Percutaneous Mechanical Thrombectomy Treatment of Acute Superior Mesenteric Artery Embolism

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Z. Zhang

Full Text Available : Objective/Background: This report presents a superior mesenteric artery (SMA embolism managed by percutaneous mechanical thrombectomy (PMT. Methods: A 61 year old woman diagnosed with SMA embolism was admitted. Emboli were found in the middle and distal segments of the SMA on abdominal computed tomography angiography. Under local anaesthesia, a 6 F Rotarex system was used to remove the emboli via left brachial artery access. Emboli were successfully removed and patency was restored to the SMA and its branches. Results: Post-operatively, the patient's symptoms were significantly relieved. No post-operative complications were observed and no discomfort was documented during follow-up. Conclusion: Endovascular treatment of SMA embolism using PMT is a feasible and alternative option. Keywords: Acute mesenteric ischaemia, Embolism, Endovascular treatment, Percutaneous mechanical thrombectomy, Superior mesenteric artery

Endovascular Mechanical Thrombectomy in Basilar Artery Occlusion: Initial Experience

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Park, Bum-Soo; Kwon, Hyon-Jo; Choi, Seung-Won; Kim, Seon-Hwan; Koh, Hyeon-Song; Youm, Jin-Young; Song, Shi-Hun

2013-01-01

Objective This study was conducted to assess the efficacy and safety of endovascular mechanical thrombectomy (EMT) for patients diagnosed with basilar artery (BA) occlusion. Materials and Methods We retrospectively analyzed clinical and imaging data of 16 patients diagnosed with BA occlusion who were treated with endovascular intervention from July 2012 to February 2013. Direct suction using the Penumbra system and thrombus retrieval by the Solitaire stent were the main endovascular techniques used to restore BA flow. The outcomes were evaluated based on rate of angiographic recanalization, rate of improvement of National Institutes of Health Stroke Scale (NIHSS) score, rate of modified Rankin Scale (mRS) at discharge and after 3 months, and rate of cerebral hemorrhagic complications. Successful recanalization was defined as achieving Thrombolysis In Cerebral Infarction (TICI) of II or III. Results Sixteen patients received thrombectomy. The mean age was 67.8 ± 11 years and the mean NIHSS score was 12.3 ± 8.2. Eight patients treated within 6 hours of symptom onset were grouped as A and the other 8 patients treated beyond 6 hours (range, 6-120) were grouped as B. Successful recanalization was met in six patients (75%) for group A and 7 (87.5%) for group B. Favorable outcome occurred in 4 patients (50%) for group A and 5 (62.5%) for group B. Conclusion Our study supports the effectiveness and safety of endovascular mechanical thrombectomy in treating BA occlusion even 6 hours after symptom onset. PMID:24167791

Endovascular Mechanical Thrombectomy in Large-Vessel Occlusion Ischemic Stroke Presenting with Low National Institutes of Health Stroke Scale: Systematic Review and Meta-Analysis.

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Griessenauer, Christoph J; Medin, Caroline; Maingard, Julian; Chandra, Ronil V; Ng, Wyatt; Brooks, Duncan Mark; Asadi, Hamed; Killer-Oberpfalzer, Monika; Schirmer, Clemens M; Moore, Justin M; Ogilvy, Christopher S; Thomas, Ajith J; Phan, Kevin

2018-02-01

Mechanical thrombectomy has become the standard of care for management of most large vessel occlusion (LVO) strokes. When patients with LVO present with minor stroke symptomatology, no consensus on the role of mechanical thrombectomy exists. A systematic review and meta-analysis were performed to identify studies that focused on mechanical thrombectomy, either as a standalone treatment or with intravenous tissue plasminogen activator (IV tPA), in patients with mild strokes with LVO, defined as a baseline National Institutes of Health Stroke Scale score ≤5 at presentation. Data on methodology, quality criteria, and outcome measures were extracted, and outcomes were compared using odds ratio as a summary statistic. Five studies met the selection criteria and were included. When compared with medical therapy without IV tPA, mechanical thrombectomy and medical therapy with IV tPA were associated with improved 90-day modified Rankin Scale (mRS) score. Among medical patients who were not eligible for IV tPA, those who underwent mechanical thrombectomy were more likely to experience good 90-day mRS than those who were not. There was no significant difference in functional outcome between mechanical thrombectomy and medical therapy with IV tPA, and no treatment subgroup was associated with intracranial hemorrhage or death. In patients with mild strokes due to LVO, mechanical thrombectomy and medical therapy with IV tPA led to better 90-day functional outcome. Mechanical thrombectomy plays an important role in the management of these patients, particularly in those not eligible for IV tPA. Copyright © 2017 Elsevier Inc. All rights reserved.

Mechanical thrombectomy: an alternative for treating cerebral venous sinus thrombosis.

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Izura Gómez, Marta; Misis Del Campo, Maite; Puyalto de Pablo, Paloma; Castaño Duque, Carlos

2018-01-01

We report the use of mechanical venous thrombectomy in 2 cases of cerebral venous sinus thrombosis in which the usual first-choice treatment with systemic anticoagulants was contraindicated. Our aim is to present this treatment as an alternative to consider when anticoagulants therapy is too risky or is contraindicated in critically ill patients.

Cerebral arterial gas embolism from attempted mechanical thrombectomy: recovery following hyperbaric oxygen therapy.

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Segan, Louise; Permezel, Fiona; Ch'ng, Wei; Millar, Ian; Brooks, Mark; Lee-Archer, Matt; Cloud, Geoffrey

2018-04-01

Cerebral arterial gas embolism is a recognised complication of endovascular intervention with an estimated incidence of 0.08%. Its diagnosis is predominantly clinical, supported by neuroimaging. The treatment relies on alleviating mechanical obstruction and reversing the proinflammatory processes that contribute to tissue ischaemia. Hyperbaric oxygen therapy is an effective treatment and has multiple mechanisms to reverse the pathological processes involved in cerebral arterial gas embolism. Symptomatic cerebral arterial gas embolism is a rare complication of endovascular intervention for acute ischaemic stroke. Although there are no previous descriptions of its successful treatment with hyperbaric oxygen therapy following mechanical thrombectomy, this is likely to become more common as mechanical thrombectomy is increasingly used worldwide to treat acute ischaemic stroke. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Mechanical thrombectomy for acute ischemic stroke with occlusion of the M2 segment of the middle cerebral artery: a meta-analysis.

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Saber, Hamidreza; Narayanan, Sandra; Palla, Mohan; Saver, Jeffrey L; Nogueira, Raul G; Yoo, Albert J; Sheth, Sunil A

2017-11-10

Endovascular thrombectomy has demonstrated benefit for patients with acute ischemic stroke from proximal large vessel occlusion. However, limited evidence is available from recent randomized trials on the role of thrombectomy for M2 segment occlusions of the middle cerebral artery (MCA). We conducted a systematic review and meta-analysis to investigate clinical and radiographic outcomes, rates of hemorrhagic complications, and mortality after M2 occlusion thrombectomy using modern devices, and compared these outcomes against patients with M1 occlusions. Recanalization was defined as Thrombolysis in Cerebral Infarction (TICI) 2b/3 or modified TICI 2b/3. A total of 12 studies with 1080 patients with M2 thrombectomy were included in our analysis. Functional independence (modified Rankin Scale 0-2) rate was 59% (95% CI 54% to 64%). Mortality and symptomatic intracranial hemorrhage rates were 16% (95% CI 11% to 23%) and 10% (95% CI 6% to 16%), respectively. Recanalization rates were 81% (95% CI 79% to 84%), and were equally comparable for stent-retriever versus aspiration (OR 1.05; 95% CI 0.91 to 1.21). Successful M2 recanalization was associated with greater rates of favorable outcome (OR 4.22; 95% CI 1.96 to 9.1) compared with poor M2 recanalization (TICI 0-2a). There was no significant difference in recanalization rates for M2 versus M1 thrombectomy (OR 1.05; 95% CI 0.77 to 1.42). This meta-analysis suggests that mechanical thrombectomy for M2 occlusions that can be safely accessed is associated with high functional independence and recanalization rates, but may be associated with an increased risk of hemorrhage. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Massive Pulmonary Embolism: Treatment with the Rotarex Thrombectomy System

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Liu Sheng; Shi Haibin; Gu Jianping; Yang Zhengqiang; Chen Liang; Lou Wensheng; He Xu; Zhou Weizhong; Zhou Chungao; Zhao Linbo; Xia Jinguo; Li Linsun

2011-01-01

This study was designed to evaluate the efficacy and safety of percutaneous mechanical thrombectomy (PMT) for acute massive pulmonary embolism (PE). Fourteen patients (8 men, 6 women) with a mean age of 55.4 (range, 38–71) years with acute massive PE were initially diagnosed by computed tomography (CT) and confirmed by pulmonary angiography. All patients presented with acute PE symptoms and hemodynamic compromise. Each patient was treated with Straub Rotarex thrombectomy device and five patients received additional thrombolysis. Technique success and clinical improvement were achieved in all patients without major complications. The mean pulmonary artery pressure (PAP) decreased from 37.6 ± 6.6 to 29 ± 6.4 mmHg (P 2 (PaO 2 ) increased from 61.1 ± 9.2 to 88 ± 5.1 mmHg (P < 0.01). The Miller index was 0.67 ± 0.11 and 0.37 ± 0.13 (P < 0.01), respectively, before and after PMT (P < 0.01). Eleven patients had no recurrence of PE on a mean follow-up of 28.3 months, whereas the other three patients were lost to follow-up. The preliminary experience in our series suggests that the Straub Rotarex thrombectomy device, which has been utilized in peripheral arteries, also is useful for the treatment of acute massive PE.

ERic Acute StrokE Recanalization: A study using predictive analytics to assess a new device for mechanical thrombectomy.

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Siemonsen, Susanne; Forkert, Nils D; Bernhardt, Martina; Thomalla, Götz; Bendszus, Martin; Fiehler, Jens

2017-08-01

Aim and hypothesis Using a new study design, we investigate whether next-generation mechanical thrombectomy devices improve clinical outcomes in ischemic stroke patients. We hypothesize that this new methodology is superior to intravenous tissue plasminogen activator therapy alone. Methods and design ERic Acute StrokE Recanalization is an investigator-initiated prospective single-arm, multicenter, controlled, open label study to compare the safety and effectiveness of a new recanalization device and distal access catheter in acute ischemic stroke patients with symptoms attributable to acute ischemic stroke and vessel occlusion of the internal cerebral artery or middle cerebral artery. Study outcome The primary effectiveness endpoint is the volume of saved tissue. Volume of saved tissue is defined as difference of the actual infarct volume and the brain volume that is predicted to develop infarction by using an optimized high-level machine learning model that is trained on data from a historical cohort treated with IV tissue plasminogen activator. Sample size estimates Based on own preliminary data, 45 patients fulfilling all inclusion criteria need to complete the study to show an efficacy >38% with a power of 80% and a one-sided alpha error risk of 0.05 (based on a one sample t-test). Discussion ERic Acute StrokE Recanalization is the first prospective study in interventional stroke therapy to use predictive analytics as primary and secondary endpoint. Such trial design cannot replace randomized controlled trials with clinical endpoints. However, ERic Acute StrokE Recanalization could serve as an exemplary trial design for evaluating nonpivotal neurovascular interventions.

Endovascular thrombectomy for M2 occlusions: comparison between forced arterial suction thrombectomy and stent retriever thrombectomy.

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Kim, Yong-Won; Son, Seungnam; Kang, Dong-Hun; Hwang, Yang-Ha; Kim, Yong-Sun

2017-07-01

To date there has been no direct comparison of two frequently used endovascular thrombectomy (EVT) methods (forced arterial suction thrombectomy (FAST) and stent retriever thrombectomy) in M2 occlusions. We review our experiences with EVT performed using FAST and stent retriever thrombectomy in such cases. The subjects comprised 41 patients with an M2 occlusion who underwent EVT (25 with FAST, 16 with stent retriever thrombectomy). The patients' data were retrospectively analyzed to evaluate the technical characteristics and angiographic outcome of the two EVT techniques. Thrombolysis In Cerebral Infarction (TICI) grades 2b-3 using the first chosen technique did not differ significantly between the two techniques (FAST 64.0% vs stent retriever thrombectomy 81.2%, p=0.305). Time from groin puncture to reperfusion was significantly shorter for stent retriever thrombectomy (53.0 vs 38.5 min; p=0.045). Distal embolization occurred in three cases (12.0%) in the FAST group and in four (26.7%) in the stent retriever group (p=0.362). However, the two techniques did not differ significantly in the final TICI 2b-3 rate (72.0% vs 87.5%; p=0.441). A frequent angiographic finding regarding the failure of FAST was that the M2 occlusion was located immediately after severe acute angulation between M1 and M2. Stent retriever thrombectomy may provide faster reperfusion than FAST, while the FAST technique might be associated with lower distal embolization and a higher reperfusion rate for the first thrombectomy attempt, but without any significant difference in clinical outcome. When choosing the EVT method for M2 occlusions, consideration of the location of the occlusion and tortuosity between M1 and M2 might be helpful to achieve a better angiographic outcome. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

t-PA power-pulse spray with rheolytic mechanical thrombectomy using cross-sectional image-guided portal vein access for single setting treatment of subacute superior mesenteric vein thrombosis.

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Syed, Mubin I; Gallagher, Ryan M; Ahmed, Rukan S; Shaikh, Azim; Roberto, Edward; Patel, Sumeet

2018-01-01

Isolated superior mesenteric vein (SMV) thrombosis is a rare but potentially fatal condition if untreated. Current treatments include transjugular or transhepatic approaches for rheolytic mechanical thrombectomy and subsequent infusions of thrombolytics. Tissue plasminogen activator (t-PA) power-pulse spray can provide benefit in a single setting without thrombolytic infusions. Computed tomography (CT) guidance for portal vein access is underutilized in this setting. Case 1 discusses acute SMV thrombosis treated with rheolytic mechanical thrombectomy alone using ultrasound guidance for portal vein access. Case 2 discusses subacute SMV thrombosis treated with the addition of t-PA power-pulse spray to the rheolytic mechanical thrombectomy, using CT guidance for portal vein access. With rheolytic mechanical thrombectomy alone, the patient in Case 1 had significant improvement in abdominal pain. Follow-up CT demonstrated no residual SMV thrombosis and the patient continued to do well in long-term follow-up. With the addition of t-PA power-pulse spray to rheolytic mechanical thrombectomy, the patient in Case 2 with subacute SMV thrombosis dramatically improved postprocedure with resolution of abdominal pain. Follow-up imaging demonstrated patency to the SMV and partial resolution of thrombus. The patient continued to do well at 2-year follow-up. Adding t-PA power-pulse spray to rheolytic mechanical thrombectomy can provide benefit in a single setting versus mechanical thrombectomy alone and prevent the need for subsequent infusions of thrombolytic therapy. CT guidance is a useful alternative of localization for portal vein access via the transhepatic route that is nonoperator-dependent and helpful in the case of obese patients.

t-PA power-pulse spray with rheolytic mechanical thrombectomy using cross-sectional image-guided portal vein access for single setting treatment of subacute superior mesenteric vein thrombosis

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Mubin I Syed

2018-01-01

Full Text Available Background: Isolated superior mesenteric vein (SMV thrombosis is a rare but potentially fatal condition if untreated. Current treatments include transjugular or transhepatic approaches for rheolytic mechanical thrombectomy and subsequent infusions of thrombolytics. Tissue plasminogen activator (t-PA power-pulse spray can provide benefit in a single setting without thrombolytic infusions. Computed tomography (CT guidance for portal vein access is underutilized in this setting. Materials and Methods: Case 1 discusses acute SMV thrombosis treated with rheolytic mechanical thrombectomy alone using ultrasound guidance for portal vein access. Case 2 discusses subacute SMV thrombosis treated with the addition of t-PA power-pulse spray to the rheolytic mechanical thrombectomy, using CT guidance for portal vein access. Results: With rheolytic mechanical thrombectomy alone, the patient in Case 1 had significant improvement in abdominal pain. Follow-up CT demonstrated no residual SMV thrombosis and the patient continued to do well in long-term follow-up. With the addition of t-PA power-pulse spray to rheolytic mechanical thrombectomy, the patient in Case 2 with subacute SMV thrombosis dramatically improved postprocedure with resolution of abdominal pain. Follow-up imaging demonstrated patency to the SMV and partial resolution of thrombus. The patient continued to do well at 2-year follow-up. Conclusions: Adding t-PA power-pulse spray to rheolytic mechanical thrombectomy can provide benefit in a single setting versus mechanical thrombectomy alone and prevent the need for subsequent infusions of thrombolytic therapy. CT guidance is a useful alternative of localization for portal vein access via the transhepatic route that is nonoperator-dependent and helpful in the case of obese patients.

Influence of a combined CT/C-arm system on periprocedural workflow and procedure times in mechanical thrombectomy.

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Pfaff, Johannes; Schönenberger, Silvia; Herweh, Christian; Pham, Mirko; Nagel, Simon; Ringleb, Peter Arthur; Heiland, Sabine; Bendszus, Martin; Möhlenbruch, Markus Alfred

2017-09-01

To achieve the fastest possible workflow in ischaemic stroke, we developed a CT/C-arm system, which allows imaging and endovascular treatment on the same patient table. This prospective, monocentric trial was conducted between October 2014 and August 2016. Patients received stroke imaging and mechanical thrombectomy under general anaesthesia (GA) or conscious sedation (CS) using our combined setup comprising a CT-scanner and a mobile C-arm X-ray device. Primary endpoint was time between stroke imaging and groin puncture. We compared periprocedural workflow and procedure times with the literature and a matched patient cohort treated with a biplane angiographic system before installation of the CT/C-arm system. In 50 patients with acute ischaemic stroke due to large-vessel occlusion in the anterior circulation, comparable recanalization rates were achieved by using the CT/C-arm setup (TICI2b-3:CT/C-arm-GA: 85.7%; CT/C-arm-CS: 90.9%; Angiosuite: 78.6%; p = 0.269) without increasing periprocedural complications. Elimination of patient transport resulted in a significant reduction of the time between stroke imaging and groin puncture: median, min (IQR): CT/C-arm-GA: 43 (35-52); CT/C-arm-CS: 39 (28-49); Angiosuite: 64 (48-74); p < 0.0001. The combined CT/C-arm system allows comparable recanalization rates as a biplane angiographic system and accelerates the start of the endovascular stroke treatment. • The CT/C-arm setup reduces median time from stroke imaging to groin puncture. • Mechanical thrombectomy using a C-arm device is feasible without increasing peri-interventional complications. • The CT/C-arm setup might be a valuable fallback solution for emergency procedures. • The CT/C-arm setup allows immediate control CT images during and after treatment.

Prospective, Multi-Centre, Single-Arm Study of Mechanical Thrombectomy using Solitaire FR in Acute Ischemic Stroke-STAR

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Pereira, Vitor M; Gralla, Jan; Davalos, Antoni; Bonafé, Alain; Castaño, Carlos; Chapot, Rene; Liebeskind, David S; Nogueira, Raul G; Arnold, Marcel; Sztajzel, Roman; Liebig, Thomas; Goyal, Mayank; Besselmann, Michael; Moreno, Alfredo; Schroth, Gerhard

2013-01-01

Background and Purpose Mechanical thrombectomy using stent retriever devices have been advocated to increase revascularization in intracranial vessel occlusion. We present the results of a large prospective study on the use of the Solitaire FR in patients with acute ischemic stroke. Methods STAR was an international, multicenter, prospective, single-arm study of Solitaire FR thrombectomy in patients with large vessel anterior circulation strokes treated within 8 hours of symptom onset. Strict criteria for site selection were applied. The primary endpoint was the revascularization rate (3TICI 2b) of the occluded vessel as determined by an independent core lab. The secondary endpoint was the rate of good functional outcome (defined as 90-day modified Rankin scale (mRS) 0–2). Results A total of 202 patients were enrolled across 14 comprehensive stroke centers in Europe, Canada and Australia. The median age was 72 years, 60% were female patients. The median National Institute of Health Stroke Scale (NIHSS) was 17. Most proximal intracranial occlusion was the internal carotid artery in 18%, the middle cerebral artery in 82%. Successful revascularization was achieved in 79.2% of patients. Device and/or procedure related severe adverse events were found in 7.4%. Favorable neurological outcome was found in 57.9%. The mortality rate was 6.9%. Any intracranial hemorrhagic transformation was found in 18.8% of patients, 1.5% were symptomatic. Conclusions In this single arm study, treatment with the Solitaire™ FR device in intracranial anterior circulation occlusions results in high rates of revascularization, low risk of clinically relevant procedural complications, and good clinical outcomes in combination with low mortality at 90 days. Clinical Trial Registration This study is registered with ClinicalTrials.gov, number NCT01327989. PMID:23908066

Transjugular Intrahepatic Portosystemic Shunt, Mechanical Aspiration Thrombectomy, and Direct Thrombolysis in the Treatment of Acute Portal and Superior Mesenteric Vein Thrombosis

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Ferro, Carlo; Rossi, Umberto G.; Bovio, Giulio; Dahamane, M'Hamed; Centanaro, Monica

2007-01-01

A patient was admitted because of severe abdominal pain, anorexia, and intestinal bleeding. Contrast-enhanced multidetector computed tomography demonstrated acute portal and superior mesenteric vein thrombosis (PSMVT). The patient was treated percutaneously with transjugular intrahepatic portosystemic shunt (TIPS), mechanical aspiration thrombectomy, and direct thrombolysis, and 1 week after the procedure, complete patency of the portal and superior mesenteric veins was demonstrated. TIPS, mechanical aspiration thrombectomy, and direct thrombolysis together are promising endovascular techniques for the treatment of symptomatic acute PSMVT

Diagnosis of acute ischemia using dual energy CT after mechanical thrombectomy.

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Gariani, Joanna; Cuvinciuc, Victor; Courvoisier, Delphine; Krauss, Bernhard; Mendes Pereira, Vitor; Sztajzel, Roman; Lovblad, Karl-Olof; Vargas, Maria Isabel

2016-10-01

To assess the performance of dual energy unenhanced CT in the detection of acute ischemia after mechanical thrombectomy. Retrospective study, approved by the local institutional review board, including all patients that underwent intra-arterial thrombectomy in our institution over a period of 2 years. The presence of acute ischemia and hemorrhage was evaluated by three readers. Sensitivity and specificity of the non-contrast CT weighted sum image (NCCT) and the virtual non-contrast reconstructed image (VNC) were estimated and compared using generalized estimating equations to account for the non-independence of regions in each patient. 58 patients (27 women and 31 men; mean age 70.4 years) were included in the study, yielding 580 regions of interest. Sensitivity and specificity in detecting acute ischemia were higher for all readers when using VNC, with a significant increase in sensitivity for two readers (pVNC images were superior in the identification of acute ischemia in comparison with NCCT. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

”Missing clot” during mechanical thrombectomy in acute stroke using Solitaire stent retrieval system

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Vikram Huded

2016-01-01

Full Text Available Stent retrieval system is an established treatment modality in acute ischemic stroke with large vessel occlusion. Here, we describe a complication which occurred during mechanical thrombectomy in three cases where the clot dislodged during retrieval. There was a possibility of the clot getting reinjected into the artery with possible dire consequences.

The primary experimental study of self-made percutaneous catheterized thrombectomy device for acute massive pulmonary embolism

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Lu Junliang; Yang Ning; Zhao Shijun; Ma Junshan; Yang Jianping

2008-01-01

Objective: To evaluate efficacy, feasibility and safety of the self-made percutaneous catheterized thrombectomy divice in animal model for thrombus removal. Methods: Seven dogs were selected, with acute massive pulmonary embolism animal models created by injecting thrombi into the pulmonary arterial trunk via percutaneous femoral vein approach. After half an hours the catheter sheath was inserted into the occluded pulmonary artery through right femoral vein in 5 dogs, left femoral vein in 1 dog and right internal jugular vein in another one. The procedure began to remove the thrombi with simultaneous recording the thrombectomy time and the blood volume drainage. Blood gass was tested before and after embolization together with those of thrombi removement, continuously monitored pulmonary arterial pressure and intermittently performed angiography. The mean time form vascular recanalization to euthanasia was 2 hours, and then the lung specimens were resected for histological examination. Results: One animal died of pulmonary arterial penetration during thrombi removal, but others were all alive by the end of the test. Mean time of removing thrombi was 2.4 minutes with mean volume blood drainage of 84 ml. Angiograms showed the approximately complete patency of the pulmonary arterial trunk after reopening of occlusion but still with remnont thrombi within distal branches and arterial pressure with blood gas returned to normal level. Pathology revealed the recanalization of pulmonary arterial trunk but with thromi still staying in the distal branches, and effusion around the arteries. Conclusions: The self-made percutaneous catheterized thrombectomy device is effective, feasible and comparatively safe in the treatment of acute massive pulmonary embolism in this primary test. (authors)

Mechanical thrombectomy after intravenous alteplase versus alteplase alone after stroke (THRACE): a randomised controlled trial.

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Bracard, Serge; Ducrocq, Xavier; Mas, Jean Louis; Soudant, Marc; Oppenheim, Catherine; Moulin, Thierry; Guillemin, Francis

2016-10-01

Intravenous thrombolysis with alteplase alone cannot reperfuse most large-artery strokes. We aimed to determine whether mechanical thrombectomy in addition to intravenous thrombolysis improves clinical outcome in patients with acute ischaemic stroke. THRACE is a randomised controlled trial done in 26 centres in France. Patients aged 18-80 years with acute ischaemic stroke and proximal cerebral artery occlusion were randomly assigned to receive either intravenous thrombolysis alone (IVT group) or intravenous thrombolysis plus mechanical thrombectomy (IVTMT group). Intravenous thrombolysis (alteplase 0·9 mg/kg [maximum 90 mg], with an initial bolus of 10% of the total dose followed by infusion of the remaining dose over 60 min) had to be started within 4 h and thrombectomy within 5 h of symptom onset. Occlusions had to be confirmed by CT or magnetic resonance angiography. Randomisation was done centrally with a computer-generated sequential minimisation method and was stratified by centre. The primary outcome was the proportion of patients achieving functional independence at 3 months, defined by a score of 0-2 on the modified Rankin scale, assessed in the modified intention-to-treat population (ie, patients lost to follow-up and those with missing data were excluded). Safety outcomes were analysed in the per-protocol population (ie, all patients who did not follow the protocol of their randomisation group precisely were excluded from the analysis). THRACE is registered with ClinicalTrials.gov, NCT01062698. Between June 1, 2010, and Feb 22, 2015, 414 patients were randomly assigned to the IVT group (n=208) or the IVTMT group (n=204). Four patients (two in each group) lost to follow-up and six (four in the IVT group and two in the IVTMT group) with missing data were excluded. 85 (42%) of 202 patients in the IVT group and 106 (53%) of 200 patients in the IVTMT group achieved functional independence at 3 months (odds ratio 1·55, 95% CI 1·05-2·30; p=0·028). The two

Percutaneous treatment of thrombosed native arteriovenous dialysis fistula insufficiency: efficacy of mechanical thrombectomy with using the stone basket

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Kim, Young Hwan; Ko, Sung Min; Kim, Mi Jung; Kwon, Jung Hyeok; Sohn, Cheol Ho; Choi, Jin Soo; Park, Kyung Sik; Kim, Yong Joo

2006-01-01

We wanted to evaluate the procedural success after percutaneous treatment of thrombosed native arteriovenous dialysis fistula insufficiency and the efficacy of performing mechanical thrombectomy with using the stone basket. From March 2004 to June 2005, 36 thrombosed native hemodialysis access shunts in the upper limbs (brachiocephalic fistulas: 16 and radiocephalic fistulas: 20) were percutaneously treated in 30 patients. Declotting procedures were performed with using urokinase (100,00-200,000 unit) and manual catheter-directed thrombo-aspiration in all the patients. Angioplasty (6 mm in diameter and 4 cm in length) was performed at the identified area of the stenosis and /or with maceration of the thrombus. In 14 cases with massive thrombosis that was refractory to the above mentioned declotting procedures, mechanical thrombectomy with using a Wittich nitinol stone basket (Cook, Bloomington, IN) was performed. Data regarding the procedural success rate and the patency rate were analyzed by means of Fischer's exact test, and the Kaplan-Meier method with the Log-rank test was used for statistical inter-group comparisons between the brachiocephalic and radiocephalic fistulas. Successful declotting and restoration of thrill were achieved in 30 of 36 procedures (83%). Reestablishment of normal dialysis for at least one session was achieved in 29 of 36 procedures (81%). The procedural success rate for the brachiocephalic fistulas was 94% compared with 70% for the radiocephalic fistulas, but the difference was not statistically significant (ρ = 0.104). In the cases with performing mechanical thrombectomy and using the stone basket, procedural success was achieved in 93% (13/14). The expected patency rates at 3, 6 and 12 months were 78%, 61% and 51%, respectively. The patency rates after declotting procedures were not significantly different between the brachiocephalic and radiocephlaic fistulas (ρ = 0.871). Percutaneous treatment of thrombosed native arteriovenous

Percutaneous treatment of thrombosed native arteriovenous dialysis fistula insufficiency: efficacy of mechanical thrombectomy with using the stone basket

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Kim, Young Hwan; Ko, Sung Min; Kim, Mi Jung; Kwon, Jung Hyeok; Sohn, Cheol Ho; Choi, Jin Soo; Park, Kyung Sik [Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of); Kim, Yong Joo [Andong General Hospital, Andon (Korea, Republic of)

2006-06-15

We wanted to evaluate the procedural success after percutaneous treatment of thrombosed native arteriovenous dialysis fistula insufficiency and the efficacy of performing mechanical thrombectomy with using the stone basket. From March 2004 to June 2005, 36 thrombosed native hemodialysis access shunts in the upper limbs (brachiocephalic fistulas: 16 and radiocephalic fistulas: 20) were percutaneously treated in 30 patients. Declotting procedures were performed with using urokinase (100,00-200,000 unit) and manual catheter-directed thrombo-aspiration in all the patients. Angioplasty (6 mm in diameter and 4 cm in length) was performed at the identified area of the stenosis and /or with maceration of the thrombus. In 14 cases with massive thrombosis that was refractory to the above mentioned declotting procedures, mechanical thrombectomy with using a Wittich nitinol stone basket (Cook, Bloomington, IN) was performed. Data regarding the procedural success rate and the patency rate were analyzed by means of Fischer's exact test, and the Kaplan-Meier method with the Log-rank test was used for statistical inter-group comparisons between the brachiocephalic and radiocephalic fistulas. Successful declotting and restoration of thrill were achieved in 30 of 36 procedures (83%). Reestablishment of normal dialysis for at least one session was achieved in 29 of 36 procedures (81%). The procedural success rate for the brachiocephalic fistulas was 94% compared with 70% for the radiocephalic fistulas, but the difference was not statistically significant ({rho} = 0.104). In the cases with performing mechanical thrombectomy and using the stone basket, procedural success was achieved in 93% (13/14). The expected patency rates at 3, 6 and 12 months were 78%, 61% and 51%, respectively. The patency rates after declotting procedures were not significantly different between the brachiocephalic and radiocephlaic fistulas ({rho} = 0.871). Percutaneous treatment of thrombosed native

The Basilar Artery on Computed Tomography Angiography Score for Acute Basilar Artery Occlusion Treated with Mechanical Thrombectomy.

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Yang, Haihua; Ma, Ning; Liu, Lian; Gao, Feng; Mo, Dapeng; Miao, Zhongrong

2018-06-01

Recently, the Basilar Artery on Computed Tomography Angiography (BATMAN) score predicts clinical outcome of acute basilar artery occlusion (BAO), yet there is no extensive external validation. The purpose of this study was to validate the prognostic value of BATMAN scoring system for the prediction of clinical outcome in patients with acute BAO treated with endovascular mechanical thrombectomy by using cerebral digital subtraction angiography (DSA). We analyzed the clinical and angiographic data of consecutive patients with acute BAO from March 2012 to November 2016. The BATMAN scoring system was used to assess the collateral status and thrombus burden. Thrombolysis in Cerebral Infarction (TICI) score 2b-3 was defined as successful recanalization. Receiver operating characteristic (ROC) curve was used to determine the area under the curve (AUC) and the optimum cutoff value. Multivariate regression analysis was used to identify the predictor of clinical outcome. This study included 63 patients with acute BAO who underwent mechanical thrombectomy. Of these patients, 90.5% (57/63) achieved successful recanalization (TICI, 2b-3) and 34.9% (22/63) had a favorable outcome (modified Rankin Scale score 0-2). ROC analysis indicated that the AUC of the BATMAN score was .722 (95% confidence interval [CI], .594-.827), and the optimal cutoff value was 3 (sensitivity = 72.73, specificity = 63.41). In multivariate logistic regression analysis, the BATMAN score higher than 3 was associated with favorable outcome (odds ratio, 5.214; 95% CI, 1.47-18.483; P = .011). The BATMAN score on DSA seems to predict the functional outcome in patients of acute BAO treated with mechanical thrombectomy. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Added value of CT perfusion compared to CT angiography in predicting clinical outcomes of stroke patients treated with mechanical thrombectomy

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Tsogkas, Ioannis; Knauth, Michael; Schregel, Katharina; Behme, Daniel; Psychogios, Marios Nikos [University Medicine Goettingen, Department of Neuroradiology, Goettingen (Germany); Wasser, Katrin; Maier, Ilko; Liman, Jan [University Medicine Goettingen, Department of Neurology, Goettingen (Germany)

2016-11-15

CTP images analyzed with the Alberta stroke program early CT scale (ASPECTS) have been shown to be optimal predictors of clinical outcome. In this study we compared two biomarkers, the cerebral blood volume (CBV)-ASPECTS and the CTA-ASPECTS as predictors of clinical outcome after thrombectomy. Stroke patients with thrombosis of the M1 segment of the middle cerebral artery were included in our study. All patients underwent initial multimodal CT with CTP and CTA on a modern CT scanner. Treatment consisted of full dose intravenous tissue plasminogen activator, when applicable, and mechanical thrombectomy. Three neuroradiologists separately scored CTP and CTA images with the ASPECTS score. Sixty-five patients were included. Median baseline CBV-ASPECTS and CTA-ASPECTS for patients with favourable clinical outcome at follow-up were 8 [interquartile range (IQR) 8-9 and 7-9 respectively]. Patients with poor clinical outcome showed a median baseline CBV-ASPECTS of 6 (IQR 5-8, P < 0.0001) and a median baseline CTA-ASPECTS of 7 (IQR 7-8, P = 0.18). Using CBV-ASPECTS and CTA-ASPECTS raters predicted futile reperfusions in 96 % and 56 % of the cases, respectively. CBV-ASPECTS is a significant predictor of clinical outcome in patients with acute ischemic stroke treated with mechanical thrombectomy. (orig.)

Outcomes of early carotid stenting and angioplasty in large-vessel anterior circulation strokes treated with mechanical thrombectomy and intravenous thrombolytics.

Science.gov (United States)

Mehta, T; Desai, N; Mehta, K; Parikh, R; Male, S; Hussain, M; Ollenschleger, M; Spiegel, G; Grande, A; Ezzeddine, M; Jagadeesan, B; Tummala, R; McCullough, L

2018-01-01

Introduction Proximal cervical internal carotid artery stenosis greater than 50% merits revascularization to mitigate the risk of stroke recurrence among large-vessel anterior circulation strokes undergoing mechanical thrombectomy. Carotid artery stenting necessitates the use of antiplatelets, and there is a theoretical increased risk of hemorrhagic transformation given that such patients may already have received intravenous thrombolytics and have a significant infarct burden. We investigate the outcomes of large-vessel anterior circulation stroke patients treated with intravenous thrombolytics receiving same-day carotid stenting or selective angioplasty compared to no carotid intervention. Materials and methods The study cohort was obtained from the National (Nationwide) Inpatient Sample database between 2006 and 2014, using International Statistical Classification of Diseases, ninth revision discharge diagnosis and procedure codes. A total of 11,825 patients with large-vessel anterior circulation stroke treated with intravenous thrombolytic and mechanical thrombectomy on the same day were identified. The study population was subdivided into three subgroups: no carotid intervention, same-day carotid angioplasty without carotid stenting, and same-day carotid stenting. Outcomes were assessed with respect to mortality, significant disability at discharge, hemorrhagic transformation, and requirement of percutaneous endoscopic gastronomy tube placement, prolonged mechanical ventilation, or craniotomy. Results This study found no statistically significant difference in patient outcomes in those treated with concurrent carotid stenting compared to no carotid intervention in terms of morbidity or mortality. Conclusions If indicated, it is reasonable to consider concurrent carotid stenting and/or angioplasty for large-vessel anterior circulation stroke patients treated with mechanical thrombectomy who also receive intravenous thrombolytics.

Uric acid therapy improves the outcomes of stroke patients treated with intravenous tissue plasminogen activator and mechanical thrombectomy.

Science.gov (United States)

Chamorro, Ángel; Amaro, Sergio; Castellanos, Mar; Gomis, Meritxell; Urra, Xabier; Blasco, Jordi; Arenillas, Juan F; Román, Luis S; Muñoz, Roberto; Macho, Juan; Cánovas, David; Marti-Fabregas, Joan; Leira, Enrique C; Planas, Anna M

2017-06-01

Background Numerous neuroprotective drugs have failed to show benefit in the treatment of acute ischemic stroke, making the search for new treatments imperative. Uric acid is an endogenous antioxidant making it a drug candidate to improve stroke outcomes. Aim To report the effects of uric acid therapy in stroke patients receiving intravenous thrombolysis and mechanical thrombectomy. Methods Forty-five patients with proximal vessel occlusions enrolled in the URICO-ICTUS trial received intravenous recombinant tissue plasminogen activator within 4.5 h after stroke onset and randomized to intravenous 1000 mg uric acid or placebo (NCT00860366). These patients also received mechanical thrombectomy because a brain computed tomogaphy angiography confirmed the lack of proximal recanalization at the end of systemic thrombolysis. The primary outcome was good functional outcome at 90 days (modified Rankin Score 0-2). Safety outcomes included mortality, symptomatic intracerebral bleeding, and gout attacks. Results The rate of successful revascularization was >80% in the uric acid and the placebo groups but good functional outcome was observed in 16 out of 24 (67%) patients treated with uric acid and 10 out of 21 (48%) treated with placebo (adjusted Odds Ratio, 6.12 (95% CI 1.08-34.56)). Mortality was observed in two out of 24 (8.3%) patients treated with uric acid and one out of 21 (4.8%) treated with placebo (adjusted Odds Ratio, 3.74 (95% CI 0.06-226.29)). Symptomatic cerebral bleeding and gout attacks were similar in both groups. Conclusions Uric acid therapy was safe and improved stroke outcomes in stroke patients receiving intravenous thrombolysis followed by thrombectomy. Validation of this simple strategy in a larger trial is urgent.

Endovascular Revascularization of Hemodialysis Thrombosed Grafts with the Hydrodynamic Thrombectomy Catheter. Our 7-Year Experience

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Bermudez, Patrícia, E-mail: pbermude@clinic.ub.es [Clinic Hospital of Barcelona, Vascular and Interventional Radiology Unit, Diagnostic Imaging Institute (Spain); Fontseré, Nestor, E-mail: fontsere@clinic.ub.es [Clinic Hospital of Barcelona, Vascular Access Unit, Nephrologic and Urologic Diseases Clinical Institute (Spain); Mestres, Gaspar, E-mail: gmestres@clinic.ub.es [Clinic Hospital of Barcelona, Cardiovascular Diseases Institute (Spain); García-Gámez, Andres, E-mail: garciagam@clinic.ub.es; Barrufet, Marta, E-mail: barrufet@clinic.ub.es; Burrel, Marta, E-mail: mburrel@clinic.ub.es; Gilabert, Rosa, E-mail: gilabert@clinic.ub.es; Gómez, Fernando, E-mail: fegomez@clinic.ub.es; Macho, Juan, E-mail: jmmacho@clinic.ub.es [Clinic Hospital of Barcelona, Vascular and Interventional Radiology Unit, Diagnostic Imaging Institute (Spain)

2017-02-15

PurposeTo evaluate the efficacy and safety of the hydrodynamic thrombectomy catheter (AngioJet DVX) in the salvage of thrombosed hemodialysis vascular grafts.Materials and MethodsA retrospective study was designed, including all patients with occluded arteriovenous grafts treated with the AngioJet system between 2007 and 2014 in our institution. Outcomes included technical success, clinical success, complications, and primary and secondary patencies. Procedural success was defined as angiographic confirmation of flow restoration, the presence of a pulsatile thrill along the graft, and successful resumption of at least one hemodialysis session. Primary and secondary patencies after first AVG thrombectomy were calculated with Kaplan–Meier curves. Cox regression was used to determine prognostic factors of primary patency after every thrombectomy episode.ResultsA total of 149 thrombectomies were performed in 68 grafts. After thrombectomy, endovascular treatment of one or more stenosis was performed in all cases. Technical success was 93% and clinical success was 86%. Complications occurred in 7 thrombectomies, most of them were minor except for one anastomosis rupture requiring surgery. Primary and secondary patencies were 52, 41, and 23 and 76, 68, and 57% at 3, 6 and 12 months, respectively. Independent prognostic factors of poor patency after every thrombectomy episode were the presence of residual thrombus (OR 1.831, P = 0.008) and time from last thrombosis (less than 1 month; and OR 7.116, P < 0.001).ConclusionPercutaneous mechanical thrombectomy with AngioJet is a safe technique with a high-clinical success rate. The presence of residual thrombus after thrombectomy and early re-occlusions are related to poorer results.

Massive Pulmonary Embolism: Percutaneous Emergency Treatment Using an Aspirex Thrombectomy Catheter

International Nuclear Information System (INIS)

Popovic, Peter; Bunc, Matjaz

2010-01-01

Massive pulmonary embolism (PE) is a life-threatening condition with a high early mortality rate caused by acute right ventricular failure and cardiogenic shock. A 51-year-old woman with a massive PE and contraindication for thrombolytic therapy was treated with percutaneous mechanical thrombectomy using an Aspirex 11F catheter (Straub Medical AG, Wangs, Switzerland). The procedure was successfully performed and showed a good immediate angiographic result. The patient made a full recovery from the acute episode and was discharged on heparin treatment. Our case report indicates that in patients with contraindications to systemic thrombolysis, catheter thrombectomy may constitute a life-saving intervention for massive PE.

Comparison of the efficacy and safety of thrombectomy devices in acute stroke : a network meta-analysis of randomized trials.

Science.gov (United States)

Saber, Hamidreza; Rajah, Gary B; Kherallah, Riyad Y; Jadhav, Ashutosh P; Narayanan, Sandra

2017-12-15

Mechanical thrombectomy (MT) is increasingly used for large-vessel occlusions (LVO), but randomized clinical trial (RCT) level data with regard to differences in clinical outcomes of MT devices are limited. We conducted a network meta-analysis (NMA) that enables comparison of modern MT devices (Trevo, Solitaire, Aspiration) and strategies (stent retriever vs aspiration) across trials. Relevant RCTs were identified by a systematic review. The efficacy outcome was 90-day functional independence (modified Rankin Scale (mRS) score 0-2). Safety outcomes were 90-day catastrophic outcome (mRS 5-6) and symptomatic intracranial hemorrhage (sICH). Fixed-effect Bayesian NMA was performed to calculate risk estimates and the rank probabilities. In a NMA of six relevant RCTs (SWIFT, TREVO2, EXTEND-IA, SWIFT-PRIME, REVASCAT, THERAPY; total of 871 patients, 472 Solitaire vs medical-only, 108 Aspiration vs medical-only, 178 Trevo vs Merci, and 113 Solitaire vs Merci) with medical-only arm as the reference, Trevo had the greatest functional independence (OR 4.14, 95% credible interval (CrI) 1.41-11.80; top rank probability 92%) followed by Solitaire (OR 2.55, 95% CrI 1.75-3.74; top rank probability 72%). Solitaire and Aspiration devices had the greatest top rank probability with respect to low sICH and catastrophic outcomes (76% and 91%, respectively), but without significant differences between each other. In a separate network of seven RCTs (MR-CLEAN, ESCAPE, EXTEND-IA, SWIFT-PRIME, REVASCAT, THERAPY, ASTER; 1737 patients), first-line stent retriever was associated with a higher top rank probability of functional independence than aspiration (95% vs 54%), with comparable safety outcomes. These findings suggest that Trevo and Solitaire devices are associated with a greater likelihood of functional independence whereas Solitaire and Aspiration devices appear to be safer. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

Efficacy and Safety of REVIVE SE Thrombectomy Device for Acute Ischemic Stroke: River JAPAN (Reperfuse Ischemic Vessels with Endovascular Recanalization Device in Japan).

Science.gov (United States)

Sakai, Nobuyuki; Ota, Shinzo; Matsumoto, Yasushi; Kondo, Rei; Satow, Tetsu; Kubo, Michiya; Tsumoto, Tomoyuki; Enomoto, Yukiko; Kataoka, Taketo; Imamura, Hirotoshi; Todo, Kenichi; Hayakawa, Mikito; Yamagami, Hiroshi; Toyoda, Kazunori; Ito, Yasushi; Sugiu, Kenji; Matsumaru, Yuji; Yoshimura, Shinichi

2018-04-15

REVIVE SE (REVIVE) is a closed-ended, self-expanding stent retriever used in the RIVER JAPAN study. We present our early experience with REVIVE for revascularization of acute ischemic stroke (AIS) in patients who have failed or are ineligible for intravenous recombinant tissue plasminogen activator treatment. This prospective, single-arm, non-randomized, multicenter registry study followed up patients undergoing mechanical thrombectomy with REVIVE for 90 days. The primary endpoint was a post-procedure Thrombolysis in Cerebral Infarction (TICI) score ≥2a. Secondary endpoints were clot migration/embolization; recanalization without symptomatic intracranial hemorrhage (ICH) at 24 h; symptomatic ICH; good neurological outcome (modified Rankin Scale score ≤2 National Institute of Health Stroke Scale (NIHSS) score decrease ≥10) at day 90; device- or procedure-related serious adverse events (SAEs) and mortality at day 90. To confirm non-inferiority of REVIVE, results were compared with historical data of the Merci Retriever. About 49 patients were enrolled (median age 73 years; males 46.9%; middle cerebral artery (MCA) occlusion 83.7%; median NIHSS score 17). A post-procedure TICI score ≥2a was observed in 73.5% (36/49, 95% confidence interval [CI] 58.9-85.1) of patients. No post-procedural clot migration/embolization events occurred. Successful recanalization without symptomatic ICH was observed in 62.5% (30/48, 95% CI 47.4-76.0). The good neurological outcome was achieved in 66.7% (32/48) patients. Symptomatic ICH and device- or procedure-related SAEs were reported in 6.3% and 12.2% of patients, respectively. Two deaths were reported. REVIVE demonstrated equivalent efficacy and safety as the Merci Retriever. Results suggest that REVIVE is effective and safe in recanalizing occluded intracranial arteries in AIS.

Endovascular thrombectomy and post-procedural headache.

Science.gov (United States)

Khan, Sabrina; Amin, Faisal Mohammad; Holtmannspötter, Markus; Hansen, Klaus; Florescu, Anna Maria; Fakhril-Din, Zainab; Petersen, Julie Falkenberg; Ghanizada, Hashmat; Ayata, Cenk; Gaist, David; Ashina, Messoud

2017-12-01

We investigated the prevalence of post-procedural headache in patients who have undergone thrombectomy for ischemic stroke, and correlated history of migraine with risk of peri-procedural complications. A total of 314 patients underwent thrombectomy at the Danish National Hospital from January 2012 to December 2014. Eligible subjects were phone-interviewed using a purpose-developed semi-structured questionnaire according to the International Classification of Headache Disorders 3, beta version criteria. Among 96 eligible subjects, there was a significant decrease in migraine (p = 0.022) within the first 3 months after EVT compared to 1 year before treatment, which was further evident at interview time (on average 1.6 years after EVT, p = 0.013). A minority of patients experienced headaches for the first time within 3 months of their EVT (migraine 2, TTH 9), which persisted at interview time for subjects with migraine. Out of 12 subjects with peri-procedural complications, 2 had a history of migraine with aura. Thrombectomy leads to a significant decrease in previously known migraine, and new onset of headache in a small subset of patients. A history of migraine does not appear to predispose to peri-procedural complications.

Mechanical thrombectomy with snare in patients with acute ischemic stroke

International Nuclear Information System (INIS)

Gonzalez, Alejandro; Mayol, Antonio; Martinez, Eva; Gonzalez-Marcos, Jose R.; Gil-Peralta, Alberto

2007-01-01

We evaluated the efficacy and safety of thrombus extraction using a microsnare in patients with acute ischemic stroke (AIS). This was a prospective, observational, cohort study in which consecutive patients with AIS (<6 hours of ischemia for anterior circulation and <24 hours for posterior circulation) who had been previously excluded from intravenous tissue plasminogen activator (tPA) thrombolysis were included and followed-up for 3 months. Mechanical embolectomy with a microsnare of 2-4 mm was undertaken as the first treatment. Low-dose intraarterial thrombolysis or angioplasty was used if needed. TIMI grade and modified Rankin stroke scale (mRSS) score were used to evaluate vessel recanalization and clinical efficacy, respectively. Nine patients (mean age 55 years, range 17-69 years) were included. Their basal mean NIHSS score was 16 (range 12-24). In seven out of the nine patients (77.8%) the clot was removed, giving a TIMI grade of 3 in four patients and TIMI grade 2 in three patients. Occlusion sites were: middle cerebral artery (four), basilar artery (two) and anterior cerebral artery plus middle cerebral artery (one). The mean time for recanalization from the start of the procedure was 50 min (range 50-75 min). At 3 months, the mRSS score was 0 in two patients and 3-4 in three patients (two patients died). According to our results, the microsnare is a safe procedure for mechanical thrombectomy with a good recanalization rate. Further studies are required to determine the role of the microsnare in the treatment of AIS. (orig.)

Mechanical thrombectomy in acute ischemic stroke: Consensus statement by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN.

Science.gov (United States)

Wahlgren, Nils; Moreira, Tiago; Michel, Patrik; Steiner, Thorsten; Jansen, Olav; Cognard, Christophe; Mattle, Heinrich P; van Zwam, Wim; Holmin, Staffan; Tatlisumak, Turgut; Petersson, Jesper; Caso, Valeria; Hacke, Werner; Mazighi, Mikael; Arnold, Marcel; Fischer, Urs; Szikora, Istvan; Pierot, Laurent; Fiehler, Jens; Gralla, Jan; Fazekas, Franz; Lees, Kennedy R

2016-01-01

The original version of this consensus statement on mechanical thrombectomy was approved at the European Stroke Organisation (ESO)-Karolinska Stroke Update conference in Stockholm, 16-18 November 2014. The statement has later, during 2015, been updated with new clinical trials data in accordance with a decision made at the conference. Revisions have been made at a face-to-face meeting during the ESO Winter School in Berne in February, through email exchanges and the final version has then been approved by each society. The recommendations are identical to the original version with evidence level upgraded by 20 February 2015 and confirmed by 15 May 2015. The purpose of the ESO-Karolinska Stroke Update meetings is to provide updates on recent stroke therapy research and to discuss how the results may be implemented into clinical routine. Selected topics are discussed at consensus sessions, for which a consensus statement is prepared and discussed by the participants at the meeting. The statements are advisory to the ESO guidelines committee. This consensus statement includes recommendations on mechanical thrombectomy after acute stroke. The statement is supported by ESO, European Society of Minimally Invasive Neurological Therapy (ESMINT), European Society of Neuroradiology (ESNR), and European Academy of Neurology (EAN). © 2016 World Stroke Organization.

Influence of a combined CT/C-arm system on periprocedural workflow and procedure times in mechanical thrombectomy

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Pfaff, Johannes; Herweh, Christian; Pham, Mirko; Heiland, Sabine; Bendszus, Martin; Moehlenbruch, Markus Alfred [University of Heidelberg, Department of Neuroradiology, Heidelberg (Germany); Schoenenberger, Silvia; Nagel, Simon; Ringleb, Peter Arthur [University of Heidelberg, Department of Neurology, Heidelberg (Germany)

2017-09-15

To achieve the fastest possible workflow in ischaemic stroke, we developed a CT/C-arm system, which allows imaging and endovascular treatment on the same patient table. This prospective, monocentric trial was conducted between October 2014 and August 2016. Patients received stroke imaging and mechanical thrombectomy under general anaesthesia (GA) or conscious sedation (CS) using our combined setup comprising a CT-scanner and a mobile C-arm X-ray device. Primary endpoint was time between stroke imaging and groin puncture. We compared periprocedural workflow and procedure times with the literature and a matched patient cohort treated with a biplane angiographic system before installation of the CT/C-arm system. In 50 patients with acute ischaemic stroke due to large-vessel occlusion in the anterior circulation, comparable recanalization rates were achieved by using the CT/C-arm setup (TICI2b-3:CT/C-arm-GA: 85.7%; CT/C-arm-CS: 90.9%; Angiosuite: 78.6%; p = 0.269) without increasing periprocedural complications. Elimination of patient transport resulted in a significant reduction of the time between stroke imaging and groin puncture: median, min (IQR): CT/C-arm-GA: 43 (35-52); CT/C-arm-CS: 39 (28-49); Angiosuite: 64 (48-74); p < 0.0001. The combined CT/C-arm system allows comparable recanalization rates as a biplane angiographic system and accelerates the start of the endovascular stroke treatment. (orig.)

Influence of a combined CT/C-arm system on periprocedural workflow and procedure times in mechanical thrombectomy

International Nuclear Information System (INIS)

Pfaff, Johannes; Herweh, Christian; Pham, Mirko; Heiland, Sabine; Bendszus, Martin; Moehlenbruch, Markus Alfred; Schoenenberger, Silvia; Nagel, Simon; Ringleb, Peter Arthur

2017-01-01

To achieve the fastest possible workflow in ischaemic stroke, we developed a CT/C-arm system, which allows imaging and endovascular treatment on the same patient table. This prospective, monocentric trial was conducted between October 2014 and August 2016. Patients received stroke imaging and mechanical thrombectomy under general anaesthesia (GA) or conscious sedation (CS) using our combined setup comprising a CT-scanner and a mobile C-arm X-ray device. Primary endpoint was time between stroke imaging and groin puncture. We compared periprocedural workflow and procedure times with the literature and a matched patient cohort treated with a biplane angiographic system before installation of the CT/C-arm system. In 50 patients with acute ischaemic stroke due to large-vessel occlusion in the anterior circulation, comparable recanalization rates were achieved by using the CT/C-arm setup (TICI2b-3:CT/C-arm-GA: 85.7%; CT/C-arm-CS: 90.9%; Angiosuite: 78.6%; p = 0.269) without increasing periprocedural complications. Elimination of patient transport resulted in a significant reduction of the time between stroke imaging and groin puncture: median, min (IQR): CT/C-arm-GA: 43 (35-52); CT/C-arm-CS: 39 (28-49); Angiosuite: 64 (48-74); p < 0.0001. The combined CT/C-arm system allows comparable recanalization rates as a biplane angiographic system and accelerates the start of the endovascular stroke treatment. (orig.)

Mechanical Thrombectomy using a solitaire stent in acute ischemic stroke; The relationship between the visible antegrade flow on first device deployment and final success in revascularization

International Nuclear Information System (INIS)

Lee, Sung Ho; Lee, Byung Hon; Hwang, Yoon Joon; Kim, Su Young; Lee, Ji Young; Hong, Keun Sik; Cho, Yong Jin

2015-01-01

The purpose of the study was to evaluate the relationship between the successful revascularization on the first Solitaire stent deployment and the successful revascularization on the final angiography in acute ischemic stroke. From February 2012 to April 2014, 24 patients who underwent Solitaire stent thrombectomy as the first thrombectomy method for treatment of acute ischemic strokes were retrospectively reviewed. When the first Solitaire stent was deployed, 9 patients showed revascularization (Group 1) and 15 patients did not show revascularization (Group 2). Revascularization immediately after the first Solitaire stent removal and on the final angiography were comparatively assessed between the 2 groups. Statistical analysis was performed by the Fisher exact test and Student's t-test. The rates of revascularization maintenance immediately after the first Solitaire stent removal were 89% in Group 1 and 27% in Group 2, respectively (p = 0.009), and the rates of final successful revascularization were 100% in Group 1 and 47% in Group 2, respectively (p = 0.009). There was a statistically significant difference between the 2 groups. Revascularization on the first Solitaire stent deployment can be a useful predictor in evaluating the success of final revascularization in the treatment of acute ischemic stroke.

Cerebrovascular Accident Secondary to Paradoxical Embolism Following Arteriovenous Graft Thrombectomy

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Jolina Pamela Santos

2012-01-01

Full Text Available Thrombectomy is a common procedure performed to declot thrombosed dialysis arteriovenous fistula (AVF or arteriovenous graft (AVG. Complications associated with access thrombectomy like pulmonary embolism have been reported, but paradoxical embolism is extremely rare. We report a case of a 74-year-old black man with past medical history significant for end-stage renal disease (ESRD, atrial fibrillation on anticoagulation with warfarin, who presented to our hospital with lethargy, aphasia, and right-sided hemiparesis following thrombectomy of a clotted AVG. Computed tomography (CT scan of brain showed a hypodensity within the left posterior parietal lobe. INR was 2.0 on admission. Echocardiogram revealed a normal sized left atrium with no intracardiac thrombus, and bubble study showed the presence of right-to-left shunting. These findings suggest that the stroke occurred as a result of an embolus originating from the AVG. Paradoxical cerebral embolism is uncommon but can occur after thrombectomy of clotted vascular access in ESRD patients. Clinicians and patients should be aware of this serious and potentially fatal complication of vascular access procedure.

Cerebrovascular accident secondary to paradoxical embolism following arteriovenous graft thrombectomy.

Science.gov (United States)

Santos, Jolina Pamela; Hamadeh, Zaher; Ansari, Naheed

2012-01-01

Thrombectomy is a common procedure performed to declot thrombosed dialysis arteriovenous fistula (AVF) or arteriovenous graft (AVG). Complications associated with access thrombectomy like pulmonary embolism have been reported, but paradoxical embolism is extremely rare. We report a case of a 74-year-old black man with past medical history significant for end-stage renal disease (ESRD), atrial fibrillation on anticoagulation with warfarin, who presented to our hospital with lethargy, aphasia, and right-sided hemiparesis following thrombectomy of a clotted AVG. Computed tomography (CT) scan of brain showed a hypodensity within the left posterior parietal lobe. INR was 2.0 on admission. Echocardiogram revealed a normal sized left atrium with no intracardiac thrombus, and bubble study showed the presence of right-to-left shunting. These findings suggest that the stroke occurred as a result of an embolus originating from the AVG. Paradoxical cerebral embolism is uncommon but can occur after thrombectomy of clotted vascular access in ESRD patients. Clinicians and patients should be aware of this serious and potentially fatal complication of vascular access procedure.

Successful thrombectomy of a stuck mechanical prosthetic mitral valve guided by perioperative transesophageal echocardiography and cinefluoroscopy

Directory of Open Access Journals (Sweden)

Paulo César Gobert Damasceno Campos

2009-03-01

Full Text Available We describe the case of a 53-year-old man with past history of rheumatic valvular disease who developed acute decompensated heart failure due to thrombosis of his mechanical mitral valve prosthesis. The diagnosis was established after a combined and complementary approach of echocardiography and cinefluoroscopy. Because of the severe heart failure at presentation, the patient was taken to surgery. The intraoperative transesophageal echocardiography was critical to guide a successful thrombectomy procedure. Postoperative pathological findings revealed the presence of thrombus and fibrotic tissue (pannus in the surgical specimens removed from the valve. The success of this case and the treatment choice are supported by the most recent literature data on prosthetic valve thrombosis. We highlight the use of three diagnostic approaches in our patient: echocardiography, cinefluoroscopy and pathology.

Acute Pancreatitis after Percutaneous Mechanical Thrombectomy: Case Report and Review of the Literature

International Nuclear Information System (INIS)

Hershberger, Richard C.; Bornak, Arash; Aulivola, Bernadette; Mannava, Krishna

2011-01-01

Purpose: We describe a case of severe acute pancreatitis after percutaneous mechanical thrombectomy (PMT) and review the literature for the occurrence of this complication. Materials and Methods: A 53-year-old man with a history of bilateral external iliac artery stent placement sought care for acute onset of lifestyle-limiting left claudication. Angiography confirmed left external iliac stent occlusion, and PMT with the AngioJet Xpeedior catheter (Possis Medical, Minneapolis MN) was performed. Results: After PMT of the occluded external iliac artery, a residual in-stent stenosis required the placement of a second iliac stent. The procedure was complicated by severe acute pancreatitis. Other causes of pancreatitis were eliminated during the patient’s hospital stay. A literature review revealed nine cases of acute pancreatitis after PMT. Conclusion: Although rare, pancreatitis can be a devastating complication of PMT. The development of pancreatitis seems to be related to the products of extensive hemolysis triggering an inflammatory process. To prevent this complication, we recommend that close attention be paid to the duration and extent of PMT, thereby avoiding extensive hemolysis and subsequent complications.

Cerebrovascular Accident Secondary to Paradoxical Embolism Following Arteriovenous Graft Thrombectomy

OpenAIRE

Santos, Jolina Pamela; Hamadeh, Zaher; Ansari, Naheed

2012-01-01

Thrombectomy is a common procedure performed to declot thrombosed dialysis arteriovenous fistula (AVF) or arteriovenous graft (AVG). Complications associated with access thrombectomy like pulmonary embolism have been reported, but paradoxical embolism is extremely rare. We report a case of a 74-year-old black man with past medical history significant for end-stage renal disease (ESRD), atrial fibrillation on anticoagulation with warfarin, who presented to our hospital with lethargy, aphasia, ...

Endovascular thrombectomy and post-procedural headache

DEFF Research Database (Denmark)

Khan, Sabrina; Amin, Faisal Mohammad; Holtmannspötter, Markus

2017-01-01

BACKGROUND: We investigated the prevalence of post-procedural headache in patients who have undergone thrombectomy for ischemic stroke, and correlated history of migraine with risk of peri-procedural complications. A total of 314 patients underwent thrombectomy at the Danish National Hospital from...... January 2012 to December 2014. Eligible subjects were phone-interviewed using a purpose-developed semi-structured questionnaire according to the International Classification of Headache Disorders 3, beta version criteria. FINDINGS: Among 96 eligible subjects, there was a significant decrease in migraine...... (p = 0.022) within the first 3 months after EVT compared to 1 year before treatment, which was further evident at interview time (on average 1.6 years after EVT, p = 0.013). A minority of patients experienced headaches for the first time within 3 months of their EVT (migraine 2, TTH 9), which...

Aspirex Thrombectomy in Occluded Dialysis Access: A Retrospective Study

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Dyer, Jules, E-mail: Jules.Dyer@nhs.net [New Cross Hospital, Department of Radiology (United Kingdom); Rosa, Joao [University Hospitals Bristol NHS Foundation Trust, ST1 Radiology (United Kingdom); Chachlani, Menka [University of Birmingham (United Kingdom); Nicholas, Johann [New Cross Hospital, Department of Radiology (United Kingdom)

2016-10-15

PurposeThis study is the first to present the outcomes of the Straub Aspirex device for the salvage of occluded renal dialysis access fistulae.Materials and MethodsThis is a retrospective study, using data from the Renal Unit and Radiology Department database. It included all the patients between 2010 and 2014 who underwent percutaneous mechanical thrombectomy (PMT) treated by JD. Aspirex is an over-the-wire, 6–10 French catheter within which is a rapidly rotating helix which draws thrombus into a window near the tip which it then macerates and removes. Access survival was assessed using the Kaplan–Meier method, and multi-variant analysis was performed using the Cox proportional hazards model. Significance was considered if p < 0.05.ResultsA total of 27 procedures were performed for 19 patients. 13 had autologous arterio-venous fistulae, and 14 had synthetic (PTFE) arterio-venous grafts. 15 were males, 4 females. 100 % of the patients successfully had a channel of thrombus removed. This resulted in an 81.5 % initial clinical success, with primary patency rates of 53.6, 44.3 and 33 % by days 30, 90 and 480, respectively, without significant difference of any analysed covariates. No major complication (pulmonary embolus, paradoxical cerebral infarction, limb ischaemia or significant haemorrhage) occurred.ConclusionAspirex has rates of patency and complication similar to other PMT devices. No covariant studied affected outcome.

Deconstruction of Interhospital Transfer Workflow in Large Vessel Occlusion: Real-World Data in the Thrombectomy Era.

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Ng, Felix C; Low, Essie; Andrew, Emily; Smith, Karen; Campbell, Bruce C V; Hand, Peter J; Crompton, Douglas E; Wijeratne, Tissa; Dewey, Helen M; Choi, Philip M

2017-07-01

Interhospital transfer is a critical component in the treatment of acute anterior circulation large vessel occlusive stroke transferred for mechanical thrombectomy. Real-world data for benchmarking and theoretical modeling are limited. We sought to characterize transfer workflow from primary stroke center (PSC) to comprehensive stroke center after the publication of positive thrombectomy trials. Consecutive patients transferred from 3 high-volume PSCs to a single comprehensive stroke center between January 2015 and August 2016 were included in a retrospective study. Factors associated with key time metrics were analyzed with emphasis on PSC intrahospital workflow. Sixty-seven patients were identified. Median age was 74 years (interquartile range [IQR], 63.5-78) and National Institutes of Health Stroke Scale 17 (IQR, 12-21). Median transfer time measured by PSC-door-to-comprehensive stroke center-door was 128 minutes (IQR, 107-164), of which 82.8% was spent at PSCs (door-in-door-out [DIDO]; 106 minutes; IQR, 86-143). The lengthiest component of DIDO was computed-tomography-to-retrieval-request (median 59.5 minutes; IQR, 44-83). The 37.3% had DIDO exceeding 120 minutes. DIDO times differed significantly between PSCs ( P =0.01). In multivariate analyses, rerecruiting the initial ambulance crew for transfer ( P workflow represents a major opportunity to expedite mechanical thrombectomy and improve patient outcomes. © 2017 American Heart Association, Inc.

