis of Buerger disease. Case 1 involved a 55-year-old male with a smoking habit who was admitted with ulcers and coldness in his fingers and toes. Angiography showed blockage in both the radial and posterior tibial arteries, which led to an initial diagnosis of Buerger disease. However, a biopsy of the right posterior tibial artery showed pathological findings of fibromuscular dysplasia (FMD. Case 2 involved a 28-year-old male with intermittent claudication who was examined at another hospital. Angiography showed occlusion of both popliteal and crural arteries, and the patient was suspected to have Buerger disease. However, computed tomography disclosed an abnormal slip on both sides of the popliteal fossa, and we diagnosed him with bilateral popliteal artery entrapment syndrome (PAES. These cases illustrate that other occlusive diseases, such as FMD and PAES, may sometimes be misdiagnosed as Buerger disease.
Duplex scanning in the diagnosis of acute deep vein thrombosis of the lower extremity
van Ramshorst, B.; Legemate, D. A.; Verzijlbergen, J. F.; Hoeneveld, H.; Eikelboom, B. C.; de Valois, J. C.; Meuwissen, O. J.
1991-01-01
In a prospective study the value of duplex scanning in the diagnosis of acute femoro-popliteal thrombosis was compared to conventional contrast venography (CV) as a gold standard. A total of 126 legs in 117 patients suspected of having deep vein thrombosis (DVT) or pulmonary embolism (PE) were
International Nuclear Information System (INIS)
Beitzke, Dietrich; Wolf, Florian; Juelg, Gregor; Lammer, Johannes; Loewe, Christian
2011-01-01
Popliteal vascular entrapment syndrome is caused by aberrations or hypertrophy of the gastrocnemius muscles, which compress the neurovascular structures of the popliteal fossa, leading to symptoms of vascular and degeneration as well as aneurysm formation. Imaging of popliteal vascular entrapment may be performed with ultrasound, magnetic resonance imaging (MRI), computed tomography angiography, and conventional angiography. The use of blood-pool contrast agents in MRI when popliteal vascular entrapment is suspected offers the possibility to perform vascular imaging with first-pass magnetic resonance angiographic, high-resolution, steady-state imaging and allows functional tests all within one examination with a single dose of contrast agent. We present imaging findings in a case of symptomatic popliteal vein entrapment diagnosed by the use of blood pool contrast-enhanced MRI.
[Traumatic knee dislocation with popliteal vascular disruption: retrospective study of 14 cases].
Bonnevialle, P; Chaufour, X; Loustau, O; Mansat, P; Pidhorz, L; Mansat, M
2006-12-01
Complex femorotibial dislocation of the knee joint generally results from high-energy trauma caused by a traffic or a contact sport accident. Besides disruption of the cruciate ligaments, in 10-25% of patients present concomitant palsy of the common peroneal nerve and more rarely disruption of the popliteal artery. The purpose of this work was to assess outcome in a monocentric consecutive series of knee dislocations with ischemia due to disruption of the popliteal artery and to focus on specific aspects of management. This retrospective series included eleven men and three women, aged 18 to 74 years (mean 47 years). The right knee was injured in five and the left knee in six. Trauma resulted from a farm accident in six patients, fall from a high level in two, a traffic accident in three and a skiing accident (fall) in one. Two other patients with morbid obesity were fall victims. Nine patients had a single injury, two presented an associated serious head injury, one a severe chest injury, and one multiple trauma with coma, chest contusion, and abdominal lesions. One patient had a fracture of the distal femur with associated ischemia. Five knee dislocations were open with a popliteal wound for three and a posteromedial wound for two. Four patients presented total sciatic nerve palsy and nine palsy of the common peroneal nerve. The dislocation was documented in ten cases: lateral (n=1), anterior (n=4), posterior (n=5). For four patients, the dislocation had been reduced during pre-hospital care. Preoperative arteriography was available for eight patients and confirmed the disruption of the popliteal artery; the diagnosis was obvious in six other patients who were directed immediately to the operative theatre without pre-operative imaging. Revascularization was achieved with a upper popliteal-lower popliteal bypass using an inverted saphenous graft. The graft was harvested from the homolateral greater saphenous vein in eight patients and the contralateral vein in six
Itoga, Nathan K; Kim, Tanner; Sailer, Anna M; Fleischmann, Dominik; Mell, Matthew W
2017-09-01
Preprocedural computed tomography angiography (CTA) assists in evaluating vascular morphology and disease distribution and in treatment planning for patients with lower extremity peripheral artery disease (PAD). The aim of the study was to determine the predictive value of radiographic findings on CTA and technical success of endovascular revascularization of occlusions in the superficial femoral artery-popliteal (SFA-pop) region. Medical records and available imaging studies were reviewed for patients undergoing endovascular intervention for PAD between January 2013 and December 2015 at a single academic institution. Radiologists reviewed preoperative CTA scans of patients with occlusions in the SFA-pop region. Radiographic criteria previously used to evaluate chronic occlusions in the coronary arteries were used. Technical success, defined as restoration of inline flow through the SFA-pop region with technical failure (P = .014). Longer lengths of occlusion were also associated with technical failure (P = .042). Multiple occlusions (P = .55), negative remodeling (P = .69), vessel runoff (P = .56), and percentage of vessel calcification (P = .059) were not associated with failure. On multivariable analysis, 100% calcification remained the only significant predictor of technical failure (odds ratio, 9.0; 95% confidence interval, 1.8-45.8; P = .008). Analysis of preoperative CTA shows 100% calcification as the best predictor of technical failure of endovascular revascularization of occlusions in the SFA-pop region. Further studies are needed to determine the cost-effectiveness of obtaining preoperative CTA for lower extremity PAD. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.
Civilian popliteal artery injuries
African Journals Online (AJOL)
with reversed vein grafting in 68 patients, primary anastomosis in 33, prosthetic graft insertion in 11, ... patients underwent delayed amputation, giving an overall amputation rate of 37.5%. .... injury, level of arterial injury and type of repair had no significant ... patients, graft occlusion, and diseased crural vessels with poor run-.
Lichtenberg, M; Stahlhoff, W; Boese, D
2013-08-01
Single center observational study analyzing the primary patency rate and freedom from target lesions revascularization rate of the Pulsar-18 nitinol stent after recanalization of long superficial femoral artery (SFA) occlusions (TASC D) in 22 patients with critical limb ischemia (CLI). Between 1/2011 and 7/2011, 22 consecutive patients (9 male, 13 female) with chronic total occlusions (CTO) of the femoro-popliteal arteries presenting with CLI (17 patients with Rutherford 4 score, and 5 patients with Rutherford 5 score) were enrolled and successfully recanalized using the Pulsar-18 self-expanding (SE) nitinol stent (BIOTRONIK AG, Buelach, Switzerland). Primary patency at 12 months was defined as no binary restenosis (>50%) on Duplex ultrasound (PSVRPulsar-18 SE nitinol stent was 77% with a per protocol restenosis in 5 of 22 patients. Seventeen patients showed a walking capacity on treadmill test >300 meters (Rutherford II). Two patients with a documented restenosis were Rutherford, these patients were treated conservatively. Three patients with restenosis and a Rutherford III score were scheduled for an endovascular target lesion revascularization leading to a freedom from target lesion revascularization rate of 86%. Endovascular intervention of long SFA occlusions using subintimal or intraluminal recanalization technique with implantation of the Pulsar-18 SE nitinol stent in CLI patients is safe and clinically effective with a primary patency rate after 12 months of 77% and a freedom from target lesion revascularization rate of 86%.
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İsa Coşkun
2012-12-01
Full Text Available A 50-year-old man, presented with sudden onset of right leg coldness, numbness and pain for 1.5 months. It was found that the right superficial femoral artery was thrombosed, which ended at the mid-thigh level and a continued as the popliteal artery in magnetic resonance angiography. Persistence of the sciatic artery is extremely rare vascular anomaly. It is prone to undergo early atherosclerotic changes, occlusive embolism, and aneurysm formation. In this article we report a patient with acute artery occlusion developed in popliteal and crural arteries in a patient with persistent sciatic artery which was successfully treated through surgical and endovascular intervention.
Energy Technology Data Exchange (ETDEWEB)
Son, Ye Na; Jin, Wook; Jahng, Geon-Ho; Park, Yong Sung; Park, So Young [Kyung Hee University School of Medicine, Department of Radiology, Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of); Cha, Jang Gyu [Soonchunhyang University Bucheon Hospital, Department of Radiology, Bucheon-si, Gyeonggi-do (Korea, Republic of); Yun, Seong Jong [Kyung Hee University School of Medicine, Department of Radiology, Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of); Department of Radiology, Aerospace Medical Center, Republic of Korea Air Force, Cheongwon-gun, Chungcheongbuk-do (Korea, Republic of); Park, Ji Seon; Ryu, Kyung Nam [Kyung Hee University Hospital, Department of Radiology, Seoul (Korea, Republic of)
2018-02-15
To investigate the efficacy of double inversion recovery (DIR) sequence for evaluating the synovium of the femoro-patellar joint without contrast enhancement (CE). Two radiologists independently evaluated the axial DIR and CE T1-weighted fat-saturated (CET1FS) images of 33 knees for agreement; the visualisation and distribution of the synovium were evaluated using a four-point visual scaling system at each of the five levels of the femoro-patellar joint and the location of the thickest synovium. The maximal synovial thickness at each sequence was measured by consensus. The interobserver agreement was good (κ = 0.736) for the four-point scale, and was excellent for the location of the thickest synovium on DIR and CET1FS (κ = 0.955 and 0.954). The intersequential agreement for the area with the thickest synovium was also excellent (κ = 0.845 and κ = 0.828). The synovial thickness on each sequence showed excellent correlation (r = 0.872). The DIR showed as good a correlation as CET1FS for the evaluation of the synovium at the femoro-patellar joint. DIR may be a useful MR technique for evaluating the synovium without CE. (orig.)
A pitfall in the measurement of arterial blood pressure in the ischaemic limb during elevation
DEFF Research Database (Denmark)
Bülow, J; Jelnes, Rolf
1987-01-01
In order to evaluate if elevation of the ischaemic limb above heart level is an alternative to the conventionally applied method with external counterpressure for estimation of skin perfusion pressure, femoral and popliteal artery pressures were measured directly in eight patients with occlusion...... of the superficial femoral artery. The measurements were done in the horizontal position and during elevation of the calf above heart level. During elevation relative blood flow, measured by arterio-venous oxygen saturation differences, decreased compared with the horizontal position. In contrast the popliteal...... arterial pressure decreased only by 20% of the value expected from the degree of elevation of the calf above the level of the heart. Thus, it could be calculated that calf vascular resistance increased two- to three-fold on average during elevation. Four patients were reexamined with the venous pressure...
Energy Technology Data Exchange (ETDEWEB)
Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it [Sapienza University of Rome, Vascular and Interventional Radiology Unit, Department of Radiological Sciences (Italy); Primo, Massimiliano Di [Hopital Europeen Georges Pompidou, University Paris Descartes (France); Boatta, Emanuele [Sapienza University of Rome, Vascular and Interventional Radiology Unit, Department of Radiological Sciences (Italy); Johnston, Krystal, E-mail: kjohnston@medinst.com [MED Institute, Inc (United States); Sapoval, Marc, E-mail: marc.sapoval2@egp.aphp.fr [Hopital Europeen Georges Pompidou, University Paris Descartes (France)
2013-10-15
Purpose: To describe the 1-year results of drug-eluting nitinol stent placement in the femoropopliteal artery of diabetic and nondiabetic patients. Materials and Methods: All patients enrolled in this prospective, multicenter study underwent paclitaxel-eluting stent placement for de novo or restenotic lesions of the superficial femoral and/or popliteal artery. Baseline and follow-up walking impairment questionnaire (WIQ) scores, Rutherford classifications, and ankle-brachial index (ABI) measurements were obtained. Follow-up was completed at 1, 6, and 12 months. Results: There were 285 diabetic patients and 502 nondiabetic patients treated. There were no significant differences in mean lesion length or lesion calcification between patient groups. Procedural success in both treatment groups was >97 %. There were no significant differences between diabetic and nondiabetic groups in Kaplan-Meier estimates of patency, event-free survival (EFS), or freedom from target lesion revascularization (TLR) at 6 and 12 months. Both groups experienced a significant increase in ABI and WIQ values after treatment, and these improvements were sustained to 12-month follow-up; however, nondiabetic patients had significantly greater 6- and 12-month WIQ scores compared with diabetic patients. Based on covariate analysis, the only factors shown to be significant and to negatively influence patency were longer lesion length (p = 0.009), higher Rutherford classification (p = 0.02), and lack of hypertension (p = 0.02); diabetic status was not found to be a significant factor. Conclusion: Diabetic and nondiabetic patients had similar estimates of primary patency, EFS, and freedom from TLR; however, diabetic patients showed less improvement in WIQ scores compared with nondiabetic patients.
Energy Technology Data Exchange (ETDEWEB)
Zocholl, G; Zapf, S; Schild, H; Thelen, M [Mainz Univ. (Germany, F.R.). Inst. fuer Klinische Strahlenkunde
1990-12-01
Angiographic studies of the arteries adjoining the knee in 25 patients show extensive kinking and stenoses of the popliteal artery and less frequently of the distal femoral artery during flexion of the knee joint. This is due to the loss of elasticity with increasing age forcing the vessel into a tortuous course during shortening of the pathway of the popliteal artery with knee flexion. Independent of the principle of the different stents available they probably will not increase the contractility of the stented vessel in the longitudinal axis. It is to expect that after implantation of stents into the original artery kinking will occur predominantly in the original segments of the vessel and at the transitions to the stented segments leading to intimal damage by shear forces thus propagating local progress of atherosclerosis. (orig.).
Satoh, Masahiro; Yoshino, Hiroyuki; Fujimura, Akira; Hitomi, Jiro; Isogai, Sumio
2016-09-01
When patients report pain in the popliteal fossa upon knee extension, the pain is usually localized in the lower region of the popliteal fossa. However, some patients complain of pain in the upper region of the popliteal fossa as the knee is flexed, which motivated us to examine the role of the popliteal fascia as the retinaculum of the hamstring muscles. Thirty-four thighs from 19 Japanese cadavers were dissected. The popliteal fascia was defined as the single aponeurotic sheet covering the popliteal fossa. We found that the fascia acted as a three-layered retinaculum for the flexor muscles of the thigh and provided a secure route for neurovascular structures to the lower leg in any kinetic position of the knee joint. The superficial layer of the popliteal fascia covering the thigh was strongly interwoven with the epimysium of biceps femoris along its lateral aspect and with that of the semimembranosus along its medial aspect, ensuring that the flexor muscles remained in their correct positions. The intermediate layer arose from the medial side of biceps femoris and merged medially with the superficial layer. The profound layer stretched transversely between the biceps femoris and the semimembranosus. Moreover, we investigated the nerve distribution in the popliteal fascia using Sihler's staining and whole-mount immunostaining for neurofilaments. The three-layered fascia was constantly innervated by branches from the posterior femoral cutaneous or saphenous nerve. The nerves were closely related and distributed to densely packed collagen fibers in the superficial layer as free or encapsulated nerve endings, suggesting that the fascia is involved in pain in the upper region of the popliteal fossa.
Stenting for peripheral artery disease of the lower extremities: an evidence-based analysis.
2010-01-01
In January 2010, the Medical Advisory Secretariat received an application from University Health Network to provide an evidentiary platform on stenting as a treatment management for peripheral artery disease. The purpose of this health technology assessment is to examine the effectiveness of primary stenting as a treatment management for peripheral artery disease of the lower extremities. CONDITION AND TARGET POPULATION Peripheral artery disease (PAD) is a progressive disease occurring as a result of plaque accumulation (atherosclerosis) in the arterial system that carries blood to the extremities (arms and legs) as well as vital organs. The vessels that are most affected by PAD are the arteries of the lower extremities, the aorta, the visceral arterial branches, the carotid arteries and the arteries of the upper limbs. In the lower extremities, PAD affects three major arterial segments i) aortic-iliac, ii) femoro-popliteal (FP) and iii) infra-popliteal (primarily tibial) arteries. The disease is commonly classified clinically as asymptomatic claudication, rest pain and critical ischemia. Although the prevalence of PAD in Canada is not known, it is estimated that 800,000 Canadians have PAD. The 2007 Trans Atlantic Intersociety Consensus (TASC) II Working Group for the Management of Peripheral Disease estimated that the prevalence of PAD in Europe and North America to be 27 million, of whom 88,000 are hospitalizations involving lower extremities. A higher prevalence of PAD among elderly individuals has been reported to range from 12% to 29%. The National Health and Nutrition Examination Survey (NHANES) estimated that the prevalence of PAD is 14.5% among individuals 70 years of age and over. Modifiable and non-modifiable risk factors associated with PAD include advanced age, male gender, family history, smoking, diabetes, hypertension and hyperlipidemia. PAD is a strong predictor of myocardial infarction (MI), stroke and cardiovascular death. Annually, approximately
Energy Technology Data Exchange (ETDEWEB)
Kueffer, G.; Ziegler, L.; Hahn, D.
1989-01-01
The article reports the clinical experience gained with the POLYTRON-1000 VR system which has been used for all functional diagnostic tasks for detection of compression syndrome of the popliteal artery, and for diagnostic preparation and execution of atherectomy of pelvic and leg arteries with the Simpson catheter.
Ruptured popliteal cyst diagnosed by ultrasound before evaluation for deep vein thrombosis.
Kim, Joon Sung; Lim, Seong Hoon; Hong, Bo Young; Park, So Young
2014-12-01
Most popliteal cysts are asymptomatic. However, cysts may rupture, resulting in pain and swelling of the leg that could also arise from other diseases, including deep vein thrombosis, lymphedema, cellulitis, and tear of a muscle or tendon. Therefore, it is difficult to diagnose a ruptured popliteal cyst based on only a patient's history and physical examination. Musculoskeletal ultrasound has been regarded as a diagnostic tool for ruptured popliteal cyst. Here, we describe a patient who was rapidly diagnosed as ruptured popliteal cyst by ultrasonography. Therefore, ultrasound could be used to distinguish a ruptured popliteal cyst from other diseases in patients with painful swollen legs before evaluation for deep vein thrombosis.
Absence of the genicular arterial anastomosis as generally depicted in textbooks.
Sabalbal, M; Johnson, M; McAlister, V
2013-09-01
Textbook representations of the genicular arterial anastomosis show a large direct communication between the descending branch of the lateral circumflex femoral artery (DBLCFA) and a genicular branch of the popliteal artery but this is not compatible with clinical experience. The aim of this study was to determine whether the arterial anastomosis at the knee is sufficient, in the event of traumatic disruption of the superficial femoral artery, to infuse protective agents or to place a stent to restore flow to the lower leg. Dissection of ten cadaveric lower limbs was performed to photograph the arterial anatomy from the inguinal ligament to the tibial tubercle. Anastomosis with branches of the popliteal artery was classified as: 'direct communication', 'approaching communication' or 'no evident communication'. A constant descending artery in the lateral thigh (LDAT) was found to have five types of origin: Type 1 (2/10 limbs) involved the lateral circumflex femoral branch of the femoral artery, Type 2 (3/10 limbs) the lateral circumflex femoral branch of the profunda femoris artery, Type 3 (1/10 limbs) the femoral artery, Type 4 (3/10 limbs) the superficial femoral artery and Type 5 (2/10 limbs) the profunda femoris artery. In one limb, there were two descending arteries (Types 4 and 5). Collateral circulation at the knee was also variable: direct communicating vessels (3/10 limbs); approaching vessels with possible communication via capillaries (5/10 limbs); no evident communication (2/10 limbs). Communicating vessels, if present, are too small to provide immediate collateral circulation. Modern representations of the genicular arterial anastomosis are inaccurate, derived commonly from an idealised image that first appeared Gray's Anatomy in 1910. The afferent vessel is not the DBLCFA. The majority of subjects have the potential to recruit collateral circulation via the LDAT following gradual obstruction to normal arterial flow, which may be important if the LDAT
Martial arts training attenuates arterial stiffness in middle aged adults.
Douris, Peter C; Ingenito, Teresa; Piccirillo, Barbara; Herbst, Meredith; Petrizzo, John; Cherian, Vincen; McCutchan, Christopher; Burke, Caitlin; Stamatinos, George; Jung, Min-Kyung
2013-09-01
Arterial stiffness increases with age and is related to an increased risk of coronary artery disease. Poor trunk flexibility has been shown to be associated with arterial stiffness in middle-aged subjects. The purpose of our research study was to measure arterial stiffness and flexibility in healthy middle-aged martial artists compared to age and gender matched healthy sedentary controls. Ten martial artists (54.0 ± 2.0 years), who practice Soo Bahk Do (SBD), a Korean martial art, and ten sedentary subjects (54.7 ± 1.8 years) for a total of twenty subjects took part in this cross-sectional study. Arterial stiffness was assessed in all subjects using pulse wave velocity (PWV), a recognized index of arterial stiffness. Flexibility of the trunk and hamstring were also measured. The independent variables were the martial artists and matched sedentary controls. The dependent variables were PWV and flexibility. There were significant differences, between the SBD practitioners and sedentary controls, in PWV (P = 0.004), in trunk flexibility (P= 0.002), and in hamstring length (P= 0.003). The middle-aged martial artists were more flexible in their trunk and hamstrings and had less arterial stiffness compared to the healthy sedentary controls. The flexibility component of martial art training or flexibility exercises in general may be considered as a possible intervention to reduce the effects of aging on arterial stiffness.
Mycotic aneurysm of the superior mesenteric artery after septic embolism
International Nuclear Information System (INIS)
Schmidt, F.; Dinkel, H.P.
2002-01-01
Mycotic aneurysms of the aorta and the visceral arteries are life-threatening diseases, due to potential rupture and organ or limb ischemia. They occur in endocarditis, immunodeficiency, bacteremia and fungemia, and have a poor prognosis.We report on a case of a 54-year-old male patient suffering from abdominal angina after mitral valve replacement for septic mycotic endocarditis. In presence of a mycotic-embolic occlusion of the left popliteal artery and multiple septic organ infarctions a mycotic aneurysm of the superior mesenteric artery was found in abdominal spiral-CT.Based on sequential spiral-CT examinations, this case demonstrates the development of a septic aneurysm of the superior mesenteric artery. (orig.) [de
Diagnosing a popliteal venous aneurysm in a primary care setting: A case report
Directory of Open Access Journals (Sweden)
Symvoulakis Emmanouil K
2008-09-01
Full Text Available Abstract Introduction Popliteal venous aneurysms are uncommon but potentially fatal vascular disorders. They can be symptomatic or asymptomatic, mimicking different conditions. Popliteal venous aneurysms are possible sources of embolism. Case presentation A 68-year-old woman presented at a rural primary health care unit in Crete, Greece, reporting local symptoms of discomfort in the right popliteal fossa with pain during palpation. Colour Doppler ultrasonography revealed local widening and saccular dilatation in the right distal popliteal vein. The diagnosis of a popliteal venous aneurysm was formulated. Conclusion Popliteal venous aneurysms are rare conditions, but are potentially more common than usually thought in daily practice. Physician awareness and access to ultrasound examination may allow for early diagnosis, before the occurrence of any thromboembolic or other major complication.
Directory of Open Access Journals (Sweden)
José Carlos R Iglézias
1989-08-01
Full Text Available É relatado, pela primeira vez na literatura, o caso de paciente adulto de 35 anos, com queixa de dor precordial aos esforços desde há 17 anos e que, após ter sido submetido a correção de coarctação de aorta, foi investigado e teve como diagnóstico: origem anômala da artéria circunflexa. No intra-operatório, constatou-se que a mesma tinha origem na artéria pulmonar direita. Foi realizada a sutura do óstio anômalo e um enxerto livre da artéria torácica interna direita para a coronária circunflexa. Além da raridade da lesão, são possíveis considerações fisiopatológicas relacionadas com a coarctação da aorta, neste caso específico.A case never described in adults before is here reported. A 35-year-old patient who had referred precordial pain in effort for seventeen years was investigated after having been submitted to correction of coarctation of the aorta, and had the following diagnosis: anomalous origin of the circunflex artery. In the intraoperatory, the latter was found to proceeed from the right pulmonary artery. The anomalous ostio was sutured and a free graft was made, from the right internal thoracic artery to the circunflex coronary. In addition to the unusualness of such pathology, some physiopatologic considerations related to the coarctation of the aorta may be made, in this particular case.
State of the States, 2012: Arts Education State Policy Summary
Arts Education Partnership (NJ1), 2012
2012-01-01
The "State of the States 2012" summarizes state policies for arts education identified in statute or code for all 50 states and the District of Columbia. Information is based primarily on results from the AEP Arts Education State Policy Survey conducted in 2010-11, and updated in April 2012.
Bilateral Persistent Sciatic Arteries Complicated with Acute Left Lower Limb Ischemia
Directory of Open Access Journals (Sweden)
Hsuan-Yin Wu
2007-12-01
Full Text Available Persistent sciatic artery (PSA is a rare congenital malformation. In the early embryonic stage, the sciatic artery is the major blood supply for the lower limb bulb and is later replaced by the iliofemoral artery as the limb develops. Its failure to regress, sometimes associated with femoral arterial hypoplasia, and therefore becoming the dominant inflow to the lower extremity is called PSA. This anomaly is often associated with a higher rate of aneurysm formation or thromboembolic complications causing lower extremity ischemia. Here, we describe a 79-year-old male patient who presented with acute left lower extremity ischemia. He was treated initially with conventional embolectomy through inguinal and popliteal incisions. The bilateral PSA with thrombosed aneurysms was not identified at first on computed tomographic angiography. It was later diagnosed intraoperatively due to the discontinuity of the superficial femoral artery and popliteal artery found with embolectomy catheter, and was managed successfully with ePTFE graft bypass. Careful interpretation of the imaging study may be helpful in preoperative diagnosis.
Settembre, N; Bouziane, Z; Bartoli, M A; Nabokov, V; Venermo, M; Feugier, P; Malikov, S
2017-04-01
Popliteal artery entrapment syndrome (PAES) is an uncommon anatomical anomaly, frequently described in adults. The most common symptom is claudication. Acute limb ischaemia (ALI) in children is rare, but it may evolve and lead to limb loss or lifelong complications. Clinical and surgical experience of PAES in children is reported. Data from the literature are analysed in order to assess the severity of this disease and to identify the factors characterising the diagnosis and the outcome of treatment in paediatric patients. Four children (aged 7-16 years) were referred with ALI due to PAES. Among the 439 articles reporting cases of PAES, 55 patients under 18 years of age were the focus. The PAES cases were classified according to the Love and Whelan classification modified by Rich. Data from 79 children (106 limbs, 27 bilateral PAES) were collected and analysed. Type I PAES was present in 41 (39%), Type II in 23 (22%), Type III in 24 (23%), Type IV in 12 (11%), and Type V in two (2%) limbs. A functional PAES was present in one patient bilaterally. In two cases, the type of PAES was not reported. Claudication occurred in 68 cases (64%), and ALI in 19 (18%). In 60 cases (57%), revascularisation with or without myotomy was required; myotomy alone was performed in 41 cases (39%). Symptomatic PAES in children should be considered a severe condition requiring urgent investigation in order to avoid any delays in the treatment. Early diagnosis and treatment are essential to prevent serious complications. The long-term outcomes of surgical treatment with the correction of the anatomical anomaly and vascular reconstruction are satisfactory with a low complication rate. Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
International Nuclear Information System (INIS)
Villar, R; Hughson, R L
2013-01-01
We tested the data repeatability for popliteal blood flow velocity (PBV), popliteal arterial diameter (AD pop ), popliteal blood flow (PBF) and lower limb vascular conductance (VC) at rest and exercise in three body positions, two work rates and two inspired oxygen fractions. Fifteen, eleven and ten healthy volunteers participated in the three phases of the studies. Resting protocols were performed in horizontal (HOR), 35° head-down tilt (HDT) and 45° head-up tilt (HUT) for 5 min in each body position. Participants also exercised at lower and higher power outputs (repeated plantar flexion contractions at 20% and 30% maximal voluntary contraction, respectively) in HOR, HDT and HUT and in normoxia (21%O 2 ) and hypoxia (14%O 2 ) with the same work rates and body positions. PBV and AD pop were measured by ultrasound to determine PBF, and VC was estimated by dividing PBF by muscle perfusion pressure (MPP). PBV, AD pop , PBF and VC were not different, demonstrated good agreement and consistency between the two days of testing during both rest and exercise conditions regardless of body position. Therefore, these data support the utilization of Doppler and echo Doppler ultrasound as a reproducible method to measure PBV and AD pop and consequently estimate PBF and VC responses in such conditions. (paper)
DEFF Research Database (Denmark)
Agerskov, K; Tønnesen, K H
1982-01-01
The vascular response in the lower extremities to 40 degrees head-up tilt was studied in 5 patients with occlusion of the superficial femoral artery and maturity onset diabetes mellitus with symptoms suggesting autonomic neuropathy. The pressure measurements were performed via catheters placed...... in the brachial artery, femoral artery and vein and popliteal artery and vein. Relative blood flow was calculated as the relative change in arterio-venous oxygen saturation. Absolute blood flow in the common femoral artery was measured by an indicator dilution technique. Resistance of the collateral arteries...
Ruptured peroneal aneurysm after infrapopliteal prosthetic bypass with Taylor patch
Directory of Open Access Journals (Sweden)
Florian Enzmann
Full Text Available Introduction: A 45-year-old mailman underwent an implantation of a femoro-peroneal polytetrafluoroethylene (PTFE bypass with a distal Taylor patch six years prior to admission after two failed autologous reconstructions and extensive fasciotomy. The initial pathology was an acute ischemia due to popliteal entrapment with subsequent popliteal thrombectomy. Report: The patient was examined because of pain, reduction of walking distance and development of a palpable mass at the medial fasciotomy site. A 6-cm pseudoaneurysm with complete disruption of the suture line of the vein patch was discovered and resected. Arterial continuity with a vein interposition graft was established using non-reversed cephalic vein. Conclusion: The etiology of the aneurysm is not entirely clear. One may argue that the fourth revascularization could have been performed with an arm vein instead of a prosthetic graft with the probability of a better long term patency in a young patient. 15 months after the procedure the bypass is patent and the patient is without any symptoms. This complication of a Taylor patch has not been reported before. Keywords: Taylor patch, Pseudoaneurysm, Infrapopliteal bypass
Unusual Presentation of Popliteal Cyst on Magnetic Resonance Imaging
Directory of Open Access Journals (Sweden)
Tsuyoshi Ohishi
2016-01-01
Full Text Available Popliteal cyst commonly presents as an ellipsoid mass with uniform low signal intensity on T1-weighted magnetic resonance images and high signal intensity on T2-weighted images. Here, we describe a popliteal cyst with unusual appearance on magnetic resonance imaging, including heterogeneous intermediate signal intensity on T2-weighted images. Arthroscopic cyst decompression revealed that the cyst was filled with necrotic synovial villi, indicative of rheumatoid arthritis. Arthroscopic enlargement of unidirectional valvular slits with synovectomy was useful for the final diagnosis and treatment.
Popliteal Venous Aneurysm: A Rare Cause of Recurrent Pulmonary Emboli and Limb Swelling
International Nuclear Information System (INIS)
Russell, David A.; Robinson, Graham J.; Johnson, Brian F.
2008-01-01
Popliteal venous aneurysm is a rare cause of recurrent pulmonary embolism, although the true incidence of aneurysm is probably underestimated. One-third of patients suffer further embolic events despite therapeutic anticoagulation. We report the case of a 59-year-old male who presented with recurrent PEs over a period of 12 years despite anticoagulation therapy. A thrombophilia screen and abdominal ultrasound were normal at that time. He reattended with recurrent pulmonary emboli, left calf swelling, and a mass in his left popliteal fossa causing limitation of knee movement. Venous duplex and MRI of his popliteal fossa demonstrated a thrombosed true popliteal venous aneurysm with popliteal and superficial femoral vein occlusion. In view of the mass effect we proceeded to surgical excision of his aneurysm after prophylactic placement of an IVC filter. The patient regained normal knee function with intensive inpatient physiotherapy. He has been recommenced on lifelong anticoagulant. The presentation, investigation, and management of the condition are briefly discussed. We suggest that a bilateral lower limb duplex is performed to exclude venous aneurysm in all patients presenting with pulmonary embolism in which an underlying source cannot otherwise be identified and no thrombophilic tendency is detected.
Design considerations for studies of the biomechanical environment of the femoropopliteal arteries.
Ansari, Farzana; Pack, Lindsay K; Brooks, Steven S; Morrison, Tina M
2013-09-01
The purpose of this study was to review the available literature regarding the biomechanics of the superficial femoral artery (SFA) and popliteal artery (PA) in patients with peripheral arterial disease (PAD). Stents are one of many available therapies used to treat patients with PAD. Because stents are permanent implants, they undergo a variety of deformations as patients go about their daily activities such as walking, sitting in a chair, or climbing stairs. As a part of the marketing application for United States Food and Drug Administration approval, stents need to be evaluated for long-term durability under a variety of loading modes. The information available in the literature provides direction for such evaluation. We performed a literature search of the PubMed database looking for "key vessel" and "mechanics" (all fields) or "deformation" (all fields) or "flexion" (all fields) or "mechanical environment" (all fields) or "tortuosity" (all fields) or "dynamics" (all fields) or "forces" (all fields), where the "key vessel" was "Femoral Artery," "Superficial Femoral Artery," "Popliteal Artery," and "Femoropopliteal." Using a decision tree, we found 12 relevant articles that focused solely on the nonradial cyclic deformations associated with musculoskeletal motion. Despite the many limitations associated with combining these studies, we learned that under walking conditions, the proximal and mid-SFA deforms, on average, by shortening in the axial direction 4.0%, by twisting 2.1°/cm, and by bending 72.1 mm; the distal SFA and proximal PA deform by shortening in the axial direction 13.9%, by twisting 3.5°/cm, and by being pinched such that the aspect ratio of the lumen changes 4.6%. The distal PA deforms by shortening in the axial direction 12.3%, by twisting 3.5°/cm, by bending 22.1 mm, and by being pinched such that the aspect ratio of the lumen changes 12.5%. A review of the current literature reveals heterogeneous study designs that confound interpretation
The “SAFARI” Technique Using Retrograde Access Via Peroneal Artery Access
International Nuclear Information System (INIS)
Zhuang, Kun Da; Tan, Seck Guan; Tay, Kiang Hiong
2012-01-01
The “SAFARI” technique or subintimal arterial flossing with antegrade–retrograde intervention is a method for recanalisation of chronic total occlusions (CTOs) when subintimal angioplasty fails. Retrograde access is usually obtained via the popliteal, distal anterior tibial artery (ATA)/dorsalis pedis (DP), or distal posterior tibial artery (PTA). Distal access via the peroneal artery has not been described and has a risk of continued bleeding, leading to compartment syndrome due to its deep location. We describe our experience in two patients with retrograde access via the peroneal artery and the use of balloon-assisted hemostasis for these retrograde punctures. This approach may potentially give more options for endovascular interventions in lower limb CTOs.
DEFF Research Database (Denmark)
Pecher, Arthur; Kofoed, Jens Peter
This report presents a short overview on the state-of-the-art of wave tank testing of wave energy converters (WEC). Here for, it focuses mainly on the Phase 1 and 2 development phases of wave energy converters, as these are done in the wave tank (WEC), while the other development phases are perfo......This report presents a short overview on the state-of-the-art of wave tank testing of wave energy converters (WEC). Here for, it focuses mainly on the Phase 1 and 2 development phases of wave energy converters, as these are done in the wave tank (WEC), while the other development phases...
Benedetto, Umberto; Altman, Douglas G; Gerry, Stephen; Gray, Alastair; Lees, Belinda; Angelini, Gianni D; Flather, Marcus; Taggart, David P
2018-03-03
There is still uncertainty about the safety of aprotinin for coronary artery bypass graft surgery. The ART (Arterial Revascularization Trial) was designed to compare survival after bilateral versus single internal thoracic artery grafting. Many of the ART patients (≈30%) received perioperative aprotinin. We investigated the association between perioperative aprotinin administration and short-term (in-hospital) and long-term outcomes by performing a post hoc analysis of the ART. Among patients enrolled in the ART (n=3102) from 2004 to 2007, we excluded those who did not undergo surgery (n=18) and those with no information about use of perioperative aprotinin (n=9). Finally, 836 of 3076 patients (27%) received aprotinin. Propensity matching was used to select 536 pairs for final comparison. Aprotinin was also associated with an increased risk of hospital mortality (9 [1.7%] versus 1 [0.2%]; odds ratio, 9.12; 95% confidence interval [CI], 1.15-72.2; P =0.03), intra-aortic balloon pump insertion (37 [6.9%] versus 17 [3.2%]; odds ratio, 2.26; 95% CI, 1.26-4.07; P =0.006), and acute kidney injury (102 [19.0%] versus 76 [14.2%]; odds ratio, 1.42; 95% CI, 1.03-1.97; P =0.03). Aprotinin was not associated with a lower incidence of transfusion (37 [6.9%] versus 28 [5.2%]; odds ratio, 1.34; 95% CI, 0.81-2.23; P =0.25) and reexploration (26 [4.9%] versus 19 [3.5%]; hazard ratio, 1.39; 95% CI, 0.76-2.53; P =0.28). At 5 years, all-cause mortality was significantly increased in the aprotinin group (56 [10.6%] versus 38 [7.3%]; hazard ratio, 1.51; 95% CI, 1.0-2.28; P =0.045). In the present post hoc ART analysis, aprotinin was associated with a significantly increased risk of early and late mortality. URL: http://www.isrctn.com. Unique identifier: ISRCTN46552265. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
The 'SAFARI' Technique Using Retrograde Access Via Peroneal Artery Access
Energy Technology Data Exchange (ETDEWEB)
Zhuang, Kun Da, E-mail: zkunda@gmail.com [Singapore General Hospital, Interventional Radiology Centre (Singapore); Tan, Seck Guan [Singapore General Hospital, Department of General Surgery (Singapore); Tay, Kiang Hiong [Singapore General Hospital, Interventional Radiology Centre (Singapore)
2012-08-15
The 'SAFARI' technique or subintimal arterial flossing with antegrade-retrograde intervention is a method for recanalisation of chronic total occlusions (CTOs) when subintimal angioplasty fails. Retrograde access is usually obtained via the popliteal, distal anterior tibial artery (ATA)/dorsalis pedis (DP), or distal posterior tibial artery (PTA). Distal access via the peroneal artery has not been described and has a risk of continued bleeding, leading to compartment syndrome due to its deep location. We describe our experience in two patients with retrograde access via the peroneal artery and the use of balloon-assisted hemostasis for these retrograde punctures. This approach may potentially give more options for endovascular interventions in lower limb CTOs.
Workie, Dagnachew W; Dardzinski, Bernard J
2005-09-01
Quantification of dynamic contrast-enhanced (DCE) MRI based on pharmacokinetic modeling requires specification of the arterial input function (AIF). A full representation of the plasma concentration data, including the initial rise and decay parts, considering the delay and dispersion of the bolus contrast is important. This work deals with modeling of DCE-MRI data from the knees of children with a history of juvenile rheumatoid arthritis (JRA) by using an AIF extracted from the signal enhancement data from the nearby popliteal artery. Three models for the AIFs were considered: a triexponential (AIF1), a gamma-variate plus a biexponential (AIF2), and a biexponential (AIF3). The pharmacokinetic parameters obtained from the model were Ktrans', kep, and V'p. The results from AIF1 and AIF2 showed no statistically significant difference. However, some statistically significant differences were seen with AIF3, particularly for parameters Ktrans' and V'p in the synovium (SNVM). These results suggest the importance of obtaining an appropriate AIF representation in pharmacokinetic modeling of JRA. Specifically, the initial rising part of the AIF should be incorporated for optimal pharmacokinetic modeling results. The pharmacokinetic parameters (mean+/-SD) derived from AIF1, using the average plasma concentration data, were as follows: SNVM Ktrans'(min-1)=0.52+/-0.34, kep(min-1)=0.71+/-0.39, and V'p=0.33+/-0.16, and for the distal femoral physis (DFP) Ktrans'(min-1)=1.83+/-1.78, kep(min-1)=2.65+/-1.80, and V'p=0.46+/-0.31. The pharmacokinetic parameters in the SNVM may be useful for investigating activity and therapeutic efficacy in studies of JRA. Longitudinal studies are necessary to find or demonstrate the parameter that is more sensitive to disease activity. Copyright (c) 2005 Wiley-Liss, Inc.
Antiphospholipid Syndrome during pregnancy: the state of the art
Di Prima, Fosca A. F.; Valenti, Oriana; Hyseni, Entela; Giorgio, Elsa; Faraci, Marianna; Renda, Eliana; De Domenico, Roberta; Monte, Santo
2011-01-01
Obstetric complications are the hallmark of antiphospholipid syndrome. Recurrent miscarriage, early delivery, oligohydramnios, prematurity, intrauterine growth restriction, fetal distress, fetal or neonatal thrombosis, pre-eclampsia/eclampsia, HELLP syndrome, arterial or venous thrombosis and placental insufficiency are the most severe APS-related complication for pregnant women. Antiphospholipid antibodies promote activation of endothelial cells, monocytes and platelets, causing an overproduction of tissue factor and thromboxane A2. Complement activation might have a central pathogenetic role. These factors, associated with the typical changes in the hemostatic system during normal pregnancy, result in a hypercoagulable state. This is responsible of thrombosis that is presumed to provoke many of the pregnancy complications associated with APS. Obstetric care is based on combined medical-obstetric high-risk management and treatment with the association between aspirin and heparin. This review aims to deter- mine the current state of the art of APS by investigating the knowledge achievements of recent years, to provide the most appropriate diagnostic and therapeutic management for pregnant women suffering from this syndrome. PMID:22439075
Cultivating Demand for the Arts: Arts Learning, Arts Engagement, and State Arts Policy. Summary
Zakaras, Laura; Lowell, Julia F.
2008-01-01
The findings summarized in this report are intended to shed light on what it means to cultivate demand for the arts, why it is necessary and important to cultivate this demand, and what state arts agencies (SAAs) and other arts and education policymakers can do to help. The research considered only the benchmark arts central to public policy:…
Popliteal lymphadenectomy for treating metastatic melanoma: case report
Directory of Open Access Journals (Sweden)
Sergio Renato Pais Costa
Full Text Available CONTEXT: Regional lymph node involvement in patients with malignant melanomas has been associated with poor prognosis. In-transit metastases also lead to poor long-term survival. Whereas for nodal disease only regional lymphadenectomy offers adequate locoregional control, for in-transit metastasis both local excision and isolated limb perfusion with chemotherapy plus tumor necrosis factor-alpha can be used for disease control. In cases of tumors located in the distal region of the legs, the lymphatic dissemination most commonly observed is to the inguinal chain. Consequently, therapeutic inguinal lymphadenectomy or even selective lymphadenectomy (sentinel lymph node biopsy have been recommended. On the other hand, involvement of the popliteal chain is very rare. When this occurs, popliteal lymphadenectomy should be indicated. Local excision may be the logical approach for a few small in-transit metastases because of the low morbidity in this procedure, when compared with isolated limb perfusion. CASE REPORT: A case of melanoma of the heel with popliteal chain involvement and in-transit metastases is presented. This was treated by means of regional lymphadenectomy plus in-transit metastases excision, with a good postoperative course.
Support for Arts Education. State Arts Agency Fact Sheet
National Assembly of State Arts Agencies, 2011
2011-01-01
Supporting lifelong learning in the arts is a top priority for state arts agencies. By supporting arts education in the schools, state arts agencies foster young imaginations, address core academic standards, and promote the critical thinking and creativity skills essential to a 21st century work force. State arts agencies also support…
Emergency interventional therapy of peripheral arterial stenosis and thrombosis
International Nuclear Information System (INIS)
Cai Fengquan; Yu Xixiang
2004-01-01
Objective: To evaluate the clinical value of emergency interventional therapy of stenosis and thrombosis of peripheral arteries. Methods: 26 patients suffered from stenosis and thrombosis of peripheral arteries including, 3 subclavical arteries, 5 iliac arteries, 7 femoral arteries, 4 popliteal arteries, 4 posterior or anterior tibial arteries, 2 graft vessels and 1 instent restenosis were undertaken interventional ATD or urokinase infusion thrombolysis, percutanous transluminal angioplasty (PTA) and stent placement. Results: The stenotic arteries were recanalized after PTA or stent placement and the thrombosis vanished after thrombolysis with distal flowes improved or resumed. Clinical symptom was ameliorated. No more complication occurred except one patient with alimentary hemorrhage after thrombolysis. The patients were followed up from 1 to 20 months with all the involved arteries keeping in constant patency without any amputation. Conclusions: Emergency thrombolysis by machine or drug along with PTA or stent placement can effectively cure the stenosis or thrombosis of peripheral artery with recanalization and no amputation. (authors)
State Arts Agency Fact Sheet: Support for Arts Education
Online Submission, 2015
2015-01-01
This national overview of state arts agency grants and services for arts education includes summary statistics and geographic distribution. The fact sheet uses data from Final Descriptive Reports of state arts agency grant-making activities submitted annually to the National Assembly of State Arts Agencies (NASAA) and the National Endowment for…
The sural artery and vein as recipient vessels in free flap reconstruction about the knee.
Johnson, P E; Harris, G D; Nagle, D J; Lewis, V L
1987-04-01
The sural artery and vein were used successfully as recipient vessels in nine patients who required free flap reconstruction about the knee. The anatomy of the sural vessels and the potential advantages of their use as free flap recipients are reviewed and discussed. Indications include popliteal vessels that are absent or severely damaged, as determined by preoperative angiography. No anastomotic complications were encountered in this series, indicating that the sural artery and vein can be used successfully as recipient vessels.
International Nuclear Information System (INIS)
Montet, Xavier; Mauget, Denis; Sandoz, Alain; Martinoli, Carlo; Bianchi, Stefano
2002-01-01
A 20-year-old white man presented with a localized unilateral swelling in the popliteal fossa. Ultrasound (US) showed the presence of an accessory muscle, the tensor fasciae suralis. The muscle was located in the proximal portion of the popliteal fossa, superficial to the medial head of the gastrocnemius. Its long tendon extended inferiorly to join the Achilles tendon. Magnetic resonance images correlated well with the US findings, confirming the diagnosis. Tensor fasciae suralis muscle is a rare cause of popliteal swelling and must be differentiated from other masses. Both US and magnetic resonance imaging can diagnose it but we suggest US as the first-line technique in its evaluation. (orig.)
