Synchronous perforation of non-Hodgkin's lymphoma of the small intestine and colon: a case report

Directory of Open Access Journals (Sweden)

Baidoun Fadi

2011-02-01

Full Text Available Abstract Introduction Primary non-Hodgkin's lymphoma of the small and large bowel presenting as a perforated viscus entity with peritonitis is extremely rare. A thorough literature review did not reveal any cases where primary lymphoma of the jejunum presented with perforation and peritonitis synchronously with primary lymphoma of the descending colon. Case presentation This report concerns a 64-year-old Caucasian woman admitted with severe abdominal pain and fever. An emergency laparotomy revealed a large mass with perforation in the proximal jejunum with intense mesenteric thickening and lymphadenopathy. The descending colon was edematous and covered with fibrinous exudate. Histopathological examination of the resected segment of jejunum revealed a T cell non-Hodgkin's lymphoma. On post-operative day 10, a computed tomography scan of our patient's abdomen and pelvis showed leakage of contrast into the pelvis. Re-exploration revealed perforation of the descending colon. The histopathology of the resected colon also showed T cell non-Hodgkin's lymphoma. Her post-operative course was complicated by acute renal and respiratory failure. The patient died on post-operative day 21. Conclusions Lymphoma of the small intestine has been reported to have a poor prognosis. The synchronous occurrence of lesions in the small intestine or colon is unusual, and impacts the prognosis adversely. Early diagnosis and treatment are important to improve the prognosis of bowel perforation in patients with non-Hodgkin's lymphoma.

[Non operative treatment for perforated peptic ulcer: results of a prospective study].

Science.gov (United States)

Songne, B; Jean, F; Foulatier, O; Khalil, H; Scotté, M

2004-12-01

The conservative management of perforated peptic ulcer has not gained widespread acceptance despite introduction of proton-pomp inhibitors because surgical procedures can achieve immediate closure by eventually using a laparoscopic approach. The aim of this prospective study was to evaluate the results of Taylor's method and to identify predictive factors of failure of medical treatment in patients presenting with perforated peptic ulcer. Between 1990 and 2000, 82 consecutive patients, with diagnosis of perforated peptic ulcer were prospectively included in this study. They were initially treated with non-operative procedure (nasogastric suction and intravenous administration of H2-blockers or proton-pomp inhibitors). No clinical improvement after 24 hours required a surgical treatment. Predictive factors of failure of non-operative treatment were tested in univariate or multivariate analysis. Clinical improvement was obtained with non-operative treatment in 54% of the patients (44/82). The overall mortality rate was 1%. In univariate analysis, significant predictive factors of failure of non-operative treatment were: size of pneumoperitoneum, heart beat >94 bpm, abdominal meteorism, pain at digital rectal exam, and age >59 years. In multivariate analysis, the significant factors were the size of pneumoperitoneum, heart beat, and abdominal meteorism. The association of these criteria: size of pneumoperitoneum >size of the first lumbar vertebra, heart beat >94 bpm, pain at digital rectal exam and age > 59 years , led to surgical treatment in all cases. These results suggest that more than 50% of patients with perforated peptic ulcer respond to conservative treatment without surgery and that the association of few criteria (size of pneumoperitoneum, heart beat, pain at digital rectal exam and age) require emergency surgery.

Perforated peptic ulcer.

Science.gov (United States)

Søreide, Kjetil; Thorsen, Kenneth; Harrison, Ewen M; Bingener, Juliane; Møller, Morten H; Ohene-Yeboah, Michael; Søreide, Jon Arne

2015-09-26

Perforated peptic ulcer is a common emergency condition worldwide, with associated mortality rates of up to 30%. A scarcity of high-quality studies about the condition limits the knowledge base for clinical decision making, but a few published randomised trials are available. Although Helicobacter pylori and use of non-steroidal anti-inflammatory drugs are common causes, demographic differences in age, sex, perforation location, and underlying causes exist between countries, and mortality rates also vary. Clinical prediction rules are used, but accuracy varies with study population. Early surgery, either by laparoscopic or open repair, and proper sepsis management are essential for good outcome. Selected patients can be managed non-operatively or with novel endoscopic approaches, but validation of such methods in trials is needed. Quality of care, sepsis care bundles, and postoperative monitoring need further assessment. Adequate trials with low risk of bias are urgently needed to provide better evidence. We summarise the evidence for perforated peptic ulcer management and identify directions for future clinical research. Copyright © 2015 Elsevier Ltd. All rights reserved.

BLOSTREAM: A HIGH SPEED STREAM CIPHER

Directory of Open Access Journals (Sweden)

ALI H. KASHMAR

2017-04-01

Full Text Available Although stream ciphers are widely utilized to encrypt sensitive data at fast speeds, security concerns have led to a shift from stream to block ciphers, judging that the current technology in stream cipher is inferior to the technology of block ciphers. This paper presents the design of an improved efficient and secure stream cipher called Blostream, which is more secure than conventional stream ciphers that use XOR for mixing. The proposed cipher comprises two major components: the Pseudo Random Number Generator (PRNG using the Rabbit algorithm and a nonlinear invertible round function (combiner for encryption and decryption. We evaluate its performance in terms of implementation and security, presenting advantages and disadvantages, comparison of the proposed cipher with similar systems and a statistical test for randomness. The analysis shows that the proposed cipher is more efficient, high speed, and secure than current conventional stream ciphers.

StreamQRE: Modular Specification and Efficient Evaluation of Quantitative Queries over Streaming Data.

Science.gov (United States)

Mamouras, Konstantinos; Raghothaman, Mukund; Alur, Rajeev; Ives, Zachary G; Khanna, Sanjeev

2017-06-01

Real-time decision making in emerging IoT applications typically relies on computing quantitative summaries of large data streams in an efficient and incremental manner. To simplify the task of programming the desired logic, we propose StreamQRE, which provides natural and high-level constructs for processing streaming data. Our language has a novel integration of linguistic constructs from two distinct programming paradigms: streaming extensions of relational query languages and quantitative extensions of regular expressions. The former allows the programmer to employ relational constructs to partition the input data by keys and to integrate data streams from different sources, while the latter can be used to exploit the logical hierarchy in the input stream for modular specifications. We first present the core language with a small set of combinators, formal semantics, and a decidable type system. We then show how to express a number of common patterns with illustrative examples. Our compilation algorithm translates the high-level query into a streaming algorithm with precise complexity bounds on per-item processing time and total memory footprint. We also show how to integrate approximation algorithms into our framework. We report on an implementation in Java, and evaluate it with respect to existing high-performance engines for processing streaming data. Our experimental evaluation shows that (1) StreamQRE allows more natural and succinct specification of queries compared to existing frameworks, (2) the throughput of our implementation is higher than comparable systems (for example, two-to-four times greater than RxJava), and (3) the approximation algorithms supported by our implementation can lead to substantial memory savings.

Hyperbilirubinaemia: its utility in non-perforated appendicitis.

Science.gov (United States)

Sandstrom, Anna; Grieve, David A

2017-07-01

The diagnosis of acute appendicitis is made using clinical findings and investigations. Recent studies have suggested that serum bilirubin, a cheap and simple biochemical test, is a positive predictor in the diagnosis of appendiceal perforation and may be more specific than C-reactive protein (CRP) and white cell count (WCC). The aim of this study was to investigate the utility of the serum bilirubin level in patients with suspected acute but non-perforative appendicitis. A retrospective chart review of 213 patients who presented with suspected appendicitis in a 6-month period to Nambour General Hospital was performed. Serum bilirubin, WCC and CRP were recorded and analysed as to their utility in relation to the final diagnosis. A total of 196 patients underwent an appendicectomy and 41 of these were negative. The specificity of hyperbilirubinaemia for appendicitis overall was 0.83 with a positive predictive value (PPV) of 0.86, compared with CRP (specificity 0.40, PPV 0.75) and WCC (specificity 0.67, PPV 0.85). The area under the receiver operating characteristic curve for bilirubin was 0.6289 compared to 0.6171 for CRP and 0.7219 for WCC. A subgroup analysis of those with complicated appendicitis demonstrated a PPV for bilirubin of 0.66 compared to 0.58 for WCC and 0.34 for CRP in agreement with the literature. Subgroup analysis of hyperbilirubinaemia in simple appendicitis demonstrated a PPV of 0.81 compared to CRP (0.71) and WCC (0.82). Bilirubin had a higher specificity than CRP and WCC overall in patients with appendicitis. Hyperbilirubinaemia had a high PPV in patients with simple appendicitis. © 2015 Royal Australasian College of Surgeons.

Approximate Stream Function wavemaker theory for highly non-linear waves in wave flumes

DEFF Research Database (Denmark)

Zhang, H.W.; Schäffer, Hemming Andreas

2007-01-01

An approximate Stream Function wavemaker theory for highly non-linear regular waves in flumes is presented. This theory is based on an ad hoe unified wave-generation method that combines linear fully dispersive wavemaker theory and wave generation for non-linear shallow water waves. This is done...... by applying a dispersion correction to the paddle position obtained for non-linear long waves. The method is validated by a number of wave flume experiments while comparing with results of linear wavemaker theory, second-order wavemaker theory and Cnoidal wavemaker theory within its range of application....

Non-traumatic perforation of the small bowel | Eid | African Health ...

African Journals Online (AJOL)

... medical records of four patients who have presented with non-traumatic perforation of the small bowel and were treated at Al-Ain Hospital during the last 5 years were studied retrospectively. Results: The presenting symptoms of all patients were similar. Erect chest X-ray has shown free air under diaphragm in 3 patients.

Fabrication of perforated isoporous membranes via a transfer-free strategy: enabling high-resolution separation of cells.

Science.gov (United States)

Ou, Yang; Lv, Chang-Jiang; Yu, Wei; Mao, Zheng-Wei; Wan, Ling-Shu; Xu, Zhi-Kang

2014-12-24

Thin perforated membranes with ordered pores are ideal barriers for high-resolution and high-efficiency selective transport and separation of biological species. However, for self-assembled thin membranes with a thickness less than several micrometers, an additional step of transferring the membranes onto porous supports is generally required. In this article, we present a facile transfer-free strategy for fabrication of robust perforated composite membranes via the breath figure process, and for the first time, demonstrate the application of the membranes in high-resolution cell separation of yeasts and lactobacilli without external pressure, achieving almost 100% rejection of yeasts and more than 70% recovery of lactobacilli with excellent viability. The avoidance of the transfer step simplifies the fabrication procedure of composite membranes and greatly improves the membrane homogeneity. Moreover, the introduction of an elastic triblock copolymer increases the interfacial strength between the membrane and the support, and allows the preservation of composite membranes in a dry state. Such perforated ordered membranes can also be applied in other size-based separation systems, enabling new opportunities in bioseparation and biosensors.

Efficient Delivery of Scalable Video Using a Streaming Class Model

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Jason J. Quinlan

2018-03-01

Full Text Available When we couple the rise in video streaming with the growing number of portable devices (smart phones, tablets, laptops, we see an ever-increasing demand for high-definition video online while on the move. Wireless networks are inherently characterised by restricted shared bandwidth and relatively high error loss rates, thus presenting a challenge for the efficient delivery of high quality video. Additionally, mobile devices can support/demand a range of video resolutions and qualities. This demand for mobile streaming highlights the need for adaptive video streaming schemes that can adjust to available bandwidth and heterogeneity, and can provide a graceful changes in video quality, all while respecting viewing satisfaction. In this context, the use of well-known scalable/layered media streaming techniques, commonly known as scalable video coding (SVC, is an attractive solution. SVC encodes a number of video quality levels within a single media stream. This has been shown to be an especially effective and efficient solution, but it fares badly in the presence of datagram losses. While multiple description coding (MDC can reduce the effects of packet loss on scalable video delivery, the increased delivery cost is counterproductive for constrained networks. This situation is accentuated in cases where only the lower quality level is required. In this paper, we assess these issues and propose a new approach called Streaming Classes (SC through which we can define a key set of quality levels, each of which can be delivered in a self-contained manner. This facilitates efficient delivery, yielding reduced transmission byte-cost for devices requiring lower quality, relative to MDC and Adaptive Layer Distribution (ALD (42% and 76% respective reduction for layer 2, while also maintaining high levels of consistent quality. We also illustrate how selective packetisation technique can further reduce the effects of packet loss on viewable quality by

Mnemonic discrimination relates to perforant path integrity: An ultra-high resolution diffusion tensor imaging study.

Science.gov (United States)

Bennett, Ilana J; Stark, Craig E L

2016-03-01

Pattern separation describes the orthogonalization of similar inputs into unique, non-overlapping representations. This computational process is thought to serve memory by reducing interference and to be mediated by the dentate gyrus of the hippocampus. Using ultra-high in-plane resolution diffusion tensor imaging (hrDTI) in older adults, we previously demonstrated that integrity of the perforant path, which provides input to the dentate gyrus from entorhinal cortex, was associated with mnemonic discrimination, a behavioral outcome designed to load on pattern separation. The current hrDTI study assessed the specificity of this perforant path integrity-mnemonic discrimination relationship relative to other cognitive constructs (identified using a factor analysis) and white matter tracts (hippocampal cingulum, fornix, corpus callosum) in 112 healthy adults (20-87 years). Results revealed age-related declines in integrity of the perforant path and other medial temporal lobe (MTL) tracts (hippocampal cingulum, fornix). Controlling for global effects of brain aging, perforant path integrity related only to the factor that captured mnemonic discrimination performance. Comparable integrity-mnemonic discrimination relationships were also observed for the hippocampal cingulum and fornix. Thus, whereas perforant path integrity specifically relates to mnemonic discrimination, mnemonic discrimination may be mediated by a broader MTL network. Copyright © 2015 Elsevier Inc. All rights reserved.

Diagnostic accuracy of cone-beam computed tomography scans with high- and low-resolution modes for the detection of root perforations.

Science.gov (United States)

Shokri, Abbas; Eskandarloo, Amir; Norouzi, Marouf; Poorolajal, Jalal; Majidi, Gelareh; Aliyaly, Alireza

2018-03-01

This study compared the diagnostic accuracy of cone-beam computed tomography (CBCT) scans obtained with 2 CBCT systems with high- and low-resolution modes for the detection of root perforations in endodontically treated mandibular molars. The root canals of 72 mandibular molars were cleaned and shaped. Perforations measuring 0.2, 0.3, and 0.4 mm in diameter were created at the furcation area of 48 roots, simulating strip perforations, or on the external surfaces of 48 roots, simulating root perforations. Forty-eight roots remained intact (control group). The roots were filled using gutta-percha (Gapadent, Tianjin, China) and AH26 sealer (Dentsply Maillefer, Ballaigues, Switzerland). The CBCT scans were obtained using the NewTom 3G (QR srl, Verona, Italy) and Cranex 3D (Soredex, Helsinki, Finland) CBCT systems in high- and low-resolution modes, and were evaluated by 2 observers. The chi-square test was used to assess the nominal variables. In strip perforations, the accuracies of low- and high-resolution modes were 75% and 83% for NewTom 3G and 67% and 69% for Cranex 3D. In root perforations, the accuracies of low- and high-resolution modes were 79% and 83% for NewTom 3G and was 56% and 73% for Cranex 3D. The accuracy of the 2 CBCT systems was different for the detection of strip and root perforations. The Cranex 3D had non-significantly higher accuracy than the NewTom 3G. In both scanners, the high-resolution mode yielded significantly higher accuracy than the low-resolution mode. The diagnostic accuracy of CBCT scans was not affected by the perforation diameter.

KDE-Track: An Efficient Dynamic Density Estimator for Data Streams

KAUST Repository

Qahtan, Abdulhakim Ali Ali; Wang, Suojin; Zhang, Xiangliang

2016-01-01

Recent developments in sensors, global positioning system devices and smart phones have increased the availability of spatiotemporal data streams. Developing models for mining such streams is challenged by the huge amount of data that cannot be stored in the memory, the high arrival speed and the dynamic changes in the data distribution. Density estimation is an important technique in stream mining for a wide variety of applications. The construction of kernel density estimators is well studied and documented. However, existing techniques are either expensive or inaccurate and unable to capture the changes in the data distribution. In this paper, we present a method called KDE-Track to estimate the density of spatiotemporal data streams. KDE-Track can efficiently estimate the density function with linear time complexity using interpolation on a kernel model, which is incrementally updated upon the arrival of new samples from the stream. We also propose an accurate and efficient method for selecting the bandwidth value for the kernel density estimator, which increases its accuracy significantly. Both theoretical analysis and experimental validation show that KDE-Track outperforms a set of baseline methods on the estimation accuracy and computing time of complex density structures in data streams.

KDE-Track: An Efficient Dynamic Density Estimator for Data Streams

KAUST Repository

Qahtan, Abdulhakim Ali Ali

2016-11-08

Recent developments in sensors, global positioning system devices and smart phones have increased the availability of spatiotemporal data streams. Developing models for mining such streams is challenged by the huge amount of data that cannot be stored in the memory, the high arrival speed and the dynamic changes in the data distribution. Density estimation is an important technique in stream mining for a wide variety of applications. The construction of kernel density estimators is well studied and documented. However, existing techniques are either expensive or inaccurate and unable to capture the changes in the data distribution. In this paper, we present a method called KDE-Track to estimate the density of spatiotemporal data streams. KDE-Track can efficiently estimate the density function with linear time complexity using interpolation on a kernel model, which is incrementally updated upon the arrival of new samples from the stream. We also propose an accurate and efficient method for selecting the bandwidth value for the kernel density estimator, which increases its accuracy significantly. Both theoretical analysis and experimental validation show that KDE-Track outperforms a set of baseline methods on the estimation accuracy and computing time of complex density structures in data streams.

Nontraumatic terminal ileal perforation

Directory of Open Access Journals (Sweden)

Wani Rauf A

2006-03-01

Full Text Available Abstract Background There is still confusion and controversy over the diagnosis and optimal surgical treatment of non traumatic terminal ileal perforation-a cause of obscure peritonitis. Methods This study was a prospective study aimed at evaluating the clinical profile, etiology and optimal surgical management of patients with nontraumatic terminal ileal perforation. Results There were 79 cases of nontraumatic terminal ileal perforation; the causes for perforation were enteric fever(62%, nonspecific inflammation(26%, obstruction(6%, tuberculosis(4% and radiation enteritis (1%. Simple closure of the perforation (49% and end to side ileotransverse anastomosis(42% were the mainstay of the surgical management. Conclusion Terminal ileal perforation should be suspected in all cases of peritonitis especially in developing countries and surgical treatment should be optimized taking various accounts like etiology, delay in surgery and operative findings into consideration to reduce the incidence of deadly complications like fecal fistula.

Cost-efficient enactment of stream processing topologies

Directory of Open Access Journals (Sweden)

Christoph Hochreiner

2017-12-01

Full Text Available The continuous increase of unbound streaming data poses several challenges to established data stream processing engines. One of the most important challenges is the cost-efficient enactment of stream processing topologies under changing data volume. These data volume pose different loads to stream processing systems whose resource provisioning needs to be continuously updated at runtime. First approaches already allow for resource provisioning on the level of virtual machines (VMs, but this only allows for coarse resource provisioning strategies. Based on current advances and benefits for containerized software systems, we have designed a cost-efficient resource provisioning approach and integrated it into the runtime of the Vienna ecosystem for elastic stream processing. Our resource provisioning approach aims to maximize the resource usage for VMs obtained from cloud providers. This strategy only releases processing capabilities at the end of the VMs minimal leasing duration instead of releasing them eagerly as soon as possible as it is the case for threshold-based approaches. This strategy allows us to improve the service level agreement compliance by up to 25% and a reduction for the operational cost of up to 36%.

Colonic perforation with peritonitis in amoebiasis: a tropical disease with high mortality.

Science.gov (United States)

Jain, Bhupendra Kumar; Garg, Pankaj Kumar; Kumar, Anjay; Mishra, Kiran; Mohanty, Debajyoti; Agrawal, Vivek

2013-01-01

Invasive colonic amoebiasis presents primarily with dysentery; colonic perforation occurs rarely. Cases of amoebic colonic perforations have been reported sporadically over the past 20 years. A retrospective study was done in the surgical unit of a tertiary care hospital in North India. The case records of those patients were reviewed who underwent exploratory laparotomy from January 2011 to September 2012 and were diagnosed with amoebic colonic perforation on histopathological examination. Details concerning the clinical presentation, investigations, intraoperative findings, operative procedures, and postoperative outcomes were retrieved. Amongst, a total of 186 emergency exploratory laparotomies carried out during the study, 15 patients of amoebic colonic perforation were identified. The median age of the patients was 42 years (IQR 32.0-58.0) and the male to female ratio was 13:2. Previous history of colitis was present in only 1 patient. The preoperative diagnosis was perforation peritonitis in 12 patients; and intussusception, intestinal obstruction and ruptured liver abscess in 1 patient each. Ten patients had single perforation while 5 had multiple colonic perforations. All the patients except one had perforations in the right colon. Bowel resection was performed depending upon the site and extent of the colon involved-right hemicolectomy (8), limited ileocolic resection (6) and sigmoidectomy (1). Bowel continuity could be restored only in 2 of the 15 patients and a stoma was constructed in the remaining 13 patients. The overall mortality rate was found to be 40% (6/15). Amoebic colonic perforation is associated with unusually high mortality.

Colonic perforation following endoscopic retrograde ...

African Journals Online (AJOL)

She developed severe upper abdominal pain after the ... non-surgical management of pancreatitis and associated complications, colonic perforation should be considered in patients who deteriorate ... To our knowledge this is the first case of a secure pre-operative diagnosis of colonic perforation due to to pancreatitis.

Perforated Duodenal Ulcer in a Young Child: An Uncommon Condition

Directory of Open Access Journals (Sweden)

Rohit Prasad Yadav

2009-04-01

Full Text Available Duodenal ulcer is an uncommonly diagnosed entity in children. H. pyloriinfection, blood group ‘O’ or secondary to medications like non steroidal anti-infl ammatory drugs (NSAID and corticosteroids or physiological stress in burns, head injury and mucosal ischemia are implicated as risk factors for their causation. The diagnosis is usually overlooked because of vague and variable symptoms and remote index of suspicion accounted for their low incidence in children. Undiagnosed or mistreated perforations may carry high morbidity and mortality. We report a successfully treated 41/2 year old male child who presented with features of perforation peritonitis and was incidentally found to have a perforated duodenal ulcer. Key Words: duodenal ulcer, laparotomy, perforation

STUDY OF CLINICAL OUTCOMES OF SUBFASCIAL PERFORATOR LIGATION SURGERY IN PERFORATOR INCOMPETENCE

Directory of Open Access Journals (Sweden)

Vasuki Rajam

2017-02-01

Full Text Available BACKGROUND Chronic venous insufficiency presents with a spectrum of clinical features ranging from pain or heaviness of affected limbs to non-healing ulcers over the lower limbs and usually require some form of surgical intervention, performing direct perforator vein division preferably by subfascial endoscopic perforator ligation surgery for perforator incompetence, as despite aggressive conservative therapy including compression, lifestyle modification and venotonic medications which are of high cost treatment with increased risk of increasing symptoms. MATERIALS AND METHODS A prospective longitudinal clinical study of 30 patients selected by systematic sampling method from November 2014 to September 2015 at our institution was conducted to determine the results of subfascial endoscopic perforator vein surgery (SEPS in perforator incompetence. RESULTS For venous clinical severity scoring pre operatively and after 3 weeks post-surgery, the mean for VCSS pre-operatively was 6.66 and a standard deviation of 2.399. The T value was calculated and was found to be 4.9321 and p value of 0.00001(p value less than 0.05 is significant. Similarly for the cases with active ulcer, the size assessment pre-operatively and post-SEPS was again analysed using student t test and the mean ulcer size prior to surgery was found to be 3.3 and standard deviation of 1.984. The T value was calculated and was found to be 1.789009 and a p value of 0.04 (p value less than 0.05 is significant. CONCLUSION Our study concluded that favourable and significant ulcer healing rate with improvement and reduction in clinical severity suggests that SEPS plays an important role in surgical management of advanced stages of venous insufficiency.

Evaluation of a protocol for the non-operative management of perforated peptic ulcer.

Science.gov (United States)

Marshall, C; Ramaswamy, P; Bergin, F G; Rosenberg, I L; Leaper, D J

1999-01-01

The non-operative management of perforated peptic ulcer has previously been shown to be both safe and effective although it remains controversial. A protocol for non-operative management was set up in this hospital in 1989. Adherence to the guidelines in the protocol has been audited over a 6-year period with a review of outcome. The case-notes of patients with a diagnosis of perforated peptic ulcer were reviewed. Twelve guidelines from the protocol were selected for evaluation of compliance to the protocol. Forty-nine patients underwent non-operative treatment initially. Eight patients failed to respond and underwent operation. Complications included abscess formation (seven patients), renal failure (one), gastric ileus (one), chest infection (two), and cardiac failure and stroke (one). Four deaths occurred in this group. Adherence to certain protocol guidelines was poor, notably those concerning prevention of thromboembolism, use of antibiotics, use of contrast examination to confirm the diagnosis and referral for follow-up endoscopy. Two gastric cancers were detected on subsequent endoscopy. This experience demonstrates that non-operative treatment can be used successfully in a general hospital. Adherence to protocol guidelines was found to be variable and the protocol has therefore been simplified. This study highlights the need for an accurate diagnosis and the importance of follow-up endoscopy.

High Temperature Perforating System for Geothermal Applications

Energy Technology Data Exchange (ETDEWEB)

Smart, Moises E. [Schlumberger Technology Corporation, Sugar Land, TX (United States)

2017-02-28

The objective of this project is to develop a perforating system consisting of all the explosive components and hardware, capable of reliable performance in high temperatures geothermal wells (>200 ºC). In this light we will focused on engineering development of these components, characterization of the explosive raw powder and developing the internal infrastructure to increase the production of the explosive from laboratory scale to industrial scale.

On-stream chemical element monitor

International Nuclear Information System (INIS)

Averitt, O.R.; Dorsch, R.R.

1979-01-01

An apparatus and method for on-stream chemical element monitoring are described wherein a multiplicity of sample streams are flowed continuously through individual analytical cells and fluorescence analyses are performed on the sample streams in sequence, together with a method of controlling the time duration of each analysis as a function of the concomitant radiation exposure of a preselected perforate reference material interposed in the sample-radiation source path

Heavy-water extraction from non-electrolytic hydrogen streams

International Nuclear Information System (INIS)

LeRoy, R.L.; Hammerli, M.; Butler, J.P.

1981-01-01

Heavy water may be produced from non-electrolytic hydrogen streams using a combined electrolysis and catalytic exchange process. The method comprises contacting feed water in a catalyst column with hydrogen gas originating partly from a non-electrolytic hydrogen stream and partly from an electrolytic hydrogen stream, so as to enrich the feed water with the deuterium extracted from both the non-electrolytic and electrolytic hydrogen gas, and passing the deuterium water to an electrolyser wherein the electrolytic hydrogen gas is generated and then fed through the catalyst column. (L.L.)

Esophageal perforation

Science.gov (United States)

... esophagus into the space around the lungs. Collapsed lung. X-rays taken after you drink a non-harmful dye can help pinpoint the location of the perforation. You may also have chest CT scan look for an abscess in the chest or esophageal cancer.

Peptic ulcer perforation

African Journals Online (AJOL)

FinePrint

2015-06-01

Jun 1, 2015 ... Peptic ulcer perforation is one of the surgical complications of peptic ulcer ... Treatment can be operative or non-operative followed by proton .... chronic gastritis without evidence of ... inhibits pancreatic bicarbonate secretion.

Energy Analysis of Solar Collector With perforated Absorber Plate

Directory of Open Access Journals (Sweden)

Ammar A. Farhan

2017-09-01

Full Text Available The thermal performance of three solar collectors with 3, 6 mm and without perforation absorber plate was assessed experimentally. The experimental tests were implemented in Baghdad during the January and February 2017. Five values of airflow rates range between 0.01 – 0.1 m3/s were used through the test with a constant airflow rate during the test day. The variation of the following parameters air temperature difference, useful energy, absorber plate temperature, and collector efficiency was recorded every 15 minutes. The experimental data reports that the increases the number of absorber plate perforations with a small diameter is more efficient rather than increasing the hole diameter of the absorber plate with decreasing the perforation numbers. Maximum air temperature difference throughout the solar collector with 3, 6 mm perforations and without perforations are 17, 15, and 12 oC, respectively. Also, it can be concluded that the energy gained from the solar collector with 3 mm perforation absorber plate is 28.2 % more than the energy gained from solar collector without holes per day for 0.1 m3/s airflow rate. The maximum values of the thermal performance curves are 0.67, 0.64, and 0.56 for the solar collector with 3, 6 mm, and without perforations, respectively.

Typhoid Intestinal Perforation: 24 Perforations in One Patient

African Journals Online (AJOL)

Intestinal perforation is a common cause of peritonitis necessitating emergency surgical intervention. Perforation ... Mortality rates of typhoid intestinal perforation (TIP) cases are ... may be obscured clinical features with resultant delays in.

Optimization of the process of steel strip perforation and nickel platting for the purpose of elimination of trichloroethylene from the cleaning process of perforated steel strip

Directory of Open Access Journals (Sweden)

Petrović Aleksandra B.

2009-01-01

Full Text Available In the production of pocket type electrodes for Ni-Cd batteries perforation of proper steel strips and then nickel platting of perforated steel strips were made. In the nickel platting process, the organic solvent, trichloroethylene, has previously been used for cleaning. Due to the carcinogenic nature of trichloroethylene and the many operations previously required during cleaning, it was considered to do cleaning of perforated steel strips without use of the mentioned organic solvent. In the purpose of elimination of trichloroethylene from the cleaning process of perforated steel strips, the tests of perforation of steel strips with use of oils of different viscosity were made. It was shown that there was no dysfunction during the work of the perforation plants, meaning there was no additional heating of the strips, deterring of the steel filings, nor excessive wearing of the perforation apparatus. The perforation percent was the same irrelevant of the viscosity of the used oil. Before being perforated using the oils with different viscosity, the nickel platting steel strips were cleaned in different degreasers (based on NaOH as well as on KOH. It was shown that efficient cleaning without the use of trichloroethylene is possible with the use of oil with smaller viscosity in the perforated steel strips process and the degreaser based on KOH in the cleaning process, before nickel platting. It also appeared that the alkali degreaser based on KOH was more efficient, bath corrections were made less often and the working period of the baths was longer, which all in summary means less quantity of chemicals needed for degreasing of perforated steel strips.

Perforated peptic ulcer

Science.gov (United States)

Søreide, Kjetil; Thorsen, Kenneth; Harrison, Ewen M.; Bingener, Juliane; Møller, Morten H.; Ohene-Yeboah, Michael; Søreide, Jon Arne

2015-01-01

Summary Perforated peptic ulcer (PPU) is a frequent emergency condition worldwide with associated mortality up to 30%. A paucity of studies on PPU limits the knowledge base for clinical decision-making, but a few randomised trials are available. While Helicobacter pylori and use of non-steroidal anti-inflammatory drugs are frequent causes of PPU, demographic differences in age, gender, perforation location and aetiology exist between countries, as do mortality rates. Clinical prediction rules are used, but accuracy varies with study population. Early surgery, either by laparoscopic or open repair, and proper sepsis management are essential for good outcome. Selected patients can perhaps be managed non-operatively or with novel endoscopic approaches, but validation in trials is needed. Quality of care, sepsis care-bundles and postoperative monitoring need further evaluation. Adequate trials with low risk of bias are urgently needed for better evidence. Here we summarize the evidence for PPU management and identify directions for future clinical research. PMID:26460663

Surface modification of silica particles with gold nanoparticles as an augmentation of gold nanoparticle mediated laser perforation

Science.gov (United States)

Kalies, Stefan; Gentemann, Lara; Schomaker, Markus; Heinemann, Dag; Ripken, Tammo; Meyer, Heiko

2014-01-01

Gold nanoparticle mediated (GNOME) laser transfection/perforation fulfills the demands of a reliable transfection technique. It provides efficient delivery and has a negligible impact on cell viability. Furthermore, it reaches high-throughput applicability. However, currently only large gold particles (> 80 nm) allow successful GNOME laser perforation, probably due to insufficient sedimentation of smaller gold nanoparticles. The objective of this study is to determine whether this aspect can be addressed by a modification of silica particles with gold nanoparticles. Throughout the analysis, we show that after the attachment of gold nanoparticles to silica particles, comparable or better efficiencies to GNOME laser perforation are reached. In combination with 1 µm silica particles, we report laser perforation with gold nanoparticles with sizes down to 4 nm. Therefore, our investigations have great importance for the future research in and the fields of laser transfection combined with plasmonics. PMID:25136494

Critical impact energy for the perforation of metallic plates

International Nuclear Information System (INIS)

Aly, S.Y.; Li, Q.M.

2008-01-01

This paper investigates the empirical formulae used in engineering practice to predict the critical perforation energy of metallic plates struck by rigid projectiles in the sub-ordnance regime. Main factors affecting the critical perforation energy are identified and valid conditions for each empirical formula are compared. Dimensional analysis is conducted to show the dependence of the non-dimensional critical impact energy on other influential non-dimensional numbers. Available empirical formulae are re-expressed in non-dimensional forms. A modified Jowett/AEA equation is proposed to predict the critical perforation energy of a flat-ended short projectile. The present work increases the confidence of using these empirical formulae and can be regarded as a quick guide for ballistic protection design of metallic shields and steel armour plates

External perforated Solar Screens for daylighting in residential desert buildings: Identification of minimum perforation percentages

KAUST Repository

Sherif, Ahmed

2012-06-01

requirements of the majority of tested cases. Illuminance levels in the examined residential space were satisfactory in 83% of the near zone cases and 53% in the mid-length zone, while the far zone suites 40% of the cases. Screen influence on daylighting was found to be very much dependent on the orientation of the window and time of the day.In stage two, the percentage of annual " Daylight Availability" was very much related to screen perforation percentage. As perforation percentage decreased, the percentage of Daylit and Over lit spaces decreased. At the same time, Partially Daylit areas of the space increased with similar percentages irrespective of the orientation. As a result of the twofold research stages, it is recommended to utilize a minimum of 80% perforation percentages for spaces similar to the tested case in the South orientation.In stage three, an initial investigation suggests that the use of screens can significantly reduce the occurrence of glare phenomena. Also, it is suggested to study the efficiency of designing Solar Screens that have non-uniform perforation ratios. These could prove useful in improving the illuminance levels in the mid-length and far zones of the unsatisfactory cases.In conclusion, minimum perforation percentages for Solar Screens were presented for specific design cases that encompassed different orientations, seasons and time of the day. In addition, a tool that could be used by architects for based on required annual " Daylit" areas for the design of Solar Screens that effectively achieve functional needs was provided. © 2012 Elsevier Ltd.

Management of biliary perforation in children

Directory of Open Access Journals (Sweden)

Mirza Bilal

2010-01-01

Full Text Available Background: To study the aetiology, management and outcome of biliary perforations in paediatric age group. Patients and Methods: In a retrospective study, the records of patients presented with biliary peritonitis due to biliary perforations, managed from March 2006 to July 2009, are reviewed. Results: Eight male patients with biliary peritonitis due to biliary perforation were managed. These patients were divided in two groups, A and B. Group A, (n = 3 patients, had common bile duct (CBD perforation, and Group B (n=5 patients had gallbladder perforation. The presenting features were abdominal pain, fever, abdominal distension, vomiting, constipation, jaundice and signs of peritonism. The management of CBD perforations in Group A was by draining the site of perforation and biliary diversion (tube cholecystostomy. In Group B, the gallbladder perforations were managed by tube cholecystostomy in four patients and cholecystectomy in one patient, however, one patient had to be re-explored and cholecystectomy performed due to complete necrosis of gall bladder. There was no mortality in our series. All patients were asymptomatic on regular follow-up. Conclusion: Early optimal management of biliary perforations remarkably improved the very high mortality and morbidity that characterised this condition in the past.

External perforated window Solar Screens: The effect of screen depth and perforation ratio on energy performance in extreme desert environments

KAUST Repository

Sherif, A.

2012-09-01

In hot arid desert environments, the solar radiation passing through windows increases the cooling loads and the energy consumption of buildings. Shading of windows can reduce these loads. Unlike the woven solar screens, wooden solar screens have a thickness that provides selective shading properties. Perforated wooden solar screens were traditionally used for windows shading. Developing modern types of these shading systems can lead to significant energy savings. The paper addresses the influence of changing the perforation percentage and depth of these screens on the annual energy loads, hence defining the optimum depth/perforation configurations for various window orientations. Series of experiments were performed using the EnergyPlus simulation software for a typical residential building in the Kharga Oasis, located in the Egyptian desert. A range of perforation percentages and depths were tested. Conclusions prove that external fixed deep perforated solar screens could effectively achieve energy savings up to 30% of the total energy consumption in the West and South orientations. Optimum range of depths and perforation percentages were recommended. These are: 80-90% perforation rate and 1:1 depth/opening width ratio. These lighter and deeper solar screen configurations were found to be more efficient in energy consumption in comparison with the traditional ones. © 2012 Elsevier B.V. All rights reserved.

Current management of peptic ulcer perforations

International Nuclear Information System (INIS)

Menakuru, S.R.

2004-01-01

Perforation is a life-threatening complication of peptic ulcer disease. Smoking and use of non-steroidal anti-inflammatory drugs are important risk factors for perforation. Diagnosis is made clinically and confirmed by the presence of pneumoperitoneum on radiographs. Nonoperative management is successful in patients identified to have a spontaneously sealed perforation proven by water-soluble contrast gastroduodenogram. Operative management consists of the time-honoured practice of mental patch closure, but now this can be done by laparoscopic methods. The practice of addition of acid-reducing procedures is currently being debated though it continues to be recommended in good-risk patients. Laparoscopic approaches to closure of duodenal perforation are now being applied widely and may become the gold standard in the future especially in patients with < 10 mm perforation size presenting within the first 24 hours of onset of pain. The role of Helicobacter pylori in duodenal ulcer perforation is controversial and more studies are needed to answer this question though recent indirect evidence suggests that eradicating H pylori may reduce the necessity for adding acid reducing procedures and the associated morbidity. Perforation is a life-threatening complication of peptic ulcer disease. The management of peptic ulcer disease has evolved over the decades, due to advances in operative techniques, bacteriology and pharmacology. While the recognition of the role of Helicobacter pylori (H. pylori) in peptic ulceration has resulted in a paradigm shift in the management of uncomplicated peptic ulcers, debate continues about the appropriate management of perforated duodenal bulb and prepyloric ulcers. A new dimension has been added to this controversy by the advent of laparoscopic techniques for closing the perforation. A Medline search of all articles dealing with the management of peptic ulcer perforation published after 1985 was undertaken. The short listed articles were

Perforated peptic ulcer

DEFF Research Database (Denmark)

Søreide, Kjetil; Thorsen, Kenneth; Harrison, Ewen M

2015-01-01

Perforated peptic ulcer is a common emergency condition worldwide, with associated mortality rates of up to 30%. A scarcity of high-quality studies about the condition limits the knowledge base for clinical decision making, but a few published randomised trials are available. Although Helicobacter...... need further assessment. Adequate trials with low risk of bias are urgently needed to provide better evidence. We summarise the evidence for perforated peptic ulcer management and identify directions for future clinical research....

StreamMap: Smooth Dynamic Visualization of High-Density Streaming Points.

Science.gov (United States)

Li, Chenhui; Baciu, George; Han, Yu

2018-03-01

Interactive visualization of streaming points for real-time scatterplots and linear blending of correlation patterns is increasingly becoming the dominant mode of visual analytics for both big data and streaming data from active sensors and broadcasting media. To better visualize and interact with inter-stream patterns, it is generally necessary to smooth out gaps or distortions in the streaming data. Previous approaches either animate the points directly or present a sampled static heat-map. We propose a new approach, called StreamMap, to smoothly blend high-density streaming points and create a visual flow that emphasizes the density pattern distributions. In essence, we present three new contributions for the visualization of high-density streaming points. The first contribution is a density-based method called super kernel density estimation that aggregates streaming points using an adaptive kernel to solve the overlapping problem. The second contribution is a robust density morphing algorithm that generates several smooth intermediate frames for a given pair of frames. The third contribution is a trend representation design that can help convey the flow directions of the streaming points. The experimental results on three datasets demonstrate the effectiveness of StreamMap when dynamic visualization and visual analysis of trend patterns on streaming points are required.

Monitoring stream temperatures—A guide for non-specialists

Science.gov (United States)

Heck, Michael P.; Schultz, Luke D.; Hockman-Wert, David; Dinger, Eric C.; Dunham, Jason B.

2018-04-19

Executive SummaryWater temperature influences most physical and biological processes in streams, and along with streamflows is a major driver of ecosystem processes. Collecting data to measure water temperature is therefore imperative, and relatively straightforward. Several protocols exist for collecting stream temperature data, but these are frequently directed towards specialists. This document was developed to address the need for a protocol intended for non-specialists (non-aquatic) staff. It provides specific step-by-step procedures on (1) how to launch data loggers, (2) check the factory calibration of data loggers prior to field use, (3) how to install data loggers in streams for year-round monitoring, (4) how to download and retrieve data loggers from the field, and (5) how to input project data into organizational databases.

Oriented cluster perforating technology and its application in horizontal wells

Directory of Open Access Journals (Sweden)

Huabin Chen

2016-11-01

Full Text Available An oriented cluster perforating technology, which integrates both advantages of cluster and oriented perforating, will help solve a series of technical complexities in horizontal well drilling. For realizing its better application in oil and gas development, a series of technologies were developed including perforator self-weight eccentricity, matching of the electronic selective module codes with the surface program control, axial centralized contact signal transmission, and post-perforation intercluster sealing insulation. In this way, the following functions could be realized, such as cable-transmission horizontal well perforator self-weight orientation, dynamic signal transmission, reliable addressing & selective perforation and post-perforation intercluster sealing. The combined perforation and bridge plug or the multi-cluster perforation can be fulfilled in one trip of perforation string. As a result, the horizontal-well oriented cluster perforating technology based on cable conveying was developed. This technology was successfully applied in unconventional gas reservoir exploitation, such as shale gas and coalbed methane, with accurate orientation, reliable selective perforation and satisfactory inter-cluster sealing. The horizontal-well oriented cluster perforating technology benefits the orientation of horizontal well drilling with a definite target and direction, which provides a powerful support for the subsequent reservoir stimulation. It also promotes the fracturing fluid to sweep the principal pay zones to the maximum extent. Moreover, it is conductive to the formation of complex fracture networks in the reservoirs, making quality and efficient development of unconventional gas reservoirs possible.

Pedicled perforator flaps

DEFF Research Database (Denmark)

Demirtas, Yener; Ozturk, Nuray; Kelahmetoglu, Osman

2009-01-01

Described in this study is a surgical concept that supports the "consider and use a pedicled perforator flap whenever possible and indicated" approach to reconstruct a particular skin defect. The operation is entirely free-style; the only principle is to obtain a pedicled perforator flap...... to reconstruct the defect. The perforators are marked with a hand-held Doppler probe and multiple flaps are designed. The appropriate flap is elevated after identifying the perforator(s). Dissection of the perforator(s) or complete incision of the flap margins are not mandatory if the flap is mobilized...... adequately to cover the defect. Defects measuring 3 x 3 cm up to 20 x 20 cm at diverse locations were successfully reconstructed in 20 of 21 patients with 26 flaps. Pedicled perforator flaps offer us reliable and satisfactory results of reconstruction at different anatomic territories of the body. It sounds...

Highly Localized Acoustic Streaming and Size-Selective Submicrometer Particle Concentration Using High Frequency Microscale Focused Acoustic Fields.

Science.gov (United States)

Collins, David J; Ma, Zhichao; Ai, Ye

2016-05-17

Concentration and separation of particles and biological specimens are fundamental functions of micro/nanofluidic systems. Acoustic streaming is an effective and biocompatible way to create rapid microscale fluid motion and induce particle capture, though the >100 MHz frequencies required to directly generate acoustic body forces on the microscale have traditionally been difficult to generate and localize in a way that is amenable to efficient generation of streaming. Moreover, acoustic, hydrodynamic, and electrical forces as typically applied have difficulty manipulating specimens in the submicrometer regime. In this work, we introduce highly focused traveling surface acoustic waves (SAW) at high frequencies between 193 and 636 MHz for efficient and highly localized production of acoustic streaming vortices on microfluidic length scales. Concentration occurs via a novel mechanism, whereby the combined acoustic radiation and streaming field results in size-selective aggregation in fluid streamlines in the vicinity of a high-amplitude acoustic beam, as opposed to previous acoustic radiation induced particle concentration where objects typically migrate toward minimum pressure locations. Though the acoustic streaming is induced by a traveling wave, we are able to manipulate particles an order of magnitude smaller than possible using the traveling wave force alone. We experimentally and theoretically examine the range of particle sizes that can be captured in fluid streamlines using this technique, with rapid particle concentration demonstrated down to 300 nm diameters. We also demonstrate that locations of trapping and concentration are size-dependent, which is attributed to the combined effects of the acoustic streaming and acoustic forces.

Perforated peptic ulcer - an update.

Science.gov (United States)

Chung, Kin Tong; Shelat, Vishalkumar G

2017-01-27

Peptic ulcer disease (PUD) affects 4 million people worldwide annually. The incidence of PUD has been estimated at around 1.5% to 3%. Perforated peptic ulcer (PPU) is a serious complication of PUD and patients with PPU often present with acute abdomen that carries high risk for morbidity and mortality. The lifetime prevalence of perforation in patients with PUD is about 5%. PPU carries a mortality ranging from 1.3% to 20%. Thirty-day mortality rate reaching 20% and 90-d mortality rate of up to 30% have been reported. In this review we have summarized the current evidence on PPU to update readers. This literature review includes the most updated information such as common causes, clinical features, diagnostic methods, non-operative and operative management, post-operative complications and different scoring systems of PPU. With the advancement of medical technology, PUD can now be treated with medications instead of elective surgery. The classic triad of sudden onset of abdominal pain, tachycardia and abdominal rigidity is the hallmark of PPU. Erect chest radiograph may miss 15% of cases with air under the diaphragm in patients with bowel perforation. Early diagnosis, prompt resuscitation and urgent surgical intervention are essential to improve outcomes. Exploratory laparotomy and omental patch repair remains the gold standard. Laparoscopic surgery should be considered when expertise is available. Gastrectomy is recommended in patients with large or malignant ulcer.

Perforated peptic ulcer - an update

Science.gov (United States)

Chung, Kin Tong; Shelat, Vishalkumar G

2017-01-01

Peptic ulcer disease (PUD) affects 4 million people worldwide annually. The incidence of PUD has been estimated at around 1.5% to 3%. Perforated peptic ulcer (PPU) is a serious complication of PUD and patients with PPU often present with acute abdomen that carries high risk for morbidity and mortality. The lifetime prevalence of perforation in patients with PUD is about 5%. PPU carries a mortality ranging from 1.3% to 20%. Thirty-day mortality rate reaching 20% and 90-d mortality rate of up to 30% have been reported. In this review we have summarized the current evidence on PPU to update readers. This literature review includes the most updated information such as common causes, clinical features, diagnostic methods, non-operative and operative management, post-operative complications and different scoring systems of PPU. With the advancement of medical technology, PUD can now be treated with medications instead of elective surgery. The classic triad of sudden onset of abdominal pain, tachycardia and abdominal rigidity is the hallmark of PPU. Erect chest radiograph may miss 15% of cases with air under the diaphragm in patients with bowel perforation. Early diagnosis, prompt resuscitation and urgent surgical intervention are essential to improve outcomes. Exploratory laparotomy and omental patch repair remains the gold standard. Laparoscopic surgery should be considered when expertise is available. Gastrectomy is recommended in patients with large or malignant ulcer. PMID:28138363

Non-operative Management of Gallbladder Perforation After Blunt ...

African Journals Online (AJOL)

management of isolated traumatic gallbladder perforation in a patient that was ... A transthoracic echocardiogram 2 days later revealed a right ventricular .... EPUB is an open e-book standard recommended by The International Digital Publishing Forum which is designed for reflowable content i.e. the text display can be ...

Low-energy plasma-cathode electron gun with a perforated emission electrode

Science.gov (United States)

Burdovitsin, Victor; Kazakov, Andrey; Medovnik, Alexander; Oks, Efim; Tyunkov, Andrey

2017-11-01

We describe research of influence of the geometric parameters of perforated electrode on emission parameters of a plasma cathode electron gun generating continuous electron beams at gas pressure 5-6 Pa. It is shown, that the emission current increases with increasing the hole diameters and decreasing the thickness of the perforated emission electrode. Plasma-cathode gun with perforated electron can provide electron extraction with an efficiency of up to 72 %. It is shown, that the current-voltage characteristic of the electron gun with a perforated emission electrode differs from that of similar guns with fine mesh grid electrode. The plasma-cathode electron gun with perforated emission electrode is used for electron beam welding and sintering.

Acoustic properties of perforates under high level multi-tone excitation

OpenAIRE

Bodén, Hans

2013-01-01

This paper discusses the effect of high level multi-tone acoustic excitation on the acoustic properties of perforates. It is based on a large experimental study of the nonlinear properties of these types of samples without mean grazing or bias flow. Compared to previously published results the present investigation concentrates on the effect of multiple harmonics. It is known from previous studies that high level acoustic excitation at one frequency will change the acoustic impedance of perfo...

Influence of perforation erosion on multiple growing hydraulic fractures in multi-stage fracturing

Directory of Open Access Journals (Sweden)

Yongming Li

2018-02-01

Full Text Available In multi-stage hydraulic fracturing, the limited-entry method is widely used to promote uniform growth of multiple fractures. However, this method's effectiveness may be lost because the perforations will be eroded gradually during the fracturing period. In order to study the influence of perforation erosion on multiple growing hydraulic fractures, we combined the solid–fluid coupled model of hydraulic fracture growth with an empirical model of perforation erosion to implement numerical simulation. The simulations show clearly that the erosion of perforation will significantly deteriorate the non-uniform growth of multiple fractures. Based on the numerical model, we also studied the influences of proppant concentration and injection rates on perforation erosion in multi-stage hydraulic fracturing. The results indicate that the initial erosion rates become higher with the rising proppant concentration, but the growth of multiple hydraulic fractures is not sensitive to the varied proppant concentration. In addition, higher injection rates are beneficial significantly to the limited-entry design, leading to more uniform growth of fractures. Thus, in multi-stage hydraulic fracturing enough high injection rates are proposed to keep uniform growths. Keywords: Unconventional oil and gas reservoir, Horizontal well, Perforation friction, Perforation erosion, Multi-stage hydraulic fracturing, Numerical simulation, Mathematic model, Uniform growth of fractures

Surgical management of perforated duodenal ulcer: the changing scene.

Science.gov (United States)

Plummer, J M; McFarlane, M E C; Newnham

2004-12-01

To determine the management of perforated duodenal ulcer at the University Hospital of the West Indies (UHWI) in this era of Helicobacter pylori, the medical records of all patients seen at the UHWI during the period July 1997 to June 2002 with an intra-operative diagnosis of perforated peptic ulcer were reviewed The records were analyzed for the following: age, gender, duration of symptoms, non-steroidal anti-inflammatory drug (NSAID) use, smoking status, operative repair duration of hospitalization, Helicobacter pylori status and medical therapy, peri-operative complications, mortality and recurrence. Ninety per cent of the cases were males. All females in whom perforation occurred were age 50 years and older compared to males where 58% of cases presented before age 50 years. Perforations in acute ulcers occurred in 80% of cases. The majority of patients were male smokers. Non-steroidal anti-inflammatory drug use was also an important risk factor in elderly females. Simple surgical closure and standard triple therapy antibiotics to eradicate Helicobacter pylori was the most common treatment offered. Mortality was one per cent and follow-up poor but 11% of patients had documented recurrent peptic ulceration. In this study population, perforated duodenal ulcer occured overwhelmingly in males less than 50 years of age. There is a trend towards exclusive simple surgical closure and H pylori eradication at the UHWI for patients with perforated duodenal ulcer but this needs to be supported by documentation of H pylori prevalence in the population of patients presenting with perforated peptic ulcers.

Successful Endoscopic Management of Non-Healing Perforated Duodenal Ulcer with Polyglycolic Acid Sheet and Fibrin Glue.

Science.gov (United States)

Mishiro, Tsuyoshi; Shibagaki, Kotaro; Matsuda, Kayo; Fukuyama, Chika; Okada, Mayumi; Mikami, Hironobu; Izumi, Daisuke; Yamashita, Noritsugu; Okimoto, Eiko; Fukuda, Naoki; Aimi, Masahito; Fukuba, Nobuhiko; Oshima, Naoki; Takanashi, Toshihiro; Matsubara, Takeshi; Ishimura, Norihisa; Ishihara, Shunji; Kinoshita, Yoshikazu

2016-08-01

In recent years, treatment techniques in which polyglycolic acid sheets are applied to various situations with fibrin glue have exhibited great clinical potential, and previous studies have reported safety and efficacy. We describe closure of a non-healing perforated duodenal ulcer with the use of a polyglycolic acid sheet and fibrin glue in an elderly patient who was not a candidate for surgery.

A Stream Function Theory Based Calculation of Wave Kinematics for Very Steep Waves Using a Novel Non-linear Stretching Technique

DEFF Research Database (Denmark)

Stroescu, Ionut Emanuel; Sørensen, Lasse; Frigaard, Peter Bak

2016-01-01

A non-linear stretching method was implemented for stream function theory to solve wave kinematics for physical conditions close to breaking waves in shallow waters, with wave heights limited by the water depth. The non-linear stretching method proves itself robust, efficient and fast, showing good...

Perforated peptic ulcer and short-term mortality among tramadol users

DEFF Research Database (Denmark)

Tørring, Marie Louise; Riis, Anders; Christensen, Steffen

2007-01-01

AIM: Use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases risk and worsens prognosis for patients with complicated peptic ulcer disease. Therefore, patients who are at high risk of peptic ulcer often use tramadol instead of NSAIDs. Tramadol's effect on peptic ulcer prognosis is unknown....... The aim was to examine mortality in the 30 days following hospitalization for perforated peptic ulcer among tramadol and NSAID users compared with non-users. METHODS: The study was based on data on reimbursed prescriptions and hospital discharge diagnoses for the 1993-2004 period, extracted from...... population-based healthcare databases. All patients with a first-time diagnosis of perforated peptic ulcer were identified, excluding those with previous ulcer diagnoses or antiulcer drug use. Cox regression was used to estimate 30-day mortality rate ratios for tramadol and NSAID users compared with non...

Estimating discharge and non-point source nitrate loading to streams from three end-member pathways using high-frequency water quality and streamflow data

Science.gov (United States)

Miller, M. P.; Tesoriero, A. J.; Hood, K.; Terziotti, S.; Wolock, D.

2017-12-01

The myriad hydrologic and biogeochemical processes taking place in watersheds occurring across space and time are integrated and reflected in the quantity and quality of water in streams and rivers. Collection of high-frequency water quality data with sensors in surface waters provides new opportunities to disentangle these processes and quantify sources and transport of water and solutes in the coupled groundwater-surface water system. A new approach for separating the streamflow hydrograph into three components was developed and coupled with high-frequency specific conductance and nitrate data to estimate time-variable watershed-scale nitrate loading from three end-member pathways - dilute quickflow, concentrated quickflow, and slowflow groundwater - to two streams in central Wisconsin. Time-variable nitrate loads from the three pathways were estimated for periods of up to two years in a groundwater-dominated and a quickflow-dominated stream, using only streamflow and in-stream water quality data. The dilute and concentrated quickflow end-members were distinguished using high-frequency specific conductance data. Results indicate that dilute quickflow contributed less than 5% of the nitrate load at both sites, whereas 89±5% of the nitrate load at the groundwater-dominated stream was from slowflow groundwater, and 84±13% of the nitrate load at the quickflow-dominated stream was from concentrated quickflow. Concentrated quickflow nitrate concentrations varied seasonally at both sites, with peak concentrations in the winter that were 2-3 times greater than minimum concentrations during the growing season. Application of this approach provides an opportunity to assess stream vulnerability to non-point source nitrate loading and expected stream responses to current or changing conditions and practices in watersheds.