Treatment of thromboembolic occlusions of peripheral arteries with a new percutaneous thrombectomy device; Behandlung peripherer arterieller Thrombembolien durch ein neuartiges perkutanes mechanisches Thrombektomiesystem

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Krankenberg, H; Gehrt, I; Walther, C; Biamino, G [Leipzig Univ. (Germany). Klinik fuer Kardiologie/Innere Medizin; Sorge, I; Conradi, S [Leipzig Univ. (Germany). Abt. Radiologie

2001-03-01

Purpose: We report our experience with a new percutaneous thrombectomy device for the treatment of thromboembolic occlusions of peripheral arteries. Material and methods: Between November 1999 and May 2000 12 patients (10 male) with thromboembolic occlusions of peripheral arteries were treated. 8 occlusions were located in the femoral and popliteal arteries, 3 in the infrapopliteal vessels and 1 in the brachial artery. In all cases a new 6 F-catheter with a rotational screw and a suction vacuum unit was used. Results: The intervention was successful in 11 patients. 1 patient with a failed procedure had a duration of occlusion >90 days. There were no complications. All patients were discharged on the same or the following day. Conclusion: Percutaneous treatment with the thrombectomy device is a feasible option in a small group of patients with thromboembolic occlusions of the peripheral arteries. Often additional treatment is necessary. The major indication seems to be acute thrombosis. The procedure is easy and safe to apply. (orig.) [German] Ziel: Wir berichten ueber die Therapie mit einem neuartigen mechanischen Embolektomiesystem zur Behandlung thrombembolischer Verschluesse peripherer Gefaesse. Material und Methoden: Von November 1999 bis Mai 2000 wurden 12 Patienten (10 maennlich) mit thrombembolischen Verschluessen peripherer Gefaesse behandelt. Die durchschnittliche Verschlusslaenge betrug 8,8{+-}8,2 cm. Verschlusslokalisation: femoropoplitealer Bereich (n=8), Truncus tibiofibularis (n=3) und A. brachialis (n=1). In allen Faellen wurde ein neuartiger 6 F-Rotationskatheter mit Moeglichkeit zur perkutanen Absaugung des thrombotischen Materials ueber ein Vakuumsystem eingesetzt. Ergebnisse: In 11 Faellen konnten die verschlossenen Gefaesse wiedereroeffnet und eine deutliche klinische Verbesserung erreicht werden. Ein Patient mit einer Verschlussdauer >90 Tage liess sich mit dem Thrombektomie-System nicht rekanalisieren. Es traten keine Komplikationen auf. Alle

Successful Recanalization of Acute Superior Mesenteric Artery Thromboembolic Occlusion by a Combination of Intraarterial Thrombolysis and Mechanical Thrombectomy with a Carotid Filter

International Nuclear Information System (INIS)

Zeleňák, Kamil; Šinák, Igor; Janík, Ján; Mikolajčík, Anton; Mištuna, Dušan

2013-01-01

Acute superior mesenteric artery (SMA) occlusion is a life-threatening disease, and acute intestinal ischemia develops from the sudden decrease in perfusion to the intestines. The key to saving the patient’s life is early diagnosis, and prompt revascularization of the SMA can prevent intestinal infarction and decrease the risk of bowel segment necrosis. Computed tomographic angiography may be useful for rapid diagnosis. We report recanalization of an SMA occlusion in an 80-year-old man with a combination of intraarterial thrombolysis and mechanical thrombectomy with a carotid filter.

Pulmonary Hypertension Among End-Stage Renal Failure Patients Following Hemodialysis Access Thrombectomy

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Harp, Richard J.; Stavropoulos, S. William; Wasserstein, Alan G.; Clark, Timothy W.I.

2005-01-01

Purpose: Percutaneous hemodialysis thrombectomy causes subclinical pulmonary emboli without short-term clinical consequence; the long-term effects on the pulmonary arterial vasculature are unknown. We compared the prevalence of pulmonary hypertension between patients who underwent one or more hemodialysis access thrombectomy procedures with controls without prior thrombectomy.Methods: A retrospective case-control study was performed. Cases (n = 88) had undergone one or more hemodialysis graft thrombectomy procedures, with subsequent echocardiography during routine investigation of comorbid cardiovascular disease. Cases were compared with controls without end-stage renal disease (ESRD) (n = 100, group 1), and controls with ESRD but no prior thrombectomy procedures (n = 117, group 2). The presence and velocity of tricuspid regurgitation on echocardiography was used to determine the prevalence and grade of pulmonary hypertension; these were compared between cases and controls using the chi-square test and logistic regression.Results: The prevalence of pulmonary hypertension among cases was 52% (46/88), consisting of mild, moderate and severe in 26% (n = 23), 10% (n = 9) and 16% (n = 14), respectively. Prevalence of pulmonary hypertension among group 1 controls was 26% (26/100), consisting of mild, moderate and severe pulmonary hypertension in 14%, 5% and 7%, respectively. Cases had 2.7 times greater odds of having pulmonary hypertension than group 1 controls (p = 0.002). The prevalence of pulmonary hypertension among group 2 controls was 42% (49/117), consisting of mild, moderate and severe pulmonary arterial hypertension in 25% (n = 49), 10% (n = 12) and 4% (n = 5), respectively. Cases were slightly more likely to have pulmonary hypertension than group 2 controls (OR = 1.5), although this failed to reach statistical significance (p = 0.14).Conclusion: Prior hemodialysis access thrombectomy does not appear to be a risk factor for pulmonary arterial hypertension

Impact and Effectiveness of Dual Aspiration Technique in Stent-Assisted Mechanical Thrombectomy: Recent Improvements in Acute Stroke Management

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Hopf-Jensen, S., E-mail: hopfsi@diako.de; Preiß, M.; Marques, L.; Lehrke, S. [Diakonissenhospital Flensburg, Department of Diagnostic and Interventional Radiology and Neuroradiology (Germany); Schattschneider, J.; Stolze, H. [Diakonissenhospital Flensburg, Department of Neurology (Germany); Müller-Hülsbeck, S. [Diakonissenhospital Flensburg, Department of Diagnostic and Interventional Radiology and Neuroradiology (Germany)

2016-11-15

Background and PurposeTo evaluate feasibility and impact of dual aspiration technique (DAT) within stent-assisted mechanical thrombectomy on procedural parameters and clinical outcome.Materials and MethodsWithin 16 months, 76 consecutive patients (mean age 70.7 year; range 33–89) underwent stent-assisted mechanical thrombectomy. Of 52 enrolled patients (68.4 %) with occlusion of the anterior circulation, 22 patients (42.3 %) underwent DAT; 30 patients (57.7 %) were treated in conventional monoaspiration technique (MAT). Epidemiological data, clinical and imaging characteristics (mRS, NIHSS, ASPECTS) as well as procedural details were analyzed (TICI, number of retrieval, procedure time). Clinical outcome was determined with mRS at discharge and after 90 days.ResultsIn the context of DAT additional carotid artery stenting was required in 45.5 % (10/22) in underlying tandem lesion (vs. 0/30 MAT). No differences were found in NIHSS at admission (MAT: 20.5, range 15–29; DAT: 18.6; range 11–25), mRS at admission (MAT: 4.6 vs. DAT: 4.57) or ASPECT score (MAT: 8.3, ±1.5; DAT: 8.4, ±1.5; P > 0.05). TICI ≥ 2b/3 was conducted in 90 % (MAT) and 100 % (DAT), respectively. The procedure time was longer in the MAT group (65 min, ±25.9, range 18–126) compared to the DAT group (49.7 min, ±15, range 32–101; P = 0.016). The clinical outcome increased from admission to discharge and in follow-up after 90 days (mRS ≥ 2: MAT: 53.3 %, DAT: 54.5 %; P > 0.05).ConclusionsThe dual aspiration technique with an additional intermediate guide catheter placed closed to the stent retriever leads to decreased procedure time in the anterior circulation. Even in cases with higher thrombus load and treated in DAT, clinical outcome improved.

Percutaneous aspiration thrombectomy with adjunctive venoplasty for iliac vein compression syndrome with lower extremity deep venous thrombosis

International Nuclear Information System (INIS)

Wang Yiping; Zhang Xiquan; Sun Yequan

2013-01-01

Objective: To investigate the clinical effect of mechanical aspiration thrombectomy with adjunctive PTA and stenting for iliac vein compression syndrome with lower extremity deep venous thrombosis. Materials and Methods: The clinical data of 184 patients who had iliac vein compression syndrome with lower extremity DVT were analyzed retrospectively. The healthy femoral vein was accessed, then a 12-14 F sheath was introduced via a guide wire to aspirate thrombus in the iliofemoral; For the cases with femoropopliteal thrombus, the thrombus was macerated and pulled by Fogarty balloon catheter, then performing mechanical aspiration thrombectomy. After thrombus removal, PTA and stenting were performed on stenosis or occlusion of common iliac vein that displayed on venography. Results: The thrombus removal rate: Grade Ⅲ 80.89% and Grade Ⅱ 19.02%. The circumference of affected limbs at 15 cm above and below knee joints were (43.9±4.7) cm and (31.5±4.1) cm, respectively, after being discharged from hospital, the differences were statistical significance (t=6.43, t=-5.79, both P=0.000)compared to be hospitalized. The follow -up result: the treatment efficiency was 97.75%. The stent patency rate of postoperation at 6, 12, and 24 months were 97.19%, 94.94%, 92.13%, respectively, on sonography or digital subtract angiography. Conclusion: Mechanical aspiration thrombectomy with adjunctive venoplasty for iliac vein compression syndrome with lower extremity deep venous thrombosis is an effective and safe therapy having notable therapeutic effect in short l middle-term follow-up and shorter hospitalization time. (authors)

Mechanical thrombectomy using Rotarex system and stent-in-stent placement for treatment of distal femoral artery occlusion secondary to stent fracture – a case report and literature review

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Dys, Krzysztof; Drelichowska-Durawa, Justyna; Dołega-Kozierowski, Bartosz; Lis, Michał; Sokratous, Kyriakos; Iwanowski, Wojciech; Drelichowski, Stanisław; Witkiewicz, Wojciech

2013-01-01

Treatment of peripheral arterial diseases may be distinguished into conservative and interventional management; the latter is divided into surgical and endovascular procedures. Management of peripheral artery stenosis and occlusion with vascular stents is associated with the risk of late complications such as restenosis, stent fracture or dislocation. A 62-year-old woman with generalized atherosclerosis, particularly extensive in lower limb arteries, was admitted to the Department of Angiology 11 months after having an endovascular procedure performed due to critical ischemia of left lower limb. Because of stent occlusion, a decision to perform angiographic examination of lower limb arteries was made. Examination revealed occlusion of the superficial femoral artery along its entire length, including previously implanted stents. Distal stent was fractured with slight dislocation of the proximal segment. A decision was made to perform mechanical thrombectomy using a Rotarex system followed by a stent-in-stent placement procedure. Follow-up angiography and ultrasound scan performed 24 hours after the procedure revealed a patent vessel with satisfactory blood flow. Nowadays, imaging diagnostics of peripheral artery stenosis involves non-invasive examinations such as ultrasound, minimally invasive examinations such as angio-MRI and MDCT, or invasive examinations such as DSA and IVUS. DSA examinations are used to confirm significant stenosis or occlusion of a vessel, particularly when qualifying a patient for endovascular treatment. Due to their anatomic location, the superficial femoral artery and the popliteal artery are subject to various forces e.g. those exerted by the working muscles. Mechanical thrombectomy and atherectomy are efficient methods of arterial recanalization used in the treatment of acute, subacute or even chronic occlusions or stenosis of peripheral vessels. Frequency of angioplasty and vascular stent implantation procedures is increased in patients

Streamlining Workflow for Endovascular Mechanical Thrombectomy: Lessons Learned from a Comprehensive Stroke Center.

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Wang, Hongjin; Thevathasan, Arthur; Dowling, Richard; Bush, Steven; Mitchell, Peter; Yan, Bernard

2017-08-01

Recently, 5 randomized controlled trials confirmed the superiority of endovascular mechanical thrombectomy (EMT) to intravenous thrombolysis in acute ischemic stroke with large-vessel occlusion. The implication is that our health systems would witness an increasing number of patients treated with EMT. However, in-hospital delays, leading to increased time to reperfusion, are associated with poor clinical outcomes. This review outlines the in-hospital workflow of the treatment of acute ischemic stroke at a comprehensive stroke center and the lessons learned in reduction of in-hospital delays. The in-hospital workflow for acute ischemic stroke was described from prehospital notification to femoral arterial puncture in preparation for EMT. Systematic review of literature was also performed with PubMed. The implementation of workflow streamlining could result in reduction of in-hospital time delays for patients who were eligible for EMT. In particular, time-critical measures, including prehospital notification, the transfer of patients from door to computed tomography (CT) room, initiation of intravenous thrombolysis in the CT room, and the mobilization of neurointervention team in parallel with thrombolysis, all contributed to reduction in time delays. We have identified issues resulting in in-hospital time delays and have reported possible solutions to improve workflow efficiencies. We believe that these measures may help stroke centers initiate an EMT service for eligible patients. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Does Preinterventional Flat-Panel Computer Tomography Pooled Blood Volume Mapping Predict Final Infarct Volume After Mechanical Thrombectomy in Acute Cerebral Artery Occlusion?

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Wagner, Marlies; Kyriakou, Yiannis; Mesnil de Rochemont, Richard du; Singer, Oliver C.; Berkefeld, Joachim

2013-01-01

PurposeDecreased cerebral blood volume is known to be a predictor for final infarct volume in acute cerebral artery occlusion. To evaluate the predictability of final infarct volume in patients with acute occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA) and successful endovascular recanalization, pooled blood volume (PBV) was measured using flat-panel detector computed tomography (FPD CT).Materials and MethodsTwenty patients with acute unilateral occlusion of the MCA or distal ACI without demarcated infarction, as proven by CT at admission, and successful Thrombolysis in cerebral infarction score (TICI 2b or 3) endovascular thrombectomy were included. Cerebral PBV maps were acquired from each patient immediately before endovascular thrombectomy. Twenty-four hours after recanalization, each patient underwent multislice CT to visualize final infarct volume. Extent of the areas of decreased PBV was compared with the final infarct volume proven by follow-up CT the next day.ResultsIn 15 of 20 patients, areas of distinct PBV decrease corresponded to final infarct volume. In 5 patients, areas of decreased PBV overestimated final extension of ischemia probably due to inappropriate timing of data acquisition and misery perfusion.ConclusionPBV mapping using FPD CT is a promising tool to predict areas of irrecoverable brain parenchyma in acute thromboembolic stroke. Further validation is necessary before routine use for decision making for interventional thrombectomy

Comparison of imaging selection criteria for intra-arterial thrombectomy in acute ischemic stroke with advanced CT

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Kim, Eung Yeop; Goh, Byeong Ho; Shin, Dong Hoon; Noh, Young; Lee, Yeong-Bae

2016-01-01

To compare two selection criteria (noncontrast CT [NCCT] with multi-phase CT Angiography [MPCTA] and CT perfusion [CTP]) for the determination of eligibility for thrombectomy. We retrospectively enrolled 71 patients who underwent head NCCT, 9.6-cm CTP, and craniocervical single-phase CTA (SPCTA) within 6 hours of onset. The simulated MPCTA was reconstructed from 1-mm CTP images for assessment of collateral circulation. Infarct core (relative CBF < 30 %) and penumbra (Tmax > 6 seconds) volumes were measured. The infarct core < 70 mL with a mismatch ratio > 1.2 (CTP-A), infarct core ≤ 40 mL with a mismatch ratio > 1.8 (CTP-B), and ASPECTS > 5 with good collaterals (50 % ≥ MCA territory) were used to determine eligibility for thrombectomy. SPCTA was compared with the simulated MPCTA for assessment of collaterals. CTP-B determined that 11 patients were ineligible for thrombectomy, of which three were eligible by NCCT with MPCTA and 6 by CTP-A. CTP-A and CTP-B showed discrepancy in determining eligibility for thrombectomy between NCCT with MPCTA in three patients each, rendering no significant statistical difference (P > 0.05). The number of patients with poor collaterals was significantly higher on SPCTA than MPCTA (n = 22 and 6 respectively; P < 0.0001). The two imaging selection criteria (NCCT with MPCTA and CTP) were statistically comparable for determining eligibility for thrombectomy. (orig.)

Regional Differences in Thrombectomy Rates : Secondary use of Billing Codes in the MIRACUM (Medical Informatics for Research and Care in University Medicine) Consortium.

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Haverkamp, Christian; Ganslandt, Thomas; Horki, Petar; Boeker, Martin; Dörfler, Arnd; Schwab, Stefan; Berkefeld, Joachim; Pfeilschifter, Waltraud; Niesen, Wolf-Dirk; Egger, Karl; Kaps, Manfred; Brockmann, Marc A; Neumaier-Probst, Eva; Szabo, Kristina; Skalej, Martin; Bien, Siegfried; Best, Christoph; Prokosch, Hans-Ulrich; Urbach, Horst

2018-01-08

Mechanical thrombectomy, in addition to intravenous (i.v.) thrombolysis is recommended for treatment of acute stroke in patients with large vessel occlusions (LVO) in the anterior circulation up to 6 h after symptom onset. We compared thrombectomy rates of eight university hospitals of the MIRACUM consortium to analyze the implementation of this guideline in clinical routine. Anonymized billing data in a standardized format were loaded into a local i2b2 data warehouse by applying already existing extract, transform and load (ETL) routines. A locally executed uniform SQL (structured query language) query delivered aggregated site data for all inpatients with a discharge diagnosis of ischemic stroke (ICD-10 I63) containing counts for type of acute treatment, type of admission and age groups, which were centrally analyzed with R. From 2014 to 2016, the thrombectomy rate almost doubled from a mean of 4.7% to 9.6%, although significant differences between centers exist (range in 2016: 5.8-17%). The number of drip-and-ship procedures increased in 3 out of 8 centers. There was no evidence for a decrease in thrombectomy rates during weekends/holiday or among patients older than 80 years, but this age group is more likely to receive i.v. recombinant tissue plasminogen activator (rtPA). The observed increase of thrombectomy rates and drip-and-ship procedures without a significant difference between weekdays and weekends or patients of different ages is substantiating a rapid implementation of stroke guidelines within the analyzed neurovascular centers. The prototype of the MIRACUM Data Integration Center already contributes to health services research in Germany.

Endovascular Treatment of Left Iliofemoral Deep Vein Thrombosis Using Urokinase Thrombolysis and Adjunctive Aspiration Thrombectomy

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Suh, Sang Hyun; Lee, Do Yun; Won, Jong Yun [Yonsei University College of Medicine, Seoul (Korea, Republic of)

2010-02-15

To evaluate the efficacy of adjunctive aspiration thrombectomy for the treatment of iliofemoral deep vein thrombosis (DVT). 24 patients (9 males and 15 females; mean age, 53 years), treated by aspiration thrombectomy were enrolled in this study. The day after undergoing urokinase (UK) thrombolysis, any residual thrombus over a long segment was treated by aspiration thrombectomy using a 12 Fr long sheath. Residual short-segment (< 10 cm) iliac vein thrombus and/or stenosis were treated with a stent. The evaluation of venous patency was conducted by color Doppler ultrasonography, venography and/or computed tomography. The technical and clinical success rates were 100% and 92%, respectively. Twenty-three patients were treated by UK thrombolysis and iliac stent. The overall patency rate at 1, 2 and 3 years was 85%, 82% and 81%, respectively. Over the course of the follow-up period, occlusion was observed in 4 cases (1 acute and 3 chronic cases). Periprocedural complication occurred in 4 cases (17%) in the form of a minimal hematoma or pain on the puncture site as well as a case of pulmonary embolism at one month after treatment. The adjunctive aspiration thrombectomy with conventional thrombolysis and stent placement can be an effective and safe method in the treatment of left iliofemoral DVT

The golden 35 min of stroke intervention with ADAPT: effect of thrombectomy procedural time in acute ischemic stroke on outcome.

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Alawieh, Ali; Pierce, Alyssa K; Vargas, Jan; Turk, Aquilla S; Turner, Raymond D; Chaudry, M Imran; Spiotta, Alejandro M

2018-03-01

In acute ischemic stroke (AIS), extending mechanical thrombectomy procedural times beyond 60 min has previously been associated with an increased complication rate and poorer outcomes. After improvements in thrombectomy methods, to reassess whether this relationship holds true with a more contemporary thrombectomy approach: a direct aspiration first pass technique (ADAPT). We retrospectively studied a database of patients with AIS who underwent ADAPT thrombectomy for large vessel occlusions. Patients were dichotomized into two groups: 'early recan', in which recanalization (recan) was achieved in ≤35 min, and 'late recan', in which procedures extended beyond 35 min. 197 patients (47.7% women, mean age 66.3 years) were identified. We determined that after 35 min, a poor outcome was more likely than a good (modified Rankin Scale (mRS) score 0-2) outcome. The baseline National Institutes of Health Stroke Scale (NIHSS) score was similar between 'early recan' (n=122) (14.7±6.9) and 'late recan' patients (n=75) (15.9±7.2). Among 'early recan' patients, recanalization was achieved in 17.8±8.8 min compared with 70±39.8 min in 'late recan' patients. The likelihood of achieving a good outcome was higher in the 'early recan' group (65.2%) than in the 'late recan' group (38.2%; p<0.001). Patients in the 'late recan' group had a higher likelihood of postprocedural hemorrhage, specifically parenchymal hematoma type 2, than those in the 'early recan' group. Logistic regression analysis showed that baseline NIHSS, recanalization time, and atrial fibrillation had a significant impact on 90-day outcomes. Our findings suggest that extending ADAPT thrombectomy procedure times beyond 35 min increases the likelihood of complications such as intracerebral hemorrhage while reducing the likelihood of a good outcome. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Use and impact of thrombectomy in primary percutaneous coronary intervention for acute myocardial infarction with persistent ST-segment elevation: results of the prospective ALKK PCI-registry.

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Härle, Tobias; Zeymer, Uwe; Hochadel, Matthias; Schmidt, Karin; Zahn, Ralf; Darius, Harald; Behrens, Steffen; Lauer, Bernward; Mudra, Harald; Schächinger, Volker; Elsässer, Albrecht

2015-10-01

Data about the impact of thrombectomy in primary percutaneous coronary intervention (PCI) are inconsistent. The aim of our study was an evaluation of both the real-world use of thrombectomy and the impact of thrombectomy on outcome in unselected patients treated with primary PCI for ST-elevation myocardial infarction (STEMI). We used the data of the prospective ALKK PCI-registry of 35 hospitals from January 2010 to December 2013. A total of 10,755 patients receiving single-vessel primary PCI for acute STEMI were included. In 2176 patients (20.2 %) thrombectomy was performed. There was a wide range of use of thrombectomy in the different ALKK hospitals from 1.1 to 61.7 % (median 18.6 %, quartiles 6.0 and 40.3 %) with a general increase of use over the first years of the study period. In patients with and without thrombectomy there was TIMI 0 flow present before PCI in 6010 patients, TIMI 1 in 1338, TIMI 2 in 2002, and TIMI 3 in 1405. Patients with acute heart failure or cardiogenic shock received significantly more often thrombectomy. Fluoroscopy time (8.1 vs. 7.3 min, p PCI had significantly higher rates of TIMI 3 flow after PCI when treated with thrombectomy (87.1 vs. 84.1 %, p PCI TIMI 3 flow in patients with TIMI 1, 2 or 3 flow before PCI. Rates of major adverse cardiac and cerebrovascular events were similar in both groups in general and in all subgroups of TIMI flow. The use of thrombectomy in patients with STEMI is heterogenous between hospitals. Overall, there was no impact of thrombectomy on TIMI 3 patency or mortality after PCI. In the subgroup of STEMI patients with TIMI 0 flow before PCI individualized thrombectomy had a positive impact on restoration of normal blood flow.

Mechanical Thrombectomy in Elderly Stroke Patients with Mild-to-Moderate Baseline Disability.

Science.gov (United States)

Slawski, Diana E; Salahuddin, Hisham; Shawver, Julie; Kenmuir, Cynthia L; Tietjen, Gretchen E; Korsnack, Andrea; Zaidi, Syed F; Jumaa, Mouhammad A

2018-04-01

The number of elderly patients suffering from ischemic stroke is rising. Randomized trials of mechanical thrombectomy (MT) generally exclude patients over the age of 80 years with baseline disability. The aim of this study was to understand the efficacy and safety of MT in elderly patients, many of whom may have baseline impairment. Between January 2015 and April 2017, 96 patients ≥80 years old who underwent MT for stroke were selected for a chart review. The data included baseline characteristics, time to treatment, the rate of revascularization, procedural complications, mortality, and 90-day good outcome defined as a modified Rankin Scale (mRS) score of 0-2 or return to baseline. Of the 96 patients, 50 had mild baseline disability (mRS score 0-1) and 46 had moderate disability (mRS score 2-4). Recanalization was achieved in 84% of the patients, and the rate of symptomatic hemorrhage was 6%. At 90 days, 34% of the patients had a good outcome. There were no significant differences in good outcome between those with mild and those with moderate baseline disability (43 vs. 24%, p = 0.08), between those aged ≤85 and those aged > 85 years (40.8 vs. 26.1%, p = 0.19), and between those treated within and those treated beyond 8 h (39 vs. 20%, p = 0.1). The mortality rate was 38.5% at 90 days. The Alberta Stroke Program Early CT Score (ASPECTS) and the National Institutes of Health Stroke Scale (NIHSS) predicted good outcome regardless of baseline disability ( p baseline disability, and delayed treatment are associated with sub-optimal outcomes after MT. However, redefining good outcome to include return to baseline functioning demonstrates that one-third of this patient population benefits from MT, suggesting the real-life utility of this treatment.

Melanotic Xp11 Translocation Renal Cancer Managed With Radical Nephrectomy and IVC Tumor Thrombectomy

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Iyad S. Khourdaji

2017-01-01

Full Text Available Melanotic Xp11 translocation renal cancer is a rarely observed neoplasm primarily affecting adolescents and young adults. Given the paucity of data describing this malignancy, its natural history and subsequent long-term management are not well understood. We report a case of melanotic Xp11 translocation with tumor thrombus extension managed with radical nephrectomy and inferior vena cava (IVC tumor thrombectomy. To our knowledge, this is the first case report to describe use of conventional tumor thrombectomy techniques in a patient with melanotic Xp11 translocation renal cancer.

DWI-ASPECTS (Diffusion-Weighted Imaging-Alberta Stroke Program Early Computed Tomography Scores) and DWI-FLAIR (Diffusion-Weighted Imaging-Fluid Attenuated Inversion Recovery) Mismatch in Thrombectomy Candidates: An Intrarater and Interrater Agreement Study.

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Fahed, Robert; Lecler, Augustin; Sabben, Candice; Khoury, Naim; Ducroux, Célina; Chalumeau, Vanessa; Botta, Daniele; Kalsoum, Erwah; Boisseau, William; Duron, Loïc; Cabral, Dominique; Koskas, Patricia; Benaïssa, Azzedine; Koulakian, Hasmik; Obadia, Michael; Maïer, Benjamin; Weisenburger-Lile, David; Lapergue, Bertrand; Wang, Adrien; Redjem, Hocine; Ciccio, Gabriele; Smajda, Stanislas; Desilles, Jean-Philippe; Mazighi, Mikaël; Ben Maacha, Malek; Akkari, Inès; Zuber, Kevin; Blanc, Raphaël; Raymond, Jean; Piotin, Michel

2018-01-01

We aimed to study the intrarater and interrater agreement of clinicians attributing DWI-ASPECTS (Diffusion-Weighted Imaging-Alberta Stroke Program Early Computed Tomography Scores) and DWI-FLAIR (Diffusion-Weighted Imaging-Fluid Attenuated Inversion Recovery) mismatch in patients with acute ischemic stroke referred for mechanical thrombectomy. Eighteen raters independently scored anonymized magnetic resonance imaging scans of 30 participants from a multicentre thrombectomy trial, in 2 different reading sessions. Agreement was measured using Fleiss κ and Cohen κ statistics. Interrater agreement for DWI-ASPECTS was slight (κ=0.17 [0.14-0.21]). Four raters (22.2%) had a substantial (or higher) intrarater agreement. Dichotomization of the DWI-ASPECTS (0-5 versus 6-10 or 0-6 versus 7-10) increased the interrater agreement to a substantial level (κ=0.62 [0.48-0.75] and 0.68 [0.55-0.79], respectively) and more raters reached a substantial (or higher) intrarater agreement (17/18 raters [94.4%]). Interrater agreement for DWI-FLAIR mismatch was moderate (κ=0.43 [0.33-0.57]); 11 raters (61.1%) reached a substantial (or higher) intrarater agreement. Agreement between clinicians assessing DWI-ASPECTS and DWI-FLAIR mismatch may not be sufficient to make repeatable clinical decisions in mechanical thrombectomy. The dichotomization of the DWI-ASPECTS (0-5 versus 0-6 or 0-6 versus 7-10) improved interrater and intrarater agreement, however, its relevance for patients selection for mechanical thrombectomy needs to be validated in a randomized trial. © 2017 American Heart Association, Inc.

Mechanical Thrombectomy for Minor and Mild Stroke Patients Harboring Large Vessel Occlusion in the Anterior Circulation: A Multicenter Cohort Study.

Science.gov (United States)

Dargazanli, Cyril; Arquizan, Caroline; Gory, Benjamin; Consoli, Arturo; Labreuche, Julien; Redjem, Hocine; Eker, Omer; Decroix, Jean-Pierre; Corlobé, Astrid; Mourand, Isabelle; Gaillard, Nicolas; Ayrignac, Xavier; Charif, Mahmoud; Duhamel, Alain; Labeyrie, Paul-Emile; Riquelme, Carlos; Ciccio, Gabriele; Smajda, Stanislas; Desilles, Jean-Philippe; Gascou, Grégory; Lefèvre, Pierre-Henri; Mantilla-García, Daniel; Cagnazzo, Federico; Coskun, Oguzhan; Mazighi, Mikael; Riva, Roberto; Bourdain, Frédéric; Labauge, Pierre; Rodesch, Georges; Obadia, Michael; Bonafé, Alain; Turjman, Francis; Costalat, Vincent; Piotin, Michel; Blanc, Raphaël; Lapergue, Bertrand

2017-12-01

Proximal large vessel occlusion (LVO) is present in up to 30% of minor strokes. The effectiveness of mechanical thrombectomy (MT) in the subgroup of minor stroke with LVO in the anterior circulation is still open to debate. Data about MT in this subgroup of patients are sparse, and their optimal management has not yet been defined. The purpose of this multicenter cohort study was to evaluate the effectiveness of MT in patients experiencing acute ischemic stroke (AIS) because of LVO in the anterior circulation, presenting with minor-to-mild stroke symptoms (National Institutes of Health Stroke Scale score of stroke centers having 2 therapeutic approaches (urgent thrombectomy associated with best medical treatment [BMT] versus BMT first and MT if worsening occurs) about management of patients with minor and mild acute ischemic stroke harboring LVO in the anterior circulation. An intention-to-treat analysis was conducted. The primary end point was the rate of excellent outcome defined as the achievement of a modified Rankin Scale score of 0 to 1 at 3 months. Three hundred one patients were included, 170 with urgent MT associated with BMT, and 131 with BMT alone as first-line treatment. Patients treated with MT were younger, more often received intravenous thrombolysis, and had shorter time to imaging. Twenty-four patients (18.0%) in the medical group had rescue MT because of neurological worsening. Overall, excellent outcome was achieved in 64.5% of patients, with no difference between the 2 groups. Stratified analysis according to key subgroups did not find heterogeneity in the treatment effect size. Minor-to-mild stroke patients with LVO achieved excellent and favorable functional outcomes at 3 months in similar proportions between urgent MT versus delayed MT associated with BMT. There is thus an urgent need for randomized trials to define the effectiveness of MT in this patient subgroup. © 2017 American Heart Association, Inc.

Outcome and periprocedural time management in referred versus directly admitted stroke patients treated with thrombectomy.

Science.gov (United States)

Weber, Ralph; Reimann, Gernot; Weimar, Christian; Winkler, Angela; Berger, Klaus; Nordmeyer, Hannes; Hadisurya, Jeffrie; Brassel, Friedhelm; Kitzrow, Martin; Krogias, Christos; Weber, Werner; Busch, Elmar W; Eyding, Jens

2016-03-01

After thrombectomy has shown to be effective in acute stroke patients with large vessel occlusion, the potential benefit of secondary referral for such an intervention needs to be validated. We aimed to compare consecutive stoke patients directly admitted and treated with thrombectomy at a neurointerventional centre with patients secondarily referred for such a procedure from hospitals with a stroke unit. Periprocedure times and mortality in 300 patients primarily treated in eight neurointerventional centres were compared with 343 patients referred from nine other hospitals in a prospective multicentre study of a German neurovascular network. Data on functional outcome at 3 months was available in 430 (76.4%) patients. In-hospital mortality (14.8% versus 11.7%, p = 0.26) and 3 months mortality (21.9% versus 24.1%, p = 0.53) were not statistically different in both patient groups despite a significant shorter symptom to groin puncture time in directly admitted patients, which was mainly caused by a longer interfacility transfer time. We found a nonsignificant trend for better functional outcome at 3 months in directly admitted patients (modified Rankin Scale 0-2, 44.0% versus 35.7%, p = 0.08). Our results show that a drip-and-ship thrombectomy concept can be effectively organized in a metropolitan stroke network. Every effort should be made to speed up the emergency interfacility transfer to a neurointerventional centre in stroke patients eligible for thrombectomy after initial brain imaging.

Endovascular treatment of iliofemoral deep vein thrombosis in pregnancy using US-guided percutaneous aspiration thrombectomy.

Science.gov (United States)

Gedikoglu, Murat; Oguzkurt, Levent

2017-01-01

We aimed to describe ultrasonography (US)-guided percutaneous aspiration thrombectomy in pregnant women with iliofemoral deep vein thrombosis. This study included nine pregnant women with acute and subacute iliofemoral deep vein thrombosis, who were severe symptomatic cases with massive swelling and pain of the leg. Patients were excluded from the study if they had only femoropopliteal deep vein thrombosis or mild symptoms of deep vein thrombosis. US-guided percutaneous aspiration thrombectomy was applied to achieve thrombus removal and uninterrupted venous flow. The treatment was considered successful if there was adequate venous patency and symptomatic relief. Complete or significant thrombus removal and uninterrupted venous flow from the puncture site up to the iliac veins were achieved in all patients at first intervention. Complete relief of leg pain was achieved immediately in seven patients (77.8%). Two patients (22.2%) had a recurrence of thrombosis in the first week postintervention. One of them underwent a second intervention, where percutaneous aspiration thrombectomy was performed again with successful removal of thrombus and establishment of in line flow. Two patients were lost to follow-up after birth. None of the remaining seven patients had rethrombosis throughout the postpartum period. Symptomatic relief was detected clinically in these patients. Endovascular treatment with US-guided percutaneous aspiration thrombectomy can be considered as a safe and effective way to remove thrombus from the deep veins in pregnant women with acute and subacute iliofemoral deep vein thrombosis.

Histopathological and Bacteriological Analysis of Thrombus Material Extracted During Mechanical Thrombectomy in Acute Stroke Patients.

Science.gov (United States)

Hernández-Fernández, Francisco; Rojas-Bartolomé, Laura; García-García, Jorge; Ayo-Martín, Óscar; Molina-Nuevo, Juan David; Barbella-Aponte, Rosa Angélica; Serrano-Heras, Gemma; Juliá-Molla, Enrique; Pedrosa-Jiménez, María José; Segura, Tomás

2017-12-01

Management of stroke secondary to septic emboli (SE) remains challenging, due to both the lack of specific recommendations and the gravity of the underlying pathology.The aim of this study is to describe the presence of SE in a series of mechanical thrombectomies (MT), analyzing technical complexity and outcomes with respect to the patients by means of histological analysis and microbiological study of the clot. All the retrieved clots were studied under an established protocol, including histopathological and bacteriological study with hematoxylin-eosin, Gram and Gomori trichrome staining.Technical complexity in SE with respect to the series was evaluated by analyzing time of the procedures, number of passes and use of intracranial definitive stents. Over a 24-month period, bacteria were detected in the retrieved clot of four out of 65 patients (incidence 6.2%). Two cases were eventually diagnosed with infective endocarditis, while the remaining two were diagnosed with urinary tract infection and respiratory septicemia, respectively. Three of the four patients (75%) required an intracranial definitive stent in order to achieve successful recanalization.These procedures were significantly longer (137.7 vs. 59.8 min, p vs. 2.2, p vs. 1.6%, p = 0.008), with respect to the rest of the series. In our series, systematic histopathological and bacteriological study of the MT samples allowed a higher proportion of SE diagnosis in comparison with previous reports.

The Use of the “Preclosure” Technique for Antegrade Aspiration Thrombectomy with Large Catheters in Acute Limb Ischemia

International Nuclear Information System (INIS)

Funke, C.; Pfiffner, R.; Husmann, M.; Pfammatter, T.

2013-01-01

This study was designed to assess retrospectively short- and mid-term outcomes of the use of a suture-mediated closure device to close the antegrade access in patients undergoing percutaneous aspiration thrombectomy with large catheters for acute leg ischemia. Between November 2005 and February 2010, a suture-mediated active closure system (ProGlide ® 6F, Abbott) was placed before arterial sheath (mean 9 F, range 6–12 F) introduction in 101 patients (74 men, 73 %, mean age 70.1 ± 12.6 years standard deviation). Data regarding mortality, complications, and factors contributing to vascular complications at the access site was collected for 6 month after the intervention to detect device-related problems. As a coincidence, 77 patients had follow-up visits for a duplex ultrasound. There were a total of 19 vascular complications (19 %) at the puncture site, all of which were of hemorrhagic nature and none of which consisted of vessel occlusion. Two major outcome complications (2 %) occurred. A retroperitoneal hematoma and a serious inguinal bleeding required additive treatment and did not result in permanent sequelae. Nine cases involved death of which eight were not attributable to the closure and one remained unclear. Successful closure was achieved in 95 patients (94 %); additional manual compression was sufficient in the majority of the remaining patients. Numerous factors contributing to vascular complications were encountered. With acceptable short- and mid-term outcomes, the “preclose” technique can be a reliable option for the closure of a large antegrade femoral access even for patients at a high risk of vascular complications, such as those undergoing aspiration thrombectomy.

Endovascular Thrombectomy for Ischemic Stroke Increases Disability-Free Survival, Quality of Life, and Life Expectancy and Reduces Cost

Directory of Open Access Journals (Sweden)

Bruce C. V. Campbell

2017-12-01

Full Text Available BackgroundEndovascular thrombectomy improves functional outcome in large vessel occlusion ischemic stroke. We examined disability, quality of life, survival and acute care costs in the EXTEND-IA trial, which used CT-perfusion imaging selection.MethodsLarge vessel ischemic stroke patients with favorable CT-perfusion were randomized to endovascular thrombectomy after alteplase versus alteplase-only. Clinical outcome was prospectively measured using 90-day modified Rankin scale (mRS. Individual patient expected survival and net difference in Disability/Quality-adjusted life years (DALY/QALY up to 15 years from stroke were modeled using age, sex, 90-day mRS, and utility scores. Level of care within the first 90 days was prospectively measured and used to estimate procedure and inpatient care costs (US$ reference year 2014.ResultsThere were 70 patients, 35 in each arm, mean age 69, median NIHSS 15 (IQR 12–19. The median (IQR disability-weighted utility score at 90 days was 0.65 (0.00–0.91 in the alteplase-only versus 0.91 (0.65–1.00 in the endovascular group (p = 0.005. Modeled life expectancy was greater in the endovascular versus alteplase-only group (median 15.6 versus 11.2 years, p = 0.02. The endovascular thrombectomy group had fewer simulated DALYs lost over 15 years [median (IQR 5.5 (3.2–8.7 versus 8.9 (4.7–13.8, p = 0.02] and more QALY gained [median (IQR 9.3 (4.2–13.1 versus 4.9 (0.3–8.5, p = 0.03]. Endovascular patients spent less time in hospital [median (IQR 5 (3–11 days versus 8 (5–14 days, p = 0.04] and rehabilitation [median (IQR 0 (0–28 versus 27 (0–65 days, p = 0.03]. The estimated inpatient costs in the first 90 days were less in the thrombectomy group (average US$15,689 versus US$30,569, p = 0.008 offsetting the costs of interhospital transport and the thrombectomy procedure (average US$10,515. The average saving per patient treated with thrombectomy was US$4

The Use of the 'Preclosure' Technique for Antegrade Aspiration Thrombectomy with Large Catheters in Acute Limb Ischemia

Energy Technology Data Exchange (ETDEWEB)

Funke, C., E-mail: claas_funke@hotmail.com; Pfiffner, R. [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology (Switzerland); Husmann, M. [University Hospital Zurich, Clinic of Angiology (Switzerland); Pfammatter, T. [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology (Switzerland)

2013-04-15

This study was designed to assess retrospectively short- and mid-term outcomes of the use of a suture-mediated closure device to close the antegrade access in patients undergoing percutaneous aspiration thrombectomy with large catheters for acute leg ischemia. Between November 2005 and February 2010, a suture-mediated active closure system (ProGlide{sup Registered-Sign} 6F, Abbott) was placed before arterial sheath (mean 9 F, range 6-12 F) introduction in 101 patients (74 men, 73 %, mean age 70.1 {+-} 12.6 years standard deviation). Data regarding mortality, complications, and factors contributing to vascular complications at the access site was collected for 6 month after the intervention to detect device-related problems. As a coincidence, 77 patients had follow-up visits for a duplex ultrasound. There were a total of 19 vascular complications (19 %) at the puncture site, all of which were of hemorrhagic nature and none of which consisted of vessel occlusion. Two major outcome complications (2 %) occurred. A retroperitoneal hematoma and a serious inguinal bleeding required additive treatment and did not result in permanent sequelae. Nine cases involved death of which eight were not attributable to the closure and one remained unclear. Successful closure was achieved in 95 patients (94 %); additional manual compression was sufficient in the majority of the remaining patients. Numerous factors contributing to vascular complications were encountered. With acceptable short- and mid-term outcomes, the 'preclose' technique can be a reliable option for the closure of a large antegrade femoral access even for patients at a high risk of vascular complications, such as those undergoing aspiration thrombectomy.

Percutaneous aspiration thrombectomy for the treatment of acute lower extremity deep vein thrombosis: is thrombolysis needed?

Energy Technology Data Exchange (ETDEWEB)

Kwon, S.H. [Department of Radiology, Kyung Hee University Medical Center, Seoul (Korea, Republic of); Oh, J.H. [Department of Radiology, Kyung Hee University Medical Center, Seoul (Korea, Republic of)], E-mail: radkwon@dreamwiz.com; Seo, T.-S. [Department of Radiology, Korea University Guro Hospital, Seoul (Korea, Republic of); Ahn, H.J.; Park, H.C. [Department of Surgery, Kyung Hee University Medical Center, Seoul (Korea, Republic of)

2009-05-15

Aim: To assess the technical feasibility and initial success of aspiration thrombectomy as a potential alternative to lytic therapy in initial endovascular management of acute lower extremity deep vein thrombosis (DVT). Materials and Methods: From July 2004 to October 2007, a retrospective analysis of 27 patients (male:female 5:22; mean age 59 years) with acute iliofemoral or femoropopliteal DVT of less than 2 weeks was performed. All patients underwent sonography of the lower extremities, and 13 patients underwent computed tomography (CT) venography. All patients received an inferior vena cava (IVC) filter and were initially treated with aspiration thrombectomy using the pullback technique with or without basket thrombus fragmentation. If persistent stenotic portions (>50% luminal narrowing) were noted, balloon angioplasty or stent placement was performed. Successful recanalization was defined as successful restoration of antegrade flow in the treated vein with elimination of any underlying obstructive lesion. Results: The mean procedure time was 65 min (range 40-100 min). Successful initial recanalization was achieved in 24 patients (88.9%) without complications. Urokinase was required for three patients (11.1%) due to a hard thrombus remaining in the iliac vein. Of the 27 patients, 23 had residual venous stenosis in the common iliac vein or external iliac vein. Therefore, balloon angioplasty (n = 23) and stent placement (n = 22) was performed. The remaining four patients were treated using only aspiration thrombectomy without angioplasty or stent placement. Conclusion: Aspiration thrombectomy without catheter-directed thrombolysis is a safe and effective treatment for acute DVT of the lower extremities, and minimizes the risk of haemorrhagic complications.

Aspiration Thrombectomy Using a Guiding Catheter in Acute Lower Extremity Deep Vein Thrombosis: Usefulness of the Calf-Squeeze Technique

Energy Technology Data Exchange (ETDEWEB)

Lee, Jae A; Kwak, Hyo Sung; Han, Young Min; Yu, Hee Chul [Chonbuk National University Medical School, Jeonju (Korea, Republic of)

2011-05-15

The effectiveness of the calf-squeeze technique during aspiration thrombectomy using guiding catheter in the treatment of an acute lower extremity deep vein thrombosis (DVT) was evaluated by the use of imaging and the clinical follow-up of patients. A prospective analysis of ten patients (seven women, three men; median age, 56.9 years) with common iliac vein (CIV) obstruction and ipsilateral DVT was performed for this study. All patients presented with leg edema or pain and were treated with catheter-directed thrombolysis via an ipsilateral popliteal vein approach after insertion of a temporary inferior vena cava (IVC) filter. Subsequently, the patients were treated with by aspiration thrombectomy using a guiding catheter to remove the residual thrombus. The calf-squeeze technique during aspiration thrombectomy can be used to induce the proximal migration of thrombi in the popliteal, tibial, and muscular veins were used to increase venous flow. The calf-squeeze technique was employed at mean of 1.3 times (range, 1-3 times). All patients showed proximal migration of a popliteal and muscular vein thrombus during the execution of the calf-squeeze technique. Successful recanalization was achieved in all patients (100%) without any complications. On duplex ultrasonography, which was performed immediately after the aspiration thrombectomy, four patients had a residual thrombus in the soleal muscular veins. However, none of the patients had a thrombus in the popliteal and tibial veins; and, during follow-up, no DVT recurred in any patient. The use of the calf-squeeze technique during aspiration thrombectomy after catheter-directed thrombolysis can induce the proximal migration of thrombi in the popliotibial and muscular veins and is an effective method that can remove a thrombus in calf veins.

Aspiration Thrombectomy Using a Guiding Catheter in Acute Lower Extremity Deep Vein Thrombosis: Usefulness of the Calf-Squeeze Technique

International Nuclear Information System (INIS)

Lee, Jae A; Kwak, Hyo Sung; Han, Young Min; Yu, Hee Chul

2011-01-01

The effectiveness of the calf-squeeze technique during aspiration thrombectomy using guiding catheter in the treatment of an acute lower extremity deep vein thrombosis (DVT) was evaluated by the use of imaging and the clinical follow-up of patients. A prospective analysis of ten patients (seven women, three men; median age, 56.9 years) with common iliac vein (CIV) obstruction and ipsilateral DVT was performed for this study. All patients presented with leg edema or pain and were treated with catheter-directed thrombolysis via an ipsilateral popliteal vein approach after insertion of a temporary inferior vena cava (IVC) filter. Subsequently, the patients were treated with by aspiration thrombectomy using a guiding catheter to remove the residual thrombus. The calf-squeeze technique during aspiration thrombectomy can be used to induce the proximal migration of thrombi in the popliteal, tibial, and muscular veins were used to increase venous flow. The calf-squeeze technique was employed at mean of 1.3 times (range, 1-3 times). All patients showed proximal migration of a popliteal and muscular vein thrombus during the execution of the calf-squeeze technique. Successful recanalization was achieved in all patients (100%) without any complications. On duplex ultrasonography, which was performed immediately after the aspiration thrombectomy, four patients had a residual thrombus in the soleal muscular veins. However, none of the patients had a thrombus in the popliteal and tibial veins; and, during follow-up, no DVT recurred in any patient. The use of the calf-squeeze technique during aspiration thrombectomy after catheter-directed thrombolysis can induce the proximal migration of thrombi in the popliotibial and muscular veins and is an effective method that can remove a thrombus in calf veins.

Endovascular Treatment of Phlegmasia Cerulea Dolens with Impending Venous Gangrene: Manual Aspiration Thrombectomy as the First-Line Thrombus Removal Method

International Nuclear Information System (INIS)

Oguzkurt, Levent; Ozkan, Ugur; Demirturk, Orhan S.; Gur, Serkan

2011-01-01

Purpose: Our purpose was to report the outcome of endovascular treatment with manual aspiration thrombectomy as the first-line thromboablative method for phlegmasia cerulea dolens. Methods: Between October 2006 and May 2010, seven consecutive patients (5 women, 2 men; age range, 31–80 years) with the diagnosis of phlegmasia cerulea dolens secondary to acute iliofemoral deep venous thrombosis had endovascular treatment with manual aspiration thrombectomy. Catheter-directed thrombolysis and stent placement were used as adjunctive procedures. Phlegmasia was left-sided in five and right-sided in two patients. Results: All patients had associated great saphenous vein thrombosis in addition to iliofemoral deep vein thrombosis (DVT). Aspiration thrombectomy completely removed the thrombus from the popliteal vein to the inferior vena cava (IVC) in all cases. Three patients with May-Thurner syndrome had stent placement in the left common iliac vein. Two patients had early recurrences. Repeated aspiration thrombectomy was unsuccessful in one patient. There were no complications related to the procedure. One patient who had been successfully treated died of sepsis and another patient who had unsuccessful repeated interventions had below-the-knee amputation. Overall, the clinical success and survival rates of patients in this study were 86%. On follow-up, three patients with successful treatment were asymptomatic with no deep venous insufficiency. One of these patients died during the 4-month follow-up period. Two patients had mild ankle swelling with deep venous insufficiency. Conclusions: Manual aspiration thrombectomy with adjunctive use of catheter-directed thrombolysis and stent placement is an effective endovascular treatment method with high clinical success and survival rates for phlegmasia cerulean dolens.

Manual Aspiration Thrombectomy with Stent Placement: Rapid and Effective Treatment for Phlegmasia Cerulea Dolens with Impending Venous Gangrene

International Nuclear Information System (INIS)

Oguzkurt, Levent; Tercan, Fahri; Ozkan, Ugur

2008-01-01

Phlegmasia cerulea dolens is an uncommon but potentially life-threatening complication of acute deep vein thrombosis. It is an emergency and delay in treatment may cause death or loss of the patient's limb. Surgical thrombectomy is the recommended treatment in venous gangrene. Catheter-directed intrathrombus thrombolysis has been reported as successful, but it may require a lengthy infusion. Manual aspiration thrombectomy may clear the entire thrombus with no need for thrombolytic administration and provide rapid and effective treatment for patients with phlegmasia cerulea dolens with impending venous gangrene

Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke

DEFF Research Database (Denmark)

Saver, Jeffrey L; Goyal, Mayank; Bonafe, Alain

2015-01-01

BACKGROUND: Among patients with acute ischemic stroke due to occlusions in the proximal anterior intracranial circulation, less than 40% regain functional independence when treated with intravenous tissue plasminogen activator (t-PA) alone. Thrombectomy with the use of a stent retriever, in addit...

Thromboelastometric evaluation of horses submitted to experimental thrombosis and jugular thrombectomy

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Dietrich Pizzigatti

Full Text Available Abstract: Jugular thrombosis in horses occurs commonly in iatrogenic situations, secondary to endotoxemic clinical condition and disseminated vascular coagulation, potentially leading to death. Thus, hemostatic evaluation becomes necessary and extremely important for monitoring the risks of systemic hypercoagulability and for the efficiency of allopathic and surgical treatment. This paper describes the hemostatic behavior in experimental jugular thrombosis of ten healthy equines, subsequently submitted to two thrombectomy techniques and receiving heparin sodium as anti-rethrombosis therapy. These animals were evaluated for 20 days by thromboelastometry (TEM, platelet count, hematocrit and fibrinogen, at four moments: pre-induction to phlebitis (D0-MPF; three days after thrombophlebitis induction (D3-MFM; 6 days after, - moment of thrombophlebitis - (D9-MT; and 54 (D16 and 126 (D19 hours after thrombectomies (PTM. Thrombectomy was performed via a Vollmar Ring (group 1, n=5 and Fogarty catheter (group 2, n=5. All the animals received heparin (150 UI/kg, SC every 12 hours, for ten days after the respective thrombectomies. Through the blood samples were evaluated TEM, activated partial thromboplastin time (aPTT and prothrombin time (PT, dosing of fibrinogen, hematocrit and platelet count at the abovementioned moments. For comparison between groups and moments the t test was applied at 5% significance level. No significant difference was verified between treatment groups at any of the moments. There were reductions in clotting time (CT and clot formation time (CFT, with increase in maximum lysis (ML until the moment D9-MT. Evaluation through INTEM® reagent presented prolongations of CT and CFT with reduction of α angle and ML starting from D16 and D19. Similarly, aPTT presented significant differences between moments pre- (D0, 3 and 9 and post- (D16 and 19 anticoagulant and surgical treatment. The platelet numbers were diminished at moments D16 and

Mechanical endovascular therapy for acute ischemic stroke: An indirect treatment comparison between Solitaire and Penumbra thrombectomy devices.

Directory of Open Access Journals (Sweden)

Jonathan T Caranfa

Full Text Available Randomized controlled trials (RCTs have compared mechanical endovascular therapy (MET in addition to intravenous tissue plasminogen activator (IVtPA to IVtPA alone for the management of acute ischemic stroke (AIS. Direct comparative studies between individual METs are not available. In lieu of head-to-head randomized control trials, we performed an adjusted indirect treatment comparison (ITC meta-analysis to assess the comparative efficacy and safety of different METs, Solitaire+IVtPA and Penumbra+IVtPA in AIS patients.We searched MEDLINE, the Cochrane Central Register of Controlled Trials and Embase from January 1, 2005 through April 1, 2017 for RCTs in AIS patients, comparing a single MET+IVtPA to IVtPA alone and reporting shift in ordinal modified Rankin Scale (mRS score at 90 days. Secondary endpoints included 90 day mortality and symptomatic intracranial hemorrhage (sICH. Endpoints were pooled using traditional random effects meta-analysis methods, producing odds ratios and 95% confidence intervals. Adjusted ITCs using pooled estimates were then performed. Three studies (SWIFT PRIME, EXTEND-IA, THERAPY were included; two evaluating the Solitaire stent retriever and one the Penumbra system. Traditional meta-analysis demonstrated that each MET+IVtPA resulted in increased odds of improving ordinal mRS score vs. IVtPA alone, but did not alter the odds of death or sICH. Adjusted ITC showed no significant difference between the METs for any outcome.No significant difference in efficacy or safety between the Solitaire and Penumbra devices was observed.

Prophylactic Placement of an Inferior Vena Cava Filter During Aspiration Thrombectomy for Acute Deep Venous Thrombosis of the Lower Extremity.

Science.gov (United States)

Kwon, Se Hwan; Park, So Hyun; Oh, Joo Hyeong; Song, Myung Gyu; Seo, Tae-Seok

2016-05-01

To evaluate the effect of an inferior vena cava (IVC) filter during aspiration thrombectomy for acute deep vein thrombosis (DVT) in the lower extremity. From July 2004 to December 2013, a retrospective analysis of 106 patients with acute DVT was performed. All patients received an IVC filter and were treated initially with aspiration thrombectomy. Among the 106 patients, DVT extension into the IVC was noted in 27 but was not evident in 79. We evaluated the presence of trapped thrombi in the filters after the procedure. The sizes of the trapped thrombi were classified into 2 grades based on the ratio of the maximum transverse length of the trapped thrombus to the diameter of the IVC (Grades I [≤ 50%] and II [> 50%]). A trapped thrombus in the filter was detected in 46 (43%) of 106 patients on final venograms. The sizes of the trapped thrombi were grade I in 12 (26.1%) patients and grade II in 34 (73.9%). Among the 27 patients with DVT extension into the IVC, 20 (74.1%) showed a trapped thrombus in the filter, 75% (15 of 20) of which were grade II. Among the 79 patients without DVT extension into the IVC, 26 (32.9%) showed a trapped thrombus in the IVC filter, 73% (19 of 26) of which were grade II. Thrombus migration occurred frequently during aspiration thrombectomy of patients with acute DVT in the lower extremity. However, further studies are needed to establish a standard protocol for the prophylactic placement of an IVC filter during aspiration thrombectomy. © The Author(s) 2016.

A Stent-Retrieving into an Aspiration Catheter with Proximal Balloon (ASAP) Technique: A Technique of Mechanical Thrombectomy.

Science.gov (United States)

Goto, Shunsaku; Ohshima, Tomotaka; Ishikawa, Kojiro; Yamamoto, Taiki; Shimato, Shinji; Nishizawa, Toshihisa; Kato, Kyozo

2018-01-01

The best technique for the first attempt at mechanical thrombectomy for acute ischemic stroke is a still matter of debate. In this study, we evaluate the efficacy of a stent-retrieving into an aspiration catheter with proximal balloon (ASAP) technique that uses a series of thrombus extraction by withdrawing the stent retriever into the aspiration catheter and continuous aspiration from the aspiration catheter at the first attempt. We performed a retrospective analysis of 42 consecutive patients with acute ischemic stroke caused by occlusions in the anterior circulation who were treated with the ASAP technique at our institution. Preoperative patient characteristic, including age, thrombus location, Alberta Stroke Program Early CT Score, National Institutions of Health Stroke Scale, and time from onset to puncture; postoperative Thrombolysis in Cerebral Infarction score; modified Rankin Scale score after 3 months; time from puncture to recanalization; the number of passes to achieve recanalization; and procedural complications, including intracranial hemorrhage, embolization to new territory, and distal embolization, were assessed. A Thrombolysis in Cerebral Infarction score of 2B or 3 was achieved in 40/42 patients (95.2%). Average time from puncture to the final recanalization was 21.5 minutes. Recanalization was achieved in a single attempt in 31 patients (77.5%). Embolization to new territory was observed in only 2 patients (4.8%); no patient developed distal embolization or intracranial hemorrhage including asymptomatic subarachnoid hemorrhage. Thirty-two patients (76.2%) achieved modified Rankin Scale scores of 0-2 at 3 months postoperatively. Our ASAP technique showed fast recanalization, minimal complications, and good clinical outcomes in this case series. Copyright © 2017 Elsevier Inc. All rights reserved.

Thrombectomy assisted by carotid stenting in acute ischemic stroke management

DEFF Research Database (Denmark)

Steglich-Arnholm, Henrik; Holtmannspötter, Markus; Kondziella, Daniel

2015-01-01

.0). Early clinical improvement was detected in 22 (46%) patients. Favorable outcome at 3 months occurred in 32 (68%) patients. Expedited patient management was associated with favorable clinical outcome. Two (4%) patients experienced symptomatic hemorrhage. Eight (17%) patients experienced stent thrombosis....... Four (9%) patients died. Thrombectomy assisted by carotid stenting seems beneficial and reasonably safe with a promising rate of favorable outcome. Nevertheless, adverse events and complications call for additional clinical investigations prior to recommendation as clinical standard. Expeditious...... patient management is central to achieve good clinical outcome....

‘Mother-in-child’ thrombectomy technique: a novel and effective approach to decrease intracoronary thrombus burden in acute myocardial infarction

Energy Technology Data Exchange (ETDEWEB)

Dauvergne, Christian; Araya, Mario [Department of Cardiology, Clinica Alemana, Santiago (Chile); Uriarte, Polentzi [Department of Cardiology, Instituto Nacional del Torax, Santiago (Chile); Novoa, Oscar; Novoa, Lilian [Department of Cardiology, Clinica Alemana, Santiago (Chile); Maluenda, Gabriel, E-mail: gabrielmaluenda@gmail.com [Department of Cardiology, Clinica Alemana, Santiago (Chile)

2013-01-15

Background: The presence of large thrombus burden in patients presenting with acute myocardial infarction (AMI) is common and associated with poor prognosis. This study aimed to describe the feasibility and safety of the novel ‘mother-in-child’ thrombectomy (MCT) technique in patients presenting with AMI and large thrombus burden undergoing percutaneous coronary intervention (PCI). Methods: We studied 13 patients presenting with AMI who underwent PCI with persistent large intracoronary thrombus after standard thrombectomy. The procedure was performed using a 5 F ‘Heartrail II-ST01’ catheter (Terumo Medical) into a 6 F guiding system. Angiographic assessment of thrombus burden and coronary flow was obtained at baseline, immediately after thrombectomy and at the end of the procedure. Results: The mean age was 55.9 ± 13.0 years and involved mostly males (76.9%). All patients underwent PCI via radial approach. Following MCT Thrombolysis In Myocardial Infarction (TIMI) flow improved by 2 or more degrees in 11 patients (84.5%), while visible angiographic thrombus was reduced in 11 patients (84.5%). In the final angiogram, normal TIMI flow was restored in 11 patients (84.5%), with normal myocardial ‘blush’ in 7 patients (53.8%) and total clearance of a visible thrombus in 7 patients (53.8%). Overall, 6 patients received thrombectomy as ‘stand-alone’ procedure. All patients were discharged alive after a mean of 5.6 ± 2 days. Conclusion: This initial report suggests that significant reduction in thrombus burden and improvement of the coronary flow can be safely achieved in patients presenting with AMI and large thrombus burden by using the novel MCT technique.

Novel Use of a Pneumatic Compression Device for Haemostasis of Haemodialysis Fistula Access Catheterisation Sites

Energy Technology Data Exchange (ETDEWEB)

O’Reilly, Michael K., E-mail: moreilly1@mater.ie; Ryan, David; Sugrue, Gavin; Geoghegan, Tony; Lawler, Leo P.; Farrelly, Cormac T. [Mater Misericordiae University Hospital, Department of Interventional Radiology (Ireland)

2016-12-15

PurposeTransradial pneumatic compression devices can be used to achieve haemostasis following radial artery puncture. This article describes a novel technique for acquiring haemostasis of arterio-venous haemodialysis fistula access sites without the need for suture placement using one such compression device.Materials and MethodsA retrospective review of fistulograms with or without angioplasty/thrombectomy in a single institution was performed. 20 procedures performed on 12 patients who underwent percutaneous intervention of failing or thrombosed arterio-venous fistulas (AVF) had 27 puncture sites. Haemostasis was achieved using a pneumatic compression device at all access sites. Procedure details including size of access sheath, heparin administration and complications were recorded.ResultsTwo diagnostic fistulograms, 14 fistulograms and angioplasties and four thrombectomies were performed via access sheaths with an average size (±SD) of 6 Fr (±1.12). IV unfractionated heparin was administered in 11 of 20 procedures. Haemostasis was achieved in 26 of 27 access sites following 15–20 min of compression using the pneumatic compression device. One case experienced limited bleeding from an inflow access site that was successfully treated with reinflation of the device for a further 5 min. No other complication was recorded.ConclusionsHaemostasis of arterio-venous haemodialysis fistula access sites can be safely and effectively achieved using a pneumatic compression device. This is a technically simple, safe and sutureless technique for acquiring haemostasis after AVF intervention.

Clinic Predictive Factors for Insufficient Myocardial Reperfusion in ST-Segment Elevation Myocardial Infarction Patients Treated with Selective Aspiration Thrombectomy during Primary Percutaneous Coronary Intervention

Directory of Open Access Journals (Sweden)

Jinfan Tian

2016-01-01

Full Text Available Background. Insufficient data are available on the potential benefit of selective aspiration and clinical predictors for no-reflow in STEMI patients undergoing primary percutaneous coronary intervention (PPCI adjunct with aspiration thrombectomy. Objective. The aim of our study was to investigate clinical predictors for insufficient reperfusion in patients with high thrombus burden treated with PPCI and manual aspiration thrombectomy. Methods. From January 2011 till December 2015, 277 STEMI patients undergoing manual aspiration thrombectomy and PPCI were selected and 202 patients with a Thrombolysis in Myocardial Infarction (TIMI thrombus grade 4~5 were eventually involved in our study. According to a cTFC value, patients were divided into Group I (cTFC > 40, namely, insufficient reperfusion group; Group II (cTFC ≤ 40, namely, sufficient reperfusion group. Results. Univariate analysis showed that hypertension, multivessel disease, time from symptom to PCI (≧4.8 hours, and postaspiration cTFC > 40 were negative predictors for insufficient reperfusion. After multivariate adjustment, age ≧ 60 years, hypertension, time from symptom to PCI (≧4.8 hours, and postaspiration cTFC > 40 were independently associated with insufficient reperfusion in STEMI patients treated with manual aspiration thrombectomy. Upfront intracoronary GP IIb/IIIa inhibitor (Tirofiban was positively associated with improved myocardial reperfusion. Conclusion. Fully identifying risk factors will help to improve the effectiveness of selective thrombus aspiration.

Symptomatic iliofemoral deep venous thrombosis treated with hybrid operative thrombectomy.

Science.gov (United States)

Rodríguez, Limael E; Aponte-Rivera, Francisco; Figueroa-Vicente, Ricardo; Bolanos-Avila, Guillermo E; Martínez-Trabal, Jorge L

2015-10-01

During the past 15 years, strategies that promote immediate and complete thrombus removal have gained popularity for the treatment of acute-onset iliofemoral deep venous thrombosis. In this case report, we describe a novel operative approach to venous thrombus removal known as hybrid operative thrombectomy. The technique employs a direct inguinal approach with concomitant retrograde advancement of a balloon catheter by femoral venotomy. Moreover, it provides effective thrombus removal through a single incision, with or without stent placement, and has the advantage of a completion venogram. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data.

