WorldWideScience

Sample records for high bypass turbofan

  1. Inlet Acoustic Data from a High Bypass Ratio Turbofan Rotor in an Internal Flow Component Test Facility

    Science.gov (United States)

    Bozak, Richard F.

    2017-01-01

    In February 2017, aerodynamic and acoustic testing was completed on a scale-model high bypass ratio turbofan rotor, R4, in an internal flow component test facility. The objective of testing was to determine the aerodynamic and acoustic impact of fan casing treatments designed to reduce noise. The baseline configuration consisted of the R4 rotor with a hardwall fan case. Data are presented for a baseline acoustic run with fan exit instrumentation removed to give a clean acoustic configuration.

  2. Acoustic Performance of Novel Fan Noise Reduction Technologies for a High Bypass Model Turbofan at Simulated Flights Conditions

    Science.gov (United States)

    Elliott, David M.; Woodward, Richard P.; Podboy, Gary G.

    2010-01-01

    Two novel fan noise reduction technologies, over the rotor acoustic treatment and soft stator vane technologies, were tested in an ultra-high bypass ratio turbofan model in the NASA Glenn Research Center s 9- by 15-Foot Low-Speed Wind Tunnel. The performance of these technologies was compared to that of the baseline fan configuration, which did not have these technologies. Sideline acoustic data and hot film flow data were acquired and are used to determine the effectiveness of the various treatments. The material used for the over the rotor treatment was foam metal and two different types were used. The soft stator vanes had several internal cavities tuned to target certain frequencies. In order to accommodate the cavities it was necessary to use a cut-on stator to demonstrate the soft vane concept.

  3. Optimal design and installation of ultra high bypass ratio turbofan nacelle

    Science.gov (United States)

    Savelyev, Andrey; Zlenko, Nikolay; Matyash, Evgeniy; Mikhaylov, Sergey; Shenkin, Andrey

    2016-10-01

    The paper is devoted to the problem of designing and optimizing the nacelle of turbojet bypass engine with high bypass ratio and high thrust. An optimization algorithm EGO based on development of surrogate models and the method for maximizing the probability of improving the objective function has been used. The designing methodology has been based on the numerical solution of the Reynolds equations system. Spalart-Allmaras turbulence model has been chosen for RANS closure. The effective thrust losses has been uses as an objective function in optimizing the engine nacelle. As a result of optimization, effective thrust has been increased by 1.5 %. The Blended wing body aircraft configuration has been studied as a possible application. Two variants of the engine layout arrangement have been considered. It has been shown that the power plant changes the pressure distribution on the aircraft surface. It results in essential diminishing the configuration lift-drag ratio.

  4. CFD simulations of the flow control performance applied for inlet of low drag high-bypass turbofan engine at cross flow regimes

    Science.gov (United States)

    Kursakov, I. A.; Kazhan, E. V.; Lysenkov, A. V.; Savelyev, A. A.

    2016-10-01

    Paper describes the optimization procedure for low cruise drag inlet of high-bypass ratio turbofan engine (HBRE). The critical cross-flow velocity when the flow separation on the lee side of the inlet channel occurs is determined. The effciency of different flow control devices used to improve the flow parameters at inlet section cross flow regime is analyzed. Boundary layer suction, bypass slot and vortex generators are considered. It is shown that flow control devices enlarge the stability range of inlet performance at cross flow regimes.

  5. Acoustic Detection of Faults and Degradation in a High-Bypass Turbofan Engine during VIPR Phase III Testing

    Science.gov (United States)

    Boyle, Devin K.

    2017-01-01

    The Vehicle Integrated Propulsion Research (VIPR) Phase III project was executed at Edwards Air Force Base, California, by the National Aeronautics and Space Administration and several industry, academic, and government partners in the summer of 2015. One of the research objectives was to use external radial acoustic microphone arrays to detect changes in the noise characteristics produced by the research engine during volcanic ash ingestion and seeded fault insertion scenarios involving bleed air valves. Preliminary results indicate the successful acoustic detection of suspected degradation as a result of cumulative exposure to volcanic ash. This detection is shown through progressive changes, particularly in the high-frequency content, as a function of exposure to greater cumulative quantities of ash. Additionally, detection of the simulated failure of the 14th stage stability bleed valve and, to a lesser extent, the station 2.5 stability bleed valve, to their fully-open fail-safe positions was achieved by means of spectral comparisons between nominal (normal valve operation) and seeded fault scenarios.

  6. 大涵道比间冷回热涡扇发动机总体方案研究%Study of an intercooled recuperated turbofan engine with high bypass ratio

    Institute of Scientific and Technical Information of China (English)

    李刚团; 黄莺; 龚昊

    2016-01-01

    在分析间冷回热涡扇发动机工作机理的基础上,进行了大涵道比间冷回热涡扇发动机循环参数分析。以波音767-200ER量级飞机为装机对象,开展了间冷回热发动机方案研究。对比分析了间冷回热涡扇发动机与多种类型涡扇发动机的总体性能方案,并从发动机总体性能及特性的角度,比较分析了大涵道比涡扇发动机引入间冷回热技术所带来的收益。最后,提出了研制间冷回热涡扇发动机需突破的主要关键技术。%Cycle parameters study and performance calculations of an intercooled recuperated turbofan en⁃gine with high bypass ratio for aircraft as large as Boeing 767-200ER were carried out on the basis of inter⁃cooled recuperated cycle working principle. The advantages of introducing intercooling and recuperation in⁃to turbofan engine were analyzed by means of comparison of performance and characteristics with other kinds of turbofan engines. At the end, key technologies for developing intercooled recuperated aero engine were proposed.

  7. 大型客机发动机振动载荷传递特性研究%Exploring Wing-Mounted Engine Vibration Transmission for New Generation Airplanes with Turbofan Engines of High Bypass Ratio

    Institute of Scientific and Technical Information of China (English)

    陈熠; 贺尔铭; 扈西枝; 韩峰

    2012-01-01

    The use of turbofan engines of high bypass ratio has caused the low-frequency structure-borne noise. To investigate the medium and low frequency vibration transmission through wing structure to airframe, we introduce the double-beam dynamic model of a wing and build the "pylon-wing-airframe" dynamic half model of a full airplane, which takes into account the dynamics of an actual airplane. Sections 1 through 4 of the full paper explain the exploration mentioned in the title; their core consists of; ( 1) we use the vibration spectrum of the turbofan engines to calculate the vibration load of the airplane at each section of the airframe transmitted from wing to the air-frame , which provides the input data for estimating the noise level of the pressurized cabin; (2) through simulation , we identify the main path of engines' vibration transmission to the airframe; the simulation results, given in Figs. 6 and 7, and their analysis form, in our opinion, a useful preparation for pylon structure vibration reduction, engine vibration isolation mounting and the acoustic design inside the cabin.%高涵道比涡扇发动机的振动冲击频段向低频转移,使得飞机舱内噪声频率分布中的低频结构传递噪声变得更加突出.为了研究发动机振动载荷通过机翼向机身传递的中低频振动特性,文章针对真实客机的结构动力特性,创新地提出了机翼双梁动力学模型概念,建立了“吊架-机翼-机身”全机动力学有限元模型;基于发动机的振动载荷谱,分析了发动机振动通过机翼向机身结构传递的载荷特性,为后续舱内噪声预计提供了数据输入;并仿真辨识了发动机振动传递的主路径,为舱内声学设计及发动机隔振安装提供了基础数据.文中研究结果对我国大型客机的减振降噪设计工作有重要的工程参考价值.

  8. The Effect of Bypass Nozzle Exit Area on Fan Aerodynamic Performance and Noise in a Model Turbofan Simulator

    Science.gov (United States)

    Hughes, Christopher E.; Podboy, Gary, G.; Woodward, Richard P.; Jeracki, Robert, J.

    2013-01-01

    The design of effective new technologies to reduce aircraft propulsion noise is dependent on identifying and understanding the noise sources and noise generation mechanisms in the modern turbofan engine, as well as determining their contribution to the overall aircraft noise signature. Therefore, a comprehensive aeroacoustic wind tunnel test program was conducted called the Fan Broadband Source Diagnostic Test as part of the NASA Quiet Aircraft Technology program. The test was performed in the anechoic NASA Glenn 9- by 15-Foot Low Speed Wind Tunnel using a 1/5 scale model turbofan simulator which represented a current generation, medium pressure ratio, high bypass turbofan aircraft engine. The investigation focused on simulating in model scale only the bypass section of the turbofan engine. The test objectives were to: identify the noise sources within the model and determine their noise level; investigate several component design technologies by determining their impact on the aerodynamic and acoustic performance of the fan stage; and conduct detailed flow diagnostics within the fan flow field to characterize the physics of the noise generation mechanisms in a turbofan model. This report discusses results obtained for one aspect of the Source Diagnostic Test that investigated the effect of the bypass or fan nozzle exit area on the bypass stage aerodynamic performance, specifically the fan and outlet guide vanes or stators, as well as the farfield acoustic noise level. The aerodynamic performance, farfield acoustics, and Laser Doppler Velocimeter flow diagnostic results are presented for the fan and four different fixed-area bypass nozzle configurations. The nozzles simulated fixed engine operating lines and encompassed the fan stage operating envelope from near stall to cruise. One nozzle was selected as a baseline reference, representing the nozzle area which would achieve the design point operating conditions and fan stage performance. The total area change from

  9. A methodology for noise prediction of turbofan engines.

    OpenAIRE

    Gustavo Di Fiore dos Santos

    2006-01-01

    A computional model is developed for prediction of noise emission from na existing or new turbofan engine. This model allows the simulation of noise generation from high bypass ratio turbofan engines, appropriate for use with computational programs for gas turbine performance developed at ITA. Analytical and empirical methods are used for spectrum shape, spectrum level, overall noise and free-field directivity noise. The most significant noise sources in turbofan engines are modeled: fan, com...

  10. Parameterization of a Conventional and Regenerated UHB Turbofan

    OpenAIRE

    Oliveira Fábio; Brójo Francisco

    2015-01-01

    The attempt to improve aircraft engines efficiency resulted in the evolution from turbojets to the first generation low bypass ratio turbofans. Today, high bypass ratio turbofans are the most traditional type of engine in commercial aviation. Following many years of technological developments and improvements, this type of engine has proved to be the most reliable facing the commercial aviation requirements. In search of more efficiency, the engine manufacturers tend t...

  11. Preliminary design study of a quiet, high flow fan (QHF) stage. [turbofans - quiet engine program

    Science.gov (United States)

    Walker, C. L.; Kisner, L. S.; Delaney, R. A.; Beguhn, A. A.; Frye, D. E.

    1974-01-01

    Concepts selected to reduce fan generated noise in a turbofan are presented. Near-sonic flow at the fan inlet to reduce upstream propagated noise and the use of long-chord vanes to reduce downstream noise is discussed. The near-sonic condition at the rotor inlet plane was achieved by designing for high specific mass flow and by maintaining the high flow at reduced power by variable stators and variable fan exhaust nozzle. The long-chord vanes reduce response to unsteady flow. The acoustic design showed that long-chord stators would significantly reduce turbofan source noise and that other stator design parameters have no appreciable effect on noise for the spacing and chord length of the turbofan design. Four rig flow paths studied in the aerodynamic preliminary design are discussed. Noise prediction results indicate that a turbofan powered aircraft would be under federal air regulations levels without any acoustic treatment.

  12. Bird Ingestion into Large Turbofan Engines

    Science.gov (United States)

    1992-05-01

    AD-A255 863 DOT/FA°• I•T91/17 Bird Ingestion into Large FAA Technical Center AtlanticCity International AirportN 4urbofan Engines L -TIC ýEP 1992...Gov.ernm.nt Accistton No, 3, Rec.p.ent’s Catalog No. DOT/FAA/CT-91/1 7 4. Title and Subtitle 5. Report fote May 1992 BIRD INGESTION INTO LARGE TURBOFAN...study of bird ingestion into certain modern, large high bypass turbofan engines. The engines under consideration were certificated to current FAA

  13. Research on performance requirements of turbofan engine used on carrier-based UAV

    Science.gov (United States)

    Zhao, Shufan; Li, Benwei; Zhang, Wenlong; Wu, Heng; Feng, Tang

    2017-05-01

    According to the mission requirements of the carrier-based unmanned aerial vehicle (UAV), a mode level flight was established to calculate the thrust requirements from altitude 9 km to 13 km. Then, the estimation method of flight profile was used to calculate the weight of UAV in each stage to get the specific fuel consumption requirements of the UAV in standby stage. The turbofan engine of carrier-based UAV should meet the thrust and specific fuel consumption requirements. Finally, the GSP software was used to verify the simulation of a small high-bypass turbofan engine. The conclusion is useful for the turbofan engine selection of carrier-based UAV.

  14. Luminescent Paints Used for Rotating Temperature and Pressure Measurements on Scale-Model High-Bypass-Ratio Fans

    Science.gov (United States)

    Bencic, Timothy J.

    1998-01-01

    NASA Lewis Research Center is a leader in the application of temperature- and pressuresensitive paints (TSP and PSP) in rotating environments. Tests were recently completed on several scale model, high-bypass-ratio turbofans in Lewis' 9- by 15-Foot Low-Speed Wind Tunnel. Two of the test objectives were to determine the aerodynamic and acoustic performance of the fan designs. Using TSP and PSP, researchers successfully achieved fullfield aerodynamic loading profiles. The visualized loading profiles may help researchers identify factors contributing to the fans' performance and to the acoustic characteristics associated with the flow physics on the surface of the blades.

  15. Supersonic Stall Flutter of High Speed Fans. [in turbofan engines

    Science.gov (United States)

    Adamczyk, J. J.; Stevens, W.; Jutras, R.

    1981-01-01

    An analytical model is developed for predicting the onset of supersonic stall bending flutter in axial flow compressors. The analysis is based on a modified two dimensional, compressible, unsteady actuator disk theory. It is applied to a rotor blade row by considering a cascade of airfoils whose geometry and dynamic response coincide with those of a rotor blade element at 85 percent of the span height (measured from the hub). The rotor blades are assumed to be unshrouded (i.e., free standing) and to vibrate in their first flexural mode. The effects of shock waves and flow separation are included in the model through quasi-steady, empirical, rotor total-pressure-loss and deviation-angle correlations. The actuator disk model predicts the unsteady aerodynamic force acting on the cascade blading as a function of the steady flow field entering the cascade and the geometry and dynamic response of the cascade. Calculations show that the present model predicts the existence of a bending flutter mode at supersonic inlet Mach numbers. This flutter mode is suppressed by increasing the reduced frequency of the system or by reducing the steady state aerodynamic loading on the cascade. The validity of the model for predicting flutter is demonstrated by correlating the measured flutter boundary of a high speed fan stage with its predicted boundary. This correlation uses a level of damping for the blade row (i.e., the log decrement of the rotor system) that is estimated from the experimental flutter data. The predicted flutter boundary is shown to be in good agreement with the measured boundary.

  16. A study to estimate and compare the total particulate matter emission indices (EIN) between traditional jet fuel and two blends of Jet A/Camelina biofuel used in a high by-pass turbofan engine: A case study of Honeywell TFE-109 engine

    Science.gov (United States)

    Shila, Jacob Joshua Howard

    and JT15D engines' families as representatives of other engines with rated thrust of 6000 pounds or below. The results of this study may be used to add to the knowledge of PM emission data that has been collected in other research studies. This study was quantitative in nature. Three factors were designated which were the types of fuels studied. The TFE-109 turbofan engine was the experimental subject. The independent variable was the engine thrust setting while the response variable was the emission index. Four engine runs were conducted for each fuel. In each engine run, four engine thrust settings were observed. The four engine thrust levels were 10%, 30%, 85%, and 100% rated thrusts levels. Therefore, for each engine thrust settings, there four replicates. The experiments were conducted using a TFE-109 engine test cell located in the Niswonger Aviation Technology building at the Purdue University Airport. The testing facility has the capability to conduct the aircraft PM emissions tests. Due to the equipment limitations, the study was limited to observe total PM emissions instead of specifically measuring the non-volatile PM emissions. The results indicate that the emissions indices of the blended biofuels were not statistically significantly lower compared to the emissions of the traditional jet fuel at rated thrust levels of 100% and 85% of TFE-109 turbofan engine. However, the emission indices for the 50%Jet A - 50%Camelina biofuel blend were statistically significantly lower compared to the emission indices of the 100% Jet A fuel at 10% and 30% engine rated thrusts levels of TFE-109 engine. The emission indices of the 50%-50% biofuel blend were lower by reductions of 15% and 17% at engine rated thrusts of 10% and 30% respectively compared to the emissions indices of the traditional jet fuel at the same engine thrust levels. Experimental modifications in future studies may provide estimates of the emissions indices range for this particular engine these

  17. An Overview of the NASA Fundamental Aeronautics Program Subsonic Fixed Wing Project and Ultra High Bypass Partnership Research Goals

    Science.gov (United States)

    Hughes, Christopher E.

    2009-01-01

    An overview of the NASA Fundamental Aeronautics Program (FAP) mission and goals is presented. One of the subprograms under the FAP, the Subsonic Fixed Wing Project (SFW), is the focus of the presentation. The SFW system environmental metrics are discussed, along with highlights of planned, systematic approach to research to reduce the environmental impact of commercial aircraft in the areas of acoustics, fuel burn and emissions. The presentation then focuses on collaborative research being conducted with U.S. Industry on the Ultra High Bypass (UHB) engine cycle, the propulsion cycle selected by the SFW to meet the system goals. The partnerships with General Electric Aviation to investigate Open Rotor propulsion concepts and with Pratt & Whitney to investigate the Geared Turbofan UHB engine are highlighted, including current and planned future collaborative research activities with NASA and each organization.

  18. Effects of Test Cell Recirculation on High-Bypass Turbofan Engines during Simulated Altitude Tests

    Science.gov (United States)

    1986-08-01

    PSPS PSP IXPRP . . . . ~:(~ ONDA RY ~--’~- PS FN ’’-~" I ~. " ~, I.I FLOW ~ ...... l L TSAP ~- DTP I, 2, 3.4 ~ PSCW I-9 -- XNAP PSTS I-8...urL.menl~." AED(’-TR-73-5. I chruary 1973. "" U is Calculated at the Lov, End of the Amplitude for Each Range and Should b¢ Ik t ler with Increased Ampli

  19. Dynamic Performance of High Bypass Ratio Turbine Engines With Water Ingestion

    Science.gov (United States)

    Murthy, S. N. B.

    1996-01-01

    The research on dynamic performance of high bypass turbofan engines includes studies on inlets, turbomachinery and the total engine system operating with air-water mixture; the water may be in vapor, droplet, or film form, and their combinations. Prediction codes (WISGS, WINCOF, WINCOF-1, WINCLR, and Transient Engine Performance Code) for performance changes, as well as changes in blade-casing clearance, have been established and demonstrated in application to actual, generic engines. In view of the continuous changes in water distribution in turbomachinery, the performance of both components and the total engine system must be determined in a time-dependent mode; hence, the determination of clearance changes also requires a time-dependent approach. In general, the performance and clearances changes cannot be scaled either with respect to operating or ingestion conditions. Removal of water prior to phase change is the most effective means of avoiding ingestion effects. Sufficient background has been established to perform definitive, full scale tests on a set of components and a complete engine to establish engine control and operability with various air-water vapor-water mixtures.

  20. Turbofan gas turbine engine with variable fan outlet guide vanes

    Science.gov (United States)

    Wood, Peter John (Inventor); Zenon, Ruby Lasandra (Inventor); LaChapelle, Donald George (Inventor); Mielke, Mark Joseph (Inventor); Grant, Carl (Inventor)

    2010-01-01

    A turbofan gas turbine engine includes a forward fan section with a row of fan rotor blades, a core engine, and a fan bypass duct downstream of the forward fan section and radially outwardly of the core engine. The forward fan section has only a single stage of variable fan guide vanes which are variable fan outlet guide vanes downstream of the forward fan rotor blades. An exemplary embodiment of the engine includes an afterburner downstream of the fan bypass duct between the core engine and an exhaust nozzle. The variable fan outlet guide vanes are operable to pivot from a nominal OGV position at take-off to an open OGV position at a high flight Mach Number which may be in a range of between about 2.5-4+. Struts extend radially across a radially inwardly curved portion of a flowpath of the engine between the forward fan section and the core engine.

  1. 大涵道比涡扇发动机试飞平台动力装置系统设计%Design of Propulsion System for Testing Platform of Large Bypass Turbofan Engine

    Institute of Scientific and Technical Information of China (English)

    吕其明; 刘虎平; 钟剑龙

    2015-01-01

    According to the request of flight testing platform for large bypass turbofan engine, the propulsion system based on the testing platform was designed. The systems consists of installation system, ground support and processing, venting and cooling system, fuel supplying and returning system, fire detection and extinguish subsystems. 3D digital mockup technology was applied in the design and CFD simulation was used for performance optimization of the system. The system was validated to be reliable by the ground test and flight test, and performance met the requirements. The design method can be a reference for the systems' design in the future.%为满足大涵道比涡扇发动机试飞平台研制需要,开展了基于试飞平台的动力装置系统设计.主要包括发动机安装系统、地面配套补加工、发动机舱通风冷却、发动机供回油系统、火警探测及灭火系统等分系统设计.设计中采用了全三维电子样机设计,采用了流体仿真计算技术对分系统性能进行了优化.通过地面调试及飞行试验表明系统工作可靠,满足性能指标要求.该设计方法可以为以后类似系统设计提供参考.

  2. Control Design for an Advanced Geared Turbofan Engine

    Science.gov (United States)

    Chapman, Jeffryes W.; Litt, Jonathan

    2017-01-01

    This paper describes the design process for the control system of an advanced geared turbofan engine. This process is applied to a simulation that is representative of a 30,000 lbf thrust class concept engine with two main spools, ultra-high bypass ratio, and a variable area fan nozzle. Control system requirements constrain the non-linear engine model as it operates throughout its flight envelope of sea level to 40,000 ft and from 0 to 0.8 Mach. The control architecture selected for this project was developed from literature and reflects a configuration that utilizes a proportional integral controller integrated with sets of limiters that enable the engine to operate safely throughout its flight envelope. Simulation results show the overall system meets performance requirements without exceeding system operational limits.

  3. Installation effects of wing-mounted turbofan nacelle-pylons on a 1/17-scale, twin-engine, low-wing transport model

    Science.gov (United States)

    Pendergraft, Odis C., Jr.; Ingraldi, Anthony M.; Re, Richard J.; Kariya, Timmy T.

    1992-01-01

    A twin-engine, low-wing transport model, with a supercritical wing of aspect ratio 10.8 designed for a cruise Mach number of 0.77 and a lift coefficient of 0.55, was tested in the Langley 16-Foot Transonic Tunnel. The purpose of this test was to compare the wing-nacelle interference effects of flow-through nacelles simulating superfan engines (very high bypass ratio (BPR is approx. = 18) turbofan engines) with the wing-nacelle interference effects of current-technology turbofans (BPR is approx. = 6). Forces and moments on the complete model were measured with a strain-gage balance, and extensive external static-pressure measurements (383 orifice locations) were made on the wing, nacelles, and pylons of the model. Data were taken at Mach numbers from 0.50 to 0.80 and at model angles of attack from -4 deg to 8 deg. Test results indicate that flow-through nacelles with a very high bypass ratio can be installed on a low-wing transport model with a lower installation drag penalty than for a conventional turbofan nacelle at a design cruise Mach number of 0.77 and lift coefficient of 0.55.

  4. A Parametric Study of Actuator Requirements for Active Turbine Tip Clearance Control of a Modern High Bypass Turbofan Engine

    Science.gov (United States)

    Kratz, Jonathan L.; Chapman, Jeffryes W.; Guo, Ten-Huei

    2017-01-01

    The efficiency of aircraft gas turbine engines is sensitive to the distance between the tips of its turbine blades and its shroud, which serves as its containment structure. Maintaining tighter clearance between these components has been shown to increase turbine efficiency, increase fuel efficiency, and reduce the turbine inlet temperature, and this correlates to a longer time-on-wing for the engine. Therefore, there is a desire to maintain a tight clearance in the turbine, which requires fast response active clearance control. Fast response active tip clearance control will require an actuator to modify the physical or effective tip clearance in the turbine. This paper evaluates the requirements of a generic active turbine tip clearance actuator for a modern commercial aircraft engine using the Commercial Modular Aero-Propulsion System Simulation 40k (C-MAPSS40k) software that has previously been integrated with a dynamic tip clearance model. A parametric study was performed in an attempt to evaluate requirements for control actuators in terms of bandwidth, rate limits, saturation limits, and deadband. Constraints on the weight of the actuation system and some considerations as to the force which the actuator must be capable of exerting and maintaining are also investigated. From the results, the relevant range of the evaluated actuator parameters can be extracted. Some additional discussion is provided on the challenges posed by the tip clearance control problem and the implications for future small core aircraft engines.

  5. Effect of Two Advanced Noise Reduction Technologies on the Aerodynamic Performance of an Ultra High Bypass Ratio Fan

    Science.gov (United States)

    Hughes, Christoper E.; Gazzaniga, John A.

    2013-01-01

    A wind tunnel experiment was conducted in the NASA Glenn Research Center anechoic 9- by 15-Foot Low-Speed Wind Tunnel to investigate two new advanced noise reduction technologies in support of the NASA Fundamental Aeronautics Program Subsonic Fixed Wing Project. The goal of the experiment was to demonstrate the noise reduction potential and effect on fan model performance of the two noise reduction technologies in a scale model Ultra-High Bypass turbofan at simulated takeoff and approach aircraft flight speeds. The two novel noise reduction technologies are called Over-the-Rotor acoustic treatment and Soft Vanes. Both technologies were aimed at modifying the local noise source mechanisms of the fan tip vortex/fan case interaction and the rotor wake-stator interaction. For the Over-the-Rotor acoustic treatment, two noise reduction configurations were investigated. The results showed that the two noise reduction technologies, Over-the-Rotor and Soft Vanes, were able to reduce the noise level of the fan model, but the Over-the-Rotor configurations had a significant negative impact on the fan aerodynamic performance; the loss in fan aerodynamic efficiency was between 2.75 to 8.75 percent, depending on configuration, compared to the conventional solid baseline fan case rubstrip also tested. Performance results with the Soft Vanes showed that there was no measurable change in the corrected fan thrust and a 1.8 percent loss in corrected stator vane thrust, which resulted in a total net thrust loss of approximately 0.5 percent compared with the baseline reference stator vane set.

  6. Results of an Advanced Fan Stage Operating Over a Wide Range of Speed and Bypass Ratio. Part 2; Comparison of CFD and Experimental Results

    Science.gov (United States)

    Celestina, Mark L.; Suder, Kenneth L.; Kulkarni, Sameer

    2010-01-01

    NASA and GE teamed to design and build a 57 percent engine scaled fan stage for a Mach 4 variable cycle turbofan/ramjet engine for access to space with multipoint operations. This fan stage was tested in NASA's transonic compressor facility. The objectives of this test were to assess the aerodynamic and aero mechanic performance and operability characteristics of the fan stage over the entire range of engine operation including: 1) sea level static take-off; 2) transition over large swings in fan bypass ratio; 3) transition from turbofan to ramjet; and 4) fan wind-milling operation at high Mach flight conditions. This paper will focus on an assessment of APNASA, a multistage turbomachinery analysis code developed by NASA, to predict the fan stage performance and operability over a wide range of speeds (37 to 100 percent) and bypass ratios.

  7. Trainees operating on high-risk patients without cardiopulmonary bypass: a high-risk strategy?

    Science.gov (United States)

    Ascione, Raimondo; Reeves, Barnaby C; Pano, Marco; Angelini, Gianni D

    2004-07-01

    The safety of teaching off-pump coronary artery bypass grafting to trainees is best tested in high-risk patients, who are more likely to experience significant morbidity after surgery. This study compared outcomes of off-pump coronary artery bypass grafting operations performed by consultants and trainees in high-risk patients. Data for consecutive patients undergoing off-pump coronary artery bypass grafting were collected prospectively. Patients satisfying at least one of the following criteria were classified as high-risk: age older than 75 years, ejection fraction less than 0.30, myocardial infarction in the previous month, current congestive heart failure, previous cerebrovascular accident, creatinine greater than 150 micromol/L, respiratory impairment, peripheral vascular disease, previous cardiac surgery, and left main stem stenosis greater than 50%. Early morbidity, 30-day mortality, and late survival were compared. From April 1996 to December 2002, 686 high-risk patients underwent off-pump coronary artery bypass grafting revascularization. Operations by five consultants (416; 61%) and four trainees (239; 35%) were the focus of subsequent analyses. Nine visiting or research fellows performed the other 31 operations. Prognostic factors were more favorable in trainee-led operations. On average, consultants and trainees grafted the same number of vessels. There were 18 (4.3%) and 5 (1.9%) deaths within 30 days, and 14 (3.4%) and 5 (1.9%) myocardial infarctions in consultant and trainee groups, respectively. After adjusting for imbalances in prognostic factors, odd ratios for almost all adverse outcomes implied no increased risk with trainee operators, although patients operated on by trainees had longer postoperative stays and were more likely to have a red blood cell transfusion. Kaplan-Meier cumulative mortality estimates at 24-month follow-up were 10.5% (95% confidence interval, 7.7% to 14.2%) and 6.4% (95% confidence interval, 3.8% to 10.9%) in consultant

  8. Experimental and Analytic Study on the Core Bypass Flow in a Very High Temperature Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Richard Schultz

    2012-04-01

    Core bypass flow has been one of key issues in the very high temperature reactor (VHTR) design for securing core thermal margins and achieving target temperatures at the core exit. The bypass flow in a prismatic VHTR core occurs through the control element holes and the radial and axial gaps between the graphite blocks for manufacturing and refueling tolerances. These gaps vary with the core life cycles because of the irradiation swelling/shrinkage characteristic of the graphite blocks such as fuel and reflector blocks, which are main components of a core's structure. Thus, the core bypass flow occurs in a complicated multidimensional way. The accurate prediction of this bypass flow and counter-measures to minimize it are thus of major importance in assuring core thermal margins and securing higher core efficiency. Even with this importance, there has not been much effort in quantifying and accurately modeling the effect of the core bypass flow. The main objectives of this project were to generate experimental data for validating the software to be used to calculate the bypass flow in a prismatic VHTR core, validate thermofluid analysis tools and their model improvements, and identify and assess measures for reducing the bypass flow. To achieve these objectives, tasks were defined to (1) design and construct experiments to generate validation data for software analysis tools, (2) determine the experimental conditions and define the measurement requirements and techniques, (3) generate and analyze the experimental data, (4) validate and improve the thermofluid analysis tools, and (5) identify measures to control the bypass flow and assess its performance in the experiment.

  9. Investigation on the Core Bypass Flow in a Very High Temperature Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Hassan, Yassin

    2013-10-22

    Uncertainties associated with the core bypass flow are some of the key issues that directly influence the coolant mass flow distribution and magnitude, and thus the operational core temperature profiles, in the very high-temperature reactor (VHTR). Designers will attempt to configure the core geometry so the core cooling flow rate magnitude and distribution conform to the design values. The objective of this project is to study the bypass flow both experimentally and computationally. Researchers will develop experimental data using state-of-the-art particle image velocimetry in a small test facility. The team will attempt to obtain full field temperature distribution using racks of thermocouples. The experimental data are intended to benchmark computational fluid dynamics (CFD) codes by providing detailed information. These experimental data are urgently needed for validation of the CFD codes. The following are the project tasks: • Construct a small-scale bench-top experiment to resemble the bypass flow between the graphite blocks, varying parameters to address their impact on bypass flow. Wall roughness of the graphite block walls, spacing between the blocks, and temperature of the blocks are some of the parameters to be tested. • Perform CFD to evaluate pre- and post-test calculations and turbulence models, including sensitivity studies to achieve high accuracy. • Develop the state-of-the art large eddy simulation (LES) using appropriate subgrid modeling. • Develop models to be used in systems thermal hydraulics codes to account and estimate the bypass flows. These computer programs include, among others, RELAP3D, MELCOR, GAMMA, and GAS-NET. Actual core bypass flow rate may vary considerably from the design value. Although the uncertainty of the bypass flow rate is not known, some sources have stated that the bypass flow rates in the Fort St. Vrain reactor were between 8 and 25 percent of the total reactor mass flow rate. If bypass flow rates are on the

  10. CLASSIFICATION OF NEURAL NETWORK FOR TECHNICAL CONDITION OF TURBOFAN ENGINES BASED ON HYBRID ALGORITHM

    Directory of Open Access Journals (Sweden)

    Valentin Potapov

    2016-12-01

    Full Text Available Purpose: This work presents a method of diagnosing the technical condition of turbofan engines using hybrid neural network algorithm based on software developed for the analysis of data obtained in the aircraft life. Methods: allows the engine diagnostics with deep recognition to the structural assembly in the presence of single structural damage components of the engine running and the multifaceted damage. Results: of the optimization of neural network structure to solve the problems of evaluating technical state of the bypass turbofan engine, when used with genetic algorithms.

  11. Modeling Commercial Turbofan Engine Icing Risk With Ice Crystal Ingestion

    Science.gov (United States)

    Jorgenson, Philip C. E.; Veres, Joseph P.

    2013-01-01

    The occurrence of ice accretion within commercial high bypass aircraft turbine engines has been reported under certain atmospheric conditions. Engine anomalies have taken place at high altitudes that have been attributed to ice crystal ingestion, partially melting, and ice accretion on the compression system components. The result was degraded engine performance, and one or more of the following: loss of thrust control (roll back), compressor surge or stall, and flameout of the combustor. As ice crystals are ingested into the fan and low pressure compression system, the increase in air temperature causes a portion of the ice crystals to melt. It is hypothesized that this allows the ice-water mixture to cover the metal surfaces of the compressor stationary components which leads to ice accretion through evaporative cooling. Ice accretion causes a blockage which subsequently results in the deterioration in performance of the compressor and engine. The focus of this research is to apply an engine icing computational tool to simulate the flow through a turbofan engine and assess the risk of ice accretion. The tool is comprised of an engine system thermodynamic cycle code, a compressor flow analysis code, and an ice particle melt code that has the capability of determining the rate of sublimation, melting, and evaporation through the compressor flow path, without modeling the actual ice accretion. A commercial turbofan engine which has previously experienced icing events during operation in a high altitude ice crystal environment has been tested in the Propulsion Systems Laboratory (PSL) altitude test facility at NASA Glenn Research Center. The PSL has the capability to produce a continuous ice cloud which are ingested by the engine during operation over a range of altitude conditions. The PSL test results confirmed that there was ice accretion in the engine due to ice crystal ingestion, at the same simulated altitude operating conditions as experienced previously in

  12. Ultra High Bypass Ratio Engine Research for Reducing Noise, Emissions, and Fuel Consumption

    Science.gov (United States)

    Hughes, Christopher E.; Schweitzer, Jeff

    2007-01-01

    A pictorial history of NASA development of advanced engine technologies for reducing environmental emissions and increasing performance from the 1970s to 2000s is presented. The goals of the Subsonic Fixed Wing Program portion of the NASA Fundamental Aeronautics Program are discussed, along with the areas of investigation currently being pursued by the Ultra High Bypass Partnership Element of the Subsonic Fixed Wing Program.

  13. Collaborative Research on the Ultra High Bypass Ratio Engine Cycle to Reduce Noise, Emissions and Fuel Consumption

    Science.gov (United States)

    Hughes, Christopher

    2008-01-01

    A pictorial history of NASA development of advanced engine technologies for reducing environmental emissions and increasing performance from the 1970s to present is presented. The goals of the Subsonic Fixed Wing Program portion of the NASA Fundamental Aeronautics Program are addressed, along with the areas of investigation currently being pursued by the Ultra High Bypass Partnership Element of the Subsonic Fixed Wing Program to meet the goals. Ultra High Bypass cycle research collaboration successes with Pratt & Whitney are presented.

  14. High Bypass Ratio Jet Noise Reduction and Installation Effects Including Shielding Effectiveness

    Science.gov (United States)

    Thomas, Russell H.; Czech, Michael J.; Doty, Michael J.

    2013-01-01

    An experimental investigation was performed to study the propulsion airframe aeroacoustic installation effects of a separate flow jet nozzle with a Hybrid Wing Body aircraft configuration where the engine is installed above the wing. Prior understanding of the jet noise shielding effectiveness was extended to a bypass ratio ten application as a function of nozzle configuration, chevron type, axial spacing, and installation effects from additional airframe components. Chevron types included fan chevrons that are uniform circumferentially around the fan nozzle and T-fan type chevrons that are asymmetrical circumferentially. In isolated testing without a pylon, uniform chevrons compared to T-fan chevrons showed slightly more low frequency reduction offset by more high frequency increase. Phased array localization shows that at this bypass ratio chevrons still move peak jet noise source locations upstream but not to nearly the extent, as a function of frequency, as for lower bypass ratio jets. For baseline nozzles without chevrons, the basic pylon effect has been greatly reduced compared to that seen for lower bypass ratio jets. Compared to Tfan chevrons without a pylon, the combination with a standard pylon results in more high frequency noise increase and an overall higher noise level. Shielded by an airframe surface 2.17 fan diameters from nozzle to airframe trailing edge, the T-fan chevron nozzle can produce reductions in jet noise of as much as 8 dB at high frequencies and upstream angles. Noise reduction from shielding decreases with decreasing frequency and with increasing angle from the jet inlet. Beyond an angle of 130 degrees there is almost no noise reduction from shielding. Increasing chevron immersion more than what is already an aggressive design is not advantageous for noise reduction. The addition of airframe control surfaces, including vertical stabilizers and elevon deflection, showed only a small overall impact. Based on the test results, the best

  15. Advanced Control of Turbofan Engines

    CERN Document Server

    Richter, Hanz

    2012-01-01

    Advanced Control of Turbofan Engines describes the operational performance requirements of turbofan (commercial)engines from a controls systems perspective, covering industry-standard methods and research-edge advances. This book allows the reader to design controllers and produce realistic simulations using public-domain software like CMAPSS: Commercial Modular Aero-Propulsion System Simulation, whose versions are released to the public by NASA. The scope of the book is centered on the design of thrust controllers for both steady flight and transient maneuvers. Classical control theory is not dwelled on, but instead an introduction to general undergraduate control techniques is provided. This book also: Develops a thorough understanding of the challenges associated with engine operability from a control systems perspective, describing performance demands and operational constraints into the framework and language of modern control theory Presents solid theoretical support for classical and advanced engine co...

  16. No major differences in 30-day outcomes in high-risk patients randomized to off-pump versus on-pump coronary bypass surgery: the best bypass surgery trial

    DEFF Research Database (Denmark)

    Møller, Christian H; Perko, Mario J; Lund, Jens T

    2010-01-01

    Off-pump coronary artery bypass grafting compared with coronary revascularization with cardiopulmonary bypass seems safe and results in about the same outcome in low-risk patients. Observational studies indicate that off-pump surgery may provide more benefit in high-risk patients. Our objective w...

  17. Advanced Engine Cycles Analyzed for Turbofans With Variable-Area Fan Nozzles Actuated by a Shape Memory Alloy

    Science.gov (United States)

    Berton, Jeffrey J.

    2002-01-01

    Advanced, large commercial turbofan engines using low-fan-pressure-ratio, very high bypass ratio thermodynamic cycles can offer significant fuel savings over engines currently in operation. Several technological challenges must be addressed, however, before these engines can be designed. To name a few, the high-diameter fans associated with these engines pose a significant packaging and aircraft installation challenge, and a large, heavy gearbox is often necessary to address the differences in ideal operating speeds between the fan and the low-pressure turbine. Also, the large nacelles contribute aerodynamic drag penalties and require long, heavy landing gear when mounted on conventional, low wing aircraft. Nevertheless, the reduced fuel consumption rates of these engines are a compelling economic incentive, and fans designed with low pressure ratios and low tip speeds offer attractive noise-reduction benefits. Another complication associated with low-pressure-ratio fans is their need for variable flow-path geometry. As the design fan pressure ratio is reduced below about 1.4, an operational disparity is set up in the fan between high and low flight speeds. In other words, between takeoff and cruise there is too large a swing in several key fan parameters-- such as speed, flow, and pressure--for a fan to accommodate. One solution to this problem is to make use of a variable-area fan nozzle (VAFN). However, conventional, hydraulically actuated variable nozzles have weight, cost, maintenance, and reliability issues that discourage their use with low-fan-pressure-ratio engine cycles. United Technologies Research, in cooperation with NASA, is developing a revolutionary, lightweight, and reliable shape memory alloy actuator system that can change the on-demand nozzle exit area by up to 20 percent. This "smart material" actuation technology, being studied under NASA's Ultra-Efficient Engine Technology (UEET) Program and Revolutionary Concepts in Aeronautics (Rev

  18. Exergetic optimization of turbofan engine with genetic algorithm method

    Energy Technology Data Exchange (ETDEWEB)

    Turan, Onder [Anadolu University, School of Civil Aviation (Turkey)], e-mail: onderturan@anadolu.edu.tr

    2011-07-01

    With the growth of passenger numbers, emissions from the aeronautics sector are increasing and the industry is now working on improving engine efficiency to reduce fuel consumption. The aim of this study is to present the use of genetic algorithms, an optimization method based on biological principles, to optimize the exergetic performance of turbofan engines. The optimization was carried out using exergy efficiency, overall efficiency and specific thrust of the engine as evaluation criteria and playing on pressure and bypass ratio, turbine inlet temperature and flight altitude. Results showed exergy efficiency can be maximized with higher altitudes, fan pressure ratio and turbine inlet temperature; the turbine inlet temperature is the most important parameter for increased exergy efficiency. This study demonstrated that genetic algorithms are effective in optimizing complex systems in a short time.

  19. High-throughput enzyme screening platform for the IPP-bypass mevalonate pathway for isopentenol production

    DEFF Research Database (Denmark)

    Kang, Aram; Meadows, Corey W.; Canu, Nicolas

    2017-01-01

    of a mevalonate diphosphate decarboxylase (PMD) and demonstrated improved performance under aeration-limited conditions. However, relatively low activity of PMD toward the non-native substrate (mevalonate monophosphate, MVAP) was shown to limit flux through this new pathway. By inhibiting all IPP production from...... ATP requirements and isopentenyl diphosphate (IPP) toxicity pose immediate challenges for engineering bacterial strains to overproduce commodities utilizing IPP as an intermediate. To overcome these limitations, we developed an “IPP-bypass� isopentenol pathway using the promiscuous activity...... the endogenous non-mevalonate pathway, we developed a high-throughput screening platform that correlated promiscuous PMD activity toward MVAP with cellular growth. Successful identification of mutants that altered PMD activity demonstrated the sensitivity and specificity of the screening platform. Strains...

  20. Windmilling of turbofan engine; calculation of performance characteristics of a turbofan engine under windmilling

    NARCIS (Netherlands)

    Ramanathan, A.

    2014-01-01

    The turbofan is a type of air breathing jet engine that finds wide use in aircraft propulsion. During the normal operation of a turbofan engine installed in aircraft, the combustor is supplied with fuel, flow to the combustor is cut off and the engine runs under so called Windmilling conditions bein

  1. Windmilling of turbofan engine; calculation of performance characteristics of a turbofan engine under windmilling

    NARCIS (Netherlands)

    Ramanathan, A.

    2014-01-01

    The turbofan is a type of air breathing jet engine that finds wide use in aircraft propulsion. During the normal operation of a turbofan engine installed in aircraft, the combustor is supplied with fuel, flow to the combustor is cut off and the engine runs under so called Windmilling conditions bein

  2. Windmilling of turbofan engine; calculation of performance characteristics of a turbofan engine under windmilling

    NARCIS (Netherlands)

    Ramanathan, A.

    2014-01-01

    The turbofan is a type of air breathing jet engine that finds wide use in aircraft propulsion. During the normal operation of a turbofan engine installed in aircraft, the combustor is supplied with fuel, flow to the combustor is cut off and the engine runs under so called Windmilling conditions

  3. The Best Bypass Surgery Trial

    DEFF Research Database (Denmark)

    Møller, Christian H; Jensen, Birte Østergaard; Gluud, Christian

    2007-01-01

    Recent trials suggest that off-pump coronary artery bypass grafting (OPCAB) reduces the risk of mortality and morbidity compared with conventional coronary artery bypass grafting (CCAB) using cardiopulmonary bypass. Patients with a moderate- to high-risk of complications after CCAB may have addit...

  4. Modeling of Commercial Turbofan Engine with Ice Crystal Ingestion; Follow-On

    Science.gov (United States)

    Jorgenson, Philip C. E.; Veres, Joseph P.; Coennen, Ryan

    2014-01-01

    The occurrence of ice accretion within commercial high bypass aircraft turbine engines has been reported under certain atmospheric conditions. Engine anomalies have taken place at high altitudes that have been attributed to ice crystal ingestion, partially melting, and ice accretion on the compression system components. The result was degraded engine performance, and one or more of the following: loss of thrust control (roll back), compressor surge or stall, and flameout of the combustor. As ice crystals are ingested into the fan and low pressure compression system, the increase in air temperature causes a portion of the ice crystals to melt. It is hypothesized that this allows the ice-water mixture to cover the metal surfaces of the compressor stationary components which leads to ice accretion through evaporative cooling. Ice accretion causes a blockage which subsequently results in the deterioration in performance of the compressor and engine. The focus of this research is to apply an engine icing computational tool to simulate the flow through a turbofan engine and assess the risk of ice accretion. The tool is comprised of an engine system thermodynamic cycle code, a compressor flow analysis code, and an ice particle melt code that has the capability of determining the rate of sublimation, melting, and evaporation through the compressor flow path, without modeling the actual ice accretion. A commercial turbofan engine which has previously experienced icing events during operation in a high altitude ice crystal environment has been tested in the Propulsion Systems Laboratory (PSL) altitude test facility at NASA Glenn Research Center. The PSL has the capability to produce a continuous ice cloud which is ingested by the engine during operation over a range of altitude conditions. The PSL test results confirmed that there was ice accretion in the engine due to ice crystal ingestion, at the same simulated altitude operating conditions as experienced previously in

  5. Modeling of Commercial Turbofan Engine With Ice Crystal Ingestion: Follow-On

    Science.gov (United States)

    Jorgenson, Philip C. E.; Veres, Joseph P.; Coennen, Ryan

    2014-01-01

    The occurrence of ice accretion within commercial high bypass aircraft turbine engines has been reported under certain atmospheric conditions. Engine anomalies have taken place at high altitudes that have been attributed to ice crystal ingestion, partially melting, and ice accretion on the compression system components. The result was degraded engine performance, and one or more of the following: loss of thrust control (roll back), compressor surge or stall, and flameout of the combustor. As ice crystals are ingested into the fan and low pressure compression system, the increase in air temperature causes a portion of the ice crystals to melt. It is hypothesized that this allows the ice-water mixture to cover the metal surfaces of the compressor stationary components which leads to ice accretion through evaporative cooling. Ice accretion causes a blockage which subsequently results in the deterioration in performance of the compressor and engine. The focus of this research is to apply an engine icing computational tool to simulate the flow through a turbofan engine and assess the risk of ice accretion. The tool is comprised of an engine system thermodynamic cycle code, a compressor flow analysis code, and an ice particle melt code that has the capability of determining the rate of sublimation, melting, and evaporation through the compressor flow path, without modeling the actual ice accretion. A commercial turbofan engine which has previously experienced icing events during operation in a high altitude ice crystal environment has been tested in the Propulsion Systems Laboratory (PSL) altitude test facility at NASA Glenn Research Center. The PSL has the capability to produce a continuous ice cloud which is ingested by the engine during operation over a range of altitude conditions. The PSL test results confirmed that there was ice accretion in the engine due to ice crystal ingestion, at the same simulated altitude operating conditions as experienced previously in

  6. Effect of reference environment on the turbofan engine with the aid of specific-exergy based methods

    Energy Technology Data Exchange (ETDEWEB)

    Turan, Onder [Anadolu University, School of Civil Aviation (Turkey)], e-mail: onderturan@anadolu.edu.tr

    2011-07-01

    Research is being carried out in the aeronautics sector on improving engine efficiency, and thereby increasing engine power, while reducing fuel consumption. The aim of this study was to determine the performance and efficiency of a turbofan engine and assess the impact of altitude on its performance. An exergetic analysis was carried out at different altitudes on a simple turbofan engine composed of inlet, fan, high pressure compressor and turbine, fan nozzle, compression chamber and exhaust. Exergy analysis allows the loss locations to be assessed and efficiencies evaluated in a meaningful way. Results showed that the turbofan engine has an efficiency of 25.68% to 28.11% and an exergy efficiency of 48.91% to 50.34%. It was found, moreover, that the combustion chamber was where the greatest efficiency losses occurred. This study permitted the exergy performance of a turbofan engine to be determined and identified the components where the greater losses occurred.

  7. [Hypoglycaemia and hypocalcaemia in a gastric bypass-operated patient with high alcohol consumption and colectomia].

    Science.gov (United States)

    Worm, Dorte; Naver, Lars S; Hansen, Dorte L

    2015-04-13

    The combination of gastric bypass, colectomia, lack of substitution with minerals and vitamins, and alcohol consumption led to severe complications in a 57-year-old man. He was submitted to different hospitals 25 times and seen in polyclinics 39 times with no improvement in symptoms of postprandial neurohypoglycaemia, ortostatic hypotension and pronounced hypocalcaemia. The importance of frequent controls after gastric bypass in centres with specialists knowing the common complications after the operation and the need for nutritionel supplements is hereby emphasised.

  8. On-Pump Beating Coronary Artery Bypass in High Risk Coronary Patients

    Directory of Open Access Journals (Sweden)

    Abbas Afrasiabirad

    2015-01-01

    Full Text Available Background: There are some conflicting results with Conventional Coronary Artery Bypass Grafts (CCABG with arrested heart in coronary high-risk patients. Moreover, performing off-pump CABG in these cases may be associated with serious complications. The objective of this study is to evaluate the efficacy of the on-pump beating CABG (OPBCABG in coronary high-risk patients in comparison with the conventional methods. Methods: In a prospective research study, 3000 off-pump CABG patients were considered during June 2003 to December 2011. Among these, 157 patients with one or more of the following risk factors were included for OPBCABG; severe left main stenosis, early post-acute myocardial infarction with ongoing chest pain, unstable angina, intractable ventricular arrhythmia, post complicated coronary intervention and severe left ventricular dysfunction. These patients were compared with 157 similar patients undergone CCABG with aortic cross clamp before 2003. Results: Preoperative patient characteristics revealed no significant differences between the two groups. The patients’ mean age and number of grafts were 57 years and 3 per patient respectively. Hospital mortality was 3.2% and 9% in OPBCABG and CCABG groups, respectively (P<0.001. Preoperative myocardial infarction, requirement of inotropic agents and intraaortic balloon pump, renal dysfunction and prolonged ventilation time were significantly higher in CCABG group. Conclusion: Our results suggest that OPBCABG is effective in coronary high-risk patients and significantly reduces mortality and the incidence of perioperative MI and other major complications.

  9. A comparison of high-dose and low-dose tranexamic acid antifibrinolytic protocols for primary coronary artery bypass surgery

    Directory of Open Access Journals (Sweden)

    Stephen M McHugh

    2016-01-01

    Full Text Available Background and Aims: Tranexamic acid (TA is used for prophylactic antifibrinolysis in coronary artery bypass surgeries to reduce bleeding. We evaluated the efficacy of two different doses of TA for prophylactic antifibrinolysis in patients undergoing primary coronary artery bypass grafting (CABG surgery in this retrospective cohort study at a tertiary care referral centre. Methods: One-hundred eighty-four patients who underwent primary CABG with cardiopulmonary bypass (CPB via sternotomy between January 2009 and June 2011 were evaluated. Pre-operative patient characteristics, intraoperative data, post-operative bleeding, transfusions, organ dysfunction and 30-day mortality were compared between high-dose TA (30 mg/kg loading dose followed by infusion of 15 mg/kg/h until the end of surgery along with 2 mg/kg priming dose in the bypass circuit and low-dose TA (15 mg/kg loading dose followed by infusion of 6 mg/kg/h until the end of surgery along with 1 mg/kg priming dose in the bypass circuit groups. Univariate comparative analysis of all categorical and continuous variables was performed between the two groups by appropriate statistical tests. Linear and logistic regression analyses were performed to control for the effect of confounding on the outcome variables. Results: Chest tube output, perioperative transfusion of blood products and incidence of re-exploration for bleeding did not differ significantly (P> 0.05 between groups. Post-operative complications and 30-day mortality were comparable between the groups. The presence of cardiogenic shock and increased pre-operative creatinine were found to be associated with increased chest tube output on the post-operative day 2 by multivariable linear regression model. Conclusions: Low-dose TA protocol is as effective as high-dose protocol for antifibrinolysis in patients undergoing primary CABG with CPB.

  10. Preoperative statin is associated with decreased operative mortality in high risk coronary artery bypass patients

    Directory of Open Access Journals (Sweden)

    Maher Thomas D

    2010-02-01

    Full Text Available Abstract Background Statins are widely prescribed to patients with atherosclerosis. A retrospective database analysis was used to examine the role of preoperative statin use in hospital mortality, for patients undergoing isolated coronary artery bypass grafting (CABG. Methods The study population comprised 2377 patients who had isolated CABG at Allegheny General Hospital between 2000 and 2004. Mean age of the patients was 65 ± 11 years (range 27 to 92 years. 1594 (67% were male, 5% had previous open heart procedures, and 4% had emergency surgery. 1004 patients (42% were being treated with a statin at the time of admission. Univariate, bivariate (Chi2, Fisher's Exact and Student's t-tests and multivariate (stepwise linear regression analyses were used to evaluate the association of statin use with mortality following CABG. Results Annual prevalence of preoperative statin use was similar over the study period and averaged 40%. Preoperative clinical risk assessment demonstrated a 2% risk of mortality in both the statin and non-statin groups. Operative mortality was 2.4% for all patients, 1.7% for statin users and 2.8% for non-statin users (p Conclusions Between 2000 and 2004 less than 50% of patients at this institution were receiving statins before admission for isolated CABG. A retrospective analysis of this cohort provides evidence that preoperative statin use is associated with lower operative mortality in high-risk patients.

  11. Windmilling of turbofan engine; calculation of performance characteristics of a turbofan engine under windmilling

    OpenAIRE

    A. Ramanathan

    2014-01-01

    The turbofan is a type of air breathing jet engine that finds wide use in aircraft propulsion. During the normal operation of a turbofan engine installed in aircraft, the combustor is supplied with fuel, flow to the combustor is cut off and the engine runs under so called Windmilling conditions being driven only by the ram pressure ratio by producing drag. In-depth analysis is done to study the performance characteristics at this state.

  12. Comparison of influence of high thoracic epidural anesthesia and central analgesia on hemodynamic during on-bypass coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    V. A. Sobokar

    2015-06-01

    Full Text Available Objective. Despite some advantages, the use of high thoracic epidural anesthesia (HTEA during cardiac operations may be discouraged by fear of adverse hemodynamic effects. Aim. To compare the hemodynamic effects of HTEA and central analgesia (CA during on-bypass CABG. Methods. 132 patients were assigned into two groups – study group (n = 85, where the surgery was carried out under HTEA and control group (n = 47 - where the surgery was carried out under CA. Data of the intraoperative monitoring and trans-oesophageal cardiac ultrasound - cardiac index (CI, stroke index (SI, ejection fraction (EF and index of systemic vascular resistance (ISVR were obtained. Results. After induction and sternotomy patients in the study group had higher EF - 57(53, 65% vs 54 ± 7% (p = 0,013 and 55 ± 8 vs 52 ± 9%, (p = 0,031. After sternotomy CI and SI in the study group were also higher, respectively 2,42 (2,0;3,1 vs 2,23±0,63 l · min-1 · m-2, (p = 0,041 and 43 (34;46 vs 37±10 ml · m-2 (p = 0.014. Conclusion. We concluded that HTEA has advantages over CA by its influence on hemodynamics.

  13. Preliminary studies of coolant by-pass flows in a prismatic very high temperature reactor using computational fluid dynamics

    Energy Technology Data Exchange (ETDEWEB)

    Hiroyuki Sato; Richard Johnson; Richard Schultz

    2009-09-01

    Three dimensional computational fluid dynamic (CFD) calculations of a typical prismatic very high temperature gas-cooled reactor (VHTR) were conducted to investigate the influence of gap geometry on flow and temperature distributions in the reactor core using commercial CFD code FLUENT. Parametric calculations changing the gap width in a whole core length model of fuel and reflector columns were performed. The simulations show the effects of core by-pass flows in the heated core region by comparing results for several gap widths including zero gap width. The calculation results underline the importance of considering inter-column gap width for the evaluation of maximum fuel temperatures and temperature gradients in fuel blocks. In addition, it is shown that temperatures of core outlet flow from gaps and channels are strongly affected by the gap width of by-pass flow in the reactor core.

  14. Long term evaluation of brain perfusion with magnetic resonance in high flow extracranial-intracranial saphenous graft bypass

    Energy Technology Data Exchange (ETDEWEB)

    Bozzao, Alessandro [University of Rome La Sapienza, Department of Neuroradiology, II Faculty of Medicine, Rome (Italy); Sant' Andrea Hospital, Rome (Italy); Fasoli, Fabrizio; Finocchi, Vanina; Romano, Andrea; Fantozzi, Luigi M. [University of Rome La Sapienza, Department of Neuroradiology, II Faculty of Medicine, Rome (Italy); Santoro, Giuseppe [University of Rome La Sapienza, Department of Neurosurgery, I Faculty of Medicine, Rome (Italy)

    2007-01-15

    Assessment was made of the cerebral vascular haemodynamic parameters in patients with a high-flow extra-intracranial (EC-IC) bypass performed for therapeutic occlusion of the internal carotid artery (ICA). Sixteen patients with ICA occlusion and EC-IC bypass (time interval from surgery 1-6 years) underwent MRI. Perfusion-weighted magnetic resonance imaging (PW-MRI) sequences were performed without the use of an arterial input function. The relative cerebral blood volume (rCBV), mean transit time (MTT) and relative cerebral blood flow (rCBF) were evaluated in all patients at the level of the basal ganglia, centrum semiovale and cortex in both hemispheres. Statistically significant differences (P<0.005) were observed in the haemodynamic parameters, indicating increased rCBV in the basal ganglia and decreased rCBF and rCBV in the cortex of the hemisphere supplied by the graft with respect to the contralateral. Patients with occlusion of the ICA and high flow EC-IC bypass do have altered vascular haemodynamic status between the hemispheres. In particular, rCBF is impaired in the surgical hemisphere at the level of the cortex. These patients should be followed-up to rule out chronic ischemia. (orig.)

  15. 78 FR 70198 - Airworthiness Directives; Rolls-Royce Deutschland Ltd & Co KG Turbofan Engines

    Science.gov (United States)

    2013-11-25

    ... & Co KG (RRD) model Tay 620-15, 650-15, and 651-54 turbofan engines. This AD requires a one-time... review of the service history of Tay engines discovered that the High Pressure (HP) air bleed valve...''. Request To Change Applicability RRD requested that we change the scope of the AD to include Tay 650-15 and...

  16. Technology Solutions Case Study: Preventing Thermal Bypass

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2012-10-01

    This project highlights the importance of continuous air barriers in full alignment with insulation to prevent thermal bypasses and achieve high energy performance, and recommends use of ENERGY STAR's Thermal Bypass Inspection Checklist.

  17. Parametric (On-Design) Cycle Analysis for a Separate-Exhaust Turbofan Engine With Interstage Turbine Burner

    Science.gov (United States)

    Liew, K. H.; Urip, E.; Yang, S. L.; Siow, Y. K.; Marek, C. J.

    2005-01-01

    Today s modern aircraft is based on air-breathing jet propulsion systems, which use moving fluids as substances to transform energy carried by the fluids into power. Throughout aero-vehicle evolution, improvements have been made to the engine efficiency and pollutants reduction. The major advantages associated with the addition of ITB are an increase in thermal efficiency and reduction in NOx emission. Lower temperature peak in the main combustor results in lower thermal NOx emission and lower amount of cooling air required. This study focuses on a parametric (on-design) cycle analysis of a dual-spool, separate-flow turbofan engine with an Interstage Turbine Burner (ITB). The ITB considered in this paper is a relatively new concept in modern jet engine propulsion. The ITB serves as a secondary combustor and is located between the high- and the low-pressure turbine, i.e., the transition duct. The objective of this study is to use design parameters, such as flight Mach number, compressor pressure ratio, fan pressure ratio, fan bypass ratio, and high-pressure turbine inlet temperature to obtain engine performance parameters, such as specific thrust and thrust specific fuel consumption. Results of this study can provide guidance in identifying the performance characteristics of various engine components, which can then be used to develop, analyze, integrate, and optimize the system performance of turbofan engines with an ITB. Visual Basic program, Microsoft Excel macrocode, and Microsoft Excel neuron code are used to facilitate Microsoft Excel software to plot engine performance versus engine design parameters. This program computes and plots the data sequentially without forcing users to open other types of plotting programs. A user s manual on how to use the program is also included in this report. Furthermore, this stand-alone program is written in conjunction with an off-design program which is an extension of this study. The computed result of a selected design

  18. Aerothermodynamic cycle analysis of a dual-spool, separate-exhaust turbofan engine with an interstage turbine burner

    Science.gov (United States)

    Liew, Ka Heng

    This study focuses on a specific engine, i.e., a dual-spool, separate-flow turbofan engine with an Interstage Turbine Burner (ITB). This conventional turbofan engine has been modified to include a secondary isobaric burner, i.e., ITB, in a transition duct between the high-pressure turbine and the low-pressure turbine. The preliminary design phase for this modified engine starts with the aerothermodynamics cycle analysis is consisting of parametric (i.e., on-design) and performance ( i.e., off-design) cycle analyses. In parametric analysis, the modified engine performance parameters are evaluated and compared with baseline engine in terms of design limitation (maximum turbine inlet temperature), flight conditions (such as flight Mach condition, ambient temperature and pressure), and design choices (such as compressor pressure ratio, fan pressure ratio, fan bypass ratio etc.). A turbine cooling model is also included to account for the effect of cooling air on engine performance. The results from the on-design analysis confirmed the advantage of using ITB, i.e., higher specific thrust with small increases in thrust specific fuel consumption, less cooling air, and less NOx production, provided that the main burner exit temperature and ITB exit temperature are properly specified. It is also important to identify the critical ITB temperature, beyond which the ITB is turned off and has no advantage at all. With the encouraging results from parametric cycle analysis, a detailed performance cycle analysis of the identical engine is also conducted for steady-state engine performance prediction. The results from off-design cycle analysis show that the ITB engine at full throttle setting has enhanced performance over baseline engine. Furthermore, ITB engine operating at partial throttle settings will exhibit higher thrust at lower specific fuel consumption and improved thermal efficiency over the baseline engine. A mission analysis is also presented to predict the fuel

  19. Bypass Flow Study

    Energy Technology Data Exchange (ETDEWEB)

    Richard Schultz

    2011-09-01

    The purpose of the fluid dynamics experiments in the MIR (Matched Index of-Refraction) flow system at Idaho National Laboratory (INL) is to develop benchmark databases for the assessment of Computational Fluid Dynamics (CFD) solutions of the momentum equations, scalar mixing, and turbulence models for the flow ratios between coolant channels and bypass gaps in the interstitial regions of typical prismatic standard fuel element (SFE) or upper reflector block geometries of typical Modular High-temperature Gas-cooled Reactors (MHTGR) in the limiting case of negligible buoyancy and constant fluid properties. The experiments use Particle Image Velocimetry (PIV) to measure the velocity fields that will populate the bypass flow study database.