Directory of Open Access Journals (Sweden)
Srinivasulu Reddy
2007-09-01
Full Text Available The principal arteries of the upper limb show a wide range of variation that is of considerable interest to orthopedic surgeons, plastic surgeons, radiologists and anatomists. We present here a case of superficial ulnar artery found during the routine dissection of right upper limb of a 50-year-old male cadaver. The superficial ulnar artery originated from the brachial artery, crossed the median nerve anteriorly and ran lateral to this nerve and the brachial artery. The superficial ulnar artery in the arm gave rise to a narrow muscular branch to the biceps brachii. At the elbow level the artery ran superficial to the bicipital aponeurosis where it was crossed by the median cubital vein. It then ran downward and medially superficial to the forearm flexor muscles, and then downward to enter the hand. At the palm, it formed the superficial and deep palmar arches together with the branches of the radial artery. The presence of a superficial ulnar artery is clinically important when raising forearm flaps in reconstructive surgery. The embryology and clinical significance of the variation are discussed.As principais artérias do membro superior apresentam uma ampla variação, que é relativamente importante a cirurgiões ortopédicos e plásticos, radiologistas e anatomistas.Apresentamosumcaso de artéria ulnar superficial encontrada durante dissecção de rotina de membro superior direito de um cadáver masculino de 50 anos de idade.Aartéria ulnar superficial originava-se da artéria braquial, cruzava o nervo mediano anteriormente e percorria lateralmente esse nervo e a artéria braquial. A artéria ulnar superficial no braço deu origem a um ramo muscular estreito do músculo bíceps braquial. Ao nível do cotovelo, a artéria percorria superficialmente a aponeurose bicipital, onde era cruzada pela veia cubital mediana. Percorria, então, em sentido descendente e medialmente superficial aos músculos flexores do antebraço, e então descendia para
Mammary-type myofibroblastoma of popliteal fossa
International Nuclear Information System (INIS)
Scotti, C.; Camnasio, F.; Fontana, F.; Fraschini, G.; Rizzo, N.; De Cobelli, F.; Peretti, G.M.
2008-01-01
Mammary-type myofibroblastoma is a very rare, benign, spindle cell lesion, arising mainly in the inguinal region. This clinical entity strictly duplicates the features of its breast counterpart. To our knowledge, this is the first report of this particular lesion occurring in the popliteal fossa. We discuss the clinical, radiological and histopathological features of this case, emphasizing the role of incisional biopsy in such an unusual neoplasia. (orig.)
State of the States 2016: Arts Education State Policy Summary
Aragon, Stephanie
2016-01-01
The "State of the States 2016" summarizes state policies for arts education identified in statute or administrative code for all 50 states and the District of Columbia. Information is based on a comprehensive search of state education statute and codes on each state's relevant websites. Complete results from this review are available in…
The Hindlimb Arterial Vessels in Lowland paca (Cuniculus paca, Linnaeus 1766).
Leal, L M; de Freitas, H M G; Sasahara, T H C; Machado, M R F
2016-04-01
This study aims to describe the origin and distribution of the hindlimb arterial vessels. Five adult lowland pacas (Cuniculus paca) were used. Stained and diluted latex was injected, caudally to the aorta. After fixation in 10% paraformaldehyde for 72 h, we dissected to visualize and identify the vessels. It was found out that the vascularization of the hindlimb in lowland paca derives from the terminal branch of the abdominal aorta. The common iliac artery divides into external iliac and internal iliac. The external iliac artery emits the deep iliac circumflex artery, the pudendal epigastric trunk, the deep femoral artery; the femoral artery originates the saphenous artery, it bifurcates into cranial and caudal saphenous arteries. Immediately after the knee joint, the femoral artery is called popliteal artery, which divides into tibial cranial and tibial caudal arteries at the level of the crural inter-osseous space. The origin and distribution of arteries in the hindlimb of lowland paca resembles that in other wild rodents, as well as in the domestic mammals. © 2014 Blackwell Verlag GmbH.
[The use of vascular prothesis Gore Viabahn in the managment of the lower limbs ischemia].
Pupka, Artur; Szyber, Przemysław Piotr; Skóra, Jan; Pawłowski, Stanisław
2011-01-01
The chronic lower limbs ischaemia is caused mainly by arteriosclerosis. After insufficient conservative treatment only the surgical intervention can salvage the limb. The revascularisation surgery can be performed by open surgery with implantation of the prosthetic bypass or by endovascular angioplasty with stent. This second method seems to be the best alternative for the patients with several concomitant systemic diseases. Nevertheless it is limited by presence of the long-distance arteriosclerotic lesions. The resolve of that problem is use of new generation of long endovascular covered stents. They can be succesfuly used in aorto-femoral and femoro-popliteal segment. Their efficiacy is simmilar to traditional prosthetic grafts.
EXERCISE-INDUCED ARTERIAL ADAPTATIONS IN ELITE JUDO ATHLETES
Directory of Open Access Journals (Sweden)
Panagiotis Karagounis
2009-09-01
Full Text Available The purpose of this study was to examine exercise-induced arterial adaptations in elite Judo male and female athletes. 27 male Judo athletes (age 24.06 ± 2 years, 11 female Judoka (age 24.27 ± 1 years, 27 sedentary healthy men (age 24.01 ± 2 years and 11 women (age 24.21 ± 1 years participated in the current study. The examined vessels included brachial, radial, ulnar, popliteal, anterior and posterior tibial arteries. The experimental parameters were recorded with the use of Duplex ultrasound at rest. Diastolic diameter and blood mean flow velocity of the examined arteries in Judo athletes were found to be both significantly increased (p < 0.05 compared to the findings of the control groups. In male Judo athletes the brachial (p < 0.001, radial (p < 0.001, and anterior tibial artery (p < 0.001 presented the highest difference on the diastolic diameter, compared with the control male group. In female Judo athletes, ulnar (p < 0.001, radial (p < 0.001, and brachial (p < 0.001 arteries illustrated the highest diastolic diameter. The highest blood mean flow velocity was recorded in ulnar (p < 0.001 and popliteal arteries (p < 0.001 of the Judo athletes groups. Recording differences between the two genders, male participants presented larger arteries than females. Conclusively, Judo has been found to be a highly demanding physical sport, involving upper and lower limbs leading to significant arterial adaptations. Obtaining vascular parameters provide a useful tool to the medical team, not only in the direction of enhancement of the efficacy of physical training, but in unknown so far parameters that may influence athletic performance of both male and female elite Judokas
Directory of Open Access Journals (Sweden)
Hsuan-Fu Kuo
2010-03-01
Full Text Available A 39-year-old female visited our cardiovascular outpatient department with paresthesia and soreness around the right popliteal fossa, where thrill was palpable. There was no history of trauma, apart from her having undergone acupuncture several years previously. An arteriovenous fistula (AVF was diagnosed by vascular ultrasonography and magnetic resonance imaging. Angiography confirmed the presence of an AVF fed by the medial geniculate artery. Transarterial embolization was performed to close the AVF using coils and tissue adhesive. To the best of our knowledge, acupuncture-induced AVF has not been previously reported. We present a case demonstrating the merits of percutaneous endovascular intervention for treating this rare complication. The additional administration of a tissue adhesive can achieve complete closure of the AVF in the event of an unsatisfactory result following coil embolization. Doctors should be aware of the potential vascular complications of acupuncture, and of the management options.
State-of-the-art MRI techniques in neuroradiology: principles, pitfalls, and clinical applications
Energy Technology Data Exchange (ETDEWEB)
Viallon, Magalie [Universite de Lyon, CREATIS, UMR CNRS 5220 - INSERM U1044, INSA de Lyon, Lyon (France); Universite de Lyon-Saint-Etienne, Department of Radiology, Centre Hospitalier Universitaire de Saint-Etienne, Saint Etienne (France); Cuvinciuc, Victor; Barnaure-Nachbar, Isabelle; Lovblad, Karl-Olof; Haller, Sven [University Hospital of Geneva, Department of Neuroradiology, Geneva (Switzerland); Delattre, Benedicte; Toso-Patel, Seema; Becker, Minerva [University Hospital of Geneva, Department of Radiology, Geneva (Switzerland); Merlini, Laura [University Hospital of Geneva, Department of Pediatric Radiology, Geneva (Switzerland)
2015-05-01
This article reviews the most relevant state-of-the-art magnetic resonance (MR) techniques, which are clinically available to investigate brain diseases. MR acquisition techniques addressed include notably diffusion imaging (diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), and diffusion kurtosis imaging (DKI)) as well as perfusion imaging (dynamic susceptibility contrast (DSC), arterial spin labeling (ASL), and dynamic contrast enhanced (DCE)). The underlying models used to process these images are described, as well as the theoretic underpinnings of quantitative diffusion and perfusion MR imaging-based methods. The technical requirements and how they may help to understand, classify, or follow-up neurological pathologies are briefly summarized. Techniques, principles, advantages but also intrinsic limitations, typical artifacts, and alternative solutions developed to overcome them are discussed. In this article, we also review routinely available three-dimensional (3D) techniques in neuro MRI, including state-of-the-art and emerging angiography sequences, and briefly introduce more recently proposed 3D quantitative neuro-anatomy sequences, and new technology, such as multi-slice and multi-transmit imaging. (orig.)
State-of-the-art MRI techniques in neuroradiology: principles, pitfalls, and clinical applications
International Nuclear Information System (INIS)
Viallon, Magalie; Cuvinciuc, Victor; Barnaure-Nachbar, Isabelle; Lovblad, Karl-Olof; Haller, Sven; Delattre, Benedicte; Toso-Patel, Seema; Becker, Minerva; Merlini, Laura
2015-01-01
This article reviews the most relevant state-of-the-art magnetic resonance (MR) techniques, which are clinically available to investigate brain diseases. MR acquisition techniques addressed include notably diffusion imaging (diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), and diffusion kurtosis imaging (DKI)) as well as perfusion imaging (dynamic susceptibility contrast (DSC), arterial spin labeling (ASL), and dynamic contrast enhanced (DCE)). The underlying models used to process these images are described, as well as the theoretic underpinnings of quantitative diffusion and perfusion MR imaging-based methods. The technical requirements and how they may help to understand, classify, or follow-up neurological pathologies are briefly summarized. Techniques, principles, advantages but also intrinsic limitations, typical artifacts, and alternative solutions developed to overcome them are discussed. In this article, we also review routinely available three-dimensional (3D) techniques in neuro MRI, including state-of-the-art and emerging angiography sequences, and briefly introduce more recently proposed 3D quantitative neuro-anatomy sequences, and new technology, such as multi-slice and multi-transmit imaging. (orig.)
[The physiopathology of critical ischemia of the lower limbs].
Novo, S; Abrignani, M G; Liquori, M; Sangiorgi, G B; Strano, A
1993-10-01
Peripheral obstructive arterial disease (POAD) of the lower limbs is the third main complication of atherosclerosis, after coronary artery disease and cerebrovascular disease. In 15-20% of cases POAD have an unfavourable evolution toward critical leg ischemia (CLI). This clinical condition is characterized by the onset of rest pain and/or trophic cutaneous lesions until gangrene appears. In some cases amputation is needed. The pathophysiological, clinical and therapeutic aspects of CLI were recently discussed in two Consensus Conferences held in Berlin in 1989 and in Rudesheim in 1991, with the elaboration of a final draft published on circulation. CLI appears when peripheral perfusion critically decreases due to macro and microcirculatory alterations. Atherosclerotic plaque is the primum movens, but often there are more plaques in sequence along the ilio-femoro-popliteal axis. The pathophysiological and clinical consequences are more severe if the stenosis is haemodynamically important, after a rapid progression of plaque growth or when thrombotic complications develop. The reduction in distal perfusion induces troubles in the microcirculation and an embalancement between the microvascular defense system (MDS) and the microvascular flow regulating system (MFRS) with endothelial dysfunction, platelet and leucocytes activation, worsening of blood viscosity due to the increase in fibrinogen levels and to the red cells deformability changes, activation of coagulation and impairment of fibrinolysis. So, a vicious circle appears with further worsening of distal perfusion and onset of trophic lesions. A further worsening of CLI can derive from local recurrent infections particularly frequent in diabetic patients.
International Nuclear Information System (INIS)
Lederman, L.M.
1983-01-01
There is a large body of experience in high luminosity data taking in fixed target research. We try to consider a wide variety of high rate experiments which were limited by the detector (not by available beam) to a preset number of collisions per second. We then attempt to translate these state-of-the-art experiments to effective collider experiments. To this end, we extend the chosen detector to a comparison 4π collider detector operating near 1 TeV. There are several issues: (1) effective solid angle must be translated to approx. = 4π, (2) environments may be quite different, e.g., beam dump near fixed target or beam halo muons vs. collider backgrounds, (3) the multiplicity varies over the experiments selected and (4) we have to treat open vs closed geometries. The large variety of experiments selected is designed to average over the causes for detector limitation. Finally we chose detectors which have produced physics in order to gauge the state of the art
Variability of the morphology of gastrocnemius muscle in an African ...
African Journals Online (AJOL)
... palpation of popliteal arterial pulse, popliteal nerve block and the assessment of gastrocnemius muscle for autografting. The additional variant heads also bear evolutionary importance. Keywords: Gastrocnemius; Multi-Pinnate; Popliteal Entrapment Syndrome; Variations; Four-Headed, Third Head Of Gastrocnemius ...
Pseudoaneurisma de artéria poplítea secundário a osteocondroma femoral: relato de caso
Directory of Open Access Journals (Sweden)
Fabricio Mascarenhas de Oliveira
Full Text Available Osteochondromas are the most common benign tumor of the bone. They are sometimes responsible for vascular complications involving either veins or arteries, principally around the knee. Pseudoaneurysms are considered a rare condition. The authors describe the occurrence of a pseudoaneurysm of the popliteal artery in association with a femoral osteochondroma in a 30-years-old man.
Pressure Sore at an Unusual Site- the Bilateral Popliteal Fossa: A Case report
Directory of Open Access Journals (Sweden)
Kamal Kataria
2012-05-01
Full Text Available Pressure sore is tissue ulceration due to unrelieved pressure, altered sensory perception, and exposure to moisture. Geriatric patients with organic problems and patients with spinal cord injuries are the high-risk groups. Soft tissues over bony prominences are the common sites for ulcer development. About 95% of pressure ulcers occur in the lower part of the body. Ischial tuberosity, greater trochanter, sacrum and heel are common sites. In addition to these, pressure sores at unusual sites like nasal alae, malar eminences, cervical region and medial side of knee have also been described. Only 1.6% of the patients present with sores in areas outside the pelvis and lower extremity. In a paraplegic patient, pressure sores are usually over extensor surface of knee and heel but pressure ulcer over popliteal fossa are extremely rare. We herein report a case of a 36-years-old diabetic and paraplegic male, who presented with multiple bed sores involving the sacral area, heels and bilateral popliteal fossa. Popliteal fossa is an unusual site for pressure sores. Only one similar case has been previously reported in the literature.
Pressure Sore at an Unusual Site- the Bilateral Popliteal Fossa: A Case report
Kataria, Kamal; Sagar, Sushma; Singhal, Manish; Yadav, Rajni
2012-01-01
Pressure sore is tissue ulceration due to unrelieved pressure, altered sensory perception, and exposure to moisture. Geriatric patients with organic problems and patients with spinal cord injuries are the high-risk groups. Soft tissues over bony prominences are the common sites for ulcer development. About 95% of pressure ulcers occur in the lower part of the body. Ischial tuberosity, greater trochanter, sacrum and heel are common sites. In addition to these, pressure sores at unusual sites like nasal alae, malar eminences, cervical region and medial side of knee have also been described. Only 1.6% of the patients present with sores in areas outside the pelvis and lower extremity. In a paraplegic patient, pressure sores are usually over extensor surface of knee and heel but pressure ulcer over popliteal fossa are extremely rare. We herein report a case of a 36-years-old diabetic and paraplegic male, who presented with multiple bed sores involving the sacral area, heels and bilateral popliteal fossa. Popliteal fossa is an unusual site for pressure sores. Only one similar case has been previously reported in the literature. PMID:29181131
The Art of the Renaissance Capitalist State
Directory of Open Access Journals (Sweden)
Rebeka Vidrih
2007-12-01
This article also highlights the fact that the concept of art developed in Florence – a city-state that played an important role in the early-capitalist world of the Renaissance, but never assumed a leading role like Venice and Genoa. »Art« was thus created through Florence’s efforts to demonstrate its equality and importance and, although it failed to achieve this in the field of the (capitalist economy, it at least succeeded in the field of the (absolutist state that was subordinate to this economy.
Kinesio taping & Síndrome femoro-patelar: una revisión sistemática
López-Aguilar, Beatriz; Merino-Marban, Rafael
2014-01-01
INTRODUCCIÓN: El síndrome femoro-patelar (SFP), también conocido como condromalacia rotuliana, aparece cuando existe una degeneración del cartílago rotuliano entre las superficies óseas del fémur y de la rótula. Su sintomatología característica es un dolor anterior de la rodilla que se agudiza al mover dicha articulación. OBJETIVOS: Actualizar los datos sobre la efectividad del Kinesiotaping (KT) en el tratamiento del SFP y aportar posibles pautas de aplicación del KT en el SFP. PALABR...
Acute pulmonary edema following inflation of arterial tourniquet.
Santhosh, M C B; Pai, R B; Rao, R P
2014-10-01
Arterial tourniquets are used as one of the methods for reducing blood loss and for allowing blood free surgical field. A 20-year-old, 45 kg healthy female with a sphere shaped pendunculated hemangioma in the popliteal fossa of her left lower limb was applied with arterial tourniquet after exsanguination. The procedure was performed under general anesthesia. Soon after exsanguination and tourniquet inflation, the patient developed pulmonary edema which subsided after deflating the tourniquet. The clinical evolution, treatment and pathophysiology of this complication are described. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.
Diagnostic accuracy of color Doppler flow imaging and Duplex US in peripheral arterial disease
International Nuclear Information System (INIS)
Karmel, M.I.; Polak, J.F.; Whittemore, A.D.; Mannick, J.A.; Donaldson, M.C.; O'Leary, D.H.
1988-01-01
Color Doppler flow imaging (5 MHz) and Duplex US were used in a prospective examination of 154 arterial segments in the lower extremities of 11 symptomatic patients. Each extremity was divided into seven arterial segments (common femoral, profunda femoral, proximal, middle, and distal superficial femoral, and proximal and distal popliteal arteries). Arterial maps were drawn for each patient and compared with the arteriograms. Seventeen significant stenoses and 18 complete occlusions were predicted and confirmed by means of arteriography. Four significant stenoses and four occlusions were predicted and not confirmed. One hundred nine normal arterial segments were correctly predicted. No significant stenoses or occlusions were missed. Prospective identification of the severity and location of disease can help to optimize both the angiographic approach and hospital services utilization
Bilateral giant femoropopliteal artery aneurysms: a case report
Directory of Open Access Journals (Sweden)
Perdikides Theodossios P
2008-04-01
Full Text Available Abstract Introduction Popliteal artery aneurysms are the most common peripheral arterial aneurysms, and are frequently bilateral. Acute limb ischemia, rupture and compression phenomena can complicate these aneurysms when the diameter exceeds 2 cm. Case Presentation We report an 82-year-old male patient with two giant femoropopliteal aneurysms, 10.5 and 8.5 cm diameters, managed in our institution. Both aneurysms were resected and a polytetrafluoroethylene (PTFE femoropopliteal interposition graft was placed successfully. Management and literature review are discussed. Conclusion We believe this is the first report in the medical literature of bilateral giant femoropopliteal aneurysms.
African Journals Online (AJOL)
muscular blastema and grows from the calcaneous cephalad to implant ... muscle regresses. The superficial popliteal artery unites with the remainder of the deep popliteal artery to form the definitive popliteal artery at the knee. Anatomical variations arise when ... dorsiflexion against resistance. An athlete or physically active ...
Verhagen, H.J.; Van Gerven, K.A.J.; Akkerman, G.J.
2005-01-01
The present report provides a state-of-the-art inventory of relevant information and technical concepts for the ComCoast project, being the first phase of the research stages of Work Package 3 (WP3). This project was assigned to Royal Haskoning by CUR. The information scan was set-up in a systematic
Multimodal Dialogue Management - State of the art
Bui Huu Trung, B.H.T.
This report is about the state of the art in dialogue management. We first introduce an overview of a multimodal dialogue system and its components. Second, four main approaches to dialogue management are described (finite-state and frame-based, information-state based and probabilistic, plan-based,
Greenhouse mechanization: State of the art and future perspective
Henten, van E.
2006-01-01
This paper reviews the state of the art and future perspective of greenhouse mechanization. Driving forces for mechanization are identified. Dutch greenhouse crop production is used as an example. Analysis of a generic crop production process combined with a review of the state of the art in
International Nuclear Information System (INIS)
Campanari, S.; Casalegno, A.
2007-01-01
This paper deals with the main features at present state-of-the-art fuel cell and hybrid cycle technologies, discussing their actual performance, possible applications, market entry perspectives and potential development [it
Heteronomy in the arts field: state funding and British arts organizations.
Alexander, Victoria D
2018-03-01
For Bourdieu, the field of cultural production is comprised of an autonomous and a heteronomous sector. A heteronomous sector is one that is interpenetrated by the commercial field. I discuss an arena that, until recently, was part of the relatively autonomous sector in the field of cultural production - the supported arts sector in the United Kingdom - and argue that it became more heteronomous, due to the penetration by the state. Heteronomy due to the commercial field is present but secondary to, and driven by, the actions of the state. Political parties' attempts to diffuse and legitimate a particular economic ideology have led to state demands that arts institutions adopt neoliberal business practices in exchange for funding. Government giving to the arts, previously at arm's length, proved to be a Faustian bargain that demanded significant repayment in the form of lost autonomy. Coercive pressures from the state, enacted over time, show how the domination of one field over another can occur, even when the domination is resisted. © London School of Economics and Political Science 2017.
Cao, Yuelong; Jones, Graeme; Han, Weiyu; Antony, Benny; Wang, Xia; Cicuttini, Flavia; Ding, Changhai
2014-03-03
The role of popliteal cysts and subgastrocnemius bursitis in knee joint homeostasis is uncertain. The aim of this study is to describe cross-sectional associations between popliteal cysts, subgastrocnemius bursitis, knee symptoms and structural abnormalities in older adults. A cross-sectional sample of 900 randomly-selected subjects (mean age 63 years, 48% female) were studied. Knee pain, stiffness and dysfunction were assessed by self-administered Western Ontario McMaster Osteoarthritis Index (WOMAC) questionnaire. Radiographic knee osteophyte and joint space narrowing (JSN) were recorded. Magnetic resonance imaging (MRI) was utilized to assess popliteal cysts, subgastrocnemius bursitis, cartilage defects and bone marrow lesions (BMLs). Popliteal cysts were present in 11.7% and subgastrocnemius bursitis in 12.7% of subjects. Subgastrocnemius bursitis was more common in those with popliteal cyst (36.2% versus 9.7%, P bursitis was associated with increased osteophytes and JSN in the medial tibiofemoral compartment. Both were significantly associated with cartilage defects in all compartments, and with BMLs in the medial tibiofemoral compartment. Furthermore, both popliteal cysts and subgastrocnemius bursitis were significantly associated with increased weight-bearing knee pain but these associations became non-significant after adjustment for cartilage defects and BMLs. Popliteal cysts and subgastrocnemius bursitis are associated with increased symptoms as well as radiographic and MRI-detected joint structural abnormalities. Longitudinal data will help resolve if they are a consequence or a cause of knee joint abnormalities.
DEFF Research Database (Denmark)
Nielsen, Nils
1998-01-01
Dette skrift omhandler nogle af de erfaringer der til dato er opnået i forbindelse med standby projektets udførelse. Hovedtemaet er en “State of the art undersøgelse” der omhandler standby-spændingsforsyninger, samt komponenter der kan anvendes til konstruktion af dem......Dette skrift omhandler nogle af de erfaringer der til dato er opnået i forbindelse med standby projektets udførelse. Hovedtemaet er en “State of the art undersøgelse” der omhandler standby-spændingsforsyninger, samt komponenter der kan anvendes til konstruktion af dem...
Where is your state of the art?
Ríos Gaona, Manuel
2015-04-01
Beyond the purposes of publishing, questioning and/or hypothesizing, every research has the noble aim to quench the constant human need of pushing farther away the boundaries of knowledge, may such frontier exist. The state of the art is the generic expression coined to limit the whereabouts of any particular knowledge. We use it just like a compass, it tells us how far we are, what has been done and where we should go. Take for instance quantum field theory, the state of the art in particle physics will tell you that everything that exists in this universe is made of bosons, quarks and leptons. What!?. Hold on, I was taught (and luckily maybe you weren't) that the fundamental particles were electrons, neutrons and protons, right?. Indeed, that is the state of the art but from almost one century ago. So, if I may ask... where is your state of the art? This is not about quantum physics; it is not even about hydrology; it is about everything. Today, everybody doing or not a PhD fiercely believes that their research is important, extremely unique, life changing (and help us God if we are wrong); but how can you be so sure that what you do, isn't already done?. We live in a modern world, cool environmental scientists now have tagged this era as the Anthropocene; globalization is everywhere and of course knowledge has not escaped to it. Not only knowledge is now global but is totally diversified, any crazy idea you can think of (or actually you can't) it is very likely that somebody already has his/hers hands on it. Nevertheless, this is a good thing, isn't it?. Well, that is the whole point. Every time I should write my research's state of the art, I always get overwhelmed because it actually is pretty difficult to establish, and later when I think I get it, it seems that I am solving issues that somebody already bothered to solve 30 years ago. Therefore, does it really have some purpose to be swimming in a huge pool of knowledge, not knowing where exactly I am? or
Directory of Open Access Journals (Sweden)
Joseph Fredric Whitaker
2005-03-01
Full Text Available OBJETIVO: Estudo retrospectivo para avaliar a morbi-mortalidade e a evolução hospitalar em pacientes com idade superior a 70 anos, submetidos à operação de revascularização do miocárdio com utilização da artéria radial como segundo enxerto arterial. MÉTODO: No período de agosto de 1994 a dezembro de 2002, foram realizadas 2487 cirurgias de revascularização do miocárdio no Instituto do Coração de Juiz de Fora. Dentre os pacientes operados, 476 tinham idade superior a 70 anos, sendo que em 36 (Grupo II foi utilizada a artéria radial como 2º enxerto arterial. O mesmo tipo de cirurgia foi realizado em 142 pacientes com idade inferior a 70 anos (Grupo I. Não foram incluídas neste estudo reoperações, cirurgias sem CEC ou com procedimentos associados. RESULTADOS: A média de idade do Grupo II foi 72,5 anos, a mortalidade hospitalar neste grupo de pacientes foi 6,0%, a incidência de complicações também foi baixa, comparável à observada no mesmo tipo de operação realizada em pacientes com idade inferior a 70 anos. CONCLUSÃO: Diante destes resultados, os autores acreditam que a artéria radial possa ser usada com segurança como 2º enxerto arterial em pacientes acima de 70 anos, criteriosamente selecionados, apesar do maior risco de co-morbidades associadas nesta faixa etária.OBJECTIVE: Retrospective study eveluating the morbid-mortality and hospital behaviour in patients over 70-years -od patients submitted to myocardial revascularization involving the radial artery as the second arterial graft. METHOD: During the period of August 1994 to December 2002, 2487 cases of myocardial revascularization were performed by the group of the Juiz de Fora Heart Institute, 476 of whom were 70 years of age or older and 36 (Group II received the radial artery as the second arterial graft. The same type of surgery was performed in 142 patients under 70-year-old (Group I. Reoperations, off-pump operations (OPCAB or associated procedures
State of the Art in the Cramer Classification Scheme and ...
Slide presentation at the SOT FDA Colloquium on State of the Art in the Cramer Classification Scheme and Threshold of Toxicological Concern in College Park, MD. Slide presentation at the SOT FDA Colloquium on State of the Art in the Cramer Classification Scheme and Threshold of Toxicological Concern in College Park, MD.
Guide to state-of-the-art electron devices
2013-01-01
Concise, high quality and comparative overview of state-of-the-art electron device development, manufacturing technologies and applications Guide to State-of-the-Art Electron Devices marks the 60th anniversary of the IEEE Electron Devices Committee and the 35th anniversary of the IEEE Electron Devices Society, as such it defines the state-of-the-art of electron devices, as well as future directions across the entire field. Spans full range of electron device types such as photovoltaic devices, semiconductor manufacturing and VLSI technology and circuits, covered by IEEE Electron and Devices Society Contributed by internationally respected members of the electron devices community A timely desk reference with fully-integrated colour and a unique lay-out with sidebars to highlight the key terms Discusses the historical developments and speculates on future trends to give a more rounded picture of the topics covered A valuable resource R&D managers; engineers in the semiconductor industry; applied scientists...
The state-of-the-art of ART sealants.
Frencken, Jo E
2014-03-01
Sealing caries-prone pits and fissure systems is an effective caries-preventive measure. There are basically two types of sealant materials: glass-ionomer and resin-based materials. Low- and medium-viscosity glass-ionomers were initially used and showed a low level of retention. With the advent of the ART approach in the mid-nineties, high-viscosity glass-ionomers were introduced as sealant material and the retention rate of ART sealants increased substantially. As the effectiveness of a sealant is measured by its capacity to prevent (dentine) carious lesion development, sealant retention is considered a surrogate endpoint. The ART sealant protocol is described. Systematic reviews and meta-analysis covering low- medium- and high-viscosity glass-ionomer (ART) sealants have concluded that there is no evidence that either glass-ionomer or resin-based sealants prevent dentine carious lesions better. The annual dentine carious lesion development in teeth with high-viscosity glass-ionomer ART sealants over the first three years is 1%. These ART sealants have a high capacity of preventing carious lesion development. Because no electricity and running water is required, ART sealants can be placed both inside and outside the dental surgery. High-viscosity glass-ionomer ART sealants can be used alongside resin-based sealants.41:119-124
State of the art in video system performance
Lewis, Michael J.
1990-01-01
The closed circuit television (CCTV) system that is onboard the Space Shuttle has the following capabilities: camera, video signal switching and routing unit (VSU); and Space Shuttle video tape recorder. However, this system is inadequate for use with many experiments that require video imaging. In order to assess the state-of-the-art in video technology and data storage systems, a survey was conducted of the High Resolution, High Frame Rate Video Technology (HHVT) products. The performance of the state-of-the-art solid state cameras and image sensors, video recording systems, data transmission devices, and data storage systems versus users' requirements are shown graphically.
The state-of-the-art of ART restorations.
Frencken, Jo E
2014-04-01
ART is less anxiety- and pain-provoking than traditional restorative treatments; administration of local anaesthesia is rarely required. Systematic reviews have provided evidence of the high level of effectiveness of high-viscosity glass-ionomer ART restoration in restoring single-surface cavities, both in primary and permanent posterior teeth, but its survival rates in restoring multiple-surface cavities in primary posterior teeth needs to be improved. Insufficient information is available regarding the survival rates of multiple-surface ART restorations in permanent teeth. Evidence from these reviews indicates no difference in the survival rates of single-surface high-viscosity glass-ionomer ART restorations and amalgam restorations in primary and permanent posterior teeth. Where indicated, high-viscosity glass-ionomer ART restorations can be used alongside traditional restorations. ART provides a much more acceptable introduction to dental restorative care than the traditional 'injection, drill and fill'.
Maehara, Akiko; Mintz, Gary S; Shimshak, Thomas M; Ricotta, Joseph J; Ramaiah, Venkatesh; Foster, Malcolm T; Davis, Thomas P; Gray, William A
2015-05-01
Endovascular treatment of calcified femoral-popliteal disease is challenging. We sought to evaluate the mechanism of lumen gain when using the JETSTREAM Atherectomy System to treat calcified peripheral artery lesions. The JETSTREAM Calcium Study was a prospective, single-arm, multicentre study to evaluate the JETSTREAM Atherectomy System for severely calcified femoral-popliteal artery lesions, i.e., patients with claudication and lesions with superficial calcium >90° and >5 mm in length as determined by intravascular ultrasound (IVUS). The 2.1 mm catheter was used in this study without distal protection. Fifty-five patients underwent angiographic screening: 26 (45%) met IVUS inclusion criteria. Angiographic calcium was moderate in eight cases and severe in 14, with no available data for four cases. Visual diameter stenosis was 86±9% pre-treatment, 37±13% post atherectomy, and 10±6% post adjunctive treatment (adjunctive PTA+stenting in eight and adjunct PTA alone in 16). IVUS showed lumen area increased from 6.6±3.7 mm2 to 10.0±3.6 mm2 (p=0.001): calcium reduction was responsible for 86±23% of the lumen increase. Although the superficial calcium arc did not change (151±70° to 146±71°, p=0.83), the arc of reverberation increased (23±20° to 65±40°, p=0.006), indicating device-related modification of calcium. Adjunctive balloon angioplasty was performed in 62% of the lesions, and stent implantation in 31%. In 11 cases with adjunctive balloon dilation, the MLA increased from 7.1 (6.4, 7.8) mm2 post atherectomy to 11.9 (10.3, 13.5) mm2 post balloon (pAtherectomy System increased lumen dimensions in moderately or severely calcified femoral-popliteal lesions by removing superficial calcium without major complications.
Femoro-acetabular impingement and hip pain with conventionally normal x-rays.
LENUS (Irish Health Repository)
Baker, J F
2010-06-01
There has in recent years been a fundamental change in the understanding of hip pain in the young adult and hip pain without plain radiographic findings of arthritis. Pain in these groups has long represented a diagnostic and therapeutic challenge. With new appreciation of hip biomechanics, pathological processes and the arrival of modern imaging modalities we now have a greater understanding of non-arthritic hip pathology. One of the commonest yet least well recognized \\'new\\' diagnoses around the hip is femoro-acetabular impingement (FAI). FAI is a developmental condition of the hip joint that is associated with abnormal anatomical configuration and thus joint mechanics on either the femoral or acetabular sides or both. It is hypothesized to have a variety of precipitants and may ultimately lead to labral and chondral injury and what has previously been referred to as \\'primary\\' or \\'idiopathic\\' hip osteoarthritis.
Directory of Open Access Journals (Sweden)
R. Doña-Jaimes
2018-04-01
Full Text Available Introduction: Inguinal hernia repair is one of the most common surgeries performed worldwide by general surgeons. More than 750,000 inguinal hernia repairs are performed each year in the United States. Complications of inguinal or femoral hernia are relatively rare, depending on the clinical circumstances in which the patient is admitted to the operating room and the type of hernia. The complications are classified as: intraoperative, short term and long term. Arterial lesions are the rarest but most dangerous. Objective: To describe surgical techniques used to repair injuries to the external iliac artery during an inguinal hernia repair that is reproducible by general surgeons. Materials and methods: A case report of an intraoperative external iliac artery injury is presented in which is a polytetrafluoroethylene (PTFE graft was used over the length of the lesion. Different techniques may be used for revascularisation: autogenous vein graft, synthetic grafts, revascularisation with ipsilateral or contralateral internal iliac artery and femoro-femoral crossover graft. Conclusion: The surgical technique using PTFE grafts is effective for repairing arterial injuries and it results in timely revascularisation that promotes satisfactory progress. Resumen: Introducción: La plastia inguinal es una de las cirugías más frecuente realizadas a nivel mundial por cirujanos generales. En Estados Unidos más de 750,000 hernioplastias inguinales se realizan por año. Las complicaciones de una hernia inguinal o femoral son relativamente infrecuentes, depende de las circunstancias clínicas en las que se ingresa a quirófano y el tipo de la hernia. Las complicaciones se clasifican en: intraoperatoría, a corto plazo y a largo plazo. Las lesiones arteriales son las más raras pero más graves. Objetivo: Describir técnicas quirúrgicas para reparación de lesiones de la arteria iliaca durante una plastia inguinal y reproducible por cirujanos generales
Peripheral arterial angiography and interventional treatment in diabetic foot ulcers
International Nuclear Information System (INIS)
Guo Xiaohua; Cheng Yongde; Hu Suying; He Jianrong; Lin Kaiqin; Jin Honglai; Shi Shijie
2003-01-01
Objective: To assess the changes of peripheral arteries and choice of interventional treatment in diabetic foot ulcers. Methods: Thirty-six diabetic patients with foot ulcers were examined by lower extremity DSA with simultaneous ultrasonic Doppler examination for correlative study and interventional treatment carried out in 17 segmental stenotic cases. Among them, 12 patients were treated by PTA and 5 patients by intravascular stenting. Results: Irregular stenoses and obstruction were observed in all patients with peripheral foot ulcers. DSA examination was more reliable comparing with Doppler examination for demonstration of the arterial injury above the level of popliteal artery. PTA and primary stenting were effective in all of these subjects outcoming with promotion of the lower extremity arterial blood perfusion and foreseen curing efficacy. Conclusions: Peripheral arterial stenoses were common in diabetic patients with foot ulcers. In clinical practice, DSA examination and interventional treatment could give a fertile prognosis and reduce disabling
Compartment syndrome and popliteal vascular injury complicating unicompartmental knee arthroplasty
Kort, Nanne Pieter; Van Raay, Jos J. J. A. M.; van Horn, Jim R.
Popliteal vascular injury and the compartment syndrome of the leg are rare but important complications of knee arthroplasties. Early diagnosis and treatment are of paramount importance in preventing the devastating complications of these conditions. To our knowledge, these complications have not
One Step Closer to the Marketplace for State-of-the-Art Wind Turbine
Drivetrain | News | NREL One Step Closer to the Marketplace for State-of-the-Art Wind Turbine Drivetrain One Step Closer to the Marketplace for State-of-the-Art Wind Turbine Drivetrain April 1, 2016 modeling, and testing in state-of-the-art facilities designed to put the drivetrain through its paces
Directory of Open Access Journals (Sweden)
Daniel P. Link
2013-01-01
Full Text Available Objective. To report an incidence of reflux in the deep venous system reversed by ablation of a popliteal fossa vein (PFV. Method. A 40-year-old man with pain and swelling in the medial upper calf was found to have an incompetent PFV. Results. Reflux in the femoral and popliteal veins was reversed utilizing endovenous laser ablation and foam sclerotherapy, documented on Duplex studies before and after the intervention. There was also resolution of symptoms. Conclusion. A PFV can be associated with deep venous reflux. Correction of this reflux with ablation of the PFV suggests that his type of reflux is secondary to volume effects of the incompetent popliteal vein.
Aneurisma da Artéria Renal: caso clínico Renal Artery Aneurysm
Directory of Open Access Journals (Sweden)
Joana Moreira
2011-12-01
Full Text Available Apresenta-se o caso clínico de um doente com volumoso aneurisma da artéria renal esquerda. Do sexo masculino, de 22 anos de idade, com lombalgia à esquerda com algumas semanas de evolução. Recorreu ao médico assistente que solicitou estudo imagiológico por ecografia abdominal. Detectada imagem sugestiva de aneurisma da aorta abdominal. Este achado motivou a transferência para o nosso Hospital onde foi admitido consciente e orientado, hemodinamicamente estável, apresentando uma massa pulsátil epigástrica, com frémito e sopro sistólico à auscultação. Angio-TC revelou um aneurisma da artéria renal esquerda com 16 cm de diâmetro. Dada a estabilidade clínica e topografia lesional optou-se por tentar embolizar, sem sucesso, o tronco da artéria renal esquerda antes da abordagem cirúrgica. O doente foi então submetido a Nefrectomia total esquerda por via toraco-abdominal. Pós-operatório sem complicações, locais ou sistémicas. Alta ao 8ºdia, mantendo boa função renal e com níveis normais de hemoglobina. Diagnóstico de aneurisma da artéria renal confirmado por estudo anátomo-patológico da peça operatória.One case of a large left renal artery aneurysm in a young patient 22 years old is presented. He appealed to his assistant physician a few weeks after development of left back pain. Abdominal ultrasound imaging study has been requested. Suggestive abdominal aortic aneurysm was detected. This finding led to the transfer to our hospital where he was admitted conscious and hemodynamically stable. A pulsatile epigastric mass with a systolic murmur on auscultation and thrill were detected. Angio-CT scan revealed a left renal artery aneurysm, 16 cm in diameter. Given the clinical stability and lesional topography we decide a previous embolization of left renal artery, unsuccessfully. The patient underwent then left total nephrectomy, through thoraco-abdominal incision. No local or systemic complications in the postoperative
The State of Comic Art Bibliography in North America
Directory of Open Access Journals (Sweden)
Michael Rhode
2010-08-01
Full Text Available Within the past two decades, several American bibliographies of comic art have been published to aid in research on comics and cartooning. Professor John Lent’s ten-volume Comic Art Bibliographies is one of the largest such projects and he began it with a self-published volume in 1986. Librarian Randy Scott published The Comic Art Collection Catalog: An Author, Artist, Title and Subject Catalog Of The Comic Art Collection, Special Collections Division, Michigan State University Libraries, whi...
State of the art in microfabrication
Schmitz, Jurriaan
2014-01-01
In this review paper the state of the art in microfabrication is presented. The focus is on trends in integrated circuit fabrication by mainstream industrial players. The article starts with Moore’s Law, describing its inception as well as the evolution of Moore’s metric of the number of components
Directory of Open Access Journals (Sweden)
Luiz Ernani Meira Jr.
2011-12-01
Full Text Available Os aneurismas da artéria radial são extremamente raros. Em sua maioria, consistem de pseudoaneurismas pós-traumáticos. Os aneurismas da artéria radial verdadeiros podem ser idiopáticos, congênitos, pós-estenóticos ou associados a patologias, tais como vasculites e doenças do tecido conjuntivo. Foi relatado um caso de aneurisma idiopático de artéria radial em uma criança de três anos, que, após completa investigação diagnóstica complementar, foi submetida à ressecção cirúrgica.Radial artery aneurysms are extremely rare. Post-traumatic pseudoaneurysms are the vast majority. True radial artery aneurysms can be idiopathic, congenital, poststenotic, or associated with some pathologies, such as vasculitis and conjunctive tissue diseases. We report a case of an idiopathic aneurysm of the radial artery in a three-year-old child who was submitted to surgical resection after a complete diagnostic approach.
State-of-the-art of home networking
Koonen, A.M.J.; Popov, M.
2012-01-01
To introduce the Symposium on "Indoor Optical Networks: a Promising Way to a Converged Service Delivery", this presentation will give a brief overview of state-of-the-art home networking architectures, technologies and applications covering both technical and techno-economic aspects.
New simulators from old - achieving state-of-the-art simulation without state-of-the-art costs
International Nuclear Information System (INIS)
Heilmeier, H.J.; Rosser, R.M.; Fyffe, K.L.; Gaerttner, G.F.; Chulick, E.T.
1990-01-01
Achieving a state-of-the-art simulator for operator training requires neither the expensive remodeling of old simulators nor the acquisition of very expensive new machines. In this paper the authors present two distinct cases where older training simulators have been upgraded to meet training requirements with a minimum of inexpensive hardware additions, including plug-in/-out panels, and software changes
14 CFR 1203.403 - State-of-the-art and intelligence.
2010-01-01
... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false State-of-the-art and intelligence. 1203.403... PROGRAM Guides for Original Classification § 1203.403 State-of-the-art and intelligence. A logical... available from intelligence sources is known or is available to others. It is also important to consider...
How the United States Funds the Arts. Third Edition
National Endowment for the Arts, 2012
2012-01-01
The infrastructure for arts and cultural support in the United States is complex and adaptive. Citizens who enjoy the arts can choose from a wide array of drama, visual and media arts, dance, music, and literature available in formal and informal settings--theaters, museums, and concert halls, but also libraries, schools, places of worship,…
Platelet kinetics: the state of the art
International Nuclear Information System (INIS)
Heyns, A. duP
1984-01-01
In this paper an overview of the state of the art of platelet kinetics 1982 is presented. The subjects considered include a discussion of the advantages and disadvantages of some of the many radionuclide platelet labels, viz 51 Cr, 111 In, focussing briefly on models for analysis of platelets survival. (Auth.)
State-of-the-art in Heterogeneous Computing
Directory of Open Access Journals (Sweden)
Andre R. Brodtkorb
2010-01-01
Full Text Available Node level heterogeneous architectures have become attractive during the last decade for several reasons: compared to traditional symmetric CPUs, they offer high peak performance and are energy and/or cost efficient. With the increase of fine-grained parallelism in high-performance computing, as well as the introduction of parallelism in workstations, there is an acute need for a good overview and understanding of these architectures. We give an overview of the state-of-the-art in heterogeneous computing, focusing on three commonly found architectures: the Cell Broadband Engine Architecture, graphics processing units (GPUs, and field programmable gate arrays (FPGAs. We present a review of hardware, available software tools, and an overview of state-of-the-art techniques and algorithms. Furthermore, we present a qualitative and quantitative comparison of the architectures, and give our view on the future of heterogeneous computing.
The Arts and State Governments: At Arm's Length or Arm in Arm?