Science.gov (United States)

Campbell, Bruce C V; van Zwam, Wim H; Goyal, Mayank; Menon, Bijoy K; Dippel, Diederik W J; Demchuk, Andrew M; Bracard, Serge; White, Philip; Dávalos, Antoni; Majoie, Charles B L M; van der Lugt, Aad; Ford, Gary A; de la Ossa, Natalia Pérez; Kelly, Michael; Bourcier, Romain; Donnan, Geoffrey A; Roos, Yvo B W E M; Bang, Oh Young; Nogueira, Raul G; Devlin, Thomas G; van den Berg, Lucie A; Clarençon, Frédéric; Burns, Paul; Carpenter, Jeffrey; Berkhemer, Olvert A; Yavagal, Dileep R; Pereira, Vitor Mendes; Ducrocq, Xavier; Dixit, Anand; Quesada, Helena; Epstein, Jonathan; Davis, Stephen M; Jansen, Olav; Rubiera, Marta; Urra, Xabier; Micard, Emilien; Lingsma, Hester F; Naggara, Olivier; Brown, Scott; Guillemin, Francis; Muir, Keith W; van Oostenbrugge, Robert J; Saver, Jeffrey L; Jovin, Tudor G; Hill, Michael D; Mitchell, Peter J

2018-01-01

General anaesthesia (GA) during endovascular thrombectomy has been associated with worse patient outcomes in observational studies compared with patients treated without GA. We assessed functional outcome in ischaemic stroke patients with large vessel anterior circulation occlusion undergoing endovascular thrombectomy under GA, versus thrombectomy not under GA (with or without sedation) versus standard care (ie, no thrombectomy), stratified by the use of GA versus standard care. For this meta-analysis, patient-level data were pooled from all patients included in randomised trials in PuMed published between Jan 1, 2010, and May 31, 2017, that compared endovascular thrombectomy predominantly done with stent retrievers with standard care in anterior circulation ischaemic stroke patients (HERMES Collaboration). The primary outcome was functional outcome assessed by ordinal analysis of the modified Rankin scale (mRS) at 90 days in the GA and non-GA subgroups of patients treated with endovascular therapy versus those patients treated with standard care, adjusted for baseline prognostic variables. To account for between-trial variance we used mixed-effects modelling with a random effect for trials incorporated in all models. Bias was assessed using the Cochrane method. The meta-analysis was prospectively designed, but not registered. Seven trials were identified by our search; of 1764 patients included in these trials, 871 were allocated to endovascular thrombectomy and 893 were assigned standard care. After exclusion of 74 patients (72 did not undergo the procedure and two had missing data on anaesthetic strategy), 236 (30%) of 797 patients who had endovascular procedures were treated under GA. At baseline, patients receiving GA were younger and had a shorter delay between stroke onset and randomisation but they had similar pre-treatment clinical severity compared with patients who did not have GA. Endovascular thrombectomy improved functional outcome at 3 months both in

Repeated Intra-Arterial Thrombectomy within 72 Hours in a Patient with a Clear Contraindication for Intravenous Thrombolysis

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Mona Laible

2015-01-01

Full Text Available Introduction. Treating patients with acute ischemic stroke, proximal arterial vessel occlusion, and absolute contraindication for administering intravenous recombinant tissue plasminogen activator (rtPA poses a therapeutic challenge. Intra-arterial thrombectomy constitutes an alternative treatment option. Materials and Methods. We report a case of a 57-year-old patient with concomitant gastric adenocarcinoma, who received three intra-arterial thrombectomies in 72 hours due to repeated occlusion of the left medial cerebral artery (MCA. Findings. Intra-arterial recanalization of the left medial cerebral artery was performed three times with initially good success. However, two days later, the right medial cerebral artery became occluded. Owing to the overall poor prognosis at that time and knowing the wishes of the patient, we decided not to perform another intra-arterial recanalization procedure. Conclusion. To our knowledge, this is the first case illustrating the use of repeated intra-arterial recanalization in early reocclusion of intracranial vessels.

Prognostic factors related to clinical outcome following thrombectomy in ischemic stroke (RECOST Study). 50 patients prospective study

International Nuclear Information System (INIS)

Costalat, V.; Lobotesis, K.; Machi, P.; Mourand, I.; Maldonado, I.; Heroum, C.; Vendrell, J.F.; Milhaud, D.; Riquelme, C.; Bonafé, A.; Arquizan, C.

2012-01-01

Background and aims: New thrombectomy devices allow successful and rapid recanalization in acute ischemic stroke. Nevertheless prognostics factors need to be systematically analyzed in the context of these new therapeutic strategies. The aim of this study was to analyze prognostic factors related to clinical outcome following Solitaire FR thrombectomy in ischemic stroke. Methods: Fifty consecutive ischemic stroke patients with large vessel occlusion were included. Three treatment strategies were applied; rescue therapy, combined therapy, and standalone thrombectomy. DWI ASPECT score < 5 was the main exclusion criterion after initial MRI (T2, T2*, TOF, FLAIR, DWI). Sexes, age, time to recanalization were prospectively collected. Clinical outcome was assessed post treatment, day one and discharge by means of a NIHSS. Three months mRS evaluation was performed by an independent neurologist. The probability of good outcome at 3 months was assessed by forward stepwise logistic regression using baseline NIHSS score, Glasgow score at entrance, hyperglycemia, dyslipidemia, blood–brain barrier disruption on post-operative CT, embolic and hemorrhagic post procedural complication, ischemic brain lesion extension on 24 h imaging, NIHSS at discharge, ASPECT score, and time to recanalization. All variables significantly associated with the outcome in the univariate analysis were entered in the model. The significance of adding or removing a variable from the logistic model was determined by the maximum likelihood ratio test. Odds-ratio (OR) and their 95% confidence intervals were calculated. Results: At 3 months 54% of patients had a mRS 0–2, 70% in MCA, 44% in ICA, and 43% in BA with an overall mortality rate of 12%. Baseline NIHSS score (p = 0.001), abnormal Glasgow score at entrance (p = 0.053) hyperglycemia (p = 0.023), dyslipidemia (p = 0.031), blood–brain barrier disruption (p = 0.022), embolic and hemorrhagic post procedural complication, ischemic brain lesion

Prognostic factors related to clinical outcome following thrombectomy in ischemic stroke (RECOST Study). 50 patients prospective study

Energy Technology Data Exchange (ETDEWEB)

Costalat, V., E-mail: vincentcost@hotmail.com [CHU Montpellier, Neuroradiology, Montpellier (France); Lobotesis, K., E-mail: kyriakos@lobotesis.co.uk [CHU Montpellier, Neuroradiology, Montpellier (France); Machi, P., E-mail: paolo.machi@gmail.com [CHU Montpellier, Neuroradiology, Montpellier (France); Mourand, I., E-mail: i-mourand@chu-montpellier.fr [CHU Montpellier, Neurology, Montpellier (France); Maldonado, I., E-mail: imaldonado@terra.com.br [CHU Montpellier, Neuroradiology, Montpellier (France); Heroum, C., E-mail: c-heroum@chu-montpellier.fr [CHU Montpellier, Neurology, Montpellier (France); Vendrell, J.F., E-mail: jf-vendrell@chu-montpellier.fr [CHU Montpellier, Neuroradiology, Montpellier (France); Milhaud, D., E-mail: d-milhaud@chu-montpellier.fr [CHU Montpellier, Neurology, Montpellier (France); Riquelme, C., E-mail: c-riquelme@chu-montpellier.fr [CHU Montpellier, Neuroradiology, Montpellier (France); Bonafé, A., E-mail: a-bonafe@chu-montpellier.fr [CHU Montpellier, Neuroradiology, Montpellier (France); Arquizan, C., E-mail: c-arquizan@chu-montpellier.fr [CHU Montpellier, Neurology, Montpellier (France)

2012-12-15

Background and aims: New thrombectomy devices allow successful and rapid recanalization in acute ischemic stroke. Nevertheless prognostics factors need to be systematically analyzed in the context of these new therapeutic strategies. The aim of this study was to analyze prognostic factors related to clinical outcome following Solitaire FR thrombectomy in ischemic stroke. Methods: Fifty consecutive ischemic stroke patients with large vessel occlusion were included. Three treatment strategies were applied; rescue therapy, combined therapy, and standalone thrombectomy. DWI ASPECT score < 5 was the main exclusion criterion after initial MRI (T2, T2*, TOF, FLAIR, DWI). Sexes, age, time to recanalization were prospectively collected. Clinical outcome was assessed post treatment, day one and discharge by means of a NIHSS. Three months mRS evaluation was performed by an independent neurologist. The probability of good outcome at 3 months was assessed by forward stepwise logistic regression using baseline NIHSS score, Glasgow score at entrance, hyperglycemia, dyslipidemia, blood–brain barrier disruption on post-operative CT, embolic and hemorrhagic post procedural complication, ischemic brain lesion extension on 24 h imaging, NIHSS at discharge, ASPECT score, and time to recanalization. All variables significantly associated with the outcome in the univariate analysis were entered in the model. The significance of adding or removing a variable from the logistic model was determined by the maximum likelihood ratio test. Odds-ratio (OR) and their 95% confidence intervals were calculated. Results: At 3 months 54% of patients had a mRS 0–2, 70% in MCA, 44% in ICA, and 43% in BA with an overall mortality rate of 12%. Baseline NIHSS score (p = 0.001), abnormal Glasgow score at entrance (p = 0.053) hyperglycemia (p = 0.023), dyslipidemia (p = 0.031), blood–brain barrier disruption (p = 0.022), embolic and hemorrhagic post procedural complication, ischemic brain lesion

Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials

NARCIS (Netherlands)

Goyal, Mayank; Menon, Bijoy K.; van Zwam, Wim H.; Dippel, Diederik W. J.; Mitchell, Peter J.; Demchuk, Andrew M.; Dávalos, Antoni; Majoie, Charles B. L. M.; van der Lugt, Aad; de Miquel, Maria A.; Donnan, Geoffrey A.; Roos, Yvo B. W. E. M.; Bonafe, Alain; Jahan, Reza; Diener, Hans-Christoph; van den Berg, Lucie A.; Levy, Elad I.; Berkhemer, Olvert A.; Pereira, Vitor M.; Rempel, Jeremy; Millán, Mònica; Davis, Stephen M.; Roy, Daniel; Thornton, John; Román, Luis San; Ribó, Marc; Beumer, Debbie; Stouch, Bruce; Brown, Scott; Campbell, Bruce C. V.; van Oostenbrugge, Robert J.; Saver, Jeffrey L.; Hill, Michael D.; Jovin, Tudor G.

2016-01-01

In 2015, five randomised trials showed efficacy of endovascular thrombectomy over standard medical care in patients with acute ischaemic stroke caused by occlusion of arteries of the proximal anterior circulation. In this meta-analysis we, the trial investigators, aimed to pool individual patient

Effectiveness of percutaneous aspiration thrombectomy for acute or subacute thromboembolism in infrainguinal arteries

Energy Technology Data Exchange (ETDEWEB)

Cha, Jung Guen; Kim, Chan Sun; Kim, Young Hwan; Kim, See Hyung [Dept. of Radiology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

2017-06-15

To report the feasibility and long-term clinical outcome of percutaneous aspiration thrombectomy for treating acute or subacute arterial thromboembolism in the infrainguinal arteries. Thirty limbs of 29 patients were enrolled in this retrospective study between January 2004 and March 2014. Nine limbs underwent overnight catheter-directed thrombolysis followed by percutaneous aspiration thrombectomy (PAT). Eighteen limbs underwent PAT with adjunctive selective intra-arterial thrombolysis in a single session. The remaining three limbs underwent PAT alone. Balloon angioplasty (n = 16) or stent placement (n = 3) was performed as required. In-hospital mortality and complications were estimated. The primary patency rate and the rate of freedom from reintervention were calculated using the Kaplan-Meier method. Technical success was achieved in 28 limbs. Clinical success was achieved in 27 limbs. The mean ankle-brachial index increased from 0.17 ± 0.26 to 0.98 ± 0.19 after the procedure. Three in-hospital deaths and no major amputations were recorded. Distal embolization of crural arteries occurred as a minor complication in five limbs, but no major complications occurred. The primary patency rate and the rate of freedom from reintervention were 74.9% and 90.9% at 1 year, respectively, and 66.6% and 80.8% at 2 years, respectively. PAT is a rapid and effective method to remove a thrombus from occluded infrainguinal arteries.

Endovascular Mechanical Recanalisation of Acute Carotid-T Occlusions: A Single-Center Retrospective Analysis

International Nuclear Information System (INIS)

Fesl, Gunther; Wiesmann, Martin; Patzig, Maximilian; Holtmannspoetter, Markus; Pfefferkorn, Thomas; Dichgans, Martin; Brueckmann, Hartmut

2011-01-01

Purpose: Acute carotid-T occlusion generally responds poorly to thrombolysis. Endovascular mechanical thrombectomy (EMT) seems to be a promising alternative. However, there are few data on EMT in carotid-T occlusions. Materials and Methods: We reviewed data of 14 consecutive patients with acute carotid-T occlusions treated with mechanical recanalisation devices. A clot separation/aspiration system was used in 11 patients; different other mechanical retriever devices were used in seven patients; and stents were used in four patients. Modified Rankin Scale scores at 90 days were recorded to assess functional outcome. Results: Six women and eight men were included in the study. Mean patient age was 59.2 years; median National Institute of Health Stroke Scale score on admission was 19; and mean time to treatment was 4.2 h. Successful recanalisation (Thrombolysis in Myocardial Infarction [TIMI] score II and III) was achieved in 11 patients (78.6%). Seven patients (50.0%) were treated with more than one device, leading to successful recanalisation in six of these patients (85.7%). Subarachnoid haemorrhage and large space-occupying bleedings occurred in one (7.1%) and three (21.4%) patients, respectively. At follow-up, three patients (21.4%) were functionally independent, and six (42.9%) had died. Conclusion: When applying different mechanical devices, we found a high recanalisation rate. However, discrepancy between recanalisation and clinical outcome remained. More data are needed to assess the effect of the different methods on the prognoses of stroke patients.

Safety of mechanical devices. Safety of automation systems

International Nuclear Information System (INIS)

Pahl, G.; Schweizer, G.; Kapp, K.

1985-01-01

The paper deals with the classic procedures of safety engineering in the sectors mechanical engineering, electrical and energy engineering, construction and transport, medicine technology and process technology. Particular stress is laid on the safety of automation systems, control technology, protection of mechanical devices, reactor safety, mechanical constructions, transport systems, railway signalling devices, road traffic and protection at work in chemical plans. (DG) [de

Angiojet thrombectomy for Blalock-Taussig shunt and pulmonary artery thrombus in an infant with tetralogy of fallot

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Brody Wehman

2014-01-01

Full Text Available We describe a new technique for treatment of shunt thrombosis in infants with complex anatomical defects. A 2-month-old girl with Tetralogy of Fallot underwent placement of a modified Blalock-Taussig shunt (MBTS at day of life (DOL 6 with revision at DOL 20. Following this surgery, the patient became hypotensive and hypoxic with new evidence of lack of flow through the MBTS on echocardiography. Angiography showed an occluded MBTS and right pulmonary artery with patent distal branches with normal pulmonary venous return. Balloon angioplasty was attempted but failed to fully recanalize the right pulmonary artery (RPA and MBTS. An AngioJet catheter was then passed through the shunt and RPA to perform rheolyticthrombectomy. Subsequent angiogram showed a widely patent RPA and MBTS. An echocardiogram at 1-month post-thrombectomy showed a widely patent MBTS with continuous flow seen entering both branch pulmonary arteries. The AngioJet system for thrombectomy provides a viable option for complex thrombus removal in patients refractory to other methods.

Refinement of a thrombectomy technique to treat acute ischemic stroke: Technical note on microcatheter advance during retrieving self expandable stent

Energy Technology Data Exchange (ETDEWEB)

Youn, Sung Won; Kim, Ho Kyun [Catholic Univ. of Daegu School of Medicine, Daegu (Korea, Republic of)

2012-07-15

Temporary stenting and thrombectomy by use of the Solitaire stent (ev3, Irvine, CA, USA) has shown prompt and successful recanalization of the acutely occluded major cerebral artery. However, even if rarely reported, inadvertent stent detachment may occur as an innate drawback and full deployment of the stent was considered to increase the risk. In our patients, the Solitaire stent did not fully unfold to prevent inadvertent detachment. Before retrieval of the stent, the tip of the microcatheter was advanced forward carefully under fluoroscopic observation until it met the presumed thrombus segment and a subtle sense of resistance was felt in the fingers guiding the stent. After retrieval, complete recanalization was achieved, and the thrombus was trapped between the tip of the microcatheter and the stent strut. We present 2 cases of successful thrombi captures by advancing a microcatheter during Solitaire stent retrieval, and we suggest that advancing the microcatheter can be a useful refinement to the thrombectomy technique for acute ischemic stroke.

Rheolytic thrombectomy: possibilities and first results.

Science.gov (United States)

Zatevakhin, I I; Shipovskiĭ, V N; Zolkin, V N; Nechaev, A I; Piliposian, E A

2008-01-01

The present study was undertaken to investigate the possibilities of using the method of rheolytic thrombectomy (hereinafter referred to as RTE) in surgical practice, and to assess its immediate outcomes in treatment of thromboses of arteries and veins of the lower extremities, as well as transjugular intrahepatic portosystemic shunts (hereinafter referred to as TIPS). We have gained experience in carrying out a total of 33 rheolytic thrombectomies with the help of the system JET 9000 (R) using the Xpeedior catheter in a total of thirty-one 43-to-87-year-old patients. Twenty-four interventions were performed for acute thromboses of arteries and shunts of the lower limbs, five - in patients presenting with floating thrombi in the inferior vena cava, and four operations were carried out in patients diagnosed with thrombosis of the segment after TIPS. In the group of the patients with thromboses of the arteries of the lower limbs (n=19), in 16 patients RTE resulted in restoration of >50% of the arterial lumen. In three patients of the same group, we managed to restore the lumen by only 50% and less. In the group of patients with thromboses of the shunts (n=5), RTE with a successful angiographic outcome was performed in three patients. In yet another patient, the lumen was restored only by 50%, and in a further one patient, the lumen of the shunt we failed to restore. Nineteen patients underwent a total of 13 balloon angioplasties (BA), 4 stenting interventions, and 2 regional thrombolytic procedures. Two patients after RTE and V A were subjected to postdilatational endarterectomy. In one patient RTE from the shunt was supplemented with plasty of its proximal anastomosis with a synthetic patch. In two patients, RTE was complicated by embolism of the deep femoral artery. In the group consisting of five patients diagnosed with floating thrombi of the inferior vena cava, a successful outcome was observed only in two. In patients presenting with thromboses of the stems

High-risk medical devices, children and the FDA: regulatory challenges facing pediatric mechanical circulatory support devices.

Science.gov (United States)

Almond, Christopher S D; Chen, Eric A; Berman, Michael R; Less, Joanne R; Baldwin, J Timothy; Linde-Feucht, Sarah R; Hoke, Tracey R; Pearson, Gail D; Jenkins, Kathy; Duncan, Brian W; Zuckerman, Bram D

2007-01-01

Pediatric mechanical circulatory support is a critical unmet need in the United States. Infant- and child-sized ventricular assist devices are currently being developed largely through federal contracts and grants through the National Heart, Lung, and Blood Institute (NHLBI). Human testing and marketing of high-risk devices for children raises epidemiologic and regulatory issues that will need to be addressed. Leaders from the US Food and Drug Administration (FDA), NHLBI, academic pediatric community, and industry convened in January 2006 for the first FDA Workshop on the Regulatory Process for Pediatric Mechanical Circulatory Support Devices. The purpose was to provide the pediatric community with an overview of the federal regulatory process for high-risk medical devices and to review the challenges specific to the development and regulation of pediatric mechanical circulatory support devices. Pediatric mechanical circulatory support present significant epidemiologic, logistic, and financial challenges to industry, federal regulators, and the pediatric community. Early interactions with the FDA, shared appreciation of challenges, and careful planning will be critical to avoid unnecessary delays in making potentially life-saving devices available for children. Collaborative efforts to address these challenges are warranted.

Dialysis grafts arterial plug: Retrieval using the tulip sheath device in vitro

International Nuclear Information System (INIS)

Sharafuddin, Melhem J.; Titus, Jack L.; Gu Xiaoping; Hunter, David W.; Amplatz, Kurt

1997-01-01

The 'arterial plug' is a resistant thrombus that frequently persists at the arterial anastomosis of clotted hemodialysis grafts following thrombolytic therapy. We studied the physical and morphological characteristics of the plug and determined the feasibility of transcatheter removal in vitro using the tulip compression thrombectomy system. Sixteen thrombus plugs were recovered during surgical thrombectomy of clotted human dialysis grafts. The physical and gross physical characteristics of all plugs were analyzed. Eight specimens were evaluated microscopically. Transcatheter compression thrombectomy of eight plugs was attempted in vitro. Each plug was embedded in a polyvinyl tube filled with newly clotted blood and connected to a flow circuit. First, balloon-assisted aspiration thrombectomy (BAT) of soft thrombus was performed, while sparing the distal-most segment containing the plug. The tulip sheath was then introduced facing the 'arterial end' of the tube. The thrombus segment containing the plug was pulled back into the tulip mesh using either a 3 Fr Fogarty balloon catheter or a self-expanding rake. The tulip was closed to compress and remove the trapped plug. Near-complete thrombectomy of soft clot was achieved in all tested tubes. Compression and retrieval of the entire arterial plug was successful in all except one, where only partial compression of the plug occurred, presumably due to fibrotic changes. No fragmentation or embolization occurred in the remaining procedures. Spongy consistency was noted in 94% of the specimens. Microscopic evaluation showed organized layered thrombus with compaction in five plugs. Transcatheter removal of a thrombus plug is feasible in vitro using the tulip compression-thrombectomy system

1800 mechanical movements, devices and appliances

CERN Document Server

Hiscox, Gardner D

2007-01-01

A fascinating compendium of early-20th-century mechanical devices, this expansive work ranges from basic levers to complex machinery. More than 1,800 engravings include simple illustrations and detailed cross-sections.

Si-semiconductor device failure mechanisms

International Nuclear Information System (INIS)

Clauss, H.

1976-12-01

This report presents investigations on failure mechanisms that may cause defects during production and operation of silicon semiconductor devices. The failure analysis of aluminium metallization defects covers topics such as step coverage, dissolution pits and electromigration. Furthermore, the generation of process induced lattice defects was investigated. Improved processes avoiding those defects were developed. (orig.) [de

Quantum Mechanical Balance Equation Approach to Semiconductor Device Simulation

National Research Council Canada - National Science Library

Cui, Long

1997-01-01

This research project was focused on the development of a quantum mechanical balance equation based device simulator that can model advanced, compound, submicron devices, under all transport conditions...

Thrombectomy in Acute Stroke With Tandem Occlusions From Dissection Versus Atherosclerotic Cause

DEFF Research Database (Denmark)

Gory, Benjamin; Piotin, Michel; Haussen, Diogo C

2017-01-01

BACKGROUND AND PURPOSE: Tandem steno-occlusive lesions were poorly represented in randomized trials and represent a major challenge for endovascular thrombectomy in acute anterior circulation strokes. The impact of the cervical carotid lesion cause (ie, atherosclerotic versus dissection) on outcome......-2). Secondary efficacy outcomes included successful reperfusion (modified Thrombolysis in Cerebrovascular Infarction scores of 2b-3), time to reperfusion, and safety outcomes encompassed procedural complications, symptomatic intracerebral hemorrhage, and 90-day mortality. RESULTS: Among the 295 included...... patients, 65 had cervical carotid dissection and 230 had cervical carotid atherosclerotic cause. The rate of favorable outcome was 56.3% in the dissection group versus 47.6% in the atherosclerotic arm (center-, age-, and admission National Institutes of Health Stroke Scale-adjusted odds ratio, 1.08; 95...

Design methodology for wing trailing edge device mechanisms

OpenAIRE

Martins Pires, Rui Miguel

2007-01-01

Over the last few decades the design of high lift devices has become a very important part of the total aircraft design process. Reviews of the design process are performed on a regular basis, with the intent to improve and optimize the design process. This thesis describes a new and innovative methodology for the design and evaluation of mechanisms for Trailing Edge High-Lift devices. The initial research reviewed existing High-Lift device design methodologies and current f...

Mechanical and thermo-mechanical response of a lead-core bearing device subjected to different loading conditions

Directory of Open Access Journals (Sweden)

Zhelyazov Todor

2018-01-01

Full Text Available The contribution is focused on the numerical modelling, simulation and analysis of a lead-core bearing device for passive seismic isolation. An accurate finite element model of a lead-core bearing device is presented. The model is designed to analyse both mechanical and thermo-mechanical responses of the seismic isolator to different loading conditions. Specifically, the mechanical behaviour in a typical identification test is simulated. The response of the lead-core bearing device to circular sinusoidal paths is analysed. The obtained shear displacement – shear force relationship is compared to experimental data found in literature sources. The hypothesis that heating of the lead-core during cyclic loading affects the degrading phenomena in the bearing device is taken into account. Constitutive laws are defined for each material: lead, rubber and steel. Both predefined constitutive laws (in the used general–purpose finite element code and semi-analytical procedures aimed at a more accurate modelling of the constitutive relations are tested. The results obtained by finite element analysis are to be further used to calibrate a macroscopic model of the lead-core bearing device seen as a single-degree-of-freedom mechanical system.

Derived virtual devices: a secure distributed file system mechanism

Science.gov (United States)

VanMeter, Rodney; Hotz, Steve; Finn, Gregory

1996-01-01

This paper presents the design of derived virtual devices (DVDs). DVDs are the mechanism used by the Netstation Project to provide secure shared access to network-attached peripherals distributed in an untrusted network environment. DVDs improve Input/Output efficiency by allowing user processes to perform I/O operations directly from devices without intermediate transfer through the controlling operating system kernel. The security enforced at the device through the DVD mechanism includes resource boundary checking, user authentication, and restricted operations, e.g., read-only access. To illustrate the application of DVDs, we present the interactions between a network-attached disk and a file system designed to exploit the DVD abstraction. We further discuss third-party transfer as a mechanism intended to provide for efficient data transfer in a typical NAP environment. We show how DVDs facilitate third-party transfer, and provide the security required in a more open network environment.

Mechanical devices for aligning optical fibers using elastic metal-deformation techniques

NARCIS (Netherlands)

van Zantvoort, J.H.C.; Plukker, S.G.L.; Kuindersma, P.I.; Mekonnen, K.A.; de Waardt, H.

2016-01-01

We designed and realized two different mechanical devices for aligning standard lensed telecom fibers to indium-phosphide-based photonic integrated circuits (PICs). The first device (Device A) can align one fiber in three degrees of freedom, while the second device (Device B) can align two fiber

Comparison of Perfusion CT Software to Predict the Final Infarct Volume After Thrombectomy.

Science.gov (United States)

Austein, Friederike; Riedel, Christian; Kerby, Tina; Meyne, Johannes; Binder, Andreas; Lindner, Thomas; Huhndorf, Monika; Wodarg, Fritz; Jansen, Olav

2016-09-01

Computed tomographic perfusion represents an interesting physiological imaging modality to select patients for reperfusion therapy in acute ischemic stroke. The purpose of our study was to determine the accuracy of different commercial perfusion CT software packages (Philips (A), Siemens (B), and RAPID (C)) to predict the final infarct volume (FIV) after mechanical thrombectomy. Single-institutional computed tomographic perfusion data from 147 mechanically recanalized acute ischemic stroke patients were postprocessed. Ischemic core and FIV were compared about thrombolysis in cerebral infarction (TICI) score and time interval to reperfusion. FIV was measured at follow-up imaging between days 1 and 8 after stroke. In 118 successfully recanalized patients (TICI 2b/3), a moderately to strongly positive correlation was observed between ischemic core and FIV. The highest accuracy and best correlation are shown in early and fully recanalized patients (Pearson r for A=0.42, B=0.64, and C=0.83; P<0.001). Bland-Altman plots and boxplots demonstrate smaller ranges in package C than in A and B. Significant differences were found between the packages about over- and underestimation of the ischemic core. Package A, compared with B and C, estimated more than twice as many patients with a malignant stroke profile (P<0.001). Package C best predicted hypoperfusion volume in nonsuccessfully recanalized patients. Our study demonstrates best accuracy and approximation between the results of a fully automated software (RAPID) and FIV, especially in early and fully recanalized patients. Furthermore, this software package overestimated the FIV to a significantly lower degree and estimated a malignant mismatch profile less often than other software. © 2016 American Heart Association, Inc.

Development of mechanical circulatory support devices in China.

Science.gov (United States)

Wang, Wei; Zhu, De-Ming; Ding, Wen-Xiang

2009-11-01

Myocardial dysfunction leading to low cardiac output syndrome is a common clinical pathophysiological state. Currently, the use of mechanical circulatory support (MCS) is an essential aspect of the treatment of patients with cardiac failure. Several groups in China are engaged in the design and development of MCS devices. These devices can be classified as pulsatile, rotary, and total artificial heart (TAH). There are two types of pulsatile pump, which are driven by air (pneumatic). One of these pumps, the Luo-Ye pump, has been used clinically for short-term support since 1998. The other is a push-plate left ventricular device, which has a variable rate mode. Various rotary devices are classified into axial and centrifugal pumps, depending on the impeller geometry. Most rotary pumps are based on the maglev principle, and some types have been used clinically. Others are still being studied in the laboratory or in animal experiments. Furthermore, certain types of total implantable pump, such as the UJS-III axial pump and the UJS-IV aortic valvo-pump, have been developed. Only one type of TAH has been developed in China. The main constituents of this artificial heart are two axial pumps, two reservoir tanks mimicking the right and left atria, flow meters, two pressure gauges, and a resistance adaptor. Although the development of mechanical assist devices in China is still in a nascent stage, a number of different types of MCS devices are currently being studied.

Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data

NARCIS (Netherlands)

Campbell, Bruce C. V.; van Zwam, Wim H.; Goyal, Mayank; Menon, Bijoy K.; Dippel, Diederik W. J.; Demchuk, Andrew M.; Bracard, Serge; White, Philip; Dávalos, Antoni; Majoie, Charles B. L. M.; van der Lugt, Aad; Ford, Gary A.; de la Ossa, Natalia Pérez; Kelly, Michael; Bourcier, Romain; Donnan, Geoffrey A.; Roos, Yvo B. W. E. M.; Bang, Oh Young; Nogueira, Raul G.; Devlin, Thomas G.; van den Berg, Lucie A.; Clarençon, Frédéric; Burns, Paul; Carpenter, Jeffrey; Berkhemer, Olvert A.; Yavagal, Dileep R.; Pereira, Vitor Mendes; Ducrocq, Xavier; Dixit, Anand; Quesada, Helena; Epstein, Jonathan; Davis, Stephen M.; Jansen, Olav; Rubiera, Marta; Urra, Xabier; Nederkoorn, Paul J.; Emmer, Bart J.; Bot, Joseph C. J.; Marquering, Henk A.; Sprengers, Marieke E. S.; Beenen, Ludo F. M.; van den Berg, René; Fleitour, Nadine; Santos, Emilie; Borst, Jordi; Jansen, Ivo; Kappelhof, Manon; Lucas, Marit; Barros, Renan Sales; Koch, S.

2018-01-01

Background General anaesthesia (GA) during endovascular thrombectomy has been associated with worse patient outcomes in observational studies compared with patients treated without GA. We assessed functional outcome in ischaemic stroke patients with large vessel anterior circulation occlusion

Charge Carrier Transport Mechanism Based on Stable Low Voltage Organic Bistable Memory Device.

Science.gov (United States)

Ramana, V V; Moodley, M K; Kumar, A B V Kiran; Kannan, V

2015-05-01

A solution processed two terminal organic bistable memory device was fabricated utilizing films of polymethyl methacrylate PMMA/ZnO/PMMA on top of ITO coated glass. Electrical characterization of the device structure showed that the two terminal device exhibited favorable switching characteristics with an ON/OFF ratio greater than 1 x 10(4) when the voltage was swept between - 2 V and +3 V. The device maintained its state after removal of the bias voltage. The device did not show degradation after a 1-h retention test at 120 degrees C. The memory functionality was consistent even after fifty cycles of operation. The charge transport switching mechanism is discussed on the basis of carrier transport mechanism and our analysis of the data shows that the charge carrier trans- port mechanism of the device during the writing process can be explained by thermionic emission (TE) and space-charge-limited-current (SCLC) mechanism models while erasing process could be explained by the FN tunneling mechanism. This demonstration provides a class of memory devices with the potential for low-cost, low-power consumption applications, such as a digital memory cell.

Pharmacomechanical Thrombectomy in Paget–Schroetter Syndrome

Energy Technology Data Exchange (ETDEWEB)

Kärkkäinen, Jussi M., E-mail: jkarkkai@gmail.com [Kuopio University Hospital, Heart Center (Finland); Nuutinen, Henrik [Kuopio University Hospital, Department of Surgery (Finland); Riekkinen, Teemu [Kuopio University Hospital, Heart Center (Finland); Sihvo, Eero [Central Finland Central Hospital, Department of Surgery (Finland); Turtiainen, Johanna [North Karelia Central Hospital, Department of Surgery (Finland); Saari, Petri [Kuopio University Hospital, Department of Clinical Radiology (Finland); Mäkinen, Kimmo [Kuopio University Hospital, Heart Center (Finland); Manninen, Hannu [Kuopio University Hospital, Department of Clinical Radiology (Finland)

2016-09-15

PurposeThe purpose of the study was to evaluate feasibility of pharmacomechanical thrombectomy (PMT) in the treatment of Paget–Schroetter syndrome (PSS) followed by thoracoscopic or open surgical decompression of the subclavian vein.MethodsTwenty-two out of 27 consecutive patients with PSS received PMT using the Trellis-8 peripheral infusion system (Covidien) between 2010 and 2014. Subsequent surgery was performed in 18 of those patients, 9 patients were treated with thoracoscopic, 7 patients with subclavicular, and 2 patients with transaxillary first rib resection, 4 patients were treated with PMT and anticoagulation alone. Technical success, complications, and patency were registered.ResultsPMT was successful in 21 (95 %) patients; 1 patient with unsatisfactory lysis received further catheter-directed thrombolysis, which, however, did not improve the result. The mean endovascular procedure time was 105 ± 33 min (range 70–200 min), and the required median amount of thrombolytic agent was 500,000 international unit (IU; range 250,000–1,000,000 IU). Adjunctive balloon venoplasty and aspiration were used in 18 (82 %) and 7 (32 %) cases, respectively. One patient had an intimal tear of the subclavian vein that was discovered and repaired during surgery. There were no other complications related to the endovascular procedure. At follow-up, 18 of 21 patients (86 %) with follow-up imaging available had patent subclavian vein, and all except 1 of the 22 patients were asymptomatic. The mean follow-up time was 25 ± 17 months.ConclusionsIn experienced hands, PMT is effective for early thrombus removal in PSS. Surgical decompression must be considered after PMT.

Manual Aspiration Thrombectomy in Patients with Acute Stroke-Related Calcified Cerebral Emboli.

Science.gov (United States)

Koh, Esther; Kwak, Hyo Sung; Chung, Gyung-Ho

2017-10-01

The aim of this study was to evaluate the effectiveness of mechanical aspiration thrombectomy (MAT) in patients with acute ischemic stroke from calcified cerebral emboli. Procedural results were reviewed for acute stroke patients with clinically neurological deficits who underwent recanalization from October 2012 through September 2015. Initial imaging studies and cerebral angiography were analyzed. Of the total number of patients with acute stroke, 5 patients were confirmed to have acute ischemic stroke by calcified cerebral emboli. On initial brain computed tomographic imaging, all patients showed small, dense single calcifications in the middle cerebral artery with no definitive ischemic low-density lesions (M1: 3, M2: 2, mean size: 4.8 mm). All patients had angiographic findings of filling defects from calcified emboli. Four patients had good collateral flow and two had continuous distal flow. All patients underwent MAT using a Penumbra catheter (Penumbra Inc., Alameda, CA). MAT did not remove calcified emboli in all patients. Two patients with good collateral flow had favorable functional outcomes (modified Rankin Scale score ≤2). Four patients had diffuse calcification in the aortic arch, carotid artery, and aortic valve. Cerebral angiography supports a diagnosis of stroke when calcified cerebral emboli have contrast-filling defects and a degree of vascular occlusion. However, in this study, MAT was not an effective treatment for patients with calcified cerebral emboli because of hardness of the calcified plaque and packing into the arterial lumen. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

A Self-Provisioning Mechanism in OpenStack for IoT Devices.

Science.gov (United States)

Solano, Antonio; Dormido, Raquel; Duro, Natividad; Sánchez, Juan Miguel

2016-08-17

The aim of this paper is to introduce a plug-and-play mechanism for an Internet of Things (IoT) device to instantiate a Software as a Service (SaaS) application in a private cloud, built up with OpenStack. The SaaS application is the digital avatar of a physical object connected to Internet. As a proof of concept, a Vending Machine is retrofitted and connected to Internet with and Arduino Open Hardware device. Once the self-configuration mechanism is completed, it is possible to order a product from a mobile communication device.

Treatment of the superior sagittal sinus and transverse sinus thrombosis associated with intracranial hemorrhage with the mechanical thrombectomy and thrombolytics: Case report.

Science.gov (United States)

Liu, Yuchun; Li, Keqin; Huang, Yi; Sun, Jie; Gao, Xiang

2017-12-01

The superior sagittal sinus (SSS) and transverse sinus are the major dural sinuses that receive a considerable amount of venous drainage. The occlusion of them has been suggested to cause intracranial hypertension, hemorrhage, and lead to potentially fatal consequences. We reported a 35-year-old woman with headache presented to our emergency department with a decreased level of consciousness and epileptic seizures. The examination of speech, higher mental function, and cranial nerve were normal. Computed tomography (CT) demonstrated both subarachnoid and intraparenchymal hemorrhage and brain edema at the right temporal lobe accompanied by high density shadow in the right transverse sinus. Digital subtraction angiography (DSA) revealed extensive thrombosis of the SSS and bilateral transverse sinus. The SSS and transverse sinus thrombosis, accompanied by right temporal lobe hemorrhage, subarachnoid hemorrhage (SAH). An emergent mechanical thrombectomy by placed Solitair AB stent in the SSS, respectively, passed left and right sigmoid sinus-transverse sinus route. We removed the most clots, DSA revealed recanalization of the SSS and left transverse sinus was seen with normalization of the venous outflow, the occlusion of right transverse sinus was still present. There were 4 hours after patient back to neurosurgical intensive care unit (NICU), patient appeared anisocoria (R/L:4.0/2.5 mm), bilateral light reflexes disappeared, then we took a CT reexamination revealed intraparenchymal hemorrhage increased, brain edema was aggravated at the left temporal lobe, and mild midline shift. Subsequently, we performed decompressive hemicraniectomy and puncture the hematoma supplemented by B ultrasonic. Anticoagulation treatment was initiated 24 hours after surgery, and follow-up DSA showed gradually improved patency in the SSS and bilateral transverse sinus. Despite occlusion of the SSS and bilateral transverse sinus, patient's symptoms resolved after the operations and he

A Self-Provisioning Mechanism in OpenStack for IoT Devices

Directory of Open Access Journals (Sweden)

Antonio Solano

2016-08-01

Full Text Available The aim of this paper is to introduce a plug-and-play mechanism for an Internet of Things (IoT device to instantiate a Software as a Service (SaaS application in a private cloud, built up with OpenStack. The SaaS application is the digital avatar of a physical object connected to Internet. As a proof of concept, a Vending Machine is retrofitted and connected to Internet with and Arduino Open Hardware device. Once the self-configuration mechanism is completed, it is possible to order a product from a mobile communication device.

Decoding the mechanisms of Antikythera astronomical device

CERN Document Server

Lin, Jian-Liang

2016-01-01

This book presents a systematic design methodology for decoding the interior structure of the Antikythera mechanism, an astronomical device from ancient Greece. The historical background, surviving evidence and reconstructions of the mechanism are introduced, and the historical development of astronomical achievements and various astronomical instruments are investigated. Pursuing an approach based on the conceptual design of modern mechanisms and bearing in mind the standards of science and technology at the time, all feasible designs of the six lost/incomplete/unclear subsystems are synthesized as illustrated examples, and 48 feasible designs of the complete interior structure are presented. This approach provides not only a logical tool for applying modern mechanical engineering knowledge to the reconstruction of the Antikythera mechanism, but also an innovative research direction for identifying the original structures of the mechanism in the future. In short, the book offers valuable new insights for all...

Arc plasma devices: Evolving mechanical design from numerical

Indian Academy of Sciences (India)

A recipe for obtaining mechanical design of arc plasma devices from numerical ... to the plasma of the mixture of molecular gases like nitrogen and oxygen. ... Temperature field, associated fluid dynamics and electrical characteristics of a ...

Efficiency of a gyroscopic device for conversion of mechanical wave energy to electrical energy

DEFF Research Database (Denmark)

Carlsen, Martin; Darula, Radoslav; Gravesen, Jens

2011-01-01

We consider a recently proposed gyroscopic device for conversion of mechanical ocean wave energy to electrical energy. Two models of the device derived from standard engineering mechanics from the literature are analysed, and a model is derived from analytical mechanics considerations. From...... these models, estimates of the power production, eciency, forces and moments are made. We nd that it is possible to extract a signicant amount of energy from an ocean wave using the described device. Further studies are required for a full treatment of the device....

Evaluation of Tissue Interactions with Mechanical Elements of a Transscleral Drug Delivery Device

Directory of Open Access Journals (Sweden)

Jeffrey T. Borenstein

2012-03-01

Full Text Available The goal of this work was to evaluate tissue-device interactions due to implantation of a mechanically operated drug delivery system onto the posterior sclera. Two test devices were designed and fabricated to model elements of the drug delivery device—one containing a free-spinning ball bearing and the other encasing two articulating gears. Openings in the base of test devices modeled ports for drug passage from device to sclera. Porous poly(tetrafluoroethylene (PTFE membranes were attached to half of the gear devices to minimize tissue ingrowth through these ports. Test devices were sutured onto rabbit eyes for 10 weeks. Tissue-device interactions were evaluated histologically and mechanically after removal to determine effects on device function and changes in surrounding tissue. Test devices were generally well-tolerated during residence in the animal. All devices encouraged fibrous tissue formation between the sclera and the device, fibrous tissue encapsulation and invasion around the device, and inflammation of the conjunctiva. Gear devices encouraged significantly greater inflammation in all cases and a larger rate of tissue ingrowth. PTFE membranes prevented tissue invasion through the covered drug ports, though tissue migrated in through other smaller openings. The torque required to turn the mechanical elements increased over 1000 times for gear devices, but only on the order of 100 times for membrane-covered gear devices and less than 100 times for ball bearing devices. Maintaining a lower device profile, minimizing microscale motion on the eye surface and covering drug ports with a porous membrane may minimize inflammation, decreasing the risk of damage to surrounding tissues and minimizing disruption of device operation.

Rivaroxaban does not influence hemorrhagic transformation in a diabetes ischemic stroke and endovascular thrombectomy model.

Science.gov (United States)

Liu, Feng-Di; Zhao, Rong; Feng, Xiao-Yan; Shi, Yan-Hui; Wu, Yi-Lan; Shen, Xiao-Lei; Li, Ge-Fei; Liu, Yi-Sheng; Zhao, Ying; He, Xin-Wei; Yin, Jia-Wen; Zhuang, Mei-Ting; Zhao, Bing-Qiao; Liu, Jian-Ren

2018-05-09

Managing endovascular thrombectomy (ET) in diabetic ischemic stroke (IS) with novel anticoagulants is challenging due to putative risk of intracerebral hemorrhage. The study evaluates increased hemorrhagic transformation (HT) risk in Rivaroxaban-treated diabetic rats post ET. Diabetes was induced in male Sprague-Dawley rats by intraperitoneal injection of 60 mg/kg streptozotocin. After 4-weeks, rats were pretreated orally with 30 mg/kg Rivaroxaban/saline; prothrombin time was monitored. IS and ET was induced after 1 h, by thread-induced transient middle cerebral artery occlusion (tMCAO) that mimicked mechanical ET for proximal MCA occlusion at 60 min. After 24 h reperfusion, infarct volumes, HT, blood-brain barrier (BBB) permeability, tight junction at peri-ischemic lesion and matrix metalloproteinase-9 (MMP-9) activity was measured. Diabetic rats seemed to exhibit increased infarct volume and HT at 24 h after ET than normal rats. Infarct volumes and functional outcomes did not differ between Rivaroxaban and diabetic control groups. A significant increase in HT volumes and BBB permeability under Rivaroxaban treatment was not detected. Compared to diabetic control group, neither the occludin expression was remarkably lower in the Rivaroxaban group nor the MMP-9 activity was higher. Together, Rivaroxaban does not increase HT after ET in diabetic rats with proximal MCA occlusion, since Rivaroxaban has fewer effects on post-ischemic BBB permeability.

Probing cell mechanical properties with microfluidic devices

Science.gov (United States)

Rowat, Amy

2012-02-01

Exploiting flow on the micron-scale is emerging as a method to probe cell mechanical properties with 10-1000x advances in throughput over existing technologies. The mechanical properties of cells and the cell nucleus are implicated in a wide range of biological contexts: for example, the ability of white blood cells to deform is central to immune response; and malignant cells show decreased stiffness compared to benign cells. We recently developed a microfluidic device to probe cell and nucleus mechanical properties: cells are forced to deform through a narrow constrictions in response to an applied pressure; flowing cells through a series of constrictions enables us to probe the ability of hundreds of cells to deform and relax during flow. By tuning the constriction width so it is narrower than the width of the cell nucleus, we can specifically probe the effects of nuclear physical properties on whole cell deformability. We show that the nucleus is the rate-limiting step in cell passage: inducing a change in its shape to a multilobed structure results in cells that transit more quickly; increased levels of lamin A, a nuclear protein that is key for nuclear shape and mechanical stability, impairs the passage of cells through constrictions. We are currently developing a new class of microfluidic devices to simultaneously probe the deformability of hundreds of cell samples in parallel. Using the same soft lithography techniques, membranes are fabricated to have well-defined pore distribution, width, length, and tortuosity. We design the membranes to interface with a multiwell plate, enabling simultaneous measurement of hundreds of different samples. Given the wide spectrum of diseases where altered cell and nucleus mechanical properties are implicated, such a platform has great potential, for example, to screen cells based on their mechanical phenotype against a library of drugs.

An overview of robotic/mechanical devices for post-stroke thumb rehabilitation.

Science.gov (United States)

Suarez-Escobar, Marian; Rendon-Velez, Elizabeth

2018-01-15

This article aims to clarify the current state-of-the-art of robotic/mechanical devices for post-stroke thumb rehabilitation as well as the anatomical characteristics and motions of the thumb that are crucial for the development of any device that aims to support its motion. A systematic literature search was conducted to identify robotic/mechanical devices for post-stroke thumb rehabilitation. Specific electronic databases and well-defined search terms and inclusion/exclusion criteria were used for such purpose. A reasoning model was devised to support the structured abstraction of relevant data from the literature of interest. Following the main search and after removing duplicated and other non-relevant studies, 68 articles (corresponding to 32 devices) were left for further examination. These articles were analyzed to extract data relative to (i) the motions assisted/permitted - either actively or passively - by the device per anatomical joint of the thumb and (ii) mechanical-related aspects (i.e., architecture, connections to thumb, other fingers supported, adjustability to different hand sizes, actuators - type, quantity, location, power transmission and motion trajectory). Most articles describe preliminary design and testing of prototypes, rather than the thorough evaluation of commercially ready devices. Defining appropriate kinematic models of the thumb upon which to design such devices still remains a challenging and unresolved task. Further research is needed before these devices can actually be implemented in clinical environments to serve their intended purpose of complementing the labour of therapists by facilitating intensive treatment with precise and repeatable exercises. Implications for Rehabilitation Post-stroke functional disability of the hand, and particularly of the thumb, significantly affects the capability to perform activities of daily living, threatening the independence and quality of life of the stroke survivors. The latest studies

Clot friction variation with fibrin content; implications for resistance to thrombectomy.

Science.gov (United States)

Gunning, Gillian M; McArdle, Kevin; Mirza, Mahmood; Duffy, Sharon; Gilvarry, Michael; Brouwer, Patrick A

2018-01-01

Despite significant advancements in the procedural efficacy of mechanical thrombectomy in patients with ischemic stroke in recent years, there still remains a portion of the population that does not achieve good recanalization. The reasons for this may be varied. We hypothesized that static friction between the clot and the vessel, or catheter wall might contribute to the difficulty in removing the clot. To determine if there is a relationship between clot composition and the resistance to sliding (friction) which might contribute to resistance to clot removal. As clot composition can vary significantly, we investigated five different types of clot in order to measure their respective frictional properties. To do this, a custom-made testing apparatus was created, consisting of various replaceable low-friction surfaces on which the clots could be placed. The surface was then gradually tilted until the clots began to slide; the angle at which this occurred is related to the coefficient of friction of the clots. The experiment was repeated on a bovine aortic surface in order to confirm the results. We found that fibrin-rich clots (friction than clots with a red blood cell content >20%. This result was confirmed by repeating the experiment on a bovine aortic surface as a representation of the interaction between clots and the arterial wall. The friction properties of clots were found to be related to the content ratio of fibrin to red blood cells. Future imaging techniques that could show fibrin and red blood cell content might help us to predict the 'stickiness' of a clot. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Low Cerebral Blood Volume Identifies Poor Outcome in Stent Retriever Thrombectomy

International Nuclear Information System (INIS)

Protto, Sara; Pienimäki, Juha-Pekka; Seppänen, Janne; Numminen, Heikki; Sillanpää, Niko

2017-01-01

BackgroundMechanical thrombectomy (MT) is an efficient treatment of acute stroke caused by large-vessel occlusion. We evaluated the factors predicting poor clinical outcome (3-month modified Rankin Scale, mRS >2) although MT performed with modern stent retrievers.MethodsWe prospectively collected the clinical and imaging data of 105 consecutive anterior circulation stroke patients who underwent MT after multimodal CT imaging. Patients with occlusion of the internal carotid artery and/or middle cerebral artery up to the M2 segment were included. We recorded baseline clinical, procedural and imaging variables, technical outcome, 24-h imaging outcome and the clinical outcome. Differences between the groups were studied with appropriate statistical tests and binary logistic regression analysis.ResultsLow cerebral blood volume Alberta stroke program early CT score (CBV-ASPECTS) was associated with poor clinical outcome (median 7 vs. 9, p = 0.01). Lower collateral score (CS) significantly predicted poor outcome in regression modelling with CS = 0 increasing the odds of poor outcome 4.4-fold compared to CS = 3 (95% CI 1.27–15.5, p = 0.02). Lower CBV-ASPECTS significantly predicted poor clinical outcome among those with moderate or severe stroke (OR 0.82, 95% CI 0.68–1, p = 0.05) or poor collateral circulation (CS 0–1, OR 0.66, 95% CI 0.48–0.90, p = 0.009) but not among those with mild strokes or good collaterals.ConclusionsCBV-ASPECTS estimating infarct core is a significant predictor of poor clinical outcome among anterior circulation stroke patients treated with MT, especially in the setting of poor collateral circulation and/or moderate or severe stroke.

Low Cerebral Blood Volume Identifies Poor Outcome in Stent Retriever Thrombectomy

Energy Technology Data Exchange (ETDEWEB)

Protto, Sara, E-mail: sara.protto@pshp.fi; Pienimäki, Juha-Pekka; Seppänen, Janne [Tampere University Hospital, Medical Imaging Center (Finland); Numminen, Heikki [Tampere University Hospital, Department of Neurology (Finland); Sillanpää, Niko [Tampere University Hospital, Medical Imaging Center (Finland)

2017-04-15

BackgroundMechanical thrombectomy (MT) is an efficient treatment of acute stroke caused by large-vessel occlusion. We evaluated the factors predicting poor clinical outcome (3-month modified Rankin Scale, mRS >2) although MT performed with modern stent retrievers.MethodsWe prospectively collected the clinical and imaging data of 105 consecutive anterior circulation stroke patients who underwent MT after multimodal CT imaging. Patients with occlusion of the internal carotid artery and/or middle cerebral artery up to the M2 segment were included. We recorded baseline clinical, procedural and imaging variables, technical outcome, 24-h imaging outcome and the clinical outcome. Differences between the groups were studied with appropriate statistical tests and binary logistic regression analysis.ResultsLow cerebral blood volume Alberta stroke program early CT score (CBV-ASPECTS) was associated with poor clinical outcome (median 7 vs. 9, p = 0.01). Lower collateral score (CS) significantly predicted poor outcome in regression modelling with CS = 0 increasing the odds of poor outcome 4.4-fold compared to CS = 3 (95% CI 1.27–15.5, p = 0.02). Lower CBV-ASPECTS significantly predicted poor clinical outcome among those with moderate or severe stroke (OR 0.82, 95% CI 0.68–1, p = 0.05) or poor collateral circulation (CS 0–1, OR 0.66, 95% CI 0.48–0.90, p = 0.009) but not among those with mild strokes or good collaterals.ConclusionsCBV-ASPECTS estimating infarct core is a significant predictor of poor clinical outcome among anterior circulation stroke patients treated with MT, especially in the setting of poor collateral circulation and/or moderate or severe stroke.

Hyper-attenuating brain lesions on CT after ischemic stroke and thrombectomy are associated with final brain infarction.

Science.gov (United States)

Cabral, F B; Castro-Afonso, L H; Nakiri, G S; Monsignore, L M; Fábio, Src; Dos Santos, A C; Pontes-Neto, O M; Abud, D G

2017-12-01

Purpose Hyper-attenuating lesions, or contrast staining, on a non-contrast brain computed tomography (NCCT) scan have been investigated as a predictor for hemorrhagic transformation after endovascular treatment of acute ischemic stroke (AIS). However, the association of hyper-attenuating lesions and final ischemic areas are poorly investigated in this setting. The aim of the present study was to assess correlations between hyper-attenuating lesions and final brain infarcted areas after thrombectomy for AIS. Methods Data from patients with AIS of the anterior circulation who underwent endovascular treatment were retrospectively assessed. Images of the brain NCCT scans were analyzed in the first hours and late after treatment. The hyper-attenuating areas were compared to the final ischemic areas using the Alberta Stroke Program Early CT Score (ASPECTS). Results Seventy-one of the 123 patients (65.13%) treated were included. The association between the hyper-attenuating region in the post-thrombectomy CT scan and final brain ischemic area were sensitivity (58.3% to 96.9%), specificity (42.9% to 95.6%), positive predictive values (71.4% to 97.7%), negative predictive values (53.8% to 79.5%), and accuracy values (68% to 91%). The highest sensitivity values were found for the lentiform (96.9%) and caudate nuclei (80.4%) and for the internal capsule (87.5%), and the lowest values were found for the M1 (58.3%) and M6 (66.7%) cortices. Conclusions Hyper-attenuating lesions on head NCCT scans performed after endovascular treatment of AIS may predict final brain infarcted areas. The prediction appears to be higher in the deep brain regions compared with the cortical regions.

Laparo-Endoscopic Single-Site Surgery for Radical and Cytoreductive Nephrectomy, Renal Vein Thrombectomy, and Partial Nephrectomy: A Prospective Pilot Evaluation

Directory of Open Access Journals (Sweden)

Ithaar H. Derweesh

2010-01-01

Full Text Available Introduction. Laparo-endoscopic single-site surgery (LESS may diminish morbidity of laparoscopic surgery. We prospectively evaluated feasibility and outcomes of LESS-Radical Nephrectomy (LESS-RN and Partial Nephrectomy (LESS-PN. Methods. 10 patients underwent LESS-RN (6 and LESS-PN (4 between 2/2009-5/2009. LESS-RN included 2 with renal vein thrombectomy, one of which was also cytoreductive. Transperitoneal LESS access was obtained by periumbilical incision. Patient/tumor characteristics, oncologic, and quality of life (QoL outcomes were analyzed. Results. 3 Men/7 Women (mean age 58.7 years, median follow-up 9.8 months underwent LESS. 9/10 cases were completed successfully. All had negative margins. Mean operative time was 161 minutes, estimated blood loss was 125 mL, and incision size was 4.4 cm. Median tumor size for LESS-RN and -PN was 5.0 and 1.7 cm (=.045. Median LESS-PN ischemia time was 24 minutes; mean preoperative/postoperative creatinine were 0.7/0.8 mg/dL (=.19. Mean pain score at discharge was 1.3. Mean preoperative, 3-, and 6-month postoperative SF-36 QoL Score was 73.8, 74.4 and 77.1 (=.222. All patients are currently alive. Conclusions. LESS-RN, renal vein thrombectomy, and PN are technically feasible and safe while maintaining adherence to oncologic principles, with excellent QoL preservation and low discharge pain scores. Further study is requisite.

Electro-mechanical probe positioning system for large volume plasma device

Science.gov (United States)

Sanyasi, A. K.; Sugandhi, R.; Srivastava, P. K.; Srivastav, Prabhakar; Awasthi, L. M.

2018-05-01

An automated electro-mechanical system for the positioning of plasma diagnostics has been designed and implemented in a Large Volume Plasma Device (LVPD). The system consists of 12 electro-mechanical assemblies, which are orchestrated using the Modbus communication protocol on 4-wire RS485 communications to meet the experimental requirements. Each assembly has a lead screw-based mechanical structure, Wilson feed-through-based vacuum interface, bipolar stepper motor, micro-controller-based stepper drive, and optical encoder for online positioning correction of probes. The novelty of the system lies in the orchestration of multiple drives on a single interface, fabrication and installation of the system for a large experimental device like the LVPD, in-house developed software, and adopted architectural practices. The paper discusses the design, description of hardware and software interfaces, and performance results in LVPD.

A high throughput mechanical screening device for cartilage tissue engineering.

Science.gov (United States)

Mohanraj, Bhavana; Hou, Chieh; Meloni, Gregory R; Cosgrove, Brian D; Dodge, George R; Mauck, Robert L

2014-06-27

Articular cartilage enables efficient and near-frictionless load transmission, but suffers from poor inherent healing capacity. As such, cartilage tissue engineering strategies have focused on mimicking both compositional and mechanical properties of native tissue in order to provide effective repair materials for the treatment of damaged or degenerated joint surfaces. However, given the large number design parameters available (e.g. cell sources, scaffold designs, and growth factors), it is difficult to conduct combinatorial experiments of engineered cartilage. This is particularly exacerbated when mechanical properties are a primary outcome, given the long time required for testing of individual samples. High throughput screening is utilized widely in the pharmaceutical industry to rapidly and cost-effectively assess the effects of thousands of compounds for therapeutic discovery. Here we adapted this approach to develop a high throughput mechanical screening (HTMS) system capable of measuring the mechanical properties of up to 48 materials simultaneously. The HTMS device was validated by testing various biomaterials and engineered cartilage constructs and by comparing the HTMS results to those derived from conventional single sample compression tests. Further evaluation showed that the HTMS system was capable of distinguishing and identifying 'hits', or factors that influence the degree of tissue maturation. Future iterations of this device will focus on reducing data variability, increasing force sensitivity and range, as well as scaling-up to even larger (96-well) formats. This HTMS device provides a novel tool for cartilage tissue engineering, freeing experimental design from the limitations of mechanical testing throughput. © 2013 Published by Elsevier Ltd.

Dump the pump: manual aspiration thrombectomy (MAT) with a syringe is technically effective, expeditious, and cost-efficient.

Science.gov (United States)

Gross, Bradley A; Jadhav, Ashutosh P; Jovin, Tudor G; Jankowitz, Brian Thomas

2018-04-01

Syringe aspiration for manual aspiration thrombectomy (MAT) is a cost- and time-efficient alternative to an aspiration pump with likely similar efficacy. It is counterintuitive to expect the pump to perform better than direct vacuum with a syringe, as the pump must deliver vacuum additionally through a canister and meters of tubing. To present in vitro and clinical results of MAT with a syringe. An in vitro analysis was performed comparing vacuum pressures generated by syringe aspiration and with pump aspiration. This was then complemented with prospective clinical data providing details of angiographic and clinical outcomes for syringe MAT. The in vitro analysis demonstrated that equal to slightly greater vacuum pressures were generated by a 60 cc syringe as compared with the pump in both static and partial flow conditions. In our clinical series, 106/113 acute stroke thrombectomies over a 6-month period were performed with syringe MAT on the first pass. Syringe usage instead of pump tubing and a canister led to a total savings of $58 300. The rate of Thrombolysis in Cerebral Infarction 2b/3 recanalization was 93%. Adjunctive stentriever usage was performed in 23% of cases. Median puncture to reperfusion time was 25 min; mean change in National Institute of Health Stroke Scale score at 24 hours was an improvement of 5.1 (median 6). The in-hospital mortality rate was 10%. Seventy percent of patients were discharged to home (modified Rankin Scale (mRS) score 0-2) or a rehabilitation facility (mRS score 2-4). MAT using a syringe is a safe, fast, and more cost-effective approach than using an aspiration pump. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Reduction of excess sludge production using mechanical disintegration devices.

Science.gov (United States)

Strünkmann, G W; Müller, J A; Albert, F; Schwedes, J

2006-01-01

The usability of mechanical disintegration techniques for the reduction of excess sludge production in the activated sludge process was investigated. Using three different disintegration devices (ultrasonic homogeniser, stirred media mill, high pressure homogeniser) and different operational parameters of the disintegration, the effect of mechanical disintegration on the excess sludge production and on the effluent quality was studied within a continuously operated, laboratory scale wastewater treatment system with pre-denitrification. Depending on the operational conditions and the disintegration device used, a reduction of excess sludge production of up to 70% was achieved. A combination of mechanical disintegration with a membrane bioreactor process with high sludge age is more energy effective concerning reduction of sludge production than with a conventional activated sludge process at lower sludge ages. Depending on the disintegration parameters, the disintegration has no, or only minor, negative effect on the soluble effluent COD and on the COD-removal capacity of the activated sludge process. Nitrogen-removal was slightly deteriorated by the disintegration, whereas the system used was not optimised for nitrogen removal before disintegration was implemented.

Opto-mechanical design of small infrared cloud measuring device

Science.gov (United States)

Zhang, Jiao; Yu, Xun; Tao, Yu; Jiang, Xu

2018-01-01

In order to make small infrared cloud measuring device can be well in a wide temperature range and day-night environment, a design idea using catadioptric infrared panoramic imaging optical system and simple mechanical structure for realizing observation clode under all-weather conditions was proposed. Firstly, the optical system of cloud measuring device was designed. An easy-to-use numerical method was proposed to acquire the profile of a catadioptric mirror, which brought the property of equidistance projection and played the most important role in a catadioptric panoramic lens. Secondly, the mechanical structure was studied in detail. Overcoming the limitations of traditional primary mirror support structure, integrative design was used for refractor and mirror support structure. Lastly, temperature adaptability and modes of the mirror support structure were analyzed. Results show that the observation range of the cloud measuring device is wide and the structure is simple, the fundamental frequency of the structure is greater than 100 Hz, the surface precision of the system reflector reaches PV of λ/10 and RMS of λ/40under the load of temperature range - 40 60°C, it can meet the needs of existing meteorological observation.

Anesthetic management of right atrial mass removal and pulmonary artery thrombectomy in a patient with primary antiphospholipid antibody syndrome

Directory of Open Access Journals (Sweden)

Rawat SKS

2010-01-01

Full Text Available Antiphospholipid antibody syndrome (APLAS characterises a clinical condition of arterial and venous thrombosis associated with phospholipids directed antibodies. APLAS occurs in 2% of the general population. However, one study demonstrated that 7.1% of hospitalised patients were tested positive for at least one of the three anticardiolipin antibody idiotype. Antiphospholipid antibodies often inhibit phospholipids dependent coagulation in vitro and interfere with laboratory testing of hemostasis. Therefore, the management of anticoagulation during cardiopulmonary bypass can be quite challenging in these patients. Here, we present a case of right atrial mass removal and pulmonary thrombectomy in a patient of APLAS.

A new gap separation mechanism for APS insertion devices

International Nuclear Information System (INIS)

Trakhtenberg, E. M.; Tcheskidov, V.; Den Hartog, P. K.; Deriy, B.; Erdmann, M.; Makarov, O.; Moog, E. R.

1999-01-01

A new gap separation mechanism for use with the standard Advanced Photon Source (APS) 3.3-cm-period undulator magnetic structures has been designed and built and the first system has been installed in the APS storage ring. The system allows a minimum magnetic gap of 10 mm for use with the APS 8-mm insertion device vacuum chambers. The mechanism is a bolted steel frame structure with a simple 4-motor mechanical drive train. The control system uses servomotors with incremental rotary encoders and virtual absolute linear encoders

A multiscale quantum mechanics/electromagnetics method for device simulations.

Science.gov (United States)

Yam, ChiYung; Meng, Lingyi; Zhang, Yu; Chen, GuanHua

2015-04-07

Multiscale modeling has become a popular tool for research applying to different areas including materials science, microelectronics, biology, chemistry, etc. In this tutorial review, we describe a newly developed multiscale computational method, incorporating quantum mechanics into electronic device modeling with the electromagnetic environment included through classical electrodynamics. In the quantum mechanics/electromagnetics (QM/EM) method, the regions of the system where active electron scattering processes take place are treated quantum mechanically, while the surroundings are described by Maxwell's equations and a semiclassical drift-diffusion model. The QM model and the EM model are solved, respectively, in different regions of the system in a self-consistent manner. Potential distributions and current densities at the interface between QM and EM regions are employed as the boundary conditions for the quantum mechanical and electromagnetic simulations, respectively. The method is illustrated in the simulation of several realistic systems. In the case of junctionless field-effect transistors, transfer characteristics are obtained and a good agreement between experiments and simulations is achieved. Optical properties of a tandem photovoltaic cell are studied and the simulations demonstrate that multiple QM regions are coupled through the classical EM model. Finally, the study of a carbon nanotube-based molecular device shows the accuracy and efficiency of the QM/EM method.

A portable air jet actuator device for mechanical system identification

Science.gov (United States)

Belden, Jesse; Staats, Wayne L.; Mazumdar, Anirban; Hunter, Ian W.

2011-03-01

System identification of limb mechanics can help diagnose ailments and can aid in the optimization of robotic limb control parameters and designs. An interesting fluid phenomenon—the Coandă effect—is utilized in a portable actuator to provide a stochastic binary force disturbance to a limb system. The design of the actuator is approached with the goal of creating a portable device which could be deployed on human or robotic limbs for in situ mechanical system identification. The viability of the device is demonstrated by identifying the parameters of an underdamped elastic beam system with fixed inertia and stiffness and variable damping. The nonparametric compliance impulse response yielded from the system identification is modeled as a second-order system and the resultant parameters are found to be in excellent agreement with those found using more traditional system identification techniques. The current design could be further miniaturized and developed as a portable, wireless, unrestrained mechanical system identification instrument for less intrusive and more widespread use.

Consumer sleep tracking devices: a review of mechanisms, validity and utility.