  20. Robotically Assisted Single Anastomosis Duodenoileal Bypass after Previous Sleeve Gastrectomy Implementing High Valuable Technology for Complex Procedures

    Directory of Open Access Journals (Sweden)

    Ramon Vilallonga

    2015-01-01

    Full Text Available Staged bariatric procedures in high risk patients are a common used strategy for morbid obese patients nowadays. After previous sleeve gastrectomy, surgical treatments in order to complete weight loss or comorbidities improvements or resolutions are possible. One strategy is to perform a novel technique named SADI (single anastomosis duodenoileal bypass-sleeve. We present the technique for totally intracorporeal robotically assisted SADI using five ports and a liver retractor. We aim to see if the robotic technology offers more advantageous anastomosis and dissection obtained by the robotic approach in comparison to standard laparoscopy. The safety, feasibility, and reproducibility of a minimally invasive robotic surgical approach to complex abdominal operations such as SADI are discussed.

  1. Coronary artery bypass graft (CABG) patency: Assessment with high-resolution submillimeter 16-slice multidetector-row computed tomography (MDCT) versus coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Anders, Katharina [Department of Radiology, Friedrich-Alexander University of Erlangen-Nuremberg (Germany)]. E-mail: katharina.anders@idr.imed.uni-erlangen.de; Baum, Ulrich [Department of Radiology, Friedrich-Alexander University of Erlangen-Nuremberg (Germany); Schmid, Michael [Department of Internal Medicine II, Friedrich-Alexander University of Erlangen-Nuremberg (Germany); Ropers, Dieter [Department of Internal Medicine II, Friedrich-Alexander University of Erlangen-Nuremberg (Germany); Schmid, Axel [Department of Radiology, Friedrich-Alexander University of Erlangen-Nuremberg (Germany); Pohle, Karsten [Department of Internal Medicine II, Friedrich-Alexander University of Erlangen-Nuremberg (Germany); Daniel, Werner G. [Department of Internal Medicine II, Friedrich-Alexander University of Erlangen-Nuremberg (Germany); Bautz, Werner [Department of Radiology, Friedrich-Alexander University of Erlangen-Nuremberg (Germany); Achenbach, Stephan [Department of Internal Medicine II, Friedrich-Alexander University of Erlangen-Nuremberg (Germany)

    2006-03-15

    Purpose: To investigate the ability of 16-slice multidetector-row computed tomography (MDCT) to visualize coronary artery bypass graft (CABG) patency and to detect bypass stenoses. Materials and methods: Thirty-two patients with 94 grafts (20 mammary artery grafts, 74 venous grafts) were investigated by 16-slice MDCT using a scan protocol with 12 x 0.75 mm slice collimation (pitch 0.3), 420 ms rotation time and simultaneous electrocardiogram (ECG)-registration. One hundred milliliters iodinated contrast agent were injected with a delay according to the individually determined contrast agent transit time. Patients with heart rates above 60 bpm received oral beta-blockade. Cross-sectional images with a slice width of 1.0 mm (0.5 mm increment) were reconstructed using an ECG-gated half-scan reconstruction or a multisegment reconstruction algorithm depending on the heart rate. Bypass grafts were evaluated concerning patency and presence of stenoses {>=}50% diameter reduction on cross-sectional images, multiplanar reformations and maximum intensity projections by two independent observers. Results were compared to coronary bypass angiography. Results: Sixteen-slice MDCT results were compared to those of invasive coronary angiography concerning absence or presence of bypass graft occlusion or relevant stenosis {>=}50% lumen reduction. Coronary CT angiography (CTA) permitted detection of bypass occlusion with 100% sensitivity (28/28) and 98% specificity (64/65). Seventy-eight percent (observer 1) and 84% (observer 2) of all patent grafts were found to be evaluable concerning presence or absence of stenosis. In 34 of 40 (observer 1) and 38 of 43 (observer 2) bypass grafts, high-grade stenoses were correctly ruled out (specificity 85% versus 88%, sensitivity 80% and 82%). Yet, if all patients with either unevaluable grafts/graft anastomosis or relevant graft stenosis were excluded, only 8/32 patients (25%) had fully diagnostic 'negative' graft-CTA. According to

  2. Hybrid Wing Body Shielding Studies Using an Ultrasonic Configurable Fan Artificial Noise Source Generating Typical Turbofan Modes

    Science.gov (United States)

    Sutliff, Daniel l.; Brown, Clifford A.; Walker, Bruce E.

    2014-01-01

    An Ultrasonic Configurable Fan Artificial Noise Source (UCFANS) was designed, built, and tested in support of the NASA Langley Research Center's 14- by 22-ft wind tunnel test of the Hybrid Wing Body (HWB) full 3-D 5.8 percent scale model. The UCFANS is a 5.8 percent rapid prototype scale model of a high-bypass turbofan engine that can generate the tonal signature of proposed engines using artificial sources (no flow). The purpose of the test was to provide an estimate of the acoustic shielding benefits possible from mounting the engine on the upper surface of an HWB aircraft using the projected signature of the engine currently proposed for the HWB. The modal structures at the rating points were generated from inlet and exhaust nacelle configurations--a flat plate model was used as the shielding surface and vertical control surfaces with correct plan form shapes were also tested to determine their additional impact on shielding. Radiated acoustic data were acquired from a traversing linear array of 13 microphones, spanning 36 in. Two planes perpendicular, and two planes parallel, to the axis of the nacelle were acquired from the array sweep. In each plane the linear array traversed four sweeps, for a total span of 168 in. acquired. The resolution of the sweep is variable, so that points closer to the model are taken at a higher resolution. Contour plots of Sound Pressure Levels, and integrated Power Levels, from nacelle alone and shielded configurations are presented in this paper; as well as the in-duct mode power levels

  3. Eulerian method for ice crystal icing in turbofan engines

    NARCIS (Netherlands)

    Norde, Ellen

    2017-01-01

    The newer generations of high-bypass-ratio engines are susceptible to the ingestion of small ice crystals which may cause engine power loss or damage. The research presented in this thesis focusses on the development of a computational method for in-engine ice crystal accretion. The work has been ca

  4. Goal-directed therapy improves the outcome of high-risk cardiac patients undergoing off-pump coronary artery bypass

    Directory of Open Access Journals (Sweden)

    Poonam Malhotra Kapoor

    2017-01-01

    Full Text Available Background: There has been a constant emphasis on developing management strategies to improve the outcome of high-risk cardiac patients undergoing surgical revascularization. The performance of coronary artery bypass surgery on an off-pump coronary artery bypass (OPCAB avoids the risks associated with extra-corporeal circulation. The preliminary results of goal-directed therapy (GDT for hemodynamic management of high-risk cardiac surgical patients are encouraging. The present study was conducted to study the outcome benefits with the combined use of GDT with OPCAB as compared to the conventional hemodynamic management. Material and Method: Patients with the European System for Cardiac Operative Risk Evaluation ≥3 scheduled for OPCAB were randomly divided into two groups; the control and GDT groups. The GDT group included the monitoring and optimization of advanced parameters, including cardiac index (CI, systemic vascular resistance index, oxygen delivery index, stroke volume variation; continuous central venous oxygen saturation (ScVO 2 , global end-diastolic volume, and extravascular lung water (EVLW, using FloTrac™ , PreSep™ , and EV-1000 ® monitoring panels, in addition to the conventional hemodynamic management in the control group. The hemodynamic parameters were continuously monitored for 48 h in Intensive Care Unit (ICU and corrected according to GDT protocol. A total of 163 patients consented for the study. Result: Seventy-five patients were assigned to the GDT group and 88 patients were in the control group. In view of 9 exclusions from the GDT group and 12 exclusions from control group, 66 patients in the GDT group and 76 patients in control group completed the study. Conclusion: The length of stay in hospital (LOS-H (7.42 ± 1.48 vs. 5.61 ± 1.11 days, P < 0.001 and ICU stay (4.2 ± 0.82 vs. 2.53 ± 0.56 days, P < 0.001 were significantly lower in the GDT group as compared to control group. The duration of inotropes (3.24 ± 0

  5. High-throughput identification and rational design of synergistic small-molecule pairs for combating and bypassing antibiotic resistance.

    Science.gov (United States)

    Wambaugh, Morgan A; Shakya, Viplendra P S; Lewis, Adam J; Mulvey, Matthew A; Brown, Jessica C S

    2017-06-01

    Antibiotic-resistant infections kill approximately 23,000 people and cost $20,000,000,000 each year in the United States alone despite the widespread use of small-molecule antimicrobial combination therapy. Antibiotic combinations typically have an additive effect: the efficacy of the combination matches the sum of the efficacies of each antibiotic when used alone. Small molecules can also act synergistically when the efficacy of the combination is greater than the additive efficacy. However, synergistic combinations are rare and have been historically difficult to identify. High-throughput identification of synergistic pairs is limited by the scale of potential combinations: a modest collection of 1,000 small molecules involves 1 million pairwise combinations. Here, we describe a high-throughput method for rapid identification of synergistic small-molecule pairs, the overlap2 method (O2M). O2M extracts patterns from chemical-genetic datasets, which are created when a collection of mutants is grown in the presence of hundreds of different small molecules, producing a precise set of phenotypes induced by each small molecule across the mutant set. The identification of mutants that show the same phenotype when treated with known synergistic molecules allows us to pinpoint additional molecule combinations that also act synergistically. As a proof of concept, we focus on combinations with the antibiotics trimethoprim and sulfamethizole, which had been standard treatment against urinary tract infections until widespread resistance decreased efficacy. Using O2M, we screened a library of 2,000 small molecules and identified several that synergize with the antibiotic trimethoprim and/or sulfamethizole. The most potent of these synergistic interactions is with the antiviral drug azidothymidine (AZT). We then demonstrate that understanding the molecular mechanism underlying small-molecule synergistic interactions allows the rational design of additional combinations that

  6. High preoperative monocyte count/high-density lipoprotein ratio is associated with postoperative atrial fibrillation and mortality in coronary artery bypass grafting.

    Science.gov (United States)

    Saskin, Hüseyin; Serhan Ozcan, Kazim; Yilmaz, Seyhan

    2017-03-01

    The monocyte to high-density lipoprotein ratio has recently emerged as an indicator of inflammation and oxidative stress. The aim of this study was to evaluate the association of the monocyte to high-density lipoprotein ratio with postoperative atrial fibrillation and mortality in coronary artery bypass grafting. Six hundred and sixty-two patients who were in sinus rhythm preoperatively and who had isolated coronary artery bypass grafting were retrospectively included in the study. Patients who had atrial fibrillation in the early postoperative period were enrolled in group 1 ( n  = 153); patients who remained in sinus rhythm in the early postoperative period were included in group 2 ( n  = 509). The clinical and demographic data of the patients, biochemical and complete blood count parameters, preoperative monocyte count/high-density lipoprotein cholesterol ratio, and operative and postoperative data were recorded. Preoperative monocyte counts ( P  = 0.0001), monocyte count/high-density lipoprotein cholesterol ratio ( P = 0.0001) and C-reactive protein levels ( P  = 0.0001) were significantly increased in group 1. In the first month, 8 patients in group 1 (5.2%) and 5 patients in group 2 (1.0%) died, which was statistically significant ( P  = 0.003). In univariate and multivariate logistic regression analyses, an elevated preoperative monocyte count/high-density lipoprotein cholesterol ratio ( P  = 0.03) and C-reactive protein levels ( P  = 0.0001) were predictors of postoperative atrial fibrillation. Preoperative monocyte counts ( P  = 0.001), monocyte count/high-density lipoprotein cholesterol ratio ( P  = 0.0001) and the use of inotropic support ( P  = 0.0001) were also predictors of mortality in the early postoperative period. We have observed that high preoperative monocyte count/ high-density lipoprotein ratio was associated with postoperative atrial fibrillation and mortality after coronary artery bypass grafting

  7. Ice crystal ingestion by turbofans

    Science.gov (United States)

    Rios Pabon, Manuel A.

    This Thesis will present the problem of inflight icing in general and inflight icing caused by the ingestion of high altitude ice crystals produced by high energy mesoscale convective complexes in particular, and propose a new device to prevent it based on dielectric barrier discharge plasma. Inflight icing is known to be the cause of 583 air accidents and more than 800 deaths in more than a decade. The new ice crystal ingestion problem has caused more than 100 flights to lose engine power since the 1990's, and the NTSB identified it as one of the causes of the Air France flight 447 accident in 1-Jun2008. The mechanics of inflight icing not caused by ice crystals are well established. Aircraft surfaces exposed to supercooled liquid water droplets will accrete ice in direct proportion of the droplet catch and the freezing heat transfer process. The multiphase flow droplet catch is predicted by the simple sum of forces on each spherical droplet and a droplet trajectory calculation based on Lagrangian or Eulerian analysis. The most widely used freezing heat transfer model for inflight icing caused by supercooled droplets was established by Messinger. Several computer programs implement these analytical models to predict inflight icing, with LEWICE being based on Lagrangian analysis and FENSAP being based on Eulerian analysis as the best representatives among them. This Thesis presents the multiphase fluid mechanics particular to ice crystals, and explains how it differs from the established droplet multiphase flow, and the obstacles in implementing the former in computational analysis. A new modification of the Messinger thermal model is proposed to account for ice accretion produced by ice crystal impingement. Because there exist no computational and experimental ways to fully replicate ice crystal inflight icing, and because existing ice protections systems consume vast amounts of energy, a new ice protection device based on dielectric barrier discharge plasma is

  8. High-flow bypass and wrap-clipping for ruptured blood blister-like aneurysm of the internal carotid artery using intraoperative monitoring of cerebral hemodynamics

    Directory of Open Access Journals (Sweden)

    Kubo Y

    2015-06-01

    Full Text Available Yoshitaka Kubo, Takahiro Koji, Kenji Yoshida, Hideo Saito, Akira Ogawa, Kuniaki Ogasawara Department of Neurosurgery, Iwate Medical University, Morioka, Japan Abstract: Aneurysms at non-branching sites in the supraclinoid internal carotid artery (ICA can be classified as “blood blister-like aneurysms” (BBAs, which have blood blister-like configurations and fragile walls. While surgical treatment for the BBA in the acute stage is recommended, the optimal surgical procedure remains controversial. In the study reported here, we describe the case of a 37-year-old woman with a ruptured BBA in the ophthalmic segment of the right ICA who underwent wrap-clipping with external carotid artery–internal carotid artery bypass by intraoperative estimation of the measurement of cortical cerebral blood flow (CoBF using a thermal diffusion flow probe. Trapping of the ICA in the acute stage of subarachnoid hemorrhage may result in ischemic complications secondary to hemodynamic hypoperfusion or occlusion of the perforating artery, and/or delayed vasospasm, even with concomitant bypass surgery. We believe that it is important to perform scheduled external carotid artery–internal carotid artery bypass before trapping of the ICA in patients with a ruptured BBA in the acute stage of subarachnoid hemorrhage and to perform wrap-clipping rather than trapping. This would provide much more CoBF if a reduction of CoBF occurs after trapping occlusion of the ICA including a ruptured BBA according to intraoperative CoBF monitoring. As far as we are aware, the case reported here is the first report on high-flow bypass and wrap-clipping for a ruptured BBA of the ICA using intraoperative monitoring of cerebral hemodynamics. Keywords: surgery, cortical blood flow, external carotid artery–internal carotid artery bypass, subarachnoid hemorrhage

  9. High allelic burden of four obesity SNPs is associated with poorer weight loss outcomes following gastric bypass surgery.

    Science.gov (United States)

    Still, Christopher D; Wood, G Craig; Chu, Xin; Erdman, Robert; Manney, Christina H; Benotti, Peter N; Petrick, Anthony T; Strodel, William E; Mirshahi, Uyenlinh L; Mirshahi, Tooraj; Carey, David J; Gerhard, Glenn S

    2011-08-01

    Genome-wide association and linkage studies have identified multiple susceptibility loci for obesity. We hypothesized that such loci may affect weight loss outcomes following dietary or surgical weight loss interventions. A total of 1,001 white individuals with extreme obesity (BMI >35 kg/m(2)) who underwent a preoperative diet/behavioral weight loss intervention and Roux-en-Y gastric bypass surgery were genotyped for single-nucleotide polymorphisms (SNPs) in or near the fat mass and obesity-associated (FTO), insulin induced gene 2 (INSIG2), melanocortin 4 receptor (MC4R), and proprotein convertase subtilisin/kexin type 1 (PCSK1) obesity genes. Association analysis was performed using recessive and additive models with pre- and postoperative weight loss data. An increasing number of obesity SNP alleles or homozygous SNP genotypes was associated with increased BMI (P weight (P weight lost from a short-term dietary intervention and any individual obesity SNP or cumulative number of obesity SNP alleles or homozygous SNP genotypes was observed. Linear mixed regression analysis revealed significant differences in postoperative weight loss trajectories across groups with low, intermediate, and high numbers of obesity SNP alleles or numbers of homozygous SNP genotypes (P weight loss with initial BMI metabolic rate, binge eating behavior, and other clinical parameters were not associated with genotype. These data suggest that response to a surgical weight loss intervention is influenced by genetic susceptibility and BMI.

  10. Indications and Outcomes of Prophylactic and Therapeutic Extracranial-to-intracranial Arterial Bypass for Cerebral Revascularization

    Directory of Open Access Journals (Sweden)

    Emre Gazyakan, MD, MSc

    2015-04-01

    Conclusions: The collaboration of neurosurgeons and plastic surgeons in performing EC-IC bypass can result in excellent outcomes with a high bypass patency rate and few complications, particularly for prophylactic EC-IC bypass.

  11. Health-related quality of life following off-pump versus on-pump coronary artery bypass grafting in elderly moderate to high-risk patients

    DEFF Research Database (Denmark)

    Jensen, Birte Østergaard; Hughes, Pia; Rasmussen, Lars S;

    2006-01-01

    Previous trials comparing coronary artery bypass grafting (CABG) with or without extracorporeal circulation have mainly enrolled selected patients at younger age and low risk. Patient-reported health-related quality of life has not been significantly different. We compared health-related quality...... of life in elderly moderate to high-risk patients randomized to either off-pump or on-pump surgery....

  12. Kalman Filter Constraint Tuning for Turbofan Engine Health Estimation

    Science.gov (United States)

    Simon, Dan; Simon, Donald L.

    2005-01-01

    Kalman filters are often used to estimate the state variables of a dynamic system. However, in the application of Kalman filters some known signal information is often either ignored or dealt with heuristically. For instance, state variable constraints are often neglected because they do not fit easily into the structure of the Kalman filter. Recently published work has shown a new method for incorporating state variable inequality constraints in the Kalman filter, which has been shown to generally improve the filter s estimation accuracy. However, the incorporation of inequality constraints poses some risk to the estimation accuracy as the Kalman filter is theoretically optimal. This paper proposes a way to tune the filter constraints so that the state estimates follow the unconstrained (theoretically optimal) filter when the confidence in the unconstrained filter is high. When confidence in the unconstrained filter is not so high, then we use our heuristic knowledge to constrain the state estimates. The confidence measure is based on the agreement of measurement residuals with their theoretical values. The algorithm is demonstrated on a linearized simulation of a turbofan engine to estimate engine health.

  13. Minimally invasive coronary artery bypass grafting versus percutaneous transluminal coronary angioplasty with stenting in isolated high-grade stenosis of the proximal left anterior descending coronary artery : Six months' angiographic and clinical follow-up of a prospective randomized study

    NARCIS (Netherlands)

    Drenth, DJ; Winter, JB; Veeger, NJGM; Monnink, SHJ; van Boven, AJ; Grandjean, JG; Mariani, MA; Boonstra, PW

    Objective: We sought to compare minimally invasive coronary artery bypass grafting (surgical intervention) with percutaneous transluminal coronary angioplasty with primary stenting (stenting) in patients having an isolated high-grade stenosis (American College of Cardiology/American Heart

  14. Coronary Artery Bypass

    Science.gov (United States)

    ... to 3 days in the Intensive Care Unit (ICU). Life After Bypass After bypass surgery, your doctor will recommend that you join a cardiac rehabilitation program. These programs help you make lifestyle changes ...

  15. Gastric bypass surgery

    Science.gov (United States)

    ... Roux-en-Y; Weight-loss surgery - gastric bypass; Obesity surgery - gastric bypass ... bypass surgery is not a quick fix for obesity. It will greatly change your lifestyle. After this surgery, you must eat healthy foods, control portion sizes of ...

  16. Digital integrated control of a Mach 2.5 mixed-compression supersonic inlet and an augmented mixed-flow turbofan engine

    Science.gov (United States)

    Batterton, P. G.; Arpasi, D. J.; Baumbick, R. J.

    1974-01-01

    A digitally implemented integrated inlet-engine control system was designed and tested on a mixed-compression, axisymmetric, Mach 2.5, supersonic inlet with 45 percent internal supersonic area contraction and a TF30-P-3 augmented turbofan engine. The control matched engine airflow to available inlet airflow. By monitoring inlet terminal shock position and over-board bypass door command, the control adjusted engine speed so that in steady state, the shock would be at the desired location and the overboard bypass doors would be closed. During engine-induced transients, such as augmentor light-off and cutoff, the inlet operating point was momentarily changed to a more supercritical point to minimize unstarts. The digital control also provided automatic inlet restart. A variable inlet throat bleed control, based on throat Mach number, provided additional inlet stability margin.

  17. On-pump beating heart coronary surgery for high risk patients requiring emergency multiple coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    von Segesser Ludwig K

    2008-07-01

    Full Text Available Abstract Background Cardiopulmonary bypass (CPB with aortic cross-clamping and cardioplegic arrest remains the method of choice for patients requiring standard myocardial revascularization. Therefore, very high-risk patients presenting with acute coronary syndrome, unstable angina, onset of cardiac decompensation and requiring emergency multiple myocardial revascularization, can have a poor outcome. The on-pump beating heart technique can reduce the mortality and the morbidity in such a selected group of patients and this report describes our clinical experience. Methods Out of 290 patients operated for CABG from January 2005 to January 2006, 25 (8.6% selected high-risk patients suffering from life threatening coronary syndrome (mean age 69 ± 7 years and requiring emergency multiple myocardial revascularization, underwent on-pump beating heart surgery. The mean pre-operative left ventricle ejection fraction (LVEF was 27 ± 8%. The majority of them (88% suffered of tri-vessel coronary disease and 6 (24% had a left main stump disease. Nine patients (35% were on severe cardiac failure and seven among them (28% received a pre-operative intra-aortic balloon pump. The pre-operative EuroScore rate was equal or above 8 in 18 patients (73%. Results All patients underwent on-pump-beating heart coronary revascularization. The mean number of graft/patient was 2.9 ± 0.6 and the internal mammary artery was used in 23 patients (92%. The mean CPB time was 84 ± 19 minutes. Two patients died during the recovery stay in the intensive care unit, and there were no postoperative myocardial infarctions between the survivors. Eight patients suffered of transitorily renal failure and 1 patient developed a sternal wound infection. The mean hospital stay was 12 ± 7 days. The follow-up was complete for all 23 patients survived at surgery and the mean follow-up time was 14 ± 5 months. One patient died during the follow-up for cardiac arrest and 2 patients required an

  18. On-pump beating heart coronary surgery for high risk patients requiring emergency multiple coronary artery bypass grafting.

    Science.gov (United States)

    Ferrari, Enrico; Stalder, Nicolas; von Segesser, Ludwig K

    2008-07-02

    Cardiopulmonary bypass (CPB) with aortic cross-clamping and cardioplegic arrest remains the method of choice for patients requiring standard myocardial revascularization. Therefore, very high-risk patients presenting with acute coronary syndrome, unstable angina, onset of cardiac decompensation and requiring emergency multiple myocardial revascularization, can have a poor outcome. The on-pump beating heart technique can reduce the mortality and the morbidity in such a selected group of patients and this report describes our clinical experience. Out of 290 patients operated for CABG from January 2005 to January 2006, 25 (8.6%) selected high-risk patients suffering from life threatening coronary syndrome (mean age 69 +/- 7 years) and requiring emergency multiple myocardial revascularization, underwent on-pump beating heart surgery. The mean pre-operative left ventricle ejection fraction (LVEF) was 27 +/- 8%. The majority of them (88%) suffered of tri-vessel coronary disease and 6 (24%) had a left main stump disease. Nine patients (35%) were on severe cardiac failure and seven among them (28%) received a pre-operative intra-aortic balloon pump. The pre-operative EuroScore rate was equal or above 8 in 18 patients (73%). All patients underwent on-pump-beating heart coronary revascularization. The mean number of graft/patient was 2.9 +/- 0.6 and the internal mammary artery was used in 23 patients (92%). The mean CPB time was 84 +/- 19 minutes. Two patients died during the recovery stay in the intensive care unit, and there were no postoperative myocardial infarctions between the survivors. Eight patients suffered of transitorily renal failure and 1 patient developed a sternal wound infection. The mean hospital stay was 12 +/- 7 days. The follow-up was complete for all 23 patients survived at surgery and the mean follow-up time was 14 +/- 5 months. One patient died during the follow-up for cardiac arrest and 2 patients required an implantable cardiac defibrillator. One

  19. Status report - DARPA/NASA convertible turbofan/turboshaft engine program

    Science.gov (United States)

    Bellin, A. I.; Brooks, A.

    1983-01-01

    A development status report is presented for the NASA/Defense Advanced Research Projects Agency convertible turbofan-turboshaft engine, which can power a high speed rotorcraft in vertical flight, as well as in horizontal flight up to speeds of Mach 0.85. The basis for this development program is a modified TF34-GE-400 engine. Program objectives include both the demonstration of dual output mode (jet thrust and shaft horsepower) capability and the development of a control system which will operate the engine in either mode and convert operation between the modes.

  20. 78 FR 47235 - Airworthiness Directives; General Electric Company Turbofan Engines

    Science.gov (United States)

    2013-08-05

    ... Electric Company (GE) model GEnx-2B67 and GEnx-2B67B turbofan engines. This proposed AD was prompted by the... in Boeing 747-8 flight tests had consumed more cyclic life than they would have in revenue flight cycles. These parts were then installed into engines and introduced into revenue service...

  1. 77 FR 67763 - Airworthiness Directives; Pratt & Whitney Division Turbofan Engines

    Science.gov (United States)

    2012-11-14

    ... by 16 reports of damaged or failed 3rd stage low-pressure turbine (LPT) duct segments. This AD..., or on the distribution of power and responsibilities among the various levels of government. For the... PW4650 turbofan engines, including models with any dash number suffix, with 3rd stage...

  2. 78 FR 21578 - Airworthiness Directives; General Electric Company Turbofan Engines

    Science.gov (United States)

    2013-04-11

    ... Company (GE) model GEnx-2B67 and GEnx-2B67B turbofan engines with booster anti-ice (BAI) air duct, part... reports of cracks in the BAI air duct. This proposed AD would require initial and repetitive visual inspections of the BAI air duct, removal from service of the BAI air duct if it fails inspection and, as...

  3. Dynamic Analysis for a Geared Turbofan Engine with Variable Area Fan Nozzle

    Science.gov (United States)

    Csank, Jeffrey T.; Thomas, George L.

    2017-01-01

    Aggressive design goals have been set for future aero-propulsion systems with regards to fuel economy, noise, and emissions. To meet these challenging goals, advanced propulsion concepts are being explored and current operating margins are being re-evaluated to find additional concessions that can be made. One advanced propulsion concept being evaluated is a geared turbofan with a variable area fan nozzle (VAFN), developed by NASA. This engine features a small core, a fan driven by the low pressure turbine through a reduction gearbox, and a shape memory alloy (SMA)-actuated VAFN. The VAFN is designed to allow both a small exit area for efficient operation at cruise, while being able to open wider at high power conditions to reduce backpressure on the fan and ensure a safe level of stall margin is maintained. The VAFN is actuated via a SMA-based system instead of a conventional system to decrease overall weight of the system, however, SMA-based actuators respond relatively slowly, which introduces dynamic issues that are investigated in this work. This paper describes both a control system designed specifically for issues associated with SMAs, and dynamic analysis of the geared turbofan VAFN with the SMA actuators. Also, some future recommendations are provided for this type of propulsion system.

  4. Flood Bypass Capacity Optimization

    Science.gov (United States)

    Siclari, A.; Hui, R.; Lund, J. R.

    2015-12-01

    Large river flows can damage adjacent flood-prone areas, by exceeding river channel and levee capacities. Particularly large floods are difficult to contain in leveed river banks alone. Flood bypasses often can efficiently reduce flood risks, where excess river flow is diverted over a weir to bypasses, that incur much less damage and cost. Additional benefits of bypasses include ecosystem protection, agriculture, groundwater recharge and recreation. Constructing or expanding an existing bypass costs in land purchase easements, and levee setbacks. Accounting for such benefits and costs, this study develops a simple mathematical model for optimizing flood bypass capacity using benefit-cost and risk analysis. Application to the Yolo Bypass, an existing bypass along the Sacramento River in California, estimates optimal capacity that economically reduces flood damage and increases various benefits, especially for agriculture. Land availability is likely to limit bypass expansion. Compensation for landowners could relax such limitations. Other economic values could affect the optimal results, which are shown by sensitivity analysis on major parameters. By including land geography into the model, location of promising capacity expansions can be identified.

  5. Cryogenic Testing of High Current By-pass Diode Stacks for the Protection of the Superconducting Magnets in the LHC

    CERN Document Server

    Brown, D; Fiamozzi-Zignani, C; Gharib, A; Hagedorn, Dietrich; Rout, C; Turtu, S

    2004-01-01

    For the protection of the LHC superconducting magnets, about 2100 specially developed by-pass diodes were manufactured by DYNEX SEMICONDUCTOR LTD (Lincoln, GB) and about 1300 of these diodes were mounted into diode stacks and submitted to tests at cryogenic temperatures. To date about 800 dipole diode stacks and about 250 quadrupole diode stacks for the protection of the superconducting lattice dipole and lattice quadrupole magnets have been assembled at OCEM (Bologna,Italy) and successfully tested in liquid helium at ENEA (Frascati, Italy). This report gives an overview of the test results obtained so far. After a short description of the test installations and test procedures, a statistical analysis is presented for test data during diode production as well as for the performance of the diode stacks during testing in liquid helium, including failure rates and degradation of the diodes.

  6. Changing trends in emergency coronary bypass surgery.

    Science.gov (United States)

    Maganti, Manjula; Brister, Stephanie J; Yau, Terrence M; Collins, Susan; Badiwala, Mitesh; Rao, Vivek

    2011-10-01

    Patients undergoing emergency coronary artery bypass grafting represent a unique and high-risk population that remains challenging for cardiac surgeons. We examined the changing trends in patients undergoing emergency bypass grafting over the past 20 years. We conducted a retrospective review of our database between 1990 and 2009 and patients were divided into 2 groups based on year of operation: 1990-1999, n = 393; 2000-2009, n = 184. The primary outcomes of interest for this study are operative mortality and incidence of low cardiac output syndrome. The percentage of patients undergoing emergency coronary bypass grafting has decreased from 2.7% to 1.7% over time. The percentage of patients with dyslipidemia, hypertension, triple vessel disease, peripheral vascular disease, and left main disease increased over time (P emergency bypass grafting. The independent predictors of low cardiac output syndrome were small body surface area, congestive heart failure, shock, myocardial infarction, earlier decade (1990-1999) and increased age. Despite a changing preoperative risk profile, the operative mortality of emergency coronary artery bypass grafting has remained stable over the years. However, mortality remains significantly above the observed mortality in elective bypass grafting. Continued improvements in the management of heart failure and the care of the elderly will likely result in reduced risks of emergency coronary artery bypass grafting. Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  7. Software Development for EECU Platform of Turbofan Engine

    Science.gov (United States)

    Kim, Bo Gyoung; Kwak, Dohyup; Kim, Byunghyun; Choi, Hee ju; Kong, Changduk

    2017-04-01

    The turbofan engine operation consists of a number of hardware and software. The engine is controlled by Electronic Engine Control Unit (EECU). In order to control the engine, EECU communicates with an aircraft system, Actuator Drive Unit (ADU), Engine Power Unit (EPU) and sensors on the engine. This paper tried to investigate the process form starting to taking-off and aims to design the EECU software mode and defined communication data format. The software is implemented according to the designed software mode.

  8. 78 FR 50320 - Airworthiness Directives; General Electric Company Turbofan Engines

    Science.gov (United States)

    2013-08-19

    ...-2B67B turbofan engines with booster anti-ice (BAI) air duct, part number (P/N) 2469M32G01, and support bracket, P/N 2469M46G01, installed. This AD was prompted by reports of cracks in the BAI air duct. This AD requires initial and repetitive visual inspections of the BAI air duct, removal from service of the BAI...

  9. System Noise Prediction of the DGEN 380 Turbofan Engine

    Science.gov (United States)

    Berton, Jeffrey J.

    2015-01-01

    The DGEN 380 is a small, separate-flow, geared turbofan. Its manufacturer, Price Induction, is promoting it for a small twinjet application in the emerging personal light jet market. Smaller, and producing less thrust than other entries in the industry, Price Induction is seeking to apply the engine to a 4- to 5-place twinjet designed to compete in an area currently dominated by propeller-driven airplanes. NASA is considering purchasing a DGEN 380 turbofan to test new propulsion noise reduction technologies in a relevant engine environment. To explore this possibility, NASA and Price Induction have signed a Space Act Agreement and have agreed to cooperate on engine acoustic testing. Static acoustic measurements of the engine were made by NASA researchers during July, 2014 at the Glenn Research Center. In the event that a DGEN turbofan becomes a NASA noise technology research testbed, it is in the interest of NASA to develop procedures to evaluate engine system noise metrics. This report documents the procedures used to project the DGEN static noise measurements to flight conditions and the prediction of system noise of a notional airplane powered by twin DGEN engines.

  10. 78 FR 5712 - Airworthiness Directives; CFM International, S.A. Turbofan Engines Modified by Supplemental Type...

    Science.gov (United States)

    2013-01-28

    ..., S.A. Turbofan Engines Modified by Supplemental Type Certificate SE00034EN AGENCY: Federal Aviation... directive (AD) for CFM International, S.A. CFM56-3, CFM56-3B, and CFM56-3C turbofan engines. This AD... of multiple turbine blades, damage to the engine, and damage to the airplane. DATES: This AD...

  11. 78 FR 6749 - Airworthiness Directives; Rolls-Royce plc Turbofan Engines

    Science.gov (United States)

    2013-01-31

    ... Directives; Rolls-Royce plc Turbofan Engines AGENCY: Federal Aviation Administration (FAA), DOT. ACTION... all Rolls-Royce plc (RR) models RB211 Trent 768-60, 772-60, and 772B-60 turbofan engines. This.... For service information identified in this proposed AD, contact Rolls-Royce plc, P.O. Box 31,...

  12. 77 FR 67582 - Airworthiness Directives; Rolls-Royce Deutschland Ltd & Co KG Turbofan Engines

    Science.gov (United States)

    2012-11-13

    ... directive (AD) for certain Rolls-Royce Deutschland Ltd & Co KG (RRD) Tay 611-8 turbofan engines. This... issued Alert Service Bulletin TAY-72-A1696, Revision 1, dated June 11, 2012. The actions described in... Ltd & Co KG (RRD) Tay 611-8 turbofan engines, serial numbers 16245, 16256, 16417, 16418, 16584, 16585...

  13. 78 FR 59291 - Airworthiness Directives; Rolls-Royce Deutschland Ltd & Co. KG Turbofan Engines

    Science.gov (United States)

    2013-09-26

    ... Rolls-Royce Deutschland Ltd & Co. KG (RRD) Tay 620-15, 650-15, and 651- 54 turbofan engines. This... history of Tay series engines discovered that low pressure compressor (LPC) fan blade leading edge could... Rolls-Royce Deutschland Ltd & Co. KG (RRD) Tay 620-15, 650-15, and 651-54 turbofan engines. (d) Reason...

  14. 77 FR 16917 - Airworthiness Directives; Rolls-Royce Deutschland Ltd & Co KG Turbofan Engines

    Science.gov (United States)

    2012-03-23

    ... ] Rolls-Royce Deutschland (RRD) Models Tay 611-8 and Tay 611-8C turbofan engines. This AD requires... Bulletin No. TAY-72-A1769, dated March 9, 2012. The actions described in this service information are...-Royce Deutschland Ltd & Co KG (RRD) turbofan engines: (1) TAY 611-8 engines, serial numbers (S/Ns) 16870...

  15. 75 FR 77570 - Airworthiness Directives; General Electric Company CF6 Series Turbofan Engines

    Science.gov (United States)

    2010-12-13

    ... engine mount assembly (also known ] as Configuration 2). These engines are installed on, but not limited... Company CF6 Series Turbofan Engines AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of...) for General Electric (GE) CF6-45/-50 series and CF6-80A series turbofan engines with certain...

  16. Direct, High-flow Bypass for a Pediatric Giant, Fusiform Aneurysm of the Inferior Division of M2: Case Report and Review of Literature.

    Science.gov (United States)

    Alamanda, Vignesh K; Tomycz, Luke; Velez, Dennis; Singer, Robert J

    2012-01-01

    In this case report, we describe the first reported case of treating a 7-year-old male patient who has a giant, fusiform aneurysm confined to the inferior M2 segment by means of a saphenous vein graft. Given the lack of good endovascular management options for this particular scenario, craniotomy was recommended and an end-to-side ECA-ICA anastomosis was carried out with technical details of the surgery outlined in the manuscript. The patient did not sustain any major postoperative complications. The graft remained patent upon completion of the surgery and at the time of last follow-up, 9 months post-surgery. This case serves as an illustrative example of the need for high-flow bypass for a select few patients even as endovascular technology continues to improve.

  17. Bypassing damaged nervous tissue

    CERN Document Server

    Shneider, M N

    2016-01-01

    We show the principal ability of bypassing damaged demyelinated portions of nervous tissue, thereby restoring its normal function for the passage of action potentials. We carry out a theoretical analysis on the basis of the synchronization mechanism of action potential propagation along a bundle of neurons, proposed recently in [1]. And we discuss the feasibility of implement a bypass to restore damaged nervous tissue and creating an artificial neuron network.

  18. High volume practice proved the safety of off-pump coronary artery bypass surgery in left main coronary artery lesions:a two-year single center experience

    Institute of Scientific and Technical Information of China (English)

    LIU Tong; LU Chun-shan; LU Jia-kai; GAN Hui-li; ZHANG Jian-qun; HUANG Fang-jong; GU Cheng-xiong; KONG Qing-yu; CAO Xiang-rong; BO Ping

    2012-01-01

    Background Left main coronary artery (LMCA) stenosis has been recognized as a risk factor for early death among patients undergoing coronary artery bypass grafting (CABG).This study aimed to assess if LMCA lesions pose an additional risk of early or mid-term mortality and/or a major adverse cardiac and cerebrovascular event (MACCE) after off-pump coronary artery bypass grafting (OPCABG),compared with non-left main coronary artery stenosis (non-mainstem disease).Methods From January 1,2009 to December 31,2010,4869 patients had a primary isolated OPCABG procedure at Beijing Anzhen Hospital.According to the pathology of LMCA lesions,they were retrospectively classified as a non-mainstem disease group (n=3933) or a LMCA group (n=936).Propensity scores were used to match the two groups,patients from the non-mainstem disease group (n=831) were also randomly selected to match patients from the LMCA group (n=831).Freedom from MACCE in the two groups was calculated using the Kaplan-Meier method.Results The difference in the mortality and the rate of MACCE during the first 30 days between the non-mainstem disease group and the LMCA group did not reach statistical significance (P=0.429,P=0.127 respectively).With a mean follow-up of (12.8±7.5) months and a cumulative follow-up of 1769.6 patient-years,the difference in the freedom from MACCEs between the two groups,calculated through Kaplan-Meier method,did not reach statistical significance (P=0.831).Conclusion Analysis of a high volume of OPCABG procedures proved that LMCA lesions do not pose additional early and mid-term risk to OPCABG.Therefore,a LMCA lesion is as safe as non-mainstem disease lesion during the OPCABG procedure.

  19. Efficacy of chronic statin therapy on major cardiac events after coronary artery bypass grafting: low-dose versus high-dose

    Directory of Open Access Journals (Sweden)

    Ayşegül Kunt

    2015-08-01

    Full Text Available Aim To investigate whether chronic statin treatment after coronary artery bypass grafting (CABG protects patients from major cardiac events and provides percutaneous coronary intervention (PCI free survival. Methods A total of 232 patients with previous CABG and chronic statin therapy were selected retrospectively and were divided into two groups according to a dosage of atorvastatin per day, e. g., 20 mg or 40 mg. Groups were compared for the major cardiac events and freedom from PCI by Kaplan Meier analysis as the primary end point. Patency of grafts including left internal thoracic artery (LITA and saphenous vein (SVG and progression of non-grafted native vessel disease were also evaluated as secondary end points. Results Cardiac mortality, periprocedural myocardial infarction (MI, target vessel revascularization and percutaneous coronary intervention free survival were as follows: 2.9% versus 2.1% (p=1.000; 16.1% versus 21.1% (p=0.331; 56.93% versus 52.63% (p>0.005; 58.4% versus 63.2% (log-rank test; p= 0.347 in atorvastatin 20 mg and atorvastatin 40 mg groups, respectively. However, these results were not statistically significant between two groups (p>0.005. Patency of openness of grafts including LITA and SVG and progression of non-grafted native vessel disease were similar between groups (p=0.112, p=0.779, p=0.379 and p=0.663, respectively. Conclusion Low-dose long-term statin treatment had similar outcomes on major cardiac events and identical rate of freedom from percutaneous coronary intervention after coronary artery bypass grafting compared with high-dose long-term statin treatment. It is better to start from low dose statin treatment after surgical interventions.

  20. Theoretical aspects of an electrostatic aerosol filter for civilian turbofan engines

    Directory of Open Access Journals (Sweden)

    Valeriu DRAGAN

    2012-03-01

    Full Text Available The paper addresses the problem of aerosol filtration in turbofan engines. The current problem of very fine aerosol admission is the impossibility for mechanical filtration; another aspect of the problem is the high mass flow of air to be filtered. Non-attended, the aerosol admission can -and usually does- lead to clogging of turbine cooling passages and can damage the engine completely. The approach is theoretical and relies on the principles of electrostatic dust collectors known in other industries. An estimative equation is deduced in order to quantify the electrical charge required to obtain the desired filtration. Although the device still needs more theoretical and experimental work, it could one day be used as a means of increasing the safety of airplanes passing trough an aerosol laden mass of air.

  1. Performance (Off-Design) Cycle Analysis for a Turbofan Engine With Interstage Turbine Burner

    Science.gov (United States)

    Liew, K. H.; Urip, E.; Yang, S. L.; Mattingly, J. D.; Marek, C. J.

    2005-01-01

    This report presents the performance of a steady-state, dual-spool, separate-exhaust turbofan engine, with an interstage turbine burner (ITB) serving as a secondary combustor. The ITB, which is located in the transition duct between the high- and the low-pressure turbines, is a relatively new concept for increasing specific thrust and lowering pollutant emissions in modern jet-engine propulsion. A detailed off-design performance analysis of ITB engines is written in Microsoft(Registered Trademark) Excel (Redmond, Washington) macrocode with Visual Basic Application to calculate engine performances over the entire operating envelope. Several design-point engine cases are pre-selected using a parametric cycle-analysis code developed previously in Microsoft(Registered Trademark) Excel, for off-design analysis. The off-design code calculates engine performances (i.e. thrust and thrust-specific-fuel-consumption) at various flight conditions and throttle settings.

  2. Your diet after gastric bypass surgery

    Science.gov (United States)

    Gastric bypass surgery - your diet; Obesity - diet after bypass; Weight loss - diet after bypass ... You had gastric bypass surgery. This surgery made your stomach smaller by closing off most of your stomach with staples. It changed the way your ...

  3. Off-pump coronary artery bypass grafting versus optimal medical therapy alone:effectiveness of incomplete revascularization in high risk patients

    Institute of Scientific and Technical Information of China (English)

    Filippo Prestipino; Cristiano Spadaccio; Antonio Nenna; Fraser WH Sutherland; Gwyn W Beattie; Mario Lusini; Francesco Nappi; Massimo Chello

    2016-01-01

    BackgroundGeriatric patients with multivessel coronary artery disease (CAD) are a challenging group to treat; these cases elicit dis-cussion within heart teams regarding the actual benefit of undertaking major surgery on these patients and often lead to abandon the surgical option. Percutaneous procedures represent an important option, but coronary anatomy may be unfavorable. Off-pump coronary artery bypass (OPCAB) provides good quality graft on left anterior descending (LAD) without exposing the patient to cardiopulmonary bypass, and might be the ideal choice in patients with multiple comorbidities, not eligible to percutaneous or on-pump procedures. The objective of this study was to compare survival during a mid-term follow-up in high-risk patients with no percutaneous alternative, either treated with OPCAB or discharged in medical therapy.MethodsWe retrospectively evaluated from June 2008 to June 2013, 83 high-risk patients with multivessel CAD were included: 42 were treated with incomplete off-pump revascularization using left internal mammary artery (LIMA) on LAD; 41 were discharged in optimal medical therapy (OMT), having refused surgery. Follow-up ended in March 2015, with a telephonic interview. Primary endpoint was survival from all-cause mortality; secondary endpoints were survival from cardiac-related mortality and freedom from non-fatal major adverse cardiac events (MACEs).ResultsDuring follow up, 11 deaths in OPCAB group and 27 deaths in OMT group occurred. Death was due to cardiac factors in 6 and 15 patients, respectively. MACEs were observed in 6 patients in OPCAB group and in 4 patients in OMT group. With regards to survival from all-cause mortality, patients who underwent OPCAB survived more than those dis-charged in OMT (Log Rank < 0.001), and OMT group carries a propensity score-adjusted hazard ratio of 3.862 (P < 0.001). With regards to survival from cardiac-related events, patients who underwent OPCAB survived more than those discharged in

  4. Part II-mechanism of adaptation: A549 cells adapt to high concentration of nitric oxide through bypass of cell cycle checkpoints.

    Science.gov (United States)

    Aqil, Madeeha; Deliu, Zane; Elseth, Kim M; Shen, Grace; Xue, Jiaping; Radosevich, James A

    2014-03-01

    Previous work has shown enhanced survival capacity in high nitric oxide (HNO)-adapted tumor cells. In Part I of this series of manuscripts, we have shown that A549-HNO cells demonstrate an improved growth profile under UV and X-ray radiation treatment. These cells exhibit increased expression of proteins involved in DNA damage recognition and repair pathway, both the non-homologous end joining pathway and homologous recombination. These include Ku80, DNA-PK, XLF ligase and MRN complex proteins. Further, the A549-HNO cells show high levels of ATM, ATR, Chk1 and Chk2, and phospho-p53. Activation of these molecules may lead to cell cycle arrest and apoptosis due to DNA damage. This is observed in parent A549 cells in response to NO donor treatment; however, the A549-HNO cells proliferate and inhibit apoptosis. Cell cycle analysis showed slowed progression through S phase which will allow time for DNA repair. Thus, to better understand the increased growth rate in A549-HNO when compared to the parent cell line A549, we studied molecular mechanisms involved in cell cycle regulation in A549-HNO cells. During the initial time period of NO donor treatment, we observe high levels of cyclin/Cdk complexes involved in regulating various stages of the cell cycle. This would lead to bypass of G1-S and G2-M checkpoints. The HNO cells also show much higher expression of Cdc25A. Cdc25A activates Cdk molecules involved in different phases of the cell cycle. In addition, there is enhanced phosphorylation of the Rb protein in HNO cells. This leads to inactivation of Rb/E2F checkpoint regulating G1-S transition. This may lead to faster progression in S phase. Thus, all of these perturbations in HNO cells lead to accelerated cell cycle progression and a higher growth rate. We also assessed expression of cell cycle inhibitors in HNO cells. Interestingly, the HNO cells show a significant decline in p21CIP1 at initial time points, but with prolonged exposure, the levels were much higher

  5. Longitudinal assessment of food intake, fecal energy loss, and energy expenditure after Roux-en-Y gastric bypass surgery in high-fat-fed obese rats.

    Science.gov (United States)

    Shin, Andrew C; Zheng, Huiyuan; Townsend, R Leigh; Patterson, Laurel M; Holmes, Gregory M; Berthoud, Hans-Rudolf

    2013-04-01

    The efficacy of Roux-en-Y gastric bypass (RYGB) surgery to produce weight loss has been well-documented, but few studies have measured the key components of energy balance, food intake, and energy expenditure longitudinally. Male Sprague-Dawley rats on a high-fat diet underwent either RYGB, sham operation, or pair feeding and were compared to chow-fed lean controls. Body weight and composition, food intake and preference, energy expenditure, fecal output, and gastric emptying were monitored before and up to 4 months after intervention. Despite the recovery of initially decreased food intake to levels slightly higher than before surgery and comparable to sham-operated rats after about 1 month, RYGB rats maintained a lower level of body weight and fat mass for 4 months that was not different from chow-fed age-matched controls. Energy expenditure corrected for lean body mass at 1 and 4 months after RYGB was not different from presurgical levels and from all other groups. Fecal energy loss was significantly increased at 6 and 16 weeks after RYGB compared to sham operation, and there was a progressive decrease in fat preference after RYGB. In this rat model of RYGB, sustained weight loss is achieved by a combination of initial hypophagia and sustained increases in fecal energy loss, without change in energy expenditure per lean mass. A shift away from high-fat towards low-fat/high-carbohydrate food preference occurring in parallel suggests long-term adaptive mechanisms related to fat absorption.

  6. Kalman Filtering with Inequality Constraints for Turbofan Engine Health Estimation

    Science.gov (United States)

    Simon, Dan; Simon, Donald L.

    2003-01-01

    Kalman filters are often used to estimate the state variables of a dynamic system. However, in the application of Kalman filters some known signal information is often either ignored or dealt with heuristically. For instance, state variable constraints (which may be based on physical considerations) are often neglected because they do not fit easily into the structure of the Kalman filter. This paper develops two analytic methods of incorporating state variable inequality constraints in the Kalman filter. The first method is a general technique of using hard constraints to enforce inequalities on the state variable estimates. The resultant filter is a combination of a standard Kalman filter and a quadratic programming problem. The second method uses soft constraints to estimate state variables that are known to vary slowly with time. (Soft constraints are constraints that are required to be approximately satisfied rather than exactly satisfied.) The incorporation of state variable constraints increases the computational effort of the filter but significantly improves its estimation accuracy. The improvement is proven theoretically and shown via simulation results. The use of the algorithm is demonstrated on a linearized simulation of a turbofan engine to estimate health parameters. The turbofan engine model contains 16 state variables, 12 measurements, and 8 component health parameters. It is shown that the new algorithms provide improved performance in this example over unconstrained Kalman filtering.

  7. Computational fluid dynamics analysis of core bypass flow and crossflow in a prismatic very high temperature gas-cooled nuclear reactor based on a two-layer block model

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Huhu, E-mail: huhuwang@tamu.edu [Department of Nuclear Engineering, Texas A and M University, 3133 TAMU, College Station, TX 77840 (United States); Dominguez-Ontiveros, Elvis, E-mail: elvisdom@tamu.edu [Department of Nuclear Engineering, Texas A and M University, 3133 TAMU, College Station, TX 77840 (United States); Hassan, Yassin A., E-mail: y-hassan@tamu.edu [Department of Nuclear Engineering, Texas A and M University, 3133 TAMU, College Station, TX 77840 (United States); Department of Mechanical Engineering, Texas A and M University, 3123 TAMU, College Station, TX 77840 (United States)

    2014-03-15

    Highlights: • A CFD model was built based on a two-layer block experimental facility at Texas A and M University. • The coolant characterizations within the uniform and wedge-shaped crossflow gap regions were investigated. • The influence on the coolant distribution from the bypass flow gap width was studied. • Discretization and iterative errors involved in the simulations were quantified. - Abstract: The very high temperature gas-cooled nuclear reactor (VHTR) has been designated as one of the promising reactors that will serve for the Next Generation (Generation IV) Nuclear Plant. For a prismatic VHTR core, the bypass flow and crossflow phenomena are important design considerations. To investigate the coolant distribution in the reactor core based on the two-layer block facility built at Texas A and M University, a three-dimensional steady-state CFD analysis was performed using the commercial code STAR-CCM+ v6.04. Results from this work serve as a guideline and validating source for the related experiments. A grid independence study was conducted to quantify related errors in the simulations. The simulation results show that the bypass flow fraction was not a strong function of the Reynolds number. The presence of the crossflow gap had a significant effect on the distribution of the coolant in the core. Uniform and wedge-shape crossflow gaps were studied. It was found that a significant secondary flow in the crossflow gap region moved from the bypass flow gap toward coolant holes, which resulted in up to a 28% reduction of the coolant mass flow rate in the bypass flow gap.

  8. Aortic valve bypass

    DEFF Research Database (Denmark)

    Lund, Jens T; Jensen, Maiken Brit; Arendrup, Henrik

    2013-01-01

    In aortic valve bypass (AVB) a valve-containing conduit is connecting the apex of the left ventricle to the descending aorta. Candidates are patients with symptomatic aortic valve stenosis rejected for conventional aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI...

  9. Partial Ileal Bypass Undone

    NARCIS (Netherlands)

    Beynen, A.C.; Schouten, J.A.; Hoitsma, H.F.W.

    1984-01-01

    Partial ileal bypass (PIB) for the treatment of hypercholesterolaemia was introduced 20 years ago. About 110 cases have been described. We know of only 1 case of restoration of intestinal continuity; no details were given. We report here the second case of PIB in the Netherlands; the operation was r

  10. Coronary Artery Bypass Surgery

    Science.gov (United States)

    In coronary artery disease (CAD), the arteries that supply blood and oxygen to your heart muscle grow hardened and narrowed. You may try ... these treatments don't help, you may need coronary artery bypass surgery. The surgery creates a new ...

  11. Experimental laparoscopic aortobifemoral bypass.

    Science.gov (United States)

    Dion, Y M; Chin, A K; Thompson, T A

    1995-08-01

    The goal of the present study is to develop a technique for laparoscopic aortobifemoral bypass. Piglets weighing between 60 and 78 kg were anesthetized with halothane. The lateral retroperitoneal approach was preferred to the more familiar anterior transperitoneal approach and was successfully completed in 19 piglets. The piglets were placed in the right lateral decubitus position. The first port (2 cm) was inserted halfway between the tip of the 12th rib and the iliac crest. Four other trocars were placed in the retroperitoneum after balloon inflation had allowed creation of a space which permitted visualization of the aorta from the left renal artery down to the aorto-iliac junction. After evacuation of the retropneumoperitoneum, the cavity was maintained using an abdominal lift device and a retractor. Using this approach, we performed four aorto-bifemoral bypasses (end-to-end aortic anastomosis) after conventional intravenous heparinization (100 IU/kg) in less than 4 h. Blood loss did not exceed 250 ml and the hematocrit remained stable. Postmortem evaluation of the grafts revealed they were positioned as in a conventional bypass, their limbs having followed in the created retroperitoneal tunnels along the path of the native arteries. No mortality occurred before sacrifice of the animals. We believe that this first performed series of totally retroperitoneal laparoscopic aortobifemoral bypasses in the porcine model is useful in preparation for human application due to the anatomical similarities in the periaortic region.

  12. High Spinal Anesthesia Enhances Anti-Inflammatory Responses in Patients Undergoing Coronary Artery Bypass Graft Surgery and Aortic Valve Replacement: Randomized Pilot Study.

    Science.gov (United States)

    Lee, Trevor W R; Kowalski, Stephen; Falk, Kelsey; Maguire, Doug; Freed, Darren H; HayGlass, Kent T

    2016-01-01

    Cardiac surgery induces many physiologic changes including major inflammatory and sympathetic nervous system responses. Here, we conducted a single-centre pilot study to generate hypotheses on the potential immune impact of adding high spinal anaesthesia to general anaesthesia during cardiac surgery in adults. We hypothesized that this strategy, previously shown to blunt the sympathetic response and improve pain management, could reduce the undesirable systemic inflammatory responses caused by cardiac surgery. This prospective randomized unblinded pilot study was conducted on 14 patients undergoing cardiac surgery for coronary artery bypass grafting and/or aortic valve replacement secondary to severe aortic stenosis. The primary outcome measures examined longitudinally were serum pro-inflammatory (IL-6, IL-1b, CCL2), anti-inflammatory (IL-10, TNF-RII, IL-1Ra), acute phase protein (CRP, PTX3) and cardiovascular risk (sST2) biomarkers. The kinetics of pro- and anti-inflammatory biomarker was determined following surgery. All pro-inflammatory and acute phase reactant biomarker responses induced by surgical stress were indistinguishable in intensity and duration between control groups and those who also received high spinal anaesthesia. Conversely, IL-10 levels were markedly elevated in both intensity and duration in the group receiving high spinal anesthesia (p = 0.005). This hypothesis generating pilot study suggests that high spinal anesthesia can alter the net inflammatory response that results from cardiac surgery. In appropriately selected populations, this may add incremental benefit by dampening the net systemic inflammatory response during the week following surgery. Larger population studies, powered to assess immune, physiologic and clinical outcomes in both acute and longer term settings, will be required to better assess potential benefits of incorporating high spinal anesthesia. ClinicalTrials.gov NCT00348920.

  13. 77 FR 20987 - Airworthiness Directives; Rolls-Royce plc Turbofan Engines

    Science.gov (United States)

    2012-04-09

    ..., Amendment 39-16970 (77 FR 13485, March 7, 2012), currently requires inspecting the front combustion liner...; AD 2012-04-14] RIN 2120-AA64 Airworthiness Directives; Rolls-Royce plc Turbofan Engines...

  14. Intra-arterial papaverine and leg vascular resistance during in situ bypass surgery with high or low epidural anaesthesia

    DEFF Research Database (Denmark)

    Rørdam, Peter; Jensen, Leif Panduro; Schroeder, T V;

    1993-01-01

    patients were operated during high epidural anaesthesia (> Th. 10). Flow increased and arterial pressure decreased after i.a. papaverine in all patients. When compared with patients operated during high epidural anaesthesia, flow increase and decrease in vascular resistance took place in patients operated...

  15. Performance of air breathing combined cycle engines with a turbofan; Leistungsverhalten luftatmender Kombinationstriebwerke mit Zweistrom-Turboteil

    Energy Technology Data Exchange (ETDEWEB)

    Schulte, H.

    2003-07-01

    In this paper the influence of the design and control parameters on the performance characteristic of a combined cycle engine consisting of a turbofan engine with a reheat system and a convergent-divergent nozzle is investigated. The studies are not based on a special mission but the two sections of a mission dominating the fuel consumption of the propulsion system - the acceleration flight and the cruise segment - are considered seperately. By that it is shown which design of the turbo engine is suitable for each section of the mission and how far these designs differ from each other. The studies start with the so-called baseline engine. Applying a performance calculation program the performance characteristic of the engine is calculated for given flight conditions and engine control parameter settings. The particularly for high speed propulsion systems important interaction between the engine and the aircraft is considered, iteratively adjusting the angle of attack of the aircraft given for the performance calculation to the one fulfilling the equations of motion of the aircraft. Based on the results of the baseline engine the design parameters of the turbo engine, namely (a) the turbine inlet temperature T{sub t4,A}, (b) the overall pressure ratio {pi}{sub tV,A} and (c) the bypass ratio {mu}{sub A} are varied systematically and the effect of these changes on the performance of the engine along the flight Mach Number is investigated. First the studies are carried out for the acceleration flight and afterwards they are being extended to the cruise flight segment. The valuation criteria for the engine performance in the acceleration section is the so-called acceleration efficiency. This efficiency is defined as the ratio of the potential and kinetic energy rise and the therefore needed fuel energy. In the cruise section the engine performance is valuated using a so-called cruise number which considers the quality of the conversion of fuel energy into propulsive

  16. Urgent treatment of severe symptomatic direct carotid cavernous fistula caused by ruptured cavernous internal carotid artery aneurysm using high-flow bypass, proximal ligation, and direct distal clipping: Technical case report

    Directory of Open Access Journals (Sweden)

    Hirotaka Hasegawa

    2014-01-01

    Full Text Available Background: Direct carotid cavernous fistula (CCF secondary to ruptured carotid cavernous aneurysms (CCAs is rare, but patients with this condition who develop acutely worsening and severe neuro-ophthalmic symptoms require urgent treatment. Endovascular methods are the first-line option, but this modality may not be available on an urgent basis. Case Description: In this article, we report a 45-year-old female with severe direct CCF due to rupture of the CCA. She presented with intractable headache and acute worsening of double vision and visual acuity. Emergent radiographic study revealed high-flow fistula tracked from the CCA toward the contralateral cavernous sinus and drained into the engorged left superior orbital vein. To prevent permanent devastating neuro-ophthalmic damages, urgent high-flow bypass with placement of a radial artery graft was performed followed by right cervical internal carotid artery (ICA ligation and the clipping of the ICA at the C3 portion, proximal to the ophthalmic artery. In the immediate postoperative period, her symptoms resolved and angiography confirmed patency of the high-flow bypass and complete occlusion of the CCF. Conclusion: With due consideration of strategy and techniques to secure safety, open surgical intervention with trapping and bypass is a good treatment option for direct severe CCF when the endovascular method is not available, not possible, or is unsuccessful.

  17. Acoustic control study of turbofan nozzles with triangular chevrons

    Directory of Open Access Journals (Sweden)

    Grigore CICAN

    2014-03-01

    Full Text Available This paper has a small part dealing with the notion of chevron and the process that helps reducing the noise pollution. Based on the gas dynamics and the geometrical parameters of the turbofan jet engine a model of CFD data processing is created. In this process the influence of chevrons on acoustic wave intensity produced by the jet is observed by analyzing this process. A series of tests have been made on 10 si 20 lobed chevrons. The combination between them and the 7 resulting cases have been studied, namely the triangular chevrons in order to settle the influence of the geometrical parameters on the flow and on the jet acoustics. Finally the contribution of the chevrons in noise pollution reduction has been highlighted.

  18. Clinical Outcomes After Drug-Eluting Stents Versus Coronary Artery Bypass Surgery in High Surgical Risk Patients With Left Main or Three-Vessel Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Tonga Nfor

    2015-08-01

    Full Text Available Purpose: Previous studies comparing percutaneous coronary intervention (PCI with coronary artery bypass graft surgery (CABG in patients with unprotected left main or three-vessel coronary artery disease (LM-3VD have excluded patients at high surgical risk. We compared clinical outcomes after PCI with drug-eluting stents to CABG in high surgical risk patients with LM-3VD. Methods: Patients with symptomatic LM-3VD who had Society of Thoracic Surgeons (STS-predicted operative mortality > 5% and were undergoing either PCI with drug-eluting stents or CABG at a tertiary care center from January 2009 to December 2010 were enrolled in this nonrandomized prospective study. Results: Mean STS score was 14.5 ± 5.8% for PCI (n=83 vs. 13.6 ± 7.1% for CABG (n=187 (P=0.31. After mean follow-up of 37 months, incidence of the composite primary endpoint (death, myocardial infarction or stroke was 42.2% for PCI and 39.6% for CABG (P=0.69, hazard ratio 1.3, 95% confidence interval 0.5-2.8. There were no differences in the individual components of the primary endpoint between PCI and CABG. Repeat revascularization was 30.1% for PCI vs. 9.6% for CABG (P=0.001. Major adverse cardiac and cerebrovascular event rates were similar between PCI and CABG, 50.6% vs. 42.2%, respectively (P=0.23. Patients in the PCI group were less likely than those in the CABG group to be discharged to a nursing home (12.1% vs. 47.1%, P 5%.

