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Sample records for port catheter implantation

  1. Combined ultrasound and fluoroscopy guided port catheter implantation-High success and low complication rate

    International Nuclear Information System (INIS)

    Gebauer, Bernhard; El-Sheik, Michael; Vogt, Michael; Wagner, Hans-Joachim

    2009-01-01

    Purpose: To evaluate peri-procedural, early and late complications as well as patients' acceptance of combined ultrasound and fluoroscopy guided radiological port catheter implantation. Materials and methods: In a retrospective analysis, all consecutive radiological port catheter implantations (n = 299) between August 2002 and December 2004 were analyzed. All implantations were performed in an angio suite under analgosedation and antibiotic prophylaxis. Port insertion was guided by ultrasonographic puncture of the jugular (n = 298) or subclavian (n = 1) vein and fluoroscopic guidance of catheter placement. All data of the port implantation had been prospectively entered into a database for interventional radiological procedures. To assess long-term results, patients, relatives or primary physicians were interviewed by telephone; additional data were generated from the hospital information system. Patients and/or the relatives were asked about their satisfaction with the port implantion procedure and long-term results. Results: The technical success rate was 99% (298/299). There were no major complications according to the grading system of SIR. A total of 23 (0.33 per 1000 catheter days) complications (early (n = 4), late (n = 19)) were recorded in the follow-period of a total of 72,727 indwelling catheter days. Infectious complications accounted for 0.15, thrombotic for 0.07 and migration for 0.04 complications per 1000 catheter days. Most complications were successfully treated by interventional measures. Twelve port catheters had to be explanted due to complications, mainly because of infection (n = 9). Patients' and relatives' satisfaction with the port catheter system was very high, even if complications occurred. Conclusion: Combined ultrasound and fluoroscopy guided port catheter implantation is a very safe and reliable procedure with low peri-procedural, early and late complication rate. The intervention achieves very high acceptance by the patients and

  2. Stabilization of a percutaneously implanted port catheter system for hepatic artery chemotherapy infusion

    International Nuclear Information System (INIS)

    Shindoh, Noboru; Ozaki, Yutaka; Kyogoku, Shinsuke; Yamana, Daigo; Sumi, Yukiharu; Katayama, Hitoshi

    1999-01-01

    A port catheter system for hepatic artery infusion chemotherapy was implanted percutaneously via the left subclavian artery in 41 patients for treatment of unresectable liver metastases. The catheter tip was inserted into the gastroduodenal artery (GDA), the end hole was occluded with a guidewire fragment, and a side-hole for infusion was positioned at the bifurcation of the proper hepatic artery and the GDA. The GDA was embolized with steel coils around the infusion catheter tip via a transfemoral catheter. This procedure is designed to reduce the incidence of hepatic artery occlusion and infusion catheter dislocation.

  3. Value of Micronester coils in port-catheter implantation for continuous hepatic arterial infusion chemotherapy with fixed catheter tip method

    International Nuclear Information System (INIS)

    Yamagami, Takuji; Kato, Takeharu; Hirota, Tatsuya; Yoshimatsu, Rika; Matsumoto, Tomohiro; Nishimura, Tsunehiko; White, Robert I.

    2008-01-01

    To retrospectively evaluate the use of Micronester coils in port-catheter implantation with the fixed catheter tip method in comparison with other previously used coils. The cohort of this study was 143 consecutive patients with unresectable advanced liver cancer for whom a port-catheter system was percutaneously implanted. In the most recent 32 patients, Micronester coils were used for catheter tip fixation. Details of embolic agents for fixation, persistent blood flow beyond the distal end of the indwelling catheter, and complications were compared between cases without and with Micronester coils. In all, percutaneous port-catheter placement was successful. Mean number of coils used for fixation was 4.2 without Micronester coils vs. 2.5 with Micronester coils. N-butyl cyanoacrylate (NBCA)-Lipiodol was additionally used for catheter tip fixation in 85.6% of 111 procedures without Micronester coils and in 50% of 32 using Micronester coils. The gastroduodenal artery beyond the distal end was not detected at the final examination after any procedure. Catheter dislocation occurred in five and hepatic arterial obstruction or severe stenosis in eight. The number of coils used and necessity of NBCA-Lipiodol could be decreased with usage of Micronester coils without decreasing fixation ability compared to other coils. (orig.)

  4. Intra-Arterial Hepatic Chemotherapy: A Comparison of Percutaneous Versus Surgical Implantation of Port-Catheters

    International Nuclear Information System (INIS)

    Deschamps, F.; Elias, D.; Goere, D.; Malka, D.; Ducreux, M.; Boige, V.; Auperin, A.; Baere, T. de

    2011-01-01

    Purpose: To compare retrospectively the safety and efficacy of percutaneous and surgical implantations of port-catheters for intra-arterial hepatic chemotherapy (IAHC). Materials and Methods: Between January 2004 and December 2008, 126 consecutive patients (mean age 58 years) suffering from liver colorectal metastases were referred for intra-arterial hepatic chemotherapy (IAHC). Port-catheters were percutaneously implanted (P) through femoral access with the patient under conscious sedation when no other surgery was planned or were surgically implanted (S) when laparotomy was performed for another purpose. We report the implantation success rate, primary functionality, functionality after revision, and complications of IAHC. Results: The success rates of implantation were 97% (n = 65 of 67) for P and 98% (n = 58 of 59) for S. One hundred eleven patients received IAHC in our institution (n = 56P and n = 55S). Primary functionality was the same for P and S (4.80 vs. 4.82 courses), but functionality after revision was significantly higher for P (9.18 vs. 5.95 courses, p = 0.004) than for S. Forty-five complications occurred during 516 courses for P and 28 complications occurred during 331 courses for S. The rates of discontinuation of IAHC linked to complications of the port-catheters were 21% (n = 12 of 56) for P and 34% (n = 19 of 55) for S. Conclusion: Overall, significantly better functionality and similar complication rates occurred after P versus S port-catheters.

  5. Implantation port-catheter permanent indwelling of pulmonary artery in treating lung metastasis from HCC

    International Nuclear Information System (INIS)

    Cheng Jiemin; Wang Jianhua; Yan Zhiping; Wang Xiaolin; Gong Gaoquan; Liu Qingxin

    2000-01-01

    Objective: To observe the efficacy of a percutaneous implantation port-catheter permanent indwelling pulmonary artery for regional chemotherapy of the metastatic lung cancer from HCC. Methods: Between 1995 and 1999, 62 patients (42 males, 20 females; mean age 46 years) suffering from the metastatic lung cancer from HCC underwent percutaneous implantation of port-catheter permanent indwelling pulmonary artery using the right subclavian vein. In 19 patients with metastatic tumor located on one side of the lung, an indwelling catheter was placed into the ipsilateral side pulmonary artery. With metastasis of both sides, the catheter was inserted into the main trunk of pulmonary artery. The regimens of the chemotherapy were 5-FU + CDDP + MMC(FDM) or 5-FU + CDDP + MMC(FDA). Results: The interventional procedure was successfully completed in all 62 cases (100%). The complications occurred in 8% cases, including infections (3.2%), unhealed wound (1.6%) and pneumothorax (3.2%). The treatment effects of 3-months after the procedure were as follows: the obvious decrease of lung tumor size was 35.5%; stable disease (SD) 32.3% and progressive disease (PD) 32.3%. 6 months follow-up: 12 patients were dead (12/62) and the others are still doing well. The response rates were 22.6%, partial response (PR) 32.3%; stable disease (SD) 25.8% and progressive disease (PD) 32.3%. Conclusions: The percutaneous implantation techniques of pulmonary arterial port-catheter could be a good method in the treatment of metastatic lung cancer from HCC because of it is simple, with few complications and positive effect

  6. Placement of an implantable port catheter in the biliary stent: an experimental study in dogs

    International Nuclear Information System (INIS)

    Ko, Gi Young; Lee, Im Sick; Choi, Won Chan

    2004-01-01

    To investigate the feasibility of port catheter placement following a biliary stent placement. We employed 14 mongrel dogs as test subject and after the puncture of their gaIl bladders using sonographic guidance, a 10-mm in diameter metallic stent was placed at the common duct. In 12 dogs, a 6.3 F port catheter was placed into the duodenum through the common duct and a port was secured at the subcutaneous space following stent placement. As a control group, an 8.5 F drain tube was placed into the gallbladder without port catheter placement in the remaining two dogs. Irrigation of the bile duct was performed every week by injection of saline into the port, and the port catheter was replaced three weeks later in two dogs. Information relating to the success of the procedure, complications and the five-week follow-up cholangiographic findings were obtained. Placement of a biliary stent and a port catheter was technically successful in 13 (93%) dogs, while stent migration (n=3), gallbladder rupture (n=1) and death (n=5) due to subcutaneous abscess and peritonitis also occurred. The follow-up was achieved in eight dogs (seven dogs with a port catheter placement and one dog with a drain tube placement). Irrigation of the bile duct and port catheter replacement were successfully achieved without any complications. Cholangiograms obtained five weeks after stent placement showed diffuse biliary dilation with granulation tissue formation. However, focal biliary stricture was seen in one dog with stent placement alone. Placement of a port catheter following biliary stent placement seems to be feasible. However, further investigation is necessary to reduce the current complications

  7. Placement of an implantable port catheter in the biliary stent: an experimental study in dogs

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    Ko, Gi Young; Lee, Im Sick; Choi, Won Chan [Asan Medical Center, Seoul (Korea, Republic of)

    2004-04-01

    To investigate the feasibility of port catheter placement following a biliary stent placement. We employed 14 mongrel dogs as test subject and after the puncture of their gaIl bladders using sonographic guidance, a 10-mm in diameter metallic stent was placed at the common duct. In 12 dogs, a 6.3 F port catheter was placed into the duodenum through the common duct and a port was secured at the subcutaneous space following stent placement. As a control group, an 8.5 F drain tube was placed into the gallbladder without port catheter placement in the remaining two dogs. Irrigation of the bile duct was performed every week by injection of saline into the port, and the port catheter was replaced three weeks later in two dogs. Information relating to the success of the procedure, complications and the five-week follow-up cholangiographic findings were obtained. Placement of a biliary stent and a port catheter was technically successful in 13 (93%) dogs, while stent migration (n=3), gallbladder rupture (n=1) and death (n=5) due to subcutaneous abscess and peritonitis also occurred. The follow-up was achieved in eight dogs (seven dogs with a port catheter placement and one dog with a drain tube placement). Irrigation of the bile duct and port catheter replacement were successfully achieved without any complications. Cholangiograms obtained five weeks after stent placement showed diffuse biliary dilation with granulation tissue formation. However, focal biliary stricture was seen in one dog with stent placement alone. Placement of a port catheter following biliary stent placement seems to be feasible. However, further investigation is necessary to reduce the current complications.

  8. [Catheter fracture and pulmonary embolization of the distal fragment: a rare complication of the totally implantable venous access port].

    Science.gov (United States)

    Rebahi, H; El Adib, A G; Mouaffak, Y; El Hattaoui, M; Chaara, A; Sadek, H; Khouchani, M; Mahmal, L; Younous, S

    2015-01-01

    Totally implantable venous access port plays a crucial role in the treatment of patients in oncology. However, its use can result sporadically in catheter fracture with catheter tip embolization into pulmonary arteries. We report this unusual but potentially serious complication in four patients. In these patients, the port had been inserted percutaneously into the subclavian vein using the infra-clavicular approach. This side effect occurred late in three patients. In all patients, the catheter fracture was asymptomatic or pauci-symptomatic and was caused by the pinch-off syndrome. The retrieval of the embolized fragments was successfully performed by transcatheter procedure in the cardiac catheterisation laboratory. We reviewed the literature and the newest guidelines and recommendations to detail the clinico-radiological features, the possible causes of this complication and discussed means to recognize, manage and prevent it. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  9. Catheter fracture of intravenous ports and its management.

    Science.gov (United States)

    Wu, Ching-Yang; Fu, Jui-Ying; Feng, Po-Hao; Kao, Tsung-Chi; Yu, Sheng-Yueh; Li, Hao-Jui; Ko, Po-Jen; Hsieh, Hung-Chang

    2011-11-01

    Intravenous ports are widely used for oncology patients. However, catheter fractures may lead to the need for re-intervention. We aimed to identify the risk factors associated with catheter fractures. Between January 1 and December 31, 2006, we retrospectively reviewed the clinical data and plain chest films of 1,505 patients implanted with an intravenous port at Chang Gung Memorial Hospital. Different vascular sites were compared using the chi-square or Fisher's exact test for categorical variables, and the t test was used for continuous variables with normal distribution; P port type Arrow French (Fr.) 8.1 (P port and catheter removal is recommended. Female gender, intravenous port implantation via the subclavian route, and the Arrow Fr. 8.1 port were found to be risk factors. Patients with these risk factors should be monitored closely to avoid catheter fractures.

  10. Concurrent use of pigtail and loop snare catheters for percutaneous retrieval of dislodged central venous port catheter

    Directory of Open Access Journals (Sweden)

    Ming-Tsung Chuang

    2011-11-01

    Full Text Available The purpose of this study was to report our experience of percutaneous retrieval of dislodged port catheters with concurrent use of pigtail and loop snare catheters. During a 5-year period at our institute (June 2005 to July 2010, a total of 23 dislodged port catheters were retrieved. The interval between port catheter implantation and dislodged catheter retrieval ranged from 43 days to 1,414 days (mean 586.7 days. The time of delayed retrieval ranged from 1 day to 45 days (mean 4.6 days. All dislodged catheters were retrieved with the concurrent use of pigtail and loop snare catheters via femoral venous route. The prevalence of port catheter dislodgement at our institute was 3.4%. All dislodged port catheters were removed successfully with pigtail and loop snare catheters together. No procedure-related complications were encountered, except for transient arrhythmia in two patients, which required no medication. In conclusion, the concurrent use of pigtail and loop snare catheters is a feasible and easy way for percutaneous retrieval of a dislodged central venous port catheter.

  11. Percutaneous placement of peritoneal port-catheter in oncologic patients

    International Nuclear Information System (INIS)

    Orsi, Franco; Vigna, Paolo Della; Bonomo, Guido; Penco, Silvia; Lovati, Elena; Bellomi, Massimo

    2004-01-01

    The aim of this paper is to describe the technique of percutaneous ultrasound (US)-guided placement of a peritoneal port-catheter in an interventional radiological setting. Nineteen patients with peritoneal carcinomatosis were selected for intraperitoneal port-catheter placement in order to perform intracavitary receptor-immuno- or radio-immunotherapy with Ytrium-90. All the procedures were performed percutaneously under US and fluoro guidance; the insertion site for catheters was chosen according to abdominal conditions and US findings: all devices were implanted at the lower abdominal quadrants. All patients were followed up with CT and US according to the therapy protocol. The procedure was successfully completed in 15/19 patients, in 4 being contraindicated by peritoneal adhesions. No procedure-related complications and device occlusions during therapy were observed; one catheter displaced 7 months later the placement. In our experience, this procedure was feasible, reliable and easy to perform, allowing the correct administration of the planned intracavitary therapy. Peritoneal adhesions are the main limitation of peritoneal port placement. (orig.)

  12. [A new port catheter system of aluminum oxide ceramics].

    Science.gov (United States)

    Haindl, H; Schmoll, E; Willmann, G

    1995-03-01

    Implantable port catheter systems are becoming increasingly important, as they often permit out-patient treatment for many indications that would otherwise require hospitalization. Moreover, they also increase the safety/reliability of infusion therapy in critical inpatients. For a variety of reasons, the materials used so far, i.e. steel, titanium and various plastics have not been completely satisfactory. The main disadvantage of metallic systems is the formation of artefacts in tomographic images, while the shortcomings of plastics are mechanical, e.g. chip formation and early membrane failure. Against this background, a port catheter system made of alumina ceramic, which is largely free of the disadvantages of the other materials, was developed. The expected advantages in terms of complication rate and radiological artefacts, were fully confirmed by the evaluation of 160 monitored patients.