Science.gov (United States)

Kolla, Bhanu Prakash; Mansukhani, Subir; Mansukhani, Meghna P

2016-05-01

Consumer sleep tracking devices such as fitness trackers and smartphone apps have become increasingly popular. These devices claim to measure the sleep duration of their users and in some cases purport to measure sleep quality and awaken users from light sleep, potentially improving overall sleep. Most of these devices appear to utilize data generated from in-built accelerometers to determine sleep parameters but the exact mechanisms and algorithms are proprietary. The growing literature comparing these devices against polysomnography/actigraphy shows that they tend to underestimate sleep disruptions and overestimate total sleep times and sleep efficiency in normal subjects. In this review, we evaluate the current literature comparing the accuracy of consumer sleep tracking devices against more conventional methods used to measure sleep duration and quality. We discuss the current technology that these devices utilize as well as summarize the value of these devices in clinical evaluations and their potential limitations.

[Collateral score based on CT perfusion can predict the prognosis of patients with anterior circulation ischemic stroke after thrombectomy].

Science.gov (United States)

Wang, Qingsong; Zhang, Sheng; Zhang, Meixia; Chen, Zhicai; Lou, Min

2017-07-25

To evaluate the value of collateral score based on CT perfusion (CTP-CS) in predicting the clinical outcome of patients with anterior circulation ischemic stroke after thrombectomy. Clinical data of acute ischemic stroke patients with anterior artery occlusion undergoing endovascular treatment in the Second Affiliated Hospital, Zhejiang University School of Medicine during October 2013 and October 2016 were retrospectively reviewed. Collateral scores were assessed based on CTP and digital subtraction angiography (DSA) images, respectively. And DSA-CS or CTP-CS 3-4 was defined as good collateral vessels. Good clinical outcome was defined as a modified Rankin Scale (mRS) ≤ 2 at 3 months after stroke. The binary logistic regression model was used to analyze the correlation between the collateral score and clinical outcome, and the receiver operating characteristic (ROC) curve was used to analyze the value of DSA-CS and CTP-CS in predicting the clinical outcome. Among 40 patients, 33 (82.5%) acquired recanalization and 16 (40.0%) got good outcome. Compared with poor outcome group, the collateral score (all P collateral vessels were higher in good outcome group (all P collateral vessels were independent factor of good outcome (CTP-CS: OR =48.404, 95% CI :1.373-1706.585, P Collateral scores based on CTP and DSA had good consistency ( κ =0.697, P <0.01), and ROC curve showed that the predictive value of CTP-CS and DSA-CS were comparable (both AUC=0.726, 95% CI :0.559-0.893, P <0.05). CTP-CS can predict the clinical outcome of patients with anterior circulation ischemic stroke after thrombectomy.

Designs for mechanical circulatory support device studies.

Science.gov (United States)

Neaton, James D; Normand, Sharon-Lise; Gelijns, Annetine; Starling, Randall C; Mann, Douglas L; Konstam, Marvin A

2007-02-01

There is increased interest in mechanical circulatory support devices (MCSDs), such as implantable left ventricular assist devices (LVADs), as "destination" therapy for patients with advanced heart failure. Because patient availability to evaluate these devices is limited and randomized trials have been slow in enrolling patients, a workshop was convened to consider designs for MCSD development including alternatives to randomized trials. A workshop was jointly planned by the Heart Failure Society of America and the US Food and Drug Administration and was convened in March 2006. One of the panels was asked to review different designs for evaluating new MCSDs. Randomized trials have many advantages over studies with no controls or with nonrandomized concurrent or historical controls. These advantages include the elimination of bias in the assignment of treatments and the balancing, on average, of known and unknown baseline covariates that influence response. These advantages of randomization are particularly important for studies in which the treatments may not differ from one another by a large amount (eg, a head-to-head study of an approved LVAD with a new LVAD). However, researchers have found it difficult to recruit patients to randomized studies because the number of clinical sites that can carry out the studies is not large. Also, there is a reluctance to randomize patients when the control device is considered technologically inferior. Thus ways of improving the design of randomized trials were discussed, and the advantages and disadvantages of alternative designs were considered. The panel concluded that designs should include a randomized component. Randomized designs might be improved by allowing the control device to be chosen before randomization, by first conducting smaller vanguard studies, and by allowing crossovers in trials with optimal medical management controls. With use of data from completed trials, other databases, and registries, alternative

Coupling device of the control rod and of the drive mechanism

International Nuclear Information System (INIS)

Savary, F.

1986-01-01

The invention proposes a coupling device removable in which the connection between the upper head of the control rod and the drive mechanism is a real rigid fixing, in the mechanical sense of the term, suppressing longitudinal play and allowing to restrict the momenta occurring when locating the control rods [fr

Triggering Mechanism for Neutron Induced Single-Event Burnout in Power Devices

Science.gov (United States)

Shoji, Tomoyuki; Nishida, Shuichi; Hamada, Kimimori

2013-04-01

Cosmic ray neutrons can trigger catastrophic failures in power devices. It has been reported that parasitic transistor action causes single-event burnout (SEB) in power metal-oxide-semiconductor field-effect transistors (MOSFETs) and insulated gate bipolar transistors (IGBTs). However, power diodes do not have an inherent parasitic transistor. In this paper, we describe the mechanism triggering SEB in power diodes for the first time using transient device simulation. Initially, generated electron-hole pairs created by incident recoil ions generate transient current, which increases the electron density in the vicinity of the n-/n+ boundary. The space charge effect of the carriers leads to an increase in the strength of the electric field at the n-/n+ boundary. Finally, the onset of impact ionization at the n-/n+ boundary can trigger SEB. Furthermore, this failure is closely related to diode secondary breakdown. It was clarified that the impact ionization at the n-/n+ boundary is a key point of the mechanism triggering SEB in power devices.

Mechanical Design of the Intensity Measurement Devices for the LHC

CERN Document Server

Belorhad, D; Odier, P; Thoulet, S

2008-01-01

The intensity measurement for the LHC ring is provided by eight current transformers (2×DCCT, 2×FBCT per beam). The measurement resolution of 1?Arms at 1s average for the DCCTs and ±10^9p in 25ns for the FBCTs is required. Such constraints call for low noise electronics and a compact magnetically shielded mechanical design. Correct integration of these devices into the vacuum system also requires the vacuum chambers equipped with the non-evaporable getter (NEG) film. The NEG is activated by heating the vacuum chamber to 200?C and more. Such temperatures affect the structure of the magnetic materials, which form the base part of the intensity measurement devices, and degrade their performace. A cooling circuit is needed. Due to the mechanical constraints, the cooling circuit, as well as heating element must form an integral part of the design. The aim of this paper is to present the solutions to these problems and discuss the mechanical construction of the DCCTs and FBCTs currently being installed in the LH...

Stenting in the treatment of acute ischemic stroke: literature review.

Directory of Open Access Journals (Sweden)

Edgar A Samaniego

2011-12-01

Full Text Available Recanalization of acute large artery occlusions is a strong predictor of good outcome. The development of thrombectomy devices resulted in a significant improvement in recanalization rates compared to thrombolytics alone. However, clinical trials and registries with these thrombectomy devices in acute ischemic stroke (AIS have shown recanalization rates in the range of 40-81%. The last decade has seen the development of nickel titanium self-expandable stents (SES. These stents, in contrast to balloon-mounted stents, allow better navigability and deployment in tortuous vessels and therefore are optimal for the cerebral circulation. SES were initially used for stent-assisted coil embolization of intracranial aneurysms and for treatment of intracranial stenosis. However, a few authors have recently reported feasibility of deployment of SES in AIS. The use of these devices yielded higher recanalization rates compared to traditional thrombectomy devices. Encouraged by these results, retrievable SES systems have been recently used in AIS. These devices offer the advantage of resheathing and retrieving of the stent even after full deployment. Some of these stents can also be detached in case permanent stent placement is needed. Retrievable SES are being used in Europe and currently tested in clinical trials in the United States. We review the recent literature in the use of stents for the treatment of AIS secondary to large vessel occlusion.

Endovascular Mechanical Thrombectomy of an Occluded Superior Division Branch of the Left MCA for Acute Cardioembolic Stroke

International Nuclear Information System (INIS)

Schumacher, H. C.; Meyers, P. M.; Yavagal, D. R.; Harel, N. Y.; Elkind, M. S. V.; Mohr, J. P.; Pile-Spellman, J.

2003-01-01

Cardiac embolism accounts for a large proportion of ischemic stroke. Revascularization using systemic or intra-arterial thrombolysis is associated with increasing risks of cerebral hemorrhageas time passes from stroke onset. We report successful mechanicalthrombectomy from a distal branch of the middle cerebral artery (MCA)using a novel technique. A 72-year old man suffered an acute ischemic stroke from an echocardiographically proven ventricular thrombus due toa recent myocardial infarction. Intra-arterial administration of 4 mgrt-PA initiated at 5.7 hours post-ictus failed to recanalize an occluded superior division branch of the left MCA. At 6 hours,symptomatic embolic occlusion persisted. Mechanical extraction of the clot using an Attracter-18 device (Target Therapeutics, Freemont, CA) resulted in immediate recanalization of the MCA branch. Attracter-18 for acute occlusion of MCA branches may be considered in selected patients who fail conventional thrombolysis or are nearing closure of the therapeutic window for use of thrombolytic agents

A new device to test cutting efficiency of mechanical endodontic instruments

Science.gov (United States)

Rubini, Alessio Giansiracusa; Plotino, Gianluca; Al-Sudani, Dina; Grande, Nicola M.; Putorti, Ermanno; Sonnino, GianPaolo; Cotti, Elisabetta; Testarelli, Luca; Gambarini, Gianluca

2014-01-01

Background The purpose of the present study was to introduce a new device specifically designed to evaluate the cutting efficiency of mechanically driven endodontic instruments. Material/Methods Twenty new Reciproc R25 (VDW, Munich, Germany) files were used to be investigated in the new device developed to test the cutting ability of endodontic instruments. The device consists of a main frame to which a mobile plastic support for the hand-piece is connected and a stainless-steel block containing a Plexiglas block against which the cutting efficiency of the instruments was tested. The length of the block cut in 1 minute was measured in a computerized program with a precision of 0.1mm. The instruments were activated by using a torque-controlled motor (Silver Reciproc; VDW, Munich, Germany) in a reciprocating movement by the “Reciproc ALL” program (Group 1) and in counter-clockwise rotation at 300 rpm (Group 2). Mean and standard deviations of each group were calculated and data were statistically analyzed with a one-way ANOVA test (P0.05). Conclusions The cutting testing device evaluated in the present study was reliable and easy to use and may be effectively used to test cutting efficiency of both rotary and reciprocating mechanical endodontic instruments. PMID:24603777

Multiscale Thermo-Mechanical Design and Analysis of High Frequency and High Power Vacuum Electron Devices

Science.gov (United States)

Gamzina, Diana

Diana Gamzina March 2016 Mechanical and Aerospace Engineering Multiscale Thermo-Mechanical Design and Analysis of High Frequency and High Power Vacuum Electron Devices Abstract A methodology for performing thermo-mechanical design and analysis of high frequency and high average power vacuum electron devices is presented. This methodology results in a "first-pass" engineering design directly ready for manufacturing. The methodology includes establishment of thermal and mechanical boundary conditions, evaluation of convective film heat transfer coefficients, identification of material options, evaluation of temperature and stress field distributions, assessment of microscale effects on the stress state of the material, and fatigue analysis. The feature size of vacuum electron devices operating in the high frequency regime of 100 GHz to 1 THz is comparable to the microstructure of the materials employed for their fabrication. As a result, the thermo-mechanical performance of a device is affected by the local material microstructure. Such multiscale effects on the stress state are considered in the range of scales from about 10 microns up to a few millimeters. The design and analysis methodology is demonstrated on three separate microwave devices: a 95 GHz 10 kW cw sheet beam klystron, a 263 GHz 50 W long pulse wide-bandwidth sheet beam travelling wave tube, and a 346 GHz 1 W cw backward wave oscillator.

Accuracy of mechanical torque-limiting devices for dental implants.

Science.gov (United States)

L'Homme-Langlois, Emilie; Yilmaz, Burak; Chien, Hua-Hong; McGlumphy, Edwin

2015-10-01

A common complication in implant dentistry is unintentional implant screw loosening. The critical factor in the prevention of screw loosening is the delivery of the appropriate target torque value. Mechanical torque-limiting devices (MTLDs) are the most frequently recommended devices by the implant manufacturers to deliver the target torque value to the screw. Two types of MTLDs are available: friction-style and spring-style. Limited information is available regarding the influence of device type on the accuracy of MTLDs. The purpose of this study was to determine and compare the accuracy of spring-style and friction-style MTLDs. Five MTLDs from 6 different dental implant manufacturers (Astra Tech/Dentsply, Zimmer Dental, Biohorizons, Biomet 3i, Straumann [ITI], and Nobel Biocare) (n=5 per manufacturer) were selected to determine their accuracy in delivering target torque values preset by their manufacturers. All torque-limiting devices were new and there were 3 manufacturers for the friction-style and 3 manufacturers for the spring-style. The procedure of target torque measurement was performed 10 times for each device and a digital torque gauge (Chatillon Model DFS2-R-ND; Ametek) was used to record the measurements. Statistical analysis used nonparametric tests to determine the accuracy of the MTLDs in delivering target torque values and Bonferroni post hoc tests were used to assess pairwise comparisons. Median absolute difference between delivered torque values and target torque values of friction-style and spring-style MTLDs were not significantly different (P>.05). Accuracy of Astra Tech and Zimmer Dental friction-style torque-limiting devices were significantly different than Biohorizons torque-limiting devices (Ptorque value. Astra Tech and Zimmer Dental friction-style torque-limiting devices were significantly more accurate than Biohorizons (C) torque-limiting devices (Ptorque-limiting devices fell within ±10% of the target torque value preset by the

Electromagnetic analysis of locking device for SMART control element drive mechanism

International Nuclear Information System (INIS)

Heo, H.; Kim, J. I.; Kim, J. H.; Kim, Y. W.; Park, J. S.

1998-01-01

A numerical electromagnetic analysis was performed for the control rod locking device which is installed in the control element drive mechanism of integral reactor, SMART. A plunger model for the electromagnetic analysis of the locking device was developed and theoretical bases for the model were established. Design parameters related to plunger pushing force were identified, and the optimum design point was determined by analyzing the trend of the plunger pushing force with finite element method

Off label use of devices and drugs in interventional radiology

Energy Technology Data Exchange (ETDEWEB)

Zvavanjanja, R.C., E-mail: Rodrick.Zvavanjanja@rlbuht.nhs.uk [Royal Liverpool University Hospital, Liverpool (United Kingdom); Odetoyinbo, T.O.; Rowlands, P.C.; Healey, A.; Abdelsalam, H.; Powell, S.; Evans, J.C.; Hughes, M.L.; Gould, D.A.; McWilliams, R.G. [Royal Liverpool University Hospital, Liverpool (United Kingdom)

2012-03-15

Aim: To establish how often off-label device and drug use occurs in interventional radiology (IR) in a UK tertiary referral hospital and consider the wider implications for the interventional radiologist. Materials and methods: Prospective data were collected during interventional procedures for 1 working week in a university hospital. Out-of-hours procedures and procedures outside the department were excluded. Operators were asked to record the drugs and devices used, the indication, and method of use. The instructions for use/summary of product characteristics were then studied for each device/drug used to assess if the use was on or off-label. Results: During the study period 52 cases were performed and data were available on 26 cases (50%). In 22 of the 26 cases (84%) there was evidence of off-label use of devices or drugs. Off-label use of drugs included treatment of venous malformations with Fibrovein{sup Copyright-Sign} (sodium tetradecyl sulphate), which is licensed for the treatment of varicose veins in the leg, and intra-arterial injection of heparin, which is licensed for intravenous and subcutaneous use. Off-label device use included placing vascular sheaths in the urinary tract, using angiographic catheters to guide wires in the urinary tract, using sheaths for thrombosuction, reshaping of the tip of most guidewires, and using angioplasty balloons to dislodge the arterial plug at fistula thrombectomy. Conclusion: Off-label device and drugs use is common in a UK tertiary hospital IR department and literature suggests this is common in the wider IR community. There are important clinical and legal implications for off-label use for patients and physicians.

Off label use of devices and drugs in interventional radiology

International Nuclear Information System (INIS)

Zvavanjanja, R.C.; Odetoyinbo, T.O.; Rowlands, P.C.; Healey, A.; Abdelsalam, H.; Powell, S.; Evans, J.C.; Hughes, M.L.; Gould, D.A.; McWilliams, R.G.

2012-01-01

Aim: To establish how often off-label device and drug use occurs in interventional radiology (IR) in a UK tertiary referral hospital and consider the wider implications for the interventional radiologist. Materials and methods: Prospective data were collected during interventional procedures for 1 working week in a university hospital. Out-of-hours procedures and procedures outside the department were excluded. Operators were asked to record the drugs and devices used, the indication, and method of use. The instructions for use/summary of product characteristics were then studied for each device/drug used to assess if the use was on or off-label. Results: During the study period 52 cases were performed and data were available on 26 cases (50%). In 22 of the 26 cases (84%) there was evidence of off-label use of devices or drugs. Off-label use of drugs included treatment of venous malformations with Fibrovein © (sodium tetradecyl sulphate), which is licensed for the treatment of varicose veins in the leg, and intra-arterial injection of heparin, which is licensed for intravenous and subcutaneous use. Off-label device use included placing vascular sheaths in the urinary tract, using angiographic catheters to guide wires in the urinary tract, using sheaths for thrombosuction, reshaping of the tip of most guidewires, and using angioplasty balloons to dislodge the arterial plug at fistula thrombectomy. Conclusion: Off-label device and drugs use is common in a UK tertiary hospital IR department and literature suggests this is common in the wider IR community. There are important clinical and legal implications for off-label use for patients and physicians.

Mechanical Revascularization for Acute Ischemic Stroke: A Single-Center, Retrospective Analysis

International Nuclear Information System (INIS)

Jeromel, Miran; Milosevic, Z. V.; Kocijancic, I. J.; Lovric, D.; Svigelj, V.; Zvan, B.

2013-01-01

BackgroundEndovascular mechanical revascularization (thrombectomy) is an increasingly used method for intracranial large vessel recanalization in acute stroke. The purpose of the study was to analyze the recanalization rate, clinical outcome, and complication rate in our stroke patients treated with mechanical revascularization. A total of 57 patients with large vessel stroke (within 3 h for anterior and 12 h for posterior circulation) were treated with mechanical revascularization at a single center during 24 months. The primary goal of endovascular treatment using different mechanical devices was recanalization of the occluded vessel. Recanalization rate (reported as thrombolysis in cerebral infarction [TICI] score), clinical outcome (reported as National Institutes of Health Stroke Scale [NIHSS] score and modified Rankin scale [mRS] score), as well as periprocedural complications were analyzed. The mean age of the patients was 63.1 ± 12.9 years, with baseline median NIHSS score of 14 (interquartile range, 9.5–19). Successful recanalization (TICI 2b or 3) was achieved in 41 (72 %) patients. Twenty patients (35 %) presented with favorable outcome (mRS ≤2) 30 days after stroke. Overall, significant neurological improvement (≥4 NIHSS point reduction) occurred in 36 (63 %) patients. A clinically significant procedure-related adverse events (vessel disruption, peri/postprocedural intracranial bleeding) defined with decline in NIHSS of ≥4 or death occurred in three (5 %) patients. The study showed a high recanalization rate with improved clinical outcome and a low rate of periprocedural complications in our stroke patients treated with mechanical revascularization. Therefore, we could conclude that endovascular revascularization (primary or in combination with a bridging thrombolysis) was an effective and safe procedure for intracranial large vessel recanalization in acute stroke.

Electromagnetic analysis of locking device for SMART control element drive mechanism

Energy Technology Data Exchange (ETDEWEB)

Huh, Hyung; Kim, J. I.; Kim, J. H. [Korea Atomic Energy Research Institute, Taejon (Korea)

1998-09-01

A numerical electromagnetic analysis was performed for the control rod locking device which is installed in the control element drive mechanism of integral reactor, SMART. A plunger model for the electromagnetic analysis of the locking device was developed and theoretical bases for the model were established. Design parameters related to plunger pushing force were identified, and the optimum design point was determined by analysing the trend of the plunger pushing force with finite element method. 8 refs., 22 figs., 2 tabs. (Author)

Intra-Arterial Therapy for Acute Stroke and the Effect of Technological Advances on Recanalization: Findings in a Community Hospital.

Science.gov (United States)

Goldstein, Jonas H; Denslow, Sheri A; Goldstein, Samuel J; Marx, William F; Short, John G; Taylor, Reid D; Schneider, Alexander L

2016-01-01

Recent randomized controlled studies have shown improvement in recanalization outcomes when physicians use the latest intra-arterial therapy devices in patients with acute, large-vessel, intracranial occlusions. The goal of this study was to explore how new procedures affected degree of and time to recanalization at a single center over the past 12 years as technology has improved. Patients were included in the study if they had a large or medium intracranial vessel occlusion and had undergone intra-arterial therapy for acute stroke during the period 2002-2013. Therapies were categorized as intra-arterial thrombolysis with tissue plasminogen activator (IA tPA), mechanical thrombectomy using 1st-generation devices (Merci and Penumbra), or mechanical thrombectomy using 2nd-generation devices (stent-trievers). Recanalization was defined using a modified Thrombolysis in Cerebral Infarction (TICI) scale. Primary treatment was IA tPA in 24 (12.4%) patients, 1st-generation devices in 128 (66.0%) patients, and 2nd-generation devices in 42 (21.6%) patients. TICI 2b was achieved in 7 (29.2%) patients treated with IA tPA, in 79 (61.7%) patients treated with 1st-generation devices, and in 38 (90.5%) patients treated with 2nd-generation devices. Compared to patients treated with IA tPA, patients treated with 2nd-generation devices were more likely to reach TICI 2b recanalization (odds ratio, 11.66; 95% CI, 1.56-87.01), and they did so in shorter times. Technological advances over 12 years in endovascular stroke treatments significantly improved the chance of and reduced time to achieving TICI 2b recanalization in our community hospital. This shows the importance of adopting new technologies in a rapidly evolving field in order to provide the best-practice standard of care for the people of our region. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

Design Strategies for Efficient Access to Mobile Device Users via Amazon Mechanical Turk

OpenAIRE

Jacques, Jason; Kristensson, Per Ola

2017-01-01

It is often challenging to access a pool of mobile device users and instruct them to perform an interactive task. Yet such data is often vital to provide design insight at various stages of the design process of a mobile application, service or system. We propose accessing a pool of mobile device users via the microtask market Amazon Mechanical Turk (MTurk). While mobile device users are still a minority on MTurk, they provide unique opportunities for requesters. Not only does catering to mob...

The association between collateral status, recanalization and long term outcome in stroke patients treated with stent retrievers - Are there indications not to perform thrombectomy based on CT angiography?

Science.gov (United States)

Nordmeyer, Hannes; Webering, Nadine; Chapot, Rene; Hadisurya, Jeffrie; Heddier, Markus; Stracke, Paul; Berger, Klaus; Isenmann, Stefan; Weber, Ralph

2017-06-01

To investigate the association between baseline pial collateral status on computed tomography angiography (CTA) with recanalization and functional outcome in patients with acute anterior circulation stroke treated with stent retriever thrombectomy. Retrospective analysis of 87 patients from a prospective thrombectomy registry. Collateral status on CTA source images was categorized into good, moderate, and poor with the Tan and Miteff scores by two-blinded readers. Association between CTA collateral status and successful recanalization was investigated with univariate regression analysis. Multivariate logistic regression was used to analyse the association between collateral score and favourable clinical outcome (mRS 0-2) and death at follow-up. Mean age was 72.5 years and baseline median NIHSS score was 15. Patients with poor collaterals on Tan score had a significant higher mortality compared with moderate or good collaterals during a mean follow-up period of 5.2 months (85.7% vs. 30.6% vs. 25.7%, Pcollateral score could be assessed only in 65 of the 87 patients and the Tan collateral score had a higher interrater reliability. Poor collaterals on CTA were associated with a very high rate of fatal outcome in anterior circulation stroke patients despite a high rate of successful recanalization with stent retrievers. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Use of a Trellis Device for Endovascular Treatment of Venous Thrombosis Involving a Duplicated Inferior Vena Cava

Energy Technology Data Exchange (ETDEWEB)

Saettele, Megan R., E-mail: SaetteleM@umkc.edu [University of Missouri, Kansas City, Department of Radiology, Saint Luke' s Hospital (United States); Morelli, John N., E-mail: dr.john.morelli@gmail.com [Texas A and M University Health Science Center, Department of Radiology, Scott and White Clinic and Hospital (United States); Chesis, Paul; Wible, Brandt C. [University of Missouri, Kansas City, Department of Interventional Radiology, Saint Luke' s Hospital (United States)

2013-12-15

Congenital anomalies of the inferior vena cava (IVC) are increasingly recognized with CT and venography techniques. Although many patients with IVC anomalies are asymptomatic, recent studies have suggested an association with venous thromboembolism. We report the case of a 62-year-old woman with extensive venous clot involving the infrarenal segment of a duplicated left IVC who underwent pharmacomechanical thrombectomy and tissue plasminogen activator catheter-directed thrombolysis with complete deep venous thrombosis resolution. To our knowledge this is the first reported case in the English literature of the use of a Trellis thrombectomy catheter in the setting of duplicated IVC.

Stroke Neurologist's Perspective on the New Endovascular Trials.

Science.gov (United States)

Grotta, James C; Hacke, Werner

2015-06-01

Before December 2014, the only proven effective treatment for acute ischemic stroke was recombinant tissue-type plasminogen activator (r-tPA). This has now changed with the publication of the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN), Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times (ESCAPE), Extending the Time for Thrombolysis in Emergency Neurological Deficits--Intra-Arterial (EXTEND IA), Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment Trial (SWIFT PRIME), and Randomized Trial of Revascularization With the Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting Within Eight Hours of Symptom Onset (REVASCAT) studies. We review the main results of these studies and how they inform stroke patient management going forward. The main take home points for neurologists are (1) intra-arterial thrombectomy is a potently effective treatment and should be offered to patients who have documented occlusion in the distal internal carotid or the proximal middle cerebral artery, have a relatively normal noncontrast head computed tomographic scan, severe neurological deficit, and can have intra-arterial thrombectomy within 6 hours of last seen normal; (2) benefits are clear in patients receiving r-tPA before intra-arterial thrombectomy; r-tPA should not be withheld if the patient meets criteria, and benefit in patients who do not receive r-tPA or have r-tPA exclusions requires further study; and (3) these favorable results occur when intra-arterial thrombectomy is performed in an endovascular stroke center by a coordinated multidisciplinary team that extends from the prehospital stage to the endovascular suite, minimizes time to recanalization, uses stent-retriever devices, and avoids general

Opto-mechanical devices for the Antares automatic beam alignment system

International Nuclear Information System (INIS)

Swann, T.; Combs, C.; Witt, J.

1981-01-01

Antares is a 24-beam CO 2 laser system for controlled fusion research, under construction at Los Alamos National Laboratory. Rapid automatic alignment of this system is required prior to each experimental shot. Unique opto-mechanical alignment devices, which have been developed specifically for this automatic alignment system, are discussed. A variable focus alignment telescope views point light sources. A beam expander/spatial filter processes both a visible Krypton Ion and a 10.6 μm CO 2 alignment laser. The periscope/carousel device provides the means by which the alignment telescope can sequentially view each of twelve optical trains in each power amplifier. The polyhedron alignment device projects a point-light source for both centering and pointing alignment at the polyhedron mirror. The rotating wedge alignment device provides a sequencing point-light source and also compensates for dispersion between visible and 10.6 μm radiation. The back reflector flip in remotely positions point-light sources at the back reflector mirrors. A light source box illuminates optic fibers with high intensity white light which is distributed to the various point-light sources in the system

An Authentication and Key Management Mechanism for Resource Constrained Devices in IEEE 802.11-based IoT Access Networks

Directory of Open Access Journals (Sweden)

Ki-Wook Kim

2017-09-01

Full Text Available Many Internet of Things (IoT services utilize an IoT access network to connect small devices with remote servers. They can share an access network with standard communication technology, such as IEEE 802.11ah. However, an authentication and key management (AKM mechanism for resource constrained IoT devices using IEEE 802.11ah has not been proposed as yet. We therefore propose a new AKM mechanism for an IoT access network, which is based on IEEE 802.11 key management with the IEEE 802.1X authentication mechanism. The proposed AKM mechanism does not require any pre-configured security information between the access network domain and the IoT service domain. It considers the resource constraints of IoT devices, allowing IoT devices to delegate the burden of AKM processes to a powerful agent. The agent has sufficient power to support various authentication methods for the access point, and it performs cryptographic functions for the IoT devices. Performance analysis shows that the proposed mechanism greatly reduces computation costs, network costs, and memory usage of the resource-constrained IoT device as compared to the existing IEEE 802.11 Key Management with the IEEE 802.1X authentication mechanism.

An Authentication and Key Management Mechanism for Resource Constrained Devices in IEEE 802.11-based IoT Access Networks.

Science.gov (United States)

Kim, Ki-Wook; Han, Youn-Hee; Min, Sung-Gi

2017-09-21

Many Internet of Things (IoT) services utilize an IoT access network to connect small devices with remote servers. They can share an access network with standard communication technology, such as IEEE 802.11ah. However, an authentication and key management (AKM) mechanism for resource constrained IoT devices using IEEE 802.11ah has not been proposed as yet. We therefore propose a new AKM mechanism for an IoT access network, which is based on IEEE 802.11 key management with the IEEE 802.1X authentication mechanism. The proposed AKM mechanism does not require any pre-configured security information between the access network domain and the IoT service domain. It considers the resource constraints of IoT devices, allowing IoT devices to delegate the burden of AKM processes to a powerful agent. The agent has sufficient power to support various authentication methods for the access point, and it performs cryptographic functions for the IoT devices. Performance analysis shows that the proposed mechanism greatly reduces computation costs, network costs, and memory usage of the resource-constrained IoT device as compared to the existing IEEE 802.11 Key Management with the IEEE 802.1X authentication mechanism.

The influence of ergonomic devices on mechanical load during patient handling activities in nursing homes.

Science.gov (United States)

Koppelaar, Elin; Knibbe, Hanneke J J; Miedema, Harald S; Burdorf, Alex

2012-07-01

Mechanical load during patient handling activities is an important risk factor for low back pain among nursing personnel. The aims of this study were to describe required and actual use of ergonomic devices during patient handling activities and to assess the influence of these ergonomic devices on mechanical load during patient handling activities. For each patient, based on national guidelines, it was recorded which specific ergonomic devices were required during distinct patient handling activities, defined by transferring a patient, providing personal care, repositioning patients in the bed, and putting on and taking off anti-embolism stockings. During real-time observations over ~60 h among 186 nurses on 735 separate patient handling activities in 17 nursing homes, it was established whether ergonomic devices were actually used. Mechanical load was assessed through observations of frequency and duration of a flexed or rotated trunk >30° and frequency of pushing, pulling, lifting or carrying requiring forces 230 N from start to end of each separate patient handling activity. The number of patients and nurses per ward and the ratio of nurses per patient were used as ward characteristics with potential influence on mechanical load. A mixed-effect model for repeated measurements was used to determine the influence of ergonomic devices and ward characteristics on mechanical load. Use of ergonomic devices was required according to national guidelines in 520 of 735 (71%) separate patient handling activities, and actual use was observed in 357 of 520 (69%) patient handling activities. A favourable ratio of nurses per patient was associated with a decreased duration of time spent in awkward back postures during handling anti-embolism stocking (43%), patient transfers (33%), and personal care of patients (24%) and also frequency of manually lifting patients (33%). Use of lifting devices was associated with a lower frequency of forces exerted (64%), adjustable bed and

Future trials of endovascular mechanical recanalisation therapy in acute ischemic stroke patients - A position paper endorsed by ESMINT and ESNR. Pt. 2. Methodology of future trials

Energy Technology Data Exchange (ETDEWEB)

Fiehler, Jens [University Medical Centre Hamburg-Eppendorf, Department of Neuroradiology, Hamburg (Germany); Soederman, Michael [Karolinska University Hospital, Department of Neuroradiology, Stockholm (Sweden); Turjman, Francis [Hopital neurologique, Centre de Neurosciences Cognitives, Department of Neuroradiology, Lyon (France); White, Philip M. [University of Edinburgh, Department of Clinical Neurosciences, Western General Hospital, Edinburgh (United Kingdom); Bakke, Soeren Jacob [Oslo University Hospital, Department of Neuroradiology, Oslo (Norway); Mangiafico, Salvatore [University Hospital Careggi, Interventional Neuroradiology Unit, Florence (Italy); Kummer, Ruediger von [University of Dresden, Department of Neuroradiology, Dresden (Germany); Muto, Mario [University of Naples, Department of Neuroradiology, Naples (Italy); Cognard, Christophe [Hopital Purpan, Service de Neuroradiologie, Toulouse (France); Gralla, Jan [Inselspital Bern, Department of Neuroradiology, Bern (Switzerland)

2012-12-15

Based on current data and experience, the joint working group of the European Society of Minimally Invasive Neurological Therapy (ESMINT) and the European Society of Neuroradiology (ESNR) make suggestions on trial design and conduct aimed to investigate therapeutic effects of mechanical thrombectomy (MT). We anticipate that this roadmap will facilitate the setting up and conduct of successful trials in close collaboration with our neighbouring disciplines. (orig.)

Future trials of endovascular mechanical recanalisation therapy in acute ischemic stroke patients - a position paper endorsed by ESMINT and ESNR : part II: methodology of future trials.

Science.gov (United States)

Fiehler, Jens; Söderman, Michael; Turjman, Francis; White, Philip M; Bakke, Søren Jacob; Mangiafico, Salvatore; von Kummer, Rüdiger; Muto, Mario; Cognard, Christophe; Gralla, Jan

2012-12-01

Based on current data and experience, the joint working group of the European Society of Minimally Invasive Neurological Therapy (ESMINT) and the European Society of Neuroradiology (ESNR) make suggestions on trial design and conduct aimed to investigate therapeutic effects of mechanical thrombectomy (MT). We anticipate that this roadmap will facilitate the setting up and conduct of successful trials in close collaboration with our neighbouring disciplines.

Resolving Overlimiting Current Mechanisms in Microchannel-Nanochannel Interface Devices

Science.gov (United States)

Yossifon, Gilad; Leibowitz, Neta; Liel, Uri; Schiffbauer, Jarrod; Park, Sinwook

2015-11-01

We present results demonstrating the space charge-mediated transition between classical, diffusion-limited current and surface-conduction dominant over-limiting currents in a shallow micro-nanochannel device. The extended space charge layer develops at the depleted micro-nanochannel entrance at high current and is correlated with a distinctive maximum in the dc resistance. Experimental results for a shallow surface-conduction dominated system are compared with theoretical models, allowing estimates of the effective surface charge at high voltage to be obtained. Further, we extend the study to microchannels of moderate to large depths where the role of various electro-convection mechanisms becomes dominant. In particular, electro-osmotic of the second kind and electro-osmotic instability (EOI) which competes each other at geometrically heterogeneous (e.g. undulated nanoslot interface, array of nanoslots) nanoslot devices. Also, these effects are also shown to be strongly modulated by the non-ideal permselectivity of the nanochannel.

No Benefit in Neurologic Outcomes of Survivors of Out-of-Hospital Cardiac Arrest with Mechanical Compression Device.

Science.gov (United States)

Newberry, Ryan; Redman, Ted; Ross, Elliot; Ely, Rachel; Saidler, Clayton; Arana, Allyson; Wampler, David; Miramontes, David

2018-01-01

Out-of-hospital cardiac arrest (OHCA) is a major cause of death and morbidity in the United States. Quality cardiopulmonary resuscitation (CPR) has proven to be a key factor in improving survival. The aim of our study was to investigate the outcomes of OHCA when mechanical CPR (LUCAS 2 Chest Compression System™) was utilized compared to conventional CPR. Although controlled trials have not demonstrated a survival benefit to the routine use of mechanical CPR devices, there continues to be an interest for their use in OHCA. We conducted a retrospective observational study of OHCA comparing the outcomes of mechanical and manual chest compressions in a fire department based EMS system serving a population of 1.4 million residents. Mechanical CPR devices were geographically distributed on 11 of 33 paramedic ambulances. Data were collected over a 36-month period and outcomes were dichotomized based on utilization of mechanical CPR. The primary outcome measure was survival to hospital discharge with a cerebral performance category (CPC) score of 1 or 2. This series had 3,469 OHCA reports, of which 2,999 had outcome data and met the inclusion criteria. Of these 2,236 received only manual CPR and 763 utilized a mechanical CPR device during the resuscitation. Return of spontaneous circulation (ROSC) was attained in 44% (334/763) of the mechanical CPR resuscitations and in 46% (1,020/2,236) of the standard manual CPR resuscitations (p = 0.32). Survival to hospital discharge was observed in 7% (52/763) of the mechanical CPR resuscitations and 9% (191/2,236) of the manual CPR group (p = 0.13). Discharge with a CPC score of 1 or 2 was observed in 4% (29/763) of the mechanical CPR resuscitation group and 6% (129/2,236) of the manual CPR group (p = 0.036). In our study, use of the mechanical CPR device was associated with a poor neurologic outcome at hospital discharge. However, this difference was no longer evident after logistic regression adjusting for confounding variables

A novel vibration assisted polishing device based on the flexural mechanism driven by the piezoelectric actuators

Directory of Open Access Journals (Sweden)

Guilian Wang

2018-01-01

Full Text Available The vibration assisted polishing has widely application fields because of higher machining frequency and better polishing quality, especially the polishing with the non-resonant mode that is regarded as a kind of promising polishing method. This paper reports a novel vibration assisted polishing device, consisting of the flexible hinge mechanism driven by the piezoelectric actuators, which is suitable for polishing planes or curve surfaces with slow curvature. Firstly, the generation methods of vibration trajectory are investigated for the same frequency and different frequency signals’ inputs, respectively, and then the types of elliptic and Lissajous’s vibration trajectories are generated respectively. Secondly, a flexural mechanism consisting of the right circular flexible hinges and the leaf springs is developed to produce two-dimensional vibration trajectory. Statics and dynamics investigating of this flexible mechanism are finished in detail. The analytical models about input and output compliances of the flexural mechanism are established according to the matrix-based compliance modeling, and the dynamic model of the flexural mechanism based on the Euler-Lagrange equation is also presented. The finite element model of the flexural mechanism was established to carry out the numerical simulation in order to testify the rationality of device design. Finally, the polishing experiment is carried out to prove the effectiveness of the vibration device. The experimental results show that this novel vibration assisted polishing device developed in this study can remove more effectively the cutting marks left by last process and obviously reduce the workpiece surface roughness.

Device for mechanized loading of coal into the sump of a skip shaft

Energy Technology Data Exchange (ETDEWEB)

Orlik, M A

1982-01-01

In order to mechanize the process of loading coal and cleaning the sump, the efficiency experts of the mine ''Promyshlennaya'' of the production association ''Vorkutaugol'' have designed a special mechanical loading device which consists of pipes-sleeves, working mechanism-worm and electric drive. The worm lifter is suspended on the beam with clamps and an intermediate floor. Because of the use of mechanical loader, manual operations have been reduced to the minimum (the coal is thrown towards the loading hole manually). Economic effect is R 3100 per year.

One-Time URL: A Proximity Security Mechanism between Internet of Things and Mobile Devices.

Science.gov (United States)

Solano, Antonio; Dormido, Raquel; Duro, Natividad; González, Víctor

2016-10-13

The aim of this paper is to determine the physical proximity of connected things when they are accessed from a smartphone. Links between connected things and mobile communication devices are temporarily created by means of dynamic URLs (uniform resource locators) which may be easily discovered with pervasive short-range radio frequency technologies available on smartphones. In addition, a multi cross domain silent logging mechanism to allow people to interact with their surrounding connected things from their mobile communication devices is presented. The proposed mechanisms are based in web standards technologies, evolving our social network of Internet of Things towards the so-called Web of Things.

Interfacial characteristics and leakage current transfer mechanisms in organometal trihalide perovskite gate-controlled devices via doping of PCBM

International Nuclear Information System (INIS)

Wang, Yucheng; Zhang, Yuming; Liu, Yintao; Pang, Tiqiang; Luan, Suzhen; Jia, Renxu; Hu, Ziyang; Zhu, Yuejin

2017-01-01

Two types of perovskite (with and without doping of PCBM) based metal-oxide-semiconductor (MOS) gate-controlled devices were fabricated and characterized. The study of the interfacial characteristics and charge transfer mechanisms by doping of PCBM were analyzed by material and electrical measurements. Doping of PCBM does not affect the size and crystallinity of perovskite films, but has an impact on carrier extraction in perovskite MOS devices. The electrical hysteresis observed in capacitance–voltage and current–voltage measurements can be alleviated by doping of PCBM. Experimental results demonstrate that extremely low trap densities are found for the perovskite device without doping, while the doped sample leads to higher density of interface state. Three mechanisms including Ohm’s law, trap-filled-limit (TFL) emission, and child’s law were used to analyze possible charge transfer mechanisms. Ohm’s law mechanism is well suitable for charge transfer of both the perovskite MOS devices under light condition at large voltage, while TFL emission well addresses the behavior of charge transfer under dark at small voltage. This change of charge transfer mechanism is attributed to the impact of the ion drift within perovskites. (paper)

Energy transmission and power sources for mechanical circulatory support devices to achieve total implantability.

Science.gov (United States)

Wang, Jake X; Smith, Joshua R; Bonde, Pramod

2014-04-01

Left ventricular assist device therapy has radically improved congestive heart failure survival with smaller rotary pumps. The driveline used to power today's left ventricular assist devices, however, continues to be a source of infection, traumatic damage, and rehospitalization. Previous attempts to wirelessly power left ventricular assist devices using transcutaneous energy transfer systems have been limited by restrictions on separation distance and alignment between the transmit and receive coils. Resonant electrical energy transfer allows power delivery at larger distances without compromising safety and efficiency. This review covers the efforts to wirelessly power mechanical circulatory assist devices and the progress made in enhancing their energy sources. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

The PTFE-nanocomposites mechanical properties for transport systems dynamic sealing devices elements

Science.gov (United States)

Mashkov, Y. K.; Egorova, V. A.; Chemisenko, O. V.; Maliy, O. V.

2017-06-01

The mechanical properties study results of polymer nanocomposites based on polytetrafluoroethylene with modifiers in the form of micro- and nanoscale cryptocrystalline graphite and silicon dioxide powders are determined. The nanocomposites mechanical properties determined values provide high sealing degree of transport systems dynamic sealing devices elements. When the temperature changes from cryogenic to high positive then the elastic modulus, tensile strength decrease significantly and nonlinearly, the latter limits the composite usage in heavily loaded tribosystems operating at elevated temperatures.

A preliminary design of mechanical device on industrial digital radiography equipment design

International Nuclear Information System (INIS)

Nur Khasan; Samuel Praptoyo

2015-01-01

A preliminary design of mechanical device on industrial digital radiography equipment has been done. this design is intended as a basis for the manufacture of complete facilities for the realization a prototype on industrial digital radiography equipment. the design and construction were carried out by paying attention to the general configuration of the basic design in which its mechanical design has several components with specific dimensions and heavy mass. this design consist of a main frame holder, flat panel detector support and hydraulic hand stacker for mounting the x-ray machine. this mechanical device design will then be fabricated to facilitate and assist work of digital radiographic retrieval. computer application programs sketch-up is used to draw this design and the analysis stress of autodesk inventor to analysis the strength construction design. the results of this design are the configuration drawing, sketch drawings of construction and the safety factor of construction design with a minimum value of 2.39 as well as a maximum value of 15 when to be simulated by the load 500 Kg which is 4 times of total workload. (author)

The optical-mechanical design of DMD modulation imaging device

Science.gov (United States)

Li, Tianting; Xu, Xiping; Qiao, Yang; Li, Lei; Pan, Yue

2014-09-01

In order to avoid the phenomenon of some image information were lost, which is due to the jamming signals, such as incident laser, make the pixels dot on CCD saturated. In this article a device of optical-mechanical structure was designed, which utilized the DMD (Digital Micro mirror Device) to modulate the image. The DMD reflection imaging optical system adopts the telecentric light path. However, because the design is not only required to guarantee a 66° angle between the optical axis of the relay optics and the DMD, but also to ensure that the optical axis of the projection system keeps parallel with the perpendicular bisector of the micro-mirror which is in the "flat" state, so the TIR prism is introduced，and making the relay optics and the DMD satisfy the optical institution's requirements. In this paper, a mechanical structure of the imaging optical system was designed and at the meanwhile the lens assembly has been well connected and fixed and fine-tuned by detailed structural design, which included the tilt decentered lens, wedge flanges, prisms. By optimizing the design, the issues of mutual restraint between the inverting optical system and the projecting system were well resolved, and prevented the blocking of the two systems. In addition, the structure size of the whole DMD reflection imaging optical system was minimized; it reduced the energy loss and ensured the image quality.

Slide release mechanism. [for space shuttle orbiter/external tank connection device

Science.gov (United States)

Bunker, J. W.; Ritchie, R. S. (Inventor)

1985-01-01

A releasable support device is described which is comprised of a hollow body with a sleeve extending transversely there-through for receiving the end of a support shank. A slider-latch, optionally lubricated, extends through side recesses in the sleeve to straddle the shank, respectively, in latched and released positions. The slider-latch is slid from its latched to its unlatched position by a pressure squib whereupon a spring or other pressure means pushes the shank out of the sleeve. At the same time, a follower element is lodged in and closed the hole in the body wall from which the shank was discharged. The mechanism was designed for the shuttle orbiter/external tank connection device.

Acute Superior Mesenteric Venous Thrombosis: Transcatheter Thrombolysis and Aspiration Thrombectomy Therapy by Combined Route of Superior Mesenteric Vein and Artery in Eight Patients

International Nuclear Information System (INIS)

Yang, Shuofei; Liu, Baochen; Ding, Weiwei; He, Changsheng; Wu, Xingjiang; Li, Jieshou

2015-01-01

PurposeTo assess the feasibility, effectiveness, and safety of catheter-directed thrombolysis and aspiration thrombectomy therapy by combined route of superior mesenteric vein and artery (SMV+SMA) for acute superior mesenteric venous thrombosis (ASMVT).MethodsThis retrospective study reviewed eight ASMVT patients with transcatheter direct thrombolysis and aspiration thrombectomy therapy via SMV and indirect thrombolysis via SMA during a period of 14 months. The demographics, etiology, risk factors, therapeutic effect, complications, mortality, and follow-up of the study population were assessed. Anatomic and imaging classification of location and extent of thrombus at diagnosis and degree of thrombus lysis were described.ResultsTechnical success was achieved with substantial improvement in symptoms and thrombus resolution after thrombolytic therapy in all patients. The local urokinase infusion by SMA and SMV was performed for 5–7 (6.13 ± 0.83) and 7–15 (12 ± 2.51) days. Anticoagulation was performed catheter-directed and then orally throughout hospitalization and after discharge. Four patients required delayed localized bowel resection after thrombolytic therapy with no death. Thrombolytic therapy was not interrupted despite minor bleeding at the puncture site in two patients and sepsis in another two postoperatively. Nearly complete removal of thrombus was demonstrated by contrast-enhanced CT scan and portography before discharge. Patients were discharged in 10–27 (19.25 ± 4.89) days after admission. No recurrence developed during the follow-up of 10–13 (12.13 ± 0.99) months.ConclusionsCatheter-directed thrombolytic and aspiration therapy via SMV+SMA is beneficial for ASMVT in avoiding patient death, efficient resolving thrombus, rapid improving symptoms, reversing extensive intestinal ischemia, averting bowel resection, or localizing infarcted bowel segment and preventing short bowel syndrome

Acute Superior Mesenteric Venous Thrombosis: Transcatheter Thrombolysis and Aspiration Thrombectomy Therapy by Combined Route of Superior Mesenteric Vein and Artery in Eight Patients

Energy Technology Data Exchange (ETDEWEB)

Yang, Shuofei, E-mail: yangshuofei@gmail.com; Liu, Baochen, E-mail: 306446264@qq.com; Ding, Weiwei, E-mail: dingwei-nju@hotmail.com; He, Changsheng, E-mail: hechsh@163.com; Wu, Xingjiang, E-mail: wuxingjiang@sohu.com; Li, Jieshou, E-mail: lijieshou2013@sohu.com [Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University (China)

2015-02-15

PurposeTo assess the feasibility, effectiveness, and safety of catheter-directed thrombolysis and aspiration thrombectomy therapy by combined route of superior mesenteric vein and artery (SMV+SMA) for acute superior mesenteric venous thrombosis (ASMVT).MethodsThis retrospective study reviewed eight ASMVT patients with transcatheter direct thrombolysis and aspiration thrombectomy therapy via SMV and indirect thrombolysis via SMA during a period of 14 months. The demographics, etiology, risk factors, therapeutic effect, complications, mortality, and follow-up of the study population were assessed. Anatomic and imaging classification of location and extent of thrombus at diagnosis and degree of thrombus lysis were described.ResultsTechnical success was achieved with substantial improvement in symptoms and thrombus resolution after thrombolytic therapy in all patients. The local urokinase infusion by SMA and SMV was performed for 5–7 (6.13 ± 0.83) and 7–15 (12 ± 2.51) days. Anticoagulation was performed catheter-directed and then orally throughout hospitalization and after discharge. Four patients required delayed localized bowel resection after thrombolytic therapy with no death. Thrombolytic therapy was not interrupted despite minor bleeding at the puncture site in two patients and sepsis in another two postoperatively. Nearly complete removal of thrombus was demonstrated by contrast-enhanced CT scan and portography before discharge. Patients were discharged in 10–27 (19.25 ± 4.89) days after admission. No recurrence developed during the follow-up of 10–13 (12.13 ± 0.99) months.ConclusionsCatheter-directed thrombolytic and aspiration therapy via SMV+SMA is beneficial for ASMVT in avoiding patient death, efficient resolving thrombus, rapid improving symptoms, reversing extensive intestinal ischemia, averting bowel resection, or localizing infarcted bowel segment and preventing short bowel syndrome.

Thromboembolic Risk of Endovascular Intervention for Lower Extremity Deep Venous Thrombosis.

Science.gov (United States)

Lindsey, Philip; Echeverria, Angela; Poi, Mun J; Matos, Jesus; Bechara, Carlos F; Cheung, Mathew; Lin, Peter H

2018-05-01

This study evaluated the risk of thromboembolism during endovascular interventions in patients with symptomatic lower extremity deep vein thrombosis (DVT) METHODS: Clinical records of all patients who underwent endovascular interventions for symptomatic lower extremity DVT from 2001 to 2017 were retrospectively analyzed using a prospectively maintained database. Only patients who received an inferior vena cava (IVC) filter were included in the analysis. Trapped intrafilter thrombus was assessed for procedure-related thromboembolism. Clinical outcomes of thrombus management and thromboembolism risk were analyzed. A total 172 patients (mean age 57.4 years, 98 females) who underwent 174 endovascular DVT interventions were included in the analysis. Treatment strategies included thrombolytic therapy (64%), mechanical thrombectomy (n = 86%), pharmacomechanical thrombolysis (51%), balloon angioplasty (98%), and stent placement (28%). Thrombectomy device used included AngioJet (56%), Trellis (19%), and Aspire (11%). Trapped IVC filter thrombus was identified in 58 patients (38%) based on the IVC venogram. No patient developed clinically evident pulmonary embolism (PE). IVC filter retrieval was performed in 98 patients (56%, mean 11.8 months after implantation). Multivariate analysis showed that iliac vein occlusion (P = 0.04) was predictive for procedure-related thromboembolism. Iliac vein thrombotic occlusion is associated with an increased thromboembolic risk in DVT intervention. Retrievable IVC filter should be considered when performing percutaneous thrombectomy in patients with iliac venous occlusion to prevent PE. Copyright © 2017 Elsevier Inc. All rights reserved.

The nanocoherer: an electrically and mechanically resettable resistive switching device based on gold clusters assembled on paper

Science.gov (United States)

Minnai, Chloé; Mirigliano, Matteo; Brown, Simon A.; Milani, Paolo

2018-03-01

We report the realization of a resettable resistive switching device based on a nanostructured film fabricated by supersonic cluster beam deposition of gold clusters on plain paper substrates. Through the application of suitable voltage ramps, we obtain, in the same device, either a complex pattern of resistive switchings, or reproducible and stable switchings between low resistance and high resistance states, with an amplitude up to five orders of magnitude. Our device retains a state of internal resistance following the history of the applied voltage similar to that reported for memristors. The two different switching regimes in the same device are both stable, the transition between them is reversible, and it can be controlled by applying voltage ramps or by mechanical deformation of the substrate. The device behavior can be related to the formation, growth and breaking of junctions between the loosely aggregated gold clusters forming the nanostructured films. The fact that our cluster-assembled device is mechanically resettable suggests that it can be considered as the analog of the coherer: a switching device based on metallic powders used for the first radio communication system.

Stroke treatment academic industry roundtable: research priorities in the assessment of neurothrombectomy devices.

Science.gov (United States)

Saver, Jeffrey L; Jovin, Tudor G; Smith, Wade S; Albers, Gregory W; Baron, Jean-Claude; Boltze, Johannes; Broderick, Joseph P; Davis, Lisa A; Demchuk, Andrew M; DeSena, Salvatore; Fiehler, Jens; Gorelick, Philip B; Hacke, Werner; Holt, Bill; Jahan, Reza; Jing, Hui; Khatri, Pooja; Kidwell, Chelsea S; Lees, Kennedy R; Lev, Michael H; Liebeskind, David S; Luby, Marie; Lyden, Patrick; Megerian, J Thomas; Mocco, J; Muir, Keith W; Rowley, Howard A; Ruedy, Richard M; Savitz, Sean I; Sipelis, Vitas J; Shimp, Samuel K; Wechsler, Lawrence R; Wintermark, Max; Wu, Ona; Yavagal, Dileep R; Yoo, Albert J

2013-12-01

The goal of the Stroke Treatment Academic Industry Roundtable (STAIR) meetings is to advance the development of stroke therapies. At STAIR VIII, consensus recommendations were developed for clinical trial strategies to demonstrate the benefit of endovascular reperfusion therapies for acute ischemic stroke. Prospects for success with forthcoming endovascular trials are robust, because new neurothrombectomy devices have superior reperfusion efficacy compared with earlier-generation interventions. Specific recommendations are provided for trial designs in 3 populations: (1) patients undergoing intravenous fibrinolysis, (2) early patients ineligible for or having failed intravenous fibrinolysis, and (3) wake-up and other late-presenting patients. Among intravenous fibrinolysis-eligible patients, key principles are that CT or MRI confirmation of target arterial occlusions should precede randomization; endovascular intervention should be pursued with the greatest rapidity possible; and combined intravenous and neurothrombectomy therapy is more promising than neurothrombectomy alone. Among patients ineligible for or having failed intravenous fibrinolysis, scientific equipoise was affirmed and the need to randomize all eligible patients emphasized. Vessel imaging to confirm occlusion is mandatory, and infarct core and penumbral imaging is desirable in later time windows. Additional STAIR VIII recommendations include approaches to test multiple devices in a single trial, utility weighting of disability end points, and adaptive designs to delineate time and tissue injury thresholds at which benefits from intervention no longer accrue. Endovascular research priorities in acute ischemic stroke are to perform trials testing new, highly effective neuro thrombectomy devices rapidly deployed in patients confirmed to have target vessel occlusions.

Mechanization devices for maintenance of technological components of nuclear power plant primary circuit

International Nuclear Information System (INIS)

Palicka, L.; Blazek, J.

1987-01-01

Selected mechanization devices are described, developed for assembly and repair jobs and for decontamination of the steam generator, the main closing valve and the main circulating pump of a WWER-440 nuclear power plant. (author). 8 figs., 3 tabs., 10 refs

Shock wave effects in copper: Design of an experimental device for post recovery mechanical testing

International Nuclear Information System (INIS)

Buy, Francois; Llorca, Fabrice

2002-01-01

The mechanical behavior of metals may prove high changes with strain rate and pressure loading history. In order to investigate the effect of a shock on the ulterior mechanical behavior of high purity copper, we set up an experimental device inspired from G. T. Gray III's works. This device, based on the trapping of shock waves after a plane plate impact is validated by numerical simulations. The aim of these simulations is the evaluation of the heterogeneity of plastic deformation. Shock pressures up to 10 GPa have been investigated. The plastic strain levels subsequent to the shock are between 0.08 and 0.15 in the sample

Morphable 3D mesostructures and microelectronic devices by multistable buckling mechanics

Science.gov (United States)

Fu, Haoran; Nan, Kewang; Bai, Wubin; Huang, Wen; Bai, Ke; Lu, Luyao; Zhou, Chaoqun; Liu, Yunpeng; Liu, Fei; Wang, Juntong; Han, Mengdi; Yan, Zheng; Luan, Haiwen; Zhang, Yijie; Zhang, Yutong; Zhao, Jianing; Cheng, Xu; Li, Moyang; Lee, Jung Woo; Liu, Yuan; Fang, Daining; Li, Xiuling; Huang, Yonggang; Zhang, Yihui; Rogers, John A.

2018-03-01

Three-dimensional (3D) structures capable of reversible transformations in their geometrical layouts have important applications across a broad range of areas. Most morphable 3D systems rely on concepts inspired by origami/kirigami or techniques of 3D printing with responsive materials. The development of schemes that can simultaneously apply across a wide range of size scales and with classes of advanced materials found in state-of-the-art microsystem technologies remains challenging. Here, we introduce a set of concepts for morphable 3D mesostructures in diverse materials and fully formed planar devices spanning length scales from micrometres to millimetres. The approaches rely on elastomer platforms deformed in different time sequences to elastically alter the 3D geometries of supported mesostructures via nonlinear mechanical buckling. Over 20 examples have been experimentally and theoretically investigated, including mesostructures that can be reshaped between different geometries as well as those that can morph into three or more distinct states. An adaptive radiofrequency circuit and a concealable electromagnetic device provide examples of functionally reconfigurable microelectronic devices.

Change of the dominant luminescent mechanism with increasing current density in molecularly doped organic light-emitting devices

International Nuclear Information System (INIS)

Zhou Liang; Zhang Hongjie; Meng Qingguo; Liu Fengyi; Yu Jiangbo; Deng Ruiping; Peng Zeping; Li Zhefeng; Guo Zhiyong

2007-01-01

We have fabricated and measured a series of electroluminescent devices with the structure of ITO/TPD/Eu(TTA) 3 phen (x):CBP/BCP/ALQ/LiF/Al, where x is the weight percentage of Eu(TTA) 3 phen (from 0% to 6%). At very low current density, carrier trapping is the dominant luminescent mechanism and the 4% doped device shows the highest electroluminescence (EL) efficiency among all these devices. With increasing current density, Foerster energy transfer participates in EL process. At the current density of 10.0 and 80.0 mA/cm 2 , 2% and 3% doped devices show the highest EL efficiency, respectively. From analysis of the EL spectra and the EL efficiency-current density characteristics, we found that the EL efficiency is manipulated by Foerster energy transfer efficiency at high current density. So we suggest that the dominant luminescent mechanism changes gradually from carrier trapping to Foerster energy transfer with increasing current density. Moreover, the conversion of dominant EL mechanism was suspected to be partly responsible for the EL efficiency roll-off because of the lower EL quantum efficiency of Foerster energy transfer compared with carrier trapping

Investigation on de-trapping mechanisms related to non-monotonic kink pattern in GaN HEMT devices

Directory of Open Access Journals (Sweden)

Chandan Sharma

2017-08-01

Full Text Available This article reports an experimental approach to analyze the kink effect phenomenon which is usually observed during the GaN high electron mobility transistor (HEMT operation. De-trapping of charge carriers is one of the prominent reasons behind the kink effect. The commonly observed non-monotonic behavior of kink pattern is analyzed under two different device operating conditions and it is found that two different de-trapping mechanisms are responsible for a particular kink behavior. These different de-trapping mechanisms are investigated through a time delay analysis which shows the presence of traps with different time constants. Further voltage sweep and temperature analysis corroborates the finding that different de-trapping mechanisms play a role in kink behavior under different device operating conditions.

Investigation on de-trapping mechanisms related to non-monotonic kink pattern in GaN HEMT devices

Science.gov (United States)

Sharma, Chandan; Laishram, Robert; Amit, Rawal, Dipendra Singh; Vinayak, Seema; Singh, Rajendra

2017-08-01

This article reports an experimental approach to analyze the kink effect phenomenon which is usually observed during the GaN high electron mobility transistor (HEMT) operation. De-trapping of charge carriers is one of the prominent reasons behind the kink effect. The commonly observed non-monotonic behavior of kink pattern is analyzed under two different device operating conditions and it is found that two different de-trapping mechanisms are responsible for a particular kink behavior. These different de-trapping mechanisms are investigated through a time delay analysis which shows the presence of traps with different time constants. Further voltage sweep and temperature analysis corroborates the finding that different de-trapping mechanisms play a role in kink behavior under different device operating conditions.

Transport mechanisms acting in toroidal devices: a theoretician's view

International Nuclear Information System (INIS)

Carreras, B.A.

1992-01-01

Understanding the basic mechanisms of transport in toroidal confinement devices remains one of the more challenging scientific issues in magnetic confinement. At the same time, it is a critical issue for the magnetic fusion program. Recent progress in understanding fluctuations and transport has been fostered by the development and use of new diagnostics, bringing new perspectives on these studies. This has stimulated new theoretical developments. A view of the most recent issues and progress in this area is given. The role of long wavelengths in core transport and the relation between shear flows and turbulence at the plasma edge are the primary topics considered. (Author)

Numerical Study on the Thermal Stress and its Formation Mechanism of a Thermoelectric Device

Science.gov (United States)

Pan, Tao; Gong, Tingrui; Yang, Wei; Wu, Yongjia

2018-06-01

The strong thermo-mechanical stress is one of the most critical failure mechanisms that affect the durability of thermoelectric devices. In this study, numerical simulations on the formation mechanism of the maximum thermal stress inside the thermoelectric device have been performed by using finite element method. The influences of the material properties and the thermal radiation on the thermal stress have been examined. The results indicate that the maximum thermal stress was located at the contact position between the two materials and occurred due to differential thermal expansions and displacement constraints of the materials. The difference in the calculated thermal stress value between the constant and the variable material properties was between 3% and 4%. At a heat flux of 1 W·cm-2 and an emissivity of 0.5, the influence of the radiation heat transfer on the thermal stress was only about 5%; however, when the heat flux was 20 W·cm-2 and the emissivity was 0.7, the influence of the radiation heat transfer was more than 30%.

Security Mechanism Based on Hospital Authentication Server for Secure Application of Implantable Medical Devices

Science.gov (United States)

2014-01-01

After two recent security attacks against implantable medical devices (IMDs) have been reported, the privacy and security risks of IMDs have been widely recognized in the medical device market and research community, since the malfunctioning of IMDs might endanger the patient's life. During the last few years, a lot of researches have been carried out to address the security-related issues of IMDs, including privacy, safety, and accessibility issues. A physician accesses IMD through an external device called a programmer, for diagnosis and treatment. Hence, cryptographic key management between IMD and programmer is important to enforce a strict access control. In this paper, a new security architecture for the security of IMDs is proposed, based on a 3-Tier security model, where the programmer interacts with a Hospital Authentication Server, to get permissions to access IMDs. The proposed security architecture greatly simplifies the key management between IMDs and programmers. Also proposed is a security mechanism to guarantee the authenticity of the patient data collected from IMD and the nonrepudiation of the physician's treatment based on it. The proposed architecture and mechanism are analyzed and compared with several previous works, in terms of security and performance. PMID:25276797

Security mechanism based on Hospital Authentication Server for secure application of implantable medical devices.

Science.gov (United States)

Park, Chang-Seop

2014-01-01

After two recent security attacks against implantable medical devices (IMDs) have been reported, the privacy and security risks of IMDs have been widely recognized in the medical device market and research community, since the malfunctioning of IMDs might endanger the patient's life. During the last few years, a lot of researches have been carried out to address the security-related issues of IMDs, including privacy, safety, and accessibility issues. A physician accesses IMD through an external device called a programmer, for diagnosis and treatment. Hence, cryptographic key management between IMD and programmer is important to enforce a strict access control. In this paper, a new security architecture for the security of IMDs is proposed, based on a 3-Tier security model, where the programmer interacts with a Hospital Authentication Server, to get permissions to access IMDs. The proposed security architecture greatly simplifies the key management between IMDs and programmers. Also proposed is a security mechanism to guarantee the authenticity of the patient data collected from IMD and the nonrepudiation of the physician's treatment based on it. The proposed architecture and mechanism are analyzed and compared with several previous works, in terms of security and performance.

BRAKE DEVICE

Science.gov (United States)

O'Donnell, T.J.

1959-03-10

A brake device is described for utilization in connection with a control rod. The device comprises a pair of parallelogram link mechanisms, a control rod moveable rectilinearly therebetween in opposite directions, and shoes resiliently supported by the mechanism for frictional engagement with the control rod.

507 mechanical movements mechanisms and devices

CERN Document Server

Brown, Henry T

2005-01-01

Epicyclic trains, oblique rollers, trip hammers, and lazy-tongs are among the ingenious mechanisms defined and illustrated in this intriguing collection. Spanning the first century of the Industrial Revolution, this 1868 compilation features simplified, concise illustrations of the mechanisms used in hydraulics, steam engines, pneumatics, presses, horologes, and scores of other machines.The movements of each of the 507 mechanisms are depicted in drawings on the left-hand page, and the facing page presents a brief description of the item's use and operation. Ranging from simple to intricately c

PARAMETER DETERMINATION FOR ADDITIONAL OPERATING FORCE MECHANISM IN DEVICE FOR PNEUMO-CENTRIFUGAL MACHINING OF BALL-SHAPED WORKPIECES

Directory of Open Access Journals (Sweden)

A. A. Sukhotsky

2014-01-01

Full Text Available The paper describes development of the methodology for optimization of parameters for an additional operating force mechanism in a device for pneumo-centrifugal machining of glass balls. Specific feature in manufacturing glass balls for micro-optics in accordance with technological process for obtaining ball-shaped workpieces is grinding and polishing of spherical surface in a free state. In this case component billets of future balls are made in the form of cubes and the billets are given preliminary a form of ball with the help of rough grinding. An advanced method for obtaining ball-shaped work-pieces from brittle materials is a pneumocentrifugal machining. This method presupposes an application of two conic rings with abrasive working surfaces which are set coaxially with large diameters to each other and the billets are rolled along these rings. Rotation of the billets is conveyed by means of pressure medium.The present devices for pneumo-centrifugal machining are suitable for obtaining balls up to 6 mm. Machining of the work-pieces with full spherical surfaces and large diameter is non-productive due to impossibility to ensure a sufficient force on the billet in the working zone. For this reason the paper proposes a modified device where an additional force on the machined billet is created by upper working disc that is making a reciprocating motion along an axis of abrasive conic rings. The motion is realized with the help of a cylindrical camshaft mechanism in the form of a ring with a profile working end face and the purpose of present paper is to optimize parameters of the proposed device.The paper presents expressions for calculation of constitutive parameters of the additional operating force mechanism including parameters of loading element motion, main dimensions of the additional operating force mechanism and parameters of a profile element in the additional operating force mechanism.Investigation method is a mathematical

Effects of sterilization on the mechanical properties of poly(methyl methacrylate) based personalized medical devices.

