Intravascular "mulberry-like" bodies

DEFF Research Database (Denmark)

Sørensen, Flemming Brandt; Klebe, J G; Henriques, U V

1988-01-01

Intravascular "mulberry-like" bodies in a stillborn female infant with moderate maceration are reported. The histogenesis of these structures is discussed based on light-microscopic, immunohistochemical and ultrastructural findings. No demonstrable causal relation between the intravascular lesions...... and fetal death was found, the cause of death being attributed to intrauterine asphyxia. It is concluded, that intravascular "mulberry-bodies" most likely represent artifacts due to red blood cell autolysis....

21 CFR 870.3375 - Cardiovascular intravascular filter.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiovascular intravascular filter. 870.3375... Cardiovascular intravascular filter. (a) Identification. A cardiovascular intravascular filter is an implant that... and Revision of 2/12/90 (K90-1)” and (ii) “Guidance for Cardiovascular Intravascular Filter 510(k...

Intravascular malignant lymphomatosis

International Nuclear Information System (INIS)

Martin-Duverneuil, N.; Lafitte, F.; Chiras, J.; Mokhtari, K.; Behin, A.; Hoang-Xuan, K.

2002-01-01

Intravascular malignant lymphomatosis is a rare and probably often overlooked disease characterised by massive intravascular proliferation of lymphoid cells, usually with a poor prognosis. CT and MRI appearances are nonspecific; the most suggestive finding being both asymmetrical, bilateral, contrast enhancing high-signal areas on T2 weighting and infarct-like lesions of the cortex and basal ganglia. We report two patients with previously unreported dural and spinal cord involvement. (orig.)

Intravascular malignant lymphomatosis

Energy Technology Data Exchange (ETDEWEB)

Martin-Duverneuil, N.; Lafitte, F.; Chiras, J. [Service de Neuroradiologie Charcot, Batiment Babinski, Hopital de la Salpetriere, 75013 Paris (France); Mokhtari, K. [Service de Neuropathologie, Hopital de la Salpetriere, 75013 Paris (France); Behin, A.; Hoang-Xuan, K. [Departement de Neurologie, Hopital de la Salpetriere, 75013 Paris (France)

2002-09-01

Intravascular malignant lymphomatosis is a rare and probably often overlooked disease characterised by massive intravascular proliferation of lymphoid cells, usually with a poor prognosis. CT and MRI appearances are nonspecific; the most suggestive finding being both asymmetrical, bilateral, contrast enhancing high-signal areas on T2 weighting and infarct-like lesions of the cortex and basal ganglia. We report two patients with previously unreported dural and spinal cord involvement. (orig.)

Mapping intravascular ultrasound controversies in interventional cardiology practice.

Directory of Open Access Journals (Sweden)

David Maresca

Full Text Available Intravascular ultrasound is a catheter-based imaging modality that was developed to investigate the condition of coronary arteries and assess the vulnerability of coronary atherosclerotic plaques in particular. Since its introduction in the clinic 20 years ago, use of intravascular ultrasound innovation has been relatively limited. Intravascular ultrasound remains a niche technology; its clinical practice did not vastly expand, except in Japan, where intravascular ultrasound is an appraised tool for guiding percutaneous coronary interventions. In this qualitative research study, we follow scholarship on the sociology of innovation in exploring both the current adoption practices and perspectives on the future of intravascular ultrasound. We conducted a survey of biomedical experts with experience in the technology, the practice, and the commercialization of intravascular ultrasound. The collected information enabled us to map intravascular ultrasound controversies as well as to outline the dynamics of the international network of experts that generates intravascular ultrasound innovations and uses intravascular ultrasound technologies. While the technology is praised for its capacity to measure coronary atherosclerotic plaque morphology and is steadily used in clinical research, the lack of demonstrated benefits of intravascular ultrasound guided coronary interventions emerges as the strongest factor that prevents its expansion. Furthermore, most of the controversies identified were external to intravascular ultrasound technology itself, meaning that decision making at the industrial, financial and regulatory levels are likely to determine the future of intravascular ultrasound. In light of opinions from the responding experts', a wider adoption of intravascular ultrasound as a stand-alone imaging modality seems rather uncertain, but the appeal for this technology may be renewed by improving image quality and through combination with

Site requirements and kinetics of immune-dependent elimination of intravascularly administered lung stage schistosomula in mice immunized with highly irradiated cercariae of Schistosoma mansoni

International Nuclear Information System (INIS)

Mangold, B.L.; Dean, D.A.; Coulson, P.S.; Wilson, R.A.

1986-01-01

Experiments were performed to compare the migration and survival of 75Se-labeled schistosomes, introduced by percutaneous cercarial exposure or by intravascular administration of 7-day-old lung stage schistosomula, in control and irradiated cercaria-immunized mice. Schistosomula were intravascularly introduced into the lungs, systemic organs and liver by injection via the femoral vein (FV), left ventricle (LV), and superior mesenteric vein (SMV), respectively. The fate of challenge larvae was examined by autoradiography of host tissues and by recovery of adult worms. It was found that both normal and immune elimination were site-dependent. In control mice 45%-60% of cercarial penetrants and lung schistosomula injected into the FV and LV were recoverable as adult worms, while a significantly greater number (70%-85%) were recoverable when lung schistosomula were injected into the SMV. In immunized mice, parasites introduced as either cercariae or FV-injected schistosomula were both highly sensitive to immune elimination. LV-injected schistosomula were also sensitive but to a slightly lesser degree. In contrast, schistosomula placed directly in the liver by SMV injection were totally insensitive to immune elimination. It was concluded that elimination of schistosomula in irradiated cercaria-immunized mice occurs in the lungs and/or in the systemic organs, but not in the liver. Also, it was concluded that immune elimination is not a rapid process, since more than 7 days were required after intravascular challenge for the development of demonstrable differences between control and immunized mice

Firewater system inadvertent actuation frequencies

International Nuclear Information System (INIS)

Schroeder, J.A.; Eide, S.A.

1993-01-01

This paper presents some recommended generic values for fire protection system inadvertent actuation frequencies. The frequencies are based on actual data from Department of Energy and commercial reactor plant facilities

Skin Necrosis with Oculomotor Nerve Palsy Due to a Hyaluronic Acid Filler Injection

Directory of Open Access Journals (Sweden)

Jae Il Lee

2017-07-01

Full Text Available Performing rhinoplasty using filler injections, which improve facial wrinkles or soft tissues, is relatively inexpensive. However, intravascular filler injections can cause severe complications, such as skin necrosis and visual loss. We describe a case of blepharoptosis and skin necrosis caused by augmentation rhinoplasty and we discuss the patient’s clinical progress. We describe the case of a 25-year-old female patient who experienced severe pain, blepharoptosis, and decreased visual acuity immediately after receiving a filler injection. Our case suggests that surgeons should be aware of nasal vascularity before performing an operation, and that they should avoid injecting fillers at a high pressure and/or in excessive amounts. Additionally, filler injections should be stopped if the patient complains of severe pain, and appropriate measures should be taken to prevent complications caused by intravascular filler injections.

Prevention of adverse reactions to intravascular contrast media

International Nuclear Information System (INIS)

Soyer, P.; Levesque, M.

1990-01-01

The exact mechanisms of adverse reactions to contrast media are still imperfectly known. However, these reactions may be classified as idiosyncratic. Non-idiosyncratic reactions can be prevented by using new, non-ionic contrast agents. Idiosyncratic reactions can be prevented by specific premedication. Patients with a history of idiosyncratic reaction may benefit from corticosteroids and antihistamines administered prophylactically. Patients who seem to be more likely than others to react to contrast media must be premedicated, the risk of reaction being identified and evaluated by questioning. It has recently been suggested that all patients about to receive an intravascular injection of contrast medium should also be premedicated [fr

21 CFR 880.5200 - Intravascular catheter.

Science.gov (United States)

2010-04-01

... Devices § 880.5200 Intravascular catheter. (a) Identification. An intravascular catheter is a device that consists of a slender tube and any necessary connecting fittings and that is inserted into the patient's vascular system for short term use (less than 30 days) to sample blood, monitor blood pressure, or...

Accidental injections of dexamethasone intravitreal implant (Ozurdex) into the crystalline lens.

Science.gov (United States)

Coca-Robinot, Javier; Casco-Silva, Bruno; Armadá-Maresca, Felix; García-Martínez, Jesús

2014-01-01

To describe the side effects and management after inadvertent injection of a dexamethasone implant (Ozurdex) into the crystalline lens. Two case reports. Two patients with macular edema due to unilateral retinal vein occlusion were scheduled for an intravitreal injection of Ozurdex. During the procedure, the implant was accidentally injected into the crystalline lens. Both patients developed cataracts during the course of several weeks and in both there was an intraocular pressure (IOP) increase, which required treatment with topical hypotensives. Macular edema improved only slightly. Cataract surgery with uneventful removal of the implant was performed 3 (case 1) and 6 months (case 2) after the injection. After inadvertent injection of Ozurdex into the crystalline lens, cataract surgery with removal of the implant should be performed as soon as possible in order to avoid IOP increase and so that the underlying condition may be treated adequately.

Role of informed consent for intravascular contrast media

International Nuclear Information System (INIS)

Hopper, K.D.; Tyler, H.N. Jr.

1988-01-01

To evaluate the usefulness of different degrees of informed consent for intravascular contrast media, the authors divided 100 patients into four groups: (1) informed consent with no information on intravascular contrast media, (2) simple written informed consent that detailed common risks, (3) detailed written informed consent that detailed all known risks, and (4) MD informed consent, during which a radiologist discussed all known risks of intravascular contrast media. Physician counseling time for group 4 averaged 11.4 minutes. On a postprocedure test about the common complications and risk factors of intravascular contrast media, the average scores were: group 1, 38.4%; group 2, 68.2%; group 3, 63.2%; and group 4, 69.8%. There was no statistical difference between groups 2-4 on the postprocedure test. If informed consent is to be used prior to intravascular contrast media administration, a simple written consent detailing the common risks and risk factors appears to be the best method

Exploring key considerations when determining bona fide inadvertent errors resulting in understatements

Directory of Open Access Journals (Sweden)

Chrizanne de Villiers

2016-03-01

Full Text Available Chapter 16 of the Tax Administration Act (28 of 2011 (the TA Act deals with understatement penalties. In the event of an ‘understatement’, in terms of Section 222 of the TA Act, a taxpayer must pay an understatement penalty, unless the understatement results from a bona fide inadvertent error. The determining of a bona fide inadvertent error on taxpayers’ returns is a totally new concept in the tax fraternity. It is of utmost importance that this section is applied correctly based on sound evaluation principles and not on professional judgement when determining if the error was indeed the result of a bona fide inadvertent error. This research study focuses on exploring key considerations when determining bona fide inadvertent errors resulting in understatements. The role and importance of tax penalty provisions is explored and the meaning of the different components in the term ‘bona fide inadvertent error’ critically analysed with the purpose to find a possible definition for the term ‘bona fide inadvertent error’. The study also compares the provisions of other tax jurisdictions with regards to errors made resulting in tax understatements in order to find possible guidelines on the application of bona fide inadvertent errors as contained in Section 222 of the TA Act. The findings of the research study revealed that the term ‘bona fide inadvertent error’ contained in Section 222 of the TA Act should be defined urgently and that guidelines must be provided by SARS on the application of the new amendment. SARS should also clarify the application of a bona fide inadvertent error in light of the behaviours contained in Section 223 of the TA Act to avoid any confusion.

Managing Inadvertent Arterial Catheterization During Central Venous Access Procedures

International Nuclear Information System (INIS)

Nicholson, Tony; Ettles, Duncan; Robinson, Graham

2004-01-01

Purpose: Approximately 200,000 central venous catheterizations are carried out annually in the National Health Service in the United Kingdom. Inadvertent arterial puncture occurs in up to 3.7%. Significant morbidity and death has been reported. We report on our experience in the endovascular treatment of this iatrogenic complication. Methods: Retrospective analysis was carried out of 9 cases referred for endovascular treatment of inadvertent arterial puncture during central venous catheterization over a 5 year period. Results: It was not possible to obtain accurate figures on the numbers of central venous catheterizations carried out during the time period. Five patients were referred with carotid or subclavian pseudoaneurysms and hemothorax following inadvertent arterial catheter insertion and subsequent removal. These patients all underwent percutaneous balloon tamponade and/or stent-graft insertion. More recently 4 patients were referred with the catheter still in situ and were successfully treated with a percutaneous closure device. Conclusion: If inadvertent arterial catheterization during central venous access procedures is recognized and catheters removed, sequelae can be treated percutaneously. However, once the complication is recognized it is better to leave the catheter in situ and seal the artery percutaneously with a closure device

Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis

OpenAIRE

Kensuke Tashiro, MD; Shuji Yamashita, MD; Mitsunaga Narushima, MD; Isao Koshima, MD; Shimpei Miyamoto, MD

2017-01-01

Background:. Although supermicrosurgical anastomosis is a widely known reconstructive microsurgical technique, it is difficult to perform. To expand the clinical use of supermicrosurgery, we used hemi-intravascular stenting (hemi-IVaS), which is performed by inserting an intravascular stent into one side of the vessel. We conducted lymphaticovenular anastomosis, free perforator flap transfer, and fingertip replantation with supermicrosurgical anastomosis using hemi-IVaS technique and examined...

The lateral neostriatum is necessary for compensatory ingestive behaviour after intravascular dehydration in female rats.

Science.gov (United States)

Lelos, M J; Harrison, D J; Rosser, A E; Dunnett, S B

2013-12-01

Aberrant striatal function results in an array of physiological symptoms, including impaired consummatory and regulatory behaviours, which can lead to weight loss and dehydration. It was hypothesised, therefore, that cell loss in the neostriatum may contribute to altered fluid intake by regulating physiological signals related to dehydration status. To test this theory, rats with lesions of the lateral neostriatum and sham controls underwent a series of physiological challenges, including the experimental induction of intracellular and intravascular dehydration. No baseline differences in prandial or non-prandial drinking were observed, nor were differences in locomotor activity evident between groups. Furthermore, intracellular dehydration increased water intake in lesion rats in a manner comparable to sham rats. Interestingly, a specific impairment was evident in lesion rats after subcutaneous injection of poly-ethylene glycol was used to induce intravascular dehydration, such that lesion rats failed to adapt their water intake to this physiological change. The results suggest that the striatal lesions resulted in regulatory dysfunction by impairing motivational control over compensatory ingestive behaviour after intravascular hydration, while the physiological signals related to dehydration remain intact. Loss of these cells in neurodegenerative disorders, such Huntington's disease, may contribute to regulatory changes evident in the course of the disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

Mapping Intravascular Ultrasound Controversies in Interventional Cardiology Practice

NARCIS (Netherlands)

Maresca, D.; Adams, S.; Maresca, B.; Van der Steen, A.F.W.

2014-01-01

Intravascular ultrasound is a catheter-based imaging modality that was developed to investigate the condition of coronary arteries and assess the vulnerability of coronary atherosclerotic plaques in particular. Since its introduction in the clinic 20 years ago, use of intravascular ultrasound

Late adverse reactions to intravascular iodinated contrast media

International Nuclear Information System (INIS)

Webb, Judith A.W.; Stacul, Fulvio; Thomsen, Henrik S.; Morcos, Sameh K.

2003-01-01

Late adverse reactions to intravascular iodinated contrast media are defined as reactions occurring 1 h to 1 week after contrast medium injection. They have received increasing interest over the past decade, but their prevalence remains uncertain and their pathophysiology is not fully understood. The Contrast Media Safety Committee of the European Society of Urogenital Radiology decided to review the literature and to issue guidelines. An extensive literature search was carried out and summarized in a report. Based on the available information, simple guidelines have been drawn up. The report and guidelines were discussed at the 8th European Symposium on Urogenital Radiology in Genoa. Late adverse reactions after intravascular iodinated contrast medium include symptoms such as nausea, vomiting, headache, itching, skin rash, musculoskeletal pain, and fever. A significant proportion of these reactions is unrelated to the contrast medium; however, allergy-like skin reactions are well-documented side effects of contrast media with an incidence of approximately 2%. Late reactions appear to be commoner after non-ionic dimers. The majority of late skin reactions after contrast medium exposure are probably T-cell-mediated allergic reactions. Patients at increased risk of late skin reactions are those with a history of previous contrast medium reaction and those on interleukin-2 treatment. Most skin reactions are self-limiting and resolve within a week. Management is symptomatic and similar to the management of other drug-induced skin reactions. (orig.)

Intravascular (catheter) MR imaging

International Nuclear Information System (INIS)

Cohen, A.M.; Hurst, G.C.; Katz, D.E.; Dverk, J.L.; Wiesen, E.J.; Czerski, L.W.; Malaya, R.; Bellon, E.M.

1989-01-01

Intravascular MR probes allow excellent spatial resolution and have the potential to detect arterial wall microstructure. Ultrasonic intravascular probes suggest that detailed morphologic information can assist clinical decision making. Catheter MR probes of 2--7 mm outside diameter (OD) were built of copper wire, Teflon, and parts from standard commercial catheters. The probes were connected to the surface coil receiver input of our Picker VISTA 2055HP 1.5-T imaging system. The extant (linear) body coil was used for transmit. Phantoms were constructed of coaxial glass MR tubes, filled with doped water. Watanabe rabbit aorta and human autopsy iliac artery specimens were examined within 4 hours of excision or stored by freezing. In vivo iliac arteries in dogs under general anesthesia were imaged, with percutaneous placement of the probe. Results are presented

Accidental intra-arterial injection of fluorescein dye.

Science.gov (United States)

Bovino, J A; Marcus, D F

1984-12-01

During fluorescein angiography, sodium fluorescein dye intended for intravenous use was inadvertently injected into an artery in the antecubital fossa. An immediate and dramatic orange discoloration of the skin distal to the injection combined with intense burning pain of the right forearm and hand were noted. The patient was treated with ice packs and analgesics. The fluorescein angiogram showed a delayed arm to eye circulation time, but was of normal quality. There were no long-term complications.

Assessing intravascular fluid status

African Journals Online (AJOL)

The assessment of intravascular fluid volume is a difficult undertaking in both the intensive care unit and theatre situation ... equally applicable to pulmonary capillary wedge pressure. .... airway pressure, the more difficult it becomes to interpret ...

Visualization of Chronic Myocardial Infarction Using the Intravascular Contrast Agent MS-325 (Gadofosveset in Patients

Directory of Open Access Journals (Sweden)

Thomas Thouet

2012-01-01

Full Text Available Aims. The aim of this study was to evaluate the potential of visualizing chronic myocardial infarction in patients using the intravascular CA MS-325 (gadofosveset, EPIX Pharmaceuticals, Mass, USA. Methods. Nine patients were enrolled in a clinical phase II multicenter trial for MRCA and perfusion imaging using MS-325. They had objective evidence of chronic myocardial infarction as visualized by previously performed late gadolinium (Gd enhancement imaging (LGE with a conventional extracellular Gd-DTPA CA (Magnevist, Bayer Healthcare, Germany, 0.2 mmol/kg/body weight serving as reference standard. A prepulse-optimized LGE study was performed immediately and at several time points after injection of MS-325 (0.05 mmol/kg/body weight. The number and localization of segments demonstrating LGE with MS-325 as well as signal intensities were compared with the reference standard (Gd-DTPA. Results. Using MS-325, LGE could be detected at every time point in all 9 patients. The accuracy of LGE with MS-325 as compared to LGE with Gd-DTPA was highest 54±4 minutes after contrast injection, resulting in a sensitivity of 84% with a specificity of 98%. Conclusion. The intravascular CA MS-325 has the potential to visualize chronic myocardial infarction. However, in comparison with Gd-DTPA, the transmural extent and the number of segments are smaller.

Disseminated intravascular coagulation (DIC)

Science.gov (United States)

... Jr, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice . 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 141. Thachil J, Toh CH. Current concepts in the management of disseminated intravascular coagulation. Thromb Res . 2012;129 ...

Novel approaches to the management of disseminated intravascular coagulation

NARCIS (Netherlands)

Levi, M. [=Marcel M.; de Jonge, E.; van der Poll, T.; ten Cate, H.

2000-01-01

Disseminated intravascular coagulation (DIC) is a syndrome characterized by systemic intravascular activation of coagulation, leading to widespread deposition of fibrin in the circulation. We addressed the issue of whether there is evidence that this fibrin deposition contributes to multiple organ

Long-acting injectable antipsychotics: focus on olanzapine pamoate

Directory of Open Access Journals (Sweden)

JP Lindenmayer

2010-05-01

Full Text Available JP LindenmayerDepartment of Psychiatry, New York University School of Medicine, New York NY, USAAbstract: Medication non-adherence in patients with schizophrenia continues to be a significant problem and threatens successful treatment outcomes. Medication non-adherence is often associated with negative consequences, including symptom exacerbation, more frequent emergency room visits, re-hospitalizations and relapse. Long-acting injectable (LAI forms of antipsychotics allow for rapid identification of non-adherence, obviate the need for the patient to take the medication on a daily basis and increase adherence to some significant degree. Eli Lilly has developed a long-acting depot formulation of olanzapine, olanzapine pamoate, which has recently been approved by the FDA for the US market, and which will be reviewed here. Olanzapine LAI appears to be an effective antipsychotic at dosages of 210 mg every 2 weeks, 300 mg every 2 weeks and 405 mg every 4 weeks in patients with acute schizophrenia, and at 150 mg every 2 weeks, 300 mg every 2 weeks and at 405 mg every 4 weeks for the maintenance treatment of stable patients. Oral supplementation appears not to be needed, particularly not at the onset of treatment with the LAI as is necessary with risperidone LAI. Its efficacy is in general comparable to the efficacy seen with oral olanzapine at a corresponding dose. The side effect profile is also comparable to the side effects observed with oral olanzapine, including lower rates of extrapyramidal symptoms, prolactin elevation and cardiovascular side effects, but significant metabolic effects. The latter include significant weight gain, lipid abnormalities and glucose dysregulation. While the injection site adverse events are overall mild, the most significant serious adverse event is the post-injection delirium sedation syndrome (PDSS. While rare, this syndrome results from inadvertent intravascular injection of olanzapine LAI and can cause a range of

Intravascular forward-looking ultrasound transducers for microbubble-mediated sonothrombolysis.

Science.gov (United States)

Kim, Jinwook; Lindsey, Brooks D; Chang, Wei-Yi; Dai, Xuming; Stavas, Joseph M; Dayton, Paul A; Jiang, Xiaoning

2017-06-14

Effective removal or dissolution of large blood clots remains a challenge in clinical treatment of acute thrombo-occlusive diseases. Here we report the development of an intravascular microbubble-mediated sonothrombolysis device for improving thrombolytic rate and thus minimizing the required dose of thrombolytic drugs. We hypothesize that a sub-megahertz, forward-looking ultrasound transducer with an integrated microbubble injection tube is more advantageous for efficient thrombolysis by enhancing cavitation-induced microstreaming than the conventional high-frequency, side-looking, catheter-mounted transducers. We developed custom miniaturized transducers and demonstrated that these transducers are able to generate sufficient pressure to induce cavitation of lipid-shelled microbubble contrast agents. Our technology demonstrates a thrombolysis rate of 0.7 ± 0.15 percent mass loss/min in vitro without any use of thrombolytic drugs.

Effector CD4+ T cells recognize intravascular antigen presented by patrolling monocytes.

Science.gov (United States)

Westhorpe, Clare L V; Norman, M Ursula; Hall, Pam; Snelgrove, Sarah L; Finsterbusch, Michaela; Li, Anqi; Lo, Camden; Tan, Zhe Hao; Li, Songhui; Nilsson, Susan K; Kitching, A Richard; Hickey, Michael J

2018-02-21

Although effector CD4 + T cells readily respond to antigen outside the vasculature, how they respond to intravascular antigens is unknown. Here we show the process of intravascular antigen recognition using intravital multiphoton microscopy of glomeruli. CD4 + T cells undergo intravascular migration within uninflamed glomeruli. Similarly, while MHCII is not expressed by intrinsic glomerular cells, intravascular MHCII-expressing immune cells patrol glomerular capillaries, interacting with CD4 + T cells. Following intravascular deposition of antigen in glomeruli, effector CD4 + T-cell responses, including NFAT1 nuclear translocation and decreased migration, are consistent with antigen recognition. Of the MHCII + immune cells adherent in glomerular capillaries, only monocytes are retained for prolonged durations. These cells can also induce T-cell proliferation in vitro. Moreover, monocyte depletion reduces CD4 + T-cell-dependent glomerular inflammation. These findings indicate that MHCII + monocytes patrolling the glomerular microvasculature can present intravascular antigen to CD4 + T cells within glomerular capillaries, leading to antigen-dependent inflammation.

Extracorporeal membrane oxygenation after intravenous injection of paraffin oil

DEFF Research Database (Denmark)

Pasgaard, Thomas; Huynh, Anh-Nhi Thi; Gjedsted, Jakob

2016-01-01

We present a rare cause of acute respiratory distress syndrome (ARDS) due to an accidental intravascular injection of paraffin oil. While there is no specific therapy, we decided to support the patient with veno-venous extracorporeal membrane oxygenation (V-V ECMO) to allow the ARDS to resolve. A...

Ultrasound-guided injection for plantar fasciitis: A brief review

Directory of Open Access Journals (Sweden)

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.

Ureteroscopic holmium laser cutting for inadvertently sutured drainage tube (report of five cases).

Science.gov (United States)

Gao, Xu; Lu, Xin; Ren, Shancheng; Xu, Chuanliang; Sun, Yinghao

2008-07-01

The aim of this paper is to report a simple solution for inadvertently sutured drainage tube after urological surgery and discuss the different managements according to different types of this embarrassing complication. From September 2001 to January 2007, five inadvertently sutured drainage tubes were treated with ureteroscopic holmium laser cutting for the suture. All drainage tubes were removed after the operation without other complications. Holmium laser cutting via ureteroscope is a simple solution for the embarrassing problem of inadvertently sutured drainage tube. It can save the patient from undergoing another open surgery.

Slow clearance gadolinium-based extracellular and intravascular contrast media for three-dimensional MR angiography.

Science.gov (United States)

Bremerich, J; Colet, J M; Giovenzana, G B; Aime, S; Scheffler, K; Laurent, S; Bongartz, G; Muller, R N

2001-04-01

The objective of this study was to assess two new slow-clearance contrast media with extracellular and intravascular distribution for magnetic resonance angiography (MRA). Extracellular Gd-DTPA-BC(2)glucA and intravascular Gd(DO3A)(3)-lys(16) were developed within the European Biomed2 MACE Program and compared with two reference compounds, intravascular CMD-A2-Gd-DOTA and extracellular GdDOTA, in 12 rats. Pre- and post-contrast three-dimensional MR (TR/TE = 5 msec/2.2 msec; isotropic voxel size 0.86 mm(3)) was acquired for 2 hours. Signal-to-noise enhancement (DeltaSNR) was calculated. Two minutes after injection, all contrast media provided strong vascular signal enhancement. The DeltaSNR for Gd-DTPA-BC(2)glucA, Gd(DO3A)(3)-lys(16), CMD-A2-Gd-DOTA, and GdDOTA were 13.0 +/- 1.8, 25.0 +/- 3.2, 25.0 +/- 4.0, and 18.0 +/- 3.4, respectively. Gd-DTPA-BC(2)glucA, Gd(DO3A)(3)-lys(16), and CMD-A2-Gd-DOTA cleared slowly from the circulation, whereas GdDOTA cleared rapidly. Vascular DeltaSNR at 2 hours were 2.9 +/- 0.6, 25.0 +/- 3.2, 25.0 +/- 4.0, and 0.4 +/- 1.0. Gd(DO3A)(3)-lys(16) provided strong vascular and minor background enhancement, and thus may be useful for MRA or perfusion imaging. Gd-DTPA-BC(2)glucA produces persistent enhancement of extracellular water, and thus may allow quantification of extracellular distribution volume and assessment of myocardial viability.

Prevention of the inadvertent movement and illicit trafficking of radioactive materials

International Nuclear Information System (INIS)

2004-05-01

By international agreements, the movement of all radioactive materials within and between States should be subject to high standards of regulatory, administrative, safety and engineering controls to ensure that such movements are conducted in a safe and secure manner. In the case of nuclear materials, there are additional requirements for physical protection and accountability to ensure against threats of nuclear proliferation and to safeguard against any attempts at diversion. The results of the terrorist attacks of September 2001 emphasized the requirement for enhanced control and security of nuclear and radioactive materials. In this regard, measures are being taken to increase the global levels of physical protection and security for nuclear materials. Experience in many parts of the world continues to prove that movements of radioactive materials outside of the regulatory and legal frameworks continue to occur. Such movements may be either deliberate or inadvertent. Deliberate, illegal movements of radioactive materials, including nuclear material, for terrorist, political or illegal profit is generally understood to be illicit trafficking. The more common movements outside of regulatory control are inadvertent in nature. An example of an inadvertent movement might be the transport of steel contaminated by a melted radioactive source that was lost from proper controls. Such a shipment may present health and safety threats to the personnel involved as well as to the general public. States have the responsibility for combating illicit trafficking and inadvertent movements of radioactive materials. The IAEA co-operates with Member States and other international organizations in joint efforts to prevent incidents of illicit trafficking and inadvertent movements and to harmonize policies and measures by the provision of relevant advice through technical assistance and documents. As an example, the IAEA and the World Customs Organization (WCO) maintain a Memorandum

Prevention of the inadvertent movement and illicit trafficking of radioactive materials

International Nuclear Information System (INIS)

2004-12-01

By international agreements, the movement of all radioactive materials within and between States should be subject to high standards of regulatory, administrative, safety and engineering controls to ensure that such movements are conducted in a safe and secure manner. In the case of nuclear materials, there are additional requirements for physical protection and accountability to ensure against threats of nuclear proliferation and to safeguard against any attempts at diversion. The results of the terrorist attacks of September 2001 emphasized the requirement for enhanced control and security of nuclear and radioactive materials. In this regard, measures are being taken to increase the global levels of physical protection and security for nuclear materials. Experience in many parts of the world continues to prove that movements of radioactive materials outside of the regulatory and legal frameworks continue to occur. Such movements may be either deliberate or inadvertent. Deliberate, illegal movements of radioactive materials, including nuclear material, for terrorist, political or illegal profit is generally understood to be illicit trafficking. The more common movements outside of regulatory control are inadvertent in nature. An example of an inadvertent movement might be the transport of steel contaminated by a melted radioactive source that was lost from proper controls. Such a shipment may present health and safety threats to the personnel involved as well as to the general public. States have the responsibility for combating illicit trafficking and inadvertent movements of radioactive materials. The IAEA co-operates with Member States and other international organizations in joint efforts to prevent incidents of illicit trafficking and inadvertent movements and to harmonize policies and measures by the provision of relevant advice through technical assistance and documents. As an example, the IAEA and the World Customs Organization (WCO) maintain a Memorandum

Prevention of the inadvertent movement and illicit trafficking of radioactive materials

International Nuclear Information System (INIS)

2003-08-01

By international agreements, the movement of all radioactive materials within and between States should be subject to high standards of regulatory, administrative, safety and engineering controls to ensure that such movements are conducted in a safe and secure manner. In the case of nuclear materials, there are additional requirements for physical protection and accountability to ensure against threats of nuclear proliferation and to safeguard against any attempts at diversion. The results of the terrorist attacks of September 2001 emphasized the requirement for enhanced control and security of nuclear and radioactive materials. In this regard, measures are being taken to increase the global levels of physical protection and security for nuclear materials. Experience in many parts of the world continues to prove that movements of radioactive materials outside of the regulatory and legal frameworks continue to occur. Such movements may be either deliberate or inadvertent. Deliberate, illegal movements of radioactive materials, including nuclear material, for terrorist, political or illegal profit is generally understood to be illicit trafficking. The more common movements outside of regulatory control are inadvertent in nature. An example of an inadvertent movement might be the transport of steel contaminated by a melted radioactive source that was lost from proper controls. Such a shipment may present health and safety threats to the personnel involved as well as to the general public. States have the responsibility for combating illicit trafficking and inadvertent movements of radioactive materials. The IAEA co-operates with Member States and other international organizations in joint efforts to prevent incidents of illicit trafficking and inadvertent movements and to harmonize policies and measures by the provision of relevant advice through technical assistance and documents. As an example, the IAEA and the World Customs Organization (WCO) maintain a Memorandum

Prevention of the inadvertent movement and illicit trafficking of radioactive materials

International Nuclear Information System (INIS)

2003-05-01

By international agreements, the movement of all radioactive materials within and between States should be subject to high standards of regulatory, administrative, safety and engineering controls to ensure that such movements are conducted in a safe and secure manner. In the case of nuclear materials, there are additional requirements for physical protection and accountability to ensure against threats of nuclear proliferation and to safeguard against any attempts at diversion. The results of the terrorist attacks of September 2001 emphasized the requirement for enhanced control and security of nuclear and radioactive materials. In this regard, measures are being taken to increase the global levels of physical protection and security for nuclear materials. Experience in many parts of the world continues to prove that movements of radioactive materials outside of the regulatory and legal frameworks continue to occur. Such movements may be either deliberate or inadvertent. Deliberate, illegal movements of radioactive materials, including nuclear material, for terrorist, political or illegal profit is generally understood to be illicit trafficking. The more common movements outside of regulatory control are inadvertent in nature. An example of an inadvertent movement might be the transport of steel contaminated by a melted radioactive source that was lost from proper controls. Such a shipment may present health and safety threats to the personnel involved as well as to the general public. States have the responsibility for combating illicit trafficking and inadvertent movements of radioactive materials. The IAEA co-operates with Member States and other international organizations in joint efforts to prevent incidents of illicit trafficking and inadvertent movements and to harmonize policies and measures by the provision of relevant advice through technical assistance and documents. As an example, the IAEA and the World Customs Organization (WCO) maintain a Memorandum

Prevention of the inadvertent movement and illicit trafficking of radioactive materials

International Nuclear Information System (INIS)

2002-09-01

By international agreements, the movement of all radioactive materials within and between States should be subject to high standards of regulatory, administrative, safety and engineering controls to ensure that such movements are conducted in a safe and secure manner. In the case of nuclear materials, there are additional requirements for physical protection and accountability to ensure against threats of nuclear proliferation and to safeguard against any attempts at diversion. The results of the terrorist attacks of September 2001 emphasized the requirement for enhanced control and security of nuclear and radioactive materials. In this regard, measures are being taken to increase the global levels of physical protection and security for nuclear materials. Experience in many parts of the world continues to prove that movements of radioactive materials outside of the regulatory and legal frameworks continue to occur. Such movements may be either deliberate or inadvertent. Deliberate, illegal movements of radioactive materials, including nuclear material, for terrorist, political or illegal profit is generally understood to be illicit trafficking. The more common movements outside of regulatory control are inadvertent in nature. An example of an inadvertent movement might be the transport of steel contaminated by a melted radioactive source that was lost from proper controls. Such a shipment may present health and safety threats to the personnel involved as well as to the general public. States have the responsibility for combating illicit trafficking and inadvertent movements of radioactive materials. The IAEA co-operates with Member States and other international organizations in joint efforts to prevent incidents of illicit trafficking and inadvertent movements and to harmonize policies and measures by the provision of relevant advice through technical assistance and documents. As an example, the IAEA and the World Customs Organization (WCO) maintain a Memorandum

Disseminated intravascular and intracardiac thrombosis after cardiopulmonary bypass

Directory of Open Access Journals (Sweden)

Deepak K Tempe

2017-01-01

Full Text Available Massive intracardiac and intravascular thrombosis is a rare complication following cardiopulmonary bypass (CPB. Most of the cases of the disseminated thrombosis have been reported in patients undergoing complex cardiac surgeries and those receiving antifibrinolytic agents during CPB. We report the occurrence of disseminated intravascular and intracardiac thrombosis after CPB in a patient undergoing mitral valve replacement in which no antifibrinolytic agent was used. The possible pathophysiology and management of the patient is discussed.

Intravascular trans-catheter fibrinolysis in acute arterial obstructions

International Nuclear Information System (INIS)

Roversi, R.; Rossi, C.; Ricci, S.; Gemelli, G.; Ciliberti, M.A.

1987-01-01

The author's experiences is reported on intravascular fibrinolytic therapy with urokinase in acute arterial obstructions. Thirty-eight patients were treated, from 1983 to 1986, for acute thrombosis and/or thromboembolization, 22 of which developed on an atherosclerotic lesion, and 10 on a surgical stenotic by-pass graft. A complete vascular recanalization has been obtained, at the end of the procedure, in 69,4% of the cases, 77,7% had a definite final clinical improvement. The results correspond to the medium statistical of the various casistics analyzed for comparison. Surgery has been performed on 27,7% of the patients. Complication have been observed in 8% of the cases. IAF technique is of greatest value in the treatment of those lesions; better results have been obtained with intra-thrombus injection of the drug (as emphasized by many authors) in association with PTA and surgery. A close cooperation between interventional radiology, vascular surgery and angiology is therefore necessary in this field

Inadvertent injection of succinylcholine as an epidural test dose

Directory of Open Access Journals (Sweden)

Chryssa Pourzitaki

Full Text Available Abstract Background and objectives: Epidural action of neuromuscular blocking agents could be explained under the light of their physicochemical characteristics and epidural space properties. In the literature there are few cases of accidental neuromuscular agent's epidural administration, manifesting mainly with neuromuscular blockade institution or fasciculations. Case report: We report a case of accidental succinylcholine administration as an epidural test dose, in a female patient undergoing scheduled laparotomy, under combined general and epidural anesthesia. Approximately 2 min after the succinylcholine injection the patient complained for shortness of breath, while mild fasciculations appeared in her trunk and face, managed by immediate general anesthesia institution. With the exception of a relatively longer duration of neuromuscular blockade compared with intravenous administration, no neurological or cardiovascular sequelae or other symptoms of local or systemic toxicity were observed. Conclusions: Oral administration of diazepam seems to lessen the adverse effects from accidental epidural administration of succinylcholine. The meticulous and discriminative labeling of syringes, as well as keeping persistent cautions during all anesthesia procedures remains of crucial importance.

Probability of inadvertent operation of electrical components in harsh environments

International Nuclear Information System (INIS)

Knoll, A.

1989-01-01

Harsh environment, which means humidity and high temperature, may and will affect unsealed electrical components by causing leakage ground currents in ungrounded direct current systems. The concern in a nuclear power plant is that such harsh environment conditions could cause inadvertent operation of normally deenergized components, which may have a safety-related isolation function. Harsh environment is a common cause failure, and one way to approach the problem is to assume that all the unsealed electrical components will simultaneously and inadvertently energize as a result of the environmental common cause failure. This assumption is unrealistically conservative. Test results indicated that insulating resistences of any terminal block in harsh environments have a random distribution in the range of 1 to 270 kΩ, with a mean value ∼59 kΩ. The objective of this paper is to evaluate a realistic conditional failure probability for inadvertent operation of electrical components in harsh environments. This value will be used thereafter in probabilistic safety evaluations of harsh environment events and will replace both the overconservative common cause probability of 1 and the random failure probability used for mild environments

Fluorescent Method for Observing Intravascular Bonghan Duct

Directory of Open Access Journals (Sweden)

Byung-Cheon Lee

2005-12-01

Full Text Available Observation of intra-vascular threadlike structures in the blood vessels of rats is reported with the images by differential interference contrast microscope, and fluorescence inverted microscope of the acridine-orange stained samples. The confocal microscope image and the hematoxylin-eosin staining revealed the distinctive pattern of nuclei distribution that clearly discerned the threadlike structure from fibrin, capillary, small venule, arteriole, or lymph vessel. Physiological function of the intra-vascular thread in connection with acupuncture is discussed. Especially, this threadlike duct can be a circulation path for herb-liquid flow, which may provide the scientific mechanism for therapeutic effect of herbal acupuncture.

Intrauterine intravascular transfusion for fetal haemolytic anaemia: the Western Australian experience.

Science.gov (United States)

Newnham, J P; Phillips, J M; Stock, R

1992-11-16

To report the first four years' clinical experience with fetal intravascular blood transfusion for the treatment of fetal haemolytic anaemia in Western Australia. King Edward Memorial Hospital, Perth, which is the sole tertiary level perinatal centre in Western Australia with a referral base of approximately 25,000 pregnancies each year. Transfusion was by injection of packed cells from Rh-negative donors into the fetal umbilical vein near the site of insertion into the placenta. Fetal haemoglobin levels were measured before and after each transfusion. In most cases, the fetus was paralysed by intramuscular tubocurarine. Sixty intravenous transfusions were performed in 20 pregnancies. At the time of the initial transfusion, the mean haemoglobin level was 5.8 g/dL (range, 2.5-8.5 g/dL) and six fetuses had signs of hydrops. The case survival rate was 80% and the procedure survival rate was 93%. Three of the deaths occurred in the first five cases. Caesarean section was performed during two of the procedures, one because of bleeding from the cord puncture site and one because of tamponade of the umbilical vessels. Fetal intravascular transfusion is a highly effective treatment for fetal alloimmunisation and allows pregnancies to continue to term and to be delivered vaginally. However, the procedure may be difficult and requires a team approach with ready access to fetal monitoring and emergency caesarean section. Our results suggest that increasing experience of the team is a major factor in improved outcome.

Intravascular bronchio-alveolar tumor

International Nuclear Information System (INIS)

Mata, J.M.; Caceres, J.; Prat, J.; Lopez, J.I.; Velilla, O.

1991-01-01

In 1975 Dail and Liebow described the clinical and pathological characteristics of a pulmonary tumor which they dominated intravascular bronchio-alveolar tumor (IVBAT). Our aim is to acquaint radiologists with the existence of this tumor by describing the radiologic findings in 2 patients with IVBAT, 1 with hepatic involvement ant the other with pulmonary osteoarthropathy. (author). 7 refs.; 2 figs

Design, construction, and validation of a rotary multifunctional intravascular diagnostic catheter combining multispectral fluorescence lifetime imaging and intravascular ultrasound.

Science.gov (United States)

Bec, Julien; Xie, Hongtao; Yankelevich, Diego R; Zhou, Feifei; Sun, Yang; Ghata, Narugopal; Aldredge, Ralph; Marcu, Laura

2012-10-01

We report the development and validation of an intravascular rotary catheter for bimodal interrogation of arterial pathologies. This is based on a point-spectroscopy scanning time-resolved fluorescence spectroscopy technique enabling reconstruction of fluorescence lifetime images (FLIm) and providing information on arterial intima composition and intravascular ultrasound (IVUS) providing information on arterial wall morphology. The catheter design allows for independent rotation of the ultrasonic and optical channels within an 8 Fr outer diameter catheter sheath and integrates a low volume flushing channel for blood removal in the optical pathways. In the current configuration, the two channels consist of (a) a standard 3 Fr IVUS catheter with single element transducer (40 MHz) and (b) a side-viewing fiber optic (400 μm core). Experiments conducted in tissue phantoms showed the ability of the catheter to operate in an intraluminal setting and to generate coregistered FLIm and IVUS in one pull-back scan. Current results demonstrate the feasibility of the catheter for simultaneous bimodal interrogation of arterial lumen and for generation of robust fluorescence lifetime data under IVUS guidance. These results facilitate further development of a FLIm-IVUS technique for intravascular diagnosis of atherosclerotic cardiovascular diseases including vulnerable plaques.

Inadvertent Intruder Analysis For The Portsmouth On-Site Waste Disposal Facility (OSWDF)

Energy Technology Data Exchange (ETDEWEB)

Smith, Frank G. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Phifer, Mark A. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

2014-01-22

The inadvertent intruder analysis considers the radiological impacts to hypothetical persons who are assumed to inadvertently intrude on the Portsmouth OSWDF site after institutional control ceases 100 years after site closure. For the purposes of this analysis, we assume that the waste disposal in the OSWDF occurs at time zero, the site is under institutional control for the next 100 years, and inadvertent intrusion can occur over the following 1,000 year time period. Disposal of low-level radioactive waste in the OSWDF must meet a requirement to assess impacts on such individuals, and demonstrate that the effective dose equivalent to an intruder would not likely exceed 100 mrem per year for scenarios involving continuous exposure (i.e. chronic) or 500 mrem for scenarios involving a single acute exposure. The focus in development of exposure scenarios for inadvertent intruders was on selecting reasonable events that may occur, giving consideration to regional customs and construction practices. An important assumption in all scenarios is that an intruder has no prior knowledge of the existence of a waste disposal facility at the site. Results of the analysis show that a hypothetical inadvertent intruder at the OSWDF who, in the worst case scenario, resides on the site and consumes vegetables from a garden established on the site using contaminated soil (chronic agriculture scenario) would receive a maximum chronic dose of approximately 7.0 mrem/yr during the 1000 year period of assessment. This dose falls well below the DOE chronic dose limit of 100 mrem/yr. Results of the analysis also showed that a hypothetical inadvertent intruder at the OSWDF who, in the worst case scenario, excavates a basement in the soil that reaches the waste (acute basement construction scenario) would receive a maximum acute dose of approximately 0.25 mrem/yr during the 1000 year period of assessment. This dose falls well below the DOE acute dose limit of 500 mrem/yr. Disposal inventory

Analysis of inadvertent containment spray actuation for NPP Krsko

International Nuclear Information System (INIS)

Grgic, D.; Spalj, S.; Fancev, T.

2000-01-01

Refueling Water Storage Tank (RWST) supplies borated water to the Chemical and Volume Control System, Emergency Core Cooling System and Containment Spray System. In the analyses of the containment external pressure the spray temperature is assumed to be equal to the RWST lower temperature limit. This value ensures that the design negative containment pressure will not be exceeded in the event of inadvertent actuation of the Containment Spray. For NPP Kriko the negative containment pressure has to be kept below 0.1 kp/cm2 to avoid the loss of containment integrity. This paper pursuents the analysis of Inadvertent Containment Spray Actuation in order to check the influence of change in RWST water temperature on containment negative pressure. GOTHIC computer code was used for calculation of containment thermal hydraulic behavior during this accident. (author)

Preventing Inadvertent Placement of Foley Catheter into Prostatic ...

African Journals Online (AJOL)

Percutaneous suprapubic trocar cystostomy (SPC) is often needed to drain the bladder when urethral catheterization either fails or is not advisable.[1] It is ... vertical or slightly tilting its tip toward umbilicus during foley placement, prevents the inadvertent migration of catheter into prostatic urethra and further complications.

Implementation of coordinated global serotype 2 oral poliovirus vaccine cessation: risks of inadvertent trivalent oral poliovirus vaccine use.

Science.gov (United States)

Duintjer Tebbens, Radboud J; Hampton, Lee M; Thompson, Kimberly M

2016-06-01

The endgame for polio eradication includes coordinated global cessation of oral poliovirus vaccine (OPV), starting with the cessation of vaccine containing OPV serotype 2 (OPV2) by switching all trivalent OPV (tOPV) to bivalent OPV (bOPV). The logistics associated with this global switch represent a significant undertaking, with some possibility of inadvertent tOPV use after the switch. We used a previously developed poliovirus transmission and OPV evolution model to explore the relationships between the extent of inadvertent tOPV use, the time after the switch of the inadvertent tOPV use and corresponding population immunity to serotype 2 poliovirus transmission, and the ability of the inadvertently introduced viruses to cause a serotype 2 circulating vaccine-derived poliovirus (cVDPV2) outbreak in a hypothetical population. We then estimated the minimum time until inadvertent tOPV use in a supplemental immunization activity (SIA) or in routine immunization (RI) can lead to a cVDPV2 outbreak in realistic populations with properties like those of northern India, northern Pakistan and Afghanistan, northern Nigeria, and Ukraine. At low levels of inadvertent tOPV use, the minimum time after the switch for the inadvertent use to cause a cVDPV2 outbreak decreases sharply with increasing proportions of children inadvertently receiving tOPV. The minimum times until inadvertent tOPV use in an SIA or in RI can lead to a cVDPV2 outbreak varies widely among populations, with higher basic reproduction numbers, lower tOPV-induced population immunity to serotype 2 poliovirus transmission prior to the switch, and a lower proportion of transmission occurring via the oropharyngeal route all resulting in shorter times. In populations with the lowest expected immunity to serotype 2 poliovirus transmission after the switch, inadvertent tOPV use in an SIA leads to a cVDPV2 outbreak if it occurs as soon as 9 months after the switch with 0.5 % of children aged 0-4 years inadvertently

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.

Quinine-induced disseminated intravascular coagulation.

Science.gov (United States)

Spearing, R L; Hickton, C M; Sizeland, P; Hannah, A; Bailey, R R

Recurrent disseminated intravascular coagulation occurred in 3 women after ingestion of quinine tablets for cramp. All had circulating quinine-dependent antibodies to platelets and in 2 there was initial evidence of antibody consumption, with low titres that rose steeply over the next few days and remained high for many months.

Intravascular Ultrasound Imaging of Peripheral Arteries as an Adjunct to Balloon Angioplasty and Atherectomy

International Nuclear Information System (INIS)

Korogi, Yukunori; Hirai, Toshinori; Takahashi, Mutsumasa

1996-01-01

This article reviews many of the applications of intravascular ultrasound (US) imaging for peripheral arterial diseases. In vitro studies demonstrate an excellent correlation between ultrasound measurements of lumen and plaque crossectional area compared with histologic sections. In vivo clinical studies reveal the enhanced diagnostic capabilities of this technology compared with angiography. Intravascular US imaging can provide valuable information on the degree, eccentricity, and histologic type of stenosis before intervention, and on the morphological changes in the arterial wall and the extent of excision after intervention. Intravascular US may also serve as a superior index for gauging the diameter of balloon, stent, laser probe, and/or atherectomy catheter appropriate for a proposed intervention. Significant new insights into the mechanisms of balloon angioplasty and atherectomy have been established by intravascular US findings. Intravascular US imaging has been shown to be a more accurate method than angiography for determining the cross-sectional area of the arterial lumen, and for assessing severity of stenosis. Quantitative assessment of the luminal cross-sectional area after the balloon dilatation should be more accurate than angiography as intimal tears or dissections produced by the dilatation may not be accurately evaluated with angiography. At the present time, intravascular US is still a controversial imaging technique. Outcome studies are currently being organized to assess the clinical value and cost effectiveness of intravascular ultrasound in the context of these interventional procedures

Cyclodialysis cleft with late hypotony maculopathy after inadvertent cannula detachment during cataract surgery.

Science.gov (United States)

Kahawita, Shyalle; Cugati, Sudha; Casson, Robert

2015-05-01

We present the case of a 69-year-old woman who presented with hypotony several years after an inadvertent cannula detachment presumably formed a cyclodialysis cleft during phacoemulsification cataract extraction and posterior chamber intraocular lens implantation in her right eye. To our knowledge, this is the first report of late hypotony maculopathy as a result of inadvertent cannula release. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

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.

Intravascular volume after aneurysmal subarachnoid hemorrhage

NARCIS (Netherlands)

Hoff, R.G.

2009-01-01

Intravascular volume after aneurysmal subarachnoid hemorrhage A subarachnoid hemorrhage (SAH) from a ruptured cerebral aneurysm is a devastating disorder with an often poor prognosis. The occurrence of delayed cerebral ischemia (DCI) is one of the most important factors determining outcome in

Three-dimensional contrast-enhanced MRI using an intravascular contrast agent for detection of traumatic intra-abdominal hemorrhage and abdominal parenchymal injuries: an experimental study

International Nuclear Information System (INIS)

Weishaupt, D.; Ruehm, S.G.; Patak, M.A.; Schmidt, M.; Debatin, J.F.; Hetzer, F.H.

2000-01-01

The aim of this study was to compare the performance of 3D MRI in conjunction with an intravascular contrast agent to spiral contrast-enhanced CT, regarding the detection of abdominal parenchymal injuries as well as peritoneal hemorrhage in an animal model. Liver and kidney injuries were created surgically in six female pigs under general anesthesia. All pigs underwent contrast-enhanced spiral CT and 3D MR imaging following administration of an intravascular contrast agent (NC100150 Injection). Two readers rated their confidence independently on MR and CT data sets using a five-point scale for the presence of organ injury and hemoperitoneum. Autopsy findings served as standard of reference. Sensitivity and specificity for MR in detecting hepatic and renal injuries as well as hemoperitoneum was 100 %. Computed tomography was less accurate with sensitivity and specificity values of 90 and 94 %, respectively. Receiver operating characteristics (ROC) analysis revealed a higher confidence when interpretation was based on MR images. In an animal model 3D MR imaging in conjunction with an intravascular contrast agent proved highly accurate in detecting and localizing parenchymal injuries to the upper abdomen as well as in detecting intraperitoneal blood collections. (orig.)

Renal Sympathetic Denervation System via Intraluminal Ultrasonic Ablation: Therapeutic Intravascular Ultrasound Design and Preclinical Evaluation.

Science.gov (United States)

Chernin, Gil; Szwarcfiter, Iris; Bausback, Yvonne; Jonas, Michael

2017-05-01

To assess the safety and performance of a nonfocused and nonballooned ultrasonic (US) catheter-based renal sympathetic denervation (RDN) system in normotensive swine. RDN with the therapeutic intravascular US catheter was evaluated in 3 experiments: (i) therapeutic intravascular US RDN vs a control group of untreated animals with follow-up of 30, 45, and 90 days (n = 6; n = 12 renal arteries for each group); (ii) therapeutic intravascular US RDN vs radiofrequency (RF) RDN in the contralateral artery in the same animal (n = 2; n = 4 renal arteries); and (iii) therapeutic intravascular US RDN in a recently stent-implanted renal artery (n = 2; n = 4 renal arteries). In the first experiment, therapeutic intravascular US RDN was safe, without angiographic evidence of dissection or renal artery stenosis. Neuronal tissue vacuolization, nuclei pyknosis, and perineuronal inflammation were evident after RDN, without renal artery wall damage. Norepinephrine levels were significantly lower after therapeutic intravascular US RDN after 30, 45, and 90 days compared with the control group (200.17 pg/mg ± 63.35, 184.75 pg/mg ± 44.51, and 203.43 pg/mg ± 58.54, respectively, vs 342.42 pg/mg ± 79.97). In the second experiment, deeper neuronal ablation penetrance was found with therapeutic intravascular US RDN vs RF RDN (maximal penetrance from endothelium of 7.0 mm vs 3.5 mm, respectively). There was less damage to the artery wall after therapeutic intravascular US RDN than with RF RDN, after which edema and injured endothelium were seen. In the third experiment, denervation inside the stent-implanted segments was feasible without damage to the renal artery wall or stent. The therapeutic intravascular US system performed safely and reduced norepinephrine levels. Deeper penetrance and better preservation of vessel wall were observed with therapeutic intravascular US RDN vs RF RDN. Neuronal ablations were observed in stent-implanted renal arteries. Copyright © 2017 SIR. Published

Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis

Directory of Open Access Journals (Sweden)

Kensuke Tashiro, MD

2017-11-01

Conclusions:. Hemi-IVaS could be a useful alternative to conventional intravascular stenting techniques and is also effective for supermicrosurgical perforator-to-perforator anastomosis. Further studies are needed to improve the success rate and to explore its other possible utilizations in supermicrosurgery.

Techniques for Intravascular Foreign Body Retrieval

International Nuclear Information System (INIS)

Woodhouse, Joe B.; Uberoi, Raman

2013-01-01

As endovascular therapies increase in frequency, the incidence of lost or embolized foreign bodies is increasing. The presence of an intravascular foreign body (IFB) is well recognized to have the potential to cause serious complications. IFB can embolize and impact critical sites such as the heart, with subsequent significant morbidity or mortality. Intravascular foreign bodies most commonly result from embolized central line fragments, but they can originate from many sources, both iatrogenic and noniatrogenic. The percutaneous approach in removing an IFB is widely perceived as the best way to retrieve endovascular foreign bodies. This minimally invasive approach has a high success rate with a low associated morbidity, and it avoids the complications related to open surgical approaches. We examined the characteristics, causes, and incidence of endovascular embolizations and reviewed the various described techniques that have been used to facilitate subsequent explantation of such materials

Closure Using a Surgical Closure Device of Inadvertent Subclavian Artery Punctures During Central Venous Catheter Placement

International Nuclear Information System (INIS)

Berlet, Matthew H.; Steffen, Diana; Shaughness, George; Hanner, James

2001-01-01

Severe complications can and do occur when central venous catheters are inadvertently placed into subclavian arteries. Two cases are discussed that describe how these inadvertent arterial punctures can be closed using the Perclose device (Abbott Laboratories, Redwood City, CA, USA)

Mitigating Inadvertent Insider Threats with Incentives

Science.gov (United States)

Liu, Debin; Wang, Xiaofeng; Camp, L. Jean

Inadvertent insiders are trusted insiders who do not have malicious intent (as with malicious insiders) but do not responsibly managing security. The result is often enabling a malicious outsider to use the privileges of the inattentive insider to implement an insider attack. This risk is as old as conversion of a weak user password into root access, but the term inadvertent insider is recently coined to identify the link between the behavior and the vulnerability. In this paper, we propose to mitigate this threat using a novel risk budget mechanism that offers incentives to an insider to behave according to the risk posture set by the organization. We propose assigning an insider a risk budget, which is a specific allocation of risk points, allowing employees to take a finite number of risk-seeking choice. In this way, the employee can complete her tasks without subverting the security system, as with absolute prohibitions. In the end, the organization penalizes the insider if she fails to accomplish her task within the budget while rewards her in the presence of a surplus. Most importantly. the risk budget requires that the user make conscious visible choices to take electronic risks. We describe the theory behind the system, including specific work on the insider threats. We evaluated this approach using human-subject experiments, which demonstrate the effectiveness of our risk budget mechanism. We also present a game theoretic analysis of the mechanism.