  19. Enhanced Core Noise Modeling for Turbofan Engines

    Science.gov (United States)

    Stone, James R.; Krejsa, Eugene A.; Clark, Bruce J.

    2011-01-01

    This report describes work performed by MTC Technologies (MTCT) for NASA Glenn Research Center (GRC) under Contract NAS3-00178, Task Order No. 15. MTCT previously developed a first-generation empirical model that correlates the core/combustion noise of four GE engines, the CF6, CF34, CFM56, and GE90 for General Electric (GE) under Contract No. 200-1X-14W53048, in support of GRC Contract NAS3-01135. MTCT has demonstrated in earlier noise modeling efforts that the improvement of predictive modeling is greatly enhanced by an iterative approach, so in support of NASA's Quiet Aircraft Technology Project, GRC sponsored this effort to improve the model. Since the noise data available for correlation are total engine noise spectra, it is total engine noise that must be predicted. Since the scope of this effort was not sufficient to explore fan and turbine noise, the most meaningful comparisons must be restricted to frequencies below the blade passage frequency. Below the blade passage frequency and at relatively high power settings jet noise is expected to be the dominant source, and comparisons are shown that demonstrate the accuracy of the jet noise model recently developed by MTCT for NASA under Contract NAS3-00178, Task Order No. 10. At lower power settings the core noise became most apparent, and these data corrected for the contribution of jet noise were then used to establish the characteristics of core noise. There is clearly more than one spectral range where core noise is evident, so the spectral approach developed by von Glahn and Krejsa in 1982 wherein four spectral regions overlap, was used in the GE effort. Further analysis indicates that the two higher frequency components, which are often somewhat masked by turbomachinery noise, can be treated as one component, and it is on that basis that the current model is formulated. The frequency scaling relationships are improved and are now based on combustor and core nozzle geometries. In conjunction with the Task

  20. Relationship of femorodistal bypass patency to clinical outcome. Iloprost Bypass International Study Group

    DEFF Research Database (Denmark)

    Watson, H R; Schroeder, T V; Simms, M H;

    1999-01-01

    To investigate the relationship between bypass patency, limb survival and clinical symptoms after femorodistal bypass procedures.......To investigate the relationship between bypass patency, limb survival and clinical symptoms after femorodistal bypass procedures....

  1. Perioperative utility of goal-directed therapy in high-risk cardiac patients undergoing coronary artery bypass grafting: “A clinical outcome and biomarker-based study”

    Science.gov (United States)

    Kapoor, Poonam Malhotra; Magoon, Rohan; Rawat, Rajinder; Mehta, Yatin

    2016-01-01

    Goal-directed therapy (GDT) encompasses guidance of intravenous (IV) fluid and vasopressor/inotropic therapy by cardiac output or similar parameters to help in early recognition and management of high-risk cardiac surgical patients. With the aim of establishing the utility of perioperative GDT using robust clinical and biochemical outcomes, we conducted the present study. This multicenter randomized controlled study included 130 patients of either sex, with European system for cardiac operative risk evaluation ≥3 undergoing coronary artery bypass grafting on cardiopulmonary bypass. The patients were randomly divided into the control and GDT group. All the participants received standardized care; arterial pressure monitored through radial artery, central venous pressure (CVP) through a triple lumen in the right internal jugular vein, electrocardiogram, oxygen saturation, temperature, urine output per hour, and frequent arterial blood gas (ABG) analysis. In addition, cardiac index (CI) monitoring using FloTrac™ and continuous central venous oxygen saturation (ScVO2) using PreSep™ were used in patients in the GDT group. Our aim was to maintain the CI at 2.5–4.2 L/min/m2, stroke volume index 30–65 ml/beat/m2, systemic vascular resistance index 1500–2500 dynes/s/cm5/m2, oxygen delivery index 450–600 ml/min/m2, continuous ScVO2 >70%, and stroke volume variation 30%, and urine output >1 ml/kg/h. The aims were achieved by altering the administration of IV fluids and doses of inotropes or vasodilators. The data of sixty patients in each group were analyzed in view of ten exclusions. The average duration of ventilation (19.89 ± 3.96 vs. 18.05 ± 4.53 h, P = 0.025), hospital stay (7.94 ± 1.64 vs. 7.17 ± 1.93 days, P = 0.025), and Intensive Care Unit (ICU) stay (3.74 ± 0.59 vs. 3.41 ± 0.75 days, P = 0.012) was significantly less in the GDT group, compared to the control group. The extra volume added and the number of inotropic dose adjustments were

  2. Perioperative utility of goal-directed therapy in high-risk cardiac patients undergoing coronary artery bypass grafting: “A clinical outcome and biomarker-based study”

    Directory of Open Access Journals (Sweden)

    Poonam Malhotra Kapoor

    2016-01-01

    Full Text Available Goal-directed therapy (GDT encompasses guidance of intravenous (IV fluid and vasopressor/inotropic therapy by cardiac output or similar parameters to help in early recognition and management of high-risk cardiac surgical patients. With the aim of establishing the utility of perioperative GDT using robust clinical and biochemical outcomes, we conducted the present study. This multicenter randomized controlled study included 130 patients of either sex, with European system for cardiac operative risk evaluation ≥3 undergoing coronary artery bypass grafting on cardiopulmonary bypass. The patients were randomly divided into the control and GDT group. All the participants received standardized care; arterial pressure monitored through radial artery, central venous pressure (CVP through a triple lumen in the right internal jugular vein, electrocardiogram, oxygen saturation, temperature, urine output per hour, and frequent arterial blood gas (ABG analysis. In addition, cardiac index (CI monitoring using FloTrac™ and continuous central venous oxygen saturation (ScVO2 using PreSep™ were used in patients in the GDT group. Our aim was to maintain the CI at 2.5–4.2 L/min/m2, stroke volume index 30–65 ml/beat/m2, systemic vascular resistance index 1500–2500 dynes/s/cm5/m2, oxygen delivery index 450–600 ml/min/m2, continuous ScVO2 >70%, and stroke volume variation 30%, and urine output >1 ml/kg/h. The aims were achieved by altering the administration of IV fluids and doses of inotropes or vasodilators. The data of sixty patients in each group were analyzed in view of ten exclusions. The average duration of ventilation (19.89 ± 3.96 vs. 18.05 ± 4.53 h, P = 0.025, hospital stay (7.94 ± 1.64 vs. 7.17 ± 1.93 days, P = 0.025, and Intensive Care Unit (ICU stay (3.74 ± 0.59 vs. 3.41 ± 0.75 days, P = 0.012 was significantly less in the GDT group, compared to the control group. The extra volume added and the number of inotropic dose adjustments were

  3. Overview of ERA Integrated Technology Demonstration (ITD) 51A Ultra-High Bypass (UHB) Integration for Hybrid Wing Body (HWB)

    Science.gov (United States)

    Flamm, Jeffrey D.; James, Kevin D.; Bonet, John T.

    2016-01-01

    The NASA Environmentally Responsible Aircraft Project (ERA) was a ve year project broken into two phases. In phase II, high N+2 Technical Readiness Level demonstrations were grouped into Integrated Technology Demonstrations (ITD). This paper describes the work done on ITD-51A: the Vehicle Systems Integration, Engine Airframe Integration Demonstration. Refinement of a Hybrid Wing Body (HWB) aircraft from the possible candidates developed in ERA Phase I was continued. Scaled powered, and unpowered wind- tunnel testing, with and without acoustics, in the NASA LARC 14- by 22-foot Subsonic Tunnel, the NASA ARC Unitary Plan Wind Tunnel, and the 40- by 80-foot test section of the National Full-Scale Aerodynamics Complex (NFAC) in conjunction with very closely coupled Computational Fluid Dynamics was used to demonstrate the fuel burn and acoustic milestone targets of the ERA Project.

  4. Coxsackievirus mutants that can bypass host factor PI4KⅢβ and the need for high levels of PI4P lipids for replication

    Institute of Scientific and Technical Information of China (English)

    Hilde M van der Schaar; Lonneke van der Linden; Kjerstin H W Lanke; Jeroen R P M Strating; Gerhard Pürstinger; Erik de Vries; Cornelis A M de Haan; Johan Neyts; Frank J M van Kuppeveld

    2012-01-01

    RNA viruses can rapidly mutate and acquire resistance to drugs that directly target viral enzymes,which poses serious problems in a clinical context.Therefore,there is a growing interest in the development of antiviral drugs that target host factors critical for viral replication,since they are unlikely to mutate in response to therapy.We recently demonstrated that phosphatidylinositol-4-kinase Ⅲβ (PI4KⅢβ) and its product phosphatidylinositol-4-phosphate (PI4P) are essential for replication of enteroviruses,a group of medically important RNA viruses including poliovirus (PV),coxsackievirus,rhinovirus,and enterovirus 71.Here,we show that enviroxime and GW5074 decreased PI4P levels at the Golgi complex by directly inhibiting PI4KⅢβ.Coxsackievirus mutants resistant to these inhibitors harbor single point mutations in the non-structural protein 3A.These 3A mutations did not confer compound-resistance by restoring the activity of PI4KⅢβ in the presence of the compounds.Instead,replication of the mutant viruses no longer depended on PI4KⅢβ,since their replication was insensitive to siRNA-mediated depletion of PI4KⅢβ.The mutant viruses also did not rely on other isoforms of PI4K.Consistently,no high level of PI4P could be detected at the replication sites induced by the mutant viruses in the presence of the compounds.Collectively,these findings indicate that through specific single point mutations in 3A,CVB3 can bypass an essential host factor and lipid for its propagation,which is a new example of RNA viruses acquiring resistance against antiviral compounds,even when they directly target host factors.

  5. Use of Aerial high resolution visible imagery to produce large river bathymetry: a multi temporal and spatial study over the by-passed Upper Rhine

    Science.gov (United States)

    Béal, D.; Piégay, H.; Arnaud, F.; Rollet, A.; Schmitt, L.

    2011-12-01

    Aerial high resolution visible imagery allows producing large river bathymetry assuming that water depth is related to water colour (Beer-Bouguer-Lambert law). In this paper we aim at monitoring Rhine River geometry changes for a diachronic study as well as sediment transport after an artificial injection (25.000 m3 restoration operation). For that a consequent data base of ground measurements of river depth is used, built on 3 different sources: (i) differential GPS acquisitions, (ii) sounder data and (iii) lateral profiles realized by experts. Water depth is estimated using a multi linear regression over neo channels built on a principal component analysis over red, green and blue bands and previously cited depth data. The study site is a 12 km long reach of the by-passed section of the Rhine River that draws French and German border. This section has been heavily impacted by engineering works during the last two centuries: channelization since 1842 for navigation purposes and the construction of a 45 km long lateral canal and 4 consecutive hydroelectric power plants of since 1932. Several bathymetric models are produced based on 3 different spatial resolutions (6, 13 and 20 cm) and 5 acquisitions (January, March, April, August and October) since 2008. Objectives are to find the optimal spatial resolution and to characterize seasonal effects. Best performances according to the 13 cm resolution show a 18 cm accuracy when suspended matters impacted less water transparency. Discussions are oriented to the monitoring of the artificial reload after 2 flood events during winter 2010-2011. Bathymetric models produced are also useful to build 2D hydraulic model's mesh.

  6. Relationship between Serum Albumin Level and Monocyte-to-High-Density Lipoprotein Cholesterol Ratio with Saphenous Vein Graft Disease in Coronary Bypass.

    Science.gov (United States)

    Akboga, Mehmet Kadri; Yayla, Cagri; Balci, Kevser Gulcihan; Ozeke, Ozcan; Maden, Orhan; Kisacik, Halil; Temizhan, Ahmet; Aydogdu, Sinan

    2017-06-01

    Background Previous studies proposed that inflammation, oxidative stress, and impaired endothelial dysfunction have a crucial role in occurrence of saphenous vein graft (SVG) disease (SVGD). The aim of this study was to assess the relationship between monocyte-to-high-density lipoprotein cholesterol (HDL-C) ratio (MHR) and serum albumin (SA) level as readily available inflammatory and oxidative stress markers with the presence of SVGD in patients with a coronary bypass. Methods In this retrospective cross-sectional study, a total of 257 patients (n = 112 SVGD [+] [mean age was 65.3 ± 8.4 years, 75.0% males] and n = 145 SVGD [-] [mean age was 66.5 ± 10.1 years, 74.5% males]) were enrolled. At least one SVG with ≥ 50% stenosis was defined as SVGD. Independent predictors of SVGD were determined by logistic regression analysis. Results White blood cell, neutrophil, monocyte, the age of SVG, and MHR were significantly higher, whereas SA level was significantly lower in patients with SVGD. In regression analysis, neutrophil, age of SVG, SA (odds ratio [OR]: 0.232 [0.156-0.370], p MHR (OR: 1.122 [1.072-1.174], p MHR (r = 0.238, p MHR has a 71.4% sensitivity and 60.0% specificity for prediction of SVGD. Conclusion Consequently, to the best of our knowledge, this is the first study showing a significant and independent association between SA and MHR with SVGD. Georg Thieme Verlag KG Stuttgart · New York.

  7. By-passing acidification limitations during the biofiltration of high formaldehyde loads via the application of ozone pulses

    Energy Technology Data Exchange (ETDEWEB)

    García-Pérez, Teresa [División de Ciencias Ambientales, Instituto Potosino de Investigación Científica y Tecnológica (IPICyT), Camino a la Presa San José 2055, Col. Lomas 4a Sección, San Luis Potosí, SLP 78216 (Mexico); Aizpuru, Aitor [Universidad del Mar, Puerto Ángel, Distrito de San Pedro Pochutla, Oaxaca, México C.P. 70902 (Mexico); Arriaga, Sonia, E-mail: sonia@ipicyt.edu.mx [División de Ciencias Ambientales, Instituto Potosino de Investigación Científica y Tecnológica (IPICyT), Camino a la Presa San José 2055, Col. Lomas 4a Sección, San Luis Potosí, SLP 78216 (Mexico)

    2013-11-15

    Highlights: • Ozone addition permits to treat higher formaldehyde loads than ever reported. • Ozone addition acts as an indirect in situ pH regulator, minimizing the accumulation of acid byproducts. • Mineralization of formaldehyde occurs, which has never been reported. • Low ozone levels have no negative effects on biological degradation activity. • The use of hybrid processes allows overcoming biofiltration limitations. -- Abstract: A formaldehyde airstream was treated in a biofilter for an extended period of time. During the first 133 days, the reactor was operated without ozone, whereas over the following 82 days ozone was intermittently implemented. The maximum stable elimination capacity obtained without ozone was around 57 g m{sup −3} h{sup −1}. A greater load could not be treated under these conditions, and no significant formaldehyde removal was maintained for inlet loads greater than 65 g m{sup −3} h{sup −1}; the activity of microorganisms was then inhibited by the presence of acidic byproducts, and the media acidified (pH < 4). The implementation of ozone pulses allowed a stable elimination capacity to be obtained, even at greater loads (74 g m{sup −3} h{sup −1}). The effect of ozone on the extra cellular polymeric substances detachment from the biofilm could not be confirmed due to the too low biofilter biomass content. Thus, the results suggest that ozone acted as an in situ pH regulator, preventing acidic byproducts accumulation, and allowing the treatment of high loads of formaldehyde.

  8. Arterial pressure and deltoid muscle gas tensions during cardiopulmonary bypass in man.

    Science.gov (United States)

    Stanley, T H

    1978-07-01

    The results of this study demonstrate that standard techniques of conducting cardiopulmonary bypass produce low muscle oxygen and high muscle carbon dioxide tensions and, thus, little perfusion of skeletal muscle. Our findings also show that PmO2 and PmCO2 do not return to pre-bypass levels until the mean arterial blood pressure exceeds 12 kPa (90 torr) during bypass and that utilization of vasopressor drugs during bypass maintains the pressure; but at the expense of muscle blood flow. The data indicate that both high mean blood pressure and high flow are necessary during bypass to ensure skeletal muscle perfusion and suggest, when combined with preliminary animal findings, that this type of bypass perfusion may prove to be superior to standard techniques in hastening recovery after cardio-pulmonary bypass.

  9. Bypass systems for shared outlets. Bypass-systemen voor gemeenschappelijke afvoersystemen

    Energy Technology Data Exchange (ETDEWEB)

    Dijkhof, W.; Huijzer, E.L.; Beltman, H.A.

    1993-05-01

    In stacked buildings large pressure differences can occur when appliances with individual air supply pipes are connected to a communal outlet. This can be prevented by using a so-called bypass system, which couples the air supply pipe directly to the combustion gases outlet. In case of overpressure on the air supply of an appliance, air will be transported to the combustion gases outlet around the appliance. Descriptions are given of two GASTEC-developed indoor systems: a mechanical bypass system and an aerodynamic bypass system. The aerodynamic system has been optimized for a retrofitting boiler project in Assen, Netherlands. In this project a communal heating system has been replaced by individual central heating boilers. The appliance used was a high-efficiency boiler, the NEFIT Turbo 21. The disadvantage of the mechanical bypass system is one of the moving parts: the valve, which is too sensitive for pollution and failures. Large pressure difference reductions are possible by means of the aerodynamic bypass system. Recirculation can be prevented by high-speed injection of the combustion gases in the combustion gases outlet. 13 figs., 26 tabs., 2 appendices, 2 refs.

  10. High-Fidelity Simulation of Turbofan Noise Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Broadband fan noise ? closely tied to turbulent flow on and around the fan blades ? represents a key challenge to the noise reduction community due to the...

  11. Coronary Artery Bypass

    Directory of Open Access Journals (Sweden)

    Kadri Ceberut

    2011-01-01

    Full Text Available Ancient schwannoma is a rare variant of neural tumors though rarely seen in the thorax. The combination with coronary artery diseases is also rare. Here we describe a 66 year-old male who had undergone one-stage combined surgery for thoracic ancient schwannomas removal and coronary artery disease. The masses were, respectively, 13 cm in the middle mediastinum and 5 cm in diameter originating from the intercostal nerve. The tumors were successfully removed using sternotomy, and then a coronary artery bypass grafting was performed. Here we discuss this rare tumor in relation to the relevant literature.

  12. Heart bypass surgery incision (image)

    Science.gov (United States)

    ... the left part of the chest between the ribs. This incision is much less traumatic than the traditional heart bypass surgery incision which separates the breast bone. Minimally invasive heart bypass surgery allows the patient less pain and a faster recovery.

  13. Spiritual Bypass: A Preliminary Investigation

    Science.gov (United States)

    Cashwell, Craig S.; Glosoff, Harriet L.; Hammond, Cheree

    2010-01-01

    The phenomenon of spiritual bypass has received limited attention in the transpersonal psychology and counseling literature and has not been subjected to empirical inquiry. This study examines the phenomenon of spiritual bypass by considering how spirituality, mindfulness, alexithymia (emotional restrictiveness), and narcissism work together to…

  14. A high-fat diet reverses improvement in glucose tolerance induced by duodenal-jejunal bypass in type 2 diabetic rats

    Institute of Scientific and Technical Information of China (English)

    LIU Shao-zhuang; SUN Dong; ZHANG Guang-yong; WANG Lei; LIU Teng; SUN Yu; LI Ming-xia; HU San-yuan

    2012-01-01

    Background Bariatric surgery offers successful resolution of type 2 diabetes mellitus (T2DM).However,recurrence of T2DM has been observed in a number of patients with initial resolution after bariatric surgery.This study aimed to induce reversal of the improvement of diabetes in T2DM rats after duodenal-jejunal bypass (DJB),and identify the effects of weight changes and gut hormones that might be involved.Methods DJB surgery was performed in two T2DM rat models (n=20 for each group):non-obese Goto-Kakizaki (GK) rats,and moderately-obese T2DM rats induced by a combination of a high-fat diet (HFD) and low-dose streptozotocin (HS rats).The controls were sham-operated and non-treated rats.All rats were then randomly divided into HFD- and low-fat diet (LFD)-fed groups.Glucose tolerance,insulin tolerance,glucose-stimulated insulin,glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) secretion,food intake and body weight were measured and compared with controls.Results DJB surgery resulted in a significant improvement in glucose tolerance in both GK and HS rats fed with either HFD or LFD.In contrast to LFD-fed rats,improved glucose tolerance was impaired in GK and HS rats fed with an HFD,accompanied by re-impairment of insulin tolerance and failure in enhancement of insulin secretion.There was no significant difference in food intake and body weight between DJB-operated and control rats,and between HFD- and LFD-fed rats.Glucose-stimulated GLP-1 and PYY levels were significantly increased after DJB surgery; however,they were not significantly different between HFD- and LFD-fed rats.Conclusion An HFD reverses the improvement in glucose tolerance induced by DJB surgery in T2DM rats,primarily ascribing to the re-impairment of insulin sensitivity,but does not change body weight,GLP-1 and PYY levels.

  15. Asendan Desendan Aortic Bypass: Atan Kalpte Mediyan Sternotomi Yoluyla Onarim

    Directory of Open Access Journals (Sweden)

    Muhammet Akyuz

    2013-10-01

    Full Text Available We report the case of a 9-month-old patient presenting for redo aortic arch surgery because of recoarctation. In present case, ascending-to-descending aortic bypass via median sternotomy was performed without cardiopulmonary bypass with good result. In spite of the fact that the different surgical and intervention treatment options of aortic coarctation are quite satisfactory, a certain group of patients need reoperation because of recoarctation. The recoarctation repair of the aorta with the extra-anatomic aortic bypass is considered a low-risk procedure with high success rate.

  16. Interactive Educational Tool for Turbofan and Afterburning Turbojet Engines

    Science.gov (United States)

    Benson, Thomas J.

    1997-01-01

    A workstation-based, interactive educational computer program has been developed at the NASA Lewis Research Center to aid in the teaching and understanding of turbine engine design and analysis. This tool has recently been extended to model the performance of two-spool turbofans and afterburning turbojets. The program solves for the flow conditions through the engine by using classical one-dimensional thermodynamic analysis found in various propulsion textbooks. Either an approximately thermally perfect or calorically perfect gas can be used in the thermodynamic analysis. Students can vary the design conditions through a graphical user interface; engine performance is calculated immediately. A variety of graphical formats are used to present results, including numerical results, moving bar charts, and student-generated temperature versus entropy (Ts), pressure versus specific volume (pv), and engine performance plots. The package includes user-controlled printed output, restart capability, online help screens, and a browser that displays teacher-prepared lessons in turbomachinery. The program runs on a variety of workstations or a personal computer using the UNIX operating system and X-based graphics. It is being tested at several universities in the midwestern United States; the source and executables are available free from the author.

  17. Numerical analysis for the matching of the core driven compression system in a double bypass engine

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xin; LIU Bao-jie

    2011-01-01

    The numerical analysis for the matching of the core driven compression system in a double bypass variable cycle engine was presented in this paper. The system consists of a one-stage-core driven fan stage (CDFS), an inner bypass duet and a five-stage high pressure compressor (HPC), providing two basic operating modes: the single bypass mode and the double bypass mode. Variable vanes are necessary to realize the mode switch of the system. The correct matching in the double bypass mode requires a proper combination of the mass flow, total pressure ratio and blade speed. The work capacity of the system decreases in the double bypass mode and the pressure ratio tends to decrease more for the CDFS and the front stages of the HPC. The overall system efficiency is higher in the double bypass mode. The radial distributions of aerodynamic parameters are similar in different modes. The notable redistribution of mass flow downstream the CDFS in the single bypass mode leads to strong radial flows and additional mixing losses. The absolute flow angles into the inner bypass increase for the inner span and decrease for the outer span when the system is switched from the single bypass mode to the double bypass mode.

  18. The Staphylococcus aureus FASII bypass escape route from FASII inhibitors.

    Science.gov (United States)

    Morvan, Claire; Halpern, David; Kénanian, Gérald; Pathania, Amit; Anba-Mondoloni, Jamila; Lamberet, Gilles; Gruss, Alexandra; Gloux, Karine

    2017-07-17

    Antimicrobials targeting the fatty acid synthesis (FASII) pathway are being developed as alternative treatments for bacterial infections. Emergence of resistance to FASII inhibitors was mainly considered as a consequence of mutations in the FASII target genes. However, an alternative and efficient anti-FASII resistance strategy, called here FASII bypass, was uncovered. Bacteria that bypass FASII incorporate exogenous fatty acids in membrane lipids, and thus dispense with the need for FASII. This strategy is used by numerous Gram-positive low GC % bacteria, including streptococci, enterococci, and staphylococci. Some bacteria repress FASII genes once fatty acids are available, and "constitutively" shift to FASII bypass. Others, such as the major pathogen Staphylococcus aureus, can undergo high frequency mutations that favor FASII bypass. This capacity is particularly relevant during infection, as the host supplies the fatty acids needed for bacteria to bypass FASII and thus become resistant to FASII inhibitors. Screenings for anti-FASII resistance in the presence of exogenous fatty acids confirmed that FASII bypass confers anti-FASII resistance among clinical and veterinary isolates. Polymorphisms in S. aureus FASII initiation enzymes favor FASII bypass, possibly by increasing availability of acyl-carrier protein, a required intermediate. Here we review FASII bypass and consequences in light of proposed uses of anti-FASII to treat infections, with a focus on FASII bypass in S. aureus. Copyright © 2017 Elsevier B.V. and Société Française de Biochimie et Biologie Moléculaire (SFBBM). All rights reserved.

  19. Cardiopulmonary bypass in pregnancy

    Directory of Open Access Journals (Sweden)

    Mukul Chandra Kapoor

    2014-01-01

    Full Text Available Cardiac surgery carried out on cardiopulmonary bypass (CPB in a pregnant woman is associated with poor neonatal outcomes although maternal outcomes are similar to cardiac surgery in non-pregnant women. Most adverse maternal and fetal outcomes from cardiac surgery during pregnancy are attributed to effects of CPB. The CPB is associated with utero-placental hypoperfusion due to a number of factors, which may translate into low fetal cardiac output, hypoxia and even death. Better maternal and fetal outcomes may be achieved by early pre-operative optimization of maternal cardiovascular status, use of perioperative fetal monitoring, optimization of CPB, delivery of a viable fetus before the operation and scheduling cardiac surgery on an elective basis during the second trimester.

  20. Cardiopulmonary bypass in Jehovah's Witnesses

    African Journals Online (AJOL)

    Jehovah's Witnesses do not accept heterologous blood transfusion for religious ... cuit allowed successful open-heart surgery using cardiop- ulmonary bypass. .... 2 after isovolaemic hacmodilution and was between 5.8g% (Hct. 17.4%) and ...

  1. Design, evaluation and test of an electronic, multivariable control for the F100 turbofan engine

    Science.gov (United States)

    Skira, C. A.; Dehoff, R. L.; Hall, W. E., Jr.

    1980-01-01

    A digital, multivariable control design procedure for the F100 turbofan engine is described. The controller is based on locally linear synthesis techniques using linear, quadratic regulator design methods. The control structure uses an explicit model reference form with proportional and integral feedback near a nominal trajectory. Modeling issues, design procedures for the control law and the estimation of poorly measured variables are presented.

  2. The completion of the mathematical model by parameter identification for simulating a turbofan engine

    Directory of Open Access Journals (Sweden)

    Irina Carmen ANDREI

    2015-09-01

    Full Text Available The purpose of this paper is to set up a method to determine the missing engine design parameters (turbine inlet temperature T3T, airflow rate which significantly influence the jet engines thrust. The authors have introduced a new non-linear equation connecting the fan specific work with the temperature T3T, customized for turbofan. The method of chords, since it converges unconditionally, has been used for solving the non-linear equation of variable temperature T3T. An alternate method, based for the same relation between fan specific work and T3T, has been presented in purpose to determine airflow rate and fan pressure ratio. Two mixed flows turbofans have been considered as study cases. For case #1 it was determined a value comparable to the Turbomeca Larzac turbofan series 04-C6 and 04-C20 which power the AlphaJet machines (series A - Luftwaffe, series E - Dassault Dornier. For the F100-PW229 turbofan, as case #2, being given T3T, then have been determined the airflow rate, fan pressure ratio and fan specific work. After completing the mathematical model with the missing parameters, the performances of the engines at off-design regimes and the operational envelopes revealing i.e. the variations of thrust, specific thrust and fuel specific consumption with altitude and Mach number have been calculated.

  3. 78 FR 61171 - Airworthiness Directives; Rolls-Royce plc Turbofan Engines

    Science.gov (United States)

    2013-10-03

    ...-01-AD; Amendment 39-17599; AD 2013-19-17] RIN 2120-AA64 Airworthiness Directives; Rolls-Royce plc... adopting a new airworthiness directive (AD) for all Rolls-Royce plc (RR) RB211-535E4-B-37 series turbofan... directive (AD): 200X-19-17 Rolls-Royce plc Amendment 39-17599; Docket No. FAA-2013- 0029;...

  4. 78 FR 68360 - Airworthiness Directives; Rolls-Royce plc Turbofan Engines

    Science.gov (United States)

    2013-11-14

    ...-01-AD; Amendment 39-17599; AD 2013-19-17] RIN 2120-AA64 Airworthiness Directives; Rolls-Royce plc.... That AD applies to all Rolls-Royce plc (RR) RB211-535E4-B-37 series turbofan engines. The AD number is...-17 Rolls-Royce plc: Amendment 39-17599; Docket No. FAA-2013- 0029; * * * * * Issued in...

  5. 76 FR 65136 - Airworthiness Directives; Rolls-Royce plc (RR) Turbofan Engines

    Science.gov (United States)

    2011-10-20

    ... Directives; Rolls-Royce plc (RR) Turbofan Engines AGENCY: Federal Aviation Administration (FAA), DOT. ACTION... Friday, except Federal holidays. For service information identified in this AD, contact Rolls-Royce plc...-07, Amendment 39-166679 (76 FR 24793, May 3, 2011), and adding the following new AD: Rolls-Royce...

  6. Minimum time acceleration of aircraft turbofan engines by using an algorithm based on nonlinear programming

    Science.gov (United States)

    Teren, F.

    1977-01-01

    Minimum time accelerations of aircraft turbofan engines are presented. The calculation of these accelerations was made by using a piecewise linear engine model, and an algorithm based on nonlinear programming. Use of this model and algorithm allows such trajectories to be readily calculated on a digital computer with a minimal expenditure of computer time.

  7. 77 FR 71085 - Airworthiness Directives; Rolls-Royce Deutschland Ltd & Co KG Turbofan Engines

    Science.gov (United States)

    2012-11-29

    ... serial number (S/N) Rolls-Royce Deutschland Ltd & Co KG (RRD) TAY 620- 15 turbofan engines. This AD... specified products. The MCAI states: Fan blade off on a TAY 620-15 engine has recently been reported... AD applies to Rolls-Royce Deutschland Ltd & Co KG (RRD) TAY 620-15 engines, serial numbers 17054...

  8. 78 FR 17075 - Airworthiness Directives; Rolls-Royce Deutschland Ltd & Co KG Turbofan Engines

    Science.gov (United States)

    2013-03-20

    ... Ltd & Co KG (RRD) Tay 611-8 turbofan engines. This AD requires inspection and replacement, if... ADs None. (c) Applicability This AD applies to Rolls-Royce Deutschland Ltd & Co KG (RRD) Tay 611-8... Agency AD 2012-0163, dated August 28, 2012, and RRD Alert Service Bulletin TAY-72-A1696, Revision 1...

  9. 76 FR 68634 - Airworthiness Directives; General Electric Company (GE) CF6 Turbofan Engines

    Science.gov (United States)

    2011-11-07

    ... visual inspections of the forward engine mount assembly side links for cracks, stripping and reapplying... 9346M99P04, installed on the forward engine mount assembly (also known as Configuration 2). Unsafe Condition...-04] RIN 2120-AA64 Airworthiness Directives; General Electric Company (GE) CF6 Turbofan Engines...

  10. Results of an Advanced Fan Stage Operating Over a Wide Range of Speed and Bypass Ratio. Part 1; Fan Stage Design and Experimental Results

    Science.gov (United States)

    Suder, Kenneth L.; Prahst, Patricia S.; Thorp, Scott A.

    2011-01-01

    NASA s Fundamental Aeronautics Program is investigating turbine-based combined cycle (TBCC) propulsion systems for access to space because it provides the potential for aircraft-like, space-launch operations that may significantly reduce launch costs and improve safety. To this end, National Aeronautics and Space Administration (NASA) and General Electric (GE) teamed to design a Mach 4 variable cycle turbofan/ramjet engine for access to space. To enable the wide operating range of a Mach 4+ variable cycle turbofan ramjet required the development of a unique fan stage design capable of multi-point operation to accommodate variations in bypass ratio (10 ), fan speed (7 ), inlet mass flow (3.5 ), inlet pressure (8 ), and inlet temperature (3 ). In this paper, NASA has set out to characterize a TBCC engine fan stage aerodynamic performance and stability limits over a wide operating range including power-on and hypersonic-unique "windmill" operation. Herein, we will present the fan stage design, and the experimental test results of the fan stage operating from 15 to 100 percent corrected design speed. Whereas, in the companion paper, we will provide an assessment of NASA s APNASA code s ability to predict the fan stage performance and operability over a wide range of speed and bypass ratio.

  11. Roux-en-Y gastric bypass operation in rats.

    Science.gov (United States)

    Bueter, Marco; Abegg, Kathrin; Seyfried, Florian; Lutz, Thomas A; le Roux, Carel W

    2012-06-11

    Currently, the most effective therapy for the treatment of morbid obesity to induce significant and maintained body weight loss with a proven mortality benefit is bariatric surgery. Consequently, there has been a steady rise in the number of bariatric operations done worldwide in recent years with the Roux-en-Y gastric bypass (gastric bypass) being the most commonly performed operation. Against this background, it is important to understand the physiological mechanisms by which gastric bypass induces and maintains body weight loss. These mechanisms are yet not fully understood, but may include reduced hunger and increased satiation, increased energy expenditure, altered preference for food high in fat and sugar, altered salt and water handling of the kidney as well as alterations in gut microbiota. Such changes seen after gastric bypass may at least partly stem from how the surgery alters the hormonal milieu because gastric bypass increases the postprandial release of peptide-YY (PYY) and glucagon-like-peptide-1 (GLP-1), hormones that are released by the gut in the presence of nutrients and that reduce eating. During the last two decades numerous studies using rats have been carried out to further investigate physiological changes after gastric bypass. The gastric bypass rat model has proven to be a valuable experimental tool not least as it closely mimics the time profile and magnitude of human weight loss, but also allows researchers to control and manipulate critical anatomic and physiologic factors including the use of appropriate controls. Consequently, there is a wide array of rat gastric bypass models available in the literature reviewed elsewhere in more detail. The description of the exact surgical technique of these models varies widely and differs e.g. in terms of pouch size, limb lengths, and the preservation of the vagal nerve. If reported, mortality rates seem to range from 0 to 35%. Furthermore, surgery has been carried out almost exclusively in male

  12. Progress on Complications of Direct Bypass for Moyamoya Disease

    Science.gov (United States)

    Yu, Jinlu; Shi, Lei; Guo, Yunbao; Xu, Baofeng; Xu, Kan

    2016-01-01

    Moyamoya disease (MMD) involves progressive occlusion of the intracranial internal carotid artery resulting in formation of moyamoya-like vessels at the base of the brain. It can be characterized by hemorrhage or ischemia. Direct vascular bypass is the main and most effective treatment of MMD. However, patients with MMD differ from those with normal cerebral vessels. MMD patients have unstable intracranial artery hemodynamics and a poor blood flow reserve; therefore, during the direct bypass of superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis, perioperative risk factors and anesthesia can affect the hemodynamics of these patients. When brain tissue cannot tolerate a high blood flow rate, it becomes prone to hyperperfusion syndrome, which leads to neurological function defects and can even cause intracranial hemorrhage in severe cases. The brain tissue is prone to infarction when hemodynamic equilibrium is affected. In addition, bypass vessels become susceptible to occlusion or atrophy when blood resistance increases. Even compression of the temporalis affects bypass vessels. Because the STA is used in MMD surgery, the scalp becomes ischemic and is likely to develop necrosis and infection. These complications of MMD surgery are difficult to manage and are not well understood. To date, no systematic studies of the complications that occur after direct bypass in MMD have been performed, and reported complications are hidden among various case studies; therefore, this paper presents a review and summary of the literature in PubMed on the complications of direct bypass in MMD. PMID:27499690

  13. Progress on Complications of Direct Bypass for Moyamoya Disease.

    Science.gov (United States)

    Yu, Jinlu; Shi, Lei; Guo, Yunbao; Xu, Baofeng; Xu, Kan

    2016-01-01

    Moyamoya disease (MMD) involves progressive occlusion of the intracranial internal carotid artery resulting in formation of moyamoya-like vessels at the base of the brain. It can be characterized by hemorrhage or ischemia. Direct vascular bypass is the main and most effective treatment of MMD. However, patients with MMD differ from those with normal cerebral vessels. MMD patients have unstable intracranial artery hemodynamics and a poor blood flow reserve; therefore, during the direct bypass of superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis, perioperative risk factors and anesthesia can affect the hemodynamics of these patients. When brain tissue cannot tolerate a high blood flow rate, it becomes prone to hyperperfusion syndrome, which leads to neurological function defects and can even cause intracranial hemorrhage in severe cases. The brain tissue is prone to infarction when hemodynamic equilibrium is affected. In addition, bypass vessels become susceptible to occlusion or atrophy when blood resistance increases. Even compression of the temporalis affects bypass vessels. Because the STA is used in MMD surgery, the scalp becomes ischemic and is likely to develop necrosis and infection. These complications of MMD surgery are difficult to manage and are not well understood. To date, no systematic studies of the complications that occur after direct bypass in MMD have been performed, and reported complications are hidden among various case studies; therefore, this paper presents a review and summary of the literature in PubMed on the complications of direct bypass in MMD.

  14. Bypass rewiring and robustness of complex networks

    Science.gov (United States)

    Park, Junsang; Hahn, Sang Geun

    2016-08-01

    A concept of bypass rewiring is introduced, and random bypass rewiring is analytically and numerically investigated with simulations. Our results show that bypass rewiring makes networks robust against removal of nodes including random failures and attacks. In particular, random bypass rewiring connects all nodes except the removed nodes on an even degree infinite network and makes the percolation threshold 0 for arbitrary occupation probabilities. In our example, the even degree network is more robust than the original network with random bypass rewiring, while the original network is more robust than the even degree networks without random bypass. We propose a greedy bypass rewiring algorithm which guarantees the maximum size of the largest component at each step, assuming which node will be removed next is unknown. The simulation result shows that the greedy bypass rewiring algorithm improves the robustness of the autonomous system of the Internet under attacks more than random bypass rewiring.

  15. Bypass Rewiring and Robustness of Complex Networks

    CERN Document Server

    Park, Junsang

    2016-01-01

    A concept of bypass rewiring is introduced and random bypass rewiring is analytically and numerically investigated with simulations. Our results show that bypass rewiring makes networks robust against removal of nodes including random failures and attacks. Especially, random bypass rewiring connects all nodes except the removed nodes on an even degree infinite network and makes the percolation threshold $0$ for arbitrary occupation probabilities. In our example, the even degree network is more robust than the original network with random bypass rewiring while the original network is more robust than the even degree networks without random bypass. We propose a greedy bypass rewiring algorithm which guarantees the maximum size of the largest component at each step, assuming which node will be removed next is unknown. The simulation result shows that the greedy bypass rewiring algorithm improves the robustness of the autonomous system of the Internet under attacks more than random bypass rewiring.

  16. Coronary artery bypass grafting for Kawasaki disease

    Institute of Scientific and Technical Information of China (English)

    GUO Hong-wei; CHANG Qian; XU Jian-ping; SONG Yun-hu; SUN Han-song; HU Sheng-shou

    2010-01-01

    Background Kawasaki disease (KD) is the leading cause of pediatric ischemic heart disease. The incidence of serious coronary sequelae is low and about 2%-3% of patients with KD, but once myocardial infarction occurs in children, the mortality is quite high and 22% at the first infarction.This study aimed to evaluate the efficacy of coronary artery bypass grafting (CABG) in patients with KD.Methods Eight patients with a history of KD underwent CABG between October 1997 and July 2005. The number of bypass grafts placed was 2 to 4 per patient (mean 2.5±0.8). Various bypass grafts were used in patients, i.e. the left internal mammary artery (LIMA) in 3 patients, bilateral internal mammary artery (IMA) in 2 patients, LIMA plus gastroepiploic artery (GEA) in 1 patient and total saphenous vein grafts (SVGs) in 2 patients. The combined procedures included ventricular aneurysmectomy in 1 patient, mitral valve plasty in 1 and right coronary aneurysmectomy in 1. One patient was not able to wean from cardiopulmonary bypass (CPB), after being supported with intra-aortic balloon pump (IABP), the patient was weaned from CPB successfully.Results One patient died of low cardiac output syndrome and acute renal failure 19 days after operation. Other patients recovered and were discharged uneventfully. During the follow-up that ranged from 3 to 57 months (mean 27 months),clincal angina disappeared or improved. Cardiac function was in Class Ⅰ-Ⅱ (NYHA).Conclusion CABG is a safe and effective procedure for Kawasaki coronary artery disease. However long-term results need to be followed up.

  17. MHD Energy Bypass Scramjet Engine

    Science.gov (United States)

    Mehta, Unmeel B.; Bogdanoff, David W.; Park, Chul; Arnold, Jim (Technical Monitor)

    2001-01-01

    Revolutionary rather than evolutionary changes in propulsion systems are most likely to decrease cost of space transportation and to provide a global range capability. Hypersonic air-breathing propulsion is a revolutionary propulsion system. The performance of scramjet engines can be improved by the AJAX energy management concept. A magneto-hydro-dynamics (MHD) generator controls the flow and extracts flow energy in the engine inlet and a MHD accelerator downstream of the combustor accelerates the nozzle flow. A progress report toward developing the MHD technology is presented herein. Recent theoretical efforts are reviewed and ongoing experimental efforts are discussed. The latter efforts also include an ongoing collaboration between NASA, the US Air Force Research Laboratory, US industry, and Russian scientific organizations. Two of the critical technologies, the ionization of the air and the MHD accelerator, are briefly discussed. Examples of limiting the combustor entrance Mach number to a low supersonic value with a MHD energy bypass scheme are presented, demonstrating an improvement in scramjet performance. The results for a simplified design of an aerospace plane show that the specific impulse of the MHD-bypass system is better than the non-MHD system and typical rocket over a narrow region of flight speeds and design parameters. Equilibrium ionization and non-equilibrium ionization are discussed. The thermodynamic condition of air at the entrance of the engine inlet determines the method of ionization. The required external power for non-equilibrium ionization is computed. There have been many experiments in which electrical power generation has successfully been achieved by magneto-hydrodynamic (MHD) means. However, relatively few experiments have been made to date for the reverse case of achieving gas acceleration by the MHD means. An experiment in a shock tunnel is described in which MHD acceleration is investigated experimentally. MHD has several

  18. Monitoring the conjunctiva for carbon dioxide and oxygen tensions and pH during cardiopulmonary bypass.

    Science.gov (United States)

    Weiss, Irwin K; Isenberg, Sherwin J; McArthur, David L; Del Signore, Madeline; McDonald, John S

    2011-03-01

    The purpose of this study was to measure, for the first time, multiple physiologic parameters of perfusion (pH, PCO2, PO2, and temperature) from the conjunctiva of adult patients during cardiopulmonary bypass while undergoing cardiothoracic surgery. Ten patients who underwent either intracardiac valve repair, atrial septal defect repair, or coronary artery bypass graft surgery had placement of a sensor which directly measured pH, PCO2, PO2, and temperature from the conjunctiva. Data were stratified into seven phases (0-5 minutes prior to bypass; 0-5, 6-10, and 11-15 minutes after initiation of bypass; 0-5 minutes prior to conclusion of bypass; and 0-5 and 6-10 minutes after bypass) and analyzed using a mixed model analysis.The change in conjunctival pH over the course of measurement was not statistically significant (p = .56). The PCO2 level followed a quadratic pattern, decreasing from a mean pre-bypass level of 37.7 mmHg at baseline prior to the initiation of cardiopulmonary bypass to a nadir of 33.2 mmHg, then increasing to a high of 39.4 mmHg at 6-10 minutes post bypass (p level of 79.5 mmHg to 31.3 mmHg by 6-10 minutes post bypass and even post-bypass, it never returned to baseline values (p levels as the patient was re-warmed following bypass (p < .01). There was no evidence of any eye injury or inflammation following the removal of the sensor. In the subjects studied, the conjunctival sensor yielded reproducible measurements during the various phases of cardiopulmonary bypass without ocular injury. Further study is necessary to determine the role of conjunctival measurements in critical settings.

  19. Hemodynamics Simulation of Stenosed Coronary Bypass Graft

    Institute of Scientific and Technical Information of China (English)

    LIU You-jun; QIAO Aike; DU Jian-jun

    2005-01-01

    By means of FEM, the physiological blood flow in coronary bypass graft is simulated. The stenosis in coronary artery is involved in the graft model,and the deformation of graft end to allow the surgical suture with a smaller diameter coronary is taken into consideration. The flow pattern, secondary flow and wall shear stress in the vicinity of anastomosis are analyzed. It is shown that a zone of low wall stress and high wall stress gradient exists downstream the toe. The floor opposed to the anastomosis is an area of high wall stress and high wall stress gradient. Both the toe downstream and the anastomosis bottom floor are prone to intimal hyperplasia.

  20. Sea Level Operation Demonstration of F404-GE-400 Turbofan Engine with JP-5/Bio-Fuel Mixture

    Science.gov (United States)

    2010-03-30

    Aircraft Test and Evaluation Facility Hush House at Naval Air Station Patuxent River, Maryland, on 13 October 2009. The test consisted of two separate...turbofan engine inside the Aircraft Test and Evaluation Facility Hush House at Naval Air Station Patuxent River, Maryland, on 13 October 2009. The test...turbofan engine (ESN 310810) inside the Aircraft Test and Evaluation Facility Hush House at Naval Air Station (NAS) Patuxent River, Maryland, on 13

  1. 涡扇发动机位置对外吹式增升效果影响的数值模拟%Numerical Simulation of Externally Blown Flap Effect with Different Turbofan Positions

    Institute of Scientific and Technical Information of China (English)

    史经纬; 王占学; 刘增文; 张建东

    2012-01-01

    A two-dimensional numerical simulation employing S-A model was conducted to determine the effect caused by altering the position of turbofan which is relative to the wing.Seen from numerical simulation results ,it is concluded that there are three main facts-.nozzle jet impact on the flap, ejector effect on upper surface of wing by high-speed jet from flap slot and the effect of nozzle jet pressure on the lower surface of wing .Analysis from turbofan s position relative to the wing shows that in the axial direction turbofan has a best position for a highest lift coefficient and in the vertical direction,the closer the turbofan gets to the wing,the higher the lift coefficient is.%基于CFD技术,对涡扇发动机相对机翼轴向和垂直安装位置对增升效果的影响进行了数值模拟.从数值模拟结果可以看出,涡扇发动机喷流对增升效果的影响主要体现在:喷管喷流对襟翼的冲击,流经襟翼翼缝的高速喷流对杌翼上表面气流的引射作用及喷管喷流压力对机翼下表面流动的影响等方面.从发动机相对机翼位置方面分析,发动机相对机翼的轴向位置存在一个使升力系数达到最大的最佳位置,而在垂直方向,发动机越靠近机翼升力系数越大.

  2. Current peripheral bypass surgery: various clinical studies

    NARCIS (Netherlands)

    Slaa, Alexander te

    2011-01-01

    Substantial post-operative edema occurs in the majority of patients who undergo peripheral bypass surgery due to severe peripheral arterial disease (PAD). The pathophysiological mechanisms that underlay edema formation following peripheral bypass surgery include hyperemia, an increased capillary per

  3. Current peripheral bypass surgery: various clinical studies

    NARCIS (Netherlands)

    Slaa, Alexander te

    2011-01-01

    Substantial post-operative edema occurs in the majority of patients who undergo peripheral bypass surgery due to severe peripheral arterial disease (PAD). The pathophysiological mechanisms that underlay edema formation following peripheral bypass surgery include hyperemia, an increased capillary per

  4. Perforation in the bypassed stomach following laparoscopic Roux-en-Y gastric bypass.

    Science.gov (United States)

    Papasavas, Pavlos K; Yeaney, Woodrow W; Caushaj, Philip F; Keenan, Robert J; Landreneau, Rodney J; Gagné, Daniel J

    2003-10-01

    Access to the bypassed stomach is difficult following laparoscopic Roux-en-Y gastric bypass (LRYGBP). The bypassed stomach is not readily available for endoscopic or radiographic evaluation. Diagnosis and treatment of peptic ulcer disease and its complications in the excluded stomach becomes difficult. We present a case of perforation in the bypassed stomach following LRYGBP secondary to peptic ulcer disease.

  5. 40 CFR 403.17 - Bypass.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 28 2010-07-01 2010-07-01 true Bypass. 403.17 Section 403.17... GENERAL PRE-TREAT-MENT REGULATIONS FOR EXIST-ING AND NEW SOURCES OF POLLUTION § 403.17 Bypass. (a) Definitions. (1) Bypass means the intentional diversion of wastestreams from any portion of an Industrial...

  6. Undiagnosed phaeochromocytoma following infrainguinal bypass surgery

    DEFF Research Database (Denmark)

    Levi, N; Schroeder, T V

    1998-01-01

    We present a rare case of undiagnosed phaeochromocytoma following infrainguinal bypass surgery. The patient, a 59-year-old lady, had a one year history of hypertension following a first femoro-tibial bypass and presented as a cardiorespiratory emergency in the admission room following her...... contralateral femoro-tibial bypass. The patient recovered after some days in intensive care despite a delayed diagnosis....

  7. In situ bypass og diabetes

    DEFF Research Database (Denmark)

    Jensen, Leif Panduro; Schroeder, T V; Lorentzen, J E

    1993-01-01

    From 1986 through to 1990 a total of 483 in situ bypass procedures were performed in 444 patients. Preoperative risk-factors were equally distributed among diabetic (DM) and non-diabetic (NDM) patients, except for smoking habits (DM:48%, NDM:64%, p = 0.002) and cardiac disease (DM:45%, NDM:29%, p...

  8. Deep-water sediment bypass

    NARCIS (Netherlands)

    Stevenson, Christopher J.; Jackson, Christopher A L; Hodgson, David M.; Hubbard, Stephen M.; Eggenhuisen, Joris T.

    2015-01-01

    Submarine gravity flows are a key process for transporting large volumes of sediment from the continents to the deep sea. The location, volume, and character of the sediment bypassed by these flows dictates the areal extent and thickness of the associated deposits. Despite its importance, sediment b

  9. A Comparative Performance Analysis of Low Power Bypassing Array Multipliers

    Directory of Open Access Journals (Sweden)

    Nirlakalla Ravi

    2013-07-01

    Full Text Available Low power design of VLSI circuits has been identified as vital technology in battery powered portable electronic devices and signal processing applications such as Digital Signal Processors (DSP. Multiplier has an important role in the DSPs. Without degrading the performance of the processor, low power parallel multipliers are needed to be design. Bypassing is the widely used technique in the DSPs when the input operand of the multiplier is zero. A Row based Bypassing Multiplier with compressor at the final addition of the ripple carry adder (RCA is designed to focus on low power and high speed. The proposed bypassing multiplier with compressor shows high performance and energy efficiency than Kuo multiplier with Carry Save Adder (CSA at the final RCA.

  10. "Orpheus" cardiopulmonary bypass simulation system.

    Science.gov (United States)

    Morris, Richard W; Pybus, David A

    2007-12-01

    In this paper we describe a high-fidelity perfusion simulation system intended for use in the training and continuing education of perfusionists. The system comprises a hydraulic simulator, an electronic interface unit and a controlling computer with associated real-time computer models. It is designed for use within an actual operating theatre, or within a specialized simulation facility. The hydraulic simulator can be positioned on an operating table and physically connected to the circuit of the institutional heart-lung machine. The institutional monitoring system is used to display the arterial and central venous pressures, the ECG and the nasopharyngeal temperature using appropriate connections. The simulator is able to reproduce the full spectrum of normal and abnormal events that may present during the course of cardiopulmonary bypass. The system incorporates a sophisticated blood gas model that accurately predicts the behavior of a modern, hollow-fiber oxygenator. Output from this model is displayed in the manner of an in-line blood gas electrode and is updated every 500 msecs. The perfusionist is able to administer a wide variety of drugs during a simulation session including: vasoconstrictors (metaraminol, epinephrine and phenylephrine), a vasodilator (sodium nitroprusside), chronotropes (epinephrine and atropine), an inotrope (epinephrine) and modifiers of coagulation (heparin and protamine). Each drug has a pharmacokinetic profile based on a three-compartment model plus an effect compartment. The simulation system has potential roles in the skill training of perfusionists, the development of crisis management protocols, the certification and accreditation of perfusionists and the evaluation of new perfusion equipment and/or techniques.

  11. Preliminary Evaluation of Altitude Scaling for Turbofan Engine Ice Crystal Icing

    Science.gov (United States)

    Tsao, Jen-Ching

    2017-01-01

    Preliminary evaluation of altitude scaling for turbofan engine ice crystal icing simulation was conducted during the 2015 LF11 engine icing test campaign in PSL.The results showed that a simplified approach for altitude scaling to simulate the key reference engine ice growth feature and associated icing effects to the engine is possible. But special considerations are needed to address the facility operation limitation for lower altitude engine icing simulation.

  12. 78 FR 71532 - Airworthiness Directives; Rolls-Royce Deutschland Ltd & Co KG Turbofan Engines

    Science.gov (United States)

    2013-11-29

    ...- 02 for all Rolls-Royce Deutschland (RRD) Tay 620-15, Tay 650-15, and Tay 651-54 turbofan engines. AD... on certain serial number (S/N) Tay 650-15 engines. AD 2007-03-02 also requires, for all Tay 611-8, 620-15, Tay 650-15, and Tay 651-54 engines, initial and repetitive UIs of LP compressor fan blades. AD...

  13. 78 FR 17079 - Airworthiness Directives; Rolls-Royce Deutschland Ltd & Co KG Turbofan Engines

    Science.gov (United States)

    2013-03-20

    ... Ltd & Co KG (RRD) models Tay 620-15 and Tay 650-15 turbofan engines. This AD was prompted by RRD... Mandatory Continuing Airworthiness Information states: The Tay 650-15 and Tay 650-15/10 engine Time Limits... installed in Tay 650-15 and Tay 650-15/10 engines as well as in Tay 620-15 and Tay 620-15/20 engines...

  14. 77 FR 74123 - Airworthiness Directives; Rolls-Royce Deutschland Ltd & Co KG Turbofan Engines

    Science.gov (United States)

    2012-12-13

    ... Rolls-Royce Deutschland Ltd & Co KG (RRD) models Tay 620-15 and Tay 650-15 turbofan engines. This... correct an unsafe condition for the specified products. The MCAI states: The Tay 650-15 and Tay 650-15/10... assemblies installed in Tay 650-15 and Tay 650-15/10 engines as well as in Tay 620-15 and Tay 620-15/20...

  15. Fuel temperature prediction using a variable bypass gap size in the prismatic VHTR

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sung Nam, E-mail: snlee@kaeri.re.kr; Tak, Nam-il; Kim, Min Hwan

    2016-04-15

    Highlights: • The bypass flow of the prismatic very high temperature reactor is analyzed. • The bypass gap sizes are calculated considering the effect of the neutron fluences and thermal expansion. • The fuel hot spot temperature and temperature profiles are calculated using the variable gap size. • The BOC, MOC and EOC condition at the cycle 07 and 14 are applied. - Abstract: The temperature gradient and hot spot temperatures were calculated in the prismatic very high temperature reactor as a function of the variable bypass gap size. Many previous studies have predicted the temperature of the reactor core based on a fixed bypass gap size. The graphite matrix of the assemblies in the reactor core undergoes a dimensional change during the operation due to thermal expansion and neutron fluence. The expansion and shrinkage of the bypass gaps change the coolant flow fractions into the coolant channels, the control rod holes, and the bypass gaps. Therefore, the temperature of the assemblies may differ compared to those for the fixed bypass gap case. The temperature gradient and the hot spot temperatures are important for the design of reactor structures to ensure their safety and efficiency. In the present study, the temperature variation of the PMR200 is studied at the beginning (BOC), middle (MOC), and end (EOC) of cycles 07 and 14. CORONA code which has been developed in KAERI is applied to solve the thermal-hydraulics of the reactor core of the PMR200. CORONA solves a fluid region using a one-dimensional formulation and a solid region using a three-dimensional formulation to enhance the computational speed and still obtain a reasonable accuracy. The maximum temperatures in the fuel assemblies using the variable bypass gaps did not differ much from the corresponding temperatures using the fixed bypass gaps. However, the maximum temperatures in the reflector assemblies using the variable bypass gaps differ significantly from the corresponding temperatures

  16. Bypass materials in vascular surgery

    Science.gov (United States)

    Eidt, Daniela; Roll, Stephanie; Kulp, Werner; Müller-Nordhorn, Jaqueline; Vauth, Christoph; Greiner, Wolfgang; Willich, Stefan N.; von der Schulenburg, Johann-Matthias

    2006-01-01

    Introduction Arteriosclerotic changes can lead to circulatory disturbances in various areas of the human vascular system. In addition to pharmacological therapy and the management of risk factors (e. g. hypertension, diabetes, lipid metabolism disorders, and lifestyle), surgical interventions also play an important role in the treatment of arteriosclerosis. Long-segment arterial occlusions, in particular, can be treated successfully with bypass sur-gery. A number of different materials are available for this type of operation, such as autologous vein or pros-thetic grafts comprised of polytetrafluoroethylene (PTFE) or Dacron®. Prosthetic materials are used especially in the treatment of peripheral artery disease, such as in aortoiliac or femoropopliteal bypass surgery. The present report will thus focus on this area in order to examine the effectiveness of different bypass materials. Among the efforts being made to refine the newly introduced DRG system in Germany, analysing the different bypass materials used in vascular surgery is particularly important. Indeed, in its current version the German DRG system does not distinguish between bypass materials in terms of reimbursement rates. Differences in cost structures are thus of especial interest to hospitals in their budget calculations, whereas both private and statutory health insurance funds are primarily interested in long-term results and their costs. Objectives The goal of this HTA is to compare the different bypass materials used in vascular surgery in terms of their medical efficiency and cost-effectiveness, as well as with regard to their ethical, social and legal implications. In addition, this report aims to point out the areas in which further medical, epidemiological and health economic research is still needed. Methods Relevant publications were identified by means of a structured search of databases accessed through the German Institute of Medical Documentation and Information (DIMDI), as well as by

  17. Bypass materials in vascular surgery

    Directory of Open Access Journals (Sweden)

    Willich, Stephan N.

    2006-03-01

    Full Text Available Introduction: Arteriosclerotic changes can lead to circulatory disturbances in various areas of the human vascular system. In addition to pharmacological therapy and the management of risk factors (e. g. hypertension, diabetes, lipid metabolism disorders, and lifestyle, surgical interventions also play an important role in the treatment of arteriosclerosis. Long-segment arterial occlusions, in particular, can be treated successfully with bypass sur-gery. A number of different materials are available for this type of operation, such as autologous vein or pros-thetic grafts comprised of polytetrafluoroethylene (PTFE or Dacron®. Prosthetic materials are used especially in the treatment of peripheral artery disease, such as in aortoiliac or femoropopliteal bypass surgery. The present report will thus focus on this area in order to examine the effectiveness of different bypass materials. Among the efforts being made to refine the newly introduced DRG system in Germany, analysing the different bypass materials used in vascular surgery is particularly important. Indeed, in its current version the German DRG system does not distinguish between bypass materials in terms of reimbursement rates. Differences in cost structures are thus of especial interest to hospitals in their budget calculations, whereas both private and statutory health insurance funds are primarily interested in long-term results and their costs. Objectives: The goal of this HTA is to compare the different bypass materials used in vascular surgery in terms of their medical efficiency and cost-effectiveness, as well as with regard to their ethical, social and legal implications. In addition, this report aims to point out the areas in which further medical, epidemiological and health economic research is still needed. Methods: Relevant publications were identified by means of a structured search of databases accessed through the German Institute of Medical Documentation and Information

  18. Rankine cycle load limiting through use of a recuperator bypass

    Science.gov (United States)

    Ernst, Timothy C.

    2011-08-16

    A system for converting heat from an engine into work includes a boiler coupled to a heat source for transferring heat to a working fluid, a turbine that transforms the heat into work, a condenser that transforms the working fluid into liquid, a recuperator with one flow path that routes working fluid from the turbine to the condenser, and another flow path that routes liquid working fluid from the condenser to the boiler, the recuperator being configured to transfer heat to the liquid working fluid, and a bypass valve in parallel with the second flow path. The bypass valve is movable between a closed position, permitting flow through the second flow path and an opened position, under high engine load conditions, bypassing the second flow path.

  19. Bypass Gástrico BII.

    OpenAIRE

    Himpens, Jaques

    2014-01-01

    Hay varias técnicas de bypass gástrico para la reducción del peso, la cual se decide dependiendo de la historia, hábitos dietéticos, evaluación psicológica, estado médico, reflujo gastroesofágico, diabetes. El bypass gástrico Roux-en-Y es la única opción en 50% de los pacientes debido a reflujo, diabetes o ambas. Estos pacientes tienen ciertas características como el IMC, síndrome metabólico y diabetes. Los pacientes obesos presentan mayor resistencia a la insulina, que se encuentra regulada ...

  20. Reconnaissance Report Yolo Bypass, California

    Science.gov (United States)

    1992-03-01

    proximity of these plans, a plan for one area could not be constructed separately without creating major hydraulic impacts to the other area. In essence ...native woody species which may be commonly found include eucalyptus , acacia, giant reed, and honey locust. Yolo Bypass. In the project area, vegetation...forbs form an often dense ground cover. Non- native woody species which may be commonly found include eucalyptus , acacia, giant reed and honey locust

  1. Exhaust emissions survey of a turbofan engine for flame holder swirl type augmentors at simulated altitude flight conditions

    Science.gov (United States)

    Moss, J. E., Jr.

    1981-01-01

    Emissions of carbon dioxide, total oxides of nitrogen, unburned hydrocarbons, and carbon monoxide from an F100 afterburning two spool turbofan engine at simulated flight conditions are reported. Tests were run at Mach 0.8 at altitudes of 10.97 and 13.71 km (36,000 and 45,000 ft), and at Mach 1.2 at 13.71 km (45,000 ft). Emission measurements were made from intermediate power (nonafterburning) through maximum afterburning, using a single point gas sample probe traversed across the horizontal diameter of the exhaust nozzle. The data show that emissions vary with flight speed, altitude, power level, and radial position across the nozzle. Carbon monoxide emissions were low for intermediate and partial afterburning power. Unburned hydrocarbons were near zero for most of the simulated flight conditions. At maximum afterburning, there were regions of NOx deficiency in regions of high CO. The results suggest that the low NOx levels observed in the tests are a result of interaction with high CO in the thermal converter. CO2 emissions were proportional to local fuel air ratio for all test conditions.

  2. Prediction of bypass transition with differential Reynolds stress models

    NARCIS (Netherlands)

    Westin, K.J.A.; Henkes, R.A.W.M.

