Complications of hysteroscopic surgery: "Beyond the learning curve".

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Shveiky, David; Rojansky, Nathan; Revel, Ariel; Benshushan, Abraham; Laufer, Neri; Shushan, Asher

2007-01-01

To investigate the actual complication rate of hysteroscopic surgery performed by experienced endoscopic surgeons in a single medical center. A prospective descriptive study (Canadian Task Force classification III). An endoscopic gynecology unit at a tertiary care university hospital. Women from 21 to 82 (median 45.0) years, undergoing operative hysteroscopy for uterine disease. Operative hysteroscopy with glycine or saline solution used as an irrigation medium. Data of short-term complications were prospectively collected during surgery and at the 2-week follow-up visit. Six hundred procedures were investigated. The total complication rate was 3%, with 1% of uterine perforations. Two-thirds of the complications were related to cervical dilation or uterine entry, and infertility was found to be a risk factor. Hysteroscopic surgery, performed by a well-trained hysteroscopic surgeon, is a safe procedure with an overall complication rate of 3%. Most complications are related to cervical dilation or uterine entry techniques. Efforts therefore should be focused on identifying the patients at risk and finding novel techniques for cervical priming.

Training and Assessment of Hysteroscopic Skills: A Systematic Review.

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Savran, Mona Meral; Sørensen, Stine Maya Dreier; Konge, Lars; Tolsgaard, Martin G; Bjerrum, Flemming

2016-01-01

The aim of this systematic review was to identify studies on hysteroscopic training and assessment. PubMed, Excerpta Medica, the Cochrane Library, and Web of Science were searched in January 2015. Manual screening of references and citation tracking were also performed. Studies on hysteroscopic educational interventions were selected without restrictions on study design, populations, language, or publication year. A qualitative data synthesis including the setting, study participants, training model, training characteristics, hysteroscopic skills, assessment parameters, and study outcomes was performed by 2 authors working independently. Effect sizes were calculated when possible. Overall, 2 raters independently evaluated sources of validity evidence supporting the outcomes of the hysteroscopy assessment tools. A total of 25 studies on hysteroscopy training were identified, of which 23 were performed in simulated settings. Overall, 10 studies used virtual-reality simulators and reported effect sizes for technical skills ranging from 0.31 to 2.65; 12 used inanimate models and reported effect sizes for technical skills ranging from 0.35 to 3.19. One study involved live animal models; 2 studies were performed in clinical settings. The validity evidence supporting the assessment tools used was low. Consensus between the 2 raters on the reported validity evidence was high (94%). This systematic review demonstrated large variations in the effect of different tools for hysteroscopy training. The validity evidence supporting the assessment of hysteroscopic skills was limited. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Factors Influencing the Recurrence Potential of Benign Endometrial Polyps after Hysteroscopic Polypectomy.

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Jehn-Hsiahn Yang

Full Text Available An endometrial polyp is a frequently encountered gynecologic disease with abnormal uterine bleeding and infertility being the two common presenting problems, and hysteroscopic polypectomy is an effective method to remove them. The postoperative polyp recurrence might result in reappearance of abnormal uterine bleeding or infertility, whereas factors influencing the postoperative recurrence potential have limited data.This case-series report included 168 premenopausal women who suffered from endometrial polyps and underwent hysteroscopic polypectomy. All of them were awaiting a future pregnancy. Office hysteroscopy was done before and after hysteroscopic polypectomy, in which preoperative hysteroscopy examined the number, type, and location of endometrial polyps, and postoperative hysteroscopy checked the polyp recurrence. Surgical indications, either infertility or the presentation of abnormal uterine bleeding, and follow-up duration were recorded.Seventy-three out of 168 (43% women had polyp recurrence after hysteroscopic polypectomy. Multivariate logistic regression analysis revealed that more endometrial polyps (P = 0.015 and longer duration of follow-up (P = 0.004 were significantly associated with an increased risk of postoperative polyp recurrence. The type of endometrial polyps was not correlated with polyp recurrence potential, whereas pedunculated type endometrial polyps were closely related to the presentation of abnormal uterine bleeding (P = 0.001.A higher number of endometrial polyps and longer follow-up duration are associated with a greater potential of polyp recurrence after hysteroscopic polypectomy.

ICSI pregnancy outcomes following hysteroscopic placement of Essure devices for hydrosalpinx in laparoscopic contraindicated patients.

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Ozgur, Kemal; Bulut, Hasan; Berkkanoglu, Murat; Coetzee, Kevin; Kaya, Gamze

2014-07-01

This study investigated the use of hysteroscopic Essure device placement for the treatment of hydrosalpinx-related infertility in patients with laparoscopic contraindications and compared their pregnancy outcomes following assisted conception treatment with those of patients having had laparoscopic tubal ligation. A total of 102 infertile patients were diagnosed with unilateral or bilateral hydrosalpinges: 26 patients had laparoscopic contraindications and were treated hysterscopically and 76 patients were treated laparoscopically. In total, 66 intracytoplasmic sperm injection (ICSI) and 39 frozen embryo transfer (FET) procedures were performed. In the hysteroscopy group, 13 ICSI and eight FET in 16 patients resulted in 10 pregnancies (pregnancy rates 47.6% per transfer and 62.5% per patient), and in the laparoscopy group, 53 ICSI and 31 FET embryo transfers in 54 patients resulted in 36 pregnancies (pregnancy rates 42.9% per transfer and 66.7% per patient). Live birth rates per assisted reproduction procedure were 23.8% (5/21) in the hysteroscopy group and 32.1% (27/84) for the laparoscopy group. The hysteroscopic placement of Essure devices to isolate hydrosalpinx prior to assisted conception treatment produced pregnancy outcomes comparable to those produced following laparoscopic tubal ligation. The live birth rates indicate that a larger, more comparative, prospectively randomized study is required. Infertile patients with tubal disease require surgical treatment before they can continue with fertility treatment. There are two main surgical methods that can be used, hysteroscopic and laparoscopic, the latter being the standard surgical method. However, some patients have disease that makes the use of laparoscopy inappropriate. For these patients the placement of Essure® devices by hysteroscopic surgery maybe the most suitable treatment method. One hundred and two patients were diagnosed with unilateral or bilateral hydrosalpinges - tubal disease. Twenty six

Safety and efficacy of hysteroscopic sterilization compared with laparoscopic sterilization: an observational cohort study

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Mao, Jialin; Pfeifer, Samantha; Schlegel, Peter

2015-01-01

Objective To compare the safety and efficacy of hysteroscopic sterilization with the “Essure” device with laparoscopic sterilization in a large, all-inclusive, state cohort. Design Population based cohort study. Settings Outpatient interventional setting in New York State. Participants Women undergoing interval sterilization procedure, including hysteroscopic sterilization with Essure device and laparoscopic surgery, between 2005 and 2013. Main outcomes measures Safety events within 30 days of procedures; unintended pregnancies and reoperations within one year of procedures. Mixed model accounting for hospital clustering was used to compare 30 day and 1 year outcomes, adjusting for patient characteristics and other confounders. Time to reoperation was evaluated using frailty model for time to event analysis. Results We identified 8048 patients undergoing hysteroscopic sterilization and 44 278 undergoing laparoscopic sterilization between 2005 and 2013 in New York State. There was a significant increase in the use of hysteroscopic procedures during this period, while use of laparoscopic sterilization decreased. Patients undergoing hysteroscopic sterilization were older than those undergoing laparoscopic sterilization and were more likely to have a history of pelvic inflammatory disease (10.3% v 7.2%, P<0.01), major abdominal surgery (9.4% v 7.9%, P<0.01), and cesarean section (23.2% v 15.4%, P<0.01). At one year after surgery, hysteroscopic sterilization was not associated with a higher risk of unintended pregnancy (odds ratio 0.84 (95% CI 0.63 to 1.12)) but was associated with a substantially increased risk of reoperation (odds ratio 10.16 (7.47 to 13.81)) compared with laparoscopic sterilization. Conclusions Patients undergoing hysteroscopic sterilization have a similar risk of unintended pregnancy but a more than 10-fold higher risk of undergoing reoperation compared with patients undergoing laparoscopic sterilization. Benefits and risks of both procedures

Advanced Hysteroscopic Surgery: Quality Assurance in Teaching Hospitals.

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Erian, Mark M S; McLaren, Glenda R; Erian, Anna-Marie

2017-01-01

Advanced hysteroscopic surgery (AHS) is a vitally important technique in the armamentarium for the management of many day-to-day clinical problems, such as menorrhagia, surgical excision of uterine myomata and septa in the management of female infertility, hysteroscopic excision of chronically retained products of conception (placenta accreta), and surgical removal of intramural ectopic pregnancy. In today's climate of accountability, it is necessary that gynecologists take a more active role in assuring the quality of their work. In this article, we discuss the quality assurance system from the point of view of the surgical audit meetings in some of the major teaching hospitals affiliated with the University of Queensland (Brisbane, Queensland, Australia).

Accuracy of pre-operative hysteroscopic guided biopsy for predicting final pathology in uterine malignancies.

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Martinelli, Fabio; Ditto, Antonino; Bogani, Giorgio; Signorelli, Mauro; Chiappa, Valentina; Lorusso, Domenica; Haeusler, Edward; Raspagliesi, Francesco

2017-07-01

To evaluate concordance (C) between pre-operative hysteroscopic-directed sampling and final pathology in uterine cancers. A retrospective cross-sectional evaluation of prospectively collected data of women who underwent hysterectomy for uterine malignancies and a previous hysteroscopic-guided biopsy was performed. Diagnostic concordance between pre-operative (hysteroscopic biopsy) and postoperative (uterine specimen) histology was evaluated. In endometrioid-endometrial cancers cases Kappa (k) statistics was applied to evaluate agreement for grading (G) between the preoperative and final pathology. A total 101 hysterectomies for uterine malignancies were evaluated. There were 23 non-endometrioid cancers: 7 serous (C:5/7, 71.4%); 10 carcinosarcomas (C:7/10, 70%, remaining 3 cases only epithelial component diagnosed); 3 clear cell (C:3/3, 100%); 3 sarcomas (C:3/3, 100%). In 78 cases an endometrioid endometrial cancer was found. In 63 cases there was a histological C (63/78, 80.8%) between hysteroscopic-guided biopsy and final pathology, while in 15 cases (19.2%) only hyperplasia (with/without atypia) was found preoperatively. Overall accuracy to detect endometrial cancer was 80.2%. In 50 out of 63 endometrial cancers (79.4%) grading was concordant. The overall level of agreement between preoperative and postoperative grading was "substantial" according to Kappa (k) statistics (k 0.64; 95% CI: 0.449-0.83; p < 0.001), as well as for G1 (0.679; 95% CI: 0.432-0.926; p < 0.001) and G3 (0.774; 94% CI: 0.534-1; p < 0.001), while for G2 (0.531; 95% CI: 0.286-0.777; p < 0.001) it was moderate. In our series we found an 80% C between pre-operative hysteroscopic-guided biopsy and final pathology, in uterine malignancies. Moreover, hysteroscopic biopsy accurately predicted endometrial cancer in 80% of cases and "substantially" predicted histological grading. Hysteroscopic-guided uterine sampling could be a useful tool to tailor treatment in patients with uterine

Simulation Training in Hysteroscopic Surgery

OpenAIRE

Janse, J.A.

2014-01-01

Hysteroscopy detects uterine cavity pathology by direct visualisation of the endometrial lining, making use of a vaginally inserted endoscope. The additional insertion of an instrument through the endoscope provides the opportunity for obtainment of histology and treatment of pathologies, and for sterilisation of women. It is therefore an essential diagnostic and therapeutic tool in the current practice of gynaecology. Even though hysteroscopic skills are often perceived to be less complicate...

COMPARATIVE STUDY OF ENDOMETRIAL SAMPLING USING PIPELLE WITH HYSTEROSCOPIC-GUIDED BIOPSY

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Nalina S

2017-07-01

Full Text Available BACKGROUND Hysteroscopic-guided biopsy is the gold standard for endometrial sampling, but it carries risk of general anaesthesia, infection and perforation, whereas Pipelle does not require anaesthesia or cervical dilatation and it allows outpatient and painless endometrial sampling. The aim of the study is to determine the reliability and accuracy of Pipelle aspiration in acquiring an adequate and representative endometrial sample and to compare its histopathology with hysteroscopic-directed biopsy. MATERIALS AND METHODS A prospective observational comparative study evaluating the role of Pipelle aspiration as an outpatient procedure in endometrial sampling of perimenopausal women with AUB. 150 perimenopausal women with clinical diagnosis of abnormal uterine bleeding were selected from the Gynaecology OPD of IOG, Chennai, between October 2014 and September 2015. They were subjected to endometrial sampling by Pipelle followed by hysteroscopic-directed biopsy. The efficacy of Pipelle was determined by correlating the histopathological results obtained from it and the hysteroscopic-directed biopsy. RESULTS The histopathology of the endometrium obtained using Pipelle’s curette showed a sensitivity of 93%, specificity of 90% in the detection of abnormal findings with PPV of 88% and NPV of 94%. However, accuracy of Pipelle is found to be less in the diagnosis of polyps and submucous fibroids with accuracy of nearing 100% when using hysteroscopy. CONCLUSION Pipelle endometrial sampling is convenient, easy, painless and safe in obtaining an adequate sample for histopathology with high sensitivity and specificity for endometrial pathologies and endometrial carcinoma.

Hysteroscopic morcellator for removal of intrauterine polyps and myomas: a randomized controlled pilot study among residents in training.

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van Dongen, Heleen; Emanuel, Mark Hans; Wolterbeek, Ron; Trimbos, J Baptist; Jansen, Frank Willem

2008-01-01

The purpose of this randomized controlled study was to compare conventional resectoscopy and hysteroscopic morcellation among residents in training (Canadian Task Force classification I). Sixty women with an intrauterine polyp or myoma were randomized to either hysteroscopic removal by conventional resectoscopy or hysteroscopic morcellation performed by 6 residents in training for obstetrics and gynecology (10 procedures per resident). The mean operating time for resectosocpy and morcellation was 17.0 (95% confidence interval [95% CI] 14.1-17.9, standard deviation [SD] 8.4) and 10.6 (95% CI 7.3-14.0, SD 9.5) min, respectively (p = .008). Multiple linear regression analysis showed that operating time increased significantly, for both resectoscopy and morcellator, when volume of intrauterine disorder increased. The use of the hysteroscopic morcellator reduced operating time more than 8 min in comparison to conventional resectoscopy (p learning curve was observed. In conclusion, the hysteroscopic morcellator for removal of intrauterine polyps and myomas offers a good alternative to conventional resectoscopy for residents in training.

Investigation of intratumoural and peritumoural lymphatics expressed by podoplanin and LYVE-1 in the hybridoma-induced tumours

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Ji, RC; Eshita, Y; Kato, S

2007-01-01

Tumour-associated lymphatics contribute to a key component of metastatic spread, however, the biological interaction of tumour cells with intratumoural and peritumoural lymphatics (ITLs and PTLs) has remained unclear. To address this important issue, we have focused on the morphological and molecular aspects of newly formed lymphatics (lymphangiogenesis) and pre-existing lymphatics in the intratumoural and peritumoural tissues by using a hybridoma-induced tumour model. In the present study, ITLs with very high vessel density within the tumour mass showed small and flattened contours that varied from non-solid-to-solid tumours, whereas PTLs were relatively disorganized and tortuous, and packed with a cluster of tumour cells at the tumour periphery. Lymphatic endothelial cells (LECs) both in ITLs and PTLs were expressed with LYVE-1 and podoplanin in various tumour tissues, in which initial lymphatics were extremely extended and dilated. The tumour cells were frequently detected adhering to or penetrating lymphatic walls, especially near the open junctions. In the metastatic tissues, lymphangiogenic vasculatures occurred within the tumour matrix, and collecting PTLs represented abnormal twisty valve leaflets. The Western blot and RT-PCR analysis showed local variations of LEC proliferating potentials and lymphatic involvement in metastasis by a distinct profile of the protein and mRNA expression by LYVE-1, podoplanin, Prox-1 and vascular endothelial growth factor-3 (VEGFR-3). These findings indicated that both ITLs and PTLs, including enlarged pre-existing and newly formed lymphatics, may play a crucial role in metastasis with an active tumour cell adhesion, invasion, migration and implantation. PMID:17696907

Office Hysteroscopic Laser Enucleation of Submucous Myomas without Mass Extraction: A Case Series Study

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Sergio Haimovich

2015-01-01

Full Text Available Background and Objectives. A new two-step hysteroscopic myomectomy carried out in the office setting and without anesthesia was feasible for the excision of submucous myomas. The objective of this study was to assess whether removal of submucous myomas from the uterine cavity after hysteroscopic laser enucleation is necessary. Methods. Between June 2009 and April 2013, all outpatients with symptomatic myomatosis (bleeding, pelvic pain, and infertility assessed ultrasonographically were eligible to participate in a prospective study. All patients underwent office hysteroscopic enucleation of submucous myomas. Enucleated myomas were left in the uterine cavity. Neither anesthesia nor antibiotic prophylaxis was used. Results. Sixty-one women (mean age: 47.3 years were included. Regardless of hysteroscopic localization and grading, all myomas were enucleated. The mean (standard deviation, SD diameter of the myoma as measured by the ultrasound scan was 22.6 (8.5 mm. In 29 cases (47.5%, the diameter of the resected myoma was >20 mm and in 10 cases (16.4% >30 mm. After a mean follow-up of 68.2 (16.5 days, none of the patients showed a residual myoma inside the uterine cavity. Conclusions. The present results indicate that leaving laser-enucleated submucous myoma in the uterine cavity is a feasible and safe therapeutic option.

Hysteroscopic tubal electrocoagulation versus laparoscopic tubal ligation for patients with hydrosalpinges undergoing in vitro fertilization.

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El-Mazny, Akmal; Abou-Salem, Nermeen; Hammam, Mohamed; Saber, Walid

2015-09-01

To investigate the use and success rate of hysteroscopic tubal electrocoagulation for the treatment of hydrosalpinx-related infertility among patients undergoing in vitro fertilization (IVF) who have laparoscopic contraindications. A prospective study was conducted among patients who had unilateral or bilateral hydrosalpinges identified on hysterosalpingography and vaginal ultrasonography, and who were undergoing IVF at a center in Cairo, Egypt, between January 1, 2013, and October 30, 2014. All patients who had contraindications for laparoscopy were scheduled for hysteroscopic tubal electrocoagulation (group 1); the other patients underwent laparoscopic tubal ligation (group 2). For all patients, hysterosalpingography was performed 3 months after their procedure to evaluate proximal tubal occlusion. Among 85 enrolled patients, 22 underwent hysteroscopic tubal electrocoagulation and 63 underwent laparoscopic tubal ligation. The procedure was successful in terms of tubal occlusion for 25 (93%) of 27 hydrosalpinges in group 1, and 78 (96%) of 81 hydrosalpinges in group 2 (P=0.597). No intraoperative or postoperative complications were reported. Hysteroscopic tubal electrocoagulation was found to be a successful treatment for hydrosalpinges before IVF when laparoscopy is contraindicated. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Hysteroscopic proximal tubal occlusion versus laparoscopic salpingectomy as a treatment for hydrosalpinges prior to IVF or ICSI: an RCT

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Dreyer, K.; Lier, M. C. I.; Emanuel, M. H.; Twisk, J. W. R.; Mol, B. W. J.; Schats, R.; Hompes, P. G. A.; Mijatovic, V.

2016-01-01

STUDY QUESTION Does hysteroscopic proximal tubal occlusion by intratubal devices as a treatment for hydrosalpinges result in comparable ongoing pregnancy rates following IVF/ICSI when compared with laparoscopic salpingectomy? SUMMARY ANSWER Hysteroscopic proximal tubal occlusion by intratubal

Hysteroscopic findings in patients with post-menstrual spotting with prior cesarean section

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Valdely Helena Talamonte

2012-03-01

Full Text Available Objective: To identify uterine hysteroscopic findings among patientswith prior cesarean section and whom had post-menstrual bleedingspotting type. Methods: We conducted a descriptive and prospective study between June 2008 and December 2009 involving women admitted to our clinic in Ji-Paraná (RO, Brazil, and who complained of prolonged genital bleeding after menstrual period. A total of 20 women with the simultaneous following characteristics were selected: at least one prior cesarean section, aged between 18 and 45 years, no use of hormonal contraceptives, and no history of uterine surgery that could change the cavity anatomy. All participants underwent a hysteroscopic examination. Results: During hysteroscopy, in 90% of the patients, the presence of a cesarean section scar was observed in the last third of the cervix. This scarring causes an anomaly in the uterine cavity anatomy, characterized by the viewing of an enlargement followed by a retraction of the anterior wall, which affords the presence of a pseudocavity with depth and lumen narrowing in variable degrees. Two patients did not present the pseudocavity. Conclusion: Pseudocavities in cesarean section scar are usually found in hysteroscopic examination of patients with prior cesarean section and abnormal uterine spotting.

Efficacy of Essure hysteroscopic sterilization--5 years follow up of 1200 women.

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Ríos-Castillo, José E; Velasco, Esther; Arjona-Berral, José E; Monserrat Jordán, José A; Povedano-Cañizares, Balbino; Castelo-Branco, Camil

2013-06-01

To assess the efficacy of the Essure hysteroscopic birth control device after 5 years follow up. Retrospective analysis of case series. Outpatient hysteroscopy facility in a large teaching hospital. One-thousand three-hundred and twenty-one women who underwent hysteroscopic sterilization with Essure device (Conceptus, Inc., Mountain View, CA) between January 2003 and May 2005. Hysteroscopic tubal sterilization using Essure system. Efficacy/effectiveness, failure rate. Satisfactory insertion was accomplished in the first attempt in 1166 women (97.16%). After the second attempt, successful insertion rate rise to 98.6%. (n = 31, 2.6%). Three pregnancies had been reported after 5 years follow up, which implies an overall absolute rate of 0.25%. This represents a Pearl index of 0.05 after 72,000 months of surveillance. All of them occurred in the first year of use of the microinsert. There has been no unintended pregnancy in the next 4 years. Essure has the lowest Pearl index never published being the most effective permanent birth control system to date. Unintended pregnancies tend to occur in the first year after the insertion, and can be avoided encouraging women to accomplish the protocol.

Hysteroscopic management of a stenotic cervix.

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Suen, Michael W H; Bougie, Olga; Singh, Sukhbir S

2017-06-01

To demonstrate an approach to the hysteroscopic management of a stenotic cervix. Step-by-step explanation of the techniques using video and animation (educational video). Academic tertiary level referral center. Patients with cervical stenosis, inclusive of both reproductive age and postmenopausal women. Gynecologists require intrauterine access for many procedures, but a stenotic cervix can obstruct surgery. Blind dilation of a stenotic cervix can lead to a cervical laceration or uterine perforation, with concomitant complications. The hysteroscopic management of a stenotic cervix includes optimizing the surgical environment, performing vaginoscopy and "no-touch" hysteroscopy, and revision of the cervical canal. Revision can be performed using microscissors, micrograspers, or a cutting loop electrode. Partial cervical canal excision to aid in hysteroscopy access should be reserved in women who are not interested in future pregnancy or those who are postmenopausal. Outpatient hysteroscopy uses smaller instruments and shows operative success with patient satisfaction. Although these techniques are demonstrated in an outpatient hysteroscopy setting, they can be adapted for use in an operating theater. The individual steps and approach are emphasized. Intrauterine access can be achieved with various techniques. The "see-and-treat" approach demonstrated in this video can allow access into the uterine cavity despite a stenotic cervix. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Management of long-term and reversible hysteroscopic sterilization: a novel device with nickel-titanium shape memory alloy

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2014-01-01

Background Female sterilization is the second most commonly used method of contraception in the United States. Female sterilization can now be performed through laparoscopic, abdominal, or hysteroscopic approaches. The hysteroscopic sterilization may be a safer option than sterilization through laparoscopy or laparotomy because it avoids invading the abdominal cavity and undergoing general anaesthesia. Hysteroscopic sterilization mainly includes chemical agents and mechanical devices. Common issues related to the toxicity of the chemical agents used have raised concerns regarding this kind of contraception. The difficulty of the transcervical insertion of such mechanical devices into the fallopian tubes has increased the high incidence of device displacement or dislodgment. At present, Essure® is the only commercially available hysteroscopic sterilization device being used clinically. The system is irreversible and is not effective immediately. Presentation of the hypothesis Our new hysteroscopic sterility system consists of nickel-titanium (NiTi) shape memory alloy and a waterproof membrane. The NiTi alloy is covered with two coatings to avoid toxic Ni release and to prevent stimulation of epithelial tissue growth around the oviducts. Because of the shape memory effect of the NiTi alloy, the device works like an umbrella: it stays collapsed at low temperature before placement and opens by the force of shape memory activated by the body temperature after it is inserted hysteroscopically into the interstitial tubal lumen. The rim of the open device will incise into interstitial myometrium during the process of unfolding. Once the device is fixed, it blocks the tube completely. When the patient no longer wishes for sterilization, the device can be closed by perfusing liquid with low temperature into the uterine cavity, followed by prospective hysteroscopic removal. After the device removal, the fallopian tube will revert to its physiological functions. Testing the

A systematic review and meta-analysis of randomized controlled trials comparing hysteroscopic morcellation with resectoscopy for patients with endometrial lesions.

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Li, Chunbo; Dai, Zhiyuan; Gong, Yuping; Xie, Bingying; Wang, Bei

2017-01-01

Results on the efficacy of hysteroscopic morcellation for patients with endometrial lesions remain conflicting. To compare hysteroscopic morcellation with conventional resectoscopy for removal of endometrial lesions. Electronic databases were searched for reports published up to February 1, 2016, using terms such as "morcellator," "morcellators," "morcellate," "morcellation," "morcellated," "hysteroscopy," "hysteroscopy," "uteroscope," and "transcervical." Randomized controlled trials were included if they assessed success rate, procedure speed, complications, tolerability, and/or learning curve. Data were extracted by two independent reviewers and a meta-analysis was performed. Four trials including 392 patients were analyzed. Successful removal of all endometrial lesions was more frequent with hysteroscopic morcellation than conventional resectoscopy (odds ratio 4.49, 95% confidence interval [CI] 1.94-10.41; Physteroscopic morcellation (mean difference -4.94 minutes, 95% CI -7.20 to -2.68; Plearning curve. In one study, hysteroscopic morcellation was acceptable to more patients (P=0.009). Hysteroscopic morcellation is associated with a higher operative success rate and a shorter operative time among patients with endometrial lesions than is resectoscopy. More high-quality trials are required to validate these results. © 2016 International Federation of Gynecology and Obstetrics.

Concomitant hysteroscopic endometrial ablation and Essure procedure: feasibility, efficacy and satisfaction.

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Levy-Zauberman, Y; Legendre, G; Nazac, A; Faivre, E; Deffieux, X; Fernandez, H

2014-07-01

Hysteroscopic endometrial destruction procedures for abnormal uterine bleeding are an alternative to hysterectomy. Such procedures are not contraceptive and are performed on fertile patients, requiring long-term contraception. This is the first study evaluating long-term results of a combined procedure associating endometrial destruction and concomitant hysteroscopic tubal sterilization by Essure(®) micro-inserts. Our goal is to evaluate efficacy of endometrial destruction as well as hysteroscopic sterilization and satisfaction after a combined procedure in the case of abnormal uterine bleeding in non-menopausal patients. This is a retrospective study (Canadian task force II-2) that includes 131 patients operated with combined endometrial destruction and hysteroscopic tubal sterilization between 2002 and 2011 at our university hospital. The patients were contacted to answer a questionnaire. Statistical analysis was performed with SAS© version 9.2. (SAS Institute Inc., Cary, NC). Ninety-three patients out of 131 could be reached. The mean follow-up was of 37.8 months (min=8, max=87, SD=6.2). Thirty-eight patients (29%) were lost to follow-up. Essure(®) micro-inserts introduction success rate (evaluated on 131 patients) was 95.8%, and their position was appropriate in 81.1% of the 106 patients with position control. Efficacy of the procedure on the haemorrhagic symptoms (evaluated on 93 patients) was 80.6%. Twelve patients (12.9%) underwent a hysterectomy, 7 of which (58.3%) were a direct consequence of treatment failure. No pregnancies were reported. Satisfaction rate was of 90.3%. Inadequate position rates of the micro-inserts after 3 months seem somewhat above literature findings, though no pregnancy has been reported. However, recurrent bleeding symptoms and hysterectomy rates are consistent with those observed after an endometrial destruction procedure alone. Limitations are the limited number of patients, the bias inherent to retrospective studies (lost of

Complications of hysteroscopic Essure(®) sterilisation: report on 4306 procedures performed in a single centre.

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Povedano, B; Arjona, J E; Velasco, E; Monserrat, J A; Lorente, J; Castelo-Branco, C

2012-06-01

To analyse the short-, medium- and long-term complications in women undergoing hysteroscopic tubal sterilisation with the Essure(®) device. Retrospective 7-year study. Office hysteroscopic unit in a teaching hospital. A total of 4306 women whoe underwent the Essure(®) sterilisation procedure from 2003 to 2010. Data on the success of the procedure and complications arising from outpatient hysteroscopic sterilisation using the Essure(®) system were collected from consecutive women undergoing the procedure over a 7-year period. Placement rate, successful bilateral tubal occlusion, perioperative adverse events, early postoperative (during the first 3 months of follow-up) and late complications (after the initial 3 months of follow-up). A total of 4108 (96.8%) women completed the standard 3-month follow-up protocol. Only 534 (13%) women had undergone the procedure within the previous year. There were 115 (out of 4306; 2.7%) recorded complications, none of which resulted in the need for hospitalisation or discharge later than 2 hours after the procedure. Vasovagal syncope was the most frequently encountered adverse event, occurring in 85 (2.0%) of 4306 cases. In 19 cases, one device was expelled, with most expulsions (14 out of 19) being detected before or during the 3-month follow-up. Outpatient hysteroscopic sterilisation using the Essure(®) system is safe, with a low rate of complications. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

HISTOSPECTROPHOTOMETRICAL AND IMMUNOHISTOCHEMISTRICAL RESEARCH OF RENAL INTRATUBULAR NEOPLASIA IN PERITUMOUROUS ZONE OF A RENAL CARCINOMA

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T. M. Cherdantseva

2012-01-01

Full Text Available In this work displays renal intratubular neoplasia (RIN in peritumourous zone of a renal carcinoma have been studied. The object of our work, are the operative materials of 42 patients. Middle age of patients has made 57,4 ± 1,4 year. Men was 25, women — 17. Characteristic of tubular epithelium in PZ a renal carcinoma have been studied morphofunctional by means of histological, histospectrophotometrical and immunohistochemistrical methods. It is shown, that in PZ tumors of a high degree displays, of RIN much more often, than in tumors of low degree anaplasia. In tumors of a high degree anaplasia in tubular epithelium PZ registered increasing of nucleus, ploidy and expression of AgNORs, Ki-67, p53 and bcl-2. The presence of displays RIN in tubular epithelium PZ at a renal carcinoma should be considered at surgery operations.

HISTOSPECTROPHOTOMETRICAL AND IMMUNOHISTOCHEMISTRICAL RESEARCH OF RENAL INTRATUBULAR NEOPLASIA IN PERITUMOUROUS ZONE OF A RENAL CARCINOMA

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T. M. Cherdantseva

2014-08-01

Full Text Available In this work displays renal intratubular neoplasia (RIN in peritumourous zone of a renal carcinoma have been studied. The object of our work, are the operative materials of 42 patients. Middle age of patients has made 57,4 ± 1,4 year. Men was 25, women — 17. Characteristic of tubular epithelium in PZ a renal carcinoma have been studied morphofunctional by means of histological, histospectrophotometrical and immunohistochemistrical methods. It is shown, that in PZ tumors of a high degree displays, of RIN much more often, than in tumors of low degree anaplasia. In tumors of a high degree anaplasia in tubular epithelium PZ registered increasing of nucleus, ploidy and expression of AgNORs, Ki-67, p53 and bcl-2. The presence of displays RIN in tubular epithelium PZ at a renal carcinoma should be considered at surgery operations.

Use of Hysterosalpingo-Foam Sonography for Assessment of the Efficacy of Essure Hysteroscopic Sterilization.

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Rosič, Maja; Žegura, Branka; Vadnjal Đonlagić, Sabina

2018-01-18

Hysterosalpingo-foam sonography (HyFoSy) has been suggested to be a possible less invasive alternative to hysterosalpingography (HSG), which is the reference standard for confirmation of tubal occlusion after Essure (Bayer AG, Leverkusen, Germany) hysteroscopic sterilization. The purpose of our study was to evaluate the accuracy of HyFoSy compared to HSG for confirmation of tubal occlusion after Essure hysteroscopic sterilization. A prospective study included 90 patients who underwent Essure hysteroscopic sterilization. Twelve weeks after the sterilization, 2-dimensional transvaginal ultrasonography was performed to assess the microinsert position and was followed by HyFoSy and HSG for evaluation of tubal occlusion. Patients with patent fallopian tubes on HSG were scheduled for additional HSG procedures at 3-month intervals until tubal occlusion was documented. Of 90 enrolled patients, 86 patients with 170 fallopian tubes underwent the complete imaging protocol. Tubal occlusion was evaluated by HyFoSy as an index test and HSG as a reference standard. The accuracy of HyFoSy was 97.1% (95% confidence interval [CI], 93%-99%). The sensitivity and specificity were 100% (95% CI, 97%-100%) and 54.6% (95% CI, 23%-83%), whereas the positive and negative predictive values were 97.0% (95% CI, 93%-99%) and 100% (95% CI, 42%-100%), respectively. No long-term complications were reported for HyFoSy or HSG. Given that the concordance rate for tubal occlusion between HyFoSy and HSG was not 100%, an occluded fallopian tube on HyFoSy should be confirmed by HSG, which remains the reference standard for confirmation of tubal occlusion after Essure hysteroscopic sterilization. © 2018 by the American Institute of Ultrasound in Medicine.

Intracavitary deposits on Essure® hysteroscopic sterilization devices : A case report

NARCIS (Netherlands)

Maassen, L. W.; van Gastel, Maatje D A; Lentjes, E. G.W.M.; Bongers, M. Y.; Veersema, S.

2017-01-01

Objective To study the composition of intracavitary deposits on Essure® hysteroscopic sterilization devices. Design Case report. Setting Reproductive Medicine and Gynecology department of a University Hospital. Patient(s) A 39 years old patient presenting with a request for surgical removal of

The HysNiche trial: hysteroscopic resection of uterine caesarean scar defect (niche) in patients with abnormal bleeding, a randomised controlled trial.

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Vervoort, A J M W; Van der Voet, L F; Witmer, M; Thurkow, A L; Radder, C M; van Kesteren, P J M; Quartero, H W P; Kuchenbecker, W K H; Bongers, M Y; Geomini, P M A J; de Vleeschouwer, L H M; van Hooff, M H A; van Vliet, H A A M; Veersema, S; Renes, W B; van Meurs, H S; Bosmans, J; Oude Rengerink, K; Brölmann, H A M; Mol, B W J; Huirne, J A F

2015-11-12

A caesarean section (CS) can cause a defect or disruption of the myometrium at the site of the uterine scar, called a niche. In recent years, an association between a niche and postmenstrual spotting after a CS has been demonstrated. Hysteroscopic resection of these niches is thought to reduce spotting and menstrual pain. However, there are no randomised trials assessing the effectiveness of a hysteroscopic niche resection. We planned a multicentre randomised trial comparing hysteroscopic niche resection to no intervention. We study women with postmenstrual spotting after a CS and a niche with a residual myometrium of at least 3 mm during sonohysterography. After informed consent is obtained, eligible women will be randomly allocated to hysteroscopic resection of the niche or expectant management for 6 months. The primary outcome is the number of days with postmenstrual spotting during one menstrual cycle 6 months after randomisation. Secondary outcomes are menstrual characteristics, menstruation related pain and experienced discomfort due to spotting or menstrual pain, quality of life, patient satisfaction, sexual function, urological symptoms, medical consultations, medication use, complications, lost productivity and medical costs. Measurements will be performed at baseline and at 3 and 6 months after randomisation. A cost-effectiveness analysis will be performed from a societal perspective at 6 months after randomisation. This trial will provide insight in the (cost)effectiveness of hysteroscopic resection of a niche versus expectant management in women who have postmenstrual spotting and a niche with sufficient residual myometrium to perform a hysteroscopic niche resection. Dutch Trial Register NTR3269 . Registered 1 February 2012. ZonMw Grant number 80-82305-97-12030.

Retrospective cost analysis comparing Essure hysteroscopic sterilization and laparoscopic bilateral tubal coagulation.

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Hopkins, Matthew R; Creedon, Douglas J; Wagie, Amy E; Williams, Arthur R; Famuyide, Abimbola O

2007-01-01

To compare the institutional cost of permanent female sterilization by Essure hysteroscopic sterilization and laparoscopic bilateral coagulation. Retrospective cohort study (Canadian Task Force classification II-2). Midwestern academic medical center. Women of reproductive age who elected for permanent contraception by the Essure method (n = 43) or by laparoscopic tubal coagulation (n = 44) during the time frame studied. Placement of the Essure inserts according to the manufacturer's instructions or laparoscopic tubal sterilization using bipolar forceps according to standard techniques of open or closed laparoscopy. Cost-center data for the institutional cost of the procedure was abstracted for each patient included in the study. In addition, demographic data and procedural information were obtained and compared for the patient populations. The Essure system of hysteroscopic sterilization had a significantly decreased cost compared with laparoscopic tubal sterilization when both procedures were performed in an operating room setting. The decrease per patient in institutional cost was 180 dollars (p = .038). This included the cost of the confirmatory hysterosalpingogram 3 months after Essure placement and the cost of laparoscopic tubal occlusion by Filshie clip if the Essure micro-inserts could not be placed. The majority of the cost was related to hospital costs as opposed to physician costs. The Essure procedure had higher costs for disposable equipment (p Essure hysteroscopic sterilization had significant cost savings compared with laparoscopic tubal sterilization (p = .038). We believe that our data represent the minimum of potential savings using this approach, and future developments will only increase the cost difference found in our study.

A prospective randomized study comparing unipolar versus bipolar hysteroscopic myomectomy in infertile women

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Kallol K Roy

2017-01-01

Full Text Available Study Objective: To compare the operative and reproductive outcome of hysteroscopic myomectomy using unipolar resectoscope versus bipolar resectoscope in patients with infertility and menorrhagia. Design: Randomized, prospective, parallel, comparative, single-blinded study. Design Classification: Canadian Task Force classification I. Setting: Tertiary care institute. Patients: Sixty women with submucous myoma and infertility. Interventions: Hysteroscopic myomectomy performed with unipolar resectoscope or bipolar resectoscope. Measurements: Primary outcome measures were the pregnancy-related indicators. Secondary outcome measures were the operative parameters, harmful outcomes related to the procedure, and comparison of improvement levels in the menstrual pattern after surgery between the two groups. Main Results: A total of 60 patients were randomized into two groups of equal size. Baseline characteristics were not significantly different between the two groups. Reduction in sodium level from pre- to postsurgery was significantly (P = 0.001 higher in the unipolar group. Nine patients (30% in the unipolar group had hyponatremia in the postoperative period compared to none in the bipolar group (P = 0.002. However, there was no significant difference in the other operative parameters between the two groups. In both the groups, a significant improvement in the menstrual symptoms was observed after myomectomy. Pregnancy-related outcomes were similar in both the groups. Conclusion: The use of bipolar resectoscope for hysteroscopic myomectomy is associated with lesser risk of hyponatremia compared to unipolar resectoscope. Bipolar resectoscopic myomectomy is found to be an effective and safer alternative to unipolar resectoscopy with similar reproductive outcome.

The spring balance: a simple monitoring system for fluid overload during hysteroscopic surgery

NARCIS (Netherlands)

Ankum, W. M.; Vonk, J.

1994-01-01

Fluid overload may arise during hysteroscopic surgery, caused by absorption of fluid used to distend the uterus. Continuous monitoring of the fluid balance is required to prevent this serious complication. Commercial equipment does not serve this purpose adequately. We describe a simple solution. We

Resection of Cesarean Scar Pregnancy at Six Weeks of Gestation with Laminaria Cervical Dilatation under Sonographic and Hysteroscopic Guidance

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Tatsuji Hoshino

2015-01-01

Full Text Available In cases of fetal heartbeat- (FHB- positive cesarean scar pregnancy (CSP, the embryo and placenta grow rapidly week by week. We experienced an FHB-positive CSP case at 6 weeks of gestation and assessed the CSP in detail with transvaginal ultrasound and transabdominal ultrasound (TAUS, preoperatively. We performed Laminaria cervical dilatation under TAUS guidance and performed hysteroscopic resection of the pregnancy conceptus and curettage under hysteroscopic and TAUS guidance. We identified the gestational sac attached to the cesarean scar pouch with small plane, decidua basalis, and chorionic villi and present the clinical history and other findings. We also reviewed the related literature and found 76 previous studies, with six cases of FHB-positive CSP that contained hysteroscopic color images of the CSP. We present a review of selected cases. The implantation site was the anterior wall in almost all cases. Cervical dilatation was mainly performed using a Hegar dilator; ours was the only case using Laminaria dilatation. Transcervical resections were performed mainly under ultrasound guidance, with only one case undergoing laparoscopy. Electrocoagulation was performed in three of the six cases.

Confirmation test for hysteroscopic sterilization: a descriptive study of patient tolerability and impressions

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Chapa HO

2013-03-01

Full Text Available Hector O Chapa, Gonzalo VenegasDepartment of Obstetrics and Gynecology, Methodist Medical and Women’s Specialty Center, Dallas, TX, USABackground: This retrospective descriptive study describes patient follow-up and tolerability of the post-hysteroscopic sterilization confirmation test.Methods: Recruitment for the original sterilization procedure was from January 2008 to March 2009; subsequent confirmation test (hysterosalpingogram capture was from March 2008 to July 2009. Patients were given a 10 cm visual analog pain scale during the hysteroscopic sterilization procedure, and took the scale with them as a take-home sheet. Following hysterosalpingography (HSG, patients received a follow-up phone call within 24 hours, and were asked to rate their pain during the hysterosalpingogram as well as during the first 2 hours following the test.Results: Eighty-nine hysteroscopic sterilizations were performed under local paracervical block and oral nonsteroidal medication. The median immediate post-sterilization visual analog pain score was 1.9 (range 1.7–2.1, 95% confidence interval [CI] 1.3–1.5. Of the 89 sterilization procedures, 79% (n = 70 patients underwent a confirmation test using HSG. Ten percent (n = 7 of the hysterosalpinograms were performed at least 3 months after sterilization (mean 17 [range 14–20] weeks. Median intratest visual analog pain score overall (n = 70 was 1.8 (range 1.6–1.9, 95% CI 1.5–1.9. Following the test, the median visual analog pain score was 1.7 (range 1.6–1.9, 95% CI 1.4–0.18. Of the 70 patients who participated in visual analog pain score capture, 64 had a paper copy of the scale had six had it via email. Of the 19 who did not complete hysterosalpinography, five were lost to follow-up. Reasons given by the remaining 14 for noncompliance with hysterosalpinography were: a busy schedule/childcare issues (62%, fear of the test (13%, trust in the sterilization procedure alone (13%, and forgetting the

Learning curve of hysteroscopic placement of tubal sterilization microinserts in 15 gynecologists in the Netherlands.

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Janse, Juliënne A; Pattij, Thyrza O S; Eijkemans, Marinus J C; Broekmans, Frank J; Veersema, Sebastiaan; Schreuder, Henk W R

2013-09-01

To evaluate the learning curve of hysteroscopic placement of tubal sterilization microinserts by gynecologists in the Netherlands. Prospective multicenter study (Canadian Task Force II-2). Ten community (teaching) hospitals in the Netherlands. A total of 631 women who underwent permanent sterilization by tubal microinserts. Hysteroscopic placement of tubal sterilization microinserts performed by 15 gynecologists experienced in performing operative hysteroscopy, starting from their very first placement. Effect of increasing experience in time on procedure time, pain score, successful bilateral placement, and complications. Bilateral successful placement with confirmation of adequate positioning at follow-up evaluation was achieved in 480 (76.1%) patients at first attempt and in 44 (7.0%) at second attempt. Median procedure time was 8.0 minutes (range: 3-40), and 31 (4.9%) patients were lost to follow-up evaluation. Gravidity showed to be a confounding factor and was consequently adjusted for. A learning curve was seen in a statistically significant decrease of procedure time with increasing experience. The decrease in procedure time extended to 11 to 15 cases and was followed by a plateau phase of the subsequent 60 cases. In contrast, pain scores, successful placement, and complication rate appeared not to improve with increasing experience. A learning curve for hysteroscopic tubal sterilization was seen for procedure time, but successful placement, pain score, and complication rate were not clearly influenced by increasing experience. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Intracavitary deposits on Essure® hysteroscopic sterilization devices : A case report

OpenAIRE

Maassen, L. W.; van Gastel, Maatje D A; Lentjes, E. G.W.M.; Bongers, M. Y.; Veersema, S.

2017-01-01

Objective: To study the composition of intracavitary deposits on Essure® hysteroscopic sterilization devices. Design: Case report. Setting: Reproductive Medicine and Gynecology department of a University Hospital. Patient(s): A 39 years old patient presenting with a request for surgical removal of Essure® sterilization devices. Diagnostic hysteroscopy showed a crystal like white deposit attached to one of the devices. Intervention: Diagnostic hysteroscopy and surgical removal of E...

MRI findings of intracranial cystic meningiomas

International Nuclear Information System (INIS)

Zhang, D.; Hu, L.-B.; Zhen, J.W.; Zou, L.-G.; Feng, X.-Y.; Wang, W.-X.; Wen, L.

2009-01-01

Aim: To report the magnetic resonance imaging (MRI) features of intracranial cystic meningiomas and compare these features in intra- and peritumoural cyst groups. Materials and methods: Fourteen cases of peritumoural cystic meningiomas were compared with 18 cases of intratumoural cystic meningiomas. All patients were examined using non-enhanced and contrast-enhanced MRI. Tumour location, tumour size, signal intensity, enhancement characteristics, and cystic changes were assessed. The MRI features were compared between the intra- and peritumoural cyst groups. Results: Most cystic meningiomas comprised two or more cysts. The solid parts of the tumours showed moderate or marked enhancement after the injection of contrast material. An enhanced cyst wall was found in six out of 14 cases in the peritumoural cyst group, but not in the intratumoural cyst group. Peritumoural cystic meningiomas were predominately located in the cerebral falx, whereas the intratumoural cystic meningiomas were predominantly found in frontal convexity (X 2 = 7.434, p = 0.024). The cysts were larger in the peritumoural cyst group than in the intratumoural cyst group (t = 5.274, p = 0.0258). Peritumoural oedema was more commonly found in the intratumoural cyst group (X 2 = 6.863, p = 0.008). Cystic meningiomas with solid parts located inside the cyst are reported for the first time. Conclusion: Cystic meningiomas, although uncommon, should be differentiated from other cystic intracranial lesions. Peri- and intratumoural cystic meningiomas have distinct MRI features. The present study provides the first report of two lesions with solid parts located inside the cyst, as well as one lesion with a calcified solid nodule and haemorrhage within the cyst.

Hysteroscopic sterilization using a virtual reality simulator: assessment of learning curve.

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Janse, Juliënne A; Goedegebuure, Ruben S A; Veersema, Sebastiaan; Broekmans, Frank J M; Schreuder, Henk W R

2013-01-01

To assess the learning curve using a virtual reality simulator for hysteroscopic sterilization with the Essure method. Prospective multicenter study (Canadian Task Force classification II-2). University and teaching hospital in the Netherlands. Thirty novices (medical students) and five experts (gynecologists who had performed >150 Essure sterilization procedures). All participants performed nine repetitions of bilateral Essure placement on the simulator. Novices returned after 2 weeks and performed a second series of five repetitions to assess retention of skills. Structured observations on performance using the Global Rating Scale and parameters derived from the simulator provided measurements for analysis. The learning curve is represented by improvement per procedure. Two-way repeated-measures analysis of variance was used to analyze learning curves. Effect size (ES) was calculated to express the practical significance of the results (ES ≥ 0.50 indicates a large learning effect). For all parameters, significant improvements were found in novice performance within nine repetitions. Large learning effects were established for six of eight parameters (p learning curve established in this study endorses future implementation of the simulator in curricula on hysteroscopic skill acquisition for clinicians who are interested in learning this sterilization technique. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

Hysteroscopic outpatient metroplasty to expand dysmorphic uteri (HOME-DU technique): a pilot study.

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Di Spiezio Sardo, A; Florio, P; Nazzaro, G; Spinelli, M; Paladini, D; Di Carlo, C; Nappi, C

2015-02-01

The new classification system of uterine anomalies from the European Society of Human Reproduction and Embryology and the European Society for Gynaecological Endoscopy defines T-shaped and tubular-shaped infantilis uteri as 'dysmorphic'. Such malformations have been proven to be associated with poor reproductive performance. A prospective observational study was conducted with 30 infertile women with dysmorphic uterus who underwent the novel Hysteroscopic Outpatient Metroplasty to Expand Dysmorphic Uteri (HOME-DU ) technique. Incisions are made on the uterine walls with a 5 Fr bipolar electrode. The procedure was conducted in outpatients under conscious sedation, using a 5-mm office hysteroscope. The technique was successful in all cases without complications. A net increase of uterine volume was found, as measured at hysteroscopy and three-dimensional transvaginal ultrasound (P dysmorphic uteri. Although the cohort was small, pregnancy and live births outcomes were favourable in this poor-prognosis group, implying desirable benefits, which should be compared with other techniques. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Unilateral placement of the Adiana device after failed bilateral placement of the Essure device for hysteroscopic sterilization.

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Gimpelson, Richard J; Wagner, Corey A

2010-01-01

This case report outlines the successful completion of hysteroscopic sterilization using the Adiana Permanent Contraception device (Hologic, Inc., Bedford, MA) after failure of multiple attempts to bilaterally place the Essure Permanent Birth Control system (Conceptus Inc., Mountain View, CA). The patient desired hysteroscopic sterilization using the Essure system. Although the first coil was easily placed in the right ostium, the second coil could not be passed beyond 2.4 cm into the left ostium. Inasmuch as the Adiana system needs to be passed only 1.4 cm into the ostium, this was found to be adequate for appropriate placement of the implant. Adiana may be an effective alternative to Essure, especially in patients in whom tubal stricture or spasm prevents Essure placement. Copyright © 2010 AAGL. Published by Elsevier Inc. All rights reserved.

Assessment of Risk Factors of Intrauterine Adhesions in Patients With Induced Abortion and the Curative Effect of Hysteroscopic Surgery.

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Mo, Xiaoliang; Qin, Guirong; Zhou, Zhoulin; Jiang, Xiaoli

2017-10-03

To explore the risk factors for intrauterine adhesions in patients with artificial abortion and clinical efficacy of hysteroscopic dissection. 1500 patients undergoing artificial abortion between January 2014 and June 2015 were enrolled into this study. The patients were divided into two groups with or without intrauterine adhesions. Univariate and Multiple logistic regression were conducted to assess the effects of multiple factors on the development of intrauterine adhesions following induced abortion. The incidence rate for intrauterine adhesions following induced abortion is 17.0%. Univariate showed that preoperative inflammation, multiple pregnancies and suction evacuation time are the influence risk factors of intrauterine adhesions. Multiple logistic regression demonstrates that multiple pregnancies, high intrauterine negative pressure, and long suction evacuation time are independent risk factors for the development of intrauterine adhesions following induced abortion. Additionally, intrauterine adhesions were observed in 105 mild, 80 moderate, and 70 severe cases. The cure rates for these three categories of intrauterine adhesions by hysteroscopic surgery were 100.0%, 93.8%, and 85.7%, respectively. Multiple pregnancies, high negative pressure suction evacuation and long suction evacuation time are independent risk factors for the development of intrauterine adhesions following induced abortions. Hysteroscopic surgery substantially improves the clinical outcomes of intrauterine adhesions.

Reproducibility of the interpretation of pelvic x-ray 3 months after hysteroscopic sterilization with Essure.

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Veersema, Sebastiaan; Mol, Ben W J; Brölmann, Hans A M

2010-09-01

To estimate the diagnostic accuracy and the interobserver reproducibility of pelvic x-rays in the diagnosis of successful bilateral sterilization with Essure after a 3-month follow-up period. Interobserver study. Outpatient department of obstetrics and gynecology in a Dutch teaching hospital. Patients with successful bilateral Essure placement. Hysteroscopic sterilization with Essure and pelvic x-ray and hysterosalpingography after a 3-month follow-up period. Six observers evaluations of 47 pelvic x-rays from 47 patients 3 months after a technical successful bilateral placement of microinserts to estimate the reliability of the sterilization. Diagnostic accuracy of pelvic x-ray per observer in detecting incorrectly positioned microinserts was expressed in terms of sensitivity and specificity, with hysterosalpingography as the reference strategy. Reproducibility of the interpretation of the pelvic x-ray was expressed as kappa-values. The sensitivity and specificity for x-rays read by gynecologists was 0.67 (95% confidence interval [CI], 0.29-0.96) and 0.79 (95% CI, 0.58-1.00) and for radiologists 1.0 and 0.5 (95% CI, 0.36-0.64). The interobserver agreement in reliability of pelvic x-ray of hysteroscopic sterilization assessment with Essure ranged from slight (kappa-value=0.09) for gynecologists to moderate (kappa-value=0.52) for radiologists. Test characteristics of pelvic x-ray as the imaging technique to assess the position of the Essure microinserts and tubal patency were poor, as was the reproducibility, particularly if gynecologists performed the evaluation. We do not recommend the use of pelvic x-ray for the assessment of the positioning of microinserts after hysteroscopic sterilization. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Management of complications encountered with Essure hysteroscopic sterilization: a systematic review.

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Adelman, Marisa R; Dassel, Mark W; Sharp, Howard T

2014-01-01

Essure hysteroscopic sterilization has been US Food and Drug Administration-approved in the United States since 2002. Complications associated with the Essure device include improper placement (malpositioning), unintended pregnancy, pain, infection, and nickel allergy. The rarity of complications, compounded by underreporting, makes it difficult to determine best practices insofar as management. This systematic review synthesizes the national and global experience with management of Essure-related complications and suggests treatment options when data allow. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

Modified hysteroscopic myomectomy of large submucous fibroids.

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Darwish, Atef

2003-01-01

To compare the efficacy, feasibility, operative time and possible complications of a modified technique of hysteroscopic removal of large submucus myomata versus traditional morcellation technique, and to assess the efficacy of preoperative sonohysterography (SHG). A prospective comparative study. Gynecologic Endoscopy Unit, Assiut University Hospital, Assiut, Egypt. One hundred forty-two women of childbearing age with a clinical and transvaginal sonographic diagnosis of large solitary submucous myomata (>3 cm in diameter) with or without an intramural element. The patients were divided into two groups. In group A (65 patients), a modified resectoscopic technique was used where the base of the myoma was excised followed by ring forceps extraction after misoprostol priming. In group B (77 patients), the myoma was cut using traditional resectoscopic morcellation. For each patient, operating time, intra- and postoperative complications and feasibility of the procedure were recorded. The accuracy of preoperative SHG in localizing submucous myoma and detecting intramural extension was assessed by diagnostic hysteroscopy. Transvaginal SHG showed good agreement with hysteroscopy in localizing submucous myomata and detecting intramural extension (k = 0.83). The operating time was significantly shorter in group A (15.6 +/- 3.02 min) than in group B (28.9 +/- 4.3 min). The procedure was completed in 60 (92%) and 51 patients (66%), whereas a second session was required in 2 (3%) and 20 patients (25.9%) in both groups respectively. Glycine volume was highly significantly less in group A (2.3 +/- 0.86 vs. 6.3+/- 1.7 liters, p = 0.001). Intraoperative complications were encountered in 9 (13.8%) and 22 patients (28.5%) in both groups respectively (p = 0.03). Cervical laceration was diagnosed in 3 cases (4.6%) in group A. Postoperative visual disturbances were diagnosed in 4 cases (5%) in group B. Hysteroscopic resection of large submucous myomata with minimal intramural

Hysteroscopic proximal tubal occlusion versus laparoscopic salpingectomy as a treatment for hydrosalpinges prior to IVF or ICSI: an RCT.

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Dreyer, K; Lier, M C I; Emanuel, M H; Twisk, J W R; Mol, B W J; Schats, R; Hompes, P G A; Mijatovic, V

2016-09-01

Does hysteroscopic proximal tubal occlusion by intratubal devices as a treatment for hydrosalpinges result in comparable ongoing pregnancy rates following IVF/ICSI when compared with laparoscopic salpingectomy? Hysteroscopic proximal tubal occlusion by intratubal devices is inferior to laparoscopic salpingectomy in the treatment of hydrosalpinges in women undergoing IVF/ICSI with respect to ongoing pregnancy rates. It is known that women with hydrosalpinges undergoing IVF have poorer pregnancy outcomes compared with women with other forms of tubal infertility. In these women, both laparoscopic salpingectomy and laparoscopic proximal tubal ligation are known to improve IVF outcomes. At present, it is unclear whether a less-invasive hysteroscopic treatment with intratubal devices leads to similar ongoing pregnancy rates following IVF when compared with laparoscopic salpingectomy. A two-centre, randomized, controlled, non-inferiority trial. Between October 2009 and December 2014 a total of 85 women were included in this study; of whom, 42 were randomized to hysteroscopic proximal occlusion by intratubal device placement and 43 were randomized to laparoscopic salpingectomy. Randomization was based on a computer-generated randomization list. The study was unblinded. The primary outcome was ongoing pregnancy rate, defined as a fetal heartbeat on ultrasound beyond 10-week gestation following one IVF/ICSI treatment (fresh and frozen-thawed embryo transfers). We studied women aged 18-41 years, with uni- or bilateral ultrasound visible hydrosalpinges who were scheduled for an IVF/ICSI treatment. The ongoing pregnancy rates per patient according to the intention-to-treat principle were 11/42 (26.2%) after hysteroscopic proximal occlusion by intratubal devices (intervention group) versus 24/43 (55.8%) after laparoscopic salpingectomy (control group) (P = 0.008) [absolute difference: 26.1%; 95% confidence interval (CI): 0.5-51.7, relative risk (RR): 0.56; 95% CI: 0.31-1.03, P

Analysis of adverse events with Essure hysteroscopic sterilization reported to the Manufacturer and User Facility Device Experience database.

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Al-Safi, Zain A; Shavell, Valerie I; Hobson, Deslyn T G; Berman, Jay M; Diamond, Michael P

2013-01-01

The Manufacturer and User Facility Device Experience database may be useful for clinicians using a Food and Drug Administration-approved medical device to identify the occurrence of adverse events and complications. We sought to analyze and investigate reports associated with the Essure hysteroscopic sterilization system (Conceptus Inc., Mountain View, CA) using this database. Retrospective review of the Manufacturer and User Facility Device Experience database for events related to Essure hysteroscopic sterilization from November 2002 to February 2012 (Canadian Task Force Classification III). Online retrospective review. Online reports of patients who underwent Essure tubal sterilization. Essure tubal sterilization. Four hundred fifty-seven adverse events were reported in the study period. Pain was the most frequently reported event (217 events [47.5%]) followed by delivery catheter malfunction (121 events [26.4%]). Poststerilization pregnancy was reported in 61 events (13.3%), of which 29 were ectopic pregnancies. Other reported events included perforation (90 events [19.7%]), abnormal bleeding (44 events [9.6%]), and microinsert malposition (33 events [7.2%]). The evaluation and management of these events resulted in an additional surgical procedure in 270 cases (59.1%), of which 44 were hysterectomies. Sixty-one unintended poststerilization pregnancies were reported in the study period, of which 29 (47.5%) were ectopic gestations. Thus, ectopic pregnancy must be considered if a woman becomes pregnant after Essure hysteroscopic sterilization. Additionally, 44 women underwent hysterectomy after an adverse event reported to be associated with the use of the device. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

The Intra Uterine Morcellator: a new hysteroscopic operating technique to remove intrauterine polyps and myomas.