Rotational multispectral fluorescence lifetime imaging and intravascular ultrasound: bimodal system for intravascular applications

Science.gov (United States)

Ma, Dinglong; Bec, Julien; Yankelevich, Diego R.; Gorpas, Dimitris; Fatakdawala, Hussain; Marcu, Laura

2014-01-01

Abstract. We report the development and validation of a hybrid intravascular diagnostic system combining multispectral fluorescence lifetime imaging (FLIm) and intravascular ultrasound (IVUS) for cardiovascular imaging applications. A prototype FLIm system based on fluorescence pulse sampling technique providing information on artery biochemical composition was integrated with a commercial IVUS system providing information on artery morphology. A customized 3-Fr bimodal catheter combining a rotational side-view fiberoptic and a 40-MHz IVUS transducer was constructed for sequential helical scanning (rotation and pullback) of tubular structures. Validation of this bimodal approach was conducted in pig heart coronary arteries. Spatial resolution, fluorescence detection efficiency, pulse broadening effect, and lifetime measurement variability of the FLIm system were systematically evaluated. Current results show that this system is capable of temporarily resolving the fluorescence emission simultaneously in multiple spectral channels in a single pullback sequence. Accurate measurements of fluorescence decay characteristics from arterial segments can be obtained rapidly (e.g., 20 mm in 5 s), and accurate co-registration of fluorescence and ultrasound features can be achieved. The current finding demonstrates the compatibility of FLIm instrumentation with in vivo clinical investigations and its potential to complement conventional IVUS during catheterization procedures. PMID:24898604

Disseminated Intravascular Coagulation Following Induction of ...

African Journals Online (AJOL)

Background: Disseminated Intravascular coagulopathy (DIC) has been reported following use of Misoprostol which is an old drug with new indications in Obstetrics and. Gynecology. Its effectiveness, low cost, stability in tropical conditions and ease of administration as well as side effects like gastrointestinal effect, uterine ...

Chemical Facial Cellulitis Due to Inadvertent Injection of Formalin into Oral Tissue Space.

Science.gov (United States)

Bector, Aditi; Virk, Pawandeep Sandhu; Arakeri, Gururaj

2015-11-05

This paper reports the accidental injection of formalin into oral tissue space, in an 8-year old child resulting in chemical facial necrotizing cellulitis and its management. The common practice of keeping formalin in local anesthesia vials should be avoided by dental clinics, to prevent such unfortunate incidents.

Inadvertent presence of genetically modified elements in maize food ...

African Journals Online (AJOL)

Kenya has a biosafety law and has tested genetically modified (GM) maize under confinement and containment, but has neither released nor commercialized any GM crop. This study assessed various maize food products from the Kenyan farms and markets for the inadvertent presence of GMOs. It assessed the possibility ...

Newer techniques for intravascular and intraoperative neurointerventional procedures

International Nuclear Information System (INIS)

Higashida, R.T.; Halbach, V.V.; Hieshima, G.B.; Yang, P.

1987-01-01

A videotape demonstrating newer techniques used in intravascular and intraoperative embolization procedures will be presented. The authors discuss the use of some of the newer embolic agents, real-time digital subtraction angiography, roadmapping techniques, and the use of microcatheters and steerable micro guide wires, which has greatly facilitated neurovascullar embolization procedures and enhanced patient safety. A number of actual intraoperative and intravascular cases will be shown demonstrating treatment of vascular malformations of the brain and spinal cord, carotid cavernous sinus fistulas, aneurysms and dural arteriovenous malformations. The indications for treatment, patient selection, technical preparation and newer methodologies and approaches to complex vascular lesions of the brain and spinal cord are discussed in detail

Beverage can stay-tabs: still a source for inadvertently ingested foreign bodies in children

Energy Technology Data Exchange (ETDEWEB)

Donnelly, Lane F. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States); University of Cincinnati, College of Medicine, Departments of Radiology and Pediatrics, Cincinnati, OH (United States)

2010-09-15

In the 1970s in part to avoid inadvertent ingestion, the beverage-can industry changed can construction from pull-tabs to the stay-tabs (remain attached to can after opening) used today. Our purpose is to identify the number of inadvertent ingestions of beverage-can stay-tabs by children recognized at our institution. The medical information system of a children's hospital was searched with key terms to identify cases in which a witnessed or self-reported inadvertent ingestion of a beverage-can stay-tab resulted in a radiograph to rule out presence of a foreign body. Demographics, identification of stay-tab on radiographs, associated abnormalities, and patient management were reviewed. Nineteen cases of stay-tab ingestion were identified over 16 years. Mean age of ingesters was 8.5 years with the majority being teenagers and 15 (79%) >5 years of age. The stay-tab could be seen radiographically only in 4 (21%) cases - all with the stay-tab identified in the stomach. The identification of 19 children who inadvertently ingested beverage-can stay-tabs at a single children's hospital suggests that such ingestions still occur. Radiologists should be aware that stay-tabs are radiographically visible in the minority (21%) of cases. (orig.)

Beverage can stay-tabs: still a source for inadvertently ingested foreign bodies in children

International Nuclear Information System (INIS)

Donnelly, Lane F.

2010-01-01

In the 1970s in part to avoid inadvertent ingestion, the beverage-can industry changed can construction from pull-tabs to the stay-tabs (remain attached to can after opening) used today. Our purpose is to identify the number of inadvertent ingestions of beverage-can stay-tabs by children recognized at our institution. The medical information system of a children's hospital was searched with key terms to identify cases in which a witnessed or self-reported inadvertent ingestion of a beverage-can stay-tab resulted in a radiograph to rule out presence of a foreign body. Demographics, identification of stay-tab on radiographs, associated abnormalities, and patient management were reviewed. Nineteen cases of stay-tab ingestion were identified over 16 years. Mean age of ingesters was 8.5 years with the majority being teenagers and 15 (79%) >5 years of age. The stay-tab could be seen radiographically only in 4 (21%) cases - all with the stay-tab identified in the stomach. The identification of 19 children who inadvertently ingested beverage-can stay-tabs at a single children's hospital suggests that such ingestions still occur. Radiologists should be aware that stay-tabs are radiographically visible in the minority (21%) of cases. (orig.)

Chemical facial cellulitis due to inadvertent injection of formalin into oral tissue space

Directory of Open Access Journals (Sweden)

Aditi Bector

2015-12-01

Full Text Available This paper reports the accidental injection of formalin into oral tissue space, in an 8-year old child resulting in chemical facial necrotizing cellulitis and its management. The common practice of keeping formalin in local anesthesia vials should be avoided by dental clinics, to prevent such unfortunate incidents.

Emergency treatment by intravascular embolization in traumatic carotid cavernous fistula

International Nuclear Information System (INIS)

Tang Jun; Sun Zengtao; Liu Zuoqin; Liu Yanjun; Li Fengxin

2006-01-01

Objective: To discuss the method of intervenfional intravascular treatment in traumatic carotid cavernous fistula (TCCF) and the significance of clinical application in emergency. Methods: In 297 eases of TCCF, 36 cases were treated by interventional intravascular embolization by detachable balloon, embolization orificium or occlusion in one side of carotid artery. In the 36 cases, serious epistaxis occurred in 22 eases, cortical vein inflow in 9 cases, intracranial hemorrhage in 3 cases, aggravation of eyesight in 3 cases, and limb dysfunction in 2 cases. Results: Fistula was successfully embolized and internal carotid artery remained patent in 19 cases. Complete embolization of orificium or internal carotid artery was achieved in 17 eases. The serious epistaxias in 22 cases and intracranial hemorrhage in 3 cases stopped. Eyesight recovered in 2 eases and improved in 1 case. Limb dysfunction improved evidently in 2 cases. Conclusion: Intravascular embolization treatment is the first therapeutic choice for TCCF, especially in emergency. It is necessary, safe and effective. (authors)

Response to events involving the inadvertent movement or illicit trafficking of radioactive materials

International Nuclear Information System (INIS)

2002-09-01

By international agreements, the movement of all radioactive materials within and between States should be subject to high standards of regulatory, administrative, safety and engineering controls to ensure that such movements are conducted in a safe and secure manner. In the case of nuclear materials, there are additional requirements for physical protection and accountability to ensure against threats of nuclear proliferation and to safeguard against any attempts at diversion. The results of the terrorist attacks of September 2001 emphasized the requirement for enhanced control and security of nuclear and radioactive materials. In this regard, measures are being taken to increase the global levels of physical protection and security for nuclear materials. Experience in many parts of the world continues to prove that movements of radioactive materials outside of the regulatory and legal frameworks continue to occur. Such movements may be either deliberate or inadvertent. Deliberate, illegal movements of radioactive materials, including nuclear material, for terrorist, political or illegal profit is generally understood to be illicit trafficking. The more common movements outside of regulatory control are inadvertent in nature. An example of an inadvertent movement might be the transport of steel contaminated by a melted radioactive source that was lost from proper controls. Such a shipment may present health and safety threats to the personnel involved as well as to the general public. States have the responsibility for combating illicit trafficking and inadvertent movements of radioactive materials. The IAEA co-operates with Member States and other international organizations in joint efforts to prevent incidents of illicit trafficking and inadvertent movements and to harmonize policies and measures by the provision of relevant advice through technical assistance and documents. As an example, the IAEA and the World Customs Organization (WCO) maintain a Memorandum

Response to events involving the inadvertent movement or illicit trafficking of radioactive materials

International Nuclear Information System (INIS)

2004-08-01

By international agreements, the movement of all radioactive materials within and between States should be subject to high standards of regulatory, administrative, safety and engineering controls to ensure that such movements are conducted in a safe and secure manner. In the case of nuclear materials, there are additional requirements for physical protection and accountability to ensure against threats of nuclear proliferation and to safeguard against any attempts at diversion. The results of the terrorist attacks of September 2001 emphasized the requirement for enhanced control and security of nuclear and radioactive materials. In this regard, measures are being taken to increase the global levels of physical protection and security for nuclear materials. Experience in many parts of the world continues to prove that movements of radioactive materials outside of the regulatory and legal frameworks continue to occur. Such movements may be either deliberate or inadvertent. Deliberate, illegal movements of radioactive materials, including nuclear material, for terrorist, political or illegal profit is generally understood to be illicit trafficking. The more common movements outside of regulatory control are inadvertent in nature. An example of an inadvertent movement might be the transport of steel contaminated by a melted radioactive source that was lost from proper controls. Such a shipment may present health and safety threats to the personnel involved as well as to the general public. States have the responsibility for combating illicit trafficking and inadvertent movements of radioactive materials. The IAEA co-operates with Member States and other international organizations in joint efforts to prevent incidents of illicit trafficking and inadvertent movements and to harmonize policies and measures by the provision of relevant advice through technical assistance and documents. As an example, the IAEA and the World Customs Organization (WCO) maintain a Memorandum

Response to events involving the inadvertent movement or illicit trafficking of radioactive materials

International Nuclear Information System (INIS)

2002-08-01

By international agreements, the movement of all radioactive materials within and between States should be subject to high standards of regulatory, administrative, safety and engineering controls to ensure that such movements are conducted in a safe and secure manner. In the case of nuclear materials, there are additional requirements for physical protection and accountability to ensure against threats of nuclear proliferation and to safeguard against any attempts at diversion. The results of the terrorist attacks of September 2001 emphasized the requirement for enhanced control and security of nuclear and radioactive materials. In this regard, measures are being taken to increase the global levels of physical protection and security for nuclear materials. Experience in many parts of the world continues to prove that movements of radioactive materials outside of the regulatory and legal frameworks continue to occur. Such movements may be either deliberate or inadvertent. Deliberate, illegal movements of radioactive materials, including nuclear material, for terrorist, political or illegal profit is generally understood to be illicit trafficking. The more common movements outside of regulatory control are inadvertent in nature. An example of an inadvertent movement might be the transport of steel contaminated by a melted radioactive source that was lost from proper controls. Such a shipment may present health and safety threats to the personnel involved as well as to the general public. States have the responsibility for combating illicit trafficking and inadvertent movements of radioactive materials. The IAEA co-operates with Member States and other international organizations in joint efforts to prevent incidents of illicit trafficking and inadvertent movements and to harmonize policies and measures by the provision of relevant advice through technical assistance and documents. As an example, the IAEA and the World Customs Organization (WCO) maintain a Memorandum

Response to events involving the inadvertent movement or illicit trafficking of radioactive materials

International Nuclear Information System (INIS)

2003-08-01

By international agreements, the movement of all radioactive materials within and between States should be subject to high standards of regulatory, administrative, safety and engineering controls to ensure that such movements are conducted in a safe and secure manner. In the case of nuclear materials, there are additional requirements for physical protection and accountability to ensure against threats of nuclear proliferation and to safeguard against any attempts at diversion. The results of the terrorist attacks of September 2001 emphasized the requirement for enhanced control and security of nuclear and radioactive materials. In this regard, measures are being taken to increase the global levels of physical protection and security for nuclear materials. Experience in many parts of the world continues to prove that movements of radioactive materials outside of the regulatory and legal frameworks continue to occur. Such movements may be either deliberate or inadvertent. Deliberate, illegal movements of radioactive materials, including nuclear material, for terrorist, political or illegal profit is generally understood to be illicit trafficking. The more common movements outside of regulatory control are inadvertent in nature. An example of an inadvertent movement might be the transport of steel contaminated by a melted radioactive source that was lost from proper controls. Such a shipment may present health and safety threats to the personnel involved as well as to the general public. States have the responsibility for combating illicit trafficking and inadvertent movements of radioactive materials. The IAEA co-operates with Member States and other international organizations in joint efforts to prevent incidents of illicit trafficking and inadvertent movements and to harmonize policies and measures by the provision of relevant advice through technical assistance and documents. As an example, the IAEA and the World Customs Organization (WCO) maintain a Memorandum

Asian-variant intravascular lymphoma in the African race

Directory of Open Access Journals (Sweden)

Holly Geyer

2012-03-01

Full Text Available Intravascular large B-cell lymphoma (IVLBCL is an exceptionally rare form of non- Hodgkin lymphoma (NHL distinguished by the preferential growth of neoplastic cells within blood vessel lumen. Challenging to detect and deemed disseminated at diagnosis, this condition is characterized by a highly aggressive, inconspicuous course with a high mortality rate. We describe the case of a 48 year-old African-American female presenting with a two month history of low-grade fevers and malaise. Laboratory data was notable for anemia, thrombocytopenia, elevated liver function tests, and hematuria. An extensive workup for infectious, rheumatologic and malignant causes was negative. Her symptoms progressed and within two weeks, she was admitted for disseminated intravascular coagulation (DIC. Her course was complicated by diffuse pulmonary hemorrhage and ultimately, care was withdrawn. Autopsy identified widespread CD-20 positive intravascular large B-cell lymphoma with significant hepatosplenic involvement, characteristic of the Asian variant IVLBCL. This case uniquely highlights development of the Asian variant IVLBVL in a previously undescribed race. Identified by its intraluminal vascular growth pattern, IVLBCL generally spares lymphatic channels. Diagnosis and differentiation of this condition from other hematological malignancies via skin, visceral and bone marrow biopsy is imperative as anthracycline-containing chemotherapies may significantly improve clinical outcomes. This article outlines the common presentation, natural course, and treatment options of IVLBCL, along with the histopathology, immunohistochemistry, and chromosomal aberrations common to this condition.

Gallium SPECT detection of neoplastic intravascular obstruction of the superior vena cava

International Nuclear Information System (INIS)

Swayne, L.C.; Kaplan, I.L.

1989-01-01

A rare case of an intravascular neoplastic obstruction of the superior vena cava is discussed. The lesion was detected with gallium single photon emission computed tomography (SPECT) despite a normal appearance on a concurrent radiographic CT study. A computer-generated composite SPECT-CT image confirmed the intravascular localization of the radioisotope, and a subsequent CT-guided transthoracic needle biopsy revealed a poorly differentiated adenocarcinoma

21 CFR 880.5440 - Intravascular administration set.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intravascular administration set. 880.5440 Section 880.5440 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use...

Intravascular photoacoustic imaging of human coronary atherosclerosis

Science.gov (United States)

Jansen, Krista; van der Steen, Antonius F. W.; Springeling, Geert; van Beusekom, Heleen M. M.; Oosterhuis, J. Wolter; van Soest, Gijs

2011-03-01

We demonstrate intravascular photoacoustic imaging of human coronary atherosclerotic plaque. We specifically imaged lipid content, a key factor in vulnerable plaques that may lead to myocardial infarction. An integrated intravascular photoacoustics (IVPA) and ultrasound (IVUS) catheter with an outer diameter of 1.25 mm was developed. The catheter comprises an angle-polished optical fiber adjacent to a 30 MHz single-element transducer. The ultrasonic transducer was optically isolated to eliminate artifacts in the PA image. We performed measurements on a cylindrical vessel phantom and isolated point targets to demonstrate its imaging performance. Axial and lateral point spread function widths were 110 μm and 550 μm, respectively, for PA and 89 μm and 420 μm for US. We imaged two fresh human coronary arteries, showing different stages of disease, ex vivo. Specific photoacoustic imaging of lipid content, is achieved by spectroscopic imaging at different wavelengths between 1180 and 1230 nm.

Late-Onset Inadvertent Bleb Formation following Pars Plana M3 Molteno Implant Tube Obstruction

Directory of Open Access Journals (Sweden)

Anmar M. Abdul-Rahman

2017-01-01

Full Text Available Purpose: To report a case of inadvertent bleb formation presenting 18 months after pars plana M3 Molteno implant tube obstruction in a patient with mixed mechanism glaucoma. Materials and Methods: An 84-year-old Caucasian male with mixed mechanism glaucoma underwent slit-lamp examination, gonioscopy, colour anterior segment photography and anterior segment optical coherence tomography (AS-OCT. Results: An inadvertent bleb developed 18 months after pars plana implant tube re-positioning with a 6/0 Vicryl tie ligature. The bleb was located in the area anterior to the implant plate; it was characterised by a thin, transparent, avascular and multi-cystic wall, with a visible stoma at the posterior edge of the bleb. The bleb was functioning as demonstrated by an intraocular pressure of 6 mm Hg at presentation and a punctate fluorescein uptake pattern of the bleb wall. The bleb over the plate of the Molteno implant was non-functioning, likely secondary to tube obstruction by vitreous in the early postoperative period. AS-OCT showed a tract from the anterior chamber commencing at an entry wound through a corneal tunnel to the posterior stoma at the base of the inadvertent bleb. Conclusions: We hypothesise that the pathophysiologic factors resulting in an inadvertent bleb are a result of a combination of apoptosis, late-onset wound dehiscence and internal gaping of a centrally placed corneal wound. In addition, aqueous hydrodynamic factors may play a role.

Myocardial blood flow rate and capillary permeability for 99mTc-DTPA in patients with angiographically normal coronary arteries. Evaluation of the single-injection, residue detection method with intracoronary indicator bolus injection and the use of a mobile gamma camera

DEFF Research Database (Denmark)

Svendsen, Jesper Hastrup; Kelbaek, H; Efsen, F

1994-01-01

The aims of the present study were to quantitate myocardial perfusion and capillary permeability in the human heart by means of the single-injection, residue detection method using a mobile gamma camera. With this method, the intravascular mean transit time and the capillary extraction fraction (E...

Renal denervation by intravascular ultrasound: Preliminary in vivo study

Science.gov (United States)

Sinelnikov, Yegor; McClain, Steve; Zou, Yong; Smith, David; Warnking, Reinhard

2012-10-01

Ultrasound denervation has recently become a subject of intense research in connection with the treatment of complex medical conditions including neurological conditions, development of pain management, reproduction of skin sensation, neuropathic pain and spasticity. The objective of this study is to investigate the use of intravascular ultrasound to produce nerve damage in renal sympathetic nerves without significant injury to the renal artery. This technique may potentially be used to treat various medical conditions, such as hypertension. The study was approved by the Institutional Animal Care and Use Committee. Ultrasound was applied to renal nerves of the swine model for histopathological evaluation. Therapeutic ultrasound energy was delivered circumferentially by an intravascular catheter maneuvered into the renal arteries. Fluoroscopic imaging was conducted pre-and post-ultrasound treatment. Animals were recovered and euthanized up to 30 hours post procedure, followed by necropsy and tissue sample collection. Histopathological examination showed evidence of extensive damage to renal nerves, characterized by nuclear pyknosis, hyalinization of stroma and multifocal hemorrhages, with little or no damage to renal arteries. This study demonstrates the feasibility of intravascular ultrasound as a minimally invasive renal denervation technique. Further studies are necessary to evaluate the long-term safety and efficacy of this technique and its related clinical significance.

Potential impact of DOE's performance objective for protection of inadvertent intruders on low-level waste disposals at Oak Ridge National Laboratory

International Nuclear Information System (INIS)

Kocher, D.C.

1993-01-01

Performance objectives for disposal of low-level radioactive waste at Department of Energy (DOE) sites include limits on radiation dose to inadvertent intruders. This paper investigates the potential impact of DOE's performance objective for protection of inadvertent intruders on the acceptability of low-level waste disposals at Oak Ridge National Laboratory (ORNL). The analysis is based on waste volumes and radionuclide inventories for recent disposals and estimated doses to an inadvertent intruder for assumed exposure scenarios. The analysis indicates that more than 99% of the total volume of waste in recent disposals meets the performance objective for inadvertent intruders, and the volume of waste found to be unacceptable for disposal is only about 16 m 3 . Therefore, DOE's performance objective for protection of inadvertent intruders probably will not have unreasonably adverse impacts on acceptable waste disposals at ORNL

Lack of plasma albumin impairs intravascular lipolysis and explains the associated free fatty acids deficiency and hypertriglyceridemia

Directory of Open Access Journals (Sweden)

Oliveira Helena CF

2010-12-01

Full Text Available Abstract Background Abnormalities in lipid metabolism and transport are hallmarks in analbuminemic Nagase rats (NAR and humans. Triglyceridemia is nearly 3- to 5-fold higher in female NAR than in control Sprague-Dawley rats (SDR. Also, NAR present with a severe plasma free fatty acid (FFA deficit. There are conflicting results regarding the mechanisms underlying NAR hypertriglyceridemia. Objective We aimed at investigating whether liver lipogenesis and triglyceride secretion rates into the plasma contribute to the hypertriglyceridemia in NAR. We also studied whether heparin or albumin administration would release the hypothesized lipolysis inhibition in NAR. Methods The incorporation of tritiated water into lipids and the linear accumulation rate of plasma triglycerides after Triton WR1339 injection were the measures of liver lipogenesis and triglyceride secretion rates. Results Lipogenesis (596 ± 40 vs. 929 ± 124 μmol 3H2O/g/h and triglyceride (4.25 ± 1.00 vs. 7.04 ± 1.68 mg/dL/min secretion rates were slower (P ≤ 0.05 in fasted NAR than in control SDR. The injection of either heparin or albumin elicited an increase in NAR plasma FFA levels over time. FFA levels reached control levels 90 min after the albumin administration, increasing from 0.36 ± 0.05 to 1.34 ± 0.16 mEq/L (P ≤ 0.05. These results indicate that the lack of plasma albumin inhibits intravascular lipolysis and causes the FFA deficit observed in NAR. Conclusion NAR hepatic triglyceride synthesis and output do not contribute to NAR hypertriglyceridemia. We propose that the lack of albumin diminishes intravascular lipolysis which reduces the plasma triglyceride removal rate and explain both NAR hypertriglyceridemia and FFA deficiency.

Therapeutic intervention in disseminated intravascular coagulation: have we made any progress in the last millennium?

NARCIS (Netherlands)

Levi, Marcel; de Jonge, Evert; van der Poll, Tom

2002-01-01

Disseminated intravascular coagulation (DIC) is a syndrome characterized by systemic intravascular activation of coagulation, leading to widespread deposition of fibrin in the circulation. Recent knowledge on important pathogenetic mechanisms that may lead to DIC has resulted in novel preventive and

Intravascular catheter sepsis | Mer | South African Medical Journal

African Journals Online (AJOL)

Intravascular devices are an integral component of modern-day medical practice. They are used to administer intravenous fluids, medications, blood products and parenteral nutrition. In addition, they serve as a valuable monitor of the haemodynamic status of critically ill patients.

Comparative study of the novel and conventional injection approach for inferior alveolar nerve block.

Science.gov (United States)

Boonsiriseth, K; Sirintawat, N; Arunakul, K; Wongsirichat, N

2013-07-01

This study aimed to evaluate the efficacy of anesthesia obtained with a novel injection approach for inferior alveolar nerve block compared with the conventional injection approach. 40 patients in good health, randomly received each of two injection approaches of local anesthetic on each side of the mandible at two separate appointments. A sharp probe and an electric pulp tester were used to test anesthesia before injection, after injection when the patients' sensation changed, and 5 min after injection. This study comprised positive aspiration and intravascular injection 5% and neurovascular bundle injection 7.5% in the conventional inferior alveolar nerve block, but without occurrence in the novel injection approach. A visual analog scale (VAS) pain assessment was used during injection and surgery. The significance level used in the statistical analysis was pinferior alveolar nerve block by the novel injection approach provided adequate anesthesia and caused less pain and greater safety during injection. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Disseminated intravascular coagulation in meningococcal sepsis. Case 7

NARCIS (Netherlands)

Zeerleder, S.; Zürcher Zenklusen, R.; Hack, C. E.; Wuillemin, W. A.

2003-01-01

We report on a man (age: 49 years), who died from severe meningococcal sepsis with disseminated intravascular coagulation (DIC), multiple organ dysfunction syndrome and extended skin necrosis. We discuss in detail the pathophysiology of the activation of coagulation and fibrinolysis during sepsis.

Intentional and inadvertent non-adherence in adult coeliac disease. A cross-sectional survey.

Science.gov (United States)

Hall, Nicola J; Rubin, Gregory P; Charnock, Anne

2013-09-01

Adherence to a gluten-free diet is the mainstay of treatment for coeliac disease. Non-adherence is common as the diet is restrictive and can be difficult to follow. This study aimed to determine the rates of intentional and inadvertent non-adherence in adult coeliac disease and to examine the factors associated with both. A self-completion questionnaire was mailed to adult coeliac patients identified from the computer records of 31 family practices within the North East of England. We received 287 responses after one reminder. Intentional gluten consumption was reported by 115 (40%) of respondents. 155 (54%) had made at least one known mistaken lapse over the same period and 82 (29%) reported neither intentional nor mistaken gluten consumption. Using logistic regression analysis, low self-efficacy, perceptions of tolerance to gluten and intention were found to be independently predictive of intentional gluten consumption. A statistical model predicted 71.8% of cases reporting intentional lapses. Intentional non-adherence to the GFD was found to be common but not as frequent as inadvertent lapses. Distinguishing the factors influencing both intentional and inadvertent non-adherence is useful in understanding dietary self-management in coeliac disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

Intravascular pulmonary metastases from sarcoma: appearance on computed tomography in 3 cases

International Nuclear Information System (INIS)

Ting, P.T.; Burrowes, P.W.; Gray, R.R.

2005-01-01

Various common malignant neoplasms (ie, liver, kidney, stomach and breast) have been reported to embolize to the pulmonary arterial system. This uncommon occurrence can also result from metastatic sarcoma. We report 3 cases- 2 chondrosarcomas and 1 osteosarcoma-associated with intravascular motastases to the pulmonary vasculature and discuss the clinical presentation and differentiating radiologic features on computed tomography (CT). Intravascular pulmonary tumour emboli may present with nonspecific respiratory symptoms or remain completely asymptomatic, and therefore, many patients are often misdiagnosed with thromboembolic disease or undiagnosed until autopsy. Chest CTs in all our patients demonstrated a striking pattern of multifocal tubular branching beaded opacities along the pulmonary vasculature in a multilobular distribution. Our observations and a review of the literature indicate that chest CT is the most useful diagnostic tool for detecting intravascular pulmonary tumour emboli. CT can distinguish this entity from mucous plugging by demonstrating the normal adjacent bronchus. The tubular nature of these metastases distinguishes them from the more common parenchymal metastases. (author)

Intravascular brachytherapy in prevention of the secondary restenosis angioplasty transluminal coronaries

International Nuclear Information System (INIS)

Mejia, S.

2001-01-01

The radiotherapy coronary intravascular has demonstrated in a convincing way in clinical and experimental studies that produces a favorable decrease of the restenosis process. There is enough evidence to define this technique as the main current therapeutic option in the handling of the reestenosis intra stent. Accumulated experience exists of up to 3 years in patient's treaties with radiation gamma and multiple studies in several centers that demonstrate similar benefits with issuing beta. The present articulates it revises a series of radiotherapy systems and makes a setting a day on the employment of the brachytherapy intravascular in cardiologic patient

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.

Currently available methodologies for the processing of intravascular ultrasound and optical coherence tomography images.

Science.gov (United States)

Athanasiou, Lambros; Sakellarios, Antonis I; Bourantas, Christos V; Tsirka, Georgia; Siogkas, Panagiotis; Exarchos, Themis P; Naka, Katerina K; Michalis, Lampros K; Fotiadis, Dimitrios I

2014-07-01

Optical coherence tomography and intravascular ultrasound are the most widely used methodologies in clinical practice as they provide high resolution cross-sectional images that allow comprehensive visualization of the lumen and plaque morphology. Several methods have been developed in recent years to process the output of these imaging modalities, which allow fast, reliable and reproducible detection of the luminal borders and characterization of plaque composition. These methods have proven useful in the study of the atherosclerotic process as they have facilitated analysis of a vast amount of data. This review presents currently available intravascular ultrasound and optical coherence tomography processing methodologies for segmenting and characterizing the plaque area, highlighting their advantages and disadvantages, and discusses the future trends in intravascular imaging.

Intravascular enhancement with identical iodine delivery rate using different iodine contrast media in a circulation phantom.

Science.gov (United States)

Mihl, Casper; Wildberger, Joachim E; Jurencak, Tomas; Yanniello, Michael J; Nijssen, Estelle C; Kalafut, John F; Nalbantov, Georgi; Mühlenbruch, Georg; Behrendt, Florian F; Das, Marco

2013-11-01

Both iodine delivery rate (IDR) and iodine concentration are decisive factors for vascular enhancement in computed tomographic angiography. It is unclear, however, whether the use of high-iodine concentration contrast media is beneficial to lower iodine concentrations when IDR is kept identical. This study evaluates the effect of using different iodine concentrations on intravascular attenuation in a circulation phantom while maintaining a constant IDR. A circulation phantom with a low-pressure venous compartment and a high-pressure arterial compartment simulating physiological circulation parameters was used (heart rate, 60 beats per minute; stroke volume, 60 mL; blood pressure, 120/80 mm Hg). Maintaining a constant IDR (2.0 g/s) and a constant total iodine load (20 g), prewarmed (37°C) contrast media with differing iodine concentrations (240-400 mg/mL) were injected into the phantom using a double-headed power injector. Serial computed tomographic scans at the level of the ascending aorta (AA), the descending aorta (DA), and the left main coronary artery (LM) were obtained. Total amount of contrast volume (milliliters), iodine delivery (grams of iodine), peak flow rate (milliliter per second), and intravascular pressure (pounds per square inch) were monitored using a dedicated data acquisition program. Attenuation values in the AA, the DA, and the LM were constantly measured (Hounsfield unit [HU]). In addition, time-enhancement curves, aortic peak enhancement, and time to peak were determined. All contrast injection protocols resulted in similar attenuation values: the AA (516 [11] to 531 [37] HU), the DA (514 [17] to 531 [32] HU), and the LM (490 [10] to 507 [17] HU). No significant differences were found between the AA, the DA, and the LM for either peak enhancement (all P > 0.05) or mean time to peak (AA, 19.4 [0.58] to 20.1 [1.05] seconds; DA, 21.1 [1.0] to 21.4 [1.15] seconds; LM, 19.8 [0.58] to 20.1 [1.05] seconds). This phantom study demonstrates that

Intravascular imaging with a storage phosphor detector

Energy Technology Data Exchange (ETDEWEB)

Shikhaliev, Polad M; Petrek, Peter; Matthews, Kenneth L II; Fritz, Shannon G [Department of Physics and Astronomy, Louisiana State University, Baton Rouge, LA (United States); Bujenovic, L Steven [PET Imaging Center, Our Lady of the Lake Medical Center, Baton Rouge, LA (United States); Xu Tong, E-mail: pshikhal@lsu.ed [Department of Physics, Carleton University, Ottawa (Canada)

2010-05-21

The aim of this study is to develop and test an intravascular positron imaging system based on a storage phosphor detector for imaging and detecting vulnerable plaques of human coronary arteries. The radiotracer F18-FDG accumulates in vulnerable plaques with inflammation of the overlying cap. The vulnerable plaques can, therefore, be imaged by recording positrons emitted from F18-FDG with a detector inserted into the artery. A prototype intravascular detector was constructed based on storage phosphor. The detector uses a flexible storage phosphor tube with 55 mm length, 2 mm diameter and 0.28 mm wall thickness. The intravascular detector is guided into the vessel using x-ray fluoroscopy and the accumulated x-ray signal must be erased prior to positron imaging. For this purpose, a light diffuser, 0.9 mm in diameter and 55 mm in length, was inserted into the detector tube. The light diffuser was connected to a laser source through a 2 m long optical fiber. The diffuser redirected the 0.38 W laser light to the inner surface of the phosphor detector to erase it. A heart phantom with 300 cm{sup 3} volume and three coronary arteries with 3.2 mm diameter and with several plaques was constructed. FDG solution with 0.5 {mu}Ci cm{sup -3} activity concentration was filled in the heart and coronary arteries. The detector was inserted in a coronary artery and the signal from the plaques and surrounding background activity was recorded for 2 min. Then the phosphor detector was extracted and read out using a storage phosphor reader. The light diffuser erased the signal resulting from fluoroscopic exposure to level below that encountered during positron imaging. Vulnerable plaques with area activities higher than 1.2 nCi mm{sup -2} were visualized by the detector. This activity is a factor of 10-20 lower than that expected in human vulnerable plaques. The detector was able to image the internal surface of the coronary vessels with 50 mm length and 360{sup 0} circumference. Spatial

Leiomyosarcoma of the Uterus with Intravascular Tumor Extension and Pulmonary Tumor Embolism

International Nuclear Information System (INIS)

McDonald, Douglas K.; Kalva, Sanjeeva P.; Fan, C.-M.; Vasilyev, Aleksandr

2007-01-01

We report the case of a 48-year-old woman presenting with recurrent uterine leiomyosarcoma (LMS) associated with right iliac vein and inferior vena cava (IVC) invasion and left lower lobe pulmonary tumor embolus. Because the prognosis and treatment differ from that of thrombotic pulmonary emboli, the differentiating imaging characteristics of intravascular tumor embolism are reviewed. To our knowledge, only two other cases of intravenous uterine leiomyosarcomatosis have been described in the existing literature, and this is the first reported case of the entity with associated intravascular tumor embolism

Cardiovascular disease in haemodialysis: role of the intravascular innate immune system.

Science.gov (United States)

Ekdahl, Kristina N; Soveri, Inga; Hilborn, Jöns; Fellström, Bengt; Nilsson, Bo

2017-05-01

Haemodialysis is a life-saving renal replacement modality for end-stage renal disease, but this therapy also represents a major challenge to the intravascular innate immune system, which is comprised of the complement, contact and coagulation systems. Chronic inflammation is strongly associated with cardiovascular disease (CVD) in patients on haemodialysis. Biomaterial-induced contact activation of proteins within the plasma cascade systems occurs during haemodialysis and initially leads to local generation of inflammatory mediators on the biomaterial surface. The inflammation is spread by soluble activation products and mediators that are generated during haemodialysis and transported in the extracorporeal circuit back into the patient together with activated leukocytes and platelets. The combined effect is activation of the endothelium of the cardiovascular system, which loses its anti-thrombotic and anti-inflammatory properties, leading to atherogenesis and arteriosclerosis. This concept suggests that maximum suppression of the intravascular innate immune system is needed to minimize the risk of CVD in patients on haemodialysis. A potential approach to achieve this goal is to treat patients with broad-specificity systemic drugs that target more than one of the intravascular cascade systems. Alternatively, 'stealth' biomaterials that cause minimal cascade system activation could be used in haemodialysis circuits.

Disseminated intravascular coagulation caused by moojenactivase, a procoagulant snake venom metalloprotease.

Science.gov (United States)

Sartim, Marco A; Cezarette, Gabriel N; Jacob-Ferreira, Anna L; Frantz, Fabiani G; Faccioli, Lucia H; Sampaio, Suely V

2017-10-01

Snake venom toxins that activate coagulation factors are key players in the process of venom-induced coagulopathy, and account for severe clinical manifestations. The present study applies a variety of biochemical, hematological, and histopathological approaches to broadly investigate the intravascular and systemic effects of moojenactivase (MooA), the first described PIIId subclass metalloprotease isolated from Bothrops sp. venom that activates coagulation factors. MooA induced consumption coagulopathy with high toxic potency, characterized by prolongation of prothrombin and activated partial thromboplastin time, consumption of fibrinogen and the plasma coagulation factors X and II, and thrombocytopenia. MooA promoted leukocytosis and expression of the proinflammatory cytokines interleukin-6 and tumor necrosis factor-α, accompanied by tissue factor-dependent procoagulant activity in peripheral blood mononuclear cells. This metalloprotease also caused intravascular hemolysis, elevated plasma levels of creatine kinase-MB, aspartate transaminase, and urea/creatinine, and induced morphopathological alterations in erythrocytes, heart, kidney, and lungs associated with thrombosis and hemorrhage. Diagnosis of MooA-induced disseminated intravascular coagulation represents an important approach to better understand the pathophysiology of Bothrops envenomation and develop novel therapeutic strategies targeting hemostatic disturbances. Copyright © 2017. Published by Elsevier B.V.

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

Directory of Open Access Journals (Sweden)

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

Anabolic agents: recent strategies for their detection and protection from inadvertent doping

Science.gov (United States)

Geyer, Hans; Schänzer, Wilhelm; Thevis, Mario

2014-01-01

According to the World Anti-Doping Agency (WADA) Prohibited List, anabolic agents consist of exogenous anabolic androgenic steroids (AAS), endogenous AAS and other anabolic agents such as clenbuterol and selective androgen receptor modulators (SARMs). Currently employed strategies for their improved detection include the prolongation of the detection windows for exogenous AAS, non-targeted and indirect analytical approaches for the detection of modified steroids (designer steroids), the athlete’s biological passport and isotope ratio mass spectrometry for the detection of the misuse of endogenous AAS, as well as preventive doping research for the detection of SARMs. The recent use of these strategies led to 4–80-fold increases of adverse analytical findings for exogenous AAS, to the detection of the misuse of new designer steroids, to adverse analytical findings of different endogenous AAS and to the first adverse analytical findings of SARMs. The strategies of the antidoping research are not only focused on the development of methods to catch the cheating athlete but also to protect the clean athlete from inadvertent doping. Within the past few years several sources of inadvertent doping with anabolic agents have been identified. Among these are nutritional supplements adulterated with AAS, meat products contaminated with clenbuterol, mycotoxin (zearalenone) contamination leading to zeranol findings, and natural products containing endogenous AAS. The protection strategy consists of further investigations in case of reasonable suspicion of inadvertent doping, publication of the results, education of athletes and development of methods to differentiate between intentional and unintentional doping. PMID:24632537

Attention and Facilitation: Converging Information Versus Inadvertent Reading in Stroop Task Performance

NARCIS (Netherlands)

Roelofs, A.P.A.

2010-01-01

Disagreement exists about whether color-word Stroop facilitation is caused by converging information (e.g.. Cohen et al.. 1990: Roelofs, 2003) or inadvertent reading (MacLeod & MacDonald, 2000). Four experiments tested between these hypotheses by examining Stroop effects oil response time (RT) both

Fluorescent Method for Observing Intravascular Bonghan Duct

OpenAIRE

Byung-Cheon Lee; Ku Youn Baik; Hyeon-Min Johng; Baekkyoung Sung; Kyung Soon Soh; Dae-In Kang; Kwang-Sup Soh

2005-01-01

Observation of intra-vascular threadlike structures in the blood vessels of rats is reported with the images by differential interference contrast microscope, and fluorescence inverted microscope of the acridine-orange stained samples. The confocal microscope image and the hematoxylin-eosin staining revealed the distinctive pattern of nuclei distribution that clearly discerned the threadlike structure from fibrin, capillary, small venule, arteriole, or lymph vessel. Physiological function of ...

Heartbeat OCT: In vivo intravascular megahertz-optical coherence tomography

NARCIS (Netherlands)

T. Wang (Tianshi); A.F.H. Pfeiffer (Andreas); E.S. Regar (Eveline); W. Wieser (Wolfgang); H.M.M. van Beusekom (Heleen); C.T. Lancée (Charles); T. Springeling (Tirza); I. Krabbendam (Ilona); A.F.W. van der Steen (Ton); R. Huber (Roman); G. van Soest (Gijs)

2015-01-01

textabstractCardiac motion artifacts, non-uniform rotational distortion and undersampling affect the image quality and the diagnostic impact of intravascular optical coherence tomography (IV-OCT). In this study we demonstrate how these limitations of IV-OCT can be addressed by using an imaging

Dosimetric implications of the infiltrated injection

International Nuclear Information System (INIS)

Castronovo, F.P.; McKusick, K.A.; Strauss, H.W.

1984-01-01

Following inadvertent infiltration of a radiopharmaceutical, there is variable and uncertain uptake in target tissue. Concomitantly, there is also a concern for the radiation dose to the infiltrated site. This investigation determined the clearance and radiation burdens from various radiopharmaceutical infiltrates in a rat model. Nine separate sites were studied for: Tc-99m microspheres; Tc-99m MDP; Ga-67 citrate; and Tl-201 chloride. Following sc injection on the shaven posteriors of anesthetized adult male Sprague-Dawley rats, gamma camera and computer data were collected up to 24 hours. The resulting data were expressed semilogarithmically as the mean (N = 9) of the ''% retained at site'' as a f(time) after injection. Nonparticulate agents showed a tri-exponential release pattern from each site, whereas the microspheres remained for an extended period of time. Using these pharma-cokinetic curves, the % remaining at each site for various times, and rems/mCi per lcc infiltrate was determined

Accidental intrathecal injection of magnesium sulfate for cesarean section

Directory of Open Access Journals (Sweden)

Mehryar Taghavi Gilani

2014-01-01

Full Text Available Magnesium sulfate is used frequently in the operation room and risks of wrong injection should be considered. A woman with history of pseudocholinesterase enzyme deficiency in the previous surgery was referred for cesarean operation. Magnesium sulfate of 700 mg (3.5 ml of 20% solution was accidentally administered in the subarachnoid space. First, the patient had warm sensation and cutaneous anesthesia, but due to deep tissue pain, general anesthesia was induced by thiopental and atracurium. After the surgery, muscle relaxation and lethargy remained. At 8-10 h later, muscle strength improved and train of four (TOF reached over 0.85, and then the endotracheal tube was removed. The patient was evaluated during the hospital stay and on the anesthesia clinic. No neurological symptoms, headache or backache were reported. Due to availability of magnesium sulfate, we should be careful for inadvertent intravenous, spinal and epidural injection; therefore before injection must be double checked.

Accidental intrathecal injection of magnesium sulfate for cesarean section.

Science.gov (United States)

Gilani, Mehryar Taghavi; Zirak, Nahid; Razavi, Majid

2014-10-01

Magnesium sulfate is used frequently in the operation room and risks of wrong injection should be considered. A woman with history of pseudocholinesterase enzyme deficiency in the previous surgery was referred for cesarean operation. Magnesium sulfate of 700 mg (3.5 ml of 20% solution) was accidentally administered in the subarachnoid space. First, the patient had warm sensation and cutaneous anesthesia, but due to deep tissue pain, general anesthesia was induced by thiopental and atracurium. After the surgery, muscle relaxation and lethargy remained. At 8-10 h later, muscle strength improved and train of four (TOF) reached over 0.85, and then the endotracheal tube was removed. The patient was evaluated during the hospital stay and on the anesthesia clinic. No neurological symptoms, headache or backache were reported. Due to availability of magnesium sulfate, we should be careful for inadvertent intravenous, spinal and epidural injection; therefore before injection must be double checked.

Intravascular catheter related infections in children admitted on the ...

African Journals Online (AJOL)

peripheral venous intravascular catheters uncoated with no antibiotic or antiseptic, was done. Social demographic characteristics, anthropometry, clinical examination including the catheter site were determined at enrollment. The children had their blood, catheter tip and hub samples taken off for culture and sensitivity as ...

Heterogeneous Intravascular Ultrasound Findings of Stent Thrombosis

OpenAIRE

Morofuji, Toru; Inaba, Shinji; Aisu, Hiroe; Takahashi, Kayo; Saito, Makoto; Higashi, Haruhiko; Yoshii, Toyofumi; Sumimoto, Takumi

2017-01-01

Objective The underlying mechanisms of stent thrombosis are not completely understood. Methods We experienced 12 definite stent thrombosis cases (1 early, 1 late, and 10 very late) at our hospital from July 2011 to April 2016 and evaluated the possible causes of stent thrombosis by intravascular ultrasound (IVUS). Results Five different potential morphological causes of stent thrombosis (neoatherosclerosis, stent malapposition, stent fracture, edge dissection, and stent underexpansion) were d...

Potential impact of DOE's performance objective for protection of inadvertent intruders on low-level waste disposals at Oak Ridge National Laboratory

International Nuclear Information System (INIS)

Kocher, D.C.

1992-01-01

The Department of Energy's Order 5820.2A, Chapter III, specifies performance objectives for disposal of low-level radioactive waste which include limits on effective dose equivalent for inadvertent intruders. This paper investigates the potential impact of the performance objective for protection of inadvertent intruders on the acceptability of waste disposals in Solid Waste Storage Area (SWSA) 6 at Oak Ridge National Laboratory (ORNL). The analysis is based on radionuclide inventories and waste volumes for recent disposals in SWSA 6 and calculated doses to an inadvertent intruder per unit concentration of radionuclides in disposed waste for assumed exposure scenarios

Intravascular radiation for restenosis prevention: could it be the holy grail?

International Nuclear Information System (INIS)

King, S.B.

1996-01-01

This brief editorial discusses the use of intravascular radiation in preventing restenosis after angioplasty in coronary interventions. Results in porcine coronary arteries and clinical applications are briefly reported. (UK)

Attention and Facilitation: Converging Information versus Inadvertent Reading in Stroop Task Performance

Science.gov (United States)

Roelofs, Ardi

2010-01-01

Disagreement exists about whether color-word Stroop facilitation is caused by converging information (e.g., Cohen et al., 1990; Roelofs, 2003) or inadvertent reading (MacLeod & MacDonald, 2000). Four experiments tested between these hypotheses by examining Stroop effects on response time (RT) both within and between languages. Words cannot be…

Use of carbon dioxide as an intravascular contrast agent: A review of current literature

OpenAIRE

Ali, Fahad; Mangi, Muhammad Asif; Rehman, Hiba; Kaluski, Edo

2017-01-01

Use of X-ray contrast allows us to differentiate between two or more adjacent structures on radiographic studies. The X-ray contrast agent can be the one with increase X-ray absorption, like iodine and a barium X-ray contrast agent or the one with decrease X-ray absorption like air and carbon dioxide contrast agent. Each contrast agent possesses different risks and benefits in various ways. Carbon dioxide as an intravascular contrast agent can be used as an alternative intravascular contrast ...

Guidelines for the diagnosis and management of disseminated intravascular coagulation

NARCIS (Netherlands)

Levi, M. [=Marcel M.; Toh, C. H.; Thachil, J.; Watson, H. G.

2009-01-01

The diagnosis of disseminated intravascular coagulation (DIC) should encompass both clinical and laboratory information. The International Society for Thrombosis and Haemostasis (ISTH) DIC scoring system provides objective measurement of DIC. Where DIC is present the scoring system correlates with

Comparison of utility of blood cultures from intravascular catheters and peripheral veins: a systematic review and decision analysis.

Science.gov (United States)

Falagas, Matthew E; Kazantzi, Maria S; Bliziotis, Ioannis A

2008-01-01

Blood cultures are sometimes obtained from intravascular catheters for convenience. However, there is controversy regarding this practice. The authors compared the diagnostic test characteristics of blood cultures obtained from intravascular catheters and peripheral veins. Relevant studies for inclusion in this review were identified through PubMed (January 1970-October 2005) and the Cochrane Central Register of Controlled Trials. Studies that reported clear definitions of true bacteraemia were included in the analysis. Two reviewers independently extracted the data. Six studies were included in the analysis, providing data for 2677 pairs of blood cultures obtained from an intravascular catheter and a peripheral venipuncture. A culture obtained from an intravascular catheter was found to be a diagnostic test for bacteraemia with better sensitivity (OR 1.85, 95 % CI 1.14-2.99, fixed effects model) and better negative predictive value (almost with statistical significance) (OR 1.55, 95 % CI 0.999-2.39, fixed effects model) but with less specificity (OR 0.33, 95 % CI 0.18-0.59, random effects model) and lower positive predictive value (OR 0.41, 95 % CI 0.23-0.76, random effects model) compared to a culture taken by peripheral venipuncture. In a group of 1000 patients, eight additional patients with true bacteraemia would be identified and 59 falsely diagnosed as having bacteraemia by a blood culture obtained from an intravascular catheter compared to results of the peripheral blood culture. Given the consequences of undertreating patients with bacteraemia, the authors believe that, based on the available evidence, at least one blood culture should be obtained from the intravascular catheter.

Cloxacillin distribution in the rabbit eye after intravenous injection

International Nuclear Information System (INIS)

Salminen, L.

1978-01-01

Distribution of isotopically labelled and intravenously injected cloxacillin was studied in the rabbit eye. The antibiotic concentration determined by liquid scintillation counting proved to be a reliable measure of the total antibiotic concentration when controlled by microbiological assay. In the rabbit eye after an intravenous injection of 50 mg/kg of cloxacillin sodium, longlasting antibiotic concentration regarded as therapeutic against penicillinase producing staphylococci was obtained in all vascularized ocular structures and in the cornea. The antibiotic present in the iris and ciliary body, and in the retina and choroid preparations, proved to be partly intravascular, whereas it penetrated better into the extravascular tissue compartment of the sclera and limbal area. Cloxacillin failed to achieve a therapeutic antibiotic concentration in the vitreous body and in the lens. Administration of probenecid had an enhancing effect on ocular cloxacillin concentration allowing improved drug diffusion into the eye by means of an elevated plasma concentration. No specific ocular effect of probenecid was noticed. Therapeutic concentration of cloxacillin in the aqueous humour, otherwise barely achieved, was more satisfactorily obtained with a previous injection of probenecid. (author)

Intravascular ultrasound evaluation of a pseudolesion created by stent placement in the right artery.

Science.gov (United States)

Zientek, D M; Rodgers, G P

1999-10-01

The creation of a pseudolesion after guidewire placement in tortuous arterial segments is a well recognized phenomenon. Intravascular ultrasound has been useful in assessing deployment of intracoronary stents and equivocal angiographic findings. We present a case in which a pseudolesion was not observed until after placement of an intracoronary stent. Intravascular ultrasound demonstrated no dissection or significant lesion; however, there was focal calcification just distal to the stent providing a substrate for the distorted vessel architecture. The lesion resolved with removal of the guidewire.

Ultrasound-guided versus fluoroscopy-guided sacroiliac joint intra-articular injections in the noninflammatory sacroiliac joint dysfunction: a prospective, randomized, single-blinded study.

Science.gov (United States)

Jee, Haemi; Lee, Ji-Hae; Park, Ki Deok; Ahn, Jaeki; Park, Yongbum

2014-02-01

To compare the short-term effects and safety of ultrasound (US)-guided sacroiliac joint (SIJ) injections with fluoroscopy (FL)-guided SIJ injections in patients with noninflammatory SIJ dysfunction. Prospective, randomized controlled trial. University hospital. Patients (N=120) with noninflammatory sacroiliac arthritis were enrolled. All procedures were performed using an FL or US apparatus. Subjects were randomly assigned to either the FL or US group. Immediately after the SIJ injections, fluoroscopy was applied to verify the correct placement of the injected medication and intravascular injections. Treatment effects and functional improvement were compared at 2 and 12 weeks after the procedures. The verbal numeric pain scale and Oswestry Disability Index improved at 2 and 12 weeks after the injections without statistical significances between groups. Of 55 US-guided injections, 48 (87.3%) were successful and 7 (12.7%) were missed. The FL-guided SIJ approach exhibited a greater accuracy (98.2%) than the US-guided approach. Vascularization around the SIJ was seen in 34 of 55 patients. Among the 34 patients, 7 had vascularization inside the joint, 23 had vascularization around the joint, and 4 had vascularization both inside and around the joint. Three cases of intravascular injections occurred in the FL group. The US-guided approach may facilitate the identification and avoidance of the critical vessels around or within the SIJ. Function and pain relief significantly improved in both groups without significant differences between groups. The US-guided approach was shown to be as effective as the FL-guided approach in treatment effects. However, diagnostic application in the SIJ may be limited because of the significantly lower accuracy rate (87.3%). Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Combined hyponatremia and hypocalcemia after intravascular absorption of 1.5% glycine during operative hysteroscopy. A case report

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Sherif S. Sultan

2016-07-01

Full Text Available Intravascular absorption of distending media may complicate operative hysteroscopy. Consequences differ according to type, amount and speed of absorption of the distending media. We report a case of intravascular absorption of more than one liter of 1.5% glycine. A 36 years old female developed metabolic acidosis, hyponatremia and hypocalcemia during operative hysteroscopy scheduled for resection of a uterine fibroid. Serum sodium reached down to 119 mmol/l and ionized calcium to 0.898 mmol/l. Serial estimations of arterial blood gases and serum electrolytes were followed. Management was successful in preventing serious side effects. Meticulous monitoring of distending media input/output balance remains the cornerstone in prevention of intravascular absorption.

Intravascular Young's modulus reconstruction using a parametric finite element model

NARCIS (Netherlands)

Baldewsing, R.A.; Oomens, C.W.J.; Steen, van der A.F.W.; Yuhas, D.; Schneider, S.C.

2003-01-01

IntraVascular UltraSound (IVUS) elastography may be used to detect vulnerable, rupture prone plaques, which are held responsible for the majority of acute coronary syndromes. IVUS elastography accomplishes this by visualising local incremental radial strain of arteries, in so-called elastograms.

Intravascular brachytherapy: a model for the calculation of the dose

International Nuclear Information System (INIS)

Pirchio, Rosana; Martin, Gabriela; Rivera, Elena; Cricco, Graciela; Cocca, Claudia; Gutierrez, Alicia; Nunez, Mariel; Bergoc, Rosa; Guzman, Luis; Belardi, Diego

2002-01-01

In this study we present the radiation dose distribution for a theoretical model with Montecarlo simulation, and based on an experimental model developed for the study of the prevention of restenosis post-angioplasty employing intravascular brachytherapy. In the experimental in vivo model, the atherosclerotic plaques were induced in femoral arteries of male New Zealand rabbits through surgical intervention and later administration of cholesterol enriched diet. For the intravascular irradiation we employed a 32P source contained within the balloon used for the angioplasty. The radiation dose distributions were calculated using the Monte Carlo code MCNP4B according to a segment of a simulated artery. We studied the radiation dose distribution in the axial and radial directions for different thickness of the atherosclerotic plaques. The results will be correlated with the biologic effects observed by means of histological analysis of the irradiated arteries (Au)

Transbiliary intravascular ultrasound-guided diagnostic biopsy of an inaccessible pancreatic head mass

Directory of Open Access Journals (Sweden)

Jeffrey Forris Beecham Chick, MD, MPH, DABR

2017-06-01

Full Text Available Percutaneous image-guided biopsies of pancreatic malignancies may prove challenging and nondiagnostic due to a variety of anatomic considerations. For patients with complex post-surgical anatomy, such as a Roux-en-Y gastric bypass, diagnosis via endoscopic ultrasound with fine-needle aspiration may not be possible because of an inability to reach the proximal duodenum. This report describes the first diagnostic case of transbiliary intravascular ultrasound-guided biopsy of a pancreatic head mass in a patient with prior Roux-en-Y gastric bypass for which a diagnosis could not be achieved via percutaneous and endoscopic approaches. Transbiliary intravascular ultrasound-guided biopsy resulted in a diagnosis of pancreatic adenocarcinoma, allowing the initiation of chemotherapy.

MDCT angiography of the pulmonary arteries: intravascular contrast enhancement does not depend on iodine concentration when injecting equal amounts of iodine at standardized iodine delivery rates

International Nuclear Information System (INIS)

Keil, S.; Plumhans, C.; Behrendt, F.F.; Das, M.; Muehlenbruch, G.; Mahnken, A.H.; Guenther, R.W.; Stanzel, S.; Seidensticker, P.; Knackstedt, C.; Wildberger, J.E.

2008-01-01

To compare the impact of iodine concentration using two different contrast materials (CM) at standardized iodine delivery rate (IDR) and overall iodine load in 16-multidetector-row-CT-angiography (MDCTA) of the pulmonary arteries of 192 patients with known or suspected pulmonary embolism. One hundred three patients (group A) received 148 ml of a CM containing 300 mg iodine/ml (Ultravist 300 trademark, BayerScheringPharma) at a flow rate of 4.9 ml/s. Eighty-nine patients (group B) received 120 ml of a CM with a concentration of 370 mg iodine/ml (Ultravist370 trademark) at a flow rate of 4.0 ml/s, resulting in a standardized IDR (∝1.5 gI/s) and the same overall amount of iodine (44.4 g). Both CM injections were followed by a saline chaser. Mean density values were determined in the pulmonary trunk, the ascending and the descending aorta, respectively. Applying repeated-measures ANOVA, no statistically significant differences between both MDCTA protocols were found (p=0.5790): the mean density in the pulmonary trunk was 355±116 Hounsfield Units (group A) and 358±115 (group B). The corresponding values for the ascending and descending aorta were 295±79 (group A) and 284±65 (group B) as well as 272±71 and 262±70. In conclusion, the use of standardized IDR and overall iodine load provides comparable intravascular CM density in pulmonary 16-MDCTA for delivering contrast materials with different iodine concentrations. (orig.)

Inadvertent raising of levels in the FFTF primary sodium pumps. Final unusual occurrence report, HEDL 79-34 (FFTF-58)

International Nuclear Information System (INIS)

Kuechle, J.D.

1981-01-01

The final unusual occurrence report describes the inadvertent raising of the sodium level in the FFTF primary sodium pumps during system testing. This event is now judged to have caused permanent deformation of the primary pump shaft on loop 1 during a period when pump rotation was stopped and sodium level in the pump tank was inadvertently increased. The shaft was subsequently removed, straightened, and returned to service in the spare FFTF pump

Dosimetric model for intravascular brachytherapy

International Nuclear Information System (INIS)

Flower, E.E.; Stroud, D.B.