Lowell, Julia F.; Ondaatje, Elizabeth Heneghan
2006-01-01
Even though a majority of Americans claim to support public funding of the arts, state government spending on the arts is minimal--and may be losing ground relative to other types of state expenditures. Moreover, most state arts agencies, or SAAs, have not succeeded in convincing state government leaders that the arts should be integral to their…
Illuminati, Giulio; Calio', Francesco G; Pizzardi, Giulia; Amatucci, Chiara; Masci, Federica; Palumbo, Piergaspare
2016-01-01
Intra and perioperative anticoagulation in patients with heparin induced thrombocytopenia (HIT), candidates for peripheral vascular surgery remains a challenge, as the best alternative to heparin has not yet been established. We evaluated the off-label use of fondaparinux in four patients with HIT, undergoing peripheral vascular surgery procedures. Four patients of whom 3 men of a mean age of 66 years, with proven heparin induced thrombocytopenia (HIT) underwent two axillo-femoral bypasses, one femoro-popliteal bypass and one resection of a splenic artery aneurysm under fondaparinux. No intra or perioperative bleeding or thrombosis of new onset was observed. In the absence of a valid alternative to heparin for intra and perioperative anticoagulation in HIT, several other anticoagulants can be used in an off-label setting. However, no general consensus exist on which should be the one of choice. In this small series fondaparinux appeared to be both safe and effective. These preliminary results seem to justify the off-label use of fondaparinux for intra and perioperative anticoagulation in patients with HIT, candidates for peripheral vascular surgery interventions. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
Directory of Open Access Journals (Sweden)
Cesar Roberto Busato
2010-09-01
Full Text Available CONTEXTO: O tratamento da isquemia crítica de membros inferiores sem leito arterial distal pode ser realizado por meio da inversão do fluxo no arco venoso do pé. OBJETIVO: O objetivo deste trabalho foi apresentar a técnica e os resultados obtidos com a arterialização do arco venoso do pé, mantendo a safena magna in situ. MÉTODOS: Dezoito pacientes, dos quais 11 com aterosclerose (AO, 6 com tromboangeíte obliterante (TO e 1 com trombose de aneurisma de artéria poplítea (TA foram submetidos ao método. A safena magna in situ foi anastomosada à melhor artéria doadora. O fluxo arterial derivado para o sistema venoso progride por meio da veia cujas válvulas são destruídas. As colaterais da veia safena magna são ligadas desde a anastomose até o maléolo medial, a partir do qual são preservadas. RESULTADOS: Dos pacientes, 10 (55,6% mantiveram suas extremidades, 5 com AO e 5 com TO; 7 (38,9% foram amputados, 5 com AO, 1 com TO e 1 com Ta; houve 1 óbito (5,5%. CONCLUSÃO: A inversão do fluxo arterial no sistema venoso do pé deve ser considerada para salvamento de extremidade com isquemia crítica sem leito arterial distal.BACKGROUND: Critical lower limb ischemia in the absence of a distal arterial bed can be treated by arterialization of the venous arch of the foot. OBJETIVE: The objective of this paper was to present the technique and the results of the arterialization of the venous arch of the foot with the in situ great saphenous vein. METHODS: Eighteen patients, 11 with atherosclerosis (AO, 6 with thromboangiitis obliterans (TO and 1 with popliteal artery aneurysm thrombosis were submitted to venous arch arterialization. The in situ great saphenous vein was anastomosed to the best donor artery. Arterial flow derived from the venous system progresses through the vein whose valves were destroyed. The collateral vessels of the great saphenous vein are linked from the anastomosis to the medial malleolus and preserved from this point
77 FR 5281 - State-of-the-Art Reactor Consequence Analyses Reports
2012-02-02
... NUCLEAR REGULATORY COMMISSION [Docket ID: NRC-2012-0022] State-of-the-Art Reactor Consequence... release of Draft NUREG-1935, ``State-of-the-Art Reactor Consequence Analyses (SOARCA) Report,'' for public... offsite radiological health consequences for potential severe reactor accidents for the Peach Bottom...
Venkatramani, H; Sabapathy, S R; Nayak, S
2014-01-01
Selection of ideal recipient vessels is one of the most important factors determining success in free-flap reconstruction of the lower limb. At the knee, the choice of vessels has traditionally been either the common femoral or the popliteal vessels and their branches but these are often difficult to use or cannot be used. A series of 32 free flaps for cover of complex injuries of the knee involving the distal femur, the knee joint and the upper tibia were reconstructed using the descending genicular branch of the femoral artery in the adductor canal and its muscular branches to the vastus medialis as the recipient vessels. All but one flap survived with no major complications. The use of the descending genicular artery as the recipient vessel for reconstruction with free flaps around the knee has various advantages including: (i) it is mostly remote from the zone of trauma, (ii) it is constant in location, (iii) the recipient vessels are an excellent size match for end-to-end anastomosis, (iv) there is no need for changes of position of the patient when using most free flaps commonly used for knee reconstruction, (v) it is easy to harvest these simultaneously, (vi) secondary exposure of the underlying skeleton from all quadrants is unlikely to divide the flap pedicle as it is superior and (vii), perhaps most important of all, it obviates the need for exploration of the popliteal fossa. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
State Arts Policy: Trends and Future Prospects
Lowell, Julia F.
2008-01-01
State arts agencies (SAAs)--key players within the U.S. system of public support for the arts--face growing economic, political, and demographic challenges to the roles and missions they adopted when founded in the mid-1960s. This report, the fourth and final in a multiyear study, looks at state arts agencies' efforts to rethink their roles and…
Directory of Open Access Journals (Sweden)
Roberto Melaragno
1971-03-01
Full Text Available Foi feito um estudo comparativo entre o quadro clínico inicial de 61 casos de oclusão da artéria carótida interna e o de 23 casos de oclusão da artéria cerebral média, diagnosticados pela angiografia cerebral e/ou pela necropsia em pacientes submetidos ou não à cirurgia vascular. Os autores comparam a idade dos pacientes, o sexo, o modo de início da afecção, a existência ou não de convulsões e/ou cefaléias, a ocorrência do acidente cerebral durante o sono ou em vigília, a existência de ictos prévios, os níveis de pressão arterial, o grau de consciência, a força muscular, os achados eletrencefalográficos, a palpação e ausculta das carótidas em nível cervical. Os resultados são demonstrados em índices percentuais, pelos quais os autores inferem que não há significância estatística nesses elementos com três exceções: a maior ocorrência de convulsões nas oclusões da artéria cerebral média em relação às da carótida, a oftalmodinamometria e a sintomatologia carotídea cervical. A oftalmodinamometria revela valores significantemente menores nas pressões da artéria central da retina, no mesmo lado da trombose da carótida em 70,0% dos casos, enquanto que medidas normais e simétricas verificaram-se em todos os casos de oclusão da artéria cerebral média em que o exame foi realizado. No que concerne a sinais arteriais no pescoço, havia anormalidades palpatórias e auscultatórias em 52,4% dos pacientes com trombose da carótida e em 8,6% dos casos com oclusão da cerebral média. Concluem os autores, portanto, que apenas a angiografia cerebral permite um diagnóstico seguro entre ambas as sedes da oclusão.A comparative study of the early clinical picture in 61 cases of internal carotid artery occlusion and 23 cases of middle cerebral artery occlusion, diagnosed by cerebral angiography and/or necropsy in patients who were either submitted to surgery or not operated upon is reported. The authors had
Ascertaining the international state of the art of PSA methodology
International Nuclear Information System (INIS)
Linden, J. von
1998-01-01
Plant-specific PSAs, to be performed within the framework of the Periodic Safety Review of German Nuclear Power Plants require further development of the methodology. For that purpose foreign PSA-guidelines and PSA-reviewes as well as relevant literature are examined and appropriate insights are adopted within task A.2 of project SR 2096. The main goal of these activities is to achieve a comparison of the state of the art of PSA-methodologies applied abroad and in Germany. The German state of the art refers to the extent as is documented in the German PSA Guide (Leitfaden Probabilistische Sicherheitsanalyse /PSUe97/) which has to be used for the Periodic Safety Review of German Nuclear Power Plants. The structure for the evaluation is based on the working steps of a PSA. In total, according to the objectives of the Periodic Safety Review the German approach for plant-specific PSAs based on the German PSA Guide is conform to the state of the art abroad. Identified deviations in some details are evaluated reflecting the view of GRS. Particular aspects resulting from the evaluation should be considered for further development of the German PSA Guide. (orig.) [de
Complications of operative treatment of injuries of peripheral arteries.
Velinovic, M M; Davidovic, B L; Lotina, I S; Vranes, R M; Djukic, L P; Arsov, J V; Ristic, V M; Kocica, J M; Petrovic, L P
2000-06-01
In 1991 and 1992, a total of 97 patients with 106 peripherial arterial injuries underwent surgery at the Institute for Cardiovascular Diseases, Clinical Centre of Serbia. Civilian injuries accounted for 53 (54.6%) patients (94.3% males, age range: 16-63 yr, mean: 35.2), and 44 patients had war injuries (93.2% males, age range: 19-61 yr, mean: 34.8). The injuries affected the superfitial femoral artery in 31 (29.24%); the popliteal artery in 28 (26.41%); the brachial artery in 17 (16.04%); the posterior tibial artery in 6 (5.66%); the axillary artery in 5 (4.72%); the anterior tibial artery in 5 (4.72%); the tibioperoneal trunk in 4 (3. 77%); the common femoral artery in 4 (3.77%); the external iliac artery in 2 (1.89%); the profound femoral artery in 2 (1.89%); the radial artery in 1 (0.94%); and ulnar artery in 1 (0.94%).A total of 98 reconstructive procedures were used to treat these patients. Graft interposition carried out in 50 (51.02%); by pass in 25 (25. 51%); end-to-end anastomosis in 9 (9.18%); suture in 8 (8.16%); ligation in 4 (4.08%); and patch-angioplasty in 2 (2.04%). Primary reconstruction of injured arteries was performed in 72.2% and secondary repair in 27.8% cases. Infection developed in 51 (52.57%) patients, and it was significantly (P<0.05) more common in the war injuries (70.45%) and in secondary repairs (88.89%). The presence of associated lesions (69.56%) was also correlated with a greater rate of infection. Amputation was necessary in 21 (21.65%) of our patients, and was significantly (P<0.05) more often performed after secondary (44.44%) than primary operations (12.86%) and in the presence of associated injuries (32.61%).
State of the art magnetic resonance imaging
International Nuclear Information System (INIS)
Weissman, J.D.
1987-01-01
In less than a decade Magnetic Resonance Imaging (MRI) has evolved from a laboratory demonstration to a safe and effective technique for clinical diagnosis. This evolutionary process continues. At this time 2-D and 3-D imaging of the head and body is firmly established in clinical use. Surface coil imaging, two-component chemical shift imaging, in-vivo spectroscopy and flow imaging are currently in various stages of development. The present state of the art of MRI is a function of an array of technologies: magnet, Rf coil, Rf pulse amplifier, gradient coil and driver, pulse programmer, A/D converter, computer system architecture, array processors and mass storage (both magnetic and optical). The overall product design is the result of a complex process which balances the advantages and disadvantages of each component for optimal system performance and flexibility. The author discusses the organization of a state-of-the-art MRI system. Several examples of the kinds of system interactions affecting design choices are given. (Auth.)
Characterizing Resting-State Brain Function Using Arterial Spin Labeling
Jann, Kay; Wang, Danny J.J.
2015-01-01
Abstract Arterial spin labeling (ASL) is an increasingly established magnetic resonance imaging (MRI) technique that is finding broader applications in studying the healthy and diseased brain. This review addresses the use of ASL to assess brain function in the resting state. Following a brief technical description, we discuss the use of ASL in the following main categories: (1) resting-state functional connectivity (FC) measurement: the use of ASL-based cerebral blood flow (CBF) measurements as an alternative to the blood oxygen level-dependent (BOLD) technique to assess resting-state FC; (2) the link between network CBF and FC measurements: the use of network CBF as a surrogate of the metabolic activity within corresponding networks; and (3) the study of resting-state dynamic CBF-BOLD coupling and cerebral metabolism: the use of dynamic CBF information obtained using ASL to assess dynamic CBF-BOLD coupling and oxidative metabolism in the resting state. In addition, we summarize some future challenges and interesting research directions for ASL, including slice-accelerated (multiband) imaging as well as the effects of motion and other physiological confounds on perfusion-based FC measurement. In summary, this work reviews the state-of-the-art of ASL and establishes it as an increasingly viable MRI technique with high translational value in studying resting-state brain function. PMID:26106930
Directory of Open Access Journals (Sweden)
Marco Aurélio Santos
2004-12-01
Full Text Available OBJETIVO: Enfatizar a possibilidade diagnóstica da origem anômala de uma artéria pulmonar da aorta ascendente, em lactentes com quadro de insuficiência cardíaca clinicamente intratável e sem defeito estrutural intracardíaco. MÉTODOS: Estudo retrospectivo em quatro lactentes com insuficiência cardíaca intratável, submetidos a estudo ecocardiográfico bidimensional com cortes subcostal, supraesternal e paraesternal, e a estudo hemodinâmico e angiocardiográfico na projeção ântero-posterior. RESULTADOS: Três dos quatro lactentes tinham a artéria pulmonar direita originando-se da aorta ascendente, como diagnóstico principal. No quarto paciente a artéria pulmonar esquerda originava-se da aorta ascendente associada à ampla comunicação interventricular. Os lactentes tinham pressão em ambas artérias pulmonares em nível sistêmico. Todos foram submetidos a tratamento cirúrgico que consistiu na translocação da artéria pulmonar anômala da aorta. Não houve óbitos cardíacos imediatos ou tardios. CONCLUSÃO: Uma vez estabelecido o diagnóstico de origem anômala de artéria pulmonar da aorta ascendente, na forma isolada, a correção cirúrgica deverá ser prontamente realizada, não só pelo desenvolvimento de doença vascular pulmonar, como pelos excelentes resultados cirúrgicos atualmente obtidos.OBJECTIVE: To emphasize the diagnostic possibility of the anomalous origin of one pulmonary artery from the ascending aorta in infants with clinically refractory heart failure and no intracardiac structural defect. METHODS: Retrospective study of 4 infants with refractory heart failure undergoing 2-dimensional echocardiographic study with subcostal, suprasternal, and parasternal views, and hemodynamic and angiocardiographic study in the anteroposterior projection. RESULTS: Three of the 4 infants had their right pulmonary artery originating from the ascending aorta as their major diagnosis. In the fourth patient, the left pulmonary
The "State of Art" of Organisational Blogging
Baxter, Gavin J.; Connolly, Thomas M.
2013-01-01
Purpose: The aim of this paper is to provide an overview of the "state of art" of organisational blogging. It also aims to provide a critical review of the literature on organisational blogging and propose recommendations on how to advance the subject area in terms of academic research. Design/methodology/approach: A systematic literature review…
Contemporary Romanian Art in the United States1
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Altman Dana
2014-08-01
Full Text Available The article discusses the recent international interest in contemporary Romanian art and its growth in market share, with a focus on the United States. The theme is followed thorough in numerous museum exhibitions, increased collector following, art fair presence, gallery representation and auction activity initially in Europe and the United States. The phenomenon is discussed both in the context of the larger international movement conducive to the contemporary art price bubble, and in that of the local socio-economic changes. My chief interest lies in the factors leading up to the entry of post 1989 Romanian art in the global arena as a manifestation of market forces in the field. The analysis follows its grass roots local emergence through non-profit institutions, individual artists, small publications, low budget galleries, as well as the lack of contribution (with few notable exceptions of state institutions, while pointing out the national context of increasing deregulation of social support systems resulting in lack of focus on cultural manifestations. The conclusion is that the recent ascent of contemporary Romanian art (and coincidentally, the award winning contemporary Romanian cinematography is a fortuitous convergence of various factors, among which, increased international mobility and sharing. At the same time, it is also the result of the evolution of various individual artists that pursued a form of art rooted in Romanian artistic tradition but with a focus on the symbolic figurative. The result is a personal semiotics of raising the mundane to extraordinary levels that reconfigured the anxiety of entering a new system into an unmistakable and lasting visual language.
Mission Accomplished: Working with State Arts Agencies
Boyer, Johanna Misey
2005-01-01
Most everyone involved professionally in the non-profit arts comes in contact with a state arts agency. A person may be on the Teaching Artist roster, works for a grantee organization, or has directly received a grant or fellowship. The work that one does in the school is probably funded by the state arts agency. Or, at a more basic level, the…
International Nuclear Information System (INIS)
Lou Wensheng; Gu Jianping; He Xu; Chen Liang; Chen Guoping; Su Haobo; Song Jinhua; Wang Tao; Xu Ke
2011-01-01
Objective: To discuss the clinical value of subintimal angioplasty in treating long segment occlusion of superficial femoral artery and to observe its midterm results. Methods: Subintimal angioplasty was performed in 45 patients with long segment occlusion of superficial femoral artery, whose clinical presentation was intermittent claudication or critical limb ischemia. The primary patency, limb salvage and factors influencing long-term patency were observed, and the clinical data were analyzed. Results: Of the total 45 cases, the subintimal angioplasty was successfully accomplished in 43. The success rate of antegrade approach technique via the superficial femoral artery was 80% (n=36), the occlusion was recanalized by using retrograde approach technique via ipsilateral popliteal artery in 7 case. The total technical success rate was 95.6%. The primary patency in 43 successful cases at 6, 12, 24 and 36 months was 85.7%, 69.0% 57.3% and 50.9%, respectively. No statistically significant difference in primary patency existed between the group of intermittent claudication and the group of critical limb ischemia (P>0.05). Statistically significant prediction factors for primary patency included the number of the run off vessels below the knee and the length of the occlusion (P<0.05). Conclusion: Subintimal angioplasty is an effective procedure for the treatment of long segment occlusions of superficial femoral artery with satisfactory mid-term results. (authors)
111In leukocyte scintigraphy in the diagnosis of vascular graft infection
International Nuclear Information System (INIS)
Royen, E.A. van; Roevekamp, M.H.; Dongen, R.J.A.M. van; Schoot, J.B. van der; Hardeman, M.R.
1982-01-01
Infection at the site of a vascular graft is a serious complication in vascular surgery especially when synthetic materials have been used. Prosthetic grafts are widely employed in aorto-iliac, aorto-femoral and femoro-popliteal bypasses. X-ray investigation, angiography, ultrasound and computer tomography are of limited value in the diagnosis of graft infection. Delay in diagnosis and treatment of this complication results in a high morbidity and mortality. Some reports are available on the use of gallium-67 citrate scintigraphy. However, its accumulation in normal intestinal structures is a serious drawback. The authors investigated the effectiveness of indium-111 leukocytes scintigraphy in the diagnosis of vascular graft infection. The possible accumulation of labelled leukocytes was assessed both subjectively by visual interpretation and quantitatively by computer evaluation. (Auth.)
International Nuclear Information System (INIS)
Loefberg, Ann-Marie; Loerelius, Lars-Erik; Karacagil, Sadettin; Westman, Bo; Almgren, Bo; Berqgvist, David
1996-01-01
Purpose: To determine the efficacy, safety and long-term results of crural artery percutaneous transluminal angioplasty (PTA) in limbs with chronic critical limb ischemia (CLI). Methods: Patients undergoing crural artery PTA due to CLI were followed at regular clinic visits with ankle brachial pressure index (ABPI) measurements. PTA of the crural arteries was attempted either alone (n= 39) or in combination with PTA of the superficial and/or popliteal artery (n= 55) in 86 limbs (82 patients and 94 procedures) presenting with CLI. The ages of patients ranged from 37 to 94 years (mean 72 years). The indications for PTA were rest pain in 10 and ulcer/gangrene in 84 limbs.Results: A technically successful PTA with at least one crural level was achieved in 88% of cases (n= 83). Cumulative primary clinical success rates at 6, 12, 24, and 36 months were 55%, 51%, 36%, and 36%, respectively. Cumulative secondary clinical success and limb salvage rates at 36 months were 44% and 72%, respectively. Conclusion: PTA of the crural arteries might be considered the primary choice of treatment in patients with CLI and distal lesions with localized stenosis or segmental short occlusions
Gaztambide-Fernández, Rubén; Nicholls, Rachael; Arráiz-Matute, Alexandra
2016-01-01
While general arts programs have declined in many schools across the United States and Canada, the number of specialized art programs in public secondary schools has swelled since the 1980s. While this increase is often celebrated by arts educators, questions about the justification of specialized arts programs are rarely raised, and their value…
International Nuclear Information System (INIS)
Fanelli, Fabrizio; Cannavale, Alessandro; Gazzetti, Marianna; Fantozzi, Cristiano; Taurino, Maurizio; Speziale, Francesco
2013-01-01
This is the case of a 72-year-old man with lower limb ischemia due to spontaneous rupture of nonaneurysmal superficial femoral artery that developed into thigh hematoma. After failure of a Fogarty revascularization, an emergency endovascular procedure was performed to restore the arterial continuity. A rendezvous procedure was performed with a double femoral and popliteal approach and two covered stent-grafts were deployed. Patient’s clinical conditions immediately improved, but 4 months later the stent-grafts were surgically removed for infection and exteriorization. A femoropopliteal bypass was performed. After 1 year follow-up, the patient is in good clinical condition.
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Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it; Cannavale, Alessandro [University of Rome ' Sapienza,' , Department of Radiological Sciences, Vascular and Interventional Radiology Unit (Italy); Gazzetti, Marianna [Sapienza University of Rome ' Sapienza,' , Department of Surgery Paride Stefanini, Vascular Surgery Division, Policlinico Umberto I (Italy); Fantozzi, Cristiano; Taurino, Maurizio [University of Rome ' Sapienza,' , Department of Vascular Surgery (Italy); Speziale, Francesco [Sapienza University of Rome ' Sapienza,' , Department of Surgery Paride Stefanini, Vascular Surgery Division, Policlinico Umberto I (Italy)
2013-02-15
This is the case of a 72-year-old man with lower limb ischemia due to spontaneous rupture of nonaneurysmal superficial femoral artery that developed into thigh hematoma. After failure of a Fogarty revascularization, an emergency endovascular procedure was performed to restore the arterial continuity. A rendezvous procedure was performed with a double femoral and popliteal approach and two covered stent-grafts were deployed. Patient's clinical conditions immediately improved, but 4 months later the stent-grafts were surgically removed for infection and exteriorization. A femoropopliteal bypass was performed. After 1 year follow-up, the patient is in good clinical condition.
State of the social responsibility art
Varela López, Leidy Viviana; Universidad de San Buenaventura Cali.
2015-01-01
From the eighties, it has been addressing the issue of corporate social responsibility, specifically toward the defense of human rights and climate change. However, although they have applied corporate social responsibility principles in some of the existing institutions, it is still very small the work being done around the specific activity of solid waste management. Some works have been compiled to build a state of the art for understanding in depth the concept of corporate social responsi...
State of the art report on design for X
DEFF Research Database (Denmark)
Papanikolaou, Apostolos; Andersen, Poul; Kristensen, Hans Otto Holmegaard
2009-01-01
The present State of the Art report aims at defining and reviewing the curent state of the ship design process in the frame of a holistic approach, accounting for various objectives and constraints. The report addresses mainly the design of transportation carriers, though some covered aspects...
DEFF Research Database (Denmark)
Jahangiri, Tohid; Bak, Claus Leth; Silva, Filipe Miguel Faria da
2015-01-01
The first EHV composite cross-arms have been used since late 1990's in Switzerland. It was the first step to the compaction of towers sizes. Since then, significant advances have been made in composite cross-arms technology while the lattice construction technique has not been seriously challenged...... of EHV composite cross-arms and lightning protection methods are reviewed based on the state of the art review and subsequently some solutions are presented to overcome the two main challenges....
Directory of Open Access Journals (Sweden)
Arthur de Azambuja Pereira Filho
2007-06-01
Full Text Available Intracranial "kissing" carotid arteries are a rare variant of the carotid arteries, where both internal carotid arteries deviate medially and touch each other near the midline within the sphenoid sinus or the sphenoid bone, including the sella. This anomaly is particularly important since it may cause or mimic pituitary disease and also may complicate transsphenoidal surgery. We report a rare case of intracranial intrasellar kissing carotid arteries in a 57-years-old woman that was submitted to a computed tomography angiography during investigation of a sudden headache, and to discuss the clinical relevance of this radiological finding.Artérias carótidas intracranianas "que se beijam" representam rara variação da anatomia arterial, onde ambas as artérias carótidas internas desviam-se medialmente e tocam-se próximo à linha media dentro do seio esfenoidal ou do osso esfenóide, incluindo a sela túrcica. Essa anomalia é particularmente importante, pois pode causar ou simular doença pituitária e ainda pode complicar uma cirurgia transesfenoidal. Relatamos um raro caso de artérias carótidas intracranianas "que se beijam" em mulher de 57 anos, a qual foi investigada por angiotomografia por quadro de cefaléia súbita. Discutimos a relevância clínica desse achado radiológico.
Meniscal Allograft Transplantation: State of the Art.
Trentacosta, Natasha; Graham, William C; Gersoff, Wayne K
2016-06-01
Meniscal allograft transplantation has evolved over the years to provide a state-of-the-art technique for the sports medicine surgeon to utilize in preserving contact mechanics and function of the knee in irreparable meniscal pathology. However, this procedure continues to spark considerable debate on proper tissue processing techniques, acceptable indications, methods of implantation, and potential long-term outcomes.
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Carlos Alberto Engelhorn
2006-11-01
EMI na origem da artéria subclávia direita pode ser considerado um marcador mais precoce para avaliação de risco cardiovascular.OBJECTIVE: Common carotid artery intima-media thickness (IMT is considered a factor of cardiovascular risk and an early marker of coronary artery disease. This study aimed to investigate the existence of a correlation between IMT in the carotid arteries and at the origin of the right subclavian artery, as well as to evaluate IMT in the subclavian artery as an earlier marker of cardiovascular risk. METHODS: One hundred and six consecutive patients, 52 males and 54 females, average age 51 years, underwent color Doppler ultrasonography to evaluate carotid and right subclavian arteries. The relationship between carotid IMT and right subclavian IMT was assessed using the Pearson's correlation coefficient analysis and a 95% confidence interval. Reliability of right subclavian artery IMT measurement for the diagnosis of early thickening (considering a > 0.8 mm carotid thickness as reference was described as to sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. Cut-off values for the right subclavian IMT were indicated by the ROC curve, and p values 0.8 mm. The mean IMT value for the carotid artery was 0.87 mm (SD = 0.23 and for the subclavian artery, 1.17 mm (SD = 0.46, with a 0.31 correlation coefficient (95% CI: 0.12; 0.47. The ROC curve analysis indicated a cut-off value of 0.7 mm for the right subclavian artery IMT, using as reference a 0.8 mm cut-off value for the carotid artery (91% sensitivity, 27% specificity, 66% PPV, 65% NPV, and 66% accuracy. CONCLUSION: Our study showed that carotid artery IMT correlates well with right subclavian artery IMT. With a 0.7 mm cut-off value, it is possible to detect IMT in the right subclavian artery earlier than in the carotid arteries. The IMT at the origin of the right subclavian artery can be considered an earlier marker for the assessment of cardiovascular
Energy Technology Data Exchange (ETDEWEB)
Christensen, Jared D.; Monu, Johnny U.V. [University of Rochester School of Medicine and Dentistry, Department of Imaging Sciences, 601 Elmwood Ave., Box 648, Rochester, NY (United States)
2008-08-15
Synergistic use of ultrasonography, radiography, multidetector CT (MDCT) and MRI enabled a prompt and accurate diagnosis of a nonocclusive popliteal vein thrombus (deep venous thrombosis, DVT) and a pseudoaneurysm complicating a sessile osteochondroma in an 11-year-old boy who presented in the emergency department with sudden-onset nontraumatic pain in the posterior aspect of the knee. (orig.)
EMERGENCY STATES IN ARTERIAL HYPERTENSION
Directory of Open Access Journals (Sweden)
M. A. Gurevich
2014-01-01
Full Text Available The article describes in detail potential emergency states in patients with different stages of arterial hypertension with special attention to diagnosis and rational management of hypertensive crisis. Differentiated approach to management of different forms of hypertensive crisis is specified.
Results of Infrageniculate Bypasses Using the Profunda Femoris Artery as Inflow Source.
Illuminati, Giulio; Calio', Francesco G; Pizzardi, Giulia; Pasqua, Rocco; Masci, Federica; Frezzotti, Francesca; Palumbo, Piergaspare; Vietri, Francesco
2018-02-01
When the common femoral artery is not accessible for infrainguinal bypass grafting, the profunda femoris artery (PFA) can be a valuable alternative inflow source for distal arterial revascularization. The purpose of this retrospective study was to evaluate the results of infrageniculate bypass grafting via the PFA as inflow source for critical limb ischemia. Between 1994 and 2016, 68 patients, 51 men of a mean age of 74 years, underwent an infrageniculate arterial bypass grafting for critical limb ischemia, using the PFA as inflow site. PFA was exposed at the Scarpa's triangle in 38 patients (56%) and at its medio-crural segment in 30 patients (44%). The distal anastomosis was performed on the infragenicular popliteal artery in 33 patients (48%), the peroneal artery in 14 patients (20%), the tibioperoneal trunk in 8 patients (12%), the posterior tibial artery in 8 patients (12%), and the dorsalis pedis artery in 5 patients (8%). The graft material consisted of a reversed great saphenous vein (GSV) in 62 patients (91%) and a 6-mm polytetrafluoroethylene graft in 6 patients (9%). The median duration of follow-up was 51 months (range, 6-72 months). As main results, postoperative mortality and morbidity, overall late patients' survival, primary grafts' patency, and limb salvage rate were considered. Operative mortality and morbidity were 3% and 4%, respectively. Overall patients' survival, primary patency and limb salvage rate, at 36 and 60 months were, respectively, 62% and 53%, 66% and 59%, and 92% and 77%. The PFA, both exposed at the Scarpa's triangle and at mid-thigh, is an excellent inflow source for infrageniculate revascularizations. It should remain an important part of the technical armamentarium of vascular surgeons, even in the endovascular era. Copyright © 2017 Elsevier Inc. All rights reserved.
State of the art of solid state dosimetry
International Nuclear Information System (INIS)
Souza, Susana O.; Yamamoto, Takayoshi; D'Errico, Francesco
2014-01-01
Passive solid-state detectors still dominate the personal dosimetry field. This article provides state of the art in this field and summarizes the most recent works presented on TL, OSL and RPL during the 17th International Conference on Solid State Dosimetry held in Recife in September 2013. The Article contains in particular the techniques Thermoluminescence (TL), Optically Stimulated Luminescence (OSL), radio photoluminescence (RPL). Thermoluminescence has the biggest advantage of the wide availability of commercial materials for dosimetry, and the nature tissue-equivalent of several of these materials. The limitation of the TL dosimetry presents fading luminance signal and the need for high temperatures to obtain the signal. The Optically Stimulated Luminescence has the advantages of high sensitivity, the possibility of multiple reading, while its limit is the need to use response compensating filters in addition to the high cost of equipment and dosimeters still restricted very few options trading . The radio photoluminescence has a reading that is completely non-destructive, but their dosimeters present lack of tissue-equivalent and a high cost. Presents the details of the techniques and the advantages and limitations of each of these will be discussed
State of the art in semiconductor detectors
International Nuclear Information System (INIS)
Rehak, P.; Gatti, E.
1990-01-01
The state of the art in semiconductor detectors for elementary particle physics and X-ray astronomy is briefly reviewed. Semiconductor detectors are divided into two groups; i) classical semiconductor diode detectors and ii) semiconductor memory detectors. Principles of signal formation for both groups of detectors are described and their performance is compared. New developments of silicon detectors are reported here. (orig.)
State of the art in semiconductor detectors
International Nuclear Information System (INIS)
Rehak, P.; Gatti, E.
1989-01-01
The state of the art in semiconductor detectors for elementary particle physics and x-ray astronomy is briefly reviewed. Semiconductor detectors are divided into two groups; classical semiconductor diode detectors; and semiconductor memory detectors. Principles of signal formation for both groups of detectors are described and their performance is compared. New developments of silicon detectors are reported here. 13 refs., 8 figs
The state-of-the-art of HSR in Europe.
Hansen, J.
2009-01-01
In this section of the workshop we present an overview based on mapping the current state-of-the-art concerning various fields of health services research, addressing the different levels of analysis in HSR. (1) HSR at the level of health care systems, being national or sometimes regional entities,
Ascher, Enrico; Hingorani, Anil; Markevich, Natalia; Costa, Tatiana; Kallakuri, Shreedhar; Khanimoy, Yuri
2002-01-01
This study reviews our experience with duplex ultrasound arterial mapping (DUAM) for preoperative evaluation in 466 patients (262 men) who underwent 485 lower extremity revascularization procedures from January 1, 1998 to May 30, 2001. Preoperative imaging consisted of DUAM alone in 449 procedures and DUAM and contrast angiography (CA) in 36. An attempt to image from the distal aorta to the pedal arteries was made in all the patients. The selection of optimal inflow and outflow bypasses anastomotic sites was based on a schematic drawing following DUAM examination. Inflow disease was also assessed by intraoperative pressure gradient (IPG) between the distal anastomosis and radial arteries, and completion arteriography of the runoff vessels was obtained, which was correlated with the preoperative findings. Indications for surgery were severe claudication in 91 (19%) limbs, tissue loss in 197 (40%), rest pain in 113 (23%), acute ischemia in 46 (10%), popliteal aneurysm in 18 (4%), superficial femoral artery aneurysm in 1, abdominal aortic aneurysm with claudication in 1, and failing graft in 18 (4%). Age ranged from 30 to 97 years (mean 72 +/- 12 (SD) years) and risk factors such as diabetes, hypertension, use of tobacco, coronary artery disease, and end-stage renal disease were present in 45%, 45%, 44%, 44%, and 13% of the patients, respectively. One hundred twenty-one (25%) limbs had at least 1 previous ipsilateral revascularization. The mean DUAM time was 66 +/- 20 (SD) min (30-150 min). Additional preoperative imaging was deemed necessary in 36 cases due to extensive ulcers, edema, severe arterial wall calcification, and very poor runoff. The distal anastomosis was to the popliteal artery in 173 cases and to the tibial and pedal arteries in 255. Inflow procedures to the femoral arteries, embolectomy, thrombectomy, balloon angioplasty, and patch angioplasty accounted for the remaining 57 cases. Overall, 6-, 12-, and -24- month secondary patency rates were 86%, 80
A case of atherosclerotic inferior mesenteric artery aneurysm secondary to high flow state.
Troisi, Nicola; Esposito, Giovanni; Cefalì, Pietro; Setti, Marco
2011-07-01
Inferior mesenteric artery aneurysms are very rare and they are among the rarest of visceral artery aneurysms. Sometimes, the distribution of the blood flow due to chronic atherosclerotic occlusion of some arteries can establish an increased flow into a particular supplying district (high flow state). A high flow state in a stenotic inferior mesenteric artery in compensation for a mesenteric occlusive disease can produce a rare form of aneurysm. We report the case of an atherosclerotic inferior mesenteric aneurysm secondary to high flow state (association with occlusion of the celiac trunk and severe stenosis of the superior mesenteric artery), treated by open surgical approach. Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
International Nuclear Information System (INIS)
Zel'dovich, Ya.B.
1983-01-01
The present state of the art in cosmology is under discussion. The general picture of the Universe evolution is presented, and its main stages are outlined. The prooess of formation of the large scale Universe structure is considered. The possibility of investigation into the ''inflation'' period of the ''very-very early Universe'' from the view point of theoretical physics is sown. It is noted that cosmology will become a complete science only when physics gives an exhaustive answer to all issues raised by cosmology
Aircraft wake vortices : a state-of-the-art review of the United States R&D program
1977-02-28
The report summarizes the current state-of-the-art understanding : of the aircraft wake vortex phenomenon and the results of the United : States program to minimize the restrictions caused by aircraft wake : vortices in the terminal environment. The ...
Zhang, Nan; Gordon, Marc L; Goldberg, Terry E
2017-01-01
Arterial spin labeling (ASL) magnetic resonance imaging uses arterial blood water as an endogenous tracer to measure cerebral blood flow (CBF). In this review, based on ASL studies in the resting state, we discuss state-of-the-art technical and data processing improvements in ASL, and ASL CBF changes in normal aging, mild cognitive impairment (MCI), Alzheimer's disease (AD), and other types of dementia. We propose that vascular and AD risk factors should be considered when evaluating CBF changes in aging, and that other validated biomarkers should be used as inclusion criteria or covariates when evaluating CBF changes in MCI and AD. With improvements in hardware and experimental design, ASL is proving to be an increasingly promising tool for exploring pathogenetic mechanisms, early detection, monitoring disease progression and pharmacological response, and differential diagnosis of AD. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
International Nuclear Information System (INIS)
Souza, Daiane C.B. de; Vicente, Roberto; Rostelato, Maria Elisa C.M.; Borges, Jessica F.; Tiezzi, Rodrigo; Peleias Junior, Fernando S.; Souza, Carla D.; Rodrigues, Bruna T.; Benega, Marcos A.G.; Souza, Anderson S. de; Silva, Thais H. da
2014-01-01
This article aims to analyze what has been done so far in relation to damage caused by the accident and the state of art in Chernobyl, as well as the impact on radiation protection applied safety nuclear power plants. In the first part of the work a data survey was done through a bibliographic review and the in the second part data was collected during a visit, in June 2013 at the crash site, when was observed dose values in the affected areas and the works of repairs that have been made in the sarcophagus and surroundings as well as in official reports available through active international bodies. The main results indicate significant improvements in radiation protection systems
Critical appraisal of paclitaxel balloon angioplasty for femoral–popliteal arterial disease
Directory of Open Access Journals (Sweden)
Herten M
2016-08-01
Full Text Available Monika Herten,1 Giovanni B Torsello,1,2 Eva Schönefeld,3 Stefan Stahlhoff2 1Department of Vascular and Endovascular Surgery, University Hospital Münster, 2Department of Vascular Surgery, St Franziskus Hospital, Münster, 3Institute for Education and Student Affairs, University Hospital Münster, Münster, Germany Abstract: Peripheral arterial disease, particularly critical limb ischemia, is an area with urgent need for optimized therapies because, to date, vascular interventions often have limited life spans. In spite of initial encouraging technical success after femoropopliteal percutaneous transluminal angioplasty or stenting, postprocedural restenosis remains the major problem. The challenging idea behind the drug-coated balloon (DCB concept is the biological modification of the injury response after balloon dilatation. Antiproliferative drugs administered via DCBs or drug-eluting stents are able to suppress neointimal hyperplasia, the main cause of restenosis. This article reviews the results of DCB treatments of femoropopliteal and infrapopliteal lesions in comparison to standard angioplasty with uncoated balloons. A systematic literature search was performed in 1 medical journals (ie, MEDLINE, 2 international registers for clinical studies (ie, www.clinicaltrials.gov, and 3 abstracts of scientific sessions. Several controlled randomized trials with follow-up periods of up to 5 years demonstrated the efficacy of paclitaxel –DCB technology. However, calcified lesions seem to affect the efficacy of DCB. Combinations of preconditioning methods with DCBs showed promising results. Although the mechanical abrasion of calcium via atherectomy or laser ablation showed favorable periprocedural results, the long-term impact on restenosis and clinical outcome has to be demonstrated. Major advantages of the DCBs are the rapid delivery of drug at uniform concentrations with a single dose, their efficacy in areas wherein stents have been
As pesquisas denominadas "estado da arte" Research called "state of the art"
Directory of Open Access Journals (Sweden)
Norma Sandra de Almeida Ferreira
2002-08-01
Full Text Available Nos últimos quinze anos, no Brasil e em outros países, tem se produzido um conjunto significativo de pesquisas conhecidas pela denominação "estado da arte" ou "estado do conhecimento". Definidas como de caráter bibliográfico, elas parecem trazer em comum o desafio de mapear e de discutir uma certa produção acadêmica em diferentes campos do conhecimento, tentando responder que aspectos e dimensões vêm sendo destacados e privilegiados em diferentes épocas e lugares, de que formas e em que condições têm sido produzidas certas dissertações de mestrado, teses de doutorado, publicações em periódicos e comunicações em anais de congressos e de seminários. Neste artigo levanto e tento responder as seguintes questões: seria possível fazer um esforço de interrogar a história a produção acadêmica sobre determinada área do conhecimento, optando por ler apenas dados bibliográficos e resumos dos trabalhos? O que significa ler esse lugar (catálogos, instituição de divulgação dos trabalhos, tomando-o como fonte documental para um mapeamento da produção acadêmica, em pesquisas denominadas "estado da arte"?These last fifteen years, Brazil and other countries have seen the production of a significant set of research, known as "state of the art" or "state of knowledge". Defined as having a bibliographic feature, they seem to share the challenge of mapping and discussing a certain academic production in different fields of knowledge. They try to show which aspects and dimensions have been highlighted and privileged at different times and places. They also pinpoint how and in what conditions certain kinds of master's degree thesis and doctor's degree dissertations, publications in periodicals and communications in annals of congress and seminary were produced. In this article, I pose and try to answer the following questions: Is it worth making the effort of interrogating the history of the academic production about a given area
International Nuclear Information System (INIS)
Jacobson, H.G.
1988-01-01
State-of-the-art magnetic resonance imaging (MRI) generates high-resolution images of the cardiovascular system. Conventional MRI techniques provide images in six to ten minutes per tomographic slice. New strategies have substantially improved the speed of imaging. The technology is relatively expensive, and its cost-effectiveness remains to be defined in relation to other effective, less expensive, and noninvasive technologies, such as echocardiography and nuclear medicine. The ultimate role of MRI will depend on several factors, including the development of specific applications such as (1) noninvasive angiography, especially of the coronary arteries;(2) noninvasive, high-resolution assessment of regional myocardial blood flow distribution (e.g., using paramagnetic contrast agents); (3) characterization of myocardial diseases using proton-relaxation property changes; and (4) evaluation of in vivo myocardial biochemistry. The three-dimensional imaging capability and the ability to image cardiovascular structures without contrast material give MRI a potential advantage over existing noninvasive diagnostic imaging techniques. This report analyzes current applications of MRI to the cardiovascular system and speculates on their future
Energy Technology Data Exchange (ETDEWEB)
Massmann, Alexander, E-mail: Alexander.Massmann@uks.eu; Katoh, Marcus [Saarland University Hospital, Department of Diagnostic and Interventional Radiology (Germany); Shayesteh-Kheslat, Roushanak [Saarland University Hospital, Department of General Surgery, Visceral, Vascular, and Pediatric Surgery (Germany); Buecker, Arno [Saarland University Hospital, Department of Diagnostic and Interventional Radiology (Germany)
2012-10-15
Purpose: To retrospectively examine the technical feasibility and safety of directional atherectomy for treatment of subacute infrainguinal arterial vessel occlusions. Methods: Five patients (one woman, four men, age range 51-81 years) with peripheral arterial disease who experienced sudden worsening of their peripheral arterial disease-related symptoms during the last 2-6 weeks underwent digital subtraction angiography, which revealed vessel occlusion in native popliteal artery (n = 4) and in-stent occlusion of the superficial femoral artery (n = 1). Subsequently, all patients were treated by atherectomy with the SilverHawk (ev3 Endovascular, USA) device. Results: The mean diameter of treated vessels was 5.1 {+-} 1.0 mm. The length of the occlusion ranged 2-14 cm. The primary technical success rate was 100%. One patient experienced a reocclusion during hospitalization due to heparin-induced thrombocytopenia. There were no further periprocedural complications, in particular no peripheral embolizations, until hospital discharge or during the follow-up period of 1 year. Conclusion: The recanalization of infrainguinal arterial vessel occlusions by atherectomy with the SilverHawk device is technically feasible and safe. In our limited retrospective study, it was associated with a high technical success rate and a low procedure-related complication rate.
The Impact of ART on Live Birth Outcomes: Differing Experiences across Three States.
Luke, Sabrina; Sappenfield, William M; Kirby, Russell S; McKane, Patricia; Bernson, Dana; Zhang, Yujia; Chuong, Farah; Cohen, Bruce; Boulet, Sheree L; Kissin, Dmitry M
2016-05-01
Research has shown an association between assisted reproductive technology (ART) and adverse birth outcomes. We identified whether birth outcomes of ART-conceived pregnancies vary across states with different maternal characteristics, insurance coverage for ART services, and type of ART services provided. CDC's National ART Surveillance System data were linked to Massachusetts, Florida, and Michigan vital records from 2000 through 2006. Maternal characteristics in ART- and non-ART-conceived live births were compared between states using chi-square tests. We performed multivariable logistic regression analyses and calculated adjusted odds ratios (aOR) to assess associations between ART use and singleton preterm delivery (birth. ART use in Massachusetts was associated with significantly lower odds of twins as well as triplets and higher order births compared to Florida and Michigan (aOR 22.6 vs. 30.0 and 26.3, and aOR 37.6 vs. 92.8 and 99.2, respectively; Pinteraction order gestations per cycle was lower in Massachusetts, which may be due to the availability of insurance coverage for ART in Massachusetts. © 2016 John Wiley & Sons Ltd.
A quick guide to wind power forecating : state-of-the-art 2009.
Energy Technology Data Exchange (ETDEWEB)
Monteiro, C.; Keko, H.; Bessa, R.; Miranda, V.; Botterud, A.; Wang, J.; Conzelmann, G.; Decision and Information Sciences; INESC Porto
2009-11-20
This document contains a summary of the main findings from our full report entitled 'Wind Power Forecasting: State-of-the-Art 2009'. The aims of this document are to provide guidelines and a quick overview of the current state-of-the-art in wind power forecasting (WPF) and to point out lines of research in the future development of forecasting systems.
The LIFE Laser Design in Context: A Comparison to the State-of-the-Art
International Nuclear Information System (INIS)
Deri, R.J.; Bayramian, A.J.; Erlandson, A.C.
2011-01-01
The current point design for the LIFE laser leverages decades of solid-state laser development in order to achieve the performance and attributes required for inertial fusion energy. This document provides a brief comparison of the LIFE laser point design to other state-of-the-art solid-state lasers. Table I compares the attributes of the current LIFE laser point design to other systems. the state-of-the-art for single-shot performance at fusion-relevant beamline energies is exemplified by performance observed on the National Ignition Facility. The state-of-the-art for high average power is exemplified by the Northrup Grumman JHPSSL laser. Several items in Table I deal with the laser efficiency; a more detailed discussion of efficiency can be found in reference 5. The electrical-to-optical efficiency of the LIFE design exceeds that of reference 4 due to the availability of higher efficiency laser diode pumps (70% vs. ∼50% used in reference 4). LIFE diode pumps are discussed in greater detail in reference 6. The 'beam steering' state of the art is represented by the deflection device that will be used in the LIFE laser, not a laser system. Inspection of Table I shows that most LIFE laser attributes have already been experimentally demonstrated. The two cases where the LIFE design is somewhat better than prior experimental work do not involve the development of new concepts: beamline power is increased simply by increasing aperture (as demonstrated by the power/aperture comparison in Table I), and efficiency increases are achieved by employing state-of-the-art diode pumps. In conclusion, the attributes anticipated for the LIFE laser are consistent with the demonstrated performance of existing solid-state lasers.
The job demands-resources model : state of the art
Bakker, A.B.; Demerouti, E.
2007-01-01
Purpose - The purpose of this paper is to give a state-of-the art overview of the Job Demands-Resources (JD-R) model Design/methodology/approach - The strengths and weaknesses of the demand-control model and the effort-reward imbalance model regarding their predictive value for employee well being
Directory of Open Access Journals (Sweden)
Ivan Romero Rivera
1998-05-01
Full Text Available A origem da artéria pulmonar direita em aorta ascendente é uma anomalia congênita rara, com poucos casos descritos na literatura. Descrevemos dois casos desta malformação, um associado à interrupção de arco aórtico tipo B. Em ambos, o diagnóstico foi realizado mediante ecocardiografia bidimensional, com confirmação angiográfica em um. A origem da artéria pulmonar direita era próxima à valva aórtica, anomalia patogeneticamente diferente da origem perto da artéria inominada.The origin of the right pulmonary artery from the ascending aorta is a rare congenital anomaly, with very few reports in the literature. We describe two cases of this rare malformation, one of them, associated with interruption of the aortic arch (type B. In both cases, the diagnosis was made by two-dimensional echocardiography, with angiographic confirmation in one of them. The origin of the right pulmonary artery was close to the aortic valve, anomaly pathogenetically distinct from the type that arises close to the innominate artery.