  13. Evaluation of the Necessity of Port Fixation in Central Venous Port Implantation

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    Kim, Sang Su; Kim, Hyung Pil [Inje University Pusan Paik Hospital, Busan (Korea, Republic of); Bae, Jae Ik; Won, Je Hwan [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2010-06-15

    The technical success and complications were especially focused on and evaluated the need for fixation of a port under fluoroscopic guidance placement of the totally implantable central venous access ports for long term central venous access. Two hundred eighty nine consecutive patients (170 men, 119 women, mean age: 52-year-old) who underwent venous port implantation for the administration of chemotherapy were followed over a 1-month period. The procedures were performed in the angiographic suite by an interventional radiologist and all access was through the right jugular vein, except for the patients who had undergone a right mastectomy. The procedures were performed in the following order: 1) venous puncture, 2) making a pocket, 3) catheter tunneling, 4) port insertion, 5) catheter sizing, and 6) insertion. A port which was connected to the tunneled catheter was inserted into the minimally sized subcutaneous pocket with the aid of a small retractor. A follow-up was performed with medical records and chest radiographs. The follow-up period for evaluating the venous port ranged from 59 to 329 days (mean: 175 days) The procedures performed to gain right jugular vein access were successful without difficulty in all cases. The 18 patients that underwent procedures to gain left jugular vein access encountered some difficulty upon insertion of a catheter into the SVC due to encountering the tortuous left brachiocephalic vein. No complications occurred during and immediately after the procedure. In one case the port chamber rotated within the subcutaneous pocket; however, no catheter migration or malfunction occurred. If port insertion was followed by catheter insertion, the port chamber can be tightly implanted in the minimally sized pocket. This would avoid the need for fixation of the catheter to the port chamber leading into the pocket

  14. Intra-arterial port implantation for intra-arterial chemotherapy : comparison between PIPS(Percutaneously Implantable Port System) and port system

    International Nuclear Information System (INIS)

    Yoon, Sang Jin; Shim, Hyung Jin; Jung, Hun Young; Choi, Yong Ho; Kim, Yang Soo; Song, In Sup; Kwak, Byung Kook

    1999-01-01

    To compare the techniques and complications of intra-arterial port implantation for intra-arterial chemotherapy between PIPS and the port system. For intra-arterial port implantation, 27 cases in 27 patients were retrospectively evaluated using PIPS(PIPS-200, William Cook Europe, Denmark) while for 21 cases in 19 patients a pediatric venous port system(Port-A-Cath, 5.8F, SIMS Deltec, U. S. A.) was used. All intra-arterial port implantation was performed percuteneously in an angiographic ward. Hepatocellular carcinoma was diagnosed in 18 patients and hepatic metastasis in 16. Peripheral cholangiocarcinoma, and pancreatic gastric, ovarian, renal cell and colon carcinoma were included. We compared the techniques and complications between PIPS and the port system. The follow up period ranged from 23 to 494(mean, 163) days in PIPS and from 12 to 431(mean, 150) days in the port system. In all cases, intra-arterial port implantations were technically successful. Port catheter tips were located in the common hepatic artery(n=8), proper hepatic artery(n=7), right hepatic artery(n=5), gastroduodenal artery(n=2), left hepatic artery(n=1), pancreaticoduodenal artery(n=1), inferior mesenteric artery(n=1), lumbar artery(n=1), and renal artery(n=1) in PIPS, and in the proper hepatic artery(n=6), gastroduodenal artery(n=6), common hepatic artery(n=3), right hepatic artery(n=4), inferior mesenteric artery(n=1), and internal iliac artery(n=1) in the port system. Port chambers were buried in infrainguinal subcutaneous tissue. Using PIPS, complications developed in seven cases(25.9%) and of these, four (57.1%) were catheter or chamber related. In the port system, catheter or chamber related complications developed in four cases(19.0%). Because PIPS and the port system have relative merits and demetrits, successful intra-arterial port implantation is possible if equipment is properly selected

  15. Ultrasound guided implantation of chest port systems via the lateral subclavian vein

    International Nuclear Information System (INIS)

    Zaehringer, M.; Hilgers, J.; Krueger, K.; Strohe, D.; Bangard, C.; Neumann, L.; Lackner, K.; Warm, M.; Reiser, M.; Toex, U.

    2006-01-01

    Purpose: Retrospective analysis of the success and complication rates of chest port implantation via the lateral subclavian vein. Materials and methods: Between January 2003 and June 2004, the lateral subclavian vein in 271 patients (186 women, 85 men, mean age 53.2 years) was punctured guided by ultrasound. This access was used to insert a port system, and the catheter tip was placed at the cavoatrial junction. The port reservoir was implanted in a subcutaneous infraclavicular pocket and fixed to the fascia of the pectoralis muscle. Indications for port implantation were chemotherapy (n=239), total parenteral nutrition (n=2) and intravenous medication (n=30). The patient follow-up was mainly performed either by the oncology division of the department of gynecology or by the department of internal medicine. Results: A chest port catheter system was successfully implanted in all patients. The catheter remained in place for a mean duration of 269.4 days (SD 192.3 days). No complications occurred during implantation. In the post-interventional period, 6 catheter dysfunctions were found (thrombotic 0.09 per 1000 catheter days; mechanic 0.05 per 1000 catheter days). While one local infection occurred in the early post-interventional period, 3 local and 15 systemic infections were independent of the port catheter placement (0.39 per 1000 catheter days). The rate of port catheter explantations due to dysfunction or infection was 0.07 per 1000 catheter days. Conclusion: Ultrasound-guided puncture of the lateral subclavian vein is a safe procedure for the insertion of central venous port catheter systems and had a very low complication rate in our study. For further evaluation of our port placement technique, prospective studies compared to placement through the internal jugular vein are necessary. (orig.)

  16. A Comparison of Clinical Outcomes with Regular- and Low-Profile Totally Implanted Central Venous Port Systems

    International Nuclear Information System (INIS)

    Teichgraeber, Ulf Karl-Martin; Steitparth, Florian; Cho, Chie Hee; Benter, Thomas; Gebauer, Bernhard

    2009-01-01

    The purpose of this study was to evaluate whether low-profile totally implanted central venous port systems can reduce the late complication of skin perforation. Forty patients (age, 57 ± 13 years; 22 females, 18 males) were randomized for the implantation of a low-profile port system, and another 40 patients (age, 61 ± 14 years; 24 females, 16 males) received a regular port system as control group. Indications for port catheter implantation were malignant disease requiring chemotherapy. All port implantations were performed in the angiography suite using sonographically guided central venous puncture and fluoroscopic guidance of the catheter placement. Procedure time, number of complications (procedure-related immediate, early, and late complications), and number of explantations were assessed. Follow-up was performed for 6 months. All port implantations were successfully completed in both study groups. There were two incidents of skin perforation observed in the control group. One skin perforation occurred 13 weeks and the other 16 weeks after port implantation (incidence, 5%) in patients with regular-profile port systems. Two infections were observed, one port infection in each study group. Both infections were characterized as catheter-related infections (infection rate: 0.15 catheter-related infections per 1000 catheter days). In conclusion, low-profile port systems can be placed as safely as traditional chest ports and reduce the risk of developing skin perforations, which occurs when the port system is too tight within the port pocket.

  17. Risk of infection due to medical interventions via central venous catheters or implantable venous access port systems at the middle port of a three-way cock: luer lock cap vs. luer access split septum system (Q-Syte).

    Science.gov (United States)

    Pohl, Fabian; Hartmann, Werner; Holzmann, Thomas; Gensicke, Sandra; Kölbl, Oliver; Hautmann, Matthias G

    2014-01-25

    Many cancer patients receive a central venous catheter or port system prior to therapy to assure correct drug administration. Even appropriate hygienic intervention maintenance carries the risk of contaminating the middle port (C-port) of a three-way cock (TWC), a risk that increases with the number of medical interventions. Because of the complexity of the cleaning procedure with disconnection and reconnection of the standard luer lock cap (referred as "intervention"), we compared luer lock caps with a "closed access system" consisting of a luer access split septum system with regard to process optimization (work simplification, process time), efficiency (costs) and hygiene (patient safety). For determination of process optimization the workflow of an intervention according to the usual practice and risks was depicted in a process diagram. For determining the actual process costs, we analyzed use of material and time parameters per intervention and used the process parameters for programming the process into a simulation run (n = 1000) to determine the process costs as well as their differences (ACTUAL vs. NOMINAL) within the framework of a discrete event simulation.Additionally cultures were carried out at the TWC C-ports to evaluate possible contamination. With the closed access system, the mean working time of 5.5 minutes could be reduced to 2.97 minutes. The results for average process costs (labour and material costs per use) were 3.92 € for luer lock caps and 2.55 € for the closed access system. The hypothesis test (2-sample t-test, CI 0.95, p-valuerisks (related to material, surroundings, staff handling) could be reduced by 65.38%. In the present research, the closed access system with a divided split septum was superior to conventional luer lock caps. The advantage of the closed access system lies in the simplified handling for staff, which results in a reduced risk of patient infection due to improved clinical hygiene.

  18. Ultrasound guided implantation of chest port systems via the lateral subclavian vein; Die sonographisch gezielte Implantation von Portkathetersystemen ueber die laterale Vena subclavia

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    Zaehringer, M.; Hilgers, J.; Krueger, K.; Strohe, D.; Bangard, C.; Neumann, L.; Lackner, K. [Inst. fuer Radiologische Diagnostik, Univ. zu Koeln (Germany); Warm, M. [Gynaekologie, Univ. zu Koeln (Germany); Reiser, M. [Medizinische Klinik I, Univ. zu Koeln (Germany); Toex, U. [Medizinische Klinik IV, Univ. zu Koeln (Germany)

    2006-03-15

    Purpose: Retrospective analysis of the success and complication rates of chest port implantation via the lateral subclavian vein. Materials and methods: Between January 2003 and June 2004, the lateral subclavian vein in 271 patients (186 women, 85 men, mean age 53.2 years) was punctured guided by ultrasound. This access was used to insert a port system, and the catheter tip was placed at the cavoatrial junction. The port reservoir was implanted in a subcutaneous infraclavicular pocket and fixed to the fascia of the pectoralis muscle. Indications for port implantation were chemotherapy (n=239), total parenteral nutrition (n=2) and intravenous medication (n=30). The patient follow-up was mainly performed either by the oncology division of the department of gynecology or by the department of internal medicine. Results: A chest port catheter system was successfully implanted in all patients. The catheter remained in place for a mean duration of 269.4 days (SD 192.3 days). No complications occurred during implantation. In the post-interventional period, 6 catheter dysfunctions were found (thrombotic 0.09 per 1000 catheter days; mechanic 0.05 per 1000 catheter days). While one local infection occurred in the early post-interventional period, 3 local and 15 systemic infections were independent of the port catheter placement (0.39 per 1000 catheter days). The rate of port catheter explantations due to dysfunction or infection was 0.07 per 1000 catheter days. Conclusion: Ultrasound-guided puncture of the lateral subclavian vein is a safe procedure for the insertion of central venous port catheter systems and had a very low complication rate in our study. For further evaluation of our port placement technique, prospective studies compared to placement through the internal jugular vein are necessary. (orig.)

  19. Radiologic placement of implantable chest ports in pediatric patients under sedation

    International Nuclear Information System (INIS)

    Shin, Tae Beom

    2003-01-01

    To evaluate the safety and efficacy of the radiologic placement of implantable chest ports under intravenous sedation in pediatric patients with malignancy. Between October 2001 and June 2002, 20 chest ports were placed in 19 pediatric patients [13 boys and six girls aged 1-11 (mean, 4.7) years] for the purpose of long-term chemotherapy. In three patients, tunneled central venous catheters had been removed because of catheter extration, infection, and tearing. Under intravenous sedation, the right internal jugular vein was used for access in 19 cases, and the left internal jugular vein in one. Venipucture was performed using a micropuncture needle with real-time ultrasound guidance. A port chamber was created at the infraclavicular fossa, and to prevent catheter kinking, a smooth-angled tunnel was created between the venipuncture site and the subcutaneous pocket. The catheter tip was positioned under fluoroscopy at the junction of the superior vena cava and right atrium. We observed technical success, complications arouse during and after the procedure, and duration of catheter use. Implantation of the port system was successful in all cases, though slight hematoma, treated with manual compression, occurred at a chamber pocket in one case. In addition, the port system was removed from one patient because of wound infection leading to dehiscence and catheter malpositiong. A new port system was implanted through the left internal jugular vein. The median period during which catheter use was followed up was 118 (range, 18-274) days. For long-term chemotherapy in pediatric patients with malignancy, radiologic placement of an implantable chest port under intravenous sedation shows a high technical success rate, with few complications. This method may thus be used instead of surgical port placement

  20. Evaluation of anterior chest wall implanted port: technical aspects, results, and complications

    International Nuclear Information System (INIS)

    Jeon, Young Hwan; Oh, Joo Hyeong; Yoon, Yup; Kim, Si Young

    2000-01-01

    To evaluate the technical aspects, results and complications of patients with implanted anterior chest wall port. Between April 1997 and June 1999, a total of 63 implanted ports were placed at the anterior chest wall of 63 consecutive patients by interventional radiologists. The indications were chemotherapy in 61 patients and total parenteral nutrition in two. The peripheral portion of the subclavian vein was punctured under fluoroscopic guidance via ipsilateral peripheral vein during venography. A central venous catheter was placed in the superior vena cava, and using the subcutaneous tunneling method, a connected infusion port was implanted at the anterior chest wall. Results and complications were reviewed, and by means of Kaplan-Meier survival analysis, the expected patency of the port was determined. The technical success rate for implanted port at the anterior chest wall was 100% (63/63 patients). In two patients, hematoma and oozing were treated by compression. The duration of port implantation ranged from 12 to 855 (mean, 187) days, and the port patency rate was 305.7±47.6 days. In seven patients (completed chemotherapy (n=3D3), central venous thrombosis (n=3D3) catheter-related infection (n=3D1)), the port was removed. Catheter obstruction occurred in two patients, and in one, the use of urokinase led to successful recanalization. Sixteen patients died of an underlying malignancy, but no catheter-related death was noted. Implantation of an anterior chest wall port is a safe and useful procedure, with long patency, for patients requiring chemotherapy and long-term venous access. (author)

  1. Evaluation of anterior chest wall implanted port: technical aspects, results, and complications

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    Jeon, Young Hwan; Oh, Joo Hyeong; Yoon, Yup; Kim, Si Young [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    2000-07-01

    To evaluate the technical aspects, results and complications of patients with implanted anterior chest wall port. Between April 1997 and June 1999, a total of 63 implanted ports were placed at the anterior chest wall of 63 consecutive patients by interventional radiologists. The indications were chemotherapy in 61 patients and total parenteral nutrition in two. The peripheral portion of the subclavian vein was punctured under fluoroscopic guidance via ipsilateral peripheral vein during venography. A central venous catheter was placed in the superior vena cava, and using the subcutaneous tunneling method, a connected infusion port was implanted at the anterior chest wall. Results and complications were reviewed, and by means of Kaplan-Meier survival analysis, the expected patency of the port was determined. The technical success rate for implanted port at the anterior chest wall was 100% (63/63 patients). In two patients, hematoma and oozing were treated by compression. The duration of port implantation ranged from 12 to 855 (mean, 187) days, and the port patency rate was 305.7{+-}47.6 days. In seven patients (completed chemotherapy (n=3D3), central venous thrombosis (n=3D3) catheter-related infection (n=3D1)), the port was removed. Catheter obstruction occurred in two patients, and in one, the use of urokinase led to successful recanalization. Sixteen patients died of an underlying malignancy, but no catheter-related death was noted. Implantation of an anterior chest wall port is a safe and useful procedure, with long patency, for patients requiring chemotherapy and long-term venous access. (author)

  2. Clinical nursing of pelvic neoplasm treated with infusion chemotherapy by using an anti-reflux arterial port-catheter system

    International Nuclear Information System (INIS)

    Xing Li; Yuan Chanjuan

    2011-01-01

    Objective: To discuss the clinical nursing care for patients with pelvic neoplasm who were treated with infusion chemotherapy by using an anti-reflux arterial port-catheter system. Methods: After the implantation of an anti-reflux arterial port-catheter system was successfully completed, intra-arterial infusion chemotherapy was carried out in 17 patients with pelvic neoplasm and the infusion chemotherapy was repeated for several times. The pre-procedural clinical nursing care was well done and the technique of proper placement was well grasped. The side effects of chemotherapy drugs and complications were dealt with in time. Medical orientation at discharge time included the protection methods for port-catheter system. Results: Seventeen patients received infusion chemotherapy successfully several times (ranged from 3 to 8 times) with a scheduled regular interval time. No severe complications occurred. No catheter leakage nor obvious irritation and compression symptoms of local skin developed during infusion period. Of the 17 patients, 6 had a complete response, 9 achieved a partial response, while the remaining 2 failed to respond. Conclusion: In accordance with characteristics of infusion chemotherapy by using an anti-reflux arterial port-catheter system, the reasonable and effective nursing care is important to guarantee the achievement of a successful performance and a satisfactory therapeutic result. (authors)

  3. Does the Implantation Technique for Totally Implantable Venous Access Ports (TIVAPs) Influence Long-Term Outcome?

    Science.gov (United States)

    Biacchi, Daniele; Sammartino, Paolo; Sibio, Simone; Accarpio, Fabio; Cardi, Maurizio; Sapienza, Paolo; De Cesare, Alessandro; Atta, Joseph Maher Fouad; Impagnatiello, Alessio; Di Giorgio, Angelo

    2016-02-01

    Totally implantable venous access ports (TIVAP) are eventually explanted for various reasons, related or unrelated to the implantation technique used. Having more information on long-term explantation would help improve placement techniques. From a series of 1572 cancer patients who had TIVAPs implanted in our center with the cutdown technique or Seldinger technique, we studied the 542 patients who returned to us to have their TIVAP explanted after 70 days or more. As outcome measures we distinguished between TIVAPs explanted for long-term complications (infection, catheter-, reservoir-, and patient-related complications) and TIVAPs no longer needed. Univariate and multivariate analyses were run to investigate the reasons for explantation and their possible correlation with implantation techniques. The most common reason for explantation was infection (47.6 %), followed by catheter-related (20.8 %), patient-related (14.7 %), and reservoir-related complications (4.7 %). In the remaining 12.2 % of cases, the TIVAP was explanted complication free after the planned treatments ended. Infection correlated closely with longer TIVAP use. Univariate and multivariate analyses identified the Seldinger technique as a major risk factor for venous thrombosis and catheter dislocation. The need for long-term TIVAP explantation in about one-third of cancer patients is related to the implantation techniques used.

  4. Placement of a Port Catheter Through Collateral Veins in a Patient with Central Venous Occlusion

    International Nuclear Information System (INIS)

    Teichgraeber, Ulf Karl-Martin; Streitparth, Florian; Gebauer, Bernhard; Benter, Thomas

    2010-01-01

    Long-term utilization of central venous catheters (CVCs) for parenteral nutrition has a high incidence of central venous complications including infections, occlusions, and stenosis. We report the case of a 31-year-old woman presenting with a malabsorption caused by short gut syndrome due to congenital aganglionic megacolon. The patient developed a chronic occlusion of all central neck and femoral veins due to long-term use of multiple CVCs over more than 20 years. In patients with central venous occlusion and venous transformation, the implantation of a totally implanted port system by accessing collateral veins is an option to continue long-term parenteral nutrition when required. A 0.014-in. Whisper guidewire (Terumo, Tokyo) with high flexibility and steerability was chosen to maneuver and pass through the collateral veins. We suggest this approach to avoid unfavorable translumbar or transhepatic central venous access and to conserve the anatomically limited number of percutaneous access sites.