2000-01-01

Full text: Intravascular brachytherapy has been shown to be a prophylaxis for restenosis. Adventitial macrophages, which are extremely radiosensitive, initiate neointima formation. A model of the dose levels of the treatment range is developed, assuming that the adventitia is the target tissue. If the adventitia receives a dose of less than 10 Gy, it is assumed the treatment will be ineffective. If the dose to any part of the wall is above 30 Gy, it is assumed that the treatment could be detrimental. Hence the treatment range is between 10 and 30 Gy, with 20 Gy being the optimum dosage to the adventitia. An algorithm using numerical integration of published dose kernels calculates the dose at any point surrounding a beta ( 32 P) line source of finite length. Dose profiles were obtained to demonstrate edge effects. For long lesions, the source is often stepped along the artery. Dose changes due to separation or overlapping of sources during source stepping procedures were also determined. Isodose curves were superimposed on intravascular ultrasound images to demonstrate dose levels. For an exposure time of 60 seconds with a 200mCi source, the optimum dose of 20 Gy occurs at a distance 1.94mm from the centre of the source. The upper limit of the treatment dose range (30 Gy) occurs at 1.59mm. The lower limit of the treatment dose range (10 Gy) occurs at 2.7mm. Significant perturbations to the treatment dose range can be caused by non-centering of the source, edge effects and separation or overlapping of sources in stepping procedures. Despite these concerns, many successful procedures have been reported and this implies that the model is over simplified and requires modifications. Copyright (2000) Australasian College of Physical Scientists and Engineers in Medicine

Pulsed arterial spin labeling using TurboFLASH with suppression of intravascular signal.

Science.gov (United States)

Pell, Gaby S; Lewis, David P; Branch, Craig A

2003-02-01

Accurate quantification of perfusion with the ADC techniques requires the suppression of the majority of the intravascular signal. This is normally achieved with the use of diffusion gradients. The TurboFLASH sequence with its ultrashort repetition times is not readily amenable to this scheme. This report demonstrates the implementation of a modified TurboFLASH sequence for FAIR imaging. Intravascular suppression is achieved with a modified preparation period that includes a driven equilibrium Fourier transform (DEFT) combination of 90 degrees-180 degrees-90 degrees hard RF pulses subsequent to the inversion delay. These pulses rotate the perfusion-prepared magnetization into the transverse plane where it can experience the suitably placed diffusion gradients before being returned to the longitudinal direction by the second 90 degrees pulse. A value of b = 20-30 s/mm(2) was thereby found to suppress the majority of the intravascular signal. For single-slice perfusion imaging, quantification is only slightly modified. The technique can be readily extended to multislice acquisition if the evolving flow signal after the DEFT preparation is considered. An advantage of the modified preparation scheme is evident in the multislice FAIR images by the preservation of the sign of the magnetization difference. Copyright 2003 Wiley-Liss, Inc.

Intravascular streaming and variable delivery to brain following carotid artery infusions in the Sprague-Dawley rat

International Nuclear Information System (INIS)

Saris, S.C.; Wright, D.C.; Oldfield, E.H.; Blasberg, R.G.

1988-01-01

Intracarotid artery infusions in animals are commonly performed in studies of the blood-brain barrier and in chemotherapy trials. Implicit in the analysis of these experiments is that the infusate will be distributed to the territory of the internal carotid artery in a manner that is proportional to blood flow. Fifteen Sprague-Dawley rats were studied to determine if poor infusate mixing with blood due to intravascular streaming occurred during intracarotid artery drug infusions and if it could be eliminated with fast retrograde infusion. In three experimental groups, a radiolabeled flow tracer-- 14 C-iodoantipyrine (IAP)--was infused retrograde through the external carotid artery into the common carotid artery at slow, medium, and fast rates (0.45, 1.5, and 5.0 ml/min). In a control group, IAP was injected intravenously (i.v.). Local isotope concentrations in the brain were determined by quantitative autoradiography, and the variability of isotope delivery was assessed in the frontoparietal cortex, temporal cortex, and caudate putamen of all animals. Streaming phenomena were manifest in all selected anatomic areas after the slow and medium rates of intraarterial infusion. After fast intracarotid infusion or i.v. injection, there was uniform distribution of isotope in the same brain regions

Perioperative Intravascular Fluid Assessment and Monitoring: A Narrative Review of Established and Emerging Techniques

Directory of Open Access Journals (Sweden)

Sumit Singh

2011-01-01

Full Text Available Accurate assessments of intravascular fluid status are an essential part of perioperative care and necessary in the management of the hemodynamically unstable patient. Goal-directed fluid management can facilitate resuscitation of the hypovolemic patient, reduce the risk of fluid overload, reduce the risk of the injudicious use of vasopressors and inotropes, and improve clinical outcomes. In this paper, we discuss the strengths and limitations of a spectrum of noninvasive and invasive techniques for assessing and monitoring intravascular volume status and fluid responsiveness in the perioperative and critically ill patient.

Evaluation of CT virtual intravascular endoscopy in fenestrated stent grafts: a preliminary study

Energy Technology Data Exchange (ETDEWEB)

Sun, Z. [Dept. of Imaging and Applied Physics, Curtin Univ. of Tech., Perth, WA (Australia); Allen, Y.; Fitzsimmons, B.; Hartely, D. [Cook R and D, WA (Australia); Lawrence-Brown, M. [Dept. of Public Health, Curtin Univ. of Tech., Perth, WA (Australia)

2007-06-15

We aim in this study to investigate the potential value of CT virtual intravascular endoscopy in patients diagnosed with abdominal aortic aneurysms undergoing fenestrated stent grafts. Both pre-and post-fenestration (within 3 months of implantation) multislice CT data were collected in eight patients and used for generation of virtual endoscopy images in our preliminary study. Variable fenestrations were deployed in 25 aortic branches with scallop fenestration implanted in six aortic ostia, large fenestration in four aortic ostia and small fenestration in 15 renal ostia, respectively. Measurements of the aortic ostia diameters both pre- and post-fenestration were successfully performed with virtual intravascular endoscopy visualization, and endovascular stents as well as their relationship to the aortic ostia were clearly demonstrated. Our results showed that there was no significant change of diameter of the aortic ostia following fenestrated stem grafts. Endovascular stents were clearly visualized on virtual endoscopy images, and no apparent deformity or malrotation was observed in this small group. Our preliminary study provides new insights into anatomic configuration/dimension of aortic ostia and endovascular stents, and virtual intravascular endoscopy could be a valuable technique to follow-up patients treated with fenestrated stent grafts. (orig.)

Evaluation of CT virtual intravascular endoscopy in fenestrated stent grafts: a preliminary study

International Nuclear Information System (INIS)

Sun, Z.; Allen, Y.; Fitzsimmons, B.; Hartely, D.; Lawrence-Brown, M.

2007-01-01

We aim in this study to investigate the potential value of CT virtual intravascular endoscopy in patients diagnosed with abdominal aortic aneurysms undergoing fenestrated stent grafts. Both pre-and post-fenestration (within 3 months of implantation) multislice CT data were collected in eight patients and used for generation of virtual endoscopy images in our preliminary study. Variable fenestrations were deployed in 25 aortic branches with scallop fenestration implanted in six aortic ostia, large fenestration in four aortic ostia and small fenestration in 15 renal ostia, respectively. Measurements of the aortic ostia diameters both pre- and post-fenestration were successfully performed with virtual intravascular endoscopy visualization, and endovascular stents as well as their relationship to the aortic ostia were clearly demonstrated. Our results showed that there was no significant change of diameter of the aortic ostia following fenestrated stem grafts. Endovascular stents were clearly visualized on virtual endoscopy images, and no apparent deformity or malrotation was observed in this small group. Our preliminary study provides new insights into anatomic configuration/dimension of aortic ostia and endovascular stents, and virtual intravascular endoscopy could be a valuable technique to follow-up patients treated with fenestrated stent grafts. (orig.)

An experimental method for detecting blood splatter from retractable phlebotomy and intravascular devices.

Science.gov (United States)

Haiduven, Donna; Applegarth, Shawn; Shroff, Miloni

2009-03-01

This study was designed to evaluate the safety of retractable intravascular devices in terms of their potential to produce blood splatter. A method for measuring this blood splatter designed by the research team was used to evaluate 3 specific intravascular devices. Scientific filters were positioned around the retraction mechanisms of the devices and weighed with an analytical scale, both before and after activation, in a simulated vein containing mock venous blood. The difference in filter mass was used as the primary unit of analysis to detect blood splatter. In addition, the filters were visually inspected for the presence or absence of blood. A paired t-test revealed significant differences in the prefilter and postfilter groups for 2 of the 3 devices tested (P blood was detected on 23% to 40% of the scientific filters for 2 of the devices. Our findings indicate a potential for bloodborne pathogen exposure with the use of intravascular devices with a retractable mechanism. This experiment may serve as a model in the design and implementation of future sharps device evaluation protocols to validate the threat of bloodborne pathogen exposure.

Carbon Dioxide Embolism during Laparoscopic Surgery

Science.gov (United States)

Park, Eun Young; Kwon, Ja-Young

2012-01-01

Clinically significant carbon dioxide embolism is a rare but potentially fatal complication of anesthesia administered during laparoscopic surgery. Its most common cause is inadvertent injection of carbon dioxide into a large vein, artery or solid organ. This error usually occurs during or shortly after insufflation of carbon dioxide into the body cavity, but may result from direct intravascular insufflation of carbon dioxide during surgery. Clinical presentation of carbon dioxide embolism ranges from asymptomatic to neurologic injury, cardiovascular collapse or even death, which is dependent on the rate and volume of carbon dioxide entrapment and the patient's condition. We reviewed extensive literature regarding carbon dioxide embolism in detail and set out to describe the complication from background to treatment. We hope that the present work will improve our understanding of carbon dioxide embolism during laparoscopic surgery. PMID:22476987

Unilateral Vision Loss after a Dental Visit

Science.gov (United States)

Khattab, Mohammed H.; Wiegand, Annette; Storch, Marcus; Hoerauf, Hans; Feltgen, Nicolas

2018-01-01

Intraoral local anesthetics are widely used for performing painless dental treatments; however, in some cases, they may cause ocular complications such as meiosis, diplopia, nystagmus, ophthalmoplegia, ptosis, and amaurosis. Mostly, the symptoms disappear after several hours; rarely, they have a prolonged character. We describe the case of a 38-year-old young man who had reduced vision in the left eye 5 days after having received intraoral local anesthesia. A diagnosis of cilioretinal artery occlusion with optic disc swelling was made. Ten weeks later, the patient's visual acuity had increased to 20/20, and the swelling of the optic disc had subsided. Although various possible mechanisms for ocular complications after intraoral local anesthetic administration were suggested in the literature, the exact etiology remains unclear. In this case, inadvertent intravascular injection is believed to be the cause. PMID:29681838

Efficacy of alfaxalone for intravascular anesthesia and euthanasia in blue crabs (Callinectes sapidus).

Science.gov (United States)

Minter, Larry J; Harms, Craig A; Archibald, Kate E; Broadhurst, Heather; Bailey, Kate M; Christiansen, Emily F; Lewbart, Gregory A; Posner, Lysa P

2013-09-01

The objective of this study was to characterize the behavioral effects and changes in heart rate of four doses of alfaxalone delivered by intravascular injection to blue crabs (Callinectes sapidus). Thirty (male, n = 27; female, n = 3) blue crabs were randomly assigned to one of four treatment groups of alfaxalone: eight animals were assigned to each of the 5-, 10-, and 15-mg/kg treatment groups, and the remaining six animals were assigned to the 100-mg/kg group. Times for anesthetic induction and recovery periods were recorded. Righting reflex, defensive posturing, and heart rate were evaluated before, during, and after the anesthetic trial. Anesthesia was induced in all 14 animals consolidated into the high-dosage group (15 mg/kg [n = 8] and 100 mg/kg [n = 6]), which was significantly greater than 8 of 16 animals in the low-dosage group (5 mg/kg [n = 2] and 10 mg/kg [n = 6]). Median anesthesia induction time for all crabs was 0.4 min, with no significant difference in induction time between groups observed. Median recovery time was 9.4 min (n = 2), 6.1 min (n = 5), 11.3 min (n = 8), and 66.1 min (n = 5) for the 5-, 10-, 15-, and 100-mg/kg groups, respectively. Recovery times were significantly longer for crabs exposed to an induction dose of 100 mg/kg compared with the 10- and 15-mg/kg induction doses. A significant decrease in the median heart rate was observed between the baseline value and that observed at both induction and 5 min postinjection in the 100-mg/kg dose trial. Two mortalities were observed during the anesthesia trials (n = 1, 10 mg/kg; n = 1, 100 mg/kg), both associated with the autotomization of limbs. In summary, the intravascular administration of alfaxalone at 15 mg/kg provided rapid and reliable sedation, whereas alfaxalone administered at 100 mg/kg produced rapid and long lasting anesthesia.

Evaluation of SPACE code for simulation of inadvertent opening of spray valve in Shin Kori unit 1

International Nuclear Information System (INIS)

Kim, Seyun; Youn, Bumsoo

2013-01-01

SPACE code is expected to be applied to the safety analysis for LOCA (Loss of Coolant Accident) and Non-LOCA scenarios. SPACE code solves two-fluid, three-field governing equations and programmed with C++ computer language using object-oriented concepts. To evaluate the analysis capability for the transient phenomena in the actual nuclear power plant, an inadvertent opening of spray valve in startup test phase of Shin Kori unit 1 was simulated with SPACE code. To evaluate the analysis capability for the transient phenomena in the actual nuclear power plant, an inadvertent opening of spray valve in startup test phase of Shin Kori unit 1 was simulated with SPACE code

The uptake of radionuclides from inadvertent consumption of soil by grazing animals

International Nuclear Information System (INIS)

Green, N.; Dodd, N.J.

1988-01-01

Investigations of the transfer to man of artificially-produced radionuclides through food chains have shown that the inadvertent consumption of soil by grazing animals can give variations in estimates of transfer coefficients, especially for radionuclides that are poorly absorbed by plant roots. Even small masses of soil adhering to herbage or directly ingested can make a significant contribution to the intake inventory in terms of activity. Although the activity concentrations of soil-contaminated herbage are elevated, the radionuclides associated with the soil may not necessarily be in a form which is easily absorbed by the animal. Attempts must be made, therefore, to quantify soil intake and the subsequent radionuclide uptake by this mechanism. A field investigation of the uptake of radionuclides by farm animals grazing near the Sellafield nuclear reprocessing plant has been pursued. The aims of the study were to estimate the transfer to muscle and other tissues. This paper describes the methods used to estimate both the soil intake and the consequent availability of radionuclides associated with the soil. The measurements were used to evaluate the contribution to tissue content of inadvertent consumption of soil by cows and sheep. 10 refs.; 2 tabs

Intravascular Large B-Cell Lymphoma Presenting with Diffuse Gallbladder Wall Thickening: A Case Report and Literature Review

Directory of Open Access Journals (Sweden)

Sayf Al-Katib

2018-01-01

Full Text Available Intravascular large B-cell lymphoma is a rare subtype of extranodal diffuse B-cell lymphoma characterized by proliferation of neoplastic cells within the lumen of small and medium sized vessels. Clinical and imaging findings are nebulous as the intravascular subtype of lymphoma can involve a multitude of organs. Involvement of the gallbladder is extremely uncommon, and imaging findings can be easily confused for more prevalent pathologies. We report a case of intravascular large B-cell lymphoma in an 83-year-old male and review clinical presentation and imaging findings on CT, ultrasound, hepatobiliary iminodiacetic acid (HIDA scan, and MRI. It is important for the radiologist to know about this disease as the imaging findings are atypical of other types of lymphoma, and this may lead to a delay in diagnosis and treatment.

Effects of Hypoxia on Erythrocyte Membrane Properties—Implications for Intravascular Hemolysis and Purinergic Control of Blood Flow

Directory of Open Access Journals (Sweden)

Ryszard Grygorczyk

2017-12-01

Full Text Available Intravascular hemolysis occurs in hereditary, acquired, and iatrogenic hemolytic conditions but it could be also a normal physiological process contributing to intercellular signaling. New evidence suggests that intravascular hemolysis and the associated release of adenosine triphosphate (ATP may be an important mechanism for in vivo local purinergic signaling and blood flow regulation during exercise and hypoxia. However, the mechanisms that modulate hypoxia-induced RBC membrane fragility remain unclear. Here, we provide an overview of the role of RBC ATP release in the regulation of vascular tone and prevailing assumptions on the putative release mechanisms. We show importance of intravascular hemolysis as a source of ATP for local purinergic regulation of blood flow and discuss processes that regulate membrane propensity to rupture under stress and hypoxia.

Intravascular optical imaging of high-risk plaques in vivo by targeting macrophage mannose receptors

Science.gov (United States)

Kim, Ji Bak; Park, Kyeongsoon; Ryu, Jiheun; Lee, Jae Joong; Lee, Min Woo; Cho, Han Saem; Nam, Hyeong Soo; Park, Ok Kyu; Song, Joon Woo; Kim, Tae Shik; Oh, Dong Joo; Gweon, Daegab; Oh, Wang-Yuhl; Yoo, Hongki; Kim, Jin Won

2016-03-01

Macrophages mediate atheroma expansion and disruption, and denote high-risk arterial plaques. Therefore, they are substantially gaining importance as a diagnostic imaging target for the detection of rupture-prone plaques. Here, we developed an injectable near-infrared fluorescence (NIRF) probe by chemically conjugating thiolated glycol chitosan with cholesteryl chloroformate, NIRF dye (cyanine 5.5 or 7), and maleimide-polyethylene glycol-mannose as mannose receptor binding ligands to specifically target a subset of macrophages abundant in high-risk plaques. This probe showed high affinity to mannose receptors, low toxicity, and allowed the direct visualization of plaque macrophages in murine carotid atheroma. After the scale-up of the MMR-NIRF probe, the administration of the probe facilitated in vivo intravascular imaging of plaque inflammation in coronary-sized vessels of atheromatous rabbits using a custom-built dual-modal optical coherence tomography (OCT)-NIRF catheter-based imaging system. This novel imaging approach represents a potential imaging strategy enabling the identification of high-risk plaques in vivo and holds promise for future clinical implications.

Mechanical scanning in intravascular ultrasound imaging: Artifacts and driving mechanisms

NARCIS (Netherlands)

H. ten Hoff (H.); E.J. Gussenhoven (Elma); C.M. Korbijn (Carin); F. Mastik (Frits); C.T. Lancée (Charles); N. Bom (Klaas)

1995-01-01

textabstractObjective: Currently, intravascular ultrasound (US) imaging catheters are developed and produced to provide a complementary diagnostic method in the treatment of blood vessel obstructive disease. Typical catheter dimensions are a diameter of 1–2.5 mm and a length of 1–1.5 m. A real-time

Monooxignase ensymic system of a liver of rats exposed to intravascular laser irradiation of blood

International Nuclear Information System (INIS)

Ibadova, G.A.

1997-01-01

Experimental study of the dynamic monooxidation of liver enzymic system was carried out on rats with experimental salmonellosis and the influence of the blood intravascular laser irradiation of blood on these enzymes was revealed. It was determined that by experimental salmonellosis oppression of the MOES activity of hepatocytes occurred. The blood intravascular irradiation by He-Ne laser promotes MOES oppression in rats suffered from salmonellosis. IVLIB as well as UV-laser show pronounced effect on the enzymes detoxication protection, mobilize their resistance to endogenic intoxication under the conditions of experimental salmonellosis. (author)

Use of an Intravascular Fluorescent Continuous Glucose Sensor in ICU Patients

NARCIS (Netherlands)

Strasma, Paul J.; Finfer, Simon; Flower, Oliver; Hipszer, Brian; Kosiborod, Mikhail; Macken, Lewis; Sechterberger, Marjolein; van der Voort, Peter H. J.; DeVries, J. Hans; Joseph, Jeffrey I.

2015-01-01

Hyperglycemia and hypoglycemia are associated with adverse clinical outcomes in intensive care patients. In product development studies at 4 ICUs, the safety and performance of an intravascular continuous glucose monitoring (IV-CGM) system was evaluated in 70 postsurgical patients. The GluCath

Thyroid storm complicated by bicytopenia and disseminated intravascular coagulation.

Science.gov (United States)

Tokushima, Yoshinori; Sakanishi, Yuta; Nagae, Kou; Tokushima, Midori; Tago, Masaki; Tomonaga, Motosuke; Yoshioka, Tsuneaki; Hyakutake, Masaki; Sugioka, Takashi; Yamashita, Shu-ichi

2014-07-24

Male, 23. Thyroid storm. Delirium • diarrhea • fever • hypertension • hyperventilation • tachycardia • weight loss. -. -. Endocrinology and Metabolic. Unusual clinical course. The clinical presentation of thyroid storm includes fever, tachycardia, hypertension, and neurological abnormalities. It is a serious condition with a high mortality rate. Furthermore, some other complications affect the clinical course of thyroid storm. Although it is reported that prognosis is poor when thyroid storm is complicated by disseminated intravascular coagulation syndrome (DIC) and leukopenia, reports of such cases are rare. A 23-year-old man presented with delirium, high pyrexia, diarrhea, and weight loss of 18 kg over 2 months. According to the criteria of Burch and Wartofsky, he was diagnosed with thyroid storm on the basis of his symptom-complex and laboratory data that confirmed the presence of hyperthyroidism. Investigations also found leukopenia, thrombocytopenia, and disseminated intravascular coagulation, all of which are very rare complications of thyroid storm. We successfully treated him with combined therapy including anti-thyroid medication, despite leukopenia. Early diagnosis and treatment are essential in ensuring a good outcome for patients with this rare combination of medical problems.

Hemostasia normal y coagulación intravascular diseminada en obstetricia Normal hemostasis and disseminated intravascular clotting in Obstetrics

Directory of Open Access Journals (Sweden)

Danilo Nápoles Méndez

2012-03-01

Full Text Available En el período gravido - puerperal, la coagulación sanguínea sufre cambios que se impone conocer para interpretar correctamente esos trastornos cuando se presentan en esta etapa, teniendo en cuenta las posibles complicaciones y el peligro para la vida que pueden presentarse. El objetivo del presente artículo es proporcionar a los obstetras una revisión bibliográfica que les permita actualizarse acerca del tema y facilite su modo de actuación ante pacientes con coagulación intravascular diseminada. Se concluye que es preciso diagnosticar tempranamente el proceso en la fase bioquímica de bajo grado y aplicar en las féminas el tratamiento expedito de la enfermedad de base para eliminar las complicaciones o disminuir su ocurrenciaIn the period from pregnancy to puerperium, blood clotting suffers changes which are important to be known in order to interpret correctly those dysfunctions when they appear in this stage, keeping in mind the possible complications and the danger for life which can take place. The objective of the present work is to provide the obstetricians a literature review that allows them to be updated about the topic and facilitate their performance in case of patients with disseminated intravascular clotting. It is concluded that it is necessary to have an early diagnosis on the process during the low grade biochemical phase and to apply in these women the expedite treatment of the base disease to eliminate complications or to decrease their occurrence.

Coagulación intravascular diseminada = Disseminated intravascular coagulation

Directory of Open Access Journals (Sweden)

Arango Barrientos, Marcos

2010-12-01

Full Text Available La coagulación intravascular diseminada (CID es una entidad clínica frecuente que se presenta como fenómeno secundario a diversas enfermedades entre las cuales se destacan las infecciones graves, las neoplasias y las catástrofes obstétricas. Se caracteriza por una activación difusa y simultánea de los sistemas endógenos de la coagulación y la fibrinólisis. El depósito de pequeños trombos en la circulación conduce finalmente a disfunción orgánica múltiple y en algunos casos a la muerte. Las manifestaciones clínicas pueden incluir fenómenos trombóticos y hemorrágicos. Se ha propuesto un puntaje de fácil aplicación para simplificar el diagnóstico de la entidad. El tratamiento incluye el control específico de la causa subyacente que favorece la aparición de la CID, el soporte con hemoderivados en pacientes con manifestaciones de sangrado y la anticoagulación terapéutica en pacientes con trombosis mayores. El desarrollo de CID es un factor pronóstico adverso que aumenta significativamente la tasa de mortalidad. En este artículo de revisión se incluyen los siguientes aspectos de la CID: historia, epidemiología, clasificación, entidades asociadas, fisiopatología, clínica, diagnóstico, tratamiento y pronóstico.

Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation

DEFF Research Database (Denmark)

Falk, Erling

2012-01-01

The purpose of this document is to make the output of the International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT) Standardization and Validation available to medical and scientific communities, through a peer-reviewed publication, in the interest of improving...

Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies : A report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation

NARCIS (Netherlands)

G.J. Tearney (Guillermo); E.S. Regar (Eveline); T. Akasaka (Takashi); S. Adriaenssens (Stef); P. Barlis (Peter); H.G. Bezerra (Hiram); B.E. Bouma (Brett); N. Bruining (Nico); J.-M. Cho (Jin-Man); S. Chowdhary (Saqib); M.A. Costa (Marco); R. de Silva (Ranil); J. Dijkstra (Jouke); C. di Mario (Carlo); D. Dudeck (Darius); E. Falk (Erling); M.D. Feldman (Marc); P.J. Fitzgerald (Peter); H.M. Garcia-Garcia (Hector); N. Gonzalo (Nieves); J.F. Granada (Juan); G. Guagliumi (Giulio); N.R. Holm (Niels); Y. Honda (Yasuhiro); F. Ikeno (Fumiaki); Y. Kawasaki; W. Kochman (Waclav); L. Koltowski (Lukasz); T. Kubo (Takashi); T. Kume (Teruyoshi); H. Kyono (Hiroyuki); C.C.S. Lam (Cheung Chi Simon); G. Lamouche (Guy); D.P. Lee (David); M.B. Leon (Martin); A. Maehara (Akiko); O. Manfrini (Olivia); G.S. Mintz (Gary); K. Mizuno (Kyiouchi); M-A.M. Morel (Marie-Angèle); S. Nadkarni (Seemantini); H. Okura (Hiroyuki); H. Otake (Hiromasa); A. Pietrasik (Arkadiusz); F. Prati (Francesco); L. Rber (Lorenz); M. Radu (Maria); N. Rieber (Nikolaus); M. Riga (Maria); S.M. Rollins; M. Rosenberg (Mireille); V. Sirbu (Vasile); P.W.J.C. Serruys (Patrick); K. Shimada; T. Shinke (Toshiro); J. Shite (Junya); E. Siegel (Eliot); S. Sonada (Shinjo); U. Suter (Ueli); S. Takarada (Shigeho); A. Tanaka (Atsushi); M. Terashima (Mitsuyasu); T. Troels (Thim); M. Uemura (Mayu); G.J. Ughi (Giovanni); H.M.M. van Beusekom (Heleen); A.F.W. van der Steen (Ton); G.A. van Es (Gerrit Anne); G. van Soest (Gijs); R. Virmani (Renu); S. Waxman (Sergio); N.J. Weissman (Neil); G. Weisz (Giora)

2012-01-01

textabstractObjectives: The purpose of this document is to make the output of the International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT) Standardization and Validation available to medical and scientific communities, through a peer-reviewed publication, in the

In vivo tracking of magnetically labeled mesenchmal stem cells injected via renal arteries in kidney failure rat

International Nuclear Information System (INIS)

Sun Junhui; Teng Gaojun; Ju Shenghong; Ma Zhanlong; Mai Xiaoli; Zhang Yu; Ma Ming

2006-01-01

Objective: To evaluate in vivo depiction and tracking for magnetically labeled bone marrow mesenchymal stern cells (MSCs) in a renal failure rat model injected intravascularly using a 1.5 T magnetic resonance imaging (MRI) system. Methods: Rat MSCs were isolated, purified, expanded and then incubated with home synthesized Fe 2 O 3 -PLL. Prussian blue stain was employed for identifying intracellular irons. An acute renal failure in rat was induced by intramuscular injection of glycerol and MSCs were injected into renal arteries of 11 recipients (labeled cells in six, unlabeled cells in five). MR images of kidneys were obtained respectively before injection of MSCs, and immediately, 1, 3, 5, and 8 clays after transplantation. MR imaging findings were analyzed, which were correlated with histological findings. Results: Rat MSCs were successfully labeled, and labeling efficiency was almost 100%. Prussian blue staining of Fe 2 O 3 -PLL labeled cells revealed the presence of iron-containing vesicles or endosomes in the cytoplasm. In the renal failure model of rats, the labeled MSCs were demonstrated as signal intensity loss in renal cortex on T 2 * -weighted MR images. The signal intensity decrease was visualized up to days 8 after transplantation. Histological analyses showed that most Prussian blue staining-positive cells were well correlated with the area where a signal intensity loss was observed in MRI. Signal intensity decrease was not detected after transplantation of unlabeled cells. Conclusion: The rat MSCs can be effectively labeled with Fe 2 O 3 -PLL. 1.5-T MR imaging seems to be a good technique to monitor the magnetically labeled MSCs in vivo in renal failure rat model intravascularly administered, which may have much more potential values for studying the engraftment of stem cells in kidneys. (authors)

P-shaped Coiled Stator Ultrasound Motor for Rotating Intravascular Surgery Device

Directory of Open Access Journals (Sweden)

Toshinobu ABE

2015-01-01

Full Text Available The primary focus of this paper is the development of an ultra-miniature ultrasound motor for use in the human blood vessel. Since the size of the drive source for rotating the atherectomy device and intravascular ultrasonography system are large currently in practical use, it is installed outside the body, and the rotational power for the atherectomy device and intravascular ultrasonography system are transmitted through the long tortuous blood vessel. Such systems suffer from the problem that the rotation becomes non-uniform, and the problem that the available time is limited. We have therefore developed a P-shaped coiled stator ultrasound motor as a miniature ultrasound motor for rotating the ultrasound sensor for use in blood vessels in order to solve these problems. In this paper, we describe measurement of the torque, revolution speed, output power, efficiency, and particle motion on acoustic waveguide of the P-shaped coiled stator ultrasound motor.

Intravascular ultrasound assessment of minimumlumen area and intimal hyperplasia in in-stent restenosis after drug-eluting or bare-metal stent implantation. The Nordic Intravascular Ultrasound Study (NIVUS)

DEFF Research Database (Denmark)

Jensen, Lisette Okkels; Vikman, Saila; Antonsen, Lisbeth

2017-01-01

presenting with a DES or bare-metal stent (BMS) in-stent restenosis. Methods: The ``Nordic Intravascular Ultrasound Study (NIVUS)'' study was conducted in Nordic and Baltic countries as a prospective multicenter registry. Two hundred nine patients (DES n = 121 and BMS n = 88) with instent restenosis were...

Combined hyponatremia and hypocalcemia after intravascular absorption of 1.5% glycine during operative hysteroscopy. A case report

OpenAIRE

Sherif S. Sultan

2016-01-01

Intravascular absorption of distending media may complicate operative hysteroscopy. Consequences differ according to type, amount and speed of absorption of the distending media. We report a case of intravascular absorption of more than one liter of 1.5% glycine. A 36 years old female developed metabolic acidosis, hyponatremia and hypocalcemia during operative hysteroscopy scheduled for resection of a uterine fibroid. Serum sodium reached down to 119 mmol/l and ionized calcium to 0.898 mmol/l...

Local intravascular coagulation and fibrin deposition on intestinal ischemia-reperfusion in rats

NARCIS (Netherlands)

Schoots, Ivo G.; Levi, Marcel; Roossink, E. H. Paulina; Bijlsma, Pieter B.; van Gulik, Thomas M.

2003-01-01

Background. This study investigates intravascular coagulation and thrombotic obstruction in the splanchnic vasculature after intestinal ischemia in relation to epithelial integrity and function. Methods. Intestinal ischemia was induced in rats by superior mesenteric artery occlusion for 20 or 40

Reduction of exit-site infections of tunnelled intravascular catheters among neutropenic patients by sustained-release chlorhexidine dressings: results from a prospective randomized controlled trial.

Science.gov (United States)

Chambers, S T; Sanders, J; Patton, W N; Ganly, P; Birch, M; Crump, J A; Spearing, R L

2005-09-01

Exit-site and tunnel infections of tunnelled central intravascular catheters are a frequent source of morbidity among neutropenic patients and may necessitate catheter removal. They require antimicrobial therapy that increases healthcare costs and is associated with adverse drug reactions. A prospective randomized clinical trial was conducted among adult patients undergoing chemotherapy in a haematology unit. Tunnelled intravascular catheters were randomized to receive the control of a standard dressing regimen as recommended by the British Committee for Standards in Haematology, or to receive the intervention of a sustained-release chlorhexidine dressing. Follow-up data were available in 112 of 114 tunnelled intravascular catheters which were randomized. Exit-site or combined exit-site/tunnel infections occurred in 23 (43%) of 54 catheters in the control group, and five (9%) of 58 catheters in the intervention group [odds ratio (OR) for intervention group compared with control group =0.13, 95% confidence intervals (CI) 0.04-0.37, P<0.001]. More tunnelled intravascular catheters were prematurely removed from the control group than the intervention group for documented infections [20/54 (37%) vs 6/58 (10%), OR=0.20, 95%CI 0.53-0.07]. However, there was no difference in the numbers of tunnelled intravascular catheters removed for all proven and suspected intravascular catheter-related infections [21/54 (39%) vs 19/58 (33%)], or in the time to removal of catheters for any reason other than death or end of treatment for underlying disease. Thus chlorhexidine dressings reduced the incidence of exit-site/tunnel infections of indwelling tunnelled intravascular catheters without prolonging catheter survival in neutropenic patients, and could be considered as part of the routine management of indwelling tunnelled intravascular catheters among neutropenic patients.

Design of low noise transimpedance amplifier for intravascular ultrasound

KAUST Repository

Reda, Dina

2009-11-01

In this paper, we study transimpedance amplifiers for capacitive sensing applications with a focus on Intravascular Ultra Sound (IVUS). We employ RF noise cancellation technique on capacitive feedback based transimpedance amplifiers. This technique eliminates the input-referred noise of TIAs completely and enhances the dynamic range of front-end electronics. Simulation results verify the proposed technique used in two different TIA topologies employing shunt-shunt feedback. ©2009 IEEE.

Polymer coating embolism from intravascular medical devices - a clinical literature review.

Science.gov (United States)

Chopra, Amitabh M; Mehta, Monik; Bismuth, Jean; Shapiro, Maksim; Fishbein, Michael C; Bridges, Alina G; Vinters, Harry V

Over the past three decades, lubricious (hydrophobic and/or hydrophilic) polymer-coated devices have been increasingly adopted by interventional physicians and vascular surgeons to access and treat a wider range of clinical presentations. Recent clinical literature highlights the presence of polymer coating emboli within the anatomy - a result of coating separation from an intravascular device - and associates it with a range of adverse clinical sequelae. The 2015 U.S. Food and Drug Administration safety communication titled "Lubricious Coating Separation from Intravascular Medical Devices" acknowledges these concerns and concludes that it will work with stakeholders to develop nonclinical test methodologies, establish performance criteria, and identify gaps in current national and international device standards for coating integrity performance. Despite this communication and multiple case reports from interventional physicians, pathologists, dermatologists and other involved physician specialties, polymer coating embolism remains clinically underrecognized. This article consolidates the available literature on polymer coating embolism (1986-2016) and highlights the following relevant information for the physician: (a) the history and elusive nature of polymer coating embolism; (b) potential incidence rates of this phenomenon; (c) reported histologic findings and clinical effects of polymer emboli in the anatomy; (d) the importance of the collaborative clinician-pathologist partnership to report polymer embolism findings; and (e) the importance to study particulate release from intravascular devices so as to further understand and potentially evolve coated interventional technologies. Preliminary research on coatings highlights the potential of using iterations of coatings on medical devices that attain the desired therapeutic result and mitigate or eliminate particulates altogether. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Inadvertent Splenectomy During Resection for Colorectal Cancer Does Not Increase Long-term Mortality in a Propensity Score Model: A Nationwide Cohort Study.

Science.gov (United States)

Lolle, Ida; Pommergaard, Hans-Christian; Schefte, David F; Bulut, Orhan; Krarup, Peter-Martin; Rosenstock, Steffen J

2016-12-01

Previous studies suggest that long-term mortality is increased in patients who undergo splenectomy during surgery for colorectal cancer. The reason for this association remains unclear. The purpose of this study was to investigate the association between inadvertent splenectomy attributed to iatrogenic lesion to the spleen during colorectal cancer resections and long-term mortality in a national cohort of unselected patients. This was a retrospective, nationwide cohort study. Data were collected from the database of the Danish Colorectal Cancer Group and merged with data from the National Patient Registry and the National Pathology Databank. Danish patients with colorectal cancer undergoing curatively intended resection between 2001 and 2011 were included in the study. The primary outcome was long-term mortality for patients surviving 30 days after surgery. Secondary outcomes were 30-day mortality and risk factors for inadvertent splenectomy. Multivariable and propensity-score matched Cox regression analyses were used to adjust for potential confounding. In total, 23,727 patients were included, of which 277 (1.2%) underwent inadvertent splenectomy. There was no association between inadvertent splenectomy and long-term mortality (adjusted HR = 1.15 (95% CI, 0.95-1.40); p = 0.16) in the propensity score-matched model, whereas 30-day mortality was significantly increased (adjusted HR = 2.31 (95% CI, 1.71-3.11); p splenectomy was most often seen during left hemicolectomy (left hemicolectomy vs right hemicolectomy: OR = 24.76 (95% CI, 15.30-40.06); p splenectomy during resection for colorectal cancer does not seem to increase long-term mortality. The previously reported reduced overall survival after inadvertent splenectomy may be explained by excess mortality in the immediate postoperative period.

The role of the adventitia in the arterial response to angioplasty: the effect of intravascular radiation

International Nuclear Information System (INIS)

Wilcox, Josiah N.; Waksman, Ron; King, Spencer B.; Scott, Neal A.

1996-01-01

Purpose: In the current series of experiments we have characterized cell proliferation leading to vascular lesion formation in a porcine model for post-angioplasty restenosis and examined the mechanism of action of intravascular beta irradiation in the prevention of lesion formation in this model. Methods and Materials: Juvenile male pigs were subjected to balloon overstretch injury of the left anterior descending and circumflex coronary arteries using clinical angioplasty catheters. Proliferating cells were labelled by injections of 50 mg/kg of bromo-deoxyuridine (BrDU) 24, 16 and 8 hrs prior to sacrifice and were detected by immunohistochemistry using a specific antibody to BrDU. In some cases, BrDU was given as a pulse 3 days after angioplasty and the animals sacrificed on day 14 to follow the migration of the cells which had proliferated earlier. Characterization of the proliferating cells was performed by immunohistochemistry using antibodies to specific cytoskeletal proteins specific for smooth muscle cells and myofibroblasts. Some vessels were treated at the time of angioplasty with 14 or 28 Gy (to a depth of 2 mm) intravascular irradiation using a flexible catheter with a pure beta emitter 90 SR/Y and the effect on cell proliferation and terminal transferase-mediated UTP nick-end labelling (TUNEL) examined 3 or 7 days later. Results: The first major site of cell proliferation between 2-3 days after angioplasty is the adventitia and not the medial wall. Seven days after angioplasty cell proliferation is predominant in the neointima and is reduced in the media and adventitia. Differential staining with antibodies directed against smooth muscle alpha actin and other cytoskeletal proteins indicates that the proliferating adventitial cells are myofibroblasts. Pulse label studies with BrDU indicates that the proliferating adventitial myofibroblasts migrate into the neointima and contribute to the mass of the restenosis lesion. Fourteen days after angioplasty the

Intravascular near-infrared fluorescence molecular imaging of atherosclerosis: toward coronary arterial visualization of biologically high-risk plaques

Science.gov (United States)

Calfon, Marcella A.; Vinegoni, Claudio; Ntziachristos, Vasilis; Jaffer, Farouc A.

2010-01-01

New imaging methods are urgently needed to identify high-risk atherosclerotic lesions prior to the onset of myocardial infarction, stroke, and ischemic limbs. Molecular imaging offers a new approach to visualize key biological features that characterize high-risk plaques associated with cardiovascular events. While substantial progress has been realized in clinical molecular imaging of plaques in larger arterial vessels (carotid, aorta, iliac), there remains a compelling, unmet need to develop molecular imaging strategies targeted to high-risk plaques in human coronary arteries. We present recent developments in intravascular near-IR fluorescence catheter-based strategies for in vivo detection of plaque inflammation in coronary-sized arteries. In particular, the biological, light transmission, imaging agent, and engineering principles that underlie a new intravascular near-IR fluorescence sensing method are discussed. Intravascular near-IR fluorescence catheters appear highly translatable to the cardiac catheterization laboratory, and thus may offer a new in vivo method to detect high-risk coronary plaques and to assess novel atherosclerosis biologics.

Effect of different saline chaser volumes and flow rates on intravascular contrast enhancement in CT using a circulation phantom

International Nuclear Information System (INIS)

Behrendt, Florian F.; Bruners, Philipp; Keil, Sebastian; Plumhans, Cedric; Mahnken, Andreas H.; Das, Marco; Ackermann, Diana; Guenther, Rolf W.; Muehlenbruch, Georg

2010-01-01

Purpose: To evaluate the influence of different saline chaser volumes and different saline chaser flow rates on the intravascular contrast enhancement in MDCT. Materials and methods: In a physiological flow phantom contrast medium (120 ml, 300 mgI/ml, Ultravist 300) was administered at a flow rate of 6 ml/s followed by different saline chaser volumes (0, 30, 60 and 90 ml) at the same injection rate or followed by a 30-ml saline chaser at different injection rates (2, 4, 6 and 8 ml/s). Serial CT-scans at a level covering the pulmonary artery, the ascending and the descending aorta replica were obtained. Time-enhancement curves were computed and both pulmonary and aortic peak enhancement and peak time were determined. Results: Compared to contrast medium injection without a saline chaser the pushing with a saline chaser (30, 60, and 90 ml) resulted in a statistically significant increased pulmonary peak enhancement (all p = 0.008) and prolonged peak time (p = 0.032, p = 0.024 and p = 0.008, respectively). Highest aortic peak enhancement values were detected for a saline chaser volume of 30 ml. A saline chaser flow rate of 8 ml/s resulted in the highest pulmonary peak enhancement values compared to flow rates of 2, 4 and 6 ml/s (all p = 0.008). Aortic peak enhancement showed the highest values for a flow rate of 6 ml/s. Conclusion: A saline chaser volume of 30 ml and an injection rate of 6 ml/s are sufficient to best improve vascular contrast enhancement in the pulmonary artery and the aorta in MDCT.

Injection Drug Use Trajectories Among Migrant Populations: A Narrative Review.

Science.gov (United States)

Melo, Jason S; Mittal, Maria Luisa; Horyniak, Danielle; Strathdee, Steffanie A; Werb, Dan

2018-01-24

Dual epidemics of injection drug use and blood-borne disease, characterized as "syndemics," are present in a range of settings. Behaviors that drive such syndemics are particularly prevalent among mobile drug-using populations, for whom cross-border migration may pose additional risks. This narrative review aims to characterize the risk factors for injection drug use initiation associated with migration, employing a risk environment framework and focusing on the San Diego-Tijuana border region as the most dynamic example of these phenomena. Based on previous literature, we divide migration streams into three classes: intra-urban, internal, and international. We synthesized existing literature on migration and drug use to characterize how mobility and migration drive the initiation of injection drug use, as well as the transmission of hepatitis and HIV, and to delineate how these might be addressed through public health intervention. Population mixing between migrants and receiving communities and the consequent transmission of social norms about injection drug use create risk environments for injection drug use initiation. These risk environments have been characterized as a result of local policy environments, injection drug use norms in receiving communities, migration-related stressors, social dislocation, and infringement on the rights of undocumented migrants. Policies that exacerbate risk environments for migrants may inadvertently contribute to the expansion of epidemics of injection-driven blood-borne disease. Successful interventions that address emerging syndemics in border regions may therefore need to be tailored to migrant populations and distinguish between the vulnerabilities experienced by different migration classes and border settings.

Intravascular ultrasound assessed incomplete stent apposition and stent fracture in stent thrombosis after bare metal versus drug-eluting stent treatment the Nordic Intravascular Ultrasound Study (NIVUS)

DEFF Research Database (Denmark)

Kosonen, Petteri; Vikman, Saila; Jensen, Lisette Okkels

2012-01-01

This prospective multicenter registry used intravascular ultrasound (IVUS) in patients with definite stent thrombosis (ST) to compare rates of incomplete stent apposition (ISA), stent fracture and stent expansion in patients treated with drug-eluting (DES) versus bare metal (BMS) stents. ST...... is a rare, but potential life threatening event after coronary stent implantation. The etiology seems to be multifactorial....

Offline fusion of co-registered intravascular ultrasound and frequency domain optical coherence tomography images for the analysis of human atherosclerotic plaques

DEFF Research Database (Denmark)

Räber, Lorenz; Heo, Jung Ho; Radu, Maria D

2012-01-01

To demonstrate the feasibility and potential usefulness of an offline fusion of matched optical coherence tomography (OCT) and intravascular ultrasound (IVUS)/virtual histology (IVUS-VH) images.......To demonstrate the feasibility and potential usefulness of an offline fusion of matched optical coherence tomography (OCT) and intravascular ultrasound (IVUS)/virtual histology (IVUS-VH) images....

[Optimal intravascular brachytherapy: safety and radiation protection, reliability and precision guaranteed by guidelines, recommendations and regulatory requirements].

Science.gov (United States)

Quast, Ulrich; Kaulich, Theodor W; Lorenz, Joachim

2002-02-01

The success of intravascular brachytherapy relies entirely on the interdisciplinary approach. Interventional cardiologists, radiation oncologists and medical physicists must form a team from day 1. All members of the team need special knowledge and regular training in the field of vascular radiation therapy. Optimization of intravascular brachytherapy requires the use of standardized methods of dose specification, recording and reporting. This also implies using standardized methods of source calibration in terms of absorbed dose to water and having methods for simple internal control of the dosimetric quantities of new or replaced sources. Guidance is offered by international recommendations (AAPM TG 60, DGMP Report 16, NCS and EVA GEC-ESTRO). LEGAL REQUIREMENTS FOR RADIATION PROTECTION--WHAT'S NEW?: In Europe, new legal requirements on radiation protection issues have to be fulfilled. For Germany, the revised "Strahlenschutzverordnung" has been released recently. Nearly all organizational and medical processes are affected. For intravascular brachytherapy, several changes of requirements have to be considered. However, to follow these requirements does not cause serious problems. DGMP REPORT 16: GUIDELINES FOR MEDICAL PHYSICAL ASPECTS OF INTRAVASCULAR BRACHYTHERAPY: Evaluation of clinical results by comparison of intravascular brachytherapy treatment parameters is possible only if the prescribed dose and the applied dose distribution are reported clearly, completely and uniformly. The DGMP guidelines thus recommend to prescribe the dose to water at the system related reference point PRef at 2 mm radial distance for intracoronary application (and at 5 mm for peripheral vessels). The mean dose at 1 mm tissue depth (respectively at 2 mm) should be reported in addition. To safely define the planning target volume from the injured length, safety margins of at least 5 mm (10 mm) have to be taken into account on both ends. Safety margins have also to be considered for

Sonographic evaluation of epidural and intrathecal injections in cats.

Science.gov (United States)

Otero, Pablo E; Verdier, Natali; Zaccagnini, Andrea S; Fuensalida, Santiago E; Sclocco, Matias; Portela, Diego A; Waxman, Samanta

2016-11-01

To describe the ultrasonographic anatomy of the caudal lumbar spine in cats and to detect ultrasound (US) signs associated with epidural or intrathecal injection. Prospective, clinical study. Twenty-six client-owned cats. Transverse (position 1) and parasagittal (position 2) two-dimensional US scanning was performed over the caudal lumbar spine in all cats. Midline distances between the identified structures were measured. Cats assigned to epidural injection (group E, n = 16) were administered a bupivacaine-morphine combination confirmed by electrical stimulation. Cats assigned to intrathecal injection (group I, n = 10) were administered a morphine-iohexol combination injected at the lumbosacral level and confirmed by lateral radiography. The total volume injected (0.3 mL kg -1 ) was divided into two equal aliquots that were injected without needle repositioning, with the US probe in positions 1 and 2, respectively. The presence or absence of a burst of color [color flow Doppler test (CFDT)], dural sac collapse and epidural space enlargement were registered during and after both injections. US scanning allowed measurement of the distances between the highly visible structures inside the spinal canal. CFDT was positive for all animals in group E. In group I, intrathecal injection was confirmed in only two animals, for which the CFDT was negative; seven cats inadvertently and simultaneously were administered an epidural injection and showed a positive CFDT during the second aliquot injection, and the remaining animal was administered epidural anesthesia and was excluded from the CFDT data analysis. Dural sac collapse and epidural space enlargement were present in all animals in which an epidural injection was confirmed. US examination allowed an anatomical description of the caudal lumbar spine and real-time confirmation of epidural injection by observation of a positive CFDT, dural sac collapse and epidural space enlargement. © 2016 Association of Veterinary

Pulmonary intravascular lymphoma detected by FDG PET-CT: a case report.

Science.gov (United States)

Kohan, A A; Paganini, L; Biedak, P; Arma, J I; Dalurzo, M C L; Garcia-Monaco, R D

2013-01-01

Intravascular lymphoma is a rare subtype of extranodal Non-Hodgkin's lymphoma. Its prognosis is poor in a high percentage of cases due to its insidious appearance and low clinical suspicion. Its diagnosis is usually only reached after an autopsy. It may affect different organs as a whole or only one organ. It is extremely rare that the lung is the only damaged organ. Its diagnosis depends of the clinician's suspicion and proper evaluation with imaging studies as well as correct selection of the organ to be biopsied. When detected on time, the treatment of choice is a combination of a series of chemotherapy associated to a monoclonal antibody (anti-CD20). We present the case of a male patient who underwent a positron emission tomography-computed tomography with 2-[F-18]-fluoro-2 deoxy-D-glucose (FDG) due to symptoms suggestive of a lymphoproliferative disease with no clear structural abnormalities. The images led to a diagnosis of pulmonary intravascular large B cell lymphoma. Copyright © 2012 Elsevier España, S.L. and SEMNIM. All rights reserved.

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

intravascular injection or blood vessel injury during the injection (occurring even with proper injection technique with subsequent seepage of the medication into the vasculature, which would produce higher than intended olanzapine concentrations and symptoms consistent with PDSS. Trial Registration ClinicalTrials.gov ID; URL: http://http//www.clinicaltrials.gov/: NCT00094640, NCT00088478, NCT00088491, NCT00088465, and NCT00320489

Effect of catecholamines and insulin on plasma volume and intravascular mass of albumin in man

DEFF Research Database (Denmark)

Hilsted, J; Christensen, N J; Larsen, S

1989-01-01

1. The effect of intravenous catecholamine infusions and of intravenous insulin on plasma volume and intravascular mass of albumin was investigated in healthy males. 2. Physiological doses of adrenaline (0.5 microgram/min and 3 microgram/min) increased peripheral venous packed cell volume...... significantly; intravenous noradrenaline at 0.5 microgram/min had no effect on packed cell volume, whereas packed cell volume increased significantly at 3 micrograms of noradrenaline/min. No significant change in packed cell volume was found during saline infusion. 3. During adrenaline infusion at 6 micrograms...... in packed cell volume, plasma volume, intravascular mass of albumin and transcapillary escape rate of albumin during hypoglycaemia may be explained by the combined actions of adrenaline and insulin....

Hydrophilic Polymer Embolism: Implications for Manufacturing, Regulation, and Postmarket Surveillance of Coated Intravascular Medical Devices.

Science.gov (United States)

Mehta, Rashi I; Mehta, Rupal I

2018-03-19

Hydrophilic polymers are ubiquitously applied as surface coatings on catheters and intravascular medical technologies. Recent clinical literature has heightened awareness on the complication of hydrophilic polymer embolism, the phenomenon wherein polymer coating layers separate from catheter and device surfaces, and may be affiliated with a range of unanticipated adverse reactions. Significant system barriers have limited and delayed reporting on this iatrogenic complication, the full effects of which remain underrecognized by healthcare providers and manufacturers of various branded devices. In 2015, the United States Food and Drug Administration acknowledged rising clinical concerns and stated that the agency would work with stakeholders to further evaluate gaps that exist in current national and international device standards for coated intravascular medical technologies. The present article reviews current knowledge on this complication as well as factors that played a role in delaying detection and dissemination of information and new knowledge once hazards and clinical risks were identified. Furthermore, organ-specific effects and adverse reaction patterns are summarized, along with implications for device manufacturing, safety assurance, and regulation. Qualitative and quantitative particulate testing are needed to optimize coated intravascular device technologies. Moreover, general enhanced processes for medical device surveillance are required for timely adverse event management and to ensure patient safety.

A comparative study of peripheral to central circulation delivery times between intraosseous and intravenous injection using a radionuclide technique in normovolemic and hypovolemic canines

International Nuclear Information System (INIS)

Cameron, J.L.; Fontanarosa, P.B.; Passalaqua, A.M.

1989-01-01

Intraosseous infusion is considered a useful technique for administration of medications and fluids in emergency situations when peripheral intravascular access is unobtainable. This study examined the effectiveness of intraosseous infusion for delivery of substances to the central circulation. Central deliveries of a radionuclide tracer administered by the intraosseous and intravenous routes were evaluated during normovolemic and hypovolemic states. Intraosseous infusion achieved peripheral to central circulation transit times comparable to those achieved by the intravenous route. Analysis of variance revealed no statistically significant differences between the peripheral to central delivery times comparing intraosseous and intravenous administration. The results demonstrate that intraosseous infusion is a rapid and effective method of delivery to the central circulation and is an alternative method for intravascular access. This study also suggests that a radionuclide tracer is useful for the evaluation of transit times following intraosseous injection

Disseminated intravascular coagulation as an unusual presentation of an Epstein-Barr virus infection

NARCIS (Netherlands)

van Steijn, JHM; van Tol, KM; van Essen, LH; Gans, ROB

2000-01-01

Epstein-Barr viral (EBV)-infection usually presents as fever, sore throat, fatigue, lymphadenopathy and atypical lymphocytosis. We describe a patient with disseminated intravascular coagulation as the presenting symptom caused by a primary EBV infection. (C) 2000 Elsevier Science B.V. All rights

A common-sense probabilistic approach to assessing inadvertent human intrusion into low-level radioactive waste at the Nevada Test Site

International Nuclear Information System (INIS)

Black, P.; Hooten, M.; Black, K.; Moore, B.; Rawlinson, S.; Barker, L.

1997-01-01

Each site disposing of low-level radioactive waste is required to prepare and maintain a site-specific performance assessment (1) to determine potential risks posed by waste management systems to the public, and the environment, and (2) to compare these risks to established performance objectives. The DOE Nevada Operations Office, Waste Management Program recently completed a one-year study of site-specific scenarios for inadvertent human intrusion by drilling into buried low-level radioactive waste sites, as part of ongoing performance assessment studies. Intrusion scenarios focus on possible penetration of buried waste through drilling for sources of groundwater. The probability of drilling penetration into waste was judged to be driven primarily by two settlement scenarios: (1) scattered individual homesteaders, and (2) a community scenario consisting of a cluster of settlers that share drilling and distribution systems for groundwater. Management control factors include institutional control, site knowledge, placards and markers, surface barriers, and subsurface barriers. The Subject Matter Experts concluded that institutional control and site knowledge may be important factors for the first few centuries, but are not significant over the evaluation period of 10,000 years. Surface barriers can be designed that would deter the siting of a drill rig over the waste site to an effectiveness of 95%. Subsurface barriers and placards and markers will not as effectively prevent inadvertent human intrusion. Homestead and community scenarios were considered by the panel to render a site-specific probability of around 10% for inadvertent human intrusion. If management controls are designed and implemented effectively, then the probability of inadvertent human intrusion can be reduced to less than 1%

Expert judgement on inadvertent human intrusion into the Waste Isolation Pilot Plant

International Nuclear Information System (INIS)

Hora, S.C.; von Winterfeldt, D.; Trauth, K.M.

1991-12-01

Four expert-judgment teams have developed analyses delineating possible future societies in the next 10,000 years in the vicinity of the Waste Isolation Pilot Plant (WIPP). Expert-judgment analysis was used to address the question of future societies because neither experimentation, observation, nor modeling can resolve such uncertainties. Each of the four, four-member teams, comprised of individuals with expertise in the physical, social, or political sciences, developed detailed qualitative assessments of possible future societies. These assessments include detailed discussions of the underlying physical and societal factors that would influence society and the likely modes of human-intrusion at the WIPP, as well as the probabilities of intrusion. Technological development, population growth, economic development, conservation of information, persistence of government control, and mitigation of danger from nuclear waste were the factors the teams believed to be most important. Likely modes of human-intrusion were categorized as excavation, disposal/storage, tunneling, drilling, and offsite activities. Each team also developed quantitative assessments by providing probabilities of various alternative futures, of inadvertent human intrusion, and in some cases, of particular modes of intrusion. The information created throughout this study will be used in conjunction with other types of information, including experimental data, calculations from physical principles and computer models, and perhaps other judgments, as input to ''performance assessment.'' The more qualitative results of this study will be used as input to another expert panel considering markers to deter inadvertent human intrusion at the WIPP

Inadvertent Splenectomy During Resection for Colorectal Cancer Does Not Increase Long-term Mortality in a Propensity Score Model

DEFF Research Database (Denmark)

Lolle, Ida; Pommergaard, Hans-Christian; Schefte, David F

2016-01-01

BACKGROUND: Previous studies suggest that long-term mortality is increased in patients who undergo splenectomy during surgery for colorectal cancer. The reason for this association remains unclear. OBJECTIVE: The purpose of this study was to investigate the association between inadvertent...... splenectomy attributed to iatrogenic lesion to the spleen during colorectal cancer resections and long-term mortality in a national cohort of unselected patients. DESIGN: This was a retrospective, nationwide cohort study. SETTINGS: Data were collected from the database of the Danish Colorectal Cancer Group...... for patients surviving 30 days after surgery. Secondary outcomes were 30-day mortality and risk factors for inadvertent splenectomy. Multivariable and propensity-score matched Cox regression analyses were used to adjust for potential confounding. RESULTS: In total, 23,727 patients were included, of which 277...