Tibiopedal access for lower extremity arterial intervention: when to use and how to perform.
Wiechmann, Bret N
2014-09-01
Tibiopedal artery access is being used with increasing frequency as an alternative access to facilitate procedural success in lower extremity arterial intervention. This technique is usually employed in the setting of critical limb ischemia and tibial artery intervention, but it may offer potential practical advantages for popliteal artery and even superficial femoral artery intervention in unique situations. As in all cases of lower extremity arterial intervention, consideration of access is important not only for initial approach to any obstructing lesion but also for exit strategy. The dorsalis pedis artery and posterior tibial artery can be readily accessed if necessary owing to their relatively superficial position in the foot or the ankle, yet their normal diameter and the presence of significant calcification (a common finding in patients with tibial occlusive disease and critical limb ischemia) can pose difficulties as well. In addition, the peroneal artery in the lower leg can be accessed percutaneously; however, its size and depth may present additional challenges. Meticulous attention to detail is paramount in avoiding complications in what may be the only distal vessel supplying the foot. This article describes common techniques in using tibiopedal artery access as a means of alternative access for successful infrainguinal intervention. Copyright © 2014 Elsevier Inc. All rights reserved.
Nickel-base superalloy powder metallurgy: state-of-the-art
International Nuclear Information System (INIS)
Allen, M.M.; Athey, R.L.; Moore, J.B.
1975-01-01
Development of powder metallurgical methods for fabrication of Ni-base superalloy turbine engine disks is reviewed. Background studies are summarized and current state-of-art is discussed for the F100 jet engine, advanced applications, and forging processes
Symposium Connects Government Problems with State of the Art Network Science Research
2015-10-16
Symposium Connects Government Problems with State-of-the- Art Network Science Research By Rajmonda S. Caceres and Benjamin A. Miller Network...the US Gov- ernment, and match these with the state-of-the- art models and techniques developed in the network science research community. Since its... science has grown significantly in the last several years as a field at the intersec- tion of mathematics, computer science , social science , and engineering
Measuring the State-of-the-Art in Laser Cut Quality
Pocorni, Jetro; Powell, John; Ilar, Torbjörn; Schwarz, A.; Kaplan, Alexander
2013-01-01
This paper discusses the strategy appropriate to investigating the state of the art of laser cutting from an industrial point of view. The importance of creating the samples in a high quality industrial environment is emphasised and preliminary results are presented.
International Nuclear Information System (INIS)
Rooij, W.J.J. van; Heeten, G.J. den
1992-01-01
Selective intra-arterial digital subtraction angiography (IA-DSA) of the pulmonary vessels was performed in 70 patients suspected of acute pulmonary embolism. A flow-directed Swan-Ganz pulmonary angiography catheter was used. The spatial resolution of the equipment used was 3.3 lp/mm for DSA and 6.0 lp/mm for conventional pulmonary angiography (CPA). Image quality of the angiograms was assessed by determining the highest visible branching division of the main pulmonary artery. The mean visible branching division for IA-DSA was 4.71 (range 3-7). In 10 patients where IA-DSA and CPA were performed during the same procedure there was no difference in visualization of peripheral arteries (mean 4.70 visible or for both modalities). IA-DSA makes the procedure rapid, saves on films and contrast material and allows good visualization of areas where exposure is difficult. The spatial resolution of state-of-the-art equipment permits sufficient definition of subsegmental vessels. The use of the flow-directed balloon catheter makes the examination easy to perform and minimizes the risk of catheter induced cardiac arrhythmias. (orig.) [de
Development of a state-of-the-art solid waste characterisation facility at JRC ISPRA
International Nuclear Information System (INIS)
Huhtiniemi, I.; Anselmi, M.; Hubert, P.; Vassallo, G.
2003-01-01
This paper will review the development and construction of a state-of-the-art waste characterisation facility that represents a fundamental element in the JRC's strategy to characterise radioactive wastes originating from four decades of nuclear research activities conducted at the Ispra Site. The state-of-the-art NDA measurement solution selected by JRC-Ispra will be presented in the light of special requirements imposed by applicable Italian legislation, norms and the qualities of the waste packages. The intended plant combines the state-of-the-art-measurement solution with comprehensive process automation in an industrial environment and is therefore of significant interest to the radioactive waste management community. (orig.)
Directory of Open Access Journals (Sweden)
Artur Lourenção Júnior
1990-12-01
Full Text Available A artéria coronária direita, em seu trajeto no sulco atrioventricular direito, pode, em raras ocasiões, penetrar na cavidade atrial direita. Esta variação anatômica poderá modificar a tática cirúrgica em operações de revascularização miocárdica. No presente trabalho, relatamos o caso em que a ponte de veia safena para a artéria coronária direita foi realizada em posição intra-atrial direita.The right coronary artery, during your course in the right atrioventricular sulcus, can sometimes penetrate the right atrial cavity. This anatomical variety can modify the surgical tactics in aortocoronary by-pass surgery. In this paper we present a patient in whom the by-pass with saphenous vein graft to the right coronary artery was made in right intracavitary position.
Flexible AC transmission systems: the state of the art
Energy Technology Data Exchange (ETDEWEB)
Edris, Abdel-Aty [Electric Power Research Inst., Palo Alto, CA (United States). Electric Systems Division
1994-12-31
Flexible AC transmission systems (FACTS) is a concept promoting the use of power electronic controllers to enhance the controllability and usable capacity of AC transmission. This paper presents the state of the art of FACTS and the status of the current projects for the application of the FACTS controllers in transmission systems. (author) 8 refs., 8 figs.
Reveley, Mary s.; Briggs, Jeffrey L.; Leone, Karen M.; Kurtoglu, Tolga; Withrow, Colleen A.
2010-01-01
Literature from academia, industry, and other Government agencies was surveyed to assess the state of the art in current Integrated Resilient Aircraft Control (IRAC) aircraft technologies. Over 100 papers from 25 conferences from the time period 2004 to 2009 were reviewed. An assessment of the general state of the art in adaptive flight control is summarized first, followed by an assessment of the state of the art as applicable to 13 identified adverse conditions. Specific areas addressed in the general assessment include flight control when compensating for damage or reduced performance, retrofit software upgrades to flight controllers, flight control through engine response, and finally test and validation of new adaptive controllers. The state-of-the-art assessment applicable to the adverse conditions include technologies not specifically related to flight control, but may serve as inputs to a future flight control algorithm. This study illustrates existing gaps and opportunities for additional research by the NASA IRAC Project
[The state of carotid arteries in young men with arterial hypertension].
Safarova, A F; Iurtaeva, V R; Kotovskaia, Iu V; Kobalava, Zh D
2012-01-01
To study elastic properties of carotid arteries in young men with arterial hypertension (AH). We examined men aged 18-25 years (mean 21.1+/-0.14 years): 36 with normal blood pressure (BP), 123 with stable and 51 with unstable AH. Parameters studied comprised intima-media thickness (IMT) of carotid arteries, their M-mode measured maximal systolic and minimal diastolic diameters (Ds and Dd), stiffness of common carotid artery (CCA) wall determined on the basis of analysis of elasticity and distensibility coefficients (CC and DC), Peterson's and Young's modules of elasticity (Ep and E), and index of flow deformation (CS). Compared with young men with normal BP and unstable AH patients with stable AH had abnormal elastic properties of CCA and increased IMT. Stable AH in young men is associated with signs of remodeling of CCA walls and increase of their rigidity.
International Nuclear Information System (INIS)
Guo Xiangjiang; Zhang Jiwei
2010-01-01
Objective: To investigate the angiographic manifestations of lower extremity atherosclerotic occlusion in patients with diabetes mellitus. Methods: The angiographic findings of lower extremity in 162 patients with diabetes mellitus were retrospectively analyzed. (1) The arteries of lower extremity were divided into the following four segments: iliac, femoral, popliteal and crural artery. The involvements of these arteries were documented. (2) Based on the lesion's number, location, nature (stricture or occlusion) and length ( 5 cm), the diabetic arterial diseases were categorized. Results: (1) Of 162 diabetic lower limbs, multiple segmental lesions were seen in 131, superficial femoral arterial lesions in 130, and crural arterial lesions in 139, of which 130 arterial lesions had at least two below-the-knee arteries being involved. (2) Based on segmental angiographic classification, a total of 660 vascular lesions were detected, including stricture lesions (33.8%) and occlusive lesions (66.2%). Of the 437 occlusions, 70.5% were located in below-the-knee arteries, and most of which were longer than 10 cm and located in anterior and posterior tibial arteries, while only a few peroneal arteries were involved (P < 0.0001). One hundred and fifty-two lesions were detected in superficial femoral arteries, of which 49 (31.2%) were located at the origin of the superficial femoral artery and 56 (35.7) were in the adductor canal hiatus. Conclusion: The main feature of peripheral arterial disease of lower extremity caused by diabetes mellitus is multi-level atherosclerotic occlusion, the superficial femoral and the crural arteries are most likely to be involved. The lesions of superficial femoral artery are often located at the arterial origin and in the adductor canal hiatus, while the deep femoral artery and the femoral artery are less involved. Long occlusive lesions are more prevalent in crural arteries, especially in anterior and posterior tibial arteries. (J Intervent
Three State-of-the-Art Methods for Condition Monitoring
Grimmelius, H.T.; Meiler, P.P.; Maas, H.L.M.M.; Bonnier, B.; Grevink, J.S.; Kuilenburg, R.F. van
1999-01-01
This paper describes and compares three different state-of-the-art condition monitoring techniques: first principles, feature extraction, and neural networks. The focus of the paper is on the application of the techniques, not on the underlying theory. Each technique is described briefly and is
Leadership and Fairness: The state of the art.
van Knippenberg, D.; de Cremer, D.; van Knippenberg, B.M.
2007-01-01
textabstractResearch in leadership effectiveness has paid less to the role of leader fairness than probably it should have. More recently, this has started to change. To capture this development, we review the empirical literature in leadership and fairness to define the field of leadership and fairness, to assess the state of the art, and to identify a research agenda for future efforts in the field. The review shows that leader distributive, procedural, and especially interactional fairness...
Nuclear Liability, State of the Art
International Nuclear Information System (INIS)
Reitsma, S. M. S.
2010-01-01
Over fifty years ago states started to introduce legislation protecting the public against the potential magnitude and peculiarity of risks arising from the nuclear energy production. They did so trough a specific liability and compensation regime. Whether legislation was based on national initiatives or, as more frequently, related to international nuclear liability conventions, it was based on a number of principles being applied universally. Furthermore, it at the same time strived for not preventing the development of the nuclear industry because of an unbearable liability. This paper aims at explaining the broad outline of the above legislation, its development since its early years, the state of the art as regards its modernisation as well as the (alleged) problems underlying the delay in its introduction in a number of countries. When dealing with those problems it will be inevitable to touch upon a number of insurance related matters, which, as an insurer I am happy to tell, will lead me to familiar territory.(author).
International Nuclear Information System (INIS)
Massmann, Alexander; Katoh, Marcus; Shayesteh-Kheslat, Roushanak; Buecker, Arno
2012-01-01
Purpose: To retrospectively examine the technical feasibility and safety of directional atherectomy for treatment of subacute infrainguinal arterial vessel occlusions. Methods: Five patients (one woman, four men, age range 51–81 years) with peripheral arterial disease who experienced sudden worsening of their peripheral arterial disease–related symptoms during the last 2–6 weeks underwent digital subtraction angiography, which revealed vessel occlusion in native popliteal artery (n = 4) and in-stent occlusion of the superficial femoral artery (n = 1). Subsequently, all patients were treated by atherectomy with the SilverHawk (ev3 Endovascular, USA) device. Results: The mean diameter of treated vessels was 5.1 ± 1.0 mm. The length of the occlusion ranged 2–14 cm. The primary technical success rate was 100%. One patient experienced a reocclusion during hospitalization due to heparin-induced thrombocytopenia. There were no further periprocedural complications, in particular no peripheral embolizations, until hospital discharge or during the follow-up period of 1 year. Conclusion: The recanalization of infrainguinal arterial vessel occlusions by atherectomy with the SilverHawk device is technically feasible and safe. In our limited retrospective study, it was associated with a high technical success rate and a low procedure-related complication rate.
Chernobyl - state of the art; Chernobyl - o estado da arte
Energy Technology Data Exchange (ETDEWEB)
Souza, Daiane C.B. de; Vicente, Roberto; Rostelato, Maria Elisa C.M.; Borges, Jessica F.; Tiezzi, Rodrigo; Peleias Junior, Fernando S.; Souza, Carla D.; Rodrigues, Bruna T.; Benega, Marcos A.G.; Souza, Anderson S. de; Silva, Thais H. da, E-mail: dcsouza@ipen.br, E-mail: rvicente@ipen.br, E-mail: elisaros@ipen.br, E-mail: rtiezzi@ipen.br, E-mail: carladdsouza@yahoo.com.br, E-mail: marcosagbenega@ipen.br, E-mail: bteigarodrigues@gmail.com, E-mail: thaishunk@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)
2014-07-01
This article aims to analyze what has been done so far in relation to damage caused by the accident and the state of art in Chernobyl, as well as the impact on radiation protection applied safety nuclear power plants. In the first part of the work a data survey was done through a bibliographic review and the in the second part data was collected during a visit, in June 2013 at the crash site, when was observed dose values in the affected areas and the works of repairs that have been made in the sarcophagus and surroundings as well as in official reports available through active international bodies. The main results indicate significant improvements in radiation protection systems.
Paediatric thoracoscopy: State of the art | Van Niekerk | South ...
African Journals Online (AJOL)
Many advanced procedures, including lobectomy, repair of tracheo-oesophageal fistula, excision of mediastinal tumours and diaphragmatic hernia repairs, are being done routinely in paediatric surgery centres around the world. This article reviews the state of the art of thoracoscopic surgery in children. The author selected ...
Teixeira, Andrea Mariana Nunes da Costa; Luzia, Liania Alves; de Souza, Suelen Jorge; de Almeida Petrilli, Aline; Pontilho, Patrícia de Moraes; de Souza, Jose Maria Pacheco; Segurado, Aluísio Augusto Cotrim; Efraim, Priscila; Picone, Camila de Melo; Rondo, Patrícia Helen de Carvalho
2017-06-21
An increase in the frequency of cardiovascular diseases has been observed in the HIV/AIDS population. Studies involving healthy subjects or subjects with other diseases have shown benefits of chocolate supplementation on endothelial function and vasodilation. We evaluate the impact of chocolate consumption on arterial elasticity in people living with human immunodeficiency virus - PLHIV. A double-blind, crossover trial including 110 PLHIV (19 to 59 years) on antiretroviral therapy - ART for at least 6 months and with a viral load of chocolate or placebo with a 15-d washout period. Each participant received one of the two sequences: A (dark chocolate, placebo chocolate); B (placebo chocolate, dark chocolate). Arterial elasticity was measured using the HDI/PulseWave™ CR-2000 CardioVascular Profiling System®. Body composition, lipid profile, C-reactive protein, and thiobarbituric acid reactive substances were also assessed. Analysis of variance (ANOVA) for repeated measures using the Stata 11.0® program was used for cross-over analysis. Most subjects were men (59.0%) and Caucasian (46.1%) and the mean age was 44.6 ± 7.1 years. The mean time since diagnosis of HIV infection was 13.7 ± 5.3 years and the mean duration of ART was 12.9 ± 4.2 years. Chocolate consumption resulted in significant alterations in the large artery elasticity index - LAEI (p = 0.049) and the mean concentration of HDL-c was higher after supplementation with dark chocolate (p = 0.045). This is the first study to evaluate the effect of chocolate on arterial elasticity in PLHIV. The results showed that dark chocolate consumption for 15 days improved the elastic properties of the LAEI in PLHIV. These findings, added to the noninvasive method used, may expand the knowledge of CVDs in this population.
Actinomyces meyeri Popliteal Cyst Infection and Review of the Literature
Directory of Open Access Journals (Sweden)
Bharath Raj Palraj
2017-01-01
Full Text Available A 66-year-old, Caucasian male presented with pain and swelling involving the left knee of one-week duration. Arthrocentesis was negative for evidence of septic arthritis. Magnetic resonance imaging (MRI study of the left knee showed degenerative arthritis, partial tear of medial meniscus, and a complex fluid collection along the posteromedial aspect of the left knee suggestive of popliteal cyst. He underwent arthroscopy with partial medial meniscectomy. Intraoperative joint fluid was noted to be cloudy but cultures were negative. Arthroscopic procedure provided him with temporary relief but the pain and swelling in the posterior aspect of the left knee recurred in 6 weeks. Repeat MRI showed complex fluid collection in the posterolateral aspect of left knee. Ultrasound guided aspiration of the fluid collection revealed purulent material and cultures grew Actinomyces meyeri. He was treated with 6 weeks of intravenous penicillin regimen followed by 18 months of oral penicillin.
State of the art: alumina ceramics for energy applications
International Nuclear Information System (INIS)
Hauth, W.E.; Stoddard, S.D.
1978-01-01
Prominent ceramic raw materials and products manufacturers were surveyed to determine the state of the art for alumina ceramic fabrication. This survey emphasized current capabilities and limitations for fabrication of large, high-density, high-purity, complex shapes. Some directions are suggested for future needs and development
Nuclear power plant decommissioning: state-of-the-art review
International Nuclear Information System (INIS)
Williams, D.H.
1984-01-01
A brief orientation to the state-of-the-art of nuclear power plant decommissioning discusses the related areas of experience, tools and techniques, and planning. There have been 68 nuclear reactor decommissionings to date, including 9 power plants, some of which were mothballed. The picture suggests that the term art may be misapplied since decommissioning is now more of a mature commercial industrial than a research and development endeavor. It also suggests that the nuclear industry has shown foresight by preparing for it before a crisis situation developed. Some of this has already influenced operators of coal power plants, especially where hazardous materials may be involved. 33 references, 1 table
Harvesting Robots for High-value Crops: State-of-the-art Review and Challenges Ahead
Bac, C.W.; Henten, van E.; Hemming, J.; Edan, Y.
2014-01-01
This review article analyzes state-of-the-art and future perspectives for harvesting robots in high-value crops. The objectives were to characterize the crop environment relevant for robotic harvesting, to perform a literature review on the state-of-the-art of harvesting robots using quantitative
Hu, Xuguang; Wen, Ya; Liu, Shasha; Luo, Jiabo; Tan, Xiaomei; Li, Zhiheng; Lu, Xinhua; Long, Xiaoying
2015-04-14
The anaphylactoid reactions induced by andrographis injection have repeatedly been reported. The aim of our study was to evaluate the immuno-sensitizing potential of extracts from Andrographis paniculata Nees and to screen for the constituent that is responsible for inducing the anaphylactoid reaction. In the direct popliteal lymph node assay (D-PLNA), female BALB/c mice were randomly divided into several groups with ten mice per group according to the experiment design, the right hind footpads of mice received a single subcutaneous injection of Andrographis paniculata (50 μl), and the left hind footpads received the same volume of vehicle. Seven days later, the mice were sacrificed by cervical dislocation, and the popliteal lymph nodes from both the left and right sides were removed. The weight (WI) and cellularity indices (CI) of the popliteal lymph nodes (PLNs) were then calculated, and the pathological changes of the PLNs were measured. In addition, P815 mast cells were collected for the in vitro cell degranulation experiment. The level of histamine, the percentage of cell degranulation and the ratio of ammonia glycosidase released were measured to further evaluate the potential allergenicity. Alcohol extract (AEE), ethyl acetate extract (EAE) and n-butanol extract (NBE) significantly increased the weight (WI > 2) and cell number (CI > 5) of PLNs (P andrographis, namely NAD, AND, and DDA, significantly increased the weight (WI > 2) and cell number (CI > 5) of the PLNs (P andrographis markedly elevated the level of histamine, the percentage of cell degranulation and the ratio of ammonia glycosidase released. The diterpene lactone compounds of Andrographis paniculata Nees (total lactones of andrographolide) may have a potential sensitizing capacity in andrographis injection.
Myxoid intraneural cysts of external popliteal ischiadic nerve
International Nuclear Information System (INIS)
Masciocchi, Carlo; Innacoli, Michele; Cisternino, Salvatore; Barile, Antonio; Rossi, Folco; Passariello, Roberto.
1992-01-01
Peripheral neuropathy of the external popliteal ischiadic nerve caused by intraneural cysts is a very rare and peculiar pathological phenomenon compared with diseases associated with extraneural cysts or colliquative phenomena of solid nervous lesions. Two cases of peripheral neuropathy of the external poplitheal ischiadic nerve caused by intra-neural cysts and evaluated with ultrasound, computed tomography and magnetic resonance are described. The diagnostic efficacy of these imaging modalities is also evaluated with particular reference to MR capability to define the morphology of such lesions and their relation-ships to the surrounding structures. It is not yet possible to obtain a correct diagnosis about histopathologic features by means of the imaging techniques currently available. Nevertheless, they provide information about the involvement of the neighboring areas, which are useful indications for possible surgical treatment of the disease. (author). 9 refs.; 2 figs
Maleckis, Kaspars; Anttila, Eric; Aylward, Paul; Poulson, William; Desyatova, Anastasia; MacTaggart, Jason; Kamenskiy, Alexey
2018-01-01
Endovascular stenting has matured into a commonly used treatment for peripheral arterial disease (PAD) due to its minimally invasive nature and associated reductions in short-termmorbidity and mortality. The mechanical properties of the superelastic Nitinol alloy have played a major role in the explosion of peripheral artery stenting, with modern stents demonstrating reasonable resilience and durability. Yet in the superficial femoral and popliteal arteries, even the newest generation Nitinol stents continue to demonstrate clinical outcomes that leave significant room for improvement. Restenosis and progression of native arterial disease often lead to recurrence of symptoms and reinterventions that increase morbidity and health care expenditures. One of the main factors thought to be associated with stent failure in the femoropopliteal artery (FPA) is the unique and highly dynamic mechanical environment of the lower limb. Clinical and experimental data demonstrate that the FPA undergoes significant deformations with limb flexion. It is hypothesized that the inability of many existing stent designs to conform to these deformations likely plays a role in reconstruction failure, as repetitive movements of the leg and thigh combine with mechanical mismatch between the artery and the stent and result in mechanical damage to both the artery and the stent. In this review we will identify challenges and provide a mechanical perspective of FPA stenting, and then discuss current research directions with promise to provide a better understanding of Nitinol, specific features of stent design, and improved characterization of the biomechanical environment of the FPA to facilitate development of better stents for patients with PAD. PMID:29470746
Maleckis, Kaspars; Anttila, Eric; Aylward, Paul; Poulson, William; Desyatova, Anastasia; MacTaggart, Jason; Kamenskiy, Alexey
2018-05-01
Endovascular stenting has matured into a commonly used treatment for peripheral arterial disease (PAD) due to its minimally invasive nature and associated reductions in short-term morbidity and mortality. The mechanical properties of the superelastic Nitinol alloy have played a major role in the explosion of peripheral artery stenting, with modern stents demonstrating reasonable resilience and durability. Yet in the superficial femoral and popliteal arteries, even the newest generation Nitinol stents continue to demonstrate clinical outcomes that leave significant room for improvement. Restenosis and progression of native arterial disease often lead to recurrence of symptoms and reinterventions that increase morbidity and health care expenditures. One of the main factors thought to be associated with stent failure in the femoropopliteal artery (FPA) is the unique and highly dynamic mechanical environment of the lower limb. Clinical and experimental data demonstrate that the FPA undergoes significant deformations with limb flexion. It is hypothesized that the inability of many existing stent designs to conform to these deformations likely plays a role in reconstruction failure, as repetitive movements of the leg and thigh combine with mechanical mismatch between the artery and the stent and result in mechanical damage to both the artery and the stent. In this review we will identify challenges and provide a mechanical perspective of FPA stenting, and then discuss current research directions with promise to provide a better understanding of Nitinol, specific features of stent design, and improved characterization of the biomechanical environment of the FPA to facilitate development of better stents for patients with PAD.
The state of the art in static and dynamic games
De Giovanni, P.
2009-01-01
Purpose - The purpose of this paper is to investigate the state of the art in static and dynamic games (or inter-firm relationships). This research area has changed significantly over the last 25 years through the development of phenomena such as the supply chain and the progressive overcoming of
The Beijing Olympics and the art of nation-state maintenance
de Kloet, J.; Pak Lei Chong, G.; Liu, W.
2008-01-01
This article maps out how different actors are involved in the promotion and mediation of the Olympics. It looks at the roles of, first, the nation-state, through an analysis of the promotional materials; second, the art world and global companies, through an analysis of the touring exhibition
Directory of Open Access Journals (Sweden)
Líria Queiroz Luz Hirano
2009-04-01
Full Text Available Este trabalho foi desenvolvido com o intuito de enriquecer o conhecimento sobre a morfologia vascular das artérias renais e gonadais de Podocnemis unifilis, facilitando o entendimento da fisiologia clínica e cirúrgica destes animais. Foram utilizados cincoexemplares machos de Podocnemis unifilis (tracajá, coletados segundo a Licença nº 066/2004- Ibama/RAM. A artéria carótida esquerda e a veia femoral direita foram canuladas e, pelas mesmas, foi introduzida solução fisiológica para lavagem do sistema vascular; em seguida,aplicou-se solução de Neoprene Látex “450” corada com pigmento específico (Globo S/A Tintas e Pigmentos. O material foi fixado em solução de Formol tamponado a 10% por um período mínimo de 96h. Uma abertura central e de formato quadrangular foi feita na metade caudal do plastrão e casco, de forma a expor os ramos da artéria aorta que irrigam os rins e as gônadas. Observou-se que as artérias renais se originam da face ventral da artéria aorta dorsal, em número de dois pares para cada rim e, em um único exemplar, elas originaram uma artéria renal direita e duas esquerdas. A artéria gonadal surgiu a partir da artéria renal, e apenas um par penetrou pela face dorsal de cada gônada.This work was developed with the aim of enriching knowledge on the vascular morphology of renal and gonadal arteries of Podocnemisunifilis, thus increasing the understanding of the clinical and surgical physiology of these animals. Five Podocnemis unifilis males were used, collected according to license no. 066/2004-Ibama/RAM.The left carotid artery and right femoral vein were cannulated, and a serum solution was introduced to remove obstructions from the vascular system. A solution of Neoprene Latex “450” dye was injected. The material was fixed in a solution of 10% formaldehyde for a period of 96 hours. Next, a square-shaped central opening was made in the caudal end of the plastron and bridge, exposing the branches
A Snapshot of State Policies for Arts Education
Arts Education Partnership, 2014
2014-01-01
It has been said that while history shapes the hand a state is dealt, public policy determines how the hand is played. State policy for K-12 education--and, by extension, for arts education--is shaped through the actions of various state governmental entities--governors, legislatures, courts, and commissioners and boards of education--in response…
Sensors and Technologies in Spain: State-of-the-Art
Directory of Open Access Journals (Sweden)
Gonzalo Pajares
2014-08-01
Full Text Available The aim of this special issue was to provide a comprehensive view on the state-of-the-art sensor technology in Spain. Different problems cause the appearance and development of new sensor technologies and vice versa, the emergence of new sensors facilitates the solution of existing real problems. [...
State of the art Advanced Driver Assistance Systems (ADAS).
OEI, H.-L.
2017-01-01
An overview of state-of-the-art ADA Advanced Driver Assistance systems is given. First a main structuring system for the ADA systems is presented, needed for purposes of relevancy, and consistency : the three phases in the accident process, i.e. pre-crash, crash and post-crash; the driving task at
Analyst workbenches state of the art report
Rock-Evans, R
1987-01-01
Analyst Workbenches examines various aspects of analyst workbenches and the tasks and data that they should support. The major advances and state of the art in analyst workbenches are discussed. A comprehensive list of the available analyst workbenches, both the experimental and the commercial products, is provided. Comprised of three parts, this book begins by describing International Computers Ltd's approach to automating analysis and design. It then explains what business analysis really means, outlines the principal features of analyst workbenches, and considers the ways in which they can
Text Generation: The State of the Art and the Literature.
Mann, William C.; And Others
This report comprises two documents which describe the state of the art of computer generation of natural language text. Both were prepared by a panel of individuals who are active in research on text generation. The first document assesses the techniques now available for use in systems design, covering all of the technical methods by which…
Teacher Evaluation in the Arts Disciplines: Three State Perspectives
Gates, Karol; Hansen, Deb; Tuttle, Lynn
2015-01-01
The purpose of this report is to provide insight into how state departments are implementing legislative requirements for educator evaluation, particularly the specific circumstances states encounter around arts education. Spotlights on Delaware, a first-round recipient of Race to the Top funding, and Colorado and Arizona, third-round recipients,…
ANATOMIC VARIATIONS OF HEPATIC ARTERY: A STUDY IN 479 LIVER TRANSPLANTATIONS.
Fonseca-Neto, Olival Cirilo Lucena da; Lima, Heloise Caroline de Souza; Rabelo, Priscylla; Melo, Paulo Sérgio Vieira de; Amorim, Américo Gusmão; Lacerda, Cláudio Moura
2017-01-01
The incidence of anatomic variations of hepatic artery ranges from 20-50% in different series. Variations are especially important in the context of liver orthotopic transplantation, since, besides being an ideal opportunity for surgical anatomical study, their precise identification is crucial to the success of the procedure. To identify the anatomical variations in the hepatic arterial system in hepatic transplantation. 479 medical records of transplanted adult patients in the 13-year period were retrospectively analyzed, and collected data on hepatic arterial anatomy of the deceased donor. It was identified normal hepatic arterial anatomy in 416 donors (86.84%). The other 63 patients (13.15%) showed some variation. According to the Michels classification, the most frequently observed abnormalities were: right hepatic artery branch of superior mesenteric artery (Type III, n=27, 5.63%); left hepatic artery branch of the left gastric artery (Type II, n=13, 2.71%); right hepatic artery arising from the superior mesenteric artery associated with the left hepatic artery arising from the left gastric artery (Type IV, n=4, 0.83%). Similarly, in relation to Hiatt classification, the most prevalent changes were: right hepatic accessory artery or substitute of the superior mesenteric artery (Type III, n=28, 6.05%)), followed by liver ancillary left artery or replacement of gastric artery left (Type II, n=16, 3.34. Fourteen donors (2.92%) showed no anatomical abnormalities defined in classifications, the highest frequency being hepatomesenteric trunk identified in five (01.04%). Detailed knowledge of the variations of hepatic arterial anatomy is of utmost importance to surgeons who perform approaches in this area, particularly in liver transplantation, since their identification and proper management are critical to the success of the procedure. A incidência das variações anatômicas da artéria hepática varia de 20-50% em diferentes casuísticas. Elas s
PARA'04, State-of-the-art in scientific computing
DEFF Research Database (Denmark)
Madsen, Kaj; Wasniewski, Jerzy
This meeting in the series, the PARA'04 Workshop with the title ``State of the Art in Scientific Computing'', was held in Lyngby, Denmark, June 20-23, 2004. The PARA'04 Workshop was organized by Jack Dongarra from the University of Tennessee and Oak Ridge National Laboratory, and Kaj Madsen and J...
The Brazilian state-of-the-art of hydrolysis; Estado da arte da hidrolise no Brasil
Energy Technology Data Exchange (ETDEWEB)
Carioca, Jose Osvaldo Beserra; Paula, Haroldo Cesar Beserra de; Lal Arora, Harbans; Selvam, P.V. Pannir [Nucleo de Fontes Nao-Convencionais de Energia, Fortaleza, CE, (Brazil)
1988-12-31
This paper presents a study of the state-of-the-art of technologies developed for acid and enzymatic hydrolysis of lignin and cellulose materials in Brazil. The information collected leads us to conclude that Brazil has achieved a high level of technological development. However, the industrial projects for production of alcohol from cassava have not proved successful due mainly to lack of agricultural experience and its low productivity. (author) 26 refs., 13 figs., 2 tabs.
State of the art of solid state dosimetry; Estado da arte em dosimetria do estado solido
Energy Technology Data Exchange (ETDEWEB)
Souza, Susana O., E-mail: sosouza@ufs.br [Universidade Federal de Sergipe (UFS), Sao Cristovao, SE (Brazil); Yamamoto, Takayoshi [Radioisotope Research Center, Osaka University (Japan); D' Errico, Francesco, E-mail: francesco.derrico@yale.edu [Yale University, School of Medicine, CT (United States)
2014-07-01
Passive solid-state detectors still dominate the personal dosimetry field. This article provides state of the art in this field and summarizes the most recent works presented on TL, OSL and RPL during the 17th International Conference on Solid State Dosimetry held in Recife in September 2013. The Article contains in particular the techniques Thermoluminescence (TL), Optically Stimulated Luminescence (OSL), radio photoluminescence (RPL). Thermoluminescence has the biggest advantage of the wide availability of commercial materials for dosimetry, and the nature tissue-equivalent of several of these materials. The limitation of the TL dosimetry presents fading luminance signal and the need for high temperatures to obtain the signal. The Optically Stimulated Luminescence has the advantages of high sensitivity, the possibility of multiple reading, while its limit is the need to use response compensating filters in addition to the high cost of equipment and dosimeters still restricted very few options trading . The radio photoluminescence has a reading that is completely non-destructive, but their dosimeters present lack of tissue-equivalent and a high cost. Presents the details of the techniques and the advantages and limitations of each of these will be discussed.
International Nuclear Information System (INIS)
Paetzel, C.; Zorger, N.; Bachthaler, M.; Voelk, M.; Seitz, J.; Herold, T.; Feuerbach, S.; Lenhart, M.; Nitz, W.R.
2004-01-01
Purpose: To show the feasibility of magnetic resonance (MR) for guided interventional therapy of femoral and popliteal artery stenoses with commercially available materials supported by MR real-time imaging and intraarterial MR angiography. Materials and Methods: Three patients (1 female, 2 male), suffering from symptomatic arterial occlusive disease with stenoses of the femoral (n=2) or popliteal (n=1) arteries were included. Intraarterial digital subtraction angiography was performed in each patient pre- and post-interventionally as standard of reference to quantify stenoses. The degree of the stenoses reached from 71-88%. The MR images were acquired on a 1.5 T MR scanner (Magnetom Sonata; Siemens, Erlangen, Germany). For MR-angiography, a Flash 3D sequence was utilized following injection of 5 mL diluted gadodiamide (Omniscan; Amersham Buchler, Braunschweig, Germany) via the arterial access. Two maximum intensity projections (MIP) were used as road maps and localizer for the interactive positioning of a continuously running 2D-FLASH sequence with a temporal solution of 2 images per second. During the intervention, an MR compatible monitor provided the image display inside the scanner room. Safety guidelines were followed during imaging in the presence of a conductive guidewire. The lesion was crossed by a commercially available balloon catheter (Wanda, Boston Scientific; Ratingen, Germany), which was mounted on a 0.035'' guidewire (Terumo; Leuven, Belgium). The visibility was provided by radiopaque markers embedded in the balloon and was improved by injection of 1 mL gadodiamide into the balloon. After dilation, the result was checked by intraarterial MR angiography and catheter angiography. Results: The stenoses could be correctly localized by intraarterial MR angiography. There was complete correlation between intraarterial MR angiography and digital subtraction angiography. The combination of guidewire and balloon was visible and the balloon was placed
Kwun, Sunna; Tucci, Joseph R
2013-01-01
To present a case of Paget's disease of bone that was unmasked after vascular reperfusion. In this case study, we review the presentation, evaluation, diagnosis, and management of a patient with Paget's disease and peripheral vascular disease. A 79-year-old-woman with a history of coronary artery heart disease and recent finding of a T5 compression fracture was hospitalized for evaluation of right lower extremity claudication. Angiography demonstrated a focal complete occlusion of the distal right femoral and popliteal arteries. A self-expanding stent was placed in the distal femoral and popliteal arteries. Approximately 48 hours after the procedure, the patient developed severe, right lower leg pain. On endocrine evaluation, the patient was found to have clinical signs suggesting Paget's disease of bone, which was subsequently confirmed by imaging. This patient's development of severe pain following reperfusion of distal femoral and popliteal arteries is in keeping with the known and aforementioned hypervascularity of pagetic bone. The finding of increased warmth over an area of skeletal deformation should always raise the possibility of Paget's disease of bone.
Supplier selection problem: A state-of-the-art review
Directory of Open Access Journals (Sweden)
Nilesh R. Ware
2012-08-01
Full Text Available In the global competitiveness and growing market environment, “Actual competition is not between firms against firm, than supplier against supplier”. Globally in the fastest market development world gets closer and closer. Consumers prefer fast delivery, economical product, excellent service and high quality product with desired service level. For successful management of this supply chain, supplier considered as the base source for all processes. Therefore, an efficient supplier selection and evaluation process needs to be incorporate. The main purpose of this paper is to provide an extensive state-of-the-art literature review and critique of the studies related to various aspects of supplier selection problem over the past two decades. Research papers appearing in the reputed and leading international journals from 1991 to 2011 are gathered and analyzed. Primary focus is given on more than 200 published and unpublished works. It has been referred extensively to carry out state-of-the-art review for supplier selection problem. Finally, paper provides future perspective based on current research trends available in the published literature.
Vasquez, Elisardo C; Gava, Agata L; Graceli, Jones B; Balarini, Camille M; Campagnaro, Bianca P; Pereira, Thiago Melo C; Meyrelles, Silvana S
2016-01-01
The usefulness of selective inhibitors of phosphodiesterase 5 (PDE5) is well known, first for the treatment of male erectile dysfunction and more recently for pulmonary hypertension. The discovery that PDE5 is present in the systemic artery endothelium and smooth muscle cells led investigators to test the extra sexual effects of sildenafil, the first and most investigated PDE5 inhibitor, in diseases affecting the systemic arteries. Cumulative data from experimental and clinical studies have revealed beneficial effects of sildenafil on systemic arterial hypertension and its target organs, such as the heart, kidneys and vasculature. An important effect of sildenafil is reduction of hypertension and improvement of endothelial function in experimental models of hypertension and hypertensive subjects. Interestingly, in angiotensin-dependent hypertension, its beneficial effects on endothelial and kidney dysfunctions seem to at least in part be caused by its ability to decrease the levels of angiotensin II and increase angiotensin 1-7, in addition to improving nitric oxide bioavailability and diminishing reactive oxygen species. Another remarkable finding on the effects of sildenafil comes from studies in apolipoprotein E knockout mice, a model of atherosclerosis that closely resembles human atherosclerotic disease. In this review, we focus on the promising beneficial effects of sildenafil for treating systemic high blood pressure, especially resistant hypertension, and the endothelial dysfunction that is present in hypertension and atherosclerosis.
Some Aspects of the State-of-the-Arts in Biomedical Science ...
African Journals Online (AJOL)
Summary: In the biomedical sciences, there is need to generate solutions for Africa's health and economic problems through the impact of university research. To guide organizational transformation, the author here presents some aspects of the state-of-the-arts of biomedical science research in advanced countries using a ...
State-of-the-Art in Open Courseware Initiatives Worldwide
Vladoiu, Monica
2011-01-01
We survey here the state-of-the-art in open courseware initiatives worldwide. First, the MIT OpenCourseWare project is overviewed, as it has been the real starting point of the OCW movement. Usually, open courseware refers to a free and open digital publication of high quality university level educational materials that are organized as courses,…
CMOS image sensors: State-of-the-art
Theuwissen, Albert J. P.
2008-09-01
This paper gives an overview of the state-of-the-art of CMOS image sensors. The main focus is put on the shrinkage of the pixels : what is the effect on the performance characteristics of the imagers and on the various physical parameters of the camera ? How is the CMOS pixel architecture optimized to cope with the negative performance effects of the ever-shrinking pixel size ? On the other hand, the smaller dimensions in CMOS technology allow further integration on column level and even on pixel level. This will make CMOS imagers even smarter that they are already.
State of the art: two-phase flow calibration techniques
International Nuclear Information System (INIS)
Stanley, M.L.
1977-01-01
The nuclear community faces a particularly difficult problem relating to the calibration of instrumentation in a two-phase flow steam/water environment. The rationale of the approach to water reactor safety questions in the United States demands that accurate measurements of mass flows in a decompressing two-phase flow be made. An accurate measurement dictates an accurate calibration. This paper addresses three questions relating to the state of the art in two-phase calibration: (1) What do we mean by calibration. (2) What is done now. (3) What should be done
State-of-the-art Versus Time-triggered Object Tracking in Advanced Driver Assistance Systems
Directory of Open Access Journals (Sweden)
Moritz Koplin
2013-04-01
Full Text Available Most state-of-the-art driver assistance systems cannot guarantee that real-time images of object states are updated within a given time interval, because the object state observations are typically sampled by uncontrolled sensors and transmitted via an indeterministic bus system such as CAN. To overcome this shortcoming, a paradigm shift toward time-triggered advanced driver assistance systems based on a deterministic bus system, such as FlexRay, is under discussion. In order to prove the feasibility of this paradigm shift, this paper develops different models of a state-of-the-art and a time-triggered advanced driver assistance system based on multi-sensor object tracking and compares them with regard to their mean performance. The results show that while the state-of-the-art model is advantageous in scenarios with low process noise, it is outmatched by the time-triggered model in the case of high process noise, i.e., in complex situations with high dynamic.
State-of-the-art report on the theoretical modeling of interfacial area concentration
International Nuclear Information System (INIS)
Lee, Won Jae; Euh, Dong Jin
1998-03-01
Classical approaches based on experimental correlations and the mechanistic approaches based on the interfacial area concentration were reviewed. The study focuses on the state-of-the-art researches based on the mechanistic modeling of the interfacial area concentration. The investigation is performed by classifying the mechanistic modeling approaches into those using the number density transport equations supported with a simple algebraic relation for obtaining interfacial area concentration and those using the direct interfacial area transport equations. The modeling approaches are subdivided into one group and multi-group models. The state-of-the-art source terms of transport equations are also investigated for their applicability and limitations. (author). 62 refs., 6 tabs., 49 figs
Directory of Open Access Journals (Sweden)
Mário de Souza Lima-e-Silva
2007-07-01
Full Text Available The Cebus monkey displays a high capacity for adaptation to urbanenvironments, and its high level of encephalization has generated great interest by scientific community to study it. The study of the vascularization of the arm of Cebus is important because of its arboreal habits. Twenty-four animals donated by Ibama (Brazilian Institute for the Environment and Renewable Natural Resources from the city of Sete Lagoas, Minas Gerais State, Brazil, and housed in the anatomy collections of the Federal University of Uberlândia (UFU and the Federal University of Goiás (UFG were used. The arterialsystem of these animals was injected with coloring latex, after which the arteries were dissected using stereoscopic microscope or the naked eye. In general terms, the findings on the brachial vessels of the Cebus monkey are identical to those found in humans and inother primates. In specific terms, the most outstanding variation was the small size or the absence of the brachial artery in Cebus. The arterial model of Cebus corroborates its arboreal behavior and constant use of its thoracic limbs.O macaco Cebus possui alta capacidade de adaptação em ambientes urbanos e o seu elevado índice de encefalização tem gerado grande interesse por parte da comunidade científica em estudá-lo. A importância do estudo da vascularização do braço desses animais éem virtude do seu hábito arbóreo. Foram usados 24 animais doados pelo Instituto Brasileiro do Meio Ambiente (Ibama de Sete Lagoas, Estado de Minas Gerais, Brasil, depositados nas coleções anatômicas da Universidade Federal de Uberlândia (UFU e Universidade Federal de Goiás (UFG. O sistema arterial dos espécimes foi injetado com látex corado e, posteriormente, as artérias foram dissecadas com o auxílio de microscópico estereoscópico ou a olhos desarmados. Em termos gerais, os achados em Cebus acerca de vasos braquiais são idênticos aos encontrados em humanos e outros primatas. Em termos
Orphan diseases: state of the drug discovery art.
Volmar, Claude-Henry; Wahlestedt, Claes; Brothers, Shaun P
2017-06-01
Since 1983 more than 300 drugs have been developed and approved for orphan diseases. However, considering the development of novel diagnosis tools, the number of rare diseases vastly outpaces therapeutic discovery. Academic centers and nonprofit institutes are now at the forefront of rare disease R&D, partnering with pharmaceutical companies when academic researchers discover novel drugs or targets for specific diseases, thus reducing the failure risk and cost for pharmaceutical companies. Considerable progress has occurred in the art of orphan drug discovery, and a symbiotic relationship now exists between pharmaceutical industry, academia, and philanthropists that provides a useful framework for orphan disease therapeutic discovery. Here, the current state-of-the-art of drug discovery for orphan diseases is reviewed. Current technological approaches and challenges for drug discovery are considered, some of which can present somewhat unique challenges and opportunities in orphan diseases, including the potential for personalized medicine, gene therapy, and phenotypic screening.
State of the art on the probabilistic safety assessment (P.S.A.)
International Nuclear Information System (INIS)
Devictor, N.; Bassi, A.; Saignes, P.; Bertrand, F.