Efficient Estimation of Dynamic Density Functions with Applications in Streaming Data

KAUST Repository

Qahtan, Abdulhakim

2016-05-11

Recent advances in computing technology allow for collecting vast amount of data that arrive continuously in the form of streams. Mining data streams is challenged by the speed and volume of the arriving data. Furthermore, the underlying distribution of the data changes over the time in unpredicted scenarios. To reduce the computational cost, data streams are often studied in forms of condensed representation, e.g., Probability Density Function (PDF). This thesis aims at developing an online density estimator that builds a model called KDE-Track for characterizing the dynamic density of the data streams. KDE-Track estimates the PDF of the stream at a set of resampling points and uses interpolation to estimate the density at any given point. To reduce the interpolation error and computational complexity, we introduce adaptive resampling where more/less resampling points are used in high/low curved regions of the PDF. The PDF values at the resampling points are updated online to provide up-to-date model of the data stream. Comparing with other existing online density estimators, KDE-Track is often more accurate (as reflected by smaller error values) and more computationally efficient (as reflected by shorter running time). The anytime available PDF estimated by KDE-Track can be applied for visualizing the dynamic density of data streams, outlier detection and change detection in data streams. In this thesis work, the first application is to visualize the taxi traffic volume in New York city. Utilizing KDE-Track allows for visualizing and monitoring the traffic flow on real time without extra overhead and provides insight analysis of the pick up demand that can be utilized by service providers to improve service availability. The second application is to detect outliers in data streams from sensor networks based on the estimated PDF. The method detects outliers accurately and outperforms baseline methods designed for detecting and cleaning outliers in sensor data. The

CLINICAL STUDY AND MANAGEMENT OF BENIGN GASTROINTESTINAL PERFORATIONS

Directory of Open Access Journals (Sweden)

Kishan

2016-05-01

Full Text Available INTRODUCTION Peritonitis due to gastrointestinal perforation is one of the commonest surgical emergencies encountered by a general surgeon. (1,2 Mortality and morbidity is still very high despite early diagnosis and intensive management. This study is aimed to find common causes of perforations, its presentations, mode of investigations and treatment done and outcome of patients. METHODS Case records of all patients, in exclusion and inclusion criteria, who were admitted in emergency surgical ward with suspected GI perforation and peritonitis were included in study and diagnosis confirmed by either investigations preoperatively or by laparotomy and results analysed over a period of 16 months. RESULTS GI perforations due to benign causes are most common causes of peritonitis, of which gastroduodenal perforations are commonest followed by appendicular perforation closely followed by infective perforations. CONCLUSION Benign causes of upper gastroduodenal perforations are common causes of peritonitis (2,3. Mortality increases with delay in presentation and treatment. Abdominal signs like guarding rigidity are present in majority of cases. X-ray erect abdomen was effective in detecting perforation in majority of cases. Surgery is the treatment in all cases of perforation.

Study on modal characteristics of perforated shell using effective Young's modulus

International Nuclear Information System (INIS)

Jhung, Myung Jo; Yu, Seon Oh

2011-01-01

Research highlights: → The effective Young's modulus of perforated shell is proposed for modal analysis. → The penetration pattern is almost negligible for effective elastic constants. → The frequency of perforated shell decreases significantly due to the hole effect. - Abstract: For the perforated cylindrical shell submerged in fluid, it is almost impossible to develop a finite element model due to the necessity of the fine meshing of the shell and the fluid at the same time. This necessitates the use of solid shell with effective material properties. Unfortunately the effective elastic constants are not found in any references even though the ASME code is suggesting those for perforated plate. Therefore in this study the effective material properties of perforated shell are suggested by performing several finite element analyses with respect to the ligament efficiencies.

Experimental perforating injury with high energy electrons to inhibit intraocular proliferation

International Nuclear Information System (INIS)

Velikay, M.; Binder, S.; Stolba, U.; Wedrich, AJ.; Datlinger, P.; Handl-Zeller, L.

1994-01-01

Since 1980, the fibroblast model creating experimental proliferative vitreoretinopathy has been used to evaluate the antiproliferative effect of various drugs. In previous studies radiation therapy was found to reduce effectively intraocular proliferation in this model. We therefore investigated the effect of high energy electrons in a standard perforating injury model creating a traumatic proliferative vitreoretinopathy. In 36 eyes we performed a 8 mm pars plana incision and injected 0.4 ml of 80% fibronection solution intravitreally. Ten rabbits (20 eyes) received radiation therapy with a Betatron accelerator in a total dosage of 3000 cGy to each eye divided into 10 single fractions starting on the first post-operative day. Maximum concentration of the dose was focused to the posterior vitreous. The other 9 rabbits, 18 eyes, served as control. In our perforating injury model we observed a reduction of retinal detachment rate of 72% in the controls to 55% in the treated group. The effect of radiation therapy with high energy electrons and total dosage of 3000 cGy was not statistically significant in experimental traumatic proliferative vitreoretinopathy. (au) (12 refs.)

Spontaneous external gallbladder perforation

International Nuclear Information System (INIS)

Noeldge, G.; Wimmer, B.; Kirchner, R.

1981-01-01

Spontaneous perforation of the gallbladder is one complication of cholelithiasis. There is a greater occurence of free perforation in the peritoneal cavity with bilary pertonitis, followed by the perforation into the stomach, small intestine and colon. A single case of the nowadays rare spontaneous perforation in and through the abdominal wall will be reported. Spontaneous gallbladder perforation appears nearly asymptomatic in its clinical course because of absent biliary peritonitis. (orig.) [de

Ceramic microsieves: influence of perforation shape and distribution on flow resistance and membrane strength

NARCIS (Netherlands)

Kuiper, S.; Brink, R.; Nijdam, W.; Krijnen, Gijsbertus J.M.; Elwenspoek, Michael Curt

2002-01-01

Ceramic microsieves with slit-shaped perforations were compared to sieves with circular-shaped perforations, regarding flow resistance and membrane strength. Destructive tests show that the highest strength is obtained if the perforations are placed in a non-alternating pattern. Especially for

Oesophageal Perforation Treated Non-Operatively in an HIV/AIDS ...

African Journals Online (AJOL)

Oesophageal perforation is a rare condition that causes significant morbidity and may be fatal. A successful outcome is obtained by prompt recognition of the diagnosis, aggressive resuscitation and institution of conservative measures, before rushing for specific surgical intervention. Oesophageal stricture is one of the ...

The effect of high level multi-tone excitation on the acoustic properties of perforates and liner samples

OpenAIRE

Bodén, Hans

2012-01-01

This paper discusses the effect of high level multi-tone acoustic excitation on the acoustic properties of perforates and liner samples. It is based on a large experimental study of the nonlinear properties of these types of samples without mean grazing or bias flow. It is known from previous studies that high level acoustic excitation at one frequency will change the acoustic impedance of perforates at other frequencies, thereby changing the boundary condition seen by the acoustic waves. Thi...

Resource synergy in stream periphyton communities

Energy Technology Data Exchange (ETDEWEB)

Hill, Walter [University of Illinois, Urbana-Champaign; Fanta, S.E. [University of Illinois; Roberts, Brian J [ORNL; Francoeur, Steven N. [Eastern Michigan University, Ypsilanti, MI

2011-03-01

1. Light and nutrients play pivotal roles in determining the growth of autotrophs, yet the potential for synergistic interactions between the two resources in algal communities is poorly understood, especially in stream ecosystems. In this study, light and phosphorus were manipulated in large experimental streams to examine resource colimitation and synergy in stream periphyton. 2. Whole-stream metabolism was simultaneously limited by light and phosphorus. Increasing the supply of either light or phosphorus resulted in significant increases in primary production and the transformation of the streams from heterotrophy to autotrophy. 3. Resource-driven changes in periphyton community structure occurred in concert with changes in production. Algal assemblages in highly shaded streams were composed primarily of small diatoms such as Achnanthidium minutissima, whereas larger diatoms such as Melosira varians predominated at higher irradiances. Phosphorus enrichment had relatively little effect on assemblage structure, but it did substantially diminish the abundance of Meridion circulare, a diatom whose mucilaginous colonies were conspicuously abundant in phosphorus-poor, high-light streams. Bacterial biomass declined relative to algal biomass with increases in primary productivity, regardless of whether the increases were caused by light or phosphorus. 4. Synergistic effects on primary production appeared to occur because the availability of one resource facilitated the utilization of the other. Light increased the abundance of large diatoms, which are known to convert high concentrations of nutrients into primary production more effectively than smaller taxa. Phosphorus enrichment led to the replacement of Meridion circulare by non-mucilaginous taxa in phosphorus-enriched streams, and we hypothesize that this change enabled more efficient use of light in photosynthesis. Higher ratios of chlorophyll a : biomass in phosphorus-enriched streams may have also led to more

Helicobacter pylori in gastroduodenal perforation

Directory of Open Access Journals (Sweden)

Bharat B Dogra

2014-01-01

Full Text Available Background:peptic ulcers were earlier believed to be caused by dietary factors, gastric acid, and stress. However, in 1983, Warren and Marshall identified the correlation between Helicobacter pylori (H. pylori and peptic ulcers. It is now well established that most of the peptic ulcers occur as a result of H. pylori infection. But the co-relation between perforated peptic ulcer and H. pylori infection is not yet fully established. Aims and objectives : to study the prevalence of H. pylori infection in patients with perforated peptic ulcer. Materials and methods: this was a prospective study carried out in all cases of perforated peptic ulcer reporting in surgical wards of a medical college during 2008-2010. A total of 50 cases, presenting as acute perforation of duodenum and stomach during this period, formed the study group. After resuscitation, all the cases were subjected to emergency exploratory laparotomy. The exact site of perforation was identified, biopsy was taken from the ulcer margin from 2-3 sites and the tissue was sent for H. pylori culture and histopathological examination. Simple closure of perforation, omentoplasty, thorough peritoneal lavage and drainage was carried out. Results: out of the 50 cases of perforated peptic ulcer, 38 happened to be males, and only 12 were females. The age of the patients ranged from 20 to 70 years. All the patients underwent only emergency laparotomy. As many as 46 cases (92% turned out to be positive for H. pylori and only four cases (8% were negative for this infection. Postoperatively, patients who were found to be positive for H. pylori were put on anti-H. pylori treatment. Conclusion: there was a high prevalence of H. pylori infection in patients with perforated gastroduodenal ulcers.

The Versatile Modiolus Perforator Flap

DEFF Research Database (Denmark)

Gunnarsson, Gudjon Leifur; Thomsen, Jorn Bo

2016-01-01

BACKGROUND: Perforator flaps are well established, and their usefulness as freestyle island flaps is recognized. The whereabouts of vascular perforators and classification of perforator flaps in the face are a debated subject, despite several anatomical studies showing similar consistency. In our...... experience using freestyle facial perforator flaps, we have located areas where perforators are consistently found. This study is focused on a particular perforator lateral to the angle of the mouth; the modiolus and the versatile modiolus perforator flap. METHODS: A cohort case series of 14 modiolus...... perforator flap reconstructions in 14 patients and a color Doppler ultrasonography localization of the modiolus perforator in 10 volunteers. RESULTS: All 14 flaps were successfully used to reconstruct the defects involved, and the location of the perforator was at the level of the modiolus as predicted...

Perforated peptic ulcer in southeastern Taiwan.

Science.gov (United States)

Li, Chin-Hsien; Chang, Wen-Hsiung; Shih, Shou-Chuan; Lin, Shee-Chan; Bair, Ming-Jong

2010-09-01

No studies focus on the population with perforated peptic ulcer in southeastern Taiwan. The present study aimed to assess the differences between the different races and the risk factors related to mortality and morbidity in postoperative patients in southeastern Taiwan. The medical records of 237 patients were reviewed retrospectively. The following factors were analyzed: patient profiles, coexisting illnesses, diagnostic method, fever, preoperative shock, clinical data at emergency room, delay operation, site of perforation, operative method, positive ascites culture, species of microbes in ascites culture, postoperative complications, death and the length of hospital stay. Aborigines were significantly different from non-aborigines in the ratio of female cases and in the habits of alcohol drinking and betel nut chewing. There were also four significantly different variables between them: fever, hemoglobin value, site of perforation and operative method. Total postoperative complication rate was 41.3% and 39 patients (16.6%) died. In multivariate analysis, age > or = 65 years, lipase > upper normal limit and preoperative shock were independent predictors of mortality. Significant risk factors associated with morbidity were NSAIDs use, creatinine > 1.5 mg/dL and preoperative shock. Aborigines were different from non-aborigines in several categories. In southeastern Taiwan, NSAIDs use, creatinine > 1.5 mg/dL and preoperative shock were independent risk factors of morbidity, and age > or = 65 years, lipase > upper normal limit and preoperative shock were independent risk factors of mortality in postoperative perforated peptic ulcer. Lipase > upper normal limit is needed for further research on the influence on mortality.

Perforated peptic ulcer and short-term mortality among tramadol users.

Science.gov (United States)

Tørring, Marie L; Riis, Anders; Christensen, Steffen; Thomsen, Reimar W; Jepsen, Peter; Søndergaard, Jens; Sørensen, Henrik T

2008-04-01

* Use of nonsteroidal anti-inflammatory drugs (NSAIDs) is a strong risk and prognostic factor for peptic ulcer perforation, and alternative analgesics are needed for high-risk patients. * Pain management guidelines propose tramadol as a treatment option for mild-to-moderate pain in patients at high risk of gastrointestinal side-effects, including peptic ulcer disease. * Tramadol may mask symptoms of peptic ulcer complications, yet tramadol's effect on peptic ulcer prognosis is unknown. * In this population-based study of 1271 patients hospitalized with peptic ulcer perforation, tramadol appeared to increase mortality at least as much as NSAIDs. * Among users of tramadol, alone or in combination with NSAIDs, adjusted 30-day mortality rate ratios were 2.02 [95% confidence interval (CI) 1.17, 3.48] and 1.32 (95% CI 0.89, 1.95), compared with patients who used neither tramadol nor NSAIDs. Use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases risk and worsens prognosis for patients with complicated peptic ulcer disease. Therefore, patients who are at high risk of peptic ulcer often use tramadol instead of NSAIDs. Tramadol's effect on peptic ulcer prognosis is unknown. The aim was to examine mortality in the 30 days following hospitalization for perforated peptic ulcer among tramadol and NSAID users compared with non-users. The study was based on data on reimbursed prescriptions and hospital discharge diagnoses for the 1993-2004 period, extracted from population-based healthcare databases. All patients with a first-time diagnosis of perforated peptic ulcer were identified, excluding those with previous ulcer diagnoses or antiulcer drug use. Cox regression was used to estimate 30-day mortality rate ratios for tramadol and NSAID users compared with non-users, adjusting for use of other drugs and comorbidity. Of 1271 patients with perforated peptic ulcers included in the study, 2.4% used tramadol only, 38.9% used NSAIDs and 7.9% used both. Thirty-day mortality was

Salmonella intestinal perforation: (27 perforations in one patient, 14 perforations in another Are the goal posts changing?

Directory of Open Access Journals (Sweden)

Adeniran J

2005-01-01

Full Text Available The pathology of salmonellosis after a faeco-oral transmission was first clearly described by Jenner in 1850. Over the years, the pathological manifestations in different tissues of the body have been described. The ileum is however mostly involved leading to enlarged Peyer′s patches, ulceration, and sometimes bleeding and perforation. Efforts at control have largely been improvement in public water supply, safe disposal of waste, and general public health measures. Despite these measures, intestinal perforation from salmonellosis remains the commonest cause of emergency operation in children above 3 years. The incidence continues to rise, so also the mortality, despite new antibiotics and improvement in facilities in the hospitals. Even more disturbing is that we now see more perforations per patient, and more involvement of the colon. Three recently managed patients with multiple ileal/colonic perforations were reviewed. Presenting problems, delay in referral, choice of antibiotics and postoperative complications were noted. One patient had 27 perforations and another 14 perforations. Both survived. Is salmonella changing? Are our patients changing? Is the environment changing? Are the goal posts changing? This article details our recent experience with this dreadful disease, reviews the new literature and makes suggestions for the way forwards.

[E-PTFE Membrane for the Management of Perforated Corneal Ulcer].

Science.gov (United States)

Pahor, D; Pahor, A

2016-10-01

Purpose: To present the surgical management of perforated corneal ulcer using PRECLUDE® Pericardial Membrane, composed of expanded polytetrafluoroethylene (e-PTFE; GORE-TEX®), as an alternative surgical procedure in patients at high risk of graft rejections and to evaluate side effects for a prolonged period. Patients and Methods: The study included all patients who were admitted to our department and underwent surgical repair of perforated corneal ulcer with the e-PTFE membrane between 2010 and 2015. In total, 8 patients (8 eyes) were enrolled. Medical records of all patients were retrospectively reviewed. The operation was performed under peribulbar anaesthesia. Non-absorbable, microporous, watertight 0.1 mm thick e-PTFE membrane was used to close the corneal ulcer. The membrane was cut to overlap the defect adequately and to achieve the desired tissue attachment without preparing the conjunctiva or superficial trephination of the cornea. The membrane was fixed to the healthy cornea with several non-absorbable sutures (Prolene® 10.0), in order to achieve the proper stress without wrinkling. Results: Five of 8 patients were treated for systemic immunological diseases. Sjögren's syndrome was diagnosed in 2 patients, granulomatosis with polyangiitis in one, vasculitis with a history of previous sclerokeratitis in one and systemic lupus erythematosus in one. In 2 patients, corneal perforation was observed as a complication of corneal infection and in one patient as a late complication of a severe chemical burn. Corneal perforations were successfully covered with e-PTFE membrane in all patients. E-PTFE membrane was well tolerated in all patients and the eye was always preserved. After 3 to 4 months, the membrane was removed in 7 patients. The underlying cornea was thin, firm, stable and vascularised. In one patient with Sjögren's syndrome, the e-PTFE membrane is still in place. Conclusion: Surgical management of perforated corneal ulcer using E-PTFE membrane

Efficient User Authentication and Key Management for Peer-to-Peer Live Streaming Systems

Institute of Scientific and Technical Information of China (English)

LIU Xuening; YIN Hao; LIN Chuang; DU Changlai

2009-01-01

Recent development of the peer-to-peer (P2P) live streaming technique has brought unprece-dented new momentum to the Internet with the characters of effective, scalable, and low cost. However, be-fore these applications can be successfully deployed as commercial applications, efficient access control mechanisms are needed. This work based on earlier research of the secure streaming architecture in Trust-Stream, analyzes how to ensure that only authorized users can access the original media in the P2P live streaming system by adopting a user authentication and key management scheme. The major features of this system include (1) the management server issues each authorized user a unique public key certificate,(2) the one-way hash chain extends the certificate's lifetime, (3) the original media is encrypted by the ses-sion key and delivered to the communication group, and (4) the session key is periodically updated and dis-tributed with the media. Finally, analyses and test results show that scheme provides a secure, scalable, re-liable, and efficient access control solution for P2P live streaming systems.

Mortality risk factor analysis in colonic perforation: would retroperitoneal contamination increase mortality in colonic perforation?

Science.gov (United States)

Yoo, Ri Na; Kye, Bong-Hyeon; Kim, Gun; Kim, Hyung Jin; Cho, Hyeon-Min

2017-10-01

Colonic perforation is a lethal condition presenting high morbidity and mortality in spite of urgent surgical treatment. This study investigated the surgical outcome of patients with colonic perforation associated with retroperitoneal contamination. Retrospective analysis was performed for 30 patients diagnosed with colonic perforation caused by either inflammation or ischemia who underwent urgent surgical treatment in our facility from January 2005 to December 2014. Patient characteristics were analyzed to find risk factors correlated with increased postoperative mortality. Using the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) audit system, the mortality and morbidity rates were estimated to verify the surgical outcomes. Patients with retroperitoneal contamination, defined by the presence of retroperitoneal air in the preoperative abdominopelvic CT, were compared to those without retroperitoneal contamination. Eight out of 30 patients (26.7%) with colonic perforation had died after urgent surgical treatment. Factors associated with mortality included age, American Society of Anesthesiologists (ASA) physical status classification, and the ischemic cause of colonic perforation. Three out of 6 patients (50%) who presented retroperitoneal contamination were deceased. Although the patients with retroperitoneal contamination did not show significant increase in the mortality rate, they showed significantly higher ASA physical status classification than those without retroperitoneal contamination. The mortality rate predicted from Portsmouth POSSUM was higher in the patients with retroperitoneal contamination. Patients presenting colonic perforation along with retroperitoneal contamination demonstrated severe comorbidity. However, retroperitoneal contamination was not found to be correlated with the mortality rate.

Investigation on the Acoustic Absorption of Flexible Micro-Perforated Panel with Ultra-Micro Perforations

Science.gov (United States)

Li, Guoxin; Tang, Xiaoning; Zhang, Xiaoxiao; Qian, Y. J.; Kong, Deyi

2017-11-01

Flexible micro-perforated panel has unique advantages in noise reduction due to its good flexibility compared with traditional rigid micro-perforated panel. In this paper, flexible micro-perforated panel was prepared by computer numerical control (CNC) milling machine. Three kinds of plastics including polyvinylchloride (PVC), polyethylene terephthalate (PET), and polyimide (PI) were taken as the matrix materials to prepare flexible micro-perforated panel. It has been found that flexible micro-perforated panel made of PET possessing good porosity and proper density, elastic modulus and poisson ratio exhibited the best acoustic absorption properties. The effects of various structural parameters including perforation diameter, perforation ratio, thickness and air gap have also been investigated, which would be helpful to the optimization of acoustic absorption properties.

Non-equilibrium Microwave Plasma for Efficient High Temperature Chemistry.

Science.gov (United States)

van den Bekerom, Dirk; den Harder, Niek; Minea, Teofil; Gatti, Nicola; Linares, Jose Palomares; Bongers, Waldo; van de Sanden, Richard; van Rooij, Gerard

2017-08-01

A flowing microwave plasma based methodology for converting electric energy into internal and/or translational modes of stable molecules with the purpose of efficiently driving non-equilibrium chemistry is discussed. The advantage of a flowing plasma reactor is that continuous chemical processes can be driven with the flexibility of startup times in the seconds timescale. The plasma approach is generically suitable for conversion/activation of stable molecules such as CO2, N2 and CH4. Here the reduction of CO2 to CO is used as a model system: the complementary diagnostics illustrate how a baseline thermodynamic equilibrium conversion can be exceeded by the intrinsic non-equilibrium from high vibrational excitation. Laser (Rayleigh) scattering is used to measure the reactor temperature and Fourier Transform Infrared Spectroscopy (FTIR) to characterize in situ internal (vibrational) excitation as well as the effluent composition to monitor conversion and selectivity.

Perforated membrane-type acoustic metamaterials

International Nuclear Information System (INIS)

Langfeldt, F.; Kemsies, H.; Gleine, W.; Estorff, O. von

2017-01-01

This letter introduces a modified design of membrane-type acoustic metamaterials (MAMs) with a ring mass and a perforation so that an airflow through the membrane is enabled. Simplified analytical investigations of the perforated MAM (PMAM) indicate that the perforation introduces a second anti-resonance, where the effective surface mass density of the PMAM is much higher than the static value. The theoretical results are validated using impedance tube measurements, indicating good agreement between the theoretical predictions and the measured data. The anti-resonances yield high low-frequency sound transmission loss values with peak values over 25 dB higher than the corresponding mass-law. - Highlights: • A new membrane-type acoustic metamaterial exhibiting negative density is presented. • The metamaterial design contains a ring mass with a perforation through the membrane. • The sound transmission loss exhibits narrow-band peaks much higher than the mass-law. • The emergence of the peaks is explained using a simple theoretical model. • Impedance tube measurements are used to validate the theoretical predictions.

Perforated membrane-type acoustic metamaterials

Energy Technology Data Exchange (ETDEWEB)

Langfeldt, F., E-mail: Felix.Langfeldt@haw-hamburg.de [Department of Automotive and Aeronautical Engineering, Hamburg University of Applied Sciences, Berliner Tor 9, D-20099 Hamburg (Germany); Kemsies, H., E-mail: Hannes.Kemsies@haw-hamburg.de [Department of Automotive and Aeronautical Engineering, Hamburg University of Applied Sciences, Berliner Tor 9, D-20099 Hamburg (Germany); Gleine, W., E-mail: Wolfgang.Gleine@haw-hamburg.de [Department of Automotive and Aeronautical Engineering, Hamburg University of Applied Sciences, Berliner Tor 9, D-20099 Hamburg (Germany); Estorff, O. von, E-mail: estorff@tu-harburg.de [Institute of Modelling and Computation, Hamburg University of Technology, Denickestr. 17, D-21073 Hamburg (Germany)

2017-04-25

This letter introduces a modified design of membrane-type acoustic metamaterials (MAMs) with a ring mass and a perforation so that an airflow through the membrane is enabled. Simplified analytical investigations of the perforated MAM (PMAM) indicate that the perforation introduces a second anti-resonance, where the effective surface mass density of the PMAM is much higher than the static value. The theoretical results are validated using impedance tube measurements, indicating good agreement between the theoretical predictions and the measured data. The anti-resonances yield high low-frequency sound transmission loss values with peak values over 25 dB higher than the corresponding mass-law. - Highlights: • A new membrane-type acoustic metamaterial exhibiting negative density is presented. • The metamaterial design contains a ring mass with a perforation through the membrane. • The sound transmission loss exhibits narrow-band peaks much higher than the mass-law. • The emergence of the peaks is explained using a simple theoretical model. • Impedance tube measurements are used to validate the theoretical predictions.

Duodenal perforation: an unusual complication of sickle cell anemia.

Science.gov (United States)

Acıpayam, Can; Aldıç, Güliz; Akçora, Bülent; Çelikkaya, Mehmet Emin; Aşkar, Hasan; Dorum, Bayram Ali

2014-01-01

Duodenal perforation in childhood is a rare condition with a high mortality rate if not treated surgically. Primary gastroduodenal perforation is frequently associated with peptic ulcer and exhibits a positive family history. Helicobacter pylorus is the most significant agent. Secondary gastroduodenal perforation may be a finding of specific diseases, such as Crohn disease, or more rarely may be associated with diseases such as cystic fibrosis or sickle cell anemia. A 14-year-old boy presented with abdominal and back pain. The patient was operated on for acute abdomen and diagnosed with duodenal perforation. Helicobacter pylorus was negative. There was no risk factor to account for duodenal perforation other than sickle cell anemia. Surgical intervention was successful and without significant sequelae. Duodenal perforation is a rare entity described in patients with sickle cell anemia. To our knowledge, this is the first report of duodenal perforation in a patient sickle cell anemia.

Primary Closure versus Gastric Resection for Perforated Gastric

African Journals Online (AJOL)

Perforated gastric ulcer is one of the most life‑threatening complications of peptic ulcer disease with high .... tubes were removed and oral nutrition resumed. The .... surgical approach for perforated gastric cancer: One‑stage vs. two‑stage ...

Jejunal diverticula with perforation in non steroidal anti inflammatory drug user: A case report

Directory of Open Access Journals (Sweden)

Shobhit Gupta

2017-01-01

Conclusion: Jejunal diverticula are rare lesions, and their perforation never features in the list of diagnoses for acute abdomen, especially in this part of the world. Further this unique case report opens the doors for further research to prove an assosiation between NSAID use and diverticular perforation which itself is a very rare entity.

[Gastric perforation by MALT lymphoma. Case report].

Science.gov (United States)

López-Zamudio, José; Ramírez-González, Luis Ricardo; Núñez-Márquez, Julia; Fuentes Orozco, Clotilde; González Ojeda, Alejandro; Leonher-Ruezga, Karla Lisseth

2015-01-01

Gastric non-Hodgkin lymphoma is a rare tumour that represents approximately 7% of all stomach cancers and 2% of all lymphomas. The most frequent location of gastric MALT (mucosa associated lymphoid tissue) lymphomas is in the antrum in 41% of the cases, and 33% can be multifocal. The risk of spontaneous perforation of a gastric MALT lymphoma is 4-10%. 24 year old male patient carrying the Human Immunodeficiency Virus, who began with signs and symptoms of acute abdomen and fever 72 hours before arriving in the emergency room. A computed tomography was performed that showed free fluid in the cavity, and gastric wall thickening. The patient underwent a laparotomy, finding absence of the anterior wall of the stomach, sealed with the left lobe of the liver, colon and omentum. Total gastrectomy, with oesophagosty and jejunostomy tube, was performed. Gastric perforation secondary to a MALT lymphoma is rare, with high mortality. There is limited information reported of this complication and should be highly suspected in order to provide appropriate treatment for a complication of this type. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Case Report: Rectal perforation during CT colonography [version 1; referees: 2 approved

Directory of Open Access Journals (Sweden)

Marianna Zukiwskyj

2016-03-01

Full Text Available Introduction Computer tomography colonoscopy (CTC is an increasingly prevalent procedure for the investigation of colorectal symptoms, or as a component of colorectal cancer screening.  It is considered a low risk procedure, however colonic perforation is a recognized significant complication.   Case Report We report the case of an 81-year-old female patient who underwent CTC after failed optical colonoscopy as part of routine colorectal cancer screening.  Perforation of the rectum with surrounding pararectal air was confirmed on CTC.  The patient had minimal symptoms and was treated successful non-operatively with bowel rest and antibiotics.   Conclusion Perforation sustained during CTC is an uncommon complication.  The incidence of perforation during CTC is still lower than that during optical colonoscopy.  In the absence of significant abdominal signs and symptoms, this rare complication may be successfully managed non-operatively.

Aductive laser iridoplasty and laser goniopuncture after non-perforating trabeculectomy.

Science.gov (United States)

D, Lawrence F Jindra M

2013-03-01

intraocular pressure (IOP). In this paper we examine the effectiveness of adjunctive Nd:YAG laser goniopuncture (YGP) in patients who underwent NPT, to reduce post-operative IOP rise, secondary to scarring at or poor aqueous outflow through the TDM. Iris prolapse (IP) is another potential complication following NPT which can result in a rise in IOP. In this paper we examine the effectiveness of adjunctive argon laser peripheral iridoplasty (ALPI) in patients who underwent NPT, to reduce post-operative IOP rise, secondary to IP obstructing outflow across the TDM. Nd:YAG laser goniopuncture consists of placing several laser shots on the undersurface of the trabeculodescemetic membrane. The result is a microperforation in this membrane, with flow of aqueous into the filtration bleb, which converts a non-perforating filtration procedure into a partial thickness filtration procedure. In this technique, several high power, multi-burst shots are applied, ab interno, by a Nd:YAG laser via a gonioprism, to the underside of the TDM, to facilitate aqueous outflow out from the anterior chamber. YGP can be effective when increased aqueous outflow is desired postoperatively. After this procedure, patent perforation in the TDM is usually observed gonioscopically, generally accompanied with reduction in IOP, and increase in bleb elevation (in height and in circumferential extent). Argon laser peripheral iridoplasty consists of placing several laser burns on the surface of the peripheral iris to contract the iris stroma, in a centripetal fashion, between the site of the burn and the anterior chamber angle. The result is iris stromal tissue contraction and compaction, movement of IP away from the angle and toward the pupil, which physically widens the angle and clears the synechial apposition of the peripheral iris against the TDM. In this technique, a series of low power, long duration, and large size burns is applied to the iris periphery to contract the iris stroma, to open the angle, and

Study on modal characteristics of perforated shell using effective Young's modulus

Energy Technology Data Exchange (ETDEWEB)

Jhung, Myung Jo, E-mail: mjj@kins.re.kr [Korea Institute of Nuclear Safety, 19 Guseong-dong, Yuseong-gu, Daejeon 305-338 (Korea, Republic of); Yu, Seon Oh [Korea Institute of Nuclear Safety, 19 Guseong-dong, Yuseong-gu, Daejeon 305-338 (Korea, Republic of)

2011-06-15

Research highlights: > The effective Young's modulus of perforated shell is proposed for modal analysis. > The penetration pattern is almost negligible for effective elastic constants. > The frequency of perforated shell decreases significantly due to the hole effect. - Abstract: For the perforated cylindrical shell submerged in fluid, it is almost impossible to develop a finite element model due to the necessity of the fine meshing of the shell and the fluid at the same time. This necessitates the use of solid shell with effective material properties. Unfortunately the effective elastic constants are not found in any references even though the ASME code is suggesting those for perforated plate. Therefore in this study the effective material properties of perforated shell are suggested by performing several finite element analyses with respect to the ligament efficiencies.

The 'disector' a tool for quantitative assessment of synaptic plasticity an example on hippocampal synapses and synapse-perforations in ageing rats

NARCIS (Netherlands)

Groot, D.M.G. de; Bierman, E.P.B.; Bruijnzeel, P.L.B.; Woutersen, R.A.

1995-01-01

The 'disector' method was used to estimate number and size of simple non-perforated and complex 'perforated' synapses and their 'perforations' in the hippocampal CA3 area of 3, 12, 24 and 30 months old rats. A decrease with age from 3 to 24 months of age in the number of non-perforated synapses per

Fouling Resilient Perforated Feed Spacers for Membrane Filtration

KAUST Repository

Kerdi, Sarah

2018-04-24

The improvement of feed spacers with optimal geometry remains a key challenge for spiral-wound membrane systems in water treatment due to their impact on the hydrodynamic performance and fouling development. In this work, novel spacer designs are proposed by intrinsically modifying cylindrical filaments through perforations. Three symmetric perforated spacers (1-Hole, 2-Hole, and 3-Hole) were in-house 3D-printed and experimentally evaluated in terms of permeate flux, feed channel pressure drop and membrane fouling. Spacer performance is characterized and compared with standard no perforated (0-Hole) design under constant feed pressure and constant feed flow rate. Perforations in the spacer filaments resulted in significantly lowering the net pressure drop across the spacer filled channel. The 3-Hole spacer was found to have the lowest pressure drop (50% - 61%) compared to 0-Hole spacer for various average flow velocities. Regarding permeate flux production, the 0-Hole spacer produced 5.7 L.m-2.h-1 and 6.6 L.m-2.h-1 steady state flux for constant pressure and constant feed flow rate, respectively. The 1-Hole spacer was found to be the most efficient among the perforated spacers with 75% and 23% increase in permeate production at constant pressure and constant feed flow, respectively. Furthermore, membrane surface of 1-Hole spacer was found to be cleanest in terms of fouling, contributing to maintain higher permeate flux production. Hydrodynamic understanding of these perforated spacers is also quantified by performing Direct Numerical Simulation (DNS). The performance enhancement of these perforated spacers is attributed to the formation of micro-jets in the spacer cell that aided in producing enough unsteadiness/turbulence to clean the membrane surface and mitigate fouling phenomena. In the case of 1-Hole spacer, the unsteadiness intensity at the outlet of micro-jets and the shear stress fluctuations created inside the cells are higher than those observed with

Fouling resilient perforated feed spacers for membrane filtration.

Science.gov (United States)

Kerdi, Sarah; Qamar, Adnan; Vrouwenvelder, Johannes S; Ghaffour, Noreddine

2018-04-24

The improvement of feed spacers with optimal geometry remains a key challenge for spiral-wound membrane systems in water treatment due to their impact on the hydrodynamic performance and fouling development. In this work, novel spacer designs are proposed by intrinsically modifying cylindrical filaments through perforations. Three symmetric perforated spacers (1-Hole, 2-Hole, and 3-Hole) were in-house 3D-printed and experimentally evaluated in terms of permeate flux, feed channel pressure drop and membrane fouling. Spacer performance is characterized and compared with standard no perforated (0-Hole) design under constant feed pressure and constant feed flow rate. Perforations in the spacer filaments resulted in significantly lowering the net pressure drop across the spacer filled channel. The 3-Hole spacer was found to have the lowest pressure drop (50%-61%) compared to 0-Hole spacer for various average flow velocities. Regarding permeate flux production, the 0-Hole spacer produced 5.7 L m -2 .h -1 and 6.6 L m -2 .h -1 steady state flux for constant pressure and constant feed flow rate, respectively. The 1-Hole spacer was found to be the most efficient among the perforated spacers with 75% and 23% increase in permeate production at constant pressure and constant feed flow, respectively. Furthermore, membrane surface of 1-Hole spacer was found to be cleanest in terms of fouling, contributing to maintain higher permeate flux production. Hydrodynamic understanding of these perforated spacers is also quantified by performing Direct Numerical Simulation (DNS). The performance enhancement of these perforated spacers is attributed to the formation of micro-jets in the spacer cell that aided in producing enough unsteadiness/turbulence to clean the membrane surface and mitigate fouling phenomena. In the case of 1-Hole spacer, the unsteadiness intensity at the outlet of micro-jets and the shear stress fluctuations created inside the cells are higher than those

Use of pulsed neutron logging to evaluate perforation washing

International Nuclear Information System (INIS)

Dimon, C.A.

1986-01-01

This invention relates to the use of pulsed neutron logging techniques before and after perforation washing operations are performed to evaluate the degree of success of the perforation washing operations. Well logging operations of a type designed to respond to the difference between a formation immediately behind the well sheath and voids in the formation are performed both before and after the perforation washing operation. differences between the two resulting logs are then indicative of voids created by perforation washing. In a preferred embodiment, pulsed neutron logging is used as the logging technique, while a weighted brine having a high absorption cross section to pulsed neutrons is used as the perforation washing fluid

High Definition Video Streaming Using H.264 Video Compression

OpenAIRE

Bechqito, Yassine

2009-01-01

This thesis presents high definition video streaming using H.264 codec implementation. The experiment carried out in this study was done for an offline streaming video but a model for live high definition streaming is introduced, as well. Prior to the actual experiment, this study describes digital media streaming. Also, the different technologies involved in video streaming are covered. These include streaming architecture and a brief overview on H.264 codec as well as high definition t...

Spectrum of perforation peritonitis in India--review of 504 consecutive cases.

Science.gov (United States)

Jhobta, Rajender Singh; Attri, Ashok Kumar; Kaushik, Robin; Sharma, Rajeev; Jhobta, Anupam

2006-09-05

Perforation peritonitis is the most common surgical emergency in India. The spectrum of etiology of perforation in Tropical countries continues to be different from its Western counterpart. The objective of the study was to highlight the spectrum of perforation peritonitis as encountered by us at Government Medical College and Hospital (GMCH), Chandigarh. Five hundred and four consecutive cases of perforation peritonitis over a period of five years were reviewed in terms of clinical presentation, operative findings and postoperative course retrospectively at GMCH, Chandigarh. The most common cause of perforation in our series was perforated duodenal ulcer (289 cases) followed by appendicitis (59 cases), gastrointestinal perforation due to blunt trauma abdomen (45 cases), typhoid fever (41 cases) and tuberculosis (20 cases). Despite delay in seeking medical treatment (53%), the overall mortality (10%) was favourably comparable with other published series though the overall morbidity (50%) was unusually high. In contrast to western literature, where lower gastrointestinal tract perforations predominate, upper gastrointestinal tract perforations constitute the majority of cases in India. The increasing incidence of post-traumatic gastro-enteric injuries may be due to an increase in high speed motor vehicle accidents which warrant early recognition and prompt treatment to avoid serious complications and death.

Spectrum of perforation peritonitis in India-review of 504 consecutive cases

Directory of Open Access Journals (Sweden)

Sharma Rajeev

2006-09-01

Full Text Available Abstract Background/objective Perforation peritonitis is the most common surgical emergency in India. The spectrum of etiology of perforation in Tropical countries continues to be different from its Western counterpart. The objective of the study was to highlight the spectrum of perforation peritonitis as encountered by us at Government Medical College and Hospital (GMCH, Chandigarh. Methods Five hundred and four consecutive cases of perforation peritonitis over a period of five years were reviewed in terms of clinical presentation, operative findings and postoperative course retrospectively at GMCH, Chandigarh. Results The most common cause of perforation in our series was perforated duodenal ulcer (289 cases followed by appendicitis (59 cases, gastrointestinal perforation due to blunt trauma abdomen (45 cases, typhoid fever (41 cases and tuberculosis (20 cases. Despite delay in seeking medical treatment (53%, the overall mortality (10% was favourably comparable with other published series though the overall morbidity (50% was unusually high. Conclusion In contrast to western literature, where lower gastrointestinal tract perforations predominate, upper gastrointestinal tract perforations constitute the majority of cases in India. The increasing incidence of post-traumatic gastro-enteric injuries may be due to an increase in high speed motor vehicle accidents which warrant early recognition and prompt treatment to avoid serious complications and death.

Reactive perforating collagenosis

Directory of Open Access Journals (Sweden)

Yadav Mukesh

2009-01-01

Full Text Available Reactive perforating collagenosis is a rare cutaneous disorder of unknown etiology. We hereby describe a case of acquired reactive perforating collagenosis in a patient of diabetes and chronic renal failure.

Combining rhinoplasty with septal perforation repair.

Science.gov (United States)

Foda, Hossam M T; Magdy, Emad A

2006-11-01

A combined septal perforation repair and rhinoplasty was performed in 80 patients presenting with septal perforations (size 1 to 5 cm) and external nasal deformities. The external rhinoplasty approach was used for all cases and the perforation was repaired using bilateral intranasal mucosal advancement flaps with a connective tissue interposition graft in between. Complete closure of the perforation was achieved in 90% of perforations of size up to 3.5 cm and in only 70% of perforations that were larger than 3.5 cm. Cosmetically, 95% were very satisfied with their aesthetic result. The external rhinoplasty approach proved to be very helpful in the process of septal perforation repair especially in large and posteriorly located perforations and in cases where the caudal septal cartilage was previously resected. Our results show that septal perforation repair can be safely combined with rhinoplasty and that some of the routine rhinoplasty maneuvers, such as medial osteotomies and dorsal lowering, could even facilitate the process of septal perforation repair.

The Heidelberg Appendicitis Score Predicts Perforated Appendicitis in Children.

Science.gov (United States)

Boettcher, Michael; Günther, Patrick; Breil, Thomas

2017-10-01

In the future, surgical management of pediatric appendicitis might become limited to nonperforating appendicitis. Thus, it becomes increasingly important to differentiate advanced from simple appendicitis and to predict perforated appendicitis among a group of children with right-sided abdominal pain, which was the aim of this study. An institutionally approved, single-center retrospective analysis of all patients with appendectomy from January 2009 to December 2010 was conducted. All diagnostic aspects were evaluated to identify predictors and differentiators of perforated appendicitis. In 2 years, 157 children suffered from appendicitis. Perforation occurred in 47 (29.9%) of the patients. C-reactive protein (CRP) levels higher than 20 mg/dL ( P = .037) and free abdominal fluid on ultrasonography ( P = .031) are the most important features to differentiate perforated from simple appendicitis. Moreover, all children with perforation had a positive Heidelberg Appendicitis Score (HAS). A negative HAS excludes perforation in all cases (negative predictive value = 100%). Perforated appendicitis can be ruled out by the HAS. In a cohort with right-sided abdominal pain, perforation should be considered in children with high CRP levels and free fluids or abscess formation on ultrasound.

Equivalent Young's Modulus of Perforated Shell with Square Penetration Pattern

Energy Technology Data Exchange (ETDEWEB)

Jhung, Myung Jo; Ryu, Yong Ho [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

2011-05-15

The analysis of a plate or shell perforated with a large number of holes, by finite element method for instance, was a very costly and time-consuming technique which solves only one particular problem. But it is possible to model the perforated plate or shell and to analyze it and it is no more time-consuming theses days due to the rapid development of the computer and software. However, if a perforated plate or shell is submerged in fluid it is almost impossible to model and analyze it as is and the fluid at the same time, which is needed to investigate the effect of the fluid structure interaction. The simplest way to avoid time consuming and costly analysis of perforated plate or shell submerged in fluid is to replace the perforated plate or shell by an equivalent solid one considering weakening effect of holes. Many authors have proposed experimental or theoretical method to solve this problem for the plate. Slot and O'Donnell determined the effective elastic constants for the thick perforated plates by equating strains in the equivalent solid material to the average strains in the perforated material. O'Donnell also presented those of thin perforated plates. These results are implemented in Article A-8000 of Appendix A to the ASME code Section III, which contains a method of analysis for flat perforated plates when subjected to directly applied loads or loadings resulting from structural interaction with adjacent members. Unfortunately the effective elastic constants for the perforated shell are not found in any references. Therefore in this study the modal characteristics of the perforated shell are investigated and the equivalent material properties of perforated shell are suggested by performing several finite element analyses with respect to the ligament efficiencies

Perforated marginal ulcers after laparoscopic gastric bypass.

Science.gov (United States)

Felix, Edward L; Kettelle, John; Mobley, Elijah; Swartz, Daniel

2008-10-01

Perforated marginal ulcer (PMU) after laparoscopic Roux-en-Y gastric bypass (LRYGB) is a serious complication, but its incidence and etiology have rarely been investigated. Therefore, a retrospective review of all patients undergoing LRYGB at the authors' center was conducted to determine the incidence of PMU and whether any causative factors were present. A prospectively kept database of all patients at the authors' bariatric center was retrospectively reviewed. The complete records of patients with a PMU were examined individually for accuracy and analyzed for treatment, outcome, and possible underlying causes of the marginal perforation. Between April 1999 and August 2007, 1% of the patients (35/3,430) undergoing laparoscopic gastric bypass experienced one or more perforated marginal ulcers 3 to 70 months (median, 18 months) after LRYGB. The patients with and without perforation were not significantly different in terms of mean age (37 vs 41 years), weight (286 vs 287 lb), body mass index (BMI) (46 vs 47), or female gender (89% vs 83%). Of the patients with perforations, 2 (6%) were taking steroids, 10 (29%) were receiving nonsteroidal antiinflammatory drugs (NSAIDs) at the time of the perforation, 18 (51%) were actively smoking, and 6 of the smokers also were taking NSAIDs. Eleven of the patients (31%) who perforated did not have at least one of these possible risk factors, but 4 (36%) of the 11 patients in this group had been treated after bypass for a marginal ulcer. Only 7 (20%) of the 35 patients who had laparoscopic bypass, or 7 (0.2%) in the entire group of 3,430 patients, perforated without any warning. There were no deaths, but three patients reperforated. The incidence of a marginal ulcer perforating after LRYGB was significant (>1%) and appeared to be related to smoking or the use of NSAIDs or steroids. Because only 0.2% of all patients acutely perforated without some risk factor or warning, long-term ulcer prophylaxis or treatment may be necessary

Experimental investigation of acoustic streaming in a cylindrical wave guide up to high streaming Reynolds numbers.

Science.gov (United States)

Reyt, Ida; Bailliet, Hélène; Valière, Jean-Christophe

2014-01-01

Measurements of streaming velocity are performed by means of Laser Doppler Velocimetry and Particle Image Velociimetry in an experimental apparatus consisting of a cylindrical waveguide having one loudspeaker at each end for high intensity sound levels. The case of high nonlinear Reynolds number ReNL is particularly investigated. The variation of axial streaming velocity with respect to the axial and to the transverse coordinates are compared to available Rayleigh streaming theory. As expected, the measured streaming velocity agrees well with the Rayleigh streaming theory for small ReNL but deviates significantly from such predictions for high ReNL. When the nonlinear Reynolds number is increased, the outer centerline axial streaming velocity gets distorted towards the acoustic velocity nodes until counter-rotating additional vortices are generated near the acoustic velocity antinodes. This kind of behavior is followed by outer streaming cells only and measurements in the near wall region show that inner streaming vortices are less affected by this substantial evolution of fast streaming pattern. Measurements of the transient evolution of streaming velocity provide an additional insight into the evolution of fast streaming.

The value of CT in detecting pathologic bowel perforation

International Nuclear Information System (INIS)

Chang, Jong Wun; Shin, Joo Yong; Kim, Hong; Rhee, Chang Soo; Lee, Sung Moon; Joo, Yang Goo; Suh, Soo Jhi

1997-01-01

To evaluate the usefulness of CT for assessing the location and cause of pathologic gastrointestinal perforation. A retrospective analysis of abdominal CT was performed in 27 perforations of 26 patients with underlying gastrointestinal pathology. Fifteen benign and 12 malignant perforations consisted of five gastric cancers, one gastric ulcer, ten duodenal bulb ulcers. two bowel adhesions, one jejunal metastasis from lung cancer, one ileocolic Crohn's disease, one radiation colitis and six colon cancers. CT scans were evaluated for 1) diagnosis of bowel perforation, 2) assessment of the cause and site of perforation, and, in particular, differentiation between benignancy and malignancy, and 3) complications and their extent. CT easily detected varying amounts of free air or fluid collection, and infiltration or abscess formation adjacent to the main lesion, and the diagnosis of gastrointestinal perforation was therefore easy. In 11 of the 12 malignancies (92%), primary tumor was diagnosed, but detection of the site of perforation was possible in only seven cases(7/12, 58%). The 15 benign lesions revealed nonspecific CT findings, and the perforation site could be presumed in six (6/15, 40%). In one case of Crohn's disease, the primary cause was visualized. Among six colonic cancers, four pericolic abscesses and two fistulas to adjacent organs were found, but there was no evidence of diffuse peritonitis. CT was helpful to lead to optimal treatment of pathologic gastrointestinal On CT the detectability of perforation, primary benign or malignant lesion, perforation site and extent of complication was high, and this modality was therefore a useful indicator of the optimal treatment for pathologic gastrointestinal perforations.=20

Spectrum of Perforation Peritonitis

Science.gov (United States)

Chakma, Sujit M.; Singh, Rahul L.; Parmekar, Mahadev V.; Singh, K.H. Gojen; Kapa, Buru; Sharatchandra, K.H.; Longkumer, Amenla T.; Rudrappa, Santhosh

2013-01-01

Introduction: Perforation peritonitis mostly results from the perforation of a diseased viscus. Other causes of perforation include abdominal trauma, ingestion of sharp foreign body and iatrogenic perforation. The diagnosis is mainly based on clinical grounds. Plain abdominal X-rays (erect) may reveal dilated and oedematous intestines with pneumoperitoneum. Ultrasound and CT scan may diagnose up to 72% and 82% of perforation respectively. The present study was carried out to study various etiological factors, modes of clinical presentation, morbidity and mortality patterns of perforation peritonitis presented in the RIMS hospital, Imphal, India. Material and Methods: The study was conducted from September 2010 to August 2012 on 490 cases of perforation peritonitis admitted and treated in the Department of Surgery. Initial diagnosis was made on the basis of detailed history, clinical examination and presence of pneumoperitoneum on erect abdominal X-ray. Results: A total of 490 patients of perforation peritonitis were included in the study, with mean age of 48.28 years. 54.29% patients were below 50 years and 45.71% patients were above 50 years. There were 54.29% male patients and 45.71% female patients. Only 30% patients presented within 24 hours of onset of symptoms, 31.43% patients presented between 24 to 72 hours and 38.57% patients presented 72 hours after the onset of symptoms. Mean duration of presentation was 54.7 hours. Overall 469 patients were treated surgically and 21 patients were managed conservatively. Overall morbidity and mortality recorded in this study were 52.24% and 10% respectively. PMID:24392388

Perforations during contrast enema

International Nuclear Information System (INIS)

Vogel, H.; Steinkamp, U.; Grabbe, E.; Allgemeines Krankenhaus Ochsenzoll, Hamburg

1983-01-01

During contrast enema, perforation into the retroperitoneal space can be differentiated from perforation into the peritoneum and perforation into the intestinal wall associated with formation of barium granulomas or submucosal spreading of the contrast medium. Other special forms are perforation with contrast medium embolism of diverticula; of the processus vermiformis; penetration of contrast medium into fistulous systems and from the operated areas. Risk factors are: balloon catheter, intestinal tubes with a hard tip, preternatural anus, excessive enema pressure, contrast medium additions, preceding manipulations, intestinal diseases, advanced age and delegation of manipulations to assistants and unskilled staff. Children are particularly at risk. (orig.) [de

Gallbladder perforation complicating typhoid fever: report of two cases.

Science.gov (United States)

Gali, B M; Ali, N; Agbese, G O; Duna, V D; Dawha, S D; Ismai, G I; Mohammed, M

2011-01-01

Gallbladder perforation (GBP) is rare and as a complication of typhoid fever is extremely rare. We present two consecutive patients with GBP diagnosed incidentally at laparotomy. Information on the management of two patients with gallbladder perforation seen at Federal Medical Centre Azare in June and October 2008 was extracted from their case records. The two patients were both males aged 13 years and 16 years. They both presented with high fever of more than 2 weeks duration; and abdominal pain and distension. Both patients had features of generalised peritonitis. Pre-operative diagnoses of typhoid enteric perforation were made based on a positive Widal test. Intra-operative findings however, were that of bile peritonitis and gallbladder perforation. Both had cholecystectomy. Culture of the bile aspirate yielded Salmonella typhi. Gallbladder perforation secondary to typhoid fever should be considered as a differential diagnosis in patients with suspected typhoid enteric perforation in typhoid fever endemic region.

Perforated duodenal diverticulum caused by Bezoar: A case report

Energy Technology Data Exchange (ETDEWEB)

Lee, Eun Jung; Moon, Sung Kyoung; Park, Seong Jin; Lim, Joo Won; Lee, Dong Ho; Ko, Young Tae [Dept. of Radiology, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

2013-11-15

Duodenal diverticulum is common, but its perforation is a rare complication. Duodenal diverticulum perforation requires prompt treatments because of its high mortality rate. However, an accurate diagnosis is difficult to make due to nonspecific symptoms and signs. It can be misdiagnosed as pancreatitis, cholecystitis, or peptic ulcer. Herein, we report a case of perforated duodenal diverticulum caused by bezoar in a 33-year-old woman whom was diagnosed by abdomen computed tomography and ultrasonography.

Duodenal perforation: an unusual complication of sickle cell anemia

OpenAIRE

Acıpayam, Can; Aldıç, Güliz; Akçora, Bülent; Çelikkaya, Mehmet Emin; Aşkar, Hasan; Dorum, Bayram Ali

2014-01-01

Duodenal perforation in childhood is a rare condition with a high mortality rate if not treated surgically. Primary gastroduodenal perforation is frequently associated with peptic ulcer and exhibits a positive family history. Helicobacter pylorus is the most significant agent. Secondary gastroduodenal perforation may be a finding of specific diseases, such as Crohn disease, or more rarely may be associated with diseases such as cystic fibrosis or sickle cell anemia. A 14-year-old boy presente...

Perforated duodenal diverticulum caused by Bezoar: A case report

International Nuclear Information System (INIS)

Lee, Eun Jung; Moon, Sung Kyoung; Park, Seong Jin; Lim, Joo Won; Lee, Dong Ho; Ko, Young Tae

2013-01-01

Duodenal diverticulum is common, but its perforation is a rare complication. Duodenal diverticulum perforation requires prompt treatments because of its high mortality rate. However, an accurate diagnosis is difficult to make due to nonspecific symptoms and signs. It can be misdiagnosed as pancreatitis, cholecystitis, or peptic ulcer. Herein, we report a case of perforated duodenal diverticulum caused by bezoar in a 33-year-old woman whom was diagnosed by abdomen computed tomography and ultrasonography.

The freestyle pedicle perforator flap

DEFF Research Database (Denmark)

Gunnarsson, Gudjon Leifur; Jackson, Ian T; Westvik, Tormod S

2015-01-01

BACKGROUND: Perforating vessels are a consistent anatomical finding and well described in the current literature. Any skin flap can be raised on a subcutaneous pedicle as long as it contains at least one supplying perforator. Perforator flaps have been interlinked with microsurgery and generally...... not widely performed by the general plastic surgeons. The aim of this paper is to present the simplicity of pedicled perforator flap reconstruction of moderate-sized defects of the extremities and torso. METHODS: We retrospectively reviewed the charts of 34 patients reconstructed using 34 freestyle pedicled...... perforator flaps for moderate-sized defects of the truncus and extremities. We registered indications, flap size and localization, success rate, and complications. Most importantly, we describe a simple approach to the design of freestyle pedicled perforator flaps and elaborate on technical aspects...