Science.gov (United States)

Münker, T J A G; van de Vijfeijken, S E C M; Mulder, C S; Vespasiano, V; Becking, A G; Kleverlaan, C J; Becking, A G; Dubois, L; Karssemakers, L H E; Milstein, D M J; van de Vijfeijken, S E C M; Depauw, P R A M; Hoefnagels, F W A; Vandertop, W P; Kleverlaan, C J; Münker, T J A G; Maal, T J J; Nout, E; Riool, M; Zaat, S A J

2018-05-01

Nowadays, personalized medical devices are frequently used for patients. Due to the manufacturing procedure sterilization is required. How different sterilization methods affect the mechanical behavior of these devices is largely unknown. Three poly(methyl methacrylate) (PMMA) based materials (Vertex Self-Curing, Palacos R+G, and NextDent C&B MFH) were sterilized with different sterilization methods: ethylene oxide, hydrogen peroxide gas plasma, autoclavation, and γ-irradiation. Mechanical properties were determined by testing the flexural strength, flexural modulus, fracture toughness, and impact strength. The flexural strength of all materials was significantly higher after γ-irradiation compared to the control and other sterilization methods, as tested in a wet environment. NextDent C&B MFH showed the highest flexural and impact strength, Palacos R+G showed the highest maximum stress intensity factor and total fracture work. Autoclave sterilization is not suitable for the sterilization of PMMA-based materials. Ethylene oxide, hydrogen peroxide gas plasma, and γ-irradiation appear to be suitable techniques to sterilize PMMA-based personalized medical devices. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

A novel mechanical design of broken rope protection device for enhancing the safety performances of overhead manned equipment in coal mine

Directory of Open Access Journals (Sweden)

Xiaoguang Zhang

2015-08-01

Full Text Available A novel mechanical design of the broken rope protection device is proposed to enhance the safety performances of the overhead manned equipment. According to the operating characteristics and functional requirements of the overhead manned equipment, a three-dimensional mechanical model of the broken rope protection device was redesigned. Based on the known parameters of the mechanical model, the stress and strength of the main components are readjusted using the statics characteristics of finite element analysis. To ensure the reliability of the control system of the broken rope protection device, the process of people’s falling, the response performance of the tension sensor, and the signal extraction of the broken rope are analyzed under different loading and unloading speeds. The working principle of the broken rope protection device is expounded in detail. The experimental results showed that better effect is obtained by the new broken rope protection device, which is characterized by good durability, low investment, and high reliability.

High Temperature Electro-Mechanical Devices For Nuclear Applications

International Nuclear Information System (INIS)

Robertson, D.

2010-01-01

Nuclear power plants require a number of electro-mechanical devices, for example, Control Rod Drive Mechanisms (CRDM's) to control the raising and lowering of control rods and Reactor Coolant Pumps (RCP's) to circulate the primary coolant. There are potential benefits in locating electro-mechanical components in areas of the plant with high ambient temperatures. One such benefit is the reduced need to make penetrations in pressure vessels leading to simplified plant design and improved inherent safety. The feature that limits the ambient temperature at which most electrical machines may operate is the material used for the electrical insulation of the machine windings. Conventional electrical machines generally use polymer-based insulation that limits the ambient temperature they can operate in to below 200 degrees Celsius. This means that when a conventional electrical machine is required to operate in a hot area it must be actively cooled necessitating additional systems. This paper presents data gathered during investigations undertaken by Rolls-Royce into the design of high temperature electrical machines. The research was undertaken at Rolls-Royce's University Technology Centre in Advanced Electrical Machines and Drives at Sheffield University. Rolls- Royce has also been investigating high temperature wire and encapsulants and latterly techniques to provide high temperature insulation to terminations. Rolls-Royce used the experience gained from these tests to produce a high temperature electrical linear actuator at sizes representative of those used in reactor systems. This machine was tested successfully at temperatures equivalent to those found inside the reactor vessel of a pressurised water reactor through a full series of operations that replicated in service duty. The paper will conclude by discussing the impact of the findings and potential electro-mechanical designs that may utilise such high temperature technologies. (authors)

Systematic review: comparative effectiveness of adjunctive devices in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention of native vessels

Directory of Open Access Journals (Sweden)

Sobieraj Diana M

2011-12-01

by 39% although the use of mechanical thrombectomy or embolic protection devices did not significantly impact other final health outcomes. Distal balloon or any embolic protection device increased the achievement of MBG-3 by 61% and 20% and TIMI3 flow by 11% and 6% but did not significantly impact other intermediate outcomes versus control. Upon qualitative analysis, all device categories, with exception of catheter aspiration devices, appear to significantly prolong procedure time compared to PCI alone while none appear to significantly impact ejection fraction. Many of the final health outcome and adverse event evaluations were underpowered and the safety of devices overall is unclear due to insufficient amounts of data. Conclusions In patients with STEMI, for most devices, few RCTs evaluated final health outcomes over a long period of follow-up. Due to insufficient data, the safety of these devices is unclear.

On a mechanism of switching off low-hybrid run away currents in tokamak devices

International Nuclear Information System (INIS)

Budnikov, V.N.; Esipov, L.A.; Irzak, M.A.

1990-01-01

The problem of the generation of low-hybrid run-away currents (LR) in tokamak devices is described. The mechanism of switching off LRCs is considered. Qualitative representation of the density limit, the transitions of which stops the generation of currents, is given

Hemocompatibility of Axial Versus Centrifugal Pump Technology in Mechanical Circulatory Support Devices.

Science.gov (United States)

Schibilsky, David; Lenglinger, Matthias; Avci-Adali, Meltem; Haller, Christoph; Walker, Tobias; Wendel, Hans Peter; Schlensak, Christian

2015-08-01

The hemocompatible properties of rotary blood pumps commonly used in mechanical circulatory support (MCS) are widely unknown regarding specific biocompatibility profiles of different pump technologies. Therefore, we analyzed the hemocompatibility indicating markers of an axial flow and a magnetically levitated centrifugal device within an in vitro mock loop. The HeartMate II (HM II; n = 3) device and a CentriMag (CM; n = 3) adult pump were investigated in a human whole blood mock loop for 360 min using the MCS devices as a driving component. Blood samples were analyzed by enzyme-linked immunosorbent assay for markers of coagulation, complement system, and inflammatory response. There was a time-dependent activation of the coagulation (thrombin-antithrombin complexes [TAT]), complement (SC5b-9), and inflammation system (polymorphonuclear [PMN] elastase) in both groups. The mean value of TAT (CM: 4.0 μg/L vs. 29.4 μg/L, P technologies and a magnetically levitated centrifugal pump design might be superior. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals Inc.

Charge transport mechanism in p-type copper ion containing triazine thiolate metallopolymer thin film devices

Science.gov (United States)

K, Deepak; Roy, Amit; Anjaneyulu, P.; Kandaiah, Sakthivel; Pinjare, Sampatrao L.

2017-10-01

The charge transport mechanism in copper ions containing 1,3,5-Triazine-2,4,6-trithiolate (CuTCA) based polymer device in sandwich (Ag/CuTCA/Cu) geometry is studied. The current-voltage (I-V) characteristics of the metallopolymer CuTCA device have shown a transition in the charge transport mechanism from Ohmic to Space-charge limited conduction when temperature and voltage are varied. The carriers in CuTCA devices exhibit hopping transport, in which carriers hop from one site to the other. The hole mobility in this polymer device is found to be dependent on electric field E ( μpα√{E } ) and temperature, which suggests that the polymer has inherent disorder. The electric-field coefficient γ and zero-field mobility μ0 are temperature dependent. The values of mobility and activation energies are estimated from temperature (90-140 K) dependent charge transport studies and found to be in the range of 1 × 10-11-8 × 10-12 m2/(V s) and 16.5 meV, respectively. Temperature dependent electric-field coefficient γ is in the order of 17.8 × 10-4 (m/V)1/2, and the value of zero-field mobility μ0 is in the order of 1.2 × 10-11 m2/(V s) at 140 K. A constant phase element (Q) is used to model the device parameters, which are extracted using the Impedance spectroscopy technique. The bandgap of the polymer is estimated to be 2.6 eV from UV-Vis reflectance spectra.

Security Mechanism Based on Hospital Authentication Server for Secure Application of Implantable Medical Devices

Directory of Open Access Journals (Sweden)

Chang-Seop Park

2014-01-01

Full Text Available After two recent security attacks against implantable medical devices (IMDs have been reported, the privacy and security risks of IMDs have been widely recognized in the medical device market and research community, since the malfunctioning of IMDs might endanger the patient’s life. During the last few years, a lot of researches have been carried out to address the security-related issues of IMDs, including privacy, safety, and accessibility issues. A physician accesses IMD through an external device called a programmer, for diagnosis and treatment. Hence, cryptographic key management between IMD and programmer is important to enforce a strict access control. In this paper, a new security architecture for the security of IMDs is proposed, based on a 3-Tier security model, where the programmer interacts with a Hospital Authentication Server, to get permissions to access IMDs. The proposed security architecture greatly simplifies the key management between IMDs and programmers. Also proposed is a security mechanism to guarantee the authenticity of the patient data collected from IMD and the nonrepudiation of the physician’s treatment based on it. The proposed architecture and mechanism are analyzed and compared with several previous works, in terms of security and performance.

Lansce Wire Scanning Diagnostics Device Mechanical Design

International Nuclear Information System (INIS)

Rodriguez Esparza, Sergio; Batygin, Yuri K.; Gilpatrick, John D.; Gruchalla, Michael E.; Maestas, Alfred J.; Pillai, Chandra; Raybun, Joseph L.; Sattler, F.D.; Sedillo, James Daniel; Smith, Brian G.

2011-01-01

The Accelerator Operations and Technology Division at Los Alamos National Laboratory operates a linear particle accelerator which utilizes 110 wire scanning diagnostics devices to gain position and intensity information of the proton beam. In the upcoming LANSCE improvements, 51 of these wire scanners are to be replaced with a new design, up-to-date technology and off-the-shelf components. This document outlines the requirements for the mechanical design of the LANSCE wire scanner and presents the recently developed linac wire scanner prototype. Additionally, this document presents the design modifications that have been implemented into the fabrication and assembly of this first linac wire scanner prototype. Also, this document will present the design for the second, third, and fourth wire scanner prototypes being developed. Prototypes 2 and 3 belong to a different section of the particle accelerator and therefore have slightly different design specifications. Prototype 4 is a modification of a previously used wire scanner in our facility. Lastly, the paper concludes with a plan for future work on the wire scanner development.

Lansce Wire Scanning Diagnostics Device Mechanical Design

Energy Technology Data Exchange (ETDEWEB)

Rodriguez Esparza, Sergio [Los Alamos National Laboratory; Batygin, Yuri K. [Los Alamos National Laboratory; Gilpatrick, John D. [Los Alamos National Laboratory; Gruchalla, Michael E. [Los Alamos National Laboratory; Maestas, Alfred J. [Los Alamos National Laboratory; Pillai, Chandra [Los Alamos National Laboratory; Raybun, Joseph L. [Los Alamos National Laboratory; Sattler, F. D. [Los Alamos National Laboratory; Sedillo, James Daniel [Los Alamos National Laboratory; Smith, Brian G. [Los Alamos National Laboratory

2011-01-01

The Accelerator Operations & Technology Division at Los Alamos National Laboratory operates a linear particle accelerator which utilizes 110 wire scanning diagnostics devices to gain position and intensity information of the proton beam. In the upcoming LANSCE improvements, 51 of these wire scanners are to be replaced with a new design, up-to-date technology and off-the-shelf components. This document outlines the requirements for the mechanical design of the LANSCE wire scanner and presents the recently developed linac wire scanner prototype. Additionally, this document presents the design modifications that have been implemented into the fabrication and assembly of this first linac wire scanner prototype. Also, this document will present the design for the second, third, and fourth wire scanner prototypes being developed. Prototypes 2 and 3 belong to a different section of the particle accelerator and therefore have slightly different design specifications. Prototype 4 is a modification of a previously used wire scanner in our facility. Lastly, the paper concludes with a plan for future work on the wire scanner development.

Corpuls cpr resuscitation device generates superior emulated flows and pressures than LUCAS II in a mechanical thorax model.

Science.gov (United States)

Eichhorn, S; Mendoza Garcia, A; Polski, M; Spindler, J; Stroh, A; Heller, M; Lange, R; Krane, M

2017-06-01

The provision of sufficient chest compression is among the most important factors influencing patient survival during cardiopulmonary resuscitation (CPR). One approach to optimize the quality of chest compressions is to use mechanical-resuscitation devices. The aim of this study was to compare a new device for chest compression (corpuls cpr) with an established device (LUCAS II). We used a mechanical thorax model consisting of a chest with variable stiffness and an integrated heart chamber which generated blood flow dependent on the compression depth and waveform. The method of blood-flow generation could be changed between direct cardiac-compression mode and thoracic-pump mode. Different chest-stiffness settings and compression modes were tested to generate various blood-flow profiles. Additionally, an endurance test at high stiffness was performed to measure overall performance and compression consistency. Both resuscitation machines were able to compress the model thorax with a frequency of 100/min and a depth of 5 cm, independent of the chosen chest stiffness. Both devices passed the endurance test without difficulty. The corpuls cpr device was able to generate about 10-40% more blood flow than the LUCAS II device, depending on the model settings. In most scenarios, the corpuls cpr device also generated a higher blood pressure than the LUCAS II. The peak compression forces during CPR were about 30% higher using the corpuls cpr device than with the LUCAS II. In this study, the corpuls cpr device had improved blood flow and pressure outcomes than the LUCAS II device. Further examination in an animal model is required to prove the findings of this preliminary study.

Electron beam and mechanical lithographies as enabling factors for organic-based device fabrication

International Nuclear Information System (INIS)

Visconti, P.; Pisignano, D.; Della Torre, A.; Persano, L.; Maruccio, G.; Biasco, A.; Cingolani, R.; Rinaldi, R.

2005-01-01

Organic-based photonics and molecular electronics are attracting an increasing interest in modern science. The realization of high-resolution master structures by electron beam lithography (EBL) and their transfer to different organic functional materials by mechanical lithographies allow to fully exploit the wide flexibility of molecular systems for opto- and nanoelectronic devices. Planar nanojunctions, consisting of two metallic electrodes separated by an insulating medium, permit to test the molecular conduction properties. Since the typical size of a biomolecule is of the order of a few nanometer, hybrid molecular electronic (HME) devices need metallic electrodes separated by a nanometer-scale channel. Conversely, photonic applications often require 100 nm to 1 μm features on large areas. In this work, we report on the fabrication of both large-area periodic master structures with resolution down to 200 nm, and planar metallic electrodes with sub-10 nm separation obtained by EBL followed by metal electroplating deposition. The fabricated 3-terminal bio-nanodevices show a transistor-like behaviour with a maximum voltage gain of 0.76. Moreover, we developed a number of mechanical patterning methods, including soft hot embossing, rapid prototyping, sub-micrometer fluidics, high- and room-temperature nanoimprinting, to fabricate planar nanostructures on both biomolecular and organic materials. These allowed us a high-fidelity pattern transfer up to 100-nm scale resolution, without reducing the emission yields of light-emitting organics, thus opening the way to the one-step realization of organic-based confined optoelectronic devices

Prototype of a mechanical assistance device for the wrists' flexion-extension movement

International Nuclear Information System (INIS)

Politti, Julio C; Puglisi, Lisandro J; Farfan, Fernando D

2007-01-01

Using CMU actuators, a Prototype of Mechanical Assistance Device for the Wrist's Flexion Movement (PMA) was developed and probed in a mechanical model, in order to be implemented in a future as a dynamic powered orthosis or as a rehabilitation assistant instrument. Two Mayor Actuators conformed by three CMU actuators arranged in a series configuration, allows to an artificial hand to be placed in four predefined positions: 0 0 , 20 0 , 40 0 and 60 0 . The synchronism and control of the actuators is achieved with the Programmable Control Module (PCM). It is capable to drive up to six CMU actuators, and possess two different modes of execution: a Manual mode and an Exercise mode. In the Manual Mode, the position of the hand responds directly to the commands of the keyboard of the front panel, and in the Exercise mode, the hand realizes a repetitive and programmed movement. The prototype was tested in 100 positions in the Manual Mode and for 225 works cycles in the Exercise Mode. The relative repetition error was less than 5% for both test. This prototype only consumes 4,15W, which makes it possible to be powered by small rechargeable batteries, allowing its use as a portable device

Conducting mechanisms of forming-free TiW/Cu{sub 2}O/Cu memristive devices

Energy Technology Data Exchange (ETDEWEB)

Yan, P.; Li, Y.; Hui, Y. J.; Zhong, S. J.; Zhou, Y. X.; Xu, L.; Liu, N.; Qian, H.; Sun, H. J., E-mail: shj@mail.hust.edu.cn; Miao, X. S. [Wuhan National Laboratory for Optoelectronics (WNLO), Huazhong University of Science and Technology (HUST), Wuhan 430074 (China); School of Optical and Electronic Information, Huazhong University of Science and Technology, Wuhan 430074 (China)

2015-08-24

P-type Cu{sub 2}O is a promising CMOS-compatible candidate to fabricate memristive devices for next-generation memory, logic and neuromorphic computing. In this letter, the microscopic switching and conducting mechanisms in TiW/Cu{sub 2}O/Cu memristive devices have been thoroughly investigated. The bipolar resistive switching behaviors without an electro-forming process are ascribed to the formation and rupture of the conducting filaments composed of copper vacancies. In the low resistive state, the transport of electrons in the filaments follows Mott's variable range hopping theory. When the devices switch back to high resistive state, the coexistence of Schottky emission at the Cu/Cu{sub 2}O interface and electron hopping between the residual filaments is found to dominate the conducting process. Our results will contribute to the further understanding and optimization of p-type memristive materials.

Testing device for pipeline groups and control method for testing device

International Nuclear Information System (INIS)

Naito, Shinji; Kajiyama, Shigeru; Takahashi, Fuminobu; Tsuchida, Kenji; Tachibana, Yukio; Shigehiro, Katsuya; Mahara, Yoichi.

1995-01-01

The device of the present invention comprises a testing device main body disposed to a rail, a movable mechanism positioning from a reference point, a circumferential direction scanning mechanism, an axial direction scanning mechanism, a posture control mechanism, and a testing probe. Upon testing of pipelines, the detection device main body and auxiliary members are moved from a reference point previously set on a rail for numerical control toward pipelines to be tested in a state where the axial direction scanning mechanism and the testing probe are suspended in the axial direction. The testing is conducted by controlling the position of the testing probe in the axial direction of the pipeline by means of the axial direction scanning mechanism, and scanning the testing probe to the outer circumference of the pipeline along the circumferential track by way of the circumferential direction scanning mechanism. The device can be extremely reduced in the thickness, and can be moved with no interference with pipelines and other obstacles by remote operation even under such undesired condition as the pipelines being crowded, so that non-destructive testing can be conducted accurately. (N.H.)

Manufacturing and testing flexible microfluidic devices with optical and electrical detection mechanisms

OpenAIRE

Ivan, M.G.; Vivet, F.; Meinders, E.R.

2010-01-01

Flexible microfluidic devices made of poly(dimethylsiloxane) (PDMS) were manufactured by soft lithography, and tested in detection of ionic species using optical absorption spectroscopy and electrical measurements. PDMS was chosen due to its flexibility and ease of surface modification by exposure to plasma and UV treatment, its transparency in UV-Vis regions of the light spectrum, and biocompatibility. The dual-detection mechanism allows the user more freedom in choosing the detection tool, ...

Manufacturing and testing flexible microfluidic devices with optical and electrical detection mechanisms

Science.gov (United States)

Ivan, Marius G.; Vivet, Frédéric; Meinders, Erwin R.

2010-06-01

Flexible microfluidic devices made of poly(dimethylsiloxane) (PDMS) were manufactured by soft lithography, and tested in detection of ionic species using optical absorption spectroscopy and electrical measurements. PDMS was chosen due to its flexibility and ease of surface modification by exposure to plasma and UV treatment, its transparency in UV-Vis regions of the light spectrum, and biocompatibility. The dual-detection mechanism allows the user more freedom in choosing the detection tool, and a functional device was successfully tested. Optical lithography was employed for manufacturing templates, which were subsequently used for imprinting liquid PDMS by thermal curing. Gold electrodes having various widths and distances among them were patterned with optical lithography on the top part which sealed the microchannels, and the devices were employed for detection of ionic species in aqueous salt solutions as well as micro-electrolysis cells. Due to the transparency of PDMS in UV-Vis the microfluidics were also used as photoreactors, and the in-situ formed charged species were monitored by applying a voltage between electrodes. Upon addition of a colorimetric pH sensor, acid was detected with absorption spectroscopy.

Mechanical device for enhancing halo density in the TMX-U tandem mirror

International Nuclear Information System (INIS)

Hsu, W.L.; Barr, W.L.; Simonen, T.C.

1984-04-01

The halo recycler, a mechanical device similar to pumped limiters used in tokamaks, is studied as a means of enhancing the halo plasma density in the Tandem Mirror Experiment Upgrade (TMX-U). The recycler structure consists of an annular chamber at each end of the tandem mirror device where the halo plasma is collected. The halo plasma density is increased by recycling the halo ions as they are neutralized by the collector plate. With sufficient power fed into the halo electrons, the recycler can sustain an upstream electron temperature of 30 eV for effective halo shielding while maintaining a low temperature of 5 eV near the collector plate to reduce sputtering. A power flow model has shown that the required power for heating the halo is low enough to make the halo recycler a practical concept

Endovascular treatment of stroke. When and How?

International Nuclear Information System (INIS)

Mantatzis, M.

2012-01-01

Full text: It is well known that stroke is the third leading cause of death and the most common cause of permanent disability in the Western countries. Ischemic stroke is the commonest between the causes and atheroembolic events is principally involved. Intravenous thrombolysis (IVT) has dramatically changed the treatment mentality which previously was mostly supportive and didn't change significantly the prognosis. IVT is now considered the standard of care, having however certain limitations that have paved the way for the development of endovascular treatment. The main disadvantage of IVT is the relatively limited available time window, leading very few patients to receive the treatment. Intra-arterial options for treatment are not confined to delivery of a thrombolytic drug into the thrombus, but extended to quite variable mechanical options. The use of thrombolytic agents regionally or locally (Intra-arterial Thrombolysis - IAT), although may be allowed for an extended time window comparatively to IVT, has more or less the same disadvantages and the complications that related to the administrated drug. Moreover and despite the good results of several randomized trials, IAT has never granted an FDA approval. Nevertheless its use is included in the AHA/ASA guidelines under recommended in certain situations. IAT can be used as a standalone treatment or may be combined (bridging therapy) with IVT. Endovascular treatment has been boosted however, after the advent of mechanical devices for clot removal in acute stroke. These devices have become more sophisticated nowadays and this treatment is more and more is preferred when endovascular means are considered. Initially, mechanical devices were used for the clot disruption in combination with IAT (augmented thrombolysis). Other devices have been developed aiming to directly remove a clot rather than disrupt or macerate it, and the procedure turned to be a thrombectomy. Many different devices had been used with

A Novel Technique for Endovascular Removal of Large Volume Right Atrial Tumor Thrombus

Energy Technology Data Exchange (ETDEWEB)

Nickel, Barbara, E-mail: nickel.ba@gmail.com [US Teleradiology and Quantum Medical Radiology Group (United States); McClure, Timothy, E-mail: tmcclure@gmail.com; Moriarty, John, E-mail: jmoriarty@mednet.ucla.edu [UCLA Medical Center, Department of Interventional Radiology (United States)

2015-08-15

Venous thromboembolic disease is a significant cause of morbidity and mortality, particularly in the setting of large volume pulmonary embolism. Thrombolytic therapy has been shown to be a successful treatment modality; however, its use somewhat limited due to the risk of hemorrhage and potential for distal embolization in the setting of large mobile thrombi. In patients where either thrombolysis is contraindicated or unsuccessful, and conventional therapies prove inadequate, surgical thrombectomy may be considered. We present a case of percutaneous endovascular extraction of a large mobile mass extending from the inferior vena cava into the right atrium using the Angiovac device, a venovenous bypass system designed for high-volume aspiration of undesired endovascular material. Standard endovascular methods for removal of cancer-associated thrombus, such as catheter-directed lysis, maceration, and exclusion, may prove inadequate in the setting of underlying tumor thrombus. Where conventional endovascular methods either fail or are unsuitable, endovascular thrombectomy with the Angiovac device may be a useful and safe minimally invasive alternative to open resection.

A Novel Technique for Endovascular Removal of Large Volume Right Atrial Tumor Thrombus

International Nuclear Information System (INIS)

Nickel, Barbara; McClure, Timothy; Moriarty, John

2015-01-01

Venous thromboembolic disease is a significant cause of morbidity and mortality, particularly in the setting of large volume pulmonary embolism. Thrombolytic therapy has been shown to be a successful treatment modality; however, its use somewhat limited due to the risk of hemorrhage and potential for distal embolization in the setting of large mobile thrombi. In patients where either thrombolysis is contraindicated or unsuccessful, and conventional therapies prove inadequate, surgical thrombectomy may be considered. We present a case of percutaneous endovascular extraction of a large mobile mass extending from the inferior vena cava into the right atrium using the Angiovac device, a venovenous bypass system designed for high-volume aspiration of undesired endovascular material. Standard endovascular methods for removal of cancer-associated thrombus, such as catheter-directed lysis, maceration, and exclusion, may prove inadequate in the setting of underlying tumor thrombus. Where conventional endovascular methods either fail or are unsuitable, endovascular thrombectomy with the Angiovac device may be a useful and safe minimally invasive alternative to open resection

Thermodynamic Modeling and Mechanical Design of a Liquid Nitrogen Vaporization and Pressure Building Device

Science.gov (United States)

Leege, Brian J.

The design of a liquid nitrogen vaporization and pressure building device that has zero product waste while recovering some of its stored energy is of interest for the cost reduction of nitrogen for use in industrial processes. Current devices may waste up to 30% of the gaseous nitrogen product by venting it to atmosphere. Furthermore, no attempt is made to recover the thermal energy available in the coldness of the cryogen. A seven step cycle with changing volumes and ambient heat addition is proposed, eliminating all product waste and providing the means of energy recovery from the nitrogen. This thesis discusses the new thermodynamic cycle and modeling as well as the mechanical design and testing of a prototype device. The prototype was able to achieve liquid nitrogen vaporization and pressurization up to 1000 psi, while full cycle validation is ongoing with promising initial results.

Catheter Ablation of Atrial Fibrillation in Patients with Hardware in the Heart - Septal Closure Devices, Mechanical Valves and More.

Science.gov (United States)

Bartoletti, Stefano; Santangeli, Pasquale; DI Biase, Luigi; Natale, Andrea

2013-01-01

Patients with mechanical "hardware" in the heart, such as those with mechanical cardiac valves or atrial septal closure devices, represent a population at high risk of developing AF. Catheter ablation of AF in these subjects might represent a challenge, due to the perceived higher risk of complications associated with the presence of intracardiac mechanical devices. Accordingly, such patients were excluded or poorly represented in major trials proving the benefit of catheter ablation for the rhythm-control of AF. However, recent evidence supports the concept that catheter ablation procedures might be equally effective in these patients, without a significant increase in the risk of procedural complications. This review will summarize the current state-of-the-art on catheter ablation of AF in patients with mechanical "hardware" in the heart.

Multifunctional Device based on phosphor-piezoelectric PZT: lighting, speaking, and mechanical energy harvesting.

Science.gov (United States)

Lee, Sunghoon; Kang, Taewook; Lee, Wunho; Afandi, Mohammad M; Ryu, Jongho; Kim, Jongsu

2018-01-10

We demonstrated the tri-functional device based on all powder-processing methods by using ZnS powder as phosphor layer and piezoelectric material as dielectric layer. The fabricated device generated the electroluminescent (EL) light from phosphor and the sound from piezoelectric sheet under a supply of external electric power, and additionally harvested the reverse-piezoelectric energy to be converted into EL light. Under sinusoidal applied voltage, EL luminances were exponentially increased with a maximum luminous efficiency of 1.3 lm/W at 40 V and 1,000 Hz, and sound pressure levels (SPLs) were linearly increased. The EL luminances were linearly dependent on applied frequency while the SPLs showed the parabolic increase behavior below 1,000 Hz and then the flat response. The temperature dependence on EL luminances and SPLs was demonstrated; the former was drastically increased and the latter was slightly decreased with the increase of temperature. Finally, as an energy harvesting application, the piezoelectric-induced electroluminescence effect was demonstrated by applying only mechanical pressure to the device without any external electric power.

Role of Molecular Weight on the Mechanical Device Properties of Organic Polymer Solar Cells

KAUST Repository

Bruner, Christopher

2014-02-11

For semiconducting polymers, such as regioregular poly(3-hexylthiophene-2, 5-diyl) (rr-P3HT), the molecular weight has been correlated to charge carrier field-effect mobilities, surface morphology, and gelation rates in solution and therefore has important implications for long-Term reliability, manufacturing, and future applications of electronic organic thin films. In this work, we show that the molecular weight rr-P3HT in organic solar cells can also significantly change the internal cohesion of the photoactive layer using micromechanical testing techniques. Cohesive values ranged from ∼0.5 to ∼17 J m -2, following the general trend of greater cohesion with increasing molecular weight. Using nanodynamic mechanical analysis, we attribute the increase in cohesion to increased plasticity which helps dissipate the applied energy. Finally, we correlate photovoltaic efficiency with cohesion to assess the device physics pertinent to optimizing device reliability. This research elucidates the fundamental parameters which affect both the mechanical stability and efficiency of polymer solar cells. © 2014 American Chemical Society.

An Authentication and Key Management Mechanism for Resource Constrained Devices in IEEE 802.11-based IoT Access Networks

OpenAIRE

Kim, Ki-Wook; Han, Youn-Hee; Min, Sung-Gi

2017-01-01

Many Internet of Things (IoT) services utilize an IoT access network to connect small devices with remote servers. They can share an access network with standard communication technology, such as IEEE 802.11ah. However, an authentication and key management (AKM) mechanism for resource constrained IoT devices using IEEE 802.11ah has not been proposed as yet. We therefore propose a new AKM mechanism for an IoT access network, which is based on IEEE 802.11 key management with the IEEE 802.1X aut...

An ex vivo porcine skin model to evaluate pressure-reducing devices of different mechanical properties used for pressure ulcer prevention.

Science.gov (United States)

Yeung, Ching-Yan C; Holmes, David F; Thomason, Helen A; Stephenson, Christian; Derby, Brian; Hardman, Matthew J

2016-11-01

Pressure ulcers are complex wounds caused by pressure- and shear-induced trauma to skin and underlying tissues. Pressure-reducing devices, such as dressings, have been shown to successfully reduce pressure ulcer incidence, when used in adjunct to pressure ulcer preventative care. While pressure-reducing devices are available in a range of materials, with differing mechanical properties, understanding of how a material's mechanical properties will influence clinical efficacy remains limited. The aim of this study was to establish a standardized ex vivo model to allow comparison of the cell protection potential of two gel-like pressure-reducing devices with differing mechanical properties (elastic moduli of 77 vs. 35 kPa). The devices also displayed differing energy dissipation under compressive loading, and resisted strain differently under constant load in compressive creep tests. To evaluate biological efficacy we employed a new ex vivo porcine skin model, with a confirmed elastic moduli closely matching that of human skin (113 vs. 119 kPa, respectively). Static loads up to 20 kPa were applied to porcine skin ex vivo with subsequent evaluation of pressure-induced cell death and cytokine release. Pressure application alone increased the percentage of epidermal apoptotic cells from less than 2% to over 40%, and increased cellular secretion of the pro-inflammatory cytokine TNF-alpha. Co-application of a pressure-reducing device significantly reduced both cellular apoptosis and cytokine production, protecting against cellular damage. These data reveal new insight into the relationship between mechanical properties of pressure-reducing devices and their biological effects. After appropriate validation of these results in clinical pressure ulcer prevention with all tissue layers present between the bony prominence and external surface, this ex vivo porcine skin model could be widely employed to optimize design and evaluation of devices aimed at reducing pressure

Anchoring in Destination-Therapy Left Ventricular Assist Device Decision Making: A Mechanical Turk Survey.

Science.gov (United States)

Paine, Arcadia M; Allen, Larry A; Thompson, Jocelyn S; McIlvennan, Colleen K; Jenkins, Amy; Hammes, Andrew; Kroehl, Miranda; Matlock, Daniel D

2016-11-01

People with end-stage heart failure may have to decide about destination-therapy left ventricular assist device (DT-LVAD). Individuals facing difficult decisions often rely on heuristics, such as anchoring, which predictably bias decision outcomes. We aimed to investigate whether showing a larger historical Heartmate XVE creates an anchoring effect, making the smaller Heartmate II (HMII) appear more favorable. With the use of Amazon Mechanical Turk, participants watched videos asking them to imagine themselves dying of end-stage heart failure, then were presented the option of LVAD as potentially life-prolonging therapy. Participants were randomized to a control group who were only shown the HMII device, and the intervention group who saw the XVE device before the HMII. Participants then completed surveys. A total of 487 participants completed the survey (control = 252; intervention = 235); 79% were affect likelihood of accepting the LVAD, it did affect device perception. This article highlights an important point with clinical implications: factors such as anchoring have the potential to inappropriately influence perceptions and decisions and should be carefully considered in research and practice. Copyright © 2016 Elsevier Inc. All rights reserved.

Flight Investigation of a Mechanical Feel Device in an Irreversible Elevator Control System of a Large Airplane

National Research Council Canada - National Science Library

Brown, B

1951-01-01

The longitudinal stability and control characteristics of a large airplane have been measured with a mechanical feel device in combination with a booster incorporated in the elevator-control system...

Control device for a nuclear reactor with a multitude of control rods, extending into the reactor core from above, with linear drive mechanisms and additional gripper devices

International Nuclear Information System (INIS)

Bevilacqua, F.

1979-01-01

The components of the additional gripper devices with magnetically operated finger-shaped latches are separated from the also magnetically operated latches of the linear drive mechanisms in order to avoid common-mode failures when fast shutdown is required. Only part of the safety rods are held by the additional gripping devices in the withdrawn position. There is provided for recording elements indicating positively which one of the safety locks is gearing with the control rods. At the upper end of each control rod there is a coupling head held by electromagnetically operated locking devices in the withdrawn position, if control power is available. (DG) [de

Mechanical property test of natural rubber bearing for the evaluation of uncertainty value of seismic isolation devices

International Nuclear Information System (INIS)

Kim, Min Kyu; Kim, Jung Han; Choi, In Kil

2012-01-01

Seismic safety of NPP is one of the most important issues in a nuclear field after great east Japan earthquake in 2011. For the improvement of seismic safety of nuclear power plant, seismic isolation is the easiest solution for increasing the seismic safety. Otherwise, the application of seismic isolation devices for nuclear power plants doesn't make the seismic risk of NPP increases always. The rubber bearing have many uncertainties of material properties and large displacement should absorb according to the application of isolation devices. In this study, for the evaluation of uncertainty of the material properties of rubber bearing, material tests for rubber and mechanical properties test for natural rubber bearing were performed. For the evaluation of effect of hardness of rubber, 4 kinds of rubber hardness for material property tests and 2 kinds of rubber hardness for mechanical property test were considered. As a result, the variation of material properties is higher than that of mechanical properties of natural rubber bearings

Multiple Coaxial Catheter System for Reliable Access in Interventional Stroke Therapy

International Nuclear Information System (INIS)

Kulcsar, Zsolt; Yilmaz, Hasan; Bonvin, Christophe; Lovblad, Karl O.; Ruefenacht, Daniel A.

2010-01-01

In some patients with acute cerebral vessel occlusion, navigating mechanical thrombectomy systems is difficult due to tortuous anatomy of the aortic arch, carotid arteries, or vertebral arteries. Our purpose was to describe a multiple coaxial catheter system used for mechanical revascularization that helps navigation and manipulations in tortuous vessels. A triple or quadruple coaxial catheter system was built in 28 consecutive cases presenting with acute ischemic stroke. All cases were treated by mechanical thrombectomy with the Penumbra System. In cases of unsuccessful thrombo-aspiration, additional thrombolysis or angioplasty with stent placement was used for improving recanalization. The catheter system consisted of an outermost 8-Fr and an intermediate 6-Fr guiding catheter, containing the inner Penumbra reperfusion catheters. The largest, 4.1-Fr, reperfusion catheter was navigated over a Prowler Select Plus microcatheter. The catheter system provided access to reach the cerebral lesions and provided stability for the mechanically demanding manipulations of thromboaspiration and stent navigation in all cases. Apart from their mechanical role, the specific parts of the system could also provide access to different types of interventions, like carotid stenting through the 8-Fr guiding catheter and intracranial stenting and thrombolysis through the Prowler Select Plus microcatheter. In this series, there were no complications related to the catheter system. In conclusion, building up a triple or quadruple coaxial system proved to be safe and efficient in our experience for the mechanical thrombectomy treatment of acute ischemic stroke.

Progress and Prospects in Stretchable Electroluminescent Devices

Directory of Open Access Journals (Sweden)

Wang Jiangxin

2017-03-01

Full Text Available Stretchable electroluminescent (EL devices are a new form of mechanically deformable electronics that are gaining increasing interests and believed to be one of the essential technologies for next generation lighting and display applications. Apart from the simple bending capability in flexible EL devices, the stretchable EL devices are required to withstand larger mechanical deformations and accommodate stretching strain beyond 10%. The excellent mechanical conformability in these devices enables their applications in rigorous mechanical conditions such as flexing, twisting, stretching, and folding.The stretchable EL devices can be conformably wrapped onto arbitrary curvilinear surface and respond seamlessly to the external or internal forces, leading to unprecedented applications that cannot be addressed with conventional technologies. For example, they are in demand for wide applications in biomedical-related devices or sensors and soft interactive display systems, including activating devices for photosensitive drug, imaging apparatus for internal tissues, electronic skins, interactive input and output devices, robotics, and volumetric displays. With increasingly stringent demand on the mechanical requirements, the fabrication of stretchable EL device is encountering many challenges that are difficult to resolve. In this review, recent progresses in the stretchable EL devices are covered with a focus on the approaches that are adopted to tackle materials and process challenges in stretchable EL devices and delineate the strategies in stretchable electronics. We first introduce the emission mechanisms that have been successfully demonstrated on stretchable EL devices. Limitations and advantages of the different mechanisms for stretchable EL devices are also discussed. Representative reports are reviewed based on different structural and material strategies. Unprecedented applications that have been enabled by the stretchable EL devices are

Working Characteristics of a Mechanical Insufflation-Exsufflation Device

Directory of Open Access Journals (Sweden)

Yan Shi

2014-01-01

Full Text Available Secretions of ventilated patients must be cleared efficiently and timely; to improve the secretion clearance efficiency of an insufflation-exsufflation device (IL-IE device and lay a foundation for the optimization of the IL-IE device, a mathematical model of the ventilation system with the IL-IE device is set up. Through the experimental and simulation research on the ventilation system, it can be concluded that, firstly, the mathematical model is proved to be authentic and reliable. Secondly, with the deposition of secretion or an increase in the respiratory compliance, the peak exsufflation airflow may be reduced. Thirdly, with a decrease in the suction pressure, the peak exsufflation airflow of the ventilated lung may rise proportionally, but the minimum pressure in the ventilated lung may descend proportionally. To improve the efficiency of the secretion clearance but not to injure the ventilated patient, the suction pressure can be elevated properly. Last, increasing the inspiratory positive airway pressure (IPAP is a method to improve the secretion clearance efficiency. This research lays a foundation for improving the secretion clearance efficiency of the IL-IE device.

A durability study of a paracorporeal pulsatile electro-mechanical pneumatic biventricular assist device.

Science.gov (United States)

Choi, Hyuk; Lee, Heung-Man; Nam, Kyoung Won; Choi, Jaesoon; Lee, Jung-Joo; Kim, Ho Chul; Song, Seung Joon; Ahn, Chi Bum; Son, Ho Sung; Lim, Choon Hak; Son, Kuk Hui; Park, Yong Doo; Jeong, Gi Seok; Sun, Kyung

2011-06-01

In 2002, the paracorporeal pulsatile electro-mechanical pneumatic ventricular assist device (VAD) began to be developed by the Korea Artificial Organ Center at Korea University under a Health & Medical Technology Research and Development program which finished in 2008. In vitro durability testing was conducted on the paracorporeal pulsatile pneumatic VAD to determine device durability and to evaluate device failures. The 1- and 2-year reliability of the paracorporeal pulsatile pneumatic VAD was shown to be 91.2% and 54.9%, respectively, with an 80% confidence level. Failure modes were analyzed using fault tree analysis, with customized software continuously acquiring data during the test period. After this period, 21 in vivo animal tests were done, with 14 cases of left atrium to left ventricle (LV) inflow cannulation (36Fr)/outflow grafting to descending aorta, and seven cases of apex cannulation of LV to descending aorta (12 mm). The longest postoperative day (182 days) in Korea was recently recorded in in vivo animal testing (bovine, 90 kg, male, 3.5-4.0 L/min flow rate, and 55 bpm). © 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Mechanical circulatory assist device development at the Texas Heart Institute: a personal perspective.

Science.gov (United States)

Frazier, O H

2014-01-01

In December 2013, we performed our 1000th ventricular assist device implantation at the Texas Heart Institute. In my professional career, I have been fortunate to see the development of numerous mechanical circulatory support devices for the treatment of patients with advanced heart failure. In fact, most of the cardiac pumps in wide use today were developed in the Texas Heart Institute research laboratories in cooperation with the National Heart, Lung and Blood Institute or device innovators and manufacturers and implanted clinically at our partner St. Luke's Episcopal Hospital. My early involvement in this field was guided by my mentors, Dr Michael E. DeBakey and, especially, Dr Denton A. Cooley. Also, many of the advances are directly attributable to my ongoing clinical experience. What I learned daily in my surgical practice allowed me to bring insights to the development of this technology that a laboratory researcher alone might not have had. Young academic surgeons interested in this field might be well served to be active not only in laboratory research but also in clinical practice. Copyright © 2014 Elsevier Inc. All rights reserved.

Recent Trends in Neuro-endovascular Treatment for Acute Ischemic Stroke, Cerebral Aneurysms, Carotid Stenosis, and Brain Arteriovenous Malformations.

Science.gov (United States)

Matsumaru, Yuji; Ishikawa, Eiichi; Yamamoto, Tetsuya; Matsumura, Akira

2017-06-15

The efficacy of mechanical thrombectomy with stent retrievers for emergent large vessel occlusion has been proved by randomized trials. Mechanical thrombectomy is increasingly being adopted in Japan since stent retrievers were first approved in 2014. An urgent clinical task is to offer structured systems of care to provide this treatment in a timely fashion to all patients with emergent large vessel occlusion. Treatment with flow-diverting stents is currently a preferred treatment option worldwide for large and giant unruptured aneurysms. Initial studies reported high rates of complete aneurysm occlusion, even in large and giant aneurysms, without delayed aneurysmal recanalization and/or growth. The Pipeline Embolic Device is a flow diverter recently approved in Japan for the treatment of large and giant wide-neck unruptured aneurysms in the internal carotid artery, from the petrous to superior hypophyseal segments. Carotid artery stenting is the preferred treatment approach for carotid stenosis in Japan, whereas it remains an alternative for carotid endarterectomy in Europe and the United States. Carotid artery stenting with embolic protection and plaque imaging is effective in achieving favorable outcomes. The design and conclusions of a randomized trial of unruptured brain arteriovenous malformations (ARUBA) trial, which compared medical management alone and medical management with interventional therapy in patients with an unruptured arteriovenous brain malformation, are controversial. However, the annual bleeding rate (2.2%) of the medical management group obtained from this study is worthy of consideration when deciding treatment strategy.

Revascularization for critical limb ischemia using the SpiderFX embolic protection device in the below-the-knee circulation: initial results.

Science.gov (United States)

Ward, Thomas J; Piechowiak, Rachel L; Patel, Rahul S; Fischman, Aaron M; Nowakowski, F Scott; Kim, Edward; Ellozy, Sharif H; Faries, Peter L; Lookstein, Robert A

2014-10-01

To examine the safety and efficacy of the SpiderFX embolic protection device (EPD) in the below-the-knee (BTK) circulation in patients with critical limb ischemia (CLI). A single-center retrospective review was performed to identify patients with CLI and single-vessel runoff in whom the SpiderFX EPD was used in the BTK circulation. Technical success and device-related complications were the primary endpoints. Retrieval of macroscopic debris in the EPD, 1-year freedom from major adverse limb events (MALEs), and 30-day perioperative death were also evaluated. A major amputation, surgical bypass, endovascular thrombectomy, or endovascular thrombolysis was considered a MALE. Thirty-six patients (21 men; mean age, 75.8 y) treated between 2008 and 2013 had endovascular revascularization with use of the SpiderFX EPD in the BTK circulation. The SpiderFX EPD was successfully deployed in all cases; the technical success rate of revascularization was 100%. Two minor and zero major complications were observed related to the SpiderFX. Two MALEs, a major amputation and a subsequent surgical bypass, were observed in the cohort. All MALEs occurred within 1 year of treatment (1-y freedom from MALE rate, 90%). Debris was retrieved in the SpiderFX device in 47% of patients. The use of the SpiderFX EPD in the BTK circulation in patients with CLI is safe and frequently retrieves debris. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

ABACUS and AQME: Semiconductor Device and Quantum Mechanics Education on nanoHUB.org

OpenAIRE

Klimeck, Gerhard; Vasileska, Dragica

2009-01-01

The ABACUS and AQME on-line tools and their associated wiki pages form one-stop shops for educators and students of existing university courses. They are geared towards courses like "introduction to Semiconductor Devices" and "Quantum Mechanics for Engineers". The service is free to anyone and no software installation is required on the user's computer. All simulations, including advanced visualization are performed at a remote computer. The tools have been deployed on nanoHUB.org in August 2...

Device Engineering and Degradation Mechanism Study of All-Phosphorescent White Organic Light-Emitting Diodes

Science.gov (United States)

Xu, Lisong

As a possible next-generation solid-state lighting source, white organic light-emitting diodes (WOLEDs) have the advantages in high power efficiency, large area and flat panel form factor applications. Phosphorescent emitters and multiple emitting layer structures are typically used in high efficiency WOLEDs. However due to the complexity of the device structure comprising a stack of multiple layers of organic thin films, ten or more organic materials are usually required, and each of the layers in the stack has to be optimized to produce the desired electrical and optical functions such that collectively a WOLED of the highest possible efficiency can be achieved. Moreover, device degradation mechanisms are still unclear for most OLED systems, especially blue phosphorescent OLEDs. Such challenges require a deep understanding of the device operating principles and materials/device degradation mechanisms. This thesis will focus on achieving high-efficiency and color-stable all-phosphorescent WOLEDs through optimization of the device structures and material compositions. The operating principles and the degradation mechanisms specific to all-phosphorescent WOLED will be studied. First, we investigated a WOLED where a blue emitter was based on a doped mix-host system with the archetypal bis(4,6-difluorophenyl-pyridinato-N,C2) picolinate iridium(III), FIrpic, as the blue dopant. In forming the WOLED, the red and green components were incorporated in a single layer adjacent to the blue layer. The WOLED efficiency and color were optimized through variations of the mixed-host compositions to control the electron-hole recombination zone and the dopant concentrations of the green-red layers to achieve a balanced white emission. Second, a WOLED structure with two separate blue layers and an ultra-thin red and green co-doped layer was studied. Through a systematic investigation of the placement of the co-doped red and green layer between the blue layers and the material

Arc plasma devices: Evolving mechanical design from numerical ...

Indian Academy of Sciences (India)

feeds power into the system for sustained operation. Depending ... distribution, velocity profiles, device efficiency, spatial concentration of nascent active species .... where V is the arc voltage and ϕ is the work function of the anode material. The first .... to predict correct potential drop within the device in a number of designs.

Mass Spectrometry-Based Proteomic Profiling of Thrombotic Material Obtained by Endovascular Thrombectomy in Patients with Ischemic Stroke

Directory of Open Access Journals (Sweden)

Roberto Muñoz

2018-02-01

Full Text Available Thrombotic material retrieved from acute ischemic stroke (AIS patients represents a valuable source of biological information. In this study, we have developed a clinical proteomics workflow to characterize the protein cargo of thrombi derived from AIS patients. To analyze the thrombus proteome in a large-scale format, we developed a workflow that combines the isolation of thrombus by endovascular thrombectomy and peptide chromatographic fractionation coupled to mass-spectrometry. Using this workflow, we have characterized a specific proteomic expression profile derived from four AIS patients included in this study. Around 1600 protein species were unambiguously identified in the analyzed material. Functional bioinformatics analyses were performed, emphasizing a clustering of proteins with immunological functions as well as cardiopathy-related proteins with blood-cell dependent functions and peripheral vascular processes. In addition, we established a reference proteomic fingerprint of 341 proteins commonly detected in all patients. Protein interactome network of this subproteome revealed protein clusters involved in the interaction of fibronectin with 14-3-3 proteins, TGFβ signaling, and TCP complex network. Taken together, our data contributes to the repertoire of the human thrombus proteome, serving as a reference library to increase our knowledge about the molecular basis of thrombus derived from AIS patients, paving the way toward the establishment of a quantitative approach necessary to detect and characterize potential novel biomarkers in the stroke field.

Mechanical engineering and design of silicon-based particle tracking devices

International Nuclear Information System (INIS)

Miller, W.O.; Thompson, T.C.; Gamble, M.T.; Reid, R.S.; Woloshun, K.A.; Dransfield, G.D.; Ziock, H.J.

1990-01-01

The Mechanical Engineering and Electronics Division of the Los Alamos National Laboratory has been investigating silicon-based particle tracking device technology as part of the Superconducting Super Collider-sponsored silicon subsystem collaboration. Structural, thermal, and materials issues have been addressed. This paper discussed detector structural integrity and stability, including detailed finite element models of the silicon chip support and predictive methods used in designing with advanced composite materials. Electronic thermal loading and efficient dissipation of such energy using heat pipe technology has been investigated. The use of materials whose coefficients of thermal expansion are engineered to match silicon or to be near zero, as appropriate, have been explored. Material analysis and test results from radiation, chemical, and static loading are compared with analytical predictions and discussed. 1 ref., 2 figs., 1 tab

Safety of mechanical chest compression devices AutoPulse and LUCAS in cardiac arrest: a randomized clinical trial for non-inferiority

NARCIS (Netherlands)

Koster, Rudolph W.; Beenen, Ludo F.; van der Boom, Esther B.; Spijkerboer, Anje M.; Tepaske, Robert; van der Wal, Allart C.; Beesems, Stefanie G.; Tijssen, Jan G.

2017-01-01

Aims Mechanical chest compression (CC) during cardiopulmonary resuscitation (CPR) with AutoPulse or LUCAS devices has not improved survival from cardiac arrest. Cohort studies suggest risk of excess damage. We studied safety of mechanical CC and determined possible excess damage compared with manual

Thermo-mechanical challenges for quantum devices

NARCIS (Netherlands)

Gielen, A.W.J.; McKenzie, F.V.

2014-01-01

In the last few years Technical University of Delft, under leadership of Prof.dr.ir. Leo Kouwenhoven, has developed several successful concepts for quantum devices that are suitable for quantum computing and quantum communication. From a quantum research point of view we are still in a very

Mechanism of a-IGZO TFT device deterioration—illumination light wavelength and substrate temperature effects

Science.gov (United States)

Chen, Te-Chih; Kuo, Yue; Chang, Ting-Chang; Chen, Min-Chen; Chen, Hua-Mao

2017-10-01

Device characteristics changes in an a-IGZO thin film transistor under light illumination and at raised temperature have been investigated. Light exposure causes a large leakage current, which is more obvious with an increase in the illumination energy, power and the temperature. The increase in the leakage current is due to the trap assisted photon excitation process that generates electron-hole pairs and the mechanism is enhanced with the additional thermal energy. The leakage current comes from the source side because holes generated in the process drift to the source side and therefore lower the barrier height. The above mechanism has been further verified with experiments of drain bias induced shifts in the threshold voltage and the subthreshold slope.

Cardiac Arrest Secondary to Bilateral Pulmonary Emboli following Arteriovenous Fistula Thrombectomy: A Case Report with Review of the Literature

Directory of Open Access Journals (Sweden)

Avni Shah

2012-01-01

Full Text Available Number of patients with End Stage Renal Disease (ESRD is growing worldwide. Hemodialysis remains the main modality of renal replacement therapy for ESRD patients. A patent hemodialysis access (arteriovenous fistula or arteriovenous graft plays a key role in successful delivery of hemodialysis. Common vascular access issues encountered by patients and nephrologists are thrombosis and infection. The thrombosed access is declotted by various percutaneous techniques these days by multiple outpatient access centers in a timely fashion. Thrombolysis can give rise to various complications, a few of which can be life threatening. A young hemodialysis patient underwent percutaneous thrombolysis of his clotted arteriovenous fistula. Outpatient access thrombectomy was complicated immediately afterwards with cardiac arrest requiring cardiac resuscitation in the recovery room. The patient was admitted to intensive care unit after life sustaining care. Work up revealed multiple pulmonary emboli to both lung fields on CT scan of the chest. Patient was anticoagulated and discharged from the hospital. Thrombolysis of clotted hemodialysis access is associated commonly with occurrences of pulmonary embolic which are usually asymptomatic. Massive pulmonary embolization due to access thrombolysis is rare. Nephrologists and radiologists should be aware of this dangerous complication particularly in patients with preexisting cardiopulmonary disease.

A complementary switching mechanism for organic memory devices to regulate the conductance of binary states

Science.gov (United States)

Vyas, Giriraj; Dagar, Parveen; Sahu, Satyajit

2016-06-01

We have fabricated an organic non-volatile memory device wherein the ON/OFF current ratio has been controlled by varying the concentration of a small organic molecule, 2,3-Dichloro-5,6-dicyano-p-benzoquinone (DDQ), in an insulating matrix of a polymer Poly(4-vinylphenol) (PVP). A maximum ON-OFF ratio of 106 is obtained when the concentration of DDQ is half or 10 wt. % of PVP. In this process, the switching direction for the devices has also been altered, indicating the disparity in conduction mechanism. Conduction due to metal filament formation through the active material and the voltage dependent conformational change of the organic molecule seem to be the motivation behind the gradual change in the switching direction.

Quantitative Evaluation of Performance in Interventional Neuroradiology: An Integrated Curriculum Featuring Theoretical and Practical Challenges.

Directory of Open Access Journals (Sweden)

Marielle Ernst

Full Text Available We sought to develop a standardized curriculum capable of assessing key competencies in Interventional Neuroradiology by the use of models and simulators in an objective, quantitative, and efficient way. In this evaluation we analyzed the associations between the practical experience, theoretical knowledge, and the skills lab performance of interventionalists.We evaluated the endovascular skills of 26 participants of the Advanced Course in Endovascular Interventional Neuroradiology of the European Society of Neuroradiology with a set of three tasks (aneurysm coiling and thrombectomy in a virtual simulator and placement of an intra-aneurysmal flow disruptor in a flow model. Practical experience was assessed by a survey. Participants completed a written and oral examination to evaluate theoretical knowledge. Bivariate and multivariate analyses were performed.In multivariate analysis knowledge of materials and techniques in Interventional Neuroradiology was moderately associated with skills in aneurysm coiling and thrombectomy. Experience in mechanical thrombectomy was moderately associated with thrombectomy skills, while age was negatively associated with thrombectomy skills. We found no significant association between age, sex, or work experience and skills in aneurysm coiling.Our study gives an example of how an integrated curriculum for reasonable and cost-effective assessment of key competences of an interventional neuroradiologist could look. In addition to traditional assessment of theoretical knowledge practical skills are measured by the use of endovascular simulators yielding objective, quantitative, and constructive data for the evaluation of the current performance status of participants as well as the evolution of their technical competency over time.

CDC field mapping device - ''ROTOTRACK''

International Nuclear Information System (INIS)

Yamada, R.; Hawtree, J.; Kaczar, K.; Leverence, R.; McGuire, K.; Newman-Holmes, C.; Schmidt, E.E.; Shallenberger, J.

1985-10-01

A field mapping device for the magnet of the Collider Detector at Fermilab (CDF) was constructed. The device was used for extensive study of the CDF magnetic field distribution. The mechanical and electrical features of the device, as well as the data acquisition system and software, are described. The mechanical system was designed so that the errors on the position and angle of the probe were +-0.75 mm and +-1 mrad, respectively

High performance flexible top-emitting warm-white organic light-emitting devices and chromaticity shift mechanism

Energy Technology Data Exchange (ETDEWEB)

Shi, Hongying; Deng, Lingling; Chen, Shufen, E-mail: iamsfchen@njupt.edu.cn, E-mail: wei-huang@njupt.edu.cn; Xu, Ying; Zhao, Xiaofei; Cheng, Fan [Key Laboratory for Organic Electronics and Information Displays (KLOEID) and Institute of Advanced Materials (IAM), Nanjing University of Posts and Telecommunications, 210023 Nanjing (China); Huang, Wei, E-mail: iamsfchen@njupt.edu.cn, E-mail: wei-huang@njupt.edu.cn [Key Laboratory for Organic Electronics and Information Displays (KLOEID) and Institute of Advanced Materials (IAM), Nanjing University of Posts and Telecommunications, 210023 Nanjing (China); Jiangsu-Singapore Joint Research Center for Organic/Bio- Electronics and Information Displays and Institute of Advanced Materials, Nanjing University of Technology, Nanjing 211816 (China)

2014-04-15

Flexible warm-white top-emitting organic light-emitting devices (TEOLEDs) are fabricated onto PET substrates with a simple semi-transparent cathode Sm/Ag and two-color phosphors respectively doped into a single host material TCTA. By adjusting the relative position of the orange-red EML sandwiched between the blue emitting layers, the optimized device exhibits the highest power/current efficiency of 8.07 lm/W and near 13 cd/A, with a correlated color temperature (CCT) of 4105 K and a color rendering index (CRI) of 70. In addition, a moderate chromaticity variation of (-0.025, +0.008) around warm white illumination coordinates (0.45, 0.44) is obtained over a large luminance range of 1000 to 10000 cd/m{sup 2}. The emission mechanism is discussed via delta-doping method and single-carrier device, which is summarized that the carrier trapping, the exciton quenching, the mobility change and the recombination zone alteration are negative to color stability while the energy transfer process and the blue/red/blue sandwiched structure are contributed to the color stability in our flexible white TEOLEDs.

Photovoltaic device and method

Science.gov (United States)

Cleereman, Robert J; Lesniak, Michael J; Keenihan, James R; Langmaid, Joe A; Gaston, Ryan; Eurich, Gerald K; Boven, Michelle L

2015-01-27

The present invention is premised upon an improved photovoltaic device ("PVD") and method of use, more particularly to an improved photovoltaic device with an integral locator and electrical terminal mechanism for transferring current to or from the improved photovoltaic device and the use as a system.

LANSCE wire scanning diagnostics device mechanical design

International Nuclear Information System (INIS)

Rodriguez Esparza, Sergio

2010-01-01

The Los Alamos Neutron Science Center (LANSCE) is one of the major experimental science facilities at the Los Alamos National Laboratory (LANL). The core of LANSCE's work lies in the operation of a powerful linear accelerator, which accelerates protons up to 84% the speed oflight. These protons are used for a variety of purposes, including materials testing, weapons research and isotopes production. To assist in guiding the proton beam, a series of over one hundred wire scanners are used to measure the beam profile at various locations along the half-mile length of the particle accelerator. A wire scanner is an electro-mechanical device that moves a set of wires through a particle beam and measures the secondary emissions from the resulting beam-wire interaction to obtain beam intensity information. When supplemented with data from a position sensor, this information is used to determine the cross-sectional profile of the beam. This measurement allows beam operators to adjust parameters such as acceleration, beam steering, and focus to ensure that the beam reaches its destination as effectively as possible. Some of the current wire scanners are nearly forty years old and are becoming obsolete. The problem with current wire scanners comes in the difficulty of maintenance and reliability. The designs of these wire scanners vary making it difficult to keep spare parts that would work on all designs. Also many of the components are custom built or out-dated technology and are no longer in production.

LANSCE wire scanning diagnostics device mechanical design

Energy Technology Data Exchange (ETDEWEB)

Rodriguez Esparza, Sergio [Los Alamos National Laboratory

2010-01-01

The Los Alamos Neutron Science Center (LANSCE) is one of the major experimental science facilities at the Los Alamos National Laboratory (LANL). The core of LANSCE's work lies in the operation of a powerful linear accelerator, which accelerates protons up to 84% the speed oflight. These protons are used for a variety of purposes, including materials testing, weapons research and isotopes production. To assist in guiding the proton beam, a series of over one hundred wire scanners are used to measure the beam profile at various locations along the half-mile length of the particle accelerator. A wire scanner is an electro-mechanical device that moves a set of wires through a particle beam and measures the secondary emissions from the resulting beam-wire interaction to obtain beam intensity information. When supplemented with data from a position sensor, this information is used to determine the cross-sectional profile of the beam. This measurement allows beam operators to adjust parameters such as acceleration, beam steering, and focus to ensure that the beam reaches its destination as effectively as possible. Some of the current wire scanners are nearly forty years old and are becoming obsolete. The problem with current wire scanners comes in the difficulty of maintenance and reliability. The designs of these wire scanners vary making it difficult to keep spare parts that would work on all designs. Also many of the components are custom built or out-dated technology and are no longer in production.

Stent-Assisted Coil Embolization of a Mycotic Renal Artery Aneurysm by Use of a Self-Expanding Neurointerventional Stent

International Nuclear Information System (INIS)

Rabellino, Martin; García-Nielsen, Luis; Zander, Tobias; Baldi, Sebastián; Llorens, Rafael; Maynar, Manuel

2011-01-01

Mycotic aneurysms are uncommon, especially those located in visceral arteries. We present a case of a patient with two visceral mycotic aneurysms due to bacterial endocarditis, one located in right upper pole renal artery and the second in the splenic artery. Both aneurysms were treated as endovascular embolization using microcoils. In the aneurysm located at the renal artery, the technique of stent-assisted coils embolization was preferred to avoid coils migration due to its wide neck. The stent used was the Solitaire AB, which was designed for the treatment of intracranial aneurysms and was used recently in acute stroke as a mechanical thrombectomy device. Complete embolization of the aneurysm was achieved, preserving all the arterial branches without nephrogram defects in the final angiogram.

Mechanisms of action of intrauterine devices.

Science.gov (United States)

Ortiz, M E; Croxatto, H B; Bardin, C W

1996-12-01

The major effect of all intrauterine devices (IUD) is to induce a local inflammatory reaction in the endometrium whose cellular and humoral components are released into the uterine cavity. This inflammatory reaction has a variable effect on the reproductive strategy of the species studied. For example, this foreign body reaction can be localized within the uterus of rodents; and in farm animals it can have striking extrauterine effects. Thus, the action of IUDs in humans cannot be discerned from animals. In humans, copper ions released from Cu-IUDs enhance the inflammatory response and reach concentrations in the luminal fluids of the genital tract that are toxic for spermatozoa and embryos. In women using the IUD, the entire genital tract seems affected, at least in part, because of luminal transmission of the fluids that accumulates in the uterine lumen. This affects the function or viability of gametes, decreasing the rate of fertilization and lowering the chances of survival of any embryo that may be formed, even before it reaches the uterus. Studies on the recovery of eggs from women using IUDs and from women not using contraception show that embryos are formed in the tubes of IUD users at a much lower rate compared with nonusers. This is believed to be the major action of IUDs. Therefore, the common belief that the major mechanism of action of IUDs in women is through destruction of embryos in the uterus (i.e., abortion) is not supported by the available evidence. In Cu-IUD users, it is likely that few spermatozoa reach the distal segment of the fallopian tube, those that encounter an egg may be in poor condition. Thus, the few eggs that are fertilized have little chance for development and their possibility for survival in the altered tubal milieu become worse as they approach the uterine cavity.

PLASMA DEVICE

Science.gov (United States)

Gow, J.D.; Wilcox, J.M.

1961-12-26

A device is designed for producing and confining highenergy plasma from which neutrons are generated in copious quantities. A rotating sheath of electrons is established in a radial electric field and axial magnetic field produced within the device. The electron sheath serves as a strong ionizing medium to gas introdueed thereto and also functions as an extremely effective heating mechanism to the resulting plasma. In addition, improved confinement of the plasma is obtained by ring magnetic mirror fields produced at the ends of the device. Such ring mirror fields are defined by the magnetic field lines at the ends of the device diverging radially outward from the axis of the device and thereafter converging at spatial annular surfaces disposed concentrically thereabout. (AFC)

[Coupled Analysis of Fluid-Structure Interaction of a Micro-Mechanical Valve for Glaucoma Drainage Devices].