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Emanuel, Mark Hans; Wamsteker, Kees

2005-01-01

A new hysteroscopic operating technique was compared retrospectively with conventional resectoscopy. Retrospective comparison (Canadian Task Force Classification II-2). Gynecology department of a university-affiliated teaching hospital. Fifty-five women, 27 with endometrial polyps and 28 with submucous myomas. Patients were treated with a prototype of the Intra Uterine Morcellator (IUM). This cutting device, 35 cm in length, was inserted into a straight working channel of a 90-mm hysteroscope. The major advantages were ease of removal of tissue fragments through the instrument and the use of saline solution instead of electrolyte-free solutions used in monopolar high-frequency resectoscopy. The mean operating time was 8.7 minutes (95% CI: 7.3-10.1) for the removal of endometrial polyps compared with 30.9 minutes (CI: 27.0-34.8) for resectoscopy, and 16.4 minutes (CI: 12.6-20.2) for submucous myomas compared with 42.2 minutes (CI: 39.7-44.7) for resectoscopy. All procedures were uneventful. This new technique is faster, and it appears to be easier to perform. Therefore, it can be expected to result in fewer fluid-related complications and to lead to a shorter learning curve when compared with conventional resectoscopy.

Bipolar hysteroscopic procedures and placement of Essure microinserts for tubal sterilization: a case control study.

Science.gov (United States)

Panel, Pierre; Grosdemouge, Isabelle; Houllier, Marie; Renouvel, Frédérique; Friederich, Ludovic; Le Tohic, Arnaud

2011-06-01

To assess the effectiveness and complication rate with Essure microinsert placements for tubal sterilization and the concomitant bipolar intrauterine surgical procedure. Case control study. Department of gynecology and obstetrics of a general hospital in France. 382 women, including 41 undergoing one or several concomitant uterine procedures with Essure placement, and 341 undergoing Essure placement only (controls). Essure placement with or without bipolar hysteroscopic procedure for polyp, myoma, or endometrial ablation. Success rate for microinsert placement and complications at 3 months. Forty-one patients had Essure microinserts placed in combination with a bipolar hysteroscopic procedure: endometrial resection (n=32), fibroma resection (n=4), or polyp ablation (n=5). They were compared with 341 patients who underwent Essure placement only. The success rate for Essure placement was 97.6% in the combination group versus 97.6% in the control group. The complication rate was 4.9% (n=2) in the combination group versus 2.6% (n=9) in the control group. The difference in the success and complication rates was not statistically significant. Performing intrauterine bipolar resection during hysteroscopy for sterilization is possible without reducing the Essure placement success rate and without increasing morbidity. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Effect of hysteroscopic adhesiolysis combined with growth hormone on endometrial blood flow and volume as well as Smad2/3 expression

Directory of Open Access Journals (Sweden)

Xing-Chan Li

2016-10-01

Full Text Available Objective: To study the effect of hysteroscopic adhesiolysis combined with growth hormone on endometrial blood flow and volume as well as Smad2/3 expression. Methods: A total of 64 patients with moderate or severe intrauterine adhesions who received hysteroscopic adhesiolysis in our hospital from May 2013 to October 2015 were selected as the research subjects and randomly divided into two groups who received different postoperative drug treatment, observation group received postoperative manual cycle intervention combined with growth hormone treatment and control group only received manual cycle intervention. Transvaginal ultrasonography was conducted after treatment to assess endometrial thickness, volume and blood flow, and endometrium was collected to determine Smad2, Smad3 and TGF- β1 levels. Results: After treatment, endometrial blood flow signal of observation group was more abundant than that of control group, ultrasound parameters RI and PI were significantly lower than those of control group, and VI, FI and VFI as well as endometrial thickness and endometrial cavity volume were significantly higher than those of control group; Smad2, Smad3 and TGF-β1 levels in endometrial tissue of observation group after treatment were significantly lower than those of control group. Conclusions: Hysteroscopic adhesiolysis combined with growth hormone therapy can promote endometrial repair and growth, increase endometrial blood flow and volume and also suppress the expression of Smad2/3 and TGF-β1 in patients with intrauterine adhesions.

A Review of Clinical Data for Currently Approved Hysteroscopic Sterilization Procedures

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Basinski, Cindy M

2010-01-01

Two hysteroscopic permanent sterilization procedures are approved for use in the United States: Essure® Permanent Birth Control System (Conceptus Incorporated, Mountain View, CA) and Adiana® Permanent Contraception (Hologic, Inc., Bedford, MA). This review compares the clinical trial data for these procedures. A notable difference is the resultant clinical pregnancy risk. The clinical trials for the Essure procedure have reported no pregnancies in 643 relying women in the 9 years since initiation of the studies. The clinical trial for the Adiana procedure has reported 12 pregnancies in 570 relying women in nearly 5 years of collected data. Other clinical outcome parameters concerning Essure and Adiana are examined in this review. PMID:21364861

Efficacy of Combined Laparoscopic and Hysteroscopic Repair of Post-Cesarean Section Uterine Diverticulum: A Retrospective Analysis

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Cuilan Li

2016-01-01

Full Text Available Background. Diverticulum, one of the long-term sequelae of cesarean section, can cause abnormal uterine bleeding and increase the risk of uterine scar rupture. In this study, we aimed to evaluate the efficacy of combined laparoscopic and hysteroscopic repair, a newly occurring method, treating post-cesarean section uterine scar diverticulum. Methods. Data relating to 40 patients with post-cesarean section uterine diverticulum who underwent combined laparoscopic and hysteroscopic repair were retrospectively analyzed. Preoperative clinical manifestations, size of uterine defects, thickness of the lower uterine segment (LUS, and duration of menstruation were compared with follow-up findings at 1, 3, and 6 months after surgery. Results. The average preoperative length and width of uterine diverticula and thickness of the lower uterine segment were recorded and analyzed. The average durations of menstruations at 1, 3, and 6 months after surgery were significantly shorter than the preoperative one (p<0.05, respectively. At 6 months after surgery, the overall success improvement rate of surgery was 90% (36/40. Three patients (3/40 = 7.5% developed partial improvement, and 1/40 (2.5% was lost to follow-up. Conclusions. Our findings showed that combined treatment with laparoscopy and hysteroscopy was an effective method for the repair of post-cesarean section uterine diverticulum.

Determinants of fertility and reproductive success after hysteroscopic septoplasty for women with unexplained primary infertility: a prospective analysis of 88 cases.

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Shokeir, Tarek; Abdelshaheed, Mahmoud; El-Shafie, Mohamed; Sherif, Lotfy; Badawy, Ahmed

2011-03-01

To evaluate prospectively the effect of hysteroscopic septoplasty as therapy for unexplained primary infertility in women with uterine septum as a sole cause for reproductive failure and to define the factors influencing reproductive success. In a prospective comparative study, we enrolled 103 infertile women with uterine septum as a sole cause for reproductive failure. They had had unexplained primary infertility >2 years and a follow-up >12 months. Uterine anomalies were diagnosed by means of hysterosalpingography (HSG) and 2D-transvaginal sonography (TVS) with intrauterine saline infusion. Hysteroscopic septoplasty was performed in the early follicular phase. Pregnancy rates (PR) according to patient and septum characteristics (septum size) were the main outcome measures. Follow-up was complete for 88 patients. The mean (±SD) age of the patients was 36.1±2.1 years. Forty-two patients became pregnant (40.7%). The mean (±SD) delay in conception was 7.5±2.6 months. Nearly 80% of the pregnant women conceived spontaneously. Of 44 pregnancies in 42 women, 36 live newborns were delivered. The PR was significantly higher in women size larger than one-half of their uterine length the PR was significantly higher than those with septum size uterine septum as a sole cause for reproductive failure seems to depend on patient age, duration of infertility before septoplasty, and septum size. Women with a septum size larger than one-half of their uterine length have a higher chance of successful pregnancy after hysteroscopic septoplasty. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Hysteroscopic hydrosalpinx occlusion with Essure device in IVF patients when salpingectomy or laparoscopy is contraindicated.

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Matorras, Roberto; Rabanal, Aintzane; Prieto, Begoña; Diez, Santiago; Brouard, Iñaki; Mendoza, Rosario; Exposito, Antonia

2013-07-01

To evaluate, in patients with hydrosalpinges, the effect on in vitro fertilization (IVF) outcome of the insertion by hysteroscopy of an intratubal blocking device, in cases where laparoscopic salpingectomy or laparoscopy was contraindicated. A prospective interventional case series study was conducted in fifteen women with unilateral (N=6) or bilateral hydrosalpinges (N=9) submitted for IVF. In all of them, laparoscopic salpingectomy was contraindicated. Hysteroscopic insertion of the Essure intratubal device in a consultation room setting was performed. IVF results were compared with those of women where hydrosalpinx was treated by laparoscopic salpingectomy (48 women, 76 cycles). There were no complications during or immediately after the procedure in any of the patients. There were four pregnancies from 16 embryo-transfers with own oocytes, one spontaneous pregnancy after unilateral Essure insertion, and one pregnancy after oocyte donation. In one case the hydrosalpinx grew and pelvic inflammatory disease developed 6 months after the insertion, requiring bilateral adnexectomy. Although not of statistical significance, IVF pregnancy rates were somewhat lower than in the laparoscopic salpingectomy group, which was attributed to the lower ovarian reserve before Essure insertion. The hysteroscopic insertion of the Essure intratubal device prior to IVF is a reasonable option in cases where laparoscopic salpingectomy is contraindicated. Larger series are required to assess pregnancy outcome. Copyright © 2013. Published by Elsevier Ireland Ltd.

Hysteroscopic sterilization of patient with intrauterine device Mirena®

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Depes, Daniella De Batista; Pereira, Ana Maria Gomes; Yatabe, Salete; Lopes, Reginaldo Guedes Coelho

2013-01-01

ABSTRACT Tubal sterilization is the definitive procedure most often used worldwide to control fecundity. Laparoscopic ligature is safe, but invasive and with possible surgical and anesthetic risks. The hysteroscopic approach enables tubal occlusion at outpatient's setting without the need of incisions or anesthesia. A microdevice (Essure®) is inserted directly into the tubes and its polyethelene fibers cause obstruction of tubes in about three months. During this period, it is recommended that patients continue the use of a temporary birth control method. Several women use the levonorgestrel-releasing intrauterine system, which is called in the market as Mirena®. This report evaluated the possibility of inserting Essure® without remove the intrauterine device; patient tolerance to the procedure was also assessed. The tubal device was successfully placed in the patient without the need to remove Mirena®. After three months the intrauterine device was removed with no intercurrent events. PMID:23579753

Successful placement of the Essure device after a failed procedure using the Adiana system for hysteroscopic sterilisation

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Schuurman, Teska; Veersema, Sebastiaan

2011-01-01

This case report describes a successful hysteroscopic sterilisation using the Essure Permanent Birth Control device (Conceptus Inc., Mountain View, California, United States) after a failed procedure of the Adiana Permanent Contraception system (Hologic, Inc., Bedford, Maryland, United States). The delivery catheter of the Adiana system was able to be inserted into the left fallopian tube without difficulty and per manufacturer specifications. However, the position detection array was unable ...

The HysNiche trial: hysteroscopic resection of uterine caesarean scar defect (niche) in patients with abnormal bleeding, a randomised controlled trial

NARCIS (Netherlands)

Vervoort, A. J. M. W.; van der Voet, L. F.; Witmer, M.; Thurkow, A. L.; Radder, C. M.; van Kesteren, P. J. M.; Quartero, H. W. P.; Kuchenbecker, W. K. H.; Bongers, M. Y.; Geomini, P. M. A. J.; de Vleeschouwer, L. H. M.; van Hooff, M. H. A.; van Vliet, H. A. A. M.; Veersema, S.; Renes, W. B.; van Meurs, H. S.; Bosmans, J.; Oude Rengerink, K.; Brölmann, H. A. M.; Mol, B. W. J.; Huirne, J. A. F.

2015-01-01

A caesarean section (CS) can cause a defect or disruption of the myometrium at the site of the uterine scar, called a niche. In recent years, an association between a niche and postmenstrual spotting after a CS has been demonstrated. Hysteroscopic resection of these niches is thought to reduce

Transfundal puncture of a large ovarian cyst with hysteroscopic and ultrasonographic guidance.

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Zolnierczyk, Piotr; Cendrowski, Krzysztof; Sawicki, Wlodzimierz

2015-01-01

This paper describes the case of an 83-year-old patient with hypertension, diabetes, obesity (body mass index - 38), congestive heart failure, and history of cardiac surgery, who was referred for a diagnostic-therapeutic decompression of a large, symptomatic ovarian cyst. Due to anatomical conditions, the only safe way was a transfundal puncture under mini-hysteroscopic and ultrasound guidance. A puncture with aspiration of 300 mL of serous fluid from the cyst was performed without technical problems and complications. Cytology showed no cancer cells in the examined liquid. Relief from pain and compression discomfort was achieved in the patient. This case shows the possibility of combining ultrasound and minimally invasive diagnostic methods like hysteroscopy in selected clinical situations.

Essure hysteroscopic sterilization versus interval laparoscopic bilateral tubal ligation: a comparative effectiveness review.

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Ouzounelli, Myrsini; Reaven, Nancy L

2015-01-01

A comparative effectiveness analysis was performed to examine the risks and benefits of laparoscopic bilateral tubal ligation compared with hysteroscopic sterilization using the Essure Permanent Birth Control System (Bayer HealthCare AG, Whippany, NJ). Existing evidence shows that both LBTL and Essure are safe and effective methods of female sterilization. Both have high rates of efficacy and low rates of complications although when complications do occur, those related to the Essure procedure are more likely to be minor in nature. The analysis was limited by the restricted number of studies involving head-to-head comparisons of the 2 approaches. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

Hysteroscopic view of uterine cavity after normal and PPROM pregnancies

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Roshan Nikbakht

2015-01-01

Full Text Available Background: Preterm premature rupture of membranes (PPROM occurs in 17% of pregnancies, which leads to 20% of perinatal death. According to previous studies uterine anomalies are one of the risk factors for preterm birth, PPROM and pregnancies complications. The aim of this study was to evaluate the relationship between PPROM and rupture of membrane (ROM with uterine cavity anomalies based on hysteroscopic findings. Methods: This cross-sectional study was conducted in Imam Khomeini Hospital, Ahvaz, Iran, from May 2011 to May 2012. After conducting a pilot study, 66 nulliparous pregnant women at 14-37 weeks of pregnancy with PPROM and ROM were selected randomly. Then the women were evaluated by hysteroscopy at least six weeks after delivery or miscarriage. The control group includes 66 women with at least one normal pregnancy (without history of PPROM, secondary infertility or recurrent abortion, who underwent diagnostic or therapeutic hysteroscopy for other reasons than PPROM. The hysteroscope instrument specifications were KARL STORZ model (KARL STORZ GmbH & Co. KG, Tuttlingen, Germany, inner sheet 26153 BI, outer sheet 26153 BO, and BA lens with 30 degree. Normal saline solution (Sodium Chloride 0.9% also was applied as distention medium. The study was approved by Ethic Committee of Ahvaz Jundihspur University of Medical Sciences. Informed consent was obtained for all participants. Results: Overall, the frequency of uterine anomalies in case and control groups was 12.12% and 3%, respectively (P<0.05 based on Chi-square test. Possibility of uterine cavity anomalies in the women with preterm premature rupture of membranes (PPROM was significantly higher than the women with normal pregnancy (OR=4.41, CI 95%: 0.9-21/63. About 3% of patients in the case group had undefined uterine anomalies. This anomaly was not in mentioned uterine anomalies classification of American fertility association. We did not observe such anomaly in control group

Hysterosalpingogram: an essential examination following Essure hysteroscopic sterilisation

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Shah, V; Panay, N; Williamson, R; Hemingway, A

2011-01-01

Objectives The aim of this study was to describe our experience of imaging following hysteroscopic sterilisation with the Essure (Conceptus Inc., Mountain View, San Carlos, CA) microinsert, and to underline the importance of a carefully performed follow-up hysterosalpingogram (HSG) in the management of these patients. Methods 18 women underwent the procedure and all returned for follow-up HSG. A standard HSG technique was used and views were acquired to establish microinsert position and tubal occlusion. Results In 16 of the 18 women, adequate microinsert positioning and bilateral tubal occlusion was present. In one woman, a unilateral microinsert occluded the fallopian tube, whereas the other fallopian tube was ligated with a clip. The final patient underwent two studies; both showed well-positioned microinserts but unilateral free spill from the right fallopian tube. There are no reported pregnancies thus far. Conclusion Essure sterilisation coils have a unique appearance when radiographed and are an effective means of permanently occluding the fallopian tubes. HSG is a rapid and safe method of confirming satisfactory placement and tubal occlusion. Non-HSG imaging techniques are suboptimal at detecting patent fallopian tubes and expose patients to the risk of an unwanted and potentially complicated pregnancy. PMID:21123309

Hysteroscopic fetoscopy: A role as virtuopsy for parents who refuse full autopsy? A case of facial clefting, proboscis, and limb deformities

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Gabriele Tonni

2015-10-01

Conclusion: Hysteroscopic fetoscopy (virtuopsy proved to be a valuable complementary diagnostic investigation and enhanced the parental bonding process concerning the fetal phenotype. Notwithstanding, the woman declared an acceptable compliance during the procedure. In selected cases, virtuopsy may be a valid option in confirming early prenatal ultrasound diagnosis in parents refusing conventional autopsy or when full postmortem examination may not be clinically indicated or warranted.

Intracavitary deposits on Essure® hysteroscopic sterilization devices: A case report.

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Maassen, L W; van Gastel, D M; Lentjes, E G W M; Bongers, M Y; Veersema, S

2017-07-01

To study the composition of intracavitary deposits on Essure® hysteroscopic sterilization devices. Case report. Reproductive Medicine and Gynecology department of a University Hospital. A 39 years old patient presenting with a request for surgical removal of Essure® sterilization devices. Diagnostic hysteroscopy showed a crystal like white deposit attached to one of the devices. Diagnostic hysteroscopy and surgical removal of Essure® devices was performed. The deposits were collected and infrared spectroscopy analysis was performed. Chemical composition of the deposits attached to the device. Infrared spectroscopy of the material showed patterns conclusive with calcite (calcium carbonate, CaCO 3 ). Until now, it is not clear if there is a relationship between reported complaints and formation of calcite deposits on Essure®. Infrared spectroscopy of deposits on Essure® devices showed a pattern conclusive with calcite. The relationship between reported complaints and the formation of calcite deposits on Essure® remains unclear.

Infiltration of peritumoural but tumour-free parenchyma with IgG4-positive plasma cells in hilar cholangiocarcinoma and pancreatic adenocarcinoma.

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Resheq, Yazid J; Quaas, Alexander; von Renteln, Daniel; Schramm, Christoph; Lohse, Ansgar W; Lüth, Stefan

2013-10-01

Recently, new guidelines for diagnosing IgG4-associated cholangitis have been published devaluing the diagnostic significance of IgG4-positive plasma cells and steroid trials. We sought to evaluate the utility of IgG4-positive plasma cells in discriminating IgG4-associated cholangitis from hilar cholangiocarcinoma and autoimmune pancreatitis from pancreatic adenocarcinoma under conditions when malignancy is likely to be missed. Resection specimens obtained from patients with hilar cholangiocarcinoma, pancreatic adenocarcinoma or hepatocellular carcinoma were re-evaluated for IgG4-positivity. Histological analysis focussed on peritumoural but tumour-free sections. Perioperative biochemical and clinical data were reviewed. Nineteen patients with hilar cholangiocarcinoma and 29 patients with pancreatic adenocarcinoma were eligible for histological re-evaluation. Six of 19 (32%) patients with hilar cholangiocarcinoma and 5 of 29 (17%) patients with pancreatic adenocarcinoma were IgG4-positive (≥20 IgG4-positive plasma cells per high power field). Patients with IgG4-positive hilar cholangiocarcinoma showed significantly higher levels of serum total bilirubin (3.6mg/dl vs. 1.8mg/dl; Philar cholangiocarcinoma. IgG4-positive plasma cells are of limited utility especially in distinguishing hilar cholangiocarcinoma from IgG4-associated cholangitis even when combined with clinical parameters and may be misleading under conditions when malignancy is missed. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Transfundal puncture of a large ovarian cyst with hysteroscopic and ultrasonographic guidance

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Zolnierczyk P

2015-05-01

Full Text Available Piotr Zolnierczyk, Krzysztof Cendrowski, Wlodzimierz Sawicki Department of Obstetrics, Gynecology and Oncology, 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland Abstract: This paper describes the case of an 83-year-old patient with hypertension, diabetes, obesity (body mass index – 38, congestive heart failure, and history of cardiac surgery, who was referred for a diagnostic–therapeutic decompression of a large, symptomatic ovarian cyst. Due to anatomical conditions, the only safe way was a transfundal puncture under mini-hysteroscopic and ultrasound guidance. A puncture with aspiration of 300 mL of serous fluid from the cyst was performed without technical problems and complications. Cytology showed no cancer cells in the examined liquid. Relief from pain and compression discomfort was achieved in the patient. This case shows the possibility of combining ultrasound and minimally invasive diagnostic methods like hysteroscopy in selected clinical situations. Keywords: ovarian cyst puncture, hysteroscopy, ultrasound guided puncture, transfundal cyst puncture, vaginoscopy 

Hysteroscopic endometrial resection: efficacy and factors for failure

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Geraldo Rodrigues de Lima

2008-09-01

Full Text Available Objective: To evaluate the effectiveness of hysteroscopic endometrial ablation in women with abnormal benign uterine bleeding resistant to clinical treatment, and to identify factors potentially related to its failure. Methods: Ninety patients with abnormal benign uterine bleeding were retrospectively evaluated. They were submitted to endometrial ablation between January 2000 and August 2003. Their mean age was 44.3 years and their average parity was 2.3 childbirths. All patients had been given gonadotrophin-releasing hormone analogues prior to surgery, to make the procedure easier. Rresults: After surgery, amenorrhea occurred in 20% of cases, hypomenorrhea in 30%, and eumenorrhea in 32.2%. In 17.8% of patients, the procedure failed. No intra or postoperative complications occurred. There was no statistically significant difference between the patients in which the ablation failed and those in which it was successful regarding mean age (p = 0.557, parity (p = 0.891, presence of intramural myoma (p= 0.29, submucosal myoma (p = 0.68 or endometrial polyps (p = 0.76. A significant difference between the two groups was observed with regard to the uterine size median (7  cm in the successful group and 9 cm in the failure group, p  = 0.008. A statistically significant difference was also found in follow-up time: 13 months in the first group and nine months in the second group (p = 0.001. Cconclusions: Endometrial ablation is a good treatment method for abnormal uterine bleeding of benign etiology. Special attention must be paid to patients with increased uterine size, since failure is more frequent in these cases.

The OPPIuM technique: office hysteroscopic technique for the preparation of partially intramural leiomyomas.

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Cicinelli, Ettore; Mitsopoulos, Vasileios; Fascilla, Fabiana D; Sioutis, Dimos; Bettocchi, Stefano

2016-06-01

Uterine fibroids, also known as leiomyomas, represent the most common benign tumors of the female genital tract. Submucosal leiomyomas are classified into three grades: G0, GI, GII according to the degree of their intramural proportion. A recently developed technique enables the preparation of G1 and G2 leiomyomas for their subsequent successful resection in a second step. The OPPIuM (office preparation of partially intramural leiomyomas) technique aims to downgrade type I and II leiomyomas, in order to facilitate a subsequent easier and safer resectoscopy. Hysteroscopic resection of large GI or GII submucosal fibroids is a complex procedure. OPPIuM technique has been invented and seems to achieve the downgrading of these types of leiomyomas in approximately 93% of cases, without any significant surgical complications or the need of hormonal agents' administration. In this way, the safer and quicker subsequent complete myomectomy is facilitated.

Sirenomelia with oligodactylia: early ultrasonographic and hysteroscopic embryoscopic diagnosis during the first trimester of gestation.

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Clemente, Claudia Maria; Farina, Marco; Cianci, Antonio; Iraci Sareri, Marco

2010-01-01

The case we describe reports the early sonographic findings of sirenomelia with oligodactylia at 9 weeks of gestation by transvaginal two-dimensional color Doppler ultrasonography imaging and its confirmation by hysteroscopic embryoscopy at 12 weeks to further characterize the findings. The embryo showed increased nuchal translucency and fused lower limbs with a large intra-abdominal vessel and two-vessel umbilical cords. The pregnancy was terminated by medical abortion induction after the patient viewed the embryoscopic images. Diagnosis is commonly made later in the second trimester of pregnancy, oligohydramnios being a warning signal, which usually makes the diagnosis difficult. Survival, only possible in the absence of renal agenesis, is extremely rare. In view of the extremely poor prognosis, early diagnosis allows for earlier counseling and less traumatic therapeutic termination of pregnancy. Copyright 2010 S. Karger AG, Basel.

A comparison of hysteroscopic mechanical tissue removal with bipolar electrical resection for the management of endometrial polyps in an ambulatory care setting: preliminary results.

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Pampalona, Jennifer Rovira; Bastos, Maria Degollada; Moreno, Gemma Mancebo; Pust, Andrea Buron; Montesdeoca, Gemma Escribano; Guerra Garcia, Angel; Pruñonosa, Juan Carles Mateu; Collado, Ramon Carreras; Torras, Pere Bresco

2015-01-01

To assess and compare efficacy, pain, and the learning curve associated with diagnostic therapeutic hysteroscopy using mechanical tissue removal versus bipolar electrical resection in the management of endometrial polyps in an ambulatory care setting. A randomized controlled clinical trial (Canadian Task Force classification I). Hospital de Igulada, Barcelona, Spain. A total of 133 patients diagnosed with endometrial polyp(s) were included and randomly assigned to 1 of the 2 hysteroscopic methods. Criteria assessed were total hysteroscopy time, full polypectomy procedure time, pain experienced by patients, and learning curve of staff in training. The average time to perform total hysteroscopy using the mechanical tissue removal system (TRUCLEAR 5.0 System; Smith & Nephew Inc., Andover, MD) was 6 minutes 49 seconds versus 11 minutes 37 seconds required for the bipolar electrosurgery system (GYNECARE VERSAPOINT; Ethicon Inc, Somerville, NJ) (p .05). A study of the residents' learning curve showed a higher level of autonomy with hysteroscopy using the TRUCLEAR Tissue Removal System with which residents showed a higher level of confidence compared with hysteroscopy with the VERSAPOINT Bipolar Electrosurgery System. In hysteroscopic polypectomy, the mechanical tissue removal system was significantly faster, achieved a greater success rate for complete polypectomy, and required a shorter learning curve from staff being trained in the management of endometrial polyps when compared with bipolar electrical resection. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

Successful placement of the Essure device after a failed procedure using the Adiana system for hysteroscopic sterilisation

Science.gov (United States)

Schuurman, Teska; Veersema, Sebastiaan

2011-01-01

This case report describes a successful hysteroscopic sterilisation using the Essure Permanent Birth Control device (Conceptus Inc., Mountain View, California, United States) after a failed procedure of the Adiana Permanent Contraception system (Hologic, Inc., Bedford, Maryland, United States). The delivery catheter of the Adiana system was able to be inserted into the left fallopian tube without difficulty and per manufacturer specifications. However, the position detection array was unable to sense four-quadrant tissue contact. The same issue occurred at the contralateral tube. Using the Essure system, the coils were able to be placed in both ostia easily and adequately. In patients in whom the Adiana system fails to occlude the fallopian tubes due to procedural, anatomic or device-related factors, the Essure procedure may be an efficient alternative. PMID:22689274

Achados histeroscópicos em mulheres na pós-menopausa com diagnóstico de espessamento endometrial por ultra-sonografia transvaginal Hysteroscopic findings in postmenopausal women with endometrial thickening diagnosed by transvaginal ultrasound

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Adriana Bittencourt Campaner

2004-02-01

Full Text Available OBJETIVO: correlacionar espessamento endometrial diagnosticado por ultra-sonografia com os achados histeroscópicos, em mulheres na pós-menopausa. MÉTODOS: foi realizado estudo transversal com avaliação histeroscópica em 121 mulheres na pós-menopausa, com diagnóstico de espessamento do endométrio por ultra-sonografia transvaginal. Das pacientes incluídas, 23 (19% recebiam diferentes esquemas de hormonioterapia e 98 não referiam uso de reposição hormnonal.; 55 pacientes queixavam-se de sangramento por via vaginal e as restantes apresentavam-se sem esta condição. Os exames endoscópicos foram realizados ambulatorialmente, utilizando-se histeroscópio rígido de 4 mm. Para a distensão da cavidade uterina empregou-se gás carbônico (CO2. Biópsia foi praticada em todas as pacientes, com auxílio de cureta tipo Novak, de 3 mm, e o material obtido submetido a estudo histopatológico. RESULTADOS: a espessura do endométrio variou entre 6 e 38 mm, com média de 10,7 ± 5,3 mm. Os achados histeroscópicos foram: lesão polipóide, em 51 pacientes (42,1%; endométrio atrófico, em 15 (12,4%; sinéquia senil, em 15 (12,4%; espessamento focal, em 13 (10,7%; lesão cerebróide, em 6 (5,0%; endométrio proliferativo, em 5 (4,1%; muco, em 5 (4,1%; mioma, em 4 (3,3%; endométrio secretor, em 3 (2,5%; hiperplasia endometrial, em 3 (2,5% e atrofia cística, em 1 (0,8%. Observou-se correlação entre os achados histeroscópicos e os resultados da histopatologia em 30 dos 51 casos de pólipo, em 12 dos 15 de endométrio atrófico e na totalidade dos casos sugestivos de hiperplasia endometrial e de adenocarcinoma. CONCLUSÃO: na maioria das pacientes, o exame histeroscópico revelou que não se tratava de real espessamento endometrial, mas sim de outras variedades de lesão da cavidade uterina.PURPOSE: to correlate endometrial thickening diagnosed by ultrasonography with hysteroscopic findings in postmenopausal women. METHODS: a transversal study

Office hysteroscopic treatment of a vanishing external uterine orifice in a postmenopausal woman with an obstetrical history of 44 abortions

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Maurizio Guida

2015-11-01

Full Text Available Cervical stenosis, defined as cervical scarring of variable degree, represents a significant anatomical impediment to hysteroscopic procedures. Acquired cervical stenoses are more common than congenital forms and they are mainly associated with aging, estrogen–progesteron drugs, cervical trauma or carcinoma. The overcoming of cervical stenosis at office hysteroscopy is challenging and it often fails requiring the scheduling of the patient for an in-patient treatment under general anesthesia. We report the office hysteroscopy treatment of a vanishing external uterine orifice in a postmenopausal woman with an ultrasonographic report of a heterogeneous and thick endometrium suggestive of endometrial pathology, focusing on the main surgical steps to perform an adequate management.

HYSTEROSCOPIC EVALUATION OF WOMEN IN REPRODUCTIVE AGE GROUP WITH ABNORMAL UTERINE BLEEDING

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E. Vanaja Reddy

2016-10-01

Full Text Available BACKGROUND Abnormal uterine bleeding is the most common complaint in gynaecology and an important source of morbidity. This study evaluates the usefulness of hysteroscopy in the diagnosis of abnormal uterine bleeding in comparison to dilatation and curettage in reproductive age group. MATERIALS AND METHODS Between September 2011 to July 2013, women with AUB attending Gynaec OP were subjected to hysteroscopy and subsequent dilatation and curettage. Data was collected and analysed. RESULTS AUB was more common in 30-34 yrs. The most common presenting complaint was menorrhagia. Normal hysteroscopic view was seen in 50% cases. Abnormalities seen were endometrial hyperplasia, polyps, submucous myoma synechiae and rue. Both hysteroscopy and curettage gave specificity of 70%, but the ability to diagnose focal lesion (sensitivity was more with hysteroscopy in comparison to curettage 70 vis. 36. 43 patients had the same tissue diagnosis in both hysteroscopy and curettage. Hysteroscopy revealed more information than curettage in 42% and curettage had more information in 15% cases, 100% accuracy was seen in case of myoma, IUCD, adhesions and polyps with hysteroscopy. CONCLUSION This study confirms the conclusion of many others that hysteroscopy is superior to dilatation and curettage in evaluating patients with abnormal uterine bleeding.

Hysteroscopic tubal sterilization: a systematic review of the Essure system.

Science.gov (United States)

Hurskainen, Ritva; Hovi, Sirpa-Liisa; Gissler, Mika; Grahn, Riitta; Kukkonen-Harjula, Katriina; Nord-Saari, Merja; Mäkelä, Marjukka

2010-06-01

To update the evidence of the efficacy and safety of the Essure system. Female sterilization has undergone changes in the last decade. Besides laparoscopic tubal occlusion, the Essure system is now a viable option, with about 200,000 women sterilized using this method. The review is based on the report of the Alberta Heritage Foundation for Medical Research and completed with systematic literature searches up to April 8, 2008. The Managed Uptake of Medical Methods program of the Finnish National Research and Development Center for Health and Welfare. Women over 30 years, who had been sterilized by the Essure method. Hysteroscopic tubal sterilization using Essure system. Efficacy/effectiveness, adverse events, costs. Sterilization by Essure can be performed under local anesthesia or with oral analgesics in ambulatory settings. However, sterilization is not immediate and women must use additional contraception for 3 months until permanent tubal occlusion is verified by transvaginal ultrasound, hysterosalpingosonography, hysterosalpingography, or pelvic radiography. The evidence on efficacy and safety is mainly available from short follow-up case series but shows good efficacy and safety of the Essure system. Only a few small risks are associated with the procedure. Two economic studies, one of which implemented Essure as an in-office procedure, suggest that Essure could be more cost-effective than laparoscopic sterilization, but more information on the total cost is needed. The Essure system appears to be safe, permanent, irreversible, and a less invasive method of contraception compared with laparoscopic sterilization. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

[Hysteroscopic fallopian tube sterilization procedure: feasibility and one-year follow-up].

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Gibon, E; Lopès, P; Linet, T; Martigny, H; Orieux, C; Philippe, H-J

2006-03-01

Hysteroscopic flexible micro-insert (Essure) is an ambulatory improvement of fallopian tube sterilization, which is a deliberated suppression of fertility. The aim of this study was an evaluation of feasibility (learning curve) and the first year outcome of this method. This prospective study, carried out between February 2002 and March 2003, included patients who were matching with manufacturer recommendations. One surgeon only realized all the device placements. Fifty patients were included (one year follow-up). Mean age was 41 (+/-3.3), mean parity was 2.7 (+/-0.8). Mean time needed for device placement was 26 minutes (+/-6.5) and was reduced with increased experience. Six failures of placement (12%) were related, because of submucus leiomyomas, proximal tubal stenotic disease or too retroverted uterus. Only 5 patients (11,4%) described intensive pelvic pain during the placement. The only case of device expulsion benefited from a successful second placement. The one-year follow-up showed no significant difference of body weight increasing, duration or quantity of menstruation, neither significant pelvic pain nor vaginal bleeding. Tolerance was rated at least at "somewhat satisfied". There have been no pregnancies reported in 670 woman-months of effectiveness. Our results agree in any point with those of larger studies. We think that hysteroscopy micro-insert placement is not only reserved to specialized centers but also to any gynecologist who is used to performing hysteroscopy because of its feasibility.

Relationship of endometrial thickness detected by transvaginal sonography with the results of endometrial biopsy & hysteroscopic directed biopsy in post menopausal bleeding

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Vahid Dastjerdi M

2008-05-01

Full Text Available Background: Post-menopausal hemorrhage is one of the most common complains in gynecologic clinics. More than 60% of these cases have abnormal findings in diagnostic work ups. There is contraversy about the best diagnostic method for evaluating post-menopausal hemorrhage. The aim of this study was to evaluate the results of Trans-Vaginal Ultrasonography and compare its result to ones derived from direct endometrial biopsy and Hysteroscopy findings.Methods: In a cross-sectional study, menopausal women who attended the outpatient clinic of Arash Hospital, Tehran University of medical Sciences, from April 2005 to March 2006 with the complain of hemorrhage were evaluated. In all of these patients, after getting informed consent, Trans-Vaginal Ultrasonography, Dilatation and Curettage and Hysteroscopy were performed.Results: The total number of 90 women was recruited to the study with the age range of 41-80 years. The mean age of participants was 53.84 ± 6 years and 4.3 ± 5.1 years had passed from their menopause. The mean thickness of endometrium, measured by Trans Vaginal ultrasonography was 6.25 ± 3.7 millimeter. In the biopsy derived specimens, the most finding pathological presentation was atrophy (48.9% and the Proliferative endometrium had the second prevalence (36.7%. Atrophy (44.4% and Proliferative endometrium (33.3% were the most prevalent finding in Hysteroscopy. There was a significant difference in endometrial thickness between groups of different pathological findings. A significant difference in endometrial thickness was also seen between groups with different Hysteroscopic finding. By grouping the data according to endometrial thickness, it became evident that endometrial thickness can predict the outcome of endometrial biopsy and Hysteroscopic finding efficiently. We used ROC curves to find the best grouping threshold for endometrial thickness to achieve the best sensitivity and specificity.Conclusion: Measuring the endometrial

Analysis of surgeries performed after hysteroscopic sterilization as tabulated from 3,803 Essure patient experiences.

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Sills, E Scott; Li, Xiang; Wood, Samuel H; Jones, Christopher A

2017-05-01

Although previous research has suggested that risk for reoperation among hysteroscopic sterilization (HS) patients is more than ten times higher than for patients undergoing standard laparoscopic tubal ligation, little has been reported about these subsequent procedures. This descriptive cohort study used a confidential online questionnaire to gather data from women (n=3,803) who volunteered information on HS followed by device removal surgery performed due to new symptoms developing after Essure placement. In this sample, mean age was 35.6 years and women undergoing hysterectomy after HS comprised 64.9% (n=2,468). Median interval between HS and hysterectomy was 3.7 (interquartile range, 3.9) years and mean age at hysterectomy was 36.3 years. Some patients (n=1,035) sought removal of HS devices and fallopian tubes only, while other miscellaneous gynecological procedures were also occasionally performed for Essure-associated symptoms. When data from all patients who had any post-Essure surgery besides hysterectomy were aggregated (e.g., device removal + "other" cases, n=1,335) and compared to those cases undergoing hysterectomy, mean age was significantly lower than for the hysterectomy group (34.4 vs. 36.3 years, respectively; P Essure, and suggests that the predominant surgical answer to HS complaints is hysterectomy for many women. Dissatisfaction with HS may represent an important indication for hysterectomy and additional study is needed to quantify this phenomenon.

[Hysteroscopic tubal sterilization with Essure® devices: a retrospective descriptive study and evaluation of hypnosis].

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Gauchotte, E; Masias, C; Bogusz, N; Koebele, A

2011-06-01

The Essure(®) system is a hysteroscopic sterilization method. The aim of our study is to retrospectively evaluate the sterilization procedure with Essure(®) devices, with and without anesthesia, and in particular with hypnosis. The descriptive study includes all tubal sterilization with Essure(®) performed during the year 2009 at the Maternité régionale de Nancy. Hypnosis efficiency is retrospectively evaluated with Verbal Numeric Rating Scale (VNRS) for peroperative pain, and analgesic medication use for postoperative pain. Ninety-four sterilizations are performed, 85% (85/94) of them without anesthesia. The mean VNRS is 3.0. The mean operative time is 8.7 minutes, positively correlated with the VNRS (P=0.0005). The rate of successful insertion is 94%. At 3 months, 91% of the implants have a correct location. Inadequate locations are more frequent when anesthesia have been performed (37% vs 4%, P=0.016). There is no significant difference between groups with and without hypnosis for the VNRS, the failure rate and the use of analgesic medication. Tubal sterilization with the Essure(®) system is a quick and efficient method. Our study does not demonstrate efficiency of hypnosis in pain control. This remains to be explored with a prospective study, including others parameters, such as anxiety. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Referrals for complications following hysteroscopic sterilisation: characteristics associated with symptomatic patients after the Essure procedure.

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Sills, E Scott; Dalton, Marie M

2016-06-01

This report summarises recent experience with a series of symptomatic Essure® patients with an emphasis on clinical presentation, preoperative imaging, surgical intervention, and outcome. This case series presents Essure® patients (n = 7) who sought medical consultation for various complications. This retrospective analysis is based on consultations during a six-month interval beginning in April 2015. In this sample, mean (± SD) patient age was 35.9 ± 3.4 yrs. The gravida/parity status was 3.6 ± 1.1 and 2.4 ± 1.4, respectively. Average duration of exposure to Essure® coils among these patients was 25.6 ± 24.5 (range 5-67) months. Except for one woman, these patients had hysteroscopic sterilisation (HS) either with heavy sedation or under general anaesthesia. More than two Essure® devices were implanted in two women. Complications reported after HS included device migration, coil fragmentation, tissue perforation, and vaginal expulsion of Essure® fragment. Three of seven women have required hysterectomy. The current series offers evidence of migration of contraceptive coils as well as Essure® inserts perforating tissue and being spontaneously expelled. Evaluation of symptomatic HS patients should include determining how many devices have been implanted, as some women have more than two.

Hysteroscopic Endometrial Resection Versus Laparoscopic Supracervical Hysterectomy for Abnormal Uterine Bleeding: Long-term Follow-up of a Randomized Trial.

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Zupi, Errico; Centini, Gabriele; Lazzeri, Lucia; Finco, Andrea; Exacoustos, Caterina; Afors, Karolina; Zullo, Fulvio; Petraglia, Felice

2015-01-01

To compare long-term efficacy of laparoscopic supracervical hysterectomy (LSH) and hysteroscopic endometrial ablation (HEA) in treating persistent abnormal uterine bleeding. Canadian Task Force II-2. University hospital. One hundred fifty-three women treated for abnormal uterine bleeding by LSH or HEA. Long-term follow-up assessment of reintervention rate and quality of life (QoL) using the Quality Metric's Health Survey Short Form 12. This study is the long-term follow-up of a randomized control trial conducted in 2003 comparing LSH and HEA in terms of reoperation rate and QoL. Starting from November 2010 all patients included in the first trial were invited to participate in this study and clinically evaluated through vaginal examination and transvaginal ultrasound. After a mean follow-up of 14.4 years, 29% of patients (20/71) treated with HEA underwent further surgery, whereas no patients after LSH had symptom recurrence. The reintervention rate was significantly higher in the HEA group (p abnormal uterine bleeding when compared with HEA. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

Comparing Transcervical Intrauterine Lidocaine Instillation with Rectal Diclofenac for Pain Relief During Outpatient Hysteroscopy: A Randomized Controlled Trial

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Sussan S. Mohammadi

2015-05-01

Full Text Available Objectives: There are a number of potential advantages to performing hysteroscopy in an outpatient setting. However, the ideal approach, using local uterine anesthesia or rectal non-steroidal anti-inflammatory drugs, has not been determined. Our objective was to compare the efficacy of intrauterine lidocaine instillation with rectal diclofenac for pain relief during diagnostic hysteroscopy. Methods: We conducted a double-blind randomized controlled trial on 70 nulliparous women with primary infertility undergoing diagnostic hysteroscopy. Subjects were assigned into one of two groups to receive either 100mg of rectal diclofenac or 5mL of 2% intrauterine lidocaine. The intensity of pain was measured by a numeric rating scale 0–10. Pain scoring was performed during insertion of the hysteroscope, during visualization of the intrauterine cavity, and during extrusion of the hysteroscope. Results: There were no statistically significant differences between the groups with regard to the mean pain score during intrauterine visualization (p=0.500. The mean pain score was significantly lower during insertion and extrusion of the hysteroscope in the diclofenac group (p=0.001 and p=0.030, respectively. Nine patients in the lidocaine group and five patients in diclofenac group needed supplementary intravenous propofol injection for sedation (p=0.060. Conclusions: Rectal diclofenac appears to be more effective than intrauterine lidocaine in reducing pain during insertion and extrusion of hysteroscope, but there are no significant statistical and clinical differences between the two methods with regard to the mean pain score during intrauterine inspection.

Do submucous myoma characteristics affect fertility and menstrual outcomes in patients underwent hysteroscopic myomectomy?

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Ahmed Namazov

2015-06-01

Full Text Available Background: Submucous myomas may be associated with menorrhagia, infertility and dysmenorrhea. Objective: The aim of this study was to determine the long term effects of submucousal myoma resection on menorrhagia and infertility; also to detect whether the type, size, and location of myoma affect the surgical success. Materials and Methods: .Totally 98 women referred to hysteroscopy for symptomatic submucousal fibroids (menorrhagia (n=51 and infertility (n=47 between 2005- 2010 were enrolled in this historical cohort study Pregnancy rates and menstrual improvement rates were compared according to myoma characteristics (size, type and location. Results: After a mean postoperative period of 23±10 months in 51 patients with excessive bleeding, 13 had recurrent menorrhagia (25%. In Other 38 patients excessive bleeding was improved (75%. The improvement rates by location and myoma type: lower segment 100%, fundus 92%, and corpus 63%; type 0 70%, type 1 78%, type 2 80%. The mean sizes of myoma in recurred and improved patients were 23.33 mm and 29.88 mm respectively. 28 of 47 infertile women spontaneously experienced thirty pregnancies (60%. Pregnancy rates according to myoma location and type: lower segment 50%, fundus 57%, and corpus 80%; type 0 75%, type 1 62%, type 2 50%. The mean myoma size in patients who became pregnant was 30.38 mm; in patients who did not conceive was 29.95 mm. Conclusion: The myoma characetesitics do not affect improvement rates after hysteroscopic myomectomy in patients with unexplained infertility or excessive uterine bleeding.

Comparative study between the hysteroscopic and histological diagnosis of patients with abnormal uterine bleeding during menacme

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Reginaldo Guedes Coelho Lopes

2006-09-01

Full Text Available Objective: The objective of this research was to evaluate the feasibilityand the diagnostic properties of hysteroscopy in a population of womenduring menacme with the complaint of abnormal uterine bleeding,comparing endoscopic with histological findings. Methods: The studywas retrospectively conducted in 314 outpatients submitted tohysteroscopy. Every woman was submitted to guided endometrialbiopsy, using a 3 or 5mm-diameter Novak curette. The hysteroscopesused were of 3 or 5mm caliber which image was reproduced in ascreen by means of an endocamera. The results of hysteroscopic andhistological exams were compared. Results: There were noabnormalities of the uterine cavity in 151 patients (48%. Submucousmyoma was the most frequent alteration found in 45 women (14.3%.Malignancy was detected in nine patients, out of which seven hadhistological confirmation. Sensibility and specificity of hysteroscopywere respectively: a 86.3% and 75.9% for abnormal uterine cavity; b100% and 99.4% for malignancy, and c 57.7% and 88.5% for endometrialhyperplasia. Five patients (6.6% were not submitted to hysteroscopydue to cervical stenosis. Two percent of the cases presented vagalreactions, such as sweating, nausea and dizziness, with short-timerecovery. Conclusions: For higher sensitivity and specificity, diagnostichysteroscopy should be complemented with histology of theendometrial biopsy. This procedure should be considered in the workupof patients at menacme with complaints of abnormal uterinebleeding.

Inhalation analgesia with nitrous oxide versus other analgesic techniques in hysteroscopic polypectomy: a pilot study.

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Del Valle Rubido, Cristina; Solano Calvo, Juan Antonio; Rodríguez Miguel, Antonio; Delgado Espeja, Juan José; González Hinojosa, Jerónimo; Zapico Goñi, Álvaro

2015-01-01

To show the decrease in pain and better tolerance to inhalation analgesia with a 50% equimolar mixture of nitrogen protoxide and oxygen in hysteroscopic polypectomy compared with paracervical anesthesia and a control group. One hundred six patients scheduled for office hysteroscopy and polypectomy were divided into the following 3 groups: the control group, the nitrous oxide group, and the paracervical infiltration group. Patients were assigned sequentially (Canadian Task Force classification II-1). The study took place in a hysteroscopy outpatient clinic under the supervision of a gynecologist and 2 nurses trained to cooperate in the trial. One hundred six women from Area III of Madrid Community, Spain, who had been diagnosed with endometrial polyps at a gynecology office and were scheduled for office hysteroscopy and polypectomy agreed to participate in the study. Patients in group 1 (control group) received no treatment. Group 2 received inhaled nitrous oxide and group 3 paracervical infiltration with 1% lidocaine. Pain was assessed using the visual analog scale (0-10). Pain perceived by patients was lower in the nitrous Oxide group (mean: 3.55 ± 0.60, median: 3) versus the control group (mean: 5.49 ± 1.88, median: 6, p nitrous oxide group, and good for the paracervical infiltration group (p nitrous oxide group, whereas in the paracervical infiltration group, there were complications in more than 50% of the patients. No severe complications occurred. Nitrous oxide is a safe and effective analgesic technique for polipectomy office hysteroscopy compared with the paracervical infiltration and control groups. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

Surgical aspects of removal of Essure microinsert.

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Albright, Catherine M; Frishman, Gary N; Bhagavath, Bala

2013-09-01

Essure is designed as a hysteroscopically placed permanent birth control. Removal of the Essure microinsert can be a technically challenging procedure. Requests for removal are uncommon but do occur. Although hysteroscopic and laparoscopic removal has been reported, there is limited information available describing appropriate surgical technique. There have been six patients requesting Essure removal at our institution (one approximately 2 years after placement). Based on this experience, we have developed specific counseling points and surgical principles for laparoscopic removal: avoid injection of a hemostatic solution into the fallopian tube; avoid excessive traction on the coils; avoid cauterization of the outer coil; follow the Essure coil into the interstitial end of the fallopian tube to ensure complete removal of the insert; perform a salpingectomy rather than a salpingostomy. By taking into account these principles, key preoperative counseling points can be discussed, and laparoscopic Essure removal years after placement can be accomplished in a safe and deliberate fashion. Copyright © 2013 Elsevier Inc. All rights reserved.

Tissue encapsulation of the proximal Essure micro-insert from the uterine cavity following hysteroscopic sterilization.

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Kerin, John F; Munday, David; Ritossa, Martin; Rosen, David

2007-01-01

To assess the interaction between the trailing ends of a sterilization micro-insert extending into the uterine cavity and the surrounding uterine tissue environment over time. Multicenter, retrospective observational study (Canadian Task Force classification II-1). Hospital-based clinical research centers. A subset of a study population of 545 women who had undergone a hysteroscopic sterilization procedure. A second-look hysteroscopy was performed in 22 (20 with uterine bleeding, 2 pre IVF) of these 545 women between 4 and 43 months from the sterilization procedure. Over a mean time period of 19.73 months, the trailing coils of the micro-inserts into the uterine cavity shortened from a mean of 5.7 mm to 2.0 mm and from 5.4 mm to 1.8 mm on the right and left sides, respectively. In cases observed within 12 months or fewer post-procedure, the complete tissue encapsulation of both micro-inserts had already occurred in 17% of the observations. Among cases evaluated from 13 to 43 months post-procedure, 25% evidenced complete encapsulation. Two mechanisms appear to be responsible for this process. First, there is an initial mechanical "winding-in" of the micro-insert of approximately 1 rotation of its outer coil, accounting for 1 mm of its length, after release from its delivery system. Second, the tissue around the ostium appears to use the trailing coils of the micro-insert as a scaffolding structure, gradually encapsulating and excluding them from the uterine cavity. The gradual tissue exclusion of the micro-insert from the uterine cavity may make it pregnancy-compatible after in vitro fertilization and embryo transfer procedures.

Preliminary evaluation of 1′-[18F]fluoroethyl-β-D-lactose ([18F]FEL) for detection of pancreatic cancer in nude mouse orthotopic xenografts

International Nuclear Information System (INIS)

Arumugam, Thiruvengadam; Paolillo, Vincenzo; Young, Daniel; Wen, XiaoXia; Logsdon, Craig D.; De Palatis, Louis; Alauddin, Mian M.

2014-01-01

Introduction: Early detection of pancreatic cancer could save many thousands of lives. Non-invasive diagnostic imaging, including PET with [ 18 F]FDG, has inadequate resolution for detection of small (2–3 mm) pancreatic tumours. We demonstrated the efficacy of PET imaging with an 18 F-labelled lactose derivative, [ 18 F]FEDL, that targets HIP/PAP, a biomarker that is overexpressed in the peritumoural pancreas. We developed another analogue, 1-[ 18 F]fluoroethyl lactose ([ 18 F]FEL), which is simpler to synthesise, for the same application. We conducted a preliminary evaluation of the new probe and its efficacy in detecting orthotopic pancreatic carcinoma xenografts in mice. Methods: Xenografts were developed in nude mice by injecting L3.6pl/GL + pancreatic carcinoma cells into the pancreas of each mouse. Tumour growth was monitored by bioluminescence imaging (BLI); accuracy of BLI tumour size estimates was verified by MRI in two representative mice. When the tumour size reached approximately 2–3 mm, the animals were injected with [ 18 F]FEL (3.7 MBq) and underwent static PET/CT scans. Blood samples were collected at 2, 5, 10, 20 and 60 min after [ 18 F]FEL injection to track blood clearance. Following imaging, animals were sacrificed and their organs and tumours/pancreatic tissue were collected and counted on a gamma counter. Pancreas, including tumour, was frozen, sliced and used for autoradiography and immunohistochemical analysis of HIP/PAP expression. Results: Tumour growth was rapid, as observed by BLI and MRI. Blood clearance of [ 18 F]FEL was bi-exponential, with half-lives of approximately 3.5 min and 40 min. Mean accumulation of [ 18 F]FEL in the peritumoural pancreatic tissue was 1.29 ± 0.295 %ID/g, and that in the normal pancreas of control animals was 0.090 ± 0.101 %ID/g. [ 18 F]FEL was cleared predominantly by the kidneys. Comparative analysis of autoradiographic images and immunostaining results demonstrated a correlation between [ 18 F

Contraceptive failure after hysteroscopic sterilization: Analysis of clinical and demographic data from 103 unplanned pregnancies

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Li, Xiang; Jones, Christopher A.; Wood, Samuel H.

2015-01-01

Objective This investigation examined data on unplanned pregnancies following hysteroscopic sterilization (HS). Methods A confidential questionnaire was used to collect data from women with medically confirmed pregnancy (n=103) registered after undergoing HS. Results Mean (±SD) patient age and body mass index (BMI) were 29.5±4.6 years and 27.7±6.1 kg/m2, respectively. Peak pregnancy incidence was reported at 10 months after HS, although <3% of unplanned pregnancies occurred within the first three months following HS. Mean (±SD) interval between HS and pregnancy was 19.6±14.9 (range, 2 to 84) months. Patients age ≥30 years and BMI <25 reported conception after HS somewhat sooner than younger patients, although the differences in time to pregnancy were not significant (P=0.24 and 0.09, respectively). The recommended post-HS hysterosalpingogram (to confirm proper placement and bilateral tubal occlusion) was obtained by 66% (68/103) of respondents. Conclusion This report is the first to provide patient-derived data on contraceptive failures after HS. While adherence to backup contraception 3 months after HS can be poor, many unintended pregnancies with HS occur long after the interval when alternate contraceptive is required. Many patients who obtain HS appear to ignore the manufacturer's guidance regarding the post-procedure hysterosalpingogram to confirm proper device placement, although limited insurance coverage likely contributes to this problem. The greatest number of unplanned pregnancies occurred 10 months after HS, but some unplanned pregnancies were reported up to 7 years later. Age, BMI, or surgical history are unlikely to predict contraceptive failure with HS. Further follow-up studies are planned to capture additional data on this issue. PMID:26623413

Comparação entre os achados ultra-sonográficos, histeroscópicos e histopatológicos no sangramento uterino da pós-menopausa Comparison of ultrasonographic, hysteroscopic and histopathologic findings in women with postmenopausal uterine bleeding

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Adriana Scavuzzi

2003-05-01

os pontos de corte de 4 mm e 5 mm, respectivamente. Nenhum caso de lesão pré-maligna ou maligna foi observado quando foi adotado o ponto de corte de 4 mm. Os achados histeroscópicos e histopatológicos mais freqüentes foram o endométrio atrófico e os pólipos endometriais, observando-se boa taxa de concordância entre esses exames.PURPOSE: to determine the association between ultrasonographic, hysteroscopic and histopathologic findings in women with postmenopausal uterine bleeding. METHODS: a retrospective, cross-sectional study was conducted enrolling 156 women with postmenopausal bleeding attended at the Diagnostic Center - IMIP during the period of January 1995 to December 2001. According to the results of the endometrial examination (ultrasound, the patients were classified as having an abnormal or normal finding depending on the cutoffs of 4 or 5 mm. The most common histologic and hysteroscopic findings were studied and classified as premalignant/malignant lesions (hyperplasia/endometrial cancer or benign findings. These results were compared using the kappa index, to establish the agreement between these techniques. RESULTS: the frequency of endometrial thickening was 75.0 and 67.3% according to cutoffs of 4 mm and 5 mm, respectively. Hysteroscopic findings were atrophic endometrium in 59 (37.8%, endometrial polyp in 56 (35.9%, endometrial hyperplasia in 17 (10.9%, cancer in 16 (10.3%, still active endometrium in 1 (3,2, and other findings in 3 (1.9%. The two most frequent histopathologic findings were also atrophic endometrium (31.4% and endometrial polyps (26,.3%, followed by scanty material (16.0%, endometrial cancer (10.9%, endometrial hyperplastic changes (9.0%, and others (6.4%. A good agreement between hysteroscopic and histopathologic findings was observed (kappa = 0.61. CONCLUSIONS: the frequency of endometrial thickening was 75.0 and 67.3% according to cutoffs of 4 mm and 5 mm, respectively. No premalignant or malignant lesions were missed when

Office hysteroscopic-guided selective tubal chromopertubation: acceptability, feasibility and diagnostic accuracy of this new diagnostic non-invasive technique in infertile women.

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Carta, Gaspare; Palermo, Patrizia; Pasquale, Chiara; Conte, Valeria; Pulcinella, Ruggero; Necozione, Stefano; Cofini, Vincenza; Patacchiola, Felice

2018-06-01

The aim of this study was to evaluate accuracy, tolerability and side effects of office hysteroscopic-guided chromoperturbations in infertile women without anaesthesia. Forty-nine infertile women underwent the procedure to evaluate tubal patency and the uterine cavity. Women with unilateral or bilateral tubal stenosis at hysteroscopy with chromoperturbation, and women with bilateral tubal patency who did not conceive during the period of six months, underwent laparoscopy with chromoperturbation. The results obtained from hysteroscopy and laparoscopy in the assessment of tubal patency were compared. Sensitivity, specificity, accuracy, positive-predictive value and negative-predictive value were used to describe diagnostic performance. Pain and tolerance were assessed during procedure using a visual analogue scale (VAS). Side effects or late complications and pregnancy rate were also recorded three and six months after the procedure. The specificity was 87.8% (95% CI: 73.80-95.90), sensitivity was 85.7% (95% CI 57.20-98.20), positive and negative predictive values were 70.6% (95% CI: 44.00-89) and 94.7% (95% CI: 82.30-99.40), respectively. Pregnancy rate (PR) within six months after performance of hysteroscopy with chromoperturbation was 27%. Office hysteroscopy-guided selective chromoperturbation in infertile patients is a valid technique to evaluate tubal patency and uterine cavity.