SmartCell: An Energy Efficient Coarse-Grained Reconfigurable Architecture for Stream-Based Applications

Directory of Open Access Journals (Sweden)

Liang Cao

2009-01-01

Full Text Available This paper presents SmartCell, a novel coarse-grained reconfigurable architecture, which tiles a large number of processor elements with reconfigurable interconnection fabrics on a single chip. SmartCell is able to provide high performance and energy efficient processing for stream-based applications. It can be configured to operate in various modes, such as SIMD, MIMD, and systolic array. This paper describes the SmartCell architecture design, including processing element, reconfigurable interconnection fabrics, instruction and control process, and configuration scheme. The SmartCell prototype with 64 PEs is implemented using 0.13  m CMOS standard cell technology. The core area is about 8.5  , and the power consumption is about 1.6 mW/MHz. The performance is evaluated through a set of benchmark applications, and then compared with FPGA, ASIC, and two well-known reconfigurable architectures including RaPiD and Montium. The results show that the SmartCell can bridge the performance and flexibility gap between ASIC and FPGA. It is also about 8% and 69% more energy efficient than Montium and RaPiD systems for evaluated benchmarks. Meanwhile, SmartCell can achieve 4 and 2 times more throughput gains when comparing with Montium and RaPiD, respectively. It is concluded that SmartCell system is a promising reconfigurable and energy efficient architecture for stream processing.

Shifts in stream hydrochemistry in responses to typhoon and non-typhoon precipitation

Science.gov (United States)

Chang, Chung-Te; Huang, -Chuan, Jr.; Wang, Lixin; Shih, Yu-Ting; Lin, Teng-Chiu

2018-04-01

Climate change is projected to increase the intensity and frequency of extreme climatic events such as tropical cyclones. However, few studies have examined the responses of hydrochemical processes to climate extremes. To fill this knowledge gap, we compared the relationship between stream discharge and ion input-output budget during typhoon and non-typhoon periods in four subtropical mountain watersheds with different levels of agricultural land cover in northern Taiwan. The results indicated that the high predictability of ion input-output budgets using stream discharge during the non-typhoon period largely disappeared during the typhoon periods. For ions such as Na+, NH4+, and PO43-, the typhoon period and non-typhoon period exhibited opposite discharge-budget relationships. In other cases, the discharge-budget relationship was driven by the typhoon period, which consisted of only 7 % of the total time period. The striking differences in the discharge-ion budget relationship between the two periods likely resulted from differences in the relative contributions of surface runoff, subsurface runoff and groundwater, which had different chemical compositions, to stream discharge between the two periods. Watersheds with a 17-22 % tea plantation cover showed large increases in NO3- export with increases in stream discharge. In contrast, watersheds with 93-99 % forest cover showed very mild or no increases in NO3- export with increases in discharge and very low levels of NO3- export even during typhoon storms. The results suggest that even mild disruption of the natural vegetation could largely alter hydrochemical processes. Our study clearly illustrates significant shifts in hydrochemical responses between regular and typhoon precipitation. We propose that hydrological models should separate hydrochemical processes into regular and extreme conditions to better capture the whole spectrum of hydrochemical responses to a variety of climate conditions.

Shifts in stream hydrochemistry in responses to typhoon and non-typhoon precipitation

Directory of Open Access Journals (Sweden)

C.-T. Chang

2018-04-01

Full Text Available Climate change is projected to increase the intensity and frequency of extreme climatic events such as tropical cyclones. However, few studies have examined the responses of hydrochemical processes to climate extremes. To fill this knowledge gap, we compared the relationship between stream discharge and ion input–output budget during typhoon and non-typhoon periods in four subtropical mountain watersheds with different levels of agricultural land cover in northern Taiwan. The results indicated that the high predictability of ion input–output budgets using stream discharge during the non-typhoon period largely disappeared during the typhoon periods. For ions such as Na+, NH4+, and PO43−, the typhoon period and non-typhoon period exhibited opposite discharge–budget relationships. In other cases, the discharge–budget relationship was driven by the typhoon period, which consisted of only 7 % of the total time period. The striking differences in the discharge–ion budget relationship between the two periods likely resulted from differences in the relative contributions of surface runoff, subsurface runoff and groundwater, which had different chemical compositions, to stream discharge between the two periods. Watersheds with a 17–22 % tea plantation cover showed large increases in NO3− export with increases in stream discharge. In contrast, watersheds with 93–99 % forest cover showed very mild or no increases in NO3− export with increases in discharge and very low levels of NO3− export even during typhoon storms. The results suggest that even mild disruption of the natural vegetation could largely alter hydrochemical processes. Our study clearly illustrates significant shifts in hydrochemical responses between regular and typhoon precipitation. We propose that hydrological models should separate hydrochemical processes into regular and extreme conditions to better capture the whole spectrum of hydrochemical responses to a

Vortex shedding control of circular cylinder by perforated shroud in deep water

Directory of Open Access Journals (Sweden)

Ozkan Gokturk M.

2017-01-01

Full Text Available The aim of the present study is to control the vortex shedding downstream of a circular cylinder (inner cylinder by the existence of outer perforated cylinder concentrically located around the inner cylinder in deep water. The flow characteristics downstream of concentrically placed coupled cylinders were investigated quantitatively by the Particle Image Velocimetry (PIV technique. Diameter of the outer perforated cylinder and inner cylinder were kept constant as Do=100 mm and Di=50 mm. The depth-averaged free-stream velocity was also kept constant as U=100 mm/s which corresponded to the Reynolds number of ReDo=10,000 based on the outer cylinder diameter. Experiments were conducted for six porosities (β = 0.3, 0.4, 0.5, 0.6, 0.7 and 0.8 in order to show the effect of these parameters on the flow control. Maximum values of both Reynolds shear stress, and turbulence kinetic energy, significantly decreased with the existence of outer perforated cylinder and also, the location of peak magnitudes of turbulence statistics occurred at locations further downstream compared to the bare cylinder case. The most effective control was revealed for the porosity of β=0.7.

Vortex shedding control of circular cylinder by perforated shroud in deep water

Science.gov (United States)

Ozkan, Gokturk M.; Durhasan, Tahir; Pinar, Engin; Aksoy, Muhammed M.; Akilli, Huseyin; Sahin, Beşir

The aim of the present study is to control the vortex shedding downstream of a circular cylinder (inner cylinder) by the existence of outer perforated cylinder concentrically located around the inner cylinder in deep water. The flow characteristics downstream of concentrically placed coupled cylinders were investigated quantitatively by the Particle Image Velocimetry (PIV) technique. Diameter of the outer perforated cylinder and inner cylinder were kept constant as Do=100 mm and Di=50 mm. The depth-averaged free-stream velocity was also kept constant as U=100 mm/s which corresponded to the Reynolds number of ReDo=10,000 based on the outer cylinder diameter. Experiments were conducted for six porosities (β = 0.3, 0.4, 0.5, 0.6, 0.7 and 0.8) in order to show the effect of these parameters on the flow control. Maximum values of both Reynolds shear stress, and turbulence kinetic energy, significantly decreased with the existence of outer perforated cylinder and also, the location of peak magnitudes of turbulence statistics occurred at locations further downstream compared to the bare cylinder case. The most effective control was revealed for the porosity of β=0.7.

The value of CT in detecting pathologic bowel perforation

Energy Technology Data Exchange (ETDEWEB)

Chang, Jong Wun; Shin, Joo Yong; Kim, Hong; Rhee, Chang Soo; Lee, Sung Moon; Joo, Yang Goo; Suh, Soo Jhi [Keimyung Univ. School of Medicine, Taegu (Korea, Republic of)

1997-10-01

To evaluate the usefulness of CT for assessing the location and cause of pathologic gastrointestinal perforation. A retrospective analysis of abdominal CT was performed in 27 perforations of 26 patients with underlying gastrointestinal pathology. Fifteen benign and 12 malignant perforations consisted of five gastric cancers, one gastric ulcer, ten duodenal bulb ulcers. two bowel adhesions, one jejunal metastasis from lung cancer, one ileocolic Crohn's disease, one radiation colitis and six colon cancers. CT scans were evaluated for (1) diagnosis of bowel perforation, (2) assessment of the cause and site of perforation, and, in particular, differentiation between benignancy and malignancy, and (3) complications and their extent. CT easily detected varying amounts of free air or fluid collection, and infiltration or abscess formation adjacent to the main lesion, and the diagnosis of gastrointestinal perforation was therefore easy. In 11 of the 12 malignancies (92%), primary tumor was diagnosed, but detection of the site of perforation was possible in only seven cases(7/12, 58%). The 15 benign lesions revealed nonspecific CT findings, and the perforation site could be presumed in six (6/15, 40%). In one case of Crohn's disease, the primary cause was visualized. Among six colonic cancers, four pericolic abscesses and two fistulas to adjacent organs were found, but there was no evidence of diffuse peritonitis. CT was helpful to lead to optimal treatment of pathologic gastrointestinal On CT the detectability of perforation, primary benign or malignant lesion, perforation site and extent of complication was high, and this modality was therefore a useful indicator of the optimal treatment for pathologic gastrointestinal perforations.=20.

Ion Streaming Instabilities in Pair Ion Plasma and Localized Structure with Non-Thermal Electrons

Science.gov (United States)

Nasir Khattak, M.; Mushtaq, A.; Qamar, A.

2015-12-01

Pair ion plasma with a fraction of non-thermal electrons is considered. We investigate the effects of the streaming motion of ions on linear and nonlinear properties of unmagnetized, collisionless plasma by using the fluid model. A dispersion relation is derived, and the growth rate of streaming instabilities with effect of streaming motion of ions and non-thermal electrons is calculated. A qausi-potential approach is adopted to study the characteristics of ion acoustic solitons. An energy integral equation involving Sagdeev potential is derived during this process. The presence of the streaming term in the energy integral equation affects the structure of the solitary waves significantly along with non-thermal electrons. Possible application of the work to the space and laboratory plasmas are highlighted.

Ion streaming instabilities in pair ion plasma and localized structure with non-thermal electrons

Energy Technology Data Exchange (ETDEWEB)

Khattak, M. Nasir; Qamar, A., E-mail: mnnasirphysics@gmail.com [Department of Physics, University of Peshawar (Pakistan); Mushtaq, A. [Department of Physics, Abdul Wali Khan University Mardan, National Center for Physics, Mardan (Pakistan)

2015-12-15

Pair ion plasma with a fraction of non-thermal electrons is considered. We investigate the effects of the streaming motion of ions on linear and nonlinear properties of unmagnetized, collisionless plasma by using the fluid model. A dispersion relation is derived, and the growth rate of streaming instabilities with effect of streaming motion of ions and non-thermal electrons is calculated. A quasi-potential approach is adopted to study the characteristics of ion acoustic solitons. An energy integral equation involving Sagdeev potential is derived during this process. The presence of the streaming term in the energy integral equation affects the structure of the solitary waves significantly along with non-thermal electrons. Possible application of the work to the space and laboratory plasmas are highlighted. (author)

Pneumatosis cystoides intestinalis associated with massive free air mimicking perforated diffuse peritonitis.

Science.gov (United States)

Sakurai, Yoichi; Hikichi, Masahiro; Isogaki, Jun; Furuta, Shinpei; Sunagawa, Risaburo; Inaba, Kazuki; Komori, Yoshiyuki; Uyama, Ichiro

2008-11-21

While pneumatosis cystoides intestinalis (PCI) is a rare disease entity associated with a wide variety of gastrointestinal and non-gastrointestinal disorders, PCI associated with massive intra- and retroperitoneal free air is extremely uncommon, and is difficult to diagnose differentially from perforated peritonitis. We present two cases of PCI associated with massive peritoneal free air and/or retroperitoneal air that mimicked perforated peritonitis. These cases highlight the clinical importance of PCI that mimics perforated peritonitis, which requires emergency surgery. Preoperative imaging modalities and diagnostic laparoscopy are useful to make an accurate diagnosis.

Self-adaptive change detection in streaming data with non-stationary distribution

KAUST Repository

Zhang, Xiangliang

2010-01-01

Non-stationary distribution, in which the data distribution evolves over time, is a common issue in many application fields, e.g., intrusion detection and grid computing. Detecting the changes in massive streaming data with a non-stationary distribution helps to alarm the anomalies, to clean the noises, and to report the new patterns. In this paper, we employ a novel approach for detecting changes in streaming data with the purpose of improving the quality of modeling the data streams. Through observing the outliers, this approach of change detection uses a weighted standard deviation to monitor the evolution of the distribution of data streams. A cumulative statistical test, Page-Hinkley, is employed to collect the evidence of changes in distribution. The parameter used for reporting the changes is self-adaptively adjusted according to the distribution of data streams, rather than set by a fixed empirical value. The self-adaptability of the novel approach enhances the effectiveness of modeling data streams by timely catching the changes of distributions. We validated the approach on an online clustering framework with a benchmark KDDcup 1999 intrusion detection data set as well as with a real-world grid data set. The validation results demonstrate its better performance on achieving higher accuracy and lower percentage of outliers comparing to the other change detection approaches. © 2010 Springer-Verlag.

Intraoperative Tumor Perforation is Associated with Decreased 5-Year Survival in Colon Cancer

DEFF Research Database (Denmark)

Bundgaard, N S; Bendtsen, V O; Ingeholm, P

2017-01-01

BACKGROUND: It is a widely held belief that intraoperative tumor perforation in colon cancer impairs survival and causes local recurrence, although the prognostic importance remains unclear. AIM: The aim of this study was to assess the effect of unintended intraoperative tumor perforation...... on postoperative mortality and long-term survival. MATERIAL AND METHODS: This national cohort study was based on data from a prospectively maintained nationwide colorectal cancer database. We included 16,517 colon cancer patients who were resected with curative intent from 2001 to 2012. RESULTS: Intraoperative...... tumor perforation produced a significantly impaired 5-year survival of 40% compared to 64% in non-perforated colon cancer. Intraoperative tumor perforation was an independent risk factor for death, hazard ratio 1.63 (95% confidence interval: 1.4-1.94), with a significantly increased 90-day postoperative...

Esophageal perforation during or after conformal radiotherapy for esophageal carcinoma

International Nuclear Information System (INIS)

Chen Haiyan; Ma Xiumei; Ye Ming; Hou Yanli; Xie Huaying; Bai Yongrui

2014-01-01

The aim of this study was to analyze the risk factors and prognosis for patients with esophageal perforation occurring during or after radiotherapy for esophageal carcinoma. We retrospectively analyzed 322 patients with esophageal carcinoma. These patients received radiotherapy for unresectable esophageal tumors, residual tumors after operation, or local recurrence. Of these, 12 had radiotherapy to the esophagus before being admitted, 68 patients had concurrent chemoradiotherapy (CRT), and 18 patients had esophageal perforation after RT (5.8%). Covered self-expandable metallic stents were placed in 11 patients. Two patients continued RT after stenting and control of infection; one of these suffered a new perforation, and the other had a massive hemorrhage. The median overall survival was 2 months (0-3 months) compared with 17 months in the non-perforation group. In univariate analysis, the Karnofsky performance status (KPS) being ≤ 70, age younger than 60, T4 stage, a second course of radiotherapy to the esophagus, extracapsular lymph nodes (LN) involving the esophagus, a total dose > 100 Gy (biologically effective dose -10 ), and CRT were risk factors for perforation. In multivariate analysis, age younger than 60, extracapsular LN involving the esophagus, T4 stage, and a second course of radiotherapy to the esophagus were risk factors. In conclusion, patients with T4 stage, extracapsular LN involving the esophagus, and those receiving a second course of RT should be given particular care to avoid perforation. The prognosis after perforation was poor. (author)

Features of Clinical Course of Perforated Ulcers of Stomach and Duodenum in Children

Directory of Open Access Journals (Sweden)

A.G. Zaporozhchenko

2013-11-01

Full Text Available We examined 52 patients aged from 14 to 17 years with perforated ulcer of stomach and the duodenum, operated using laparoscopic and open ways. It is established, that perforated ulcer of stomach and the duodenum in children onset suddenly, the are characterized by absence of «ulcer anamnesis» and clinical picture of acute peritonitis in 77 % of children. Maximum efficiency of diagnosis of perforated gastric and duodenal ulcers is achieved by using a comprehensive diagnostic program that includes the use of phased diagnostic measures in accordance with their resolution in each case.

CT in acute perforated sigmoid diverticulitis

International Nuclear Information System (INIS)

Lohrmann, Christian; Ghanem, Nadir; Pache, Gregor; Makowiec, Frank; Kotter, Elmar; Langer, Mathias

2005-01-01

Background: To assess the value of computed tomography (CT) in patients with acute perforated sigmoid diverticulitis in correlation with the Hinchey classification of perforated diverticular disease. Methods: Thirty patients with acute perforated sigmoid diverticulitis underwent computed tomography prior to surgery. Computed tomography scans were compared with the surgical and histopathological reports, utilizing the Hinchey classification. Results: In 28 of the 30 (93%) patients examined, the Hinchey stage was correctly determined by means of computed tomography. One patient with Hinchey stage IV was falsely classified as Hinchey stage III, and one patient with Hinchey stage III as Hinchey stage II. Computed tomography revealed 12 out of 14 (86%) patients with perforation sites and 3 out of 3 (100%) patients with contained perforation. In one of 17 (6%) patients with surgically or histopathologically proven perforation or contained perforation, a bowel wall discontinuity was revealed by computed tomography. In 6 of the 17 (35%) patients with surgical or histopathological perforation or contained perforation, extraluminal contrast material was detected by computed tomography. Conclusions: Computed tomography is a valuable imaging tool for determining the degree of acute perforated sigmoid diverticulitis, by means of which patients can be stratified according to the severity of the disease; furthermore, this tool is of assistance in surgical planning

The interactive effects of climate change, riparian management, and a non-native predators on stream-rearing salmon

Science.gov (United States)

Lawrence, David J.; Stewart-Koster, Ben; Olden, Julian D.; Ruesch, Aaron S.; Torgersen, Christian E.; Lawler, Joshua J.; Butcher, Don P.; Crown, Julia K.

2014-01-01

Predicting how climate change is likely to interact with myriad other stressors that threaten species of conservation concern is an essential challenge in aquatic ecosystems. This study provides a framework to accomplish this task in salmon-bearing streams of the northwestern United States, where land-use related reductions in riparian shading have caused changes in stream thermal regimes, and additional warming from projected climate change may result in significant losses of coldwater fish habitat over the next century. Predatory non-native smallmouth bass have also been introduced into many northwestern streams and their range is likely to expand as streams warm, presenting an additional challenge to the persistence of threatened Pacific salmon. The goal of this work was to forecast the interactive effects of climate change, riparian management, and non-native species on stream-rearing salmon, and to evaluate the capacity of restoration to mitigate these effects. We intersected downscaled global climate forecasts with a local-scale water temperature model to predict mid- and end-of-century temperatures in streams in the Columbia River basin; we compared one stream that is thermally impaired due to the loss of riparian vegetation and another that is cooler and has a largely intact riparian corridor. Using the forecasted stream temperatures in conjunction with fish-habitat models, we predicted how stream-rearing Chinook salmon and bass distributions would change as each stream warmed. In the highly modified stream, end-of-century warming may cause near total loss of Chinook salmon rearing habitat and a complete invasion of the upper watershed by bass. In the less modified stream, bass were thermally restricted from the upstream-most areas. In both systems, temperature increases resulted in higher predicted spatial overlap between stream-rearing Chinook salmon and potentially predatory bass in the early summer (2-4-fold increase) and greater abundance of bass. We

Accuracy of clinical prediction rules in peptic ulcer perforation: an observational study

DEFF Research Database (Denmark)

Buck, David Levarett; Vester-Andersen, Morten; Møller, Morten Hylander

2012-01-01

Abstract Objective. The aim of the present study was to compare the ability of four clinical prediction rules to predict adverse outcome in perforated peptic ulcer (PPU): the Boey score, the American Society of Anesthesiologists (ASA) score, the Acute Physiology and Chronic Health Evaluation...... and breastfeeding women, non-surgically treated patients, patients with malignant ulcers, and patients with perforation of other organs were excluded. Primary outcome measure: 30-day mortality rate. Statistical analysis: the ability of four clinical prediction rules to distinguish survivors from non...

Efficient Streaming Mass Spatio-Temporal Vehicle Data Access in Urban Sensor Networks Based on Apache Storm.

Science.gov (United States)

Zhou, Lianjie; Chen, Nengcheng; Chen, Zeqiang

2017-04-10

The efficient data access of streaming vehicle data is the foundation of analyzing, using and mining vehicle data in smart cities, which is an approach to understand traffic environments. However, the number of vehicles in urban cities has grown rapidly, reaching hundreds of thousands in number. Accessing the mass streaming data of vehicles is hard and takes a long time due to limited computation capability and backward modes. We propose an efficient streaming spatio-temporal data access based on Apache Storm (ESDAS) to achieve real-time streaming data access and data cleaning. As a popular streaming data processing tool, Apache Storm can be applied to streaming mass data access and real time data cleaning. By designing the Spout/bolt workflow of topology in ESDAS and by developing the speeding bolt and other bolts, Apache Storm can achieve the prospective aim. In our experiments, Taiyuan BeiDou bus location data is selected as the mass spatio-temporal data source. In the experiments, the data access results with different bolts are shown in map form, and the filtered buses' aggregation forms are different. In terms of performance evaluation, the consumption time in ESDAS for ten thousand records per second for a speeding bolt is approximately 300 milliseconds, and that for MongoDB is approximately 1300 milliseconds. The efficiency of ESDAS is approximately three times higher than that of MongoDB.

Efficient Streaming Mass Spatio-Temporal Vehicle Data Access in Urban Sensor Networks Based on Apache Storm

Directory of Open Access Journals (Sweden)

Lianjie Zhou

2017-04-01

Full Text Available The efficient data access of streaming vehicle data is the foundation of analyzing, using and mining vehicle data in smart cities, which is an approach to understand traffic environments. However, the number of vehicles in urban cities has grown rapidly, reaching hundreds of thousands in number. Accessing the mass streaming data of vehicles is hard and takes a long time due to limited computation capability and backward modes. We propose an efficient streaming spatio-temporal data access based on Apache Storm (ESDAS to achieve real-time streaming data access and data cleaning. As a popular streaming data processing tool, Apache Storm can be applied to streaming mass data access and real time data cleaning. By designing the Spout/bolt workflow of topology in ESDAS and by developing the speeding bolt and other bolts, Apache Storm can achieve the prospective aim. In our experiments, Taiyuan BeiDou bus location data is selected as the mass spatio-temporal data source. In the experiments, the data access results with different bolts are shown in map form, and the filtered buses’ aggregation forms are different. In terms of performance evaluation, the consumption time in ESDAS for ten thousand records per second for a speeding bolt is approximately 300 milliseconds, and that for MongoDB is approximately 1300 milliseconds. The efficiency of ESDAS is approximately three times higher than that of MongoDB.

Perceived Non-Overlap of Objects in an Audiovisual Stream/Bounce Display

Directory of Open Access Journals (Sweden)

Yousuke Kawachi

2011-10-01

Full Text Available In a stream/bounce display in which two identical visual objects move toward each other, coincide (completely overlap, and then move apart, the objects can be perceived as either streaming through or bouncing off each other. Despite the perceptual ambiguity in this display, the streaming percept is dominant. However, a sound burst presented at the time that the objects coincide facilitates the bouncing percept. Herein, we report a perceptual phenomenon in which the overlap between objects is illusorily perceived as a non-overlap in the stream/bounce display accompanied with sound. In the experiment, the amount of overlap between two objects was systematically manipulated in the presence/absence of a sound. Observers were asked to judge whether the two objects overlapped with each other and then asked whether the objects appeared to stream through or bounce off each other. The results were consistent with those of previous studies showing that sound promoted the bouncing percept. Most importantly, the sound presentation facilitated the perception of a non-overlap between the objects instead of a physical overlap, suggesting that the momentary overlap was inadequately perceived. We discuss the possibility that an abrupt sound temporally interrupts visual processing such as the formation of dynamic object representations.

Efficient Non Linear Loudspeakers

DEFF Research Database (Denmark)

Petersen, Bo R.; Agerkvist, Finn T.

2006-01-01

Loudspeakers have traditionally been designed to be as linear as possible. However, as techniques for compensating non linearities are emerging, it becomes possible to use other design criteria. This paper present and examines a new idea for improving the efficiency of loudspeakers at high levels...... by changing the voice coil layout. This deliberate non-linear design has the benefit that a smaller amplifier can be used, which has the benefit of reducing system cost as well as reducing power consumption....

Method for improved gas-solids separation

Science.gov (United States)

Kusik, C.L.; He, B.X.

1990-11-13

Methods are disclosed for the removal of particulate solids from a gas stream at high separation efficiency, including the removal of submicron size particles. The apparatus includes a cyclone separator type of device which contains an axially mounted perforated cylindrical hollow rotor. The rotor is rotated at high velocity in the same direction as the flow of an input particle-laden gas stream to thereby cause enhanced separation of particulate matter from the gas stream in the cylindrical annular space between the rotor and the sidewall of the cyclone vessel. Substantially particle-free gas passes through the perforated surface of the spinning rotor and into the hollow rotor, from where it is discharged out of the top of the apparatus. Separated particulates are removed from the bottom of the vessel. 4 figs.

High-speed image processing systems in non-destructive testing

Science.gov (United States)

Shashev, D. V.; Shidlovskiy, S. V.

2017-08-01

Digital imaging systems are using in most of both industrial and scientific industries. Such systems effectively solve a wide range of tasks in the field of non-destructive testing. There are problems in digital image processing for decades associated with the speed of the operation of such systems, sufficient to efficiently process and analyze video streams in real time, ideally in mobile small-sized devices. In this paper, we consider the use of parallel-pipeline computing architectures in image processing problems using the example of an algorithm for calculating the area of an object on a binary image. The approach used allows us to achieve high-speed performance in the tasks of digital image processing.

Free vibration analysis of perforated plate with square penetration pattern using equivalent material properties

Energy Technology Data Exchange (ETDEWEB)

Jhung, Myung Ho [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of); Jeong, Kyeong Hoon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2015-06-15

In this study, the natural frequencies of the perforated square plate with a square penetration pattern are obtained as a function of ligament efficiency using the commercial finite-element analysis code ANSYS. In addition, they are used to extract the effective modulus of elasticity under an assumption of a constant Poisson's ratio. The effective modulus of elasticity of the fully perforated square plate is applied to the modal analysis of a partially perforated square plate using a homogeneous finite-element analysis model. The natural frequencies and the corresponding mode shapes of the homogeneous model are compared with the results of the detailed finite-element analysis model of the partially perforated square plate to check the validity of the effective modulus of elasticity. In addition, the theoretical method to calculate the natural frequencies of a partially perforated square plate with fixed edges is suggested according to the Rayleigh-Ritz method.

Early Management Experience of Perforation after ERCP

Directory of Open Access Journals (Sweden)

Guohua Li

2012-01-01

Full Text Available Background and Aim. Perforation after endoscopic retrograde cholangiopancreatography (ERCP is a rare complication, but it is associated with significant mortality. This study evaluated the early management experience of these perforations. Patients and Methods. Between November 2003 and December 2011, a total of 8504 ERCPs were performed at our regional endoscopy center. Sixteen perforations (0.45% were identified and retrospectively reviewed. Results. Nine of these 16 patients with perforations were periampullary, 3 duodenal, 1 gastric fundus, and 3 patients had a perforation of an afferent limb of a Billroth II anastomosis. All patients with perforations were recognized during ERCP by X-ray and managed immediately. One patient with duodenal perforation and three patients with afferent limb perforation received surgery, others received medical conservative treatment which included suturing lesion, endoscopic nasobiliary drainage (ENBD, endoscopic retrograde pancreatic duct drainage (ERPD, gastrointestinal decompression, fasting, broad-spectrum antibiotics, and so on. All patients with perforation recovered successfully. Conclusions. We found that: (1 the diagnosis of perforation during ERCP may be easy, but you must pay attention to it. (2 Most retroperitoneal perforations can recover with only medical conservative treatment in early phase. (3 Most peritoneal perforations need surgery unless you can close the lesion up under endoscopy in early phase.

Self-adaptive change detection in streaming data with non-stationary distribution

KAUST Repository

Zhang, Xiangliang; Wang, Wei

2010-01-01

Non-stationary distribution, in which the data distribution evolves over time, is a common issue in many application fields, e.g., intrusion detection and grid computing. Detecting the changes in massive streaming data with a non

Using an ultra-thin non-doped orange emission layer to realize high efficiency white organic light-emitting diodes with low efficiency roll-off

Energy Technology Data Exchange (ETDEWEB)

Zhu, Liping; Chen, Jiangshan; Ma, Dongge, E-mail: mdg1014@ciac.ac.cn [State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Graduate University of the Chinese Academy of Sciences, Changchun 130022 (China); Zhao, Yongbiao [Luminous Center of Excellence for Semiconductor Lighting and Displays, School of Electrical and Electronic Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore, Singapore 639798 (Singapore); Zhang, Hongmei [Department of Materials Science and Engineering, Nanjing University of Posts and Telecommunications, Nanjing 210023 (China)

2014-06-28

By adopting an ultra-thin non-doped orange emission layer sandwiched between two blue emission layers, high efficiency white organic light-emitting diodes (WOLEDs) with reduced efficiency roll-off were fabricated. The optimized devices show a balanced white emission with Internationale de L'Eclairage of (0.41, 0.44) at the luminance of 1000 cd/m{sup 2}, and the maximum power efficiency, current efficiency (CE), and external quantum efficiency reach 63.2 lm/W, 59.3 cd/A, and 23.1%, which slightly shift to 53.4 lm/W, 57.1 cd/A, and 22.2% at 1000 cd/m{sup 2}, respectively, showing low efficiency roll-off. Detailed investigations on the recombination zone and the transient electroluminescence (EL) clearly reveal the EL processes of the ultra-thin non-doped orange emission layer in WOLEDs.

Effective information flow through efficient supply chain management - Value stream mapping approach Case Outokumpu Tornio Works

OpenAIRE

Juvonen, Piia

2012-01-01

ABSTRACT Juvonen, Piia Suvi Päivikki 2012. Effective information flow through efficient supply chain management -Value stream mapping approach - Case Outokumpu Tornio Works. Master`s Thesis. Kemi-Tornio University of Applied Sciences. Business and Culture. Pages 63. Appendices 2. The general aim of this thesis is to explore effective information flow through efficient supply chain management by following one of the lean management principles, value stream mapping. The specific research...

The Perforation-Operation time Interval; An Important Mortality Indicator in Peptic Ulcer Perforation.

Science.gov (United States)

Surapaneni, Sushama; S, Rajkumar; Reddy A, Vijaya Bhaskar

2013-05-01

To find out the significance of the Perforation-Operation Interval (POI) with respect to an early prognosis, in patients with peritonitis which is caused by peptic ulcer perforation. Case series. Place and Duration of the Study: Department of General Surgery, Konaseema Institute of Medical Sciences and RF Amalapuram, Andhra Pradesh, India from 2008-2011. This study included 150 patients with generalized peritonitis, who were diagnosed to have Perforated Peptic Ulcers (PPUs). The diagnosis of the PPUs was established on the basis of the history , the clinical examination and the radiological findings. The perforation-operation interval was calculated from the time of onset of the symptoms like severe abdominal pain or vomiting till the time the patient was operated. Out of the 150 patients 134 were males and 16 were females, with a male : female ratio of 9:1. Their ages ranged between 25-70 years. Out of the 150 patients, 65 patients (43.3%) presented within 24 hours of the onset of severe abdominal pain (Group A), 27 patients (18%) presented between 24-48 hours of the onset of severe abdominal pain (Group B) and 58 patients (38.6%) presented after 48 hours. There was no mortality in Group A and the morbidity was more in Group B and Group C. There were 15 deaths in Group C. The problem of peptic ulcer perforation with its complication, can be decreased by decreasing the perforation -operation time interval, which as per our study, appeared to be the single most important mortality and morbidity indicator in peptic ulcer perforation.

Streaming Compression of Hexahedral Meshes

Energy Technology Data Exchange (ETDEWEB)

Isenburg, M; Courbet, C

2010-02-03

We describe a method for streaming compression of hexahedral meshes. Given an interleaved stream of vertices and hexahedral our coder incrementally compresses the mesh in the presented order. Our coder is extremely memory efficient when the input stream documents when vertices are referenced for the last time (i.e. when it contains topological finalization tags). Our coder then continuously releases and reuses data structures that no longer contribute to compressing the remainder of the stream. This means in practice that our coder has only a small fraction of the whole mesh in memory at any time. We can therefore compress very large meshes - even meshes that do not file in memory. Compared to traditional, non-streaming approaches that load the entire mesh and globally reorder it during compression, our algorithm trades a less compact compressed representation for significant gains in speed, memory, and I/O efficiency. For example, on the 456k hexahedra 'blade' mesh, our coder is twice as fast and uses 88 times less memory (only 3.1 MB) with the compressed file increasing about 3% in size. We also present the first scheme for predictive compression of properties associated with hexahedral cells.

Reinforcement learning on slow features of high-dimensional input streams.

Directory of Open Access Journals (Sweden)

Robert Legenstein

Full Text Available Humans and animals are able to learn complex behaviors based on a massive stream of sensory information from different modalities. Early animal studies have identified learning mechanisms that are based on reward and punishment such that animals tend to avoid actions that lead to punishment whereas rewarded actions are reinforced. However, most algorithms for reward-based learning are only applicable if the dimensionality of the state-space is sufficiently small or its structure is sufficiently simple. Therefore, the question arises how the problem of learning on high-dimensional data is solved in the brain. In this article, we propose a biologically plausible generic two-stage learning system that can directly be applied to raw high-dimensional input streams. The system is composed of a hierarchical slow feature analysis (SFA network for preprocessing and a simple neural network on top that is trained based on rewards. We demonstrate by computer simulations that this generic architecture is able to learn quite demanding reinforcement learning tasks on high-dimensional visual input streams in a time that is comparable to the time needed when an explicit highly informative low-dimensional state-space representation is given instead of the high-dimensional visual input. The learning speed of the proposed architecture in a task similar to the Morris water maze task is comparable to that found in experimental studies with rats. This study thus supports the hypothesis that slowness learning is one important unsupervised learning principle utilized in the brain to form efficient state representations for behavioral learning.

Simulation of air velocity in a vertical perforated air distributor

Science.gov (United States)

Ngu, T. N. W.; Chu, C. M.; Janaun, J. A.

2016-06-01

Perforated pipes are utilized to divide a fluid flow into several smaller streams. Uniform flow distribution requirement is of great concern in engineering applications because it has significant influence on the performance of fluidic devices. For industrial applications, it is crucial to provide a uniform velocity distribution through orifices. In this research, flow distribution patterns of a closed-end multiple outlet pipe standing vertically for air delivery in the horizontal direction was simulated. Computational Fluid Dynamics (CFD), a tool of research for enhancing and understanding design was used as the simulator and the drawing software SolidWorks was used for geometry setup. The main purpose of this work is to establish the influence of size of orifices, intervals between outlets, and the length of tube in order to attain uniformity of exit flows through a multi outlet perforated tube. However, due to the gravitational effect, the compactness of paddy increases gradually from top to bottom of dryer, uniform flow pattern was aimed for top orifices and larger flow for bottom orifices.

Nitrogen saturation in stream ecosystems.

Science.gov (United States)

Earl, Stevan R; Valett, H Maurice; Webster, Jackson R

2006-12-01

The concept of nitrogen (N) saturation has organized the assessment of N loading in terrestrial ecosystems. Here we extend the concept to lotic ecosystems by coupling Michaelis-Menten kinetics and nutrient spiraling. We propose a series of saturation response types, which may be used to characterize the proximity of streams to N saturation. We conducted a series of short-term N releases using a tracer (15NO3-N) to measure uptake. Experiments were conducted in streams spanning a gradient of background N concentration. Uptake increased in four of six streams as NO3-N was incrementally elevated, indicating that these streams were not saturated. Uptake generally corresponded to Michaelis-Menten kinetics but deviated from the model in two streams where some other growth-critical factor may have been limiting. Proximity to saturation was correlated to background N concentration but was better predicted by the ratio of dissolved inorganic N (DIN) to soluble reactive phosphorus (SRP), suggesting phosphorus limitation in several high-N streams. Uptake velocity, a reflection of uptake efficiency, declined nonlinearly with increasing N amendment in all streams. At the same time, uptake velocity was highest in the low-N streams. Our conceptual model of N transport, uptake, and uptake efficiency suggests that, while streams may be active sites of N uptake on the landscape, N saturation contributes to nonlinear changes in stream N dynamics that correspond to decreased uptake efficiency.

Highly efficient star formation in NGC 5253 possibly from stream-fed accretion.

Science.gov (United States)

Turner, J L; Beck, S C; Benford, D J; Consiglio, S M; Ho, P T P; Kovács, A; Meier, D S; Zhao, J-H

2015-03-19

Gas clouds in present-day galaxies are inefficient at forming stars. Low star-formation efficiency is a critical parameter in galaxy evolution: it is why stars are still forming nearly 14 billion years after the Big Bang and why star clusters generally do not survive their births, instead dispersing to form galactic disks or bulges. Yet the existence of ancient massive bound star clusters (globular clusters) in the Milky Way suggests that efficiencies were higher when they formed ten billion years ago. A local dwarf galaxy, NGC 5253, has a young star cluster that provides an example of highly efficient star formation. Here we report the detection of the J = 3→2 rotational transition of CO at the location of the massive cluster. The gas cloud is hot, dense, quiescent and extremely dusty. Its gas-to-dust ratio is lower than the Galactic value, which we attribute to dust enrichment by the embedded star cluster. Its star-formation efficiency exceeds 50 per cent, tenfold that of clouds in the Milky Way. We suggest that high efficiency results from the force-feeding of star formation by a streamer of gas falling into the galaxy.

Free vibration analysis of perforated plate with square penetration pattern using equivalent material properties

Directory of Open Access Journals (Sweden)

Myung Jo Jhung

2015-06-01

Full Text Available In this study, the natural frequencies of the perforated square plate with a square penetration pattern are obtained as a function of ligament efficiency using the commercial finite-element analysis code ANSYS. In addition, they are used to extract the effective modulus of elasticity under an assumption of a constant Poisson's ratio. The effective modulus of elasticity of the fully perforated square plate is applied to the modal analysis of a partially perforated square plate using a homogeneous finite-element analysis model. The natural frequencies and the corresponding mode shapes of the homogeneous model are compared with the results of the detailed finite-element analysis model of the partially perforated square plate to check the validity of the effective modulus of elasticity. In addition, the theoretical method to calculate the natural frequencies of a partially perforated square plate with fixed edges is suggested according to the Rayleigh–Ritz method.

Low transient storage and uptake efficiencies in seven agricultural streams: implications for nutrient demand.

Science.gov (United States)

Sheibley, Richard W; Duff, John H; Tesoriero, Anthony J

2014-11-01

We used mass load budgets, transient storage modeling, and nutrient spiraling metrics to characterize nitrate (NO), ammonium (NH), and inorganic phosphorus (SRP) demand in seven agricultural streams across the United States and to identify in-stream services that may control these conditions. Retention of one or all nutrients was observed in all but one stream, but demand for all nutrients was low relative to the mass in transport. Transient storage metrics (/, , , and ) correlated with NO retention but not NH or SRP retention, suggesting in-stream services associated with transient storage and stream water residence time could influence reach-scale NO demand. However, because the fraction of median reach-scale travel time due to transient storage () was ≤1.2% across the sites, only a relatively small demand for NO could be generated by transient storage. In contrast, net uptake of nutrients from the water column calculated from nutrient spiraling metrics were not significant at any site because uptake lengths calculated from background nutrient concentrations were statistically insignificant and therefore much longer than the study reaches. These results suggest that low transient storage coupled with high surface water NO inputs have resulted in uptake efficiencies that are not sufficient to offset groundwater inputs of N. Nutrient retention has been linked to physical and hydrogeologic elements that drive flow through transient storage areas where residence time and biotic contact are maximized; however, our findings indicate that similar mechanisms are unable to generate a significant nutrient demand in these streams relative to the loads. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Percutaneous drainage in conservative therapy for perforated gastroduodenal ulcers.

Science.gov (United States)

Oida, Takatsugu; Kano, Hisao; Mimatsu, Kenji; Kawasaki, Atsushi; Kuboi, Youichi; Fukino, Nobutada; Kida, Kazutoshi; Amano, Sadao

2012-01-01

The management of peptic ulcers has dramatically changed and the incidence of elective surgery for gastroduodenal peptic ulcers has markedly decreased; hence, the incidence of emergency surgery for perforated peptic ulcers has slightly increased. In select cases, conservative therapy can be used as an alternative for treating perforated gastroduodenal ulcers. In this study, we evaluated the efficacy of percutaneous abdominal drainage for the conservative treatment of perforated gastroduodenal ulcers. We retrospectively studied 51 patients who had undergone conservative therapy for perforated gastroduodenal ulcers. These patients were divided into 2 groups on the basis of the initial treatment with conservative therapy with or without percutaneous drainage: group PD included patients who had undergone percutaneous drainage and group NPD, patients who had undergone non-percutaneous drainage. In the PD group, 14.3% (n=3) of the patients did not respond to conservative therapy, while this value was 43.3% (n=13) in the NPD group. The 2 groups differed significantly with respect to conversion from conservative therapy to surgery (pperforated gastroduodenal ulcers should be performed only in the case of patients meeting the required criteria; its combination with percutaneous intraperitoneal drainage is effective as initial conservative therapy.

Evaluating performance of high efficiency mist eliminators

Energy Technology Data Exchange (ETDEWEB)

Waggoner, Charles A.; Parsons, Michael S.; Giffin, Paxton K. [Mississippi State University, Institute for Clean Energy Technology, 205 Research Blvd, Starkville, MS (United States)

2013-07-01

Processing liquid wastes frequently generates off gas streams with high humidity and liquid aerosols. Droplet laden air streams can be produced from tank mixing or sparging and processes such as reforming or evaporative volume reduction. Unfortunately these wet air streams represent a genuine threat to HEPA filters. High efficiency mist eliminators (HEME) are one option for removal of liquid aerosols with high dissolved or suspended solids content. HEMEs have been used extensively in industrial applications, however they have not seen widespread use in the nuclear industry. Filtering efficiency data along with loading curves are not readily available for these units and data that exist are not easily translated to operational parameters in liquid waste treatment plants. A specialized test stand has been developed to evaluate the performance of HEME elements under use conditions of a US DOE facility. HEME elements were tested at three volumetric flow rates using aerosols produced from an iron-rich waste surrogate. The challenge aerosol included submicron particles produced from Laskin nozzles and super micron particles produced from a hollow cone spray nozzle. Test conditions included ambient temperature and relative humidities greater than 95%. Data collected during testing HEME elements from three different manufacturers included volumetric flow rate, differential temperature across the filter housing, downstream relative humidity, and differential pressure (dP) across the filter element. Filter challenge was discontinued at three intermediate dPs and the filter to allow determining filter efficiency using dioctyl phthalate and then with dry surrogate aerosols. Filtering efficiencies of the clean HEME, the clean HEME loaded with water, and the HEME at maximum dP were also collected using the two test aerosols. Results of the testing included differential pressure vs. time loading curves for the nine elements tested along with the mass of moisture and solid

Non-equilibrium microwave plasma for efficient high temperature chemistry

NARCIS (Netherlands)

van den Bekerom, D.C.M.; den Harder, N.; Minea, T.; Palomares Linares, J.M.; Bongers, W.; van de Sanden, M.C.M.; van Rooij, G.J.

2017-01-01

This article describes a flowing microwave reactor that is used to drive efficient non-equilibrium chemistry for the application of conversion/activation of stable molecules such as CO2, N2 and CH4. The goal of the procedure described here is to measure the in situ gas temperature and gas

Pneumatosis cystoides intestinalis associated with massive free air mimicking perforated diffuse peritonitis

OpenAIRE

Sakurai, Yoichi; Hikichi, Masahiro; Isogaki, Jun; Furuta, Shinpei; Sunagawa, Risaburo; Inaba, Kazuki; Komori, Yoshiyuki; Uyama, Ichiro

2008-01-01

While pneumatosis cystoides intestinalis (PCI) is a rare disease entity associated with a wide variety of gastrointestinal and non-gastrointestinal disorders, PCI associated with massive intra- and retroperitoneal free air is extremely uncommon, and is difficult to diagnose differentially from perforated peritonitis. We present two cases of PCI associated with massive peritoneal free air and/or retroperitoneal air that mimicked perforated peritonitis. These cases highlight the clinical import...

Perforated peptic ulcer in an infant.

Science.gov (United States)

Feng, C Y; Hsu, W M; Chen, Y

2001-02-01

We describe a case of perforated peptic ulcer (PPU) in a 9-month-old boy. Abdominal distension was the first clinical sign of PPU. Before he developed abdominal distension, the patient had suffered from an upper respiratory tract infection with fever for about 2 weeks, which was treated intermittently with ibuprofen. A plain abdominal radiograph revealed pneumoperitoneum with a football sign. At laparotomy, a 0.8-cm perforated hole was found over the prepyloric area. Simple closure with omental patching was performed after debridement of the perforation. Pathologic examination showed chronic peptic ulcer with Helicobacter pylori infection. The postoperative course and outcome were satisfactory. The stress of underlying disease, use of ibuprofen, blood type (A), and H. pylori infection might have contributed to the development of PPU in this patient. PPU in infancy is rare and has a high mortality rate; early recognition and prompt surgical intervention are key to successful management.

Outcome and management of invasive candidiasis following oesophageal perforation.

Science.gov (United States)

Hoffmann, Martin; Kujath, Peter; Vogt, Florian-M; Laubert, Tilman; Limmer, Stefan; Mulrooney, Thomas; Bruch, Hans-Peter; Jungbluth, Thomas; Schloericke, Erik

2013-03-01

The regular colonisation of the oesophagus with a Candida species can, after oesophageal perforation, result in a contamination of the mediastinum and the pleura with a Candida species. A patient cohort of 80 patients with oesophageal perforation between 1986 and 2010 was analysed retrospectively. The most common sources with positive results for Candida were mediastinal biopsies and broncho-alveolar secretions. Candida species were detected in 30% of the patients. The mortality rate was 41% in patients with positive microbiology results for Candida, whereas it was 23% in the remaining patient cohort. This difference did not reach statistical significance (P = 0.124). Mortality associated with oesophageal perforation was attributed mainly to septic complications, such as mediastinitis and severe pneumonia. During the study period we observed a shift towards non-albicans species that were less susceptible or resistant to fluconazole. In selected patients with risk factors as immunosuppression, granulocytopenia and long-term intensive-care treatment together with the finding of Candida, an antimycotic therapy should be started. A surgical approach offers the possibility to obtain deep tissue biopsies. The antimycotic therapy should start with an echinocandin, as the resistance to fluconazole is growing and to cover non-albicans Candida species, too. © 2012 Blackwell Verlag GmbH.

Perforated small intestine in a patient with T-cell lymphoma; a rare cause of peritonitis

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Petrişor Banu

2016-04-01

Full Text Available The nontraumatic perforations of the small intestine are pathological entities with particular aspects in respect to diagnosis and treatment. These peculiarities derive from the nonspecific clinical expression of the peritonitis syndrome, and from the multitude of causes that might be the primary sources of the perforation: foreign bodies, inflammatory diseases, tumors, infectious diseases, etc. Accordingly, in most cases intestinal perforation is discovered only by laparotomy and the definitive diagnosis is available only after histopathologic examination. Small bowel malignancies are rare; among them, lymphomas rank third in frequency, being mostly B-cell non Hodgkin lymphomas. Only 10% of non-Hodgkin lymphomas are with T-cell. We report the case of a 57 years’ old woman with intestinal T-cell lymphoma, whose first clinical symptomatology was related to a complication represented by perforation of the small intestine. Laparotomy performed in emergency identified an ulcerative lesion with perforation in the jejunum, which required segmental enterectomy with anastomosis. The nonspecific clinical manifestations of intestinal lymphomas make from diagnosis a difficult procedure. Due to the fact that surgery does not have a definite place in the treatment of the small intestinal lymphomas (for cases complicated with perforation, and beyond the morbidity associated with the surgery performed in emergency conditions, prognosis of these patients is finally given by the possibility to control the systemic disease through adjuvant therapy.

Perforated coins from graves at the Viminacium necropolis of Više Grobalja

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Vojvoda Mirjana D.

2015-01-01

Full Text Available A common problem that occurs when interpreting finds of perforated Roman coins is whether they had been perforated in Roman times or later. Hence, the specimens that originate from an undisturbed archaeological context, as is the case with finds from the Viminacium necropolis of Više Grobalja, are indispensable. A total of 47 perforated coins were discovered: 31 with a single and 16 with three perforations. The analysis of the context of the finds, in some specimens, allows the confident assertion that they had constituted a part of jewellery. [Projekat Ministarstva nauke Republike Srbije, br. 47018: IRS - Viminacium, Roman city and military legion camp - research of the material and non-material culture of inhabitants using the latest technologies of remote detection, geophysics, GIS, digitalisation and 3D visualisation

CT findings of exophageal perforation

Energy Technology Data Exchange (ETDEWEB)

Heo, Jeong Nam; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Hahm, Chang Kok [Hanyang University College of Medicine, Seoul (Korea, Republic of)

2002-09-01

To determine which CT findings are useful for the early disgnosis of esophageal perforation, and on the basis of these findings, to assess the accuracy of prediction of the perforation site. A review of medical records indicated that between January 1995 and December 2001, 36 patients with esophageal perforation were admitted to our hospital. Thirteen of these [M:F=8:5, age; 28-69 (mean, 52.4) years], who had undergone CT chest scanning, were included in this study. The causes of esophageal perforation were trauma (n=5), infectious diseases (n=4), Boerhaave syndrome (n=1), lung cancer (n=1), esophageal cancer (n=1), and idiopathic. Two chest radiologists unaware of the clinical findings reviewed the CT scans and predicted whether the upper or lower esophagus was perforated. The most common CT finding was extraluminal air at the posterior mediastinum (n=11), while other findings included pulmonary consolidation (n=10), pleural effusion (n=7), discontinuity of the esophageal wall (n=6) and subcutaneous emphysema (n=4), fluid collection around the esophagus (n-4), esophageal wall thickening (n=4), pneumothorax (n=2), and lung abscess (n=2). The perforation site was accurately predicted in 76.9% of cases (10/13). The CT findings which help the diagnosis of esophageal perforation, and prediction of the sites at which it occurs, are extraluminal air of fluid collection, focal defect of the esophageal wall, and esophageal wall thickening.

CT findings of exophageal perforation

International Nuclear Information System (INIS)

Heo, Jeong Nam; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Hahm, Chang Kok

2002-01-01

To determine which CT findings are useful for the early disgnosis of esophageal perforation, and on the basis of these findings, to assess the accuracy of prediction of the perforation site. A review of medical records indicated that between January 1995 and December 2001, 36 patients with esophageal perforation were admitted to our hospital. Thirteen of these [M:F=8:5, age; 28-69 (mean, 52.4) years], who had undergone CT chest scanning, were included in this study. The causes of esophageal perforation were trauma (n=5), infectious diseases (n=4), Boerhaave syndrome (n=1), lung cancer (n=1), esophageal cancer (n=1), and idiopathic. Two chest radiologists unaware of the clinical findings reviewed the CT scans and predicted whether the upper or lower esophagus was perforated. The most common CT finding was extraluminal air at the posterior mediastinum (n=11), while other findings included pulmonary consolidation (n=10), pleural effusion (n=7), discontinuity of the esophageal wall (n=6) and subcutaneous emphysema (n=4), fluid collection around the esophagus (n-4), esophageal wall thickening (n=4), pneumothorax (n=2), and lung abscess (n=2). The perforation site was accurately predicted in 76.9% of cases (10/13). The CT findings which help the diagnosis of esophageal perforation, and prediction of the sites at which it occurs, are extraluminal air of fluid collection, focal defect of the esophageal wall, and esophageal wall thickening

Glove Perforations During Interventional Radiological Procedures

International Nuclear Information System (INIS)

Leena, R. V.; Shyamkumar, N. K.

2010-01-01

Intact surgical gloves are essential to avoid contact with blood and other body fluids. The objective of this study was to estimate the incidence of glove perforations during interventional radiological procedures. In this study, a total of 758 gloves used in 94 interventional radiological procedures were examined for perforations. Eleven perforations were encountered, only one of which was of occult type. No significant difference in the frequency of glove perforation was found between the categories with varying time duration.

Nontrivial influence of acoustic streaming on the efficiency of annular thermoacoustic prime movers

International Nuclear Information System (INIS)

Penelet, G.; Gusev, V.; Lotton, P.; Bruneau, M.

2006-01-01

The nonlinear processes controlling the time-dependent evolution of sound in annular thermoacoustic prime movers are studied. It is demonstrated that, under some heating conditions, the evolution of the temperature field induced by the excitation of acoustic streaming provides an additional amplification of sound which results in a complicated periodic onset and damping of thermoacoustic instability. The study of this particular example provides the opportunity to demonstrate that the excitation of acoustic streaming does not necessarily imply a decrease in the engine's efficiency

Typhoid ileal perforation: a 13-year experience

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Poras Chaudhary

2015-07-01

Full Text Available Typhoid fever is endemic in many developing countries with a high rate of complications. Aim of this study is to analyse epidemiological features, clinical presentations, complications and therapeutic outcomes of enteric perforation peritonitis diagnosed and treated in our hospital. Records of total number of 646 patients, who presented with perforation peritonitis due to enteric fever in the surgical emergency unit of Dr Ram Manohar Lohia hospital, New Delhi between January 2001 and December 2013, were reviewed retrospectively. Descriptive statistics was used to analyze the data. Out of 646 patients, 62 (9.59% presented in shock. Stomal, peristomal, local and systemic complications were high in these patients. Primary closure was done in 212 (33.12 patients, primary ileostomy was created in 410 (64.06 patients, and resection and anastomosis was done in 24 (3.75 patients. Thirteen patients (2.01% died of typhoid intestinal perforation. To prevent complications of typhoid fever, in addition to control sanitation, it is also important to control quackery and malpractices. Awareness and education about the disease, its nature and complications will also be of great help.

Efficiency and Loading Evaluation of High Efficiency Mist Eliminators (HEME) - 12003

Energy Technology Data Exchange (ETDEWEB)

Giffin, Paxton K.; Parsons, Michael S.; Waggoner, Charles A. [Institute for Clean Energy Technology, Mississippi State University, 205 Research Blvd Starkville, MS 39759 (United States)

2012-07-01

High efficiency mist eliminators (HEME) are filters primarily used to remove moisture and/or liquid aerosols from an air stream. HEME elements are designed to reduce aerosol and particulate load on primary High Efficiency Particulate Air (HEPA) filters and to have a liquid particle removal efficiency of approximately 99.5% for aerosols down to sub-micron size particulates. The investigation presented here evaluates the loading capacity of the element in the absence of a water spray cleaning system. The theory is that without the cleaning system, the HEME element will suffer rapid buildup of solid aerosols, greatly reducing the particle loading capacity. Evaluation consists of challenging the element with a waste surrogate dry aerosol and di-octyl phthalate (DOP) at varying intervals of differential pressure to examine the filtering efficiency of three different element designs at three different media velocities. Also, the elements are challenged with a liquid waste surrogate using Laskin nozzles and large dispersion nozzles. These tests allow the loading capacity of the unit to be determined and the effectiveness of washing down the interior of the elements to be evaluated. (authors)

Spectrum of perforation peritonitis in delhi: 77 cases experience.