2008-01-01
The use of Probabilistic Safety Assessment (PSA) is internationally increasing as a means of assessing and improving the safety of nuclear and non-nuclear facilities. To support the development of a competence on Probabilistic Safety Assessment, a set of states of the art regarding these tools and their use has been made between 2001 and 2005, in particular on the following topics: - Definition of the PSA of level 1, 2 and 3; - Use of PSA in support to design and operation of nuclear plants (risk-informed applications); - Applications to Non Reactor Nuclear Facilities. The report compiled in a single document these states of the art in order to ensure a broader use; this work has been done in the frame of the Project 'Reliability and Safety of Nuclear Facility' of the Nuclear Development and Innovation Division of the Nuclear Energy Division. As some of these states of the art have been made in support to exchanges with international partners and were written in English, a section of this document is written in English. This work is now applied concretely in support to the design of 4. Generation nuclear systems as Sodium-cooled Fast Reactors and especially Gas-cooled Fast Reactor, that have been the subject of communications during the conferences ANS (Annual Meeting 2007), PSA'08, ICCAP'08 and in the journal Science and Technology of Nuclear Installations. (authors)
Directory of Open Access Journals (Sweden)
Jussara Rocha Ferreira
2001-05-01
Full Text Available Arteries of the encephalon basis of 30 monkeys (Cebus paella were studied. Arteries were injected with colored latex, fixed in formaldehyde solution at 10% and dissected under magnifying lenses. Since the animals died from natural causes they had been previously used in other experiments. Human and veterinary anatomical terminology and literature were used as a reference for the determination of vessels studied in the primates. Arteries of the encephalon base represent division branches of three vascular pedicules: the right and left internal carotid arteries and the basilar system. Vessels in the basilar system of the animal were called vertebral arteries; anterior spinal artery; anterior and posterior cerebelar arteries; pontine arteries; satellite cerebelar arteries; caudal and cranial cerebelar arteries. The basilar artery bifurcates into two posterior cerebral arteries (100%. The caudal area of the encephalon’s arterial circuit is thus constituted. Linking between the vertebro-basilar and the carotid segments is done by the posterior communicating artery, that caudally anastomizes (100% with the posterior cerebral artery. The internal carotid artery gives origin to the posterior communicating artery. The right and left internal carotid artery (intracranial portion compounds the carotid system. The following vessels were identified: middle cerebral artery; anterior cerebral artery; interhemispheric artery; olfactory arteries. Results report that Cebus paella presents an arterial pattern of relative morphological stabilityEstudaram-se as artérias da base do encéfalo do Cebus apella em 30 animais, vindos a óbito por morte natural no Zoológico de São Paulo e coletados durante 10 anos. O material recebeu injeção de látex corado, fixado em formol a 10%, e foi dissecado sob lupa. Encontramos dificuldade e denominar estes vasos. As terminologias anatômicas humana e veterinária e a recuperação da literatura nos serviram de base para
International Nuclear Information System (INIS)
Bourgois, J.; Vaillant, Herve; Moszkowicz, P.; Alimi Ichola, Ibrahim; Foret, Suzanne
1997-02-01
Industrial companies use and produce numerous substances which can induce a pollution of our environment and especially of soil and groundwater. Thus, it's necessary to estimate the risk of an environmental impact from an accidental or chronic, real or potential pollution. Modelling, which allow the simulation of pollutant migration, can be used as a decision support system, either for the pollution control and prevention of the resource, or for the monitoring of the remediation of polluted sites. In the first part of this study, we established a state of the art on modelling of pollutant migration in soils. In the second part, we focused on the main simulation tools currently available on the market, and on the main agencies or laboratories working on this subject, especially in France. At the end of this study, we drew some conclusions concerning modelling of pollutant migration in soils and the main points which will form the subject of further studies: - sensitivity analysis of model to input parameters and ranking of the main parameters, - achievement of a database on the state of the art of the results on modelling realized on case studies, - development of a mobility indicator of pollutant in soil, - application field and relevance of the models. (authors)
Digital astrophotography the state of the art
Ratledge, David
2005-01-01
The CCD (Charge-Coupled Device) has revolutionised optical astronomy during the past 20 years, and specialised astronomical CCD cameras are now even more affordable, colour is standard, and they provide spectacular results. "Digital Astrophotography: The State of the Art", provides some examples of the best images, and gives readers hints and tips about how to get the best out of this extraordinary technology. Experts in CCD astronomy from North America and Europe have contributed to this book, illustrating their help and advice with many beautiful colour images - the book is in full colour throughout. Techniques range from using simple webcams to highly technical aspects such as supernovae patrolling. Computer processing, stacking and image-enhancement are detailed, along with many hints and tips from the experts.
Augmented Reality and Mobile Learning: The State of the Art
FitzGerald, Elizabeth; Ferguson, Rebecca; Adams, Anne; Gaved, Mark; Mor, Yishay; Thomas, Rhodri
2013-01-01
In this paper, the authors examine the state of the art in augmented reality (AR) for mobile learning. Previous work in the field of mobile learning has included AR as a component of a wider toolkit but little has been done to discuss the phenomenon in detail or to examine in a balanced fashion its potential for learning, identifying both positive…
Electron beam melting state-of-the-art 1984
International Nuclear Information System (INIS)
Bakish, R.
1984-01-01
In 1984 electron beam melting and refining appear poised for an important new growth phase. The driving force for this phase is improved production economics made possible by technological advances. There is also a new and exciting growth application for electron beam melting: its use for surface properties beneficiation. This article is based in part on the content of the Conference on Electron Beam Melting and Refining, The State-of-the-Art 1983, held in November 1983 in Reno, Nevada
Directory of Open Access Journals (Sweden)
Silvio Romero de Barros Marques
2006-03-01
Full Text Available Neste artigo, faz-se o relato de um caso de aneurisma verdadeiro bilateral da artéria tibial posterior em paciente de 57 anos. Os aneurismas surgiram em épocas diferentes. Os aspectos clínicos, diagnósticos e terapêuticos deste caso são discutidos. Este relato é importante, pois os autores não têm conhecimento de caso semelhante na literatura consultada.This article reports a case of true bilateral aneurysm of the tibial posterior artery in a 57 year-old patient. The aneurysms occurred at different times. The clinical, diagnostic and therapeutic aspects of this case are discussed. This report is important because the authors did not find a similar description in the literature.
Digital Breast Tomosynthesis: State of the Art
Vedantham, Srinivasan; Vijayaraghavan, Gopal R.; Kopans, Daniel B.
2015-01-01
This topical review on digital breast tomosynthesis (DBT) is provided with the intent of describing the state of the art in terms of technology, results from recent clinical studies, advanced applications, and ongoing efforts to develop multimodality imaging systems that include DBT. Particular emphasis is placed on clinical studies. The observations of increase in cancer detection rates, particularly for invasive cancers, and the reduction in false-positive rates with DBT in prospective trials indicate its benefit for breast cancer screening. Retrospective multireader multicase studies show either noninferiority or superiority of DBT compared with mammography. Methods to curtail radiation dose are of importance. © RSNA, 2015 PMID:26599926
Hassan, Ali H M; Ako, Junya; Waseda, Katsuhisa; Honda, Yasuhiro; Zeller, Thomas; Leon, Martin B; Fitzgerald, Peter J
2010-01-01
The purpose of this study was to evaluate the mechanism of luminal gain with a novel atheroablation system (Pathway PV) for the treatment of peripheral artery disease using intravascular ultrasound (IVUS). The atherectomy system is a rotational atherectomy device, which employs expandable rotating blades with ports that allow flushing and aspiration of the plaque material or thrombus. In this first-in-man clinical study, IVUS analysis was available in 6 patients with lower limb ischemia treated with this device. The treatment results were assessed using IVUS at pre and post atherectomy. Lumen beyond burr size (LBB) was defined as lumen gain divided by the estimated burr area determined by the burr-size. IVUS analysis was available in six patients (superficial femoral artery n=3, popliteal artery n=2, posterior tibial artery n=1). Atheroablation achieved a significant increase in lumen area (LA) (preintervention 3.9+/-0.4, postatheroablation 8.0+/-1.7 mm(2), Patherectomy device achieved significant luminal gain by debulking in the absence of vessel stretching. The LA was greater than burr-sized lumen expectancy at cross-sections along the treated segments, suggesting a complimentary role of aspiration in luminal gain in atherosclerotic peripheral artery lesions.
State of the art-hydraulic yaw systems for wind turbines
DEFF Research Database (Denmark)
Stubkier, Søren; Pedersen, Henrik C.; Andersen, Torben Ole
2011-01-01
This paper addresses the yawing systems of Horizontal Axis Wind Turbines (HAWT’s). HAWT’s represents close to all of the commercial large wind turbines sold today and must be considered state-of-the art within wind turbine technology. Two choices exists when considering components for the active ...
Intracytoplasmic sperm injection: state of the art in humans.
Palermo, G D; O'Neill, C L; Chow, S; Cheung, S; Parrella, A; Pereira, N; Rosenwaks, Z
2017-12-01
Among infertile couples, 25% involve both male and female factors, while male factor alone accounts for another 25% due to oligo-, astheno-, teratozoospermia, a combination of the three, or even a complete absence of sperm cells in the ejaculate and can lead to a poor prognosis even with the help of assisted reproductive technology (ART). Intracytoplasmic sperm injection (ICSI) has been with us now for a quarter of a century and in spite of the controversy generated since its inception, it remains in the forefront of the techniques utilized in ART. The development of ICSI in 1992 has drastically decreased the impact of male factor, resulting in millions of pregnancies worldwide for couples who, without ICSI, would have had little chance of having their own biological child. This review focuses on the state of the art of ICSI regarding utility of bioassays that evaluate male factor infertility beyond the standard semen analysis and describes the current application and advances in regard to ICSI, particularly the genetic and epigenetic characteristics of spermatozoa and their impact on reproductive outcome. © 2017 Society for Reproduction and Fertility.
Thomas, Kate N; van Rij, André M; Lucas, Samuel J E; Cotter, James D
2017-03-01
Passive heat induces beneficial perfusion profiles, provides substantive cardiovascular strain, and reduces blood pressure, thereby holding potential for healthy and cardiovascular disease populations. The aim of this study was to assess acute responses to passive heat via lower-limb, hot-water immersion in patients with peripheral arterial disease (PAD) and healthy, elderly controls. Eleven patients with PAD (age 71 ± 6 yr, 7 male, 4 female) and 10 controls (age 72 ± 7 yr, 8 male, 2 female) underwent hot-water immersion (30-min waist-level immersion in 42.1 ± 0.6°C water). Before, during, and following immersion, brachial and popliteal artery diameter, blood flow, and shear stress were assessed using duplex ultrasound. Lower-limb perfusion was measured also using venous occlusion plethysmography and near-infrared spectroscopy. During immersion, shear rate increased ( P Lower-limb blood flow increased significantly in both groups, as measured from duplex ultrasound (>200%), plethysmography (>100%), and spectroscopy, while central and peripheral pulse-wave velocity decreased in both groups. Mean arterial blood pressure was reduced by 22 ± 9 mmHg (main effect P lower 3 h afterward. In PAD, popliteal shear profiles and claudication both compared favorably with those measured immediately following symptom-limited walking. A 30-min hot-water immersion is a practical means of delivering heat therapy to PAD patients and healthy, elderly individuals to induce appreciable systemic (chronotropic and blood pressure lowering) and hemodynamic (upper and lower-limb perfusion and shear rate increases) responses. Copyright © 2017 the American Physiological Society.
Martin, Catherine; Naidoo, Nicolette P; Venter, W D Francois; Jaffer, Ambereen; Barker, Pierre M
2014-05-12
Target setting is useful in planning, assessing and improving antiretroviral treatment (ART) programmes. In the past 4 years, the ART initiation environment has been transformed due to the change in eligibility criteria (starting ART at a CD4+ count ART. To describe and illustrate the use of a target-setting model for estimating district-based targets in the era of an expanding ART programme and changing CD4+ count thresholds for ART initiation. Using previously described models and data for annual new HIV infections, we estimated both steady-state need for ART initiation and backlog in a North West Province district, accounting for the shift in eligibility. Comparison of actual v. targeted ART initiations was undertaken. The change in CD4+ count threshold adds a once-off group of newly eligible patients to the pool requiring ART - the backlog. The steady-state remains unchanged as it is determined by the annual rate of new HIV infections in previous years. The steady-state need for the district was 639 initiations/month, and the backlog was ~15,388 patients. After the shift in eligibility in September 2011, the steady-state target was exceeded over several months with some backlog addressed. Of the total backlog for this district, 72% remains to be cleared. South Africa has two pools of patients who need ART: the steady-state of HIV-infected patients entering the programme each year, determined by historical infection rates; and the backlog created by the shift in eligibility. The healthcare system needs to build long- term capacity to meet the steady-state need for ART and additional capacity to address the backlog.
Directory of Open Access Journals (Sweden)
Thejodhar Pulakunta
2007-09-01
Full Text Available BACKGROUND: Considering the paucity of information presently available concerning inferior phrenic arteries, a more definitive study seemed appropriate and necessary, both for its potential clinical applications and to provide additional data to contemporary anatomical literature. OBJECTIVE: Most anatomical textbooks of gross anatomy offer very little information concerning the anatomy and distribution of the inferior phrenic artery (IPA. For that reason, the origin of the IPA has been studied and the available literature has been reviewed. METHODS: Thirty-two human adult cadavers preserved in formalin obtained from the departments of Anatomy, Kasturba Medical College, Manipal and Mangalore were dissected and the origin of the IPA was studied. RESULTS: The IPA had its usual origin from the abdominal aorta in 28 cases but in the remaining four cases, two were arising from the celiac trunk, one from the left gastric artery and one from the right renal artery. CONCLUSION: The IPA usually originates from the aorta or celiac artery, and less frequently from the renal, hepatic or left gastric arteries. The IPA is a major source of collateral or parasitized arterial supply to hepatocellular carcinoma, second only to the hepatic artery. Literature on the IPA origin and clinical implications of variation in its origin have been reviewed in this article.CONTEXTO: Considerando a escassez de informações atualmente disponíveis sobre artérias frênicas inferiores, umestudo mais definitivo nos pareceu apropriado e necessário, tanto por suas potenciais aplicações clínicas quanto para fornecer dados adicionais à literatura anatômica contemporânea. OBJETIVO: A maioria dos livros-texto de anatomia oferece muito poucas informações referentes à anatomia e distribuição da artéria frênica inferior (AFI. Por este motivo, a origem da AFI foi investigada e a literatura disponível foi revisada. MÉTODOS: Trinta e dois cadáveres humanos adultos
PRA: an evaluation of state-of-the-art
International Nuclear Information System (INIS)
Joksimovich, V.
1985-01-01
Some elements of the probabilistic risk assessment (PRA) methodology can be characterized as mature and are even ready for some kind of a standardization effort. Other elements are still, however, in a rapid state of evolution. Questions are continuously being asked regarding maturity of PRA techniques vis-a-vis a regulatory decision-making process. Establishing a framework for evaluating state-of-the-art in any technological field is a challenging task. An implementation of a selected framework to a satisfactory conclusion is a monumental task. Of course, these types of issues can be discussed meaningfully only if they are tied to a particular application. The author's participation in the NSF-sponsored risk assessment project is discussed in the paper. The evaluation employed here makes use of the following five evaluation criteria: logical soundness, completeness, accuracy, acceptability, and practicality
Mechanical Ventilation: State of the Art.
Pham, Tài; Brochard, Laurent J; Slutsky, Arthur S
2017-09-01
Mechanical ventilation is the most used short-term life support technique worldwide and is applied daily for a diverse spectrum of indications, from scheduled surgical procedures to acute organ failure. This state-of-the-art review provides an update on the basic physiology of respiratory mechanics, the working principles, and the main ventilatory settings, as well as the potential complications of mechanical ventilation. Specific ventilatory approaches in particular situations such as acute respiratory distress syndrome and chronic obstructive pulmonary disease are detailed along with protective ventilation in patients with normal lungs. We also highlight recent data on patient-ventilator dyssynchrony, humidified high-flow oxygen through nasal cannula, extracorporeal life support, and the weaning phase. Finally, we discuss the future of mechanical ventilation, addressing avenues for improvement. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
Directory of Open Access Journals (Sweden)
Murilo S. Meneses
1997-01-01
Full Text Available In the surgical management of skull base lesions and vascular diseases such as giant aneurysms, involvement of the internal carotid artery may require the resection or the occlusion of the vessel. The anastomosis of the external carotid artery and the middle cerebral artery with venous graft may be indicated to re-establish the blood flow. To determine the best suture site in the middle cerebral artery, an anatomical study was carried out. Fourteen cerebral hemispheres were analysed after the injection of red latex into the internal carotid artery. The superior and inferior trunk of the main division of the middle cerebral artery have more than 2 mm of diameter. They are superficial allowing an anastomosis using a venous graft. The superior trunk has a disadvantage, it gives rise to branches for the precentral and post-central giri. The anastomosis with the inferior trunk presents lower risk of neurological deficit even though the angular artery originates from it.No tratamento cirúrgico das lesões da base do crânio e patologias vasculares como aneurismas gigantes, a ressecção ou oclusão da artéria carótida interna pode ser necessária. A anastomose das artérias carótida externa e cerebral média com interposição de enxerto venoso pode ser utilizada para restabelecer o fluxo sangüíneo. Para determinar o melhor local de sutura na artéria cerebral média, realizou-se um estudo anatômico. Quatorze hemisférios cerebrais foram analisados depois da injeção de látex vermelho na artéria carótida interna. Os ramos superior e inferior da divisão principal da artéria cerebral média têm mais de 2 mm de diâmetro. Eles são superficiais e permitem uma anastomose utilizando um enxerto venoso. O tronco superior tem a desvantagem de dar origem aos ramos para os giros pré e pós-centrais. A anastomose com o tronca inferior apresenta menor risco de déficit neurológico, apesar da artéria angular ter origem desse vaso.
Mining Tacitus: secrets of empire, nature and art in the reason of state.
Keller, Vera
2012-06-01
A new political practice, the 'reason of state', informed the ends and practices of natural study in the late sixteenth century. Informed by the study of the Roman historian Tacitus, political writers gathered 'secrets of empire' from both history and travel. Following the economic reorientation of 'reason of state' by Giovanni Botero (1544-1617), such secrets came to include bodies of useful particulars concerning nature and art collected by an expanding personnel of intelligencers. A comparison between various writers describing wide-scale collections, such as Botero, Francis Bacon (1561-1626), Jakob Bornitz (1560-1625) and Matthias Bernegger (1582-1640), reveals that seventeenth-century natural intelligencers across Europe not only were analogous to political intelligencers, but also were sometimes one and the same. Those seeking political prudence cast themselves as miners, prying precious particulars from the recesses of history, experience and disparate disciplines, including mathematics, alchemy and natural philosophy. The seventeenth-century practice of combining searches for secrets of empire, nature and art contests a frequent historiographical divide between empirical science and Tacitism or reason of state. It also points to the ways political cunning shaped the management of information for both politics and the study of nature and art.
Lyon, Matthew; Johnson, Daniel; Gordon, Richard
2015-01-01
Penetrating injuries of the proximal large arteries are a common cause of death on the battlefield due to rapid exsanguination. Applying an effective tourniquet to stop bleeding at the axillary and proximal femoral arteries (junctional sites) is difficult. Prior studies have shown that the Abdominal Aortic and Junctional Tourniquet (AAJT) effectively reduced blood flow in the common femoral artery with application of the device around the lower abdomen. Our objective was to determine the effectiveness of the AAJT to stop blood flow in the proximal femoral artery (PFA), and the axillary artery (AA). This was a prospective observational trial using human volunteers. The AAJT consists of a wedge-shaped bladder and integrated strap. The bladder has an integrated manometer, which is used to measure the pressure in the bladder. For the AA, the AAJT was placed over the axillary junction at the anterior axillary line with the strap placed across the contralateral shoulder. For the PFA, the AAJT bladder was placed over the right groin with the strap positioned across both femoral trochanters. Spectral Doppler measurements were taken of the PFA and AA at baseline and as the bladder was inflated. Collected data included pressure of the AAJT.
State of art of nuclear telerobots
Energy Technology Data Exchange (ETDEWEB)
Yoon, Ji Sup; Oh, S C; Park, Y S; Kim, K S
1997-03-01
A state-of-the-art survey on telerobotics technology for nuclear applications is made with view to provide technical data base to interested users. Most of the information are gathered from G7 countries with some addition of Korean status of development. Although the bulk of information is focussed on mobile robots, graphic simulation for man-machine interface is also included in the survey. Examples of telerobotics application to nuclear work are investigated. (author). 108 refs., 9 tabs., 64 figs
Thermoluminescence dosimetry: State-of-the-art and frontiers of future research
International Nuclear Information System (INIS)
Horowitz, Y.S.
2014-01-01
The state-of-the-art in the use of thermoluminescence for the measurement of energy imparted by ionizing radiation is discussed. Emphasis is on the advantages obtainable by the use of computerized glow curve analysis in (i) quality control, (ii) low dose environmental dosimetry, (iii) medical applications (especially precision) and microdosimetric applications, and (iv) mixed field ionization-density–dosimetry. Possible frontiers of future research are highlighted: (i) vector representation in glow curve analysis, (ii) combined OSL/TL measurements, (iii) detection of sub-ionization electrons, (iv) requirements for new TL materials and (v) theoretical subjects involving kinetic modeling invoking localized/delocalized recombination applied to dose response and track structure theory including creation of defects. - Highlights:: • State of the art in thermoluminescence dosimetry. • Benefits of computerized glow curve deconvolution. • Frontiers of future research:new materials, mixed-field dosimetry. • Localized/delocalized kinetic theory:ionization density dependence. • Kinetic theory:creation of defects:track structure theory
Energy Technology Data Exchange (ETDEWEB)
Schmidt, F.; Dinkel, H.P. [Institut fuer Diagnostische Radiologie, Inselspital, Universitaetsklinik Bern (Switzerland)
2002-07-01
Mycotic aneurysms of the aorta and the visceral arteries are life-threatening diseases, due to potential rupture and organ or limb ischemia. They occur in endocarditis, immunodeficiency, bacteremia and fungemia, and have a poor prognosis.We report on a case of a 54-year-old male patient suffering from abdominal angina after mitral valve replacement for septic mycotic endocarditis. In presence of a mycotic-embolic occlusion of the left popliteal artery and multiple septic organ infarctions a mycotic aneurysm of the superior mesenteric artery was found in abdominal spiral-CT.Based on sequential spiral-CT examinations, this case demonstrates the development of a septic aneurysm of the superior mesenteric artery. (orig.) [German] Mykotische Aneurysmen der Aorta und ihrer Aeste stellen wegen Rupturgefahr und moeglicher Minderperfusion von Organen und Extremitaeten eine lebensgefaehrliche Erkrankung mit unguenstiger Prognose dar. Beguenstigende Faktoren sind geschwaechte Immunabwehr, Endokarditis, Bakteriaemie und Fungaemie.Wir berichten ueber einen 54-jaehrigen Patienten, der nach einem Mitralklappenersatz bei mykotischer Endokarditis zunehmende abdominelle Beschwerden im Sinne einer Angina abdominalis entwickelte. Die abdominelle Spiralcomputertomographie zeigte ein mykotisches Aneurysma der A. mesenterica superior. Daneben bestanden ein mykotischer Verschluss der linken A. poplitea und multiple septische Organinfarkte.Der Fall demonstriert anhand sequentieller Computertomographien eindrucksvoll die Entwicklung eines septischen Viszeralarterienaneurysmas. (orig.)
State of the art on bioethanol production
International Nuclear Information System (INIS)
Barisano, D.; De Bari, I.; Viola, E.; Zimbardi, F.; Braccio, G.; Cantarella, M.; Gallifuoco, A.
2001-01-01
The state of the art, deals with the ethanol production from current processes based on the use of sugar and starch as feedstock and those under development based on lignocellulosic biomass. In the first section are reported the commercially available processes together with hints to the newest technologies. As regard the ethanol production from lignocellulosics, it has been collected data on the biomass availability in Europe as energy crops, industrial crops, agricultural residues and domestic waste. It is provided a bibliographic study on the technologies and processes under development worldwide for the conversion of lignocellulosics into ethanol. Finally, a brief discussion on the economics highlights the near term viability of producing ethanol by this way [it
State of the Art on Alternative Fuels in Aviation. Executive summary
Blakey, S.; Novelli, P.; Costes, P.; Bringtown, S.; Christensen, D.; Sakintuna, B.; Peineke, C.; Jongschaap, R.E.E.; Conijn, J.G.; Rutgers, B.; Valot, L.; Joubert, E.; Perelgritz, J.F.; Filogonio, A.; Roetger, T.; Prieur, A.; Starck, L.; Jeuland, N.; Bogers, P.; Midgley, R.; Bauldreay, J.; Rollin, G.; Rye, L.; Wilson, C.
2010-01-01
This paper summarises the findings from the SWAFEA preliminary state of the art study. It covers trends in aspects of future air transport, potential candidate fuels and associated feedstock along with sustainability and economical issues relevant for alternative fuels in aviation..
Cultivating Demand for the Arts: Arts Learning, Arts Engagement, and State Arts Policy
Zakaras, Laura; Lowell, Julia F.
2008-01-01
To shed light on the decline in demand for the nonprofit arts, the authors describe what it means to cultivate demand for the arts, examine how well U.S. institutions are serving this function, and discuss whether it is in the public interest to make such cultivation a higher priority than it has been in the past. The authors propose that a strong…
Analysis and simulation of emergency departments: state of the art and prospects
Vanbrabant, Lien; Braekers, Kris; Ramaekers, Katrien
2017-01-01
This abstract gives a brief overview of the state of the art on the analysis and simulation of emergency departments in hospitals. Based on this, research opportunities which will be addressed during my PhD are identified.
[Ultrastructure of the intima of human pial arteries in arterial hypertension].
Chertok, V M; Kotsiuba, A E; Babich, E V
2009-01-01
Ultrastructure of the intima of human pial arteries obtained from 5 male cadavers of practically healthy individuals and from 8 cadavers of the patients with the intravitally diagnosed grade I arterial hypertension (AH) was studied by scanning and transmission electron microscopy. AH was found to be associated with the remodeling of the intimal structural elements in the pial arteries. In most arteries, the changes were detected in the microrelief of the luminal surface and in the permeability of the vascular endothelial lining and of the subendothelial layer. During this remodeling, some endothelial cells were found in the state of structural and functional adaptation to the elevated arterial pressure, while the others were undergoing the dystrophic changes. The latter include the cells containing lipid inclusions, as well as the endothelial cells presumably in the state of apoptosis. The destruction of the intercellular junctions, the disturbances in the endothelium permeability contributed to the development of subendothelial layer edema, resulting in its significant thickening. This layer became looser and contained abundant collagen fibrils.
Performance Measurement in Belgian Hospitals : a state-of-the-art
Van Caillie, Didier; Rouhana, Rima; Santin, Sarah
2007-01-01
This communication proposes a global state-of-the-art around the central question : "How is performance measured and controlled in Belgian hospitals. As a first step in a global research project dedicated to the use of Balanced ScoreCard in publics hospitals around the world, it is essentially focused on global economic aspects and on major macroeconomic statistics.
Survey of the state of art in robotics and artificial intelligence, Volume 2
Energy Technology Data Exchange (ETDEWEB)
Thieme, G; Lux, P; Knappmann, R J; Schmidt, U
1981-07-01
This survey presents the state of the art in robotics and AI with emphasis on control and intelligence. It gives an introduction and summary description of robots and AI, identifies main application areas in space and benefits of the new technologies. Basic methods and concepts are illustrated. The state of the art, evolution trends and problem areas are described for industrial robots and space systems. Two reference missions are used to identify space opportunities. The potential application of existing know-how to space usage is identified. Recommendations for future research and development are given to overcome the problem areas. The survey comprises inventories of relevant publications, firms and institutions and know-how.
Directory of Open Access Journals (Sweden)
Luís Roberto Gerola
1993-12-01
angioplastia, 7 apresentaram infarto do miocárdio não fatal e 1 paciente foi reoperado por oclusão das duas artérias torácicas internas. Foram realizados 69 cateterismos pós-operatórios, sendo 38 imediatos e 31 tardios, num período que variou de 3 a 120 meses (média de 51,6 meses. No período pós-operatório imediato, ATIE estava pérvia em 37 casos (97% e a ATID em 36 (95%. No reestudo tardio, a ATIE estava pérvia em 30 pacientes (97% e a ATID em 29 (92,7%. A análise atuarial mostrou que a percentagem de casos que apresentavam a ATIE pérvia foi de 97,6% em 1 ano e de 93,8% aos 5-10 anos de seguimento, enquanto que a incidência de casos em que a ATID estava pérvia foi de 92,1% em 1 ano e de 84,1% em 5 e 10 anos. Os resultados apresentados mostram que a revascularização de ramos da artéria coronária esquerda com as ATI E e ATI D proporciona aos pacientes uma boa evolução tardia, em decorrência da baixa incidência de eventos cardíacos durante o período estudado. A alta incidência de enxertos pérvios em 10 anos, com a utilização da ATID posicionada através do seio transverso, sugere que esta opção técnica deve ser sempre lembrada na revascularização da artéria circunflexa e seus ramos.From April 1983 to November 1993,185 patients were submitted to myocardial revascularization using bilateral thoracic internal artery. The left internal thoracic artery was used to left anterior descending artery and the right internal thoracic artery was used through transversus sinus to circunflex artery and his branches. We performed 38 angiographic studies during the late follow-up and demonstrated that the right internal thoracic artery was patent in 29 patients (92.7% and the left internal thoracic artery in 30 (97%. We conclude that myocardial revascularyzation should be performed using bilateral internal thoracic artery routinely.
Elias, Merrill F; Torres, Rachael V; Davey, Adam
2018-02-22
Randomized controlled trials of blood pressure (BP) lowering and antihypertensive medication use on cognitive outcomes have often been disappointing, reporting mixed findings and small effect sizes. We evaluate the extent to which cognitive assessment protocols used in these trials approach state-of-the-art. Overall, we find that a primary focus on cognition and the systematic selection of cognitive outcomes across trials take a backseat to other trial goals. Twelve trials investigating change in cognitive functioning were examined and none met criteria for state-of-the-art assessment, including use of at least 4 tests indexing 2 cognitive domains. Four trials investigating incident dementia were also examined. Each trial used state-of-the-art diagnostic criteria to assess dementia, although follow-up periods were relatively short, with only 2 trials lasting for at least 3 years. Weaknesses in each trial may act to obscure or weaken the positive effects of BP lowering on cognitive functioning. Improving trial designs in terms of cognitive outcomes selected and length of follow-up periods employed could lead to more promising findings. We offer logical steps to achieve state-of-the-art assessment protocols, with examples, in hopes of improving future trials.
Downstream anastomotic hyperplasia. A mechanism of failure in Dacron arterial grafts.
LoGerfo, F W; Quist, W C; Nowak, M D; Crawshaw, H M; Haudenschild, C C
1983-01-01
The precise location and progression of anastomotic hyperplasia and its possible relationship to flow disturbances was investigated in femoro-femoral Dacron grafts in 28 dogs. In 13 grafts, the outflow from the end-to-side downstream anastomosis was bidirectional (BDO), and in 15 it was unidirectional (UDO) (distally). Grafts were electively removed at intervals of two to 196 days or at the time of thrombosis. Each anastomosis and adjacent artery was perfusion-fixed and sectioned sagittally. The mean sagittal section was projected onto a digitized pad, and the total area of hyperplasia internal to the arterial internal elastic lamina and within the adjacent graft was integrated by computer. The location of the hyperplasia was compared with previously established sites of flow separation and stagnation. The observation was made that hyperplasia is significantly greater at the downstream, as compared with the upstream, anastomosis in both groups (BDO = p less than 0.001 and UDO = p less than 0.001) (analysis of variance for independent groups). Furthermore, this downstream hyperplasia was progressive with time (BDO p less than 0.01) (UDO p less than 0.01); Spearman Rank Correlation. There was no significant increase in the extent of downstream hyperplasia where flow separation was known to be greater (BDO). Five grafts failed (three BDO, two UDO), as a result of complete occlusion of the downstream anastomosis by fibrous hyperplasia. Transmission electron microscopy showed the hyperplasia to consist of collagen-producing smooth muscle cells. Anastomotic hyperplasia is significantly greater at the downstream anastomosis, is progressive with time, and is the primary cause of failure of Dacron arterial grafts in this model. Quantitative analysis of downstream anastomotic hyperplasia may be a valuable measure of the biocompatibility of Dacron grafts. Images Fig. 2. Fig. 3. Fig. 5. Fig. 6. Fig. 7. Fig. 8. PMID:6219641
Current State-of-the-Art MRI for Comprehensive Evaluation of Potential Living Liver Donors.
Jhaveri, Kartik S; Guo, Lijun; Guimarães, Luís
2017-07-01
This review focuses on the role of state-of-the-art MRI-based techniques for comprehensive evaluation of living donors providing single-visit assessment of the liver vasculature via MR angiography, of the biliary tract via conventional T2-weighted MR cholangiography and T1-weighted gadoxetate disodium-enhanced MR cholangiography, and of hepatic steatosis via T2*-corrected multiecho chemical shift-based water-fat separation MRI and high-speed T2-corrected multiecho MR spectroscopy. By using current state-of-the-art techniques, MRI can provide a one-stop-shop method for evaluation of the potential living liver donors.
International Nuclear Information System (INIS)
Bostroem Ardin, A.; Hellberg, A.; Ljungman, C.; Logason, K.; Karacagil, S.; Loefberg, A.M.; Andren, B.
2002-01-01
Aim: To evaluate the role of duplex scanning in the selection of patients with infrainguinal arterial occlusive disease for percutaneous transluminal angioplasty (PTA). Material and Methods: From January 1995 through May 2000, 702 patients (952 limbs), with chronic lower extremity ischemia due to infrainguinal atherosclerotic disease diagnosed by duplex scanning, were retrospectively studied. Diagnostic angiography (130 limbs) or infrainguinal PTA (108 limbs) was performed in 238 limbs. Two investigators retrospectively analyzed the duplex examinations and angiographies in a blinded manner and used similar criteria for the interpretation of lesions suitable or not suitable for PTA. Results: The superficial femoral, popliteal and crural artery lesions were correctly selected for PTA in 85%, 66% and 32%, respectively. The accuracy, sensitivity, specificity, negative predictive value and positive predictive value of duplex scanning to appropriately categorize femoropopliteal lesions as suitable or unsuitable for PTA were 89%, 83%, 92%, 94% and 78%, respectively. The accuracy of duplex scanning for predicting the performance of infrainguinal PTA was 83%. Conclusion: Duplex scanning has an important impact on the selection of treatment modalities in limbs with infrainguinal arterial occlusive disease. Femoropopliteal lesions can be reliably selected to PTA according to duplex scan findings
Exchange rate predictability and state-of-the-art models
Yeșin, Pınar
2016-01-01
This paper empirically evaluates the predictive performance of the International Monetary Fund's (IMF) exchange rate assessments with respect to future exchange rate movements. The assessments of real trade-weighted exchange rates were conducted from 2006 to 2011, and were based on three state-of-the-art exchange rate models with a medium-term focus which were developed by the IMF. The empirical analysis using 26 advanced and emerging market economy currencies reveals that the "diagnosis" of ...
The state-of-the-art in research on Science teaching for deaf students
Directory of Open Access Journals (Sweden)
Ronaldo Santos Santana
2018-05-01
Full Text Available This study aimed to highlight the state-of-the-art in research on Science teaching for deaf students from 2012 to 2017, in order to outline an overview of the latest studies in the area, as well as their trends and main considerations. For that, a state-of-the-art research was carried out and, for the construction of the data corpus, abstracts of papers published in scientific journals, course conclusion papers, Masters thesis and Doctoral dissertations were used. From the data analysis, categories were elaborated and trends and challenges in the field were made explicit. The results demonstrate that research in this field is in imminent growth and they are being articulated to the theoretical frameworks that underpin the teaching of Science for hearing students.
State of the art survey of network operating systems development
1985-01-01
The results of the State-of-the-Art Survey of Network Operating Systems (NOS) performed for Goddard Space Flight Center are presented. NOS functional characteristics are presented in terms of user communication data migration, job migration, network control, and common functional categories. Products (current or future) as well as research and prototyping efforts are summarized. The NOS products which are revelant to the space station and its activities are evaluated.
Critical appraisal of paclitaxel balloon angioplasty for femoral-popliteal arterial disease.
Herten, Monika; Torsello, Giovanni B; Schönefeld, Eva; Stahlhoff, Stefan
2016-01-01
Peripheral arterial disease, particularly critical limb ischemia, is an area with urgent need for optimized therapies because, to date, vascular interventions often have limited life spans. In spite of initial encouraging technical success after femoropopliteal percutaneous transluminal angioplasty or stenting, postprocedural restenosis remains the major problem. The challenging idea behind the drug-coated balloon (DCB) concept is the biological modification of the injury response after balloon dilatation. Antiproliferative drugs administered via DCBs or drug-eluting stents are able to suppress neointimal hyperplasia, the main cause of restenosis. This article reviews the results of DCB treatments of femoropopliteal and infrapopliteal lesions in comparison to standard angioplasty with uncoated balloons. A systematic literature search was performed in 1) medical journals (ie, MEDLINE), 2) international registers for clinical studies (ie, www.clinicaltrials.gov), and 3) abstracts of scientific sessions. Several controlled randomized trials with follow-up periods of up to 5 years demonstrated the efficacy of paclitaxel -DCB technology. However, calcified lesions seem to affect the efficacy of DCB. Combinations of preconditioning methods with DCBs showed promising results. Although the mechanical abrasion of calcium via atherectomy or laser ablation showed favorable periprocedural results, the long-term impact on restenosis and clinical outcome has to be demonstrated. Major advantages of the DCBs are the rapid delivery of drug at uniform concentrations with a single dose, their efficacy in areas wherein stents have been contraindicated until now (ie, bifurcation, ostial lesions), and in leaving no stent scaffold behind. Reinterventions are easier to perform because DCBs leave no metal behind. Various combinations of DCBs with other treatment modalities may prove to be viable options in future. The follow-up results of clinical studies will evaluate the long-term impact
State-of-the-Art Methods for Brain Tissue Segmentation: A Review.
Dora, Lingraj; Agrawal, Sanjay; Panda, Rutuparna; Abraham, Ajith
2017-01-01
Brain tissue segmentation is one of the most sought after research areas in medical image processing. It provides detailed quantitative brain analysis for accurate disease diagnosis, detection, and classification of abnormalities. It plays an essential role in discriminating healthy tissues from lesion tissues. Therefore, accurate disease diagnosis and treatment planning depend merely on the performance of the segmentation method used. In this review, we have studied the recent advances in brain tissue segmentation methods and their state-of-the-art in neuroscience research. The review also highlights the major challenges faced during tissue segmentation of the brain. An effective comparison is made among state-of-the-art brain tissue segmentation methods. Moreover, a study of some of the validation measures to evaluate different segmentation methods is also discussed. The brain tissue segmentation, content in terms of methodologies, and experiments presented in this review are encouraging enough to attract researchers working in this field.
Link Prediction in Social Networks: the State-of-the-Art
Wang, Peng; Xu, Baowen; Wu, Yurong; Zhou, Xiaoyu
2014-01-01
In social networks, link prediction predicts missing links in current networks and new or dissolution links in future networks, is important for mining and analyzing the evolution of social networks. In the past decade, many works have been done about the link prediction in social networks. The goal of this paper is to comprehensively review, analyze and discuss the state-of-the-art of the link prediction in social networks. A systematical category for link prediction techniques and problems ...
Integrated Simulation for HVAC Performance Prediction: State-of-the-Art Illustration
Hensen, J.L.M.; Clarke, J.A.
2000-01-01
This paper aims to outline the current state-of-the-art in integrated building simulation for performance prediction of heating, ventilating and air-conditioning (HVAC) systems. The ESP-r system is used as an example where integrated simulation is a core philosophy behind the development. The
Transcatheter Pulmonary Valve Replacement: Current State of Art.
Alkashkari, Wail; Alsubei, Amani; Hijazi, Ziyad M
2018-03-15
The past couple of decades have brought tremendous advances to the field of pediatric and adult congenital heart disease (CHD). Percutaneous valve interventions are now a cornerstone of not just the congenital cardiologist treating patients with congenital heart disease, but also-and numerically more importantly-for adult interventional cardiologists treating patients with acquired heart valve disease. Transcatheter pulmonary valve replacement (tPVR) is one of the most exciting recent developments in the treatment of CHD and has evolved to become an attractive alternative to surgery in patients with right ventricular outflow tract (RVOT) dysfunction. This review aims to summarize (1) the current state of the art for tPVR, (2) the expanding indications, and (3) the technological obstacles to optimizing tPVR. Since its introduction in 2000, more than ten thousands tPVR procedures have been performed worldwide. Although the indications for tPVR have been adapted earlier from those accepted for surgical intervention, they remain incompletely defined. The new imaging modalities give better assessment of cardiac anatomy and function and determine candidacy for the procedure. The procedure has been shown to be feasible and safe when performed in patients who received pulmonary conduit and or bioprosthetic valves between the right ventricle and the pulmonary artery. Fewer selected patients post trans-annular patch repair for tetralogy of Fallot may also be candidates for this technology. Size restrictions of the currently available valves limit deployment in the majority of patients post trans-annular patch repair. Newer valves and techniques are being developed that may help such patients. Refinements and further developments of this procedure hold promise for the extension of this technology to other patient populations.
Directory of Open Access Journals (Sweden)
Ben Hur Junitiro Kajimoto
2007-01-01
Full Text Available O aumento da utilização de novas técnicas e materiais de síntese para o tratamento cirúrgico de afecções da coluna cervical baixa foi acompanhado da crescente preocupação em relação às complicações que podem ocorrer. A técnica de fixação transpedicular, amplamente utilizada para os outros níveis da coluna vertebral, quando realizada na coluna cervical, apesar de conferir maior estabilidade quando comparada a outras técnicas, pode cursar com complicações graves como lesão da artéria vertebral, lesão de raiz nervosa, além de lesão da articulação facetária. A vértebra C7, no entanto, é considerada mais segura para a realização de tal procedimento, já que, na grande maioria das pessoas, segundo os estudos anatômicos disponíveis, esta não possui a artéria vertebral dentro de seu forame transverso, pois este vaso irá penetrar tal estrutura apenas na vértebra C6. Como hoje existem apenas estudos de imagem para avaliação do trajeto desta artéria e suas variações anatômicas, realizamos este estudo anatômico dissecando 40 artérias vertebrais de cadáveres para avaliar a incidência das variações anatômicas. Encontramos 3 casos onde a artéria vertebral penetrou o forame transverso já em C7 (7,5%, o que aumentaria o risco de uma técnica transpedicular neste nível. O restante das peças anatômicas possuíam anatomia habitual.The increasing use of new techniques and materials for surgical treatment of lower cervical spine conditions has come along with an increasing concern regarding potential complications that might occur. The transpedicular fixation technique, frequently used in other spine levels, is used on the cervical spine, while providing more stability than other techniques, it may cause serious complications such as vertebral artery injury, nervous root injury, or facet joint injuries. However, the C7 vertebra is considered safer for performing this procedure, since, in the vast majority of
State-of-the-art computer technologies used to train nuclear specialists and to conduct research
International Nuclear Information System (INIS)
Korovin, Yu.A.; Tikhonenko, A.V.
2011-01-01
The paper discusses innovative methods used in the process of training nuclear specialists and conducting research which are based on state-of-the-art computer technologies. The approach proposed makes wide use of mathematical modeling and state-of-the-art programming techniques. It is based on the development, improvement and application of problem-oriented computer codes to support the teaching process and to solve fundamental and applied problems of nuclear physics and nuclear engineering.
Arnal Burró, Juan
2017-01-01
El dolor de origen femoro-patelar (FP) es una de las causas mas frecuentes de dolor en la rodilla, predomina en mujeres adolescentes y adultos jóvenes, aunque globalmente es una de las patologías de mayor prevalencia en las consultas de cirugía ortopédica en todos los rangos etarios. Este dolor tiene su mecanismo fisiopatológico en el aumento de la presión y tensión (estrés) experimentados por la rótula. Existe además una asociación entre el dolor anterior de rodilla (dolor FP) y la artrosis ...
State-of-the-art of biodegradable composite materials
International Nuclear Information System (INIS)
Baley, Ch.; Grohens, Y.; Pillin, I.
2004-01-01
Nowadays, the market demand for environment friendly materials is in strong growth. The biodegradable composites (biodegradable fibres and polymers) mainly extracted from renewable resources will be a major contributor to the production of new industrial high performance products partially solving the problem of waste management. At the end of the lifetime, a structural bio-composite could be be crushed and recycled through a controlled industrial composting process. This the state-of-the-art report focuses on the biopolymers the vegetable fibres properties, the mechanisms of biodegradation and the examples of biodegradable composites. Eco-design of new products requires these new materials for which a life cycle analysis is nevertheless necessary to validate their environmental benefits. (authors)
INFORMATION STORAGE AND RETRIEVAL, A STATE-OF-THE-ART REPORT
The objective of the study was to compile relevant background and interpretive material and prepare a state-of-the-art report which would put the...to-person communications. Section III presents basic IS and R concepts and techniques. It traces the history of traditional librarianship through...the process of communication between the originators and users of information. Section V categorizes the information system operations required to
Analysis of Respiratory Sounds: State of the Art
Directory of Open Access Journals (Sweden)
Sandra Reichert
2008-01-01
Full Text Available Objective This paper describes state of the art, scientific publications and ongoing research related to the methods of analysis of respiratory sounds. Methods and material Review of the current medical and technological literature using Pubmed and personal experience. Results The study includes a description of the various techniques that are being used to collect auscultation sounds, a physical description of known pathologic sounds for which automatic detection tools were developed. Modern tools are based on artificial intelligence and on technics such as artificial neural networks, fuzzy systems, and genetic algorithms… Conclusion The next step will consist in finding new markers so as to increase the efficiency of decision aid algorithms and tools.
MRI Sequences in Head & Neck Radiology - State of the Art.
Widmann, Gerlig; Henninger, Benjamin; Kremser, Christian; Jaschke, Werner
2017-05-01
Background Magnetic resonance imaging (MRI) has become an essential imaging modality for the evaluation of head & neck pathologies. However, the diagnostic power of MRI is strongly related to the appropriate selection and interpretation of imaging protocols and sequences. The aim of this article is to review state-of-the-art sequences for the clinical routine in head & neck MRI and to describe the evidence for which medical question these sequences and techniques are useful. Method Literature review of state-of-the-art sequences in head & neck MRI. Results and Conclusion Basic sequences (T1w, T2w, T1wC+) and fat suppression techniques (TIRM/STIR, Dixon, Spectral Fat sat) are important tools in the diagnostic workup of inflammation, congenital lesions and tumors including staging. Additional sequences (SSFP (CISS, FIESTA), SPACE, VISTA, 3D-FLAIR) are used for pathologies of the cranial nerves, labyrinth and evaluation of endolymphatic hydrops in Menière's disease. Vessel and perfusion sequences (3D-TOF, TWIST/TRICKS angiography, DCE) are used in vascular contact syndromes, vascular malformations and analysis of microvascular parameters of tissue perfusion. Diffusion-weighted imaging (EPI-DWI, non-EPI-DWI, RESOLVE) is helpful in cholesteatoma imaging, estimation of malignancy, and evaluation of treatment response and posttreatment recurrence in head & neck cancer. Understanding of MRI sequences and close collaboration with referring physicians improves the diagnostic confidence of MRI in the daily routine and drives further research in this fascinating image modality. Key Points: · Understanding of MRI sequences is essential for the correct and reliable interpretation of MRI findings.. · MRI protocols have to be carefully selected based on relevant clinical information.. · Close collaboration with referring physicians improves the output obtained from the diagnostic possibilities of MRI.. Citation Format · Widmann G, Henninger B, Kremser C et
art and culture administration in Edo State
African Journals Online (AJOL)
imitch
its environment the social, political, economic, aesthetic and religious norms and .... December, 2009, the Ministry of Arts, Culture and Tourism did organize a well ... and Social Welfare Departments and the mass media in the state so that the ...