Cervical foraminal steroid injections under CT guidance: retrospective study of in situ contrast aspects in a serial of 248 cases

Energy Technology Data Exchange (ETDEWEB)

Pottecher, Pierre; Krause, Denis; Di Marco, Lucy; Loffroy, Romaric; Estivalet, Louis [CHU Dijon Bocage Central, Departement de Radiologie et Imagerie Diagnostique et Interventionnelle, Dijon (France); Duhal, Romain; Demondion, Xavier [CHRU de Lille, Service de Radiologie Musculosquelettique, CCIAL, Laboratoire d' Anatomie, Faculte de Medecine de Lille, Hopital Roger Salengro, Lille (France)

2015-01-15

To describe all the CT findings after in situ contrast injection just before steroid injection and to recognize the abnormal aspects associated with intravascular contamination. We retrospectively evaluated 248 cervical transforaminal steroid injections done at the university hospital in Dijon, France, in 2008-2012, to treat cervicobrachial neuralgia inadequately improved by optimal medical treatment for at least 3 weeks. Features describing the opacification patterns were recorded. Five main nonvascular opacification patterns were identified: clumps of contrast agent outside the foramen (16 %), a crab claw pattern surrounding the ganglion (13 %), a ''French'' circumflex accent pattern (15 %), reflux along the needle (7 %), and facet joint capsule opacification (22 %). Concerning the situations requiring a change in needle position, intravenous injection occurred in 26 % of the patients, with a crab claw pattern in half the cases and a clump pattern in half the cases. Intraarteriolar injection was noted in two patients. CT after in situ contrast injection ensures proper needle positioning outside the blood vessels before steroid injection. Penetration of the needle tip into a vein is very common, whereas arteriolar puncture is extremely rare. (orig.)

Intravascular versus surface cooling for targeted temperature management after out-of-hospital cardiac arrest

DEFF Research Database (Denmark)

Glover, Guy W; Thomas, Richard M; Vamvakas, George

2016-01-01

, maintenance and rewarming phases in addition to adverse events. All-cause mortality, as well as a composite of poor neurological function or death, as evaluated by the Cerebral Performance Category and modified Rankin scale were analysed. RESULTS: For patients managed at 33 °C there was no difference between......BACKGROUND: Targeted temperature management is recommended after out-of-hospital cardiac arrest and may be achieved using a variety of cooling devices. This study was conducted to explore the performance and outcomes for intravascular versus surface devices for targeted temperature management after...... out-of-hospital cardiac arrest. METHOD: A retrospective analysis of data from the Targeted Temperature Management trial. N = 934. A total of 240 patients (26%) managed with intravascular versus 694 (74%) with surface devices. Devices were assessed for speed and precision during the induction...

New treatment strategies for disseminated intravascular coagulation based on current understanding of the pathophysiology

NARCIS (Netherlands)

Levi, Marcel; de Jonge, Evert; van der Poll, Tom

2004-01-01

A variety of clinical conditions may cause systemic activation of coagulation, ranging from insignificant laboratory changes to severe disseminated intravascular coagulation (DIC). DIC consists of a widespread, systemic activation of coagulation, resulting in diffuse fibrin deposition in small and

Inadvertent pump start with gas expansion modules

International Nuclear Information System (INIS)

Campbell, L.R.; Harris, R.A.; Heard, F.J.; Dautel, W.A.

1992-01-01

Previous testing demonstrated the effectiveness of gas expansion modules (GEMs) in mitigating the consequences of a loss-of-flow-without-scram transient in Fast Flux Test Facility (FFTF)-sized sodium cooled cores. As a result, GEMs have been included in the advance liquid-metal reactor (PRISM) design project sponsored by the US Department of Energy. The PRISM design is under review at the US Nuclear Regulatory Commission for licensability. In the unlikely event that the reactor does not scram during a loss of low, the GEMs quickly insert sufficient negative reactivity to limit fuel and cladding temperatures to acceptable values. This is the positive benefit of the GEMs; however, the reverse situation must be considered. A primary pump could be inadvertently started from near-critical conditions resulting in a positive reactivity insertion and a power transient. One mitigating aspect of this event is that as the reactivity associated with the GEMs is inserted, the increasing flow increases core cooling. A test was conducted in the FFTF to demonstrate that the GEM and feedback reactivity are well predicted following pump start, and the reactivity transient is benign

Evaluation of two different epidural catheters in clinical practice. narrowing down the incidence of paresthesia!

Science.gov (United States)

Bouman, E A C; Gramke, H F; Wetzel, N; Vanderbroeck, T H T; Bruinsma, R; Theunissen, M; Kerkkamp, H E M; Marcus, M A E

2007-01-01

Although epidural anesthesia is considered safe, several complications may occur during puncture and insertion of a catheter. Incidences of paresthesia vary between 0.2 and 56%. A prospective, open, cohort-controlled pilot study was conducted in 188 patients, ASA I-III, age 19-87 years, scheduled for elective surgery and epidural anesthesia. We evaluated a 20 G polyamide (standard) catheter and a 20 G combined polyurethane-polyamide (new) catheter. Spontaneous reactions upon catheter-insertion, paresthesia on questioning, inadvertent dural or intravascular puncture, and reasons for early catheter removal were recorded. The incidence of paresthesia reported spontaneously was 21.3% with the standard catheter and 16.7% with the new catheter. Systematically asking for paresthesia almost doubled the paraesthesia rate. Intravascular cannulation occurred in 5%. No accidental dural punctures occurred. An overall incidence of 13.3% of technical problems led to early catheter removal. The new catheter was at least equivalent to the standard regarding epidural success rate and safety : rate of paresthesia, intravascular and dural cannulation.

Management of subarachnoid hemorrhage classified grade V. Possibility of intravascular treatment

Energy Technology Data Exchange (ETDEWEB)

Uzura, Masahiko; Oshima, Kousuke; Morishima, Hiroyuki; Uchida, Kazuyoshi; Watanabe, Hiroyuki; Nakamura, Homare; Tanaka, Katsuyuki; Sekino, Hiroaki; Akashi, Katsuya [St. Marianna Univ., Kawasaki, Kanagawa (Japan). School of Medicine

2001-10-01

Management outcomes in poor-grade patients (World Federation of Neurological Surgeons Committee on a Universal Subarachnoid Hemorrhage Grading Scale Grade V) with ruptured cerebral aneurysms have historically been unsatisfactory. In the present study, we examined the possibility of intravascular treatment for ruptured aneurysm detected by 3-Dimensional CT angiography (3D-CTA) in poor-grade SAH patients. From April 1997 to July 2000, 3D-CTA was performed on 54 of 73 patients admitted with Grade V subarachnoid hemorrhage (SAH). Excluding 3 patients who underwent emergency surgery for ruptured aneurysms and intracerebral hematomas, CT findings from the remaining 51 patients were analyzed. The study included 23 men and 28 women, ranging in age from 28 to 91 with an average age of 63.6. The patients' initial scores on the Glasgow Coma Scale upon admission were 3 in 36 patients (including 19 patients who had undergone cardio-pulmonary arrest), 4 in 11 patients, 5 in 2 patients, and 6 in 2 patients. Ruptured aneurysms responsible for SAH were clearly delineated in 41 aneurysms from 39 patients, with 32 aneurysms in the anterior circulation and 9 in the posterior circulation. Patients with Glasgow Coma Scale of 4 or higher whose score did not progressively decrease for 12 hours after symptom onset were considered for intravascular treatment. In our study, 4 of 39 patients (10.3%) met these criteria. Glasgow Outcome Scale results were good recovery in 1 case, moderate disability in 1 case, severe disability in 1 case, and death in the remaining 48 cases. These results suggest that the management course for poor-grade (WFNS Grade V) SAH patients who retain brain stem reflexes contain the following: identification of aneurysms by 3D-CTA, maintenance of adequate sedation and external drainage to treat acute hydrocephalus, continued minimum 12-hour observation, monitoring levels of consciousness where possible, and consideration of aggressive therapy including

Subacute fat-embolism-like syndrome following high-volume intramuscular and accidental intravascular injection of mineral oil

DEFF Research Database (Denmark)

Hjort, Mathias; Hoegberg, Lotte Christine Groth; Jansen, Tejs

2015-01-01

and the patient was treated with organ-specific supportive measures, tranexamic acid, and prednisolone and discharged after 11 days in the hospital. Conclusion. Subacute FES-like was associated with injection of body filler in muscle tissue. FES-like can mimic pneumonia, posttraumatic lung injury, and other more...

Dosimetry in intravascular brachytherapy; Calculos dosimetricos em braquiterapia intravascular

Energy Technology Data Exchange (ETDEWEB)

Campos, Laelia Pumilla Botelho

2000-03-01

Among the cardiovascular diseases responsible for deaths in the adult population in almost all countries of the world, the most common is acute myocardial infarction, which generally occurs because of the occlusion of one or more coronary arteries. Several diagnostic techniques and therapies are being tested for the treatment of coronary artery disease. Balloon angioplasty has been a popular treatment which is less invasive than traditional surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment).Recently, the idea of delivering high radiation doses to coronary arteries to avoid or delay restenosis has been suggested. Known as intravascular brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis in some patient populations. In order to study the radiation dosimetry in the patient and radiological protection for the attending staff for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, o,30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several candidate radionuclides as well. Two s tent sources (metallic prosthesis that put inside of patient's artery through angioplasty) employing {sup 32} P are also simulated. Advantages and disadvantages of the various radionuclides and source geometries are discussed. The dosimetry developed here will aid in the realization of the benefits obtained in patients for this promising new technology. (author)

Dosimetry in intravascular brachytherapy; Calculos dosimetricos em braquiterapia intravascular

Energy Technology Data Exchange (ETDEWEB)

Campos, Laelia Pumilla Botelho

2000-03-01

Among the cardiovascular diseases responsible for deaths in the adult population in almost all countries of the world, the most common is acute myocardial infarction, which generally occurs because of the occlusion of one or more coronary arteries. Several diagnostic techniques and therapies are being tested for the treatment of coronary artery disease. Balloon angioplasty has been a popular treatment which is less invasive than traditional surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment).Recently, the idea of delivering high radiation doses to coronary arteries to avoid or delay restenosis has been suggested. Known as intravascular brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis in some patient populations. In order to study the radiation dosimetry in the patient and radiological protection for the attending staff for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, o,30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several candidate radionuclides as well. Two s tent sources (metallic prosthesis that put inside of patient's artery through angioplasty) employing {sup 32} P are also simulated. Advantages and disadvantages of the various radionuclides and source geometries are discussed. The dosimetry developed here will aid in the realization of the benefits obtained in patients for this promising new technology. (author)

Ventricular metastasis resulting in disseminated intravascular coagulation

Directory of Open Access Journals (Sweden)

Davis Ian D

2005-05-01

Full Text Available Abstract Background Disseminated Intravascular Coagulation (DIC complicates up to 7% of malignancies, the commonest solid organ association being adenocarcinoma. Transitional Cell Carcinoma (TCC has rarely been associated with DIC. Case presentation A 74-year-old woman with TCC bladder and DIC was found to have a cardiac lesion suspicious for metastatic disease. The DIC improved with infusion of plasma and administration of Vitamin K, however the cardiac lesion was deemed inoperable and chemotherapy inappropriate; given the patients functional status. We postulate that direct activation of the coagulation cascade by the intraventricular metastasis probably triggered the coagulopathy in this patient. Conclusion Cardiac metastases should be considered in cancer patients with otherwise unexplained DIC. This may influence treatment choices.

Protection against high intravascular pressure in giraffe legs

DEFF Research Database (Denmark)

Petersen, Karin K; Hørlyck, Arne; Østergaard, Kristine Hovkjær

2013-01-01

The high blood pressure in giraffe leg arteries renders giraffes vulnerable to edema. We investigated in 11 giraffes whether large and small arteries in the legs and the tight fascia protect leg capillaries. Ultrasound imaging of foreleg arteries in anesthetized giraffes and ex vivo examination....... All three findings can contribute to protection of the capillaries in giraffe legs from a high arterial pressure....... revealed abrupt thickening of the arterial wall and a reduction of its internal diameter just below the elbow. At and distal to this narrowing, the artery constricted spontaneously and in response to norepinephrine and intravascular pressure recordings revealed a dynamic, viscous pressure drop along...

An Implantable Intravascular Pressure Sensor for a Ventricular Assist Device

Directory of Open Access Journals (Sweden)

Luigi Brancato

2016-08-01

Full Text Available The aim of this study is to investigate the intravascular application of a micro-electro-mechanical system (MEMS pressure sensor to directly measure the hemodynamic characteristics of a ventricular assist device (VAD. A bio- and hemo-compatible packaging strategy is implemented, based on a ceramic thick film process. A commercial sub-millimeter piezoresistive sensor is attached to an alumina substrate, and a double coating of polydimethylsiloxane (PDMS and parylene-C is applied. The final size of the packaged device is 2.6 mm by 3.6 mm by 1.8 mm. A prototype electronic circuit for conditioning and read-out of the pressure signal is developed, satisfying the VAD-specific requirements of low power consumption (less than 14.5 mW in continuous mode and small form factor. The packaged sensor has been submitted to extensive in vitro tests. The device displayed a temperature-independent sensitivity (12 μ V/V/mmHg and good in vitro stability when exposed to the continuous flow of saline solution (less than 0.05 mmHg/day drift after 50 h. During in vivo validation, the transducer has been successfully used to record the arterial pressure waveform of a female sheep. A small, intravascular sensor to continuously register the blood pressure at the inflow and the outflow of a VAD is developed and successfully validated in vivo.

46 CFR 308.536 - Declaration where failure to comply with Clause 21 was inadvertent, Form MA-314.

Science.gov (United States)

2010-10-01

... TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance Ii-Open Policy War Risk Cargo... Assured that fails inadvertently to maintain a collateral deposit fund or surety bond in an amount..., which may be obtained from the American War Risk Agency or MARAD. III—Facultative War Risk Cargo...

Ischemia monitoring in off-pump coronary artery bypass surgery using intravascular near-infrared spectroscopy

Directory of Open Access Journals (Sweden)

Zerkowski Hans-Reinhard

2006-05-01

Full Text Available Abstract Background In off-pump coronary artery bypass surgery, manipulations on the beating heart can lead to transient interruptions of myocardial oxygen supply, which can generate an accumulation of oxygen-dependent metabolites in coronary venous blood. The objective of this study was to evaluate the reliability of intravascular near-infrared spectroscopy as a monitoring method to detect possible ischemic events in off-pump coronary artery bypass procedures. Methods In 15 elective patients undergoing off-pump myocardial revascularization, intravascular near-infrared spectroscopic analysis of coronary venous blood was performed. NIR signals were transferred through a fiberoptic catheter for signal emission and collection. For data analysis and processing, a miniature spectrophotometer with multivariate statistical package was used. Signal acquisition and analysis were performed before and after revascularization. Spectroscopic data were compared with hemodynamic parameters, electrocardiogram, transesophageal echocardiography and laboratory findings. Results A conversion to extracorporeal circulation was not necessary. The mean number of grafts per patient was 3.1 ± 0.6. An intraoperative myocardial ischemia was not evident, as indicated by electrocardiogram and transesophageal echocardiography. Continuous spectroscopic analysis showed reproducible absorption spectra of coronary sinus blood. Due to uneventful intraoperative courses, clear ischemia-related changes could be detected in none of the patients. Conclusion Our initial results show that intravascular near-infrared spectroscopy can reliably be used for an online intraoperative ischemia monitoring in off-pump coronary artery bypass surgery. However, the method has to be further evaluated and standardized to determine the role of spectroscopy in off-pump coronary artery bypass surgery.

Intravascular ultrasonic-photoacoustic (IVUP) endoscope with 2.2-mm diameter catheter for medical imaging.

Science.gov (United States)

Bui, Nhat Quang; Hlaing, Kyu Kyu; Nguyen, Van Phuc; Nguyen, Trung Hau; Oh, Yun-Ok; Fan, Xiao Feng; Lee, Yong Wook; Nam, Seung Yun; Kang, Hyun Wook; Oh, Junghwan

2015-10-01

Intravascular ultrasound (IVUS) imaging is extremely important for detection and characterization of high-risk atherosclerotic plaques as well as gastrointestinal diseases. Recently, intravascular photoacoustic (IVPA) imaging has been used to differentiate the composition of biological tissues with high optical contrast and ultrasonic resolution. The combination of these imaging techniques could provide morphological information and molecular screening to characterize abnormal tissues, which would help physicians to ensure vital therapeutic value and prognostic significance for patients before commencing therapy. In this study, integration of a high-frequency IVUS imaging catheter (45MHz, single-element, unfocused, 0.7mm in diameter) with a multi-mode optical fiber (0.6mm in core diameter, 0.22 NA), an integrated intravascular ultrasonic-photoacoustic (IVUP) imaging catheter, was developed to provide spatial and functional information on light distribution in a turbid sample. Simultaneously, IVUS imaging was co-registered to IVPA imaging to construct 3D volumetric sample images. In a phantom study, a polyvinyl alcohol (PVA) tissue-mimicking arterial vessel phantom with indocyanine green (ICG) and methylene blue (MB) inclusion was used to demonstrate the feasibility of mapping the biological dyes, which are used in cardiovascular and cancer diagnostics. For the ex vivo study, an excised sample of pig intestine with ICG was utilized to target the biomarkers present in the gastrointestinal tumors or the atherosclerotic plaques with the proposed hybrid technique. The results indicated that IVUP endoscope with the 2.2-mm diameter catheter could be a useful tool for medical imaging. Copyright © 2015 Elsevier Ltd. All rights reserved.

Neonicotinoid insecticides can serve as inadvertent insect contraceptives

Science.gov (United States)

Villamar-Bouza, Laura; Bruckner, Selina; Chantawannakul, Panuwan; Gauthier, Laurent; Khongphinitbunjong, Kitiphong; Retschnig, Gina; Troxler, Aline; Vidondo, Beatriz; Neumann, Peter; Williams, Geoffrey R.

2016-01-01

There is clear evidence for sublethal effects of neonicotinoid insecticides on non-target ecosystem service-providing insects. However, their possible impact on male insect reproduction is currently unknown, despite the key role of sex. Here, we show that two neonicotinoids (4.5 ppb thiamethoxam and 1.5 ppb clothianidin) significantly reduce the reproductive capacity of male honeybees (drones), Apis mellifera. Drones were obtained from colonies exposed to the neonicotinoid insecticides or controls, and subsequently maintained in laboratory cages until they reached sexual maturity. While no significant effects were observed for male teneral (newly emerged adult) body mass and sperm quantity, the data clearly showed reduced drone lifespan, as well as reduced sperm viability (percentage living versus dead) and living sperm quantity by 39%. Our results demonstrate for the first time that neonicotinoid insecticides can negatively affect male insect reproductive capacity, and provide a possible mechanistic explanation for managed honeybee queen failure and wild insect pollinator decline. The widespread prophylactic use of neonicotinoids may have previously overlooked inadvertent contraceptive effects on non-target insects, thereby limiting conservation efforts. PMID:27466446

Interventional and intravascular MR angiography

International Nuclear Information System (INIS)

Ladd, M.E.; Debatin, J.F.

2000-01-01

Magnetic resonance imaging (MRI) has a number of characteristics which make it attractive for guidance of intravascular therapeutic procedures, including high soft tissue contrast, imaging in any arbitrary oblique plane, lack of ionizing radiation, and the ability to provide functional information, such as flow velocity and volume per unit time. For MR guidance of vascular interventions to be safe, catheters and guidewires must be visualized relative to the vascular system and surrounding tissues. A number of approaches for making instruments visible in an MR environment are presented, including both passive and active techniques. Passive techniques depend on contrast agents or susceptibility artifacts, whereas active techniques, including MR tracking, MR profiling, and active field inhomogeneity, use some form of electrical coil built into the instrument. The potential for obtaining high-resolution images of the vessel wall using coils built into a catheter is also discussed. These images provide the capability to distinguish and identify various plaque components. The additional capabilities of MRI could potentially open up new applications beyond those currently performed under X-ray fluoroscopic guidance. (orig.) [de

Why Have So Many Intravascular Glucose Monitoring Devices Failed?

Science.gov (United States)

Smith, John L; Rice, Mark J

2015-07-01

Secondary to the inherent limitations of both point-of-care and central laboratory glucose technologies, continuous glucose measurement has recently enjoyed a high level of investment. Because of the perceived advantages by some of measuring in the intravascular space compared to the subcutaneous tissue, a number of technologies have been developed. In this review, we evaluate nine systems that have shown promise, although only one of these has been cleared for sale in the United States. The detection methodology, regulatory status, technical issues, and company circumstance surrounding each technology are examined. © 2015 Diabetes Technology Society.

Radiation Dose Reduction in CT Fluoroscopy-Guided Cervical Transforaminal Epidural Steroid Injection by Modifying Scout and Planning Steps

Energy Technology Data Exchange (ETDEWEB)

Paik, Nam Chull, E-mail: pncspine@gmail.com [Arumdaun Wooldul Spine Hospital, Department of Radiology (Korea, Republic of)

2016-04-15

Background and PurposeIn CT fluoroscopy (CTF)-guided cervical transforaminal epidural steroid injection (TFESI), the majority of radiation dose is contributed by the planning CT scan rather than the CTF procedure itself. We replaced the planning helical CT with a spot CTF and accordingly changed the patient posture during scout and planning scans. The aim of this study was to test whether radiation dose reduction would be achieved by this protocol modification while still maintaining technical performance.MethodsOverall, 338 consecutive procedures before (control group: n = 163) and after (study group: n = 175) instituting the above-mentioned protocol modification were analyzed retrospectively, comparing patient characteristics (age, sex, neck diameter, and level injected) and technical performance [technical success rate, dose-length product (DLP), inadvertent contrast flow incidence, number of CTF acquisitions, and procedural time] between the two groups.ResultsAll injections were technically successful at every level from C3–C4 to C7–T1 without serious complications in both groups. The median DLP of the study group (7.92 mGy·cm) was significantly reduced compared to that of the control group (39.05 mGy·cm, P < 0.001). There were no significant differences between the two groups regarding the incidence of inadvertent contrast flow (20.6 vs. 17.2 %, P = 0.426), number of CTF acquisitions (median 5 vs. 4, P = 0.123), and the procedural time (median 6.62 vs. 6.90 min, P = 0.100).ConclusionsWhen conducting CTF-guided cervical TFESIs, a significant radiation dose reduction (median 79.7 % in DLP) can be achieved by modifying scout and planning steps, without compromising the technical performance.

Focus on the research utility of intravascular ultrasound - comparison with other invasive modalities

Directory of Open Access Journals (Sweden)

Hoye Angela

2011-01-01

Full Text Available Abstract Intravascular ultrasound (IVUS is an invasive modality which provides cross-sectional images of a coronary artery. In these images both the lumen and outer vessel wall can be identified and accurate estimations of their dimensions and of the plaque burden can be obtained. In addition, further processing of the IVUS backscatter signal helps in the characterization of the type of the plaque and thus it has been used to study the natural history of the atherosclerotic evolution. On the other hand its indigenous limitations do not allow IVUS to assess accurately stent struts coverage, existence of thrombus or exact site of plaque rupture and to identify some of the features associated with increased plaque vulnerability. In order this information to be obtained, other modalities such as optical coherence tomography, angioscopy, near infrared spectroscopy and intravascular magnetic resonance imaging have either been utilized or are under evaluation. The aim of this review article is to present the current utilities of IVUS in research and to discuss its advantages and disadvantages over the other imaging techniques.

Adherence to a Gluten-Free Diet in Mexican Subjects with Gluten-Related Disorders: A High Prevalence of Inadvertent Gluten Intake.

Science.gov (United States)

Ramírez-Cervantes, Karen Lizzette; Romero-López, Angélica Viridiana; Núñez-Álvarez, Carlos Alberto; Uscanga-Domínguez, Luis F

2016-01-01

The rate of compliance with a gluten-free diet in patients with gluten-related disorders is unknown in most Latin American countries. To study the adherence to a gluten-free diet of Mexican individuals with celiac disease and nonceliac gluten sensitivity at the time of their first medical and nutritional consultation at a tertiary referral center. A cross-sectional study was performed. A specific questionnaire was used to gather information on demographics, clinical condition, and self-reported adherence to a gluten-free diet, and to determine strict compliance and intentional or inadvertent gluten consumption. All questionnaires were applied by a nutritionist with expertise in gluten-related disorders. Fifty-six patients with celiac disease and 24 with non-celiac gluten sensitivity were included. Overall, 46 (57.5%) subjects perceived themselves as strictly adherent; however, inadvertent gluten intake was frequent in both celiac disease and non-celiac gluten sensitivity patients (39.2 vs. 33.3%; p = 0.2). Intentional consumption was more prevalent in subjects with celiac disease (48.8 vs. 29.1%; p = 0.048) and individuals with non-celiac gluten sensitivity showed better adherence (37.5 vs. 12.5%; p = 0.035). The importance of a gluten-free diet is underestimated by Mexican patients with celiac disease. The role of a team with expertise in gluten-related disorders is essential to identify inadvertent gluten intake.

13 CFR 126.308 - What happens if SBA inadvertently omits a qualified HUBZone SBC from the List?

Science.gov (United States)

2010-01-01

... writing at U.S. Small Business Administration, 409 Third Street, SW., Washington, DC 20416 or via e-mail... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What happens if SBA inadvertently omits a qualified HUBZone SBC from the List? 126.308 Section 126.308 Business Credit and Assistance...

Robust intravascular optical coherence elastography by line correlations

International Nuclear Information System (INIS)

Soest, Gijs van; Mastik, Frits; Jong, Nico de; Steen, Anton F W van der

2007-01-01

We present a new method for intravascular optical coherence elastography, which is robust against motion artefacts. It employs the correlation between adjacent lines, instead of subsequent frames. Pressure to deform the tissue is applied synchronously with the line scan rate of the optical coherence tomography (OCT) instrument. The viability of the method is demonstrated with a simulation study. We find that the root mean square (rms) error of the displacement estimate is 0.55 μm, and the rms error of the strain is 0.6%. It is shown that high-strain spots in the vessel wall, such as observed at the sites of vulnerable atherosclerotic lesions, can be detected with the technique

Intravascular Large B-Cell Lymphoma

Directory of Open Access Journals (Sweden)

Maria S. Khan MD, FACP

2014-03-01

Full Text Available Case Presentation . A 69-year-old Hispanic male, with a past history of diabetes and coronary disease, was admitted for fever, diarrhea, and confusion of 4 weeks duration. Physical examination showed a disoriented patient with multiple ecchymoses, possible ascites, and bilateral scrotal swelling. Hemoglobin was 6.7, prothrombin time (PT 21.4 seconds with international normalized ratio 2.1, partial thromboplastin time (PTT 55.6 seconds, fibrin split 10 µg/L, and lactate dehydrogenase (LDH 1231 IU/L. Except for a positive DNA test for Epstein–Barr virus (EBV infection, extensive diagnostic workup for infections, malignancy, or a neurological cause was negative. Mixing studies revealed a nonspecific inhibitor of PT and PTT but Factor VIII levels were normal. The patient was empirically treated with antibiotics but developed hypotension and died on day 27 of admission. At autopsy, patient was found to have intravascular diffuse large B-cell lymphoma involving skin, testes, lung, and muscles. The malignant cells were positive for CD20, CD791, Mum-1, and Pax-5 and negative for CD3, CD5, CD10, CD30, and Bcl-6. The malignant cells were 100% positive for Ki-67. Discussion . Intravascular large cell B-cell lymphoma (IVLBCL is rare form of diffuse large B-cell lymphoma and tends to proliferate within small blood vessels, particularly capillaries and postcapillary venules. The cause of its affinity for vascular bed remains unknown. In many reports, IVLBCL was associated with HIV, HHV8, and EBV infections. The fact that our case showed evidence of EBV infection lends support to the association of this diagnosis to viral illness. The available literature on this subject is scant, and in many cases, the diagnosis was made only at autopsy. The typical presentation of this disorder is with B symptoms, progressive neurologic deficits, and skin findings. Bone marrow, spleen, and liver are involved in a minority of patients. Nearly all patients have elevated LDH

High speed intravascular photoacoustic imaging of atherosclerotic arteries (Conference Presentation)

Science.gov (United States)

Piao, Zhonglie; Ma, Teng; Qu, Yueqiao; Li, Jiawen; Yu, Mingyue; He, Youmin; Shung, K. Kirk; Zhou, Qifa; Kim, Chang-Seok; Chen, Zhongping

2016-02-01

Cardiovascular disease is the leading cause of death in the industrialized nations. Accurate quantification of both the morphology and composition of lipid-rich vulnerable atherosclerotic plaque are essential for early detection and optimal treatment in clinics. In previous works, intravascular photoacoustic (IVPA) imaging for detection of lipid-rich plaque within coronary artery walls has been demonstrated in ex vivo, but the imaging speed is still limited. In order to increase the imaging speed, a high repetition rate laser is needed. In this work, we present a high speed integrated IVPA/US imaging system with a 500 Hz optical parametric oscillator laser at 1725 nm. A miniature catheter with 1.0 mm outer diameter was designed with a 200 μm multimode fiber and an ultrasound transducer with 45 MHz center frequency. The fiber was polished at 38 degree and enclosed in a glass capillary for total internal reflection. An optical/electrical rotary junction and pull-back mechanism was applied for rotating and linearly scanning the catheter to obtain three-dimensional imaging. Atherosclerotic rabbit abdominal aorta was imaged as two frame/second at 1725 nm. Furthermore, by wide tuning range of the laser wavelength from 1680 nm to 1770 nm, spectroscopic photoacoustic analysis of lipid-mimicking phantom and an human atherosclerotic artery was performed ex vivo. The results demonstrated that the developed IVPA/US imaging system is capable for high speed intravascular imaging for plaque detection.

Intravascular photoacoustic imaging: a new tool for vulnerable plaque identification.

Science.gov (United States)

Jansen, Krista; van Soest, Gijs; van der Steen, Antonius F W

2014-06-01

The vulnerable atherosclerotic plaque is believed to be at the root of the majority of acute coronary events. Even though the exact origins of plaque vulnerability remain elusive, the thin-cap fibroatheroma, characterized by a lipid-rich necrotic core covered by a thin fibrous cap, is considered to be the most prominent type of vulnerable plaque. No clinically available imaging technique can characterize atherosclerotic lesions to the extent needed to determine plaque vulnerability prognostically. Intravascular photoacoustic imaging (IVPA) has the potential to take a significant step in that direction by imaging both plaque structure and composition. IVPA is a natural extension of intravascular ultrasound that adds tissue type specificity to the images. IVPA utilizes the optical contrast provided by the differences in the absorption spectra of plaque components to image composition. Its capability to image lipids in human coronary atherosclerosis has been shown extensively ex vivo and has recently been translated to an in vivo animal model. Other disease markers that have been successfully targeted are calcium and inflammatory markers, such as macrophages and matrix metalloproteinase; the latter two through application of exogenous contrast agents. By simultaneously displaying plaque morphology and composition, IVPA can provide a powerful prognostic marker for disease progression, and as such has the potential to transform the current practice in percutaneous coronary intervention. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Anticipated transient without scram analysis of the simplified boiling water reactor following main steam isolation valve closure with boron injection

International Nuclear Information System (INIS)

Khan, H.J.; Cheng, H.S.; Rohatgi, U.S.

1996-01-01

The simplified boiling water reactor (SBWR) operating in natural circulation is designed with many passive safety features. An anticipated transient without scram (ATWS) initiated by inadvertent closure of the main steam isolation valve (MSIV) in an SBWR has been analyzed using the RAMONA-4B code of Brookhaven National Laboratory. This analysis demonstrates the predicted performance of the SBWR during an MSIV closure ATWS, followed by shutdown of the reactor through injection of boron into the reactor core from the standby liquid control system

Association of insulin resistance and coronary artery remodeling: an intravascular ultrasound study

OpenAIRE

Kim, Sang-Hoon; Moon, Jae-Youn; Lim, Yeong Min; Kim, Kyung Ho; Yang, Woo-In; Sung, Jung-Hoon; Yoo, Seung Min; Kim, In Jai; Lim, Sang-Wook; Cha, Dong-Hun; Cho, Seung-Yun

2015-01-01

Background There are few studies that investigated the correlation between insulin resistance (IR) and the coronary artery remodeling. The aim of the study is to investigate the association of IR measured by homeostasis model assessment of insulin resistance (HOMA-IR) and coronary artery remodeling evaluated by intravascular ultrasound (IVUS). Methods A total of 298 consecutive patients who received percutaneous coronary interventions under IVUS guidance were retrospectively enrolled. The val...

Prevention of the inadvertent movement and illicit trafficking of radioactive and nuclear materials in Argentine border

International Nuclear Information System (INIS)

Bonet Duran, Stella M.; Canibano, Javier A.; Menossi, Sergio A.; Rodriguez, Carlos E.

2004-01-01

The inadvertent and illegal movements of radioactive and nuclear materials are issues of increased national and international awareness. States are progressively becoming more conscious of the need to adequately respond to these events. As regards the States' regulatory infrastructure, the design and enforcement of control and verification measures to maintain the continuity of knowledge about possession, use and movements of radioactive and nuclear materials is of critical importance. The existence of an appropriate legislative framework and a regulatory authority empowered to establish effective safety and security measures are essential to prevent inadvertent and illegal movements of nuclear materials and other radioactive materials. The events of Sep. 11, 2001 in the US have increased the States' awareness on the need to review their national infrastructure to identify additional measures against inadvertent and illegal movements of radioactive and nuclear materials as well as against sabotage of nuclear facilities. Argentina has more than a half- century- old tradition regarding the control and supervision of all activities involving the use of nuclear and radioactive materials. The Nuclear Regulatory Authority (ARN) of Argentina is the organization with federal competence in radiation protection, nuclear safety, safeguards and physical protection. It is responsible for issuing licenses and permits to any activity involving radioactive materials and for controlling and verifying that these activities are performed in full compliance with ARN standards and requirements. In the region, Argentina has been playing an important role in the prevention of illicit traffic of nuclear and radioactive materials for the last years within the framework of Security Commission of MERCOSUR. The last goals of this initiative are to define and coordinate actions and to establish a set of common operational procedures in the countries participating in the mentioned multilateral

Death following intravascular administration of contrast media

International Nuclear Information System (INIS)

Shehadi, W.H.

1985-01-01

Adverse reactions to intravascularly administered contrast media preceding death and the autopsy findings in 44 patients are presented. There is a wide scatter of the age distribution of fatal reactions. The highest incidence is in the 50-70 year age group. Similar observations were obtained from the 405 deaths due to contrast media reported to the Food and Drug Administration of the United States. In the same age group the number of reactions is highest, likewise the autopsy findings. The predominant autopsy findings are pulmonary edema, congestion and hemorrhage; arteriosclerosis, both general and coronary. In the younger age group the autopsy findings are limited mostly to the respiratory tract. Fatal reactions to contrast media occur often without warning and most deaths occur within 15 min to 6 hours. Reactions to contrast media occur without relation to sex or age. (orig.)

Conceptual source design and dosimetric feasibility study for intravascular treatment: a proposal for intensity modulated brachytherapy

Energy Technology Data Exchange (ETDEWEB)

Kim, Si Yong; Han, Eun Young; Palta, Jatinder R. [College of Medicine, Florida Univ., Florida (United States); Ha, Sung W. [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

2003-06-01

To propose a conceptual design of a novel source for intensity modulated brachytherapy. The source design incorporates both radioactive and shielding materials (stainless steel or tungsten), to provide an asymmetric dose intensity in the azimuthal direction. The intensity modulated intravascular brachytherapy was performed by combining a series of dwell positions and times, distributed along the azimuthal coordinates. Two simple designs for the beta-emitting sources, with similar physical dimensions to a {sub 90}Sr/Y Novoste Beat-Cath source, were considered in the dosimetric feasibility study. In the first design, the radioactive and materials each occupy half of the cylinder and in the second, the radioactive material occupies only a quarter of the cylinder. The radial and azimuthal dose distributions around each source were calculated using the MCNP Monte Carlo code. The preliminary hypothetical simulation and optimization results demonstrated the 87% difference between the maximum and minimum doses to the lumen wall, due to off-centering of the radiation source, could be reduced to less than 7% by optimizing the azimuthal dwell positions and times of the partially shielded intravascular brachytherapy sources. The novel brachytherapy source design, and conceptual source delivery system, proposed in this study show promising dosimetric characteristics for the realization of intensity modulated brachytherapy in intravascular treatment. Further development of this concept will center on building a delivery system that can precisely control the angular motion of a radiation source in a small-diameter catheter.

Conceptual source design and dosimetric feasibility study for intravascular treatment: a proposal for intensity modulated brachytherapy

International Nuclear Information System (INIS)

Kim, Si Yong; Han, Eun Young; Palta, Jatinder R.; Ha, Sung W.

2003-01-01

To propose a conceptual design of a novel source for intensity modulated brachytherapy. The source design incorporates both radioactive and shielding materials (stainless steel or tungsten), to provide an asymmetric dose intensity in the azimuthal direction. The intensity modulated intravascular brachytherapy was performed by combining a series of dwell positions and times, distributed along the azimuthal coordinates. Two simple designs for the beta-emitting sources, with similar physical dimensions to a 90 Sr/Y Novoste Beat-Cath source, were considered in the dosimetric feasibility study. In the first design, the radioactive and materials each occupy half of the cylinder and in the second, the radioactive material occupies only a quarter of the cylinder. The radial and azimuthal dose distributions around each source were calculated using the MCNP Monte Carlo code. The preliminary hypothetical simulation and optimization results demonstrated the 87% difference between the maximum and minimum doses to the lumen wall, due to off-centering of the radiation source, could be reduced to less than 7% by optimizing the azimuthal dwell positions and times of the partially shielded intravascular brachytherapy sources. The novel brachytherapy source design, and conceptual source delivery system, proposed in this study show promising dosimetric characteristics for the realization of intensity modulated brachytherapy in intravascular treatment. Further development of this concept will center on building a delivery system that can precisely control the angular motion of a radiation source in a small-diameter catheter

Inadvertent puncture of the aortic noncoronary cusp during postoperative left atrial tachycardia ablation

Directory of Open Access Journals (Sweden)

Dursun Aras, MD

2015-08-01

Full Text Available Transseptal catheterization has become part of the interventional electrophysiologist׳s technical armamentarium since the development of left atrial catheter ablation and percutaneous technologies for treating mitral and aortic valve disease. Although frequently performed, the procedure׳s most feared complication is aortic root penetration. Focal atrial tachycardia has been described as the most common late sequela of surgical valve replacements. We present a complicated case involving the inadvertent delivery of an 8 French sheath across the noncoronary cusp during radiofrequency catheter ablation for left atrial tachycardia originating from the mitral annulus in a patient with prior mitral valve replacement.

Relation between lung perfusion defects and intravascular clots in acute pulmonary thromboembolism: assessment with breath-hold SPECT-CT pulmonary angiography fusion images.

Science.gov (United States)

Suga, Kazuyoshi; Yasuhiko, Kawakami; Iwanaga, Hideyuki; Tokuda, Osamu; Matsunaga, Naofumi

2008-09-01

The relation between lung perfusion defects and intravascular clots in acute pulmonary thromboembolism (PTE) was comprehensively assessed on deep-inspiratory breath-hold (DIBrH) perfusion SPECT-computed tomographic pulmonary angiography (CTPA) fusion images. Subjects were 34 acute PTE patients, who had successfully performed DIBrH perfusion SPECT using a dual-headed SPECT and a respiratory tracking system. Automated DIBrH SPECT-CTPA fusion images were used to assess the relation between lung perfusion defects and intravascular clots detected by CTPA. DIBrH SPECT visualized 175 lobar/segmental or subsegmental defects in 34 patients, and CTPA visualized 61 intravascular clots at variable locations in 30 (88%) patients, but no clots in four (12%) patients. In 30 patients with clots, the fusion images confirmed that 69 (41%) perfusion defects (20 segmental, 45 subsegmental and 4 lobar defects) of total 166 defects were located in lung territories without clots, although the remaining 97 (58%) defects were located in lung territories with clots. Perfusion defect was absent in lung territories with clots (one lobar branch and three segmental branches) in four (12%) of these patients. In four patients without clots, nine perfusion defects including four segmental ones were present. Because of unexpected dissociation between intravascular clots and lung perfusion defects, the present fusion images will be a useful adjunct to CTPA in the diagnosis of acute PTE.

One-stage surgery for removal of intravascular leiomyomatosis extending to right ventricle.

Science.gov (United States)

Chiang, Ching-Shu; Chen, Po-Lin; Kuo, Tzu-Ting; Chen, I-Ming; Wu, Nai-Yuan; Chang, Hsiao-Huang

2018-03-01

Intravascular leiomyomatosis (IVL) is a rare nonmalignant tumor that can be fatal if untreated. A 49-year-old nulliparous Asian woman who underwent hysterectomy and left salpingo-oophorectomy for multiple uterine leiomyomas 18 months prior presented complaining of intermittent palpitation and chest tightness for approximately 1 month. Echocardiography revealed a large mobile tumor mass extending from the inferior vena cava (IVC) to the right atrium that partially obstructed IVC flow and tricuspid inflow. Thoracicabdominopelvic computed tomography revealed a left adnexal tumor (4.8 × 2.5 cm) causing intravascular obstruction extending from the left internal iliac vein to the IVC, right atrium, and right ventricle. IVL with right heart involvement INTERVENTIONS:: Under cardiopulmonary bypass, a one-stage surgery combining sternotomy and laparotomy was performed. The tumor was approached and extracted via sternotomy, and tumor detachment and removal of residual tumors was accomplished via laparotomy. A firm, smooth, and regularly shape tumor 15.5 × 5.5 × 2.5 in size was completely removed and histopathologically confirmed as IVL. The patient tolerated the surgical procedure well and no postoperative complication was noted. We describe a one-stage surgical approach to completely remove an IVL extending to the right ventricle.

Plasma volume, intravascular albumin and its transcapillary escape rate in patients with extensive skin disease

DEFF Research Database (Denmark)

Parving, H H; Worm, A M; Rossing, N

1976-01-01

Plasma volume and plasma concentration and transcapillary escape rate of albumin (TER alb), i.e. the fraction of intravascular mass of albumin that passes to the extravascular space per unit time, were determined using 125I-labelled human albumin in eight patients with extensive skin disease....... Plasma volume and plasma albumin concentration were reduced (P less than 0-05). Thus the intravascular albumin mass was moderately decreased to an average of 0-55 +/- 0-06 (s.d.) g/cm height compared with a normal mean value of 0-77 +/- 0-07 (s.d.) g/cm. This 29% decrease is statistically significant (P...... less than 0-001). The transcapillary escape rate of albumin (TER alb) was significantly elevated, mean 8-6 +/- 1-1 (s.d.) % X h-1, as compared to normal subjects, mean 5-6 +/- 1-1 (s.d.) % X h-1, (+54%, P less than 0-001). The same patients were studied again after a 1-week treatment with prednisone...

MR-guided perineural injection of the ganglion impar: technical considerations and feasibility

Energy Technology Data Exchange (ETDEWEB)

Marker, David R.; Carrino, John A.; Fritz, Jan [Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Musculoskeletal Radiology, Baltimore, MD (United States); U-Thainual, Paweena [Queen' s University, Department of Mechanical and Materials Engineering, Kingston, ON (Canada); Ungi, Tamas; Fichtinger, Gabor [Queen' s University, School of Computing, Kingston, ON (Canada); Flammang, Aaron J. [Siemens Corporate Research, Center for Applied Medical Imaging, Baltimore, MD (United States); Iordachita, Iulian I. [Johns Hopkins University, Department of Mechanical Engineering and Laboratory for Computational Sensing and Robotics, Baltimore, MD (United States)

2016-05-15

Perineural ganglion impar injections are used in the management of pelvic pain syndromes; however, there is no consensus regarding the optimal image guidance. Magnetic resonance imaging (MRI) provides high soft tissue contrast and the potential to directly visualize and target the ganglion. The purpose of this study was to assess the feasibility of MR-guided percutaneous perineural ganglion impar injections. Six MR-guided ganglion impar injections were performed in six human cadavers. Procedures were performed with a clinical 1.5-Tesla MRI system through a far lateral transgluteus approach. Ganglion impar visibility, distance from the sacrococcygeal joint, number of intermittent MRI control steps required to place the needle, target error between the intended and final needle tip location, inadvertent punctures of non-targeted vulnerable structures, injectant distribution, and procedure time were determined. The ganglion impar was seen on MRI in 4/6 (66 %) of cases and located 0.8 mm cephalad to 16.3 mm caudad (average 1.2 mm caudad) to the midpoint of the sacrococcygeal joint. Needle placement required an average of three MRI control steps (range, 2-6). The average target error was 2.2 ± 2.1 mm. In 6/6 cases (100 %), there was appropriate periganglionic distribution and filling of the presacrococcygeal space. No punctures of non-targeted structures occurred. The median procedure time was 20 min (range, 12-29 min). Interventional MRI can visualize and directly target the ganglion impar for accurate needle placement and successful periganglionic injection with the additional benefit of no ionizing radiation exposure to patient and staff. Our results support clinical evaluation. (orig.)

Disseminated intravascular coagulation or acute coagulopathy of trauma shock early after trauma? A prospective observational study

DEFF Research Database (Denmark)

Johansson, Per Ingemar; Sorensen, Anne Marie; Perner, Anders

2011-01-01

ABSTRACT: INTRODUCTION: It is debated whether the early trauma induced coagulopathy (TIC) in severely injured patients reflects disseminated intravascular coagulation (DIC) with a fibrinolytic phenotype, acute coagulopathy of trauma shock (ACoTS) or yet other entities. This study investigated the...

Development of sup 1 sup 9 sup 2 Ir radiation sources for intravascular irradiation

CERN Document Server

Kogure, H; Iwamoto, S; Iwata, K; Kawauchi, Y; Nagata, Y; Sorita, T; Suzuki, K

2003-01-01

Intravascular brachytherapy is a novel therapy for preventing the restenosis of coronary artery by use of low-dose irradiation. JAERI and Kyoto University have been developing sup 1 sup 9 sup 2 Ir radiation sources by the cooperative research project entitled as 'The research on safety and effectiveness of the intravascular brachytherapy for preventing restenosis of the coronary artery disease' since 1998. The radiation source was introduced into the stenosis through a catheter (a guide-tube to insert directly into vascular) to irradiate the diseased part. Ten sup 1 sup 9 sup 2 Ir seed sources (phi 0.4 mm x 2.5 mm) were positioned between nylon spacers (phi 0.3 mm x 1.0 mm) in a flexible covering tube and the tube was plugged with a core-wire; the tube was shrunk to fix the inside materials and the size is 0.46 mm in diameter and 3 m in length. The physically optimal design was determined to insert the radiation source easily into vascular and to get the dose uniformity in the diseased part. The production me...

Analyses of natural resources in 10 CFR Part 60 as related to inadvertent human intrusion

International Nuclear Information System (INIS)

Miklas, M.P.; Lefevre, H.E.

1993-01-01

The purpose of this paper is to examine the intent of the regulatory language of the portions of 10 CFR Part 60 which deal with considerations of the natural resources of a proposed geologic repository for high-level radioactive wastes as they relate to inadvertent human intrusion. Four Potentially Adverse Conditions (PAC) the requirements of 10 CFR 60.21(c)(13) are shown to be related to natural resources. Groundwater is identified as a natural resource known to be present at Yucca Mountain, Nevada. For economic considerations of natural resources, the open-quotes foreseeable futureclose quotes is thought to be no more than 50 years. Two of the topics addressed by the PACs, subsurface mining and drilling at a proposed repository site, are pre-site-characterization activities which must be evaluated in the context of repository performance criteria set by the US EPA standard, 40 CFR Part 191. An alternative US DOE compliance demonstration to another PAC, 10 CFR 60.122(c)(17), might be to use an open-quotes explorationist perspectiveclose quotes of natural resource assessment. The Commission intends for DOE to evaluate the likelihood and consequence of inadvertent human intrusion into a geologic repository as a result of exploration or exploitation of natural resources within or near a proposed high-level radioactive waste geologic repository

Study of 'inadvertent human intrusion or rare natural event scenarios' for sub-surface disposal of radioactive waste

International Nuclear Information System (INIS)

Nakatani, Takayoshi; Ishitoya, Kimihide; Funabashi, Hideyuki; Sugaya, Toshikatsu; Sone, Tomoyuki; Shimada, Hidemitsu; Nakai, Kunihiro

2010-03-01

Japan Atomic Energy Agency (JAEA) is making preparations for the sub-surface disposal of radioactive wastes, in an integrated fashion according to the properties of the waste material regardless of the generators or waste sources. In this study, 'Inadvertent Human Intrusion or Rare Natural Event Scenarios' of 'Three Types scenarios' was considered according to the standard of the Atomic Energy Society of Japan (AESJ) on the sub-surface disposal system that was based on 'Basic Policy for Safety Regulation Concerning Land Disposal of Low-Level Radioactive Waste (Interim Report)' by Nuclear Safety Commission of Japan (NSC). Selection of the assessed scenarios, development of the assessment tool and preliminary exposure dose assessment for general public were conducted. Among the assessed scenarios, the exposure dose of 'well water drinking scenario' was the highest under the very conservative assessment condition. This scenario assumed that the groundwater in Excavation Disturbed Zone (EDZ) was directly used as drinking water without any dilution. Although this was very conservative condition and the result exceeded 10 mSv/y, it stayed under the upper limit of standard dose value for 'Inadvertent Human Intrusion or Rare Natural Event Scenarios' (10 - 100 mSv/y). (author)

Preintervention lesion remodelling affects operative mechanisms of balloon optimised directional coronary atherectomy procedures: a volumetric study with three dimensional intravascular ultrasound

Science.gov (United States)

von Birgelen, C; Mintz, G; de Vrey, E A; Serruys, P; Kimura, T; Nobuyoshi, M; Popma, J; Leon, M; Erbel, R; de Feyter, P J

2000-01-01

AIMS—To classify atherosclerotic coronary lesions on the basis of adequate or inadequate compensatory vascular enlargement, and to examine changes in lumen, plaque, and vessel volumes during balloon optimised directional coronary atherectomy procedures in relation to the state of adaptive remodelling before the intervention.
DESIGN—29 lesion segments in 29 patients were examined with intravascular ultrasound before and after successful balloon optimised directional coronary atherectomy procedures, and a validated volumetric intravascular ultrasound analysis was performed off-line to assess the atherosclerotic lesion remodelling and changes in plaque and vessel volumes that occurred during the intervention. Based on the intravascular ultrasound data, lesions were classified according to whether there was inadequate (group I) or adequate (group II) compensatory enlargement.
RESULTS—There was no significant difference in patient and lesion characteristics between groups I and II (n = 10 and 19), including lesion length and details of the intervention. Quantitative coronary angiographic data were similar for both groups. However, plaque and vessel volumes were significantly smaller in group I than in II. In group I, 9 (4)% (mean (SD)) of the plaque volume was ablated, while in group II 16 (11)% was ablated (p = 0.01). This difference was reflected in a lower lumen volume gain in group I than in group II (46 (18) mm3 v 80 (49) mm3 (p atherectomy procedures. Plaque ablation was found to be particularly low in lesions with inadequate compensatory vascular enlargement.


Keywords: intravascular ultrasound; ultrasonics; remodelling; coronary artery disease; atherectomy PMID:10648496

High grade primary adrenal intravascular large B-cell lymphoma manifesting as Addison disease Linfoma intravascular de alto grado de células B grandes y origen suprarrenal que se manifiesta en forma de enfermedad de Addison

Directory of Open Access Journals (Sweden)

J. Venizelos

2007-08-01

Full Text Available We report a rare case of a 68 aged male who presented with adrenal failure and was diagnosed of high grade large B-cell lymphoma primarily arising in the adrenal glands. The patient was administrated with additional chemotherapy but he passed away 7 months later due to infection in the lungs. Intravascular lymphoma should be suspected in patients with bilateral adrenal masses who present with rapidly progressive adrenal insufficiency.Publicamos el caso poco frecuente de un varón de 68 años de edad que debutó con insuficiencia adrenal y fue diagnosticado de linfoma de alto grado de células B grandes ubicado principalmente en las glándulas suprarrenales. Al paciente le administraron quimioterapia adicional, pero falleció 7 meses después de infección pulmonar. El linfoma intravascular debe sospecharse en los pacientes con masas suprarrenales bilaterales que presenten insuficiencia adrenal rápidamente progresiva.

Prospective validation of the International Society of Thrombosis and Haemostasis scoring system for disseminated intravascular coagulation

NARCIS (Netherlands)

Bakhtiari, Kamran; Meijers, Joost C. M.; de Jonge, Evert; Levi, Marcel

2004-01-01

Objectives: A diagnosis of disseminated intravascular coagulation (DIC) is hampered by the lack of an accurate diagnostic test. Based on the retrospective analysis of studies in patients with DIC, a scoring system (0-8 points) using simple and readily available routine laboratory tests has been

Direct sGC activation bypasses no scavenging reactions of intravascular free oxy-hemoglobin and limits vasoconstriction

NARCIS (Netherlands)

N.J.H. Raat (Nicolaas); D.M. Tabima (D. Marcela); P. Specht (Patricia); J. Tejero (Jesús); M.P. Champion (Michael); D.B. Kim-Shapiro (Daniel); J.G. Baust (John ); E.G. Mik (Egbert); M. Hildesheim (Mariana); J.-P. Stasch (Johannes-Peter); E.-M. Becker (Eva-Maria); H. Truebel (Hubert); M.T. Gladwin (Mark)

2013-01-01

textabstractAims: Hemoglobin-based oxygen carriers (HBOC) provide a potential alternative to red blood cell (RBC) transfusion. Their clinical application has been limited by adverse effects, in large part thought to be mediated by the intravascular scavenging of the vasodilator nitric oxide (NO) by

Endovascular repair of inadvertent arterial injury induced by central venous catheterization using a vascular closure device: A case report

Energy Technology Data Exchange (ETDEWEB)

Kim, So Hee; Jang, Woo Jin; Oh, Ju Heyon; Song, Yun Gyu [Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon (Korea, Republic of)

2017-04-15

Central venous catheterization can cause various complications. Inadvertent subclavian artery catheterization was performed during insertion of a central venous catheter in a 73-year-old man suffering from panperitonitis due to small-bowel perforation. Endovascular treatment was conducted to treat the injured subclavian artery with a FemoSeal vascular closure device.

3D dosimetry study of 188Re liquid balloon for intravascular brachytherapy using BANG polymer gel dosemeters

International Nuclear Information System (INIS)

Wuu, S.; Schiff, P.B.; Maryanski, M.; Liu, T.; Borzillary, S.; Weinberger, J.

2002-01-01

It has been suggested that the combination of intravascular brachytherapy and coronary stent implantation may result in further reduction of restenosis after percutaneous balloon angioplasty. The use of an angioplasty balloon filled with a P 188 Re liquid beta source for intravascular brachytherapy provides the advantage of accurate source positioning and uniform dose distribution to the coronary vessel wall. The effect of source edge and stent on the dose distribution of the target tissue may be clinically important. In BANG gels, the absorbed radiation produces free-radical chain polymerisation of acrylic monomers that are initially dissolved in the gel. The number of polymer particles is proportional to the absorbed dose. In this study, 3D dose distributions are presented for 188 Re balloons, with and without stents, using a prototype He-Ne laser CT scanner and the proprietary BANG polymer gel dosemeters. (author)

Head to head comparison of optical coherence tomography, intravascular ultrasound echogenicity and virtual histology for the detection of changes in polymeric struts over time

DEFF Research Database (Denmark)

Brugaletta, Salvatore; Gomez-Lara, Josep; Bruining, Nico

2012-01-01

To analyse and to compare the changes in the various optical coherence tomography (OCT), echogenicity and intravascular ultrasound virtual histology (VH) of the everolimus-eluting bioresorbable scaffold (ABSORB) degradation parameters during the first 12 months after ABSORB implantation. In the A......To analyse and to compare the changes in the various optical coherence tomography (OCT), echogenicity and intravascular ultrasound virtual histology (VH) of the everolimus-eluting bioresorbable scaffold (ABSORB) degradation parameters during the first 12 months after ABSORB implantation...

Intravascular Papillary Endothelial Hyperplasia Associated with Venous Pool Arising in the Lower Lip: A Case Report

Directory of Open Access Journals (Sweden)

Hisanobu Yonezawa

2009-01-01

Full Text Available Intravascular papillary endothelial hyperplasia is a benign nonneoplastic vascular lesion that consists of endothelial cells with abundant vascular tissue with papillary proliferation. An adult female had a painless growing dark red nodule on the left side of the lower lip and often touched and gnawed at it for more than 4 years. The lesion was a tender, smooth mass approximately 1 cm in diameter without discoloration reaction. Magnetic resonance imaging of the lesion showed specific findings. She was diagnosed clinically as having mimicked hemangioma, and the lesion was totally excised under local anesthesia. Histopathological examination revealed that papillary proliferated endothelial cells with venous pool, and the lesion was diagnosed as intravascular papillary endothelial hyperplasia associated with venous pool. There has been no recurrence for more than 1 year. Despite the benign nature of this lesion, it could have been mistaken for a malignant tumor because of its clinical course and radiologic findings.

CT findings in ischaemic hepatic failure due to intra-arterial embolisation: A case report

International Nuclear Information System (INIS)

Catalano, O.