  5. Long-term Outcome of Peripherally Implanted Venous Access Ports in the Forearm in Female Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Klösges, Laura, E-mail: l.kloesges@uni-bonn.de; Meyer, Carsten, E-mail: carsten.meyer@ukb.uni-bonn.de; Boschewitz, Jack, E-mail: jack.boschewitz@ukb.uni-bonn.de; Andersson, Magnus, E-mail: magnus.andersson@ukb.uni-bonn.de [Universitätsklinikum Bonn, Department of Radiology (Germany); Rudlowski, Christian, E-mail: c.rudlowski@evk.de [Evangelisches Krankenhaus Bergisch Gladbach, Department of Gynecology (Germany); Schild, Hans H., E-mail: hans.schild@ukb.uni-bonn.de [Universitätsklinikum Bonn, Department of Radiology (Germany); Wilhelm, Kai, E-mail: kai.wilhelm@ek-bonn.de [Ev. Kliniken Bonn, Johanniter-Krankenhaus, Department of Radiology (Germany)

    2015-06-15

    PurposeThe aim of this retrospective study was to analyze the long-term outcome of peripherally implanted venous access ports in the forearm at our institution in a female patient collective.MethodsBetween June 2002 and May 2011, a total of 293 female patients with an underlying malignancy had 299 forearm ports implanted in our interventional radiology suite. The mean age of the cohort was 55 ± 12 years (range 26–81 years). The majority of women suffered from breast (59.5 %) or ovarian cancer (28.1 %). Complications were classified as infectious complications, thrombotic and nonthrombotic catheter dysfunction (dislocation of the catheter or port chamber, fracture with/without embolization or kinking of the catheter, port occlusion), and others.ResultsWe analyzed a total of 90,276 catheter days in 248 port systems (47 patients were lost to follow-up). The mean device service interval was 364 days per catheter (range 8–2,132, median 223 days, CI 311–415, SD 404). Sixty-seven early (≤30 days from implantation) or late complications (>30 days) occurred during the observation period (0.74/1,000 catheter days). Common complications were port infection (0.18/1,000 days), thrombotic dysfunction (0.12/1,000 days), and skin dehiscence (0.12/1,000 days). Nonthrombotic dysfunction occurred in a total of 21 cases (0.23/1,000 days) and seemed to cumulate on the venous catheter entry site on the distal upper arm.ConclusionPeripherally implanted venous access ports in the forearm are a safe alternative to chest or upper-arm ports in female oncology patients. Special attention should be paid to signs of skin dehiscence and nonthrombotic dysfunction, especially when used for long-term treatment.

  6. Totally implantable venous catheters for chemotherapy: experience in 500 patients

    Directory of Open Access Journals (Sweden)

    Nelson Wolosker

    Full Text Available CONTEXT: Totally implantable devices are increasingly being utilized for chemotherapy treatment of oncological patients, although few studies have been done in our environment to analyze the results obtained from the implantation and utilization of such catheters. OBJECTIVE: To study the results obtained from the implantation of totally implantable catheters in patients submitted to chemotherapy. TYPE OF STUDY: Prospective. SETTING: Hospital do Câncer A.C. Camargo, São Paulo, Brazil. METHODS: 519 totally implantable catheters were placed in 500 patients submitted to chemotherapy, with preference for the use of the right external jugular vein. Evaluations were made of the early and late-stage complications and patient evolution until removal of the device, death or the end of the treatment. RESULTS: The prospective analysis showed an average duration of 353 days for the catheters. There were 427 (82.2% catheters with no complications. Among the early complications observed, there were 15 pathway hematomas, 8 cases of thrombophlebitis of the distal stump of the external jugular vein and one case of pocket infection. Among the late-stage complications observed, there were 43 infectious complications (0.23/1000 days of catheter use, 11 obstructions (0.06/1000 days of catheter use and 14 cases of deep vein thrombosis (0.07/1000 days of catheter use. Removal of 101 catheters was performed: 35 due to complications and 66 upon terminating the treatment. A total of 240 patients died while the catheter was functioning and 178 patients are still making use of the catheter. CONCLUSION: The low rate of complications obtained in this study confirms the safety and convenience of the use of totally implantable accesses in patients undergoing prolonged chemotherapy regimes.

  7. Complications after percutaneous placement of totally implantable venous access ports in the forearm

    International Nuclear Information System (INIS)

    Goltz, J.P.; Petritsch, B.; Thurner, A.; Hahn, D.; Kickuth, R.

    2012-01-01

    This article focuses on radiological imaging of complications after interventional percutaneous insertion of totally implantable venous access ports (TIVAPs) which were placed in the forearm. Thus far most reviews have dealt with pectorally-placed TIVAPs. Compared with the pectoral approach, implantation in the forearm has been associated with certain complications owing to a longer route of the port catheter within a smaller vein, and owing to the route across the elbow joint, resulting in higher rates of catheter-associated thrombosis and possible mechanical complications. The purpose of this review is to describe the complications after implantation of TIVAPs in the forearm, and to make radiologists familiar with the key findings of the complications during radiological imaging, including colour-coded and compression Duplex ultrasound, computed tomography, and digital subtraction venography.

  8. Peripherally Placed Totally Implantable Venous-access Port Systems of the Forearm: Clinical Experience in 763 Consecutive Patients

    International Nuclear Information System (INIS)

    Goltz, Jan P.; Scholl, Anne; Ritter, Christian O.; Wittenberg, Guenther; Hahn, Dietbert; Kickuth, Ralph

    2010-01-01

    The aim of this study is to evaluate the effectiveness and safety of percutaneously placed totally implantable venous-access ports (TIVAPs) of the forearm. Between January 2006 and October 2008, peripheral TIVAPs were implanted in 763 consecutive patients by ultrasound and fluoroscopic guidance. All catheters were implanted under local anesthesia and were tunneled subcutaneously. Indication, technical success, and complications were retrospectively analyzed according to Society of Interventional Radiology (SIR) criteria. Presence of antibiotic prophylaxis, periprocedurally administered drugs (e.g., sedation), and laboratory results at the time of implantation were analyzed. Maintenance during the service interval was evaluated. In total, 327,499 catheter-days were analyzed. Technical success rate was 99.3%. Reasons for initial failure of implantation were either unexpected thrombosis of the subclavian vein, expanding tumor mass of the mediastinum, or failure of peripheral venous access due to fragile vessels. Mean follow-up was 430 days. There were 115 complications observed (15.1%, 0.03 per 100 catheter-days), of which 33 (4.3%) were classified as early (within 30 days from implantation) and 82 (10.7%) as late. Catheter-related venous thrombosis was found in 65 (8.5%) of 763 (0.02 per 100 catheter-days) TIVAPs. Infections were observed in 41 (5.4%) of 763 (0.01 per 100 catheter-days) devices. Other complications observed included dislocation of the catheter tip (0.8%), occlusion (0.1%), or rupture (0.1%) of the port catheter. Dislocated catheters were corrected during a second interventional procedure. In conclusion, implantation of percutaneously placed peripheral TIVAPs shows a high technical success rate and low risk of early complications when ultrasound and fluoroscopic guidance are used. Late complications are observed three times as often as early complications.

  9. Peritoneal catheter fixation combined with straight upward tunnel and low implant position to prevent catheter malfunction.

    Science.gov (United States)

    Zhang, Qingyan; Jiang, Chunming; Zhu, Wei; Sun, Cheng; Xia, Yangyang; Tang, Tianfeng; Wan, Cheng; Shao, Qiuyuan; Liu, Jing; Jin, Bo; Zhang, Miao

    2018-03-01

    Catheter malfunction is the main reason for early peritoneal dialysis (PD) technique failure. This study aimed to evaluate the effect of a new surgery technique with catheter fixation to the lower abdominal wall combined with straight upward tunnel and low implant position in reducing catheter malfunction. Patients with end stage renal disease who received PD in our centre from January 2013 to December 2015 were involved in this study. They were randomly divided into three groups according to surgical technique: traditional open surgery group, modified open surgery group and modified open surgery with catheter fixation group. All patients were followed up for six months after surgery. Catheter- related complications were analyzed. A total of 152 patients were involved. Among them, 49 received traditional open surgery (TOS group), 49 received modified open surgery (MOS group), and 54 received modified open surgery with catheter fixation (MOS-F group). During follow-up, no patients (0%) in MOS-F group developed catheter malfunction which was significantly lower than that of the TOS group (0 vs 16.33%, P = 0.002). Although not statistically significant, the incidence of catheter malfunction was lower in MOS-F group than that in MOS group (0 vs 4.08%, P = 0.134). No significant difference was observed in the episodes of infection, bleeding, leakage, inflow or outflow pain, hernia and delayed wound healing among the three groups (all P > 0.05). Catheter fixation combined with straight upward tunnel and low implant position can effectively prevent catheter malfunction in PD catheter placement. © 2016 Asian Pacific Society of Nephrology.

  10. A unique case of pulmonary artery catheter bleeding from the oximetry connection port

    Directory of Open Access Journals (Sweden)

    Suman Rajagopalan

    2014-12-01

    Full Text Available Pulmonary artery catheter is an invasive monitor usually placed in high-risk cardiac surgical patients to optimize the cardiac functions. We present this case of blood oozing from the oximetry connection port of the pulmonary artery catheter that resulted in the inability to monitor continuous cardiac output requiring replacement of the catheter. The cause of this abnormal bleeding was later confirmed to be due to a manufacturing defect.

  11. Urinary catheter with polyurethane coating modified by ion implantation

    International Nuclear Information System (INIS)

    Kondyurina, I.; Nechitailo, G.S.; Svistkov, A.L.; Kondyurin, A.; Bilek, M.

    2015-01-01

    A low friction urinary catheter that could be used without a lubricant is proposed in this work. A polyurethane coating was synthesised on the surface of a metal guide wire catheter. Ion implantation was applied to surface modify the polyurethane coating. FTIR ATR, wetting angle, AFM and friction tests were used for analysis. Low friction was found to be provided by the formation of a hard carbonised layer on the polyurethane surface

  12. Pacemaker implantation after catheter ablation for atrial fibrillation.

    Science.gov (United States)

    Deshmukh, Abhishek J; Yao, Xiaoxi; Schilz, Stephanie; Van Houten, Holly; Sangaralingham, Lindsey R; Asirvatham, Samuel J; Friedman, Paul A; Packer, Douglas L; Noseworthy, Peter A

    2016-01-01

    Sinus node dysfunction requiring pacemaker implantation is commonly associated with atrial fibrillation (AF), but may not be clinically apparent until restoration of sinus rhythm with ablation or cardioversion. We sought to determine frequency, time course, and predictors for pacemaker implantation after catheter ablation, and to compare the overall rates to a matched cardioversion cohort. We conducted a retrospective analysis using a large US commercial insurance database and identified 12,158 AF patients who underwent catheter ablation between January 1, 2005 and December 31, 2012. Over an average of 2.4 years of follow-up, 5.6 % of the patients underwent pacemaker implantation. Using the Cox proportional hazards models, we found that risk of risks of pacemaker implantation was associated with older age (50-64 and ≥65 versus pacemaker implantation between ablation patients and propensity score (PS)-matched cardioversion groups (3.5 versus. 4.1 % at 1 year and 8.8 versus 8.3 % at 5 years). Overall, pacemaker implantation occurs in about 1/28 patients within 1 year of catheter ablation. The overall implantation rate decreased between 2005 and 2012. Furthermore, the risk after ablation is similar to cardioversion, suggesting that patients require pacing due to a common underlying electrophysiologic substrate, rather than the ablation itself.

  13. Placement of central venous port catheters and peripherally inserted central catheters in the routine clinical setting of a radiology department: analysis of costs and intervention duration learning curve.

    Science.gov (United States)

    Rotzinger, Roman; Gebauer, Bernhard; Schnapauff, Dirk; Streitparth, Florian; Wieners, Gero; Grieser, Christian; Freyhardt, Patrick; Hamm, Bernd; Maurer, Martin H

    2017-12-01

    Background Placement of central venous port catheters (CVPS) and peripherally inserted central catheters (PICC) is an integral component of state-of-the-art patient care. In the era of increasing cost awareness, it is desirable to have more information to comprehensively assess both procedures. Purpose To perform a retrospective analysis of interventional radiologic implantation of CVPS and PICC lines in a large patient population including a cost analysis of both methods as well as an investigation the learning curve in terms of the interventions' durations. Material and Methods All CVPS and PICC line related interventions performed in an interventional radiology department during a three-year period from January 2011 to December 2013 were examined. Documented patient data included sex, venous access site, and indication for CVPS or PICC placement. A cost analysis including intervention times was performed based on the prorated costs of equipment use, staff costs, and expenditures for disposables. The decrease in intervention duration in the course of time conformed to the learning curve. Results In total, 2987 interventions were performed by 16 radiologists: 1777 CVPS and 791 PICC lines. An average implantation took 22.5 ± 0.6 min (CVPS) and 10.1 ± 0.9 min (PICC lines). For CVPS, this average time was achieved by seven radiologists newly learning the procedures after performing 20 CVPS implantations. Total costs per implantation were €242 (CVPS) and €201 (PICC lines). Conclusion Interventional radiologic implantations of CVPS and PICC lines are well-established procedures, easy to learn by residents, and can be implanted at low costs.

  14. Higher complication risk of totally implantable venous access port systems in patients with advanced cancer - a single institution retrospective analysis.

    Science.gov (United States)

    Chang, Yi-Fang; Lo, An-Chi; Tsai, Chung-Hsin; Lee, Pei-Yi; Sun, Shen; Chang, Te-Hsin; Chen, Chien-Chuan; Chang, Yuan-Shin; Chen, Jen-Ruei

    2013-02-01

    Totally implantable port systems are generally recommended for prolonged central venous access in diverse settings, but their risk of complications remains unclear for patients with advanced cancer. The aim of this study was to assess the risk of port system failure in patients with advanced cancer. We conducted a retrospective cohort study in a comprehensive cancer centre. A detailed chart review was conducted among 566 patients with 573 ports inserted during January-June, 2009 (average 345.3 catheter-days). Cox regression analysis was applied to evaluate factors during insertion and early maintenance that could lead to premature removal of the port systems due to infection or occlusion. Port system-related infection was significantly associated with receiving palliative care immediately after implantation (hazard ratio, HR = 7.3, 95% confidence interval, 95% CI = 1.2-46.0), after adjusting for probable confounders. Primary cancer site also impacted the occurrence of device-related infection. Receiving oncologic/palliative care (HR = 3.0, P = 0.064), advanced cancer stage (HR = 6.5, P = 0.077) and body surface area above 1.71 m(2) (HR = 3.4, P = 0.029) increased the risk of port system occlusion. Our study indicates that totally implantable port systems yield a higher risk of complications in terminally ill patients. Further investigation should be carefully conducted to compare outcomes of various central venous access devices in patients with advanced cancer and to develop preventive strategies against catheter failure.

  15. Percutaneous implantation of intra-arterial port system for regional drug infusion: results and complications in 110 cases

    International Nuclear Information System (INIS)

    Won, Je Hwan; Lee, Jong Hyuk; Ko, Kyung Hee; Won, Jong Yoon; Park, Sung Il; Lee, Do Yun; Kang, Byung Chul

    2000-01-01

    To investigate the feasibility and complications of a percutaneously implantable port system for regional drug infusion. For intra-arterial drug infusion, a 5.8 or 5-F pediatric venous port system was implanted in 110 patients with hepatocellular carcinoma (n=79), liver metastasis (n=16), gallbladder cancer (n=4), stomach cancer (n=3), pancreatic cancer (n=3), Burger's diseases mellitus (n=2), or lymphoma (n=1). All intra-arterial port implantations were performed percutaneously in an angiographic ward through the common femoral artery (n=98), left subclavian artery (n=10), or left superficial femoral artery (n=2). Complications were evaluated during the follow-up period, which ranged from 21 to 530 (mean, 163) days. The technical success rate for percutaneous implantation of the system was 97.3% (107 of 110 patients). The tips of the port catheter were located in the common hepatic artery (n=34), proper hepatic artery (n=49), right hepatic artery quick resulthepatic artery (n=1), descending aorta at T9 level (n=10), left popliteal artery (n=2), right external iliac artery (n=1), left external iliac artery (n=1), or left deep femoral artery (n=1). Complications were encountered in 24 patients (22.4%), namely chamber site infection (n=7), catheter dislodgement (n=7), catheter occlusion (n=3), migration of coil (n=2), disconnection between chamber and catheter (n=1), kinking of catheter (n=1), arterial occlusion (n=1), necrosis of overlying skin (n=1), and leakage around port chamber (n=1). Outcomes of complications included removal of port systems or cessation of therapy in 12 cases (11.2%), correction of catheter location using a guide wire in five (4.7%), thrombolysis with urokinase in three (2.8%), and straightening using a snare in one (0.9%). In three patients, the port system was used without reintervention. Percutaneous implantation of an intra-arterial port system showed a high technical success rate and a low rate of serious complications. The method may be

  16. Preliminary Experience with Locoregional Intraarterial Chemotherapy of Uterine Cervical or Endometrial Cancer Using the Peripheral Implantable Port System (PIPSTM): A Feasibility Study

    International Nuclear Information System (INIS)

    Strecker, Ernst-Peter; Heber, Ralf; Boos, Irene; Goettmann, Dieter; Heinrich, Dirk

    2003-01-01

    The purpose of this study was to assess the suitability of a percutaneously implantable catheter port system (PIPS)for repeated intraarterial locoregional chemotherapy (ILC) for cervical and endometrial carcinoma. In 30 patients with advanced, recurrent, or high-risk cervical (n 23) or endometrial(n = 7) carcinoma, PIPS for ILC was implanted via a femoral access, the catheter localized in the infrarenal abdominal aorta. Chemotherapy was performed adjuvantly after surgery(n = 14) or neo-adjuvantly to enable surgery, or for palliation (n = 16). Port implantation, catheter placement, and repeated port puncture was uneventful in all patients.Complications included catheter dislocation (n = 1),catheter thrombosis (n = 2), subcutaneous infection(n = 1), port-bed skin atrophy (n = 1),requiring port explantation in 3 patients. At 2 years follow-up,complete remission was observed in 7/14 patients with adjuvant chemotherapy, partial remission in 3/14. Successful down-staging could be achieved in 4/8 patients with neo-adjuvant chemotherapy. The PIPS is suitable for repeated ILC which may be a valuable method for pre- and post-surgical therapy of advanced or high-risk cervical and endometrial cancer, for adjuvant chemotherapy as well as neo-adjuvantly for down-staging, or for palliation

  17. The Monorail Technique to Overcome Difficult Anatomical Course During Implantation of Central Venous Port via the Left Internal Jugular Vein

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eu Hyun, E-mail: doorihyun6@gmail.com; Oh, Jung Suk; Chun, Ho Jong; Lee, Hae Giu; Choi, Byung Gil, E-mail: cbg@catholic.ac.kr [The Catholic University of Korea, Department of Radiology, Seoul St. Mary’s Hospital (Korea, Republic of)

    2017-03-15

    PurposeThe study aimed to introduce a monorail technique to overcome difficult anatomical course via left internal jugular vein in implantable port insertion.MethodsFrom 2007 to 2016, a total of 9346 patients were referred for implantable port insertion in our interventional unit, among which 79 cases were requested to insert on the left side. Our monorail technique was applied only when the technical challenge of the catheter tip entering the azygos vein instead of the superior vena cava occurred (n = 7). The technique consists of puncturing at the distal tip of the port catheter with a 21-gauge micropuncture needle and advancing a 0.018-in. hair-wire to guide and provide support for pre-assembled port.ResultsThe monorail technique was performed in seven patients and all but one case were technically successful, showing a technical success rate of 85.7%. There were no immediate or delayed complications.ConclusionsThe monorail technique is helpful to overcome the difficult anatomical course via left internal jugular vein in implantable port insertion.

