WorldWideScience

Sample records for non-woven obstructive barriers

  1. Non-Wovens as Sound Reducers

    Science.gov (United States)

    Belakova, D.; Seile, A.; Kukle, S.; Plamus, T.

    2018-04-01

    Within the present study, the effect of hemp (40 wt%) and polyactide (60 wt%), non-woven surface density, thickness and number of fibre web layers on the sound absorption coefficient and the sound transmission loss in the frequency range from 50 to 5000 Hz is analysed. The sound insulation properties of the experimental samples have been determined, compared to the ones in practical use, and the possible use of material has been defined. Non-woven materials are ideally suited for use in acoustic insulation products because the arrangement of fibres produces a porous material structure, which leads to a greater interaction between sound waves and fibre structure. Of all the tested samples (A, B and D), the non-woven variant B exceeded the surface density of sample A by 1.22 times and 1.15 times that of sample D. By placing non-wovens one above the other in 2 layers, it is possible to increase the absorption coefficient of the material, which depending on the frequency corresponds to C, D, and E sound absorption classes. Sample A demonstrates the best sound absorption of all the three samples in the frequency range from 250 to 2000 Hz. In the test frequency range from 50 to 5000 Hz, the sound transmission loss varies from 0.76 (Sample D at 63 Hz) to 3.90 (Sample B at 5000 Hz).

  2. Medical effects of poly-ethylene terephthalate (PET) non-woven ...

    African Journals Online (AJOL)

    In this study, bamboo activated charcoal was mixed with acrylic resin in various proportions and deposited on poly-ethylene terephthalate (PET) non-woven fabrics. A series of characterizations were carried out to estimate the performances of PET non-woven fabrics such as far infrared ray emission, heat retention, negative ...

  3. Comparative Study of the Properties of some Non-Woven Diapers ...

    African Journals Online (AJOL)

    ABSTRACT: The properties of locally made non-woven diapers were studied. Four locally made non-woven absorbent pads samples namely; Always ultra absorbent pad (sample A), Dr. Brown absorbent pad (sample B),. Everyday ultra thin normal absorbent pad (sample C), and Enjoy leto absorbent pad (sample D) were ...

  4. Increasing Mechanical Properties of 2-D-Structured Electrospun Nylon 6 Non-Woven Fiber Mats

    Directory of Open Access Journals (Sweden)

    Chunhui Xiang

    2016-04-01

    Full Text Available Tensile strength, Young’s modulus, and toughness of electrospun nylon 6 non-woven fiber mats were improved by increasing individual nanofiber strength and fiber–fiber load sharing. Single-walled carbon nanotubes (CNTs were used as reinforcement to increase the strength of the electrospun nylon 6 nanofibers. Young’s modulus, tensile strength, and toughness of the nylon 6 non-woven fiber mats electrospun from 20 wt % solutions increased 51%, 87%, and 136%, respectively, after incorporating 1 wt % CNTs into the nylon 6 nanofibers. Three methods were investigated to enhance fiber–fiber load sharing: increasing friction between fibers, thermal bonding, and solvent bonding. The addition of beaded nylon 6 nanofibers into the non-woven fiber mats to increase fiber-fiber friction resulted in a statistically significantly increase in Young’s modulus over comparable smooth non-woven fiber mats. After annealing, tensile strength, elongation, and toughness of the nylon 6 non-woven fiber mats electrospun from 20 wt % + 10 wt % solutions increased 26%, 28%, and 68% compared to those from 20 wt % solutions. Solvent bonding with formic acid vapor at room temperature for 30 min caused increases of 56%, 67%, and 39% in the Young’s modulus, tensile strength, and toughness of non-woven fiber mats, respectively. The increases attributed to increased individual nanofiber strength and solvent bonding synergistically resulted in the improvement of Young’s modulus of the electrospun nylon 6 non-woven fiber mats.

  5. Antibacterial properties of modified biodegradable PHB non-woven fabric.

    Science.gov (United States)

    Slepička, P; Malá, Z; Rimpelová, S; Švorčík, V

    2016-08-01

    The antibacterial properties of poly(hydroxybutyrate) (PHB) non-woven fabric were explored in this study. The PHB was activated by plasma modification and subsequently processed with either immersion into a solution of nanoparticles or direct metallization. The wettability and surface chemistry of the PHB surface was determined. The thickness of the sputtered nanolayer on PHB fabric was characterized. It was found that plasma modification led to a formation of strongly hydrophilic surface, while the subsequent metallization by silver or gold resulted in a significantly increased water contact angle. Further, it was found that antibacterial activity may be controlled by the type of a metal and deposition method used. The immersion of plasma modified fabric into Ag nanoparticle solution led to enhanced antibacterial efficiency of PHB against Escherichia coli (E. coli). Direct silver sputtering on PHB fabric was proved to be a simple method for construction of a surface with strong antibacterial potency against both Escherichia coli (E. coli) and Staphylococcus epidermidis (S. epidermidis). We demonstrated the antibacterial activity of PHB fabric modified by plasma activation and consecutive selection of a treatment method for an effective antibacterial surface construction. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Anticoagulant and antimicrobial finishing of non-woven polypropylene textiles

    International Nuclear Information System (INIS)

    Degoutin, S; Jimenez, M; Casetta, M; Bellayer, S; Chai, F; Blanchemain, N; Neut, C; Kacem, I; Traisnel, M; Martel, B

    2012-01-01

    The aim of this work is to prepare non-woven polypropylene (PP) textile functionalized with bioactive molecules in order to improve its anticoagulation and antibacterial properties. This paper describes the optimization of the grafting process of acrylic acid (AA) on low-pressure cold-plasma pre-activated PP, the characterization of the modified substrates and the effect of these modifications on the in vitro biological response towards cells. Then, the immobilization of gentamicin (aminoglycoside antibiotic) and heparin (anticoagulation agent) has been carried out on the grafted samples by either ionic interactions or covalent linkages. Their bioactivity has been investigated and related to the nature of their interactions with the substrate. For gentamicin-immobilized AA-grafted samples, an inhibition radius and a reduction of 99% of the adhesion of Escherichia coli have been observed when gentamicin was linked by ionic interactions, allowing the release of the antibiotic. By contrast, for heparin-immobilized AA-grafted PP samples, a strong increase of the anticoagulant effect up to 35 min has been highlighted when heparin was covalently bonded on the substrate, by contact with the blood drop. (paper)

  7. Physical properties of recycled PET non-woven fabrics for buildings

    Science.gov (United States)

    Üstün Çetin, S.; Tayyar, A. E.

    2017-10-01

    Recycled fibers have been commonly used in non-woven production technology for engineering applications such as textile engineering and civil engineering. Nonwovens including recycled fibers can be utilized in insulation, roofing and floor separation applications. In this study, physical performance properties such as drape, bending resistance, tensile strength, and breaking elongation values of non-woven fabrics consisting of v-PET (virgin) and r-PET (recycled) fibers in five different blend ratios are examined comparatively. The test results indicated that r-PET can be used in non-wovens for civil engineering applications such as insulation, roofing and floor separation fulfilling the acceptable quality level values.

  8. Preparation and Characterization of Polypropylene Non-woven Fabrics Prepared by Melt-blown Spinning for Filtration Membranes

    Energy Technology Data Exchange (ETDEWEB)

    Chu, Konghee; Park, Mira; Kim, Hakyong [Chonbuk National Univ., Jeonju (Korea, Republic of); Jin, Fanlong; Park, Soojin [Inha Univ., Incheon (Korea, Republic of)

    2014-06-15

    PP non-woven fabrics were prepared by melt-blown spinning, followed by heat and plasma treatments. After heat treatment, the PP non-woven fabrics displayed decreased water flux, increased tensile strength, decreased elongation, and an average pore size of 0.7 μm. The hydrophilicity of the PP non-woven fabrics was improved by plasma treatment. The water flux of the PP non-woven fabrics increased about two fold after the plasma treatment. The particle removal efficiency was determined to be 97.2-99.4% for 1-3 μm sized particles, demonstrating a high particle removal efficiency. Polypropylene (PP) non-woven fabrics have been widely used as filtration membranes in wastewater purification with industrial applications due to their low cost, good mechanical strength, and high thermal and chemical stability. The membrane fouling behavior depends strongly on the physical and mechanical properties of the membrane, including pore size, porosity, morphology, and hydrophilicity. In general, PP non-woven fabrics have poor hydrophilicity; this has limited their application in the biomedical field. It is therefore necessary to develop PP non-woven fabrics with improved surface hydrophilicity to increase the scope of their use. Plasma treatment, an environmentally friendly alternative to traditional chemical activation, only changes the uppermost atomic layers of a membrane surface without affecting the bulk properties of the polymer.

  9. Effect of storage conditions on graft of polypropylene non-woven fabric induced by electron beam

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jin Young; Jeun, Joon Pyo; Kang, Phil Hyun [Radiation Research Dvision for Industry and Environment, Korea Atomic Energy Research Institute, Jeongeup(Korea, Republic of)

    2015-05-15

    In this study, we fabricated effect of storage conditions on graft of polypropylene (PP) non-woven fabric induced by electron beam. The electron beam irradiations on PP non-woven fabric were carried out over a range of irradiation doses from 25 to 100 kGy to make free radicals on fabric surface. The radical measurement was established by electron spin resonance (ESR) for confirming the changes of the alkyl radical and peroxy radical according to effect of storage time, storage temperature and atmosphere. It was observed that the free radicals were increased with irradiation dose and decreased with storage time due to the continuous oxidation. However, the radical extinction was significantly delayed due to reduced mobility of radicals at extremely low temperature. The degree of graft based on the analysis of ESR was investigated. The conditions of graft reaction were set at a temperature: 60 degrees Celcius, reaction time: 6 hours and styrene monomer concentration: 20 wt%.

  10. Functionalisation of polypropylene non-woven fabrics (NWFs): Functionalisation by oxyfluorination as a first step for graft polymerisation

    CSIR Research Space (South Africa)

    Vargha, V

    2011-10-01

    Full Text Available Surface oxyfluorination had been carried out on polypropylene non-woven fabric (PP NWF) samples of different morphologies and pore sizes. The modified surfaces were characterised by Attenuated Total Reflectance Fourier Transform InfraRed (ATR...

  11. Biliary obstruction dissipates bioelectric sinusoidal-canalicular barrier without altering taurocholate uptake

    International Nuclear Information System (INIS)

    Cotting, J.; Zysset, T.; Reichen, J.

    1989-01-01

    To study immediate events during extrahepatic cholestasis, we investigated the effect of short-term biliary obstruction on the bioelectrical sinusoidal-canalicular barrier in the rat using molecular weight-matched uncharged and negatively charged inert solute pairs. The bioelectrical barrier averaged -22 +/- 5 and -18 +/- 4 mV (NS) using the pair carboxy-/methoxyinulin and ferrocyanide/sucrose, respectively. After a 20-min biliary obstruction both decreased by 61 and 11%, respectively, but only the large molecular weight pair (the inulins) returned to base line after release of the obstruction. Inert solute clearances were increased after short biliary obstruction depending on molecular size and negative charge (ferrocyanide greater than sucrose greater than carboxyinulin greater than inulin), suggesting that both permeability and bioelectrical barriers were affected by obstruction. The hepatic extraction in vivo of a passively transported drug not excreted into bile (D-propranolol) was not affected by obstruction, whereas that of an actively transported drug (glycocholate) decreased from 66 +/- 8 to 41 +/- 20% during biliary obstruction (P less than 0.01). Unidirectional transfer of glycocholate was not affected by short-term biliary obstruction in the situ perfused rat liver; however, 2 min after [14C]glycocholate administration, increased return was observed in hepatic venous effluent in obstructed animals. Our findings demonstrate a loss of the bioelectrical barrier immediately after short-term biliary obstruction. Decreased hepatic extraction in the view of unaltered sinusoidal uptake demonstrates regurgitation of bile into blood during short-term biliary obstruction

  12. Advanced soft coverpad made of non-woven fabric; Soft fushokufu coverpad no kaihatsu

    Energy Technology Data Exchange (ETDEWEB)

    Hayakawa, t; Kamezaki, K; Tokita, T [Takashimaya Nippatsu Kogyo, Aichi (Japan); Yamada, Y; Ono, H; Araki, O [Toyota Motor Corp., Aichi (Japan)

    1997-10-01

    At the present expected to enhance the product-value of automobile, it can be considered that advancement of touching and fitting feeling of seat would be important factors. For the purpose of materializing of these factors, We have noted softening of seat cover and carried out development of cover pad made of non-woven fablic. As a result of pursuing compatibility of soft feeling and durability of the cover pad, we could achieve to ensure the quality required for the material as the seat cover pad. 3 refs., 15 figs., 4 tabs.

  13. High energy ballistic and fracture comparison between multilayered armor systems using non-woven curaua fabric composites and aramid laminates

    Directory of Open Access Journals (Sweden)

    Fábio de Oliveira Braga

    2017-10-01

    Full Text Available For personal protection against high kinetic energy projectiles, multilayered armor systems (MAS are usually the best option. They combine synergistically the properties of different materials such as ceramics, composites and metals. In the present work, ballistic tests were performed to evaluate multilayered armor systems (MAS using curaua non-woven fabric epoxy composites as second layer. A comparison to a MAS using aramid (Kevlar™ fabric laminates was made. The results showed that the curaua non-woven fabric composites are suitable to the high ballistic applications, and are promising substitutes for aramid fabric laminates. Keywords: Composite, Natural fiber, Curaua fiber, Non-woven fabric, Aramid laminate, Ballistic test

  14. Studies of LENRA-Toughened PVC non-woven membranes prepared by electro spinning technique

    International Nuclear Information System (INIS)

    Dahlan Mohd; Mahathir Mohamed; Khirul Hafiz mohd Yusof

    2010-01-01

    Lately research in use of so-called green chemicals draws strong interest from research community due to the climate change issues. Malaysia is in strong position to take this advantage because we are among the world biggest producers of natural rubber and palm oil - the two sources of important green renewable chemical feedstock in the near future. For the last couple of years we have shown how modified natural rubbers especially liquid natural rubber and its derivatives such as liquid epoxidized natural rubber acrylate (LENRA) could be used in various applications via among others sol-gel technique and radiation curing technology. This time around we will show another application on how non-woven membranes made from PVC can be prepared by electro spinning technique using radiation curable LENRA as toughener. The electro spinning technique has great potential in producing nano fiber materials to be used in various applications to ensure sustainable energy and environments for the future. (author)

  15. Airway Epithelial Barrier Dysfunction in Chronic Obstructive Pulmonary Disease : Role of Cigarette Smoke Exposure

    NARCIS (Netherlands)

    Aghapour, Mahyar; Raee, Pourya; Moghaddam, Seyed Javad; Hiemstra, Pieter S.; Heijink, Irene H.

    The epithelial lining of the airway forms the first barrier against environmental insults, such as inhaled cigarette smoke, which is the primary risk factor for the development of chronic obstructive pulmonary disease (COPD). The barrier is formed by airway epithelial junctions, which are

  16. Extended FMEA for Sustainable Manufacturing: An Empirical Study in the Non-Woven Fabrics Industry

    Directory of Open Access Journals (Sweden)

    Thanh-Lam Nguyen

    2016-09-01

    Full Text Available Failure modes and effects analysis ( F M E A substantially facilitates the efforts of industrial manufacturers in prioritizing failures that require corrective actions to continuously improve product quality. However, the conventional approach fails to provide satisfactory explanation of the aggregate effects of a failure from different perspectives such as technical severity, economic severity, and production capacity in some practical applications. To fulfill the existing gap in the F M E A literature, this paper proposes an extension by considering associated quality cost and the capability of failure detection system as additional determinants to signify the priority level for each failure mode. The quality cost and capacity are considered as key factors for sustainable survival and development of an industrial manufacturer in the fierce competition market these days. The performance of the extended scheme was tested in an empirical case at a non-woven fabrics manufacturer. Analytical results indicate that the proposed approach outperforms the traditional one and remarkably reduces the percentage of defective fabrics from about 2.41% before the trial period to 1.13%,thus significantly reducing wastes and increasing operation efficiency, thereby providing valuable advantages to improve organizational competition power for their sustainable growth.

  17. Protozoa and metazoa relations to technological conditions of non-woven textile filters for wastewater treatment.

    Science.gov (United States)

    Spychała, Marcin; Sowińska, Aleksandra; Starzyk, Justyna; Masłowski, Adam

    2015-01-01

    The objective of this study was a preliminary identification of basic groups of micro-organisms in the cross-sectional profile of geotextile filters for septic tank effluent (STE) treatment and their relations to technological conditions. Reactors with textile filters treating wastewater were investigated on a semi-technical scale. Filters were vertically situated and STE was filtered through them under hydrostatic pressure at a wastewater surface height of 7-20 cm. Filters were made of four layers of non-woven TS 20 geotextile of 0.9 mm thickness. Various groups of organisms were observed; the most abundant group comprised free-swimming and crawling ciliates, less abundant were stalked ciliates and the least numerous were nematodes. The individual counts of all groups of micro-organisms investigated during the study were variable according to time and space. The high abundance of Opercularia, a commonly observed genus of stalked ciliates, was related to the high efficiency of wastewater treatment and dissolved oxygen concentration of about 1.0 g/m3. Numbers of free-swimming and crawling ciliates had a tendency to decrease in relation to the depth of filter cross-sectional profile. The variability in counts of particular groups of organisms could be related to the local stress conditions. No correlation between identified organism count and total mass concentration in the cross-sectional filter profile was found.

  18. Mechanical Properties of Non-Woven Polyester Fibers and Polymer-Modified Bitumen Composites

    Directory of Open Access Journals (Sweden)

    V. Hadadi

    2007-12-01

    Full Text Available Blown bitumen (110/10 was mixed with heavy vacuum slops (H.V.S, 60/70 penetration grade bitumen and recycled isotactic polypropylene (iPP at different levels. The resulting resins were used to impregnate non-woven poly(ethylene terephthalate fibers to form composites. The modulus and penetration grade of the resulting bituminous resins were determined. It was found that these bituminous resins drastically affect the modulus of the composites formed by low-Young’s modulus fibers such as polyesters. Consequently, interactions between resin and fibers and the correlation length of asphalthenes (in absence of iPP and interdiffused coalescence and segregated network of asphalthenes (in presence of iPP result in a non-linear behavior of composite’s modulus. The behavior of the composites with or without iPP is controlled by resin toughness and resin interactions with the fiber through the viscosity. Comparison of the experimental composite modulus data with the theoretical modulus data revealed that the Takayanangi’s model best predicts the behavior of these composites. The adjustment factors of this model were reported and proposed as an indication of fiber-resin interaction. It was also found that the modulus of fibers is affected by toughness, viscosity and the iPP content of the bituminous resin.

  19. Preparation of Non-Woven Fiber Mats by Mixture of PVC and Epoxidized Natural Rubber

    International Nuclear Information System (INIS)

    Muhammad Hariz Othman; Mahathir Mohamed; Dahlan Mohd

    2014-01-01

    Eletrospun non-woven fibre mats prepared from ENR modified PVC were successfully fabricated at ambient temperature by electro spinning method. Liquid epoxidized natural rubber (LENR) was used because it is easier to handle compared to dried ENR. PVC was mixed with LENR based on 3 different ratios (9:1, 8:2 and 7:3). The effect of ENR on electrospinnibality of PVC was investigated.The morphologies and thermal properties of the electro span fibre mats were characterized and assessed using scanning calorimetry (DSC). The polymer solution concentration 16 aut % formed a diameter of the fibres were mainly affected by the addition of natural rubber and weight ratio of the solution. The diameter of the fibres also decreased with increasing amount of LENR in the solution. Thermal degradation involved two-step degradation with the first degradation representing the dehydro chlorination of PVC to form polyene and followed by the decomposition of LENR and the polyene.Addition of LENR into the sample caused the T g of electro spun fibre mats of PVC/LENR to shift toward lower temperature. (author)

  20. Bacteria in non-woven textile filters for domestic wastewater treatment.

    Science.gov (United States)

    Spychała, Marcin; Starzyk, Justyna

    2015-01-01

    The objective of this study was preliminary identification of heterotrophic and ammonia oxidizing bacteria (AOB) cell concentration in the cross-sectional profile of geotextile filters for wastewater treatment. Filters of thicknesses 3.6 and 7.2 mm, made of non-woven textile TS20, were supplied with septic tank effluent and intermittently dosed and filtered under hydrostatic pressure. The cumulative loads of chemical oxygen demand (COD) and total solids were about 1.36 and 1.06 kg/cm2, respectively. The filters under analysis reached a relatively high removal efficiency for organic pollution 70-90% for biochemical oxygen demand (BOD5) and 60-85% for COD. The ammonia nitrogen removal efficiency level proved to be unstable (15-55%). Biomass samples for dry mass identification were taken from two regions: continuously flooded with wastewater and intermittently flooded with wastewater. The culturable heterotrophic bacteria were determined as colony-forming units (CFUs) on microbiological-selective media by means of the plate method. AOB and nitrite oxidizing bacteria (NOB) were examined using the FISH technique. A relatively wide range of heterotrophic bacteria was observed from 7.4×10(5)/cm2 to 3.8×10(6)/cm2 in geotextile layers. The highest concentration of heterotrophic bacteria (3.8×10(6)/cm2) was observed in the first layer of the textile filter. AOB were identified occasionally--about 8-15% of all bacteria colonizing the last filter layer, but occasionally much higher concentrations and ammonia nitrogen efficiency were achieved. Bacteria oxidizing nitrite to nitrate were not observed. The relation of total and organic fraction of biomass to culturable heterotrophic bacteria was also found.

  1. Gut epithelial barrier markers in patients with obstructive sleep apnea.

    Science.gov (United States)

    Barceló, Antonia; Esquinas, Cristina; Robles, Juan; Piérola, Javier; De la Peña, Mónica; Aguilar, Irene; Morell-Garcia, Daniel; Alonso, Alberto; Toledo, Nuria; Sánchez-de la Torre, Manuel; Barbé, Ferran

    2016-10-01

    Obstructive sleep apnea (OSA) is now being recognized as an additional contributing factor to the pathogenesis of obesity-related comorbidities. At the same time, there is now increasing evidence to suggest that intestinal wall permeability plays a role in the development of metabolic syndrome. In the present study, circulating zonulin and fatty acid binding protein (I-FABP) were measured in association with metabolic, hepatic, and inflammatory parameters. Compared with controls, plasma I-FABP levels were significantly higher in patients with OSA (571 pg/mL [IQR 290-950] vs 396 pg/mL [IQR 234-559], p = 0.04). Zonulin levels were similar between groups. Significant relationships were observed between zonulin levels and waist circumference (p zonulin levels correlated negatively with the mean nocturnal oxygenation saturation (p zonulin and ALT, AST, and hs-CRP were attenuated, but not eliminated, after adjustment for other variables. The results of this study suggest that OSA is a risk factor for intestinal damage, regardless of metabolic profile, and that intestinal permeability might be a possible contributor to nonalcoholic fatty liver disease in patients with OSA. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Production of chitosan-based non-woven membranes using the electrospinning process

    Science.gov (United States)

    Pakravan Lonbani, Mehdi

    Chitosan is a modified natural polymer mainly produced from chitin, one of the most abundant organic materials in the world. Highly porous chitosan mats present the specific physicochemical properties of the base material and also benefit from the physical characteristics of nanoporous membranes. Electrospinning is a novel technique developed long time ago and revisited recently that can generate polymeric fibers with nanometric size. The ultimate purpose of this work is to fabricate microporous non-woven chitosan membranes for wound healing dressings and heavy metal ion removal from drinking water. In this dissertation, two approaches have been utilized to prepare chitosan-based nanofibers; blending and co-axial electrospinning of chitosan solution with a readily electrospinnable solution, i.e. an aqueous solution of polyethylene oxide (PEO). Consequently, understanding the phase behavior and miscibility of aqueous acidic solutions of chitosan and PEO and their blends is of crucial importance, as any phase separation occurring during the electrospinning process greatly changes the morphology and physico-mechanical properties of the final products. First we employed the rheological approach on a well-known aqueous PEO solution to develop the experimental protocol. By comparing these critical points with that obtained from other experimental techniques, we showed that rheological measurements can sensitively detect early stages of phase separation. Subsequently the method was applied to 50 wt% aqueous acetic acid solutions of PEO, chitosan and their blends at different ratios. These solutions showed a lower critical solution temperature (LCST) phase diagram that is attributed to the existence of hydrogen bonds between active groups on chitosan and PEO backbone and the solvent. Critical decomposition temperatures for binodal and spinodal points were estimated from isochronal temperature sweep experiments. The obtained binodal temperatures confirmed that chitosan

  3. Airway Epithelial Barrier Dysfunction in Chronic Obstructive Pulmonary Disease: Role of Cigarette Smoke Exposure.

    Science.gov (United States)

    Aghapour, Mahyar; Raee, Pourya; Moghaddam, Seyed Javad; Hiemstra, Pieter S; Heijink, Irene H

    2018-02-01

    The epithelial lining of the airway forms the first barrier against environmental insults, such as inhaled cigarette smoke, which is the primary risk factor for the development of chronic obstructive pulmonary disease (COPD). The barrier is formed by airway epithelial junctions, which are interconnected structures that restrict permeability to inhaled pathogens and environmental stressors. Destruction of the epithelial barrier not only exposes subepithelial layers to hazardous agents in the inspired air, but also alters the normal function of epithelial cells, which may eventually contribute to the development of COPD. Of note, disruption of epithelial junctions may lead to modulation of signaling pathways involved in differentiation, repair, and proinflammatory responses. Epithelial barrier dysfunction may be particularly relevant in COPD, where repeated injury by cigarette smoke exposure, pathogens, inflammatory mediators, and impaired epithelial regeneration may compromise the barrier function. In the current review, we discuss recent advances in understanding the mechanisms of barrier dysfunction in COPD, as well as the molecular mechanisms that underlie the impaired repair response of the injured epithelium in COPD and its inability to redifferentiate into a functionally intact epithelium.

  4. Preparation and characterization of thermal-responsive non-woven poly (propylene) materials grafted with N-isopropylacrylamide/β-cyclodextrin

    DEFF Research Database (Denmark)

    Amiri, Setareh; Zadhoush, Ali; Mallakpour, Shadpour

    2013-01-01

    A temperature-sensitive hydrogel was successfully grafted on the surface of non-woven poly(propylene) materials. This was carried out by the application of unmodified β-cyclodextrin and N-isopropylacrylamide monomer in order to develop new functional hydrogels for textile science and technology......(N-isopropylacrylamide) and β-cyclodextrin components on the surface of the textile. Unmodified β-cyclodextrin content was estimated by the use of elemental analysis to be 97 µg/cm2. The water uptake measurements and differential scanning calorimetry analyses showed that the hydrogel maintained its temperature...... of smart textiles which possess the temperature-sensitive property of poly(N-isopropylacrylamide) and the ability of inclusion complex formation with guest molecules due to the presence of unmodified β-cyclodextrin in the hydrogel network....

  5. Sterility and property of norecoverable medical items from non-woven fabric

    International Nuclear Information System (INIS)

    Tashmetov, M.Yu.; Ismatov, N.B.; Makhkamov, Sh.M.; Saidov, R.P.; Abdulmanov, R.G.

    2014-01-01

    Full text: The purpose of present study is determination of the sterilization dose of surgery coat and sheet from spanbond-meltbond-spanbond material with minimum deviation of initial strength value. All seams of this surgery coat are sewed by dual insertion and soldered by ultrasonic solder for strenthening of the protective-barrier properties. It is established that after the radiation sterilization of disposable surgery coat at dose 20 kGy the breaking load of material lengthwise and width corresponds to permissible standards

  6. Effects of Lactobacillus plantarum on gut barrier function in experimental obstructive jaundice

    Science.gov (United States)

    Zhou, Yu-Kun; Qin, Huan-Long; Zhang, Ming; Shen, Tong-Yi; Chen, Hong-Qi; Ma, Yan-Lei; Chu, Zhao-Xin; Zhang, Peng; Liu, Zhi-Hua

    2012-01-01

    AIM: To investigate the mechanisms of Lactobacillus plantarum (L. plantarum) action on gut barrier in preoperative and postoperative experimental obstructive jaundice in rats. METHODS: Forty rats were randomly divided into groups of sham-operation, bile duct ligation (BDL), BDL + L. plantarum, BDL + internal biliary drainage (IBD), and BDL + IBD + L. plantarum. Ten days after L. plantarum administration, blood and ileal samples were collected from the rats for morphological examination, and intestinal barrier function, liver function, intestinal oxidative stress and protein kinase C (PKC) activity measurement. The distribution and expression of the PKC and tight junction (TJ) proteins, such as occludin, zonula occludens-1, claudin-1, claudin-4, junction adhesion molecule-A and F-actin, were examined by confocal laser scanning microscopy, immunohistochemistry, Western blotting, real-time fluorescent quantitative polymerase chain reaction assay. RESULTS: L. plantarum administration substantially restored gut barrier, decreased enterocyte apoptosis, improved intestinal oxidative stress, promoted the activity and expression of protein kinase (BDL vs BDL + L. plantarum, 0.295 ± 0.007 vs 0.349 ± 0.003, P plantarum, 0.407 ± 0.046 vs 0.465 ± 0.135, P plantarum, 0.266 ± 0.118 vs 0.326 ± 0.009, P plantarum was more prominent after internal biliary drainage ( BDL + IBD vs BDL + IBD + L. plantarum, 0.415 ± 0.105 vs 0.494 ± 0.145, P plantarum can decrease intestinal epithelial cell apoptosis, reduce oxidative stress, and prevent TJ disruption in biliary obstruction by activating the PKC pathway. PMID:22912548

  7. Glucagon-like peptide-2 protects impaired intestinal mucosal barriers in obstructive jaundice rats.

    Science.gov (United States)

    Chen, Jun; Dong, Jia-Tian; Li, Xiao-Jing; Gu, Ye; Cheng, Zhi-Jian; Cai, Yuan-Kun

    2015-01-14

    To observe the protective effect of glucagon-like peptide-2 (GLP-2) on the intestinal barrier of rats with obstructive jaundice and determine the possible mechanisms of action involved in the protective effect. Thirty-six Sprague-Dawley rats were randomly divided into a sham operation group, an obstructive jaundice group, and a GLP-2 group; each group consisted of 12 rats. The GLP-2 group was treated with GLP-2 after the day of surgery, whereas the other two groups were treated with the same concentration of normal saline. Alanine aminotransferase (ALT), total bilirubin, and endotoxin levels were recorded at 1, 3, 7, 10 and 14 d. Furthermore, on the 14(th) day, body weight, the wet weight of the small intestine, pathological changes of the small intestine and the immunoglobulin A (IgA) expressed by plasma cells located in the small intestinal lamina propria were recorded for each group. In the rat model, jaundice was obvious, and the rats' activity decreased 4-6 d post bile duct ligation. Compared with the sham operation group, the obstructive jaundice group displayed increased yellow staining of abdominal visceral serosa, decreased small intestine wet weight, thinning of the intestinal muscle layer and villi, villous atrophy, uneven height, fusion, partial villous epithelial cell shedding, substantial inflammatory cell infiltration and significantly reduced IgA expression. However, no significant gross changes were noted between the GLP-2 and sham groups. With time, the levels of ALT, endotoxin and bilirubin in the GLP-2 group were significantly increased compared with the sham group (P jaundice group than in the GLP-2 group (P jaundice rats, which might be attributed to increased intestinal IgA and reduced bilirubin and endotoxin.

  8. Non-woven Textile Materials from Waste Fibers for Cleanup of Waters Polluted with Petroleum and Oil Products

    Science.gov (United States)

    Neznakomova, Margarita; Boteva, Silvena; Tzankov, Luben; Elhag, Mohamed

    2018-04-01

    The aim of this work was to investigate the possibility of using non-woven materials (NWM) from waste fibers for oil spill cleanup and their subsequent recovery. Manufacture of textile and readymade products generates a significant amount of solid waste. A major part of it is deposited in landfills or disposed of uncontrollably. This slowly degradable waste causes environmental problems. In the present study are used two types of NWM obtained by methods where waste fibers are utilized. Thus, real textile products are produced (blankets) with which spills are covered and removed by adsorption. These products are produced by two methods: the strengthening of the covering from recovered fibers is made by entanglement when needles of special design pass through layers (needle-punching) or by stitching with thread (technology Maliwatt). Regardless of the random nature of the fiber mixture, the investigated products are good adsorbents of petroleum products. The nature of their structure (a significant void volume and developed surface) leads to a rapid recovery of the spilled petroleum products without sinking of the fiber layer for the sampled times. The used NWM can be burned under special conditions.

  9. Moisture transfer and pressure drop of humidifying elements made of non-woven fabric (Rayon/PET)

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Nae-Hyun [Incheon National University, Incheon (Korea, Republic of)

    2017-06-15

    In modern buildings, humidity control is an essential constituent of the building management, where spray-type humidifying element is widely used. For the spray-type element, there is a concern about the durability and the resistance to formation of mold. In this study, we made new humidifying elements were made using non-woven fabric rayon/PET and investigated the moisture transfer and pressure drop characteristics. Samples consisted of two different rayon compositions (30 % and 50 %). From the results the sample with 50 % rayon and 50 % PET showed superior moisture transfer performance than the sample with 50 % Kraft fiber and 50 % PET, probably due to better water absorption characteristics of rayon over Kraft fiber. However, pressure drop of the rayon/PET sample was larger than Kraft fiber/PET sample due to increased surface roughness. The moisture transfer performance of the rayon/PET sample deteriorated as the rayon content decreased. The efficiency (j{sub m}/{sup f}1/3) was the largest for rayon/PET (5:5) sample, followed by Kraft fiber/PET and rayon/PET (3:7) sample. The efficiency of commercially available Glasdek was much lower than other samples.

  10. Polyester non-woven fabric finger cover as a TRUCT Braille reading assistance tool for Braille learners.

    Science.gov (United States)

    Doi, Kouki; Fujimoto, Hiroshi

    2007-11-01

    Transparent resinous ultraviolet-curing type (TRUCT) Braille signs are becoming more and more popular in Japan, especially when they are printed together with visual characters. These signs are made by screen printing, a technique that can be applied to various base materials, such as paper, metal, and plastic. TRUCT Braille signs have begun to be used in public facilities, such as on tactile maps and on handrails. Naturally, it is expected that Braille beginners will utilize these signs. However, it has been pointed out that the friction between the forefinger and the base material may affect reading accuracy and speed. In this study, we developed a finger cover made of soft, thin polyester non-woven fabric to reduce friction during Braille reading. We also carried out a study to investigate the effect of its use. The subjects were 12 Braille learners with acquired visual impairment, who were asked to read randomly selected characters with and without the finger cover. The results showed that most participants could read TRUCT Braille significantly faster and more accurately with a finger cover than without it, regardless of the base material and dot height. This result suggests that wearing the finger cover enables Braille learners to read TRUCT Braille more efficiently. The finger cover can be used as a Braille reading assistance tool for Braille learners. An additional, health-related advantage of the finger cover is that the forefinger remains clean. We expect that the finger cover will be in practical use in Japan within 1 or 2 years.

  11. Obstructive sleep apnea and cognitive impairment: Addressing the blood–brain barrier

    Science.gov (United States)

    Lim, Diane C.; Pack, Allan I.

    2013-01-01

    SUMMARY Increasing data support a connection between obstructive sleep apnea (OSA) and cognitive impairment but a causal link has yet to be established. Although neuronal loss has been linked to cognitive impairment, emerging theories propose that changes in synaptic plasticity can cause cognitive impairment. Studies demonstrate that disruption to the blood–brain barrier (BBB), which is uniquely structured to tightly maintain homeostasis inside the brain, leads to changes in the brain’s microenvironment and affects synaptic plasticity. Cyclical intermittent hypoxia is a stressor that could disrupt the BBB via molecular responses already known to occur in either OSA patients or animal models of intermittent hypoxia. However, we do not yet know if or how intermittent hypoxia can cause cognitive impairment by mechanisms operating at the BBB. Therefore, we propose that initially, adaptive homeostatic responses at the BBB occur in response to increased oxygen and nutrient demand, specifically through regulation of influx and efflux BBB transporters that alter microvessel permeability. We further hypothesize that although these responses are initially adaptive, these changes in BBB transporters can have long-term consequences that disrupt the brain’s microenvironment and alter synaptic plasticity leading to cognitive impairment. PMID:23541562

  12. Thermo-responsive wound dressings by grafting chitosan and poly(N-isopropylacrylamide) to plasma-induced graft polymerization modified non-woven fabrics

    International Nuclear Information System (INIS)

    Chen, Jyh-Ping; Kuo, Chang-Yi; Lee, Wen-Li

    2012-01-01

    Highlights: ► Poly(N-isopropylacrylamide) and chitosan were grafted to polypropylene non-wovens. ► An easily stripped off thermo-responsive wound dressing was developed. ► The wound dressing is biocompatible, has antibacterial and wound healing abilities. ► The bigraft non-woven will be a potential wound dressing for biomedical use. - Abstract: To obtain a chitosan wound dressings with temperature-responsive characteristics, polypropylene (PP) non-woven fabric (NWF) was modified by direct current pulsed oxygen plasma-induced grafting polymerization of acrylic acid (AAc) to improve hydrophilicity and to introduce carboxylic acid groups. Conjugation of chitosan and poly(N-isopropylacrylamide) (PNIPAAm) followed by using water-soluble carbodiimide as a coupling agent to form a novel bigraft PP-g-chitosan-g-PNIPAAm wound dressing. The amount of chitosan and PNIPAAm grafted to PP-g-chitosan-g-PNIPAAm were 83.0 ± 4.6 μg/cm 2 and 189.5 ± 8.2 μg/cm 2 , respectively. The surface chemical composition and microstructure of the NWF were studied by electron spectroscopy for chemical analysis (ESCA) and scanning electron microscopy (SEM). The linkages between AAc, chitosan, and PNIPAAm were confirmed with the formation of amide bonds. Physical properties of the NWF were characterized and potentials of these NWFs as wound dressings were evaluated using SD rat as the animal model. NWFs contained PNIPAAm were better than those contained only chitosan in wound healing rates and the wound areas covered by PP-g-chitosan-g-PNIPAAm wound dressings healed completely in 17 days.

  13. Performance of non woven synthetic fabric and disc filters for fertirrigation water treatment Desempenho dos filtros de mantas não tecidas e de disco no tratamento de água para fertirrigação

    Directory of Open Access Journals (Sweden)

    Túlio Assunção Pires Ribeiro

    2004-04-01

    Full Text Available Obstruction of emitters caused by the presence of solid particles in the water raises the cost and maintenance of trickle irrigation systems, and might compromise their utilization. This research was performed through test fields, with the objective of evaluating the performance of a disc filter (130 microns and a non woven synthetic fabric filter on the removal of physical, chemical and biological impurities from the irrigation water, which may cause emitter obstruction during fertirrigation processes. The evaluation criteria of the impurities present in the irrigation water, were based on studies performed on trickle irrigation systems. Specifically, physical, chemical and biological parameters analyzed in the inflow and outflow water from both filters were: pH, turbidity, total suspended solids, salinity, total iron, sulphites, manganese, algae and bacteria. Results pointed to chemical factors, which presented medium clogging risks to the emitters; those factors were: pH, total iron and sulphite concentration. All the other parameters of water quality did not present clogging risks. A comparative analysis of head loss evolution, according to the filtered volume, was also atempted Non woven synthetic fabric filter presented a higher evolution when compared to the disc filter.Um dos fatores que elevam os custos de operação e manutenção dos sistemas de irrigação localizada e, em certos casos, inviabiliza a utilização desse método, é a obstrução de emissores pela presença de partículas sólidas na água de irrigação. O presente trabalho teve por objetivo principal estimar, através de ensaios experimentais de campo, o desempenho de um filtro de disco (130 microns com outro de manta sintética não tecida na remoção de impurezas de origens físicas, químicas e biológicas presentes na água de irrigação que promovem o entupimento dos emissores, quando se utiliza a fertirrigação. Os critérios para avaliação das impurezas

  14. Polypropylene non-woven fabric membrane via surface modification with biomimetic phosphorylcholine in Ce(IV)/HNO{sub 3} redox system

    Energy Technology Data Exchange (ETDEWEB)

    Zhao Jie; Shi Qiang; Luan Shifang; Song Lingjie; Yang Huawei [State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022 (China); Stagnaro, Paola [Istituto per Io Studio delle Macromolecole, Consiglio Nazionale delle Ricerche, Via de Marini 6, 16149 Genova (Italy); Yin Jinghua, E-mail: yinjh@ciac.jl.cn [State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022 (China)

    2012-10-01

    Surface modification of polypropylene non-woven fabric membrane (NWF) for improving its hemocompatibility was developed by grafting a biomimic monomer, 2-methacryloyloxyethyl phosphorycholine (MPC). The NWF membrane surface was first activated by potassium peroxydisulfate to form hydroxyl groups, and then grafted with MPC using ceric (IV) ammonium nitrate as the redox initiator. The surface chemical changes before and after modification were confirmed by Fourier transform infrared spectroscopy with an ATR unit (FTIR-ATR) and X-ray photoelectron spectroscopy (XPS); the water contact angle results showed the gradual changes in wettability from hydrophobic to hydrophilic surface. Meanwhile, the hemocompatibility of these samples was also evaluated by protein adsorption and platelet adhesion. These experimental results exhibited that the introduction of poly(MPC) onto the NWF membrane surfaces substantially improved their hemocompatibility. The feasibility and simplicity of this procedure may lead to potential applications of NWF membranes in biomedical separation and blood purification. - Graphical abstract: 2-methacryloyloxyethyl phosphorycholine (MPC), was grafted onto non-woven fabric (NWF) membrane surface by Ce(IV)/HNO{sub 3} redox system. The protein adsorption and platelet adhesion were substantially suppressed by the introduction of poly(MPC). Highlights: Black-Right-Pointing-Pointer MPC was successfully grafted onto NWF PP membrane surface. Black-Right-Pointing-Pointer Obviously enhanced hemocompatibility was acquired by the modified samples. Black-Right-Pointing-Pointer A facile redox grafting was adopted in the whole process.

  15. Barriers for recruitment of patients with chronic obstructive pulmonary disease to a controlled telemedicine trial

    DEFF Research Database (Denmark)

    Broendum, Eva; Ulrik, Charlotte Suppli; Gregersen, Thorbjorn

    2018-01-01

    The aim of this analysis is to investigate reasons why patients with chronic obstructive pulmonary disease decline to participate in a controlled trial of telemedicine. Patients with previous chronic obstructive pulmonary disease exacerbations were invited to participate in a 6-month randomized...... not want to participate in clinical research. Compared to consenting patients, subjects declining participation were significantly older, more often female, had higher lung function (%predicted), lower body mass index, higher admission-rate for chronic obstructive pulmonary disease in the previous year...

  16. Barriers to palliative care in people with chronic obstructive pulmonary disease in home care

    DEFF Research Database (Denmark)

    Mousing, Camilla Askov; Timm, Helle; Lomborg, Kirsten

    2018-01-01

    . Non-awareness and organisational barriers led to difficulties in identifying PC needs and reluctance to initiate conversations about PC. CONCLUSION: The findings indicate a need for education, training and reflection among professional caregivers in home care. Also, organisational changes may...... vague understanding of palliative care and lack of knowledge about the disease. Organisational barriers, such as lack of time and continuity in patient care and lack of opportunity to discuss palliative care and lack of peer learning were experienced as challenging in the provision of palliative care...... be needed to reduce the barriers to palliative care. This article is protected by copyright. All rights reserved....

  17. Screening Commercial Vehicle Drivers for Obstructive Sleep Apnea: Tools, Barriers, and Recommendations.

    Science.gov (United States)

    Evans, Kelly A; Yap, Tracey; Turner, Barbara

    2017-10-01

    Obstructive sleep apnea (OSA) is a disorder characterized by a cessation of breathing during sleep, leading to poor sleep patterns and daytime somnolence. Daytime somnolence is of particular concern for commercial vehicle drivers, whose crash risk increases 50% with untreated OSA. The process of diagnosing and treating OSA in commercial drivers begins with effective and consistent screening. Therefore, the researchers screened drivers with both the STOP-Bang Questionnaire and the Obstructive Sleep Apnea Evaluation Worksheet (OSAEW) and compared the two tools. Drivers screening positive on the STOP-Bang Questionnaire, OSAEW, and both questionnaires were 28%, 23%, and 13%, respectively. Sleep study referrals were made for 50 drivers; 12 drivers were scheduled for sleep tests within 3 months. Health care provider referral rates for drivers screening at high risk (37%) and commercial driver monitoring rates (24%) were both low. Recommendations to improve OSA screening and testing practices include Federal Motor Carrier Safety Administration-mandated screening and referral guidelines, employee-facilitated sleep testing, and OSA awareness campaigns.

  18. Non-woven PET fabric reinforced and enhanced the performance of ultrafiltration membranes composed of PVDF blended with PVDF-g-PEGMA for industrial applications

    Science.gov (United States)

    Wang, Shuai; Li, Tong; Chen, Chen; Chen, Sheng; Liu, Baicang; Crittenden, John

    2018-03-01

    Ultrafiltration (UF) membranes composed of poly(vinylidene fluoride) (PVDF) blended with poly(vinylidene fluoride)-graft-poly(ethylene glycol) methyl ether methacrylate (PVDF-g-PEGMA) can present high flux and excellent foulant removal efficiencies under suitable preparation conditions. However, these PVDF/PVDF-g-PEGMA blended membranes cannot be applied industrially because of the insufficient mechanical strength (strength-to-break value of 8.4 ± 0.6 MPa). We incorporated two types of non-woven polyethylene terephthalate (PET) fabrics (thin hydrophobic and thick hydrophilic fabrics) as support layers to improve the mechanical properties of the blended membranes. The thin and thick PET fabrics were able to significantly improve the tensile strength to 23.3 ± 3.7 MPa and 30.1 ± 1.4 MPa, respectively. The PET fabrics had a limited impact on the separation-related membrane performance such as hydrophilicity, foulant rejection, whereas the mechanical strength and pure water flux was improved several folds. The enhanced flux was attributed to the higher surface porosity and wider finger-like voids in the cross-section. The thin PET fabric with larger porosity was able to maintain a consistent toughness simultaneously; thus it is recommended as a support material for this blended membrane.

  19. Biocompatibility of polypropylene non-woven fabric membrane via UV-induced graft polymerization of 2-acrylamido-2-methylpropane sulfonic acid

    Energy Technology Data Exchange (ETDEWEB)

    Song Lingjie [State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022 (China); Graduate University of Chinese Academy of Sciences, Beijing 100049 (China); Zhao Jie; Yang Huawei; Jin Jing; Li Xiaomeng [State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022 (China); Stagnaro, Paola [Istituto per Io Studio delle Macromolecole, Consiglio Nazionale delle Ricerche, Via de Marini 6, 16149 Genova (Italy); Yin Jinghua, E-mail: yinjh@ciac.jl.cn [State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022 (China)

    2011-10-15

    This work described the graft polymerization of a sulfonic acid terminated monomer, 2-acrylamido-2-methylpropane sulfonic acid (AMPS), onto the surface of polypropylene non-woven (NWF PP) membrane by O{sub 2} plasma pretreatment and UV-induced photografting method. The chemical structure and composition of the modified surfaces were analyzed by FTIR-ATR and XPS, respectively. The wettability was investigated by water contact angle and equilibrium water adsorption. And the biocompatibility of the modified NWF PP membranes was evaluated by protein adsorption and platelet adhesion. It was found that the graft density increased with prolonging UV irradiation time and increasing AMPS concentration; the water contact angles of the membranes decreased from 124{sup o} to 26{sup o} with the increasing grafting density of poly(AMPS) from 0 to 884.2 {mu}g cm{sup -2}, while the equilibrium water adsorption raised from 5 wt% to 75 wt%; the protein absorption was effectively suppressed with the introduction of poly(AMPS) even at the low grafting density (132.4 {mu}g cm{sup -2}); the number of platelets adhering to the modified membrane was dramatically reduced when compared with that on its virgin surface. These results indicated that surface modification of NWF PP membrane with AMPS was a facile approach to construct biocompatible surface.

  20. Preparation of a non-woven poly(ε-caprolactone) fabric with partially embedded apatite surface for bone tissue engineering applications by partial surface melting of poly(ε-caprolactone) fibers.

    Science.gov (United States)

    Kim, In Ae; Rhee, Sang-Hoon

    2017-07-01

    This article describes a novel method for the preparation of a biodegradable non-woven poly(ε-caprolactone) fabric with a partially embedded apatite surface designed for application as a scaffold material for bone tissue engineering. The non-woven poly(ε-caprolactone) fabric was generated by the electro-spinning technique and then apatite was coated in simulated body fluid after coating the PVA solution containing CaCl 2 ·2H 2 O. The apatite crystals were partially embedded or fully embedded into the thermoplastic poly(ε-caprolactone) fibers by controlling the degree of poly(ε-caprolactone) fiber surface melting in a convection oven. Identical apatite-coated poly(ε-caprolactone) fabric that did not undergo heat-treatment was used as a control. The features of the embedded apatite crystals were evaluated by FE-SEM, AFM, EDS, and XRD. The adhesion strengths of the coated apatite layers and the tensile strengths of the apatite coated fabrics with and without heat-treatment were assessed by the tape-test and a universal testing machine, respectively. The degree of water absorbance was assessed by adding a DMEM droplet onto the fabrics. Moreover, cell penetrability was assessed by seeding preosteoblastic MC3T3-E1 cells onto the fabrics and observing the degrees of cell penetration after 1 and 4 weeks by staining nuclei with DAPI. The non-woven poly(ε-caprolactone) fabric with a partially embedded apatite surface showed good water absorbance, cell penetrability, higher apatite adhesion strength, and higher tensile strength compared with the control fabric. These results show that the non-woven poly(ε-caprolactone) fabric with a partially embedded apatite surface is a potential candidate scaffold for bone tissue engineering due to its strong apatite adhesion strength and excellent cell penetrability. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 1973-1983, 2017. © 2017 Wiley Periodicals, Inc.

  1. Modulation of gut barrier function in patients with obstructive jaundice using probiotic LP299v.

    Science.gov (United States)

    Jones, Claire; Badger, Stephen A; Regan, Mark; Clements, Barry W; Diamond, Tom; Parks, Rowan W; Taylor, Mark A

    2013-12-01

    This study aimed to determine the effect of LP229v on intestinal permeability and tumour necrosis factor (TNF) p55 receptor concentrations in patients with obstructive jaundice undergoing biliary drainage. Patients undergoing biliary drainage were recruited and randomized into three groups to receive Lactobacillus plantarum 299v (LP299v), inactivated LP299v (placebo) or water. These were administered daily at noon until 7 days after biliary drainage. Intestinal permeability was measured using the lactulose/mannitol (L/M) dual sugar absorption test on admission, the day before biliary drainage and on days 1 and 7 after biliary drainage. Blood and urine were collected to determine the L/M ratio and the TNF p55 receptor levels at each time point. A total of 25 patients were recruited; 12 had choledocholithiasis and nine had a periampullary tumour. Open surgical biliary drainage was performed in nine patients, endoscopic retrograde cholangiopancreatography in 12 and percutaneous transhepatic cholangiography in two. Five patients received LP299v, five received placebo and seven, water. The median L/M ratio was 0.035 (0.018-0.065) at baseline. No difference existed between the groups on admission, before drainage and on day 7 after drainage (P=0.59, 0.175 and 0.61, respectively). The L/M ratio was lower in the LP299v group on day 1 after drainage [0.01 (0.01) vs. 0.18 (0.03-0.3) and 0.11 (0.07-0.14); P=0.37]. Although the TNF p55 receptor levels were lower on day 1 after drainage in the LP299v group (15.3 vs. 30.9 vs. 82.7 ng/ml; P=0.43), the concentration at the four time points was similar (P=0.24, 0.96, 0.43 and 0.68). Pretreatment with probiotic LP299v improves intestinal permeability after biliary drainage and attenuates the inflammatory response. However, a larger multicentre trial is required to determine the effect on clinical outcome.

  2. In vitro hemocompatibility of sulfonated polypropylene non-woven fabric prepared via a facile γ-ray pre-irradiation grafting method

    Energy Technology Data Exchange (ETDEWEB)

    Li, Rong [Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800 (China); Wu, Guozhong [Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800 (China); School of Physical Science and Technology, ShanghaiTech University, Shanghai 200031 (China); Ye, Yin, E-mail: yeyin@sinap.ac.cn [Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800 (China)

    2015-11-30

    Graphical abstract: - Highlights: • Sulfonated PP{sub NWF} was successfully fabricated via γ-ray pre-irradiation-induced graft polymerization of SSS method with the aid of AAm. • Compared with the pristine PP{sub NWF}, the sulfonated PP{sub NWF} material presented outstanding hydrophilicity. • The sulfonated PP{sub NWF} exhibited good hemocompatibility. - Abstract: Sulfonated polypropylene non-woven fabric (PP{sub NWF}) was successfully prepared via γ-ray pre-irradiation-induced graft polymerization of sodium styrenesulfonate (SSS) and acrylamide (AAm). The effect of pre-irradiation dose, reaction temperature, reaction time and concentration of binary monomer on the degree of grafting (DG) was studied. The chemical structure of the original and modified PP{sub NWF} materials were investigated by attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy and X-ray photoelectron spectroscopy (XPS) to confirm the successful introduction of sulfonated (−SO{sub 3}{sup −}) group. The wettability was examined via measurement of de-ionized water adsorption percentage, which demonstrated that the hydrophilicity of PP{sub NWF} was greatly enhanced after graft modification. A little amount of bovine serum albumin (BSA) adsorption and nearly no platelet adhesion on the surface of modified PP{sub NWF} and low hemolytic ratio of the modified PP{sub NWF} revealed that the sulfonated PP{sub NWF} exhibited good hemocompatibility. Besides, blood clotting time measurement indicated that the anticoagulant property of PP{sub NWF} was effectively enhanced via SSS modification. Consequently, the hydrophilicity, in vitro hemocompatibility and anticoagulant effect of PP{sub NWF} were significantly improved by γ-ray pre-irradiation-induced graft polymerization of SSS.

  3. Assessment and characterization of degradation effect for the varied degrees of ultra-violet radiation onto the collagen-bonded polypropylene non-woven fabric surfaces.

    Science.gov (United States)

    Tyan, Yu-Chang; Liao, Jiunn-Der; Klauser, Ruth; Wu, Ie-Der; Weng, Chih-Chiang

    2002-01-01

    Exposure to ultra-violet (UV)-C radiation is a frequently used method to prevent bacteria from invasion of blood-contact biomedical products. Potential damage induced by UV radiation to collagen is of concern due to the decay of bioactivity, considerably correlated with structural alterations. Our current investigation studies the collagen-bonded non-woven polypropylene (PP) fabric surface. In this experiment, antenna-coupling microwave plasma is utilized to activate PP fabric and then the sample is grafted with acrylic acid (AAc). Type III collagen is immobilized by using water soluble 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide as coupling agent. The collagen-bonded samples with sample temperature ca. 4 degrees C are then exposed to UV-254nm radiation for different time intervals. By using fourier-transformed infrared with attenuated total reflection (FTIR-ATR) and XPS (X-ray photoelectron spectroscopy), we examine the chemical structures of samples with different treatments. Coomassie brilliant blue G250 method is utilized to quantify the immobilized collagen on the PP fabric surfaces. Blood-clotting effects are evaluated by activated partial thromboplastin time, thrombin time, and fibrinogen concentration tests. By means of cell counter and scanning electron microscopy we count red blood cells and platelets adhesion in the modified porous matrix. Our experimental results have demonstrated that with pAAc-grafting of ca. 173 microg cm(-2) and immobilized collagen of 80.5+/-4.7 microg cm(-2), for human plasma incubated samples of various intervals of UV-254 nm radiation, fibrinogen concentration decreases in human plasma, while platelets and red blood cells adhesions increase before UV radiation. However, the required time for thrombination shows significant change for UV radiation exposure of less than 20 h (alpha = 0.05). The decay of bioactivity for the UV-irradiated, collagen-bonded surfaces is thus evaluated. Surface analyses indicate that the decrease of

  4. Layout designs of surface barrier coatings for boosting the capability of oxygen/vapor obstruction utilized in flexible electronics

    Science.gov (United States)

    Lee, Chang-Chun; Huang, Pei-Chen; He, Jing-Yan

    2018-04-01

    Organic light-emitting diode-based flexible and rollable displays have become a promising candidate for next-generation flexible electronics. For this reason, the design of surface multi-layered barriers should be optimized to enhance the long-term mechanical reliability of a flexible encapsulation that prevents the penetration of oxygen and vapor. In this study, finite element-based stress simulation was proposed to estimate the mechanical reliability of gas/vapor barrier design with low-k/silicon nitride (low-k/SiNx) stacking architecture. Consequently, stress-induced failure of critical thin films within the flexible display under various bending conditions must be considered. The feasibility of one pair SiO2/SiNx barrier design, which overcomes the complex lamination process, and the critical bending radius, which is decreased to 1.22 mm, were also examined. In addition, the influence of distance between neutral axes to the concerned layer surface dominated the induced-stress magnitude rather than the stress compliant mechanism provided from stacked low-k films.

  5. Efficient catalytic ozonation by ruthenium nanoparticles supported on SiO2 or TiO2: Towards the use of a non-woven fiber paper as original support

    KAUST Repository

    Biard, Pierre-François

    2015-12-24

    This work focuses on the use of Ru(0) nanoparticles as heterogeneous catalyst for ozone decomposition and radical production. In a first set of experiments, the nanoparticles have been deposited on two inorganic supports (TiO2 or SiO2) by a wet impregnation approach. This study confirmed the high potential of Ru nanoparticles as active species for ozone decomposition at pH 3, since the ozone half-life time decreases by a factor 20-25, compared to the reference experiment carried out without any catalyst. The enhancement of the ozone decomposition kinetics provided an improved radical production and a higher transient radical concentration in a shorten ozone exposure. Consequently, lower oxidant dosage and contact time would be necessary. Thus, very significant atrazine consumption kinetics enhancements were measured. In a second set of experiments, a non-woven fiber paper composed of a TiO2/SiO2/zeolite mixture has been evaluated as an original support for ruthenium nanoparticles. Even if lower ozone decomposition kinetics was observed compared to TiO2 or SiO2, this support would be a promising alternative to inorganic powders to avoid the catalyst recovery step and to design reactors such as tubular reactors. A new numerical procedure is presented for the evaluation of the transient HO° concentration and of the Rct.