Science.gov (United States)

Yadav, Dinesh; Garg, Puneet K

2013-04-01

Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well in India. The spectrum of etiology of perforation peritonitis in tropical countries continues to differ from its western counterpart. This study was conducted at Hindu Rao Hospital, Municipal Corporation of Delhi, New Delhi, India, designed to highlight the spectrum of perforation peritonitis in the eastern countries and to improve its outcome. This prospective study included 77 consecutive patients of perforation peritonitis studied in terms of clinical presentations, causes, site of perforation, surgical treatment, postoperative complications, and mortality at Hindu Rao Hospital, Delhi, from March 1, 2011 to December 1, 2011, over a period of 8 months. All patients were resuscitated and underwent emergency exploratory laparotomy. On laparotomy cause of perforation peritonitis was found and controlled. The most common cause of perforation peritonitis noticed in our series was perforated duodenal ulcer (26.4 %) and ileal typhoid perforation (26.4 %), each followed by small bowel tuberculosis (10.3 %) and stomach perforation (9.2 %), perforation due to acute appendicitis (5 %). The highest number of perforations was seen in ileum (39.1 %), duodenum (26.4 %), stomach (11.5 %), appendix (3.5 %), jejunum (4.6 %), and colon (3.5 %). Overall mortality was 13 %. The spectrum of perforation peritonitis in India continuously differs from western countries. The highest number of perforations was noticed in the upper part of the gastrointestinal tract as compared to the western countries where the perforations seen mostly in the distal part. The most common cause of perforation peritonitis was perforated duodenal ulcer and small bowel typhoid perforation followed by typhoid perforation. Large bowel perforations and malignant perforations were least common in our setup.

Acute spontaneous gastric perforation in neonates: A report of three ...

African Journals Online (AJOL)

Gastric perforation in neonates is a rare, serious and life-threatening problem. The precise aetiology is obscure in most cases. By virtue of its high mortality rate, it requires prompt recognition and surgical intervention. We report three cases of neonatal gastric perforation managed by early resuscitation and primary repair.

Comparison of Thermal Performances between Low Porosity Perforate Plate and Flat Plate Solar Air Collector

Science.gov (United States)

Chan, Hoy-Yen; Vinson, A. A.; Baljit, S. S. S.; Ruslan, M. H.

2018-04-01

Flat plate solar air collector is the most common collector design, which is relatively simpler to fabricate and lower cost. In the present study, perforated plate solar collector was developed to improve the system thermal performance. A glazed perforated plate of 6mm holes diameter with square geometry was designed and installed as the absorber of the collector. The influences of solar radiation intensity and mass flow rate on the thermal performance were investigated. The perforated collector was compared with the flat plate solar collector under the same operating conditions. The highest values of thermal efficiency in this study for the perforated plate (PP) and the flat plate (FP) solar collectors were 59% and 36% respectively, at solar radiation intensity of 846 Wm-2 and mass flow rate of 0.02 kgs-1. Furthermore, PP collector gave better thermal performance compared to FP collector; and compared to previous studies, the present perforated design was compatible with the flat plate with double pass designs.

The management of large perforations of duodenal ulcers

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Sharma Rajeev

2005-06-01

Full Text Available Abstract Background Duodenal ulcer perforations are a common surgical emergency, but literature is silent on the exact definition, incidence, management and complications of large perforations of duodenal ulcers. Methods The case files of 162 patients who underwent emergency laparotomy for duodenal ulcer perforations over a period of three years (2001 – 2003 were retrospectively reviewed and sorted into groups based on the size of the perforations – one group was defined as 'small 'perforations (less than 1 cm in diameter, another 'large' (when the perforation was more than 1 cm but less than 3 cms, and the third, 'giant'(when the perforation exceeded 3 cm. These groups of patients were then compared with each other in regard to the patient particulars, duration of symptoms, surgery performed and the outcome. Results A total of 40 patients were identified to have duodenal ulcer perforations more than 1 cm in size, thus accounting for nearly 25 % of all duodenal ulcer perforations operated during this period. These patients had a significantly higher incidence of leak, morbidity and mortality when compared to those with smaller perforations. Conclusion There are three distinct types of perforations of duodenal ulcers that are encountered in clinical practice. The first, are the 'small' perforations that are easy to manage and have low morbidity and mortality. The second are the 'large' perforations, that are also not uncommon, and omental patch closure gives the best results even in this subset of patients. The word 'giant' should be reserved for perforations that exceed 3 cms in diameter, and these are extremely uncommon.

Real scale experimental study for performance evaluation of unidirectional air diffuser perforated panels

Science.gov (United States)

Tăcutu, Laurenţiu; Nastase, Ilinca; Iordache, Vlad; Catalina, Tiberiu; Croitoru, Cristiana Verona

2018-02-01

Nowadays, there is an increasing emphasis on indoor air quality due to technological evolution and the fact that people spend most of the time in enclosed spaces. Also, energy efficiency is another related factor that gains more and more attention. Improving air distribution in an enclosure can lead to achieve these goals. This improvement can be done by adjustingthe air terminals position, theredimensions or the air diffuser perforations. The paper presents the study of 8 types of panels with different perforations shapes. The systems were characterized by flow, pressure loss and noise. Usualand special geometries were chosen, all having the same flowsurface. The perforated panels were mounted in a unidirectional air flow (UAF)diffuser, also called a laminar air flow (LAF)diffuser, that is placed in a real scale operating room (OR) in our laboratory.The purpose of this study is to determine whether changing the shape in the perforated panels can improve the technical parameters of the diffuser.

A method for the separation of non-ferrous metal containing particles from a particle stream

NARCIS (Netherlands)

Van der Weijden, R.D.; Rem, P.C.

2004-01-01

The invention relates to a method for the recovery of non-ferrous metal-comprising particles from a particle stream. According to the invention, the particle stream is put onto a conveyor belt in the form of a monolayer such that with the aid of a liquid, at least the non-ferrous metal comprising

A Case Report of Stercoraceous Perforation of the Cecum due to Scybalum

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HR Khorshidi

2006-10-01

Introduction & Objective: Non-traumatic colon perforations are usually caused by malignancy, diverticulum and colitis. Stercoraceous perforation of the colon has rarely been reported in the literature. This lesion is assumed to be produced by the pressure from a hard scybalum resulting in a perforated ulcer with necrotic edges. We report a case of stercoraceous perforation of the cecum due to scybalum. Case: We report a 50-year-old man who had a severe abdominal pain from 3 days ago and had peritonitis in physical exam. He was admitted in Mars, 2005 at Mobasher Kashani Hospital in Hamadan and he was parapelegic from 8 months ago due to trauma in his medical history and then he had severe and chronic constipation that necessitated the use of cathartic drugs. We operated him with diagnosis of peritonitis, and perforation of cecum due to scybalum was seen and right hemicolectomy and colostomy and ileostomy was done. Conclusion: The most common site of colon perforation due to scybalum is rectosigmoid area and cecal perforation is a rare area in the literature. It is presented with peritonitis in old patients that have chronic constipation. It is difficult to diagnose this lesion preoperatively. This lesion was only 11% correctly diagnosed before operation and should be always suspected when a patient with chronic constipation suffers from sudden abdominal pain. Resection and colostomy is the treatment of choice in most situations.

Laparoscopic pyloroplasty for perforated peptic ulcer.

Science.gov (United States)

Grišin, Edvard; Mikalauskas, Saulius; Poškus, Tomas; Jotautas, Valdemaras; Strupas, Kęstutis

2017-09-01

Peptic ulcer is a common disease affecting millions of people every year. Despite improved understanding and treatment of the disease, the number of patients admitted with duodenal peptic ulcer perforation has not decreased. Deaths from peptic ulcer disease overcome other common emergency situations. Laparoscopic repair of the perforated peptic ulcer (PPU) is the gold standard approach for simple perforation. However, in patients with large perforated chronic ulcers laparotomy with pyloroplasty is the standard treatment. It is generally accepted to perform open surgery in PPU emergencies because of the greater knowledge and experience gathered over the past decades and less potential harm for the patient or surgical complications. We present a case of successful laparoscopic pyloroplasty of a perforated duodenal ulcer with stenosis.

Perforating arteries originating from the posterior communicating artery: a 7.0-Tesla MRI study

Energy Technology Data Exchange (ETDEWEB)

Conijn, Mandy M.A.; Hendrikse, Jeroen; Takahara, Taro; Mali, Willem P.T.M. [University Medical Center Utrecht, Department of Radiology (Hp E 01.132), P.O. Box 85500, Utrecht (Netherlands); Zwanenburg, Jaco J.M. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Geerlings, Mirjam I. [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Luijten, Peter R. [University Medical Center Utrecht, Department of Radiology (Hp E 01.132), P.O. Box 85500, Utrecht (Netherlands); University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands)

2009-12-15

The aim of this study was to investigate the ability of time-of-flight (TOF) magnetic resonance (MR) angiography at 7.0 Tesla to show the perforating branches of the posterior communicating artery (PCoA), and to investigate the presence of such visible perforating branches in relation to the size of the feeding PCoA. The secondary aim was to visualise and describe the anterior choroidal artery and the perforating branches of the P1-segment of posterior cerebral artery (P1). Forty-six healthy volunteers underwent TOF MR angiography at 7.0 Tesla. With 7.0-Tesla imaging, we visualised for the first time perforating arteries originating from the PCoA in vivo without the use of contrast agents. A perforating artery from the PCoA was found in a large proportion of the PCoAs (64%). The presence was associated with a larger diameter of the underlying PCoA (1.23 versus 1.06 mm, P = 0.03). The anterior choroidal artery was visible bilaterally in all participants. In 83% of all P1s, one or two perforating branches were visible. Non-invasive assessment of the perforating arteries of the PCoA together with the anterior choroidal artery and the perforating arteries of the P1 may increase our understanding of infarcts in the deep brain structures supplied by these arteries. (orig.)

Perforating arteries originating from the posterior communicating artery: a 7.0-Tesla MRI study

International Nuclear Information System (INIS)

Conijn, Mandy M.A.; Hendrikse, Jeroen; Takahara, Taro; Mali, Willem P.T.M.; Zwanenburg, Jaco J.M.; Geerlings, Mirjam I.; Luijten, Peter R.

2009-01-01

The aim of this study was to investigate the ability of time-of-flight (TOF) magnetic resonance (MR) angiography at 7.0 Tesla to show the perforating branches of the posterior communicating artery (PCoA), and to investigate the presence of such visible perforating branches in relation to the size of the feeding PCoA. The secondary aim was to visualise and describe the anterior choroidal artery and the perforating branches of the P1-segment of posterior cerebral artery (P1). Forty-six healthy volunteers underwent TOF MR angiography at 7.0 Tesla. With 7.0-Tesla imaging, we visualised for the first time perforating arteries originating from the PCoA in vivo without the use of contrast agents. A perforating artery from the PCoA was found in a large proportion of the PCoAs (64%). The presence was associated with a larger diameter of the underlying PCoA (1.23 versus 1.06 mm, P = 0.03). The anterior choroidal artery was visible bilaterally in all participants. In 83% of all P1s, one or two perforating branches were visible. Non-invasive assessment of the perforating arteries of the PCoA together with the anterior choroidal artery and the perforating arteries of the P1 may increase our understanding of infarcts in the deep brain structures supplied by these arteries. (orig.)

Perforating arteries originating from the posterior communicating artery: a 7.0-Tesla MRI study.

Science.gov (United States)

Conijn, Mandy M A; Hendrikse, Jeroen; Zwanenburg, Jaco J M; Takahara, Taro; Geerlings, Mirjam I; Mali, Willem P Th M; Luijten, Peter R

2009-12-01

The aim of this study was to investigate the ability of time-of-flight (TOF) magnetic resonance (MR) angiography at 7.0 Tesla to show the perforating branches of the posterior communicating artery (PCoA), and to investigate the presence of such visible perforating branches in relation to the size of the feeding PCoA. The secondary aim was to visualise and describe the anterior choroidal artery and the perforating branches of the P1-segment of posterior cerebral artery (P1). Forty-six healthy volunteers underwent TOF MR angiography at 7.0 Tesla. With 7.0-Tesla imaging, we visualised for the first time perforating arteries originating from the PCoA in vivo without the use of contrast agents. A perforating artery from the PCoA was found in a large proportion of the PCoAs (64%). The presence was associated with a larger diameter of the underlying PCoA (1.23 versus 1.06 mm, P = 0.03). The anterior choroidal artery was visible bilaterally in all participants. In 83% of all P1s, one or two perforating branches were visible. Non-invasive assessment of the perforating arteries of the PCoA together with the anterior choroidal artery and the perforating arteries of the P1 may increase our understanding of infarcts in the deep brain structures supplied by these arteries.

CLINICAL STUDY OF DUODENAL PERFORATION

Directory of Open Access Journals (Sweden)

Sambasiva Rao

2016-04-01

Full Text Available BACKGROUND The duodenal injury can pose a formidable challenge to the surgeon and failure to manage it properly may have devastating results. Over the centuries, there was little to offer the patient of acute abdomen beyond cupping, purgation and enemas, all of which did more harm than good. It was not until 1884 that Mikulicz made an attempt to repair a perforation. Recent statistics indicate roughly 10% of population develop gastric or duodenal ulcer in life time. Roughly 1-3% of population above the age of 20 years have some degree of peptic ulcer activity during any annual period. A detailed history with regards to the signs and symptoms of the patient, a meticulous examination, radiological and biochemical investigations help to arrive at a correct preoperative diagnosis. In this study, a sincere effort has been put to understand the demographic patterns, to understand the underlying aetiology and to understand the effectiveness of the standard methods of investigation and treatment in use today. METHODS This is a 24 months prospective study i.e., from September 2011 to September 2013 carried out at Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation. The study included the patients presenting to Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation to emergency ward with signs and symptoms of hollow viscus perforation. The sample size included 30 cases of duodenal perforation. RESULTS Duodenal ulcer perforation commonly occurs in the age group of 30-60 years, but it can occur in any age group. Majority of the patients were male. Smoking and alcohol consumption were risk factors in most cases (53.3% for the causation of duodenal ulcer perforation. Sudden onset of abdominal pain, situated at epigastrium and right hypochondrium was a constant symptom (100%. Vomiting, constipation and fever were not so common. CONCLUSION The emergency surgical management for perforated duodenal ulcer is by

Performance Study of Solar Air Heater Having Absorber Plate with Half-Perforated Baffles

OpenAIRE

Maheshwari, B. K.; Karwa, Rajendra; Gharai, S. K.

2011-01-01

The paper presents a detailed mathematical model for performance prediction of a smooth duct solar air heater validated against the experimental results. Experimental study on a solar air heater having absorber plate with half-perforated baffles on the air flow side shows thermal efficiency enhancement of 28%–45% over that of the smooth duct solar air heater, which is attributed to the heat transfer enhancement (of the order of 180%–235%) due to the perforated baffles attached to the absorber...

A perforated diverticulum in Cushing's disease

OpenAIRE

de Havenon, Adam; Ehrenkranz, Joel

2011-01-01

We report a case of perforated colonic diverticulum in Cushing's disease. Although perforated diverticuli have been described in patients with Cushing's syndrome secondary to exogenous glucocorticoids, this complication has not been described in patients with Cushing's disease. Patients with hypercortisolism, from either exogenous or endogenous sources, should be monitored for diverticular perforation.

Risk of surgical glove perforation in oral and maxillofacial surgery.

Science.gov (United States)

Kuroyanagi, N; Nagao, T; Sakuma, H; Miyachi, H; Ochiai, S; Kimura, Y; Fukano, H; Shimozato, K

2012-08-01

Oral and maxillofacial surgery, which involves several sharp instruments and fixation materials, is consistently at a high risk for cross-contamination due to perforated gloves, but it is unclear how often such perforations occur. This study aimed to address this issue. The frequency of the perforation of surgical gloves (n=1436) in 150 oral and maxillofacial surgeries including orthognathic surgery (n=45) was assessed by the hydroinsufflation technique. Orthognathic surgery had the highest perforation rate in at least 1 glove in 1 operation (91.1%), followed by cleft lip and palate surgery (55.0%), excision of oral soft tumour (54.5%) and dental implantation (50.0%). The perforation rate in scrub nurses was 63.4%, followed by 44.4% in surgeons and first assistants, and 16.3% in second assistants. The odds ratio for the perforation rate in orthognathic surgery versus other surgeries was 16.0 (95% confidence interval: 5.3-48.0). The protection rate offered by double gloving in orthognathic surgery was 95.2%. These results suggest that, regardless of the surgical duration and blood loss in all fields of surgery, orthognathic surgery must be categorized in the highest risk group for glove perforation, following gynaecological and open lung surgery, due to the involvement of sharp objects. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

High-efficiency white organic light-emitting devices with a non-doped yellow phosphorescent emissive layer

Energy Technology Data Exchange (ETDEWEB)

Zhao Juan; Yu Junsheng, E-mail: jsyu@uestc.edu.cn; Hu Xiao; Hou Menghan; Jiang Yadong

2012-03-30

Highly efficient phosphorescent white organic light-emitting devices (PHWOLEDs) with a simple structure of ITO/TAPC (40 nm)/mCP:FIrpic (20 nm, x wt.%)/bis[2-(4-tertbutylphenyl)benzothiazolato-N,C{sup 2} Prime ] iridium (acetylacetonate) (tbt){sub 2}Ir(acac) (y nm)/Bphen (30 nm)/Mg:Ag (200 nm) have been developed, by inserting a thin layer of non-doped yellow phosphorescent (tbt){sub 2}Ir(acac) between doped blue emitting layer (EML) and electron transporting layer. By changing the doping concentration of the blue EML and the thickness of the non-doped yellow EML, a PHWOLED comprised of higher blue doping concentration and thinner yellow EML achieves a high current efficiency of 31.7 cd/A and Commission Internationale de l'Eclairage coordinates of (0.33, 0.41) at a luminance of 3000 cd/m{sup 2} could be observed. - Highlights: Black-Right-Pointing-Pointer We introduce a simplified architecture for phosphorescent white organic light-emitting device. Black-Right-Pointing-Pointer The key concept of device fabrication is combination of doped blue emissive layer (EML) with non-doped ultra-thin yellow EML. Black-Right-Pointing-Pointer Doping concentration of the blue EML and thickness of the yellow EML are sequentially adjusted. Black-Right-Pointing-Pointer High device performance is achieved due to improved charge carrier balance as well as two parallel emission mechanisms in the EMLs.

Neutron streaming evaluation for the DREAM fusion power reactor

International Nuclear Information System (INIS)

Seki, Yasushi; Nishio, Satoshi; Ueda, Shuzo; Kurihara, Ryoichi

2000-01-01

Aiming at high degree of safety and benign environmental effect, we have proposed a tokamak fusion reactor concept called DREAM, which stands for DRastically EAsy Maintenance Reactor. The blanket structure of the reactor is made from very low activation SiC/SiC composites and cooled by non-reactive helium gas. High net thermal efficiency of about 50% is realized by 900 C helium gas and high plant availability is possible with simple maintenance scheme. In the DREAM Reactor, neutron streaming is a big problem because cooling pipes with diameter larger than 80 cm are used for blanket heat removal. Neutron streaming through the cooling pipes could cause hot spots in the superconducting magnets adjacent to the cooling pipes to shorten the magnet lifetime or increase cryogenic cooling requirement. Neutron streaming could also activate components such as gas turbine further away from the fusion plasma. The effect of neutron streaming through the helium cooling pipes was evaluated for the two types of cooling pipe extraction scheme. The result of a preliminary calculation indicates the gas turbine activation prohibits personnel access in the case of inboard pipe extraction while with additional shielding measures, limited contact maintenance is possible in the case of outboard extraction. (author)

Fs-laser-induced Ca2+ concentration change during membrane perforation for cell transfection.

Science.gov (United States)

Baumgart, J; Bintig, W; Ngezahayo, A; Lubatschowski, H; Heisterkamp, A

2010-02-01

Fs-laser based opto-perforation is a gentle method for gene transfer into sensitive cells such as stem cells or primary cells. The high selectivity and the low damage to the cell lead to a high efficiency of transfection. However, there are side effects which induce stress to the cell due to the exchange of intra- and extracellular media as well as the disintegration of the structure of biomolecules resulting from the laser exposure. Moreover, the mechanisms of the optical transfection are still unclear. In this paper, we present our study on calcium (Ca(2+)) homeostasis during cell surgery, especially during laser induced membrane perforation. We show that the manipulation of cells can induce an increase in the cytosolic Ca(2+) concentration. This increase was not observed if the manipulation of the cells was performed in absence of the extracellular calcium indicating the importance of the Ca(2+) uptake. We found, that the uptake of extracellular Ca(2+) strongly depends on the repetition rate and the irradiation time of the laser pulses. The exposure for several seconds to kHz pulses even induces Ca(2+) induced Ca(2+) release. Dependent on the location of perforation, probably in the vicinity of an intracellular Ca(2+) stock, an instantaneous intracellular Ca(2+) release can be induced. Since Ca(2+) could be involved in negative side effect by cell surgery, we propose an application of the optoperforation technique in nominal Ca(2+)-free external solution.

Response of non-added solutes during nutrient addition experiments in streams

Science.gov (United States)

Rodriguez-Cardona, B.; Wymore, A.; Koenig, L.; Coble, A. A.; McDowell, W. H.

2015-12-01

Nutrient addition experiments, such as Tracer Additions for Spiraling Curve Characterization (TASCC), have become widely popular as a means to study nutrient uptake dynamics in stream ecosystems. However, the impact of these additions on ambient concentrations of non-added solutes is often overlooked. TASCC addition experiments are ideal for assessing interactions among solutes because it allows for the characterization of multiple solute concentrations across a broad range of added nutrient concentrations. TASCC additions also require the addition of a conservative tracer (NaCl) to track changes in conductivity during the experimental manipulation. Despite its use as a conservative tracer, chloride (Cl) and its associated sodium (Na) might change the concentrations of other ions and non-added nutrients through ion exchange or other processes. Similarly, additions of biologically active solutes might change the concentrations of other non-added solutes. These methodological issues in nutrient addition experiments have been poorly addressed in the literature. Here we examine the response of non-added solutes to pulse additions (i.e. TASCC) of NaCl plus nitrate (NO3-), ammonium, and phosphate across biomes including temperate and tropical forests, and arctic taiga. Preliminary results demonstrate that non-added solutes respond to changes in the concentration of these added nutrients. For example, concentrations of dissolved organic nitrogen (DON) in suburban headwater streams of New Hampshire both increase and decrease in response to NO3- additions, apparently due to biotic processes. Similarly, cations such as potassium, magnesium, and calcium also increase during TASCC experiments, likely due to cation exchange processes associated with Na addition. The response of non-added solutes to short-term pulses of added nutrients and tracers needs to be carefully assessed to ensure that nutrient uptake metrics are accurate, and to detect biotic interactions that may

Adding Live-Streaming to Recorded Lectures in a Non-Distributed Pre-Clerkship Medical Education Model.

Science.gov (United States)

Sandhu, Amanjot; Fliker, Aviva; Leitao, Darren; Jones, Jodi; Gooi, Adrian

2017-01-01

Live-streaming video has had increasing uses in medical education, especially in distributed education models. The literature on the impact of live-streaming in non-distributed education models, however, is scarce. To determine the attitudes towards live-streaming and recorded lectures as a resource to pre-clerkship medical students in a non-distributed medical education model. First and second year medical students were sent a voluntary cross-sectional survey by email, and were asked questions on live-streaming, recorded lectures and in person lectures using a 5-point Likert and open answers. Of the 118 responses (54% response rate), the data suggested that both watching recorded lectures (Likert 4.55) and live-streaming lectures (4.09) were perceived to be more educationally valuable than face-to-face attendance of lectures (3.60). While responses indicated a statistically significant increase in anticipated classroom attendance if both live-streaming and recorded lectures were removed (from 63% attendance to 76%, p =0.002), there was no significant difference in attendance if live-streaming lectures were removed but recorded lectures were maintained (from 63% to 66%, p=0.76). The addition of live-streaming lectures in the pre-clerkship setting was perceived to be value added to the students. The data also suggests that the removal of live-streaming lectures would not lead to a statistically significant increase in classroom attendance by pre-clerkship students.

A decision support system using combined-classifier for high-speed data stream in smart grid

Science.gov (United States)

Yang, Hang; Li, Peng; He, Zhian; Guo, Xiaobin; Fong, Simon; Chen, Huajun

2016-11-01

Large volume of high-speed streaming data is generated by big power grids continuously. In order to detect and avoid power grid failure, decision support systems (DSSs) are commonly adopted in power grid enterprises. Among all the decision-making algorithms, incremental decision tree is the most widely used one. In this paper, we propose a combined classifier that is a composite of a cache-based classifier (CBC) and a main tree classifier (MTC). We integrate this classifier into a stream processing engine on top of the DSS such that high-speed steaming data can be transformed into operational intelligence efficiently. Experimental results show that our proposed classifier can return more accurate answers than other existing ones.

Corneal perforation after conductive keratoplasty with previous refractive surgery.

Science.gov (United States)

Kymionis, George D; Titze, Patrik; Markomanolakis, Marinos M; Aslanides, Ioannis M; Pallikaris, Ioannis G

2003-12-01

A 56-year-old woman had conductive keratoplasty (CK) for residual hyperopia and astigmatism. Three years before the procedure, the patient had arcuate keratotomy, followed by laser in situ keratomileusis 2 years later for high astigmatism correction in both eyes. During CK, a corneal perforation occurred in the right eye; during the postoperative examination, an iris perforation and anterior subcapsule opacification were seen beneath the perforation site. The perforation was managed with a bandage contact lens and an antibiotic-steroid ointment; it had a negative Seidel sign by the third day. The surgery in the left eye was uneventful. Three months after the procedure, the uncorrected visual acuity was 20/32 and the best corrected visual acuity 20/20 in both eyes with a significant improvement in corneal topography. Care must be taken to prevent CK-treated spots from coinciding with areas in the corneal stroma that might have been altered by previous refractive procedures.

Joint Optimized CPU and Networking Control Scheme for Improved Energy Efficiency in Video Streaming on Mobile Devices

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Sung-Woong Jo

2017-01-01

Full Text Available Video streaming service is one of the most popular applications for mobile users. However, mobile video streaming services consume a lot of energy, resulting in a reduced battery life. This is a critical problem that results in a degraded user’s quality of experience (QoE. Therefore, in this paper, a joint optimization scheme that controls both the central processing unit (CPU and wireless networking of the video streaming process for improved energy efficiency on mobile devices is proposed. For this purpose, the energy consumption of the network interface and CPU is analyzed, and based on the energy consumption profile a joint optimization problem is formulated to maximize the energy efficiency of the mobile device. The proposed algorithm adaptively adjusts the number of chunks to be downloaded and decoded in each packet. Simulation results show that the proposed algorithm can effectively improve the energy efficiency when compared with the existing algorithms.

Delayed Diagnosis of Pharyngeal Perforation following Exploding Tyre Blast Barotrauma

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Samantha M. Field

2014-01-01

Full Text Available Introduction. Pharyngoesophageal perforation secondary to barotrauma is a rare phenomenon that can have serious complications if identified late. It is challenging to detect due to nonspecific symptoms. We present a case in which detection proved difficult leading to delayed diagnosis. Case Report. A 27-year-old mechanic presented with haemoptysis, dysphonia, and odynophagia after a car tyre exploded in his face. Flexible nasoendoscopy (FNE revealed blood in the pharynx, thought to represent mucosal haemorrhage. Initial treatment consisted of IV dexamethasone and antibiotics. After 3 days, odynophagia persisted prompting a CT scan. This revealed a defect in the posterior hypopharynx and surgical emphysema in the deep neck tissues. Contrast swallow confirmed posterior hypopharyngeal leak. NG feeding was commenced until repeated contrast swallow confirmed resolution of the defect. Discussion. Prompt nonsurgical management of pharyngoesophageal perforation has good outcomes but untreated perforation can have serious complications. FNE should be performed routinely, but only a contrast swallow can diagnose a functional perforation. Clinicians should have a high index of clinical suspicion when patients present with barotrauma and odynophagia. Patients should be kept nil by mouth until perforation has been excluded. Conclusion. When faced with cases of facial barotrauma, clinicians should have a low threshold for further imaging to exclude pharyngoesophageal perforation.

Diagnostics of high-speed streams and coronal holes using geomagnetic pulsations

International Nuclear Information System (INIS)

Bol'shakova, O.V.; Troitskaya, V.A.

1980-01-01

In order to study the relations of high-speed solar wind streams and coronal holes analyzed are the parameters of geomagnetic pulsations of the Rs3 type and of high-speed streams at the decrease branch and in the minimum of solar activity. On the basis of the analysis of exciting pulsation regime determined are the differences in characteristics of high-speed stream properties. Presented are the graphical distributions of a number of occurrances of high-speed streams, coronal holes and pure regimes of Rs3R pulsations in several sections of 1973 in the Sun rotations of N1903-1919 and of the change of solar wind velocity while passing through the high-speed streams. It is found that Rs3R occurrance can serve an indicator of the high-speed flux connection with the large equatorial coronal hole. On the basis of the analysis of exciting pulsation properties determined are the differences in the stream characteristics. However the preliminary estimates permit to adopt neither the first nor the second of the existing hypotheses on the sourse of formation of high-speed streams

Risk factors for reintervention after surgery for perforated gastroduodenal ulcer

DEFF Research Database (Denmark)

Hasselager, R B; Lohse, N; Duch, P

2016-01-01

BACKGROUND: Perforated gastroduodenal ulcer carries a high mortality rate. Need for reintervention after surgical repair is associated with worse outcome, but knowledge on risk factors for reintervention is limited. The aim was to identify prognostic risk factors for reintervention after perforated...... gastroduodenal ulcer in a nationwide cohort. METHODS: All patients treated surgically for perforated gastroduodenal ulcer in Denmark between 2003 and 2014 were included using data from the Danish Clinical Register of Emergency Surgery. Potential risk factors for reintervention were assessed, and their crude...... and adjusted associations calculated by the competing risks subdistribution hazards approach. RESULTS: A total of 4086 patients underwent surgery for perforated gastroduodenal ulcer during the study interval. Median age was 71·1 (i.q.r. 59·6-81·0) years and the overall 90-day mortality rate was 30·8 per cent...

Multiple, Pan-Enteric Perforation Secondary to Intestinal Tuberculosis

Science.gov (United States)

Masood, Irfan; Majid, Zain; Rafiq, Ali; Rind, Waqas; Zia, Aisha; Raza, Sajjad

2015-01-01

Free perforation is one of the most feared complications of the intestinal tuberculosis. The terminal ileum is the most common site of perforation, while the majority of (90%) perforations are solitary. Herein, we describe a case of a 25-year-old male who presented with generalized peritonitis requiring an emergency exploratory laparotomy, which revealed pan-enteric perforation characterized by multiple perforations of the small bowel extending 10–15 cm from the DJ flexure up to the terminal ileum. The perforations were primarily closed, while 6–8 cm of the diseased terminal ileum was resected and the two ends were brought out as double-barreled ostomy. To the best of our knowledge, such an extensive tuberculous perforation of the small bowel has not been previously reported in the literature before. PMID:26798540

Medical image of the week: eosphageal perforation

Directory of Open Access Journals (Sweden)

Bilal J

2015-04-01

Full Text Available No abstract available. Article truncated after 150 words. A 74 year old man with a past medical history of esophageal strictures status post dilatation, coronary artery disease status post CABG, and atrial fibrillation presented to hospital with complaints of severe chest pain that began after the consumption of tortilla chips one hour prior to presentation. Electrocardiogram and cardiac enzymes were not consistent with acute coronary syndrome. Chest X-ray was consistent with a widened mediastinal silhouette. Contrast esophogram was negative for extra luminal extravasation. CT scan of the chest with oral contrast demonstrated thickening of the mid-thoracic esophagus with an extra-luminal focus of gas in the mediastinum along with fluid along the inferior aspect of the esophagus (Figures 1 and 2. These findings were concerning for esophageal perforation. The patient was taken to the operating room for endoscopy which showed micro perforation in mid-esophagus. Esophageal perforation remains a highly morbid condition. Mortality rates are based predominantly on time of ...

Improved productivity justifies world record underbalanced perforating operation

Energy Technology Data Exchange (ETDEWEB)

Johnson, A. M.; Bakker, E. R. [NAM B.V. (Netherlands); Hungerford, K.

1998-12-31

To achieve vertical connectivity with all the layers, and thus long term sustained productivity in a highly stratified reservoir, a one run underbalanced perforating operation was considered necessary. Due to coiled tube limitations in this deep (5136 m along hole, 3700 m true vertical depth, with a maximum deviation of 89 degrees), high pressure well a hydraulic workover unit (HWU) was selected to deploy and retrieve the guns. The operation is considered a world record since this is the longest section (total gross interval of 1026 m perforated) of guns conveyed, fired underbalanced and deployed out of a live well. It is concluded that the improved productivity more than justified the additional time, effort and expenditure; considering the full life cycle of the well it is readily apparent that the operation was an economic and technical success. Details of the considerations leading to the perforating technique selection, the planning and the execution of the operation, and the validation of the technique in terms of productivity gains, are provided. 13 refs., 7 figs.

Error Control Techniques for Efficient Multicast Streaming in UMTS Networks: Proposals andPerformance Evaluation

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Michele Rossi

2004-06-01

Full Text Available In this paper we introduce techniques for efficient multicast video streaming in UMTS networks where a video content has to be conveyed to multiple users in the same cell. Efficient multicast data delivery in UMTS is still an open issue. In particular, suitable solutions have to be found to cope with wireless channel errors, while maintaining both an acceptable channel utilization and a controlled delivery delay over the wireless link between the serving base station and the mobile terminals. Here, we first highlight that standard solutions such as unequal error protection (UEP of the video flow are ineffective in the UMTS systems due to its inherent large feedback delay at the link layer (Radio Link Control, RLC. Subsequently, we propose a local approach to solve errors directly at the UMTS link layer while keeping a reasonably high channel efficiency and saving, as much as possible, system resources. The solution that we propose in this paper is based on the usage of the common channel to serve all the interested users in a cell. In this way, we can save resources with respect to the case where multiple dedicated channels are allocated for every user. In addition to that, we present a hybrid ARQ (HARQ proactive protocol that, at the cost of some redundancy (added to the link layer flow, is able to consistently improve the channel efficiency with respect to the plain ARQ case, by therefore making the use of a single common channel for multicast data delivery feasible. In the last part of the paper we give some hints for future research, by envisioning the usage of the aforementioned error control protocols with suitably encoded video streams.

ASSESSMENT OF RADIOACTIVE AND NON-RADIOACTIVE CONTAMINANTS FOUND IN LOW LEVEL RADIOACTIVE WASTE STREAMS

International Nuclear Information System (INIS)

R.H. Little, P.R. Maul, J.S.S. Penfoldag

2003-01-01

This paper describes and presents the findings from two studies undertaken for the European Commission to assess the long-term impact upon the environment and human health of non-radioactive contaminants found in various low level radioactive waste streams. The initial study investigated the application of safety assessment approaches developed for radioactive contaminants to the assessment of nonradioactive contaminants in low level radioactive waste. It demonstrated how disposal limits could be derived for a range of non-radioactive contaminants and generic disposal facilities. The follow-up study used the same approach but undertook more detailed, disposal system specific calculations, assessing the impacts of both the non-radioactive and radioactive contaminants. The calculations undertaken indicated that it is prudent to consider non-radioactive, as well as radioactive contaminants, when assessing the impacts of low level radioactive waste disposal. For some waste streams with relatively low concentrations of radionuclides, the potential post-closure disposal impacts from non-radioactive contaminants can be comparable with the potential radiological impacts. For such waste streams there is therefore an added incentive to explore options for recycling the materials involved wherever possible

Neonatal gastric perforation: a report of 3 cases and literature review ...

African Journals Online (AJOL)

Neonatal gastric perforation (NGP) is an uncommon disease. Historical reports regard the aetiology as spontaneous while the mortality remains high. We present the report of the cases of neonatal gastric perforations who presented to our facility, its diverse aetiology and a review of the literature. Their clinical data including ...

Proton-pump inhibitors are associated with a reduced risk for bleeding and perforated gastroduodenal ulcers attributable to non-steriodal anti-inflammatory drugs: a nested case-control study

NARCIS (Netherlands)

Vonkeman, Harald Erwin; Fernandes, Robert W.; van der Palen, Jacobus Adrianus Maria; van Roon, Eric N.; van de Laar, Mart A F J

2007-01-01

Treatment with non-steroidal anti-inflammatory drugs (NSAIDs) is hampered by gastrointestinal ulcer complications, such as ulcer bleeding and perforation. The efficacy of proton-pump inhibitors in the primary prevention of ulcer complications arising from the use of NSAIDs remains unproven.

Multiple, Pan-Enteric Perforation Secondary to Intestinal Tuberculosis

Directory of Open Access Journals (Sweden)

Irfan Masood

2015-01-01

Full Text Available Free perforation is one of the most feared complications of the intestinal tuberculosis. The terminal ileum is the most common site of perforation, while the majority of (90% perforations are solitary. Herein, we describe a case of a 25-year-old male who presented with generalized peritonitis requiring an emergency exploratory laparotomy, which revealed pan-enteric perforation characterized by multiple perforations of the small bowel extending 10–15 cm from the DJ flexure up to the terminal ileum. The perforations were primarily closed, while 6–8 cm of the diseased terminal ileum was resected and the two ends were brought out as double-barreled ostomy. To the best of our knowledge, such an extensive tuberculous perforation of the small bowel has not been previously reported in the literature before.

StreamExplorer: A Multi-Stage System for Visually Exploring Events in Social Streams.

Science.gov (United States)

Wu, Yingcai; Chen, Zhutian; Sun, Guodao; Xie, Xiao; Cao, Nan; Liu, Shixia; Cui, Weiwei

2017-10-18

Analyzing social streams is important for many applications, such as crisis management. However, the considerable diversity, increasing volume, and high dynamics of social streams of large events continue to be significant challenges that must be overcome to ensure effective exploration. We propose a novel framework by which to handle complex social streams on a budget PC. This framework features two components: 1) an online method to detect important time periods (i.e., subevents), and 2) a tailored GPU-assisted Self-Organizing Map (SOM) method, which clusters the tweets of subevents stably and efficiently. Based on the framework, we present StreamExplorer to facilitate the visual analysis, tracking, and comparison of a social stream at three levels. At a macroscopic level, StreamExplorer uses a new glyph-based timeline visualization, which presents a quick multi-faceted overview of the ebb and flow of a social stream. At a mesoscopic level, a map visualization is employed to visually summarize the social stream from either a topical or geographical aspect. At a microscopic level, users can employ interactive lenses to visually examine and explore the social stream from different perspectives. Two case studies and a task-based evaluation are used to demonstrate the effectiveness and usefulness of StreamExplorer.Analyzing social streams is important for many applications, such as crisis management. However, the considerable diversity, increasing volume, and high dynamics of social streams of large events continue to be significant challenges that must be overcome to ensure effective exploration. We propose a novel framework by which to handle complex social streams on a budget PC. This framework features two components: 1) an online method to detect important time periods (i.e., subevents), and 2) a tailored GPU-assisted Self-Organizing Map (SOM) method, which clusters the tweets of subevents stably and efficiently. Based on the framework, we present Stream

Tricholithobezoar Causing Gastric Perforation

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Juliana Santos Valenciano

2012-01-01

Full Text Available A bezoar is an intraluminal mass formed by the accumulation of undigested material in the gastrointestinal tract. Trichobezoar is a rare condition seen almost exclusively in young women with trichotillomania and trichotillophagia. When not recognized, the trichobezoar continues to grow, which increases the risk of severe complications such as gastric ulceration and even perforation. Formation of a gallstone within the trichobezoar (tricholithobezoar is an event that has not yet been described. We report the case of a 22-year-old woman admitted to the emergency room with signals and symptoms of an epigastric mass and perforative acute abdomen. Radiological study revealed bilateral pneumoperitoneum. Personal history revealed depressive syndrome, trichotillomania and trichophagia. With a diagnosis of visceral perforation, an urgent exploratory laparotomy was performed. This confirmed the diagnosis of gastric perforation due to a large trichobezoar with the formation of a gastrolith that was removed by anterior gastrotomy. Biochemical study of the gastric stone revealed that it was composed of bile salts. There were no complications. The patient was discharged on the 5th postoperative day and was referred for psychiatric treatment.

Clinical applications of the superior epigastric artery perforator (SEAP) flap: anatomical studies and preoperative perforator mapping with multidetector CT.

Science.gov (United States)

Hamdi, Moustapha; Van Landuyt, Koenraad; Ulens, Sara; Van Hedent, Eddy; Roche, Nathalie; Monstrey, Stan

2009-09-01

Pedicled superior epigastric artery perforator (SEAP) flaps can be raised to cover challenging thoracic defects. We present an anatomical study based on multidetector computerized tomography (MDCT) scan findings of the SEA perforators in addition to the first reported clinical series of SEAP flaps in anterior chest wall reconstruction. (a) In the CT scan study, images of a group of 20 patients who underwent MDCT scan analysis were used to visualise bilaterally the location of musculocutaneous SEAP. X- and Y-axes were used as landmarks to localise the perforators. The X-axis is a horizontal line at the junction of sternum and xyphoid (JCX) and the Y-axis is at the midline. (b) In the clinical study, seven pedicled SEAP flaps were performed in another group of patients. MDCT images revealed totally 157 perforators with a mean of 7.85 perforators per patient. The dominant perforators (137 perforators) were mainly localised in an area between 1.5 and 6.5 cm from the X-axis on both sides and between 3 and 16 cm below the Y-axis. The calibre of these dominant perforators was judged as 'good' to 'very good' in 82.5% of the cases. The average dimension of the flap was 21.7x6.7 cm. All flaps were based on one perforator. Mean harvesting time was 110 min. There were no flap losses. Minor tip necrosis occurred in two flaps. One of them was treated with excision and primary closure. Our clinical experience indicates that the SEAP flap provides a novel and useful approach for reconstruction of anterior chest wall defects. CT-based imaging allows for anatomical assessment of the perforators of the superior epigastric artery (SEA).

Biliary peritonitis due to gall bladder perforation after percutaneous nephrolithotomy

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Nikhil Ranjan

2015-01-01

Full Text Available A 19-year-old male patient underwent right percutaneous nephrolithotomy (PNL for right renal 1.5 × 1.5 cm lower pole stone. The procedure was completed uneventfully with complete stone clearance. The patient developed peritonitis and shock 48 h after the procedure. Exploratory laparotomy revealed a large amount of bile in the abdomen along with three small perforations in the gall bladder (GB and one perforation in the caudate lobe of the liver. Retrograde cholecystectomy was performed but the patient did not recover and expired post-operatively. This case exemplifies the high mortality of GB perforation after PNL and the lack of early clinical signs.

Research on the Perforating Algorithm Based on STL Files

Science.gov (United States)

Yuchuan, Han; Xianfeng, Zhu; Yunrui, Bai; Zhiwen, Wu

2018-04-01

In the process of making medical personalized external fixation brace, the 3D data file should be perforated to increase the air permeability and reduce the weight. In this paper, a perforating algorithm for 3D STL file is proposed, which can perforate holes, hollow characters and engrave decorative patterns on STL files. The perforating process is composed of three steps. Firstly, make the imaginary space surface intersect with the STL model, and reconstruct triangles at the intersection. Secondly, delete the triangular facets inside the space surface and make a hole on the STL model. Thirdly, triangulate the inner surface of the hole, and thus realize the perforating. Choose the simple space equations such as cylindrical and rectangular prism equations as perforating equations can perforate round holes and rectangular holes. Through the combination of different holes, lettering, perforating decorative patterns and other perforated results can be accomplished. At last, an external fixation brace and an individual pen container were perforated holes using the algorithm, and the expected results were reached, which proved the algorithm is feasible.

Spectrum of perforation peritonitis in Pakistan: 300 cases Eastern experience.

Science.gov (United States)

Afridi, Shahida Parveen; Malik, Faiza; Ur-Rahman, Shafiq; Shamim, Shahid; Samo, Khursheed A

2008-11-08

Perforation peritonitis is the most common surgical emergency encountered by the surgeons all over the world as well in Pakistan. The spectrum of etiology of perforation peritonitis in tropical countries continues to differ from its western counter part. This study was conducted at Dow University of health sciences and Civil Hospital Karachi (DUHS & CHK) Pakistan, designed to highlight the spectrum of perforation peritonitis in the East and to improve its outcome. A prospective study includes three hundred consecutive patients of perforation peritonitis studied in terms of clinical presentations, Causes, site of perforation, surgical treatment, post operative complications and mortality, at (DUHS&CHK) Pakistan, from 1st September 2005 - 1st March 2008, over a period of two and half years. All patients were resuscitated underwent emergency exploratory laparotomy. On laparotomy cause of perforation peritonitis was found and controlled. The most common cause of perforation peritonitis noticed in our series was acid peptic disease 45%, perforated duodenal ulcer (43.6%) and gastric ulcer 1.3%. followed by small bowel tuberculosis (21%) and typhoid (17%). large bowel perforation due to tuberculosis 5%, malignancy 2.6% and volvulus 0.3%. Perforation due to acute appendicitis (5%). Highest number of perforations has seen in the duodenum 43.6%, ileum37.6%, and colon 8%, appendix 5%, jejunum 3.3%, and stomach 2.3%. Overall mortality was (10.6%). The spectrum of perforation peritonitis in Pakistan continuously differs from western country. Highest number of perforations noticed in the upper part of the gastrointestinal tract as compared to the western countries where the perforations seen mostly in the distal part. Most common cause of perforation peritonitis is perforated duodenal ulcer, followed by small bowel tuberculosis and typhoid perforation. Majority of the large bowel perforations are also tubercular. Malignant perforations are least common in our setup.

Spectrum of perforation peritonitis in Pakistan: 300 cases Eastern experience

Directory of Open Access Journals (Sweden)

Ur-Rahman Shafiq

2008-11-01

Full Text Available Abstract Background Perforation peritonitis is the most common surgical emergency encountered by the surgeons all over the world as well in Pakistan. The spectrum of etiology of perforation peritonitis in tropical countries continues to differ from its western counter part. This study was conducted at Dow University of health sciences and Civil Hospital Karachi (DUHS & CHK Pakistan, designed to highlight the spectrum of perforation peritonitis in the East and to improve its outcome. Methods A prospective study includes three hundred consecutive patients of perforation peritonitis studied in terms of clinical presentations, Causes, site of perforation, surgical treatment, post operative complications and mortality, at (DUHS&CHK Pakistan, from 1st September 2005 – 1st March 2008, over a period of two and half years. All patients were resuscitated underwent emergency exploratory laparotomy. On laparotomy cause of perforation peritonitis was found and controlled. Results The most common cause of perforation peritonitis noticed in our series was acid peptic disease 45%, perforated duodenal ulcer (43.6% and gastric ulcer 1.3%. followed by small bowel tuberculosis (21% and typhoid (17%. large bowel perforation due to tuberculosis 5%, malignancy 2.6% and volvulus 0.3%. Perforation due to acute appendicitis (5%. Highest number of perforations has seen in the duodenum 43.6%, ileum37.6%, and colon 8%, appendix 5%, jejunum 3.3%, and stomach 2.3%. Overall mortality was (10.6%. Conclusion The spectrum of perforation peritonitis in Pakistan continuously differs from western country. Highest number of perforations noticed in the upper part of the gastrointestinal tract as compared to the western countries where the perforations seen mostly in the distal part. Most common cause of perforation peritonitis is perforated duodenal ulcer, followed by small bowel tuberculosis and typhoid perforation. Majority of the large bowel perforations are also tubercular

The research progress of acute small bowel perforation

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Rudolf Schiessel

2015-08-01

Full Text Available This article reviews the various aetiologies of small bowel perforations and their management. In addition to the well-known aetiologies such as trauma, inflammation and circulatory disorders, several new causes of small bowel perforation have been described in recent years. The spectrum reaches from iatrogenic perforations during laparoscopic surgery or enteroscopies to drug-induced perforations with new anticancer agents. The management of small bowel perforations requires a concept consisting of the safe revision of the leaking bowel and the treatment of the peritonitis. Depending on the local situation and the condition of the patient, several treatment options are available. The surgical management of the bowel leak can range from a simple primary closure to a delayed restoration of bowel continuity. When the condition of the bowel or patient is frail, the risk of a failure of a closure or anastomosis is too high, and the exteriorization of the bowel defect as a primary measure is a safe option. The treatment of the peritonitis is also dependent on the condition of the patient and the local situation. Early stages of peritonitis can be treated by a simple peritoneal lavage, either performed by laparoscopy or laparotomy. Severe forms of peritonitis with multi-organ failure and an abdominal compartment syndrome need repeated peritoneal revisions. In such cases, the abdomen can only be closed temporarily. Different technical options are available in order to overcome the difficult care of these patients.

Numerical investigation of symmetry breaking and critical behavior of the acoustic streaming field in high-intensity discharge lamps

International Nuclear Information System (INIS)

Baumann, Bernd; Schwieger, Joerg; Wolff, Marcus; Manders, Freddy; Suijker, Jos

2015-01-01

For energy efficiency and material cost reduction it is preferred to drive high-intensity discharge lamps at frequencies of approximately 300 kHz. However, operating lamps at these high frequencies bears the risk of stimulating acoustic resonances inside the arc tube, which can result in low frequency light flicker and even lamp destruction. The acoustic streaming effect has been identified as the link between high frequency resonances and low frequency flicker. A highly coupled three-dimensional multiphysics model has been set up to calculate the acoustic streaming velocity field inside the arc tube of high-intensity discharge lamps. It has been found that the velocity field suffers a phase transition to an asymmetrical state at a critical acoustic streaming force. In certain respects the system behaves similar to a ferromagnet near the Curie point. It is discussed how the model allows to investigate the light flicker phenomenon. Concerning computer resources the procedure is considerably less demanding than a direct approach with a transient model. (paper)

High-efficiency ballistic electrostatic generator using microdroplets

Science.gov (United States)

Xie, Yanbo; Bos, Diederik; de Vreede, Lennart J.; de Boer, Hans L.; van der Meulen, Mark-Jan; Versluis, Michel; Sprenkels, Ad J.; van den Berg, Albert; Eijkel, Jan C. T.

2014-04-01

The strong demand for renewable energy promotes research on novel methods and technologies for energy conversion. Microfluidic systems for energy conversion by streaming current are less known to the public, and the relatively low efficiencies previously obtained seemed to limit the further applications of such systems. Here we report a microdroplet-based electrostatic generator operating by an acceleration-deceleration cycle (‘ballistic’ conversion), and show that this principle enables both high efficiency and compact simple design. Water is accelerated by pumping it through a micropore to form a microjet breaking up into fast-moving charged droplets. Droplet kinetic energy is converted to electrical energy when the charged droplets decelerate in the electrical field that forms between membrane and target. We demonstrate conversion efficiencies of up to 48%, a power density of 160 kW m-2 and both high- (20 kV) and low- (500 V) voltage operation. Besides offering striking new insights, the device potentially opens up new perspectives for low-cost and robust renewable energy conversion.

Acute mesenteric ischemia and duodenal ulcer perforation: a unique double pathology

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Haruna Lois

2012-10-01

Full Text Available Abstract Background Acute mesenteric ischaemia and duodenal perforation are surgical emergencies with serious consequences. Patients presenting with acute mesenteric ischaemia alone face a high mortality rate as high as 60% whereas those presenting with peptic ulcer perforation the mortality rates range from 6-14%. There are very few reported cases of patients presenting with this dual pathology. Case presentation We report a unique case of a 53 year old Italian lady who presented with acute mesenteric ischaemia and duodenal perforation. This is the first report of massive bowel ischaemia and duodenal perforation with no apparent underlying common pathophysiology leading to this presentation. Conclusion Early management in the intensive care unit and appropriate surgical intervention maximised the patient’s chances of survival despite the poor prognosis associated with her dual pathology. The rare pathology of the patient described can be explained by two possible hypotheses: peptic ulcer disease causing duodenal ulceration, which precipitated ischaemic infarction of the small bowel. The second hypothesis is the patient developed a stress related ulcer following ischaemic bowel infarction secondary to arterial thrombosis.

Experimental investigation of the unsteady one-phase flow through perforated plates

International Nuclear Information System (INIS)

Casadei, F.

1982-07-01

The flow of the coolant through the perforated dip-plate during a hypothetical core-disruptive accident in a sodium-cooled fast breeder reactor was simulated in a one-dimensional model. Several experiments with water as fluid and with various perforation ratios of the dip-plate and different initial heights of the fluid head over the dip plate were run. The pressure drop through the dip-plate and the forces acting on the dip-plate and on the upper plug of the reactor vessel in a wide range of the Reynolds and Strouhal numbers were measured. The flow pattern downstreams the perforated plate was filmed with high-speed cameras. The resistance coefficients for the unsteady flow of the coolant through the perforated plate were obtained as a function of the acceleration. The forces acting on the upper plug and their time integral were compared with those acting on the dip-plate. Finally, using the high-speed film pictures the formation of fluid jets downstream the dip-plate was investigated. (orig.) [de

Radiologic Study of Meniscus Perforations in the Temporomandibular Joint

International Nuclear Information System (INIS)

Kim, Kee Duck; Park, Chang Seo

1990-01-01

Thirty-nine patients (forty-four joints) who had been diagnosed as having meniscus perforation of the temporomandibular joint by inferior joint space arthrography and had been treated by surgical procedures were evaluated retrospectively. Information of clinical findings, arthrotomographic findings and surgical findings was collected on a standardized form and evaluated. The results were as follows: 1. On the 34 patients of 38 joints which were surgically confirmed perforation of meniscus or its attachments of the temporomandibular joint, there were 29 females and 5 males (5.8:1). The average age was 36 years (range 17 to 70). 2. The common clinical findings of group that had meniscus displacement without reduction and with perforation were pain on the affected joint and limitation of mouth opening. In the group showing meniscus displacement with reduction and with perforation the common clinical findings were pain and clicking on the affected joint. 3. 32 joints (84.2%) were arthrotomographically anterior meniscus displacement without reduction and with perforation, 6 joints (15.8%) showed anterior meniscus displacement with reduction and with perforation. 4. Joints categorized arthrotomographically as having meniscus displacement without reduction and with perforation were less likely to have full translation of the condyle in comparison with the normal or meniscus displacement with reduction and with perforation groups (p<0.05) 5. The arthrographic findings of 44 joints having meniscus perforation were compared with surgical findings, there were 6 false positive findings of meniscus perforation, the reliability of arthrographic findings of meniscus perforation was a 86.4% correlation with surgical findings. 6. On the site of perforations of 38 joints which were surgically confirmed perforation of meniscus or its attachments, twenty-three of perforations (60.5%) were in location at the junction of the meniscus and posterior attachment, fourteen (36.9%) were

Premixed Combustion of Kapok (ceiba pentandra seed oil on Perforated Burner

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I.K.G. Wirawan

2014-05-01

Full Text Available Availability of fossil fuels in the world decrease gradually due to excessive fuel exploitation. This situations push researcher to look for alternative fuels as a source of renewable energy, one of them is kapok (ceiba pentandra seed oil. The aim this study was to know the behavior of laminar burning velocity, secondary Bunsen flame with open tip, cellular and triple flame. Premixed combustion of kapok seed oil was studied experimentally on perforated burner with equivalence ratio (φ varied from 0.30 until 1.07. The results showed that combustion of glycerol requires a large amount of air so that laminar burning velocity (SL is the highest at very lean mixture (φ =0.36 in the form of individual Bunsen flame on each of the perforated plate hole.  Perforated and secondary Bunsen flame both reached maximum SL similar with that of ethanol and higher than that of hexadecane. Slight increase of φ decreases drastically SL of perforated and secondary Bunsen flame. When the mixture was enriched, secondary Bunsen and perforated flame disappears, and then the flame becomes Bunsen flame with open tip and triple flame (φ = 0.62 to 1.07. Flame was getting stable until the mixture above the stoichiometry. Being isolated from ambient air, the SL of perforated flame, as well as secondary Bunsen flame, becomes equal with non-isolated flame. This shows the decreasing trend of laminar burning velocity while φ is increasing. When the mixture was enriched island (φ = 0.44 to 0.48 and petal (φ = 0.53 to 0.62 cellular flame take place. Flame becomes more unstable when the mixture was changed toward stoichiometry.