Safe injection procedures, injection practices, and needlestick ...

African Journals Online (AJOL)

Results: Safe injection procedures regarding final waste disposal were sufficiently adopted, while measures regarding disposable injection equipment, waste containers, hand hygiene, as well as injection practices were inadequately carried out. Lack of job aid posters that promote safe injection and safe disposal of ...

A novel medical protocol to treat uterotubal spasm during Essure hysteroscopic sterilization: a pilot study

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Chapa HO

2012-06-01

postmedication.Conclusion: Essure sterilization has a high bilateral, first-attempt success rate. Hyoscyamine may aid in spasm relief and increase single procedure, bilateral placement success rate further.Keywords: hysteroscopic sterilization, Essure, tubal spasm, hyoscyamine

Surgical excision of Essure® devices with ESHRE Class IIb uterine malformation: sequential hysteroscopic-laparoscopic approach to the septate uterus.

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Sills, E S; Palermo, G D

2016-03-28

While contraindications to Essure® placement have been provided by the manufacturer, there is no consensus on how best to remove these contraceptive devices. Here, we describe a non-hysterectomy removal of Essure® for a patient with a septate uterus (ESHRE Class IIb uterine malformation). A 35yr old G4 P2 presented for removal of Essure® implants after three years of gradually increasing pelvic pain, weight gain, headache, dizziness, lower extremity paresthesia, and fatigue which followed hysteroscopic sterilization (HS). Prior to HS, the patient was in good general health. She did not smoke and had never had a miscarriage. HS was performed under general anesthesia in October 2012. HSG obtained three months later, confirmed bilateral tubal occlusion but revealed an abnormal uterine cavity. A repeat HSG in 2015 showed minimal device migration, no contrast dye spill and a deeply bifid uterine cavity. At our center laparoscopic cornual dissection and bilateral partial tubal resection achieved removal of both devices intact and the patient was discharged three hours after surgery. Her postoperative recovery was uneventful. The presence of a Müllerian anomaly is a relative contraindication to the Essure® procedure. This is the first reported description of successful removal of Essure® coils in the setting of an ESHRE Class IIb uterine anomaly, and underscores the importance of careful patient selection, accurate pre-operative imaging and a conservative technique which renders hysterectomy unnecessary.

Shear-wave elastography contributes to accurate tumour size estimation when assessing small breast cancers

International Nuclear Information System (INIS)

Mullen, R.; Thompson, J.M.; Moussa, O.; Vinnicombe, S.; Evans, A.

2014-01-01

Aim: To assess whether the size of peritumoural stiffness (PTS) on shear-wave elastography (SWE) for small primary breast cancers (≤15 mm) was associated with size discrepancies between grey-scale ultrasound (GSUS) and final histological size and whether the addition of PTS size to GSUS size might result in more accurate tumour size estimation when compared to final histological size. Materials and methods: A retrospective analysis of 86 consecutive patients between August 2011 and February 2013 who underwent breast-conserving surgery for tumours of size ≤15 mm at ultrasound was carried out. The size of PTS stiffness was compared to mean GSUS size, mean histological size, and the extent of size discrepancy between GSUS and histology. PTS size and GSUS were combined and compared to the final histological size. Results: PTS of >3 mm was associated with a larger mean final histological size (16 versus 11.3 mm, p < 0.001). PTS size of >3 mm was associated with a higher frequency of underestimation of final histological size by GSUS of >5 mm (63% versus 18%, p < 0.001). The combination of PTS and GSUS size led to accurate estimation of the final histological size (p = 0.03). The size of PTS was not associated with margin involvement (p = 0.27). Conclusion: PTS extending beyond 3 mm from the grey-scale abnormality is significantly associated with underestimation of tumour size of >5 mm for small invasive breast cancers. Taking into account the size of PTS also led to accurate estimation of the final histological size. Further studies are required to assess the relationship of the extent of SWE stiffness and margin status. - Highlights: • Peritumoural stiffness of greater than 3 mm was associated with larger tumour size. • Underestimation of tumour size by ultrasound was associated with peri-tumoural stiffness size. • Combining peri-tumoural stiffness size to ultrasound produced accurate tumour size estimation

Efficacy and satisfaction rate comparing endometrial ablation by rollerball electrocoagulation to uterine balloon thermal ablation in a randomised controlled trial.

NARCIS (Netherlands)

Zon-Rabelink, I.A.A. van; Vleugels, M.P.; Merkus, J.M.W.M.; Graaf, R.M. de

2004-01-01

OBJECTIVE: To compare two methods of endometrial ablation, hysteroscopic rollerball electrocoagulation (RBE) and non-hysteroscopic uterine balloon thermal ablation (Thermachoice trade mark ), regarding efficacy for reducing dysfunctional uterine bleeding and patients satisfaction rate. METHODS: A

Endometrial ablation by rollerball electrocoagulation compared to uterine balloon thermal ablation. Technical and safety aspects.

NARCIS (Netherlands)

Zon-Rabelink, I.A.A. van; Vleugels, M.P.; Merkus, J.M.W.M.; Graaf, R.M. de

2003-01-01

OBJECTIVE: To compare two methods of endometrial ablation, hysteroscopic rollerball electrocoagulation (RBE) and non-hysteroscopic uterine balloon thermal (UBT) ablation (Thermachoice), regarding intra- and post-operative technical complications and safety aspects. STUDY DESIGN: A randomised

Hysteroscopic sterilization with occlusion of sheep uterine tube using n-butyl-2-cyanoacrylate adhesive Esterilização histeroscópica com oclusão da tuba uterina de ovelha com adesivo de n-butil-2-cianoacrilato

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Sergio Bigolin

2007-10-01

Full Text Available PURPOSE: To evaluate the fertility and analyze the macroscopic, microscopic and morphometric aspects of sheep uterine tube sterilization with a hysteroscopically insert of n-butyl-2-cyanoacrylate adhesive. METHODS: 12 adult sheep, with one previous pregnancy, were distributed as follows: group L (n=3 subjected to laparotomy and Pomeroy uterine tube ligation, group S (n=3 subjected to hysteroscopic application of saline solution in tube isthmus and group AD(n=6, that was subjected to hysteroscopic application of 0.5 ml of n-2-butil-cyanoacrylate in tube isthmus. They were mated with fertile males for ninety days. The non pregnant sheep, at the 90th day, were subjected to laparotomy with uterus and tubes uterine resection. The fragments of uterine tubes were fixated in 10% formalin and processes for histology evaluated, and slices dyes for H.E. Data were evaluated by Wilcoxon and Mann-Whitney and Fisher's exact test. RESULTS: All sheep from groups L and AD did not get pregnant (0% in contrast with sheep from group S (100%; the adhesive remained integral in the uterine tube lumen. The percentual of adherences (66.6% and fibrosis responses (100% was significantly higher in the group L than group AD (0% (pOBJETIVO: Avaliar a fertilidade e aspectos macroscópicos, microscópicos e morfométricos da esterilização histeroscópica de tubas uterinas de ovelhas com o adesivo de n-butil-2-cianoacrilato. MÉTODOS: 12 ovelhas adultas, com uma prenhez anterior, foram distribuídas como segue: o grupo L (n=3 submetidas à laparotomia e laqueadura tipo Pomeroy, grupo S (n=3 submetidas à aplicação histeroscópica de solução salina no istmo tubário e grupo AD (n=6, com aplicação histeroscópica de 0,5 ml de cianoacrilato. As ovelhas foram acasaladas com machos de comprovada fertilidade por noventa dias. As ovelhas não prenhes aos 90 dias, foram submetidas à laparotomia com ressecção do útero e tubas uterinas, que foram fixadas em formalina 10%s e os

Non-injection Drug Use and Injection Initiation Assistance among People Who Inject Drugs in Tijuana, Mexico.

Science.gov (United States)

Ben Hamida, Amen; Rafful, Claudia; Jain, Sonia; Sun, Shelly; Gonzalez-Zuniga, Patricia; Rangel, Gudelia; Strathdee, Steffanie A; Werb, Dan

2018-02-01

Although most people who inject drugs (PWID) report receiving assistance during injection initiation events, little research has focused on risk factors among PWID for providing injection initiation assistance. We therefore sought to determine the influence of non-injection drug use among PWID on their risk to initiate others. We used generalized estimating equation (GEE) models on longitudinal data among a prospective cohort of PWID in Tijuana, Mexico (Proyecto El Cuete IV), while controlling for potential confounders. At baseline, 534 participants provided data on injection initiation assistance. Overall, 14% reported ever initiating others, with 4% reporting this behavior recently (i.e., in the past 6 months). In a multivariable GEE model, recent non-injection drug use was independently associated with providing injection initiation assistance (adjusted odds ratio [AOR] = 2.42, 95% confidence interval [CI] = 1.39-4.20). Further, in subanalyses examining specific drug types, recent non-injection use of cocaine (AOR = 9.31, 95% CI = 3.98-21.78), heroin (AOR = 4.00, 95% CI = 1.88-8.54), and methamphetamine (AOR = 2.03, 95% CI = 1.16-3.55) were all significantly associated with reporting providing injection initiation assistance. Our findings may have important implications for the development of interventional approaches to reduce injection initiation and related harms. Further research is needed to validate findings and inform future approaches to preventing entry into drug injecting.

Injection, injectivity and injectability in geothermal operations: problems and possible solutions. Phase I. Definition of the problems

Energy Technology Data Exchange (ETDEWEB)

Vetter, O.J.; Crichlow, H.B.

1979-02-14

The following topics are covered: thermodynamic instability of brine, injectivity loss during regular production and injection operations, injectivity loss caused by measures other than regular operations, heat mining and associated reservoir problems in reinjection, pressure maintenance through imported make-up water, suggested solutions to injection problems, and suggested solutions to injection problems: remedial and stimulation measures. (MHR)

Testosterone Injection

Science.gov (United States)

... typical male characteristics. Testosterone injection works by supplying synthetic testosterone to replace the testosterone that is normally ... as a pellet to be injected under the skin.Testosterone injection may control your symptoms but will ...

Riboflavin photoactivation by upconversion nanoparticles for cancer treatment

Science.gov (United States)

Khaydukov, E. V.; Mironova, K. E.; Semchishen, V. A.; Generalova, A. N.; Nechaev, A. V.; Khochenkov, D. A.; Stepanova, E. V.; Lebedev, O. I.; Zvyagin, A. V.; Deyev, S. M.; Panchenko, V. Ya.

2016-10-01

Riboflavin (Rf) is a vitamin and endogenous photosensitizer capable to generate reactive oxygen species (ROS) under UV-blue irradiation and kill cancer cells, which are characterized by the enhanced uptake of Rf. We confirmed its phototoxicity on human breast adenocarcinoma cells SK-BR-3 preincubated with 30-μM Rf and irradiated with ultraviolet light, and proved that such Rf concentrations (60 μM) are attainable in vivo in tumour site by systemic intravascular injection. In order to extend the Rf photosensitization depth in cancer tissue to 6 mm in depth, we purpose-designed core/shell upconversion nanoparticles (UCNPs, NaYF4:Yb3+:Tm3+/NaYF4) capable to convert 2% of the deeply-penetrating excitation at 975 nm to ultraviolet-blue power. This power was expended to photosensitise Rf and kill SK-BR-3 cells preincubated with UCNPs and Rf, where the UCNP-Rf energy transfer was photon-mediated with ~14% Förster process contribution. SK-BR-3 xenograft regression in mice was observed for 50 days, following the Rf-UCNPs peritumoural injection and near-infrared light photodynamic treatment of the lesions.

Safe injection procedures, injection practices, and needlestick ...

African Journals Online (AJOL)

Nermine Mohamed Tawfik Foda

2017-01-10

Jan 10, 2017 ... sures regarding disposable injection equipment, waste containers, hand hygiene ... injection practices lead to high prevalence of NSSIs in operating rooms. .... guidelines, the availability of training courses to HCWs, and provi-.

Acupuncture Injection Combined with Electrokinetic Injection for Polydimethylsiloxane Microfluidic Devices

Directory of Open Access Journals (Sweden)

Ji Won Ha

2017-01-01

Full Text Available We recently reported acupuncture sample injection that leads to reproducible injection of nL-scale sample segments into a polydimethylsiloxane (PDMS microchannel for microchip capillary electrophoresis. The advantages of the acupuncture injection in microchip capillary electrophoresis include capability of minimizing sample loss and voltage control hardware and capability of introducing sample plugs into any desired position of a microchannel. However, the challenge in the previous study was to achieve reproducible, pL-scale sample injections into PDMS microchannels. In the present study, we introduce an acupuncture injection technique combined with electrokinetic injection (AICEI technique to inject pL-scale sample segments for microchip capillary electrophoresis. We carried out the capillary zone electrophoresis (CZE separation of FITC and fluorescein, and the mixture of 10 μM FITC and 10 μM fluorescein was separated completely by using the AICEI method.

Bicornuate-Septate Uterus: A New Congenital Uterine Anomaly

Directory of Open Access Journals (Sweden)

Babak Dabir-Ashrafi

2008-08-01

Full Text Available Bicornuate uterus is class IV and septate uterus is class Vin uterine anomaly classification.Bicornuate uterus is almost always treated by laparotomy and metroplasty. But the treatment of choice for septate uterus is hysteroscopic metroplasty. Bicornuate- septate uterus which is described in this paper is a new class of uterine anomaly(between class IV & V. The advantages of hysteroscopic metroplasty to laparotomy and metroplasty have been proven previously.It is important to know if the uterine anomaly is pure bicornuate or bicornuate-septate. In the latter case, we suggest the first line of operation should be hysteroscopic metroplasty.

Compressed air injection technique to standardize block injection pressures.

Science.gov (United States)

Tsui, Ban C H; Li, Lisa X Y; Pillay, Jennifer J

2006-11-01

Presently, no standardized technique exists to monitor injection pressures during peripheral nerve blocks. Our objective was to determine if a compressed air injection technique, using an in vitro model based on Boyle's law and typical regional anesthesia equipment, could consistently maintain injection pressures below a 1293 mmHg level associated with clinically significant nerve injury. Injection pressures for 20 and 30 mL syringes with various needle sizes (18G, 20G, 21G, 22G, and 24G) were measured in a closed system. A set volume of air was aspirated into a saline-filled syringe and then compressed and maintained at various percentages while pressure was measured. The needle was inserted into the injection port of a pressure sensor, which had attached extension tubing with an injection plug clamped "off". Using linear regression with all data points, the pressure value and 99% confidence interval (CI) at 50% air compression was estimated. The linearity of Boyle's law was demonstrated with a high correlation, r = 0.99, and a slope of 0.984 (99% CI: 0.967-1.001). The net pressure generated at 50% compression was estimated as 744.8 mmHg, with the 99% CI between 729.6 and 760.0 mmHg. The various syringe/needle combinations had similar results. By creating and maintaining syringe air compression at 50% or less, injection pressures will be substantially below the 1293 mmHg threshold considered to be an associated risk factor for clinically significant nerve injury. This technique may allow simple, real-time and objective monitoring during local anesthetic injections while inherently reducing injection speed.

"Injection first": a unique group of injection drug users in Tijuana, Mexico.

Science.gov (United States)

Morris, Meghan D; Brouwer, Kimberly C; Lozada, Remedios M; Gallardo, Manuel; Vera, Alicia; Strathdee, Steffanie A

2012-01-01

Using baseline data from a study of injection drug users (IDUs) in Tijuana, Mexico (N = 1,052), we identified social and behavioral factors associated with injecting at the same age or earlier than other administration routes of illicit drug use (eg, "injection first") and examined whether this IDU subgroup had riskier drug using and sexual behaviors than other IDUs. Twelve-percent "injected first." Characteristics independently associated with a higher odds of "injection first" included being younger at first injection, injecting heroin as their first drug, being alone at the first injection episode, and having a sexual debut at the same age or earlier as when they initiated drug use; family members' illicit drug use was associated with lower odds of injecting first. When adjusting for age at first injection and number of years injecting, "injection first" IDUs had lower odds of ever overdosing, and ever trading sex. On the other hand, they were less likely to have ever been enrolled in drug treatment, and more commonly obtained their syringes from potentially unsafe sources. In conclusion, a sizable proportion of IDUs in Tijuana injected as their first drug using experience, although evidence that this was a riskier subgroup of IDUs was inconclusive.  Copyright © American Academy of Addiction Psychiatry.

Safe injection procedures, injection practices, and needlestick ...

African Journals Online (AJOL)

Nermine Mohamed Tawfik Foda

2017-01-10

Jan 10, 2017 ... Background: Of the estimated 384,000 needle-stick injuries occurring in hospitals each year, 23% occur in surgical settings. This study was conducted to assess safe injection procedures, injection practices, and circumstances contributing to needlestick and sharps injures (NSSIs) in operating rooms.

Prevalence and correlates of neck injection among people who inject drugs in Tijuana, Mexico.

Science.gov (United States)

Rafful, Claudia; Wagner, Karla D; Werb, Dan; González-Zúñiga, Patricia E; Verdugo, Silvia; Rangel, Gudelia; Strathdee, Steffanie A

2015-11-01

Injecting drugs in the neck has been related to adverse health conditions such as jugular vein thrombosis, deep neck infections, aneurysm, haematomas, airway obstruction, vocal cord paralysis and wound botulism, among others. We identified prevalence and correlates of neck injection among people who inject drugs (PWID) in Tijuana, Mexico. Beginning in 2011, PWID aged ≥18 years who injected drugs within the last month were recruited into a prospective cohort. At baseline and semi-annually, PWID completed interviewer-administered surveys soliciting data on drug-injecting practices. Logistic regression was used to identify predictors of injecting in the neck as the most frequent injection site at a single visit. Of 380 PWID, 35.3% injected in the neck at least once in the past 6 months, among whom 71.6% reported it as their most common injection site, the most common injecting site after the arms (47%). Controlling for age, years injecting and injecting frequency, injecting heroin and methamphetamine two or more times per day and having sought injection assistance were associated with injecting in the neck [adjusted odds ratios (AOR): 2.12; 95% confidence intervals (CI): 1.27-3.53 and AOR: 2.65; 95% CI: 1.52-4.53 respectively]. Injecting in the neck was very common among PWID in Tijuana and was associated with polydrug use and seeking injection assistance. Tailoring harm reduction education interventions for individuals who provide injection assistance ('hit doctors') may allow for the dissemination of safe injecting knowledge to reduce injection-related morbidity and mortality. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Small-Volume Injections: Evaluation of Volume Administration Deviation From Intended Injection Volumes.

Science.gov (United States)

Muffly, Matthew K; Chen, Michael I; Claure, Rebecca E; Drover, David R; Efron, Bradley; Fitch, William L; Hammer, Gregory B

2017-10-01

In the perioperative period, anesthesiologists and postanesthesia care unit (PACU) nurses routinely prepare and administer small-volume IV injections, yet the accuracy of delivered medication volumes in this setting has not been described. In this ex vivo study, we sought to characterize the degree to which small-volume injections (≤0.5 mL) deviated from the intended injection volumes among a group of pediatric anesthesiologists and pediatric postanesthesia care unit (PACU) nurses. We hypothesized that as the intended injection volumes decreased, the deviation from those intended injection volumes would increase. Ten attending pediatric anesthesiologists and 10 pediatric PACU nurses each performed a series of 10 injections into a simulated patient IV setup. Practitioners used separate 1-mL tuberculin syringes with removable 18-gauge needles (Becton-Dickinson & Company, Franklin Lakes, NJ) to aspirate 5 different volumes (0.025, 0.05, 0.1, 0.25, and 0.5 mL) of 0.25 mM Lucifer Yellow (LY) fluorescent dye constituted in saline (Sigma Aldrich, St. Louis, MO) from a rubber-stoppered vial. Each participant then injected the specified volume of LY fluorescent dye via a 3-way stopcock into IV tubing with free-flowing 0.9% sodium chloride (10 mL/min). The injected volume of LY fluorescent dye and 0.9% sodium chloride then drained into a collection vial for laboratory analysis. Microplate fluorescence wavelength detection (Infinite M1000; Tecan, Mannedorf, Switzerland) was used to measure the fluorescence of the collected fluid. Administered injection volumes were calculated based on the fluorescence of the collected fluid using a calibration curve of known LY volumes and associated fluorescence.To determine whether deviation of the administered volumes from the intended injection volumes increased at lower injection volumes, we compared the proportional injection volume error (loge [administered volume/intended volume]) for each of the 5 injection volumes using a linear

Anesthetic efficacy of a repeated intraosseous injection following a primary intraosseous injection.

Science.gov (United States)

Jensen, Joanne; Nusstein, John; Drum, Melissa; Reader, Al; Beck, Mike

2008-02-01

The purpose of this prospective, randomized, single-blinded study was to determine the anesthetic efficacy of a repeated intraosseous injection given 30 minutes after a primary intraosseous injection. Using a crossover design, 55 subjects randomly received a primary X-tip intraosseous injection (Dentsply Inc, York, PA) of 1.4 mL of 2% lidocaine with epinephrine (using the Wand; Milestone Scientific, Deerfield, IL) and a repeated intraosseous or mock injection at 30 minutes in two appointments. The first molar and adjacent teeth were pulp tested every 2 minutes for a total of 120 minutes. Success was defined as obtaining two consecutive 80 readings with the electric pulp tester. Success of the initial intraosseous injection was 100% for the first molar. The repeated intraosseous injection mimicked the initial intraosseous injection in terms of pulpal anesthesia and statistically provided another 15 minutes of pulpal anesthesia. In conclusion, using the methodology presented, repeating the intraosseous injection 30 minutes after an initial intraosseous injection will provide an additional 15 minutes of pulpal anesthesia.

Colistimethate Injection

Science.gov (United States)

... injection is in a class of medications called antibiotics. It works by killing bacteria.Antibiotics such as colistimethate injection will not work for colds, flu, or other viral infections. Using ...

Injection Laryngoplasty Materials

OpenAIRE

Haldun Oðuz

2013-01-01

Injection laryngoplasty is one of the treatment options for voice problems. In the recent years, more safe and more biocompatible injection materials are available on the market. Long and short term injection materials are discussed in this review.

Glenohumeral Joint Injections

Science.gov (United States)

Gross, Christopher; Dhawan, Aman; Harwood, Daniel; Gochanour, Eric; Romeo, Anthony

2013-01-01

Context: Intra-articular injections into the glenohumeral joint are commonly performed by musculoskeletal providers, including orthopaedic surgeons, family medicine physicians, rheumatologists, and physician assistants. Despite their frequent use, there is little guidance for injectable treatments to the glenohumeral joint for conditions such as osteoarthritis, adhesive capsulitis, and rheumatoid arthritis. Evidence Acquisition: We performed a comprehensive review of the available literature on glenohumeral injections to help clarify the current evidence-based practice and identify deficits in our understanding. We searched MEDLINE (1948 to December 2011 [week 1]) and EMBASE (1980 to 2011 [week 49]) using various permutations of intra-articular injections AND (corticosteroid OR hyaluronic acid) and (adhesive capsulitis OR arthritis). Results: We identified 1 and 7 studies that investigated intra-articular corticosteroid injections for the treatment of osteoarthritis and adhesive capsulitis, respectively. Two and 3 studies investigated the use of hyaluronic acid in osteoarthritis and adhesive capsulitis, respectively. One study compared corticosteroids and hyaluronic acid injections in the treatment of osteoarthritis, and another discussed adhesive capsulitis. Conclusion: Based on existing studies and their level of evidence, there is only expert opinion to guide corticosteroid injection for osteoarthritis as well as hyaluronic acid injection for osteoarthritis and adhesive capsulitis. PMID:24427384

Injection Tests

CERN Document Server

Kain, V

2009-01-01

The success of the start-up of the LHC on 10th of September was in part due to the preparation without beam and injection tests in 2008. The injection tests allowed debugging and improvement in appropriate portions to allow safe, efficient and state-of-the-art commissioning later on. The usefulness of such an approach for a successful start-up becomes obvious when looking at the problems we encountered before and during the injection tests and could solve during this period. The outline of the preparation and highlights of the different injection tests will be presented and the excellent performance of many tools discussed. A list of shortcomings will follow, leading to some planning for the preparation of the run in 2009.

Meropenem Injection

Science.gov (United States)

... injection is in a class of medications called antibiotics. It works by killing bacteria that cause infection.Antibiotics such as meropenem injection will not work for colds, flu, or other viral infections. Taking ...

Chloramphenicol Injection

Science.gov (United States)

... injection is in a class of medications called antibiotics. It works by stopping the growth of bacteria..Antibiotics such as chloramphenicol injection will not work for colds, flu, or other viral infections. Taking ...

Worldwide Injection Technique Questionnaire Study: Population Parameters and Injection Practices.

Science.gov (United States)

Frid, Anders H; Hirsch, Laurence J; Menchior, Astrid R; Morel, Didier R; Strauss, Kenneth W

2016-09-01

From February 1, 2014, through June 30, 2015, 13,289 insulin-injecting patients from 423 centers in 42 countries took part in one of the largest surveys ever performed in diabetes. The goal was to assess patient characteristics, as well as historical and practical aspects of their injection technique. Results show that 4- and 8-mm needle lengths are each used by nearly 30% of patients and 5- and 6-mm needles each by approximately 20%. Higher consumption of insulin (as measured by total daily dose) is associated with having lipohypertrophy (LH), injecting into LH, leakage from the injection site, and failing to reconstitute cloudy insulin. Glycated hemoglobin values are, on average, 0.5% higher in patients with LH and are significantly higher with incorrect rotation of sites and with needle reuse. Glycated hemoglobin values are lower in patients who distribute their injections over larger injection areas and whose sites are inspected routinely. The frequencies of unexpected hypoglycemia and glucose variability are significantly higher in those with LH, those injecting into LH, those who incorrectly rotate sites, and those who reuse needles. Needles associated with diabetes treatment are the most commonly used medical sharps in the world. However, correct disposal of sharps after use is critically suboptimal. Many used sharps end up in public trash and constitute a major accidental needlestick risk. Use of these data should stimulate renewed interest in and commitment to optimizing injection practices in patients with diabetes. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Granisetron Injection

Science.gov (United States)

Granisetron immediate-release injection is used to prevent nausea and vomiting caused by cancer chemotherapy and to ... nausea and vomiting that may occur after surgery. Granisetron extended-release (long-acting) injection is used with ...

Edaravone Injection

Science.gov (United States)

Edaravone injection is used to treat amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease; a condition in which ... die, causing the muscles to shrink and weaken). Edaravone injection is in a class of medications called ...

Defibrotide Injection

Science.gov (United States)

Defibrotide injection is used to treat adults and children with hepatic veno-occlusive disease (VOD; blocked blood ... the body and then returned to the body). Defibrotide injection is in a class of medications called ...

Nalbuphine Injection

Science.gov (United States)

... injection is in a class of medications called opioid agonist-antagonists. It works by changing the way ... suddenly stop using nalbuphine injection, you may experience withdrawal symptoms including restlessness; teary eyes; runny nose; yawning; ...

Hysteroscopic Essure Inserts for Permanent Contraception: Extended Follow-Up Results of a Phase III Multicenter International Study.

Science.gov (United States)

Chudnoff, Scott G; Nichols, John E; Levie, Mark

2015-01-01

To describe safety, tolerability, and effectiveness results through 5 years of follow-up of a Phase III trial with Essure inserts. Multicenter, nonrandomized, single-arm international study (Canadian Task Force classification II-3). Thirteen clinical study centers in the United States, Europe, and Australia. A total of 518 previously fertile women seeking permanent contraception. The objective of the hysteroscopic sterilization procedure was bilateral Essure insert placement (ESS205 model) and tubal occlusion. Women with satisfactory device location and tube occlusion (based on modified hysterosalpingography [HSG]) were instructed to discontinue alternative contraception and to rely on Essure inserts for permanent contraception. The primary endpoint for the Phase III study was the rate of pregnancies occurring during the first year of relying (i.e., HSG-confirmed occlusion) on the Essure inserts for permanent contraception (i.e., 12 months after HSG). For the full 5 years of follow-up (5 years total of relying on the Essure inserts for contraception), the endpoints of interest were safety, prevention of pregnancy, and satisfaction. No pregnancies were reported among women relying on the Essure inserts who completed the full 5 years of follow-up. As of December 5, 2007, 449 women with successful bilateral placement relying on the Essure inserts contributed a total 24 942 woman-months of follow-up for assessing effectiveness. Overall, the Essure inserts were generally well tolerated, with participant comfort rated as "good" to "excellent" by 99% of women (382 of 385) after 5 years of use. Similarly, overall satisfaction was rated as "somewhat" to "very satisfied" by 98% of women (376 of 384) after 5 years of use. The majority of adverse events reported during the 5 years of follow-up were rated as either "mild" or "moderate" in severity. Three severe events (abdominal pain with very heavy periods and irregular menstrual bleeding) were reported in 2 subjects during

Sampling in Atypical Endometrial Hyperplasia: Which Method Results in the Lowest Underestimation of Endometrial Cancer? A Systematic Review and Meta-analysis.

Science.gov (United States)

Bourdel, Nicolas; Chauvet, Pauline; Tognazza, Enrica; Pereira, Bruno; Botchorishvili, Revaz; Canis, Michel

2016-01-01

Our objective was to identify the most accurate method of endometrial sampling for the diagnosis of complex atypical hyperplasia (CAH), and the related risk of underestimation of endometrial cancer. We conducted a systematic literature search in PubMed and EMBASE (January 1999-September 2013) to identify all registered articles on this subject. Studies were selected with a 2-step method. First, titles and abstracts were analyzed by 2 reviewers, and 69 relevant articles were selected for full reading. Then, the full articles were evaluated to determine whether full inclusion criteria were met. We selected 27 studies, taking into consideration the comparison between histology of endometrial hyperplasia obtained by diagnostic tests of interest (uterine curettage, hysteroscopically guided biopsy, or hysteroscopic endometrial resection) and subsequent results of hysterectomy. Analysis of the studies reviewed focused on 1106 patients with a preoperative diagnosis of atypical endometrial hyperplasia. The mean risk of finding endometrial cancer at hysterectomy after atypical endometrial hyperplasia diagnosed by uterine curettage was 32.7% (95% confidence interval [CI], 26.2-39.9), with a risk of 45.3% (95% CI, 32.8-58.5) after hysteroscopically guided biopsy and 5.8% (95% CI, 0.8-31.7) after hysteroscopic resection. In total, the risk of underestimation of endometrial cancer reaches a very high rate in patients with CAH using the classic method of evaluation (i.e., uterine curettage or hysteroscopically guided biopsy). This rate of underdiagnosed endometrial cancer leads to the risk of inappropriate surgical procedures (31.7% of tubal conservation in the data available and no abdominal exploration in 24.6% of the cases). Hysteroscopic resection seems to reduce the risk of underdiagnosed endometrial cancer. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

Piezoelectric Injection Systems

Science.gov (United States)

Mock, R.; Lubitz, K.

The origin of direct injection can be doubtlessly attributed to Rudolf Diesel who used air assisted injection for fuel atomisation in his first self-ignition engine. Although it became apparent already at that time that direct injection leads to reduced specific fuel consumption compared to other methods of fuel injection, it was not used in passenger cars for the moment because of its disadvantageous noise generation as the requirements with regard to comfort were seen as more important than a reduced specific consumption.

A comparison of molding procedures - Contact, injection and vacuum injection

Science.gov (United States)

Cathiard, G.

1980-06-01

The technical and economic aspects of the contact, injection and vacuum injection molding of reinforced plastic components are compared for the example of a tractor roof with a gel-coated surface. Consideration is given to the possibility of reinforcement, number of smooth faces, condition of the gel-coated surface, reliability, and labor and workplace requirements of the three processes, and advantages of molding between the mold and a countermold in smooth faces, reliability, labor requirements, working surface and industrial hygiene are pointed out. The times and labor requirements of each step in the molding cycles are examined, and material requirements and yields, investment costs, amortization and product cost prices of the processes are compared. It is concluded that, for the specific component examined, the processes of vacuum injection and injection molding appear very interesting, with injection molding processes resulting in lower cost prices than contact molding for any production volume.

Prevalence of injections and knowledge of safe injections among rural residents in Central China.

Science.gov (United States)

Yan, Y W; Yan, J; Zhang, G P; Gao, Z L; Jian, H X

2007-08-01

Abuse of the injection services, namely unnecessary injections and unsafe injections, exists extensively in developing countries. Unsafe injection practices contribute to the transmission of blood-borne pathogens. The aims of this study were to survey the prevalence of injections and knowledge of injection safety among the rural residents in Jingzhou district, Hubei, China and to provide scientific data for developing a health educational programme. A retrospective cross-sectional study was conducted in 12 villages, which were selected from the Jingzhou district by the random sampling method. 50 rural residents were interviewed per village using a questionnaire. Among the 595 residents studied, 192 had received at least one injection in the past three months, with an injection prevalence of 32.3 percent and an average of 0.93 injections. 90.3 percent of the rural residents knew that unsafe injections could transmit the following blood-borne pathogens: human immunodeficiency virus (74.4 percent), hepatitis B virus (55.8 percent) and hepatitis C virus (22.9 percent). Logistic regression analysis showed that the residents' age, educational level and residential area were important factors in influencing their knowledge about injection safety. The results indicated that the injection prevalence was high among rural residents in the study area, and their knowledge regarding injection safety should be further improved.

Injection-controlled laser resonator

Science.gov (United States)

Chang, J.J.

1995-07-18

A new injection-controlled laser resonator incorporates self-filtering and self-imaging characteristics with an efficient injection scheme. A low-divergence laser signal is injected into the resonator, which enables the injection signal to be converted to the desired resonator modes before the main laser pulse starts. This injection technique and resonator design enable the laser cavity to improve the quality of the injection signal through self-filtering before the main laser pulse starts. The self-imaging property of the present resonator reduces the cavity induced diffraction effects and, in turn, improves the laser beam quality. 5 figs.

CT-guided cervical nerve root injections: comparing the immediate post-injection anesthetic-related effects of the transforaminal injection with a new indirect technique

International Nuclear Information System (INIS)

Sutter, Reto; Pfirrmann, Christian W.A.; Peterson, Cynthia K.; Zanetti, Marco; Hodler, Juerg

2011-01-01

To describe an ''indirect'' cervical nerve root injection technique with a dorsal approach that should carry less inherent risk than the ''direct'' cervical transforaminal injection approach, and to compare the immediate post-injection results of the two procedures. The indirect and direct cervical nerve root injection procedures are described in detail. Fifty-three consecutive patients receiving the indirect nerve root injections during 2009-2010 were age- and gender-matched to 53 patients who underwent direct transforaminal nerve root injections performed in 2006. Pain level data were collected immediately before and 20-30 min after each procedure. The percentages of pain change in the two groups were compared using the unpaired Student's t test. Fifty-two men (mean age 49) and 54 women (mean age 55) were included. The mean percentage of pain reduction for patients receiving indirect nerve root injections was 38.4% and for those undergoing the direct nerve root injections approach it was 43.2%. This was not significantly different (P = 0.455). No immediate or late adverse effects were reported after either injection procedure. The indirect cervical nerve root injection procedure is a potentially safer alternative to direct cervical transforaminal nerve root injections. The short-term pain reduction is similar using the two injection methods. (orig.)

Optimization of injection law for direct injection diesel engine

International Nuclear Information System (INIS)

Feola, M.; Bella, G.; Pelloni, P.; Casoli, P.; Toderi, G.; Cantore, G.

1992-01-01

This paper describes how different timing and shape of the injection law can influence pollutant emission of a direct injection diesel engine. The study was carried out making use of a multizone thermodynamic model as regards the closed valve phase, and a filling-emptying one as regards the open valve phase. After being calibrated by comparison with experimental data, the abovementioned model was used for injection law optimization as regards minimum pollutant concentration (NO x and soot) in the exhaust gases with the smallest engine performance reduction possible

Subcutaneous Injections

DEFF Research Database (Denmark)

Thomsen, Maria

This thesis is about visualization and characterization of the tissue-device interaction during subcutaneous injection. The tissue pressure build-up during subcutaneous injections was measured in humans. The insulin pen FlexTouchr (Novo Nordisk A/S) was used for the measurements and the pressure ...

Hydromorphone Injection

Science.gov (United States)

... anyone else to use your medication. Store hydromorphone injection in a safe place so that no one else can use it accidentally or on purpose. Keep track of how much medication is left so ... with hydromorphone injection may increase the risk that you will develop ...

Ketorolac Injection

Science.gov (United States)

... an older adult, you should know that ketorolac injection is not as safe as other medications that can be used to treat your condition. Your doctor may choose to prescribe a different medication ... to ketorolac injection.Your doctor or pharmacist will give you the ...

Sonographically guided deep plantar fascia injections: where does the injectate go?

Science.gov (United States)

Maida, Eugene; Presley, James C; Murthy, Naveen; Pawlina, Wojciech; Smith, Jay

2013-08-01

To determine the distribution of sonographically guided deep plantar fascia injections in an unembalmed cadaveric model. A single experienced operator completed 10 sonographically guided deep plantar fascia injections in 10 unembalmed cadaveric specimens (5 right and 5 left) obtained from 6 donors (2 male and 4 female) aged 49 to 95 years (mean, 77.5 years) with a mean body mass index of 23.2 kg/m(2) (range, 18.4-26.3 kg/m(2)). A 12-3-MHz linear array transducer was used to direct a 22-gauge, 38-mm stainless steel needle deep to the plantar fascia at the anterior aspect of the calcaneus using an in-plane, medial-to-lateral approach. In each case, 1.5 mL of 50% diluted colored latex was injected deep to the plantar fascia. After a minimum of 72 hours, study coinvestigators dissected each specimen to assess injectate placement. All 10 injections accurately placed latex adjacent to the deep side of the plantar fascia at the anterior calcaneus. However, the flexor digitorum brevis (FDB) origin from the plantar fascia variably limited direct latex contact with the plantar fascia, and small amounts of latex interdigitated with the FDB origin in 90% (9 of 10). In all 10 specimens, latex also covered the traversing first branch of the lateral plantar nerve (FBLPN, ie, Baxter nerve) between the FDB and quadratus plantae muscles. No latex was found in the plantar fat pad or plantar fascia in any specimen. Sonographically guided deep plantar fascia injections reliably deliver latex deep to the plantar fascia while avoiding intrafascial injection. However, the extent of direct plantar fascia contact is variable due to the intervening FDB. On the contrary, the traversing FBLPN is reliably covered by the injection. Deep plantar fascia injections may have a role in the management of refractory plantar fasciitis, particularly following failed superficial perifascial or intrafascial injections, in cases of preferential deep plantar fascia involvement, or when entrapment

Paclitaxel Injection

Science.gov (United States)

(pak'' li tax' el)Paclitaxel injection must be given in a hospital or medical facility under the supervision of a doctor who is experienced in giving chemotherapy medications for cancer.Paclitaxel injection may cause a large decrease in the number of white blood cells (a type of blood cell ...

Compressed air injection technique to standardize block injection pressures : [La technique d'injection d'air comprimé pour normaliser les pressions d'injection d'un blocage nerveux].

Science.gov (United States)

Tsui, Ban C H; Li, Lisa X Y; Pillay, Jennifer J

2006-11-01

Presently, no standardized technique exists to monitor injection pressures during peripheral nerve blocks. Our objective was to determine if a compressed air injection technique, using an in vitro model based on Boyle's law and typical regional anesthesia equipment, could consistently maintain injection pressures below a 1293 mmHg level associated with clinically significant nerve injury. Injection pressures for 20 and 30 mL syringes with various needle sizes ( 18G, 20G, 21 G, 22G, and 24G) were measured in a closed system. A set volume of air was aspirated into a saline-filled syringe and then compressed and maintained at various percentages while pressure was measured. The needle was inserted into the injection port of a pressure sensor, which had attached extension tubing with an injection plug clamped "off". Using linear regression with all data points, the pressure value and 99% confidence interval (CI) at 50% air compression was estimated. The linearity of Boyle's law was demonstrated with a high correlation, r = 0.99, and a slope of 0.984 (99% CI: 0.967-1.001). The net pressure generated at 50% compression was estimated as 744.8 mmHg, with the 99% CI between 729.6 and 760.0 mmHg. The various syringe/needle combinations had similar results. By creating and maintaining syringe air compression at 50% or less, injection pressures will be substantially below the 1293 mmHg threshold considered to be an associated risk factor for clinically significant nerve injury. This technique may allow simple, real-time and objective monitoring during local anesthetic injections while inherently reducing injection speed. Présentement, aucune technique normalisée ne permet de vérifier les pressions d'injection pendant les blocages nerveux périphériques. Nous voulions vérifier si une technique d'injection d'air comprimé, utilisant un modèle in vitro fondé sur la loi de Boyle et du matériel propre à l'anesthésie régionale, pouvait maintenir avec régularité les

Comparative study of diode-pumping self-injection and injection-locking Tm:YAG lasers

International Nuclear Information System (INIS)

Wu, C T; Chen, F; Ju, Y L; Wang, Y Z

2013-01-01

A comparative study of the laser characteristics of self-injection and injection-locking Tm:YAG lasers is given in this paper. At a pump energy of 145 mJ and Q-switched repetition rate of 100 Hz, an output energy of 2.39 mJ was obtained for an injection-locking Tm:YAG laser, with a pulse width of 403.2 ns and a pulse building-up time of 2.12 μs. Under the same conditions, the output energy, pulse width and pulse build-up time for a self-injection Tm:YAG laser were 2.21 mJ, 407.0 ns and 3.95 μs, respectively. The threshold of the Q-switched injection-locking Tm:YAG laser was much lower than that of the self-injection laser, and the pulse width was narrower and the pulse build-up time shorter. Additionally, the output spectrum was much purer for the injection-locking laser. (paper)

Calculation method of water injection forward modeling and inversion process in oilfield water injection network

Science.gov (United States)

Liu, Long; Liu, Wei

2018-04-01

A forward modeling and inversion algorithm is adopted in order to determine the water injection plan in the oilfield water injection network. The main idea of the algorithm is shown as follows: firstly, the oilfield water injection network is inversely calculated. The pumping station demand flow is calculated. Then, forward modeling calculation is carried out for judging whether all water injection wells meet the requirements of injection allocation or not. If all water injection wells meet the requirements of injection allocation, calculation is stopped, otherwise the demand injection allocation flow rate of certain step size is reduced aiming at water injection wells which do not meet requirements, and next iterative operation is started. It is not necessary to list the algorithm into water injection network system algorithm, which can be realized easily. Iterative method is used, which is suitable for computer programming. Experimental result shows that the algorithm is fast and accurate.

Worldwide Injection Technique Questionnaire Study: Injecting Complications and the Role of the Professional.

Science.gov (United States)

Frid, Anders H; Hirsch, Laurence J; Menchior, Astrid R; Morel, Didier R; Strauss, Kenneth W

2016-09-01

From February 1, 2014, through June 30, 2015, 13,289 insulin-injecting patients from 423 centers in 42 countries participated in one of the largest surveys ever performed in diabetes. The first results of this survey are published elsewhere in this issue. Herein we report that the most common complication of injecting insulin is lipohypertrophy (LH), which was self-reported by 29.0% of patients and found by physical examination in 30.8% by health care professionals (HCPs). Patients with LH consumed a mean of 10.1 IU more insulin daily than patients without LH. Glycated hemoglobin levels averaged 0.55% higher in patients with vs without LH. Lipohypertrophy was associated with higher rates of unexplained hypoglycemia and glycemic variability as well as more frequent diabetic ketoacidosis, incorrect rotation of injection sites, use of smaller injection zones, longer duration of insulin use, and reuse of pen needles (each P<.05). Routine inspection of injection sites by the HCP was associated with lower glycated hemoglobin levels, less LH, and more correct injection site rotation. Patients were also more likely to rotate correctly if they received injection instructions from their HCP in the past 6 months. Fewer than 40% of patients claimed to have gotten such instructions in the past 6 months, and 10% said that they have never received training on how to inject correctly despite injecting for a mean of nearly 9 years. Use of these data should stimulate renewed commitment to optimizing insulin injection practices. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Hydrogen/oxygen injection stopping method for nuclear power plant and emergent hydrogen/oxygen injection device

International Nuclear Information System (INIS)

Ishida, Ryoichi; Ota, Masamoto; Takagi, Jun-ichi; Hirose, Yuki

1998-01-01

The present invention provides a device for suppressing increase of electroconductivity of reactor water during operation of a BWR type reactor, upon occurrence of reactor scram of the plant or upon stopping of hydrogen/oxygen injection due to emergent stoppage of an injection device so as not to deteriorate the integrity of a gas waste processing system upon occurrence of scram. Namely, when injection of hydrogen/oxygen is stopped during plant operation, the injection amount of hydrogen is reduced gradually. Subsequently, injection of hydrogen is stopped. With such procedures, the increase of electroconductivity of reactor water can be suppressed upon stoppage of hydrogen injection. When injection of hydrogen/oxygen is stopped upon shut down of the plant, the amount of hydrogen injection is changed depending on the change of the feedwater flow rate, and then the plant is shut down while keeping hydrogen concentration of feedwater to a predetermined value. With such procedures, increase of the reactor water electroconductivity can be suppressed upon stoppage of hydrogen injection. Upon emergent stoppage of the hydrogen/oxygen injection device, an emergent hydrogen/oxygen injection device is actuated to continue the injection of hydrogen/oxygen. With such procedures, elevation of reactor water electroconductivity can be suppressed. (I.S.)

Penicillin G Procaine Injection

Science.gov (United States)

Penicillin G procaine injection is used to treat certain infections caused by bacteria. Penicillin G procaine injection should not be used to ... early in the treatment of certain serious infections. Penicillin G procaine injection is in a class of ...

A new hysteroscopic technique for the preparation of partially intramural myomas in office setting (OPPIuM technique): A pilot study.

Science.gov (United States)

Bettocchi, Stefano; Di Spiezio Sardo, Attilio; Ceci, Oronzo; Nappi, Luigi; Guida, Maurizio; Greco, Elena; Pinto, Lauro; Camporiale, Anna Lina; Nappi, Carmine

2009-01-01

To assess the safety and the effectiveness of a novel hysteroscopic technique for the Office Preparation of Partially Intramural Myomas (OPPIuM), to facilitate the subsequent, already scheduled, resectoscopic myomectomy. Pilot study. University of Bari, Naples and Foggia. Fifty-nine fertile women (age 27-48 years) diagnosed at office hysteroscopy as having symptomatic submucous myomas>1.5 cm with intramural development (G1 and G2), scheduled for resectoscopic surgery. The OPPIuM technique consisted of an incision of the endometrial mucosa covering the myoma by means of Fr scissors or bipolar Versapoint Twizzle electrode, along its reflection line on the uterine wall, up to the precise identification of the cleavage surface between the myoma and its pseudo-capsule. Such procedure was aimed at triggering the protrusion of the intramural portion of the myoma into the uterine cavity during the following menstrual cycles, thus facilitating the subsequent total removal of the lesion via resectoscopic surgery. All patients underwent follow-up in-patient hysteroscopy after 2 menstrual cycles before resectoscopic surgery were performed. The OPPIuM technique was successfully performed in all cases. The mean diameter of successfully prepared myomas was 2.9+/-0.8 cm. At follow-up hysteroscopy, the conversion of partially intramural myomas into totally or prevalently intracavitary ones was observed in 93.2% (55/59) of cases. In 2 of 3 cases of failure, the myomas' size was>4 cm. One patient was excluded from the study because of the occurrence of total spontaneous expulsion of the myoma at the subsequent menstrual cycle. Our preliminary findings seem to support the safety and the effectiveness of the OPPIuM procedure by reporting the conversion of myomas with intramural development>1.5 cm into totally or prevalently intracavitary ones in nearly 93% of cases. Such technique may allow surgeons to perform resectoscopic surgery more safely and quickly as dealing with prevalently

Therapeutic hip injections: Is the injection volume important?

International Nuclear Information System (INIS)

Young, R.; Harding, J.; Kingsly, A.; Bradley, M.

2012-01-01

Aim: To assess whether an increased volume of local anaesthetic injection given with intra-articular steroids improves symptom relief in osteoarthritis of the hip. Materials and methods: One hundred and ten patients with hip osteoarthritis were randomized into two groups (A and B). All patients were given 40 mg triamcinolone and 2 ml bupivicaine, and patients from group B were also given 6 ml of sterile water for injection. Change in WOMAC (Western Ontario and McMaster University Osteoarthritis Index Version 3.1) scores from baseline to 3 months were calculated and assessed for clinical and statistical significance. The patients were assessed for pain at 2 weekly intervals using the Oxford pain chart. Results: Patients from group B showed some reduction in stiffness (7%) and improved function (3%) compared with group A, and there were more clinical responders in these two categories. However, there was no significant statistical or clinical difference in WOMAC scores between the two groups at 3 months. There was also no statistical difference in pain symptoms between the two groups during the study period, measured at 2 weekly intervals. One hundred and two patients reached the study endpoint; eight patients who had bilateral hip injections were subsequently included in the analysis, and these patients did not alter the findings significantly. Conclusions: Published total injection volumes used for treating osteoarthritis of the hip with intra-articular steroids vary from 3 to 12 ml. The present study has shown that there is no detriment to using a larger volume of injectate, and recommends that practitioners use total volumes between 3 and 9 ml.

Therapeutic hip injections: Is the injection volume important?

Energy Technology Data Exchange (ETDEWEB)

Young, R., E-mail: russell.young@gwh.nhs.uk [Department of Radiology, Great Western Hospital, Swindon (United Kingdom); Harding, J. [Department of Radiology, University Hospital Coventry, Coventry (United Kingdom); Kingsly, A. [Department of Mathematics and Statistics, Bristol Institue of Technology, University of the West of England, Bristol (United Kingdom); Bradley, M. [Department of Radiology, Southmead Hospital, Bristol (United Kingdom)

2012-01-15

Aim: To assess whether an increased volume of local anaesthetic injection given with intra-articular steroids improves symptom relief in osteoarthritis of the hip. Materials and methods: One hundred and ten patients with hip osteoarthritis were randomized into two groups (A and B). All patients were given 40 mg triamcinolone and 2 ml bupivicaine, and patients from group B were also given 6 ml of sterile water for injection. Change in WOMAC (Western Ontario and McMaster University Osteoarthritis Index Version 3.1) scores from baseline to 3 months were calculated and assessed for clinical and statistical significance. The patients were assessed for pain at 2 weekly intervals using the Oxford pain chart. Results: Patients from group B showed some reduction in stiffness (7%) and improved function (3%) compared with group A, and there were more clinical responders in these two categories. However, there was no significant statistical or clinical difference in WOMAC scores between the two groups at 3 months. There was also no statistical difference in pain symptoms between the two groups during the study period, measured at 2 weekly intervals. One hundred and two patients reached the study endpoint; eight patients who had bilateral hip injections were subsequently included in the analysis, and these patients did not alter the findings significantly. Conclusions: Published total injection volumes used for treating osteoarthritis of the hip with intra-articular steroids vary from 3 to 12 ml. The present study has shown that there is no detriment to using a larger volume of injectate, and recommends that practitioners use total volumes between 3 and 9 ml.

78 FR 23246 - Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for...

Science.gov (United States)

2013-04-18

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9804-8] Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for Exemption--Class I Hazardous Waste Injection; BASF... exemption to the land disposal Restrictions, under the 1984 Hazardous and Solid Waste [[Page 23247...

Efficient Spin Injection into Semiconductor

International Nuclear Information System (INIS)

Nahid, M.A.I.

2010-06-01

Spintronic research has made tremendous progress nowadays for making future devices obtain extra advantages of low power, and faster and higher scalability compared to present electronic devices. A spintronic device is based on the transport of an electron's spin instead of charge. Efficient spin injection is one of the very important requirements for future spintronic devices. However, the effective spin injection is an exceedingly difficult task. In this paper, the importance of spin injection, basics of spin current and the essential requirements of spin injection are illustrated. The experimental technique of electrical spin injection into semiconductor is also discussed based on the experimental experience. The electrical spin injection can easily be implemented for spin injection into any semiconductor. (author)

77 FR 26755 - Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for...

Science.gov (United States)

2012-05-07

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9669-6] Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for Exemption--Class I Hazardous Waste Injection; Diamond... reissuance of an exemption to the land disposal Restrictions, under the 1984 Hazardous and Solid Waste...

76 FR 55908 - Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for...

Science.gov (United States)

2011-09-09

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9461-5] Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for Exemption--Class I Hazardous Waste Injection; Great Lakes... of an exemption to the land disposal restrictions, under the 1984 Hazardous and Solid Waste...

76 FR 36129 - Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for...

Science.gov (United States)

2011-06-21

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9321-3] Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for Exemption--Class I Hazardous Waste Injection; ExxonMobil... disposal Restrictions, under the 1984 Hazardous and Solid Waste Amendments to the Resource Conservation and...

78 FR 42776 - Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for...

Science.gov (United States)

2013-07-17

... ENVIRONMENTAL PROTECTION AGENCY [FRL9834-8] Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for Exemption--Class I Hazardous Waste Injection; Blanchard Refining... disposal Restrictions, under the 1984 Hazardous and Solid Waste Amendments to the Resource Conservation and...

77 FR 52717 - Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for...

Science.gov (United States)

2012-08-30

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9724-1] Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for Exemption--Class I Hazardous Waste Injection; Cornerstone... exemption to the land disposal Restrictions, under the 1984 Hazardous and Solid Waste Amendments to the...

76 FR 42125 - Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for...

Science.gov (United States)

2011-07-18

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9440-3] Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for Exemption--Class I Hazardous Waste Injection; ConocoPhillips... Restrictions, under the 1984 Hazardous and Solid Waste Amendments to the Resource Conservation and Recovery Act...

78 FR 76294 - Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for...

Science.gov (United States)

2013-12-17

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9904-21-OW] Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for Exemption--Class I Hazardous Waste Injection; Mosaic... Restrictions, under the 1984 Hazardous and Solid Waste Amendments to the Resource Conservation and Recovery Act...

75 FR 60457 - Underground Injection Control Program Hazardous Waste Injection Restrictions; Petition for...

Science.gov (United States)

2010-09-30

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9208-4] Underground Injection Control Program Hazardous Waste Injection Restrictions; Petition for Exemption--Class I Hazardous Waste Injection Dow Chemical Company (DOW... 1984 Hazardous and Solid Waste Amendments to the Resource Conservation and Recovery Act have been...

Water quality considerations resulting in the impaired injectivity of water injection and disposal wells

International Nuclear Information System (INIS)

Bennion, D.B.; Thomas, F.B.; Imer, D.; Ma, T.

2000-01-01

An environmentally responsible way to improve hydrocarbon recovery is to maintain pressure by water injection. This is a desirable method because unwanted produced water from oil and gas wells can be re-injected into producing or disposal formations. The success of the operation, however, depends on injecting the necessary volume of water economically, below the fracture gradient pressure of the formation. Well placement, geometry and inherent formation quality and relative permeability characteristics are some of the many other factors which influence the success of any injection project. Poor injection or poor quality of disposal water can also compromise the injectivity for even high quality sandstone or carbonate formations. This would necessitate costly workovers and recompletions. This paper presented some leading edge diagnostic techniques and evaluation methods to determine the quality of injected water. The same techniques could be used to better understand the effect of potential contaminants such as suspended solids, corrosion products, skim/carryover oil and grease, scales, precipitates, emulsions, oil wet hydrocarbon agglomerates and many other conditions which cause injectivity degradation. 14 refs., 1 tab., 15 figs

Laparoscopic hemi-hysterectomy in treatment of a didelphic uterus with a hypoplastic cervix and obstructed hemi-vagina.

Science.gov (United States)

Boudhraa, K; Barbarino, A; Gara, Mohamed Faouzi

2008-11-01

Maldevelopment of the Müllerian duct system may result in various urogenital anomalies including didelphic uterus with a hypoplastic cervix and obstructed hemi-vagina. We report a patient with this anomaly who was treated by laparoscopic hemi-hysterectomy and hysteroscopic resection of hemi-vagina. A 16-year-old patient who had complained of vaginal pus-like discharge on and off for 1 year was diagnosed by MRI to have a double uterus with obstructed right hemi-vagina and ipsilateral renal agenesis. After hysteroscopic identification of hypoplasia of the right uterine cervix, laparoscopic resection of the right uterus and right fallopian tube and hysteroscopic assisted resection of the vaginal septa were performed successfully. We think that combined laparoscopy and hysteroscopy may be an effective alternative in the management and diagnosis of Mullerian anomalies.

Physics of the current injection process during localized helicity injection

Science.gov (United States)

Hinson, Edward Thomas

An impedance model has been developed for the arc-plasma cathode electron current source used in localized helicity injection tokamak startup. According to this model, a potential double layer (DL) is established between the high-density arc plasma (narc ˜ 1021 m-3) in the electron source, and the less-dense external tokamak edge plasma (nedge ˜ 10 18 m-3) into which current is injected. The DL launches an electron beam at the applied voltage with cross-sectional area close to that of the source aperture: Ainj ≈ 2 cm 2. The injected current, Iinj, increases with applied voltage, Vinj, according to the standard DL scaling, Iinj ˜ V(3/2/ inj), until the more restrictive of two limits to beam density nb arises, producing Iinj ˜ V(1/2/inj), a scaling with beam drift velocity. For low external tokamak edge density nedge, space-charge neutralization of the intense electron beam restricts the injected beam density to nb ˜ nedge. At high Jinj and sufficient edge density, the injected current is limited by expansion of the DL sheath, which leads to nb ˜ narc. Measurements of narc, Iinj , nedge, Vinj, support these predicted scalings, and suggest narc as a viable control actuator for the source impedance. Magnetic probe signals ≈ 300 degrees toroidally from the injection location are consistent with expectations for a gyrating, coherent electron beam with a compact areal cross-section. Technological development of the source has allowed an extension of the favorable Iinj ˜ V(1/2/inj) to higher power without electrical breakdown.

Calcitonin Salmon Injection

Science.gov (United States)

Calcitonin salmon injection is used to treat osteoporosis in postmenopausal women. Osteoporosis is a disease that causes bones to weaken and break more easily. Calcitonin salmon injection is also used to treat Paget's disease ...