  6. Influence of ionic strength in the adsorption and during photocatalysis of reactive black 5 azo dye on TiO{sub 2} coated on non woven paper with SiO{sub 2} as a binder

    Energy Technology Data Exchange (ETDEWEB)

    Aguedach, Abdelkahhar [Laboratoire de l' Eau et environnement, Universite Chouaib Doukkali, Faculte des Sciences, BP.20, El Jadida, Maroc (Morocco); Brosillon, Stephan [Laboratoire Science Chimiques de Rennes UMR 6226, Equipe Chimie et Ingenierie des Procedes, Ecole Nationale Superieure de Chimie, Universite Rennes 1, avenue du General Leclerc, 35700 Rennes (France)], E-mail: Stephan.Brosillon@ensc-rennes.fr; Morvan, Jean [Laboratoire Science Chimiques de Rennes UMR 6226, Equipe Chimie et Ingenierie des Procedes, Ecole Nationale Superieure de Chimie, Universite Rennes 1, avenue du General Leclerc, 35700 Rennes (France); Lhadi, El Kbir [Laboratoire de l' Eau et environnement, Universite Chouaib Doukkali, Faculte des Sciences, BP.20, El Jadida, Maroc (Morocco)

    2008-01-31

    Reactive black 5 (RB5), an azo dye, was degraded by using UV-irradiated TiO{sub 2} coated on non woven paper with SiO{sub 2} as a binder. The adsorption capacity of the photocatalyst was studied at natural pH, superior to pH{sub pzc} of the binder, for various ionic strengths. Different salts such as NaCl, KCl, CaCl{sub 2}, LiCl, Ca(NO{sub 3}){sub 2} were used to increase the ionic strength. The presence of salt increased the adsorption capacity. The electrostatic interactions between dye and oxide surface charges (TiO{sub 2}/SiO{sub 2}) is very important in the adsorption phenomena. The effect of the ionic strength of the solution on photocatalyst degradation was studied. The rate of degradation was increased by the presence of salts in the range of the experimental conditions. The increase of the initial decolorization rate was observed in the following order: Ca{sup 2+} > K{sup +} > Na{sup +} > Li{sup +}. Experiments with different anions (Cl{sup -}, NO{sub 3}{sup -}) had shown that nitrate was an indifferent electrolyte for the adsorption and photodegradation of the dye on SiO{sub 2}/TiO{sub 2}.

  7. Influence of ionic strength in the adsorption and during photocatalysis of reactive black 5 azo dye on TiO2 coated on non woven paper with SiO2 as a binder

    International Nuclear Information System (INIS)

    Aguedach, Abdelkahhar; Brosillon, Stephan; Morvan, Jean; Lhadi, El Kbir

    2008-01-01

    Reactive black 5 (RB5), an azo dye, was degraded by using UV-irradiated TiO 2 coated on non woven paper with SiO 2 as a binder. The adsorption capacity of the photocatalyst was studied at natural pH, superior to pH pzc of the binder, for various ionic strengths. Different salts such as NaCl, KCl, CaCl 2 , LiCl, Ca(NO 3 ) 2 were used to increase the ionic strength. The presence of salt increased the adsorption capacity. The electrostatic interactions between dye and oxide surface charges (TiO 2 /SiO 2 ) is very important in the adsorption phenomena. The effect of the ionic strength of the solution on photocatalyst degradation was studied. The rate of degradation was increased by the presence of salts in the range of the experimental conditions. The increase of the initial decolorization rate was observed in the following order: Ca 2+ > K + > Na + > Li + . Experiments with different anions (Cl - , NO 3 - ) had shown that nitrate was an indifferent electrolyte for the adsorption and photodegradation of the dye on SiO 2 /TiO 2

  8. Identification of Barriers to Influenza Vaccination in Patients with Chronic Obstructive Pulmonary Disease: Analysis of the 2012 Behavioral Risk Factors Surveillance System.

    Science.gov (United States)

    Hsu, Douglas J; North, Crystal M; Brode, Sarah K; Celli, Bartolome R

    2016-01-01

    Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for influenza-related morbidity and mortality. Influenza vaccination is known to decrease influenza incidence, severity, hospitalizations, and mortality. Identification of barriers to influenza vaccination among patients with COPD may aid in efforts to increase vaccination rates. This study aims to identify predictors of influenza vaccination in COPD patients. This study used data from the 2012 Behavioral Risk Factor Surveillance System (BRFSS). Participants with self-reported COPD and receiving an influenza vaccination in the prior 12 months were identified. Independent predictors of the exposure were identified by estimating a parsimonious logistic regression model of influenza vaccination. All analyses were performed using weighted data. The final study sample consisted of 36,811 COPD participants, with 48.5% of COPD patients reporting having been vaccinated and 51.5% reporting being unvaccinated. A total of 15 independent predictors of influenza vaccination in COPD patients were identified. Negative predictors included predisposing factors (younger age, male gender, household children, black or non-white/non-Hispanic/non-black race/ethnicity, lower education level, heavy alcohol use, current tobacco use) and enabling factors that reflect access to medical care (insurance status, ability to afford care, having a recent check-up). Positive predictors of influenza vaccination included need factors (chronic comorbidities), being a military veteran, or being a former smoker. This analysis identifies multiple predictors of influenza vaccination in persons with COPD. Identification of at risk-groups provides the foundation for development of focused efforts to improve influenza vaccination rates in patients with COPD.

  9. Socio-Economic Status: A Barrier to Access to Mandibular Advancement Device Therapy for Patients with Obstructive Sleep Apnea Syndrome in France.

    Directory of Open Access Journals (Sweden)

    Marion Fleury

    Full Text Available Obstructive sleep apnea syndrome (OSAS is a major public health problem which affects between 5 to 10% of the general population. OSAS is known to be associated with high rates of morbidity and mortality mainly due to cardiovascular diseases and traffic accidents. The burden of illness is high for the individual and society. There are 2 treatment options for OSAS, Continuous Positive Airway Pressure (CPAP and Mandibular Advancement Device therapy (MAD. CPAP is known to be an effective but very constraining treatment. Patients are usually poorly adherent. MAD is a more recent treatment easier to use and consequently better tolerated, but MAD can only be prescribed to patients with satisfactory oral hygiene. Oral health constitutes a real issue particularly among underprivileged groups in France. Through this link, the question of whether low socio-economic status constitutes a barrier to access to care for patients with OSAS is raised.In a multicenter prospective cohort of 2822 consecutive OSAS patients in whom MAD has been proposed as an alternative to CPAP between May 15, 2007 and December 1st, 2014, we identified the factors that lead to a patient diagnosed with OSAS to be treated by MAD instead of CPAP. A logistic regression was performed using a stepwise forward procedure. The main outcome of the study was that treatment by MAD was significantly associated with both educational attainment, as determined by the age at which the patient left full-time education, ≥18 years compared with <18 (adjusted odds ratio (aOR: 1.64, 95% CI 1.23 to 2.20, and the patient's occupational category. Executives and higher intellectual professions, intermediate professions, technicians, foremen and employees were significantly more likely to be treated by MAD than workers (aOR: 2.21, 95% CI 1.88 to 2.58; aOR: 1.74, 95% CI 1.15 to 2.63; aOR: 1.96, 95% CI 1.11 to 3.47, respectively.Overall, these results suggest that low socio-economic status constitutes a

  10. UPJ obstruction

    Science.gov (United States)

    ... junction obstruction; Obstruction of the ureteropelvic junction Images Kidney anatomy References Elder JS. Obstruction of the urinary tract. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, St. Geme JW, Schor NF, eds. ... The Kidney . 10th ed. Philadelphia, PA: Elsevier; 2016:chap 38. ...

  11. Conservação de rúcula minimamente processada produzida em campo aberto e cultivo protegido com agrotêxtil Conservation of minimally processed rocket produced under open field conditions and non woven polypropylene

    Directory of Open Access Journals (Sweden)

    Angela F Gonzalez

    2006-09-01

    Full Text Available Folhas de rúcula produzidas em campo aberto e sob cultivo protegido com agrotêxtil foram minimamente processadas, embaladas inteiras ou picadas em bandejas de poliestireno expandido e cobertas com filme de PVC de 14 micras. O delineamento adotado foi o inteiramente casualizado em esquema fatorial 2x2x2 (ambiente de cultivo, forma de preparo e refrigeração a 0(0C e 10(0C, com quatro repetições por tratamento, totalizando 32 bandejas. Os tratamentos foram armazenados a 0ºC e 10ºC por 10 dias, quando foram avaliadas as variáveis perda de massa (%; pH; sólidos solúveis; acidez titulável; cor e aparência. A conservação a 0ºC promoveu uma diminuição da perda de peso da rúcula minimamente processada. A utilização de folhas inteiras ou minimamente processadas foi significativa para sólidos solúveis sendo os maiores valores encontrados para as folhas inteiras. Para folhas picadas observou-se valores de acidez significativamente maiores para as produzidas sob ambiente natural. Independente da forma de preparo, a rúcula produzida em ambiente natural apresentou menor valor de pH. A cor e aparência da rúcula não foram influenciadas pelos tratamentos.Leaves of rocket salad produced under open field and non woven polypropylene were minimally processed and packed entire or pricked in polyestyrene trays covered with PVC film of 14 micras. The treatments were stored at 0(0C and 10(0C per 10 days, when the variables weight loss (%; pH; soluble solids; titratable acidity; colour and appearance were evaluated. The conservation under 0(0C promoted a reduction of weight loss on rocket salad minimally processed. Using entire or minimally processed leaves were significant for soluble solids the biggest values being found for entire leaves. For pricked leaves bigger values of acidity were observed for the produced ones under natural environment. Independent of the preparation form rocket salad produced under natural environment presented minor

  12. Obstructive Sleep Apnea

    Medline Plus

    Full Text Available ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ...

  13. Obstructive Sleep Apnea

    Science.gov (United States)

    ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ...

  14. Obstructive uropathy

    Science.gov (United States)

    ... the kidney and causes it to become swollen ( hydronephrosis ). Obstructive uropathy can affect one or both kidneys. ... occurs during pregnancy. This condition is called idiopathic hydronephrosis of pregnancy.

  15. Intestinal Obstruction

    Science.gov (United States)

    ... Colostomy ) is required to relieve an obstruction. Understanding Colostomy In a colostomy, the large intestine (colon) is cut. The part ... 1 What Causes Intestinal Strangulation? Figure 2 Understanding Colostomy Gastrointestinal Emergencies Overview of Gastrointestinal Emergencies Abdominal Abscesses ...

  16. Simultaneous antibacterial and anticoagulant properties of polypropylene non-woven textiles Elaboration d'un textile polypropylène non-tissé présentant simultanément des propriétés antibactériennes et anticoagulantes

    Directory of Open Access Journals (Sweden)

    Jimenez Maude

    2013-11-01

    Full Text Available The aim of this work was to prepare a non-woven Polypropylene (PP textile functionalized with bioactive molecules to improve simultaneously its anticoagulation and antibacterial properties. The immobilization of either heparin (anticoagulation agent or gentamicin (aminoglycoside antibiotic was already proven to be effective on non-woven PP textiles. This work details how we managed to immobilize both gentamicin and heparin on the textile [1]. The immobilization times were studied in order to determine the best compromise between cytocompatibility, anticoagulant effect and antimicrobial activity. Cetté étude décrit le procédé de fonctionnalisation d'un textile polypropylène (PP non-tissé afin d'améliorer à la fois ses propriétés antibactériennes et anticoagulantes. Dans des précédents travaux, l'immobilisation soit de l'héparine (agent anticoagulant, soit de la gentamicine (agent antibiotique aminoglycoside a déjà été reportée. Des effets respectivement anticoagulants et antibactériens ont été obtenus. Cette étude décrit la faç on d'immobiliser ces deux principes actifs sur un même textile. L'effet des temps d'imprégnation sur les propriétés antibactériennes et anticoagulantes a été étudié afin d'obtenir le meilleur compromis possible en termes de cytocompatibilité, effet anticoagulant et activité antimicrobienne.

  17. Obstructive ventriculomegaly

    International Nuclear Information System (INIS)

    Amato, M.; Howald, H.; Muralt, G. von

    1986-01-01

    Intracranial Hemorrhage (ICH) occurs primarily in premature infants, and posthemorrhagic ventricular dilatation is a well-known complication in this age-group. Blood clots within the ventricle are diagnostic of ICH but not usually seen. In our case Real-Time Ultrasonography has proved to be very helpful to identify intraventricular hematomas and to control obstructive ventriculomegaly without therapeutic intervention. (Author)

  18. Qualitative systematic review of barriers and facilitators to self-management of chronic obstructive pulmonary disease: views of patients and healthcare professionals.

    Science.gov (United States)

    Russell, Siân; Ogunbayo, Oladapo J; Newham, James J; Heslop-Marshall, Karen; Netts, Paul; Hanratty, Barbara; Beyer, Fiona; Kaner, Eileen

    2018-01-17

    Self-management interventions for chronic obstructive pulmonary disease (COPD) can improve quality of life, reduce hospital admissions, and improve symptoms. However, many factors impede engagement for patients and practitioners. Qualitative research, with its focus on subjective experience, can provide invaluable insights into such factors. Therefore, a systematic review and synthesis of qualitative evidence on COPD self-management from the perspective of patients, carers, and practitioners was conducted. Following a systematic search and screening, 31 studies were appraised and data extracted for analysis. This review found that patients can adapt to COPD; however, learning to self-manage is often a protracted process. Emotional needs are considerable; frustration, depression, and anxiety are common. In addition, patients can face an assortment of losses and limitations on their lifestyle and social interaction. Over time, COPD can consume their existence, reducing motivation. Support from family can prove vital, yet tinged with ambivalence and burden. Practitioners may not have sufficient time, resources, or appropriate skills or confidence to provide effective self-management support, particularly in regard to patients' psychosocial needs. This can compound patients' capability to engage in self-management. For COPD self-management to be effective, patients' psychosocial needs must be prioritised alongside medication and exacerbation management. In addition, patients' personal beliefs regarding COPD and its management should be reviewed periodically to avoid problematic behaviours and enhance positive adaptions to the disease. Patients with COPD are not a homogenous group and no one intervention will prove effective for all. Finally, practitioners require greater education, training, and support to successfully assist patients.

  19. Barriers and outcomes of an evidence-based approach to diagnosis and management of chronic obstructive pulmonary disease (COPD) in Australia: a qualitative study.

    Science.gov (United States)

    Dennis, Sarah; Reddel, Helen K; Middleton, Sandy; Hasan, Iqbal; Hermiz, Oshana; Phillips, Rosemary; Crockett, Alan J; Vagholkar, Sanjyot; Marks, Guy B; Zwar, Nicholas

    2017-08-01

    Chronic obstructive pulmonary disease (COPD) is commonly managed in primary care but there is poor awareness of evidence-based guidelines and the quality and interpretation of spirometry is suboptimal. The aims of this qualitative study were to explore how an intervention involving case finding and management of COPD was implemented, and the extent to which the GPs and practice nurses (PNs) worked in partnership to diagnose and manage COPD. Semi-structured interviews with PNs (n = 7), GPs (n = 4) and patients (n = 26) who had participated in the Primary care EarLy Intervention for Copd mANagement (PELICAN) study. The Theoretical Domains Framework was used to guide the coding and analysis of the interviews with PN and GPs. The patient interviews were analysed thematically. PNs developed technical skills and understood the requirements for good-quality spirometry. However, many lacked confidence in its interpretation and felt this was not part of their professional role. This was reflected in responses from the GPs. Once COPD was diagnosed, the GPs tended to manage the patients with the PNs less involved. This was in contrast with PNs' active role in managing patients with other chronic diseases such as diabetes. The extent to which the GPs and PNs worked in partnership to manage COPD varied. PNs improved their skills and confidence in performing spirometry. Beliefs about their professional role, identity and confidence influenced the extent to which PNs were involved in interpretation of the spirometry results and managing the patient in partnership with the GP. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Penetration of a dielectric barrier discharge plasma into textile structures at medium pressure

    International Nuclear Information System (INIS)

    Geyter, N De; Morent, R; Leys, C

    2006-01-01

    Plasma treatment of textiles is becoming more and more popular as a surface modification technique. Plasma treatment changes the outermost layer of a material without interfering with the bulk properties. However, textiles are several millimetres thick and need to be treated homogeneously throughout the entire thickness. To control the penetration depth of the plasma effect, it is necessary to study the influence of operating parameters. Three layers of a 100% polyester non-woven are treated in the medium pressure range (0.3-7 kPa) with a dielectric barrier discharge to study the influence of pressure and treatment time. Current and voltage waveforms and Lichtenberg figures are used to characterize the discharge. Process pressure proved to have an important effect on the penetration of the plasma through the textile layers. This is caused not only by the pressure dependence of diffusive transport of textile modifying particles but also by a different behaviour of the barrier discharge

  1. Obstructive Sleep Apnoea

    African Journals Online (AJOL)

    Cheyne-Stokes respiration), obstructive sleep apnoea and mixed or complex sleep apnoea.1. Obstructive sleep apnoea (OSA) is the most common of these three disorders and is defined as airway obstruction during sleep, accompanied by at least ...

  2. INTESTINAL OBSTRUCTION

    Science.gov (United States)

    Whipple, G. H.; Stone, H. B.; Bernheim, B. M.

    1913-01-01

    Closed duodenal loops may be made in dogs by ligatures placed just below the pancreatic duct and just beyond the duodenojejunal junction, together with a posterior gastro-enterostomy. These closed duodenal loop dogs die with symptoms like those of patients suffering from volvulus or high intestinal obstruction. This duodenal loop may simulate closely a volvulus in which there has been no vascular disturbance. Dogs with closed duodenal loops which have been washed out carefully survive a little longer on the average than animals with unwashed loops. The duration of life in the first instance is one to three days, with an average of about forty-eight hours. The dogs usually lose considerable fluid by vomiting and diarrhea. A weak pulse, low blood pressure and temperature are usually conspicuous in the last stages. Autopsy shows more or less splanchnic congestion which may be most marked in the mucosa of the upper small intestine. The peritoneum is usually clear and the closed loop may be distended with thin fluid, or collapsed, and contain only a small amount of pasty brown material. The mucosa of the loop may show ulceration and even perforation, but in the majority of cases it is intact and exhibits only a moderate congestion. Simple intestinal obstruction added to a closed duodenal loop does not modify the result in any manner, but it may hasten the fatal outcome. The liver plays no essential role as a protective agent against this poison, for a dog with an Eck fistula may live three days with a closed loop. A normal dog reacts to intraportal injection and to intravenous injection of the toxic substance in an identical manner. Drainage of this loop under certain conditions may not interfere with the general health over a period of weeks or months. Excision of the part of the duodenum included in this loop causes no disturbance. The material from the closed duodenal loops contains no bile, pancreatic juice, gastric juice, or split products from the food. It can be

  3. Pathophysiology of increased intestinal permeability in obstructive jaundice

    Science.gov (United States)

    Assimakopoulos, Stelios F; Scopa, Chrisoula D; Vagianos, Constantine E

    2007-01-01

    Despite advances in preoperative evaluation and postoperative care, intervention, especially surgery, for relief of obstructive jaundice still carries high morbidity and mortality rates, mainly due to sepsis and renal dysfunction. The key event in the pathophysiology of obstructive jaundice-associated complications is endotoxemia of gut origin because of intestinal barrier failure. This breakage of the gut barrier in obstructive jaundice is multi-factorial, involving disruption of the immunologic, biological and mechanical barrier. Experimental and clinical studies have shown that obstructive jaundice results in increased intestinal permeability. The mechanisms implicated in this phenomenon remain unresolved, but growing research interest during the last decade has shed light in our knowledge in the field. This review summarizes the current concepts in the pathophysiology of obstructive jaundice-induced gut barrier dysfunction, analyzing pivotal factors, such as altered intestinal tight junctions expression, oxidative stress and imbalance of enterocyte proliferation and apoptosis. Clinicians handling patients with obstructive jaundice should not neglect protecting the intestinal barrier function before, during and after intervention for the relief of this condition, which may improve their patients’ outcome. PMID:18161914

  4. Bladder outlet obstruction

    Science.gov (United States)

    BOO; Lower urinary tract obstruction; Prostatism; Urinary retention - BOO ... these diseases increases greatly. Other common causes of BOO include: Pelvic tumors (cervix, prostate, uterus, rectum) Narrowing ...

  5. Obstructive Sleep Apnea

    Medline Plus

    Full Text Available ... can also invite bacteria that lead to gum disease. Click here to find out more. Obstructive Sleep Apnea (OSA) Download Download the ebook for further information Obstructive sleep ... high blood pressure, heart disease and decreased libido. In addition, OSA causes daytime ...

  6. Obstructive sleep apnea therapy

    NARCIS (Netherlands)

    Hoekema, A.; Stegenga, B.; Wijkstra, P. J.; van der Hoeven, J. H.; Meinesz, A. F.; de Bont, L. G. M.

    In clinical practice, oral appliances are used primarily for obstructive sleep apnea patients who do not respond to continuous positive airway pressure (CPAP) therapy. We hypothesized that an oral appliance is not inferior to CPAP in treating obstructive sleep apnea effectively. We randomly assigned

  7. Obstructive Sleep Apnea

    Medline Plus

    Full Text Available ... Oral Surgeries Facial Cosmetic Surgery Facial Injury / Trauma Surgery Obstructive Sleep Apnea (OSA) Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are ...

  8. Obstructive Sleep Apnea

    Medline Plus

    Full Text Available ... It can also invite bacteria that lead to gum disease. Click here to find out more. Who We ... It can also invite bacteria that lead to gum disease. Click here to find out more. Obstructive Sleep ...

  9. Obstructive Sleep Apnea

    Medline Plus

    Full Text Available ... The National Sleep Foundation estimates that 18 million adults have obstructive sleep apnea and it is likely ... Maxillofacial Surgeon (OMS). An estimated 18-20 million adults in the US suffer from OSA. What Is ...

  10. Wrecks and Obstructions

    Data.gov (United States)

    Department of Homeland Security — In 1981, NOAA�s National Ocean Service (NOS) implemented the Automated Wreck and Obstruction Information System (AWOIS) to assist in planning hydrographic survey...

  11. Obstructive sleep apnea - adults

    Science.gov (United States)

    ... SM. Obstructive sleep apnea: clinical features, evaluation, and principles of management. In: Kryger M, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine . 6th ed. Philadelphia, ...

  12. Obstructive Sleep Apnea

    Medline Plus

    Full Text Available ... Apnea (OSA) Download Download the ebook for further information Obstructive sleep apnea (OSA) is a serious and ... that can create the necessary air passageway. The information provided here is not intended as a substitute ...

  13. Obstructive Sleep Apnea

    Medline Plus

    Full Text Available ... can also invite bacteria that lead to gum disease. Click here to find out more. Who We ... can also invite bacteria that lead to gum disease. Click here to find out more. Obstructive Sleep ...

  14. Imaging of obstructed defecation

    International Nuclear Information System (INIS)

    Ganeshan, A.; Anderson, E.M.; Upponi, S.; Planner, A.C.; Slater, A.; Moore, N.; D'Costa, H.; Bungay, H.

    2008-01-01

    Constipation is a common problem in the western world, which occurs as a consequence of impaired colonic transit and/or due to obstructed defecation. Imaging plays an important role in distinguishing structural from functional causes of constipation. In this article a description of common imaging techniques for diagnosing structural causes of constipation with illustrations of abnormal defecographic findings in patients with obstructive defecation are presented

  15. Imaging of obstructed defecation

    Energy Technology Data Exchange (ETDEWEB)

    Ganeshan, A. [Radiology Department, John Radcliffe Hospital, Oxford (United Kingdom); Anderson, E.M. [Radiology Department, John Radcliffe Hospital, Oxford (United Kingdom)], E-mail: eanderson@doctors.org.uk; Upponi, S.; Planner, A.C.; Slater, A.; Moore, N.; D' Costa, H.; Bungay, H. [Radiology Department, John Radcliffe Hospital, Oxford (United Kingdom)

    2008-01-15

    Constipation is a common problem in the western world, which occurs as a consequence of impaired colonic transit and/or due to obstructed defecation. Imaging plays an important role in distinguishing structural from functional causes of constipation. In this article a description of common imaging techniques for diagnosing structural causes of constipation with illustrations of abnormal defecographic findings in patients with obstructive defecation are presented.

  16. 28 CFR 36.304 - Removal of barriers.

    Science.gov (United States)

    2010-07-01

    ..., vending machines, display racks, and other furniture; (5) Repositioning telephones; (6) Adding raised.... These measures include, for example, removal of obstructing furniture or vending machines, widening of...) General. A public accommodation shall remove architectural barriers in existing facilities, including...

  17. Acute GI obstruction.

    Science.gov (United States)

    Hucl, Tomas

    2013-10-01

    Acute gastrointestinal obstruction occurs when the normal flow of intestinal contents is interrupted. The blockage can occur at any level throughout the gastrointestinal tract. The clinical symptoms depend on the level and extent of obstruction. Various benign and malignant processes can produce acute gastrointestinal obstruction, which often represents a medical emergency because of the potential for bowel ischemia leading to perforation and peritonitis. Early recognition and appropriate treatment are thus essential. The typical clinical symptoms associated with obstruction include nausea, vomiting, dysphagia, abdominal pain and failure to pass bowel movements. Abdominal distention, tympany due to an air-filled stomach and high-pitched bowel sounds suggest the diagnosis. The diagnostic process involves imaging including radiography, ultrasonography, contrast fluoroscopy and computer tomography in less certain cases. In patients with uncomplicated obstruction, management is conservative, including fluid resuscitation, electrolyte replacement, intestinal decompression and bowel rest. In many cases, endoscopy may aid in both the diagnostic process and in therapy. Endoscopy can be used for bowel decompression, dilation of strictures or placement of self-expandable metal stents to restore the luminal flow either as a final treatment or to allow for a delay until elective surgical therapy. When gastrointestinal obstruction results in ischemia, perforation or peritonitis, emergency surgery is required. Copyright © 2013. Published by Elsevier Ltd.

  18. Occupational chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Omland, Oyvind; Würtz, Else Toft; Aasen, Tor Børvig

    2014-01-01

    Occupational-attributable chronic obstructive pulmonary disease (COPD) presents a substantial health challenge. Focusing on spirometric criteria for airflow obstruction, this review of occupational COPD includes both population-wide and industry-specific exposures....

  19. Nasal obstruction and human communication.

    Science.gov (United States)

    Malinoff, R; Moreno, C

    1989-04-01

    Nasal obstruction may cause a variety of communication disorders, particularly in children. The effects of nasal obstruction on hearing, speech, language, and voice are examined. Methods for assessing the effects of nasal obstruction are delineated, and recommendations for therapeutic interventions are described.

  20. Inducible laryngeal obstruction

    DEFF Research Database (Denmark)

    Halvorsen, Thomas; Walsted, Emil Schwarz; Bucca, Caterina

    2017-01-01

    Inducible laryngeal obstruction (ILO) describes an inappropriate, transient, reversible narrowing of the larynx in response to external triggers. ILO is an important cause of a variety of respiratory symptoms and can mimic asthma. Current understanding of ILO has been hampered by imprecise nomenc...

  1. Obstructive sleep apnea

    DEFF Research Database (Denmark)

    Jennum, Poul; Tønnesen, Philip; Ibsen, Rikke

    2017-01-01

    OBJECTIVE: Most studies have used cardiovascular and cerebrovascular disease (CVD) end-points to measure the effect of continuous positive airway pressure (CPAP), but pre-diagnostic morbidities involve a range of comorbidities that may influence the consequences of obstructive sleep apnea (OSA). We...

  2. Deliberate Perspectival Obstructions

    DEFF Research Database (Denmark)

    Mikkelsen, Henrik Hvenegaard; Rasmussen, Anders Emil

    2017-01-01

    This article discusses the collaborative use of what the authors call ‘perspectival obstructions’. Taking its outset in the events revolving around a series of challenges given to each other, as well as to their interlocutors, in Papua New Guinea, the article unfolds how obstructions may be tied...

  3. Imaging of obstructive azoospermia

    Energy Technology Data Exchange (ETDEWEB)

    Cornud, F. [Clinique Radiologique, 15 Avenue Robert Schuman, F-75 007 Paris (France)]|[Service de Radiologie, Hopital Necker, 169 rue de Sevres, F-75 015 Paris (France); Belin, X. [Clinique Radiologique, 15 Avenue Robert Schuman, F-75 007 Paris (France)]|[Service de Radiologie, Hopital Necker, 169 rue de Sevres, F-75 015 Paris (France); Delafontaine, D. [Medicine de la Reproduction, 8 rue Jean Richepin, F-75 016 Paris (France); Amar, T. [Uro-Andrologist, 19 Avenue Victor Hugo, F-75016, Paris (France); Helenon, O. [Service de Radiologie, Hopital Necker, 169 rue de Sevres, F-75 015 Paris (France); Moreau, J.F. [Service de Radiologie, Hopital Necker, 169 rue de Sevres, F-75 015 Paris (France)

    1997-09-01

    Obstructive azoospermia represents approximately 10 % of cases of male hypofertility. It is classified according to the volume of ejaculate. When the latter is normal a proximal obstruction is suspected. Scrotal sonography can help to detect dilation of the epididymal head when clinical findings are equivocal. Ejaculatory duct obstruction (EDO) is suspected when the volume of ejaculate is low. The use of transrectal ultrasonography (TRUS) plays a major role in the investigation of these patients, and endorectal MRI is a very useful adjunct in selected cases. The most common cause of EDO is congenital bilateral absence of vas deferens, which is now thought to be a genital form of cystic fibrosis in 80 % of cases. Consequently, a definitive diagnosis must be made before any attempt at in vitro fertilization. TRUS accurately visualizes abnormalities of the caudal junction of the vas deferens and seminal vesicles, yielding a definitive diagnosis without scrototomy. Other causes of EDO are congenital cysts compressing the distal part of the ejaculatory ducts and inflammatory distal stenosis. The former are accurately identified by TRUS, but the latter give more or less marked signs of obstruction which are only of value in azoospermic patients with a low-volume ejaculate. More invasive imaging is required to diagnose partial obstruction of the ED. Surgical vasography is still the reference, but puncture of the seminal vesicles under TRUS guidance is an attractive alternative, as it permits aspiration of seminal fluid (to seek motile sperm) and vasography without scrototomy. Lastly, endorectal MRI well assesses the relationships between the proximal prostatic urethra and the posterior wall of the ejaculatory ducts, which need to be precisely known when endoscopic resection of the ejaculatory ducts is planned. (orig.). With 9 figs.

  4. Imaging of obstructive azoospermia

    International Nuclear Information System (INIS)

    Cornud, F.; Belin, X.; Delafontaine, D.; Amar, T.; Helenon, O.; Moreau, J.F.

    1997-01-01

    Obstructive azoospermia represents approximately 10 % of cases of male hypofertility. It is classified according to the volume of ejaculate. When the latter is normal a proximal obstruction is suspected. Scrotal sonography can help to detect dilation of the epididymal head when clinical findings are equivocal. Ejaculatory duct obstruction (EDO) is suspected when the volume of ejaculate is low. The use of transrectal ultrasonography (TRUS) plays a major role in the investigation of these patients, and endorectal MRI is a very useful adjunct in selected cases. The most common cause of EDO is congenital bilateral absence of vas deferens, which is now thought to be a genital form of cystic fibrosis in 80 % of cases. Consequently, a definitive diagnosis must be made before any attempt at in vitro fertilization. TRUS accurately visualizes abnormalities of the caudal junction of the vas deferens and seminal vesicles, yielding a definitive diagnosis without scrototomy. Other causes of EDO are congenital cysts compressing the distal part of the ejaculatory ducts and inflammatory distal stenosis. The former are accurately identified by TRUS, but the latter give more or less marked signs of obstruction which are only of value in azoospermic patients with a low-volume ejaculate. More invasive imaging is required to diagnose partial obstruction of the ED. Surgical vasography is still the reference, but puncture of the seminal vesicles under TRUS guidance is an attractive alternative, as it permits aspiration of seminal fluid (to seek motile sperm) and vasography without scrototomy. Lastly, endorectal MRI well assesses the relationships between the proximal prostatic urethra and the posterior wall of the ejaculatory ducts, which need to be precisely known when endoscopic resection of the ejaculatory ducts is planned. (orig.). With 9 figs

  5. Defaecography and obstructed defaecation

    International Nuclear Information System (INIS)

    Schmelzer, H.; Schweiberer, L.; Muenchen Univ.; Mangel, E.; Muenchen Univ.

    1988-01-01

    Severe constipation or unexplained anorectal symptoms may be caused by obstructed defaecation due to functional pelvic floor disorders that can be identified or verified by defaecography. Based upon own experiences this paper deals with the methodology and the parameters of this late radiological technique as well as the clinical picture of the disorders encountered. The possibilities of management and operative therapy are discussed in short. (orig.) [de

  6. Pré-filtração em pedregulho e filtração lenta com areia, manta não tecida e carvão ativado para polimento de efluentes domésticos tratados em leitos cultivados Pré-filtration in boulder and slow sand filtration with non-woven synthetic layers and granulated vegetal coal to improve quality in wastewater treated by constructed wetlands

    Directory of Open Access Journals (Sweden)

    José E. S. Paterniani

    2011-01-01

    Full Text Available O presente trabalho teve como objetivo comparar sistemas de filtragem, composto de pré-filtro de pedregulho seguido de filtro lento com o meio filtrante areia e no topo manta sintética não tecida e pré-filtro de pedregulho seguido de filtro lento com meio filtrante areia e carvão ativado granular e no topo manta sintética não tecida, para polimento de efluentes domésticos tratados em leitos cultivados, visando à aplicação na fertirrigação. Na comparação dos sistemas de filtragem, avaliou-se a eficiência de remoção dos parâmetros: sólidos em suspensão, turbidez, cor aparente, demanda química de oxigênio, oxigênio dissolvido, ferro, manganês, coliformes totais e E. coli. Os dois sistemas operavam 24 horas por dia, com a mesma taxa de aplicação, tratando uma vazão total final de 1,5 m³ dia-1, sendo que a taxa de aplicação para a unidade de pré-filtração era, em média, de 8,4 m³ m-2 dia-1 e para cada uma das unidades de filtração lenta era, em media, de 2,7 m³ m-2 dia-1. As unidades de pré-filtração e filtração lenta mostraram-se eficientes na redução das concentrações de sólidos suspensos, turbidez, cor aparente e DQO, como polimento de esgotos domésticos previamente tratados. O uso de carvão ativado granular, em combinação com areia, proporcionou ao filtro lento maior eficiência na remoção de sólidos suspensos, cor, turbidez, coliformes totais e E. Coli., sem com isso aumentar a perda de carga inicial. Existe a possibilidade de utilização dos efluentes para a prática da fertirrigação, sendo necessário o processo de desinfecção ou não, dependendo da cultura e o sistema de irrigação utilizado.The objective of this study was the comparison between two filtration systems, being one composed of a boulder pre-filter followed by a slow filter with sand as filtration media and a non-woven synthetic fabric in the upper part, and the other one composed of a boulder pre-filter followed by a

  7. Aortic obstruction: anatomy and echocardiography

    Directory of Open Access Journals (Sweden)

    Keirns Candace

    2006-09-01

    Full Text Available Abstract Echocardiography is a valuable non-invasive technique for identifying the site and type of aortic obstruction. Knowledge of the morphological details of each type of obstruction is the basis for correct interpretation of the diagnostic images and clinical decisions. This study was undertaken to correlate the echocardiographic images with anatomic specimens of equivalent valvular and supravalvular aortic obstruction. Specimens were part of the collection of the Department of Embryology. Fifty six patients were studied, and forty specimens with aortic obstruction were analyzed. Echocardiographic characteristics: Thirty one (55.3% patients were women and twenty five (44.7% men. Valvular aortic obstruction was found in Thirty six patients (64.3 % and supravalvular aortic obstruction in twenty (35.7%. Anatomic characteristics: Of the forty specimens examined, twenty one (52.5% had valvular aortic obstruction and nineteen (47.5% supravalvular aortic obstruction. The anatomoechocardiographic correlation clearly showed that the anatomic findings of the specimen hearts and aortas corresponded to echocardiographic images of valvular and supravalvular aortic obstruction and provided solid corroboration of echocardiographic diagnoses.

  8. Subtotal obstruction of the male reproductive tract

    NARCIS (Netherlands)

    Pierik, F.H.; Dohle, G.R.; Roijen, J.H. van; Vreeburg, J.T.M.; Weber, R.F.A.

    2003-01-01

    Bilateral obstruction of the male reproductive tract is suspected in men with azoospermia, normal testicular volume and normal FSH. A testicular biopsy is required to differentiate between an obstruction and a testicular insufficiency. Unilateral or subtotal bilateral obstructions and epididymal

  9. Equine recurrent airway obstruction

    Directory of Open Access Journals (Sweden)

    Artur Niedźwiedź

    2014-10-01

    Full Text Available Equine Recurrent Airway Obstruction (RAO, also known as heaves or broken wind, is one of the most common disease in middle-aged horses. Inflammation of the airway is inducted by organic dust exposure. This disease is characterized by neutrophilic inflammation, bronchospasm, excessive mucus production and pathologic changes in the bronchiolar walls. Clinical signs are resolved in 3-4 weeks after environmental changes. Horses suffering from RAO are susceptible to allergens throughout their lives, therefore they should be properly managed. In therapy the most importanthing is to eliminate dustexposure, administration of corticosteroids and use bronchodilators to improve pulmonary function.

  10. Chronic obstructive pulmonary disease

    International Nuclear Information System (INIS)

    Karabulut, N.

    2012-01-01

    Full text: Chronic obstructive pulmonary diseases (COPD) denote progressive lung diseases characterized by airway obstruction. COPD exhibits specific morphologic changes in the lung parenchyma, central and peripheral airways and pulmonary vasculature. A person with COPD may have either emphysema or chronic bronchitis, but most have both. Some people with COPD may also have an asthma-like or reactive component. Imaging modalities play important role in the detection or exclusion of COPD, distribution and extent of disease processes. Combined inspiratory and expiratory high resolution CT allows phenotyping of COPD (emphysema predominant, airway predominant, or mixed) and quantification of severity. Magnetic resonance imaging enables functional evaluation and demonstrates ventilation defects correlating closely with pulmonary function tests. Imaging techniques are also helpful in guiding the treatment, such as bullectomy in patients with bullous emphysema, lung volume reduction surgery or endoscopic interventions in those with severe emphysema, and smoking cessation and medical treatment designed to stop lung destruction in patients with mild or moderate emphysema or bronchiectasis.

  11. Percutaneous intervention in obstructive

    International Nuclear Information System (INIS)

    Souftas, V.

    2012-01-01

    Percutaneous intervention procedures in obstructive uropathy include percutaneous nephrostomy tube placements, nephroureteral stents, percutaneous nephrostomy combined with ureteral embolization, percutaneous management of stone disease, suprapubic tube placements into the bladder, and perinephric/retroperitoneal urinomas/abscesses drainages. Percutaneous nephrostomy is performed to relieve urinary obstruction or divert the urinary stream away from the ureter or bladder. Patients are given preprocedure antibiotics. Percutaneous nephrostomies can be emergent cases because of risk of pyuria and sepsis from a stagnant urine collection. The procedure is performed using both ultrasound and fluoroscopy (or fluoroscopy alone using anatomic landmarks, or an internal radiopaque calculus, or delayed phase excretion of the contrast into the renal collecting system) under local anesthesia or conscious sedation. Ureteral stents are placed to bypass an obstructing stone or to stent across of an area of stricture or ureteral laceration. Stents may be placed by the urologist via a transurethral approach or by the interventional radiologist via a percutaneous approach. The decision as to method of stent placement is based upon the location and accessibility of the ureteral pathology. Ureteral embolization is performed in patients with unresectable tumors of the pelvis with long-standing nephrostomy tubes and distal urine leaks refractory to other treatments. Coils, gelfoam and liquid embolic materials can be used. Ureteral embolization for ureteral fistulas and incontinence is technically successful in 100% of the patients. Complications include bleeding, infection, ureteral or renal injury, and deployment (or movement) of the coils within the renal pelvis. Percutaneous management of stone disease, including renal, ureteral, and bladder stones requires close cooperation between the urologist and interventional radiologist, because of availability of sonographic lithotripsy

  12. Management of obstructed defecation.

    Science.gov (United States)

    Podzemny, Vlasta; Pescatori, Lorenzo Carlo; Pescatori, Mario

    2015-01-28

    The management of obstructed defecation syndrome (ODS) is mainly conservative and mainly consists of fiber diet, bulking laxatives, rectal irrigation or hydrocolontherapy, biofeedback, transanal electrostimulation, yoga and psychotherapy. According to our experience, nearly 20% of the patients need surgical treatment. If we consider ODS an "iceberg syndrome", with "emerging rocks", rectocele and rectal internal mucosal prolapse, that may benefit from surgery, at least two out of ten patients also has "underwater rocks" or occult disorders, such as anismus, rectal hyposensation and anxiety/depression, which mostly require conservative treatment. Rectal prolapse excision or obliterative suture, rectocele and/or enterocele repair, retrograde Malone's enema and partial myotomy of the puborectalis muscle are effective in selected cases. Laparoscopic ventral sacral colporectopexy may be an effective surgical option. Stapled transanal rectal resection may lead to severe complications. The Transtar procedure seems to be safer, when dealing with recto-rectal intussusception. A multidisciplinary approach to ODS provides the best results.

  13. Sinusoidal obstruction syndrome.

    Science.gov (United States)

    Valla, Dominique-Charles; Cazals-Hatem, Dominique

    2016-09-01

    Sinusoidal obstruction syndrome (SOS) is characterized by damage to small hepatic vessels affecting particularly sinusoidal endothelium. Damaged sinusoids can be associated with a partial or complete occlusion of small hepatic veins, hence the previous denomination of hepatic veno-occlusive disease (VOD). Exposure to certain exogenous toxins appears to be specific to this condition and is frequently included in its definition. Typical histopathological features of SOS in a liver biopsy specimen are presented in the text. The purpose of this article is to provide an overview on the different entities corresponding to this general definition. Such entities include: (i) liver disease related to pyrrolizidine alcaloids; (ii) liver injury related to conditioning for hematopoietic stem cell transplantation; (iii) vascular liver disease occurring in patients treated with chemotherapy for liver metastasis of colorectal cancer; and (iv) other liver diseases related to toxic agents. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  14. Acquired Duodenal Obstruction in Children

    Directory of Open Access Journals (Sweden)

    Jen-Hung Chien

    2008-10-01

    Full Text Available Traumatic intramural hematoma of the duodenum is a rare cause of acquired duodenal obstruction in children, and a high degree of suspicion is therefore required to make an early and accurate diagnosis. We report a 6-year-old boy whose epigastrium was impacted by the handlebar of his bicycle during a traffic accident. The boy then experienced epigastralgia. Six days later, progressive bilious vomiting suggestive of gastrointestinal obstruction was noted. Imaging studies revealed a large hematoma extending from the fourth portion of the duodenum to the jejunum. Conservative methods of treatment failed to manage his condition. He underwent laparoscopic surgery to evacuate the hematoma. We also report a case of duodenal obstruction in a previously healthy 2-year-old girl who presented for the first time with acute symptoms of proximal intestinal obstruction. Contrast examinations showed apparent barium retention over the stomach and proximal duodenum. She underwent surgery due to persistent obstruction, and a mushroom-like foreign body was detected embedded in the orifice of the windsock duodenal web. After duodenoduodenostomy and removal of the bezoar, she had a smooth recovery and tolerated feeding well. We conclude that blunt abdominal trauma and incomplete duodenal obstruction, such as that caused by duodenal web, should be considered as possible causes of acquired proximal gastrointestinal obstruction in previously healthy children, despite their rarity.

  15. Chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2013-01-01

    Full Text Available The global prevalence of physiologically defined chronic obstructive pulmonary disease (COPD in adults aged >40 yr is approximately 9-10 per cent. Recently, the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults had shown that the overall prevalence of chronic bronchitis in adults >35 yr is 3.49 per cent. The development of COPD is multifactorial and the risk factors of COPD include genetic and environmental factors. Pathological changes in COPD are observed in central airways, small airways and alveolar space. The proposed pathogenesis of COPD includes proteinase-antiproteinase hypothesis, immunological mechanisms, oxidant-antioxidant balance, systemic inflammation, apoptosis and ineffective repair. Airflow limitation in COPD is defined as a postbronchodilator FEV1 (forced expiratory volume in 1 sec to FVC (forced vital capacity ratio <0.70. COPD is characterized by an accelerated decline in FEV1. Co morbidities associated with COPD are cardiovascular disorders (coronary artery disease and chronic heart failure, hypertension, metabolic diseases (diabetes mellitus, metabolic syndrome and obesity, bone disease (osteoporosis and osteopenia, stroke, lung cancer, cachexia, skeletal muscle weakness, anaemia, depression and cognitive decline. The assessment of COPD is required to determine the severity of the disease, its impact on the health status and the risk of future events (e.g., exacerbations, hospital admissions or death and this is essential to guide therapy. COPD is treated with inhaled bronchodilators, inhaled corticosteroids, oral theophylline and oral phosphodiesterase-4 inhibitor. Non pharmacological treatment of COPD includes smoking cessation, pulmonary rehabilitation and nutritional support. Lung volume reduction surgery and lung transplantation are advised in selected severe patients. Global strategy for the diagnosis, management and prevention of Chronic Obstructive Pulmonary Disease

  16. Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    LENUS (Irish Health Repository)

    Lee, Ruth

    2011-03-01

    Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome.

  17. Collateral circulations in inferior vena cava obstruction

    International Nuclear Information System (INIS)

    Lee, Jong Beum; Park, Jae Hyung; Han, Man Chung; Park, Soo Soung

    1985-01-01

    Obstruction of the inferior vena cava (IVC) is an uncommon condition, and the collateral pathway varies according to the level, extent, duration and the cause of obstruction. Membranous obstruction of IVC in its hepatic portion might be one of the principle cause among Korean, though not reported till now. Analytical study was performed in 26 cases of IVC obstruction with various cause. 1. The level of the obstruction showed relatively even distribution as follows, upper caval in 11 cases, middle caval in 6 cases and infrarenal in 9 cases. 2. The main cause of upper caval obstruction was membranous obstruction. 3. As a whole, the main collateral pathway was the central route (22 cases: 85%). 4. Characteristic collateral pathway unique to upper caval obstruction was transhepatic venous collateral, developed between the obstructed segment and unobstructed segment of IVC. 5. Scalloping of left cardiac border produced by pericardiophrenic venous collateral was characteristic simple chest x-ray finding in IVC obstruction

  18. Surgical management of nasal obstruction.

    Science.gov (United States)

    Moche, Jason A; Palmer, Orville

    2012-05-01

    The proper evaluation of the patient with nasal obstruction relies on a comprehensive history and physical examination. Once the site of obstruction is accurately identified, the patient may benefit from a trial of medical management. At times however, the definitive treatment of nasal obstruction relies on surgical management. Recognizing the nasal septum, nasal valve, and turbinates as possible sites of obstruction and addressing them accordingly can dramatically improve a patient's nasal breathing. Conservative resection of septal cartilage, submucous reduction of the inferior turbinate, and structural grafting of the nasal valve when appropriate will provide the optimal improvement in nasal airflow and allow for the most stable results. Copyright © 2012. Published by Elsevier Inc.

  19. Bolus obstruction by Ascaris lumbricoides

    African Journals Online (AJOL)

    In 67 cases conservative treatment was successful. ... bolus of worms, biliary ascariasis,3.6 pancreatitis and acute ... or chronic granulomatous peritonitis is rare.i These complica- ... obstruction admitted to the paediatric surgical wards of the.

  20. Barrier Systems

    NARCIS (Netherlands)

    Heteren, S. van

    2015-01-01

    Barrier-system dynamics are a function of antecedent topography and substrate lithology, Relative sea-level (RSL) changes, sediment availability and type, climate, vegetation type and cover, and various aero- and hydrodynamic processes during fair-weather conditions and extreme events. Global change

  1. Intrabilary obstruction by colorectal metastases

    OpenAIRE

    Traeger, Luke; Kiroff, George

    2018-01-01

    Abstract Intrabiliary colorectal metastases are rare. We present a case of an 84-year-old man who developed obstructive jaundice secondary to intrabiliary growth of colorectal metastases. The patient presented with three weeks of jaundice and significant weight loss in the preceding months. The patient’s background included metastatic colorectal carcinoma, with a previous right hemicolectomy and left hepatectomy for liver metastases. A MRCP showed an obstruction of the biliary tract transitio...

  2. Chronic intestinal pseudo-obstruction.

    Science.gov (United States)

    Gabbard, Scott L; Lacy, Brian E

    2013-06-01

    Chronic intestinal pseudo-obstruction (CIP) is a rare and serious disorder of the gastrointestinal (GI) tract characterized as a motility disorder with the primary defect of impaired peristalsis; symptoms are consistent with a bowel obstruction, although mechanical obstruction cannot be identified. CIP is classified as a neuropathy, myopathy, or mesenchymopathy; it is a neuropathic process in the majority of patients. The natural history of CIP is generally that of a progressive disorder, although occasional patients with secondary CIP note significant symptomatic improvement when the underlying disorder is identified and treated. Symptoms vary from patient to patient depending on the location of the luminal GI tract involved and the degree of involvement; however, the small intestine is nearly always involved. Common symptoms include dysphagia, gastroesophageal reflux, abdominal pain, nausea, vomiting, bloating, abdominal distension, constipation or diarrhea, and involuntary weight loss. Unfortunately, these symptoms are nonspecific, which can contribute to misdiagnosis or a delay in diagnosis and treatment. Since many of the symptoms and signs suggest a mechanical bowel obstruction, diagnostic tests typically focus on uncovering a mechanical obstruction, although routine tests do not identify an obstructive process. Nutrition supplementation is required for many patients with CIP due to symptoms of dysphagia, nausea, vomiting, and weight loss. This review discusses the epidemiology, etiology, pathogenesis, diagnosis, and treatment of patients with CIP, with an emphasis on nutrition assessment and treatment options for patients with nutrition compromise.

  3. Obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Steven D. Brass

    2011-11-01

    Full Text Available Obstructive sleep apnea (OSA affects millions of Americans and is estimated to be as prevalent as asthma and diabetes. Given the fact that obesity is a major risk factor for OSA, and given the current global rise in obesity, the prevalence of OSA will increase in the future. Individuals with sleep apnea are often unaware of their sleep disorder. It is usually first recognized as a problem by family members who witness the apneic episodes or is suspected by their primary care doctor because of the individual’s risk factors and symptoms. The vast majority remain undiagnosed and untreated, despite the fact that this serious disorder can have significant consequences. Individuals with untreated OSA can stop breathing hundreds of times a night during their sleep. These apneic events can lead to fragmented sleep that is of poor quality, as the brain arouses briefly in order for the body to resume breathing. Untreated, sleep apnea can have dire health consequences and can increase the risk of hypertension, diabetes, heart disease, and heart failure. OSA management has also become important in a number of comorbid neurological conditions, including epilepsy, stroke, multiple sclerosis, and headache. Diagnosis typically involves use of screening questionnaires, physical exam, and an overnight polysomnography or a portable home study. Treatment options include changes in lifestyle, positive airway pressure, surgery, and dental appliances.

  4. Obstructive sleep apnea.

    Science.gov (United States)

    Ho, Matthew L; Brass, Steven D

    2011-11-29

    Obstructive sleep apnea (OSA) affects millions of Americans and is estimated to be as prevalent as asthma and diabetes. Given the fact that obesity is a major risk factor for OSA, and given the current global rise in obesity, the prevalence of OSA will increase in the future. Individuals with sleep apnea are often unaware of their sleep disorder. It is usually first recognized as a problem by family members who witness the apneic episodes or is suspected by their primary care doctor because of the individual's risk factors and symptoms. The vast majority remain undiagnosed and untreated, despite the fact that this serious disorder can have significant consequences. Individuals with untreated OSA can stop breathing hundreds of times a night during their sleep. These apneic events can lead to fragmented sleep that is of poor quality, as the brain arouses briefly in order for the body to resume breathing. Untreated, sleep apnea can have dire health consequences and can increase the risk of hypertension, diabetes, heart disease, and heart failure. OSA management has also become important in a number of comorbid neurological conditions, including epilepsy, stroke, multiple sclerosis, and headache. Diagnosis typically involves use of screening questionnaires, physical exam, and an overnight polysomnography or a portable home study. Treatment options include changes in lifestyle, positive airway pressure, surgery, and dental appliances.

  5. Obstructive sleep apnea.

    Science.gov (United States)

    White, David P; Younes, Magdy K

    2012-10-01

    Obstructive sleep apnea (OSA) is a common disorder characterized by repetitive collapse of the pharyngeal airway during sleep. Control of pharyngeal patency is a complex process relating primarily to basic anatomy and the activity of many pharyngeal dilator muscles. The control of these muscles is regulated by a number of processes including respiratory drive, negative pressure reflexes, and state (sleep) effects. In general, patients with OSA have an anatomically small airway the patency of which is maintained during wakefulness by reflex-driven augmented dilator muscle activation. At sleep onset, muscle activity falls, thereby compromising the upper airway. However, recent data suggest that the mechanism of OSA differs substantially among patients, with variable contributions from several physiologic characteristics including, among others: level of upper airway dilator muscle activation required to open the airway, increase in chemical drive required to recruit the pharyngeal muscles, chemical control loop gain, and arousal threshold. Thus, the cause of sleep apnea likely varies substantially between patients. Other physiologic mechanisms likely contributing to OSA pathogenesis include falling lung volume during sleep, shifts in blood volume from peripheral tissues to the neck, and airway edema. Apnea severity may progress over time, likely due to weight gain, muscle/nerve injury, aging effects on airway anatomy/collapsibility, and changes in ventilatory control stability. © 2012 American Physiological Society

  6. Information barriers

    International Nuclear Information System (INIS)

    Fuller, J.L.; Wolford, J.

    2001-01-01

    Full text: An information barrier (IB) consists of procedures and technology that prevent the release of sensitive information during a joint inspection of a sensitive nuclear item, and provides confidence that the measurement system into which it has been integrated functions exactly as designed and constructed. Work in the U.S. on radiation detection system information barriers dates back at least to 1990, even though the terminology is more recent. In January 1999 the Joint DoD-DOE Information Barrier Working Group was formed in the United States to help coordinate technical efforts related to information barrier R and D. This paper presents an overview of the efforts of this group, by its Chairs, as well as recommendations for further information barrier R and D. Progress on the demonstration of monitoring systems containing IBs is also provided. From the U.S. perspective, the basic, top-level functional requirements for the information barrier portion of an integrated radiation signature-information barrier inspection system are twofold: The host must be assured that his classified information is protected from disclosure to the inspecting party; and The inspecting party must be confident that the integrated inspection system measures, processes, and presents the radiation-signature-based measurement conclusion in an accurate and reproducible manner. It is the position of the United States that in the absence of any agreement to share classified nuclear weapons design information in the conduct of an inspection regime, the requirement to protect host country classified warhead design information is paramount and admits no tradeoff versus the confidence provided to the inspecting party in the accuracy and reproducibility of the measurements. The U.S. has reached an internal consensus on several critical design elements that define a general standard for radiation signature information barrier design. These criteria have stood the test of time under intense

  7. Floating barrier

    Energy Technology Data Exchange (ETDEWEB)

    1968-05-06

    This floating barrier consists of relatively long elements which can be connected to form a practically continuous assembly. Each element consists of an inflatable tube with an apron of certain height, made of impregnated fabric which is resistant to ocean water and also to hydrocarbons. Means for connecting one element to the following one, and means for attaching ballast to the apron are also provided.

  8. Computed tomography of obstructive jaundice

    International Nuclear Information System (INIS)

    Suh, Jung Hek; Lee, Joong Suk; Chun, Beung He; Suh, Soo Jhi

    1982-01-01

    It is well known that the computed tomography (CT) is very useful in the evaluation of obstructive jaundice. We have studied 55 cases of obstructive jaundice with whole body scanner from Jun.1980 to Jun. 1981. The results were as follows: 1. The sex distribution was 36 males and 19 females, and 40 cases of obstructive jaundice were seen in fifth, sixth, and seventh decades. 2. Causes of obstructive jaundice were 25 cases of pancreas cancer, 8 cases of common duct cancer, 4 cases of gallbladder cancer, 4 cases of ampulla vater cancer, 12 cases of common duct stone, and 2 cases of common duct stricture. 3. Levels of obstruction were 8 cases of hepatic portion, 15 cases of suprapancreatic portion, 28 cases of pancreatic portion, and 4 cases of ampullary portion. 4. In tumorous condition, CT demonstrated metastasis of other organs, 9 cases of the liver, 1 case of the lung, 3 cases of the pancreas, 3 cases of the common bile duct, 1 case of the stomach, and 12 cases of adjacent lymph nodes. 5. Associated diseases were 12 cases of intrahepatic stone, 4 cases of clonorchiasis, 2 cases of pancreas pseudocyst, 1 cases of hydronephrosis, and 1 case of renal cyst

  9. Magnetic resonance in obstructive jaundice

    International Nuclear Information System (INIS)

    Gupta, R.K.; Jena, A.; Khushu, S.; Kakar, A.K.; Mishra, P.K.

    1989-01-01

    Twelve cases of obstructive jaundice in whom ultrasound failed to demonstrate the site and/or the cause of obstruction of the biliary tract were examined with magnetic resonance imaging (MRI), correctly diagnosing the site and cause of obstruction in 10 of 12 surgically proven cases. In one case of cholangiocarcinoma, the site of obstruction was well shown on MR but a definite cause could not be ascertained. In another patient who developed intermittent jaundice following surgery for choledochal cyst, MR demonstrated a solitary stone in the common hepatic duct. Surgical confirmation could not be achieved as the patient was lost to follow up. There were 6 cases of choledocholithiasis, 3 cases of gall bladder carcinoma and one case each of pancreatic adenocarcinoma and cholangiocarcinoma. It is believed that MRI will provide obstructive jaundice and will be able to minimize the use of percutaneous transhepatic cholangiography (PTC) and endoscopic retrograde cholangiopancreatography (ERCP) in view of its ability to perform multiplanar imaging in multiple sequences. 11 refs., figs., 1 tab

  10. Smart parking barrier

    KAUST Repository

    Alharbi, Abdulrazaq M.

    2016-01-01

    positioning of the movable parking barrier, and a parking controller configured to initiate movement of the parking barrier, via the barrier drive. The movable parking barrier can be positioned between a first position that restricts access to the parking

  11. Perceived Online Education Barriers of Administrators and Faculty at a U.S. University in Lebanon

    Science.gov (United States)

    El Turk, Sahar; Cherney, Isabelle D.