Isolated jejunal perforation following blunt abdominal trauma

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Ahmet Pergel

2012-09-01

Full Text Available Isolated perforation of the jejunum, following blunt abdominaltrauma, is extremely rare. These injuries aredifficult to diagnose because initial clinical signs are frequentlynonspecific and a delay in treatment increasesmortality and morbidity of the patients. Conventional radiogramsare often inadequate for diagnosing this subsetof trauma. For an accurate and timely diagnosis, thepossibility of bowel perforation and the need for repeatedexaminations should be kept in mind. Herein, we presenta 28-year-old man with isolated jejunal perforation followingblunt abdominal trauma.Key words: Blunt abdominal trauma, isolated jejunal perforation,early diagnosis

[Saphenous perforator flap].

Science.gov (United States)

Winkel, R; Tajsic, N; Husum, H; Schlageter, M; Hanebuth, G; Hoffmann, R

2013-04-01

Replacement of full thickness soft tissue defects in the lower leg and ankle, appropriate to the defect and following the course of blood vessels feeding the skin of a distally hinged fasciocutaneous flap most reliably based on the individual anatomy of distal perforators of the posterior tibial artery. Full thickness soft tissue defects, up to 12 cm in length and up to 8 cm in width. Sufficient vascularization of the foot required, in osteomyelitis, and when joints, fractures, implants and tendons are exposed and when a split skin graft, a local flap, a suralis perforator flap or a free flap is not indicated. For patients, in whom a 1-2 h operation is not possible; necessity of angioplasty; decollement or scars around the distal perforators of the posterior tibial artery; local infection or necrosis of soft tissues and/or bone, which cannot be totally excised. Radical debridement; flap dissection without tourniquet; microdissection; design of the flap on the skin: pivot point ~ 10 cm (6-14 cm) proximal of the tip of the medial malleolus; base ~ 5 cm in width, between the course of the saphenous nerve and of the great saphenous vein and the Achilles tendon; adipofascial pedicle up to 15 cm in length sited over the septum between soleus and flexor digitorum muscles, following the course of the saphenous nerve, with a central skin stripe, which expands into a proximal skin island; skin island is outlined similar to the defect, but larger by 1 to 2 cm, surrounded by an adipofascial border: adjustment of the planning as well as of the elevation of these flaps according to the individual position and the caliber of perforators requires in each case the search for a perforator at the estimated pivot point. Delay of transposition, if the division of more than one perforator proximal to the pivot point obviously diminishes circulation. No "tunnelling "of the pedicle; defects of skin due to the elevation of the flap are replaced by split and meshed skin grafts or temporary

Perforation with and without vinegar injection as a mitigation strategy against two invasive tunicates, Ciona intestinalis and Styela clava

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Marianne PARENT

2011-01-01

Full Text Available Ciona intestinalis and Styela clava, two nuisance species for Prince Edward Island’s blue mussel industry, were treated with individual perforations using nails or hypodermic needles. Other treatments using the same species included simultaneous perforations using perforation devices with low, medium and high needle density, either with or without vinegar injections. Mortality levels estimated for all ranges of individual perforations were significantly higher than mortality levels estimated in control groups during treatments conducted at laboratory facilities. Mortality of C. intestinalis reached 100% for 60 individual perforations or injection of 0.05 mL of vinegar. In S. clava, 100 individual perforations resulted in 100% mortality. Two applications of the high-density perforation device resulted in 80% mortality of C. intestinalis. During field testing, two applications of the same high-density needle device did not significantly decrease C. intestinalis wet weight, regardless of the addition of vinegar. The field applicability of perforation upon tunicates fouling mussel socks was at least in part limited by the uneven surface created by the mussels and the possible inhibition of bacterial growth caused by low water temperatures. Perforation and vinegar injection showed to be successful in laboratory trials and should be further studied with different perforation devices under field conditions.

Imaging gastrointestinal perforation in pediatric blunt abdominal trauma

International Nuclear Information System (INIS)

Jamieson, D.H.; Babyn, P.S.; Pearl, R.

1996-01-01

Objective. To assess the role of imaging, in particular CT, in the early detection of GI perforation. Subjects and methods. In a 10-year period, 43 patients with surgically confirmed GI perforation were identified from hospital records; 22 of these had preoperative CT evaluation. Medical records and radiology were retrospectively reviewed and CT studies were particularly assessed for extraluminal air, free intraperitoneal fluid, bowel wall thickening, bowel wall enhancement, and bowel dilatation. During the study period an additional 12 trauma patients were identified who had CT studies demonstrating the above findings, but who had hypovolemic shock bowel or nondisrupting bowel injury without perforation evident. Results. Extraluminal air was demonstrated in 47 % of the imaged perforations. There was one false-positive extraluminal air. Perforation was confirmed in patients who had all five of the above CT findings, but this was the case for only 18 % of patients with perforation. One or more of the five specified CT findings were present in all CT studies reviewed. No false-negative CT study was performed in the study period. Conclusion. Separating nondisrupting bowel injury from perforation is diagnostically difficult; however, CT remains a good modality for assessing GI perforation in pediatric blunt trauma, but it cannot replace diligent and repeated clinical evaluation of all potential perforation victims. (orig.). With 4 figs., 1 tab

The Peptic Ulcer Perforation (PULP) score: a predictor of mortality following peptic ulcer perforation. A cohort study

DEFF Research Database (Denmark)

Møller, M H; Engebjerg, M C; Adamsen, S

2012-01-01

Accurate and early identification of high-risk surgical patients with perforated peptic ulcer (PPU) is important for triage and risk stratification. The objective of the present study was to develop a new and improved clinical rule to predict mortality in patients following surgical treatment...

High efficiency particulate removal with sintered metal filters

International Nuclear Information System (INIS)

Kirstein, B.E.; Paplawsky, W.J.; Pence, D.T.; Hedahl, T.G.

1981-01-01

Because of their particle removal efficiencies and durability, sintered metal filters have been chosen for high efficiency particulate air (HEPA) filter protection in the off-gas treatment system for the proposed Idaho National Engineering Laboratory Transuranic Waste Treatment Facility. Process evaluation of sintered metal filters indicated a lack of sufficient process design data to ensure trouble-free operation. Subsequence pilot scale testing was performed with flyash as the test particulate. The test results showed that the sintered metal filters can have an efficiency greater than 0.9999999 for the specific test conditions used. Stable pressure drop characteristics were observed in pulsed and reversed flow blowback modes of operation. Over 4900 hours of operation were obtained with operating conditions ranging up to approximately 90 0 C and 24 vol % water vapor in the gas stream

ASSESSMENT OF SEVERITY OF PERFORATED PERITONITIS USING MODIFIED APACHE II SCORE

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L. Rajeswar Reddy

2016-06-01

Full Text Available Acute generalised peritonitis from gastrointestinal hollow viscus perforation is a potentially life threatening condition. It is a common surgical emergency in many general surgical units in the developing countries and it is often associated with high morbidity and mortality. Grading the severity of acute peritonitis has assisted in no small way in decision making and has improved therapy in the management of severely ill patients. Empirically based risk assessment for important clinical events has been extremely useful in evaluating new therapies, in monitoring resources for effective use and improving quality of care. MATERIAL AND METHODS A prospective survey of patients with acute generalised peritonitis due to gastrointestinal perforation was carried out in general surgical wards of KIMS Hospital, Amalapuram during the period starting from July 2013-November 2016. The study population consisted of 50 consecutive patients who had laparotomy during the study period for acute peritonitis due to gastrointestinal perforation, after diagnostic conformation. RESULT AND DISCUSSION The most common cause of peritonitis in our study was perforated duodenal ulcer (31 cases, followed by appendicular perforation (7 cases, followed by stomach perforation (7 cases. Despite delay in seeking treatment, the overall mortality rate (14% was favourably comparable with other published series.

Gastric cancer perforation: experience from a tertiary care hospital.

Science.gov (United States)

Kandel, Bishnu Prasad; Singh, Yogendra; Singh, Keshav Prasad; Khakurel, Mahesh

2013-01-01

Gastric cancer perforation can occurs in advanced stage of the disease and is often associated with a high morbidity and mortality. Peritonitis due to perforation needs emergency laparotomy and different surgical procedures can be performed for definitive treatment. Surgical procedures largely depend on the stage of the disease and general condition of the patient. This study was carried out to evaluate the outcome and role of different surgical procedures in gastric cancer perforation. Medical record of patients with gastric perforation, who were treated during ten years period, was reviewed retrospectively. Data regarding clinical presentation, surgical procedures, staging and survival of patients were obtained. Features suggestive of diffuse peritonitis were evident in all cases. The majority of the patients underwent emergency surgery except one who died during resuscitation. The majority of patients were in stage III and stage IV. Surgical procedure includes simple closure and omental patch in five patients, simple closure and gastrojejunostomy in nine patients, gastrectomy in six patients and Devine's antral exclusion in one patient. Surgical site infection was the most common (45.5%) postoperative complication. Four patients died within one month of the surgery. Three patients who underwent gastrectomy survived for one year and one patient survived for five years. Although gastric cancer perforation usually occurs in advanced stage of the disease, curative resection should be considered as far as possible.

High-speed packet filtering utilizing stream processors

Science.gov (United States)

Hummel, Richard J.; Fulp, Errin W.

2009-04-01

Parallel firewalls offer a scalable architecture for the next generation of high-speed networks. While these parallel systems can be implemented using multiple firewalls, the latest generation of stream processors can provide similar benefits with a significantly reduced latency due to locality. This paper describes how the Cell Broadband Engine (CBE), a popular stream processor, can be used as a high-speed packet filter. Results show the CBE can potentially process packets arriving at a rate of 1 Gbps with a latency less than 82 μ-seconds. Performance depends on how well the packet filtering process is translated to the unique stream processor architecture. For example the method used for transmitting data and control messages among the pseudo-independent processor cores has a significant impact on performance. Experimental results will also show the current limitations of a CBE operating system when used to process packets. Possible solutions to these issues will be discussed.

Experimental perforation of tubing with a hydraulic sand jet

Energy Technology Data Exchange (ETDEWEB)

Semenov, Yu V

1970-01-01

A series of field tests has shown that perforation with a hydraulic sand jet improves the quality of well completion. The sand jet does not crack the cement sheath or the casing, and the perforations are larger and deeper than perforations formed by explosive charges. Fluid circulation during sand jet perforation can safely be stopped for at least 10 min. Water containing a surfactant can be used as a sand carrier. Sand jet perforation allows successful completion of wells cased by 2 tubing strings. Sand jet perforation can be used to clean the borehole well and to remove foreign objects from the well.

Characteristic of Gastric Perforation Type and The Histopathology at Haji Adam Malik General Hospital Medan-Indonesia

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Kamsir Koto

2016-10-01

Full Text Available Background: According to BPPK of health department in 2008, gastric ulcers ranks 10 in cause of mortality on male with age group 45-54 at Indonesia. To date, there is no report of gastric perforation characteristic at Haji Adam Malik General Hospital Medan. Methods: This was a non-experimental study with descriptive retrospective design. Data retrieved from patients’ medical record with diagnosis of gastric perforation at Haji Adam Malik General Hospital Medan on January 2011-December 2014. Results: Majority of patients involved in this study was male with 44 subjects (78.6%, while female was 12 subjects (21.4%. The most frequent age group with gastric perforation was 47-53 and 61-67 years old and the least frequent age group was 40-46 years old and 75-81 years old. 28 subjects were patients with type 3 gastric perforation and no type 2 gastric perforation was found. Histopathology examination revealed that no malignancy was found. Majority of subjects both in male and female use NSAID. Conclusions: Majority of subjects was male. The most frequent age group with gastric perforation was 47-53 and 61-67 years old. The most frequent type of gastric perforation was type 3. Histopathology examination showed that all subjects were with chronic inflammation.

Conservative Management of an Epicardial Collateral Perforation During Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention.

Science.gov (United States)

Ngo, Christian; Christopoulos, George; Brilakis, Emmanouil S

2016-01-01

Coronary artery perforation is a highly feared complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) and can lead to pericardial effusion, tamponade, and, rarely, emergent cardiac surgery. Perforation of epicardial collaterals during retrograde CTO-PCI may be particularly challenging to treat, as embolization from both sides of the perforation may be required to control the bleeding. However, conservative measures can occasionally be effective. We present a case of epicardial collateral vessel perforation that was managed conservatively with anticoagulation reversal.

Time-Efficiency of Sorting Chironomidae Surface-Floating Pupal Exuviae Samples from Urban Trout Streams in Northeast Minnesota, USA

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Alyssa M Anderson

2012-10-01

Full Text Available Collections of Chironomidae surface-floating pupal exuviae (SFPE provide an effective means of assessing water quality in streams. Although not widely used in the United States, the technique is not new and has been shown to be more cost-efficient than traditional dip-net sampling techniques in organically enriched stream in an urban landscape. The intent of this research was to document the efficiency of sorting SFPE samples relative to dip-net samples in trout streams with catchments varying in amount of urbanization and differences in impervious surface. Samples of both SFPE and dip-nets were collected from 17 sample sites located on 12 trout streams in Duluth, MN, USA. We quantified time needed to sort subsamples of 100 macroinvertebrates from dip-net samples, and less than or greater than 100 chironomid exuviae from SFPE samples. For larger samples of SFPE, the time required to subsample up to 300 exuviae was also recorded. The average time to sort subsamples of 100 specimens was 22.5 minutes for SFPE samples, compared to 32.7 minutes for 100 macroinvertebrates in dip-net samples. Average time to sort up to 300 exuviae was 37.7 minutes. These results indicate that sorting SFPE samples is more time-efficient than traditional dip-net techniques in trout streams with varying catchment characteristics.doi: 10.5324/fn.v31i0.1380.Published online: 17 October 2012.

Perforated Sigmoid Diverticular Disease: a Management Protocol

Science.gov (United States)

Moin, Thajammul

2008-01-01

Background: To develop an evidence-based protocol for the management of perforated sigmoid diverticular disease. Methods: A search of the literature was undertaken. All publications pertaining to perforated sigmoid diverticular disease were analyzed and then categorized according to their level of evidence. Recommendations were then made on the basis of this. Results: Multiple case reports suggest that primary closure of perforation of sigmoid diverticula is safe in the absence of peritoneal contamination. Conclusions: A 2-stage laparoscopic approach incorporating the principles of damage limitation surgery may be a safe strategy in the management of perforated diverticular disease. PMID:18435896

Perforator anatomy of the ulnar forearm fasciocutaneous flap.

Science.gov (United States)

Mathy, Jon A; Moaveni, Zachary; Tan, Swee T

2012-08-01

The ulnar forearm fasciocutaneous flap (UFFF) is a favourable alternative to the radial forearm flap when thin and pliable tissue is required. The precise anatomy of the cutaneous perforators of UFFF has not been previously reported. The position of cutaneous perforators>0.5 mm was recorded while raising 52 consecutive free UFFFs in 51 patients at our Centre. Three (6%) UFFFs in two patients demonstrated direct cutaneous supply through a superficial ulnar artery, a known anatomic variance. There was no cutaneous perforator>0.5 mm in one flap. Among the remaining 48 dissections, an average of 3 (range, 1-6) cutaneous perforators were identified. Ninety-four percent of these forearms demonstrated at least one perforator>0.5 mm within 3 cm, and all had at least one perforator within 6 cm of the midpoint of the forearm. Proximal perforators were more likely to be musculo-cutaneous through the edge of flexor carpi ulnaris or flexor digitorum superficialis, while mid- to distal perforators were septo-cutaneous. UFFF skin paddle designed to overlie an area within 3 cm of the midpoint between the medial epicondyle and the pisiform is most likely to include at least one cutaneous perforator from the ulnar artery, without a need for intra-operative skin island adjustment. This novel anatomic finding and other practical generalisations are discussed to facilitate successful elevation of UFFF. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Sustainable Capture: Concepts for Managing Stream-Aquifer Systems.

Science.gov (United States)

Davids, Jeffrey C; Mehl, Steffen W

2015-01-01

Most surface water bodies (i.e., streams, lakes, etc.) are connected to the groundwater system to some degree so that changes to surface water bodies (either diversions or importations) can change flows in aquifer systems, and pumping from an aquifer can reduce discharge to, or induce additional recharge from streams, springs, and lakes. The timescales of these interactions are often very long (decades), making sustainable management of these systems difficult if relying only on observations of system responses. Instead, management scenarios are often analyzed based on numerical modeling. In this paper we propose a framework and metrics that can be used to relate the Theis concepts of capture to sustainable measures of stream-aquifer systems. We introduce four concepts: Sustainable Capture Fractions, Sustainable Capture Thresholds, Capture Efficiency, and Sustainable Groundwater Storage that can be used as the basis for developing metrics for sustainable management of stream-aquifer systems. We demonstrate their utility on a hypothetical stream-aquifer system where pumping captures both streamflow and discharge to phreatophytes at different amounts based on pumping location. In particular, Capture Efficiency (CE) can be easily understood by both scientists and non-scientist alike, and readily identifies vulnerabilities to sustainable stream-aquifer management when its value exceeds 100%. © 2014, National Ground Water Association.

Perforated gastric carcinoma in a young-age patient

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Feng-Hsu Wu

2018-06-01

Full Text Available Perforation is a rare complication of gastric carcinoma, and it occurs in less than 5% of all gastric carcinoma cases and in less than 1% within all acute abdomen cases. The diagnosis of malignancy is usually not validated preoperatively. In previous reported English literature, all patients with perforated gastric cancer have the feature of old age. This feature might be able to guide the surgeon to impress the differential diagnosis of malignancy before or during the emergent operation of gastric perforation.This 32-year-old male patient suffered from sudden onset of epigastric pain. We performed emergent operation under the impression of hollow organ perforation. The postoperative pathologic report of gastric ulcer revealed gastric carcinoma. We performed second-stage operation of total gastrectomy with D2 lymphadenectomy smoothly 7 days later. As we know, this is the youngest patient having the condition of perforated gastric carcinoma reported in the literature. This case reminds us that it is possible for perforated gastric carcinoma to occur in young-age patients. Keywords: Gastric cancer, Acute abdomen, Gastric perforation

A non-permutation flowshop scheduling problem with lot streaming: A Mathematical model

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Daniel Rossit

2016-06-01

Full Text Available In this paper we investigate the use of lot streaming in non-permutation flowshop scheduling problems. The objective is to minimize the makespan subject to the standard flowshop constraints, but where it is now permitted to reorder jobs between machines. In addition, the jobs can be divided into manageable sublots, a strategy known as lot streaming. Computational experiments show that lot streaming reduces the makespan up to 43% for a wide range of instances when compared to the case in which no job splitting is applied. The benefits grow as the number of stages in the production process increases but reach a limit. Beyond a certain point, the division of jobs into additional sublots does not improve the solution.

PERFORATED PEPTIC ULCER: A CLINICAL ANALYSIS AND OUTCOME

OpenAIRE

Bijit

2016-01-01

BACKGROUND The incidence of perforated peptic ulcer is approximately 7-10 cases per one lakh population per year. Perforation is seen in about 7% of patients hospitalized for peptic ulcer disease. Peptic ulcer perforation, which can be gastric/duodenal perforation can be a serious life-threatening condition if not detected early and treated urgently. Peptic ulcer disease has decreased considerably worldwide with the advent of potent anti-ulcer medicines, but its complication l...

High Efficiency Particulate Air (HEPA) Filter Generation, Characterization, and Disposal Experiences at the Oak Ridge National Laboratory

International Nuclear Information System (INIS)

Coffey, D. E.

2002-01-01

High Efficiency Particulate Air filtration is an essential component of the containment and ventilation systems supporting the research and development activities at the Oak Ridge National Laboratory. High Efficiency Particulate Air filters range in size from 7.6cm (3 inch) by 10.2 cm (4 inch) cylindrical shape filters to filter array assemblies up to 2.1 m (7 feet) high by 1.5 m (5 feet) wide. Spent filters are grouped by contaminates trapped in the filter media and become one of the components in the respective waste stream. Waste minimization and pollution prevention efforts are applied for both radiological and non-radiological applications. Radiological applications include laboratory hoods, glove boxes, and hot cells. High Efficiency Particulate Air filters also are generated from intake or pre-filtering applications, decontamination activities, and asbestos abatement applications. The disposal avenues include sanitary/industrial waste, Resource Conservation and Recovery Act and Toxic Substance Control Act, regulated waste, solid low-level waste, contact handled transuranic, and remote handled transuranic waste. This paper discusses characterization and operational experiences associated with the disposal of the spent filters across multiple applications

A CLINICAL STUDY ON PATIENTS WITH DUODENAL ULCER PERFORATION

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Kishore Babu

2016-03-01

Full Text Available INTRODUCTION Perforated duodenal ulcer, the most catastrophic complication was Associated with high mortality in the past due to late presentation of the patients, delay in surgery and lack of antibiotics. Various authors state that the incidence of peptic ulcer disease and perforation has been declining for the past 3 decades. Because of advances in the medical therapy of peptic ulcer with a wide range of drugs the management of peptic ulcer disease has been changing and the role of surgery has been declining. Perforation is usually seen in 3rd and 4th decades with a male preponderance and the epidemiological trend is not the same worldwide. Incidence is slightly declining in western countries. The present study has been done during the period between 2013 and 2014 in S. V. R. R. Government general hospital Tirupati. AIMS AND OBJECTIVES The aim of the present study is to analyze the probable factors for increase in incidence of duodenal ulcer perforation, with particular emphasis on assessment of impact of H2 receptor antagonists and Proton Pump inhibitors on the incidence of perforation. STUDY SETTING S. V. Medical College, Department of General Surgery, Tirupati. STUDY PERIOD Patients attending S. V. Medical College, Department of General Surgery with perforation during the period from November 2013 to October 2014. INCLUSION CRITERIA Patients between age group of more than 14 years presenting with pain abdomen and who are diagnosed to have peritonitis due to duodenal ulcer perforation. EXCLUSION CRITERIA Patients with peritonitis due causes other than duodenal ulcer. STUDY METHOD Prospective Observational study among the selected patients. Total numbers of peptic ulcer cases that were admitted in this hospital and treated either medically or surgically were noted. The details of their clinical history and findings, investigation reports, operative findings, post-operative complications were recorded. Simple closure was performed for all the

Equivalent material properties of perforated plate with triangular or square penetration pattern for dynamic analysis

International Nuclear Information System (INIS)

Jhung, Myung Jo; Jo, Jong Chull

2006-01-01

For a perforated plate, it is challenging to develop a finite element model due to the necessity of the fine meshing of the plate, especially if it is submerged in fluid. This necessitates the use of a solid plate with equivalent material properties. Unfortunately, the effective elastic constants suggested by the ASME code are deemed not valid for a model analysis. Therefore, in this study the equivalent material properties of a perforated plate are suggested by performing several finite element analyses with respect to the ligament efficiencies

Duodenal perforation during percutaneous nephrolithotomy (PCNL ...

African Journals Online (AJOL)

A. Bansal

2016-06-03

Jun 3, 2016 ... Calculus;. Duodenum;. Injury;. Paediatric;. Percutaneous nephrolithotomy. Abstract. Introduction: Colonic perforations are known complications of percutaneous nephrolithotomy (PCNL). However, to the best of our knowledge, small bowel perforation has rarely been reported.. Observation: We report the ...

Intestinal perforation by an ingested foreign body*

Science.gov (United States)

Nicolodi, Gabriel Cleve; Trippia, Cesar Rodrigo; Caboclo, Maria Fernanda F. S.; de Castro, Francisco Gomes; Miller, Wagner Peitl; de Lima, Raphael Rodrigues; Tazima, Leandro; Geraldo, Jamylle

2016-01-01

Objective To identify the computed tomography findings suggestive of intestinal perforation by an ingested foreign body. Materials and Methods This was a retrospective study of four cases of surgically proven intestinal perforation by a foreign body, comparing the computed tomography findings with those described in the literature. Results None of the patients reported having ingested a foreign body, all were over 60 years of age, three of the four patients used a dental prosthesis, and all of the foreign bodies were elongated and sharp. In all four patients, there were findings indicative of acute abdomen. None of the foreign bodies were identified on conventional X-rays. The computed tomography findings suggestive of perforation were thickening of the intestinal walls (in all four cases), increased density of mesenteric fat (in all four cases), identification of the foreign body passing through the intestinal wall (in three cases), and gas in the peritoneal cavity (in one case). Conclusion In cases of foreign body ingestion, intestinal perforation is more common when the foreign body is elongated and sharp. Although patients typically do not report having ingested such foreign bodies, the scenario should be suspected in elderly individuals who use dental prostheses. A computed tomography scan can detect foreign bodies, locate perforations, and guide treatment. The findings that suggest perforation are thickening of the intestinal walls, increased mesenteric fat density, and, less frequently, gas in the peritoneal cavity, often restricted to the point of perforation. PMID:27818542

Intestinal perforation by an ingested foreign body

International Nuclear Information System (INIS)

Nicolodi, Gabriel Cleve; Trippia, Cesar Rodrigo; Caboclo, Maria Fernanda F.S.; Castro, Francisco Gomes de; Miller, Wagner Peitl; Lima, Raphael Rodrigues de; Tazima, Leandro; Geraldo, Jamylle

2016-01-01

Objective: To identify the computed tomography findings suggestive of intestinal perforation by an ingested foreign body. Materials and Methods: This was a retrospective study of four cases of surgically proven intestinal perforation by a foreign body, comparing the computed tomography findings with those described in the literature. Results: None of the patients reported having ingested a foreign body, all were over 60 years of age, three of the four patients used a dental prosthesis, and all of the foreign bodies were elongated and sharp. In all four patients, there were findings indicative of acute abdomen. None of the foreign bodies were identified on conventional X-rays. The computed tomography findings suggestive of perforation were thickening of the intestinal walls (in all four cases), increased density of mesenteric fat (in all four cases), identification of the foreign body passing through the intestinal wall (in three cases), and gas in the peritoneal cavity (in one case). Conclusion: In cases of foreign body ingestion, intestinal perforation is more common when the foreign body is elongated and sharp. Although patients typically do not report having ingested such foreign bodies, the scenario should be suspected in elderly individuals who use dental prostheses. A computed tomography scan can detect foreign bodies, locate perforations, and guide treatment. The findings that suggest perforation are thickening of the intestinal walls, increased mesenteric fat density, and, less frequently, gas in the peritoneal cavity, often restricted to the point of perforation. (author)

Intestinal perforation by an ingested foreign body.

Science.gov (United States)

Nicolodi, Gabriel Cleve; Trippia, Cesar Rodrigo; Caboclo, Maria Fernanda F S; de Castro, Francisco Gomes; Miller, Wagner Peitl; de Lima, Raphael Rodrigues; Tazima, Leandro; Geraldo, Jamylle

2016-01-01

To identify the computed tomography findings suggestive of intestinal perforation by an ingested foreign body. This was a retrospective study of four cases of surgically proven intestinal perforation by a foreign body, comparing the computed tomography findings with those described in the literature. None of the patients reported having ingested a foreign body, all were over 60 years of age, three of the four patients used a dental prosthesis, and all of the foreign bodies were elongated and sharp. In all four patients, there were findings indicative of acute abdomen. None of the foreign bodies were identified on conventional X-rays. The computed tomography findings suggestive of perforation were thickening of the intestinal walls (in all four cases), increased density of mesenteric fat (in all four cases), identification of the foreign body passing through the intestinal wall (in three cases), and gas in the peritoneal cavity (in one case). In cases of foreign body ingestion, intestinal perforation is more common when the foreign body is elongated and sharp. Although patients typically do not report having ingested such foreign bodies, the scenario should be suspected in elderly individuals who use dental prostheses. A computed tomography scan can detect foreign bodies, locate perforations, and guide treatment. The findings that suggest perforation are thickening of the intestinal walls, increased mesenteric fat density, and, less frequently, gas in the peritoneal cavity, often restricted to the point of perforation.

Intestinal perforation by an ingested foreign body

Energy Technology Data Exchange (ETDEWEB)

Nicolodi, Gabriel Cleve; Trippia, Cesar Rodrigo; Caboclo, Maria Fernanda F.S.; Castro, Francisco Gomes de; Miller, Wagner Peitl; Lima, Raphael Rodrigues de; Tazima, Leandro; Geraldo, Jamylle, E-mail: gabrielnicolodi@gmail.com [Hospital Sao Vicente - Funef, Curitiba, PR (Brazil)

2016-09-15

Objective: To identify the computed tomography findings suggestive of intestinal perforation by an ingested foreign body. Materials and Methods: This was a retrospective study of four cases of surgically proven intestinal perforation by a foreign body, comparing the computed tomography findings with those described in the literature. Results: None of the patients reported having ingested a foreign body, all were over 60 years of age, three of the four patients used a dental prosthesis, and all of the foreign bodies were elongated and sharp. In all four patients, there were findings indicative of acute abdomen. None of the foreign bodies were identified on conventional X-rays. The computed tomography findings suggestive of perforation were thickening of the intestinal walls (in all four cases), increased density of mesenteric fat (in all four cases), identification of the foreign body passing through the intestinal wall (in three cases), and gas in the peritoneal cavity (in one case). Conclusion: In cases of foreign body ingestion, intestinal perforation is more common when the foreign body is elongated and sharp. Although patients typically do not report having ingested such foreign bodies, the scenario should be suspected in elderly individuals who use dental prostheses. A computed tomography scan can detect foreign bodies, locate perforations, and guide treatment. The findings that suggest perforation are thickening of the intestinal walls, increased mesenteric fat density, and, less frequently, gas in the peritoneal cavity, often restricted to the point of perforation. (author)

Intestinal perforation by an ingested foreign body

Directory of Open Access Journals (Sweden)

Gabriel Cleve Nicolodi

Full Text Available Abstract Objective: To identify the computed tomography findings suggestive of intestinal perforation by an ingested foreign body. Materials and Methods: This was a retrospective study of four cases of surgically proven intestinal perforation by a foreign body, comparing the computed tomography findings with those described in the literature. Results: None of the patients reported having ingested a foreign body, all were over 60 years of age, three of the four patients used a dental prosthesis, and all of the foreign bodies were elongated and sharp. In all four patients, there were findings indicative of acute abdomen. None of the foreign bodies were identified on conventional X-rays. The computed tomography findings suggestive of perforation were thickening of the intestinal walls (in all four cases, increased density of mesenteric fat (in all four cases, identification of the foreign body passing through the intestinal wall (in three cases, and gas in the peritoneal cavity (in one case. Conclusion: In cases of foreign body ingestion, intestinal perforation is more common when the foreign body is elongated and sharp. Although patients typically do not report having ingested such foreign bodies, the scenario should be suspected in elderly individuals who use dental prostheses. A computed tomography scan can detect foreign bodies, locate perforations, and guide treatment. The findings that suggest perforation are thickening of the intestinal walls, increased mesenteric fat density, and, less frequently, gas in the peritoneal cavity, often restricted to the point of perforation.

Neurodevelopmental outcome after neonatal perforator stroke

NARCIS (Netherlands)

Ecury-Goossen, Ginette M; van der Haer, Marit; Smit, Liesbeth S; Feijen-Roon, Monique; Lequin, Maarten; de Jonge, Rogier C J; Govaert, Paul; Dudink, Jeroen

AIM: To assess outcome after neonatal perforator stroke in the largest cohort to date. METHOD: Survivors from a cohort of children diagnosed with neonatal perforator stroke using cranial ultrasound or magnetic resonance imaging were eligible for inclusion. Recovery and Recurrence Questionnaire

Internal Drainage of an Esophageal Perforation in a Patient with a High Surgical Risk

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Hongsun Kim

2017-10-01

Full Text Available A 71-year-old man presented with a productive cough and fever, and he was diagnosed as having an esophageal perforation and a mediastinal abscess. He had a history of traumatic hemothorax and pleural drainage for empyema in the right chest and was considered unable to tolerate thoracic surgery because of sepsis and progressive aspiration pneumonia. In order to aggressively drain the mediastinal contamination, we performed internal drainage by placing a Levin tube into the mediastinum through the perforation site. This procedure, in conjunction with controlling sepsis and providing sufficient postpyloric nutrition, allowed the esophageal injury to completely heal.

Diagnosing perforated appendicitis in pediatric patients: a new model.

Science.gov (United States)

van den Bogaard, Veerle A B; Euser, Sjoerd M; van der Ploeg, Tjeerd; de Korte, Niels; Sanders, Dave G M; de Winter, Derek; Vergroesen, Diederik; van Groningen, Krijn; de Winter, Peter

2016-03-01

Studies have investigated sensitivity and specificity of symptoms and tests for diagnosing appendicitis in children. Less is known with regard to the predictive value of these symptoms and tests with respect to the severity of appendicitis. The aim of this study was to determine the predictive value of patient's characteristics and tests for discriminating between perforated and nonperforated appendicitis in children. Pediatric patients who underwent an appendectomy at Spaarne Hospital Hoofddorp, the Netherlands, between January 1, 2009 and December 31, 2013, were included. Baseline patient's characteristics, history, physical examination, laboratory data and results of ultrasounds were collected. Univariate and multivariate logistic regressions were used to determine predictors of perforation. In total, 375 patients were included in this study of which 97 children (25.9%) had significant signs of perforation. Univariate analysis showed that age, duration of complaints, temperature, vomiting, CRP, WBC, different findings on ultrasound and the diameter of the appendix were good predictors of a perforated appendicitis. The final multivariate prediction model included temperature, CRP, clearly visible appendix and free fluids on ultrasound and diameter of the appendix and resulted in an area under the curve (AUC) of 0.91 showing sensitivity and specificity of respectively 85.2% and 81.2%. This prediction model can be used for identification of 'high-risk' children for a perforated appendicitis and might be helpful to prevent complications and longer hospitalization by bringing these children to theater earlier. Copyright © 2016 Elsevier Inc. All rights reserved.

Laparoscopic treatment of perforated appendicitis

Science.gov (United States)

Lin, Heng-Fu; Lai, Hong-Shiee; Lai, I-Rue

2014-01-01

The use of laparoscopy has been established in improving perioperative and postoperative outcomes for patients with simple appendicitis. Laparoscopic appendectomy is associated with less wound pain, less wound infection, a shorter hospital stay, and faster overall recovery when compared to the open appendectomy for uncomplicated cases. In the past two decades, the use of laparoscopy for the treatment of perforated appendicitis to take the advantages of minimally invasiveness has increased. This article reviewed the prevalence, approaches, safety disclaimers, perioperative and postoperative outcomes of the laparoscopic appendectomy in the treatment of patients with perforated appendicitis. Special issues including the conversion, interval appendectomy, laparoscopic approach for elderly or obese patient are also discussed to define the role of laparoscopic treatment for patients with perforated appendicitis. PMID:25339821

DETERMINATION OF THE TEMPERATURE DISTRIBUTION THE PERFORATED FINS UNDER

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Aziz7 M. Mhamuad

2015-02-01

Full Text Available This work treats the problem of heat transfer for perforated fins under natural convection. The temperature distribution is examined for an array of rectangular fins (15 fins with uniform cross-sectional area (100x270 mm embedded with various vertical body perforations that extend through the fin thickness. The patterns of perforations include 18 circular perforations (holes. Experiments were carried out in an experimental facility that was specifically design and constructed for this purpose. The heat transfer rate and the coefficient of heat transfer increases with perforation diameter increased. 

Trans-anal barotrauma by compressed air leading to sigmoid perforation due to a dangerous practical joke.

Science.gov (United States)

Pahwa, Harvinder Singh; Kumar, Awanish; Srivastava, Rohit; Rai, Anurag

2012-08-01

To present a case report of trans-anal barotrauma by high-pressure compressed air jet as a dangerous practical joke, that is, playful insufflation of high-pressure air jet through the anal orifice resulting in sigmoid perforation. The patient presented to emergency a day later with complaints of severe pain in the abdomen and abdominal distension following insufflation of high-pressure air jet through the anus. On examination, he had signs suggestive of perforation peritonitis and x-ray of the abdomen showed gas under the diaphragm. An emergency exploratory laparotomy was performed which revealed a 4-cm perforation in the sigmoid colon. Resection of the segment containing perforation along with the surrounding devitalised part was done with double-barrel colostomy. Reversal of colostomy was done after 8 weeks. Follow-up was uneventful.

Perforated Gastric Ulcer Associated with Anti-Angiogenic Therapy

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Diogo Libânio

2017-08-01

Full Text Available Anti-angiogenic therapy with bevacizumab, an inhibitor of vascular endothelial growth factor, is commonly used in metastatic colorectal cancer and is rarely associated with gastrointestinal perforation, perforation being more frequent in the primary tumor site or at the anastomotic level. We present the case of a 64-year-old male with stage IV rectal adenocarcinoma who was on palliative chemotherapy with FOLFOX and bevacizumab. After the 4th chemotherapy cycle, our patient started fever and epigastric pain. He was hemodynamically stable, and signs of peritoneal irritation were absent. There were no alterations in the abdominal X-ray, and C-reactive protein was markedly elevated. A CT scan revealed a de novo thickness in the gastric antrum. Upper digestive endoscopy showed an ulcerated 40-mm lesion in the angulus, with a 20-mm orifice communicating with an exsudative cavity revested by the omentum. A conservative approach was decided including fasting, broad-spectrum intravenous antibiotics, and proton-pump inhibitors. Subsequent gastroduodenal series showed no contrast extravasation, allowing the resumption of oral nutrition. Esophagogastroduodenoscopy after 8 weeks showed perforation closure. Biopsies did not show neoplastic cells or Heliobacter pylori infection. Although the success in the conservative management of perforation allowing the maintenance of palliative chemotherapy (without bevacizumab, the patient died after 4 months due to liver failure. The reported case shows an uncommon endoscopic finding due to a rare complication of anti-angiogenic therapy. Additionally, it reminds clinicians that a history of gastroduodenal ulcers should be actively sought before starting anti-angiogenic treatment and that suspicion for perforation should be high in these cases.

Perforated peptic ulcer: How to improve outcome?

DEFF Research Database (Denmark)

Møller, Morten Hylander; Adamsen, Sven; Wøjdemann, Morten

2008-01-01

Despite the introduction of histamine H(2)-receptor antagonists, proton-pump inhibitors and the discovery of Helicobacter pylori, both the incidence of emergency surgery for perforated peptic ulcer and the mortality rate for patients undergoing surgery for peptic ulcer perforation have increased...... with an emphasis on risks that are preventable. A systematic review including randomized studies was carried out. There are a limited number of studies of patients with peptic ulcer perforation. Most of these studies are of low evidential status. Only a few randomized, controlled trials have been published...... to improve the outcome of patients with peptic ulcer perforation, sepsis needs to be factored into the existing knowledge and treatment Udgivelsesdato: 2008/8/27...

Fast track pathway for perforated appendicitis.

Science.gov (United States)

Frazee, Richard; Abernathy, Stephen; Davis, Matthew; Isbell, Travis; Regner, Justin; Smith, Randall

2017-04-01

Perforated appendicitis is associated with an increased morbidity and length of stay. "Fast track" protocols have demonstrated success in shortening hospitalization without increasing morbidity for a variety of surgical processes. This study evaluates a fast track pathway for perforated appendicitis. In 2013, a treatment pathway for perforated appendicitis was adopted by the Acute Care Surgery Service for patients having surgical management of perforated appendicitis. Interval appendectomy was excluded. Patients were treated initially with intravenous antibiotics and transitioned to oral antibiotics and dismissed when medically stable and tolerating oral intake. A retrospective review of patients managed on the fast track pathway was undertaken to analyze length of stay, morbidity, and readmissions. Thirty-four males and twenty-one females with an average age of 46.8 years underwent laparoscopic appendectomy for perforated appendicitis between January 2013 and December 2014. Pre-existing comorbidities included hypertension 42%, diabetes mellitus 11%, COPD 5% and heart disease 2%. No patient had conversion to open appendectomy. Average length of stay was 2.67 days and ranged from 1 to 12 days (median 2 days). Postoperative morbidity was 20% and included abscess (6 patients), prolonged ileus (3 patients), pneumonia (1 patient), and congestive heart failure (1 patient). Five patients were readmitted for abscess (3 patients), congestive heart failure (1 patient), and pneumonia (1 patient). A fast track pathway for perforated appendicitis produced shorter length of stay and acceptable postoperative morbidity and readmission. This offers the potential for significant cost savings over current national practice patterns. Copyright © 2016 Elsevier Inc. All rights reserved.

Large Gastric Perforation Sealed by Splenic Lysis: Emphasis on Indirect Signs – A Rare Case Report

International Nuclear Information System (INIS)

Garg, Lalit; Jain, Mansi; Taori, Kishor; Patil, Ajinky; Hatgaonkar, Anand; Rathod, Jawhar; Shah, Swenil; Patwa, Darshan; Kasat, Akshat

2015-01-01

Gastric perforation is a life-threatening condition, requiring early and reliable discovery. The delay before surgical treatment is a strong determinant of poor outcome, associated complications and hospitalization costs. By using ultrasound and multi-detector computed tomography (MDCT) we can further evaluate undiagnosed cases of silent gastric perforations presenting with non-specific acute abdomen. Here we bring forth the role of a radiologist in cases of perforation which present with indirect signs involving the organs forming the stomach bed, like the spleen, pancreas and kidney. A 25-year-old male patient presented with an acute onset of severe upper abdominal pain radiating to the back and vomiting. MDCT of the abdomen was done which revealed atrophic pancreas with organized collection in the sub-capsular location indenting the superior pole of the left kidney. Spleen was not visualized. The most striking imaging finding in that case was destruction of the splenic parenchyma with protrusion of the remaining tissue into the stomach lumen. The hypothesis behind this was a cascade of events which started with gastric perforation, spillage of highly destructive gastric juice over the stomach bed and finally becoming silent with rapid sealing of the defect by the omentum and the spleen. Acute abdomen is a diagnostic challenge to a clinician and radiologist with gastric perforation being a great mimicker of other urgent abdominal pathologies. To avoid a delayed diagnosis or a misdiagnosis, familiarity with typical and atypical imaging features is essential as in our case of splenic lysis. It acted as the 2 nd policeman and provided a great clue to solve the diagnostic dilemma

Medicolegal aspects of iatrogenic root perforations

DEFF Research Database (Denmark)

Tsesis, I; Rosen, E; Bjørndal, L

2014-01-01

AIM: To retrospectively analyze the medico-legal aspects of iatrogenic root perforations (IRP) that occurred during endodontic treatments. METHODOLOGY: A comprehensive search in a professional liability insurance database was conducted to retrospectively identify cases of IRP following root canal...... treatment (p root perforation is a complication of root canal treatment and may result in tooth extraction...... and in legal actions against the treating practitioner. Mandibular molars are more prone to medico-legal claims related to root perforations. The patient should be informed of the risks during RCT and should get information on alternative treatments and their risks and prognosis...

Spontaneous ileal perforation complicating low anorectal malformation

Directory of Open Access Journals (Sweden)

TiJesuni Olatunji

2015-01-01

Full Text Available Anorectal malformation is a common anomaly in neonates. Although colorectal perforations have been reported as a complication, ileal perforation is rarely encountered. This is a report of a 2-day-old boy presenting with a low anorectal malformation, complicated with ileal perforation, necessitating laparotomy and ileal repair. Anoplasty was done for the low anomaly. Early presentation and prompt treatment of anorectal malformations is important to prevent such potential life threatening complication.

EVALUAT I ON OF VARIOUS PROGNOSTIC FACTORS IN PERFORATIVE PERITONITIS MANAGEMENT

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Sarada

2015-09-01

Full Text Available Peritonitis is one of the major problems confronting the surgeons in day to day practice. Despite many advances in understanding pathophysiology, mortality rate of diffuse suppurative peritonitis remains high. A prospective study, with prior institutional ethics committee approval, involving 100 patients of perforative peritonitis is done to assess the vari ous prognostic factors in management of generalized peritonitis. Role of age, gender, duration, type of perforation, associated systemic factors are studied in relation to morbidity and mortality in the outcome of management of peritonitis. Elderly age, il eal perforations, delay in presentation of more than 24 hours and associated shock on day one are found to have bad prognosis

Premixed Combustion of Coconut Oil on Perforated Burner

Directory of Open Access Journals (Sweden)

I.K.G. Wirawan

2013-10-01

Full Text Available Coconut oil premixed combustion behavior has been studied experimentally on perforated burner with equivalence ratio (φ varied from very lean until very rich. The results showed that burning of glycerol needs large number of air so that the laminar burning velocity (SL is the highest at very lean mixture and the flame is in the form of individual Bunsen flame on each of the perforated plate hole. As φ is increased the  SL decreases and the secondary Bunsen flame with open tip occurs from φ =0.54 at the downstream of perforated flame. The perforated flame disappears at φ = 0.66 while the secondary Bunsen flame still exist with SL increases following that of hexadecane flame trend and then extinct when the equivalence ratio reaches one or more. Surrounding ambient air intervention makes SL decreases, shifts lower flammability limit into richer mixture, and performs triple and cellular flames. The glycerol diffusion flame radiation burned fatty acids that perform cellular islands on perforated hole.  Without glycerol, laminar flame velocity becomes higher and more stable as perforated flame at higher φ. At rich mixture the Bunsen flame becomes unstable and performs petal cellular around the cone flame front. Keywords: cellular flame; glycerol; perforated flame;secondary Bunsen flame with open tip; triple flame

Micro direct methanol fuel cell with perforated silicon-plate integrated ionomer membrane

DEFF Research Database (Denmark)

Larsen, Jackie Vincent; Dalslet, Bjarke Thomas; Johansson, Anne-Charlotte Elisabeth Birgitta

2014-01-01

This article describes the fabrication and characterization of a silicon based micro direct methanol fuel cell using a Nafion ionomer membrane integrated into a perforated silicon plate. The focus of this work is to provide a platform for micro- and nanostructuring of a combined current collector...... at a perforation ratio of 40.3%. The presented fuel cells also show a high volumetric peak power density of 2 mW cm−3 in light of the small system volume of 480 μL, while being fully self contained and passively feed....... and catalytic electrode. AC impedance spectroscopy is utilized alongside IV characterization to determine the influence of the plate perforation geometries on the cell performance. It is found that higher ratios of perforation increases peak power density, with the highest achieved being 2.5 mW cm−2...

Frequent Pairs in Data Streams: Exploiting Parallelism and Skew

DEFF Research Database (Denmark)

Campagna, Andrea; Kutzkow, Konstantin; Pagh, Rasmus

2011-01-01

We introduce the Pair Streaming Engine (PairSE) that detects frequent pairs in a data stream of transactions. Our algorithm finds the most frequent pairs with high probability, and gives tight bounds on their frequency. It is particularly space efficient for skewed distribution of pair supports...... items mining in data streams. We show how to efficiently scale these approaches to handle large transactions. We report experimental results showcasing precision and recall of our method. In particular, we find that often our method achieves excellent precision, returning identical upper and lower...... bounds on the supports of the most frequent pairs....

Spontaneous acalculous gallbladder perforation in a man secondary to chemotherapy and radiation: A rare case report.

Science.gov (United States)

Zhang, Jungang; Shen, Guoliang; Shi, Ying; Zhang, Chengwu; Hong, Defei; Jin, Li; Yang, Hongguo; Sun, Wei; Cai, Hanhui; Hu, Zhiming; Wu, Weiding

2018-05-01

Gallbladder perforation is a serious clinical condition and associated with high morbidity and mortality. A definitive diagnosis is contentious before surgery. We herein report a case of perforation of the gallbladder neck secondary to chemotherapy and radiation for nasopharyngeal carcinoma patient. Gallbladder perforation secondary to chemotherapy and radiation. To decrease the mortality associated with gallbladder perforation, Laparoscopic cholecystectomy and peritoneal lavage were performed followed for gallbladder perforation patient because of chemotherapy and radiation. The patient recovered fully without serious complication and discharged on the 10th postoperative day. A pathological examination of the resected gallbladder revealed cholecystitis in the thinning of the neck. Early diagnosis and surgical intervention of gallbladder perforation in relation to asopharyngeal carcinoma chemotherapy and radiation are of prime importance. The laparoscopic procedure is safe and feasible in the selected patients.

Reconstruction of hand contracture by reverse ulnar perforator flap

Directory of Open Access Journals (Sweden)

Cengiz Eser

2016-04-01

Full Text Available Hand burn scar contractures affect patients in aesthetic and functional aspects. After releasing these scars, the defects should be repaired. The reconstruction methods include primary suturation, Z plasty, skin grafting, local or free flaps, etc. All methods have their own advantages and disadvantages. One of the most useful flaps is the reverse ulnar perforator flap. We performed a two-staged procedure for repairing a post-burn contracture release defect in a 40-year-old male. In the first stage we applied reverse ulnar perforator flap for the hand defect, and ulnar artery and vein repair in the second stage. In conclusion, this two-staged procedure is a non-primary but useful option for hand and finger defects and prevents major vascular structure damage of the forearm. [Hand Microsurg 2016; 5(1.000: 40-43

Learning From Short Text Streams With Topic Drifts.

Science.gov (United States)

Li, Peipei; He, Lu; Wang, Haiyan; Hu, Xuegang; Zhang, Yuhong; Li, Lei; Wu, Xindong

2017-09-18

Short text streams such as search snippets and micro blogs have been popular on the Web with the emergence of social media. Unlike traditional normal text streams, these data present the characteristics of short length, weak signal, high volume, high velocity, topic drift, etc. Short text stream classification is hence a very challenging and significant task. However, this challenge has received little attention from the research community. Therefore, a new feature extension approach is proposed for short text stream classification with the help of a large-scale semantic network obtained from a Web corpus. It is built on an incremental ensemble classification model for efficiency. First, more semantic contexts based on the senses of terms in short texts are introduced to make up of the data sparsity using the open semantic network, in which all terms are disambiguated by their semantics to reduce the noise impact. Second, a concept cluster-based topic drifting detection method is proposed to effectively track hidden topic drifts. Finally, extensive studies demonstrate that as compared to several well-known concept drifting detection methods in data stream, our approach can detect topic drifts effectively, and it enables handling short text streams effectively while maintaining the efficiency as compared to several state-of-the-art short text classification approaches.

Perforated appendicitis: accuracy of CT diagnosis and correlation of CT findings with the length of hospital

International Nuclear Information System (INIS)

Siddiqui, H.A.; Afzal, S.

2007-01-01

To determine the sensitivity and specificity of CT findings in the differentiation of perforated from nonperforated appendicitis and correlate CT diagnosis with the length of hospital stay. The study included 70 patients who presented with right lower quadrant abdominal pain and underwent preoperative CT scan followed by appendectomy. Patients were divided into two groups of having perforated and nonperforated appendicitis on the basis of CT scan findings. The surgical and pathological reports combined were considered the reference standard for the diagnosis of perforated appendicitis. Various CT scan findings and average duration of hospital stay in days was compared by t-test. Twenty-six (37%) of 70 patients had perforated appendicitis. It was correctly identified on pre-operative CT scan in 18 patients. There were 18 true positive diagnoses, 43 true negative diagnoses, 1 false positive diagnosis and 8 false negative diagnoses which yielded a sensitivity of 69%, specificity of 97%, positive predictive value of 94% and negative predictive value of 84%. Mean length of hospital stay in perforated group was 6.3 days and 2.9 days in nonperforated group. Severe periappendiceal inflammation, periappendiceal and or abdominopelvic fluid and abscess were significantly associated with perforated appendicitis and with a significant longer hospital stay (p <.001). CT scan is 69% sensitive and 97% specific for the diagnosis of perforated appendicitis and constellation of CT findings can be used to select patients with perforated appendicitis for initial non-operative management. Presence of CT signs of significant appendiceal inflammation is independent predictor of longer hospital stay. (author)

Microvascular anatomy of the cerebellar parafloccular perforating space.

Science.gov (United States)

Sosa, Pablo; Dujovny, Manuel; Onyekachi, Ibe; Sockwell, Noressia; Cremaschi, Fabián; Savastano, Luis E

2016-02-01

The cerebellopontine angle is a common site for tumor growth and vascular pathologies requiring surgical manipulations that jeopardize cranial nerve integrity and cerebellar and brainstem perfusion. To date, a detailed study of vessels perforating the cisternal surface of the middle cerebellar peduncle-namely, the paraflocculus or parafloccular perforating space-has yet to be published. In this report, the perforating vessels of the anterior inferior cerebellar artery (AICA) in the parafloccular space, or on the cisternal surface of the middle cerebellar peduncle, are described to elucidate their relevance pertaining to microsurgery and the different pathologies that occur at the cerebellopontine angle. Fourteen cadaveric cerebellopontine cisterns (CPCs) were studied. Anatomical dissections and analysis of the perforating arteries of the AICA and posterior inferior cerebellar artery at the parafloccular space were recorded using direct visualization by surgical microscope, optical histology, and scanning electron microscope. A comprehensive review of the English-language and Spanish-language literature was also performed, and findings related to anatomy, histology, physiology, neurology, neuroradiology, microsurgery, and endovascular surgery pertaining to the cerebellar flocculus or parafloccular spaces are summarized. A total of 298 perforating arteries were found in the dissected specimens, with a minimum of 15 to a maximum of 26 vessels per parafloccular perforating space. The average outer diameter of the cisternal portion of the perforating arteries was 0.11 ± 0.042 mm (mean ± SD) and the average length was 2.84 ± 1.2 mm. Detailed schematics and the surgical anatomy of the perforating vessels at the CPC and their clinical relevance are reported. The parafloccular space is a key entry point for many perforating vessels toward the middle cerebellar peduncle and lateral brainstem, and it must be respected and protected during surgical approaches to the

A Guide to Ordinary High Water Mark (OHWM) Delineation for Non-Perennial Streams in the Western Mountains, Valleys, and Coast Region of the United States

Science.gov (United States)

2014-08-01

38 15 Remotely sensed images acquired from Google Earth and ground-based images from 2011 of a non-perennial stream in Teton County, WY...less confined. Debris flows and landslides are common in the region, accounting for much, if not most, of the sediment flux from headwater streams in...information is becoming in- creasingly available and easy to analyze via free, open-access resources such as Google Earth (www.earth.google.com). Where

A Novel Perforator Flap Training Model Using a Chicken Leg.

Science.gov (United States)

Cifuentes, Ignacio J; Yañez, Ricardo A; Salisbury, Maria C; Rodriguez, José R; Varas, Julian E; Dagnino, Bruno L

2016-04-01

Living animal models are frequently used for perforator flap dissection training, but no ex vivo models have been described. The aim of this study is to present a novel nonliving model for perforator flap training based on a constant perforator in the chicken leg. A total of 15 chicken legs were used in this study. Anatomical dissection of the perforator was performed after its identification using ink injection, and in four of these specimens a perforator-based flap was raised. The anatomical dissection revealed a constant intramuscular perforator with a median length of 5.7 cm. Median proximal and distal vessel diameters were 0.93 and 0.4 mm, respectively. The median dissection time was 77.5 minutes. This study introduces a novel, affordable, and reproducible model for the intramuscular dissection of a perforator-based flap using an ex vivo animal model. Its consistent perforator and appropriate-sized vessels make it useful for training.

[Iatrogen perforation of the rectum after colon radiography].