    1998-01-01

    Boundary layer transition induced by high levels of free stream turbulence (FSl), so called bypass transition, can not be predicted with conventional stability calculations (e.g. the en-method). The use of turbulence models for transition prediction has shown some success for this type of flows, and

  3. Gastric cancer after mini-gastric bypass surgery: a case report and literature review.

    Science.gov (United States)

    Wu, Chun-Chi; Lee, Wei-Jei; Ser, Kong-Han; Chen, Jung-Chien; Tsou, Jun-Juin; Chen, Shu-Chun; Kuan, Wai-Sang

    2013-11-01

    Gastric cancer in the stomach after Roux-en-Y gastric bypass or mini-gastric bypass is rare, but a few cases have been reported since 1991, when the first case emerged. According to the literature, the interval between bypass surgery and the diagnosis of cancer ranged from 1 to 22 years. Given the difficulty of monitoring a bypassed stomach, the potential for gastric cancer must be considered, especially in countries with high incidence of this cancer. The literature reported the first case in the Asia-Pacific region - a woman developed advanced gastric cancer in her stomach 9 years after laparoscopic mini-gastric bypass for morbid obesity. © 2013 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

  4. The efficacy, safety and cost-effectiveness of intra-operative cell salvage in high-bleeding-risk cardiac surgery with cardiopulmonary bypass: a prospective randomized and controlled trial.

    Science.gov (United States)

    Xie, Yihong; Shen, Sheliang; Zhang, Jun; Wang, Wenyuan; Zheng, Jiayin

    2015-01-01

    Intra-operative cell salvage (CS) was reported to be ineffective, safe and not cost-effective in low-bleeding-risk cardiac surgery with cardiopulmonary bypass (CPB), but studies in high-bleeding-risk cardiac surgery are limited. The objective of this study is to evaluate the efficacy, safety and cost-effectiveness of intra-operative CS in high-bleeding-risk cardiac surgery with CPB. One hundred and fifty patients were randomly assigned to either with intra-operative CS group (Group CS) or without intra-operative CS group (Group C). Study endpoints were defined as perioperative allogeneic red blood cell (RBC) transfusion, perioperative impairment of blood coagulative function, postoperative adverse events and costs of transfusion-related. Both the proportion and quantity of perioperative allogeneic RBC transfusion were significantly lower in Group CS than that in Group C (p=0.0002, after surgery, the incidence of postoperative excessive bleeding, were significantly higher in Group CS than that in Group C (p=0.018, 0.042, 0.034, respectively). Cost of both allogeneic RBC transfusion and total allogeneic blood transfusion were significantly lower in Group CS than that in Group C (pbleeding-risk cardiac surgery with CPB is effective, generally safe, and cost-effective in developed countries but not in China.

  5. Bypass system modification at Bonneville Dam on the Columbia River improved the survival of juvenile salmon

    Science.gov (United States)

    Ferguson, J.W.; Sandford, B.P.; Reagan, R.E.; Gilbreath, L.G.; Meyer, E.B.; Ledgerwood, R.D.; Adams, N.S.

    2007-01-01

    From 1987 to 1992, we evaluated a fish bypass system at Bonneville Dam Powerhouse 2 on the Columbia River. The survival of subyearling Chinook salmon Oncorhynchus tshawytscha released into the system ranged from 0.774 to 0.911 and was significantly lower than the survival of test fish released into turbines and the area immediately below the powerhouse where bypass system flow reentered the river. Yearling and subyearling Chinook salmon and yearling coho salmon O. kisutch released into the bypass system were injured or descaled. Also, levels of blood plasma cortisol and lactate were significantly higher in yearling and subyearling Chinook salmon that passed through the bypass system than in fish released directly into a net located over the bypass exit. This original system was then extensively modified using updated design criteria, and the site where juvenile fish reentered the river was relocated 2.8 km further downstream to reduce predation on bypassed fish by northern pikeminnow Ptychocheilus oregonensis. Based on studies conducted from 1999 to 2001, the new bypass system resulted in high fish survival, virtually no injuries to fish, fish passage times that were generally similar to water travel times, and mild stress responses from which fish recovered quickly. The mean estimated survival of subyearling Chinook salmon passing through the new bypass system was 0.946 in 2001, which was an usually low-flow year. Survival, physical condition, passage timing, and blood physiological indicators of stress were all useful metrics for assessing the performance of both bypass systems and are discussed. The engineering and hydraulic criteria used to design the new bypass system that resulted in improved fish passage conditions are described.

  6. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass coronary pressure gauge... Cardiopulmonary bypass coronary pressure gauge. (a) Identification. A cardiopulmonary bypass coronary pressure... the coronary arteries. (b) Classification. Class II (performance standards). ...

  7. Development of dynamic simulation of TF34-GE-100 turbofan engine with post-stall capability

    Science.gov (United States)

    Krosel, S. M.

    1984-01-01

    This paper describes the development of a hybrid computer simulation of a TF34-GE-100 turbofan engine with post-stall capability. The simulation operates in real-time and will be used to test and evaluate stall recovery control modes for this engine. The simulation calculations are performed by an analog computer with a peripheral multivariable function generation unit used for computing bivariate functions. Tabular listings of simulation variables are obtained by interfacing to a digital computer and using a custom software package for data collection and display.

  8. Coronary Artery Bypass in Octogenarians

    Directory of Open Access Journals (Sweden)

    Chen-Yen Chien

    2012-09-01

    Full Text Available Prevalence of coronary artery disease (CAD has increased with the expansion of life span among the elderly population in the world. Hence, the issue of the coronary artery bypass in octogenarians has attracted more attention. Recent literature about the topic revealed nearly the same excellent results as those in the younger population under the newly developed operative techniques and improving concept in perioperative management and postoperative care. In this article, we review the current status of the procedure that was thought to be dangerous in the earlier era, including its risk factors, result, and benefit.

  9. History of cardiopulmonary bypass (CPB).

    Science.gov (United States)

    Hessel, Eugene A

    2015-06-01

    The development of cardiopulmonary bypass (CPB), thereby permitting open-heart surgery, is one of the most important advances in medicine in the 20th century. Many currently practicing cardiac anesthesiologists, cardiac surgeons, and perfusionists are unaware of how recently it came into use (60 years) and how much the practice of CPB has changed during its short existence. In this paper, the development of CPB and the many changes and progress that has taken place over this brief period of time, making it a remarkably safe endeavor, are reviewed. The many as yet unresolved questions are also identified, which sets the stage for the other papers in this issue of this journal.

  10. Gut hormones and gastric bypass

    DEFF Research Database (Denmark)

    Holst, Jens J.

    2016-01-01

    , oxyntomodulin, neurotensin and peptide YY (PYY). However, some proximal hormones also show changes probably reflecting that the distribution of these hormones is not restricted to the bypassed segments of the gut. Thus, cholecystokinin responses are increased, whereas gastric inhibitory polypeptide responses......%. The increased insulin responses after the operation, one of the important mechanisms whereby these operations cause diabetes remission, is clearly due to a combination of the increased glucose absorption rates and the exaggerated GLP-1 secretion. The hormonal changes are therefore very important...

  11. Li-Ion Battery By-Pass Removal Qualification

    Science.gov (United States)

    Borthomieu, Y.; Pasquier, E.

    2005-05-01

    The reasons of the by-pass use on Space batteries is to avoid open circuit, short-circuit and dramatic performances drift on the power system. By-pass diodes are currently used in NiH2 batteries due to the high probability of open circuit at cell level. This probability is mainly linked to the possibility to have a hydrogen leak within the pressure vessel due to the high operating pressure (70 bars) that can induce cell open circuit. For the Lithium-Ion batteries, first items had bypass implemented by similarity, but: All the cell failure cases have been analyzed at battery level: - Cell Open circuit: In contrast to NiCd and NiH2 cells, Li-Ion cells can be put in parallel due to the fact the open circuit voltage (OCV) is linked to the State Of Charge (SOC). With cells in parallel, a battery open circuit failure can never be encountered even with a cell in open circuit. - Cell Short circuit: In case of cell short, the entire cells within the module will be shorted. - Cell capacity spread: If the capacities of cells in series are strongly diverging, the worst module limits the battery. In case the battery is no more able to deliver the requested power for which it was designed, the worst module has to be reversed. In reversal, a Li-Ion cell is self-shorted. So, the strong capacity decrease in one module leads to the short of this module. These three failure cases cover all the possible Li-Ion failure root causes. Considering these three events, the analysis demonstrates that the Li-Ion battery still functions in any case without any by-pass system because the design of the battery size always takes into account the loss of one module. Nevertheless, the by-pass removal should allow to: - Improve the battery reliability as each bypass unit represents a single - Reduce by at least 30 % of the total price of the battery, - Reduce significant weight at battery level, - Shorten the battery manufacturing lead time (at least 8 months for by-pass purchasing), - Avoid US

  12. Epicardial ultrasound in coronary artery bypass surgery

    NARCIS (Netherlands)

    Budde, R.P.J.

    2005-01-01

    Chapter 1 Coronary artery bypass surgery (CABG) is traditionally performed via a median sternotomy approach on cardiopulmonary bypass (arrested heart). Since the mid 1990ties, beating heart, minimally invasive and even totally endoscopic CABG are (re)explored. In all approaches to CABG, the

  13. Multimodality imaging of coronary artery bypass grafts

    NARCIS (Netherlands)

    Salm, Liesbeth Pauline

    2006-01-01

    This thesis describes multiple imaging modalities to examine coronary artery bypass grafts, and the research which was performed to further develop noninvasive imaging techniques to detect stenoses in native coronary arteries and bypass grafts in patients who experienced recurrent chest pain after

  14. Multimodality imaging of coronary artery bypass grafts

    NARCIS (Netherlands)

    Salm, Liesbeth Pauline

    2006-01-01

    This thesis describes multiple imaging modalities to examine coronary artery bypass grafts, and the research which was performed to further develop noninvasive imaging techniques to detect stenoses in native coronary arteries and bypass grafts in patients who experienced recurrent chest pain after c

  15. [Cardiopulmonary bypass in cardiac surgery].

    Science.gov (United States)

    Baehner, T; Boehm, O; Probst, C; Poetzsch, B; Hoeft, A; Baumgarten, G; Knuefermann, P

    2012-10-01

    Cardiopulmonary bypass (CPB) is a standard procedure in cardiac surgery; however, apart from its therapeutic options a CPB might also initiate systemic and organ-specific complications, such as heart failure, renal and pulmonary dysfunction, impaired coagulation as well as neurological and cognitive dysfunction. The immunological response to the extracorporeal circulation generates systemic inflammation which often meets the definition of systemic inflammatory response syndrome (SIRS). The main inducers of SIRS are contact of blood with the artificial surfaces of the CPB, mechanical stress which affects the blood components and the extensive surgical trauma. Hence, a number of technical and surgical developments aim at reduction of the inflammatory response caused by the CPB. By reason of surgical demands, the majority of cardiothoracic procedures still depend on the use of CPB; however, there is an on-going development of new techniques trying to reduce the surgical trauma and the negative consequences of CPB. Here, minimized systems with biocompatible surfaces have been shown to be effective in attenuating the inflammatory response to CPB. Alternative procedures such as off-pump surgery may help to avoid CPB-associated complications but due to specific limitations will not replace conventional bypass surgery.

  16. PV modules without bypass diodes; PV-Module ohne Bypass-Dioden? - Untersuchungen an einer PV-Fassade

    Energy Technology Data Exchange (ETDEWEB)

    Laukamp, H.; Kresse, A.; Leithold, W. [Fraunhofer-Institut fuer Solare Energiesysteme (ISE), Freiburg im Breisgau (Germany)]|[Ingenieurbuero A. Kresse, Karlsruhe (Germany)]|[Solare Systemtechnik GmbH, Freiburg (Germany)

    1998-12-01

    In order to protect solar modules against high output losses with non-homogeneous irradiation, bypass diodes which are mostly accommodated in the module connection socket are used. One would often gladly dispense with these connection sockets for integration of customer-specific large modules in facades. The question: ``Where will the diodes go?`` must then be satisfactorily answered. Both laminating the diodes in the module and their external accommodation cause extra expense elsewhere. It would be ideal if one could dispense with the bypass diodes altogether. This article tries to answer the question, in what conditions this is possible. Starting from the PV facade `Freiburg solar centre`, where one dispensed with the protective diodes, investigations are carried out experimentally and by means of simulation calculations. [Deutsch] Um Solarmodule bei inhomogener Bestrahlung vor hohen Verlustleistungen zu schuetzen, werden ueblicherweise Bypass-Dioden eingesetzt, die zumeist in der Modulanschlussdose untergebracht sind. Zur Fassadenintegration von kundenspezifischen Grossmodulen wuerde man manchmal gerne auf die Anschlussdosen verzichten. Hierfuer muesste zunaechst die Frage `wohin mit den Dioden?` befriedigend beantwortet werden. Sowohl die Einlaminierung der Dioden in das Modul, als auch deren externe Unterbringung versursachen an anderer Stelle einen erhoehten Aufwand. Ideal waere es, wenn man auf die Bypass-Dioden ganz verzichten koennte. Die vorliegende Arbeit versucht die Frage zu beantworten, unter welchen Bedingungen dies moeglich ist. Ausgehend von der PV-Fassade `Solarzentrum Freiburg` - hier wurde auf den Einsatz von Schutzdioden verzichtet - werden experimentell und mittels Simulationsrechnungen Untersuchungen durchgefuehrt. (orig./RHM)

  17. 75 FR 69611 - Airworthiness Directives; Rolls-Royce plc RB211-Trent 768, 772, and 772B Turbofan Engines

    Science.gov (United States)

    2010-11-15

    ... Directives; Rolls-Royce plc RB211-Trent 768, 772, and 772B Turbofan Engines AGENCY: Federal Aviation... require the same initial and repetitive visual inspections of Rolls-Royce plc RB211-Trent 768 and 772... directive (AD) 98-09-27, Amendment 39-10508 (63 FR 24911, May 6, 1998): Rolls-Royce plc: Docket No....

  18. 76 FR 40217 - Airworthiness Directives; Rolls-Royce plc (RR) RB211-524 Series Turbofan Engines

    Science.gov (United States)

    2011-07-08

    ...; AD 2011-13-01] RIN 2120-AA64 Airworthiness Directives; Rolls-Royce plc (RR) RB211-524 Series Turbofan... plc (RR): Amendment 39-16724; Docket No. FAA- 2011-0624; Directorate Identifier 2010-NE-11-AD.... (2) For service information identified in this AD, contact Rolls-Royce plc, P.O. Box 31, Derby,...

  19. Demonstration of a Packaged Capacitive Pressure Sensor System Suitable for Jet Turbofan Engine Health Monitoring

    Science.gov (United States)

    Scardelletti, Maximilian C.; Jordan, Jennifer L.; Meredith, Roger D.; Harsh, Kevin; Pilant, Evan; Usrey, Michael W.; Beheim, Glenn M.; Hunter, Gary W.; Zorman, Christian A.

    2016-01-01

    In this paper, the development and characterization of a packaged pressure sensor system suitable for jet engine health monitoring is demonstrated. The sensing system operates from 97 to 117 MHz over a pressure range from 0 to 350 psi and a temperature range from 25 to 500 deg. The sensing system consists of a Clapp-type oscillator that is fabricated on an alumina substrate and is comprised of a Cree SiC MESFET, MIM capacitors, a wire-wound inductor, chip resistors and a SiCN capacitive pressure sensor. The pressure sensor is located in the LC tank circuit of the oscillator so that a change in pressure causes a change in capacitance, thus changing the resonant frequency of the sensing system. The chip resistors, wire-wound inductors and MIM capacitors have all been characterized at temperature and operational frequency, and perform with less than 5% variance in electrical performance. The measured capacitive pressure sensing system agrees very well with simulated results. The packaged pressure sensing system is specifically designed to measure the pressure on a jet turbofan engine. The packaged system can be installed by way of borescope plug adaptor fitted to a borescope port exposed to the gas path of a turbofan engine.

  20. Certain Type Turbofan Engine Whole Vibration Model with Support Looseness Fault and Casing Response Characteristics

    Directory of Open Access Journals (Sweden)

    H. F. Wang

    2014-01-01

    Full Text Available Support looseness fault is a type of common fault in aeroengine. Serious looseness fault would emerge under larger unbalanced force, which would cause excessive vibration and even lead to rubbing fault, so it is important to analyze and recognize looseness fault effectively. In this paper, based on certain type turbofan engine structural features, a rotor-support-casing whole model for certain type turbofan aeroengine is established. The rotor and casing systems are modeled by means of the finite element beam method; the support systems are modeled by lumped-mass model; the support looseness fault model is also introduced. The coupled system response is obtained by numerical integral method. In this paper, based on the casing acceleration signals, the impact characteristics of symmetrical stiffness and asymmetric stiffness models are analyzed, finding that the looseness fault would lead to the longitudinal asymmetrical characteristics of acceleration time domain wave and the multiple frequency characteristics, which is consistent with the real trial running vibration signals. Asymmetric stiffness looseness model is verified to be fit for aeroengine looseness fault model.

  1. Load Sharing Behavior of Star Gearing Reducer for Geared Turbofan Engine

    Science.gov (United States)

    Mo, Shuai; Zhang, Yidu; Wu, Qiong; Wang, Feiming; Matsumura, Shigeki; Houjoh, Haruo

    2017-07-01

    Load sharing behavior is very important for power-split gearing system, star gearing reducer as a new type and special transmission system can be used in many industry fields. However, there is few literature regarding the key multiple-split load sharing issue in main gearbox used in new type geared turbofan engine. Further mechanism analysis are made on load sharing behavior among star gears of star gearing reducer for geared turbofan engine. Comprehensive meshing error analysis are conducted on eccentricity error, gear thickness error, base pitch error, assembly error, and bearing error of star gearing reducer respectively. Floating meshing error resulting from meshing clearance variation caused by the simultaneous floating of sun gear and annular gear are taken into account. A refined mathematical model for load sharing coefficient calculation is established in consideration of different meshing stiffness and supporting stiffness for components. The regular curves of load sharing coefficient under the influence of interactions, single action and single variation of various component errors are obtained. The accurate sensitivity of load sharing coefficient toward different errors is mastered. The load sharing coefficient of star gearing reducer is 1.033 and the maximum meshing force in gear tooth is about 3010 N. This paper provides scientific theory evidences for optimal parameter design and proper tolerance distribution in advanced development and manufacturing process, so as to achieve optimal effects in economy and technology.

  2. A Comparison of Hybrid Approaches for Turbofan Engine Gas Path Fault Diagnosis

    Science.gov (United States)

    Lu, Feng; Wang, Yafan; Huang, Jinquan; Wang, Qihang

    2016-09-01

    A hybrid diagnostic method utilizing Extended Kalman Filter (EKF) and Adaptive Genetic Algorithm (AGA) is presented for performance degradation estimation and sensor anomaly detection of turbofan engine. The EKF is used to estimate engine component performance degradation for gas path fault diagnosis. The AGA is introduced in the integrated architecture and applied for sensor bias detection. The contributions of this work are the comparisons of Kalman Filters (KF)-AGA algorithms and Neural Networks (NN)-AGA algorithms with a unified framework for gas path fault diagnosis. The NN needs to be trained off-line with a large number of prior fault mode data. When new fault mode occurs, estimation accuracy by the NN evidently decreases. However, the application of the Linearized Kalman Filter (LKF) and EKF will not be restricted in such case. The crossover factor and the mutation factor are adapted to the fitness function at each generation in the AGA, and it consumes less time to search for the optimal sensor bias value compared to the Genetic Algorithm (GA). In a word, we conclude that the hybrid EKF-AGA algorithm is the best choice for gas path fault diagnosis of turbofan engine among the algorithms discussed.

  3. Constrained Kalman Filtering Via Density Function Truncation for Turbofan Engine Health Estimation

    Science.gov (United States)

    Simon, Dan; Simon, Donald L.

    2006-01-01

    Kalman filters are often used to estimate the state variables of a dynamic system. However, in the application of Kalman filters some known signal information is often either ignored or dealt with heuristically. For instance, state variable constraints (which may be based on physical considerations) are often neglected because they do not fit easily into the structure of the Kalman filter. This paper develops an analytic method of incorporating state variable inequality constraints in the Kalman filter. The resultant filter truncates the PDF (probability density function) of the Kalman filter estimate at the known constraints and then computes the constrained filter estimate as the mean of the truncated PDF. The incorporation of state variable constraints increases the computational effort of the filter but significantly improves its estimation accuracy. The improvement is demonstrated via simulation results obtained from a turbofan engine model. The turbofan engine model contains 3 state variables, 11 measurements, and 10 component health parameters. It is also shown that the truncated Kalman filter may be a more accurate way of incorporating inequality constraints than other constrained filters (e.g., the projection approach to constrained filtering).

  4. Load Sharing Behavior of Star Gearing Reducer for Geared Turbofan Engine

    Science.gov (United States)

    Mo, Shuai; Zhang, Yidu; Wu, Qiong; Wang, Feiming; Matsumura, Shigeki; Houjoh, Haruo

    2017-03-01

    Load sharing behavior is very important for power-split gearing system, star gearing reducer as a new type and special transmission system can be used in many industry fields. However, there is few literature regarding the key multiple-split load sharing issue in main gearbox used in new type geared turbofan engine. Further mechanism analysis are made on load sharing behavior among star gears of star gearing reducer for geared turbofan engine. Comprehensive meshing error analysis are conducted on eccentricity error, gear thickness error, base pitch error, assembly error, and bearing error of star gearing reducer respectively. Floating meshing error resulting from meshing clearance variation caused by the simultaneous floating of sun gear and annular gear are taken into account. A refined mathematical model for load sharing coefficient calculation is established in consideration of different meshing stiffness and supporting stiffness for components. The regular curves of load sharing coefficient under the influence of interactions, single action and single variation of various component errors are obtained. The accurate sensitivity of load sharing coefficient toward different errors is mastered. The load sharing coefficient of star gearing reducer is 1.033 and the maximum meshing force in gear tooth is about 3010 N. This paper provides scientific theory evidences for optimal parameter design and proper tolerance distribution in advanced development and manufacturing process, so as to achieve optimal effects in economy and technology.

  5. W-8 Acoustic Casing Treatment Test Overview

    Science.gov (United States)

    Bozak, Rick; Podboy, Gary; Dougherty, Robert

    2017-01-01

    During February 2017, aerodynamic and acoustic testing was performed on a scale-model high bypass ratio turbofan rotor, R4, in an internal flow component test facility. An overview of the testing completed is presented.

  6. Particles deposition induced by the magnetic field in the coronary bypass graft model

    Energy Technology Data Exchange (ETDEWEB)

    Bernad, Sandor I., E-mail: sandor.bernad@upt.ro [Centre of Advanced Research in Engineering Sciences, Romanian Academy, Timisoara Branch, 300223 Timisoara (Romania); Totorean, Alin F. [Department of Mechanical Machines, Equipment and Transportation, Politehnica University of Timisoara, RO-300222 Timisoara (Romania); Vekas, Ladislau, E-mail: vekas.ladislau@gmail.com [Centre of Advanced Research in Engineering Sciences, Romanian Academy, Timisoara Branch, 300223 Timisoara (Romania)

    2016-03-01

    Bypass graft failures is a complex process starting with intimal hyperplasia development which involve many hemodynamic and biological factors. This work presents experimental results regarding the possibility to use magnetic drug delivery to prevent the development of the intimal hyperplasia using a simplified but intuitive model. The primary goal is to understand the magnetic particle deposition in the anastomosis region of the bypass graft taking into account the complex flow field created in this area which involves recirculation region, flow mixing and presence of particles with high residence time. The three-dimensional geometry model was used to simulate the motion and accumulation of the particles under the magnetic field influence in anastomotic region of the coronary bypass graft. The flow patterns are evaluated both numerically and experimentally and show a good correlation in term of flow parameters like vortex length and flow stagnation point positions. Particle depositions are strongly dependent on the magnet position and consequently of the magnetic field intensity and field gradient. Increased magnetic field controlled by the magnet position induces increased particle depositions in the bypass graft anastomosis. The result shows that particle depositions depend on the bypass graft angle, and the deposition shape and particle accumulation respectively, depend by the flow pattern in the anastomosis region. - Highlights: • Particularity of the particle targeting in the bypass graft anastomosis. • Hemodynamic characteristics influence about the particle deposition. • Particle accumulation induces changes of the flow field in the graft anastomosis. • Bypass graft geometries influence the particle deposition.

  7. Pre-test CFD Calculations for a Bypass Flow Standard Problem

    Energy Technology Data Exchange (ETDEWEB)

    Rich Johnson

    2011-11-01

    The bypass flow in a prismatic high temperature gas-cooled reactor (HTGR) is the flow that occurs between adjacent graphite blocks. Gaps exist between blocks due to variances in their manufacture and installation and because of the expansion and shrinkage of the blocks from heating and irradiation. Although the temperature of fuel compacts and graphite is sensitive to the presence of bypass flow, there is great uncertainty in the level and effects of the bypass flow. The Next Generation Nuclear Plant (NGNP) program at the Idaho National Laboratory has undertaken to produce experimental data of isothermal bypass flow between three adjacent graphite blocks. These data are intended to provide validation for computational fluid dynamic (CFD) analyses of the bypass flow. Such validation data sets are called Standard Problems in the nuclear safety analysis field. Details of the experimental apparatus as well as several pre-test calculations of the bypass flow are provided. Pre-test calculations are useful in examining the nature of the flow and to see if there are any problems associated with the flow and its measurement. The apparatus is designed to be able to provide three different gap widths in the vertical direction (the direction of the normal coolant flow) and two gap widths in the horizontal direction. It is expected that the vertical bypass flow will range from laminar to transitional to turbulent flow for the different gap widths that will be available.

  8. Cardiopulmonary Bypass and Oxidative Stress

    Directory of Open Access Journals (Sweden)

    Mustafa Zakkar

    2015-01-01

    Full Text Available The development of the cardiopulmonary bypass (CPB revolutionized cardiac surgery and contributed immensely to improved patients outcomes. CPB is associated with the activation of different coagulation, proinflammatory, survival cascades and altered redox state. Haemolysis, ischaemia, and perfusion injury and neutrophils activation during CPB play a pivotal role in oxidative stress and the associated activation of proinflammatory and proapoptotic signalling pathways which can affect the function and recovery of multiple organs such as the myocardium, lungs, and kidneys and influence clinical outcomes. The administration of agents with antioxidant properties during surgery either intravenously or in the cardioplegia solution may reduce ROS burst and oxidative stress during CPB. Alternatively, the use of modified circuits such as minibypass can modify both proinflammatory responses and oxidative stress.

  9. 高流量颅内-外血管搭桥术治疗复杂性颅内动脉瘤%High-flow extracranial-intracranial bypass for complex intracranial aneurysms

    Institute of Scientific and Technical Information of China (English)

    陈风华; 张隆伯; 宋涛; 刘宏伟; 黄军; 王君宇

    2016-01-01

    Objective To summarize the efficacy and experiences of high-flow extracranialintracranial bypass for complex intracranial aneurysms.Methods From August 2010 to August 2015,the clinical data of 55 patients with intracranial aneurysm treated with high-flow extracranial-intracranial bypasses at the Department of Neurosurgery,Xiangya Hospital,Central South University were analyzed retrospectively.Fifteen patients conducted balloon occlusion test (BOT) before procedure,and 11 of them could not tolerate it.The grafts were the radial artery,the calf or thigh saphenous vein segment;the feeding arteries were common carotid (external)) artery,maxillary artery,and superficial temporal artery trunk;the middle cerebral arteries were the blood reception arteries in anterior circulation;the posterior cerebral arteries were the blood reception arteries in posterior circulation.Results There were no death in this group of patients.The grafts of all patients were patent at day 1 after procedure.One patient had hemiplegia immediately after surgery.CT scan revealed that a small infarct was in the basal ganglia region.The muscle strength reached grade Ⅲ-Ⅳ at day 8 after surgery.The grafts (saphenous vein of the calf segment) of 2 patients were occluded at day 3 and day 4 without symptoms.The graft (radial artery) of 1 patient was occluded at day 25 after procedure.Fortythree patients were followed up for 6 months to 52 months.The grafts (saphenous veins of the calf segment) of 2 patients were occluded at 6 months after procedure without any symptoms.In 5 patients with the graft occlusion did not conduct BOT.Conclusions High-flow extracranial-intracranial bypass for the treatment of complex intracranial aneurysms is effective.All the selected feeding vessels meet the requirements of blood supply.Graft occlusion may occur early or late after surgery.As grafts,both the saphenous vein of the calf segment and radial artery are more prone to occlusion.If they are well compensated

  10. Modeling of a Turbofan Engine with Ice Crystal Ingestion in the NASA Propulsion System Laboratory

    Science.gov (United States)

    Veres, Joseph P.; Jorgenson, Philip C. E.; Jones, Scott M.; Nili, Samaun

    2017-01-01

    The main focus of this study is to apply a computational tool for the flow analysis of the turbine engine that has been tested with ice crystal ingestion in the Propulsion Systems Laboratory (PSL) at NASA Glenn Research Center. The PSL has been used to test a highly instrumented Honeywell ALF502R-5A (LF11) turbofan engine at simulated altitude operating conditions. Test data analysis with an engine cycle code and a compressor flow code was conducted to determine the values of key icing parameters, that can indicate the risk of ice accretion, which can lead to engine rollback (un-commanded loss of engine thrust). The full engine aerothermodynamic performance was modeled with the Honeywell Customer Deck specifically created for the ALF502R-5A engine. The mean-line compressor flow analysis code, which includes a code that models the state of the ice crystal, was used to model the air flow through the fan-core and low pressure compressor. The results of the compressor flow analyses included calculations of the ice-water flow rate to air flow rate ratio (IWAR), the local static wet bulb temperature, and the particle melt ratio throughout the flow field. It was found that the assumed particle size had a large effect on the particle melt ratio, and on the local wet bulb temperature. In this study the particle size was varied parametrically to produce a non-zero calculated melt ratio in the exit guide vane (EGV) region of the low pressure compressor (LPC) for the data points that experienced a growth of blockage there, and a subsequent engine called rollback (CRB). At data points where the engine experienced a CRB having the lowest wet bulb temperature of 492 degrees Rankine at the EGV trailing edge, the smallest particle size that produced a non-zero melt ratio (between 3 percent - 4 percent) was on the order of 1 micron. This value of melt ratio was utilized as the target for all other subsequent data points analyzed, while the particle size was varied from 1 micron - 9

  11. Anesthetic considerations for the patients with off-pump coronary artery bypass grafting

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    New surgical techniques for coronary artery bypass graft (CABG) have been explored in order to minimize disfiguring scars, avoid cardiopulmonary bypass and decrease hospital residence and costs etc. Improved surgical expertise can perform the procedures in some high-risk patients such as poor left ventricular function, redo CABG, advanced age and renal dysfunction etc. Intraoperatively there is an obligatory period of myocardial ischemia, which may lead to significant hemodynamic consequences. It is a quite challenge to anesthetist in managing the intraoperative patient.

  12. Numerical Simulation of Oil Jet Lubrication for High Speed Gears

    Directory of Open Access Journals (Sweden)

    Tommaso Fondelli

    2015-01-01

    Full Text Available The Geared Turbofan technology is one of the most promising engine configurations to significantly reduce the specific fuel consumption. In this architecture, a power epicyclical gearbox is interposed between the fan and the low pressure spool. Thanks to the gearbox, fan and low pressure spool can turn at different speed, leading to higher engine bypass ratio. Therefore the gearbox efficiency becomes a key parameter for such technology. Further improvement of efficiency can be achieved developing a physical understanding of fluid dynamic losses within the transmission system. These losses are mainly related to viscous effects and they are directly connected to the lubrication method. In this work, the oil injection losses have been studied by means of CFD simulations. A numerical study of a single oil jet impinging on a single high speed gear has been carried out using the VOF method. The aim of this analysis is to evaluate the resistant torque due to the oil jet lubrication, correlating the torque data with the oil-gear interaction phases. URANS calculations have been performed using an adaptive meshing approach, as a way of significantly reducing the simulation costs. A global sensitivity analysis of adopted models has been carried out and a numerical setup has been defined.

  13. 30 CFR 57.19018 - Overtravel by-pass switches.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Overtravel by-pass switches. 57.19018 Section... Hoisting Hoists § 57.19018 Overtravel by-pass switches. When an overtravel by-pass switch is installed, the... switch is held in the closed position by the hoistman. The overtravel by-pass switch shall...

  14. 30 CFR 56.19018 - Overtravel by-pass switches.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Overtravel by-pass switches. 56.19018 Section... Hoisting Hoists § 56.19018 Overtravel by-pass switches. When an overtravel by-pass switch is installed, the... switch is held in the closed position by the hoistman. The overtravel by-pass switch shall...

  15. 34 CFR 76.677 - Continuation of a bypass.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Continuation of a bypass. 76.677 Section 76.677... Be Met by the State and Its Subgrantees? Procedures for Bypass § 76.677 Continuation of a bypass. The Secretary continues a bypass until the Secretary determines that the grantee or subgrantee will meet...

  16. Human gut microbiota in obesity and after gastric bypass.

    Science.gov (United States)

    Zhang, Husen; DiBaise, John K; Zuccolo, Andrea; Kudrna, Dave; Braidotti, Michele; Yu, Yeisoo; Parameswaran, Prathap; Crowell, Michael D; Wing, Rod; Rittmann, Bruce E; Krajmalnik-Brown, Rosa

    2009-02-17

    Recent evidence suggests that the microbial community in the human intestine may play an important role in the pathogenesis of obesity. We examined 184,094 sequences of microbial 16S rRNA genes from PCR amplicons by using the 454 pyrosequencing technology to compare the microbial community structures of 9 individuals, 3 in each of the categories of normal weight, morbidly obese, and post-gastric-bypass surgery. Phylogenetic analysis demonstrated that although the Bacteria in the human intestinal community were highly diverse, they fell mainly into 6 bacterial divisions that had distinct differences in the 3 study groups. Specifically, Firmicutes were dominant in normal-weight and obese individuals but significantly decreased in post-gastric-bypass individuals, who had a proportional increase of Gammaproteobacteria. Numbers of the H(2)-producing Prevotellaceae were highly enriched in the obese individuals. Unlike the highly diverse Bacteria, the Archaea comprised mainly members of the order Methanobacteriales, which are H(2)-oxidizing methanogens. Using real-time PCR, we detected significantly higher numbers of H(2)-utilizing methanogenic Archaea in obese individuals than in normal-weight or post-gastric-bypass individuals. The coexistence of H(2)-producing bacteria with relatively high numbers of H(2)-utilizing methanogenic Archaea in the gastrointestinal tract of obese individuals leads to the hypothesis that interspecies H(2) transfer between bacterial and archaeal species is an important mechanism for increasing energy uptake by the human large intestine in obese persons. The large bacterial population shift seen in the post-gastric-bypass individuals may reflect the double impact of the gut alteration caused by the surgical procedure and the consequent changes in food ingestion and digestion.

  17. Coronary Bypass Surgery in a 105-Year-Old Patient with Cardiopulmonary Bypass

    Directory of Open Access Journals (Sweden)

    Temucin Noyan Ogus

    2010-01-01

    Full Text Available Coronary artery bypass grafting is one of the routine daily surgical procedures in the current era. Parallel to the increasing life expectancy, cardiac surgery is commonly performed in octogenarians. However, literature consists of only seldom reports of coronary artery bypass grafting in patients above 90 years of age. In this report, we present our management strategy in a 105-year-old patient who underwent coronary artery bypass grafting at our institution.

  18. Exhaust gas bypass valve control for thermoelectric generator

    Science.gov (United States)

    Reynolds, Michael G; Yang, Jihui; Meisner, Greogry P.; Stabler, Francis R.; De Bock, Hendrik Pieter Jacobus; Anderson, Todd Alan

    2012-09-04

    A method of controlling engine exhaust flow through at least one of an exhaust bypass and a thermoelectric device via a bypass valve is provided. The method includes: determining a mass flow of exhaust exiting an engine; determining a desired exhaust pressure based on the mass flow of exhaust; comparing the desired exhaust pressure to a determined exhaust pressure; and determining a bypass valve control value based on the comparing, wherein the bypass valve control value is used to control the bypass valve.

  19. Doppler spectral characteristics of infrainguinal vein bypasses

    DEFF Research Database (Denmark)

    Nielsen, Tina G; von Jessen, F; Sillesen, H

    1993-01-01

    With the aim of assessing the velocity profile of femoropopliteal and femorocrural vein bypasses, 128 patients undergoing infrainguinal vein bypass surgery entered a postoperative Duplex surveillance protocol, which included clinical assessment and Duplex scanning, using Doppler spectral analysis...... of arteriovenous fistulas the initially antegrade diastolic velocity was replaced by a retrograde flow within 3 months, whereas a forward flow in diastole was sustained in grafts with patent fistulas. Abnormal Duplex findings in 31 patients led to angiography and revision in 13 cases. Four revised grafts failed......, while nine remained patent at follow-up 1-12 months later. Ten (56%) of 18 non-revised bypasses with abnormal Duplex findings failed within 9 months compared to 1 (1%) of 76 bypasses with a normal velocity profile (p analysis provides...

  20. Monsanto may bypass NIH in microbe test.

    Science.gov (United States)

    Sun, Marjorie

    1985-01-11

    The Monsanto Company is planning to ask the Environmental Protection Agency for clearance to field test a genetically engineered microbial pesticide, bypassing the traditional approval process of the National Institutes of Health. Although only federally funded institutions are required to obtain NIH approval for genetic engineering tests, Monsanto is the first company to bypass the NIH regulatory process, which has become mired in a lawsuit brought by Jeremy Rifkin.

  1. Prophylactic digitalization for coronary artery bypass surgery.

    Science.gov (United States)

    Johnson, L W; Dickstein, R A; Fruehan, C T; Kane, P; Potts, J L; Smulyan, H; Webb, W R; Eich, R H

    1976-05-01

    One hundred and twenty patients undergoing aortocoronary bypass procedures were randomly placed into control and digitalized groups. All were initially in normal sinus rhythm and without evidence of congestive heart failure. Supraventricular arrhythmias occurred in 17 of 66 controls and in only three of 54 digitalized patients (P less than 0.01). There was no evidence of digitals toxicity. Based on this evidence we recommend prophylactic digitalization for patients having aortocoronary bypass operations.

  2. Bypass diode for a solar cell

    Science.gov (United States)

    Rim, Seung Bum; Kim, Taeseok; Smith, David D.; Cousins, Peter J.

    2012-03-13

    Bypass diodes for solar cells are described. In one embodiment, a bypass diode for a solar cell includes a substrate of the solar cell. A first conductive region is disposed above the substrate, the first conductive region of a first conductivity type. A second conductive region is disposed on the first conductive region, the second conductive region of a second conductivity type opposite the first conductivity type.

  3. Multiplexed Predictive Control of a Large Commercial Turbofan Engine

    Science.gov (United States)

    Richter, hanz; Singaraju, Anil; Litt, Jonathan S.

    2008-01-01

    Model predictive control is a strategy well-suited to handle the highly complex, nonlinear, uncertain, and constrained dynamics involved in aircraft engine control problems. However, it has thus far been infeasible to implement model predictive control in engine control applications, because of the combination of model complexity and the time allotted for the control update calculation. In this paper, a multiplexed implementation is proposed that dramatically reduces the computational burden of the quadratic programming optimization that must be solved online as part of the model-predictive-control algorithm. Actuator updates are calculated sequentially and cyclically in a multiplexed implementation, as opposed to the simultaneous optimization taking place in conventional model predictive control. Theoretical aspects are discussed based on a nominal model, and actual computational savings are demonstrated using a realistic commercial engine model.

  4. Unsteady Operation of New Type Turbofan Engine with Aerodynamic Torque Converter Reducing Front Fan Speed

    Institute of Scientific and Technical Information of China (English)

    Toshiaki KANEMOTO; Seita SEKI; Kazunori IDENO; Ahmed Mohamed GALAL

    2005-01-01

    It is desired to increase the rotational speed of the core engine of the turbofan so as to get the best efficiency for the next leap of engine technology. The conventional mechanism in which the front fan is directly connected to the output shaft of a core engine, have a limit of increasing the spool speed, because the fan diameter is very large. The authors have proposed a new driving system in which the front fan is driven through the aerodynamic torque converter. The front fan can work at the best performance at slower speed while the core engine runs more efficiently at higher speed. Continuously, this paper discusses the response of the front fan in the unsteady operation of the core engine, accompanying with the internal flow. The system has the acceptable responsibility in the unsteady operation which is very important for the aircrafts.

  5. Commercial turbofan engine exhaust nozzle flow analyses using PAB3D

    Science.gov (United States)

    Abdol-Hamid, Khaled S.; Uenishi, K.; Carlson, John R.; Keith, B. D.

    1992-01-01

    Recent developments of a three-dimensional (PAB3D) code have paved the way for a computational investigation of complex aircraft aerodynamic components. The PAB3D code was developed for solving the simplified Reynolds Averaged Navier-Stokes equations in a three-dimensional multiblock/multizone structured mesh domain. The present analysis was applied to commercial turbofan exhaust flow systems. Solution sensitivity to grid density is presented. Laminar flow solutions were developed for all grids and two-equation k-epsilon solutions were developed for selected grids. Static pressure distributions, mass flow and thrust quantities were calculated for on-design engine operating conditions. Good agreement between predicted surface static pressures and experimental data was observed at different locations. Mass flow was predicted within 0.2 percent of experimental data. Thrust forces were typically within 0.4 percent of experimental data.

  6. [Simplified laparoscopic gastric bypass. Initial experience].

    Science.gov (United States)

    Hernández-Miguelena, Luis; Maldonado-Vázquez, Angélica; Cortes-Romano, Pablo; Ríos-Cruz, Daniel; Marín-Domínguez, Raúl; Castillo-González, Armando

    2014-01-01

    Obesity surgery includes various gastrointestinal procedures. Roux-en-Y gastric bypass is the prototype of mixed procedures being the most practiced worldwide. A similar and novel technique has been adopted by Dr. Almino Cardoso Ramos and Dr. Manoel Galvao called "simplified bypass," which has been accepted due to the greater ease and very similar results to the conventional technique. The aim of this study is to describe the results of the simplified gastric bypass for treatment of morbid obesity in our institution. We performed a descriptive, retrospective study of all patients undergoing simplified gastric bypass from January 2008 to July 2012 in the obesity clinic of a private hospital in Mexico City. A total of 90 patients diagnosed with morbid obesity underwent simplified gastric bypass. Complications occurred in 10% of patients; these were more frequent bleeding and internal hernia. Mortality in the study period was 0%. The average weight loss at 12 months was 72.7%. Simplified gastric bypass surgery is safe with good mid-term results and a loss of adequate weight in 71% of cases.

  7. An experimental study of nerve bypass graft

    Institute of Scientific and Technical Information of China (English)

    XU Jie; LI Xue-shi

    2008-01-01

    Objective: To study the use of a nerve "bypass" graft as a possible alternative to neurolysis or segmental resection with interposition grafting in the treatment of neuroma-in-continuity. Methods: A sciatic nerve crush injury model was established in the Sprague-Dawley rat by compression with a straight hemostatic forceps. Epineurial windows were created proximal and distal to the injury site. An 8-mm segment of radial nerve was harvested and coaptated to the sciatic nerve at the epineurial window sites proximal and distal to the compressed segment (bypass group). A sciatic nerve crush injury without bypass served as a control. Nerve conduction studies were performed over an 8-week period. Sciatic nerves were then harvested and studied under transmission electron microscopy. Myelinated axon counts were obtained. Results: Nerve conduction velocity was significantly faster in the bypass group than in the control group at 8 weeks (63.57 m/s±5.83 m/s vs. 54.88 m/s±4.79m/s, P<0.01). Myelinated axon counts in distal segments were found more in the experimental sciatic nerve than in the control sciatic nerve. Significant axonal growth was noted in the bypass nerve segment itself. Conclusion: Nerve bypass may serve to augment peripheral axonal growth while avoiding further loss of the native nerve.

  8. Breast cancer biomarkers predict weight loss after gastric bypass surgery

    Directory of Open Access Journals (Sweden)

    Sauter Edward R

    2012-01-01

    Full Text Available Abstract Background Obesity has long been associated with postmenopausal breast cancer risk and more recently with premenopausal breast cancer risk. We previously observed that nipple aspirate fluid (n levels of prostate specific antigen (PSA were associated with obesity. Serum (s levels of adiponectin are lower in women with higher body mass index (BMI and with breast cancer. We conducted a prospective study of obese women who underwent gastric bypass surgery to determine: 1 change in n- and s-adiponectin and nPSA after surgery and 2 if biomarker change is related to change in BMI. Samples (30-s, 28-n and BMI were obtained from women 0, 3, 6 and 12 months after surgery. Findings There was a significant increase after surgery in pre- but not postmenopausal women at all time points in s-adiponectin and at 3 and 6 months in n-adiponectin. Low n-PSA and high s-adiponectin values were highly correlated with decrease in BMI from baseline. Conclusions Adiponectin increases locally in the breast and systemically in premenopausal women after gastric bypass. s-adiponectin in pre- and nPSA in postmenopausal women correlated with greater weight loss. This study provides preliminary evidence for biologic markers to predict weight loss after gastric bypass surgery.

  9. Interpositional carotid artery bypass strategies in the surgical management of aneurysms and tumors of the skull base.

    Science.gov (United States)

    Liu, James K; Couldwell, William T

    2003-03-15

    Cerebral revascularization is an important component in the surgical management of complex skull base tumors and aneurysms. Patients who harbor complex aneurysms that cannot be clipped directly and in whom parent vessel occlusion cannot be tolerated may require cerebrovascular bypass surgery. In cases in which skull base tumors encase the carotid artery (CA) and a resection is desired, a cerebrovascular bypass may be necessary in planned CA occlusion or sacrifice. In this review the authors discuss options for performing high-flow anterograde interposition CA bypass for lesions of the skull base. The authors review three important bypass techniques involving saphenous vein grafts: the cervical-to-petrous internal carotid artery (ICA), petrous-to-supraclinoid ICA, and cervical-to-supraclinoid ICA bypass. These revascularization techniques are important tools in the surgical treatment of complex aneurysms and tumors of the skull base and cavernous sinus.

  10. Post-gastric bypass hypoglycaemia: a review.

    Science.gov (United States)

    Shantavasinkul, Prapimporn C; Torquati, Alfonso; Corsino, Leonor

    2016-07-01

    Bariatric surgery is a highly effective treatment for severe obesity, resulting in substantial weight loss and normalizing obesity-related comorbidities. However, long-term consequences can occur, such as postbariatric surgery hypoglycaemia. This is a challenging medical problem, and the number of patients presenting with it has been increasing. Roux-en-Y gastric bypass (RYGB) is the most popular bariatric procedure, and it is the surgery most commonly associated with the development of postbariatric surgery hypoglycaemia. To date, the pathogenesis of this condition has not been completely established. However, various factors - particularly increased postprandial glucagon-like peptide (GLP)-1 secretion - have been considered as crucial mediator. The mechanisms responsible for diabetic remission after bariatric surgery may be responsible for the development of hypoglycaemia, which typically occurs 1-3 h after a meal and is concurrent with inappropriate hyperinsulinaemia. Carbohydrate-rich foods usually provoke hypoglycaemic symptoms, which can typically be alleviated by strict dietary modifications, including carbohydrate restriction and avoidance of high glycaemic index foods and simple sugars. Few patients require further medical intervention, such as medications, but some patients have required a pancreatectomy. Because this option is not always successful, it is no longer routinely recommended. Clinical trials are needed to further determine the pathophysiology of this condition as well as the best diagnostic and treatment approaches for these patients.

  11. Effects of cardiopulmonary bypass on propofol pharmacokinetics and bispectral index during coronary surgery

    Directory of Open Access Journals (Sweden)

    Ricardo Antonio G. Barbosa

    2009-03-01

    Full Text Available PURPOSE: Cardiopulmonary bypass is known to alter propofol pharmacokinetics in patients undergoing cardiac surgery. However, few studies have evaluated the impact of these alterations on postoperative pharmacodynamics. This study was designed to test the hypothesis that changes in propofol pharmacokinetics increase hypnotic effects after cardiopulmonary bypass. METHODS: Twenty patients scheduled for on-pump coronary artery bypass graft (group, n=10 or off-pump coronary artery bypass graft (group, n=10 coronary artery bypass grafts were anesthetized with sufentanil and a propofol target controlled infusion (2.0 µg/mL. Depth of hypnosis was monitored using the bispectral index. Blood samples were collected from the induction of anesthesia up to 12 hours after the end of propofol infusion, at predetermined intervals. Plasma propofol concentrations were measured using high-performance liquid chromatography, followed by a non-compartmental propofol pharmacokinetic analysis. Data were analyzed using ANOVA, considering p<0.05 as significant. RESULTS: After cardiopulmonary bypass, despite similar plasma propofol concentrations in both groups, bispectral index values were lower in the on-pump coronary artery bypass graft group. Time to extubation after the end of propofol infusion was greater in the on-pump coronary artery bypass graft group (334 ± 117 vs. 216 ± 85 min, p = 0.04. Patients undergoing cardiopulmonary bypass had shorter biological (1.82 ± 0.5 vs. 3.67 ± 1.15h, p < 0.01 and terminal elimination (6.27 ± 1.29 vs. 10.5h ± 2.18, p < 0.01 half-life values, as well as higher total plasma clearance (28.36 ± 11.40 vs.18.29 ± 7.67 mL/kg/min, p = 0.03, compared to patients in the off-pump coronary artery bypass graft group. CONCLUSION: Aside from the increased sensitivity of the brain to anesthetics after cardiopulmonary bypass, changes in propofol pharmacokinetics may contribute to its central nervous system effects.

  12. A linear control design structure to maintain loop properties during limit operation in a multi-nozzle turbofan engine

    Science.gov (United States)

    Mattern, Duane; Ouzts, Peter

    1991-01-01

    The implementation of multi-variable control systems on turbofan engines requires the use of limit protection to maintain safe engine operation. Since a turbofan engine typically encounters limits during transient operation, the use of a limit protection scheme that modifies the feedback loop may void the desired 'guarantees' associated with linear multi-variable control design methods, necessitating considerable simulation to validate the control with limit protection. An alternative control design structure is proposed that maintains the desired linear feedback properties when certain safety limits are encountered by moving the limit protection scheme outside of the feedback loop. This proposed structure is compared to a structure with a limit protection scheme that modifies the feedback loop properties. The two design structures are compared using both linear and nonlinear simulations. The evaluation emphasizes responses where the fan surge margin limit is encountered.

  13. The prevalence of body contouring surgery after gastric bypass surgery.

    Science.gov (United States)

    Kitzinger, Hugo B; Abayev, Sara; Pittermann, Anna; Karle, Birgit; Kubiena, Harald; Bohdjalian, Arthur; Langer, Felix B; Prager, Gerhard; Frey, Manfred

    2012-01-01

    As bariatric surgery has become more popular, more patients are undergoing body contouring surgery after massive weight loss. Many of the surgical procedures performed on the massive weight loss patient are complex and labor-intensive. Therefore, the plastic surgery unit needs to be prepared for a patient's demand. Little literature is available on how frequently patients who have undergone gastric bypass surgery receive body contouring surgery. Two hundred fifty-two subjects (out of 425 who were mailed the questionnaire) who had undergone gastric bypass surgery between 2003 and 2009 completed the questionnaire, which obtained information on body image satisfaction and frequency of body contouring surgery after massive weight loss. Of all patients, 74% desire a body contouring surgery after gastric bypass surgery. Fifty-three patients (21%) have undergone a total of 61 body contouring procedures. The most common were abdominoplasties (59%), followed by lower body lifts (20%). In contrast to a positive judgment of the general aspect of the body image satisfaction after massive weight loss, both genders are unsatisfied with body areas like abdomen/waist, breast, and thighs. Paralleling the increasing use of bariatric surgery, there is a high demand for body contouring surgery. A huge disparity exists between the number of subjects who desire a body contouring surgery and those who actually received it.

  14. Reversal of severe SPECT asymmetry after venous extra-intracranial high flow bypass in a patient submitted to therapeutic internal carotid occlusion: case report Reversão de importante assimetria ao SPECT após bypass venoso de alto fluxo extra-intracraniano em paciente submetido a oclusão terapêutica da carótida interna: relato de caso

    Directory of Open Access Journals (Sweden)

    Jorge Marcondes

    2001-09-01

    Full Text Available Therapeutic occlusion of the internal carotid artery is the main option for the treatment of the symptomatic intracavernous internal carotid artery aneurysms, but the issue of the best way of doing the balloon test occlusion (BTO regarding prediction of future ischemic events remains debatable. Single photon emission computerized tomography (SPECT has been offered as one of the best option of monitoring regional cerebral blood flow (rCBF during the BTO, where severe asymmetry is predictive of delayed ischemia. We describe a case of important SPECT asymmetry during BTO clinically negative and its complete reversal with carotid occlusion after extra-intracranial bypass with high flow safenous vein bypass between the cervical carotid artery and the middle cerebral artery.Oclusão terapêutica carotídea ainda é a principal escolha para o tratamento dos aneurismas sintomáticos da artéria carótida interna ao nível do seio cavernoso.Existem controvérsias em relação à obtenção de testes com maior valor preditivo em relação à complicações isquêmicas futuras durante a realização do teste de oclusão carotídeo por balão. A tomografia computorizada de emissão de fóton único (SPECT tem sido defendida como uma opção para a melhor avaliação do fluxo sanguíneo regional cerebral, onde evidente assimetria é indicativa de isquemia tardia. Descrevemos um caso de importante assimetria ao SPECT durante o teste clinicamente negativo e sua reversão completa após anastomose extra-intracraniana com interposição de veia safena magna (alto fluxo entre a artéria carótida cervical e a artéria cerebral média.

  15. Investigation of Inlet Guide Vane Wakes in a F109 Turbofan Engine with and without Flow Control

    OpenAIRE

    Kozak, Jeffrey D

    2000-01-01

    A series of experiments were conducted in a F109 turbofan engine to investigate the unsteady wake profiles of an Inlet Guide Vane (IGV) at a typical spacing to the downstream fan at subsonic and transonic relative blade velocities. The sharp trailing-edge vanes were designed to produce a wake profile consistent with modern IGV. Time averaged baseline measurements were first performed with the IGV located upstream of the aerodynamic influence of the fan. Unsteady experiments were performed ...

  16. 75 FR 801 - Airworthiness Directives; Rolls-Royce plc RB211-Trent 500, 700, and 800 Series Turbofan Engines

    Science.gov (United States)

    2010-01-06

    ... requires replacing the fuel-to-oil heat exchanger (FOHE). This proposed AD would require replacing the FOHE..., 553A2-61, 556A2-61, 556B2-61, and 560A2-61 turbofan engines with fuel-to-oil heat exchangers (FOHEs... through Friday, except Federal holidays. Fax: (202) 493-2251. Contact Rolls-Royce plc, P.O. Box 31,...

  17. 75 FR 15326 - Airworthiness Directives; Rolls-Royce plc RB211-Trent 500, 700, and 800 Series Turbofan Engines

    Science.gov (United States)

    2010-03-29

    ... aviation product, and results from the risk of engine fuel-to-oil heat exchanger (FOHE) blockage. The MCAI..., 556A2-61, 556B2-61, and 560A2-61 turbofan engines with fuel-to-oil heat exchangers (FOHEs) part number...., West Building Ground Floor, Room W12-140, Washington, DC 20590- 0001. Contact Rolls-Royce plc, P.O....

  18. A study of flow and initial stage of water condensation in the exhaust jet of the aircraft turbofan engine

    OpenAIRE

    Lobanova, Maria,; Tsirkunov, Yury,

    2013-01-01

    The paper describes the results of numerical study of flow in the exhaust jet of turbofan engine CFM 56-3. Influence of computational domain decomposition, grid refinement and flow model on the jet flow field is discussed. Special attention is payed to simulation of nucleation and condensation processes in the exhaust jet. Growth of water clusters in the jet and cluster distribution in size are obtained.; International audience; The paper describes the results of numerical study of flow in th...

  19. 76 FR 12277 - Airworthiness Directives; Rolls-Royce plc RB211-Trent 768, 772, and 772B Turbofan Engines

    Science.gov (United States)

    2011-03-07

    ...-AD; Amendment 39-16620; AD 98-09-27R1] RIN 2120-AA64 Airworthiness Directives; Rolls-Royce plc RB211... of Rolls-Royce plc RB211-Trent 768 and 772 series turbofan engine thrust reverser hinge lugs and..., Amendment 39-10508 (63 FR 24911, May 6, 1998): 98-09-27R1 Rolls-Royce plc: Amendment 39-16620. Docket...

  20. Internal Maxillary Bypass for Complex Pediatric Aneurysms.

    Science.gov (United States)

    Wang, Long; Lu, Shuaibin; Qian, Hai; Shi, Xiang'en

    2017-07-01

    Complex pediatric aneurysms (PAs) are an unusual clinicopathologic entity. Data regarding the use of a bypass procedure to treat complex PAs are limited. Internal maxillary artery-to-middle cerebral artery bypass with radial artery graft was used to isolate PAs. Bypass patency and aneurysm stability were evaluated using intraoperative Doppler ultrasound, indocyanine green videoangiography, and postoperative angiography. Modified Rankin Scale was used to assess neurologic function. Over a 5-year period, 7 pediatric patients (≤18 years old) were included in our analysis. Mean age of patients was 14.4 years (range, 12-18 years), and mean size of PAs was 23.6 mm (range, 9-37 mm). All cases manifested with complex characteristics. Proximal artery occlusion was performed in 3 cases, complete excision following aneurysmal distal internal maxillary artery bypass was performed in 2 cases, and combined proximal artery occlusion and aneurysm excision was performed in the 2 remaining cases. Mean intraoperative blood flow was 61.6 mL/minute (range, 40.0-90.8 mL/minute). Graft patency rate was 100% during postoperative recovery and at the last follow-up examination (mean, 20 months; range, 7-45 months). All patients had excellent outcomes except for 1 patient who died of multiple-organ failure. Internal maxillary artery bypass is an essential technique for treatment of selected cases of complex PAs. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Modeling Sediment Bypassing around Rocky Headlands

    Science.gov (United States)

    George, D. A.; Largier, J. L.; Pasternack, G. B.; Erikson, L. H.; Storlazzi, C. D.; Barnard, P.

    2016-12-01

    Sediment bypassing rocky headlands remains understudied despite the importance of characterizing littoral processes and sediment budgets for erosion abatement, climate change adaptation, and beach management. This study was developed to identify controlling factors on and the mechanisms supporting sediment bypassing. Sediment flux around four idealized rocky headlands was investigated using the hydrodynamic model Delft3D and spectral wave model SWAN. The experimental design involved 120 simulations to explore the influence of headland morphology, substrate composition, sediment grain size, and oceanographic forcing. Headlands represented sizes and shapes found in natural settings, grain sizes ranged from fine to medium sand, and substrates from sandy beds to offshore bedrock reefs. The oceanography included a constructed representative tide, an alongshore background current, and four wave conditions derived from observational records in the eastern Pacific Ocean. A bypassing ratio was developed for alongshore flux between upstream and downstream cross-shore transects to determine the degree of blockage by a headland. Results showed that northwesterly oblique large waves (Hs = 7 m, Tp = 16 s) generated the most flux around headlands, whereas directly incident waves blocked flux across a headland apex. The headland shape heavily influenced the sediment fate by changing the relative angle between the shoreline and the incident waves. The bypassing ratio characterized each headland's capacity to allow alongshore flux under different wave conditions. All headlands may allow flux, although larger ones block sediment more effectively, promoting their ability to be littoral cell boundaries compared to smaller headlands. The controlling factors on sediment bypassing were determined to be wave angle, shape and size of the headland, and sediment grain size. This novel numerical modeling study advances headland modeling from the generic realm to broadly applicable classes of

  2. Analgesic Treatment in Laparoscopic Gastric Bypass Surgery

    DEFF Research Database (Denmark)

    Andersen, Lars P H; Werner, Mads U; Rosenberg, Jacob

    2014-01-01

    This review aimed to present an overview of the randomized controlled trials investigating analgesic regimens used in laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery. Literature search was performed in PubMed and EMBASE databases in August 2013 in accordance to PRISMA guidelines. The litera......This review aimed to present an overview of the randomized controlled trials investigating analgesic regimens used in laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery. Literature search was performed in PubMed and EMBASE databases in August 2013 in accordance to PRISMA guidelines...

  3. Variable volume combustor with an air bypass system

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Thomas Edward; Ziminsky, Willy Steve; Ostebee, Heath Michael; Keener, Christopher Paul

    2017-02-07

    The present application provides a combustor for use with flow of fuel and a flow of air in a gas turbine engine. The combustor may include a number of micro-mixer fuel nozzles positioned within a liner and an air bypass system position about the liner. The air bypass system variably allows a bypass portion of the flow of air to bypass the micro-mixer fuel nozzles.

  4. 46 CFR 154.550 - Excess flow valve: Bypass.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Excess flow valve: Bypass. 154.550 Section 154.550... and Process Piping Systems § 154.550 Excess flow valve: Bypass. If the excess flow valve allowed under § 154.532(b) has a bypass, the bypass must be of 1.0 mm (0.0394 in.) or less in diameter. Cargo Hose...

  5. 21 CFR 870.3545 - Ventricular bypass (assist) device.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ventricular bypass (assist) device. 870.3545... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3545 Ventricular bypass (assist) device. (a) Identification. A ventricular bypass (assist) device is a device that...

  6. Obstructive and enteropathic syndromes after jejunoileal bypass surgery

    Energy Technology Data Exchange (ETDEWEB)

    Karasick, D.; Karasick, S.

    1981-05-15

    Small bowel bypass procedures for morbid obesity have been associated with many postoperative complications. With the use of the Scott procedure, the bypassed or excluded small bowel segment has recently been the focus of 2 syndromes - 'bypass enteritis' and 'defunctioned bowel syndrome'. We describe these postoperative complications and present their significant radiologic features.

  7. 21 CFR 870.4430 - Cardiopulmonary bypass intracardiac suction control.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass intracardiac suction....4430 Cardiopulmonary bypass intracardiac suction control. (a) Identification. A cardiopulmonary bypass intracardiac suction control is a device which provides the vacuum and control for a cardiotomy return sucker...

  8. 20 CFR 631.18 - Federal by-pass authority.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Federal by-pass authority. 631.18 Section 631... Procedures § 631.18 Federal by-pass authority. (a) In the event that a State fails to submit a biennial State... Secretary's intent to exercise by-pass authority and an opportunity to request and to receive a...

  9. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass heat exchanger. 870.4240... bypass heat exchanger. (a) Identification. A cardiopulmonary bypass heat exchanger is a device, consisting of a heat exchange system used in extracorporeal circulation to warm or cool the blood...

  10. Why women bypass front-line health facility services in pursuit of obstetric care provided elsewhere: a case study in three rural districts of Tanzania.

    Science.gov (United States)

    Kanté, A M; Exavery, A; Phillips, J F; Jackson, E F

    2016-04-01

    In the Tanzanian health system, women are expected to first visit their nearest front-line health facility (FLF) for delivery. However, women frequently bypass these FLF. Our study estimates the extent of bypassing for childbirth and assesses factors associated with this behaviour. Data describing the experiences of 597 women who recently delivered at a facility and the EmONC service capability at 107 health facilities were collected in 2011. Women who did not deliver at their nearest FLF were considered 'bypassers'. Factors associated with bypassing were assessed using multivariate logistic regression models. Three sets of analyses were conducted: among 597 women who delivered at the first facility they visited, among 521 women with no previous complications, and among 407 women not primigravida and without previous complications. More than 75.4% of women bypassed. In the fully adjusted model of all 597 women those who had experienced complications were more likely to bypass for delivery [OR = 6.31 (2.36, 16.86)]. In the fully adjusted model excluding women with previous complications, primigravida women were more likely to bypass [OR = 3.70 (1.71, 8.01)]. Fully adjusted models for each set of analysis found that, for each additional emergency obstetric and newborn care signal function (EmONC SF) available at the nearest FLF, women's odds of bypassing almost halved. Bypassing is highly associated with EmONC SF score at nearest FLF, controlling for individual and community-level factors. © 2016 John Wiley & Sons Ltd.