    2016-01-01

    The purpose of this quantitative study was to identify the perceived barriers obstructing the implementation of online education by administrators and faculty at the School of Arts and Sciences of a U.S. university located in Lebanon. The aim of this study was to offer a solution to the most important perceived barriers to online education that…

  12. Barrier-beliefs about physical activity in active and inactive adults : an explorative study

    NARCIS (Netherlands)

    Bouma, Adrie

    2018-01-01

    Objectives: Perceived barriers are often a reason why people do not start physical activity or relapse to inactivity. From a psychological perspective, barriers can be seen as beliefs about what is obstructing people’s behavior. To understand inactivity and relapse from physical activity, this study

  13. Ultrasonographic Demonstration of Intestinal Obstruction

    International Nuclear Information System (INIS)

    Lee, Dong Hoo; Choi, Hyae Seoun; Kim, S. K.; Han, S.U.; Park, K. S.; Park, H. N.

    1982-01-01

    The cardinal feature of intestinal obstruction is the intraluminal fluid accumulation within the bowel segments. The presence of air simply makes it easier to find dilated fluid-filled bowel loop on plain radiographic films. Distended fluid-filed loop, however, may be obscure on X-ray film when gas is absent, secondary to vomiting, or to cessation of air swallowing. furthermore, in closed loop obstruction, air cannot enter the involved bowel, and thereby in this situation gray scale ultrasonography may be a useful device in making a rapid diagnosis. By sonographic confirmations of intestinal obstruction, a tonic, fluid-filled bowel loops usually were revealed as multiple, circular or cylindrical cystic structures with a finely irregular wall. Valvulae connivente sexhibit a characteristic key-board appearance when they project into the fluid-filled lumen

  14. Scintigraphic visualization of bacterial translocation in experimental strangulated intestinal obstruction

    International Nuclear Information System (INIS)

    Galeev, Yu.M.; Popov, M.V.; Salato, O.V.; Lishmanov, Yu.B.; Grigorev, E.G.; Aparcin, K.A.

    2009-01-01

    The purpose of this study was to obtain scintigraphic images depicting translocation of 99m Tc-labelled Escherichia coli bacteria through the intestinal barrier and to quantify this process using methods of nuclear medicine. Thirty male Wistar rats (including 20 rats with modelled strangulated intestinal obstruction and 10 healthy rats) were used for bacterial scintigraphy. 99m Tc-labelled E. coli bacteria ( 99m Ts-E. coli) with an activity of 7.4-11.1 MBq were administered into a section of the small intestine. Scintigraphic visualization of bacterial translocation into organs and tissues of laboratory animals was recorded in dynamic (240 min) and static (15 min) modes. The number of labelled bacteria, which migrated through the intestinal barrier, was quantified by calculating the translocation index (TI). Control indicated no translocation of 99m Ts-E. coli administered into the intestine through the parietes of the small intestine's distal part in healthy animals. Animals with strangulated obstruction demonstrated different migration strength and routes of labelled bacteria from strangulated and superior to strangulation sections of the small intestine. 99m Ts-E. coli migrated from the strangulated loop into the peritoneal cavity later causing systemic bacteraemia through peritoneal resorption. The section of the small intestine, which was superior to the strangulation, demonstrated migration of labelled bacteria first into the portal and then into the systemic circulation. The strangulated section of the small intestine was the main source of bacteria dissemination since the number of labelled bacteria, which migrated from this section significantly, exceeded that of the area superior to the strangulation section of the small intestine (p = 0.0003). Bacterial scintigraphy demonstrated the possibility of visualizing migration routes of labelled bacteria and quantifying their translocation through the intestinal barrier. This approach to study bacterial

  15. Prosthodontic Approach to Treat Obstructive Sleep Apnea ...

    African Journals Online (AJOL)

    Prosthodontic Approach to Treat Obstructive Sleep Apnea. ... Annals of Medical and Health Sciences Research ... disordered breathing represents a continuum, ranging from simple snoring sans sleepiness, upper‑airway resistance syndrome, obstructive sleep apnea (OSA) syndrome, to hypercapnic respiratory failure.

  16. Chronic obstructive pulmonary disease - adults - discharge

    Science.gov (United States)

    ... coughing up dark mucus Your fingertips or the skin around your fingernails are blue Alternative Names COPD - adults - discharge; Chronic obstructive airways disease - adults - discharge; Chronic obstructive lung disease - adults - discharge; ...

  17. Adult small bowel obstruction.

    Science.gov (United States)

    Taylor, Mark R; Lalani, Nadim

    2013-06-01

    Small bowel obstruction (SBO) is a clinical condition that is often initially diagnosed and managed in the emergency department (ED). The high rates of potential complications that are associated with an SBO make it essential for the emergency physician (EP) to make a timely and accurate diagnosis. The primary objective was to perform a systematic review and meta-analysis of the history, physical examination, and imaging modalities associated with the diagnosis of SBO. The secondary objectives were to identify the prevalence of SBO in prospective ED-based studies of adult abdominal pain and to apply Pauker and Kassirer's threshold approach to clinical decision-making to the diagnosis and management of SBO. MEDLINE, EMBASE, major emergency medicine (EM) textbooks, and the bibliographies of selected articles were scanned for studies that assessed one or more components of the history, physical examination, or diagnostic imaging modalities used for the diagnosis of SBO. The selected articles underwent a quality assessment by two of the authors using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Data used to compile sensitivities and specificities were obtained from these studies and a meta-analysis was performed on those that examined the same historical component, physical examination technique, or diagnostic test. Separate information on the prevalence and management of SBO was used in conjunction with the meta-analysis findings of computed tomography (CT) to determine the test and treatment threshold. The prevalence of SBO in the ED was determined to be approximately 2% of all patients who present with abdominal pain. Having a previous history of abdominal surgery, constipation, abnormal bowel sounds, and/or abdominal distention on examination were the best history and physical examination predictors of SBO. X-ray was determined to be the least useful imaging modality for the diagnosis of SBO, with a pooled positive likelihood ratio (+LR

  18. Obstructive Sleep Apnea Hypopnea Syndrome

    African Journals Online (AJOL)

    hanumantp

    Obstructive sleep apnea hypopnea syndrome (OSAHS) is an important medical condition brought to limelight in the last five decades.[1] It is a major cause of morbidity and significant cause of mortality worldwide, including developed and developing nations. A survey done in Abuja, Nigeria,[2] showed that OSAHS may be a ...

  19. Wallstents for metastatic biliary obstruction

    NARCIS (Netherlands)

    van Berkel, A. M.; Bergman, J. J.; Waxman, I.; Andres, P.; Huibregtse, K.

    1996-01-01

    In patients with obstruction of the common bile duct caused by primary pancreaticoblliary tumors, Wallstents have been shown to remain patent for a median duration of 273 days (range: 14-363). However, in one study that included both patients with primary pancreaticobillary malignancies and patients

  20. Oxidative stress in obstructive nephropathy

    NARCIS (Netherlands)

    Dendooven, Amelie; Ishola, David A.; Nguyen, Tri Q.; Van der Giezen, Dionne M.; Kok, Robbert Jan; Goldschmeding, Roel; Joles, Jaap A.

    P>Unilateral ureteric obstruction (UUO) is one of the most commonly applied rodent models to study the pathophysiology of renal fibrosis. This model reflects important aspects of inflammation and fibrosis that are prominent in human kidney diseases. In this review, we present an overview of the

  1. Obstruction theory on 8-manifolds

    Czech Academy of Sciences Publication Activity Database

    Čadek, M.; Crabb, M.; Vanžura, Jiří

    2008-01-01

    Roč. 127, č. 2 (2008), s. 167-186 ISSN 0025-2611 R&D Projects: GA ČR GA201/05/2117 Institutional research plan: CEZ:AV0Z10190503 Keywords : 8-manifolds * obstruction theory Subject RIV: BA - General Mathematics Impact factor: 0.509, year: 2008

  2. Anaesthesia and subglottic airway obstruction

    African Journals Online (AJOL)

    2009-07-14

    Jul 14, 2009 ... Introduction. Surgery on the upper airway remains challenging for both surgeon and ... from her upper airway obstruction rather than asthma.1 She had made a long ... patient was well oxygenated with oxygen saturation above. 95%. .... Difficulties relate to tidal volume measurement, CO2 detection and the.

  3. Unusual causes of obstructive jaundice. Computed tomography

    International Nuclear Information System (INIS)

    Rodriguez, E.; Pombo, F.; Cao, I.; Fernandez, R.; Riba da, M.

    1998-01-01

    The purpose of this study is to present selected computed tomography (CT) images showing unusual causes of obstructive jaundice. We reviewed retrospectively the Ct findings of obstructive jaundice in 227 patients. The most common causes of biliary obstruction were adenocarcinoma of the pancreatic head (n=77) and cholangiocarcinoma (n=65). In 13 cases (5.7%), the etiology of obstructive jaundice was unusual or exceptional: tuberculous adenitis (n=3), obstruction of afferent loop (n=2)signet ring cell adenocarcinoma (n=3); in duodenum, gallbladder and papilla of Water), Mirizzi syndrome (n=1), adenocarcinoma of the hepatic flexure (n=1), choledochal cyst (n=1) and pancreatic lymphoma (n=1). (Author) 13 refs

  4. Optimization of mechanical properties of non-woven short sisal fibre ...

    Indian Academy of Sciences (India)

    fibre-reinforced vinyl ester composite using factorial design and GA method ... fibre is extracted from the plant Agave sisalana and is avai- lable in abundant quantity ..... Sotton M and Ferrari M 1989 L'industrie Textile 1197 58. Woodhams R T ...

  5. Production of a textile reinforced concrete protective layers with non-woven polypropylene fabric

    Science.gov (United States)

    Žák, J.; Štemberk, P.; Vodička, J.

    2017-09-01

    Textile concrete with nonwoven polypropylene fabric can be used for protective layers of reinforced concrete structures, reducing the thickness of the cover layer or reducing the water penetration rate into the structure. The material consists of cement matrix with finegrained aggregate and nonwoven textile reinforcement. The maximum grain size of the mixture suitable for the nonwoven textile infiltration is 0.25 mm. The interlayer contains larger aggregates and short fibers. Tensile loading causes a large amount of microcracks in the material. The material can withstand strain over 25% without collapsing. Increased quality and water-cement ratio reduction was achieved using the plasticizers and distribution of the mixture into a fabric using a vibrating trowel. It is possible to make flat plates and even curved structures from this material. Larger curvatures of structures should be solved by cutting and overlapping the fabric. Small curvatures can be solved within the deformability of the fabric. Proper infiltration of the cement mixture into the fabric is the most important task in producing this material.

  6. Development of thermoresponsive non-woven 3D scaffold for smart cell culture

    CSIR Research Space (South Africa)

    Mahlangu, T

    2012-10-01

    Full Text Available morphology of the NWF scaffolds. 2-2-Diphenyl-1-picrylhydrazyl (DPPH), a stable free radical, was used to quantify the amount of peroxy free radicals on the oNWF. Scheme 1: A schematic representation showing the possible mechanism for oxyfluorination... 2: Typical ATR-FTIR spectra of pNWF, oNWF, PP-g-PNIPAAm (gNWF) and PNIPAAm homopolymer It is well-known that oxyfluorination produces peroxy free radicals on polymer surfaces. After oxyfluorination, new bands were observed on the oNWF at 3 700...

  7. Estimation of axial stiffness of plant fibres from compaction of non-woven mats

    International Nuclear Information System (INIS)

    Gamstedt, E K; Bommier, E; Madsen, B

    2014-01-01

    Plant fibres are known to show a large variability in stiffness, which makes it time-consuming to experimentally characterize this property by conventional tensile testing. In this work, an alternative method is used, where the average fibre stiffness is back-calculated from compaction tests of in-plane randomly oriented fibre mats. The model by Toll is used to relate the load–displacement curve from the test to the Young modulus of the fibre, taking into account the natural variability in fibre cross section. Several tests have been performed on hemp fibre mats and compared with results from single-fibre tensile testing. The average back-calculated Young's modulus of the fibres was 45 GPa, whereas the average value from tensile testing ranged from 30 to 60 GPa. The straightforward compaction test can be useful in ranking of fibre stiffness, provided that the mat is composed of well-separated fibres and not of twisted yarns. (paper)

  8. REMOVING BIOMASS FROM WATER PONDS AND SMALL WATER RESERVOIRS BY USING NON-WOVEN FILTERS

    Directory of Open Access Journals (Sweden)

    Jakub Nieć

    2015-10-01

    Full Text Available Small water bodies, for example garden ponds, play many functions in the environment, including biocenotic, hydrological, climatic, sozological, landfill-creative, and aesthetic. Due to their small size, these reservoirs are sensitive to external and internal factors, they are also a common natural contaminants receivers. Nonwoven filters have been investigated for several years as a useful device for treatment of domestic wastewater pre-treated in a septic tank. The aim of this study was to verify the possibility of using this type of filters for water originating from small water body purification. The effectiveness of filters were tested on the water originating from the garden pond, contained high levels of nutrients and intensive algal bloom. Research was carried out on three filters (each filter consisted of four geotextile TS 20 layers. Basic water quality indicators: total suspended solids, turbidity, COD and BOD5, temperature, pH and dissolved oxygen were measured. The research results can be considered as satisfactory in terms of mechanical treatment (removal of turbidity and total suspended solids. An important positive effect of the filters was the oxygenation of the treated water, which is especially important for fish.

  9. Estimation of axial stiffness of plant fibres from compaction of non-woven mats

    DEFF Research Database (Denmark)

    Gamstedt, E. K.; Bommier, E.; Madsen, Bo

    2014-01-01

    -plane randomly oriented fibre mats. The model by Toll is used to relate the load-displacement curve from the test to the Young modulus of the fibre, taking into account the natural variability in fibre cross section. Several tests have been performed on hemp fibre mats and compared with results from single...

  10. Non-woven PGA/PVA Fibrous Mesh as an Appropriate Scaffold for Chondrocyte Proliferation

    Czech Academy of Sciences Publication Activity Database

    Rampichová, Michala; Košťáková, E.; Filová, Eva; Prosecká, Eva; Plencner, Martin; Ocheretná, L.; Lytvynets, Andriy; Lukáš, D.; Amler, Evžen

    2010-01-01

    Roč. 59, č. 5 (2010), s. 773-781 ISSN 0862-8408 R&D Projects: GA AV ČR IAA500390702; GA ČR GAP304/10/1307 Grant - others:GA UK(CZ) 119209; EU(XE) BIOSCENT ID 214539; GA MŠk(CZ) 1M0510; GA ČR(CZ) GA202/09/1151; GA MŠk(CZ) 2B06130 Program:1M; GA; 2B Institutional research plan: CEZ:AV0Z50390703; CEZ:AV0Z50390512 Keywords : PGA * PVA * chondrocyte Subject RIV: BO - Biophysics Impact factor: 1.646, year: 2010

  11. The angiographic demonstration of hepatic vein obstruction

    International Nuclear Information System (INIS)

    Zu Maoheng; Xu Hao; Li Guojun; Gu Yuming; Wei Ning; Wang Cheng; Xu Wei

    2004-01-01

    Objective: To evaluate the angiographic feature of hepatic vein obstruction. Methods Forty-five patients (male 23, female 22, age 9-54 years) suffered from hepatic vein obstruction. The inferior vena cavography and the hepatic venography were performed in all cases. Results: IVC was free in 37 patients with hepatic vein obstruction, both IVC and HV were obstructed in 8 patients. The local or long stenosis of IVC was found in 31 inferior vena cavography. The diameter of IVC was normal in 12 patients. The sign of membranous dome was found in hepatic vein orifice in 5 cases and in accessory hepatic vein orifice in 4 cases. Intrahepatic venous collaterals were found in 45 cases. Conclusion: Hepatic vein obstruction can be reproached primarily in inferior vena cavography, the membranous dome is a direct sign of membranous obstruction of HV and AHV in inferior vena cavography. The selected hepatic venography can provide reliable evidence to diagnose hepatic vein obstruction

  12. Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    LENUS (Irish Health Repository)

    Lee, Ruth

    2012-02-01

    PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome. RECENT FINDINGS: The severity of obstructive ventilatory impairment and hyperinflation, especially the inspiratory capacity to total lung capacity (TLC) ratio, correlates with the severity of sleep-related breathing disturbances. Early treatment with continuous positive airway pressure (CPAP) improves survival, reduces hospitalization and pulmonary hypertension, and also reduces hypoxemia. Evidence of systemic inflammation and oxidative stress in COPD and sleep apnea provides insight into potential interactions between both disorders that may predispose to cardiovascular disease. Long-term outcome studies of overlap patients currently underway should provide further evidence of the clinical significance of the overlap syndrome. SUMMARY: Studies of overlap syndrome patients at a clinical, physiological and molecular level should provide insight into disease mechanisms and consequences of COPD and sleep apnea, in addition to identifying potential relationships with cardiovascular disease.

  13. Sprache als Barriere (Language as a Barrier)

    Science.gov (United States)

    Mattheier, Klaus

    1974-01-01

    The concept of language barrier has its derivations in the fields of dialectology, sociology and psychology. In contemporary usage however, the concept has two meanings i.e. regional-cultural barrier and socio-cultural barrier. (Text is in German.) (DS)

  14. Hg uptake in ureteral obstructions

    International Nuclear Information System (INIS)

    Desgrez, J.P.; Bourguignon, M.; Raynaud, C.; CEA, 91 - Orsay

    1976-01-01

    In the presence of a total obstruction the results obtained with the Hg uptake test, as indeed with other functional tests, inform on the value of the kidney function at the time but have no prognostic value where repair possibilities are concerned. Some preliminary results seem to show however that very soon after the obstacle is removed, by the 10th or 15th day perhaps, quantitative functional tests may once more be used to evaluate the functional prognosis. This would mean that by waiting about two weeks after the disappearance of a total obstruction the Hg uptake test may again be used in all confidence. In order to check this deduction, which is based on slender evidence but which nevertheless has important practical implications, the measurement of the Hg uptake rate during the days following removal of the obstacle appears essential. In long-standing partial obstructions the Hg uptake rate gives an accurate assessment of the functional balance and helps considerably in the choice of therapy [fr

  15. Depression and obstructive sleep apnea.

    Science.gov (United States)

    Hobzova, Milada; Prasko, Jan; Vanek, Jakub; Ociskova, Marie; Genzor, Samuel; Holubova, Michaela; Grambal, Ales; Latalova, Klara

    2017-10-01

    Obstructive sleep apnea (OSA), is described as intermittent interruptions or reductions in airflow which are initiated by an incomplete or complete collapse of the upper airways despite respiratory effort. When left untreated, OSA is connected with comorbid conditions, such as cardiovascular and metabolic illnesses. The PubMed database was used to examine papers published until April 2017 using the subsequent terms: "obstructive sleep apnea" or "obstructive sleep apnoea" and "depression" in successive combination with "CPAP (continuous positive airway pressure)", "therapy", "pharmacotherapy", "psychotherapy", "cognitive behavioral therapy" or "quality of life". After assessment for the suitability, 126 articles were chosen. The numerous evidence of a connection between OSA and depressive symptoms, as well as depressive disorder, were found. This connection may be directly or indirectly linked due to the participation of some OSA mediators consequences such as obesity, hypertension, and the decreased quality of life. Patients with the comorbid major depression and OSA reported more severe and longer episodes of depression. Nevertheless, the information on the effect of the treatment of OSA using CPAP on the depressive symptoms was limited. Still, the current state of the art suggests that this treatment decreases the severity of the comorbid depressive symptoms. It is important to evaluate the symptoms of depression in the patients with OSA. On the other side, a psychiatrist should not just treat the depression, as it is also important to screen individuals at high risk of OSA when assessing patients for depressive disorder, especially those with depression resistant to treatment.

  16. Obstructive Sleep Apnea in MPS

    Directory of Open Access Journals (Sweden)

    Abhijit Ricky Pal MBBChir, MA, MD, FRCS(ORL-HNS

    2015-11-01

    Full Text Available The mucopolysaccharidoses (MPSs are a group of inherited, metabolic disorders characterized by progressive multisystem accumulation of partially degraded glycosaminoglycans. This manifests with multilevel airway obstruction, presenting with obstructive sleep apnea (OSA. We systematically reviewed the literature to determine the severity and prevalence of OSA in MPS based on polysomnography analysis. Fifteen studies with 294 participants met the inclusion criteria for review. The pretreatment prevalence of OSA in MPS was 81% with a mean apnea–hypopnea index (AHI of 10.4. Patients with MPS I are most significantly affected, with 75% suffering with moderate to severe OSA (mean AHI, 16.6. Enzyme replacement therapy (ERT results in an almost significant reduction in OSA in MPS I ( P = .06, while adenotonsillar surgery significantly improves AHI ( P = .002. Obstructive sleep apnea least affects MPS III. There is a lack of long-term post-ERT and hematopoietic stem cell transplant data relating to OSA outcomes in this population, with further prospective studies required to determine the ongoing response to treatment.

  17. Inferior vena cava obstruction and shock

    Directory of Open Access Journals (Sweden)

    Megri Mohammed

    2018-01-01

    Full Text Available Shock is one of the most challenging life-threatening conditions with high mortality and morbidity; the outcomes are highly dependent on the early detection and management of the condition. Septic shock is the most common type of shock in the Intensive Care Unit. While not as common as other subsets of shock, obstructive shock is a significant subtype due to well defined mechanical and pathological causes, including tension pneumothorax, massive pulmonary embolism, and cardiac tamponade. We are presenting a patient with obstructive shock due to inferior vena cava obstruction secondary to extensive deep venous thrombosis. Chance of survival from obstructive shock in our patient was small; however, there was complete and immediate recovery after treatment of the obstruction on recognizing the affected vessels. This case alerts the practicing intensivist and the emergency medicine physician to consider occlusion of the great vessels other than the pulmonary artery or aorta as causes of obstructive shock.

  18. Airways obstruction, coal mining, and disability.

    OpenAIRE

    Lapp, N L; Morgan, W K; Zaldivar, G

    1994-01-01

    It has recently been suggested that the inhalation of coal in the absence of complicated coal workers' pneumoconiosis (CWP) or smoking can lead to disabling airways obstruction. The cause of such obstruction has been variously attributed to emphysema or bronchitis. The frequency of significant airways obstruction in a group of United States coal miners seeking compensation for occupationally induced pulmonary impairment was therefore determined. In a sample of 611 "Black Lung" claimants there...

  19. Managing neonatal bowel obstruction: clinical perspectives

    Directory of Open Access Journals (Sweden)

    Desoky SM

    2018-02-01

    Full Text Available Sarah M Desoky,1 Ranjit I Kylat,2 Unni Udayasankar,1 Dorothy Gilbertson-Dahdal1 1Department of Medical Imaging, University of Arizona College of Medicine, Tucson, AZ, USA; 2Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Arizona College of Medicine, Tucson, AZ, USA Abstract: Neonatal intestinal obstruction is a common surgical emergency and occurs in approximately 1 in 2,000 live births. The causes of obstruction are diverse with varied embryological origins, and some underlying etiologies are not yet well described. Some findings of neonatal bowel obstruction can be detected prenatally on ultrasound imaging. The obstruction is classified as “high” when the level of obstruction is proximal to the ileum, and “low” when the level of obstruction is at the ileum or colon. Early diagnosis of the type of intestinal obstruction and localization of the obstructive bowel segment guides timely and appropriate management of the underlying pathologic entity. Neonatal bowel obstructions are ideally managed at specialized centers with a large volume of neonatal surgery and dedicated pediatric surgical and anesthesia expertise. Although surgical intervention is necessary in most cases, initial management strategies often target underlying metabolic, cardiac, or respiratory abnormalities. Imaging plays a key role in early and accurate diagnosis of the abnormalities. When bowel obstruction is suspected clinically, initial imaging workup usually involves abdominal radiography, which may direct further evaluation with fluoroscopic examination such as upper gastrointestinal (UGI contrast study or contrast enema. This article provides a comprehensive review of clinical and radiological features of common and less common causes of intestinal obstruction in the neonatal age group, including esophageal atresia, enteric duplication cysts, gastric volvulus, congenital microgastria, hypertrophic pyloric stenosis, duodenal atresia

  20. Unusual causes of mechanical small bowel obstruction

    International Nuclear Information System (INIS)

    Shatnawi, Nawaf J.; Bani-Hani, Kamal E.

    2005-01-01

    We herein report our experience regarding unusual causes of bowel obstruction to increase the awareness of surgeons regarding this disease. From 1991 to 2003, we had experience at the University affiliated hospitals, northern Jordan with 24 patients with small bowel obstruction resulting from unusual causes. We retrospectively reviewed the medical records of these patients with regards to the mode of presentation, cause of obstruction, radiological and operative findings, management and outcome. We recorded 15 patients who underwent previous abdominal surgery. Preoperative diagnosis was correct in only one patient with an internal hernia, but the abdominal CT scan suggested the diagnosis in 5 of the 9 patients who had the scan. The final diagnosis was internal hernias in 11 patients, foreign bodies in 5, ischemic strictures in 3, carcinoid tumors in 2, endometriosis in 2, and metastatic deposit from interstitial bladder carcinoma in one patient. Nine of the 12 patients with recurrent obstruction had either short course or recurrence obstruction during the same hospital admission. W carried out bowel resections in 15 patients (5 resections were due to bowel strangulation). Post operative death occurred in 4 patients. Awareness of these rare causes of intestinal obstruction even in patients with previous abdominal operation might improve the outcome. The tentative diagnosis of adhesion obstruction in patients with unusual obstructive etiology might lead to a higher rate of gangrenous complications. Rigorous preoperative evaluation including careful history and early abdominal CT may show the obstructive cause. (author)

  1. A etiological factors in mechanical intestinal obstruction

    International Nuclear Information System (INIS)

    Asad, S.; Khan, H.; Khan, I.A.; Ghaffar, S.; Rehman, Z.U.

    2012-01-01

    Background: Intestinal obstruction occurs when the normal flow of intestinal contents is interrupted. The most frequent causes of intestinal obstruction are postoperative adhesions and hernias, which cause extrinsic compression of the intestine. Less frequently, tumours or strictures of the bowel can cause intrinsic blockage. Objective of the study was to find out the various a etiological factors of mechanical intestinal obstruction and to evaluate the morbidity and mortality in adult patients presenting to Surgical 'A' unit of Ayub teaching hospital with mechanical intestinal obstruction. Methods: This cross-sectional study was conducted from March 2009 to September, 2009. All patients presenting with intestinal obstruction and were above the age of 12 years were included in the study. Patients with non-mechanical obstruction were excluded from the study and those who responded to conservative measures were also excluded. Results: A total of 36 patients with age ranging from 12 to 80 years (Mean age 37.72+-19.74 years) and male to female ratio of 1.77:1, were treated for mechanical intestinal obstruction. The most common cause for mechanical intestinal obstruction was adhesions (36.1%). Intestinal tuberculosis was the second most common cause (19.4%), while hernias and sigmoid volvulus affected 13.9% patients each. Malignancies were found in 5.6% cases. Conclusion: Adhesions and Tuberculosis are the leading causes of mechanical intestinal obstruction in Pakistan. Although some patients can be treated conservatively, a substantial portion requires immediate surgical intervention. (author)

  2. Adult large bowel obstruction: A review of clinical experience

    African Journals Online (AJOL)

    Background: Adult large bowel obstruction is an infrequent cause of acute obstruction in Africa ... of obstruction varies between regions of the world. .... were obtained for bacteriological culture. ... attachment, as observed in previous studies.

  3. Gastrointestinal obstruction in penguin chicks.

    Science.gov (United States)

    Perpiñán, David; Curro, Thomas G

    2009-12-01

    A 7-day-old gentoo penguin (Pygoscelis papua) was found dead and postmortem examination revealed impaction of the ventriculus with feathers. A review of mortality in gentoo penguin chicks from 1997 to 2007 at that institution revealed another case of feather impaction of the ventriculus in a 4-week-old chick, a sibling of the previous chick. A third case of gastrointestinal impaction occurred in a 24-day-old king penguin (Aptenodytes patagonicus) with omphallitis and enteritis. In this chick, a fibrin mat produced a complete obstruction of the intestine at the level of Meckel's diverticulum.

  4. Multidetector row computed tomography in bowel obstruction. Part 2. Large bowel obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Sinha, R. [Department of Radiology, Glenfield Hospital, Leicester (United Kingdom)]. E-mail: rakesh.sinha@uhl-tr.nhs.uk; Verma, R. [Department of Radiology, Glenfield Hospital, Leicester (United Kingdom)

    2005-10-01

    Large bowel obstruction may present as an emergency as high-grade colonic obstruction and can result in perforation. Perforated large bowel obstruction causes faecal peritonitis, which can result in high morbidity and mortality. Multidetector row computed tomography (MDCT) has the potential of providing an accurate diagnosis of large bowel obstruction. The rapid acquisition of images within one breath-hold reduces misregistration artefacts than can occur in critically ill or uncooperative patients. The following is a review of the various causes of large bowel obstruction with emphasis on important pathogenic factors, CT appearances and the use of multiplanar reformatted images in the diagnostic workup.

  5. Airflow obstruction in young adults in Canada

    DEFF Research Database (Denmark)

    Al-Hazmi, Manal; Wooldrage, Kate; Anthonisen, Nicholas R.

    2007-01-01

    OBJECTIVE: Airflow obstruction is relatively uncommon in young adults, and may indicate potential for the development of progressive disease. The objective of the present study was to enumerate and characterize airflow obstruction in a random sample of Canadians aged 20 to 44 years. SETTING: The ...

  6. Is nonoperative management of adhesive intestinal obstruction ...

    African Journals Online (AJOL)

    Background: Nonoperative management of adhesive intestinal obstruction gives good results in adults but there are scant studies on its outcome in children. This study reports outcomes and experiences with nonoperative and operative management of adhesive intestinal obstruction in children in a resource-poor country.

  7. Real time ultrasonography in obstructive jaundice

    International Nuclear Information System (INIS)

    Cho, Kyung Sik; Kim, Ho Kyun; Sung, Nak Kwan; Kim, Soon Yong

    1982-01-01

    Ultrasonography is a predominantly accurate, relatively simple unique diagnostic method of obstructive jaundice. The ultrasonographic findings of obstructive jaundice are dilated intra- and extrahepatic duct with intraluminal hyper reflective echo or mass in and/ or around the bile duct. The superiority of high resolution real time ultrasonography for the diagnosis of obstructive jaundice is bases on the easy detectability of extra- and intrahepatic bile ducts by its multiple sectional images in a short time, the flexibility of probe and small crystal size. Author evaluated real time sonographic findings 46 obstructive jaundice patients confirmed by surgery or radiographical examinations. The results were: 1. Diameter of extrahepatic duct in obstructive jaundice were varied from normal to 4.0 Cm, mostly 8 to 10 mm in diameter (26%). Degree of dilatation of biliary duct appeared more prominent in cancer patients than other causes of obstruction. 2. The site of obstruction was detected in 85% (39/46) and its common site was common bile duct in 63% (29/46). 3. The diagnostic accuracy of choledocholithiasis and cancer was 82% (22/27) and 44% (4/9), respectively. Diagnostic accuracy of the real time ultrasonography in obstructive jaundice was over all 75% (34/46)

  8. A CLINICAL STUDY OF ADHESIVE INTESTINAL OBSTRUCTION

    OpenAIRE

    Haricharan; Murali Krishna; Koti Reddy; Nara Hari

    2015-01-01

    INTRODUCTION: Adhesive intestinal obstruction is an inevitable complication of abdominal surgeries. It has high morbidity with associated poor quality of life and predisposition to repeated hospitalization. Commonest cause of bowel obstruction in developed countries is postoperative adhesions with extrinsic compression of the intestine. Most of them can be managed conservatively. METHODS: A retrospective study of 30 patients admit...

  9. Danish Register of chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Lange, Peter; Tøttenborg, Sandra Søgaard; Sorknæs, Anne Dichmann

    2016-01-01

    AIM OF DATABASE: The Danish Register of Chronic Obstructive Pulmonary Disease (DrCOPD) is a nationwide database aiming to describe the quality of treatment of all patients with chronic obstructive pulmonary disease (COPD) in Denmark. STUDY POPULATION: DrCOPD comprises data on all patients...

  10. Osteoporosis in chronic obstructive pulmonary disease patients

    DEFF Research Database (Denmark)

    Jørgensen, Niklas Rye; Schwarz, Peter

    2008-01-01

    The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence.......The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence....

  11. 25 CFR 11.435 - Obstructing justice.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Obstructing justice. 11.435 Section 11.435 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Criminal Offenses § 11.435 Obstructing justice. A person commits a misdemeanor if, with...

  12. The baby has not come: obstructed labour

    African Journals Online (AJOL)

    Introduction. This article is about how to recognize obstructed labour and deal with it in a way that preserves the life and health of mother and child. It is for midwives and others who work in maternity care and is based on our experiences in Yei, South Sudan. Obstructed labour means that the baby is too big to pass through ...

  13. Accuracy of abdominal auscultation for bowel obstruction

    DEFF Research Database (Denmark)

    Breum, Birger Michael; Rud, Bo; Kirkegaard, Thomas

    2015-01-01

    AIM: To investigate the accuracy and inter-observer variation of bowel sound assessment in patients with clinically suspected bowel obstruction. METHODS: Bowel sounds were recorded in patients with suspected bowel obstruction using a Littmann(®) Electronic Stethoscope. The recordings were process...

  14. Gastric cancer and obstructive uropathy

    International Nuclear Information System (INIS)

    Saida, Yukihisa; Tsunoda, H.S.; Matsueda, Kiyoshi; Kurosaki, Yoshihisa; Kuramoto, Kenmei

    1990-01-01

    In recent 5 years, we have experienced 24 cases of advanced gastric cancer associated with obstructive uropathy. Included were 19 cases of undifferentiated, 3 cases of differentiated and 2 cases of unknown histological type. Obstructive uropathy is diagnosed based on the typical radiological findings such as dilatation and delayed demonstration of the upper collecting systems. Pathologically, undifferentiated type of gastric cancer had tendency to spread infiltratively along the vessels, nerves and the lymphatics without alteration of the ordinary anatomical structures. In such cases, mucosal surface of the urinary tract tended to be spared in spite of extensive tumor invasion. It was proven that several radiological findings were characteristic of urinary tract involvement secondary to gastric cancer. Either thread-like ureteral stricture by IVU or ring-like appearance of the ureter by CT is one of those typical findings. Renal sinus involvement may occur continuously to diffuse retroperitoneal invasion and it appears as a thickened wall of renal pelvis or soft tissue mass directly extending into the fatty tissue of renal sinus by CT. In such cases IVU has less diagnostic ability because of the lack of mucosal destruction. If the urinary bladder is involved, it typically shows chestnut-bur appearance by IVU and diffuse wall thickening by CT. In cases of advanced gastric cancer, particularly in cases of histologically undifferentiated type, CT and IVU images should be carefully interpreted in consideration of the infiltrative part of tumor extention. (author)

  15. Management of Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2014-03-01

    Full Text Available Obstructive Sleep Apnea (OSA is an important public health problem and is associatedwith considerable morbidity and mortality. Therefore, treatment of this condition is ofparamount importance. The treatment of OSA includes general and behaviouralmeasures, mechanical measures including continuous positive airway pressure(CPAP, Bilevel positive airway pressure (BiPAP and Oral Appliances (OA,pharmacological treatment and surgical procedures. Continuous positive airwaypressure (CPAP treatment reverses the repetitive upper airway obstruction of sleepapnea and associated daytime sleepiness and is the most effective treatment for OSA.However maintaining patient adherence to CPAP therapy is a challenge. Weight lossshould be recommended to overweight patients with OSA, as it has been shown thatweight reduction has additional health benefits. Treatment of underlying medicalconditions such as hypothyroidism or acromegaly has profound effect onapnea/hypopnea index. A subset of patients with OSA may benefit from supplementaloxygen and positional therapy. Presently, there are no effective pharmacotherapeuticagents for treatment of patients with OSA and the role of surgical treatment in OSA iscontroversial. However, pharmacological treatment of persisting residual sleepiness,despite adequate positive airway pressure therapy delivery and adherence, is indicatedand may improve daytime sleepiness.Key words : CPAP, Oral appliances, Modafinil, CPAP complianceUvulopalatopharyngoplasty, positional therapy

  16. Hypertension and obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Phillips CL

    2013-05-01

    Full Text Available Craig L Phillips,1–3 Denise M O'Driscoll4,51Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, Australia; 2National Health and Medical Research Council Center for Integrated Research and Understanding of Sleep, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; 3Discipline of Sleep Medicine, Sydney Medical School, University of Sydney, Sydney, Australia; 4Monash Lung and Sleep, Monash Medical Centre, Monash University, Melbourne, Australia; 5Department of Medicine, Southern Clinical School, Monash University, Melbourne, AustraliaAbstract: Obstructive sleep apnea (OSA is increasingly being recognized as a major health burden with strong focus on the associated cardiovascular risk. Studies from the last two decades have provided strong evidence for a causal role of OSA in the development of systemic hypertension. The acute physiological changes that occur during apnea promote nocturnal hypertension and may lead to the development of sustained daytime hypertension via the pathways of sympathetic activation, inflammation, oxidative stress, and endothelial dysfunction. This review will focus on the acute hemodynamic disturbances and associated intermittent hypoxia that characterize OSA and the potential pathophysiological mechanisms responsible for the development of hypertension in OSA. In addition the epidemiology of OSA and hypertension, as well as the role of treatment of OSA, in improving blood pressure control will be examined.Keywords: obstructive sleep apnea, hypertension, intermittent hypoxia, ambulatory blood pressure, sympathetic activation

  17. Smart parking barrier

    KAUST Repository

    Alharbi, Abdulrazaq M.

    2016-05-06

    Various methods and systems are provided for smart parking barriers. In one example, among others, a smart parking barrier system includes a movable parking barrier located at one end of a parking space, a barrier drive configured to control positioning of the movable parking barrier, and a parking controller configured to initiate movement of the parking barrier, via the barrier drive. The movable parking barrier can be positioned between a first position that restricts access to the parking space and a second position that allows access to the parking space. The parking controller can initiate movement of the movable parking barrier in response to a positive identification of an individual allowed to use the parking space. The parking controller can identify the individual through, e.g., a RFID tag, a mobile device (e.g., a remote control, smartphone, tablet, etc.), an access card, biometric information, or other appropriate identifier.

  18. CT and ERCP diagnosis of obstructive jaundice

    International Nuclear Information System (INIS)

    Wang Dongfang; Cao Ran

    2003-01-01

    Objective: To evaluate some specific CT and ERCP findings for differentiating the nature of biliary obstructive diseases. Methods: In total 85 cases of obstructive jaundice verified by pathology were selected. The CT findings in 45 cases and ERCP features in 68 cases were retrospectively analyzed. Results: Mild dilatation of intrahepatic bile ducts were usually found in benign diseases, while moderately or severely dilated intrahepatic bile ducts were revealed in malignancies. Dilatation of intrahepatic bile ducts in vine pattern was one of the characteristic signs of malignant lesions, while 'withered branches' dilatation was usually found in benign diseases. Dilated extra-hepatic bile duct abruptly narrowed or obstructed was a typical finding in malignancies, while gradual tapering of common bile duct at the obstructed level usually indicated benign nature of the disease. Conclusion: Both CT and ERCP are valuable modalities in locating and differential diagnosis of biliary obstruction. A combined evaluation improves the accuracy of diagnosis

  19. Obstructive acute abdomen: reviewing important points

    International Nuclear Information System (INIS)

    Francisco, Marina Celli; Abud, Thiago Giansante; Reibscheid, Samuel; Szejnfeld, Jacob; Lederman, Henrique Manoel; Colleone Neto, Ramiro

    2008-01-01

    The obstructive acute abdomen is a common presentation, for which safe and effective management depends on a fast and accurate diagnosis. Conventional radiograph remains the first choice among the imaging exams because of its availability, low cost and the possibility to be done serially to follow the patient's clinical progression. The ultrasonography does not require ionizing radiation. It is a dynamic and in realtime exam. Computed tomography is used increasingly due to the provision of essential diagnostic information not apparent from radiographs, such as the confirmation of the obstruction, degree and place of the occlusion, presence of ischemia as well as the causes of the obstruction. Magnetic resonance imaging has presented great technological advances and it may play a role in the future of obstructive acute abdomen diagnosis. The objective of this pictorial essay is to review the different imaging techniques used on diagnosing obstructive acute abdomen. (author)

  20. Small Bowel Obstruction due to Intestinal Xanthomatosis

    Directory of Open Access Journals (Sweden)

    L. E. Barrera-Herrera

    2015-01-01

    Full Text Available Vast majority of bowel obstruction is due to postoperative adhesions, malignancy, intestinal inflammatory disease, and hernias; however, knowledge of other uncommon causes is critical to establish a prompt treatment and decrease mortality. Xanthomatosis is produced by accumulation of cholesterol-rich foamy macrophages. Intestinal xanthomatosis is an uncommon nonneoplastic lesion that may cause small bowel obstruction and several cases have been reported in the English literature as obstruction in the jejunum. We report a case of small intestinal xanthomatosis occurring in a 51-year-old female who presented with one day of copious vomiting and intermittent abdominal pain. Radiologic images revealed jejunal loop thickening and inflammatory changes suggestive of foreign body obstruction, diagnostic laparoscopy found two strictures at the jejunum, and a pathologic examination confirmed a segmental small bowel xanthomatosis. This case illustrates that obstruction even without predisposing factors such as hyperlipidemia or lymphoproliferative disorders.

  1. Barriers to guideline-compliant psoriasis care: analyses and concepts.

    Science.gov (United States)

    Eissing, L; Radtke, M A; Zander, N; Augustin, M

    2016-04-01

    Despite the availability of effective therapeutics and evidence-based treatment guidelines, a substantial proportion of patients with moderate-to-severe psoriasis does not receive appropriate care. This under-provision of health care may cause further worsening of health, remarkable limitations of the patient's quality of life, and indirect costs for the health care system. In order to provide guideline-compliant care for every psoriasis patient, it is important to identify barriers obstructing optimal care. Studies have identified various barriers on the physician's and on the patient's side; however, respective studies approached only single barriers, and not all of them in the context of psoriasis. Other publications that describe barriers systematically did not focus on psoriasis either. The objective of this literature review was to identify barriers and facilitators, based on studies analysing quality of care and single barriers, resulting in a comprehensive model of causal factors. Our analyses revealed three categories of barriers - patient-related, physician-related and external factors: On the patient side, we found non-adherence to therapies to be an important barrier, often in close association with psychiatric factors. Barriers on the physician's side predominantly are incomplete knowledge of the guidelines as well as the complexity of psoriasis comorbidity. In some countries, payment for patients with complex disease status is poor and inconsistent reimbursement regulations potentially interfere with optimal care. The current analysis indicates that most barriers are interdependent. Thus, measures approaching related barriers simultaneously are required. To improve care for psoriasis patients, further studies systematically addressing all potentially relevant barriers in conjoint are needed. © 2015 European Academy of Dermatology and Venereology.

  2. Chronic Obstructive Pulmonary Disease Biomarkers

    Directory of Open Access Journals (Sweden)

    Tatsiana Beiko

    2016-04-01

    Full Text Available Despite significant decreases in morbidity and mortality of cardiovascular diseases (CVD and cancers, morbidity and cost associated with chronic obstructive pulmonary disease (COPD continue to be increasing. Failure to improve disease outcomes has been related to the paucity of interventions improving survival. Insidious onset and slow progression halter research successes in developing disease-modifying therapies. In part, the difficulty in finding new therapies is because of the extreme heterogeneity within recognized COPD phenotypes. Novel biomarkers are necessary to help understand the natural history and pathogenesis of the different COPD subtypes. A more accurate phenotyping and the ability to assess the therapeutic response to new interventions and pharmaceutical agents may improve the statistical power of longitudinal clinical studies. In this study, we will review known candidate biomarkers for COPD, proposed pathways of pathogenesis, and future directions in the field.

  3. Pediatric Obstructive Uropathy: Clinical Trials

    International Nuclear Information System (INIS)

    Chan, C. M. C.; Scheinman, J. I.; Roth, K. S.

    2005-01-01

    As the powerful tools of molecular biology continue to delineate new concepts of pathogenesis of diseases, new molecular-level therapeutic modalities are certain to emerge. In order to design and execute clinical trials to evaluate outcomes of these new treatment modalities, we will soon need a new supply of investigators with training and experience in clinical research. The slowly-progressive nature of chronic pediatric kidney disease often results in diagnosis being made at a time remote from initial result, and the inherently slow rate of progression makes changes difficult to measure. Thus, development of molecular markers for both diagnosis and rate of progression will be critical to studies of new therapeutic modalities. We will review general aspects of clinical trials and will use current and past studies as examples to illustrate specific points, especially as these apply to chronic kidney disease associated with obstructive uropathy in children. (author)

  4. Obstructive Sleep Apnea and Aldosterone

    Science.gov (United States)

    Svatikova, Anna; Olson, Lyle J.; Wolk, Robert; Phillips, Bradley G.; Adachi, Taro; Schwartz, Gary L.; Somers, Virend K.

    2009-01-01

    Background: Obstructive sleep apnea (OSA) is a major risk factor for hypertension and has been associated with increased risk for cardiovascular morbidity. A dysregulated renin-angiotensin-aldosterone system may contribute to excess sodium retention and hypertension and may be activated in OSA. We tested the hypothesis that serum levels of aldosterone and plasma renin activity (PRA) are increased by apneic sleep in subjects without cardiovascular disease, compared to healthy control subjects. Methods and Results: Plasma aldosterone level was measured in 21 subjects with moderate to severe OSA and was compared to 19 closely matched healthy subjects. Plasma renin activity (PRA) was measured in 19 OSA patients and in 20 healthy controls. Aldosterone and PRA were measured before sleep (9pm), after 5 hrs of untreated OSA (2am) and in the morning after awakening (6am). There were no baseline (9pm) differences in serum aldosterone levels and PRA between the healthy controls and OSA patients (aldosterone: 55.2 ± 9 vs 56.0 ± 9 pg/mL; PRA: 0.99 ± 0.15 vs 1.15 ± 0.15 ng/mL/hr). Neither several hours of untreated severe OSA nor CPAP treatment affected aldosterone levels and PRA in OSA patients. Diurnal variation of both aldosterone and PRA was observed in both groups, in that morning renin and aldosterone levels were higher than those measured at night before sleep. Conclusions: Our study shows that patients with moderate to severe OSA without co-existing cardiovascular disease have plasma aldosterone and renin levels similar to healthy subjects. Neither untreated OSA nor CPAP treatment acutely affect plasma aldosterone or renin levels. Citation: Svatikova A; Olson LJ; Wolk R; Phillips BG; Adachi T; Schwartz GL; Somers VK. Obstructive sleep apnea and aldosterone. SLEEP 2009;32(12):1589-1592. PMID:20041594

  5. Barrier cell sheath formation

    International Nuclear Information System (INIS)

    Kesner, J.

    1980-04-01

    The solution for electrostatic potential within a simply modeled tandem mirror thermal barrier is seen to exhibit a sheath at each edge of the cell. The formation of the sheath requires ion collisionality and the analysis assmes that the collisional trapping rate into the barrier is considerably slower than the barrier pump rate

  6. Barriers to fusion

    International Nuclear Information System (INIS)

    Berriman, A.C.; Butt, R.D.; Dasgupta, M.; Hinde, D.J.; Morton, C.R.; Newton, J.O.

    1999-01-01

    The fusion barrier is formed by the combination of the repulsive Coulomb and attractive nuclear forces. Recent research at the Australian National University has shown that when heavy nuclei collide, instead of a single fusion barrier, there is a set of fusion barriers. These arise due to intrinsic properties of the interacting nuclei such deformation, rotations and vibrations. Thus the range of barrier energies depends on the properties of both nuclei. The transfer of matter between nuclei, forming a neck, can also affect the fusion process. High precision data have been used to determine fusion barrier distributions for many nuclear reactions, leading to new insights into the fusion process

  7. Extremal surface barriers

    International Nuclear Information System (INIS)

    Engelhardt, Netta; Wall, Aron C.

    2014-01-01

    We present a generic condition for Lorentzian manifolds to have a barrier that limits the reach of boundary-anchored extremal surfaces of arbitrary dimension. We show that any surface with nonpositive extrinsic curvature is a barrier, in the sense that extremal surfaces cannot be continuously deformed past it. Furthermore, the outermost barrier surface has nonnegative extrinsic curvature. Under certain conditions, we show that the existence of trapped surfaces implies a barrier, and conversely. In the context of AdS/CFT, these barriers imply that it is impossible to reconstruct the entire bulk using extremal surfaces. We comment on the implications for the firewall controversy

  8. Safety- barrier diagrams

    DEFF Research Database (Denmark)

    Duijm, Nijs Jan

    2008-01-01

    Safety-barrier diagrams and the related so-called 'bow-tie' diagrams have become popular methods in risk analysis. This paper describes the syntax and principles for constructing consistent and valid safety-barrier diagrams. The relation of safety-barrier diagrams to other methods such as fault...... trees and Bayesian networks is discussed. A simple method for quantification of safety-barrier diagrams is proposed. It is concluded that safety-barrier diagrams provide a useful framework for an electronic data structure that integrates information from risk analysis with operational safety management....

  9. Safety-barrier diagrams

    DEFF Research Database (Denmark)

    Duijm, Nijs Jan

    2007-01-01

    Safety-barrier diagrams and the related so-called "bow-tie" diagrams have become popular methods in risk analysis. This paper describes the syntax and principles for constructing consistent and valid safety-barrier diagrams. The relation with other methods such as fault trees and Bayesian networks...... are discussed. A simple method for quantification of safety-barrier diagrams is proposed, including situations where safety barriers depend on shared common elements. It is concluded that safety-barrier diagrams provide a useful framework for an electronic data structure that integrates information from risk...... analysis with operational safety management....

  10. Spirometry in Greenland: a cross-sectional study on patients treated with medication targeting obstructive pulmonary disease.

    Science.gov (United States)

    Nielsen, Lasse Overballe; Olsen, Sequssuna; Jarbøl, Dorte Ejg; Pedersen, Michael Lynge

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) is globally increasing in frequency and is expected to be the third largest cause of death by 2020. Smoking is the main risk factor of developing COPD. In Greenland, more than half of the adult population are daily smokers, and COPD may be common. International guidelines recommend the usage of spirometry as a golden standard for diagnosing COPD. The current number of spirometries performed among patients treated with medication targeting obstructive pulmonary disease in Greenland remains unexplored. To estimate the prevalence of patients aged 50 years or above treated with medication targeting obstructive pulmonary disease and the extent to which spirometry was performed among them within 2 years. An observational, cross-sectional study based on the review of data obtained from electronic medical records in Greenland was performed. The inclusion criterion was that patients must have been permanent residents aged 50 years or above who had medication targeting obstructive pulmonary disease prescribed within a period of 15 months prior to data extraction. A full review of electronic patient records was done on each of the identified users of medication targeting obstructive pulmonary disease. Information on age, gender, town and spirometry was registered for each patient within the period from October 2013 to October 2015. The prevalence of patients treated with medication targeting obstructive pulmonary disease aged 50 years or above was 7.9%. Of those, 34.8% had spirometry performed within 2 years and 50% had a forced expiratory volume (1 sec)/ forced vital capacity (FEV1/FVC) under 70% indicating obstructive pulmonary disease. The use of medication targeting obstructive pulmonary disease among patients over 50 years old is common in Greenland. About one third of the patients had a spirometry performed within 2 years. To further increase spirometry performance, it is recommended to explore possible barriers in health

  11. Barriers to Investment in Utility-scale Variable Renewable Electricity (VRE) Projects

    NARCIS (Netherlands)

    Hu, J.; Harmsen, R.; Crijns-Graus, W.; Worrell, E.

    To effectively mitigate climate change, variable renewable electricity (VRE) is expected to substitute a great share of current fossil-fired electricity generation. However, VRE investments can be obstructed by many barriers, endangering the amount of investments needed in order to be consistent

  12. Within-breath respiratory impedance and airway obstruction in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Silva, Karla Kristine Dames da; Faria, Alvaro Camilo Dias; Lopes, Agnaldo José; Melo, Pedro Lopes de

    2015-07-01

    Recent work has suggested that within-breath respiratory impedance measurements performed using the forced oscillation technique may help to noninvasively evaluate respiratory mechanics. We investigated the influence of airway obstruction on the within-breath forced oscillation technique in smokers and chronic obstructive pulmonary disease patients and evaluated the contribution of this analysis to the diagnosis of chronic obstructive pulmonary disease. Twenty healthy individuals and 20 smokers were assessed. The study also included 74 patients with stable chronic obstructive pulmonary disease. We evaluated the mean respiratory impedance (Zm) as well as values for the inspiration (Zi) and expiration cycles (Ze) at the beginning of inspiration (Zbi) and expiration (Zbe), respectively. The peak-to-peak impedance (Zpp=Zbe-Zbi) and the respiratory cycle dependence (ΔZrs=Ze-Zi) were also analyzed. The diagnostic utility was evaluated by investigating the sensitivity, the specificity and the area under the receiver operating characteristic curve. ClinicalTrials.gov: NCT01888705. Airway obstruction increased the within-breath respiratory impedance parameters that were significantly correlated with the spirometric indices of airway obstruction (R=-0.65, pdisease patients presented significant expiratory-inspiratory differences (p90%). We conclude the following: (1) chronic obstructive pulmonary disease introduces higher respiratory cycle dependence, (2) this increase is proportional to airway obstruction, and (3) the within-breath forced oscillation technique may provide novel parameters that facilitate the diagnosis of respiratory abnormalities in chronic obstructive pulmonary disease.

  13. Within-breath respiratory impedance and airway obstruction in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Karla Kristine Dames da Silva

    2015-07-01

    Full Text Available OBJECTIVE: Recent work has suggested that within-breath respiratory impedance measurements performed using the forced oscillation technique may help to noninvasively evaluate respiratory mechanics. We investigated the influence of airway obstruction on the within-breath forced oscillation technique in smokers and chronic obstructive pulmonary disease patients and evaluated the contribution of this analysis to the diagnosis of chronic obstructive pulmonary disease. METHODS: Twenty healthy individuals and 20 smokers were assessed. The study also included 74 patients with stable chronic obstructive pulmonary disease. We evaluated the mean respiratory impedance (Zm as well as values for the inspiration (Zi and expiration cycles (Ze at the beginning of inspiration (Zbi and expiration (Zbe, respectively. The peak-to-peak impedance (Zpp=Zbe-Zbi and the respiratory cycle dependence (ΔZrs=Ze-Zi were also analyzed. The diagnostic utility was evaluated by investigating the sensitivity, the specificity and the area under the receiver operating characteristic curve. ClinicalTrials.gov: NCT01888705. RESULTS: Airway obstruction increased the within-breath respiratory impedance parameters that were significantly correlated with the spirometric indices of airway obstruction (R=−0.65, p90%. CONCLUSIONS: We conclude the following: (1 chronic obstructive pulmonary disease introduces higher respiratory cycle dependence, (2 this increase is proportional to airway obstruction, and (3 the within-breath forced oscillation technique may provide novel parameters that facilitate the diagnosis of respiratory abnormalities in chronic obstructive pulmonary disease.

  14. Role of ureteric stents in relieving obstruction in patients with obstructive uropathy

    Directory of Open Access Journals (Sweden)

    M Shehab

    2013-01-01

    Conclusion: The predictors of renal recoverability revealed that ureteral stents alone can help in regaining renal function and significant improvement of clinical condition in patients with obstructive uropathy.

  15. Ureteral valve masquerading as obstructive megaureter

    Directory of Open Access Journals (Sweden)

    Sushmita Bhatnagar

    2017-05-01

    Full Text Available Primary obstructed megaureter is a common urological condition in the pediatric age group. It is one of the differentials for congenital anomalies of the kidney and urinary tract that include a myriad of structural anomalies of the urinary tract. The obstructive conditions are usually managed conservatively unless there is deterioration in renal function, repeated urinary tract infection, or any other symptom such as abdominal pain on ipsilateral side and hypertension. Presented here is a case of left lower ureteral valve that was diagnosed as primary obstructed megaureter with pain in abdomen and reduced ipsilateral renal function wherein ureteral valve was detected incidentally intraoperatively. Excision of the valve with end to end uretero-ureteral anastomoses over a D-J stent, without resorting to ureteric reimplantation was successful in relieving the obstruction and hydronephrosis

  16. Dams and Obstructions along Iowa's Canoe Routes

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — This dataset represents obstruction to canoe and boat users of the canoe routes of Iowa. This may represent actual dams, rock dams (natural or man made), large...

  17. Obstructive sleep apnea: Awakening the hidden truth

    African Journals Online (AJOL)

    2014-01-16

    Jan 16, 2014 ... The repetitive nocturnal hypoxemia experienced by patients with OSA is ... etiopathogenesis, epidemiology, associated systemic diseases such as cardiovascular diseases, diabetes, and dental .... Obstructive sleep apnea and cardiovascular diseases ... showing that successful treatment of sleep apnea.

  18. Genetics Home Reference: obstructive sleep apnea

    Science.gov (United States)

    ... eCollection 2014. Review. Citation on PubMed or Free article on PubMed Central de Lima FF, Mazzotti DR, Tufik S, Bittencourt L. The role inflammatory response genes in obstructive sleep apnea syndrome: a review. Sleep ...

  19. Modern imaging in patients with obstructive jaundice

    African Journals Online (AJOL)

    2007-07-19

    Jul 19, 2007 ... chronic pancreatitis, sclerosing cholangitis, benign bile duct strictures or ... ducts are obstructed, surgery or therapeutic endoscopy may be required, but ... expensive and invasive procedures, is now available for evaluating.

  20. Complications in obstructive jaundice: role of endotoxins

    NARCIS (Netherlands)

    Greve, J. W.; Gouma, D. J.; Buurman, W. A.

    1992-01-01

    Surgical treatment of patients with obstructive jaundice is associated with a high postoperative morbidity and mortality. A correlation was suggested between endotoxins and the observed complications. The mechanism by which endotoxins affect the negative outcome in operated jaundiced patients was,

  1. An obstructing endobronchial lipoma simulating COPD

    DEFF Research Database (Denmark)

    Sivapalan, Pradeesh; Gottlieb, Magnus; Christensen, Merete

    2014-01-01

    Endobronchial lipomas are rare benign tumors of the respiratory tract. Bronchial occlusion may cause parenchymal damage and lead to a misdiagnosis of chronic obstructive pulmonary disease or malignancy. Therefore, both accurate diagnosis and radical treatment of endobronchial lipomas are essentia...

  2. Chronic obstructive pulmonary disease – diagnosis and ...

    African Journals Online (AJOL)

    Chronic obstructive pulmonary disease – diagnosis and classification of ... biomass fuel exposure/household pollution, tuberculosis, HIV and mining ... There is a very high prevalence of COPD in SA and it is the third leading cause of mortality ...