Science.gov (United States)

Siewert, S; Sämann, M; Schmidt, W; Stiehm, M; Falke, K; Grabow, N; Guthoff, R; Schmitz, K-P

2015-12-01

Glaucoma is the leading cause of irreversible blindness worldwide. In therapeutically refractory cases, alloplastic glaucoma drainage devices (GDD) are being increasingly used to decrease intraocular pressure. Current devices are mainly limited by fibrotic encapsulation and postoperative hypotension. Preliminary studies have described the development of a glaucoma microstent to control aqueous humour drainage from the anterior chamber into the suprachoroidal space. One focus of these studies was on the design of a micro-mechanical valve placed in the anterior chamber to inhibit postoperative hypotension. The present report describes the coupled analysis of fluid-structure interaction (FSI) as basis for future improvements in the design micro-mechanical valves. FSI analysis was carried out with ANSYS 14.5 software. Solid and fluid geometry were combined in a model, and the corresponding material properties of silicone (Silastic Rx-50) and water at room temperature were assigned. The meshing of the solid and fluid domains was carried out in accordance with the results of a convergence study with tetrahedron elements. Structural and fluid mechanical boundary conditions completed the model. The FSI analysis takes into account geometric non-linearity and adaptive remeshing to consider changing geometry. A valve opening pressure of 3.26 mmHg was derived from the FSI analysis and correlates well with the results of preliminary experimental fluid mechanical studies. Flow resistance was calculated from non-linear pressure-flow characteristics as 8.5 × 10(-3) mmHg/µl  · min(-1) and 2.7 × 10(-3) mmHg/µl  · min(-1), respectively before and after valve opening pressure is exceeded. FSI analysis indicated leakage flow before valve opening, which is due to the simplified model geometry. The presented bidirectional coupled FSI analysis is a powerful tool for the development of new designs of micro-mechanical valves for GDD and may help to minimise the time and cost

Impacts of Mechanical Macrophyte Removal Devices on Sediment Scouring in Littoral Habitats: II. Experimental Operation in the Littoral Zone of Eau Galle Reservoir, Wisconsin

National Research Council Canada - National Science Library

James, William F; Wright, David I; Barko, John W; Eakin, Harry L

2006-01-01

... in Eau Galle Reservoir, Wisconsin. Mechanical macrophyte removal devices are an attractive, low-cost means of removing macrophytes in specific areas without herbicides or repeated mechanical harvesting...

Very large scale characterization of graphene mechanical devices using a colorimetry technique.

Science.gov (United States)

Cartamil-Bueno, Santiago Jose; Centeno, Alba; Zurutuza, Amaia; Steeneken, Peter Gerard; van der Zant, Herre Sjoerd Jan; Houri, Samer

2017-06-08

We use a scalable optical technique to characterize more than 21 000 circular nanomechanical devices made of suspended single- and double-layer graphene on cavities with different diameters (D) and depths (g). To maximize the contrast between suspended and broken membranes we used a model for selecting the optimal color filter. The method enables parallel and automatized image processing for yield statistics. We find the survival probability to be correlated with a structural mechanics scaling parameter given by D 4 /g 3 . Moreover, we extract a median adhesion energy of Γ = 0.9 J m -2 between the membrane and the native SiO 2 at the bottom of the cavities.

Mechanical stability of custom-made implants: Numerical study of anatomical device and low elastic Young's modulus alloy.

Science.gov (United States)

Didier, P; Piotrowski, B; Fischer, M; Laheurte, P

2017-05-01

The advent of new manufacturing technologies such as additive manufacturing deeply impacts the approach for the design of medical devices. It is now possible to design custom-made implants based on medical imaging, with complex anatomic shape, and to manufacture them. In this study, two geometrical configurations of implant devices are studied, standard and anatomical. The comparison highlights the drawbacks of the standard configuration, which requires specific forming by plastic strain in order to be adapted to the patient's morphology and induces stress field in bones without mechanical load in the implant. The influence of low elastic modulus of the materials on stress distribution is investigated. Two biocompatible alloys having the ability to be used with SLM additive manufacturing are considered, commercial Ti-6Al-4V and Ti-26Nb. It is shown that beyond the geometrical aspect, mechanical compatibility between implants and bones can be significantly improved with the modulus of Ti-26Nb implants compared with the Ti-6Al-4V. Copyright © 2016 Elsevier B.V. All rights reserved.

Multilevel characteristics and memory mechanisms for nonvolatile memory devices based on CuInS2 quantum dot-polymethylmethacrylate nanocomposites

International Nuclear Information System (INIS)

Zhou, Yang; Yun, Dong Yeol; Kim, Tae Whan; Kim, Sang Wook

2014-01-01

Nonvolatile memory devices based on CuInS 2 (CIS) quantum dots (QDs) embedded in a polymethylmethacrylate (PMMA) layer were fabricated using spin-coating method. The memory window widths of the capacitance-voltage (C-V) curves for the Al/CIS QDs embedded in PMMA layer/p-Si devices were 0.3, 0.6, and 1.0 V for sweep voltages of ±3, ±5, and ±7 V, respectively. Capacitance-cycle data demonstrated that the charge-trapping capability of the devices with an ON/OFF ratio value of 2.81 × 10 −10 was maintained for 8 × 10 3 cycles without significant degradation and that the extrapolation of the ON/OFF ratio value to 1 × 10 6 cycles converged to 2.40 × 10 −10 , indicative of the good stability of the devices. The memory mechanisms for the devices are described on the basis of the C-V curves and the energy-band diagrams

[Study on an Exoskeleton Hand Function Training Device].

Science.gov (United States)

Hu, Xin; Zhang, Ying; Li, Jicai; Yi, Jinhua; Yu, Hongliu; He, Rongrong

2016-02-01

Based on the structure and motion bionic principle of the normal adult fingers, biological characteristics of human hands were analyzed, and a wearable exoskeleton hand function training device for the rehabilitation of stroke patients or patients with hand trauma was designed. This device includes the exoskeleton mechanical structure and the electromyography (EMG) control system. With adjustable mechanism, the device was capable to fit different finger lengths, and by capturing the EMG of the users' contralateral limb, the motion state of the exoskeleton hand was controlled. Then driven by the device, the user's fingers conducting adduction/abduction rehabilitation training was carried out. Finally, the mechanical properties and training effect of the exoskeleton hand were verified through mechanism simulation and the experiments on the experimental prototype of the wearable exoskeleton hand function training device.

External chest compressions using a mechanical feedback device : cross-over simulation study.

Science.gov (United States)

Skorning, M; Derwall, M; Brokmann, J C; Rörtgen, D; Bergrath, S; Pflipsen, J; Beuerlein, S; Rossaint, R; Beckers, S K

2011-08-01

External chest compressions (ECC) are essential components of resuscitation and are usually performed without any adjuncts in professional healthcare. Even for healthcare professionals during in-hospital and out-of-hospital resuscitation poor performance in ECC has been reported in recent years. Although several stand-alone devices have been developed none has been implemented as a standard in patient care. The aim of this study was to examine if the use of a mechanical device providing visual feedback and audible assistance during ECC improves performance of healthcare professionals following minimal and simplified instructions. In a prospective, randomized cross-over study 81 healthcare professionals performed ECC for 3 min (in the assumed setting of a secured airway) twice on a manikin (Skillreporter ResusciAnne®, with PC-Skillreporting System Version 1.3.0, Laerdal, Stavanger, Norway) in a mock cardiac arrest scenario. Group 1 (n=40) performed ECC with the device first followed by classic ECC and group 2 (n=41) in the opposite order. Minimal instructions were standardized and provided by video instruction (1 min 38 s). Endpoints were achievement of a mean compression rate between 90 and 110/min and a mean compression depth of 40-50 mm. In addition participants had to answer questionnaires about demographic data, professional experience and recent recommendations for ECC as well as their impression of the device concerning the ease of use and their personal level of confidence. Data were analyzed for group-related and inter-group differences using SAS (Version 9.1.3, SAS Institute, Cary, NC). A total of 81 healthcare professionals regularly involved in resuscitation attempts in pre-hospital or in-hospital settings took part in the study with no differences between the groups: females 35.8% (n=52), emergency medical technicians 32.1% (n=26), anesthesia nurses 32.1% (n=26), physicians (anesthesiology) 45% (n=29). In group 1 33 out of 40 (82.5%; 99.7±4

General Anesthesia Versus Conscious Sedation in Acute Stroke Treatment: The Importance of Head Immobilization

Energy Technology Data Exchange (ETDEWEB)

Janssen, H., E-mail: hendrik.janssen@med.uni-muenchen.de [Ludwig-Maximilians-University Hospital, Department of Neuroradiology (Germany); Buchholz, G. [Ludwig-Maximilians-University Hospital, Department of Neurology (Germany); Killer, M. [Paracelsus Medical University, Neurology/Research Institute of Neurointervention (Austria); Ertl, L.; Brückmann, H. [Ludwig-Maximilians-University Hospital, Department of Neuroradiology (Germany); Lutz, J. [Ingolstadt Hospital, Department of Neuroradiology (Germany)

2016-09-15

PurposeWhile today mechanical thrombectomy is an established treatment option for main branch occlusions in anterior circulation stroke, there is still an ongoing debate on the kind of anesthesia to be preferred. Introducing a simple method for head stabilization, we analyzed safety and duration of endovascular recanalization procedures under general anesthesia (GA) and conscious sedation (CS).MethodsWe retrospectively identified 84 consecutive patients who underwent mechanical thrombectomy owing to acute anterior circulation stroke. Fifty-three were treated under GA and 31 under CS equipped with a standard cervical collar to reduce head movement. We evaluated recanalization results, in-house time to start recanalization, procedure times, technical and clinical complication rates, and conversion rates from CS to GA.ResultsRecanalization of mTICI ≥2b was achieved in 80 % under CS and in 81 % under GA. Median in-house time to start recanalization for CS was 60 min (IQR 28; 44–72) and 77 min (IQR 23; 68–91) for GA (P = 0.001). Median procedure time under CS was 35 min (IQR 43; 69–25) and 41 min (IQR 43; 66–23) for GA (P = 0.9). No major complications such as ICH occurred in either group, and no conversions from CS to GA were necessary.ConclusionMechanical thrombectomy can be performed faster and safely under CS in combination with simple head immobilization using a standard cervical collar.

General Anesthesia Versus Conscious Sedation in Acute Stroke Treatment: The Importance of Head Immobilization

International Nuclear Information System (INIS)

Janssen, H.; Buchholz, G.; Killer, M.; Ertl, L.; Brückmann, H.; Lutz, J.

2016-01-01

PurposeWhile today mechanical thrombectomy is an established treatment option for main branch occlusions in anterior circulation stroke, there is still an ongoing debate on the kind of anesthesia to be preferred. Introducing a simple method for head stabilization, we analyzed safety and duration of endovascular recanalization procedures under general anesthesia (GA) and conscious sedation (CS).MethodsWe retrospectively identified 84 consecutive patients who underwent mechanical thrombectomy owing to acute anterior circulation stroke. Fifty-three were treated under GA and 31 under CS equipped with a standard cervical collar to reduce head movement. We evaluated recanalization results, in-house time to start recanalization, procedure times, technical and clinical complication rates, and conversion rates from CS to GA.ResultsRecanalization of mTICI ≥2b was achieved in 80 % under CS and in 81 % under GA. Median in-house time to start recanalization for CS was 60 min (IQR 28; 44–72) and 77 min (IQR 23; 68–91) for GA (P = 0.001). Median procedure time under CS was 35 min (IQR 43; 69–25) and 41 min (IQR 43; 66–23) for GA (P = 0.9). No major complications such as ICH occurred in either group, and no conversions from CS to GA were necessary.ConclusionMechanical thrombectomy can be performed faster and safely under CS in combination with simple head immobilization using a standard cervical collar.

Mechanical Properties in Metal-Organic Frameworks: Emerging Opportunities and Challenges for Device Functionality and Technological Applications

International Nuclear Information System (INIS)

Burtch, Nicholas C.; Heinen, Jurn

2017-01-01

We report that some of the most remarkable recent developments in metal–organic framework (MOF) performance properties can only be rationalized by the mechanical properties endowed by their hybrid inorganic–organic nanoporous structures. While these characteristics create intriguing application prospects, the same attributes also present challenges that will need to be overcome to enable the integration of MOFs with technologies where these promising traits can be exploited. In this review, emerging opportunities and challenges are identified for MOF-enabled device functionality and technological applications that arise from their fascinating mechanical properties. This is discussed not only in the context of their more well-studied gas storage and separation applications, but also for instances where MOFs serve as components of functional nanodevices. Recent advances in understanding MOF mechanical structure–property relationships due to attributes such as defects and interpenetration are highlighted, and open questions related to state-of-the-art computational approaches for quantifying their mechanical properties are critically discussed.

Projected phase-change memory devices.

Science.gov (United States)

Koelmans, Wabe W; Sebastian, Abu; Jonnalagadda, Vara Prasad; Krebs, Daniel; Dellmann, Laurent; Eleftheriou, Evangelos

2015-09-03

Nanoscale memory devices, whose resistance depends on the history of the electric signals applied, could become critical building blocks in new computing paradigms, such as brain-inspired computing and memcomputing. However, there are key challenges to overcome, such as the high programming power required, noise and resistance drift. Here, to address these, we present the concept of a projected memory device, whose distinguishing feature is that the physical mechanism of resistance storage is decoupled from the information-retrieval process. We designed and fabricated projected memory devices based on the phase-change storage mechanism and convincingly demonstrate the concept through detailed experimentation, supported by extensive modelling and finite-element simulations. The projected memory devices exhibit remarkably low drift and excellent noise performance. We also demonstrate active control and customization of the programming characteristics of the device that reliably realize a multitude of resistance states.

Unconventional Quantum Computing Devices

OpenAIRE

Lloyd, Seth

2000-01-01

This paper investigates a variety of unconventional quantum computation devices, including fermionic quantum computers and computers that exploit nonlinear quantum mechanics. It is shown that unconventional quantum computing devices can in principle compute some quantities more rapidly than `conventional' quantum computers.

Mechanisms and clinical applications of the vacuum-assisted closure (VAC) Device: a review.

Science.gov (United States)

Venturi, Mark L; Attinger, Christopher E; Mesbahi, Ali N; Hess, Christopher L; Graw, Katherine S

2005-01-01

The use of sub-atmospheric pressure dressings, available commercially as the vacuum-assisted closure (VAC) device, has been shown to be an effective way to accelerate healing of various wounds. The optimal sub-atmospheric pressure for wound healing appears to be approximately 125 mm Hg utilizing an alternating pressure cycle of 5 minutes of suction followed by 2 minutes off suction. Animal studies have demonstrated that this technique optimizes blood flow, decreases local tissue edema, and removes excessive fluid from the wound bed. These physiologic changes facilitate the removal of bacteria from the wound. Additionally, the cyclical application of sub-atmospheric pressure alters the cytoskeleton of the cells in the wound bed, triggering a cascade of intracellular signals that increases the rate of cell division and subsequent formation of granulation tissue. The combination of these mechanisms makes the VAC device an extremely versatile tool in the armamentarium of wound healing. This is evident in the VAC device's wide range of clinical applications, including treatment of infected surgical wounds, traumatic wounds, pressure ulcers, wounds with exposed bone and hardware, diabetic foot ulcers, and venous stasis ulcers. VAC has also proven useful in reconstruction of wounds by allowing elective planning of the definitive reconstructive surgery without jeopardizing the wound or outcome. Furthermore, VAC has significantly increased the skin graft success rate when used as a bolster over the freshly skin-grafted wound. VAC is generally well tolerated and, with few contraindications or complications, is fast becoming a mainstay of current wound care.

Evaluation of mechanical and thermal properties of insulation materials for HTS power devices at liquid nitrogen temperature

Energy Technology Data Exchange (ETDEWEB)

Shin, Hyung Seop; Diaz, Mark Angelo [Dept. of Mechanical Design Engineering, Andong National University, Andong (Korea, Republic of)

2017-06-15

In superconducting power devices including power cables in which high temperature superconducting (HTS) tapes are utilized, a reliable electrical insulation should be achieved for its maximum performance. For an efficient design of HTS superconducting devices, a comparative evaluation of the mechanical and thermal propperties for various insulation materials at cryogenic temperatures is required. Especially, in the process of the property evaluation of the sheet-shaped insulation materials, anisotropy according to the machining direction should be considered because the mechanical and thermal properties are significantly influenced by the sample orientation. In this study, the cryogenic thermal and mechanical properties of various insulation material sheets such as PPLP, Cryoflex, Teflon, and Kapton were determined considering sample orientation. All samples tested at cryogenic temperature showed significantly higher tensile strength as compared with that of room temperature. The ultimate tensile strength at both temperature conditions significantly depended upon the sample orientation. The thermal properties of the insulation materials exhibited a slight difference among samples depending on the orientation: for the PPLP and Cryoflex, the CD orientation showed larger thermal contraction up to 77 K as compared to the MD one. MD samples in PPLP and Cryoflex showed a lower CTE and thermal contraction which made it more promising as an insulation material due to its comparable CTE with HTS CC tapes.

Analysis of chemical degradation mechanism of phosphorescent organic light emitting devices by laser-desorption/ionization time-of-flight mass spectrometry

Energy Technology Data Exchange (ETDEWEB)

Rabelo de Moraes, Ines; Scholz, Sebastian; Luessem, Bjoern; Leo, Karl [Institut fuer Angewandte Photophysik, Technische Universitaet Dresden (Germany)

2010-07-01

Phosphorescent organic light emitting diodes (OLEDs) have attracted much interest for their potential application in full color flat-panel displays and as an alternative lighting source. However, low efficiency, and the short operation lifetime, in particular in the case of blue emitting devices, are the major limitations for the current OLEDs commercialization. In order to overcome these limitations, a deep knowledge about the aging and the degradation mechanism is required. Our work focuses on the chemical degradation mechanism of different iridium based emitter materials like FIrpic (light blue) and Ir(ppy)3 (green), commonly used in OLEDs. For this purpose, the devices were aged by electrical driving until the luminance reached 6% of the initial luminance. The laser-desorption/ionization time-of-flight mass spectrometry was used to determine specific degradation pathways.

[Mechanical circulatory support saves lives -- three years' experience of the newly established assist device program at Semmelweis University, Budapest, Hungary].

Science.gov (United States)

Fazekas, Levente; Sax, Balázs; Hartyánszky, István; Pólos, Miklós; Horkay, Ferenc; Varga, Tamás; Rácz, Kristóf; Németh, Endre; Székely, Andrea; Paulovich, Erzsébet; Heltai, Krisztina; Zima, Endre; Szabolcs, Zoltán; Merkely, Béla

2015-03-29

Since the celebration of the 20th anniversary of the first heart transplantation in Hungary in 2012 the emerging need for modern heart failure management via mechanical circulatory support has evolved. In May 2012 the opening of a new heart failure and transplant unit with 9 beds together with the procurement of necessary devices at Semmelweis University accomplished this need. The aim of the authors was to report their initial experience obtained in this new cardiac assist device program. Since May, 2012, mechanical circulatory support system was applied in 89 cases in 72 patients. Indication for support were end stage heart failure refractory to medical treatment and acute left or right heart failure. Treatment was initiated for acute graft failure after heart transplantation in 27 cases, for end stage heart failure in 24 cases, for acute myocardial infarction in 21 cases, for acute postcardiotomy heart failure in 14 cases, for severe respiratory insufficiency in 2 cases and for drug intoxication in one case. Among the 30 survivor of the whole program 13 patients were successfully transplanted. The available devices can cover all modalities of current bridge therapy from short term support through medium support to heart transplantation or long term support and destination therapy. These conditions made possible the successful start of a new cardiac assist device program.

Building Interfaces: Mechanisms, fabrication, and applications at the biotic/abiotic interface for silk fibroin based bioelectronic and biooptical devices

Science.gov (United States)

Brenckle, Mark

Recent efforts in bioelectronics and biooptics have led to a shift in the materials and form factors used to make medical devices, including high performance, implantable, and wearable sensors. In this context, biopolymer-based devices must be processed to interface the soft, curvilinear biological world with the rigid, inorganic world of traditional electronics and optics. This poses new material-specific fabrication challenges in designing such devices, which in turn requires further understanding of the fundamental physical behaviors of the materials in question. As a biopolymer, silk fibroin protein has remarkable promise in this space, due to its bioresorbability, mechanical strength, optical clarity, ability to be reshaped on the micro- and nano-scale, and ability to stabilize labile compounds. Application of this material to devices at the biotic/abiotic interface will require the development of fabrication techniques for nano-patterning, lithography, multilayer adhesion, and transfer printing in silk materials. In this work, we address this need through fundamental study of the thermal and diffusional properties of silk protein as it relates to these fabrication strategies. We then leverage these properties to fabricate devices well suited to the biotic/abiotic interface in three areas: shelf-ready sensing, implantable transient electronics, and wearable biosensing. These example devices will illustrate the advantages of silk in this class of bioelectronic and biooptical devices, from fundamentals through application, and contribute to a silk platform for the development of future devices that combine biology with high technology.

Heterostructures and quantum devices

CERN Document Server

Einspruch, Norman G

1994-01-01

Heterostructure and quantum-mechanical devices promise significant improvement in the performance of electronic and optoelectronic integrated circuits (ICs). Though these devices are the subject of a vigorous research effort, the current literature is often either highly technical or narrowly focused. This book presents heterostructure and quantum devices to the nonspecialist, especially electrical engineers working with high-performance semiconductor devices. It focuses on a broad base of technical applications using semiconductor physics theory to develop the next generation of electrical en

Large - scale Rectangular Ruler Automated Verification Device

Science.gov (United States)

Chen, Hao; Chang, Luping; Xing, Minjian; Xie, Xie

2018-03-01

This paper introduces a large-scale rectangular ruler automated verification device, which consists of photoelectric autocollimator and self-designed mechanical drive car and data automatic acquisition system. The design of mechanical structure part of the device refer to optical axis design, drive part, fixture device and wheel design. The design of control system of the device refer to hardware design and software design, and the hardware mainly uses singlechip system, and the software design is the process of the photoelectric autocollimator and the automatic data acquisition process. This devices can automated achieve vertical measurement data. The reliability of the device is verified by experimental comparison. The conclusion meets the requirement of the right angle test procedure.

Stud manipulating device

International Nuclear Information System (INIS)

Bunyan, T.W.

1980-01-01

A device for inserting and removing studs from bores in a workpiece, for example a nuclear reactor vessel, comprises manipulating devices for operating on individual studs, each capable of tensioning a stud slackening a working nut on the stud, and subsequently removing the stud from the bore. A ring has dogs which can engage working nut recesses to interlock with the nut against relative rotation. Motors coupled to the ring rotate the working nut. A top nut is coupled to the motors to rotate the nut and screw it onto the stud. The top nut with other device parts can be raised and lowered on a tube by a hydraulic actuator. A hydraulic load cell between the top nut and a stool on the workpiece is pressurised to tension the stud by means of the top nut and thus facilitate rotation of the working nut when tightening or slackening. A dog clutch mechanism engages a stud end fitting against relative axial and rotational movement. The mechanism is raised and lowered on a guide member by an actuator. The mechanism has a tubular member and the drive coupling for the motors to the top nut includes a tubular member. Tubular members carry teeth which are engaged when the top nut is raised and the clutch mechanism is lowered, to provide a coupling between the motors and the mechanism for rotating the stud. (U.K.)

21 CFR 890.3100 - Mechanical chair.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mechanical chair. 890.3100 Section 890.3100 Food... DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Prosthetic Devices § 890.3100 Mechanical chair. (a) Identification. A mechanical chair is a manually operated device intended for medical purposes that is used to...

Predictors of response to a nasal expiratory resistor device and its potential mechanisms of action for treatment of obstructive sleep apnea.

Science.gov (United States)

Patel, Amit V; Hwang, Dennis; Masdeu, Maria J; Chen, Guo-Ming; Rapoport, David M; Ayappa, Indu

2011-02-15

A one-way nasal resistor has recently been shown to reduce sleep disordered breathing (SDB) in a subset of patients with Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS). The purpose of this study was to examine characteristics predictive of therapeutic response to the device and provide pilot data as to its potential mechanisms of action. PATIENTS, INTERVENTIONS, AND MEASUREMENTS: 20 subjects (15M/5F, age 54 ± 12 years, BMI 33.5 ± 5.6 kg/m²) with OSAHS underwent 3 nocturnal polysomnograms (NPSG) including diagnostic, therapeutic (with a Provent® nasal valve device), and CPAP. Additional measurements included intranasal pressures and PCO₂, closing pressures (Pcrit), and awake lung volumes in different body positions. In 19/20 patients who slept with the device, RDI was significantly reduced with the nasal valve device compared to the diagnostic NPSG (27 ± 29/h vs 49 ± 28/h), with 50% of patients having an acceptable therapeutic response. Among demographic, lung volume, or diagnostic NPSG measures or markers of collapsibility, no significant predictors of therapeutic response were found. There was a suggestion that patients with position-dependent SDB (supine RDI > lateral RDI) were more likely to have an acceptable therapeutic response to the device. Successful elimination of SDB was associated with generation and maintenance of an elevated end expiratory pressure. No single definitive mechanism of action was elucidated. The present study shows that the nasal valve device can alter SDB across the full spectrum of SDB severity. There was a suggestion that subjects with positional or milder SDB in the lateral position were those most likely to respond.

21 CFR 890.3825 - Mechanical walker.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mechanical walker. 890.3825 Section 890.3825 Food... DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Prosthetic Devices § 890.3825 Mechanical walker. (a) Identification. A mechanical walker is a four-legged device with a metal frame intended for medical purposes to...

21 CFR 890.3750 - Mechanical table.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mechanical table. 890.3750 Section 890.3750 Food... DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Prosthetic Devices § 890.3750 Mechanical table. (a) Identification. A mechanical table is a device intended for medical purposes that has a flat surface that can be...

Current voltage perspective of an organic electronic device

Science.gov (United States)

Mukherjee, Ayash K.; Kumari, Nikita

2018-05-01

Nonlinearity in current (I) - voltage (V) measurement is a well-known attribute of two-terminal organic device, irrespective of the geometrical or structural arrangement of the device. Most of the existing theories that are developed for interpretation of I-V data, either focus current-voltage relationship of charge injection mechanism across the electrode-organic material interface or charge transport mechanism through the organic active material. On the contrary, both the mechanisms work in tandem charge conduction through the device. The transport mechanism is further complicated by incoherent scattering from scattering centres/charge traps that are located at the electrode-organic material interface and in the bulk of organic material. In the present communication, a collective expression has been formulated that comprises of all the transport mechanisms that are occurring at various locations of a planar organic device. The model has been fitted to experimental I-V data of Au/P3HT/Au device with excellent degree of agreement. Certain physical parameters such as the effective area of cross-section and resistance due to charge traps have been extracted from the fit.

Parametric mechanical design of new insertion devices at the APS.

Energy Technology Data Exchange (ETDEWEB)

Grimmer, J.; Kmak, R.

2005-01-01

Three permanent-magnet, planar, hybrid insertion device (ID) designs have recently been completed at the APS. The periods of these undulators are 2.7 cm, 3.0 cm and 3.5 cm with nominal lengths of 2.4 m. Several design studies were performed for the initial 2.7-cm-period device. Then a parametric solid model for the initial device was developed and value engineered to minimize manufacturing, assembly and tuning costs. The model allowed the very rapid design of subsequent devices of similar periods and allowed commonality of several components of the IDs. This design family incorporates a low-cost method of pole retention and registration. Poles are secured by screws in two holes tapped into each pole. Pole location is registered by means of two small dowel pins in mating holes reamed into each pole and a 'divider' plate common to the poles and magnets. This divider plate is flexible along its length so shimming behind it can be used to accurately change the height of a pair of poles for tuning. Another feature of the design is modular construction to allow each device to be used full length or shortened to a nominal 2.1 m length for use in APS 'canted undulator' sectors.

Multifunctional Energy Storage and Conversion Devices.

Science.gov (United States)

Huang, Yan; Zhu, Minshen; Huang, Yang; Pei, Zengxia; Li, Hongfei; Wang, Zifeng; Xue, Qi; Zhi, Chunyi

2016-10-01

Multifunctional energy storage and conversion devices that incorporate novel features and functions in intelligent and interactive modes, represent a radical advance in consumer products, such as wearable electronics, healthcare devices, artificial intelligence, electric vehicles, smart household, and space satellites, etc. Here, smart energy devices are defined to be energy devices that are responsive to changes in configurational integrity, voltage, mechanical deformation, light, and temperature, called self-healability, electrochromism, shape memory, photodetection, and thermal responsivity. Advisable materials, device designs, and performances are crucial for the development of energy electronics endowed with these smart functions. Integrating these smart functions in energy storage and conversion devices gives rise to great challenges from the viewpoint of both understanding the fundamental mechanisms and practical implementation. Current state-of-art examples of these smart multifunctional energy devices, pertinent to materials, fabrication strategies, and performances, are highlighted. In addition, current challenges and potential solutions from materials synthesis to device performances are discussed. Finally, some important directions in this fast developing field are considered to further expand their application. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Tension pneumothorax secondary to automatic mechanical compression decompression device.

Science.gov (United States)

Hutchings, A C; Darcy, K J; Cumberbatch, G L A

2009-02-01

The details are presented of the first published case of a tension pneumothorax induced by an automatic compression-decompression (ACD) device during cardiac arrest. An elderly patient collapsed with back pain and, on arrival of the crew, was in pulseless electrical activity (PEA) arrest. He was promptly intubated and correct placement of the endotracheal tube was confirmed by noting equal air entry bilaterally and the ACD device applied. On the way to the hospital he was noted to have absent breath sounds on the left without any change in the position of the endotracheal tube. Needle decompression of the left chest caused a hiss of air but the patient remained in PEA. Intercostal drain insertion in the emergency department released a large quantity of air from his left chest but without any change in his condition. Post-mortem examination revealed a ruptured abdominal aortic aneurysm as the cause of death. Multiple left rib fractures and a left lung laceration secondary to the use of the ACD device were also noted, although the pathologist felt that the tension pneumothorax had not contributed to the patient's death. It is recommended that a simple or tension pneumothorax should be considered when there is unilateral absence of breath sounds in addition to endobronchial intubation if an ACD device is being used.

A monitoring device for pressurised-air-driven diaphragm-based artificial heart assist devices

NARCIS (Netherlands)

Hoeben, F.P.; Hoeben, F.P.; de Mul, F.F.M.; Stokkink, J.S.D.; Stokkink, H.S.D.; Koelink, M.H.; Koelink, M.H.; Greve, Jan

1992-01-01

A non-invasive device has been developed to monitor the diaphragm position and the blood flow in artificial heart assist devices equipped with a pressurised-air-driven diaphragm. Light scattering from the diaphragm is used as a mechanism for measuring. Information about the position of several

Comparison of Low-Dose Catheter-Directed Thrombolysis with and without Pharmacomechanical Thrombectomy for Acute Lower Extremity Ischemia.

Science.gov (United States)

Gandhi, Sagar S; Ewing, Joseph A; Cooper, Emily; Chaves, Jose Mauro; Gray, Bruce H

2018-01-01

Catheter-directed thrombolysis (CDT) and/or pharmacomechanical thrombectomy (PMT) can dissolve/remove thrombus; PMT alone, however, may require the adjunctive use of CDT. The aim of this study was to compare the use of CDT with and without PMT for the treatment of acute lower extremity ischemia (ALI). We retrospectively reviewed all patients with ALI who underwent CDT with or without PMT between January 2008 and April 2014 (n = 99). Patients with incomplete medical charts were excluded (n = 16). Remaining patients were divided into 2 cohorts: group 1 included patients who underwent PMT + CDT (n = 54); group 2 included those who underwent CDT alone (n = 29). Lesions were further characterized by anatomic location: iliac disease (n = 14), femoropopliteal disease (n = 53), tibial disease (n = 2), and multilevel disease (n = 14). Data collection included patient and limb characteristics, duration of treatment, complications, clinical outcomes, adjunctive interventions, and follow-up. No significant differences were seen between treatment groups in terms of patient characteristics, occlusion length and location, Rutherford class, median duration of ischemia time (P = 0.22), or mean lysis time (P = 0.58). Treatment groups were also similar with regard to outcomes, including periprocedure complications, patency, reintervention, limb salvage, and amputation-free survival. There was no different between PMT + CDT and CDT alone in terms of periprocedural complications or outcomes. In the quest to resolve ALI, initial thrombus extraction with PMT may not reduce the need, duration, or efficacy of CDT. Copyright © 2017 Elsevier Inc. All rights reserved.

Parametric Mechanical Design of New Insertion Devices at the APS

CERN Document Server

Grimmer, John H

2005-01-01

Three permanent-magnet, planar, hybrid ID designs have recently been completed at the APS. The periods of the devices are 2.7 cm, 3.0 cm and 3.5 cm with nominal lengths of 2.4 m. Several design studies were performed for the initial 2.7 cm period device to investigate the utility of various design features. Then a parametric solid model for the initial device was developed and value engineered to minimize manufacturing, assembly and tuning costs. The model allowed the very rapid design of subsequent devices of similar periods and allowed commonality of several components of the IDs. This design family incorporates a low-cost method of pole retention and registration. Poles are secured by screws in two holes tapped into each pole. Pole location is registered by means of two small dowel pins for each pole in mating holes reamed into each pole and a base plate common to the poles and magnets. This base plate is flexible in bending along its length so shimming behind it can be used to accurately change the height...

The way to zeros: The future of semiconductor device and chemical mechanical polishing technologies

Science.gov (United States)

Tsujimura, Manabu

2016-06-01

For the last 60 years, the development of cutting-edge semiconductor devices has strongly emphasized scaling; the effort to scale down current CMOS devices may well achieve the target of 5 nm nodes by 2020. Planarization by chemical mechanical polishing (CMP), is one technology essential for supporting scaling. This paper summarizes the history of CMP transitions in the planarization process as well as the changing degree of planarity required, and, finally, introduces innovative technologies to meet the requirements. The use of CMP was triggered by the replacement of local oxidation of silicon (LOCOS) as the element isolation technology by shallow trench isolation (STI) in the 1980s. Then, CMP’s use expanded to improving embedability of aluminum wiring, tungsten (W) contacts, Cu wiring, and, more recently, to its adoption in high-k metal gate (HKMG) and FinFET (FF) processes. Initially, the required degree of planarity was 50 nm, but now 0 nm is required. Further, zero defects on a post-CMP wafer is now the goal, and it is possible that zero psi CMP loading pressure will be required going forward. Soon, it seems, everything will have to be “zero” and perfect. Although the process is also chemical in nature, the CMP process is actually mechanical with a load added using slurry particles several tens of nm in diameter. Zero load in the loading process, zero nm planarity with no trace of processing, and zero residual foreign material, including the very slurry particles used in the process, are all required. This article will provide an overview of how to achieve these new requirements and what technologies should be employed.

Future trials of endovascular mechanical recanalisation therapy in acute ischemic stroke patients: a position paper endorsed by ESMINT and ESNR. Pt. 1. Current situation and major research questions

Energy Technology Data Exchange (ETDEWEB)

Fiehler, Jens [University Medical Centre Hamburg-Eppendorf, Department of Neuroradiology, Hamburg (Germany); Soederman, Michael [Karolinska University Hospital, Department of Neuroradiology, Stockholm (Sweden); Turjman, Francis [Hopital Neurologique, Centre de Neurosciences Cognitives, Department of Neuroradiology, Lyon (France); White, Philip M. [Western General Hospital, University of Edinburgh, Department of Clinical Neurosciences, Edinburgh (United Kingdom); Bakke, Soeren Jacob [Oslo University Hospital, Rikshospitalet, Department of Neuroradiology, Oslo (Norway); Mangiafico, Salvatore [University Hospital Careggi, Interventional Neuroradiology Unit, Florence (Italy); Kummer, Ruediger von [University of Dresden, Department of Neuroradiology, Dresden (Germany); Muto, Mario [University of Naples, Department of Neuroradiology, Naples (Italy); Cognard, Christophe [Hopital Purpan, Service de Neuroradiologie, Toulouse (France); Gralla, Jan [Inselspital Bern, Department of Neuroradiology, Bern (Switzerland)

2012-12-15

A new era of stroke treatment may have begun with mechanical thrombectomy (MT) by fully deployed closed-cell self-expanding stents (stent-triever). Multiple case series and the first randomised controlled trials (RCTs) have now been published. More studies are under way involving large numbers of patients, which in turn has resulted in less strict ''pragmatic'' study protocols. Problems with current trials include a lack of standardisation in the conduct of the recanalisation procedure, the definition of primary endpoints such as the grade of arterial recanalisation and tissue reperfusion, and the post-surgical care provided. In Part 1 of this two part series, we outline the current situation and the major research questions. (orig.)

Mechanical CPR: Who? When? How?

Science.gov (United States)

Poole, Kurtis; Couper, Keith; Smyth, Michael A; Yeung, Joyce; Perkins, Gavin D

2018-05-29

In cardiac arrest, high quality cardiopulmonary resuscitation (CPR) is a key determinant of patient survival. However, delivery of effective chest compressions is often inconsistent, subject to fatigue and practically challenging.Mechanical CPR devices provide an automated way to deliver high-quality CPR. However, large randomised controlled trials of the routine use of mechanical devices in the out-of-hospital setting have found no evidence of improved patient outcome in patients treated with mechanical CPR, compared with manual CPR. The limited data on use during in-hospital cardiac arrest provides preliminary data supporting use of mechanical devices, but this needs to be robustly tested in randomised controlled trials.In situations where high-quality manual chest compressions cannot be safely delivered, the use of a mechanical device may be a reasonable clinical approach. Examples of such situations include ambulance transportation, primary percutaneous coronary intervention, as a bridge to extracorporeal CPR and to facilitate uncontrolled organ donation after circulatory death.The precise time point during a cardiac arrest at which to deploy a mechanical device is uncertain, particularly in patients presenting in a shockable rhythm. The deployment process requires interruptions in chest compression, which may be harmful if the pause is prolonged. It is recommended that use of mechanical devices should occur only in systems where quality assurance mechanisms are in place to monitor and manage pauses associated with deployment.In summary, mechanical CPR devices may provide a useful adjunct to standard treatment in specific situations, but current evidence does not support their routine use.

Efficacy of Blunt Force Trauma, a Novel Mechanical Cervical Dislocation Device, and a Non-Penetrating Captive Bolt Device for On-Farm Euthanasia of Pre-Weaned Kits, Growers, and Adult Commercial Meat Rabbits.

Science.gov (United States)

Walsh, Jessica L; Percival, Aaron; Turner, Patricia V

2017-12-15

The commercial meat rabbit industry is without validated on-farm euthanasia methods, potentially resulting in inadequate euthanasia protocols. We evaluated blunt force trauma (BFT), a mechanical cervical dislocation device (MCD), and a non-penetrating captive bolt device (NPCB) for euthanasia of pre-weaned kits, growers, and adult rabbits. Trials were conducted on three commercial meat rabbit farms using 170 cull rabbits. Insensibility was assessed by evaluating absence of brainstem and spinal reflexes, rhythmic breathing, and vocalizations. Survey radiographs on a subsample of rabbits ( n = 12) confirmed tissue damage prior to gross dissection and microscopic evaluation. All 63 rabbits euthanized by the NPCB device were rendered immediately and irreversibly insensible. The MCD device was effective in 46 of 49 (94%) rabbits. Method failure was highest for BFT with euthanasia failures in 13 of 58 (22%) rabbits. Microscopically, brain sections from rabbits killed with the NPCB device had significantly more damage than those from rabbits killed with BFT ( p = 0.001). We conclude that BFT is neither consistently humane nor effective as a euthanasia method. MCD is an accurate and reliable euthanasia method generally causing clean dislocation and immediate and irreversible insensibility, and the NPCB device was 100% effective and reliable in rabbits >150 g.

Efficacy of Blunt Force Trauma, a Novel Mechanical Cervical Dislocation Device, and a Non-Penetrating Captive Bolt Device for On-Farm Euthanasia of Pre-Weaned Kits, Growers, and Adult Commercial Meat Rabbits

Directory of Open Access Journals (Sweden)

Jessica L. Walsh

2017-12-01

Full Text Available The commercial meat rabbit industry is without validated on-farm euthanasia methods, potentially resulting in inadequate euthanasia protocols. We evaluated blunt force trauma (BFT, a mechanical cervical dislocation device (MCD, and a non-penetrating captive bolt device (NPCB for euthanasia of pre-weaned kits, growers, and adult rabbits. Trials were conducted on three commercial meat rabbit farms using 170 cull rabbits. Insensibility was assessed by evaluating absence of brainstem and spinal reflexes, rhythmic breathing, and vocalizations. Survey radiographs on a subsample of rabbits (n = 12 confirmed tissue damage prior to gross dissection and microscopic evaluation. All 63 rabbits euthanized by the NPCB device were rendered immediately and irreversibly insensible. The MCD device was effective in 46 of 49 (94% rabbits. Method failure was highest for BFT with euthanasia failures in 13 of 58 (22% rabbits. Microscopically, brain sections from rabbits killed with the NPCB device had significantly more damage than those from rabbits killed with BFT (p = 0.001. We conclude that BFT is neither consistently humane nor effective as a euthanasia method. MCD is an accurate and reliable euthanasia method generally causing clean dislocation and immediate and irreversible insensibility, and the NPCB device was 100% effective and reliable in rabbits >150 g.

Ergonomic material-handling device

Science.gov (United States)

Barsnick, Lance E.; Zalk, David M.; Perry, Catherine M.; Biggs, Terry; Tageson, Robert E.

2004-08-24

A hand-held ergonomic material-handling device capable of moving heavy objects, such as large waste containers and other large objects requiring mechanical assistance. The ergonomic material-handling device can be used with neutral postures of the back, shoulders, wrists and knees, thereby reducing potential injury to the user. The device involves two key features: 1) gives the user the ability to adjust the height of the handles of the device to ergonomically fit the needs of the user's back, wrists and shoulders; and 2) has a rounded handlebar shape, as well as the size and configuration of the handles which keep the user's wrists in a neutral posture during manipulation of the device.

21 CFR 866.2500 - Microtiter diluting and dispensing device.

Science.gov (United States)

2010-04-01

... SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2500... a mechanical device intended for medical purposes to dispense or serially dilute very small...

Comparative Efficacy of Pulse-Spray Thrombolysis and Angioplasty Versus Surgical Salvage Procedures for Treatment of Recurrent Occlusion of PTFE Dialysis Access Grafts

International Nuclear Information System (INIS)

Polak, Joseph F.; Berger, Markus F.; Pagan-Marin, Heriberto; Aruny, John E.; Meyerovitz, Michael F.

1998-01-01

Purpose: To compare the efficacy of surgery versus pulse-spray thrombolysis and angioplasty in patients with recurrent thrombosis of polytetrafluoroethylene (PTFE) dialysis access grafts. Methods: We analyzed 96 consecutive interventions for thrombosed PTFE dialysis access grafts in 18 patients. Primary patency after thrombolysis and angioplasty (n= 25) was compared with primary patency following thrombectomy alone (n= 50) or thrombectomy followed by graft revision (n= 21) using life-table analysis. A Cox proportional hazards model that accounted for graft age and number of previous interventions was used to generate the relative risk for recurrent occlusion following therapy. Results: Life-table analysis showed that patency after thrombolysis and angioplasty was greater than that following thrombectomy alone (p= 0.02). After accounting for the age of the graft and the number of previous interventions (average six per patient), the relative risk for recurrent occlusion [3.0; 95% confidence intervals (CI): 1.5, 6.4] was greater for thrombectomy alone than for thrombolysis/angioplasty [0.6; CI = 0.3, 1.3]. The relative risks of repeat occlusion following thrombolysis/angioplasty [0.6; CI = 0.3, 1.3] and thrombectomy/surgical revision [1.0; CI = 0.5, 1.7] were similar. Conclusion: Outcome data from our retrospective study on recurrent thrombosis of PTFE dialysis access grafts suggest that thrombolysis/angioplasty is superior to thrombectomy alone, and equivalent to thrombectomy/surgical revision

Microstructure and mechanical properties of stress-tailored piezoelectric AlN thin films for electro-acoustic devices

Energy Technology Data Exchange (ETDEWEB)

Reusch, Markus, E-mail: markus.reusch@iaf.fraunhofer.de [Laboratory for Compound Semiconductor Microsystems, IMTEK - Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg (Germany); Fraunhofer Institute for Applied Solid State Physics, Tullastrasse 72, 79108 Freiburg (Germany); Cherneva, Sabina [Institute of Mechanics, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl. 4, 1113 Sofia (Bulgaria); Lu, Yuan; Žukauskaitė, Agnė; Kirste, Lutz; Holc, Katarzyna [Fraunhofer Institute for Applied Solid State Physics, Tullastrasse 72, 79108 Freiburg (Germany); Datcheva, Maria [Institute of Mechanics, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl. 4, 1113 Sofia (Bulgaria); Stoychev, Dimitar [Institute of Physical Chemistry, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl. 11, 1113 Sofia (Bulgaria); Lebedev, Vadim [Fraunhofer Institute for Applied Solid State Physics, Tullastrasse 72, 79108 Freiburg (Germany); Ambacher, Oliver [Laboratory for Compound Semiconductor Microsystems, IMTEK - Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg (Germany); Fraunhofer Institute for Applied Solid State Physics, Tullastrasse 72, 79108 Freiburg (Germany)

2017-06-15

Highlights: • Sputtered AlN thin films with minimized intrinsic stress gradient. • Gradual increase of N{sub 2} concentration during film growth. • No degradation of AlN film properties by changing process conditions. • 2D Raman mapping of nanoindentation area. - Abstract: Nanoindentation measurements along with atomic force microscopy, X-ray diffraction, and residual stress analyses on the basis of Raman measurements have been performed to characterize stress-tailored AlN thin films grown using reactive RF magnetron sputtering. The intrinsic stress gradient caused by the growing in-plane grain size along film thickness was minimized by increasing the N{sub 2} concentration in the Ar/N{sub 2} gas mixture during the growth process. The increase of N{sub 2} concentration did not degrade the device-relevant material properties such as crystallographic orientation, surface morphology, piezoelectric response, or indentation modulus. Due to comparable crystallographic film properties for all investigated samples it was concluded that mainly the AlN crystallites contribute to the mechanical film properties such as indentation modulus and hardness, while the film stress or grain boundaries had only a minor influence. Therefore, by tailoring the stress gradient in the AlN films, device performance, fabrication yield, and the design flexibility of electro-acoustic devices can be greatly improved.

Brain-controlled body movement assistance devices and methods

Energy Technology Data Exchange (ETDEWEB)

Leuthardt, Eric C.; Love, Lonnie J.; Coker, Rob; Moran, Daniel W.

2017-01-10

Methods, devices, systems, and apparatus, including computer programs encoded on a computer storage medium, for brain-controlled body movement assistance devices. In one aspect, a device includes a brain-controlled body movement assistance device with a brain-computer interface (BCI) component adapted to be mounted to a user, a body movement assistance component operably connected to the BCI component and adapted to be worn by the user, and a feedback mechanism provided in connection with at least one of the BCI component and the body movement assistance component, the feedback mechanism being configured to output information relating to a usage session of the brain-controlled body movement assistance device.

Realization of the Switching Mechanism in Resistance Random Access Memory™ Devices: Structural and Electronic Properties Affecting Electron Conductivity in a Hafnium Oxide-Electrode System Through First-Principles Calculations

Science.gov (United States)

Aspera, Susan Meñez; Kasai, Hideaki; Kishi, Hirofumi; Awaya, Nobuyoshi; Ohnishi, Shigeo; Tamai, Yukio

2013-01-01

The resistance random access memory (RRAM™) device, with its electrically induced nanoscale resistive switching capacity, has attracted considerable attention as a future nonvolatile memory device. Here, we propose a mechanism of switching based on an oxygen vacancy migration-driven change in the electronic properties of the transition-metal oxide film stimulated by set pulse voltages. We used density functional theory-based calculations to account for the effect of oxygen vacancies and their migration on the electronic properties of HfO2 and Ta/HfO2 systems, thereby providing a complete explanation of the RRAM™ switching mechanism. Furthermore, computational results on the activation energy barrier for oxygen vacancy migration were found to be consistent with the set and reset pulse voltage obtained from experiments. Understanding this mechanism will be beneficial to effectively realizing the materials design in these devices.

Meniscal repair devices.

Science.gov (United States)

Barber, F A; Herbert, M A

2000-09-01

Meniscal repair devices not requiring accessory incisions are attractive. Many factors contribute to their clinical effectiveness including their biomechanical characteristics. This study compared several new meniscal repair devices with standard meniscal suture techniques. Using a porcine model, axis-of-insertion loads were applied to various meniscal sutures and repair devices. A single device or stitch was placed in a created meniscal tear and a load applied. Both loads and modes of failure were recorded. The load-to-failure data show stratification into 4 distinct statistical groups. Group A, 113 N for a double vertical stitch; group B, 80 N for a single vertical stitch; group C, 57 N for the BioStinger, 56 N for a horizontal mattress stitch, and 50 N for the T-Fix stitch; and group D, 33 N for the Meniscus Arrow (inserted by hand or gun), 32 N for the Clearfix screw, 31 N for the SDsorb staple, 30 N for the Mitek meniscal repair system, and 27 N for the Biomet staple. The failure mechanism varied. Sutures broke away from the knot. The Meniscus Arrow and BioStinger pulled through the inner rim with the crossbar intact. The Clearfix screw failed by multiple mechanisms, whereas 1 leg of the SDsorb staple always pulled out of the outer rim. The Mitek device usually failed by pullout from the inner rim. The Biomet staple always broke at the crosshead or just below it. Although the surgeon should be aware of the material properties of the repair technique chosen for a meniscal repair, this information is only an indication of device performance and may not correlate with clinical healing results.

Short structured feedback training is equivalent to a mechanical feedback device in two-rescuer BLS: a randomised simulation study.

Science.gov (United States)

Pavo, Noemi; Goliasch, Georg; Nierscher, Franz Josef; Stumpf, Dominik; Haugk, Moritz; Breckwoldt, Jan; Ruetzler, Kurt; Greif, Robert; Fischer, Henrik

2016-05-13

Resuscitation guidelines encourage the use of cardiopulmonary resuscitation (CPR) feedback devices implying better outcomes after sudden cardiac arrest. Whether effective continuous feedback could also be given verbally by a second rescuer ("human feedback") has not been investigated yet. We, therefore, compared the effect of human feedback to a CPR feedback device. In an open, prospective, randomised, controlled trial, we compared CPR performance of three groups of medical students in a two-rescuer scenario. Group "sCPR" was taught standard BLS without continuous feedback, serving as control. Group "mfCPR" was taught BLS with mechanical audio-visual feedback (HeartStart MRx with Q-CPR-Technology™). Group "hfCPR" was taught standard BLS with human feedback. Afterwards, 326 medical students performed two-rescuer BLS on a manikin for 8 min. CPR quality parameters, such as "effective compression ratio" (ECR: compressions with correct hand position, depth and complete decompression multiplied by flow-time fraction), and other compression, ventilation and time-related parameters were assessed for all groups. ECR was comparable between the hfCPR and the mfCPR group (0.33 vs. 0.35, p = 0.435). The hfCPR group needed less time until starting chest compressions (2 vs. 8 s, p feedback or by using a mechanical audio-visual feedback device was similar. Further studies should investigate whether extended human feedback training could further increase CPR quality at comparable costs for training.

Rf superconducting devices

International Nuclear Information System (INIS)

Hartwig, W.H.; Passow, C.

1975-01-01

Topics discussed include (1) the theory of superconductors in high-frequency fields (London surface impedance, anomalous normal surface resistance, pippard nonlocal theory, quantum mechanical model, superconductor parameters, quantum mechanical calculation techniques for the surface, impedance, and experimental verification of surface impedance theories); (2) residual resistance (separation of losses, magnetic field effects, surface resistance of imperfect and impure conductors, residual loss due to acoustic coupling, losses from nonideal surfaces, high magnetic field losses, field emission, and nonlinear effects); (3) design and performance of superconducting devices (design considerations, materials and fabrication techniques, measurement of performance, and frequency stability); (4) devices for particle acceleration and deflection (advantages and problems of using superconductors, accelerators for fast particles, accelerators for particles with slow velocities, beam optical devices separators, and applications and projects under way); (5) applications of low-power superconducting resonators (superconducting filters and tuners, oscillators and detectors, mixers and amplifiers, antennas and output tanks, superconducting resonators for materials research, and radiation detection with loaded superconducting resonators); and (6) transmission and delay lines

Electromagnetic brake/clutch device

Science.gov (United States)

Vranish, John M. (Inventor)

1994-01-01

An electromagnetic brake/clutch device includes a drive shaft supported by at least one bearing for transmitting torque, a housing, affixed to prevent its rotation, surrounding the drive shaft, and an electromagnetically activated device within the housing to selectively prevent and allow rotation of the drive shaft. The electromagnetically activated device includes a plurality of cammed rollers to prevent counter-clockwise rotation of the drive shaft. The drive shaft includes a circumferential disk and the housing includes a reaction ring for engagement with the plurality of cammed rollers. The plurality of cammed rollers are released from engagement with the circumferential disk and the reaction ring by a plurality of tripping mechanisms within the housing. The tripping action uses the locking force to act as a release force merely by changing the boundary conditions of the roller interface angles. The tripping mechanisms include trippers for disengaging the plurality of cammed rollers and an anvil shaped portion for providing lateral movement of the trippers. The plurality of cammed rollers is preloaded to engagement with the circumferential disk and reaction ring by a spring, and is located with respect to an adjacent tripping mechanism with another spring.

Latching device

Science.gov (United States)

Ulrich, G. W. (Inventor)

1975-01-01

A latching device is suited for use in establishing a substantially motionless connection between a stationary receiver and a movable latching mechanism. The latching mechanism includes a pivotally supported restraining hook continuously urged into a capturing relationship with the receiver, characterized by a spring-biased pawl having a plurality of aligned teeth. The teeth are seated in the surface of the throat of the hook and positionable into restraining engagement with a rigid restraining shoulder projected from the receiver.

The effect of sterilization and number of use on the accuracy of friction-style mechanical torque limiting devices for dental implants

Directory of Open Access Journals (Sweden)

Ali Fayaz

2014-01-01

Full Text Available Background: Mechanical torque limiting devices (MTLDs are necessary tools to control a peak torque and achieving target values of screw component of dental implants. Due to probable effect of autoclaving and number of use on the accuracy of these devices, this study aimed to evaluate the effect of sterilization and number of use on the accuracy of friction-style mechanical torque limiting devices (F-S MTLDs in achieving their target torque values. Materials and Methods: Peak torque measurements of 15 new F-S MTLDs from three different manufacturers (Astra Tech, BioHorizons, Dr. Idhe were measured ten times before and after 100 steam sterilization using a digital torque gauge. To simulate the clinical situation of aging (number of use target torque application process was repeated 10 times after each sterilization cycle and the peak torque values were registered. Comparison of the mean differences with target torque in each cycle was performed using one sample t test. Considering the type of MTLDs as inter subject comparison, One-way repeated measure ANOVA was used to evaluate the absolute values of differences between devices of each manufacturer in each group (α = 0.05. Results: The results of this study in Dr. Idhe group showed that, mean of difference values significantly differed from the target torque (P = 0.002 until 75 cycles. In Astra Tech group, also mean of difference values with under estimation trend, showed a significant difference with the target torque (P < 0.001. Mean of difference values significantly differed from the target torque with under estimation trend during all the 100 cycles in BioHorizons group (P < 0.05. Conclusion: The torque output of each individual device stayed in 10% difference from target torque values before 100 sterilization cycles, but more than 10% difference from the target torque was seen in varying degrees during these consequent cycles.

A Trusted Portable Computing Device

Science.gov (United States)

Ming-wei, Fang; Jun-jun, Wu; Peng-fei, Yu; Xin-fang, Zhang

A trusted portable computing device and its security mechanism were presented to solve the security issues, such as the attack of virus and Trojan horse, the lost and stolen of storage device, in mobile office. It used smart card to build a trusted portable security base, virtualization to create a secure virtual execution environment, two-factor authentication mechanism to identify legitimate users, and dynamic encryption to protect data privacy. The security environment described in this paper is characteristic of portability, security and reliability. It can meet the security requirement of mobile office.

Design and Analysis of a Novel Centrifugal Braking Device for a Mechanical Antilock Braking System.

Science.gov (United States)

Yang, Cheng-Ping; Yang, Ming-Shien; Liu, Tyng

2015-06-01

A new concept for a mechanical antilock braking system (ABS) with a centrifugal braking device (CBD), termed a centrifugal ABS (C-ABS), is presented and developed in this paper. This new CBD functions as a brake in which the output braking torque adjusts itself depending on the speed of the output rotation. First, the structure and mechanical models of the entire braking system are introduced and established. Second, a numerical computer program for simulating the operation of the system is developed. The characteristics of the system can be easily identified and can be designed with better performance by using this program to studying the effects of different design parameters. Finally, the difference in the braking performance between the C-ABS and the braking system with or without a traditional ABS is discussed. The simulation results indicate that the C-ABS can prevent the wheel from locking even if excessive operating force is provided while still maintaining acceptable braking performance.

Piezoelectric Structures and Low Power Generation Devices

Directory of Open Access Journals (Sweden)

Irinela CHILIBON

2016-10-01

Full Text Available A short overview of different piezoelectric structures and devices for generating renewable electricity under mechanical actions is presented. A vibrating piezoelectric device differs from a typical electrical power source in that it has capacitive rather than inductive source impedance, and may be driven by mechanical vibrations of varying amplitude. Several techniques have been developed to extract energy from the environment. Generally, “vibration energy” could be converted into electrical energy by three techniques: electrostatic charge, magnetic fields and piezoelectric. Mechanical resonance frequency of piezoelectric bimorph transducers depends on geometric size (length, width, and thickness of each layer, and the piezoelectric coefficients of the piezoelectric material. Manufacturing processes and intended applications of several energy harvesting devices are presented.

Fundamentals of semiconductor devices

CERN Document Server

Lindmayer, Joseph

1965-01-01

Semiconductor properties ; semiconductor junctions or diodes ; transistor fundamentals ; inhomogeneous impurity distributions, drift or graded-base transistors ; high-frequency properties of transistors ; band structure of semiconductors ; high current densities and mechanisms of carrier transport ; transistor transient response and recombination processes ; surfaces, field-effect transistors, and composite junctions ; additional semiconductor characteristics ; additional semiconductor devices and microcircuits ; more metal, insulator, and semiconductor combinations for devices ; four-pole parameters and configuration rotation ; four-poles of combined networks and devices ; equivalent circuits ; the error function and its properties ; Fermi-Dirac statistics ; useful physical constants.

Lung deposition and systemic bioavailability of different aerosol devices with and without humidification in mechanically ventilated patients.

Science.gov (United States)

Moustafa, Islam O F; Ali, Mohammed R A-A; Al Hallag, Moataz; Rabea, Hoda; Fink, James B; Dailey, Patricia; Abdelrahim, Mohamed E A

During mechanical ventilation medical aerosol delivery has been reported to be upto two fold greater with dry inhaled gas than with heated humidity. Urine levels at 0.5 h post dose (URSAL0.5%) has been confirmed as an index of lung deposition and 24 h (URSAL24%) as index of systemic absorption. Our aim was to determine the effect of humidification and aerosol device type on drug delivery to ventilated patients using urine levels. In a randomized crossover design, 36 (18female) mechanically ventilated patients were assigned to one of three groups. Groups 1 and 2 received 5000 μg salbutamol using vibrating mesh (VM) and jet nebulizers (JN), respectively, while group 3 received 1600 μg (16 puffs) of salbutamol via metered dose inhaler with AeroChamber Vent (MDI-AV). All devices were placed in the inspiratory limb of ventilator downstream from the humidifier. Each subject received aerosol with and without humidity at >24 h intervals with >12 h washout periods between salbutamol doses. Patients voided urine 15 min before each study dose and urine samples were collected at 0.5 h post dosing and pooled for the next 24 h. The MDI-AV and VM resulted in a higher percentage of urinary salbutamol levels compared to the JN (p < 0.05). Urine levels were similar between humidity and dry conditions. Our findings suggest that in-vitro reports overestimate the impact of dry vs. heated humidified conditions on the delivery of aerosol during invasive mechanical ventilation. Copyright © 2017 Elsevier Inc. All rights reserved.

Personalized biomedical devices & systems for healthcare applications

Science.gov (United States)

Chen, I.-Ming; Phee, Soo Jay; Luo, Zhiqiang; Lim, Chee Kian

2011-03-01

With the advancement in micro- and nanotechnology, electromechanical components and systems are getting smaller and smaller and gradually can be applied to the human as portable, mobile and even wearable devices. Healthcare industry have started to benefit from this technology trend by providing more and more miniature biomedical devices for personalized medical treatments in order to obtain better and more accurate outcome. This article introduces some recent development in non-intrusive and intrusive biomedical devices resulted from the advancement of niche miniature sensors and actuators, namely, wearable biomedical sensors, wearable haptic devices, and ingestible medical capsules. The development of these devices requires carful integration of knowledge and people from many different disciplines like medicine, electronics, mechanics, and design. Furthermore, designing affordable devices and systems to benefit all mankind is a great challenge ahead. The multi-disciplinary nature of the R&D effort in this area provides a new perspective for the future mechanical engineers.

Tunable organic distributed feedback dye laser device excited through Förster mechanism

Science.gov (United States)

Tsutsumi, Naoto; Hinode, Taiki

2017-03-01

Tunable organic distributed feedback (DFB) dye laser performances are re-investigated and characterized. The slab-type waveguide DFB device consists of air/active layer/glass substrate. Active layer consisted of tris(8-quinolinolato)aluminum (Alq3), 4-(dicyanomethylene)-2-methyl-6-(4-dimethylaminostyryl)-4H-pyran (DCM) dye, and polystyrene (PS) matrix. Effective energy transfer from Alq3 to DCM through Förster mechanism enhances the laser emission. Slope efficiency in the range of 4.9 and 10% is observed at pump energy region higher than 0.10-0.15 mJ cm-2 (lower threshold), which is due to the amplified spontaneous emission (ASE) and lasing. Typical slope efficiency for lasing in the range of 2.0 and 3.0% is observed at pump energy region higher than 0.25-0.30 mJ cm-2 (higher threshold). The tuning wavelength for the laser emission is ranged from 620 to 645 nm depending on the ASE region.

Assessment of the viscoelastic mechanical properties of polycarbonate urethane for medical devices.

Science.gov (United States)

Beckmann, Agnes; Heider, Yousef; Stoffel, Marcus; Markert, Bernd

2018-06-01

The underlying research work introduces a study of the mechanical properties of polycarbonate urethane (PCU), used in the construction of various medical devices. This comprises the discussion of a suitable material model, the application of elemental experiments to identify the related parameters and the numerical simulation of the applied experiments in order to calibrate and validate the mathematical model. In particular, the model of choice for the simulation of PCU response is the non-linear viscoelastic Bergström-Boyce material model, applied in the finite-element (FE) package Abaqus®. For the parameter identification, uniaxial tension and unconfined compression tests under in-laboratory physiological conditions were carried out. The geometry of the samples together with the applied loadings were simulated in Abaqus®, to insure the suitability of the modelling approach. The obtained parameters show a very good agreement between the numerical and the experimental results. Copyright © 2018 Elsevier Ltd. All rights reserved.

An Overview of Biofield Devices

Science.gov (United States)

Muehsam, David; Chevalier, Gaétan; Barsotti, Tiffany

2015-01-01

Advances in biophysics, biology, functional genomics, neuroscience, psychology, psychoneuroimmunology, and other fields suggest the existence of a subtle system of “biofield” interactions that organize biological processes from the subatomic, atomic, molecular, cellular, and organismic to the interpersonal and cosmic levels. Biofield interactions may bring about regulation of biochemical, cellular, and neurological processes through means related to electromagnetism, quantum fields, and perhaps other means of modulating biological activity and information flow. The biofield paradigm, in contrast to a reductionist, chemistry-centered viewpoint, emphasizes the informational content of biological processes; biofield interactions are thought to operate in part via low-energy or “subtle” processes such as weak, nonthermal electromagnetic fields (EMFs) or processes potentially related to consciousness and nonlocality. Biofield interactions may also operate through or be reflected in more well-understood informational processes found in electroencephalographic (EEG) and electrocardiographic (ECG) data. Recent advances have led to the development of a wide variety of therapeutic and diagnostic biofield devices, defined as physical instruments best understood from the viewpoint of a biofield paradigm. Here, we provide a broad overview of biofield devices, with emphasis on those devices for which solid, peer-reviewed evidence exists. A subset of these devices, such as those based upon EEG- and ECG-based heart rate variability, function via mechanisms that are well understood and are widely employed in clinical settings. Other device modalities, such a gas discharge visualization and biophoton emission, appear to operate through incompletely understood mechanisms and have unclear clinical significance. Device modes of operation include EMF-light, EMF-heat, EMF-nonthermal, electrical current, vibration and sound, physical and mechanical, intentionality and nonlocality

A novel in vitro model for hematogenous spreading of S. aureus device biofilms demonstrating clumping dispersal as an advantageous dissemination mechanism

DEFF Research Database (Denmark)

Grønnemose, Rasmus Birkholm; Lindhardt Sæderup (Madsen), Kirstine; Kolmos, Hans Jørn

2017-01-01

Staphylococcus aureus is able to disseminate from vascular device biofilms to the blood and organs, resulting in life-threatening infections such as endocarditis. The mechanisms behind spreading are largely unknown, especially how the bacterium escapes immune effectors and antibiotics in the proc......Staphylococcus aureus is able to disseminate from vascular device biofilms to the blood and organs, resulting in life-threatening infections such as endocarditis. The mechanisms behind spreading are largely unknown, especially how the bacterium escapes immune effectors and antibiotics...... the ability to adhere to and initiate colonization of endothelial cell layers under flow. In vivo experiments showed that the released biofilm material reached the heart similarly as ordinary broth-grown bacteria, but also that clumps to some extend were trapped in the lungs. The clumping dispersal of S....... aureus from in vivo-like vascular biofilms and their specific properties demonstrated here help explain the pathophysiology associated with S. aureus bloodstream infections....

Pharmaceutical counselling about different types of tablet-splitting methods based on the results of weighing tests and mechanical development of splitting devices.