  18. The Monorail Technique to Overcome Difficult Anatomical Course During Implantation of Central Venous Port via the Left Internal Jugular Vein

    International Nuclear Information System (INIS)

    Kim, Eu Hyun; Oh, Jung Suk; Chun, Ho Jong; Lee, Hae Giu; Choi, Byung Gil

    2017-01-01

    PurposeThe study aimed to introduce a monorail technique to overcome difficult anatomical course via left internal jugular vein in implantable port insertion.MethodsFrom 2007 to 2016, a total of 9346 patients were referred for implantable port insertion in our interventional unit, among which 79 cases were requested to insert on the left side. Our monorail technique was applied only when the technical challenge of the catheter tip entering the azygos vein instead of the superior vena cava occurred (n = 7). The technique consists of puncturing at the distal tip of the port catheter with a 21-gauge micropuncture needle and advancing a 0.018-in. hair-wire to guide and provide support for pre-assembled port.ResultsThe monorail technique was performed in seven patients and all but one case were technically successful, showing a technical success rate of 85.7%. There were no immediate or delayed complications.ConclusionsThe monorail technique is helpful to overcome the difficult anatomical course via left internal jugular vein in implantable port insertion.

  19. The Monorail Technique to Overcome Difficult Anatomical Course During Implantation of Central Venous Port via the Left Internal Jugular Vein.

    Science.gov (United States)

    Kim, Eu Hyun; Oh, Jung Suk; Chun, Ho Jong; Lee, Hae Giu; Choi, Byung Gil

    2017-03-01

    The study aimed to introduce a monorail technique to overcome difficult anatomical course via left internal jugular vein in implantable port insertion. From 2007 to 2016, a total of 9346 patients were referred for implantable port insertion in our interventional unit, among which 79 cases were requested to insert on the left side. Our monorail technique was applied only when the technical challenge of the catheter tip entering the azygos vein instead of the superior vena cava occurred (n = 7). The technique consists of puncturing at the distal tip of the port catheter with a 21-gauge micropuncture needle and advancing a 0.018-in. hair-wire to guide and provide support for pre-assembled port. The monorail technique was performed in seven patients and all but one case were technically successful, showing a technical success rate of 85.7%. There were no immediate or delayed complications. The monorail technique is helpful to overcome the difficult anatomical course via left internal jugular vein in implantable port insertion.

  20. Complications of an implantable venous access port: Prevention and treatment

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Tae Seok; Song, Myung Gyu [Dept. of Radiology, Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Cha, In Ho [Dept. Radiology, Chungang University Hospital, Chungang University College of Medicine, Seoul (Korea, Republic of)

    2016-11-15

    Placement of an implantable venous access port (IVAP) is a popular procedure for repeated and intermittent chemotherapy in patients with malignancy. In this article, we present various IVAP related complications. In addition, we review the technical tips to prevent and manage the complications. It is important that the operator should keep the mechanism of the complications in mind, perform a careful procedure for prevention, and manage the complication properly and immediately in case of its development for safety and satisfaction of the patients Complications of an implantable venous access port: Prevention and treatment.

  1. ["Let me tell you about my little box": phenomenological study on the experience of living with a totally implantable central venous catheter].

    Science.gov (United States)

    Mutti, Carolina; Fumagalli, Anna; Monni, Pierina; Rancati, Stefania; Rosi, Ivana Maria

    2016-01-01

    . "Let me tell you about my little box": phenomenological study on the experience of living with a totally implantable central venous catheter. Many variables impact on the choice to implant a totally implantable long-term central venous catheter's (Port), in spite of its proven efficacy. The patients' perception is pivotal, and only few qualitative studies dig deep into patients' feelings and experiences. To understand if, and how, the Port affects the patient's life. Qualitative phenomenological study based on semi-structured interviews on a convenience sample of patients implanted a Port, selected in an oncohematology Day Hospital in Milan. The analysis was carried out by three researchers with a phenomenological method. Four main themes, and sub-themes, emerged from twenty interviews. Relief, both physical and psychological; the process of the choice of inserting the Port and the importance of thinking about its positioning since the beginning of the treatment course; the symbol- the device reminds of the disease and its removal is of utmost importance; the technology progresses- the need of trust in the health care personnel and in their competences. The Port improved the patients' quality of life. The study allows some reflections on the need of considering the actual and future conditions of the patient to make a shared and informed choice.

  2. Complications after implantation of subcutaneous central venous ports (PowerPortⓇ

    Directory of Open Access Journals (Sweden)

    Takatoshi Nakamura

    2017-05-01

    Conclusion: PowerPort is a multifunctional port. Benign disease was a risk factor for postoperative complications. Because many types of subcutaneously implanted ports are used in our hospital, we had to inform the hospital staff about the functions of PowerPort.

  3. Does the real-time ultrasound guidance provide safer venipuncture in implantable venous port implantation?

    Science.gov (United States)

    Yıldırım, İlknur; Tütüncü, Ayşe Çiğdem; Bademler, Süleyman; Özgür, İlker; Demiray, Mukaddes; Karanlık, Hasan

    2018-03-01

    To examine whether the real-time ultrasound-guided venipuncture for implantable venous port placement is safer than the traditional venipuncture. The study analyzed the results of 2153 venous ports placed consecutively from January 2009 to January 2016. A total of 922 patients in group 1 and 1231 patients in group 2 were admitted with venous port placed using the traditional landmark subclavian approach and real-time ultrasound-guided axillary approach, respectively. Sociodemographic characteristics of patients, early (pneumothorax, pinch-off syndrome, arterial puncture, hematoma, and malposition arrhythmia) and late (deep vein thrombosis, obstruction, infection, erosion-dehiscence, and rotation of the port chamber) complications and the association of these complications with the implantation method were evaluated. There were no significant differences in the sociodemographic characteristics of the patients between the two groups. The overall and early complications in group 2 were significantly lower than those in group 1. Pinch-off syndrome only developed in group 1. Seven patients and two patients had pneumothorax in groups 1 and 2, respectively. Puncture number was significantly associated with the development of the overall complications. The ultrasound-guided axillary approach may be preferred as a method to reduce the risk of both early and late complications. Large, randomized, controlled prospective trials will be helpful in determining a safer implantable venous port implantation technique.

  4. Incidence and risk factors of infections complications related to implantable venous-access ports

    International Nuclear Information System (INIS)

    Shim, Ji Sue; Seo, Tae Seok; Song, Myung Gyu; Cha, In Ho; Kim, Jun Suk; Choi, Chul Won; Seo, Jae Hong; Oh, Sang Cheul

    2014-01-01

    The purpose of this study was to determine the incidence and risk factors of infections associated with implantable venous access ports (IVAPs.) From August 2003 through November 2011, 1747 IVAPs were placed in our interventional radiology suite. One hundred forty four IVAPs were inserted in patients with hematologic malignancy and 1603 IVAPs in patients with solid tumors. Among them, 40 ports (23 women and 17 men; mean age, 57.1 years; range, 13-83) were removed to treat port-related infections. We evaluated the incidence of port-related infection, patient characteristics, bacteriologic data, and patient progress. Univariable analyses (t test, chi-square test, and Fisher's exact test) and multiple logistic regression analyses were used to determine the risk factors for IVAP related infection. Overall, 40 (2.3%) of 1747 ports were removed for symptoms of infection with an incidence rate of 0.067 events/1000 catheter-days. According to the univariable study, the incidences of infection were seemingly higher in the patients who received the procedure during inpatient treatment (p = 0.016), the patients with hematologic malignancy (p = 0.041), and the patients receiving palliative chemotherapy (p = 0.022). From the multiple binary logistic regression, the adjusted odds ratios of infection in patients with hematologic malignancies and those receiving palliative chemotherapy were 7.769 (p = 0.001) and 4.863 (p = 0.003), respectively. Microorganisms were isolated from 26 (65%) blood samples, and two of the most causative organisms were found to be Staphylococcus (n = 10) and Candida species (n = 7). The underlying hematologic malignancy and the state of receiving palliative chemotherapy were the independent risk factors of IVAP-related infection.

  5. Incidence and risk factors of infections complications related to implantable venous-access ports

    Energy Technology Data Exchange (ETDEWEB)

    Shim, Ji Sue; Seo, Tae Seok; Song, Myung Gyu; Cha, In Ho; Kim, Jun Suk; Choi, Chul Won; Seo, Jae Hong; Oh, Sang Cheul [Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

    2014-08-15

    The purpose of this study was to determine the incidence and risk factors of infections associated with implantable venous access ports (IVAPs.) From August 2003 through November 2011, 1747 IVAPs were placed in our interventional radiology suite. One hundred forty four IVAPs were inserted in patients with hematologic malignancy and 1603 IVAPs in patients with solid tumors. Among them, 40 ports (23 women and 17 men; mean age, 57.1 years; range, 13-83) were removed to treat port-related infections. We evaluated the incidence of port-related infection, patient characteristics, bacteriologic data, and patient progress. Univariable analyses (t test, chi-square test, and Fisher's exact test) and multiple logistic regression analyses were used to determine the risk factors for IVAP related infection. Overall, 40 (2.3%) of 1747 ports were removed for symptoms of infection with an incidence rate of 0.067 events/1000 catheter-days. According to the univariable study, the incidences of infection were seemingly higher in the patients who received the procedure during inpatient treatment (p = 0.016), the patients with hematologic malignancy (p = 0.041), and the patients receiving palliative chemotherapy (p = 0.022). From the multiple binary logistic regression, the adjusted odds ratios of infection in patients with hematologic malignancies and those receiving palliative chemotherapy were 7.769 (p = 0.001) and 4.863 (p = 0.003), respectively. Microorganisms were isolated from 26 (65%) blood samples, and two of the most causative organisms were found to be Staphylococcus (n = 10) and Candida species (n = 7). The underlying hematologic malignancy and the state of receiving palliative chemotherapy were the independent risk factors of IVAP-related infection.

  6. J-tipped guidewire as a target for puncture of the subclavian artery in the placement of a reservoir port and catheter system

    International Nuclear Information System (INIS)

    Hama, Yukihiro; Kusano, Shoichi; Makita, Kohzoh

    2004-01-01

    The aim of this study was to verify the feasibility of using a J-tipped guidewire as a target for puncture of the subclavian artery in the placement of a reservoir port and catheter system (RPCS). Twenty-five patients with various hepatic malignancies underwent percutaneous implantation of an RPCS through the left subclavian artery for regional chemotherapy. To successfully puncture the left subclavian artery, a J-tipped guidewire was used as a target with fluoroscopic guidance. Technical success and complication rates, and numbers of puncture failures, were retrospectively analyzed. Implantation of the RPCS was successful in all patients. Eight (32%) patients had minor complications and no patient had major complications. The number of puncture failures per patient was 0 to 1 (mean=0.32). The J-tipped guidewire is a safe and appropriate target for puncture of the subclavian artery in the placement of an RPCS. (orig.)

  7. Metastatic spread from squamous cell carcinoma of the hypopharynx to the totally implantable venous access port insertion site: Case report and review of literature.

    Science.gov (United States)

    Mangla, Ankit; Agarwal, Nikki; Mullane, Michael Russell

    2017-12-01

    The totally implantable venous access port plays a crucial role in delivering chemotherapy in the outpatient setting. Here, we report the first case of a patient with hypopharyngeal tumor who developed chest wall metastasis over the totally implantable venous access port inserted in the internal jugular vein. Our patient, a 58-year-old man with a hypopharyngeal tumor presented with a lump over the totally implantable venous access port site. The port was removed and the lump was biopsied. The CT studies showed that the tumor had spread along the catheter from the hypopharynx to the chest wall. The pathology from the biopsy showed squamous cell carcinoma (SCC). The patient had poor performance status and opted for hospice care. We present a novel case of metastasis over the totally implantable venous access port implanted in a patient with a hypopharyngeal tumor. We also reviewed relevant literature comparing the data from percutaneous endoscopic gastrostomy (PEG) tube site metastasis with our patient and other similar case reports. © 2017 Wiley Periodicals, Inc.

  8. Short-term and long-term outcome of radiological-guided insertion of central venous access port devices implanted at the forearm: a retrospective monocenter analysis in 1704 patients

    Energy Technology Data Exchange (ETDEWEB)

    Wildgruber, Moritz; Borgmeyer, Sebastian; Gaa, Jochen; Meier, Reinhard; Berger, Hermann [Technische Universitaet Muenchen, Division of Interventional Radiology, Department of Radiology, Klinikum Rechts der Isar, Muenchen (Germany); Haller, Bernhard [Technische Universitaet Muenchen, Department of Medical Statistics and Epidemiology, Klinikum Rechts der Isar, Munich (Germany); Jansen, Heike; Kiechle, Marion; Ettl, Johannes [Technische Universitaet Muenchen, Department of Obstetrics and Gynecology, Klinikum Rechts der Isar, Munich (Germany)

    2014-09-20

    The objectives are to analyze the technical success rate as well as the short-term and long-term complications of totally implantable venous access ports (TIVAPs) at the forearm. Retrospective analysis of 1,704 consecutively implanted TIVAPs was performed. Primary endpoints were defined as technical success rate, clinical outcome, device service interval, and rates of major complications. Minor complications not requiring port explantation were defined as secondary endpoints. The technical success rate was 99.2 % with no major complications. During follow-up, a total of 643,200 catheter-days were documented, the mean device service interval was 380.6 days/patient. A total of 243 complications (14.4 %) in 226 patients were observed (0.4/1000 catheter-days), in 140 patients (8.3 %) the port device had to be explanted. Disconnection between the port device and the catheter (1.6 %) was more frequent than fracture (0.8 %) and leakage (0.6 %) of the catheter, which occurred more frequently when the catheter was inserted via the cephalic versus the brachial vein. TIVAP implantation at the forearm is a simple and safe procedure with a low rate of early and late complications. (orig.)

  9. Echocardiography-guided Radiofrequency Catheter Ablation of Atrioventricular Node and VVI Pacemaker Implantation

    Directory of Open Access Journals (Sweden)

    T Guo

    2014-05-01

    Full Text Available Objective: This study is to evaluate the feasibility and safety of intracardiac radiofrequency catheter ablation (RFCA of the atrioventricular node (AVN and pacemaker implantation using transthoracic echocardiography. Methods: Eleven patients – six males and five females (mean age 66 years – with persistent or permanent atrial fibrillation/atrial flutter received RFCA of AVN and VVI pacemaker implantation (paces and senses the ventricle and is inhibited if it senses ventricular activity. Under transthoracic echocardiography, the electrode catheters were positioned intracardiac, and target ablation was performed, with the permanent pacemaking catheter in the left subclavian vein and the ablation catheter in the right femoral vein. The multi-view imaging and dynamic observation applied during the stable AV dissociation were successful. Results: Atrioventricular node ablation and permanent pacemaker implantation in 11 patients were completed successfully without X-ray exposure. The operation success rate was 100%. All patients recovered well within the follow-up period. Conclusions: Radiofrequency catheter ablation of AVN and VVI pacemaker implantation under transthoracic echocardiography guidance is a safe, easy and feasible approach. This procedure could be an important supplemental measure to catheter ablation of arrhythmia under routine X-ray fluoroscopy.

  10. A case-control study to identify risk factors for totally implantable central venous port-related bloodstream infection.

    Science.gov (United States)

    Lee, Guk Jin; Hong, Sook Hee; Roh, Sang Young; Park, Sa Rah; Lee, Myung Ah; Chun, Hoo Geun; Hong, Young Seon; Kang, Jin Hyoung; Kim, Sang Il; Kim, Youn Jeong; Chun, Ho Jong; Oh, Jung Suk

    2014-07-01

    To date, the risk factors for central venous port-related bloodstream infection (CVPBSI) in solid cancer patients have not been fully elucidated. We conducted this study in order to determine the risk factors for CVP-BSI in patients with solid cancer. A total of 1,642 patients with solid cancer received an implantable central venous port for delivery of chemotherapy between October 2008 and December 2011 in a single center. CVP-BSI was diagnosed in 66 patients (4%). We selected a control group of 130 patients, who were individually matched with respect to age, sex, and catheter insertion time. CVP-BSI occurred most frequently between September and November (37.9%). The most common pathogen was gram-positive cocci (n=35, 53.0%), followed by fungus (n=14, 21.2%). Multivariate analysis identified monthly catheter-stay as a risk factor for CVP-BSI (p=0.000), however, its risk was lower in primary gastrointestinal cancer than in other cancer (p=0.002). Initial metastatic disease and long catheter-stay were statistically significant factors affecting catheter life span (p=0.005 and p=0.000). Results of multivariate analysis showed that recent transfusion was a risk factor for mortality in patients with CVP-BSI (p=0.047). In analysis of the results with respect to risk factors, prolonged catheter-stay should be avoided as much as possible. It is necessary to be cautious of CVP-BSI in metastatic solid cancer, especially non-gastrointestinal cancer. In addition, avoidance of unnecessary transfusion is essential in order to reduce the mortality of CVP-BSI. Finally, considering the fact that confounding factors may have affected the results, conduct of a well-designed prospective controlled study is warranted.