UV-visible digital imaging of split injection in a Gasoline Direct Injection engine

Directory of Open Access Journals (Sweden)

Merola Simona Silvia

2015-01-01

Full Text Available Ever tighter limits on pollutant emissions and the need to improve energy conversion efficiency have made the application of gasoline direct injection (GDI feasible for a much wider scale of spark ignition engines. Changing the way fuel is delivered to the engine has thus provided increased flexibility but also challenges, such as higher particulate emissions. Therefore, alternative injection control strategies need to be investigated in order to obtain optimum performance and reduced environmental impact. In this study, experiments were carried out on a single-cylinder GDI optical engine fuelled with commercial gasoline in lean-burn conditions. The single-cylinder was equipped with the head of a commercial turbocharged engine with similar geometrical specifications (bore, stroke, compression ratio and wall guided fuel injection. Optical accessibility was ensured through a conventional elongated hollow Bowditch piston and an optical crown, accommodating a fused-silica window. Experimental tests were performed at fixed engine speed and injection pressure, whereas the injection timing and the number of injections were adjusted to investigate their influence on combustion and emissions. UV-visible digital imaging was applied in order to follow the combustion process, from ignition to the late combustion phase. All the optical data were correlated with thermodynamic analysis and measurements of exhaust emissions. Split injection strategies (i.e. two injections per cycle with respect to single injection increased combustion efficiency and stability thanks to an improvement of fuel air mixing. As a consequence, significant reduction in soot formation and exhaust emission with acceptable penalty in terms of HC and NOx were measured.

Deoxycholic Acid Injection

Science.gov (United States)

Deoxycholic acid injection is used to improve the appearance and profile of moderate to severe submental fat ('double chin'; fatty tissue located under the chin). Deoxycholic acid injection is in a class of medications called ...

Antigen injection (image)

Science.gov (United States)

Leprosy is caused by the organism Mycobacterium leprae . The leprosy test involves injection of an antigen just under ... if your body has a current or recent leprosy infection. The injection site is labeled and examined ...

Injection of tennis elbow: Hit and miss? A cadaveric study of injection accuracy

NARCIS (Netherlands)

Keijsers, Renee; van den Bekerom, Michel P. J.; Koenraadt, Koen L. M.; Bleys, Ronald L. A. W.; van Dijk, C. Niek; Eygendaal, Denise; van Riet, Roger; Middernacht, Bart; Defoort, Saartje; Wagener, Marc; Harake, Ramzi; Ciornohac, Jean-Florin; Montarnal, Robert; van Benthem, Yasmin; Cattaneo, Stefano; Faber, Dirk; Galatz, Leesa; Birkisson, Illugi; van der Hoeven, Henk; Witjes, Suzanne; Heeren, M.; Ahmed, El-Gammal; Husif, N. N.; Beumer, Annechien; The, Bertram

2017-01-01

Different injection therapies are used in the treatment of lateral epicondylitis (LE). Usually, the extensor carpi radialis brevis (ECRB) tendon is affected. Therefore, an injection should be aimed at the origin of this tendon. This study demonstrates the accuracy of manual injections in the

Iron Dextran Injection

Science.gov (United States)

Iron dextran injection is used to treat iron-deficiency anemia (a lower than normal number of red blood cells ... treated with iron supplements taken by mouth. Iron dextran injection is in a class of medications called ...

Aminocaproic Acid Injection

Science.gov (United States)

Aminocaproic acid injection is used to control bleeding that occurs when blood clots are broken down too quickly. This ... the baby is ready to be born). Aminocaproic acid injection is also used to control bleeding in ...

Cluster beam injection

International Nuclear Information System (INIS)

Bottiglioni, F.; Coutant, J.; Fois, M.

1978-01-01

Areas of possible applications of cluster injection are discussed. The deposition inside the plasma of molecules, issued from the dissociation of the injected clusters, has been computed. Some empirical scaling laws for the penetration are given

Injection and lessons for 2012

International Nuclear Information System (INIS)

Bracco, C.; Barnes, M.J.; Bartmann, W.; Cornelis, K.; Drosdal, L.N.; Goddard, B.; Kain, V.; Meddahi, M.; Mertens, V.; Uythoven, J.

2012-01-01

Injection of 144 bunches into the LHC became fully operational during the 2011 run and one nominal injection of 288 bunches was accomplished. Several mitigation solutions were put in place to minimise losses from the Transfer Line (TL) collimators and losses from kicking de-bunched beam during injection. Nevertheless, shot-by- shot and bunch-by-bunch trajectory variations, as well as long terms drifts, were observed and required a regular re-steering of the TL implying a non negligible amount of time spent for injection setup. Likely sources of instability have been identified (i.e. MKE and MSE ripples) and possible cures to optimise 2012 operation are presented. Well defined references for TL steering will be defined in a more rigorous way in order to allow a more straightforward and faster injection setup. Encountered and potential issues of the injection system, in particular the injection kickers MKI, are discussed also in view of injections with a higher number of bunches. (authors)

Injection and lessons for 2012

CERN Document Server

Bracco, C; Bartmann, W; Cornelis, K; Drosdal, L N; Goddard, B; Kain, V; Meddahi, M; Mertens, V; Uythoven, J

2012-01-01

Injection of 144 bunches into the LHC became fully operational during the 2011 run and a nominal injection of 288 bunches was accomplished during MD time. Several mitigation solutions were put in place to minimise losses from the transfer line (TL) collimators and losses from kicking debunched beam during injection. Nevertheless, shot-by-shot and bunch-by-bunch trajectory variations, as well as long terms drifts, were observed and required a regular resteering of the TL implying a non negligible amount of time spent for injection setup. Likely sources of instability have been identified (i.e. MKE and MSE ripples) and possible cures to optimise 2012 operation are presented. Well defined references for TL steering will be defined in a more rigorous way in order to allow a more straightforward and faster injection setup. Encountered and potential issues of the injection system, in particular the injection kickers MKI, are discussed also in view of injections with a higher number of bunches.

Surgical versus injection treatment for injection-confirmed chronic sacroiliac joint pain

Science.gov (United States)

Spiker, William Ryan; Lawrence, Brandon D.; Raich, Annie L.; Skelly, Andrea C.; Brodke, Darrel S.

2012-01-01

Study design: Systematic review. Study rationale: Chronic sacroiliac joint pain (CSJP) is a common clinical entity with highly controversial treatment options. A recent systematic review compared surgery with denervation, but the current systematic review compares outcomes of surgical intervention with therapeutic injection for the treatment of CSJP and serves as the next step for evaluating current evidence on the comparative effectiveness of treatments for non-traumatic sacroiliac joint pain. Objective or clinical question: In adult patients with injection-confirmed CSJP, does surgical treatment lead to better outcomes and fewer complications than injection therapy? Methods: A systematic review of the English-language literature was undertaken for articles published between 1970 and June 2012. Electronic databases and reference lists of key articles were searched to identify studies evaluating surgery or injection treatment for injection-confirmed CSJP. Studies involving traumatic onset or non-injection–confirmed CSJP were excluded. Two independent reviewers assessed the level of evidence quality using the grading of recommendations assessment, development and evaluation (GRADE) system, and disagreements were resolved by consensus. Results: We identified twelve articles (seven surgical and five injection treatment) meeting our inclusion criteria. Regardless of the type of treatment, most studies reported over 40% improvement in pain as measured by Visual Analog Scale or Numeric rating Scale score. Regardless of the type of treatment, most studies reported over 20% improvement in functionality. Most complications were reported in the surgical studies. Conclusion: Surgical fusion and therapeutic injections can likely provide pain relief, improve quality of life, and improve work status. The comparative effectiveness of these interventions cannot be evaluated with the current literature. PMID:23526911

Injection Technique and Pen Needle Design Affect Leakage From Skin After Subcutaneous Injections

DEFF Research Database (Denmark)

Præstmark, Kezia Ann; Stallknecht, Bente; Jensen, Morten Lind

2016-01-01

BACKGROUND: After a subcutaneous injection fluid might leak out of the skin, commonly referred to as leakage or backflow. The objective was to examine the influence of needle design and injection technique on leakage after injections in the subcutaneous tissue of humans and pigs. METHOD: Leakage ...

Multi-shot type pellet injection device

International Nuclear Information System (INIS)

Onozuka, Masaki; Uchikawa, Takashi; Kuribayashi, Shitomi.

1988-01-01

Purpose: To inject pellets at high speed without melting or sublimating not-injected pellets even at a long pellet injection interval. Constitution: In the conventional multi-shot pellet injection device, the pellet injection interval is set depending on the plasma retention time. However, as the pellet injection interval is increased, not-injected pellets are melted or sublimated due to the introduced heat of acceleration gases supplied from an acceleration gas introduction pipe to give an effect on the dimensional shape of the pellets. In view of the above, a plurality of pellet forming and injection portions each comprising a carrier, an injection pipe and a holder are disposed independently of each other and pellets are formed and injected independently to thereby prevent the thermal effects of the acceleration gases. (Kamimura, M.)

Multi-shot type pellet injection device

Energy Technology Data Exchange (ETDEWEB)

Onozuka, Masaki; Uchikawa, Takashi; Kuribayashi, Shitomi.

1988-07-27

Purpose: To inject pellets at high speed without melting or sublimating not-injected pellets even at a long pellet injection interval. Constitution: In the conventional multi-shot pellet injection device, the pellet injection interval is set depending on the plasma retention time. However, as the pellet injection interval is increased, not-injected pellets are melted or sublimated due to the introduced heat of acceleration gases supplied from an acceleration gas introduction pipe to give an effect on the dimensional shape of the pellets. In view of the above, a plurality of pellet forming and injection portions each comprising a carrier, an injection pipe and a holder are disposed independently of each other and pellets are formed and injected independently to thereby prevent the thermal effects of the acceleration gases. (Kamimura, M.).

Syringe injectable electronics

Science.gov (United States)

Hong, Guosong; Zhou, Tao; Jin, Lihua; Duvvuri, Madhavi; Jiang, Zhe; Kruskal, Peter; Xie, Chong; Suo, Zhigang; Fang, Ying; Lieber, Charles M.

2015-01-01

Seamless and minimally-invasive three-dimensional (3D) interpenetration of electronics within artificial or natural structures could allow for continuous monitoring and manipulation of their properties. Flexible electronics provide a means for conforming electronics to non-planar surfaces, yet targeted delivery of flexible electronics to internal regions remains difficult. Here, we overcome this challenge by demonstrating syringe injection and subsequent unfolding of submicrometer-thick, centimeter-scale macroporous mesh electronics through needles with a diameter as small as 100 micrometers. Our results show that electronic components can be injected into man-made and biological cavities, as well as dense gels and tissue, with > 90% device yield. We demonstrate several applications of syringe injectable electronics as a general approach for interpenetrating flexible electronics with 3D structures, including (i) monitoring of internal mechanical strains in polymer cavities, (ii) tight integration and low chronic immunoreactivity with several distinct regions of the brain, and (iii) in vivo multiplexed neural recording. Moreover, syringe injection enables delivery of flexible electronics through a rigid shell, delivery of large volume flexible electronics that can fill internal cavities and co-injection of electronics with other materials into host structures, opening up unique applications for flexible electronics. PMID:26053995

Cost-Utility of a Single-Injection Combined Corticosteroid-Hyaluronic Acid Formulation vs a 2-Injection Regimen of Sequential Corticosteroid and Hyaluronic Acid Injections.

Science.gov (United States)

Belzile, Etienne L; Deakon, Robert T; Vannabouathong, Christopher; Bhandari, Mohit; Lamontagne, Martin; McCormack, Robert

2017-01-01

Research has shown early and sustained relief with a combination therapy of a corticosteroid (CS) and hyaluronic acid (HA) in knee osteoarthritis (OA) patients. This can be administered via a single injection containing both products or as separate injections. The former may be more expensive when considering only product cost, but the latter incurs the additional costs and time of a second procedure. The purpose of this study was to compare the cost-utility of the single injection with the 2-injection regimen. The results of this analysis revealed that the single-injection formulation of a CS and HA may be cost-effective, assuming a willingness-to-pay of $50 000 per quality-adjusted life year gained, for symptomatic relief of OA symptoms. This treatment may also be more desirable to patients who find injections to be inconvenient or unpleasant.

Characteristics of pressure wave in common rail fuel injection system of high-speed direct injection diesel engines

Directory of Open Access Journals (Sweden)

Mohammad Reza Herfatmanesh

2016-05-01

Full Text Available The latest generation of high-pressure common rail equipment now provides diesel engines possibility to apply as many as eight separate injection pulses within the engine cycle for reducing emissions and for smoothing combustion. With these complicated injection arrangements, optimizations of operating parameters for various driving conditions are considerably difficult, particularly when integrating fuel injection parameters with other operating parameters such as exhaust gas recirculation rate and boost pressure together for evaluating calibration results. Understanding the detailed effects of fuel injection parameters upon combustion characteristics and emission formation is therefore particularly critical. In this article, the results and discussion of experimental investigations on a high-speed direct injection light-duty diesel engine test bed are presented for evaluating and analyzing the effects of main adjustable parameters of the fuel injection system on all regulated emission gases and torque performance. Main injection timing, rail pressure, pilot amount, and particularly pilot timing have been examined. The results show that optimization of each of those adjustable parameters is beneficial for emission reduction and torque improvement under different operating conditions. By exploring the variation in the interval between the pilot injection and the main injection, it is found that the pressure wave in the common rail has a significant influence on the subsequent injection. This suggests that special attentions must be paid for adjusting pilot timing or any injection interval when multi-injection is used. With analyzing the fuel amount oscillation of the subsequent injections to pilot separation, it demonstrates that the frequency of regular oscillations of the actual fuel amount or the injection pulse width with the variation in pilot separation is always the same for a specified fuel injection system, regardless of engine speed

Syringe-injectable electronics.

Science.gov (United States)

Liu, Jia; Fu, Tian-Ming; Cheng, Zengguang; Hong, Guosong; Zhou, Tao; Jin, Lihua; Duvvuri, Madhavi; Jiang, Zhe; Kruskal, Peter; Xie, Chong; Suo, Zhigang; Fang, Ying; Lieber, Charles M

2015-07-01

Seamless and minimally invasive three-dimensional interpenetration of electronics within artificial or natural structures could allow for continuous monitoring and manipulation of their properties. Flexible electronics provide a means for conforming electronics to non-planar surfaces, yet targeted delivery of flexible electronics to internal regions remains difficult. Here, we overcome this challenge by demonstrating the syringe injection (and subsequent unfolding) of sub-micrometre-thick, centimetre-scale macroporous mesh electronics through needles with a diameter as small as 100 μm. Our results show that electronic components can be injected into man-made and biological cavities, as well as dense gels and tissue, with >90% device yield. We demonstrate several applications of syringe-injectable electronics as a general approach for interpenetrating flexible electronics with three-dimensional structures, including (1) monitoring internal mechanical strains in polymer cavities, (2) tight integration and low chronic immunoreactivity with several distinct regions of the brain, and (3) in vivo multiplexed neural recording. Moreover, syringe injection enables the delivery of flexible electronics through a rigid shell, the delivery of large-volume flexible electronics that can fill internal cavities, and co-injection of electronics with other materials into host structures, opening up unique applications for flexible electronics.

Spin Injection from Ferromagnetic Metal Directly into Non-Magnetic Semiconductor under Different Injection Currents

International Nuclear Information System (INIS)

Ning, Deng; Lei, Zhang; Shu-Chao, Zhang; Pei-Yi, Chen; Jian-Shi, Tang

2010-01-01

For ferromagnetic metal (FM)/semiconductor (SC) structure with ohmic contact, the effect of carrier polarization in the semiconductor combined with drift part of injection current on current polarization is investigated. Based on the general model we established here, spin injection efficiency under different injection current levels is calculated. Under a reasonable high injection current, current polarization in the semiconductor is actually much larger than that predicted by the conductivity mismatch model because the effect of carrier polarization is enhanced by the increasing drift current. An appreciable current polarization of 1% could be achieved for the FM/SC structure via ohmic contact, which means that efficient spin injection from FM into SC via ohmic contact is possible. The reported dependence of current polarization on temperature is verified quantitatively. To achieve even larger spin injection efficiency, a gradient doping semiconductor is suggested to enhance the drift current effect

Towards spin injection into silicon

Energy Technology Data Exchange (ETDEWEB)

Dash, S.P.

2007-08-15

Si has been studied for the purpose of spin injection extensively in this thesis. Three different concepts for spin injection into Si have been addressed: (1) spin injection through a ferromagnet-Si Schottky contact, (2) spin injection using MgO tunnel barriers in between the ferromagnet and Si, and (3) spin injection from Mn-doped Si (DMS) as spin aligner. (1) FM-Si Schottky contact for spin injection: To be able to improve the interface qualities one needs to understand the atomic processes involved in the formation of silicide phases. In order to obtain more detailed insight into the formation of such phases the initial stages of growth of Co and Fe were studied in situ by HRBS with monolayer depth resolution.(2) MgO tunnel barrier for spin injection into Si: The fabrication and characterization of ultra-thin crystalline MgO tunnel barriers on Si (100) was presented. (3) Mn doped Si for spin injection: Si-based diluted magnetic semiconductor samples were prepared by doping Si with Mn by two different methods i) by Mn ion implantation and ii) by in-diffusion of Mn atoms (solid state growth). (orig.)

Reduced injection pressures using a compressed air injection technique (CAIT): an in vitro study.

Science.gov (United States)

Tsui, Ban C H; Knezevich, Mark P; Pillay, Jennifer J

2008-01-01

High injection pressures have been associated with intraneural injection and persistent neurological injury in animals. Our objective was to test whether a reported simple compressed air injection technique (CAIT) would limit the generation of injection pressures to below a suggested 1,034 mm Hg limit in an in vitro model. After ethics board approval, 30 consenting anesthesiologists injected saline into a semiclosed system. Injection pressures using 30 mL syringes connected to a 22 gauge needle and containing 20 mL of saline were measured for 60 seconds using: (1) a typical "syringe feel" method, and (2) CAIT, thereby drawing 10 mL of air above the saline and compressing this to 5 mL prior to and during injections. All anesthesiologists performed the syringe feel method before introduction and demonstration of CAIT. Using CAIT, no anesthesiologist generated pressures above 1,034 mm Hg, while 29 of 30 produced pressures above this limit at some time using the syringe feel method. The mean pressure using CAIT was lower (636 +/- 71 vs. 1378 +/- 194 mm Hg, P = .025), and the syringe feel method resulted in higher peak pressures (1,875 +/- 206 vs. 715 +/- 104 mm Hg, P = .000). This study demonstrated that CAIT can effectively keep injection pressures under 1,034 mm Hg in this in vitro model. Animal and clinical studies will be needed to determine whether CAIT will allow objective, real-time pressure monitoring. If high pressure injections are proven to contribute to nerve injury in humans, this technique may have the potential to improve the safety of peripheral nerve blocks.

Injectable barriers for waste isolation

International Nuclear Information System (INIS)

Persoff, P.; Finsterle, S.; Moridis, G.J.; Apps, J.; Pruess, K.; Muller, S.J.

1995-03-01

In this paper the authors report laboratory work and numerical simulation done in support of development and demonstration of injectable barriers formed from either of two fluids: colloidal silica or polysiloxane. Two principal problems addressed here are control of gel time and control of plume emplacement in the vadose zone. Gel time must be controlled so that the viscosity of the barrier fluid remains low long enough to inject the barrier, but increases soon enough to gel the barrier in place. During injection, the viscosity must be low enough to avoid high injection pressures which could uplift or fracture the formation. To test the grout gel time in the soil, the injection pressure was monitored as grouts were injected into sandpacks. When grout is injected into the vadose zone, it slumps under the influence of gravity, and redistributes due to capillary forces as it gels. The authors have developed a new module for the reservoir simulator TOUGH2 to model grout injection into the vadose zone, taking into account the increase of liquid viscosity as a function of gel concentration and time. They have also developed a model to calculate soil properties after complete solidification of the grout. The numerical model has been used to design and analyze laboratory experiments and field pilot tests. The authors present the results of computer simulations of grout injection, redistribution, and solidification

AAGL Practice Report

DEFF Research Database (Denmark)

Munro, Malcolm G; Storz, Karl; Abbott, Jason A

2013-01-01

The objective of this guideline is to provide clinicians with evidence-based information about commonly used and available hysteroscopic distending media to guide them in their performance of both diagnostic and operative hysteroscopy. While necessary for the performance of hysteroscopy and hyste...... is critical for the safe performance of hysteroscopic procedures. This report was developed under the direction of the Practice Committee of the AAGL as a service to their members and other practicing clinicians....

Financial methods for waterflooding injectate design

Science.gov (United States)

Heneman, Helmuth J.; Brady, Patrick V.

2017-08-08

A method of selecting an injectate for recovering liquid hydrocarbons from a reservoir includes designing a plurality of injectates, calculating a net present value of each injectate, and selecting a candidate injectate based on the net present value. For example, the candidate injectate may be selected to maximize the net present value of a waterflooding operation.

Influence of fuel injection pressures on Calophyllum inophyllum methyl ester fuelled direct injection diesel engine

International Nuclear Information System (INIS)

Nanthagopal, K.; Ashok, B.; Karuppa Raj, R. Thundil

2016-01-01

Highlights: • Effect of injection pressure of Calophyllum inophyllum biodiesel is investigated. • Engine characteristics of 100% Calophyllum inophyllum biodiesel has been performed. • Calophyllum inophyllum is a non-edible source for biodiesel production. • Increase in injection pressure of biodiesel, improves the fuel economy. • Incylinder pressure characteristics of biodiesel follows similar trend as of diesel. - Abstract: The trend of using biodiesels in compression ignition engines have been the focus in recent decades due to the promising environmental factors and depletion of fossil fuel reserves. This work presents the effect of Calophyllum inophyllum methyl ester on diesel engine performance, emission and combustion characteristics at different injection pressures. Experimental investigations with varying injection pressures of 200 bar, 220 bar and 240 bar have been carried out to analyse the parameters like brake thermal efficiency, specific fuel consumption, heat release rate and engine emissions of direct injection diesel engine fuelled with 100% biodiesel and compared with neat diesel. The experimental results revealed that brake specific fuel consumption of C. inophyllum methyl ester fuelled engine has been reduced to a great extent with higher injection pressure. Significant reduction in emissions of unburnt hydrocarbons, carbon monoxide and smoke opacity have been observed during fuel injection of biodiesel at 220 bar compared to other fuel injection pressures. However oxides of nitrogen increased with increase in injection pressures of C. inophyllum methyl ester and are always higher than that of neat diesel. In addition the combustion characteristics of biodiesel at all injection pressures followed a similar trend to that of conventional diesel.

Hysteroscopic Sterilization

Science.gov (United States)

... sterilization? Sterilization is a permanent form of birth control. What is tubal sterilization? Sterilization procedures for women are ... is quicker than from other types of sterilization. What are the risks of ... on for birth control. • There is a risk of injury to the ...

INJECTING EQUPMENT SHARING AND PERCEPTION OF HIV AND HEPATITIS RISK AMONG INJECTING DRUG USERS IN BUDAPEST

Science.gov (United States)

Gyarmathy, V. Anna; Neaigus, Alan; Ujhelyi, Eszter

2008-01-01

In Central European states, rates of HIV among IDUs have been low although HCV infection is widespread. The goal of our study was to assess HIV infection, risk perceptions and injecting equipment sharing among injection drug users in Budapest, Hungary. Altogether 150 IDUs were interviewed (121 structured between 1999-2000 and 29 ethnographic between 2003-2004). The majority of them injected heroin (52% and 79%) and many injected amphetamines (51% and 35%). One person tested positive for HIV. Two thirds (68% of 121) shared injecting equipment (syringes, cookers and filters). Some participants said they shared syringes because they were not carrying them for fear of police harassment, and that they reused filters as a backup drug supply. In multivariate analysis, sharing of injecting equipment was associated with higher perceived susceptibility to HIV/AIDS, lower self-efficacy for sterile equipment use, higher motivation to comply with peer pressure to use dirty injecting equipment, and with having a criminal record. The high levels of injecting risk behaviors found in this study are a cause for serious concern. HIV prevention interventions need to address not only sharing syringes but also sharing and reusing other injecting equipment and drug filters. PMID:17129858

SQL injection detection system

OpenAIRE

Vargonas, Vytautas

2017-01-01

SQL injection detection system Programmers do not always ensure security of developed systems. That is why it is important to look for solutions outside being reliant on developers. In this work SQL injection detection system is proposed. The system analyzes HTTP request parameters and detects intrusions. It is based on unsupervised machine learning. Trained by regular request data system detects outlier user parameters. Since training is not reliant on previous knowledge of SQL injections, t...

Integration and Validation of Hysteroscopy Simulation in the Surgical Training Curriculum.

Science.gov (United States)

Elessawy, Mohamed; Skrzipczyk, Moritz; Eckmann-Scholz, Christel; Maass, Nicolai; Mettler, Liselotte; Guenther, Veronika; van Mackelenbergh, Marion; Bauerschlag, Dirk O; Alkatout, Ibrahim

The primary objective of our study was to test the construct validity of the HystSim hysteroscopic simulator to determine whether simulation training can improve the acquisition of hysteroscopic skills regardless of the previous levels of experience of the participants. The secondary objective was to analyze the performance of a selected task, using specially designed scoring charts to help reduce the learning curve for both novices and experienced surgeons. The teaching of hysteroscopic intervention has received only scant attention, focusing mainly on the development of physical models and box simulators. This encouraged our working group to search for a suitable hysteroscopic simulator module and to test its validation. We decided to use the HystSim hysteroscopic simulator, which is one of the few such simulators that has already completed a validation process, with high ratings for both realism and training capacity. As a testing tool for our study, we selected the myoma resection task. We analyzed the results using the multimetric score system suggested by HystSim, allowing a more precise interpretation of the results. Between June 2014 and May 2015, our group collected data on 57 participants of minimally invasive surgical training courses at the Kiel School of Gynecological Endoscopy, Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel. The novice group consisted of 42 medical students and residents with no prior experience in hysteroscopy, whereas the expert group consisted of 15 participants with more than 2 years of experience of advanced hysteroscopy operations. The overall results demonstrated that all participants attained significant improvements between their pretest and posttests, independent of their previous levels of experience (p hysteroscopic skills, proving an adequate construct validation of the HystSim. Using the multimetric scoring system enabled a more accurate analysis of the performance of the

Injecting drug use: Gendered risk.

Science.gov (United States)

Zahnow, Renee; Winstock, Adam R; Maier, Larissa J; Levy, Jay; Ferris, Jason

2018-06-01

Research demonstrates gender related differences in drug-use practices and risk behaviours. Females' structural vulnerability stemming from traditional gender roles and gender-power relations may enhance their propensity to experience injecting related risk. In this paper we explore gender differences in injection practices at the initiation event, during the first year of injecting and in the most recent 12-month period, to inform more effective harm reduction strategies. Data used in this study were drawn from the Global Drug Survey 2015. The study employs chi-square and logistic regression to assess gender differences in injection behaviours in a sample of current injectors residing in six global regions: North-West Europe; Southern Eastern Europe; North America. South America and Oceania. Females were more likely than males to report being injected by an intimate partner at initiation (OR = 4.4, 95%CI: 2.2-8.8), during the first year of injecting (OR = 4.8, 95% CI: 2.4-9.3) and in the most recent 12-month period (OR = 2.5, 95%CI: 1.0-6.2). Females reported greater difficulties accessing sterile equipment (X 2 (2,N = 453) = 8.2, p = 0.02) and were more likely to share injecting equipment than males (X 2 (1,N = 463) = 3.9, p = 0.05). Our findings highlight females' continued dependence on their intimate partner to administer the injection into the first year of their injecting career. Females remained more likely than males to rely on intimate partners for injection during the most recent 12-month period. Females report greater difficulties in sourcing sterile equipment and are more likely to share injecting equipment. We suggest that these findings reflect the broader social structure in which females are disempowered through traditional gender roles and the lack of gender appropriate harm reduction services. Copyright © 2018 Elsevier B.V. All rights reserved.

Assessment of injection bolus in first-pass radionuclide angiography. Evaluation of injection site and needle size

International Nuclear Information System (INIS)

Tonami, Syuichi; Inagaki, Syoichi; Yasui, Masakazu; Sugishita, Kouki; Yoshita, Hisashi; Nakamura, Mamoru; Kuranishi, Makoto

1996-01-01

First-pass radionuclide angiography (FPRNA) using a multi-crystal gamma camera can correctly provide many quantitative and qualitative indices of left ventricular function as well as anatomic information. A compact injection bolus of radiotracer is, however, essential to the first-pass study since the temporal separation of cardiac chambers is required for the first-pass acquisition. To examine which factors affect the quality of an injection bolus, 327 patients who had FPRNA in the anterior projection were randomized for injection site of radiotracer (right or left external jugular veins, and right antecubital vein) and needle size (19- or 21-gauge). The injected bolus was assessed from the full width at half maximum (FWHM) of the bolus time-activity curve in the superior vena cava. As to injection site using a 19-gauge needle, an attemption through right external jugular vein (EJV) revealed the shortest FWHM of an injection bolus, followed by left EJV and right antecubital vein (AV). In right EJV 91% of injected bolus FWHM was less than 1.5 sec, which was significantly higher (p<0.001) than those of the other sites (left EJV: 70%. right AV: 65%). Approximately 7% of injection from left EJV and right AV, showed a split bolus of radiotracer. However, no split bolus was observed from right EJV. There was no significant difference in FWHM of an injection bolus between 19- and 21-gauge needle from EJV. Our present study demonstrated that the quality of an injection bolus from left EJV and AV was affected by RVEF in a case of low right ventricular function. In conclusion, right EJV is the first choice of injection site to obtain a compact bolus of radiotracer for the first-pass cardiac study. A 21-gauge needle can also be inserted from the external jugular vein to perform a good bolus injection. (author)

Effects of injection angles on combustion processes using multiple injection strategies in an HSDI diesel engine

Energy Technology Data Exchange (ETDEWEB)

Tiegang Fang; Robert E. Coverdill; Chia-fon F. Lee; Robert A. White [North Carolina State University, Raleigh, NC (United States). Department of Mechanical and Aerospace Engineering

2008-11-15

Effects of injection angles and injection pressure on the combustion processes employing multiple injection strategies in a high-speed direct-injection (HSDI) diesel engine are presented in this work. Whole-cycle combustion and liquid spray evolution processes were visualized using a high-speed video camera. NOx emissions were measured in the exhaust pipe. Different heat release patterns are seen for two different injectors with a 70-degree tip and a 150-degree tip. No evidence of fuel-wall impingement is found for the first injection of the 150-degree tip, but for the 70-degree tip, some fuel impinges on the bowl wall and a fuel film is formed. For the second injection, a large amount of fuel deposition is observed for the 70-degree tip. Weak flame is seen for the first injection of the 150-degree tip while two sorts of flames are seen for the first injection of the 70-degree tip including an early weak flame and a late luminous film combustion flame. Ignition occurs near the spray tip in the vicinity of the bowl wall for the second injection events of the 150-degree tip, however, it is near the injector tip in the central region of the bowl for the 70-degree tip. The flame is more homogeneous for the 150-degree tip with higher injection pressure with little soot formation similar to a premixed-charge-compression-ignition (PCCI) combustion. For other cases, liquid fuel is injected into flames showing diffusion flame combustion. More soot luminosity is seen for the 70-degree tip due to significant fuel film deposition on the piston wall with fuel film combustion for both injection events. Lower NOx emissions were obtained for the narrow-angle injector due to the rich air-fuel mixture near the bowl wall during the combustion process. 30 refs., 11 figs., 3 tabs.

Assessment of injection bolus in first-pass radionuclide angiography. Evaluation of injection site and needle size

Energy Technology Data Exchange (ETDEWEB)

Tonami, Syuichi; Inagaki, Syoichi; Yasui, Masakazu; Sugishita, Kouki; Yoshita, Hisashi; Nakamura, Mamoru; Kuranishi, Makoto [Toyama Medical and Pharmaceutical Univ. (Japan). Hospital

1996-09-01

First-pass radionuclide angiography (FPRNA) using a multi-crystal gamma camera can correctly provide many quantitative and qualitative indices of left ventricular function as well as anatomic information. A compact injection bolus of radiotracer is, however, essential to the first-pass study since the temporal separation of cardiac chambers is required for the first-pass acquisition. To examine which factors affect the quality of an injection bolus, 327 patients who had FPRNA in the anterior projection were randomized for injection site of radiotracer (right or left external jugular veins, and right antecubital vein) and needle size (19- or 21-gauge). The injected bolus was assessed from the full width at half maximum (FWHM) of the bolus time-activity curve in the superior vena cava. As to injection site using a 19-gauge needle, an attemption through right external jugular vein (EJV) revealed the shortest FWHM of an injection bolus, followed by left EJV and right antecubital vein (AV). In right EJV 91% of injected bolus FWHM was less than 1.5 sec, which was significantly higher (p<0.001) than those of the other sites (left EJV: 70%. right AV: 65%). Approximately 7% of injection from left EJV and right AV, showed a split bolus of radiotracer. However, no split bolus was observed from right EJV. There was no significant difference in FWHM of an injection bolus between 19- and 21-gauge needle from EJV. Our present study demonstrated that the quality of an injection bolus from left EJV and AV was affected by RVEF in a case of low right ventricular function. In conclusion, right EJV is the first choice of injection site to obtain a compact bolus of radiotracer for the first-pass cardiac study. A 21-gauge needle can also be inserted from the external jugular vein to perform a good bolus injection. (author)

Two Cases of Postmyomectomy Pseudoaneurysm Treated by Transarterial Embolization

Energy Technology Data Exchange (ETDEWEB)

Ito, Nobutake, E-mail: nobutake@rad.med.keio.ac.jp [Keio University, School of Medicine, Department of Diagnostic Radiology (Japan); Natimatsu, Yoshiaki; Tsukada, Jitsuro; Sato, Akihiro; Hasegawa, Ichiro [Kawasaki Municipal Hospital, Department of Diagnostic Radiology (Japan); Lin, Bao-Liang [Kawasaki Municipal Hospital, Department of Gynecologic Endoscopy (Japan)

2013-12-15

Pseudoaneurysm resulting from hysteroscopic myomectomy is a rare clinical situation, and interventional radiologists are not traditionally involved in the management. To our knowledge, endovascular treatment of a pseudoaneurysm resulting from hysteroscopic myomectomy has not yet been reported in the English-language literature. Here, two such cases are reported, including one of a woman who later became pregnant. The case is unique because little is known about the influence of unilateral coil embolization of the uterine artery on fertility.

Two Cases of Postmyomectomy Pseudoaneurysm Treated by Transarterial Embolization

International Nuclear Information System (INIS)

Ito, Nobutake; Natimatsu, Yoshiaki; Tsukada, Jitsuro; Sato, Akihiro; Hasegawa, Ichiro; Lin, Bao-Liang

2013-01-01

Pseudoaneurysm resulting from hysteroscopic myomectomy is a rare clinical situation, and interventional radiologists are not traditionally involved in the management. To our knowledge, endovascular treatment of a pseudoaneurysm resulting from hysteroscopic myomectomy has not yet been reported in the English-language literature. Here, two such cases are reported, including one of a woman who later became pregnant. The case is unique because little is known about the influence of unilateral coil embolization of the uterine artery on fertility

Impact of physical properties of biodiesel on the injection process in a common-rail direct injection system

International Nuclear Information System (INIS)

Boudy, Frederic; Seers, Patrice

2009-01-01

This paper presents the influence of biodiesel fuel properties on the injection mass flow rate of a diesel common-rail injection system. Simulations are first performed with ISO 4113 diesel fuel on a four-cylinder common-rail system to evaluate a single and triple injection strategies. For each injection strategy, the impact of modifying a single fuel property at a time is evaluated so as to quantify its influence on the injection process. The results show that fuel density is the main property that affects the injection process, such as total mass injected and pressure wave in the common-rail system. The fuel's viscosity and bulk modulus also influence, but to a lessen degree, the mass flow rate of the injector notably during multiple injection strategies as individual properties change the fuel's dampening property and friction coefficient.

In Vitro Fertilization Outcomes After Placement of Essure Microinserts in Patients With Hydrosalpinges Who Previously Failed In Vitro Fertilization Treatment: A Multicenter Study.

Science.gov (United States)

Cohen, Shlomo B; Bouaziz, Jerome; Schiff, Eyal; Simon, Alexander; Nadjary, Michel; Goldenberg, Mordechai; Orvieto, Raoul; Revel, Ariel

2016-01-01

To investigate whether hysteroscopic proximal tubal occlusion with Essure microinserts (Conceptus Inc.; Bayer, AG, North Rhine-Westphalia, Germany) can improve pregnancy rates in patients with hydrosalpinges who had failed in vitro fertilization (IVF) treatment. A prospective cohort study. University-affiliated tertiary centers. Twenty-four consecutive women with hydrosalpinges who had failed IVF treatment were included. Hysteroscopic placement of Essure microinserts for hydrosalpinx blockage followed by IVF treatment. Ongoing pregnancy and live birth rates were recorded. Of the 24 patients undergoing a total of 42 IVF cycles after Essure insertion, 18 (75% of patients and 42.8% of IVF cycle attempts) conceived and 16 delivered live births (66.6% of patients and 38.1% of IVF cycle attempts). Hysteroscopic proximal occlusion of hydrosalpinges with Essure microinserts is a valuable alternative to laparoscopic salpingectomy, resulting in reasonable pregnancy rates. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

Injection and extraction for cyclotrons

International Nuclear Information System (INIS)

Heikkinen, P.

1994-01-01

External ion sources for cyclotrons are needed for polarised and heavy ions. This calls for injection systems, either radial or axial. Radial injection is also needed when a cyclotron works as a booster after another cyclotron or a linear accelerator (usually tandem). Requirements for injection differ from separated sector cyclotrons where there is plenty of room to house inflectors and/or strippers, to superconducting cyclotrons where the space is limited by a small magnet gap, and high magnetic field puts other limitations to the inflectors. Several extraction schemes are used in cyclotrons. Stripping injection is used for H - and also for heavy ions where the q/m ratio is usually doubled. For other cases, electric and magnetic deflection has to be used. To increase the turn separation before the first deflector, both resonant and non-resonant schemes are used. In this lecture, external injection systems are surveyed and some rules to thumb for injection parameters are given. Extraction schemes are also reviewed. (orig.)

Predictors of sharing injection equipment by HIV-seropositive injection drug users.

Science.gov (United States)

Latkin, Carl A; Buchanan, Amy S; Metsch, Lisa R; Knight, Kelly; Latka, Mary H; Mizuno, Yuko; Knowlton, Amy R

2008-12-01

Among HIV-positive injection drug users (IDUs), we examined baseline predictors of lending needles and syringes and sharing cookers, cotton, and rinse water in the prior 3 months at follow-up. Participants were enrolled in Intervention for Seropositive Injectors-Research and Evaluation, a secondary prevention intervention for sexually active HIV-positive IDUs in 4 US cities during 2001-2005. The analyses involved 357 participants who reported injecting drugs in the prior 6 months at either the 6- or 12-month follow-up visit. About half (49%) reported at least 1 sharing episode. In adjusted analyses, peer norms supporting safer injection practices and having primary HIV medical care visits in the prior 6 months were associated with reporting no sharing of injection equipment. Higher levels of psychological distress were associated with a greater likelihood of reporting drug paraphernalia sharing. These findings suggest that intervention approaches for reducing HIV-seropositive IDUs' transmission of blood-borne infections should include peer-focused interventions to alter norms of drug paraphernalia sharing and promoting primary HIV care and mental health services.

The energetic ion substorm injection boundary

International Nuclear Information System (INIS)

Lopez, R.E.; Sibeck, D.G.; McEntire, R.W.; Krimigis, S.M.

1990-01-01

The substorm injection boundary model has enjoyed considerable success in explaining plasma signatures in the near-geosynchronous region. However, the injection boundary has remained primarily a phenomenological model. In this paper the authors examine 167 dispersionless energetic ion injections which were observed by AMPTE CCE. The radial and local time distribution of the events as a function of Kp is qualitatively similar to that envisioned in the injection boundary model of Mauk and McIlwain (1974). They argue that particles observed during dispersionless injections are locally energized during the disruption of the cross-tail current sheet. Therefore they identify the injection boundary, as derived from the spatial distribution of dispersionless injections, with the earthward edge of the region of the magnetotail which undergoes current sheet disruption during the substorm expansion phase. The authors show that this qualitative model for the generation of the injection boundary can provide an explanation for the dispersionless nature, the double spiral shape, and the Kp dependence of the boundary

Radial oil injection applied to main engine bearings: evaluation of injection control rules

DEFF Research Database (Denmark)

Estupiñan, EA; Santos, Ilmar

2012-01-01

, the dynamic behaviour of the main bearing of a medium-size engine is theoretically analysed when the engine operates with controllable radial oil injection and four different injection control rules. The theoretical investigation is based on a single-cylinder combustion engine model. The performance......The performance of main bearings in a combustion engine affects key functions such as durability, noise and vibration. Thus, with the aim of reducing friction losses and vibrations between the crankshaft and the bearings, the work reported here evaluates different strategies for applying...... controllable radial oil injection to main crankshaft journal bearings. In an actively lubricated bearing, conventional hydrodynamic lubrication is combined with controllable hydrostatic lubrication, where the oil injection pressures can be modified depending on the operational conditions. In this study...

Injection moulding antireflective nanostructures

DEFF Research Database (Denmark)

Christiansen, Alexander Bruun; Clausen, Jeppe Sandvik; Mortensen, N. Asger

2014-01-01

We present a method for injection moulding antireflective nanostructures on large areas, for high volume production. Nanostructured black silicon masters were fabricated by mask-less reactive ion etching, and electroplated with nickel. The nickel shim was antistiction coated and used in an inject......We present a method for injection moulding antireflective nanostructures on large areas, for high volume production. Nanostructured black silicon masters were fabricated by mask-less reactive ion etching, and electroplated with nickel. The nickel shim was antistiction coated and used...

Injection moulding antireflective nanostructures

DEFF Research Database (Denmark)

Christiansen, Alexander Bruun; Clausen, Jeppe Sandvik; Mortensen, N. Asger

We present a method for injection moulding antireflective nanostructures on large areas, for high volume production. Nanostructured black silicon masters were fabricated by mask-less reactive ion etching, and electroplated with nickel. The nickel shim was antistiction coated and used in an inject......We present a method for injection moulding antireflective nanostructures on large areas, for high volume production. Nanostructured black silicon masters were fabricated by mask-less reactive ion etching, and electroplated with nickel. The nickel shim was antistiction coated and used...

Enhanced Injection Molding Simulation of Advanced Injection Molds

Directory of Open Access Journals (Sweden)

Béla Zink

2017-02-01

Full Text Available The most time-consuming phase of the injection molding cycle is cooling. Cooling efficiency can be enhanced with the application of conformal cooling systems or high thermal conductivity copper molds. The conformal cooling channels are placed along the geometry of the injection-molded product, and thus they can extract more heat and heat removal is more uniform than in the case of conventional cooling systems. In the case of copper mold inserts, cooling channels are made by drilling and heat removal is facilitated by the high thermal conductivity coefficient of copper, which is several times that of steel. Designing optimal cooling systems is a complex process; a proper design requires injection molding simulations, but the accuracy of calculations depends on how precise the input parameters and boundary conditions are. In this study, three cooling circuit designs and three mold materials (Ampcoloy 940, 1.2311 (P20 steel, and MS1 steel were used and compared using numerical methods. The effect of different mold designs and materials on cooling efficiency were examined using calculated and measured results. The simulation model was adjusted to the measurement results by considering the joint gap between the mold inserts.

Sodium Ferric Gluconate Injection

Science.gov (United States)

Sodium ferric gluconate injection is used to treat iron-deficiency anemia (a lower than normal number of ... are also receiving the medication epoetin (Epogen, Procrit). Sodium ferric gluconate injection is in a class of ...

Comparison of two modalities: a novel technique, 'chromohysteroscopy', and blind endometrial sampling for the evaluation of abnormal uterine bleeding.

Science.gov (United States)

Alay, Asli; Usta, Taner A; Ozay, Pinar; Karadugan, Ozgur; Ates, Ugur

2014-05-01

The objective of this study was to compare classical blind endometrial tissue sampling with hysteroscopic biopsy sampling following methylene blue dyeing in premenopausal and postmenopausal patients with abnormal uterine bleeding. A prospective case-control study was carried out in the Office Hysteroscopy Unit. Fifty-four patients with complaints of abnormal uterine bleeding were evaluated. Data of 38 patients were included in the statistical analysis. Three groups were compared by examining samples obtained through hysteroscopic biopsy before and after methylene blue dyeing, and classical blind endometrial tissue sampling. First, uterine cavity was evaluated with office hysteroscopy. Methylene blue dye was administered through the hysteroscopic inlet. Tissue samples were obtained from stained and non-stained areas. Blind endometrial sampling was performed in the same patients immediately after the hysteroscopy procedure. The results of hysteroscopic biopsy from methylene blue stained and non-stained areas and blind biopsy were compared. No statistically significant differences were determined in the comparison of biopsy samples obtained from methylene-blue stained, non-stained areas and blind biopsy (P > 0.05). We suggest that chromohysteroscopy is not superior to endometrial sampling in cases of abnormal uterine bleeding. Further studies with greater sample sizes should be performed to assess the validity of routine use of endometrial dyeing. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

SQL Injection Attacks and Defense

CERN Document Server

Clarke, Justin

2012-01-01

SQL Injection Attacks and Defense, First Edition: Winner of the Best Book Bejtlich Read Award "SQL injection is probably the number one problem for any server-side application, and this book unequaled in its coverage." -Richard Bejtlich, Tao Security blog SQL injection represents one of the most dangerous and well-known, yet misunderstood, security vulnerabilities on the Internet, largely because there is no central repository of information available for penetration testers, IT security consultants and practitioners, and web/software developers to turn to for help. SQL Injection Att

Oxygen injection facility

International Nuclear Information System (INIS)

Ota, Masamoto; Hirose, Yuki

1998-01-01

A compressor introduces air as a starting material and sends it to a dust removing device, a dehumidifying device and an adsorption/separation system disposed downstream. The facility of the present invention is disposed in the vicinity of an injection point and installed in a turbine building of a BWR type reactor having a pipeline of a feedwater system to be injected. The adsorbing/separation system comprises an adsorbing vessel and an automatic valve, and the adsorbing vessel is filled with an adsorbent for selectively adsorbing nitrogen. Zeolite is used as the adsorbent. Nitrogen in the air passing through the adsorbing vessel is adsorbed and removed under a pressurized condition, and a highly concentrated oxygen gas is formed. The direction of the steam of the adsorbed nitrogen is changed by an opening/closing switching operation of an automatic valve and released to the atmosphere (the pressure is released). Generated oxygen gas is stored under pressure in a tank, and injected to the pipeline of the feedwater system by an oxygen injection conduit by way of a flow rate control valve. In the adsorbing vessel, steps of adsorption, separation and storage under pressure are repeated successively. (I.N.)

Sequential injection lab-on-valve: the third generation of flow injection analysis

DEFF Research Database (Denmark)

Wang, Jianhua; Hansen, Elo Harald

2003-01-01

Termed the third generation of flow injection analysis, sequential injection (SI)-lab-on-valve (LOV) has specific advantages and allows novel, unique applications - not least as a versatile front end to a variety of detection techniques. This review presents snd discusses progress to date of the ...

Zinc injection on the EDF fleet monitoring the injection on 12 units

International Nuclear Information System (INIS)

Le-Meur, Gaelle Harmand; Anne-Marie; Stutzmann, Agnes; Taunier, Stephane; Benfarah, Moez; Bretelle, Jean-Luc; Alain, Rocher; Claeys, Myriam; Bonne, Sebastien

2012-09-01

After a first implementation of zinc injection at Bugey 2 and Bugey 4, EDF decided to extend the program to other units of its fleet. 14 more reactors from the French fleet of 58 were chosen in order to - Reduce the radiation sources for curative or preventive (after SGR) reasons - Mitigate stress corrosion cracking on nickel alloys and reduce the rate of generalized corrosion - Prevent the risk of CIPS, mainly after a fuel management change. Zinc injection started on 9 new units in 2011, 1 unit in 2012 and will be extended to 4 other units before the end of 2013. To monitor the injection, EDF has defined a complete program concerning chemistry, radiation protection (dose rate and deposited activities measurements), materials (statistical analysis of SG tube cracks), fuel (oxide measurements) and waste (radiochemical characterization of filters). Reference units were chosen for each field because of the size of the fleet. This paper will detail the different monitoring programs on the EDF plants injecting zinc. (authors)

Promoting Safe Injection Practices : The Challenge Ahead

Directory of Open Access Journals (Sweden)

V K Srivastava

2006-06-01

Full Text Available Injections are one of the most common health care procedures in the world. Global estimates range between 12 billion-16 billion injections each year’. Most of the injections (90 to 95% are given for therapeutic purposes and only 5 to 10% are given for immunization. It is estimated that worldwide every year a billion injections are given to women and children for immunization. Up to half of these injections are currently thought to be unsafe. Due to the sheer burden of injections and the coresponding magnitude of unsafe injections, the proportion of blood borne pathogen transmission is much larger than is due to unsafe blood transfusion. Unsafe injections are responsible for million cases of Hepatitis B and C and an estimated one-quarter of a million cases of HIV annually. Worldwide 8 to 16 million hepatitis B, 2.3 - 4.7 million hepatitis C and 80,000 - 1,60,000 HIV infections are estimated to occur yearly form reuse of syringes and needles without adequate sterilization2. In the less developed countries, the unsafe injection practices account for an estimated $ 535 million in health care costs and result in nearly 1.3 million deaths a year. In a developing country like India where unnecessary injections are common, the total bur­den of injections is estimated to be 3.7 billion injections per year3. Certain studies that have been carried out in India,along with anecdotal evidence point towards a large numbe- of unnecessary, inappropriate, unsafe injections and inadequate sharps waste management4 5. A high proportion of injections given in India for immunization are unsafe due to reuse of needles/ syringes. The popularity of curative injections remains high due to various factors influencing the behaviour of prescribers / injection givers as well as clients.

Cross-border drug injection relationships among injection drug users in Tijuana, Mexico

Science.gov (United States)

Wagner, Karla D.; Pollini, Robin A.; Patterson, Thomas L.; Lozada, Remedios; Ojeda, Victoria D.; Brouwer, Kimberly C.; Vera, Alicia; Volkmann, Tyson A.; Strathdee, Steffanie A.

2010-01-01

Background International borders are unique social and environmental contexts characterized by high levels of mobility. Among drug users, mobility increases risk for human immunodeficiency virus (HIV) in part through its effects on the social environment. However, the social dynamics of drug users living in border regions are understudied. Methods 1056 injection drug users (IDUs) residing in Tijuana, Mexico were recruited using respondent-driven sampling (RDS) from 2006 to 2007, and underwent surveys and testing for HIV, syphilis, and tuberculosis (TB). Using logistic regression on baseline data, we identified correlates of having ever injected drugs with someone from the US. Results Almost half (48%) reported ever injecting drugs with someone from the US. In RDS-adjusted logistic regression, factors independently associated with having ever injected with someone from the US included: having greater than middle school education (Adjusted Odds Ratio [AOR] 2.91; 95% Confidence Interval [C.I.] 1.52, 5.91), speaking English (AOR 3.24, 95% C.I. 1.96, 5.36), age (AOR 1.10 per year; 95% C.I. 1.07, 1.14), age at initiation of injection drug use (AOR 0.90 per year; 95% C.I. 0.86, 0.94), homelessness (AOR 2.61; 95% C.I. 1.27, 5.39), and having ever been incarcerated (AOR 11.82; 95% C.I., 5.22, 26.77). No associations with HIV, syphilis, TB, drug use, or injection risk behavior were detected. Conclusion Findings suggest that IDU networks in Mexico and the US may transcend international borders, with implications for cross-border transmission of infectious disease. Binational programs and policies need to consider the structure and geographic distribution of drug using networks. PMID:20889270

"Vivo para consumirla y la consumo para vivir" ["I live to inject and inject to live"]: high-risk injection behaviors in Tijuana, Mexico.

Science.gov (United States)

Strathdee, Steffanie A; Fraga, Wendy Davila; Case, Patricia; Firestone, Michelle; Brouwer, Kimberly C; Perez, Saida Gracia; Magis, Carlos; Fraga, Miguel Angel

2005-09-01

Injection drug use is a growing problem on the US-Mexico border, where Tijuana is situated. We studied the context of injection drug use among injection drug users (IDUs) in Tijuana to help guide future research and interventions. Guided in-depth interviews were conducted with 10 male and 10 female current IDUs in Tijuana. Topics included types of drug used, injection settings, access to sterile needles, and environmental influences. Interviews were taped, transcribed verbatim, and translated. Content analysis was conducted to identify themes. Of the 20 IDUs, median age and age at first injection were 30 and 18. Most reported injecting at least daily: heroin ("carga", "chiva", "negra"), methamphetamine ("crico", "cri-cri"), or both drugs combined. In sharp contrast to Western US cities, almost all regularly attended shooting galleries ("yongos" or "picaderos") because of the difficulties obtaining syringes and police oppression. Almost all shared needles/paraphernalia ["cuete" (syringe), "cacharros" (cookers), cotton from sweaters/socks (filters)]. Some reported obtaining syringes from the United States. Key themes included (1) pharmacies refusing to sell or charging higher prices to IDUs, (2) ample availability of used/rented syringes from "picaderos" (e.g., charging approximately 5 pesos or "10 drops" of drug), and (3) poor HIV/AIDS knowledge, such as beliefs that exposing syringes to air "kills germs." This qualitative study suggests that IDUs in Tijuana are at high risk of HIV and other blood-borne infections. Interventions are urgently needed to expand access to sterile injection equipment and offset the potential for a widespread HIV epidemic.

Effect of the Ethanol Injection Moment During Compression Stroke on the Combustion of Ethanol - Diesel Dual Direct Injection Engine

Science.gov (United States)

Liang, Yu; Zhou, Liying; Huang, Haomin; Xu, Mingfei; Guo, Mei; Chen, Xin

2018-01-01

A set of GDI system is installed on a F188 single-cylinder, air-cooled and direct injection diesel engine, which is used for ethanol injection, with the injection time controlled by the crank angle signal collected by AVL angle encoder. The injection of ethanol amounts to half of the thermal equivalent of an original diesel fuel. A 3D combustion model is established for the ethanol - diesel dual direct injection engine. Diesel was injected from the original fuel injection system, with a fuel supply advance angle of 20°CA. The ethanol was injected into the cylinder during compression process. Diesel injection began after the completion of ethanol injection. Ethanol injection starting point of 240°CA, 260°CA, 280°CA, 300°CA and 319.4°CA were simulated and analyzed. Due to the different timing of ethanol injection, the ignition of the ethanol mixture when diesel fires, results in non-uniform ignition distribution and flame propagation rate, since the distribution and concentration gradients of the ethanol mixture in the cylinder are different, thus affecting the combustion process. The results show that, when ethanol is injected at 319.4°CA, the combustion heat release rate and the pressure rise rate during the initial stage are the highest. Also, the maximum combustion pressure, with a relatively advance phase, is the highest. In case of later initial ethanol injection, the average temperature in the cylinder during the initial combustion period will have a faster rise. In case of initial injection at 319.4°CA, the average temperature in the cylinder is the highest, followed by 240°CA ethanol injection. In the post-combustion stage, the earlier ethanol injection will result in higher average temperature in the cylinder and more complete fuel combustion. The injection of ethanol at 319.4°CA produces earlier and highest NOX emissions.

Injection related anxiety in insulin-treated diabetes.

Science.gov (United States)

Zambanini, A; Newson, R B; Maisey, M; Feher, M D

1999-12-01

The presence of injection related anxiety and phobia may influence compliance, glycaemic control and quality of life in patients with insulin-treated diabetes. Unselected consecutive, insulin-treated patients attending a diabetes clinic for follow-up, completed a standardised questionnaire providing an injection anxiety score (IAS) and general anxiety score (GAS). A total of 115 insulin-treated (80 Type 1 and 35 Type 2) diabetic patients completed the questionnaire. Injections had been avoided secondary to anxiety in 14% of cases and 42% expressed concern at having to inject more frequently. An IAS > or = 3 was seen in 28% of patients and of these, 66% injected insulin one to two times/day, 45% had avoided injections, and 70% would be bothered by more frequent injections. A significant correlation between IAS and GAS was seen (Kendall's tau-a 0.30, 95% CI 0.19-0.41, P < 0.001). GAS was significantly associated with both previous injection avoidance and expressed concern at increased injection frequency. No significant correlation was seen with HbA1c and injection or general anxiety scores. Symptoms relating to insulin injection anxiety and phobia have a high prevalence in an unselected group of diabetic patients requiring insulin injections and are associated with higher levels of general anxiety.

CT guided diagnostic foot injections

International Nuclear Information System (INIS)

Saifuddin, A.; Abdus-Samee, M.; Mann, C.; Singh, D.; Angel, J.C.

2005-01-01

AIM: To describe a CT technique for guiding diagnostic and therapeutic injections in the hind- and mid-foot. MATERIALS AND METHODS: Over a period of 50 months, 28 individuals were referred for diagnostic and therapeutic hind- and mid-foot injections before possible arthrodesis. A CT technique was developed that allowed entry into the various joints using a vertical approach. Numbers of joints injected were as follows: posterior subtalar, 21; talonavicular, 4; calcaneonavicular, calcaneocuboid, navicular-cuneiform and 5th metatarsocuboid joints, 1 each. RESULTS: All injections but one were technically successful. Significant relief of symptoms was noted by 16 participants, whereas for 9 there was no improvement and for 3 a partial response was achieved. CONCLUSION: CT is a simple and safe alternative to fluoroscopy for guiding diagnostic and therapeutic foot injections, and may be the technique of choice in cases of disordered anatomy

Self-injection is a success

DEFF Research Database (Denmark)

Jensen, Jonna Gintberg; Høi, Henriette Brahe

these people have so far received injections from their own doctor. Many of the 29 feel healthy, are on the labor market and live a normal life. Therefore, it may be a recurring nuisance having to consult their physician monthly to get the injection. On this background, it is believed that self......-injection will increase the individual's quality of life. For that reason this project on quality assurance of the 29 citizens current quality of life, if they want training for self-administration in our hospital unit, and follow-up contact about how self-injections are going on. Method for data generation: Data...... out qualitative interviews Transcription of interview material Follow-up telephone interviews Analysis (Steiner Kvale's three operational levels) Significant findings: Causes of training for self-administration is desired. Family doctor injects quickly – which gives bruising, and may bleed profusely...

Delayed flumazenil injection after endoscopic sedation increases patient satisfaction compared with immediate flumazenil injection.

Science.gov (United States)

Chung, Hyun Jung; Bang, Byoung Wook; Kim, Hyung Gil; Kwon, Kye Sook; Shin, Yong Woon; Jeong, Seok; Lee, Don Haeng; Park, Shin Goo

2014-01-01

Flumazenil was administered after the completion of endoscopy under sedation to reduce recovery time and increase patient safety. We evaluated patient satisfaction after endoscopy under sedation according to the timing of a postprocedural flumazenil injection. In total, 200 subjects undergoing concurrent colonoscopy and upper endoscopy while sedated with midazolam and meperidine were enrolled in our investigation. We randomly administered 0.3 mg of flumazenil either immediately or 15 minutes after the endoscopic procedure. A postprocedural questionnaire and next day telephone interview were conducted to assess patient satisfaction. Flumazenil injection timing did not affect the time spent in the recovery room when comparing the two groups of patients. However, the subjects in the 15 minutes injection group were more satisfied with undergoing endoscopy under sedation than the patients in the immediate injection group according to the postprocedural survey (p=0.019). However, no difference in overall satisfaction, memory, or willingness to undergo a future endoscopy was observed between the two groups when the telephone survey was conducted on the following day. This study demonstrated that a delayed flumazenil injection after endoscopic sedation increased patient satisfaction without prolonging recovery time, even though the benefit of the delayed flumazenil injection did not persist into the following day.