  3. Acute pseudo-obstruction of the colon

    International Nuclear Information System (INIS)

    Beese, M.; Heller, M.

    1988-01-01

    The radiological correlate to the pseudo-obstruction of the colon is not specific, but it does supply a pointer to the disease of it shows dilation of the caecum, colon ascendens and colon transversum with air-pockets and reflected imaging as well as a usually not dilated colon descendens with remarkably little air. To make the diagnosis quite sure we must exclude intestinal obstruction by using X-ray contrast media or by coloscopy. (orig./GDG) [de

  4. Obstructive sleep apnoea syndrome in children

    Directory of Open Access Journals (Sweden)

    Anna Włodarska

    2016-09-01

    Full Text Available Sleep-related breathing disorders in children are a clinical problem which is more and more often diagnosed by doctors nowadays. They can be the basis for diagnosing obstructive sleep apnoea syndrome that causes a number of complications: lowering the quality of life, behavioural problems, complications involving cardiovascular system. The incidence of obstructive sleep apnoea syndrome in the paediatric population is estimated to be at the level of 2%. The symptoms of obstructive sleep apnoea syndrome can be divided into daytime and night ones. Night symptoms in children include: snoring, apnoea, breathing with open mouth (both during the day and at night, dry tongue and mouth during sleep, agitated sleep in unnatural positions. Among daytime symptoms of obstructive sleep apnoea syndrome there are: irritability, aggressiveness, hyperactivity, attention deficit disorder, delayed development and growth pattern (mainly failure to thrive, learning problems, morning headaches. Parents often do not connect the night and daytime symptoms with the possible development of obstructive sleep apnoea syndrome in their children. The main predisposing factor of obstructive sleep apnoea syndrome in children is adenotonsillar hypertrophy. Effective and in most cases preferred treatment for the management of obstructive sleep apnoea syndrome in children is adenotonsillectomy. Polysomnography and polygraphy are diagnostic tools helpful in the study of sleep-related disorders. The objective of this study was to systematise the knowledge on the epidemiology, aetiology, clinical image and prevention of obstructive sleep apnoea syndrome in children.

  5. Chronic obstructive pulmonary disease : a proteomics approach

    OpenAIRE

    Alexandre, Bruno Miguel Coelho, 1980-

    2011-01-01

    Tese de doutoramento, Biologia (Biologia Molecular), Universidade de Lisboa, Faculdade de Ciências, 2012 Chronic obstructive pulmonary disease (COPD) is characterized by chronic airflow limitation that is not fully reversible even under bronchodilators effect, caused by a mixture of small airway disease – obstructive bronchiolitis – and parenchymal destruction – emphysema. At the present time, COPD is the fourth leading cause of death and its prevalence and mortality are expected to contin...

  6. Neonatal intestinal obstruction in Benin, Nigeria

    Directory of Open Access Journals (Sweden)

    Osifo Osarumwense

    2009-01-01

    Full Text Available Background: Intestinal obstruction is a life threatening condition in the newborn, with attendant high mortality rate especially in underserved subregion. This study reports the aetiology, presentation, and outcome of intestinal obstruction management in neonates. Materials and Methods: A prospective study of neonatal intestinal obstruction at the University of Benin Teaching Hospital, Benin, Nigeria, between January 2006-June 2008. Data were collated on a structured proforma and analysed for age, sex, weight, presentation, type/date of gestation/delivery, aetiology, clinical presentation, associated anomaly, treatment, and outcome. Results: There were 71 neonates, 52 were males and 19 were females (2.7:1. Their age range was between 12 hours and 28 days (mean, 7.9 ± 2.7 days and they weighed between 1.8 and 5.2 kg (average, 3.2 kg. The causes of intestinal obstruction were: Anorectal anomaly, 28 (39.4%; Hirschsprung′s disease, 8 (11.3%′ prematurity, 3 (4.2%; meconeum plug, 2 (2.8%; malrotation, 6 (8.5%; intestinal atresia, 8 (11.3%; necrotising enterocolitis (NEC, 4 (5.6%; obstructed hernia, 4 (5.6%; and spontaneous gut perforation, 3 (4.2%. Also, 27 (38% children had colostomy, 24 (33.8% had laparotomy, 9 (12.8% had anoplasty, while 11 (15.4% were managed nonoperatively. A total of 41 (57.7% neonates required incubator, 26 (36.6% needed total parenteral nutrition, while 15 (21.1% require d paediatric ventilator. Financial constraint, late presentation, presence of multiple anomalies, aspiration, sepsis, gut perforation, and bowel gangrene were the main contributors to death. Neonates with lower obstructions had a better outcome compared to those having upper intestinal obstruction ( P < 0.0001. Conclusion: Outcomes of intestinal obstruction are still poor in our setting; late presentation, financial constraints, poor parental motivation and lack of basic facilities were the major determinants of mortality.

  7. The genetics of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Silverman Edwin K

    2001-01-01

    Full Text Available Abstract Chronic obstructive pulmonary disease (COPD is a significant cause of global morbidity and mortality. Previous studies have shown that COPD aggregates in families, suggesting a genetic predisposition to airflow obstruction. Many candidate genes have been assessed, but the data are often conflicting. We review the genetic factors that predispose smokers to COPD and highlight the future role of genomic scans in identifying novel susceptibility genes.

  8. Obstructive Sleep Apnea Due To Extrathoracic Tracheomalacia

    OpenAIRE

    Muzumdar, Hiren; Nandalike, K.; Bent, J.; Arens, Raanan

    2013-01-01

    We report obstructive sleep apnea in a 3-year-old boy with tracheomalacia secondary to tracheotomy that resolved after placement of a metallic stent in the region of tracheomalacia. The tracheal location of obstruction during sleep in this case contrasts with the usual location in the pharynx or, less often, the larynx. This case also demonstrates the utility of polysomnography in managing decannulation of tracheostomies.

  9. Obstructive sleep apnea due to extrathoracic tracheomalacia.

    Science.gov (United States)

    Muzumdar, Hiren; Nandalike, K; Bent, J; Arens, Raanan

    2013-02-01

    We report obstructive sleep apnea in a 3-year-old boy with tracheomalacia secondary to tracheotomy that resolved after placement of a metallic stent in the region of tracheomalacia. The tracheal location of obstruction during sleep in this case contrasts with the usual location in the pharynx or, less often, the larynx. This case also demonstrates the utility of polysomnography in managing decannulation of tracheostomies.

  10. Rendezvous endoscopic recanalization for complete esophageal obstruction.

    Science.gov (United States)

    Fusco, Stefano; Kratt, Thomas; Gani, Cihan; Stueker, Dietmar; Zips, Daniel; Malek, Nisar P; Goetz, Martin

    2018-03-30

    Complete esophageal obstruction after (chemo)radiation for head and neck cancers is rare. However, inability to swallow one's own saliva strongly inflicts upon quality of life. Techniques for endoscopic recanalization in complete obstruction are not well established. We assessed the efficacy and safety of rendezvous recanalization. We performed a retrospective review of all patients who underwent endoscopic recanalization of complete proximal esophageal obstruction after radiotherapy between January 2009 and June 2016. Technical success was defined as an ability to pass an endoscope across the recanalized lumen, clinical success by changes in the dysphagia score. Adverse events were recorded prospectively. 19 patients with complete obstruction (dysphagia IV°), all of whom had failed at least one trial of conventional dilatation, underwent recanalization by endoscopic rendezvous, a combined approach through a gastrostomy and perorally under fluoroscopic control. Conscious sedation was used in all patients. In 18/19 patients (94.7%), recanalization was technically successful. In 14/18 patients (77.8%), the post-intervention dysphagia score changed to ≤ II. Three patients had their PEG removed. Factors negatively associated with success were obstruction length of 50 mm; and tumor recurrence for long-term success. No severe complications were recorded. Rendezvous recanalization for complete esophageal obstruction is a reliable and safe method to re-establish luminal patency. Differences between technical and clinical success rates highlight the importance of additional functional factors associated with dysphagia. Given the lack of therapeutic alternatives, rendezvous recanalization is a valid option to improve dysphagia.

  11. MR cholangiography: usefulness in obstructive jaundice

    International Nuclear Information System (INIS)

    Bae, Sang Hoon; Lee, In Jae; Nam, Kung Sook; Hong, Myung Sun; Lee, Kyung Hwan; Yun, Ku Sub

    1994-01-01

    Three-dimensional(3D) magnetic resonance(MR) projection imaging was evaluated as a noninvasive alternative to direct cholangiography for the assessment of its reliability in patients with obstructive jaundice. A heavily T2-weighted gradient-echo sequence(PSIF) was used for 3D MR projection imaging of the biliary system in five healthy volunteers and 25 patients with obstructive jaundice. The 3D images of the bile ducts were formed by stacking consecutive coronal MR images obtained with a fast imaging method to a maximum-intensity projection algorithm. In the volunteers, MR cholangiography could demonstrate the anatomy of the biliary tract in only two subjects. The extrahepatic and intrahepatic bile ducts were well visualized in 23 patients with obstructive jaundice. The leve of obstruction and the grade of dilatation were depicted with MR cholangiography in all cases. And the cause of obstruction could be determined with MR cholangiography in 18 cases, MR cholangiography wa successful in two patients in whom ERCP failed. The gallbladder or dilated pancreatic duct not demonstrated by means of direct cholangiography was demonstrated with MR cholangiography in six cases. MR cholangiography may be a useful adjunctive tool for the noninvasive evaluation of patients with obstructive Jaundice

  12. Obstructive sleep apnea and inflammation.

    LENUS (Irish Health Repository)

    McNicholas, Walter T

    2012-02-01

    The pathogenesis of cardiovascular complications in obstructive sleep apnea syndrome (OSAS) is not fully understood but is likely multifactorial in origin. Inflammatory processes play an important role in the pathogenesis of atherosclerosis, and circulating levels of several markers of inflammation have been associated with future cardiovascular risk. These include cell adhesion molecules such as intercellular adhesion molecule-1 and selectins, cytokines such as tumour necrosis factor alpha and interleukin 6, chemokines such as interleukin 8, and C-reactive protein. There is also increasing evidence that inflammatory processes play an important role in the cardiovascular pathophysiology of OSAS and many of the inflammatory markers associated with cardiovascular risk have been reported as elevated in patients with OSAS. Furthermore, animal and cell culture studies have demonstrated preferential activation of inflammatory pathways by intermittent hypoxia, which is an integral feature of OSAS. The precise role of inflammation in the development of cardiovascular disease in OSAS requires further study, particularly the relationship with oxidative stress, metabolic dysfunction, and obesity.

  13. Determinants of CPAP Adherence in Hispanics with Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Montserrat Diaz-Abad

    2014-01-01

    Full Text Available Purpose. We hypothesized that socioeconomic factors and a language barrier would impact adherence with continuous positive airway pressure (CPAP among Hispanics with obstructive sleep apnea (OSA. Methods. Patients with OSA who were prescribed CPAP for at least 1 year and completed a questionnaire evaluating demographic data, socioeconomic status, and CPAP knowledge and adherence participated in the study. Results. Seventy-nine patients (26 males; 53±11 yrs; body mass index (BMI=45±9 kg/m2 with apnea-hypopnea index (AHI 33±30 events/hr completed the study. Included were 25 Hispanics, 39 African Americans, and 15 Caucasians, with no difference in age, AHI, CPAP use, or BMI between the groups. While there was a difference in educational level (P=0.006, income level (P<0.001, and employment status (P=0.03 between the groups, these did not influence CPAP adherence. Instead, overall improvement in quality of life and health status and perceived benefit from CPAP influenced adherence, both for the group as a whole (P=0.03, P=0.004, and P=0.001, resp., as well as in Hispanics (P=0.02, P=0.02, P=0.03, resp.. Conclusion. In Hispanic patients with OSA, perceived benefit with therapy, rather than socioeconomic status or a language barrier, appears to be the most important factor in determining CPAP adherence.

  14. Teaching inhaler use in chronic obstructive pulmonary disease patients.

    Science.gov (United States)

    Lareau, Suzanne C; Hodder, Richard

    2012-02-01

    To review barriers to the successful use of inhalers in patients with chronic obstructive pulmonary disease (COPD), and the role of the nurse practitioner (NP) in facilitating optimum inhaler use. Review of the national and international scientific literature. Pharmacologic treatment of COPD patients comprises mainly inhaled medications. Incorrect use of inhalers is very common in these individuals. Some of the consequences of poor inhaler technique include reduced therapeutic dosing, medication adherence, and disease stability, which can lead to increased morbidity, decreased quality of life, and a high burden on the healthcare system. Knowledgeable evaluation and frequent reassessment of inhaler use coupled with education of patients, caregivers, and healthcare professionals can significantly improve the benefits COPD patients derive from inhaled therapy. Patient education is vital for correct use of inhalers and to ensure the effectiveness of inhaled medications. The NP has a critical role in assessing potential barriers to successful learning by the patient and improving inhaler technique and medication management. The NP can also facilitate success with inhaled medications by providing up-to-date inhaler education for other healthcare team members, who may then act as patient educators. ©2011 The Author(s) Journal compilation ©2011 American Academy of Nurse Practitioners.

  15. Multilayer moisture barrier

    Science.gov (United States)

    Pankow, Joel W; Jorgensen, Gary J; Terwilliger, Kent M; Glick, Stephen H; Isomaki, Nora; Harkonen, Kari; Turkulainen, Tommy

    2015-04-21

    A moisture barrier, device or product having a moisture barrier or a method of fabricating a moisture barrier having at least a polymer layer, and interfacial layer, and a barrier layer. The polymer layer may be fabricated from any suitable polymer including, but not limited to, fluoropolymers such as polyethylene terephthalate (PET) or polyethylene naphthalate (PEN), or ethylene-tetrafluoroethylene (ETFE). The interfacial layer may be formed by atomic layer deposition (ALD). In embodiments featuring an ALD interfacial layer, the deposited interfacial substance may be, but is not limited to, Al.sub.2O.sub.3, AlSiO.sub.x, TiO.sub.2, and an Al.sub.2O.sub.3/TiO.sub.2 laminate. The barrier layer associated with the interfacial layer may be deposited by plasma enhanced chemical vapor deposition (PECVD). The barrier layer may be a SiO.sub.xN.sub.y film.

  16. Barrier penetration database

    International Nuclear Information System (INIS)

    Fainberg, A.; Bieber, A.M. Jr.

    1978-11-01

    This document is intended to supply the NRC and nuclear power plant licensees with basic data on the times required to penetrate forcibly the types of barriers commonly found in nuclear plants. These times are necessary for design and evaluation of the physical protection system required under 10CFR73.55. Each barrier listed is described in detail. Minor variations in basic barrier construction that result in the same penetration time, are also described

  17. Severity of Airflow Obstruction in Chronic Obstructive Pulmonary Disease (COPD): Proposal for a New Classification.

    Science.gov (United States)

    Coton, Sonia; Vollmer, William M; Bateman, Eric; Marks, Guy B; Tan, Wan; Mejza, Filip; Juvekar, Sanjay; Janson, Christer; Mortimer, Kevin; P A, Mahesh; Buist, A Sonia; Burney, Peter G J

    2017-10-01

    Current classifications of Chronic Obstructive Pulmonary Disease (COPD) severity are complex and do not grade levels of obstruction. Obstruction is a simpler construct and independent of ethnicity. We constructed an index of obstruction severity based on the FEV 1 /FVC ratio, with cut-points dividing the Burden of Obstructive Lung Disease (BOLD) study population into four similarly sized strata to those created by the GOLD criteria that uses FEV 1 . We measured the agreement between classifications and the validity of the FEV 1 -based classification in identifying the level of obstruction as defined by the new groupings. We compared the strengths of association of each classification with quality of life (QoL), MRC dyspnoea score and the self-reported exacerbation rate. Agreement between classifications was only fair. FEV 1 -based criteria for moderate COPD identified only 79% of those with moderate obstruction and misclassified half of the participants with mild obstruction as having more severe COPD. Both scales were equally strongly associated with QoL, exertional dyspnoea and respiratory exacerbations. Severity assessed using the FEV 1 /FVC ratio is only in moderate agreement with the severity assessed using FEV 1 but is equally strongly associated with other outcomes. Severity assessed using the FEV 1 /FVC ratio is likely to be independent of ethnicity.

  18. Ultrasonography of small intestinal obstructions: a contemporary approach.

    Science.gov (United States)

    Garcia, D A A; Froes, T R; Vilani, R G D O C; Guérios, S D; Obladen, A

    2011-09-01

    To assess the accuracy of intestinal ultrasound for diagnosis of intestinal obstruction in dogs and cats. A prospective clinical study was performed. Inclusion criteria were dogs and cats with clinical signs suggestive of gastrointestinal obstruction. Animals with no obstruction detected on ultrasound were excluded if they could not be monitored for 48 hours to confirm absence of obstruction. Sonographic diagnosis of small intestinal obstruction was based on identification of at least two findings suggestive of intestinal obstruction. Ninety-two patients suspected of having intestinal obstruction were included. Correct diagnosis of intestinal obstruction was made in 21 cases (23%), and in 68 (74%) this diagnosis was excluded. Interpretation of the images on prospective analysis had sensitivity, positive predictive, specificity and negative predictive values of 100%, 87.5%, 95.8% and 100%, respectively. Ultrasonography is an excellent method for investigation of animals with gastrointestinal disorders, and is particularly useful for excluding obstructive processes. © 2011 British Small Animal Veterinary Association.

  19. Transport barriers in plasmas

    International Nuclear Information System (INIS)

    Caldas, I L; Szezech, J D Jr; Kroetz, T; Marcus, F A; Roberto, M; Viana, R L; Lopes, S R

    2012-01-01

    We discuss the creation of transport barriers in magnetically confined plasmas with non monotonic equilibrium radial profiles. These barriers reduce the transport in the shearless region (i.e., where the twist condition does not hold). For the chaotic motion of particles in an equilibrium electric field with a nonmonotonic radial profile, perturbed by electrostatic waves, we show that a nontwist transport barrier can be created in the plasma by modifying the electric field radial profile. We also show non twist barriers in chaotic magnetic field line transport in the plasma near to the tokamak wall with resonant modes due to electric currents in external coils.

  20. Accuracy of abdominal auscultation for bowel obstruction.

    Science.gov (United States)

    Breum, Birger Michael; Rud, Bo; Kirkegaard, Thomas; Nordentoft, Tyge

    2015-09-14

    To investigate the accuracy and inter-observer variation of bowel sound assessment in patients with clinically suspected bowel obstruction. Bowel sounds were recorded in patients with suspected bowel obstruction using a Littmann(®) Electronic Stethoscope. The recordings were processed to yield 25-s sound sequences in random order on PCs. Observers, recruited from doctors within the department, classified the sound sequences as either normal or pathological. The reference tests for bowel obstruction were intraoperative and endoscopic findings and clinical follow up. Sensitivity and specificity were calculated for each observer and compared between junior and senior doctors. Interobserver variation was measured using the Kappa statistic. Bowel sound sequences from 98 patients were assessed by 53 (33 junior and 20 senior) doctors. Laparotomy was performed in 47 patients, 35 of whom had bowel obstruction. Two patients underwent colorectal stenting due to large bowel obstruction. The median sensitivity and specificity was 0.42 (range: 0.19-0.64) and 0.78 (range: 0.35-0.98), respectively. There was no significant difference in accuracy between junior and senior doctors. The median frequency with which doctors classified bowel sounds as abnormal did not differ significantly between patients with and without bowel obstruction (26% vs 23%, P = 0.08). The 53 doctors made up 1378 unique pairs and the median Kappa value was 0.29 (range: -0.15-0.66). Accuracy and inter-observer agreement was generally low. Clinical decisions in patients with possible bowel obstruction should not be based on auscultatory assessment of bowel sounds.

  1. Spectrum of diseases in acute intestinal obstruction

    International Nuclear Information System (INIS)

    Masud, M.; Khan, A.; Gondal, Z.I.; Adil, M.

    2015-01-01

    To determine the etiological spectrum of acute intestinal obstruction in our clinical setup Military Hospital Rawalpindi. Study Design: Descriptive study. Place and Duration of Study: Surgical department of Military Hospital, Rawalpindi from Jul 2012 to Jul 2013, over a period of about 1 year. Material and Methods: A total of 120 patients with acute mechanical intestinal obstruction who underwent laparotomy were included in our study while those with non-mechanical intestinal obstruction like history of trauma and paralytic ileus were excluded from the study. All the patients were selected by non-probability purposive sampling technique. Emergency laparotomy was done and operative findings were recorded. Results: A total of 120 patients with mechanical intestinal obstruction were included in this study out of which 93 (69.17%) were female and remaining 27 (30.83%) were males. Male to female ratio was 1:2.24. Age range of patients was 22-85 years. Out of 120 patients operated for acute intestinal obstruction post-op adhesions were found in 37 (30.83%) patients followed by intestinal tuberculosis in 23 (19.17%) patients, obstructed inguinal hernias in 13 (10.83%), gut malignancies in 15 (12.5%) , Meckel's diverticulum with bands in 7 (5.83%), volvulus in 7 (5.83%), perforated appendix in 6 (5%), intussusception in 2 (1.7%), inflammatory bands in 5 (4.17%), trichobezoar and faecal impaction in 2 (1.7%) while in 3 (2.5%) patients no definite cause was found. Conclusion: Post-op adhesions are the commonest cause of mechanical intestinal obstruction in our setup followed by intestinal tuberculosis as second most common clinical pattern of presentation. (author)

  2. Microscopy of bacterial translocation during small bowel obstruction and ischemia in vivo – a new animal model

    Directory of Open Access Journals (Sweden)

    Hafner Mathias

    2002-08-01

    Full Text Available Abstract Background Existing animal models provide only indirect information about the pathogenesis of infections caused by indigenous gastrointestinal microflora and the kinetics of bacterial translocation. The aim of this study was to develop a novel animal model to assess bacterial translocation and intestinal barrier function in vivo. Methods In anaesthetized male Wistar rats, 0.5 ml of a suspension of green fluorescent protein-transfected E. coli was administered by intraluminal injection in a model of small bowel obstruction. Animals were randomly subjected to non-ischemic or ischemic bowel obstruction. Ischemia was induced by selective clamping of the terminal mesenteric vessels feeding the obstructed bowel loop. Time intervals necessary for translocation of E. coli into the submucosal stroma and the muscularis propria was assessed using intravital microscopy. Results Bacterial translocation into the submucosa and muscularis propria took a mean of 36 ± 8 min and 80 ± 10 min, respectively, in small bowel obstruction. Intestinal ischemia significantly accelerated bacterial translocation into the submucosa (11 ± 5 min, p E. coli were visible in frozen sections of small bowel, mesentery, liver and spleen taken two hours after E. coli administration. Conclusions Intravital microscopy of fluorescent bacteria is a novel approach to study bacterial translocation in vivo. We have applied this technique to define minimal bacterial transit time as a functional parameter of intestinal barrier function.

  3. Asthma and Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Yi-Xian Qiao

    2015-01-01

    Full Text Available Objective: To get a comprehensive understanding about the relationship between obstructive sleep apnea (OSA and asthma by reviewing the epidemiology, pathophysiology, and clinical manifestation and then summarizing the latest progress on diagnosis and treatment. Data Sources: Articles referred in this review were mainly collected from a comprehensive search of the PubMed published in English from 1990 to 2015 with the terms "OSA" and "asthma" as the main keywords. Highly regarded older publications were also included. Study Selection: Information about the features of the two diseases in common, the pathophysiologic association between them and their current treatments from the literature search were identified, retrieved, and summarized. Results: Both OSA and asthma are very prevalent conditions. The incidences of them have kept on rising in recent years. Asthma is often accompanied by snoring and apnea, and OSA often combines with asthma, as well. They have many predisposing and aggravating factors in common. Possible shared direct mechanistic links between them include mechanical effects, intermittent hypoxia, nerve reflex, inflammation, leptin, etc. Indirect mechanistic links include medication, nose diseases, smoking, obesity, and gastroesophageal reflux disease. Since OSA presents many similar features with nocturnal asthma, some scholars termed them as a sole syndrome - "alternative overlap syndrome," and proved that asthma symptoms in those patients could be improved through the treatment of continuous positive airway pressure. Conclusions: OSA and asthma are closely associated in pathogenesis, symptoms, and therapies. With the growing awareness of the relationship between them, we should raise our vigilance on the coexistence of OSA in those difficult-to-control asthmatic patients. Further studies are still needed to guide the clinical works.

  4. Percutaneous transhepatic cholangiographic evaluation of obstructive jaundice

    International Nuclear Information System (INIS)

    Kang, Hee Tae; Kim, Hong Soo; Kim, Jong Deok; Rhee, Hak Song

    1983-01-01

    PTC is the single most valuable diagnostic method available to evaluate the size, shape and site of the causes of obstructive jaundice among various radiological procedures. The authors reviewed and radiologically classified the PTC films of 203 cases of obstructive jaundice from July, 1977 to June, 1983 at Presbyterian Medical Center, Jeonju confirmed clinically, operatively and pathologically. The results are as follows; 1. The most common cause of obstructive jaundice was bile duct stone (64/203: 31.53%) and the other causes were bile duct cancer (43/203: 21.18%), pancreas cancer (41/203: 20.19%), biliary ascariasis and/or clonorchiasis (20/203: 9.8%), ampulla and duodenal cancer (7/203: 3.45%), fibrotic stenosis of sphincter of Oddi (6/203: 2.96%) etc. in the order. Of these primary involvement with cancer was more frequent (91/203: 44.33%) than stone. 3. The average maximal diameter of extrahepatic bile duct just proximal to the site of obstruction or stenosis by stones or by cancers was nearly equal (2.36 cm : 2.38 cm). 4. Cancers caused complete bile duct obstruction in about 75% (68/91) of cases and also were associated with intrahepatic duct dilatation about 92% (84/91) of cases. But in contrast biliary calculi showed good drainage of contrast medium in 75% (48/64) of cases and 92% (59/64) showed normal diameter

  5. A CLINICAL STUDY OF ADHESIVE INTESTINAL OBSTRUCTION

    Directory of Open Access Journals (Sweden)

    Haricharan

    2015-09-01

    Full Text Available INTRODUCTION: Adhesive intestinal obstruction is an inevitable complication of abdominal surgeries. It has high morbidity with associated poor quality of life and predisposition to repeated hospitalization. Commonest cause of bowel obstruction in developed countries is postoperative adhesions with extrinsic compression of the intestine. Most of them can be managed conservatively. METHODS: A retrospective study of 30 patients admitted with the diagnosis of post - operative adhesive partial bowel obstruction was conducted by analyzing their medical records. Demographic data, clinical presentation including duration, previous surgical procedures, treatments received for the condition and successful conservative approach versus requirement of operative intervention were assesse d. RESULTS: The median age was 31yrs, most in their third decade of life. Male predominance was noted. Pelvic surgeries and gynecological surgeries (26% were found to be the most common cause of adhesive bowel obstruction followed by appendectomy (16%. M ore than two third of the patients (76.7% developed symptoms within two years of the initial surgery. Successful conservative treatment was noted in 22 patients (73.3% and discharged on fourth day of admission. Eight patients (26.6% underwent surgery. T hey all underwent adhesiolysis and had good outcome. CONCLUSIONS: The time - honored practice of expectant management of adhesive partial bowel obstruction has equally good outcome, as compared to various interventions practiced

  6. Body imaging diagnosis of obstructive jaundice

    International Nuclear Information System (INIS)

    Tanehiro, Kenji; Kuno, Nobuyoshi; Kurimoto, Kumiko; Yokota, Tetsuo; Kato, Tomoyuki

    1983-01-01

    We have evaluated the efficacy of ultrasonography (US) and computed tomography (CT) in comparison with endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC), and angiography (AG), and discussed a rational diagnostic approach for the evaluation of obstructive jaundice. The subjects were 70 patients with obstructive jaundice, finally confirmed by subsequent surgery or autopsy. In this study, US and CT achieved a diagnostic accuracy of 95% and 98%, respectively, in detection of the presence and level of an obstruction. Therefore, we consider that US is the best initial procedure for evaluation of obstructive jaundice; followed by CT only when the bilialy ducts should be poorly demonstrated by US because of body habitus or gaseous distension. US might be able to identify even the specific etiology of an obstructive lesion. In tumors of the bilialy tract and the pancreas including small and resectable ones, the diagnostic rate of US was high, 91% for bilialy tract tumor and 100% for pancreatic tumor, which was almost the same as that of ERCP, PTC or AG. This result suggests that US eliminates the need of invasive procedures in some cases before making decision of therapeutic approach, while CT was not so accurate diagnostic modality as US in small lesions. But in papillary tumors, small lesions of the distal common bile duct, and gallstone diseases, either ERCP or PTC yielding almost 100% diagnostic accuracy, is the most reliable procedure, while US or CT did not show a good diagnostic accuracy. (J.P.N.)

  7. Endoscopic third ventriculostomy for obstructive hydrocephalus

    International Nuclear Information System (INIS)

    Ali, M.; Usman, M.; Khan, Z.; Khan, K.M.; Hussain, R.; Khanzada, K.

    2013-01-01

    To determine the success rate of endoscopic third ventriculostomy (ETV) for treating obstructive hydrocephalus. Study Design: Cross-sectional observational study. Place and Duration of Study: The Neurosurgery Department of PGMI, Lady Reading Hospital, Peshawar, from May 2010 to November 2011. Methodology: Patients with obstructive hydrocephalus due to aqueductal stenosis, tectal and non-tectal tumour and already shunted patients for obstructive hydrocephalus presented with blocked shunt were included in the study. Patients with congenital hydrocephalus and secondary to meningitis were excluded. Endoscopic third ventriculostomy was performed. Success, complications and mortality was noted. Data was analyzed by descriptive statistics using SPSS software version 17. Results: There were 155 patients including 72 males and 83 females with ratio of 1: 1.33. Success rate was 71%. Indication of surgery was obstructive hydrocephalus due to aqueductal stenosis, posterior fossa tumour, brain stem and CP angle tumour. Complications were seen in 18 patients including mortality in 3 patients. Conclusion: ETV is effective, safe and successful procedure in patients with obstructive hydrocephalus. It may be used as replacement procedure of ventriculo-peritoneal shunt as initial line of management in selected patients. (author)

  8. MR urography evaluation of obstructive uropathy

    International Nuclear Information System (INIS)

    Grattan-Smith, J.D.; Jones, Richard A.; Little, Stephen B.

    2008-01-01

    Hydronephrosis and the evaluation of obstructive uropathy are the most common indications for MR urography in our practice. Typically our patients fall into one of two groups: infants with antenatal hydronephrosis and older children who present with abdominal pain, hematuria or urinary tract infection. Obstruction in children is usually chronic and partial. Intermittent episodes of increased pressure occur when the urine production exceeds the capacity for drainage. MR urography uses a fluid and diuretic challenge to assess the hydronephrotic kidney. High-quality anatomic images provide a morphologic assessment of the hydronephrotic system. Although it is relatively straightforward to determine if a system is not obstructed on the basis of the renal transit time (RTT), no single parameter is adequate to fully characterize obstruction. By evaluating the changes in signal intensity in the renal parenchyma following contrast administration, the hydronephrotic systems are classified as compensated or decompensated. Delayed RTT and the presence of urine-contrast levels indicate stasis. Calyceal transit time and the difference between the volumetric and the Patlak differential renal function (vDRF-pDRF) are measures of the physiologic changes within the kidney. Additionally, MR urography provides prognostic information by assessing the quality of the renal parenchyma and identifying uropathy preoperatively. MR urography combines both anatomic and functional information in a single test and is capable of providing a comprehensive evaluation of obstructive uropathy that could ultimately help select those patients most likely to benefit from surgical intervention. (orig.)

  9. MR urography evaluation of obstructive uropathy

    Energy Technology Data Exchange (ETDEWEB)

    Grattan-Smith, J.D.; Jones, Richard A. [Emory University School of Medicine, Department of Radiology, Children' s Healthcare of Atlanta, Atlanta, GA (United States); Little, Stephen B. [Children' s Healthcare of Atlanta, Department of Radiology, Atlanta, GA (United States)

    2008-01-15

    Hydronephrosis and the evaluation of obstructive uropathy are the most common indications for MR urography in our practice. Typically our patients fall into one of two groups: infants with antenatal hydronephrosis and older children who present with abdominal pain, hematuria or urinary tract infection. Obstruction in children is usually chronic and partial. Intermittent episodes of increased pressure occur when the urine production exceeds the capacity for drainage. MR urography uses a fluid and diuretic challenge to assess the hydronephrotic kidney. High-quality anatomic images provide a morphologic assessment of the hydronephrotic system. Although it is relatively straightforward to determine if a system is not obstructed on the basis of the renal transit time (RTT), no single parameter is adequate to fully characterize obstruction. By evaluating the changes in signal intensity in the renal parenchyma following contrast administration, the hydronephrotic systems are classified as compensated or decompensated. Delayed RTT and the presence of urine-contrast levels indicate stasis. Calyceal transit time and the difference between the volumetric and the Patlak differential renal function (vDRF-pDRF) are measures of the physiologic changes within the kidney. Additionally, MR urography provides prognostic information by assessing the quality of the renal parenchyma and identifying uropathy preoperatively. MR urography combines both anatomic and functional information in a single test and is capable of providing a comprehensive evaluation of obstructive uropathy that could ultimately help select those patients most likely to benefit from surgical intervention. (orig.)

  10. Transrectal Ultrasonographic Findings of Obstructive Male Infertility

    International Nuclear Information System (INIS)

    Kim, Chang Il; Kim, Yun Hyeon; Kang, Heoung Keun; Kim, Jae Kyu; Park, Jin Gyoon; Park, Heung Il; Park, Kwang Seong

    1996-01-01

    To evaluate the usefulness of the transrectal ultrasound in infertile men with suspected obstructive lesions of sperm transport system. We performed transrectal US in 26 infertile patients in whom obstructive lesions of sperm transport system were suspected in physical examination and laboratory data. 7.0 MHz transrectal transducer was used and the content of analysis of sonographic findings was the presence of vas deferens, seminal vesicle and ejaculatory duct. Also, we measured the width of seminal vesicle and diameter of ejaculatory duct. Transrectal US revealed an accurate diagnosis in 12 infertile men who had obstructive lesions and associated abnormalities in distal sperm transport system, two of congenital bilateral absence of the vasa deferentia and seminal vesicles, two of congenital unilateral absence of the vas deferens and seminal vesicle, three of dilatation of seminal vesicles, and five of dilatation of ejaculatory ducts and proximal ducts. The other 14 patients who had normal findings on transrectal US were revealed to have testicular failure (10 patients) and obstruction of proximal sperm transport system (4 patients) which were beyond the field-of-view of transrectal US. Transrectal US is the useful diagnostic method for the evaluation of infertile men with suspected obstructive lesions of sperm transport system. It can possibly decrease the need for the invasive vasography and may be helpful in the guidance of appropriate management of male infertility

  11. Converse Barrier Certificate Theorems

    DEFF Research Database (Denmark)

    Wisniewski, Rafael; Sloth, Christoffer

    2016-01-01

    This paper shows that a barrier certificate exists for any safe dynamical system. Specifically, we prove converse barrier certificate theorems for a class of structurally stable dynamical systems. Other authors have developed a related result by assuming that the dynamical system has neither...

  12. Skin barrier function

    DEFF Research Database (Denmark)

    2016-01-01

    Renowned experts present the latest knowledge Although a very fragile structure, the skin barrier is probably one of the most important organs of the body. Inward/out it is responsible for body integrity and outward/in for keeping microbes, chemicals, and allergens from penetrating the skin. Since...... the role of barrier integrity in atopic dermatitis and the relationship to filaggrin mutations was discovered a decade ago, research focus has been on the skin barrier, and numerous new publications have become available. This book is an interdisciplinary update offering a wide range of information...... on the subject. It covers new basic research on skin markers, including results on filaggrin and on methods for the assessment of the barrier function. Biological variation and aspects of skin barrier function restoration are discussed as well. Further sections are dedicated to clinical implications of skin...

  13. Barriers to the future

    Energy Technology Data Exchange (ETDEWEB)

    Massey, C T

    1986-09-01

    Opportunities for the British coal industry seem vast yet there are still barriers to progress. Seven areas are identified and discussed: mining mobility (for example, longwall mining systems are rigid and inflexible compared with American stall and pillar working); mine structure (many mines are more suitable to pit ponies than to large pieces of equipment); financial barriers (Government requires the industry to break even in 1987/88); personnel barriers (less specialization, better use of skills); safety barriers (increased use of remote control, ergonomics and robotics to protect workers); microelectronic management (nationalization has cushioned management from the market place; there is a need for a more multidisciplinary approach to the industry); and legal barriers (most legislation in the past has been in response to accidents; legislation external to the industry but affecting it is more fundamental).

  14. Airway distensibility in Chronic Obstructive Airway Disease

    DEFF Research Database (Denmark)

    Winkler Wille, Mathilde Marie; Pedersen, Jesper Holst; Dirksen, Asger

    2013-01-01

    Rationale – Chronic Obstructive Pulmonary Disease (COPD) is a combination of chronic bronchitis and emphysema, which both may lead to airway obstruction. Under normal circumstances, airway dimensions vary as a function of inspiration level. We aim to study the influence of COPD and emphysema......-20% (mild), 20%-30% (moderate) or >30% (severe). Spirometry was performed annually and participants were divided into severity groups according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Data were analysed in a mixed effects regression model with log(airway lumen diameter...... and emphysema, respectively. Conclusions – Airway distensibility decreases significantly with increasing severity of both GOLD status and emphysema, indicating that in COPD the dynamic change in airway calibre during respiration is compromised. Chronic bronchitis and emphysema appear to be interacting...

  15. Evaluation of computed tomography for obstructive jaundice

    International Nuclear Information System (INIS)

    Matsuoka, Shoji; Toda, Hiroshi; Suzuki, Toshihiko

    1980-01-01

    Findings of computed tomography were reviewed in 54 cases where obstructive jaundice was suggested by liver function studies and computed tomography was done with the diagnosis subsequently confirmed by surgery. Dilatation of the intrahepatic bile duct was found in 49 (91%) of the cases and the site of obstruction was determined in 44 cases (82%). The cause was shown in 28 cases (52%). By disease, the cause was correctly diagnosed with gallbladder in 40%, bile duct cancer in 46%, pancreas cancer in 71%, and choledocal cyst in 100%, but cholelithiasis was diagnosed correctly in only 17%. Further, non-calcium cholelithiasis is very difficult to diagnose by computed tomography. Computed tomography is a useful tool for diagnosis of obstructive jaundice as a noninvasive means of evaluating the patient; however, concomitand use of other diagnostic studies is essential for greater accuracy of diagnosis. (author)

  16. Obstructive jaundice due to hepatobiliary cystadenoma or cystadenocarcinoma

    NARCIS (Netherlands)

    Erdogan, Deha; Busch, Olivier R. C.; Rauws, Erik A. J.; van Delden, Otto M.; Gouma, Dirk J.; van-Gulik, Thomas M.

    2006-01-01

    Hepatobiliary cystadenomas (HBC) and cystadenocarcinomas are rare cystic lesions. Most patients with these lesions are asymptomatic, but presentation with obstructive jaundice may occur. The first patient presented with intermittent colicky pain and recurrent obstructive jaundice. Imaging studies

  17. Office of Coast Survey Wrecks and Obstructions Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Office of Coast Survey's Wrecks and Obstructions database contains information on the identified submerged wrecks and obstructions within the U.S. maritime...

  18. Obstruction, US, and the minimally dilated renal collecting system

    International Nuclear Information System (INIS)

    Kamholtz, R.G.; Cronan, J.J.; Dorfman, G.S.

    1987-01-01

    To assess the significance of grade 1 hydronephrosis in the diagnosis of renal obstruction, the authors retrospectively reviewed the abdominal or renal US scans in 395 patients. In 80 patients there was a question of renal obstruction. Grade I hydronephrosis was observed in 33 of the 80 patients and obstruction was confirmed in more than 45% of these. In 315 patients, US was performed for reasons other than renal obstruction. Grade I hydronephrosis was observed in 39 of 315 patients, and obstruction was confirmed in less than 6%. The authors conclude that grade I hydronephrosis is significant when the question of renal obstruction exists. As an incidental finding, however, it is unlikely to represent obstruction. In the recent radiologic and medical literature grade I hydroephrosis is often dismissed as ''normal'' even in the clinical setting of obstruction. This trend is clearly not justified

  19. Office of Coast Survey's Automated Wreck and Obstruction Information System

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Automated Wreck and Obstruction Information System (AWOIS) is an automated file that contains information on wrecks and obstructions, and other significant...

  20. Fibroepithelial ureteral polyps presenting as ureteropelvic obstruction

    Science.gov (United States)

    Cusano, Antonio; Abarzua-Cabezas, Fernando; Kesler, Stuart

    2014-01-01

    A 57-year-old woman presented with bilateral abdominal pain and flank discomfort. Imaging studies, consisting of CT scan, diethylene triamine pentaacetic acid renal scan with Lasix and a retrograde pyelogram, indicated an obstruction at the uteropelvic junction (UPJ), possibly due to fibroepithelial polyps within the ureter. A robotic pyeloplasty revealed a ureteral diverticulum and a thin, still-attached fibroepithelial polyp of approximately 2 cm in length. The patient tolerated the procedure well and was discharged one day postpyeloplasty with no reported complications. This rare clinical scenario should be considered when formulating a diagnosis for a UPJ obstruction. PMID:24759168

  1. Bronchial or Laryngeal Obstruction Induced by Exercise?

    Directory of Open Access Journals (Sweden)

    Ayoub Bey

    2017-06-01

    Full Text Available A child suspected of exercise-induced laryngeal obstruction and asthma is examined by laryngoscopy and respiratory resistance (Rrs after exercise challenge. Immediately at exercise cessation, the visualized adduction of the larynx in inspiration is reflected in a paroxystic increase in Rrs. While normal breathing has apparently resumed later on during recovery from exercise, the pattern of Rrs in inspiration is observed to reoccur following a deep breath or swallowing. The procedure may thus help diagnosing the site of exercise-induced obstruction when laryngoscopy is not available and identify re-inducers of laryngeal dysfunction.

  2. [Obstructive renal insufficiency caused by amoxicillin crystalluria].

    Science.gov (United States)

    Boursas, M; Benhassine, L; Kempf, J; Petit, B; Vuillemin, F

    1997-01-01

    A 76-year-old woman was admitted to the ICU for a meningitis with rhombencephalitis due to Listeria monocytogenes. The treatment included amoxicillin (250 mg.kg-1.day-1) and gentamicin (3 mg.kg-1.day-1 over 6 days). Neurological outcome was favourable. However at the 14th day, an acute renal failure occurred, following macroscopic haematuria and milkiness urine. CT scan and sonography confirmed the diagnosis of obstructive renal failure with bilateral ureteral obstruction. Crystalluria caused by amoxicillin was suspected. Endoscopic ureteral insertion of double-J catheters permitted the recovery of a normal renal function.

  3. Vehicle barrier systems

    International Nuclear Information System (INIS)

    Sena, P.A.

    1986-01-01

    The ground vehicle is one of the most effective tools available to an adversary force. Vehicles can be used to penetrate many types of perimeter barriers, transport equipment and personnel rapidly over long distances, and deliver large amounts of explosives directly to facilities in suicide missions. The function of a vehicle barrier system is to detain or disable a defined threat vehicle at a selected distance from a protected facility. Numerous facilities are installing, or planning to install, vehicle barrier systems and many of these facilities are requesting guidance to do so adequately. Therefore, vehicle barriers are being evaluated to determine their stopping capabilities so that systems can be designed that are both balanced and capable of providing a desired degree of protection. Equally important, many of the considerations that should be taken into account when establishing a vehicle barrier system have been identified. These considerations which pertain to site preparation, barrier selection, system integration and operation, and vehicle/barrier interaction, are discussed in this paper

  4. Increased renal adrenomedullin expression in rats with ureteral obstruction

    DEFF Research Database (Denmark)

    Nørregaard, Rikke; Bødker, Tina; Jensen, Boye L

    2009-01-01

    Ureteral obstruction is characterized by decreased renal blood flow that is associated with hypoxia within the kidney. Adrenomedullin (AM) is a peptide hormone with tissue-protective capacity that is stimulated through hypoxia. We tested the hypothesis that ureteral obstruction stimulates...... increases in response to ureteral obstruction in agreement with expected oxygen gradients. Hypoxia acting through HIF-1alpha accumulation may be an important pathway for the renal response to ureteral obstruction....

  5. Uptake Mechanism of ApoE-Modified Nanoparticles on Brain Capillary Endothelial Cells as a Blood-Brain Barrier Model

    OpenAIRE

    Wagner, Sylvia; Zensi, Anja; Wien, Sascha L.; Tschickardt, Sabrina E.; Maier, Wladislaw; Vogel, Tikva; Worek, Franz; Pietrzik, Claus U.; Kreuter, Jörg; von Briesen, Hagen

    2012-01-01

    Background: The blood-brain barrier (BBB) represents an insurmountable obstacle for most drugs thus obstructing an effective treatment of many brain diseases. One solution for overcoming this barrier is a transport by binding of these drugs to surface-modified nanoparticles. Especially apolipoprotein E (ApoE) appears to play a major role in the nanoparticle-mediated drug transport across the BBB. However, at present the underlying mechanism is incompletely understood. Methodology/Principal Fi...

  6. Converse Barrier Certificate Theorem

    DEFF Research Database (Denmark)

    Wisniewski, Rafael; Sloth, Christoffer

    2013-01-01

    This paper presents a converse barrier certificate theorem for a generic dynamical system.We show that a barrier certificate exists for any safe dynamical system defined on a compact manifold. Other authors have developed a related result, by assuming that the dynamical system has no singular...... points in the considered subset of the state space. In this paper, we redefine the standard notion of safety to comply with generic dynamical systems with multiple singularities. Afterwards, we prove the converse barrier certificate theorem and illustrate the differences between ours and previous work...

  7. Intestinal Obstruction Due to Rectal Endometriosis: A Surgical Enigma

    Directory of Open Access Journals (Sweden)

    Razman Jarmin

    2006-07-01

    Full Text Available Obstructed rectal endometriosis is an uncommon presentation. The clinical and intraoperative presentation may present as malignant obstruction. The difficulty in making the diagnosis may delay the definitive management of the patient. We report a unique case of rectal endometriosis mimicking malignant rectal mass causing intestinal obstruction and discuss the management of the case.

  8. Gastroesophageal Reflux Symptoms in Patients with Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Zlatica Goseva

    2014-09-01

    CONCLUSION: GER symptoms are more prevalent in patients with severe airways obstruction when compared to less airways obstructed group and controls. We could suggest an association between the degree of airways obstruction in patients with COPD and the increased rate of GER symptoms.

  9. Apple-peel atresia presenting as foetal intestinal obstruction ...

    African Journals Online (AJOL)

    Apple-peel atresia or Type 3 jejuno-ileal atresia (JIA) is an uncommon cause of foetal intestinal obstruction. Bowel obstruction in the foetus is diagnosed on the prenatal ultrasonography only in 50% cases. We report a case in which foetal intestinal obstruction was diagnosed on prenatal ultrasonography. The child showed ...

  10. A framework to overcome barriers to green innovation in SMEs using BWM and Fuzzy TOPSIS.

    Science.gov (United States)

    Gupta, Himanshu; Barua, Mukesh Kumar

    2018-08-15

    Recent years have witnessed a significant rise in exploring the barriers which obstruct adoption of green practices by SMEs. There is a constant need to innovate in terms of products, processes, and management so that we can overcome these barriers to green practices adoption and implementation. This study employs a three-phase methodology to identify barriers and solutions to overcome these barriers to green innovation in SMEs. Through extensive literature review and the opinion of selective manager's, seven main category barriers, thirty-six sub-category barriers, and twenty solutions to overcome these barriers were identified. BWM is used to rank these barriers and Fuzzy TOPSIS is used to rank solutions to overcome these barriers. Four Indian SMEs are taken to exemplify the proposed three paged model. To check the robustness of the model, a sensitivity analysis was also performed. The results of the analysis can act as a stepping stone for SME managers to eliminate and overcome barriers to green innovation in their firm and compete healthily in the market. The paper sets a framework for future studies in this area of research-work. Copyright © 2018 Elsevier B.V. All rights reserved.

  11. Information barriers and authentication

    International Nuclear Information System (INIS)

    MacArthur, D.W.; Wolford, J.K.

    2001-01-01

    Acceptance of nuclear materials into a monitoring regime is complicated if the materials are in classified shapes or have classified composition. An attribute measurement system with an information barrier can be emplo,yed to generate an unclassified display from classified measurements. This information barrier must meet two criteria: (1) classified information cannot be released to the monitoring party, and (2) the monitoring party must be convinced that the unclassified output accurately represents the classified input. Criterion 1 is critical to the host country to protect the classified information. Criterion 2 is critical to the monitoring party and is often termed the 'authentication problem.' Thus, the necessity for authentication of a measurement system with an information barrier stems directly from the description of a useful information barrier. Authentication issues must be continually addressed during the entire development lifecycle of the measurement system as opposed to being applied only after the system is built.

  12. Barrier Infrared Detector (BIRD)

    Data.gov (United States)

    National Aeronautics and Space Administration — A recent breakthrough in MWIR detector design, has resulted in a high operating temperature (HOT) barrier infrared detector (BIRD) that is capable of spectral...

  13. Protective barrier development: Overview

    International Nuclear Information System (INIS)

    Wing, N.R.; Gee, G.W.

    1990-01-01

    Protective barrier and warning marker systems are being developed to isolate wastes disposed of near the earth's surface at the Hanford Site. The barrier is designed to function in an arid to semiarid climate, to limit infiltration and percolation of water through the waste zone to near-zero, to be maintenance free, and to last up to 10,000 yr. Natural materials (e.g., fine soil, sand, gravel, riprap, clay, asphalt) have been selected to optimize barrier performance and longevity and to create an integrated structure with redundant features. These materials isolate wastes by limiting water drainage; reducing the likelihood of plant, animal, and human intrusion; controlling emission of noxious gases; and minimizing erosion. Westinghouse Hanford Company and Pacific Northwest Laboratory efforts to assess the performance of various barrier and marker designs will be discussed

  14. Engineered barriers: current status

    International Nuclear Information System (INIS)

    Atkinson, A.; Marsh, G.P.

    1988-01-01

    This report summarises the current state of research relevant to assessing the performance of engineered barriers made of steel and concrete in radioactive waste repositories. The objective of these barriers is to contain the radionuclides within them by providing both physical and chemical impediment to their release. The physical barriers are of most value for highly soluble isotopes with relatively short half-lives (eg 137 Cs), since they can provide containment until a large fraction of the activity has decayed. In addition they can facilitate retrievability for some period after disposal. The chemical barriers operate by beneficial conditioning of the near field groundwater and providing sites for sorption of radionuclides. Both of these reduce the aqueous concentration of radionuclides in the near field. (author)

  15. Intestinal obstruction secondary to infantile polyarteritis nodosa ...

    African Journals Online (AJOL)

    Polyarteritis Nodosa (PAN) is a rare systemic necrotising vasculitis of medium and small-sized arteries. Patients typically present with systemic symptoms. Obstructive intestinal symptoms are described but usually resolve with treatment of the underlying vascular disease. We report a case of a one year old boy with multiple ...

  16. Snoring and obstructive sleep apnoea syndrome among ...

    African Journals Online (AJOL)

    Background: Obstructive sleep apnoea (OSA) syndrome is a common disorder in the community. Association between hypertension and sleep apnoea and /or snoring has been described. The Berlin questionnaire is a validated instrument that is used to identify individuals who are at risk for OSA. The study aim to describe ...

  17. Obstructive jaundice promotes bacterial translocation in humans.

    Science.gov (United States)

    Kuzu, M A; Kale, I T; Cöl, C; Tekeli, A; Tanik, A; Köksoy, C

    1999-01-01

    Significant bacterial translocation was demonstrated following experimental biliary obstruction, however very little is known about the importance and the prevalence of gut-origin sepsis in obstructive jaundice patients. Therefore, the aim of this study was to investigate the concept of gut-origin sepsis in obstructive jaundiced patients and its clinical importance. Twenty-one patients requiring laparotomy for obstructive jaundice (group I) and thirty patients operated on electively mainly for chronic cholecystitis (group II) were studied. Peritoneal swab, mesenteric lymph node, portal venous blood, liver wedge biopsy and bile were sampled for culture immediately after opening the peritoneum. Additionally, peripheral blood samples were taken pre- and post-operatively from all patients. Post-operatively, patients were monitored for infectious complications. The mean serum bilirubin concentration, gamma glutamyl transferase and alkaline phosphatase levels in jaundiced patients before therapeutic intervention were significantly higher than in control patients. Five patients demonstrated bacterial translocation in group I (24%), whereas only one did so in group II (3.5%, p jaundice significantly promotes bacterial translocation in humans, however, its clinical importance has yet to be defined.

  18. Extrahepatic biliary obstruction; postoperative morbidity and mortality

    International Nuclear Information System (INIS)

    Hussain, Z.; Khan, K.I.; Vaseem, M.; Rana, S.H.

    2010-01-01

    The objectives of this study are to evaluate the surgical management, both definitive and palliative, in selected patients with biliary obstruction and to find out the postoperative morbidity and mortality in these patients. Duration of the study is two years conducted from June 2002 to May 2004. The study was carried out at. the surgical. unit 4 of the Combined Military Hospital and surgical department of the Military Hospital. Thirty eight cases of biliary obstruction were included. A convenient sampling technique was followed. Data analyzed by using SPSS version 10.0 for windows on computer. Descriptive statistics like frequency, percentage, average etc were computed for data presentation. Any inferential test-was not found to be applicable for this descriptive type case series. We selected 38 patients with features of extrahepatic biliary obstruction. Out of these (n 38) 15 patients (39.5%) suffered from benign diseases while those having malignant diseases were 23 (60.5%). 19 (50%) patients died within two years of follow up while 19 (50%) were the survivors. Mortality was maximum for the malignant cases. In benign cases only one patient died. Maximum deaths 6 (31.6%) occurred in the period of up to one month of operation. 20 patients had one or another complication of operation and hence the morbidity came out to be 52%. According to our results the mortality and morbidity related to extrahepatic biliary obstruction in our patients was higher compared to other studies which can only be reduced by early detection and treatment. (author)

  19. Exceptional cause of bowel obstruction: rectal endometriosis ...

    African Journals Online (AJOL)

    Endometriosis with intestinal serosal involvement is not uncommon in women of childbearing age. However, endometriosis presenting as colon obstruction is rare and occurs in less than 1% of cases. The Lack of pathognomonic signs makes the diagnosis difficult, mostly because the main differential diagnosis is with ...

  20. Mandibular advancement appliance for obstructive sleep apnoea

    DEFF Research Database (Denmark)

    Petri, Niels; Svanholt, Palle; Solow, Beni

    2008-01-01

    The aim of this trial was to evaluate the efficacy of a mandibular advancement appliance (MAA) for obstructive sleep apnoea (OSA). Ninety-three patients with OSA and a mean apnoea-hypopnoea index (AHI) of 34.7 were centrally randomised into three, parallel groups: (a) MAA; (b) mandibular non...

  1. Management of obstructive sleep apnea in Europe

    DEFF Research Database (Denmark)

    Fietze, I; Penzel, T; Alonderis, A

    2011-01-01

    In Europe, the services provided for the investigation and management of obstructive sleep apnoea (OSA) varies from country to country. The aim of this questionnaire-based study was to investigate the current status of diagnostic pathways and therapeutic approaches applied in the treatment of OSA...

  2. Natural histories of chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Rennard, Stephen I; Vestbo, Jørgen

    2008-01-01

    Concepts relating to the natural history of chronic obstructive pulmonary disease (COPD) arise most importantly from the classic study of Fletcher and colleagues (The Natural History of Chronic Bronchitis and Emphysema, Oxford University Press, New York, 1976). This study, which evaluated working...

  3. Chronic obstructive pulmonary disease and cancer risk

    DEFF Research Database (Denmark)

    Kornum, Jette Brommann; Sværke, Claus; Thomsen, Reimar Wernich

    2012-01-01

    Little is known about the risk of cancer in patients with chronic obstructive pulmonary disease (COPD), including which cancer sites are most affected. We examined the short- and long-term risk of lung and extrapulmonary cancer in a nationwide cohort of COPD patients....

  4. Chronic obstructive pulmonary disease in Denmark

    DEFF Research Database (Denmark)

    Lykkegaard, Jesper; Kristensen, Gustav N

    2016-01-01

    BACKGROUND: During the 80s and 90s the mortality and number of hospitalisations due to chronic obstructive pulmonary disease (COPD) in the country of Denmark almost doubled. Since then there has been a plateau. OBJECTIVE: To analyse age, period, and cohort effects on rates of deaths and first...

  5. Dynamic bowel obstruction: aetiology, clinical presentation ...

    African Journals Online (AJOL)

    This study was conducted to describe in our region, the aetiology, clinical presentation, management and outcome of dynamic bowel obstruction. Data were analyzed using SPSS software system. A total of 342 patients were studied. Males outnumbered females by a ratio of 2.1: 1. The median age of patients at presentation ...

  6. Obstructive jaundice and advanced gastric carcinoma

    International Nuclear Information System (INIS)

    Saida, Yukihisa; Tsunoda, Hiroko; Kurosaki, Yoshihisa

    1989-01-01

    One hundred twenty-nine patients with far advanced or recurrent gastric carcinoma underwent computed tomography (CT) of the abdomen. There were three histologic types: differentiated (n=41), undifferentiated (n=68), and unclassified (n=20). Eighteen patients who had developed obstructive jaundice were retrospectively studied to elucidate the nature of obstruction with histologic correlation. In differentiated carcinomas tumor tended to grow in an expansive fashion. A fairly large, well-defined lymph adenopathy was observed on CT. The extrahepatic bile duct surrounded by lymph nodes appeared as ''doughnot sign'' in six of eight patients. Undifferentiated gastric carcinoma had tendency to extend infiltratively. Bile duct obstruction was only a part of diffuse spreading. In spite of the presence of obstructive jaundice, no discrete mass was demonstrated around the extrahepatic bile duct on CT. In none of nine patients was present ''doughnot sign''. The significance of lymph node dissection along the extrahepatic bile duct in patients with differentiated gastric carcinoma was emphasized. The region of hepatoduodenal and pancreatico-duodenal lymph nodes should be carefully evaluated in interpretation of abdominal CT. (author)

  7. Postoperative Adhesive Intestinal Obstruction from Gossypiboma ...

    African Journals Online (AJOL)

    We report a case of 41.year.old female admitted with features of intestinal obstruction and had a previous history of hysterectomy performed 2 months back at another hospital. Pathologists must be aware of this entity and its proper reporting as the cases are liable to go to court. Surgeons must recognize the risk factors that ...