  11. Epidemiologic Surveillance for Staphylococcus epidermidis infections related to cardiopulmonary bypass.

    Science.gov (United States)

    Lathrop, G D; Brockett, R M; Blouse, L E

    1978-07-01

    Epidemiologic investigation of 20 Staphylococcus infections among valvular and aortocoronary bypass graft patients indicated a broad spectrum of clinical illness in these two groups. The highest infection rate (9.3%) and case specific mortality rate (54.5%) were noted among those patients undergoing cardiovalvular replacement surgery with protheses. The median onset of infection was 6 days suggesting infection during the intraoperative period. Using the epidemiologic data from this investigation, a transmission pattern was formulated and a series of control measures designed to interdict the routes of transmission were instituted wigh marked success. These measures significantly reduced the incidence of S. epidermidis infections among these high risk patients.

  12. Bypassing BDD Construction for Reliability Analysis

    DEFF Research Database (Denmark)

    Williams, Poul Frederick; Nikolskaia, Macha; Rauzy, Antoine

    2000-01-01

    In this note, we propose a Boolean Expression Diagram (BED)-based algorithm to compute the minimal p-cuts of boolean reliability models such as fault trees. BEDs make it possible to bypass the Binary Decision Diagram (BDD) construction, which is the main cost of fault tree assessment....

  13. Robotically-Assisted Coronary Artery Bypass Grafting

    Directory of Open Access Journals (Sweden)

    Thierry A. Folliguet

    2010-01-01

    Full Text Available Objectives. Robotic surgery enables to perform coronary surgery totally endoscopically. This report describes our experience using the da Vinci system for coronary artery bypass surgery. Methods. Patients requiring single-or-double vessel revascularization were eligible. The procedure was performed without cardiopulmonary bypass on a beating heart. Results. From April 2004 to May 2008, fifty-six patients were enrolled in the study. Twenty-four patients underwent robotic harvesting of the mammary conduit followed by minimal invasive direct coronary artery bypass (MIDCAB, and twenty-three patients had a totally endoscopic coronary artery bypass (TECAB grafting. Nine patients (16% were converted to open techniques. The mean total operating time for TECAB was 372±104 minutes and for MIDCAB was 220±69 minutes. Followup was complete for all patients up to one year. There was one hospital death following MIDCAB and two deaths at follow up. Forty-eight patients had an angiogram or CT scan revealing occlusion or anastomotic stenoses (>50% in 6 patients. Overall permeability was 92%. Conclusions. Robotic surgery can be performed with promising results.

  14. Intraoperative arteriography during femoral-popliteal bypass.

    Science.gov (United States)

    Liddicoat, J E; Bekassy, S M; DeBakey, M E

    1975-07-01

    Minor technical errors may jeopardize the patency of femoral-popliteal bypass grafts. In an attempt to detect such errors, intraoperative arteriography has been routinely employed. It allows immediate recognition and correction of the most common abnormal findings: intraluminal debris, intimal dissection, distal thrombosis, arterial spasm, and kinking of the graft.

  15. Cephalic veins in coronary artery bypass surgery

    DEFF Research Database (Denmark)

    Licht, P; Jakobsen, Erik; Lerbjerg, G

    1996-01-01

    Various alternative conduits for aortocoronary bypass grafting have been suggested when the saphenous vein quality is inadequate. During a 10-year period we have used the cephalic vein in 39 patients. Eighteen entered an angiographic follow-up study. A total of 31 arm vein grafts were used with 4...

  16. Planetary science: Bypassing the habitable zone

    Science.gov (United States)

    Ingersoll, Andrew P.

    2017-08-01

    In our own solar system, Venus is too hot, Mars is too cold and Earth is just right. Simulations show that making an icy planet habitable is not as simple as melting its ice: many icy bodies swing from too cold to too hot, bypassing just right.

  17. Gastric infarction following gastric bypass surgery

    Science.gov (United States)

    Do, Patrick H; Kang, Young S; Cahill, Peter

    2016-01-01

    Gastric infarction is an extremely rare occurrence owing to the stomach’s extensive vascular supply. We report an unusual case of gastric infarction following gastric bypass surgery. We describe the imaging findings and discuss possible causes of this condition. PMID:27200168

  18. Cephalic veins in coronary artery bypass surgery

    DEFF Research Database (Denmark)

    Licht, P; Jakobsen, Erik; Lerbjerg, G;

    1996-01-01

    Various alternative conduits for aortocoronary bypass grafting have been suggested when the saphenous vein quality is inadequate. During a 10-year period we have used the cephalic vein in 39 patients. Eighteen entered an angiographic follow-up study. A total of 31 arm vein grafts were used with 4...

  19. Flow Through Aerodynamic Torque Converter Installed in New Type Turbofan Engine

    Institute of Scientific and Technical Information of China (English)

    Toshiaki Kanemoto; Dai Sakihama; Seita Seki; Ahmed Mohamed Galal; FengQin Han; YeXiang Xiao

    2007-01-01

    It is desired to increase the core engine speed of the turbofan, to get the best efficiency for the next leap of the engine technology. The conventional mechanism in which the front fan is directly connected to the output shaft of the core engine has a limit of increasing the spool speed because the fan diameter is very large. The authors have proposed a new driving system in which the front fan is driven through the aerodynamic torque converter. The front fan can work at the conventional speed while the core engine runs more efficiently at higher speed. Continuously, in this paper, the flow through the converter is simulated numerically by CFX-5 with the k-εturbulence model of the commercial CFD code. The secondary flow occurred on the hub wall affects markedly the flow condition on the blade surfaces, and the flow along the suction surface of the driver blade separates near the trailing edge, which is deviated to the blade tip by the centrifugal force due to the wheel rotation.

  20. Application of the Systematic Sensor Selection Strategy for Turbofan Engine Diagnostics

    Science.gov (United States)

    Sowers, T. Shane; Kopasakis, George; Simon, Donald L.

    2008-01-01

    The data acquired from available system sensors forms the foundation upon which any health management system is based, and the available sensor suite directly impacts the overall diagnostic performance that can be achieved. While additional sensors may provide improved fault diagnostic performance, there are other factors that also need to be considered such as instrumentation cost, weight, and reliability. A systematic sensor selection approach is desired to perform sensor selection from a holistic system-level perspective as opposed to performing decisions in an ad hoc or heuristic fashion. The Systematic Sensor Selection Strategy is a methodology that optimally selects a sensor suite from a pool of sensors based on the system fault diagnostic approach, with the ability of taking cost, weight, and reliability into consideration. This procedure was applied to a large commercial turbofan engine simulation. In this initial study, sensor suites tailored for improved diagnostic performance are constructed from a prescribed collection of candidate sensors. The diagnostic performance of the best performing sensor suites in terms of fault detection and identification are demonstrated, with a discussion of the results and implications for future research.

  1. 3D Multistage Simulation of Each Component of the GE90 Turbofan Engine

    Science.gov (United States)

    Turner, Mark; Topp, Dave; Veres, Joe

    1999-01-01

    A 3D multistage simulation of each component of the GE90 Turbofan engine has been made. This includes 49 blade rows. A coupled simulation of all blade rows will be made very soon. The simulation is running using two levels of parallelism. The first level is on a blade row basis with information shared using files. The second level is using a grid domain decomposition with information shared using MPI. Timings will be shown for running on the SP2, an SGI Origin and a distributed system of HP workstations. On the HP workstations, the CHIMP version of MPI is used, with queuing supplied by LSF (Load Sharing Facility). A script-based control system is used to ensure reliability. An MPEG movie illustrating the flow simulation of the engine has been created using PV3, a parallel visualization library created by Bob Haimes of MIT. PVM is used to create a virtual machine from 10 HP workstations and display on an SGI workstation. A representative component simulation will be compared to rig data to demonstrate its usefulness in turbomachinery design and analysis.

  2. Time Delay Analysis of Turbofan Engine Direct and Indirect Combustion Noise Sources

    Science.gov (United States)

    Miles, Jeffrey Hilton

    2008-01-01

    The core noise components of a dual spool turbofan engine were separated by the use of a coherence function. A source location technique based on adjusting the time delay between the combustor pressure sensor signal and the far-field microphone signal to maximize the coherence and remove as much variation of the phase angle with frequency as possible was used. The discovery was made that for the 130o microphone a 90.027 ms time shift worked best for the frequency band from 0 to 200 Hz while a 86.975 ms time shift worked best for the frequency band from 200 to 400 Hz. Hence, the 0 to 200 Hz band signal took more time than the 200 to 400 Hz band signal to travel the same distance. This suggests the 0 to 200 Hz coherent cross spectral density band is partly due to indirect combustion noise attributed to entropy fluctuations, which travel at the flow velocity, interacting with the turbine. The signal in the 200 to 400 Hz frequency band is attributed mostly to direct combustion noise. Results are presented herein for engine power settings of 48, 54, and 60 percent of the maximum power setting

  3. Source Methodology for Turbofan Noise Prediction (SOURCE3D Technical Documentation)

    Science.gov (United States)

    Meyer, Harold D.

    1999-01-01

    This report provides the analytical documentation for the SOURCE3D Rotor Wake/Stator Interaction Code. It derives the equations for the rotor scattering coefficients and stator source vector and scattering coefficients that are needed for use in the TFANS (Theoretical Fan Noise Design/Prediction System). SOURCE3D treats the rotor and stator as isolated source elements. TFANS uses this information, along with scattering coefficients for inlet and exit elements, and provides complete noise solutions for turbofan engines. SOURCE3D is composed of a collection of FORTRAN programs that have been obtained by extending the approach of the earlier V072 Rotor Wake/Stator Interaction Code. Similar to V072, it treats the rotor and stator as a collection of blades and vanes having zero thickness and camber contained in an infinite, hardwall annular duct. SOURCE3D adds important features to the V072 capability-a rotor element, swirl flow and vorticity waves, actuator disks for flow turning, and combined rotor/actuator disk and stator/actuator disk elements. These items allow reflections from the rotor, frequency scattering, and mode trapping, thus providing more complete noise predictions than previously. The code has been thoroughly verified through comparison with D.B. Hanson's CUP2D two- dimensional code using a narrow annulus test case.

  4. Acoustic theory of axisymmetric multisectioned ducts. [reduction of turbofan engine noise

    Science.gov (United States)

    Zorumski, W. E.

    1974-01-01

    Equations are developed for the acoustic field in a duct system which is made up of a number of connected circular and annular ducts. These equations are suitable for finding the acoustic field inside of and radiated from an aircraft turbofan engine. Acoustic modes are used as generalized coordinates in order to develop a set of matrix equations for the acoustic field. Equations for these modes are given for circular and annular ducts with uniform flow. Modal source equations are derived for point acoustic sources. General equations for mode transmission and reflection are developed and detailed equations are derived for ducts with multiple sections of acoustic treatment and for ducts with circumferential splitter rings. The general theory is applied to the special case of a uniform area circular duct with multisection liners and it is shown that the mode reflection effects are proportional to differences of the acoustic admittances of adjacent liners. A numerical example is given which shows that multisection liners may provide greater noise suppression than uniform liners.

  5. Core Noise Diagnostics of Turbofan Engine Noise Using Correlation and Coherence Functions

    Science.gov (United States)

    Miles, Jeffrey H.

    2009-01-01

    Cross-correlation and coherence functions are used to look for periodic acoustic components in turbofan engine combustor time histories, to investigate direct and indirect combustion noise source separation based on signal propagation time delays, and to provide information on combustor acoustics. Using the cross-correlation function, time delays were identified in all cases, clearly indicating the combustor is the source of the noise. In addition, unfiltered and low-pass filtered at 400 Hz signals had a cross-correlation time delay near 90 ms, while the low-pass filtered at less than 400 Hz signals had a cross-correlation time delay longer than 90 ms. Low-pass filtering at frequencies less than 400 Hz partially removes the direct combustion noise signals. The remainder includes the indirect combustion noise signal, which travels more slowly because of the dependence on the entropy convection velocity in the combustor. Source separation of direct and indirect combustion noise is demonstrated by proper use of low-pass filters with the cross-correlation function for a range of operating conditions. The results may lead to a better idea about the acoustics in the combustor and may help develop and validate improved reduced-order physics-based methods for predicting direct and indirect combustion noise.

  6. Full-Scale Turbofan Engine Noise-Source Separation Using a Four-Signal Method

    Science.gov (United States)

    Hultgren, Lennart S.; Arechiga, Rene O.

    2016-01-01

    Contributions from the combustor to the overall propulsion noise of civilian transport aircraft are starting to become important due to turbofan design trends and expected advances in mitigation of other noise sources. During on-ground, static-engine acoustic tests, combustor noise is generally sub-dominant to other engine noise sources because of the absence of in-flight effects. Consequently, noise-source separation techniques are needed to extract combustor-noise information from the total noise signature in order to further progress. A novel four-signal source-separation method is applied to data from a static, full-scale engine test and compared to previous methods. The new method is, in a sense, a combination of two- and three-signal techniques and represents an attempt to alleviate some of the weaknesses of each of those approaches. This work is supported by the NASA Advanced Air Vehicles Program, Advanced Air Transport Technology Project, Aircraft Noise Reduction Subproject and the NASA Glenn Faculty Fellowship Program.

  7. Post-Bypass Extensive Ascites due to Splanchnic Bypass and the Effectiveness of Hyperalimentation Treatment

    Directory of Open Access Journals (Sweden)

    Veysel Temizkan

    2013-04-01

    Full Text Available Reperfusion edema may develop in the early periods of chronic ischemic tissue reperfusion. Reperfusion edema may be represented after the splanchnic bypass with ascites, abdominal distension, and liver and kidney function impairment. In this article, we are reporting the hyperalimentation treatment and its results for the common ascites and hepatorenal syndrome, after a coeliac and superior mesenteric artery bypass. [Arch Clin Exp Surg 2013; 2(2.000: 124-128

  8. Annular MHD Physics for Turbojet Energy Bypass

    Science.gov (United States)

    Schneider, Steven J.

    2011-01-01

    The use of annular Hall type MHD generator/accelerator ducts for turbojet energy bypass is evaluated assuming weakly ionized flows obtained from pulsed nanosecond discharges. The equations for a 1-D, axisymmetric MHD generator/accelerator are derived and numerically integrated to determine the generator/accelerator performance characteristics. The concept offers a shockless means of interacting with high speed inlet flows and potentially offers variable inlet geometry performance without the complexity of moving parts simply by varying the generator loading parameter. The cycle analysis conducted iteratively with a spike inlet and turbojet flying at M = 7 at 30 km altitude is estimated to have a positive thrust per unit mass flow of 185 N-s/kg. The turbojet allowable combustor temperature is set at an aggressive 2200 deg K. The annular MHD Hall generator/accelerator is L = 3 m in length with a B(sub r) = 5 Tesla magnetic field and a conductivity of sigma = 5 mho/m for the generator and sigma= 1.0 mho/m for the accelerator. The calculated isentropic efficiency for the generator is eta(sub sg) = 84 percent at an enthalpy extraction ratio, eta(sub Ng) = 0.63. The calculated isentropic efficiency for the accelerator is eta(sub sa) = 81 percent at an enthalpy addition ratio, eta(sub Na) = 0.62. An assessment of the ionization fraction necessary to achieve a conductivity of sigma = 1.0 mho/m is n(sub e)/n = 1.90 X 10(exp -6), and for sigma = 5.0 mho/m is n(sub e)/n = 9.52 X 10(exp -6).

  9. Electroencephalography during surgery with cardiopulmonary bypass and hypothermia.

    Science.gov (United States)

    Bashein, G; Nessly, M L; Bledsoe, S W; Townes, B D; Davis, K B; Coppel, D B; Hornbein, T F

    1992-06-01

    After more than 30 yr of use, electroencephalographic (EEG) monitoring during cardiopulmonary bypass has not gained wide clinical acceptance. To assess its utility to predict central nervous system injury, two-channel recordings were made from 78 patients undergoing cardiopulmonary bypass and anesthetized with fentanyl/diazepam/enflurane. The perfusion regimen included the use of high pump flow, a bubble oxygenator, and no arterial tubing filter. Target values were 28-32 degrees C for the minimum rectal temperature, 60-80 mmHg for mean arterial pressure, and 20-25% for hematocrit. Eight descriptors of the Fourier power spectra of the EEG were calculated off-line, and outcome comparisons were made with the results from neuropsychological tests. Among 58 patients yielding complete data of acceptable quality, a statistically significant reduction in total power was observed from prebypass to postbypass, accompanied by an increase in the fractional power in the theta and beta frequency bands and in the spectral edge frequency. The shifts in total and theta power were weakly associated with short-term but not with long-term changes in neuropsychological scores. Nearly 40% of the patients' EEGs were corrupted with electrical noise at some time during bypass. In 15 patients selected for having high-quality recordings and no neuropsychological deficit, an extensive statistical analysis failed to reveal any consistent variation in the EEG descriptors with hypothermia. Under the conditions studied, it appears that for other than gross signal dropout, the strong background variability in the EEG makes it have little value for detecting harbingers of brain injury.

  10. Low Incidence of Early Postoperative Cerebral Edema After Coronary Artery Bypass Grafting

    NARCIS (Netherlands)

    Ottens, Thomas H.; Hendrikse, J; Slooter, Arjen J. C.; van Herwerden, LA; Dieleman, Stefan; van Dijk, Diederik

    2015-01-01

    Objective: Using magnetic resonance imaging, the authors studied the influence of a single high dose of intraoperative dexamethasone on the severity of cerebral edema that can occur early after coronary artery bypass grafting (CABG). It was hypothesized that high-dose intraoperative dexamethasone re

  11. Audiometric changes after coronary artery bypass graft

    Directory of Open Access Journals (Sweden)

    Khorsandi M T

    2007-09-01

    Full Text Available Background: Hearing is one of the most significant senses; There fore, any defect can be frightening. The incidence of sever hearing loss following coronary artery bypass surgery has been estimated as one per thousand. This Prospective study carried out to determine hearing effects of coronary artery bypass surgery."nMethods: age, audiometric changes before and after surgery (hearing levels at multiple frequencies, speech reception threshold and speech discrimination score, minimum blood pressure during the operation, and the time on bypass, measured on One hundred consecutive patients who candidate for coronary artery bypass surgery and the results analysed."nResults: One hundred patients completed the tests. Based on hearing changes found on pre- and post-operative tests, the patients were divided into 3 groups: Those with no change (47 patients according to their audiometric results; those with slight changes ≤10 db (43 patients; and those having average deficits of more than 10 db (10 patients. All the patients were male. None of the patients had complete or severe sensorineural hearing loss. The third group had more prolonged pumping duration when compared with the others groups (p=0.002. Furthermore, 90 percent of patients with a sensorineural hearing loss more than 10 db had diabetes mellitus and hyperlipidemia as risk factors."nConclusion: Sudden sensorineural hearing loss is a sequela in patients who undergoing coronary artery bypass surgery; however, it was usually mild and asymptomatic. Pumping time during the operation is a significant factor in occurring of this complication. With proper treatment of underlying diseases and eliminating the risk factors with improvement of our cardiopulmonary pumps we probably can get better hearing results.

  12. Superficial temporal artery to proximal posterior cerebral artery bypass through the anterior temporal approach

    Directory of Open Access Journals (Sweden)

    Satoru Takeuchi

    2015-01-01

    Full Text Available Background: The superficial temporal artery (STA to proximal posterior cerebral artery (PCA (P2 segment bypass is one of the most difficult procedures to perform because the proximal PCA is located deep and high within the ambient cistern. STA to proximal PCA bypass is usually performed through a subtemporal approach or posterior transpetrosal approach, and rarely through a transsylvian approach. The aim of this study was to describe the operative technique of STA to proximal PCA bypass through a modified transsylvian approach (anterior temporal approach. Methods: STA to proximal PCA bypass was performed through an anterior temporal approach in three patients with intracranial aneurysm. We describe the details of the surgical technique. Results: The STA was successfully anastomosed to the proximal PCA in all cases. One patient suffered hemiparesis and aphasia due to infarction in the anterior thalamoperforating artery territory. Conclusions: STA to proximal PCA bypass can be performed through an anterior temporal approach in selected patients. We recommend that every precaution, including complete hemostasis, placement of cellulose sponges beneath the recipient artery to elevate the site of the anastomosis, and placement of a continuous drainage tube at the bottom of the operative field to avoid blood contamination during the anastomosis, should be taken to shorten the temporary occlusion time.

  13. History and current status of robotic totally endoscopic coronary artery bypass.

    Science.gov (United States)

    Lee, Jeffrey D; Srivastava, Mukta; Bonatti, Johannes

    2012-01-01

    Robotic totally endoscopic coronary artery bypass (TECAB) is a minimally invasive endoscopic surgical approach using the daVinci robotic telemanipulation system to perform coronary artery bypass grafting on the arrested or beating heart. It is a procedure that can be a useful alternative to the classic open procedure performed through sternotomy. After extensive modeling in cadavers, the first clinical case was performed in June 1998 placing a left internal thoracic artery graft (LITA) to the left anterior descending artery completely robotically on the arrested heart. During the early and late 2000s, international groups have adopted this evolving technology, which has included iterations such as beating-heart TECAB, use of bilateral ITA grafting and radial artery grafting, as well as 3- and 4-vessel TECAB. TECAB is combined with percutaneous coronary intervention in hybrid procedures. Despite increasing complexity of endoscopic coronary bypass surgery, conversion rates to open bypass surgery have dropped significantly and operative times have decreased. Published major morbidities and mortality rates in arrested-and beating-heart TECAB have been cumulatively in the 0-2% range and are considered well within the expected range for these highly complex surgical procedures. Long-term survival and freedom from major adverse events also meet the standards of open bypass surgery.

  14. Coronary artery bypass grafting in a patient with active idiopathic cryoglobulinemia: revisiting the issue

    Directory of Open Access Journals (Sweden)

    Hafiz Abdul Moiz Fakih

    2016-02-01

    Full Text Available Background: Cryoglobulinemia is a cold-reactive autoimmune disease. It is of distinctive importance in cardiac surgery because of the use of hypothermic cardiopulmonary bypass (CPB. Cryoglobulins, which activate at variable levels of hypothermia, can cause precipitation during surgery leading to possibly severe leukocytoclastic or necrotizing vasculitis, clinically manifested as ischemic events, such as cutaneous ulcerations, glomerulonephritis, arthritis, or peripheral neuropathies among the most reported associated comorbidities. Management of CPB and systemic protection in this rare but unique scenario requires individualized planning. We report the case of a patient with active cryoglobulinemia who was preoperatively managed with plasmapheresis. He underwent hypothermic coronary bypass with no precipitation and flare during and after surgery. Case presentation: We describe the case of a 59-year-old Caucasian male with clinically significant idiopathic cryoglobulinemia and history of recurrent skin lesions and toe amputations secondary to cold exposure. He presented with 2-h duration of chest pain and new onset atrial fibrillation. After cardiac catheterization, a diagnosis of three-vessel coronary artery disease was established and coronary artery bypass grafting (CABG was scheduled. Because of a high risk of flare-up during surgery, the patient was preemptively treated with two sessions of plasmapheresis before bypass. He then underwent hypothermic CABG. The pre- and perioperative course was unremarkable without any clinical evidence of precipitation. The patient was discharged on day 6 postoperatively without any complications. Conclusion: Preoperative plasmapheresis before hypothermic coronary bypass can prevent fatal cryoglobulinemia-related complications in patients with active disease.

  15. Particles deposition induced by the magnetic field in the coronary bypass graft model

    Science.gov (United States)

    Bernad, Sandor I.; Totorean, Alin F.; Vekas, Ladislau

    2016-03-01

    Bypass graft failures is a complex process starting with intimal hyperplasia development which involve many hemodynamic and biological factors. This work presents experimental results regarding the possibility to use magnetic drug delivery to prevent the development of the intimal hyperplasia using a simplified but intuitive model. The primary goal is to understand the magnetic particle deposition in the anastomosis region of the bypass graft taking into account the complex flow field created in this area which involves recirculation region, flow mixing and presence of particles with high residence time. The three-dimensional geometry model was used to simulate the motion and accumulation of the particles under the magnetic field influence in anastomotic region of the coronary bypass graft. The flow patterns are evaluated both numerically and experimentally and show a good correlation in term of flow parameters like vortex length and flow stagnation point positions. Particle depositions are strongly dependent on the magnet position and consequently of the magnetic field intensity and field gradient. Increased magnetic field controlled by the magnet position induces increased particle depositions in the bypass graft anastomosis. The result shows that particle depositions depend on the bypass graft angle, and the deposition shape and particle accumulation respectively, depend by the flow pattern in the anastomosis region.

  16. Anesthesia for off-pump coronary artery bypass surgery

    Directory of Open Access Journals (Sweden)

    Thomas M Hemmerling

    2013-01-01

    Full Text Available The evolution of techniques and knowledge of beating heart surgery has led anesthesia toward the development of new procedures and innovations to promote patient safety and ensure high standards of care. Off-pump coronary artery bypass (OPCAB surgery has shown to have some advantages compared to on-pump cardiac surgery, particularly the reduction of postoperative complications including systemic inflammation, myocardial injury, and cerebral injury. Minimally invasive surgery for single vessel OPCAB through a limited thoracotomy incision can offer the advantage of further reduction of complications. The anesthesiologist has to deal with different issues, including hemodynamic instability and myocardial ischemia during aorto-coronary bypass grafting. The anesthesiologist and surgeon should collaborate and plan the best perioperative strategy to provide optimal care and ensure a rapid and complete recovery. The use of high thoracic epidural analgesia and fast-track anesthesia offers particular benefits in beating heart surgery. The excellent analgesia, the ability to reduce myocardial oxygen consumption, and the good hemodynamic stability make high thoracic epidural analgesia an interesting technique. New scenarios are entering in cardiac anesthesia: ultra-fast-track anesthesia with extubation in the operating room and awake surgery tend to be less invasive, but can only be performed on selected patients.

  17. A kernel principal component analysis–based degradation model and remaining useful life estimation for the turbofan engine

    Directory of Open Access Journals (Sweden)

    Delong Feng

    2016-05-01

    Full Text Available Remaining useful life estimation of the prognostics and health management technique is a complicated and difficult research question for maintenance. In this article, we consider the problem of prognostics modeling and estimation of the turbofan engine under complicated circumstances and propose a kernel principal component analysis–based degradation model and remaining useful life estimation method for such aircraft engine. We first analyze the output data created by the turbofan engine thermodynamic simulation that is based on the kernel principal component analysis method and then distinguish the qualitative and quantitative relationships between the key factors. Next, we build a degradation model for the engine fault based on the following assumptions: the engine has only had constant failure (i.e. no sudden failure is included, and the engine has a Wiener process, which is a covariate stand for the engine system drift. To predict the remaining useful life of the turbofan engine, we built a health index based on the degradation model and used the method of maximum likelihood and the data from the thermodynamic simulation model to estimate the parameters of this degradation model. Through the data analysis, we obtained a trend model of the regression curve line that fits with the actual statistical data. Based on the predicted health index model and the data trend model, we estimate the remaining useful life of the aircraft engine as the index reaches zero. At last, a case study involving engine simulation data demonstrates the precision and performance advantages of this prediction method that we propose. At last, a case study involving engine simulation data demonstrates the precision and performance advantages of this proposed method, the precision of the method can reach to 98.9% and the average precision is 95.8%.

  18. Extracranial to intracranial bypass for the treatment of cerebral aneurysms in the pediatric population.

    Science.gov (United States)

    Strickland, Ben A; Attenello, Frank; Russin, Jonathan J

    2016-12-01

    Cerebral aneurysms are rare in the pediatric population, making a definitive treatment algorithm difficult. Microsurgical clipping is the first choice for treatment but is not always feasible, while high recurrence rates and radiation exposure make endovascular options less favorable. Extracranial-intracranial (EC-IC) bypass, though not commonly performed in the pediatric aneurysm population, has been reported in a small number of studies to be both safe and effective for the management of cerebral aneurysms. The authors present the case of a child with a distal middle cerebral artery (MCA) aneurysm in eloquent territory, successfully treated with a superficial temporal artery (STA) to MCA bypass and trapping. A review of the current literature on pediatric EC-IC bypass in the treatment of intracranial aneurysms is presented. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Methylene Blue for Vasoplegia When on Cardiopulmonary Bypass During Double-Lung Transplantation.

    Science.gov (United States)

    Carley, Michelle; Schaff, Jacob; Lai, Terrance; Poppers, Jeremy

    2015-10-15

    Vasoplegia syndrome, characterized by hypotension refractory to fluid resuscitation or high-dose vasopressors, low systemic vascular resistance, and normal-to-increased cardiac index, is associated with increased morbidity and mortality after cardiothoracic surgery. Methylene blue inhibits inducible nitric oxide synthase and guanylyl cyclase, and has been used to treat vasoplegia during cardiopulmonary bypass. However, because methylene blue is associated with increased pulmonary vascular resistance, its use in patients undergoing lung transplantion has been limited. Herein, we report the use of methylene blue to treat refractory vasoplegia during cardiopulmonary bypass in a patient undergoing double-lung transplantation.

  20. Bypass of a 5',8-cyclopurine-2'-deoxynucleoside by DNA polymerase β during DNA replication and base excision repair leads to nucleotide misinsertions and DNA strand breaks.

    Science.gov (United States)

    Jiang, Zhongliang; Xu, Meng; Lai, Yanhao; Laverde, Eduardo E; Terzidis, Michael A; Masi, Annalisa; Chatgilialoglu, Chryssostomos; Liu, Yuan

    2015-09-01

    5',8-Cyclopurine-2'-deoxynucleosides including 5',8-cyclo-dA (cdA) and 5',8-cyclo-dG (cdG) are induced by hydroxyl radicals resulting from oxidative stress such as ionizing radiation. 5',8-cyclopurine-2'-deoxynucleoside lesions are repaired by nucleotide excision repair with low efficiency, thereby leading to their accumulation in the human genome and lesion bypass by DNA polymerases during DNA replication and base excision repair (BER). In this study, for the first time, we discovered that DNA polymerase β (pol β) efficiently bypassed a 5'R-cdA, but inefficiently bypassed a 5'S-cdA during DNA replication and BER. We found that cell extracts from pol β wild-type mouse embryonic fibroblasts exhibited significant DNA synthesis activity in bypassing a cdA lesion located in replication and BER intermediates. However, pol β knock-out cell extracts exhibited little DNA synthesis to bypass the lesion. This indicates that pol β plays an important role in bypassing a cdA lesion during DNA replication and BER. Furthermore, we demonstrated that pol β inserted both a correct and incorrect nucleotide to bypass a cdA at a low concentration. Nucleotide misinsertion was significantly stimulated by a high concentration of pol β, indicating a mutagenic effect induced by pol β lesion bypass synthesis of a 5',8-cyclopurine-2'-deoxynucleoside. Moreover, we found that bypass of a 5'S-cdA by pol β generated an intermediate that failed to be extended by pol β, resulting in accumulation of single-strand DNA breaks. Our study provides the first evidence that pol β plays an important role in bypassing a 5',8-cyclo-dA during DNA replication and repair, as well as new insight into mutagenic effects and genome instability resulting from pol β bypassing of a cdA lesion.

  1. Power turbine bypass for improved compression braking

    Energy Technology Data Exchange (ETDEWEB)

    Brooks, R.M.; Lutz, T.P.; Stang, J.

    1992-06-09

    This patent describes a turbocompound engine having a power turbine bypass control. It comprises an internal combustion engine having a crankshaft, an intake manifold and an exhaust manifold; turbocharger means connected with the intake and exhaust manifolds for converting exhaust gas energy into mechanical energy for boosting intake air pressure; power turbine means for producing mechanical energy from energy remaining in the exhaust gases exiting the first turbine.

  2. Patient's Perception About Coronary Artery Bypass Grafting

    Directory of Open Access Journals (Sweden)

    Kelminda Maria Bulhões Mendonça

    2015-10-01

    Full Text Available ABSTRACT OBJECTIVE: The diagnosis of coronary artery disease referred for heart surgery has an important psychological component. The purpose of this study was to access the difficulties experienced by individuals awaiting coronary artery bypass grafting and to determine strategies that facilitate adaptation to a new lifestyle, modified by the disease. METHODS: A qualitative, exploratory study involving patients admitted to a university teaching hospital in the city of Salvador, Bahia, Brazil, awaiting coronary artery bypass grafting. Semi-structured interviews were performed in accordance with a previously defined script based on the study objective. Each transcription was read in its entirety to verify the representativeness, homogeneity and pertinence of the data obtained (pre-analysis, followed by separation of categories of analysis. RESULTS: The descriptions of this study show that patients admitted to the completion of coronary artery bypass grafting experience a wide range of psychological difficulties, considering that surgery acquires interpretations that vary according to individuals' subjectivity. The patients recognized the benefit of being able to discuss their feelings as a means of diminishing their fear and anxiety. CONCLUSION: Helping patients find resources to confront more positively the daily hospitalization is an important aspect for the health care professionals who assist them. This goal can be achieved through modification of the biomedical model of care for a biopsychosocial view. The investment of time and attention is of fundamental importance and aims to overcome existing deficiencies that interfere with the outcome of patients after cardiac surgery.

  3. Atypical complications of gastric bypass surgery

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, Myrosia T. [University of Chicago, Department of Radiology, 5841 S. Maryland Avenue, MC 2026, Chicago, IL 60637 (United States)]. E-mail: mmitchell@radiology.bsd.uchicago.edu; Pizzitola, Victor J. [University of Chicago, Department of Radiology, 5841 S. Maryland Avenue, MC 2026, Chicago, IL 60637 (United States); Knuttinen, M-Grace [University of Chicago, Department of Radiology, 5841 S. Maryland Avenue, MC 2026, Chicago, IL 60637 (United States); Robinson, Tiffany [University of Chicago, Department of Internal Medicine, 5841 S. Maryland Avenue, MC 2026, Chicago, IL 60637 (United States); Gasparaitis, Arunas E. [University of Chicago, Department of Radiology, 5841 S. Maryland Avenue, MC 2026, Chicago, IL 60637 (United States)

    2005-03-01

    Although gastric bypass surgery continues to grow in popularity for weight loss and weight maintenance in the morbidly obese, there has been little attention given to the imaging of complications associated with these surgeries. The purpose of our study is to demonstrate the variety of gastric bypass surgery complications that can be identified radiographically, with attention to the more unusual complications. This study was performed with institutional Internal Review Board approval. We performed a 5-year retrospective review of all patients who had undergone gastric bypass surgery, had complications of the surgery, and had studies performed in our department to image these complications. These studies consisted of contrast fluoroscopy and CT. We identified the more common complications of anastomotic stenoses and anastomotic leaks. We also identified six unusual complications as follow: (1) internal herniation through the small bowel mesentery, (2) internal herniation through the transverse mesocolon, (3) external herniation through the abdominal wall incision, (4) enterocutaneous fistulas, (5) antiperistaltic construction of the Roux-en-Y, and (6) incorrect anstomoses of the Roux limbs resulting in a Roux-en-O configuration. Our findings show that a thorough understanding of expected postoperative bowel configuration is essential in the evaluation of these patients. In addition, fluoroscopic evaluation should assess not only anatomy, but also motility.

  4. The combined ipsilateral antegrade-retrograde approach to insert an endoluminal femoropopliteal bypass

    NARCIS (Netherlands)

    Lensvelt, M.M.A.; Zeebregts, C.J.A.; Stoer-Bouwman, M.; Reijnen, M.M.P.J.

    2011-01-01

    The endoluminal femoropopliteal bypass is a minimally invasive treatment modality for occlusive superficial femoral artery disease. Technical failure of endovascular treatment of chronic total occlusions is often caused by the inability to re-enter the true lumen. Re-entry devices have a high techni

  5. THE ROLE OF DIFFERENT TYPES OF CORTICOSTEROIDS ON THE INFLAMMATORY MEDIATORS IN CARDIOPULMONARY BYPASS

    NARCIS (Netherlands)

    JANSEN, NJG; VANOEVEREN, W; VANVLIET, M; STOUTENBEEK, CP; EYSMAN, L; WILDEVUUR, CRH

    1991-01-01

    In a placebo-controlled double-blind study on patients undergoing cardiopulmonary bypass (CPB) we studied the inhibited effects of dexamethasone, a high dose of methylprednisolone, and a low dose of prednisolone on the inflammatory reaction induced by CPB. During CPB two episodes of blood activation

  6. A new beating-heart off-pump coronary artery bypass grafting training model

    NARCIS (Netherlands)

    Bouma, Wobbe; Kuijpers, Michiel; Bijleveld, Aanke; De Maat, Gijs E.; Koene, Bart M.; Erasmus, Michiel E.; Natour, Ehsan; Mariani, Massimo A.

    OBJECTIVES: Training models are essential in mastering the skills required for off-pump coronary artery bypass grafting (OPCAB). We describe a new, high-fidelity, effective and reproducible beating-heart OPCAB training model in human cadavers. METHODS: Human cadavers were embalmed according to the

  7. How to train surgical residents to perform laparoscopic roux-en-Y gastric bypass safely

    NARCIS (Netherlands)

    G.I.T. Iordens (Gijs); R.A. Klaassen (René); E.M.M. van Lieshout (Esther); B.I. Cleffken (Berry); E. van der Harst (Erwin)

    2012-01-01

    textabstractBackground As a result of increasing numbers of patients with morbid obesity there is a worldwide demand for bariatric surgeons. The Roux-en-Y gastric bypass, nowadays performed mostly laparoscopically (LRYGB), has been proven to be a highly effective surgical treatment for morbid

  8. Hedonic changes in food choices following Roux-en-Y gastric bypass

    DEFF Research Database (Denmark)

    Hansen, Thea Toft; Jakobsen, Tine Anette; Nielsen, Mette Søndergaard

    2016-01-01

    It has been suggested that a shift in food choices leading to a diet with a lower energy density plays an important role in successful weight loss after Roux-en-Y gastric bypass (RYGB) surgery. A decreased hedonic drive to consume highly palatable foods may explain these changes in eating behavior...

  9. CARDIAD approach to system dominance with application to turbofan engine models. [Complex Acceptability Region for DIAgonal Dominance in multivariable systems analysis and design

    Science.gov (United States)

    Schafer, R. M.; Sain, M. K.

    1980-01-01

    The paper presents the CARDIAD (complex acceptability region for diagonal dominance) method for achieving the diagonal dominance condition in the inverse Nyquist array approach to the analysis and design of multivariable systems in the frequency domain. A design example is given for a sixth order, 4-input, 4-output model of a turbofan engine.

  10. 75 FR 34924 - Airworthiness Directives; CFM International, S.A. CFM56-5, -5B, and -7B Series Turbofan Engines

    Science.gov (United States)

    2010-06-21

    ... stage 3 low-pressure turbine (LPT) disks, identified by serial number (S/N). This AD results from the... International CFM56-5, -5B, and -7B series turbofan engines with stage 3 low-pressure turbine (LPT) disks part... distribution of power and responsibilities among the various levels of government. For the reasons...

  11. Development of techniques for gastrojejunal bypass surgery in obese mice.

    Science.gov (United States)

    Lan, Zhu; Zassoko, Roman; Liu, Weihua; Garcia, Bertha; Sun, Hongtao; Wang, Rennian; Wang, Hao

    2010-05-01

    We have previously described a duodenojejunal bypass (DJB) surgical model in healthy C57BL/6 mice. However, our pilot study showed that the same surgical technique caused a high mortality rate in obese mice. In this study, to significantly improve animal survival rate following bariatric surgery and thereby providing a stable surgical model for the study of glucose homeostasis in obese mice, we have used modified techniques and developed the end-to-side gastrojejunal bypass (GJB) surgery in obese C57BL/6 with impaired glucose tolerance. The modification consisted of using the distal part of the jejunum for biliopancreatic diversion including: 1) ligation of the distal stomach at the level of the pylorus; 2) connection the jejunum to the anterior wall of stomach in an end-to-side fashion; and 3) diverting the biliopancreatic secretions through the blind limb into the distal jejunum through an end-to-side anastomosis. We found that by modifying the proximal end-to-end duodenojejunal anastomosis, described in our original model, to an end-to-side gastrojejunal anastomosis in these obese mice, we were able to significantly improve the postoperative mortality in this study. We have also demonstrated that performing the GJB surgery in obese mice resulted in significant weight loss, normalized blood glucose levels, and prevented acute pancreatitis. This newly developed GJB surgery in the obese mice offers a unique advantage to study the mechanisms of gastrointestinal surgery as treatment for type 2 diabetes.

  12. Emergency coronary artery bypass surgery after failed percutaneous coronary intervention.

    Science.gov (United States)

    Darwazah, A K; Islim, I; Hanbali, B; Shama, R A; Aloul, J

    2009-12-01

    The incidence of patients subjected to emergency coronary artery bypass graft (CABG) after percutaneous coronary intervention (PCI) is decreasing due to improvement of PCI technique and device technology. The aim of our study is to evaluate cases subjected to emergency CABG after complicated PCI to determine incidence, indications and results of surgery and to compare them with other emergency cases which are not related to angioplasty or stenting. From April 1999 to December 2005, 1 200 patients who underwent PCI were analysed. Those patients who developed complications related to PCI and required surgical intervention were included (PCI group N.=31). These patients were compared with other emergency cases not related to PCI (non-PCI group N.=48). The selection of these patients was based on the criteria of the Society of Thoracic Surgeons. The incidence of PCI complications which necessitated emergency surgical intervention was 2.6%. The main indication was due to unsatisfactory angioplasty with ongoing myocardial ischemia (68%), stent thrombosis (13%), dissection (10%) retained angioplasty wire (6.5%), and perforation (3%). The incidence of cardiogenic shock, ongoing ischemia, acute infarction Emergency coronary artery bypass grafting among patients with PCI complications and those patients not related to PCI is associated with high mortality and morbidity. Although, the percentage of mortality and morbidity was more among PCI patients the difference between both groups was not significant. Surgical backup and collaboration between cardiologist and surgeons is needed to reduce delay in management and patients transfer to obtain the best surgical outcome.

  13. Dynamic Experimental Study of a Multi—bypass Pulse Tube Refrigerator with Two—bypass Tubes

    Institute of Scientific and Technical Information of China (English)

    YonglinJu; ChaoWang; 等

    1998-01-01

    A dynamic experimental apparatus to measure the instantaneous velocity and pressure in the multibypass pulse tube refrigerator(MPTR) was designed and constructed.Some important experimental results of the instantaneous measurements of the velocity and the pressure in the MPTR with twobypass tubes during actual operation are prsented.The effects of the middle-bypass version on the dynamic pressure and mass flow rate at the cold end of the pulse tube are ev aluated from experimental measurements.DC-flow phenomena are observed in this MPTR.The reasons of the multi-bypass version improved the performance of pulse tube refrigertor are given.

  14. EFFECTS OF GRAPHITE SURFACE ROUGHNESS ON BYPASS FLOW COMPUTATIONS FOR AN HTGR

    Energy Technology Data Exchange (ETDEWEB)

    Rich Johnson; Yu-Hsin Tung; Hiroyuki Sato

    2011-07-01

    Bypass flow in a prismatic high temperature gas reactor (HTGR) occurs between graphite blocks as they sit side by side in the core. Bypass flow is not intentionally designed to occur in the reactor, but is present because of tolerances in manufacture, imperfect installation and expansion and shrinkage of the blocks from heating and irradiation. It is desired to increase the knowledge of the effects of such flow, which has been estimated to be as much as 20% of the total helium coolant flow. Computational fluid dynamic (CFD) simulations can provide estimates of the scale and impacts of bypass flow. Previous CFD calculations have examined the effects of bypass gap width, level and distribution of heat generation and effects of shrinkage. The present contribution examines the effects of graphite surface roughness on the bypass flow for different relative roughness factors on three gap widths. Such calculations should be validated using specific bypass flow measurements. While such experiments are currently underway for the specific reference prismatic HTGR design for the next generation nuclear plant (NGNP) program of the U. S. Dept. of Energy, the data are not yet available. To enhance confidence in the present calculations, wall shear stress and heat transfer results for several turbulence models and their associated wall treatments are first compared for flow in a single tube that is representative of a coolant channel in the prismatic HTGR core. The results are compared to published correlations for wall shear stress and Nusselt number in turbulent pipe flow. Turbulence models that perform well are then used to make bypass flow calculations in a symmetric onetwelfth sector of a prismatic block that includes bypass flow. The comparison of shear stress and Nusselt number results with published correlations constitutes a partial validation of the CFD model. Calculations are also compared to ones made previously using a different CFD code. Results indicate that

  15. Extra-intracranial standard bypass in the elderly

    DEFF Research Database (Denmark)

    Sandow, Nora; von Weitzel-Mudersbach, Paul; Rosenbaum, Sverre;

    2013-01-01

    Patients with chronic atherosclerotic vessel occlusion and cerebrovascular hemodynamic insufficiency may benefit from extra-intracranial (EC-IC) bypass surgery. Due to demographic changes, an increasing number of elderly patients presents with cerebrovascular hemodynamic insufficiency. So far......, little data for EC-IC bypass surgery in elderly patients suffering occlusive cerebrovascular disease are available. We therefore designed a retrospective study to address the question whether EC-IC bypass is a safe and efficient treatment in a patient cohort ≥70 years....

  16. A marked increase in gastric fluid volume during cardiopulmonary bypass

    OpenAIRE

    2011-01-01

    Major physiological stress occurs during cardiac surgery with cardiopulmonary bypass. This is related to hypothermia and artificial organ perfusion. Thus, serious gastrointestinal complications, particularly upper gastrointestinal bleeding, sometimes follow cardiac surgery. We have compared the antisecretory effects of a preanesthetic H2 antagonist (roxatidine, cardiopulmonary bypass-H2 group, n = 15) and a proton pump inhibitor (rabeprazole, cardiopulmonary bypass-PPI group, n = 15) in patie...

  17. Extra-corporeal membrane oxygenation during the beating heart coronary artery bypass grafting for ;high risk patients-a single center experience%体外膜肺氧合在高危重症冠心病患者心脏不停跳冠状动脉旁路移植术中的应用

    Institute of Scientific and Technical Information of China (English)

    段大为; 刘迎午; 胡晓旻; 刘博江; 吴鹏; 张强; 李彤

    2016-01-01

    目的:总结体外膜肺氧合( extra-corporeal membrane oxygenation,ECMO)在高危重症冠心病患者心脏不停跳冠状动脉旁路移植术( coronary artery bypass grafting,CABG)中的应用方法和效果。方法选取2007年11月至2014年6月天津市第三中心医院心脏外科的高危重症冠心病行CABG术患者21例,年龄70~83(75.7±3.6)岁,在ECMO辅助下实施择期心脏不停跳CABG术。结果21例患者中,8例术后即刻顺利脱离ECMO辅助;8例桥血管吻合后ECMO不能立即撤离,继续辅助2.0~4.5 h 后撤离;5例在手术室时 ECMO 不能撤离,关胸后返回冠心病重症监护病房( CCU),考虑ECMO辅助时间较长,为克服ECMO非搏动性灌注,联合主动脉内球囊反搏( intra-aortic balloon pump,IABP)支持,IABP辅助时间76~147(115.2±25.9)h。5例CCU内ECMO辅助患者中:股动静脉插管部位渗血1例,经止血及加压包扎后好转;下肢缺血1例,安装旁路循环后缺血改善;均顺利脱机。21例患者均康复出院,住院时间11~28(17.4±2.8) d。结论 ECMO用于心脏不停跳CABG术可为高危重症冠心病患者提供手术治疗的支持和保护。%Objective To summarize clinical application, method and result of extra-corporeal membrane oxygenation ( ECMO) used during beating heart coronary artery bypass grafting ( CABG) in high risk patients. Methods Twenty one patients [ mean age ( 75. 7 ± 3. 6 ) years old ] who received beating-heart CABG surgery assisted with ECMO were included in the study. We observed the condition when ECMO weaned off, the duration on mechanical rentilato time of ICU stay and the occurance of related complications. Results Among the 21 patients, ECMO was weaned off uneventfully after surgery in 8 patients. Immediate weaning was failed in another 8 patients and required gradual weaning in 2. 0-4. 5 hrs. Five patients could not wean off the ECMO in operation room needing continuous ECMO support in CCU. ECMO was weaned off in CCU gradually with

  18. Hormonal and metabolic responses of fetal lamb during cardiopulmonary bypass

    Institute of Scientific and Technical Information of China (English)

    苏肇伉; 周成斌; 张海波; 祝忠群

    2003-01-01

    Objective To study the hormonal and metabolic responses of fetal lamb during cardiopulmonary bypass.Methods Six pregnant ewes underwent fetal cardiopulmonary bypasses with artificial oxygenators and roller pumps for 30 minutes, which maintained the blood gas value at the fetal physiological level. The fetal blood pressure, heart rate, pH value and blood lactate levels were monitored. The levels of catecholamine, cortisol and insulin were measured pre-bypass and then again 30 minutes later. The blood glucose and free fatty acid levels were monitored continuously during the bypass. Fetal hepatic PAS staining was also carried out.Results There were no changes before and during the bypass in fetal blood pressure, heart rate and blood gas. However, pH values decreased and blood lactate levels increased (P<0.05). The fetal catecholamine and cortisol levels increased significantly (P<0.01), while the levels of insulin did not change. The blood glucose and free fatty acid levels increased at the beginning of the bypass (P<0.01), and then gradually slowed down during the bypass. The fetal hepatic PAS staining showed that hepatic glycogen was consumed in large amounts. After 30 minutes of bypass, the fetal lamb would not survive more than 1 hour.Conclusion The fetal lamb has a strong negative reaction to cardiopulmonary bypass.

  19. Obstetrical and neonatal outcomes in women following gastric bypass

    DEFF Research Database (Denmark)

    Berlac, Janne Foss; Skovlund, Charlotte Wessel; Lidegaard, Ojvind

    2014-01-01

    OBJECTIVE: To assess obstetrical and neonatal outcomes in women following gastric bypass, compared with adipose women without surgery and with a normal weight control population. DESIGN: Historical controlled cohort study. SETTING: Denmark. POPULATION: All women undergoing gastric bypass during...... the period 1996-2011, and subsequently giving birth. METHODS AND MAIN OUTCOME MEASURES: Obstetrical and neonatal outcomes in women without gastric bypass matched on age, parity, plurality, year, and body mass index, and normal weight women. RESULTS: In 415 women giving birth after gastric bypass we found...

  20. Endovascular exclusion of aortoesophageal fistula after coarctation extraanatomical bypass.

    Science.gov (United States)

    Myers, Patrick O; Gemayel, Gino; Mugnai, Damiano; Murith, Nicolas; Kalangos, Afksendiyos

    2014-07-01

    Extraanatomical bypass has been advocated as the primary technique in adolescents or adults presenting with aortic coarctation. This approach carries significant morbidity, and graft-related complications may be more important in the young patient population. A 52-year-old man who had previously undergone extraanatomical bypass of aortic coarctation was diagnosed with a distal anastomotic pseudoaneurysm and aortoesophageal fistula. This was managed by proximal bypass plugging with an occluder, endovascular exclusion with a stent-graft in the thoracic descending aorta covering the pseudoaneurysm, and coarctation balloon dilation. Aortoesophageal fistula is a late complication observed after extraanatomical bypass for coarctation. This case illustrates this rare complication.

  1. Awake off-pump coronary artery bypass surgery in 25 patients

    Institute of Scientific and Technical Information of China (English)

    GUO Huiming(郭惠明); Murali Chakravarthy; Vivek Jawali; K Jayaprakash; NV Shivananda

    2003-01-01

    Objectives To test the fea-sibility of the use of high thoracic epidural anesthesia as a sole anesthetic in patients undergoing off pump coronary artery bypass surgery, avoiding general anesthesia. Methods Between October 2002 to April 2003, twenty five cases underwent beating heart coronary artery revascularization without endotracheal general anesthesia, using high thoracic epidural anesthesia and analgesia. All the patients underwent epidural catheterization on the evening before the surgery. Results The patients in all received 71 grafts (single n = 11, double n = 5, triple n = 6, quadruple n = 3). Six patients underwent repeat coronary artery bypass. Except one was converted to general anesthesia and cardiopulmonary bypass, the other patients underwent off-pump coronary artery bypass graft surgery, 2 patients underwent grafting via left thoracotomy (MIDCAB) and the rest through mid sternotony. There was no mortality. Mean length of stay in the intensive care tnit was 16.2 ( 4.2 hours and hospital was 3.0(1.2 days. Conclusions Our experience confirms the feasibility of performing multiple coronary artery bypassesin conscious patients without endotracheal general an esthesia.

  2. Peripheral arterial blood pressure versus central crterial blood pressure monitoring in critically ill patients after Cardio-pulmonary Bypass.

    Science.gov (United States)

    Ahmad, Rana Altaf; Ahmad, Suhail; Naveed, Anjum; Baig, Mirza Ahmad Raza

    2017-01-01

    To determine the accuracy of peripheral (radial) arterial access as compared to central (femoral) arterial access for measurement of invasive blood pressure (IBP) in critically ill patients after cardiopulmonary bypass. Sixty patients (60) who required high inotropic/vasopressor support on weaning from cardio-pulmonary bypass and weaned off in 2(nd) attempt were included in this study. The duration of this study was from June 2015 to August 2016. Radial and femoral arterial access was achieved in all patients for simultaneous measurement of blood pressure. Arterial pressures were noted after 5, 15 and 30 minutes of weaning from cardiopulmonary bypass for both radial and femoral artery simultaneously. Mean age of study patients was 56.48±11.17 years. 85% patients were male. There was significant difference in systolic blood pressure, diastolic blood pressure and mean arterial pressures between the radial artery and femoral artery cannulation. Mean arterial pressures were significantly high in femoral artery as compared to the radial artery. The mean arterial pressures after five minutes of weaning using central access were 76.28±10.21 mmHg versus 64.15±6.76 mmHg in peripheral arterial access (p-value arterial pressures after 15 minutes of weaning from cardiopulmonary bypass 78.70±10.12 mmHg in central access versus 72.03±6.76 mmHg using peripheral arterial access (p-value arterial pressures were less marked as compared to the previous differences after 30 minutes of weaning from cardiopulmonary bypass as compared to the earlier readings (p-value 0.001). Peripheral arterial pressures are unreliable in critically ill patients after cardiopulmonary bypass receiving high dose of inotropic drugs. Central arterial access should be used in these patients to get accurate estimates of patients' blood pressure in early periods after cardiopulmonary bypass.

  3. Reoperative coronary bypass grafting without cardiopulmonary bypass through a small thoracotomy

    NARCIS (Netherlands)

    Boonstra, PW; Grandjean, JG; Mariani, MA

    Background. The danger of coronary reoperations is mainly hidden in the reopening of the sternum and in the manipulation of the heart and the old grafts. Therefore, the minimally invasive direct coronary artery bypass procedure seems an ideal technique for coronary reoperations if only the left

  4. On streak breakdown in bypass transition

    Science.gov (United States)

    Schlatter, Philipp; Brandt, Luca; de Lange, H. C.; Henningson, Dan S.

    2008-10-01

    Recent theoretical, numerical, and experimental investigations performed at the Department of Mechanics, KTH Stockholm, and the Department of Mechanical Engineering, Eindhoven University of Technology, are reviewed, and new material is presented to clarify the role of the boundary-layer streaks and their instability with respect to turbulent breakdown in bypass transition in a boundary layer subject to free-stream turbulence. The importance of the streak secondary-instability process for the generation of turbulent spots is clearly shown. The secondary instability manifests itself as a growing wave packet located on the low-speed streak, increasing in amplitude as it is dispersing in the streamwise direction. In particular, qualitative and quantitative data pertaining to temporal sinuous secondary instability of a steady streak, impulse responses both on a parallel and a spatially developing streak, a model problem of bypass transition, and full simulations and experiments of bypass transition itself are collected and compared. In all the flow cases considered, similar characteristics in terms of not only growth rates, group velocity, and wavelengths but also three-dimensional visualizations of the streak breakdown have been found. The wavelength of the instability is about an order of magnitude larger than the local boundary-layer displacement thickness δ∗, the group velocity about 0.8 of the free-stream velocity U∞, and the growth rate on the order of a few percent of U∞/δ∗. The characteristic structures at the breakdown are quasistreamwise vortices, located on the flanks of the low-speed region arranged in a staggered pattern.

  5. Methylprednisolone in patients undergoing cardiopulmonary bypass (SIRS): a randomised, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Whitlock, Richard P; Devereaux, P J; Teoh, Kevin H; Lamy, Andre; Vincent, Jessica; Pogue, Janice; Paparella, Domenico; Sessler, Daniel I; Karthikeyan, Ganesan; Villar, Juan Carlos; Zuo, Yunxia; Avezum, Álvaro; Quantz, Mackenzie; Tagarakis, Georgios I; Shah, Pallav J; Abbasi, Seyed Hesameddin; Zheng, Hong; Pettit, Shirley; Chrolavicius, Susan; Yusuf, Salim

    2015-09-26

    Cardiopulmonary bypass initiates a systemic inflammatory response syndrome that is associated with postoperative morbidity and mortality. Steroids suppress inflammatory responses and might improve outcomes in patients at high risk of morbidity and mortality undergoing cardiopulmonary bypass. We aimed to assess the effects of steroids in patients at high risk of morbidity and mortality undergoing cardiopulmonary bypass. The Steroids In caRdiac Surgery (SIRS) study is a double-blind, randomised, controlled trial. We used a central computerised phone or interactive web system to randomly assign (1:1) patients at high risk of morbidity and mortality from 80 hospital or cardiac surgery centres in 18 countries undergoing cardiac surgery with the use of cardiopulmonary bypass to receive either methylprednisolone (250 mg at anaesthetic induction and 250 mg at initiation of cardiopulmonary bypass) or placebo. Patients were assigned with block randomisation with random block sizes of 2, 4, or 6 and stratified by centre. Patients aged 18 years or older were eligible if they had a European System for Cardiac Operative Risk Evaluation of at least 6. Patients were excluded if they were taking or expected to receive systemic steroids in the immediate postoperative period or had a history of bacterial or fungal infection in the preceding 30 days. Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcomes were 30-day mortality and a composite of death and major morbidity (ie, myocardial injury, stroke, renal failure, or respiratory failure) within 30 days, both analysed by intention to treat. Safety outcomes were also analysed by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00427388. Patients were recruited between June 21, 2007, and Dec 19, 2013. Complete 30-day data was available for all 7507 patients randomly assigned to methylprednisolone (n=3755) and to placebo (n=3752). Methylprednisolone, compared

  6. Flow characteristics in narrowed coronary bypass graft

    Energy Technology Data Exchange (ETDEWEB)

    Bernad, S. I. [Romanian Academy – Timisoara Branch, Mihai Viteazul Str. 24, RO-300223, Timisoara (Romania); Bosioc, A.; Totorean, A. F. [University Politehnica of Timisoara, Department of Hydraulic Machinery, Mihai Viteazul Str. 1, RO-300222, Timisoara (Romania); Bernad, E. S.; Petre, I. [University of Medicine and Pharmacy Victor Babes Timisoara, P-ta Eftimie Murgu, 2, Timisoara (Romania)

    2016-06-08

    Tortuous saphenous vein graft (SVG) hemodynamics was investigated using computational fluid dynamics (CFD) techniques. Computed tomography (CT) technology is used for non-invasive bypass graft assessment 7 days after surgery. CT investigation shown two regions with severe shape remodelling first is an elbow type contortion and second is a severe curvature with tortuous area reduction. In conclusion, the helical flow induced by vessel torsion may stabilize the blood flow in the distal part of the SVG, reducing the flow disturbance and suppressing the flow separation, but in the distal end of the graft, promote the inflammatory processes in the vessels.

  7. TRAS principles blight arterial bypass and plasty.

    Directory of Open Access Journals (Sweden)

    Kothari M

    1997-04-01

    Full Text Available A new concept--Tissue Requisitions (Principle I/Relinquishes (Principle II Arterial Supply--of TRAS principles is introduced to help appreciate the failures/successes of modern medicine′s attempts at restoring arterial flow in luminally compromised coronary/carotid fields, an invasive branch rightly called vascular ReRheology, which comprises diagnosing/treating arterial blocks. The technical wizardry of arterial reconstruction (bypass or lumen--restoration (plasty has to reckon with the TRAS principles all the time.

  8. Bypass variants of Zgornji Hotič

    OpenAIRE

    Vozelj, Nejc

    2014-01-01

    In my Graduation Thesis we presented the solution of road through Zgornji Hotič. This road si daily very busy, because the road is the main connection between the capital of Slovenia and the region Zasavje. The discussed road through Zgornji Hotič is problematic because of dangerous sections of the road and nearby buildings, which lower the transportability and safety of the road. As a solution we have decided to make a bypass between the south-end of Zgornji Hotič and the river Sava. We have...

  9. Work on the Geneva motorway bypass

    CERN Multimedia

    État de Genève, DCTI, Direction du génie civil

    2006-01-01

    Work on the airport section of the Geneva motorway bypass is continuing and will require the temporary closure of two sliproads allowing traffic to make a U-turn near the airport and the Palexpo exhibition centre. The sliproads on the French and Lausanne sides will be closed until autumn 2006. U-turns will still be possible via clearly marked deviations. For further information: www.autoroute-aeroport.ch We would like to thank you in advance for your understanding. Civil Engineering Department, DCTI, State of Geneva

  10. Flow characteristics in narrowed coronary bypass graft

    Science.gov (United States)

    Bernad, S. I.; Bosioc, A.; Bernad, E. S.; Petre, I.; Totorean, A. F.

    2016-06-01

    Tortuous saphenous vein graft (SVG) hemodynamics was investigated using computational fluid dynamics (CFD) techniques. Computed tomography (CT) technology is used for non-invasive bypass graft assessment 7 days after surgery. CT investigation shown two regions with severe shape remodelling first is an elbow type contortion and second is a severe curvature with tortuous area reduction. In conclusion, the helical flow induced by vessel torsion may stabilize the blood flow in the distal part of the SVG, reducing the flow disturbance and suppressing the flow separation, but in the distal end of the graft, promote the inflammatory processes in the vessels.

  11. Hematological Disorders following Gastric Bypass Surgery: Emerging Concepts of the Interplay between Nutritional Deficiency and Inflammation

    Directory of Open Access Journals (Sweden)

    Mingyi Chen

    2013-01-01

    Full Text Available Obesity and the associated metabolic syndrome are among the most common and detrimental metabolic diseases of the modern era, affecting over 50% of the adult population in the United States. Surgeries designed to promote weight loss, known as bariatric surgery, typically involve a gastric bypass procedure and have shown high success rates for treating morbid obesity. However, following gastric bypass surgery, many patients develop chronic anemia, most commonly due to iron deficiency. Deficiencies of vitamins B1, B12, folate, A, K, D, and E and copper have also been reported after surgery. Copper deficiency can cause hematological abnormalities with or without neurological complications. Despite oral supplementation and normal serum concentrations of iron, copper, folate, and vitamin B12, some patients present with persistent anemia after surgery. The evaluation of hematologic disorders after gastric bypass surgery must take into account issues unique to the postsurgery setting that influence the development of anemia and other cytopenias. In this paper, the clinical characteristics and differential diagnosis of the hematological disorders associated with gastric bypass surgery are reviewed, and the underlying molecular mechanisms are discussed.