To study the effect of injection dexmedetomidine for prevention of pain due to propofol injection and to compare it with injection lignocaine

Directory of Open Access Journals (Sweden)

Manisha Sapate

2015-12-01

Full Text Available BACKGROUND: Pain due to injection propofol is a common problem. Different methods are used to decrease the pain but with limited success. The objective of this study was to assess the effect of injection dexmedetomidine 0.2 mcg/kg for prevention of pain due to propofol injection and compare it with injection lignocaine 0.2 mg/kg. METHOD: After taking permission of the Institutional Ethical Committee, written informed consent was obtained from all patients, in a randomized prospective study. 60 American Society of Anesthesiology I and II patients of age range 20-60 years of either sex posted for elective surgeries under general anaesthesia were randomly allocated into two groups. Group I (dexmedetomidine group: Inj. dexmedetomidine 0.2 mcg/kg diluted in 5 mL normal saline and Group II (lignocaine group: Inj. lignocaine 0.2 mg/kg diluted in 5 mL normal saline. IV line was secured with 20 G cannula and venous occlusion was applied to forearm using a pneumatic tourniquet and inflated to 70 mm Hg for 1 min. Study drug was injected, tourniquet released and then 25% of the calculated dose of propofol was given intravenously over 10 s. After 10 s of injection, severity of pain was evaluated using McCrirrick and Hunter scale and then remaining propofol and neuromuscular blocking agent was given. Endotracheal intubation was done and anaesthesia was maintained on O2, N2O and isoflurane on intermittent positive pressure ventilation with Bain's circuit and inj. vecuronium was used as muscle relaxant. RESULTS: Demographic data showed that there was no statistically significant difference between the 2 groups. There was no statistically significant difference between 2 groups in respect to inj. propofol pain. No adverse effects like oedema, pain, wheal response at the site of injection were observed in the two groups.

Closure of shallow underground injection wells

International Nuclear Information System (INIS)

Veil, J.A.; Grunewald, B.

1993-01-01

Shallow injection wells have long been used for disposing liquid wastes. Some of these wells have received hazardous or radioactive wastes. According to US Environmental Protection Agency (EPA) regulations, Class IV wells are those injection wells through which hazardous or radioactive wastes are injected into or above an underground source of drinking water (USDW). These wells must be closed. Generally Class V wells are injection wells through which fluids that do not contain hazardous or radioactive wastes are injected into or above a USDW. Class V wells that are responsible for violations of drinking water regulations or that pose a threat to human health must also be closed. Although EPA regulations require closure of certain types of shallow injection wells, they do not provide specific details on the closure process. This paper describes the regulatory background, DOE requirements, and the steps in a shallow injection well closure process: Identification of wells needing closure; monitoring and disposal of accumulated substances; filling and sealing of wells; and remediation. In addition, the paper describes a major national EPA shallow injection well enforcement initiative, including closure plan guidance for wells used to dispose of wastes from service station operations

Premixed direct injection disk

Science.gov (United States)

York, William David; Ziminsky, Willy Steve; Johnson, Thomas Edward; Lacy, Benjamin; Zuo, Baifang; Uhm, Jong Ho

2013-04-23

A fuel/air mixing disk for use in a fuel/air mixing combustor assembly is provided. The disk includes a first face, a second face, and at least one fuel plenum disposed therebetween. A plurality of fuel/air mixing tubes extend through the pre-mixing disk, each mixing tube including an outer tube wall extending axially along a tube axis and in fluid communication with the at least one fuel plenum. At least a portion of the plurality of fuel/air mixing tubes further includes at least one fuel injection hole have a fuel injection hole diameter extending through said outer tube wall, the fuel injection hole having an injection angle relative to the tube axis. The invention provides good fuel air mixing with low combustion generated NOx and low flow pressure loss translating to a high gas turbine efficiency, that is durable, and resistant to flame holding and flash back.

Increasing energy efficiency of a gasoline direct injection engine through optimal synchronization of single or double injection strategies

International Nuclear Information System (INIS)

Costa, Michela; Sorge, Ugo; Allocca, Luigi

2012-01-01

Highlights: ► Advantages of split injection in a GDI engine are studied through numerical simulation. ► At high load and speed, rich conditions, split injection does not improve engine performance. ► At moderate load and speed, lean conditions, double injection improves charge stratification. ► Optimal double injection increases work, reduces HC and increases NO. - Abstract: The greatest fuel efficiency advantages of gasoline direct injection (GDI) engines are achieved under the so-called mixed mode boosting, where mixture characteristics are properly adapted to the specific working condition. In particular, in the medium range of load and speed, overall lean mixtures are suitable of being used in the so-called direct injection stratified charge operation. Present paper reports the results of numerical optimization analyses aimed at increasing the energetic efficiency of a GDI engine equipped with a high pressure multi-hole injector under both single and double injection events. In moderate-load moderate-speed lean conditions, the single or double injection synchronization in the working cycle is effected through a procedure that couples a 3D numerical model of the in-cylinder processes with an optimization tool. The choice of both the start of the injection events and the time of spark advance is realized to maximize the engine work. The optimal double injection solution is shown to increase the engine energy efficiency with respect to the case injection is realized in one shot, thus confirming that split injections improve the quality of the charge stratification under lean operation. The effect on the major pollutants is also discussed.

Fluid injection and induced seismicity

Science.gov (United States)

Kendall, Michael; Verdon, James

2016-04-01

The link between fluid injection, or extraction, and induced seismicity has been observed in reservoirs for many decades. In fact spatial mapping of low magnitude events is routinely used to estimate a stimulated reservoir volume. However, the link between subsurface fluid injection and larger felt seismicity is less clear and has attracted recent interest with a dramatic increase in earthquakes associated with the disposal of oilfield waste fluids. In a few cases, hydraulic fracturing has also been linked to induced seismicity. Much can be learned from past case-studies of induced seismicity so that we can better understand the risks posed. Here we examine 12 case examples and consider in particular controls on maximum event size, lateral event distributions, and event depths. Our results suggest that injection volume is a better control on maximum magnitude than past, natural seismicity in a region. This might, however, simply reflect the lack of baseline monitoring and/or long-term seismic records in certain regions. To address this in the UK, the British Geological Survey is leading the deployment of monitoring arrays in prospective shale gas areas in Lancashire and Yorkshire. In most cases, seismicity is generally located in close vicinity to the injection site. However, in some cases, the nearest events are up to 5km from the injection point. This gives an indication of the minimum radius of influence of such fluid injection projects. The most distant events are never more than 20km from the injection point, perhaps implying a maximum radius of influence. Some events are located in the target reservoir, but most occur below the injection depth. In fact, most events lie in the crystalline basement underlying the sedimentary rocks. This suggests that induced seismicity may not pose a leakage risk for fluid migration back to the surface, as it does not impact caprock integrity. A useful application for microseismic data is to try and forecast induced seismicity

77 FR 71006 - Sodium Nitrite Injection and Sodium Thiosulfate Injection Drug Products Labeled for the Treatment...

Science.gov (United States)

2012-11-28

... poisoning and unapproved injectable drug products containing sodium thiosulfate labeled for the treatment of... for the treatment of cyanide poisoning are new drugs that require approved new drug applications (NDAs... Injection and Sodium Thiosulfate Injection drug product, labeled for treatment of acute cyanide poisoning...

Associations between injection risk and community disadvantage among suburban injection drug users in southwestern Connecticut, USA.

Science.gov (United States)

Heimer, Robert; Barbour, Russell; Palacios, Wilson R; Nichols, Lisa G; Grau, Lauretta E

2014-03-01

Increases in drug abuse, injection, and opioid overdoses in suburban communities led us to study injectors residing in suburban communities in southwestern Connecticut, US. We sought to understand the influence of residence on risk and injection-associated diseases. Injectors were recruited by respondent-driven sampling and interviewed about sociodemographics, somatic and mental health, injection risk, and interactions with healthcare, harm reduction, substance abuse treatment, and criminal justice systems. HIV, hepatitis B and C (HBV and HCV) serological testing was also conducted. Our sample was consistent in geographic distribution and age to the general population and to the patterns of heroin-associated overdose deaths in the suburban towns. High rates of interaction with drug abuse treatment and criminal justice systems contrasted with scant use of harm reduction services. The only factors associated with both dependent variables-residence in less disadvantaged census tracts and more injection risk-were younger age and injecting in one's own residence. This contrasts with the common association among urban injectors of injection-associated risk behaviors and residence in disadvantaged communities. Poor social support and moderate/severe depression were associated with risky injection practices (but not residence in specific classes of census tracts), suggesting that a region-wide dual diagnosis approach to the expansion of harm reduction services could be effective at reducing the negative consequences of injection drug use.

Dimethyl Ether Injection Studies

DEFF Research Database (Denmark)

Sorenson, Spencer C.; Glensvig, Michael; Abata, Duane L.

1998-01-01

A series of preliminary investigations has been performed in order to investigate the behavior of DME in a diesel injection environment. These studies have in-cluded visual observations of the spray penetration and angles for high pressure injection into Nitrogen using conventional jerk pump inje...

Hydrogen injection device in BWR type reactor

International Nuclear Information System (INIS)

Takagi, Jun-ichi; Kubo, Koji.

1988-01-01

Purpose: To reduce the increasing ratio of main steam system dose rate due to N-16 activity due to excess hydrogen injection in the hydrogen injection operation of BWR type reactors. Constitution: There are provided a hydrogen injection mechanism for injecting hydrogen into primary coolants of a BWR type reactor, and a chemical injection device for injecting chemicals such as methanol, which makes nitrogen radioisotopes resulted in the reactor water upon hydrogen injection non-volatile, into the pressure vessel separately from hydrogen. Injected hydrogen and the chemicals are not reacted in the feedwater system, but the reaction proceeds due to the presence of radioactive rays after the injection into the pressure vessel. Then, hydrogen causes re-combination in the downcomer portion to reduce the dissolved oxygen concentration. Meanwhile, about 70 % of the chemicals is supplied by means of a jet pump directly to the reactor core, thereby converting the chemical form of N-16 in the reactor core more oxidative (non-volatile). (Kawakami, Y.)

Post-injection delirium/sedation syndrome in patients with schizophrenia treated with olanzapine long-acting injection, I: analysis of cases

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Stefaniak Victoria J

2010-06-01

Full Text Available Abstract Background An advance in the treatment of schizophrenia is the development of long-acting intramuscular formulations of antipsychotics, such as olanzapine long-acting injection (LAI. During clinical trials, a post-injection syndrome characterized by signs of delirium and/or excessive sedation was identified in a small percentage of patients following injection with olanzapine LAI. Methods Safety data from all completed and ongoing trials of olanzapine LAI were reviewed for possible cases of this post-injection syndrome. Descriptive analyses were conducted to characterize incidence, clinical presentation, and outcome. Regression analyses were conducted to assess possible risk factors. Results Based on approximately 45,000 olanzapine LAI injections given to 2054 patients in clinical trials through 14 October 2008, post-injection delirium/sedation syndrome occurred in approximately 0.07% of injections or 1.4% of patients (30 cases in 29 patients. Symptomatology was consistent with olanzapine overdose (e.g., sedation, confusion, slurred speech, altered gait, or unconsciousness. However, no clinically significant decreases in vital signs were observed. Symptom onset ranged from immediate to 3 to 5 hours post injection, with a median onset time of 25 minutes post injection. All patients recovered within 1.5 to 72 hours, and the majority continued to receive further olanzapine LAI injections following the event. No clear risk factors were identified. Conclusions Post-injection delirium/sedation syndrome can be readily identified based on symptom presentation, progression, and temporal relationship to the injection, and is consistent with olanzapine overdose following probable accidental intravascular injection of a portion of the olanzapine LAI dose. Although there is no specific antidote for olanzapine overdose, patients can be treated symptomatically as needed. Special precautions include use of proper injection technique and a post-injection

Policing behaviors, safe injection self-efficacy, and intervening on injection risks: Moderated mediation results from a randomized trial.

Science.gov (United States)

Pitpitan, Eileen V; Patterson, Thomas L; Abramovitz, Daniela; Vera, Alicia; Martinez, Gustavo; Staines, Hugo; Strathdee, Steffanie A

2016-01-01

We aim to use conditional or moderated mediation to simultaneously test how and for whom an injection risk intervention was efficacious at reducing receptive needle sharing among female sex workers who inject drugs (FSWs-IDUs) in Mexico. Secondary analysis of data from a randomized trial. A total of 300 FSW-IDUs participated in Mujer Mas Segura in Ciudad Juarez, Mexico, and were randomized to an interactive injection risk intervention or a didactic injection risk intervention. We measured safe injection self-efficacy as the hypothesized mediator and policing behaviors (being arrested and syringe confiscation) as hypothesized moderators. In total, 213 women provided complete data for the current analyses. Conditional (moderated) mediation showed that the intervention affected receptive needle sharing through safe injection self-efficacy among women who experienced syringe confiscation. On average, police syringe confiscation was associated with lower safe injection self-efficacy (p = .04). Among those who experienced syringe confiscation, those who received the interactive (vs. didactic) intervention reported higher self-efficacy, which in turn predicted lower receptive needle sharing (p = .04). Whereas syringe confiscation by the police negatively affected safe injection self-efficacy and ultimately injection risk behavior, our interactive intervention helped to "buffer" this negative impact of police behavior on risky injection practices. The theory-based, active skills building elements included in the interactive condition, which were absent from the didactic condition, helped participants' self-efficacy for safer injection in the face of syringe confiscation. (c) 2015 APA, all rights reserved).

WGA-Alexa transsynaptic labeling in the phrenic motor system of adult rats: Intrapleural injection versus intradiaphragmatic injection.

Science.gov (United States)

Buttry, Janelle L; Goshgarian, Harry G

2015-02-15

Intrapleural injection of CTB-Alexa 488, a retrograde tracer, provides an alternative labeling technique to the surgically invasive laparotomy required for intradiaphragmatic injection. However, CTB-Alexa 488 is incapable of crossing synapses restricting the tracer to the phrenic nuclei and the intercostal motor nuclei in the spinal cord. Intrapleural injection of WGA-Alexa 488, a transsynaptic tracer, provides a method to label the respiratory motor pathway in both the spinal cord and medulla. Intradiaphragmatic injection of WGA-Alexa 594 and vagal nerve injections of True blue were used to confirm the phrenic nuclei and to differentiate between the rVRG and the NA in the medulla. Following intrapleural injection, WGA-Alexa 488 was retrogradely transported to the phrenic nuclei and to the intercostal motor nuclei. Subsequently WGA-Alexa 488 was transsynaptically transported from the phrenic motoneurons to the pre-motor neurons in the rVRG that provide the descending drive to the phrenic neurons during inspiration. In addition WGA-Alexa 488 was identified in select cells of the NA confirmed by a dual label of both WGA-Alexa 488 and True blue. WGA-Alexa 488 demonstrates retrograde transsynaptic labeling following intrapleural injection whereas the previous method of injecting CTB-Alexa 488 only demonstrates retrograde labeling. Intrapleural injection of WGA-Alexa fluor conjugates is an effective method to transsynaptically label the phrenic motor system providing an alternative for the invasive laparotomy required for intradiaphragmatic injections. Furthermore, the study provides the first anatomical evidence of a direct synaptic relationship between rVRG and select NA cells. Copyright © 2014 Elsevier B.V. All rights reserved.

Electron injection in microtron

International Nuclear Information System (INIS)

Axinescu, S.

1977-01-01

A review of the methods of injecting electrons in the microtron is presented. A special attention is paid to efficient injection systems developed by Wernholm and Kapitza. A comparison of advantages and disadvantages of both systems is made in relation to the purpose of the microtron. (author)

Rapid assessment of injection practices in Cambodia, 2002

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Goldstein Susan

2005-06-01

Full Text Available Abstract Background Injection overuse and unsafe injection practices facilitate transmission of bloodborne pathogens such as hepatitis B virus (HBV, hepatitis C virus (HCV, and human immunodeficiency virus (HIV. Anecdotal reports of unsafe and unnecessary therapeutic injections and the high prevalence of HBV (8.0%, HCV (6.5%, and HIV (2.6% infection in Cambodia have raised concern over injection safety. To estimate the magnitude and patterns of such practices, a rapid assessment of injection practices was conducted. Methods We surveyed a random sample of the general population in Takeo Province and convenience samples of prescribers and injection providers in Takeo Province and Phnom Penh city regarding injection-related knowledge, attitudes, and practices. Injection providers were observed administering injections. Data were collected using standardized methods adapted from the World Health Organization safe injection assessment guidelines. Results Among the general population sample (n = 500, the overall injection rate was 5.9 injections per person-year, with 40% of participants reporting receipt of ≥ 1 injection during the previous 6 months. Therapeutic injections, intravenous infusions, and immunizations accounted for 74%, 16% and 10% of injections, respectively. The majority (>85% of injections were received in the private sector. All participants who recalled their last injection reported the injection was administered with a newly opened disposable syringe and needle. Prescribers (n = 60 reported that 47% of the total prescriptions they wrote included a therapeutic injection or infusion. Among injection providers (n = 60, 58% recapped the syringe after use and 13% did not dispose of the used needle and syringe appropriately. Over half (53% of the providers reported a needlestick injury during the previous 12 months. Ninety percent of prescribers and injection providers were aware HBV, HCV, and HIV were transmitted through unsafe

The PEP injection system

International Nuclear Information System (INIS)

Brown, K.L.; Avery, R.T.; Peterson, J.M.

1988-01-01

A system to transport 10-to-15-GeV electron and positron beams from the Stanford Linear Accelerator and to inject them into the PEP storage ring under a wide variety of lattice configurations has been designed. Optically, the transport line consists of three 360/degree/ phase-shift sections of FODO lattice, with bending magnets interspersed in such a way as to provide achromaticity, convenience in energy and emittance definition, and independent tuning of the various optical parameters for matching into the ring. The last 360/degree/ of phase shift has 88 milliradians of bend in a vertical plane and deposits the beam at the injection septum via a Lambertson magnet. Injection is accomplished by launching the beam with several centimeters of radial betatron amplitude in a fast bump provided by a triad of pulsed kicker magnets. Radiation damping reduces the collective amplitude quickly enough to allow injection at a high repetition rate

Two injection digital block versus single subcutaneous palmar injection block for finger lacerations.

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Okur, O M; Şener, A; Kavakli, H Ş; Çelik, G K; Doğan, N Ö; Içme, F; Günaydin, G P

2017-12-01

We aimed to compare two digital nerve block techniques in patients due to traumatic digital lacerations. This was a randomized-controlled study designed prospectively in the emergency department of a university-based training and research hospital. Randomization was achieved by sealed envelopes. Half of the patients were randomised to traditional (two-injection) digital nerve block technique while single-injection digital nerve block technique was applied to the other half. Score of pain due to anesthetic infiltration and suturing, onset time of total anesthesia, need for an additional rescue injection were the parameters evaluated with both groups. Epinephrin added lidocaine hydrochloride preparation was used for the anesthetic application. Visual analog scale was used for the evaluation of pain scores. Outcomes were compared by using Mann-Whitney U test and Student t-test. Fifty emergency department patients ≥18 years requiring digital nerve block were enrolled in the study. Mean age of the patients was 33 (min-max: 19-86) and 39 (78 %) were male. No statistically significant difference was found between the two groups in terms of our main parameters; anesthesia pain score, suturing pain score, onset time of total anesthesia and rescue injection need. Single injection volar digital nerve block technique is a suitable alternative for digital anesthesias in emergency departments.

Effects of turbulence enhancement on combustion process using a double injection strategy in direct-injection spark-ignition (DISI) gasoline engines

International Nuclear Information System (INIS)

Kim, Taehoon; Song, Jingeun; Park, Sungwook

2015-01-01

Highlights: • Using double injection strategy, turbulent kinetic energy can be improved with slight decrease in mixture homogeneity. • Retarded first injection timing reduces vapor fuel loss to intake port. • Double injection increases tumble intensity. • High turbulent intensity caused by double injection increases flame propagation speed. - Abstract: Direct-injection spark-ignition (DISI) gasoline engines have been spotlighted due to their high thermal efficiency. Increase in the compression ratio that result from the heat absorption effect of fuel vaporization induces higher thermal efficiency than found in port fuel injection (PFI) engines. Since fuel is injected at the cylinder directly, various fuel injection strategies can be used. In this study, turbulent intensity was improved by a double injection strategy while maintaining mixture homogeneity. To analyze the turbulence enhancement effects using the double injection strategy, a side fuel injected, homogeneous-charge-type DISI gasoline engine with a multi-hole-type injector was utilized. The spray model was evaluated using experimental data for various injection pressures and the combustion model was evaluated for varied ignition timing. First and second injection timing was swept by 20 degree interval. The turbulent kinetic energy and mixture inhomogeneity index were mapped. First injection at the middle of the intake stroke and second injection early in the compression stroke showed improved turbulent characteristics that did not significantly decrease with mixture homogeneity. A double injection case that showed improved turbulent intensity while maintaining an adequate level of mixture homogeneity and another double injection case that showed significantly improved turbulent intensity with a remarkable decrease in mixture homogeneity were considered for combustion simulation. We found that the improved turbulent intensity increased the flame propagation speed. Also, the mixture homogeneity

Survey of Botulinum Toxin Injections in Anticoagulated Patients: Korean Physiatrists' Preference in Controlling Anticoagulation Profile Prior to Intramuscular Injection.

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Jang, Yongjun; Park, Geun-Young; Park, Jihye; Choi, Asayeon; Kim, Soo Yeon; Boulias, Chris; Phadke, Chetan P; Ismail, Farooq; Im, Sun

2016-04-01

To evaluate Korean physiatrists' practice of performing intramuscular botulinum toxin injection in anticoagulated patients and to assess their preference in controlling the bleeding risk before injection. As part of an international collaboration survey study, a questionnaire survey was administered to 100 Korean physiatrists. Physiatrists were asked about their level of experience with botulinum toxin injection, the safe international normalized ratio range in anticoagulated patients undergoing injection, their tendency for injecting into deep muscles, and their experience of bleeding complications. International normalized ratio injection by 41% of the respondents. Thirty-six respondents replied that the international normalized ratio should be lowered to sub-therapeutic levels before injection, and 18% of the respondents reported that anticoagulants should be intentionally withheld and discontinued prior to injection. In addition, 20%-30% of the respondents answered that they were uncertain whether they should perform the injection regardless of the international normalized ratio values. About 69% of the respondents replied that they did have any standardized protocols for performing botulinum toxin injection in patients using anticoagulants. Only 1 physiatrist replied that he had encountered a case of compartment syndrome. In accordance with the lack of consensus in performing intramuscular botulinum toxin injection in anticoagulated patients, our survey shows a wide range of practices among many Korean physiatrists; they tend to avoid botulinum toxin injection in anticoagulated patients and are uncertain about how to approach these patients. The results of this study emphasize the need for formulating a proper international consensus on botulinum toxin injection management in anticoagulated patients.

Injection Pressure as a Marker of Intraneural Injection in Procedures of Peripheral Nerves Blockade

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Ilvana Vučković

2006-11-01

Full Text Available The blockade of peripheral nerves carries a certain risk of unwanted complications, which can follow after unintentional intraneural injection of a local anesthetic. Up till today, the research of measuring injection pressure has been based on animal models, even though the histological structure of periphery nerve is different for animal and human population, so the application pressure which presages intraneural injection in human population is still unknown. As material in performing this study there have been used 12 Wistar rats and 12 delivered stillborns. After bilateral access to the median nerve, we applied 3 ml of 2% lidocaine with epinephrine, with the help of automatic syringe charger. The needle was at first placed perineural on one side, and then intraneural on the other side of both examination groups. During every application the pressure values were monitored using the manometer, and then they were analyzed by special software program BioBench. All perineural injections resulted with the pressure < or = 27.92 kPa, while the majority of intraneural injections were combined with the injectionpressure > or = 69.8 kPa. The difference between intraneural and perineural injection pressures for the two different examination groups (rats and delivered stillborns was not statistically significant (P>0.05. As prevention from intraneural injections today are in use two methods: the method of causing paresthesia or the method of using the peripheral nerve stimulator. However the nerve injury can still occur, independent from the technique used. If our results are used in clinical practice on human population, than the high injection pressure could be the markerof intraneural lodging of a needle.

Injecting risk behavior among traveling young injection drug users: travel partner and city characteristics.

Science.gov (United States)

Montgomery, Martha E; Fatch, Robin S; Evans, Jennifer L; Yu, Michelle; Davidson, Peter J; Page, Kimberly; Hahn, Judith A

2013-06-01

Young injection drug users (IDUs), a highly mobile population, engage in high levels of injecting risk behavior, yet little is understood about how such risk behavior may vary by the characteristics of the cities to which they travel, including the existence of a syringe exchange program (SEP), as well as travel partner characteristics. In 2004-2005, we conducted a 6-month prospective study to investigate the risk behavior of 89 young IDUs as they traveled, with detailed information gathered about 350 city visits. In multivariable analyses, travel to larger urban cities with a population of 500,000-1,000,000 was significantly associated with injecting drugs (adjusted odds ratio (AOR) = 3.71; 95 % confidence interval (CI), 1.56-8.82), ancillary equipment sharing (AES; AOR = 7.05; 95 % CI, 2.25-22.06) and receptive needle sharing (RNS; AOR = 5.73; 95 % CI, 1.11-27.95), as compared with visits to smaller cities with populations below 50,000. Region of the country, and the existence of a SEP within the city visited, were not independently associated with injecting drugs, AES, or RNS during city visits. Traveling with more than one injecting partner was associated with injecting drugs during city visits (AOR = 2.77; 95 % CI, 1.46-5.27), when compared with traveling alone. Additionally, both non-daily and daily/almost daily alcohol use during city visits were associated with AES (AOR = 3.37; 95 % CI, 1.42-7.68; AOR = 3.03; 95 % CI, 1.32-6.97, respectively) as compared with no alcohol consumption. Traveling young IDUs are more likely to inject when traveling with other IDUs and to engage in higher risk injection behavior when they are in large cities. Risk behavior occurring in city visits, including equipment sharing and alcohol consumption, suggests further need for focused interventions to reduce risk for viral infection among this population.

Avaliação histeroscópica em pacientes com infertilidade Hysteroscopic evaluation in patients with infertility

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Ricardo Bassil Lasmar

2010-08-01

Full Text Available OBJETIVO: descrever os achados da histeroscopia em pacientes com infertilidade. MÉTODOS: série retrospectiva de 953 pacientes com diagnóstico de infertilidade avaliadas por histeroscopia. As 957 pacientes em pesquisa de infertilidade foram submetidas à histeroscopia, preferencialmente na primeira fase do ciclo menstrual. Quando necessário, foram realizadas as biópsias, dirigida (sob visão direta durante o exame ou orientada, utilizando uma cureta de Novak após definir o local a ser biopsiado durante o exame histeroscópico. Foram utilizadas porcentagens para determinação da frequência dos desfechos e teste de χ2 para correlações. O programa estatístico EpiInfo 2000 (CDC foi utilizado para análise dos dados. RESULTADOS: cavidade uterina normal foi encontrada em 436 casos (45,8%. Esse foi o diagnóstico mais frequente em mulheres com infertilidade primária e naquelas com nenhum ou um aborto (pPURPOSE: to describe hysteroscopy findings in infertile patients. METHODS: this was a retrospective series of 953 patients with diagnosis of infertility evaluated by hysteroscopy. A total of 957 patients investigated for infertility were subjected to hysteroscopy, preferentially during the first phase of the menstrual cycle. When necessary, directed biopsies (under direct visualization during the exam or guided biopsies were obtained using a Novak curette after defining the site to be biopsied during the hysteroscopic examination. Outcome frequencies were determined as percentages, and the χ2 test was used for the correlations. The statistical software EpiInfo 2000 (CDC was used for data analysis. RESULTS: a normal uterine cavity was detected in 436 cases (45.8%. This was the most frequent diagnosis for women with primary infertility and for women with one or no abortion (p<0.05. Abnormal findings were obtained in 517 of 953 cases (54.2%, including intrauterine synechiae in 185 patients (19.4%, endometrial polyps in 115 (12.1%, endocervical

THE RHIC INJECTION SYSTEM.

Energy Technology Data Exchange (ETDEWEB)

FISCHER,W.; GLENN,J.W.; MACKAY,W.W.; PTITSIN,V.; ROBINSON,T.G.; TSOUPAS,N.

1999-03-29

The RHIC injection system has to transport beam from the AGS-to-RHIC transfer line onto the closed orbits of the RHIC Blue and Yellow rings. This task can be divided into three problems. First, the beam has to be injected into either ring. Second, once injected the beam needs to be transported around the ring for one turn. Third, the orbit must be closed and coherent beam oscillations around the closed orbit should be minimized. We describe our solutions for these problems and report on system tests conducted during the RHIC Sextant test performed in 1997. The system will be fully commissioned in 1999.

An experimental study of injection and spray characteristics of diesel and gasoline blends on a common rail injection system

International Nuclear Information System (INIS)

Han, Dong; Wang, Chunhai; Duan, Yaozong; Tian, Zhisong; Huang, Zhen

2014-01-01

The injection and spray characteristics of diesel and gasoline blends are investigated on a common rail injection system. The injection rate, fuel spray evolution process (tip penetration distance, spray cone angle, projected spray area and relative brightness intensity contour) and microscopic droplet features are analyzed. The results show that diesel and gasoline blends have higher volumetric injection rates, earlier starts of injection and shorter injection delays, but little variances are observed in the mass injection rates for different test fuels. Increased gasoline proportion in the test blends causes slightly decreased spray tip penetration distance but increased spray cone angle. Also, more smaller-size droplets are observed in the fuel jet of the diesel and gasoline blends, indicating that the spray breakup and atomization processes are promoted. - Highlights: • Injection rate and spray characteristics of diesel and gasoline blends are studied. • Diesel and gasoline blends have higher volumetric injection rates. • Earlier starts of injection are found when using diesel and gasoline blends. • Diesel and gasoline blends produce shorter spray penetration but higher cone angle. • The number of small droplets increases in the spray of diesel and gasoline blends

ITER Neutral Beam Injection System

International Nuclear Information System (INIS)

Ohara, Yoshihiro; Tanaka, Shigeru; Akiba, Masato

1991-03-01

A Japanese design proposal of the ITER Neutral Beam Injection System (NBS) which is consistent with the ITER common design requirements is described. The injection system is required to deliver a neutral deuterium beam of 75MW at 1.3MeV to the reactor plasma and utilized not only for plasma heating but also for current drive and current profile control. The injection system is composed of 9 modules, each of which is designed so as to inject a 1.3MeV, 10MW neutral beam. The most important point in the design is that the injection system is based on the utilization of a cesium-seeded volume negative ion source which can produce an intense negative ion beam with high current density at a low source operating pressure. The design value of the source is based on the experimental values achieved at JAERI. The utilization of the cesium-seeded volume source is essential to the design of an efficient and compact neutral beam injection system which satisfies the ITER common design requirements. The critical components to realize this design are the 1.3MeV, 17A electrostatic accelerator and the high voltage DC acceleration power supply, whose performances must be demonstrated prior to the construction of ITER NBI system. (author)

Modelling the effect of injection pressure on heat release parameters and nitrogen oxides in direct injection diesel engines

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Yüksek Levent

2014-01-01

Full Text Available Investigation and modelling the effect of injection pressure on heat release parameters and engine-out nitrogen oxides are the main aim of this study. A zero-dimensional and multi-zone cylinder model was developed for estimation of the effect of injection pressure rise on performance parameters of diesel engine. Double-Wiebe rate of heat release global model was used to describe fuel combustion. extended Zeldovich mechanism and partial equilibrium approach were used for modelling the formation of nitrogen oxides. Single cylinder, high pressure direct injection, electronically controlled, research engine bench was used for model calibration. 1000 and 1200 bars of fuel injection pressure were investigated while injection advance, injected fuel quantity and engine speed kept constant. The ignition delay of injected fuel reduced 0.4 crank angle with 1200 bars of injection pressure and similar effect observed in premixed combustion phase duration which reduced 0.2 crank angle. Rate of heat release of premixed combustion phase increased 1.75 % with 1200 bar injection pressure. Multi-zone cylinder model showed good agreement with experimental in-cylinder pressure data. Also it was seen that the NOx formation model greatly predicted the engine-out NOx emissions for both of the operation modes.

The effect of blood injection for the prevention of Ethanol reflux after intrahepatic Ethanol injection in the rat

International Nuclear Information System (INIS)

Ahn, Kook Jin; Kim, Choon Yul; Kim, Bum Soo; Hahn, Seong Tai; Lee, Jae Mun; Shinn, Kyung Sub

1998-01-01

To reduce ethanol reflux from the needle channel by injecting rat blood immediately after the injection of ethanol into rat liver. The first experiment involved 33 rat livers which were divided into four groups (three livers in group 1;ten in groups 2, 3, and 4). Group 1 animals were used as controls, and 0.1ml saline was injected into the liver; in group 2, ethanol-Tc-99m-O 4 - mixed solution (0.1ml, 0.2mCi) was injected into the liver;in groups 3 and 4, the needle channel was blocked with 0.02ml of fresh blood and old blood, respectively, after the injection of ethanol. After removing the needle, a 3cm round filter paper was laid on each injection site to absorb refluxed ethanol-T c -99m-O 4 - mixed solution from the liver, and each paper was then counted by a gamma camera unit. In the second experiment, 33rats were divided into four groups (three rats in group 1;ten in groups 2, 3, and 4). Group 1 animals were used as controls, and after exposing the left lateral lobe of the liver, 0.05 ml of saline was injected;in group 2, 0.05 ml of ethanol was injected into the livder;in groups 3 and 4 the needle channel was blocked with 0.02 ml of fresh blood and old blood, respectively, after the injection of ethanol. After ten days, peritoneal adhesions were scored macroscopically and microscopically. In the first experiment using ethanol- T c -99m-O 4 - mixed solution, groups blocked with blood after the injection of mixed solution showed lower gamma counts than the group injected with mixed solution only (p-value=3D0.0002). The group blocked with old blood showed the lowest count. Macroscopical and microscopical examination of peritoneal adhesions indicated that the grade of adhesion was lower in groups blocked with blood than in the group injected with ethanol onluy (p-value=3D0.0261 and 0.0163, respectively). The above results suggest that an injection of blood after an injection of ethanol is a very effective way of preventing reflux from the liver.=20

Ultrasound-guided botulinum toxin injections

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S. E. Khatkova

2016-01-01

Full Text Available One of the key conditions for achieving the desirable result during botulinum toxin therapy for muscular dystonia, spasticity, and other diseases accompanied by spasm, pain, and autonomic dysfunction (dystonias, spasticity, etc. is the proper administration of the agent into the muscles directly involved in the pathological process. The exact entry of botulinum toxin into the target muscles is essential for successful and safe treatment because its injection into a normal muscle may cause side effects. The most common errors are the incorrect depth and incorrect direction of a needle on insertion. Therefore, the exact injection of the agent particularly into the shallow and deep muscles is a difficult task even for an experienced specialist and requires the use of controlling methods.The European Consensus on Botulinum Toxin Therapy points out that various injection techniques are needed for the better identification of necessary muscles. However, there are currently no reports on the clear advantage of any technique. In our country, injections using palpation and anatomical landmarks have been widely used in routine practice so far; electromyographic monitoring and electrostimulation have been less frequently applied. In recent years, the new method ultrasound-guided injection has continued to grow more popular. This effective, accessible, and easy-to-use method makes it possible to manage a real-time injection process and to ensure the exact entry of the agent into the muscle. This paper is dedicated to a comparative analysis of different injection methods and to a description of the ultrasound-guided technique and its advantages over others. 

Assessment of the safety of injection practices and injection-related procedures in family health units and centers in Alexandria.

Science.gov (United States)

Elhoseeny, Taghareed A; Mourad, Juidan K

2014-08-01

The Safe Injection Global Network (SIGN) developed an intervention strategy for reducing overuse of injections and promoting the administration of safe injections. Tool C--Revised is designed to assess the safety of the most common procedures that puncture the skin within health services. The aim of the study was to assess injection safety within the primary healthcare facilities in Alexandria using Tool C--Revised. A total of 45 family health units and centers in Alexandria were selected by proportional allocation from the eight regions of Alexandria. The Tool C--Revised of the WHO was used for observation of the entire facility, injection practices and injection-related procedures, and sterilization practices. Interview of different health providers and immediate supervisor of injections was carried out. Indicators that reflect risk included: deficiency of alcohol-based hand rub for cleansing hands (13.3%), compliance with hand wash before preparing a procedure (56.9% before injection practices, 61.3% before phlebotomy, and 67.6% before lancet puncture), and wearing a new pair of gloves before new procedures (48.6% before injection practices, 9.7% for phlebotomy, 11.8% for lancet puncture, and 80% for both intravenous injections and infusions). Enough disposable equipment in all facilities for at least 2 weeks dependent on the statement of the average numbers of procedures per week was shown. Only 38% of the providers had received training regarding injection safety in the last 2 years and 62.5% had completed their three doses of hepatitis B vaccine. Only 42.2% of staffs who handled healthcare waste had access to heavy gloves. Indicators related to injection and injection-related practices that reflect risk to patients include deficiency of alcohol-based hand rub tools, nonadherence to hand hygiene before preparing an injection, and inadequate adherence to using a clean barrier when opening a glass ampule and use of gloves. Indicators that may reflect risk to

Meta-Analysis of the Clinical Value of Danshen Injection and Huangqi Injection in Liver Cirrhosis

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Changtai Zhu

2013-01-01

Full Text Available Objective. To evaluate the clinical value of Danshen injection and Huangqi injection for the treatment of liver cirrhosis. Methods. The Chinese Biomedical Literature Database (CBM, Chinese Scientific Journals Full-Text Database (VIP, Wanfang Database, China National Knowledge Infrastructure (CNKI, PubMed, and EMBASE database were searched to collect the literatures about the randomized controlled trials involving the treatment of liver cirrhosis with Danshen injection combined with Huangqi injection, and the data analyses were performed using RevMan 4.2 software. Results. A total of 11 studies involving 1086 patients (trials group: 554 cases, control group: 532 cases were included in this study. Compared with those in control group, the meta-analysis showed-that the total effectiveness rate and the level of serum albumin increased, while serum total bilirubin, alanine transmninase, type III procollagen, hyaluronic acid, laminin, and type-IV collagen decreased in trials group. The Jadad score ranged from 1 to 2 and the funnel plot analysis suggests that publication bias may occur. Conclusions. Danshen injection combined with Huangqi injection may promote the curative efficacy of liver cirrhosis, which is a promising novel treatment approach. The exact outcome needs to perform rigorously designed, multicenter, and large randomized controlled trials.

Helical axial injection concept for cyclotrons

Energy Technology Data Exchange (ETDEWEB)

Hudson, E.D.

1981-01-01

A concept for an external beam injection system using a helical beam path centered on the cyclotron axis is described. This system could be used to couple two accelerator stages, with or without intermediate stripping, in cases where conventional axial injection or radial injection are not practical.

Helical axial injection concept for cyclotrons

International Nuclear Information System (INIS)

Hudson, E.D.

1981-01-01

A concept for an external beam injection system using a helical beam path centered on the cyclotron axis is described. This system could be used to couple two accelerator stages, with or without intermediate stripping, in cases where conventional axial injection or radial injection are not practical

Addendum: First injection technique recommendations for patients with diabetes, Forum for Injection Techniques India

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Sanjay Kalra

2013-01-01

Full Text Available The forum for injection techniques, India recommendation, the first ever in the country on insulin injcetion techniques, have covered the science and the art of insulin injection technique in an exhaustive manner. However, a few gaps were identified in the document, which are addressed in the current addendum. This article focuses on insulin injection technique in special clinical situations, including geriatric people, women in pregnancy and those with dermatological or surgical disease who live with diabetes. The addendum also covers salient features of administration of insulin using the insulin pump.

Evolution of Surface Texture and Cracks During Injection Molding of Fiber-Reinforced, Additively-Manufactured, Injection Molding Inserts

DEFF Research Database (Denmark)

Hofstätter, Thomas; Mischkot, Michael; Pedersen, David Bue

2016-01-01

This paper investigates the lifetime and surfacedeterioration of additively-manufactured, injection-moulding inserts. The inserts were produced using digital light processing and were reinforcedwith oriented short carbon fibers. Theinserts were used during injection molding oflow-density polyethy......This paper investigates the lifetime and surfacedeterioration of additively-manufactured, injection-moulding inserts. The inserts were produced using digital light processing and were reinforcedwith oriented short carbon fibers. Theinserts were used during injection molding oflow......-density polyethylene until their failure. The molded products were used to analyse the development of the surface roughness and wear. By enhancing the lifetime of injection-molding inserts,this work contributes to the establishment of additively manufactured inserts in pilot production....

Cold water injection nozzles

International Nuclear Information System (INIS)

Kura, Masaaki; Maeda, Masamitsu; Endo, Takio.

1979-01-01

Purpose: To inject cold water in a reactor without applying heat cycles to a reactor container and to the inner wall of a feedwater nozzle by securing a perforated plate at the outlet of the cold water injection nozzle. Constitution: A disc-like cap is secured to the final end of a return nozzle of a control rod drive. The cap prevents the flow of a high temperature water flowing downward in the reactor from entering into the nozzle. The cap is perforated with a plurality of bore holes for injecting cold water into the reactor. The cap is made to about 100 mm in thickness so that the cold water passing through the bore holes is heated by the heat conduction in the cap. Accordingly, the flow of high temperature water flowing downwardly in the reactor is inhibited by the cap from backward flowing into the nozzle. Moreover, the flow of the cold water in the nozzle is controlled and rectified when passed through the bore holes in the cap and then injected into the reactor. (Yoshino, Y.)

Penicillin G (Potassium, Sodium) Injection

Science.gov (United States)

Penicillin G injection is used to treat and prevent certain infections caused by bacteria. Penicillin G injection is in a class of medications called penicillins. It works by killing bacteria that cause infections. ...

Botulinum toxin injection in laryngeal dyspnea.

Science.gov (United States)

Woisard, Virginie; Liu, Xuelai; Bes, Marie Christine Arné; Simonetta-Moreau, Marion

2017-02-01

Data, regarding the use of botulinum toxin (BT-A) in laryngeal dyspnea, are scarce, coming from some cases reports in the literature, including Vocal fold paralysis, laryngeal dystonia, vocal cord dysfunction also called paradoxical motion of the vocal fold (PMVF), and post-neuroleptic laryngeal dyskinesia. There is no consensus regarding the muscles and the doses to inject. The aim of this study is to present a retrospective review of patients treated in our ENT Department by BT-A injection in this indication. This study is a retrospective study describing patients who underwent an injection of botulinum toxin for laryngeal dyspnea in the ENT Department from 2005 to 2015 years. The inclusion criteria were a dyspnea associated with a laryngeal dysfunction, confirmed by flexible fiberoptic nasopharyngolaryngoscopy. Information concerning the causes of the dyspnea, the botulinum toxin BT-A injections procedure, post-injection follow-up, and respiratory outcome were collected for all patients included. In the group of 13 patients included, the main cause identified as principal factor linked with the short breath was: a bilateral VF paralysis (Patel et al., Otolaryngol Head Neck Surg 130:686-689, 7), laryngeal dystonia (Balkissoon and Kenn, Semin Respir Crit Care Med 33:595-605, 2), Anxiety syndrome associated with unilateral vocal fold paralysis or asthma (Marcinow et al., Laryngoscope 124:1425-1430, 3), and an isolated asthma (Zwirner et al., Eur Arch Otorhinolaryngol 254:242-245, 1). Nine out of the thirteen patients were improved by the injections. A BT-A-induced stable benefit for four patients led them to stop the injections in the follow-up. Good outcome was observed in five other patients (main cause: bilateral VP paralysis), allowing a progressive lengthening of the delay between BT-A injections. Four patients did not report a positive risk/benefit ratio after BT-A injections; two of them (with bilateral VF paralysis), because of respiratory side effects and

Proton accumulator ring injection studies

International Nuclear Information System (INIS)

Cooper, R.K.; Neil, V.K.

1977-01-01

Protons may be created in an accelerator or storage ring by stripping electrons from neutral hydrogen atoms that have been injected into the machine. Because Liouville's theorem is violated by this type of injection, particles may be continually injected into a region of phase space that is already populated, and the density in that region increases with time. A computational investigation was made of the evolution of the distribution of particles in longitudinal phase space during such an injection process for a storage ring operating below the transition energy. In one calculation, an rf cavity is present in the ring and particles are injected into the stable phase region once each revolution. The purpose of this calculation is to determine the rf voltage necessary to overcome the longitudinal self-forces and contain the particles within the region of stable phase. In a second calculation, the rf is turned off, so that there is spreading in azimuth of the injected particles (i.e., de-bunching). The de-bunching occurs because of the initial energy spread and the action of the self-forces. One purpose of the calculation is to determine the total energy spread after a given number of revolutions. Another purpose is to elucidate the effect of finite resistance in the vacuum tank walls. For sufficiently high current, the finite resistance can cause bunching of a beam that is initially uniform in azimuth. Therefore it might be expected that the finite resistance would inhibit or prevent de-bunching once the number of particles injected reaches some threshold, and that this threshold would depend upon the energy spread in the beam

Pellet injection into ASDEX upgrade plasmas

International Nuclear Information System (INIS)

Lang, P.T.; Zohm, H.; Buechl, K.; Fuchs, J.C.; Gehre, O.; Gruber, O.; Lang, R.S.; Mertens, V.; Neuhauser, J.; Salzmann, H.

1996-04-01

This work comprises results obtained using the new centrifuge injection system for the two first years of pellet injection experiments at Asdex Upgrade until the end of the 1995 experimental campaign. The main aim of the pellet injection investigation is to develop scenarios allowing for a more flexible plasma density control means of injection of cryogenic solid hydrogen pellets. Efforts have been made to develop scenarios allowing more flexible plasma density control by injecting cryogenic solid hydrogen pellets. While the injection of pellets during ohmic discharges was found to be most efficient and also improves the plasma performance, increasing the auxiliary heating power causes a detoriation of the pellet fuelling efficiency. A further strong reduction of the pellet fuelling efficiency by an additional process was observed for the more reactor-relevant conditions of shallow particle deposition during H-mode phases. With injection during type I ELMy H-mode phases, each pellet was found to trigger the release of an ELM and therefore cause particle losses mainly from the edge region. In the type I ELMy H-mode, only sufficient pellet penetration allowed noticeable, persistent particle deposition in the plasma by the pellets. Applying adequate pellet injection conditions and favourable scenarios using combined pellet/gas puff refuelling, significant density ramp-up to densities exceeding the empirical Greenwald limit by up to a factor of two was achieved even for strongly heated H-mode plasmas. (orig.)

Comparison Between the Two-Injection Technique and the Four-Injection Technique in Axillary Brachial Plexus Block with Articaine.

Science.gov (United States)

Ertikin, Aysun; Argun, Güldeniz; Mısırlıoğlu, Mesut; Aydın, Murat; Arıkan, Murat; Kadıoğulları, Nihal

2017-10-01

In this study, we aimed to compare axillary brachial plexus block using the two-injection and four-injection techniques assisted with ultrasonography (USG) and nerve stimulator in patients operated for carpal tunnel syndrome with articaine. To evaluate which technique is more effective, we compared the onset time, effectiveness, and duration of block procedures, patient satisfaction, adverse effect of the drug, and complication rates of the motor and sensory blocks. Sixty patients were randomly divided into two groups. A mixture of physiologic serum added to articain with NaHCO 3 (30 mL) was injected into the patients' axilla in both the groups. After the blockage of the musculocutaneous nerve in both the groups, the median nerve in the two-injection group and the median nerve, ulnar nerve, and radial nerve in the four-injection group were blocked. In brachial plexus nerves, sensorial blockage was evaluated with pinprick test, and motor block was evaluated by contraction of the muscles innervated by each nerve. The adverse effects and complications, visual analog scale (VAS) values during the operation, and post-operative patient satisfaction were recorded. Sufficient analgesia and anaesthesia were achieved with no need for an additional local anaesthetics in both the groups. Furthermore, additional sedation requirements were found to be similar in both the groups. A faster rate and a more effective complete block were achieved in more patients from the four-injection group. In the two-injection group, the block could not be achieved for N. radialis in one patient. All other nerves were successfully blocked. Whereas the blockage procedure lasted longer in the four-injection group, the VAS values recorded during the blockage procedure were higher in the four-injection group. No statistical difference was found with regard to patient satisfaction, and no adverse effects and complications were observed in any group. Although the multi-injection method takes more time

Cefotaxime Injection

Science.gov (United States)

... is in a class of medications called cephalosporin antibiotics. It works by killing bacteria.Antibiotics such as cefotaxime injection will not work for colds, flu, or other viral infections. Using ...

Cefuroxime Injection

Science.gov (United States)

... is in a class of medications called cephalosporin antibiotics. It works by killing bacteria.Antibiotics such as cefuroxime injection will not work for colds, flu, or other viral infections. Using ...

Doripenem Injection

Science.gov (United States)

... is in a class of medications called carbapenem antibiotics. It works by killing bacteria.Antibiotics such as doripenem injection will not work for colds, flu, or other viral infections. Taking ...

Daptomycin Injection

Science.gov (United States)

... in a class of medications called cyclic lipopeptide antibiotics. It works by killing bacteria.Antibiotics such as daptomycin injection will not work for treating colds, flu, or other viral infections. ...

Ceftaroline Injection

Science.gov (United States)

... is in a class of medications called cephalosporin antibiotics. It works by killing bacteria.Antibiotics such as ceftaroline injection will not work for colds, flu, or other viral infections. Using ...

Aztreonam Injection

Science.gov (United States)

... is in a class of medications called carbapenem antibiotics. It works by killing bacteria.Antibiotics such as aztreonam injection will not work for colds, flu, or other viral infections. Taking ...

Cefazolin Injection

Science.gov (United States)

... is in a class of medications called cephalosporin antibiotics. It works by killing bacteria.Antibiotics such as cefazolin injection will not work for colds, flu, or other viral infections. Taking ...

Ceftazidime Injection

Science.gov (United States)

... is in a class of medications called cephalosporin antibiotics. It works by killing bacteria.Antibiotics such as ceftazidime injection will not work for colds, flu, or other viral infections. Using ...

Cefotetan Injection

Science.gov (United States)

... is in a class of medications called cephalosporin antibiotics. It works by killing bacteria.Antibiotics such as cefotetan injection will not work for colds, flu, or other viral infections. Using ...

Cefoxitin Injection

Science.gov (United States)

... is in a class of medications called cephamycin antibiotics. It works by killing bacteria.Antibiotics such as cefoxitin injection will not work for colds, flu, or other viral infections. Taking ...

Ertapenem Injection

Science.gov (United States)

... is in a class of medications called carbapenem antibiotics. It works by killing bacteria.Antibiotics such as ertapenem injection will not work for colds, flu, or other viral infections. Taking ...

Ceftriaxone Injection

Science.gov (United States)

... is in a class of medications called cephalosporin antibiotics. It works by killing bacteria.Antibiotics such as ceftriaxone injection will not work for colds, flu, or other viral infections.Using ...

Cefepime Injection

Science.gov (United States)

... is in a class of medications called cephalosporin antibiotics. It works by killing bacteria.Antibiotics such as cefepime injection will not work for colds, flu, or other viral infections. Using ...

Concomitant radio- and fluorescence-guided sentinel lymph node biopsy in squamous cell carcinoma of the oral cavity using ICG-{sup 99m}Tc-nanocolloid

Energy Technology Data Exchange (ETDEWEB)

Berg, Nynke S. van den; Leeuwen, Fijs W.B. van [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Leiden University Medical Center, Department of Radiology, Interventional Molecular Imaging Section, Albinusdreef 2 (C2-S zone), P.O. Box 9600, Leiden (Netherlands); Brouwer, Oscar R.; Valdes Olmos, Renato A. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Klop, W.M.C.; Karakullukcu, Baris; Zuur, Charlotte L.; Tan, I.B.; Balm, Alfons J.M.; Brekel, Michiel W.M. van den [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Head and Neck Surgery and Oncology, Amsterdam (Netherlands)

2012-07-15

For oral cavity malignancies, sentinel lymph node (SLN) mapping is performed by injecting a radiocolloid around the primary tumour followed by lymphoscintigraphy. Surgically, SLNs can then be localized using a handheld gamma ray detection probe. The aim of this study was to evaluate the added value of intraoperative fluorescence imaging to the conventional radioguided procedure. For this we used indocyanine green (ICG)-{sup 99m}Tc-nanocolloid, a hybrid tracer that is both radioactive and fluorescent. Fourteen patients with oral cavity squamous cell carcinoma were peritumourally injected with ICG-{sup 99m}Tc-nanocolloid. SLNs were preoperatively identified with lymphoscintigraphy followed by single photon emission computed tomography (SPECT)/CT for anatomical localization. During surgery, SLNs were detected with a handheld gamma ray detection probe and a handheld near-infrared fluorescence camera. Pre-incision and post-excision imaging with a portable gamma camera was performed to confirm complete removal of all SLNs. SLNs were preoperatively identified using the radioactive signature of ICG-{sup 99m}Tc-nanocolloid. Intraoperatively, 43 SLNs could be localized and excised with combined radio- and fluorescence guidance. Additionally, in four patients, an SLN located close to the primary injection site (in three patients this SLN was located in level I) could only be intraoperatively localized using fluorescence imaging. Pathological analysis of the SLNs revealed a metastasis in one patient. Combined preoperative SLN identification and intraoperative radio- and fluorescence guidance during SLN biopsies for oral cavity cancer proved feasible using ICG-{sup 99m}Tc-nanocolloid. The addition of fluorescence imaging was shown to be of particular value when SLNs were located in close proximity to the primary tumour. (orig.)

Necrotizing Soft Tissue Fasciitis after Intramuscular Injection

Directory of Open Access Journals (Sweden)

Angelica Abbate

2018-01-01

Full Text Available Necrotizing soft tissue fasciitis (NSTIs or necrotizing fasciitis is an infrequent and serious infection. Herein, we describe the clinical course of a female patient who received a diagnosis of NSTIs after gluteus intramuscular injection. We also report the results of our review of published papers from 1997 to 2017. Since now, 19 cases of NSTIs following intramuscular injections have been described. We focus on the correlation between intramuscular injection and NSTIs onset, especially in immunosuppressed patients treated with corticosteroids, suffering from chronic diseases or drug addicted. Intramuscular injections can provoke severe tissue trauma, representing local portal of infection, even if correctly administrated. Otherwise, it is important not to inject drug in subcutaneous, which is a less vascularized area and therefore more susceptible to infections. Likewise, a proper injecting technique and aspiration prior to injection seem to be valid measure to prevent intra-arterial or para-arterial drug injection with the consequent massive inflammatory reaction. Necrosis at the infection site appears to be independent of the drug, and it is a strong additional risk factor for NSTIs.

In-situ combustion with solvent injection

Energy Technology Data Exchange (ETDEWEB)

D' Silva, J.; Kakade, G. [Society of Petroleum Engineers, Kuala Lumpur (Malaysia)]|[Maharashtra Inst. of Technology, Pune (India)

2008-10-15

The effects of combining in situ combustion and heavy hydrocarbon naphtha vapor injection techniques in a heavy oil reservoir were investigated. Oil production rates and steam injection efficiencies were considered. The technique was also combined with toe-to-heel air injection (THAI) processes. The study showed that the modified THAI process achieved high rates of recovery for both primary production and as a follow-up technique in partially depleted reservoirs after cyclic steam and cold production. Oil produced using the modified THAI technique was also partially upgraded by the process. Results of the vapour chamber pressure calculations showed that the volume of oil produced by naphtha assisted gravity drainage was between 1 to 3 times higher than amounts of oil produced by SAGD processes during the same amount of time. The naphtha injection process produced more oil than the steam only process. However, high amounts of naphtha were needed to produce oil. Injection and production rates during the naphtha injection process were higher. Naphtha vapor was injected near the heel of a horizontal producer well. The vapor acted as a thermal and diluent mechanism in order to reduce the viscosity of the heavy oil . 9 refs., 4 tabs., 6 figs.

Temporal fossa defects: techniques for injecting hyaluronic acid filler and complications after hyaluronic acid filler injection.

Science.gov (United States)

Juhász, Margit Lai Wun; Marmur, Ellen S

2015-09-01

Facial changes with aging include thinning of the epidermis, loss of skin elasticity, atrophy of muscle, and subcutaneous fat and bony changes, all which result in a loss of volume. As temporal bones become more concave, and the temporalis atrophies and the temporal fat pad decreases, volume loss leads to an undesirable, gaunt appearance. By altering the temporal fossa and upper face with hyaluronic acid filler, those whose specialty is injecting filler can achieve a balanced and more youthful facial structure. Many techniques have been described to inject filler into the fossa including a "fanned" pattern of injections, highly diluted filler injection, and the method we describe using a three-injection approach. Complications of filler in the temporal fossa include bruising, tenderness, swelling, Tyndall effect, overcorrection, and chewing discomfort. Although rare, more serious complications include infection, foreign body granuloma, intravascular necrosis, and blindness due to embolization into the ophthalmic artery. Using reversible hyaluronic acid fillers, hyaluronidase can be used to relieve any discomfort felt by the patient. Injectors must be aware of the complications that may occur and provide treatment readily to avoid morbidities associated with filler injection into this sensitive area. © 2015 Wiley Periodicals, Inc.

Shoulder pain: the role of diagnostic injections.

Science.gov (United States)

Larson, H M; O'Connor, F G; Nirschl, R P

1996-04-01

Many different shoulder disorders cause similar symptoms and pain patterns. An accurate diagnosis can generally be made by obtaining a detailed history, performing a comprehensive, directed physical examination and obtaining selected radiographs. Occasionally, shoulder injections can be of great assistance in establishing a clear diagnosis and providing relief of symptoms. Subacromial space injection, acromioclavicular joint injection, intra-articular injection and injection of the biceps tendon are helpful in identifying such disorders as subacromial bursitis, acromioclavicular arthritis, injury to the glenohumeral joint and bicipital tendinitis.

Pick 'n' mix: neuropatholgical detection of peri-tumour taupathy.

LENUS (Irish Health Repository)

Lonergan, Roisin

2013-11-01

Radiotherapy is used to treat recurrent oligodendrogliomas, WHO grade 2 tumours. Potential morbitities include steroid-responsive radiation necrosis and radiation leucoencephalopathy, characterised pathologically by reactive astrogliosis, focal necrosis, demyelination, axonal loss, and clinically by progressive subcortical deficits (ataxia, amnesia, incontinence, cognitive decline), with relative sparing of cortical function. Although subcortical features may overlap with neurodegenerative conditions (eg frontotemporal dementia), focal cortical atrophy of FTD causes loss of language function in addition to memory, and specific histopathological features characterise FTD subtypes (eg Pick disease). Association between mitotic disease and tauopathy has not been reported widely, but co-existence is possible. Diagnostic accuracy may guide management.

Injection and Non-Injection Drug Use and Infectious Disease in Baltimore City: Differences by Race

Science.gov (United States)

Keen, Larry; Khan, Maria; Clifford, Lisa; Harrell, Paul T.; Latimer, William W.