Laser Beam Machining (LBM), State of the Art and New Opportunities
Meijer, J.
2004-01-01
An overview is given of the state of the art of laser beam machining in general with special emphasis on applications of short and ultrashort lasers. In laser welding the trend is to apply optical sensors for process control. Laser surface treatment is mostly used to apply corrosion and wear
The state of the art in intrusion prevention and detection
Pathan, Al-Sakib Khan
2013-01-01
The State of the Art in Intrusion Prevention and Detection analyzes the latest trends and issues surrounding intrusion detection systems in computer networks, especially in communications networks. Its broad scope of coverage includes wired, wireless, and mobile networks; next-generation converged networks; and intrusion in social networks.Presenting cutting-edge research, the book presents novel schemes for intrusion detection and prevention. It discusses tracing back mobile attackers, secure routing with intrusion prevention, anomaly detection, and AI-based techniques. It also includes infor
2014-11-01
Predicting Electrocardiogram and Arterial Blood Pressure Waveforms with Different Echo State Network Architectures Allan Fong, MS1,3, Ranjeev...the medical staff in Intensive Care Units. The ability to predict electrocardiogram and arterial blood pressure waveforms can potentially help the...type of neural network for mining, understanding, and predicting electrocardiogram and arterial blood pressure waveforms. Several network
International Nuclear Information System (INIS)
Ahn, S.S.; Auth, D.; Marcus, D.R.; Moore, W.S.
1988-01-01
A new high-speed rotary atherectomy device, inserted over a guide wire and directed with an angioscope, offers the potential of restoring patency of outflow vessels by boring out the atheromatous lesion of the orifices of runoff vessels. The device was tested on 68 cadaver arteries with atheromatous lesions involving the superficial femoral, popliteal, and tibial arteries. This was performed with either free segments or in situ with the device placed through a popliteal arteriotomy. The gross results of rotary atherectomy were assessed by angioscopy, angiography, or both. The luminal surfaces were studied with scanning electron microscopy and transverse sections of vessels were studied with light microscopy. The pulverized atheroma, in colloidal suspension, was analyzed for particle size by Coulter counter. The effect of a colloidal suspension of atheromatous particles on distal capillary circulation was measured in animal experiments. Obstructive lesions were successfully removed in 36 of 37 stenotic arteries (97%) and 18 of 31 completely occluded arteries (58%), an overall efficacy of 54 of 68 (79%). In successfully atherectomized arteries, angioscopy and angiography demonstrated a widely patent, smooth, polished surface. Light microscopy demonstrated removal of the diseased intima with maintenance of the outer media and adventitia. The pulverized atheroma particles were generally smaller than red blood cells and injection of the colloidal atheroma into canine femoral arteries failed to produce local tissue injury. We conclude that in the human cadaver this atherectomy device effectively enlarges and recanalizes obstructed superficial femoral, popliteal, and tibial arteries
Directory of Open Access Journals (Sweden)
Adelaide Arruda
1997-12-01
Full Text Available OBJETIVO: Avaliar o valor do ecocardiograma Doppler(ECO transtorácico na identificação de perviabilidade da anastomose entre artéria torácica interna esquerda (ATIE e interventricular anterior, realizada pela técnica de revascularização miocárdica pela minitoracotomia sem circulação extracorpórea. MÉTODOS: Estudaram-se os primeiros 12 pacientes, consecutivos, no período de pós-operatório intra-hospitalar pelo ECO, utilizando-se transdutores de 5MHz, pela via paraesternal esquerda, preferencialmente. Foram analisadas velocidades máximas e integrais de velocidade dos componentes sistólico e diastólico das curvas espectrais de fluxo Doppler. Todos pacientes foram submetidos à cinecoronariografia, enquanto hospitalizados. RESULTADOS: O ECO foi exeqüível em 93% dos pacientes. Nos com anastomose pérvia (6/7, observou-se ao estudo Doppler amplo componente diastólico (padrão A. Naqueles com anastomose obstruída (4/4 o padrão observado foi de predomínio sistólico (padrão B (p=0,003*. CONCLUSÃO: O ECO da ATIE anastomosada com a artéria interventricular anterior, após cirurgia de revascularização miocárdica pela técnica de minitoracotomia, permitiu caracterizar precocemente, com precisão, a perviabilidade da anastomose.PURPOSE: To study the value of Doppler echocardiography as a tool for the evaluation of left internal thoracic artery graft (LITAG patency in patients who underwent coronary revascularization using minimally invasive bypass surgery without extracorporeal circulation. METHODS: The first 12 consecutive patients were studied after coronary artery bypass surgery using a 5MHz Doppler transducer. Doppler signals for the systolic and diastolic flow velocities were preferably obtained in the second intercostal space. All patients underwent coronary angiography while hospitalized. RESULTS: The exam was feasible in 93% of patients. Doppler flow pattern was predominantly diastolic (pattern A in patients with patent
State-of-the-art methodology of forest inventory: a symposium proceedings.
Vernon J. LaBau; Tiberius Cunia
1990-01-01
The state-of-the-art of forest inventory methodology, being closely integrated with the fast-moving, high technology computer world, has been changing at a rapid pace over the past decade. Several successful conferences were held during the 1980s with the goal and purpose of staying abreast of such change. This symposium was conceived, not just with the idea of helping...
International Nuclear Information System (INIS)
Ohai, D.; Meleg, T.; Dumitrescu, I.; Benga, D.
2009-01-01
Full text: The paper presents the FIPRED (Fission Product Release from Debris Bed) Project state of art (UO 2 sintered pellets oxidation). The FIPRED Project is dedicated to the study of the fission products released from irradiated pellets present in debris bed. The fission product release is produced by oxidative self disintegration of sintered pellets at air ingress and it depends on temperature. The experimental program covered experiments of 300-1400 deg. C in air diluted with nitrogen at different concentrations of oxygen and different steam-air mixture. The experiments were performed using the SETARAM thermo-gravimetric equipment and the FIPRED EQ equipment designed and manufactured especially for this type of experiment. The powders (fragments), resulted from UO 2 pellets self disintegration, were characterized by sieving and SEM. The self disintegration mechanism was demonstrated using the experimental result obtained and thermodynamically data of uranium oxides. (authors)
Subintimal Angioplasty for Peripheral Arterial Occlusive Disease: A Systematic Review
International Nuclear Information System (INIS)
Met, Rosemarie; Lienden, Krijn P. Van; Koelemay, Mark J. W.; Bipat, Shandra; Legemate, Dink A.; Reekers, Jim A.
2008-01-01
The objective of this study was to summarize outcomes of subintimal angioplasty (SA) for peripheral arterial occlusive disease. The Cochrane Library, Medline and Embase databases were searched to perform a systematic review of the literature from 1966 through May 2007 on outcomes of SA for peripheral arterial occlusive disease of the infrainguinal vessels. The keywords 'percutaneous intentional extraluminal revascularization,' 'subintimal angioplasty,' 'peripheral arterial disease,' 'femoral artery,' 'popliteal artery,' and 'tibial artery' were used. Assessment of study quality was done using a form based on a checklist of the Dutch Cochrane Centre. The recorded outcomes were technical and clinical success, primary (assisted) patency, limb salvage, complications, and survival, in relation to the clinical grade of disease (intermittent claudication or critical limb ischemia [CLI] or mixed) and location of lesion (femoropopliteal, crural, or mixed). Twenty-three cohort studies including a total of 1549 patients (range, 27 to 148) were included in this review. Methodological and reporting quality were moderate, e.g., there was selection bias and reporting was not done according to the reporting standards. These and significant clinical heterogeneity obstructed a meta-analysis. Reports about length of the lesion and TASC classification were too various to summarize or were not mentioned at all. The technical success rates varied between 80% and 90%, with lower rates for crural lesions compared with femoral lesions. Complication rates ranged between 8% and 17% and most complications were minor. After 1 year, clinical success was between 50% and 70%, primary patency was around 50% and limb salvage varied from 80% to 90%. In conclusion, taking into account the methodological shortcomings of the included studies, SA can play an important role in the treatment of peripheral arterial disease, especially in the case of critical limb ischemia. Despite the moderate patency
Native American Arts and Crafts of the United States. Bibliography 1.
Indian Arts and Crafts Board, Washington, DC.
The selected readings listed in this annotated bibliography are suggested as an introduction to the varied arts and crafts created from prehistoric to modern times by Native American peoples of the United States. The publications are organized by culture area to encompass major media practiced by Native American artists and craftsmen of these…
Directory of Open Access Journals (Sweden)
Eduardo Maurício Mendes de Lima
2010-09-01
Full Text Available Foram estudados 26 encéfalos de gatos, adultos, sem diferenciação de sexo, sem raça definida, corados com látex e fixados por solução aquosa de formaldeído. As artérias cerebrais caudais, direita e esquerda, apresentaram-se únicas em 96,1 e 88,4% dos casos, respectivamente. Em 69,2% dos casos no antímero direito e 80,8% no esquerdo, a artéria cerebral caudal originou-se pela anastomose entre o ramo caudal da artéria carótida interna, com maior contribuição, e o ramo terminal da artéria basilar. Em 88,4% dos casos no antímero direito e em 84,6% no esquerdo, a artéria cerebral caudal originou a artéria tectal rostral e um ramo caudal. O ramo caudal bifurcou-se e vascularizou os colículos rostrais e caudais dos corpos quadrigêmeos e em alguns casos contribuiu na formação do plexo coroide do terceiro ventrículo. A artéria tectal rostral seguiu ventralmente ao lobo piriforme e durante seu trajeto liberou ramos para o hipocampo e, no antímero esquerdo, supriu a superfície dorsal do tálamo, contribuindo para a formação do plexo coroide do terceiro ventrículo.In this study were used 26 brains of adult cats, without sex differentiation and definable race, colored with latex and fixed in formaldehyde aqueous solution. The right and left caudal cerebral arteries were single in 96.1% and 88.4% of the sample, respectively. In 69.2% of the samples on the right side and 80.8% on the left, the caudal cerebral artery fin from the anastomosis behind the caudal branch of the internal carotid artery, with a large contribution, and the basal artery terminal branch. In 88.4% of the samples on the right side and 84.6% on the left, the caudal cerebral artery showed the tectal rostral artery and one caudal branche. The caudal branch forked in two branches that supplied the rostral and caudal colliculis of the quadruplet bodies and formed the choroid plexus of the third ventricle. The tectal rostral artery followed ventrally to the
Entrepreneurship Education: State of the Art
Directory of Open Access Journals (Sweden)
José Carlos Sánchez García
2017-10-01
Full Text Available Job uncertainty and ambiguity is a reality in many current societies, therefore, the idea of self-employment has taken a more active role, not only out of necessity, but also because it brings innovation and development to societies. In view of this situation, the following question arises: how can we strengthen the entrepreneurial spirit of our students? This article has the objective to collect theoretical information of the state of the art on entrepreneurship education: what it has been, what it is, and what can it be, in order to present the current condition of the topic, both in the psychological and pedagogical field. To achieve this objective, information from 108 research sources, mainly from scientific articles and books was collected, concluding that, although generally, entrepreneurship education has significantly contributed to the creation of businesses, developing countries, specifically, those in Latin America, still require extra effort to fully implement entrepreneurship topic in the curriculums, particularly because of challenges such as political instability, technology and international competition.
State Arts Agencies 1965-2003. Whose Interests to Serve?
National Research Council Canada - National Science Library
Lowell, Julia
2004-01-01
... (referred to as state arts agencies, or SAAs). In fiscal year (FY) 2003, a record 43 of 56 SAAs reported year-over-year declines in the general fund appropriations budgeted to them by their state legislatures...
State-of-the-art report on radioactive waste disposal
International Nuclear Information System (INIS)
Larsson, A.
1989-01-01
In view of the considerable work required to develop repositories for radioactive waste, an extensive international co-operation has evolved within the area. The work has also engaged the IAEA to a great extent. The Agency has published a number of reports, covering different aspects of waste disposal. Following a recommendation by its Technical Review Committee on Underground Disposal (TRCUD) the Agency will publish a ''state-of-the-art'' report on radioactive waste disposal. The report is still in the preparation stage. In this article the principal subjects of the future report are discussed
Pragmatics: The State of the Art: An Online Interview with Keith Allan
Allan, Keith; Salmani Nodoushan, Mohammad Ali
2015-01-01
This interview was conducted with Professor Keith Allan with the aim of providing a brief but informative summary of the state of the art of pragmatics. In providing answers to the interview questions, Professor Allan begins with a definition of pragmatics as it is practiced today, i.e., the study of the meanings of utterances with attention to…
Weber, Garret; Liao, Sherry; Burns, Micah Alexander
2017-11-15
Sickle cell crisis, or vaso-occlusive crisis (VOC), is a major cause of hospitalizations for adults and children with sickle cell disease, and is associated with increased morbidity and mortality. Despite prompt pharmacological treatment and multimodal pain management, acute pain during a VOC is often not adequately controlled in the pediatric population. We placed a continuous popliteal sciatic nerve block under ultrasound guidance in a pediatric patient for localized refractory pain during a VOC, resulting in improved pain control with preserved sensorimotor function.
State of the art in power cable design, failure mechanisms and testing
International Nuclear Information System (INIS)
Orton, H.
2005-01-01
This presentation describes state of the art in power cable design, failure mechanisms and testing. It gives a history of cable usage and design of cables, describes different cable types, assessment of the condition of cables, aging and failures, testing and diagnostics
Pulmonary hypertension-"state of the art" management in 2012.
Saxena, Anita
2012-01-01
Pulmonary artery hypertension (PAH) is a pathological condition of small pulmonary arteries, characterised by vascular proliferation and remodelling. The pulmonary artery pressure and pulmonary vascular resistance progressively rise, leading to right heart failure and death. Pulmonary artery hypertension may be secondary to various conditions, or it may be idiopathic where no underlying cause is identifiable. Earlier, only symptomatic treatment was available for such patients which did not change the natural history of the disease. However, over the years, improvement in understanding the pathogenesis has resulted in the development of targeted approaches to the treatment of PAH. Survival advantage has also been shown with some of the pharmacologic agents. This review article discusses the current management strategy for PAH with special emphasis on an idiopathic variety, in an Indian context. Copyright © 2012 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.
Macro-defect free cements. State of art
International Nuclear Information System (INIS)
Holanda, J.N.F.; Povoa, G.E.A.M.; Souza, G.P.; Pinatti, D.G.
1998-01-01
The purpose of this work is to prevent a state of art about macro-defect-free cement pastes (MDF cement ) of high mechanical strength. This new type of cement paste is obtained through addition of a water-soluble polymer, followed by intense shear mixing and application of low compacting pressure. It is presented fundamental aspects related to the processing of this MDF paste, as well as its main properties and applications are discussed. (author)
Directory of Open Access Journals (Sweden)
Cristina Toledo Afonso
2009-03-01
Full Text Available Aneurismas isolados da artéria ilíaca interna são raros, acometem 0,1% da população e correspondem a 1% dos aneurismas aorto-ilíacos. Na maioria das vezes, os pacientes são assintomáticos, mas podem apresentar dor abdominal, massa pulsátil no hipogástrio ou na fossa ilíaca, sintomas compressivos urinários, gastrointestinais ou neurológicos. Podem ocasionar quadro de abdome agudo, principalmente quando há ruptura. O diagnóstico precoce dos aneurismas isolados de artéria ilíaca interna é incomum, sendo identificados quando mais volumosos ou rotos, o que aumenta significativamente sua morbimortalidade e torna seu prognóstico mais reservado. Dessa forma, representam um desafio terapêutico. A ligadura cirúrgica tem sido o tratamento mais comum, entretanto a cirurgia endovascular tem mostrado bons resultados, inclusive nos aneurismas rotos. É relatado caso de aneurisma de artéria ilíaca interna isolado roto diagnosticado durante laparotomia para abordagem de abdome agudo.Isolated internal iliac artery aneurysms are rare. They affect 0.1% of the population, and account for 1% of aortoiliac aneurysms. Patients are mostly asymptomatic, yet they can have abdominal pain, pulsatile mass in the hypogastrium or iliac fossa, or urinary, gastrointestinal or neurological compressive symptoms. Such aneurysms are likely to course with an acute abdomen, especially when ruptured. Early diagnosis of isolated internal iliac artery aneurysms is difficult, as they are more easily detected when larger or ruptured, which significantly raises their morbidity and mortality rate and determines a poor prognosis. Therefore, they are a therapeutic challenge. Surgical ligation has been the most common treatment; however, the endovascular approach has presented good outcomes, even in the event of ruptured aneurysms. A case of ruptured isolated iliac artery aneurysm diagnosed during a laparotomy (acute abdomen approach is reported.
Vacuum assisted closure in vascular surgery.
Beno, M; Martin, J; Sager, P
2011-01-01
Vacuum assisted closure (VAC-therapy) is a well established method in nearly all surgical disciplines. The aim is to present the efficiency of vacuum assisted closure in the treatment of acute and chronic wounds in patients admitted in the department of vascular surgery. Within the year 2008 there were 59 patients (44 men, 15 women) treated with VAC therapy in our Department of Vascular surgery (Landshut, Germany). VAC was used 22x (37.28 %) in therapy of ulcus cruris (venous, arterial, mixed genesis), 15x (25.42%) in patients with diabetic foot syndrome, 12x (20.33%) in secondary healing wounds and infected wounds, 5x (8.47%) in wounds after several injuries and soft skin tissue infections and 5x (8.47%) in wound infections connected with vascular graft infections after vascular revascularization. VAC therapy seems to be very effective in the management of patients with venous ulcers, especially after a proper surgical treatment (100%), patients with soft skin tissue infections (100%) and secondary healing wounds (100%) especially in combination with MESH-Grafting. In patients with diabetic foot syndrome (80%) and peripheral arterial occlusive disease (72.7%), an evaluation of peripheral blood perfusion and revascularization prior to VAC therapy is often necessary. Although VAC was used 5x in the therapy of infected vascular grafts, successful preservation of infected graft material was observed in only one case (infection of PTFE femoro-popliteal bypass graft). Vacuum assisted closure in vascular surgery proved to be simple and efficient method in therapy of acute and chronic wounds. The efficiency of VAC systems in therapy of infected graft material after revascularization needs further studies (Tab. 3, Ref. 10).
Bidirectional Texture Function Modeling: State of the Art Survey
Czech Academy of Sciences Publication Activity Database
Filip, Jiří; Haindl, Michal
2009-01-01
Roč. 31, č. 11 (2009), s. 1921-1940 ISSN 0162-8828 R&D Projects: GA MŠk 1M0572; GA ČR GA102/08/0593; GA AV ČR 1ET400750407 Grant - others:EC Marie Curie(BE) 41358; GA MŠk(CZ) 2C06019 Institutional research plan: CEZ:AV0Z10750506 Keywords : BTF * surface texture * 3D texture Subject RIV: BD - Theory of Information Impact factor: 4.378, year: 2009 http://library.utia.cas.cz/separaty/2009/RO/filip-bidirectional texture function modeling state of the art survey.pdf
EVALUATION OF THE STATE-OF-THE-ART CONTAMINATED SEDIMENT TRANSPORT AND FATE MODELING SYSTEM
Modeling approaches for evaluating the transport and fate of sediment and associated contaminants are briefly reviewed. The main emphasis is on: 1) the application of EFDC (Environmental Fluid Dynamics Code), the state-of-the-art contaminated sediment transport and fate public do...
Lim, Kyungeun
2017-01-01
Policy changes influence various aspects of art education such as K-12 art education curricula, state licensure systems, and contexts of art teacher preparation. Despite strong relationships between art education policy and practical fields, few studies have attempted to understand art education from the perspective of policy analysis. This study…
State of the art on historic building insulation materials and retrofit strategies
DEFF Research Database (Denmark)
Blumberga, Andra; Kass, Kristaps; Kamendere, Edite
2016-01-01
This report provides an analysis and evaluation of a state-of-the-art of internal insulation materials and methods for application in historic buildings, and review on methods, tools and guidelines used as decision making tools for implementation of internal insulation in historic buildings. Hist...
Dusseldorp, Joseph R; Pham, Quy J; Ngo, Quan; Gianoutsos, Mark; Moradi, Pouria
2014-09-01
The medial sural artery perforator (MSAP) flap is a versatile fasciocutaneous flap. The main difficulty encountered when raising the MSAP flap is in obtaining adequate pedicle length during intra-muscular dissection. The objective of this study was to determine the pattern of intra-muscular course of the MSAP flap pedicle. 14 cadaveric specimens were dissected and CT angiograms of 84 legs were examined. The intra-muscular branching pattern and depths of the medial sural artery branches were analyzed. The number of perforators, position of the dominant perforator and both intra-muscular and total pedicle length were also recorded and compared to existing anatomical data. Three types of arterial branching pattern were identified within the medial gastrocnemius, demonstrating one (31%), two (59%) or three or more (10%) main branches. A dominant perforator from the medial sural artery was present in 92% of anatomical specimens (13/14). Vertically, the location of the perforator from the popliteal crease was on average 13 cm (±2 cm). Transversely, the perforator originated 2.5 cm (±1 cm) from the posterior midline. Using CT angiography it was possible in 10 consecutive patients to identify a more superficial intra-muscular branch and determine the leg with the optimal branching pattern type for flap harvest. This study is the first to describe the variability of the intra-muscular arterial anatomy of the medial head of gastrocnemius muscle. Surgeons utilizing the MSAP flap option should be aware of the possible branching pattern types and consequently the differing perforator distribution and depths of intra-muscular branches. Routine use of pre-operative CT angiogram may help determine which leg has the most favorable branching pattern type and intra-muscular course for flap harvest. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Directory of Open Access Journals (Sweden)
Hyun Lee Kim
2012-06-01
Full Text Available Acid-base unbalance is most common problem in severe ill patient, especially in condition of abnormal renal function state. Acid-base unbalances are respiratory acidosis, respiratory alkalosis, metabolic acidosis, and metabolic alkalosis. Metabolic acidosis is frequently appeared in clinical state. Arterial blood gas analysis is considered as a basic test to the intensive care unit patient and emergency state. Recently some researches were done, comparing with arterial blood gas analysis and venous blood gas analysis. Because of venous blood sampling is safer than arterial blood gas analysis, and beside not so different among them for detecting pH, pCO2, HCO3, except pO2 measuring. This research was done in emergency room, and for explaining no different between arterial blood gas analysis and peripheral blood gas analysis result in acid-base unbalance state patient. Especially in kidney functions decreased state. : The study was done from March, 2010 to January, 2011. The object was 89 peoples who came to emergency room for treating internal medicine problem. (Women 53, average age: 66.7±12.1 Then compare between arterial blood gas analysis and peripheral blood gas analysis. Result: The mean arterial minus venous difference for pH, pCO2, and bicarbonate was −0.0170, 2.6528, and 0.6124. Bland-Altman plot was done for predicting agreement of two groups, and the scale was pH −2.95 to 4.17, pCO2 −4.45 to 9.76, bicarbonate −2.95 to 4.16, in 95% relative. Conclusion: The peripheral blood gas pH, pCO2, bicarbonate level is almost same as arterial blood gas analysis results. And enough to measuring acid-base unbalance state, in absent of arterial blood testing.
Plugging wells for abandonment: a state-of-the-art study and recommended procedures
International Nuclear Information System (INIS)
Herndon, J.; Smith, D.K.
1976-09-01
The state-of-the-art of borehole plugging of abandoned oil wells and the tools and materials used are discussed. Special problems encountered are considered and several case studies are outlined. The special procedures which must be followed if the plugged borehole is to be considered as a repository for radioactive wastes are discussed and special recommendations are made. A state-by-state summary is given of the regulatory requirements for borehole plugging
Nuclear scanning microprobe: state of the art, applications and progress trends
International Nuclear Information System (INIS)
Ponomarev, A.G.
2011-01-01
The physical principles of nuclear scanning microprobe are considered. The analysis of state of the art of the microprobe setup from point of view of its spatial resolution and sensitivity of microanalysis techniques is given. The regions of nuclear microprobe applications are reviewed. The ways of spatial resolution and data acquisition system improvement under consideration of microprobe setup progress trends are considered. (authors)
Directory of Open Access Journals (Sweden)
Angélica Lemos Debs Diniz
2005-04-01
evaluate ophthalmic and retinal central artery Doppler indices during the second and third trimesters of normal pregnancy and to compare the right with left eye Doppler indices of normotensive women. METHODS: a cross-sectional study which evaluated central retinal and ophthalmic artery Doppler velocimetry values of 51 normal pregnant women, in the 20th to 38th week of gestation. The following values were analyzed: pulsatility and resistance indexes (PI, RI, peak systolic and end-diastolic flow velocity (PSV, EDFV and peak velocity ratio (PVR. The Doppler indices in the right and left eyes were studied by the median. The paired Student's t test was used to confront the right and left eye values and the Pearson linear correlation analysis was performed to study the value changes throughout the gestation, with the level of significance set at 5%. RESULTS: Doppler velocimetry indices of ophthalmic and central retinal arteries (median values were, respectively: PI=1.83; RI=0.78; PSV=34.20; EDFV=6.80; PVR=0.48 and PI=1.34; RI=0.70; PSV=7.40; EDFV=2.10. There was no significant difference between the right and left side Doppler values. Linear correlation analysis showed no association between the arterial values and pregnancy age. CONCLUSION: the unilateral analysis of ophthalmic and central retinal artery Doppler velocimetry values can be used in systemic maternal disease. There is no significant change in ophthalmic and central retinal artery Doppler velocimetry values throughout normal pregnancy.
DEFF Research Database (Denmark)
Hauritz, R W; Pedersen, E M; Linde, F S
2016-01-01
Popliteal sciatic nerve catheters (PSNCs) are associated with a high frequency of displacement. We aimed to estimate the frequency of catheter displacement after 48 h with magnetic resonance imaging (MRI) in patients with PSNCs after major foot and ankle surgery randomized to catheter insertion e...
International Nuclear Information System (INIS)
Won, Je Hwan; Lee, Jong Hyuk; Ko, Kyung Hee; Won, Jong Yoon; Park, Sung Il; Lee, Do Yun; Kang, Byung Chul
2000-01-01
To investigate the feasibility and complications of a percutaneously implantable port system for regional drug infusion. For intra-arterial drug infusion, a 5.8 or 5-F pediatric venous port system was implanted in 110 patients with hepatocellular carcinoma (n=79), liver metastasis (n=16), gallbladder cancer (n=4), stomach cancer (n=3), pancreatic cancer (n=3), Burger's diseases mellitus (n=2), or lymphoma (n=1). All intra-arterial port implantations were performed percutaneously in an angiographic ward through the common femoral artery (n=98), left subclavian artery (n=10), or left superficial femoral artery (n=2). Complications were evaluated during the follow-up period, which ranged from 21 to 530 (mean, 163) days. The technical success rate for percutaneous implantation of the system was 97.3% (107 of 110 patients). The tips of the port catheter were located in the common hepatic artery (n=34), proper hepatic artery (n=49), right hepatic artery quick resulthepatic artery (n=1), descending aorta at T9 level (n=10), left popliteal artery (n=2), right external iliac artery (n=1), left external iliac artery (n=1), or left deep femoral artery (n=1). Complications were encountered in 24 patients (22.4%), namely chamber site infection (n=7), catheter dislodgement (n=7), catheter occlusion (n=3), migration of coil (n=2), disconnection between chamber and catheter (n=1), kinking of catheter (n=1), arterial occlusion (n=1), necrosis of overlying skin (n=1), and leakage around port chamber (n=1). Outcomes of complications included removal of port systems or cessation of therapy in 12 cases (11.2%), correction of catheter location using a guide wire in five (4.7%), thrombolysis with urokinase in three (2.8%), and straightening using a snare in one (0.9%). In three patients, the port system was used without reintervention. Percutaneous implantation of an intra-arterial port system showed a high technical success rate and a low rate of serious complications. The method may be
Kim, Hyoung Ook; Kim, Jae Kyu; Park, Jin Gyoon; Yim, Nam Yeol; Kang, Yang Jun; Jung, Hye Doo
2016-01-01
PURPOSE We aimed to evaluate the efficiency of placing an inferior vena cava (IVC) filter through the same popliteal vein access site used for percutaneous endovenous intervention in patients with extensive lower extremity deep vein thrombosis. METHODS This retrospective study included 21 patients who underwent IVC filter insertion through the popliteal vein over a three-year period. Patient medical records were reviewed for the location of the deep vein thrombosis, result of filter removal, and total number of endovascular procedures needed for filter insertion and recanalization of the lower extremity venous system. Follow-up lower extremity computed tomography (CT) venography was also reviewed in each patient to assess the degree of filter tilt in the IVC. RESULTS All patients had extensive lower extremity deep vein thrombosis involving the iliac vein and/or femoral vein. Seventeen patients showed deep vein thrombosis of the calf veins. In all patients, IVC filter insertion and the recanalization procedure were performed during a single procedure through the single popliteal vein access site. In the 17 patients undergoing follow-up CT, the mean tilt angle of the filter was 7.14°±4.48° in the coronal plane and 8.77°±5.49° in the sagittal plane. Filter retrieval was successful in 16 of 17 patients (94.1%) in whom filter retrieval was attempted. CONCLUSION Transpopliteal IVC filter insertion is an efficient technique that results in low rates of significant filter tilt and enables a single session procedure using a single venous access site for filter insertion and percutaneous endovenous intervention. PMID:27559713
Thrombolysis for acute lower limb arterial embolism in patients with recent cerebral embolism
International Nuclear Information System (INIS)
Si Tongguo; Guo Zhi
2008-01-01
Objective: To assess the feasibility and efficacy of catheter-directed thrombolysis with recombinant tissue plasminogen activator (rt-PA)for acute limb embolism in patients with recent cerebral embolism. Methods: Eight patients with atrial fibrillation history happened to suffer acute limb embolism after recent cerebral embolism. The affected arteries included 2 left common iliac arteries, 4 femoral arteries (3 left, 1 right), 2 right popliteal arteries. Catheter-directed thrombolysis with rt-PA was applied with bolus administration plus continuous perfusion. Percutaneous transluminal angioplasty with balloon dilatation was applied in 3 patients, and one stent placement in one patient. Results: The mean duration of continuous perfusion was 3.6 hours and the mean dose of rt-PA administered was 23.6 mg (range, 20-28 mg)with complete recanalization rate of 100%. Clinical complete relief rate was 7/8 with one patient suffering from rest pain due to distal occlusion of anterior/posterior tibial artery. The complications included hematoma at puncture site (6/8), bleeding around the vascular sheath (2/8)and hematuria (1/8). NO intracerebral hemorrhage was found on CT scans after the thrombolysis. During follow up of 3-6 months, no recurrent embolism or thrombosis occurred in the limbs except one patient with recurrent cerebral embolism and died. Conclusions: Catheter-directed thrombolysis with rt-PA is probably to be a safe and effective method for acute limb embolism in patients with recent cerebral embolism and atrial fibrillation history. (authors)
Modelling and simulation SSM: latest state of the art technology
CSIR Research Space (South Africa)
Jahajeeah, N
2005-10-01
Full Text Available as one phase ? One Phase model ?Wider volume solid fraction 0 – 1 ? Implementation in Power Law Cut-Off Model (PLCO) of Procast Supporting the Manufacturing and Materials Industry in its quest for global competitiveness Assumptions of the PLCO Model... and Materials Industry in its quest for global competitiveness Modelling and Simulation SSM Latest state of the art technology N Jahajeeah Supporting the Manufacturing and Materials Industry in its quest for global competitiveness BEHAVIOUR OF THIXOTROPIC...
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Ana Rita Lima
2013-02-01
Full Text Available O circuito arterial do encéfalo é de grande importância, pois é responsável pela vascularização do encéfalo, sendo este o principal órgão do sistema nervoso central e responsável por receber e processar informações. A espécie estudada foi escolhida por tratar-se de um mamífero pertencente à ordem Xenarthra e os integrantes dessa ordem são pouco estudados, devido à dificuldade de acesso a esses animais. Para desenvolver este trabalho, foram estudados cinco espécimes de Tamanduá-mirim (Tamandua tetradactyla. O material teve o sistema arterial injetado com látex Neoprene 650, corado em vermelho e fixado em solução aquosa de Formaldeído 10%, sendo posteriormente dissecados para sistematização dos vasos. O circuito arterial da base do encéfalo do tamanduá-mirim circunda o corpo mamilar, a fossa interpenduncular, o túber cinéreo, a hipófise e o quiasma óptico. A porção rostral desse circuito é caracterizada pelos ramos rostrais das artérias carótidas internas e a porção caudal é constituída pelas artérias comunicantes caudais e ramos caudais da artéria carótida interna. Esta espécie animal apresenta o tipo II de irrigação encefálica no qual existe a participação das artérias carótidas internas e do sistema vértebro-basilar para a formação do circuito arterial.The arterial circuit of the brain is of great importance because it is responsible for vascularization of the brain and this is the main organ of the central nervous system and responsible for receiving and processing information. The species was chosen because it is a mammal belonging to the Xenarthra order and the members of this order are little studied because of the difficulty of access to these animals. To develop this work were studied five specimens of lesser anteater (Tamandua tetradactyla. The material had the arterial system filled with Neoprene latex stained in red, fixed in aqueous solution of 10% paraformaldehyde and dissected
State of art and perspectives of using renewable energy sources
International Nuclear Information System (INIS)
Berkovskij, B.M.; Mikhalevich, A.A.
1996-01-01
State of art of renewable energy sources for the beginning of the nineties and perspectives up to 2020 are considered by the forecast of the European Commission. The program of the World Sun Summit up to 1996-2005 is presented
Directory of Open Access Journals (Sweden)
Alex Sandro Rolland Souza
2009-02-01
ção intravenosa de 6 g do sulfato de magnésio nas pacientes com pré-eclâmpsia grave, ocorre uma diminuição da pressão arterial e do IP das artérias uterinas, umbilicais e cerebral média fetal, além de aumento da frequência cardíaca materna, não influenciada pela presença de incisura protodiastólica bilateral nas artérias uterinas.PURPOSE: to evaluate the effect of magnesium sulphate on the pulsatility index (PI of the uterine, umbilical and fetal middle cerebral arteries, according to the persistency or not of the bilateral protodiastolic notch of the uterine arteries in severe pre-eclampsia. METHODS: a cohort study including 40 pregnant women with severe pre-eclampsia, 23 of them presenting bilateral protodiastolic notch, and 17, unilateral/absent notch. The patients were submitted to Doppler velocimetry before and 20 minutes after the intravenous administration of 6 g of magnesium sulphate. The examination was carried out with the patient in semi-Fowler position, the sonograms being obtained during fetal inactivity, in apnea and absent uterine contraction periods. All the exams were performed by two researchers, the average being considered as the final result. Wilcoxon's test was used to compare the PI, before and after magnesium sulphate in both groups. The difference between the two measurements (before and after magnesium sulphate was compared between the groups (bilateral incision and unilateral/absent incision using the Mann-Whitney test. RESULTS: there was a significant increase in the maternal heart rate (MHR and decrease in the maternal blood pressure, and in the PI medians of the two uterine arteries and in the fetal middle cerebral artery, after magnesium sulphate in both groups. There was a significant decrease in the PI of the left uterine artery and in the umbilical artery, only in the protodiastolic unilateral/absent notch group. Nevertheless, it was not found any significant difference regarding the PI of the right uterine artery, or the cerebral
Babaev, Anvar; Zavlunova, Susanna; Attubato, Michael J; Martinsen, Brad J; Mintz, Gary S; Maehara, Akiko
2015-10-01
The Tissue Removal Assessment with Ultrasound of the SFA and Popliteal (TRUTH) study assessed the performance of the orbital atherectomy system (OAS) to treat femoropopliteal arteries, including determining its effect on plaque removal. Patients with symptomatic femoropopliteal peripheral arterial disease were treated with the OAS followed by adjunctive balloon angioplasty (BA). Intravascular ultrasound (IVUS) images were collected pre- and post-OAS and post-OAS BA. Patients were followed through 12 months post-procedure. Twenty-nine lesions were treated with OAS-BA in 25 patients. The mean maximum balloon inflation pressure was 5.2 ± 1.2 atm. Virtual histology IVUS (VH-IVUS) analysis revealed at the maximum calcium ablation site that calcium reduction was responsible for 86% of the lumen area increase. The minimum lumen area increased from 4.0 mm(2) to 9.1 mm(2) (<.0001), and the percentage of area stenosis decreased from 76.9% to 43.0% (<.0001) after OAS-BA. At 12 months, the target lesion revascularization rate was 8.2%, and ankle-brachial index and Rutherford classification improved significantly from baseline through follow-up. The VH-IVUS analysis reveals that OAS modifies the calcified component of the plaque burden. It is hypothesized that calcium modification by OAS changes the lesion compliance, allowing for low pressure adjunctive BA. The clinical outcomes were favorable through 12-month follow-up. © The Author(s) 2015.
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Francisco I Ramirez-Perez
Full Text Available Maternal obesity affects the incidence of cardiovascular disease and diabetes in offspring. Also the use of assisted reproductive technologies (ART has been associated with cardiovascular deficiencies in offspring. Obese women often suffer from infertility and use ART to achieve a pregnancy, but the combined effects of maternal obesity and ART on cardiovascular health and incidence of diabetes in the offspring is not known. Here, we report the effects of the use of ART within an obesogenic environment, consisting of feeding a western diet (WD to dams and offspring, on resistance artery function and presence of diabetes biomarkers in juvenile mice offspring. Our results indicate that WD and ART interacted to induce endothelial dysfunction in mesenteric resistance arteries isolated from 7-week-old mice offspring. This was determined by presence of a reduced acetylcholine-induced dilation compared to controls. The arteries from these WD-ART mice also had greater wall cross-sectional areas and wall to lumen ratios indicative of vascular hypertrophic remodeling. Of the diabetes biomarkers measured, only resistin was affected by a WD×ART interaction. Serum resistin was significantly greater in WD-ART offspring compared to controls. Diet and sex effects were observed in other diabetes biomarkers. Our conclusion is that in mice the use of ART within an obesogenic environment interacts to favor the development of endothelial dysfunction in the resistance arteries of juvenile offspring, while having marginal effects on diabetes biomarkers.
Leadless Pacemakers: State of the Art and Future Perspectives.
Della Rocca, Domenico G; Gianni, Carola; Di Biase, Luigi; Natale, Andrea; Al-Ahmad, Amin
2018-03-01
Leadless pacemaker therapy is a new technology that aims at avoiding lead- and pocket-related complications of conventional transvenous and epicardial pacing. To date, 2 self-contained leadless pacemakers for right ventricular pacing have been clinically available: the Nanostim Leadless Pacemaker System and the Micra Transcatheter Pacing System. Additionally, a new multicomponent leadless pacemaker for endocardial left ventricular pacing has been proposed as an alternative choice for cardiac resynchronization therapy. In this review, we describe the state of the art of leadless pacing and compare the currently available devices with traditional transvenous leadless pacemakers. Copyright © 2017 Elsevier Inc. All rights reserved.
Vercellio, G; Castelli, P; Coletti, M; Carlesi, R; Agrifoglio, G
1986-01-01
In the seventies atherosclerotic femoropopliteal lesions were extensively treated by means of retrograde semiclosed thromboendarterectomy (FP-TEA) an analytic follow-up of cases, until 1980, induced the modification of the indications to FP-TEA. Currently the FP-TEA technique is only employed for patients at the 2nd Fontaine's stage with disabling claudication (generally less than 100 mt) with a good distal run-off (at least 2 tibial vessels patent). The report deals with a series of 595 cases operated in the period January 1971-December 1984. In 45% of cases FP-TEA was associated with a proximal revascularization. In an attempt to focus on the factors that may influence the outcome, the patients operated in 1976, 1980, 1984, were assessed and the results related to clinical stage, angiographic pattern and postoperative treatment.
The state of art of the methods for thermohydraulics design of LMFBR fuel elements
International Nuclear Information System (INIS)
Fernandez y Fernandez, E.; Carajilescov, P.
1981-09-01
The present (experimental and analytical) state of art of the methods for thermohydraulics design of LMFBR fuel elements is analyzed. A development program is suggested, in order to obtain a computer code for modelling the distribution of coolant enthalpy in reactor core. This computer code is in development. (Author) [pt
State of the art in HGPT (Heuristically Based Generalized Perturbation) methodology
International Nuclear Information System (INIS)
Gandini, A.
1993-01-01
A distinctive feature of heuristically based generalized perturbation theory (HGPT) methodology consists in the systematic use of importance conservation concepts. As well known, this use leads to fundamental reciprocity relationships from which perturbation, or sensitivity, expressions can be derived. The state of the art of the HGPT methodology is here illustrated. The application to a number of specific nonlinear fields of interest is commented. (author)
Directory of Open Access Journals (Sweden)
Claudio Roberto Assumpção
2008-06-01
Full Text Available Relatamos dois casos um menino de 11 anos e uma menina de um ano e seis meses, portadores de tetralogia de Fallot com artéria coronária de origem anômala, cruzando a via de saída de ventrículo direito. O diagnóstico foi feito com ecocardiografia e cateterismo cardíaco. Utilizamos, na correção, um enxerto externo composto de pericárdio bovino e parede posterior da artéria pulmonar, entre o ventrículo direito e o tronco da artéria pulmonar. As crianças tiveram boa evolução pós-operatória, obtendo alta hospitalarassintomáticas. É mais uma opção técnica na correção da tetralogia de Fallot com artéria coronária anômala.Report on two children, one 11 year-male and another one year-six-month-female with tetralogy of Fallot associated with anomalous origin of coronary artery crossing the right ventricle outlet tract. Diagnosis was done by echocardiography and cardiac catheterization. On surgical correction we used an external composite tubular pericardium bovine graft and posterior wall of the pulmonary artery between the right ventricle and the pulmonary artery trunk. Patients had an uneventful post-operative period and were discharged asymptomatic. It is more an option on correction of tetralogy of Fallot with anomalous coronary artery.
Conservation physiology of marine fishes: state of the art and prospects for policy
Mckenzie, David J.; Axelsson, Michael; Chabot, Denis; Claireaux, Guy; Cooke, Steven J.; Corner, Richard A.; Boeck, De Gudrun; Domenici, Paolo; Guerreiro, Pedro M.; Hamer, Bojan; Jørgensen, Christian; Killen, Shaun S.; Lefevre, Sjannie; Marras, Stefano; Michaelidis, Basile; Nilsson, Göran E.; Peck, Myron A.; Perez-Ruzafa, Angel; Rijnsdorp, Adriaan D.; Shiels, Holly A.; Steffensen, John F.; Svendsen, Jon C.; Svendsen, Morten B.S.; Teal, Lorna R.; Meer, Van Der Jaap; Wang, Tobias; Wilson, Jonathan M.; Wilson, Rod W.; Metcalfe, Julian D.
2016-01-01
The state of the art of research on the environmental physiology of marine fishes is reviewed from the perspective of how it can contribute to conservation of knowledge for conservation of marine fishes is the limited knowledge base; international collaboration is needed to study the environmental
Conservation physiology of marine fishes: state of the art and prospects for policy
DEFF Research Database (Denmark)
McKenzie, David J.; Axelsson, Michael; Chabot, Denis
2016-01-01
The state of the art of research on the environmental physiology of marine fishes is reviewed from the perspective of how it can contribute to conservation of biodiversity and fishery resources. A major constraint to application of physiological knowledge for conservation of marine fishes is the ...
van der Werf, N R; Willemink, M J; Willems, T P; Greuter, M J W; Leiner, T
2017-12-28
The objective of this study was to evaluate the influence of iterative reconstruction on coronary calcium scores (CCS) at different heart rates for four state-of-the-art CT systems. Within an anthropomorphic chest phantom, artificial coronary arteries were translated in a water-filled compartment. The arteries contained three different calcifications with low (38 mg), medium (80 mg) and high (157 mg) mass. Linear velocities were applied, corresponding to heart rates of 0, 75 bpm. Data were acquired on four state-of-the-art CT systems (CT1-CT4) with routinely used CCS protocols. Filtered back projection (FBP) and three increasing levels of iterative reconstruction (L1-L3) were used for reconstruction. CCS were quantified as Agatston score and mass score. An iterative reconstruction susceptibility (IRS) index was used to assess susceptibility of Agatston score (IRS AS ) and mass score (IRS MS ) to iterative reconstruction. IRS values were compared between CT systems and between calcification masses. For each heart rate, differences in CCS of iterative reconstructed images were evaluated with CCS of FBP images as reference, and indicated as small ( 10%). Statistical analysis was performed with repeated measures ANOVA tests. While subtle differences were found for Agatston scores of low mass calcification, medium and high mass calcifications showed increased CCS up to 77% with increasing heart rates. IRS AS of CT1-T4 were 17, 41, 130 and 22% higher than IRS MS . Not only were IRS significantly different between all CT systems, but also between calcification masses. Up to a fourfold increase in IRS was found for the low mass calcification in comparison with the high mass calcification. With increasing iterative reconstruction strength, maximum decreases of 21 and 13% for Agatston and mass score were found. In total, 21 large differences between Agatston scores from FBP and iterative reconstruction were found, while only five large differences were found between
State-of-art report III/1984 (June 29 to November 27, 1984)
International Nuclear Information System (INIS)
1985-01-01
The state-of-art report III/1984 gives a survey of the activities of the Nuclear Committee (KTA) and its panels and of KTA regulation projects in the period between the 35th and 36th KTA meeting. The state-of-art report is designed to give fast, synoptical, adequate information on the current state of KTA work. With regulation projects, data which are subject to miner variations only, for instance concerning the contents or organization of a regulation project, data on the flow of work, members of the panels, are included in the KTA manual. In case of alterations, the data in the KTA manual are updated by replacing the respective pages. (orig./HP) [de
International Nuclear Information System (INIS)
Lee, Da Un; Kim, Jae Kyu; Jung, Hye Doo; Huh, Tae Wook; Yim, Nam Yeol; Oh, Hyun jun; Choi, Soo Jin Na; Chang, Nam Kyu
2010-01-01
To evaluate the occurrence of superficial femoral artery stent fractures, the risk factors of stent fracture, and the relationship between fractures and clinical findings. Of the 38 patients who underwent treatment with Prote'ge'GPS stenting due to arterial occlusions on the superficial femoral artery, 17 also underwent a clinical analysis. Forty-three stents were inserted in the 17 superficial femoral arteries, ranging between 15 and 50 cm in length, with a mean treated length of 26.4 cm (15-50 cm). A fracture was evaluated by taking a PA and lateral simple radiography, as well as a follow-up evaluation accompanied with a CT angiography, DSA, and a color Doppler sonography. The examination involved the assessment of the difference between bone fractures due to length, placement, and frequency. Fractures occurred in 13 of 43 stents (30.2%). A total of 10 (71.4%) occurred in the upper third, compared to 4 (28.6%) in the lower third of the superficial femoral artery. In addition, 10 stents (71.4%) had a single strut fracture, whereas 4 (28.6%) had multiple strut fractures. A stent fracture occurred more frequently when the stents and lesions were longer (p=0.021, 0.012) and the stents were inserted near the joint. However, there was no significant relationship between stent numbers and the fractures (p=0.126). When the stents were inserted along the popliteal artery, a stent fracture occurred more frequently in the lower third of the artery. The stent fractures did not significantly influence the patency rate of the stented artery (p=0.44) Prote'ge'GPS stents in the superficial femoral artery revealed a considerable number of fractures and the fracture frequency showed a significant relationship with the length of stents and lesions. The closer stent insertion was to the joints, the more frequently fractures occurred. There were no evident significant relationships between the presence of stent fractures and the patency of the stented arteries
Summary of State-of-the-Art Power Conversion Systems for Energy Storage Applications
Energy Technology Data Exchange (ETDEWEB)
Atcitty, S.; Gray-Fenner, A.; Ranade, S.