  8. Emergency management of acute colonic cancer obstruction.

    Science.gov (United States)

    Gainant, A

    2012-02-01

    Emergency management of obstructing colonic cancer depends on both tumor location and stage, general condition of the patient and surgeon's experience. Right sided or transverse colon obstructing cancers are usually treated by right hemicolectomy-extended if necessary to the transverse colon-with primary anastomosis. For left-sided obstructing cancer, in patients with low surgical risk, primary resection and anastomosis associated with on-table irrigation or manual decompression can be performed. It prevents the confection of a loop colostomy but presents the risk of anastomotic leakage. Subtotal or total colectomy allows the surgeon to encompass distended and fecal-loaded colon, and to perform one-stage resection and anastomosis. Its disadvantage is an increased daily frequency of stools. It must be performed only in cases of diastatic colon perforation or synchronous right colonic cancer. In patients with high surgical risk, Hartmann procedure must be preferred. It allows the treatment of both obstruction and cancer, and prevents anastomotic leakage but needs a second operation to reverse the colostomy. Colonic stenting is clinically successful in up to 90% in specialized groups. It is used as palliation in patients with disseminated disease or bridge to surgery in the others. If stent insertion is not possible, loop colostomy is still indicated in patients at high surgical risk. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  9. Antegrade Colonic Lavage in Acute Colonic Obstruction

    OpenAIRE

    Foster, Michael E.; Johnson, Colin D.

    1986-01-01

    Conventional management of acute left sided colonic obstruction employs some form of proximal colostomy. Intraoperative antegrade colonic irrigation relieves proximal faecal loading and may permit safer primary resection and anastomosis. The results of a pilot study are presented, and are shown to be favourable.

  10. Dynamic bowel obstruction: aetiology, clinical presentation ...

    African Journals Online (AJOL)

    2005). This makes it essential that studies are made periodically in every region to define the local causes with the idea to do work on their prevention (Adhikari et al., 2010). This study was conducted to describe in our region, the aetiology, clinical presentation, management and outcome of dynamic bowel obstruction.

  11. Genetics Home Reference: intestinal pseudo-obstruction

    Science.gov (United States)

    ... A characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to their sons. Intestinal pseudo-obstruction caused by ACTG2 gene mutations is inherited in an autosomal dominant pattern , which means one copy of the altered ...

  12. Unusual cause of neonatal intestinal obstruction | Zikavska ...

    African Journals Online (AJOL)

    There are many causes of intestinal obstruction in the neonatal age. The most common types are mechanical and result from congenital malformations of the gastrointestinal tract. However, functional disorders also occur. In some cases, diagnosis can be made prenatally but in others manifestation occurs after birth. The aim ...

  13. Cognitive complaints in obstructive sleep apnea

    NARCIS (Netherlands)

    Vaessen, T.J.A.; Overeem, S.; Sitskoorn, M.M.

    2015-01-01

    Obstructive sleep apnea (OSA) is associated with impairments in cognitive functioning. Although cognitive complaints are related to quality of life, work productivity and health care expenditures, most research and all reviews have focused exclusively on objective cognitive functioning so far. In

  14. 36 CFR 1004.13 - Obstructing traffic.

    Science.gov (United States)

    2010-07-01

    ... road, except as authorized by the Executive Director, or in the event of an accident or other condition... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Obstructing traffic. 1004.13 Section 1004.13 Parks, Forests, and Public Property PRESIDIO TRUST VEHICLES AND TRAFFIC SAFETY § 1004.13...

  15. 36 CFR 4.13 - Obstructing traffic.

    Science.gov (United States)

    2010-07-01

    ... VEHICLES AND TRAFFIC SAFETY § 4.13 Obstructing traffic. The following are prohibited: (a) Stopping or parking a vehicle upon a park road, except as authorized by the superintendent, or in the event of an accident or other condition beyond the control of the operator. (b) Operating a vehicle so slowly as to...

  16. Pulmonary biomarkers in chronic obstructive pulmonary disease

    NARCIS (Netherlands)

    Barnes, Peter J.; Chowdhury, Badrul; Kharitonov, Sergei A.; Magnussen, Helgo; Page, Clive P.; Postma, Dirkje; Saetta, Marina

    2006-01-01

    There has been increasing interest in using pulmonary biomarkers to understand and monitor the inflammation in the respiratory tract of patients with chronic obstructive pulmonary disease (COPD). In this Pulmonary Perspective we discuss the merits of the various approaches by reviewing the current

  17. Obstruction of cerebral arteries in childhood stroke

    International Nuclear Information System (INIS)

    Velkey, I.; Lombay, B.; Panczel, G.

    1992-01-01

    Middle cerebral artery obstruction in children is reviewed by our two cases. Ischemic childhood stroke was caused by moyamoya disease in the first, and by fibromuscular dysplasia in the second patient. In both cases transcranial Doppler sonography and cranial CT were performed, but the final diagnosis was made by angiography. The importance of angiography in childhood stroke is emphasized. (orig.)

  18. Skin barrier composition

    International Nuclear Information System (INIS)

    Osburn, F.G.

    1985-01-01

    A skin barrier composition comprises a mixture of a copolymer resin of ethylene and vinyl acetate (EVA), and a water-insoluble dry tack-providing elastomer such as polyisobutylene. The composition after mixing and molding, is subjected to ionizing irradiation to form cross-linked polymer networks of the EVA. The compositions have exceptional properties for use as barrier sheets, rings, or strips in ostomy, wound drainage, and incontinence devices. (author)

  19. Skin barrier composition

    Energy Technology Data Exchange (ETDEWEB)

    Osburn, F G

    1985-06-12

    A skin barrier composition comprises a mixture of a copolymer resin of ethylene and vinyl acetate (EVA), and a water-insoluble dry tack-providing elastomer such as polyisobutylene. The composition after mixing and molding, is subjected to ionizing irradiation to form cross-linked polymer networks of the EVA. The compositions have exceptional properties for use as barrier sheets, rings, or strips in ostomy, wound drainage, and incontinence devices.

  20. Reduced upper obstructions in N3 and increased lower obstructions in REM sleep stage detected with manometry.

    Science.gov (United States)

    Wirth, Markus; Schramm, Juliane; Bautz, Maximilian; Hofauer, Benedikt; Edenharter, Günther; Ott, Armin; Heiser, Clemens

    2018-01-01

    In obstructive sleep apnea (OSA), airway obstruction occurs at different anatomic levels. The frequency and location of obstructions play a crucial role in the planning of surgical treatment. The aim of this study was to evaluate the pharyngeal obstruction levels in different sleep stages with manometry in OSA patients. In addition, the manometry results were compared with drug-induced sleep endoscopy (DISE). Forty-one patients with OSA received manometry measurements during one night of sleep. All patients were simultaneously evaluated with polysomnography. The frequency of obstructions in different sleep stages was assessed. Twenty patients were additionally studied with DISE. Obstruction levels detected with manometry were compared with DISE. The frequency of upper and to a lesser extent lower obstructions decreased in sleep stage N3. In rapid eye movement (REM) sleep, lower obstructions increased. The overall proportion of upper and lower obstructions detected with manometry corresponded with DISE in 13 of 20 cases. A significant change in the obstruction levels was detected with manometry in N3 and REM sleep. The reduction of both upper and to a lesser extent lower obstructions in N3 suggests more stable airways in slow-wave sleep. Relevant lower obstructions were not detected in DISE compared to manometry in 5 out of 20 examinations. This could be a potential reason for treatment failure of site-specific surgical OSA treatment when only performing DISE preoperatively. Therefore, manometry could be a useful complementary tool in the preoperative evaluation for OSA.

  1. Obstructive sleep apnea syndrome and growth failure.

    Science.gov (United States)

    Esteller, E; Villatoro, J C; Agüero, A; Lopez, R; Matiñó, E; Argemi, J; Girabent-Farrés, M

    2018-05-01

    Obstructive sleep apnea syndrome is a common problem among children and is recognized as a cause of significant medical morbidity. Since the 1980s, it has been suggested that obstructive sleep apnea syndrome is a risk factor for growth failure in children. In many cases, it has been shown that growth failure is reversible once the obstructive sleep apnea syndrome is resolved. The objectives of this study were to analyze and compare growth failure prevalence in a Mediterranean population of children with obstructive sleep apnea syndrome and healthy children matched in age and sex, and to assess the effectiveness of tonsillectomy and adenoidectomy in resolving growth retardation. We compared 172 children with obstructive sleep apnea syndrome (apnea-hypopnea index ≥ 3) who had undergone tonsillectomy and adenoidectomy with 172 healthy controls in terms of key anthropometric parameters. Most of the criteria used for growth failure were higher to a statistically significant degree in the study group vs the control group: height-for-age ≤ 3rd percentile (7.56% vs 2.91%; p = 0.044), weight-for-age ≤ 5th percentile (9.30% vs 2.33%; p = 0.005), weight-for-age ≤ 3rd percentile (8.14% vs 2.33%; p = 0.013) and height and/or weight for-age ≤ 5th percentile (13.95% vs 5.81%; p = 0.009). The height-for-age ≤ 5th percentile was almost at the limit of statistical significance (8.72% for the study group vs 4.65% for the control group; p = 0.097). At one-year post-surgery follow-up, 10 of 15 children with height-for-age ≤ 5th percentile had achieved catch-up growth (66.6%), and 14 of 24 children with height- and/or weight-for-age ≤ 5th percentile had normalized growth (58.33%). For children with failure to thrive or who have growth failure, physicians should consider the possibility of obstructive sleep apnea. A significant number of children with obstructive sleep apnea concurrent with growth failure could benefit from

  2. Association of chronic obstructive pulmonary disease and obstructive sleep apnea consequences

    Directory of Open Access Journals (Sweden)

    Carlos Zamarrón

    2009-01-01

    Full Text Available Carlos Zamarrón1, Vanesa García Paz1, Emilio Morete1, Felix del Campo Matías21Servicio de Neumología, Hospital Clínico Universitario de Santiago, Santiago, Spain; 2Servicio de Neumologia, Hospital Universitario Rio Ortega de Vallaclolid, Vallaclolid, SpainAbstract: Obstructive sleep apnea syndrome (OSAS and chronic obstructive pulmonary disease (COPD are two diseases that often coexist within an individual. This coexistence is known as overlap syndrome and is the result of chance rather than a pathophysiological link. Although there are claims of a very high incidence of OSAS in COPD patients, recent studies report that it is similar to the general population. Overlap patients present sleep-disordered breathing associated to upper and lower airway obstruction and a reduction in respiratory drive. These patients present unique characteristics, which set them apart from either COPD or OSAS patients. COPD and OSAS are independent risk factors for cardiovascular events and their coexistence in overlap syndrome probably increases this risk. The mechanisms underlying cardiovascular risk are still unclear, but may involve systemic inflammation, endothelial dysfunction, and tonic elevation of sympathetic neural activity. The treatment of choice for overlap syndrome in stable patients is CPAP with supplemental oxygen for correction of upper airway obstructive episodes and hypoxemia during sleep.Keywords: chronic obstructive pulmonary disease, obstructive sleep apnea syndrome, overlap syndrome, sleep, cardiovascular disease

  3. Murine model of long term obstructive jaundice

    Science.gov (United States)

    Aoki, Hiroaki; Aoki, Masayo; Yang, Jing; Katsuta, Eriko; Mukhopadhyay, Partha; Ramanathan, Rajesh; Woelfel, Ingrid A.; Wang, Xuan; Spiegel, Sarah; Zhou, Huiping; Takabe, Kazuaki

    2016-01-01

    Background With the recent emergence of conjugated bile acids as signaling molecules in cancer, a murine model of obstructive jaundice by cholestasis with long-term survival is in need. Here, we investigated the characteristics of 3 murine models of obstructive jaundice. Methods C57BL/6J mice were used for total ligation of the common bile duct (tCL), partial common bile duct ligation (pCL), and ligation of left and median hepatic bile duct with gallbladder removal (LMHL) models. Survival was assessed by Kaplan-Meier method. Fibrotic change was determined by Masson-Trichrome staining and Collagen expression. Results 70% (7/10) of tCL mice died by Day 7, whereas majority 67% (10/15) of pCL mice survived with loss of jaundice. 19% (3/16) of LMHL mice died; however, jaundice continued beyond Day 14, with survival of more than a month. Compensatory enlargement of the right lobe was observed in both pCL and LMHL models. The pCL model demonstrated acute inflammation due to obstructive jaundice 3 days after ligation but jaundice rapidly decreased by Day 7. The LHML group developed portal hypertension as well as severe fibrosis by Day 14 in addition to prolonged jaundice. Conclusion The standard tCL model is too unstable with high mortality for long-term studies. pCL may be an appropriate model for acute inflammation with obstructive jaundice but long term survivors are no longer jaundiced. The LHML model was identified to be the most feasible model to study the effect of long-term obstructive jaundice. PMID:27916350

  4. Obstructive sleep apnea, inflammation, and cardiopulmonary disease.

    Science.gov (United States)

    Arter, Jim L; Chi, David S; M, Girish; Fitzgerald, S Matthew; Guha, Bhuvana; Krishnaswamy, Guha

    2004-09-01

    Obstructive sleep apnea (OSA) occurs commonly in the U.S. population and is seen in both obese as well as non-obese individuals. OSA is a disease characterized by periodic upper airway collapse during sleep, which then results in either apnea, hypopnea, or both. The disorder leads to a variety of medical complications. Neuropsychiatric complications include daytime somnolence, cognitive dysfunction, and depression. Increased incidence of motor vehicle accidents has been documented in these patients and probably reflects disordered reflex mechanisms or excessive somnolence. More importantly, vascular disorders such as hypertension, stroke, congestive cardiac failure, arrhythmias, and atherosclerosis occur frequently in these patients. The lungs may be affected by pulmonary hypertension and worsening of asthma. Recent data from several laboratories demonstrate that obstructive sleep apnea is characterized by an inflammatory response. Cytokines are elaborated during the hypoxemic episodes leading to inflammatory responses as marked clinically by elevated C-reactive protein (CRP). As elevated CRP levels are considered markers of the acute phase response and characterize progression of vascular injury in coronary artery disease, it is likely that obstructive sleep apnea could lead to worsening of vasculopathy. Moreover, as inflammatory mechanisms regulate bronchial asthma, it is also likely that cytokines and superoxide radicals generated during hypoxemic episodes could exacerbate reactive airway disease. Patients with Cough, Obstructive sleep apnea, Rhinosinusitis, and Esophageal reflux clustered together can be categorized by the acronym, "CORE", syndrome. The purpose of this manuscript is to review the inflammatory responses that occur in patients with obstructive sleep apnea and relate them to the occurrence of cardiopulmonary disease.

  5. Double obstruction of ureter: A diagnostic challenge.

    Science.gov (United States)

    Halder, Pankaj; Shukla, Ram Mohan; Mandal, Kartik Chandra; Mukhopadhyay, Biswanath; Barman, Shibsankar

    2014-07-01

    Isolated obstruction of the ureteropelvic junction and the vesico-ureteric junction are the two most common causes of hydronephrosis in a pediatric population.[1] They do not pose diagnostic difficulties when are present alone but when together can be difficult to diagnose. Here, we discuss the problems we faced when we encountered these two anomalies in the same ureter and the way in which we managed them. To assess the difficulties in diagnosis of pediatric patients who present with both ureteropelvic junction obstruction (UPJO) and vesico-ureteric junction obstruction (VUJO) in the ipsilateral ureter and their management protocol. This is a retrospective study. The study period is from 1 January 2004 to 31 December 2011. Out of 254 children who were diagnosed to have hydronephrosis due to UPJO in our institute, 5 patients (in the age range of 5 to 10 years) had both UPJO and VUJO in the ipsilateral ureter. The problems we faced in diagnosing the two conditions are mentioned with a literature review. Operative intervention was used in four out of five patients; none of the patients had an accurate diagnosis before surgery. All patients were suspected of having double obstruction during pyeloplasty when appropriate size double J stent could not be negotiated through the vesicoureteric junction into the bladder. Postoperative nephrostogram confirmed the diagnosis in all patients. Children with double obstruction of the ipsilateral ureter present as a diagnostic dilemma. Because of the rarity of this condition it can escape the eye of even an astute clinician. Early diagnosis can be made if this condition is kept in mind while treating any hydronephrosis due to UPJO or UVJO.

  6. Double obstruction of ureter: A diagnostic challenge

    Directory of Open Access Journals (Sweden)

    Pankaj Halder

    2014-01-01

    Full Text Available Introduction: Isolated obstruction of the ureteropelvic junction and the vesico-ureteric junction are the two most common causes of hydronephrosis in a pediatric population. [1] They do not pose diagnostic difficulties when are present alone but when together can be difficult to diagnose. Here, we discuss the problems we faced when we encountered these two anomalies in the same ureter and the way in which we managed them. Aim: To assess the difficulties in diagnosis of pediatric patients who present with both ureteropelvic junction obstruction (UPJO and vesico-ureteric junction obstruction (VUJO in the ipsilateral ureter and their management protocol. Materials and Methods: This is a retrospective study. The study period is from 1 January 2004 to 31 December 2011. Out of 254 children who were diagnosed to have hydronephrosis due to UPJO in our institute, 5 patients (in the age range of 5 to 10 years had both UPJO and VUJO in the ipsilateral ureter. The problems we faced in diagnosing the two conditions are mentioned with a literature review. Results: Operative intervention was used in four out of five patients; none of the patients had an accurate diagnosis before surgery. All patients were suspected of having double obstruction during pyeloplasty when appropriate size double J stent could not be negotiated through the vesicoureteric junction into the bladder. Postoperative nephrostogram confirmed the diagnosis in all patients. Conclusion: Children with double obstruction of the ipsilateral ureter present as a diagnostic dilemma. Because of the rarity of this condition it can escape the eye of even an astute clinician. Early diagnosis can be made if this condition is kept in mind while treating any hydronephrosis due to UPJO or UVJO.

  7. Iliocaval Confluence Stenting for Chronic Venous Obstructions

    Energy Technology Data Exchange (ETDEWEB)

    Graaf, Rick de, E-mail: r.de.graaf@mumc.nl [Maastricht University Medical Centre (MUMC), Department of Radiology (Netherlands); Wolf, Mark de, E-mail: markthewolf@gmail.com [Maastricht University Medical Centre (MUMC), Department of Surgery (Netherlands); Sailer, Anna M., E-mail: anni.sailer@mumc.nl [Maastricht University Medical Centre (MUMC), Department of Radiology (Netherlands); Laanen, Jorinde van, E-mail: jorinde.van.laanen@mumc.nl; Wittens, Cees, E-mail: c.wittens@me.com [Maastricht University Medical Centre (MUMC), Department of Surgery (Netherlands); Jalaie, Houman, E-mail: hjalaie@ukaachen.de [University Hospital Aachen, Department of Surgery (Germany)

    2015-10-15

    PurposeDifferent techniques have been described for stenting of venous obstructions. We report our experience with two different confluence stenting techniques to treat chronic bi-iliocaval obstructions.Materials and MethodsBetween 11/2009 and 08/2014 we treated 40 patients for chronic total bi-iliocaval obstructions. Pre-operative magnetic resonance venography showed bilateral extensive post-thrombotic scarring in common and external iliac veins as well as obstruction of the inferior vena cava (IVC). Stenting of the IVC was performed with large self-expandable stents down to the level of the iliocaval confluence. To bridge the confluence, either self-expandable stents were placed inside the IVC stent (24 patients, SECS group) or high radial force balloon-expandable stents were placed at the same level (16 patients, BECS group). In both cases, bilateral iliac extensions were performed using nitinol stents.ResultsRecanalization was achieved for all patients. In 15 (38 %) patients, a hybrid procedure with endophlebectomy and arteriovenous fistula creation needed to be performed because of significant involvement of inflow vessels below the inguinal ligament. Mean follow-up was 443 ± 438 days (range 7–1683 days). For all patients, primary, assisted-primary, and secondary patency rate at 36 months were 70, 73, and 78 %, respectively. Twelve-month patency rates in the SECS group were 85, 85, and 95 % for primary, assisted-primary, and secondary patency. In the BECS group, primary patency was 100 % during a mean follow-up period of 134 ± 118 (range 29–337) days.ConclusionStenting of chronic bi-iliocaval obstruction shows relatively high patency rates at medium follow-up. Short-term patency seems to favor confluence stenting with balloon-expandable stents.

  8. Progress in surgical palliative treatment for malignant obstructive jaundice

    Directory of Open Access Journals (Sweden)

    LIANG Zhang

    2013-06-01

    Full Text Available Obstructive jaundice, also known as surgical jaundice, is divided into benign and malignant types. Most of the patients newly diagnosed with malignant obstructive jaundice have lost the opportunity of receiving radical surgery due to its insidious onset, so surgical palliative treatment is very important for patients with advanced malignant obstructive jaundice. This paper elaborates on various current modalities of surgical palliative treatment for malignant obstructive jaundice. Appropriate modality of surgical palliative treatment is of great significance for patients with advanced malignant obstructive jaundice.

  9. Percutaneous Transhepatic Duodenal Drainage as an Alternative Approach in Afferent Loop Obstruction with Secondary Obstructive Jaundice in Recurrent Gastric Cancer

    International Nuclear Information System (INIS)

    Yao, N.-S.; Wu, C.-W.; Tiu, Chui-Mei; Liu, Jacqueline M.; Whang-Peng, Jacqueline; Chen, L.-T.

    1998-01-01

    Two cases are reported of chronic, partial afferent loop obstruction with resultant obstructive jaundice in recurrent gastric cancer. The diagnosis was made by characteristic clinical presentations, abdominal computed tomography, and cholescintigraphy. Percutaneous transhepatic duodenal drainage (PTDD) provided effective palliation for both afferent loop obstruction and biliary stasis. We conclude that cholescintigraphy is of value in making the diagnosis of partial afferent loop obstruction and in differentiating the cause of obstructive jaundice in such patients, and PTDD provides palliation for those patients in whom surgical intervention is not feasible

  10. Thermo-Responsive non-woven scaffolds for ‘‘smart’’ 3D cell culture

    CSIR Research Space (South Africa)

    Rossouw, CL

    2012-08-01

    Full Text Available fabricated from poly(propylene) (PP), poly(ethylene terephthalate) (PET), and nylon that had been grafted with PNIPAAm were tested for their ability to support the proliferation and subsequent thermal release of HC04 and HepG2 hepatocytes. Hepatocyte...

  11. Statistical model for the mechanical behavior of the tissue engineering non-woven fibrous matrices under large deformation.

    Science.gov (United States)

    Rizvi, Mohd Suhail; Pal, Anupam

    2014-09-01

    The fibrous matrices are widely used as scaffolds for the regeneration of load-bearing tissues due to their structural and mechanical similarities with the fibrous components of the extracellular matrix. These scaffolds not only provide the appropriate microenvironment for the residing cells but also act as medium for the transmission of the mechanical stimuli, essential for the tissue regeneration, from macroscopic scale of the scaffolds to the microscopic scale of cells. The requirement of the mechanical loading for the tissue regeneration requires the fibrous scaffolds to be able to sustain the complex three-dimensional mechanical loading conditions. In order to gain insight into the mechanical behavior of the fibrous matrices under large amount of elongation as well as shear, a statistical model has been formulated to study the macroscopic mechanical behavior of the electrospun fibrous matrix and the transmission of the mechanical stimuli from scaffolds to the cells via the constituting fibers. The study establishes the load-deformation relationships for the fibrous matrices for different structural parameters. It also quantifies the changes in the fiber arrangement and tension generated in the fibers with the deformation of the matrix. The model reveals that the tension generated in the fibers on matrix deformation is not homogeneous and hence the cells located in different regions of the fibrous scaffold might experience different mechanical stimuli. The mechanical response of fibrous matrices was also found to be dependent on the aspect ratio of the matrix. Therefore, the model establishes a structure-mechanics interdependence of the fibrous matrices under large deformation, which can be utilized in identifying the appropriate structure and external mechanical loading conditions for the regeneration of load-bearing tissues. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Exploration of nano-finished non-wovens for potential use in protective clothing for agricultural workers in South Africa

    CSIR Research Space (South Africa)

    Zwane, PE

    2011-01-01

    Full Text Available The global trade requirements have made protective clothing paramount in the agricultural sector. The aim of the study was to find the views of farmers on the use of protective garment for the agricultural sector in South Africa, and to measure...

  13. Preparation of well-defined erythromycin imprinted non-woven fabrics via radiation-induced RAFT-mediated grafting

    Science.gov (United States)

    Söylemez, Meshude Akbulut; Barsbay, Murat; Güven, Olgun

    2018-01-01

    Radiation-induced RAFT polymerization technique was applied to synthesize well-defined molecularly imprinted polymers (MIPs) of erythromycin (ERY). Methacrylic acid (MAA) was grafted onto porous polyethylene (PE)/polypropylene (PP) nonwoven fabrics, under γ-irradiation by employing 2-pheny-2-propyl benzodithioate as the RAFT agent and ethylene glycol dimethacrylate (EGDMA) as the crosslinker. MAA/erythromycin ratios of 2/1, 4/1, 6/1 were tested to optimize the synthesis of MIPs. The highest binding capacity was encountered at a MAA/ERY ratio of 4/1. Non-imprinted polymers (NIPs) were also synthesized in the absence of ERY. The MIPs synthesized by RAFT method presented a better binding capacity compared to those prepared by conventional method where no RAFT agent was employed.

  14. End of life care in chronic obstructive pulmonary disease: in search of a good death

    Directory of Open Access Journals (Sweden)

    Anna Spathis

    2008-03-01

    Full Text Available Anna Spathis, Sara BoothPalliative Care Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England, UKAbstract: Chronic obstructive pulmonary disease (COPD is an incurable, progressive illness that is the fourth commonest cause of death worldwide. Death tends to occur after a prolonged functional decline associated with uncontrolled symptoms, emotional distress and social isolation. There is increasing evidence that the end of life needs of those with advanced COPD are not being met by existing services. Many barriers hinder the provision of good end of life care in COPD, including the inherent difficulties in determining prognosis. This review provides an evidence-based approach to overcoming these barriers, summarising current evidence and highlighting areas for future research. Topics include end of life needs, symptom control, advance care planning, and service development to improve the quality of end of life care.Keywords: chronic obstructive pulmonary disease (MeSH, palliative care (MeSH, dyspnoea (MeSH, advance care planning (MeSH

  15. Fuzzy barrier distributions

    International Nuclear Information System (INIS)

    Piasecki, E.

    2009-01-01

    Heavy-ion collisions often produce a fusion barrier distribution with structures displaying a fingerprint of couplings to highly collective excitations [1]. Basically the same distribution can be obtained from large-angle quasi-elastic scattering, though here the role of the many weak direct-reaction channels is unclear. For 2 0N e + 9 0Z r we have observed the barrier structures expected for the highly deformed neon projectile, but for 2 0N e + 9 2Z r we find completely smooth distribution (see Fig.1). We find that transfer channels in these systems are of similar strength but single particle excitations are significantly stronger in the latter case. They apparently reduce the 'resolving power' of the quasi-elastic channel, what leads to smeared out, or 'fuzzy' barrier distribution. This is the first case when such a phenomenon has been observed.(author)

  16. Health Barriers to Learning

    Directory of Open Access Journals (Sweden)

    Delaney Gracy

    2014-01-01

    Full Text Available This article summarizes the results from a 2013 online survey with 408 principals and assistant principals in New York City public elementary and middle schools. The survey assessed three primary areas: health issues in the school, health issues perceived as barriers to learning for affected students, and resources needed to address these barriers. Eighteen of the 22 health conditions listed in the survey were considered a moderate or serious issue within their schools by at least 10% of respondents. All 22 of the health issues were perceived as a barrier to learning by between 12% and 87% of the respondents. Representatives from schools that serve a higher percentage of low-income students reported significantly higher levels of concern about the extent of health issues and their impact on learning. Respondents most often said they need linkages with organizations that can provide additional services and resources at the school, especially for mental health.

  17. Annular pancreas causing extrahepatic biliary obstruction

    International Nuclear Information System (INIS)

    Ogulin, M.; Jamar, B.

    2004-01-01

    Background. Annular pancreas is an uncommon congenital abnormality, consisting of a flat band of pancreatic tissue, which encircles duodenum or extrahepatic biliary duct. We present a case of obstructive jaundice, caused by annular pancreas. Case report. A 46 years old female was admitted because of a sudden onset of abdominal pain, vomiting and jaundice. For the last six years she occasionally noticed her skin was light yellow, in the last year she felt distension in the upper abdomen, especially after fatty meals. Conclusions. Two US examinations, the first one six months before the admission, showed dilated hepatic ducts. The reason of dilatation was unclear, even after the endoscopic US examination. At operation an almost complete obstruction of the common hepatic duct was found, caused by a narrow band of pancreatic tissue. (author)

  18. Mitral Prosthetic Valve Obstruction and Its Complications

    Directory of Open Access Journals (Sweden)

    Rajesh Rajan

    2015-12-01

    Full Text Available Prosthetic Valve Obstruction (PVO is a serious complication which is associated with increased morbidity and mortality. This could result from thrombus formation, development of pannus, or a combination of both. Patients with this complication often present with symptoms and signs of heart failure, systemic embolism, acute cardiovascular collapse, and sudden death. Transesophageal echocardiography and cine fluoroscopy play a vital role in diagnosis of this potentially lethal condition. Herein, we reported a 56-year-old male patient who presented with severe heart failure and was found to have obstructed ATS27 bileaflet mitral prosthetic valve. Thrombolysis and redo surgery are two important options for treating this condition although guidelines for choosing between the two are not very definite.

  19. Brain Structural Changes in Obstructive Sleep Apnea

    Science.gov (United States)

    Macey, Paul M.; Kumar, Rajesh; Woo, Mary A.; Valladares, Edwin M.; Yan-Go, Frisca L.; Harper, Ronald M.

    2008-01-01

    Study Objectives: Determine whether obstructive sleep apnea (OSA) subjects show indications of axonal injury. Design: We assessed fiber integrity in OSA and control subjects with diffusion tensor imaging (DTI). We acquired four whole-brain DTI series from each subject. The four series were realigned, and the diffusion tensor calculated at each voxel. Fractional anisotropy (FA), a measure of fiber integrity, was derived from the diffusion tensor, resulting in a whole brain FA “map.” The FA maps were spatially normalized, smoothed, and compared using voxel-based statistics to determine differences between OSA and control groups, with age as a covariate (P Valladares EM; Yan-Go FL; Harper RM. Brain structural changes in obstructive sleep apnea. SLEEP 2008;31(7):967-977. PMID:18652092

  20. Indicators for surgery in adhesive bowel obstruction.

    Science.gov (United States)

    Rajanikmanth, P V; Kate, V; Ananthakrishnan, N

    2001-01-01

    There is lack of data on risk factors, which, if present, would indicate the need for surgery in patients with adhesive bowel obstruction. A Cohort of 100 consecutive patients with adhesive obstruction was studied prospectively to compare clinical and investigative parameters between the operative and conservative group. It was found that female gender, previous obstetric or gynaecological procedures, pulse and BP on admission, nature of nasogastric aspirate, single distended loop on abdominal x-ray as also predominant ileal distension were independent factors indicating a high probability of surgical intervention. Patients with 2 or more risk factors had 12 times higher probability of surgery and in those with 3 or more the relative risk was 30 times. Patients with such risk factors should be monitored closely after admission and should be taken for surgery after an initial short trial of conservative measures.

  1. Health promotion in obstructive sleep apnea syndrome.

    Science.gov (United States)

    Corrêa, Camila de Castro; Blasca, Wanderléia Quinhoneiro; Berretin-Felix, Giédre

    2015-04-01

    Introduction Obstructive sleep apnea syndrome (OSAS), which is commonly underdiagnosed, has a high occurrence in the world population. Health education concerning sleep disorders and OSAS should be implemented. Objectives The objective was to identify studies related to preventive actions on sleep disorders, with emphasis on OSAS. Data Synthesis A literature review was conducted using Lilacs, Medline, PubMed, and Scopus by combining the following keywords: "Health Promotion," "Sleep Disorders," "Primary Prevention," "Health Education," and "Obstructive Sleep Apnea Syndromes." Initially, 1,055 papers, from 1968 to 2013, were located, with the majority from the Scopus database. The inclusion criteria were applied, and four articles published between 2006 and 2012 were included in the present study. Conclusions The studies on preventive actions in sleep disorders, with emphasis on OSAS, involved the general population and professionals and students in the health field and led to increased knowledge on sleep disorders and more appropriate practices.

  2. Nonsurgical Fluoroscopically Guided Dacryocystoplasty of Common Canalicular Obstructions

    Energy Technology Data Exchange (ETDEWEB)

    Wilhelm, Kai E; Hofer, Ulrich; Textor, Hans J [Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany); Boeker, Thorsten [Department of Ophthalmology, University Hospital Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany); Strunk, Holger; Schild, Hans H [Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany)

    2000-01-15

    Purpose: To assess dacryocystoplasty in the treatment of epiphora due to obstructions of the common canaliculus.Methods: Twenty patients with severe epiphora due to partial (n = 16) or complete (n = 4) obstruction of the common canaliculus underwent fluoroscopically guided dacryocystoplasty. In all cases of incomplete obstruction balloon dilation was performed. Stent implantation was attempted in cases with complete obstruction. Dacryocystography and clinical follow-up was performed at intervals of 1 week, and 3, 6, 12, and 18 months after the procedure. The mean follow-up was 6 months (range 3-18 months).Results: Balloon dilation was technically successfully performed in all patients with incomplete obstructions (n = 16). In three of four patients with complete obstruction stent implantation was performed successfully. Subsequent to failure of stent implantation in one of these patients balloon dilation was performed instead. The long-term primary patency rate in patients with incomplete obstructions was 88% (n = 14/16). In three of four cases with complete obstruction long-term patency was achieved during follow-up. Severe complications, infections, or punctal splitting were not observed.Conclusion: Fluoroscopically guided balloon dacryocystoplasty is a feasible nonsurgical therapy in canalicular obstructions with good clinical results that may be used as an alternative to surgical procedures. In patients with complete obstructions stent placement is possible but further investigations are needed to assess the procedural and long-term results.

  3. Nonsurgical Fluoroscopically Guided Dacryocystoplasty of Common Canalicular Obstructions

    International Nuclear Information System (INIS)

    Wilhelm, Kai E.; Hofer, Ulrich; Textor, Hans J.; Boeker, Thorsten; Strunk, Holger; Schild, Hans H.

    2000-01-01

    Purpose: To assess dacryocystoplasty in the treatment of epiphora due to obstructions of the common canaliculus.Methods: Twenty patients with severe epiphora due to partial (n = 16) or complete (n = 4) obstruction of the common canaliculus underwent fluoroscopically guided dacryocystoplasty. In all cases of incomplete obstruction balloon dilation was performed. Stent implantation was attempted in cases with complete obstruction. Dacryocystography and clinical follow-up was performed at intervals of 1 week, and 3, 6, 12, and 18 months after the procedure. The mean follow-up was 6 months (range 3-18 months).Results: Balloon dilation was technically successfully performed in all patients with incomplete obstructions (n = 16). In three of four patients with complete obstruction stent implantation was performed successfully. Subsequent to failure of stent implantation in one of these patients balloon dilation was performed instead. The long-term primary patency rate in patients with incomplete obstructions was 88% (n = 14/16). In three of four cases with complete obstruction long-term patency was achieved during follow-up. Severe complications, infections, or punctal splitting were not observed.Conclusion: Fluoroscopically guided balloon dacryocystoplasty is a feasible nonsurgical therapy in canalicular obstructions with good clinical results that may be used as an alternative to surgical procedures. In patients with complete obstructions stent placement is possible but further investigations are needed to assess the procedural and long-term results

  4. Is ursodeoxycholic acid detrimental in obstructive cholestasis? A propos of a case of malignant biliary obstruction.

    Science.gov (United States)

    Bessone, Fernando; Roma, Marcelo Gabriel

    2016-01-01

    Ursodeoxycholic acid (UDCA) is the first choice medication for most cholestatic hepatopathies, due to its capability to counteract inflammation and bile-acid-induced liver damage, two common features in cholestasis. However, UDCA is usually contraindicated in obstructive cholestasis, due to the alleged risk of biliary integrity disruption due to its choleretic effect. We report on an 83-year-old man with an unsuspected malignant biliary obstruction who received moderate doses of UDCA (8-12 mg/kg/day) for 5 weeks, because the preliminary evidence suggested he had chemotherapy-induced cholestasis. Liver integrity was extensively protected by UDCA, as indicated by a marked decrease in serum liver enzymes, despite a steady increase in the levels of bilirubin and serum bile acids due to the obstructive process. In conclusion, this report shows, for the first time in humans, that moderate UDCA doses can reduce liver injury associated with complete biliary obstruction. This may contribute to a better understanding of the risk-benefit ratio of the use of UDCA in obstructive cholangiopathies.

  5. Pressure drop in flashing flow through obstructions

    International Nuclear Information System (INIS)

    Weinle, M.E.; Johnston, B.S.

    1985-01-01

    An experiment was designed to investigate the pressure drop for flashing flow across obstructions of different geometries at various flow rates. Tests were run using two different orifices to determine if the two-phase pressure drop could be characterized by the single phase loss coefficient and the general behavior of the two-phase multiplier. For the geometries studied, it was possible to correlate the multiplier in a geometry-independent fashion

  6. Acute respiratory tract obstruction in children

    OpenAIRE

    Ahmad, Zahoor

    1999-01-01

    35 cases of acute respiratory tract obstruction in paediatric age group who needed surgical intervention in the form of bronchoscopy, tracheostomy or both are reviewed here. All these patients were seen and managed at National Iranian Oil company Hospital Ummeidiya Khouzestan Iran, from April 1985 to April 1988. The results obtained with a review of use of instruments is described. Most of the patients presented with foreign body inhalations, some due to allergic oedema and one case had laryn...

  7. Subtotal obstruction of the male reproductive tract.

    Science.gov (United States)

    Dohle, G R; van Roijen, J H; Pierik, F H; Vreeburg, J T M; Weber, R F A

    2003-03-01

    Bilateral obstruction of the male reproductive tract is suspected in men with azoospermia, normal testicular volume and normal FSH. A testicular biopsy is required to differentiate between an obstruction and a testicular insufficiency. Unilateral or subtotal bilateral obstructions and epididymal dysfunction may cause severe oligozoospermia in men with a normal spermatogenesis. However, information on spermatogenesis in oligozoospermic men is lacking, since testicular biopsy is not routinely performed. Men with a sperm concentration of scoring method. A testicular biopsy was performed in 78 men with severe oligozoospermia. The medical history showed male accessory gland infection in 12.8%, previous hernia repair in 14.1% and a history of cryptorchidism in 12.8%. A normal or slightly disturbed spermatogenesis (Johnsen score >8) was present in 39/78 (50%) of the men. Hernia repair occurred more often in men with normal spermatogenesis. A varicocele was predominantly seen in men with a disturbed spermatogenesis. FSH was significantly lower ( Preproductive tract is a frequent cause of severe oligozoospermia in men with a normal testicular volume and a normal FSH. In other cases, an epididymal dysfunction might explain the oligozoospermia in men with a normal testicular biopsy score.

  8. Biliary intervention for malignant obstructive jaundice

    International Nuclear Information System (INIS)

    Naoi, Yutaka; Suzuki, Fuminao.

    1990-01-01

    Currently, diagnosis of obstructive jaundice has become easier with CT and USEG, and percutaneous transhepatic cholangialdrainage (PTCD) for obstructive jaundice has also become much safer using USEG control. We have performed PTCD in 277 cases, from December 1976 to May 1989 at Saitama Cancer Center with specially designed thin needle. And using a PTCD fistula, we have been attempted radiotherapy for 7 cases of the bile duct cancer using Remoto After Loading System (RALS), and hyperthermia for 5 cases of bile duct cancer using antenna of microwaves. From autopsy cases, we evaluated treated lesion pathologically, and we obtained the following results. Dosage of biliary RALS need up to 50 Gy at the point of 1 cm from 60 Co sourse. Biliary hyperthermia using microwave seem to be unsuccessful, and further improvement to the antenna of microwave were necessary. Furthermore, we have attempted biliary endoprosthesis 27 cases, for better quality of life to the patients with malignant obstructive jaundice. These methods seem to be effective in prolonging patient's lives, comparing of cases in which PTCD of an external fistula has been performed. (author)

  9. Lifestyle modification for obstructive sleep apnoea.

    Science.gov (United States)

    Shneerson, J; Wright, J

    2001-01-01

    Obstructive sleep apnoeas are due to transient closure of the upper airway during sleep and merge into hypopnoeas in which the airway narrows, but some airflow continues. They are due to the forces compressing the airway overcoming those which stabilise its patency. The commonest association is obesity in which fatty tissue is deposited around the airway. Exercise has been recommended as a method of losing weight, but other techniques which achieve this are also thought to improve symptoms due to sleep apnoeas. Sleep hygiene may alter the sleep structure and the control of the upper airway during sleep and thus promote its patency. The objectives of this review are to determine whether weight loss, sleep hygiene and exercise are effective in the treatment of obstructive sleep apnoeas. The Cochrane Airways Group Trials Register, MEDLINE, EMBASE, CINAHL and reference lists of review articles have been searched. Randomised, single or double blind placebo controlled, either parallel group or crossover design studies of any of these interventions were to have been included. No completed trials have been identified. No randomised trial data were available for analysis. There is a need for randomised controlled trials of these commonly used treatments in obstructive sleep apnoeas. These should identify which sub groups of patients with sleep apnoeas benefit most from each type of treatment and they should have clear and standardised outcome measures.

  10. [Anaesthesia for patients with obstructive airway diseases].

    Science.gov (United States)

    Groeben, H; Keller, V; Silvanus, M T

    2014-01-01

    Obstructive lung diseases like asthma or chronic obstructive lung diseases have a high prevalence and are one of the four most frequent causes of death. Obstructive lung diseases can be significantly influenced by the choice of anesthetic techniques and anesthetic agents. Basically, the severity of the COPD and the degree of bronchial hyperreactivity will determine the perioperative anesthetic risk. This risk has to be assessed by a thorough preoperative evaluation and will give the rationale on which to decide for the adequate anaesthetic technique. In particular, airway instrumentation can cause severe reflex bronchoconstriction. The use of regional anaesthesia alone or in combination with general anaesthesia can help to avoid airway irritation and leads to reduced postoperative complications. Prophylactic antiobstructive treatment, volatile anesthetics, propofol, opioids, and an adequate choice of muscle relaxants minimize the anesthetic risk, when general anesthesia is required In case, despite all precautions intra-operative bronchospasm occurs, deepening of anaesthesia, repeated administration of beta2-adrenergic agents and parasympatholytics, and a single systemic dose of corticosteroids represent the main treatment options.

  11. Obstructive sleep apnea and oral language disorders.

    Science.gov (United States)

    Corrêa, Camila de Castro; Cavalheiro, Maria Gabriela; Maximino, Luciana Paula; Weber, Silke Anna Theresa

    Children and adolescents with obstructive sleep apnea (OSA) may have consequences, such as daytime sleepiness and learning, memory, and attention disorders, that may interfere in oral language. To verify, based on the literature, whether OSA in children was correlated to oral language disorders. A literature review was carried out in the Lilacs, PubMed, Scopus, and Web of Science databases using the descriptors "Child Language" AND "Obstructive Sleep Apnea". Articles that did not discuss the topic and included children with other comorbidities rather than OSA were excluded. In total, no articles were found at Lilacs, 37 at PubMed, 47 at Scopus, and 38 at Web of Science databases. Based on the inclusion and exclusion criteria, six studies were selected, all published from 2004 to 2014. Four articles demonstrated an association between primary snoring/OSA and receptive language and four articles showed an association with expressive language. It is noteworthy that the articles used different tools and considered different levels of language. The late diagnosis and treatment of obstructive sleep apnea is associated with a delay in verbal skill acquisition. The professionals who work with children should be alert, as most of the phonetic sounds are acquired during ages 3-7 years, which is also the peak age for hypertrophy of the tonsils and childhood OSA. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  12. Impulse oscillometry: a measure for airway obstruction.

    Science.gov (United States)

    Vink, Geraldine R; Arets, Hubertus G M; van der Laag, Johan; van der Ent, Cornelis K

    2003-03-01

    The impulse oscillometry system (IOS) was introduced as a new technique to assess airflow obstruction in patients who are not able to perform forced breathing maneuvers, e.g., subjects with cerebral palsy or severe mental retardation, and young children. This study evaluates the sensitivity and specificity of IOS parameters to quantify changes in airflow obstruction in comparison with forced expiratory volume in the first second (FEV(1)) and peak expiratory flow (PEF) measurements. Measurements of FEV(1), PEF, and resistance (R) and reactance (X) at frequencies of 5-35 Hz were performed in 19 children with asthma before, during, and after methacholine challenge and subsequent bronchodilatation. All parameters changed significantly during tests. Values of R5 and R10 correlated with FEV(1) (r = -0.71 and -0.73, respectively, P operating characteristic (ROC) curve to predict a 15% fall in FEV(1) showed better sensitivity and specificity for R5 (area under the curve, 0.85) compared to PEF (0.79) or R10 (0.73). We conclude that IOS parameters can be easily used as an indirect measure of airflow obstruction. This might be helpful in patients who are not able to perform forced breathing maneuvers. In individual subjects, R values measured at 5 Hz showed to be superior to PEF measurements in the detection of a 15% fall in FEV(1). Copyright 2003 Wiley-Liss, Inc.

  13. Obstructive sleep apnea and oral language disorders

    Directory of Open Access Journals (Sweden)

    Camila de Castro Corrêa

    Full Text Available Abstract Introduction Children and adolescents with obstructive sleep apnea (OSA may have consequences, such as daytime sleepiness and learning, memory, and attention disorders, that may interfere in oral language. Objective To verify, based on the literature, whether OSA in children was correlated to oral language disorders. Methods A literature review was carried out in the Lilacs, PubMed, Scopus, and Web of Science databases using the descriptors “Child Language” AND “Obstructive Sleep Apnea”. Articles that did not discuss the topic and included children with other comorbidities rather than OSA were excluded. Results In total, no articles were found at Lilacs, 37 at PubMed, 47 at Scopus, and 38 at Web of Science databases. Based on the inclusion and exclusion criteria, six studies were selected, all published from 2004 to 2014. Four articles demonstrated an association between primary snoring/OSA and receptive language and four articles showed an association with expressive language. It is noteworthy that the articles used different tools and considered different levels of language. Conclusion The late diagnosis and treatment of obstructive sleep apnea is associated with a delay in verbal skill acquisition. The professionals who work with children should be alert, as most of the phonetic sounds are acquired during ages 3–7 years, which is also the peak age for hypertrophy of the tonsils and childhood OSA.

  14. Expiratory timing in obstructive sleep apnoeas.

    Science.gov (United States)

    Cibella, F; Marrone, O; Sanci, S; Bellia, V; Bonsignore, G

    1990-03-01

    Diaphragmatic electromyogram was recorded during NREM sleep in 4 patients affected by obstructive sleep apnoea (OSA) syndrome in order to evaluate the behaviour of expiratory time (TE) in the course of the obstructive apnoea-ventilation cycle. The two components of TE, i.e. time of post-inspiratory inspiratory activity (TPIIA) and time of expiratory phase 2 (TE2) were separately analysed. TPIIA showed a short duration, with only minor variations, within the apnoea, while its duration was more variable and longer in the interapnoeic periods: the longest TPIIA values were associated with the highest inspiratory volumes in the same breaths. This behaviour seemed regulated according to the need of a more or less effective expiratory flow braking, probably as a result of pulmonary stretch receptors discharge. Conversely TE2 showed a continuous gradual modulation, progressively increasing in the pre-apnoeic period, decreasing during the apnoea and increasing in the post-apnoeic period: these TE2 variations seemed related to oscillations in chemical drive. These data show that TE in the obstructive apnoea-ventilation cycle results from a different modulation in its two components and suggest that both mechanical and chemical influences play a role in its overall duration.

  15. Laparoscopic jejunostomy for obstructing upper gastrointestinal malignancies

    Science.gov (United States)

    TSUJIMOTO, HIRONORI; HIRAKI, SHUICHI; TAKAHATA, RISA; NOMURA, SHINSUKE; ITO, NOZOMI; KANEMATSU, KYOHEI; HORIGUCHI, HIROYUKI; AOSASA, SUEFUMI; YAMAMOTO, JUNJI; HASE, KAZUO

    2015-01-01

    The aim of this study was to describe a minimally invasive laparoscopic jejunostomy (Lap-J) technique for obstruction due to upper gastrointestinal malignancies and evaluate the nutritional benefit of Lap-J during neoadjuvant chemotherapy (NAC) in cases with obstructing esophageal cancer. Under general anesthesia, the jejunum 20–30 cm distant from the Treitz ligament was pulled out through an extended umbilical laparoscopic incision and a jejunal tube was inserted to 30 cm. The loop of bowel was gently returned to the abdomen and the feeding tube was drawn through the abdominal wall via the left lower incision. The jejunum was then laparoscopically sutured to the anterior abdominal wall. Lap-J was performed in 26 cases. The median operative time was 82 min. The postoperative course was uneventful. Lap-J prior to NAC was not associated with a decrease in body weight or serum total protein during NAC, compared with patients who received NAC without Lap-J. This minimally invasive jejunostomy technique may be particularly useful in patients in whom endoscopic therapy is not feasible due to obstruction from upper gastrointestinal malignancies. PMID:26807238

  16. Models of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Chung K Fan

    2004-11-01

    Full Text Available Abstract Chronic obstructive pulmonary disease (COPD is a major global health problem and is predicted to become the third most common cause of death by 2020. Apart from the important preventive steps of smoking cessation, there are no other specific treatments for COPD that are as effective in reversing the condition, and therefore there is a need to understand the pathophysiological mechanisms that could lead to new therapeutic strategies. The development of experimental models will help to dissect these mechanisms at the cellular and molecular level. COPD is a disease characterized by progressive airflow obstruction of the peripheral airways, associated with lung inflammation, emphysema and mucus hypersecretion. Different approaches to mimic COPD have been developed but are limited in comparison to models of allergic asthma. COPD models usually do not mimic the major features of human COPD and are commonly based on the induction of COPD-like lesions in the lungs and airways using noxious inhalants such as tobacco smoke, nitrogen dioxide, or sulfur dioxide. Depending on the duration and intensity of exposure, these noxious stimuli induce signs of chronic inflammation and airway remodelling. Emphysema can be achieved by combining such exposure with instillation of tissue-degrading enzymes. Other approaches are based on genetically-targeted mice which develop COPD-like lesions with emphysema, and such mice provide deep insights into pathophysiological mechanisms. Future approaches should aim to mimic irreversible airflow obstruction, associated with cough and sputum production, with the possibility of inducing exacerbations.

  17. Managing obstructive gastric volvulus: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Rodriguez-Garcia HA

    2017-03-01

    Full Text Available Hector Alejandro Rodriguez-Garcia,1 Andrew S Wright,2–4 Robert B Yates1–3 1Department of Surgery, Center for Esophageal and Gastric Surgery, 2Center for Videoendoscopic Surgery, 3Hernia Center, 4Institute for Simulation and Interprofessional Studies, UWMC, University of Washington, Seattle, USA Abstract: Gastric volvulus is the abnormal torsion of the stomach along its short or long axis. Most patients who experience gastric volvulus present with mild or intermittent gastric obstructive symptoms. However, severe acute gastric volvulus can result in complete gastric outlet obstruction and ischemia. Consequently, acute gastric volvulus warrants immediate evaluation and management. The goals of management are to relieve the obstruction and prevent recurrent volvulus. Techniques to manage gastric volvulus depend on patient characteristics and the presence of gastric ischemia. In the absence of gastric ischemia, gastric volvulus can be managed with anterior abdominal wall gastropexy or paraesophageal hernia repair. If gastric ischemia is present, operative resection of the affected portion of the stomach is indicated. When operative management is indicated, many patients with gastric volvulus can be managed with minimally invasive (laparoscopic, endoscopic, or laparoendoscopic techniques. Keywords: gastric volvulus, paraesophageal hernia, hiatal hernia

  18. Intestinal obstruction in germ-free dogs.

    Science.gov (United States)

    Heneghan, J B; Robinson, J W; Menge, H; Winistörfer, B

    1981-08-01

    Mechanical occlusions were created in the intestines of four germ-free dogs. At the time of the operation, a control loop of mid-intestine was perfused in vivo and then excised for examinations in vitro, which included the determination of the equilibrium uptake of phenylalanine and of beta-methyl-glucoside, the influx kinetics of phenylalanine and morphometric analysis of the mucosa by microdissection and stereological techniques. Seven days after establishment of the occlusion the abdomen was reopened, and loops above and below the occlusion were perfused, and then excised for the same tests in vitro. Unlike occluded loops of conventional dogs, the intestine of the germ-free animal above the occlusion does not secrete water and electrolytes into the lumen. Its transport properties in vitro do not differ from those of the control loop, and the morphometric analyses reveal only slight changes in villus structure. The loop below the obstruction undergoes marked atrophy, as has been observed in conventional dogs. The results suggest that the copious secretion that occurs above an intestinal obstruction in normal animals is due to the presence of an abundant bacterial population in the obstruction fluid.

  19. Post-extubation airway obstruction. Literature review

    Directory of Open Access Journals (Sweden)

    Álvaro SÁNCHEZ-TABERNERO

    2017-03-01

    Full Text Available Introduction and objective: airway obstruction after extubation in any surgery is a critical event with low incidence, which may require reintubation or tracheostomy, which often otolaryngologist is required. Objective: To determine the prevalence of BVA and its causes through systematic literature review. Method: Literature review in PubMed, Scopus and Cochrane clinical trials, meta-analysis, reviews and case series and control over airway obstruction after extubation that requires reintubation in adults. Results: 6 studies and one clinical practice guidelines were selected. The most common cause of extubation failure is blocking the airway for various reasons (pharyngeal muscle weakness residual effect -often farmacologycal-, laryngospasm, vocal cord paralysis, edema of upper respiratory tract, cervical postoperative hematoma, foreign bodies or secretions. Most cases of re-intubation occurred within 2 hours after extubation. Conclusions: The most common cause of failure after general anesthesia extubation is blocking the airway generally caused by residual neuromuscular blocking effect. Airway obstruction risk increases in airway and head and neck surgery. Difficult intubation guidlines have improved performance and reduced adverse events and similar strategies must be implemented in extubation. The procedure extubation and reintubation should be documented. Working groups airway must be multidisciplinary and include specialists in otolaryngology.

  20. Central Airway Obstruction: Benign Strictures, Tracheobronchomalacia, and Malignancy-related Obstruction.

    Science.gov (United States)

    Murgu, Septimiu Dan; Egressy, Katarine; Laxmanan, Balaji; Doblare, Guillermo; Ortiz-Comino, Rosamaria; Hogarth, D Kyle

    2016-08-01

    The purpose of this article is to provide an update on methods for palliating symptoms in patients with histologically benign and malignant central airway obstruction. We review the published literature within the past decade on postintubation, posttracheostomy, and TB- and transplant-related airway strictures; tracheobronchomalacia; and malignant airway obstruction. We review terminology, classification systems, and parameters that impact treatment decisions. The focus is on how airway stent insertion fits into the best algorithm of care. Several case series and cohort studies demonstrate that airway stents improve dyspnea, lung function, and quality of life in patients with airway obstruction. Airway stenting, however, is associated with high rates of adverse events and should be used only when curative open surgical interventions are not feasible or are contraindicated. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  1. Neonatal Intestinal Obstruction-Four Year Experience

    Directory of Open Access Journals (Sweden)

    D. Rathore

    2015-06-01

    Full Text Available Aim of study: To study the aetiology and frequency, sex incidence, age of presentation, management and outcome of neonatal intestinal obstruction. Material and Methods: This prospective study of 316 neonates with intestinal obstruction was conducted over a period of 4 years from November 2009 to October 2013 at single institute. These cases were managed by various surgical procedures. Their epidemiology, day of presentation, associated anomalies and outcomes were studied. Results: A total of 316 neonates (277 males and 39 females were operated for intestinal obstruction. 268(84.81% neonates presented in the 1st week of life. Imperforate anus occurred in 206 (65.19%.Small bowel atresia accounted for23 (7.27% cases while duodenal atresia was seen in19 (6.01% patients. Infantile hypertrophic pyloric stenosis and Malrotation each occurred in 14 (4.43% patients; Hirschsprung’s disease in 18(5.69%, Necrotising Enterocolitis in 12(3.79%, Meconium disease of newborn in 9(2.85% while colonic atresia was seen in one (0.3% patient. Colostomy was performed in 145(45.88%, Pouchostomy in 15(4.74% and Cutback anoplasty in 56(17.72% patients. Ramsted’s Pyloromyotomy in 13(4.11%% neonates, Laparoscopic Pyloromyotomy in 1(0.3%,Kimura’s Duodenoduodenostomy in 19(6.01% ,End to Back anastomosis in 24(7.59% , End to End anastomosis in 7(2.21% , Multiple anastomosis in 2(0.6% , Enterotomy with irrigation in 7(2.21% , Ladd’s procedure in 14(4.43% , ,Single stage transanal pull through in 8(2.53% , Ileostomy in 2(0.6% , Single stage Abdominoperineal pull through in 2(0.6%, Levelling colostomy in 6(1.89% ,Peritoneal drain insertion under Local anaesthesia in 5(1.58% . Overall mortality was 13.60%. Conclusion: Intestinal Obstruction is the most common surgical emergency in neonatal period. Early and accurate diagnosis is paramount for proper patient management. The etiology, mode of presentation, morbidity and outcome of surgery of intestinal obstruction in

  2. Interventional therapy for congenital urinary obstruction in children

    International Nuclear Information System (INIS)

    Qin Zenhui; Huang Sui; Liu Fan; Yang Jinyuan

    2005-01-01

    Objective: To investigate the interventional therapy in children's congenital urinary obstruction and its efficacy. Methods: Thirty-three children with congenital obstruction of ureteropelvic junction were treated through percutaneous dilation and/or stent placement, and 42 cases with posterior urethral valves were treated through trans-urethra dilation. Results: Thirty-three cases with upper urinary obstruction were improved with symptoms disappeared and stable efficacy on long-term follow-up of 1-7 years. Another 2 cases with the upper urethral obstruction had not been relieved of symptoms and resorted to surgical operation. For patients with posterior urethral valves, the lower urethral obstruction was totally got rid of after interventional therapy with stable efficacy on long-term follow-up of 1-10 years. Conclusions: Interventional therapy is safe , micro-invasive and efficient in treating congenital urinary obstruction with stable efficacy on long-term follow-up. (authors)

  3. Sonographic diagnosis of intestinal obstruction in the dog.

    Science.gov (United States)

    Manczur, F; Vörös, K; Vrabély, T; Wladár, S; Németh, T; Fenyves, B

    1998-01-01

    Ultrasonography was performed on 44 dogs to decide whether small bowel obstruction was present. The sonographic criteria for small bowel obstruction were (1) the presence of pendulous movement of the ingesta inside the dilated bowel, (2) observation of invaginated intestines or an ingested intraluminal foreign body, (3) observation of non-uniform peristaltic activity of the dilated intestines, or (4) observation of akinetic intestinal loops together with abdominal fluid accumulation. By using these criteria, obstruction was correctly diagnosed by ultrasonography in 11 of the 13 dogs with mechanical ileus, and obstruction was correctly excluded in 29 of the 31 non-obstructive cases. Thus, the above-mentioned sonographic criteria had 85% sensitivity and positive predictive value, and 94% specificity and negative predictive value. The present study suggests that ultrasonography is a valuable tool for diagnosing small intestinal obstruction in the dog.