Science.gov (United States)

Eggum, R; Kressner, U; Haffner, J

1998-05-10

Perforation of the rectum following barium enema is relatively rare, occurring in 1 of 3,000 procedures. Colorectal perforation is a serious condition and early diagnosis is of paramount importance in order to avoid any delay in treating the patient. Direct suture of the perforation, lavage, presacral drainage and stomia are the preferred methods of primary surgical treatment.

Secure remote service execution for web media streaming

OpenAIRE

Mikityuk, Alexandra

2017-01-01

Through continuous advancements in streaming and Web technologies over the past decade, the Web has become a platform for media delivery. Web standards like HTML5 have been designed accordingly, allowing for the delivery of applications, high-quality streaming video, and hooks for interoperable content protection. Efficient video encoding algorithms such as AVC/HEVC and streaming protocols such as MPEG-DASH have served as additional triggers for this evolution. Users now employ...

The Effect of Perforation on the Dynamics of a Flexible Panel

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A. Putra

2014-01-01

Full Text Available Introduction of holes into plate-like structures is commonly found as one of the practical noise control measures to reduce sound radiation. However, perforation also reduces the panel stiffness and hence increases its vibration. The discussion on this effect is lacking and hence this paper discusses the dynamics of a perforated panel from the results obtained from Finite Element (FE model. Different hole geometries and arrangement are simulated to investigate their effect on the plate mobility. In general, it is found that increasing the perforation ratio increases the plate mobility. For a fixed perforation ratio, the mobility increases at high frequency (above 1 kHz for a smaller hole density in the plate. The plate with holes concentrated at the middle shows the largest increase of vibration around the plate centre compared to those uniformly distributed or away from the middle and concentrated at the plate edges. This is because as the hole separation becomes smaller, the reduction of the global stiffness around the mid area of the plate becomes greater. This also corresponds to the finding here that the mobility is greater at the vicinity of the hole. Different conditions of the plate edges are found to give consistent trend of the effect of perforation.

LaPlace's law revisited: Cecal perforation as an unusual presentation of pancreatic carcinoma

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Cason Frederick D

2007-02-01

Full Text Available Abstract Background Pancreatic cancer is often locally and distally aggressive, but initial presentation as cecal perforation is uncommon. Case presentation We describe a patient presenting with pneumoperitoneum, found at initial exploration to have a cecal perforation believed to be secondary to a large cecal adenoma, after palpation of the remainder of the colon revealed hard stool but no distal obstruction. Postoperatively, however, the patient progressed to large bowel obstruction and upon reexploration, a mass could now be delineated, encompassing the splenic flexure, splenic hilum, and distal pancreas. Histological evaluation determined this was locally invasive pancreatic adenocarcinoma, and therefore the true etiology of the original cecal perforation. Conclusion Any perforation localized to the cecum must be highly suspicious for a distal obstruction, as dictated by the law of LaPlace.

Perforated duodenal ulcer: an unusual complication of gastroenteritis.

OpenAIRE

Wilson, J M; Darby, C R

1990-01-01

A 7 year old boy was admitted to hospital with gastroenteritis, which was complicated by an acute perforated duodenal ulcer. After oversewing of the perforation he made an uncomplicated recovery. Peptic ulceration is under-diagnosed in childhood and this leads to delay in diagnosis and appropriate management. Ulceration is associated with severe illness and viral infections, but perforation is rare.

Iatrogen perforation of the rectum following barium enema

International Nuclear Information System (INIS)

Eggum, R.; Kressner, U.; Haffner, J.

1998-01-01

Perforation of the rectum following barium enema is relatively rare, occurring in 1 of 3,000 procedures. Colorectal perforation is a serious condition and early diagnosis is of paramount importance in order to avoid any delay in treating the patient. Direct suture of the perforation, lavage, presacral drainage and stomia are the preferred methods of primary surgical treatment. 10 refs., 1 fig

Buffering Implications for the Design Space of Streaming MEMS Storage

NARCIS (Netherlands)

Khatib, M.G.; Abelmann, Leon; Preas, Kathy

2011-01-01

Emerging nanotechnology-based systems encounter new non-functional requirements. This work addresses MEMS storage, an emerging technology that promises ultrahigh density and energy-efficient storage devices. We study the buffering requirement of MEMS storage in streaming applications. We show that

Bowel perforation in type IV vascular Ehlers-Danlos syndrome. A systematic review.

Science.gov (United States)

El Masri, H; Loong, T-H; Meurette, G; Podevin, J; Zinzindohoue, F; Lehur, P-A

2018-05-01

Spontaneous gastrointestinal (GI) perforation is a well-known complication occurring in patients suffering from Type IV vascular Ehlers-Danlos syndrome (EDS IV). The aim of the present study was to review the current literature on spontaneous GI perforation in EDS IV and illustrate the surgical management and outcome when possible. A systematic review of all the published data on EDS IV patients with spontaneous GI perforation between January 2000 and December 2015 was conducted using three major databases PUBMED, EMBASE, and Cochrane Central Register of Controlled Trails. References of the selected articles were screened to avoid missing main articles. Twenty-seven published case reports and four retrospective studies, including 31 and 527 cases, respectively, matched the search criteria. A case from our institution was added. Mean age was 26 years (range 6-64 years). The most frequent site of perforation was the colon, particularly the sigmoid, followed by small bowel, upper rectum, and finally stomach. The majority of cases were initially managed with Hartmann's procedure. In recurrent perforations, total colectomy was performed. The reperforation rate was considerably higher in the "partial colectomy with anastomosis" group than in the Hartmann group. Colonic perforation is the most common spontaneous GI perforation in EDS IV patients. An unexpected fragility of the tissues should raise the possibility of a connective tissue disorder and prompt further investigation with eventual management of these high-risk patients with a multidisciplinary team approach in dedicated centres. In the emergency setting, a Hartmann procedure should be performed.

Parasacral Perforator Flaps for Reconstruction of Sacral Pressure Sores.

Science.gov (United States)

Lin, Chin-Ta; Chen, Shih-Yi; Chen, Shyi-Gen; Tzeng, Yuan-Sheng; Chang, Shun-Cheng

2015-07-01

Despite advances in reconstruction techniques, pressure sores continue to present a challenge to the plastic surgeon. The parasacral perforator flap is a reliable flap that preserves the entire contralateral side as a future donor site. On the ipsilateral side, the gluteal muscle itself is preserved and all flaps based on the inferior gluteal artery are still possible. We present our experience of using parasacral perforator flaps in reconstructing sacral defects. Between August 2004 and January 2013, 19 patients with sacral defects were included in this study. All the patients had undergone surgical reconstruction of sacral defects with a parasacral perforator flap. The patients' sex, age, cause of sacral defect, flap size, flap type, numbers of perforators used, rotation angle, postoperative complications, and hospital stay were recorded. There were 19 parasacral perforator flaps in this series. All flaps survived uneventfully except for 1 parasacral perforator flap, which failed because of methicillin-resistant Staphylococcus aureus infection. The overall flap survival rate was 95% (18/19). The mean follow-up period was 17.3 months (range, 2-24 months). The average length of hospital stay was 20.7 days (range, 9-48 days). No flap surgery-related mortality was found. Also, there was no recurrence of sacral pressure sores or infected pilonidal cysts during the follow-up period. Perforator-based flaps have become popular in modern reconstructive surgery because of low donor-site morbidity and good preservation of muscle. Parasacral perforator flaps are durable and reliable in reconstructing sacral defects. We recommend the parasacral perforator flap as a good choice for reconstructing sacral defects.

Acquired perforating dermatosis in a patient with chronic renal failure.

Science.gov (United States)

Fernandes, Karen de Almeida Pinto; Lima, Lourenço de Azevedo; Guedes, Juliana Chaves Ruiz; Lima, Ricardo Barbosa; D'Acri, Antônio Macedo; Martins, Carlos José

2016-01-01

Perforating dermatoses are a group of skin diseases characterized by transepidermal elimination of dermal material. The disease is divided into two groups: the primary group and the secondary group. The classical or primary perforating dermatoses are subdivided into four types according to the eliminated dermal materials: Kyrle disease, perforating reactive collagenosis, elastosis perforans serpiginosa, and perforating folliculitis. The secondary form is known as acquired perforating dermatosis. The term was proposed in 1989 by Rapini to designate the perforating dermatoses affecting adult patients with systemic disease, regardless of the dermal materials eliminated. This report describes a case of the disease with elimination of collagen and elastic fibers in a patient with chronic renal failure.

Large-scale environmental controls on microbial biofilms in high-alpine streams

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T. J. Battin

2004-01-01

Full Text Available Glaciers are highly responsive to global warming and important agents of landscape heterogeneity. While it is well established that glacial ablation and snowmelt regulate stream discharge, linkage among streams and streamwater geochemistry, the controls of these factors on stream microbial biofilms remain insufficiently understood. We investigated glacial (metakryal, hypokryal, groundwater-fed (krenal and snow-fed (rhithral streams - all of them representative for alpine stream networks - and present evidence that these hydrologic and hydrogeochemical factors differentially affect sediment microbial biofilms. Average microbial biomass and bacterial carbon production were low in the glacial streams, whereas bacterial cell size, biomass, and carbon production were higher in the tributaries, most notably in the krenal stream. Whole-cell in situ fluorescence hybridization revealed reduced detection rates of the Eubacteria and higher abundance of α-Proteobacteria in the glacial stream, a pattern that most probably reflects the trophic status of this ecosystem. Our data suggest low flow during the onset of snowmelt and autumn as a short period (hot moment of favorable environmental conditions with pulsed inputs of allochthonous nitrate and dissolved organic carbon, and with disproportionately high microbial growth. Tributaries are relatively more constant and favorable environments than kryal streams, and serve as possible sources of microbes and organic matter to the main glacial channel during periods (e.g., snowmelt of elevated hydrologic linkage among streams. Ice and snow dynamics - and their impact on the amount and composition of dissolved organic matter - have a crucial impact on stream biofilms, and we thus need to consider microbes and critical hydrological episodes in future models of alpine stream communities.

Idiopathic gastric perforation in an asplenic infant | Olsen | African ...

African Journals Online (AJOL)

Introduction: The cause of idiopathic gastric perforations in neonates remains unknown. Perforations of the abdominal oesophagus, stomach and duodenum in infants and children are the rarest type of intestinal perforations. There are 21 reported cases of an idiopathic gastric rupture in nonneonates. Case Report: A ...

An efficient reversible privacy-preserving data mining technology over data streams.

Science.gov (United States)

Lin, Chen-Yi; Kao, Yuan-Hung; Lee, Wei-Bin; Chen, Rong-Chang

2016-01-01

With the popularity of smart handheld devices and the emergence of cloud computing, users and companies can save various data, which may contain private data, to the cloud. Topics relating to data security have therefore received much attention. This study focuses on data stream environments and uses the concept of a sliding window to design a reversible privacy-preserving technology to process continuous data in real time, known as a continuous reversible privacy-preserving (CRP) algorithm. Data with CRP algorithm protection can be accurately recovered through a data recovery process. In addition, by using an embedded watermark, the integrity of the data can be verified. The results from the experiments show that, compared to existing algorithms, CRP is better at preserving knowledge and is more effective in terms of reducing information loss and privacy disclosure risk. In addition, it takes far less time for CRP to process continuous data than existing algorithms. As a result, CRP is confirmed as suitable for data stream environments and fulfills the requirements of being lightweight and energy-efficient for smart handheld devices.

Acute otitis media with spontaneous tympanic membrane perforation.

Science.gov (United States)

Principi, N; Marchisio, P; Rosazza, C; Sciarrabba, C S; Esposito, S

2017-01-01

The principal aim of this review is to present the current knowledge regarding acute otitis media (AOM) with spontaneous tympanic membrane perforation (STMP) and to address the question of whether AOM with STMP is a disease with specific characteristics or a severe case of AOM. PubMed was used to search for all studies published over the past 15 years using the key words "acute otitis media" and "othorrea" or "spontaneous tympanic membrane perforation". More than 250 articles were found, but only those published in English and providing data on aspects related to perforation of infectious origin were considered. Early Streptococcus pneumoniae infection due to invasive pneumococcal strains, in addition to coinfections and biofilm production due mainly to non-typeable Haemophilus influenzae, seem to be precursors of STMP. However, it is unclear why some children have several STMP episodes during the first years of life that resolve without complications in adulthood, whereas other children develop chronic suppurative otitis media. Although specific aetiological agents appear to be associated with an increased risk of AOM with STMP, further studies are needed to determine whether AOM with STMP is a distinct disease with specific aetiological, clinical and prognostic characteristics or a more severe case of AOM than the cases that occur without STMP. Finally, it is important to identify preventive methods that are useful not only in otitis-prone children with uncomplicated AOM, but also in children with recurrent AOM and those who experience several episodes with STMP.

Propulsive efficiency and non- expert swimmers performance

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Tiago Barbosa

2009-12-01

Full Text Available Propulsive efficiency is one of the most interesting issues for competitive swimming researchers, has it presents significant relationships with the swimmer’s biophysical behavior and his/her performance. Although propulsive efficiency is a variable that has been quite studied in elite swimmers, there is no research on this issue in young and non-expert swimmers. Thus, the aim of this study was to: (i estimate the propulsive efficiency on non-expert swimmers; (ii identify biomechanical and anthropometrical parameters that are associated with propulsive efficiency; (iii identify the association between the propulsive efficiency and swim performance. Twenty-eight non-expert swimmers participated on this study. It was assessed the propulsive efficiency, biomechanical and anthropometrical parameters, as well as, the swim performance. The propulsive efficiency of non-expert swimmers is lower than data reported in the literature to higher competitive levels swimmers and there are no significant differences between boys and girls. It was also noted that several biomechanical and anthropometrical parameters, as well as, the swim performance are associated with the propulsive efficiency.

Segmental resection with primary anastomosis is not always safe in splenic flexure perforation.

Science.gov (United States)

Weledji, Elroy P; Mokake, Martin D; Sinju, Motaze

2016-01-16

Familial adenomatous polyposis (FAP) is caused by a rare mutation of the adenomatous polyposis coli gene on Chromosome 5q. The risk of colorectal cancer in patients with FAP is nearly 100% and intensive endoscopic surveillance or prophylactic colectomy are mandatory. If extensive endoscopic surveillance is chosen, there is a cumulative risk of perforation and bleeding especially after polypectomy. We discussed the problems and options in the management of the late diagnosis of an iatrogenic perforation of the splenic flexure complicating endoscopic surveillance in FAP. We present a 35-year-old black African man with FAP who sustained a splenic flexure perforation following a colonoscopic polypectomy of a suspicious lesion. He underwent a splenic flexure resection and primary anastomosis that dehisced and the patient benefited from an emergency definitive colectomy and ileorectal anastomosis. Resection with primary anastomosis following iatrogenic perforation of the splenic flexure is not safe because of a high chance of anastomotic dehiscence. Following a late diagnosis in an unstable patient exteriorization of the perforation as a stoma is a better option prior to a definitive prophylactic colectomy.

CORRELATION BETWEEN TYMPANIC MEMBRANE PERFORATION AND HEARING LOSS

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Lidija RISTOVSKA

2016-04-01

Full Text Available Introduction: Perforation of the tympanic membrane primarily results from middle ear infections, trauma or iatrogenic causes. The perforation causes conductive hearing loss by reducing the surface area available for sound transmission to the ossicular chain. Objective: The objective was to analyze the characteristics of tympanic membrane perforations in relation to hearing loss and to determine the type and degree of hearing loss. Materials and methods: We analyzed audiometric, otoscopic findings and medical reports of 218 patients, 114 males (52.3% and 104 females (47.7%, aged 9 to 75 years (mean age of 47.9 years, examined during the period of November 2012 to October 2015. For statistical data analysis we used Chi-square test with level of significance p<0.05. Results: Most of the patients had unilateral perforations (89% with right ear predominance and involvement of two quadrants of pars tensa (37.2%. Mean air-bone gap was 23.9 dB. The largest air-bone gap was at frequency of 250 Hz. Most of the patients (73.1% had mixed hearing loss (p=0.032, and average hearing thresholds from 21 to 40 dB. Conclusion: Mean air-bone gap is largest at the lower frequencies, and decreases as frequency increases. Size of the perforation has effect on hearing loss. Mean air-bone gap increases with increasing size of the perforation. There is no big difference between the mean air-bone gap in posterior versus anterior perforations.

Respiratory distress and chest pain: a perforated peptic ulcer with an unusual presentation.

Science.gov (United States)

Bruner, David I; Gustafson, Corey

2011-06-22

Dyspnea and chest pain are common presenting complaints to the ED, and coupled together can present a challenging diagnostic dilemma in patients in extremis. A thoughtful evaluation is required, giving due diligence to the immediate life threats as well as multiple etiologies which can cause serious morbidity. A perforated peptic ulcer is one such possibility and requires rapid diagnosis and prompt intervention to avoid the associated high risk of morbidity and mortality. We present a case report of a 54 year old man with respiratory distress and chest pain as the initial Emergency Department presentation of a perforated duodenal ulcer. We discuss an unusual presentation of a perforated duodenal ulcer that was recognized in the emergency department and treated promptly. The patient was surgically treated immediately, had a prolonged and complicated post-operative course, but is ultimately doing well. We also provide a brief literature review of the risk factors, imaging choices, and management decision required to treat a perforated ulcer. Perforated ulcers can have highly varied presentations and are occasionally difficult to diagnose in a complicated patient. Knowledge of the risk factors and a thorough history and physical can point to the diagnosis, but timely and appropriate imaging is often required because delays in diagnosis and treatment lead to poor outcomes. Early administration of antibiotics and immediate surgical repair are necessary to limit morbidity and mortality.

Perfuração de Luvas durante Cirurgias Ginecológicas Glove Perforation during Gynecologic Surgeries

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Eddie Fernando Candido Murta

2000-05-01

Full Text Available Objetivo: analisar a incidência de perfuração de luvas cirúrgicas durante atos operatórios ginecológicos. Métodos: estudo prospectivo de 454 luvas usadas em 65 procedimentos utilizando-se o método de pressão de água. Resultados: do total de 454 luvas examinadas, foram verificadas perfurações em 54 (11,9%, sendo estatisticamente significativo o maior número de perfurações em comparação ao grupo controle, uma (1,7% em 60 analisadas (pPurpose: to analyze the frequency of glove perforation during gynecologic surgeries. Methods: a prospective study of 454 gloves used in 65 surgeries by the water pressure method. Results: of a total of 454 gloves, 54 (11.9% had perforations. Comparison with the control group showed p<0.05 (chi² test, 1 (1.7% perforation in 60 gloves tested. Of the total of gloves used in 65 surgeries, 29 (44.6% had perforations, 44 (81% had one perforation and 10 (19% had more than one perforation. The two most common sites of perforations were the index finger, 20 (29.5% and the thumb, 14 (25.9%. Perforation was predominant in the left hand (72.1%. The surgeons were the members of the team with the greatest number of glove perforations. Total hysterectomy was the most frequent surgery in which glove perforations occurred (50% of the cases. Conclusion: the glove perforations occurred with relatively high frequency during gynecologic surgeries. The index finger of the left hand proved to be the most affected region. Among the members of the team, the highest percentage of glove perforations occurred in those of the surgeons. Total hysterectomy had the highest perforation rate.

High-efficiency ballistic electrostatic generator using microdroplets

NARCIS (Netherlands)

Xie, Yanbo; Bos, Diederik; de Vreede, Lennart; de Boer, Hans L.; van der Meulen, Mark-Jan; van der Meulen, Mark-Jan; Versluis, Michel; Sprenkels, A.J.; van den Berg, Albert; Eijkel, Jan C.T.

2014-01-01

The strong demand for renewable energy promotes research on novel methods and technologies for energy conversion. Microfluidic systems for energy conversion by streaming current are less known to the public, and the relatively low efficiencies previously obtained seemed to limit the further

Are macroinvertebrates in high altitude streams affected by oxygen deficiency?

DEFF Research Database (Denmark)

Jacobsen, Dean; Rostgaard, S.; Vásconez, J. J.

2003-01-01

1. The solubility of oxygen in water increases with decreasing temperature. This has led to a general perception of cold, high mountain streams as more oxygen rich than warmer lowland streams, and that macroinvertebrates inhabiting high altitude streams have had no need to adapt to critical oxygen...... conditions. However, this fails to take into account that oxygen solubility declines with decreasing atmospheric pressure, which may be of importance at high altitudes. 2. Based on samples of macroinvertebrate benthos and in situ measurements of respiratory oxygen demand of macroinvertebrates in small...... the mean weight-specific respiratory rate of macroinvertebrates declined by only 50%, from 400 to 3800 m. We suggest that this disproportionately large gap between availability and demand of oxygen at high altitudes may imply a potential oxygen deficiency for the fauna, and we discuss how oxygen deficiency...

Pneumoperitoneum without Intestinal Perforation in a Neonate: Case Report and Literature Review

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Prabhavathi Gummalla

2017-01-01

Full Text Available Pneumoperitoneum in a preterm neonate usually indicates perforation of the intestine and is considered a surgical emergency. However, there are cases of pneumoperitoneum with no evidence of rupture of the intestine reported in the literature. We report a case of pneumoperitoneum with no intestinal perforation in a preterm neonate with respiratory distress syndrome who was on high frequency oscillatory ventilation (HFOV. He developed bilateral pulmonary interstitial emphysema with localized cystic lesion, likely localized pulmonary interstitial emphysema, and recurrent pneumothoraces. He was treated with dexamethasone to wean from the ventilator. Pneumoperitoneum developed in association with left sided pneumothorax following mechanical ventilation and cardiopulmonary resuscitation. Pneumoperitoneum resolved after the pneumothorax was resolved with chest tube drainage. He died from acute cardiorespiratory failure. At autopsy, there was no evidence of intestinal perforation. This case highlights the fact that pneumoperitoneum can develop secondary to pneumothorax and does not always indicate intestinal perforation or require exploratory laparotomy.

A case of perforating injury of eyeball and traumatic cataract caused by acupuncture

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Han Shuang

2016-01-01

Full Text Available Perforating globe injury is the leading cause of monocular blindness and vision loss. A 58-year-old male was injured by acupuncture needle during acupuncture treatment for his cerebral infarction. To the best of our knowledge, this is the first case report of perforating injury of the eyeball and traumatic cataract caused by acupuncture. The patient was hospitalized due to diagnosis of perforating ocular injury, traumatic cataract, and corneal and iris perforating injury. Moreover, he had to accept treatments of phacoemulsification, anterior vitrectomy along with intraocular lens implantation in the sulcus to improve his visual acuity. As acupuncture therapy has been widely performed for various diseases and achieved highly approval, the aim of this report is to remind acupuncturists operating accurately to avoid unnecessary injury during the treatment process, or the cure can also become the weapon.

A case of perforating injury of eyeball and traumatic cataract caused by acupuncture.

Science.gov (United States)

Shuang, Han; Yichun, Kong

2016-04-01

Perforating globe injury is the leading cause of monocular blindness and vision loss. A 58-year-old male was injured by acupuncture needle during acupuncture treatment for his cerebral infarction. To the best of our knowledge, this is the first case report of perforating injury of the eyeball and traumatic cataract caused by acupuncture. The patient was hospitalized due to diagnosis of perforating ocular injury, traumatic cataract, and corneal and iris perforating injury. Moreover, he had to accept treatments of phacoemulsification, anterior vitrectomy along with intraocular lens implantation in the sulcus to improve his visual acuity. As acupuncture therapy has been widely performed for various diseases and achieved highly approval, the aim of this report is to remind acupuncturists operating accurately to avoid unnecessary injury during the treatment process, or the cure can also become the weapon.

Hyperbilirubinemia as a predictor for appendiceal perforation

DEFF Research Database (Denmark)

Burcharth, J; Pommergaard, H C; Rosenberg, J

2013-01-01

Delayed or wrong diagnosis in patients with appendicitis can result in perforation and consequently increased morbidity and mortality. Serum bilirubin may be a useful marker for appendiceal perforation. The purpose of this systematic review was to evaluate studies investigating elevated serum...

Sigmoid Colonic Perforation with Faecal Peritonitis due to Faecaloma

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Ibrahim Khalil

2014-09-01

Full Text Available Colon perforation is an uncommon event usually caused by malignancy, diverticular disease, amoebic colitis, steroid therapy, trauma and ulcerative colitis, but stercoral perforation is very rare. Severe chronic constipation is considered to be the main causative factor in development of stercoral perforation of colon. Sometimes it can also produce catastrophic complications like colonic obstruction, faecal peritonitis and septicaemia. We report a rare case of sigmoid colonic perforation with faecal peritonitis and pneumoperitonium due to faecaloma which was diagnosed after exploratory laparotomy.

Organic carbon spiralling in stream ecosystems

Energy Technology Data Exchange (ETDEWEB)

Newbold, J D; Mulholland, P J; Elwood, J W; O' Neill, R V

1982-01-01

The term spiralling has been used to describe the combined processes of cycling and longitudinal transport in streams. As a measure or organic carbon spiralling, we introduced organic carbon turnover length, S, defined as the average or expected downstream distance travelled by a carbon atom between its entry or fixation in the stream and its oxidation. Using a simple model for organic carbon dynamics in a stream, we show that S is closely related to fisher and Likens' ecosystem efficiency. Unlike efficiency, however, S is independent of the length of the study reach, and values of S determined in streams of differing lengths can be compared. Using data from three different streams, we found the relationship between S and efficiency to agree closely with the model prediction. Hypotheses of stream functioning are discussed in the context of organic carbeon spiralling theory.

Acoustic and streaming velocity components in a resonant waveguide at high acoustic levels.

Science.gov (United States)

Daru, Virginie; Reyt, Ida; Bailliet, Hélène; Weisman, Catherine; Baltean-Carlès, Diana

2017-01-01

Rayleigh streaming is a steady flow generated by the interaction between an acoustic wave and a solid wall, generally assumed to be second order in a Mach number expansion. Acoustic streaming is well known in the case of a stationary plane wave at low amplitude: it has a half-wavelength spatial periodicity and the maximum axial streaming velocity is a quadratic function of the acoustic velocity amplitude at antinode. For higher acoustic levels, additional streaming cells have been observed. Results of laser Doppler velocimetry measurements are here compared to direct numerical simulations. The evolution of axial and radial velocity components for both acoustic and streaming velocities is studied from low to high acoustic amplitudes. Two streaming flow regimes are pointed out, the axial streaming dependency on acoustics going from quadratic to linear. The evolution of streaming flow is different for outer cells and for inner cells. Also, the hypothesis of radial streaming velocity being of second order in a Mach number expansion, is not valid at high amplitudes. The change of regime occurs when the radial streaming velocity amplitude becomes larger than the radial acoustic velocity amplitude, high levels being therefore characterized by nonlinear interaction of the different velocity components.

Temperature driven annealing of perforations in bicellar model membranes.

Science.gov (United States)

Nieh, Mu-Ping; Raghunathan, V A; Pabst, Georg; Harroun, Thad; Nagashima, Kazuomi; Morales, Hannah; Katsaras, John; Macdonald, Peter

2011-04-19

Bicellar model membranes composed of 1,2-dimyristoylphosphatidylcholine (DMPC) and 1,2-dihexanoylphosphatidylcholine (DHPC), with a DMPC/DHPC molar ratio of 5, and doped with the negatively charged lipid 1,2-dimyristoylphosphatidylglycerol (DMPG), at DMPG/DMPC molar ratios of 0.02 or 0.1, were examined using small angle neutron scattering (SANS), (31)P NMR, and (1)H pulsed field gradient (PFG) diffusion NMR with the goal of understanding temperature effects on the DHPC-dependent perforations in these self-assembled membrane mimetics. Over the temperature range studied via SANS (300-330 K), these bicellar lipid mixtures exhibited a well-ordered lamellar phase. The interlamellar spacing d increased with increasing temperature, in direct contrast to the decrease in d observed upon increasing temperature with otherwise identical lipid mixtures lacking DHPC. (31)P NMR measurements on magnetically aligned bicellar mixtures of identical composition indicated a progressive migration of DHPC from regions of high curvature into planar regions with increasing temperature, and in accord with the "mixed bicelle model" (Triba, M. N.; Warschawski, D. E.; Devaux, P. E. Biophys. J.2005, 88, 1887-1901). Parallel PFG diffusion NMR measurements of transbilayer water diffusion, where the observed diffusion is dependent on the fractional surface area of lamellar perforations, showed that transbilayer water diffusion decreased with increasing temperature. A model is proposed consistent with the SANS, (31)P NMR, and PFG diffusion NMR data, wherein increasing temperature drives the progressive migration of DHPC out of high-curvature regions, consequently decreasing the fractional volume of lamellar perforations, so that water occupying these perforations redistributes into the interlamellar volume, thereby increasing the interlamellar spacing. © 2011 American Chemical Society

Comparison of differently viscous iodinated and bariumcontaining contrast agents in the detection of pharyngeal perforation

International Nuclear Information System (INIS)

Keberle, M.; Wittenberg, G.; Trusen, A.; Hahn, D.; Baumgartner, W.

2001-01-01

Purpose: In contrast to esophageal perforations, the more radiopaque barium-suspensions are not as important as iodinated aqueous contrast agents for the detection of pharyngeal perforations. This study was performed to find out whether the highly different viscosities (of iodinated and barium-containing contrast agents with comparable radiopacities) are a reason for this. Methods: Viscosity, subjective difference in contrast, and CT-density of an iodinated aqueous (Telebrix) and a 50 wt/vol% barium-containing contrast agent (Micropaque) were determined. Moreover, to exclude postoperative perforation, 104 patients were prospectively examined by pharyngography using both contrast media. Pharyngographies of patients with perforation were later compared by two independent readers. All patients with perforation were followed up clinically to exclude complications due to barium administration. Results: In-vitro comparison showed comparable radiopacity but the 50 wt/vol% barium-suspension was much more viscous that the iodinated contrast agent. During pharyngography, totally, 14 perforations were clearly delineated with the iodinated aqueous contrast agent. However, two of them were not detected with the barium-suspension. All the other perforations presented equally. Conclusions: Given a sufficient radiopacity, a low viscosity appears to be essential for a contrast agent to detect especially pharyngeal perforations. Thus, we recommend the sole use of an iodinated contrast agent (at suspicion of aspiration as isoosmolar variant) for this purpose. (orig.) [de

Perforated peptic ulcer following gastric bypass for obesity.

Science.gov (United States)

Macgregor, A M; Pickens, N E; Thoburn, E K

1999-03-01

Peptic ulcer in the excluded segment of a gastric bypass performed in the management of morbid obesity has only rarely been reported in the literature. The purpose of this study is to review our experience with the condition in a series of 4300 patients who underwent gastric-restrictive surgery between 1978 and 1997. Eleven patients presented with acute perforation of a peptic ulcer in the excluded gastric segment. Nine ulcers were duodenal, one was gastric, and one patient had both gastric and duodenal perforations. The time between primary gastric-restrictive surgery and ulcer perforation varied from 20 days to 12 years. All patients presented with upper abdominal pain. The classical radiological sign of perforated peptic ulcer, free air under the diaphragm, did not occur in any patient. Nine patients were initially treated by primary closure of the perforation with subsequent definitive ulcer therapy by vagotomy, pyloroplasty, or gastrectomy. One case, initially treated elsewhere, was managed by placement of a Malecot catheter through the duodenal perforation, gastrostomy, and peritoneal drainage. One recent case remains symptom-free on H2 blockers after simple closure. There was no mortality. Six cases were previously reported in the literature with a 33 per cent mortality rate.

Stercoral perforation in a 17-year old.

LENUS (Irish Health Repository)

McHugh, S

2012-02-01

INTRODUCTION: Stercoral perforation is a rare cause of perforation. This is the first reported case where a partial eating disorder (ED) is the primary causative differential. CASE PRESENTATION: We present the case of a 17-year-old girl who presented to her local Emergency Department with a 24-h history of left-sided abdominal pain. She subsequently deteriorated and a computed tomography scan of her abdomen showed gross distension of the large bowel with a sigmoid perforation. She underwent total colectomy with end ileostomy. Histology reported stercoral perforation but normal bowel ganglia. While an inpatient she was reviewed by the Psychiatric team who were concerned she was suffering from a partial ED. CONCLUSION: This case highlights the importance of a multidisciplinary approach in optimally treating patients such as these. Aggressive medical management with involvement of a psychiatric team and dietetics addresses any underlying causative psychiatric issues and helps prevent recurrence.

Stercoral perforation in a 17-year old.

LENUS (Irish Health Repository)

McHugh, S

2009-04-02

INTRODUCTION: Stercoral perforation is a rare cause of perforation. This is the first reported case where a partial eating disorder (ED) is the primary causative differential. CASE PRESENTATION: We present the case of a 17-year-old girl who presented to her local Emergency Department with a 24-h history of left-sided abdominal pain. She subsequently deteriorated and a computed tomography scan of her abdomen showed gross distension of the large bowel with a sigmoid perforation. She underwent total colectomy with end ileostomy. Histology reported stercoral perforation but normal bowel ganglia. While an inpatient she was reviewed by the Psychiatric team who were concerned she was suffering from a partial ED. CONCLUSION: This case highlights the importance of a multidisciplinary approach in optimally treating patients such as these. Aggressive medical management with involvement of a psychiatric team and dietetics addresses any underlying causative psychiatric issues and helps prevent recurrence.

Colonic carcinoma with multiple small bowel perforations mimicking intestinal obstruction

Directory of Open Access Journals (Sweden)

Khanna Rahul

2006-09-01

Full Text Available Abstract Background Carcinoma of the colon may present with perforation proximal to the site of malignancy. Caecum is the commonest site of perforation if the ileocecal valve is patent and the jejunal and ileal perforations are very rare. Case presentation A 35 year male presented with intestinal obstruction. Emergency laparotomy revealed carcinoma of the transverse colon with multiple pinpoint perforations along antimesenteric border of ileum, which were wrapped with omentum, and no peritoneal contamination was present. Extended right hemicolectomy with jejunocolic anastomosis was done. Patient made uneventful recovery in postoperative period and was treated with adjuvant chemotherapy. Conclusion Patients with colonic carcinoma and incompetent ileocecal valve may present with intestinal perforation. Increased intraluminal pressure and closed loop obstruction may lead to ischemia and perforation of the small bowel.

Dynamic Programming Optimization of Multi-rate Multicast Video-Streaming Services

Directory of Open Access Journals (Sweden)

Nestor Michael Caños Tiglao

2010-06-01

Full Text Available In large scale IP Television (IPTV and Mobile TV distributions, the video signal is typically encoded and transmitted using several quality streams, over IP Multicast channels, to several groups of receivers, which are classified in terms of their reception rate. As the number of video streams is usually constrained by both the number of TV channels and the maximum capacity of the content distribution network, it is necessary to find the selection of video stream transmission rates that maximizes the overall user satisfaction. In order to efficiently solve this problem, this paper proposes the Dynamic Programming Multi-rate Optimization (DPMO algorithm. The latter was comparatively evaluated considering several user distributions, featuring different access rate patterns. The experimental results reveal that DPMO is significantly more efficient than exhaustive search, while presenting slightly higher execution times than the non-optimal Multi-rate Step Search (MSS algorithm.

Arrangement for formation perforating and fracturing

Energy Technology Data Exchange (ETDEWEB)

Belyaev, B M; Vitsenii, E M; Zheltov, Yu P; Nikolaev, S I

1962-03-06

An arrangement for perforating and hydraulic fracturing, to be lowered on a wire line, consists of a chamber with a shaped charge, a head and a nozzle. This arrangement enables carrying out, simultaneously, the operations of perforating and fracturing. The device may be equipped with separate sections with shaped charges and a powder chamber in which powder charges are placed, designed to be ignited in sequence by slow- acting electric igniters. For controlling the gas pressure and strengthening the arrangement in the zone of perforation, the device is equipped with rubber seals which release the ring elements under pressure of explosive gas. Between the walls of the casing and the rubber seals is an annular space through the gas escapes.

Perforated SiN membrane resonators for nanomechanical IR spectroscopy poster

DEFF Research Database (Denmark)

Kurek, Maksymilian; Carnoy, Matthias; Boisen, Anja

Constant progress in micro- and nanofabrication provides a great opportunity in development of micro- and nanomechanical resonatorsthat can be used for sensing purposes. These sensors usually consist of singly-clamped cantilever beams, doubly-clamped bridges ormembranes that exhibit resonant......, lateral dimension of1×1 mm2 and 2 µm perforation grid pitch were used instead of strings which makes the IR beam alignment significantly simpler whilemaintaining similar sampling efficiency and photothermal IR absorption sensitivity....

Investigation of incidence and risk factors for surgical glove perforation in small animal surgery.

Science.gov (United States)

Hayes, Galina M; Reynolds, Deborah; Moens, Noel M M; Singh, Ameet; Oblak, Michelle; Gibson, Thomas W G; Brisson, Brigitte A; Nazarali, Alim; Dewey, Cate

2014-05-01

To identify incidence and risk factors for surgical glove perforation in small animal surgery. Observational cohort study. Surgical gloves (n = 2132) worn in 363 surgical procedures. All gloves worn by operative personnel were assessed for perforation at end-procedure using a water leak test. Putative risk factors were recorded by a surgical team member. Associations between risk factors and perforation were assessed using multivariable multi-level random-effects logistic regression models to control for hierarchical data structure. At least 1 glove perforation occurred in 26.2% of procedures. Identified risk factors for glove perforation included increased surgical duration (surgery >1 hour OR = 1.79, 95% CI = 1.12-2.86), performing orthopedic procedures (OR = 1.88; 95% CI = 1.23-2.88), any procedure using powered instruments (OR = 1.93; 95% CI = 1.21-3.09) or surgical wire (OR = 3.02; 95% CI = 1.50-6.05), use of polyisoprene as a glove material (OR = 1.59, 95% CI = 1.05-2.39), and operative role as primary surgeon (OR = 2.01; 95% CI = 1.35-2.98). The ability of the wearer to detect perforations intraoperatively was poor, with a sensitivity of 30.8%. There is a high incidence of unrecognized glove perforations in small animal surgery. © Copyright 2014 by The American College of Veterinary Surgeons.

Postvaginal Delivery Caecal Volvulus and Perforation

Directory of Open Access Journals (Sweden)

M. M. Abdullah Agha

2012-01-01

Full Text Available Intestinal obstruction is an uncommon complication of pregnancy and pueperium. It has different etiologies and voluvlus is one of the common causes. High index of suspicion is needed to diagnose it as initial presentation is nonspecific and that is critical to avoid adverse outcomes. We presented here one of these cases that followed vaginal delivery and ended with caecal perforation and hemicolectomy.

Efficiency of portable antennas for detecting passive integrated transponder tags in stream-dwelling salmonids

Science.gov (United States)

Banish, Nolan P.; Burdick, Summer M.; Moyer, Katherine R.

2016-01-01

Portable antennas have become an increasingly common technique for tracking fish marked with passive integrated transponder (PIT) tags. We used logistic regression to evaluate how species, fish length, and physical habitat characteristics influence portable antenna detection efficiency in stream-dwelling brown trout (Salmo trutta), bull trout (Salvelinus confluentus), and redband trout (Oncorhynchus mykiss newberrii) marked with 12-mm PIT tags. We redetected 56% (20/36) of brown trout, 34% (68/202) of bull trout, and 33% (20/61) of redband trout after a recovery period of 21 to 46 hours. Models indicate support for length and species and minor support for percent boulder, large woody debris, and percent cobble as parameters important for describing variation in detection efficiency, although 95% confidence intervals for estimates were large. The odds of detecting brown trout (1.5 ± 2.2 [mean ± SE]) are approximately four times as high as bull trout (0.4 ± 1.6) or redband trout (0.3 ± 1.8) and species-specific differences may be related to length. Our reported detection efficiency for brown trout falls within the range of other studies, but is the first reported for bull trout and redband trout. Portable antennas may be a relatively unbiased way of redetecting varying sizes of all three salmonid species.

Pilot-Streaming: Design Considerations for a Stream Processing Framework for High-Performance Computing

OpenAIRE

Andre Luckow; Peter Kasson; Shantenu Jha

2016-01-01

This White Paper (submitted to STREAM 2016) identifies an approach to integrate streaming data with HPC resources. The paper outlines the design of Pilot-Streaming, which extends the concept of Pilot-abstraction to streaming real-time data.

Intraabdominal contamination after gallbladder perforation during laparoscopic cholecystectomy and its complications.

Science.gov (United States)

Kimura, T; Goto, H; Takeuchi, Y; Yoshida, M; Kobayashi, T; Sakuramachi, S; Harada, Y

1996-09-01

Gallbladder perforation often occurs during laparoscopic cholecystectomy. The frequency and causes of gallbladder perforation as well as the relevant clinical background factors were investigated in 110 patients undergoing laparoscopic cholecystectomy. We also evaluated intraperitoneal contamination by bacteria and gallstones at the time of gallbladder perforation and investigated whether perforation caused early or late postoperative complications. Intraoperative gallbladder perforation occurred in 29 of the 110 patients (26.3%). It was caused by injury with an electric knife during dissection of the gallbladder bed, injury during gallbladder retraction with grasping forceps, injury during gallbladder extraction from the abdomen, and slippage of cystic duct clips (potentially causing bile and stone spillage). Perforation was more frequent in patients with positive bile cultures and in those with pigment stones (p gallbladder perforation is sometimes unavoidable during laparoscopic cholecystectomy, the risk of severe complications appears to be minimized by early closure of perforation, retrieval of as many of the spilled stones as possible, and intraperitoneal lavage.

Highly efficient high temperature electrolysis

DEFF Research Database (Denmark)

Hauch, Anne; Ebbesen, Sune; Jensen, Søren Højgaard

2008-01-01

High temperature electrolysis of water and steam may provide an efficient, cost effective and environmentally friendly production of H-2 Using electricity produced from sustainable, non-fossil energy sources. To achieve cost competitive electrolysis cells that are both high performing i.e. minimum...... internal resistance of the cell, and long-term stable, it is critical to develop electrode materials that are optimal for steam electrolysis. In this article electrolysis cells for electrolysis of water or steam at temperatures above 200 degrees C for production of H-2 are reviewed. High temperature...... electrolysis is favourable from a thermodynamic point of view, because a part of the required energy can be supplied as thermal heat, and the activation barrier is lowered increasing the H-2 production rate. Only two types of cells operating at high temperature (above 200 degrees C) have been described...

Surface dose measurements under stretched, perforated thermoplast sheets and under protective wound dressings for high energy photon radiation

International Nuclear Information System (INIS)

Staudenraus, J.; Christ, G.

2000-01-01

Patient fixation masks made of perforated thermoplast sheets are widely used in radiotherapy. These masks in particular serve to immobilize the head and neck region during radiation treatment. We placed samples made of differently stretched, perforated mask material on the surface of a white polystyrene (RW3) phantom and measured for high energy photon beams from Co-60 radiation up to 25 MV bremsstrahlung the dose increase resulting from the build-up under the hole and bridge areas. Depending on the energy of the incident beam and the thickness of the stretched mask material we observed a dose increase under the bridges at the phantom surface of 55% up to 140% compared to the dose without a layer of mask material. Under a hole the dose increase is almost half the value found under a bridge. However, deeper than 1 mm under the phantom surface this difference in dose increase under holes and bridges decreases to less than 10%. The mean dose increase under a perforated thermoplast sheet is lower than the dose increase under a homogeneous sheet made of the same material with the same mean thickness. Radiation induced skin lesions or an ulcerating tumour, respectively, may require a protective wound dressing under a patient fixation mask during radiation therapy. Choosing a thin hydrocolloid wound dressing the additional dose increase of the skin, compared to the dose increase due to the fixation mask, can be kept low. (orig.) [de

MRI of perforated gall bladder

International Nuclear Information System (INIS)

Sood, B.; Jain, M.; Khandelwal, N.; Singh, P.; Suri, S.

2002-01-01

Gall bladder perforation is a dreaded complication of acute cholecystitis that, if not diagnosed early in the course, might have a poor prognosis. Both CT and ultrasonography have been used until now extensively for the diagnosis of acute cholecystitis, but diagnosis of perforation is always difficult. Magnetic resonance, by its superior soft tissue resolution and multiplanar capability, is a better modality and should fare better than ultrasonography and CT, as demonstrated in our case. Magnetic resonance imaging demonstrates the wall of the gall bladder and defects to a much better advantage and more convincingly. In addition, MR colangiopancreatography images demonstrate the biliary tree better than other modalities. We suggest that in the case of acute cholecystitis, if perforation is suspected and CT and ultrasonography are not conclusive, MR should be the modality of choice. It can be used as a first line of investigation; however, it might not be cost-effective. Copyright (2002) Blackwell Science Pty Ltd

The impact of Indian Ocean high pressure system on rainfall and stream flow

International Nuclear Information System (INIS)

Rehman, S.; Nasir, H.; Zia, S.S.; Ansari, W.A.; Salam, K.; Tayyab, N.

2012-01-01

Centre of Action approach is very useful in getting insight of rainfall and stream flow variability of specific region. Hameed et al. showed that Inter-annual variability of Gulf Stream north wall is influenced by low Icelandic pressure system and has more statistically significant correlation than North Atlantic Oscillation (NAO) with longitude of Icelandic low. This study also aims to explore possible relationships between rainfall and stream flow in Collie river catchment in Southwest Western Australia (SWWA) with Indian Ocean high pressure dynamics. The relationship between rainfall and stream flow with Indian Ocean high pressure system have been investigated using correlation analysis for early winter season (MJJA), lag correlation for MJJA versus SOND rainfall and stream flow are also calculated and found significant at 95% confidence level. By investigating the relationship between COA indices with rainfall and stream flow over the period 1976-2008, significant correlations suggests that rainfall and stream flow in Collie river basin is strongly influenced by COA indices. Multiple correlations between rainfall and stream flow with Indian Ocean high pressure (IOHPS and IOHLN) is 0.7 and 0.6 respectively. Centers of Action (COA) indices explain 51% and 36% of rainfall and stream flow respectively. The correlation between rainfall and stream flow with IOHPS is -0.4 and -0.3 whereas, with IOHLN is -0.47 and -0.52 respectively. (author)

Correlation of Pc5 wave power inside and outside themagnetosphere during high speed streams

Directory of Open Access Journals (Sweden)

R. L. Kessel

2004-01-01

Full Text Available We show a clear correlation between the ULF wave power (Pc5 range inside and outside the Earth's magnetosphere during high speed streams in 1995. We trace fluctuations beginning 200R_E upstream using Wind data, to fluctuations just upstream from Earth's bow shock and in the magnetosheath using Geotail data and compare to pulsations on the ground at the Kilpisjarvi ground station. With our 5-month data set we draw the following conclusions. ULF fluctuations in the Pc5 range are found in high speed streams; they are non-Alfvénic at the leading edge and Alfvénic in the central region. Compressional and Alfvénic fluctuations are modulated at the bow shock, some features of the waveforms are preserved in the magnetosheath, but overall turbulence and wave power is enhanced by about a factor of 10. Parallel (compressional and perpendicular (transverse power are at comparable levels in the solar wind and magnetosheath, both in the compression region and in the central region of high speed streams. Both the total parallel and perpendicular Pc5 power in the solar wind (and to a lesser extent in the magnetosheath correlate well with the total Pc5 power of the ground-based H-component magnetic field. ULF fluctuations in the magnetosheath during high speed streams are common at frequencies from 1–4mHz and can coincide with the cavity eigenfrequencies of 1.3, 1.9, 2.6, and 3.4mHz, though other discrete frequencies are also often seen.

Key words. Interplanetary physics (MHD waves and turbulence – Magnetospheric physics (solar wind-magnetosphere interactions; MHD waves and instabilities

Method for high temperature mercury capture from gas streams

Science.gov (United States)

Granite, Evan J [Wexford, PA; Pennline, Henry W [Bethel Park, PA

2006-04-25

A process to facilitate mercury extraction from high temperature flue/fuel gas via the use of metal sorbents which capture mercury at ambient and high temperatures. The spent sorbents can be regenerated after exposure to mercury. The metal sorbents can be used as pure metals (or combinations of metals) or dispersed on an inert support to increase surface area per gram of metal sorbent. Iridium and ruthenium are effective for mercury removal from flue and smelter gases. Palladium and platinum are effective for mercury removal from fuel gas (syngas). An iridium-platinum alloy is suitable for metal capture in many industrial effluent gas streams including highly corrosive gas streams.

Outcome, comorbidity, hospitalization and 30-day mortality after closure of acute perforations and postoperative anastomotic leaks by the over-the-scope clip (OTSC) in an unselected cohort of patients.

Science.gov (United States)

Raithel, M; Albrecht, H; Scheppach, W; Farnbacher, M; Haupt, W; Hagel, A F; Schellerer, V; Vitali, F; Neurath, M F; Schneider, H T

2017-06-01

Acute gastrointestinal (GI) wall defects contain a high risk of morbidity and mortality and may be closed endoscopically by a full-thickness over-the-scope clip (OTSC). Unselected consecutive patients presenting with acute non-surgical perforations or postoperative anastomotic leaks or perforations underwent attempted OTSC placement as primary closure method after interdisciplinary consensus in three tertiary referral centres. Their clinical data and intervention characteristics were evaluated in an intention to treat analysis during a 24-month period to assess closure rates, 30-day mortality, hospitalization and comorbidity. In total, 34 patients (16 females, 18 males, 69.5 years) were included with 22 non-surgical perforations and 12 postoperative anastomotic leaks or perforations. Definitive closure of the perforations and leaks was achieved in 26/34 patients (76.5 %). Successful closure of the GI wall defect resulted in a significantly shorter hospital stay (8 days, p = 0.03) and was significantly correlated with comorbidity (r = 0.56, p = 0.005). In the group with OTSC failure, hospitalization was 18 days and 6 of 8 patients (75 %) required immediate surgery. Three deaths occurred in the group with successful OTSC closure due to comorbidity, while one death in the OTSC failure group was related to a refractory perforation. Favourable indications and locations for a successful OTSC procedure were identified as PEG complications, endoscopic or postoperative leaks of stomach, colon or rectum, respectively. In unselected patients, OTSC was effective for closure of acute GI wall defects in more than 75 % of all patients. Clinical success and short hospitalization were best achieved in patients without comorbidity, but closure of the perforation or the anastomotic leak was found to be not the only parameter relevant for patient outcome and mortality.

[Perforation of hollow organs in the abdominal contusion: diagnostic features and prognostic factors of death].

Science.gov (United States)

Nicolau, A E; Merlan, V; Dinescu, G; Crăciun, M; Kitkani, A; Beuran, M

2012-01-01

Blunt hollow viscus perforations (HVP) due to abdominal contusions (AC), although rare, are difficult to diagnose early and are associated with a high mortality. Our paper analyses retrospectively data from patients operated for HVP between January 2005 and January 2009, the efficiency of different diagnostic tools, mortality and prognostic factors for death. There were 62 patients operated for HVP, 14 of which had isolated abdominal contusion and 48 were poly trauma patients. There were 9 women and 53 men, the mean age was 41.5 years (SD: +17,9), the mean ISS was 32.94 (SD: +15,94), 23 patients had associated solid viscus injuries (SVI). Clinical examination was irelevant for 16 of the 62 patients, abdominal Xray was false negative for 30 out of 35 patients and abdominal ultrasound was false negative for 16 out of 60 patients. Abdominal CT was initially false negative for 7 out of 38 patients: for 4 of them the abdominal CT was repeated and was positive for HVP, for 3 patients a diagnostic laparoscopy was performed. Direct signs for HVP on abdominal CT were present for 3 out of 38 patients. Diagnostic laparoscopy was performed for 7 patients with suspicion for HVP, and was positive for 6 of them and false negative for a patient with a duodenal perforation. Single organ perforations were present in 55 cases, multi organ perforations were present in 7 cases. There were 15 deaths (15.2%), most of them caused by haemodynamic instability (3 out of 6 patients) and associated lesions: SOL for 9 out of 23 cases, pelvic fracture (PF) for 6 out of 14 patients, craniocerebral trauma (CCT) for 12 out of 33 patients.Multivariate analysis showed that the prognostic factors for death were ISS value (p = 0,023) and associated CCT (odds ratio = 4,95; p = 0,017). The following factors were not confirmed as prognostic factors for death: age, haemodynamic instability, associated SVI, thoracic trauma (TT), pelvic fractures (PF), limbs fractures (LF) and admission-operation interval

A comparative study of cone-beam computed tomography and digital periapical radiography in detecting mandibular molars root perforations

Energy Technology Data Exchange (ETDEWEB)

Haghanifar, Sina; Moudi, Ehsan; Mesgarani, Abbas; Abbaszadeh, Naghi [Dental Material Research Center, Dental Faculty, Babol University of Medical Sciences, Babol (Iran, Islamic Republic of); Bijani, Ali [Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol (Iran, Islamic Republic of)

2014-06-15

The aim of this in vitro study was to determine the sensitivity and specificity of cone-beam computed tomography (CBCT) and digital periapical radiography in the detection of mesial root perforations of mandibular molars. In this in vitro study, 48 mandibular molars were divided into 4 groups. First, the mesial canals of all the 48 teeth were endodontically prepared. In 2 groups (24 teeth each), the roots were axially perforated in the mesiolingual canal 1-3 mm below the furcation region, penetrating the root surface ({sup r}oot perforation{sup )}. Then, in one of these 2 groups, the mesial canals were filled with gutta-percha and AH26 sealer. Mesial canals in one of the other 2 groups without perforation (control groups) were filled with the same materials. The CBCT and periapical radiographs with 3 different angulations were evaluated by 2 oral and maxillofacial radiologists. The specificity and sensitivity of the two methods were calculated, and P<0.05 was considered significant. The sensitivity and specificity of CBCT scans in the detection of obturated root canal perforations were 79% and 96%, respectively, and in the case of three-angled periapical radiographs, they were 92% and 100%, respectively. In non-obturated root canals, the sensitivity and specificity of CBCT scans in perforation detection were 92% and 100%, respectively, and for three-angled periapical radiographs, they were 50% and 96%, respectively. For perforation detection in filled-root canals, periapical radiography with three different horizontal angulations would be trustworthy, but it is recommended that CBCT be used for perforation detection before obturating root canals.

Mining Frequent Item Sets in Asynchronous Transactional Data Streams over Time Sensitive Sliding Windows Model

International Nuclear Information System (INIS)

Javaid, Q.; Memon, F.; Talpur, S.; Arif, M.; Awan, M.D.