  11. Principles of subcutaneous port placement.

    Science.gov (United States)

    Gonda, Shaun J; Li, Ruizong

    2011-12-01

    The introduction of totally implantable subcutaneous devices in the early 1980s provided patients with secure, reliable venous access and also gave them the ability to move more freely and have a more normal lifestyle with these devices in place. The most common totally implantable device used today is the subcutaneous port. These ports consist of an injection port connected to a catheter. Ports provide a number of advantages compared with other venous catheters; the most important is the reduced risk of infection. These devices have significantly lower rates of infection than nontunneled and tunneled catheters. Additional advantages include less frequent irrigation and minimal home care, and they are less prone to environmental or cutaneous contamination when not being accessed. This article will focus on the placement of these ports. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. Image-guided placement of port catheters: is there an increased risk of infection if the port is immediately accessed and used?

    Science.gov (United States)

    Salazar, Gloria; Yeddula, Kalpana; Wicky, Stephan; Oklu, Ramhi; Ganguli, Suvranu; Waltman, Arthur C; Walker, Thomas G; Kalva, Sanjeeva P

    2013-01-01

    To compare complication rates in patients who have port-a-catheters inserted and left accessed for immediate use and those who have ports inserted but not accessed. In this retrospective, IRB-approved study, medical records of patients who received a port catheter between 9/2009 and 2/2010 were reviewed. The data collected included patient demographics, diagnosis, procedure and complications. The patients were categorized into two groups: accessed (patients in whom the port was accessed with a Huber needle for immediate intravenous use and the patient left the procedure area with needle indwelling) and control (patients in whom the ports were not accessed). Complications were classified according to Society of Interventional Radiology guidelines. Results are given as mean ±SD. Statistical analysis was performed with student t test and statistical significance was considered at Pports were placed in 465 patients (Men: 206); 10.7% in the accessed group (n=50, age: 60±13.9) and 89.3% in the control group (n=417, age: 59±13.5). There were no statistically significant differences in patient demographics between the groups. The overall complication rate was 0.6% (n=3). Two complications (hematoma causing skin necrosis and thrombosis of the port) occurred in the control group and one (infection) in the accessed group. Infection rates after procedures were 2% (1/50) in the accessed group and 0% (0/417) in the control group. There was no statistically significant difference in overall complication (P=.1) and infection (P=.1) rates among the groups. Leaving the port accessed immediately after placement does not increase the risk of infection or other complications.

  13. Venous Access Ports: Indications, Implantation Technique, Follow-Up, and Complications

    Energy Technology Data Exchange (ETDEWEB)

    Walser, Eric M., E-mail: walser.eric@mayo.edu [Mayo Clinic, Department of Radiology (United States)

    2012-08-15

    The subcutaneous venous access device (SVAD or 'port') is a critical component in the care of patients with chronic disease. The modern SVAD provides reliable access for blood withdrawal and medication administration with minimal disruption to a patient's lifestyle. Because of improved materials and catheter technology, today's ports are lighter and stronger and capable of high-pressure injections of contrast for cross-sectional imaging. The majority of SVAD placement occurs in interventional radiology departments due to their ability to provide this service at lower costs, lower, complication rates, and greater volumes. Port-insertion techniques vary depending on the operator, but all consist of catheter placement in the central venous circulation followed by subcutaneous pocket creation and port attachment to the catheter with fixation and closure of the pocket. Venous access challenges occasionally occur in patients with central vein occlusions, necessitating catheterization of collateral veins or port placement in alternate locations. Complications of SVADs include those associated with the procedure as well as short- (<30 days) and long-term problems. Procedural and early complications are quite rare due to the near-universal use of real-time ultrasound guidance for vein puncture, but they can include hematoma, catheter malposition, arrhythmias, and pneumothorax. Late problems include both thrombotic complications (native venous or port-catheter thrombosis) and infections (tunnel or pocket infections or catheter-associated bloodstream infections). Most guidelines suggest that 0.3 infections/1000 catheter days is an appropriate upper threshold for the insertion of SVADs.

  14. Port type is a possible risk factor for implantable venous access port-related bloodstream infections and no sign of local infection predicts the growth of gram-negative bacilli.

    Science.gov (United States)

    Hsu, Jui-Feng; Chang, Hsu-Liang; Tsai, Ming-Ju; Tsai, Ying-Ming; Lee, Yen-Lung; Chen, Pei-Huan; Fan, Wen-Chieh; Su, Yu-Chung; Yang, Chih-Jen

    2015-09-30

    Implantable venous access port (IVAP)-related blood stream infections (BSIs) are one of the most common complications of implantable venous ports. The risk factors and pathogens for IVAP-related BSIs are still controversial. We retrospectively reviewed all patients who received IVAPs at a Hospital in Taiwan from January 1, 2011 to June 31, 2014. Two types of venous port, BardPort® 6.6 fr (Bard port) and Autosuture Chemosite® 7.5 fr (TYCO port) were used. All patients with clinically proven venous port-related BSIs were enrolled. A total of 552 patients were enrolled. There were 34 episodes of IVAP-related BSIs during the study period for a total incidence of 0.177 events/1000 catheter days. Port type (TYCO vs. Bard, HR = 7.105 (95% confidence interval (CI), 1.688-29.904), p = 0.0075), age > 65 years (HR = 2.320 (95 % CI, 1.179-4.564), p = 0.0148), and lung cancer (HR = 5.807 (95% CI, 2.946-11.447), p port infections. We also found that no local sign of infection was significantly associated with the growth of gram-negative bacilli (p = 0.031). TYCO venous ports, age > 65 years, and lung cancer were all significant risk factors for IVAP-related BSIs, and no sign of infection was significantly associated with the growth of gram-negative bacilli.

  15. Surgical complications after peritoneal dialysis catheter implantation depend on children's weight.

    Science.gov (United States)

    Radtke, Josephine; Lemke, Anja; Kemper, Markus J; Nashan, Bjoern; Koch, Martina

    2016-08-01

    Surgical complications are estimated to be as high as 30%-40% during the first 8 weeks after implantation of peritoneal dialysis (PD) catheters. 70 PD catheters which were implanted by transplant surgeons in 61 children (median age 3.3years, range 0.01-15.5years, 31 boys and 30 girls) in 2009-2014 were retrospectively reviewed. The incidence of complications and revisions during the first 6months after implantation was analyzed depending on children's weight and diagnosis. 17 out of 70 catheters needed a surgical revision within 6months after implantation (24.3%). Peritonitis was the most common complication affecting 18.6% of peritoneal dialysis catheters followed by obstruction and dislocation, which it occurred in 9 (12.9%) and 7 (10%) catheters, respectively. Leakage (n=5) only occurred in children with a weight of less than 10kg. The total proportion of complications was higher in children with less than 10kg of weight (P<0.001). PD is safe in children with acute renal failure and older children with chronic renal failure; however children with a weight of less than 10kg are more likely to develop complications. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Minimally Invasive Catheter Procedures to Assist Complicated Pacemaker Lead Extraction and Implantation in the Operating Room

    International Nuclear Information System (INIS)

    Kröpil, Patric; Lanzman, Rotem S.; Miese, Falk R.; Blondin, Dirk; Winter, Joachim; Scherer, Axel; Fürst, Günter

    2011-01-01

    We report on percutaneous catheter procedures in the operating room (OR) to assist complicated manual extraction or insertion of pacemaker (PM) and implantable cardioverter defibrillator leads. We retrospectively reviewed complicated PM revisions and implantations performed between 2004 and 2009 that required percutaneous catheter procedures performed in the OR. The type of interventional procedure, catheter and retrieval system used, venous access, success rates, and procedural complications were analyzed. In 41 (12 female and 29 male [mean age 62 ± 17 years]) of 3021 (1.4%) patients, standard manual retrieval of old leads or insertion of new leads was not achievable and thus required percutaneous catheter intervention for retrieval of misplaced leads and/or recanalisation of occluded central veins. Thirteen of 18 (72.2%) catheter-guided retrieval procedures for misplaced (right atrium [RA] or ventricle [RV; n = 3], superior vena cava [n = 2], brachiocephalic vein [n = 5], and subclavian vein [n = 3]) lead fragments in 16 patients were successful. Percutaneous catheter retrieval failed in five patients because there were extremely fixed or adhered lead fragments. Percutaneous transluminal angiography (PTA) of central veins for occlusion or high-grade stenosis was performed in 25 patients. In 22 of 25 patients (88%), recanalization of central veins was successful, thus enabling subsequent lead replacement. Major periprocedural complications were not observed. In the case of complicated manual PM lead implantation or revision, percutaneous catheter-guided extraction of misplaced lead fragments or recanalisation of central veins can be performed safely in the OR, thus enabling subsequent implantation or revision of PM systems in the majority of patients.

  17. Implantation of peritoneal catheters by laparotomy: nephrologists obtained similar results to general surgeons

    Directory of Open Access Journals (Sweden)

    Restrepo CA

    2014-10-01

    Full Text Available Cesar A Restrepo, Carlos Alberto Buitrago, Cielo Holguin Division of Nephrology, Department of Health Sciences, Caldas University, Caldas, ColombiaPurpose: To analyze the complications and costs of minilaparotomies performed by a nephrologist (group A compared with conventional laparotomies performed by a surgeon (group B for peritoneal catheter implantation.Setting: Two university hospitals (Santa Sofia and Caldas in Manizales, Caldas, Colombia.Methods: The study included stage 5 chronic kidney disease patients, with indication of renal replacement therapy, who were candidates for peritoneal dialysis and gave informed consent for a peritoneal catheter implant. Minilaparotomies were performed by a nephrologist in a minor surgery room under local anesthesia. Conventional laparotomies were performed by a surgeon in an operating room under general anesthesia.Results: Two nephrologists inserted 157 peritoneal catheters, and seven general surgeons inserted 185 peritoneal catheters. The groups had similar characteristics: the mean age was 55 years, 49.5% were men, and the primary diagnoses were diabetic nephropathy, hypertensive nephropathy, and unknown etiology. The implant was successful for 98.09% of group A and 99.46% of group B. There was no procedure-related mortality. The most frequent complications in the first 30 days postsurgery in group A versus group B, respectively, were: peritonitis (6.37% versus 3.78%, exit-site infection (3.82% versus 2.16%, tunnel infection (0% versus 0.54%, catheter entrapment by omentum (1.27% versus 3.24%, peritoneal effluent spillover (1.91% versus 2.16%, draining failure (4.46% versus 6.49%, hematoma (0% versus 1.08%, catheter migration with kinking (3.18% versus 2.70%, hemoperitoneum (1.27% versus 0%, and hollow viscera accidental puncture (1.91% versus 0.54%. There were no statistically significant differences in the number of complications between groups. In 2013, the cost of a surgeon-implanted peritoneal

  18. When one port does not return blood: two case reports of rare causes for misplaced central venous catheters

    Directory of Open Access Journals (Sweden)

    Sandra Pereira

    2016-01-01

    Full Text Available We present two cases of misplaced central venous catheters having in common the absence of free blood return from one lumen immediately after placement. The former is a case of right hydrothorax associated with central venous catheterization with the catheter tip in intra-pleural location. In this case the distal port was never patent. In the latter case there was an increased aspiration pressure through the middle port due to a catheter looping.The absence of free flow on aspiration from one lumen of a central catheter should not be undervalued. In these circumstances the catheter should not be used and needs to be removed. Resumo: Apresentamos dois casos de mau posicionamento de cateter venoso central. Têm em comum a ausência do retorno sanguíneo livre em um dos lúmens imediatamente após a colocação. O primeiro é um caso de hidrotórax direito associado ao cateterismo venoso central, com a ponta do cateter em localização intrapleural. Nesse caso, a porta distal nunca esteve patente. No segundo caso houve um aumento da pressão de aspiração através da porta medial por causa da formação de alça no cateter.A ausência de fluxo livre na aspiração de um lúmen do cateter central não deve ser subestimada. Nessas circunstâncias, o cateter não deve ser usado e deve ser removido. Keywords: Central venous catheter, Hydrothorax, Looping, Malposition, Palavras-chave: Cateter venoso central, Hidrotórax, Alça, Mau posicionamento

  19. Repositioning of malpositioned or flipped central venous catheters

    Energy Technology Data Exchange (ETDEWEB)

    Thalhammer, A.; Jacobi, V.; Balzer, J.; Vogl, T.J. [Institute for Diagnostic and Interventional Radiology, Central Radiology Clinic, J.W. Goethe University, Frankfurt am Main (Germany)

    2002-03-01

    Primary misplaced or secondary flipped implanted catheters are located mostly in the right jugular vein. We demonstrate an effective method to replace fix implanted catheters such as Ports, Grochomg or Hickman catheters. Using a femoral venous approach, replacement into the superior vena cava can easily be done with a Sidewinder 1 catheter which is hooked over the misplaced central venous approach. In all our patients the method was successful. The repositioning technique described is simple, fast and has low costs. We can keep sterile conditions and do not need to solve the catheters' fixation. (orig.)

  20. [Subcutaneous implantation type central venous port management in patients with malignant tumors effect of different antiseptic agents on central venous port-related infection].

    Science.gov (United States)

    Sato, Junya; Kumagai, Masumi; Kato, Kenichi; Akahane, Akio; Suzuki, Michiko; Kashiwaba, Masahiro; Sone, Miyuki; Kudo, Kenzo

    2014-08-01

    Subcutaneous implantation type central venous ports(CV ports)are used in chemotherapy. Here, we prospectively examined the frequency of CV port-related infections when the disinfectant was changed from 10% povidone iodine to 1% chlorhexidine ethanol or 70% ethanol. The subjects were patients with malignant tumors, who had newly been implanted with CV ports. We examined CV port-related infections at 1 week after CV port implantation and every 2 weeks thereafter, following sterilization upon insertion of a Huber needle to the CV port. CV port evulsion due to CV port-related infection was noted in 3 patients(4.8%)in whom 15%chlorhexidine ethanol was used(n=62)and in 2 patients(3.3%)in whom 70% ethanol was used(n=60). Infection rates per 1,000 days of CV port use were 1.48% and 1.01%, respectively. Thus, the outcomes of sterilization using 1% chlorhexidine ethanol and 70% ethanol did not differ significantly from those on using 10% povidone iodine for sterilization, based on preliminary results at our institution(3 of 59 patients[5.1%]had port evulsion due to CV port-related infection and the infection rate per 1,000 days of CV port use was 1.47%, Akahane et al, 2012). Chlorhexidine ethanol and ethanol are very convenient to use because they dry quickly and do not need discoloration. Accordingly, chlorhexidine ethanol and ethanol might be useful in CV port management.

  1. Catheter Entrapment During Posterior Mitral Leaflet Pushing Maneuver for MitraClip Implantation.

    Science.gov (United States)

    Castrodeza, Javier; Amat-Santos, Ignacio J; Tobar, Javier; Varela-Falcón, Luis H

    2016-06-01

    MitraClip (Abbott Vascular) therapy has been reported to be an effective procedure for mitral regurgitation, especially in high-risk patients. Recently, the novel pushing maneuver technique has been described for approaching restricted and short posterior leaflets with a pigtail catheter in order to facilitate grasping of the clip. However, complications or unexpected situations may occur. We report the case of an 84-year-old patient who underwent MitraClip implantation wherein the pushing maneuver was complicated by the clip accidentally gripping the pigtail catheter along with the two leaflets.

  2. Electrophysiology Catheter-Facilitated coronary sinus cannulation and implantation of cardiac resynchronization therapy systems

    Directory of Open Access Journals (Sweden)

    Antonis S. Manolis, MD, FESC, FACC, FHRS

    2018-01-01

    Full Text Available Background: Cardiac resynchronization therapy (CRT device implantation is hampered by difficult placement of the left ventricular (LV lead. We have routinely used a steerable electrophysiology catheter to guide coronary sinus (CS cannulation and facilitate LV lead positioning. The aim of this prospective study is to present our results with this approach in 138 consecutive patients receiving a CRT device over 10 years. Methods: The study included 120 men and 18 women, aged 64.8±11.4 years, with coronary disease (n=63, cardiomyopathy (n=72, or other disease (n=3, and mean ejection fraction of 24.5±4.5%. Devices were implanted for refractory heart failure and dyssynchrony, all but 2 in the presence of left bundle branch block. Implanted devices included biventricular pacemakers (CRT-P (n=33 and cardioverter defibrillators (CRT-D (n=105. Results: Using the electrophysiology catheter, the CS could be engaged in 134 (97.1% patients. In 4 patients failing CS cannulation, a dual-chamber device was implanted in 2, and bifocal right ventricular pacing was effected in 2. Bifocal (n=2 or conventional (n=1 systems were implanted in another 3 patients, in whom the LV lead got dislodged (n=2 or removed because of local dissection (n=1. Thus, finally, a CRT system was successfully established in 131 (94.9% patients. There were 3 patients with CS dissection, of whom 1 was complicated by cardiac tamponade managed with pericardiocentesis. There were no perioperative deaths. During follow-up (31.0±21.2 months, clinical improvement was reported by 108 (82.4% patients. Conclusion: Routine use of an electrophysiology catheter greatly facilitated CS cannulation and successful LV lead placement in ∼95% of patients undergoing CRT system implantation. Keywords: heart failure, cardiac resynchronization therapy, implantable cardioverter defibrillator, coronary sinus, left ventricular lead

  3. Severe Neutropenia at the Time of Implantable Subcutaneous Chest Port Insertion Is Not a Risk Factor for Port Removal at a Tertiary Pediatric Center.