1997-01-01

Liver infarction is relatively uncommon. It may be secondary to several conditions such as sepsis, shock, sickle-cell anaemia, eclampsia, vasculitis, metastatic disease, bacterial endocarditis, rheumatic heart disease, trauma, portal venous occlusion or compression, oral contraception, anaesthesia, hepatic artery thrombosis, therapeutical or inadvertent hepatic artery ligation, intra-arterial chemotherapy or embolisation. A case of hepatic infraction, unusual for iatrogenic pathogenesis, submassive extension with acute hepatic failure, and CT findings of an internally branching pattern due to intravascular gas was observed. (orig./AJ)

Evaluation of Disseminated Intravascular Coagulation in the Craniocerebral Traumas

Directory of Open Access Journals (Sweden)

Faruk Altinel

2014-06-01

Full Text Available Traumatic injury is one of the most important cause of disseminated intravascular coagulation (DIC. It occurs because of blood loss and hemodilution due to fluid resuscitation. The incidence of trauma associated DIC is mainly higher in the craniocerebral traumas. Even though craniocerebral trauma related DIC is well defined, the pathophysiology has been poorly characterized in the literature. Due to the fact that brain tissue is highly significant for procoagulant molecules, craniocerebral traumas are closely related to DIC. In the current study, 30 patients admitted to emergency room have been considered on the first and fifth day of admission to the hospital for the coagulation tests to evaluate DIC in both two groups. [Cukurova Med J 2014; 39(3.000: 488-495

Emerging Technology Update Intravascular Photoacoustic Imaging of Vulnerable Atherosclerotic Plaque.

Science.gov (United States)

Wu, Min; Fw van der Steen, Antonius; Regar, Evelyn; van Soest, Gijs

2016-10-01

The identification of vulnerable atherosclerotic plaques in the coronary arteries is emerging as an important tool for guiding atherosclerosis diagnosis and interventions. Assessment of plaque vulnerability requires knowledge of both the structure and composition of the plaque. Intravascular photoacoustic (IVPA) imaging is able to show the morphology and composition of atherosclerotic plaque. With imminent improvements in IVPA imaging, it is becoming possible to assess human coronary artery disease in vivo . Although some challenges remain, IVPA imaging is on its way to being a powerful tool for visualising coronary atherosclerotic features that have been specifically associated with plaque vulnerability and clinical syndromes, and thus such imaging might become valuable for clinical risk assessment in the catheterisation laboratory.

The use of protective barriers to deter inadvertent human intrusion into a mined geologic facility for the disposal of radioactive waste: A review of previous investigations and potential concepts

International Nuclear Information System (INIS)

Tolan, T.L.

1993-06-01

Sandia National Laboratories is evaluating the feasibility of developing protective barrier system for the Waste Isolation Pilot Plant (WIPP) to thwart inadvertent human intrusion into this radioactive-waste disposal system for a period of 9,900 years after assumed loss of active institutional controls. The protective barrier system would be part of a series of enduring passive institutional controls whose long-term function will be to reduce the likelihood of inadvertent human activities (e.g., exploratory drilling for resources) that could disrupt the WIPP disposal system

Procedure Oriented Torsional Anatomy of the Forearm for Spasticity Injection.

Science.gov (United States)

Chiou-Tan, Faye; Cianca, John; John, Joslyn; Furr-Stimming, Erin; Pandit, Sindhu; Taber, Katherine H

2015-01-01

: This is the second in a series of articles related to the concept of "torsional" anatomy. The objective of this article is to provide musculoskeletal ultrasound (MSKUS) anatomy of the forearm in the position of hemispastic flexion as a reference relevant to needle procedures. The MSKUS images were obtained in a healthy human subject. Marker dots were placed over common injection sites in the forearm for spasticity. The MSKUS probe was centered over each dot to obtain a cross-sectional view. A pair of MSKUS images was recorded for each site: the first in anatomic neutral and second in hemiparetic spastic position. The images were compared side to side. In addition, a video recording was made at each site to track the movement of the muscles and nerves during internal rotation. The pronator teres (PT) rotated medially and the brachialis and biceps tendon rotated in view. In addition, the median nerve became more superficial. The flexor carpi radialis rotated medially and was replaced by PT and the median nerve. The flexor carpi ulnaris and flexor digitorum profundus rotated medially and were replaced by the flexor carpi radialis, PT and median nerve. The flexor digitorum superficialis was replaced by the brachioradialis, extensor carpi radialis brevis, and radial nerve. The brachioradialis was replaced by the extensor carpi radialis brevis and extensor digitorum communis. Intended muscle targets rotate out of view and injection range. These are replaced by other muscles and nerves that could inadvertently be injected. This potentially could result in both increased complications and decreased efficacy of the procedure. It is hoped that this series of images will increase the accuracy and safety of needle placement for spasticity injections in the forearm.

Interventions for treating inadvertent postoperative hypothermia.

Science.gov (United States)

Warttig, Sheryl; Alderson, Phil; Campbell, Gillian; Smith, Andrew F

2014-11-20

Inadvertent postoperative hypothermia (a drop in core body temperature to below 36°C) occurs as an effect of surgery when anaesthetic drugs and exposure of the skin for long periods of time during surgery result in interference with normal temperature regulation. Once hypothermia has occurred, it is important that patients are rewarmed promptly to minimise potential complications. Several different interventions are available for rewarming patients. To estimate the effectiveness of treating inadvertent perioperative hypothermia through postoperative interventions to decrease heat loss and apply passive and active warming systems in adult patients who have undergone surgery. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2014, Issue 2), MEDLINE (Ovid SP) (1956 to 21 February 2014), EMBASE (Ovid SP) (1982 to 21 February 2014), the Institute for Scientific Information (ISI) Web of Science (1950 to 21 February 2014) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EBSCO host (1980 to 21 February 2014), as well as reference lists of articles. We also searched www.controlled-trials.com and www.clincialtrials.gov. Randomized controlled trials of postoperative warming interventions aiming to reverse hypothermia compared with control or with each other. Three review authors identified studies for inclusion in this review. One review author extracted data and completed risk of bias assessments; two review authors checked the details. Meta-analysis was conducted when appropriate by using standard methodological procedures as expected by The Cochrane Collaboration. We included 11 trials with 699 participants. Ten trials provided data for analysis. Trials varied in the numbers and types of participants included and in the types of surgery performed. Most trials were at high or unclear risk of bias because of inappropriate or unclear randomization procedures, and because blinding of assessors and participants generally was

Pregnancy outcome after 1st-trimester inadvertent exposure to barium sulphate as a contrast media for upper gastrointestinal tract radiography.

Science.gov (United States)

Han, B H; Lee, K S; Han, J Y; Choi, J S; Ahn, H K; Ryu, H M; Yang, J H; Han, H W; Nava-Ocampo, A A

2011-10-01

Despite barium being used as a contrast media for decades, the specific assessment of its safety in pregnant women is scarce. We are reporting the favourable pregnancy outcome in women who were inadvertently exposed to barium swallow and associated ionising radiation, early in pregnancy. A control group of age- and gravidity-matched unexposed pregnant women was also included. There were 32 live-born babies in the exposed group and 94 in the control group. Women had undergone diagnostic upper gastrointestinal tract (UGT) fluoroscopic examination at 3.3 ± 1.5 weeks' gestation. Estimated maternal radiation dose secondary to barium swallow varied widely, the maximum dose was estimated to be 2.45 mSv. Similar pregnancy outcomes were observed between the groups. The number of babies born with major malformations was not significantly different (p = 1.0) between cases and controls: one (3.1%) vs three (3.2%), respectively. In conclusion, our small prospective cohort study of women suggests no association between inadvertent exposure to ionising radiation and barium sulphate during fluoroscopic barium swallow and adverse fetal outcomes.

Life-threatening urethral hemorrhage after placement of a Foley catheter in a patient with uroseptic disseminated intravascular coagulation due to chronic urinary retention induced by untreated benign prostatic hyperplasia.

Science.gov (United States)

Ikegami, Yukihiro; Yoshida, Keisuke; Imaizumi, Tsuyoshi; Isosu, Tsuyoshi; Kurosawa, Shin; Murakawa, Masahiro

2016-10-01

A 77-year-old man with severe septic disseminated intravascular coagulation following urinary infection was transported to our hospital. He had developed urinary retention induced by untreated prostatic hyperplasia. Immediate drainage with a Foley catheter was successfully carried out, but the hematuria progressed to life-threatening hemorrhage. Complete hemostasis was impossible by surgical treatment because the tissue around the prostatic urethra was very fragile and hemorrhagic. Organized treatments (continuous hemodiafiltration combined with polymyxin-B immobilized fiber column hemoperfusion and systemic treatment with antibiotics and coagulation factors) were commenced soon after the operation. The patient eventually recovered from the septic disseminated intravascular coagulation. This case report illustrates the risk of placement of Foley catheters in patients with severe septic disseminated intravascular coagulation.

Safety analysis of increase in heat removal from reactor coolant system with inadvertent operation of passive residual heat removal at no load conditions

Energy Technology Data Exchange (ETDEWEB)

Shao, Ge; Cao, Xuewu [School of Mechanical and Engineering, Shanghai Jiao Tong University, Shanghai (China)

2015-06-15

The advanced passive pressurized water reactor (PWR) is being constructed in China and the passive residual heat removal (PRHR) system was designed to remove the decay heat. During accident scenarios with increase of heat removal from the primary coolant system, the actuation of the PRHR will enhance the cooldown of the primary coolant system. There is a risk of power excursion during the cooldown of the primary coolant system. Therefore, it is necessary to analyze the thermal hydraulic behavior of the reactor coolant system (RCS) at this condition. The advanced passive PWR model, including major components in the RCS, is built by SCDAP/RELAP5 code. The thermal hydraulic behavior of the core is studied for two typical accident sequences with PRHR actuation to investigate the core cooling capability with conservative assumptions, a main steam line break (MSLB) event and inadvertent opening of a steam generator (SG) safety valve event. The results show that the core is ultimately shut down by the boric acid solution delivered by Core Makeup Tank (CMT) injections. The effects of CMT boric acid concentration and the activation delay time on accident consequences are analyzed for MSLB, which shows that there is no consequential damage to the fuel or reactor coolant system in the selected conditions.

A new method to measure necrotic core and calcium content in coronary plaques using intravascular ultrasound radiofrequency-based analysis

NARCIS (Netherlands)

E.S. Shin (Eun-Seok); H.M. Garcia-Garcia (Hector); P.W.J.C. Serruys (Patrick)

2010-01-01

textabstractAlthough previous intravascular ultrasound (IVUS) radiofrequency-based analysis data showed acceptable reproducibility for plaque composition, measurements are not easily obtained, particularly that of lumen contour, because of the limited IVUS resolution. The purpose of this study was

Dosimetry in intravascular brachytherapy

International Nuclear Information System (INIS)

Campos, Laelia Pumilla Botelho

2000-03-01

Among the cardiovascular diseases responsible for deaths in the adult population in almost all countries of the world, the most common is acute myocardial infarction, which generally occurs because of the occlusion of one or more coronary arteries. Several diagnostic techniques and therapies are being tested for the treatment of coronary artery disease. Balloon angioplasty has been a popular treatment which is less invasive than traditional surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment).Recently, the idea of delivering high radiation doses to coronary arteries to avoid or delay restenosis has been suggested. Known as intravascular brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis in some patient populations. In order to study the radiation dosimetry in the patient and radiological protection for the attending staff for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, o,30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several candidate radionuclides as well. Two s tent sources (metallic prosthesis that put inside of patient's artery through angioplasty) employing 32 P are also simulated. Advantages and disadvantages of the various radionuclides and source geometries are discussed. The dosimetry developed here will aid in the realization of the benefits obtained in patients for this promising new technology. (author)

Multicenter assessment of the reproducibility of volumetric radiofrequency-based intravascular ultrasound measurements in coronary lesions that were consecutively stented

NARCIS (Netherlands)

Huisman, Jeroen; Egede, R.; Rdzanek, A.; Böse, D.; Erbel, R.; van der Palen, Jacobus Adrianus Maria; von Birgelen, Clemens

2012-01-01

To assess in a multicenter design the between-center reproducibility of volumetric virtual histology intravascular ultrasound (VH-IVUS) measurements with a semi-automated, computer-assisted contour detection system in coronary lesions that were consecutively stented. To evaluate the reproducibility

SIADH and partial hypopituitarism in a patient with intravascular large B-cell lymphoma: a rare cause of a common presentation

Science.gov (United States)

Akhtar, Simeen; Cheesman, Edmund; Jude, Edward B

2013-01-01

Hyponatraemia is a very common electrolyte abnormality with varied presenting features depending on the underlying cause. The authors report the case of a 75-year-old, previously fit, gentleman who presented with weight loss, lethargy and blackouts. He required four admissions to the hospital over an 8-month period. Investigations revealed persistent hyponatraemia consistent with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion, macrocytic anaemia and partial hypopituitarism. Unfortunately, all other investigations that were performed failed to identify the underlying cause and a diagnosis of intravascular large B-cell lymphoma was only confirmed following postmortem studies. The authors recommend that endocrinologists should be involved at the outset in the management of patients with persistent hyponatraemia and that intravascular large B-cell lymphoma should be considered in the differential diagnosis of hyponatraemia. PMID:23362070

Primary intravascular large B-cell lymphoma of pituitary

Directory of Open Access Journals (Sweden)

K R Anila

2012-01-01

Full Text Available A 68-year-old retired nurse, who was a known hypertensive on medication, presented with prolonged fever of 2-month duration without any clinical evidence of infection. On examination she had altered mental status. She also had other nonspecific complaints such as sleep disturbances, loss of weight, etc. On investigation, she was found to have anemia, thrombocytopenia, raised erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, and lactate dehydrogenase (LDH values. She also had electrolyte imbalance. Radiological evaluation of brain showed mass lesion in the sella turcica, suggestive of pituitary adenoma. Biochemical evaluation showed hypopituitarism. Trans-sphenoidal biopsy was done. Based on histopathological and immunohistochemical findings a diagnosis of intravascular large B-cell lymphoma (IVLBCL of pituitary was made. Our patient′s condition deteriorated rapidly and she succumbed to her illness before therapy could be initiated. We are reporting this case because of the rare subtype of large B-cell lymphoma presenting at an extremely unusual primary site.

Reliability of mechanical and phased-array designs for serial intravascular ultrasound examinations--animal and clinical studies in stented and non-stented coronary arteries.

Science.gov (United States)

Tardif, J C; Bertrand, O F; Mongrain, R; Lespérance, J; Grégoire, J; Paiement, P; Bonan, R

2000-10-01

Both mechanical and multi-element intravascular ultrasound designs have potential advantages and limitations that may impact on their value for clinical and research purposes. Determination of the reproducibility of measurements is critical before a given system can be used in studies such as regression of atherosclerosis trials. We performed serial intravascular ultrasound imaging with catheters using mechanical and phased-array designs in stented and non-stented coronary arteries in dogs and in patients. Both systems correlated well for areas (r > or = 0.90, p or = 0.84. p mechanical designs for measurements of area (mean difference in dogs and in patients: -0.24 and 0.96 mm2, p mechanical system (r > or = 0.96 for all measurements). The differences in absolute and relative variability between the mechanical and phased-array designs, both for reanalysis of same frames and serial pullbacks, were very small. Although multi-element and mechanical intravascular ultrasound designs are not strictly interchangeable, their similar reproducibility and the small differences in measurements demonstrate that both designs are acceptable alternatives for trials of regression of atherosclerosis. Determination of the variability for serial pullbacks of both designs was also important to assess the statistical power of such trials.

[Intravascular Hemolysis Caused by Stenosis of an Elephant Trunk;Report of a Case].

Science.gov (United States)

Takamaru, Rikako; Kawahito, Koji; Aizawa, Kei; Misawa, Yoshio

2017-07-01

Symptomatic intravascular hemolysis after prosthetic aortic graft replacement is rare. It is primarily attributed to mechanical injury of red blood cells caused by stenosis of the vascular graft. A 50-year-old man presented with hemolytic anemia, 5 years after total arch replacement with an elephant trunk for type A aortic dissection. The hemolysis was caused by graft stenosis of the elephant trunk. Endovascular treatment for the stenotic elephant trunk was successfully performed. The postoperative course was uneventful, and the hemolysis was resolved immediately after operation.

Intravascular Large B-Cell Lymphoma Presenting as Interstitial Lung Disease

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Elham Vali Khojeini

2014-01-01

Full Text Available Intravascular large B-cell lymphoma (IVLBL is a rare subtype of diffuse large B-cell lymphoma that resides in the lumen of blood vessels. Patients typically present with nonspecific findings, particularly bizarre neurologic symptoms, fever, and skin lesions. A woman presented with shortness of breath and a chest CT scan showed diffuse interstitial thickening and ground glass opacities suggestive of an interstitial lung disease. On physical exam she was noted to have splenomegaly. The patient died and at autopsy was found to have an IVLBL in her lungs as well as nearly all her organs that were sampled. Although rare, IVLBL should be included in the differential diagnosis of interstitial lung disease and this case underscores the importance of the continuation of autopsies.

Design and implementation of an intravascular brachytherapy installation in cardiology

International Nuclear Information System (INIS)

Prieto, C.; Vano, E.; Fernandez, J.M.; Sabate, M.; Galvan, Y.C.

2001-01-01

Intravascular Brachytherapy (IVB) is a very promising technique for reducing restenosis rates. However, neither the exact absolute dose needed nor the optimal spatial and temporal distribution of dose inside the vessel wall for a successful treatment, nor the physical dosimetry of the various radioactive sources and devices for dose delivery, are well known. In this paper, an overview will be given of the design strategy, the dosimetric and radiation protection-related problems that we have met during the implementation of this technique at San Carlos hospital, adopted or foreseen solutions, and future research fields that we intend to carry out in order to reduce uncertainties and to achieve a deeper knowledge of the parameters that have an influence on the treatment. (author)

Inadvertent Apical Extrusion of Sodium Hypochlorite with Evaluation by Dental Volumetric Tomography

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Elif Delve Başer Can

2015-01-01

Full Text Available This case report describes the tissue injury caused by inadvertently extruded NaOCl through the apical constriction. A 56-year-old female patient with complaints of pain, swelling, and ecchymosis on the left side of her face was referred to our clinic. The symptoms had emerged following root canal treatment of the maxillary left first premolar, and a soft tissue complication due to apical extrusion of NaOCl was diagnosed. Antibiotics and analgesics were prescribed. DVT images revealed that the buccal root apex had perforated the maxillary bone. The patient was followed up every other day and became asymptomatic on the 10th day. Endodontic therapy was completed with routine procedures. Determining working length precisely and following irrigation protocols meticulously are indispensable to prevent this type of complication. 3D visualization of the affected area may reveal the cause of the incident.

Fully integrated high-speed intravascular optical coherence tomography/near-infrared fluorescence structural/molecular imaging in vivo using a clinically available near-infrared fluorescence-emitting indocyanine green to detect inflamed lipid-rich atheromata in coronary-sized vessels.

Science.gov (United States)

Lee, Sunki; Lee, Min Woo; Cho, Han Saem; Song, Joon Woo; Nam, Hyeong Soo; Oh, Dong Joo; Park, Kyeongsoon; Oh, Wang-Yuhl; Yoo, Hongki; Kim, Jin Won

2014-08-01

Lipid-rich inflamed coronary plaques are prone to rupture. The purpose of this study was to assess lipid-rich inflamed plaques in vivo using fully integrated high-speed optical coherence tomography (OCT)/near-infrared fluorescence (NIRF) molecular imaging with a Food and Drug Administration-approved indocyanine green (ICG). An integrated high-speed intravascular OCT/NIRF imaging catheter and a dual-modal OCT/NIRF system were constructed based on a clinical OCT platform. For imaging lipid-rich inflamed plaques, the Food and Drug Administration-approved NIRF-emitting ICG (2.25 mg/kg) or saline was injected intravenously into rabbit models with experimental atheromata induced by balloon injury and 12- to 14-week high-cholesterol diets. Twenty minutes after injection, in vivo OCT/NIRF imaging of the infrarenal aorta and iliac arteries was acquired only under contrast flushing through catheter (pullback speed up to ≤20 mm/s). NIRF signals were strongly detected in the OCT-visualized atheromata of the ICG-injected rabbits. The in vivo NIRF target-to-background ratio was significantly larger in the ICG-injected rabbits than in the saline-injected controls (Pfluorescence reflectance imaging, which correlated well with the in vivo target-to-background ratios (Pfluorescence microscopy, and histopathology also corroborated the in vivo imaging findings. Integrated OCT/NIRF structural/molecular imaging with a Food and Drug Administration -approved ICG accurately identified lipid-rich inflamed atheromata in coronary-sized vessels. This highly translatable dual-modal imaging approach could enhance our capabilities to detect high-risk coronary plaques. © 2014 American Heart Association, Inc.

Intravascular large B-cell lymphoma of the kidney: A case report

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Jia Nan

2011-09-01

Full Text Available Abstract We report a 41-year-old Chinese woman with intravascular large B-cell lymphoma diagnosed by percutaneous renal biopsy. The patient was admitted to Nanfang Hospital of Southern Medical University, Guangzhou, China with complaints of high spiking fever for a month and bilateral lower limb fatigue with difficulty ambulating for the past 5 months. She had renal dysfunction with a total urinary protein of 5.61 g/dL (56.1 g/L, serum albumin of 2.89 g/dL (28.9 g/L, urea nitrogen of 2.24 mg/dL (1.6 mmol/L, and serum creatinine of 0.54 mg/dL (48 μmol/L. Bone marrow biopsy revealed myeloproliferative disorder without abnormal myeloid or lymphocytic proliferation. Positron Emission Tomography-Computed Tomography (PET-CT showed marked bilateral swelling and enlargement of the renal parenchyma with splenic enlargement and involvement of multiple vertebrae. Percutaneous renal biopsy showed island-like accumulations of medium to large lymphoid cells in many areas of the interstitium, with round vesicular nuclei containing distinct basophilic nucleoli. Immunohistochemical analysis together with other supportive investigation confirmed the diagnosis of intravascular large B-cell lymphoma. Ten days later, she was started on chemotherapy with CHOP (cyclophosphamide, doxorubicin, leurocristime and prednisone for a week. Palliative radiotherapy DT 40Gy/20F with other supportive treatment was provided for metastatic foci in the medullary cavity of the sternum, T1-T7. The patient regained muscle strength in both lower limbs and was able to walk again after three weeks. The patient was discharged after hepatic and renal function and proteinuria values had returned to normal. Follow-up data shows the patient to be alive nine months after discharge.

Th1 differentiation drives the accumulation of intravascular, non-protective CD4 T cells during tuberculosis

Science.gov (United States)

Sallin, Michelle A.; Sakai, Shunsuke; Kauffman, Keith D.; Young, Howard A.; Zhu, Jinfang; Barber, Daniel L.

2017-01-01

SUMMARY Recent data indicate that the differentiation state of Th1 cells determines their protective capacity against tuberculosis. Therefore, we examined the role of Th1 polarizing factors in the generation of protective and non-protective subsets of Mtb-specific Th1 cells. We find IL-12/23p40 promotes Th1 cell expansion and maturation beyond the CD73+CXCR3+T-betdim stage, and T-bet prevents deviation of Th1 cells into Th17 cells. Nevertheless, IL-12/23p40 and T-bet are also essential for the production of a prominent subset of intravascular CX3CR1+KLRG1+ Th1 cells that persists poorly and can neither migrate into the lung parenchyma nor control Mtb growth. Furthermore, T-bet suppresses development of CD69+CD103+ tissue resident phenotype effectors in lung. In contrast, Th1 cell-derived IFNγ inhibits the accumulation of intravascular CX3CR1+KLRG1+ Th1 cells. Thus, although IL-12 and T-bet are essential host survival factors, they simultaneously oppose lung CD4 T cell responses at several levels, demonstrating the dual nature of Th1 polarization in tuberculosis. PMID:28355562

Treatment Approach to Small Inadvertent Injury of the Crystalline Lens Anterior Capsule During Iridodialysis Repair Surgery

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Gökçen Gökçe

2013-01-01

Full Text Available A 22-year-old man presented to our ophthalmology department with photophobia. On ophthalmic examination, iridodialysis secondary to blunt trauma that occurred 5 years ago was diagnosed. During iridodialysis repair surgery, long curved double-armed needle of 10-0 polypropylene suture (PC-9 inserted into the 19 gauge side port turned down inadvertently by its own weight, resulting in crystalline lens anterior capsule perforation. Postoperative clinical observation revealed no lens opacification affecting visual acuity. This case report showed that lens aspiration surgery should be postponed if the capsule injury is small.(Turk J Ophthalmol 2013; 43: 61-3

Impact of statin therapy on coronary plaque composition: A systematic review and meta-analysis of virtual histology intravascular ultrasound studies

NARCIS (Netherlands)

M. Banach (Maciej); C. Serban (Corina); A. Sahebkar (Amirhossein); D.P. Mikhailidis (Dimitri P.); S. Ursoniu (Sorin); K.K. Ray (Kausik K.); J. Rysz (Jacek); P.P. Toth (Peter); P. Muntner (Paul); S. Mosteoru (Svetlana); H.M. Garcia-Garcia (Hector); G.K. Hovingh (Kees); J.J.P. Kastelein (John); P.W.J.C. Serruys (Patrick)

2015-01-01

textabstractBackground: Virtual histology intravascular ultrasound (VH-IVUS) imaging is an innovative tool for the morphological evaluation of coronary atherosclerosis. Evidence for the effects of statin therapy on VH-IVUS parameters have been inconclusive. Consequently, we performed a systematic

MRI phenotypes of localized intravascular coagulopathy in venous malformations

Energy Technology Data Exchange (ETDEWEB)

Koo, Kevin S.H. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Dowd, Christopher F.; Hess, Christopher P. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Mathes, Erin F.; Frieden, Ilona J. [University of California, San Francisco, Department of Dermatology, San Francisco, CA (United States); Rosbe, Kristina W. [University of California, San Francisco, Department of Otolaryngology, San Francisco, CA (United States); Hoffman, William Y. [University of California, San Francisco, Department of Surgery, San Francisco, CA (United States)

2015-10-15

The incidence of localized intravascular coagulopathy (LIC) in venous malformations varies with lesion size and location, as well as the presence of palpable phleboliths. The development of LIC can cause pain and hemorrhage and can progress to disseminated intravascular coagulopathy (DIC) and thromboembolic disease resulting in death in some cases. Early recognition of LIC can relieve symptoms and prevent progression to life-threatening complications. The aim of this work was to identify MRI features of venous malformation associated with LIC. We hypothesized that venous malformations with larger capacitance, slower flow and less physiological compression (greater stasis) were more likely to be associated with LIC. In this HIPAA-compliant and IRB-approved study, we retrospectively reviewed clinical records and MRI for consecutive patients undergoing evaluation of venous malformations at our multidisciplinary Birthmarks and Vascular Anomalies Center between 2003 and 2013. Inclusion required consensus diagnosis of venous malformation and availability of laboratory data and MRI; patients on anticoagulation or those previously undergoing surgical or endovascular treatment were excluded. LIC was diagnosed when D-dimer exceeded 1,000 ng/mL and/or fibrinogen was less than 200 mg/dL. Two board-certified radiologists assessed the following MRI features for each lesion: morphology (spongiform vs. phlebectatic), presence of phleboliths, size, location (truncal vs. extremity), and tissue type(s) involved (subcutis, muscle, bone and viscera). Univariate logistic regression analyses were used to test associations between LIC and MRI findings, and stepwise regression was applied to assess the significance of the individual imaging predictors. Seventy patients, 37 with LIC, met inclusion criteria during the 10-year study period (age: 14.5 +/- 13.6 years [mean +/- standard deviation]; 30 male, 40 female). Both elevated D-dimer and low fibrinogen were associated with the presence of

MRI phenotypes of localized intravascular coagulopathy in venous malformations

International Nuclear Information System (INIS)

Koo, Kevin S.H.; Dowd, Christopher F.; Hess, Christopher P.; Mathes, Erin F.; Frieden, Ilona J.; Rosbe, Kristina W.; Hoffman, William Y.

2015-01-01

The incidence of localized intravascular coagulopathy (LIC) in venous malformations varies with lesion size and location, as well as the presence of palpable phleboliths. The development of LIC can cause pain and hemorrhage and can progress to disseminated intravascular coagulopathy (DIC) and thromboembolic disease resulting in death in some cases. Early recognition of LIC can relieve symptoms and prevent progression to life-threatening complications. The aim of this work was to identify MRI features of venous malformation associated with LIC. We hypothesized that venous malformations with larger capacitance, slower flow and less physiological compression (greater stasis) were more likely to be associated with LIC. In this HIPAA-compliant and IRB-approved study, we retrospectively reviewed clinical records and MRI for consecutive patients undergoing evaluation of venous malformations at our multidisciplinary Birthmarks and Vascular Anomalies Center between 2003 and 2013. Inclusion required consensus diagnosis of venous malformation and availability of laboratory data and MRI; patients on anticoagulation or those previously undergoing surgical or endovascular treatment were excluded. LIC was diagnosed when D-dimer exceeded 1,000 ng/mL and/or fibrinogen was less than 200 mg/dL. Two board-certified radiologists assessed the following MRI features for each lesion: morphology (spongiform vs. phlebectatic), presence of phleboliths, size, location (truncal vs. extremity), and tissue type(s) involved (subcutis, muscle, bone and viscera). Univariate logistic regression analyses were used to test associations between LIC and MRI findings, and stepwise regression was applied to assess the significance of the individual imaging predictors. Seventy patients, 37 with LIC, met inclusion criteria during the 10-year study period (age: 14.5 +/- 13.6 years [mean +/- standard deviation]; 30 male, 40 female). Both elevated D-dimer and low fibrinogen were associated with the presence of

LWRA analysis of inadvertent closing of the main steam isolation valve in NPP Krsko

International Nuclear Information System (INIS)

Feretic, D.; Cavlina, N.; Grgic, D.; Spalj, S.

1996-01-01

The paper describes the use of system code RELAP5/mod2 and analyzer code LWRA in analysis of inadvertent closing of the main steam isolation valve that happened in NPP Krsko on September, 25 1995. Three cases were calculated in order to address different aspects of the modelled transient. This preliminary calculation showed that, even though the real plant behaviour was not completely reproduced, such kind of analysis can help to better understand plant behaviour and to identify important phenomena in the plant during transient. The results calculated by RELAP5 and LWRA were similar and both codes indicated lack of better understanding of the plant systems status. The LWRA was more than 5 times faster than real time. (author)

Update on ropivacaine.

Science.gov (United States)

Wang, R D; Dangler, L A; Greengrass, R A

2001-12-01

Long-acting local anaesthetics are primarily used in the practice of anaesthesia, particularly in regional anaesthesia and analgesia. Ropivacaine is a new long-acting local anaesthetic that has been the focus of interest because of its increased cardiovascular safety compared with bupivacaine. Other advantages of ropivacaine over bupivacaine include a greater sensorimotor differential block and shorter elimination half-life (t(1/2)), with a lower potential for accumulation. The most important attribute of ropivacaine, however, is its increased margin of safety compared with bupivacaine when given in equal doses. Many post-marketing studies have focused on the comparisons of efficacy in blocks and toxicity profiles of bupivacaine versus ropivacaine. Recent animal toxicity studies confirm the results of original studies showing that ropivacaine has less cardiovascular toxicity than bupivacaine with respect to direct myocardial depression, success of resuscitation and arrhythmogenic potential when given in equal doses. Reduced cardiotoxicity may be a distinct characteristic of ropivacaine. A review of current literature suggests that, at clinically relevant doses, ropivacaine provides the lowest potential risk of cardiotoxicity for inadvertent intravascular injection. Studies are currently under way comparing ropivacaine with levobupivacaine, the latest addition to the group of long-acting local anaesthetics.

MRI evaluation and follow-up of bone necrosis after meningococcal infection and disseminated intravascular coagulation

International Nuclear Information System (INIS)

Damry, N.; Schurmans, T.; Perlmutter, N.

1993-01-01

Disseminated intravascular coagulation (DIC) is a serious complication of meningococcal septicaemia. It often results in infarction of various tissues namely the skin, adrenal glands, kidneys, brain and, much less commonly, bones. We describe a patient who presented bone lesions after meningococcal septicaemia. In addition to plain radiography and scintigraphy the lesions were evaluated with MRI and have proved to be extensive and still progressive, approxximately 18 months after the onset of the disease. (orig.)

Impact of statin therapy on coronary plaque composition: a systematic review and meta-analysis of virtual histology intravascular ultrasound studies

NARCIS (Netherlands)

Banach, Maciej; Serban, Corina; Sahebkar, Amirhossein; Mikhailidis, Dimitri P.; Ursoniu, Sorin; Ray, Kausik K.; Rysz, Jacek; Toth, Peter P.; Muntner, Paul; Mosteoru, Svetlana; García-García, Hector M.; Hovingh, G. Kees; Kastelein, John J. P.; Serruys, Patrick W.

2015-01-01

Virtual histology intravascular ultrasound (VH-IVUS) imaging is an innovative tool for the morphological evaluation of coronary atherosclerosis. Evidence for the effects of statin therapy on VH-IVUS parameters have been inconclusive. Consequently, we performed a systematic review and meta-analysis

Theoretical model of intravascular paramagnetic tracers effect on tissue relaxation

DEFF Research Database (Denmark)

Kjølby, Birgitte Fuglsang; Østergaard, Leif; Kiselev, Valerij G

2006-01-01

The concentration of MRI tracers cannot be measured directly by MRI and is commonly evaluated indirectly using their relaxation effect. This study develops a comprehensive theoretical model to describe the transverse relaxation in perfused tissue caused by intravascular tracers. The model takes...... into account a number of individual compartments. The signal dephasing is simulated in a semianalytical way by embedding Monte Carlo simulations in the framework of analytical theory. This approach yields a tool for fast, realistic simulation of the change in the transverse relaxation. The results indicate...... with bulk blood. The enhancement of relaxation in tissue is due to the contrast in magnetic susceptibility between blood vessels and parenchyma induced by the presence of paramagnetic tracer. Beyond the perfusion measurements, the results can be applied to quantitation of functional MRI and to vessel size...

Investigations on the inadvertent power increase in a PHWR as ASSET experience

Energy Technology Data Exchange (ETDEWEB)

Kumar, S H [Operating Plants Safety Div., Atomic Energy Regulatory Board, Mumbai (India)

1997-12-31

Investigations were carried out using the ASSET methodology to find out the root cause of an incident involving inadvertent increase in reactor power in the Unit 1 of Narora Atomic Power Station (NAPS) in India. NAPS is a twin Unit, 220 MWe PHWR based power station. On December 4, 1992, when NPAS Unit 1 was operating at 130 MWe, the reactor power increased steadily on its own and touched 147 MWe, over a period of 14 minutes. The set (demand) power of the triplicated reactor regulating system had increased on its own and in turn has made the reactor to operated at higher power. The power was brought down to 120 MWe by manual intervention. Since adequate system related data during the incident was not available, laboratory studies were carried out using computer simulations for the various process disturbances which could affect the reactor regulating system, for establishing the causes of the event. 4 figs.

Investigations on the inadvertent power increase in a PHWR as ASSET experience

International Nuclear Information System (INIS)

Kumar, S.H.

1996-01-01

Investigations were carried out using the ASSET methodology to find out the root cause of an incident involving inadvertent increase in reactor power in the Unit 1 of Narora Atomic Power Station (NAPS) in India. NAPS is a twin Unit, 220 MWe PHWR based power station. On December 4, 1992, when NPAS Unit 1 was operating at 130 MWe, the reactor power increased steadily on its own and touched 147 MWe, over a period of 14 minutes. The set (demand) power of the triplicated reactor regulating system had increased on its own and in turn has made the reactor to operated at higher power. The power was brought down to 120 MWe by manual intervention. Since adequate system related data during the incident was not available, laboratory studies were carried out using computer simulations for the various process disturbances which could affect the reactor regulating system, for establishing the causes of the event. 4 figs

The clinical importance and prediction of steal following femoro-femoral cross-over bypass: study of the donor iliac artery by intravascular ultrasound, arteriography, duplex scanning and pressure measurements

DEFF Research Database (Denmark)

Vogt, K C; Rasmussen, J G; Schroeder, T V

2000-01-01

to evaluate the clinical significance of the steal phenomenon following femoro-femoral bypass, and whether the addition of intravascular ultrasound (IVUS) to the established examinations of the donor iliac artery can improve the prediction of patients who will develop steal.......to evaluate the clinical significance of the steal phenomenon following femoro-femoral bypass, and whether the addition of intravascular ultrasound (IVUS) to the established examinations of the donor iliac artery can improve the prediction of patients who will develop steal....

Acute kidney injury and disseminated intravascular coagulation due to mercuric chloride poisoning

Directory of Open Access Journals (Sweden)

J Dhanapriya

2016-01-01

Full Text Available Mercury is a toxic heavy metal and occurs in organic and inorganic forms. Inorganic mercury includes elemental mercury and mercury salts. Mercury salts are usually white powder or crystals, and widely used in indigenous medicines and folk remedies in Asia. Inorganic mercury poisoning causes acute kidney injury (AKI and gastrointestinal manifestations and can be life-threatening. We describe a case with unknown substance poisoning who developed AKI and disseminated intravascular coagulation (DIC. Renal biopsy showed acute tubular necrosis. Later, the consumed substance was proven to be mercuric chloride. His renal failure improved over time, and his creatinine normalized after 2 months.

Catheter design optimization for practical intravascular photoacoustic imaging (IVPA) of vulnerable plaques

Science.gov (United States)

Iskander-Rizk, Sophinese; Wu, Min; Springeling, Geert; Mastik, Frits; Beurskens, Robert H. S. H.; van der Steen, Antonius F. W.; van Soest, Gijs

2018-02-01

Intravascular photoacoustic/ultrasound imaging (IVPA/US) can image the structure and composition of atherosclerotic lesions identifying lipid-rich plaques ex vivo and in vivo. In the literature, multiple IVPA/US catheter designs were presented and validated both in ex-vivo models and preclinical in-vivo situations. Since the catheter is a critical component of the imaging system, we discuss here a catheter design oriented to imaging plaque in a realistic and translatable setting. We present a catheter optimized for light delivery, manageable flush parameters and robustness with reduced mechanical damage risks at the laser/catheter joint interface. We also show capability of imaging within sheath and in water medium.

A Micromotor Catheter for Intravascular Optical Coherence Tomography

Directory of Open Access Journals (Sweden)

Tianshi Wang

2015-03-01

Full Text Available We have developed a new form of intravascular optical coherence tomography (IV-OCT that allows the extremely fast acquisition of high-resolution images of the coronary arteries. This process leads to much better image quality by eliminating cardiac motion artefacts and undersampling. It relies on a catheter that incorporates a synchronous micromotor with a diameter of 1.0 mm and a rotational speed of up to 5600 revolutions per second, enabling an IV-OCT frame rate of 5.6 kHz. This speed is matched by a wavelength-swept laser that generates up to 2.8 million image lines per second. With this setup, our team achieved IV-OCT imaging of up to 5600 frames per second (fps in vitro and 4000 fps in vivo, deployed at a 100 mm·s−1 pullback velocity. The imaging session is triggered by the electrocardiogram of the subject, and can scan a coronary artery in the phase of the heartbeat where the heart is at rest, providing a name for this new technology: the “Heartbeat OCT.”

Long-term safety and feasibility of three-vessel multimodality intravascular imaging in patients with ST-elevation myocardial infarction

DEFF Research Database (Denmark)

Taniwaki, Masanori; Radu, Maria D; Garcia-Garcia, Hector M

2015-01-01

We assessed the feasibility and the procedural and long-term safety of intracoronary (i.c) imaging for documentary purposes with optical coherence tomography (OCT) and intravascular ultrasound (IVUS) in patients with acute ST-elevation myocardial infarction (STEMI) undergoing primary PCI in the s......We assessed the feasibility and the procedural and long-term safety of intracoronary (i.c) imaging for documentary purposes with optical coherence tomography (OCT) and intravascular ultrasound (IVUS) in patients with acute ST-elevation myocardial infarction (STEMI) undergoing primary PCI...... in the setting of IBIS-4 study. IBIS4 (NCT00962416) is a prospective cohort study conducted at five European centers including 103 STEMI patients who underwent serial three-vessel coronary imaging during primary PCI and at 13 months. The feasibility parameter was successful imaging, defined as the number...... of pullbacks suitable for analysis. Safety parameters included the frequency of peri-procedural complications, and major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction (MI) and any clinically-indicated revascularization at 2 years. Clinical outcomes were compared...

Intravascular brachytherapy for peripheral vascular disease

Directory of Open Access Journals (Sweden)

Hagen, Anja

2008-09-01

Full Text Available Scientific background: Percutaneous transluminal angioplasties (PTA through balloon dilatation with or without stenting, i.e. vessel expansion through balloons with or without of implantation of small tubes, called stents, are used in the treatment of peripheral artery occlusive disease (PAOD. The intravascular vessel irradiation, called intravascular brachytherapy, promises a reduction in the rate of repeated stenosis (rate of restenosis after PTA. Research questions: The evaluation addresses questions on medical efficacy, cost-effectiveness as well as ethic, social and legal implications in the use of brachytherapy in PAOD patients. Methods: A systematic literature search was conducted in August 2007 in the most important medical electronic databases for publications beginning from 2002. The medical evaluation included randomized controlled trials (RCT. The information synthesis was performed using meta-analysis. Health economic modeling was performed with clinical assumptions derived from the meta-analysis and economical assumptions derived from the German Diagnosis Related Groups (G-DRG-2007. Results: Medical evaluation: Twelve publications about seven RCT on brachytherapy vs. no brachytherapy were included in the medical evaluation. Two RCT showed a significant reduction in the rate of restenosis at six and/or twelve months for brachytherapy vs. no brachytherapy after successful balloon dilatation, the relative risk in the meta-analysis was 0.62 (95% CI: 0.46 to 0.84. At five years, time to recurrence of restenosis was significantly delayed after brachytherapy. One RCT showed a significant reduction in the rate of restenosis at six months for brachytherapy vs. no brachytherapy after PTA with optional stenting, the relative risk in the meta-analysis was 0.76 (95% CI: 0.61 to 0.95. One RCT observed a significantly higher rate of late thrombotic occlusions after brachytherapy in the subgroup of stented patients. A single RCT for brachytherapy

A case of pulmonary edema developed after intraarterial injection of iodinated contrast medium

International Nuclear Information System (INIS)

Min, Byoung Chol; Chun, Kang Woo; Koh, Jae Hyu; Yoon, Jong Sup

1982-01-01

Pulmonary edema is a rare adverse reaction to the iodinated contrast medium. Complaining of huge abdominal mass, a 52 years old female was admitted to the Hangang Sungsim Hospital. On physical examination, the patient appeared to be healthy. She had stable vital signs, i.e. BP: 120/80 mmHg, pulse rate: 80/min.etc. An adult head sized mass was palpated in the left mid and lower abdomen. Otherwise nonspecific. On laboratory studies the positive findings were 8-10 WBC/HPF in urine, 25.6 mg/dl for BUN and PVC in EKG. It was negative for urine protein, serum creatinline and liver function test. We injected 100 ml and 30 ml of Urografin 60 through the abdominal aorta dividing 3 times and major branches of the abdominal aorta, respectively. Immediately after complicating angiography, interstitial pulmonary edema was found, showing blurring of the vascular margins, perivascular haziness and thickening of the interlobular septal lines in the both lower lung fields. The blood pressure was dropped to 80/60 mmHg, but pulse rate was normal. She did not complain of dyspnea, and cyanosis was not developed. The urine volume was normally maintained. She was treated for pulmonary edema, which was completely absorbed after 20 hours. And the blood pressure was also normalized. We have experienced a case of pulmonary edema developed after intraarterial injection of the iodinated contrast medium without underlying cardiac, renal and hepatic problems, and reviewed the literatures on mechanisms of pulmonary edema caused by intravascular injection of the iodinated contrast materials

Heartbeat OCT: in vivo intravascular megahertz-optical coherence tomography

Science.gov (United States)

Wang, Tianshi; Pfeiffer, Tom; Regar, Evelyn; Wieser, Wolfgang; van Beusekom, Heleen; Lancee, Charles T.; Springeling, Geert; Krabbendam, Ilona; van der Steen, Antonius F.W.; Huber, Robert; van Soest, Gijs

2015-01-01

Cardiac motion artifacts, non-uniform rotational distortion and undersampling affect the image quality and the diagnostic impact of intravascular optical coherence tomography (IV-OCT). In this study we demonstrate how these limitations of IV-OCT can be addressed by using an imaging system that we called “Heartbeat OCT”, combining a fast Fourier Domain Mode Locked laser, fast pullback, and a micromotor actuated catheter, designed to examine a coronary vessel in less than one cardiac cycle. We acquired in vivo data sets of two coronary arteries in a porcine heart with both Heartbeat OCT, working at 2.88 MHz A-line rate, 4000 frames/s and 100 mm/s pullback speed, and with a commercial system. The in vivo results show that Heartbeat OCT provides faithfully rendered, motion-artifact free, fully sampled vessel wall architecture, unlike the conventional IV-OCT data. We present the Heartbeat OCT system in full technical detail and discuss the steps needed for clinical translation of the technology. PMID:26713214

The availability of soil-associated radionuclides for uptake after inadvertent ingestion by humans

International Nuclear Information System (INIS)

Shaw, S.; Green, N.

2002-01-01

Assessments of the radiological impact of radionuclides released into the environment generally take into account the inadvertent ingestion of radionuclides associated with soil or sediment. Such assessments often assume that gut uptake factors for radionuclides that are biologically incorporated in food are also applicable when the ingested activity is associated with soil. Studies of the availability of soil-associated radionuclides after ingestion have been mainly conducted on ruminant animals and few data exist for humans. The digestive tract of ruminants is totally different from that of a mono-gastric animal and so the availability estimated from the animal studies may not be valid in the case of man. A simple in-vitro enzymolysis procedure was therefore developed to simulate human digestion closely. The measured availability of 137 Cs, 241 Am, 239 PU and 90 Sr associated with loam, sand and peat soils was about 3%, 3%, 10% and 50% respectively. (author)

Exogenous normal lymph alleviates microcirculation disturbances and abnormal hemorheological properties in rats with disseminated intravascular coagulation

Energy Technology Data Exchange (ETDEWEB)

Niu, Chun-Yu; Zhao, Zi-Gang; Zhang, Yu-Ping [Institute of Microcirculation, Hebei North University, Zhangjiakou (China); Hou, Ya-Li [Department of Clinical Laboratory, First Affiliated Hospital, Hebei North University, Zhangjiakou (China); Li, Jun-Jie; Jiang, Hua; Zhang, Jing [Institute of Microcirculation, Hebei North University, Zhangjiakou (China)

2013-02-01

Disturbances of the microcirculation and abnormal hemorheological properties are important factors that play an important role in disseminated intravascular coagulation (DIC) and result in organ dysfunction or failure. In the present study, we established an animal model of DIC using intravenous Dextran 500 in rats, and used exogenous normal lymph corresponding to 1/15 of whole blood volume for injection through the left jugular vein. We found that normal lymph could improve the blood pressure and survival time of rats with DIC. The results regarding the mesenteric microcirculation showed that the abnormality of the diameter of mesenteric microvessels and micro-blood flow speed in the DIC+lymph group was significantly less than in the DIC+saline group. Whole blood viscosity, relative viscosity, plasma viscosity, hematocrit (Hct), erythrocyte sedimentation rate (ESR), and electrophoresis time of erythrocytes were significantly increased in the DIC+saline group compared to the control group. The electrophoretic length and migration of erythrocytes from the DIC+saline and DIC+lymph groups were significantly slower than the control group. Blood relative viscosity, Hct, ESR, and electrophoretic time of erythrocytes were significantly increased in the DIC+lymph group compared to the control group. Whole blood viscosity, relative viscosity and reduced viscosity were significantly lower in the DIC+lymph group than in the DIC+saline group, and erythrocyte deformability index was also significantly higher than in the DIC+saline and control groups. These results suggest that exogenous normal lymph could markedly improve the acute microcirculation disturbance and the abnormal hemorheological properties in rats with DIC induced by Dextran 500.

Exogenous normal lymph alleviates microcirculation disturbances and abnormal hemorheological properties in rats with disseminated intravascular coagulation

International Nuclear Information System (INIS)

Niu, Chun-Yu; Zhao, Zi-Gang; Zhang, Yu-Ping; Hou, Ya-Li; Li, Jun-Jie; Jiang, Hua; Zhang, Jing

2013-01-01

Disturbances of the microcirculation and abnormal hemorheological properties are important factors that play an important role in disseminated intravascular coagulation (DIC) and result in organ dysfunction or failure. In the present study, we established an animal model of DIC using intravenous Dextran 500 in rats, and used exogenous normal lymph corresponding to 1/15 of whole blood volume for injection through the left jugular vein. We found that normal lymph could improve the blood pressure and survival time of rats with DIC. The results regarding the mesenteric microcirculation showed that the abnormality of the diameter of mesenteric microvessels and micro-blood flow speed in the DIC+lymph group was significantly less than in the DIC+saline group. Whole blood viscosity, relative viscosity, plasma viscosity, hematocrit (Hct), erythrocyte sedimentation rate (ESR), and electrophoresis time of erythrocytes were significantly increased in the DIC+saline group compared to the control group. The electrophoretic length and migration of erythrocytes from the DIC+saline and DIC+lymph groups were significantly slower than the control group. Blood relative viscosity, Hct, ESR, and electrophoretic time of erythrocytes were significantly increased in the DIC+lymph group compared to the control group. Whole blood viscosity, relative viscosity and reduced viscosity were significantly lower in the DIC+lymph group than in the DIC+saline group, and erythrocyte deformability index was also significantly higher than in the DIC+saline and control groups. These results suggest that exogenous normal lymph could markedly improve the acute microcirculation disturbance and the abnormal hemorheological properties in rats with DIC induced by Dextran 500

Compensation of spectral artifacts in dual-modality intravascular optical coherence tomography and near-infrared spectroscopy (Conference Presentation)

Science.gov (United States)

Fard, Ali M.; Gardecki, Joseph A.; Ughi, Giovanni J.; Hyun, Chulho; Tearney, Guillermo J.

2016-02-01

Intravascular optical coherence tomography (OCT) is a high-resolution catheter-based imaging method that provides three-dimensional microscopic images of coronary artery in vivo, facilitating coronary artery disease treatment decisions based on detailed morphology. Near-infrared spectroscopy (NIRS) has proven to be a powerful tool for identification of lipid-rich plaques inside the coronary walls. We have recently demonstrated a dual-modality intravascular imaging technology that integrates OCT and NIRS into one imaging catheter using a two-fiber arrangement and a custom-made dual-channel fiber rotary junction. It therefore enables simultaneous acquisition of microstructural and composition information at 100 frames/second for improved diagnosis of coronary lesions. The dual-modality OCT-NIRS system employs a single wavelength-swept light source for both OCT and NIRS modalities. It subsequently uses a high-speed photoreceiver to detect the NIRS spectrum in the time domain. Although use of one light source greatly simplifies the system configuration, such light source exhibits pulse-to-pulse wavelength and intensity variation due to mechanical scanning of the wavelength. This can be in particular problematic for NIRS modality and sacrifices the reliability of the acquired spectra. In order to address this challenge, here we developed a robust data acquisition and processing method that compensates for the spectral variations of the wavelength-swept light source. The proposed method extracts the properties of the light source, i.e., variation period and amplitude from a reference spectrum and subsequently calibrates the NIRS datasets. We have applied this method on datasets obtained from cadaver human coronary arteries using a polygon-scanning (1230-1350nm) OCT system, operating at 100,000 sweeps per second. The results suggest that our algorithm accurately and robustly compensates the spectral variations and visualizes the dual-modality OCT-NIRS images. These

Splenic angiomyxoma with intravascular tumor embolus in a dog: a case report.

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Lee, Eun-Mi; Kim, Ah-Young; Lee, Eun-Joo; Park, Jin-Kyu; Kim, Tae-Hwan; Park, Se-Il; Jeong, Kyu-Shik

2016-07-01

A 13-year-old castrated male Yorkshire terrier dog had a soft splenic mass, which measured 11 cm in the greatest diameter. Microscopically, the parenchyma of the spleen was completely replaced by myxoid substances. Numerous spindle and stellate cells were loosely arranged in the myxoid stroma, and variable vessels of variable sizes were observed in a loose matrix with poorly defined margins. Immunohistochemical analysis showed that tumor cells were positive for desmin and alpha-SMA, but negative for S-100. Interestingly, intravascular tumor embolus with positive α-SMA expression was observed. This case is meaningful, because angiomyxoma, a rare tumor of dogs, occurs in the spleen. Even in human cases, splenic angiomyxoma was not reported.

Disseminated intravascular coagulation in solid tumors

International Nuclear Information System (INIS)

Terzieff, V.; Alonso, I.; Vázquez, A.

2004-01-01

It is estimated that 20-25% of cases of disseminated intravascular coagulation (DIC) relate to an underlying neoplasia primarily hematologic. It is estimated that about 5% of patients with solid tumors have CID clinic, although the incidence of subclinical alterations is much higher. The CID is not limited to the activation of the coagulation cascade, which leads to bleeding micro thrombosis and consumption of coagulation factors. Solid tumors are frequently associated adenocarcinomas producers mucin (especially gastric), usually in the context of a disseminated disease. The mucin may act as a promoter of the cascade, but probably it is a multi-event. High levels of TNF to produced by the tumor mass and chemotherapy-induced cell lysis have Also linked. Although the bleeding is usually oriented diagnosis, the most frequent cause of death is thrombosis. There are no specific tests for diagnosis. Elevated levels of D-dimer and products oriented fibrinogen degradation diagnosis. No reduction fibrinogen and almost always, one thrombocytopenia consumption. Treatment is complex and there is no consensus on many points. To recover the lost factors for consumption, it is recommended to use fresh frozen plasma and / or washed red blood cells. the heparin anticoagulation low dose is indicated since the disease causal can not be controlled quickly, but should not be initiated if there thrombocytopenia 50.000.El under profuse bleeding can require the use of tranexamic acid or EACA. Acute DIC, the case of our patient, is rare and very serious

The effects of serial intravascular transfusions in ascitic/hydropic RhD-alloimmunized fetuses.

Science.gov (United States)

Craparo, F J; Bonati, F; Gementi, P; Nicolini, U

2005-02-01

To evaluate the effects of serial intravascular transfusions on RhD-alloimmunized fetuses with ascites/hydrops at the time of the first transfusion by measuring multiple hematological/biochemical blood variables. Thirty-one singleton pregnancies were referred for management of RhD alloimmunization. Seven fetuses had hydrops on presentation and were transfused immediately. The remainder underwent weekly ultrasound examinations, and fetal blood sampling and transfusion were performed on development of ascites. In the 104 samples collected overall from the 31 fetuses, glucose, uric acid, urea, creatinine, total protein, total and direct bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase, alkaline phosphatase, lactic dehydrogenase, amylase, pseudocholinesterase (PCHE), creatine kinase, triglycerides and cholesterol were measured and compared with a reference range for non-anemic fetuses. The median gestational age at first transfusion was 26 (range, 18-34) weeks. There were three fetal losses after the first transfusion, two of which were due to procedure-related complications; one further loss occurred. At the first transfusion fetal hematocrit, pO2, total protein, PCHE, creatinine and urea concentrations were significantly decreased compared to reference data, while total and direct bilirubin, AST, ALT, amylase, triglyceride and uric acid concentrations were increased. In all surviving fetuses ascites/hydrops had disappeared by the second transfusion. Fetal pO2, total protein, AST, ALT and PCHE concentrations had normalized by the third transfusion. Correction of fetal anemia did not affect the other variables. RhD-alloimmunized fetuses with ascites/hydrops at the time of the first transfusion had a survival rate of 87%. Alterations of several biochemical fetal blood indices are present at the first sampling/transfusion, but most variables normalize with intravascular transfusions. Copyright 2005 ISUOG.

Histopathological approach for diagnosis of intravascular leiomyosarcoma of the femoral vein

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Gaurav Singal

2016-04-01

Full Text Available Malignant tumors arising from venous walls in the lower extremities are uncommon and intravascular leiomyosarcoma represents only a small proportion and rare of soft tissue leiomyosarcoma. All publications in the literature are of small clinical series or case reports. We present a case of primary leiomyosarcoma of the femoral vein in a 40 year old man; which is a rare lesion with less than 40 cases reported. The patient presented with swelling and localized leg pain. The diagnosis was made histopathologically, the tumor was resected, vascular reconstruction was performed, and for postoperative radiation therapy and chemotherapy patient was referred to the oncologist. Primary leiomyosarcoma of a major peripheral artery is extremely rare, and this report share the clinical presentation, histopathological findings, treatment, and prognosis in these patients

Lumen and calcium characteristics within calcified coronary lesions. Comparison of computed tomography coronary angiography versus intravascular ultrasound

OpenAIRE

Noll, Dariusz; Kruk, Mariusz; Pręgowski, Jerzy; Kaczmarska, Edyta; Kryczka, Karolina; Pracoń, Radosław; Skwarek, Mirosław; Dzielińska, Zofia; Petryka, Joanna; Śpiewak, Mateusz; Lubiszewska, Barbara; Norwa-Otto, Bożena; Opolski, Maksymilian; Witkowski, Adam; Demkow, Marcin

2013-01-01

Introduction Computed tomography coronary angiography (CTCA) is a diagnostic method used for exclusion of coronary artery disease. However, lower accuracy of CTCA in assessment of calcified lesions is a significant factor impeding applicability of CTCA for assessment of coronary atherosclerosis. Aim To provide insight into lumen and calcium characteristics assessed with CTCA, we compared these parameters to the reference of intravascular ultrasound (IVUS). Material and methods Two hundred and...