2016-01-01

EPs (Extracting Frequent Patterns) from the continuous transactional data streams is a challenging and critical task in some of the applications, such as web mining, data analysis and retail market, prediction and network monitoring, or analysis of stock market exchange data. Many algorithms have been developed previously for mining FPs (Frequent Patterns) from a data stream. Such algorithms are currently highly required to develop new solutions and approaches to the precise handling of data streams. New techniques, solutions, or approaches are developed to address unbounded, ordered, and continuous sequences of data and for the generation of data at a rapid speed from data streams. Hence, extracting FPs using fresh or recent data involves the high-level analysis of data streams. We have suggested an efficient technique for the window sliding model; this technique extracts new and fresh FPs from high-speed data streams. In this study, a CPILT (Compacted Tree Compact Pattern Tree) is developed to capture the latest contents in the stream and to efficiently remove outdated contents from the data stream. The main concept introduced in this work on CPILT is the dynamic restructuring of a tree, which is helpful in producing a compacted tree and the frequency descending structure of a tree on runtime. With the help of the mining technique of FP growth, a complete list of new and fresh FPs is obtained from a CPILT using an existing window. The memory usage and time complexity of the latest FPs in high-speed data streams can efficiently be determined through proper experimentation and analysis. (author)

Ileal perforation induced by acute radiation injury under gefitinib treatment

International Nuclear Information System (INIS)

Muraoka, Takayuki; Tsukuda, Kazunori; Toyooka, Shinichi

2011-01-01

Enteritis is one of the side effects of radiotherapy to the abdominal cavity. Radiation enteritis involves damage to mucous membranes in the acute phase and to stromal tissues in the late phase. Perforation of the intestine tends to occur in the late phase, and rarely in the acute phase. However, we describe here a case of intestinal perforation occurring in the acute phase after irradiation in a patient who received gefitinib treatment. Gefitinib, one of the epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), is widely used to treat non-small cell lung cancer (NSCLC) patients, but is simultaneously known to inhibit wound healing. We suspect that gefitinib may affect regeneration of the small intestinal mucosa injured by irradiation. A 76-year-old woman had NSCLC with metastases to the 5th lumbar, sacral, and right iliac bones. To control the pain from bone metastasis, anterior-posterior opposing portal irradiation (total 35 Gy) was started, and was completed over 22 days. On day 25 after starting radiotherapy, the patient began to take gefitinib. On day 35, she presented with acute peritonitis, and an emergency laparotomy was performed. The terminal ileum was affected by radiation enteritis and there were two pin-hole perforations. In the surgical specimen, no cancerous lesions were detected, and immunohistochemical staining of phosphorylated EGFR (pEGFR) was negative. pEGFR has an important role in mucous membrane repair after irradiation. Intestinal perforation in the acute phase of radiation enteritis may be associated with impaired mucosal repair mechanisms due to the use of an EGFR-TKI such as gefitinib, as evidenced by the absence of pEGFR. (author)

Exploiting the Power of Relational Databases for Efficient Stream Processing

NARCIS (Netherlands)

E. Liarou (Erietta); R.A. Goncalves (Romulo); S. Idreos (Stratos)

2009-01-01

textabstractStream applications gained significant popularity over the last years that lead to the development of specialized stream engines. These systems are designed from scratch with a different philosophy than nowadays database engines in order to cope with the stream applications

Prognostic factors and scoring system for survival in colonic perforation.

Science.gov (United States)

Komatsu, Shuhei; Shimomatsuya, Takumi; Nakajima, Masayuki; Amaya, Hirokazu; Kobuchi, Taketsune; Shiraishi, Susumu; Konishi, Sayuri; Ono, Susumu; Maruhashi, Kazuhiro

2005-01-01

No ideal and generally accepted prognostic factors and scoring systems exist to determine the prognosis of peritonitis associated with colonic perforation. This study was designed to investigate prognostic factors and evaluate the various scoring systems to allow identification of high-risk patients. Between 1996 and 2003, excluding iatrogenic and trauma cases, 26 consecutive patients underwent emergency operations for colorectal perforation and were selected for this retrospective study. Several clinical factors were analyzed as possible predictive factors, and APACHE II, SOFA, MPI, and MOF scores were calculated. The overall mortality was 26.9%. Compared with the survivors, non-survivors were found more frequently in Hinchey's stage III-IV, a low preoperative marker of pH, base excess (BE), and a low postoperative marker of white blood cell count, PaO2/FiO2 ratio, and renal output (24h). According to the logistic regression model, BE was a significant independent variable. Concerning the prognostic scoring systems, an APACHE II score of 19, a SOFA score of 8, an MPI score of 30, and an MOF score of 7 or more were significantly related to poor prognosis. Preoperative BE and postoperative white blood cell count were reliable prognostic factors and early classification using prognostic scoring systems at specific points in the disease process are useful to improve our understanding of the problems involved.

Advances in Glass Formulations for Hanford High-Aluminum, High-Iron and Enhanced Sulphate Management in HLW Streams - 13000

Energy Technology Data Exchange (ETDEWEB)

Kruger, Albert A. [WTP Engineering Division, United States Department of Energy, Office of River Protection, Post Office Box 450, Richland, Washington 99352 (United States)

2013-07-01

The current estimates and glass formulation efforts have been conservative in terms of achievable waste loadings. These formulations have been specified to ensure that the glasses are homogenous, contain essentially no crystalline phases, are processable in joule-heated, ceramic-lined melters and meet Hanford Tank Waste Treatment and Immobilization Plant (WTP) Contract terms. The WTP's overall mission will require the immobilization of tank waste compositions that are dominated by mixtures of aluminum (Al), chromium (Cr), bismuth (Bi), iron (Fe), phosphorous (P), zirconium (Zr), and sulphur (S) compounds as waste-limiting components. Glass compositions for these waste mixtures have been developed based upon previous experience and current glass property models. Recently, DOE has initiated a testing program to develop and characterize HLW glasses with higher waste loadings and higher throughput efficiencies. Results of this work have demonstrated the feasibility of increases in waste loading from about 25 wt% to 33-50 wt% (based on oxide loading) in the glass depending on the waste stream. In view of the importance of aluminum limited waste streams at Hanford (and also Savannah River), the ability to achieve high waste loadings without adversely impacting melt rates has the potential for enormous cost savings from reductions in canister count and the potential for schedule acceleration. Consequently, the potential return on the investment made in the development of these enhancements is extremely favorable. Glass composition development for one of the latest Hanford HLW projected compositions with sulphate concentrations high enough to limit waste loading have been successfully tested and show tolerance for previously unreported tolerance for sulphate. Though a significant increase in waste loading for high-iron wastes has been achieved, the magnitude of the increase is not as substantial as those achieved for high-aluminum, high-chromium, high-bismuth or

Advances in Glass Formulations for Hanford High-Alumimum, High-Iron and Enhanced Sulphate Management in HLW Streams-13000

International Nuclear Information System (INIS)

Kruger, Albert A.

2013-01-01

The current estimates and glass formulation efforts have been conservative in terms of achievable waste loadings. These formulations have been specified to ensure that the glasses are homogenous, contain essentially no crystalline phases, are processable in joule-heated, ceramic-lined melters and meet Hanford Tank Waste Treatment and Immobilization Plant (WTP) Contract terms. The WTP's overall mission will require the immobilization of tank waste compositions that are dominated by mixtures of aluminum (Al), chromium (Cr), bismuth (Bi), iron (Fe), phosphorous (P), zirconium (Zr), and sulphur (S) compounds as waste-limiting components. Glass compositions for these waste mixtures have been developed based upon previous experience and current glass property models. Recently, DOE has initiated a testing program to develop and characterize HLW glasses with higher waste loadings and higher throughput efficiencies. Results of this work have demonstrated the feasibility of increases in waste loading from about 25 wt% to 33-50 wt% (based on oxide loading) in the glass depending on the waste stream. In view of the importance of aluminum limited waste streams at Hanford (and also Savannah River), the ability to achieve high waste loadings without adversely impacting melt rates has the potential for enormous cost savings from reductions in canister count and the potential for schedule acceleration. Consequently, the potential return on the investment made in the development of these enhancements is extremely favorable. Glass composition development for one of the latest Hanford HLW projected compositions with sulphate concentrations high enough to limit waste loading have been successfully tested and show tolerance for previously unreported tolerance for sulphate. Though a significant increase in waste loading for high-iron wastes has been achieved, the magnitude of the increase is not as substantial as those achieved for high-aluminum, high-chromium, high-bismuth or sulphur

Nasal Septum Perforation due to Methamphetamine abuse

Directory of Open Access Journals (Sweden)

Mehdi Bakhshaee

2012-07-01

Full Text Available Introduction: Spontaneous Perforation of the nasal septum is an uncommon condition. Nasal inhalation of substances such as cocaine has long been linked to this Perforation. Case Report: This report describes the case of a 46-year-old woman who was addicted to methamphetamine and who presented with perforation of the nasal septum.This is the first reported case of nasal septal necrosis linked to nasal inhalation of methamphetamine. Conclusions: Patient history and assurance regardingillegal drug consumption and abuse is a key point for fast and accurate diagnosis. The pathophysiology of drug-induced sinunasal disease and a review of the literature are also presented.

Web Audio/Video Streaming Tool

Science.gov (United States)

Guruvadoo, Eranna K.

2003-01-01

In order to promote NASA-wide educational outreach program to educate and inform the public of space exploration, NASA, at Kennedy Space Center, is seeking efficient ways to add more contents to the web by streaming audio/video files. This project proposes a high level overview of a framework for the creation, management, and scheduling of audio/video assets over the web. To support short-term goals, the prototype of a web-based tool is designed and demonstrated to automate the process of streaming audio/video files. The tool provides web-enabled users interfaces to manage video assets, create publishable schedules of video assets for streaming, and schedule the streaming events. These operations are performed on user-defined and system-derived metadata of audio/video assets stored in a relational database while the assets reside on separate repository. The prototype tool is designed using ColdFusion 5.0.

PRESENTATION AND MANAGEMENT OF PERFORATED PEPTIC ULCER DISEASE IN A TERTIARY CENTRE IN SOUTH SOUTH NIGERIA.

Science.gov (United States)

Dodiyi-Manuel, A; Wichendu, P N; Enebeli, V C

2015-01-01

Perforations of the stomach and duodenum are common complications of peptic ulcer disease (PUD), abuse of non steroidal anti inflammatory drugs (NSAIDS) and gastric cancer. Being a life threatening complication of PUD, it needs special attention with prompt resuscitation and appropriate surgical management if morbidity and mortality are to be avoided. To determine the pattern and management outcome of perforated peptic ulcer disease PUD as seen in University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Rivers State, Nigeria). All the patients with perforated PUD that were managed at UPTH between January 2006 and December 2014 were studied. Relevant data were extracted from the case notes and analysed using the Statistical Package for Social Sciences (SPSS) version 17. Thirty six patients with perforated PUD were evaluated consisting of 28 males and 8 females with a male to female ratio of 3.5:1. Their ages ranged from 24 to 65 years with a mean of 42.1± 12.3 years and the peak age was at the third decade. After adequate resuscitation, all the patients had exploratory laparotomy. In 26 (72.2%) patients, the perforation was in the duodenum while in 10 (27.8%), it was in the stomach. Thirty two (88.9%) patients had Graham's omental patch repair of the perforation while simple closure only was done in 4 (11.1%) patients. Surgical site infection was the commonest post operative complication which was seen in 7 (19.4%) patients while 4 patients died giving a mortality rate of 11.1%. Perforated peptic ulcer predominantly affected young males and Graham's omental patch followed by Helicobacter pylori eradication was an effective treatment modality.

High-Bandwidth, High-Efficiency Envelope Tracking Power Supply for 40W RF Power Amplifier Using Paralleled Bandpass Current Sources

DEFF Research Database (Denmark)

Høyerby, Mikkel Christian Wendelboe; Andersen, Michael Andreas E.

2005-01-01

This paper presents a high-performance power conversion scheme for power supply applications that require very high output voltage slew rates (dV/dt). The concept is to parallel 2 switching bandpass current sources, each optimized for its passband frequency space and the expected load current....... The principle is demonstrated with a power supply, designed for supplying a 40 W linear RF power amplifier for efficient amplification of a 16-QAM modulated data stream...

Management of perforated peptic ulcer in patients at a teaching hospital.

Science.gov (United States)

Bin-Taleb, Ali K; Razzaq, Riyadh A; Al-Kathiri, Zaki O

2008-02-01

To explore and analyze the current status in management of patients with perforated peptic ulcers (PPU). A retrospective study carried out at the Surgical Department, Al-Gamhouria Teaching Hospital, Aden, Yemen. Patients admitted with perforated benign peptic ulcers from January 1997 to December 2006 were included in the study. A total of 156 patients, 138 (88.5%) male and 18 (11.5%) female, with an overall mean age of 39.08 years (range 14-75 years) and a higher frequency of PPU was noted in patients 21-40 years (58.3%). The perforated duodenal ulcer and perforated gastric ulcer ratio was 4.38:1. The mean time of presentation was 16.5 hours, and operative intervention after admission was 5.25 hours. Simple perforation closure was used in 91.7% of the patients. Postoperative complication rate was 41% (statistically significant in cases admitted later than 12 hours), wound sepsis making the majority at 55.2%, 6 deaths (3.9%), the correlation with presentation time was not significant. The overall mean post-operative hospitalization period was 12.76 days; 14.7% of the patients stayed more than 3 weeks. Younger patients (21-40 years) were frequently affected. Emphasis should be placed on shortening the time to surgery. Simple closure remains the selected treatment in the majority of patients. Overall post-operative mortality was low (3.9%). Improving the surgical skills, wound care, administrative regulations, hospital environment, and equipment are needed to reduce the high rate of complications.

A Gossip-Based Optimistic Replication for Efficient Delay-Sensitive Streaming Using an Interactive Middleware Support System

Science.gov (United States)

Mavromoustakis, Constandinos X.; Karatza, Helen D.

2010-06-01

While sharing resources the efficiency is substantially degraded as a result of the scarceness of availability of the requested resources in a multiclient support manner. These resources are often aggravated by many factors like the temporal constraints for availability or node flooding by the requested replicated file chunks. Thus replicated file chunks should be efficiently disseminated in order to enable resource availability on-demand by the mobile users. This work considers a cross layered middleware support system for efficient delay-sensitive streaming by using each device's connectivity and social interactions in a cross layered manner. The collaborative streaming is achieved through the epidemically replicated file chunk policy which uses a transition-based approach of a chained model of an infectious disease with susceptible, infected, recovered and death states. The Gossip-based stateful model enforces the mobile nodes whether to host a file chunk or not or, when no longer a chunk is needed, to purge it. The proposed model is thoroughly evaluated through experimental simulation taking measures for the effective throughput Eff as a function of the packet loss parameter in contrast with the effectiveness of the replication Gossip-based policy.

The suitability of using dissolved gases to determine groundwater discharge to high gradient streams

Science.gov (United States)

Gleeson, Tom; Manning, Andrew H.; Popp, Andrea; Zane, Matthew; Clark, Jordan F.

2018-02-01

Determining groundwater discharge to streams using dissolved gases is known to be useful over a wide range of streamflow rates but the suitability of dissolved gas methods to determine discharge rates in high gradient mountain streams has not been sufficiently tested, even though headwater streams are critical as ecological habitats and water resources. The aim of this study is to test the suitability of using dissolved gases to determine groundwater discharge rates to high gradient streams by field experiments in a well-characterized, high gradient mountain stream and a literature review. At a reach scale (550 m) we combined stream and groundwater radon activity measurements with an in-stream SF6 tracer test. By means of numerical modeling we determined gas exchange velocities and derived very low groundwater discharge rates (∼15% of streamflow). These groundwater discharge rates are below the uncertainty range of physical streamflow measurements and consistent with temperature, specific conductance and streamflow measured at multiple locations along the reach. At a watershed-scale (4 km), we measured CFC-12 and δ18O concentrations and determined gas exchange velocities and groundwater discharge rates with the same numerical model. The groundwater discharge rates along the 4 km stream reach were highly variable, but were consistent with the values derived in the detailed study reach. Additionally, we synthesized literature values of gas exchange velocities for different stream gradients which show an empirical relationship that will be valuable in planning future dissolved gas studies on streams with various gradients. In sum, we show that multiple dissolved gas tracers can be used to determine groundwater discharge to high gradient mountain streams from reach to watershed scales.

The suitability of using dissolved gases to determine groundwater discharge to high gradient streams

Science.gov (United States)

Gleeson, Tom; Manning, Andrew H.; Popp, Andrea; Zane, Mathew; Clark, Jordan F.

2018-01-01

Determining groundwater discharge to streams using dissolved gases is known to be useful over a wide range of streamflow rates but the suitability of dissolved gas methods to determine discharge rates in high gradient mountain streams has not been sufficiently tested, even though headwater streams are critical as ecological habitats and water resources. The aim of this study is to test the suitability of using dissolved gases to determine groundwater discharge rates to high gradient streams by field experiments in a well-characterized, high gradient mountain stream and a literature review. At a reach scale (550 m) we combined stream and groundwater radon activity measurements with an in-stream SF6 tracer test. By means of numerical modeling we determined gas exchange velocities and derived very low groundwater discharge rates (∼15% of streamflow). These groundwater discharge rates are below the uncertainty range of physical streamflow measurements and consistent with temperature, specific conductance and streamflow measured at multiple locations along the reach. At a watershed-scale (4 km), we measured CFC-12 and δ18O concentrations and determined gas exchange velocities and groundwater discharge rates with the same numerical model. The groundwater discharge rates along the 4 km stream reach were highly variable, but were consistent with the values derived in the detailed study reach. Additionally, we synthesized literature values of gas exchange velocities for different stream gradients which show an empirical relationship that will be valuable in planning future dissolved gas studies on streams with various gradients. In sum, we show that multiple dissolved gas tracers can be used to determine groundwater discharge to high gradient mountain streams from reach to watershed scales.

Contact lens rehabilitation following repaired corneal perforations

Science.gov (United States)

Titiyal, Jeewan S; Sinha, Rajesh; Sharma, Namrata; Sreenivas, V; Vajpayee, Rasik B

2006-01-01

Background Visual outcome following repair of post-traumatic corneal perforation may not be optimal due to presence of irregular keratometric astigmatism. We performed a study to evaluate and compare rigid gas permeable contact lens and spectacles in visual rehabilitation following perforating corneal injuries. Method Eyes that had undergone repair for corneal perforating injuries with or without lens aspiration were fitted rigid gas permeable contact lenses. The fitting pattern and the improvement in visual acuity by contact lens over spectacle correction were noted. Results Forty eyes of 40 patients that had undergone surgical repair of posttraumatic corneal perforations were fitted rigid gas permeable contact lenses for visual rehabilitation. Twenty-four eyes (60%) required aphakic contact lenses. The best corrected visual acuity (BCVA) of ≥ 6/18 in the snellen's acuity chart was seen in 10 (25%) eyes with spectacle correction and 37 (92.5%) eyes with the use of contact lens (p < 0.001). The best-corrected visual acuity with spectacles was 0.20 ± 0.13 while the same with contact lens was 0.58 ± 0.26. All the patients showed an improvement of ≥ 2 lines over spectacles in the snellen's acuity chart with contact lens. Conclusion Rigid gas permeable contact lenses are better means of rehabilitation in eyes that have an irregular cornea due to scars caused by perforating corneal injuries. PMID:16536877

Isolated ileal perforation in infancy: a lethal initial presentation of Hirschsprung’s disease

Directory of Open Access Journals (Sweden)

Fadi Iskandarani

2017-06-01

Full Text Available A rare case of ileal perforation, as a fatal initial presentation of total colonic aganglionosis (TCA in infancy is reported. A 10-week-old boy, was brought to the emergency department with symptoms of complicated intestinal obstruction. He looked ill, was lethargic, markedly dehydrated and had a severely distended abdomen. An abdominal X-ray revealed multiple air fluid levels seen in a distended small intestine. During exploratory laparotomy the ileum was massively dilated with distal segment perforation. Ileal perforation repair was performed. A totally collapsed microcolon was identified. Biopsies were taken from the high rectum, sigmoid and hepatic flexure. Appendectomy and ileostomy were performed. All biopsies, as well as the appendix, showed absence of ganglion cells. Despite this procedure the patient progressively deteriorated and later died due to sepsis. Ileal perforation in infants is a rare, but potentially fatal initial presentation of TCA. Early detection is essential to prevent life-threatening complications.

Perforation of the colon during combined radio and steroid therapy. Diagnosis and treatment

International Nuclear Information System (INIS)

Wiig, J.N.; Aass, N.; Karlsen, K.O.; Giercksky, K.E.

1996-01-01

Eighth patients with colon perforations after combined treatment with radiotherapy and steroid medication are studied retrospectively. Sigmoid diverticuli perforated after a minimum of 5 days treatment. The main symptom was a varying degree of abdominal pain. Clinical parameters were of limited value. The most important single examination was plain abdominal x-ray, though this was not positive in all cases. Seven patients were operated on, one with simple suture, the rest with Hartmann's procedure. None developed postoperative peritonitis. One died from cerebral infarction. Four died within 38 days postoperatively after discharge from hospital. Abdominal symptoms during high dose steroid treatment may indicate perforation on the colon. Immediate operative intervention may have an uncomplicated postoperative course. 8 refs., 2 tabs

An experimental investigation of the efficacy of perforated holes on unsteady aerodynamic force reduction for a 2D cylinder in uniform incoming flow

Science.gov (United States)

Sudalaimuthu, Vignesh; Liu, Xiaofeng

2017-11-01

A series of wind tunnel aerodynamic force measurements have been conducted on a 2D hollow cylinder with perforated holes uniformly-distributed on its surface to evaluate the efficacy of perforation as a means of passive flow control in reducing unsteady aerodynamic forces. Both smooth and perforated cylinders were tested for comparison at Reynolds numbers ranging from 50,000 to 200,000 corresponding to free stream velocities varying from 5 to 20 m/s (at an increment of 5 m/s) and a cylinder diameter of 0.152 m. The aerodynamic forces acting on the testing model were measured using a 6-component load cell. For each tunnel speed, the test has been repeated for 10 runs at a sampling rate of 10 kHz for 60 seconds each, with a total of 6,000,000 samples acquired for each test. Both mean and r.m.s. values of the lift and drag coefficients were calculated. Power spectral density distributions of the unsteady aerodynamic force loading was analyzed to investigate the effect of the perforation on the frequency composition. Comparisons indicate that the perforated cylinder with a 8% porosity and a hole diameter of about 2% of that of the cylinder gives both substantially less unsteady drag and lift than those of the smooth cylinder for the entire Reynolds number range tested, with the r.m.s. force reduction from 8% to 82% for the drag and 64% to 85% for the lift, confirming a corresponding beneficial reduction in flow-induced cylinder vibration as observed during the experiments. Sponsor: San Diego State University.

Preoperative chest x-ray findings in peptic ulcer perforation

Energy Technology Data Exchange (ETDEWEB)

Kim, T. H.; Kim, S. W.; Lim, J. S.; Kim, Y. J. [Kyungpook National University School of Medicine, Taegu (Korea, Republic of)

1981-12-15

This study was carried out to analyze the distribution of age, sex, chief complaint, physical examination and findings of chest x-ray films before operation in 59 cases of peptic ulcer perforation. The ratio of male to female was 1.7 : 1 and incidence of the ulcer perforation was most common in 5th decades. Thirty five among 59 cases showed pleural effusion, segmental atelectasis and pneumonic infiltration on chest x-ray film. Twenty nine among 50 cases of duodenal ulcer perforation and 6 of 9 cases of stomach ulcer perforation showed positive chest x-ray findings. No relationship was found between fever and preoperative chest x-ray findings.

Preoperative chest x-ray findings in peptic ulcer perforation

International Nuclear Information System (INIS)

Kim, T. H.; Kim, S. W.; Lim, J. S.; Kim, Y. J.

1981-01-01

This study was carried out to analyze the distribution of age, sex, chief complaint, physical examination and findings of chest x-ray films before operation in 59 cases of peptic ulcer perforation. The ratio of male to female was 1.7 : 1 and incidence of the ulcer perforation was most common in 5th decades. Thirty five among 59 cases showed pleural effusion, segmental atelectasis and pneumonic infiltration on chest x-ray film. Twenty nine among 50 cases of duodenal ulcer perforation and 6 of 9 cases of stomach ulcer perforation showed positive chest x-ray findings. No relationship was found between fever and preoperative chest x-ray findings

Prediction of inelastic behavior and creep-fatigue life of perforated plates

International Nuclear Information System (INIS)

Igari, Toshihide; Setoguchi, Katsuya; Nakano, Shohki; Nomura, Shinichi

1991-01-01

Prediction methods of macroscopic and local stress-strain behavior of perforated plates in plastic and creep regime which are proposed by the authors are applied to the inelastic analysis and creep-fatigue life prediction of perforated cylinder subjected to cyclic thermal stress. Stress-strain behavior of perforated cylinder is analyzed by modeling the perforated portion to cylinder with equivalent-solid-plate properties. Creep-fatigue lives at around a hole of perforated plates are predicted by using the local stress-strain behavior and are compared with experimentally observed lives. (author)

Performance Evaluation of Concurrent Multipath Video Streaming in Multihomed Mobile Networks

Directory of Open Access Journals (Sweden)

James Nightingale

2013-01-01

Full Text Available High-quality real-time video streaming to users in mobile networks is challenging due to the dynamically changing nature of the network paths, particularly the limited bandwidth and varying end-to-end delay. In this paper, we empirically investigate the performance of multipath streaming in the context of multihomed mobile networks. Existing schemes that make use of the aggregated bandwidth of multiple paths can overcome bandwidth limitations on a single path but suffer an efficiency penalty caused by retransmission of lost packets in reliable transport schemes or path switching overheads in unreliable transport schemes. This work focuses on the evaluation of schemes to permit concurrent use of multiple paths to deliver video streams. A comprehensive streaming framework for concurrent multipath video streaming is proposed and experimentally evaluated, using current state-of-the-art H.264 Scalable Video Coding (H.264/SVC and the next generation High Efficiency Video Coding (HEVC standards. It provides a valuable insight into the benefit of using such schemes in conjunction with encoder specific packet prioritisation mechanisms for quality-aware packet scheduling and scalable streaming. The remaining obstacles to deployment of concurrent multipath schemes are identified, and the challenges in realising HEVC based concurrent multipath streaming are highlighted.

A case of radiation enteritis with perforated peritonitis caused by a piece of eggshell

International Nuclear Information System (INIS)

Kitamura, Hirotaka; Maeda, Kazuya; Miyanaga, Tamonn; Doden, Kenji; Hattori, Masakazu; Hashizume, Yasuo

2011-01-01

The patient was a woman in her sixties who had received radiation therapy for cancer of uterine cervix 7 years earlier and had been suffering from diarrhea for these several years. The patient was seen at our emergency clinic because of a 5 hour-history of lower abdominal pain at the beginning of July 2010. An abdominal CT scan showed free air and ascites. A high density structure 1.5 cm in size was identified within the small intestine, but its relation with the perforation was obscure. Emergency operation was done with the most likely diagnosis of intestinal perforation and general peritonitis. When the lower abdomen was opened by midline incision, about 200 ml of cloudy ascites was observed and the ileum became white in color and hard resulting from the radiation therapy. A perforation was identified in the ileum about 15 cm distant from the ileocecal valve, and a 1.5-cm sized thin and hard material was palpated within the intestine at the same portion. Ilececal resection including the perforated portion was performed and functional end-to-end anastomosis was made at a grossly normal area. There was a piece of eggshell 1.5-cm in size in the perforated portion in the resected specimen. From this together with histopathologial findings, perforation of the small intestine caused by a piece of eggshell associated with radiation enteritis was finally diagnosed. Small bowel perforation must be kept in mind as a possible late complication of radiation therapy, however, no cases of small bowel perforation caused by eggshell have been reported so far. This rare case is reported here, with a review of the literature. (author)

Study on Dynamic Response of Downhole Tools under Perforation Impact Load

Directory of Open Access Journals (Sweden)

Liu Jun

2017-01-01

Full Text Available A model of a multibody system is established to investigate the dynamic response of an oil tube-shock absorber-perforating gun system in downhole perforation-test joint operation. In the model, the oil tube and perforating gun are modeled as elastic rods and the shock absorber is modeled as single particle system with damping and a spring. Two force continuity conditions are used to simulate the interactions among the three components. The perforation impact load is determined by an experiment of underwater explosion of perforating bullets. Using the model, the effects of charge quantity of perforating bullet, the number of shock absorbers, and the length of oil tube on the dynamic response of oil tube and packer are investigated. On this basis, a basic principle of the combination design of shock absorber and oil tube is proposed to improve the mechanical state of downhole tools. The study results can provide theoretical support for the design of downhole perforation-test joint operation.

Removal of Contaminants from Waste Streams at Gas Evolving Flow-Through Porous Electrodes

International Nuclear Information System (INIS)

Mahmoud Saleh, M.

1999-01-01

Electrochemical techniques have been used for the removal of inorganic and organic toxic materials from industrial waste streams. One of the most important branch of these electrochemical techniques is the flow-through porous electrode. Such systems allow for the continuous operation and hence continuous removal of the contaminants from waste streams at high rates and high efficiency. However, when there is an evolution of gas bubbles with the removal process, the treatment process needs a much different treatment of both the design and the mathematical treatment of the such these systems. The evolving gas bubbles within the electrode decrease the pore electrolyte conductivity of the porous electrodes, decrease the efficiency and make the current more non-uniform. This cause the under utilization of the reaction area and finally make the electrode inoperable. In this work the harmful effects of the gas bubbles on the performance of the porous electrode will be modeled. The model accounts for the effects of kinetic, mass transfer and gas bubbles resistance on the overall performance of the electrode. This will help in optimizing the operating conditions and the cell design

[Comparison of iodinated and barium-containing contrast media of different viscosity in the detection of pharyngeal perforation].

Science.gov (United States)

Keberle, M; Wittenberg, G; Trusen, A; Baumgartner, W; Hahn, D

2001-08-01

In contrast to esophageal perforations, the more radiopaque barium-suspensions are not as important as iodinated aqueous contrast agents for the detection of pharyngeal perforations. This study was performed to find out whether the highly different viscosities (of iodinated and barium-containing contrast agents with comparable radiopacities) are a reason for this. Viscosity, subjective difference in contrast, and CT-density of an iodinated aqueous (Telebrix) and a 50 wt/vol% barium-containing contrast agent (Micropaque) were determined. Moreover, to exclude postoperative perforation, 104 patients were prospectively examined by pharyngography using both contrast media. Pharyngographies of patients with perforation were later compared by two independent readers. All patients with perforation were followed up clinically to exclude complications due to barium administration. In-vitro comparison showed comparable radiopacity but the 50 wt/vol% barium-suspension was much more viscous than the iodinated contrast agent. During pharyngography, totally, 14 perforations were clearly delineated with the iodinated aqueous contrast agent. However, two of them were not detected with the barium-suspension. All the other perforations presented equally. Given a sufficient radiopacity, a low viscosity appears to be essential for a contrast agent to detect especially pharyngeal perforations. Thus, we recommend the sole use of an iodinated contrast agent (at suspicion of aspiration as isoosmolar variant) for this purpose.

Successful Management of Jejunal Perforation in Burkitt’s Lymphoma: A Case Report

Directory of Open Access Journals (Sweden)

David A. Finch

2012-01-01

Full Text Available Burkitt’s lymphoma (BL is rare, rapidly growing, and highly aggressive. Urgent commencement of chemotherapy is vital to prevent complications and promote a favourable prognosis. Any factor causing a delay in the initiation of chemotherapy will affect prognosis significantly. Intestinal perforation is a well-known complication with devastating consequences. It inevitably leads to a delay in the initiation of chemotherapy. There are few reports in the literature that discuss this complication. Furthermore, there are no reports of patients that have survived intestinal perforation occurring prior to the commencement of chemotherapy. We present a case of a 55-year-old male who survived perforation of advanced sporadic BL of the jejunum occurring prior to the commencement of chemotherapy. Critical aspects of the patients care are discussed.

LHCb trigger streams optimization

Science.gov (United States)

Derkach, D.; Kazeev, N.; Neychev, R.; Panin, A.; Trofimov, I.; Ustyuzhanin, A.; Vesterinen, M.

2017-10-01

The LHCb experiment stores around 1011 collision events per year. A typical physics analysis deals with a final sample of up to 107 events. Event preselection algorithms (lines) are used for data reduction. Since the data are stored in a format that requires sequential access, the lines are grouped into several output file streams, in order to increase the efficiency of user analysis jobs that read these data. The scheme efficiency heavily depends on the stream composition. By putting similar lines together and balancing the stream sizes it is possible to reduce the overhead. We present a method for finding an optimal stream composition. The method is applied to a part of the LHCb data (Turbo stream) on the stage where it is prepared for user physics analysis. This results in an expected improvement of 15% in the speed of user analysis jobs, and will be applied on data to be recorded in 2017.

Clinical Factors of Delayed Perforation after Endoscopic Submucosal Dissection for Gastric Neoplasms

Directory of Open Access Journals (Sweden)

Yoshinobu Yamamoto

2017-01-01

Full Text Available Background. Delayed perforation is a rare but severe complication of endoscopic submucosal dissection (ESD for early gastric neoplasm (EGN. The aim of this study was to clarify clinical factors related to delayed perforation after ESD. Methods. A total of 1158 consecutive patients with 1199 EGNs underwent ESD at our hospital between January 2000 and December 2015. Univariate analysis was used to identify clinicopathological factors related to delayed perforation. Moreover, duration of cautery needed for hemostasis was measured by comparison between perforated and nonperforated points in patients with delayed perforation. Results. Delayed perforation occurred in 5 of 1158 consecutive patients with 1199 EGNs who underwent ESD (0.42%. All cases were diagnosed within 24 h after ESD and recovered with conservative management. On univariate analysis, location in the upper stomach was the factor most significantly associated with delayed perforation (P<0.01. Duration of cautery needed for hemostasis was significantly longer at perforated points (9 s than at nonperforated points (3.5 s in five patients. Conclusions. Location in the upper stomach was the risk factor most prominently associated with delayed perforation after ESD for EGNs. In addition, delayed perforation appears associated with excessive electrocautery for hemostasis.

Clinicopathological Analysis of Factors Related to Colorectal Tumor Perforation

OpenAIRE

Medina-Arana, Vicente; Martínez-Riera, Antonio; Delgado-Plasencia, Luciano; Rodríguez-González, Diana; Bravo-Gutiérrez, Alberto; Álvarez-Argüelles, Hugo; Alarcó-Hernández, Antonio; Salido-Ruiz, Eduardo; Fernández-Peralta, Antonia M.; González-Aguilera, Juan J.

2015-01-01

Abstract Colorectal tumor perforation is a life-threatening complication of this disease. However, little is known about the anatomopathological factors or pathophysiologic mechanisms involved. Pathological and immunohistochemical analysis of factors related with tumoral neo-angiogenesis, which could influence tumor perforation are assessed in this study. A retrospective study of patients with perforated colon tumors (Group P) and T4a nonperforated (controls) was conducted between 2001 and 20...

Predictors of appendiceal perforation in an equal access system.

Science.gov (United States)

Walker, Avery; Hatch, Quinton; Drake, Thurston; Nelson, Daniel W; Fitzpatrick, Emilie; Bingham, Jason; Black, George; Maykel, Justin A; Steele, Scott R

2014-07-01

Discrepancies in socioeconomic factors have been associated with higher rates of perforated appendicitis. As an equal-access health care system theoretically removes these barriers, we aimed to determine if remaining differences in demographics, education, and pay result in disparate outcomes in the rate of perforated appendicitis. All patients undergoing appendectomy for acute appendicitis (November 2004-October 2009) at a tertiary care equal access institution were categorized by demographics and perioperative data. Rank of the sponsor was used as a surrogate for economic status. A multivariate logistic regression model was performed to determine patient and clinical characteristics associated with perforated appendicitis. A total of 680 patients (mean age 30±16 y; 37% female) were included. The majority were Caucasian (56.4% [n=384]; African Americans 5.6% [n=38]; Asians 1.9% [n=13]; and other 48.9% [n=245]) and enlisted (87.2%). Overall, 6.4% presented with perforation, with rates of 6.6%, 5.8%, and 6.7% (P=0.96) for officers, enlisted soldiers, and contractors, respectively. There was no difference in perforation when stratified by junior or senior status for either officers or enlisted (9.3% junior versus 4.40% senior officers, P=0.273; 6.60% junior versus 5.50% senior enlisted, P=0.369). On multivariate analysis, parameters such as leukocytosis and temperature, as well as race and rank were not associated with perforation (P=0.7). Only age had a correlation, with individuals aged 66-75 y having higher perforation rates (odds ratio, 1.04; 95% confidence interval, 1.02-1.05; P<0.001). In an equal-access health care system, older age, not socioeconomic factors, correlated with increased appendiceal perforation rates. Published by Elsevier Inc.

Efficiency of Portable Antennas for Detecting Passive Integrated Transponder Tags in Stream-Dwelling Salmonids.

Directory of Open Access Journals (Sweden)

Nolan P Banish

Full Text Available Portable antennas have become an increasingly common technique for tracking fish marked with passive integrated transponder (PIT tags. We used logistic regression to evaluate how species, fish length, and physical habitat characteristics influence portable antenna detection efficiency in stream-dwelling brown trout (Salmo trutta, bull trout (Salvelinus confluentus, and redband trout (Oncorhynchus mykiss newberrii marked with 12-mm PIT tags. We redetected 56% (20/36 of brown trout, 34% (68/202 of bull trout, and 33% (20/61 of redband trout after a recovery period of 21 to 46 hours. Models indicate support for length and species and minor support for percent boulder, large woody debris, and percent cobble as parameters important for describing variation in detection efficiency, although 95% confidence intervals for estimates were large. The odds of detecting brown trout (1.5 ± 2.2 [mean ± SE] are approximately four times as high as bull trout (0.4 ± 1.6 or redband trout (0.3 ± 1.8 and species-specific differences may be related to length. Our reported detection efficiency for brown trout falls within the range of other studies, but is the first reported for bull trout and redband trout. Portable antennas may be a relatively unbiased way of redetecting varying sizes of all three salmonid species.

Influence of operating microscope in the sealing of cervical perforations.

Science.gov (United States)

Schmidt, Bruna Schwingel; Zaccara, Ivana Maria; Reis Só, Marcus Vinícius; Kuga, Milton Carlos; Palma-Dibb, Regina Guenka; Kopper, Patrícia Maria Poli

2016-01-01

Accidental root canal perforations are among the main complications of endodontic treatment. This study evaluated the influence of operating microscope (OM) in the marginal adaptation of mineral trioxide aggregate (MTA) (Angelus(®)) and glass ionomer (Vitremer) inserted into cervical perforations. Perforations were made in the cervical third of the buccal wall of the root canal in mandibular incisors. Next, the teeth were divided into four groups (N = 10): MG - MTA without OM; VG - Vitremer without OM; MOMG - MTA with OM; VOMG - Vitremer with OM. The perforations were sealed according to the group and the teeth were prepared for analysis by confocal laser scanning microscope. Images of perforation region (1,024×) were made and the gap presented by the materials was measured using the Image J program. LEXT OLS4100 three dimensional (3D) measuring laser microscope measured the volumetric misfit. Data of gap were analyzed by Kruskal-Wallis and Dunn's tests. Analysis of variance (ANOVA) and Tukey's tests compared the volumetric misfits. The results showed lower volume and gap in the interface dentin/material in VOMG compared to the other groups (P < 0.05). The use of OM improved the quality of cervical perforations sealed with Vitremer, being indicated in clinical situations of iatrogenic cervical perforations.

Laparoscopic Primary Colorrhaphy for Acute Iatrogenic Perforations during Colonoscopy

Directory of Open Access Journals (Sweden)

Eric M. Haas

2013-01-01

Full Text Available Purpose. We present our experience with laparoscopic colorrhaphy as definitive surgical modality for the management of colonoscopic perforations. Methods. Over a 17-month period, we assessed the outcomes of consecutive patients presenting with acute colonoscopic perforations. Patient characteristics and perioperative parameters were tabulated. Postoperative outcomes were evaluated within 30 days following discharge. Results. Five female patients with a mean age of 71.4 ± 9.7 years (range: 58–83, mean BMI of 26.4 ± 3.4 kg/m2 (range: 21.3–30.9, and median ASA score of 2 (range: 2-3 presented with acute colonoscopic perforations. All perforations were successfully managed through laparoscopic colorrhaphy within 24 hours of development. The perforations were secondary to direct trauma (n=3 or thermal injury (n=2 and were localized to the sigmoid (n=4 or cecum (n=1. None of the patients required surgical resection, diversion, or conversion to an open procedure. No intra- or postoperative complications were encountered. The mean length of hospital stay was 3.8 ± 0.8 days (range: 3–5. There were no readmissions or reoperations. Conclusion. Acute colonoscopic perforations can be safely managed via laparoscopic primary repair without requiring resection or diversion. Early recognition and intervention are essential for successful outcomes.

Streaming simplification of tetrahedral meshes.

Science.gov (United States)

Vo, Huy T; Callahan, Steven P; Lindstrom, Peter; Pascucci, Valerio; Silva, Cláudio T

2007-01-01

Unstructured tetrahedral meshes are commonly used in scientific computing to represent scalar, vector, and tensor fields in three dimensions. Visualization of these meshes can be difficult to perform interactively due to their size and complexity. By reducing the size of the data, we can accomplish real-time visualization necessary for scientific analysis. We propose a two-step approach for streaming simplification of large tetrahedral meshes. Our algorithm arranges the data on disk in a streaming, I/O-efficient format that allows coherent access to the tetrahedral cells. A quadric-based simplification is sequentially performed on small portions of the mesh in-core. Our output is a coherent streaming mesh which facilitates future processing. Our technique is fast, produces high quality approximations, and operates out-of-core to process meshes too large for main memory.

Bioblendstocks that Enable High Efficiency Engine Designs

Energy Technology Data Exchange (ETDEWEB)

McCormick, Robert L.; Fioroni, Gina M.; Ratcliff, Matthew A.; Zigler, Bradley T.; Farrell, John

2016-11-03

The past decade has seen a high level of innovation in production of biofuels from sugar, lipid, and lignocellulose feedstocks. As discussed in several talks at this workshop, ethanol blends in the E25 to E50 range could enable more highly efficient spark-ignited (SI) engines. This is because of their knock resistance properties that include not only high research octane number (RON), but also charge cooling from high heat of vaporization, and high flame speed. Emerging alcohol fuels such as isobutanol or mixed alcohols have desirable properties such as reduced gasoline blend vapor pressure, but also have lower RON than ethanol. These fuels may be able to achieve the same knock resistance benefits, but likely will require higher blend levels or higher RON hydrocarbon blendstocks. A group of very high RON (>150) oxygenates such as dimethyl furan, methyl anisole, and related compounds are also produced from biomass. While providing no increase in charge cooling, their very high octane numbers may provide adequate knock resistance for future highly efficient SI engines. Given this range of options for highly knock resistant fuels there appears to be a critical need for a fuel knock resistance metric that includes effects of octane number, heat of vaporization, and potentially flame speed. Emerging diesel fuels include highly branched long-chain alkanes from hydroprocessing of fats and oils, as well as sugar-derived terpenoids. These have relatively high cetane number (CN), which may have some benefits in designing more efficient CI engines. Fast pyrolysis of biomass can produce diesel boiling range streams that are high in aromatic, oxygen and acid contents. Hydroprocessing can be applied to remove oxygen and consequently reduce acidity, however there are strong economic incentives to leave up to 2 wt% oxygen in the product. This oxygen will primarily be present as low CN alkyl phenols and aryl ethers. While these have high heating value, their presence in diesel fuel

The use of endoluminal vacuum (E-Vac) therapy in the management of upper gastrointestinal leaks and perforations.

Science.gov (United States)

Smallwood, Nathan R; Fleshman, James W; Leeds, Steven G; Burdick, J S

2016-06-01

Upper intestinal leaks and perforations are associated with high morbidity and mortality rates. Despite the growing experience using endoscopically placed stents, the treatment of these leaks and perforations remain a challenge. Endoluminal vacuum (E-Vac) therapy is a novel treatment that has been successfully used in Germany to treat upper gastrointestinal leaks and perforations. There currently are no reports on its use in the USA. E-Vac therapy was used to treat 11 patients with upper gastrointestinal leaks and perforations from September 2013 to September 2014. Five patients with leaks following sleeve gastrectomy were excluded from this study. A total of six patients were treated with E-Vac therapy; these included: (n = 2) iatrogenic esophageal perforations, (n = 1) iatrogenic esophageal and gastric perforations, (n = 1) iatrogenic gastric perforation, (n = 1) gastric staple line leak following a surgical repair of a traumatic gastric perforation, and (n = 1) esophageal perforation due to an invasive fungal infection. Four patients had failed an initial surgical repair prior to starting E-Vac therapy. All six patients (100 %) had complete closure of their perforation or leak after an average of 35.8 days of E-Vac therapy requiring 7.2 different E-Vac changes. No deaths occurred in the 30 days following E-Vac therapy. One patient died following complete closure of his perforation and transfer to an acute care facility due to an unrelated complication. There were no complications directly related to the use of E-Vac therapy. Only one patient had any symptoms of dysphagia. This patient had severe dysphagia from an esophagogastric anastomotic stricture prior to her iatrogenic perforations. Following E-Vac therapy, her dysphagia had actually improved and she could now tolerate a soft diet. E-Vac therapy is a promising new method in the treatment of upper gastrointestinal leaks and perforations. Current successes need to be validated through future

Esophageal Perforation due to Transesophageal Echocardiogram: New Endoscopic Clip Treatment

Directory of Open Access Journals (Sweden)

John Robotis

2014-07-01

Full Text Available Esophageal perforation due to transesophageal echocardiogram (TEE during cardiac surgery is rare. A 72-year-old female underwent TEE during an operation for aortic valve replacement. Further, the patient presented hematemesis. Gastroscopy revealed an esophageal bleeding ulcer. Endoscopic therapy was successful. Although a CT scan excluded perforation, the patient became febrile, and a second gastroscopy revealed a big perforation at the site of ulcer. The patient's clinical condition required endoscopic intervention with a new OTSC® clip (Ovesco Endoscopy, Tübingen, Germany. The perforation was successfully sealed. The patient remained on intravenous antibiotics, proton pump inhibitors and parenteral nutrition for few days, followed by enteral feeding. She was discharged fully recovered 3 months later. We clearly demonstrate an effective, less invasive treatment of an esophageal perforation with a new endoscopic clip.

Perforated plates for cryogenic regenerators and method of fabrication

International Nuclear Information System (INIS)

Hendricks, J.B.

1994-01-01

Perforated plates having very small holes with a uniform diameter throughout the plate thickness are prepared by a open-quotes wire drawingclose quotes process in which a billet of sacrificial metal is disposed in an extrusion can of the plate metal, and the can is extruded and restacked repeatedly, converting the billet to a wire of the desired hole diameter. At final size, the rod is then sliced into wafers, and the wires are removed by selective etching. This process is useful for plate metals of interest for high performance regenerator applications, in particular, copper, niobium, molybdenum, erbium, and other rare earth metals. Er 3 Ni, which has uniquely favorable thermophysical properties for such applications, may be incorporated in regions of the plates by providing extrusion cans containing erbium and nickel metals in a stacked array with extrusion cans of the plate metal, which may be copper. The array is heated to convert the erbium and nickel metals to Er 3 Ni. Perforated plates having two sizes of perforations, one of which is small enough for storage of helium, are also disclosed. 10 figures

Spectrum of Perforation Peritonitis in Delhi: 77 Cases Experience

OpenAIRE

Yadav, Dinesh; Garg, Puneet K.

2012-01-01

Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well in India. The spectrum of etiology of perforation peritonitis in tropical countries continues to differ from its western counterpart. This study was conducted at Hindu Rao Hospital, Municipal Corporation of Delhi, New Delhi, India, designed to highlight the spectrum of perforation peritonitis in the eastern countries and to improve its outcome. This prospective study included 77 co...

Streaming Pool: reuse, combine and create reactive streams with pleasure

CERN Multimedia

CERN. Geneva

2017-01-01

When connecting together heterogeneous and complex systems, it is not easy to exchange data between components. Streams of data are successfully used in industry in order to overcome this problem, especially in the case of "live" data. Streams are a specialization of the Observer design pattern and they provide asynchronous and non-blocking data flow. The ongoing effort of the ReactiveX initiative is one example that demonstrates how demanding this technology is even for big companies. Bridging the discrepancies of different technologies with common interfaces is already done by the Reactive Streams initiative and, in the JVM world, via reactive-streams-jvm interfaces. Streaming Pool is a framework for providing and discovering reactive streams. Through the mechanism of dependency injection provided by the Spring Framework, Streaming Pool provides a so called Discovery Service. This object can discover and chain streams of data that are technologically agnostic, through the use of Stream IDs. The stream to ...

Factors related to persisting perforations after ventilation tube insertion.

Science.gov (United States)

O'Connell Ferster, Ashley P; Tanner, April Michelle; Karikari, Kodjo; Roberts, Christopher; Wiltz, Derek; Carr, Michele M

2016-02-01

Over a million ventilation tubes are placed annually in the United States, making this one of the most commonly performed procedures in the field of medicine. Certain factors increase the risk of persistent tympanic membrane perforation following the extrusion of short term ventilation tubes. Persistent perforations may fail to heal on their own, necessitating surgical closure to avoid conductive hearing loss. It is important to detect factors that may predict children who are at increased risk for persistent perforations. This study was a retrospective chart review that involved 757 patients between 2003 and 2008. The patients studied were within the age of 2 months-17 years, and all had short term tubes placed. The chart data also included demographic information, comorbidities, and information related to tube insertion and follow-up care. Chi-square, t-test, and multivariate logistic regression were conducted to compare variables between patients with perforations and those without. Data from 757 patients was analyzed, showing that perforation rate is associated with rhinorrhea, operative tube removal, aural polyps, and otorrhea (OR 1.72, 8.16, 4.69, and 1.72 respectively). The absence of otorrhea decreased the likelihood of TM perforations and no significant differences were found in gender, total number of sets of tubes, type of tube, use of nasal steroids, adenoidectomy, or nasal congestion. Our findings suggest that children with rhinorrhea, otorrhea, aural polyps, or prolonged intubation requiring operative tube removal should be identified clinically as children at risk of persisting perforation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Common Bile Duct Perforation Due to Tuberculosis: A Case Report

OpenAIRE

Razman Jarmin; Shaharin Shaharuddin

2004-01-01

A young man with HIV presented with biliary peritonitis secondary to spontaneous common bile duct perforation. Investigation revealed that the perforation was due to Mycobacterium tuberculosis. Tuberculosis of the bile duct is uncommon and usually presents with obstructive jaundice due to stricture. Bile duct perforation due to tuberculosis is extremely rare. Its management is discussed.

Pseudotumoural gastric lesion caused by fish bone perforation

Directory of Open Access Journals (Sweden)

Walid Al-Deeb

2009-01-01

Full Text Available

We report the case of a 34-year-old previously fit and healthy male who presented to the accident & emergency department with non-specific abdominal pain. The patient proceeded to undergo laparotomy at which a large mass was found adjacent to the stomach. The impression at surgery was of a lymphoma or gastric carcinoma though CT had reported the likelihood of a fish bone or foreign body causing duodenal perforation. Histology later confirmed the presence of a fish bone surrounded by reactive tissue.

Management of perforated peptic ulcer in patients at a teaching hospital

International Nuclear Information System (INIS)

Bin-Taleb, Ali K.; Razzaq, Riyadh A.; Al-Kathiri, Zaki O.

2008-01-01

Objective was to explore and analyze the current status in management of patients with perforated peptic ulcers (PPU). A retrospective study carried out at the Surgical Department, Al-Gamhouria Teaching Hospital, Aden, Yemen. Patients admitted with perforated benign peptic ulcers from January 1997 to December 2006 were included in the study. A total of 156 patients, 138 (88.5%) male and 18 (11.5%) female, with an overall mean age of 39.08 years (range 14-75 years) and a higher frequency of PPU were noted in patients 21-40 years (58.3%). The perforated duodenal ulcer and perforated gastric ulcer ratio was 4.8:1. The mean time of presentation was 16.5 hours, and operative intervention after admission was 5.25 hours. Simple perforation closure was used in 91.7% of the patients. Postoperative complication rate was 41% (statistically significant in cases admitted later than 12 hours) wound sepsis making the majority at 55.2%, 6 deaths (3.9%), the correlation with presentation time was not significant. The overall mean post-operative hospitalization period was 12.76 days; 14.7% of the patients stayed more than 3 weeks. Younger patients (21-40 years) were frequently affected. Emphasis should be placed on shortening the time to surgery. Simple closure remains the selected treatment in the majority of patients. Overall post-operative mortality was low (3.9%). Improving the surgical skills, wound care, administrative regulations, hospital environment and the equipments are needed to reduce the high rate of complications. (author)

Spectrum of perforation peritonitis in India-review of 504 consecutive cases

OpenAIRE

Jhobta, Rajender Singh; Attri, Ashok Kumar; Kaushik, Robin; Sharma, Rajeev; Jhobta, Anupam

2006-01-01

Abstract Background/objective Perforation peritonitis is the most common surgical emergency in India. The spectrum of etiology of perforation in Tropical countries continues to be different from its Western counterpart. The objective of the study was to highlight the spectrum of perforation peritonitis as encountered by us at Government Medical College and Hospital (GMCH), Chandigarh. Methods Five hundred and four consecutive cases of perforation peritonitis over a period of five years were r...

Development of a high efficient conventional type cold neutron source using a non-explosive material

International Nuclear Information System (INIS)

Kiyanagi, Y.; Satoh, S.

1999-01-01

An efficient cold moderator that can be used easily at a small neutron source would be useful for neutron radiography, prompt gamma ray analysis and so on. Non-explosive materials are chosen for a cold moderator since explosive materials such as hydrogen and methane require a safety system. Neutronic performances of coupled moderators of various non-explosive materials are studied so as to develop such a cold moderator since the coupled moderator system is the best to obtain high intensity of cold neutrons. Effect of premoderator is studied and neutron spectra from methanol, ethanol, benzene, mesitylene and benzene methanol are measured around 20 K. The premoderator increased the cold neutron intensity by about 50∼70%. Methanol and mesitylene gave the highest cold neutron intensity. Effect of Be filter-reflector is also studied and a intensity gain of about 20% was obtained below about 5 MeV. (author)

Diaphragmatic eventration complicated by gastric volvulus with perforation

OpenAIRE

Gupta, V; Chandra, A; Gupta, P

2012-01-01

Eventration of the diaphragm with gastric volvulus is uncommon. Gastric perforation in these cases is rare and usually associated with acute gastric volvulus with strangulation. We describe a case of diaphragmatic eventration with chronic gastric volvulus with gastric perforation without strangulation in an elderly man.

Common Bile Duct Perforation Due to Tuberculosis: A Case Report

Directory of Open Access Journals (Sweden)

Razman Jarmin

2004-10-01

Full Text Available A young man with HIV presented with biliary peritonitis secondary to spontaneous common bile duct perforation. Investigation revealed that the perforation was due to Mycobacterium tuberculosis. Tuberculosis of the bile duct is uncommon and usually presents with obstructive jaundice due to stricture. Bile duct perforation due to tuberculosis is extremely rare. Its management is discussed.

Preoperative factors influencing mortality and morbidity in peptic ulcer perforation.

Science.gov (United States)

Sivaram, P; Sreekumar, A

2018-04-01

Perforated peptic ulcer is one of the most common surgical emergencies worldwide. With the improvement in medical therapy for peptic ulcers, the number of elective surgical procedures has come down. However, the incidence of perforated peptic ulcer is still increasing and remains as a substantial health problem with significant postoperative morbidity and mortality. This study aimed to find out the association between various preoperative and intraoperative factors with the postoperative mortality and morbidity in patients operated for peptic ulcer perforation. This prospective observational study had a time based sample of 101 perforation peritonitis cases admitted to the surgical wards of a tertiary care center from February 2015 to January 2016 who underwent laparotomy, diagnosed to have peptic ulcer perforation and underwent simple closure with an omental patch. Data regarding age, gender, presenting complaints, time elapsed from the onset of symptoms to surgery, physical examination findings, comorbid diseases, laboratory and imaging findings, intraoperative findings, length of hospital stay, postoperative morbidity, and mortality were recorded and analyzed. Female gender, older age group, perforation surgery interval more than 36 h, and size of perforation more than 1 cm 2 were found to be significant factors influencing postoperative mortality and morbidity. Postoperative morbidity was also associated with comorbid diseases. Abnormal renal function on presentation was identified as an additional risk factor for postoperative morbidity and longer hospital stay. An understanding of these factors, identification of patients at risk and early intervention can help in reducing the postoperative morbidity and mortality in peptic ulcer perforation.