1998-09-01
The power conversion system (PCS) is a vital part of many energy storage systems. It serves as the interface between the storage device, an energy source, and an AC load. This report summarizes the results of an extensive study of state-of-the-art power conversion systems used for energy storage applications. The purpose of the study was to investigate the potential for cost reduction and performance improvement in these power conversion systems and to provide recommendations for fiture research and development. This report provides an overview of PCS technology, a description of several state-of-the-art power conversion systems and how they are used in specific applications, a summary of four basic configurations for l:he power conversion systems used in energy storage applications, a discussion of PCS costs and potential cost reductions, a summary of the stancku-ds and codes relevant to the technology, and recommendations for future research and development.
International Nuclear Information System (INIS)
Tepe, Gunnar; Heller, Stephan; Wiskirchen, Jakub; Fischmann, Arne; Claussen, Claus D.; Zeller, Thomas; Coerper, Stephan; Beckert, Stefan; Balletshofer, Bernd
2007-01-01
The feasibility of self-expanding nitinol stents for treatment of infragenicular arteries following unsuccessful balloon angioplasty was assessed. Options for lower limb percutaneous revascularization are limited, especially for complex vessel obstruction. Depending on the lesion and the experience of the interventionalist, the failure rate of balloon angioplasty (PTA) ranges between 10 and 40%. Until recently, no self-expanding stent for the use in the infragenicular arteries was available. This is the first report of the results for 18 consecutive patients who received 4F sheath compatible self-expanding nitinol stents following unsuccessful PTA or early restenosis. Twenty-four stents were implanted in 21 lesions for various indications residual stenosis >50% due to heavy calcification, flow-limiting dissection, occluding thrombus resistant to thrombolyis, thrombaspiration, and PTA, and early restenosis after previous PTA. Stent implantation was feasible in all cases. No complications occurred. After the stent implantation, all primarily unsuccessful interventions could be transformed into successful procedures with no residual stenosis >30% in any case. After 6 ± 2 months, two of the 18 patients died, and 14 of the 16 remaining patients improved clinically. At follow-up, the patency could be assessed in 14 stented arteries. Three stents were occluded, one stent showed some neointimal hyperplasia (50-70% restenosis), the remaining ten stents showed no restenosis (0-30%). The use of self-expanding nitinol stents in tibioperoneal and popliteal arteries is a safe and feasible option for the treatment of unsuccessful PTA. The 6-months patency is high. (orig.)
Role played by acid-sensitive ion channels in evoking the exercise pressor reflex.
Hayes, Shawn G; McCord, Jennifer L; Rainier, Jon; Liu, Zhuqing; Kaufman, Marc P
2008-10-01
The exercise pressor reflex arises from contracting skeletal muscle and is believed to play a role in evoking the cardiovascular responses to static exercise, effects that include increases in arterial pressure and heart rate. This reflex is believed to be evoked by the metabolic and mechanical stimulation of thin fiber muscle afferents. Lactic acid is known to be an important metabolic stimulus evoking the reflex. Until recently, the only antagonist for acid-sensitive ion channels (ASICs), the receptors to lactic acid, was amiloride, a substance that is also a potent antagonist for both epithelial sodium channels as well as voltage-gated sodium channels. Recently, a second compound, A-317567, has been shown to be an effective and selective antagonist to ASICs in vitro. Consequently, we measured the pressor responses to the static contraction of the triceps surae muscles in decerebrate cats before and after a popliteal arterial injection of A-317567 (10 mM solution; 0.5 ml). We found that this ASIC antagonist significantly attenuated by half (Pacid injection into the popliteal artery. In contrast, A-317567 had no effect on the pressor responses to tendon stretch, a pure mechanical stimulus, and to a popliteal arterial injection of capsaicin, which stimulated transient receptor potential vanilloid type 1 channels. We conclude that ASICs on thin fiber muscle afferents play a substantial role in evoking the metabolic component of the exercise pressor reflex.
International Nuclear Information System (INIS)
EL-SHERBINY, M.
2008-01-01
To highlight on the versatility of superiorly based pedicled gastrocnemius muscle flap in the limb-sparing surgery for bone or soft tissue sarcoma around the knee and popliteal fossa. Patients and Methods: A total of 30 patients with localized bone or soft tissue sarcoma around the knee and popliteal fossa were treated with limb-salvage procedure. The study included 5 cases with bone sarcoma of the distal femur, 15 cases having bone sarcoma of proximal tibia and 10 cases having soft tissue sarcoma around the knee region and popliteal fossa. Routine preoperative staging studies were done for every patient and included local plain radiography, local MRI, isotopic bone scan and CT chest. Local MRA or angiography was done in selected cases. According to the Enneking staging system, 19 patients had stage IIB and 11 had stage IIA. Patients having bone sarcoma of the proximal tibia were subjected to wide resection, endo prosthetic reconstruction and reconstruction of the extensor mechanism by the medial gastrocnemius muscle flap. Patients having bone sarcoma of the distal femur were subjected to wide resection, endo prosthetic reconstruction and coverage of the prosthesis and re balance of the patellar tendon by the medial gas-trocnemius flap. Patients having soft tissue sarcoma were subjected to wide resection and soft tissue coverage with either medial or lateral myocutaneous gastrocnemius flap or muscle flap with grafting. Limb function was evaluated according to MSTS functional scores. Adjuvant chemotherapy or radiotherapy was given according to nationally agreed protocols. Results: There were 18 males and 12 females with a mean age of 29 years at the time of surgery (range 11-44 years). The mean follow-up period was 52 months (range 25-72 months). Resection with a negative bony and soft tissue margins could be achieved in all cases. A total of 30 flaps were used and included medial gastrocnemius muscle flaps in 21 cases (15 cases had proximal tibia endoprothesis, 5
Fine pitch thermosonic wire bonding: analysis of state-of-the-art manufacturing capability
Cavasin, Daniel
1995-09-01
A comprehensive process characterization was performed at the Motorola plastic package assembly site in Selangor, Malaysia, to document the current fine pitch wire bond process capability, using state-of-the-art equipment, in an actual manufacturing environment. Two machines, representing the latest technology from two separate manufacturers, were operated one shift per day for five days, bonding a 132 lead Plastic Quad Flat Pack. Using a test device specifically designed for fine pitch wire bonding, the bonding programs were alternated between 107 micrometers and 92 micrometers pad pitch, running each pitch for a total of 1600 units per machine. Wire, capillary type, and related materials were standardized and commercially available. A video metrology measurement system, with a demonstrated six sigma repeatability band width of 0.51 micrometers , was utilized to measure the bonded units for bond dimensions and placement. Standard Quality Assurance (QA) metrics were also performed. Results indicate that state-of-the-art thermosonic wire bonding can achieve acceptable assembly yields at these fine pad pitches.
Seismic response of buried pipelines: a state-of-the-art review
International Nuclear Information System (INIS)
Datta, T.K.
1999-01-01
A state-of-the-art review of the seismic response of buried pipelines is presented. The review includes modeling of soil-pipe system and seismic excitation, methods of response analysis of buried pipelines, seismic behavior of buried pipelines under different parametric variations, seismic stresses at the bends and intersections of network of pipelines. pipe damage in earthquakes and seismic risk analysis of buried pipelines. Based on the review, the future scope of work on the subject is outlined. (orig.)
Radioactive waste management: State of the art in the world. Part 2
International Nuclear Information System (INIS)
Pahissa Campa, Jaime; Pahissa, Marta H. de
2001-01-01
In the former number of this publication, the management of low and intermediate level wastes (LILW) was described as well as an overview of the state of art in the world. This report summarizes the strategies for high level waste management including final disposal. What is being done on an international basis in this field in different countries will be described in the next number of this review. (author)
Blade root design a state of the art survey
Energy Technology Data Exchange (ETDEWEB)
Sandberg, O
1988-06-01
This report was conceived in the wake of recent blade root failures in several horizontal axis turbines. Ten blade root designs are presented. They are considered to represent the state of the art. The information was obtained partly from literature partly from a few important projects with little or no documentation. Suggestions are made how to proceed in the development of the bonded bolt type of root retention. Presently the conclusion is that this type of arrangement seems the most promising. Developments in this field should be closely monitored, however. For this type of very high cycle fatigue designs there is a need for two redundant design principles. (author).
The state-of-the-art in short-term prediction of wind power. A literature overview
Energy Technology Data Exchange (ETDEWEB)
Giebel, G.; Brownsword, R.; Kariniotakis, G.
2003-08-01
Based on an appropriate questionnaire (WP1.1) and some other works already in progress, this report details the state-of-the-art in short term prediction of wind power, mostly summarising nearly all existing literature on the topic. (au)
The state-of-the-art in the rehabilitation of a PIONEER Crane
Directory of Open Access Journals (Sweden)
Cosmin Bledea
2005-10-01
Full Text Available The paper is focused on the analysis about the state of stress in the girder of a PIONEER crane with a prescribed vertical loading of 0,75 tones belonging to the thermal power-station Timisoara. The analysis has been performed with a FEA software (COSMOS/M which is able to conduct to important results regarding the map of stress, especially in areas where high stress concentration are present. There have been automatically combined a wide range of finite elements: shell, brick, beam,truss-cable simulating the different zones of the girder. The combination of the most advanced standard components as well the implementation of the modular product concepts and the state-of-the-art regarding the design of cranes must be in a perfect agreement with the state of stress in the metallic structure. In the end, a comparison between the FEA results and the classical calculus with the strength of materials theory has been performed.
Big-hole drilling - the state of the art
International Nuclear Information System (INIS)
Lackey, M.D.
1983-01-01
The art of big-hole drilling has been in a continual state of evolution at the Nevada Test Site since the start of underground testing in 1961. Emplacement holes for nuclear devices are still being drilled by the rotary-drilling process, but almost all the hardware and systems have undergone many changes during the intervening years. The current design of bits, cutters, and other big-hole-drilling hardware results from contributions of manufacturers and Test Site personnel. The dual-string, air-lift, reverse-circulation system was developed at the Test Site. Necessity was really the Mother of this invention, but this circulation system is worthy of consideration under almost any condition. Drill rigs for big-hole drilling are usually adaptations of large oil-well drill rigs with minor modifications required to handle the big bits and drilling assemblies. Steel remains the favorite shaft lining material, but a lot of thought is being given to concrete linings, especially precast concrete
The emancipatory character of action research, its history and the present state of the art
Boog, B.
2003-01-01
Right from the start. action research was intended to be emancipatory research, and it still is. This article will underpin this by outlining its history and the present state of the art. Though a variety of action research approaches have developed along divergent theoretical pathways, it will be
Saeid Khalafvand, Seyed; Han, Hai-Chao
2015-01-01
It has been shown that arteries may buckle into tortuous shapes under lumen pressure, which in turn could alter blood flow. However, the mechanisms of artery instability under pulsatile flow have not been fully understood. The objective of this study was to simulate the buckling and post-buckling behaviors of the carotid artery under pulsatile flow using a fully coupled fluid–structure interaction (FSI) method. The artery wall was modeled as a nonlinear material with a two-fiber strain-energy function. FSI simulations were performed under steady-state flow and pulsatile flow conditions with a prescribed flow velocity profile at the inlet and different pressures at the outlet to determine the critical buckling pressure. Simulations were performed for normal (160 ml/min) and high (350 ml/min) flow rates and normal (1.5) and reduced (1.3) axial stretch ratios to determine the effects of flow rate and axial tension on stability. The results showed that an artery buckled when the lumen pressure exceeded a critical value. The critical mean buckling pressure at pulsatile flow was 17–23% smaller than at steady-state flow. For both steady-state and pulsatile flow, the high flow rate had very little effect (<5%) on the critical buckling pressure. The fluid and wall stresses were drastically altered at the location with maximum deflection. The maximum lumen shear stress occurred at the inner side of the bend and maximum tensile wall stresses occurred at the outer side. These findings improve our understanding of artery instability in vivo. PMID:25761257
Saeid Khalafvand, Seyed; Han, Hai-Chao
2015-06-01
It has been shown that arteries may buckle into tortuous shapes under lumen pressure, which in turn could alter blood flow. However, the mechanisms of artery instability under pulsatile flow have not been fully understood. The objective of this study was to simulate the buckling and post-buckling behaviors of the carotid artery under pulsatile flow using a fully coupled fluid-structure interaction (FSI) method. The artery wall was modeled as a nonlinear material with a two-fiber strain-energy function. FSI simulations were performed under steady-state flow and pulsatile flow conditions with a prescribed flow velocity profile at the inlet and different pressures at the outlet to determine the critical buckling pressure. Simulations were performed for normal (160 ml/min) and high (350 ml/min) flow rates and normal (1.5) and reduced (1.3) axial stretch ratios to determine the effects of flow rate and axial tension on stability. The results showed that an artery buckled when the lumen pressure exceeded a critical value. The critical mean buckling pressure at pulsatile flow was 17-23% smaller than at steady-state flow. For both steady-state and pulsatile flow, the high flow rate had very little effect (<5%) on the critical buckling pressure. The fluid and wall stresses were drastically altered at the location with maximum deflection. The maximum lumen shear stress occurred at the inner side of the bend and maximum tensile wall stresses occurred at the outer side. These findings improve our understanding of artery instability in vivo.
State-of-the-art report of spent fuel management technology
International Nuclear Information System (INIS)
Ro, S. G.; Park, S. W.; Shin, Y. J. and others
1998-06-01
Essential technologies for a long-term management of domestic nuclear fuel have been described in this report. The technologies of interest are advanced processes for spent fuel management, spent fuel examination technology, evaluation of radiation effect on equipment, chemical characterization of spent fuel, and hot cell-related technology state of the art for the above-mentioned technologies has been reviewed and analyzed in detail. As a result, a future R and D direction that seems to be appropriate for us is drawn up in due consideration of in- and out-circumstances encountered with. (author). 304 refs., 28 tabs., 43 figs
International Nuclear Information System (INIS)
Subhash, P.V.; Tadepalli, Sai Chaitanya; Deshpande, Shishir P.; Kanth, Priti; Srinivasan, R.
2017-01-01
Rigorous activation calculations are warranted for safer and efficient design of future fusion machines. Suitable activation codes, which yield accurate results with faster performance yet include all fusion relevant reactions are a prerequisite. To meet these, an indigenous project called ACTYS-Project is initiated and as a result, four state-of-art codes are developed so far. The goal of this project is to develop indigenous state-of-the-art code suites for nuclear activation analysis
The fifth generation computer project state of the art report 111
Scarrott
1983-01-01
The Fifth Generation Computer Project is a two-part book consisting of the invited papers and the analysis. The invited papers examine various aspects of The Fifth Generation Computer Project. The analysis part assesses the major advances of the Fifth Generation Computer Project and provides a balanced analysis of the state of the art in The Fifth Generation. This part provides a balanced and comprehensive view of the development in Fifth Generation Computer technology. The Bibliography compiles the most important published material on the subject of The Fifth Generation.
The State of the Art in Cold Forging Lubrication
DEFF Research Database (Denmark)
Bay, Niels
1994-01-01
The manufature of components in steel, aluminium and copper alloys by cold forging production has increased ever since the 1950's. Typical processes are forward rod extrusion and backward can extrusion, upsetting, ironing, tube extrusion and radial extrusion. The tribological conditions in cold...... forging are extremely severe due to large surface expansion and normal pressure in the tool/workpiece interface combined with elevated tool temperatures. Except for the more simple cold forging operations successful production therefore requires advanced lubrication systems. The present paper gives...... a detailed description of the state of art for lubricant systems for cold forging of C-steels and low alloy steels as well as aluminium alloys including all the basic operations such as cleaning of the slugs, application of eventual conversion coating and lubrication. As regards cold forging of steel...
Huang, Hanrui; Sejdić, Ervin
2013-12-01
Trans-cranial Doppler (TCD) recordings are used to monitor cerebral blood flow in the main cerebral arteries. The resting state is usually characterized by the mean velocity or the maximum Doppler shift frequency (an envelope signal) by insonating the middle cerebral arteries. In this study, we characterized cerebral blood flow in the anterior cerebral arteries. We analyzed both envelope signals and raw signals obtained from bilateral insonation. We recruited 20 healthy patients and conducted the data acquisition for 15 min. Features were extracted from the time domain, the frequency domain and the time-frequency domain. The results indicate that a gender-based statistical difference exists in the frequency and time-frequency domains. However, no handedness effect was found. In the time domain, information-theoretic features indicated that mutual dependence is higher in raw signals than in envelope signals. Finally, we concluded that insonation of the anterior cerebral arteries serves as a complement to middle cerebral artery studies. Additionally, investigation of the raw signals provided us with additional information that is not otherwise available from envelope signals. Use of direct trans-cranial Doppler raw data is therefore validated as a valuable method for characterizing the resting state. Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.
Solar water detoxification: state of the art of the research in Spain
International Nuclear Information System (INIS)
Perez Martinez, M.; Cuesta Santianes, J.; Cabrera Jimenez, J. A.; Garcia Garcia, D.; Trevino Sanchez, A. C.; Berges Garcia, A.
2010-01-01
The CIEMAT's Foresight and Technology Watch Unit, whose technology watch management system is certified by Aenor as per standards UNE 16006:2006, has developed this study in order to review the state of the art of national research on solar water detoxification. to reach this goal, data bases of scientific publications, research projects and patents have been used. The technology watch information management solution VICUBO, developed by E-intelligent, was used as support tool for the afore-mentioned standard. (Author) 3 refs.
A state-of-the-art passive gamma-ray assay system
International Nuclear Information System (INIS)
Sampson, T.E.; Parker, J.L.; Cowder, L.R.; Kern, E.A.; Garcia, D.L.; Ensslin, N.
1987-01-01
We report details of the development of a high-accuracy, high-precision system for the non-destructive assay of 235 U in solution. The system can measure samples with concentrations ranging from 0.0001 to 500 g 235 U/l using 200-ml samples at low concentrations, 30-ml samples at high concentrations, and 1000-s measurement times. The accuracy and precision goals of 0.1% were essentially attained for concentrations above 100 g/l. This at-line system, designed for a production plant environment, represents a significant improvement in the state of the art
On the state of the art: risk communication to decision-makers
International Nuclear Information System (INIS)
Bier, V.M.
2001-01-01
This paper reviews the state of the art on risk communication to decision-makers, with an emphasis on issues involved in communicating technical results. In particular, the paper discusses the treatment of uncertainty, variability, and dependence. It also reviews suggestions from the literature regarding the appropriate format of risk communication messages to decision-makers. Due to the lack of detailed empirical investigations and definitive results about this topic, the paper is not intended to be a comprehensive review, but rather as an exploration of key issues in this area
The state-of-the-art in short-term prediction of wind power. A literature overview
Energy Technology Data Exchange (ETDEWEB)
Giebel, G.; Draxl, C. (Risoe DTU, Roskilde (Denmark)); Brownsword, R. (Rutherford Appleton Laboratory (RAL), Oxford (United Kingdom)); Kariniotakis, G. (ARMINES, Paris (France)); Denhard, M. (ECMWF, Reading (United Kingdom))
2011-01-15
This Deliverable of ANEMOS.plus (Advanced Tools for the Management of Electricity Grids with Large-Scale Wind Generation) and SafeWind projects presents the state of the art in wind power forecasting. More than 380 references of journal and conference papers have been reviewed. (LN)
Hemodynamic factors as a cause of vascular surgery failures in diabetics
DEFF Research Database (Denmark)
Tønnesen, K H; Agerskov, K; Faris, I
1983-01-01
Thirty-six legs in thirty-three diabetic patients with ischemia at rest and multiple level arterial disease were studied preoperatively. Direct intraarterial femoral and popliteal artery blood pressures were measured together with indirect arm and foot blood pressures. Based on the systolic...
Directory of Open Access Journals (Sweden)
Ludmylla Teixeira Soares
2015-06-01
Full Text Available BACKGROUND:Vascular traumas are associated with high morbidity rates.OBJECTIVE: To report the characteristics of vascular traumas in the Brazilian state of Pará, in trauma victims treated at the Hospital Metropolitano de Urgência e Emergência (HMUE, from 2011 to 2013.METHOD: This was a descriptive, cross-sectional, retrospective and quantitative study that analyzed data on sex, age group, geographical origin, time waiting for care, mechanism of trauma, clinical status, anatomic site of injury, prevalence of associated fractures, vascular structures injured, types of vascular injury, principal types of surgery, early postoperative outcomes, level of amputation, number of deaths, length of hospital stay and multidisciplinary care for 264 medical records.RESULTS: The majority of victims were male and the most common age group was from 16 to 30 years. The majority of cases were from towns other than the state capital, accounting for 169 cases (64.02%. The principal mechanism of injury was firearm wounding - 110 (41.67% followed by cold weapon wounds - 65 (24.62% and traffic accidents - 42 (15.91%. The segments of the body and the vascular structures most often injured were lower limbs - 120 (45.45% and injuries to the popliteal and femoral arteries and veins. The most common clinical presentation at admission was hemorrhage - 154 (58.33%. The most common surgeries were ligatures of veins and arteries. There were 163 (61.74% hospital discharges and 33 (12.5% deaths.CONCLUSIONS: The greatest prevalence observed was related to traumas caused by urban violence. Victims were most frequently male, of working age and from towns other than the capital of the state of Pará.
CEN standards for solar thermal systems - State of the art and expectted impact
Ree, B.G.C. van der; Pauschinger, Th.
1996-01-01
Since 1994, the European Committee for Standardization (CEN) Technical Committee TC 312 has been active in producing European Standards for thermal solar energy systems and components. In this paper, an overview of the present State of the Art of the draft standards is presented. These standards
Thomas Kühn
2005-01-01
On March 9th, 2005, a conference entitled "Qualitative Market Research—State of the Art and Prospects" was held in Frankfurt/M., organized by the Association of German Social and Market Researchers (BVM e.V.). Because of the great interest generated by the conference it was repeated on April 20th, 2005. The aim of the conference was to bring together market research professionals from the supply and demand sector to discuss the state of the art of qualitative market research in Germany. Withi...
The state-of-the-art port of entry workshop
Energy Technology Data Exchange (ETDEWEB)
Godfrey, B.
1995-05-01
The increased demand for freight movements through international ports of entry and the signing of the North American Free Trade Agreement (NAFTA) have increased freight traffic at border ports of entry. The State-of-the-Art Port of Entry Workshop initiated a dialogue among technologists and stakeholders to explore the potential uses of technology at border crossings and to set development priorities. International ports of entry are both information and labor intensive, and there are many promising technologies that could be used to provide timely information and optimize inspection resources. Participants universally held that integration of technologies and operations is critical to improving port services. A series of Next Steps was developed to address stakeholder issues and national priorities, such as the National Transportation Policy and National Drug Policy. This report documents the views of the various stakeholders and technologists present at the workshop and outlines future directions of study.
State of the art report on aging reliability analysis
International Nuclear Information System (INIS)
Choi, Sun Yeong; Yang, Joon Eon; Han, Sang Hoon; Ha, Jae Joo
2002-03-01
The goal of this report is to describe the state of the art on aging analysis methods to calculate the effects of component aging quantitatively. In this report, we described some aging analysis methods which calculate the increase of Core Damage Frequency (CDF) due to aging by including the influence of aging into PSA. We also described several research topics required for aging analysis for components of domestic NPPs. We have described a statistical model and reliability physics model which calculate the effect of aging quantitatively by using PSA method. It is expected that the practical use of the reliability-physics model will be increased though the process with the reliability-physics model is more complicated than statistical model
Desiccant cooling: State-of-the-art assessment
Energy Technology Data Exchange (ETDEWEB)
Pesaran, A.A.; Penney, T.R.; Czanderna, A.W.
1992-10-01
The objectives of this document are to present an overview of the work accomplished to date on desiccant cooling to provide assessment of the state of the art of desiccant cooling technology in the field of desiccant material dehumidifier components, desiccant systems, and models. The report also discusses the factors that affect the widespread acceptance of desiccant cooling technology. This report is organized as follows. First, a basic description and historical overview of desiccant cooling technology is provided. Then, the recent research and development (R D) program history (focusing on DOE's funded efforts) is discussed. The status of the technology elements (materials, components, systems) is discussed in detail and a preliminary study on the energy impact of desiccant technology is presented. R D needs for advancing the technology in the market are identified. The National Renewable Energy Laboratory's unique desiccant test facilities and their typical outputs are described briefly. Finally, the results of a comprehensive literature search on desiccant cooling are presented in a bibliography. The bibliography contains approximately 900 citations on desiccant cooling.
Desiccant cooling: State-of-the-art assessment
Energy Technology Data Exchange (ETDEWEB)
Pesaran, A.A.; Penney, T.R.; Czanderna, A.W.
1992-10-01
The objectives of this document are to present an overview of the work accomplished to date on desiccant cooling to provide assessment of the state of the art of desiccant cooling technology in the field of desiccant material dehumidifier components, desiccant systems, and models. The report also discusses the factors that affect the widespread acceptance of desiccant cooling technology. This report is organized as follows. First, a basic description and historical overview of desiccant cooling technology is provided. Then, the recent research and development (R&D) program history (focusing on DOE`s funded efforts) is discussed. The status of the technology elements (materials, components, systems) is discussed in detail and a preliminary study on the energy impact of desiccant technology is presented. R&D needs for advancing the technology in the market are identified. The National Renewable Energy Laboratory`s unique desiccant test facilities and their typical outputs are described briefly. Finally, the results of a comprehensive literature search on desiccant cooling are presented in a bibliography. The bibliography contains approximately 900 citations on desiccant cooling.
State of the Art in Pediatric Lung Transplantation.
Lancaster, Timothy S; Eghtesady, Pirooz
2018-04-24
Pediatric lung transplantation is a highly specialized therapy for end stage pulmonary disease in children, performed in only a handful of transplant centers around the world. Advancement in the field has been made on many fronts in recent years, including in public policy and organ allocation strategies, donor selection and management, emerging technologies for donor lung rehabilitation and bridge-to-transplant support of listed candidates, and ongoing refinement of surgical techniques. Despite this progress, children continue to suffer discrepant waitlist mortality and longer waiting times than their adult counterparts, and face special challenges of donor availability and size matching. Here we review the current state of the art in pediatric lung transplantation, reviewing progress made to date and further opportunities to improve care for this unique group of patients. Copyright © 2018 Elsevier Inc. All rights reserved.
Energy Technology Data Exchange (ETDEWEB)
Tay, Keng Yeow; U-King-Im, Jean Marie; Trivedi, Rikin A.; Higgins, Nicholas J.; Cross, Justin J.; Antoun, Nagui M. [Addenbrooke' s Hospital and University of Cambridge, Department of Radiology, Cambridge (United Kingdom); Davies, John R.; Weissberg, Peter L. [Addenbrooke' s Hospital and University of Cambridge, Division of Cardiovascular Medicine, Cambridge (United Kingdom); Gillard, Jonathan H. [Addenbrooke' s Hospital and University of Cambridge, Department of Radiology, Cambridge (United Kingdom); Addenbrooke' s Hospitald, University Department of Radiology, Cambridge (United Kingdom)
2005-07-01
Although conventional intraarterial digital subtraction angiography remains the gold standard method for imaging the vertebral artery, noninvasive modalities such as ultrasound, multislice computed tomographic angiography and magnetic resonance angiography are constantly improving and are playing an increasingly important role in diagnosing vertebral artery pathology in clinical practice. This paper reviews the current state of vertebral artery imaging from an evidence-based perspective. Normal anatomy, normal variants and a number of pathological entities such as vertebral atherosclerosis, arterial dissection, arteriovenous fistula, subclavian steal syndrome and vertebrobasilar dolichoectasia are discussed. (orig.)
International Nuclear Information System (INIS)
Tay, Keng Yeow; U-King-Im, Jean Marie; Trivedi, Rikin A.; Higgins, Nicholas J.; Cross, Justin J.; Antoun, Nagui M.; Davies, John R.; Weissberg, Peter L.; Gillard, Jonathan H.
2005-01-01
Although conventional intraarterial digital subtraction angiography remains the gold standard method for imaging the vertebral artery, noninvasive modalities such as ultrasound, multislice computed tomographic angiography and magnetic resonance angiography are constantly improving and are playing an increasingly important role in diagnosing vertebral artery pathology in clinical practice. This paper reviews the current state of vertebral artery imaging from an evidence-based perspective. Normal anatomy, normal variants and a number of pathological entities such as vertebral atherosclerosis, arterial dissection, arteriovenous fistula, subclavian steal syndrome and vertebrobasilar dolichoectasia are discussed. (orig.)
Rexhaj, Emrush; Pireva, Agim; Paoloni-Giacobino, Ariane; Allemann, Yves; Cerny, David; Dessen, Pierre; Sartori, Claudio; Scherrer, Urs; Rimoldi, Stefano F
2015-10-01
Assisted reproductive technologies (ART) induce vascular dysfunction in humans and mice. In mice, ART-induced vascular dysfunction is related to epigenetic alteration of the endothelial nitric oxide synthase (eNOS) gene, resulting in decreased vascular eNOS expression and nitrite/nitrate synthesis. Melatonin is involved in epigenetic regulation, and its administration to sterile women improves the success rate of ART. We hypothesized that addition of melatonin to culture media may prevent ART-induced epigenetic and cardiovascular alterations in mice. We, therefore, assessed mesenteric-artery responses to acetylcholine and arterial blood pressure, together with DNA methylation of the eNOS gene promoter in vascular tissue and nitric oxide plasma concentration in 12-wk-old ART mice generated with and without addition of melatonin to culture media and in control mice. As expected, acetylcholine-induced mesenteric-artery dilation was impaired (P = 0.008 vs. control) and mean arterial blood pressure increased (109.5 ± 3.8 vs. 104.0 ± 4.7 mmHg, P = 0.002, ART vs. control) in ART compared with control mice. These alterations were associated with altered DNA methylation of the eNOS gene promoter (P culture media prevented eNOS dysmethylation (P = 0.005, vs. ART + vehicle), normalized nitric oxide plasma concentration (23.1 ± 14.6 μM, P = 0.002 vs. ART + vehicle) and mesentery-artery responsiveness to acetylcholine (P culture media prevents ART-induced vascular dysfunction. We speculate that this approach will also allow preventing ART-induced premature atherosclerosis in humans. Copyright © 2015 the American Physiological Society.
Directory of Open Access Journals (Sweden)
Herbert Coelho Hortmann
2010-06-01
Full Text Available OBJETIVO: Comparar a perviedade da artéria radial e veia safena em pacientes com retorno dos sintomas após cirurgia de revascularização do miocárdio (CRVM. MÉTODOS: Estudo retrospectivo. No período de janeiro de 1998 a dezembro de 2005, foram realizadas 469 CRVMs com o uso da artéria radial dentre os enxertos, no Hospital Vera Cruz, em Belo Horizonte/MG. Destes, 94 pacientes apresentaram alterações isquêmicas no pós-operatório recente ou tardio e foram reestudados com cineangiocoronariografia. Os enxertos foram divididos em três grupos: artéria torácica interna (ATI, artéria radial (AR e veia safena (VS, e foram estratificados segundo a gravidade das lesões: sem lesão grave (OBJECTIVE: To compare the radial artery and saphenous vein's patency in patients with recurrence of symptoms in a coronary artery bypass grafting (CABG. METHODS: Retrospective study. From January 1998 to December 2005, 469 CABGs were performed using the radial artery as a graft, in Vera Cruz Hospital in Belo Horizonte/ MG. Among the patients who underwent those surgeries, 94 presented ischemic changes in early or late postoperative period, which led them to be re-evaluated by coronary angiography. The grafts were divided in three groups: internal thoracic artery (ITA, radial artery (RA and saphenous vein (SV, and they were stratified according to the severity of injury: uninjured or patent (< 70%, severe obstruction (70 to 99% and occlusion. RESULTS: For the 94 patients in the study, 86 grafts of ITA, 94 of RA and 111 of SV were used. For the 86 ITA grafts, 73 (84.88% were found patent. For the 94 RA grafts, 55 (58.51% were found patent, and for the 111 SV grafts, 73 (65.76% were uninjured. A statistically significant difference (P= 0.001 was found between RA and SV grafts, with a higher patency found for VS graft. For the RA grafts, women presented a worse result concerning the RA patency (65.7% and 40.7%, with P = 0.006. Concerning coronary
State of the art of UO2 fuel fabrication processes
International Nuclear Information System (INIS)
Henke, M.; Klemm, U.
1980-01-01
Starting from the need of UO 2 for thermal power reactors in the period from 1980 to 1990 and the role of UF 6 conversion into UO 2 within the fuel cycle, the state-of-the-art of the three established industrial processes - ADU process, AUC process, IDR process - is assessed. The number of process stages and requirements on process management are discussed. In particular, the properties of the fabricated UO 2 powders, their influence on the following pellet production and on operational behaviour of the fuel elements under reactor conditions are described. Hence, an evaluation of the three essential conversion processes is derived. (author)
Preliminary power train design for a state-of-the-art electric vehicle
Ross, J. A.; Wooldridge, G. A.
1978-01-01
The state-of-the-art (SOTA) of electric vehicles built since 1965 was reviewed to establish a base for the preliminary design of a power train for a SOTA electric vehicle. The performance of existing electric vehicles were evaluated to establish preliminary specifications for a power train design using state-of-the-art technology and commercially available components. Power train components were evaluated and selected using a computer simulation of the SAE J227a Schedule D driving cycle. Predicted range was determined for a number of motor and controller combinations in conjunction with the mechanical elements of power trains and a battery pack of sixteen lead-acid batteries - 471.7 kg at 0.093 MJ/Kg (1040 lbs. at 11.7 Whr/lb). On the basis of maximum range and overall system efficiency using the Schedule D cycle, an induction motor and 3 phase inverter/controller was selected as the optimum combination when used with a two-speed transaxle and steel belted radial tires. The predicted Schedule D range is 90.4 km (56.2 mi). Four near term improvements to the SOTA were identified, evaluated, and predicted to increase range approximately 7%.
Directory of Open Access Journals (Sweden)
Marcelo Abidu-Figueiredo
2008-05-01
Full Text Available Rabbits have been used as an experimental model in many diseases and for the study of toxicology, pharmacology and surgery in many universities. However, some aspects of their macro anatomy need a more detailed description, especially the abdominal and pelvic arterial vascular system, which has a huge variability in distribution and trajectory. Thirty cadaveric adult New Zealand rabbits, 13 male and 17 female, with an average weight and rostrum-sacral length of 2.5 kg and 40cm, respectively, were used. The thoracic aorta was cannulated and the vascular system was filled with stained latex S-65. The celiac artery and its proximal branches were dissected and lengthened in order to evidence origin and proximal ramifications. The celiac artery emerged between the 12th and 13th thoracic vertebra in 11 (36.7% rabbits; at the level of the 13th thoracic vertebra in 6 (20% rabbits; between the 13th thoracic vertebra and the 1st lumbar vertebra in 12 (40% rabbits; and at the level of the 1st lumbar vertebra in only one (3.3% rabbit. The mean length of the celiac artery was 0.5cm. The celiac artery first branch was the lienal artery, the second branch was the left gastric artery and the hepatic artery arose from the left gastric artery in all the dissected rabbits. No relation was observed between the celiac artery length and the rostrum-sacral length in rabbits. The number of left gastric and lienal artery branches and the distribution of celiac artery origin are not gender dependent.Os coelhos têm sido usados como modelo experimental em diferentes patologias e para estudos de toxicologia, farmacologia e cirurgia em várias universidades. Entretanto apesar de sua grande utilização, muitos aspectos de sua macroanatomia, em especial os que se referem ao sistema vascular arterial que irrigam as viscerais abdomino-pélvicas ainda carecem de uma descrição mais detalhada, pois os vasos arteriais apresentam grande variabilidade na sua distribuição e
Assisted Reproduction Techniques (Art): The State of the Art in Nigeria
African Journals Online (AJOL)
Background: Infertility has become a social stigma in our environment because of the erroneous belief that a childless marriage is a failed marriage. This has placed a lot of marriages under pressure. Therefore any solution to infertility is a welcome relief. This is where Assisted Reproduction Techniques (ART) belongs.
Airway clearance techniques in neuromuscular disorders: A state of the art review.
Chatwin, Michelle; Toussaint, Michel; Gonçalves, Miguel R; Sheers, Nicole; Mellies, Uwe; Gonzales-Bermejo, Jesus; Sancho, Jesus; Fauroux, Brigitte; Andersen, Tiina; Hov, Brit; Nygren-Bonnier, Malin; Lacombe, Matthieu; Pernet, Kurt; Kampelmacher, Mike; Devaux, Christian; Kinnett, Kathy; Sheehan, Daniel; Rao, Fabrizio; Villanova, Marcello; Berlowitz, David; Morrow, Brenda M
2018-03-01
This is a unique state of the art review written by a group of 21 international recognized experts in the field that gathered during a meeting organized by the European Neuromuscular Centre (ENMC) in Naarden, March 2017. It systematically reports the entire evidence base for airway clearance techniques (ACTs) in both adults and children with neuromuscular disorders (NMD). We not only report randomised controlled trials, which in other systematic reviews conclude that there is a lack of evidence base to give an opinion, but also include case series and retrospective reviews of practice. For this review, we have classified ACTs as either proximal (cough augmentation) or peripheral (secretion mobilization). The review presents descriptions; standard definitions; the supporting evidence for and limitations of proximal and peripheral ACTs that are used in patients with NMD; as well as providing recommendations for objective measurements of efficacy, specifically for proximal ACTs. This state of the art review also highlights how ACTs may be adapted or modified for specific contexts (e.g. in people with bulbar insufficiency; children and infants) and recommends when and how each technique should be applied. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.
Processing emotional body expressions: state-of-the-art.
Enea, Violeta; Iancu, Sorina
2016-10-01
Processing emotional body expressions has become recently an important topic in affective and social neuroscience along with the investigation of facial expressions. The objective of the study is to review the literature on emotional body expressions in order to discuss the current state of knowledge on this topic and identify directions for future research. The following electronic databases were searched: PsychINFO, Ebsco, ERIC, ProQuest, Sagepub, and SCOPUS using terms such as "body," "bodily expression," "body perception," "emotions," "posture," "body recognition" and combinations of them. The synthesis revealed several research questions that were addressed in neuroimaging, electrophysiological and behavioral studies. Among them, one important question targeted the neural mechanisms of emotional processing of body expressions to specific subsections regarding the time course for the integration of emotional signals from face and body, as well as the role of context in the perception of emotional signals. Processing bodily expression of emotion is similar to processing facial expressions, and the holistic processing is extended to the whole person. The current state-of-the-art in processing emotional body expressions may lead to a better understanding of the underlying neural mechanisms of social behavior. At the end of the review, suggestions for future research directions are presented.
Wouters, E; Van Loon, F; Van Rensburg, D; Meulemans, H
2009-11-01
The South African public-sector antiretroviral treatment (ART) program has yielded promising early results. To extend and reinforce these preliminary findings, we undertook a detailed assessment of the clinical efficacy and outcomes over two years of ART. The primary objective was to assess the clinical outcomes and adverse effects of two years of ART, while identifying the possible effects of baseline health and patient characteristics. A secondary objective was to address the interplay between positive and negative outcomes (clinical benefits versus adverse effects) in terms of the patients' physical and emotional quality of life (QoL). Clinical outcome, baseline characteristics, health status, and physical and emotional QoL scores were determined from clinical files and interviews with 268 patients enrolled in the Free State ART program at three time points (6, 12, and 24 months of ART). Age, sex, education, and baseline health (CD4 cell count and viral load) were all independently associated with the ART outcome in the early stages of treatment, but their impact diminished as the treatment progressed. The number of patients classified as treatment successes increased over the first two years of ART, whereas the proportion of patients experiencing adverse effects diminished. Importantly, our findings show that ART had strong and stable positive effects on physical and emotional QoL. These favorable results demonstrate that a well-managed public-sector ART program can be very successful within a high-HIV-prevalence resource-limited setting. This finding emphasizes the need to adopt treatment scale-up as a key policy priority, while at the same time ensuring that the highest standards of healthcare provision are maintained. Healthcare services should also target vulnerable groups (males, less-educated patients, those with low baseline CD4 cell counts, and high baseline viral loads) who are most likely to experience treatment failure.
International Nuclear Information System (INIS)
Efimov, O.N.; Gabuniya, R.I.; Kamynin, Yu.F.; Matveenko, E.G.; Buyuklyan, A.N.; Skoropad, L.S.; Syzgantseva, L.M.
1978-01-01
Hemodynamics and functional state of parenchyma of the kidney were studied in 39 patients with stenosis of the renal arteries by means of pertechnetate 99 Tc, hippuran 131 I and chlormerodrine 197 Hg. In patients with vasorenal hypertension the following changes in the stenosed kidney were revealed: a significant decrease in the renal blood flow, renal fraction, volume of maximal saturation, specific blood flow, systolic renal index; elevation of the intrarenal vascular resistance; and impairment of the functional state of the renal parenchyma. It was established that there was a direct dependence between the renal blood flow and the volume of maximal saturation and a reverse dependence between the renal blood flow and intrarenal vascular resistance. Hemodynamic changes in the stenosed kidney played an important role and led at first to a bias in renographic indices and then - to a decrease in accumulation of chlormerodrine 197 Hg in the kidneys. It was noted that changes in the functional state of the renal parenchyma tended to be dependent upon the level of the renal blood flow, and indices of the renal blood flow - upon the values of arterial pressure. From diagnostic point of view, methods of radioiangiography, as compared with renography and scintigraphy, were found to be the most informative
Geothermal well log interpretation state of the art. Final report
Energy Technology Data Exchange (ETDEWEB)
Sanyal, S.K.; Wells, L.E.; Bickham, R.E.
1980-01-01
An in-depth study of the state of the art in Geothermal Well Log Interpretation has been made encompassing case histories, technical papers, computerized literature searches, and actual processing of geothermal wells from New Mexico, Idaho, and California. A classification scheme of geothermal reservoir types was defined which distinguishes fluid phase and temperature, lithology, geologic province, pore geometry, salinity, and fluid chemistry. Major deficiencies of Geothermal Well Log Interpretation are defined and discussed with recommendations of possible solutions or research for solutions. The Geothermal Well Log Interpretation study and report has concentrated primarily on Western US reservoirs. Geopressured geothermal reservoirs are not considered.
State-of-the-art of fiber-reinforced polymers in additive manufacturing technologies
DEFF Research Database (Denmark)
Hofstätter, Thomas; Pedersen, David Bue; Tosello, Guido
2017-01-01
Additive manufacturing technologies have received a lot of attention in recent years for their use in multiple materials such as metals, ceramics, and polymers. The aim of this review article is to analyze the technology of fiber-reinforced polymers and its implementation with additive...... manufacturing. This article reviews recent developments, ideas, and state-of-the-art technologies in this field. Moreover, it gives an overview of the materials currently available for fiber-reinforced material technology....
Fast reactors in Russia: State of the art and trends of development
International Nuclear Information System (INIS)
Poplavsky, V.M.; Ashurko, Yu.M.; Zverev, K.V.; Oshkanov, N.N.; Korol'kov, A.S.; Filin, A.I.
2002-01-01
This status report contains the following: facts on nuclear power in Russia from 2001-2002; plans for further development of nuclear power; state of the art on operation of fast reactors in 2002, namely BN-600, experimental reactors BOR-60 and BR-10; construction of NPP BN-800; participation in activities on BN-350 reactor decommissioning; description of trends of design studies in the field of fast reactors and accelerator driven systems
Maintenance treatment of diabetic patients, associating arterial obstructive tibio-peroneal disease
Directory of Open Access Journals (Sweden)
Nelson Wolosker
Full Text Available When a melito-diabetic patient presents trophic infected injury on the limb, it is essential an evaluation of the circulatory conditions for therapeutic procedures orientation. In some circumstances, although arterial pulsation is absent, there is no ischemia of tissues. In these cases, the maintenance treatment, with eventual resection of the necrosed and infected tissues may be adopted. Evolution of 70 diabetic patients with trophic injuries on extremities were submitted to a maintenance treatment. Age of patients varied from 28 to 88 years, with an average of 56.8. The most occurrence was verified in women, with 42 cases. Diabetes non-dependant on insuline (type II was observed in 64 patients (91.5%, being the remaining 6 patients of type I. Diabetic retinopathy was observed in 14 (20% of the patients, neuropathy in 22 (31% and nephropathy in 8 patients (11.4%. All the patients presented arterial pulsation until the popliteal region. They were divided in 2 groups, considering trunk arteries of legs: Group I, pervial legs arteries, composed by 48 patients; Group II, occluded legs arteries, with 22 patients. In what refers to the anatomic local of the injuries, patients were classified in three groups: Group A, formed by 32 patients (45.7%, presenting injuries in one or two toes only, without affecting the metatarsic region; Group B, formed by 16 patients (22.9%, trophic injuries affecting the metatarsic region and Group C, formed by 22 patients (31.4%, injuries affecting the calcaneous region. Injuries in both of the groups were caused by mechanical traumatism. Duration of the injury in the inferior member varied from 7 to 48 days, resulting in a 12 days average. Analyzing pervicacity in trunk arterias and evolution of patients, it may be observed that there has been a significantly better result in those with all the pulses present (81.3% x 45.5%(p0,05(Table IV.