  12. Mechanisms by which Human Cells Bypass Damaged Bases during DNA Replication after Ultraviolet Irradiation

    Directory of Open Access Journals (Sweden)

    James E. Cleaver

    2002-01-01

    Full Text Available The replication of damaged DNA involves cascading mechanisms of increasing complexity but decreasing accuracy. The most accurate mechanism uses low-fidelity DNA polymerases, Pol H and Pol I, which have active sites sufficiently large to accommodate a pyrimidine dimer. Replicative bypass of DNA damage by these polymerases produces an accurately replicated, newly synthesized strand. Pol H negative cells (XP-V cell lines either adopt a proposed secondary bypass mechanism or a recombinational mode. The mechanism of the secondary bypass is unclear, but a number of experiments suggests roles for excision repair to remove damage ahead of replication forks, hRad6/18 proteolysis to clear the blocked forks, and the Rad17-RFC and 9-1-1 complexes to establish a new replication apparatus. This alternative pathway requires functional p53. In Pol H negative cells in which p53 is also inactive, the arrested fork fragments into DNA double strand breaks. Foci containing PCNA, Mre11/Rad50/Nbs1, and gamma-H2Ax can then be detected, along with chromosomal rearrangement and high frequencies of sister chromatid exchanges. The recruitment of recombination components to the arrested forks represents the ultimate failure of replication machinery to relieve the arrested state and bypass the damage. The resulting chromosomal instability in surviving cells will contribute to malignant transformation.

  13. Giant and complex aneurysms treatment with preservation of flow via bypass technique.

    Science.gov (United States)

    Thines, L; Proust, F; Marinho, P; Durand, A; van der Zwan, A; Regli, L; Lejeune, J-P

    2016-02-01

    Due to their anatomical characteristics and the complexity of the procedures required to obtain their complete occlusion, the treatment of giant intracranial aneurysms is a real challenge. Direct reconstructive strategies, whether by interventional neuroradiology (coils, stents) or microsurgical (clipping) means, are not always applicable and, in patients that would not tolerate parent or collateral artery sacrifice, the adjunction of a revascularization procedure using a bypass technique might be necessary. Cerebral arterial bypasses can be classified according to their function (3 types: flow replacement, flow reversal or protective), the branching mode of the graft used (3 types: pedicled, interpositional or in situ), the sites of anastomosis (2 types: extracranial-intracranial or intracranial-intracranial) and the class of flow they are supposed to provide (3 types: low-, intermediate- or high-flow). In this article, the authors review the different aspects in the management of patients with a giant intracranial aneurysm using a bypass: preoperative work-up, types of bypass and indications, surgical techniques and results.

  14. Microvolt T-wave alternans in patients undergoing elective coronary artery bypass grafting: a pilot study.

    Science.gov (United States)

    Khoueiry, G; Abdallah, M; Shariff, M; Kowalski, M; Lafferty, J

    2015-01-01

    We designed a prospective observational study targeting a selective population of patients undergoing elective coronary artery bypass grafting with normal systolic function. In this study we looked at the prevalence of pre-operative microvolt T-wave alternans and if it predicts atrial fibrillation after surgery. The inclusion criteria included all patients referred to the cardiothoracic outpatient clinic for elective bypass, who can perform aerobic exercise, with a recent exercise stress test exercising at least to 85% of the maximal predicted heart rate (220 - age) and with non-limiting chest pain at maximal exercise. Twenty patients met the inclusion/exclusion criteria between May 2008 and February 2010. The hospital course of those patients was followed, and in-hospital events were recorded. Nine out twenty (45%) of patients had a non-negative microvolt T-wave alternans tracing. Six patients (30%) developed new onset atrial fibrillation post surgery. Patients with non-negative microvolt level T-wave alternans are more likely to develop atrial fibrillation post coronary artery bypass grafting then patients with negative microvolt level T-wave alternans (p=0.05). This pilot study provides the first clinical evidence that patients with ischemic heart disease and normal systolic function have a high prevalence of abnormal microvolt T-wave alternans and might be at higher risk of sudden cardiac death. In addition our results show that microvolt level T-wave alternans predicts post coronary artery bypass grafting new onset atrial fibrillation.

  15. Dacron or PTFE for above-knee femoropopliteal bypass. a multicenter randomised study

    DEFF Research Database (Denmark)

    Jensen, L P; Lepäntalo, M; Fossdal, J E

    2007-01-01

    To compare polytetrafluorethylene (PTFE) and polyester grafts (Dacron) for above knee femoropopliteal bypass.......To compare polytetrafluorethylene (PTFE) and polyester grafts (Dacron) for above knee femoropopliteal bypass....

  16. Computed tomography perfusion evaluation after extracranial-intracranial bypass surgery

    NARCIS (Netherlands)

    Vos, P.C.; Riordan, A.J.; Smit, E.J.; Jong, H.W. de; Zwan, A. van der; Velthuis, B.K.; Viergever, M.A.; Dankbaar, J.W.

    2015-01-01

    OBJECTIVE: Perfusion imaging is increasingly used for postoperative evaluation of extracranial to intracranial (EC-IC) bypass surgery. Altered hemodynamics and delayed arrival of the contrast agent in the area fed by the bypass can influence perfusion measurement. We compared perfusion asymmetry obt

  17. Haemodynamics during maximal exercise after coronary bypass surgery

    NARCIS (Netherlands)

    P.W.J.C. Serruys (Patrick); M.F. Rousseau (Francois); J. Cosyns; R. Ponlot; L.A. Brasseur; J-M.R. Detry (Jean-Marie)

    1978-01-01

    textabstractFifty patients underwent an objective measurement of physical working capacity by means of a multistage test of maximally tolerated exertion before and after coronary bypass surgery; 29 patients also had haemodynamic measurements during maximal exercise before and after coronary bypass s

  18. Renal tubular acidosis secondary to jejunoileal bypass for morbid obesity

    DEFF Research Database (Denmark)

    Schaffalitzky de Muckadell, O B; Ladefoged, Jens; Thorup, Jørgen Mogens

    1985-01-01

    Renal handling of acid and base was studied in patients with persistent metabolic acidosis 3-9 years after jejunoileal bypass for morbid obesity. Excretion of acid was studied before and after intravenous infusion of NH4Cl and excretion of bicarbonate after infusion of NaHCO3. Bypass patients...

  19. Haemodynamics during maximal exercise after coronary bypass surgery

    NARCIS (Netherlands)

    P.W.J.C. Serruys (Patrick); M.F. Rousseau (Francois); J. Cosyns; R. Ponlot; L.A. Brasseur; J-M.R. Detry (Jean-Marie)

    1978-01-01

    textabstractFifty patients underwent an objective measurement of physical working capacity by means of a multistage test of maximally tolerated exertion before and after coronary bypass surgery; 29 patients also had haemodynamic measurements during maximal exercise before and after coronary bypass

  20. 20 CFR 631.38 - State by-pass authority.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false State by-pass authority. 631.38 Section 631.38 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROGRAMS UNDER TITLE III OF THE JOB TRAINING PARTNERSHIP ACT State Administration § 631.38 State by-pass authority....

  1. Computed tomography perfusion evaluation after extracranial-intracranial bypass surgery

    NARCIS (Netherlands)

    Vos, Pieter C.; Riordan, Alan J.; Smit, Ewoud J.; de Jong, Hugo W. A. M.; van der Zwan, Albert; Velthuis, BK; Viergever, Max A.; Dankbaar, Jan Willem

    2015-01-01

    Objective: Perfusion imaging is increasingly used for postoperative evaluation of extracranial to intracranial (EC-IC) bypass surgery. Altered hemodynamics and delayed arrival of the contrast agent in the area fed by the bypass can influence perfusion measurement. We compared perfusion asymmetry obt

  2. Lower leg electrical impedance after distal bypass surgery

    DEFF Research Database (Denmark)

    Belanger, G K; Bolbjerg, M L; Heegaard, N H;

    1998-01-01

    Electrical impedance was determined in 13 patients following distal bypass surgery to evaluate lower leg oedema as reflected by its circumference. Tissue injury was assessed by the plasma concentration of muscle enzymes. After surgery, the volume of the control lower leg increased from 1250 (816...... to be a useful method for the evaluation of lower leg oedema after distal bypass surgery....

  3. Diagnostic tools for post-gastric bypass hypoglycaemia

    NARCIS (Netherlands)

    Emous, M.; Ubels, F. L.; van Beek, A. P.

    2015-01-01

    In spite of its evident success, several late complications can occur after gastric bypass surgery. One of these is post-gastric bypass hypoglycaemia. No evidence-based guidelines exist in the literature on how to confirm the presence of this syndrome. This study aims to describe and compare the tes

  4. Sen perforation af tyndtarm efter laparoskopisk gastrisk bypass

    DEFF Research Database (Denmark)

    Spanager, Lene; Sigild, Ulf Henrik; Neuenschwander, Anders Ulrich

    2010-01-01

    We present two cases in which the patients were admitted to a local hospital with acute abdominal pain four or five months after having undergone laparoscopic gastric bypass. In both cases, operation revealed a perforation of the small bowel close to the distal anastomosis. In the first case...... bypass but as our two cases illustrate they are important to keep in mind....

  5. Reverse bias protected solar array with integrated bypass battery

    Science.gov (United States)

    Landis, Geoffrey A (Inventor)

    2012-01-01

    A method for protecting the photovoltaic cells in a photovoltaic (PV) array from reverse bias damage by utilizing a rechargeable battery for bypassing current from a shaded photovoltaic cell or group of cells, avoiding the need for a bypass diode. Further, the method mitigates the voltage degradation of a PV array caused by shaded cells.

  6. The in situ saphenous vein bypass graft: radiologic aspects.

    Science.gov (United States)

    Schwarz, W; Nozick, J; Richmand, D; Rodgers, B; Simpson, A; Argila, C; Honickman, S

    1986-03-01

    The use of the in situ saphenous vein for bypassing arterial occlusions in the lower extremities appears to have a higher patency rate than other bypass procedures but presents unique technical problems, such as lysing valves and occluding venous tributaries. Forty-four patients undergoing in situ bypasses had preoperative arteriograms. Special attention was paid to the small runoff vessels around the ankle, which are not suitable for reversed bypass procedures but may be adequate for in situ bypasses. Eight patients also had preoperative saphenous venograms, which revealed surgically important abnormalities in six cases. Postoperative arteriograms obtained within 2 weeks in 10 patients and within 2-12 months in 15 patients revealed persistent arteriovenous fistulas in four patients, stenoses in nine, occlusions in five, and progressive disease in the nonbypassed arteries in five patients. Early recognition of these problems led to 11 surgical repairs; nine repairs used the interventional radiologic procedures of balloon angioplasty, transcatheter embolization, and catheter thrombolysis. In this group of 44 patients, five patients died with patent bypasses and three patients required amputation despite functioning bypasses. Only four amputations were attributed to bypass failure. This low figure may be due to the close cooperation of the vascular surgeons and the vascular radiologists in dealing with these complicated cases.

  7. Previous gastric bypass surgery complicating total thyroidectomy.

    Science.gov (United States)

    Alfonso, Bianca; Jacobson, Adam S; Alon, Eran E; Via, Michael A

    2015-03-01

    Hypocalcemia is a well-known complication of total thyroidectomy. Patients who have previously undergone gastric bypass surgery may be at increased risk of hypocalcemia due to gastrointestinal malabsorption, secondary hyperparathyroidism, and an underlying vitamin D deficiency. We present the case of a 58-year-old woman who underwent a total thyroidectomy for the follicular variant of papillary thyroid carcinoma. Her history included Roux-en-Y gastric bypass surgery. Following the thyroid surgery, she developed postoperative hypocalcemia that required large doses of oral calcium carbonate (7.5 g/day), oral calcitriol (up to 4 μg/day), intravenous calcium gluconate (2.0 g/day), calcium citrate (2.0 g/day), and ergocalciferol (50,000 IU/day). Her serum calcium levels remained normal on this regimen after hospital discharge despite persistent hypoparathyroidism. Bariatric surgery patients who undergo thyroid surgery require aggressive supplementation to maintain normal serum calcium levels. Preoperative supplementation with calcium and vitamin D is strongly recommended.

  8. Efficiency Biliopancreatic bypass surgery in bulimia nervosa

    Directory of Open Access Journals (Sweden)

    Yu I Yashkov

    2008-06-01

    Full Text Available A clinical significance in the treatment of bulimia nervosa patients with morbid obesity had already been raised [10, 13], but we did not find publications on the effectiveness of bariatric surgery in these cases. There is also information about the possibility of applying the operation bilio-pancreatic bypass, effective in patients with morbid obesity with uncontrolled eating behavior for the treatment of patients with anorexia BILIM not suffering from morbid obesity. In this article the data of clinical observation of a small sample of patients. As a result, the treatment of these patients found that severe nervous BILIM can be seen as a latent form of morbid obesity. The choice of treatment should depend not only on the initial body weight of the patient, but also on the severity of the nervous BILIM. Unsuccessful attempts at organized-balanced, conservative treatment of patients with severe bulimia nervosa may be considered a variant of surgical treatment, while bilio-pancreatic bypass surgery is considered as the most preferred operation, compared with the installation of the gastric balloon and others. All candidates for surgical treatment of obesity must identify clinical signs of bulimia nervosa, as this may influence the choice of method of operation. Further study of the role of hyperinsulinemia, secretion of ghrelin, leptin, intestinal peptide may contribute to the elucidation of the true causes of bulimia nervosa, probably has a similar origin with morbid obesity.

  9. An analytical study on the performance of the organic Rankine cycle for turbofan engine exhaust heat recovery

    Science.gov (United States)

    Saadon, S.; Abu Talib, A. R.

    2016-10-01

    Due to energy shortage and global warming, issues of energy saving have become more important. To increase the energy efficiency and reduce the fuel consumption, waste heat recovery is a significant method for energy saving. The organic Rankine cycle (ORC) has great potential to recover the waste heat from the core jet exhaust of a turbofan engine and use it to produce power. Preliminary study of the design concept and thermodynamic performance of this ORC system would assist researchers to predict the benefits of using the ORC system to extract the exhaust heat engine. In addition, a mathematical model of the heat transfer of this ORC system is studied and developed. The results show that with the increment of exhaust heat temperature, the mass flow rate of the working fluid, net power output and the system thermal efficiency will also increase. Consequently, total consumption of jet fuel could be significantly saved as well.

  10. Bypass flow computations using a one-twelfth symmetric sector for normal operation in a 350 MWth prismatic VHTR

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Richard W., E-mail: rich.johnson@inl.gov [Idaho National Laboratory, P.O. Box 1625, M.S. 3855, Idaho Falls, ID (United States); Sato, Hiroyuki, E-mail: sato.hiroyuki09@jaea.go.jp [Idaho National Laboratory, P.O. Box 1625, M.S. 3855, Idaho Falls, ID (United States)

    2012-10-15

    Highlights: Black-Right-Pointing-Pointer CFD calculations are made of bypass flow between graphite blocks in VHTR. Black-Right-Pointing-Pointer Parameters varied include bypass gap width, heat generation and geometry. Black-Right-Pointing-Pointer Bypass flow causes lateral temperature gradients in graphite block. Black-Right-Pointing-Pointer Bypass flow causes increases in max fuel and coolant temperatures. Black-Right-Pointing-Pointer Bypass flow causes large increase in outlet coolant temperature variation - Abstract: Significant uncertainty exists about the effects of bypass flow in a prismatic gas-cooled very high temperature reactor (VHTR). Bypass flow is the flow in the gaps between prismatic graphite blocks in the core. The gaps are present because of variations in graphite block construction, imperfect installation and expansion and shrinkage from thermal heating and neutron fluence. Calculations are performed using computational fluid dynamics (CFD) for flow of the helium coolant in the gap and coolant channels along with conjugate heat generation and heat transfer in the fuel compacts and core graphite. A commercial CFD code is used for all of the computations. A one-twelfth sector of a standard hexagonal block column is used for the CFD model because of its symmetry. Various scenarios are investigated including varying the gap width, varying the total heat generation between average and peak rates and varying the graphite block geometry to account for the effects of shrinkage caused by irradiation. The calculations are for a 350 MWth prismatic reactor. It is shown that the effect of increasing gap width, while maintaining the same total mass flow rate, causes increased maximum fuel temperature while providing significant cooling to the near-gap region. The maximum outlet coolant temperature variation is increased by the presence of gap flow and also by an increase in total heat generation. The effect of block shrinkage is actually to decrease maximum

  11. Complement activation in coronary artery bypass grafting patients without cardiopulmonary bypass - The role of tissue injury by surgical incision

    NARCIS (Netherlands)

    Gu, YJ; Mariani, MA; Boonstra, PW; Grandjean, JG; van Oeveren, W

    1999-01-01

    Study objectives: Complement activation is a trigger in inducing inflammation in patients who undergo coronary artery bypass grafting (CABG) and is usually thought to be induced by the use of cardiopulmonary bypass (CPB), In this study, we examined whether tissue injury caused by chest surgical inci

  12. Distribution of pathogens causing postoperative central venous catheter-related infections in patients undergoing cardiopulmonary bypass heart surgery and high risk factors%体外循环心脏直视术后中心静脉导管感染的病原菌分布与危险因素分析

    Institute of Scientific and Technical Information of China (English)

    杜守峰; 师文华; 孙君隽

    2015-01-01

    OBJECTIVE To explore the distribution of pathogens causing postoperative central venous catheter‐re‐lated infections in patients undergoing cardiopulmonary bypass heart surgery and analyze the high risk factors so as to provide guidance for the prevention of central venous catheter‐related infections .METHODS The clinical data of 137 patients who underwent the central venous catheter indwelling after the cardiopulmonary bypass heart surgery were retrospectively analyzed ;34 patients with infections were assigned as the infection group ,and 103 patients without infections were set as the non‐infection group ;the bacterial culture and the drug susceptibility testing were carried out for the infection group ,and the logistic regression analysis of the high risk factors for the central ve‐nous catheter‐related infections was performed .RESULTS Totally 34 strains of pathogens have been isolated from the 137 patients with the positive rate of 24 .82% ,including 17 (50 .00% ) strains of gram‐positive bacteria ,13 (38 .24% ) strains of gram‐negative bacteria ,and 4 (11 .76% ) strains of fungi .The drug susceptibility rates of the gram‐positive bacteria to teicoplanin and vancomycin were 100 .00% ;the drug susceptibility rate of the gram‐nega‐tive bacteria to meropenem was 100 .00% ;the drug susceptibility rate of the fungi to fluconazole was 66 .67% . There was significant difference in the catheter indwelling time ,time of cardiopulmonary bypass ,femoral venous puncture ,catheter connector ,or proportion of triple lumen catheter between the infection group and the non‐infec‐tion group (P<0 .05);the logistic regression analysis indicated that the time of cardiopulmonary bypass ,femoral venous puncture ,double lumen catheter indwelling ,and catheter indwelling time were the independent risk fac‐tors .CONCLUSION The excessively long time of cardiopulmonary bypass and catheter indwelling ,femoral venous puncture ,and double lumen catheter

  13. Buprenorphine pharmacokinetic parameters during coronary artery bypass graft surgery.

    Science.gov (United States)

    Amani, A; Joseph, T; Balasaraswathi, K

    1997-10-01

    The pharmacokinetic parameters of buprenorphine (BN) after a single bolus dose of 10 microg/kg i.v. was investigated in 6 male patients whose age averaged 59+/-9.8 years and body weight of 65.8+/-5.7 kg undergoing coronary artery bypass graft surgery (CABG). The unbound BN plasma concentrations were detected using ultrafiltration and high performance liquid chromatography/electro-chemical detection (HPLC/ECD) method. During cardiopulmonary bypass (CPB) there was a fall in BN plasma concentrations, observations similar to reports on fentanyl, sufentanil and alfentanil. This is probably due to haemodilution, hypothermia and hydrophobic sequestration of drug on to the CPB tubing. After CPB the concentrations rose to values higher than during CPB, though it did not attain pre CPB concentrations. These variations were not statistically significant indicating that plasma levels were adequately stable during CPB. The plasma concentration time curves were biexponential and the pharmacokinetic parameters obtained were : distribution half-life 37.24+/-6.57 min, elimination half-life 482.69+/-79 min, clearance 1221.97+/-209.42 ml/min, and volume of distribution 736.46+/-71.25 L. BN in the dose used follows the pharmacokinetic pattern of other commonly used narcotics during CABG. The mean +/- SEM plasma BN concentration during CPB was 0.51+/-0.03 ng/ml which was adequate for the maintenance of analgesia and anaesthesia, as none of our patients expressed the signs and symptoms of awareness during surgery. Further, unlike the other narcotics muscle rigidity was absent. Thus BN is a safe and good alternative to other narcotics for patients undergoing CABG.

  14. Implementing tight glucose control after coronary artery bypass surgery.

    Science.gov (United States)

    Carr, Justine M; Sellke, Frank W; Fey, Michelle; Doyle, Mathew J; Krempin, Judy A; de la Torre, Ralph; Liddicoat, John R

    2005-09-01

    The clinical benefit of tight glucose control has been demonstrated in diabetic patients. In adopting an approach of tight glucose control for all cardiac surgery patients at Beth Israel Deaconess Medical Center, we encountered several challenges, including defining good glucose control, meaningfully measuring control, and assessing the impact of variables that may affect control. An interdisciplinary team used an insulin protocol to achieve tight glucose control of cardiac surgery patients in the operating room and intensive care unit as part of an effort to reduce sternal wound infections. Good control was defined as glucose less than 130 mg/dL for more than 50% of measured time. Eight hundred eighteen patients underwent coronary artery bypass grafting between November 2002 and August 2004. Seven hundred thirty-seven (90%) received insulin. Fifty-seven percent did not have a preoperative diagnosis of diabetes. The trigger for insulin initiation was decreased sequentially from 150 mg/dL to 110 mg/dL, but the measure of good control remained the same: glucose less than 130 mg/dL. The factor most highly predictive of glucose being well controlled was the protocol with the 110 mg/dL trigger for insulin (p < 0.001). Patient factors such as age, ejection fraction, preoperative angiotensin-converting enzyme inhibitor or beta-blocker use, or time on cardiopulmonary bypass were not significantly associated with glucose control. During the course of the protocols, the rate of mediastinitis decreased from 1.6% to 0%. Key elements to implementing tight glucose control include having a standard protocol and metrics to track protocol performance. This practice improved control and was associated with a marked reduction in mediastinitis.

  15. A marked increase in gastric fluid volume during cardiopulmonary bypass

    Science.gov (United States)

    Hirota, Kazuyoshi; Kudo, Mihoko; Hashimoto, Hiroshi; Kushikata, Tetsuya

    2011-01-01

    Major physiological stress occurs during cardiac surgery with cardiopulmonary bypass. This is related to hypothermia and artificial organ perfusion. Thus, serious gastrointestinal complications, particularly upper gastrointestinal bleeding, sometimes follow cardiac surgery. We have compared the antisecretory effects of a preanesthetic H2 antagonist (roxatidine, cardiopulmonary bypass-H2 group, n = 15) and a proton pump inhibitor (rabeprazole, cardiopulmonary bypass-PPI group, n = 15) in patients undergoing cardiac surgery with cardiopulmonary bypass, and also compared in patients undergoing a off-pump coronary artery bypass graft surgery (off-pump cardiopulmonary bypass-H2 group, n = 15). Gastric pH (5.14 ± 0.61) and gastric fluid volume (13.2 ± 2.4 mL) at the end of surgery in off-pump cardiopulmonary bypass-H2 groups was significantly lower and higher than those in both cardiopulmonary bypass-H2 (6.25 ± 0.54, 51.3 ± 8.0 mL) and cardiopulmonary bypass-PPI (7.29 ± 0.13, 63.5 ± 14.8 mL) groups, respectively although those variables did not differ between groups after the induction of anesthesia. Plasma gastrin (142 ± 7 pg/mL) at the end of surgery and maximal blood lactate levels (1.50 ± 0.61 mM) in off-pump cardiopulmonary bypass-H2 group were also significantly lower than those in both cardiopulmonary bypass-H2 (455 ± 96 pg/mL, 3.97 ± 0.80 mM) and cardiopulmonary bypass-PPI (525 ± 27 pg/mL, 3.15 ± 0.44 mM) groups, respectively. In addition, there was a significant correlation between gastric fluid volume and maximal blood lactate (r = 0.596). In conclusion, cardiopulmonary bypass may cause an increase in gastric fluid volume which neither H2 antagonist nor PPI suppresses. A significant correlation between gastric fluid volume and maximal blood lactate suggests that gastric fluid volume may predict degree of gastrointestinal tract hypoperfusion. PMID:21765601

  16. Bypass technology enhances the efficiency of wind power plants; Bypass-Technologie erhoeht WEA-Effizienz

    Energy Technology Data Exchange (ETDEWEB)

    Ebach, Thorsten [EKS Engel GmbH und Co. KG, Wenden (Germany)

    2013-04-01

    A reliable operation of wind power parks significantly depends on a trouble-free data communication. If one or more network participants break down, then it depends on the topology whether the complete power distribution system is available or not. An optical bypass such as it is supplied by EKS Engel GmbH and Co. KG (Wenden, Federal Republic of Germany) offers a remedial action.

  17. Transient Diabetes Insipidus Following Cardiopulmonary Bypass.

    Science.gov (United States)

    Ekim, Meral; Ekim, Hasan; Yilmaz, Yunus Keser; Bolat, Ali

    2015-04-01

    Diabetes insipidus (DI) results from inadequate output of Antidiuretic Hormone (ADH) from the pituitary gland (central DI) or the inability of the kidney tubules to respond to ADH (nephrogenic DI). ADH is an octapeptide produced in the supraoptic and paraventricular nuclei of the hypothalamus and stored in the posterior lobe of the pituitary gland. Cardiopulmonary Bypass (CPB) has been shown to cause a six-fold increased circulating ADH levels 12 hours after surgery. However, in some cases, ADH release may be transiently suppressed due to cardioplegia (cardiac standstill) or CPB leading to DI. We present the postoperative course of a 60-year-old man who developed transient DI after CPB. He was successfully treated by applying nasal desmopressin therapy. Relevant biochemical parameters should be monitored closely in patients who produce excessive urine after open heart surgery.

  18. Current status of coronary artery bypass surgery

    Institute of Scientific and Technical Information of China (English)

    CHEN Xin

    2009-01-01

    @@ Surgical revascularization for atherosclerotic heart disease, also called coronary artery bypass grafting (CABG), was first performed in 1962, and is one of the great achievements in medicine. Relief of angina, improvement of exercise tolerance, and the realization of survival benefit have been documented.1 CABG has been used in multi-vessel disease and left main stenosis for over 40 years.2 In the last two decades the mortality of CABG has decreased to less than 2% despite an aging population with increased risk factors. However, percutaneous coronary intervention (PCI), especially with drug-eluting stents, has been challenging CABG, While PCI has improved, CABG has also progressed with better peri-operative management, a higher use of arterial grafting, off-pump surgery, and improved techniques with minimally invasive surgical options.3,4

  19. Factor V Leiden and Cardiopulmonary Bypass.

    Science.gov (United States)

    Uppal, Victor; Rosin, Mark; Marcoux, Jo-Anne; Olson, Marnie; Bezaire, Jennifer; Dalshaug, Gregory

    2015-12-01

    We present a case of a patient with factor V Leiden with an antithrombin III activity of 67% who received a successful aortic valve replacement supported by cardiopulmonary bypass (CPB). A safe level of anticoagulation was achieved by monitoring activated clotting time (ACT) and heparin concentration ensuring adequate anticoagulation throughout the procedure. Results from ACT, heparin dose response, heparin protamine titration, and thrombelastography are given. Factor V Leiden patients can be safely anti-coagulated using heparin for CPB procedures when monitored with ACT, heparin protamine titration, and thrombelastography. Postoperative chest tube losses were 360 mL, less than half our institutional average. Anticoagulation for the pre-and post-operative phase is also discussed.

  20. Emergent cardiopulmonary bypass during pectus excavatum repair

    Directory of Open Access Journals (Sweden)

    Ryan Craner

    2013-01-01

    Full Text Available Pectus excavatum is a chest wall deformity that produces significant cardiopulmonary disability and is typically seen in younger patients. Minimally invasive repair of pectus excavatum or Nuss procedure has become a widely accepted technique for adult and pediatric patients. Although it is carried out through a thoracoscopic approach, the procedure is associated with a number of potential intraoperative and post-operative complications. We present a case of cardiac perforation requiring emergent cardiopulmonary bypass in a 29-year-old male with Marfan syndrome and previous mitral valve repair undergoing a Nuss procedure for pectus excavatum. This case illustrates the importance of vigilance and preparation by the surgeons, anesthesia providers as well as the institution to be prepared with resources to handle the possible complications. This includes available cardiac surgical backup, perfusionist support and adequate blood product availability.

  1. Alongshore sediment bypassing as a control on river mouth morphodynamics

    Science.gov (United States)

    Nienhuis, Jaap H.; Ashton, Andrew D.; Nardin, William; Fagherazzi, Sergio; Giosan, Liviu

    2016-04-01

    River mouths, shoreline locations where fluvial and coastal sediments are partitioned via erosion, trapping, and redistribution, are responsible for the ultimate sedimentary architecture of deltas and, because of their dynamic nature, also pose great management and engineering challenges. To investigate the interaction between fluvial and littoral processes at wave-dominated river mouths, we modeled their morphologic evolution using the coupled hydrodynamic and morphodynamic model Delft3D-SWAN. Model experiments replicate alongshore migration of river mouths, river mouth spit development, and eventual spit breaching, suggesting that these are emergent phenomena that can develop even under constant fluvial and wave conditions. Furthermore, we find that sediment bypassing of a river mouth develops though feedbacks between waves and river mouth morphology, resulting in either continuous bypassing pathways or episodic bar bypassing pathways. Model results demonstrate that waves refracting into the river mouth bar create a zone of low alongshore sediment transport updrift of the river mouth, which reduces sediment bypassing. Sediment bypassing, in turn, controls the river mouth migration rate and the size of the river mouth spit. As a result, an intermediate amount of river discharge maximizes river mouth migration. The fraction of alongshore sediment bypassing can be predicted from the balance between the jet and the wave momentum flux. Quantitative comparisons show a match between our modeled predictions of river mouth bypassing and migration rates observed in natural settings.

  2. CFD Analysis of Core Bypass Phenomena

    Energy Technology Data Exchange (ETDEWEB)

    Richard W. Johnson; Hiroyuki Sato; Richard R. Schultz

    2010-03-01

    The U.S. Department of Energy is exploring the potential for the VHTR which will be either of a prismatic or a pebble-bed type. One important design consideration for the reactor core of a prismatic VHTR is coolant bypass flow which occurs in the interstitial regions between fuel blocks. Such gaps are an inherent presence in the reactor core because of tolerances in manufacturing the blocks and the inexact nature of their installation. Furthermore, the geometry of the graphite blocks changes over the lifetime of the reactor because of thermal expansion and irradiation damage. The existence of the gaps induces a flow bias in the fuel blocks and results in unexpected increase of maximum fuel temperature. Traditionally, simplified methods such as flow network calculations employing experimental correlations are used to estimate flow and temperature distributions in the core design. However, the distribution of temperature in the fuel pins and graphite blocks as well as coolant outlet temperatures are strongly coupled with the local heat generation rate within fuel blocks which is not uniformly distributed in the core. Hence, it is crucial to establish mechanistic based methods which can be applied to the reactor core thermal hydraulic design and safety analysis. Computational Fluid Dynamics (CFD) codes, which have a capability of local physics based simulation, are widely used in various industrial fields. This study investigates core bypass flow phenomena with the assistance of commercial CFD codes and establishes a baseline for evaluation methods. A one-twelfth sector of the hexagonal block surface is modeled and extruded down to whole core length of 10.704m. The computational domain is divided vertically with an upper reflector, a fuel section and a lower reflector. Each side of the sector grid can be set as a symmetry boundary

  3. CFD Analysis of Core Bypass Phenomena

    Energy Technology Data Exchange (ETDEWEB)

    Richard W. Johnson; Hiroyuki Sato; Richard R. Schultz

    2009-11-01

    The U.S. Department of Energy is exploring the potential for the VHTR which will be either of a prismatic or a pebble-bed type. One important design consideration for the reactor core of a prismatic VHTR is coolant bypass flow which occurs in the interstitial regions between fuel blocks. Such gaps are an inherent presence in the reactor core because of tolerances in manufacturing the blocks and the inexact nature of their installation. Furthermore, the geometry of the graphite blocks changes over the lifetime of the reactor because of thermal expansion and irradiation damage. The existence of the gaps induces a flow bias in the fuel blocks and results in unexpected increase of maximum fuel temperature. Traditionally, simplified methods such as flow network calculations employing experimental correlations are used to estimate flow and temperature distributions in the core design. However, the distribution of temperature in the fuel pins and graphite blocks as well as coolant outlet temperatures are strongly coupled with the local heat generation rate within fuel blocks which is not uniformly distributed in the core. Hence, it is crucial to establish mechanistic based methods which can be applied to the reactor core thermal hydraulic design and safety analysis. Computational Fluid Dynamics (CFD) codes, which have a capability of local physics based simulation, are widely used in various industrial fields. This study investigates core bypass flow phenomena with the assistance of commercial CFD codes and establishes a baseline for evaluation methods. A one-twelfth sector of the hexagonal block surface is modeled and extruded down to whole core length of 10.704m. The computational domain is divided vertically with an upper reflector, a fuel section and a lower reflector. Each side of the one-twelfth grid can be set as a symmetry boundary

  4. Hernia de Petersen: Complicación del bypass gástrico: hallazgos tomográficos Petersen's hernia: Complication of gastric bypass: CT findings

    Directory of Open Access Journals (Sweden)

    Cecilia Carrera

    2012-09-01

    being the method of choice. Retrocolic anastomosis creates a space in the mesentery, allowing for the formation of a transmesenteric type of hernia known as Petersen's hernia. The aim of this article is to describe and analyze the CT findings of Petersen's hernia in patients with a history of gastric bypass. The medical records of 92 patients with a history of RYGBP (performed at our institution were reviewed. Three patients had bowel obstruction and underwent abdominal multislice computed tomography (MSCT. Based on CT findings consistent with internal hernia, surgery was performed and the presence of Petersen's hernia was confirmed. Knowledge of the surgical technique, anatomical changes and possible complications is very useful for diagnosing the cause of abdominal pain in patients who underwent gastric bypass. MSCT provides information on extraluminal structures and its high spatial resolution allows for better visualization of both anatomical changes and probable complications of gastric bypass.

  5. Non-invasive assessment of coronary artery bypass grafts - an update; Koronare Bypassdiagnostik mit CT und MRT - eine Bestandsaufnahme

    Energy Technology Data Exchange (ETDEWEB)

    Kreitner, K.F.; Ehrhard, K.; Kunz, R.P.; Oberholzer, K.; Mildenberger, P.; Thelen, M. [Klinik und Poliklinik fuer Radiologie der Johannes Gutenberg-Univ. Mainz (Germany); Abegunewardene, N.; Horstick, G. [2. Medizinische Klinik und Poliklinik der Johannes Gutenberg-Univ. Mainz (Germany); Hake, U. [Klinik und Poliklinik fuer Herz-Thorax- und Gefaesschirurgie der Johannes Gutenberg-Univ. Mainz (Germany)

    2004-08-01

    The limited lifetime and the correlation between graft occlusion and recurring symptoms underline the need for repeated imaging of coronary artery bypass grafts. CT and MRI allow for noninvasive imaging of coronary bypasses with high accuracies concerning the patency of these vessels. Multidetector CT seem to be the CT technique of choice, especially after the introduction of 16 slice CT scanners for morphologic assessment of coronary artery bypass grafts. Compared with MRI, CT is a robust technique for assessment of cardiac anastomoses, native coronary arteries, anf for the detection of graft stenoses. MRI, however, is able to deliver functional information about the grafts and the recipient coronary arteries by determining the coronary flow reserve. Furthermore, it can be integrated in a multiparametric MR examination protocol. The follow-up of asymptomatic patients can primarily be done by these non-invasive techniques as nearly every third patient reveals an asymptomatic bypass occlusion 5 years after operation. Furthermore, patients with atypical complaints after the operation may undergo non-invasive imaging as long as documented patency of the bypass averts coronary angiography. Patients with recurrent angina pectoris and/or myocardial ischemia discovered by other cardiologic tests have to undergo coronary angiography. (orig.)

  6. Seasonal Variation of Climatological Bypassing Flows around the Tibetan Plateau

    Institute of Scientific and Technical Information of China (English)

    LI Qiang; ZHANG Renhe

    2012-01-01

    The present study investigated diagnostically the seasonal variation of the bypassing flows caused by the splitting effect of the Tibetan Plateau (TP).The relationships among the splitting bypassing flows around the TP to precipitation in China,the westerly jet stream,and the thermal status over the TP are revealed.The bypassing flows occur from the 1st to the 22nd pentad and from the 59th to the 73rd pentad,respectively,and they disappear from the 29th to the 58th pentad.They are strongest in winter from the 1st to the 22nd pentad and from the 59th to the 73rd pentad,respectively.During the rebuilding of the bypassing flows from mid-October to mid-February,they are the main cause of precipitation over southeastern China.The enhancement of the bypassing flow intensity in March cau cause the precipitation to increase in the early stage of the persistent spring rain over southeastern China.From winter to summer,the seasonal transition of the bypassing flows in the lower troposphere precedes that of the westerly jet stream axis in the upper troposphere to the west of the TP by ~4 pentads,while from summer to winter lags by ~4 pentads.The seasonal variation of the thermal status over the TP plays an important role in the bypassing flows around the TP.The strengthening of the heating over the TP weakens the bypassing flows,and the increase in cooling over the TP is related to the rebuilding and strengthening of the bypassing flows.

  7. Effect of cardiopulmonary bypass on gastrointestinal perfusion and function.

    Science.gov (United States)

    Gaer, J A; Shaw, A D; Wild, R; Swift, R I; Munsch, C M; Smith, P L; Taylor, K M

    1994-02-01

    Gastric mucosal tonometry was used to determine the adequacy of gastrointestinal perfusion in 10 patients undergoing elective myocardial revascularization. Patients were prospectively randomized to receive either pulsatile or nonpulsatile flow during cardiopulmonary bypass. All patients showed a reduction in gastric mucosal perfusion during bypass, manifested by a reduction in the gastric mucosal pH, which occurred independently of variations in the arterial pH. In the group of patients receiving nonpulsatile flow, this reduction was significantly greater (p < 0.05). Cardiopulmonary bypass using nonpulsatile flow is associated with the development of a gastric mucosal acidosis, which may have implications for the development of postoperative complications.

  8. 34 CFR 300.198 - Continuation of a by-pass.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Continuation of a by-pass. 300.198 Section 300.198... CHILDREN WITH DISABILITIES State Eligibility By-Pass for Children in Private Schools § 300.198 Continuation of a by-pass. The Secretary continues a by-pass until the Secretary determines that the SEA, LEA...

  9. 34 CFR 300.192 - Notice of intent to implement a by-pass.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Notice of intent to implement a by-pass. 300.192... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility By-Pass for Children in Private Schools § 300.192 Notice of intent to implement a by-pass. (a) Before taking any final action to implement a by-pass,...

  10. 34 CFR 300.191 - Provisions for services under a by-pass.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Provisions for services under a by-pass. 300.191... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility By-Pass for Children in Private Schools § 300.191 Provisions for services under a by-pass. (a) Before implementing a by-pass, the Secretary consults...

  11. Linitis Plastica of the bypassed stomach 7 years after Roux-en-Y gastric bypass. A Case Report.

    Science.gov (United States)

    Haenen, Filip Wn; Gys, Ben; Moreels, Tom; Michielsen, Maartje; Gys, Tobie; Lafullarde, Thierry

    2016-06-03

    Laparoscopic Roux-en-Y gastric bypass (RYGB) is currently the preferred surgical procedure to treat morbid obesity. It has proven its effects on excess weight loss and its positive effect on comorbidities. One of the main issues, however, is the postoperative evaluation of the bypassed gastric remnant. In literature, cancer of the excluded stomach after RYGB is rare. We describe the case of a 52-year-old woman with gastric linitis plastica in the bypassed stomach after Roux-en-Y gastric bypass, diagnosed by means of laparoscopy and Single-Balloon enteroscopy, and it's clinical importance. Linitis plastica of the excluded stomach after RYGB is a very rare entity. This case report shows the importance of long-term postoperative follow-up, and the importance of Single-Balloon enteroscopy for visualization of the bypassed stomach remnant, when other investigations remain without results. This case report is only the second report of a linitis plastica in the bypassed stomach after Roux-en-Y gastric bypass.

  12. Influence of Cardiopulmonary Bypass on the Interaction of Recombinant Factor VIIa with Activated Platelets

    OpenAIRE

    Kjalke, Marianne; Runge, Marx; Rojkjaer, Rasmus; Steinbruchel, Daniel; Johansson, Pär I

    2009-01-01

    Recombinant factor VIIa (rFVIIa) interacts preferentially with coated platelets characterized by a high exposure of phosphatidyl serine (PS), FV, FVIII, FIX, and FX binding, and fibrinogen. Cardiopulmonary bypass (CPB) is known to impair platelet function. In this study, the influence of CPB on formation of coated platelets and the interaction of rFVIIa with the platelets were studied. Blood was either exposed to a closed CPB circuit or obtained from patients undergoing CPB-assisted cardiac s...

  13. Transradial approach for coronary angiography and interventions in patients with coronary bypass grafts: tips and tricks.

    Science.gov (United States)

    Burzotta, Francesco; Trani, Carlo; Hamon, Martial; Amoroso, Giovanni; Kiemeneij, Ferdinand

    2008-08-01

    Among patients undergoing coronary procedures, patients with coronary artery bypass grafts represent an important, high risk subgroup. Routine transradial approach may be successfully adopted in these patients to reduce access-site complications. However, transradial cannulation of the grafts may result technically demanding. In this article we discuss the specific technical issues and we present a series of tips and tricks which may facilitate angiography and interventions on both internal mammary and aorto-coronary grafts.

  14. Preserved Renal Function in Kidney Transplantation over a Thrombosed Aortobifemoral Bypass Graft: The Role of Retrograde Flow and Early Thrombolysis

    Directory of Open Access Journals (Sweden)

    Saúl Pampa-Saico

    2016-01-01

    Full Text Available Aortobifemoral bypass (ABFB thrombosis is not uncommon, and when the artery of a renal graft is implanted on a bypass the risk of graft loss is high. We report the case of a 48-year-old woman with a previous history of ABFB under antiplatelet therapy and a kidney allograft implanted on the vascular prosthesis, who presented with acute limb ischemia and severe renal impairment. Imaging techniques revealed a complete thrombosis of the proximal left arm of the ABFB. However, a faint retrograde flow over the graft was observed thanks to the recanalization of distal left bypass by collateral native arteries. This unusual situation not previously reported in a kidney transplant setting, together with an early diagnosis, allowed graft survival until an early local thrombolysis resolved the problem. Two years later, renal function remains normal.

  15. Preserved Renal Function in Kidney Transplantation over a Thrombosed Aortobifemoral Bypass Graft: The Role of Retrograde Flow and Early Thrombolysis

    OpenAIRE

    Saúl Pampa-Saico; Sara Jiménez-Alvaro; Fernando Caravaca-Fontán; Ana Fernández-Rodríguez; Maite Rivera-Gorrín; Juan Sánchez; Antonio Chinchilla; Roberto Marcén

    2016-01-01

    Aortobifemoral bypass (ABFB) thrombosis is not uncommon, and when the artery of a renal graft is implanted on a bypass the risk of graft loss is high. We report the case of a 48-year-old woman with a previous history of ABFB under antiplatelet therapy and a kidney allograft implanted on the vascular prosthesis, who presented with acute limb ischemia and severe renal impairment. Imaging techniques revealed a complete thrombosis of the proximal left arm of the ABFB. However, a faint retrograde ...

  16. Rodent models of cardiopulmonary bypass: utility in improving perioperative outcomes

    NARCIS (Netherlands)

    de Lange, F.

    2008-01-01

    Despite advances in surgical and anesthesia techniques, subtle neurologic injury still remains an important complication after cardiac surgery. Because the causes are multifactorial and complex, research in an appropriate small animal model for cardiopulmonary bypass (CPB) is warranted. This thesis

  17. Value of Optical Bypass in Packet Ring Networks

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    This paper firstly examines the value of optical bypass scheme in packet ring networks. An Integer Linear Program (ILP) formulation is presented and analytical results under different traffic patterns are given.

  18. Severe hypoglycaemia post-gastric bypass requiring partial pancreatectomy

    DEFF Research Database (Denmark)

    Patti, M E; McMahon, G; Mun, E C;

    2005-01-01

    was assessed in all three patients. RESULTS: All three patients had evidence of severe postprandial hyperinsulinaemia and hypoglycaemia. In one patient, reversal of gastric bypass was ineffective in reversing hypoglycaemia. All three patients ultimately required partial pancreatectomy for control...

  19. [Psychoprophylaxis in patients after coronary artery bypass graft operations].

    Science.gov (United States)

    Rymaszewska, Joanna; Chładzińska-Kiejna, Sylwia; Górna, Renata; Kustrzycki, Wojciech

    2004-05-01

    The paper presented problems of quality of life and psychosocial functioning of patients following coronary artery bypass grafting operations. Possibilities of psychoprophylactic effects towards these patients and its efficacy were described.

  20. Predicting the need for blood during cardiopulmonary bypass

    African Journals Online (AJOL)

    Adele

    from the depot. Supply logistics of banked blood may be problematic during car- ... delivery that occurs on initiation of cardiopulmonary bypass (CPB). In spite of patient ... whole body oxygen consumption, there is a time lapse before stable.

  1. Oil Bypass Filter Technology Performance Evaluation - January 2003 Quarterly Report

    Energy Technology Data Exchange (ETDEWEB)

    Laurence R. Zirker; James E. Francfort

    2003-01-01

    This report details the initial activities to evaluate the performance of the oil bypass filter technology being tested by the Idaho National Engineering and Environmental Laboratory (INEEL) for the U.S. Department of Energy's FreedomCAR & Vehicle Technologies Program. Eight full-size, four-cycle diesel-engine buses used to transport INEEL employees on various routes have been equipped with oil bypass systems from the puraDYN Corporation. Each bus averages about 60,000 miles a year. The evaluation includes an oil analysis regime to monitor the presence of necessary additives in the oil and to detect undesirable contaminants. Very preliminary economic analysis suggests that the oil bypass system can reduce life-cycle costs. As the evaluation continues and oil avoidance costs are quantified, it is estimated that the bypass system economics may prove increasingly favorable, given the anticipated savings in operational costs and in reduced use of oil and waste oil avoidance.

  2. Oil Bypass Filter Technology Performance Evaluation - First Quarterly Report

    Energy Technology Data Exchange (ETDEWEB)

    Zirker, L.R.; Francfort, J.E.

    2003-01-31

    This report details the initial activities to evaluate the performance of the oil bypass filter technology being tested by the Idaho National Engineering and Environmental Laboratory (INEEL) for the U.S. Department of Energy's FreedomCAR & Vehicle Technologies Program. Eight full-size, four-cycle diesel-engine buses used to transport INEEL employees on various routes have been equipped with oil bypass systems from the puraDYN Corporation. Each bus averages about 60,000 miles a year. The evaluation includes an oil analysis regime to monitor the presence of necessary additives in the oil and to detect undesirable contaminants. Very preliminary economic analysis suggests that the oil bypass system can reduce life-cycle costs. As the evaluation continues and oil avoidance costs are quantified, it is estimated that the bypass system economics may prove increasingly favorable, given the anticipated savings in operational costs and in reduced use of oil and waste oil avoidance.

  3. Induction and detection of disturbed homeostasis in cardiopulmonary bypass

    NARCIS (Netherlands)

    de Vroege, R; Meerman, FT; Eijsman, L; Wildevuur, WR; Wildevuur, CRH; van Oeveren, W

    2004-01-01

    During cardiopulmonary bypass (CPB) haemodynamic alterations, haemostasis and the inflammatory response are the main causes of homeostatic disruption. Even with CPB procedures of short duration, the homeostasis of a patient is disrupted and, in many cases, requires intensive postoperative treatment

  4. Prolonged successful therapy for hyperinsulinaemic hypoglycaemia after gastric bypass

    DEFF Research Database (Denmark)

    Myint, K S; Greenfield, J R; Farooqi, I S;

    2012-01-01

    Spontaneous hyperinsulinaemic hypoglycaemia following gastric bypass surgery (GBS) is increasingly recognised. However, its pathophysiology remains unclear. Some patients require pancreatectomy. Medical therapy with calcium channel blockers, acarbose and diazoxide has been reported to be beneficial...

  5. Antiplatelet therapy at the time of coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Kremke, Michael; Tang, Mariann; Bak, Mikkel;

    2013-01-01

    OBJECTIVES: The purpose of this multicentre cohort study was to examine the relationship between antiplatelet therapy (APT) at the time of coronary artery bypass grafting (CABG) and postoperative bleeding complications, transfusion requirements and adverse cardiovascular events. METHODS: A matched...

  6. Canals, Bypass Canal, Published in 2002, Duchesne County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Canals dataset, was produced all or in part from Other information as of 2002. It is described as 'Bypass Canal'. Data by this publisher are often provided in...

  7. Palliative surgical bypass for unresectable periampullar y carcinoma

    Institute of Scientific and Technical Information of China (English)

    Shivendra Singh; Ajay Kumar Sachdev; Adarsh Chaudhary; Anil Kumar Agarwal

    2008-01-01

    BACKGROUND:Around 60% to 80% of patients with periampullary carcinoma are unresectable either due to distant metastasis or local vascular invasion. With the advancement of endoscopic interventional procedures, the role of surgical bypass has diminished. However, surgical bypass is still appropriate in patients with unresectable disease discovered at the time of surgery. This study was conducted to assess the results of palliative surgical bypass for patients with unresectable periampullary carcinoma at our hospital, a tertiary referral center of Northern India. METHOD:The study group comprised 204 patients who had undergone surgical bypass for advanced periampullary carcinoma over the last 15 years. RESULTS:Between January 1990 and December 2004, 204 patients (128 males, 76 females) consisting of 179 patients with carcinoma of head of the pancreas, 14 patients with ampullary carcinoma, 8 patients with lower end cholangiocarcinoma and 3 patients with duodenal carcinoma underwent surgical bypass. Their average age was 51 years (range 20-78 years). Both biliary and gastric bypasses were done in 158 (77.45%), biliary bypass alone in 37 (18.13%), and gastric bypass alone in 9 (4.32%). Biliary bypass was done by Roux-en-Y hepaticojejunostomy, and gastric bypass by retrocolic gastrojejunostomy. The overall postoperative mortality and morbidity were 0.98%and 26.9%, respectively. The patients who died had undergone previously endoscopic intervention. Complications included wound infection in 12.25% of the patients, bile leak in 5.12%, delayed gastric emptying in 5.38%, ascitic leak from drains in 8.8%, and upper gastrointestinal bleeding in 1.96%. The incidences of wound infection and bile leak both were signiifcantly higher in patients who had had preoperative biliary stenting. None of the patients who had undergone Roux-en-Y hepati-cojejunostomy+retrocolic gastrojejunostomy required any intervention later in their life. CONCLUSIONS:Surgical bypass is a safe procedure with

  8. Night Blindness and Vitamin A Deficiency following Jejunoilieal Bypass Surgery

    OpenAIRE

    Adams, Paul C; Canny, Christopher L.

    1989-01-01

    A 42-year-old man who developed severe night blindness 15 years following jejunoileal bypass surgery for morbid obesity is described. Ophthamological testing, including dark adaptation, electroretinography and serum vitamin A levels, confirmed a diagnosis of vitamin A deficiency. Oral vitamin A 25,000 iu/day for two months resulted in a full recovery of visual deficits. Nutritional vitamin A deficiency is discussed in the context of intestinal bypass surgery.

  9. Severe peripheral neuropathy following gastric bypass surgery for morbid obesity.

    OpenAIRE

    Maryniak, O.

    1984-01-01

    Severe weakness in the limbs developed in a young woman 3 1/2 months after successful gastric bypass surgery for morbid obesity. Electromyography confirmed the clinical impression of generalized axonal polyneuropathy. Vitamin B replacement therapy was started. The gastric bypass was not reversed, and the patient continued to lose weight while undergoing rehabilitation. After 10 months she had almost fully recovered. Her total weight loss was 76 kg. Neuropathy is an uncommon but serious compli...

  10. Association of sex with patency of femorodistal bypass grafts

    DEFF Research Database (Denmark)

    Watson, H R; Schroeder, T V; Simms, M H;

    2000-01-01

    There is evidence for superior patency in infra-inguinal bypass procedures in men compared to women. A large, prospectively planned series was investigated in order to confirm this finding and to determine the origin of this difference in outcome.......There is evidence for superior patency in infra-inguinal bypass procedures in men compared to women. A large, prospectively planned series was investigated in order to confirm this finding and to determine the origin of this difference in outcome....

  11. Emergency coronary artery bypass surgery for failed percutaneous coronary angioplasty. A 10-year experience.

    Science.gov (United States)

    Craver, J M; Weintraub, W S; Jones, E L; Guyton, R A; Hatcher, C R

    1992-01-01

    Six hundred ninety-nine patients have required emergency coronary artery bypass after failed elective percutaneous coronary angioplasty during the decade September 1980 through December 1990. This represents 4% of 9860 patients having 12,146 elective percutaneous coronary angioplasty procedures during this interval. Emergency coronary artery bypass was required for acute refractory myocardial ischemia in 82%. Hospital mortality rate for all patients was 3.1%; 3.7% in patients with refractory myocardial ischemia but 0.8% in patients without refractory myocardial ischemia, p = 0.08. Postprocedural Q-wave myocardial infarctions were observed in 21% versus 2.4%, p less than 0.0001, and intra-aortic balloon pumping was required in 19% with versus 0.8% without refractory myocardial ischemia, p less than 0.0001. Multivessel disease, p = 0.004, age older than 65 years, p = 0.005, and refractory myocardial ischemia, p = 0.08, interacted to produce the highest risk of in-hospital death. Follow-up shows that there have been 28 additional late deaths, including 23 of cardiac causes for a 91% survival at 5 years. Freedom from both late death and Q-wave myocardial infarction at 5 years was 61%. In the group going to emergency coronary artery bypass with refractory myocardial ischemia, the late cardiac survival was 90%, and in those without ischemia, 92% at 5 years, p = not significant. The MI--free survival in the group with refractory ischemia, however, was 56% versus 83% in the group without ischemia, p less than 0.0001. Multivariate analysis showed the highest late event rates for patients with Q-wave myocardial infarction at the initial emergency coronary artery bypass, age older than 65 years, angina class III or IV, and prior coronary bypass surgery. In spite of a continuing high incidence of early acute myocardial infarction and an increasing operative mortality rate (7%) in the latest 3 years cohort of patients, excellent late survival and low subsequent cardiac event

  12. Severe Hypocalcemia due to Vitamin D Deficiency after Extended Roux-en-Y Gastric Bypass.

    Science.gov (United States)

    Miñambres, I; Chico, A; Pérez, A

    2011-01-01

    Vitamin D deficiency is a well-known comorbidity of obesity that can be exacerbated after bariatric surgery and can predispose the patient for hypocalcemia. Vitamin D and calcium doses to prevent and treat vitamin D deficiency after weight loss surgery are not well defined. We describe a patient who developed severe hypocalcemia due to vitamin D deficiency 5 years after an extended Roux-en-Y gastric bypass for a type II obesity. No precipitating factors were present and malabsorption induced by the bypass was considered to be the main causative factor. High doses of vitamin D and calcium were needed to reach and maintain normal calcium and vitamin D concentrations. This case emphasises the importance of routine screening for vitamin D deficiency in obese individuals and reflects that while consensus does not exist regarding optimal dosage, vitamin D replacement should be tittered based on calcidiol levels.

  13. Severe Hypocalcemia due to Vitamin D Deficiency after Extended Roux-en-Y Gastric Bypass

    Directory of Open Access Journals (Sweden)

    I. Miñambres

    2011-01-01

    Full Text Available Vitamin D deficiency is a well-known comorbidity of obesity that can be exacerbated after bariatric surgery and can predispose the patient for hypocalcemia. Vitamin D and calcium doses to prevent and treat vitamin D deficiency after weight loss surgery are not well defined. We describe a patient who developed severe hypocalcemia due to vitamin D deficiency 5 years after an extended Roux-en-Y gastric bypass for a type II obesity. No precipitating factors were present and malabsorption induced by the bypass was considered to be the main causative factor. High doses of vitamin D and calcium were needed to reach and maintain normal calcium and vitamin D concentrations. This case emphasises the importance of routine screening for vitamin D deficiency in obese individuals and reflects that while consensus does not exist regarding optimal dosage, vitamin D replacement should be tittered based on calcidiol levels.

  14. Bypass Diode Temperature Tests of a Solar Array Coupon Under Space Thermal Environment Conditions

    Science.gov (United States)

    Wright, Kenneth H., Jr.; Schneider, Todd A.; Vaughn, Jason A.; Hoang, Bao; Wong, Frankie; Wu, Gordon

    2016-01-01

    Tests were performed on a 56-cell Advanced Triple Junction solar array coupon whose purpose was to determine margin available for bypass diodes integrated with new, large multi-junction solar cells that are manufactured from a 4-inch wafer. The tests were performed under high vacuum with coupon back side thermal conditions of both cold and ambient. The bypass diodes were subjected to a sequence of increasing discrete current steps from 0 Amp to 2.0 Amp in steps of 0.25 Amp. At each current step, a temperature measurement was obtained via remote viewing by an infrared camera. This paper discusses the experimental methodology, experiment results, and the thermal model.

  15. Effects of amiodarone and thoracic epidural analgesia on atrial fibrillation after coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Nygård, Eigil; Sørensen, Lars H; Hviid, Lamia B;

    2004-01-01

    OBJECTIVE: This study was designed to assess the effects of a perioperative dosing regimen of amiodarone administration, high thoracic epidural anesthesia (TEA), or a combination of the 2 regimens on atrial fibrillation (AF) after coronary artery bypass grafting (CABG). DESIGN AND SETTING......: The study was prospective, controlled, and randomized and was performed in a tertiary health care center associated with a university. PARTICIPANTS: One hundred sixty-three patients scheduled for coronary artery bypass graft surgery. INTERVENTIONS: In this 2 x 2 factorial-designed study the patients were...... randomized to 1 of 4 regimens in which group E had perioperative TEA, group E+A had TEA and amiodarone, group A had amiodarone, and group C served as control. The epidural catheter was inserted at T1-3 the day before surgery. TEA groups received TEA for 96 hours. The amiodarone regimen consisted of a single...

  16. Introduction of a synthetic CO₂-fixing photorespiratory bypass into a cyanobacterium.

    Science.gov (United States)

    Shih, Patrick M; Zarzycki, Jan; Niyogi, Krishna K; Kerfeld, Cheryl A

    2014-04-01

    Global photosynthetic productivity is limited by the enzymatic assimilation of CO2 into organic carbon compounds. Ribulose-1,5-bisphosphate carboxylase/oxygenase (RuBisCO), the carboxylating enzyme of the Calvin-Benson cycle, poorly discriminates between CO2 and O2, leading to photorespiration and the loss of fixed carbon and nitrogen. With the advent of synthetic biology, it is now feasible to design, synthesize, and introduce biochemical pathways in vivo. We engineered a synthetic photorespiratory bypass based on the 3-hydroxypropionate bi-cycle into the model cyanobacterium, Synechococcus elongatus sp. PCC 7942. The heterologously expressed cycle is designed to function as both a photorespiratory bypass and an additional CO2-fixing pathway, supplementing the Calvin-Benson cycle. We demonstrate the function of all six introduced enzymes and identify bottlenecks to be targeted in subsequent bioengineering. These results have implications for efforts to improve photosynthesis and for the "green" production of high value products of biotechnological interest.

  17. Continuous crossover femoropopliteal bypass in a 68-year-old gentleman with rest pain.

    LENUS (Irish Health Repository)

    Smith, F M

    2012-02-03

    Patients who have had multiple previous attempts at limb salvaging surgery frequently go on to have an amputation. This, however, results both in psychological perturbation for the patient and high rehabilitation costs for the community. Successful limb salvage surgery therefore has an important role in vascular surgery. We describe the management of a patient with critical limb ischemia that had previously undergone multiple limb salvage procedures and whose limb was saved by the use of a continuous femoropopliteal crossover bypass graft. The patient, who may have been deemed by some as a candidate for amputation, has full use of his limb 6 months after surgery with ankle brachial pressure index readings of 0.6. Continuous femoropopliteal crossover bypass grafting is a poorly described surgical technique that may be appropriate in a subgroup of patients and may allow salvage of a limb that otherwise may have been deemed fit for amputation.

  18. One-dimensional Arterial Network Model for Bypass Grafts Assessment

    CERN Document Server

    Ghigo, Arthur; Wang, Xiaofei; Lagrée, Pierre-Yves; Fullana, Jose-Maria

    2016-01-01

    We propose an arterial network model based on 1D blood hemodynamic equations to study the behavior of different vascular surgical bypass grafts in case of an arterial occlusive pathology: an obliteration or stenosis of the iliac artery. We investigate the performances of three different bypass grafts (Aorto-Femoral, Axillo-Femoral and cross-over Femoral) depending on the degree of obliteration of the stenosis. Numerical simulations show that all bypass grafts are efficient since we retrieve in all cases the normal hemodynamics in the stenosed region while ensuring at the same time a global healthy circulation. We analyze in particular the Axillo-Femoral bypass graft by performing hundreds of simulations by varying the values of the Young's modulus [0.1--50 MPa] and the radius [0.01--5 cm] of the bypass graft. We show that the Young's modulus and radius of commercial bypass grafts are optimal in terms of hemodynamic considerations. The numerical findings prove that this approach could be used to optimize or pl...

  19. Bypass Selection for Control of Heat Exchanger Network

    Institute of Scientific and Technical Information of China (English)

    SUN Lin; LUO Xionglin; HOU Benquan; BAI Yujie

    2013-01-01

    Considering the flexibility and controllability of heat exchanger networks (HENs),bypasses are widely used for effective control of process stream target temperatures.However,the optimal location for the bypass is generally difficult to design with the trade-off between controllability and capital investments.In this paper,based on the steady-state model of heat exchanger networks the optimal bypass location was firstly selected by iteratively calculating the non-square Relative Gain Array (ns-RGA).To simplify the calculation process,rules of bypass selection were also proposed.In order to evaluate this method,then,the structural controllability of heat exchanger networks was analyzed.With both the consideration of the controllability and capital investments,the bypasses locations were finally selected.A case study on the HEN in Crude Distillation Unit was presented in which the ns-RGA and structural controllability were used to select bypasses and also to evaluate the results.