    Science.gov (United States)

    Hoss, Daniel R; Bedros, Antranik A; Mesipam, Avinash; Criddle, Jared; Smith, Jason C

    2017-03-01

    To determine if severe neutropenia at the time of chest port insertion is a risk factor for port removal and central catheter-associated bloodstream infection (CCABSI) in pediatric patients. From May 2007 to June 2015, 183 consecutive patients (mean age, 9.9 y; range, 0.75-21 y) had a port inserted at a single tertiary pediatric center. Seventy-two had severe neutropenia at the time of port insertion (absolute neutrophil count [ANC] range, 0-500/mm 3 ; mean, 185/mm 3 ). Follow-up until port removal or death and CCABSI events were recorded. Within the first 30 days, similar incidences of CCABSI (12.5% of patients with severe neutropenia [n = 9] vs 4.5% of patients without [n = 5]), port removal for infection (2.8% [n = 2] vs 2.7% [n = 3]), and local port infection (2.8% [n = 2] vs 0.9% [n = 1]) were observed in both groups (P > .05), but the rate of CCABSI per 1,000 catheter-days was higher for patients with severe neutropenia (P = .045). Overall, similar incidences of CCABSI (18.1% [n = 13] vs 16.2% [n = 18]), port removal for infection (2.8% [n = 2] vs 7.2% [n = 8]), local port infection (2.8% [n = 2] vs 2.7% [n = 3]), and CCABSIs per 1,000 catheter-days (0.332 vs 0.400) were observed in both groups (P > .05). Port placement in patients with severe neutropenia can be performed without an increased incidence of port removal for infection. The majority of CCABSIs were successfully treated without port removal. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

  4. Implantable electrolyte conductance-based pressure sensing catheter, II. Device construction and testing.

    Science.gov (United States)

    Tan, Robert; Benharash, Peyman; Schulam, Peter; Schmidt, Jacob J

    2013-12-01

    Direct measurements of arterial blood pressure most commonly use bulky external instrumentation containing a pressure transducer connected to an ex vivo fluid-filled arterial line, which is subject to several sensing artifacts. In situ blood pressure sensors, typically solid state piezoresistive, capacitive, and interferometric sensors, are unaffected by these artifacts, but can be expensive to produce and miniaturize. We have developed an alternative approach to blood pressure measurement based on deformation of an elastic tube filled with electrolyte solution. Simple measurement of the electrical conductance of this solution as the tube dimensions change allows determination of the external pressure. The sensor is made from inexpensive materials and its miniaturization is straightforward. In vitro static testing of initial sensor prototypes mounted on a catheter tip showed a linear response with applied pressure and a resolution of 1 mmHg. In vivo sensing followed catheterization of the sensor into the femoral artery of a porcine model through a 7F catheter port. The sensor performed comparably to a commercial pressure transducer also connected to the catheter port. Due to its scalability and cost, this sensor has the potential for use in a range of pressure sensing applications, such as measurement of intracranial, spinal, or interstitial pressures.

  5. Brachial insertion of fully implantable venous catheters for chemotherapy: complications and quality of life assessment in 35 patients.

    Science.gov (United States)

    Fonseca, Igor Yoshio Imagawa; Krutman, Mariana; Nishinari, Kenji; Yazbek, Guilherme; Teivelis, Marcelo Passos; Bomfim, Guilherme André Zottele; Cavalcante, Rafael Noronha; Wolosker, Nelson

    2016-01-01

    To prospectively evaluate the perioperative safety, early complications and satisfaction of patients who underwent the implantation of central catheters peripherally inserted via basilic vein. Thirty-five consecutive patients with active oncologic disease requiring chemotherapy were prospectively followed up after undergoing peripheral implantation of indwelling venous catheters, between November 2013 and June 2014. The procedures were performed in the operating room by the same team of three vascular surgeons. The primary endpoints assessed were early postoperative complications, occurring within 30 days after implantation. The evaluation of patient satisfaction was based on a specific questionnaire used in previous studies. In all cases, ultrasound-guided puncture of the basilic vein was feasible and the procedure successfully completed. Early complications included one case of basilic vein thrombophlebitis and one case of pocket infection that did not require device removal. Out of 35 patients interviewed, 33 (94.3%) would recommend the device to other patients. Implanting brachial ports is a feasible option, with low intraoperative risk and similar rates of early postoperative complications when compared to the existing data of the conventional technique. The patients studied were satisfied with the device and would recommend the procedure to others. Avaliar prospectivamente segurança perioperatória, complicações precoces e grau de satisfação de pacientes submetidos ao implante de cateteres centrais de inserção periférica pela veia basílica. Foram acompanhados prospectivamente e submetidos ao implante de cateteres de longa permanência de inserção periférica, entre novembro de 2013 e junho de 2014, 35 pacientes consecutivos com doença oncológica ativa necessitando de quimioterapia. Os procedimentos foram realizados em centro cirúrgico por uma mesma equipe composta por três cirurgiões vasculares. Os desfechos primários avaliados foram as

  6. Adjuvant Hepatic Arterial Infusion Chemotherapy After Resection for Pancreatic Cancer Using Coaxial Catheter-Port System Compared with Conventional System

    International Nuclear Information System (INIS)

    Hashimoto, Aya; Tanaka, Toshihiro; Sho, Masayuki; Nishiofuku, Hideyuki; Masada, Tetsuya; Sato, Takeshi; Marugami, Nagaaki; Anai, Hiroshi; Sakaguchi, Hiroshi; Kanno, Masatoshi; Tamamoto, Tetsuro; Hasegawa, Masatoshi; Nakajima, Yoshiyuki; Kichikawa, Kimihiko

    2016-01-01

    PurposePrevious reports have shown the effectiveness of adjuvant hepatic arterial infusion chemotherapy (HAIC) in pancreatic cancer. However, percutaneous catheter placement is technically difficult after pancreatic surgery. The purpose of this study was to evaluate the feasibility and outcome of HAIC using a coaxial technique compared with conventional technique for postoperative pancreatic cancer.Materials and Methods93 consecutive patients who received percutaneous catheter-port system placement after pancreatectomy were enrolled. In 58 patients from March 2006 to August 2010 (Group A), a conventional technique with a 5-Fr indwelling catheter was used and in 35 patients from September 2010 to September 2012 (Group B), a coaxial technique with a 2.7-Fr coaxial catheter was used.ResultsThe overall technical success rates were 97.1 % in Group B and 86.2 % in Group A. In cases with arterial tortuousness and stenosis, the success rate was significantly higher in Group B (91.7 vs. 53.8 %; P = 0.046). Fluoroscopic and total procedure times were significantly shorter in Group B: 14.7 versus 26.7 min (P = 0.001) and 64.8 versus 80.7 min (P = 0.0051), respectively. No differences were seen in the complication rate. The 1 year liver metastasis rates were 9.9 % using the conventional system and 9.1 % using the coaxial system (P = 0.678). The overall median survival time was 44 months. There was no difference in the survival period between two systems (P = 0.312).ConclusionsThe coaxial technique is useful for catheter placement after pancreatectomy, achieving a high success rate and reducing fluoroscopic and procedure times, while maintaining the safety and efficacy for adjuvant HAIC in pancreatic cancer.

  7. Adjuvant Hepatic Arterial Infusion Chemotherapy After Resection for Pancreatic Cancer Using Coaxial Catheter-Port System Compared with Conventional System

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Aya; Tanaka, Toshihiro, E-mail: toshihir@bf6.so-net.ne.jp [Nara Medical University, Department of Radiology (Japan); Sho, Masayuki [Nara Medical University, Department of Surgery (Japan); Nishiofuku, Hideyuki; Masada, Tetsuya; Sato, Takeshi; Marugami, Nagaaki [Nara Medical University, Department of Radiology (Japan); Anai, Hiroshi [Nara City Hospital, Department of Radiology (Japan); Sakaguchi, Hiroshi [Nara Prefectural Western Medical Center, Department of Radiology (Japan); Kanno, Masatoshi [Nara Medical University, Oncology Center (Japan); Tamamoto, Tetsuro; Hasegawa, Masatoshi [Nara Medical University, Department of Radiation Oncology (Japan); Nakajima, Yoshiyuki [Nara Medical University, Department of Surgery (Japan); Kichikawa, Kimihiko [Nara Medical University, Department of Radiology (Japan)

    2016-06-15

    PurposePrevious reports have shown the effectiveness of adjuvant hepatic arterial infusion chemotherapy (HAIC) in pancreatic cancer. However, percutaneous catheter placement is technically difficult after pancreatic surgery. The purpose of this study was to evaluate the feasibility and outcome of HAIC using a coaxial technique compared with conventional technique for postoperative pancreatic cancer.Materials and Methods93 consecutive patients who received percutaneous catheter-port system placement after pancreatectomy were enrolled. In 58 patients from March 2006 to August 2010 (Group A), a conventional technique with a 5-Fr indwelling catheter was used and in 35 patients from September 2010 to September 2012 (Group B), a coaxial technique with a 2.7-Fr coaxial catheter was used.ResultsThe overall technical success rates were 97.1 % in Group B and 86.2 % in Group A. In cases with arterial tortuousness and stenosis, the success rate was significantly higher in Group B (91.7 vs. 53.8 %; P = 0.046). Fluoroscopic and total procedure times were significantly shorter in Group B: 14.7 versus 26.7 min (P = 0.001) and 64.8 versus 80.7 min (P = 0.0051), respectively. No differences were seen in the complication rate. The 1 year liver metastasis rates were 9.9 % using the conventional system and 9.1 % using the coaxial system (P = 0.678). The overall median survival time was 44 months. There was no difference in the survival period between two systems (P = 0.312).ConclusionsThe coaxial technique is useful for catheter placement after pancreatectomy, achieving a high success rate and reducing fluoroscopic and procedure times, while maintaining the safety and efficacy for adjuvant HAIC in pancreatic cancer.

  8. Optimal application of the Contura multilumen balloon breast brachytherapy catheter vacuum port to deliver accelerated partial breast irradiation.

    Science.gov (United States)

    Tokita, Kenneth M; Cuttino, Laurie W; Vicini, Frank A; Arthur, Douglas W; Todor, Dorin A; Julian, Thomas B; Lyden, Maureen R

    2011-01-01

    The impact of using the Contura multilumen balloon (MLB) (SenoRx, Inc., Irvine, CA) breast brachytherapy catheter's vacuum port in patients treated with accelerated partial breast irradiation (APBI) was analyzed. Data from 32 patients at two sites were reviewed. Variables analyzed included the seroma fluid (SF):air volume around the MLB before and after vacuum port use and on its ability to improve (1) the eligibility of patients for APBI and (2) dose coverage of the planning target volume for evaluation (PTV_EVAL) in eligible patients. The median SF/air volume before vacuum removal was 6.8 cc vs. 0.8 cc after vacuum removal (median reduction in SF/air volume was 90.5%). Before vacuum port use, the median SF/air volume expressed as percentage of the PTV_EVAL was 7.8% (range, 1.9-26.6) in all patients. After application of the vacuum, this was reduced to 1.2%. Before vacuum port use, 10 (31.3%) patients were not considered acceptable candidates for APBI because the SF/air volume:PTV_EVAL ratio (SF:PTV) was greater than 10% (range, 10.1-26.6%; median, 15.2%). After vacuum port use, the median SF:PTV ratio was 1.6% for a median reduction of 91.5%. In addition, the percentage of the prescribed dose covering greater than or equal to 90% of the PTV_EVAL proportionally increased a median of 8% (range, 3-10%) in eligible patients. Use of the Contura MLB vacuum port significantly improved the conformity of the target tissue to the balloon surface, leading to reproducible dose delivery and increased target volume coverage. In addition, application of the vacuum allowed the safe treatment of unacceptable patients with APBI. Copyright © 2011 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  9. Risk factors for central line-associated bloodstream infection in pediatric oncology patients with a totally implantable venous access port: A cohort study.

    Science.gov (United States)

    Viana Taveira, Michelle Ribeiro; Lima, Luciana Santana; de Araújo, Cláudia Corrêa; de Mello, Maria Júlia Gonçalves

    2017-02-01

    Totally implantable venous access ports (TIVAPs) are used for prolonged central venous access, allowing the infusion of chemotherapy and other fluids and improving the quality of life of children with cancer. TIVAPs were developed to reduce the infection rates associated with central venous catheters; however, infectious events remain common and have not been fully investigated in pediatric oncology patients. A retrospective cohort was formed to investigate risk factors for central line-associated bloodstream infection (CLABSI) in pediatric cancer patients. Sociodemographic, clinical, and TIVAP insertion-related variables were evaluated, with the endpoint being the first CLABSI. A Kaplan-Meier analysis was performed to determine CLABSI-free catheter survival. Overall, 188 children were evaluated over 77,541 catheter days, with 94 being diagnosed with CLABSI (50%). Although coagulase-negative staphylococci were the pathogens most commonly isolated, Gram-negative microorganisms (46.8%) were also prevalent. In the multivariate analysis, factors that increased the risk for CLABSI were TIVAP insertion prior to chemotherapy (risk ratio [RR] = 1.56; P Risk factors for CLABSI in pediatric cancer patients with a TIVAP may be related to the severity of the child's condition at catheter insertion. Insertion of the catheter before chemotherapy and unfavorable conditions such as malnutrition and bone marrow aplasia can increase the risk of CLABSI. Protocols must be revised and surveillance increased over the first 10 weeks of treatment. © 2016 Wiley Periodicals, Inc.

  10. [Percutaneous catheter-based implantation of artificial pulmonary valves in patients with congenital heart defects].

    Science.gov (United States)

    Wyller, Vegard Bruun; Aaberge, Lars; Thaulow, Erik; Døhlen, Gaute

    2011-07-01

    Percutaneous catheter-based implantation of artificial heart valves is a new technique that may supplement surgery and which may be used more in the future. We here report our first experience with implantation of artificial pulmonary valves in children with congenital heart defects. Eligible patients were those with symptoms of heart failure combined with stenosis and/or insufficiency in an established artificial right ventricular outflow tract. The valve was inserted through a catheter from a vein in the groin or neck. Symptoms, echocardiography, invasive measurements and angiography were assessed for evaluation of treatment effect. Our treatment results are reported for the period April 2007-September 2009. Ten patients (seven men and three women, median age 17 years) were assessed. The procedure reduced pressure in the right ventricle (p = 0.008) and resolved the pulmonary insufficiency in all patients. The median time in hospital was two days. No patients had complications that were directly associated with the implantation procedure. One patient developed a pseudoaneurysm in the femoral artery, another had a short-lasting fever two days after the procedure and one patient experienced a stent fracture that required surgery 9 months after the implantation. After 6 months all patients had a reduced pressure gradient in the right ventricular outflow tract (p = 0.008), the pulmonary insufficiency had improved (p = 0.006) and they all reported improval of symptoms. These results persisted for at least 24 months for the four patients who were monitored until then. Percutaneous catheter-based implantation of artificial pulmonary valves improves hemodynamics in the right ventricle of selected patients with congenital heart defects. A randomized controlled study should be undertaken to provide a stronger evidence-base for usefulness of this procedure.

  11. Long-term facial artery catheter implantation for serial arterial blood sampling and invasive arterial blood pressure measurement in horses.

    Science.gov (United States)

    Dias, Deborah Penteado Martins; Teixeira, Luisa Gouvêa; Canola, Paulo Aléscio; Albernaz, Raquel Mincarelli; Marques, José Antônio; Neto, José Corrêa de Lacerda

    2012-06-01

    The purpose of this investigation was to evaluate surgical catheter implantation in the facial artery of horses and the long-term maintenance of such arteries using heparin and ascorbic acid as filling solution. Nine horses were implanted with a polyurethane catheter. The catheters were flushed with a heparin/ascorbic acid solution every 8h and remained patent for 25 days. Arterial blood samples were collected twice a day, and one exercise test that included serial blood samples and arterial pressure recordings was performed on a treadmill. Polyurethane catheters surgically implanted in the facial artery can be kept patent by filling with a heparin/ascorbic acid solution and provide convenient invasive arterial access in horses which is suitable for use for serial blood sampling and blood pressure recordings, even during exercise on treadmill. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Risk factors for venous port migration in a single institute in Taiwan

    OpenAIRE

    Fan, Wen-Chieh; Wu, Cheng-Han; Tsai, Ming-Ju; Tsai, Ying-Ming; Chang, Hsu-Liang; Hung, Jen-Yu; Chen, Pei-Huan; Yang, Chih-Jen

    2014-01-01

    Background An implantable port device provides an easily accessible central route for long-term chemotherapy. Venous catheter migration is one of the rare complications of venous port implantation. It can lead to side effects such as pain in the neck, shoulder, or ear, venous thrombosis, and even life-threatening neurologic problems. To date, there are few published studies that discuss such complications. Methods This retrospective study of venous port implantation in a single center, a Taiw...

  13. Severe neutropenia at time of port insertion is not a risk factor for catheter-associated infections in children with acute lymphoblastic leukemia.