Establishment of virtual three-dimensional model for intravascular interventional devices and its clinical value

International Nuclear Information System (INIS)

Wei Xin; Zhong Liming; Xie Xiaodong; Wang Chaohua; You Jian; Hu Hong; Hu Kongqiong; Zhao Xiaowei

2012-01-01

Objective: To explore virtual three-dimensional (3D) model for intravascular interventional devices,the method of preoperative simulation and its value in clinical work. Methods: The virtual models including catheter, guide wire, stent and coil were established by using the 3D moulding software of 3D Studio MAX R3. The interventional preoperative simulation was performed on personal computer including 21 patients of cerebral aneurysm embolization (anterior communicating artery 5, posterior communicating artery 10,middle cerebral artery 3, internal carotid artery 2, and vertebral artery 1), during interventional procedures, the surgeon relied on the simulation results for plastic micro-guide wire, catheter and the release of micro-coils and stents. Results: (1) All the virtual instruments and real instruments had similar shape,the overall tine for constructing virtual model was about 20 hours. The preoperative simulation took 50 to 80 minutes. (2) The simulation result of catheter insertion in the 18 cases had relevant value to guide micro-catheter, molding micro-guide wire tip, and shortened the operating time. For embolization, the simulation results of filling coil and releasing stent were similar to surgical results in 76% of the patients (16/21). (3)For teaching and training, 93% (38/41) of doctors in training believed that preoperative simulation facilitated the understanding of surgery. Conclusions: The method of virtual model of intravascular interventional devices was reliable. The preoperative simulation results could be used to guide practical clinical operation with relatively high degree of similarity, and could play a role in promoting researches on interventional virtual operations. (authors)

Th1 Differentiation Drives the Accumulation of Intravascular, Non-protective CD4 T Cells during Tuberculosis.

Science.gov (United States)

Sallin, Michelle A; Sakai, Shunsuke; Kauffman, Keith D; Young, Howard A; Zhu, Jinfang; Barber, Daniel L

2017-03-28

Recent data indicate that the differentiation state of Th1 cells determines their protective capacity against tuberculosis. Therefore, we examined the role of Th1-polarizing factors in the generation of protective and non-protective subsets of Mtb-specific Th1 cells. We find that IL-12/23p40 promotes Th1 cell expansion and maturation beyond the CD73 + CXCR3 + T-bet dim stage, and T-bet prevents deviation of Th1 cells into Th17 cells. Nevertheless, IL- 12/23p40 and T-bet are also essential for the production of a prominent subset of intravascular CX3CR1 + KLRG1 + Th1 cells that persists poorly and can neither migrate into the lung parenchyma nor control Mtb growth. Furthermore, T-bet suppresses development of CD69 + CD103 + tissue resident phenotype effectors in lung. In contrast, Th1-cell-derived IFN-γ inhibits the accumulation of intravascular CX3CR1 + KLRG1 + Th1 cells. Thus, although IL-12 and T-bet are essential host survival factors, they simultaneously oppose lung CD4 T cell responses at several levels, demonstrating the dual nature of Th1 polarization in tuberculosis. Published by Elsevier Inc.

Th1 Differentiation Drives the Accumulation of Intravascular, Non-protective CD4 T Cells during Tuberculosis

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Michelle A. Sallin

2017-03-01

Full Text Available Recent data indicate that the differentiation state of Th1 cells determines their protective capacity against tuberculosis. Therefore, we examined the role of Th1-polarizing factors in the generation of protective and non-protective subsets of Mtb-specific Th1 cells. We find that IL-12/23p40 promotes Th1 cell expansion and maturation beyond the CD73+CXCR3+T-betdim stage, and T-bet prevents deviation of Th1 cells into Th17 cells. Nevertheless, IL- 12/23p40 and T-bet are also essential for the production of a prominent subset of intravascular CX3CR1+KLRG1+ Th1 cells that persists poorly and can neither migrate into the lung parenchyma nor control Mtb growth. Furthermore, T-bet suppresses development of CD69+CD103+ tissue resident phenotype effectors in lung. In contrast, Th1-cell-derived IFN-γ inhibits the accumulation of intravascular CX3CR1+KLRG1+ Th1 cells. Thus, although IL-12 and T-bet are essential host survival factors, they simultaneously oppose lung CD4 T cell responses at several levels, demonstrating the dual nature of Th1 polarization in tuberculosis.

Cardiac variation of inferior vena cava: new concept in the evaluation of intravascular blood volume.

Science.gov (United States)

Nakamura, Kensuke; Tomida, Makoto; Ando, Takehiro; Sen, Kon; Inokuchi, Ryota; Kobayashi, Etsuko; Nakajima, Susumu; Sakuma, Ichiro; Yahagi, Naoki

2013-07-01

Evaluation of the intravascular blood volume is an important assessment in emergency and critical care medicine. Measurement of the inferior vena cava (IVC) respiratory variation by ultrasound echography is useful, but it entails subjective problems. We have hypothesized that IVC cardiac variation is also correlated with intravascular blood volume and analyzed it automatically using computer software of two kinds, later comparing the results. Snakes, software to track boundaries by curve line continuity, and template matching software were incorporated into a computer with an ultrasound machine to track the short-axis view of IVC automatically and analyze it with approximation by ellipse. Eight healthy volunteers with temporary mild hypovolemia underwent echography before and after passive leg raising and while wearing medical anti-shock trousers. IVC cardiac variation was visually decreased by both leg raising and medical anti-shock trousers. The collapse index (maximum - minimum/maximum) of area during three cardiac beats was decreased showing a good relationship to fluid load simulations; 0.24 ± 0.03 at baseline versus 0.11 ± 0.01 with leg raising and 0.12 ± 0.01 with medical anti-shock trousers. In conclusion, IVC cardiac variation has the potential to provide an evaluation of water volume. It presents some advantages in mechanical analysis over respiratory variation. At the very least, we need to exercise some caution with cardiac variation when evaluating respiratory variation.

Disseminated intravascular coagulopathy caused by Kikuchi–Fujimoto disease resulting in death: first case report in Turkey

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Uslu E

2014-02-01

Full Text Available Emine Uslu,1 Sibel Gurbuz,2 Abdulsamet Erden,1 Fatma Aykas,1 Hatice Karagoz,1 Samet Karahan,1 Hatice Karaman,3 Ali Cetinkaya,1 Deniz Avci1 1Internal Medicine Department, 2Infection Disease Department, 3Clinical Pathology Department, Kayseri Training and Research Hospital, Kayseri, Turkey Abstract: Kikuchi disease, also called Kikuchi–Fujimoto disease or Kikuchi's histiocytic necrotizing lymphadenitis, is a rare, benign condition of unknown cause, usually characterized by cervical lymphadenopathy and fever. The diagnosis is based on histopathology. Our patient was a woman with bilateral cervical lymphadenopathy, fever, chest and abdominal pain, fatigue, maculopapular rash on her face, trunk, and upper and lower extremities. Immunological and rheumatological tests were negative. We took a cervical lymph node biopsy that showed a proliferative and necrotizing process centered in the paracortex characterized by patchy circumscribed or confluent areas of necrosis associated with karyorrhexis, and was remarkable by the absence of granulocytes and the paucity of plasma cells. These findings confirmed the diagnosis of Kikuchi's disease. The patient's hemoglobin values decreased, and the peripheral blood smear revealed schistocytes. Blood tests showed raised D-dimer, activated partial thromboplastin time, prothrombin time, and international normalized ratio with decreased fibrinogen. The patient's condition quickly worsened and disseminated intravascular coagulopathy eventually developed. Her initial management consisted of a corticosteroid and hydroxychloroquine. Keywords: disseminated intravascular coagulopathy, Kikuchi–Fujimoto disease, necrotizing lymphadenitis

Stepping in Place While Voluntarily Turning Around Produces a Long-Lasting Posteffect Consisting in Inadvertent Turning While Stepping Eyes Closed

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Stefania Sozzi

2016-01-01

Full Text Available Training subjects to step in place on a rotating platform while maintaining a fixed body orientation in space produces a posteffect consisting in inadvertent turning around while stepping in place eyes closed (podokinetic after-rotation, PKAR. We tested the hypothesis that voluntary turning around while stepping in place also produces a posteffect similar to PKAR. Sixteen subjects performed 12 min of voluntary turning while stepping around their vertical axis eyes closed and 12 min of stepping in place eyes open on the center of a platform rotating at 60°/s (pretests. Then, subjects continued stepping in place eyes closed for at least 10 min (posteffect. We recorded the positions of markers fixed to head, shoulder, and feet. The posteffect of voluntary turning shared all features of PKAR. Time decay of angular velocity, stepping cadence, head acceleration, and ratio of angular velocity after to angular velocity before were similar between both protocols. Both postrotations took place inadvertently. The posteffects are possibly dependent on the repeated voluntary contraction of leg and foot intrarotating pelvic muscles that rotate the trunk over the stance foot, a synergy common to both protocols. We propose that stepping in place and voluntary turning can be a scheme ancillary to the rotating platform for training body segment coordination in patients with impairment of turning synergies of various origin.

[Epidural anaesthesia: Simulated intravascular test dose with S(+) ketamine, lidocaine and adrenaline. A prospective, randomized, double blind and placebo controlled study].

Science.gov (United States)

Higueras, R; Errando, C L; Soriano-Bru, J L

2015-02-01

The use of a test dose in epidural anaesthesia is a safety recommendation. However specificity and sensitivity of the drugs used with this indication have been not conclusive. The main objective of this study was to compare the effectiveness and the adverse effects of a simulated intravascular test dose of adrenaline, lidocaine and S(+)-ketamine. A prospective, randomized, double blinded, placebo controlled study was designed. ASA I patients scheduled for elective surgery were included. These were randomized to the following study groups: S(+)-ketamine 0.5 mg.kg-1 (S+K group), 5% lidocaine 1.5 mg.kg-1 (L5% group), adrenaline 15μg (ADR group), and physiological saline 3 ml (SF group; control group). An evaluation was made during the first 15 minutes after the study drug was administered. Variables including heart rate (HR) systolic and diastolic blood pressure (sBP and dBP), mean arterial pressure (MAP), and SpO2 were recorded at 0 min (baseline) and at 2, 5, 8, 10 and 15 minutes after drug injection. An increase of at least 20 beats per minute (bpm) in relation to the baseline measurement was considered a positive result, as was an increase sBP >15 mmHg. The clinical effects described as related to iv injection of the study drugs recorded were: sedation-hypnosis, dizziness, nystagmus, metallic taste perception, perioral or facial paresthesias, tinnitus, as well as any other effect the patients mentioned. Sensitivity and specificity were calculated as was the percent increase in the parameters in order to see if these were clinically useful. A total of 80 patients, 20 per group, were included. The sBP, dBP, and MAP were significantly raised at the 2, 5, 8 and 10 minutes measurements in the S(+)K group compared to the rest of the groups (Padrenaline at the scheduled doses showed low sensitivity and specificity as a simulated iv epidural test dose. S(+)-ketamine could be a feasible marker after accidental iv injection during epidural anaesthesia or analgesia

Method and apparatus for preventing inadvertent criticality in a nuclear fueled electric power generating unit

International Nuclear Information System (INIS)

Tuley, C.R.; Bauman, D.A.; Neuner, J.A.; Feilchenfeld, M.M.; Greenberg, L.

1984-01-01

An inadvertent approach to criticality in a nuclear fueled electric power generating unit is detected and an alarm is generated through on-line monitoring of the neutron flux. The difficulties of accurately measuring the low levels of neutron flux in a subcritical reactor are overcome by the use of a microcomputer which continuously generates average flux count rate signals for incremental time periods from thousands of samples taken during each such period and which serially stores the average flux count rate signals for a preselected time interval. At the end of each incremental time period, the microcomputer compares the latest average flux count rate signal with the oldest, and preferably each of the intervening stored values, and if it exceeds any of them by at least a preselected multiplication factor, an alarm is generated. (author)

Inadvertent yellow fever vaccination of a patient with Crohn's disease treated with infliximab and methotrexate

DEFF Research Database (Denmark)

Ekenberg, C.; Friis-Møller, N.; Ulstrup, Thomas

2016-01-01

We present a case of a 56-year-old woman with Crohn's disease, treated with methotrexate and infliximab, who inadvertently received yellow fever vaccination (YFV) prior to a journey to Tanzania. She was not previously vaccinated against YF. YFV contains live-attenuated virus, and is contraindicated...... in patients treated with immunosuppressive drugs. Following vaccination, the patient fell ill with influenza-like illness. Elevated transaminase levels and YF viremia were detected. Despite being immunocompromised, the patient did not develop more severe adverse effects. Neutralising antibodies to YF virus...... were detected on day 14 following vaccination and remained protective at least 10 months after vaccination. Limited data is available on outcomes of YFV in patients receiving immunosuppressive therapy, including biologics, and we report this case as a reminder of vigilance of vaccine recommendations...

One Patient, Two Uncommon B-Cell Neoplasms: Solitary Plasmacytoma following Complete Remission from Intravascular Large B-Cell Lymphoma Involving Central Nervous System

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Joycelyn Lee

2014-01-01

Full Text Available Second lymphoid neoplasms are an uncommon but recognized feature of non-Hodgkin’s lymphomas, putatively arising secondary to common genetic or environmental risk factors. Previous limited evaluations of clonal relatedness between successive mature B-cell malignancies have yielded mixed results. We describe the case of a man with intravascular large B-cell lymphoma involving the central nervous system who went into clinical remission following immunochemotherapy and brain radiation, only to relapse 2 years later with a plasmacytoma of bone causing cauda equina syndrome. The plasmacytoma stained strongly for the cell cycle regulator cyclin D1 on immunohistochemistry, while the original intravascular large cell lymphoma was negative, a disparity providing no support for clonal identity between the 2 neoplasms. Continued efforts atcataloging and evaluating unique associations of B-cell malignancies are critical to improving understanding of overarching disease biology in B-cell malignancies.

Neuroendocrine and renal effects of intravascular volume expansion in compensated heart failure

DEFF Research Database (Denmark)

Gabrielsen, A; Bie, P; Holstein-Rathlou, N H

2001-01-01

To examine if the neuroendocrine link between volume sensing and renal function is preserved in compensated chronic heart failure [HF, ejection fraction 0.29 +/- 0.03 (mean +/- SE)] we tested the hypothesis that intravascular and central blood volume expansion by 3 h of water immersion (WI) elicits...... sustained angiotensin-converting enzyme inhibitor therapy, n = 9) absolute and fractional sodium excretion increased (P Renal free water clearance increased during WI in control subjects but not in HF......, albeit plasma vasopressin concentrations were similar in the two groups. In conclusion, the neuroendocrine link between volume sensing and renal sodium excretion is preserved in compensated HF. The natriuresis of WI is, however, modulated by the prevailing ANG II and Aldo concentrations. In contrast...

A quality management program in intravascular brachytherapy

International Nuclear Information System (INIS)

Chakri, Abderrahim; Thomadsen, Bruce

2002-01-01

While simple, intravascular brachytherapy (IVB) presents a considerable potential for harm to the patient. The medical physicist maintains the responsibility to minimize the likelihood of operational problems or dosimetric errors. The principals for safe operation remain the same as with any radiotherapy treatment: to deliver the correct dose, to the correct location, safety. To develop an effective and comprehensive quality management (QM) program for IVB, a physicist should utilize proven risk assessment techniques rather than simply thinking of things to check, and follow guidances such as ISO9001:2000. The proposed QM program includes the following: Procedures designed to assure the safety of the patient: Identification of the patient; tests of the integrity and patency for the delivery catheter, operation of the source train, and patency of the catheter in the treatment position; a check for recovery preparations; and verification of source recovery. Procedures to assure positional accuracy of the treatment: Verification of the positioning the catheter in the artery and of the sources in the catheter. Procedures to assure dosimetry accuracy: Acceptance testing of the device, including verification of the source strength and uniformity, and of the treatment duration tables; verification of the treatment prescription and duration for each patient; and control measures that minimize the likelihood of errors removing the source at the correct time

Is the inferior vena cava diameter measured by bedside ultrasonography valuable in estimating the intravascular volume in patients with septic shock?

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Mortaza Talebi Doluie

2016-07-01

Full Text Available Introduction:Resuscitation should be initiated immediately in shock. Early goal-directed therapy is an established algorithm for the resuscitation in septic shock. The first step is to maintain cardiac preload. Central venous pressure (CVP plays an important role in goal-directed therapy. Central venous catheterization is invasive and time-consuming in emergency conditions. There are some alternative and noninvasive methods for estimating the intravascular volume such as measuring the inferior vena cava (IVC diameter by ultrasonography. Methods: We searched PubMed, Google scholar, and Scopus databases with keywords (central venous pressure OR venous pressure OR CVP AND (ultrasonography OR sonography AND (sepsis OR septic shock AND (inferior vena cava OR IVC.Result: The search resulted in 2550 articles. The articles were appraised regarding the relevance, type of article, and statistical methods. Finally, 12 articles were selected. The number of patients was between 30 and 83 cases (mean age=57-67 years, intubated and non-intubated in each study. The IVC diameter was measured in respiratory cycle by bedside ultrasonography in longitudinal subxiphoid view and caval index was calculated, then they were compared with the CVP measured by central venous catheter.Discussion: CVP is an indicator of intravascular fluid status and right heart function. CVP measurement is an invasive method and of course with some complications. The IVC is the biggest vein of venous system with low-pressure; expansion of the vein reflects intravascular volume.Conclusion: It seems that IVC diameter measured by ultrasonography could be used as an alternative method for the determination of CVP in the emergency or critical patients.

Feedforward Coordinate Control of a Robotic Cell Injection Catheter.

Science.gov (United States)

Cheng, Weyland; Law, Peter K

2017-08-01

Remote and robotically actuated catheters are the stepping-stones toward autonomous catheters, where complex intravascular procedures may be performed with minimal intervention from a physician. This article proposes a concept for the positional, feedforward control of a robotically actuated cell injection catheter used for the injection of myogenic or undifferentiated stem cells into the myocardial infarct boundary zones of the left ventricle. The prototype for the catheter system was built upon a needle-based catheter with a single degree of deflection, a 3-D printed handle combined with actuators, and the Arduino microcontroller platform. A bench setup was used to mimic a left ventricle catheter procedure starting from the femoral artery. Using Matlab and the open-source video modeling tool Tracker, the planar coordinates ( y, z) of the catheter position were analyzed, and a feedforward control system was developed based on empirical models. Using the Student's t test with a sample size of 26, it was determined that for both the y- and z-axes, the mean discrepancy between the calibrated and theoretical coordinate values had no significant difference compared to the hypothetical value of µ = 0. The root mean square error of the calibrated coordinates also showed an 88% improvement in the z-axis and 31% improvement in the y-axis compared to the unmodified trial run. This proof of concept investigation leads to the possibility of further developing a feedfoward control system in vivo using catheters with omnidirectional deflection. Feedforward positional control allows for more flexibility in the design of an automated catheter system where problems such as systemic time delay may be a hindrance in instances requiring an immediate reaction.

High grade primary adrenal intravascular large B-cell lymphoma manifesting as Addison disease Linfoma intravascular de alto grado de células B grandes y origen suprarrenal que se manifiesta en forma de enfermedad de Addison

OpenAIRE

J. Venizelos; D. Tamiolakis; M. Lambropoulou; G. Alexiadis; G. Petrakis; N. Papadopoulos

2007-01-01

We report a rare case of a 68 aged male who presented with adrenal failure and was diagnosed of high grade large B-cell lymphoma primarily arising in the adrenal glands. The patient was administrated with additional chemotherapy but he passed away 7 months later due to infection in the lungs. Intravascular lymphoma should be suspected in patients with bilateral adrenal masses who present with rapidly progressive adrenal insufficiency.Publicamos el caso poco frecuente de un varón de 68 años de...

Higher lung accumulation of intravenously injected organic nanotubes

Directory of Open Access Journals (Sweden)

Maitani Y

2013-01-01

Full Text Available Yoshie Maitani,1 Yuri Nakamura,1 Masao Kon,1 Emi Sanada,1 Kae Sumiyoshi,1 Natsuki Fujine,1 Masumi Asakawa,2 Masaki Kogiso,2 Toshimi Shimizu21Institute of Medicinal Chemistry, Hoshi University, Tokyo, Japan; 2Nanotube Research Center (NTRC, National Institute of Advanced Industrial Science and Technology (AIST, Tsukuba, JapanAbstract: The size and shape of intravenously injected particles can affect their biodistribution and is of importance for the development of particulated drug carrier systems. In this study, organic nanotubes (ONTs with a carboxyl group at the surface, a length of approximately 2 µm and outer diameter of 70–90 nm, were injected intravenously into tumor-bearing mice. To use ONTs as drug carriers, the biodistribution in selected organs of ONTs postinjection was examined using irinotecan, as an entrapped water-soluble marker inside ONTs, and gadolinium-chelated ONT, as an ONT marker, and compared with that of a 3 µm fluorescently labeled spherical microparticle which was similar size to the length of ONTs. It was found that for irinotecan, its active metabolite and gadolinium-chelated ONTs were highly accumulated in the lung, but to a lower level in the liver and spleen. On the other hand, microparticles deposited less in the lung and more highly in the liver. Moreover, histologic examination showed ONTs distributed more in lung tissues in part, whereas microparticles were present in blood vessels postinjection. These preliminary results support the notion of using negatively charged ONTs as intravascular carriers to maximize accumulation in the lung whilst reducing sequestration by the liver and spleen. This finding suggested that ONTs are potential carriers for lung-targeting drug delivery.Keywords: organic nanotube, lung, biodistribution, microparticle, particle shape

Intravascular papillary endothelial hyperplasia of the extremities: MR imaging findings with pathologic correlation

International Nuclear Information System (INIS)

Lee, Sang Hoon; Suh, Jin-Suck; Lim, Byung Il; Yang, Woo Ick; Shin, Kyoo-Ho

2004-01-01

We report the MRI findings of three cases of intravascular papillary endothelial hyperplasia (IPEH) of the extremities with correlation of the pathologic findings. The IPEH is a non-neoplastic reactive lesion within the vessels and is commonly associated with thrombi. Signal intensity of the IPEH is complex due to the thrombi and the PEH itself. The thrombi are characterized by a slightly hyperintense signal on T1- and T2-weighted images compared with that of muscle when it comes at the medium stage of hemorrhage. Papillary endothelial hyperplastic tissue appears either as iso- or hyperintense to the muscle on T2- and T1-weighted images and shows variable enhancement on Gd-DTPA-enhanced images. (orig.)

Novel electric power-driven hydrodynamic injection system for gene delivery: safety and efficacy of human factor IX delivery in rats.

Science.gov (United States)

Yokoo, T; Kamimura, K; Suda, T; Kanefuji, T; Oda, M; Zhang, G; Liu, D; Aoyagi, Y

2013-08-01

The development of a safe and reproducible gene delivery system is an essential step toward the clinical application of the hydrodynamic gene delivery (HGD) method. For this purpose, we have developed a novel electric power-driven injection system called the HydroJector-EM, which can replicate various time-pressure curves preloaded into the computer program before injection. The assessment of the reproducibility and safety of gene delivery system in vitro and in vivo demonstrated the precise replication of intravascular time-pressure curves and the reproducibility of gene delivery efficiency. The highest level of luciferase expression (272 pg luciferase per mg of proteins) was achieved safely using the time-pressure curve, which reaches 30 mm Hg in 10 s among various curves tested. Using this curve, the sustained expression of a therapeutic level of human factor IX protein (>500 ng ml(-1)) was maintained for 2 months after the HGD of the pBS-HCRHP-FIXIA plasmid. Other than a transient increase in liver enzymes that recovered in a few days, no adverse events were seen in rats. These results confirm the effectiveness of the HydroJector-EM for reproducible gene delivery and demonstrate that long-term therapeutic gene expression can be achieved by automatic computer-controlled hydrodynamic injection that can be performed by anyone.

Specific features of a neonatal period in infants following intrauterine intravascular blood transfusion for fetal hemolytic disease

Directory of Open Access Journals (Sweden)

A. V. Ivanova

2015-01-01

Full Text Available The paper gives data on the characteristics of a neonatal period in infants following intrauterine blood transfusion for Rh-induced fetal hemolytic disease. It is shown that the early diagnosis and detection of the signs of fetal hemolytic disease, and intrauterine intravascular blood transfusion may prolong pregnancy, ensure the birth of a baby with normal anthropometric indicators, optimize his/her neonatal period and prognosis of severe hemolytic disease in the fetus and newborn.

Rash, disseminated intravascular coagulation and legionella: Episode 10 and a rewind into the past

Directory of Open Access Journals (Sweden)

Prashanth M. Thalanayar

2015-01-01

Full Text Available Legionella pneumophila is the most common cause of legionellosis and is one of the organisms causing atypical pneumonia. We report the presentation of disseminated intravascular coagulation (DIC and skin rash in a single case of severe Legionella pneumonia. The unique clinical presentation of a diffuse rash diagnosed as purpura fulminans and the unpredictable variations encountered during the diagnostic work-up of the case make this write-up crucial. This article synthesizes all reported cases of L. pneumonia associated with cutaneous manifestations as well as cases presenting with DIC. Furthermore, this manuscript illustrates the correlation between cutaneous and coagulopathic manifestations, and morbidity and mortality from L. pneumonia.

Sinus anatomy associated with inadvertent cerebrospinal fluid leak during functional endoscopic sinus surgery.

Science.gov (United States)

Heaton, Chase M; Goldberg, Andrew N; Pletcher, Steven D; Glastonbury, Christine M

2012-07-01

Anatomic variations in skull base anatomy may predispose the surgeon to inadvertent skull base injury with resultant cerebrospinal fluid (CSF) leak during functional endoscopic sinus surgery (ESS). Our objective was to compare preoperative sinus imaging of patients who underwent FESS with and without CSF leak to elucidate these variations. In this retrospective case-control study, 18 patients with CSF leak following FESS for chronic rhinosinusitis (CRS) from 2000 to 2011 were compared to 18 randomly selected patients who underwent preoperative imaging for FESS for CRS. Measurements were obtained from preoperative computed tomography images with specific attention to anatomic differences in cribriform plate and ethmoid roof heights in the coronal plane, and the skull base angle in the sagittal plane. Mean values of measured variables were compared using a nonparametric Mann-Whitney test. When compared to controls, patients with CSF leak demonstrated a greater angle of the skull base in the sagittal plane (P variations may help to prevent iatrogenic CSF leak. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Fatal Klebsiella pneumoniae meningitis and concomitant disseminated intravascular coagulation in a patient with diabetes mellitus

Directory of Open Access Journals (Sweden)

Ho Min-Po

2009-01-01

Full Text Available Bacterial meningitis remains a major cause of death and long-term neurologic sequelae worldwide. We present a case of fatal Klebsiella pneumoniae meningitis and concomitant disseminated intravascular coagulation (DIC in a 72-year-old woman with diabetes mellitus (DM. Both blood and cerebrospinal fluid cultures grew Klebsiella pneumoniae . Due to advanced age, newly recognized DM, K. pneumoniae bacteremia, and DIC, the prognosis of our patient was poor. Eight hours after arrival to the emergency department, cardiopulmonary resuscitation was necessary in this patient, but she died despite an early diagnosis and appropriate antibiotic therapy.

Disseminated intravascular coagulation in a patient with metastatic prostate cancer: Fatal outcome following strontium-89 therapy

Energy Technology Data Exchange (ETDEWEB)

Leong, C.; McKenzie, R.; Coupland, D.B. [Univ. of British Columbia, (Canada)] [and others

1994-10-01

A patient with metastatic prostate cancer was found to have low-grade disseminated intravascular coagulation (DIC). He had significant bone pain despite external-beam radiotherapy and was given {sup 89}Sr with subsequent thrombocytopenia and epistaxis. The patient died from generalized hemorrhage 36 days postinjection. Although it is not possible to establish a causal relationship between {sup 89}Sr and DIC, practitioners should be alert to complications associated with the primary disorder which might occur at a time to raise concern about the intervention. 8 refs., 1 tab.

Impact of analyzing fewer image frames per segment during offline volumetric radiofrequency based intravascular ultrasound measurements of target lesions prior to percutaneous coronary interventions

NARCIS (Netherlands)

Huisman, J.; Hartmann, M.; Hartmann, M.; Mintz, G.S.; van Houwelingen, G.K.; Stoel, M.G.; de Man, F.H.; Louwerenburg, H.; von Birgelen, Clemens

2012-01-01

In the present study, we evaluated the impact of a 50% reduction in number of image frames (every second frame) on the analysis time and variability of offline volumetric radiofrequency-based intravascular ultrasound (RF-IVUS) measurements in target lesions prior to percutaneous coronary

Expert judgment on markers to deter inadvertent human intrusion into the Waste Isolation Pilot Plant

Energy Technology Data Exchange (ETDEWEB)

Trauth, K.M. [Sandia National Labs., Albuquerque, NM (United States); Hora, S.C. [Hawaii Univ., Hilo, HI (United States); Guzowski, R.V. [Science Applications International Corp., San Diego, CA (United States)

1993-11-01

The expert panel identified basic principles to guide current and future marker development efforts: (1) the site must be marked, (2) message(s) must be truthful and informative, (3) multiple components within a marker system, (4) multiple means of communication (e.g., language, pictographs, scientific diagrams), (5) multiple levels of complexity within individual messages on individual marker system elements, (6) use of materials with little recycle value, and (7) international effort to maintain knowledge of the locations and contents of nuclear waste repositories. The efficacy of the markers in deterring inadvertent human intrusion was estimated to decrease with time, with the probability function varying with the mode of intrusion (who is intruding and for what purpose) and the level of technological development of the society. The development of a permanent, passive marker system capable of surviving and remaining interpretable for 10,000 years will require further study prior to implementation.

Expert judgment on markers to deter inadvertent human intrusion into the Waste Isolation Pilot Plant

International Nuclear Information System (INIS)

Trauth, K.M.; Hora, S.C.; Guzowski, R.V.

1993-11-01

The expert panel identified basic principles to guide current and future marker development efforts: (1) the site must be marked, (2) message(s) must be truthful and informative, (3) multiple components within a marker system, (4) multiple means of communication (e.g., language, pictographs, scientific diagrams), (5) multiple levels of complexity within individual messages on individual marker system elements, (6) use of materials with little recycle value, and (7) international effort to maintain knowledge of the locations and contents of nuclear waste repositories. The efficacy of the markers in deterring inadvertent human intrusion was estimated to decrease with time, with the probability function varying with the mode of intrusion (who is intruding and for what purpose) and the level of technological development of the society. The development of a permanent, passive marker system capable of surviving and remaining interpretable for 10,000 years will require further study prior to implementation

Plasma firocoxib concentrations after intra-articular injection of autologous conditioned serum prepared from firocoxib positive horses.

Science.gov (United States)

Ortved, K F; Goodale, M B; Ober, C; Maylin, G A; Fortier, L A

2017-12-01

Orthobiologics such as autologous conditioned serum (ACS) are often used to treat joint disease in horses. Because ACS is generated from the horse's own blood, any medication administered at the time of preparation would likely be present in stored ACS, which could lead to an inadvertent positive drug test following intra-articular (IA) injection. The main objective of this study was to determine if ACS prepared from firocoxib positive horses could result in detectable plasma concentrations of the drug following IA injection. Firocoxib was administered to six horses at 0.1mg/kg PO twice at a 24h interval. Blood was obtained at 4h following the second dose and transferred to a separate syringe (Arthrex IRAP II) for ACS preparation. Plasma and ACS concentrations of firocoxib were analysed by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). When horses were confirmed firocoxib negative, 7.5mL of ACS was injected into both tarsocrural joints. Blood samples were collected at 0, 4, 8, 12, 24, and 48h, and firocoxib concentration was measured. Mean (±standard error of the mean, SEM) plasma concentration of firocoxib 4h following the second dose was 33.3±4.72ng/mL. Mean (±SEM) firocoxib concentration in ACS was 35.4±4.47ng/mL. Fourteen days following the second and last dose of firocoxib, mean plasma concentration was below the lower limit of detection (LOD=1ng/mL) in all horses. Following IA injection of ACS, plasma concentrations of firocoxib remained below LOD at all times in all horses. ACS generated from horses with therapeutic plasma concentrations of firocoxib did not contain sufficient firocoxib to lead to a positive plasma drug test following IA administration. Copyright © 2017 Elsevier Ltd. All rights reserved.

Accidental deposition of local anaesthetic in the subdural space ...

African Journals Online (AJOL)

The incidence of accidental injection of local anaesthetic into the subdural space during neuraxial blockade is rare. The presentation of unexplainable clinical signs that do not match the clinical picture of subarachnoid or intravascular injection of the local anaesthetic agent should invoke high suspicion of unintentional ...

Intravascular Immune Surveillance by CXCR6+ NKT Cells Patrolling Liver Sinusoids

Directory of Open Access Journals (Sweden)

Geissmann Frederic

2005-01-01

Full Text Available We examined the in vivo behavior of liver natural killer T cells (NKT cells by intravital fluorescence microscopic imaging of mice in which a green fluorescent protein cDNA was used to replace the gene encoding the chemokine receptor CXCR6. NKT cells, which account for most CXCR6+ cells in liver, were found to crawl within hepatic sinusoids at 10-20 µm/min and to stop upon T cell antigen receptor activation. CXCR6-deficient mice exhibited a selective and severe reduction of CD1d-reactive NKT cells in the liver and decreased susceptibility to T-cell-dependent hepatitis. CXCL16, the cell surface ligand for CXCR6, is expressed on sinusoidal endothelial cells, and CXCR6 deficiency resulted in reduced survival, but not in altered speed or pattern of patrolling of NKT cells. Thus, NKT cells patrol liver sinusoids to provide intravascular immune surveillance, and CXCR6 contributes to liver-based immune responses by regulating their abundance.

Local release of ATP into the arterial inflow and venous drainage of human skeletal muscle: insight from ATP determination with the intravascular microdialysis technique

DEFF Research Database (Denmark)

Mortensen, Stefan; Thaning, Pia; Nyberg, Michael Permin

2011-01-01

is released into plasma, we measured plasma [ATP] with the intravascular microdialysis technique at rest and during dynamic exercise (normoxia and hypoxia), passive exercise, thigh compressions and arterial ATP, tyramine and ACh infusion in a total of 16 healthy young men. Femoral arterial and venous...

Prediction of postpercutaneous coronary intervention myocardial infarction: insights from intravascular imaging, coronary flow, and biomarker evaluation.

Science.gov (United States)

Hoole, Stephen P; Hernández-Sánchez, Jules; Brown, Adam J; Giblett, Joel P; Bennett, Martin R; West, Nick E J

2018-05-01

Percutaneous coronary intervention-induced myocardial infarction (PMI) has prognostic significance. Identifying patients at high risk for PMI is desirable as it may alter strategy and facilitate early preventative therapy. We therefore sought to establish whether preprocedural demographic, interventional (plaque characteristics and coronary microcirculatory function), and inflammatory, endothelial damage, and platelet-derived biomarker data could predict the risk of PMI. We performed target vessel pressure wire to assess fractional flow reserve, index of microcirculatory resistance (IMR) and coronary flow reserve, plaque characterization by virtual histology intravascular ultrasound, and assayed peripheral biomarkers before uncomplicated PCI in 88 patients. We then analyzed post-PCI cardiac troponin level to adjudicate PMI based on the third universal definition of myocardial infarction. Overall incidence of PMI was 27%. Women [10/15 (66%) vs. 14/73 (19%), PPMI. Preprocedural coronary flow reserve was lower in individuals with a subsequent PMI (1.8±1.2 vs. 2.1±1.3. P=0.03), and patients with higher pre-PCI IMR were more likely to sustain PMI [IMR>22: 10/23 (44%) vs. ≤22: 14/65 (22%), P=0.04], although neither was predictive after multivariate analysis. Plaque characterization by virtual histology intravascular ultrasound did not discriminate those at risk of PMI. However, peripheral venous interleukin (IL)-18 and IL-8 levels were independently negatively and positively associated with PMI, respectively. Women and those with low BMI, particularly when associated with high IL-8 and low IL-18 levels, appear to be at increased risk of PMI.

Intravascular ultrasound based dose assessment in endovascular brachytherapy

International Nuclear Information System (INIS)

Catalano, Gianpiero; Tamburini, Vittorio; Colombo, Antonio; Nishida, Takahiro; Parisi, Giovanni; Mazzetta, Chiara; Orecchia, Roberto

2003-01-01

Background: the role of endovascular brachytherapy in restenosis prevention is well documented. Dose is usually prescribed at a fixed distance from the source axis by angiographic quantification of vessel diameter. Recently, intravascular ultrasound (IVUS) was introduced in dose prescription, allowing a better evaluation of the vessel anatomy. This study retrospectively explores the difference between prescription following angiographic vessel sizing and delivered dose calculated with IVUS. Methods and results: Seventeen lesions were studied with IVUS, identifying on irradiated segment, three sections on which measuring minimal and maximal distance from the centre of IVUS catheter to the adventitia; using dedicated software, corresponding doses were calculated. The dose ranged widely, with maximal and minimal values of 71.6 and 4.9 Gy; furthermore, heterogeneity in dose among different sections was observed. In the central section, the maximal dose was 206% of the one prescribed with the QCA model at 2 mm from the source axis, while the minimal dose was 96%. In proximal and distal sections, respective values were 182, 45, 243, and 122%. Conclusions: Our analysis confirmed the dose inhomogeneity delivered with an angiographic fixed-dose prescription strategy. A dose variation was found along the irradiated segment due to the differences in vessel thickness. IVUS emerged as an important tool in endovascular brachytherapy, especially for irregular-shaped vessels

A proposed alternative approach for protection of inadvertent human intruders from buried Department of Energy low level radioactive wastes

International Nuclear Information System (INIS)

Cochran, J.R.

1995-01-01

The burial of radioactive wastes creates a legacy. To limit the impact of this legacy on future generations, we establish and comply with performance objectives. This paper reviews performance objectives for the long-term isolation of buried radioactive wastes; identifies regulatorly-defined performance objectives for protecting the inadvertent human intruder (IHI) from buried low-level radioactive waste (LLW); (3) discusses a shortcoming of the current approach; and (4) offers an alternative approach for protecting the IHI. This alternative approach is written specifically for the burial of US Department of Energy (DOE) wastes at the Nevada Test Site (NTS), although the approach might be applied at other DOE burial sites

Absence of accelerated atherosclerotic disease progression after intracoronary infusion of bone marrow derived mononuclear cells in patients with acute myocardial infarction--angiographic and intravascular ultrasound--results from the TErapia Celular Aplicada al Miocardio Pilot study.

Science.gov (United States)

Arnold, Roman; Villa, Adolfo; Gutiérrez, Hipólito; Sánchez, Pedro L; Gimeno, Federico; Fernández, Maria E; Gutiérrez, Oliver; Mota, Pedro; Sánchez, Ana; García-Frade, Javier; Fernández-Avilés, Francisco; San Román, Jose A

2010-06-01

We tried to evaluate a putative negative effect on coronary atherosclerosis in patients receiving intracoronary infusion of unfractionated bone marrow mononuclear cells (BMMC) following an acute ST-elevation myocardial infarction. Peripheral blood mononuclear cells or enriched CD133(+) BMMC have been associated with accelerated atherosclerosis of the distal segment of the infarct related artery (IRA). Thirty-seven patients with ST-elevation myocardial infarction from the TECAM pilot study underwent intracoronary infusion of autologous BMMC 9 +/- 3.1 days after onset of symptoms. We compared angiographic changes from baseline to 9 months of follow-up in the distal non-stented segment of the IRA, as well as in the contralateral coronary artery, with a matched control group. A subgroup of 15 treated patients underwent additional IVUS within the distal segment of the IRA. No difference between stem cell and control group were found regarding changes in minimum lumen diameter (0.006 +/- 0.42 vs 0.06 +/- 0.41 mm, P = ns) and the percentage of stenosis (-2.68 +/- 12.33% vs -1.78 +/- 8.75%, P = ns) at follow-up. Likewise, no differences were seen regarding changes in the contralateral artery (minimum lumen diameter -0.004 +/- 0.54 mm vs -0.06 +/- 0.35 mm, P = ns). In the intravascular ultrasound substudy, no changes were demonstrated comparing baseline versus follow-up in maximum area stenosis and plaque volume. In this pilot study, analysis of a subgroup of patients found that intracoronary injection of unfractionated BMMC in patients with acute ST-elevation myocardial infarction was not associated with accelerated atherosclerosis progression at mid term. Prospective, randomised studies in large cohorts with long-term angiographic and intravascular ultrasound follow-up are necessary to determine the safety of this therapy. Copyright 2010 Mosby, Inc. All rights reserved.

Passive Barriers to Inadvertent Human Intrusion for Use at the Nevada Test Site

International Nuclear Information System (INIS)

NSTec Environmental Management

2007-01-01

In July1996, BN transmitted Passive Barriers to Inadvertent Human Intrusion for Use at the Nevada Test Site to the United States Department of Energy, under Contract DE-AC08-91NV10833. The 1996 paper had a limited distribution and was not reviewed for public release. In 2007, National Security Technologies LLC (NSTec) made minor revisions to conform to current editorial standards of the NNSA/NSO and to meet current security requirements for public release. The primary purpose of this study was to identify types of engineered passive barriers that could deter future intrusion into buried low-level radioactive waste, particularly intrusion by drilling water wells. The study considered drilling technology, many natural and man-made materials, and both underground and above-ground barriers. Based on cost and effectiveness, the report recommended underground barriers consisting of a layer of rubble or tires. An aboveground barrier mound might also prove effective, but would cost more, and may become an attractive nuisance (e.g., might, after their purpose has been forgotten, encourage exploration for the sake of satisfying curiosity). Advances in drilling technology could render any engineered barriers ineffective if there is motivation to penetrate the barriers

Fulminant intravascular lymphomatosis mimicking acute haemorrhagic leukoencephalopathy.

Science.gov (United States)

Marino, D; Sicurelli, F; Cerase, A; Tripodi, S; Cintorino, M; Lazzi, S; Federico, A

2012-09-15

Intravascular lymphomatosis (IVL) is a rare non-Hodgkin's lymphoma, usually of B cell lineage, characterized by massive angiotropic growth. The clinical presentation of IVL may include changes in mental status, non-localizing neurological deficits, seizures, fever of unknown origin and skin changes. Because of its rarity and the absence of specific diagnostic procedures except for cerebral biopsy, diagnosis is often postmortem. Brain MRI usually shows non-specific abnormalities. The purpose of this case report is to increase the knowledge of clinical and neuroimaging features of IVL by describing the findings observed in a 71-year-old patient. A 71-year-old male was admitted for right hemiparesis, acute cognitive impairment and febricula. A bone marrow biopsy resulted normal. He then developed a rapid progressive impairment of his mental status and left hemisoma motor seizures. Brain CT and MRI were interpreted as consistent with acute haemorrhagic leukoencephalopathy (AHLE), including multiple areas of restricted diffusion without gadolinium enhancement and a small focal area of gadolinium enhancement in the left temporal lobe white matter. The patient died within a few days and the autopsy led to the diagnosis of IVL. IVL may present with a variety of clinical signs and symptoms, including stroke and hemiparesis. IVL may mimic AHLE at brain MRI. However, the evidence of multiple areas of restricted diffusion without gadolinium enhancement and of a small area of gadolinium enhancement could have led to the correct diagnosis. IVL should be added to the differential diagnosis of AHLE at brain MRI. Copyright © 2012 Elsevier B.V. All rights reserved.

Inadvertent weather modification urban areas - lessons for global climate change

Energy Technology Data Exchange (ETDEWEB)

Changnon, S A [Illinois State Water Survey, Champaign, IL (USA)

1992-05-01

Large metropolitan areas in North America, home to 65% of the USA's population, have created major changes in their climates over the past 150 years. The rate and amount of the urban climate change approximate those being predicted globally using climate models. Knowledge of urban weather and climate modification holds lessons for the global climate change issue. First, adjustments to urban climate changes can provide guidance for adjusting to global change. A second lesson relates to the difficulty but underscores the necessity of providing scientifically credible proof of change within the noise of natural climatic variability. The evolution of understanding about how urban conditions influence weather reveals several unexpected outcomes, particularly relating to precipitation changes. These suggest that similar future surprises can be expected in a changed global climate, a third lesson. In-depth studies of how urban climate changes affected the hydrologic cycle, the regional economy, and human activities were difficult because of data problems, lack of impact methodology, and necessity for multidisciplinary investigations. Similar impact studies for global climate change will require diverse scientific talents and funding commitments adequate to measure the complexity of impacts and human adjustments. Understanding the processes whereby urban areas and other human activities have altered the atmosphere and changed clouds and precipitation regionally appears highly relevant to the global climate-change issue. Scientific and governmental policy development needs to recognize an old axiom that became evident in the studies of inadvertent urban and regional climate change and their behavioural implications: Think globally but act locally. Global climate change is an international issue, and the atmosphere must be treated globally. But the impacts and the will to act and adjust will occur regionally.

Inadvertent weather modification urban areas - lessons for global climate change

International Nuclear Information System (INIS)

Changnon, S.A.

1992-01-01

Large metropolitan areas in North America, home to 65% of the USA's population, have created major changes in their climates over the past 150 years. The rate and amount of the urban climate change approximate those being predicted globally using climate models. Knowledge of urban weather and climate modification holds lessons for the global climate change issue. First, adjustments to urban climate changes can provide guidance for adjusting to global change. A second lesson relates to the difficulty but underscores the necessity of providing scientifically credible proof of change within the noise of natural climatic variability. The evolution of understanding about how urban conditions influence weather reveals several unexpected outcomes, particularly relating to precipitation changes. These suggest that similar future surprises can be expected in a changed global climate, a third lesson. In-depth studies of how urban climate changes affected the hydrologic cycle, the regional economy, and human activities were difficult because of data problems, lack of impact methodology, and necessity for multidisciplinary investigations. Similar impact studies for global climate change will require diverse scientific talents and funding commitments adequate to measure the complexity of impacts and human adjustments. Understanding the processes whereby urban areas and other human activities have altered the atmosphere and changed clouds and precipitation regionally appears highly relevant to the global climate-change issue. Scientific and governmental policy development needs to recognize an old axiom that became evident in the studies of inadvertent urban and regional climate change and their behavioural implications: Think globally but act locally. Global climate change is an international issue, and the atmosphere must be treated globally. But the impacts and the will to act and adjust will occur regionally

Intravascular Papillary Endothelial Hyperplasia (Masson’s Tumor) of the Radial Artery: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Stark, Christopher, E-mail: Christopher.stark@uvmhealth.org [University of Vermont Medical Center, Department of Radiology (United States); Olsen, Daniel [Mayo Clinic, Department of Pathology (United States); Morris, Christopher [University of Vermont Medical Center, Department of Radiology (United States); Bertges, Daniel [University of Vermont Medical Center, Department of Surgery (United States); Najarian, Kenneth [University of Vermont Medical Center, Department of Radiology (United States)

2016-11-15

Intravascular papillary endothelial hyperplasia (IPEH), often referred to as Masson’s tumor, is a benign non-neoplastic vascular lesion of the skin and subcutaneous tissues. Although it is rare, knowledge of the existence of IPEH is important as it can mimic other benign and malignant tumors, most notably angiosarcoma. IPEH remains an incompletely understood entity; however, most consider it to be the result of reactive endothelial proliferation following thrombus formation within a vessel, vascular malformation, or adjacent to a vessel. In this article, we report a case of IPEH arising within an arteriovenous malformation of the radial artery and present accompanying multimodality imaging and pathology figures. We will also describe the clinical presentation, pathophysiology, histology, imaging features, and management of IPEH.

Intravascular Papillary Endothelial Hyperplasia (Masson’s Tumor) of the Radial Artery: A Case Report

International Nuclear Information System (INIS)

Stark, Christopher; Olsen, Daniel; Morris, Christopher; Bertges, Daniel; Najarian, Kenneth

2016-01-01

Intravascular papillary endothelial hyperplasia (IPEH), often referred to as Masson’s tumor, is a benign non-neoplastic vascular lesion of the skin and subcutaneous tissues. Although it is rare, knowledge of the existence of IPEH is important as it can mimic other benign and malignant tumors, most notably angiosarcoma. IPEH remains an incompletely understood entity; however, most consider it to be the result of reactive endothelial proliferation following thrombus formation within a vessel, vascular malformation, or adjacent to a vessel. In this article, we report a case of IPEH arising within an arteriovenous malformation of the radial artery and present accompanying multimodality imaging and pathology figures. We will also describe the clinical presentation, pathophysiology, histology, imaging features, and management of IPEH.

Dynamic magnetic resonance angiography of the arteries of the hand. A comparison between an extracellular and an intravascular contrast agent

International Nuclear Information System (INIS)

Reisinger, Clemens; Gluecker, Thomas; Jacob, Augustinus Ludwig; Bongartz, Georg; Bilecen, Deniz

2009-01-01

The purpose of this study was to compare the image quality of the intravascular contrast agent gadofosveset with the extracellular contrast agent gadoterate meglumine in time-resolved three-dimensional magnetic resonance (MR) angiography of the human arteries of the hand. The value of cuff compression technique for suppression of venous enhancement for both contrast agents was also investigated. Three-dimensional MR angiograms of both hands of 11 healthy volunteers were acquired for each contrast agent at 1.5-T, while subsystolic cuff compression was applied at one side. Quantitative and qualitative evaluation were performed and analyzed with Student's t-test. Visualization of vessels was superior in the images acquired with gadofosveset, especially in the late phases. Quantitative and qualitative evaluation showed significantly higher values for gadofosveset. The cuff compression at the lower arm proved to be an effective method to enhance arterial vessels. In conclusion the blood pool agent gadofosveset is superior for the dynamic imaging of the vessels of the hand when compared with the extracellular contrast agent gadoterate meglumine. To fully utilize the advantages of intravascular contrast agents, venous overlay has to be delayed or reduced, which can be achieved effectively by subsystolic lower arm cuff compression. (orig.)

Observation of Intravascular Changes of Superabsorbent Polymer Microsphere (SAP-MS) with Monochromatic X-Ray Imaging

International Nuclear Information System (INIS)

Tanimoto, Daigo; Ito, Katsuyoshi; Yamamoto, Akira; Sone, Teruki; Kobatake, Makito; Tamada, Tsutomu; Umetani, Keiji

2010-01-01

This study was designed to evaluate the intravascular transformation behavior of superabsorbent polymer microsphere (SAP-MS) in vivo macroscopically by using monochromatic X-ray imaging and to quantitatively compare the expansion rate of SAP-MS among different kinds of mixtures. Fifteen rabbits were used for our study and transcatheter arterial embolization (TAE) was performed for their auricular arteries using monochromatic X-ray imaging. We used three kinds of SAP-MS (particle diameter 100-150 μm) mixture as embolic spherical particles: SAP-MS(H) absorbed with sodium meglumine ioxaglate (Hexabrix 320), SAP-MS(V) absorbed with isosmolar contrast medium (Visipaque 270), and SAP-MS(S) absorbed with 0.9% sodium saline. The initial volume of SAP-MS particles just after TAE and its final volume 10 minutes after TAE in the vessel were measured to calculate the expansion rate (ER) (n = 30). Intravascular behavior of SAP-MS particles was clearly observed in real time at monochromatic X-ray imaging. Averaged initial volumes of SAP-MS (H) (1.24 x 10 7 μm 3 ) were significantly smaller (p 7 μm 3 ) and SAP-MS (S) (5.85 x 10 7 μm 3 ). Averaged final volumes of SAP-MS (H) were significantly larger than averaged initial volumes (4.41 x 10 7 μm 3 vs. 1.24 x 10 7 μm 3 ; p < 0.0001, ER = 3.55). There were no significant difference between averaged final volumes and averaged initial volumes of SAP-MS (V) and SAP-MS (S). SAP-MS (H), which first travels distally, reaches to small arteries, and then expands to adapt to the vessel lumen, is an effective particle as an embolic agent, causing effective embolization.

Control of Transboundary Movement of Radioactive Material Inadvertently Incorporated into Scrap Metal and Semi-finished Products of the Metal Recycling Industries. Results of the Meetings Conducted to Develop a Draft Code of Conduct

International Nuclear Information System (INIS)

2014-02-01

In 2010, the IAEA initiated the development of a code of conduct on the transboundary movement of radioactive material inadvertently incorporated into scrap metal and semi- finished products of the metal recycling industries (Metal Recycling Code of Conduct). The Metal Recycling Code of Conduct was intended to harmonize the approaches of Member States in relation to the discovery of radioactive material that may inadvertently be present in scrap metals and semi-finished products subject to transboundary movement, and their safe handling and management to facilitate regulatory control. The Metal Recycling Code of Conduct was envisaged as being complementary to the Safety Guide on Control of Orphan Sources and Other Radioactive Material in the Metal Recycling and Production Industries (IAEA Safety Standards Series No. SSG-17), which provides recommendations, principally within a national context, on the protection of workers, members of the public and the environment in relation to the control of radioactive material inadvertently incorporated in scrap metal. In February 2013, the third open-ended meeting of technical and legal experts to develop the Metal Recycling Code of Conduct was organized. The objective of this meeting was to address the comments received from Member States and to finalize the text of the draft Metal Recycling Code of Conduct. Representatives from 55 Member States, one non-Member State and the EU, together with seven observers from the metal recycling industry, reviewed the comments and revised the draft accordingly. In September 2013, in Resolution GC(57)/RES/9, the IAEA General Conference recorded that it 'Appreciates the intensive efforts undertaken by the Secretariat to develop a code of conduct on the transboundary movement of scrap metal, or materials produced from scrap metal, that may inadvertently contain radioactive material, and encourages the Secretariat to make the results of the discussion conducted on this issue available to

Primary Intra-aortic Epstein-Barr Virus-Positive Large B-Cell Lymphoma Presenting as Aortic Mural Thrombosis: An Entity Distinct From Intravascular Large B-Cell Lymphoma.

Science.gov (United States)

Nakao, Ryuta; Sakashita, Aki; Omoto, Atsushi; Sato, Osamu; Hino, Yoko; Yanagisawa, Akio; Urata, Yoji

2017-12-01

Intravascular selective growth of neoplastic B lymphocytes is a characteristic finding of intravascular large B-cell lymphoma (IVLBCL). However, because neoplastic B cells of IVLBCL grow merely in the lumina of capillaries or small vessels, primary IVLBCL of the great vessels is considered exceptional. To our knowledge, only 2 primary B-cell lymphomas in the lumina of the vena cava have been reported. However, there has been no report of primary B-cell lymphoma with intra-aortic growth. We describe a novel manifestation of primary Epstein-Barr virus-positive large B-cell lymphoma mainly affecting the lumina of the aorta and its major branches in a 76-year-old man. He had a long-term fever that was refractory to antibiotics and aortic mural thrombosis with visceral embolization. Because he had no detectable mass suggesting a malignancy, it was difficult to diagnose while he was alive. He died without anticancer treatment, and the confirmed diagnosis was made at autopsy.

Evaluation of cerebral intravascular blood flow by time density curve study of intravenous digital subtraction angiography

Energy Technology Data Exchange (ETDEWEB)

Imamura, Toru; Kogure, Kyuya (Tohoku Univ., Sendai (Japan). School of Medicine); Sekine, Teiko; Satoh, Kei; Endoh, Minoru; Tsuburaya, Kenji; Hoshi, Akihiko

1992-01-01

Time density curve (TDC) can be reconstructed from the data of intravenous digital subtraction angiography (IVDSA). We evaluated peak time (PT) and modal transit time (MOTT) of the TDC as the probable indicator of cerebral intravascular blood flow. Cerebral IVDSA and single photon emission CT (SPECT) were performed on 12 patients with ischemic cerebrovascular disease, which consisted of 3 internal carotid artery (ICA) occlusions, one middle cerebral artery (MCA) occlusion, one anterior cerebral artery (ACA) branch occlusion and 7 lacunar infarctions. We classified former 4 patients as occlusion group and latter 8 as reference group. In 3 patients (2 ICA and one MCA occlusions), SPECT study revealed definite hypoaccumulation in the MCA territory of occlusive side. Two regions of interest (ROI) were placed on the territories of right and left middle cerebral arteries in the frontal view of cerebral IVDSA. Digital data processor fitted {gamma} curve to the TDC of each ROI, and calculated PT and MOTT. The absolute lateralities of PT and MOTT of MCA territory was significantly (p<0.05) larger in occlusion group than reference group. Patients with hypoaccumulation in SPECT had significantly (p<0.02) larger laterality of MOTT than patients with isoaccumulation. One ICA occluded patient without hypoaccumulation in corresponding MCA territory had relatively small laterality of MOTT similar to the patients of ACA branch occlusion and lacunar infarction. These results suggest that PT and MOTT are possible to detect the laterality of the intravascular blood flow in MCA territories caused by major artery occlusion. Cerebral TDC study of IVDSA may be useful in some clinical therapeutic situations such as hemodilution or intra-arterial thrombolysis, and worth further clinical evaluation. (author).