  20. Cerebroprotective effect of piracetam in patients undergoing coronary bypass burgery.

    Science.gov (United States)

    Holinski, Sebastian; Claus, Benjamin; Alaaraj, Nour; Dohmen, Pascal Maria; Kirilova, Kremena; Neumann, Konrad; Uebelhack, Ralf; Konertz, Wolfgang

    2008-11-01

    Reduction of cognitive function is a possible side effect after cardiac surgery using cardiopulmonary bypass. We investigated the cerebroprotective effect of piracetam on cognitive performance in patients undergoing coronary artery bypass surgery under cardiopulmonary bypass. Patients scheduled for elective, primary and isolated coronary bypass surgery were randomised either to piracetam or placebo group. The study was performed in a double blind fashion. Patients received either 12 g piracetam or placebo at the beginning of the operation. Six neuropsychological subtests from the Syndrom Kurz Test and the Alzheimer's Disease Assessment Scale were performed preoperatively and on the third postoperative day. To assess the overall cognitive function and the degree of cognitive decline across all tests after surgery we combined the six test-scores by principal component analysis. A total number of 120 patients were enrolled into the study. Preoperative overall cognitive function were not significantly different between the groups. The postoperative combined score of the neuropsychological tests showed a deterioration of cognitive function in both groups (placebo-pre: -0.06+/-0.99 vs placebo-post: -1.38+/-1.11; ppiracetam-pre: 0.06+/-1.02 vs piracetam-post: -0.65+/-0.93; ppiracetam patients performed significantly better compared to the placebo patients after the operation and had a less decline of overall cognitive function (pPiracetam has a cerebroprotective effect in patients undergoing coronary artery bypass surgery with the use of cardiopulmonary bypass. It reduces an early postoperative substantial decline of neuropsychological abilities.

  1. Surgical Treatment of Renal Cell Carcinoma with Inferior Vena Cava Thrombus: Using Liver Mobilization Technique to Avoid Cardiopulmonary Bypass

    Directory of Open Access Journals (Sweden)

    Tawatchai Taweemonkongsap

    2008-04-01

    CONCLUSION: These results support the aggressive surgical removal of RCC with IVC thrombus as the initial treatment. Most of the thrombi can be approached and safely controlled by a transabdominal approach without any form of bypass. Tumour thrombus removal provides a high survival chance and offers improvement in quality of life.

  2. Improving the Sustainability of Transportation: Environmental and Functional Benefits of Right Turn By-Pass Lanes at Roundabouts

    Directory of Open Access Journals (Sweden)

    Marco Guerrieri

    2015-05-01

    Full Text Available The functional performances of conventional roundabouts (single-lane and multi-lane and innovative roundabouts (spiral, flower, C and turbo can be improved through right-turn bypass lanes controlled by stop, yield or free-flow signs. The article presents evaluations of the emissions of air pollutants (carbon dioxide, nitrogen oxides, particle pollution (PM10 and PM2.5, fuel consumption and construction, management, energetic and environmental costs in roundabouts without or with bypass lanes (controlled by stop, yield or free-flow. The suggested methodology has a general character and can be applied as a multi-parametric criterion for choosing road intersections, although, in the present paper, it has been employed only for a case study. For the aims of this research, we employed recent closed-form formulations to determine roundabout performances; moreover, we used the COPERT IV® software to estimate air emissions in nine different types of vehicles. Numerous traffic simulations were carried out. The variation in the maximum hourly traffic Qmax and annual traffic QTOT provided the appropriate domains of the examined geometric layouts, both in functional and environmental terms and with regard to generalized costs, estimated for a 10-year period. It resulted that the introduction of right-turn bypasses in all arms of conventional roundabouts with a one ring lane and one lane at the entries (single-lane roundabouts is the most cost-effective when the flows entering the roundabout are higher than Qmax = 2000 veh/h. Moreover, free-flow bypass lanes always provide greater capacity and lower delays than stop- or yield-signaled bypasses. However, with extremely high Qmax values, stop-controlled bypasses guarantee lower fuel consumption, while those with a yield sign lower total costs.

  3. Current status of mini-gastric bypass

    Science.gov (United States)

    Mahawar, Kamal K.; Kumar, Parveen; Carr, William RJ; Jennings, Neil; Schroeder, Norbert; Balupuri, Shlok; Small, Peter K.

    2016-01-01

    Mini-gastric bypass (MGP) is a promising bariatric procedure. Tens of thousands of this procedure have been performed throughout the world since Rutledge performed the first procedure in the United States of America in 1997. Several thousands of these have even been documented in the published scientific literature. Despite a proven track record over nearly two decades, this operation continues to polarise the bariatric community. A large number of surgeons across the world have strong objections to this procedure and do not perform it. The risk of symptomatic (bile) reflux, marginal ulceration, severe malnutrition, and long-term risk of gastric and oesophageal cancers are some of the commonly voiced concerns. Despite these expressed fears, several advantages such as technical simplicity, shorter learning curve, ease of revision and reversal, non-inferior weight loss and comorbidity resolution outcomes have prompted some surgeons to advocate a wider adoption of this procedure. This review examines the current status of these controversial aspects in the light of the published academic literature in English. PMID:27251826

  4. Postoperative abdominal complications after cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Dong Guohua

    2012-10-01

    Full Text Available Abstract Background To summarize the diagnostic and therapeutic experiences on the patients who suffered abdominal complications after cardiovascular surgery with cardiopulmonary bypass(CPB. Methods A total of 2349 consecutive patients submitted to cardiovascular surgery with CPB in our hospital from Jan 2004 to Dec 2010 were involved. The clinical data of any abdominal complication, including its incidence, characters, relative risks, diagnostic measures, medical or surgical management and mortality, was retrospectively analyzed. Results Of all the patients, 33(1.4% developed abdominal complications postoperatively, including 11(33.3% cases of paralytic ileus, 9(27.3% of gastrointestinal haemorrhage, 2(6.1% of gastroduodenal ulcer perforation, 2(6.1% of acute calculus cholecystitis, 3(9.1% of acute acalculus cholecystitis, 4(12.1% of hepatic dysfunction and 2(6.1% of ischemia bowel diseases. Of the 33 patients, 26 (78.8% accepted medical treatment and 7 (21.2% underwent subsequent surgical intervention. There were 5(15.2% deaths in this series, which was significantly higher than the overall mortality (2.7%. Positive history of peptic ulcer, advanced ages, bad heart function, preoperative IABP support, prolonged CPB time, low cardiac output and prolonged mechanical ventilation are the risk factors of abdominal complications. Conclusions Abdominal complications after cardiovascular surgery with CPB have a low incidence but a higher mortality. Early detection and prompt appropriate intervention are essential for the outcome of the patients.

  5. Current status of mini-gastric bypass

    Directory of Open Access Journals (Sweden)

    Kamal K Mahawar

    2016-01-01

    Full Text Available Mini-gastric bypass (MGP is a promising bariatric procedure. Tens of thousands of this procedure have been performed throughout the world since Rutledge performed the first procedure in the United States of America in 1997. Several thousands of these have even been documented in the published scientific literature. Despite a proven track record over nearly two decades, this operation continues to polarise the bariatric community. A large number of surgeons across the world have strong objections to this procedure and do not perform it. The risk of symptomatic (bile reflux, marginal ulceration, severe malnutrition, and long-term risk of gastric and oesophageal cancers are some of the commonly voiced concerns. Despite these expressed fears, several advantages such as technical simplicity, shorter learning curve, ease of revision and reversal, non-inferior weight loss and comorbidity resolution outcomes have prompted some surgeons to advocate a wider adoption of this procedure. This review examines the current status of these controversial aspects in the light of the published academic literature in English.

  6. SUrgical versus PERcutaneous Bypass: SUPERB-trial; Heparin-bonded endoluminal versus surgical femoro-popliteal bypass: study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Lensvelt, M.M.A.; Holewijn, S.; Fritschy, W.M.; Wikkeling, O.R.; Walraven, L.A. van; Wallis de Vries, B.M.; Zeebregts, C.J.A.; Reijnen, M.M.P.J.

    2011-01-01

    BACKGROUND: Endovascular treatment options for the superficial femoral artery are evolving rapidly. For long lesions, the venous femoropopliteal bypass considered to be superior above the prosthetic bypass. An endoluminal bypass, however, may provide equal patency rates compared to the prosthetic ab

  7. SUrgical versus PERcutaneous Bypass : SUPERB-trial; Heparin-bonded endoluminal versus surgical femoro-popliteal bypass: study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Lensvelt, Mare M. A.; Holewijn, Suzanne; Fritschy, Wilbert M.; Wikkeling, Otmar R. M.; van Walraven, Laurens A.; de Vries, Bas M. Wallis; Zeebregts, Clark J.; Reijnen, Michel M. P. J.

    2011-01-01

    Background: Endovascular treatment options for the superficial femoral artery are evolving rapidly. For long lesions, the venous femoropopliteal bypass considered to be superior above the prosthetic bypass. An endoluminal bypass, however, may provide equal patency rates compared to the prosthetic ab

  8. Acute mesenteric ischemia after cardio-pulmonary bypass surgery

    Institute of Scientific and Technical Information of China (English)

    Bassam Abboud; Ronald Daher; Joe Boujaoude

    2008-01-01

    Acute mesenteric ischemia (AMI) is a highly-lethal surgical emergency.Several pathophysiologic events (arterial obstruction,venous thrombosis and diffuse vasospasm) lead to a sudden decrease in mesenteric blood flow.Ischemia/reperfusion syndrome of the intestine is responsible for systemic abnormalities,leading to multi-organ failure and death.Early diagnosis is difficult because the clinical presentation is subtle,and the biological and radiological diagnostic tools lack sensitivity and specificity.Therapeutic options vary from conservative resuscitation,medical treatment,endovascular techniques and surgical resection and revascularization.A high index of suspicion is required for diagnosis,and prompt treatment is the only hope of reducing the mortality rate.Studies are in progress to provide more accurate diagnostic tools for early diagnosis.AMI can complicate the post-operative course of patients following cardio-pulmonary bypass (CPB).Several factors contribute to the systemic hypo-perfusion state,which is the most frequent pathophysiologic event.In this particular setting,the clinical presentation of AMI can be misleading,while the laboratory and radiological diagnostic tests often produce inconclusive results.The management strategies are controversial,but early treatment is critical for saving lives.Based on the experience of our team,we consider prompt exploratory laparotomy,irrespective of the results of the diagnostic tests,is the only way to provide objective assessment and adequate treatment,leading to dramatic reduction in the mortality rate.

  9. Juxtarenal Inflammatory Aneurysm Treated with Bilateral Iliac-Renal Bypass Using the Gore Hybrid Device and Total Sealing of the Aneurysmal Sac with a Nellix Device.

    Science.gov (United States)

    Martinelli, Ombretta; Malaj, Alban; Gattuso, Roberto; Irace, Luigi; Gossetti, Bruno

    2017-01-01

    The aim of this study is to present the treatment of a juxtarenal inflammatory aneurysm using a Nellix device (Endologix, Inc., Irvine, CA) to seal the entire aneurysmatic aorta combined with bilateral iliac-renal bypass using the Gore hybrid vascular graft (W. L. Gore & Associates, Inc., Flagstaff, AZ). A 63-year-old man was diagnosed with a 6-cm juxtarenal inflammatory aneurysm. It was initially decided to treat him with an aorto-aortic bypass and to revascularize the 2 renal arteries with "graft to renal artery bypass" using Gore hybrid vascular grafts. Due to the high intraoperative bleeding preparing the proximal neck and the tight adhesion of the aorta to the adjacent structures, we decided to change our plans and to treat the patient using the Nellix system combined with bilateral iliac-renal bypass using the Gore hybrid vascular grafts. Contrast computed tomography control at 1 month showed complete sealing of the aneurysm sac and patent iliac renal bypasses. The reported case demonstrated that the Nellix Endovascular Aneurysm Sealing system combined with Gore hybrid vascular grafts for bilateral iliac-renal bypass showed that it can be an effective modality for the treatment of juxtarenal, inflammatory aortic aneurysm and revascularization of the renal arteries from the distal iliac arteries. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Fan Noise Source Diagnostic Test Completed and Documented

    Science.gov (United States)

    Envia, Edmane

    2003-01-01

    The specially organized session offered an international forum to disseminate the results from a year long test that was conducted in 1999 in NASA Glenn Research Center s 9- by 15-Foot Low-Speed Wind Tunnel on a 22-in. scale-model turbofan bypass stage, which was designed to be representative of current aircraft engine technology. The test was a cooperative effort involving Glenn, the NASA Langley Research Center, GE Aircraft Engines, and the Boeing Company. The principal objective of the project was to study the source mechanisms of noise in a modern high-bypass-ratio turbofan engine through detailed aerodynamic and acoustic measurements.

  11. Deep Vein Thrombosis in A Post-Coronary Artery Bypass Grafting Patient: Successful Conservative Management.

    Science.gov (United States)

    Sarker, S H; Miraj, A K; Hossain, M A; Aftabuddin, M

    2017-07-01

    Deep vein thrombosis is an alarming medical emergency. Deep vein thrombosis or deep venous thrombosis (DVT) is the formation of a blood clot (thrombus) within a deep vein predominantly in the legs. Post-Coronary Artery Bypass Grafting deep vein thrombosis is a very rare medical condition relatively in Asian. Approximately 80% of deep vein thrombosis (DVTs) is clinically asymptomatic, 20% of those that actually demonstrate signs and symptoms can be easily confused with symptoms of other commonly presenting musculoskeletal disorders. Proper medical management can reduce patient's morbidity and further burden. A 50 years old diabetic Post-Coronary Artery Bypass Grafting gentleman had been suffering for left leg swelling, high grade fever and calf muscle pain for 5 days. He had absent Arteria Dorsalis Paedis pulse on left foot, Positive Homan sign and Wells score is 7. His left leg was hugely swelled. He had normal leg hair distribution. Duplex study of Left Leg-Deep Vein Thrombosis in left lower limb (Popliteal segment) with sign of recanalization. He is also a patient of anemia of chronic disease due to hemorrhoid. Several investigations have done to find the cause of his chronic anemia. His treatment was meticulous with complete bed rest, elevation of left lower limb, heparinization, oralrivaroxaban. He had rapid recovery following treatment. Post-Coronary Artery Bypass Grafting patient should be given post-operative enoxaparin (Low molecular weight Heparin) or Heparin for 3-5 days. Early diagnosis of the disease condition reduces morbidity. Combined treatment with Rivaroxaban and Heparin is of great clinical value and outcome in a case of Post-Coronary Artery Bypass Grafting Deep Vein Thrombosis patient.

  12. Remote ischemic preconditioning in cyanosed neonates undergoing cardiopulmonary bypass: a randomized controlled trial.

    Science.gov (United States)

    Jones, Bryn O; Pepe, Salvatore; Sheeran, Freya L; Donath, Susan; Hardy, Pollyanna; Shekerdemian, Lara; Penny, Daniel J; McKenzie, Ian; Horton, Stephen; Brizard, Christian P; d'Udekem, Yves; Konstantinov, Igor E; Cheung, Michael M H

    2013-12-01

    The myocardial protective effect of remote ischemic preconditioning has been demonstrated in heterogeneous groups of patients undergoing cardiac surgery. No studies have examined this technique in neonates. The present study was performed to examine the remote ischemic preconditioning efficacy in this high-risk patient group. A preliminary, randomized, controlled trial was conducted to investigate whether remote ischemic preconditioning in cyanosed neonates undergoing cardiac surgery confers protection against cardiopulmonary bypass. Two groups of neonates undergoing cardiac surgery were recruited for the present study: patients with transposition of the great arteries undergoing the arterial switch procedure and patients with hypoplastic left heart syndrome undergoing the Norwood procedure. The subjects were randomized to the remote ischemic preconditioning or sham control groups. Remote ischemic preconditioning was induced by four 5-minute cycles of lower limb ischemia and reperfusion using a blood pressure cuff. Troponin I and the biomarkers for renal and cerebral injury were measured pre- and postoperatively. A total of 39 neonates were recruited-20 with transposition of the great arteries and 19 with hypoplastic left heart syndrome. Of the 39 neonates, 20 were randomized to remote ischemic preconditioning and 19 to the sham control group. The baseline demographics appeared similar between the randomized groups. The cardiopulmonary bypass and crossclamp times were not significantly different between the 2 groups. The troponin I levels were not significantly different at 6 hours after cardiopulmonary bypass nor were the postoperative inotrope requirements. Markers of renal (neutrophil gelatinase-associated lipocalin) and cerebral injury (S100b, neuron-specific enolase) were not significantly different between the 2 groups. Our data suggest that remote ischemic preconditioning in hypoxic neonates undergoing cardiopulmonary bypass surgery does not provide

  13. Reinforced long saphenous vein bypass graft for infrainguinal reconstruction procedures: case series and literature review.

    LENUS (Irish Health Repository)

    Hynes, Niamh

    2006-03-01

    Poor rehabilitation rates and the high-cost of managing postamputation patients justify an aggressive revascularization policy in critical lower limb ischemia. Endovascular therapy is our first choice for limb salvage in these patients. However there are patients for whom endovascular therapy is not feasible. When bypass is necessary, autologous vein is a superior conduit to synthetic material. However, varicosities usually contraindicate autologous vein bypass because of the risk of aneurysm formation, rupture and increased intimal hyperplasia compared with nonvaricose venous grafts. We report the use of varicosed long saphenous vein (LSV) with external Dacron support in infrainguinal bypass procedures for limb salvage, where endovascular therapy was not feasible. The external Dacron tube was not brought close to the distal anastomotic area itself. With a mean follow-up of 18 months, duplex ultrasonography and computed tomography angiography showed no evidence of stenosis of the reinforced vein segments or aneurysmal degeneration of the residual vein. External reinforcement with Dacron prosthesis allows the use of autogenous greater saphenous veins with varicose dilatation without compromising graft patency and limb salvage.

  14. Development of the Current Bypassing Methods into the Transverse Direction in Non-insulation HTS Coils

    Science.gov (United States)

    Tanaka, K.; Kim, S. B.; Ikoma, H.; Kanemoto, D.

    In the case of motors and generators, the benefits of using high temperature superconducting (HTS) coils can be represented by the reduction of 50% in both losses and sizes compared to conventional machines. However, it is hard to establish quench detection and protection devices for the HTS coils applied to the rotors of motors and generators. So, the stability of the coils is lower than for the quiescent coils applied to NMR, MRI and so on. Therefore, it is important to improve the self-protection ability of HTS coils. We have studied the methods to improve the self-protection ability of HTS coils by removing the layer-to-layer insulation and inserting metal tape instead of the electrical insulation. The operating current in the non-insulated HTS coil was bypassed into the transverse direction by the generated normal region because of their electrical contact among the winding. In this study, we examined the method to control the current bypassing on layer-to-layer for controlling the inductance of the non-insulated HTS coil. The current bypassing properties on non-insulated HTS coil wound with 2G wires will be discussed.

  15. Tandem GM Type-Pulse Tube Refrigerator with Novel Rotary Valve and Bypass Valve Mechanism

    Science.gov (United States)

    Jung, J.; Jeong, S.; Kwon, Y.; Sohn, M.

    2006-04-01

    A single-stage tandem pulse tube refrigerator has been fabricated, which is driven by two pulsating pressures of opposite phase. The refrigerator is designed as the first stage machine of a 4 K pulse tube refrigerator using a recuperator as the second stage regenerator. In this tandem configuration, two pressure pulsations are generated by a single GM-cryocooler compressor. Two identical pulse tube refrigerators are operated with a novel rotary valve that can supply high and low pressures simultaneously. The pressure measurement at the regenerator inlets of the pulse tube refrigerators confirmed the proper pressure wave of two pulsating pressures in opposite phase. Detrimental DC-flow characteristic of double-inlet GM-type pulse tube refrigerator has been suppressed by the newly designed bypass valve mechanism. This new bypass valve set has one more extra degree of freedom than usual ones to eliminate DC-flow easily. This paper describes a novel feature of the bypass valve set and its performance in the experiment. The two twin pulse tube refrigerators in a tandem mode respectively reached 35 K at no load.

  16. Genome-Wide Overexpression Screen Identifies Genes Able to Bypass p16-Mediated Senescence in Melanoma.

    Science.gov (United States)

    Lee, Won Jae; Škalamera, Dubravka; Dahmer-Heath, Mareike; Shakhbazov, Konstanin; Ranall, Max V; Fox, Carly; Lambie, Duncan; Stevenson, Alexander J; Yaswen, Paul; Gonda, Thomas J; Gabrielli, Brian

    2017-03-01

    Malignant melanomas often arise from nevi, which result from initial oncogene-induced hyperproliferation of melanocytes that are maintained in a CDKN2A/p16-mediated senescent state. Thus, genes that can bypass this senescence barrier are likely to contribute to melanoma development. We have performed a gain-of-function screen of 17,030 lentivirally expressed human open reading frames (ORFs) in a melanoma cell line containing an inducible p16 construct to identify such genes. Genes known to bypass p16-induced senescence arrest, including the human papilloma virus 18 E7 gene ( HPV18E7), and genes such as the p16-binding CDK6 with expected functions, as well as panel of novel genes, were identified, including high-mobility group box (HMGB) proteins. A number of these were further validated in two other models of p16-induced senescence. Tissue immunohistochemistry demonstrated higher levels of CDK6 in primary melanomas compared with normal skin and nevi. Reduction of CDK6 levels drove melanoma cells expressing functional p16 into senescence, demonstrating its contribution to bypass senescence.

  17. Shunt for bypass graft of the cavernous carotid artery: an anatomical and technical study.

    Science.gov (United States)

    al-Mefty, O; Khalil, N; Elwany, M N; Smith, R R

    1990-11-01

    During direct surgery of neoplastic and vascular lesions of the cavernous sinus, the intracavernous carotid artery may be injured beyond repair, or its total isolation may be necessary for surgical management of these lesions. The newly developed procedure of a saphenous vein graft bypass of the cavernous carotid artery allows re-establishment of carotid circulation. Patients with poor collateral circulation are at high risk for ischemic complications induced by the prolonged temporary occlusion required to perform the bypass graft. Optimal management of these patients is to perform the venous bypass graft for permanent vascularization while maintaining carotid cerebral circulation through an intraoperative shunt. We studied this procedure in cadavers, and three shunt types were evaluated: the external intrapetrous-supraclinoid shunt (Type A), the internal intrapetrous-supraclinoid shunt (Type B), and the neck internal carotid-supraclinoid shunt (Type C). Anatomical landmarks, techniques, distances, caliber, and materials used are presented. The rationale and candidates for such a procedure are discussed. The specifications of an optimal balloon shunt are presented, and the three procedures are compared.

  18. Rotordynamic analysis of asymmetric turbofan rotor due to fan blade-loss event with contact-impact rub loads

    Science.gov (United States)

    Sinha, Sunil K.

    2013-04-01

    Loss of a blade from a running turbofan rotor introduces not only huge imbalance into the dynamical system rather it makes the entire rotor asymmetric as well. In a nonsymmetric rotor, the various terms of mass, gyroscopic and stiffness matrices also become time-dependent. In this paper, all the dynamical equations include the effect of the rotary inertia and gyroscopic moments as a result of both shaft bending as well as staggered blades flexing in-and-out of the plane of the disk. The governing equations also account for internal material damping in the shaft and the external damping in the support bearing system. In addition to the unbalance load at the disk location, the shaft may also be subjected to a torque and axial forces. Here, the fan blades are modeled as pre-twisted thin shallow shells. They have coupled flexural-torsional motion in the lateral out-of-plane direction as well as extensional degrees-of-freedom in the longitudinal spanwise direction of the blade airfoil. The effect of blade tip rub forces being transmitted to the shaft are analyzed in terms of the dynamic stability of the rotor, especially during windmilling.

  19. Cardiopulmonary bypass considerations for pediatric patients on the ketogenic diet.

    Science.gov (United States)

    Melchior, R W; Dreher, M; Ramsey, E; Savoca, M; Rosenthal, T

    2015-07-01

    There is a population of children with epilepsy that is refractory to anti-epileptic drugs. The ketogenic diet, a high-fat, low-carbohydrate regimen, is one alternative treatment to decrease seizure activity. Special considerations are required for patients on the ketogenic diet undergoing cardiopulmonary bypass (CPB) to prevent exposure to glucose substrates that could alter ketosis, increasing the risk of recurrent seizures. A 2-year-old, 9 kilogram male with a history of infantile spasms with intractable epilepsy, trisomy 21 status post tetralogy of Fallot repair, presented to the cardiac operating room for closure of a residual atrial septal defect. All disciplines of the surgical case minimized the use of carbohydrate-containing and contraindicated medications. Changes to the standard protocol and metabolic monitoring ensured the patient maintained ketosis. All disciplines within cardiac surgery need to be cognizant of patients on the ketogenic diet and prepare a modified protocol. Future monitoring considerations include thromboelastography, electroencephalography and continuous glucose measurement. Key areas of focus with this patient population in the cardiac surgical theater are to maintain a multidisciplinary approach, alter the required CPB prime components, address cardiac pharmacological concerns and limit any abnormal hematological occurrences. © The Author(s) 2014.

  20. Smoking and alcohol use in gastric bypass patients.

    Science.gov (United States)

    Lent, Michelle R; Hayes, Sharon M; Wood, G Craig; Napolitano, Melissa A; Argyropoulos, George; Gerhard, Glenn S; Foster, Gary D; Still, Christopher D

    2013-12-01

    Bariatric surgery may increase the risk of substance use. The purpose of this study was to prospectively assess smoking and alcohol use before and after bariatric surgery, identify characteristics associated with alcohol use and smoking, and examine substance use and weight loss. Participants (N = 155, mean = 50.1 ± 11.3 y and 45.7 ± 7.0 kg/m(2)) were Roux-en-Y gastric bypass (RYGB) patients that completed surveys on substance use preoperatively and postoperatively. Alcohol use decreased significantly from the preoperative (72.3%) to the postoperative (63.2%) period. As preoperative alcohol quantity rose, the odds of consuming any alcohol postoperatively increased six-fold. Higher BMI increased the odds of high alcohol consumption. Older age decreased the odds of alcohol use and smoking. Smoking status did not differ pre- (19.4%) to post- (14.8%) surgery. Alcohol use and smoking were not associated with weight loss. After weight-loss surgery, alcohol use declined but smoking rates did not significantly change. Younger patients were more likely to use alcohol and smoke postoperatively. Patients with a higher BMI or a history of substance use may be more likely to use alcohol postoperatively. © 2013.

  1. Off-Pump Coronary Bypass Grafting Causing Stunned Myocardium

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi

    2015-10-01

    Full Text Available The term “stunned myocardium” refers to abnormalities in the myocardial function following reperfusion and is common in on-pump coronary artery bypass grafting (CABG and is exceedingly rare in off- pump CABG. A 53-year-old man presented with unstable angina due to the severe stenosis of the left anterior descending coronary artery (LAD and the obtuse marginal. Laboratory findings and Chest X-ray revealed nothing abnormal. The intraoperative course was uneventful. The patient left the operating room without any inotropic support. Six hours later, however, he developed low cardiac output .At exploration, cardiac tamponade was excluded and flowmetry showed that the graft had adequate function. Cardiac enzymes were normal. High-dose adrenalin and Dobutamine were administrated and an intra-aortic balloon pump was used. After hemodynamic stabilization, the patient left the Intensive Care Unit without an intra-aortic balloon pump and inotropic support. On the fifth postoperative day, coronary angiography showed patent grafts and correct anastomotic sites. On the seventh postoperative day, the akinetic lateral wall of the left ventricle changed to dyskinesia. Finally after hospital discharge on the thirtieth postoperative day, an echocardiogram showed normal left ventricular function without regional wall motion abnormalities

  2. Photovoltaic-module bypass-diode encapsulation. Annual report

    Energy Technology Data Exchange (ETDEWEB)

    1983-06-20

    The design and processing techniques necessary to incorporate bypass diodes within the module encapsulant are presented in this annual report. A comprehensive survey of available pad-mounted PN junction and Schottky diodes led to the selection of Semicon PN junction diode cells for this application. Diode junction-to-heat spreader thermal resistance measurements, performed on a variety of mounted diode chip types and sizes, have yielded values which are consistently below 1/sup 0/C per watt, but show some instability when thermally cycled over the temperature range from -40 to 150/sup 0/C. Based on the results of a detailed thermal analysis, which covered the range of bypass currents from 2 to 20 amperes, three representative experimental modules, each incorporating integral bypass diode/heat spreader assemblies of various sizes, were designed and fabricated. Thermal testing of these modules has enabled the formation of a recommended heat spreader plate sizing relationship. The production cost of three encapsulated bypass diode/heat spreader assemblies were compared with similarly rated externally-mounted packaged diodes. An assessment of bypass diode reliability, which relies heavily on rectifying diode failure rate data, leads to the general conclusion that, when proper designed and installed, these devices will improve the overall reliability of a terrestrial array over a 20 year design lifetime.

  3. Thermal activation of dislocations in large scale obstacle bypass

    Science.gov (United States)

    Sobie, Cameron; Capolungo, Laurent; McDowell, David L.; Martinez, Enrique

    2017-08-01

    Dislocation dynamics simulations have been used extensively to predict hardening caused by dislocation-obstacle interactions, including irradiation defect hardening in the athermal case. Incorporating the role of thermal energy on these interactions is possible with a framework provided by harmonic transition state theory (HTST) enabling direct access to thermally activated reaction rates using the Arrhenius equation, including rates of dislocation-obstacle bypass processes. Moving beyond unit dislocation-defect reactions to a representative environment containing a large number of defects requires coarse-graining the activation energy barriers of a population of obstacles into an effective energy barrier that accurately represents the large scale collective process. The work presented here investigates the relationship between unit dislocation-defect bypass processes and the distribution of activation energy barriers calculated for ensemble bypass processes. A significant difference between these cases is observed, which is attributed to the inherent cooperative nature of dislocation bypass processes. In addition to the dislocation-defect interaction, the morphology of the dislocation segments pinned to the defects play an important role on the activation energies for bypass. A phenomenological model for activation energy stress dependence is shown to describe well the effect of a distribution of activation energies, and a probabilistic activation energy model incorporating the stress distribution in a material is presented.

  4. Reversal of Gastric Bypass Resolves Hyperoxaluria and Improves Oxalate Nephropathy Secondary to Roux-en-Y Gastric Bypass

    Science.gov (United States)

    Agrawal, Varun; Wilfong, Jonathan B.; Rich, Christopher E.; Gibson, Pamela C.

    2016-01-01

    Hyperoxaluria after Roux-en-Y gastric bypass (RYGB) increases the risk for kidney injury. Medical therapies for hyperoxaluria have limited efficacy. A 65-year-old female was evaluated for acute kidney injury [AKI, serum creatinine (Cr) 2.1 mg/dl, baseline Cr 1.0 mg/dl]. She did not have any urinary or gastrointestinal symptoms or exposure to nephrotoxic agents. Sixteen months prior to this evaluation, she underwent RYGB for morbid obesity. Her examination was unremarkable for hypertension or edema and there was no protein or blood on urine dipstick. Kidney biopsy revealed acute tubulointerstitial nephritis with oxalate crystals in tubules. The concurrent finding of severe hyperoxaluria (urine oxalate 150 mg/day) confirmed the diagnosis of oxalate nephropathy. Despite medical management of hyperoxaluria, her AKI worsened. Laparoscopic reversal of RYGB was performed and within 1 month, her hyperoxaluria resolved (urine oxalate 20 mg/day) and AKI improved (Cr 1.7 mg/dl). Surgical reversal of RYGB may be considered in patients with oxalate nephropathy at high risk of progression who fail medical therapy. Physicians need to be aware of the possibility of oxalate nephropathy after RYGB and promptly treat the hyperoxaluria to halt further kidney damage. PMID:27781207

  5. Collaboration with Williams International to Demonstrate the Characteristics of a Foam-Metal-Liner Installed Over-the-Rotor of a Turbofan Engine

    Science.gov (United States)

    Sutliff, Daniel; Elliott, Dave; Jones, Mike; Hartley, Tom

    2008-01-01

    A Williams International FJ44-3A 3000-lb thrust class turbofan engine was used as a demonstrator for foam-metal liner installed in close proximity to the fan. Two foam metal liner designs were tested and compared to the hardwall. Traditional Single-Degree-of-Freedom liner designs were also evaluated to provide a comparison. Normalized information on farfield acoustics is presented in this paper. The results show that up to 5 dB PWL overall attenuation was achieved in the forward quadrant. In general, the foam-metal liners performed better when the fan tip speed was below sonic.

  6. Neuroprotective Strategies during Cardiac Surgery with Cardiopulmonary Bypass

    Science.gov (United States)

    Salameh, Aida; Dhein, Stefan; Dähnert, Ingo; Klein, Norbert

    2016-01-01

    Aortocoronary bypass or valve surgery usually require cardiac arrest using cardioplegic solutions. Although, in principle, in a number of cases beating heart surgery (so-called off-pump technique) is possible, aortic or valve surgery or correction of congenital heart diseases mostly require cardiopulmonary arrest. During this condition, the heart-lung machine also named cardiopulmonary bypass (CPB) has to take over the circulation. It is noteworthy that the invention of a machine bypassing the heart and lungs enabled complex cardiac operations, but possible negative effects of the CPB on other organs, especially the brain, cannot be neglected. Thus, neuroprotection during CPB is still a matter of great interest. In this review, we will describe the impact of CPB on the brain and focus on pharmacological and non-pharmacological strategies to protect the brain. PMID:27879647

  7. Vitamin deficiency after gastric bypass surgery: a review.

    Science.gov (United States)

    Matrana, Marc R; Davis, William E

    2009-10-01

    More than 60% of the adult US population now meets the criteria for being overweight or obese. Gastric bypass surgery has become a popular and effective way to combat this medical problem. Despite the success of these procedures, they are associated with many complications, including malnutrition, neurological compromise, and vitamin deficiency. Research has determined that even with multivitamin supplementation for life, a large percentage of bypass patients develop vitamin deficiencies. We present a case of beriberi after Roux-en-Y bypass that illustrates the importance of close follow up. A thorough review of vitamin deficiencies in this unique patient population is explored. Vitamin supplementation and treatment recommendations are compiled from the most up-to-date sources. Even patients on regular supplements should be closely monitored for vitamin deficiencies. Patient education regarding vitamin supplementation is vital; it should begin prior to surgery and continue throughout the postoperative period and beyond.

  8. Coronary artery bypass and superior vena cava syndrome.

    Science.gov (United States)

    Thomas, T V; Masrani, K; Thomas, J L

    1999-01-01

    Superior vena cava syndrome is the obstruction of the superior vena cava or its main tributaries by benign or malignant lesions. The syndrome causes edema and engorgement of the vessels on the face, neck, and arms, nonproductive cough, and dyspnea. We discuss the case of a 48-year-old obese diabetic woman who was admitted with unstable angina. She had previously been diagnosed with superior vena cava syndrome. Urgent coronary artery bypass grafting was necessary Although thousands of coronary artery bypasses are performed every year, there are not many reports on patients with superior vena cava syndrome who successfully undergo cardiopulmonary bypass and coronary artery grafting with an internal mammary artery as the conduit. The results of the case and alternative recommended methods are discussed.

  9. Proposal of bypass in heat recovery system with sucking air

    Science.gov (United States)

    Siažik, Ján; Malcho, Milan; Rezničák, Štefan

    2016-06-01

    Waste heat is utilized in a wide variety of technologies for a number of reasons. But the significant one such reason is use of the energy contained for example in waste water or waste heat that would otherwise left unused. Other considerable reason it is also reduces primary costs to operate the technology. The article deals with the arrangement section of the unit in heat recovery systems where the entry of waste gases into defluorinastion device. The technologies re-use heat often use the bypass. Bypass fulfill their duty in equipment failures, for example heat exchanger where it is not possible to stop the operationimmediately and the hot combustion gases can flow bypass without interrupting operation.

  10. Comparison of the Birds Point-New Madrid Floodway, Mississippi River and the Yolo Bypass, Sacramento River

    Institute of Scientific and Technical Information of China (English)

    Brad Walker

    2016-01-01

    ABSTRACT:The Birds Point-New Madrid Floodway (BP-NMF) and the Yolo Bypass, located on the Mississippi and Sacramento rivers, respectively, are agriculture areas that were once each part of vast wetlands but are now intermittently used for flood control. Here the similarity stops, the BP-NMF has been used to convey floodwaters only twice in nearly 80 years, while the Yolo Bypass is used for this purpose on average every other year. The consequences are greatly different. In 2011, the BP-NMF was activated through the explosive detonation of the‘fuse plug”portion of its levees, resulting in ele-vated property and economic damages, crop losses, and litigation. High-energy flows following the opening of the BP-NMF scour coarse sediment in the vicinity of the opening of the BP-NMF and depo-sit this material within the floodway, including on agricultural fields. In general the environment of much of the BP-NMF provides poor wildlife habitat. In contrast, the routine operation of Yolo Bypass is expected, avoids damage and litigation, supplies organic-rich sediment to fields, and provides good wildlife habitat. The difference between the two systems is attributed to a better approximation of natural conditions on the Yolo Bypass.

  11. The study of neuropsychological alterations following coronary artery bypass operation as predicted by computed tomography scan of the brain

    Energy Technology Data Exchange (ETDEWEB)

    Iguchi, Atsushi; Sato, Kiyoharu (Sendai Tokushu-kai Hospital (Japan)); Sadahiro, Mitsuaki; Endo, Masato; Yokoyama, Hitoshi; Ohmi, Mikio

    1993-01-01

    The objective of this clinical study is to provide information regarding the association between coexistent cerebrovascular disease and neuropsychological abnormalities after coronary artery bypass operations. Computed tomography scan of the brain was performed in 104 patients pre-operatively, and their post-operative neuropsychological functions were evaluated. The patients were categorized as follows according to the CT findings. Seventy-three patients showed normal or slight cerebral cortical atrophy which usually seen in patients over fifty of age (group A). Sixteen showed moderate or severe cortical atrophy (group B). Fifteen patients demonstrated the characteristic findings of Binswanger type; severe white matter hypodensity especially in frontal horns and dilated ventricles (group C). Overt neuropsychological dysfunction was not observed in patients in groups A and B. Six patients in group C showed a combination of dementia, bizarre behavior, disorientation and gait dyspraxia following bypass operations. The pseudobulbar signs were also found in 3 patients. These clinical abnormalities persisted for six days to three weeks, and were most often reversible. Although the underlying mechanism of these deleterious alterations is not elucidated, the ischemic nature of the characteristic white matter lesions was highly suspected. The arteriosclerotic changes of the arteriole of the cerebral cortex and hypoperfusion during cardio-pulmonary bypass were supposed to be responsible. Therefore it was concluded that special attention should be focused on neurological evaluation for bypass surgery in group C patients. (author).

  12. Piping coarse-grained sediment to a deep water fan through a shelf-edge delta bypass channel: Tank experiments

    Science.gov (United States)

    Kim, Yuri; Kim, Wonsuck; Cheong, Daekyo; Muto, Tetsuji; Pyles, David R.

    2013-12-01

    is now generally accepted that deltas that prograde to the shelf edge are able to transport coarse sediment to deep water either with or without sea level changes. However, it is still unclear how feeder rivers behave differently in the shelf-edge delta case to rivers found in a delta that progrades over the shelf. A series of nine shelf-edge delta experiments are presented to investigate the lateral mobility of the feeder channel at the shelf edge and the associated deep water depositional system under a range of sediment supply rates and shelf-front depths. In the experiments, constant sediment supply from an upstream point source under static sea level led the fluviodeltaic system to prograde over the shallow shelf surface and advance beyond the shelf edge into deep water. The feeder river of the fluviodeltaic system became a bypass system once the toe of the delta front reached the shelf edge. After the delta front was perched at the shelf edge, a submarine fan developed in deep water although remaining disconnected from the delta. In this bypass stage, no regional avulsion or lateral migration of the feeder river occurred and all sediment from the upstream source bypassed the river, delta front, and shelf-front slope. The duration of the bypass stage is proportional to shelf-front depth and inversely proportional to sediment discharge. The combined duration of the shelf-transit phase of the fluviodeltaic system and the bypass phase is the characteristic time scale for the continental margin to "anneal" transgression-inducing perturbation due to high-frequency and/or high-amplitude relative sea level rise. The sequential evolution in the experiment compares favorably to the Eocene Sobrarbe Formation, a shelf-edge delta in Spain, although natural variations are noted. This comparison justifies the application of concepts proposed herein to natural systems and provides insight into interpreting processes from ancient shelf-edge delta systems.

  13. Clinical outcomes in randomized trials of off- vs. on-pump coronary artery bypass surgery

    DEFF Research Database (Denmark)

    Møller, Christian H; Penninga, Luit; Wetterslev, Jørn

    2008-01-01

    To assess the clinical outcomes of off- vs. on-pump coronary artery bypass surgery in randomized trials.......To assess the clinical outcomes of off- vs. on-pump coronary artery bypass surgery in randomized trials....

  14. Managing the Inflammatory Response after Cardiopulmonary Bypass : Review of the Studies in Animal Models

    NARCIS (Netherlands)

    Liguori, Gabriel Romero; Kanas, Alexandre Fligelman; Moreira, Luiz Felipe Pinho

    2014-01-01

    OBJECTIVE: To review studies performed in animal models that evaluated therapeutic interventions to inflammatory response and microcirculatory changes after cardiopulmonary bypass. METHODS: It was used the search strategy ("Cardiopulmonary Bypass" (MeSH)) and ("Microcirculation" (MeSH) or "Inflammat

  15. Off-pump coronary artery bypass grafting in patients with mirror-imaging dextrocardia.

    Science.gov (United States)

    Yuan, Xin; Sun, Hansong; Wang, Xianqiang

    2015-08-01

    Dextrocardia requires alterations in techniques during coronary artery bypass graft (CABG) surgery. We report two cases undergoing off-pump coronary artery bypass graft (OPCAB) surgery and discuss techniques for the operative management of these patients.

  16. History and Current Status of Robotic Totally Endoscopic Coronary Artery Bypass

    National Research Council Canada - National Science Library

    Lee, Jeffrey D; Srivastava, Mukta; Bonatti, Johannes

    2012-01-01

    Robotic totally endoscopic coronary artery bypass (TECAB) is a minimally invasive endoscopic surgical approach using the daVinci robotic telemanipulation system to perform coronary artery bypass grafting on the arrested or beating heart...

  17. Tidlige erfaringer med duplexovervågning af femoropopliteale og -krurale vene-bypass

    DEFF Research Database (Denmark)

    Nielsen, Tina G; von Jessen, Frants; Schroeder, T V

    1993-01-01

    Identification and correction of graft stenoses in femoropopliteal and -crural vein bypasses can prevent reconstruction failure. Sixty six consecutive vein bypasses entered a postoperative surveillance protocol, which implied clinical assessment, measurement of ankle blood pressure and duplex-sca...

  18. Reduced complement activation during cardiopulmonary bypass does not affect the postoperative acute phase response

    NARCIS (Netherlands)

    van den Goor, J.; Nieuwland, R.; van den Brink, A.; van Oeveren, W.; Rutten, 27818; Tijssen, J.; Eijsman, L.; Rutten, P

    2004-01-01

    Objective: In the present study the relationship was evaluated between perioperative inflammation and the postoperative acute phase response in patients undergoing elective coronary artery bypass grafting (CABG) assisted by cardiopulmonary bypass (CPB). CPB circuits contained either non-coated-

  19. [Prevalence of early and late dumping after gastric bypass].

    Science.gov (United States)

    Héraïef, R; Giusti, V

    2014-03-26

    Gastric bypass surgery is an effective treatment of obesity, bringing a significant weight loss and a major improvement of carbohydrate profile. However, in some patients, a deregulation in carbohydrate metabolism between insulin secretion and sensitivity is observed, whereupon early and late dumping happen. Their prevalence isn't well studied, although it seems that 10 to 20% of patients are affected. We've studied a cohort of 70 patients who undergone gastric bypass surgery at the CHUV. 18 (25.7%) patients have a positive anamnesis for early dumping and 10 (14.3%) for late dumping, being it superior as what is described in the literature.

  20. Dextrocardia with situs inversus totalis: coronary artery bypass grafting.

    Science.gov (United States)

    Hashmi, Salila; Anis, Mariam; Darr, Umer

    2012-01-01

    Dextrocardia with situs inversus is a rare congenital abnormality involving a left-handed mal rotation of the visceral organs. The incidence of coronary artery disease is the same as that in the general population. Performing coronary artery bypass surgery on patients with dextrocardia poses a more challenging task. It is recommended that the right internal mammary artery be the first choice of graft for the anterior descending artery for a "situs inversus" situation. We report 2 cases of patients with Dextrocardia who developed coronary artery disease and underwent coronary artery bypass grafting. Also mentioned is the slight difference in our technique.

  1. Fibrin Adhesive: Clinical Application in Coronary Artery Bypass Graft Surgery

    Science.gov (United States)

    Fundaró, Pino; Velardi, Antonio R.; Santoli, Carmine

    1985-01-01

    Fibrin adhesive was used 72 times in a group of 67 patients undergoing elective coronary artery bypass graft surgery. The indications were prophylactic sealing of potential sources of bleeding, topical hemostasis (control of bleeding sites dangerous or difficult to suture), and fixation of the graft in the optimal position. The method of glue application under varying circumstances is described and the results are reported. This experience suggests that in some cases the glue expedites the operation and makes it safer. We conclude that the fibrin sealing represents a valid aid in coronary artery bypass graft surgery. PMID:15227018

  2. Gene expression profile after cardiopulmonary bypass and cardioplegic arrest.

    Science.gov (United States)

    Ruel, Marc; Bianchi, Cesario; Khan, Tanveer A; Xu, Shu; Liddicoat, John R; Voisine, Pierre; Araujo, Eugenio; Lyon, Helen; Kohane, Isaac S; Libermann, Towia A; Sellke, Frank W

    2003-11-01

    This study examines the cardiac and peripheral gene expression responses to cardiopulmonary bypass and cardioplegic arrest. Atrial myocardium and skeletal muscle were harvested from 16 patients who underwent coronary artery bypass grafting before and after cardiopulmonary bypass and cardioplegic arrest. Ten sample pairs were selected for patient similarity, and oligonucleotide microarray analyses of 12,625 genes were performed using matched precardiopulmonary bypass tissues as controls. Array results were validated with Northern blotting, real-time polymerase chain reaction, in situ hybridization, and immunoblotting. Statistical analyses were nonparametric. Median durations of cardiopulmonary bypass and cardioplegic arrest were 74 and 60 minutes, respectively. Compared with precardiopulmonary bypass, postcardiopulmonary bypass myocardial tissues revealed 480 up-regulated and 626 down-regulated genes with a threshold P value of.025 or less (signal-to-noise ratio: 3.46); skeletal muscle tissues showed 560 and 348 such genes, respectively (signal-to-noise ratio: 3.04). Up-regulated genes in cardiac tissues included inflammatory and transcription activators FOS; jun B proto-oncogene; nuclear receptor subfamily 4, group A, member 3; MYC; transcription factor-8; endothelial leukocyte adhesion molecule-1; and cysteine-rich 61; apoptotic genes nuclear receptor subfamily 4, group A, member 1 and cyclin-dependent kinase inhibitor 1A; and stress genes dual-specificity phosphatase-1, dual-specificity phosphatase-5, and B-cell translocation gene 2. Up-regulated skeletal muscle genes included interleukin 6; interleukin 8; tumor necrosis factor receptor superfamily, member 11B; nuclear receptor subfamily 4, group A, member 3; transcription factor-8; interleukin 13; jun B proto-oncogene; interleukin 1B; glycoprotein Ib, platelet, alpha polypeptide; and Ras-associated protein RAB27A. Down-regulated genes included haptoglobin and numerous immunoglobulins in the heart, and factor H

  3. Broadband Fan Noise Prediction System for Turbofan Engines. Volume 2; BFaNS User's Manual and Developer's Guide

    Science.gov (United States)

    Morin, Bruce L.

    2010-01-01

    Pratt & Whitney has developed a Broadband Fan Noise Prediction System (BFaNS) for turbofan engines. This system computes the noise generated by turbulence impinging on the leading edges of the fan and fan exit guide vane, and noise generated by boundary-layer turbulence passing over the fan trailing edge. BFaNS has been validated on three fan rigs that were tested during the NASA Advanced Subsonic Technology Program (AST). The predicted noise spectra agreed well with measured data. The predicted effects of fan speed, vane count, and vane sweep also agreed well with measurements. The noise prediction system consists of two computer programs: Setup_BFaNS and BFaNS. Setup_BFaNS converts user-specified geometry and flow-field information into a BFaNS input file. From this input file, BFaNS computes the inlet and aft broadband sound power spectra generated by the fan and FEGV. The output file from BFaNS contains the inlet, aft and total sound power spectra from each noise source. This report is the second volume of a three-volume set documenting the Broadband Fan Noise Prediction System: Volume 1: Setup_BFaNS User s Manual and Developer s Guide; Volume 2: BFaNS User s Manual and Developer s Guide; and Volume 3: Validation and Test Cases. The present volume begins with an overview of the Broadband Fan Noise Prediction System, followed by step-by-step instructions for installing and running BFaNS. It concludes with technical documentation of the BFaNS computer program.

  4. Broadband Fan Noise Prediction System for Turbofan Engines. Volume 1; Setup_BFaNS User's Manual and Developer's Guide

    Science.gov (United States)

    Morin, Bruce L.

    2010-01-01

    Pratt & Whitney has developed a Broadband Fan Noise Prediction System (BFaNS) for turbofan engines. This system computes the noise generated by turbulence impinging on the leading edges of the fan and fan exit guide vane, and noise generated by boundary-layer turbulence passing over the fan trailing edge. BFaNS has been validated on three fan rigs that were tested during the NASA Advanced Subsonic Technology Program (AST). The predicted noise spectra agreed well with measured data. The predicted effects of fan speed, vane count, and vane sweep also agreed well with measurements. The noise prediction system consists of two computer programs: Setup_BFaNS and BFaNS. Setup_BFaNS converts user-specified geometry and flow-field information into a BFaNS input file. From this input file, BFaNS computes the inlet and aft broadband sound power spectra generated by the fan and FEGV. The output file from BFaNS contains the inlet, aft and total sound power spectra from each noise source. This report is the first volume of a three-volume set documenting the Broadband Fan Noise Prediction System: Volume 1: Setup_BFaNS User s Manual and Developer s Guide; Volume 2: BFaNS User's Manual and Developer s Guide; and Volume 3: Validation and Test Cases. The present volume begins with an overview of the Broadband Fan Noise Prediction System, followed by step-by-step instructions for installing and running Setup_BFaNS. It concludes with technical documentation of the Setup_BFaNS computer program.

  5. Hereditary spherocytosis in a patient undergoing coronary artery bypass grafting with cardiopulmonary bypass--a case report.

    Science.gov (United States)

    Spegar, J; Riha, H; Kotulak, T; Vanek, T

    2015-01-01

    Hereditary spherocytosis is a genetically determined abnormality of red blood cells. It is the most common cause of inherited haemolysis in Europe and North America within the Caucasian population. We document a patient who underwent an aortocoronary bypass procedure on cardiopulmonary bypass. In view of the uncertain tolerance of the abnormal red cells in hereditary spherocytosis to cardiopulmonary bypass, we reviewed the patient's chart and analyzed recorded values of these parameters: free plasma haemoglobin, renal parameters, cystatin C, bilirubin, liver tests, urine samples. From the results, we can see that slight haemolysis-elevated bilirubin in the blood sample and elevated bilirubin and urobilinogen in the urine sample occurred on the first postoperative day. The levels of these parameters slowly decreased during the next postoperative days. There was no real clinical effect of this haemolysis on renal functions.

  6. Paediatric CPB: bypass in a high risk group.

    Science.gov (United States)

    Jones, T J; Elliott, M J

    2006-07-01

    Children and particularly neonates present unique challenges during CPB. Patient age, size, underlying anatomy and surgical strategy influence the perfusion techniques and the construction of the CPB circuit. The normal changes in physiology in the first weeks of life impact upon surgical technique and outcome of repair. Limited surgical access necessitates alternative cannulation strategies. Deep hypothermia, low flow CPB and circulatory arrest are frequently used. An understanding of the related pathophysiology is therefore required to make the correct choices and to optimise patient outcome.

  7. 21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.

    Science.gov (United States)

    2010-04-01

    ... Devices § 870.4210 Cardiopulmonary bypass vascular catheter, cannula, or tubing. (a) Identification. A cardiopulmonary bypass vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery to... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass vascular catheter,...

  8. Natural headland sand bypassing; towards identifying and modelling the mechanisms and processes

    NARCIS (Netherlands)

    Bin Ab Razak, M.S.

    2015-01-01

    Natural headland sand bypassing: Towards identifying and modelling the mechanisms and processes contributes to the understanding of the mechanisms and processes of sand bypassing in artificial and non-artificial coastal environments through a numerical modelling study. Sand bypassing processes in ge

  9. 21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass cardiotomy suction line... Devices § 870.4270 Cardiopulmonary bypass cardiotomy suction line blood filter. (a) Identification. A cardiopulmonary bypass cardiotomy suction line blood filter is a device used as part of a gas exchange (oxygenator...

  10. On-Pump Versus Off-Pump Coronary Artery Bypass Surgery in Elderly Patients

    DEFF Research Database (Denmark)

    Holme, Susanne Juel; Houlind, Kim; Kjeldsen, Bo Juul;

    2012-01-01

    Conventional coronary artery bypass grafting performed with the use of cardiopulmonary bypass is a well-validated treatment for patients with ischemic heart disease. Off-pump coronary artery bypass grafting (OPCAB) has been suggested to reduce the number of perioperative complications, especially...... in elderly patients....

  11. Fabrication of nanofiber non-wovens on the melt blowing die with air by-passes

    OpenAIRE

    Chen Ting; Yang Kang; Wu Li-Li

    2016-01-01

    The air flow field of the melt blowing die with air by-passes is simulated. The results show that fibers fabricated on the die with air by-passes are much finer than those without air by-passes, which indicates an energy-saving approach to fabricating nanofibers on the melt blowing equipment.

  12. Fabrication of nanofiber non-wovens on the melt blowing die with air by-passes

    Directory of Open Access Journals (Sweden)

    Chen Ting

    2016-01-01

    Full Text Available The air flow field of the melt blowing die with air by-passes is simulated. The results show that fibers fabricated on the die with air by-passes are much finer than those without air by-passes, which indicates an energy-saving approach to fabricating nanofibers on the melt blowing equipment.

  13. On-pump versus off-pump coronary artery bypass surgery

    DEFF Research Database (Denmark)

    Houlind, Kim Christian

    2013-01-01

    Off pump coronary artery bypass surgery has been purported to be safer than conventional coronary artery bypass surgery performed using cardiopulmonary bypass. This theory was supported by a number of early series, but failed to be confirmed by a number of small, randomized controlled trials . Co...

  14. 21 CFR 870.4410 - Cardiopulmonary bypass in-line blood gas sensor.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass in-line blood gas sensor... Cardiopulmonary bypass in-line blood gas sensor. (a) Identification. A cardiopulmonary bypass in-line blood gas sensor is a transducer that measures the level of gases in the blood. (b) Classification. Class II...

  15. Patient Bypass Behavior and Critical Access Hospitals: Implications for Patient Retention

    Science.gov (United States)

    Liu, Jiexin (Jason); Bellamy, Gail R.; McCormick, Melissa

    2007-01-01

    Purpose: To assess the extent of bypass for inpatient care among patients living in Critical Access Hospital (CAH) service areas, and to determine factors associated with bypass, the reasons for bypass, and what CAHs can do to retain patients locally. Methods: Six hundred and forty-seven subjects, aged 18 years and older, who had been admitted to…

  16. The influence of biomaterials on inflammatory responses to cardiopulmonary bypass.

    Science.gov (United States)

    Courtney, J M; Matata, B M; Yin, H Q; Esposito, A; Mahiout, A; Taggart, D P; Lowe, G D

    1996-05-01

    The nature of cardiopulmonary bypass and the complexity of the inflammatory response make the detection and interpretation of a biomaterial influence difficult. However, if mediation of the inflammatory response is considered to be an appropriate clinical goal, alteration to the biomaterial influence merits further investigation.

  17. Gastrointestinal motility during cardiopulmonary bypass : A sonomicrometric study

    NARCIS (Netherlands)

    Gu, YJ; de Kroon, TL; Elstrodt, JM; Rakhorst, G

    2006-01-01

    Cardiopulmonary bypass (CPB) is known to impair the integrity of the gastrointestinal tract. However, little is known about the movement behavior of the gastrointestinal tract during CPB. This study was aimed to assess the gastrointestinal motility with sonomicrometry, a distance measurement using u

  18. Inpatient healthcare provider bypassing by women and their ...

    African Journals Online (AJOL)

    ... to a person's decision to seek care at a healthcare facility that is not the nearest one ... Methods: this study examined inpatient care facility bypassing in urban Bo, ... The locations of residential structures and hospitals were identified using a ...

  19. Blood concentrations of cefuroxime in cardiopulmonary bypass surgery

    NARCIS (Netherlands)

    Bertholee, Daphne; ter Horst, Peter G. J.; Hijmering, Michel L.; Spanjersberg, Alexander J.; Hospes, Wobbe; Wilffert, Bob

    2013-01-01

    Objectives Patients with coronary artery bypass graft (CABG) surgery are at risk for severe postoperative infections. Prophylactic cefuroxime may help to reduce this risk, however sufficient concentrations, i.e. above the breakpoint (32 mg/L), are mandatory. The aim of this study is to evaluate the

  20. Polarization for the by-pass SLAC/PEP collider

    Energy Technology Data Exchange (ETDEWEB)

    Chao, A.W.

    1980-06-01

    It was suggested that one can collide the store e/sup +/ beam in PEP with the e/sup /minus// beam from SLAC to reach a center-of-mass energy higher than that achieved by the PEP colliding beams. Although the future of this PEP/SLAC collider is not yet certain, it is useful to first explore its physics possibilities. One possible version of the SLAC/PEP collider utilizes a by-pass at the interaction point; the stored beam is displaced vertically by a set of vertical bending magnets every time the linac beam arrives. One feature of this by-pass scheme that makes it attractive is that the amount of the vertical displacement of the by-pass can be chosen so that the spin polarization of the stored beam is made longitudinal at the point of interaction. In this note, we have studied the various depolarization effects of the stored e/sup +/ beam due to the perturbation of the by-pass magnets. 1 fig.

  1. Emergency bypass post percutaneous atrial ablation: a case report.

    LENUS (Irish Health Repository)

    Hargrove, M

    2010-11-01

    A 34-year-old male undergoing percutaneous atrial ablation procedure for paroxysmal fibrillation required emergency sternotomy for cardiac tamponade. The patient had been anticoagulated and had received plavix and aspirin prior to and during the ablation procedure. Seven units of red cell concentrate had been transfused in the cardiac catherisation laboratory. On arrival in theatre, the patient was hypotensive, but was awake on induction of anaesthesia. No recordable blood pressure with non-invasive monitoring was observed. A sternotomy was immediately performed and, on evacuation of the pericardium, a bleeding site was not visible. The patient was commenced on cardiopulmonary bypass. Bleeding site was identified and the defect closed. The patient was weaned from cardiopulmonary bypass with minimal inotropic support and made an uneventful recovery. Bypass time was 38 minutes. A literature review showed a 1% incidence of post-ablation bleeding(1). The incidence of reverting to bypass for such an event has not been reported previously. During these procedures, it might be wise to have the cardiothoracic team notified while atrial ablation procedures are being performed in the cardiac catheterization laboratory.

  2. Pathophysiology and treatment of edema following femoropopliteal bypass surgery

    NARCIS (Netherlands)

    te Slaa, A.; Dolmans, D. E. J. G. J.; Ho, G. H.; Moll, F. L.; van der Laan, L.

    2012-01-01

    Substantial lower-limb edema affects the majority of patients who undergo peripheral bypass surgery. Edema has impairing effects on the microvascular and the macrovascular circulation, causes discomfort and might delay the rehabilitation process of the patient. However, the pathophysiology of this e

  3. Bypassing of a barrier by dissociated and superlattice dislocations

    DEFF Research Database (Denmark)

    Bhushan, Karihaloo

    1975-01-01

    Very simple procedures are used to calculate the upper and lower bounds for the applied stress required for the leading extended (superlattice) dislocation in a group of n coplanar screw dislocations of like sign with Burgers vector b to bypass a noncoplanar perfect screw dislocation with Burgers...... vector mb (m...

  4. 21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass oxygenator. 870.4350 Section 870.4350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... gases between blood and a gaseous environment to satisfy the gas exchange needs of a patient during...

  5. Emergency EC-IC bypass for symptomatic atherosclerotic ischemic stroke.

    Science.gov (United States)

    Horiuchi, Tetsuyoshi; Nitta, Junpei; Ishizaka, Shigetoshi; Kanaya, Kohei; Yanagawa, Takao; Hongo, Kazuhiro

    2013-10-01

    Previous studies have shown that extracranial-intracranial (EC-IC) bypass surgery has no preventive effect on subsequent ipsilateral ischemic stroke in patients with symptomatic atherosclerotic internal carotid occlusion and hemodynamic cerebral ischemia. A few studies have assessed whether an urgent EC-IC bypass surgery is an effective treatment for main trunk stenosis or occlusion in acute stage. The authors retrospectively reviewed 58 consecutive patients who underwent urgent EC-IC bypass for symptomatic internal carotid artery or the middle cerebral artery stenosis or occlusion between January 2003 and December 2011. Clinical characteristics and neuroimagings were evaluated and analyzed. Based on preoperative angiogram, responsible lesions were the internal carotid artery in 19 (32.8%) patients and the middle cerebral artery in 39 (67.2%). No hemorrhagic complication occurred. Sixty-nine percent of patients showed improvement of neurological function after surgery, and 74.1% of patients had favorable outcome. Unfavorable outcome was associated with insufficient collateral flow and new infarction after bypass surgery.

  6. Fabric heart retractor for coronary artery bypass operations.

    Science.gov (United States)

    Kazama, S; Ishihara, A

    1993-06-01

    A new device for heart retraction during coronary artery bypass operations has been developed. It provides safe and steady support and an unobstructed view of the lateral, posterior, and inferior surfaces of the heart; in addition, it is easy to handle.

  7. Pathophysiology and treatment of edema following femoropopliteal bypass surgery

    NARCIS (Netherlands)

    te Slaa, A.; Dolmans, D. E. J. G. J.; Ho, G. H.; Moll, F. L.; van der Laan, L.

    2012-01-01

    Substantial lower-limb edema affects the majority of patients who undergo peripheral bypass surgery. Edema has impairing effects on the microvascular and the macrovascular circulation, causes discomfort and might delay the rehabilitation process of the patient. However, the pathophysiology of this e

  8. Clinical benefit of steroid use in patients undergoing cardiopulmonary bypass

    DEFF Research Database (Denmark)

    Whitlock, Richard P; Chan, Simon; Devereaux, P J;

    2008-01-01

    We sought to establish the efficacy and safety of prophylactic steroids in adult patients undergoing cardiopulmonary bypass (CPB). We performed a meta-analysis of randomized trials reporting the effects of prophylactic steroids on clinical outcomes after CPB. Outcomes examined were mortality...