    Science.gov (United States)

    Junqueira, Beatriz L P; Connolly, Bairbre; Abla, Oussama; Tomlinson, George; Amaral, Joao G

    2010-09-15

    The objective of this study was to determine whether severe neutropenia on the day of port-a-catheter (PORT) insertion was a risk factor for catheter-associated infection (CAI) in children with acute lymphoblastic leukemia (ALL). This was a retrospective study of children with ALL who had a PORT insertion between January 2005 and August 2008. Early (≤ 30 days) and late (>30 days) postprocedure complications were reviewed. The length of follow-up ranged between 7 months and 42 months. In total, 192 PORTs were inserted in 179 children. There were 43 CAIs (22%), and the infection rate was 0.35 per 1000 catheter-days. The CAI rate (15%) in children who had severe neutropenia on the day of the procedure did not differ statistically from the CAI rate (24%) in children who did not have severe neutropenia (P = .137). Conversely, patients with severe neutropenia who had a CAI were more likely to have their PORT removed (P = .019). The most common organisms to cause catheter removal were coagulase-negative Staphylococcus and Staphylococcus aureus. Patients with high-risk ALL had a statistically significant higher incidence of late CAI than patients with standard-risk ALL (P = .012). Age (P = .272), positive blood culture preprocedure (P = 1.0), and dexamethasone use (P = .201) were not risk factors for CAI. Patients who had an early CAI did not have a greater chance of having a late CAI. The catheter infection-free survival rate at 1 year was 88.6%. The current results indicated that severe neutropenia on the day of PORT insertion does not increase the risk of CAI in children with ALL. © 2010 American Cancer Society.

  14. Can using a peel-away sheath in shunt implantation prevent ventricular catheter obstruction?

    Science.gov (United States)

    Camlar, Mahmut; Ersahin, Yusuf; Ozer, Fusun Demirçivi; Sen, Fatih; Orman, Mehmet

    2011-02-01

    Shunt obstruction is the most common shunt complication. In 2003, Kehler et al. used peel-away sheath while implanting the ventricular catheter in 20 patients. They found less revision rate in the peel-away sheath group. We aimed to test the efficacy of this technique in cadavers. We used 100 fresh brains obtained from medicolegal autopsies. Posterior parietal and frontal approaches were used to puncture the lateral ventricle in each cerebral hemisphere. The ventricle is punctured with a peel-away sheath system. After the ventricle is reached, the mandarin is retracted and the ventricular catheter is introduced through the opening. The ventricular catheter was removed from the ventricle, the opening at the tip of the ventricular catheter was checked out for obstruction, and the number of patent and plugged openings was recorded. This procedure was repeated four times for each location with and without using peel-away sheath. The control group consisted of the procedures done without using peel-away sheath. The number of the plugged openings in the peel-away sheath group was significantly smaller than the control group. There was no significant difference between the two groups in terms of gender and left and right cerebral hemispheres. The obstruction rate was significantly lower in the posterior parietal approach. Pearson's correlation showed that increasing age was associated with less obstruction rate. Peel-away sheath decreases the number of plugged openings of the ventricular catheter. A clinical cooperative study is needed to prove that a peel-away sheath should be included in the ventricular shunt systems in the market.

  15. An ovine model of cerebral catheter venography for implantation of an endovascular neural interface.

    Science.gov (United States)

    Oxley, Thomas James; Opie, Nicholas Lachlan; Rind, Gil Simon; Liyanage, Kishan; John, Sam Emmanuel; Ronayne, Stephen; McDonald, Alan James; Dornom, Anthony; Lovell, Timothy John Haynes; Mitchell, Peter John; Bennett, Iwan; Bauquier, Sebastien; Warne, Leon Norris; Steward, Chris; Grayden, David Bruce; Desmond, Patricia; Davis, Stephen M; O'Brien, Terence John; May, Clive N

    2018-04-01

    OBJECTIVE Neural interface technology may enable the development of novel therapies to treat neurological conditions, including motor prostheses for spinal cord injury. Intracranial neural interfaces currently require a craniotomy to achieve implantation and may result in chronic tissue inflammation. Novel approaches are required that achieve less invasive implantation methods while maintaining high spatial resolution. An endovascular stent electrode array avoids direct brain trauma and is able to record electrocorticography in local cortical tissue from within the venous vasculature. The motor area in sheep runs in a parasagittal plane immediately adjacent to the superior sagittal sinus (SSS). The authors aimed to develop a sheep model of cerebral venography that would enable validation of an endovascular neural interface. METHODS Cerebral catheter venography was performed in 39 consecutive sheep. Contrast-enhanced MRI of the brain was performed on 13 animals. Multiple telescoping coaxial catheter systems were assessed to determine the largest wide-bore delivery catheter that could be delivered into the anterior SSS. Measurements of SSS diameter and distance from the motor area were taken. The location of the motor area was determined in relation to lateral and superior projections of digital subtraction venography images and confirmed on MRI. RESULTS The venous pathway from the common jugular vein (7.4 mm) to the anterior SSS (1.2 mm) was technically challenging to selectively catheterize. The SSS coursed immediately adjacent to the motor cortex (SSS. Attempted access with 5-Fr and 6-Fr delivery catheters was associated with longer procedure times and higher complication rates. A 4-Fr catheter (internal lumen diameter 1.1 mm) was successful in accessing the SSS in 100% of cases with no associated complications. Complications included procedure-related venous dissection in two major areas: the torcular herophili, and the anterior formation of the SSS. The

  16. A Simplified Technique of Percutaneous Hepatic Artery Port-Catheter Insertion for the Treatment of Advanced Hepatocellular Carcinoma with Portal Vein Invasion

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sun Young [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Kim, Ah Hyun; Lee, Do Yun; Lee, Kwang Hun; Won, Jong Yun [Yonsei University College of Medicine, Severance Hospital, Seoul (Korea, Republic of); Kim, Kyung Ah [Inje University Ilsan Paik Hospital, Ilsan (Korea, Republic of)

    2010-12-15

    We assessed the outcomes of a simplified technique for the percutaneous placement of a hepatic artery port-catheter system for chemotherapy infusion in advanced hepatocellular carcinoma with portal vein invasion. From February 2003 to February 2008, percutaneous hepatic artery port-catheter insertion was performed in 122 patients who had hepatocellular carcinoma with portal vein invasion. The arterial access route was the common femoral artery. The tip of the catheter was wedged into the right gastroepiploic artery without an additional fixation device. A side hole was positioned at the distal common hepatic artery to allow the delivery of chemotherapeutic agents into the hepatic arteries. Coil embolization was performed only to redistribute to the hepatic arteries or to prevent the inadvertent delivery of chemotherapeutic agents into extrahepatic arteries. The port chamber was created at either the supra-inguinal or infra-inguinal region. Technical success was achieved in all patients. Proper positioning of the side hole was checked before each scheduled chemotherapy session by port angiography. Catheter-related complications occurred in 19 patients (16%). Revision was achieved in 15 of 18 patients (83%). This simplified method demonstrates excellent technical feasibility, an acceptable range of complications, and is hence recommended for the management of advanced hepatocellular carcinoma with portal vein thrombosis

  17. Expanding TAVI options: elective rotational atherectomy during trans-catheter aortic valve implantation

    International Nuclear Information System (INIS)

    Piccoli, Anna; Lunardi, Mattia; Ariotti, Sara; Ferrero, Valeria; Vassanelli, Corrado; Ribichini, Flavio

    2015-01-01

    Summary: Aortic valve stenosis (AVS) in the elderly is frequently associated to coronary artery disease (CAD). In patients with significant coronary stenosis surgical valve replacement is associated to coronary bypass grafting, but whether coronary angioplasty is needed in patients receiving trans-catheter aortic valve implantation (TAVI) is unknown. Given the frequent complexity of CAD in the elderly with calcific AVS, rotational atherectomy (RA) may be needed in some cases. No data are available about feasibility and safety of RA during TAVI. The need for myocardial revascularization in TAVI candidates is discussed, and a series of RA cases performed during TAVI is described

  18. Expanding TAVI options: elective rotational atherectomy during trans-catheter aortic valve implantation

    Energy Technology Data Exchange (ETDEWEB)

    Piccoli, Anna; Lunardi, Mattia; Ariotti, Sara; Ferrero, Valeria; Vassanelli, Corrado; Ribichini, Flavio, E-mail: flavio.ribichini@univr.it

    2015-01-15

    Summary: Aortic valve stenosis (AVS) in the elderly is frequently associated to coronary artery disease (CAD). In patients with significant coronary stenosis surgical valve replacement is associated to coronary bypass grafting, but whether coronary angioplasty is needed in patients receiving trans-catheter aortic valve implantation (TAVI) is unknown. Given the frequent complexity of CAD in the elderly with calcific AVS, rotational atherectomy (RA) may be needed in some cases. No data are available about feasibility and safety of RA during TAVI. The need for myocardial revascularization in TAVI candidates is discussed, and a series of RA cases performed during TAVI is described.

  19. Transdermal power transfer for recharging implanted drug delivery devices via the refill port.

    Science.gov (United States)

    Evans, Allan T; Chiravuri, Srinivas; Gianchandani, Yogesh B

    2010-04-01

    This paper describes a system for transferring power across a transdermal needle into a smart refill port for recharging implantable drug delivery systems. The device uses a modified 26 gauge (0.46 mm outer diameter) Huber needle with multiple conductive elements designed to couple with mechanical springs in the septum of the refill port of a drug delivery device to form an electrical connection that can sustain the current required to recharge a battery during a reservoir refill session. The needle is fabricated from stainless steel coated with Parylene, and the refill port septum is made from micromachined stainless steel contact springs and polydimethylsiloxane. The device properties were characterized with dry and wet ambient conditions. The needle and port pair had an average contact resistance of less than 2 Omega when mated in either environment. Electrical isolation between the system, the liquid in the needle lumen, and surrounding material has been demonstrated. The device was used to recharge a NiMH battery with currents up to 500 mA with less than 15 degrees C of resistive heating. The system was punctured 100 times to provide preliminary information with regard to device longevity, and exhibited about 1 Omega variation in contact resistance. The results suggest that this needle and refill port system can be used in an implant to enable battery recharging. This allows for smaller batteries to be used and ultimately increases the volume efficiency of an implantable drug delivery device.

  20. Stuck long-term indwelling central venous catheters in adolescents: three cases and a short topical review

    DEFF Research Database (Denmark)

    Mortensen, A; Afshari, A; Henneberg, S W

    2010-01-01

    We present three cases of fixated vascular injection ports. Two patients had cystic fibrosis and one had an immunological defect. All catheters were made from polyurethane and implanted in adolescent patients. Indwelling time were 6-8 years. One patient's catheter was entirely integrated in the v......We present three cases of fixated vascular injection ports. Two patients had cystic fibrosis and one had an immunological defect. All catheters were made from polyurethane and implanted in adolescent patients. Indwelling time were 6-8 years. One patient's catheter was entirely integrated...

  1. Totally implantable central venous access port infections in patients with digestive cancer: incidence and risk factors.

    Science.gov (United States)

    Touré, Abdoulaye; Vanhems, Philippe; Lombard-Bohas, Catherine; Cassier, Philippe; Péré-Vergé, Denis; Souquet, Jean-Christophe; Ecochard, René; Chambrier, Cécile

    2012-12-01

    Central venous access port-related bloodstream infection (CVAP-BSI) is associated with morbidity and mortality in patients with cancer. This study examined the incidence rates and risk factors for CVAP-BSI in adult patients with digestive cancer. This prospective observational cohort study was performed from 2007 to 2011 in 2 oncology units of a university hospital. Incidence rate was expressed as number of CVAP-BSI per 1,000 catheter-days. A Cox regression model was used to identify risk factors for CVAP-BSI. A total of 315 patients were included. CVAP-BSI occurred in 41 patients (13.0%). The overall incidence rate was 0.76/1,000 catheter-days. The rate was higher in patients with esophageal cancer (1.28. P = .05) and pancreatic cancer (1.24; P = .007). Risk factors independently associated with CVAP-BSI were World Health Organization performance status between 2 and 4, catheter utilization-days in the previous month, pancreatic cancer, and parenteral nutrition. Coagulase-negative Staphylococci and enterobacteria were the main microorganisms isolated. In adult patients with digestive cancer, pancreatic cancer, cumulative catheter utilization-days, World Health Organization performance status, and parenteral nutrition were identified as independent risk factors for CVAP-BSI. Patients with any of these risk factors could be candidates for preventive strategies. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  2. Radiologically-placed venous ports in children under venous anesthesia

    International Nuclear Information System (INIS)

    Jang, Joo Yeon; Jeon, Ung Bae; Choo, Ki Seok; Hwang, Jae Yeon; Kim, Yong Woo; Lee, Yun Jin; Nam, Sang Ool; Lim, Young Tak

    2015-01-01

    To evaluate the efficacy and safety of radiologic venous port placement in children under venous anesthesia. Between April 2009 and July 2011, 44 ports were implanted in 41 children (24 boys, 17 girls). The age of patients ranged from 9 months to 19 years (mean, 6.5 years) and their body weights ranged from 6.8 kg to 56.3 kg (mean, 23.2 kg). Right internal jugular vein access was used in 42 ports, right subclavian vein in 1, and left subclavian in 1. Durability and complications of port implantation were reviewed. The technical success rate was 100%. The catheter life was 10-661 days (mean 246 days). Two patients died during the follow-up period, 21 and 6 ports were removed at the end of treatment or as a result of complications, respectively. One port was removed and replaced by a Hickmann catheter. Three ports were explanted due to port-related sepsis, one due to a catheter kink, and two for unexplained fever or insertion site pain. The overall port-related infection was 3 cases (6.8%, 0.28/1000 catheter days). Venous port placement by interventional radiologists in children under intravenous sedation is relatively safe, with a high rate of technical success and low rate of complications.

  3. Radiologically-placed venous ports in children under venous anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Joo Yeon; Jeon, Ung Bae; Choo, Ki Seok; Hwang, Jae Yeon; Kim, Yong Woo; Lee, Yun Jin; Nam, Sang Ool; Lim, Young Tak [Pusan National University School of Medicine, Yangsan (Korea, Republic of)

    2015-02-15

    To evaluate the efficacy and safety of radiologic venous port placement in children under venous anesthesia. Between April 2009 and July 2011, 44 ports were implanted in 41 children (24 boys, 17 girls). The age of patients ranged from 9 months to 19 years (mean, 6.5 years) and their body weights ranged from 6.8 kg to 56.3 kg (mean, 23.2 kg). Right internal jugular vein access was used in 42 ports, right subclavian vein in 1, and left subclavian in 1. Durability and complications of port implantation were reviewed. The technical success rate was 100%. The catheter life was 10-661 days (mean 246 days). Two patients died during the follow-up period, 21 and 6 ports were removed at the end of treatment or as a result of complications, respectively. One port was removed and replaced by a Hickmann catheter. Three ports were explanted due to port-related sepsis, one due to a catheter kink, and two for unexplained fever or insertion site pain. The overall port-related infection was 3 cases (6.8%, 0.28/1000 catheter days). Venous port placement by interventional radiologists in children under intravenous sedation is relatively safe, with a high rate of technical success and low rate of complications.

  4. Risk of extravasation after power injection of contrast media via the proximal port of multilumen central venous catheters. Case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Schummer, C.; Sakr, Y.; Reinhart, K. [Jena Univ. (Germany). Klinik fuer Anaestesiologie und Intensivtherapie; Steenbeck, J. [Jena Univ. (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Gugel, M. [Zentralklinik Bad Berka (Germany). Klinik fuer Anaesthesiologie und Intensivtherapie; Schummer, W. [SRH Zentralklinikum Suhl (Germany). Dept. of Anaesthesiology and Intensive Care Medicine

    2010-01-15

    Multilumen central venous catheters (CVCs) are not commonly used for power injection. However, in critically ill patients, CVCs - most of which do not have FDA approval for power injection - may be the only available venous access. The pitfalls of multilumen CVCs are illustrated by a case report of a patient in whom extravasation of intravenously administered contrast medium occurred after power injection in a triple-lumen CVC using the lumen with the port furthest from the catheter tip. The underlying mechanisms for the displacement of the initially correctly placed right subclavian CVC could include elevation of both arms of the obese patient or the power injection itself. The distances between port openings and catheter tips of various commercially available multilumen CVCs are assessed. We examine the possible caveats of ECG-guided CVC placement for optimal tip position, discuss technical difficulties related to power injection via CVCs, and review commonly used drugs that may cause extravasation injury. Knowledge of the distances between CVC port openings and the catheter tip are essential for safe intravasal administration of fluids. (orig.)

  5. Risk of extravasation after power injection of contrast media via the proximal port of multilumen central venous catheters. Case report and review of the literature

    International Nuclear Information System (INIS)

    Schummer, C.; Sakr, Y.; Reinhart, K.; Steenbeck, J.; Gugel, M.; Schummer, W.

    2010-01-01

    Multilumen central venous catheters (CVCs) are not commonly used for power injection. However, in critically ill patients, CVCs - most of which do not have FDA approval for power injection - may be the only available venous access. The pitfalls of multilumen CVCs are illustrated by a case report of a patient in whom extravasation of intravenously administered contrast medium occurred after power injection in a triple-lumen CVC using the lumen with the port furthest from the catheter tip. The underlying mechanisms for the displacement of the initially correctly placed right subclavian CVC could include elevation of both arms of the obese patient or the power injection itself. The distances between port openings and catheter tips of various commercially available multilumen CVCs are assessed. We examine the possible caveats of ECG-guided CVC placement for optimal tip position, discuss technical difficulties related to power injection via CVCs, and review commonly used drugs that may cause extravasation injury. Knowledge of the distances between CVC port openings and the catheter tip are essential for safe intravasal administration of fluids. (orig.)

  6. Comparison of Conventional versus Steerable-Catheter Guided Coronary Sinus Lead Positioning in Patients Undergoing Cardiac Resynchronization Device Implantation.