Application of Gafchromic registered film in the dosimetry of an intravascular brachytherapy source

International Nuclear Information System (INIS)

Song Haijun; Roa, D. Eduardo; Yue Ning; D'Errico, Francesco; Chen Zhe; Nath, Ravinder

2006-01-01

The methodology of brachytherapy source dosimetry with Gafchromic registered MD 55-2 film (ISP Technologies, Inc.) is examined with an emphasis on the nonlinearity of the optical density-dose relation within the dynamic dose range, the radial distance-dependent measurement uncertainty, and the format of data presentation. The specific source chosen for this study was a Checkmate trade mark sign (Cordis Corporation) intravascular brachytherapy system. The two-dimensional dose distribution around the source was characterized by a comprehensive analysis of measurement uncertainties. A comparative analysis of the dosimetric data from the vendor and from the scientific literature showed a substantial consistency of the information available for the Checkmate trade mark sign source. Our two-dimensional dosimetric data for the Checkmate trade mark sign source trains is presented in the form of measured along and away dose tables

Imminent Cardiac Risk Assessment via Optical Intravascular Biochemical Analysis

Energy Technology Data Exchange (ETDEWEB)

Wetzel, D.; Wetzel, L; Wetzel, M; Lodder, R

2009-01-01

Heart disease is by far the biggest killer in the United States, and type II diabetes, which affects 8% of the U.S. population, is on the rise. In many cases, the acute coronary syndrome and/or sudden cardiac death occurs without warning. Atherosclerosis has known behavioral, genetic and dietary risk factors. However, our laboratory studies with animal models and human post-mortem tissue using FT-IR microspectroscopy reveal the chemical microstructure within arteries and in the arterial walls themselves. These include spectra obtained from the aortas of ApoE-/- knockout mice on sucrose and normal diets showing lipid deposition in the former case. Also pre-aneurysm chemical images of knockout mouse aorta walls, and spectra of plaque excised from a living human patient are shown for comparison. In keeping with the theme of the SPEC 2008 conference Spectroscopic Diagnosis of Disease this paper describes the background and potential value of a new catheter-based system to provide in vivo biochemical analysis of plaque in human coronary arteries. We report the following: (1) results of FT-IR microspectroscopy on animal models of vascular disease to illustrate the localized chemical distinctions between pathological and normal tissue, (2) current diagnostic techniques used for risk assessment of patients with potential unstable coronary syndromes, and (3) the advantages and limitations of each of these techniques illustrated with patent care histories, related in the first person, by the physician coauthors. Note that the physician comments clarify the contribution of each diagnostic technique to imminent cardiac risk assessment in a clinical setting, leading to the appreciation of what localized intravascular chemical analysis can contribute as an add-on diagnostic tool. The quality of medical imaging has improved dramatically since the turn of the century. Among clinical non-invasive diagnostic tools, laboratory tests of body fluids, EKG, and physical examination are

Transcatheter Arterial Embolization for Postpartum Hemorrhage with Disseminated Intravascular Coagulation: Outcome Assessment

Energy Technology Data Exchange (ETDEWEB)

An, Eun Jung; Kim, Young Hwan; Kwon, Bo Ra; Kim, See Hyung [Dept. of Radiology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of)

2011-12-15

We evaluated the efficacy and predictors of clinical outcome after transcatheter arterial embolization (TAE) for treatment of postpartum hemorrhage with disseminated intravascular coagulation (DIC). Of 127 patients who underwent TAE for postpartum hemorrhage, 46 progressed to DIC (group 1), 81 showed normal range hematological parameters (group 2). We retrospectively evaluated etiology, embolization methods and the efficacy of TAE for intergroup comparison Pearson Chi-Square test and logistic regression model. Overall TAE failed to control bleeding in 9 patients in spite of technical success. Lower bleeding control rate was found in group 2 (82.6%) relative to group 1 (98.8%, p = 0.001). And embolization methods were not statistically different between two groups no statistically significant predictors associated with failed hemostasis except the amount of transfusion in group 1. Although bleeding control rate is lower in postpartum hemorrhage with DIC than without DIC, we believe that TAE with correction of DIC is an effective method for postpartum hemorrhage with DIC.

Transcatheter Arterial Embolization for Postpartum Hemorrhage with Disseminated Intravascular Coagulation: Outcome Assessment

International Nuclear Information System (INIS)

An, Eun Jung; Kim, Young Hwan; Kwon, Bo Ra; Kim, See Hyung

2011-01-01

We evaluated the efficacy and predictors of clinical outcome after transcatheter arterial embolization (TAE) for treatment of postpartum hemorrhage with disseminated intravascular coagulation (DIC). Of 127 patients who underwent TAE for postpartum hemorrhage, 46 progressed to DIC (group 1), 81 showed normal range hematological parameters (group 2). We retrospectively evaluated etiology, embolization methods and the efficacy of TAE for intergroup comparison Pearson Chi-Square test and logistic regression model. Overall TAE failed to control bleeding in 9 patients in spite of technical success. Lower bleeding control rate was found in group 2 (82.6%) relative to group 1 (98.8%, p = 0.001). And embolization methods were not statistically different between two groups no statistically significant predictors associated with failed hemostasis except the amount of transfusion in group 1. Although bleeding control rate is lower in postpartum hemorrhage with DIC than without DIC, we believe that TAE with correction of DIC is an effective method for postpartum hemorrhage with DIC.

Patent hepatic falciform artery detected after Tc-99m-macroaggregated albumin injection on SPECT/CT prior to Yttrium-90 microsphere radioembolization: a case report

International Nuclear Information System (INIS)

Karaman, B.; Aslan, A.; Hamcan, S.; Ugurel, M.

2012-01-01

Full text: Introduction: Yttrium-90 (Y-90) microsphere radioembolization is increasingly used for the treatment of unresectable hepatocellular carcinoma and liver metastasis. Objectives and tasks: We aim to present the upper abdominal wall skin involvement detected during routine pre-therapy Technetium-99m-macroaggregated albumin (Tc-99m-MAA) on SPECT/CT due to patent hepatic falciform artery and the precautions to avoid this potential complication. Material and methods: 38-year-old male with colon cancer and multiple liver metastasis was evaluated prior to radioembolization and Tc-99 MAA was slowly hand injected at the bifurcation of the proper hepatic artery. Then, the SPECT/CT scan was performed in order to investigate the systemic shunt or gastric involvement. Results: On SPECT/CT scan, involvement of the upper abdominal wall through falciform ligament was seen. Re-evaluation of the hepatic angiogram identified a patent hepatic falciform artery arising from the left hepatic artery. Y-90 microspheres were slowly hand injected to the left hepatic artery superselectively and no extra-hepatic activity was seen on SPECT/CT scan. Conclusion: Upper abdominal pain and dermatitis are uncommon findings after radioembolization and may occur due to inadvertent delivery of Y-90 microspheres into patent hepatic falciform artery. To prevent these complications, either patent hepatic falciform artery must be embolized by coil or Y-90 injection must be performed superselectively

Dose-volume histograms based on serial intravascular ultrasound: a calculation model for radioactive stents

International Nuclear Information System (INIS)

Kirisits, Christian; Wexberg, Paul; Gottsauner-Wolf, Michael; Pokrajac, Boris; Ortmann, Elisabeth; Aiginger, Hannes; Glogar, Dietmar; Poetter, Richard

2001-01-01

Background and purpose: Radioactive stents are under investigation for reduction of coronary restenosis. However, the actual dose delivered to specific parts of the coronary artery wall based on the individual vessel anatomy has not been determined so far. Dose-volume histograms (DVHs) permit an estimation of the actual dose absorbed by the target volume. We present a method to calculate DVHs based on intravascular ultrasound (IVUS) measurements to determine the dose distribution within the vessel wall. Materials and methods: Ten patients were studied by intravascular ultrasound after radioactive stenting (BX Stent, P-32, 15-mm length) to obtain tomographic cross-sections of the treated segments. We developed a computer algorithm using the actual dose distribution of the stent to calculate differential and cumulative DVHs. The minimal target dose, the mean target dose, the minimal doses delivered to 10 and 90% of the adventitia (DV10, DV90), and the percentage of volume receiving a reference dose at 0.5 mm from the stent surface cumulated over 28 days were derived from the DVH plots. Results were expressed as mean±SD. Results: The mean activity of the stents was 438±140 kBq at implantation. The mean reference dose was 111±35 Gy, whereas the calculated mean target dose within the adventitia along the stent was 68±20 Gy. On average, DV90 and DV10 were 33±9 Gy and 117±41 Gy, respectively. Expanding the target volume to include 2.5-mm-long segments at the proximal and distal ends of the stent, the calculated mean target dose decreased to 55±17 Gy, and DV 90 and DV 10 were 6.4±2.4 Gy and 107±36 Gy, respectively. Conclusions: The assessment of DVHs seems in principle to be a valuable tool for both prospective and retrospective analysis of dose-distribution of radioactive stents. It may provide the basis to adapt treatment planning in coronary brachytherapy to the common standards of radiotherapy

A test to prevent subarachnoid and intravascular injections during ...

African Journals Online (AJOL)

The test involves 3 steps after removal of the filter: (i) the open end of the epidural catheter is lifted and the liquid meniscus present in the catheter is observed to drop rapidly; (H) the open end of the epidural catheter is lowered and the liquid meniscus is again observed to fill the catheter with clear liquid and no blood; (iii) the ...

Intravascular large B-cell lymphoma presenting with anasarca-type edema and acute renal failure.

Science.gov (United States)

Bilgili, Serap Gunes; Yılmaz, Deniz; Soyoral, Yasemin Usul; Karadag, Ayse Serap; Bayram, Irfan

2013-09-01

Intravascular lymphoma (IVL) is a rare extra nodal subtype (usually of B-cell origin) presenting with infiltration of large neoplastic lymphocytes into lumina of blood vessels, leading to vascular occlusion. The early diagnosis is very crucial, however it is usually diagnosed postmortem investigation in most of the cases. A 56-year-old female presented with elevated creatinine level, and anasarca-type edema that superimposed with hard, indurated, erythematous plaques extending to inguinal region, abdomen, anterior aspect of chest, and face. B-cell IVL was confirmed with skin biopsy. The patient had some degree of clinical improvement following chemotherapy. B-cell IVL presenting with anasarca edema was not previously reported in the literature. Even if its rarity, IVL should be considered in the differential diagnosis of renal failure with anasarca edema.

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 ...

Long-term tissue distribution and steady state activity ratios of 232Th and its daughters in rats after intravascular injection of thorotrast

International Nuclear Information System (INIS)

Norimura, Toshiyuki; Tsuchiya, Takehiko; Hatakeyama, Satoru; Yamamoto, Hisao; Okajima, Shunzo.

1989-01-01

To estimate the absorbed dose in the critical organs of Thorotrast patients, it is necessary to know not only the distribution and concentration of 232 Th but also its daughter nuclides in the body. The present investigation was undertaken in order to clarify the long-term 232 Th tissue distribution and steady state activity ratios between subsequent daughters in the critical tissues, using about 30 Wister male rats, as a basis for estimating absorbed doses. The tissue distribution of thorium was examined by means of an autoradiographty of the whole body and/or the gamma-ray spectrometry at various times during 2 to 24 months following injection. The concentrations of daughter nuclides in tissues were determined by repetitive gamma examination over a period from 1 hr to 35 days after being sacrificed. The data indicate (1) that approximately 90% of injected Thorotrast is retained in the body for a prolonged period, but about 50% of radium and 10% of radon produced from thorium are eliminated from the body, (2) that the mean steady state activity ratios of 224 Ra and 212 Pb to 228 Th for liver are 0.56 and 0.28, and 0.54 and 0.16 for spleen, 0.58 and 0.82 for lungs, respectively, and (3) that the parent 228 Th is translocated to the bone. (author)

Intravascular ultrasound-guided optimized stent deployment. Immediate and 6 months clinical and angiographic results from the Multicenter Ultrasound Stenting in Coronaries Study (MUSIC Study)

Science.gov (United States)

de Jaegere, P; Mudra, H; Figulla, H; Almagor, Y; Doucet, S; Penn, I; Colombo, A; Hamm, C; Bartorelli, A; Rothman, M; Nobuyoshi, M; Yamaguchi, T; Voudris, V; DiMario, C; Makovski, S; Hausmann, D; Rowe, S; Rabinovich, S; Sunamura, M; van Es, G A

1998-08-01

A study was set up to validate the safety and feasibility of intravascular ultrasound-guided stenting without subsequent anticoagulation, and its impact on the 6 months restenosis rate. The study was designed to be multicentred, prospective, and observational. One hundred and sixty-one patients with stable angina and a de novo coronary artery lesion were enrolled. In four patients, the implantation of a Palmaz-Schatz (with spiral bridge) stent had failed. One of these four patients died 3 days following bypass surgery. In two other patients, intravascular ultrasound assessment was not performed. One hundred and twenty-five of the remaining 155 patients (81%) were treated with aspirin (100 mg x day(-1)), because all three criteria for optimized stent expansion were met. Twenty-two of the remaining 38 patients (25%), in whom at least one criterion was not met were treated with aspirin and acenocoumarol (3 months, INR 2.5-3.5), while 16 patients only received aspirin. Stent thrombosis was documented in two patients (1.3%) for which repeat angioplasty was performed. During the hospital stay, there were no deaths or Q-wave myocardial infarctions. Five patients (3.2%) sustained a non-Q-wave myocardial infarction. During the follow-up period (198+/-38 days, complete for all patients, except one), one patient (0.6%) sustained a Q-wave myocardial infarction, one (0.6%) underwent bypass surgery, and repeat angioplasty was performed in nine patients (5.7%). In two of the nine patients, repeat angioplasty involved another lesion. Therefore, the target lesion revascularization rate during follow-up was 4.5% (seven patients). At quantitative coronary angiography, the minimal lumen diameter (mean+/-SD) increased from 1.12+/-0.34 mm before to 2.89+/-0.35 mm after stenting. Repeat angiography at 6 months was performed in 144 patients (92%). The minimal lumen diameter at follow-up was 2.12+/-0.67 mm. Restenosis (diameter stenosis of 50% or more) was documented in 12 patients or 8

Current (1986) status of the Japanese follow-up study of the Thorotrast patients, and its relationships to the statistical analysis of the autopsy series

International Nuclear Information System (INIS)

Mori, T.; Kumatori, T.; Hatakeyama, S.

1989-01-01

Although the Japanese Thorotrast study was limited by the number of cases that could be followed or autopsied, (286 and 333) the following conclusions were made:- 1. Shortening of the lifespan occurred in the intravascular Thorotrast follow-up cases as compared with their controls. 2. The incidence of malignant hepatic tumours, liver cirrhosis, blood diseases and carcinoma of the gall-bladder was significantly higher in the intravascular Thorotrast cases than in their controls. 3. A chronological change occurred in the distribution of histological types of Thorotrast-induced malignant hepatic tumours during the 42-year period from 1945 to 1986. 4. A significantly higher rate of malignant peritoneal tumours was proved in the intravascular Thorotrast autopsy series as compared with the control autopsy series. 5. From the relationship between the follow-up study and the autopsy series, the authors estimated that 2000-3000 Japanese lived more than 3 years after intravascular injection of Thorotrast. (author)

Human pharmacokinetics of iohexol. A new nonionic contrast medium

International Nuclear Information System (INIS)

Olsson, B.; Aulie, A.; Sveen, K.; Andrew, E.

1983-01-01

The pharmacokinetics of iohexol, a new nonionic, water-soluble contrast medium, have been determined after intravenous injection in 20 healthy volunteers, at four different dose levels (125-500 mg I/kg). The apparent volume of distribution was 0.27 1/kg, indicating distribution in the extracellular water. The biologic half-life was 121 minutes, comparable with that of other intravascular contrast media. Iohexol was excreted completely unmetabolized in the urine, with a 100% recovery 24 hours after injection. A comparison of iohexol and chromium-51 ( 51 Cr)-EDTA clearances indicates that iohexol is mainly excreted by glomerular filtration. The 51 Cr-EDTA clearance was the same when injected separately and concomitantly with iohexol, indicating that glomerular filtration rate is not affected by iohexol. No dose dependency was observed in the investigated parameters t1/2 alpha, t1/2 beta, Vd, ClT or ClR. Iohexol pharmacokinetics are in correspondence with previously reported data on intravascular contrast media

Specific features of red blood cell morphology in hemolytic disease neonates undergoing intrauterine intravascular blood transfusion

Directory of Open Access Journals (Sweden)

A. V. Ivanova

2016-01-01

Full Text Available The paper presents data on the characteristics of red blood cell morphology in infants who have undergone intrauterine intravascular blood transfusion for hemolytic disease of the fetus. The infants are shown to have a reduction in the mean volume of red blood cells and in their mean level of hemoglobin, a decrease in the fraction of fetal hemoglobin and an increase in oxygen tension at half saturation. The above morphological characteristics of red blood cells remain decreased during the neonatal period after exchange transfusion or others, as clinically indicated, which seems to suggest that the compensatory-adaptive mechanisms to regulate hematopoiesis are exhausted and a donor’s red blood cells continue to be predominant.

Risk evaluation of the alternate-3A modification to the ATWS prevention/mitigation system in a BWR-4, MARK-II power plant

International Nuclear Information System (INIS)

Papazoglou, I.A.; Bari, R.A.; Karol, R.; Shiu, K.

1983-01-01

The authors present a risk evaluation of the ATWS Alternate 3A modification proposed by NRC staff in NUREG-0460 to the ATWS prevention/mitigation system in a BWR nuclear power plant. The evaluation is done relative to three risk indices: the frequency of core damage, the expected early fatalities, and the expected latent fatalities. The ATWS prevention tree includes: the mechanical subsystem of the reactor protection system, the electrical subsystem of the reactor protection system, the recirculation pump trip and the Alternate Rod Insertion System. The mitigation tree includes: standby liquid control system, opening of the relief valves, reclosing the relief valves, failure of coolant injection, inadvertent actuation of the automatic depressurization system, inadvertent operation of high-pressure injection system and containment heat removal

A state-of-the-art review on segmentation algorithms in intravascular ultrasound (IVUS) images.

Science.gov (United States)

Katouzian, Amin; Angelini, Elsa D; Carlier, Stéphane G; Suri, Jasjit S; Navab, Nassir; Laine, Andrew F

2012-09-01

Over the past two decades, intravascular ultrasound (IVUS) image segmentation has remained a challenge for researchers while the use of this imaging modality is rapidly growing in catheterization procedures and in research studies. IVUS provides cross-sectional grayscale images of the arterial wall and the extent of atherosclerotic plaques with high spatial resolution in real time. In this paper, we review recently developed image processing methods for the detection of media-adventitia and luminal borders in IVUS images acquired with different transducers operating at frequencies ranging from 20 to 45 MHz. We discuss methodological challenges, lack of diversity in reported datasets, and weaknesses of quantification metrics that make IVUS segmentation still an open problem despite all efforts. In conclusion, we call for a common reference database, validation metrics, and ground-truth definition with which new and existing algorithms could be benchmarked.

The cerebral intravascular enhancement sign is not specific: a contrast-enhanced MRI study

Energy Technology Data Exchange (ETDEWEB)

Bakshi, R.; Kinkel, W.R.; Bates, V.E.; Mechtler, L.L.; Kinkel, P.R. [Lucy Dent Imaging Center, University at Buffalo, NY (United States)

1999-02-01

The intravascular enhancement (IVE) sign, also known as the ``arterial enhancement sign``, is an abnormal finding in the brain on contrast-enhanced MRI studies. IVE has been described in arterial cerebrovascular disorders, most commonly in acute or subacute arterial ischemic infarcts. However, the specificity of this sign has not been established. We describe four patients with disorders other than arterial strokes in whom gadolinium-enhanced high-field (1.5 T) MRI suggested IVE. The conditions were herpes simplex viral encephalitis, idiopathic cerebellitis, pneumococcal meningitis, and superior sagittal sinus thrombosis with venous infarction. IVE in these cases may be due to multiple factors, including arterial, venous, perivascular, and leptomeningeal or sulcal contrast medium accumulation. Our observations suggest that arterial ischemia, previously described as the cardinal cause of IVE, probably does not explain all instances, and urge caution in interpreting this sign as a specific MRI manifestation of acute arterial infarction or ischemia. (orig.) With 4 figs., 1 tab., 44 refs.

Validating Intravascular Imaging with Serial Optical Coherence Tomography and Confocal Fluorescence Microscopy.

Science.gov (United States)

Tardif, Pier-Luc; Bertrand, Marie-Jeanne; Abran, Maxime; Castonguay, Alexandre; Lefebvre, Joël; Stähli, Barbara E; Merlet, Nolwenn; Mihalache-Avram, Teodora; Geoffroy, Pascale; Mecteau, Mélanie; Busseuil, David; Ni, Feng; Abulrob, Abedelnasser; Rhéaume, Éric; L'Allier, Philippe; Tardif, Jean-Claude; Lesage, Frédéric

2016-12-15

Atherosclerotic cardiovascular diseases are characterized by the formation of a plaque in the arterial wall. Intravascular ultrasound (IVUS) provides high-resolution images allowing delineation of atherosclerotic plaques. When combined with near infrared fluorescence (NIRF), the plaque can also be studied at a molecular level with a large variety of biomarkers. In this work, we present a system enabling automated volumetric histology imaging of excised aortas that can spatially correlate results with combined IVUS/NIRF imaging of lipid-rich atheroma in cholesterol-fed rabbits. Pullbacks in the rabbit aortas were performed with a dual modality IVUS/NIRF catheter developed by our group. Ex vivo three-dimensional (3D) histology was performed combining optical coherence tomography (OCT) and confocal fluorescence microscopy, providing high-resolution anatomical and molecular information, respectively, to validate in vivo findings. The microscope was combined with a serial slicer allowing for the imaging of the whole vessel automatically. Colocalization of in vivo and ex vivo results is demonstrated. Slices can then be recovered to be tested in conventional histology.

Perspectives on Imaging the Left Main Coronary Artery Using Intravascular Ultrasound and Optical Coherence Tomography

Directory of Open Access Journals (Sweden)

Harry C Lowe

2015-01-01

Full Text Available Percutaneous Coronary Intervention (PCI for significant left main coronary artery (LMCA stenosis is increasingly being viewed as a viable alternative to Coronary Artery Bypass Grafting (CABG (1. This is leading to an expectation of increasing numbers of such procedures, with a consequent focus on both the ability to image both lesion severity, and assess more accurately the results of PCI. While there have been advances in physiologic assessment of left main severity using fractional flow reserve (FFR, imaging of the LMCA using Intravascular Ultrasound (IVUS and more recently Optical Coherence Tomography (OCT has the specific advantage of being able to provide detailed anatomical information both pre and post PCI, such that it is timely to review briefly the current status of these two imaging technologies in the context of LMCA intervention.

Retraction of the Plunger on a Syringe of Hyaluronic Acid Before Injection: Are We Safe?

Science.gov (United States)

Carey, Wayne; Weinkle, Susan

2015-12-01

Controversy exists concerning the need for aspiration before injection with hyaluronic acid (HA) fillers. The authors undertook a study of HA products to determine if blood could be aspirated back into a syringe of HA when the needle has been primed or filled with HA. Two studies were set up to determine if or when blood could be withdrawn from a heparinized fresh tube of blood into the HA syringe. Two different techniques were tested; one using a slow-pull retraction of the plunger and up to a 5-second waiting time before release versus a rapid pullback and quick release. Review of these data demonstrates that the usual clinical method, which involves quick withdrawal and instant release of the syringe plunger does not allow for sufficient removal of the filler found intraluminal in the needle and may give rise to false negative results in vitro and likely in vivo with the exception being the Galderma/Medicis products. In summary, withdrawal of the syringe plunger with no visible blood in the syringe does not eliminate the possibility of intravascular placement of the syringe needle.

The reasoning of the selection of local anesthetic for patients with systemic disease

Directory of Open Access Journals (Sweden)

Nasman Nur Alim

2016-06-01

upon the patient’s medical conditions. Aspiration is critical to prevent intravascular injection. Discipline in carrying out the operational standards is very important to reduce the risk unwanted things, due to local anesthesia and vasoconstrictor used.

Inadvertent recovery in communication deficits following the upper limb mirror therapy in stroke: A case report.

Science.gov (United States)

Arya, Kamal Narayan; Pandian, Shanta

2014-10-01

Broca's aphasia is the most challenging communication deficit in stroke. Left inferior frontal gyrus (IFG), a key region of the mirror-neuron system, gets lesioned in Broca's aphasia. Mirror therapy (MT), a form of action-observation, may trigger the mirror neurons. The aim of this study was to report a case of poststroke subject with Broca's aphasia, who exhibited an inadvertent and significant improvement in speech after MT for the paretic upper limb. The 20-month old stroke patient underwent MT through goal-directed tasks. He received a total absence of spontaneous speech, writing, and naming. After 45 sessions of task-based MT for the upper limb, he showed tremendous recovery in expressive communication. He had fluent and comprehensive communication; however, with a low pitch and minor pronunciation errors. He showed a substantial change (from 18/100 to 79/100) on the Communicative Effective Index, particularly, on items such as expressing emotions, one-to-one conversation, naming, and spontaneous conversation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Study for on-line system to identify inadvertent control rod drops in PWR reactors using ex-core detector and thermocouple measures

International Nuclear Information System (INIS)

Souza, Thiago J.; Medeiros, Jose A.C.C.; Goncalves, Alessandro C.

2015-01-01

Accidental control rod drops event in PWR reactors leads to an unsafe operating condition. It is important to quickly identify the rod to minimize undesirable effects in such a scenario. In this event, there is a distortion in the power distribution and temperature in the reactor core. The goal of this study is to develop an on-line model to identify the inadvertent control rod dropped in PWR reactor. The proposed model is based on physical correlations and pattern recognition of ex-core detector responses and thermocouples measures. The results of the study demonstrated the feasibility of an on-line system, contributing to safer operation conditions and preventing undesirable effects, as its shutdown. (author)

Study for on-line system to identify inadvertent control rod drops in PWR reactors using ex-core detector and thermocouple measures

Energy Technology Data Exchange (ETDEWEB)

Souza, Thiago J.; Medeiros, Jose A.C.C.; Goncalves, Alessandro C., E-mail: tsouza@nuclear.ufrj.br, E-mail: canedo@lmp.ufrj.br, E-mail: alessandro@nuclear.ufrj.br [Coordenacao dos Programas de Pos-Graduacao em Engenharia (COPPE/UFRJ), Rio de Janeiro, RJ (Brazil). Programa de Engenharia Nuclear

2015-07-01

Accidental control rod drops event in PWR reactors leads to an unsafe operating condition. It is important to quickly identify the rod to minimize undesirable effects in such a scenario. In this event, there is a distortion in the power distribution and temperature in the reactor core. The goal of this study is to develop an on-line model to identify the inadvertent control rod dropped in PWR reactor. The proposed model is based on physical correlations and pattern recognition of ex-core detector responses and thermocouples measures. The results of the study demonstrated the feasibility of an on-line system, contributing to safer operation conditions and preventing undesirable effects, as its shutdown. (author)

Thyroid storm with multiple organ failure, disseminated intravascular coagulation, and stroke with a normal serum FT3 level.

Science.gov (United States)

Harada, Yuko; Akiyama, Hisanao; Yoshimoto, Tatsuji; Urao, Yasuko; Ryuzaki, Munekazu; Handa, Michiko

2012-01-01

Thyroid storm is a rare disorder with a sudden onset, rapid progression and high mortality. We experienced a case of thyroid storm which had a devastating course, including multiple organ failure (MOF), severe hypoglycemia, disseminated intravascular coagulation (DIC), and stroke. It was difficult to make a diagnosis of thyroid storm in the present patient, because she did not have a history of thyroid disease and her serum FT3 level was normal. Clinicians should be aware that thyroid storm can occur even when there is an almost normal level of thyroid hormones, and that intensive anticoagulation is required for patients with atrial fibrillation to prevent stroke after thyroid storm.

Intravascular Lipiodol Presenting as an Atrial Mass

NARCIS (Netherlands)

Kootte, Ruud S.; Haeck, Joost D. E.; van Lienden, Krijn P.; van Boven, Wim J. P.; van der Wal, Allard C.; de Boer, Hans H.

2017-01-01

A 68-year-old woman, previously treated with embolization of the thoracic duct with Lipiodol (an ethiodized oil injection) and cyanoacrylate glue (a topical tissue adhesive), was admitted with an asymptomatic mass in the inferior vena cava (IVC) and right atrium. The mass was surgically removed, and

Reducing risk of overdose with midazolam injection in adults: an evaluation of change in clinical practice to improve patient safety in England.

Science.gov (United States)

Flood, Chris; Matthew, Linda; Marsh, Rachel; Patel, Bhavesh; Mansaray, Mariama; Lamont, Tara

2015-02-01

This study sought to evaluate potential reductions in risk associated with midazolam injection, a sedating medication, following a UK National Patient Safety Alert. This alert, 'Reducing risk of overdose with midazolam injection in adults', was sent to all National Health Service organizations as a Rapid Response Report detailing actions services should take to minimize risks. To evaluate any potential changes arising from this alert, a number of data sources were explored including reported incidents to a national reporting system for health care error, clinician survey and audit data, pharmaceutical purchasing patterns and feedback from National Health Service managers. Prior to the Rapid Response Report, 498 incidents were received by the National Patient Safety Agency including three deaths. Post-implementation of the Rapid Response Report (June 2009), no incidents resulting in death or severe harm had been received. All organizations reported having completed the Rapid Response Report actions. Purchase and use of risk-prone, high-strength sedating midazolam by health care organizations decreased significantly as did the increased use of safer, lower strength doses (as recommended in the Rapid Response Report). Organizations can achieve safer medication practices, better knowledge, awareness and implementation of national safer practice recommendations. Risks from inadvertent overdose of midazolam injection were reduced post-implementation of national recommendations. Ongoing monitoring of this particular adverse event will be required with a sustained patient safety message to health services to maintain awareness of the issue and reduction in the number of midazolam-related errors. © 2014 John Wiley & Sons, Ltd.

A Randomized, Double-Blind, Placebo-Controlled, Phase 2b Study to Evaluate the Safety and Efficacy of Recombinant Human Soluble Thrombomodulin, ART-123, in Patients With Sepsis and Suspected Disseminated Intravascular Coagulation

NARCIS (Netherlands)

Vincent, Jean-Louis; Ramesh, Mayakonda K.; Ernest, David; Larosa, Steven P.; Pachl, Jan; Aikawa, Naoki; Hoste, Eric; Levy, Howard; Hirman, Joe; Levi, Marcel; Daga, Mradul; Kutsogiannis, Demetrios J.; Crowther, Mark; Bernard, Gordon R.; Devriendt, Jacques; Puigserver, Joan Vidal; Blanzaco, Daniel U.; Esmon, Charles T.; Parrillo, Joseph E.; Guzzi, Louis; Henderson, Seton J.; Pothirat, Chaicharn; Mehta, Parthiv; Fareed, Jawed; Talwar, Deepak; Tsuruta, Kazuhisa; Gorelick, Kenneth J.; Osawa, Yutaka; Kaul, Inder

2013-01-01

Objectives: To determine the safety and efficacy of recombinant thrombomodulin (ART-123) in patients with suspected sepsis-associated disseminated intravascular coagulation. Design: Phase 2b, international, multicenter, double-blind, randomized, placebo-controlled, parallel group, screening trial.

Peptide Inhibitor of Complement C1 (PIC1 Rapidly Inhibits Complement Activation after Intravascular Injection in Rats.

Directory of Open Access Journals (Sweden)

Julia A Sharp

Full Text Available The complement system has been increasingly recognized to play a pivotal role in a variety of inflammatory and autoimmune diseases. Consequently, therapeutic modulators of the classical, lectin and alternative pathways of the complement system are currently in pre-clinical and clinical development. Our laboratory has identified a peptide that specifically inhibits the classical and lectin pathways of complement and is referred to as Peptide Inhibitor of Complement C1 (PIC1. In this study, we determined that the lead PIC1 variant demonstrates a salt-dependent binding to C1q, the initiator molecule of the classical pathway. Additionally, this peptide bound to the lectin pathway initiator molecule MBL as well as the ficolins H, M and L, suggesting a common mechanism of PIC1 inhibitory activity occurs via binding to the collagen-like tails of these collectin molecules. We further analyzed the effect of arginine and glutamic acid residue substitution on the complement inhibitory activity of our lead derivative in a hemolytic assay and found that the original sequence demonstrated superior inhibitory activity. To improve upon the solubility of the lead derivative, a pegylated, water soluble variant was developed, structurally characterized and demonstrated to inhibit complement activation in mouse plasma, as well as rat, non-human primate and human serum in vitro. After intravenous injection in rats, the pegylated derivative inhibited complement activation in the blood by 90% after 30 seconds, demonstrating extremely rapid function. Additionally, no adverse toxicological effects were observed in limited testing. Together these results show that PIC1 rapidly inhibits classical complement activation in vitro and in vivo and is functional for a variety of animal species, suggesting its utility in animal models of classical complement-mediated diseases.

Intravascular ultrasound assessment of remodelling and reference segment plaque burden in type-2 diabetic patients

DEFF Research Database (Denmark)

Jensen, Lisette Okkels; Thayssen, Per; Mintz, Gary S

2007-01-01

AIMS: Intravascular ultrasound (IVUS) assesses arterial remodelling by comparing the lesion external elastic membrane (EEM) with the reference segments; however, reference segments are rarely disease-free. The aim was to assess lesion and reference segment remodelling and plaque burden in patients...... with type-2 diabetes mellitus. METHODS AND RESULTS: We used pre-intervention IVUS to study 62 de novo lesions in 43 patients with type-2 diabetes mellitus. The lesion site was the image slice with the smallest lumen cross-sectional area (CSA). The proximal and distal reference segments were the most normal...... size [slope = -0.12 (95% CI -0.17 to -0.07); P type-2 diabetes mellitus. CONCLUSION: Lesions in type-2 diabetic patients are different from previous reports in non-diabetics. Lesions in type-2 diabetics are characterized by a large reference segment plaque burden...

Comparison of angiography and intravascular ultrasound before and after balloon angioplasty of the femoropopliteal artery

International Nuclear Information System (INIS)

Lankeren, Winnifred van; Gussenhoven, Elma J.; Pieterman, Herman; Sambeek, Marc R. H. M. van; Lugt, Aad van der

1998-01-01

Purpose: To compare angiographic and intravascular ultrasound (IVUS) data before and after balloon angioplasty (PTA) of the femoropopliteal artery.Methods: Qualitative and quantitative analyses were performed on corresponding angiographic and IVUS levels obtained from 135 patients.Results: IVUS detected more lesions, calcified lesions, and vascular damage than angiography. Sensitivity of angiography was good for the presence of a lesion (84%), moderate for eccentric lesions (53%) and for vascular damage (52%), and poor for calcified lesions (30%). The increase in angiographic diameter stenosis was associated with a decrease in lumen area and increase in percentage area stenosis on IVUS.Conclusions: Angiography is less sensitive than IVUS for detecting lesion eccentricity, calcified lesions, and vascular damage. Presence of a lesion and amount of plaque were underestimated angiographically. Only before PTA was good agreement found between angiographic diameter stenosis and lumen size on IVUS.

Hyperkalemia after irradiation of packed red blood cells: Possible effects with intravascular fetal transfusion

International Nuclear Information System (INIS)

Thorp, J.A.; Plapp, F.V.; Cohen, G.R.; Yeast, J.D.; O'Kell, R.T.; Stephenson, S.

1990-01-01

Plasma potassium, calcium, and albumin concentrations in irradiated blood, and in fetal blood before and after transfusion, were measured. Dangerously high plasma potassium levels were observed in some units of irradiated packed red blood cells (range, 13.9 to 66.5 mEq/L; mean, 44.7 mEq/L) and could be one possible explanation for the high incidence of fetal arrhythmia associated with fetal intravascular transfusion. There are many factors operative in the preparation of irradiated packed red blood cells that may predispose to high potassium levels: the age of the red blood cells, the number of procedures used to concentrate the blood, the duration of time elapsed from concentration, the duration of time elapsed from irradiation, and the hematocrit. Use of fresh blood, avoidance of multiple packing procedures, limiting the hematocrit in the donor unit to less than or equal to 80%, and minimizing the time between concentration, irradiation and transfusion may minimize the potassium levels, and therefore making an additional washing procedure unnecessary

Early Blood Transfusion and Resolution of Disseminated Intravascular Coagulation Associated with Massive Subgaleal Hemorrhage.

Science.gov (United States)

Modanlou, Houchang; Hutson, Shandee; Merritt, Allan Thurman

2016-01-01

A male infant delivered to a primipara woman following vacuum applications. He was vigorous at birth, with small caput and scalp bruising. His head was enlarging; he became pale with respiratory distress. Subgaleal hemorrhage (SGH) was suspected. His hematocrit was noted to be 26.2 percent prior to transfusion of O, Rh-negative blood (40 mL/kg). Moderate disseminated intravascular coagulation (DIC) was noted at 12 hours of age. Posttransfusion of fresh frozen plasma (FFP), his condition became stable, and DIC gradually resolved. Head magnetic resonance imaging did not show intracranial hemorrhage. Although one episode of seizures was noted, electroencephalogram was normal. With the application of obstetric vacuum, we recommend that the neonatal health care professionals frequently evaluate the infant's condition. In light of developing fluctuant subgaleal fluid associated with pallor, anemia, metabolic acidosis, and respiratory distress, immediate blood transfusion is warranted. In the presence of DIC, transfusion of FFP is beneficial.

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)

Erythrocyte creatine as a marker of intravascular hemolysis due to left ventricular outflow tract obstruction in hypertrophic cardiomyopathy.

Science.gov (United States)

Kubo, Toru; Okumiya, Toshika; Baba, Yuichi; Hirota, Takayoshi; Tanioka, Katsutoshi; Yamasaki, Naohito; Sugiura, Tetsuro; Doi, Yoshinori L; Kitaoka, Hiroaki

2016-03-01

Erythrocyte creatine, a marker of erythrocyte age that increases with shortening of erythrocyte survival, has been reported to be a quantitative and reliable marker for intravascular hemolysis. We hypothesized that hemolysis could also occur due to intraventricular obstruction in patients with hypertrophic cardiomyopathy (HCM). The purpose of this study was to examine the presence of subclinical hemolysis and the relation between intravascular hemolysis and intraventricular pressure gradient (IVPG). We measured erythrocyte creatine in 92 HCM patients. Twelve patients had left ventricular outflow tract obstruction (LVOTO), 4 had midventricular obstruction (MVO), and the remaining 76 were non-obstructive. Erythrocyte creatine levels ranged from 0.92 to 4.36μmol/g hemoglobin. Higher levels of erythrocyte creatine were associated with higher IVPG (r=0.437, pcreatine levels are high (≥1.8μmol/g hemoglobin), subclinical hemolysis is considered to be present. Half of LVOTO patients and no MVO patients showed high erythrocyte creatine levels. Although non-obstructive patients did not show significant intraventricular obstruction at rest, some showed high erythrocyte creatine levels. When LVOT-PG was measured during the strain phase of the Valsalva maneuver in 20 non-obstructive patients, 7 of those 20 patients showed LVOTO. In the 20 patients, there was no relation between erythrocyte creatine levels and LVOT-PG before the Valsalva maneuver (r=0.125, p=0.600), whereas there was a significant correlation between erythrocyte creatine and LVOT-PG provoked by the Valsalva maneuver (r=0.695, p=0.001). There is biochemical evidence of subclinical hemolysis in patients with HCM, and this hemolysis seems to be associated with LVOTO provoked by daily physical activities. Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Impact of peri-stent remodeling on restenosis: a volumetric intravascular ultrasound study.

Science.gov (United States)

Nakamura, M; Yock, P G; Bonneau, H N; Kitamura, K; Aizawa, T; Tamai, H; Fitzgerald, P J; Honda, Y

2001-05-01

Vessel remodeling is an important mechanism of late lumen loss after nonstent coronary interventions. However, its impact on in-stent restenosis has not been systematically investigated. Serial volumetric intravascular ultrasound analyses (poststent and follow-up) were performed in 55 lesions treated with a balloon-expandable stent (ACS MultiLink) using standard stent deployment techniques. The vessel volume (VV), lumen volume (LV), and volume bordered by the stent (SV) were measured using Simpson's method. The volume of plaque and neointima outside the stent (peri-stent volume, PSV) and volume of neointima within the stent (intrastent volume) were also measured. The change of each parameter during the follow-up period (follow-up minus poststent) was calculated and then divided by SV to normalize these values (designated as percent change [%]). As expected, %PSV directly correlated with %VV (Pexterior to a coronary stent occurs to a variable degree after stent implantation. There is a distinct trade-off between positive remodeling and in-stent hyperplasia: in segments in which the degree of peri-stent remodeling is less, intrastent neointimal proliferation is greater and accompanied by more significant late lumen loss.

Risk of disseminated intravascular coagulation in patients undergoing US-guided transperineal prostatic biopsy

International Nuclear Information System (INIS)

Stella, M.S.; Comparato, D.; Camici, M.; Evangelisti, L.; Gaudio, V.; De Negri, F.; Talarico, L.; Giusti, C.; Morelli, G.

1991-01-01

Disseminated intravascular coagulation (DIC) is a severe life-threatening acute bleeding disorder. Traumatized tissues, tumors, necrotic tissues, or bacterial endotoxines release similar material in the blood to the tissutal factors activating the coagulation cascade. This preliminary study was aimed at verifying the risk of DIV in patients undergoing US-guided transperineal prostatic biopsy with Chiba and Tru-Cut needles. To evaluate the activation degree of coagulation factors in the circulation, the authors measured the concentrations of urinary fibrin degradation products in 10 patients undergoing US-guided transperineal prostatic biopsy, both before and after biopsy, every second hour, for 24 hours. Every tube of urine sample contained soya bean trypsin inhibitor and bovine thrombin to prevent any further fibrin degradation during incubation period for the possible presence of blood in urine samples. The results showed that 7/10 patients had marked increase in urinary fibrin degradation product levels (up to 800 XXXX%), with a 3-phase trend: early peak after 2-6 hours, middle peak after 6-14 hours, and late peak after 18-24 hours, which proved the activation of the coagulation cascade

Acute Kidney Injury due to Menstruation-related Disseminated Intravascular Coagulation in an Adenomyosis Patient: A Case Report

Science.gov (United States)

Son, Jungmin; Seong, Eun Young; Song, Sang Heon; Lee, Soo Bong; Kang, Jin; Yang, Byeong Yun; Lee, Su Jin; Choi, Jong-Ryeol; Lee, Kyu-Sup; Kwak, Ihm Soo

2010-01-01

The authors report a case of acute kidney injury (AKI) resulting from menstruation-related disseminated intravascular coagulation (DIC) in an adenomyosis patient. A 40-yr-old woman who had received gonadotropin for ovulation induction therapy presented with anuria and an elevated serum creatinine level. Her medical history showed primary infertility with diffuse adenomyosis. On admission, her pregnancy test was negative and her menstrual cycle had started 1 day previously. Laboratory data were consistent with DIC, and it was believed to be related to myometrial injury resulting from heavy intramyometrial menstrual flow. Gonadotropin is considered to play an important role in the development of fulminant DIC. This rare case suggests that physicians should be aware that gonadotropin may provoke fulminant DIC in women with adenomyosis. PMID:20808684

A new method for real-time co-registration of 3D coronary angiography and intravascular ultrasound or optical coherence tomography

Energy Technology Data Exchange (ETDEWEB)

Carlier, Stéphane, E-mail: sgcarlier@hotmail.com [Department of Cardiology, Universitair Ziekenhuis - UZ Brussel, Brussels (Belgium); Department of Cardiology, Erasme University Hospital, Université Libre de Bruxelles (ULB), Brussels (Belgium); Didday, Rich [INDEC Medical Systems Inc., Santa Clara, CA (United States); Slots, Tristan [Pie Medical Imaging BV, Maastricht (Netherlands); Kayaert, Peter; Sonck, Jeroen [Department of Cardiology, Universitair Ziekenhuis - UZ Brussel, Brussels (Belgium); El-Mourad, Mike; Preumont, Nicolas [Department of Cardiology, Erasme University Hospital, Université Libre de Bruxelles (ULB), Brussels (Belgium); Schoors, Dany; Van Camp, Guy [Department of Cardiology, Universitair Ziekenhuis - UZ Brussel, Brussels (Belgium)

2014-06-15

We present a new clinically practical method for online co-registration of 3D quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) or optical coherence tomography (OCT). The workflow is based on two modified commercially available software packages. Reconstruction steps are explained and compared to previously available methods. The feasibility for different clinical scenarios is illustrated. The co-registration appears accurate, robust and induced a minimal delay on the normal cath lab activities. This new method is based on the 3D angiographic reconstruction of the catheter path and does not require operator’s identification of landmarks to establish the image synchronization.

A new method for real-time co-registration of 3D coronary angiography and intravascular ultrasound or optical coherence tomography

International Nuclear Information System (INIS)

Carlier, Stéphane; Didday, Rich; Slots, Tristan; Kayaert, Peter; Sonck, Jeroen; El-Mourad, Mike; Preumont, Nicolas; Schoors, Dany; Van Camp, Guy

2014-01-01

We present a new clinically practical method for online co-registration of 3D quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) or optical coherence tomography (OCT). The workflow is based on two modified commercially available software packages. Reconstruction steps are explained and compared to previously available methods. The feasibility for different clinical scenarios is illustrated. The co-registration appears accurate, robust and induced a minimal delay on the normal cath lab activities. This new method is based on the 3D angiographic reconstruction of the catheter path and does not require operator’s identification of landmarks to establish the image synchronization

Intravascular ultrasound as a novel tool for the diagnosis and targeted treatment of functional popliteal artery entrapment syndrome

Directory of Open Access Journals (Sweden)

Anna E. Boniakowski, MD

2017-06-01

Full Text Available Functional popliteal artery entrapment syndrome can be difficult to diagnose, as the imaging modalities presently employed are designed to detect anatomic entrapment. We describe a novel imaging technique to aid in diagnosis in this cohort. A 22-year-old cyclist presented with exercise-limiting claudication. Magnetic resonance angiography with provocative maneuvers was nondiagnostic. Digital subtraction angiography revealed long-segment occlusion of the popliteal artery with plantar flexion; however, the specific site of compression remained unclear. Intravascular ultrasound allowed specific localization of compression and further confirmed the diagnosis. Thus, we report this as an adjunctive imaging modality to definitively diagnose functional popliteal artery entrapment syndrome and to assist in operative planning.

Multicompartmental analysis of the kinetics of monoclonal antibody in cancer patients

International Nuclear Information System (INIS)

Koizumi, K.; De Nardo, G.L.; De Nardo, S.J.; Peng, J.S.; Macey, D.J.; Hisada, K.; Tonami, N.

1985-01-01

Multicompartmental models were applied for analysis of kinetics of iodide labeled monoclonal antibody in cancer patients. About 14 compartments such as intravascular antibody pool, interstitial antibody pool, antibody processors, tumor antigen site, intravascular immune complex pool, intravascular iodide pool, and urine iodide pool were assumed. This model accounts for three molecular species, the antibody, and antibody complex, and free iodide or iodinated peptides. Patients were injected with I-123-Lym-1 IgG2a (anti B cell lymphoma antibody). After injection, blood and urine samples were sequentially collected. Plasma and urine were separated by HPLC into fractions of intact antibody, immune complex, and free iodide. This information was used for input data in the theoretical model. SAAM computer program was used to solve these compartmental models. Published linear rate constants for human serum albumin and human non-immune IgG were initially used. However, data calculated from the model differed from observed curves in several respects. The kinetics of mouse monoclonal antibody, a foreign protein in a patient, were significantly different from those reported for human IgG. When a nonlinear, saturable hepatic processor was incorporated in the model, calculated data fit the observed data better. This kinetic model provides a basis for calculating radiation doses for radioiodinated antibodies

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 ...

In Vitro Capture of Small Ferrous Particles with a Magnetic Filtration Device Designed for Intravascular Use with Intraarterial Chemotherapy: Proof-of-Concept Study.

Science.gov (United States)

Mabray, Marc C; Lillaney, Prasheel; Sze, Chia-Hung; Losey, Aaron D; Yang, Jeffrey; Kondapavulur, Sravani; Liu, Derek; Saeed, Maythem; Patel, Anand; Cooke, Daniel; Jun, Young-Wook; El-Sayed, Ivan; Wilson, Mark; Hetts, Steven W

2016-03-01

To establish that a magnetic device designed for intravascular use can bind small iron particles in physiologic flow models. Uncoated iron oxide particles 50-100 nm and 1-5 µm in size were tested in a water flow chamber over a period of 10 minutes without a magnet (ie, control) and with large and small prototype magnets. These same particles and 1-µm carboxylic acid-coated iron oxide beads were likewise tested in a serum flow chamber model without a magnet (ie, control) and with the small prototype magnet. Particles were successfully captured from solution. Particle concentrations in solution decreased in all experiments (P particles in water with a large magnet), 97% (50-100-nm particles in water with a small magnet), 99% (1-5-µm particles in water with a large magnet), 99% (1-5-µm particles in water with a small magnet), 95% (50-100-nm particles in serum with a small magnet), 92% (1-5-µm particles in serum with a small magnet), and 75% (1-µm coated beads in serum with a small magnet) lower compared with matched control runs. This study demonstrates the concept of magnetic capture of small iron oxide particles in physiologic flow models by using a small wire-mounted magnetic filter designed for intravascular use. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

Increased transvascular escape rate of albumin during experimental portal and hepatic venous hypertension in the pig. Relation to findings in patients with cirrhosis of the liver

DEFF Research Database (Denmark)

Henriksen, Jens Henrik Sahl; Parving, H H; Christiansen, L

1981-01-01

Transvascular escape rate of albumin [TERalb, i.e. the fraction of the intravascular mass of albumin (IVMalb) passing to the extravascular space per unit time] was determined from the disappearance of i.v. injected radioiodinated serum albumin in anaesthetized pigs during control conditions...

Comparison of resistive heating and forced-air warming to prevent inadvertent perioperative hypothermia.

Science.gov (United States)

John, M; Crook, D; Dasari, K; Eljelani, F; El-Haboby, A; Harper, C M

2016-02-01

Forced-air warming is a commonly used warming modality, which has been shown to reduce the incidence of inadvertent perioperative hypothermia (heating mattresses offer a potentially cheaper alternative, however, and one of the research recommendations from the National Institute for Health and Care Excellence was to evaluate such devices formally. We conducted a randomized single-blinded study comparing perioperative hypothermia in patients receiving resistive heating or forced-air warming. A total of 160 patients undergoing non-emergency surgery were recruited and randomly allocated to receive either forced-air warming (n=78) or resistive heating (n=82) in the perioperative period. Patient core temperatures were monitored after induction of anaesthesia until the end of surgery and in the recovery room. Our primary outcome measures included the final intraoperative temperature and incidence of hypothermia at the end of surgery. There was a significantly higher rate of hypothermia at the end of surgery in the resistive heating group compared with the forced-air warming group (P=0.017). Final intraoperative temperatures were also significantly lower in the resistive heating group (35.9 compared with 36.1°C, P=0.029). Hypothermia at the end of surgery in both warming groups was common (36% forced air warming, 54% resistive heating). Our results suggest that forced-air warming is more effective than resistive heating in preventing postoperative hypothermia. NCT01056991. © The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Presencia de Inmunocomplejos circulantes y alteraciones del sistema complemento en pacientes con leucemia promielocítica y coagulación intravascular diseminada Presence of circulating immune complexes and alterations of the complement system in patients with promyelocytic leukaemia and disseminates intravascular coagulation

Directory of Open Access Journals (Sweden)

Rinaldo Villaescusa Blanco

1999-04-01

Full Text Available Se efectuó la determinación de inmunocomplejos circulantes (ICC así como la medición del sistema complemento por la vía clásica, vía alterna, actividad del factor B y la cuantificación del tercer (C3 y cuarto (C4 componentes de complemento en 30 pacientes con leucemia promielocítica (LPM al diagnóstico, 22 de los cuales presentaron coagulación intravascular diseminada (CID. Se demostró la existencia de niveles elevados de ICC en los enfermos con CID y una disminución significativa de la actividad de la vía clásica, los componentes C3 y C4 en los enfermos con CID, al compararlos con el grupo de pacientes que no presentaba el trastorno de la hemostasia y los controles normales, lo que sugiere la posible participación de estos parámetros en el fenómeno de la CID en estos enfermosThe determination of the circulating immunecomplexes (CIC as well as the measurement of the complement system were carried out by the classical pathway, alternate pathway, factor B activity and the quantitation of the third (C3 and fourth (C4 components of the complement in 30 patients with promyelocytic leukaemia (PML on diagnosis, 22 of whom presented disseminated intravascular coagulation (DIC. It was proved the existance of elevated levels of CIC in patients with DIC and a marked reduction of the ativity of the classical pathway and of the C3 and C4 components in patients with DIC, on comparing them with the group of patients that did not have hemostasis disorder and with the normal controls, which suggest the possible participation of these parameters in the phenomenon of DIC in these patients

Linear-regression convolutional neural network for fully automated coronary lumen segmentation in intravascular optical coherence tomography

Science.gov (United States)

Yong, Yan Ling; Tan, Li Kuo; McLaughlin, Robert A.; Chee, Kok Han; Liew, Yih Miin

2017-12-01

Intravascular optical coherence tomography (OCT) is an optical imaging modality commonly used in the assessment of coronary artery diseases during percutaneous coronary intervention. Manual segmentation to assess luminal stenosis from OCT pullback scans is challenging and time consuming. We propose a linear-regression convolutional neural network to automatically perform vessel lumen segmentation, parameterized in terms of radial distances from the catheter centroid in polar space. Benchmarked against gold-standard manual segmentation, our proposed algorithm achieves average locational accuracy of the vessel wall of 22 microns, and 0.985 and 0.970 in Dice coefficient and Jaccard similarity index, respectively. The average absolute error of luminal area estimation is 1.38%. The processing rate is 40.6 ms per image, suggesting the potential to be incorporated into a clinical workflow and to provide quantitative assessment of vessel lumen in an intraoperative time frame.

Epidemiological follow-up study of Japanese Thorotrast cases

International Nuclear Information System (INIS)

Mori, T.; Maruyama, T.; Kato, Y.; Takahashi, S.

1979-01-01

The authors conducted a follow-up study on 243 Thorotrast-administered war-wounded ex-servicemen in 1975, after a lapse of 30 to 38 years from Thorotrast injections, and found 18 cases of malignant hepatic tumor, 15 cases of other malignant tumors, 2 cases of blood diseases, and 9 cases of liver cirrhosis in 224 cases who had been given Thorotrast intravascularly. The incidence of hepatic and other malignant tumors, blood diseases, and liver cirrhosis was significantly higher than in the controls. The total number of deaths in the Thorotrast-administered cases was also significantly higher than in the controls. In the remaining 19 cases who had been given Thorotrast by a route other than intravascularly, no fatal case related to Thorotrast administration was discovered. In the living cases, however, one sarcoma was observed to have developed at the site of the Thorotrast injection

Clinical application of intravascular administration of non-ionic, low osmolar contrast agent, Ioversol (Optiray 320) and its side effects comparison with Meglumine Iothalamate (Conray 60)

International Nuclear Information System (INIS)

Hong, Hyun Sook; Kim, Dae Ho; Lee, Hae Kyung; Chung, Moo Chan; Choi, Deuk Lin; Kwon, Kuy Hyang; Kim, Ki Jung

1990-01-01

Ioversol, the non-ionic, low osmolar contrast agent has been well characterized chemically and in terms of basic toxicity testing. Ioversol has a fomula similar to that of other nonionic agent. We review the results of intravascular use of this contrast agent, compared ionic contrast media(Meglumine Iothalamate (Conray 60)). Each study was assessed for imaging quality,and patients were monitored vital signs, changes of hematology and blood chemistry and urinalysis before and after contrast administration and were observed for occurrence of side effects. A small number of side effects were reported but no clinically significant sequelae in Ioversol group and much less vital sign changes compared with Conray group. There were no significant changes in vital signs related to the use of Ioversol, and no significant alterations in the renal function parameter or other blood chemistry and hematology measurement were encountered in both contrast media. In most cases, the image qualities were good. In conclusion, Ioversol is safe, well tolerated and efficious for use in intravascular contrast agent, and less vital sign changes and side effect than ionic Meglumine Iothalamte, and Ioversol is likely to provide a useful and acceptable alternative to other low osmolar and nonionic contrast agents

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-.

Influence of high-dose lipid lowering treatment compared to low-dose lipid lowering treatment on plaque composition assessed by intravascular ultrasound virtual histology in patients with ST-segment elevation acute myocardial infarction

DEFF Research Database (Denmark)

Egede, Rasmus; Jensen, Lisette Okkels; Hansen, Henrik Steen

2013-01-01

Aims: The aim of this study was to evaluate the effect of low-dose versus high-dose rosuvastatin therapy on the necrotic core content in coronary plaques of angiographic non-significant lesions as assessed by intravascular ultrasound - virtual histology. Methods and results: Eighty-seven statin...

An automated approach for segmentation of intravascular ultrasound images based on parametric active contour models

International Nuclear Information System (INIS)

Vard, Alireza; Jamshidi, Kamal; Movahhedinia, Naser

2012-01-01

This paper presents a fully automated approach to detect the intima and media-adventitia borders in intravascular ultrasound images based on parametric active contour models. To detect the intima border, we compute a new image feature applying a combination of short-term autocorrelations calculated for the contour pixels. These feature values are employed to define an energy function of the active contour called normalized cumulative short-term autocorrelation. Exploiting this energy function, the intima border is separated accurately from the blood region contaminated by high speckle noise. To extract media-adventitia boundary, we define a new form of energy function based on edge, texture and spring forces for the active contour. Utilizing this active contour, the media-adventitia border is identified correctly even in presence of branch openings and calcifications. Experimental results indicate accuracy of the proposed methods. In addition, statistical analysis demonstrates high conformity between manual tracing and the results obtained by the proposed approaches.

A century of indicator dilution technique

DEFF Research Database (Denmark)

Henriksen, Jens H; Jensen, Gorm B; Larsson, Henrik B W

2014-01-01

This review imparts the history and the present status of the indicator dilution technique with quantitative bolus injection. The first report on flow measurement with this technique appeared 100 years ago. In 1928, the use of intravascular dyes made possible a widespread application in animals...

A new method for real-time co-registration of 3D coronary angiography and intravascular ultrasound or optical coherence tomography.

Science.gov (United States)

Carlier, Stéphane; Didday, Rich; Slots, Tristan; Kayaert, Peter; Sonck, Jeroen; El-Mourad, Mike; Preumont, Nicolas; Schoors, Dany; Van Camp, Guy

2014-06-01

We present a new clinically practical method for online co-registration of 3D quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) or optical coherence tomography (OCT). The workflow is based on two modified commercially available software packages. Reconstruction steps are explained and compared to previously available methods. The feasibility for different clinical scenarios is illustrated. The co-registration appears accurate, robust and induced a minimal delay on the normal cath lab activities. This new method is based on the 3D angiographic reconstruction of the catheter path and does not require operator's identification of landmarks to establish the image synchronization. Copyright © 2014 Elsevier Inc. All rights reserved.

Intravascular ultrasound guided directional atherectomy versus directional atherectomy guided by angiography for the treatment of femoropopliteal in-stent restenosis

Science.gov (United States)

Krishnan, Prakash; Tarricone, Arthur; K-Raman, Purushothaman; Majeed, Farhan; Kapur, Vishal; Gujja, Karthik; Wiley, Jose; Vasquez, Miguel; Lascano, Rheoneil A.; Quiles, Katherine G.; Distin, Tashanne; Fontenelle, Ran; Atallah-Lajam, Farah; Kini, Annapoorna; Sharma, Samin

2017-01-01

Background: The aim of this study was to compare 1-year outcomes for patients with femoropopliteal in-stent restenosis using directional atherectomy guided by intravascular ultrasound (IVUS) versus directional atherectomy guided by angiography. Methods and results: This was a retrospective analysis for patients with femoropopliteal in-stent restenosis treated with IVUS-guided directional atherectomy versus directional atherectomy guided by angiography from a single center between March 2012 and February 2016. Clinically driven target lesion revascularization was the primary endpoint and was evaluated through medical chart review as well as phone call follow up. Conclusions: Directional atherectomy guided by IVUS reduces clinically driven target lesion revascularization for patients with femoropopliteal in-stent restenosis. PMID:29265002

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.