2014-01-01

Purpose The current study examines differences in the prevalence of biologically-confirmed hepatitis C virus (HCV), HIV, and coinfection between Black and White adult cocaine/heroin users across three drug use subgroups identified in previous research (Harrell et al, 2012): non-injection smoking crack/nasal heroin users, heroin injectors, and polydrug injectors. Results 59% of the 482 participants in the study were male. Significant race differences emerged between drug use subgroup memberships. Non-injection smoking crack/nasal heroin users were predominantly Black (75%), while heroin injectors and polydrug injectors were predominantly White (69% and 72%, respectively). Polydrug injectors accounted for nearly three quarters of the HCV positive diagnoses in Whites. Though HIV disease status, stratified by race, did not differ significantly between drug use subgroups, the non-injection smoking crack/nasal heroin subgroup contained over half of the HIV positive diagnoses in the sample and was predominantly Black. Despite much lower rates of injection, Blacks (8%) had a higher prevalence of coinfection than Whites (3%; X2 (2) = 6.18, p = .015). Conclusions The current findings are consistent with trends in recent HIV transmission statistics where sexual activity has overtaken injection drug use as a HIV risk factor. The current findings also provide further support to the notion of injection drug use as an exceedingly high-risk behavior for HCV and coinfection, specifically those who are polysubstance injectors. PMID:24837755

Fat Injection: A Systematic Review of Injection Volumes by Facial Subunit.

Science.gov (United States)

Shue, Shirley; Kurlander, David E; Guyuron, Bahman

2017-08-08

Fat grafting to the aging face has become an integral component of esthetic surgery. However, the amount of fat to inject to each area of the face is not standardized and has been based mainly on the surgeon's experience. The purpose of this study was to perform a systematic review of injected fat volume to different facial zones. A systematic review of the literature was performed through a MEDLINE search using keywords "facial," "fat grafting," "lipofilling," "Coleman technique," "autologous fat transfer," and "structural fat grafting." Articles were then sorted by facial subunit and analyzed for: author(s), year of publication, study design, sample size, donor site, fat preparation technique, average and range of volume injected, time to follow-up, percentage of volume retention, and complications. Descriptive statistics were performed. Nineteen articles involving a total of 510 patients were included. Rhytidectomy was the most common procedure performed concurrently with fat injection. The mean volume of fat injected to the forehead is 6.5 mL (range 4.0-10.0 mL); to the glabellar region 1.4 mL (range 1.0-4.0 mL); to the temple 5.9 mL per side (range 2.0-10.0 mL); to the eyebrow 5.5 mL per side; to the upper eyelid 1.7 mL per side (range 1.5-2.5 mL); to the tear trough 0.65 mL per side (range 0.3-1.0 mL); to the infraorbital area (infraorbital rim to lower lid/cheek junction) 1.4 mL per side (range 0.9-3.0 mL); to the midface 1.4 mL per side (range 1.0-4.0 mL); to the nasolabial fold 2.8 mL per side (range 1.0-7.5 mL); to the mandibular area 11.5 mL per side (range 4.0-27.0 mL); and to the chin 6.7 mL (range 1.0-20.0 mL). Data on exactly how much fat to inject to each area of the face in facial fat grafting are currently limited and vary widely based on different methods and anatomical terms used. This review offers the ranges and the averages for the injected volume in each zone. This journal requires that authors assign a level of evidence

Amphotericin B Lipid Complex Injection

Science.gov (United States)

Amphotericin B lipid complex injection is used to treat serious, possibly life-threatening fungal infections in people who did ... respond or are unable to tolerate conventional amphotericin B therapy. Amphotericin B lipid complex injection is in ...

Epidural steroid injection for lumbosacral radiculopathy

International Nuclear Information System (INIS)

Sung, Mi Sook

2006-01-01

Low back pain combined with radicular pain remains as one of the most challenging musculoskeletal problems for its therapeutic management. This malady results from nerve root impingement and/or inflammation that causes neurologic symptoms in the distribution of the affected nerve root(s) Conservative treatment, percutaneous spine interventions and surgery have all been used as treatment; and the particular treatment that's chosen depends on the severity of the clinical and neurologic presentation. In 1930, Evans reported that sciatica could treated by epidural injection. The use of epidural corticosteroid injections for the treatment of axial and radicular back pain was first reported in 1953. Epidural steroid injections are currently used by many medical professionals for the treatment of lumbosacral radiculopathy. Performing 'blind' epidural steroid injection lacks target specificity that often results in incorrect delivery of medication to the lesion. Imaging-guided steroid injections are now becoming more popular despite the controversy regarding their efficacy. Many reports, including a few randomized controlled trials, have documented the clinical utility of epidural steroid injections

Epidural steroid injection for lumbosacral radiculopathy

Energy Technology Data Exchange (ETDEWEB)

Sung, Mi Sook [The Catholic University of Korea, Pucheon (Korea, Republic of)

2006-06-15

Low back pain combined with radicular pain remains as one of the most challenging musculoskeletal problems for its therapeutic management. This malady results from nerve root impingement and/or inflammation that causes neurologic symptoms in the distribution of the affected nerve root(s) Conservative treatment, percutaneous spine interventions and surgery have all been used as treatment; and the particular treatment that's chosen depends on the severity of the clinical and neurologic presentation. In 1930, Evans reported that sciatica could treated by epidural injection. The use of epidural corticosteroid injections for the treatment of axial and radicular back pain was first reported in 1953. Epidural steroid injections are currently used by many medical professionals for the treatment of lumbosacral radiculopathy. Performing 'blind' epidural steroid injection lacks target specificity that often results in incorrect delivery of medication to the lesion. Imaging-guided steroid injections are now becoming more popular despite the controversy regarding their efficacy. Many reports, including a few randomized controlled trials, have documented the clinical utility of epidural steroid injections.

Spring-loaded syringe for multiple rapid injections

Directory of Open Access Journals (Sweden)

C R Srinivas

2017-01-01

Full Text Available Mesotherapy refers to multiple injections of small quantity of the drug over a large area. The mesoguns available are expensive and the motor-driven models tends to waste the expensive material to be injected since the plunger stops after injecting without recoil. We searched for a less expensive device which would inject like the mesogun and still not waste the solution. On searching the web, we identified a spring-loaded syringe. We describe the assembly and use of this inexpensive syringe for delivering multiple injections with minimal wastage.

Spring-loaded Syringe for Multiple Rapid Injections

Science.gov (United States)

Srinivas, CR; Somani, Anirudh; Shashidharan Nair, CK; Mylswamy, Thirumurthy

2017-01-01

Mesotherapy refers to multiple injections of small quantity of the drug over a large area. The mesoguns available are expensive and the motor-driven models tends to waste the expensive material to be injected since the plunger stops after injecting without recoil. We searched for a less expensive device which would inject like the mesogun and still not waste the solution. On searching the web, we identified a spring-loaded syringe. We describe the assembly and use of this inexpensive syringe for delivering multiple injections with minimal wastage. PMID:28529423

Porous media heat transfer for injection molding

Science.gov (United States)

Beer, Neil Reginald

2016-05-31

The cooling of injection molded plastic is targeted. Coolant flows into a porous medium disposed within an injection molding component via a porous medium inlet. The porous medium is thermally coupled to a mold cavity configured to receive injected liquid plastic. The porous medium beneficially allows for an increased rate of heat transfer from the injected liquid plastic to the coolant and provides additional structural support over a hollow cooling well. When the temperature of the injected liquid plastic falls below a solidifying temperature threshold, the molded component is ejected and collected.

Anesthetic efficacy of a repeated intraosseous injection given 30 min following an inferior alveolar nerve block/intraosseous injection.

OpenAIRE

Reitz, J.; Reader, A.; Nist, R.; Beck, M.; Meyers, W. J.

1998-01-01

To determine whether a repeated intraosseous (IO) injection would increase or prolong pulpal anesthesia, we measured the degree of anesthesia obtained by a repeated IO injection given 30 min following a combination inferior alveolar nerve block/intraosseous injection (IAN/IO) in mandibular second premolars and in first and second molars. Using a repeated-measures design, we randomly assigned 38 subjects to receive two combinations of injections at two separate appointments. The combinations w...

A Review of the Effect of Injected Dextranomer/Hyaluronic Acid Copolymer Volume on Reflux Correction Following Endoscopic Injection

Directory of Open Access Journals (Sweden)

Sumit Dave

2008-01-01

Full Text Available The current literature suggests that multiple variables affect vesicoureteric reflux (VUR resolution rates following dextranomer/hyaluronic acid copolymer (Dx/HA injection. This article reviews the evidence pertaining to the effect of injected Dx/HA volume on success rates following endoscopic correction. Lack of prospective studies which use injected volume as a continuous variable coupled with a nonstandardized injection technique and endpoint hinders the ability to reach a definite conclusion.

21 CFR 522.1182 - Iron injection.

Science.gov (United States)

2010-04-01

... follows: (i) For prevention of iron deficiency anemia, inject 100 mg (1 mL) by intramuscular injection at 2 to 4 days of age. (ii) For treatment of iron deficiency anemia, inject 100 mg (1 mL) by... repeated in 14 to 21 days. (ii) For the treatment of anemia due to iron deficiency, administer an...

Multiobjective Design of Turbo Injection Mode for Axial Flux Motor in Plastic Injection Molding Machine by Particle Swarm Optimization

Directory of Open Access Journals (Sweden)

Jian-Long Kuo

2015-01-01

Full Text Available This paper proposes a turbo injection mode (TIM for an axial flux motor to apply onto injection molding machine. Since the injection molding machine requires different speed and force parameters setting when finishing a complete injection process. The interleaved winding structure in the motor provides two different injection levels to provide enough injection forces. Two wye-wye windings are designed to switch two control modes conveniently. Wye-wye configuration is used to switch two force levels for the motor. When only one set of wye-winding is energized, field weakening function is achieved. Both of the torque and speed increase under field weakening operation. To achieve two control objectives for torque and speed of the motor, fuzzy based multiple performance characteristics index (MPCI with particle swarm optimization (PSO is used to find out the multiobjective optimal design solution. Both of the torque and speed are expected to be maximal at the same time. Three control factors are selected as studied factors: winding diameter, winding type, and air-gap. Experimental results show that both of the torque and speed increase under the optimal condition. This will provide enough large torque and speed to perform the turbo injection mode in injection process for the injection molding machine.

Tigecycline Injection

Science.gov (United States)

... is in a class of medications called tetracycline antibiotics. It works by killing bacteria that cause infection.Antibiotics such as tigecycline injection will not work for colds, flu, or other viral infections. Using ...

Telavancin Injection

Science.gov (United States)

... is in a class of medications called lipoglycopeptide antibiotics. It works by killing bacteria that cause infection.Antibiotics such as telavancin injection will not work for colds, flu, or other viral infections. Using ...

Doxycycline Injection

Science.gov (United States)

... is in a class of medications called tetracycline antibiotics. It works by killing bacteria that cause infections.Antibiotics such as doxycycline injection will not work for colds, flu, or other viral infections. Taking ...

Vancomycin Injection

Science.gov (United States)

... is in a class of medications called glycopeptide antibiotics. It works by killing bacteria that cause infections.Antibiotics such as vancomycin injection will not work for colds, flu, or other viral infections. Taking ...

Steam injection for heavy oil recovery: Modeling of wellbore heat efficiency and analysis of steam injection performance

International Nuclear Information System (INIS)

Gu, Hao; Cheng, Linsong; Huang, Shijun; Li, Bokai; Shen, Fei; Fang, Wenchao; Hu, Changhao

2015-01-01

Highlights: • A comprehensive mathematical model was established to estimate wellbore heat efficiency of steam injection wells. • A simplified approach of predicting steam pressure in wellbores was proposed. • High wellhead injection rate and wellhead steam quality can improve wellbore heat efficiency. • High wellbore heat efficiency does not necessarily mean good performance of heavy oil recovery. • Using excellent insulation materials is a good way to save water and fuels. - Abstract: The aims of this work are to present a comprehensive mathematical model for estimating wellbore heat efficiency and to analyze performance of steam injection for heavy oil recovery. In this paper, we firstly introduce steam injection process briefly. Secondly, a simplified approach of predicting steam pressure in wellbores is presented and a complete expression for steam quality is derived. More importantly, both direct and indirect methods are adopted to determine the wellbore heat efficiency. Then, the mathematical model is solved using an iterative technique. After the model is validated with measured field data, we study the effects of wellhead injection rate and wellhead steam quality on steam injection performance reflected in wellbores. Next, taking cyclic steam stimulation as an example, we analyze steam injection performance reflected in reservoirs with numerical reservoir simulation method. Finally, the significant role of improving wellbore heat efficiency in saving water and fuels is discussed in detail. The results indicate that we can improve the wellbore heat efficiency by enhancing wellhead injection rate or steam quality. However, high wellbore heat efficiency does not necessarily mean satisfactory steam injection performance reflected in reservoirs or good performance of heavy oil recovery. Moreover, the paper shows that using excellent insulation materials is a good way to save water and fuels due to enhancement of wellbore heat efficiency

J-regular rings with injectivities

OpenAIRE

Shen, Liang

2010-01-01

A ring $R$ is called a J-regular ring if R/J(R) is von Neumann regular, where J(R) is the Jacobson radical of R. It is proved that if R is J-regular, then (i) R is right n-injective if and only if every homomorphism from an $n$-generated small right ideal of $R$ to $R_{R}$ can be extended to one from $R_{R}$ to $R_{R}$; (ii) R is right FP-injective if and only if R is right (J, R)-FP-injective. Some known results are improved.

Risperidone Injection

Science.gov (United States)

... release (long-acting) injection is used to treat schizophrenia (a mental illness that causes disturbed or unusual ... may help control your symptoms but will not cure your condition. Continue to keep appointments to receive ...

Haloperidol Injection

Science.gov (United States)

... haloperidol extended-release injection are used to treat schizophrenia (a mental illness that causes disturbed or unusual ... may help control your symptoms but will not cure your condition. Continue to keep appointments to receive ...

Temozolomide Injection

Science.gov (United States)

... balance or coordination fainting dizziness hair loss insomnia memory problems pain, itching, swelling, or redness in the place where the medication was injected changes in vision Some side effects can be serious. If you ...

Moxifloxacin Injection

Science.gov (United States)

... tendon area, or inability to move or to bear weight on an affected area.Using moxifloxacin injection ... muscle weakness) and cause severe difficulty breathing or death. Tell your doctor if you have myasthenia gravis. ...

Delafloxacin Injection

Science.gov (United States)

... a tendon area, or inability to move or bear weight on an affected area.Using delafloxacin injection ... muscle weakness) and cause severe difficulty breathing or death. Tell your doctor if you have myasthenia gravis. ...

Levofloxacin Injection

Science.gov (United States)

... tendon area, or inability to move or to bear weight on an affected area.Using levofloxacin injection ... muscle weakness) and cause severe difficulty breathing or death. Tell your doctor if you have myasthenia gravis. ...

Ciprofloxacin Injection

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... a tendon area, or inability to move or bear weight on an affected area.Using ciprofloxacin injection ... muscle weakness) and cause severe difficulty breathing or death. Tell your doctor if you have myasthenia gravis. ...

Buprenorphine Injection

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... injection is in a class of medications called opiate partial agonists. It works to prevent withdrawal symptoms ... help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, ...

Butorphanol Injection

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... Butorphanol is in a class of medications called opioid agonist-antagonists. It works by changing the way ... suddenly stop using butorphanol injection, you may experience withdrawal symptoms such as nervousness, agitation, shakiness, diarrhea, chills, ...

Improving Rates of Post-Essure Hysterosalpingography in an Urban Population Using Electronic Tracking Reminders.

Science.gov (United States)

Virginia Hu, Yu-Han; Arora, Kavita Shah

2017-02-01

To demonstrate the efficacy of electronic reminders for follow-up hysterosalpingography (HSG) after Essure hysteroscopic sterilization in an urban tertiary care hospital obstetrics and gynecology practice. Retrospective cohort study (Canadian Task Force classification II-3). Obstetrics and gynecology practice at a university-affiliated urban tertiary care teaching hospital. Two hundred and fifty patients who underwent Essure hysteroscopic sterilization between June 2011 and July 2014. Implementation of electronic reminders for the office staff. Two hundred and fifty of 259 patients (96.5%) underwent Essure hysteroscopic sterilization and successful placement of coils into bilateral Fallopian tubes. Among these 250 patients, 135 (54%) returned for HSG at 3 months post-Essure as advised at the time of procedure. The use of electronic reminders prompted another 45 patients (18%) to return for HSG, improving the total post-Essure follow-up rate to 72%. Electronic reminders for the office staff of an urban tertiary care hospital's obstetrics and gynecology practice is an effective method for improving the rate of post-Essure HSG. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

Assessment of complications due to intratympanic injections

Directory of Open Access Journals (Sweden)

Yu-Chuan Liu

2016-03-01

Full Text Available Objective: The purpose of the study is to report and to analyze the complications following intratympanic injections (ITI of steroids. The occurrence rate of complications at different ITI sites, four quadrants of eardrum, was also compared. Methods: A retrospective clinical review in a medical center. Each patient received ITI twice in a week for 2–3 consecutive weeks as a salvage therapy for sudden sensorineural hearing loss. Post-injection complications, especially transient dizziness and vertigo, were recorded. Patients with acute or chronic vertigo episodes in 1 month were excluded. Results: A total of 59 patients with sudden sensorineural hearing loss and a total of 278 times of ITI were performed in 1 year. The post-injection complications included pain, tongue numbness, transient dizziness, vertigo, tinnitus, and a small persistent perforation. There was no significant difference in the occurrence of these complications between the injections sites on the 4 quadrants of the tympanic membrane. However, there was statistical significance in the post-injection vertiginous episode after IT injections to posterior-inferior quadrant (Q3 and posterior-superior quadrant (Q4 compared to anterior-superior quadrant (Q1 and anterior-inferior quadrant (Q2 (P = 0.0113. Conclusion: IT injection is recommended to be applied to the Q2 since the Q1 and Q4 injections are more likely to induce the adverse effect of tongue numbness, while the Q3 and Q4 areas are more likely to induce post-injection vertigo. Keywords: Intratympanic injection, Sudden deafness, Complications, Vertigo

Blindness following cosmetic injections of the face.

Science.gov (United States)

Lazzeri, Davide; Agostini, Tommaso; Figus, Michele; Nardi, Marco; Pantaloni, Marcello; Lazzeri, Stefano

2012-04-01

Complications following facial cosmetic injections have recently heightened awareness of the possibility of iatrogenic blindness. The authors conducted a systematic review of the available literature to provide the best evidence for the prevention and treatment of this serious eye injury. The authors included in the study only the cases in which blindness was a direct consequence of a cosmetic injection procedure of the face. Twenty-nine articles describing 32 patients were identified. In 15 patients, blindness occurred after injections of adipose tissue; in the other 17, it followed injections of various materials, including corticosteroids, paraffin, silicone oil, bovine collagen, polymethylmethacrylate, hyaluronic acid, and calcium hydroxyapatite. Some precautions may minimize the risk of embolization of filler into the ophthalmic artery following facial cosmetic injections. Intravascular placement of the needle or cannula should be demonstrated by aspiration before injection and should be further prevented by application of local vasoconstrictor. Needles, syringes, and cannulas of small size should be preferred to larger ones and be replaced with blunt flexible needles and microcannulas when possible. Low-pressure injections with the release of the least amount of substance possible should be considered safer than bolus injections. The total volume of filler injected during the entire treatment session should be limited, and injections into pretraumatized tissues should be avoided. Actually, no safe, feasible, and reliable treatment exists for iatrogenic retinal embolism. Nonetheless, therapy should theoretically be directed to lowering intraocular pressure to dislodge the embolus into more peripheral vessels of the retinal circulation, increasing retinal perfusion and oxygen delivery to hypoxic tissues. Risk, V.

Injection and Dump Systems

CERN Document Server

Bracco, C; Barnes, M J; Carlier, E; Drosdal, L N; Goddard, B; Kain, V; Meddahi, M; Mertens, V; Uythoven, J

2012-01-01

Performance and failures of the LHC injection and ex- traction systems are presented. In particular, a comparison with the 2010 run, lessons learnt during operation with high intensity beams and foreseen upgrades are described. UFOs, vacuum and impedance problems related to the injection and extraction equipment are analysed together with possible improvements and solutions. New implemented features, diagnostics, critical issues of XPOC and IQC applications are addressed.

Gender differences in sexual and injection risk behavior among active young injection drug users in San Francisco (the UFO Study).

Science.gov (United States)

Evans, Jennifer L; Hahn, Judith A; Page-Shafer, Kimberly; Lum, Paula J; Stein, Ellen S; Davidson, Peter J; Moss, Andrew R

2003-03-01

Female injection drug users (IDUs) represent a large proportion of persons infected with HIV in the United States, and women who inject drugs have a high incidence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. Therefore, it is important to understand the role of gender in injection risk behavior and the transmission of blood-borne virus. In 2000-2002, 844 young (<30 years old) IDUs were surveyed in San Francisco. We compared self-reported risk behavior between 584 males and 260 female participants from cross-sectional baseline data. We used logistic regression to determine whether demographic, structural, and relationship variables explained increased needle borrowing, drug preparation equipment sharing, and being injected by another IDU among females compared to males. Females were significantly younger than males and were more likely to engage in needle borrowing, ancillary equipment sharing, and being injected by someone else. Females were more likely than males to report recent sexual intercourse and to have IDU sex partners. Females and males were not different with respect to education, race/ethnicity, or housing status. In logistic regression models for borrowing a used needle and sharing drug preparation equipment, increased risk in females was explained by having an injection partner who was also a sexual partner. Injecting risk was greater in the young female compared to male IDUs despite equivalent frequency of injecting. Overlapping sexual and injection partnerships were a key factor in explaining increased injection risk in females. Females were more likely to be injected by another IDU even after adjusting for years injecting, being in a relationship with another IDU, and other potential confounders. Interventions to reduce sexual and injection practices that put women at risk of contracting hepatitis and HIV are needed.

A volumetric flow sensor for automotive injection systems

International Nuclear Information System (INIS)

Schmid, U; Krötz, G; Schmitt-Landsiedel, D

2008-01-01

For further optimization of the automotive power train of diesel engines, advanced combustion processes require a highly flexible injection system, provided e.g. by the common rail (CR) injection technique. In the past, the feasibility to implement injection nozzle volumetric flow sensors based on the thermo-resistive measurement principle has been demonstrated up to injection pressures of 135 MPa (1350 bar). To evaluate the transient behaviour of the system-integrated flow sensors as well as an injection amount indicator used as a reference method, hydraulic simulations on the system level are performed for a CR injection system. Experimentally determined injection timings were found to be in good agreement with calculated values, especially for the novel sensing element which is directly implemented into the hydraulic system. For the first time pressure oscillations occurring after termination of the injection pulse, predicted theoretically, could be verified directly in the nozzle. In addition, the injected amount of fuel is monitored with the highest resolution ever reported in the literature

A volumetric flow sensor for automotive injection systems

Science.gov (United States)

Schmid, U.; Krötz, G.; Schmitt-Landsiedel, D.

2008-04-01

For further optimization of the automotive power train of diesel engines, advanced combustion processes require a highly flexible injection system, provided e.g. by the common rail (CR) injection technique. In the past, the feasibility to implement injection nozzle volumetric flow sensors based on the thermo-resistive measurement principle has been demonstrated up to injection pressures of 135 MPa (1350 bar). To evaluate the transient behaviour of the system-integrated flow sensors as well as an injection amount indicator used as a reference method, hydraulic simulations on the system level are performed for a CR injection system. Experimentally determined injection timings were found to be in good agreement with calculated values, especially for the novel sensing element which is directly implemented into the hydraulic system. For the first time pressure oscillations occurring after termination of the injection pulse, predicted theoretically, could be verified directly in the nozzle. In addition, the injected amount of fuel is monitored with the highest resolution ever reported in the literature.

Octreotide Injection

Science.gov (United States)

... carton and protect it from light. Dispose of multi-dose vials of the immediate-release injection 14 ... and immediately place the medication in a safe location – one that is up and away and out ...

Alirocumab Injection

Science.gov (United States)

... 9 (PCSK9) inhibitor monoclonal antibodies. It works by blocking the production of LDL cholesterol in the body ... hives difficulty breathing or swallowing swelling of the face, throat, tongue, lips, and eyes Alirocumab injection may ...

Evolocumab Injection

Science.gov (United States)

... 9 (PCSK9) inhibitor monoclonal antibody. It works by blocking the production of LDL cholesterol in the body ... hives difficulty breathing or swallowing swelling of the face, throat, tongue, lips, and eyes Evolocumab injection may ...

Risk Factors Associated with Unsafe Injection Practices at the First Injection Episode among Intravenous Drug Users in France: Results from PrimInject, an Internet Survey.

Science.gov (United States)

Guichard, Anne; Guignard, Romain; Lert, France; Roy, Elise

2015-01-01

Background. New drug use patterns may increase the risk of human immunodeficiency virus and hepatitis infections. In France, new injection patterns among youths with diverse social backgrounds have emerged, which may explain the persistently high rates of hepatitis C virus infection. This study explores factors associated with injection risk behaviours at first injection among users who began injecting in the post-2000 era. Methods. A cross-sectional study was conducted on the Internet from October 2010 to March 2011, through an online questionnaire. Multivariate logistic regression identified the independent correlates of needle sharing and equipment (cooker/cotton filter) sharing. Results. Among the 262 respondents (mean age 25 years), 65% were male. Both risk behaviours were positively associated with initiation before 18 years of age (aOR 3.7 CI 95% 1.3-10.6 and aOR 3.0 CI 95% 1.3-7.0) and being injected by another person (aOR 3.1 CI 95% 1.0-9.9 and aOR 3.0 CI 95% 1.3-7.1). Initiation at a party was an independent correlate of equipment sharing (aOR 2.6 95% CI 1.0-6.8). Results suggest a need for innovative harm reduction programmes targeting a variety of settings and populations, including youths and diverse party scenes. Education of current injectors to protect both themselves and those they might initiate into injection is critically important.

Risk Factors Associated with Unsafe Injection Practices at the First Injection Episode among Intravenous Drug Users in France: Results from PrimInject, an Internet Survey

Directory of Open Access Journals (Sweden)

Anne Guichard

2015-01-01

Full Text Available Background. New drug use patterns may increase the risk of human immunodeficiency virus and hepatitis infections. In France, new injection patterns among youths with diverse social backgrounds have emerged, which may explain the persistently high rates of hepatitis C virus infection. This study explores factors associated with injection risk behaviours at first injection among users who began injecting in the post-2000 era. Methods. A cross-sectional study was conducted on the Internet from October 2010 to March 2011, through an online questionnaire. Multivariate logistic regression identified the independent correlates of needle sharing and equipment (cooker/cotton filter sharing. Results. Among the 262 respondents (mean age 25 years, 65% were male. Both risk behaviours were positively associated with initiation before 18 years of age (aOR 3.7 CI 95% 1.3–10.6 and aOR 3.0 CI 95% 1.3–7.0 and being injected by another person (aOR 3.1 CI 95% 1.0–9.9 and aOR 3.0 CI 95% 1.3–7.1. Initiation at a party was an independent correlate of equipment sharing (aOR 2.6 95% CI 1.0–6.8. Conclusions. Results suggest a need for innovative harm reduction programmes targeting a variety of settings and populations, including youths and diverse party scenes. Education of current injectors to protect both themselves and those they might initiate into injection is critically important.

Frequency of booster injections of allergoids.

Science.gov (United States)

Norman, P S; Creticos, P S; Marsh, D G

1990-01-01

In 1982, 43 ragweed-sensitive patients receiving maintenance injections of full doses of ragweed allergoid were selected for a study of the immunologic and clinical efficacy of booster injections only four times a year. These patients had participated for 2 to 7 years as part of a trial of mixes of up to four allergoids to common pollens in the mid-Atlantic area tailored to each patient's skin test sensitivity. They were divided into a group (21 patients) to receive injections every 3 months and a group (22 patients) to receive injections about every 6 weeks (eight injections per year). Patients were rerandomized after 1 year so that half of each original group switched to the alternate treatment, and this program was continued until after the ragweed season of 1985. Thirty-four patients were still under study the last year. Doses, per injection, were 100 allergoid units (1 allergoid unit equals 100 PNU) of each allergen in the mixture. Symptom scores during the 8 weeks of each of the four ragweed seasons were not significantly higher in the 3-month treated group. IgG antibody levels to Amb a I (antigen E) were followed until early 1984 and were not significantly different in the two groups, even though the 6-week treated patients received a two times higher cumulative dose per year. Rates of local and systemic reactions (percent of injections eliciting reactions) were not different in the groups, which means that the 3-month treated group had about half as many reactions by virtue of taking half as many injections.(ABSTRACT TRUNCATED AT 250 WORDS)

Omalizumab Injection

Science.gov (United States)

... injection is used to decrease the number of asthma attacks (sudden episodes of wheezing, shortness of breath, and ... about how to treat symptoms of a sudden asthma attack. If your asthma symptoms get worse or if ...

Acyclovir Injection

Science.gov (United States)

... It is also used to treat first-time genital herpes outbreaks (a herpes virus infection that causes sores ... in the body. Acyclovir injection will not cure genital herpes and may not stop the spread of genital ...

Injection into the LNLS UVX electron storage ring

International Nuclear Information System (INIS)

Lin, Liu

1991-01-01

To inject the 1.15 GeV electron storage ring - UVX - a beam from a linear accelerator - MAIRA - is used. The electrons are injected and accumulated at low energy (100MeV) until the nominal current of 100 mA is reached and than are ramped to the nominal energy. A study on a conventional injection scheme has been carried out. Two injection modes are investigated: injection with the phase ellipse parameters matched and mismatched to the ring's acceptance. The mismatched mode is optimized to fit the maximum of the injected beam into the acceptance

Magnetic resonance imaging with gadoxetic acid for local tumour progression after radiofrequency ablation in patients with hepatocellular carcinoma

Energy Technology Data Exchange (ETDEWEB)

Kang, Tae Wook; Rhim, Hyunchul; Lee, Jisun; Song, Kyoung Doo; Lee, Min Woo; Kim, Young-sun; Lim, Hyo Keun; Jang, Kyung Mi; Kim, Seong Hyun [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea, Republic of); Gwak, Geum-Youn [Sungkyunkwan University School of Medicine, Division of Hepatology, Department of Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Jung, Sin-Ho [Sungkyunkwan University School of Medicine, Biostatics and Clinical Epidemiology Center, Samsung Medical Center, Seoul (Korea, Republic of)

2016-10-15

To develop and validate a prediction model using magnetic resonance imaging (MRI) for local tumour progression (LTP) after radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) patients. Two hundred and eleven patients who had received RFA as first-line treatment for HCC were retrospectively analyzed. They had undergone gadoxetic acid-enhanced MRI before treatment, and parameters including tumour size; margins; signal intensities on T1-, T2-, and diffusion-weighted images, and hepatobiliary phase images (HBPI); intratumoral fat or tumoral capsules; and peritumoural hypointensity in the HBPI were used to develop a prediction model for LTP after treatment. This model to discriminate low-risk from high-risk LTP groups was constructed based on Cox regression analysis. Our analyses produced the following model: 'risk score = 0.617 x tumour size + 0.965 x tumour margin + 0.867 x peritumoural hypointensity on HBPI'. This was able to predict which patients were at high risk for LTP after RFA (p < 0.001). Patients in the low-risk group had a significantly better 5-year LTP-free survival rate compared to the high-risk group (89.6 % vs. 65.1 %; hazard ratio, 3.60; p < 0.001). A predictive model based on MRI before RFA could robustly identify HCC patients at high risk for LTP after treatment. (orig.)

Immunohistochemical Expression of Tissue Inhibitor of Metalloproteinase-1 (Timp-1 in Invasive Breast Carcinoma

Directory of Open Access Journals (Sweden)

Suada Kuskunović

2009-05-01

Full Text Available Tissue inhibitor of metalloproteinase-1 (TIMP-1 is a natural inhibitor of matrix metalloproteinas-es (MMPs. Aim of this study was to assess the immunohistochemical expression of TIMP-1 in invasive breast carcinomas, and to examine its association with classical clinico-pathological parameters, oestrogen receptor, progesterone receptor and Her-2/neu protein expression. Immuno-histochemistry was used to determine the expression of TIMP-1 on 38 paraffin-embedded breast tissue specimens - 18 with invasive ductal carcinoma, 10 with invasive lobular carcinoma, and 10 specimens from patients with fibrocystic breast disease. TIMP-1 protein was immunodetected in the carcinoma cells, fibroblasts and inflammatory cells of the stroma in 92,9%, 65,8%, and 65,8% of cases, respectively. TIMP-1 protein expression in carcinoma cells showed positive correlation with TIMP-1 protein expression in peritumoural fibroblasts (p=0,010. Positive peritumoural fibroblast TIMP-1 expression was associated with histological tumour type with higher frequency in ductal carcinomas (p=0,023. Negative association was found between TIMP-1 protein expression in carcinoma cells and HER-2/neu nuclear staining (p=0,005. TIMP-1 may be particularly useful as a predictive marker in breast carcinoma when evaluated along with HER-2/neu protein being a promising indicator of favourable prognosis in breast carcinoma.

Effects of pilot injection parameters on low temperature combustion diesel engines equipped with solenoid injectors featuring conventional and rate-shaped main injection

International Nuclear Information System (INIS)

D’Ambrosio, S.; Ferrari, A.

2016-01-01

Highlights: • The influence of the principal pilot injection parameters is discussed for low-temperature combustion systems. • Swirl-sweep and dwell-time sweep results are combined to analyze soot emissions. • The pilot injection effects are investigated in injection profiles featuring rate-shaped main injections. - Abstract: The potential of pilot injection has been assessed on a low-temperature combustion diesel engine for automotive applications, which was characterized by a reduced compression-ratio, high EGR rates and postponed main injection timings. Dwell time sweeps have been carried out for pilot injections with distinct energizing times under different representative steady-state working conditions of the medium load and speed area of the New European Driving Cycle. The results of in-cylinder analyses of the pressure, heat-release rate, temperature and emissions are presented. Combustion noise has been shown to decrease significantly when the pilot injected mass increases, while it is scarcely affected by the dwell time between the pilot and main injections. The HC, CO and fuel consumption trends, with respect to both the pilot injection dwell time and mass, are in line with those of conventional combustion systems, and in particular decreasing trends occur as the pilot injection energizing time is increased. Furthermore, a reduced sensitivity of NO_x emissions to both dwell time and pilot injected mass has been found, compared to conventional combustion systems. Finally, it has been observed that soot emissions diminish as the energizing time is shortened, and their dependence on dwell time is influenced to a great extent by the presence of local zones with reduced air-to-fuel ratios within the cylinder. A combined analysis of the results of swirl sweeps and dwell time sweeps is here proposed as a methodology for the detection of any possible interference between pilot combustion burned gases and the main injected fuel. The effect of pilot

Percutaneous spine injection: considerations for improving treatment

International Nuclear Information System (INIS)

Lee, Joon Woo; Kim, Sung Hyun; Lee, In Sook; Choi, Jung Ah; Yoon, Chang Jin; Hwang, Sung Il; Kang, Heung Sik; Choi, Ja Young; Koh, Young Hwan; Hong, Sung Hwan

2005-01-01

To discuss the causes of treatment failure in percutaneous spine injections for low back pain or radiculopathy by analyzing patients who have experienced negative treatment effect on their first visit and a positive treatment effect on their second visit. The authors reviewed the cases of 24 patients who visited the pain intervention outpatient department in our hospital due to back pain or radiculopathy. All patients reviewed experienced a negative treatment effect following their first spine injection, but a positive treatment effect following the second injection. The dates of the cases range from June 2003 to May 2004. Two radiologists analyzed the possible causes of the negative treatment effect following the first injection therapies by considering clinical aspects as well as reviewing radiological images. The most common condition was the presence of the change in the level of the second selective nerve root block (n=13). In seven cases, the methods for administering the injections were changed to facet block (n=2), midline epidural block (n=1), selective nerve root block (n=3) and caudal epidural block (n=1). In four cases, there were no changes in the methods for administering the injections nor were there any changes in the level of the selective nerve root block between first and second visit. In those cases, after reviewing spot radiographs performed during injection, we attributed the causes of failure of injection therapy to an inappropriate distribution of drugs. We can improve the effect of percutaneous spine injections for low back pain or radioculopathy by determining the exact level of perineural root block, trying alternative methods, and insuring a good distribution of the injected drugs

Oil injection into the blast furnace

Energy Technology Data Exchange (ETDEWEB)

Dongsheng Liao; Mannila, P.; Haerkki, J.

1997-12-31

Fuel injection techniques have been extensively used in the commercial blast furnaces, a number of publications concerning the fuels injection have been reported. This present report only summarizes the study achievements of oil injection due to the research need the of authors, it includes the following parts: First, the background and the reasons reducing coke rate of oil injection are analyzed. Reducing coke rate and decreasing the ironmaking costs are the main deriving forces, the contents of C, H and ash are direct reasons reducing coke rate. It was also found that oil injection had great effects on the state of blast furnace, it made operation stable, center gas flow develop fully, pressure drop increase, descent speed of burden materials decrease and generation of thermal stagnation phenomena, the quality of iron was improved. Based on these effects, as an ideal mean, oil injection was often used to adjust the state of blast furnace. Secondly, combustion behavior of oil in the raceway and tuyere are discussed. The distribution of gas content was greatly changed, the location of CO, H{sub 2} generation was near the tuyere; the temperature peak shifts from near the raceway boundary to the tuyere. Oxygen concentration and blast velocity were two important factors, it was found that increasing excess oxygen ratio 0.9 to 1.3, the combustion time of oil decreases 0.5 msec, an increase of the blast velocity results in increasing the flame length. In addition, the nozzle position and oil rate had large effects on the combustion of oil. Based on these results, the limit of oil injection is also discussed, soot formation is the main reason limiting to further increase oil injection rate, it was viewed that there were three types of soot which were generated under blast furnace operating conditions. The reason generating soot is the incomplete conversion of the fuel. Finally, three methods improving combustion of oil in the raceway are given: Improvement of oil

Injection nozzle for a turbomachine

Science.gov (United States)

Uhm, Jong Ho; Johnson, Thomas Edward; Kim, Kwanwoo

2012-09-11

A turbomachine includes a compressor, a combustor operatively connected to the compressor, an end cover mounted to the combustor, and an injection nozzle assembly operatively connected to the combustor. The injection nozzle assembly includes a first end portion that extends to a second end portion, and a plurality of tube elements provided at the second end portion. Each of the plurality of tube elements defining a fluid passage includes a body having a first end section that extends to a second end section. The second end section projects beyond the second end portion of the injection nozzle assembly.

New injection recommendations for patients with diabetes

NARCIS (Netherlands)

Frid, A.; Hirsch, L.; Gaspar, R.; Hicks, D.; Kreugel, G.; Liersch, J.; Letondeur, C.; Sauvanet, J. P.; Tubiana-Rufi, N.; Strauss, K.

Aim: Injections administered by patients are one of the mainstays of diabetes management. Proper injection technique is vital to avoiding intramuscular injections, ensuring appropriate delivery to the subcutaneous tissues and avoiding common complications such as lipohypertrophy. Yet few formal

Existing Evidence on Ultrasound-Guided Injections in Sports Medicine.

Science.gov (United States)

Daniels, Eldra W; Cole, David; Jacobs, Bret; Phillips, Shawn F

2018-02-01

Office-based ultrasonography has become increasingly available in many settings, and its use to guide joint and soft tissue injections has increased. Numerous studies have been conducted to evaluate the use of ultrasound-guided injections over traditional landmark-guided injections, with a rapid growth in the literature over the past few years. A comprehensive review of the literature was conducted to demonstrate increased accuracy of ultrasound-guided injections regardless of anatomic location. In the upper extremity, ultrasound-guided injections have been shown to provide superior benefit to landmark-guided injections at the glenohumeral joint, the subacromial space, the biceps tendon sheath, and the joints of the hand and wrist. Ultrasound-guided injections of the acromioclavicular and the elbow joints have not been shown to be more efficacious. In the lower extremity, ultrasound-guided injections at the knee, ankle, and foot have superior efficacy to landmark-guided injections. Conclusive evidence is not available regarding improved efficacy of ultrasound-guided injections of the hip, although landmark-guided injection is performed less commonly at the hip joint. Ultrasound-guided injections are overall more accurate than landmark-guided injections. While current studies indicate that ultrasound guidance improves efficacy and cost-effectiveness of many injections, these studies are limited and more research is needed.

What Is the Economic Cost of Unplanned Pregnancy Following Hysteroscopic Sterilization in the US? A New National Estimate Based on Essure® Procedure Prevalence, Failure Rates and Workforce Productivity.

Science.gov (United States)

Sills, E Scott; Fernandez, Luca P; Jones, Christopher A

Although hysteroscopic sterilization (HS) (Essure ®) has been available in the US since 2002, there is disagreement regarding its efficacy, and there has been no study of the economic impact of HS failure. Our investigation examined the economic consequences of contraceptive failure with Essure in the US. Contraceptive failure rates (CFR) of 5.7%, 7.7% and 9.6% were applied to the US cohort of HS patients (n = 600,000). Direct economic impact of productivity losses resulting from unplanned conceptions after HS was calculated by factoring Essure failure rate, the exposed population, US female labour force participation, unemployment rate, time away from work owing to vaginal delivery or pregnancy termination and weekly wages. For the 9.6% CFR scenario, US workforce productivity loss from unplanned pregnancy and delivery was estimated at 771,065 days (2,112 years). Productivity loss secondary to conception and subsequent termination of pregnancy after Essure was approximately 23,725 days (65 years). Assuming CFR at 5.7%, livebirth delivery with total time missed from work at 65 days, this was associated with an aggregate economic impact of $49.2M in lost annual wages. Direct economic impact of unplanned pregnancy after Essure irrespective of outcome (terminations and deliveries) was estimated to result in US productivity losses valued at ~$130M. Although not all unplanned pregnancy costs are attributable to failed HS, estimates derived from earlier surveys have not considered this contraceptive method, and the economic consequences of unplanned pregnancy after Essure are not trivial. Quantifying the economic consequences of HS failure would be improved with specific ICD-10 coding for Essure-associated symptoms.

Injection system of teh SSC Medium Energy Booster

International Nuclear Information System (INIS)

Mao, N.; Gerig, R.; McGill, J.; Brown, K.

1994-04-01

The Medium Energy Booster (MEB) is the third of the SSCL accelerators and the largest of the resistive magnet synchrotrons. It accelerates protons from an injection momentum of 12 GeV/c to a top momentum of 200 GeV/c. A beam injection system has been designed to inject the beam transferred from the Low Energy Booster onto the MEB closed orbit in the MEB injection insertion region. The beam is injected via a vertical bending Lambertson septum magnet and a horizontal kicker with appropriate matching and very little beam loss and emittance dilution. The beam optics of the injection system is described in this paper. The required parameters of the Lambertson septum magnet and the injection kicker are given

Effect of fuel injection pressure and injection timing of Karanja biodiesel blends on fuel spray, engine performance, emissions and combustion characteristics

International Nuclear Information System (INIS)

Agarwal, Avinash Kumar; Dhar, Atul; Gupta, Jai Gopal; Kim, Woong Il; Choi, Kibong; Lee, Chang Sik; Park, Sungwook

2015-01-01

Highlights: • Effect of FIP on microscopic spray characteristics. • Effect of FIP and SOI timing on CRDI engine performance, emissions and combustion. • Fuel injection duration shortened, peak injection rate increased with increasing FIP. • SMD (D 32 ) and AMD (D 10 ) of fuel droplets decreased for lower biodiesel blends. • Increase in biodiesel blend ratio and FIP, fuel injection duration decreased. - Abstract: In this investigation, effect of 10%, 20% and 50% Karanja biodiesel blends on injection rate, atomization, engine performance, emissions and combustion characteristics of common rail direct injection (CRDI) type fuel injection system were evaluated in a single cylinder research engine at 300, 500, 750 and 1000 bar fuel injection pressures at different start of injection timings and constant engine speed of 1500 rpm. The duration of fuel injection slightly decreased with increasing blend ratio of biodiesel (Karanja Oil Methyl Ester: KOME) and significantly decreased with increasing fuel injection pressure. The injection rate profile and Sauter mean diameter (D 32 ) of the fuel droplets are influenced by the injection pressure. Increasing fuel injection pressure generally improves the thermal efficiency of the test fuels. Sauter mean diameter (D 32 ) and arithmetic mean diameter (D 10 ) decreased with decreasing Karanja biodiesel content in the blend and significantly increased for higher blends due to relatively higher fuel density and viscosity. Maximum thermal efficiency was observed at the same injection timing for biodiesel blends and mineral diesel. Lower Karanja biodiesel blends (up to 20%) showed lower brake specific hydrocarbon (BSHC) and carbon monoxide (BSCO) emissions in comparison to mineral diesel. For lower Karanja biodiesel blends, combustion duration was shorter than mineral diesel however at higher fuel injection pressures, combustion duration of 50% blend was longer than mineral diesel. Up to 10% Karanja biodiesel blends in a CRDI

Outcome analysis of two different injection solutions for epidural injection in radicular lumbar backache syndromes

International Nuclear Information System (INIS)

Saqib, M.; Mukhtar, M.; Bhatti, S.N; Afridi, E.A.K.; Khan, R.

2017-01-01

Background: Backache is a significant source of disability and suffering in our society. The treatment modalities need continued enhancement in order to achieve the desired goals of lowering morbidity and financial losses while improving the response of the patient. Methods: This prospective comparative study was conducted at the department of Orthopaedics and Spine Surgery, Khyber Teaching Hospital Peshawar from July 2013 to June 2015. Two interventional groups were designated; Group 1 was comprised of 54 patients who were injected with epidural bupivacaine plus methylprednisolone while Group 2 included 55 patients who were injected with bupivacaine only. Outcome was assessed using the visual analogue scale and Oswestry disability index (ODI). Results: Fifty-five female and 54 male patients with mean age 49.37 years+-10.46 SD, Mean symptoms duration was 15.01 months+-9.32 SD. Common presenting symptoms were backache (77.1 percent), lower limbs pain (66.1 percent), dermatomal paresthesias (54.1 percent) and neurogenic claudication in 57.8 percent patients. The mean visual analogue score (VAS) after injection was 3.18+-1.29 while mean ODI after injection was 23.615. There was a statistically significant reduction in VAS scores (2-sided p=0.003, OR =4.03, 95 percent CI: 1.535-10.60) following the injection. Conclusion: An epidural spinal injection is a viable option for achieving relief of pain and improves functioning in individuals with radicular backache. However, further research is advised in order to clarify the role of ESI for long-term relief. (author)

Intrathecal Spread of Injectate Following an Ultrasound-Guided Selective C5 Nerve Root Injection in a Human Cadaver Model.

Science.gov (United States)

Falyar, Christian R; Abercrombie, Caroline; Becker, Robert; Biddle, Chuck

2016-04-01

Ultrasound-guided selective C5 nerve root blocks have been described in several case reports as a safe and effective means to anesthetize the distal clavicle while maintaining innervation of the upper extremity and preserving diaphragmatic function. In this study, cadavers were injected with 5 mL of 0.5% methylene blue dye under ultrasound guidance to investigate possible proximal and distal spread of injectate along the brachial plexus, if any. Following the injections, the specimens were dissected and examined to determine the distribution of dye and the structures affected. One injection revealed dye extended proximally into the epidural space, which penetrated the dura mater and was present on the spinal cord and brainstem. Dye was noted distally to the divisions in 3 injections. The anterior scalene muscle and phrenic nerve were stained in all 4 injections. It appears unlikely that local anesthetic spread is limited to the nerve root following an ultrasound-guided selective C5 nerve root injection. Under certain conditions, intrathecal spread also appears possible, which has major patient safety implications. Additional safety measures, such as injection pressure monitoring, should be incorporated into this block, or approaches that are more distal should be considered for the acute pain management of distal clavicle fractures.

The Third Injection Technique Workshop In Athens (TITAN)

NARCIS (Netherlands)

Frid, A.; Hirsch, L.; Gaspar, R.; Hicks, D.; Kreugel, G.; Liersch, J.; Letondeur, C.; Sauvanet, J. P.; Tubiana-Rufi, N.; Strauss, K.

The first Injection Technique workshop brought together endocrinologists and injection experts from around the world in Strasbourg in 1997. From its work came groundbreaking recommendations which advanced best practices in areas such as the use of a skin fold when injecting. The second Injection

Rapid colorimetric assay for gentamicin injection.

Science.gov (United States)

Tarbutton, P

1987-01-01

A rapid colorimetric method for determining gentamicin concentration in commercial preparations of gentamicin sulfate injection was developed. Methods currently available for measuring gentamicin concentration via its colored complex with cupric ions in alkaline solution were modified to reduce the time required for a single analysis. The alkaline copper tartrate (ACT) reagent solution was prepared such that each milliliter contained 100 mumol cupric sulfate, 210 mumol potassium sodium tartrate, and 1.25 mmol sodium hydroxide. The assay involves mixing 0.3 mL gentamicin sulfate injection 40 mg/mL (of gentamicin), 1.0 mL ACT reagent, and 0.7 mL water; the absorbance of the resulting solution at 560 nm was used to calculate the gentamicin concentration in the sample. For injections containing 10 mg/mL of gentamicin, the amount of the injection was increased to 0.5 mL and water decreased to 0.5 mL. The concentration of gentamicin in samples representing 11 lots of gentamicin sulfate injection 40 mg/mL and 8 lots of gentamicin sulfate injection 10 mg/mL was determined. The specificity, reproducibility, and accuracy of the assay were assessed. The colored complex was stable for at least two hours. Gentamicin concentration ranged from 93.7 to 108% and from 95 to 109% of the stated label value of the 40 mg/mL and the 10 mg/mL injections, respectively. No components of the preservative system present in the injections interfered with the assay. Since other aminoglycosides produced a colored complex, the assay is not specific for gentamicin. The assay was accurate and reproducible over the range of 4-20 mg of gentamicin. This rapid and accurate assay can be easily applied in the hospital pharmacy setting.

Fluoroscopically Guided Sacroiliac Joint Injections: Comparison of the Effects of Intraarticular and Periarticular Injections on Immediate and Short-Term Pain Relief.

Science.gov (United States)

Nacey, Nicholas C; Patrie, James T; Fox, Michael G

2016-11-01

The purpose of this study was to determine whether intraarticular sacroiliac joint injections provide greater immediate and short-term pain relief than periarticular sacroiliac joint injections do. The records of all fluoroscopically guided sacroiliac joint injections performed over a 4-year period were identified. Patients who received an injection of 0.5 mL of bupivacaine and 0.5 mL (20 mg) of triamcinolone and who had preinjection, immediate, and 1-week postinjection pain scores (0-10 numeric scale) were included. Images from the procedures were retrospectively reviewed by two musculoskeletal radiologists to determine intraarticular or periarticular administration of the injection with discrepancies resolved by consensus. One hundred thirteen injections in 99 patients (65 women, 34 men; mean age, 59.4 years) met the inclusion criteria. There were 55 intraarticular and 58 periarticular injections. The mean preinjection, immediate, and 1-week postinjection pain scores for the intraarticular injections were 6.0, 1.6, and 4.1 and for the periarticular injections were 6.1, 2.0, and 4.2. The mean immediate and 1-week postinjection pain reduction were statistically significant in both groups (p sacroiliac joint injections provide statistically significant immediate and 1-week postinjection pain relief, no significant difference in the degree of pain relief achieved with intraarticular and periarticular injections was noted.

AA injection kicker in its tank

CERN Multimedia

CERN PhotoLab

1980-01-01

For single-turn injection of the antiprotons, a septum at the end of the injection line made the beam parallel to the injection orbit, and a quarter of a betatron-wavelength downstream a fast kicker corrected the angle. Kicker type: lumped delay line. PFN voltage 56 kV. Bending angle 7.5 mrad; kick-strength 0.9 Tm; fall-time 95%-5% in 150 ns. The injection orbit is to the left, the stack orbit to the far right. A fast shutter near the central orbit had to be closed before the kicker fired, so as to protect the stack core from being shaken by the kicker's fringe field. The shutter is shown in closed position.

Dual fuel injection piggyback controller system

Science.gov (United States)

Muji, Siti Zarina Mohd.; Hassanal, Muhammad Amirul Hafeez; Lee, Chua King; Fawzi, Mas; Zulkifli, Fathul Hakim

2017-09-01

Dual-fuel injection is an effort to reduce the dependency on diesel and gasoline fuel. Generally, there are two approaches to implement the dual-fuel injection in car system. The first approach is changing the whole injector of the car engine, the consequence is excessive high cost. Alternatively, it also can be achieved by manipulating the system's control signal especially the Electronic Control Unit (ECU) signal. Hence, the study focuses to develop a dual injection timing controller system that likely adopted to control injection time and quantity of compressed natural gas (CNG) and diesel fuel. In this system, Raspberry Pi 3 reacts as main controller unit to receive ECU signal, analyze it and then manipulate its duty cycle to be fed into the Electronic Driver Unit (EDU). The manipulation has changed the duty cycle to two pulses instead of single pulse. A particular pulse mainly used to control injection of diesel fuel and another pulse controls injection of Compressed Natural Gas (CNG). The test indicated promising results that the system can be implemented in the car as piggyback system. This article, which was originally published online on 14 September 2017, contained an error in the acknowledgment section. The corrected acknowledgment appears in the Corrigendum attached to the pdf.

Predictors of injection drug use cessation and relapse in a prospective cohort of young injection drug users in San Francisco, CA (UFO Study).

Science.gov (United States)

Evans, Jennifer L; Hahn, Judith A; Lum, Paula J; Stein, Ellen S; Page, Kimberly

2009-05-01

Studies of injection drug use cessation have largely sampled adults in drug treatment settings. Little is known about injection cessation and relapse among young injection drug users (IDU) in the community. A total of 365 HCV-negative IDU under age 30 years were recruited by street outreach and interviewed quarterly for a prospective cohort between January 2000 and February 2008. Participants were followed for a total of 638 person-years and 1996 visits. We used survival analysis techniques to identify correlates of injection cessation (> or =3 months) and relapse to injection. 67% of subjects were male, median age was 22 years (interquartile range (IQR) 20-26) and median years injecting was 3.6 (IQR 1.3-6.5). 28.8% ceased injecting during the follow-up period. Among those that ceased injecting, nearly one-half resumed drug injection on subsequent visits, one-quarter maintained injecting cessation, and one-quarter were lost to follow-up. Participating in a drug treatment program in the last 3 months and injecting less than 30 times per month were associated with injection cessation. Injecting heroin or heroin mixed with other drugs, injecting the residue from previously used drug preparation equipment, drinking alcohol, and using benzodiazepines were negatively associated with cessation. Younger age was associated with relapse to injection. These results suggest that factors associated with stopping injecting involve multiple areas of intervention, including access to drug treatment and behavioral approaches to reduce injection and sustain cessation. The higher incidence of relapse in the younger subjects in this cohort underscores the need for earlier detection and treatment programs targeted to adolescents and transition-age youth.

Teduglutide Injection

Science.gov (United States)

... who need additional nutrition or fluids from intravenous (IV) therapy. Teduglutide injection is in a class of medications ... of the ingredients.tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking ...

Combustion characteristics of a gasoline engine with independent intake port injection and direct injection systems for n-butanol and gasoline

International Nuclear Information System (INIS)

He, Bang-Quan; Chen, Xu; Lin, Chang-Lin; Zhao, Hua

2016-01-01

Highlights: • Different injection approaches for n-butanol and gasoline affect combustion events. • High n-butanol percentage in the total energy of fuels improves combustion stability. • N-butanol promotes ignition and shortens combustion duration. • Lean burn increases indicated mean effective pressure at fixed total energy of fuels. • Different fuel injection methods slightly affect indicated mean effective pressure. - Abstract: N-butanol, as a sustainable biofuel, is usually used as a blend with gasoline in spark ignition engines. In this study, the combustion characteristics were investigated on a four-cylinder spark ignition gasoline engine with independent port fuel injection and direct injection systems for n-butanol and gasoline in different operating conditions. The results show that in the case of port fuel injection of n-butanol with direct injection gasoline at a given total energy released in a cycle, indicated mean effective pressure is slightly affected by spark timing at stoichiometry while it changes much more with delayed spark timing in lean burn conditions and is much higher in lean burn conditions compared to stoichiometry at given spark timings. With the increase of n-butanol percentage in a fixed total energy released in a cycle at given spark timings, ignition timing advances, combustion duration shortens, indicated mean effective pressure and indicated thermal efficiency increase. For the cases of port fuel injection of n-butanol with direction injection gasoline and port fuel injection of gasoline with direction injection n-butanol at a fixed total energy released in a cycle, their indicated mean effective pressures are close. But their combustion processes are dependent on fuel injection approaches.

Performance Analysis of Multi Stage Safety Injection Tank

International Nuclear Information System (INIS)

Shin, Soo Jai; Kim, Young In; Bae, Youngmin; Kang, Han-Ok; Kim, Keung Koo

2015-01-01

In general the integral reactor has such characteristics, the integral reactor requires a high flow rate of coolant safety injection at the initial stage of the accident in which the core level is relatively fast decreased, A medium flow rate of coolant safety injection at the early and middle stages of the accident in which the coolant discharge flow rate is relatively large due to a high internal pressure of the reactor vessel, and a low flow rate of coolant safety injection is required at the middle and late stages of the accident in which the coolant discharge flow rate is greatly reduced due to a decreased pressure of the reactor vessel. It is noted that a high flow rate of the integral reactor is quite smaller compared to a flow rate required in the commercial loop type reactor. However, a nitrogen pressurized safety injection tank has been typically designed to quickly inject a high flow rate of coolant when the internal pressure of the reactor vessel is rapidly decreased, and a core makeup tank has been designed to safely inject at a single mode flow rate due to a gravitational head of water subsequent to making a pressure balance between the reactor vessel and core makeup tank. As a result, in order to compensate such a disadvantage, various type systems are used in a complicated manner in a reactor according to the required characteristic of safety injection during an accident. In the present study, we have investigated numerically the performance of the multi stage safety injection tank. A parameter study has performed to understand the characteristics of the multi stage safety injection tank. The performance of the multi stage safety injection tank has been investigated numerically. When an accident occurs, the coolant in the multi stage safety injection tank is injected into a reactor vessel by a gravitational head of water subsequent to making a pressure balance between the reactor and tank. At the early stages of the accident, the high flow rate of

Performance Analysis of Multi Stage Safety Injection Tank

Energy Technology Data Exchange (ETDEWEB)

Shin, Soo Jai; Kim, Young In; Bae, Youngmin; Kang, Han-Ok; Kim, Keung Koo [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2015-10-15

In general the integral reactor has such characteristics, the integral reactor requires a high flow rate of coolant safety injection at the initial stage of the accident in which the core level is relatively fast decreased, A medium flow rate of coolant safety injection at the early and middle stages of the accident in which the coolant discharge flow rate is relatively large due to a high internal pressure of the reactor vessel, and a low flow rate of coolant safety injection is required at the middle and late stages of the accident in which the coolant discharge flow rate is greatly reduced due to a decreased pressure of the reactor vessel. It is noted that a high flow rate of the integral reactor is quite smaller compared to a flow rate required in the commercial loop type reactor. However, a nitrogen pressurized safety injection tank has been typically designed to quickly inject a high flow rate of coolant when the internal pressure of the reactor vessel is rapidly decreased, and a core makeup tank has been designed to safely inject at a single mode flow rate due to a gravitational head of water subsequent to making a pressure balance between the reactor vessel and core makeup tank. As a result, in order to compensate such a disadvantage, various type systems are used in a complicated manner in a reactor according to the required characteristic of safety injection during an accident. In the present study, we have investigated numerically the performance of the multi stage safety injection tank. A parameter study has performed to understand the characteristics of the multi stage safety injection tank. The performance of the multi stage safety injection tank has been investigated numerically. When an accident occurs, the coolant in the multi stage safety injection tank is injected into a reactor vessel by a gravitational head of water subsequent to making a pressure balance between the reactor and tank. At the early stages of the accident, the high flow rate of

Bolus injections of measured amounts of radioactivity

International Nuclear Information System (INIS)

Wesolowski, C.A.; Hogendoorn, P.; Vandierendonck, R.; Driedger, A.A.