Jejunal Diverticular Perforation due to Enterolith

Directory of Open Access Journals (Sweden)

Ronaldo Nonose

2011-08-01

Full Text Available Jejunal diverticulosis is a rare entity with variable clinical and anatomical presentations. Although there is no consensus on the management of asymptomatic jejunal diverticular disease, some complications are potentially life-threatening and require early surgical treatment. Small bowel perforation secondary to jejunal diverticulitis by enteroliths is rare. The aim of this study was to report a case of small intestinal perforation caused by a large jejunal enterolith. An 86-year-old woman was admitted with signs of diffuse peritonitis. After initial fluid recovery the patient underwent emergency laparotomy. The surgery showed that she had small bowel diverticular disease, mainly localized in the proximal jejunum. The peritonitis was due to intestinal perforation caused by an enterolith 12 cm in length, localized inside one of these diverticula. The intestinal segment containing the perforated diverticulum with the enterolith was removed and an end-to-end anastomosis was done to reconstruct the intestinal transit. The patient recovered well and was discharged from hospital on the 5th postoperative day. There were no signs of abdominal pain 1 year after the surgical procedure. Although jejunal diverticular disease with its complications, such as formation of enteroliths, is difficult to suspect in patients with peritonitis, it should be considered as a possible source of abdominal infection in the elderly patient when more common diagnoses have been excluded.

Sonographic templates of newborn perforator stroke.

Science.gov (United States)

Abels, Lyanne; Lequin, Maarten; Govaert, Paul

2006-07-01

Many paediatric strokes occur in the perinatal period. Improvement in neuroimaging has increased detection in newborns with neurological symptoms. To define sonographic templates of neonatal stroke in the territory of perforators of the anterior choroidal artery (AChA) and the anterior (ACA), middle (MCA) and posterior (PCA) cerebral arteries. In 24 neonates with perforator stroke, we retrospectively studied antenatal and perinatal events. Brain sonography was performed with an 8.5-MHz probe. Only hyperechoic lesions in the thalamus and/or striatum and/or centrum semiovale were included. MRI was obtained using a 1.5-T machine. We detected 28 perforator strokes in 24 infants (6 preterm): 5 MCA medial striate, 8 MCA lateral striate, 3 MCA centrum semiovale, 4 ACA Heubner's, 5 PCA thalamic arteries, 1 AChA, and 2 hypothalamic perforators. We attributed clinical seizures to stroke in two infants only. Catheter-related embolism (certain in three, possible in six others) and birth trauma (two) were probable causes. Specific conditions were found in six others. Only one infant (in nine evaluated) had an increased prothrombotic risk (fII mutation). In describing the lesions, we focused on the templates of infarction as seen in a parasagittal US sweep. Infarcts were confirmed by MRI in 21 patients. Our study showed that infarct topography can be evaluated reliably with brain sonography. This is important given the asymptomatic character of most lesions.

Potential population and assemblage influences of non-native trout on native nongame fish in Nebraska headwater streams

Science.gov (United States)

Turek, Kelly C.; Pegg, Mark A.; Pope, Kevin L.; Schainost, Steve

2014-01-01

Non-native trout are currently stocked to support recreational fisheries in headwater streams throughout Nebraska. The influence of non-native trout introductions on native fish populations and their role in structuring fish assemblages in these systems is unknown. The objectives of this study were to determine (i) if the size structure or relative abundance of native fish differs in the presence and absence of non-native trout, (ii) if native fish-assemblage structure differs in the presence and absence of non-native trout and (iii) if native fish-assemblage structure differs across a gradient in abundances of non-native trout. Longnose dace Rhinichthys cataractae were larger in the presence of brown trout Salmo trutta and smaller in the presence of rainbow trout Oncorhynchus mykiss compared to sites without trout. There was also a greater proportion of larger white suckers Catostomus commersonii in the presence of brown trout. Creek chub Semotilus atromaculatus and fathead minnow Pimephales promelas size structures were similar in the presence and absence of trout. Relative abundances of longnose dace, white sucker, creek chub and fathead minnow were similar in the presence and absence of trout, but there was greater distinction in native fish-assemblage structure between sites with trout compared to sites without trout as trout abundances increased. These results suggest increased risk to native fish assemblages in sites with high abundances of trout. However, more research is needed to determine the role of non-native trout in structuring native fish assemblages in streams, and the mechanisms through which introduced trout may influence native fish populations.

Sen perforation af tyndtarm efter laparoskopisk gastrisk bypass

DEFF Research Database (Denmark)

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

2010-01-01

We present two cases in which the patients were admitted to a local hospital with acute abdominal pain four or five months after having undergone laparoscopic gastric bypass. In both cases, operation revealed a perforation of the small bowel close to the distal anastomosis. In the first case......, a massive constipation of the small bowel was most likely a contributing factor. In the second case, the cause was a kink of the entero-entero anastomosis leading to obstruction and finally perforation of the biliary limp. Late perforations are among the rarely reported complications associated with gastric...

Non-uniform groundwater discharge across a stream bed: Heat as a tracer

DEFF Research Database (Denmark)

Jensen, Jannick Kolbjørn; Engesgaard, Peter Knudegaard

2011-01-01

Time series analysis of conO nuous streambed temperature during a period of 47 d revealed that discharge to a stream is nonuniform, with strongly increasing verO cal fl uxes throughout the top 20 cm of the streambed–aquifer interface. An analyO cal soluO on to the transient heat transport equa...... near the streambed. Seepage meter measurements in the middle of the stream oO en resulted in highly variable fl ux esO - mates, which could have been caused by hyporheic fl ow due to the presence of a gravel layer. Discharge and recharge to the stream at the bank near the meadow was relaO vely steady...

EVALUATION OF HYPERBILIRUBINAEMIA AS A NEW DIAGNOSTIC MARKER FOR ACUTE APPENDICITIS AND ITS ROLE IN THE PREDICTION OF APPENDICULAR PERFORATION

Directory of Open Access Journals (Sweden)

Lalit Kumar Regar

2016-07-01

Full Text Available BACKGROUND There are various investigations recommended to diagnose acute appendicitis; however, till date there is no confirmatory laboratory marker to diagnose preoperatively acute appendicitis & appendicular perforation. The purpose of study is to evaluate hyperbilirubinaemia as a new diagnostic marker for acute appendicitis and its role in the prediction of appendicular perforation. Preoperative assessment of serum bilirubin appears to be a promising new laboratory marker for diagnosing acute appendicitis & have a predictive potential for the diagnosis of appendicular perforation. METHODS A prospective analytical study of 100 cases comprising of a non-randomised cohort. RESULTS Hyperbilirubinaemia was found in most of the patients diagnosed with acute appendicitis (68.23% or appendicular perforation (73.33%. The mean total bilirubin level in patients diagnosed with acute appendicitis was 1.34 mg% while in patients diagnosed with appendicular perforation was 2.12 mg%. CONCLUSIONS Preoperative assessment of serum bilirubin should be routinely performed in cases of acute appendicitis as it can help in diagnosis of acute appendicitis as well as also serve as an important maker of acute gangrenous appendicitis.

Density-dependent effects of non-native brown trout Salmo trutta on the species-area relationship in stream fish assemblages.

Science.gov (United States)

Hasegawa, K; Mori, T; Yamazaki, C

2017-01-01

The spatial scale and density-dependent effects of non-native brown trout Salmo trutta on species richness of fish assemblages were examined at 48 study sites in Mamachi Stream, a tributary of Chitose River, Hokkaido, Japan. The density of age ≥1 year S. trutta was high in the upstream side of the main stem of Mamachi Stream. Fish species richness increased with increasing area of study sites (habitat size), but the increasing magnitude of the species richness with area decreased with increasing age of ≥1 year S. trutta density. The relationships between age ≥1 year S. trutta, however, and presence-absence of each species seemed to be different among species. Species richness was also determined by location and physical environmental variables, i.e. it was high on the downstream side and in structurally complex environments. © 2016 The Fisheries Society of the British Isles.

PROXY-BASED PATCHING STREAM TRANSMISSION STRATEGY IN MOBILE STREAMING MEDIA SYSTEM

Institute of Scientific and Technical Information of China (English)

Liao Jianxin; Lei Zhengxiong; Ma Xutao; Zhu Xiaomin

2006-01-01

A mobile transmission strategy, PMPatching (Proxy-based Mobile Patching) transmission strategy is proposed, it applies to the proxy-based mobile streaming media system in Wideband Code Division Multiple Access (WCDMA) network. Performance of the whole system can be improved by using patching stream to transmit anterior part of the suffix that had been played back, and by batching all the demands for the suffix arrived in prefix period and patching stream transmission threshold period. Experimental results show that this strategy can efficiently reduce average network transmission cost and number of channels consumed in central streaming media server.

Changes in outcome and management of perforated diverticulitis over a 10 year period.

LENUS (Irish Health Repository)

O'Leary, D P

2013-03-04

Aggressive non-operative intervention and evolving surgical strategies have altered the treatment of perforated diverticulitis in the acute setting. These strategies have predominantly been implemented over the last decade. The aim of this study was to assess the impact of this on patient outcome during their index admission and subsequently.

Acute surgical treatment of perforated peptic ulcer in the elderly patients.

Science.gov (United States)

Su, Yen-Hao; Yeh, Chi-Chuan; Lee, Chih-Yuan; Lin, Mong-Wei; Kuan, Chen-Hsiang; Lai, I-Rue; Chen, Chiung-Nien; Lin, Hong-Mau; Lee, Po-Huang; Lin, Ming-Tsan

2010-01-01

Emergency abdominal surgery is associated with high morbidity and mortality rates, especially in the elderly patients, but prompt diagnoses and treatment should not be delayed. We conducted a retrospective review (1) to identify risk factors for morbidity and mortality among elderly patients admitted for emergent surgery of perforated peptic ulcers; and (2) to determine whether there were any differences between those who are 70-79 years old and those 80 years old and older. 94 patients who were older than 70 years old and underwent emergency surgery for perforated peptic ulcer between 2000 and 2004 in our institution were reviewed retrospectively. The following variables were followed: age, sex, comorbidity, previous medications, time from onset of symptoms/signs to surgery, time from arrival in emergent room to surgery, perioperative risks, operative findings, type of operation, morbidity, mortality and length of hospital stay. The age, morbidity, mortality and the length of intensive care unit stay were increased in Group 2 (>80 yrs) than Group 1 (70 to 79 yrs), but they did not achieve significant differences statistically. Time from symptoms/signs to emergency room over 24 hours, American Society of Anesthesiologist grade over IV and limited procedure showed significant contributions to postoperative morbidity on univariate analysis. Comorbidity, time from emergency room to operation room over 12 hours, American Society of Anesthesiologists grade over IV, peri-operative blood transfusion, postoperative morbidity and duration of ICU stays over 5 days were significant factors contributed to mortality on univariate analysis. Further analysis showed comorbidity, peri-operative blood transfusion, and postoperative morbidity were independent and predictive factors of mortality on multivariate model. Although perforated peptic ulcer in the elderly patients is associated with high morbidity and mortality, we should not delay the surgical intervention for patients with

Brief Report: Risk of Gastrointestinal Perforation Among Rheumatoid Arthritis Patients Receiving Tofacitinib, Tocilizumab, or Other Biologic Treatments.

Science.gov (United States)

Xie, Fenglong; Yun, Huifeng; Bernatsky, Sasha; Curtis, Jeffrey R

2016-11-01

To evaluate gastrointestinal (GI) perforation in rheumatoid arthritis (RA) patients receiving tofacitinib, tocilizumab, or other biologic agents. Using health plan data from 2006 through 2014, RA patients without prior GI perforation were identified. Those in whom treatment with tofacitinib or a biologic agent was being initiated were followed up for incident GI perforation with hospitalization. Crude incidence rates were calculated by exposure. Adjusted Cox proportional hazards models were used to evaluate the association between GI perforation and exposures. Hazard ratios (HRs) with 95% confidence intervals (95% CIs) were calculated. A cohort of 167,113 RA patients was analyzed. Among them, 4,755 began treatment with tofacitinib, 11,705 with tocilizumab, 115,047 with a tumor necrosis factor inhibitor (TNFi), 31,214 with abatacept, and 4,392 with rituximab. Compared to TNFi recipients, abatacept recipients were older, tofacitinib and rituximab recipients were younger, and tocilizumab recipients were similar in age. Patients beginning treatment with a non-TNFi agent were more likely to have previously received biologic agents than patients beginning treatment with a TNFi. The incidence of GI perforation per 1,000 patient-years was 0.86 (tofacitinib), 1.55 (tocilizumab), 1.07 (abatacept), 0.73 (rituximab), and 0.83 (TNFi). Most perforations occurred in the lower GI tract: the incidence of lower GI tract perforation per 1,000 patient-years was 0.86 (tofacitinib), 1.26 (tocilizumab), 0.76 (abatacept), 0.48 (rituximab), and 0.46 (TNFi). Lower GI tract perforation risk was significantly elevated with tocilizumab treatment, and numerically elevated with tofacitinib treatment, versus treatment with TNFi. Adjusted HRs were 2.51 (95% CI 1.31-4.80) for tocilizumab and 1.94 (95% CI 0.49-7.65) for tofacitinib. Older age (HR 1.16 per 5 years [95% CI 1.10-1.22]), diverticulitis/other GI conditions (HR 3.25 [95% CI 1.62-6.50]), and prednisone use at >7.5 mg/day (HR 2.29 [95% CI 1

Perforated pyloroduodenal peptic ulcer and sonography.

Science.gov (United States)

Kuzmich, Siarhei; Harvey, Chris J; Fascia, Daniel T M; Kuzmich, Tatsiana; Neriman, Deena; Basit, Rizwan; Tan, Kai Lee

2012-11-01

The purpose of this article is to illustrate the spectrum of sonographic findings in perforated pyloroduodenal peptic ulcer and discuss the potential role of sonography in the diagnosis. Although sonography is not the first-line investigation of choice in suspected perforated peptic ulcer, understanding of the characteristic appearances seen during general abdominal sonography may aid the reader in the diagnosis of this important and sometimes overlooked cause of nonspecific abdominal pain. This may shorten time to the diagnosis and ultimate surgical management.

Spontaneous Uterine Perforation due to Pyometra Presenting as Acute Abdomen

Directory of Open Access Journals (Sweden)

Loabat Geranpayeh

2006-01-01

Full Text Available Spontaneous perforation of the uterus is rare, its incidence being about 0.01%–0.05%. We report a rare case of diffuse peritonitis caused by spontaneously perforated pyometra. A 63-year-old woman with severe abdominal pain was admitted to our hospital. Laparotomy was performed because of the suspicion of gastrointestinal perforation with generalized peritonitis. At laparotomy, about 900 mL of pus was found in the peritoneal cavity. There were no abnormal findings in the alimentary tract, liver, or gallbladder. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Pathological investigation of the surgical specimen revealed endometritis and myometritis of the uterus; but there was no evidence of malignancy, and the cervical canal was patent. Although spontaneously perforated pyometra is rare, a perforated pyometra should therefore also be considered when elderly women present with acute abdominal pain.

Mathematical models for diffusive mass transfer from waste package container with multiple perforations

International Nuclear Information System (INIS)

Lee, J.H.; Andrews, R.W.; Chambre, P.L.

1996-01-01

A robust engineered barrier system (EBS) is employed in the current design concept for the potential high-level nuclear waste repository at Yucca Mountain, Nevada, US. The primary component of the EBS is a multi-barrier waste package container. Simplifying the geometry of the cylindrical waste package container and the underlying invert into the equivalent spherical configuration, mathematical models are developed for steady-state and transient diffusive releases from the failed waste container with multiple perforations (or pit penetrations) at the boundary of the invert. Using the models the steady-state and transient diffusive release behaviors form the failed waste container are studied. The analyses show that the number of perforations, the size of perforation, the container wall thickness, the geometry of the waste container and invert, and the adsorption of radionuclide in the invert are the important parameters that control the diffusive release rate. It is emphasized that the failed (or perforated) waste package container can still perform as a potentially important barrier (or diffusion barrier) to radionuclide release

A multi-centre open-label randomised non-inferiority trial comparing watchful waiting to antibiotic treatment for acute otitis media without perforation in low-risk urban Aboriginal and Torres Strait Islander children (the WATCH trial): study protocol for a randomised controlled trial.

Science.gov (United States)

Abbott, Penelope; Gunasekera, Hasantha; Leach, Amanda Jane; Askew, Deborah; Walsh, Robyn; Kong, Kelvin; Girosi, Federico; Bond, Chelsea; Morris, Peter; Lujic, Sanja; Hu, Wendy; Usherwood, Tim; Tyson, Sissy; Spurling, Geoffrey; Douglas, Markeeta; Schubert, Kira; Chapman, Shavaun; Siddiqui, Nadeem; Murray, Reeion; Rabbitt, Keitha; Porykali, Bobby; Woodall, Cheryl; Newman, Tina; Reath, Jennifer

2016-03-03

Treatment guidelines recommend watchful waiting for children older than 2 years with acute otitis media (AOM) without perforation, unless they are at high risk of complications. The high prevalence of chronic suppurative otitis media (CSOM) in remote Aboriginal and Torres Strait Islander communities leads these children to be classified as high risk. Urban Aboriginal and Torres Strait Islander children are at lower risk of complications, but evidence to support the subsequent recommendation for watchful waiting in this population is lacking. This non-inferiority multi-centre randomised controlled trial will determine whether watchful waiting is non-inferior to immediate antibiotics for urban Aboriginal and Torres Strait Islander children with AOM without perforation. Children aged 2 - 16 years with AOM who are considered at low risk for complications will be recruited from six participating urban primary health care services across Australia. We will obtain informed consent from each participant or their guardian. The primary outcome is clinical resolution on day 7 (no pain, no fever of at least 38 °C, no bulging eardrum and no complications of AOM such as perforation or mastoiditis) as assessed by general practitioners or nurse practitioners. Participants and outcome assessors will not be blinded to treatment. With a sample size of 198 children in each arm, we have 80 % power to detect a non-inferiority margin of up to 10 % at a significance level of 5 %, assuming clinical improvement of at least 80 % in both groups. Allowing for a 20 % dropout rate, we aim to recruit 495 children. We will analyse both by intention-to-treat and per protocol. We will assess the cost- effectiveness of watchful waiting compared to immediate antibiotic prescription. We will also report on the implementation of the trial from the perspectives of parents/carers, health professionals and researchers. The trial will provide evidence for the safety and effectiveness of watchful waiting

Gas stream clean-up filter and method for forming same

International Nuclear Information System (INIS)

Mei, J.S.; DeVault, J.; Halow, J.S.

1993-01-01

A gas cleaning filter is formed in-situ within a vessel containing a fluidizable bed of granular material of a relatively large size fraction. A filter membrane provided by a porous metal or ceramic body or such a body supported a perforated screen on one side thereof is coated in-situ with a layer of the granular material from the fluidized bed by serially passing a bed-fluidizing gas stream through the bed of granular material and the membrane. The layer of granular material provides the filtering medium for the combined membrane-granular layer filter. The filter is not blinded by the granular material and provides for the removal of virtually all of the particulates from a process gas stream. The granular material can be at least partially provided by a material capable of chemically reacting with and removing sulfur compounds from the process gas stream. Low level radioactive waste containing organic material may be incinerated in a fluidized bed in communication with the described filter for removing particulates from the gaseous combustion products

Perforated peptic ulcer associated with abdominal compartment syndrome.

Science.gov (United States)

Lynn, Jiun-Jen; Weng, Yi-Ming; Weng, Chia-Sui

2008-11-01

Abdominal compartment syndrome (ACS) is defined as an increased intra-abdominal pressure with adverse physiologic consequences. Abdominal compartment syndrome caused by perforated peptic ulcer is rare owing to early diagnosis and management. Delayed recognition of perforated peptic ulcer with pneumoperitoneum, bowel distension, and decreased abdominal wall compliance can make up a vicious circle and lead to ACS. We report a case of perforated peptic ulcer associated with ACS. A 74-year-old man with old stroke and dementia history was found to have distended abdomen, edema of bilateral legs, and cyanosis. Laboratory tests revealed deterioration of liver and kidney function. Abdominal compartment syndrome was suspected, and image study was arranged to find the cause. The study showed pneumoperitoneum, contrast stasis in heart with decreased caliber of vessels below the abdominal aortic level, and diffuse lymphedema at the abdominal walls. Emergent laparotomy was performed. Perforated peptic ulcer was noted and the gastrorrhaphy was done. The symptoms, and liver and kidney function improved right after emergent operation.

Esophageal Perforation Following Anterior Cervical Spine Surgery: Case Report and Review of the Literature

OpenAIRE

Hershman, Stuart H.; Kunkle, William A.; Kelly, Michael P.; Buchowski, Jacob M.; Ray, Wilson Z.; Bumpass, David B.; Gum, Jeffrey L.; Peters, Colleen M.; Singhatanadgige, Weerasak; Kim, Jin Young; Smith, Zachary A.; Hsu, Wellington K.; Nassr, Ahmad; Currier, Bradford L.; Rahman, Ra?Kerry K.

2017-01-01

Study Design: Multicenter retrospective case series and review of the literature. Objective: To determine the rate of esophageal perforations following anterior cervical spine surgery. Methods: As part of an AOSpine series on rare complications, a retrospective cohort study was conducted among 21 high-volume surgical centers to identify esophageal perforations following anterior cervical spine surgery. Staff at each center abstracted data from patients? charts and created case report forms fo...

A case report of esophageal perforation: Complication of nasogastric tube placement

Science.gov (United States)

Isik, Arda; Firat, Deniz; Peker, Kemal; Sayar, Ilyas; Idiz, Oguz; Soytürk, Mehmet

2014-01-01

Patient: Male, 70 Final Diagnosis: Esophageal perforation Symptoms: Abdominal pain • nausea • vomiting Medication: — Clinical Procedure: — Specialty: Surgery Objective: Unusual clinical course Background: Esophageal perforation is a well-defined and severe clinical condition. There are several etiologies of esophagus perforation. Case Report: We report the case of a 70-year-old Caucasian man who underwent an emergency cholecystectomy due to acute cholecystitis. Two days after surgery, his condition deteriorated. Thorax computerized tomography revealed an esophageal perforation. Conclusions: Esophageal perforation due to nasogastric application is relatively rare but the consequences are potentially serious. The anatomy of the upper gastrointestinal system should be understood by all healthcare professionals involved in the treatment. PMID:24803977

Type II perforation of the body of the gallbladder in acalculous ...

African Journals Online (AJOL)

Arun Kumar Agnihotri

have necrosis or gangrene, but may have a small perforation. Gallbladder ... surgical conditions and so specific treatment is ... persisting obstruction leads to vascular compromise gangrene ... alternative especially in high-risk patients19.

Rectal impalement with bladder perforation: A review from a single institution

Directory of Open Access Journals (Sweden)

E I Bachir Benjelloun

2013-01-01

Conclusions: A high index of clinical suspicion is required to make the diagnosis of bladder perforation while assessing patients presenting with rectal impalement. Meticulous preoperative assessment is the clue of successful management.

Perforate on CHO cell membranes induced by electromagnetic ...

African Journals Online (AJOL)

STORAGESEVER

2009-06-17

Jun 17, 2009 ... Key words: Electromagnetic pulse (EMP), atomic force microscope, CHO cell, cell membrane. INTRODUCTION .... of perforation ranges from 390 to 660 nm and the depth is. 392.95 nm. ... cell membrane perforations increased when both the field intensity and ..... Melatonin and a spin-trap compound block.

Perforated appendicitis: Risk factors and outcomes of management ...

African Journals Online (AJOL)

The case files of patients with perforated appendicitis were analysed in relation to age, sex, clinical presentation, management and outcome of management. The aim was to detect the main factors that contributed to the perforation of the appendix in these patients and assess the effectiveness of the treatment offered.

Wave Reflection and Loss Characteristics of an Emerged Quarter Circle Breakwater with Varying Seaside Perforations

Science.gov (United States)

Binumol, S.; Rao, Subba; Hegde, Arkal Vittal

2017-09-01

Breakwaters are one of the most important harbour structures constructed to withstand and dissipate the dynamic energy due to the action of the waves. Due to fast growing need of the universe and advances in technology different types of breakwaters are being developed. Quarter circle breakwater is a new type of breakwater emerged from semi circular breakwater and the first model was developed in Peoples Republic of China (2006). Quarter circle breakwater with perforations posses merits of caisson as well as perforated breakwaters such as low weight, requires less materials, suited for poor soil conditions, easily transported, handled and placed at the site, aesthetically pleasing, cost effective, eco-friendly and stable. Therefore it is necessary to carry out detailed studies on hydrodynamic characteristics to investigate the suitability and applicability of various types of quarter circle breakwaters. The present study investigates the wave reflection and loss characteristics of an emerged seaside perforated quarter circle breakwater of radius 55 cm and with varying ratios of spacing to diameter of perforations, for different water depths and wave conditions. The tests were conducted in the two-dimensional monochromatic wave flume available in Marine Structures laboratory of Department of Applied Mechanics and Hydraulics of National Institute of Technology, Surathkal, Karnataka, India. The results were plotted as non-dimensional graphs and it was observed that the reflection coefficient increases with increase in wave steepness for all values of ratio of height of breakwater structure to water depth. For a constant water depth, wave reflection increases with increase in ratio of spacing to diameter of perforations. It was also found that the loss coefficient decreases with increase in wave steepness for all values of ratio of height of breakwater structure to water depth, and ratio of spacing to diameter of perforations.

Color Doppler Ultrasonography-Targeted Perforator Mapping and Angiosome-Based Flap Reconstruction

DEFF Research Database (Denmark)

Gunnarsson, Gudjon Leifur; Tei, Troels; Thomsen, Jørn Bo

2016-01-01

Knowledge about perforators and angiosomes has inspired new and innovative flap designs for reconstruction of defects throughout the body. The purpose of this article is to share our experience using color Doppler ultrasonography (CDU)-targeted perforator mapping and angiosome-based flap reconstr......Knowledge about perforators and angiosomes has inspired new and innovative flap designs for reconstruction of defects throughout the body. The purpose of this article is to share our experience using color Doppler ultrasonography (CDU)-targeted perforator mapping and angiosome-based flap...

Optimizing time management after perforation by colonoscopy results in better outcome for the patients.

Science.gov (United States)

Rumstadt, Bernhard; Schilling, Dieter

2008-01-01

Perforation during colonoscopy is a rare but severe complication. The aim of this study was to assess the time management and laparoscopic therapy of this complication and to evaluate patient outcomes. A retrospective analysis was done on 15 patients operated for a perforation from colonoscopy between January 2000 and December 2006. Three perforations occurred during diagnostic and 12 perforations during interventional colonoscopy. Two perforations occurred as transmural thermal injury to the colon wall. Peritonitis was found in 4 cases and significantly correlated with the mean time between perforation and operation. Twelve perforations were oversewn laparoscopically and 3 perforations were oversewn by laparotomy. After laparoscopic treatment, hospital stay was significantly shorter than after laparotomy. One patient had a postoperative wound infection, mortality was 0%. Laparoscopic oversewing is a safe and effective method in the treatment of perforation from colonoscopy. Optimizing the time range between perforation and laparoscopic therapy results in a better outcome for the patients.

Primary omental gangrene mimicking appendicular perforation peritonitis-A case report.

Science.gov (United States)

Kumar, A; Shah, J; Vaidya, P

2016-01-01

Primary omental torsion is a rare cause of acute abdomen in adults and presents with variable signs and symptoms. Establishing a preoperative diagnosis may be difficult in the emergency setting. It is rarely diagnosed preoperatively as it mimics common surgical emergencies such as acute appendicitis, appendicular perforation, acute cholecystitis and perforated peptic ulcers and can lead to the clinical deterioration of patient if missed A 47 years old male was taken to the operating room with a diagnosis of appendicular perforation peritonitis and during surgery was found to have a primary omental gangrene with pyoperitoneum, for which omentectomy and peritoneal lavage was performed. Torsion of the omentum is a condition in which the organ twists on its long axis to such an extent that its vascularity is compromised. Omental torsion can be primary (idiopathic) or secondary, depending on an underlying cause. Primary omental torsion was first described by Eitel in 1899. However, very few cases have been reported. Our case was a rare case presenting with omental gangrene with pyoperitoneum mimicking appendicular perforation peritonitis. Primary omental torsion is a rare diagnosis. A high index of clinical suspicion is required for a preoperative diagnosis. In doubtful cases a CT scan may be helpful. Surgical excision of the omentum remains the treatment of choice; however, conservative management may be attempted in an uncomplicated omental torsion. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

T2[sup *] weighted MR imaging for the diagnosis of the perforation of triangular fibrocartilage; Comparison with arthrography

Energy Technology Data Exchange (ETDEWEB)

Nakamura, Taro; Nakamura, Eiziro; Ahsoh, Kuniichi; Masumi, Shogo (Oita Medical Univ., Takatsuki (Japan))

1994-05-01

Perforation of the triangular fibrocartilage (TFC) has been considered an important factor in the etiology of pain in the ulnar wrist joint, and arthrography has been used conventionally to diagnose the perforation. Recently, magnetic resonance imaging (MRI) has been used to diagnose TFC perforation. Gundy et al. examined cadaver wrists with Tl weighted imaging and arthrography, and obtained findings suggesting that arthrography provides a more accurate diagnosis of the TFC perforation. To our knowledge, no comparison has yet been made between T2[sup *] weighted imaging and arthrography in the diagnosis of TFC perforation. The present study compared the usefulness of T2[sup *]-weighted imaging and arthrography in the diagnosis of TFC perforation in 22 wrist joints of 11 cadavers (5 males and 6 females with ages ranging from 61 to 92 years and an average age of 78.8 years) fixed in 60% formalin. The specimens were firstly analyzed by a T2[sup *]-weighted 0.5T MRI scan and subsequently by arthrography. After diagnosing the image obtained by the two methods, the accuracy of the diagnosis was determined by comparison with the macroscopic findings of autopsy, including the presence and degree of TFC perforation. A T2[sup *]-weighted MRI scan of the TFC perforation showed high-intensity areas over the distal radio-ulnar joint, and demonstrated the same diagnostic accuracy as arthrography, providing correct diagnoses in all cases other than linear perforation. However, neither of the image diagnostic methods allowed definition of the type of perforation. (author).

High performance multiple stream data transfer

International Nuclear Information System (INIS)

Rademakers, F.; Saiz, P.

2001-01-01

The ALICE detector at LHC (CERN), will record raw data at a rate of 1.2 Gigabytes per second. Trying to analyse all this data at CERN will not be feasible. As originally proposed by the MONARC project, data collected at CERN will be transferred to remote centres to use their computing infrastructure. The remote centres will reconstruct and analyse the events, and make available the results. Therefore high-rate data transfer between computing centres (Tiers) will become of paramount importance. The authors will present several tests that have been made between CERN and remote centres in Padova (Italy), Torino (Italy), Catania (Italy), Lyon (France), Ohio (United States), Warsaw (Poland) and Calcutta (India). These tests consisted, in a first stage, of sending raw data from CERN to the remote centres and back, using a ftp method that allows connections of several streams at the same time. Thanks to these multiple streams, it is possible to increase the rate at which the data is transferred. While several 'multiple stream ftp solutions' already exist, the authors' method is based on a parallel socket implementation which allows, besides files, also objects (or any large message) to be send in parallel. A prototype will be presented able to manage different transfers. This is the first step of a system to be implemented that will be able to take care of the connections with the remote centres to exchange data and monitor the status of the transfer

Bladder perforations in children

African Journals Online (AJOL)

2014-11-20

Nov 20, 2014 ... Mean recovery time for patients was 15 days. ... fracture.[1,2] Isolated bladder perforations are rare, and they .... PA, perineal injury, pelvic fracture. Trauma .... Lower genitourinary injury and pelvic fractures in pediatric patients.

Traumatic oesophageal perforation due to haematoma

DEFF Research Database (Denmark)

Grønhøj Larsen, Christian; Brandt, Bodil

2014-01-01

. Three explanations postulated to be the cause for late perforation which might be due to esophageal wall ischemia from pressure built up between the hematoma, azygos vein and the lower part of thoracic trachea; or could be an immediate rupture walled-off until the patient became symptomatic......; or the intramural hematoma gradually lysed and causing late perforation. CONCLUSION: Although extremely rare, an oesophageal haematoma and late complications must be considered in patients on anti-coagulant therapy following blunt thoracic trauma and complaining only of chest pain....

A rare cause of acute abdomen: jejunal diverticulosis with perforation.

Science.gov (United States)

Aydin, Ibrahim; Pergel, Ahmet; Yucel, Ahmet Fikret; Sahin, Dursun Ali

2013-01-01

Jejunal diverticulosis is generally asymptomatic and is associated with high morbidity and mortality secondary to complications, especially in elderly patients. We present a case report of a 74-year-old female patient with jejunal diverticulosis and perforation due to diverticulitis.

Green computing: efficient energy management of multiprocessor streaming applications via model checking

NARCIS (Netherlands)

Ahmad, W.

2017-01-01

Streaming applications such as virtual reality, video conferencing, and face detection, impose high demands on a system’s performance and battery life. With the advancement in mobile computing, these applications are increasingly implemented on battery-constrained platforms, such as gaming consoles,

Verification of high-speed solar wind stream forecasts using operational solar wind models

DEFF Research Database (Denmark)

Reiss, Martin A.; Temmer, Manuela; Veronig, Astrid M.

2016-01-01

and the background solar wind conditions. We found that both solar wind models are capable of predicting the large-scale features of the observed solar wind speed (root-mean-square error, RMSE ≈100 km/s) but tend to either overestimate (ESWF) or underestimate (WSA) the number of high-speed solar wind streams (threat......High-speed solar wind streams emanating from coronal holes are frequently impinging on the Earth's magnetosphere causing recurrent, medium-level geomagnetic storm activity. Modeling high-speed solar wind streams is thus an essential element of successful space weather forecasting. Here we evaluate...... high-speed stream forecasts made by the empirical solar wind forecast (ESWF) and the semiempirical Wang-Sheeley-Arge (WSA) model based on the in situ plasma measurements from the Advanced Composition Explorer (ACE) spacecraft for the years 2011 to 2014. While the ESWF makes use of an empirical relation...

THE CLINICAL MANIFESTATIONS AND COURSE OF DUODENAL ULCER DISEASE AFTER PERFORATED ULCER

Directory of Open Access Journals (Sweden)

L. A. Lyubskaya

2014-01-01

Full Text Available Objective: to compare clinical manifestations, course, mental status in duodenal ulcer (DU patients with a history of perforated ulcer and its uncomplicated course.Subjects and methods. One hundred and thirteen patents with DU were examined. Group 1 included 61 patients with uncomplicated DUand Group 2 comprised 52 patients with a history of perforated ulcer. A comparison group consisted of 20 patients who had undergone laparotomy. Physical and mental status examinations, esophagogastroduodenoscopy (EGDS, and 24-hour pH-metry were performed.Results. Classical pain syndrome was observed in 75 % of the patients with uncomplicated DU. Prior to perforation, the pain and dyspeptic syndromes were distinguished only by a significantly lower degree in Group 2; following perforation, the pain syndrome was recorded more frequently, it was more extensive, meal-unrelated, and similar to that in the patients who had undergone laparotomy and had diminished appetite (36.5 %. EGDS showed that the complicated course was accompanied by the significantly higher incidence of erosive esophagitis (21.2 %, gastritis (51.9 %, duodenitis (25.0 %, multiple ulcers (28.8 %, and larger ulcers. 24-hour pH-metry indicated that the level of hyperacidity in Group 2 was higher and the circadian intragastric pH variations were less marked than those in uncomplicated DU. The patients with a history of perforated ulcer showed a high rate of anxiety and depressive changes. Conclusion. In complicated DU, marked monotonic hyperacidity causes common erosive-ulcerative lesions in the gastroduodenal area in relatively mild pain syndrome, late referrals, and long-term ulcer healing. After perforation followed by wound closure, the pain and dyspeptic syndromes become more pronounced, which is associated with anxiety and depressive changes in the mental status, as well as with early referrals and less healing time.

Investigating methods of stream planform identification

Science.gov (United States)

Lohberg, M. M.; Lusk, K.; Miller, D.; Stonedahl, F.; Stonedahl, S. H.

2013-12-01

Stream planforms are used to map scientific measurements, estimate volumetric discharge, and model stream flow. Changes in these planforms can be used to quantify erosion and water level fluctuations. This research investigated five cost-effective methods of identifying stream planforms: (1) consumer-grade digital camera GPS (2) multi-view stereo 3D scene reconstruction (using Microsoft Photosynth (TM)) (3) a cross-sectional measurement approach (4) a triangulation-based measurement approach and (5) the 'square method' - a novel photogrammetric procedure which involved floating a large wooden square in the stream, photographing the square and banks from numerous angles and then using the square to correct for perspective and extract the outline (using custom post-processing software). Data for each of the five methods was collected at Blackhawk Creek in Davenport, Iowa. Additionally we placed 30 control points near the banks of the stream and measured 88 lengths between these control points. We measured or calculated the locations of these control points with each of our five methods and calculated the average percent error associated with each method using the predicted control point locations. The effectiveness of each method was evaluated in terms of accuracy, affordability, environmental intrusiveness, and ease of use. The camera equipped with GPS proved to be a very ineffective method due to an extremely high level of error, 289%. The 3D point cloud extracted from Photosynth was missing markers for many of the control points, so the error calculation (which yielded 11.7%) could only be based on five of the 88 lengths and is thus highly uncertain. The two non-camera methods (cross-sectional and triangulation measurements) resulted in low percent error (2.04% and 1.31% respectively) relative to the control point lengths, but these methods were very time consuming, exhausting, and only provided low resolution outlines. High resolution data collection would

Appendicular perforation in dengue fever: our experience

Directory of Open Access Journals (Sweden)

Gunjan Desai

2014-09-01

Full Text Available Dengue viral infections have become one of major emerging infectious diseases in the tropics. Acute abdomen occurring in dengue viral infection is not uncommon. The spectrums of acute surgical emergencies which raise suspicion of an abdominal catastrophe in patients presenting with dengue fever include acute pancreatitis, acute acalculous cholecystitis, non-specific peritonitis and very rarely acute appendicitis. The presence of low white cell count and platelet count can raise suspicion of a diagnosis of dengue in a patient presenting with acute abdominal pain, during a dengue epidemic. We herein report three patients with dengue fever who had appendicular perforation during the course of their viral fever.

Influences of gas stream conditions on efficiency of tritiated moisture collection with P2O5-desiccant and isotope effect

International Nuclear Information System (INIS)

Kotoh, Kenji; Miura, Katsuya; Kashio, Yousuke; Nishikawa, Masabumi

1991-01-01

A method was proposed previously for collection and measurement of tritiated moisture in gas stream using P 2 O 5 -desiccant. Influences of the gas humidity, the gas flow rate and the distance between gas nozzle and P 2 O 5 -desiccant layer surface on the moisture collection efficiency have been examined through experiments, and the isotope effect on the collection has been investigated. The collection efficiency is the ratio of collected to supplied moisture, and the moisture supplying rate is in proportion to the humidity and flow rate of feed gas. The experiments show that; the collection efficiency dose not depend on the gas humidity, but is affected by the gas flow rate and by the nozzle-layer distance. The effects of the flow rate and the nozzle position are related to the mass transfer distance from the bulk of gas stream to the desiccant layer surface in the collection cell. The moisture collecting rate is promoted by the approach of the gas stream to the layer surface. An expression of effective separation factor has been derived to explain the isotope effect on the moisture collection. Experimental data distribution of the separation factor have been reasonably simulated by the analysis. (author)

Perforation of the Esophagus Secondary to Insertion of Covered Wallstent Endoprostheses

International Nuclear Information System (INIS)

Farrugia, Mark; Morgan, Robert A.; Latham, Jennifer A.; Glynos, Michael; Mason, Robert C.; Adam, Andreas

1997-01-01

Perforation of the esophagus is a very rare complication of metallic esophageal stent insertion. Two cases are presented in which esophageal perforations were caused by the sharp ends of metallic stents impinging on the esophageal wall. In retrospect, both perforations might have been prevented by additional stent insertion

The US findings of acute nonperforated and perforated appendicitis in children

International Nuclear Information System (INIS)

Bae, Jun Gi; Lee, Young Seok; Jung, Yoon Ho; Kim, Ji Hye; Lee, Woon Ki; Lee, Tae Hoon

1996-01-01

To analyse and interpret different sonographic findings in acute nonperforated and appendicitis. In 46 cases of acute appendicitis in children(26 girls, 20 boys) proven by surgery, sonographic findings were reviewed retrospectively. The findings of nonperforated and perforated appendicitis were analysed, focusing on the size, shape and echogenicity of the appendix, echo patterns of periappendiceal abscesses, mesenteric lymphadenopathy, and the prevalence of appendicolith. A noncompressible distended appendix was present in 18 of 21 patients with nonperforated appendicitis and in 13 of 25 patients with perforation. In 18 patients with nonperforated appendicitis, the average diameter of distended appendix was 8.6 mm ; target appearance was noted in 16 patients and loss of echogenic submucosa in two. In 13 patients with perforated appendicitis, the average diameter of appendix was 9.1 mm ; target appearance was noted in four patients and loss of echogenic submucosa in nine. Periappendiceal abscesses were present in 21 of 25 cases of perforated appendicitis, and the echogenicity of abscesses was mixed in 12 patients, hypoechogenic in eight, and hyperechogenic in one. Mesenteric lymphadenopathy was present in two of 21 patients with nonperforated appendicitis and in four of 25 with perforation. Appendicolith was detected on sonography in three of 25 patients with perforated appendicitis, but was found in seven patients during surgery. One patients with perforated appendicitis also had right side hydronephrosis. Sonographically false-negative results were obtained in six cases. A sonographic examination was useful to differenciate perforated and nonperforated appendicitis in children. Loss of echogenic submucosa in the distended appendix and periappendiceal abscess formation were important findings in diagnosis of perforated appendicitis

Symptomatic duodenal perforation by inferior vena cava filter.

Science.gov (United States)

Baptista Sincos, Anna Pw; Sincos, Igor R; Labropoulos, Nicos; Donegá, Bruno C; Klepacz, Andrea; Aun, Ricardo

2017-01-01

Objectives Duodenal perforation by an inferior vena cava filter is rare and life threatening. Our objective is to find out number of occurrences and compare diagnosis and treatments. Method The reference list of Malgor's review in 2012 was considered as well as all new articles with eligible features. Search was conducted on specific databases: MEDLINE, Web of Sciences, and Literatura Latino-Americana e do Caribe em Ciências da Saúde. Results Most of the patients presented with upper abdominal pain and the use of radiologic studies was crucial for diagnosis. The most common treatment was laparotomy with filter or strut removal plus duodenum repair. However, clinical conditions of patients must be considered and the endovascular technique with endograft deployment into inferior vena cava may be an alternative. Conclusion Duodenal perforation by an inferior vena cava filter is uncommon and in high-risk surgical patients endovascular repair must be considered.

New Innovations in Highly Ion Specific Media for Recalcitrant Waste stream Radioisotopes

International Nuclear Information System (INIS)

Denton, M. S.; Wilson, J.; Ahrendt, M.; Bostick, W. D.; DeSilva, F.; Meyers, P.

2006-01-01

Specialty ion specific media were examined and developed for, not only pre- and post-outage waste streams, but also for very difficult outage waste streams. This work was carried out on first surrogate waste streams, then laboratory samples of actual waste streams, and, finally, actual on-site waste streams. This study was particularly focused on PWR wastewaters such as Floor Drain Tank (FDT), Boron Waste Storage Tank (BWST), and Waste Treatment Tank (WTT, or discharge tank). Over the last half decade, or so, treatment technologies have so greatly improved and discharge levels have become so low, that certain particularly problematic isotopes, recalcitrant to current treatment skids, are all that remain prior to discharge. In reality, they have always been present, but overshadowed by the more prevalent and higher activity isotopes. Such recalcitrants include cobalt, especially Co 58 [both ionic/soluble (total dissolved solids, TDS) and colloidal (total suspended solids, TSS)] and antimony (Sb). The former is present in most FDT and BWST wastewaters, while the Sb is primarily present in BWST waste streams. The reasons Co 58 can be elusive to granulated activated carbon (GAC), ultrafiltration (UF) and ion exchange (IX) demineralizers is that it forms submicron colloids as well as has a tendency to form metal complexes with chelating agents (e.g., ethylene diamine tetraacetic acid, or EDTA). Such colloids and non-charged complexes will pass through the entire treatment skid. Antimony (Sb) on the other hand, has little or no ionic charge, and will, likewise, pass through both the filtration and de-min skids into the discharge tanks. While the latter will sometimes (the anionic vs. the cationic or neutral species) be removed on the anion bed(s), it will slough off (snow-plow effect) when a higher affinity anion (iodine slugs, etc.) comes along; thus causing effluents not meeting discharge criteria. The answer to these problems found in this study, during an actual

Jejunal perforation by swallowed ibuprofen caplet | Njoku | Nigerian ...

African Journals Online (AJOL)

We present a case of jejunal perforation caused by an unusual foreign body, an ibuprofen caplet in its blister packing believed to be the first of its kind, perforation of the intestine caused by an ingested medication. The patient eventually developed an enterocutaneous fistula through the weak wall of a preexisting incisional ...

Regional Curves of Bankfull Channel Geometry for Non-Urban Streams in the Piedmont Physiographic Province, Virginia

Science.gov (United States)

Lotspeich, R. Russell

2009-01-01

Natural-channel design involves constructing a stream channel with the dimensions, slope, and plan-view pattern that would be expected to transport water and sediment and yet maintain habitat and aesthetics consistent with unimpaired stream segments, or reaches. Regression relations for bankfull stream characteristics based on drainage area, referred to as 'regional curves,' are used in natural stream channel design to verify field determinations of bankfull discharge and stream channel characteristics. One-variable, ordinary least-squares regressions relating bankfull discharge, bankfull cross-sectional area, bankfull width, bankfull mean depth, and bankfull slope to drainage area were developed on the basis of data collected at 17 streamflow-gaging stations in rural areas with less than 20 percent urban land cover within the basin area (non-urban areas) of the Piedmont Physiographic Province in Virginia. These regional curves can be used to estimate the bankfull discharge and bankfull channel geometry when the drainage area of a watershed is known. Data collected included bankfull cross-sectional geometry, flood-plain geometry, and longitudinal profile data. In addition, particle-size distributions of streambed material were determined, and data on basin characteristics were compiled for each reach. Field data were analyzed to determine bankfull cross-sectional area, bankfull width, bankfull mean depth, bankfull discharge, bankfull channel slope, and D50 and D84 particle sizes at each site. The bankfull geometry from the 17 sites surveyed during this study represents the average of two riffle cross sections for each site. Regional curves developed for the 17 sites had coefficient of determination (R2) values of 0.950 for bankfull cross-sectional area, 0.913 for bankfull width, 0.915 for bankfull mean depth, 0.949 for bankfull discharge, and 0.497 for bankfull channel slope. The regional curves represent conditions for streams with defined channels and bankfull

Online feature selection with streaming features.

Science.gov (United States)

Wu, Xindong; Yu, Kui; Ding, Wei; Wang, Hao; Zhu, Xingquan

2013-05-01

We propose a new online feature selection framework for applications with streaming features where the knowledge of the full feature space is unknown in advance. We define streaming features as features that flow in one by one over time whereas the number of training examples remains fixed. This is in contrast with traditional online learning methods that only deal with sequentially added observations, with little attention being paid to streaming features. The critical challenges for Online Streaming Feature Selection (OSFS) include 1) the continuous growth of feature volumes over time, 2) a large feature space, possibly of unknown or infinite size, and 3) the unavailability of the entire feature set before learning starts. In the paper, we present a novel Online Streaming Feature Selection method to select strongly relevant and nonredundant features on the fly. An efficient Fast-OSFS algorithm is proposed to improve feature selection performance. The proposed algorithms are evaluated extensively on high-dimensional datasets and also with a real-world case study on impact crater detection. Experimental results demonstrate that the algorithms achieve better compactness and higher prediction accuracy than existing streaming feature selection algorithms.

Cause rare d'une perforation de la cloison nasale

Science.gov (United States)

Jahidi, Ali; Hemmaoui, Bouchaïb; Itoua, Wulfran Rosaire; Errami, Noureddine; Benariba, Fouad

2014-01-01

Les perforations de la cloison nasale constituent une pathologie fréquente en ORL. Leurs causes sont multiples et restent dominées par les traumatismes chirurgicaux. Les étiologies infectieuses et notamment la tuberculose sont rares. Nous présentons le cas d'une patiente ayant bénéficié d'une méatotomie bilatérale et chez laquelle une perforation de la cloison nasale a été découverte lors d'un examen systématique à un an de son intervention. D'abord considérée comme une complication de la chirurgie, la biopsie des berges de la perforation a permis de déterminer son origine tuberculeuse. La présentation clinique des perforations de la cloison nasale n'est pas spécifique. Elles sont souvent asymptomatiques et de découverte fortuite. Les traumatismes notamment chirurgicaux sont le plus siuvent en cause. L′orogine tuberculeuse resta très rare. Le diagnostic de certitude de tuberculose repose sur la biopsie des berges de cette perforation. Le but de ce travail est de mettre en avant l'intérêt de la biopsie dans le diagnostic de la tuberculose de la cloison nasale. Cette biopsie doit être systématique même en cas d'antécédents de chirurgie endonasale qui est le plus souvent en cause dans les perforations de la cloison nasale. PMID:24932334

Reconstruction of pressure sores with perforator-based propeller flaps.

Science.gov (United States)

Jakubietz, Rafael G; Jakubietz, Danni F; Zahn, Robert; Schmidt, Karsten; Meffert, Rainer H; Jakubietz, Michael G

2011-03-01

Perforator flaps have been successfully used for reconstruction of pressure sores. Although V-Y advancement flaps approximate debrided wound edges, perforator-based propeller flaps allow rotation of healthy tissue into the defect. Perforator-based propeller flaps were planned in 13 patients. Seven pressure sores were over the sacrum, five over the ischial tuberosity, and one on the tip of the scapula. Three patients were paraplegic, six were bedridden, and five were ambulatory. In three patients, no perforators were found. In 10 patients, propeller flaps were transferred. In two patients, total flap necrosis occurred, which was reconstructed with local advancement flaps. In two cases, a wound dehiscence occurred and had to be revised. One hematoma required evacuation. No further complications were noted. No recurrence at the flap site occurred. Local perforator flaps allow closure of pressure sores without harvesting muscle. The propeller version has the added benefit of transferring tissue from a distant site, avoiding reapproximation of original wound edges. Twisting of the pedicle may cause torsion and venous obstruction. This can be avoided by dissecting a pedicle of at least 3 cm. Propeller flaps are a safe option for soft tissue reconstruction of pressure sores. © Thieme Medical Publishers.

Small bowel perforation due to fish bone: A case report

Directory of Open Access Journals (Sweden)

Huseyin Pulat

2015-09-01

Full Text Available Accidental ingestion of foreign bodies are a common condition in clinical practice. However, small bowel perforation which dues to ingestion foreign bodies has been rarely seen. In this article, we report a case of small bowel perforation which dues to ingestion foreign body. A 80-year-old female patient, presenting with complaints of acute abdomen, was admitted to the emergency department. She denied abdominal pain, nausea and vomiting. The patient had tenderness and defense on the right lower quadrant. Contrast enhanced abdominal computed tomography has been used on the patient's diagnosis. This revealed small bowel perforation due to the ingestion of foreign body. The patient was operated emergency. A microperforation due to fish bone was detected on the terminal ileum. The patient underwent debridement and primary repair. The patient was discharged postoperative 7th day without problem. Bowel perforation due to the ingestion of foreign bodies should be considered in the differential diagnosis of acute abdomen. Keywords: Foreign body, Small intestine, Perforation

A Rare Cause of Acute Abdomen: Jejunal Diverticulosis with Perforation

Directory of Open Access Journals (Sweden)

Ibrahim Aydin

2013-01-01

Full Text Available Jejunal diverticulosis is generally asymptomatic and is associated with high morbidity and mortality secondary to complications, especially in elderly patients. We present a case report of a 74-year-old female patient with jejunal diverticulosis and perforation due to diverticulitis.

Optimal Multi-Interface Selection for Mobile Video Streaming in Efficient Battery Consumption and Data Usage

Directory of Open Access Journals (Sweden)

Seonghoon Moon

2016-01-01

Full Text Available With the proliferation of high-performance, large-screen mobile devices, users’ expectations of having access to high-resolution video content in smooth network environments are steadily growing. To guarantee such stable streaming, a high cellular network bandwidth is required; yet network providers often charge high prices for even limited data plans. Moreover, the costs of smoothly streaming high-resolution videos are not merely monetary; the device’s battery life must also be accounted for. To resolve these problems, we design an optimal multi-interface selection system for streaming video over HTTP/TCP. An optimization problem including battery life and LTE data constraints is derived and then solved using binary integer programming. Additionally, the system is designed with an adoption of split-layer scalable video coding, which provides direct adaptations of video quality and prevents out-of-order packet delivery problems. The proposed system is evaluated using a prototype application in a real, iOS-based device as well as through experiments conducted in heterogeneous mobile scenarios. Results show that the system not only guarantees the highest-possible video quality, but also prevents reckless consumption of LTE data and battery life.

Pool Boiling Enhancement of R-123 Using Perforated Plates

Energy Technology Data Exchange (ETDEWEB)

Kim, Nae-Hyun [Incheon Nat’l Univ., Incheon(Korea, Republic of)

2016-05-15

In this study, we investigate the pool boiling enhancement caused by perforated plates on top of a smooth surface. We conduct tests using R-123 at atmospheric pressure. It was shown that perforated plates significantly enhanced the pool boiling of the smooth surface. The reason may be attributed to the increased bubble contact area between the plates. The results showed that the enhancement ratio was dependent on the heat flux. At high heat flux, the enhancement ratio increased as the porosity increased. However, at low heat flux, the enhancement ratio decreased as the porosity increased. For the present investigation, the optimum configuration had a pore diameter of 2.0 mm, pore pitch of 2.5 mm×5.0 mm or 5.0 mm×5.0 mm, and a gap width of 0.5 mm, which yielded heat-transfer coefficients that are close to those of GEWA-T. The optimum porosity for R-123 was significantly larger than that of water or ethanol. The reason for this may be the large liquid-to-vapor density ratio along with the small latent heat of vaporization of R-123. The perforated plates yielded smaller boiling hysteresis compared with that of the smooth surface.

High water-use efficiency and growth contribute to success of non-native Erodium cicutarium in a Sonoran Desert winter annual community.

Science.gov (United States)

Kimball, Sarah; Gremer, Jennifer R; Barron-Gafford, Greg A; Angert, Amy L; Huxman, Travis E; Venable, D Lawrence

2014-01-01

The success of non-native, invasive species may be due to release from natural enemies, superior competitive abilities, or both. In the Sonoran Desert, Erodium cicutarium has increased in abundance over the last 30 years. While native species in this flora exhibit a strong among-species trade-off between relative growth rate and water-use efficiency, E. cicutarium seems to have a higher relative growth rate for its water-use efficiency value relative to the pattern across native species. This novel trait combination could provide the non-native species with a competitive advantage in this water-limited environment. To test the hypothesis that E. cicutarium is able to achieve high growth rates due to release from native herbivores, we compared the effects of herbivory on E. cicutarium and its native congener, Erodium texanum. We also compared these two species across a range of environmental conditions, both in a common garden and in two distinct seasons in the field, using growth analysis, isotopic compositions and leaf-level gas exchange. Additionally, we compared the competitive abilities of the two Erodium species in a greenhouse experiment. We found no evidence of herbivory to either species. Physiological measurements in a common environment revealed that E. cicutarium was able to achieve high growth rates while simultaneously controlling leaf-level water loss. Non-native E. cicutarium responded to favourable conditions in the field with greater specific leaf area and leaf area ratio than native E. texanum. The non-native Erodium was a stronger competitor than its native congener in a greenhouse competition experiment. The ability to maintain relatively higher values of water-use efficiency:relative growth rate in comparison to the native flora may be what enables E. cictarium to outcompete native species in both wet and dry years, resulting in an increase in abundance in the highly variable Sonoran Desert.

Perforated choledochal cyst in a Jehovah's Witness patient.