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.

Protein Z efficiently depletes thrombin generation in disseminated intravascular coagulation with poor prognosis.

Science.gov (United States)

Lee, Nuri; Kim, Ji-Eun; Gu, Ja-Yoon; Yoo, Hyun Ju; Kim, Inho; Yoon, Sung-Soo; Park, Seonyang; Han, Kyou-Sup; Kim, Hyun Kyung

2016-01-01

Disseminated intravascular coagulation (DIC) is characterized by consumption of coagulation factors and anticoagulants. Thrombin generation assay (TGA) gives useful information about global hemostatic status. We developed a new TGA system that anticoagulant addition can deplete thrombin generation in plasma, which may reflect defective anticoagulant system in DIC. TGAs were measured on the calibrated automated thrombogram with and without thrombomodulin or protein Z in 152 patients who were suspected of having DIC, yielding four parameters including lag time, endogenous thrombin potential, peak thrombin and time-to-peak in each experiment. Nonsurvivors showed significantly prolonged lag time and time-to-peak in TGA-protein Z system, which was performed with added protein Z. In multivariate Cox regression analysis, lag time and time-to-peak in TGA system were significant independent prognostic factors. In TGA-protein Z system, lag time and time-to-peak were revealed as independent prognostic factors of DIC. Protein Z addition could potentiate its anticoagulant effect in DIC with poor prognosis, suggesting the presence of defective protein Z system. The prolonged lag time and time-to-peak in both TGA and TGA-protein Z systems are expected to be used as independent prognostic factors of DIC.

Linfoma intravascular do pulmão: A propósito de um caso clínico com boa resposta à terapêutica

Directory of Open Access Journals (Sweden)

M. Felizardo

2008-11-01

Full Text Available Resumo: O linfoma intravascular é uma forma muito rara de linfoma não Hodgkin de células grandes B. Caracte-riza-se pela proliferação celular tumoral de linfócitos limitada aos pequenos vasos, particularmente nos capilares. Apresentamos o caso de uma doente de 54 anos, não fumadora, que foi admitida no nosso hospital para investigação de um quadro com quatro meses de evolução de febre, sudorese nocturna, emagrecimento não quantificado e dispneia progressiva. Ao exame objectivo apresentava-se febril, taquicárdica e polipneica. Analiticamente, destacava-se anemia, leucocitose e LDH elevada. Gasometria arterial -FiO2 1 l/m: PaO2-63,6 mm Hg. A telerradiografia de tórax revelava infiltado intersticial difuso. Foram excluídas todas as causas de febre de origem indeterminada. O diagnóstico foi realizado por biópsia pulmonar cirúrgica e foi prescrita terapêutica citostática combinada e rituximab com boa resposta clínica. Relatamos o caso pela dificuldade diagnóstica e pela boa resposta à terapêutica.Rev Port Pneumol 2008; XIV (6: 857-868 Abstract: Intravascular lymphoma is a very rare form of large B cell non-Hodgkin’s lymphoma, characterised by the presence of lymphoma cells in the lumina of small vessels only, particulary in the capillaries. We report a 54 year-old female non-smoker, admitted to hospital for further examination of a four month long clinical condition involving high fever, night sweats, unqualified weight loss and progressive dyspnea. Patient’s temperature was 38.5 ºC, pulse 100/min and respiratory 22 cycles/min.Patient’s haemoglobin was 9.4 g/dL, she had leukocytosis, elevated LDH and arterial blood gas analysis with moderate hypoxaemia (FiO2 1 l/m: PaO2-63.6 mm Hg. Chest X-ray revealed diffuse interstitial changes. All the possible causes of unknown origin fever were excluded.Diagnosis was made through lung biopsy and treatment

"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.

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

International Nuclear Information System (INIS)

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

2013-01-01

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

CT-guided injection for ganglion impar blockade: a radiological approach to the management of coccydynia

International Nuclear Information System (INIS)

Datir, A.; Connell, D.

2010-01-01

-guided injection over those performed under fluoroscopy may include accurate and confident needle placement in the sacro-coccygeal region, ease of wide area coverage, lesser risk of complications due to inadvertent injections into the major pelvic structures, and increased likelihood of reaching the ganglion impar, especially in cases with anatomical variation in the ganglion impar location. These factors may have implications in the overall success rate of ganglion impar blockade.

CT-guided injection for ganglion impar blockade: a radiological approach to the management of coccydynia

Energy Technology Data Exchange (ETDEWEB)

Datir, A., E-mail: apdatir@gmail.co [Jackson Memorial Hospital, Miami, FL (United States); Connell, D. [Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex (United Kingdom)

2010-01-15

-guided injection over those performed under fluoroscopy may include accurate and confident needle placement in the sacro-coccygeal region, ease of wide area coverage, lesser risk of complications due to inadvertent injections into the major pelvic structures, and increased likelihood of reaching the ganglion impar, especially in cases with anatomical variation in the ganglion impar location. These factors may have implications in the overall success rate of ganglion impar blockade.

The social image of drinking - mass media campaigns may inadvertently increase binge drinking.

Science.gov (United States)

Zimmermann, Friederike; Kohlmann, Karoline; Monter, Anne; Ameis, Nina

2017-10-01

Mass media campaigns that promote responsible drinking are rarely tested for their usefulness in reducing heavy alcohol consumption. Existing campaigns that appeal to responsible drinking while simultaneously displaying young people in social drinking situations may even have paradoxical effects. To examine such possible effects, we drew on a real-world media campaign, which we systematically modified on the basis of recent prototype research. We pilot tested questionnaires (using n = 41 participants), developed two different sets of posters in the style of an existing campaign (n = 39) and investigated their effectiveness (n = 102). In the main study, young men were randomly assigned to one of three conditions: sociable or unsociable binge drinker prototype condition or a control group. Outcome variables were intention, behavioural willingness, attitude, subjective norm, self-efficacy, prototype evaluation and prototype similarity with respect to binge drinking. Binge drinking as a habit was included to control for the fact that habitual drinking in social situations is hard to overcome and poses a particular challenge to interventions. The manipulation check showed that the experimental variation (sociable vs. unsociable drinker prototype condition) was successful. Results of the main study showed that the sociable drinker prototype condition resulted in a higher willingness and - for those with less of a habit - a higher intention to binge drink the next weekend. The unsociable drinker prototype condition had no effects. The results imply that the social components of mass media campaigns might inadvertently exacerbate binge drinking in young men. We therefore advocate against campaigns including aspects of alcohol consumption that might be positively associated with drinker prototype perception. Finally, we provide suggestions for future research.

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.

Transcapillary escape rate of albumin and right atrial pressure in chronic congestive heart failure before and after treatment

DEFF Research Database (Denmark)

Hesse, B; Parving, H H; Lund-Jacobsen, H

1976-01-01

The transcapillary escape rate of albumin (TERalb), i.e., the fraction of intravascular mass of albumin that passes to the extravascular space per unit of time, was determined from the disappearance of intravenously injected 125I-labeled human serum albumin during the first 60 minutes after injec...

Determination of albumin transport rate between plasma and peritoneal space in decompensated cirrhosis

DEFF Research Database (Denmark)

Ring-Larsen, H; Henriksen, Jens Henrik Sahl

1984-01-01

Plasma-to-peritoneal transport rate of albumin (TERperit.space) was determined in eighteen patients with decompensated cirrhosis by sampling ascitic fluid after i.v. injection of 125I-labelled serum albumin. Median TERperit.space was 0.30% of the intravascular albumin mass (IVM) per hour (range 0...

Noninvasive in vivo plasma volume and hematocrit in humans: observing long-term baseline behavior to establish homeostasis for intravascular volume and composition

Science.gov (United States)

Dent, Paul; Deng, Bin; Goodisman, Jerry; Peterson, Charles M.; Narsipur, Sriram; Chaiken, J.

2016-04-01

A new device incorporating a new algorithm and measurement process allows simultaneous noninvasive in vivo monitoring of intravascular plasma volume and red blood cell volume. The purely optical technique involves probing fingertip skin with near infrared laser light and collecting the wavelength shifted light, that is, the inelastic emission (IE) which includes the unresolved Raman and fluorescence, and the un-shifted emission, that is, the elastic emission (EE) which includes both the Rayleigh and Mie scattered light. Our excitation and detection geometry is designed so that from these two simultaneous measurements we can calculate two parameters within the single scattering regime using radiation transfer theory, the intravascular plasma volume fraction and the red blood cell volume fraction. Previously calibrated against a gold standard FDA approved device, 2 hour monitoring sessions on three separate occasions over a three week span for a specific, motionless, and mostly sleeping individual produced 3 records containing a total of 5706 paired measurements of hematocrit and plasma volume. The average over the three runs, relative to the initial plasma volume taken as 100%, of the plasma volume±1σ was 97.56+/-0.55 or 0.56%.For the same three runs, the average relative hematocrit (Hct), referenced to an assumed initial value of 28.35 was 29.37+/-0.12 or stable to +/-0.4%.We observe local deterministic circulation effects apparently associated with the pressure applied by the finger probe as well as longer timescale behavior due to normal ebb and flow of internal fluids due to posture changes and tilt table induced gravity gradients.

Application of intravascular ultrasound in percutaneous coronary interventional therapy

International Nuclear Information System (INIS)

Wang Jingping; Li Bao; An Jian; Yang Bin; Wang Zhongchao; Wang Rijun; Zhang Wutang; Lei Xinyu; Wang Huixian; Lu Lifang; Gao Yongli

2009-01-01

Objective: To evaluate intravascular ultrasound (IVUS)in demonstrating the characteristics of coronary plaque and in implanting the coronary stent. Methods: Before stent implantation, IVUS was used to observe the plaque character/sties(soft, fibrotic, calcified or mixed) as well as the eccentric degree in 28 patients with angiographically-proved single coronary branch lesion. The minimal luminal diameter, minimal cross-sectional area and plaque area were measured. After stent deployment the above measurements were repeated, and the location, symmetrical index and expansion of the stent were observed. Results: A total of 36 stents was implanted in 28 patients with coronary disease. After the procedure the minimal luminal diameter and the minimal cross-sectional area was increased, while the plaque area was decreased. The difference between the values before and after the stent implantation was statistically significant (P<0.01). IVUS after stent deployment found that in all cases the stent had a nice location and covered the lesion completely with no interlayer at its both ends. Excellent expansion of the stent was seen in 30 cases (83.3%). Insufficient expansion occurred in 3 cases and undesirable contact of the stent to the arterial wall was found in 3 cases (16.7%). In such circumstances, one size bigger low-compliance balloon dilatation was adopted, or the original balloon was used again with higher pressure (18-22 atm), in order to expand the stent once more, and good results accord with IVUS optimal criteria were obtained. Conclusions: IVUS can clearly demonstrate the pathological features of the coronary lesions, such as plaque type, eccentric degree, luminal diameter, cross-sectional area and plaque area, which are very helpful in guiding the selection of the proper stent before the procedure, and are also very useful in evaluating the location, expansion of the stent as well as the stent-to-wall contact condition after the procedure. (authors)

Increased transcapillary escape rate of albumin in patients with cirrhosis of the liver

DEFF Research Database (Denmark)

Parving, H H; Ranek, L; Lassen, N A

1977-01-01

The transcapillary escape rate of albumin (TERalb), i.e. the fraction of intravascular mass of albumin that passes to the extravascular space per unit time, was determined from the disappearance of intravenously injected 125I-labelled human serum albumin during the first 60 min after injection...... in nine patients with cirrhosis of the liver. Six of the patients had ascites. The wedged hepatic venous pressure or splenic pulp pressure ranged from 20 to 30 mmHg, mean 26 mmHg. Plasma albumin concentration was low, but plasma volume was slightly enlarged, and thus the intravascular mass of albumin...... was only moderately reduced. The transcapillary escape rate of albumin was significantly elevated in all the cirrhotics, mean 10.2%/h, range 8.8 to 12.3%/h, in comparison to values for twenty-eight normal subjects 5.4%/h, range 3.5-7.2%/h. Our results can best be explained by increased filtration out...

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

Linear-regression convolutional neural network for fully automated coronary lumen segmentation in intravascular optical coherence tomography.

Science.gov (United States)

Yong, Yan Ling; Tan, Li Kuo; McLaughlin, Robert A; Chee, Kok Han; Liew, Yih Miin

2017-12-01

Intravascular optical coherence tomography (OCT) is an optical imaging modality commonly used in the assessment of coronary artery diseases during percutaneous coronary intervention. Manual segmentation to assess luminal stenosis from OCT pullback scans is challenging and time consuming. We propose a linear-regression convolutional neural network to automatically perform vessel lumen segmentation, parameterized in terms of radial distances from the catheter centroid in polar space. Benchmarked against gold-standard manual segmentation, our proposed algorithm achieves average locational accuracy of the vessel wall of 22 microns, and 0.985 and 0.970 in Dice coefficient and Jaccard similarity index, respectively. The average absolute error of luminal area estimation is 1.38%. The processing rate is 40.6 ms per image, suggesting the potential to be incorporated into a clinical workflow and to provide quantitative assessment of vessel lumen in an intraoperative time frame. (2017) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

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.

Development of an intravascular ultrasound elastography based on a dual-element transducer

Science.gov (United States)

Shih, Cho-Chiang; Chen, Pei-Yu; Ma, Teng; Zhou, Qifa; Shung, K. Kirk; Huang, Chih-Chung

2018-04-01

The ability to measure the elastic properties of plaques and vessels would be useful in clinical diagnoses, particularly for detecting a vulnerable plaque. This study demonstrates the feasibility of the combination of intravascular ultrasound (IVUS) and acoustic radiation force elasticity imaging for detecting the distribution of stiffness within atherosclerotic arteries ex vivo. A dual-frequency IVUS transducer with two elements was used to induce the propagation of the shear wave (by the 8.5 MHz pushing element) which could be simultaneously monitored by the 31 MHz imaging element. The wave-amplitude image and the wave-velocity image were reconstructed by measuring the peak displacement and wave velocity of shear wave propagation, respectively. System performance was verified using gelatin phantoms. The phantom results demonstrate that the stiffness differences of shear modulus of 1.6 kPa can be distinguished through the wave-amplitude and wave-velocity images. The stiffness distributions of the atherosclerotic aorta from a rabbit were obtained, for which the values of peak displacement and the shear wave velocity were 3.7 ± 1.2 µm and 0.38 ± 0.19 m s-1 for the lipid-rich plaques, and 1.0 ± 0.2 µm and 3.45 ± 0.45 m s-1 for the arterial walls, respectively. These results indicate that IVUS elasticity imaging can be used to distinguish the elastic properties of plaques and vessels.

Safety significance of inadvertent operation of motor-operated valves in nuclear power plants

International Nuclear Information System (INIS)

Ruger, C.J.; Higgins, J.C.; Carbonaro, J.F.; Hall, R.E.

1994-01-01

Concerns about the consequences of valve mispositioning were brought to the forefront following an event at Davis Besse in 1985. The concern related to the ability to reposition open-quotes position-changeableclose quotes motor-operated valves (MOVs) from the control room in the event of their inadvertent operation and was documented in U.S. Nuclear Regulatory Commission (USNRC) Bulletin 85-03 and Generic Letter (GL) 89-10. The mispositioned MOVs may not be able to be returned to their required position due to high differential pressure or high flow conditions across the valves. The inability to reposition such valves may have significantly safety consequences, as in the Davis Besse event. However, full consideration of such mispositioning in safety analyses and in MOV test programs can be labor intensive and expensive. Industry raised concerns that consideration of position-changeable valves under GL 89-10 would not decrease the probability of core damage to an extent that would justify licensee costs. As a response, Brookhaven National Laboratory has conducted separate scoping studies for both boiling water reactors (BWRs) and pressurized water reactors (PWRs) using probabilistic risk assessment (PRA) techniques to determine if such valve mispositioning by itself is significant to safety. The approach used internal events PRA models to survey the order of magnitude of the risk-significance of valve mispositioning by considering the failure of selected position-changeable MOVs. The change in core damage frequency was determined for each valve considered, and the results were presented as a risk increase ratio for each of four assumed MOV failure rates. The risk increase ratios resulting from this failure rate sensitivity study can be used as a basis for a determination of the risk-significance of the MOV mispositioning issues for BWRs and PWRs

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.

Persistent lesion hyperintensity on brain diffusion-weighted MRI is an early sign of intravascular lymphoma.

Science.gov (United States)

Kageyama, Takashi; Yamanaka, Haruo; Nakamura, Fumihiko; Suenaga, Toshihiko

2017-06-08

A 63-year-old man presented with right-sided hemianopia and unsteady gait. Brain MRI revealed multiple hyperintense infarct-like lesions on diffusion-weighted images (DWI). Hyperintensity persisted in some of these lesions even after 6 weeks, although his symptoms were ameliorated then. The patient developed episodic dizziness and a transient event of apraxia at 18 weeks after the first episode. Brain MRI revealed additional hyperintense lesions on DWI, which persisted even after 7 weeks. Eventually, the patient manifested cauda equina syndrome 39 weeks after the first episode. Brain MRI showed the presence of new lesions in addition to the persistent hyperintense lesions on DWI over 21 weeks in the right frontal lobe. Based on laboratory findings and the pathological assessment of bone marrow and random skin biopsies, the patient was diagnosed with intravascular lymphoma (IVL). Persistent hyperintense lesions on DWI of brain MRI may precede the clinical exacerbation of IVL. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Bioresorbable Scaffold for Treatment of Coronary Artery Lesions: Intravascular Ultrasound Results From the ABSORB Japan Trial.

Science.gov (United States)

Okada, Kozo; Honda, Yasuhiro; Kitahara, Hideki; Otagiri, Kyuhachi; Tanaka, Shigemitsu; Hollak, M Brooke; Yock, Paul G; Popma, Jeffrey J; Kusano, Hajime; Cheong, Wai-Fung; Sudhir, Krishnankutty; Fitzgerald, Peter J; Kimura, Takeshi

2018-04-09

The aim of this study was to characterize post-procedural intravascular ultrasound (IVUS) findings in the ABSORB Japan trial, specifically stratified by the size of target coronary arteries. Despite overall noninferiority confirmed in recent randomized trials comparing bioresorbable vascular scaffolds (BVS) (Absorb BVS) and cobalt-chromium everolimus-eluting metallic stents (CoCr-EES), higher event rates of Absorb BVS have been reported with suboptimal deployment, especially in small coronary arteries. In the ABSORB Japan trial, 150 patients (2:1 randomization) were scheduled in the IVUS cohort. Small vessel was defined as mean reference lumen diameter strategy, possibly different between polymeric and metallic devices, needs to be established for bioresorbable scaffold technology. (AVJ-301 Clinical Trial: A Clinical Evaluation of AVJ-301 Absorb™ BVS) in Japanese Population [ABSORB JAPAN]; NCT01844284). Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Optical Coherence Tomography Analysis of Attenuated Plaques Detected by Intravascular Ultrasound in Patients with Acute Coronary Syndromes

Directory of Open Access Journals (Sweden)

Takashi Kubo

2011-01-01

Full Text Available Background. Recent intravascular ultrasound (IVUS studies have demonstrated that hypoechoic plaque with deep ultrasound attenuation despite absence of bright calcium is common in acute coronary syndrome. Such “attenuated plaque” may be an IVUS characteristic of unstable lesion. Methods. We used optical coherence tomography (OCT in 104 patients with unstable angina to compare lesion characteristics between IVUS-detected attenuated plaque and nonattenuated plaque. Results. IVUS-detected attenuated plaque was observed in 41 (39% patients. OCT-detected lipidic plaque (88% versus 49%, <0.001, thin-cap fibroatheroma (48% versus 16%, <0.001, plaque rupture (44% versus 11%, <0.001, and intracoronary thrombus (54% versus 17%, <0.001 were more often seen in IVUS-detected attenuated plaques compared with nonattenuated plaques. Conclusions. IVUS-detected attenuated plaque has many characteristics of unstable coronary lesion. The presence of attended plaque might be an important marker of lesion instability.

Indium-111-oxine labeled platelet scintigraphy for detection of intracardiac and intravascular thrombi

Energy Technology Data Exchange (ETDEWEB)

Kimura, Michio; Ojima, Kenji; Tsuda, Takashi [Niigata Univ. (Japan). School of Medicine

1983-09-01

This study was designed to evaluate the efficacy of scintigraphy by using /sup 111/In-oxine labeled platelets for the detection of either intracardiac or intravascular thrombi. Fourteen cases of thrombi diagnosed or suspected on the basis of either angiography or two-dimensional echography were examined. They included four cases of left ventricular thrombi, three of left atrial thrombi, four of vascular thrombi and three of inflammatory disease. Platelet samples from the patients were labeled by /sup 111/In-oxine according to the method originated by Yui et al. The labeling efficiency was 72.4+-9.8%. The platelets retained good function except for collagen aggregability. Hot areas of high quality in the scintigram were demonstrated in six cases including two with left ventricular thrombi, two with left atrial thrombi and two with vascular thrombi. These areas accorded well with the findings of angiography, echography or surgery. The removed thrombi had a layer of aggregated platelets on the surface. Platelet survival was shortened in a case of prosthetic valve endocarditis without a hot area, and was normal in four out of the five cases including two with a hot area. It is concluded that this method is potentially predictive in detecting thrombi.

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; ...

Determination of regional flow by use of intravascular PET tracers: microvascular theory and experimental validation for pig livers

DEFF Research Database (Denmark)

Munk, O L; Bass, L; Feng, H

2003-01-01

Today, the standard approach for the kinetic analysis of dynamic PET studies is compartment models, in which the tracer and its metabolites are confined to a few well-mixed compartments. We examine whether the standard model is suitable for modern PET data or whether theories including more...... physiologic realism can advance the interpretation of dynamic PET data. A more detailed microvascular theory is developed for intravascular tracers in single-capillary and multiple-capillary systems. The microvascular models, which account for concentration gradients in capillaries, are validated and compared...... with the standard model in a pig liver study. METHODS: Eight pigs underwent a 5-min dynamic PET study after (15)O-carbon monoxide inhalation. Throughout each experiment, hepatic arterial blood and portal venous blood were sampled, and flow was measured with transit-time flow meters. The hepatic dual...

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.

Biophysical model for thorotrast-induced liver cancers

International Nuclear Information System (INIS)

Noesterer, M; Hofmann, W.; Andreev, S.G.

1996-01-01

In Germany between 1930 and 1950, an estimated 10,000 to 20,000 patients received Thorostrast injections, mostly for angiographic examinations. About 59% of the intravascularly injected Thorotrast was retained by the liver. Based on a mean injected volume of 25 ml and an average exposure time of about 40 years, Thorotrast patients received a mean liver dose of about 9.5 Gy. As a consequence, about 20% of the 2,326 Thorotrast patients examined in the German Thorotrast Study died of liver tumors, while only 2 cases of primary liver tumors were observed in the 1,890 control patients

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.

Multidimensional segmentation of coronary intravascular ultrasound images using knowledge-based methods

Science.gov (United States)

Olszewski, Mark E.; Wahle, Andreas; Vigmostad, Sarah C.; Sonka, Milan

2005-04-01

In vivo studies of the relationships that exist among vascular geometry, plaque morphology, and hemodynamics have recently been made possible through the development of a system that accurately reconstructs coronary arteries imaged by x-ray angiography and intravascular ultrasound (IVUS) in three dimensions. Currently, the bottleneck of the system is the segmentation of the IVUS images. It is well known that IVUS images contain numerous artifacts from various sources. Previous attempts to create automated IVUS segmentation systems have suffered from either a cost function that does not include enough information, or from a non-optimal segmentation algorithm. The approach presented in this paper seeks to strengthen both of those weaknesses -- first by building a robust, knowledge-based cost function, and then by using a fully optimal, three-dimensional segmentation algorithm. The cost function contains three categories of information: a compendium of learned border patterns, information theoretic and statistical properties related to the imaging physics, and local image features. By combining these criteria in an optimal way, weaknesses associated with cost functions that only try to optimize a single criterion are minimized. This cost function is then used as the input to a fully optimal, three-dimensional, graph search-based segmentation algorithm. The resulting system has been validated against a set of manually traced IVUS image sets. Results did not show any bias, with a mean unsigned luminal border positioning error of 0.180 +/- 0.027 mm and an adventitial border positioning error of 0.200 +/- 0.069 mm.

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.

Bursitis efter vaccination i skulderregionen

DEFF Research Database (Denmark)

Bliddal, Henning; Torp-Pedersen, Søren; Falk-Riecke, Birgit

2017-01-01

Shoulder pain may develop after vaccination in the deltoid area due to inadvertent injection of the vaccine into the subdeltoid bursa, which may be located close to the skin. As far as we know, such vaccination reactions occur more frequently than officially registered, and doctors may not be awa...

Posterior reversible encephalopathy syndrome following an inadvertent dural puncture during an emergency laparotomy for ischemic colitis – a case report

Directory of Open Access Journals (Sweden)

Shah R

2014-01-01

Full Text Available Reena Shah, Agnieszka Kubisz-Pudelko, Jeremy Reid Yeovil District Hospital, Yeovil, UK Abstract: Posterior reversible encephalopathy syndrome (PRES is a clinico-neuroradiological syndrome characterized by various symptoms of neurological disease. It has commonly been reported in association with acute hypertension, pre-eclampsia, eclampsia, sepsis, and exposure to immunosuppressants. Here, we report on a normotensive woman who developed a severe frontal headache, visual disturbances, and hypertension 3 days after undergoing an emergency laparotomy for ischemic colitis during which she suffered an inadvertent dural puncture. Neuro-imaging revealed features consistent with PRES. The patient went on to make a good recovery, being discharged 21 days postoperatively, with only minor visual disturbances and memory problems. This case highlights the importance of awareness of PRES to all specialties. On reviewing the literature, we feel that PRES may be a potential differential diagnosis to post-procedural neurological symptoms in those patients undergoing routine procedures such as spinal anesthetics or lumbar punctures. Keywords: PRES, neurological disease, lumbar puncture, spinal anesthetic

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.)

Differentiation of early from advanced coronary atherosclerotic lesions: systematic comparison of CT, intravascular US, and optical frequency domain imaging with histopathologic examination in ex vivo human hearts.

Science.gov (United States)

Maurovich-Horvat, Pál; Schlett, Christopher L; Alkadhi, Hatem; Nakano, Masataka; Stolzmann, Paul; Vorpahl, Marc; Scheffel, Hans; Tanaka, Atsushi; Warger, William C; Maehara, Akiko; Ma, Shixin; Kriegel, Matthias F; Kaple, Ryan K; Seifarth, Harald; Bamberg, Fabian; Mintz, Gary S; Tearney, Guillermo J; Virmani, Renu; Hoffmann, Udo

2012-11-01

To establish an ex vivo experimental setup for imaging coronary atherosclerosis with coronary computed tomographic (CT) angiography, intravascular ultrasonography (US), and optical frequency domain imaging (OFDI) and to investigate their ability to help differentiate early from advanced coronary plaques. All procedures were performed in accordance with local and federal regulations and the Declaration of Helsinki. Approval of the local Ethics Committee was obtained. Overall, 379 histologic cuts from nine coronary arteries from three donor hearts were acquired, coregistered among modalities, and assessed for the presence and composition of atherosclerotic plaque. To assess the discriminatory capacity of the different modalities in the detection of advanced lesions, c statistic analysis was used. Interobserver agreement was assessed with the Cohen κ statistic. Cross sections without plaque at coronary CT angiography and with fibrous plaque at OFDI almost never showed advanced lesions at histopathologic examination (odds ratio [OR]: 0.02 and 0.06, respectively; both Padvanced lesions (OR: 2.49, P=.0003; OR: 2.60, P=.002; and OR: 31.2, Padvanced lesions than intravascular US and coronary CT angiography (area under the receiver operating characteristic curve: 0.858 [95% confidence interval {CI}: 0.802, 0.913], 0.631 [95% CI: 0.554, 0.709], and 0.679 [95% CI: 0.618, 0.740]; respectively, Padvanced coronary plaques. © RSNA, 2012

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

Chronic intravascular coagulation associated with chronic myelocytic leukemia. Use of heparin in connection with a surgical procedure.

Science.gov (United States)

German, H J; Smith, J A; Lindenbaum, J

1976-10-01

A women with Philadelphia chromosome-positive chronic myelocytic leukemia lived nearly 12 years from the time of diagnosis. During most of this period she received no therapy, and marked cyclic oscillations in the white blood cell count were documented. The last two years of her illness were marked by a hemorrhagic disorder associated with hypofibrinogenemia, thrombocytopenia, increased plasma fibrinopeptide A concentration and markedly elevated serum levels of fibrin degradation products. The coagulation disorder was rapidly reversible on several occasions with heparin therapy. After treatment with heparin and platelet transfusions, the patient underwent successful resection of a large ovarian cyst with excellent hemostasis during the procedure. Postoperatively, the administration of heparin and platelets was discontinued and a large wound hematoma developed. After resumption of therapy with heparin and platelets, the remainder of her postoperative course was uneventful. The literature on the subject is reviewed and tentative guidelines are offered concerning the management of patients with intravascular coagulation who require diagnostic or therapeutic surgical procedures.

Intravascular papillary endothelial hyperplasia: magnetic resonance imaging of finger lesions

Energy Technology Data Exchange (ETDEWEB)

Sung, Jinkyeong; Kim, Jee-Young [The Catholic University of Korea, Department of Radiology, St. Vincent' s Hospital, College of Medicine, Suwon, Gyeonggi-do (Korea, Republic of); Yoo, Changyoung [The Catholic University of Korea, Department of Hospital Pathology, St. Vincent' s Hospital, College of Medicine, Suwon, Gyeonggi-do (Korea, Republic of)

2016-02-15

To describe magnetic resonance imaging (MRI) features of intravascular papillary endothelial hyperplasia (IPEH), to identify findings differentiating IPEH of the finger from that of other locations, and to correlate these with pathology. Nineteen patients with 20 I.E. masses of the finger (n = 13) and other locations (n = 7) were evaluated. All patients underwent MRI, and the results were correlated with pathology. Seventeen IPEHs, including all IPEHs of the finger, were located in the subcutis, the three other lesions in the muscle layer. On T1WI, all masses were isointense or slightly hyperintense. IPEHs of the finger (n = 13) revealed focal hyperintense nodules (n = 2) or central hypointensity (n = 2) on T1WI, hypointensity with a hyperintense rim (n = 7), hyperintensity with hypointense nodules (n = 5), or isointensity with a hypointense rim (n = 1) on T2WI, and rim enhancement (n = 5), heterogeneous enhancement with nodular nonenhanced areas (n = 6), peripheral nodular enhancement (n = 1), or no enhancement (n = 1) on gadolinium-enhanced T1WI. IPEHs of other locations (n = 7) demonstrated focal hyperintense nodules (n = 5) on T1WI, hyperintensity with hypointense nodules (n = 5) or heterogeneous signal intensity (n = 2) on T2WI, and rim or rim and septal enhancement (n = 6) or peripheral nodular enhancement (n = 1). Microscopically, IPEHs were composed of thrombi that were hypointense on T2WI and papillary endothelial proliferations that showed T2 hyperintensity and enhancement. MRI of finger IPEH reveals well-demarcated subcutaneous masses with hypointensity or hypointense nodules with peripheral hyperintensity on T2WI, as well as peripheral enhancement. T1 hyperintense nodules, internal heterogeneity on T2WI, and septal enhancement are more common in IPEH of other locations. (orig.)

ARCOCT: Automatic detection of lumen border in intravascular OCT images.

Science.gov (United States)

Cheimariotis, Grigorios-Aris; Chatzizisis, Yiannis S; Koutkias, Vassilis G; Toutouzas, Konstantinos; Giannopoulos, Andreas; Riga, Maria; Chouvarda, Ioanna; Antoniadis, Antonios P; Doulaverakis, Charalambos; Tsamboulatidis, Ioannis; Kompatsiaris, Ioannis; Giannoglou, George D; Maglaveras, Nicos

2017-11-01

Intravascular optical coherence tomography (OCT) is an invaluable tool for the detection of pathological features on the arterial wall and the investigation of post-stenting complications. Computational lumen border detection in OCT images is highly advantageous, since it may support rapid morphometric analysis. However, automatic detection is very challenging, since OCT images typically include various artifacts that impact image clarity, including features such as side branches and intraluminal blood presence. This paper presents ARCOCT, a segmentation method for fully-automatic detection of lumen border in OCT images. ARCOCT relies on multiple, consecutive processing steps, accounting for image preparation, contour extraction and refinement. In particular, for contour extraction ARCOCT employs the transformation of OCT images based on physical characteristics such as reflectivity and absorption of the tissue and, for contour refinement, local regression using weighted linear least squares and a 2nd degree polynomial model is employed to achieve artifact and small-branch correction as well as smoothness of the artery mesh. Our major focus was to achieve accurate contour delineation in the various types of OCT images, i.e., even in challenging cases with branches and artifacts. ARCOCT has been assessed in a dataset of 1812 images (308 from stented and 1504 from native segments) obtained from 20 patients. ARCOCT was compared against ground-truth manual segmentation performed by experts on the basis of various geometric features (e.g. area, perimeter, radius, diameter, centroid, etc.) and closed contour matching indicators (the Dice index, the Hausdorff distance and the undirected average distance), using standard statistical analysis methods. The proposed method was proven very efficient and close to the ground-truth, exhibiting non statistically-significant differences for most of the examined metrics. ARCOCT allows accurate and fully-automated lumen border

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

Intravascular application of electrocautery in a rabbit model of abdominal aortic endarterectomy.

Science.gov (United States)

Wang, Chuan; Xin, Yi; Li, Na; Li, Diankun; Li, Jingxing; Gu, Chengxiong

2017-07-01

Effective therapies for preventing perioperative complications such as thrombosis and inflammation after coronary endarterectomy (CE) are lacking. Electrocoagulation electrotomes have been routinely used in surgery for their cutting, clotting, and hemostatic properties. As strong flattening tools, their electrocautery function may prevent mechanical intimal-adventitial injury to arterial circulation and attenuate stenosis. The present study investigated the effects of intravascular application of electrocautery on ameliorating inflammation and thrombosis in a rabbit model of abdominal aortic endarterectomy. New Zealand rabbits were randomly divided into the sham, control (endarterectomy), and study (endarterectomy + electrocautery) groups with 10 in each group. Abdominal aortas were partially blocked and intima was removed. Electrocautery was performed with an electrocoagulation electrotome through the entire blocked vessel lumen. Vascular ultrasound parameters, molecular biological and histological characteristics of the abdominal aorta including vascular diameter, blood flow velocity, serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels, and apoptosis rate of vascular endothelial cells (ECs) were evaluated postoperatively by vascular Doppler ultrasound, ELISA, real-time RT-PCR, flow cytometry, and immunofluorescence at various time points. Compared with the endarterectomy + electrocautery group, the isolated endarterectomy group had significantly increased levels and gene expression of TNF-α and IL-6 (Pelectrocautery has favorable short-term effects on the abdominal aorta and can reduce inflammation in a rabbit model of abdominal aorta endarterectomy. Long-term anti-inflammatory and anti-thrombotic effects on arterial remodeling and the clinical value of electrocautery in CE remain to be determined.

Characteristics of virtual histology-intravascular unltrasound of infarction-related artery atheromatous plaque and pregnancy-associated plasma protein A level: a correlation study

International Nuclear Information System (INIS)

Chen Shaobo; Jiang Tiemin; Liang Guoqing; Zhao Jihong; Li Yuming

2011-01-01

Objective: To observe the characteristics of virtual histology-intravascular ultrasound (VH-IVUS) in 70 patients with acute ST segment elevated type myocardial infarction (AMI), the findings were compared with that in 70 patients with stable angina (control group), and to analyze the correlation between VH-IVUS characteristics and pregnancy-associated plasma protein A (PAPPA) level. Methods: Seventy patients with ST segment elevated AMI and 70 patients with stable angina, who received percutaneous coronary artery intervention and were encountered from Jan. 2008 to Dec. 2009, were involved in this study. After coronary angiography was completed,the plasma was aspirated from culprit coronary artery with ZEEK catheter. Then, IVUS examination to culprit lesion was carried out and grayscale and VH data were stored. The characteristics of VH-IVUS of culprit atheromatous plaque were observed and its correlation with PAPPA was analyzed. Results: The difference in age,gender, hypertension, smoking, diabetes mellitus and hyperlipidemia between two groups was of no statistical significance, but statistically significant difference in VH-IVUS characteristics of the atheromatous plaque existed between two groups, more fibro-fatty tissue and necrotic tissue with less dense calcium were seen in AMI group. The ratio of necrotic tissue area to calcified tissue area was (3.62±1.46) in AMI group and(7.18±2.53) in control group (P<0.01). PAPPA in AMI group was significantly higher than that in control group (P<0.01). Parameters of VH-IVUS in AMI group were highly correlated with PAPPA (P<0.05 or P<0.01). Conclusion: The characteristics of virtual histology-intravascular ultrasound of infarction-related artery atheromatous plaque include more necrotic tissue, higher ratio of necrotic tissue area to calcified tissue area and a closer correlation with PAPPA. (authors)

Regulation of pulpal blood flow

International Nuclear Information System (INIS)

Kim, S.

1985-01-01

The regulation of blood flow of the dental pulp was investigated in dogs and rats anesthetized with sodium pentobarbital. Pulpal blood flow was altered by variations of local and systemic hemodynamics. Macrocirculatory blood flow (ml/min/100 g) in the dental pulp was measured with both the 133 Xe washout and the 15-microns radioisotope-labeled microsphere injection methods on the canine teeth of dogs, to provide a comparison of the two methods in the same tooth. Microcirculatory studies were conducted in the rat incisor tooth with microscopic determination of the vascular pattern, RBC velocity, and intravascular volumetric flow distribution. Pulpal resistance vessels have alpha- and beta-adrenergic receptors. Activation of alpha-receptors by intra-arterial injection of norepinephrine (NE) caused both a reduction in macrocirculatory Qp in dogs and decreases in arteriolar and venular diameters and intravascular volumetric flow (Qi) in rats. These responses were blocked by the alpha-antagonist PBZ. Activation of beta-receptors by intra-arterial injection of isoproterenal (ISO) caused a paradoxical reduction of Qp in dogs. In rats, ISO caused a transient increase in arteriolar Qi followed by a flow reduction; arteriolar dilation was accompanied by venular constriction. These macrocirculatory and microcirculatory responses to ISO were blocked by the alpha-antagonist propranolol

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 ...

Study on sup(99m)Tc-colloid accumulation of in vitro clots and thrombi in rats

Energy Technology Data Exchange (ETDEWEB)

Ohguchi, Manabu [Kanazawa Univ. (Japan). School of Medicine

1983-02-01

The accumulation of different sup(99m)Tc-colloids in vitro clot, venous thrombi and intravascular fibrin deposits in rats was studied. Blood clot was produced by incubating fresh blood at room temperature for three hours. The mean value of % uptake of sup(99m)Tc-Sn colloid in clot was 96.2 % and higher than that of any other sup(99m)Tc-colloids. Venous thrombi in rats were made by clamping the left femoral vein segments for 5 minutes. With sup(99m)Tc-Sn colloid, the mean value of the ratio of the radioactivity in the clamped vein segment to the control segment (L/R ratio) was 54.5. L/R ratios of others were 24.2 with sup(99m)Tc-phytate, 12.1 with sup(99m)Tc-sulfur colloid, 3.9 with sup(99m)Tc-rhenium colloid, 2.4 with sup(99m)Tc-millimicrosphere albumin. L/R ratios were higher for the fresh thrombi, significant uptake was also observed up to seven days. Intravascular fibrin deposits were induced by i.p. injection of endotoxin into rats. Three hours after injection of endotoxin, sup(99m)Tc-colloids were i.v. injected. Significant lung uptake was observed in sup(99m)Tc-colloids except in sup(99m)Tc-rhenium colloid. And the most remarkable change of lung uptake was observed in sup(99m)Tc-Sn colloid. Significant kidney uptake was observed in sup(99m)Tc-Sn colloid and sup(99m)Tc-sulfur colloid. And the most remarkable change of kidney uptake was also observed in sup(99m)Tc-Sn colloid. When heparin was injected i.v. at the same time as endotoxin injection, lung uptake of sup(99m)Tc-Sn colloid was significantly decreased. However, the heparin effect on kidney uptake of sup(99m)Tc-Sn colloid was more significant than on lung uptake. The results in this study indicated that sup(99m)Tc-Sn colloid showed the greatest affinity to in vitro clots, venous thrombi and intravascular fibrin deposits.

Multicenter assessment of the reproducibility of volumetric radiofrequency-based intravascular ultrasound measurements in coronary lesions that were consecutively stented

DEFF Research Database (Denmark)

Huisman, Jennifer; Egede, Rasmus; Rdzanek, Adam

2012-01-01

To assess in a multicenter design the between-center reproducibility of volumetric virtual histology intravascular ultrasound (VH-IVUS) measurements with a semi-automated, computer-assisted contour detection system in coronary lesions that were consecutively stented. To evaluate the reproducibility...... of volumetric VH-IVUS measurements, experienced analysts of 4 European IVUS centers performed independent analyses (in total 8,052 cross-sectional analyses) to obtain volumetric data of 40 coronary segments (length 20.0 ± 0.3 mm) from target lesions prior to percutaneous intervention that were performed...... in the setting of stable (65%) or unstable angina pectoris (35%). Geometric and compositional VH-IVUS measurements were highly correlated for the different comparisons. Overall intraclass correlation for vessel, lumen, plaque volume and plaque burden was 0.99, 0.92, 0.96, and 0.83, respectively; for fibrous...

Comparison of intravascular ultrasound and angiographic assessement of coronary reference segment size in patients with type 2 diabetes mellitus

DEFF Research Database (Denmark)

Jensen, Lisette Okkels; Thayssen, Per; Mintz, Gary S

2008-01-01

During percutaneous coronary intervention, the reference segment is assessed angiographically. This report described the discrepancy between angiographic and intravascular ultrasound (IVUS) assessment of reference segment size in patients with type 2 diabetes mellitus. Preintervention IVUS was used...... to study 62 de novo lesions in 41 patients with type 2 diabetes mellitus. The lesion site was the image slice with the smallest lumen cross-sectional area (CSA). The proximal and distal reference segments were the most normal-looking segments within 5 mm proximal and distal to the lesion. Plaque burden...... was measured as plaque CSA/external elastic membrane (EEM) CSA. Using IVUS, the reference lumen diameter was 2.80 +/- 0.42 mm and the reference EEM diameter was 4.17 +/- 0.56 mm. The angiographic reference diameter was 2.63 +/- 0.36 mm. Mean difference between the IVUS EEM diameter and angiographic reference...

Monte Carlo dosimetry of a tandem positioned beta-emitting intravascular brachytherapy source train

International Nuclear Information System (INIS)

Wallace, Steven A.; Schumer, Wendy; Horrigan, Mark

2002-01-01

Prevention of restenosis following interventional coronary procedures with catheter based beta-emitting sources is currently under clinical trial investigations. Systems utilizing fixed length source trains limit the clinician's ability to increase the radiation source length as required. A technique known as 'pull back' is used when the segment of artery requiring radiation is longer than the available fixed length source train. In this instance, tandem positioning of the fixed length source is used to treat the longer length of artery. The aim of this study was to examine the dosimetry of the junction region associated with pull back treatments using a commercially available 90 Sr/Y catheter based intravascular brachytherapy source train. Dose profiles were calculated, using the Monte Carlo code MCNP4B, at radial distances of 1.5, 2.0, and 2.5 mm for pull back techniques using 2.5 mm overlapping, abutting, and 2.5 mm spaced source trains. Results at the protocol prescription radius of 2 mm showed a junction dose elevated 61% above prescription for 2.5 mm overlapping source trains. For 2.5 mm spaced trains, this figure falls to 64% below prescription dose. In contrast, abutted source trains exhibited only a 1% depression below prescription dose in the junction region. The reference point dose rate per unit activity of this source was found to be consistent with previous studies

Concordant pressure paresthesia during interlaminar lumbar epidural steroid injections correlates with pain relief in patients with unilateral radicular pain.

Science.gov (United States)

Candido, Kenneth D; Rana, Maunak V; Sauer, Ruben; Chupatanakul, Lalida; Tharian, Antony; Vasic, Vladimir; Knezevic, Nebojsa Nick

2013-01-01

Transforaminal and interlaminar epidural steroid injections are commonly used interventional pain management procedures in the treatment of radicular low back pain. Even though several studies have shown that transforaminal injections provide enhanced short-term outcomes in patients with radicular and low back pain, they have also been associated with a higher incidence of unintentional intravascular injection and often dire consequences than have interlaminar injections. We compared 2 different approaches, midline and lateral parasagittal, of lumbar interlaminar epidural steroid injection (LESI) in patients with unilateral lumbosacral radiculopathic pain. We also tested the role of concordant pressure paresthesia occurring during LESI as a prognostic factor in determining the efficacy of LESI. Prospective, randomized, blinded study. Pain management center, part of a teaching-community hospital in a major metropolitan US city. After Institutional Review Board approval, 106 patients undergoing LESI for radicular low back pain were randomly assigned to one of 2 groups (53 patients each) based on approach: midline interlaminar (MIL) and lateral parasagittal interlaminar (PIL). Patients were asked to grade any pressure paresthesia as occurring ipsilaterally or contralaterally to their "usual and customary pain," or in a distribution atypical of their daily pain. Other variables such as: the Oswestry Disability Index questionnaire, pain scores at rest and during movement, use of pain medications, etc. were recorded 20 minutes before the procedure, and on days 1, 7, 14, 21, 28, 60, 120, 180 and 365 after the injection. Results of this study showed statistically and clinically significant pain relief in patients undergoing LESI by both the MIL and PIL approaches. Patients receiving LESI using the lateral parasagittal approach had statistically and clinically longer pain relief then patients receiving LESI via a midline approach. They also had slightly better quality of

Successful Control of Disseminated Intravascular Coagulation by Recombinant Thrombomodulin during Arsenic Trioxide Treatment in Relapsed Patient with Acute Promyelocytic Leukemia

Directory of Open Access Journals (Sweden)

Motohiro Shindo

2012-01-01

Full Text Available Disseminated intravascular coagulation (DIC frequently occurs in patients with acute promyelocytic leukemia (APL. With the induction of therapy in APL using all-trans retinoic acid (ATRA, DIC can be controlled in most cases as ATRA usually shows immediate improvement of the APL. However, arsenic trioxide (ATO which has been used for the treatment of relapse in APL patients has shown to take time to suppress APL cells, therefore the control of DIC in APL with ATO treatment is a major problem. Recently, the recombinant soluble thrombomodulin fragment has received a lot of attention as the novel drug for the treatment of DIC with high efficacy. Here, we present a relapsed patient with APL in whom DIC was successfully and safely controlled by rTM during treatment with ATO.

Optimization of dual-wavelength intravascular photoacoustic imaging of atherosclerotic plaques using Monte Carlo optical modeling

Science.gov (United States)

Dana, Nicholas; Sowers, Timothy; Karpiouk, Andrei; Vanderlaan, Donald; Emelianov, Stanislav

2017-10-01

Coronary heart disease (the presence of coronary atherosclerotic plaques) is a significant health problem in the industrialized world. A clinical method to accurately visualize and characterize atherosclerotic plaques is needed. Intravascular photoacoustic (IVPA) imaging is being developed to fill this role, but questions remain regarding optimal imaging wavelengths. We utilized a Monte Carlo optical model to simulate IVPA excitation in coronary tissues, identifying optimal wavelengths for plaque characterization. Near-infrared wavelengths (≤1800 nm) were simulated, and single- and dual-wavelength data were analyzed for accuracy of plaque characterization. Results indicate light penetration is best in the range of 1050 to 1370 nm, where 5% residual fluence can be achieved at clinically relevant depths of ≥2 mm in arteries. Across the arterial wall, fluence may vary by over 10-fold, confounding plaque characterization. For single-wavelength results, plaque segmentation accuracy peaked at 1210 and 1720 nm, though correlation was poor (blood, a primary and secondary wavelength near 1210 and 1350 nm, respectively, may offer the best implementation of dual-wavelength IVPA imaging. These findings could guide the development of a cost-effective clinical system by highlighting optimal wavelengths and improving plaque characterization.

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.)

Late lumen loss and intima hyperplasia after sirolimus-eluting and zotarolimus-eluting stent implantation in diabetic patients: the diabetes and drug-eluting stent (DiabeDES III) angiography and intravascular ultrasound trial

DEFF Research Database (Denmark)

Jensen, Lisette Okkels; Mæng, Michael; Thayssen, Per

2011-01-01

Patients with diabetes mellitus have increased risk of in-stent restenosis after coronary stent implantation due to neointimal hyperplasia (NIH). The aim of this study was to use quantitative coronary angiography (QCA) and volumetric intravascular ultrasound (IVUS) to evaluate the effects...... of the sirolimus-eluting Cypher® stent (SES) and the zotarolimus-eluting Endeavor® stent (ZES) on angiographic late lumen loss and intima hyperplasia in diabetic patients....

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 ...

Percutaneous transvenous retrieval of CVP catheter emboli in S. V. C.-A case report-

International Nuclear Information System (INIS)

Zeon, Seok Kil; Lee, Deock Hee; Kim, Hong; Kim, Ok Bae

1987-01-01

The increasing use of the indwelling venous catheters and cardiovascular catheters has led to many iatrogenic complications. One of the most serious complications is catheter embolization, caused by inadvertent fracture of a fragment of catheter remaining within cardiovascular systems. In the catheter embolization, there are serious consequence such as thromboembolism, sepsis, cardiac arrhythmia and others. Fisher and Ferreyro (1978) reported a 71% incidence of serious morbidity or death following to intravascular foreign bodies in patients without removal. The authors experienced a case of retained central venous pressure monitoring catheter (CVP catheter) fragment extending from superior vena cava to hepatic segment of inferior vena cava. CVP catheter wa introduced into right subclavian venous route for hyperalimentation, because of poor general condition for operation of afferent loop syndrome following to resection of the gastric carcinoma with Billoth II operation (5 years age). On attempting removal of CVP catheter on recovery from afferent loop syndrome, a large portion of the CVP catheter was cut off in S.V.C. Percutaneous puncture of right femoral vein with Seldinger technique was done and 9F introducer sheath was indwelled. The helical basket of Dotter intravascular retriever set was advance through the sheath up to retained CVP catheter, and it was grasped. The retrieved CVP catheter fragment showed several tiny blood clots on surface. The patient was uneventfully recovered and was discharged asymptomatic on second day of the procedure.

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

TWO NOVEL ACM (ACTIVE CONTOUR MODEL) METHODS FOR INTRAVASCULAR ULTRASOUND IMAGE SEGMENTATION

International Nuclear Information System (INIS)

Chen, Chi Hau; Potdat, Labhesh; Chittineni, Rakesh

2010-01-01

One of the attractive image segmentation methods is the Active Contour Model (ACM) which has been widely used in medical imaging as it always produces sub-regions with continuous boundaries. Intravascular ultrasound (IVUS) is a catheter based medical imaging technique which is used for quantitative assessment of atherosclerotic disease. Two methods of ACM realizations are presented in this paper. The gradient descent flow based on minimizing energy functional can be used for segmentation of IVUS images. However this local operation alone may not be adequate to work with the complex IVUS images. The first method presented consists of basically combining the local geodesic active contours and global region-based active contours. The advantage of combining the local and global operations is to allow curves deforming under the energy to find only significant local minima and delineate object borders despite noise, poor edge information and heterogeneous intensity profiles. Results for this algorithm are compared to standard techniques to demonstrate the method's robustness and accuracy. In the second method, the energy function is appropriately modified and minimized using a Hopfield neural network. Proper modifications in the definition of the bias of the neurons have been introduced to incorporate image characteristics. The method overcomes distortions in the expected image pattern, such as due to the presence of calcium, and employs a specialized structure of the neural network and boundary correction schemes which are based on a priori knowledge about the vessel geometry. The presented method is very fast and has been evaluated using sequences of IVUS frames.

CT virtual intravascular endoscopy assessment of coronary artery plaques: A preliminary study

International Nuclear Information System (INIS)

Sun Zhonghua; Dimpudus, Franky Jacobus; Nugroho, Johanes; Adipranoto, Jeffrey Daniel

2010-01-01

Purpose: The purpose of this study was to investigate the potential value of CT virtual intravascular endoscopy (VIE) in the visualization and assessment of coronary plaques in patients suspected of coronary artery disease. Materials and methods: 20 (13 men, 7 women, mean age 54 years) consecutive patients with suspected coronary artery disease undergoing 64-slice CT angiography were included in the study. Four main coronary artery branches were assessed with regard to the presence of coronary plaques based on 2D axial, multiplanar reformation, 3D volume rendering and VIE visualizations. The coronary plaques were characterized into calcified, noncalcified and mixed plaques. The intraluminal appearances of these coronary plaques were demonstrated with VIE images and correlated with 2D and 3D images to determine the diagnostic value of VIE for the assessment of the plaques. Results: VIE was able to identify and demonstrate the intraluminal appearances of coronary plaques in 18 patients involving 32 coronary artery branches which were shown as an irregularly intraluminal protruding sign in extensively calcified plaques and smooth protruding appearance in noncalcified or focally calcified plaques. An irregular intraluminal appearance was also noticed in the presence of mixed plaques due to variable components with different CT attenuations contained within the plaques. VIE accurately confirmed the degree of coronary stenosis or occlusion despite the presence of heavy calcification. Conclusion: VIE could be used as a complementary tool to conventional CT visualizations for the analysis of luminal changes and assessment of disease extent caused by the coronary plaques.

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.

The Precise Determination of Vascular Lumen and Stent Diameters: Correlation Among Calibrated Angiography, Intravascular Ultrasound, and Pressure-Fixed Specimens

International Nuclear Information System (INIS)

Froelich, Jens J.; Hoppe, Martin; Nahrstedt, Christoph; Barth, Klemens H.; Wagner, H. Joachim; Klose, Klaus J.

1997-01-01

Purpose: Luminal diameters measured in vivo by calibrated-catheter angiography and by intravascular ultrasound were correlated with those obtained from pressure-fixed histologic cross-sections to determine the accuracy of both methods. Methods: Angiographic and endosonographic diameter measurements were performed in the center of stents placed in the iliac arteries of 10 miniature pigs and were compared with luminal and stent diameters in postmortem, pressure-fixed, histologic cross-sections from identical locations. Results: Compared with histologic diameters, magnification-corrected angiographic measurements still magnified vascular luminal diameters by 0.7 ± 0.71 mm (r= 0.41, Pearson; p 0.5, Wilcoxon, matched pairs). Similarly, stent diameters correlated well between endosonographic and histologic measurements (r= 0.91; p= 0.002), and less well between angiographic and histologic diameters (r= 0.62; p= 0.002). Conclusion: Since calibrated angiography still overestimates vascular lumina, endosonography is the preferred technique for accurate in vivo measurements

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 ...

Análisis in vivo de la vasculopatía arterial pulmonar mediante ultrasonido intravascular (IVUS) en pacientes con insuficiencia respiratoria crónica evaluados para trasplante pulmonar

OpenAIRE

Acosta Vélez, Juan Gabriel

2013-01-01

El objetivo del estudio es evaluar el remodelado estructural y funcional de las arterias pulmonares asociado a insuficiencia respiratoria crónica severa, mediante ecografía intravascular (IVUS). Se incluyeron 80 pacientes en estudio pretrasplante pulmonar a los que se les realizó cateterismo cardiaco derecho e IVUS de una arteria pulmonar de mediano calibre. A través del IVUS se determinó el módulo elástico, pulsatilidad y porcentaje de fibrosis arterial. La insuficiencia respiratoria crónica...

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

Intravascular ultrasound and angiographic demonstration of left main stem thrombus-high-risk presentation in a young adult with anabolic steroid abuse.

Science.gov (United States)

Garg, Pankaj; Davis, Gershan; Wilson, John Ian; Sivananthan, Mohan

2010-01-01

We present a case of acute myocardial infarction in a young adult with a history of anabolic steroid abuse. On diagnostic coronary angiography and intravascular ultrasound, he was found to have a distal left main stem thrombus extending into the proximal left anterior descending artery and a large intermediate vessel. As he was hemodynamically stable and pain-free, he was managed conservatively with triple antiplatelet therapy (aspirin, clopidogrel, and abciximab). This was also to avoid the risk of 'wiring the vessel,' especially if there was underlying dissection. Repeat angiography a few weeks later showed complete thrombus resolution. This is the first reported case of extensive left main stem thrombus in a young patient with anabolic steroid abuse. Management of such cases is not straightforward and our case highlights one approach to both diagnosis and treatment.

Effect of pre-donation fluid intake on fluid shift from interstitial to intravascular compartment in blood donors.

Science.gov (United States)

Deepika, Chenna; Murugesan, Mohandoss; Shastry, Shamee

2018-02-01

Fluid shifts from interstitial to intravascular space during blood donation helps in compensating the lost blood volume. We aimed to determine the volume of fluid shift following donation in donors with and without pre-donation fluid intake. We studied the fluid shift in 325 blood donors prospectively. Donors were divided in groups- with no fluid intake (GI) and either water (GII) or oral rehydrating fluids (GIII) before donation. Fluid shift following donation was calculated based on the difference between the pre and post donation blood volume. The influence of oral fluid intake, age, gender and body mass index (BMI) on volume of fluid shift was analyzed. The fluid shift was significant between donors without fluids (GI: 127 ± 81 ml) and donors with fluid intake (GII & III: 96 ± 45 ml) (p donation. As per our observation, the oral fluids before donation might not contribute to increase in fluid shift in blood donors after donation. Copyright © 2017 Elsevier Ltd. All rights reserved.

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