  4. Acute intestinal obstruction: an electromyographic study in dogs.

    Science.gov (United States)

    Summers, R W; Yanda, R; Prihoda, M; Flatt, A

    1983-12-01

    We have investigated the motility effects of acute experimental canine intestinal obstruction. A 30-min midjejunal obstruction was produced by clamping a Biebl loop or by inflating an intraluminal balloon. Spike bursts from serosal electrodes proximal to the site of obstruction increased markedly, while those from distal electrodes decreased. When the obstruction from an intraluminal Foley catheter was continued for 5.5 h, the inhibition persisted distally but the proximal contractile activity gradually fell to control levels. The reduced proximal activity after prolonged obstruction was largely due to clusters of regular intense spike bursts preceded and followed by lengthening periods of absent motor activity. Similar clustered contractions obliterated the lumen when the passage of barium through a Thiry-Vella loop was monitored fluoroscopically. Significant motility changes occur in intestinal obstruction, but an increased understanding of the mechanisms involved awaits future studies.

  5. Barrier Data Base user's guide

    International Nuclear Information System (INIS)

    Worrell, R.B.; Gould, D.J.; Wall, D.W.

    1977-06-01

    A special purpose data base for physical security barriers has been developed. In addition to barriers, the entities accommodated by the Barrier Data Base (BDB) include threats and references. A threat is established as a configuration of people and equipment which has been employed to penetrate (or attempt to penetrate) a barrier. References are used to cite publications pertinent to the barriers and threats in the data base. Utilization and maintenance of the Barrier Data Base is achieved with LIST, QUERY, ENTER, DELETE, and CHANGE commands which are used to manipulate the data base entities

  6. Adhesion barriers at cesarean delivery: advertising compared with the evidence.

    Science.gov (United States)

    Albright, Catherine M; Rouse, Dwight J

    2011-07-01

    Cesarean delivery, the most common surgery performed in the United States, is complicated by adhesion formation in 24-73% of cases. Because adhesions have potential sequelae, different synthetic adhesion barriers are currently heavily marketed as a means of reducing adhesion formation resultant from cesarean delivery. However, their use for this purpose has been studied in only two small, nonblinded and nonrandomized trials, both of which were underpowered and subject to bias. Neither demonstrated improvement in meaningful clinical outcomes. In the only cost-effectiveness analysis of adhesion barriers to date, the use of synthetic adhesion barriers was cost-effective only when the subsequent rate of small bowel obstruction was at least 2.4%, a rate far higher than that associated with cesarean delivery. In fact, intra-abdominal adhesions from prior cesarean delivery rarely cause maternal harm and have not been demonstrated to adversely affect perinatal outcome. Based on our review of the available literature, we think the use of adhesion barriers at the time of cesarean delivery would be ill-advised at the present time.

  7. On the obstructions to non-Cliffordian pin structures

    Energy Technology Data Exchange (ETDEWEB)

    Chamblin, A. (Dept. of Applied Maths and Theoretical Physics, Univ. of Cambridge (United Kingdom))

    1994-07-01

    We derive the topological obstructions to the existence of non-Cliffordian pin structures on four-dimensional spacetimes. We apply these obstructions to the study of non-Cliffordian pin-Lorentz cobordism. We note that our method of derivation applies equally well in any dimension and in any signature, and we present a general format for calculating obstructions in these situations. Finally, we interpret the breakdown of pin structure and discuss the relevance of this to aspects of physics. (orig.)

  8. Fetal tracheolaryngeal airway obstruction: prenatal evaluation by sonography and MRI

    Science.gov (United States)

    Courtier, Jesse; Poder, Liina; Wang, Zhen J.; Westphalen, Antonio C.; Yeh, Benjamin M.

    2010-01-01

    We reviewed the sonographic and MRI findings of tracheolaryngeal obstruction in the fetus. Conditions that can cause tracheolaryngeal obstruction include extrinsic causes such as lymphatic malformation, cervical teratoma and vascular rings and intrinsic causes such as congenital high airway obstruction syndrome (CHAOS). Accurate distinction of these conditions by sonography or MRI can help facilitate parental counseling and management, including the decision to utilize the ex utero intrapartum treatment (EXIT) procedure. PMID:20737145

  9. Renal Structural And Physiological Alterations Subsequent To Unilateral Ureteral Obstruction

    OpenAIRE

    El Gohary, Z. M. A. [زينب محمود احمد الجوهري

    1992-01-01

    Complete obstruction of the right ureter of male rabbits for eight weeks resulted in filling of the obstructed kidney with clear urine, no precipitation or stone formation. The calyces and pelvis were distinctly dilated with parenchymal atrophy, the medulla was almost completely destroyed and the cortex was reduced to a thin extensively sclerotic rim. When compared with the contralateral control kidney, the parenchymal weight and water content of the obstructed kidney were distinctly greater....

  10. Hypertrophic cardiomyopathy with mid-ventricular obstruction and apical aneurysm

    Directory of Open Access Journals (Sweden)

    N.D. Oryshchyn

    2016-11-01

    Full Text Available A case report of apical left ventricular aneurysm in patient with hypertrophic cardiomyopathy with mid-ventricular obstruction (diagnosis and surgical treatment is presented. We revealed apical aneurysm and mid-ventricular obstruction during echocardiography and specified anatomical characteristics of aneurysm during computer tomography. There was no evidence of obstructive coronary artery disease during coronary angiography. Taking into consideration multiple cerebral infarcts, aneurysm resection and left ventricular plastics was performed. Electronic microscopy of myocardium confirmed the diagnosis of hypertrophic cardiomyopathy.

  11. Fetal tracheolaryngeal airway obstruction: prenatal evaluation by sonography and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Courtier, Jesse; Poder, Liina; Wang, Zhen J.; Westphalen, Antonio C.; Yeh, Benjamin M.; Coakley, Fergus V. [University of California San Francisco, Department of Radiology, San Francisco, CA (United States)

    2010-11-15

    We reviewed the sonographic and MRI findings of tracheolaryngeal obstruction in the fetus. Conditions that can cause tracheolaryngeal obstruction include extrinsic causes such as lymphatic malformation, cervical teratoma and vascular rings and intrinsic causes such as congenital high airway obstruction syndrome (CHAOS). Accurate distinction of these conditions by sonography or MRI can help facilitate parental counseling and management, including the decision to utilize the ex utero intrapartum treatment (EXIT) procedure. (orig.)

  12. Cushing's syndrome in pregnancy and neonatal hypertrophic obstructive cardiomyopathy.

    Science.gov (United States)

    Fayol, L; Masson, P; Millet, V; Simeoni, U

    2004-10-01

    Cushing's syndrome is rare in pregnancy but can cause spontaneous abortion, stillbirth or premature birth. We report a case of transient hypertrophic obstructive cardiomyopathy in a newborn whose mother had hypercortisolism due to a primary adrenal lesion. There was no family history of hypertrophic obstructive cardiomyopathy. Follow-up revealed complete resolution of the cardiac abnormalities in the infant. Cushing's syndrome in the mother resolved after delivery. Although maternal hypercortisolism seldom results in symptomatic hypercortisolism in the newborn, hypertrophic obstructive cardiomyopathy can occur.

  13. A Case of Polyarteritis Nodosa with Bilateral Ureteral Obstruction

    Science.gov (United States)

    Yoo, Bin; Kim, Hong Kyu; Choi, Seung Won; Moon, Hee Bom

    1996-01-01

    We report a case of bilateral ureteral obstruction most likely caused by polyarteritis nodosa. The diagnosis was based upon muscle biopsy which showed typical necrotizing vasculitis in medium size artery in conjunction with microaneurysms in renal angiography. Ureteral obstruction is a rare manifestation of polyarteritis nodosa. This condition is thought to result from vasculitis of periureteral vessels. The patient was managed with prednisolone alone, which resulted in complete resolution of ureteral obstruction on both sides. PMID:8854655

  14. Fatal Airway Obstruction in a Man With a Cystic Hygroma.

    Science.gov (United States)

    Wygant, Cassandra Maria; Cohle, Stephen D

    2018-05-03

    We describe a 24-year-old man with a cystic hygroma of the left side of the lower neck that led to sudden death. Cystic hygroma (cystic lymphangioma) is a congenital malformation of the lymphatic system. The patient, who had a tracheostomy because of airway obstruction from the cystic hygroma, was found dead with his tracheostomy tube on the floor next to him. Complications of cystic hygroma include infiltration of the neck causing airway obstruction, dysphagia, pain, and obstructive sleep apnea.

  15. Geophysical characterization of subsurface barriers

    International Nuclear Information System (INIS)

    Borns, D.J.

    1995-08-01

    An option for controlling contaminant migration from plumes and buried waste sites is to construct a subsurface barrier of a low-permeability material. The successful application of subsurface barriers requires processes to verify the emplacement and effectiveness of barrier and to monitor the performance of a barrier after emplacement. Non destructive and remote sensing techniques, such as geophysical methods, are possible technologies to address these needs. The changes in mechanical, hydrologic and chemical properties associated with the emplacement of an engineered barrier will affect geophysical properties such a seismic velocity, electrical conductivity, and dielectric constant. Also, the barrier, once emplaced and interacting with the in situ geologic system, may affect the paths along which electrical current flows in the subsurface. These changes in properties and processes facilitate the detection and monitoring of the barrier. The approaches to characterizing and monitoring engineered barriers can be divided between (1) methods that directly image the barrier using the contrasts in physical properties between the barrier and the host soil or rock and (2) methods that reflect flow processes around or through the barrier. For example, seismic methods that delineate the changes in density and stiffness associated with the barrier represents a direct imaging method. Electrical self potential methods and flow probes based on heat flow methods represent techniques that can delineate the flow path or flow processes around and through a barrier

  16. Recruitment barriers in a randomized controlled trial from the physicians' perspective – A postal survey

    Directory of Open Access Journals (Sweden)

    Karrer Werner

    2009-03-01

    Full Text Available Abstract Background The feasibility of randomized trials often depends on successful patient recruitment. Although numerous recruitment barriers have been identified it is unclear which of them complicate recruitment most. Also, most surveys have focused on the patients' perspective of recruitment barriers whereas the perspective of recruiting physicians has received less attention. Therefore, our aim was to conduct a postal survey among recruiting physicians of a multi-center trial to weigh barriers according to their impact on recruitment. Methods We identified any potential recruitment barriers from the literature and from our own experience with a multi-center trial of respiratory rehabilitation in patients with chronic obstructive pulmonary disease. We developed and pilot-tested a self-administered questionnaire where recruiting physicians were asked to express their agreement with statements about recruitment barriers on a Likert-type scale from 1 (full agreement with statement = very substantial recruitment barrier to 7 (no agreement with statement = no recruitment barrier. Results 38 of 55 recruiting physicians returned questionnaires (69% response rate, of which 35 could be analyzed (64% useable response rate. Recruiting physicians reported that "time constraints" (median agreement of 3, interquartile range 2–5 had the most negative impact on recruitment followed by "difficulties including identified eligible patients" (median agreement of 5, IQR 3–6. Other barriers such as "trial design barriers", "lack of access to treatment", "individual barriers of recruiting physicians" or "insufficient training of recruiting physicians" were perceived to have little or no impact on patient recruitment. Conclusion Physicians perceived time constraints as the most relevant recruitment barrier in a randomized trial. To overcome recruitment barriers interventions, that are affordable for both industry- and investigator-driven trials, need to be

  17. Chaotic correlations in barrier billiards with arbitrary barriers

    International Nuclear Information System (INIS)

    Osbaldestin, A H; Adamson, L N C

    2013-01-01

    We study autocorrelation functions in symmetric barrier billiards for golden mean trajectories with arbitrary barriers. Renormalization analysis reveals the presence of a chaotic invariant set and thus that, for a typical barrier, there are chaotic correlations. The chaotic renormalization set is the analogue of the so-called orchid that arises in a generalized Harper equation. (paper)

  18. Value and Accuracy of Multidetector Computed Tomography in Obstructive Jaundice

    International Nuclear Information System (INIS)

    Mathew, Rishi Philip; Moorkath, Abdunnisar; Basti, Ram Shenoy; Suresh, Hadihally B.

    2016-01-01

    Objective; To find out the role of MDCT in the evaluation of obstructive jaundice with respect to the cause and level of the obstruction, and its accuracy. To identify the advantages of MDCT with respect to other imaging modalities. To correlate MDCT findings with histopathology/surgical findings/Endoscopic Retrograde CholangioPancreatography (ERCP) findings as applicable. This was a prospective study conducted over a period of one year from August 2014 to August 2015. Data were collected from 50 patients with clinically suspected obstructive jaundice. CT findings were correlated with histopathology/surgical findings/ERCP findings as applicable. Among the 50 people studied, males and females were equal in number, and the majority belonged to the 41–60 year age group. The major cause for obstructive jaundice was choledocholithiasis. MDCT with reformatting techniques was very accurate in picking a mass as the cause for biliary obstruction and was able to differentiate a benign mass from a malignant one with high accuracy. There was 100% correlation between the CT diagnosis and the final diagnosis regarding the level and type of obstruction. MDCT was able to determine the cause of obstruction with an accuracy of 96%. MDCT with good reformatting techniques has excellent accuracy in the evaluation of obstructive jaundice with regards to the level and cause of obstruction

  19. The role of computed tomography in uncertain obstructive jaundice

    International Nuclear Information System (INIS)

    Saito, Yoshihiro; Yoshino, Toyoaki; Takayanagi, Ryuichi; Negishi, Ken; Tanaka, Teruhiko; Ito, Ichiro.

    1985-01-01

    42 patients with uncertain obstructive jaundice were examined by computed tomography (CT). CT correctly diagnosed obstructive jaundice in 97% of 37 proven cases and the accuracy of CT in determing the level of obstruction was also 97%. But the sensitivity of CT in determing the cause of obstructive jaundice was 62.5%, particularly poor in common bile duct stone (61.5%), inflammation of common bile duct (0%), and common bile duct carcinoma (50%). All cases of diagnosed malignant tumors were inoperable. (author)

  20. Obstructive sleep apnea: role of intermittent hypoxia and inflammation.

    Science.gov (United States)

    May, Anna M; Mehra, Reena

    2014-10-01

    Obstructive sleep apnea results in intermittent hypoxia via repetitive upper airway obstruction leading to partial or complete upper airway closure, apneas and hypopneas, respectively. Intermittent hypoxia leads to sympathetic nervous system activation and oxidative stress with a resultant systemic inflammatory cascade. The putative mechanism by which obstructive sleep apnea has been linked to numerous pathologic conditions including stoke, cardiovascular disease, hypertension, and metabolic derangements is through these systemic effects. Treatment of obstructive sleep apnea appears to reduce systemic markers of inflammation and ameliorates the adverse sequelae of this disease. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  1. Apple-peel atresia presenting as foetal intestinal obstruction

    Directory of Open Access Journals (Sweden)

    Ashok Yadavrao Kshirsagar

    2011-01-01

    Full Text Available Apple-peel atresia or Type 3 jejuno-ileal atresia (JIA is an uncommon cause of foetal intestinal obstruction. Bowel obstruction in the foetus is diagnosed on the prenatal ultrasonography only in 50% cases. We report a case in which foetal intestinal obstruction was diagnosed on prenatal ultrasonography. The child showed signs of intestinal obstruction on day one after birth, for which an exploratory laparotomy was performed. Type 3 JIA was found for which resection of atretic segments with jejuno-ascending colon anastomosis was preformed.

  2. [Acid-base imbalance in acute obstructive uropathies].

    Science.gov (United States)

    Belyĭ, L E

    2007-01-01

    The aim of this study was to evaluate impairment of acid-base balance (ABB) in acute obstructive uropathies. Evaluation of acid-base balance was performed by pH, partial carbon dioxide pressure, plasma bicarbonate concentration, buffer bases, basis excess, hydrogen ion concentration. An automatic gas analyzer was used, plasma anion gap was calculated. Characteristic ABB alterations in different acute obstructive uropathies were detected. Acidotic shifts in acute obstruction of the upper urinary tracts and its inflammatory complications were assessed pathophysiologically. A comparative study of pathological acid-base disorders in acute supra- and infravesical obstructive uropathies was performed.

  3. Design of engineered sorbent barriers

    International Nuclear Information System (INIS)

    Jones, E.O.; Freeman, H.D.

    1988-08-01

    A sorbent barrier uses sorbent material such as activated carbon or natural zeolites to prevent the migration of radionuclides from a low-level waste site to the aquifer. The sorbent barrier retards the movement of radioactive contaminants, thereby providing time for the radionuclides to decay. Sorbent barriers can be a simple, effective, and inexpensive method for reducing the migration of radionuclides to the environment. Designing a sorbent barrier consists of using soil and sorbent material properties and site conditions as input to a model which will determine the necessary sorbent barrier thickness to meet contaminant limits. The paper will cover the following areas: techniques for measuring sorption properties of barrier materials and underlying soils, use of a radionuclide transport model to determine the required barrier thickness and performance under a variety of site conditions, and cost estimates for applying the barrier. 8 refs., 6 figs., 1 tab

  4. Design of engineered sorbent barriers

    International Nuclear Information System (INIS)

    Jones, E.O.; Freeman, H.D.

    1988-01-01

    A sorbent barrier uses sorbent material such as activated carbon or natural zeolites to prevent the migration of radionuclides from a low-level waste site to the aquifer. The sorbent barrier retards the movement of radioactive contaminants, thereby providing time for the radionuclides to decay. Sorbent barriers can be a simple, effective, and inexpensive method for reducing the migration of radionuclides to the environment. Designing a sorbent barrier consists of using soil and sorbent material properties and site conditions as input to a model which will determine the necessary sorbent barrier thickness to meet contaminant limits. The paper covers the following areas: techniques for measuring sorption properties of barrier materials and underlying soils, use of a radionuclide transport model to determine the required barrier thickness and performance under a variety of site conditions, and cost estimates for applying the barrier

  5. Major Care Gaps in Asthma, Sleep and Chronic Obstructive Pulmonary Disease: A Road Map for Knowledge Translation

    Directory of Open Access Journals (Sweden)

    Louis-Philippe Boulet

    2013-01-01

    Full Text Available Large gaps between best evidence-based care and actual clinical practice exist in respiratory medicine, and carry a significant health burden. The authors reviewed two key care gaps in each of asthma, chronic obstructive pulmonary disease and obstructive sleep apnea. Using the ‘Knowledge-to-Action Framework’, the nature of each gap, its magnitude, the barriers that cause and perpetuate it, and past and future strategies that might address the problem were considered. In asthma: disease control is ascertained inadequately, leading to a prevalence of poor asthma control of approximately 50%; and asthma action plans, a key component of asthma management, are provided by only 22% of physicians. In obstructive sleep apnea: disease is under-recognized, with sleep histories ascertained in only 10% of patients; and Canadian polysomnography wait times remain longer than recommended, leading to unnecessary morbidity and societal cost. In chronic obstructive pulmonary disease: a large proportion of patients seen in primary care remain undiagnosed, mainly due to underuse of spirometry; and <10% of patients are referred for pulmonary rehabilitation, despite strong evidence demonstrating its cost effectiveness. Given the prevalence of these chronic conditions and the size and nature of these gaps, the latter exact an important toll on patients, the health care system and society. In turn, complex barriers at the patient, provider and health care system levels contribute to each gap. There have been few previous attempts to bridge these gaps. Innovative and multifaceted implementation approaches are needed and have the potential to make a large impact on Canadian respiratory health.

  6. Shottky-barrier formation

    International Nuclear Information System (INIS)

    Guines, F.; Sanchez-Dehesa, J.; Flores, F.

    1983-01-01

    In this paper a realistic selfconsistent calculation of an abrupt metal-semiconductor junction is presented by means of a tight-binding approach. A specific Si-Ag junction has been considered, and the charge neutrality level as well as the barrier height have been determined in good agreement with experiments. For a generaljunction it is shown that the interface properties depend essentially on the characteristics of the first metal layer and its interaction with the semiconductor. (Author) [pt

  7. Energy barrier to decoherence

    International Nuclear Information System (INIS)

    Mizel, Ari; Mitchell, M. W.; Cohen, Marvin L.

    2001-01-01

    We propose a ground-state approach to realizing quantum computers. This scheme is time-independent and inherently defends against decoherence by possessing an energy barrier to excitation. We prove that our time-independent qubits can perform the same algorithms as their time-dependent counterparts. Advantages and disadvantages of the time-independent approach are described. A model involving quantum dots is provided for illustration

  8. Performance of engineered barriers

    International Nuclear Information System (INIS)

    Rajaram, V.; Dean, P.V.; McLellan, S.A.

    1997-01-01

    Engineered barriers, both vertical and horizontal, have been used to isolate hazardous wastes from contact, precipitation, surface water and groundwater. The primary objective of this study was to determine the performance of subsurface barriers installed throughout the U.S. over the past 20 years to contain hazardous wastes. Evaluation of Resource Conservation and Recovery Act (RCRA) Subtitle C or equivalent caps was a secondary objective. A nationwide search was launched to select hazardous waste sites at which vertical barrier walls and/or caps had been used as the containment method. None of the sites selected had an engineered floor. From an initial list of 130 sites, 34 sites were selected on the basis of availability of monitoring data for detailed analysis of actual field performance. This paper will briefly discuss preliminary findings regarding the design, construction quality assurance/construction quality control (CQA/CQC), and monitoring at the 34 sites. In addition, the short-term performance of these sites (less than 5 years) is presented since very little long-term performance data was available

  9. Fluctuations in Schottky barrier heights

    International Nuclear Information System (INIS)

    Mahan, G.D.

    1984-01-01

    A double Schottky barrier is often formed at the grain boundary in polycrystalline semiconductors. The barrier height is shown to fluctuate in value due to the random nature of the impurity positions. The magnitude of the fluctuations is 0.1 eV, and the fluctuations cause the barrier height measured by capacitance to differ from the one measured by electrical conductivity

  10. Chronic obstructive pulmonary disease and obstructive sleep apnea. Association, consequences and treatment.

    Science.gov (United States)

    Pronzato, C

    2010-12-01

    Obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD) are two diseases that often co-exist within an individual. This co-existence, known as overlap syndrome (OS), is the result of chance rather than a pathophysiological linkage and epidemiological studies indicate a prevalence of 1% in adult males. Patients vith OS have a more important sleep-related O2 desaturation than COPD patients with the same degree of bronchial obstruction and show an increased risk of developing hypercapnic respiratory failure and pulmonary hypertension when compared with patients affected by only one of he diseases. COPD and OSAS are independent risk factors for cardiovascular events and their co-existence in OS probably increases this risk. Evidence of systemic inflammation in COPD and sleep apnea and consequentely OS, is interesting because it may contribute to the pathogenesis of cardiovascular diseases. Treatment consists of continuous positive airway pressure (CPAP) or non-invasive positive pressure ventilation (NIPPV), with or without associated O2, for correction of the upper airway obstructive episodes and hypoxemia during sleep.

  11. Timing Matters: Circadian Rhythm in Sepsis, Obstructive Lung Disease, Obstructive Sleep Apnea, and Cancer.

    Science.gov (United States)

    Truong, Kimberly K; Lam, Michael T; Grandner, Michael A; Sassoon, Catherine S; Malhotra, Atul

    2016-07-01

    Physiological and cellular functions operate in a 24-hour cyclical pattern orchestrated by an endogenous process known as the circadian rhythm. Circadian rhythms represent intrinsic oscillations of biological functions that allow for adaptation to cyclic environmental changes. Key clock genes that affect the persistence and periodicity of circadian rhythms include BMAL1/CLOCK, Period 1, Period 2, and Cryptochrome. Remarkable progress has been made in our understanding of circadian rhythms and their role in common medical conditions. A critical review of the literature supports the association between circadian misalignment and adverse health consequences in sepsis, obstructive lung disease, obstructive sleep apnea, and malignancy. Circadian misalignment plays an important role in these disease processes and can affect disease severity, treatment response, and survivorship. Normal inflammatory response to acute infections, airway resistance, upper airway collapsibility, and mitosis regulation follows a robust circadian pattern. Disruption of normal circadian rhythm at the molecular level affects severity of inflammation in sepsis, contributes to inflammatory responses in obstructive lung diseases, affects apnea length in obstructive sleep apnea, and increases risk for cancer. Chronotherapy is an underused practice of delivering therapy at optimal times to maximize efficacy and minimize toxicity. This approach has been shown to be advantageous in asthma and cancer management. In asthma, appropriate timing of medication administration improves treatment effectiveness. Properly timed chemotherapy may reduce treatment toxicities and maximize efficacy. Future research should focus on circadian rhythm disorders, role of circadian rhythm in other diseases, and modalities to restore and prevent circadian disruption.

  12. Obesity and chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Čekerevac Ivan

    2011-01-01

    Full Text Available Introduction. Nutritional abnormalities have one of the most important systematic effects on chronic obstructive pulmonary disease (COPD. A relationship between COPD and obesity has been observed and recognized. In COPD patients, beside changes in the total body weight, changes in body composition are also possible with the loss of fat-free mass (FFM. Objective. This study was undertaken to evaluate the impact of obesity and the change of body composition on the pulmonary function, dyspnoea level and the quality of life in COPD patients. Methods. Seventy-nine patients in the stable state of COPD were evaluated. Pulmonary function and arterial blood gas analysis were assessed. Nutritional status was analyzed according to Body Mass Index (BMI. Body composition was evaluated by using anthropometric measurement by fat free mass index (FFMI. Quality of life was assessed using the St. George Respiratory Questionnaire (SGRQ. The Visual Analogue Scale (VAS was used to evaluate dyspnoea. Results. The highest prevalence of obesity (50.0% was found in patients with mild COPD, while the lowest prevalence was detected in very severe COPD patients (10.0%. The loss of FFM occurred in 22.2% patients with normal body weight and in 9.0% of overweight COPD patients. The quality of life was lower in obese patients compared to other COPD patients. A higher dyspnoea level was also present in obese patients. The lowest airflow obstruction was in obese patients (p=0.023. We found a significant positive correlation between forced expiratory volume in the first second (FEV1% and BMI (r=0.326, p=0.003, FEV1% and FFMI (r=0.321, p=0.004. Conclusion. The highest prevalence of obesity was in patients with mild COPD. Obese patients with COPD had the lowest level of airflow obstruction, higher dyspnoea level and lower quality of life in comparison to other COPD patients.

  13. Volvulus as a complication of chronic intestinal pseudo-obstruction syndrome

    NARCIS (Netherlands)

    de Betue, Carlijn T.; Boersma, Doeke; Oomen, Matthijs W.; Benninga, Marc A.; de Jong, Justin R.

    2011-01-01

    Chronic intestinal pseudo-obstruction syndrome (CIPS) is a severe motility disorder of the gastrointestinal tract that presents with continuous or recurrent symptoms and signs of intestinal obstruction without evidence of a structural lesion occluding the intestinal lumen. Mechanical obstruction

  14. Obstructive sleep apnoea and atopy among middle aged chronic obstructive pulmonary disease and bronchial asthma patients.

    Science.gov (United States)

    Kumar, Raj; Nagar, Devender; Mallick, Adeeb; Kumar, Manoj; Tarke, Chandrakant R; Goel, Nitin

    2013-09-01

    Obstructive sleep apnoea syndrome is associated with significant morbidity. A high prevalence of obstructive sleep apnoea (OSA) symptoms has been reported in patients with asthma and chronic obstructive pulmonary disease (COPD). There are limited studies regarding relationship between atopy and OSA. To study the risk of obstructive sleep apnoea among middle aged chronic obstructive pulmonary disease and asthma patients by a home based sleep study and its association with atopy. Patients with asthma and COPD were evaluated for OSA symptoms by Epworth sleepiness scale (ESS) and Berlin questionnaire (BQ). ESS score > or = 9 was considered as high risk for OSA. Patients having high risk for OSA by ESS and BQ were further evaluated for OSA by home based sleep study. Skin prick test against common allergens was done to diagnose atopy in these patients. Among 400 patients (229, 57.25% male and 171, 42.75% female) 328 were asthmatics and 72 were COPD patients. ESS and BQ was positive in 11.25% (45/400) and 18.25% (73/400) patients respectively. ESS was positive in 10.67% (35/328) of asthma and 13.88% (10/72) of COPD patients. BQ was positive in 18.29% (60/328) of asthmatic and 18.05% (13/72) of COPD patients. Skin prick test was positive in 74.16% patients. The maximum positivity was found in asthmatics (139/155, 89.68%) compared to COPD patients (16/155, 10.32%). Skin prick test was done for 40 patients out of 73 of Asthma and COPD patients who were found positive by ESS and BQ. 72.5% patients were found to be atopic. Out of 19 patients in whom home polysomnography was done, 13 patients consented for skin prick test with common aeroallergens and 9 (69.23%) patients were found to be atopic. There is an increased risk of obstructive sleep apnoea among middle aged chronic obstructive pulmonary disease and asthma patients. Atopy could be associated with OSA. The association needs to be proved in a larger study.

  15. New noninvasive treatment for prostate outflow obstruction

    International Nuclear Information System (INIS)

    Richards, D.; Milroy, E.; Chapple, C.; Eldin, A.; Wallstein, H.

    1989-01-01

    Sixteen patients with prostatic outflow obstruction underwent implantation of the Wallstent endoprothesis, a woven mesh of fine stainless steel, mounted on a 9-F delivery system with an unconstrained diameter of 14 mm. The stent was inserted under local anesthesia, and placement was guided by linear transrectal US and flexible urethroscopy. In no patient was the distal sphincter mechanism compromised. In four, stent balloon dilation was needed. Urodynamic parameters (especially flow rate, voiding detrusor pressure, and postvoid residual) improved in all patients. Our experience showed the Wallstent endoprosthesis to be a safe, clinically acceptable, and minimally invasive alternative to prostatectomy

  16. Electrocardiographic changes in obstructive sleep apnea syndrome.

    Science.gov (United States)

    Prakasa, Kalpana; Ahmed, Jehanara; Hasan, Syed; Yousef, Mahmoud; Shridharani, Sachin

    2005-01-01

    The acute electrocardiographic changes during apneic episodes in patients with sleep apnea are well known. Long-term electro-cardiographic changes in these patients are not well studied. We conducted a retrospective case-control study to assess the electrocardiographic changes in African-American patients with established obstructive sleep apnea syndrome (OSA). A significant percentage of patients with OSA had abnormal EKGs as compared to the control group. The effect of sleep apnea on the cardiovascular system is more complex in African-Americans due to higher prevalence of co-morbid conditions. Seventy-three percent of our patients with OSA had metabolic syndrome.

  17. Biomarkers in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Sin, Don D; Vestbo, Jørgen

    2009-01-01

    Currently, with exception of lung function tests, there are no well validated biomarkers or surrogate endpoints that can be used to establish efficacy of novel drugs for chronic obstructive pulmonary disease (COPD). However, the lung function test is not an ideal surrogate for short-term drug...... trials because it (1) does not provide information regarding disease activity or the underlying pathologic process, (2) cannot separate the various phenotypes of COPD, (3) is not specific for COPD, and (4) is relatively unresponsive to known therapies that prolong survival. Accordingly, there are large...

  18. Chronic obstructive pulmonary disease and genetics

    DEFF Research Database (Denmark)

    Ingebrigtsen, T.; Thomsen, S.F.; Vestbo, J.

    2008-01-01

    Chronic obstructive pulmonary disease (COPD) is characterised by airflow limitation and is associated with an inflammatory response of the lungs primarily caused by cigarette smoking. Cigarette smoking is by far the most important environmental risk factor for COPD, but less than half of all heavy...... smokers develop COPD. This indicates a genetic contribution to the individual disease susceptibility. Although many genes have been examined, the puzzle of COPD genetics seems still largely unsolved. It is therefore important to measure phenotypes and to perform genome-wide scans of COPD patients in order...

  19. Autoimmune pancreatitis presenting as obstructive jaundice

    Directory of Open Access Journals (Sweden)

    Nurul Amin Miah

    2016-08-01

    Full Text Available A 71 years cachexic male presented with sign symptoms of biliary tract obstruction. There was a large mass in the head of pancreases with raised CA 19.9. But elevated serum lipase raised the suspicion of paocreatitis. Elevated immunoglobu­lin IgG4 confmned this case as a auto immune aetiology. Initially there was much difficulty to differentiate auto immune pancreatitis from pancreatic carcinoma but after successful stenting and a course of corticosteroids, patient improved dramatically along with nonnalisation of all the radiological, bio-chemical and immunological parameters.

  20. MR defecography for obstructed defecation syndrome

    Directory of Open Access Journals (Sweden)

    Ravikumar B Thapar

    2015-01-01

    Full Text Available Patients with obstructed defecation syndrome (ODS form an important subset of patients with chronic constipation. Evaluation and treatment of these patients has traditionally been difficult. Magnetic resonance defecography (MRD is a very useful tool for the evaluation of these patients. We evaluated the scans and records of 192 consecutive patients who underwent MRD at our center between January 2011 and January 2012. Abnormal descent, rectoceles, rectorectal intussusceptions, enteroceles, and spastic perineum were observed in a large number of these patients, usually in various combinations. We discuss the technique, its advantages and limitations, and the normal findings and various pathologies.

  1. An Unusual Cause of Biliary Obstruction

    Directory of Open Access Journals (Sweden)

    Sern Wei Yeoh

    2012-01-01

    Full Text Available Portal biliary ductopathy (PBD is a condition in which biliary and pancreatic ducts are extrinsically compressed by collateral branches of the portal venous system, which in turn have become dilated and varicosed due to portal hypertension. While the majority of patients with PBD are asymptomatic, a minority can present with symptoms of biliary obstruction and cholangitis with the potential of developing secondary chronic liver disease. This paper reports the case of a 29 year old male presenting with acute cholangitis, in whom PBD was diagnosed radiologically. A brief review of current literature regarding the diagnosis and management of this condition will also be presented.

  2. Analysis of the patterns of bronchial obstruction at bronchography

    International Nuclear Information System (INIS)

    Huh, Suk; Kim, Yong Chul; Han, Sang Don; Lee, Yong Chul

    1981-01-01

    Of the bronchographic findings of 408 patients, performed in our hospital for recent 5 years, 108 cases showed definite bronchial obstruction, and 61 cases of those were selected and obstructive findings were evaluated. All that not confirmed were abandoned. For evaluation of the reliability of 9 braonchographic obstruction signs on applying to diagnose malignant or benign pulmonary diseases, each sign was identified and applied to each of the 61 confirmed cases. In addition, obstructed bronchi, distance of obstruction from the bifurcation site, and the direction of meniscus, if present, were evaluated. The results were follows: 1. The most frequent cause of bronchial obstruction was lung cancer (59.0%), and that of the benign obstruction was pulmonary tuberculosis (13.1%). 2. Amputation, asymmetric narrowing, thumbprint indentation, rat-tail narrowing and encasement signs were the most accurate signs of malignancy and were practically diagnostic ones. 3. The most frequent sign in lung cancer was sharp cutoff one, but it could be seen in lung abscess and in unresolved pneumonia, too. 4. Circumferential symmetric narrowing and regular concavity with a small central projection signs were specific ones to benignancy. 5. The most frequent obstruction sign in benign lung disease was gradual tapering sign, but it also could be seen in bronchogenic epidermoid and alveolar cell carcinoma. 6. Of all bronchial obstructions, 55.4% occurred at lobar bronchus and 77.4% of those were caused by lung cancer. 7. 77.2% of those obstruction which located within 3 times distance of the bronchial diameter at the nearest proximal bifurcation site, were lung cancer, but 75.0% of those located at over 3 times distance were benign pulmonary diseases. 8. There were no correlation of the direction of the meniscus at the obstructing end in differential diagnosis between benign and malignant pulmonary diseases

  3. Analysis of the patterns of bronchial obstruction at bronchography

    Energy Technology Data Exchange (ETDEWEB)

    Huh, Suk; Kim, Yong Chul; Han, Sang Don; Lee, Yong Chul [National Medical Center, Seoul (Korea, Republic of)

    1981-12-15

    Of the bronchographic findings of 408 patients, performed in our hospital for recent 5 years, 108 cases showed definite bronchial obstruction, and 61 cases of those were selected and obstructive findings were evaluated. All that not confirmed were abandoned. For evaluation of the reliability of 9 braonchographic obstruction signs on applying to diagnose malignant or benign pulmonary diseases, each sign was identified and applied to each of the 61 confirmed cases. In addition, obstructed bronchi, distance of obstruction from the bifurcation site, and the direction of meniscus, if present, were evaluated. The results were follows: 1. The most frequent cause of bronchial obstruction was lung cancer (59.0%), and that of the benign obstruction was pulmonary tuberculosis (13.1%). 2. Amputation, asymmetric narrowing, thumbprint indentation, rat-tail narrowing and encasement signs were the most accurate signs of malignancy and were practically diagnostic ones. 3. The most frequent sign in lung cancer was sharp cutoff one, but it could be seen in lung abscess and in unresolved pneumonia, too. 4. Circumferential symmetric narrowing and regular concavity with a small central projection signs were specific ones to benignancy. 5. The most frequent obstruction sign in benign lung disease was gradual tapering sign, but it also could be seen in bronchogenic epidermoid and alveolar cell carcinoma. 6. Of all bronchial obstructions, 55.4% occurred at lobar bronchus and 77.4% of those were caused by lung cancer. 7. 77.2% of those obstruction which located within 3 times distance of the bronchial diameter at the nearest proximal bifurcation site, were lung cancer, but 75.0% of those located at over 3 times distance were benign pulmonary diseases. 8. There were no correlation of the direction of the meniscus at the obstructing end in differential diagnosis between benign and malignant pulmonary diseases.

  4. Scattering of a two skyrmion configuration on potential holes or barriers in a model Landau-Lifshitz equation

    International Nuclear Information System (INIS)

    Collins, J C; Zakrzewski, W J

    2009-01-01

    The dynamics of a baby-skyrmion configuration, in a model Landau-Lifshitz equation, was studied in the presence of various potential obstructions. The baby-skyrmion configuration was constructed from two Q = 1 hedgehog solutions to the baby-skyrme model in (2+1) dimensions. The potential obstructions were created by introducing a new term into the Lagrangian which resulted in a localized inhomogeneity in the potential terms' coefficient. In the barrier system, the normal circular path was deformed as the skyrmions traversed the barrier. During the same period, it was seen that the skyrmions sped up as they went over the barrier. For critical values of the barrier height and width, the skyrmions were no longer bound and were free to separate. In the case of a potential hole, the baby skyrmions no longer formed a bound state and moved asymptotically along the axis of the hole. It is shown how to modify the definition of the angular momentum to include the effects of the obstructions, so that it is conserved

  5. Identifying patients at high risk for obstructive sleep apnoea ...

    African Journals Online (AJOL)

    Background: Obstructive sleep apnoea is associated with significant health consequences. A significant proportion of hospitalized patients at risk for obstructive sleep apnoea were never identified and referred for polysomnography for diagnosis. The objective of this study was to determine the factors associated with high ...

  6. High‑risk of obstructive sleep apnea and excessive daytime ...

    African Journals Online (AJOL)

    Background: The burden of obstructive sleep apnea among commercial drivers in Nigeria is not known. Aim: To assess the prevalence of high risk of obstructive sleep apnea (OSA) and excessive daytime sleepiness (EDS) among intra‑city commercial drivers. Setting and Design: A descriptive cross‑sectional study in three ...

  7. Prevalence, awareness and reporting of symptoms of obstructive ...

    African Journals Online (AJOL)

    Background: Obstructive sleep apnoea is the most common form of sleep- disordered breathing in adults and children. It is associated with many adverse health consequences. The objectives this study were to determine the prevalence, awareness and reporting of symptoms of obstructive sleep apnoea among hospitalized ...

  8. A Surgical Treatment of Obstructive Sleep Apnoea (OSA)

    African Journals Online (AJOL)

    Snoring is now seen as one end of sleep-related breathing disorder resulting ultimately in obstructive sleep apnea. Uvulopalatopharyngoplasty (UPPP) is the first surgical procedure specifically designed to alleviate the abnormalities, although the use of laser appears to be the new trend. We present a case of Obstructive ...

  9. Cholescintigraphy in experimentally induced obstructive and parenchymatous jaundice

    International Nuclear Information System (INIS)

    Baehre, M.; Biersack, H.J.; Hofmann, S.; Winkler, C.

    1979-01-01

    Animal studies have been performed in 30 dogs in order to obtain information concerning typical patterns of cholescintigraphy in acute obstructive jaundice. In 14 the choledochus was ligated and in 16 galactosamine-hepatitis was induced as an experimental model for parenchymatous jaundice. The results suggest a number of diagnostic criteria in obstructive disease. (Auth.)

  10. Predictors of outcome among patients with obstructive jaundice at ...

    African Journals Online (AJOL)

    Despite recent advances both in preoperative diagnosis and postoperative care, obstructive jaundice still contributes significantly to high morbidity and mortality. A prospective study was undertaken to identify predictors of outcome among patients with obstructive jaundice at Bugando Medical Centre in north-western ...

  11. Operable severe obstructive jaundice: How should we use pre ...

    African Journals Online (AJOL)

    Obstructive jaundice is a common surgical problem, and surgery in jaundiced patients is associated with a higher risk of postoperative complications than surgery in non-jaundiced patients. However, the efficacy of pre-operative biliary drainage (PBD) for patients with obstructive jaundice remains controversial. Many studies ...

  12. Non-traumatic abdominal emergencies: imaging of acute intestinal obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Taourel, P.; Kessler, N.; Lesnik, A.; Blayac, P.M.; Morcos, L. [Departement d' Imagerie Medicale, Hopital Lapeyronie, 371, avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5 (France); Bruel, J.M. [Departement d' Imagerie Medicale, Hopital Saint-Eloi, 80 rue Augustin Fliche, 34295 Montpellier Cedex 5 (France)

    2002-09-01

    The purpose of this paper is to give an overview of the main clinical questions in bowel obstruction, to discuss the value of various imaging modalities, including conventional radiography, ultrasound, and CT, to underline the impact of imaging in the management of patients with suspect bowel obstruction, and then to suggest a diagnostic triage in such patients. (orig.)

  13. Old dilemma : asthma with irreversible airway obstruction or COPD

    NARCIS (Netherlands)

    Fattahi, Fatemeh; Vonk, Judith M.; Bulkmans, Nicole; Fleischeuer, Ruth; Gouw, Annette; Grunberg, Katrien; Mauad, Thais; Popper, Helmut; Felipe-Silva, Aloisio; Vrugt, Bart; Wright, Joanne L.; Yang, Hui-Min; Kocks, Janwillem W. H.; Hylkema, Machteld N.; Postma, Dirkje S.; Timens, Wim; ten Hacken, Nick H. T.

    2015-01-01

    Older asthmatic patients may develop fixed airway obstruction and clinical signs of chronic obstructive pulmonary disease (COPD). We investigated the added value of pathological evaluation of bronchial biopsies to help differentiate asthma from COPD, taking into account smoking, age, and inhaled

  14. Inflammatory biomarkers and exacerbations in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Thomsen, Mette; Ingebrigtsen, Truls Sylvan; Marott, Jacob Louis

    2013-01-01

    Exacerbations of respiratory symptoms in chronic obstructive pulmonary disease (COPD) have profound and long-lasting adverse effects on patients.......Exacerbations of respiratory symptoms in chronic obstructive pulmonary disease (COPD) have profound and long-lasting adverse effects on patients....

  15. Predictors of objective cough frequency in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Sumner, Helen; Woodcock, Ashley; Kolsum, Umme

    2013-01-01

    Cough is one of the principal symptoms of chronic obstructive pulmonary disease (COPD) but the potential drivers of cough are likely to be multifactorial and poorly understood.......Cough is one of the principal symptoms of chronic obstructive pulmonary disease (COPD) but the potential drivers of cough are likely to be multifactorial and poorly understood....

  16. Inflammatory biomarkers and comorbidities in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Thomsen, Mette; Dahl, Morten; Lange, Peter

    2012-01-01

    Patients with chronic obstructive pulmonary disease (COPD) have evidence of systemic inflammation that may be implicated in the development of comorbidities.......Patients with chronic obstructive pulmonary disease (COPD) have evidence of systemic inflammation that may be implicated in the development of comorbidities....

  17. Gastric Outlet Obstruction from Duodenal Lipoma in an Adult ...

    African Journals Online (AJOL)

    Gastric Outlet Obstruction from Duodenal Lipoma in an Adult. ... Nigerian Journal of Surgery ... Although, peptic ulcer disease remains the most common benign cause of gastric outlet obstruction (GOO), duodenal lipomas remain a rare, but possible cause of GOO and could pose a diagnostic challenge, especially in ...

  18. Ectopic pancreas causing partial gastric outlet obstruction: a case ...

    African Journals Online (AJOL)

    Ectopic pancreas causing partial gastric outlet obstruction: a case report and review of literature. ... Nigerian Journal of Surgery ... Gastric outlet obstruction resulting from ectopic pancreas in an adult is the first of its kind in our center; we, therefore, present this case to describe the challenges faced with diagnosis, treatment, ...

  19. Obstructed Labour at the University of Ilorin Teaching Hospital. Ilorin ...

    African Journals Online (AJOL)

    Obstructed Labour at the University of Ilorin Teaching Hospital. Ilorin. AAG Jimoh, OR Balogun, Abubakar Danladi. Abstract. During a five-year period between 1st January 1995 to 31st December 1999, three hundred and twenty eight cases of obstructed labour were encountered out of a total of 12,614 deliveries managed ...

  20. Epidemiology of small-bowel obstruction beyond the neonatal period

    African Journals Online (AJOL)

    Background The aim of this study was to evaluate the etiologies causing intestinal obstruction beyond the neonatal period. Patients and methods An observational study was conducted on children between 1 month and 17 years of age who underwent surgery for small-bowel obstruction. (SBO) at this tertiary referral center ...

  1. Systematic review: the influence of nasal obstruction on sleep apnea

    Directory of Open Access Journals (Sweden)

    Debora Petrungaro Migueis

    2016-04-01

    Full Text Available ABSTRACT INTRODUCTION: Obstructive sleep apnea syndrome (OSAS is a common disorder that can lead to cardiovascular morbidity and mortality, as well as to metabolic, neurological, and behavioral consequences. It is currently believed that nasal obstruction compromises the quality of sleep when it results in breathing disorders and fragmentation of sleep. However, recent studies have failed to objectively associate sleep quality and nasal obstruction. OBJECTIVE: The aim of this systematic review is to evaluate the influence of nasal obstruction on OSAS and polysomnographic indices associated with respiratory events. METHODS: Eleven original articles published from 2003 to 2013 were selected, which addressed surgical and non-surgical treatment for nasal obstruction, performing polysomnography type 1 before and after the intervention. RESULTS/CONCLUSIONS: In most trials, nasal obstruction was not related to the apnea-hypopnea index (AHI, indicating no improvement in OSAS with reduction in nasal resistance. However, few researchers evaluated other polysomnography indices, such as the arousal index and rapid eye movement (REM sleep percentage. These could change with nasal obstruction, since it is possible that the nasal obstruction does not completely block the upper airways, but can increase negative intrathoracic pressure, leading to sleep fragmentation.

  2. Original Research Identifying patients at high risk for obstructive ...

    African Journals Online (AJOL)

    determine the factors associated with high risk for obstructive sleep apnoea and use it to identify patients at risk for the condition in ... mainstay of management is CPAP in addition to behavioral ..... the present study has some potential limitations which ... consequences of obstructive sleep apnea and short sleep duration.

  3. Collagen levels are normalized after decompression of experimentally obstructed colon

    DEFF Research Database (Denmark)

    Rehn, Martin; Ågren, Sven Per Magnus; Syk, I

    2011-01-01

    Our aim was to define the dynamics in collagen concentrations in the large bowel wall following decompression of experimental obstruction.......Our aim was to define the dynamics in collagen concentrations in the large bowel wall following decompression of experimental obstruction....

  4. Influence of obstructive jaundice on pharmacodynamics of rocuronium.

    Science.gov (United States)

    Wang, Zhen-Meng; Zhang, Peng; Lin, Mi-Jia; Tan, Bo; Qiu, Hai-Bo; Yu, Wei-Feng

    2013-01-01

    Anesthetics are variable in patients with obstructive jaundice. The minimum alveolar concentration awake of desflurane is reduced in patients with obstructive jaundice, while it has no effect on pharmacodynamics and pharmacokinetics of propofol. In this study, we investigated the influence of obstructive jaundice on the pharmacodynamics and blood concentration of rocuronium. Included in this study were 26 control patients and 27 patients with obstructive jaundice. Neuromuscular block of rocuronium was monitored by acceleromyography. Onset time, spontaneous recovery of the height of twitch first (T1) to 25% of the final T1 value (Duration 25%, Dur 25%), recovery index (RI), and spontaneous recovery of train-of-four (TOF) ratios to 70% were measured. The plasma rocuronium concentrations were determined by high performance liquid chromatography using berberine as an internal standard. There was no significant difference in onset time between the two groups. The Dur 25%, the recovery index and the time of recovery of the TOF ratios to 70% were all prolonged in the obstructive jaundice group compared with the control group. The plasma concentration of rocuronium at 60, 90 and 120 min after bolus administration was significantly higher in the obstructive jaundice group. The neuromuscular blockade by rocuronium is prolonged in obstructive jaundice patients, and therefore precautions should be taken in case of postoperative residual neuromuscular block. The possible reason is impedance of rocuronium excretion due to biliary obstruction and increased plasma unbound rocuronium because of free bilirubin competing with it for albumin binding.

  5. Mesenteric Cysts Presenting with Acute Intestinal Obstruction: A ...

    African Journals Online (AJOL)

    The 3 children needed bowel resection with primary anastomosis. All made uneventful recovery. A high index of suspicion is important when managing children with acute intestinal obstruction as mesenteric cyst may be an uncommon cause. (Key words: Mesenteric Cyst: Intestinal Obstruction). Sahel Medical Journal ...

  6. Bolus obstruction by Ascaris lumbricoides | Wynne | South African ...

    African Journals Online (AJOL)

    Bolus obstruction by Ascaris lumbricoides. J.M. Wynne, B.A.H. Ellman. Abstract. Seventy-three cases of obstruction due to a bolus of Ascaris worms are reviewed, The diagnosis was made on the basis either of a characteristic palpable mass or a characteristic radiographic appearance. In 67 cases conservative treatment ...

  7. Radiation-induced recurrent intestinal pseudo-obstruction

    International Nuclear Information System (INIS)

    Conklin, J.L.; Anuras, S.

    1981-01-01

    The syndrome of intestinal pseudo-obstruction is a complex of signs and symptoms of intestinal obstruction without evidence of mechanical obstruction of the intestinal lumen. A patient with radiation-induced intestinal pseudoobstruction is described. The patient is a 74-year old woman with a history of chronic diarrhea, recurrent episodes of crampy abdominal pain, nausea and vomiting since receiving a 13,000 rad radiation dose to the pelvis in 1954. She has been hospitalized on many occasions for symptoms and signs of bowel obstruction. Upper gastrointestinal contrast roentgenograms with small bowel follow-through done during these episodes revealed multiple dilated loops of small bowel with no obstructing lesion. Barium enemas revealed no obstructing lesion. Each episode resolved with conservative therapy. Other secondary causes for intestinal pseudo-obstruction were ruled out in our patient. She gave no history of familial gastrointestinal disorders. Although postirradiation motility abnormalities have been demonstrated experimentally this is the first report of radiation induced intestinal pseudo-obstruction

  8. Chronic constipation causing obstructive nephropathy in a delayed toddler.

    LENUS (Irish Health Repository)

    Barrett, Michael Joseph

    2012-01-01

    Chronic constipation causing obstructive nephropathy is very rare in children. However, it can cause urinary tract obstruction with acute impairment of renal function with a need for emergent disimpaction. The authors discuss a 2 years 4 months old child who presented to our emergency department with acute renal failure due to faecal impaction.

  9. Endotracheal tube connector defect causing airway obstruction in an ...

    African Journals Online (AJOL)

    detected during routine visual inspection before their use, while some go unnoticed during such inspection and can lead to partial or complete airway obstruction in intubated patients. We report one case of partial airway obstruction resulting from manufacturing defect in the ET connector. A 3-month-old infant girl weighing 5 ...

  10. Malignant biliary obstruction: percutaneous use of self-expandable stents

    NARCIS (Netherlands)

    Laméris, J. S.; Stoker, J.; Nijs, H. G.; Zonderland, H. M.; Terpstra, O. T.; van Blankenstein, M.; Schütte, H. E.

    1991-01-01

    A total of 83 self-expandable metallic stents were placed percutaneously in 69 patients for palliation of malignant biliary obstruction. Stent diameter was 1 cm; length, 3.5-10.5 cm. Of the 41 patients with common bile duct obstruction, 27 died 0.2-12 months (median, 3.2 months) after stent

  11. Intestinal obstruction in children due to Ascariasis: A tertiary health ...

    African Journals Online (AJOL)

    of worms per mouth or rectum and on x-ray and ultrasonography fi ndings. Only the patients of intestinal obstruction with documented evidence of roundworm infestation were included in the study and were followed for one year. Results: One hundred and three children with intestinal obstruction due to Ascaris lumbricoides

  12. Systematic review: the influence of nasal obstruction on sleep apnea.

    Science.gov (United States)

    Migueis, Debora Petrungaro; Thuler, Luiz Claudio Santos; Lemes, Lucas Neves de Andrade; Moreira, Chirlene Santos Souza; Joffily, Lucia; Araujo-Melo, Maria Helena de

    2016-01-01

    Obstructive sleep apnea syndrome (OSAS) is a common disorder that can lead to cardiovascular morbidity and mortality, as well as to metabolic, neurological, and behavioral consequences. It is currently believed that nasal obstruction compromises the quality of sleep when it results in breathing disorders and fragmentation of sleep. However, recent studies have failed to objectively associate sleep quality and nasal obstruction. The aim of this systematic review is to evaluate the influence of nasal obstruction on OSAS and polysomnographic indices associated with respiratory events. Eleven original articles published from 2003 to 2013 were selected, which addressed surgical and non-surgical treatment for nasal obstruction, performing polysomnography type 1 before and after the intervention. In most trials, nasal obstruction was not related to the apnea-hypopnea index (AHI), indicating no improvement in OSAS with reduction in nasal resistance. However, few researchers evaluated other polysomnography indices, such as the arousal index and rapid eye movement (REM) sleep percentage. These could change with nasal obstruction, since it is possible that the nasal obstruction does not completely block the upper airways, but can increase negative intrathoracic pressure, leading to sleep fragmentation. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  13. Ectopic Pancreas Causing Partial Gastric Outlet Obstruction: A Case ...

    African Journals Online (AJOL)

    Ectopic pancreas is a rare cause of gastric outlet obstruction, perhaps rarer still among Africans. Although the entity is known, the diagnostic challenges are enormous, especially in the poor‑resource environment. Gastric outlet obstruction resulting from ectopic pancreas in an adult is the first of its kind in our center;.

  14. Obstructive uropathy in childhood: A review | Eke | Port Harcourt ...

    African Journals Online (AJOL)

    Methods: Contemporary information on the management of obstructive uropathy was obtained by searching the Medline and adding information from the authors\\' experience. Results: Obstructive uropathy causes renal impairment in all age groups. The causes in children may be congenital or acquired. The congenital ...

  15. Obstructed Labour in Adigrat Zonal Hospital, Tigray Region, Ethiopia

    African Journals Online (AJOL)

    Background: Obstructed labour is a common cause of maternal and pernatal morbidity and mortality in developing countries. There are few data from Ethiopia, although the problem is believed to be common. Objective: To describe the frequency, causes, complications and treatment outcome of mothers with obstructed ...

  16. Secondary obstructive jaundice to pancreatic calculus impacted in the papilla

    International Nuclear Information System (INIS)

    Rafael Angel, Luis M. Limas; Lazaro Arango

    2004-01-01

    Bile duct stones obstructing the papilla are a quite common finding. On the other hand a pancreatic stone obstructing the papilla is quite rare. There are few reports of this complication of chronic pancreatitis in the literature. Here we inform of another unique case

  17. Interventional therapy of cervical esophageal malignant obstruction

    International Nuclear Information System (INIS)

    Mao Aiwu; Gao Zhongdu; Li Guofen; Jiang Tinghui; Hu Xuan; Wu Jieru; Yang Renjie; Xiao Xiangsheng

    2003-01-01

    Objective: To explore the feasibility of microinvasive technique in high level malignant esophageal obstruction and to provide the palliative therapy that can't be dredged by traditional methods. Methods: There were 39 patients suffered from high level esophageal obstruction, involving the segments from esophageal circular pharynx to 12 mm below. Tube-reticular nitinol metal stents woven by single thread were placed in orally to dredge the esophagus under fluoroscopic guidance after repeated tolerant expanding performance through expandable catheter. Interventional chemical therapy were administrated through blood-supply vessels. Results: Thirty nine patients were grafted with 46 high level esophageal stents. 34 patients accepted 156 times of interventional chemical therapy. All patients restored with fine residue diet without showing side-effects except slight pain and tolerant uncomfortable feeling. The survival rate of the patients with both interventional chemical therapy and stents was longer than those with stent therapy alone. Conclusion: Cervical high level segment of esophagus shouldn't be the restricted zone in the management of inner-stents. Interventional chemical therapy showed tumor-inhibiting effect in the cervical malignant diseases

  18. Obstructive sialoadenitis role of interventional sialography

    International Nuclear Information System (INIS)

    Aslam, M.O.