Alkali activated materials state-of-the-art report, RILEM TC 224-AAM
Deventer, Jannie
2014-01-01
This is a State of the Art Report resulting from the work of RILEM Technical Committee 224-AAM in the period 2007-2013. The Report summarises research to date in the area of alkali-activated binders and concretes, with a particular focus on the following areas: binder design and characterisation, durability testing, commercialisation, standardisation, and providing a historical context for this rapidly-growing research field.
Vicissitudes of Edo State Council for Arts and Culture Performing ...
African Journals Online (AJOL)
Abstract. The ding-dong charade of Edo State Council for Arts and Culture Performing Troupe (ESCFAACPT) cannot be divorced from the vacillating condition the establishment had been experiencing since its establishment. This condition is fore-grounded, first, on the cacophony of nomenclature that the council had been ...
State of the art/science: Visual methods and information behavior research
DEFF Research Database (Denmark)
Hartel, Jenna; Sonnenwald, Diane H.; Lundh, Anna
2012-01-01
This panel reports on methodological innovation now underway as information behavior scholars begin to experiment with visual methods. The session launches with a succinct introduction to visual methods by Jenna Hartel and then showcases three exemplar visual research designs. First, Dianne Sonne...... will have gained: knowledge of the state of the art/science of visual methods in information behavior research; an appreciation for the richness the approach brings to the specialty; and a platform to take new visual research designs forward....
A Comparative Analysis of Internal Communication and Public Relations Audits. State of the Art.
Dozier, David M.; Hellweg, Susan A.
A review of current literature regarding the state of the art in the conduct of internal communication and public relations audits by public relations practitioners reveals that these two related measurement activities are of considerable importance to the practice of public relations. Public relations audits are concerned with exploratory…
International Nuclear Information System (INIS)
Obenhaus, W.; Kuckuck, B.
1980-01-01
The authors examine the function and the structural characteristcs of the state-of-the-art concept. It is described as a yardstick in judging the means to be employed to attain the goals of protection under Sec. 1, Subsec. 2 of the Atomic Energy Act. The concept was used to ensure that the advances in theoretical knowledge were met also by an adequate development of technical measures of protection so as to ensure a maximum of safety. The concept included a scientific and engineering state of the art, which allowed a sufficiently reliable forecast to be made of the technical feasibility of science-based concepts of safety and protection. The forecast constituted an obligation to monitor the progress of the state of the art by elucidating progressive developments in safety proposals and concerns. (HSCH) [de
Directory of Open Access Journals (Sweden)
Marcus Jose do Amaral Vasconcellos
2000-06-01
patients were accompanied: study group (n = 61, submitted to verapamil 240 mg/day and control group (n = 62, submitted to placebo. These patients were randomized into groups of four women and treatment or placebo was given for thirty days. A flow examination of the uterine arteries and umbilical artery through doppler-velocimetry was recorded. The values of resistance (RI and pulsatility index (PI and of the systole/diastole ratio (S/D of the arteries were compared after the drug administration calculating means and standard deviations. Results: the verapamil group showed RI = 0.82 (0.28, PI = 1.06 (0.12 and S/D = 2.42 (0.51 in the uterine arteries. The placebo group showed RI = 0.75 (0.35, PI = 1.00 (0.18 and S/D = 2.30 (0.38. When we analyzed the umbilical artery, the verapamil group showed RI = 0.73 (0.12, PI = 1.04 (0.13 and S/D = 2.94 (0.32. The placebo group showed RI = 0.70 (0.14, PI = 1.03 (0.07 and S/D = 3.02 (0.78. The statistical analysis of the differences of the means by the F ratio showed that there was no difference between these two groups. Conclusion: this study indicates the use of verapamil for chronic hypertensive pregnants since it does not provoke damage to the uterine and fetal blood flow.
Thermal imagers: from ancient analog video output to state-of-the-art video streaming
Haan, Hubertus; Feuchter, Timo; Münzberg, Mario; Fritze, Jörg; Schlemmer, Harry
2013-06-01
The video output of thermal imagers stayed constant over almost two decades. When the famous Common Modules were employed a thermal image at first was presented to the observer in the eye piece only. In the early 1990s TV cameras were attached and the standard output was CCIR. In the civil camera market output standards changed to digital formats a decade ago with digital video streaming being nowadays state-of-the-art. The reasons why the output technique in the thermal world stayed unchanged over such a long time are: the very conservative view of the military community, long planning and turn-around times of programs and a slower growth of pixel number of TIs in comparison to consumer cameras. With megapixel detectors the CCIR output format is not sufficient any longer. The paper discusses the state-of-the-art compression and streaming solutions for TIs.
Directory of Open Access Journals (Sweden)
Ruchi Sogarwal
2012-07-01
Full Text Available Objectives: The present study was attempted to assess the perception of patients on ART about the services availed at Link ART Centers (LAC in selected states of India. Methods: A total of 354 PLHAs were selected from 20 systematic randomly selected LACs from Gujarat, Maharashtra, Rajasthan and Uttar Pradesh. Results: Study reveals that majority (97% of the patients seeking services from LACs made regular visits to the center. It was found that 57 percent of the patients had spent less than 100 rupees during the last visit. More than 95 percent of the clients reported waiting time less than 30 minutes for availing counseling and collection of drugs at LACs. The mean±SD score of patient’s level of satisfaction with the services availed at LACs is 4.7±0.5. Conclusions: Study concludes that while majority of the patients were satisfied with the services at LACs, there is need of strengthening the existing ‘package’ of services in these centers and expand the network across the country.
Directory of Open Access Journals (Sweden)
Ruchi Sogarwal
2012-06-01
Full Text Available Objectives: The present study was attempted to assess the perception of patients on ART about the services availed at Link ART Centers (LAC in selected states of India. Methods: A total of 354 PLHAs were selected from 20 systematic randomly selected LACs from Gujarat, Maharashtra, Rajasthan and Uttar Pradesh. Results: Study reveals that majority (97% of the patients seeking services from LACs made regular visits to the center. It was found that 57 percent of the patients had spent less than 100 rupees during the last visit. More than 95 percent of the clients reported waiting time less than 30 minutes for availing counseling and collection of drugs at LACs. The mean±SD score of patient’s level of satisfaction with the services availed at LACs is 4.7±0.5. Conclusions: Study concludes that while majority of the patients were satisfied with the services at LACs, there is need of strengthening the existing ‘package’ of services in these centers and expand the network across the country.
State-of-the art for production of fertilizers with regard to the IPPC-directive
International Nuclear Information System (INIS)
Wiesenberger, H.
2002-01-01
In the following section general and process-specific measures for the reduction of waste gas and waste water emissions as well as achievable emission levels for the production of fertilizers are summarized, which should be taken into account when considering state-of-the-art. As far as it is not explicitly noted, measures are applicable and emission levels are achievable for both new and existing plants. (author)
[State of the art diagnostic criteria of severe periodontitis].
Ouyang, X Y
2017-02-09
Periodontitis could be categorized as mild, moderate, and severe according to the severity of the disease. This categorizing system could also be used together with other classification systems. The present article introduced the status about the case definition of severe periodontitis, including the standard of case definitions for surveillance of periodontitis reported by the Centers for Disease Control and Prevention (CDC) in partnership with the American Academy of Periodontology (AAP) and the consensus report on the definition of periodontitis case for use in risk factor research by Europe workshop. A consensus on the state of the art definition of severe periodontitis for use in clinical work was gained base on the expertise of Chinese Society of Periodontology, Chinese Association of Stomatology. The background of this consensus and the significance of the criteria for the case definition were discussed.
Dynamic Test of a Collision Post of a State-of-the-Art End Frame Design
2008-09-24
In support of the Federal Railroad Administration's (FRA) : Railroad Equipment Safety Program, a full-scale dynamic test : of a collision post of a state-of-the-art (SOA) end frame was : conducted on April 16, 2008. The purpose of the test was to : e...
International Nuclear Information System (INIS)
Loefberg, Anne-Marie; Karacagil, Sadettin; Hellberg, Anders; Bostroem, Annika; Ljungman, Christer; Ostholm, Goerel
2001-01-01
Purpose: To investigate the role of duplex scanning in the selection of patients with critical lower-limb ischemia (CLI) for infrainguinal percutaneous transluminal angioplasty (PTA).Methods: One hundred and sixty-two limbs with CLI (150 patients) that underwent duplex scanning within 3 months prior to conventional diagnostic angiography (n = 88) or infrainguinal PTA (n = 74) were retrospectively studied. The findings obtained from duplex scanning and angiography were analyzed in a masked fashion by two different investigators.Results: The accuracy, sensitivity, specificity, and negative and positive predictive values of duplex scanning in the selection of patients for infrainguinal PTA were 86%, 84%, 89%, 86%, and 87% respectively. Forty-two procedures (57%) were performed at multiple arterial segments. The accuracy of duplex scanning in the selection of femoropopliteal and crural lesions for PTA was over 85%. However, the sensitivity of duplex scanning in the selection of popliteal and crural lesions for PTA was 49% and 38% respectively, compared with 80% for superior femoral artery lesions. In 39% of patients who were correctly selected for PTA, duplex scanning misdiagnosed one of the multiple lesions treated by PTA.Conclusion: Duplex scanning can safely be used for the selection of patients for infrainguinal PTA. The sensitivity of duplex scanning in the selection of lesions for PTA was less satisfactory in the popliteal and crural arteries compared with the femoropopliteal arteries
Directory of Open Access Journals (Sweden)
Rosimeire Alves da Silva
2002-04-01
Full Text Available Dando continuidade a estudos já existentes na área de mapeamento da vascularização cerebral do Cebus apella e considerando a semelhança desse animal com outros primatas descritos, inclusive os humanos, estudou-se a morfologia das artérias cerebelares superiores, que destinam a irrigar a superfície superior do cerebelo. 57 hemisférios cerebelares foram injetados com látex corado e fixados em solução de formol a 10%, dissecados sob mesoscopia de luz com microdissecações. As artérias cerebelares superiores são simétricas em 84,21% e assimétricas em 7,01%, ramificam-se em 4 ramos: sendo 1 para o mesencéfalo e 3 troncos principais para a superfície superior do cerebelo e regiões anterior dessa superfície. Estas artérias terminam na fissura póstero-superior ou pós-semilunar após emitir vários ramos colaterais de hierarquia decrescente de calibreIn order to continue studies already done in the area of mapping the cerebral vascularization of Cebus paella and taking into consideration the resemblance of this animal with other primates described, humans included, we studied the morphology of the superior cerebellar arteries determined to perfuse the superior surface of the cerebellum. Fifty-seven cerebellar hemispheres were injected with stained latex, fixed in 10% formol solution and dissected under light mesoscopy. The superior cerebellar arteries are symmetrical in 84,21% and asymmetrical in 7,01%, and give off four branches, one to the mesencephalon and three mains branches to the upper surface of the cerebellum and its anterior portion. These arteries end in the posterior superior or post-semilunar fissure, after giving off many collaterals of decreasing diameter
Directory of Open Access Journals (Sweden)
Luis Carlos Mendes de Brito
2011-06-01
Full Text Available O tratamento endovascular dos aneurismas de artéria renal tem sido descrito como alternativa à cirurgia convencional. Relatamos o caso de uma paciente com um aneurisma de artéria renal complexo à direita que apresentava hipertensão arterial de difícil controle. O tratamento endovascular foi realizado com a técnica de remodelagem de colo (técnica de Moret, ou técnica de embolização assistida por balão. A paciente obteve normalização da pressão arterial após o procedimento sem recidiva dos sintomas ou necessidade do uso de drogas anti-hipertensivas.Endovascular treatment of renal artery aneurysms has been described as an alternative to conventional surgery. We report the case of a patient with complex renal artery aneurysm on the right kidney who had hard-to-control arterial hypertension. Endovascular treatment was performed with the aneurysm neck remodeling technique (Moret technique, or balloon-assisted coil embolization. The patient achieved blood pressure normalization after the procedure without recurrence of symptoms or need for antihypertensive drugs.
Schühle, Judith
2018-03-01
Over the last 40 years, several thousand Nigerian-trained doctors have migrated to the U.S. to practice in what they regard as the state-of-the-art of global biomedicine. Based on interviews with Nigerian physicians, this article shows how their professional mobility, and their transition to the new professional environment of U.S. biomedicine, makes them aware of local differences in practicing medicine. Adapting to local ways of practicing in the U.S. creates a new sense of belonging and professional identity. Yet they also juxtapose highly technologised U.S. biomedicine with what they were trained to excel in within the medical profession in Nigeria - namely the 'art of medicine' - that is, possessing profound clinical skills to diagnose with few investigative technologies. By stressing their competence in the art of medicine, which they see as lacking among their U.S.-trained colleagues, they negotiate their position in a global biomedical landscape and reconnect to a distinctly Nigerian way of practicing medicine. Their narratives thus shed light on perceptions of multiple biomedicines from the point of view of physicians moving from the global South to the global North, and how within a global biomedical landscape both ruptures and connectivities of competence are imagined.
Doppler-ultralydundersøgelse af underekstremitetsarteriosklerose
DEFF Research Database (Denmark)
Rørdam, P; von Jessen, F; Sillesen, H H
1992-01-01
and in the femoral artery but that this does not appear to be employable at present in cases of multiple lesions. Examination of the popliteal artery is still too unreliable and reasonably certain assessment of the crural arteries is not possible with the present technique. Duplex scanning can thus not replace...
Directory of Open Access Journals (Sweden)
Carlos Alberto C Abreu Filho
1995-03-01
Full Text Available Paciente de 39 anos, portador de hipertensão arterial não controlada, submetido a cirurgia para tratamento de dissecção aguda de aorta tipo I. Devido ao grande envolvimento do óstio coronário direito pela dissecção aórtica, optou-se pela ressecção da porção comprometida do vaso, com interposição de tubo não valvulado de Dacron na aorta ascendente, suspensão da valva aórtica e ligadura do óstio da artéria coronária direita. Como não havia presença de aterosclerose no ramo interventricular anterior e na artéria coronária direita, decidimos realizar um enxerto venoso entre as artérias. O enxerto intercoronário apresentou bom funcionamento e todo o território dependente da coronária direita manteve boa contratilidade. O paciente recebeu alta hospitalar em boas condições clínicas, com função rniocárdica preservada.A thirty nine-year-old patient presenting arterial hypertension was operated upon for type I acute aortic dissection. Due to important alterations in the ascendent aorta with involvement of the right coronary ostium, the surgical procedure included resection of the segment of aorta containing the intimal tear and replacement with a Dacron prosthesis, suspension of the aortic valve and ligadure of the right coronary ostium. Technical difficulties brought the necessity of a different approach for the myocardium revascularization. Instead of the traditional described procedures, an intercoronary venous graft was put between the anterior interventricular artery (branch of the left coronary artery and the right coronary artery. The intercoronary graft presented a good flow since the begining, keeping a good myocardial contratility. Patient left the hospital in a good clinical condition, with preserved myocardial function. Intercoronary graft should be an efficient alternative for revascularization of a corohary artery involved by aortic dissections.
MRI sequences in head and neck radiology. State of the art
Energy Technology Data Exchange (ETDEWEB)
Widmann, Gerlig; Henninger, Benjamin; Kremser, Christian; Jaschke, Werner [Medical Univ. of Innsbruck (Austria). Dept. of Radiology
2017-05-15
Magnetic resonance imaging (MRI) has become an essential imaging modality for the evaluation of head and neck pathologies. However, the diagnostic power of MRI is strongly related to the appropriate selection and interpretation of imaging protocols and sequences. The aim of this article is to review state-of-the-art sequences for the clinical routine in head and neck MRI and to describe the evidence for which medical question these sequences and techniques are useful. Literature review of state-of-the-art sequences in head and neck MRI. Basic sequences (T1w, T2w, T1wC+) and fat suppression techniques (TIRM/STIR, Dixon, Spectral Fat sat) are important tools in the diagnostic workup of inflammation, congenital lesions and tumors including staging. Additional sequences (SSFP (CISS, FIESTA), SPACE, VISTA, 3D-FLAIR) are used for pathologies of the cranial nerves, labyrinth and evaluation of endolymphatic hydrops in Meniere's disease. Vessel and perfusion sequences (3D-TOF, TWIST/TRICKS angiography, DCE) are used in vascular contact syndromes, vascular malformations and analysis of microvascular parameters of tissue perfusion. Diffusion-weighted imaging (EPI-DWI, non-EPI-DWI, RESOLVE) is helpful in cholesteatoma imaging, estimation of malignancy, and evaluation of treatment response and posttreatment recurrence in head and neck cancer. Understanding of MRI sequences and close collaboration with referring physicians improves the diagnostic confidence of MRI in the daily routine and drives further research in this fascinating image modality.
MRI sequences in head and neck radiology. State of the art
International Nuclear Information System (INIS)
Widmann, Gerlig; Henninger, Benjamin; Kremser, Christian; Jaschke, Werner
2017-01-01
Magnetic resonance imaging (MRI) has become an essential imaging modality for the evaluation of head and neck pathologies. However, the diagnostic power of MRI is strongly related to the appropriate selection and interpretation of imaging protocols and sequences. The aim of this article is to review state-of-the-art sequences for the clinical routine in head and neck MRI and to describe the evidence for which medical question these sequences and techniques are useful. Literature review of state-of-the-art sequences in head and neck MRI. Basic sequences (T1w, T2w, T1wC+) and fat suppression techniques (TIRM/STIR, Dixon, Spectral Fat sat) are important tools in the diagnostic workup of inflammation, congenital lesions and tumors including staging. Additional sequences (SSFP (CISS, FIESTA), SPACE, VISTA, 3D-FLAIR) are used for pathologies of the cranial nerves, labyrinth and evaluation of endolymphatic hydrops in Meniere's disease. Vessel and perfusion sequences (3D-TOF, TWIST/TRICKS angiography, DCE) are used in vascular contact syndromes, vascular malformations and analysis of microvascular parameters of tissue perfusion. Diffusion-weighted imaging (EPI-DWI, non-EPI-DWI, RESOLVE) is helpful in cholesteatoma imaging, estimation of malignancy, and evaluation of treatment response and posttreatment recurrence in head and neck cancer. Understanding of MRI sequences and close collaboration with referring physicians improves the diagnostic confidence of MRI in the daily routine and drives further research in this fascinating image modality.
In situ saphenous vein bypass surgery in diabetic patients
DEFF Research Database (Denmark)
Jensen, L P; Schroeder, T V; Lorentzen, J E
1992-01-01
.005). Indication for surgery was gangrene or ulceration in 57% of diabetics, as opposed to 36% in non-diabetic patients (p = 0.0002). A femoro-popliteal bypass was performed in 18% of patients, whereas 82% received an infrapopliteal procedure, of which 42% were to the distal third of the calf or foot. Diabetic......From 1986 through to 1990 a total of 483 consecutive in situ infra-inguinal vein bypass procedures were performed in 444 patients, of whom 112 (25%) were diabetics (57 insulin dependent diabetes mellitus and 55 non-insulin-dependent diabetes mellitus). Based on a prospective vascular data registry...... this material was analysed to determine the influence of diabetes on the outcome. Preoperative risk factors were equally distributed among diabetic and non-diabetic patients, except for smoking habits (diabetics: 48%; non-diabetics: 64%, p = 0.002) and cardiac disease (diabetics: 45%; non-diabetics: 29%, p = 0...
Wind power forecasting : state-of-the-art 2009.
Energy Technology Data Exchange (ETDEWEB)
Monteiro, C.; Bessa, R.; Miranda, V.; Botterud, A.; Wang, J.; Conzelmann, G.; Decision and Information Sciences; INESC Porto
2009-11-20
uncertainty in wind power and to more efficiently operate power systems with large wind power penetrations. Moreover, in a market environment, the wind power contribution to the generation portofolio becomes important in determining the daily and hourly prices, as variations in the estimated wind power will influence the clearing prices for both energy and operating reserves. With the increasing penetration of wind power, WPF is quickly becoming an important topic for the electric power industry. System operators (SOs), generating companies (GENCOs), and regulators all support efforts to develop better, more reliable and accurate forecasting models. Wind farm owners and operators also benefit from better wind power prediction to support competitive participation in electricity markets against more stable and dispatchable energy sources. In general, WPF can be used for a number of purposes, such as: generation and transmission maintenance planning, determination of operating reserve requirements, unit commitment, economic dispatch, energy storage optimization (e.g., pumped hydro storage), and energy trading. The objective of this report is to review and analyze state-of-the-art WPF models and their application to power systems operations. We first give a detailed description of the methodologies underlying state-of-the-art WPF models. We then look at how WPF can be integrated into power system operations, with specific focus on the unit commitment problem.
Mathematical E-Learning: State of the Art and Experiences at the Open University of Catalonia
Juan, A.; Huertas, A.; Steegmann, C.; Corcoles, C.; Serrat, C.
2008-01-01
In this article we present a review of the state of the art in mathematical e-learning and some personal experiences on this area developed during the last eleven years at the Open University of Catalonia (UOC), a completely online university located in Spain. The article discusses important aspects related to online mathematics courses offered in…
The state of art of internal fire PSA in nuclear power plant
International Nuclear Information System (INIS)
Yu Xinli; Zhao Bo; Zheng Xiangyang
2010-01-01
The operational experiences of nuclear power plants (NPPs) show that the internal fires challenge effectively the nuclear safety of NPPs. Thus, the authorities having jurisdiction in the world have enhanced the supervision on fire safety in NPPs, asking the licensees to perform fire hazard analysis and evaluate the fire risk. This article mainly describes the state of art of internal fire probabilistic safety assessment (PSA) in the world, and compares the main methods and standards for internal fire PSA. (authors)
International Nuclear Information System (INIS)
Lee, Sung Uk; Seo, Yong Chil; Jung, Seung Ho; Cho, Jai Wan; Choi, Young Soo
2007-08-01
In this report, we review the existing concept of construction automation and also survey the state of the art on construction automation and robotic system in domestic and foreign construction industry. On the basis of the result of review and survey, we want to suggest an applicable robotic technology to construction industry and points to be duly considered for activating construction automation. We investigate the state of the art on construction automation and robotic system in domestic and foreign construction industry and also applicable area and direction of domestic construction automation and robotic system. We hope that construction automation and robotic technology, which are improved rapidly nowadays, can contribute to the growth of construction industry
Radioactive waste management: State of the art in the world. Part 3
International Nuclear Information System (INIS)
Pahissa Campa, Jaime; Phahissa, Marta H. de
2001-01-01
A summary of current management plans in the world for high level wastes and spent fuel is presented in this paper. Countries have programs in different development stages. Some of them formally begun the sitting process, others have underground laboratory projects in progress either as part of the site selection process (site characterization) or as REtD demonstrations. Besides the safety related requirements, various political, social, legal and environmental considerations are taken into account. Lessons learned can be drawn from the analysis of the state of art described in this paper. (author)
Subliminal Priming—State of the Art and Future Perspectives
Directory of Open Access Journals (Sweden)
Mohamed Elgendi
2018-05-01
Full Text Available The influence of subliminal priming (behavior outside of awareness in humans is an interesting phenomenon and its understanding is crucial as it can impact behavior, choices, and actions. Given this, research about the impact of priming continues to be an area of investigative interest, and this paper provides a technical overview of research design strengths and issues in subliminal priming research. Efficient experiments and protocols, as well as associated electroencephalographic and eye movement data analyses, are discussed in detail. We highlight the strengths and weaknesses of different priming experiments that have measured affective (emotional and cognitive responses. Finally, very recent approaches and findings are described to summarize and emphasize state-of-the-art methods and potential future directions in research marketing and other commercial applications.
State-of-the-art Review : Vol. 2A. Responsive Building Elements
DEFF Research Database (Denmark)
Blümel, Ernst; Haghighat, Fariborz; Li, Yuguo
This report resumes and presents the activity done in Subtask A of IEA-ECBCS Annex 44 “Integrating Environmentally Responsive Elements in Buildings” concerning the state of the art review of Responsive Building Elements. It is based on the contributions from the participating countries...... at researchers in the field and gives an overview of how these elements work together with available performance data. It is hoped, that this report will be helpful for researchers in their search for new solutions to the problem of designing and constructing sustainable buildings....
Malformação ílio-femoral Iliofemoral arterial malformation
Directory of Open Access Journals (Sweden)
Mangala M. Pai
2006-12-01
Full Text Available Durante uma dissecção de rotina realizada em um cadáver do sexo masculino com 65 anos de idade foi constatada malformação arterial iliofemoral. A aorta abdominal estava consideravelmente deslocada lateralmente e também bifurcava em nível mais alto. A artéria ilíaca comum dividia-se uma vértebra acima do nível normal e a artéria femoral dava origem à artéria femoral profunda aproximadamente l,2 cm abaixo do ligamento inguinal, o que é consideravelmente proximal ao seu nível normal. Aqui nós apresentamos uma breve revisão de literatura e base embriológica dessas anomalias.During routine dissection, an Iliofemoral arterial malformation was noticed in a 65 year old male cadaver. The abdominal aorta was considerably laterally displaced and also bifurcated higher up. The common iliac artery divided one vertebral level higher and the femoral artery gave the profunda femoris artery about 1.2 cm below the inguinal ligament, which is considerably proximal to its usual level of origin. A brief review of literature and embryological basis of the anomalies are discussed.
Stored energy calculation: the state of the art
International Nuclear Information System (INIS)
Cunningham, M.E.; Lanning, D.D.; Olsen, A.R.; Williford, R.E.; Hann, C.R.
1978-05-01
The report is the result of an investigation to determine the current state of the art of fuel temperature, gap conductance, and stored energy calculations. Major emphasis was placed on the propagation of input and model uncertainties. To support this study a comparison was made to the observed variability of experimental data for fuel centerline temperature and gap conductance values. The uncertainty analysis was performed by identifying major thermal models and collecting them into an abstract of a thermal performance code. Uncertainties in the calculations were determined using the method of propagation of uncertainties with a first order Taylor series approximation to the nonlinear functions. Output uncertainty results are presented for the beginning of fuel life, the end of life, and throughout a typical power history. Also presented is an influence and importance analysis for the input parameters. It is concluded that the relative uncertainty in stored energy is approximately +-20 percent at beginning of fuel life, and increases to +-25 to 40 percent contact. The foregoing are 3 sigma (99.9 percent) confidence intervals. The most important contributors to stored energy uncertainty are linear heat rating and fuel thermal conductivity
Ukwatta, Eranga; Yuan, Jing; Qiu, Wu; Rajchl, Martin; Chiu, Bernard; Fenster, Aaron
2015-12-01
Three-dimensional (3D) measurements of peripheral arterial disease (PAD) plaque burden extracted from fast black-blood magnetic resonance (MR) images have shown to be more predictive of clinical outcomes than PAD stenosis measurements. To this end, accurate segmentation of the femoral artery lumen and outer wall is required for generating volumetric measurements of PAD plaque burden. Here, we propose a semi-automated algorithm to jointly segment the femoral artery lumen and outer wall surfaces from 3D black-blood MR images, which are reoriented and reconstructed along the medial axis of the femoral artery to obtain improved spatial coherence between slices of the long, thin femoral artery and to reduce computation time. The developed segmentation algorithm enforces two priors in a global optimization manner: the spatial consistency between the adjacent 2D slices and the anatomical region order between the femoral artery lumen and outer wall surfaces. The formulated combinatorial optimization problem for segmentation is solved globally and exactly by means of convex relaxation using a coupled continuous max-flow (CCMF) model, which is a dual formulation to the convex relaxed optimization problem. In addition, the CCMF model directly derives an efficient duality-based algorithm based on the modern multiplier augmented optimization scheme, which has been implemented on a GPU for fast computation. The computed segmentations from the developed algorithm were compared to manual delineations from experts using 20 black-blood MR images. The developed algorithm yielded both high accuracy (Dice similarity coefficients ≥ 87% for both the lumen and outer wall surfaces) and high reproducibility (intra-class correlation coefficient of 0.95 for generating vessel wall area), while outperforming the state-of-the-art method in terms of computational time by a factor of ≈ 20. Copyright © 2015 Elsevier B.V. All rights reserved.
Denoising of Microscopy Images: A Review of the State-of-the-Art, and a New Sparsity-Based Method.
Meiniel, William; Olivo-Marin, Jean-Christophe; Angelini, Elsa D
2018-08-01
This paper reviews the state-of-the-art in denoising methods for biological microscopy images and introduces a new and original sparsity-based algorithm. The proposed method combines total variation (TV) spatial regularization, enhancement of low-frequency information, and aggregation of sparse estimators and is able to handle simple and complex types of noise (Gaussian, Poisson, and mixed), without any a priori model and with a single set of parameter values. An extended comparison is also presented, that evaluates the denoising performance of the thirteen (including ours) state-of-the-art denoising methods specifically designed to handle the different types of noises found in bioimaging. Quantitative and qualitative results on synthetic and real images show that the proposed method outperforms the other ones on the majority of the tested scenarios.
Theory and state-of-the-art technology of software reliability
International Nuclear Information System (INIS)
Suzudo, Tomoaki; Watanabe, Norio
1999-11-01
Since FY 1997 , the Japan Atomic Energy Research Institute has been conducting a project , Study on Reliability of Digital I and C Systems. As part of the project , the methodologies and tools to improve software reliability were reviewed in order to examine the theory and the state-of-the-art technology in this field. It is surmised, as results from the review, that computerized software design and implementation tool (CASE tool), algebraic analysis to ensure the consistency between software requirement framework and its detailed design specification, and efficient test method using the internal information of the software (white-box test) at the validation phase just before the completion of the development will play a key role to enhance software reliability in the future. (author)
Nuclear and radiation techniques - state of art and development trends
International Nuclear Information System (INIS)
Chmielewski, A.G.
1995-01-01
The state of art and development trends of nuclear and radiation techniques in Poland and worldwide have been presented. Among them the radiometric gages, radiation technologies, radiotracer methods and measuring systems for pipeline and vessels, brightness control have been described and their applications in industry, agriculture, health and environment protection have been shown and discussed. 35 refs, 1 fig
Herrera-Usagre, Manuel; Pérez-Pérez, Pastora; Vázquez-Vázquez, Marta; Santana-López, Vicente
2014-10-01
The hand hygiene (HH) is one of the preventive practices more .widely and effectively implemented in the control of healthcare associated infections. However, there are several barriers to compliance. To assess which strategy, state-of-the-art strategies (availability of alcohol-based preparations, posters, instructions and training) or extended strategies (feedbacks, formal and informal leadership), are seen as more effective to improve hand hygiene (HH) compliance. Analytical study using a self-completed questionnaire developed by the World Health Organization. 2,068 questionnaires, completed by healthcare professionals (HP) in Andalusia (Spain), were received from 2010 to 2012. Analytical technique: Structural equation modeling and multi group measurement invariance. Once the reliability of the proposed constructs was achieved (Cronbach α=0.73, 0.84, 0.70), it was found that those HP working in centers with the highest level of commitment with HH are those who see extended strategies as more effective (χ2=298.3, df=39, CFI=0.972, TLI=0.961, RMSEA=0.057, SRMR=0.028). Our results have shown that hospitals' HP, compared to primary care HP, see state-of-the-art strategies as more effective, as well as they give less importance to HH, meanwhile nurses, compared to physicians, see effective both strategies. HP contemplate the combination of state-of-the-art and extended strategies as an effective way to improve the HH compliance. In addition, extended strategies are considered more effective amongst the most "advanced" healthcare settings in terms of their commitment to HH. The results highlight the need for commitment at management, collective and individual level in order to maintain patient safety.
State of the art and prospects for the future of nuclear-medical in-vitro diagnostics
International Nuclear Information System (INIS)
Boettger, I.
1984-01-01
Following a bried outline of the history of the radioimmunoassay, the current state of the art and the range of application of RIAs in clinical routine examinations are summarized. The recently developed ''non-isotopic immunoassays'' (NIIA) are compared with the more conventional RIA techniques, their range of application is discussed, and an outlook is given on future developments. (MG) [de
Electric automation history and state of the art; Historia da automacao eletrica e estado da arte
Energy Technology Data Exchange (ETDEWEB)
Mendes, M.F. [Itaipu Binacional, Foz do Iguacu, PR (Brazil). Div. de Engenharia Eletronica e Sistemas de Controle], E-mail: mendes@ieee.org; Jardini, J.A. [Universidade de Sao Paulo (PEA/EP/USP), SP (Brazil). Escola Politecnica. Dept. de Engenharia de Energia e Automacao Eletricas], E-mail: jardini@pea.usp.br
2009-07-01
The article summarizes the history of electric systems automation, used in hydroelectric power plants, since the rise to the present day. Technologies are presented employed at various times, developments, the difference and the reasons for evolution. The emphasis is on today's modern systems technology, covering: communication, standardization, hardware, software, architecture, maintenance, operation and challenges. This work pretend to give subsidies for the design and implementation of automation systems electricity using state of the art. The scope are the new plants as well as those being modernized. Knowledge of history is important to investigate, to plan and evaluate the costs and benefits of automation systems for new electric plants and those that are undergoing processes technological upgrading.
Directory of Open Access Journals (Sweden)
Wenes Pereira Reis
2010-01-01
Full Text Available Contexto: A eventual relação entre a aterosclerose das artérias dos membros inferiores com a aterosclerose das artérias intestinais foi pouco estudada. Objetivo: Avaliar pela ecografia vascular (Doppler presença de lesões com estenose 70% na artéria mesentérica superior e/ou tronco celíaco em doentes com arteriopatia obstrutiva crônica dos membros inferiores. Método: Foram estudados dois grupos, cada um com 60 doentes (40 homens e 20 mulheres. O grupo-caso foi composto por doentes com arteriopatia obstrutiva crônica dos membros inferiores, claudicação intermitente limitante ou dor de repouso e/ou lesões tróficas de extremidade, sem queixas gastrintestinais. O grupo-controle foi constituído por enfermos sem doença arterial obstrutiva dos membros inferiores e sem queixas gastrintestinais. Consideraram-se fatores de risco presença de diabetes melito, hipertensão arterial, obesidade, angina/infarto, tabagismo e dislipidemia. Todos os doentes foram submetidos a ecografia vascular do tronco celíaco e da artéria mesentérica superior. Os doentes do grupo-caso foram separados pela presença de claudicação intermitente limitante (N = 12 ou lesão trófica e/ou dor de repouso (N = 48. Resultados: Houve associação significante entre idade (p = 0,04 e cardiopatia isquêmica (p = 0,04 com aterosclerose da artéria mesentérica superior. Os fatores de risco não mostraram associação significante com presença de estenose do tronco celíaco. Observou-se associação significante entre arteriopatia dos membros inferiores e lesão estenótica da artéria mesentérica superior (p = 0,006 e do tronco celíaco (p Background: The occasional relationship between arterial atherosclerosis of lower limbs and atherosclerosis of intestinal arteries has not been fully studied yet. Objective: To assess the presence of lesions with ≥ 70% stenosis in the superior mesenteric artery and/or in the celiac trunk in patients with chronic obstructive
Friedman, Carol; Rindflesch, Thomas C; Corn, Milton
2013-10-01
Natural language processing (NLP) is crucial for advancing healthcare because it is needed to transform relevant information locked in text into structured data that can be used by computer processes aimed at improving patient care and advancing medicine. In light of the importance of NLP to health, the National Library of Medicine (NLM) recently sponsored a workshop to review the state of the art in NLP focusing on text in English, both in biomedicine and in the general language domain. Specific goals of the NLM-sponsored workshop were to identify the current state of the art, grand challenges and specific roadblocks, and to identify effective use and best practices. This paper reports on the main outcomes of the workshop, including an overview of the state of the art, strategies for advancing the field, and obstacles that need to be addressed, resulting in recommendations for a research agenda intended to advance the field. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.
Obturator or "lateral" bypass in the management of infected vascular prostheses at the groin
Directory of Open Access Journals (Sweden)
Davidović Lazar B.
2002-01-01
Full Text Available The infection of the previously implanted vascular graft at the groin, is associated with great mortality and morbidity rate [1]. The authors present a retrospective study in which they analyzed management of infected vascular prostheses at the groin, using obturator bypass in 26 cases, and "lateral" bypass in 15 cases. The indications for obturator bypass reconstructions included: 20 infections of aorto-femoral grafts, two infected pse udoaneurysms in the groin after RTA of the superficial femoral artery, and 4 infections of iliac-femoral grafts. The indications for lateral bypass reconstructions were: infections after aorto-femoral reconstructions - 8 cases; infection after femora-popliteal reconstructions - 4 cases; infection after iliac-femoral reconstruction - 2 patients, and one infected pseudoaneurysm in the groin after RTA of the superficial femoral artery. In 3 subjects obturator bypass was performed using extraperitoneal approach while in other 23 patients transperitoneal approach was done by donor's artery. The obturator bypass was performed using a PTFE graft in 3 cases and Dacron graft in 23. The donor's artery used for obturator bypass was a noninfected proximal part of aortofemoral graft in 20 cases, and iliac artery in 6 patients. The superfical femoral artery was recipient artery for obturator bypass in 3 cases, deep femoral artery in one case, and above the knee popliteal artery in 22 cases (Figure 1. In two patients transperitoenal approach to donors artery for "lateral" bypass has been used, and in 13 cases extraperitoneal. The proximal noninfected part of aorto femoral graft was used as a donor's artery for lateral bypass in 8 patients, while common iliac artery in 7 subjects. In 5 cases recon structions were performed using PTFE grafts, in 3 using autologous saphenous vein grafts, and in 7 using Dacron grafts. The recipient artery for "lateral" bypass was deep femoral in 8 cases, superficial femoral in three patients and
State-of-the-art management of low back pain in athletes: Instructional lecture.
Sairyo, Koichi; Nagamachi, Akihiro
2016-05-01
In this paper, we describe "state of the art" on the diagnosis and treatment for low back pain in athletes. Lumbar motion that induces specific pain would be a clue to the exact diagnosis. In the flexion pain group, lumbar herniated nucleus pulposus is the most common disorder. Discogenic pain and type 1 Modic endplate inflammation may also cause flexion pain; however, the diagnosis is sometimes difficult. In children and adolescents, apophyseal ring fracture is prevalent. In the extension pain group, lumbar spondylolysis is very common, especially in pediatric athletes. In adults, facet pain due to overloading would be the pathology, while low back pain with trunk rotation is not common. However, throwing athletes, such as pitchers and hammer throwers, may experience this kind of pain; facet arthritis contralateral to the throwing arm would be the origin of the pain. Low back pain on lumbar lateral bending is rare, but we experienced some cases in golfers in whom type 1 Modic change at the lateral corner was the source of pain. In this article, we explained strategies for state-of-the-art diagnosis and minimally invasive treatment. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
Integrating the English Language Arts Common Core State Standards into Physical Education
James, Alisa R.; Bullock, Kerri
2015-01-01
Physical education teachers are expected to implement the English language arts (ELA) Common Core State Standards (CCSS) in their instruction. This has proved to be challenging for many physical educators. The purpose of this article is to provide developmentally appropriate examples of how to incorporate the ELA CCSS into physical education,…
Shetty, Surekha D; Nayak, Satheesha; Kumar, Naveen; Abhinitha, P
2013-01-01
Arterial variations of distal parts of lower limb are well documented. However, continuation of fibular artery as dorsalis pedis artery is a rare finding. Unusual course and distribution of the anterior tibial artery and fibular artery were observed during routine anatomical dissection of the right lower limb of an approximately 40-year-old male cadaver. The arteries of the crural region arose from the popliteal artery, as usual. However the anterior tibial artery was hypoplastic. The fibular...
State of the art in crystal oscillators - Present and future
Rosati, V. J.; Filler, R. L.; Schodowski, S. S.; Vig, J. R.
It is pointed out that most military communication, navigation, surveillance and IFF systems which are currently under development require stable oscillators for frequency control and/or timing. Examples of such systems are the Single Channel Ground and Airborne Radio System (SINCGARS), MILSTAR, the Global Positioning System (GPS), the Combat Identification System (CIS), and several radar systems. In 1981, a survey and evaluation program was initiated with the aim to determine the state-of-the-art of both TCXOs (temperature compensated crystal oscillators) and OCXOs (oven controlled crystal oscillators). This program is continuing. The results obtained to date are considered because they can provide useful guidance to system users on the availability of stable oscillators.
Hunt, Julie E A; Stodart, Clare; Ferguson, Richard A
2016-07-01
Previous investigations to establish factors influencing the blood flow restriction (BFR) stimulus have determined cuff pressures required for complete arterial occlusion, which does not reflect the partial restriction prescribed for this training technique. This study aimed to establish characteristics that should be accounted for when prescribing cuff pressures required for partial BFR. Fifty participants were subjected to incremental blood flow restriction of the upper and lower limbs by proximal pneumatic cuff inflation. Popliteal and brachial artery diameter, blood velocity and blood flow was assessed with Doppler ultrasound. Height, body mass, limb circumference, muscle-bone cross-sectional area, adipose thickness (AT) and arterial blood pressure were measured and used in different models of hierarchical linear regression to predict the pressure at which 60 % BFR (partial occlusion) occurred. Combined analysis revealed a difference in cuff pressures required to elicit 60 % BFR in the popliteal (111 ± 12 mmHg) and brachial arteries (101 ± 12 mmHg). MAP (r = 0.58) and AT (r = -0.45) were the largest independent determinants of lower and upper body partial occlusion pressures. However, greater variance was explained by upper and lower limb regression models composed of DBP and BMI (48 %), and arm AT and DBP (30 %), respectively. Limb circumference has limited impact on the cuff pressure required for partial blood flow restriction which is in contrast to its recognised relationship with complete arterial occlusion. The majority of the variance in partial occlusion pressure remains unexplained by the predictor variables assessed in the present study.
State of the Art Power-in Tube Niobium-Tin Superconductors
Energy Technology Data Exchange (ETDEWEB)
Godeke, A.; Ouden, A. Den; Nijhuis, A.; ten Kate, H.H.J.
2008-06-01
Powder-in-Tube (PIT) processed Niobium-Tin wires are commercially manufactured for nearly three decades and have demonstrated a combination of very high current density (presently up to 2500 A mm{sup -2} non-Cu at 12 T and 4.2 K) with fine (35 {micro}m), well separated filaments. We review the developments that have led to the present state of the art PIT Niobium-Tin wires, discuss the wire manufacturing and A15 formation processes, and describe typical superconducting performance in relation to magnetic field and strain. We further highlight successful applications of PIT wires and conclude with an outlook on possibilities for further improvements in the performance of PIT Niobium-Tin wires.
The state of the art of the impact of sampling uncertainty on measurement uncertainty
Leite, V. J.; Oliveira, E. C.
2018-03-01
The measurement uncertainty is a parameter that marks the reliability and can be divided into two large groups: sampling and analytical variations. Analytical uncertainty is a controlled process, performed in the laboratory. The same does not occur with the sampling uncertainty, which, because it faces several obstacles and there is no clarity on how to perform the procedures, has been neglected, although it is admittedly indispensable to the measurement process. This paper aims at describing the state of the art of sampling uncertainty and at assessing its relevance to measurement uncertainty.
State of the art in marketing hospital foodservice departments.
Pickens, C W; Shanklin, C W
1985-11-01
The purposes of this study were to identify the state of the art relative to the utilization of marketing techniques within hospital foodservice departments throughout the United States and to determine whether any relationships existed between the degree of utilization of marketing techniques and selected demographic characteristics of the foodservice administrators and/or operations. A validated questionnaire was mailed to 600 randomly selected hospital foodservice administrators requesting information related to marketing in their facilities. Forty-five percent of the questionnaires were returned and analyzed for frequency of response and significant relationship between variables. Chi-square was used for nominal data and Spearman rho for ranked data. Approximately 73% of the foodservice administrators stated that marketing was extremely important in the success of a hospital foodservice department. Respondents (79%) further indicated that marketing had become more important in their departments in the past 2 years. Departmental records, professional journals, foodservice suppliers, observation, and surveys were the sources most often used to obtain marketing data, a responsibility generally assumed by the foodservice director (86.2%). Merchandising, public relations, and word-of-mouth reputation were regarded as the most important aspects of marketing. Increased sales, participation, good will, departmental recognition, and employee satisfaction were used most frequently to evaluate the success of implemented marketing techniques. Marketing audits as a means of evaluating the success of marketing were used to a limited extent by the respondents.
DEFF Research Database (Denmark)
Jensen, Thomas; Duun, Sune Bro; Larsen, Jan
2009-01-01
We examine various independent component analysis (ICA) digital signal processing algorithms for estimating the arterial oxygen saturation (SpO2) as measured by a reflective pulse oximeter. The ICA algorithms examined are FastICA, Maximum Likelihood ICA (ICAML), Molgedey and Schuster ICA (ICAMS......), and Mean Field ICA (ICAMF). The signal processing includes pre-processing bandpass filtering to eliminate noise, and post-processing by calculating the SpO2. The algorithms are compared to the commercial state-of-the-art algorithm Discrete Saturation Transform (DST) by Masimo Corporation...
Energy Technology Data Exchange (ETDEWEB)
Devictor, N.; Bassi, A.; Saignes, P.; Bertrand, F
2008-07-01
The use of Probabilistic Safety Assessment (PSA) is internationally increasing as a means of assessing and improving the safety of nuclear and non-nuclear facilities. To support the development of a competence on Probabilistic Safety Assessment, a set of states of the art regarding these tools and their use has been made between 2001 and 2005, in particular on the following topics: - Definition of the PSA of level 1, 2 and 3; - Use of PSA in support to design and operation of nuclear plants (risk-informed applications); - Applications to Non Reactor Nuclear Facilities. The report compiled in a single document these states of the art in order to ensure a broader use; this work has been done in the frame of the Project 'Reliability and Safety of Nuclear Facility' of the Nuclear Development and Innovation Division of the Nuclear Energy Division. As some of these states of the art have been made in support to exchanges with international partners and were written in English, a section of this document is written in English. This work is now applied concretely in support to the design of 4. Generation nuclear systems as Sodium-cooled Fast Reactors and especially Gas-cooled Fast Reactor, that have been the subject of communications during the conferences ANS (Annual Meeting 2007), PSA'08, ICCAP'08 and in the journal Science and Technology of Nuclear Installations. (authors)