1988-01-01

Many time-based radionuclide techniques, such as glomerular filtration rate measurement (GFR), require prompt intravenous delivery of and accurately measured tracer bolus with minimal residual tracer retention at the injection site. The quality assurance aspects of two antecubital vein, quantitative injection techniques were investigated. A flush bolus technique using a tuberculin syringe piggybacked onto a 10-ml saline flush was compared to a single blood pressure cuff injection technique. Scintillation camera data for each technique were compared for bolus duration in the abdominal aorta and for residual activity at the injection site at 5 min. Bolus times were measured as the FWHM of the gamma variate fit to the abdominal aortic regional time-activity curves. Relatively little focal activity was seen in the antecubital injection site following the flush bolus: marked residual activity was seen following the blood pressure cuff injections. The injection site/arm background ratios averaged 1.3 for the flush bolus and 30.1 for the cuff technique. Although both methods allowed accurate in vitro determination of administered radioactivity, only the tuberculin syringe flush bolus technique was acceptable for time-based quantitation because of its superior in vivo characteristics

Factors associated with pathways toward concurrent sex work and injection drug use among female sex workers who inject drugs in northern Mexico.

Science.gov (United States)

Morris, Meghan D; Lemus, Hector; Wagner, Karla D; Martinez, Gustavo; Lozada, Remedios; Gómez, Rangel María Gudelia; Strathdee, Steffanie A

2013-01-01

To identify factors associated with time to initiation of (i) sex work prior to injecting drugs initiation; (ii) injection drug use prior to sex work initiation; and (iii) concurrent sex work and injection drug use (i.e. initiated at the same age) among female sex workers who currently inject drugs (FSW-IDU). Parametric survival analysis of baseline data for time to initiation event. Tijuana and Ciudad Juarez situated on the Mexico-US border. A total of 557 FSW-IDUs aged ≥18 years. Interview-administered surveys assessing context of sex work and injection drug use initiation. Nearly half (n = 258) initiated sex work prior to beginning to inject, a third (n = 163) initiated injection first and a quarter (n = 136) initiated both sex work and injection drug use concurrently. Low education and living in Ciudad Juarez accelerated time to sex work initiation. Being from a southern Mexican state and initiating drug use with inhalants delayed the time to first injection drug use. Having an intimate partner encourage entry into sex work and first injecting drugs to deal with depression accelerated time to initiating sex work and injection concurrently. Early physical abuse accelerated time to initiating sex work and injection, and substantially accelerated time to initiation of both behaviors concurrently. Among female sex workers who currently inject drugs in two Mexican-US border cities, nearly half appear to initiate sex work prior to beginning to inject, nearly one-third initiate injection drug use before beginning sex work and one-quarter initiate both behaviors concurrently. Predictors of these three trajectories differ, and this provides possible modifiable targets for prevention. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Cellulitis Developing After Intramuscular Metamizole Injection

Directory of Open Access Journals (Sweden)

Onur Ozturk

2016-12-01

Full Text Available If the suitable technique is not used in intramuscular injection applications and the injection area is not detected correctly, complications may be observed. Our patient was given intramuscular Metamizole in his house and then he had cellulitis with necrosis area. Following an antibiotic treatment, tissue defect was primarily covered with gluteal muscle skin flap. Cellulitis development after metamizole injection is not common still potential side effects should be considered before prescription.

Ultrasound-Guided Single-Injection Infraclavicular Block Versus Ultrasound-Guided Double-Injection Axillary Block: A Noninferiority Randomized Controlled Trial.

Science.gov (United States)

Boivin, Ariane; Nadeau, Marie-Josée; Dion, Nicolas; Lévesque, Simon; Nicole, Pierre C; Turgeon, Alexis F

2016-01-01

Single-injection ultrasound-guided infraclavicular block is a simple, reliable, and effective technique. A simplified double-injection ultrasound-guided axillary block technique with a high success rate recently has been described. It has the advantage of being performed in a superficial and compressible location, with a potentially improved safety profile. However, its effectiveness in comparison with single-injection infraclavicular block has not been established. We hypothesized that the double-injection ultrasound-guided axillary block would show rates of complete sensory block at 30 minutes noninferior to the single-injection ultrasound-guided infraclavicular block. After approval by our research ethics committee and written informed consent, adults undergoing distal upper arm surgery were randomized to either group I, ultrasound-guided single-injection infraclavicular block, or group A, ultrasound-guided double-injection axillary block. In group I, 30 mL of 1.5% mepivacaine was injected posterior to the axillary artery. In group A, 25 mL of 1.5% mepivacaine was injected posteromedial to the axillary artery, after which 5 mL was injected around the musculocutaneous nerve. Primary outcome was the rate of complete sensory block at 30 minutes. Secondary outcomes were the onset of sensory and motor blocks, surgical success rates, performance times, and incidence of complications. All outcomes were assessed by a blinded investigator. The noninferiority of the double-injection ultrasound-guided axillary block was considered if the limits of the 90% confidence intervals (CIs) were within a 10% margin of the rate of complete sensory block of the infraclavicular block. At 30 minutes, the rate of complete sensory block was 79% in group A (90% CI, 71%-85%) compared with 91% in group I (90% CI, 85%-95%); the upper limit of CI of group A is thus included in the established noninferiority margin of 10%. The rate of complete sensory block was lower in group A (proportion

"The first shot": the context of first injection of illicit drugs, ongoing injecting practices, and hepatitis C infection in Rio de Janeiro, Brazil.

Science.gov (United States)

Oliveira, Maria de Lourdes Aguiar; Hacker, Mariana A; Oliveira, Sabrina Alberti Nóbrega de; Telles, Paulo Roberto; O, Kycia Maria Rodrigues do; Yoshida, Clara Fumiko Tachibana; Bastos, Francisco I

2006-04-01

The context of first drug injection and its association with ongoing injecting practices and HCV (hepatitis C virus) infection were investigated. Injection drug users (IDUs) (N = 606) were recruited in "drug scenes" (public places, bars) in Rio de Janeiro, Brazil, interviewed, and tested for HCV. Sharing of needles/syringes was more prevalent at the first injection (51.3%) than at the baseline interview (36.8%). Those who shared syringes/needles at first injection were more likely to be currently engaged in direct/indirect sharing practices. Among young injectors (drug injection were identified as independent predictors of HCV infection. To effectively curb HCV transmission among IDUs and minimize harms associated with risk behaviors, preventive strategies should target individuals initiating drug injection beginning with their very first injection and discourage the transition from non-injecting use to the self-injection of illicit drugs.

Selective Uterine Artery Embolization for Management of Interstitial Ectopic Pregnancy

International Nuclear Information System (INIS)

Yang, Seung Boo; Lee, Sang Jin; Joe, Hwan Sung; Goo, Dong Erk; Chang, Yun Woo; Kim, Dong Hun

2007-01-01

Interstitial pregnancy is defined as any gestation that develops in the uterine portion of the fallopian tubes lateral to the round ligament. Interstitial pregnancies account for 2-4% of all ectopic pregnancies and have been reported to have an associated 2% to 2.5% maternal mortality rate. The traditional treatment for interstitial pregnancy using surgical cornual resection may cause infertility or uterine rupture in subsequent pregnancies. Recently, the early identification of intact interstitial pregnancy has been made possible in many cases with high resolution transvaginal ultrasound as well as more sensitive assays for betahuman chorionic gonadotropin (β-hCG). The treatment includes: hysteroscopic transcervical currettage, local and systemic methotrexate (MTX) therapy and prostaglandin or potassium chloride injection of the ectopic mass under sonographic guidance. We describe a case of successful treatment of interstitial pregnancy using uterine artery embolization, after failure of methotrexate treatment

Selective Uterine Artery Embolization for Management of Interstitial Ectopic Pregnancy

Energy Technology Data Exchange (ETDEWEB)

Yang, Seung Boo; Lee, Sang Jin; Joe, Hwan Sung; Goo, Dong Erk; Chang, Yun Woo [Soonchunhyang University Gumi Hospital, Gumi (Korea, Republic of); Kim, Dong Hun [Chosun University Hospital, Gwangju (Korea, Republic of)

2007-04-15

Interstitial pregnancy is defined as any gestation that develops in the uterine portion of the fallopian tubes lateral to the round ligament. Interstitial pregnancies account for 2-4% of all ectopic pregnancies and have been reported to have an associated 2% to 2.5% maternal mortality rate. The traditional treatment for interstitial pregnancy using surgical cornual resection may cause infertility or uterine rupture in subsequent pregnancies. Recently, the early identification of intact interstitial pregnancy has been made possible in many cases with high resolution transvaginal ultrasound as well as more sensitive assays for betahuman chorionic gonadotropin ({beta}-hCG). The treatment includes: hysteroscopic transcervical currettage, local and systemic methotrexate (MTX) therapy and prostaglandin or potassium chloride injection of the ectopic mass under sonographic guidance. We describe a case of successful treatment of interstitial pregnancy using uterine artery embolization, after failure of methotrexate treatment.

Examination of injection moulded thermoplastic maize starch

Directory of Open Access Journals (Sweden)

2007-12-01

Full Text Available This paper focuses on the effect of the different injection moulding parameters and storing methods on injection moulded thermoplastic maize starch (TPS. The glycerol and water plasticized starch was processed in a twin screw extruder and then with an injection moulding machine to produce TPS dumbbell specimens. Different injection moulding set-ups and storing conditions were used to analyse the effects on the properties of thermoplastic starch. Investigated parameters were injection moulding pressure, holding pressure, and for the storage: storage at 50% relative humidity, and under ambient conditions. After processing the mechanical and shrinkage properties of the manufactured TPS were determined as a function of the ageing time. While conditioning, the characteristics of the TPS changed from a soft material to a rigid material. Although this main behaviour remained, the different injection moulding parameters changed the characteristics of TPS. Scanning electron microscope observations revealed the changes in the material on ageing.

Factors associated with time between using a drug and injection initiation among people who inject drugs in Kermanshah, Iran.

Science.gov (United States)

Noroozi, Mehdi; Farhadi, Mohammad Hassan; Armoon, Bahram; Farhoudian, Ali; Shushtari, Zahra Jorjoran; Sharhani, Asaad; Karimi, Salah Eddin; Sayadnasiri, Mohammad; Rezaei, Omid; Ghiasvand, Hesam

2018-05-17

Background The transition from non-injection to injection drug use dramatically increases the risk of transmitting HIV and other blood borne infections including hepatitis B virus (HBV) and hepatitis C virus (HCV). The aim of this study was to explore factors associated with the transition from first illicit drug use to first injection among drug users. Methods Using snowball sampling and convenience sampling through needle and syringe programmes (NSPs), we recruited 500 people who inject drugs (PWID) in Kermanshah, between September and December 2014. Trained interviewers collected data on socio-demographic characteristics, HIV testing and drug-related risk behaviors over the last month prior to interview using a structured questionnaire. Our main outcome variable was first illicit drug use to first injection (TIJ). TIJ was calculated by subtracting age at first drug injection from age of first illicit drug use. Results Overall, the average age at first drug use and injection were 21.4 [standard deviation (SD 5.6)] and 22.8 (SD 8.9), respectively. The average duration of injection was 6.0 (SD 4.6) years. Overall, the mean of TIJ for participants was 1.4 (IQR = 2, 4) years. Age of first injecting drug use negatively correlated with TIJ (R2 = 0.219, p = 0.001). Education level and socioeconomic status (SES), and negatively correlated with TIJ. Conclusion Some demographic factors and drug use characteristics including educational level, SES, knowledge of HIV status, age of initiating drug use, being a poly drug user and using methamphetamine were predictors of the time to transition.

Numerical investigation of the effect of injection strategy on mixture formation and combustion process in a port injection natural gas rotary engine

International Nuclear Information System (INIS)

Fan, Baowei; Pan, Jianfeng; Yang, Wenming; Liu, Yangxian; Bani, Stephen; Chen, Wei

2017-01-01

Highlights: • For injection timing, the fuel movement is controlled by the intensity of the vortex I. • For injection duration, the fuel movement is controlled by the value of jet flux. • The ideal fuel distribution at ignition timing for high combustion rate is studied. • The optimal injection strategy had an increase in the peak pressure and NO emissions. - Abstract: This work aimed to numerically study the influence of injection strategy on mixture formation and combustion process in a port injection natural gas rotary engine. On the base of a 3D dynamic simulation model which was established in our previous work, some critical information was obtained, which was difficult to obtain through experiment, in terms of the flow field, the fuel distribution, the temperature field and the concentration fields of some intermediates. Simulation results showed that for mixture formation, the movements of fuel in injection stage were mainly controlled by the intensity of the vortex I for injection timing, and the value of jet flux for injection duration respectively. With retarded injection timing, the decreasing intensity of the vortex I resulted in less fuel moving toward the back of the combustion chamber. With the extension in injection duration, the decreasing value of jet flux resulted in more fuel staying at the back of the combustion chamber. For combustion process, the overall combustion rate for injection strategy which had an injection timing of 390 °CA (BTDC) and injection duration of 51.5 °CA (case ID4) was the fastest. This was mainly due to the fact that the accumulation area of fuel was at the middle and front of the combustion chamber. Meanwhile, fuel concentration near the leading and trailing spark plugs was conducive for the flame kernel formation. Compared with the injection strategy which had an injection timing of 450 °CA (BTDC) and an injection duration of 55 °CA (case IT1), the improved combustion rate of case ID4 had a 23% increase in

Rituals in nursing: intramuscular injections.

Science.gov (United States)

Greenway, Kathleen

2014-12-01

To consider to what extent intramuscular injection technique can be described to remain entrenched in ritualistic practice and how evidence-based practice should be considered and applied to the nursing practice of this essential skill. The notion of rituals within nursing and the value or futile impact they afford to this essential nursing skill will be critically reviewed. Discursive paper. Literature review from 2002-2013 to review the current position of intramuscular injection injections. Within the literature review, it became clear that there are several actions within the administration of an intramuscular injection that could be perceived as ritualistic and require consideration for contemporary nursing practice. The essential nursing skill of intramuscular injection often appears to fit into the description of a ritualised practice. By providing evidence-based care, nurses will find themselves empowered to make informed decisions based on clinical need and using their clinical judgement. For key learning, it will outline with rationale how site selection, needle selection, insertion technique and aspiration can be cited as examples of routinised or ritualistic practice and why these should be rejected in favour of an evidence-based approach. The effect on some student nurses of experiencing differing practices between what is taught at university and what is often seen in clinical practice will also be discussed. © 2014 John Wiley & Sons Ltd.

Triptorelin Injection

Science.gov (United States)

... puberty too soon, resulting in faster than normal bone growth and development of sexual characteristics) in children 2 years and older. Triptorelin injection is in a class of medications called gonadotropin-releasing hormone (GnRH) agonists. It works by decreasing the amount ...

Experimental optimization of a direct injection homogeneous charge compression ignition gasoline engine using split injections with fully automated microgenetic algorithms

Energy Technology Data Exchange (ETDEWEB)

Canakci, M. [Kocaeli Univ., Izmit (Turkey); Reitz, R.D. [Wisconsin Univ., Dept. of Mechanical Engineering, Madison, WI (United States)

2003-03-01

Homogeneous charge compression ignition (HCCI) is receiving attention as a new low-emission engine concept. Little is known about the optimal operating conditions for this engine operation mode. Combustion under homogeneous, low equivalence ratio conditions results in modest temperature combustion products, containing very low concentrations of NO{sub x} and particulate matter (PM) as well as providing high thermal efficiency. However, this combustion mode can produce higher HC and CO emissions than those of conventional engines. An electronically controlled Caterpillar single-cylinder oil test engine (SCOTE), originally designed for heavy-duty diesel applications, was converted to an HCCI direct injection (DI) gasoline engine. The engine features an electronically controlled low-pressure direct injection gasoline (DI-G) injector with a 60 deg spray angle that is capable of multiple injections. The use of double injection was explored for emission control and the engine was optimized using fully automated experiments and a microgenetic algorithm optimization code. The variables changed during the optimization include the intake air temperature, start of injection timing and the split injection parameters (per cent mass of fuel in each injection, dwell between the pulses). The engine performance and emissions were determined at 700 r/min with a constant fuel flowrate at 10 MPa fuel injection pressure. The results show that significant emissions reductions are possible with the use of optimal injection strategies. (Author)

Radiotracer injections through microfilters

International Nuclear Information System (INIS)

Huber, H.; Maschek, G.; Pichler, R.; Giesen, I.; Hatzl-Griesenhofer, M.; Maschek, W.

2002-01-01

Full text: Problems with the injection of radiotracers ( 99m Tc-HAMS, 99m Tc-DPD) to infants when administered through polar-filter-protected venous pathways caused us to get a closer look of what happens to a tracer in such a system. We simulated injections of the tracers mainly used at our institution in an in-vitro array and measured full and empty tracer syringes, filters (0.2 μm micropores) and the post-filter receptacle of the radioactivity. We calculated the percentage of filter-trapped activity and of activity in the receptacle. For several tracers we repeated this process with a neutral filter of the same pore size to get a comparison between the behavior in polarized and electrically inert filters. In general injection of a soluble radiotracer through a polar filter system means a dose loss in the filter of about 10 %, up to the tracer molecule size of IgG-antibodies. Suspended tracers, which consist of comparatively large particles, like RES- or pulmonary perfusion markers, are blocked by the filter, as can be foreseen with a particle size of >> 0.2 μm. DMSA and DPD (a biphosphonate), although both being soluble and rather small molecules, were blocked by the polar filter to a high extent, and by the neutral filter to a much lower, almost neglectable degree. The conclusions are: if possible avoid any use of a filter in your tracer injection pathway. Never use a filter with bone scan or DMSA applications. When doing uptake calculations you have to add the filter counts to the empty syringe value in the formula. If you cannot avoid to inject the radiotracer through a filter you have to replace the filter afterwards and treat the used filter as radioactive waste. The polarity of the filter material might severely affect retention of radiotracer in the filter. (author)

Deuterium pellet injection in the TFR Tokamak

International Nuclear Information System (INIS)

Lazare, O.

1985-07-01

Injecting fresh fuel deep inside the plasma of a thermonuclear reactor appears to be necessary; the only way to do that is to inject fast solid deuterium pellets. The existing theoretical, technical and experimental aspects of this method are presented. The experiments on TFR have confirmed that injecting pellets is technically feasible; a new kind of injector is presented. The injection does not degrade stability nor confinement of the plasma. The study of the transient phenomena occuring during the injection has proved to be an efficient way to investigate particles and energy transport in the discharge; in particular, a fast transport phenomenon, similar to those occuring during disruptions, has been studied in details. Conclusions about disruptions are drawn. (Ref 101) [fr

Construction of a Direct Water-Injected Two-Stroke Engine for Phased Direct Fuel Injection-High Pressure Charging Investigations

Science.gov (United States)

Somsel, James P.

1998-01-01

The development of a water injected Orbital Combustion Process (OCP) engine was conducted to assess the viability of using the powerplant for high altitude NASA aircraft and General Aviation (GA) applications. An OCP direct fuel injected, 1.2 liter, three cylinder, two-stroke engine has been enhanced to independently inject water directly into the combustion chamber. The engine currently demonstrates low brake specific fuel consumption capability and an excellent power to weight ratio. With direct water injection, significant improvements can be made to engine power, to knock limits/ignition advance timing, and to engine NO(x) emissions. The principal aim of the testing was to validate a cyclic model developed by the Systems Analysis Branch at NASA Ames Research Center. The work is a continuation of Ames' investigations into a Phased Direct Fuel Injection Engine with High Pressure Charging (PDFI-ITPC).

Characterization of an intravenously injected bolus

International Nuclear Information System (INIS)

Samuel, A.M.; Raikar, U.R.; Atmaram, S.H.; Ganatra, R.D.

1976-01-01

A study of some parameters affecting the time activity histogram of an intravenous bolus injection of radioactivity was performed. A scoring system for bolus compactness was attempted. A score of 2 and above was considered to be a satisfactory bolus. Volumes less than 1 ml tended to result in a satisfactory bolus. The nature of radiopharmaceutical injected, different injecters and age of the patient did not affect the score. Thyrotoxic patients gave the best bolus score. (orig.) [de

Near-surface groundwater responses to injection of geothermal wastes

Energy Technology Data Exchange (ETDEWEB)

Arnold, S.C.

1984-06-01

Experiences with injecting geothermal fluids have identified technical problems associated with geothermal waste disposal. This report assesses the feasibility of injection as an alternative for geothermal wastewater disposal and analyzes hydrologic controls governing the upward migration of injected fluids. Injection experiences at several geothermal developments are presented, including: Raft River, Salton Sea, East Mesa, Otake and Hatchobaru in Japan, and Ahuachapan in El Salvador. Hydrogeologic and design/operational factors affecting the success of an injection program are identified. Hydrogeologic factors include subsidence, near-surface effects of injected fluids, and seismicity. Design/operational factors include hydrodynamic breakthrough, condition of the injection system and reservoir maintenance. Existing and potential effects of production/injection on these factors are assessed.

Interface state generation after hole injection

International Nuclear Information System (INIS)

Zhao, C. Z.; Zhang, J. F.; Groeseneken, G.; Degraeve, R.; Ellis, J. N.; Beech, C. D.

2001-01-01

After terminating electrical stresses, the generation of interface states can continue. Our previous work in this area indicates that the interface state generation following hole injection originates from a defect. These defects are inactive in a fresh device, but can be excited by hole injection and then converted into interface states under a positive gate bias after hole injection. There is little information available on these defects. This article investigates how they are formed and attempts to explain why they are sensitive to processing conditions. Roles played by hydrogen and trapped holes will be clarified. A detailed comparison between the interface state generation after hole injection in air and that in forming gas is carried out. Our results show that there are two independent processes for the generation: one is caused by H 2 cracking and the other is not. The rate limiting process for the interface state generation after hole injection is discussed and the relation between the defects responsible for this generation and hole traps is explored. [copyright] 2001 American Institute of Physics

Comparative effectiveness of injection therapies in lateral epicondylitis

DEFF Research Database (Denmark)

Krogh, Thøger Persson; Bartels, Else Marie; Ellingsen, Torkell Juulsgaad

2013-01-01

Injection therapy with glucocorticoids has been used since the 1950s as a treatment strategy for lateral epicondylitis (tennis elbow). Lately, several novel injection therapies have become available.......Injection therapy with glucocorticoids has been used since the 1950s as a treatment strategy for lateral epicondylitis (tennis elbow). Lately, several novel injection therapies have become available....

H- charge exchange injection systems

International Nuclear Information System (INIS)

Ankenbrandt, C.; Curtis, C.; Hojvat, C.; Johnson, R.P.; Owen, C.; Schmidt, C.; Teng, L.; Webber, R.C.

1980-01-01

The techniques and components required for injection of protons into cyclic accelerators by means of H - charge exchange processes are reviewed, with emphasis on the experience at Fermilab. The advantages of the technique are described. The design and performance of the system of injection of H - ions into the Fermilab Booster are detailed. (Auth.)

The injection and extraction of SSRF booster

International Nuclear Information System (INIS)

Li Yuan; Li Haohu; Liu Guimin; Li Deming

2008-01-01

The layout of injection and extraction system were introduced in this paper. The horizontal and vertical injection acceptance are about 23 πmm·mrad and 37 πmm·mrad, respectively, while emittance of the injected beam is 9 πmm·mrad (3σ). This ensures the high injection efficiency. Three slow kickers can form a good bump. The inside position of the entrance of septum is set to 15 mm, where the bumped beam and the extraction beam are 10 mm and 22 mm, respectively, far from the booster central orbit. (authors)

Nicolau Syndrome after Intramuscular Benzathine Penicillin Injection

Directory of Open Access Journals (Sweden)

Morteza Noaparast

2014-11-01

Full Text Available A 3-year-old boy was admitted to the emergency department with right lower limb pain, edema, and livedoid discoloration that occurred immediately after intramuscular injection of benzathine penicillin. The patient was diagnosed with Nicolau syndrome, a rare complication of intramuscular injection presumed to be related to the inadvertent intravascular injection. It was first reported following intramuscular injection of bismuth salt, but it can occur as a complication of various other drugs. Fasciotomy was carried out due to the resultant compartment syndrome and medical therapy with heparin, corticosteroid, and pentoxifyllin was initiated.

Hyaluronic acid filler injections for tear-trough deformity: injection technique and high-frequency ultrasound follow-up evaluation.

Science.gov (United States)

De Pasquale, Antonino; Russa, Giuseppina; Pulvirenti, Manuela; Di Rosa, Luigi

2013-06-01

This study aimed to describe the technique used by the authors in treating tear-trough deformity and to illustrate the effectiveness of high-frequency diagnostic ultrasound in the assessment of dermal filler longevity. In this consecutive interventional nonrandomized case series, 22 patients (18 women and 4 men) were evaluated. They ranged in age from 29 to 65 years (mean, 46.59 years ± 10.0 years). The patients were given multiple hyaluronic acid injections in the tear-trough area between 2009 and 2011. The injected areas then were evaluated with sonographic scans during the follow-up period. All the patients were examined preoperatively, 7 days after injection, then after 1, 6, and 12 months, and finally once a year. Pre- and postoperative photographs using standard positioning and lighting were taken as well as high-frequency ultrasound scans using a 15-MHz scanner with an axial resolution of 15 mm. The injection technique consisted of three to five injections perpendicular to the skin. These were administered just under the orbital rim, creating three column-shaped hyaluronic acid deposits deep in the orbicularis oculi muscle, from 0.2 mm to 0.5 mm below the orbital rim. Approximately 0.1 ml-0.3 ml was injected at a time. This technique creates a deep scaffolding that can fill the orbital hollow. The amount of filler used in each area ranged from 0.1 ml to 0.3 ml (mean, 0.267 ml ± 0.128 ml), whereas the mean filler quantity in each eyelid was 0.45 ml ± 0.14 ml. During the follow-up visit 1 week after the treatment, 21 patients (90 %) required a second series of injections either in the exact same areas or right next to the injected area to obtain a smoother appearance of the skin surface. During the sonographer examination, it was always possible to identify and measure the filler at the site of the injection. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please

Injection-induced moment release can also be aseismic

Science.gov (United States)

McGarr, Arthur; Barbour, Andrew J.

2018-01-01

The cumulative seismic moment is a robust measure of the earthquake response to fluid injection for injection volumes ranging from 3100 to about 12 million m3. Over this range, the moment release is limited to twice the product of the shear modulus and the volume of injected fluid. This relation also applies at the much smaller injection volumes of the field experiment in France reported by Guglielmi, et al. (2015) and laboratory experiments to simulate hydraulic fracturing described by Goodfellow, et al. (2015). In both of these studies, the relevant moment release for comparison with the fluid injection was aseismic and consistent with the scaling that applies to the much larger volumes associated with injection-induced earthquakes with magnitudes extending up to 5.8. Neither the micro-earthquakes, at the site in France, nor the acoustic emission in the laboratory samples contributed significantly to the deformation due to fluid injection.

Development of devices for self-injection: using tribological analysis to optimize injection force

Directory of Open Access Journals (Sweden)

Lange J

2016-05-01

Full Text Available Jakob Lange, Leos Urbanek, Stefan BurrenYpsomed Delivery Systems, Ypsomed AG, Burgdorf, Switzerland Abstract: This article describes the use of analytical models and physical measurements to characterize and optimize the tribological behavior of pen injectors for self-administration of biopharmaceuticals. One of the main performance attributes of this kind of device is its efficiency in transmitting the external force applied by the user on to the cartridge inside the pen in order to effectuate an injection. This injection force characteristic is heavily influenced by the frictional properties of the polymeric materials employed in the mechanism. Standard friction tests are available for characterizing candidate materials, but they use geometries and conditions far removed from the actual situation inside a pen injector and thus do not always generate relevant data. A new test procedure, allowing the direct measurement of the coefficient of friction between two key parts of a pen injector mechanism using real parts under simulated use conditions, is presented. In addition to the absolute level of friction, the test method provides information on expected evolution of friction over lifetime as well as on expected consistency between individual devices. Paired with an analytical model of the pen mechanism, the frictional data allow the expected overall injection system force efficiency to be estimated. The test method and analytical model are applied to a range of polymer combinations with different kinds of lubrication. It is found that material combinations used without lubrication generally have unsatisfactory performance, that the use of silicone-based internal lubricating additives improves performance, and that the best results can be achieved with external silicone-based lubricants. Polytetrafluoroethylene-based internal lubrication and external lubrication are also evaluated but found to provide only limited benefits unless used in

Modeling the effects of auxiliary gas injection and fuel injection rate shape on diesel engine combustion and emissions

Science.gov (United States)

Mather, Daniel Kelly

1998-11-01

The effect of auxiliary gas injection and fuel injection rate-shaping on diesel engine combustion and emissions was studied using KIVA a multidimensional computational fluid dynamics code. Auxiliary gas injection (AGI) is the injection of a gas, in addition to the fuel injection, directly into the combustion chamber of a diesel engine. The objective of AGI is to influence the diesel combustion via mixing to reduce emissions of pollutants (soot and NO x). In this study, the accuracy of modeling high speed gas jets on very coarse computational grids was addressed. KIVA was found to inaccurately resolve the jet flows near walls. The cause of this inaccuracy was traced to the RNG k - ɛ turbulence model with the law-of-the-wall boundary condition used by KIVA. By prescribing the lengthscale near the nozzle exit, excellent agreement between computed and theoretical jet penetration was attained for a transient gas jet into a quiescent chamber at various operating conditions. The effect of AGI on diesel engine combustion and emissions was studied by incorporating the coarse grid gas jet model into a detailed multidimensional simulation of a Caterpillar 3401 heavy-duty diesel engine. The effects of AGI timing, composition, amount, orientation, and location were investigated. The effects of AGI and split fuel injection were also investigated. AGI was found to be effective at reducing soot emissions by increasing mixing within the combustion chamber. AGI of inert gas was found to be effective at reducing emissions of NOx by depressing the peak combustion temperatures. Finally, comparison of AGI simulations with experiments were conducted for a TACOM-LABECO engine. The results showed that AGI improved soot oxidation throughout the engine cycle. Simulation of fuel injection rate-shaping investigated the effects of three injection velocity profiles typical of unit-injector type, high-pressure common-rail type, and accumulator-type fuel injectors in the Caterpillar 3401 heavy

One-month injectables are popular choice in Mexico.

Science.gov (United States)

1984-01-01

In Latin America over 100,000 women use monthly injectable contraceptives. These injectables are not part of any national program and are manufactured by local companies. Convenience and secretiveness were 2 primary reasons given by a group of injectable contraceptive users for preferring this method to all other forms of birth control. This was 1 of the findings of a study undertaken by Promotora de Planificacion Familiar A.C. (PROFAM) in Mexico to assess the market for a 1 month injectable, to include in its contraceptive social marketing program. In depth information was obtained about the attitudes and perceptions of present users of injectables with regard to the advantages of the method compared to other contraceptives and the motivation to use the 1 month rather than the 3 month product. In December 1983 PROFAM conducted a motivational study of injectable contraceptive users, utilizing 4 discussion groups composed of women who used 1 month injectables and were residents of several randomly selected lower middle income and low income areas of metropolitan Mexico City. The older women in the study had generally begun to use injectables after other methods were deemed unsatisfactory. They had either had physical or psychological complaints about their previous methods or were worried about effectiveness. Injectables were considered by all the women to be "less troublesome" than but as effective as either oral contraceptives (OCs) or the IUD. Features most often cited in favor of injectables were their effectiveness, lack of rumors about side effects, the possibility of secrecy, and ease of correct use. Knowledge about injectables was widespread, and the women reported no difficulty in getting the information they wanted from friends, drugstore personnel, or doctors. The product usually reached the consumer without a medical prescription. Finding someone to administer the shot was the principal drawback of an injectable contraceptive. Middle class women usually

Autologous Fat Injection for Augmented Mammoplasty

International Nuclear Information System (INIS)

Yoon, Eul Sik; Seo, Bo Kyoung; Yi, Ann; Cho, Kyu Ran

2008-01-01

Autologous fat injection is one of the methods utilized for augmented mammoplasty methods. In this surgical procedure, the fat for transfer is obtained from the donor site of the patient's own body by liposuction and the fat is then injected into the breast. We report here cases of three patients who underwent autologous fat injection. Two of the patients had palpable masses that were present after surgery. The serial imaging findings and surgical method of autologous fat transfer are demonstrated

Prevalence and Correlates of Heroin–Methamphetamine Co-Injection Among Persons Who Inject Drugs in San Diego, California, and Tijuana, Baja California, Mexico

Science.gov (United States)

Meacham, Meredith C.; Strathdee, Steffanie A.; Rangel, Gudelia; Armenta, Richard F.; Gaines, Tommi L.; Garfein, Richard S.

2016-01-01

Objective: Although persons who inject drugs (PWID) in the western United States–Mexico border region are known to inject both heroin and methamphetamine, little is known about the prevalence and risks associated with co-injection of this depressant–stimulant combination (also known as “goofball” and “Mexican speedball”). Method: Baseline data from parallel cohort studies of PWID conducted concurrently in San Diego, CA, and Tijuana, Mexico, were used to estimate the prevalence and identify correlates of heroin–methamphetamine co-injection. PWID older than 18 years of age who reported injecting illicit drugs in the past month (N = 1,311; 32.7% female) were recruited in San Diego (n = 576) and Tijuana (n = 735) and completed interviewer-administered questionnaires. Bivariate and multivariable logistic regression analyses were used to identify correlates of heroin–methamphetamine co-injection. Results: The prevalence of co-injection in the past 6 months was 39.9% overall and was higher in Tijuana (55.8%) than in San Diego (19.8%). In multivariable analyses adjusting for study cohort, distributive syringe sharing, purchasing syringes prefilled with drugs, finding it hard to get new syringes, reporting great or urgent need for treatment, and younger age were independently associated with co-injection. Past-6-month overdose was significantly associated with higher odds of co-injection in San Diego than in Tijuana. Conclusions: These findings indicate that heroin–methamphetamine co-injection is more common in Tijuana than in San Diego, yet this practice was only associated with overdose in San Diego. Heroin–methamphetamine co-injection was also independently associated with HIV-associated injection risk behaviors. Overdose-prevention interventions should address co-injection of depressants and stimulants. PMID:27588536

Effects of pilot injection timing and EGR on a modern V6 common rail direct injection diesel engine

Science.gov (United States)

Rosli Abdullah, Nik; Mamat, Rizalman; Wyszynski, Miroslaw L.; Tsolakis, Anthanasios; Xu, Hongming

2013-12-01

Nitric oxide and smoke emissions in diesel engine can be controlled by optimising the air/fuel mixture. Early injection produces premixed charge resulted in simultaneous NOx and smoke emissions reduction. However, there could be an increase in hydrocarbons and CO emissions due to fuel impinged to the cylinder wall. The focus of the present work is to investigate the effects of a variation of pilot injection timing with EGR to NOx and smoke level on a modern V6 common rail direct injection. This study is carried out at two different engine load conditions of 30 Nm and 55 Nm, at constant engine speed of 2000 rpm. The results show that the early pilot injection timing contributed to the lower smoke level and higher NOx emissions. The higher level of NOx is due to higher combustion temperatures resulting from the complete combustion. Meanwhile, the lower smoke level is due to complete fuel combustion and soot oxidation. The early pilot injection timing produces an intermediate main ignition delay which also contributed to complete combustion. The formation of smoke is higher at a high engine load compared with low engine load due to the higher amount of fuel being injected.

Drug injecting and HIV risk among injecting drug users in Hai Phong, Vietnam: a qualitative analysis.

Science.gov (United States)

Ahmed, Tanvir; Long, Thanh Nguyen; Huong, Phan Thi; Stewart, Donald Edwin

2015-01-29

Hai Phong, located in northern Vietnam, has become a high HIV prevalence province among Injecting Drug Users (IDUs) since the infection shifted from the southern to the northern region of the country. Previous research indicates high levels of drug and sex related risk behaviour especially among younger IDUs. Our recent qualitative research provides a deeper understanding of HIV risk behaviour and highlights views and experiences of IDUs relating to drug injecting and sharing practices. Fifteen IDUs participated in semi-structured interviews conducted in September-October, 2012. Eligible participants were selected from those recruited in a larger scale behavioural research project and identified through screening questions. Interviews were conducted by two local interviewers in Vietnamese and were audiotaped. Ethical procedures, including informed consent and participants' understanding of their right to skip and withdraw, were applied. Transcripts were translated and double checked. The data were categorised and coded according to themes. Thematic analysis was conducted and a qualitative data analysis thematic framework was used. Qualitative analysis highlighted situational circumstances associated with HIV risks among IDUs in Hai Phong and revealed three primary themes: (i) places for injecting, (ii) injecting drugs in small groups, and (iii) sharing practices. Our results showed that shared use of jointly purchased drugs and group injecting were widespread among IDUs without adequate recognition of these as HIV risk behaviours. Frequent police raids generated a constant fear of arrest. As a consequence, the majority preferred either rail lines or isolated public places for injection, while some injected in their own or a friend's home. Price, a heroin crisis, and strong group norms encouraged collective preparation and group injecting. Risk practices were enhanced by a number of factors: the difficulty in getting new syringes, quick withdrawal management

Ceramic injection molding

International Nuclear Information System (INIS)

Agueda, Horacio; Russo, Diego

1988-01-01

Interest in making complex net-shape ceramic parts with good surface finishing and sharp tolerances without machining is a driving force for studying the injection molding technique. This method consists of softhening the ceramic material by means of adding some plastic and heating in order to inject the mixture under pressure into a relatively cold mold where solidification takes place. Essentially, it is the same process used in thermoplastic industry but, in the present case, the ceramic powder load ranges between 80 to 90 wt.%. This work shows results obtained from the fabrication of pieces of different ceramic materials (alumina, barium titanate ferrites, etc.) in a small scale, using equipments developed and constructed in the laboratory. (Author) [es

Reactor water injection facility

Energy Technology Data Exchange (ETDEWEB)

Yoshikawa, Kazuhiro; Kinoshita, Shoichiro

1997-05-02

A steam turbine and an electric generator are connected by way of a speed convertor. The speed convertor is controlled so that the number of rotation of the electric generator is constant irrespective of the speed change of the steam turbine. A shaft coupler is disposed between the turbine and the electric generator or between the turbine and a water injection pump. With such a constitution, the steam turbine and the electric generator are connected by way of the speed convertor, and since the number of revolution of the electric generator is controlled to be constant, the change of the number of rotation of the turbine can be controlled irrespective of the change of the number of rotation of the electric generator. Accordingly, the flow rate of the injection water from the water injection pump to a reactor pressure vessel can be controlled freely thereby enabling to supply stable electric power. (T.M.)

CONCEPTUAL DESIGN OF THE NSLS-II INJECTION SYSTEM.

Energy Technology Data Exchange (ETDEWEB)

SHAFTAN,T.; ROSE, T.; PINAYEV, I.; HEESE, R.; BENGTSSON, J.; SKARITKA, J.; MENG, W.; OZAKI, S.; MEIER, R.; STELMACH, C.; LITVINENKO, V.; PJEROV, S.; SHARMA, S.; GANETIS, G.; HSEUH, H.C.; JOHNSON, E.D.; TSOUPAS, N.; GUO, W.; BEEBE-WANG, J.; LUCCIO, A.U.; YU, L.H.; RAPARIA, D.; WANG, D.

2007-06-25

We present the conceptual design of the NSLS-II injection system [1,2]. The injection system consists of a low-energy linac, booster and transport lines. We review two different injection system configurations; a booster located in the storage ring tunnel and a booster housed in a separate building. We briefly discuss main parameters and layout of the injection system components.

Injection practice in Kaski district, Western Nepal: a community perspective.

Science.gov (United States)

Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, Pathiyil Ravi; Kumar, Vikash K C; Maskey, Manisha; Jha, Nisha

2015-04-29

Previous studies have shown that unsafe injection practice is a major public health problem in Nepal but did not quantify the problem. The present community-based study was planned to: 1) quantify injection usage, 2) identify injection providers, 3) explore differences, if any, in injection usage and injection providers, and 4) study and compare people's knowledge and perception about injections between the urban and rural areas of Kaski district. A descriptive, cross-sectional mixed-methods study was conducted from July to November 2012, using a questionnaire based survey and focus group discussions (FGDs). A semi-structured questionnaire advocated by the World Health Organization was modified and administered to household heads and injection receivers in selected households and the FGDs were conducted using a topic guide. The district was divided into urban and rural areas and 300 households from each area were selected. Twenty FGDs were held. In 218 households (36.33%) [99 in urban and 119 in rural] one or more members received at least one injection. During the three month recall period, 258 subjects (10.44%) reported receiving injection(s) with a median of two injections. The average number of injections per person per year was calculated to be 2.37. Health care workers (34.8%), staff of medical dispensaries (37.7%), physicians (25.2%), and traditional healers (2.3%) were consulted by the respondents for their basic health care needs and for injections. Compared to urban respondents, more rural respondents preferred injections for fever (p injections due to injections being perceived by them as being powerful, fast-acting, and longer lasting than oral pills. More than 82% of respondents were aware of, and named, at least one disease transmitted by using unsterile syringes during injection administration or when syringes are shared between people. Less preference for injections and high awareness about the association between injections and injection

High power neutral beam injection in LHD

International Nuclear Information System (INIS)

Tsumori, K.; Takeiri, Y.; Nagaoka, K.

2005-01-01

The results of high power injection with a neutral beam injection (NBI) system for the large helical device (LHD) are reported. The system consists of three beam-lines, and two hydrogen negative ion (H - ion) sources are installed in each beam-line. In order to improve the injection power, the new beam accelerator with multi-slot grounded grid (MSGG) has been developed and applied to one of the beam-lines. Using the accelerator, the maximum powers of 5.7 MW were achieved in 2003 and 2004, and the energy of 189 keV reached at maximum. The power and energy exceeded the design values of the individual beam-line for LHD. The other beam-lines also increased their injection power up to about 4 MW, and the total injection power of 13.1 MW was achieved with three beam-lines in 2003. Although the accelerator had an advantage in high power beam injection, it involved a demerit in the beam focal condition. The disadvantage was resolved by modifying the aperture shapes of the steering grid. (author)

"The first shot": the context of first injection of illicit drugs, ongoing injecting practices, and hepatitis C infection in Rio de Janeiro, Brazil

Directory of Open Access Journals (Sweden)

Maria de Lourdes Aguiar Oliveira

Full Text Available The context of first drug injection and its association with ongoing injecting practices and HCV (hepatitis C virus infection were investigated. Injection drug users (IDUs (N = 606 were recruited in "drug scenes" (public places, bars in Rio de Janeiro, Brazil, interviewed, and tested for HCV. Sharing of needles/syringes was more prevalent at the first injection (51.3% than at the baseline interview (36.8%. Those who shared syringes/needles at first injection were more likely to be currently engaged in direct/indirect sharing practices. Among young injectors (< 30 years, those reporting sharing of needles/ syringes at the first injection were about four times more likely to have been infected by HCV. Hepatitis C virus prevalence among active IDUs (n = 272 was 11%. Prison history and longer duration of drug injection were identified as independent predictors of HCV infection. To effectively curb HCV transmission among IDUs and minimize harms associated with risk behaviors, preventive strategies should target individuals initiating drug injection beginning with their very first injection and discourage the transition from non-injecting use to the self-injection of illicit drugs.

The association between neighborhood socioeconomic disadvantage and high-risk injection behavior among people who inject drugs.

Science.gov (United States)

DeCuir, Jennifer; Lovasi, Gina S; El-Sayed, Abdulrahman; Lewis, Crystal Fuller

2018-02-01

Although much research has been conducted on the determinants of HIV risk behavior among people who inject drugs (PWID), the influence of the neighborhood context on high-risk injection behavior remains understudied. To address this gap in the literature, we measured associations between neighborhood socioeconomic disadvantage and high-risk injection behavior, and determined whether these associations were modified by drug-related police activity and syringe exchange program (SEP) accessibility. Our sample was comprised of 484 pharmacy-recruited PWID in New York City. Measures of neighborhood socioeconomic disadvantage were created using data from the 2006-2010 American Community Survey. Associations with high-risk injection behavior were estimated using multivariable Poisson regression. Effect modification by drug-related police activity and SEP accessibility was assessed by entering cross-product terms into adjusted models of high-risk injection behavior. Neighborhood socioeconomic disadvantage was associated with decreased receptive syringe sharing and unsterile syringe use. In neighborhoods with high drug-related police activity, associations between neighborhood disadvantage and unsterile syringe use were attenuated to the null. In neighborhoods with high SEP accessibility, neighborhood disadvantage was associated with decreased acquisition of syringes from an unsafe source. PWID in disadvantaged neighborhoods reported safer injection behaviors than their counterparts in neighborhoods that were relatively better off. The contrasting patterns of effect modification by SEP accessibility and drug-related police activity support the use of harm reduction approaches over law enforcement-based strategies for the control of blood borne virus transmission among PWID in disadvantaged urban areas. Copyright © 2017 Elsevier B.V. All rights reserved.

Incidence of plantar fascia ruptures following corticosteroid injection.

Science.gov (United States)

Kim, Chul; Cashdollar, Michael R; Mendicino, Robert W; Catanzariti, Alan R; Fuge, LaDonna

2010-12-01

Plantar fasciitis is commonly treated with corticosteroid injections to decrease pain and inflammation. Therapeutic benefits often vary in terms of efficacy and duration. Rupture of the plantar fascia has been reported as a possible complication following corticosteroid injection. A retrospective chart review of 120 patients who received corticosteroid injection for plantar fasciitis was performed at the authors' institution to determine the incidence of plantar fascia rupture. The plantar fascia rupture was diagnosed clinically and confirmed with magnetic resonance imaging. Various factors were analyzed, including the number of injections, interval between injections, body mass index (BMI), and activity level. Four patients (2.4%) consequently experienced plantar fascia rupture following an average of 2.67 injections. The average BMI of these patients was 38.6 kg/m². The authors conclude that corticosteroid injection therapy appears to be a safe and effective form of nonoperative treatment with minimal complications and a relatively low incident of plantar fascia rupture.

Embolic stroke associated with injection of buprenorphine tablets.

Science.gov (United States)

Lim, C C Tchoyoson; Lee, Sze Haur; Wong, Yee-Choon; Hui, Francis

2009-09-15

Drug users who crush, dissolve, and inject buprenorphine tablets parenterally may be at risk of severe thromboembolic complications or death. We describe patients with neurologic complications after injecting buprenorphine tablets. Brain MRI including diffusion-weighted imaging (DWI) in patients admitted to the neurologic department after injecting buprenorphine tablets were reviewed. Seven men had neurologic complications after buprenorphine tablet injection. In 5 patients, multiple small scattered hyperintense lesions were detected on DWI in the cortex, white matter, and basal ganglia of the cerebral hemisphere; one patient had a single small lesion. The side of MRI abnormality corresponded to the side of needle marks on the neck except in one patient who had bilateral injections. One patient, who denied injecting into the neck, had DWI abnormalities in the middle cerebral artery territory on one side and occlusion of the ipsilateral internal carotid artery. Buprenorphine tablets can be intentionally or inadvertently injected into the carotid artery, causing a characteristic appearance on diffusion-weighted imaging, consistent with embolic cerebral infarction.

Automated injection of slurry samples in flow-injection analysis

NARCIS (Netherlands)

Hulsman, M.H.F.M.; Hulsman, M.; Bos, M.; van der Linden, W.E.

1996-01-01

Two types of injectors are described for introducing solid samples as slurries in flow analysis systems. A time-based and a volume-based injector based on multitube solenoid pinch valves were built, both can be characterized as hydrodynamic injectors. Reproducibility of the injections of dispersed

Single-needle temporomandibular joint arthrocentesis with hyaluronic acid injections. Preliminary data after a five-injection protocol.

Science.gov (United States)

Manfredini, D; Guarda-Nardini, L; Ferronato, G

2009-10-01

The classical technique for temporomandibular joint (TMJ) arthrocentesis provides a double access to the joint space, which may lead to patient's postoperatory discomfort. For this reason, a less invasive, single-needle approach has been recently described, and the present investigation reports findings on a case series of patients with TMJ osteoarthritis treated with hyaluronic acid injections following a single needle arthrocentesis. METHODS. Fourteen consecutive patients with a diagnosis of TMJ osteoarthritis according to the Research Diagnostic Criteria for Temporo-mandibular Disorders were treated with a cycle of five weekly injections of hyaluronic acid after arthrocentesis. A number of subjective (pain at rest and mastication, masticatory efficiency, functional limitation, subjective efficacy of treatment, tolerability of treatment) and objective (maximum assisted and unassited mouth opening, protrusive and laterotrusive movements) outcome variables were assessed before and after the treatment period. At the end of the five-injection protocol, significant improvements were showed in almost all the subjective outcome variables. Tolerability of the treatment was good on a four-point ordinal scale since the time of the first injection. The present investigation suggested that the single needle technique for TMJ hyaluronic injection following arthrocentesis in osteoarthritic joints may have promising applications in the clinical setting, which have to be confirmed with future studies.

Creating fluid injectivity in tar sands formations

Science.gov (United States)

Stegemeier, George Leo; Beer, Gary Lee; Zhang, Etuan

2010-06-08

Methods for treating a tar sands formation are described herein. Methods for treating a tar sands may include heating a portion of a hydrocarbon layer in the formation from one or more heaters located in the portion. The heat may be controlled to increase the permeability of at least part of the portion to create an injection zone in the portion with an average permeability sufficient to allow injection of a fluid through the injection zone. A drive fluid and/or an oxidizing fluid may be provided into the injection zone. At least some hydrocarbons are produced from the portion.

The staying safe intervention: training people who inject drugs in strategies to avoid injection-related HCV and HIV infection.

Science.gov (United States)

Mateu-Gelabert, Pedro; Gwadz, Marya Viorst; Guarino, Honoria; Sandoval, Milagros; Cleland, Charles M; Jordan, Ashly; Hagan, Holly; Lune, Howard; Friedman, Samuel R

2014-04-01

This pilot study explores the feasibility and preliminary efficacy of the Staying Safe Intervention, an innovative, strengths-based program to facilitate prevention of infection with the human immunodeficiency virus and with the hepatitis C virus among people who inject drugs (PWID). The authors explored changes in the intervention's two primary endpoints: (a) frequency and amount of drug intake, and (b) frequency of risky injection practices. We also explored changes in hypothesized mediators of intervention efficacy: planning skills, motivation/self-efficacy to inject safely, skills to avoid PWID-associated stigma, social support, drug-related withdrawal symptoms, and injection network size and risk norms. A 1-week, five-session intervention (10 hours total) was evaluated using a pre- versus 3-month posttest design. Fifty-one participants completed pre- and posttest assessments. Participants reported significant reductions in drug intake and injection-related risk behavior. Participants also reported significant increases in planning skills, motivation/self-efficacy, and stigma management strategies, while reducing their exposure to drug withdrawal episodes and risky injection networks.

Effect of main injection timing for controlling the combustion phasing of a homogeneous charge compression ignition engine using a new dual injection strategy

International Nuclear Information System (INIS)

Das, Pranab; Subbarao, P.M.V.; Subrahmanyam, J.P.

2015-01-01

Highlights: • A new dual injection concept is developed by minimum geometry modification. • The occurrence of combustion parameters strongly depend on main injection timing. • At higher load, premixed equivalence ratio dominates over main injection timing. • Retarded of main injection timing tends to retard combustion phasing. • Slightly retarded main injection timing is recommended to avoid intense knocking. - Abstract: Homogeneous charge compression ignition combustion of diesel fuel is implemented using a novel dual injection strategy. A new experimental technique is developed to modify a single cylinder direct injection diesel engine to run on homogeneous combustion mode. Effect of main injection timing is investigated covering a range from 26 to 8 crank angle degrees before top dead center with an interval of 3°. Retarded main injection timing is identified as a control strategy for delaying combustion phasing and a means of controlled combustion phasing of direct injection homogeneous charge compression ignition combustion. Two load conditions were investigated and it was observed that at higher load, start of combustion depends more on fuel air equivalence ratio than main injection timing, whereas at low load, it significantly varies with varying main injection timing. Significant improvements in smoke and oxides of nitrogen emissions are observed when compared with the baseline conventional combustion. By studying different combustion parameters, it is observed that there is an improvement in performance and emissions with marginal loss in thermal efficiency when the main injection timing is 20° before top dead center. This is identified as the optimum main injection timing for such homogeneous combustion under the same operating condition

Reverse-Tangent Injection in a Centrifugal Compressor

Science.gov (United States)

Skoch, Gary J.

2007-01-01

Injection of working fluid into a centrifugal compressor in the reverse tangent direction has been invented as a way of preventing flow instabilities (stall and surge) or restoring stability when stall or surge has already commenced. The invention applies, in particular, to a centrifugal compressor, the diffuser of which contains vanes that divide the flow into channels oriented partly radially and partly tangentially. In reverse-tangent injection, a stream or jet of the working fluid (the fluid that is compressed) is injected into the vaneless annular region between the blades of the impeller and the vanes of the diffuser. As used here, "reverse" signifies that the injected flow opposes (and thereby reduces) the tangential component of the velocity of the impeller discharge. At the same time, the injected jet acts to increase the radial component of the velocity of the impeller discharge.

Dexrazoxane Injection

Science.gov (United States)

... are used to treat or prevent certain side effects that may be caused by chemotherapy medications. Dexrazoxane injection (Zinecard) is used to prevent or decrease heart damage caused by doxorubicin in women who are taking the medication to treat breast cancer that has spread to other parts of the ...

Magnetic detection of ferrofluid injection zones

Energy Technology Data Exchange (ETDEWEB)

Borglin, S.; Moridis, G.; Becker, A.

1998-03-01

Ferrofluids are stable colloidal suspensions of magnetic particles that can be stabilized in various carrier liquids. In this study the authors investigate the potential of ferrofluids to trace the movement and position of liquids injected in the subsurface using geophysical methods. An ability to track and monitor the movement and position of injected liquids is essential in assessing the effectiveness of the delivery system and the success of the process. Ferrofluids can also provide a significant detection and verification tool in containment technologies, where they can be injected with the barrier liquids to provide a strong signature allowing determination of the barrier geometry, extent, continuity and integrity. Finally, ferrofluids may have unique properties as tracers for detecting preferential flow features (such as fractures) in the subsurface, and thus allow the design of more effective remediation systems. In this report the authors review the results of the investigation of the potential of ferrofluids to trace the movement and position of liquids injected in the subsurface using geophysical methods. They demonstrate the feasibility of using conventional magnetometry for detecting subsurface zones of injected ferrofluids used to trace liquids injected for remediation or barrier formation. The geometrical shapes considered were a sphere, a thin disk, a rectangular horizontal slab, and a cylinder. Simple calculations based on the principles of magnetometry are made to determine the detection depths of FTs. Experiments involving spherical, cylindrical and horizontal slabs show a very good agreement between predictions and measurements.

Diagnosing the PEP-II Injection System

Energy Technology Data Exchange (ETDEWEB)

Decker, F.-J.; Donald, M.H.; Iverson, R.H.; Kulikov, A.; Pappas, G.C.; Weaver, M.; /SLAC

2005-05-09

The injection of beam into the PEP-II B-Factory, especially into the High Energy Ring (HER) has some challenges. A high background level in the BaBar detector has for a while inhibited us from trickling charge into the HER similar to the Low Energy Ring (LER). Analyzing the injection system has revealed many issues which could be improved. The injection bump between two kickers was not closed, mainly because the phase advance wasn't exactly 180{sup o} and the two kicker strengths were not balanced. Additionally we found reflections which kick the stored beam after the main kick and cause the average luminosity to drop about 3% for a 10 Hz injection rate. The strength of the overall kick is nearly twice as high as the design, indicating a much bigger effective septum thickness. Compared with single beam the background is worse when the HER beam is colliding with the LER beam. This hints that the beam-beam force and the observed vertical blow-up in the HER pushes the beam and especially the injected beam further out to the edge of the dynamic aperture or beyond.

Diagnosing the PEP-II Injection System

International Nuclear Information System (INIS)

Decker, F.-J.; Donald, M.H.; Iverson, R.H.; Kulikov, A.; Pappas, G.C.; Weaver, M.; SLAC

2005-01-01

The injection of beam into the PEP-II B-Factory, especially into the High Energy Ring (HER) has some challenges. A high background level in the BaBar detector has for a while inhibited us from trickling charge into the HER similar to the Low Energy Ring (LER). Analyzing the injection system has revealed many issues which could be improved. The injection bump between two kickers was not closed, mainly because the phase advance wasn't exactly 180 o and the two kicker strengths were not balanced. Additionally we found reflections which kick the stored beam after the main kick and cause the average luminosity to drop about 3% for a 10 Hz injection rate. The strength of the overall kick is nearly twice as high as the design, indicating a much bigger effective septum thickness. Compared with single beam the background is worse when the HER beam is colliding with the LER beam. This hints that the beam-beam force and the observed vertical blow-up in the HER pushes the beam and especially the injected beam further out to the edge of the dynamic aperture or beyond

The biological effects of radium-224 injected into dogs

International Nuclear Information System (INIS)

Muggenburg, B.A.; Hahn, F.F.; Boecker, B.B.

1996-01-01

A life-span study was conducted in 128 beagle dogs to determine the biological effects of intravenously injected 224 Ra chloride. The 224 Ra chloride was prepared by the same method used for intravenous injections in humans who were treated for ankylosing spondylitis and tuberculosis. Thus the results obtained from dogs can be compared directly to the population of treated humans, both for the elucidation of the effect of exposure rate and for comparison with other radionuclides for which data for humans are unavailable. Using equal numbers of males and females, the dogs were injected with one of four levels of 224 Ra resulting in initial body burdens of approximately 13, 40, 120 or 350 kBq of 224 Ra kg -1 body mass. A control group of dogs was injected with diluent only. All dogs were divided further into three groups for which the amount of injected 224 Ra (half-life of 3.62 days) or diluent was given in a single injection or divided equally into 10 or 50 weekly injections. As a result of these three injection schedules, the accumulation of dose from the injected 224 Ra was distributed over approximately 1, 3 or 12 months. Each injection schedule included four different injection levels resulting in average absorbed α-particle doses to bone of 0.1, 0.3, 1 and 3 Gy, respectively. The primary early effect observed was a hematological dyscrasia in the dogs receiving either of the two highest injection levels. The effect was most severe in the dogs receiving a single injection of 224 Ra and resulted in the death of three dogs injected at the highest level. The late-occurring biological effects were tumors. Bone tumors were the most common followed by tumors in the nasal mucosa. 52 refs., 8 figs., 8 tabs

Effects of hypertonic dextrose injections in the rabbit carpal tunnel.