Science.gov (United States)

Somogyi, O; Meskó, A; Csorba, L; Szabó, P; Zelkó, R

2017-08-30

The division of tablets and adequate methods of splitting them are a complex problem in all sectors of health care. Although tablet-splitting is often required, this procedure can be difficult for patients. Four tablets were investigated with different external features (shape, score-line, film-coat and size). The influencing effect of these features and the splitting methods was investigated according to the precision and "weight loss" of splitting techniques. All four types of tablets were halved by four methods: by hand, with a kitchen knife, with an original manufactured splitting device and with a modified tablet splitter based on a self-developed mechanical model. The mechanical parameters (harness and friability) of the products were measured during the study. The "weight loss" and precision of splitting methods were determined and compared by statistical analysis. On the basis of the results, the external features (geometry), the mechanical parameters of tablets and the mechanical structure of splitting devices can influence the "weight loss" and precision of tablet-splitting. Accordingly, a new decision-making scheme was developed for the selection of splitting methods. In addition, the skills of patients and the specialties of therapy should be considered so that pharmaceutical counselling can be more effective regarding tablet-splitting. Copyright © 2017 Elsevier B.V. All rights reserved.

A DNA Origami Mechanical Device for the Regulation of Microcosmic Structural Rigidity.

Science.gov (United States)

Wan, Neng; Hong, Zhouping; Wang, Huading; Fu, Xin; Zhang, Ziyue; Li, Chao; Xia, Han; Fang, Yan; Li, Maoteng; Zhan, Yi; Yang, Xiangliang

2017-11-01

DNA origami makes it feasible to fabricate a tremendous number of DNA nanostructures with various geometries, dimensions, and functionalities. Moreover, an increasing amount of research on DNA nanostructures is focused on biological and biomedical applications. Here, the reversible regulation of microcosmic structural rigidity is accomplished using a DNA origami device in vitro. The designed DNA origami monomer is composed of an internal central axis and an external sliding tube. Due to the external tube sliding, the device transforms between flexible and rigid states. By transporting the device into the liposome, the conformational change of the origami device induces a structural change in the liposome. The results obtained demonstrate that the programmed DNA origami device can be applied to regulate the microcosmic structural rigidity of liposomes. Because microcosmic structural rigidity is important to cell proliferation and function, the results obtained potentially provide a foundation for the regulation of cell microcosmic structural rigidity using DNA nanostructures. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Mechanical Devices Readiness FY04.0402.1

Energy Technology Data Exchange (ETDEWEB)

Bender, Thomas R.

2008-10-10

This Advanced Design and Production Technologies (ADAPT) project funded production process and tooling improvements to meet and sustain rate production for the program mechanism assemblies. Techniques were developed to allow evaluation and rework of sealed mechanisms that will result in prevention of the scrapping of future mechanisms. Future system mechanisms will likely be smaller with tighter tolerance parts that will require improved inspection equipment and techniques. During the latter phase of this project, the ISL (Intent Stronglink) PRT (Product Realization Team) developed designs and manufacturing processes at Sandia and at multiple KCP (Kansas City Plant) vendors, to produce glass ceramic headers to replace the brazed ceramic headers in the ISL. This achievement will result in significant production costs savings (unit cost and product scrap due to leaking headers).

RFQ device for accelerating particles

Science.gov (United States)

Shepard, K.W.; Delayen, J.R.

1995-06-06

A superconducting radio frequency quadrupole (RFQ) device includes four spaced elongated, linear, tubular rods disposed parallel to a charged particle beam axis, with each rod supported by two spaced tubular posts oriented radially with respect to the beam axis. The rod and post geometry of the device has four-fold rotation symmetry, lowers the frequency of the quadrupole mode below that of the dipole mode, and provides large dipole-quadrupole mode isolation to accommodate a range of mechanical tolerances. The simplicity of the geometry of the structure, which can be formed by joining eight simple T-sections, provides a high degree of mechanical stability, is insensitive to mechanical displacement, and is particularly adapted for fabrication with superconducting materials such as niobium. 5 figs.

RFQ device for accelerating particles

Energy Technology Data Exchange (ETDEWEB)

Shepard, Kenneth W. (Park Ridge, IL); Delayen, Jean R. (Naperville, IL)

1995-01-01

A superconducting radio frequency quadrupole (RFQ) device includes four spaced elongated, linear, tubular rods disposed parallel to a charged particle beam axis, with each rod supported by two spaced tubular posts oriented radially with respect to the beam axis. The rod and post geometry of the device has four-fold rotation symmetry, lowers the frequency of the quadrupole mode below that of the dipole mode, and provides large dipole-quadrupole mode isolation to accommodate a range of mechanical tolerances. The simplicity of the geometry of the structure, which can be formed by joining eight simple T-sections, provides a high degree of mechanical stability, is insensitive to mechanical displacement, and is particularly adapted for fabrication with superconducting materials such as niobium.

Use of piezoelectric multicomponent force measuring devices in fluid mechanics

Science.gov (United States)

Richter, A.; Stefan, K.

1979-01-01

The characterisitics of piezoelectric multicomponent transducers are discussed, giving attention to the advantages of quartz over other materials. The main advantage of piezoelectric devices in aerodynamic studies is their ability to indicate rapid changes in the values of physical parameters. Problems in the accuracy of measurments by piezoelectric devices can be overcome by suitable design approaches. A practical example is given of how such can be utilized to measure rapid fluctuations of fluid forces exerted on a circular cylinder mounted in a water channel.

Stenting of the cervical internal carotid artery in acute stroke management: The Karolinska experience.

Science.gov (United States)

Mpotsaris, Anastasios; Kabbasch, Christoph; Borggrefe, Jan; Gontu, Vamsi; Soderman, Michael

2017-04-01

Background Emergency stent placement in the extracranial internal carotid artery in combination with anterior circulation thrombectomy is a routine procedure. Yet, precise indications and clinical safety in this setting remains controversial. Present data for mechanical thrombectomy include few studies with acute stenting of tandem occlusions. We evaluated the feasibility, safety and clinical outcome of this endovascular treatment in a retrospective analysis of all consecutive cases at a comprehensive stroke centre. Methods This was a retrospective analysis of all consecutive patients with acute extracranial carotid artery occlusion including acute dissection or high-grade stenosis and concomitant intracranial large-vessel occlusion treated with emergency carotid stenting and intracranial mechanical thrombectomy between November 2007 and May 2015. Results A total of 63 patients with a median age of 67 years (range 33-84 years) were treated. Of these, 33 (52%) patients had concomitant intravenous thrombolysis with recombinant tissue-type plasminogen activator initially. Median admission National Institutes of Health Stroke Scale was 14 (range 1-29). Median time from stroke onset to recanalization was 408 minutes (range 165-1846 minutes). Procedure time was significantly shorter after intravenous thrombolysis (110 minutes [range 15-202 minutes] vs. 130 minutes [range 60-280 minutes]; p = 0.02). Three (5%) patients experienced post-procedural symptomatic intracerebral haemorrhage. In 55/63 (87%) patients, a score of ≥2b on the Thrombolysis in Cerebral Infarction scale could be achieved. Eight (13%) patients died, five (8%) during the acute phase. A total of 29/63 (46%) patients showed a favourable outcome (modified Rankin Scale score of 0-2) after three months. Conclusions Our single-centre retrospective analysis of emergency stent placement in the extracranial internal carotid artery in combination with anterior circulation thrombectomy demonstrated high

Long-term outcomes of acute ischemic stroke patients treated with endovascular thrombectomy: A real-world experience.

Science.gov (United States)

Zhao, Wenbo; Shang, Shuyi; Li, Chuanhui; Wu, Longfei; Wu, Chuanjie; Chen, Jian; Song, Haiqing; Zhang, Hongqi; Zhang, Yunzhou; Duan, Jiangang; Feng, Wuwei; Ji, Xunming

2018-07-15

Long-term follow-up of large trials have confirmed the superiority of endovascular thrombectomy (ET) for treating acute ischemic stroke (AIS). However, it is still unknown whether these results can be generalized to clinical practice. In this study, we aimed to determine the long-term outcomes of AIS post-ET in the real-world clinical practice. This observational study is based on a single-center prospective registry study. AIS patients were treated with second-generation stent retrievers from December 2012 to April 2016. The primary outcome was modified Ranks scale (mRS) at the time of the latest assessment. Favorable outcome was defined as mRS scores 0-2, and the unfavorable outcome was defined as mRS scores 3-6. Eighty-nine AIS subjects with large artery occlusion in anterior circulation undergoing ET were eligible for analysis. Median follow-up duration was 20 months (interquartile range 6-32), and 47 subjects (53%) achieved favorable outcome whereas 17 subjects (19%) were functional dependence and 25 subjects (28%) died. Independent predicators for long-term unfavorable outcome were higher baseline National Institutes of Health Stroke Scale (NIHSS) score (odd ratio:1.21;95% confidence interval 1.09-1.35; p < 0.001) and symptomatic intracerebral hemorrhage (sICH) (odd ratio:16.45;95% confidence interval 1.34-193.44; p = 0.026). More subjects of large-artery-atherosclerosis underwent permanent intracranial stenting (22%vs.10%) as compared with those of cardioembolism, while subjects of cardioembolism were more likely to experience sICH (13%vs.8%) and died (32%vs.16%). Over half of AIS patients can achieve favorable long-term outcomes post-ET. Higher baseline NIHSS scores and sICH are independently associated with unfavorable outcome. Overall, clinical practice in this single canter can replicate the long-term outcomes from the published endovascular clinical trials. Copyright © 2018 Elsevier B.V. All rights reserved.

Inhalation drug delivery devices: technology update

Directory of Open Access Journals (Sweden)

Ibrahim M

2015-02-01

Full Text Available Mariam Ibrahim, Rahul Verma, Lucila Garcia-ContrerasDepartment of Pharmaceutical Sciences, College of Pharmacy, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USAAbstract: The pulmonary route of administration has proven to be effective in local and systemic delivery of miscellaneous drugs and biopharmaceuticals to treat pulmonary and non-pulmonary diseases. A successful pulmonary administration requires a harmonic interaction between the drug formulation, the inhaler device, and the patient. However, the biggest single problem that accounts for the lack of desired effect or adverse outcomes is the incorrect use of the device due to lack of training in how to use the device or how to coordinate actuation and aerosol inhalation. This review summarizes the structural and mechanical features of aerosol delivery devices with respect to mechanisms of aerosol generation, their use with different formulations, and their advantages and limitations. A technological update of the current state-of-the-art designs proposed to overcome current challenges of existing devices is also provided.Keywords: pulmonary delivery, asthma, nebulizers, metered dose inhaler, dry powder inhaler

Electrical bistabilities and memory mechanisms of nonvolatile organic bistable devices based on exfoliated muscovite-type mica nanoparticle/poly(methylmethacrylate) nanocomposites

Science.gov (United States)

Lim, Won Gyu; Lee, Dea Uk; Na, Han Gil; Kim, Hyoun Woo; Kim, Tae Whan

2018-02-01

Organic bistable devices (OBDs) with exfoliated mica nanoparticles (NPs) embedded into an insulating poly(methylmethacrylate) (PMMA) layer were fabricated by using a spin-coating method. Current-voltage (I-V) curves for the Al/PMMA/exfoliated mica NP/PMMA/indium-tin-oxide/glass devices at 300 K showed a clockwise current hysteresis behavior due to the existence of the exfoliated muscovite-type mica NPs, which is an essential feature for bistable devices. Write-read-erase-read data showed that the OBDs had rewritable nonvolatile memories and an endurance number of ON/OFF switching for the OBDs of 102 cycles. An ON/OFF ratio of 1 × 103 was maintained for retention times larger than 1 × 104 s. The memory mechanisms of the fabricated OBDs were described by using the trapping and the tunneling processes within a PMMA active layer containing exfoliated muscovite-type mica NPs on the basis of the energy band diagram and the I-V curves.

Cardiac implantable electronic device lead extraction using the lead-locking device system: keeping it simple, safe, and inexpensive with mechanical tools and local anesthesia.

Science.gov (United States)

Manolis, Antonis S; Georgiopoulos, Georgios; Metaxa, Sofia; Koulouris, Spyridon; Tsiachris, Dimitris

2017-10-01

We have previously reported our successful approach for percutaneous cardiac implantable electronic device (CIED) lead extraction using inexpensive tools, which we have continued over the years. Herein we report the results of the systematic use of a unique stylet, the lead-locking device (LLD), which securely locks the entire lead lumen, aided with non-powered telescoping sheaths in 54 patients to extract 98 CIED leads. This prospective observational clinical study included 38 men and 16 women aged 68.9±13.1 years undergoing lead extraction for device infection (n=46), lead malfunction (n=5), or prior to defibrillator implant (n=3). Leads were in place for 6.7±4.3 years. Infections were more commonly due to Staphylococcus species (n=40). There were 78 pacing (31 ventricular, 37 atrial, 4 VDD, and 6 coronary sinus leads) and 20 defibrillating leads. Using simple traction (6 leads) and the LLD stylets (92 leads) aided with telescoping sheaths (15 patients), 96 (98%) leads in 52 (96.3%) patients were successfully removed, with all but one leads removed using a subclavian approach; in 1 patient, the right femoral approach was also required. In 2 patients, distal fragments from one ventricular pacing and one defibrillating lead could not be removed. Finally, lead removal was completely (52/54) (96.3%) or partially (2/54) (3.7%) successful in 54 patients for 96 of 98 leads (98%) without major complications. Percutaneous lead extraction can be successful with mechanical tools using the LLD locking stylet aided with non-powered telescoping sheaths through a simplified, safe, and inexpensive procedure using local anesthesia.

Microfiber devices based on carbon materials

OpenAIRE

Gengzhi Sun; Xuewan Wang; Peng Chen

2015-01-01

Microfiber devices are able to extend the micro/nano functionalities of materials or devices to the macroscopic scale with excellent flexibility and weavability, promising a variety of unique applications and, sometimes, also improved performance as compared with bulk counterparts. The fiber electrodes in these devices are often made of carbon materials (e.g. carbon nanotubes and graphene) because of their exceptional electrical, mechanical, and structural properties. Covering the latest deve...

Macro-mechanics controls quantum mechanics: mechanically controllable quantum conductance switching of an electrochemically fabricated atomic-scale point contact.

Science.gov (United States)

Staiger, Torben; Wertz, Florian; Xie, Fangqing; Heinze, Marcel; Schmieder, Philipp; Lutzweiler, Christian; Schimmel, Thomas

2018-01-12

Here, we present a silver atomic-scale device fabricated and operated by a combined technique of electrochemical control (EC) and mechanically controllable break junction (MCBJ). With this EC-MCBJ technique, we can perform mechanically controllable bistable quantum conductance switching of a silver quantum point contact (QPC) in an electrochemical environment at room temperature. Furthermore, the silver QPC of the device can be controlled both mechanically and electrochemically, and the operating mode can be changed from 'electrochemical' to 'mechanical', which expands the operating mode for controlling QPCs. These experimental results offer the perspective that a silver QPC may be used as a contact for a nanoelectromechanical relay.

Obstacles delaying the prompt deployment of piston-type mechanical cardiopulmonary resuscitation devices during emergency department resuscitation: a video-recording and time-motion study.

Science.gov (United States)

Huang, Edward Pei-Chuan; Wang, Hui-Chih; Ko, Patrick Chow-In; Chang, Anna Marie; Fu, Chia-Ming; Chen, Jiun-Wei; Liao, Yen-Chen; Liu, Hung-Chieh; Fang, Yao-De; Yang, Chih-Wei; Chiang, Wen-Chu; Ma, Matthew Huei-Ming; Chen, Shyr-Chyr

2013-09-01

The quality of cardiopulmonary resuscitation (CPR) is important to survival after cardiac arrest. Mechanical devices (MD) provide constant CPR, but their effectiveness may be affected by deployment timeliness. To identify the timeliness of the overall and of each essential step in the deployment of a piston-type MD during emergency department (ED) resuscitation, and to identify factors associated with delayed MD deployment by video recordings. Between December 2005 and December 2008, video clips from resuscitations with CPR sessions using a MD in the ED were reviewed using time-motion analyses. The overall deployment timeliness and the time spent on each essential step of deployment were measured. There were 37 CPR recordings that used a MD. Deployment of MD took an average 122.6 ± 57.8s. The 3 most time-consuming steps were: (1) setting the device (57.8 ± 38.3s), (2) positioning the patient (33.4 ± 38.0 s), and (3) positioning the device (14.7 ± 9.5s). Total no flow time was 89.1 ± 41.2s (72.7% of total time) and associated with the 3 most time-consuming steps. There was no difference in the total timeliness, no-flow time, and no-flow ratio between different rescuer numbers, time of day of the resuscitation, or body size of patients. Rescuers spent a significant amount of time on MD deployment, leading to long no-flow times. Lack of familiarity with the device and positioning strategy were associated with poor performance. Additional training in device deployment strategies are required to improve the benefits of mechanical CPR. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

MemFlash device: floating gate transistors as memristive devices for neuromorphic computing

Science.gov (United States)

Riggert, C.; Ziegler, M.; Schroeder, D.; Krautschneider, W. H.; Kohlstedt, H.

2014-10-01

Memristive devices are promising candidates for future non-volatile memory applications and mixed-signal circuits. In the field of neuromorphic engineering these devices are especially interesting to emulate neuronal functionality. Therefore, new materials and material combinations are currently investigated, which are often not compatible with Si-technology processes. The underlying mechanisms of the device often remain unclear and are paired with low device endurance and yield. These facts define the current most challenging development tasks towards a reliable memristive device technology. In this respect, the MemFlash concept is of particular interest. A MemFlash device results from a diode configuration wiring scheme of a floating gate transistor, which enables the persistent device resistance to be varied according to the history of the charge flow through the device. In this study, we investigate the scaling conditions of the floating gate oxide thickness with respect to possible applications in the field of neuromorphic engineering. We show that MemFlash cells exhibit essential features with respect to neuromorphic applications. In particular, cells with thin floating gate oxides show a limited synaptic weight growth together with low energy dissipation. MemFlash cells present an attractive alternative for state-of-art memresitive devices. The emulation of associative learning is discussed by implementing a single MemFlash cell in an analogue circuit.

MemFlash device: floating gate transistors as memristive devices for neuromorphic computing

International Nuclear Information System (INIS)

Riggert, C; Ziegler, M; Kohlstedt, H; Schroeder, D; Krautschneider, W H

2014-01-01

Memristive devices are promising candidates for future non-volatile memory applications and mixed-signal circuits. In the field of neuromorphic engineering these devices are especially interesting to emulate neuronal functionality. Therefore, new materials and material combinations are currently investigated, which are often not compatible with Si-technology processes. The underlying mechanisms of the device often remain unclear and are paired with low device endurance and yield. These facts define the current most challenging development tasks towards a reliable memristive device technology. In this respect, the MemFlash concept is of particular interest. A MemFlash device results from a diode configuration wiring scheme of a floating gate transistor, which enables the persistent device resistance to be varied according to the history of the charge flow through the device. In this study, we investigate the scaling conditions of the floating gate oxide thickness with respect to possible applications in the field of neuromorphic engineering. We show that MemFlash cells exhibit essential features with respect to neuromorphic applications. In particular, cells with thin floating gate oxides show a limited synaptic weight growth together with low energy dissipation. MemFlash cells present an attractive alternative for state-of-art memresitive devices. The emulation of associative learning is discussed by implementing a single MemFlash cell in an analogue circuit. (paper)

Innovative energy absorbing devices based on composite tubes

Science.gov (United States)

Tiwari, Chandrashekhar

Analytical and experimental study of innovative load limiting and energy absorbing devices are presented here. The devices are based on composite tubes and can be categorized in to two groups based upon the energy absorbing mechanisms exhibited by them, namely: foam crushing and foam fracturing. The device based on foam crushing as the energy absorbing mechanism is composed of light weight elastic-plastic foam filling inside an angle ply composite tube. The tube is tailored to have a high Poisson’s ratio (>20). Upon being loaded the device experiences large transverse contraction resulting in rapid decrease in diameter. At a certain axial load the foam core begins to crush and energy is dissipated. This device is termed as crush tube device. The device based upon foam shear fracture as the energy absorbing mechanism involves an elastic-plastic core foam in annulus of two concentric extension-twist coupled composite tubes with opposite angles of fibers. The core foam is bonded to the inner and outer tube walls. Upon being loaded axially, the tubes twist in opposite directions and fracture the core foam in out of plane shear and thus dissipate the energy stored. The device is termed as sandwich core device (SCD). The devices exhibit variations in force-displacement characteristics with changes in design and material parameters, resulting in wide range of energy absorption capabilities. A flexible matrix composite system was selected, which was composed of high stiffness carbon fibers as reinforcements in relatively low stiffness polyurethane matrix, based upon large strain to failure capabilities and large beneficial elastic couplings. Linear and non-linear analytical models were developed encapsulating large deformation theory of the laminated composite shells (using non-linear strain energy formulation) to the fracture mechanics of core foam and elastic-plastic deformation theory of the foam filling. The non-linear model is capable of including material and

Thermonuclear device

International Nuclear Information System (INIS)

Takano, Hirohisa; Nakamoto, Kazunari; Hanai, Satoshi.

1984-01-01

Purpose: To provide coils of high mechanical strength for use at the center of a torus type thermonuclear device. Constitution: A plurality of copper plates having cooling holes and bolt holes and insulation paper sheets of the same shape are prepared. The copper plate is different from the insulation paper sheet only in that the position-phase angle of the opening portion is larger by 15 - 30 0 . The copper plates and the insulation paper sheets are alternately stacked by a required number of turns while displacing the angle, and then clamped by bolts to form a mechanically strong coil with no metallurgical joining. Further, since the insulation paper sheets are not present in the radial direction and only one insulation paper sheet is inserted for each turn in the direction of the coil height, the space occupied by the coil can be decreased. According to this invention, the magnetic flux density at the center of the device can be increased as compared with the conventional case to thereby apply a higher voltage on the side of plasmas. (Moriyama, K.)

Control rod drive hydraulic device

International Nuclear Information System (INIS)

Takekawa, Toru.

1994-01-01

The device of the present invention can reliably prevent a possible erroneous withdrawal of control rod driving mechanism when the pressure of a coolant line is increased by isolation operation of hydraulic control units upon periodical inspection for a BWR type reactor. That is, a coolant line is connected to the downstream of a hydraulic supply device. The coolant line is connected to a hydraulic control unit. A coolant hydraulic detection device and a pressure setting device are disposed to the coolant line. A closing signal line and a returning signal line are disposed, which connect the hydraulic supply device and a flow rate control valve for the hydraulic setting device. In the device of the present invention, even if pressure of supplied coolants is elevated due to isolation of hydraulic control units, the elevation of the hydraulic pressure can be prevented. Accordingly, reliability upon periodical reactor inspection can be improved. Further, the facility is simplified and the installation to an existent facility is easy. (I.S.)

Materials and Reliability Handbook for Semiconductor Optical and Electron Devices

CERN Document Server

Pearton, Stephen

2013-01-01

Materials and Reliability Handbook for Semiconductor Optical and Electron Devices provides comprehensive coverage of reliability procedures and approaches for electron and photonic devices. These include lasers and high speed electronics used in cell phones, satellites, data transmission systems and displays. Lifetime predictions for compound semiconductor devices are notoriously inaccurate due to the absence of standard protocols. Manufacturers have relied on extrapolation back to room temperature of accelerated testing at elevated temperature. This technique fails for scaled, high current density devices. Device failure is driven by electric field or current mechanisms or low activation energy processes that are masked by other mechanisms at high temperature. The Handbook addresses reliability engineering for III-V devices, including materials and electrical characterization, reliability testing, and electronic characterization. These are used to develop new simulation technologies for device operation and ...

Medical instruments and devices principles and practices

CERN Document Server

Schreiner, Steven; Peterson, Donald R

2015-01-01

Medical Instruments and Devices: Principles and Practices originates from the medical instruments and devices section of The Biomedical Engineering Handbook, Fourth Edition. Top experts in the field provide material that spans this wide field. The text examines how biopotential amplifiers help regulate the quality and content of measured signals. It includes instruments and devices that span a range of physiological systems and the physiological scale: molecular, cellular, organ, and system. The book chronicles the evolution of pacemakers and their system operation and discusses oscillometry, cardiac output measurement, and the direct and indirect methods of measuring cardiac output. The authors also expound on the mechanics and safety of defibrillators and cover implantable stimulators, respiration, and the structure and function of mechanical ventilators. In addition, this text covers in depth: Anesthesia Delivery Electrosurgical Units and Devices Biomedical Lasers Measuring Cellular Traction Forces Blood G...

Control rod driving mechanism of reactor, control device and operation method therefor

International Nuclear Information System (INIS)

Ariyoshi, Masahiko; Matsumoto, Fujio; Matsumoto, Koji; Kinugasa, Kunihiko; Nara, Yoshihiko; Otama, Kiyomaro; Mikami, Takao

1998-01-01

The present invention provides a device for and a method of directly driving control rods of an FBR type reactor linearly by a cylinder type linear motor while having a driving shaft as an electric conductor. Namely, a linear induction motor drives a driving shaft connected with a control rod and vertically moving the control rod by electromagnetic force as an electric conductor. The position of the control rod is detected by a position detector. The driving shaft is hung by a wire by way of an electromagnet which is attachably/detachably held. With such a constitution, the driving shaft connected with the control rod can be vertically moved linearly, stopped or kept. Since they can be driven smoothly at a wide range speed, the responsibility and reliability of the reactor operation can be improved. In addition, since responsibility of the control rod operation is high, scram can be conducted by the linear motor. Since the driving mechanism can be simplified, maintenance and inspection operation can be mitigated. (I.S.)

Compound semiconductor device modelling

CERN Document Server

Miles, Robert

1993-01-01

Compound semiconductor devices form the foundation of solid-state microwave and optoelectronic technologies used in many modern communication systems. In common with their low frequency counterparts, these devices are often represented using equivalent circuit models, but it is often necessary to resort to physical models in order to gain insight into the detailed operation of compound semiconductor devices. Many of the earliest physical models were indeed developed to understand the 'unusual' phenomena which occur at high frequencies. Such was the case with the Gunn and IMPATI diodes, which led to an increased interest in using numerical simulation methods. Contemporary devices often have feature sizes so small that they no longer operate within the familiar traditional framework, and hot electron or even quantum­ mechanical models are required. The need for accurate and efficient models suitable for computer aided design has increased with the demand for a wider range of integrated devices for operation at...

Guide device

International Nuclear Information System (INIS)

Brammer, C.M. Jr.

1977-01-01

Disclosed is a fuel handling guide tube centering device for use in nuclear reactors during fuel assembly handling operations. The device comprises an outer ring secured to the flange of a nuclear reactor pressure vessel, a rotatable table rotatably coupled to the outer ring, and a plurality of openings through the table. Truncated locating cones are positioned in each of the openings in the table, and the locating cones center the guide tube during fuel handling operations. The openings in the table are located such that each fuel assembly in the nuclear core may be aligned with one of the openings by a suitable rotation of the table. The locating cones thereby provide alignment between the fuel handling mechanism located in the guide tube and the individual fuel assemblies of the cone. The need for a device to provide alignment is especially critical for floating nuclear power plants, where wave motion may exist during fuel handling operations. 5 claims, 4 figures

Basic mechanisms for the new millennium

International Nuclear Information System (INIS)

Dressendorfer, P.V.

1998-01-01

This part of the Short Course will review the basic mechanisms for radiation effects in semiconductor devices. All three areas of radiation damage will be considered -- total dose, displacement effects, and single event effects. Each of these areas will be discussed in turn. First an overview and background will be provided on the historical understanding of the damage mechanism. Then there will be a discussion of recent enhancements to the understanding of those mechanisms and an up-to-date picture provided of the current state of knowledge. Next the potential impact of each of these damage mechanisms on devices in emerging technologies and how the mechanisms may be used to understand device performance will be described, with an emphasis on those likely to be of importance in the new millennium. Finally some additional thoughts will be presented on how device scaling expected into the next century may impact radiation hardness

Compressed optimization of device architectures

Energy Technology Data Exchange (ETDEWEB)

Frees, Adam [Univ. of Wisconsin, Madison, WI (United States). Dept. of Physics; Gamble, John King [Microsoft Research, Redmond, WA (United States). Quantum Architectures and Computation Group; Ward, Daniel Robert [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States). Center for Computing Research; Blume-Kohout, Robin J [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States). Center for Computing Research; Eriksson, M. A. [Univ. of Wisconsin, Madison, WI (United States). Dept. of Physics; Friesen, Mark [Univ. of Wisconsin, Madison, WI (United States). Dept. of Physics; Coppersmith, Susan N. [Univ. of Wisconsin, Madison, WI (United States). Dept. of Physics

2014-09-01

Recent advances in nanotechnology have enabled researchers to control individual quantum mechanical objects with unprecedented accuracy, opening the door for both quantum and extreme- scale conventional computation applications. As these devices become more complex, designing for facility of control becomes a daunting and computationally infeasible task. Here, motivated by ideas from compressed sensing, we introduce a protocol for the Compressed Optimization of Device Architectures (CODA). It leads naturally to a metric for benchmarking and optimizing device designs, as well as an automatic device control protocol that reduces the operational complexity required to achieve a particular output. Because this protocol is both experimentally and computationally efficient, it is readily extensible to large systems. For this paper, we demonstrate both the bench- marking and device control protocol components of CODA through examples of realistic simulations of electrostatic quantum dot devices, which are currently being developed experimentally for quantum computation.

Topical review: spins and mechanics in diamond

Science.gov (United States)

Lee, Donghun; Lee, Kenneth W.; Cady, Jeffrey V.; Ovartchaiyapong, Preeti; Bleszynski Jayich, Ania C.

2017-03-01

There has been rapidly growing interest in hybrid quantum devices involving a solid-state spin and a macroscopic mechanical oscillator. Such hybrid devices create exciting opportunities to mediate interactions between disparate quantum bits (qubits) and to explore the quantum regime of macroscopic mechanical objects. In particular, a system consisting of the nitrogen-vacancy defect center (NV center) in diamond coupled to a high-quality-factor mechanical oscillator is an appealing candidate for such a hybrid quantum device, as it utilizes the highly coherent and versatile spin properties of the defect center. In this paper, we will review recent experimental progress on diamond-based hybrid quantum devices in which the spin and orbital dynamics of single defects are driven by the motion of a mechanical oscillator. In addition, we discuss prospective applications for this device, including long-range, phonon-mediated spin-spin interactions, and phonon cooling in the quantum regime. We conclude the review by evaluating the experimental limitations of current devices and identifying alternative device architectures that may reach the strong coupling regime.

In Situ TEM Creation of Nanowire Devices

DEFF Research Database (Denmark)

Alam, Sardar Bilal

Integration of silicon nanowires (SiNWs) as active components in devices requires that desired mechanical, thermal and electrical interfaces can be established between the nanoscale geometry of the SiNW and the microscale architecture of the device. In situ transmission electron microscopy (TEM),...

Building blocks of Collagen based biomaterial devices

Indian Academy of Sciences (India)

First page Back Continue Last page Overview Graphics. Building blocks of Collagen based biomaterial devices. Collagen as a protein. Collagen in tissues and organs. Stabilizing and cross linking agents. Immunogenicity. Hosts (drugs). Controlled release mechanisms of hosts. Biodegradability, workability into devices ...

Mechanically flexible optically transparent silicon fabric with high thermal budget devices from bulk silicon (100)

KAUST Repository

Hussain, Muhammad Mustafa

2013-05-30

Today’s information age is driven by silicon based electronics. For nearly four decades semiconductor industry has perfected the fabrication process of continuingly scaled transistor – heart of modern day electronics. In future, silicon industry will be more pervasive, whose application will range from ultra-mobile computation to bio-integrated medical electronics. Emergence of flexible electronics opens up interesting opportunities to expand the horizon of electronics industry. However, silicon – industry’s darling material is rigid and brittle. Therefore, we report a generic batch fabrication process to convert nearly any silicon electronics into a flexible one without compromising its (i) performance; (ii) ultra-large-scale-integration complexity to integrate billions of transistors within small areas; (iii) state-of-the-art process compatibility, (iv) advanced materials used in modern semiconductor technology; (v) the most widely used and well-studied low-cost substrate mono-crystalline bulk silicon (100). In our process, we make trenches using anisotropic reactive ion etching (RIE) in the inactive areas (in between the devices) of a silicon substrate (after the devices have been fabricated following the regular CMOS process), followed by a dielectric based spacer formation to protect the sidewall of the trench and then performing an isotropic etch to create caves in silicon. When these caves meet with each other the top portion of the silicon with the devices is ready to be peeled off from the bottom silicon substrate. Release process does not need to use any external support. Released silicon fabric (25 μm thick) is mechanically flexible (5 mm bending radius) and the trenches make it semi-transparent (transparency of 7%). © (2013) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.

Mechanically flexible optically transparent silicon fabric with high thermal budget devices from bulk silicon (100)

KAUST Repository

Hussain, Muhammad Mustafa; Rojas, Jhonathan Prieto; Sevilla, Galo T.

2013-01-01

Today’s information age is driven by silicon based electronics. For nearly four decades semiconductor industry has perfected the fabrication process of continuingly scaled transistor – heart of modern day electronics. In future, silicon industry will be more pervasive, whose application will range from ultra-mobile computation to bio-integrated medical electronics. Emergence of flexible electronics opens up interesting opportunities to expand the horizon of electronics industry. However, silicon – industry’s darling material is rigid and brittle. Therefore, we report a generic batch fabrication process to convert nearly any silicon electronics into a flexible one without compromising its (i) performance; (ii) ultra-large-scale-integration complexity to integrate billions of transistors within small areas; (iii) state-of-the-art process compatibility, (iv) advanced materials used in modern semiconductor technology; (v) the most widely used and well-studied low-cost substrate mono-crystalline bulk silicon (100). In our process, we make trenches using anisotropic reactive ion etching (RIE) in the inactive areas (in between the devices) of a silicon substrate (after the devices have been fabricated following the regular CMOS process), followed by a dielectric based spacer formation to protect the sidewall of the trench and then performing an isotropic etch to create caves in silicon. When these caves meet with each other the top portion of the silicon with the devices is ready to be peeled off from the bottom silicon substrate. Release process does not need to use any external support. Released silicon fabric (25 μm thick) is mechanically flexible (5 mm bending radius) and the trenches make it semi-transparent (transparency of 7%). © (2013) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.

Processing device for discharged water from radioactive material handling facility

International Nuclear Information System (INIS)

Kono, Takao; Kono, Hiroyuki; Yasui, Katsuaki; Kataiki, Koichi.

1995-01-01

The device of the present invention comprises a mechanical floating material-removing means for removing floating materials in discharged water, an ultrafiltration device for separating processed water discharged from the removing means by membranes, a reverse osmotic filtration device for separating the permeated water and a condensing means for evaporating condensed water. Since processed water after mechanically removing floating materials is supplied to the ultrafiltration device, the load applied on the filtering membrane is reduced, to simplify the operation control as a total. In addition, since the amount of resultant condensed water is reduced, and the devolumed condensed water is condensed and dried, the condensing device is made compact and the amount of resultant wastes is reduced. (T.M.)

Parameter extraction from I-V characteristics of PV devices

Energy Technology Data Exchange (ETDEWEB)

Macabebe, Erees Queen B. [Department of Electronics, Computer and Communications Engineering, Ateneo de Manila University, Loyola Heights, Quezon City 1108 (Philippines); Department of Physics and Centre for Energy Research, Nelson Mandela Metropolitan University, PO Box 77000, Port Elizabeth 6031 (South Africa); Sheppard, Charles J. [Department of Physics, University of Johannesburg, PO Box 524, Auckland Park 2006 (South Africa); Dyk, E. Ernest van [Department of Physics and Centre for Energy Research, Nelson Mandela Metropolitan University, PO Box 77000, Port Elizabeth 6031 (South Africa)

2011-01-15

Device parameters such as series and shunt resistances, saturation current and diode ideality factor influence the behaviour of the current-voltage (I-V) characteristics of solar cells and photovoltaic modules. It is necessary to determine these parameters since performance parameters are derived from the I-V curve and information provided by the device parameters are useful in analyzing performance losses. This contribution presents device parameters of CuIn(Se,S){sub 2}- and Cu(In,Ga)(Se,S){sub 2}-based solar cells, as well as, CuInSe{sub 2}, mono- and multicrystalline silicon modules determined using a parameter extraction routine that employs Particle Swarm Optimization. The device parameters of the CuIn(Se,S){sub 2}- and Cu(In,Ga)(Se,S){sub 2}-based solar cells show that the contribution of recombination mechanisms exhibited by high saturation current when coupled with the effects of parasitic resistances result in lower maximum power and conversion efficiency. Device parameters of photovoltaic modules extracted from I-V characteristics obtained at higher temperature show increased saturation current. The extracted values also reflect the adverse effect of temperature on parasitic resistances. The parameters extracted from I-V curves offer an understanding of the different mechanisms involved in the operation of the devices. The parameter extraction routine utilized in this study is a useful tool in determining the device parameters which reveal the mechanisms affecting device performance. (author)

Degradation mechanisms in organic photovoltaic devices

NARCIS (Netherlands)

Grossiord, Nadia; Kroon, Jan M.; Andriessen, Ronn; Blom, Paul W. M.

In the present review, the main degradation mechanisms occurring in the different layer stacking (i.e. photoactive layer, electrode, encapsulation film, interconnection) of polymeric organic solar cells and modules are discussed. Bulk and interfacial, as well as chemical and physical degradation

Bistable Mechanisms for Space Applications.

Science.gov (United States)

Zirbel, Shannon A; Tolman, Kyler A; Trease, Brian P; Howell, Larry L

2016-01-01

Compliant bistable mechanisms are monolithic devices with two stable equilibrium positions separated by an unstable equilibrium position. They show promise in space applications as nonexplosive release mechanisms in deployment systems, thereby eliminating friction and improving the reliability and precision of those mechanical devices. This paper presents both analytical and numerical models that are used to predict bistable behavior and can be used to create bistable mechanisms in materials not previously feasible for compliant mechanisms. Materials compatible with space applications are evaluated for use as bistable mechanisms and prototypes are fabricated in three different materials. Pin-puller and cutter release mechanisms are proposed as potential space applications.

Intervention radiology for venous thrombosis: early thrombus removal using invasive methods.

Science.gov (United States)

Casanegra, Ana I; McBane, Robert D; Bjarnason, Haraldur

2017-04-01

The post thrombotic syndrome is one of the most dreaded complications of proximal deep vein thrombosis. This syndrome leads to pain and suffering with leg swelling, recalcitrant ulceration and venous claudication which greatly impairs mobility and quality of life. The prevalence can be high in patients with iliofemoral venous involvement particularly in the setting of a proximal venous stenosis, such as occurs in May Thurner syndrome. Anticoagulation alone does not reduce the likelihood of this outcome. Compression therapy may be effective but garment discomfort limits its implementation. Pharmacomechanical thrombectomy, which combines catheter-directed thrombolysis with mechanical thrombus dissolution, provides an attractive treatment strategy for such patients. The rationale and delivery of pharmacomechanical thrombectomy, including patient selection and adjunctive antithrombotic therapy, will be reviewed in addition to tips and tricks for managing difficult patient scenarios. © 2017 John Wiley & Sons Ltd.

Electromechanically Actuated Multifunctional Wireless Auxetic Device for Wound Management.

Science.gov (United States)

Mir, Mariam; Ansari, Umar; Ali, Murtaza Najabat; Iftikhar, Muhammad Hassan Ul; Qayyum, Faisal

2017-01-01

The design and fabrication of a wound healing device for chronic wounds, with multiple functions for controlled drug delivery and exudate removal, has been described in this paper. The structural features have been machined and modified through laser cutting in a biocompatible polymer cast. Miniaturized versions of electronically actuated (lead-screw and pulley) mechanisms are used for the specific purpose of controlled drug delivery. These mechanisms have been studied and tested, being controlled through a microcontroller setup. An auxetic polymeric barrier membrane has been used for restricting the drug quantities administered. Drug delivery mechanisms are powered wirelessly, through an external, active RF component; this communicates with a passive component that is buried inside the wound healing device. The exudate removal efficiency of the device has been assessed through several simple tests using simulated wound exudate. It has been found that reasonably precise quantities of drug dosages to be administered to the wound site can be controlled through both drug delivery mechanisms; however, the lead-screw mechanism provides a better control of auxetic barrier membrane actuation and hence controlled drug delivery. We propose that this device can have potential clinical significance in controlled drug delivery and exudate removal in the management of chronic wounds.

Simulation of leakage through mechanical sealing device

Science.gov (United States)

Tikhomorov, V. P.; Gorlenko, O. A.; Izmerov, M. A.

2018-03-01

The procedure of mathematical modeling of leakage through the mechanical seal taking into account waviness and roughness is considered. The percolation process is represented as the sum of leakages through a gap between wavy surfaces and percolation through gaps formed by fractal roughness, i.e. the total leakage is determined by the slot model and filtration leakage. Dependences of leaks on the contact pressure of corrugated and rough surfaces of the mechanical seal elements are presented.

Substrate structures for InP-based devices

International Nuclear Information System (INIS)

Wanlass, M.W.; Sheldon, P.

1990-01-01

A substrate structure for an InP-based semiconductor device having an InP based film is described. The substrate structure includes a substrate region having a lightweight bulk substrate and an upper GaAs layer. An interconnecting region is disposed between the substrate region and the InP-based device. The interconnecting region includes a compositionally graded intermediate layer substantially lattice-matched at the opposite end to the InP=based film. The interconnecting region further includes a dislocation mechanism disposed between the GaAs layer and the InP-based film in cooperation with the graded intermediate layer, the buffer mechanism blocking and inhibiting propagation of threading dislocations between the substrate region, and the InP-based device

Processes for multi-layer devices utilizing layer transfer

Science.gov (United States)

Nielson, Gregory N; Sanchez, Carlos Anthony; Tauke-Pedretti, Anna; Kim, Bongsang; Cederberg, Jeffrey; Okandan, Murat; Cruz-Campa, Jose Luis; Resnick, Paul J

2015-02-03

A method includes forming a release layer over a donor substrate. A plurality of devices made of a first semiconductor material are formed over the release layer. A first dielectric layer is formed over the plurality of devices such that all exposed surfaces of the plurality of devices are covered by the first dielectric layer. The plurality of devices are chemically attached to a receiving device made of a second semiconductor material different than the first semiconductor material, the receiving device having a receiving substrate attached to a surface of the receiving device opposite the plurality of devices. The release layer is etched to release the donor substrate from the plurality of devices. A second dielectric layer is applied over the plurality of devices and the receiving device to mechanically attach the plurality of devices to the receiving device.

Implementation of a mechanical CPR device in a physician staffed HEMS - a prospective observational study.

Science.gov (United States)

Rauch, Simon; Strapazzon, Giacomo; Brodmann, Monika; Fop, Ernst; Masoner, Christian; Rauch, Lydia; Forti, Alessandro; Pietsch, Urs; Mair, Peter; Brugger, Hermann

2018-04-28

In this prospective, observational study we describe the incidence and characteristics of out of hospital cardiac arrest (OHCA) cases who received mechanical CPR, after the implementation of a mechanical CPR device (LUCAS 2; Physio Control, Redmond, WA, USA) in a physician staffed helicopter emergency medical service (HEMS) in South Tyrol, Italy. During the study period (06/2013-04/2016), 525 OHCA cases were registered by the dispatch centre, 271 (51.6%) were assisted by HEMS. LUCAS 2 was applied in 18 (6.6%) of all HEMS-assisted OHCA patients; ten were treated with LUCAS 2 at the scene only, and eight were transported to hospital with ongoing CPR. Two (11.1%) of the 18 patients survived long term with full neurologic recovery. In seven of eight patients transferred to hospital with ongoing CPR, CPR was ceased in the emergency room without further intervention. Retrospectively, all HEMS-assisted OHCA cases were screened for proposed indication criteria for prolonged CPR. Thirteen patients fulfilled these criteria, but only two of them were transported to hospital. Based on these results, we propose a standard operating procedure for HEMS-assisted patients with refractory OHCA in a region without hospitals with ECLS capacity.

Application of magnetic devices in otiatria

Energy Technology Data Exchange (ETDEWEB)

Kuznetsov, Anatoly A. E-mail: akuz@sky.chph.ras.ru; Yunin, Alexander M.; Savichev, Alexander A.; Kuznetsov, Oleg A. E-mail: oleg@louisiana.edu; Dmitriev, Nikolai S.; Palchun, Victor T

2001-07-01

Several implantable prostheses and other devices based on permanent magnets and using magneto-mechanical forces for their operation were developed for treating middle ear diseases and hearing rehabilitation. Methods of surgical application of the devices were developed and in clinical trials more than 85% of 127 patients with different degrees of middle ear system degradation have shown stable improvement.

Application of magnetic devices in otiatria

International Nuclear Information System (INIS)

Kuznetsov, Anatoly A.; Yunin, Alexander M.; Savichev, Alexander A.; Kuznetsov, Oleg A.; Dmitriev, Nikolai S.; Palchun, Victor T.

2001-01-01

Several implantable prostheses and other devices based on permanent magnets and using magneto-mechanical forces for their operation were developed for treating middle ear diseases and hearing rehabilitation. Methods of surgical application of the devices were developed and in clinical trials more than 85% of 127 patients with different degrees of middle ear system degradation have shown stable improvement

Surgical treatment of Renal Cell Carcinoma (RCC with level III–IV tumor venous thrombosis

Directory of Open Access Journals (Sweden)

M. I. Davydov

2016-01-01

Full Text Available Objective: to assess the results of nephrectomy, thrombectomy in RCC patients with level III–IV tumor venous thrombosis with and without cardiopulmonary bypass.Materials and methods. Medical data of 167 consecutive RCC patients with level III–IV tumor venous thrombosis underwent nephrectomy thrombectomy in N.N. Blokhin Russian Cancer Research Center between 1998 and 2012 were collected. Right side tumor was in 122 (73.1 %, left side – in 42 (25.1 %, bilateral – in 3 (1.8 % cases. The extent of thrombus was defined as intrahepatic in 82 (49.1 %, supradiaphragmatic – in 85 (50.9 % (intrapericardial – in 44 (26.3 %, intraatrial – in 39 (23.4 %, intraventricular – in 2 (1.2 % cases. Nephrectomy, thrombectomy with cardiopulmonary bypass was used in 9 (5.4 %, 158 (94.6 % patients underwent radical nephrectomy with thrombectomy without CPBP and sternotomy. Intrapericardial IVC and right atrium were exposed through transdiaphragmatic approach and providing vascular control over infradiaphragmatic IVC and renal veins.Results. Median blood loss was 6000 (600–27 000 ml. Complications rate was 62.8 %, 90-day mortality – 13.2 %. Intraoperative complications were registered in 80 (47.9 %, postoperative – in 66 (40.5 % (grade II – 16 (9.8 %, grade IIIb – 1 (0.6 %, grade IVа – 28 (17.2 %, grade IVb – 3 (1.8 %, grade V – 18 (11.1 % patients. Modified thrombectomy technique insignificantly decreased blood loss compared to thrombectomy with CPB, did nоt increase complications rate including pulmonary vein thromboembolism, or mortality. Five-year overall, cancer-specific and recurrence-free survival was 46.2, 58.3 and 47.1 %, respectively. Thrombectomy technique did nоt affect survival.Conclusion. In selected patients with mobile thrombi transdiaphragmatic approach allows to avoid the use of CPBP and decrease surgical morbidity without survival compromising.

Surface micromachined counter-meshing gears discrimination device

International Nuclear Information System (INIS)

Polosky, M.A.; Garcia, E.J.; Allen, J.J.

1998-01-01

This paper discusses the design, fabrication and testing of a surface micromachined Counter-Meshing Gears (CMG) discrimination device which functions as a mechanically coded lock, A 24 bit code is input to unlock the device. Once unlocked, the device provides a path for an energy or information signal to pass through the device. The device is designed to immediately lock up if any portion of the 24 bit code is incorrect. The motivation for the development of this device is based on occurrences referred to as High Consequence Events, A High Consequence Event is an event where an inadvertent operation of a system could result in the catastrophic loss of life, property, or damage to the environment

Macro-mechanics controls quantum mechanics: mechanically controllable quantum conductance switching of an electrochemically fabricated atomic-scale point contact

Science.gov (United States)

Staiger, Torben; Wertz, Florian; Xie, Fangqing; Heinze, Marcel; Schmieder, Philipp; Lutzweiler, Christian; Schimmel, Thomas

2018-01-01

Here, we present a silver atomic-scale device fabricated and operated by a combined technique of electrochemical control (EC) and mechanically controllable break junction (MCBJ). With this EC-MCBJ technique, we can perform mechanically controllable bistable quantum conductance switching of a silver quantum point contact (QPC) in an electrochemical environment at room temperature. Furthermore, the silver QPC of the device can be controlled both mechanically and electrochemically, and the operating mode can be changed from ‘electrochemical’ to ‘mechanical’, which expands the operating mode for controlling QPCs. These experimental results offer the perspective that a silver QPC may be used as a contact for a nanoelectromechanical relay.

Mechanical Properties of Organic Semiconductors for Stretchable, Highly Flexible, and Mechanically Robust Electronics.

Science.gov (United States)

Root, Samuel E; Savagatrup, Suchol; Printz, Adam D; Rodriquez, Daniel; Lipomi, Darren J

2017-05-10

Mechanical deformability underpins many of the advantages of organic semiconductors. The mechanical properties of these materials are, however, diverse, and the molecular characteristics that permit charge transport can render the materials stiff and brittle. This review is a comprehensive description of the molecular and morphological parameters that govern the mechanical properties of organic semiconductors. Particular attention is paid to ways in which mechanical deformability and electronic performance can coexist. The review begins with a discussion of flexible and stretchable devices of all types, and in particular the unique characteristics of organic semiconductors. It then discusses the mechanical properties most relevant to deformable devices. In particular, it describes how low modulus, good adhesion, and absolute extensibility prior to fracture enable robust performance, along with mechanical "imperceptibility" if worn on the skin. A description of techniques of metrology precedes a discussion of the mechanical properties of three classes of organic semiconductors: π-conjugated polymers, small molecules, and composites. The discussion of each class of materials focuses on molecular structure and how this structure (and postdeposition processing) influences the solid-state packing structure and thus the mechanical properties. The review concludes with applications of organic semiconductor devices in which every component is intrinsically stretchable or highly flexible.

49 CFR 173.340 - Tear gas devices.

Science.gov (United States)

2010-10-01

... SHIPMENTS AND PACKAGINGS Gases; Preparation and Packaging § 173.340 Tear gas devices. (a) Packagings for...) Tear gas devices may not be assembled with, or packed in the same packaging with, mechanically- or manually-operated firing, igniting, bursting, or other functioning elements unless of a type and design...

DEVICE FOR CONTROL OF OXYGEN PARTIAL PRESSURE

Science.gov (United States)

Bradner, H.; Gordon, H.S.

1957-12-24

A device is described that can sense changes in oxygen partial pressure and cause a corresponding mechanical displacement sufficient to actuate meters, valves and similar devices. A piston and cylinder arrangement contains a charge of crystalline metal chelate pellets which have the peculiar property of responding to variations in the oxygen content of the ambient atmosphere by undergoing a change in dimension. A lever system amplifies the relative displacement of the piston in the cylinder, and actuates the controlled valving device. This partial pressure oxygen sensing device is useful in controlled chemical reactions or in respiratory devices such as the oxygen demand meters for high altitude aircraft.

Mechanical performance of cervical intervertebral body fusion devices: A systematic analysis of data submitted to the Food and Drug Administration.

Science.gov (United States)

Peck, Jonathan H; Sing, David C; Nagaraja, Srinidhi; Peck, Deepa G; Lotz, Jeffrey C; Dmitriev, Anton E

2017-03-21

Cervical intervertebral body fusion devices (IBFDs) are utilized to provide stability while fusion occurs in patients with cervical pathology. For a manufacturer to market a new cervical IBFD in the United States, substantial equivalence to a cervical IBFD previously cleared by FDA must be established through the 510(k) regulatory pathway. Mechanical performance data are typically provided as part of the 510(k) process for IBFDs. We reviewed all Traditional 510(k) submissions for cervical IBFDs deemed substantially equivalent and cleared for marketing from 2007 through 2014. To reduce sources of variability in test methods and results, analysis was restricted to cervical IBFD designs without integrated fixation, coatings, or expandable features. Mechanical testing reports were analyzed and results were aggregated for seven commonly performed tests (static and dynamic axial compression, compression-shear, and torsion testing per ASTM F2077, and subsidence testing per ASTM F2267), and percentile distributions of performance measurements were calculated. Eighty-three (83) submissions met the criteria for inclusion in this analysis. The median device yield strength was 10,117N for static axial compression, 3680N for static compression-shear, and 8.6Nm for static torsion. Median runout load was 2600N for dynamic axial compression, 1400N for dynamic compression-shear, and ±1.5Nm for dynamic torsion. In subsidence testing, median block stiffness (Kp) was 424N/mm. The mechanical performance data presented here will aid in the development of future cervical IBFDs by providing a means for comparison for design verification purposes. Published by Elsevier Ltd.

Parasitic phenomena in the dynamics of industrial devices

CERN Document Server

Borboni, Alberto

2011-01-01

In the real world the dynamic behavior of a real machine presents either unforeseen or limiting phenomena: both are undesired, and can be therefore be classified as parasitic phenomena - unwanted, unforeseen, or limiting behaviors. Parasitic Phenomena in the Dynamics of Industrial Devices describes the potential causes and effects of these behaviors and provides indications that could minimize their influence on the mechanical system in question. The authors introduce the phenomena and explore them through real cases, avoiding academic introductions, but inserting the entire academic and experimental knowledge that is useful to understand and solve real-world problems. They then examine these parasitic phenomena in the machine dynamics, using two cases that cover the classical cultural division between cam devices and mechanisms. They also present concrete cases with an amount of experimental data higher than the proposed ones and with a modern approach that can be applied to various mechanical devices, acqui...

Mechanical appliances, mechanical movements and novelties of construction

CERN Document Server

Hiscox, Gardner D

2008-01-01

From the devices that power ships and trains to the workings of clocks, typewriters, and guns, this engrossing visual narrative profiles the specific and unique properties of hundreds of mechanical devices. Nearly 1,000 detailed illustrations depict steam-powered appliances, spring-powered devices, hydraulic equipment, and other machines, many of which remain in common use today. Each apparatus features a detailed line drawing and an informative explanation of its workings and uses. A final chapter chronicles 400 years of impassioned but futile searching for a perpetual motion machine.The comp

Investigation of mechanical bending instability in flexible low-temperature-processed electrochromic display devices

Energy Technology Data Exchange (ETDEWEB)

Cheng, Chin-Pao; Chou, Chuan-Pu; Hsu, Che-Hsiang; Teng, Tun-Chien; Cheng, Chun-Hu, E-mail: chcheng@ntnu.edu.tw; Syu, Yu-Yang

2015-06-01

In this study, polyethylene naphthalate (PEN) was investigated as a flexible substrate because, compared with polyethylene terephthalate, it achieves a lower root mean square roughness and transmittance, which is favorable for reducing leakage from the bottom of flexible substrates. A flexible device structure composed of tungsten oxide/indium-doped tin oxide/PEN was used in an electrochromic (EC) test. The experimental results show that the flexible EC display device achieved a high transmittance difference of > 40% and color efficiency of 70.2 cm{sup 2}/C at 560 nm. The transmittance difference was degraded in the visible range after 200 cycles of continuous bending. Furthermore, compared with flat fresh devices, the WO{sub 3} device exhibited poor retention properties in a colored state after being subjected to longer bending cycles. - Highlights: • Flexible electrochromic device with endurance bending was demonstrated. • Interface defects or vacancies near the flexible substrate affect the self-bleaching behavior. • High color efficiency of 117.2 cm{sup 2}/coul at 700 nm wavelength is reached. • Interface defect centers lower the redox energy barrier which reduces the bleaching time.

Nature-Inspired Structural Materials for Flexible Electronic Devices.

Science.gov (United States)

Liu, Yaqing; He, Ke; Chen, Geng; Leow, Wan Ru; Chen, Xiaodong

2017-10-25

Exciting advancements have been made in the field of flexible electronic devices in the last two decades and will certainly lead to a revolution in peoples' lives in the future. However, because of the poor sustainability of the active materials in complex stress environments, new requirements have been adopted for the construction of flexible devices. Thus, hierarchical architectures in natural materials, which have developed various environment-adapted structures and materials through natural selection, can serve as guides to solve the limitations of materials and engineering techniques. This review covers the smart designs of structural materials inspired by natural materials and their utility in the construction of flexible devices. First, we summarize structural materials that accommodate mechanical deformations, which is the fundamental requirement for flexible devices to work properly in complex environments. Second, we discuss the functionalities of flexible devices induced by nature-inspired structural materials, including mechanical sensing, energy harvesting, physically interacting, and so on. Finally, we provide a perspective on newly developed structural materials and their potential applications in future flexible devices, as well as frontier strategies for biomimetic functions. These analyses and summaries are valuable for a systematic understanding of structural materials in electronic devices and will serve as inspirations for smart designs in flexible electronics.

Compliant Interfacial Layers in Thermoelectric Devices

Science.gov (United States)

Firdosy, Samad A. (Inventor); Li, Billy Chun-Yip (Inventor); Ravi, Vilupanur A. (Inventor); Fleurial, Jean-Pierre (Inventor); Caillat, Thierry (Inventor); Anjunyan, Harut (Inventor)

2017-01-01

A thermoelectric power generation device is disclosed using one or more mechanically compliant and thermally and electrically conductive layers at the thermoelectric material interfaces to accommodate high temperature differentials and stresses induced thereby. The compliant material may be metal foam or metal graphite composite (e.g. using nickel) and is particularly beneficial in high temperature thermoelectric generators employing Zintl thermoelectric materials. The compliant material may be disposed between the thermoelectric segments of the device or between a thermoelectric segment and the hot or cold side interconnect of the device.

Travelling type monitoring and inspection device

International Nuclear Information System (INIS)

Ito, Takao; Maruki, Hideaki.

1994-01-01

The present invention sufficiently ensures video output images even if lenses of a television camera of a monitoring means are degraded to reduce the quantity of transmission light. That is, a light amount control mechanism capable of controlling the quantity of illumination light irradiated from an illumination device at an output level of a sensor of an inspection device main body. A test chart for measuring a luminance which is an output level of the sensor is disposed. During plant operation, the lenses of the television camera undergo influences of radioactivity and are degraded to reduce the quantity of transmission light on every periodical monitoring and inspection using a travelling type monitoring inspection device. In this case, the test chart disposed near the equipment to be monitored and inspected is caught by the television camera to measure a sensor output luminance. Then, the light amount control mechanism of the illumination device is controlled so as to provide a luminance which has been set at an initial stage of the plant inspection. With such procedures, video data of the objective equipment to be monitored and inspected can be obtained at a constant luminance during inspection. (I.S.)

Endovascular management of deep venous thrombotic diseases of the lower extremity

International Nuclear Information System (INIS)

Roh, Byung Suk

2004-01-01

Pulmonary embolism and venous ischemia are acute complications of deep vein thrombosis (DVT) of the lower extremities. Delayed complications include a spectrum of debilitating symptoms referred to as postthrombotic syndrome (PST). Because the early symptoms and patient signs are nonspecific for DVT, careful history taking and radiological evaluation of the extent and migration of thrombus should be used to establish an objective diagnosis and the need for treatment. Anticoagulation therapy is recognized as the mainstay treatment in acute DVT. However, there are few data to suggest any major beneficial effect of the early clearing of massive DVT and PTS. Endovascular, catheter-directed, thrombolysis techniques, used alone or in combination with mechanical thrombectomy devices, have been proven to be highly effective in clearing acute DVT, which may allow the preservation of venous valve function and the prevention of subsequent venous occlusive disease. Definitive management of the underlying anatomic occlusive abnormalities should also be undertaken

Endovascular management of deep venous thrombotic diseases of the lower extremity

Energy Technology Data Exchange (ETDEWEB)

Roh, Byung Suk [School of Medicine, Wonkwang Univ., Iksan (Korea, Republic of)

2004-07-01

Pulmonary embolism and venous ischemia are acute complications of deep vein thrombosis (DVT) of the lower extremities. Delayed complications include a spectrum of debilitating symptoms referred to as postthrombotic syndrome (PST). Because the early symptoms and patient signs are nonspecific for DVT, careful history taking and radiological evaluation of the extent and migration of thrombus should be used to establish an objective diagnosis and the need for treatment. Anticoagulation therapy is recognized as the mainstay treatment in acute DVT. However, there are few data to suggest any major beneficial effect of the early clearing of massive DVT and PTS. Endovascular, catheter-directed, thrombolysis techniques, used alone or in combination with mechanical thrombectomy devices, have been proven to be highly effective in clearing acute DVT, which may allow the preservation of venous valve function and the prevention of subsequent venous occlusive disease. Definitive management of the underlying anatomic occlusive abnormalities should also be undertaken.

Endovascular Treatment Options in the Management of Lower Limb Deep Venous Thrombosis

International Nuclear Information System (INIS)

Nazir, Sarfraz Ahmed; Ganeshan, Arul; Nazir, Sheraz; Uberoi, Raman

2009-01-01

Lower limb deep vein thrombosis (DVT) is a common cause of significant morbidity and mortality. Systemic anticoagulation therapy is the mainstay of conventional treatment instituted by most physicians for the management of DVT. This has proven efficacy in the prevention of thrombus extension and reduction in the incidence of pulmonary embolism and rethrombosis. Unfortunately, especially in patients with severe and extensive iliofemoral DVT, standard treatment may not be entirely adequate. This is because a considerable proportion of these patients eventually develops postthrombotic syndrome. This is characterized by chronic extremity pain and trophic skin changes, edema, ulceration, and venous claudication. Recent interest in endovascular technologies has led to the development of an assortment of minimally invasive, catheter-based strategies to deal with venous thrombus. These comprise catheter-directed thrombolysis, percutaneous mechanical thrombectomy devices, adjuvant venous angioplasty and stenting, and inferior vena cava filters. This article reviews these technologies and discusses their current role as percutaneous treatment strategies for venous thrombotic conditions.

Optoelectronic Devices Advanced Simulation and Analysis

CERN Document Server

Piprek, Joachim

2005-01-01

Optoelectronic devices transform electrical signals into optical signals and vice versa by utilizing the sophisticated interaction of electrons and light within micro- and nano-scale semiconductor structures. Advanced software tools for design and analysis of such devices have been developed in recent years. However, the large variety of materials, devices, physical mechanisms, and modeling approaches often makes it difficult to select appropriate theoretical models or software packages. This book presents a review of devices and advanced simulation approaches written by leading researchers and software developers. It is intended for scientists and device engineers in optoelectronics, who are interested in using advanced software tools. Each chapter includes the theoretical background as well as practical simulation results that help to better understand internal device physics. The software packages used in the book are available to the public, on a commercial or noncommercial basis, so that the interested r...

Remoção cirúrgica de trombos em próteses valvulares mecânicas Surgical removal of thrombi in mechanical valvular prostheses

Directory of Open Access Journals (Sweden)

Pablo M. A Pomerantzeff

1993-03-01

prosthesis. He was directed to the Surgical Centre where surgical depletion of the prosthesis was opted for, thus reducing the period of extracorporeal circulation of the patient in an extemely critical condition. Another patient, a two and a half years old female with a diagnosis of mitral insufficiency resulting from mixomatous degeneration, underwent mitral valve substitution for a mechanical prosthesis, on October 13, 1992. Despite satisfactory anticoagulation, the patient exhibited thrombosis of the prosthesis on January 12, 1993, and was also submitted to surgical thrombectomy. Both patients presented satisfactory pastoperative evolution. Three months following the thrombectomy, the second above mentioned patient exhibited a further acute thrombosis, which was followed by sucessful streptokinase. Surgical thrombectomy could be a satisfactory surgical option in high risk surgical patients exhibiting thrombi in metal prosthesis.

Orbital atherectomy: device evolution and clinical data.

Science.gov (United States)

Staniloae, Cezar S; Korabathina, Ravikiran

2014-05-01

A number of atherectomy devices were developed in the last few years. Among them, the DiamondBack 360° Peripheral Orbital Atherectomy System (Cardiovascular Systems, Inc) was specifically designed to work in severely calcified plaque. This article reviews the history, mechanism of action, evolution, clinical data, and future applications of this particular atherectomy device.

Resistive switching mechanism of ZnO/ZrO2-stacked resistive random access memory device annealed at 300 °C by sol-gel method with forming-free operation

Science.gov (United States)

Jian, Wen-Yi; You, Hsin-Chiang; Wu, Cheng-Yen

2018-01-01

In this work, we used a sol-gel process to fabricate a ZnO-ZrO2-stacked resistive switching random access memory (ReRAM) device and investigated its switching mechanism. The Gibbs free energy in ZnO, which is higher than that in ZrO2, facilitates the oxidation and reduction reactions of filaments in the ZnO layer. The current-voltage (I-V) characteristics of the device revealed a forming-free operation because of nonlattice oxygen in the oxide layer. In addition, the device can operate under bipolar or unipolar conditions with a reset voltage of 0 to ±2 V, indicating that in this device, Joule heating dominates at reset and the electric field dominates in the set process. Furthermore, the characteristics reveal why the fabricated device exhibits a greater discrete distribution phenomenon for the set voltage than for the reset voltage. These results will enable the fabrication of future ReRAM devices with double-layer oxide structures with improved characteristics.

Reactor scram device for FBR type reactor

International Nuclear Information System (INIS)

Kumasaka, Katsuyuki; Arashida, Genji; Itooka, Satoshi.

1991-01-01

In a control rod attaching structure in a reactor scram device of an FBR type reactor, an anti-rising mechanism proposed so far against external upward force upon occurrence of earthquakes relies on the engagement of a mechanical structure but temperature condition is not taken into consideration. Then, in the present invention, a material having curie temperature characteristics and which exhibits ferromagnetism only under low temperature condition and a magnet device are disposed to one of a movable control rod and a portion secured to the reactor. Alternatively, a bimetal member or a shape memory alloy which actuates to fix to the mating member only under low temperature condition is secured. The fixing device is adapted to operate so as to secure the control rods when the low temperature state is caused depending on the temperature condition. With such a constitution, when the control rods are separated from a driving device, they are prevented from rising even if they undergo external upward force due to earthquakes and so on, which can improve the reactor safety. (N.H.)