    2014-01-01

    The Salivary stones and strictures are the most common cause of unilateral parotid or submandibular gland swelling. Traditionally, these patients treated by open surgery submandibular stones are still the most common cause of submandibular gland resection parotid gland resection is less frequent as it is major surgical procedure with postoperative complication like facial nerve paresis. The common cause of stone formation is obstruction, stricture formation leading to stasis of saliva, dehydration, change in salivary pH associated with oropharngeal sepsis. Over the last two decades, increasing awareness for minimally invasive treatment and with development of interventional radiological procedures for the management of obstructive sialadenitis has led to avoid surgical removal of gland and complications associated with surgery The interventional sialographic procedures can be used to remove salivary duct stones and is treatment of first choice in salivary duct strictures. For stone removal and stricture dilatation local anesthesia, I/V cannulas of different sizes, balloon dilators and wire baskets are used under fluoroscopy. The wire guided sialographic technique (1) is used for sialography and the I/V cannula used for sialography is used as access for interventional sialography. The stones in the intraglandular ducts, large stones and distal stones near the hilum of the gland are difficult to remove and the small size mobile stones can be easily removed. (author)

  19. Pulmonary Venous Obstruction in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Chuang-Chi Liaw

    2015-01-01

    Full Text Available Background. We study the clinical significance and management of pulmonary venous obstruction in cancer patients. Methods. We conducted a prospective cohort study to characterize the syndrome that we term “pulmonary vein obstruction syndrome” (PVOS between January 2005 and March 2014. The criteria for inclusion were (1 episodes of shortness of breath; (2 chest X-ray showing abnormal pulmonary hilum shadow with or without presence of pulmonary edema and/or pleural effusion; (3 CT scan demonstrating pulmonary vein thrombosis/tumor with or without tumor around the vein. Results. Two hundred and twenty-two patients developed PVOS. Shortness of breath was the main symptom, which was aggravated by chemotherapy in 28 (13%, and medical/surgical procedures in 21 (9% and showed diurnal change in intensity in 32 (14%. Chest X-rays all revealed abnormal pulmonary hilum shadows and presence of pulmonary edema in 194 (87% and pleural effusion in 192 (86%. CT scans all showed pulmonary vein thrombosis/tumor (100% and surrounding the pulmonary veins by tumor lesions in 140 patients (63%. PVOS was treated with low molecular weight heparin in combination with dexamethasone, and 66% of patients got clinical/image improvement. Conclusion. Physicians should be alert to PVOS when shortness of breath occurs and chest X-ray reveals abnormal pulmonary hilum shadows.

  20. Childhood Obesity and Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Indra Narang

    2012-01-01

    Full Text Available The global epidemic of childhood and adolescent obesity and its immediate as well as long-term consequences for obese individuals and society as a whole cannot be overemphasized. Obesity in childhood and adolescence is associated with an increased risk of adult obesity and clinically significant consequences affecting the cardiovascular and metabolic systems. Importantly, obesity is additionally complicated by obstructive sleep apnea (OSA, occurring in up to 60% of obese children. OSA, which is diagnosed using the gold standard polysomnogram (PSG, is characterised by snoring, recurrent partial (hypopneas or complete (apneas obstruction of the upper airway. OSA is frequently associated with intermittent oxyhemoglobin desaturations, sleep disruption, and sleep fragmentation. There is emerging data that OSA is associated with cardiovascular burden including systemic hypertension, changes in ventricular structure and function, arterial stiffness, and metabolic syndromes. Thus, OSA in the context of obesity may independently or synergistically magnify the underlying cardiovascular and metabolic burden. This is of importance as early recognition and treatment of OSA in obese children are likely to result in the reduction of cardiometabolic burden in obese children. This paper summarizes the current state of understanding of obesity-related OSA. Specifically, this paper will discuss epidemiology, pathophysiology, cardiometabolic burden, and management of obese children and adolescents with OSA.

  1. Health Promotion in Obstructive Sleep Apnea Syndrome

    Directory of Open Access Journals (Sweden)

    Corrêa, Camila de Castro

    2015-01-01

    Full Text Available Introduction Obstructive sleep apnea syndrome (OSAS, which is commonly underdiagnosed, has a high occurrence in the world population. Health education concerning sleep disorders and OSAS should be implemented. Objectives The objective was to identify studies related to preventive actions on sleep disorders, with emphasis on OSAS. Data Synthesis A literature review was conducted using Lilacs, Medline, PubMed, and Scopus by combining the following keywords: “Health Promotion,” “Sleep Disorders,” “Primary Prevention,” “Health Education,” and “Obstructive Sleep Apnea Syndromes.” Initially, 1,055 papers, from 1968 to 2013, were located, with the majority from the Scopus database. The inclusion criteria were applied, and four articles published between 2006 and 2012 were included in the present study. Conclusions The studies on preventive actions in sleep disorders, with emphasis on OSAS, involved the general population and professionals and students in the health field and led to increased knowledge on sleep disorders and more appropriate practices.

  2. Autoantibodies in Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Lifang Wen

    2018-01-01

    Full Text Available Chronic obstructive pulmonary disease (COPD, the fourth leading cause of death worldwide, is characterized by irreversible airflow limitation based on obstructive bronchiolitis, emphysema, and chronic pulmonary inflammation. Inhaled toxic gases and particles, e.g., cigarette smoke, are major etiologic factors for COPD, while the pathogenesis of the disease is only partially understood. Over the past decade, an increasing body of evidence has been accumulated for a link between COPD and autoimmunity. Studies with clinical samples have demonstrated that autoantibodies are present in sera of COPD patients and some of these antibodies correlate with specific disease phenotypes. Furthermore, evidence from animal models of COPD has shown that autoimmunity against pulmonary antigens occur during disease development and is capable of mediating COPD-like symptoms. The idea that autoimmunity could contribute to the development of COPD provides a new angle to understand the pathogenesis of the disease. In this review article, we provide an advanced overview in this field and critically discuss the role of autoantibodies in the pathogenesis of COPD.

  3. Small Intestinal Obstruction Caused by Anisakiasis

    Directory of Open Access Journals (Sweden)

    Yuichi Takano

    2013-01-01

    Full Text Available Small intestinal anisakiasis is a rare disease that is very difficult to diagnose, and its initial diagnosis is often surgical. However, it is typically a benign disease that resolves with conservative treatment, and unnecessary surgery can be avoided if it is appropriately diagnosed. This case report is an example of small intestinal obstruction caused by anisakiasis that resolved with conservative treatment. A 63-year-old man admitted to our department with acute abdominal pain. A history of raw fish (sushi ingestion was recorded. Abdominal CT demonstrated small intestinal dilatation with wall thickening and contrast enhancement. Ascitic fluid was found on the liver surface and in the Douglas pouch. His IgE (RIST was elevated, and he tested positive for the anti-Anisakis antibodies IgG and IgA. Small intestinal obstruction by anisakiasis was highly suspected and conservative treatment was performed, ileus tube, fasting, and fluid replacement. Symptoms quickly resolved, and he was discharged on the seventh day of admission. Small intestinal anisakiasis is a relatively uncommon disease, the diagnosis of which may be difficult. Because it is a self-limiting disease that usually resolves in 1-2 weeks, a conservative approach is advisable to avoid unnecessary surgery.

  4. [Nutritional abnormalities in chronic obstructive pulmonary disease].

    Science.gov (United States)

    Gea, Joaquim; Martínez-Llorens, Juana; Barreiro, Esther

    2014-07-22

    Nutritional abnormalities are associated with chronic obstructive pulmonary disease with a frequency ranging from 2 to 50%, depending on the geographical area and the study design. Diagnostic tools include anthropometry, bioelectrical impedance, dual energy radioabsortiometry and deuterium dilution, being the body mass and the lean mass indices the most frequently used parameters. While the most important consequences of nutritional abnormalities are muscle dysfunction and exercise limitation, factors implicated include an imbalance between caloric intake and consumption, and between anabolic and catabolic hormones, inflammation, tobacco smoking, poor physical activity, hypoxemia, some drugs and aging/comorbidities. The most important molecular mechanism for malnutrition associated with chronic obstructive pulmonary disease appears to be the mismatching between protein synthesis and breakdown. Among the therapeutic measures proposed for these nutritional abnormalities are improvements in lifestyle and nutritional support, although the use of anabolic drugs (such as secretagogues of the growth hormone) offers a new therapeutic strategy. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  5. Barrier mechanisms in the Drosophila blood-brain barrier

    Directory of Open Access Journals (Sweden)

    Samantha Jane Hindle

    2014-12-01

    Full Text Available The invertebrate blood-brain barrier field is growing at a rapid pace and, in recent years, studies have shown a physiologic and molecular complexity that has begun to rival its vertebrate counterpart. Novel mechanisms of paracellular barrier maintenance through GPCR signaling were the first demonstrations of the complex adaptive mechanisms of barrier physiology. Building upon this work, the integrity of the invertebrate blood-brain barrier has recently been shown to require coordinated function of all layers of the compound barrier structure, analogous to signaling between the layers of the vertebrate neurovascular unit. These findings strengthen the notion that many blood-brain barrier mechanisms are conserved between vertebrates and invertebrates, and suggest that novel findings in invertebrate model organisms will have a significant impact on the understanding of vertebrate BBB functions. In this vein, important roles in coordinating localized and systemic signaling to dictate organism development and growth are beginning to show how the blood-brain barrier can govern whole animal physiologies. This includes novel functions of blood-brain barrier gap junctions in orchestrating synchronized neuroblast proliferation, and of blood-brain barrier secreted antagonists of insulin receptor signaling. These advancements and others are pushing the field forward in exciting new directions. In this review, we provide a synopsis of invertebrate blood-brain barrier anatomy and physiology, with a focus on insights from the past 5 years, and highlight important areas for future study.

  6. Mild obstructive sleep apnoea: clinical relevance and approaches to management.

    Science.gov (United States)

    McNicholas, Walter T; Bonsignore, Maria R; Lévy, Patrick; Ryan, Silke

    2016-10-01

    Obstructive sleep apnoea is highly prevalent in the general population worldwide, especially in its mild form. Clinical manifestations correlate poorly with disease severity measured by the apnoea-hypopnoea index (AHI), which complicates diagnosis. Full polysomnography might be more appropriate to assess suspected mild cases because limited ambulatory diagnostic systems are least accurate in mild disease. Treatment options in mild obstructive sleep apnoea include continuous positive airway pressure (CPAP) and oral appliance therapy, in addition to positional therapy and weight reduction when appropriate. The superior efficacy of CPAP in reducing AHI is offset by greater tolerance of oral appliances, especially in mild disease. Although severe obstructive sleep apnoea is associated with adverse health consequences, including cardiometabolic comorbidities, the association with mild disease is unclear, and reports differ regarding the clinical relevance of mild obstructive sleep apnoea. Improved diagnostic techniques and evidence-based approaches to management in mild obstructive sleep apnoea require further research. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Positive predictive value of cholescintigraphy in common bile duct obstruction

    International Nuclear Information System (INIS)

    Lecklitner, M.L.; Austin, A.R.; Benedetto, A.R.; Growcock, G.W.

    1986-01-01

    Technetium-99m DISIDA imaging was employed in 400 patients to differentiate obstruction of the common bile duct from medical and other surgical causes of hyperbilirubinemia. Sequential anterior images demonstrated variable degrees of liver uptake, yet there was no evidence of intrabiliary or extrabiliary radioactivity for at least 4 hr after injection in 25 patients. Twenty-three patients were surgically documented to have complete obstruction of the common bile duct. One patient had hepatitis, and another had sickle cell crisis without bile duct obstruction. The remaining patients had either partial or no obstruction of the common bile duct. We conclude that the presence of liver uptake without evident biliary excretion by 4 hr on cholescintigraphy is highly sensitive and predictive of total obstruction of the common bile duct

  8. Airway Obstruction Among Latino Poultry Processing Workers in North Carolina

    Science.gov (United States)

    MIRABELLI, MARIA C.; CHATTERJEE, ARJUN B.; MORA, DANA C.; ARCURY, THOMAS A.; BLOCKER, JILL N.; CHEN, HAIYING; GRZYWACZ, JOSEPH G.; MARÍN, ANTONIO J.; SCHULZ, MARK R.; QUANDT, SARA A.

    2015-01-01

    This analysis was conducted to evaluate the prevalence of airway obstruction among Latino poultry processing workers. Data were collected from 279 poultry processing workers and 222 other manual laborers via spirometry and interviewer-administered questionnaires. Participants employed in poultry processing reported the activities they perform at work. Participants with forced expiratory volume in 1 second (FEV1) or FEV1/forced expiratory volume (FVC) below the lower limits of normal were categorized as having airway obstruction. Airway obstruction was identified in 13% of poultry processing workers and 12% of the comparison population. Among poultry processing workers, the highest prevalence of airway obstruction (21%) occurred among workers deboning chickens (prevalence ratio: 1.75; 95% confidence interval: 0.97, 3.15). These findings identify variations in the prevalence of airway obstruction across categories of work activities. PMID:24965321

  9. Barriers to accessing urethroplasty.

    Science.gov (United States)

    Consolo, Michael J; Syed, Kirin K; Robison, Christopher; McFadden, Jacob; Shalowitz, David I; Brown, Gordon A; Sussman, David O; Figler, Bradley D

    2016-01-01

    Urethroplasty is an effective treatment for men with anterior urethral strictures, but is utilized less frequently than ineffective treatments such as internal urethrotomy. We sought to identify provider-level barriers to urethroplasty. An anonymous online survey was emailed to all Mid-Atlantic American Urological Association members. Six scenarios in which urethroplasty was the most appropriate treatment were presented. Primary outcome was recommendation for urethroplasty in ≥ three clinical scenarios. Other factors measured include practice zip code, urethroplasty training, and proximity to a urethroplasty surgeon. Multivariate logistic regression identified factors associated with increased likelihood of urethroplasty recommendation. Of 670 members emailed, 109 (16%) completed the survey. Final analysis included 88 respondents. Mean years in practice was 17.2. Most respondents received formal training in urethroplasty: 43 (49%) in residency, 5 (6%) in fellowship, and 10 (11%) in both; 48 respondents (55%) had a urethroplasty surgeon in their practice, whereas 18 (20%) had a urethroplasty surgeon within 45 minutes of his or her primary practice location. The only covariate that was associated with an increased likelihood of recommending urethroplasty in ≥ three scenarios was formal urethroplasty training. Most members (68%) reported no barriers to referring patients for urethroplasty; the most common barriers cited were long distance to urethroplasty surgeon (n 5 13, 15%) and concern about complications (n 5 8, 9%). Urethroplasty continues to be underutilized in men with anterior urethral strictures, potentially due to lack of knowledge dissemination and access to a urethroplasty surgeon. Appropriate urethroplasty utilization may increase with greater exposure to urethroplasty in training.

  10. Racial Trade Barriers?

    DEFF Research Database (Denmark)

    Bjerre, Jacob Halvas

    . This paper analyzes the racial policies pursued in the foreign trade and argues that we need to recognize Aryanization as a world-wide policy in order to fully understand its character and possible consequences. I focus on the pre-war period and analyze the case of Denmark from three different perspectives......: perpetrators, victims and bystanders. The analysis will show that race, economy and foreign trade were combined in an attempt to raise racial trade barriers. This forced the question of German racial policies on the Danish government, Danish-Jewish businesses, and German companies involved in foreign trade...

  11. Support or Barrier?

    DEFF Research Database (Denmark)

    Sanden, Guro Refsum; Lønsmann, Dorte

    This study offers a critical look at how corporate-level language management influences front-line language practices among employees in three multinational corporations (MNCs) headquartered in Scandinavia. Based on interview and document data, we examine, firstly, what front-line practices...... employees use to cross language boundaries in their everyday work, and, secondly, how these practices relate to top-down language management in the case companies. Our findings show that employees are often dependent on ad hoc and informal solutions in cross- language situations, which leads us...... to a discussion of how a company’s language policy may be seen as both support and a barrier....

  12. Malignant duodenal obstructions: palliative treatment with covered expandable nitinol stent

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Chul; Jung, Gyoo Sik; Lee, Sang Hee; Kim, Sung Min; Oh, Kyung Seung; Huh, Jin Do; Cho, Young Duk [College of Medicine, Kosin Univ, Pusan (Korea, Republic of); Song, Ho Young [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)

    2002-04-01

    To evaluate the feasibility and clinical effectiveness of using a polyurethane-covered expandable nitinol stent in the palliative treatment of malignant duodenal obstruction. Under fluoroscopic guidance, a polyurethane-covered expandable nitinol stent was placed in 12 consecutive patients with malignant duodenal obstructions. All presented with severe nausea and recurrent vomiting. The underlying causes of obstruction were duodenal carcinoma (n=4), pancreatic carcinoma (n=4), gall bladder carcinoma (n=2), distal CBD carcinoma (n=1), and uterine cervical carcinoma (n=1). The sites of obstruction were part I (n=1), part II (n=8), and III (n=3). Due to pre-existing jaundice, eight patients with part II obstructions underwent biliary decompression prior to stent placement. An introducer sheath with a 6-mm outer diameter and stents 16 mm in diameter were employed, and to place the stent, and after-loading technique was used. Stent placement was technically successful in ten patients, and no procedural complications occuured. In one of two patients in whom there was technical failure, and in whom the obstructions were located in part III, the stent was placed transgastrically. Stent migration occurred in one patient four days after the procedure, and treatment involved the palcement of a second, uncovered, nitinol stent. After stent placement, symptoms improved in all patients. During follow-up, obstructive symptoms due to stent stenosis (n=1), colonic obstruction (n=1), and multiple small bowel obstruction (n=1) recurred in three patients. Two of these were treated by placing additional stents in the duodenum and colon, respectively. One of the eight patients in whom a stent was placed in the second portion of the duodenum developed jaundice. The patients died a mean 14 (median, 9) weeks after stent placement. The placement of a polyurethane-covered expandable nitinol stent seems to be technically feasible, safe and effective for the palliative treatment of malignant

  13. Morphological measurements in computed tomography correlate with airflow obstruction in chronic obstructive pulmonary disease : systematic review and meta-analysis

    NARCIS (Netherlands)

    Xie, X.Q.; de Jong, P.A.; Oudkerk, M.; Wang, Y.; ten Hacken, N.H.T.; Miao, J.T.; Zhang, GuiXiang; de Bock, G.H.; Vliegenthart, R.

    2012-01-01

    To determine the correlation between CT measurements of emphysema or peripheral airways and airflow obstruction in chronic obstructive pulmonary disease (COPD). PubMed, Embase and Web of Knowledge were searched from 1976 to 2011. Two reviewers independently screened 1,763 citations to identify

  14. Prevalence of exercise-induced left ventricular outflow tract obstruction in symptomatic patients with non-obstructive hypertrophic cardiomyopathy.

    LENUS (Irish Health Repository)

    Shah, J S

    2008-10-01

    Resting left ventricular outflow tract obstruction (LVOTO) occurs in 25% of patients with hypertrophic cardiomyopathy (HCM) and is an important cause of symptoms and disease progression. The prevalence and clinical significance of exercise induced LVOTO in patients with symptomatic non-obstructive HCM is uncertain.

  15. Drug-induced sleep endoscopy in the identification of obstruction sites in patients with obstructive sleep apnea: a systematic review.

    Science.gov (United States)

    Viana, Alonço da Cunha; Thuler, Luiz Claudio Santos; Araújo-Melo, Maria Helena de

    2015-01-01

    Obstructive sleep apnea syndrome has multifactorial causes. Although indications for surgery are evaluated by well-known diagnostic tests in the awake state, these do not always correlate with satisfactory surgical results. To undertake a systematic review on endoscopy during sleep, as one element of the diagnosis routine, aiming to identify upper airway obstruction sites in adult patients with OSAS. By means of electronic databases, a systematic review was performed of studies using drug-induced sleep endoscopy to identify obstruction sites in patients with OSAS. Ten articles were selected that demonstrated the importance of identifying multilevel obstruction, especially in relation to retrolingual and laryngeal collapse in OSAS. DISE is an additional method to reveal obstruction sites that have not been detected in awake patients. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  16. Stability of barrier buckets with zero RF-barrier separations

    Energy Technology Data Exchange (ETDEWEB)

    Ng, K.Y.; /Fermilab

    2005-03-01

    A barrier bucket with very small separation between the rf barriers (relative to the barrier widths) or even zero separation has its synchrotron tune decreasing rather slowly from a large value towards the boundary of the bucket. As a result, large area at the bucket edges can become unstable under the modulation of rf voltage and/or rf phase. In addition, chaotic regions may form near the bucket center and extend outward under increasing modulation. Application is made to those barrier buckets used in the process of momentum mining at the Fermilab Recycler Ring.

  17. Danish Register of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Lange P

    2016-10-01

    Full Text Available Peter Lange,1,2 Sandra Søgaard Tøttenborg,1 Anne Dichmann Sorknæs,3 Jørgen Steen Andersen,4 Mette Søgaard,5 Henrik Nielsen,5 Reimar Wernich Thomsen,5 Katrine Abildtrup Nielsen6 1Section of Social Medicine, Department of Public Health, University of Copenhagen, 2Lung Diseases Department, Respiratory Medicine Section, Lung Diseases Department, Hvidovre Hospital, University of Copenhagen, Copenhagen, 3Medical Department, Odense Universitetshospital–Svendborg Hospital, Svendborg, 4Danish College of General Practitioners, Copenhagen, 5Department of Clinical Epidemiology, Aarhus University Hospital, 6Registry Support Centre of Clinical Quality and Health Informatics (West, Århus, Denmark Aim of database: The Danish Register of Chronic Obstructive Pulmonary Disease (DrCOPD is a nationwide database aiming to describe the quality of treatment of all patients with chronic obstructive pulmonary disease (COPD in Denmark. Study population: DrCOPD comprises data on all patients with a diagnosis of COPD. In the hospital setting, both in- and outpatients are included. In the setting of the general practice (GP, DrCOPD aims to include all patients with a COPD diagnosis who attend an annual control visit for COPD. Main variables: DrCOPD includes information on forced expiratory volume in 1 second, smoking status, body mass index, dyspnea, treatment modalities such as rehabilitation, smoking cessation, medical treatment, and the use of noninvasive ventilation during hospitalization due to exacerbations. The outcome variables include frequency of readmission and death 30 days after discharge from hospital. Descriptive data: Since 2008, the registration in the Danish hospitals has gradually become more comprehensive. In 2014, ~90% of 16,106 eligible patients had complete data sets that showed an improvement in the processes describing quality of care, including increased offering of smoking cessation, rehabilitation, and correct treatment with inhaled

  18. AN ANALYTICAL STUDY IN ADHESIVE BOWEL OBSTRUCTION

    Directory of Open Access Journals (Sweden)

    Gerald Anand Raja

    2017-04-01

    Full Text Available BACKGROUND Peritoneal adhesions can be defined as abnormal fibrous bands between organs or tissues or both in the abdominal cavity that are normally separated. Adhesions may be acquired or congenital; however, most are acquired as a result of peritoneal injury, the most common cause of which is abdominopelvic surgery. Less commonly, adhesions may form as the result of inflammatory conditions, intraperitoneal infection or abdominal trauma. The extent of adhesion formation varies from one patient to another and is most dependent on the type and magnitude of surgery performed as well as whether any postoperative complications develop. Fortunately, most patients with adhesions do not experience any overt clinical symptoms. For others, adhesions may lead to any one of a host of problems and can be the cause of significant morbidity and mortality. MATERIALS AND METHODS This is a retrospective study of 50 patients admitted in Government Royapettah Hospital with adhesive bowel obstruction between September 2008 to September 2010. All patients were admitted and managed either conservatively or surgically. RESULTS 1. Adhesive bowel disease is the most common cause for bowel obstruction followed by hernias. 2. Increased incidence is noted in females. 3. Increased incidence of adhesions was documented in gynaecological and colorectal surgeries. 4. Below umbilical incisions have higher propensity for adhesion formation. 5. Laparotomies done for infective aetiology have higher adhesion risks. 6. Most of adhesive obstructions can be managed conservatively. 7. Adhesiolysis preferably laparoscopic can be done. For gangrenous bowel resection and anastomosis or ostomy done. 8. Given the above risk factors, adhesive bowel disease can be prevented to a certain extent. CONCLUSION The formation of peritoneal adhesions continues to plague patients, surgeons and society. Although, research in this area is ongoing, there is currently no method that is 100% effective in

  19. Pulmonary hypertension in chronic obstructive pulmonary disease

    International Nuclear Information System (INIS)

    Aguirre F, Carlos E; Torres D, Carlos A.

    2010-01-01

    Pulmonary hypertension (PH) is a relatively common complication of chronic obstructive pulmonary disease (COPD). Its appearance during the course of COPD is associated with a worsened prognosis, due to reduced life expectancy and greater use of health care resources. Although a well-defined lineal relationship has not been shown, the prevalence of PH in patients with COPD is higher in cases characterized by greater obstruction and severity. PH is infrequent in cases of mild and moderate COPD. In cases of COPD, PH is generally mild or moderate, and seldom impairs right ventricular function. In many cases it is not apparent during rest, and manifests itself during exercise. PH can be severe or out of proportion with the severity of COPD. In this situation, the possibility of associated conditions should be explored, although COPD might be the only final explanation. There is scarce knowledge about the prevalence and behavior of PH in patients with COPD residing at intermediate and high altitudes (>2.500 meters above sea level), which is a common situation in Latin America and Asia. PH in COPD is not exclusively related with hypoxia/hypoxaemia and hypercapnia. The mechanical disturbances related with COPD (hyper inflation and high alveolar pressure) and inflammation may prevail as causes of endothelial injury and remodeling of pulmonary circulation, which contribute to increased pulmonary vascular pressure and resistance. The appearance of signs of cor p ulmonale indicates advanced PH. This condition should therefore be suspected early when dyspnoea, hypoxaemia, and impairment of diffusion are not in keeping with the degree of obstruction. PH is confirmed by Doppler echocardiography. Right heart catheterization may be justified in selected cases. Long-term oxygen therapy is the only intervention proven to be temporarily useful. Conventional vasodilators do not produce medium- or long-term improvement and can be detrimental to the ventilation-perfusion relation

  20. Diagnostic Accuracy of Obstructive Airway Adult Test for Diagnosis of Obstructive Sleep Apnea.

    Science.gov (United States)

    Gasparini, Giulio; Vicini, Claudio; De Benedetto, Michele; Salamanca, Fabrizio; Sorrenti, Giovanni; Romandini, Mario; Bosi, Marcello; Saponaro, Gianmarco; Foresta, Enrico; Laforì, Andreina; Meccariello, Giuseppe; Bianchi, Alessandro; Toraldo, Domenico Maurizio; Campanini, Aldo; Montevecchi, Filippo; Rizzotto, Grazia; Cervelli, Daniele; Moro, Alessandro; Arigliani, Michele; Gobbi, Riccardo; Pelo, Sandro

    2015-01-01

    The gold standard for the diagnosis of Obstructive Sleep Apnea (OSA) is polysomnography, whose access is however reduced by costs and limited availability, so that additional diagnostic tests are needed. To analyze the diagnostic accuracy of the Obstructive Airway Adult Test (OAAT) compared to polysomnography for the diagnosis of OSA in adult patients. Ninety patients affected by OSA verified with polysomnography (AHI ≥ 5) and ten healthy patients, randomly selected, were included and all were interviewed by one blind examiner with OAAT questions. The Spearman rho, evaluated to measure the correlation between OAAT and polysomnography, was 0.72 (p diagnostic accuracy for the diagnosis of OSA. It has also been shown to be able to discriminate among the different degrees of severity of OSA. Additional large studies aiming to validate this questionnaire as a screening or diagnostic test are needed.

  1. Dynamical SUSY Breaking at Meta-Stable Minima from D-branes at Obstructed Geometries

    CERN Document Server

    Franco, S; Franco, Sebastian; Uranga, Angel M .

    2006-01-01

    We study the existence of long-lived meta-stable supersymmetry breaking vacua in gauge theories with massless quarks, upon the addition of extra massive flavors. A simple realization is provided by a modified version of SQCD with N_{f,0} < N_c massless flavors, N_{f,1} massive flavors and additional singlet chiral fields. This theory has local meta-stable minima separated from a runaway behavior at infinity by a potential barrier. We find further examples of such meta-stable minima in flavored versions of quiver gauge theories on fractional branes at singularities with obstructed complex deformations, and study the case of the dP_1 theory in detail. Finally, we provide an explicit String Theory construction of such theories. The additional flavors arise from D7-branes on non-compact 4-cycles of the singularity, for which we find a new efficient description using dimer techniques.

  2. Chronic obstructive pulmonary disease and obstructive sleep apnea: overlaps in pathophysiology, systemic inflammation, and cardiovascular disease.

    LENUS (Irish Health Repository)

    McNicholas, Walter T

    2012-02-01

    Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome represent two of the most prevalent chronic respiratory disorders in clinical practice, and cardiovascular diseases represent a major comorbidity in each disorder. The two disorders coexist (overlap syndrome) in approximately 1% of adults but asymptomatic lower airway obstruction together with sleep-disordered breathing is more prevalent. Although obstructive sleep apnea syndrome has similar prevalence in COPD as the general population, and vice versa, factors such as body mass index and smoking influence relationships. Nocturnal oxygen desaturation develops in COPD, independent of apnea\\/hypopnea, and is more severe in the overlap syndrome, thus predisposing to pulmonary hypertension. Furthermore, upper airway flow limitation contributes to nocturnal desaturation in COPD without apnea\\/hypopnea. Evidence of systemic inflammation in COPD and sleep apnea, involving C-reactive protein and IL-6, in addition to nuclear factor-kappaB-dependent pathways involving tumor necrosis factor-alpha and IL-8, provides insight into potential basic interactions between both disorders. Furthermore, oxidative stress develops in each disorder, in addition to activation and\\/or dysfunction of circulating leukocytes. These findings are clinically relevant because systemic inflammation may contribute to the pathogenesis of cardiovascular diseases and the cell\\/molecular pathways involved are similar to those identified in COPD and sleep apnea. However, the pathophysiological and clinical significance of systemic inflammation in COPD and sleep apnea is not proven, and thus, studies of patients with the overlap syndrome should provide insight into the mechanisms of systemic inflammation in COPD and sleep apnea, in addition to potential relationships with cardiovascular disease.

  3. Performing a local barrier operation

    Science.gov (United States)

    Archer, Charles J; Blocksome, Michael A; Ratterman, Joseph D; Smith, Brian E

    2014-03-04

    Performing a local barrier operation with parallel tasks executing on a compute node including, for each task: retrieving a present value of a counter; calculating, in dependence upon the present value of the counter and a total number of tasks performing the local barrier operation, a base value, the base value representing the counter's value prior to any task joining the local barrier; calculating, in dependence upon the base value and the total number of tasks performing the local barrier operation, a target value of the counter, the target value representing the counter's value when all tasks have joined the local barrier; joining the local barrier, including atomically incrementing the value of the counter; and repetitively, until the present value of the counter is no less than the target value of the counter: retrieving the present value of the counter and determining whether the present value equals the target value.

  4. What hinder the further development of wind power in China?—A socio-technical barrier study

    International Nuclear Information System (INIS)

    Zhao, Zhen-Yu; Chang, Rui-Dong; Chen, Yu-Long

    2016-01-01

    Promoting wind power is a long-term strategy of China to respond to both energy shortage and environmental pollution. Stimulated by various incentive policies, wind power generation in China has achieved tremendous growth, with the cumulative installed capacity being the largest worldwide for five consecutive years since 2010. However, obstructed by various barriers, wind power provides only 2.6% of national electricity generation in China, despite the strong support from the government. From a socio-technical transition perspective, this paper aims to systematically analyze the barriers hindering the further development of China's wind power. A wind power niche model is established to illustrate the complex interactions among actors in the wind power industry and electricity supply regime. Then, qualitative content analysis is adopted to process the related evidence and data, and four categories of socio-technical barriers are identified, including technology, governance, infrastructure and culture barriers. The study shows that various interrelated barriers form a blocking mechanism which prohibits the further development of wind power in China. Policy suggestions are proposed to eliminate the barriers and further empower the wind power niche. The lesson learned from China can offer useful references for other economies to promote wind power industries of their own. - Highlights: • Use wind power niche model to illustrate the interactions among actors in the industry. • Analyze technological, governance, infrastructural and cultural barriers. • Multidimensionality and interconnectedness of the barriers are illustrated. • Policy suggestions are proposed to deal with the wind power development barriers.

  5. Radionuclidedacryography for diagnosis of lacrimal obstruction

    International Nuclear Information System (INIS)

    Dressler, J.; Denffer, H.V.; Gullotta, U.; Pabst, H.W.

    1982-01-01

    The lacrimal drainage systems of 69 eyes were studied by both radionuclidedacryography (RND) and conventional X-ray dacryocystography (DCG). Sequential scanning is peformed by employing a small volume of Tc-99m as an eye drop a gamma camera with a specially designed pinhole collimator. Compared to DCG the radionuclide method is more reliable in detecting functional blockage of the lacrimal drainage apparatus (LDA). No radiographically detected stenosis was missed by RND but in 6 out of 44 patients the site of obstruction was localisized somewhat higher up in the LDA. RND is recommended as a valuable diagnostic tool in all patients with epiphora, especially in follow up studies before and after surgical treatment and radiotherapy in the region of the LDA

  6. Prosthetic valve obstruction: Redo surgery or fibrinolysis?

    Directory of Open Access Journals (Sweden)

    Avinash Inamdar

    2017-01-01

    Full Text Available Objective: The aim of this study was to compare the efficacy and safety of surgery versus fibrinolytic therapy in patients with prosthetic valve obstruction. Materials and Methods: We compared 15 patients of prosthetic valve thrombosis treated by surgical line of management and another 15 patients treated by thrombolysis. All patients were initially assessed by clinical evaluation and diagnosis confirmed by transthoracic and transesophageal two-dimensional echocardiography. Depending on hemodynamic stability, pannus, or thrombus on transesophageal echocardiography, the patients were assigned surgical or medical line of management. Results: Patients mortality rate was 40% in fibrinolytic group and 13.33% in surgical group. Recurrence was 40% in fibrinolytic group while there was no recurrence till date in surgery group. Complications were more in fibrinolytic group as opposed to surgery group patient. Conclusion: From our experience, we conclude that redo surgery is effective and definitive treatment, especially in patients with stable hemodynamic conditions.

  7. Chronic Obstructive Pulmonary Disease and Hepatitis C

    Directory of Open Access Journals (Sweden)

    Mekov Evgeni V.

    2017-06-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is a preventable, treatable disease with significant extrapulmonary manifestations that could affect negatively its course in some patients. Hepatitis C virus infection (HCV, on the other hand, is associated with a number of extrahepatic manifestations. COPD patients have increased prevalence of HCV and patients with HCV, especially older ones, have increased prevalence and faster progression of COPD. HCV infection exerts long-term effects on lung tissue and is an additional risk factor for the development of COPD. The presence of HCV is associated with an accelerated loss of lung function in COPD patients, especially in current smokers. COPD could represent extrahepatic manifestation associated with HCV infection. The aim of this article was to review the literature on prevalence of HCV in COPD and vice versa, pathogenetic link and the consequences of their mutual existence.

  8. Imaging in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Shaker, Saher B; Dirksen, Asger; Bach, Karen S; Mortensen, Jann

    2007-06-01

    Chronic obstructive pulmonary disease (COPD) is divided into pulmonary emphysema and chronic bronchitis (CB). Emphysema is defined patho-anatomically as "permanent enlargement of airspaces distal to the terminal bronchiole, accompanied by the destruction of their walls, and without obvious fibrosis" (1). These lesions are readily identified and quantitated using computed tomography (CT), whereas the accompanying hyperinflation is best detected on plain chest X-ray, especially in advanced disease. The diagnosis of CB is clinical and relies on the presence of productive cough for 3 months in 2 or more successive years. The pathological changes of mucosal inflammation and bronchial wall thickening have been more difficult to identify with available imaging techniques. However, recent studies using Multi-detector row CT (MDCT) reported more reproducible assessment of air wall thickening.

  9. Thyroid gland in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Miłkowska-Dymanowska, Joanna; Białas, Adam J; Laskowska, Paulina; Górski, Paweł; Piotrowski, Wojciech J

    2017-01-01

    The risk of chronic obstructive pulmonary disease (COPD), as well as thyroid diseases increases with age. COPD is a common systemic disease associated with chronic inflammation. Many endocrinological disorders, including thyroid gland diseases are related to systemic inflammation. Epidemiological studies suggest that patients with COPD are at higher risk of thyroid disorders. These associations are not well-studied and thyroid gland diseases are not included on the broadly acknowledged list of COPD comorbidities. They may seriously handicap quality of life of COPD patients. Unfortunately, the diagnosis may be difficult, as many signs are masked by the symptoms of the index disease. The comprehension of the correlation between thyroid gland disorders and COPD may contribute to better care of patients. In this review, we attempt to revise available literature describing existing links between COPD and thyroid diseases.

  10. OBSTRUCTION OF THE EXERCISE OF ELECTORAL RIGHTS

    Directory of Open Access Journals (Sweden)

    MIRCEA CONSTANTIN SINESCU

    2012-05-01

    Full Text Available Throughout the present study, we analyze the crime of obstruction of the exercise of electoral rights, as it is presented in the New Criminal Code, in comparison with the current regulation within the specific election laws. Taking into consideration the fact that the election crimes have been inserted as a separate title (section in the New Criminal Code, we need to highlight the vision of the legislator regarding these crimes. Furthermore, this study consists of a synthetic analysis of the constitutive elements of the mentioned crime, as reconfigured in the form provided by art.385 of the New Criminal Code. We consider that examining this crime is a necessity, because of the lack of Court decisions in this area of practice - probably due to the gaps in the legislation preceding the Criminal Code that is to be enforced in the near future.

  11. Office management of obstructive sleep apnoea: appliances.

    Science.gov (United States)

    Johnson, Matthew D

    2015-08-01

    Oral appliances are becoming increasingly common in the treatment of obstructive sleep apnoea (OSA). They work by advancing the mandible and opening the pharynx. There are several types of devices available for use. Many patients intolerant to continuous positive airway pressure (CPAP) are using oral appliances for OSA. Oral appliances have been shown to improve polysomnography, quality of life and health measures associated with OSA. There is current work to better identify patients who are ideal candidates. Development of titratable devices and monitoring are optimizing usage. They have been compared with CPAP, with both showing improvement in OSA; however, CPAP remains superior overall. Oral appliances are becoming first-line therapy for mild and moderate OSA. They provide a meaningful alternative in severe OSA for patients unable to use CPAP. Device titration and usage monitoring are beginning to hone oral appliances as a therapeutic option.

  12. Overlap syndrome: obstructive sleep apnea in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Weitzenblum, Emmanuel; Chaouat, Ari; Kessler, Romain; Canuet, Matthieu

    2008-02-15

    Chronic obstructive pulmonary disease (COPD) and sleep apnea-hypopnea syndrome (SAHS) are both common diseases affecting respectively 10 and 5% of the adult population over 40 years of age, and their coexistence, which is denominated overlap syndrome, can be expected to occur in about 0.5% of this population. A recent epidemiologic study has shown that the prevalence of SAHS is not higher in COPD than in the general population, and that the coexistence of the two conditions is due to chance and not through a pathophysiologic linkage between these two diseases. Patients with overlap have a more important sleep-related O(2) desaturation than do patients with COPD with the same degree of bronchial obstruction. They have an increased risk of developing hypercapnic respiratory insufficiency and pulmonary hypertension when compared with patients with SAHS alone and with patients with "usual" COPD. In patients with overlap, hypoxemia, hypercapnia, and pulmonary hypertension can be observed in the presence of mild to moderate bronchial obstruction, which is different from "usual" COPD. Therapy of the overlap syndrome consists of nasal continuous positive airway pressure or nocturnal noninvasive ventilation (NIV), with or without associated nocturnal O(2). Patients who are markedly hypoxemic during daytime (Pa(O(2)) < 55-60 mm Hg) should be given conventional long-term O(2) therapy in addition to nocturnal ventilation.

  13. Chronic partial ureteral obstruction and the developing kidney

    Energy Technology Data Exchange (ETDEWEB)

    Chevalier, Robert L. [University of Virginia, Department of Pediatrics, Box 800386, Charlottesville, VA (United States)

    2008-01-15

    Although congenital urinary tract obstruction is a common disorder, its pathophysiology remains poorly understood and clinical practice is controversial. Animal models have been used to elucidate the mechanisms responsible for obstructive nephropathy, and the models reveal that renal growth and function are impaired in proportion to the severity and duration of obstruction. Ureteral obstruction in the neonatal rat or mouse leads to activation of the renin-angiotensin system, renal infiltration by macrophages, and tubular apoptosis. Nephrons are lost by glomerular sclerosis and the formation of atubular glomeruli, and progressive injury leads to tubular atrophy and interstitial fibrosis. Recovery following release of obstruction depends on the timing, severity, and duration of obstruction. Growth factors and cytokines are produced by the hydronephrotic kidney, including MCP-1 and TGF-{beta}1, which are excreted in urine and can serve as biomarkers of renal injury. Because MRI can be used to monitor renal morphology, blood flow, and filtration rate, its use might supplant current imaging modalities (ultrasonography and diuretic renography), which have significant drawbacks. Combined use of MRI and new urinary biomarkers should improve our understanding of human congenital obstructive nephropathy and should lead to new approaches to evaluation and management of this challenging group of patients. (orig.)

  14. Analysis of electrocardiogram in chronic obstructive pulmonary disease patients.

    Science.gov (United States)

    Lazović, Biljana; Svenda, Mirjana Zlatković; Mazić, Sanja; Stajić, Zoran; Delić, Marina

    2013-01-01

    Chronic obstructive pulmonary disease is the fourth leading cause of mortality worldwide. It is defined as a persistent airflow limitation usually progressive and not fully reversible to treatment. The diagnosis of chronic obstructive pulmonary disease and severity of disease is confirmed by spirometry. Chronic obstructive pulmonary disease produces electrical changes in the heart which shows characteristic electrocardiogram pattern. The aim of this study was to observe and evaluate diagnostic values of electrocardiogram changes in chronic obstructive pulmonary disease patients with no other comorbidity. We analyzed 110 electrocardiogram findings in clinically stable chronic obstructive pulmonary disease patients and evaluated the forced expiratory volume in the first second, ratio of forces expiratory volume in the first second to the fixed vital capacity, chest radiographs and electrocardiogram changes such as p wave height, QRS axis and voltage, right bundle branch block, left bundle branch block, right ventricular hypertrophy, T wave inversion in leads V1-V3, S1S2S3 syndrome, transition zone in praecordial lead and QT interval. We found electrocardiogram changes in 64% patients, while 36% had normal electrocardiogram. The most frequent electrocardiogram changes observed were transition zone (76.36%) low QRS (50%) and p pulmonale (14.54%). Left axis deviation was observed in 27.27% patients. Diagnostic values of electrocardiogram in patients with chronic obstructive pulmonary disease suggest that chronic obstructive pulmonary disease patients should be screened electrocardiographically in addition to other clinical investigations.

  15. Obstructive sleep apnea: a clinical review

    Directory of Open Access Journals (Sweden)

    M. Marvisi

    2013-05-01

    Full Text Available BACKGROUND Since the original classification of the obstructive nature of obstructive sleep apnea syndrome (OSAS in 1965, much has been learned about the disorder. In 1990 respiratory disturbances during sleep have come to be recognized as extremely common disorders with important clinical consequences. DISCUSSION It is a condition with high prevalence of obesity as a major risk factor. Premenopausal women are relatively protected from the disorder: its prevalence in women rises after menopause. Although OSAS is a risk factor for excessive daytime sleepiness, there is developing evidence that it is also a risk factor for hypertension, acute cardiovascular events, and insulin resistance. Definitive diagnosis still depends on in-laboratory polysomnography. This involves recording of multiple variables during sleep, including electroencephalogram. There is a considerable interest in the role of unattended home sleep-monitoring and some evidence of its usefulness has yet to be established. The first line of therapy is nasal continuous positive airway pressure (CPAP. Data into the efficacy of CPAP in severe OSAS have come from randomized, placebo-controlled clinical trials the endpoints of which being sleepiness, quality of life, and 24-h ambulatory blood pressure. Data are currently less convincing for treatment outcomes in mild to moderate OSAS, and new clinical trails to assess outcomes in this group are underway. CONCLUSION The field of sleep medicine has now firmly entered the mainstream of clinical practice, substantial progress has been made, and OSAS has increasingly emerged as a major public health concern. The Internal Medicine specialist has to recognize this clinical entity.

  16. Barrier rf systems in synchrotrons

    International Nuclear Information System (INIS)

    Bhat, Chandra M.

    2004-01-01

    Recently, many interesting applications of the barrier RF system in hadron synchrotrons have been realized. A remarkable example of this is the development of longitudinal momentum mining and implementation at the Fermilab Recycler for extraction of low emittance pbars for the Tevatron shots. At Fermilab, we have barrier RF systems in four different rings. In the case of Recycler Ring, all of the rf manipulations are carried out using a barrier RF system. Here, the author reviews various uses of barrier rf systems in particle accelerators including some new schemes for producing intense proton beam and possible new applications

  17. Tunnel superpenetrability of potential barriers

    International Nuclear Information System (INIS)

    Zakhariev, B N.

    1982-01-01

    The transmission of two particles through the same barrier is considered. The limiting cases are compared when the particles are joined together in a single particle with double mass-energy and potential and when they pass the barrier independently. As an intermediate case a pair of particles bound in a quasideuteron of a finite size is considered. It is shown that long-range collective correlations of particles (of the superfluidity type and others) simplify very much for them passing through high potential barriers. This happens due to the transfer of the additional energy from the particles outside the barriers to those inside it

  18. Barriers for recess physical activity

    DEFF Research Database (Denmark)

    Pawlowski, Charlotte Skau; Tjørnhøj-Thomsen, Tine; Schipperijn, Jasper

    2014-01-01

    BACKGROUND: Many children, in particular girls, do not reach the recommended amount of daily physical activity. School recess provides an opportunity for both boys and girls to be physically active, but barriers to recess physical activity are not well understood. This study explores gender...... differences in children's perceptions of barriers to recess physical activity. Based on the socio-ecological model four types of environmental barriers were distinguished: natural, social, physical and organizational environment. METHODS: Data were collected through 17 focus groups (at 17 different schools...... this study, we recommend promoting recess physical activity through a combination of actions, addressing barriers within the natural, social, physical and organizational environment....

  19. Linguistic Barriers and Bridges

    DEFF Research Database (Denmark)

    Thuesen, Frederik

    2016-01-01

    The influence of language on social capital in low-skill and ethnically diverse workplaces has thus far received very limited attention within the sociology of work. As the ethnically diverse workplace is an important social space for the construction of social relations bridging different social...... groups, the sociology of work needs to develop a better understanding of the way in which linguistic diversity influences the formation of social capital, i.e. resources such as the trust and reciprocity inherent in social relations in such workplaces. Drawing on theories about intergroup contact...... and intercultural communication, this article analyses interviews with 31 employees from two highly ethnically diverse Danish workplaces. The article shows how linguistic barriers such as different levels of majority language competence and their consequent misunderstandings breed mistrust and hostility, whilst...

  20. Countermeasures and barriers

    Energy Technology Data Exchange (ETDEWEB)

    Petersen, Johannes [Oersted - DTU, Automation, Kgs. Lyngby (Denmark)

    2005-10-01

    In 1973 Haddon proposed ten strategies for reducing and avoiding damages based on a model of potential harmful energy transfer (Haddon, 1973). The strategies apply to a large variety of unwanted phenomena. Haddon's pioneering work on countermeasures has had a major influence on later thinking about safety. Considering its impact it is remarkable that the literature offers almost no discussions related to the theoretical foundations of Haddon's countermeasure strategies. The present report addresses a number of theoretical issues related to Haddon's countermeasure strategies, which are: 1) A reformulation and formalization of Haddon's countermeasure strategies. 2) An identification and description of some of the problems associated with the term 'barrier'. 3) Suggestions for a more precise terminology based on the causal structure of countermeasures. 4) Extending the scope of countermeasures to include sign-based countermeasures. (au)

  1. Countermeasures and barriers

    International Nuclear Information System (INIS)

    Petersen, Johannes

    2005-10-01

    In 1973 Haddon proposed ten strategies for reducing and avoiding damages based on a model of potential harmful energy transfer (Haddon, 1973). The strategies apply to a large variety of unwanted phenomena. Haddon's pioneering work on countermeasures has had a major influence on later thinking about safety. Considering its impact it is remarkable that the literature offers almost no discussions related to the theoretical foundations of Haddon's countermeasure strategies. The present report addresses a number of theoretical issues related to Haddon's countermeasure strategies, which are: 1) A reformulation and formalization of Haddon's countermeasure strategies. 2) An identification and description of some of the problems associated with the term 'barrier'. 3) Suggestions for a more precise terminology based on the causal structure of countermeasures. 4) Extending the scope of countermeasures to include sign-based countermeasures. (au)

  2. Thames barrier (flood protection barriers on the Thames)

    International Nuclear Information System (INIS)

    Ilkovic, J.

    2005-01-01

    In this paper the flood protection barriers on the Thames are presented. The flood protection system on the Thames in 1984 was commissioned. During two decades this barrier was used 54 times against to the high water and 34 times against storm-sewage. There is installed buttress type hydroelectric power plant

  3. Radiological findings in patients with obstructive sleep apnea

    Energy Technology Data Exchange (ETDEWEB)

    Mello Junior, Carlos Fernando de; Guimaraes Filho, Helio Antonio; Gomes, Camila Albuquerque de Brito; Paiva, Camila Caroline de Amorim, E-mail: carlosfmello@hotmail.com [Universidade Federal da Paraiba UFPB, Joao Pessoa (Brazil)

    2013-01-15

    Obstructive sleep apnea (OSA) is characterized by recurrent upper airway obstruction occurring at the level of the pharynx during sleep. Although cephalometric analysis is an important method in the diagnosis of craniofacial deformities, CT and magnetic resonance imaging have been highlighted as the major imaging methods to investigate the possible causes of OSA, which, in most cases, is multifactorial. Magnetic resonance and CT both allow an excellent evaluation of the various anatomical planes of the site of obstruction, which enables better clinical assessment and surgical approach. This pictorial essay aims to describe the aspects that must be evaluated in the diagnostic imaging of patients presenting with the major predisposing factors for OSA. (author)

  4. Diagnostic value of high strength MRCP in the obstructive jaundice

    International Nuclear Information System (INIS)

    Yang Yang; Dong Yuhai; Yin Jie; Lv Guoyi

    2007-01-01

    Objective: To evaluate the diagnostic value of high strength MRCP in patients with obstructive jaundice. Methods: Routine MRI and MRCP examination on 161 patients with obstructive jaundice were carded out with 1.5T Siemens super-conductive magnetic resonance machine. Of them, 103 cases were benign lesions and 58 were malignant after surgical and ERCP pathological confirmation. Results: The diagnostic accuracy of MRCP was 100%, with the qualitative diagnostic accuracy at 90.2%. Conclusion: MRCP was the best method in diagnosing patients with obstructive jaundice, the concerned performances of MRCP could provide the dependable basis for surgical operation project. (authors)

  5. Radiological findings in patients with obstructive sleep apnea

    International Nuclear Information System (INIS)

    Mello Junior, Carlos Fernando de; Guimaraes Filho, Helio Antonio; Gomes, Camila Albuquerque de Brito; Paiva, Camila Caroline de Amorim

    2013-01-01

    Obstructive sleep apnea (OSA) is characterized by recurrent upper airway obstruction occurring at the level of the pharynx during sleep. Although cephalometric analysis is an important method in the diagnosis of craniofacial deformities, CT and magnetic resonance imaging have been highlighted as the major imaging methods to investigate the possible causes of OSA, which, in most cases, is multifactorial. Magnetic resonance and CT both allow an excellent evaluation of the various anatomical planes of the site of obstruction, which enables better clinical assessment and surgical approach. This pictorial essay aims to describe the aspects that must be evaluated in the diagnostic imaging of patients presenting with the major predisposing factors for OSA. (author)

  6. Prognostic value of weight change in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Prescott, E; Almdal, T; Mikkelsen, K L

    2002-01-01

    An association between low body mass index (BMI) and poor prognosis in patients with chronic obstructive pulmonary disease (COPD) has been found in a number of studies. The prevalence and prognostic importance of weight change in unselected subjects with COPD was examined. Subjects with COPD...... change: in the normal-to-underweight (BMI or = 25), best survival was seen in stable weight. A high proportion of subjects with chronic obstructive pulmonary disease experienced a significant weight loss......, which was associated with increased mortality. The results support further intervention studies that aim at avoiding weight loss in normal-to-underweight chronic obstructive pulmonary disease patients....

  7. Sharp metric obstructions for quasi-Einstein metrics

    Science.gov (United States)

    Case, Jeffrey S.

    2013-02-01

    Using the tractor calculus to study smooth metric measure spaces, we adapt results of Gover and Nurowski to give sharp metric obstructions to the existence of quasi-Einstein metrics on suitably generic manifolds. We do this by introducing an analogue of the Weyl tractor W to the setting of smooth metric measure spaces. The obstructions we obtain can be realized as tensorial invariants which are polynomial in the Riemann curvature tensor and its divergence. By taking suitable limits of their tensorial forms, we then find obstructions to the existence of static potentials, generalizing to higher dimensions a result of Bartnik and Tod, and to the existence of potentials for gradient Ricci solitons.

  8. Acute small bowel obstruction due to chicken bone bezoar

    Directory of Open Access Journals (Sweden)

    Vetpillai P

    2012-12-01

    Full Text Available Preadeepan Vetpillai,1 Ayo Oshowo21CT2 Surgery in General, Charing Cross Hospital, 2Colorectal and Laparoscopic Surgery, Whittington Hospital, London, UKAbstract: Acute intestinal obstruction due to foreign bodies, or bezoar, is a rare occurrence in an adult with a normal intestinal tract. We report an unusual case of a 43-year-old black man with no previous abdominal surgery and no significant medical history who presented with an acute episode of small bowel obstruction due to an impacted undigested chicken bone.Keywords: small bowel obstruction, chicken bone, bezoar

  9. Hormonal treatment of obstructed kidneys in patients with prostatic cancer

    DEFF Research Database (Denmark)

    Honnens de Lichtenberg, M; Miskowiak, J; Rolff, H

    1993-01-01

    A review of 1288 patients with previously untreated prostatic cancer revealed 209 patients (16%) with ureteric obstruction; the obstruction was bilateral in 36%. The effect of hormonal treatment was assessed in 88 patients with 120 obstructed kidneys: 77 patients had androgen deprivation...... or hormonal medication alone and 11 patients needed percutaneous nephrostomy or ureteric catheters in addition. Drainage improved in 58% of the kidneys. The diverting catheter was withdrawn in 9 of the 11 patients after a median of 4 weeks. In all, 95% of patients were discharged. The patients with hormonal...

  10. Morphological measurements in computed tomography correlate with airflow obstruction in chronic obstructive pulmonary disease: systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Xie, XueQian; Oudkerk, Matthijs; Vliegenthart, Rozemarijn [University of Groningen, University Medical Center Groningen, Center for Medical Imaging-North East Netherlands (CMI-NEN), Department of Radiology, Hanzeplein 1, P.O. Box 30.001, RB, Groningen (Netherlands); Jong, Pim A. de [University Medical Center Utrecht, University of Utrecht, Department of Radiology, Heidelberglaan 100, P.O. Box 85.500, CX, Utrecht (Netherlands); Wang, Ying [Tianjin Medical University General Hospital, Department of Radiology, Tianjin (China); Hacken, Nick H.T. ten [University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Hanzeplein 1, P.O. Box 30.001, RB, Groningen (Netherlands); Miao, Jingtao; Zhang, GuiXiang [Shanghai Jiao Tong University Affiliated First People' s Hospital, Department of Radiology, Shanghai (China); Bock, Geertruida H. de [University of Groningen, University Medical Center Groningen, Department of Epidemiology, Hanzeplein 1, P.O. Box 30.001, RB, Groningen (Netherlands)

    2012-10-15

    To determine the correlation between CT measurements of emphysema or peripheral airways and airflow obstruction in chronic obstructive pulmonary disease (COPD). PubMed, Embase and Web of Knowledge were searched from 1976 to 2011. Two reviewers independently screened 1,763 citations to identify articles that correlated CT measurements to airflow obstruction parameters of the pulmonary function test in COPD patients, rated study quality and extracted information. Three CT measurements were accessed: lung attenuation area percentage < -950 Hounsfield units, mean lung density and airway wall area percentage. Two airflow obstruction parameters were accessed: forced expiratory volume in the first second as percentage from predicted (FEV{sub 1} %pred) and FEV{sub 1} divided by the forced volume vital capacity. Seventy-nine articles (9,559 participants) were included in the systematic review, demonstrating different methodologies, measurements and CT airflow obstruction correlations. There were 15 high-quality articles (2,095 participants) in the meta-analysis. The absolute pooled correlation coefficients ranged from 0.48 (95 % CI, 0.40 to 0.54) to 0.65 (0.58 to 0.71) for inspiratory CT and 0.64 (0.53 to 0.72) to 0.73 (0.63 to 0.80) for expiratory CT. CT measurements of emphysema or peripheral airways are significantly related to airflow obstruction in COPD patients. CT provides a morphological method to investigate airway obstruction in COPD. (orig.)

  11. Energy barriers in patterned media

    NARCIS (Netherlands)

    de Vries, Jeroen

    2013-01-01

    Due to the fact that thermal activation aids in overcoming the energy barrier, the required field for reversal varies from instance to instance for the same island. This thermally induced switching field distribution can be used to determine the difference in energy barrier of magneticallyweak and

  12. Simulating complex noise barrier reflections

    NARCIS (Netherlands)

    Eerden, F.J.M. van der; Lutgendorf, D.; Roo, F. de

    2011-01-01

    Within the EU FP7 QUIESST project, QUIeting the Environment for a Sustainable Surface Transport, a test method is being developed for the reflectivity of noise barriers. The method needs to account for a complex shape of barriers and the use of various types of absorbing materials. The performance

  13. BARRIERS OF STRATEGIC ALLIANCES ORGANIZATION

    Directory of Open Access Journals (Sweden)

    Vladislav M. Sannikov

    2014-01-01

    Full Text Available General barriers of organization of different types of strategic alliances have beenconsidered in the article. There are several recommendations for overcoming themin cases of international alliances, and in case of work in one state. The article also identified goals and tasks of single coordination center of alliance to overcome organization barriers.