  9. Hyperhomocysteinemia and mortality after coronary artery bypass grafting.

    Directory of Open Access Journals (Sweden)

    Domenico Girelli

    Full Text Available BACKGROUND: The independent prognostic impact, as well as the possible causal role, of hyperhomocysteinemia (HHcy in coronary artery disease (CAD is controversial. No previous study specifically has addressed the relationship between HHcy and mortality after coronary artery bypass grafting (CABG surgery. The aim of this study is to evaluate the prognostic impact of HHcy after CABG surgery. METHODOLOGY AND PRINCIPAL FINDINGS: We prospectively followed 350 patients who underwent elective CABG between May 1996 and May 1999. At baseline, fasting total homocysteine (tHcy levels were measured in all participants, and a post-methionine loading (PML test was performed in 77.7% of them (n = 272. After a median follow-up of 58 months, 33 patients (9.4% had died, 25 because of cardiovascular events. HHcy, defined by levels higher than the 90th percentile (25.2 micromol/L of the population's distribution, was significantly associated to total and cardiovascular mortality (P = 0.018 [log-rank test 5.57]; P = 0.002 [log-rank test 9.76], respectively. The PML test had no prognostic value. After multiple adjustment for other univariate predictors by Cox regression, including statin therapy (the most powerful predictor in uni-/multivariate analyses, high-sensitivity C Reactive Protein (hs-CRP levels, and all known major genetic (MTHFR 677C-->T polymorphism and non-genetic (B-group vitamin status and renal function tHcy determinants, HHcy remained an independent prognostic factor for mortality (HRs: 5.02, 95% CIs 1.88 to 13.42, P = 0.001. CONCLUSIONS: HHcy is an important prognostic marker after CABG, independent of modern drug therapy and biomarkers.

  10. The Rationale and Results of Gastroplasty/Distal Gastric Bypass.

    Science.gov (United States)

    Salmon; McArdle

    1992-02-01

    A recent review of the results of gastroplasties done at the University of Alberta Hospital showed that there was a high incidence of late weight loss failure. Therefore a new operation, gastroplasty/distal gastric bypass, has been performed on 263 patients. This operation results In a profound (mean greatest percentage excess weight loss of 87% at approximately 2 years) and lasting weight loss (mean final percentage excess weight loss of 78%) at 4 years, range 2-7.5 years post-operatively. Only 0.9 % of patients failed to maintain at least a 40% excess weight loss. The operation achieves its effect through a moderate restriction that permits patients to eat normal table food from the time of discharge and with a mild metabsorption that is not ordinarily associated with diarrhea or notable deficiencies. Certain patients required debanding of the stoma and others developed staple-line eventration. Neither of these events after long-term follow-up resulted in weight loss failure nor in other serious side-effects. It Is concluded that moderate failure of the gastroplasty stoma and staple line does not necessarily result in weight loss failure, because the malabsorptive portion of the operation remains intact. Low hemoglobin occurred in 16% of cases and deficiency of serum iron In 34%; a much smaller number of patients had chronic or Intermittent deficiencies of these entities. Correction was easily achieved with oral replacement. Deficiencies in albumin, calcium, phosphorus and folate were rarely seen and minimal elevation of serum AST values occurred In just over 1% of patients. Chronic deficiencies or elevations were not seen in these patients. Stomal ulcer occurred in 6% of patients and bleeding associated with stomal ulcer in 1%. Half the patients with ulcer were managed with H&inf2; blockers, the other half with vagotomy. Both forms of treatment when individualized effectively prevent re-ulceration.

  11. Neurodevelopmental outcome after cardiac surgery utilizing cardiopulmonary bypass in children

    Directory of Open Access Journals (Sweden)

    Aymen N Naguib

    2015-01-01

    Full Text Available Introduction: Modulating the stress response and perioperative factors can have a paramount impact on the neurodevelopmental outcome of infants who undergo cardiac surgery utilizing cardiopulmonary bypass. Materials and Methods: In this single center prospective follow-up study, we evaluated the impact of three different anesthetic techniques on the neurodevelopmental outcomes of 19 children who previously underwent congenital cardiac surgery within their 1 st year of life. Cases were done from May 2011 to December 2013. Children were assessed using the Stanford-Binet Intelligence Scales (5 th edition. Multiple regression analysis was used to test different parental and perioperative factors that could significantly predict the different neurodevelopmental outcomes in the entire cohort of patients. Results: When comparing the three groups regarding the major cognitive scores, a high-dose fentanyl (HDF patients scored significantly higher than the low-dose fentanyl (LDF + dexmedetomidine (DEX (LDF + DEX group in the quantitative reasoning scores (106 ± 22 vs. 82 ± 15 P = 0.046. The bispectral index (BIS value at the end of surgery for the -LDF group was significantly higher than that in LDF + DEX group (P = 0.011. For the entire cohort, a strong correlation was seen between the standard verbal intelligence quotient (IQ score and the baseline adrenocorticotropic hormone level, the interleukin-6 level at the end of surgery and the BIS value at the end of the procedure with an R 2 value of 0.67 and P < 0.04. There was an inverse correlation between the cardiac Intensive Care Unit length of stay and the full-scale IQ score (R = 0.4675 and P 0.027. Conclusions: Patients in the HDF group demonstrated overall higher neurodevelopmental scores, although it did not reach statistical significance except in fluid reasoning scores. Our results may point to a possible correlation between blunting the stress response and improvement of the neurodevelopmental

  12. Emergency Coronary Artery Bypass Grafting: Indications and Outcomes from 2003 through 2013.

    Science.gov (United States)

    Schumer, Erin M; Chaney, John H; Trivedi, Jaimin R; Linsky, Paul L; Williams, Matthew L; Slaughter, Mark S

    2016-06-01

    Emergency coronary artery bypass grafting (CABG) is associated with increased in-hospital mortality rates and adverse events. This study retrospectively evaluated indications and outcomes in patients who underwent emergency CABG. The Society of Thoracic Surgeons database for a single center (Jewish Hospital) was queried to identify patients undergoing isolated CABG. Univariate analysis was performed. From January 2003 through December 2013, 5,940 patients underwent CABG; 212 presented with emergency status. A high proportion of female patients (28.2%) underwent emergency surgery. Emergency CABG patients experienced high rates of intra-aortic balloon pump support, bleeding, dialysis, in-hospital death, and prolonged length of stay. The proportion of emergency coronary artery bypass grafting declined during years 2008-2013 compared with 2003-2007 (2.2% vs. 4.5%, P emergency CABG, yet the incidence of angiographic accident has greatly increased. In-hospital mortality rates and adverse events remain high. If we look specifically at emergency CABG cases arising from angiographic accident, we find that 14 (15%) of all 93 emergency CABG deaths occurred in that subset of patients. Efforts to improve outcomes should therefore be focused on this high-risk group.

  13. Reoperations for occluded arterial bypasses in the lower limbs

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background We reviewed the outcomes of reoperations for 29 patients (30 limbs) who had undergone occluded arterial bypass in the lower limbs from May 1996 to September 2005. Methods The 30 lower limbs of the 29 patients with arteriosclerotic obstruction received 44 reoperations, including thrombectomy alone (group T, 27) and inflow or outflow reconstruction plus thrombectomy (group C, 17). Among the 17 operations in group C, 17.6% (3/17) were inflow reconstructions involving the axillary-femoral (1), aorta-iliac (1) and aorta-femoral (1) arteries, and 76.4% (13/17) outflow reconstructions involving the femoral-popliteal bypass-tibial (8), femoral-tibial (1), femoral-popliteal bypass-popliteal arteries below the knee (2), and the femoral-popliteal bypass-tibial-peroneal trunk (2). One patient (1 limb) underwent both inflow and outflow reconstructions with an iliac arterial stent and a graft-popliteal anastomosis patch. Polytetrafluoroethylene (PTFE) grafts were used in the inflow or outflow reconstructions abve the knee. Autovenous grafts or autovenously combined PTFE grafts were used in the outflow reconstructions below the knee. Results The percentages of Fontaine stage III and IV before primary operation and reoperation were 60% (18/30) and 86.7% (26/30), respectively (P0.05). Among 42 reoperations, 19 failed within 1 month in groups T (16) and C (3) (P0.05). The rate of limb salvage was 64.29% (18/28). Conclusions The percentages of Fontaine stage III and IV before reoperation may be much higher than those before primary operation. Thrombectomy plus inflow/outflow reconstruction creates patency better than thrombectomy alone for re-occluded bypass.

  14. Sequestration of fentanyl by the cardiopulmonary bypass (CPBP).

    Science.gov (United States)

    Koren, G; Crean, P; Klein, J; Goresky, G; Villamater, J; MacLeod, S M

    1984-01-01

    Immediately following the connection of pediatric patients to cardiopulmonary bypass we have consistently observed a steep decrease in fentanyl plasma concentration (74 +/- 8.7%) (mean +/- SD), much greater than would have been expected from hemodilution alone (50.6% +/- 12.0%) (p less than 0.0001). Priming of the pump with 20 ng/ml of fentanyl before connection to the patients did not prevent this phenomenon. In order to study the possibility that fentanyl is sequestered by the bypass, levels of the primed drug in the bypass were assessed before connecting the pump to the children and a steep fall from 20 ng/ml to zero was shown before initiation of bypass. Pharmacokinetic assessment of fentanyl in a closed pump circuit showed that levels of 120 ng/ml fall to 2 ng/ml within 3 min and remain stable at the lower concentration for at least 30 min. Further studies have identified the membrane oxygenator as the major site of fentanyl sequestration. Concentrations across the membrane fall from 120 ng/ml to 10 ng/ml. The attached siliconized tubing is associated with a minor binding effect sufficient to reduce concentrations from 110 to 84 ng/ml. The pvc tubing, aluminium heat exchanger and plastic reservoir had no binding effect on fentanyl. The possibility that a decrease in fentanyl protein binding caused the fall in serum concentration was checked in 5 patients undergoing open heart surgery. After initiation of the cardiopulmonary bypass, there was a significant decrease in albumin serum concentrations from 32.0 +/- 2.3 mM to 15.0 +/- 1.6 mM (p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Computer-assisted LAD bypass grafting at the open heart

    Science.gov (United States)

    Hartung, Christine; Gnahm, Claudia; Friedl, Reinhard; Hoffmann, Martin; Dietmayer, Klaus

    2009-02-01

    Open heart bypass surgery is the standard treatment in advanced coronary heart diseases. For an effective revascularization procedure, optimal placement of the bypass is very important. To accelerate the intraoperative localization of the anastomosis site and to increase the precision of the procedure, a concept for computer assistance in open heart bypass surgery has been developed comprising the following steps: 1. Preprocedural planning: A patient-specific coronary map with information on vessel paths and wall plaque formations is extracted from a multi-slice computed tomography (MSCT). On this basis, the heart surgeon and the cardiac radiologist define the optimal anastomosis site prior to surgery. 2. Intraoperative navigation: During surgery, data are recorded at the beating heart using a stereo camera system. After registering the pre- and intraoperative data sets, preprocedural information can be transferred to the surgical site by overlaying the coronary map and the planned anastomosis site on the live video stream. With this visual guidance system, the surgeon can navigate to the planned anastomosis site. In this work, the proposed surgical assistance system has been validated for the left anterior descending coronary artery (LAD). The accuracy of the registration mechanism has been evaluated in retrospective on patient data sets and the effects of breathing motion were quantified. The promising results of the retrospective evaluation led to the in-vivo application of the computer assistance system during several bypass grafting procedures. Intraoperative navigation has been performed successfully and postoperative evaluation confirms that the bypass grafts were accurately positioned to the preoperatively planned anastomosis sites.

  16. Long-term patency of superficial temporal artery to middle cerebral artery bypass for cerebral atherosclerotic disease: factors determining the bypass patent.

    Science.gov (United States)

    Matano, Fumihiro; Murai, Yasuo; Tateyama, Kojiro; Tamaki, Tomonori; Mizunari, Takayuki; Matsukawa, Hideoshi; Teramoto, Akira; Morita, Akio

    2016-10-01

    Long-term patency of superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery for atherosclerotic disease and associated risk factors for loss of patency have rarely been discussed. We retrospectively analyzed long-term patency following STA-MCA bypass and evaluated various demographic and clinical factors to identify the ones predictive of postsurgical loss of patency using records of 84 revascularization procedures (58 patients, 45 males; mean age at surgery 63.6 years, range 31-78 years). Bypass patency was diagnosed based on magnetic resonance angiography or three-dimensional computed tomography. The mean follow-up period was 24.7 months (range 6-63 months). Decreased bypass patency was observed in 4 of 58 patients (6.9 %) who collectively underwent 6 bypasses (7.1 %) of 84. All cases of decreased bypass patency were first detected within 6 months of surgery. Bypass patency was not correlated with age, sex, number of anastomoses, postoperative cerebral infarction, or control of postoperative diabetes mellitus. We found a significant association of bypass patency with hyperperfusion (p = 0.01) and postoperative smoking (p = 0.0036). Furthermore, we found a significant association of hyperperfusion with STA diameter (p bypass patency in cerebral atherosclerotic disease patients. Careful monitoring of patency to prevent hyperperfusion and cessation of smoking are recommended, particularly within 6 months of the surgery.

  17. Three Dimensional FEM Simulation of Titanium Hollow Blade Forming Process

    NARCIS (Netherlands)

    Zhao Bing, [No Value; Li Zhiqiang, [No Value; Hou Hongliang, [No Value; Liao Jinhua, [No Value; Bai Bingzhe, [No Value

    2010-01-01

    With the introduction of high by-pass turbofan engines into both commercial and military aircraft industries, the fabrication of large size fan blade through superplastic forming/diffusion bonding (SPF/DB) has become a pivotal technique of turbine fan engine. There are three key steps to form a holl

  18. RF Stealth (Or Low Observable) and Counter- RF Stealth Technologies: Implications of Counter- RF Stealth Solutions for Turkish Air Force

    Science.gov (United States)

    2009-03-01

    Aircraft engines which inhale a large volume of air but push a small amount, such as high-bypass-ratio turbofans, are quieter than those that inhale a...small volume of air but 65 push a large amount, such as low-bypass-ratio engines. Despite this efficiency and acoustic signal reduction advantages...of Defense, Office of the Executive Secretary, “Science and Tecnology Chapter 16,” http://www.dod.mil/execsec/adr97/chap16.html, (Accessed March

  19. Thyromental Height Test for Prediction of Difficult Laryngoscopy in Patients Undergoing Coronary Artery Bypass Graft Surgical Procedure

    OpenAIRE

    Nilesh Jain; Sucharita Das; Muralidhar Kanchi

    2017-01-01

    Background: Patients undergoing coronary artery bypass graft (CABG) procedures have higher incidence of difficult laryngoscopy and intubation than general surgery population. Accurate prediction of difficult laryngoscopy in CABG patients is desirable to reduce the hemodynamic response and myocardial oxygen requirements. Recently, thyromental height test (TMHT) has been proposed as one of the highly sensitive and specific bedside tests to predict difficult airway. We, in our prospective observ...

  20. GLP1 and glucagon co-secreting pancreatic neuroendocrine tumor presenting as hypoglycemia after gastric bypass

    Science.gov (United States)

    Guimarães, Marta; Rodrigues, Pedro; Pereira, Sofia S; Nora, Mário; Gonçalves, Gil; Albrechtsen, Nicolai Wewer; Hartmann, Bolette; Holst, Jens Juul

    2015-01-01

    Summary Post-prandial hypoglycemia is frequently found after bariatric surgery. Although rare, pancreatic neuroendocrine tumors (pNET), which occasionally are mixed hormone secreting, can lead to atypical clinical manifestations, including reactive hypoglycemia. Two years after gastric bypass surgery for the treatment of severe obesity, a 54-year-old female with previous type 2 diabetes, developed post-prandial sweating, fainting and hypoglycemic episodes, which eventually led to the finding by ultrasound of a 1.8-cm solid mass in the pancreatic head. The 72-h fast test and the plasma chromogranin A levels were normal but octreotide scintigraphy showed a single focus of abnormal radiotracer uptake at the site of the nodule. There were no other clinical signs of hormone secreting pNET and gastrointestinal hormone measurements were not performed. The patient underwent surgical enucleation with complete remission of the hypoglycemic episodes. Histopathology revealed a well-differentiated neuroendocrine carcinoma with low-grade malignancy with positive chromogranin A and glucagon immunostaining. An extract of the resected tumor contained a high concentration of glucagon (26.707 pmol/g tissue), in addition to traces of GLP1 (471 pmol/g), insulin (139 pmol/g) and somatostatin (23 pmol/g). This is the first report of a GLP1 and glucagon co-secreting pNET presenting as hypoglycemia after gastric bypass surgery. Although pNET are rare, they should be considered in the differential diagnosis of the clinical approach to the post-bariatric surgery hypoglycemia patient. Learning points pNETs can be multihormonal-secreting, leading to atypical clinical manifestations.Reactive hypoglycemic episodes are frequent after gastric bypass.pNETs should be considered in the differential diagnosis of hypoglycemia after bariatric surgery. PMID:26266036

  1. Enterobacter cloacae infection of an expanded polytetrafluoroethylene femoral-popliteal bypass graft: a case report

    Directory of Open Access Journals (Sweden)

    Schilling Jolyon

    2010-05-01

    Full Text Available Abstract Introduction Enterobacter cloacae infections are common among burn victims, immunocompromised patients, and patients with malignancy. Most commonly these infections are manifested as nosocomial urinary tract or pulmonary infections. Nosocomial outbreaks have also been associated with colonization of certain surgical equipment and operative cleaning solutions. Infections of an aortobifemoral prosthesis, an aortic graft, and arteriovenous fistulae are noted in the literature. To our knowledge, this is the first isolated account of an E. cloacae infection of a femoral-popliteal expanded polytetrafluoroethylene bypass graft. Case presentation A 68-year-old Caucasian man presented with fever and rest pain in the right lower extremity five months after the placement of a vascular expanded polytetrafluoroethylene graft for femoral-popliteal bypass. Computed tomography angiography demonstrated peri-graft fluid that was aspirated percutaneously with image guidance and cultured to reveal E. cloacae. The graft was revised and then removed. The patient completed a six-week course of ceftazidime and is currently without signs of infection. There were no other reports of E. cloacae graft infections in any patients receiving treatment in the same surgical suite within a month of this report. Conclusion Isolated cases of E. cloacae infection of surgical bypass grafts are rare (unique in this setting. Clinicians should have a high index of suspicion for device contamination in such cases and should consider testing for possible microbial reservoirs. Graft removal is required due to the formation of biofilm and the recent emergence of Enterobacteriaceae producing extended-spectrum beta-lactamase in community acquired infections.

  2. Physical function improvements after laparoscopic Roux-en-Y gastric bypass surgery.

    Science.gov (United States)

    Miller, Gary D; Nicklas, Barbara J; You, Tongjian; Fernandez, Adolfo

    2009-01-01

    Obesity is a risk factor for impaired physical function and disability, with the degree of impairment most compromised in extreme obesity. Mild-to-moderate weight loss has been shown to improve function in older adults. The impact of laparoscopic Roux-en-Y gastric bypass surgery on weight loss and physical function in morbidly obese individuals was assessed. This longitudinal, observational study followed up 28 morbidly obese men and women (body mass index > or = 40.0 kg/m(2)) for 12 months after laparoscopic Roux-en-Y gastric bypass. Physical function (self-report using the Fitness Arthritis and Seniors Trial disability questionnaire; performance tasks using the Short Physical Performance Battery and a lateral mobility task); strength (maximal isometric knee torque); and body composition measured using bioelectrical impedance were determined before surgery (baseline) and at 3 weeks, 3 months, 6 months, and 12 months after surgery. The 12-month weight loss was 34.2% (excess weight loss 59.8%), with a mean fat mass loss of 46 kg and a loss of fat free mass of 6.6 kg. The performance tasks and self-reported questionnaire scores had improved by 3 months after surgery compared with baseline, with selected measures showing less impairment and disability in as few as 3 weeks after surgery. Muscle quality, as measured using the maximal torque per kilogram body weight, was greater at 6 months than at baseline. The results of our study have shown that in morbidly obese individuals with a high risk of mobility impairments, surgical procedures to reduce body weight increase mobility and improve performance of daily activities in as few as 3 weeks after gastric bypass surgery.

  3. Analytical and computational investigations of a magnetohydrodynamics (MHD) energy-bypass system for supersonic gas turbine engines to enable hypersonic flight

    Science.gov (United States)

    Benyo, Theresa Louise

    Historically, the National Aeronautics and Space Administration (NASA) has used rocket-powered vehicles as launch vehicles for access to space. A familiar example is the Space Shuttle launch system. These vehicles carry both fuel and oxidizer onboard. If an external oxidizer (such as the Earth's atmosphere) is utilized, the need to carry an onboard oxidizer is eliminated, and future launch vehicles could carry a larger payload into orbit at a fraction of the total fuel expenditure. For this reason, NASA is currently researching the use of air-breathing engines to power the first stage of two-stage-to-orbit hypersonic launch systems. Removing the need to carry an onboard oxidizer leads also to reductions in total vehicle weight at liftoff. This in turn reduces the total mass of propellant required, and thus decreases the cost of carrying a specific payload into orbit or beyond. However, achieving hypersonic flight with air-breathing jet engines has several technical challenges. These challenges, such as the mode transition from supersonic to hypersonic engine operation, are under study in NASA's Fundamental Aeronautics Program. One propulsion concept that is being explored is a magnetohydrodynamic (MHD) energy- bypass generator coupled with an off-the-shelf turbojet/turbofan. It is anticipated that this engine will be capable of operation from takeoff to Mach 7 in a single flowpath without mode transition. The MHD energy bypass consists of an MHD generator placed directly upstream of the engine, and converts a portion of the enthalpy of the inlet flow through the engine into electrical current. This reduction in flow enthalpy corresponds to a reduced Mach number at the turbojet inlet so that the engine stays within its design constraints. Furthermore, the generated electrical current may then be used to power aircraft systems or an MHD accelerator positioned downstream of the turbojet. The MHD accelerator operates in reverse of the MHD generator, re-accelerating the

  4. Fever of unknown origin: Importance of 18F-FDG PET/CT in the diagnosis of a late infectious complication after aneurysm bypass.

    Science.gov (United States)

    Goudard, Y; Pierret, C; Dusaud, M; Falzone, E; Tourtier, J P; de Kerangal, X

    2011-09-01

    Persistent blood flow in aneurysmal sac after bypass-exclusion is well documented in the literature. Aneurysm enlargement, local compressive symptoms and even sac rupture are commonly described complications. Late secondary infection of popliteal artery aneurysm (PAA) following ligation and venous bypass is exceptional. We report the case of late PAA infection six years after bypass-exclusion in a 75 year-old man which was diagnosed by 18F-FDG PET/CT. The patient was successfully treated by aneurysm resection and antibiotics. The diagnosis of popliteal aneurysm infection is often clinical, echographic and sonographic, but computed tomography scan can be false negative in chronic low-grade infection. 18F-FDG PET/CT is able to accurately diagnose and localize infection with high sensibility and specificity.

  5. Totally laparoscopic bypass surgery for aortoiliac occlusive disease in China

    Institute of Scientific and Technical Information of China (English)

    GUO Lian-rui; GU Yong-quan; QI Li-xing; TONG Zhu; WU Xin; GUO Jian-ming; ZHANG Jian

    2013-01-01

    Background Totally laparoscopic aortic surgery is still in its infancy in China.One of the factors preventing adoption of this technique is its steep learning curve.The objective of this study was to evaluate the feasibility and safety of laparoscopic surgery for aortoiliac occlusive disease (AIOD).Methods From November 2008 to November 2012,12 patients were treated for severe AIOD with a totally laparoscopic bypass surgery at our university hospital.The demographic data,operative data,postoperative recovery data,morbidity and mortality were analyzed and compared with those of conventional open approach.Results Twelve totally laparoscopic aortic surgery procedures,including two iliofemoral bypasses (IFB),three unilateral aortofemoral bypasses (UAFB),and seven aortobifemoral bypasses (ABFB),were performed.Conversion to open procedures was required in three patients.The mean operation time was 518 (range,325-840) minutes,mean blood loss was 962 (range,400-2500) ml,and mean aortic anastomosis time was 75 (range,40-150) minutes.Compared with conventional open approach for aortofemoral bypasses performed concomitantly during this period,laparoscopic patients required fewer narcotics and a shorter in-hospital stay and earlier recovery.Postoperative complications developed in four patients,including a single patient with transient left hydronephrosis,ischemic colonic fistula and pneumonia,residual aortic stenosis proximal to the anastomotic site,and asymptomatic partial left renal infarction.All patients recovered and were discharged on postoperative Days 7-14 except one patient that died of respiratory failure on Day 46.All grafts were patent with follow-up imaging performed by Duplex examination,with a mean follow-up time of 10.7 (range,2-61) months.Conclusion Totally laparoscopic bypass surgery is a feasible and safe procedure forAIOD,but attention needs to be paid to improve laparoscopic skills of vascular surgery in order to minimize morbidity during the learning

  6. A simulation study of turbofan engine deterioration estimation using Kalman filtering techniques

    Science.gov (United States)

    Lambert, Heather H.

    1991-01-01

    Deterioration of engine components may cause off-normal engine operation. The result is an unecessary loss of performance, because the fixed schedules are designed to accommodate a wide range of engine health. These fixed control schedules may not be optimal for a deteriorated engine. This problem may be solved by including a measure of deterioration in determining the control variables. These engine deterioration parameters usually cannot be measured directly but can be estimated. A Kalman filter design is presented for estimating two performance parameters that account for engine deterioration: high and low pressure turbine delta efficiencies. The delta efficiency parameters model variations of the high and low pressure turbine efficiencies from nominal values. The filter has a design condition of Mach 0.90, 30,000 ft altitude, and 47 deg power level angle (PLA). It was evaluated using a nonlinear simulation of the F100 engine model derivative (EMD) engine, at the design Mach number and altitude over a PLA range of 43 to 55 deg. It was found that known high pressure turbine delta efficiencies of -2.5 percent and low pressure turbine delta efficiencies of -1.0 percent can be estimated with an accuracy of + or - 0.25 percent efficiency with a Kalman filter. If both the high and low pressure turbine are deteriorated, the delta efficiencies of -2.5 percent to both turbines can be estimated with the same accuracy.

  7. 75 FR 31330 - Airworthiness Directives; Pratt & Whitney PW4000 Series Turbofan Engines

    Science.gov (United States)

    2010-06-03

    ... during flight. Investigation revealed that the engine had an internal oil fire caused by a cracked No. 3... bearing oil pressure tubes which could result in internal oil fire, failure of the high- pressure turbine.... SUPPLEMENTARY INFORMATION: Comments Invited We invite you to send us any written relevant data, views,...

  8. Clinical outcome of patients with familial hypercholesterolemia and coronary artery disease undergoing partial ileal bypass surgery

    Directory of Open Access Journals (Sweden)

    Jaqueline Scholz Issa

    2000-07-01

    Full Text Available Familial hypercholesterolemia is characterized by high serum levels of total cholesterol and LDL-cholesterol. It may be homozygous or heterozygous. In homozygous patients, LDL-cholesterol levels range from 500 to 1000mg/dL and coronary artery disease is precocious, usually manifesting itself between the 2nd and 3rd decades of life. The diagnosis is often made by the presence of xanthoma tuberosum and tendinous xanthomas that appear between the 1st and 2nd decades of life. The use of high doses of statins or even unusual procedures (apheresis, partial ileal bypass surgery, liver transplantation, gene therapy, or both, is necessary for increasing survival and improving quality of life, because a reduction in cholesterol levels is essential for stabilizing the coronary artery disease and reducing xanthomas. We report our experience with 3 patients with xanthomatous familial hypercholesterolemia and coronary artery disease, who underwent partial ileal bypass surgery. Their follow-up over the years (approximately 8 years showed a mean 30% reduction in total cholesterol, with a significant reduction in the xanthomas and stabilization of the coronary artery disease.

  9. Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial Protection

    Directory of Open Access Journals (Sweden)

    Kambiz Alizadeh

    2014-02-01

    Full Text Available Cold agglutinins are of unique relevance in cardiac surgerybecause of the use of hypothermic cardiopulmonary bypass (CPB. Cold autoimmune diseases are defined by the presence of abnormal circulating proteins (usually IgM or IgA antibodies that agglutinate in response to a decrease in body temperature. These disorders include cryoglobulinemia and cold hemagglutinin disease.Immunoglobulin M autoantibodies to red blood cells, which activateat varying levels of hypothermia, can cause catastrophic hemagglutination,microvascular thrombosis, or hemolysis. Management of anesthesia in these patients includes strict maintenance of normothermia. Patients scheduled for the surgery requiring cardiopulmonary bypass present significant challenges. Use of systemic hypothermia may be contraindicated, and cold cardioplegia solutions may precipitate intracoronary hemagglutination with consequent thrombosis, ischemia, or infarction. Management of CPB andmyocardial protection requires individualized planning. We describea case of MV repair and CABG in a patient with high titercold agglutinins and high thermal amplitude for antibody activation.Normothermic CPB and continuous warm blood cardioplegia weresuccessfully used.

  10. Acoustic evaluation of a novel swept-rotor fan. [noise reduction in turbofan engines

    Science.gov (United States)

    Lucas, J. G.; Woodward, R. P.; Mackinnon, M. J.

    1978-01-01

    Inlet noise and aerodynamic performance are presented for a high tip speed fan designed with rotor blade leading edge sweep that gives a subsonic component of inlet Mach number normal to the edge at all radii. The intent of the design was to minimize the generation of rotor leading edge shock waves thereby minimizing multiple pure tone noise. Sound power level and spectral comparisons are made with several high-speed fans of conventional design. Results show multiple pure tone noise at levels below those of some of the other fans and this noise was initiated at a higher tip speed. Aerodynamic performance of the fan did not meet design goals for this first build which applied conventional design procedures to the swept fan geometry.

  11. Differential pre-mRNA splicing regulates Nnat isoforms in the hypothalamus after gastric bypass surgery in mice.

    Directory of Open Access Journals (Sweden)

    William R Scott

    Full Text Available BACKGROUND: Neuronatin (NNAT is an endoplasmic reticulum proteolipid implicated in intracellular signalling. Nnat is highly-expressed in the hypothalamus, where it is acutely regulated by nutrients and leptin. Nnat pre-mRNA is differentially spliced to create Nnat-α and -β isoforms. Genetic variation of NNAT is associated with severe obesity. Currently, little is known about the long-term regulation of Nnat. METHODS: Expression of Nnat isoforms were examined in the hypothalamus of mice in response to acute fast/feed, chronic caloric restriction, diet-induced obesity and modified gastric bypass surgery. Nnat expression was assessed in the central nervous system and gastrointestinal tissues. RTqPCR was used to determine isoform-specific expression of Nnat mRNA. RESULTS: Hypothalamic expression of both Nnat isoforms was comparably decreased by overnight and 24-h fasting. Nnat expression was unaltered in diet-induced obesity, or subsequent switch to a calorie restricted diet. Nnat isoforms showed differential expression in the hypothalamus but not brainstem after bypass surgery. Hypothalamic Nnat-β expression was significantly reduced after bypass compared with sham surgery (P = 0.003, and was positively correlated with post-operative weight-loss (R(2 = 0.38, P = 0.01. In contrast, Nnat-α expression was not suppressed after bypass surgery (P = 0.19, and expression did not correlate with reduction in weight after surgery (R(2 = 0.06, P = 0.34. Hypothalamic expression of Nnat-β correlated weakly with circulating leptin, but neither isoform correlated with fasting gut hormone levels post- surgery. Nnat expression was detected in brainstem, brown-adipose tissue, stomach and small intestine. CONCLUSIONS: Nnat expression in hypothalamus is regulated by short-term nutrient availability, but unaltered by diet-induced obesity or calorie restriction. While Nnat isoforms in the hypothalamus are co-ordinately regulated by acute

  12. Axillobifemoral bypass: a brief surgical and historical review

    Science.gov (United States)

    Mishall, Priti L.; Matakas, Jason D.; English, Keara; Allyn, Katherine; Algava, Diane; Howe, Ruth A.; Downie, Sherry A.

    2017-01-01

    Peripheral artery disease (PAD) occurs when plaque accumulates in the arterial system and obstructs blood flow. Narrowing of the abdominal aorta and the common iliac arteries due to atherosclerotic plaques restricts blood supply to the lower limbs. Clinically, the lower limb symptoms of PAD are intermittent claudication, discoloration of the toes, and skin ulcers, all due to arterial insufficiency. Surgical revascularization is the primary mode of treatment for patients with severe limb ischemia. The objective of the surgical procedure is to bypass a blockage in an occluded major vessel by constructing an alternate route for blood flow using an artificial graft. This article presents information on aortoiliac reconstruction, with an emphasis on axillobifemoral bypass grafting.

  13. Dobutamine for inotropic support during emergence from cardiopulmonary bypass.

    Science.gov (United States)

    Tinker, J H; Tarhan, S; White, R D; Pluth, J R; Barnhorst, D A

    1976-04-01

    Dobutamine, a recently introduced derivative of dopamine, is reported to retain inotropic properties with less pronounced chronotropic and arrhythmogenic effects than isoproterenol. The drug was evaluated in two doses, 5 mug/kg/min and 10 mug/kg/min, in two groups of ten patients each, during emergence from cardiopulmonary bypass. A third group of five patients was studied similarly with isoproterenol, 0.02 mug/kg/min. Cardiac index increased 16 and 28 per cent eith the two doses of dobutamine, respectively, and 9 per cent with isoproterenol. Heart rate, in contrast, increased 6 and 15 per cent with dobutamine (not significant) and 44 per cent with isoproterenol (significant). Dobutamine seemed to associated with fewer arrhythmias than isoproterenol. It is concluded that dobutamine, 5-10 mug/kg/min, is suitable for use during emergence from cardiopulmonary bypass and may possess advantages over isoproterenol.

  14. Dacron or PTFE for above-knee femoropopliteal bypass

    DEFF Research Database (Denmark)

    Jensen, Leif P.; Lepäntalo, M.; Fossdal, J.E.

    2007-01-01

    OBJECTIVES: To compare polytetrafluorethylene (PTFE) and polyester grafts (Dacron) for above knee femoropopliteal bypass. DESIGN: Multicenter randomised clinical trial. MATERIAL AND METHODS: 427 patients were randomised between 6mm Dacron (Uni-Graft, B. Braun Melsungen AG, 34212 Melsungen, Germany......) and PTFE (Goretex, W. L. Gore & Ass. Inc., Newark DE 19711, USA) above-knee femoropopliteal bypass grafts within 13 centres in Denmark (n=261), Norway (n=113) & Finland (n=53) between 1993 and 1998. Fourteen (3%) patients were excluded, leaving 413 patients with 208 Dacron and 205 PTFE grafts for analysis......-brachial pressures or imaging in case of doubt. RESULTS: The two-year primary patency rates for Dacron and PTFE were 70% and 57% (p=0.02), whereas the secondary patency rates were 76% and 65% (p=0.04), respectively. Primary patency at two years was significantly influenced by the number of patent crural vessels (two...

  15. Jugular-axillary vein bypass for salvage of arteriovenous access.

    Science.gov (United States)

    Fulks, K D; Hyde, G L

    1989-01-01

    Stenosis or occlusion of the subclavian vein can cause incapacitating upper extremity swelling and venous hypertension in the patient with an arteriovenous (AV) access. A case of subclavian vein occlusion is reported that was treated with internal jugular-axillary vein bypass. This procedure resulted in salvage of the access and rapid resolution of the associated upper extremity swelling. It was concluded that jugular-axillary vein bypass should be considered in patients who have massive upper extremity edema resulting from a functioning AV access and ipsilateral subclavian vein occlusion. Patients undergoing creation of an AV access who have had previous temporary subclavian catheters or previous early failure of an AV access should have phlebography before surgery.

  16. Coronary artery bypass grafting in a patient with organophosphate poisoning.

    Science.gov (United States)

    Pieris, Rajeeva R; Fernando, Ravindra

    2015-08-30

    A 43-year-old male, with no previous history of mental illness, was diagnosed with coronary heart disease, after which he became acutely depressed and attempted suicide by ingesting an organophosphate pesticide. He was admitted to an intensive care unit and treated with pralidoxime, atropine, and oxygen. His coronary occlusion pattern required early coronary artery bypass grafting (CABG) surgery. His family, apprehensive of a repeat suicidal attempt, requested surgery be performed as soon as possible. He recovered well from the OP poisoning and was mentally fit to express informed consent 2 weeks after admission. Seventeen days after poisoning, he underwent coronary artery bypass grafting and recovered uneventfully. Six years later, he remains in excellent health. We report this case because to the best of our knowledge there is no literature regarding CABG performed soon after organophosphate poisoning.

  17. 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...

  18. Arteriovenous fistulas aggravate the hemodynamic effect of vein bypass stenoses

    DEFF Research Database (Denmark)

    Nielsen, T G; Djurhuus, C; Pedersen, Erik Morre;

    1996-01-01

    PURPOSE: The purpose of this study was to assess the impact of arteriovenous fistulas combined with varying degrees of stenosis on distal bypass hemodynamics and Doppler spectral parameters. METHODS: In an in vitro flow model bypass stenoses causing 30%, 55%, and 70% diameter reduction were induced...... 10 cm upstream of a fistula with low outflow resistance. Flow and intraluminal pressure were measured proximal to the stenosis and downstream of the fistula. The waveform parameters peak systolic velocity, end-diastolic velocity, pulsatility index, and pulse rise time were determined from midstream...... Doppler spectra obtained 10 cm downstream of the fistula. All measurements were carried out with open and clamped fistula. RESULTS: At 30% diameter reducing stenosis opening of the fistula induced a 12% systolic pressure drop across the stenosis but had no adverse effect on the Doppler waveform parameters...

  19. ANALYSIS OF 312 CASES OF REPEAT CORONARY ARTERY BYPASS GRAFTING

    Institute of Scientific and Technical Information of China (English)

    陈长志; 陆佩中

    2003-01-01

    Objective To evaluate repeat coronary artery bypass grafting (CABG) in 312 patients.Methods The data of 312 patients (average age 65±9 years) who had CABG operation in Hartford hospital were collected and analyzed. The mean duration follow up after the first CABG was 11.8±4.5 years. A total of 1069 bypass grafts were performed. Among them, 386 were arterial grafts such as internal mammary artery, radial artery and gastroepiploic artery; 682 were venous grafts and 1 Gore-Tex graft. Results The operative mortality was 4. 5%. Fifteen patients (4. 8%) had peri-operative myocardial infarction and 46 patients (15%) had low cardiac output syndrome. Intra-aortic balloon pump (IABP) was used in 131 patients before, during and after operation. One hundred and nineteen patients weaned off IABP and recovered. ConclusionAlthough the difficulties and risk factors were increased, the results of redo CABG were still good.

  20. A rare case of small bowel volvulus after jenjunoileal bariatric bypass requiring emergency surgery: a case report

    Directory of Open Access Journals (Sweden)

    Patel Pranav H

    2012-03-01

    Full Text Available Abstract Introduction Bariatric surgery is on the increase throughout the world. Jejunoileal bypass bariatric procedures have fallen out of favor in western surgical centers due to the high rate of associated complications. They are, however, performed routinely in other centers and as a consequence of health tourism, management of complications related to these procedures may still be encountered. Case presentation We describe a rare case of small bowel obstruction in a 45-year-old British Caucasian woman, secondary to a volvulus of the jejunoileal anastomosis following bariatric bypass surgery. The pre-operative diagnosis was confirmed by radiology. We describe a successful surgical technique for this rare complication. Conclusions Bariatric surgery may be complicated by bowel obstruction. Early imaging is vital for diagnosis and effective management. The use of our surgical technique provides a simple and effective approach for the successful management of this bariatric complication.

  1. [Pathogenic variants of brain injuries and pharmalogic cerebroprotection performed on the model of brain condition during cardiovascular bypass surgery].

    Science.gov (United States)

    Tsygan, N V; Trashkov, A P

    2014-10-01

    Developed and approved a pathogenic grounded experimental model of brain condition during cardiovascular bypass surgery. Undertaken in Wistar rats research allowed to evaluate in detail effectiveness and safety of protracted cerebroprotective treatment. Advantages of this model are researches in laboratory animals with the aim to research condition of nerve tissue, not intensive procedures and consequently high reproducibility and possibility of complex evaluation of changes at every stage of research. Results of neurons, neuroglia and activation of neurotrophic mechanisms prove that simulation of brain condition during cardiovascular bypass surgery is accompanied with acute and delayed brain injuries. Use of Cytoflavin under pharmalogic cerebroprotection had prolonged multimodal and neuroprotactive effect, leading to improvement of neurotrophic protection from the first days.

  2. Coronary flow reserve evaluated by {sup 201}Tl myocardial perfusion SPECT after coronary artery bypass grafting (CABG) for angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Ishino, Yoichi; Nakata, Hajime [Univ. of Occupational and Environmental Health, Kitakyusyu, Fukuoka (Japan)

    2000-11-01

    We compared the flow reserves of the coronary bypass vessels between arterial and venous grafts by {sup 201}Tl myocardial perfusion SPECT on the patients with angina pectoris who had no past history of myocardial infarction or intervention therapy such as PTCA. Thirty two patients had undergone a total of 70 bypass grafts and 66 of them were proved to be patent at postoperative CAG. Reversible defects were observed in 6 of 40 segments (15.0%) covered by patent venous grafts, and in 11 of 26 segments (42.3%) by patent arterial grafts. The rate of postoperative reversible defects was higher in the areas grafted by artery but this had no relation with the severity of coronary artery stenosis before CABG. This reversible defect is most likely to be caused by the character of artery graft itself and this should not be considered to highly suggest the restenosis or occlusion of the graft vessel. (author)

  3. The impact of avoiding cardiopulmonary by-pass during coronary artery bypass surgery in elderly patients: the Danish On-pump Off-pump Randomisation Study (DOORS)

    DEFF Research Database (Denmark)

    Houlind, Kim; Kjeldsen, Bo Juul; Madsen, Susanne Nørgaard;

    2009-01-01

    BACKGROUND: Coronary Artery Bypass Graft operation for ischemic heart disease provides improved quality of life and, in some patients, prolonged survival. Concern has, however, been raised about complications that may be related to the use of cardiopulmonary by-pass (CPB) and aortic cross-clampin...

  4. Assessing Patient bypass Behavior Using Taxi Trip Origin–Destination (OD Data

    Directory of Open Access Journals (Sweden)

    Gege Yang

    2016-09-01

    Full Text Available Many patients prefer to use the best hospitals even if there are one or more other hospitals closer to their homes; this behavior is called “hospital bypass behavior”. Because this behavior can be problematic in urban areas, it is important that it be reduced. In this paper, the taxi GPS data of Beijing and Suzhou were used to measure hospital bypass behavior. The “bypass behavior index” (BBI represents the bypass behavior for each hospital. The results indicated that the mean hospital bypass trip distance value ranges from 5.988 km to 9.754 km in Beijing and from 4.168 km to 10.283 km in Suzhou. In general, the bypass shares of both areas show a gradually increasing trend. The following hospitals exhibited significant patient bypass behavior: the 301 Hospital, Beijing Children’s Hospital, the Second Affiliated Hospital of Soochow University and the Suzhou Hospital of Traditional Chinese Medicine. The hospitals’ reputation, transport accessibility and spatial distribution were found to be the main factors affecting patient bypass behavior. Although the hospital bypass phenomena generally appeared to be more pronounced in Beijing, the bypass trip distances between hospitals were found to be more significant in Suzhou.

  5. Interventions in infrainguinal bypass grafts; Interventionen an infrainguinalen Bypaessen

    Energy Technology Data Exchange (ETDEWEB)

    Schoder, M.; Cejna, M.; Lammer, J. [Univ. Klinik fuer Radiodiagnostik, Wien (Austria). Abt. fuer Angiographie und Interventionelle Radiologie

    2001-12-01

    The long-term success of infrainguinal bypass grafts depends on meticulous surgical technique and a periodic program of postoperative surveillance. Duplex scanning is the method of choice for the detection of stenotic lesions that threaten graft patency. As an alternative to surgery, PTA is gaining increasing acceptance for the treatment of non-recurrent, short, and single stenotic lesions, despite somewhat controversial opinions. The initial technical success rates for PTA were reported to be up to 100%, and a 5-year primary assisted patency rate of up to 65% has been achieved. Some authors favorize intra-arterial infusion of fibrinolytic agents for the treatment of bypass graft occlusion with technical success rates of up to 92%. In addition to a reduced trauma compared to surgical thrombectomy, of the venous wall the advantage of thrombolytic therapy is clot lysis in run-off vessels, and uncovering of the stenotic lesions. This stenosis may then be treated by an endovascular or surgical approach. (orig.) [German] Der Langzeiterfolg infrainguinaler Bypaesse wird vor allem durch Anastomosenstenosen, seltener durch Stenosen im Bypass selbst, bestimmt. Neben exakten Operationstechniken ist deshalb eine regelmaessige postoperative Ueberwachung des Bypasses zur Verbesserung der Langzeitdurchgaengigkeit allgemein akzeptiert. Zur Identifizierung von bypassgefaehrdenden Stenosen hat die Duplexsonographie als Untersuchungsmodalitaet der Wahl einen fixen Stellenwert erlangt. Die perkutane transluminale Angioplastie (PTA) ist eine sinnvolle, minimal invasive Alternative zur offenen chirurgischen Revision von erstmalig aufgetretenen kurzstreckigen und singulaeren Bypassstenosen respektive Anastomosenstenosen. Primaer technische Erfolgsraten nach PTA werden bis zu 100%, primaer assistierte 5-Jahres-Offenheitsraten bis zu 65% angegeben. Die intraarterielle Thrombolyse bei Bypassthrombosen ist mit bis zu 92%iger technischer Erfolgsrate von manchen Arbeitsgruppen als primaere

  6. secondary Prevention of Coronary Events by Coronary Artery Bypass Surgery

    OpenAIRE

    2003-01-01

    Coronary artery bypass surgery has shown its superiority on other therapeutic options in specific but frequent indications such as left main lesions, multivessel disease with alteration of ventricular function, proximal lesions of the LAD, and multivessel diseases in diabetic patients. After reviewing the epidemiology of coronary artherosclerosis, we emphasize the efficacy of the surgical treatment compared to medical or interventional therapy for preventing ischemic events. The results deriv...

  7. Coronary artery bypass and superior vena cava syndrome.

    OpenAIRE

    Thomas, T V; Masrani, K; Thomas, J.L.

    1999-01-01

    Superior vena cava syndrome is the obstruction of the superior vena cava or its main tributaries by benign or malignant lesions. The syndrome causes edema and engorgement of the vessels on the face, neck, and arms, nonproductive cough, and dyspnea. We discuss the case of a 48-year-old obese diabetic woman who was admitted with unstable angina. She had previously been diagnosed with superior vena cava syndrome. Urgent coronary artery bypass grafting was necessary Although thousands of coronary...

  8. Pipelining and bypassing in a RISC/DSP processor

    Science.gov (United States)

    Yu, Guojun; Yao, Qingdong; Liu, Peng; Jiang, Zhidi; Li, Fuping

    2005-03-01

    This paper proposes pipelining and bypassing unit (BPU) design method in our 32-bit RISC/DSP processor: MediaDsp3201 (briefly, MD32). MD32 is realized in 0.18μm technology, 1.8v, 200MHz working clock and can achieve 200 million/s Multiply-Accumulate (MAC) operations. It merges RISC architecture and DSP computation capability thoroughly, achieves fundamental RISC, extended DSP and single instruction multiple data (SIMD) instruction set with various addressing modes in a unified and customized DSP pipeline stage architecture. We will first describe the pipeline structure of MD32, comparing it to typical RISC-style pipeline structure. And then we will study the validity of two bypassing schemes in terms of their effectiveness in resolving pipeline data hazards: Centralized and Distributed BPU design strategy (CBPU and DBPU). A bypassing circuit chain model is given for DBPU, which register read is only placed at ID pipe stage. Considering the processor"s working clock which is decided by the pipeline time delay, the optimization of circuit that serial select with priority is also analyzed in detail since the BPU consists of a long serial path for combination logic. Finally, the performance improvement is analyzed.

  9. Augmented reality-assisted bypass surgery: embracing minimal invasiveness.

    Science.gov (United States)

    Cabrilo, Ivan; Schaller, Karl; Bijlenga, Philippe

    2015-04-01

    The overlay of virtual images on the surgical field, defined as augmented reality, has been used for image guidance during various neurosurgical procedures. Although this technology could conceivably address certain inherent problems of extracranial-to-intracranial bypass procedures, this potential has not been explored to date. We evaluate the usefulness of an augmented reality-based setup, which could help in harvesting donor vessels through their precise localization in real-time, in performing tailored craniotomies, and in identifying preoperatively selected recipient vessels for the purpose of anastomosis. Our method was applied to 3 patients with Moya-Moya disease who underwent superficial temporal artery-to-middle cerebral artery anastomoses and 1 patient who underwent an occipital artery-to-posteroinferior cerebellar artery bypass because of a dissecting aneurysm of the vertebral artery. Patients' heads, skulls, and extracranial and intracranial vessels were segmented preoperatively from 3-dimensional image data sets (3-dimensional digital subtraction angiography, angio-magnetic resonance imaging, angio-computed tomography), and injected intraoperatively into the operating microscope's eyepiece for image guidance. In each case, the described setup helped in precisely localizing donor and recipient vessels and in tailoring craniotomies to the injected images. The presented system based on augmented reality can optimize the workflow of extracranial-to-intracranial bypass procedures by providing essential anatomical information, entirely integrated to the surgical field, and help to perform minimally invasive procedures. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Ileal loop interposition:an alternative biliar y bypass technique

    Institute of Scientific and Technical Information of China (English)

    Felipe JF Coimbra; Alessandro L Diniz; Heber SC Ribeiro; Wilson L Costa Jr.; Eduardo NP Lima; André L Montagnini

    2010-01-01

    BACKGROUND: Obstructive jaundice is a common condition in advanced digestive cancer. Palliative procedures can improve quality of life and allow patients to attempt a systemic treatment. Bilioenteric anastomosis is still the procedure of choice for patients in many centers. When a surgical bypass is not possible, biliary drainage can be done by placing endoscopic or transparietal stents, which are less durable methods even when an expandable stent is employed. METHODS: A 47-year-old male with an excellent clinical status and a previous cholecystectomy and an exploratory laparotomy for advanced gastric cancer was referred with obstructive jaundice. A preoperative CT scan showed a dilated bile duct and a small mass at the distal hepatic hilum. No other signs of metastasis were found. A surgical bilioenteric anastomosis was indicated. At surgery, a distal choledochal obstruction and a mesenteric retraction by a lymph node mass prevented the jejunum to ascend for a bilioenteric anastomosis. Surgically, an alternative bilioenteric bypass was performed by means of an ileal loop interposition between the bile duct and the jejunum. RESULT: The recovery of the patient was uneventful and his bilirubin levels normalized after one week. The patient was then referred for systemic chemotherapy. CONCLUSIONS: This alternative biliary bypass can be safely and easily performed, and may be a good alternative for patients already referred for surgery because of a better life expectancy and when the jejunum is not an alternative.

  11. Distal wound complications following pedal bypass: analysis of risk factors.

    Science.gov (United States)

    Robison, J G; Ross, J P; Brothers, T E; Elliott, B M

    1995-01-01

    Wound complications of the pedal incision continue to compromise successful limb salvage following aggressive revascularization. Significant distal wound disruption occurred in 14 of 142 (9.8%) patients undergoing pedal bypass with autogenous vein for limb salvage between 1986 and 1993. One hundred forty-two pedal bypass procedures were performed for rest pain in 66 patients and tissue necrosis in 76. Among the 86 men and 56 women, 76% were diabetic and 73% were black. All but eight patients had a history of diabetes and/or tobacco use. Eight wounds were successfully managed with maintenance of patent grafts from 5 to 57 months. Exposure of a patent graft precipitated amputation in three patients, as did graft occlusion in an additional patient. One graft was salvaged by revision to the peroneal artery and one was covered by a local bipedicled flap. Multiple regression analysis identified three factors associated with wound complications at the pedal incision site: diabetes mellitus (p = 0.03), age > 70 years (p = 0.03), and rest pain (p = 0.05). Ancillary techniques ("pie-crusting") to reduce skin tension resulted in no distal wound problems among 15 patients considered to be at greatest risk for wound breakdown. Attention to technique of distal graft tunneling, a wound closure that reduces tension, and control of swelling by avoiding dependency on and use of gentle elastic compression assume crucial importance in minimizing pedal wound complications following pedal bypass.

  12. Percutaneous mechanical thrombectomy for treatment of acute femoropopliteal bypass occlusion

    Directory of Open Access Journals (Sweden)

    Lichtenberg M

    2012-05-01

    Full Text Available Michael Lichtenberg1, Matthias Käunicke1, Birgit Hailer1,21Cardiovascular Clinic, Vascular Center, Katholisches Klinikum Essen, Germany; 2University of Witten/Herdecke, GermanyAbstract: Acute and subacute ischemia of the legs in acute and subacute femoropopliteal bypass occlusion is a dramatic situation that endangers the survival of the limbs, depending on the severity of the ischemia. Different therapy options like percutaneous mechanical thrombectomy procedures, which include rotational thrombectomy, have become available in recent years, in addition to local lysis and surgical thrombectomy. Surgical thrombectomy using the Fogarty catheter technique, in particular, shows an increased incidence of perioperative complications but only small technical success rates in randomized trials. On the other hand, local lysis is associated with increased costs due to resource-consuming measures, such as intensive monitoring and repeat angiographies, in addition to bleeding complications. In the past, further development of the Straub Rotarex® system as an endovascular therapy option has demonstrated good success leading to amputation-free survival in multiple studies. At the same time, a low rate of complications with use has been documented. Most examinations have been conducted in the thigh. To date, there are little investigational data on its use in acutely and subacutely occluded femoropopliteal bypasses. In this paper, the current study-based significance of the Rotarex system for this indication is analyzed based on the existing literature and the authors' own experiences with 22 patients.Keywords: acute limb ischemia, femoropopliteal bypass, local lysis, rotational thrombectomy

  13. EARLY POSTOPERATIVE COMPLICATIONS IN ROUX-EN-Y GASTRIC BYPASS

    Science.gov (United States)

    STOLL, Aluisio; ROSIN, Leandro; DIAS, Mariana Fernandes; MARQUIOTTI, Bruna; GUGELMIN, Giovana; STOLL, Gabriela Fanezzi

    2016-01-01

    ABSTRACT Background: Roux-en-Y gastric bypass is one of the most common bariatric surgery and leads to considerable weight loss in the first months. Aim: To quantify the main early postoperative complications in patients submitted to the gastric bypass. Method: Observational retrospective cohort. Data of 1051 patients with class II obesity associated with comorbidities or class III obesity submitted to the gastric bypass with 30 days of follow-up starting from the date of the surgery. Results: The age average was 36 years with a predominance of females (81.1%). The mean preoperative body mass index was 43 kg/m². The major complication was fistula (2.3%), followed by intestinal obstruction (0.5%) and pulmonary embolism (0.5%). Death occurred in 0.6% of the cases. Conclusion: In the period of 30 days after surgery the overall complication rate was 3.8%; reoperation was necessary in 2.6% and death occurred in 0.6%. Fistula was the main complication and the leading cause of hospitalization in intensive care unit, reoperation and death. PMID:27683781

  14. COMPLICATIONS RELATED TO GASTRIC BYPASS PERFORMED WITH DIFFERENT GASTROJEJUNAL DIAMETERS

    Science.gov (United States)

    SAMPAIO-NETO, José; BRANCO-FILHO, Alcides José; NASSIF, Luis Sérgio; BROSKA, Anne Caroline; KAMEI, Douglas Jun; NASSIF, André Thá

    2016-01-01

    ABSTRACT Background: Among the options for surgical treatment of obesity, the most widely used has been the Roux-en-Y gastric bypass. The gastrojejunal anastomosis can be accomplished in two ways: handsewn or using circular and linear stapled. The complications can be divided in early and late. Aim: To compare the incidence of early complications related with the handsewn gastrojejunal anastomosis in gastric bypass using Fouchet catheter with different diameters. Method: The records of 732 consecutive patients who had undergone the bypass were retrospectively analyzed and divided in two groups, group 1 with 12 mm anastomosis (n=374), and group 2 with 15 mm (n=358). Results: The groups showed anastomotic stenosis with rates of 11% and 3.1% respectively, with p=0.05. Other variables related to the anastomosis were also analyzed, but without statistical significance (p>0.05). Conclusion: The diameter of the anastomosis of 15 mm was related with lower incidence of stenosis. It was found that these patients had major bleeding postoperatively and lower surgical site infection, and in none was observed presence of anastomotic leak. PMID:27683767

  15. Flow Simulation of Supersonic Inlet with Bypass Annular Duct

    Science.gov (United States)

    Kim, HyoungJin; Kumano, Takayasu; Liou, Meng-Sing; Povinelli, Louis A.; Conners, Timothy R.

    2011-01-01

    A relaxed isentropic compression supersonic inlet is a new concept that produces smaller cowl drag than a conventional inlet, but incurs lower total pressure recovery and increased flow distortion in the (radially) outer flowpath. A supersonic inlet comprising a bypass annulus to the relaxed isentropic compression inlet dumps out airflow of low quality through the bypass duct. A reliable computational fluid dynamics solution can provide considerable useful information to ascertain quantitatively relative merits of the concept, and further provide a basis for optimizing the design. For a fast and reliable performance evaluation of the inlet performance, an equivalent axisymmetric model whose area changes accounts for geometric and physical (blockage) effects resulting from the original complex three-dimensional configuration is proposed. In addition, full three-dimensional calculations are conducted for studying flow phenomena and verifying the validity of the equivalent model. The inlet-engine coupling is carried out by embedding numerical propulsion system simulation engine data into the flow solver for interactive boundary conditions at the engine fan face and exhaust plane. It was found that the blockage resulting from complex three-dimensional geometries in the bypass duct causes significant degradation of inlet performance by pushing the terminal normal shock upstream.

  16. Off-pump coronary artery bypass grafting or percutaneous transluminal coronary angioplasty with stenting for proximal left anterior descending coronary artery disease?

    NARCIS (Netherlands)

    Drenth, Derk Jan

    2005-01-01

    This thesis describes and discusses the results of a prospective randomized controlled clinical trial comparing percutaneous coronary angioplasty with stenting (stenting) and off-pump coronary artery bypass grafting with a left internal mammary artery (surgery) in patients with a high-grade stenosis

  17. Preoperative Hba1c level in prediction of short-term morbidity and mortality outcomes following coronary artery bypass grafting surgery

    Directory of Open Access Journals (Sweden)

    Ümit Arslan

    2015-05-01

    Conclusion ― We concluded that in those diabetic patients that elective coronart artery bypass graft is applied, highly reactive HbA1c levels (HbA1c ≥7, may indicate morbitity in the early stages of post operation.

  18. Off-pump coronary artery bypass grafting or percutaneous transluminal coronary angioplasty with stenting for proximal left anterior descending coronary artery disease?

    NARCIS (Netherlands)

    Drenth, Derk Jan

    2005-01-01

    This thesis describes and discusses the results of a prospective randomized controlled clinical trial comparing percutaneous coronary angioplasty with stenting (stenting) and off-pump coronary artery bypass grafting with a left internal mammary artery (surgery) in patients with a high-grade stenosis

  19. Drug disposition before and after gastric bypass: fenofibrate and posaconazole.

    Science.gov (United States)

    Gesquiere, Ina; Hens, Bart; Van der Schueren, Bart; Mols, Raf; de Hoon, Jan; Lannoo, Matthias; Matthys, Christophe; Foulon, Veerle; Augustijns, Patrick

    2016-11-01

    Roux-en-Y gastric bypass (RYGB) alters the anatomical structure of the gastrointestinal tract, which can result in alterations in drug disposition. The aim of the present study was to evaluate the oral disposition of two compounds belonging to the Biopharmaceutical Classification System Class II - fenofibrate (bile salt-dependent solubility) and posaconazole (gastric pH-dependent dissolution) - before and after RYGB in the same individuals. A single-dose pharmacokinetic study with two model compounds - namely, 67 mg fenofibrate (Lipanthyl®) and 400 mg posaconazole (Noxafil®) - was performed in 12 volunteers pre- and post-RYGB. After oral administration, blood samples were collected at different time points up to 48 h after administration. Plasma concentrations were determined by high-performance liquid chromatography in order to calculate the area under the concentration-time curve up to 48 h (AUC0-48 h ), the peak plasma concentration (Cmax) and the time to reach peak concentration (Tmax ). After administration of fenofibrate, no relevant differences in AUC0-48 h , Cmax and Tmax between the pre- and postoperative setting were observed. The geometric mean of the ratio of AUC0-48 h post/pre-RYGB for fenofibrate was 1.10 [95% confidence interval (CI) 0.87, 1.40; P = 0.40]. For posaconazole, an important decrease in AUC0-48 h and Cmax following RYGB was shown; the geometric mean of the AUC0-48 h post/pre-RYGB ratio was 0.68 (95% CI 0.48, 0.96; P = 0.03) and the geometric mean of the Cmax pre/post-RYGB ratio was 0.60 (95% CI 0.39, 0.94; P = 0.03). The decreased exposure of posaconazole could be explained by the increased gastric pH and accelerated gastric emptying of fluids post-RYGB. No difference for Tmax was observed. The disposition of fenofibrate was not altered after RYGB, whereas the oral disposition of posaconazole was significantly decreased following RYGB. © 2016 The British Pharmacological Society.

  20. 主动脉内球囊反搏在高危患者非体外循环冠状动脉旁路移植术中的应用%Application of Intra-aortic Balloon Pump for High-risk Patients before Off-pump Coronary Artery Bypass Grafting

    Institute of Scientific and Technical Information of China (English)

    丁文军; 魏强; 孙勇新; 史昀青; 王春生

    2013-01-01

    目的 分析行非体外循环冠状动脉旁路移植术(off-pump coronary artery bypass grafting,OPCAB)的高危患者术前应用主动脉内球囊反搏(intraaortic balloon pump,IABP)的治疗效果,总结IABP的应用及撤机指征.方法 回顾性分析自2008年1月至2011年7月复旦大学附属中山医院102例高危冠心病患者[IABP组,男71例,女31例;年龄(63.0±8.2)岁]在OPCAB术前置入IABP治疗的临床资料,另外选择100例未于术前置入IABP的患者作为对照[对照组,男55例,女45例;年龄(64.1±9.5)岁].监测两组患者手术后有创动脉收缩压(SABP)、有创平均动脉压(MABP)、机械辅助通气时间、住ICU时间、并发症发生情况、IABP辅助时间、围术期死亡等.术后3个月复查心脏超声心动图检测左心室射血分数(LVEF).结果 IABP组患者术后SABP[(95.3±12.2) mm Hgvs.(80.1±11.7) mm Hg; t=8.440,P=0.000]、MABP[(78.9±13.5) mm Hg vs.(52.3±15.1)mm Hg; t=12.410,P=0.000]明显高于对照组;机械辅助通气时间、住ICU时间、正性肌力药物辅助时间较对照组短;室性心律失常、低心排血量、围术期心肌梗死和围术期肾功能不全血液透析的发生较对照组少;围术期死亡率低于对照组[5.9% (6/102) vs.17.0%(17/100),x2=6.180,P=0.020].IABP组随访96例,对照组随访83例,随访时间均为3个月.术后3个月时心脏超声心动图提示IABP组LVEF显著高于对照组(45.3%±12.0% vs.39.1%±8.2%,t=3.950,P=0.000).结论 对具有高危因素的OPCAB患者术前预防性置入IABP、且把握好撤机时机,可降低手术风险,明显提高手术效果,加快患者术后恢复,改善心功能,减少并发症的发生,降低围术期病死率.%Objective To analyze clinical outcomes of intra-aortic balloon pump (IABP) application for high-risk patients before undergoing off-pump coronary artery bypass grafting (OPC AB), and summarize our experience and weaning indications of IABP. Methods We retrospectively analyzed