Device Physics of Narrow Gap Semiconductors

CERN Document Server

Chu, Junhao

2010-01-01

Narrow gap semiconductors obey the general rules of semiconductor science, but often exhibit extreme features of these rules because of the same properties that produce their narrow gaps. Consequently these materials provide sensitive tests of theory, and the opportunity for the design of innovative devices. Narrow gap semiconductors are the most important materials for the preparation of advanced modern infrared systems. Device Physics of Narrow Gap Semiconductors offers descriptions of the materials science and device physics of these unique materials. Topics covered include impurities and defects, recombination mechanisms, surface and interface properties, and the properties of low dimensional systems for infrared applications. This book will help readers to understand not only the semiconductor physics and materials science, but also how they relate to advanced opto-electronic devices. The last chapter applies the understanding of device physics to photoconductive detectors, photovoltaic infrared detector...

Energy harvesting: an integrated view of materials, devices and applications

Science.gov (United States)

Radousky, H. B.; Liang, H.

2012-12-01

Energy harvesting refers to the set of processes by which useful energy is captured from waste, environmental, or mechanical sources and is converted into a usable form. The discipline of energy harvesting is a broad topic that includes established methods and materials such as photovoltaics and thermoelectrics, as well as more recent technologies that convert mechanical energy, magnetic energy and waste heat to electricity. This article will review various state-of-the-art materials and devices for direct energy conversion and in particular will include multistep energy conversion approaches. The article will highlight the nano-materials science underlying energy harvesting principles and devices, but also include more traditional bulk processes and devices as appropriate and synergistic. Emphasis is placed on device-design innovations that lead to higher efficiency energy harvesting or conversion technologies ranging from the cm/mm-scale down to MEMS/NEMS (micro- and nano-electromechanical systems) devices. Theoretical studies are reviewed, which address transport properties, crystal chemistry, thermodynamic analysis, energy transfer, system efficiency and device operation. New developments in experimental methods; device design and fabrication; nanostructured materials fabrication; materials properties; and device performance measurement techniques are discussed.

Carbon based prosthetic devices

Energy Technology Data Exchange (ETDEWEB)

Devlin, D.J.; Carroll, D.W.; Barbero, R.S.; Archuleta, T. [Los Alamos National Lab., NM (US); Klawitter, J.J.; Ogilvie, W.; Strzepa, P. [Ascension Orthopedics (US); Cook, S.D. [Tulane Univ., New Orleans, LA (US). School of Medicine

1998-12-31

This is the final report of a one-year, Laboratory Directed Research and Development (LDRD) project at the Los Alamos National Laboratory (LANL). The project objective was to evaluate the use of carbon/carbon-fiber-reinforced composites for use in endoprosthetic devices. The application of these materials for the metacarpophalangeal (MP) joints of the hand was investigated. Issues concerning mechanical properties, bone fixation, biocompatibility, and wear are discussed. A system consisting of fiber reinforced materials with a pyrolytic carbon matrix and diamond-like, carbon-coated wear surfaces was developed. Processes were developed for the chemical vapor infiltration (CVI) of pyrolytic carbon into porous fiber preforms with the ability to tailor the outer porosity of the device to provide a surface for bone in-growth. A method for coating diamond-like carbon (DLC) on the articulating surface by plasma-assisted chemical vapor deposition (CVD) was developed. Preliminary results on mechanical properties of the composite system are discussed and initial biocompatibility studies were performed.

Nuclear-burst strength detecting and measuring device

International Nuclear Information System (INIS)

Balut, J.A.L.G.; Lemaire, P.E.G.K.; Loisy, C.M.

1976-01-01

A continuous-operation automatic device is described for detection and accurate measurement of the strength of a burst generating an emission from luminous or infrared sources. This device characterizes and analyzes the maxima and minima of a ''thermal flux/time'' curve. The device comprises a master time element and an assembly of photoelectric detectors, an electronic processing system coupled to the detectors, and a mechanical system securing the rigidity and positioning of the photoelectric detector assembly with respect to an octahedral prism based on a horizontal plane

Interfacial behavior of resistive switching in ITO–PVK–Al WORM memory devices

International Nuclear Information System (INIS)

Whitcher, T J; Woon, K L; Wong, W S; Chanlek, N; Nakajima, H; Saisopa, T; Songsiriritthigul, P

2016-01-01

Understanding the mechanism of resistive switching in a memory device is fundamental in order to improve device performance. The mechanism of current switching in a basic organic write-once read-many (WORM) memory device is investigated by determining the energy level alignments of indium tin oxide (ITO), poly(9-vinylcarbazole) (PVK) and aluminum (Al) using x-ray and ultraviolet photoelectron spectroscopy, current–voltage characterization and Auger depth profiling. The current switching mechanism was determined to be controlled by the interface between the ITO and the PVK. The electric field applied across the device causes the ITO from the uneven surface of the anode to form metallic filaments through the PVK, causing a shorting effect within the device leading to increased conduction. This was found to be independent of the PVK thickness, although the switch-on voltage was non-linearly dependent on the thickness. The formation of these filaments also caused the destruction of the interfacial dipole at the PVK–Al interface. (paper)

Interfacial behavior of resistive switching in ITO-PVK-Al WORM memory devices

Science.gov (United States)

Whitcher, T. J.; Woon, K. L.; Wong, W. S.; Chanlek, N.; Nakajima, H.; Saisopa, T.; Songsiriritthigul, P.

2016-02-01

Understanding the mechanism of resistive switching in a memory device is fundamental in order to improve device performance. The mechanism of current switching in a basic organic write-once read-many (WORM) memory device is investigated by determining the energy level alignments of indium tin oxide (ITO), poly(9-vinylcarbazole) (PVK) and aluminum (Al) using x-ray and ultraviolet photoelectron spectroscopy, current-voltage characterization and Auger depth profiling. The current switching mechanism was determined to be controlled by the interface between the ITO and the PVK. The electric field applied across the device causes the ITO from the uneven surface of the anode to form metallic filaments through the PVK, causing a shorting effect within the device leading to increased conduction. This was found to be independent of the PVK thickness, although the switch-on voltage was non-linearly dependent on the thickness. The formation of these filaments also caused the destruction of the interfacial dipole at the PVK-Al interface.

Integrated microfluidic device for single-cell trapping and spectroscopy

KAUST Repository

Liberale, Carlo

2013-02-13

Optofluidic microsystems are key components towards lab-on-a-chip devices for manipulation and analysis of biological specimens. In particular, the integration of optical tweezers (OT) in these devices allows stable sample trapping, while making available mechanical, chemical and spectroscopic analyses.

Integrated microfluidic device for single-cell trapping and spectroscopy

KAUST Repository

Liberale, Carlo; Cojoc, G.; Bragheri, F.; Minzioni, P.; Perozziello, G.; La Rocca, R.; Ferrara, L.; Rajamanickam, V.; Di Fabrizio, Enzo M.; Cristiani, I.

2013-01-01

Optofluidic microsystems are key components towards lab-on-a-chip devices for manipulation and analysis of biological specimens. In particular, the integration of optical tweezers (OT) in these devices allows stable sample trapping, while making available mechanical, chemical and spectroscopic analyses.

Self-folding miniature elastic electric devices

International Nuclear Information System (INIS)

Miyashita, Shuhei; Meeker, Laura; Rus, Daniela; Tolley, Michael T; Wood, Robert J

2014-01-01

Printing functional materials represents a considerable impact on the access to manufacturing technology. In this paper we present a methodology and validation of print-and-self-fold miniature electric devices. Polyvinyl chloride laminated sheets based on metalized polyester film show reliable self-folding processes under a heat application, and it configures 3D electric devices. We exemplify this technique by fabricating fundamental electric devices, namely a resistor, capacitor, and inductor. Namely, we show the development of a self-folded stretchable resistor, variable resistor, capacitive strain sensor, and an actuation mechanism consisting of a folded contractible solenoid coil. Because of their pre-defined kinematic design, these devices feature elasticity, making them suitable as sensors and actuators in flexible circuits. Finally, an RLC circuit obtained from the integration of developed devices is demonstrated, in which the coil based actuator is controlled by reading a capacitive strain sensor. (paper)

Biofabrication to build the biology-device interface

International Nuclear Information System (INIS)

Liu Yi; Kim, Eunkyoung; Culver, James N; Bentley, William E; Payne, Gregory F; Ghodssi, Reza; Rubloff, Gary W

2010-01-01

The last century witnessed spectacular advances in both microelectronics and biotechnology yet there was little synergy between the two. A challenge to their integration is that biological and electronic systems are constructed using divergent fabrication paradigms. Biology fabricates bottom-up with labile components, while microelectronic devices are fabricated top-down using methods that are 'bio-incompatible'. Biofabrication-the use of biological materials and mechanisms for construction-offers the opportunity to span these fabrication paradigms by providing convergent approaches for building the bio-device interface. Integral to biofabrication are stimuli-responsive materials (e.g. film-forming polysaccharides) that allow directed assembly under near physiological conditions in response to device-imposed signals. Biomolecular engineering, through recombinant technology, allows biological components to be endowed with information for assembly (e.g. encoded in a protein's amino acid sequence). Finally, self-assembly and enzymatic assembly provide the mechanisms for construction over a hierarchy of length scales. Here, we review recent advances in the use of biofabrication to build the bio-device interface. We anticipate that the biofabrication toolbox will expand over the next decade as more researchers enlist the unique construction capabilities of biology. Further, we look forward to observing the application of this toolbox to create devices that can better diagnose disease, detect pathogens and discover drugs. Finally, we expect that biofabrication will enable the effective interfacing of biology with electronics to create implantable devices for personalized and regenerative medicine. (topical review)

The likely market potential for electricity saving ASD devices

International Nuclear Information System (INIS)

Sparow, F.T.; McKenzie, L.

1993-01-01

Many utility demand-side management (DSM) programs encourage the adoption of adjustable speed drives (ASD) in the industrial and commercial sectors, since such devices save KW and KWh. The term open-quotes adjustable speed drives close-quote is used to refer to any device which allows the speed of the motor to be adjusted to better match process requirements. Thus, motor input control devices, such as electronic adjustable speed drives for AC motors (i.e., adjustable frequency drives (AFD)), voltage controlled DC motors, and the use of floating pressure setpoint controls, or other devices which better control on/off compressor operation, would be considered ASD devices. Also included would be motor technologies, such as multi-speed windings, etc., which allow the synchronous speed of the motor to be altered. Not included in this definition would be mechanical systems such as gear boxes, friction disks, etc., which maintain motor speed, but alter the drive r.p.m. to the equipment. The importance of the distinction is that ASDs, as defined above, have the potential to substantially reduce KW and KWh consumption if the equipment duty cycle is varying, while mechanical drive r.p.m. varying devices don't

Failed fuel detection device

International Nuclear Information System (INIS)

Kasahara, Yoshiyuki; Soroi, Masatoshi.

1992-01-01

A pair of coil springs each of different spring rigidity are disposed independently to an interface mechanism which engages a reactor core fuel assembly. The springing reaction of the coil springs is utilized for providing a structure capable of detaching. A driving portion vertically movable in an inner cylinder of a system main body interlocking with the intrface mechanism is disposed, as well as a system separation mechanism is disposed for conducting electromotive remote control when it is required. With such a constitution, although it has been necessary so far that a plurality of operators access the reactor core upper mechanisms, it is not necessary according to the device of the present invention. Accordingly, the problem of operator's exposure can be overcome. (I.S.)

Diamond: a material for acoustic devices

OpenAIRE

MORTET, Vincent; WILLIAMS, Oliver; HAENEN, Ken

2008-01-01

Diamond has been foreseen to replace silicon for high power, high frequency electronic applications or for devices that operates in harsh environments. However, diamond electronic devices are still in the laboratory stage due to the lack of large substrates and the complexity of diamond doping. On another hand, surface acoustic wave filters based on diamond are commercially available. Diamond is especially suited for acoustic applications because of its exceptional mechanical properties. The ...

Improvement of fuel sampling device for STACY and TRACY

International Nuclear Information System (INIS)

Hirose, Hideyuki; Sakuraba, Koichi; Onodera, Seiji

1998-05-01

STACY and TRACY, static and transient experiment facilities in NUCEF, use solution fuel. It is important to analyze accurately fuel composition (uranium enrichment, uranium concentration, nitric acid morality, amount of impurities, radioactivity of FP) for their safety operation and improvement of experimental accuracy. Both STACY and TRACY have the sampling devices to sample fuel solution for that purpose. The previous sampling devices of STACY and TRACY had been designed to dilute fuel sample with nitric acid. Its sampling mechanism could pour fuel sample into sampling vessel by a piston drive of nitric acid in the burette. It was, however, sometimes found that sample fuel solution was diluted by mixing with nitric acid in the burette. Therefore, the sampling mechanism was change into a fixed quantity pump drive which didn't use nitric acid. The authors confirmed that the performance of the new sampling device was improved by changing sampling mechanism. It was confirmed through the function test that the uncertainty in uranium concentration measurement using the improved sampling device was 0.14%, and less than the designed value of 0.2% (coefficient of variation). (author)

LOW PRESSURE CARBURIZING IN A LARGE-CHAMBER DEVICE FOR HIGH-PERFORMANCE AND PRECISION THERMAL TREATMENT OF PARTS OF MECHANICAL GEAR

Directory of Open Access Journals (Sweden)

Emilia Wołowiec-Korecka

2017-03-01

Full Text Available This paper presents the findings of research of a short-pulse low pressure carburizing technology developed for a new large-chamber furnace for high-performance and precision thermal treatment of parts of mechanical gear. Sections of the article discuss the novel constructions of the device in which parts being carburized flow in a stream, as well as the low-pressure carburizing experiment. The method has been found to yield uniform, even and repeatable carburized layers on typical gear used in automotive industry.

Experimental study of glass sampling devices

International Nuclear Information System (INIS)

Jouan, A.; Moncouyoux, J.P.; Meyere, A.

1992-01-01

Two high-level liquid waste containment glass sampling systems have been designed and built. The first device fits entirely inside a standard glass storage canister, and may thus be used in facilities not initially designed for this function. It has been tested successfully in the nonradioactive prototype unit at Marcoule. The work primarily covered the design and construction of an articulated arm supporting the sampling vessel, and the mechanisms necessary for filling the vessel and recovering the sample. System actuation and operation are fully automatic, and the resulting sample is representative of the glass melt. Implementation of the device is delicate however, and its reliability is estimated at about 75%. A second device was designed specifically for new vitrification facilities. It is installed directly on the glass melting furnace, and meets process operating and quality control requirements. Tests conducted at the Marcoule prototype vitrification facility demonstrated the feasibility of the system. Special attention was given to the sampling vessel transfer mechanisms, with two filling and controlled sample cooling options

Downstream bioprocess characterisation within microfluidic devices

DEFF Research Database (Denmark)

Marques, Marco; Krühne, Ulrich; Szita, Nicolas

2016-01-01

developed which has, to some extent, hindered their implementation as early process development tools. Microfluidic devices are particularly attractive for using fewer resources, for having the possibility of parallelisation and for requiring fewer mechanical manipulations. The expectation...... is that these devices will facilitate the rapid definition of critical process parameters, and thus ultimately reduce production costs. We have developed several microfluidic mDUOs and combined them with advanced and novel analytical approaches, resulting in devices that can potentially be employed for both analytical...... for the liquid–liquid extraction of pharmaceuticals, for the purification and concentration of drug delivery vehicles, and for the flocculation of yeast cells in microfluidic devices. For the latter, we will present for the first time the capability to study flocculation-growth independent from the floc breakage...

Role of failure-mechanism identification in accelerated testing

Science.gov (United States)

Hu, J. M.; Barker, D.; Dasgupta, A.; Arora, A.

1993-01-01

Accelerated life testing techniques provide a short-cut method to investigate the reliability of electronic devices with respect to certain dominant failure mechanisms that occur under normal operating conditions. However, accelerated tests have often been conducted without knowledge of the failure mechanisms and without ensuring that the test accelerated the same mechanism as that observed under normal operating conditions. This paper summarizes common failure mechanisms in electronic devices and packages and investigates possible failure mechanism shifting during accelerated testing.

Verification of Fowler–Nordheim electron tunneling mechanism in Ni/SiO{sub 2}/n-4H SiC and n{sup +} poly-Si/SiO{sub 2}/n-4H SiC MOS devices by different models

Energy Technology Data Exchange (ETDEWEB)

Kodigala, Subba Ramaiah, E-mail: kodigala@gmail.com [Department of Electrical Engineering, University of South Carolina, Columbia, SC 29208 (United States); Department of Physics and Astronomy, Department of Electrical and Computer Engineering, California State University, Northridge, CA 91330 (United States)

2016-11-01

This article emphasizes verification of Fowler–Nordheim electron tunneling mechanism in the Ni/SiO{sub 2}/n-4H SiC MOS devices by developing three different kinds of models. The standard semiconductor equations are categorically solved to obtain the change in Fermi energy level of semiconductor with effect of temperature and field that extend support to determine sustainable and accurate tunneling current through the oxide layer. The forward and reverse bias currents with variation of electric field are simulated with help of different models developed by us for MOS devices by applying adequate conditions. The latter is quite different from former in terms of tunneling mechanism in the MOS devices. The variation of barrier height with effect of quantum mechanical, temperature, and fields is considered as effective barrier height for the generation of current–field (J–F) curves under forward and reverse biases but quantum mechanical effect is void in the latter. In addition, the J–F curves are also simulated with variation of carrier concentration in the n-type 4H SiC semiconductor of MOS devices and the relation between them is established.

Mechanism of artificial heart

CERN Document Server

Yamane, Takashi

2016-01-01

This book first describes medical devices in relation to regenerative medicine before turning to a more specific topic: artificial heart technologies. Not only the pump mechanisms but also the bearing, motor mechanisms, and materials are described, including expert information. Design methods are described to enhance hemocompatibility: main concerns are reduction of blood cell damage and protein break, as well as prevention of blood clotting. Regulatory science from R&D to clinical trials is also discussed to verify the safety and efficacy of the devices.

A Mechatronic Loading Device to Stimulate Bone Growth via a Human Knee.

Science.gov (United States)

Prabhala, Sai Krishna; Chien, Stanley; Yokota, Hiroki; Anwar, Sohel

2016-09-29

This paper presents the design of an innovative device that applies dynamic mechanical load to human knee joints. Dynamic loading is employed by applying cyclic and periodic force on a target area. The repeated force loading was considered to be an effective modality for repair and rehabilitation of long bones that are subject to ailments like fractures, osteoporosis, osteoarthritis, etc. The proposed device design builds on the knowledge gained in previous animal and mechanical studies. It employs a modified slider-crank linkage mechanism actuated by a brushless Direct Current (DC) motor and provides uniform and cyclic force. The functionality of the device was simulated in a software environment and the structural integrity was analyzed using a finite element method for the prototype construction. The device is controlled by a microcontroller that is programmed to provide the desired loading force at a predetermined frequency and for a specific duration. The device was successfully tested in various experiments for its usability and full functionality. The results reveal that the device works according to the requirements of force magnitude and operational frequency. This device is considered ready to be used for a clinical study to examine whether controlled knee-loading could be an effective regimen for treating the stated bone-related ailments.

A Mechatronic Loading Device to Stimulate Bone Growth via a Human Knee

Directory of Open Access Journals (Sweden)

Sai Krishna Prabhala

2016-09-01

Full Text Available This paper presents the design of an innovative device that applies dynamic mechanical load to human knee joints. Dynamic loading is employed by applying cyclic and periodic force on a target area. The repeated force loading was considered to be an effective modality for repair and rehabilitation of long bones that are subject to ailments like fractures, osteoporosis, osteoarthritis, etc. The proposed device design builds on the knowledge gained in previous animal and mechanical studies. It employs a modified slider-crank linkage mechanism actuated by a brushless Direct Current (DC motor and provides uniform and cyclic force. The functionality of the device was simulated in a software environment and the structural integrity was analyzed using a finite element method for the prototype construction. The device is controlled by a microcontroller that is programmed to provide the desired loading force at a predetermined frequency and for a specific duration. The device was successfully tested in various experiments for its usability and full functionality. The results reveal that the device works according to the requirements of force magnitude and operational frequency. This device is considered ready to be used for a clinical study to examine whether controlled knee-loading could be an effective regimen for treating the stated bone-related ailments.

Penetration testing using mobile devices

CSIR Research Space (South Africa)

Shelembe, S

2012-10-01

Full Text Available et.al, 2006) ? An attempt to compromise the security of the mechanism undergoing the test, it can be host or network based (Fiocca, 2009) Difference: pen-testing and hacking is permission Its purpose is to find system vulnerabilities ? CSIR 2012... is not enough, cell-phones can hack too ? Pocket sized device is more convenient, since it is easy to carry around at anytime ? A power plug is not innocent, need to look for activity other than just traditional PCs / devices ? CSIR 2012 Slide 6 Mobile...

Predictors of survival and ability to wean from short-term mechanical circulatory support device following acute myocardial infarction complicated by cardiogenic shock.

Science.gov (United States)

Garan, A Reshad; Eckhardt, Christina; Takeda, Koji; Topkara, Veli K; Clerkin, Kevin; Fried, Justin; Masoumi, Amirali; Demmer, Ryan T; Trinh, Pauline; Yuzefpolskaya, Melana; Naka, Yoshifumi; Burkhoff, Dan; Kirtane, Ajay; Colombo, Paolo C; Takayama, Hiroo

2017-11-01

Cardiogenic shock following acute myocardial infarction (AMI-CS) portends a poor prognosis. Short-term mechanical circulatory support devices (MCSDs) provide hemodynamic support for patients with cardiogenic shock but predictors of survival and the ability to wean from short-term MCSDs remain largely unknown. All patients > 18 years old treated at our institution with extra-corporeal membrane oxygenation or short-term surgical ventricular assist device for AMI-CS were studied. We collected acute myocardial infarction details with demographic and hemodynamic variables. Primary outcomes were survival to discharge and recovery from MCSD (i.e. survival without heart replacement therapy including durable ventricular assist device or heart transplant). One hundred and twenty-four patients received extra-corporeal membrane oxygenation or short-term surgical ventricular assist device following acute myocardial infarction from 2007 to 2016; 89 received extra-corporeal membrane oxygenation and 35 short-term ventricular assist device. Fifty-five (44.4%) died in the hospital and 69 (55.6%) survived to discharge. Twenty-six (37.7%) required heart replacement therapy (four transplant, 22 durable ventricular assist device) and 43 (62.3%) were discharged without heart replacement therapy. Age and cardiac index at MCSD implantation were predictors of survival to discharge; patients over 60 years with cardiac index <1.5 l/min per m 2 had a low likelihood of survival. The angiographic result after revascularization predicted recovery from MCSD (odds ratio 9.00, 95% confidence interval 2.45-32.99, p=0.001), but 50% of those optimally revascularized still required heart replacement therapy. Cardiac index predicted recovery from MCSD among this group (odds ratio 4.06, 95% confidence interval 1.45-11.55, p=0.009). Among AMI-CS patients requiring short-term MCSDs, age and cardiac index predict survival to discharge. Angiographic result and cardiac index predict ventricular recovery but 50

Graphene devices based on laser scribing technology

Science.gov (United States)

Qiao, Yan-Cong; Wei, Yu-Hong; Pang, Yu; Li, Yu-Xing; Wang, Dan-Yang; Li, Yu-Tao; Deng, Ning-Qin; Wang, Xue-Feng; Zhang, Hai-Nan; Wang, Qian; Yang, Zhen; Tao, Lu-Qi; Tian, He; Yang, Yi; Ren, Tian-Ling

2018-04-01

Graphene with excellent electronic, thermal, optical, and mechanical properties has great potential applications. The current devices based on graphene grown by micromechanical exfoliation, chemical vapor deposition (CVD), and thermal decomposition of silicon carbide are still expensive and inefficient. Laser scribing technology, a low-cost and time-efficient method of fabricating graphene, is introduced in this review. The patterning of graphene can be directly performed on solid and flexible substrates. Therefore, many novel devices such as strain sensors, acoustic devices, memory devices based on laser scribing graphene are fabricated. The outlook and challenges of laser scribing technology have also been discussed. Laser scribing may be a potential way of fabricating wearable and integrated graphene systems in the future.

Fully Device-Independent Quantum Key Distribution

Science.gov (United States)

Vazirani, Umesh; Vidick, Thomas

2014-10-01

Quantum cryptography promises levels of security that are impossible to replicate in a classical world. Can this security be guaranteed even when the quantum devices on which the protocol relies are untrusted? This central question dates back to the early 1990s when the challenge of achieving device-independent quantum key distribution was first formulated. We answer this challenge by rigorously proving the device-independent security of a slight variant of Ekert's original entanglement-based protocol against the most general (coherent) attacks. The resulting protocol is robust: While assuming only that the devices can be modeled by the laws of quantum mechanics and are spatially isolated from each other and from any adversary's laboratory, it achieves a linear key rate and tolerates a constant noise rate in the devices. In particular, the devices may have quantum memory and share arbitrary quantum correlations with the eavesdropper. The proof of security is based on a new quantitative understanding of the monogamous nature of quantum correlations in the context of a multiparty protocol.

Solid-state electronic devices an introduction

CERN Document Server

Papadopoulos, Christo

2014-01-01

A modern and concise treatment of the solid state electronic devices that are fundamental to electronic systems and information technology is provided in this book. The main devices that comprise semiconductor integrated circuits are covered in a clear manner accessible to the wide range of scientific and engineering disciplines that are impacted by this technology. Catering to a wider audience is becoming increasingly important as the field of electronic materials and devices becomes more interdisciplinary, with applications in biology, chemistry and electro-mechanical devices (to name a few) becoming more prevalent. Updated and state-of-the-art advancements are included along with emerging trends in electronic devices and their applications. In addition, an appendix containing the relevant physical background will be included to assist readers from different disciplines and provide a review for those more familiar with the area. Readers of this book can expect to derive a solid foundation for understanding ...

Stent malapposition, as a potential mechanism of very late stent thrombosis after bare-metal stent implantation: A case report

Energy Technology Data Exchange (ETDEWEB)

Higuma, Takumi, E-mail: higuma@cc.hirosaki-u.ac.jp; Abe, Naoki; Hanada, Kenji; Yokoyama, Hiroaki; Tomita, Hirofumi; Okumura, Ken

2014-04-15

A 90-year-old man was admitted to our hospital with acute ST-segment elevation myocardial infarction. He had a history of post-infarction angina pectoris 79 months ago and had a bare-metal stent (BMS) implanted in the proximal left anterior descending artery at our hospital. Emergent coronary angiography demonstrated thrombotic occlusion in the previously stented segment. After catheter thrombectomy, antegrade flow was restored, but 90% stenosis with haziness persisted in the proximal and distal portions of the previously stented segment. Intravascular ultrasound imaging showed interstrut cavities or stent malapposition at the proximal and distal sites of stented segment. In close proximity to the sites, residual thrombi were also observed. Optical coherence tomography (OCT) demonstrated neither lipid-laden neointimal tissue nor rupture but clearly demonstrated residual thrombus adjacent to the malapposed region in addition to the stent malapposition. PCI with balloon was successfully performed and stent apposition was confirmed by OCT. Stent malapposition is an unusual mechanism of very late stent thrombosis after BMS implantation. OCT can clearly reveal the etiology of stent thrombosis.

The Role of a Mental Model in Learning to Operate a Device.

Science.gov (United States)

Kieras, David E.; Bovair, Susan

1984-01-01

Describes three studies concerned with learning to operate a control panel device and how this learning is affected by understanding a device model that describes its internal mechanism. Results indicate benefits of a device model depend on whether it supports direct inference of exact steps required to operate the device. (Author/MBR)

Artificial Stroke Clots: How Wide is the Gap to the Real World?

Science.gov (United States)

Berndt, Maria; Prothmann, Sascha; Maegerlein, Christian; Oberdieck, Paul; Zimmer, Claus; Hegge, Barbara; Pelisek, Jaroslav; Schirmer, Lucas; Poppert, Holger; Boeckh-Behrens, Tobias

2018-02-01

Especially since the establishment of mechanical thrombectomy as part of standard stroke therapy, artificial thrombi have become important in the training of interventionalists as well as for the development and testing of devices. So far, these in vitro clots have lacked direct comparisons with ex vivo thrombi. We therefore compared the histologic appearance of dynamically produced clots with that of stroke thrombi acquired during mechanical recanalization. Thrombi of 145 consecutive patients with stroke with large-vessel occlusions were histologically compared with 10 artificial clots, dynamically created from human blood and pig's blood using a Chandler loop system. Quantified FP/RBC ratios (fibrin/platelets divided by red blood cell fraction) and white blood cell (WBC) fractions were identified and compared between artificial (human and pig) and ex vivo thrombi obtained from patients with various stroke causes. There were no significant differences in the analysis of FP/RBC ratios between artificial thrombi and ex vivo thrombi (P = 0.42) or in the more precise analyses considering etiologic subgroups. Distinct differences were observed for the WBC fraction, with lower values in artificial thrombi (median, 1.34%) than in ex vivo thrombi (median, 5%) (P < 0.001). The main clot components, FP and RBC, are presumably the most influential factors for clot stability and mechanical resistance. Similarities between artificially generated and ex vivo stroke clots (and when considering different stroke subgroups) support the usefulness of these artificial thrombi in the pre-evaluation of thrombus extraction devices and as appropriate training material. Copyright © 2017 Elsevier Inc. All rights reserved.

Control-rod driving mechanism

International Nuclear Information System (INIS)

Jodoi, Takashi.

1976-01-01

Purpose: To prevent falling of control rods due to malfunction. Constitution: The device of the present invention has a scram function in particular, and uses principally a fluid pressure as a scram accelerating means. The control rod is held by upper and lower holding devices, which are connected by a connecting mechanism. This connecting mechanism is designed to be detachable only at the lower limit of driving stroke of the control rod so that there occurs no erroneous scram resulting from careless disconnection of the connecting mechanism. Further, scramming operation due to own weight of the scram operating portion such as control rod driving shaft may be effected to increase freedom. (Kamimura, M.)

Efficacy and safety of rotating pigtail catheter: lower extremity deep vein thrombosis of may-thurner syndrome

International Nuclear Information System (INIS)

Kim, Yoon Kyung; Kang, Byung Chul; Gang, Sung Gown

2004-01-01

The purpose of this study was to evaluate the efficacy and safety of mechanical fragmentation of iliofemoral deep vein thromboses (DVTs) with a rotating pigtail catheter followed by aspiration thrombectomy. Ten patients (eight females, two males, 56.8 +/- 21.37 years) with iliofemoral DVT underwent treatment for a total of ten affected limbs. Approximately 5-10 min after infusing 400,000-700,000 IU urokinase (UK) into the thrombosed deep veins, the thromboses were fragmented by the mechanical action of the rotating pigtail catheter tip. Following their fragmentation, the fragmented thromboses were aspirated. After completion of the above procedure, a stent was inserted if iliac vein stenosis was demonstrated. We evaluated the total procedure time, volume of thrombolytic agent (urokinase), valvular injury, symptom-free time interval and success rate (primary patency rate). In all 10 patients, the iliofemoral deep vein thrombosis was successfully fragmented and aspirated using the combination method of a rotating pigtail catheter and aspiration thrombectomy (clinical and technical success rate, 100%). The thromboses were declotted by means of a rotating pigtail catheter with an average treatment time of 5.7 minutes. The average duration of the total intervention was 108 min. The mean primary patency was approximately 4 months with no recurrence. The total UK dose was 890,000 IU on average. There were no major complications, such as pulmonary embolism or cerebral hemorrhage, while performing the thrombus-fragmentation procedure using the rotating pigtail catheter. The combination method of a rotating pigtail catheter and aspiration thrombectomy for the treatment of iliofemoral deep vein thrombosis was found to be rapid, safe and effective for accomplishing recanalization in all cases without complication. Therefore, this procedure constitutes a potential treatment option in patients presenting with iliofemoral vein thrombosis

Safety syringes and anti-needlestick devices in orthopaedic surgery.

Science.gov (United States)

Sibbitt, Wilmer L; Band, Philip A; Kettwich, Lawrence G; Sibbitt, Cristina R; Sibbitt, Lori J; Bankhurst, Arthur D

2011-09-07

The American Academy of Orthopaedic Surgery (AAOS), The Joint Commission, the Occupational Safety and Health Administration (OSHA), and the Needlestick Safety and Prevention Act encourage the integration of safety-engineered devices to prevent needlestick injuries to health-care workers and patients. We hypothesized that safety syringes and needles could be used in outpatient orthopaedic injection and aspiration procedures. The study investigated the orthopaedic uses and procedural idiosyncrasies of safety-engineered devices, including (1) four safety needles (Eclipse, SafetyGlide, SurGuard, and Magellan), (2) a mechanical safety syringe (RPD), (3) two automatic retractable syringes (Integra, VanishPoint), (4) three manual retractable syringes (Procedur-SF, Baksnap, Invirosnap), and (5) three shielded syringes (Safety-Lok, Monoject, and Digitally Activated Shielded [DAS] Syringe). The devices were first tested ex vivo, and then 1300 devices were used for 425 subjects undergoing outpatient arthrocentesis, intra-articular injections, local anesthesia, aspiration biopsy, and ultrasound-guided procedures. During the clinical observation, there were no accidental needlesticks (0 needlesticks per 1300 devices). Safety needles could be successfully used on a Luer syringe but were limited to ≤1.5 in (≤3.81 cm) in length and the shield could interfere with sonography. The mechanical safety syringes functioned well in all orthopaedic procedures. Automatic retractable syringes were too small for arthrocentesis of the knee, and the plunger blew out and prematurely collapsed with high-pressure injections. The manual retractable syringes and shielded syringes could be used with conventional needles for most orthopaedic procedures. The most effective and reliable safety devices for orthopaedic syringe procedures are shielded safety needles, mechanical syringes, manual retractable syringes, and shielded syringes, but not automatic retractable syringes. Even when adopting

30 CFR 77.410 - Mobile equipment; automatic warning devices.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Mobile equipment; automatic warning devices. 77... UNDERGROUND COAL MINES Safeguards for Mechanical Equipment § 77.410 Mobile equipment; automatic warning devices. (a) Mobile equipment such as front-end loaders, forklifts, tractors, graders, and trucks, except...

Flexible spintronic devices on Kapton

DEFF Research Database (Denmark)

Bedoya-Pinto, Amilcar; Donolato, Marco; Gobbi, Marco

2014-01-01

Magnetic tunnel junctions and nano-sized domain-wall conduits have been fabricated on the flexible substrate Kapton. Despite the delicate nature of tunneling barriers and zig-zag shaped nanowires, the devices show an outstanding integrity and robustness upon mechanical bending. High values of ben...

Analysis of seismic noise to check the mechanical isolation of a medical device

Directory of Open Access Journals (Sweden)

Sara Rombetto

2011-07-01

Full Text Available We have investigated the mechanical response of a magnetically shielded room that hosts a magnetoencephalography system that is subject to external vibrations. This is a superconducting quantum interference device, which are the most sensitive sensors for magnetic flux variations. When the magnetoencephalography operates with people inside the room, the spectrum of the flux of the magnetic field shows anomalous peaks at several frequencies between 1 Hz and 20 Hz, independent of the experiment that is being run. As the variations in the flux of the magnetic field through the sensors might not only be related to the electrical currents circulating inside the brain, but also to non-damped mechanical oscillations of the room, we installed seismic instrumentation to measure the effective motion inside the room and to compare it to the external motion. For this analysis, we recorded the ambient seismic noise at two very close stations, one inside the magnetically shielded room, the other one outside in the room in which the magnetically shielded room is itself located. Data were collected over four days, including a week-end, to study the response of the magnetically shielded room subjected to different energy levels of external vibrations. The root mean square, Fourier spectra and power spectral density show significant differences between the signal recorded inside and outside the magnetically shielded room, with several anomalous peaks in the frequency band of 1 Hz to 20 Hz. The normalized spectral quantities (horizontal to vertical spectral ratio, and ratio between the internal and external spectra show large amplification at several frequencies, reaching in some cases one order of magnitude. We concluded that the magnetically shielded room does not dampen the external vibrations, but it instead appears to amplify these across a broad frequency range.

Chemically sensitive interfaces on SAW devices

Energy Technology Data Exchange (ETDEWEB)

Ricco, A.J.; Martin, S.J. [Sandia National Labs., Albuquerque, NM (United States); Crooks, R.M.; Xu, Chuanjing [Texas A and M Univ., College Station, TX (United States); Allred, R.E. [Adherent Technologies, Inc., Albuquerque, NM (United States)

1993-11-01

Using surface acoustic wave (SAW) devices, three approaches to the effective use of chemically sensitive interfaces that are not highly chemically selective have been examined: (1) molecular identification from time-resolved permeation transients; (2) using multifrequency SAW devices to determine the frequency dependence of analyte/film interactions; (3) use of an array of SAW devices bearing diverse chemically sensitive interfaces to produce a distinct response pattern for each analyte. In addition to their well-known sensitivity to mass changes (0.0035 monolayer of N{sub 2} can be measured), SAW devices respond to the mechanical and electronic properties of thin films, enhancing response information content but making a thorough understanding of the perturbation critical. Simultaneous measurement of changes in frequency and attenuation, which can provide the information necessary to determine the type of perturbation, are used as part of the above discrimination schemes.

Physical models of semiconductor quantum devices

CERN Document Server

Fu, Ying

2013-01-01

The science and technology relating to nanostructures continues to receive significant attention for its applications to various fields including microelectronics, nanophotonics, and biotechnology. This book describes the basic quantum mechanical principles underlining this fast developing field. From the fundamental principles of quantum mechanics to nanomaterial properties, from device physics to research and development of new systems, this title is aimed at undergraduates, graduates, postgraduates, and researchers.

Proton irradiation effects on gallium nitride-based devices

Science.gov (United States)

Karmarkar, Aditya P.

Proton radiation effects on state-of-the-art gallium nitride-based devices were studied using Schottky diodes and high electron-mobility transistors. The device degradation was studied over a wide range of proton fluences. This study allowed for a correlation between proton irradiation effects between different types of devices and enhanced the understanding of the mechanisms responsible for radiation damage in GaN-based devices. Proton irradiation causes reduced carrier concentration and increased series resistance and ideality factor in Schottky diodes. 1.0-MeV protons cause greater degradation than 1.8-MeV protons because of their higher non-ionizing energy loss. The displacement damage in Schottky diodes recovers during annealing. High electron-mobility transistors exhibit extremely high radiation tolerance, continuing to perform up to a fluence of ˜1014 cm-2 of 1.8-MeV protons. Proton irradiation creates defect complexes in the thin-film structure. Decreased sheet carrier mobility due to increased carrier scattering and decreased sheet carrier density due to carrier removal by the defect centers are the primary damage mechanisms. Interface disorder at either the Schottky or the Ohmic contact plays a relatively unimportant part in overall device degradation in both Schottky diodes and high electron-mobility transistors.

A piezoelectric device for impact energy harvesting

International Nuclear Information System (INIS)

Jacquelin, E; Adhikari, S; Friswell, M I

2011-01-01

This paper studies a piezoelectric impact energy harvesting device consisting of two piezoelectric beams and a seismic mass. The aim of this work is to find the influence of several mechanical design parameters on the output power of such a harvester so as to optimize its performance; the electrical design parameters were not studied. To account for the dynamics of the beams, a model including the mechanical and piezoelectric properties of the system is proposed. The impacts involved in the energy harvesting process are described through a Hertzian contact law that requires a time domain simulation to solve the nonlinear equations. A transient regime and a steady-state regime have been identified and the performance of the device is characterized by the steady-state mean electrical power and the transient electrical power. The time simulations have been used to study the influence of various mechanical design parameters (seismic mass, beam length, gap, gliding length, impact location) on the performance of the system. It has been shown that the impact location is an important parameter and may be optimized only through simulation. The models and the simulation technique used in this work are general and may be used to assess any other impact energy harvesting device

Electronic bipolar resistive switching behavior in Ni/VOx/Al device

Energy Technology Data Exchange (ETDEWEB)

Xia, Mengseng [School of Electronic Information Engineering, Hebei University of Technology, Tianjin Key Laboratory of Electronic Materials and Devices, Tianjin 300130 (China); School of Electronic Information Engineering, Tianjin Key Laboratory of Film Electronic & Communication Devices, Tianjin University of Technology, Tianjin 300384 (China); Zhang, Kailiang, E-mail: kailiang_zhang@163.com [School of Electronic Information Engineering, Tianjin Key Laboratory of Film Electronic & Communication Devices, Tianjin University of Technology, Tianjin 300384 (China); Yang, Ruixia, E-mail: yangrx@hebut.edu.cn [School of Electronic Information Engineering, Hebei University of Technology, Tianjin Key Laboratory of Electronic Materials and Devices, Tianjin 300130 (China); Wang, Fang; Zhang, Zhichao; Wu, Shijian [School of Electronic Information Engineering, Tianjin Key Laboratory of Film Electronic & Communication Devices, Tianjin University of Technology, Tianjin 300384 (China)

2017-07-15

Highlights: • The resistive random access memory of Ni/VOx/Al was fabricated. • The device has the electronic bipolar resistive switching characteristic. • The activity energy (Ea) of HRS has been calculated. • The reasons of the degradation of the resistance ratio of HRS/LRS were analyzed. - Abstract: In this paper, the Ni/VOx/Al resistive random access memory (RRAM) device is constructed and it shows bipolar resistive switching behavior, low resistive state (LRS) nonlinearity, and good retention. The set and reset processes are likely induced by the electron trapping and detrapping of trapping centers in the VOx films, respectively. The conduction mechanism in negative/positive region are controlled by space charge limited current mechanism (SCLC)/Schottky emission. The temperature dependence of I–V curves for HRS is measured to confirm the defects trapping and detrapping electrons model. activation energy was calculated to analyze the endurance performance of the device. The detailed analysis of the switching behavior with SCLC mechanism and Schottky emission mechanism could provide useful information for electronic bipolar resistive switching (eBRS) characteristics.

Electronic bipolar resistive switching behavior in Ni/VOx/Al device

International Nuclear Information System (INIS)

Xia, Mengseng; Zhang, Kailiang; Yang, Ruixia; Wang, Fang; Zhang, Zhichao; Wu, Shijian

2017-01-01

Highlights: • The resistive random access memory of Ni/VOx/Al was fabricated. • The device has the electronic bipolar resistive switching characteristic. • The activity energy (Ea) of HRS has been calculated. • The reasons of the degradation of the resistance ratio of HRS/LRS were analyzed. - Abstract: In this paper, the Ni/VOx/Al resistive random access memory (RRAM) device is constructed and it shows bipolar resistive switching behavior, low resistive state (LRS) nonlinearity, and good retention. The set and reset processes are likely induced by the electron trapping and detrapping of trapping centers in the VOx films, respectively. The conduction mechanism in negative/positive region are controlled by space charge limited current mechanism (SCLC)/Schottky emission. The temperature dependence of I–V curves for HRS is measured to confirm the defects trapping and detrapping electrons model. activation energy was calculated to analyze the endurance performance of the device. The detailed analysis of the switching behavior with SCLC mechanism and Schottky emission mechanism could provide useful information for electronic bipolar resistive switching (eBRS) characteristics.

A review on mechanical considerations for chronically-implanted neural probes

Science.gov (United States)

Lecomte, Aziliz; Descamps, Emeline; Bergaud, Christian

2018-06-01

This review intends to present a comprehensive analysis of the mechanical considerations for chronically-implanted neural probes. Failure of neural electrical recordings or stimulation over time has shown to arise from foreign body reaction and device material stability. It seems that devices that match most closely with the mechanical properties of the brain would be more likely to reduce the mechanical stress at the probe/tissue interface, thus improving body acceptance. The use of low Young’s modulus polymers instead of hard substrates is one way to enhance this mechanical mimetism, though compliance can be achieved through a variety of means. The reduction of probe width and thickness in comparison to a designated length, the use of soft hydrogel coatings and the release in device tethering to the skull, can also improve device compliance. Paradoxically, the more compliant the device, the more likely it will fail during the insertion process in the brain. Strategies have multiplied this past decade to offer partial or temporary stiffness to the device to overcome this buckling effect. A detailed description of the probe insertion mechanisms is provided to analyze potential sources of implantation failure and the need for a mechanically-enhancing structure. This leads us to present an overview of the strategies that have been put in place over the last ten years to overcome buckling issues. Particularly, great emphasis is put on bioresorbable polymers and their assessment for neural applications. Finally, a discussion is provided on some of the key features for the design of mechanically-reliable, polymer-based next generation of chronic neuroprosthetic devices.

Early Right Ventricular Assist Device Use in Patients Undergoing Continuous-Flow Left Ventricular Assist Device Implantation: Incidence and Risk Factors From the Interagency Registry for Mechanically Assisted Circulatory Support.

Science.gov (United States)

Kiernan, Michael S; Grandin, E Wilson; Brinkley, Marshall; Kapur, Navin K; Pham, Duc Thinh; Ruthazer, Robin; Rame, J Eduardo; Atluri, Pavan; Birati, Edo Y; Oliveira, Guilherme H; Pagani, Francis D; Kirklin, James K; Naftel, David; Kormos, Robert L; Teuteberg, Jeffrey J; DeNofrio, David

2017-10-01

To investigate preimplant risk factors associated with early right ventricular assist device (RVAD) use in patients undergoing continuous-flow left ventricular assist device (LVAD) surgery. Patients in the Interagency Registry for Mechanically Assisted Circulatory Support who underwent primary continuous-flow-LVAD surgery were examined for concurrent or subsequent RVAD implantation within 14 days of LVAD. Risk factors for RVAD implantation and the combined end point of RVAD or death within 14 days of LVAD were assessed with stepwise logistic regression. We compared survival between patients with and without RVAD using Kaplan-Meier method and Cox proportional hazards modeling. Of 9976 patients undergoing continuous-flow-LVAD implantation, 386 patients (3.9%) required an RVAD within 14 days of LVAD surgery. Preimplant characteristics associated with RVAD use included interagency registry for mechanically assisted circulatory support patient profiles 1 and 2, the need for preoperative extracorporeal membrane oxygenation or renal replacement therapy, severe preimplant tricuspid regurgitation, history of cardiac surgery, and concomitant procedures other than tricuspid valve repair at the time of LVAD. Hemodynamic determinants included elevated right atrial pressure, reduced pulmonary artery pulse pressure, and reduced stroke volume. The final model demonstrated good performance for both RVAD implant (area under the curve, 0.78) and the combined end point of RVAD or death within 14 days (area under the curve, 0.73). Compared with patients receiving an isolated LVAD, patients requiring RVAD had decreased 1- and 6-month survival: 78.1% versus 95.8% and 63.6% versus 87.9%, respectively ( P The need for RVAD implantation after LVAD is associated with indices of global illness severity, markers of end-organ dysfunction, and profiles of hemodynamic instability. © 2017 American Heart Association, Inc.

A suspicious reason for Raynaud's phenomenon: Intrauterine device.

Science.gov (United States)

Diken, Adem I; Yalçınkaya, Adnan; Aksoy, Eray; Yılmaz, Seyhan; Çağlı, Kerim

2015-06-01

Primary Raynaud's phenomenon may be insistent in patients under medical therapy, and intrauterine devices may be an unnoticed reason in these patients. Fluctuations in female sex hormone status were reported to be associated with the emergence of primary Raynaud's phenomenon symptoms. The use of intrauterine devices was not reported to be associated with Raynaud's phenomenon previously. Intrauterine device may stimulate vascular hyperactivity regarding hormonal or unknown mechanisms that result in Raynaud's phenomenon. We present a postmenopausal patient who complained of primary Raynaud's phenomenon symptoms and had recovery after the removal of her copper intrauterine device. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

76 FR 6551 - Medical Devices; General and Plastic Surgery Devices; Classification of Contact Cooling System...

Science.gov (United States)

2011-02-07

... (classes) of devices, depending on the regulatory controls needed to provide reasonable assurance of their... addressed by adequate bench testing demonstrating that the feedback controls for temperature/ cooling are functional and do maintain target temperature within the stated value. Proper function of mechanical controls...

Left Ventricular Assist Devices

Directory of Open Access Journals (Sweden)

Khuansiri Narajeenron

2017-04-01

Full Text Available Audience: The audience for this classic team-based learning (cTBL session is emergency medicine residents, faculty, and students; although this topic is applicable to internal medicine and family medicine residents. Introduction: A left ventricular assist device (LVAD is a mechanical circulatory support device that can be placed in critically-ill patients who have poor left ventricular function. After LVAD implantation, patients have improved quality of life.1 The number of LVAD patients worldwide continues to rise. Left-ventricular assist device patients may present to the emergency department (ED with severe, life-threatening conditions. It is essential that emergency physicians have a good understanding of LVADs and their complications. Objectives: Upon completion of this cTBL module, the learner will be able to: 1 Properly assess LVAD patients’ circulatory status; 2 appropriately resuscitate LVAD patients; 3 identify common LVAD complications; 4 evaluate and appropriately manage patients with LVAD malfunctions. Method: The method for this didactic session is cTBL.

Near-field NanoThermoMechanical memory

International Nuclear Information System (INIS)

Elzouka, Mahmoud; Ndao, Sidy

2014-01-01

In this letter, we introduce the concept of NanoThermoMechanical Memory. Unlike electronic memory, a NanoThermoMechanical memory device uses heat instead of electricity to record, store, and recover data. Memory function is achieved through the coupling of near-field thermal radiation and thermal expansion resulting in negative differential thermal resistance and thermal latching. Here, we demonstrate theoretically via numerical modeling the concept of near-field thermal radiation enabled negative differential thermal resistance that achieves bistable states. Design and implementation of a practical silicon based NanoThermoMechanical memory device are proposed along with a study of its dynamic response under write/read cycles. With more than 50% of the world's energy losses being in the form of heat along with the ever increasing need to develop computer technologies which can operate in harsh environments (e.g., very high temperatures), NanoThermoMechanical memory and logic devices may hold the answer

Chemical mechanical polisher technology for 300mm/0.18-0.13{mu}m semiconductor devices; 300mm/0.18-0.-0.13{mu}m sedai no CMP gijutsu

Energy Technology Data Exchange (ETDEWEB)

Tsujimura, M.; Kobayashi, F. [Ebara Corp., Tokyo (Japan)

1998-10-20

Described herein are problems involved in, and development points and measures for chemical mechanical polisher (CMP) technology for the generation of 300mm/0.18 to 0.13{mu}m semiconductor devices. Ebara has developed a CMP system for 300mm devices for I300I and Selete (semiconductor high-technologies). The polishing process conditions are set for the time being based on those for the 200mm devices, and the driver and machine structures are set at 2.25 times larger than those for the 200mm devices. Its space requirement is compacter at 1.3 times increase. The company has adopted a concept of `dry-in and dry-out,` which is not common for a CMP. This needs integration of the washer with the polisher, and aerodynamic designs for dust-free conditions. These are already developed for the 200mm devices, and applicable to the 300mm devices without causing any problem. The special chamber for the conventional CMP can be dispensed with, reducing cost. Expendables, such as slurry pad, are being developed to double their service lives and halve their consumption. 8 figs.

Humidification during mechanical ventilation in the adult patient.

Science.gov (United States)

Al Ashry, Haitham S; Modrykamien, Ariel M

2014-01-01

Humidification of inhaled gases has been standard of care in mechanical ventilation for a long period of time. More than a century ago, a variety of reports described important airway damage by applying dry gases during artificial ventilation. Consequently, respiratory care providers have been utilizing external humidifiers to compensate for the lack of natural humidification mechanisms when the upper airway is bypassed. Particularly, active and passive humidification devices have rapidly evolved. Sophisticated systems composed of reservoirs, wires, heating devices, and other elements have become part of our usual armamentarium in the intensive care unit. Therefore, basic knowledge of the mechanisms of action of each of these devices, as well as their advantages and disadvantages, becomes a necessity for the respiratory care and intensive care practitioner. In this paper, we review current methods of airway humidification during invasive mechanical ventilation of adult patients. We describe a variety of devices and describe the eventual applications according to specific clinical conditions.

Electromagnetic device of linear displacement

International Nuclear Information System (INIS)

Savary, F.; Le Saulnier, G.

1986-01-01

The device moves a rod integral with a nuclear reactor control element. It has a grab for the rod operated by a mobil pole drive by a coil carried by a surrounding sealed casing, a second grab with fixed and mobile poles with facing surfaces shaped to limit the variation of magnetic force with distance between them, and a plunger driven by a coil to bear against another mobile pole moved by a coil. The invention proposes a device ensuring a displacement while the impact forces at the different level of the mechanism are reduced [fr

Mechanical circulatory treatment of advanced heart failure

DEFF Research Database (Denmark)

Løgstrup, Brian B; Vase, Henrik; Gjedsted, Jakob

2016-01-01

Heart failure is one of the most common causes of morbidity and mortality worldwide. When patients cease to respond adequately to optimal medical therapy mechanical circulatory support has been promising. The advent of mechanical circulatory support devices has allowed significant improvements...... in patient survival and quality of life for those with advanced or end-stage heart failure. We provide a general overview of current mechanical circulatory support devices encompassing options for both short- and long-term ventricular support....

Prehospital randomised assessment of a mechanical compression device in out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised trial and economic evaluation.

Science.gov (United States)

Gates, Simon; Lall, Ranjit; Quinn, Tom; Deakin, Charles D; Cooke, Matthew W; Horton, Jessica; Lamb, Sarah E; Slowther, Anne-Marie; Woollard, Malcolm; Carson, Andy; Smyth, Mike; Wilson, Kate; Parcell, Garry; Rosser, Andrew; Whitfield, Richard; Williams, Amanda; Jones, Rebecca; Pocock, Helen; Brock, Nicola; Black, John Jm; Wright, John; Han, Kyee; Shaw, Gary; Blair, Laura; Marti, Joachim; Hulme, Claire; McCabe, Christopher; Nikolova, Silviya; Ferreira, Zenia; Perkins, Gavin D

2017-03-01

Mechanical chest compression devices may help to maintain high-quality cardiopulmonary resuscitation (CPR), but little evidence exists for their effectiveness. We evaluated whether or not the introduction of Lund University Cardiopulmonary Assistance System-2 (LUCAS-2; Jolife AB, Lund, Sweden) mechanical CPR into front-line emergency response vehicles would improve survival from out-of-hospital cardiac arrest (OHCA). Evaluation of the LUCAS-2 device as a routine ambulance service treatment for OHCA. Pragmatic, cluster randomised trial including adults with non-traumatic OHCA. Ambulance dispatch staff and those collecting the primary outcome were blind to treatment allocation. Blinding of the ambulance staff who delivered the interventions and reported initial response to treatment was not possible. We also conducted a health economic evaluation and a systematic review of all trials of out-of-hospital mechanical chest compression. Four UK ambulance services (West Midlands, North East England, Wales and South Central), comprising 91 urban and semiurban ambulance stations. Clusters were ambulance service vehicles, which were randomly assigned (approximately 1 : 2) to the LUCAS-2 device or manual CPR. Patients were included if they were in cardiac arrest in the out-of-hospital environment. Exclusions were patients with cardiac arrest as a result of trauma, with known or clinically apparent pregnancy, or aged CPR groups [193/2819, 6.8%; adjusted odds ratio (OR) 0.86, 95% confidence interval (CI) 0.64 to 1.15]. Survival with a CPC score of 1 or 2 may have been worse in the LUCAS-2 group (adjusted OR 0.72, 95% CI 0.52 to 0.99). No serious adverse events were noted. The systematic review found no evidence of a survival advantage if mechanical chest compression was used. The health economic analysis showed that LUCAS-2 was dominated by manual chest compression. There was substantial non-compliance in the LUCAS-2 arm. For 272 out of 1652 patients (16.5%), mechanical

Handbook of compliant mechanisms

CERN Document Server

Howell, Larry L; Olsen, Brian M

2013-01-01

A fully illustrated reference book giving an easy-to-understand introduction to compliant mechanisms A broad compilation of compliant mechanisms to give inspiration and guidance to those interested in using compliant mechanisms in their designs, the Handbook of Compliant Mechanisms includes graphics and descriptions of many compliant mechanisms. It comprises an extensive categorization of devices that can be used to help readers identify compliant mechanisms related to their application. It also provides chapters on the basic background in compliant mechanisms, the categories o

Pumps in wearable ultrafiltration devices: pumps in wuf devices.

Science.gov (United States)

Armignacco, Paolo; Garzotto, Francesco; Bellini, Corrado; Neri, Mauro; Lorenzin, Anna; Sartori, Marco; Ronco, Claudio

2015-01-01

The wearable artificial kidney (WAK) is a device that is supposed to operate like a real kidney, which permits prolonged, frequent, and continuous dialysis treatments for patients with end-stage renal disease (ESRD). Its functioning is mainly related to its pumping system, as well as to its dialysate-generating and alarm/shutoff ones. A pump is defined as a device that moves fluids by mechanical action. In such a context, blood pumps pull blood from the access side of the dialysis catheter and return the blood at the same rate of flow. The main aim of this paper is to review the current literature on blood pumps, describing the way they have been functioning thus far and how they are being engineered, giving details about the most important parameters that define their quality, thus allowing the production of a radar comparative graph, and listing ideal pumps' features. © 2015 S. Karger AG, Basel.

Plasticity in memristive devices for Spiking Neural Networks

Directory of Open Access Journals (Sweden)

Sylvain eSaïghi

2015-03-01

Full Text Available Memristive devices present a new device technology allowing for the realization of compact nonvolatile memories. Some of them are already in the process of industrialization. Additionally, they exhibit complex multilevel and plastic behaviors, which make them good candidates for the implementation of artificial synapses in neuromorphic engineering. However, memristive effects rely on diverse physical mechanisms, and their plastic behaviors differ strongly from one technology to another. Here, we present measurements performed on different memristive devices and the opportunities that they provide. We show that they can be used to implement different learning rules whose properties emerge directly from device physics: real time or accelerated operation, deterministic or stochastic behavior, long term or short term plasticity. We then discuss how such devices might be integrated into a complete architecture. These results highlight that there is no unique way to exploit memristive devices in neuromorphic systems. Understanding and embracing device physics is the key for their optimal use.

The Impact of Conscious Sedation versus General Anesthesia for Stroke Thrombectomy on the Predictive Value of Collateral Status: A Post Hoc Analysis of the SIESTA Trial.

Science.gov (United States)

Schönenberger, S; Pfaff, J; Uhlmann, L; Klose, C; Nagel, S; Ringleb, P A; Hacke, W; Kieser, M; Bendszus, M; Möhlenbruch, M A; Bösel, J

2017-08-01

Radiologic selection criteria to identify patients likely to benefit from endovascular stroke treatment are still controversial. In this post hoc analysis of the recent randomized Sedation versus Intubation for Endovascular Stroke TreAtment (SIESTA) trial, we aimed to investigate the impact of sedation mode (conscious sedation versus general anesthesia) on the predictive value of collateral status. Using imaging data from SIESTA, we assessed collateral status with the collateral score of Tan et al and graded it from absent to good collaterals (0-3). We examined the association of collateral status with 24-hour improvement of the NIHSS score, infarct volume, and mRS at 3 months according to the sedation regimen. In a cohort of 104 patients, the NIHSS score improved significantly in patients with moderate or good collaterals (2-3) compared with patients with no or poor collaterals (0-1) ( P = .011; mean, -5.8 ± 7.6 versus -1.1 ± 10.7). Tan 2-3 was also associated with significantly higher ASPECTS before endovascular stroke treatment (median, 9 versus 7; P collateral status (0.1 versus 2.3), the sedation modes conscious sedation and general anesthesia were not associated with significant differences in the predictive value of collateral status regarding infarction size or functional outcome. The sedation mode, conscious sedation or general anesthesia, did not influence the predictive value of collaterals in patients with large-vessel occlusion anterior circulation stroke undergoing thrombectomy in the SIESTA trial. © 2017 by American Journal of Neuroradiology.

Device for radiotherapy

International Nuclear Information System (INIS)

Levinta, A.

2002-01-01

The invention refers to medicine, in particular to radiology. Summary of the invention consists in that the device for the radiotherapy includes a base a headrest, a mechanism for head fixation, means for placement of the formation element, the mechanism for head fixation representing a semicircle situated in horizontal position and fixed to the base with the possibility of displacement, in the centre of which it is installed a fixing arm, and the means for placement of the formation elements representing at least two semicircles, mounted in vertical position and fixed into supports with the possibility of mutual swiveling of each of them, between the headrest and the base being installed the neck support

High performance bio-integrated devices

Science.gov (United States)

Kim, Dae-Hyeong; Lee, Jongha; Park, Minjoon

2014-06-01

In recent years, personalized electronics for medical applications, particularly, have attracted much attention with the rise of smartphones because the coupling of such devices and smartphones enables the continuous health-monitoring in patients' daily life. Especially, it is expected that the high performance biomedical electronics integrated with the human body can open new opportunities in the ubiquitous healthcare. However, the mechanical and geometrical constraints inherent in all standard forms of high performance rigid wafer-based electronics raise unique integration challenges with biotic entities. Here, we describe materials and design constructs for high performance skin-mountable bio-integrated electronic devices, which incorporate arrays of single crystalline inorganic nanomembranes. The resulting electronic devices include flexible and stretchable electrophysiology electrodes and sensors coupled with active electronic components. These advances in bio-integrated systems create new directions in the personalized health monitoring and/or human-machine interfaces.

Effects of mobile phone use on specific intensive care unit devices.

Science.gov (United States)

Hans, Nidhi; Kapadia, Farhad N

2008-10-01

To observe the effects of mobile phone use in the vicinity of medical devices used in a critical care setting. Electromagnetic interference (EMI) was tested by using two types of mobile phones - GSM and CDMA. Mobile phones were placed at a distance of one foot from three medical devices - syringe pump, mechanical ventilator, and the bedside monitor - in switch off, standby, and talking modes of the phone. Medical devices were observed for any interference caused by the electromagnetic radiations (EMR) from the mobile phones. Out of the three medical devices that were tested, EMI occurred while using the mobile phone in the vicinity of the syringe pump, in the 'talk mode.' The mean variation observed in the calculated and delivered volume of the syringe pump was 2.66 ml. Mechanical ventilator did not show any specific adverse effects with mobile phone use in the one-foot vicinity. No other adverse effects or unexplained malfunctions or shutdown of the syringe pump, mechanical ventilator, or the bedside monitor was noted during the study period of 36 hours. EMI from mobile phones have an adverse effect on the medical devices used in critical care setup. They should be used at least one foot away from the diameter of the syringe pump.

Quantum effects in ion implanted devices

International Nuclear Information System (INIS)

Jamieson, D.N.; Chan, V.; Hudson, F.E.; Andresen, S.E.; Yang, C.; Hopf, T.; Hearne, S.M.; Pakes, C.I.; Prawer, S.; Gauja, E.; Yang, C.; Dzurak, A.S.; Yang, C.; Clark, R.G.; Yang, C.

2005-01-01

Fabrication of nanoscale devices that exploit the rules of quantum mechanics to process information presents formidable technical challenges because it will be necessary to control quantum states at the level of individual atoms, electrons or photons. We have developed a pathway to the construction of quantum devices using ion implantation and demonstrate, using charge transport analysis, that the devices exhibit single electron effects. We construct devices that employ two P donors in Si by employing the technique of ion beam induced charge (IBIC) in which single 14 keV P ions can be implanted into ultra-pure silicon by monitoring on-substrate detector electrodes. We have used IBIC with a MeV nuclear microprobe to map and measure the charge collection efficiency in the development of the electrode structure and show that 100% charge collection efficiency can be achieved leading to the fabrication of prototype devices that display quantum effects in the transport of single charge quanta between the islands of implanted donors. (author). 9 refs., 4 figs., 1 tab

Chemical-to-Electricity Carbon: Water Device.

Science.gov (United States)

He, Sisi; Zhang, Yueyu; Qiu, Longbin; Zhang, Longsheng; Xie, Yun; Pan, Jian; Chen, Peining; Wang, Bingjie; Xu, Xiaojie; Hu, Yajie; Dinh, Cao Thang; De Luna, Phil; Banis, Mohammad Norouzi; Wang, Zhiqiang; Sham, Tsun-Kong; Gong, Xingao; Zhang, Bo; Peng, Huisheng; Sargent, Edward H

2018-03-26

The ability to release, as electrical energy, potential energy stored at the water:carbon interface is attractive, since water is abundant and available. However, many previous reports of such energy converters rely on either flowing water or specially designed ionic aqueous solutions. These requirements restrict practical application, particularly in environments with quiescent water. Here, a carbon-based chemical-to-electricity device that transfers the chemical energy to electrical form when coming into contact with quiescent deionized water is reported. The device is built using carbon nanotube yarns, oxygen content of which is modulated using oxygen plasma-treatment. When immersed in water, the device discharges electricity with a power density that exceeds 700 mW m -2 , one order of magnitude higher than the best previously published result. X-ray absorption and density functional theory studies support a mechanism of operation that relies on the polarization of sp 2 hybridized carbon atoms. The devices are incorporated into a flexible fabric for powering personal electronic devices. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

New Perspectives on the Charging Mechanisms of Supercapacitors

Science.gov (United States)

2016-01-01

Supercapacitors (or electric double-layer capacitors) are high-power energy storage devices that store charge at the interface between porous carbon electrodes and an electrolyte solution. These devices are already employed in heavy electric vehicles and electronic devices, and can complement batteries in a more sustainable future. Their widespread application could be facilitated by the development of devices that can store more energy, without compromising their fast charging and discharging times. In situ characterization methods and computational modeling techniques have recently been developed to study the molecular mechanisms of charge storage, with the hope that better devices can be rationally designed. In this Perspective, we bring together recent findings from a range of experimental and computational studies to give a detailed picture of the charging mechanisms of supercapacitors. Nuclear magnetic resonance experiments and molecular dynamics simulations have revealed that the electrode pores contain a considerable number of ions in the absence of an applied charging potential. Experiments and computer simulations have shown that different charging mechanisms can then operate when a potential is applied, going beyond the traditional view of charging by counter-ion adsorption. It is shown that charging almost always involves ion exchange (swapping of co-ions for counter-ions), and rarely occurs by counter-ion adsorption alone. We introduce a charging mechanism parameter that quantifies the mechanism and allows comparisons between different systems. The mechanism is found to depend strongly on the polarization of the electrode, and the choice of the electrolyte and electrode materials. In light of these advances we identify new directions for supercapacitor research. Further experimental and computational work is needed to explain the factors that control supercapacitor charging mechanisms, and to establish the links between mechanisms and performance