  14. Release of obstructing rectal cuff following transanal endorectal ...

    African Journals Online (AJOL)

    symptoms after transanal endorectal pullthrough for ... In both patients, the obstructing symptoms were because of a rectal cuff ... widely adopted for the treatment of Hirschsprung's disease ... The cuff was identified and cut strictly in the midline.

  15. Endoscopic retrograde cholangiopancreatographic evaluation of patients with obstructive jaundice

    International Nuclear Information System (INIS)

    Khurram, M.; Durrani, A.A.; Butt, A.A.; Ashfaq, S.

    2003-01-01

    Objective: To evaluate the role of endoscopic retrograde cholangiopancreatography (ERCP) in patients with obstructive jaundice. Results: Of the 226 patients, 117 (51.8%) were males, and 109 (48.2%) females, their mean age being 51.8 plus minus 16.6 years. Common bile and pancreatic ducts were visualized in 81.8% and 68.1% patients respectively. Growth/masses and stones were commonest causes of obstructive jaundice. Choledocholithias was common in males, while biliary channel related growth/masses were common in females (p-value = 0.03). Common bile duct stone clearance rate was 88%, stenting was highly successful in patients with growth and strictures. ERCP related complications were noted in 11 (4.8%) patients. Conclusion: ERCP is an important diagnostic and therapeutic modality for evaluation of patients with obstructive jaundice. Growth/masses and stones are common causes of obstructive jaundice, which can be diagnosed and treated with ERCP. (author)

  16. Evidence-Based Decompression in Malignant Biliary Obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Ho, Chia Sing [University of Toronto, Toronto General Hospital, Toronto (Canada); Warkentin, Andrew E [University of Toronto, 1 King& #x27; s College Circle, Toronto (Canada)

    2012-02-15

    As recent advances in chemotherapy and surgical treatment have improved outcomes in patients with biliary cancers, the search for an optimal strategy for relief of their obstructive jaundice has become even more important. Without satisfactory relief of biliary obstruction, many patients would be ineligible for treatment. We review all prospective randomized trials and recent retrospective non-randomized studies for evidence that would support such a strategy. For distal malignant biliary obstruction, an optimal strategy would be insertion of metallic stents either endoscopically or percutaneously. Evidence shows that a metallic stent inserted percutaneously has better outcomes than plastic stents inserted endoscopically. For malignant hilar obstruction, percutaneous biliary drainage with or without metallic stents is preferred.

  17. The interventional treatment with two stents in malignant hilar obstruction

    International Nuclear Information System (INIS)

    Gao Kun; Dai Dingke; Zhao Renyou; Qian Xiaojun

    2006-01-01

    Objective: To evaluate the methodology of interventional treatment with two stents in malignant hilar obstructions. Methods: Retrospectively analyzing the two stents, interventional management of unresectable malignant hilar obstruction in 22 patients included unilateral and bilateral puncture routes for placing 'T' shape stent set and 'Y' shape stent set, respectively; together with recording the related complications. Results: The overall technical success rate was 100%, without severe complication. The total serum bilirubin reduced from (337.9 + 81.7) μmol/L before procedure to (129.1 + 51.1) μmol/L after the stent placement. Stent obstruction was found in 8 cases at 6 months; 5 cases by the time of 6-12 months and only 2 cases after 1 year. Conclusion: The method of two stents interventional treatment is a safe and useful management for malignant hilar obstructions. (authors)

  18. Endometriosis: A Rare Cause of Large Bowel Obstruction

    Directory of Open Access Journals (Sweden)

    Gonçalo Alexandrino

    2017-10-01

    Full Text Available Large bowel obstruction can result in significant morbidity and mortality, especially in cases of acute complete obstruction. There are many possible causes, the most common in adults being colorectal cancer. Endometriosis is a benign disease, and the most affected extragenital location is the bowel, especially the rectosigmoid junction. However, transmural involvement and acute occlusion are very rare events. We report an exceptional case of acute large bowel obstruction as the initial presentation of endometriosis. The differential diagnosis of colorectal carcinoma may be challenging, and this case emphasizes the need to consider intestinal endometriosis in females at a fertile age presenting with gastrointestinal symptoms and an intestinal mass causing complete large bowel obstruction.

  19. Six-minute-walk test in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Polkey, Michael I; Spruit, Martijn A; Edwards, Lisa D

    2013-01-01

    Outcomes other than spirometry are required to assess nonbronchodilator therapies for chronic obstructive pulmonary disease. Estimates of the minimal clinically important difference for the 6-minute-walk distance (6MWD) have been derived from narrow cohorts using nonblinded intervention....

  20. Emerging bronchoscopic treatments for chronic obstructive pulmonary disease

    NARCIS (Netherlands)

    van Geffen, Wouter H.; Kerstjens, Huib A. M.; Slebos, Dirk-Jan

    2017-01-01

    Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by pathophysiological factors including airflow limitation, hyperinflation and reduced gas exchange. Treatment consists of lifestyle changes, lung rehabilitation and pharmacological therapies such as long acting

  1. Ileal angiodysplasia presentation as a bowel obstruction: A case report

    Directory of Open Access Journals (Sweden)

    Ons Ghdes

    2017-01-01

    Conclusion: Angiodysplasia should be kept in the back of one’s mind as one of the causes of acute abdomen and bowel obstruction, especially in elderly people suffering from occult gastrointestinal bleeding.

  2. Genetically increased antioxidative protection and decreased chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Juul, Klaus; Tybjærg-Hansen, Anne; Marklund, Stefan

    2006-01-01

    RATIONALE: Increased oxidative stress is involved in chronic obstructive pulmonary disease (COPD); however, plasma and bronchial lining fluid contains the antioxidant extracellular superoxide dismutase. Approximately 2% of white individuals carry the R213G polymorphism in the gene encoding extrac...

  3. Congenital giant epulis obstructing oral cavity: newborn emergency ...

    African Journals Online (AJOL)

    Congenital giant epulis obstructing oral cavity: newborn emergency. Komla Gnassingbe, Komlan A Mihluedo-Agbolan, Harefetéguéna Bissa, Koffi Amegbor, Nguefack Blanchard Noumedem, Pilakimwe Egbohou, Wakatou Mama, Gamedzi K Akakpo-Numado, Hubert Tekou ...

  4. Propagation of obstructed Bessel and Bessel–Gauss beams

    CSIR Research Space (South Africa)

    Litvin, IA

    2008-08-01

    Full Text Available and phase of the beam after encountering an obstruction. Although this self reconstruction property has been previously modelled by numerous groups, the techniques involve rigorous, time-consuming computations. In this work we present an efficient method...

  5. Obstructed abdominal hernia at the Wesley Guild Hospital, Nigeria ...

    African Journals Online (AJOL)

    Obstructed abdominal hernia at the Wesley Guild Hospital, Nigeria. ... wall hernia who had operative intervention and other postoperative management. ... elective in 23 patients (21%) who had spontaneous reduction while awaiting surgery.

  6. Endoscopic or surgical intervention for painful obstructive chronic pancreatitis.

    NARCIS (Netherlands)

    Ahmed Ali, U.; Pahlplatz, J.M.; Nealon, W.H.; Goor, H. van; Gooszen, H.G.; Boermeester, M.A.

    2012-01-01

    BACKGROUND: Endoscopy and surgery are the treatment modalities of choice in patients with obstructive chronic pancreatitis. Physicians face the decision between endoscopy and surgery for this group of patients, without clear consensus. OBJECTIVES: To assess and compare the effectiveness and

  7. Endoscopic or surgical intervention for painful obstructive chronic pancreatitis

    NARCIS (Netherlands)

    Ahmed Ali, Usama; Pahlplatz, Johanna M.; Nealon, Wiliam H.; van Goor, Harry; Gooszen, Hein G.; Boermeester, Marja A.

    2012-01-01

    Background Endoscopy and surgery are the treatment modalities of choice in patients with obstructive chronic pancreatitis. Physicians face the decision between endoscopy and surgery for this group of patients, without clear consensus. Objectives To assess and compare the effectiveness and

  8. Endoscopic or surgical intervention for painful obstructive chronic pancreatitis

    NARCIS (Netherlands)

    Ali, U. Ahmed; Pahlplatz, J.M.; Nealon, W.H.; Goor, H. van; Gooszen, H.G.; Boermeester, M.A.

    2015-01-01

    BACKGROUND: Endoscopy and surgery are the treatment modalities of choice for patients with chronic pancreatitis and dilated pancreatic duct (obstructive chronic pancreatitis). Physicians face, without clear consensus, the choice between endoscopy or surgery for this group of patients. OBJECTIVES: To

  9. Physical Activity Recommendations in Patients with Chronic Obstructive Pulmonary Disease

    NARCIS (Netherlands)

    Hartman, Jorine E.; Boezen, H. Marike; Zuidema, Menno J.; de Greef, Mathieu H. G.; ten Hacken, Nick H. T.; Boezen, Hendrika

    2014-01-01

    Background: Physical activity recommendations are hardly studied in patients with chronic obstructive pulmonary disease (COPD), and specifically recommendations that are individualized to a patient's aerobic fitness level are not studied. Objectives: To compare individualized (relative) and

  10. Appendicular knot causing closed-loop obstruction, volvulus and ...

    African Journals Online (AJOL)

    Keywords: appendix, appendicular tie/knot syndrome, intestinal obstruction, volvulus, strangulation .... possible contrast reaction and high cost) and its unavailability in some ... morbidity and mortality rise significantly with delay. In. Fevang's ...

  11. [Diaphragm dysfunction in patients with chronic obstructive pulmonary disease

    NARCIS (Netherlands)

    Verheul, A.J.; Dekhuijzen, P.N.R.

    2003-01-01

    Chronic obstructive pulmonary disease (COPD) is characterised by alterations in the airways and lung parenchyma resulting in an increased respiratory workload. Besides an increased load and hyperinflation of the thorax, additional factors, such as systemic inflammation, oxidative stress, hypoxia and

  12. Neuroglial Heterotopia and Nasopharyngeal Obstruction in a Neonate

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2008-12-01

    Full Text Available The clinical presentation, imaging, treatment, and pathology of a case of neuroglial heterotopia in the nasopharynx causing airway obstruction in a newborn are reported from Columbus Children’s Hospital, OH.

  13. Chronic obstructive airway diseases: Is the EDL sufficient? A study ...

    African Journals Online (AJOL)

    STG's) and Essential Drug List (EDL) in 1996 some of the traditional medication for the treatment of asthma and chronic obstructive pulmonary disease (COPD) were removed from the medication list, e.g. slow release oral theophylline.

  14. Advances in the treatment of malignant large-bowel obstruction

    African Journals Online (AJOL)

    2007-07-19

    Jul 19, 2007 ... Most cases of large-bowel obstruction are due to colonic adeno- carcinoma. 324 ... to perforation and faeculent peritonitis. .... advance in emergency colorectal surgery has been the .... where there is clinical suspicion of bowel.

  15. A multiparous woman with lately diagnosed multilevel left ventricular obstruction

    International Nuclear Information System (INIS)

    Rahman, M. N.; Gul, I.; Nabi, A.

    2017-01-01

    A 56-year hypertensive, multiparous woman presented to the cardiology unit with Canadian Cardiovascular Society (CCS) class-III angina and worsening dyspnea for the past few weeks. Her clinical examination showed high blood pressure and mid-systolic crescendo-decrescendo murmur radiating to carotids. However, there was no radio-femoral delay or significant blood pressure difference between her arms. Her transthoracic echocardiography (TTE) revealed moderate aortic stenosis (AS) and mid cavity left ventricular outflow (LVO) obstruction. Left heart catheterization (LHC) showed coarctation of aorta with extensive collaterals, mid cavity LVO obstruction, and moderate AS. Thus, she was diagnosed as a case of multi-level LVO obstruction including mid cavity LVO obstruction AS and coarctation of aorta. She underwent stenting of aortic coarctation as the initial step of graded approach to her disease, and is doing well. (author)

  16. Diagnostic challenge of intestinal obstruction secondary to Henoch ...

    African Journals Online (AJOL)

    disease was bowel obstruction and ischemia requiring surgical intervention twice ... skin manifestations (purpura) being the most prominent feature and the initial ... pseudomembranous colitis, necrotizing cholecystitis, and ileal strictures [5].

  17. Stentless pyeloplasty for ureteropelvic junction obstruction in children

    African Journals Online (AJOL)

    in patients with ureteropelvic junction (UPJ) obstruction. In all,. 42 patients ... of Urology, National Institute of Rehabilitation Medicine, Islamabad, Pakistan. Correspondence to ... stentless pyeloplasty in open, laparoscopic, and robotic- assisted ...

  18. The Effect of Slipstream Obstructions on Air Propellers

    Science.gov (United States)

    Lesley, E P; Woods, B M

    1924-01-01

    The screw propeller on airplanes is usually placed near other objects, and hence its performance may be modified by them. Results of tests on propellers free from slip stream obstructions, both fore and aft, are therefore subject to correction, for the effect of such obstructions and the purpose of the investigation was to determine the effect upon the thrust and torque coefficients and efficiency, for previously tested air propellers, of obstructions placed in the slip stream, it being realized that such previous tests had been conducted under somewhat ideal conditions that are impracticable of realization in flight. Simple geometrical forms were used for the initial investigation. Such forms offered the advantage of easy, exact reproduction at another time or in other laboratories, and it was believed that the effects of obstructions usually encountered might be deduced or surmise from those chosen.

  19. Case series of unusual causes intestinal obstruction in infants and ...

    African Journals Online (AJOL)

    Introduction Many of the causes of intestinal obstruction arise from ... In this work, we report eight unusual cases of intestinal ..... lymph is considered to be the result of an imbalance ... During fetal life, midgut communicates with the yolk sac.

  20. Chronic Obstructive Pulmonary Disease (COPD) Includes: Chronic Bronchitis and Emphysema

    Science.gov (United States)

    ... Submit Button NCHS Home Chronic Obstructive Pulmonary Disease (COPD) Includes: Chronic Bronchitis and Emphysema Recommend on Facebook ... Percent of visits to office-based physicians with COPD indicated on the medical record: 3.2% Source: ...

  1. Inhaled corticosteroids and mortality in chronic obstructive pulmonary disease

    NARCIS (Netherlands)

    Sin, DD; Wu, L; Anderson, JA; Anthonisen, NR; Buist, AS; Burge, PS; Calverley, PM; Connett, JE; Lindmark, B; Pauwels, RA; Postma, DS; Soriano, JB; Szafranski, W; Vestbo, J

    2005-01-01

    Background: Clinical studies suggest that inhaled corticosteroids reduce exacerbations and improve health status in chronic obstructive pulmonary disease (COPD). However, their effect on mortality is unknown. Methods: A pooled analysis, based on intention to treat, of individual patient data from

  2. Electrocardiographic Characteristics of Patients with Chronic Obstructive Pulmonary Disease

    NARCIS (Netherlands)

    Warnier, M.J.; Rutten, F.H.; Numans, M.E.; Kors, J.A.; Tan, H.L.; de Boer, A.; Hoes, A.W.; de Bruin, M.L.

    2013-01-01

    Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular disease. Electrocardiography (ECG) carries information about cardiac disease and prognosis, but studies comparing ECG characteristics between patients with and without COPD are lacking. We related ECG

  3. Lung volume reduction in chronic obstructive pulmonary disease ...

    African Journals Online (AJOL)

    Lung volume reduction in chronic obstructive pulmonary disease. ... loss to improve pulmonary mechanics and compliance, thereby reducing the work of breathing. ... of obtaining similar functional advantages to surgical lung volume reduction, ...

  4. [Tomato peel: rare cause of biliary tract obstruction].

    Science.gov (United States)

    Hagymási, Krisztina; Péter, Zoltán; Csöregh, Eva; Szabó, Emese; Tulassay, Zsolt

    2011-11-20

    Foreign bodies in the biliary tree are rare causes of obstructive jaundice. Food bezoars are infrequent as well. They can cause biliary obstruction after biliary tract interventions, or in the presence of biliary-bowel fistula or duodenum diverticulum. Food bezoars usually pass the gastrointestinal tract without any symptoms, but they can cause abdominal pain and obstructive jaundice in the case of biliary tract obstruction. Endoscopic retrograde cholangio-pancreatography has the major role in the diagnosis and the treatment of the disease. Authors summarize the medical history of a 91-year-old female patient, who developed vomiting and right subcostal pain due to the presence of tomato peel within the ductus choledochus.

  5. Surgical treatment of colorectal cancer complicated with acute intestinal obstruction

    Directory of Open Access Journals (Sweden)

    S. N. Schaeva

    2016-01-01

    Full Text Available Background. The main reason for urgent complications of colon cancer is an acute intestinal obstruction (AIO. This is complex pathological condition in 90 % of cases caused by colorectal cancer (CRC.Objective – to evaluate radicality of the performed operations in complicated colorectal cancer in general surgical hospitals. Dependence of the severity of intestinal obstruction by tumor localization, its morphological characteristics, determine dependence of the type of the surgical operation performed on the severity of intestinal obstruction.Materials and methods. We have studied the data on 667 patients with colorectal cancer complicated by acute intestinal obstruction. These patients were treated in the period from 2001 to 2013 in general surgical hospital in the territory of Smolensk and Smolensk region. For the processing of the obtained results we have used software Statistica 6.1. Differences were considered statistically at p ≤ 0.05.Results. All the patients were divided into 3 groups by the expression of intestinal obstruction. Group 1 (n = 279 consisted of patients with the presence of decompensated intestinal obstruction (DIO, group 2 (n = 313 consisted of patients with subcompensated intestinal obstruction (SIO, group 3 (n = 75 included patients with compensated intestinal obstruction (CIO. In case of tumor localization in right halfof the colon we most commonly observed clinical picture of acute development of decompensated intestinal obstruction (p = 0.041. Subcompensated intestinal obstruction prevailed in case of tumor localization in left half of the colon and rectal localization. In general surgical hospitals it is not always possible to speak about radicality of surgical treatment, as in a large number of cases (62.5 % the number of examined lymph nodes was less than 4. When DIO patients are admitted in the clinic, the percentage of singlestage operations is equal to 7.5 % (n = 21. In case of DIO and SIO there was a high

  6. ANESTHETIC CONSIDERATION S IN CHRONIC OBSTRUCTIVE PULMON ARY DISEASE

    Directory of Open Access Journals (Sweden)

    Awati

    2015-03-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is a spectrum of diseases that includes emphysema, chronic bronchitis, and small airway disease. It i s characterized by progressive increased resistance to breathing. Patients with marked obstructive pulmonary disease are at increased risk for both intraoperative and Postoperative pulmonary complications. These patients require thorough preoperative prepa ration, meticulous intraoperative management & postoperative care. This article describes anesthetic considerations in a patient with COPD.

  7. Genetic influences on chronic obstructive pulmonary disease - a twin study

    DEFF Research Database (Denmark)

    Sylvan Ingebrigtsen, Truls; Thomsen, Simon Francis; Vestbo, Jørgen

    2010-01-01

    Genes that contribute to the risk of developing Chronic Obstructive Pulmonary Disease (COPD) have been identified, but an attempt to accurately quantify the total genetic contribution to COPD has to our knowledge never been conducted.......Genes that contribute to the risk of developing Chronic Obstructive Pulmonary Disease (COPD) have been identified, but an attempt to accurately quantify the total genetic contribution to COPD has to our knowledge never been conducted....

  8. C reactive protein and chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Dahl, Morten; Vestbo, Jørgen; Zacho, Jeppe

    2011-01-01

    It is unclear whether elevated plasma C reactive protein (CRP) is causally related to chronic obstructive pulmonary disease (COPD). The authors tested the hypothesis that genetically elevated plasma CRP causes COPD using a Mendelian randomisation design.......It is unclear whether elevated plasma C reactive protein (CRP) is causally related to chronic obstructive pulmonary disease (COPD). The authors tested the hypothesis that genetically elevated plasma CRP causes COPD using a Mendelian randomisation design....

  9. A New Contention Management Technique for Obstruction Free Transactional Memory

    OpenAIRE

    Ghosh, Ammlan; Sahin, Anubhab; Silsarma, Anirban; Chaki, Rituparna

    2014-01-01

    Part 2: Algorithms; International audience; Transactional Memory, one of the most viable alternatives to lock based concurrent systems, was explored by the researchers for practically implementing parallel processing. The goal was that threads will run parallel and improve system performance, but the effect of their execution will be linear. In STM, the non-blocking synchronization can be implemented by Wait-Freedom, Lock-Freedom or Obstruction-Freedom philosophy. Though Obstruction Free Tran...

  10. Balloon dacryocystoplasty: Incomplete versus complete obstruction of the nasolacrimal system

    International Nuclear Information System (INIS)

    Lee, Jeong Min; Lee, Sang Hoon; Han, Young Min; Chung, Gyung Ho; Kim, Chong Soo; Choi, Ki Chul; Song, Ho Young

    1993-01-01

    Balloon dilatation of nasolacrimal drainage apparatus was attempted for the treatment of stenoses or obstructures of the nasolacrimal system in 49 eyes of 41 consecutive patients with complete obstructions and 16 eyes of 14 patients with incomplete obstructions. These two groups were compared with regards to the effectiveness of balloon dacryocystoplasty. All patients suffered from severe epiphora had already undergone multiple probings. A 0.018 inch hair or ball guide wire was introduced through the superior punctum into the inferior meatus of the nasal cavity and pulled out through the nasal aperture using a hemostat under nasal endoscopy. A deflated angiography balloon catheter was then introduced in a retrograde direction and dilated under fluoroscopic control. No major complications occurred in any of the patients. At 7 days after balloon dilatation, 25 of 49 eyes with complete obstruction demonstrated improvement in epiphora (initial success rate: 51.0%) and among them 17 eyes showed complete resolution of symptoms. Reocclusion occurred in 12 of the 25 eyes with initial improvement at the 2 months follow up. For the 16 eyes with incomplete obstruction, and improvement of epiphora was attained in 11 eyes (initial success rate 68.8%): 5 of these eyes showed complete resolution of epiphora, and 3 was failed to maintain initial improvement at the 2 month follow up. Although this study demonstrate that results of balloon dacryocystoplasty are not encouraging because of the high failure and recurrence rate, balloon dacryocystoplasty is a simple and safe nonsurgical technique that can be used to treat for obstructions of the nasolacrimal system. In addition, balloon dacryocystoplasty shows better results in incomplete obstruction than in complete obstruction than complete obstruction of the nasolacrimal system

  11. Bile Duct Obstruction Secondary to Chronic Pancreatitis in Seven Dogs

    OpenAIRE

    Cribb, Alastair E.; Burgener, David C.; Reimann, Keith A.

    1988-01-01

    Seven icteric dogs were determined to have bile duct obstruction secondary to chronic pancreatitis. All dogs had histories of intermittent vomiting and diarrhea. Alkaline phosphatase and alanine aminotransferase activities and total bilirubin concentrations were markedly elevated. Diagnosis was based on exploratory laparotomy and histological examination. Each dog had a 3 to 10 cm mass in the body of the pancreas and obstruction of the common bile duct. Three dogs treated with pancreatectomy,...

  12. Quantitative Assessment of Obstructive Uropathy with Diuretic Renography in children

    International Nuclear Information System (INIS)

    Kim, Jong Ho; Lee, Dong Soo; Kwark, Cheol Eun; Lee, Kyung Han; Choi, Chang Woon; Chung, June Key; Lee, Myung Chul; Koh, Chang Soon; Choi, Yong; Choi, Hwang

    1993-01-01

    Differentiating the various causes of hydronephrosis from that of obstruction can be very difficult. The decision-marking process for those instances of urinary tract dilatation that require surgical correction and those that do not is based in part on the findings of diuresis renography. The methodology for performing this test has differed among nuclear medicine practitioners and the surgical findings are occasionally discrepant from the diuretic renogram interpretation. Consequently we made an automatic computer software program that calculates the slope of the response curve. The quantitative indices, such as the injection and response t1/2 by linear-fitting and monoexponential-fitting, were compared with the visual assessment of the diuretic cinerenography and clinical outcome in 50 children (62 kidneys) with ureteropelvic junction obstruction. Pooled diuresis renogram data indicated that: (1) Visual evaluation of the diuretic cinerenography is a sensitive (87%, 54/62) tool to differentiate obstruction in suspected ureteropelvic junction obstruction. (2) The cut-off value (maximum washout t1/2 with non-obstruction) of injection and response t1/2 by linear-fitting were 40 min. (3) The sensitivity and specificity using injection and response t1/2 by linear-fitting for obstruction were 89%(23/26) and 100%(30/30), respectively. (4) Response t1/2 as well as injection t1/2 by monoexponential-fitting do not stratify children with possible ureteropelivic junction obstruction. In conclusion, quantitative assessment of diuretic renography as well as visual assessment of diuretic cinerenography correlate well with surgical and clinical outcome of suspected ureteropelvic junction obstruction.

  13. A Rare Cause of Upper Airway Obstruction in a Child

    OpenAIRE

    Ahmed, H.; Ndiaye, C.; Barry, M. W.; Thiongane, Aliou; Mbaye, A.; Zemene, Y.; Ndiaye, I. C.

    2017-01-01

    Ventricular band cyst is a rare condition in children but can result in severe upper airway obstruction with laryngeal dyspnea or death. The diagnosis should be considered in any stridor in children with previous history of intubation or respiratory infections. We report a case of a 4-year-old girl, received in an array of severe respiratory distress, emergency endoscopy was done, and a large ventricular tape band cyst obstructing the air way was found. Complete excision was made, and postope...

  14. Intestinal sclerosis with pseudo-obstruction in three dogs.

    Science.gov (United States)

    Moore, R; Carpenter, J

    1984-04-01

    Intestinal sclerosis causing chronic intestinal pseudo-obstruction was diagnosed in 3 dogs. The pseudo-obstruction was characterized by vomiting and weight loss of 2 weeks' to 3 months' duration. A patent intestinal lumen was determined by contrast radiography and verified at surgery. Intestinal biopsy revealed diffuse atrophy, fibrosis, and mononuclear cell infiltration of the tunica muscularis. Each dog was euthanatized because of a progressive, deteriorating clinical course.

  15. Pulmonary artery hypertension in chronic obstructive lung disease

    International Nuclear Information System (INIS)

    Dinkel, E.; Mundinger, A.; Reinbold, W.D.; Wuertemberger, G.

    1989-01-01

    Standard biplane chest X-rays were tested for the validity of morphometric criteria in the diagnosis of pulmonary artery hypertension. Twenty-seven patients suffering from chronic obstructive lung disease were examined and compared with a control group without cardiopulmonary disease. The diameter of the right and left pulmonary artery, pulmonary conus and the hilar-to-thoracic ratio were significantly increased in patients with chronic obstructive lung disease (p [de

  16. Tunnelling without barriers

    International Nuclear Information System (INIS)

    Lee, K.

    1987-01-01

    The evolution in flat and curved space-time of quantum fields in theories with relative flat potential and its consequences are considered. It is shown that bubble nucleation, a quantum mechanical tunnelling process, may occur in flat space-time, having a bounce solution, even if V(phi) has no barrier. It is shown that bubble nucleation can also occur in curved space-time even though there is no bounce solution in the standard formalism for the bubble nucleation rate in curved space-time. Additionally, bubbles can nucleate during the slow rolling period on the potential in flat and curved space-time, in this case also there is no bounce solution. It is known in the new inflationary scenario that energy density perturbations caused by quantum fluctuations of the scalar field can satisfy the presently observed bounds on density perturbations. Bubble nucleation during the slow rolling period also gives rise to density perturbations. For a model potential density perturbations by bubbles are calculated at the horizon reentering. By applying the bound from the almost isotropic microwave black body radiation on these density perturbations, a constraint on the model potential is obtained. Finally, some further implications on the galaxy formation and applications in more realistic potential are discussed

  17. Development of engineered barrier

    Energy Technology Data Exchange (ETDEWEB)

    Chun, Kwan Sik; Cho, Won Jin; Lee, Jae Owan; Kim, Seung Soo; Kang, Mu Ja

    1999-03-01

    Engineered barrier development was carried out into the three research fields : waste form, disposal container, and buffer. The waste form field dealt with long-term leaching tests with borosilicate waste glasses surrounded by compacted bentonite. The leach rate decreased with increasing time, and was higher for the waste specimen rich in U and Na. In the container field, preliminary concepts of disposal containers were recommended by conducting structural analysis, thermal analysis, and shielding analysis, and major properties of stainless steel, copper, and titanium as a container material were surveyed. The sensitization degrees of SUS 316 and316L were lower than those of SUS 304 and 304L, respectively. The crevice corrosion of sensitized stainless steel was sensitive to the content of salt. Researches into the buffer included establishment of its performance criteria followed by investigating major properties of buffer using potential material in Korea. Experiments were made for measuring hydraulic conductivities, swelling properties, mechanical properties, thermal conductivities, pore-water chemistry properties, and adsorption properties was also investigated. (author)

  18. Omnidirectional ventilated acoustic barrier

    Science.gov (United States)

    Zhang, Hai-long; Zhu, Yi-fan; Liang, Bin; Yang, Jing; Yang, Jun; Cheng, Jian-chun

    2017-11-01

    As an important problem in acoustics, sound insulation finds applications in a great variety of situations. In the existing schemes, however, there has always been a trade-off between the thinness of sound-insulating devices and their ventilating capabilities, limiting their potentials in the control of low-frequency sound in high ventilation environments. Here, we design and experimentally implement an omnidirectional acoustic barrier with a planar profile, subwavelength thickness ( 0.18 λ ), yet high ventilation. The proposed mechanism is based on the interference between the resonant scattering of discrete states and the background scattering of continuous states which induces a Fano-like asymmetric transmission profile. Benefitting from the binary-structured design of the coiled unit and hollow pipe, it maximally simplifies the design and fabrication while ensuring the ventilation for all the non-resonant units with open tubes. The simulated and measured results agree well, showing the effectiveness of our proposed mechanism to block low frequency sound coming from various directions while allowing 63% of the air flow to pass. We anticipate our design to open routes to design sound insulators and to enable applications in traditionally unattainable cases such as those calling for noise reduction and cooling simultaneously.

  19. Alternative geochemical barrier materials

    International Nuclear Information System (INIS)

    1991-07-01

    Previous investigations of the effects of neutralization and reduction on uranium mill tailings pore fluids by the Technical Support Contractor indicated that arsenic, selenium, and molybdenum continue to remain in solution in all but reducing conditions. These hazardous constituents are present in groundwaters as oxyanions and, therefore, are not expected to be removed by adsorption into clays and most other soil constituents. It was decided to investigate the attenuation capacity of two commonly available crystalline iron oxides, taconite and scoria, and a zeolite, a network aluminosilicate with a cage structure. Columns of the candidate materials were exposed to solutions of individual constituents, including arsenic, molybdenum, selenium, and, uranium, and to the spiked tailings pore fluid from the Bodo Canyon disposal cell near Durango, Colorado. In addition to the single material columns, a homogeneous blend of the three materials and layers of the materials were exposed to spiked tailings pore fluids. The results of these experiments indicate that with the exception of molybdenum, the constituents of concern are attenuated by the taconite; however, they are not sufficiently attenuated to meet the groundwater protection standards applicable to the UMTRA Project. Therefore, the candidate barrier materials did not prove to be useful to the UMTRA Project for the cleanup of groundwaters

  20. Mobilitet, barrierer & muligheder

    DEFF Research Database (Denmark)

    Petersen, Mimi

    2011-01-01

    stereotypering. På den ene side peger udsagn fra de unge drenge på en oplevelse af at blive kriminaliseret i kraft af deres køn (det maskuline kombineret med at have en anden hudfarve). Og de unge piger oplever, at de udover at blive kategoriseret som ”indvandrere” også bliver kategoriseret som passive, umyndige...... som en vej ud af irakiske Kurdistan, men ikke tilbage til Danmark. Drengene fra familier med bedre økonomiske ressourcer giver udtryk for, ønske om at rejse til andre lande. På grund af begrænsede sproglige kompetencer oplever hovedparten af de unge (både i Danmark og i irakiske Kurdistan) barrierer i...... har planer for at flytte fra Kurdistan. De har dansk statsborgerskab, men de vil ikke tilbage til Danmark. I de fortællinger, som afhandlingen bygger på, er det tydeligt at samspillet mellem flere sociale dimensioner, spiller ind på de unges selvforståelse, tilhørsforhold, erfaringer og deres valg af...

  1. Development of engineered barrier

    International Nuclear Information System (INIS)

    Chun, Kwan Sik; Cho, Won Jin; Lee, Jae Owan; Kim, Seung Soo; Kang, Mu Ja

    1999-03-01

    Engineered barrier development was carried out into the three research fields : waste form, disposal container, and buffer. The waste form field dealt with long-term leaching tests with borosilicate waste glasses surrounded by compacted bentonite. The leach rate decreased with increasing time, and was higher for the waste specimen rich in U and Na. In the container field, preliminary concepts of disposal containers were recommended by conducting structural analysis, thermal analysis, and shielding analysis, and major properties of stainless steel, copper, and titanium as a container material were surveyed. The sensitization degrees of SUS 316 and 316L were lower than those of SUS 304 and 304L, respectively. The crevice corrosion of sensitized stainless steel was sensitive to the content of salt. Researches into the buffer included establishment of its performance criteria followed by investigating major properties of buffer using potential material in Korea. Experiments were made for measuring hydraulic conductivities, swelling properties, mechanical properties, thermal conductivities, pore-water chemistry properties, and adsorption properties was also investigated. (author)

  2. Palliative care provision for patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Yohannes Abebaw

    2007-04-01

    Full Text Available Abstract Chronic obstructive pulmonary disease (COPD is a major cause of disability, morbidity and mortality in old age. Patients with advanced stage COPD are most likely to be admitted three to four times per year with acute exacerbations of COPD (AECOPD which are costly to manage. The adverse events of AECOPD are associated with poor quality of life, severe physical disability, loneliness, and depression and anxiety symptoms. Currently there is a lack of palliative care provision for patients with advanced stage COPD compared with cancer patients despite having poor prognosis, intolerable dyspnoea, lower levels of self efficacy, greater disability, poor quality of life and higher levels of anxiety and depression. These symptoms affect patients' quality of life and can be a source of concern for family and carers as most patients are likely to be housebound and may be in need of continuous support and care. Evidence of palliative care provision for cancer patients indicate that it improves quality of life and reduces health care costs. The reasons why COPD patients do not receive palliative care are complex. This partly may relate to prognostic accuracy of patients' survival which poses a challenge for healthcare professionals, including general practitioners for patients with advanced stage COPD, as they are less likely to engage in end-of-life care planning in contrast with terminal disease like cancer. Furthermore there is a lack of resources which constraints for the wider availability of the palliative care programmes in the health care system. Potential barriers may include unwillingness of patients to discuss advance care planning and end-of-life care with their general practitioners, lack of time, increased workload, and fear of uncertainty of the information to provide about the prognosis of the disease and also lack of appropriate tools to guide general practitioners when to refer patients for palliative care. COPD is a chronic

  3. Interventional Radiological Management of Prehepatic Obstruction the Splanchnic Venous System

    International Nuclear Information System (INIS)

    Semiz-Oysu, Aslihan; Keussen, Inger; Cwikiel, Wojciech

    2007-01-01

    Purpose. The purpose of this study was to retrospectively evaluate interventional radiological management of patients with symptomatic portal hypertension secondary to obstruction of splanchnic veins. Material and Methods. Twenty-four patients, 15 males and 9 females, 0.75 to 79 years old (mean, 36.4 years), with symptomatic portal hypertension, secondary to splanchnic venous obstruction, were treated by percutaneous methods. Causes and extent of splanchnic venous obstruction and methods are summarized following a retrospective evaluation. Results. Obstructions were localized to the main portal vein (n = 22), intrahepatic portal veins (n = 8), splenic vein (n = 4), and/or mesenteric veins (n = 4). Interventional treatment of 22 (92%) patients included recanalization (n = 19), pharmacological thrombolysis (n = 1), and mechanical thrombectomy (n = 5). Partial embolization of the spleen was done in five patients, in two of them as the only possible treatment. TIPS placement was necessary in 10 patients, while an existing occluded TIPS was revised in two patients. Transhepatic embolization of varices was performed in one patient, and transfemoral embolization of splenorenal shunt was performed in another. Thirty-day mortality was 13.6% (n=3). During the follow-up, ranging between 2 days and 58 months, revision was necessary in five patients. An immediate improvement of presenting symptoms was achieved in 20 patients (83%). Conclusion. We conclude that interventional procedures can be successfully performed in the majority of patients with obstruction of splanchnic veins, with subsequent improvement of symptoms. Treatment should be customized according to the site and nature of obstruction

  4. RADIOLOGICAL EVALUATION OF OBSTRUCTIVE JAUNDICE BY ULTRASOUND AND CT

    Directory of Open Access Journals (Sweden)

    Padmalatha

    2015-10-01

    Full Text Available INTRODUCTION: The goals of any radiologic procedure in obstructive Jaundice are to confirm the presence of bile duct obstruction, its location, its extent & the probable cause. It should also attempt to obtain a map of the biliary tree that will help the surgeon to det ermine the best approach to each individual case. OBJECTIVES: 1. To evaluate the role of Ultrasound and CT in patients presenting with clinical features of obstructive jaundice. 2. To evaluate the causes of obstructive jaundice by Ultrasound and CT. PATIENTS AND METHODS: The study was carried with 45 patients from January 2006 to September 2007 who were attending the surgical and Gastroenterology Departments, Govt. General Hospital, Kurnool, which is an attached hospital to Kurnool Medical College, Kurnool. O BSERVATIONS AND RESULTS: In our study, there is female predominance with male: female ratio 1: 1.6.Majority of patients are in age group of 41 - 50 years. Jaundice was the commonest presentation in all patients followed by pruritis in 72% and pain abdomen in 67% of patients. Ultrasound identified the benign cause of biliary obstruction in 79.1% cases and the malignant cause in 61.9% cases. CT identified the benign cause of biliary obstruction in 91.6% of patients and the malignant cause in 80.9% cases.

  5. Genioglossus fatigue in obstructive sleep apnea.

    LENUS (Irish Health Repository)

    McSharry, David

    2012-08-15

    Obstructive sleep apnea (OSA) is a prevalent disorder that may cause cardiovascular disease and fatal traffic accidents but the pathophysiology remains incompletely understood. Increased fatigability of the genioglossus (the principal upper airway dilator muscle) might be important in OSA pathophysiology but the existing literature is uncertain. We hypothesized that the genioglossus in OSA subjects would fatigue more than in controls. In 9 OSA subjects and 9 controls during wakefulness we measured maximum voluntary tongue protrusion force (Tpmax). Using surface electromyography arrays we measured the rate of decline in muscle fiber conduction velocity (MFCV) during an isometric fatiguing contraction at 30% Tpmax. The rate of decline in MFCV provides an objective means of quantifying localized muscle fatigue. Linear regression analysis of individual subject data demonstrated a significantly greater decrease in MFCV in OSA subjects compared to control subjects (29.2 ± 20.8% [mean ± SD] versus 11.2 ± 20.8%; p=0.04). These data support increased fatigability of the genioglossus muscle in OSA subjects which may be important in the pathophysiology of OSA.

  6. Management of intestinal obstruction in advanced malignancy

    Directory of Open Access Journals (Sweden)

    Henry John Murray Ferguson

    2015-09-01

    Full Text Available Patients with incurable, advanced abdominal or pelvic malignancy often present to acute surgical departments with symptoms and signs of intestinal obstruction. It is rare for bowel strangulation to occur in these presentations, and spontaneous resolution often occurs, so the luxury of time should be afforded while decisions are made regarding surgery. Cross-sectional imaging is valuable in determining the underlying mechanism and pathology. The majority of these patients will not be suitable for an operation, and will be best managed in conjunction with a palliative medicine team. Surgeons require a good working knowledge of the mechanisms of action of anti-emetics, anti-secretories and analgesics to tailor early management to individual patients, while decisions regarding potential surgery are made. Deciding if and when to perform operative intervention in this group is complex, and fraught with both technical and emotional challenges. Surgery in this group is highly morbid, with no current evidence available concerning quality of life following surgery. The limited evidence concerning operative strategy suggests that resection and primary anastomosis results in improved survival, over bypass or stoma formation. Realistic prognostication and involvement of the patient, care-givers and the multidisciplinary team in treatment decisions is mandatory if optimum outcomes are to be achieved.

  7. The genetics of obstructive sleep apnoea.

    LENUS (Irish Health Repository)

    Kent, Brian D

    2012-02-01

    PURPOSE OF REVIEW: Obstructive sleep apnoea syndrome (OSAS) is a highly prevalent disorder associated with reduced quality of life and adverse cardiovascular and metabolic sequelae. Recent years have seen an intensification of the research effort to establish the genetic contribution to the development of OSAS and its sequelae. This review explores emerging evidence in this field. RECENT FINDINGS: A genetic basis for sleep-disordered breathing has been demonstrated for discrete disorders such as Treacher-Collins and Down syndromes, but the picture is less clear in so-called idiopathic OSAS. A degree of heritability appears likely in some of the intermediate phenotypes that lead to OSAS, particularly craniofacial morphology. However, only sparse and often contradictory evidence exists regarding the role of specific polymorphisms in causing OSAS in the general population. Similarly, investigations of the cardiovascular sequelae of OSAS have in general failed to consistently find single causative genetic mutations. Nonetheless, evidence suggests a role for tumour necrosis factor-alpha polymorphisms in particular, and large-scale family studies have suggested shared pathogenetic pathways for the development of obesity and OSAS. SUMMARY: As with other common disorders, OSAS is likely to result from multiple gene-gene interactions occurring in a suitable environment. The application of modern genetic investigative techniques, such as genome-wide association studies, may facilitate new discoveries in this field.

  8. Cephalometric risk factors of obstructive sleep apnea.

    Science.gov (United States)

    Bayat, Mohamad; Shariati, Mahsa; Rakhshan, Vahid; Abbasi, Mohsen; Fateh, Ali; Sobouti, Farhad; Davoudmanesh, Zeinab

    2017-09-01

    Previous studies on risk factors of obstructive sleep apnea (OSA) are highly controversial and mostly identifying a few cephalometric risk factors. OSA diagnosis was made according to the patients' apnea-hypopnea index (AHI). Included were 74 OSA patients (AHI > 10) and 52 control subjects (AHI ≤ 10 + free of other OSA symptoms). In both groups, 18 cephalometric parameters were traced (SNA, SNB, ANB, the soft palate's length (PNS-P), inferior airway space, the distance from the mandibular plane to the hyoid (MP-H), lengths of mandible (Go-Gn) and maxilla (PNS-ANS), vertical height of airway (VAL), vertical height of the posterior maxilla (S-PNS), superior posterior airway space (SPAS), middle airway space, distances from hyoid to third cervical vertebra and retrognathion (HH1), C3 (C3H), and RGN (HRGN), the maximum thickness of soft palate (MPT), tongue length (TGL), and the maximum height of tongue). These parameters were compared using t-test. Significant variables were SPAS (p = 0.027), MPT, TGL, HH1, C3H, HRGN, PNS-P, S-PNS, MP-H, VAL, and Go-Gn (all p values ≤ 0.006). OSA patients exhibited thicker and longer soft palates, hyoid bones more distant from the vertebrae, retrognathion, and mandibular plane, higher posterior maxillae, longer mandibles, and smaller superior-posterior airways.

  9. Sediment particle entrainment in an obstructed annular

    Energy Technology Data Exchange (ETDEWEB)

    Loureiro, Bruno Venturini; Siqueira, Renato do Nascimento [Faculdade do Centro Leste (UCL), Serra, ES (Brazil). Lab. de Fenomenos de Transporte], e-mail: brunovl@ucl.br, e-mail: renatons@ucl.br

    2006-07-01

    Flow in an annular region with internal cylinder rotation is a classic problem in fluid mechanics and has been widely studied. Besides its importance as a fundamental problem, flow in annular regions has several practical applications. This project was motivated by an application of this kind of flow to the drilling of oil and gas wells. In this work, an erosion apparatus was constructed in order to study the effect of the internal cylinder rotation on particle entrainment in an obstructed annular space and bed package as well. The study also analyzed the influence of height of the particles bed on the process performance. The experiment was designed so that the internal cylinder rotation could be measured by an encoder. The fluid temperature was measured by a thermocouple and the experiments were carried out at the temperature of 25 deg C. The study revealed that the particle entrainment for the height of the bed that is close to the center of the cylinders is negligible and the internal cylinder rotation provokes the movement and packing of the bed. For lower height of the bed, with same dimension of the annular gap, the particle entrainment process was satisfactory and the bed compaction was smaller than in the previous case, leading to a more efficient cleaning process in the annular space. (author)

  10. Protein misfolding and obstructive lung disease.

    LENUS (Irish Health Repository)

    Greene, Catherine M

    2010-11-01

    The endoplasmic reticulum has evolved a number of mechanisms to manage the accumulation of incorrectly folded proteins. This results in loss of function of these proteins, but occasionally, in conditions such as α-1 antitrpysin (A1AT) deficiency, the misfolded protein can acquire a toxic gain of function promoting exaggerated ER stress responses and inflammation. Mutations leading to deficiency in a second serine proteinase inhibitor, α-1 antichymotrpysin (ACT), can induce potentially similar consequences. A1AT and ACT deficiencies are associated with chronic obstructive lung disease. Until recently, it was thought that the lung diseases associated with these conditions were entirely due to loss of antiprotease protection in the lung (i.e., loss of function), whereas gain of function was the major cause of the liver disease associated with A1AT deficiency. This paradigm is being increasingly challenged because ER stress is being recognized in bronchial epithelial cells and inflammatory cells normally resident in the lung, giving rise to an inflammatory phenotype that adds to the proteolytic burden associated with these conditions. In this article, we describe the cellular mechanisms that are activated to cope with an increasing burden of misfolded proteins within the ER in A1AT and ACT deficiency, show how these events are linked to inflammation, and outline the therapeutic strategies that can potentially interfere with production of misfolded proteins.

  11. [Obesity and obstructive sleep apnea in children].

    Science.gov (United States)

    Amaddeo, A; de Sanctis, L; Olmo Arroyo, J; Giordanella, J-P; Monteyrol, P-J; Fauroux, B

    2017-02-01

    Obesity, along with hypertrophy of the adenoids and the tonsils, represents one of the major risk factors for obstructive sleep apnea (OSA) in children. Obesity is associated with an increase in the prevalence and the severity of OSA and is a major factor in the persistence and aggravation of OSA over time. Neurocognitive dysfunction and abnormal behavior are the most important and frequent end-organ morbidities associated with OSA in children. Other deleterious consequences such as cardiovascular stress and metabolic syndrome are less common in children than in adults with OSA. Defining the exact role of obesity in OSA-associated end-organ morbidity in children is difficult because of the complex and multidimensional interactions between sleep in general, OSA, obesity, and metabolic dysregulation. This may explain why obesity itself has not been shown to be associated with a significant increase in OSA-associated end-organ morbidity. Obesity is linked to a decreased treatment efficacy and, in particular, of adenotonsillectomy. Peri- and postoperative complications are more common and more severe in obese children as compared with normal-weight controls. Continuous positive airway pressure (CPAP) is frequently needed, but compliance with CPAP is less optimal in obese children than in non-obese children. In conclusion, obesity represents a major public health problem worldwide; its prevention is one of the most efficient tools for decreasing the incidence and the morbidity associated with OSA in children. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. Papilledema in obstructive sleep apnea syndrome

    International Nuclear Information System (INIS)

    Gaayathri, N.; Kalthum, U.; Jemaima, C.H.

    2015-01-01

    We report a diagnostically challenging case of papilloedema in a morbidly obese, 25 year old male who presented to us with blurring of vision of both eyes, but more marked in the right. Fundus examination revealed severe papilloedema, with corresponding visual field and colour vision defects. He was worked up for possible life threatening causes of papilloedema like intracranial space occupying lesion but his CT scan was normal. As his hematocrit was in the polycythemic range, multiple venesections were performed in fear that the hyperviscosity picture could be a contributing factor. However there was no change in symptoms or the fundus appearance. We could not come to a diagnosis of idiopathic intracranial hypertension too because he refused lumbar puncture. A sleep study was done as he did give symptoms of mild obstructive sleep apnea but the results were that of severe disease. He was given therapeutic nocturnal oxygen by CPAP to prevent further cardiovascular and respiratory complications and interestingly enough it helped in treating the papilloedema. He was seen 2 months after commencement of continuous positive airway pressure (CPAP) with good functional and anatomical recovery. (author)

  13. Animal models of chronic obstructive pulmonary disease.

    Science.gov (United States)

    Pérez-Rial, Sandra; Girón-Martínez, Álvaro; Peces-Barba, Germán

    2015-03-01

    Animal models of disease have always been welcomed by the scientific community because they provide an approach to the investigation of certain aspects of the disease in question. Animal models of COPD cannot reproduce the heterogeneity of the disease and usually only manage to represent the disease in its milder stages. Moreover, airflow obstruction, the variable that determines patient diagnosis, not always taken into account in the models. For this reason, models have focused on the development of emphysema, easily detectable by lung morphometry, and have disregarded other components of the disease, such as airway injury or associated vascular changes. Continuous, long-term exposure to cigarette smoke is considered the main risk factor for this disease, justifying the fact that the cigarette smoke exposure model is the most widely used. Some variations on this basic model, related to exposure time, the association of other inducers or inhibitors, exacerbations or the use of transgenic animals to facilitate the identification of pathogenic pathways have been developed. Some variations or heterogeneity of this disease, then, can be reproduced and models can be designed for resolving researchers' questions on disease identification or treatment responses. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  14. Outlet obstruction constipation (anismus) managed by biofeedback.

    Science.gov (United States)

    Kawimbe, B M; Papachrysostomou, M; Binnie, N R; Clare, N; Smith, A N

    1991-10-01

    Fifteen subjects presenting with intractable constipation due to obstructive defecation, mean (SEM) duration 8.8 (1.8) years, had the inappropriate contraction and electromyographic changes in the pelvic floor muscles and external and sphincter typical of this condition. An electromyographically derived index was used to grade its severity. A self applied biofeedback device was used to allow electromyographic recording of the abnormal external anal sphincter. The subjects were encouraged to reduce the abnormal electromyographic activity on straining after instruction and training. The procedure was intended as a relearning process in which the non-relaxing activity of the pelvic floor was gradually suppressed. Biofeedback training was maintained on a domiciliary basis for a mean time of 3.1 weeks and resulted in a significant reduction in the anismus index (mean (SEM) 69.9 (7.8)% before biofeedback, mean 14 (3.9)% after biofeedback, p less than 0.01). There was an associated reduction in the time spent straining at stool and in the difficulty of defecation and an increased frequency of defecation. Defecatory video proctograms in six subjects showed improvements in the anorectal angle during straining and evacuation. The clinical benefit to the patients persisted after a mean follow up of 6.2 months.

  15. A clinical series of strangulated bowel obstructions

    International Nuclear Information System (INIS)

    Shoji, Yasuhito; Taira, Kohji; Nakamura, Yutaka; Manase, Hiroto; Takahashi, Osamu; Hishiyama, Hohhei

    2007-01-01

    We evaluated 40 patients with strangulated bowel obstructions who underwent surgery at our hospital between September 2000 and August 2005. Here, the patients' background characteristics, cause of strangulation, clinical symptoms, laboratory and imaging results, preoperative diagnosis, treatment and prognosis are discussed. The sex ratio was 1:1, the average age was 71.2 years, and 31 cases (77.5%) had past histories of abdominal surgery, mainly in the lower abdominal region. As for the causes of the constrictions, adhesions and funiculi accounted for half of the cases. We recognized 23 cases (57.5%) because of peritoneal irritation signs and 8 cases (20.0%) because of a state of shock; both groups underwent emergency operations. Regarding imaging findings, abdominal computed tomography revealed ascites in 28 cases (77.8%) and limited bowel dilation in 25 cases (69.4%) the correct preoperative diagnosis rate was 85.0%. Bowel resections were performed in 29 cases (72.5%). Five patients (12.5%) died, three because of multiple organ failure and two because of respiratory insufficiency (i.e., pneumonia). Patients with a poor general condition or severe complications must be adequately cared for, although the diagnosis of this disease is comparatively easy. (author)

  16. Metabolic aspects of obstructive sleep apnoea syndrome

    Directory of Open Access Journals (Sweden)

    M. R. Bonsignore

    2009-06-01

    Full Text Available Insulin resistance is often associated with obstructive sleep apnoea syndrome (OSAS and could contribute to cardiovascular risk in OSAS. Sleep loss and intermittent hypoxia could contribute to the pathogenesis of the metabolic alterations associated with obesity, a common feature of OSAS. The biology of the adipocyte is being increasingly studied, and it has been found that hypoxia negatively affects adipocyte function. In November 2007, the European Respiratory Society and two EU COST Actions (Cardiovascular risk in OSAS (B26 and Adipose tissue and the metabolic syndrome (BM0602, held a Research Seminar in Düsseldorf, Germany, to discuss the following: 1 the effects of hypoxia on glucose metabolism and adipocyte function; 2 the role of inflammatory activation in OSAS and obesity; 3 the alarming rates of obesity and OSAS in children; 4 the harmful effects of the metabolic syndrome in OSAS; 5 the effects of OSAS treatment on metabolic variables; and 6 the relationship between daytime sleepiness and hormonal and inflammatory responses. Insulin resistance in skeletal muscle, the role of the endocannabinoid system and novel pharmacological approaches to treat insulin resistance were also discussed. As obesity and hypoxia could be the basic links between OSAS and adipocyte dysfunction, further research is needed to translate these new data into clinical practice.

  17. Resistant Hypertension and Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Akram Khan

    2013-01-01

    Full Text Available Hypertension (HTN is a modifiable, highly prevalent risk factor for cardiovascular morbidity and renal dysfunction worldwide. In the United States, HTN affects one in three adults, contributes to one out of every seven deaths and to nearly half of all cardiovascular disease-related deaths. HTN is considered resistant when the blood pressure remains above goal despite lifestyle modification and administration of three antihypertensive agents of different classes including a diuretic. Large population-based studies have suggested that obstructive sleep apnea (OSA is a risk factor for resistant HTN. The mechanism proposed is a pattern of intermittent hypoxia associated with hyperaldosteronism, increased sympathetic tone, endothelial dysfunction, and inflammation. In this review we discuss the association between OSA and resistant HTN, the physiologic mechanisms linking OSA with resistant HTN, and the effect of continuous positive airway pressure therapy (CPAP on blood pressure in patients with resistant HTN. While the reduction in blood pressure with CPAP is usually modest in patients with OSA, a decrease of only a few mmHg in blood pressure can significantly reduce cardiovascular risk. Patients presenting to a center specializing in management of hypertension should be screened and treated for OSA as a potentially modifiable risk factor.

  18. Malignant Biliary Obstruction: Evidence for Best Practice

    Directory of Open Access Journals (Sweden)

    Leonardo Zorrón Cheng Tao Pu

    2016-01-01

    Full Text Available What should be done next? Is the stricture benign? Is it resectable? Should I place a stent? Which one? These are some of the questions one ponders when dealing with biliary strictures. In resectable cases, ongoing questions remain as to whether the biliary tree should be drained prior to surgery. In palliative cases, the relief of obstruction remains the main goal. Options for palliative therapy include surgical bypass, percutaneous drainage, and stenting or endoscopic stenting (transpapillary or via an endoscopic ultrasound approach. This review gathers scientific foundations behind these interventions. For operable cases, preoperative biliary drainage should not be performed unless there is evidence of cholangitis, there is delay in surgical intervention, or intense jaundice is present. For inoperable cases, transpapillary stenting after sphincterotomy is preferable over percutaneous drainage. The use of plastic stents (PS has no benefit over Self-Expandable Metallic Stents (SEMS. In case transpapillary drainage is not possible, Endoscopic Ultrasonography- (EUS- guided drainage is still an option over percutaneous means. There is no significant difference between the types of SEMS and its indication should be individualized.

  19. Localizing obstructive sites with dynamic MRI and consequentially proper therapy selection for obstructive sleep apnea/hypopnea syndrome

    International Nuclear Information System (INIS)

    Oda, Makoto

    2004-01-01

    At present, selection of therapies for obstructive sleep apnea/hypopnea syndrome (OSAHS) relies on the localizing the obstructive sites and determination of its severity by polysomnography (PSG). Many methods have been applied to localize the obstructive sites. We attempted to evaluate the morphology of upper airway during sleep with dynamic MRI, and assessed the severity of OSAHS and results of therapies in groups classified by the patterns of obstructive sites. A categorizing system was set up, by which the obstructive sites were reviewed on axial and sagittal sections and accordingly classified into four patterns: front-to-back pattern, left-to-right pattern, circular pattern and epiglottis pattern. Comparison of apnea/hypopnea index (AHI), lowest SpO2 and BMI was performed between the different patterns. The results showed that the left-to-right pattern and circular pattern had a higher AHI and lower lowest SpO2, and more cases of obesity with higher BMI were found in these two groups. We also evaluated the results of different therapies for different obstructive site patterns. Radiofrequency coblation of soft palate was found to be effective for the front-to-back pattern. Improvement was found in 67% of all the cases that received uvulopalatopharyngoplasty (UPPP), while a significant postoperative improvement of AHI was confirmed in left-to-right pattern and circular pattern groups. No significant difference in the results was found between different obstructive sites or patterns when nasal continuous positive airway pressure (n-CPAP) was applied alone. Being completely free from CPAP (completed treatment with improvement of symptoms) was achieved in 71.4% of all the cases and 85.7% in the left-to-right pattern group who received UPPP. We conclude that an optimal treatment results could be achieved by selecting the therapies based on the severity of OSAHS and result of localizing the obstructive sites by dynamic MRI. (author)

  20. Tritium/hydrogen barrier development

    International Nuclear Information System (INIS)

    Hollenberg, G.W.; Simonen, E.P.; Kalinen, G.; Terlain, A.

    1994-06-01

    A review of hydrogen permeation barriers that can be applied to structural metals used in fusion power plants is presented. Both implanted and chemically available hydrogen isotopes must be controlled in fusion plants. The need for permeation barriers appears strongest in Li17-Pb blanket designs, although barriers also appear necessary for other blanket and coolant systems. Barriers that provide greater than a 1000 fold reduction in the permeation of structural metals are desired. In laboratory experiments, aluminide and titanium ceramic coatings provide permeation reduction factors, PRFS, from 1000 to over 100,000 with a wide range of scatter. The rate-controlling mechanism for hydrogen permeation through these barriers may be related to the number and type of defects in the barriers. Although these barriers appear robust and resistant to liquid metal corrosion, irradiation tests which simulate blanket environments result in very low PRFs in comparison to laboratory experiments, i.e., <150. It is anticipated from fundamental research activities that the REID enhancement of hydrogen diffusion in oxides may contribute to the lower permeation reduction factors during in-reactor experiments