Science.gov (United States)

Yoshii, Yuichi; Zhao, Chunfeng; Schmelzer, James D; Low, Phillip A; An, Kai-Nan; Amadio, Peter C

2011-07-01

This study investigated the effects of different doses of hypertonic dextrose injection on the carpal tunnel subsynovial connective tissue (SSCT) and median nerve in a rabbit model. Thirty-eight New Zealand white rabbits weighing 4.0-4.5 kg were used. One forepaw carpal tunnel was randomly injected with one of five different treatments: saline-single injection; saline-two injections 1 week apart; 10% dextrose-single injection; 20% dextrose-single injection; or 10% dextrose-two injections 1 week apart. Animals were sacrificed at 12 weeks after the initial injection and were evaluated by electrophysiology (EP), SSCT mechanical testing and histology. There were significant increases in the energy absorption of the SSCT in the 10% dextrose-double injection group compared to the saline injection groups. SSCT stiffness was also significantly increased in the 10% dextrose-double injection group compared to the other groups. There was a significant increase in the thickness of the SSCT in the 10% dextrose-double injection group compared to the saline-single injection group and a significant decrease in the nerve short-long diameter ratio in the 10% dextrose-double injection group compared to the saline-single injection group. There were no changes in EP among the groups. SSCT fibrosis is present for up to 12 weeks after dextrose injection; multiple injections have bigger effects, including what appears to be a secondary change in nerve flattening. This model may be useful to study the effects of external fibrosis on nerve morphology and physiology, such as occurs clinically in carpal tunnel syndrome. Copyright © 2011 Orthopaedic Research Society.

Prevalence and Correlates of Heroin-Methamphetamine Co-Injection Among Persons Who Inject Drugs in San Diego, California, and Tijuana, Baja California, Mexico.

Science.gov (United States)

Meacham, Meredith C; Strathdee, Steffanie A; Rangel, Gudelia; Armenta, Richard F; Gaines, Tommi L; Garfein, Richard S

2016-09-01

Although persons who inject drugs (PWID) in the western United States-Mexico border region are known to inject both heroin and methamphetamine, little is known about the prevalence and risks associated with co-injection of this depressant-stimulant combination (also known as "goofball" and "Mexican speedball"). Baseline data from parallel cohort studies of PWID conducted concurrently in San Diego, CA, and Tijuana, Mexico, were used to estimate the prevalence and identify correlates of heroin-methamphetamine co-injection. PWID older than 18 years of age who reported injecting illicit drugs in the past month (N = 1,311; 32.7% female) were recruited in San Diego (n = 576) and Tijuana (n = 735) and completed interviewer-administered questionnaires. Bivariate and multivariable logistic regression analyses were used to identify correlates of heroin-meth-amphetamine co-injection. The prevalence of co-injection in the past 6 months was 39.9% overall and was higher in Tijuana (55.8%) than in San Diego (19.8%). In multivariable analyses adjusting for study cohort, distributive syringe sharing, purchasing syringes prefilled with drugs, finding it hard to get new syringes, reporting great or urgent need for treatment, and younger age were independently associated with co-injection. Past-6-month overdose was significantly associated with higher odds of co-injection in San Diego than in Tijuana. These findings indicate that heroin-methamphetamine co-injection is more common in Tijuana than in San Diego, yet this practice was only associated with overdose in San Diego. Heroin-methamphetamine coinjection was also independently associated with HIV-associated injection risk behaviors. Overdose-prevention interventions should address co-injection of depressants and stimulants.

Update on the management of menometrorrhagia: new surgical approaches.

Science.gov (United States)

Fernandez, Hervé

2011-12-01

Hysterectomy has traditionally been the definitive surgical approach for heavy menstrual bleeding. However, the more modern concept of 'save the uterus' has led to new surgical approaches for the treatment of heavy menstrual bleeding, based on second-generation endometrial destruction (ablation/resection) techniques, including microwave endometrial ablation, thermal balloon endometrial ablation, radiofrequency electrosurgery, hydrothermal ablation and cryoablation. As pregnancy following endometrial ablation is still possible, we proposed to combine endometrial ablation and sterilization with Essure(®) micro-inserts in women with confirmed menometrorrhagia and the desire, or medical need, for permanent tubal sterilization. Although large diameter resectoscopy provides excellent results in the surgical treatment of myomas, the technique requires dilation of the cervical canal (difficult in nulliparous or menopausal patients), and requires general or epidural anaesthesia and, therefore, must be performed in an operating theatre. A major advance in terms of hysteroscopic procedures is the 'see and treat' approach (i.e. when performing an initial diagnostic hysteroscopy, it is now possible to treat the pathology concurrently). Newer hysteroscopic techniques, often not requiring anaesthesia or analgesia, include OPPIuM (Office Preparation of Partially Intramural Myomas) and use of a mini-resectoscope, allowing office diagnostic-operative hysteroscopic procedures.

Comparison of the degree of pulpal anesthesia achieved with the intraosseous injection and infiltration injection using 2% lidocaine with 1:100,000 epinephrine.

Science.gov (United States)

Nusstein, John; Wood, Mark; Reader, Al; Beck, Mike; Weaver, Joel

2005-01-01

This prospective, randomized study compared the degree of pulpal anesthesia obtained from an intraosseous injection to an infiltration injection that used 2% lidocaine with 1:100,000 epinephrine. The success rate for the intraosseous injection was 98%; for the infiltration injection, the success rate was 85%. There was no significant difference between the two techniques. The mean time for the onset of pulpal anesthesia was significantly faster with the intraosseous injection and the infiltration injection resulted in a significantly longer duration of pulpal anesthesia.

Large scale injection test (LASGIT) modelling

International Nuclear Information System (INIS)

Arnedo, D.; Olivella, S.; Alonso, E.E.

2010-01-01

Document available in extended abstract form only. With the objective of understanding the gas flow processes through clay barriers in schemes of radioactive waste disposal, the Lasgit in situ experiment was planned and is currently in progress. The modelling of the experiment will permit to better understand of the responses, to confirm hypothesis of mechanisms and processes and to learn in order to design future experiments. The experiment and modelling activities are included in the project FORGE (FP7). The in situ large scale injection test Lasgit is currently being performed at the Aespoe Hard Rock Laboratory by SKB and BGS. An schematic layout of the test is shown. The deposition hole follows the KBS3 scheme. A copper canister is installed in the axe of the deposition hole, surrounded by blocks of highly compacted MX-80 bentonite. A concrete plug is placed at the top of the buffer. A metallic lid anchored to the surrounding host rock is included in order to prevent vertical movements of the whole system during gas injection stages (high gas injection pressures are expected to be reached). Hydration of the buffer material is achieved by injecting water through filter mats, two placed at the rock walls and two at the interfaces between bentonite blocks. Water is also injected through the 12 canister filters. Gas injection stages are performed injecting gas to some of the canister injection filters. Since the water pressure and the stresses (swelling pressure development) will be high during gas injection, it is necessary to inject at high gas pressures. This implies mechanical couplings as gas penetrates after the gas entry pressure is achieved and may produce deformations which in turn lead to permeability increments. A 3D hydro-mechanical numerical model of the test using CODE-BRIGHT is presented. The domain considered for the modelling is shown. The materials considered in the simulation are the MX-80 bentonite blocks (cylinders and rings), the concrete plug

Trends and perspectives of flow injection/sequential injection on-line sample-pretreatment schemes coupled to ETAAS

DEFF Research Database (Denmark)

Wang, Jianhua; Hansen, Elo Harald

2005-01-01

Flow injection (FI) analysis, the first generation of this technique, became in the 1990s supplemented by its second generation, sequential injection (SI), and most recently by the third generation (i.e.,Lab-on-Valve). The dominant role played by FI in automatic, on-line, sample pretreatments in ...

Class I Underground Injection Control Program: Study of the Risks Associated with Class I Underground Injection Wells

Science.gov (United States)

The document provides describes the current Class I UIC program, the history of Class I injection, and studies of human health risks associated with Class I injection wells, which were conducted for past regulatory efforts and policy documentation.

[THREE CASES OF ACCIDENTAL AUTO-INJECTION OF ADRENALINE].

Science.gov (United States)

Yanagida, Noriyuki; Iikura, Katsuhito; Ogura, Kiyotake; Wang, Ling-jen; Asaumi, Tomoyuki; Sato, Sakura; Ebisawa, Motohiro

2015-12-01

Reports on accidental auto-injection of adrenaline are few. We encountered three cases of accidental injection of adrenaline. In this study, we have examined and reported the clinical courses and symptoms of our cases. CASE 1 involved a female physician in her 50s who had attended an explanatory meeting on auto-injection of adrenaline. She mistook EpiPen® to be the EpiPen trainer and accidentally injected herself with 0.3 mg EpiPen®. Her systolic/diastolic pressure peaked at 7 min to reach 144/78 mmHg and decreased to 120/77 mmHg at 14 min. Except for palpitation after 7 min, the only subjective symptom was local pain at the injection site. CASE 2 was noted in a 6-year-old boy. He accidentally pierced his right forefinger with 0.15 mg EpiPen®, and after 20 min, his right forefinger was swollen. The swelling improved 80 min after the accidental injection. CASE 3 was noted in a 4-year-old girl. She accidentally injected herself with 0.15 mg EpiPen®. Her systolic/diastolic pressure peaked at 23 min to reach 123/70 mmHg and decreased to 96/86 mmHg at 28 min. Severe adverse effects of accidental auto-injection of adrenaline were not observed in these three cases. Our findings suggest that while handling adrenaline auto-injectors, we should keep in mind the possibility of accidental injection.

Effectiveness of Hysteroscopic Repair of Uterine Lesions in Reproductive Outcome

Directory of Open Access Journals (Sweden)

Ebrahim Cheraghi

2014-07-01

Full Text Available Background: Studies have demonstrated the efficacy of metformin (MTF in reducing insulin resistance and N-acetyl cysteine (NAC in inhibiting oxidative stress which are involved in the pathogenesis of polycystic ovarian syndrome (PCOS. We aimed to compare the effects of MTF and NAC combination on serum metabolite and hormonal levels during the course of ovulation induction in PCOS individual candidates of intracytoplasmic sperm injection (ICSI. Materials and Methods: In this prospective randomized clinical trial, placebo controlled pilot study, 80 patients of polycystic ovarian syndrome at the age of 25-35 years were divided into 4 groups (n=20: i. NAC=treated with N-acetyl cysteine (600 mg three times daily, ii. MTF=treated with metformin (500 mg three times daily, iii. MTF+NAC=treated with N-acetyl cysteine plus metformin (the offered doses and iv. placebo (PLA. A total number of 20 patients (6 from MTF group, 4 from NAC group, 6 from MTF+NAC group and 4 from PLA group were dropped of the study. The drugs were administrated from day 3 of menses of previous cycle until ovum pick-up. Results: Serum levels of luteinizing hormone (LH, total testosterone, cholesterol and triglyceride, insulin and leptin significantly reduced in the MTF and NAC groups compared to the placebo (p<0.01. But levels of LH, total testosterone, cholesterol and triglyceride had no significant reduction in the MTF+NAC groups compared to the placebo. The serum levels of malonyldialdehyde (MDA, insulin and leptin reduced significantly after treatment in the MTF+NAC group compared to the placebo (p<0.05. Conclusion: Considering the adverse effect of combination therapy, we proposed the conadministration might have no beneficial effect for PCOS patient during course of ovulation induction of ICSI (Registration Number: IRCT201204159476N1.

Digital Twin concept for smart injection molding

Science.gov (United States)

Liau, Y.; Lee, H.; Ryu, K.

2018-03-01

Injection molding industry has evolved over decades and became the most common method to manufacture plastic parts. Monitoring and improvement in the injection molding industry are usually performed separately in each stage, i.e. mold design, mold making and injection molding process. However, in order to make a breakthrough and survive in the industrial revolution, all the stages in injection molding need to be linked and communicated with each other. Any changes in one stage will cause a certain effect in other stage because there is a correlation between each other. Hence, the simulation should not only based on the input of historical data, but it also needs to include the current condition of equipment and prediction of future events in other stages to make the responsive decision. This can be achieved by implementing the concept of Digital Twin that models the entire process as a virtual model and enables bidirectional control with the physical process. This paper presented types of data and technology required to build the Digital Twin for the injection molding industry. The concept includes Digital Twin of each stage and integration of these Digital Twin model as a thoroughgoing model of the injection molding industry.

Injection system of compact SR light source 'AURORA'

International Nuclear Information System (INIS)

Takayama, Takeshi; Yano, Takashi; Sasaki, Yasushi; Yasumitsu, Naoki

1991-01-01

A half-integer-resonance injection method is introduced for a superconducting SR-ring of 1 m orbit diameter, which is made of a weak focussing single-body magnet. The present method makes it possible to inject an electron beam of an energy of as high as 150 MeV into the ring of a magnetic field strength of 1 T. Several new injection devices are introduced in order to guide the beam under the strong magnetic fringing field, and to excite the half-integer-resonance. The field index of 0.73 is selected for the half-integer-resonance injection. The field index of 0.35 at the maximum magnetic field strength of 4.3 T is to get a sufficiently long quantum lifetime. A new device named resonance jumper is used to pass quickly several resonances of betatron motion without beam loss. The resonances occur when the magnetic field is ramped up and the field index decreases from 0.73 to 0.35. The injection devices except the inflector are air-core magnets in order to work in the strong magnetic field. In November of 1989, the beam was successfully injected and stored. The injection devices and the half-integer-resonance injection method were established. (author)

An update on blast furnace granular coal injection

Energy Technology Data Exchange (ETDEWEB)

Hill, D.G. [Bethlehem Steel Corp., Burns Harbor, IN (United States); Strayer, T.J.; Bouman, R.W. [Bethlehem Steel Corp., PA (United States)

1997-12-31

A blast furnace coal injection system has been constructed and is being used on the furnace at the Burns Harbor Division of Bethlehem Steel. The injection system was designed to deliver both granular (coarse) and pulverized (fine) coal. Construction was completed on schedule in early 1995. Coal injection rates on the two Burns Harbor furnaces were increased throughout 1995 and was over 200 lbs/ton on C furnace in September. The injection rate on C furnace reached 270 lbs/ton by mid-1996. A comparison of high volatile and low volatile coals as injectants shows that low volatile coal replaces more coke and results in a better blast furnace operation. The replacement ratio with low volatile coal is 0.96 lbs coke per pound of coal. A major conclusion of the work to date is that granular coal injection performs very well in large blast furnaces. Future testing will include a processed sub-bituminous coal, a high ash coal and a direct comparison of granular versus pulverized coal injection.

Advanced diesel electronic fuel injection and turbocharging

Science.gov (United States)

Beck, N. J.; Barkhimer, R. L.; Steinmeyer, D. C.; Kelly, J. E.

1993-12-01

The program investigated advanced diesel air charging and fuel injection systems to improve specific power, fuel economy, noise, exhaust emissions, and cold startability. The techniques explored included variable fuel injection rate shaping, variable injection timing, full-authority electronic engine control, turbo-compound cooling, regenerative air circulation as a cold start aid, and variable geometry turbocharging. A Servojet electronic fuel injection system was designed and manufactured for the Cummins VTA-903 engine. A special Servojet twin turbocharger exhaust system was also installed. A series of high speed combustion flame photos was taken using the single cylinder optical engine at Michigan Technological University. Various fuel injection rate shapes and nozzle configurations were evaluated. Single-cylinder bench tests were performed to evaluate regenerative inlet air heating techniques as an aid to cold starting. An exhaust-driven axial cooling air fan was manufactured and tested on the VTA-903 engine.

Nicolau Syndrome after Intramuscular Injection: 3 Cases

Directory of Open Access Journals (Sweden)

Seok-Kwun Kim

2012-05-01

Full Text Available Nicolau syndrome is a rare complication of intramuscular injection consisting of ischemic necrosis of skin, soft tissue, and muscular tissue that arises locoregionally. The characteristic pattern is pain around the injection site, developing into erythema, a livedoid dermatitis patch, and necrosis of the skin, subcutaneous fat, and muscle tissue. Three patients were injected with drugs (diclofenac sodium, ketoprofen, meperidine for pain relief. Three patients complained of pain, and a skin lesion was observed, after which necrosis developed on their buttocks. Each patient underwent debridement and coverage. The wound healed uneventfully. We report three cases of Nicolau syndrome in the buttocks following diclofenac intramuscular injection.

DC injection into low voltage AC networks

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-07-01

This report summarises the results of a study investigating the impact of levels of injected DC current injections on a low voltage AC distribution network systems in order to recommend acceptable limits of DC from microgeneration. Relevant literature is reviewed, and the impact of DC levels in distribution transformers, transformer modelling, and instrumental transformers are discussed. The impact of DC in residual current devices (RCD) and in domestic electricity watt hour meters is examined along with DC enhanced corrosion, corrosion failure, and the measurement of DC current injection. Sources of DC injection outlined include DC from computer power supplies, network faults, geomagnetic phenomena, lighting circuits/dimmers, and embedded generators.

Injective Labeled Oriented Trees are Aspherical

OpenAIRE

Harlander, Jens; Rosebrock, Stephan

2012-01-01

A labeled oriented tree is called injective if each generator occurs at most once as an edge label. We show that injective labeled oriented trees are aspherical. The proof relies on a new relative asphericity test based on a lemma of Stallings.

Steam injections wells: topics to consider in casing design of steam injection wells; Revestimento para pocos de vapor

Energy Technology Data Exchange (ETDEWEB)

Conceicao, Antonio Carlos Farias [PETROBRAS, Recife, PE (Brazil). Gerencia de Perfuracao do Nordeste. Div. de Operacoes

1994-07-01

Steam injection is one of the processes used to increase production from very viscous oil reservoirs. A well is completed at a temperature of about 110 deg F and during steam injection that temperature varies around 600 deg F. Strain or breakdowns may occur to the casing, due to the critical conditions generated by the change of temperature. The usual casing design methods, do not take into account special environmental conditions, such as those which exist for steam injection. From the results of this study we come up to the conclusion that casing grade K-55, heavy weight with premium connections, without pre-stressing and adequately heated, is the best option for steam injection well completion for most of the fields in Brazil. (author)

Post-injection delirium/sedation syndrome in patients with schizophrenia treated with olanzapine long-acting injection, II: investigations of mechanism

Directory of Open Access Journals (Sweden)

Stickelmeyer Mary

2010-06-01

Full Text Available Abstract Background Olanzapine long-acting injection (LAI is a salt-based depot antipsychotic combining olanzapine and pamoic acid. The slow intramuscular dissolution of this practically insoluble salt produces an extended release of olanzapine lasting up to 4 weeks. However, in a small number of injections ( Methods Healthcare providers involved in the PDSS cases were queried for clinical information around the events. Plasma samples from patients experiencing PDSS were collected when possible (12/30 cases and olanzapine concentrations compared with the known pharmacokinetic profile for olanzapine LAI. Product batches and used vials from the PDSS cases were evaluated for compliance with established manufacturing standards and/or possible user error. Because this depot formulation depends upon slow dissolution at the intramuscular injection site, in-vitro experiments were conducted to assess solubility of olanzapine pamoate in various media. Results Injection administrators reported no unusual occurrences during the injection. No anomalies were found with the product batches or the remaining suspension in the used vials. Olanzapine concentrations during PDSS events were higher than the expected 5-73 ng/mL range, with concentrations exceeding 100 ng/mL and in some cases reaching >600 ng/mL during the first hours after injection but then returning to the expected therapeutic range within 24 to 72 hours. Solubility and dissolution rate of olanzapine pamoate were also found to be substantially greater in plasma than in other media such as those approximating the environment in muscle tissue. Conclusions Manufacturing irregularities, improper drug reconstitution, and inappropriate dosing were ruled out as possible causes of PDSS. In-vitro solubility and in-vivo pharmacokinetic investigations suggest that PDSS is related to exposure of the injected product to a substantial volume of blood. This exposure is most likely the result of unintended partial

Failure of botulinum toxin injection for neurogenic detrusor overactivity: Switch of toxin versus second injection of the same toxin.

Science.gov (United States)

Peyronnet, Benoit; Castel-Lacanal, Evelyne; Manunta, Andréa; Roumiguié, Mathieu; Marque, Philippe; Rischmann, Pascal; Gamé, Xavier

2015-12-01

To evaluate the efficacy of a second injection of the same toxin versus switching to a different botulinum toxin A after failure of a first detrusor injection in patients with neurogenic detrusor overactivity. The charts of all patients who underwent detrusor injections of botulinum toxin A (either abobotulinumtoxinA or onabotulinumtoxinA) for the management of neurogenic detrusor overactivity at a single institution were retrospectively reviewed. Patients in whom a first detrusor injection had failed were included in the present study. They were managed by a second injection of the same toxin at the same dosage or by a new detrusor injection using a different botulinum toxin A. Success was defined as a resolution of urgency, urinary incontinence and detrusor overactivity in a patient self-catheterizing seven times or less per 24 h. A total of 58 patients were included for analysis. A toxin switch was carried out in 29 patients, whereas the other 29 patients received a reinjection of the same toxin at the same dose. The success rate was higher in patients who received a toxin switch (51.7% vs. 24.1%, P = 0.03). Patients treated with a switch from abobotulinumtoxinA to onabotulinumtoxinA and those treated with a switch from onabotulinumtoxinA to abobotulinumtoxinA had similar success rates (52.9% vs. 50%, P = 0.88). After failure of a first detrusor injection of botulinum toxin for neurogenic detrusor overactivity, a switch to a different toxin seems to be more effective than a second injection of the same toxin. The replacement of onabotulinumtoxin by abobotulinumtoxin or the reverse provides similar results. © 2015 The Japanese Urological Association.

Study of status of safe injection practice and knowledge regarding injection safety among primary health care workers in Baglung district, western Nepal.

Science.gov (United States)

Gyawali, Sudesh; Rathore, Devendra S; Kc, Bhuvan; Shankar, P Ravi

2013-01-03

Unsafe injection practices and injection overuse are widespread in developing countries harming the patient and inviting risks to the health care workers. In Nepal, there is a dearth of documented information about injection practices so the present study was carried out: a) to determine whether the selected government health facilities satisfy the conditions for safe injections in terms of staff training, availability of sterile injectable equipment and their proper disposal after use and b) to assess knowledge and attitudes of healthcare workers in these health care facilities with regard to injection safety. A descriptive cross-sectional mixed type (qualitative and quantitative) survey was carried out from 18th May to 16th June 2012. In-depth interviews with the in-charges were conducted using a semi-structured questionnaire. Observation of the health facilities using a structured observation tool was done. The data were analysed manually by summarizing, tabulating and presenting in various formats. The in-charges (eight males, two females) who participated in the study ranged in age from 30 to 50 years with a mean age of 37.8 years. Severe infection followed by pain was the most important cause for injection use with injection Gentamicin being most commonly prescribed. New single use (disposable) injections and auto-disable syringes were used to inject curative drugs and vaccines respectively. Sufficient safety boxes were also supplied to dispose the used syringe. All health care workers had received full course of Hepatitis B vaccine and were knowledgeable about at least one pathogen transmitted through unsafe injection practices. Injection safety management policy and waste disposal guideline was not available for viewing in any of the facilities. The office staff who disposed the bio-medical wastes did so without taking any safety measures. Moreover, none of these staff had received any formal training in waste management. Certain safe injection

Study of status of safe injection practice and knowledge regarding injection safety among primary health care workers in Baglung district, western Nepal

Directory of Open Access Journals (Sweden)

Gyawali Sudesh

2013-01-01

Full Text Available Abstract Background Unsafe injection practices and injection overuse are widespread in developing countries harming the patient and inviting risks to the health care workers. In Nepal, there is a dearth of documented information about injection practices so the present study was carried out: a to determine whether the selected government health facilities satisfy the conditions for safe injections in terms of staff training, availability of sterile injectable equipment and their proper disposal after use and b to assess knowledge and attitudes of healthcare workers in these health care facilities with regard to injection safety. Methodology A descriptive cross-sectional mixed type (qualitative and quantitative survey was carried out from 18th May to 16th June 2012. In-depth interviews with the in-charges were conducted using a semi-structured questionnaire. Observation of the health facilities using a structured observation tool was done. The data were analysed manually by summarizing, tabulating and presenting in various formats. Results The in-charges (eight males, two females who participated in the study ranged in age from 30 to 50 years with a mean age of 37.8 years. Severe infection followed by pain was the most important cause for injection use with injection Gentamicin being most commonly prescribed. New single use (disposable injections and auto-disable syringes were used to inject curative drugs and vaccines respectively. Sufficient safety boxes were also supplied to dispose the used syringe. All health care workers had received full course of Hepatitis B vaccine and were knowledgeable about at least one pathogen transmitted through unsafe injection practices. Injection safety management policy and waste disposal guideline was not available for viewing in any of the facilities. The office staff who disposed the bio-medical wastes did so without taking any safety measures. Moreover, none of these staff had received any formal

Spin injection into GaAs

Energy Technology Data Exchange (ETDEWEB)

Endres, Bernhard

2013-11-01

In this work spin injection into GaAs from Fe and (Ga,Mn)As was investigated. For the realization of any spintronic device the detailed knowledge about the spin lifetime, the spatial distribution of spin-polarized carriers and the influence of electric fields is essential. In the present work all these aspects have been analyzed by optical measurements of the polar magneto-optic Kerr effect (pMOKE) at the cleaved edge of the samples. Besides the attempt to observe spin pumping and thermal spin injection into n-GaAs the spin solar cell effect is demonstrated, a novel mechanism for the optical generation of spins in semiconductors with potential for future spintronic applications. Also important for spin-based devices as transistors is the presented realization of electrical spin injection into a two-dimensional electron gas.

Systematic assessment of microneedle injection into the mouse cornea.

Science.gov (United States)

Matthaei, Mario; Meng, Huan; Bhutto, Imran; Xu, Qingguo; Boelke, Edwin; Hanes, Justin; Jun, Albert S

2012-06-20

Corneal intrastromal injection is an important mode of gene-vector application to subepithelial layers. In a mouse model, this procedure is substantially complicated by the reduced corneal dimensions. Furthermore, it may be difficult to estimate the corneal area reached by the volume of a single injection. This study aimed to investigate intrastromal injections into the mouse cornea using different microneedles and to quantify the effect of injecting varying volumes. A reproducible injection technique is described. Forty eyes of 20 129 Sv/J mice were tested. India ink was intrastromally injected using 30° beveled 33 G needles, tri-surface 25° beveled 35 G needles, or hand-pulled and 25° beveled glass needles. Each eye received a single injection of a volume of 1 or 2 μL. Corneoscleral buttons were fixed and flat mounted for computer-assisted quantification of the affected corneal area. Histological assessment was performed to investigate the intrastromal location of the injected dye. A mean corneal area of 5.0 ± 1.4 mm(2) (mean ± SD) and 7.7 ± 1.4 mm(2) was covered by intrastromal injections of 1 and 2 μL, respectively. The mean percentage of total corneal area reached ranged from 39% to 53% for 1 μL injections, and from 65% to 81% for 2 μL injections. Injections using the 33 G needles tended to provide the highest distribution area. Perforation rates were 8% for 30° beveled 33 G needles and 44% for tri-surface beveled 35 G needles. No perforation was observed with glass needle; however, intrastromal breakage of needle tips was noted in 25% of these cases. Intracorneal injection using a 30° beveled 33 G needle was safe and effective. The use of tri-surface beveled 35 G needles substantially increased the number of corneal perforations. Glass needles may break inside the corneal stroma. Injections of 1 μL and 2 μL resulted in an overall mean of 49% and 73% respectively of total corneal area involved.

A three-dimensional laboratory steam injection model allowing in situ saturation measurements. [Comparing steam injection and steam foam injection with nitrogen and without nitrogen

Energy Technology Data Exchange (ETDEWEB)

Demiral, B.M.R.; Pettit, P.A.; Castanier, L.M.; Brigham, W.E.

1992-08-01

The CT imaging technique together with temperature and pressure measurements were used to follow the steam propagation during steam and steam foam injection experiments in a three dimensional laboratory steam injection model. The advantages and disadvantages of different geometries were examined to find out which could best represent radial and gravity override flows and also fit the dimensions of the scanning field of the CT scanner. During experiments, steam was injected continuously at a constant rate into the water saturated model and CT scans were taken at six different cross sections of the model. Pressure and temperature data were collected with time at three different levels in the model. During steam injection experiments, the saturations obtained by CT matched well with the temperature data. That is, the steam override as observed by temperature data was also clearly seen on the CT pictures. During the runs where foam was present, the saturation distributions obtained from CT pictures showed a piston like displacement. However, the temperature distributions were different depending on the type of steam foam process used. The results clearly show that the pressure/temperature data alone are not sufficient to study steam foam in the presence of non-condensible gas.

Skin Necrosis from Intra-articular Hyaluronic Acid Injection.

Science.gov (United States)

Kim, Whan B; Alhusayen, Raed O

2015-01-01

Tissue necrosis is a rare yet potentially serious complication of intra-articular (IA) hyaluronic acid (HA) injections for treatment of knee osteoarthritis. To report a case of a patient with cutaneous necrosis after IA HA injection for treatment of knee osteoarthritis, presenting as a livedoid violaceous patch on the right knee. We report a case of cutaneous necrosis as a rare complication of IA HA injection for treatment of knee osteoarthritis. A literature review was undertaken of similar cases. Use of HA IA injections in the treatment of osteoarthritis can result in similar skin necrosis at uncommon anatomic locations corresponding to the site of HA injection. Although tissue necrosis is a rare complication, physicians need to be aware of this possibility as a complication of HA IA injections in the treatment of osteoarthritis and should be mindful of potential treatment options to manage this adverse event. © 2014 Canadian Dermatology Association.

Intraoperative radioguidance with a portable gamma camera: a novel technique for laparoscopic sentinel node localisation in urological malignancies

International Nuclear Information System (INIS)

Vermeeren, L.; Valdes Olmos, R.A.; Vogel, W.V.; Sivro, F.; Hoefnagel, C.A.; Meinhardt, W.; Bex, A.; Poel, H.G. van der; Horenblas, S.

2009-01-01

Our aim was to assess the feasibility of intraoperative radioguidance with a portable gamma camera during laparoscopic sentinel node (SN) procedures in urological malignancies. We evaluated the use of the intraoperative portable gamma camera in 20 patients: 16 patients with prostate carcinoma (PCC), 2 patients with renal cell carcinoma (RC) and 2 patients with testicular cancer (TC). Intra/peritumoural injection of 99m Tc-nanocolloid ( 99m Tc) was followed by planar lymphoscintigraphy, SPECT/CT and marking of SN levels. Before laparoscopy a 125 I seed was fixed on the laparoscopic gamma probe as a pointer of SN seeking. The portable gamma camera was set to display the 99m Tc signal for SN localisation and the 125 I signal for SN seeking. Matching of these signals on screen indicated exact SN localisation, and consequently this SN was removed. The mean injected dose was 218 MBq in PCC, 228 MBq in RC and 88 MBq in TC. Pelvic SN were visualised in all PCC patients, with uncommonly located SN in seven patients. SN metastases were found in seven patients (one in a uncommonly located SN). Both RC patients and TC patients had para-aortic SN, which were all tumour free. A total of 59 SN were removed. The portable gamma camera enabled real-time SN display/identification in 18 patients (90%). The use of a portable gamma camera in combination with a laparoscopic gamma probe incorporates intraoperative real-time imaging with improved SN identification in urological malignancies. This procedure might also be useful for SN identification of other deep draining malignancies. (orig.)

Effects of Supercritical Environment on Hydrocarbon-fuel Injection

Institute of Scientific and Technical Information of China (English)

Bongchul Shin; Dohun Kim; Min Son; Jaye Koo

2017-01-01

In this study,the effects of environment conditions on decane were investigated.Decane was injected in subcritical and supercritical ambient conditions.The visualization chamber was pressurized to 1.68 MPa by using nitrogen gas at a temperature of 653 K for subcritical ambient conditions.For supercritical ambient conditions,the visualization chamber was pressurized to 2.52 MPa by using helium at a temperature of 653 K.The decane injection in the pressurized chamber was visualized via a shadowgraph technique and gradient images were obtained by a post processing method.A large variation in density gradient was observed at jet interface in the case of subcritical injection in subcritical ambient conditions.Conversely,for supercritical injection in supercritical ambient conditions,a small density gradient was observed at the jet interface.In a manner similar to that observed in other cases,supercritical injection in subcritical ambient conditions differed from supercritical ambient conditions such as sphere shape liquid.Additionally,there were changes in the interface,and the supercritical injection core width was thicker than that in the subcritical injection.Furthermore,in cases with the same injection conditions,the change in the supercritical ambient normalized core width was smaller than the change in the subcritical ambient normalized core width owing to high specific heat at the supercritical injection and small phase change at the interface.Therefore,the interface was affected by the changing ambient condition.Given that the effect of changing the thermodynamic properties of propellants could be essential for a variable thrust rocket engine,the effects of the ambient conditions were investigated experimentally.

Effects of supercritical environment on hydrocarbon-fuel injection

Science.gov (United States)

Shin, Bongchul; Kim, Dohun; Son, Min; Koo, Jaye

2017-04-01

In this study, the effects of environment conditions on decane were investigated. Decane was injected in subcritical and supercritical ambient conditions. The visualization chamber was pressurized to 1.68 MPa by using nitrogen gas at a temperature of 653 K for subcritical ambient conditions. For supercritical ambient conditions, the visualization chamber was pressurized to 2.52 MPa by using helium at a temperature of 653 K. The decane injection in the pressurized chamber was visualized via a shadowgraph technique and gradient images were obtained by a post processing method. A large variation in density gradient was observed at jet interface in the case of subcritical injection in subcritical ambient conditions. Conversely, for supercritical injection in supercritical ambient conditions, a small density gradient was observed at the jet interface. In a manner similar to that observed in other cases, supercritical injection in subcritical ambient conditions differed from supercritical ambient conditions such as sphere shape liquid. Additionally, there were changes in the interface, and the supercritical injection core width was thicker than that in the subcritical injection. Furthermore, in cases with the same injection conditions, the change in the supercritical ambient normalized core width was smaller than the change in the subcritical ambient normalized core width owing to high specific heat at the supercritical injection and small phase change at the interface. Therefore, the interface was affected by the changing ambient condition. Given that the effect of changing the thermodynamic properties of propellants could be essential for a variable thrust rocket engine, the effects of the ambient conditions were investigated experimentally.

Accidental epidural injection of Atropine

Directory of Open Access Journals (Sweden)

Udayan Bakshi

2013-01-01

Full Text Available Intrathecal injection of drugs for anesthesia, regional analgesia, and chronic pain management are common practice now. Local anesthetic, adjuvants, and opioids are in common use. Human error in the Operation Theater and the Intensive Care Unit setup is also known and reported, due to stress and overwork. A case of unintentional atropine injection intrathecally, which was closely observed for any untoward effects, is reported here.

Mechanical design of injection line for VEC

International Nuclear Information System (INIS)

Nandi, C.; Bandopadhyay, D.K.; Pal, G.; Sharma, R.N.; Mallik, C.; Chaudhuri, J.; Bhandari, R.K.

2003-01-01

A 14.5 GHz ECR ion source along with its analyzing section was earlier installed at VECC for injecting multiply charged gaseous and metallic ions into the existing K 130 cyclotron. The injection line from this ECR ion source was connected to the vertical section of the existing injection line for integrating it with the K 130 cyclotron. The injection line comprises two solenoid magnets, a steering magnet, and a bending magnet. In between the solenoid magnets a length about 1.5 metres has been provided for future atomic physics experimental applications. Two gate valves are used to isolate this area. For beam diagnostics, two Faraday cups, designed and fabricated in this centre, have been installed

Neutral beam injection optimization at TJ-II

International Nuclear Information System (INIS)

Fuentes, C.; Liniers, M.; Wolfers, G.; Alonso, J.; Marcon, G.; Carrasco, R.; Guasp, J.; Acedo, M.; Sanchez, E.; Medrano, M.; Garcia, A.; Doncel, J.; Alejaldre, C.; Tsai, C.C.; Barber, G.; Sparks, D.

2005-01-01

Neutral beam injection (NBI) heating has been used on the TJ-II stellarator for the first time. The beam has a port-through power between 200 and 400 kW and injection energy 28 kV. Beam transmission is limited by beam interception at the injection port and the first toroidal field coil, therefore, beam steering optimization is of critical importance. The beam interaction areas inside TJ-II vacuum chamber are surveyed by infrared thermography. Beam reionization can be a problem due to the presence of residual gas in the duct region. Halpha emission is used to monitor the reionization at the duct. A careful optimization of the injected gas has been carried out

Injection Protection Upgrade for the HL-LHC

CERN Document Server

AUTHOR|(CDS)2067108; Biancacci, Nicolo; Bracco, Chiara; Frasciello, Oscar; Gentini, Luca; Goddard, Brennan; Lechner, Anton; Maciariello, Fausto; Perillo Marcone, Antonio; Salvant, Benoit; Shetty, Nikhil Vittal; Steele, Genevieve; Velotti, Francesco; Zobov, Mikhail

2015-01-01

The injector complex of the LHC is undergoing important changes in the light of the LIU project to provide brighter beams to the LHC. For this reason and as part of the High Luminosity LHC project the injection protection system of the LHC will be upgraded in the Long Shutdown 2 (2018 - 2019) to be able to protect downstream elements against injection failures with the high brightness, high intensity HL-LHC beams. The upgraded LHC injection protection system will consist of a segmented injection protection absorber TDIS, and auxiliary collimators and masks. The layout modifications are described, and the machine element protection and absorber jaw robustness studies are presented for the new systems.

Strategies and challenges for safe injection practice in developing countries.

Science.gov (United States)

Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kumar, Kc Vikash

2013-01-01

Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the early twentieth century but has not received adequate attention in developing countries. The establishment of "Safe Injection Global Network (SIGN)" was an milestone towards safe injection practice globally. In developing countries, people perceive injection as a powerful healing tool and do not hesitate to pay more for injections. Unsafe disposal and reuse of contaminated syringe is common. Ensuring safe injection practice is one of the greatest challenges for healthcare system in developing countries. To address the problem, interventions with active involvement of a number of stakeholders is essential. A combination of educational, managerial and regulatory strategies is found to be effective and economically viable. Rational and safe use of injections can save many lives but unsafe practice threatens life. Safe injection practice is crucial in developing countries. Evidence based interventions, with honest commitment and participation from the service provider, recipient and community with aid of policy makers are required to ensure safe injection practice.

Injectable biomaterials for adipose tissue engineering

International Nuclear Information System (INIS)

Young, D A; Christman, K L

2012-01-01

Adipose tissue engineering has recently gained significant attention from materials scientists as a result of the exponential growth of soft tissue filler procedures being performed within the clinic. While several injectable materials are currently being marketed for filling subcutaneous voids, they often face limited longevity due to rapid resorption. Their inability to encourage natural adipose formation or ingrowth necessitates repeated injections for a prolonged effect and thus classifies them as temporary fillers. As a result, a significant need for injectable materials that not only act as fillers but also promote in vivo adipogenesis is beginning to be realized. This paper will discuss the advantages and disadvantages of commercially available soft tissue fillers. It will then summarize the current state of research using injectable synthetic materials, biopolymers and extracellular matrix-derived materials for adipose tissue engineering. Furthermore, the successful attributes observed across each of these materials will be outlined along with a discussion of the current difficulties and future directions for adipose tissue engineering. (paper)

Stability study of methotrexate in 0.9% sodium chloride injection and 5% dextrose injection with limit tests for impurities

DEFF Research Database (Denmark)

Nissen, Klaus; Bogedal Jorgensen, Lene; Lindegaard Berg, Dorthe

2017-01-01

Purpose. Results of an evaluation of the stability of methotrexate in 0.9% sodium chloride injection and 5% dextrose injection are presented. Methods. Methotrexate concentrated solution (100 mg/mL) was diluted to nominal concentrations of 0.2 and 20 mg/mL in infusion bags containing 0.9% sodium...... chloride injection or 5% dextrose injection. The filled bags were stored for 28 days at 25 °C and 60% relative humidity and protected from light. Samples were withdrawn for analysis on the day of preparation and after 3, 7, 14, 21, and 28 days. The test program included visual inspections, measurements...... in amounts of known and unknown degradation products were detected. In 5% dextrose injection, methotrexate at the higher concentration was stable for 28 days, with minor formation of degradation products; in the 0.2-mg/mL solution, however, methotrexate was stable for only 3 days. At later time points...

Hip joint injection

Science.gov (United States)

... medicine into the joint. The provider uses a real-time x-ray (fluoroscopy) to see where to place ... Wakefield RJ. Arthrocentesis and injection of joints and soft tissue. In: Firestein GS, Budd RC, Gabriel SE, ...

Trends in Utilization of Vocal Fold Injection Procedures.

Science.gov (United States)

Rosow, David E

2015-11-01

Office-based vocal fold injections have become increasingly popular over the past 15 years. Examination of trends in procedure coding for vocal fold injections in the United States from 2000 to 2012 was undertaken to see if they reflect this shift. The US Part B Medicare claims database was queried from 2000 through 2012 for multiple Current Procedural Terminology codes. Over the period studied, the number of nonoperative laryngoscopic injections (31513, 31570) and operative medialization laryngoplasties (31588) remained constant. Operative vocal fold injection (31571) demonstrated marked linear growth over the 12-year study period, from 744 procedures in 2000 to 4788 in 2012-an increase >640%. The dramatic increased incidence in the use of code 31571 reflects an increasing share of vocal fold injections being performed in the operating room and not in an office setting, running counter to the prevailing trend toward awake, office-based injection procedures. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

Injection quality measurements with diamond based particle detectors

CERN Document Server

Stein, Oliver; CERN. Geneva. ATS Department

2016-01-01

During the re-commissioning phase of the LHC after the long shutdown 1 very high beam losses were observed at the TDI during beam injection. The losses reached up to 90% of the dump threshold. To decrease the through beam losses induced stress on the accelerator components these loss levels need to be reduced. Measurements with diamond based particle detectors (dBLMs), which have nano-second time resolution, revealed that the majority of these losses come from recaptured SPS beam surrounding the nominal bunch train. In this MD the injection loss patterns and loss intensities were investigated in greater detail. Performed calibration shots on the TDI (internal beam absorber for injection) gave a conversion factor from impacting particles intensities to signal in the dBLMs (0.1Vs/109 protons). Using the SPS tune kicker for cleaning the recaptured beam in the SPS and changing the LHC injection kicker settings resulted in a reduction of the injection losses. For 144 bunch injections the loss levels were decreased...

Geothermal Injection Monitoring in Klamath Falls, OR

Energy Technology Data Exchange (ETDEWEB)

Culver, G

1990-01-01

Klamath Falls has nearly a 150-year history of geothermal utilization. The geothermal aquifer has been the subject of many studies and is probably the most tested direct use reservoir in the world. This provides good background data for increased monitoring needed as new injection wells are drilled. Prior to July 1990, few injection wells existed. A city ordinance requires injection after July 1990. The city and major injectors have initiated a monitoring system.

Transient CFD studies on multiple jets issuing from injection tube

International Nuclear Information System (INIS)

Kumawat, Ganesh Lal; Kansal, Anuj Kumar; Maheshwari, Naresh Kumar; Rama Rao, A.

2016-01-01

Shut down system 2 of Advanced Heavy Water reactor incorporates the injection of liquid poison into moderator through injection tubes. The injection tubes consist of several holes distributed axially and circumferentially. Investigation of the poison jet progression and spreading from the holes of injection tube is important aspect of determining negative reactivity injection rate. This paper presents the CFD simulation to investigate poison jet progression and its spreading from the holes of injection tube. (author)

Injection error monitor for KEK 12 GeV PS

International Nuclear Information System (INIS)

Shirakata, Masashi; Sato, Hikaru; Toyama, Takeshi; Marutsuka, Katsumi.

1994-01-01

The injection error monitor is now developing for an easy tuning of the main ring beam injection at the KEK 12 GeV proton synchrotron. The beam trajectory on the horizontal phase space plane is obtained by a test bench system. The injection error monitor proved to be available for the beam injection tuning. (author)

Are intravenous injections of contrast media really less nephrotoxic than intra-arterial injections?

Energy Technology Data Exchange (ETDEWEB)

Nyman, Ulf [University of Lund, Department of Diagnostic Radiology, Trelleborg (Sweden); Almen, Torsten [Skaane University Hospital, Department of Clinical Sciences/Medical Radiology, University of Lund, Malmoe (Sweden); Jacobsson, Bo [University of Gothenburg and the Sahlgrenska Academy, Department of Diagnostic Radiology, The Queen Silvia Children' s Hospital, Goeteborg (Sweden); Aspelin, Peter [Karolinska Institute and University Hospital, Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden)

2012-06-15

We oppose the opinion that the intra-arterial administration of iodine-based contrast media (CM) appears to pose a greater risk of contrast medium-induced nephropathy (CIN) than intravenous administration since (1) in intra-arterial coronary procedures and most other intra-arterial angiographic examinations, CM injections are also intravenous relative to the kidneys, (2) there is a lack of comparative trials studying the risk of CIN between intra-arterial and intravenous procedures with matched risk factors and CM doses, (3) a bias selection of patients with fewer risk factors may explain the seemingly lower rate of CIN after CT in comparison with coronary interventions, (4) the rate of CIN following intra-arterial coronary procedures may also be exaggerated owing to other causes of acute kidney failure, such as haemodynamic instability and microembolisation, (5) roughly the same gram-iodine/GFR ratio ({approx}1:1) as a limit of relatively safe CM doses has preliminarily been found for both intravenous CT and intra-arterial coronary procedures and (6) the substantially higher injected intravenous CM dose rate during CT relative to an intra-arterial coronary procedure might actually pose a higher risk of CIN following CT. Key Points circle Most intra-arterial injections of contrast media are intravenous relative to the kidneys. circle No evidence that intravenous CM injections should be less nephrotoxic than intra-arterial. circle Considerably higher dose rates of CM are used for CT relative to intra-arterial procedures. circle Higher dose rates may pose higher nephrotoxic risk for intravenous based CT studies. (orig.)

[Incidence of endophthalmitis after intravitreal injection: is antibioprophylaxis mandatory?].

Science.gov (United States)

Ramel, J-C; Bron, A-M; Isaico, R; Meillon, C; Binquet, C; Creuzot-Garcher, C

2014-04-01

Endophthalmitis is the most dreaded complication after intravitreal injection. With the rise of antiangiogenics their rate is getting higher each year. The use of antibioprophylaxis is controversial. We tried to evaluate the impact of antibioprophylaxis on intravitreal injection endophthalmitis incidence. All patients who received intravitreal injections between January 2007 and October 2012 were included in this retrospective study. Until June 2012 all patients had antibiotics the days following the injection. From July 2012 the antibiotic was replaced by an antiseptic immediately after the injection. An overall number of 11,450 injections were performed. The overall rate of endophthalmitis was 6/11,450 (0.052%). The incidence of endophthalmitis in the group with antibiotics was 3/10,144 injections (0.03%), 2 were culture proven (0.02%). The incidence in the group without antibiotics was 3/1306 (0.23%). The difference was significant (P=0.024). The incidence of endophthalmitis post-intravitreal injections seems to be lower when using antibiotics. However, a prospective study is mandatory to draw more robust conclusions. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

A randomized clinical trial on comparison of corticosteroid injection with or without splinting versus saline injection with or without splinting in patients with lateral epicondylitis

Directory of Open Access Journals (Sweden)

Mohammad Ali Tahririan

2014-01-01

Full Text Available Background: Lateral epicondylitis is a common problem affecting 1-3% of the population. There has been much debate about the best treatment modality for this condition. There is, however, no conclusive evidence in support of any of the proposed treatment modalities. In this trial, we have studied the effect of corticosteroid injection (with or without splinting with normal saline injection (with or without splinting. Materials and Methods: In this double-blind, randomized clinical trial, individuals were randomly assigned to either of four treatment groups and received either 40 mg depomedrol injection alone, 40 mg depomedrol injection with splinting, normal saline injection alone, or normal saline injection with splinting. They were evaluated using the visual analog scale (VAS at weeks 2, 4 and 24 and with the Oxford elbow scale (OES at 24 weeks. Results: A total of 79 patients were participated in the study. The corticosteroid injection groups had better pain relief as measured by VAS at 2 and 4 weeks compared with the two saline injection groups. Mean VAS difference at week 0 versus week 2 was 4.5 ± 0.9 and 2.8 ± 0.6 in corticosteroid injection groups and saline injection groups respectively (P < 0.01 but at 24 weeks, there was only moderate benefit reported for the group which received steroid injection and splinting (P < 0.01 compared to the saline injection groups. The saline injection groups reported better improvement in OES scores (20.1 ± 3.7 at the end of the trial compared corticosteroid injection groups (16.1 ± 2.9 (P < 0.05. Conclusion: Our results indicate that despite the clear pain reduction benefit associated with steroid injection in short term, this benefit in comparison with normal saline injection fades by the 24 th week of follow-up.

Trapping of gun-injected plasma by a tokamak

International Nuclear Information System (INIS)

Leonard, A.W.; Dexter, R.N.; Sprott, J.C.

1986-01-01

It is shown that a plasma produced by a Marshall gun can be injected into and trapped by a tokamak plasma. Gun injection raises the line-averaged density and peaks the density profile. Trapping of the gun-injected plasma is explainable in terms of a depolarization current mechanism

Performance of injection-limited polymer light-emitting diodes

NARCIS (Netherlands)

Blom, P.W.M.; Woudenberg, T.V.; Huiberts, H.; Jabbour, GE; Carter, SA; Kido, J; Lee, ST; Sariciftci, NS

2002-01-01

The electro-optical characteristics of a polymer light emitting diode (PLED) with a strongly reduced hole injection have been investigated. The device consists of a poly-p-phenylene vinylene semiconductor with a Ag hole injecting contact, which has an injection barrier of about 1 eV. It is observed

Influence of diet or intrarectal bile acid injections on colon epithelial cell proliferation in rats previously injected with 1,2-dimethylhydrazine

International Nuclear Information System (INIS)

Glauert, H.P.; Bennink, M.R.

1983-01-01

The effects of varying colon bile acid concentrations on rat colon epithelial cell proliferation were studied. Bile acid concentrations were altered by intrarectally injecting either deoxycholic or lithocholic acid for 4 weeks or by increasing the dietary fat or fiber (wheat bran, agar, or carrageenan) intake for 4 weeks. 1,2-Dimethylhydrazine (DMH) was s.c. injected into half of the rats 1 week before treatments began. Colon epithelial cell proliferation was measured by [ 3 H]thymidine autoradiography of colon crypts. Rats injected with DMH had more DNA-synthesizing cells per crypt. Neither bile acid injection nor any of the diets altered the number of DNA-synthesizing cells per crypt. DMH injections, deoxycholic and lithocholic acid intrarectal injections, and dietary agar and wheat bran all increased the total number of cells per crypt. High fat diets and dietary carrageenan did not affect cell number. All diets containing fiber lowered total fecal bile acid concentrations, but increasing the fat content of the diet did not affect them. These results indicate that the bile acid injections and dietary agar and wheat bran induce a slight hyperplasia in the colon

Integrated semiconductor twin-microdisk laser under mutually optical injection

Energy Technology Data Exchange (ETDEWEB)

Zou, Ling-Xiu; Liu, Bo-Wen; Lv, Xiao-Meng; Yang, Yue-De; Xiao, Jin-Long; Huang, Yong-Zhen, E-mail: yzhuang@semi.ac.cn [State Key Laboratory on Integrated Optoelectronics, Institute of Semiconductors, Chinese Academy of Sciences, Beijing 100083 (China)

2015-05-11

We experimentally study the characteristics of an integrated semiconductor twin-microdisk laser under mutually optical injection through a connected optical waveguide. Based on the lasing spectra, four-wave mixing, injection locking, and period-two oscillation states are observed due to the mutually optical injection by adjusting the injected currents applied to the two microdisks. The enhanced 3 dB bandwidth is realized for the microdisk laser at the injection locking state, and photonic microwave is obtained from the electrode of the microdisk laser under the period-two oscillation state. The plentifully dynamical states similar as semiconductor lasers subject to external optical injection are realized due to strong optical interaction between the two microdisks.

Ultrasound-guided injection for plantar fasciitis: A brief review

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A S Nair

2016-01-01

Full Text Available Plantar fasciitis (PF is a distressing condition experienced by many patients. Although self-limiting, it tends to become a chronic ailment if the precipitating factors are not addressed. One of the modality of treating PF is intra-lesional corticosteroid injection. This was done using palpation technique earlier but nowadays many specialists use ultrasound (US imaging as a guide to give injection accurately instead of inadvertently damaging the plantar fascia or injecting into surrounding soft tissue, both of which can have serious implications. We did a literature search in Medline, Scopus, and Embase databases to find out articles describing US-guided corticosteroid injection for treating PF and whether guided injection was effective than injection given by palpation.

Vocal fold injection medialization laryngoplasty.

Science.gov (United States)

Modi, Vikash K

2012-01-01

Unilateral vocal fold paralysis (UVFP) can cause glottic insufficiency that can result in hoarseness, chronic cough, dysphagia, and/or aspiration. In rare circumstances, UVFP can cause airway obstruction necessitating a tracheostomy. The treatment options for UVFP include observation, speech therapy, vocal fold injection medialization laryngoplasty, thyroplasty, and laryngeal reinnervation. In this chapter, the author will discuss the technique of vocal fold injection for medialization of a UVFP. Copyright © 2012 S. Karger AG, Basel.

Large scale gas injection test (Lasgit): Results from two gas injection tests

International Nuclear Information System (INIS)

Cuss, R. J.; Harrington, J. F.; Noy, D. J.; Wikman, A.; Sellin, P.

2011-01-01

This paper describes the initial results from a large scale gas injection test (Lasgit) performed at the Aespoe Hard Rock Laboratory (Sweden)). Lasgit is a full-scale field-scale experiment based on the Swedish KBS-3V repository concept, examining the processes controlling gas and water flow in compact buffer bentonite. The first 2 years of the test focused on the artificial hydration of the bentonite buffer. This was followed by a programme of hydraulic and gas injection tests which ran from day 843 to 1110. A further period of artificial hydration occurred from day 1110 to 1385, followed by a more complex programme of gas injection testing which remains on going (day 1385+). After 2 years of hydration, hydraulic conductivity and specific storage values in the lower filter array were found to range from 9 x 10 -14 to 1.6 x 10 -13 m/s and 5.5 x 10 -5 to 4.4 x 10 -4 m -1 respectively, with the injection filter FL903 yielding values of 7.5 x 10 -14 m/s and 2.5 x 10 -5 m -1 . A second set of hydraulic measurements were performed over 1 year and a half later yielding similar values, in the range 7.8 x 10 -14 m/s and 1.3 x 10 -13 m/s. The hydraulic conductivity of FL903 had reduced slightly to 5.3 x 10 -14 m/s while specific storage had increased to 4.0 x 10 -5 m -1 . Both datasets agree with laboratory values performed on small-scale saturated samples. Two sets of gas injection tests were performed over a 3 year period. During the course of testing, gas entry pressure was found to increase from around 650 kPa to approximately 1.3 MPa, indicative of the maturation of the clay. The sequential reduction in volumetric flow rate and lack of correlation between the rate of gas inflow and the gas pressure gradient observed during constant pressure steps prior to major gas entry, is suggestive of a reduction in gas permeability of the buffer and indicates only limited quantities of gas can be injected into the clay without interacting with the continuum stress field. Major gas

Systematic assessment of microneedle injection into the mouse cornea

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Matthaei Mario

2012-06-01

Full Text Available Abstract Background Corneal intrastromal injection is an important mode of gene-vector application to subepithelial layers. In a mouse model, this procedure is substantially complicated by the reduced corneal dimensions. Furthermore, it may be difficult to estimate the corneal area reached by the volume of a single injection. This study aimed to investigate intrastromal injections into the mouse cornea using different microneedles and to quantify the effect of injecting varying volumes. A reproducible injection technique is described. Methods Forty eyes of 20 129 Sv/J mice were tested. India ink was intrastromally injected using 30° beveled 33 G needles, tri-surface 25° beveled 35 G needles, or hand-pulled and 25° beveled glass needles. Each eye received a single injection of a volume of 1 or 2 μL. Corneoscleral buttons were fixed and flat mounted for computer-assisted quantification of the affected corneal area. Histological assessment was performed to investigate the intrastromal location of the injected dye. Results A mean corneal area of 5.0 ±1.4 mm2 (mean ± SD and 7.7 ±1.4 mm2 was covered by intrastromal injections of 1 and 2 μL, respectively. The mean percentage of total corneal area reached ranged from 39% to 53% for 1 μL injections, and from 65% to 81% for 2 μL injections. Injections using the 33 G needles tended to provide the highest distribution area. Perforation rates were 8% for 30° beveled 33 G needles and 44% for tri-surface beveled 35 G needles. No perforation was observed with glass needle; however, intrastromal breakage of needle tips was noted in 25% of these cases. Conclusions Intracorneal injection using a 30° beveled 33 G needle was safe and effective. The use of tri-surface beveled 35 G needles substantially increased the number of corneal perforations. Glass needles may break inside the corneal stroma. Injections of 1 μL and 2 μL resulted in an overall mean of 49% and 73% respectively

Vibration of safety injection pump motors

Energy Technology Data Exchange (ETDEWEB)

Wattrelos, D.

1996-12-01

This paper covers a fault encountered in the safety injection pump motors of the French 900 MWe unit nuclear power stations. This fault was not revealed either during the low pressure safety injection and containment spray system pump qualification tests under accident conditions or during the special tests on a test bench carried out to attempt to replicate the fault and to identify ways of remedying it. This constitutes a potential common mode of failure of the safety injection system and the containment spray system pumps. The vibration phenomena illustrate the importance of carrying out tests in the plants under conditions as close as possible to those of actual accident situations.

Alkaline sorbent injection for mercury control

Science.gov (United States)

Madden, Deborah A.; Holmes, Michael J.

2002-01-01

A mercury removal system for removing mercury from combustion flue gases is provided in which alkaline sorbents at generally extremely low stoichiometric molar ratios of alkaline earth or an alkali metal to sulfur of less than 1.0 are injected into a power plant system at one or more locations to remove at least between about 40% and 60% of the mercury content from combustion flue gases. Small amounts of alkaline sorbents are injected into the flue gas stream at a relatively low rate. A particulate filter is used to remove mercury-containing particles downstream of each injection point used in the power plant system.

Vibration of safety injection pump motors

International Nuclear Information System (INIS)

Wattrelos, D.

1996-01-01

This paper covers a fault encountered in the safety injection pump motors of the French 900 MWe unit nuclear power stations. This fault was not revealed either during the low pressure safety injection and containment spray system pump qualification tests under accident conditions or during the special tests on a test bench carried out to attempt to replicate the fault and to identify ways of remedying it. This constitutes a potential common mode of failure of the safety injection system and the containment spray system pumps. The vibration phenomena illustrate the importance of carrying out tests in the plants under conditions as close as possible to those of actual accident situations

Vibration of safety injection pump motors