    Directory of Open Access Journals (Sweden)

    Fikret Er

    Full Text Available The aim of this study was to compare conventional versus steerable catheter guided coronary sinus (CS cannulation in patients with advanced heart failure undergoing cardiac resynchronization therapy (CRT.Steerable catheter guided coronary sinus cannulation could reduce fluoroscopy time and contrast medium use during CRT implantation.176 consecutive patients with ischemic and non-ischemic heart failure undergoing CRT implantation from January 2008 to December 2012 at the University Hospital of Cologne were identified. During the study period two concurrent CS cannulation techniques were used: standard CS cannulation technique (standard-group, n = 113 and CS cannulation using a steerable electrophysiology (EP catheter (EPCath-group, n = 63. Propensity-score matched pairs of conventional and EP-catheter guided CS cannulation made up the study population (n = 59 pairs. Primary endpoints were total fluoroscopy time and contrast medium amount used during procedure.The total fluoroscopy time was 30.9 min (interquartile range (IQR, 19.9-44.0 min in the standard-group and 23.4 min (IQR, 14.2-34-2 min in the EPCath-group (p = 0.011. More contrast medium was used in the standard-group (60.0 ml, IQR, 30.0-100 ml compared to 25.0 ml (IQR, 20.0-50.0 ml in the EPCath-group (P<0.001.Use of steerable EP catheter was associated with significant reduction of fluoroscopy time and contrast medium use in patients undergoing CRT implantation.

  7. Hematologic patients' clinical and psychosocial experiences with implanted long-term central venous catheter

    DEFF Research Database (Denmark)

    Møller, Tom; Adamsen, Lis

    2010-01-01

    A significant decrease in catheter-related infections was demonstrated in our earlier randomized controlled trial of central venous catheter (CVC) care in hematologic patients.......A significant decrease in catheter-related infections was demonstrated in our earlier randomized controlled trial of central venous catheter (CVC) care in hematologic patients....

  8. Long-term amnioinfusion through a subcutaneously implanted amniotic fluid replacement port system for treatment of PPROM in humans.

    Science.gov (United States)

    Tchirikov, Michael; Steetskamp, Joscha; Hohmann, Manfred; Koelbl, Heinz

    2010-09-01

    To introduce a novel method for the treatment of PPROM (preterm premature rupture of membranes) using continuous amnioinfusion via a subcutaneously implanted port system. After development and testing since 2001 in a fetal sheep model, the port system has been successfully implanted in two humans with PPROM. In the first case, the subcutaneous port system was implanted during the 23rd week of gestation in a 39-year-old 5th-gravida with PPROM since the 18th week of gestation; in the second case, the port system was implanted during the 24th week of gestation in a 27-year-old 3rd gravida with PPROM since the 21st week of gestation. After port implantation, 100ml/h saline solution was infused intermittently into the amniotic cavity. The whole course of treatment was supported by tocolysis. In the cases presented, gestation was terminated by cesarean section, in one case in the 29th week of gestation, and in the other case in the 30th week. The newborns showed no signs of lung hypoplasia and were successfully extubated on the 1st or 2nd day after delivery. Six months later the children did not exhibit any deviation from the normal development. Long-term amnioinfusion via a subcutaneously implanted port system could be used in humans with PPROM for prolongation of pregnancy and to avoid lung hypoplasia. Prospective randomized studies are ongoing. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  9. Unplanned Start on Peritoneal Dialysis Right after PD Catheter Implantation for Older People with End-Stage Renal Disease.

    Science.gov (United States)

    Povlsen, Johan V; Sørensen, Anette Bagger; Ivarsen, Per

    2015-11-01

    Unplanned start on dialysis remains a major problem for the dialysis community worldwide. Late-referred patients with end-stage renal disease (ESRD) and urgent need for dialysis are overrepresented among older people. These patients are particularly likely to be started on in-center hemodialysis (HD), with a temporary vascular access known to be associated with excess mortality and increased risks of potentially lethal complications such as bacteremia and central venous thrombosis or stenosis.The present paper describes in detail our program for unplanned start on automated peritoneal dialysis (APD) right after PD catheter implantation and summarizes our experiences with the program so far. Compared with planned start on PD after at least 2 weeks of break-in between PD catheter implantation and initiation of dialysis, unplanned start may be associated with a slight increased risk of mechanical complications but apparently no detrimental effect on mortality, peritonitis-free survival, or PD technique survival.In our opinion and experience, the risk of serious complications associated with the implantation and immediate use of a PD catheter is less than the risk of complications associated with unplanned start on HD with a temporary central venous catheter (CVC). Unplanned start on APD is a gentle, safe, and feasible alternative to unplanned start on HD with a temporary CVC that is also valid for the late-referred older patient with ESRD and urgent need for dialysis. Copyright © 2015 International Society for Peritoneal Dialysis.

  10. Impact of the shape of the implantable ports on their efficiency of flow (injection and flushing

    Directory of Open Access Journals (Sweden)

    Guiffant G

    2014-09-01

    Full Text Available Gérard Guiffant,1 Patrice Flaud,1 Jean Jacques Durussel,1 Jacques Merckx1,2 1Université Paris Diderot, Paris, France; 2University Teaching Hospital Necker-Enfants Malades, Paris, FranceAbstract: Now widely used, totally implantable venous access devices allow mid- and long-term, frequent, repeated, or continuous injection of therapeutic products by vascular, cavitary, or perineural access. The effective flushing of these devices is a key factor that ensures their long-lasting use. We present experimental results and a numerical simulation to demonstrate that the implementation of rounded edge wall cavities improves flushing efficiency. We use the same approaches to suggest that the deposit amount may be reduced by the use of rounded edge wall cavities. Keywords: implantable ports, totally implantable venous access devices, flushing, obstruction, prevention

  11. Combined therapy involving hepatic arterial chemoinfusion through a percutaneously implanted port, and external irradiation for advanced hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Kim, Jong Won; Suh, Sang Hyun; Won, Jong Yun

    2002-01-01

    To evaluate the efficacy of combined therapy involving intra-arterial hepatic chemoinfusion through a percutaneously implanted port and external irradiation for the treatment of advanced hepatocellular carcinoma. Fifteen patients (2 males and 3 females; mean age=47.5 years) with advanced hepatocellular carcinoma localized in one lobe and with portal vein thrombosis (stage IVa) were included in this study. To permit chemoinfusion through the hepatic artery, a chemoport was implanted percutaneously in the right inguinal area via the femoral artery. Initial external radiation therapy lasted five weeks (44 Gy in a daily fraction of 1.8 Gy), with concurrent intra-arterial hepatic infusion of 5-fluorouracil. This initial treatment was followed by five cycles of intra-arterial hepatic infusion of cisplatin and 5-fluorouracil for three consecutive days every month.Two and six months after treatment was begun, the patients underwent CT scanning and angiography, and their response was assessed in terms of change in tumor size and vascularity, the degree of portal vein thrombosis and arterio-portal shunt, and alpha-fetoprotein levels. Any complications arising from this combined therapy and the clinical status of each patient were also followed up during the treatment period. The response rates at months 2 and 6 were 60% and 33.3%, respectively. One patient (6.7%) showed complete remission, and serum alpha-fetoprotein levels decreased significantly in all patients who responded. In five of the twelve patients, the thrombi in the main portal vein showed marked regression. The one-year survival rate was 30% and the median survival period was 10.6 (range, 3.7 to 28) months. The complications arising after treatment involved the catheter-port system (n=2) or were due to gastroduodenitis (n=9). In these patients with advanced hepatocellular carcinoma and portal vein thronbosis, combined therapy involving hepatic arterial chemoinfusion through a chemoport and external irradiation

  12. Combined therapy involving hepatic arterial chemoinfusion through a percutaneously implanted port, and external irradiation for advanced hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Kim, Jong Won; Suh, Sang Hyun; Won, Jong Yun; Lee, Do Yun; Park, Sung Il; Lee, Jong Tae; Moon, Young Myoung; Chon, Chae Yoon; Han, Kwang Hyup; Seoung, Jin Sil

    2002-01-01

    To evaluate the efficacy of combined therapy involving intra-arterial hepatic chemoinfusion through a percutaneously implanted port and external irradiation for the treatment of advanced hepatocellular carcinoma. Fifteen patients (12 males and 3 females; mean age = 47.5 years) with advanced hepatocellular carcinoma localized in one lobe and with portal vein thrombosis (stage IVa) were included in this study. To permit chemoinfusion through the hepatic artery, a Chemoport was implanted percutaneously in the right inguinal area via the femoral artery. Initial external radiation therapy lasted five weeks (44 Gy in a daily fraction of 1.8 Gy), with concurrent intra-arterial hepatic infusion of 5-fluorouracil. This initial treatment was followed by five cycles of intra-arterial hepatic infusion of cisplatin and 5-fluorouracil for three consecutive days every month. Two and six months after treatment was begun, the patients underwent CT scanning and angiography, and their response was assessed in terms of change in tumor size and vascularity, the degree of portal vein thrombosis and arterio-portal shunt, and alpha-fetoprotein levels. Any complications arising from this combined therapy and the clinical status of each patient were also followed up during the treatment period. The response rates at months 2 and 6 were 60% and 33.3%, respectively. One patient (6.7%) showed complete remission, and serum alpha-fetoprotein levels decreased significantly in all patients who responded. In five of the twelve patients, the thrombi in the main portal vein showed marked regression. The one-year survival rate was 30% and the median survival period was 10.6 (range, 3.7 to 28) months. The complications arising after treatment involved the catheter-port system (n=2) or were due to gastroduodenitis (n=9). In these patients with advanced hepatocellular carcinoma and portal vein thronbosis, combined therapy involving hepatic arterial chemoinfusion through a chemoport and external

  13. Combined therapy involving hepatic arterial chemoinfusion through a percutaneously implanted port, and external irradiation for advanced hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Won; Suh, Sang Hyun; Won, Jong Yun [Yonsei University College of Medicine, Seoul (Korea, Republic of)] [and others

    2002-12-01

    To evaluate the efficacy of combined therapy involving intra-arterial hepatic chemoinfusion through a percutaneously implanted port and external irradiation for the treatment of advanced hepatocellular carcinoma. Fifteen patients (2 males and 3 females; mean age=47.5 years) with advanced hepatocellular carcinoma localized in one lobe and with portal vein thrombosis (stage IVa) were included in this study. To permit chemoinfusion through the hepatic artery, a chemoport was implanted percutaneously in the right inguinal area via the femoral artery. Initial external radiation therapy lasted five weeks (44 Gy in a daily fraction of 1.8 Gy), with concurrent intra-arterial hepatic infusion of 5-fluorouracil. This initial treatment was followed by five cycles of intra-arterial hepatic infusion of cisplatin and 5-fluorouracil for three consecutive days every month.Two and six months after treatment was begun, the patients underwent CT scanning and angiography, and their response was assessed in terms of change in tumor size and vascularity, the degree of portal vein thrombosis and arterio-portal shunt, and alpha-fetoprotein levels. Any complications arising from this combined therapy and the clinical status of each patient were also followed up during the treatment period. The response rates at months 2 and 6 were 60% and 33.3%, respectively. One patient (6.7%) showed complete remission, and serum alpha-fetoprotein levels decreased significantly in all patients who responded. In five of the twelve patients, the thrombi in the main portal vein showed marked regression. The one-year survival rate was 30% and the median survival period was 10.6 (range, 3.7 to 28) months. The complications arising after treatment involved the catheter-port system (n=2) or were due to gastroduodenitis (n=9). In these patients with advanced hepatocellular carcinoma and portal vein thronbosis, combined therapy involving hepatic arterial chemoinfusion through a chemoport and external irradiation

  14. Risk factors and possible mechanisms of superior vena cava intravenous port malfunction.

    Science.gov (United States)

    Wu, Ching-Yang; Hu, Han-Chung; Ko, Po-Jen; Fu, Jui-Ying; Wu, Ching-Feng; Liu, Yun-Hen; Li, Hao-Jui; Kao, Tsung-Chi; Kao, Kuo-Chin; Yu, Sheng-Yueh; Chang, Chee-Jen; Hsieh, Hong-Chang

    2012-05-01

    To identify the risk factors leading to catheter malfunction. Reliable venous access is crucial for cancer patients. Malfunction of intravenous ports may lead to discontinuation of treatment and repeated interventions. We retrospectively reviewed the independent risk factors for catheter malfunction among patients receiving intravenous port implantations. A total of 1508 procedures were included from the calendar year 2006, and clinical data and chest plain films were analyzed. The patients were followed-up until June 30, 2010. For patients still alive, the last outpatient follow-up date was considered as the end point. For the remaining patients, the date of death or discharge against advice was considered as the end points. The risk factors for catheter malfunction were then evaluated. The intervention-free periods of the malfunction group and nonmalfunction group were 317 and 413 days, respectively. Statistical analyses showed that the Nut-Catheter Angle was the only risk factor for catheter malfunction (P = 0.001). A logistic model also confirmed that the Nut-Catheter Angle was the only risk factor for catheter malfunction (P risk for catheter malfunction. Catheter impingement caused by inadequate pocket creation and port implantation lead to compromised catheter lumen and difficulty flushing. The possibility of retained blood and medications increased thin thrombotic biofilm formation and medication precipitation. Catheter malfunctions can be avoided by using proper surgical techniques and adequate maintenance.

  15. Compatibility of electrolytically produced sodium hypochlorite solutions on long- term implanted dialysis catheters.

    Science.gov (United States)

    Mishkin, G J

    2007-01-01

    More than 20% of the world's population use a catheter for dialysis, despite guidelines limiting their use. Although the structure and design of the catheters differ by manufacturer, the material used in central venous catheters and peritoneal dialysis catheters are the same across manufacturers. Given the long-term use of these catheters in the dialysis population, the good compatibility of the antiseptics and disinfectants used on the catheters is imperative to prevent failure and cracking of the catheter material. Tensile strengths of commercially available catheters were measured after exposure to commonly used disinfectants. The tensile strength was then compared between the catheters by analyzing the displacement vs. force (N) curves produced during the evaluation. A total of 44 catheter lumens were evaluated. The electrolytically produced sodium hypochlorite solution, Alcavis 50/ExSept Plus, was the only solution shown to be compatible with all three catheter materials resulting in a deviation of less than 10% for each of the different catheter types. Electrolytically produced sodium hypochlorite solutions were the only solutions in this study that did not alter the physical properties of any of the catheters after long-term exposure.

  16. Safety related to the implantation of jugular catheters for haemodialysis and usefulness of PA chest X rays post procedure

    International Nuclear Information System (INIS)

    Restrepo, Cesar A; Chacon, Jose Arnob; Mauricio Villota, Duvan

    2007-01-01

    The objective is to determine how safe the implantation of transient double lumen jugular catheters is for hemodialysis in patients with renal disease, and who require dialysis therapy and Posterior Anterior (PA) chest X-Ray post procedure. Design: observational descriptive study. Site: renal units at RTS Ltda. Sucursal Caldas (Hospital Santa Sofia y Hospital Infantil Rafael Henao Toro de la Cruz Roja). Patients: all patients with renal disease in whom it was necessary to do hemodyalitic therapy with implantation of a jugular catheter, with medical records of the events and complications that occurred during the procedure, with subsequent control AP chest X Ray and that showed reports made by the radiologist or physician who carried out the procedure, about the findings in the chest X Ray. Patients with renal disease, in whom jugular catheters had been inserted: Methods: variables such as age, gender, race, body mass index (BMI) etiology of the renal failure,time of evolution of the disease, indications for insertion, priority of catheter insertion, type of catheter inserted, amount of punctures, physician who carried out the procedure and patient's co-morbidities were analyzed. The events considered as complicated were analyzed as well as if there was any relationship with co-morbidities and the analyzed variables. Findings in the PA chest X-Ray were recorded and their relationship with the difficulties encountered during the procedure. A bi-variance analysis was done. The dependent and independent variables were classified in the nominal measurement scale. Results: 774 clinical histories were reviewed. 562 were excluded due to lack of variables and impossibility to read the notes. Men older than de 55 (45,7%). 212 (97.1%) patients with diagnosis of chronic renal disease (CRD) and in whom 238 procedures were carried out. seven patients (2,85%) had acute renal failure (ARF). The fi rst indication for central catheter insertion was in patients with chronic uremia

  17. [Pain control by continuous infusion of morphine using subarachnoid catheter access to the port--a report of a home death case].

    Science.gov (United States)

    Kawagoe, Koh; Matsuura, Shinobu

    2008-12-01

    This is a case of a 50s male with cecal cancer suffering from severe pain caused by osteolytic metastasis to the lumbar vertebra, right iliac bone, and the head of the right femur. The pain was palliated by continuous infusion of morphine using a subarachnoid catheter that had access to the subcutaneous "Port". The maximum dose of morphine used a day was 384 mg, which corresponded to 57,600 mg/day of oral morphine. Sixty eight days after the start of home hospice care, the patient died at home because of diffuse peritonitis caused by intestinal rupture.

  18. Effect of Foley catheters on seed positions and urethral dose in 125I and 103Pd prostate implants

    International Nuclear Information System (INIS)

    Brezovich, Ivan A.; Pareek, Prem N.; Duan, Jun; Fiveash, John

    2001-01-01

    Purpose: To estimate the perturbation of seed position and urethral dose, subsequent to withdrawal of urethral catheters. Methods and Materials: A mathematical model based on the volume incompressibility of tissues was used to compute seed positions and doses following removal of the Foley. The model assumed that the central axis of the urethra remains stationary, and that prostate tissue and seeds move radially toward the center of the urethra to fill the void left by the catheter. Seed motion has also been measured using transrectal ultrasound. Results: Based on the computations, seeds located originally close to the urethra travel relatively large distances toward the urethra upon Foley removal, whereas seeds located further away move substantially less. This seed motion leads to higher urethral doses than shown in a standard treatment plan. Dose enhancements increase with catheter size, decrease with increasing prostate volume, are more pronounced for 103 Pd than for 125 I, and range between 3.5% and 32.4%. Postimplant dosimetry is equally affected if images are taken with urethral catheters in place, showing lower urethral doses than actually delivered. Preliminary ultrasound based measurements of seed motion agree with the theory. Conclusion: During the implantation procedure, 12 fr or smaller urethral catheters are preferable to larger diameter catheters if urine drainage is sufficient. Treatment planners should avoid planning seeds at 5 mm or closer from the urethra. Special caution is indicated in prostates having about 20 cm 3 or smaller volumes, and when 103 Pd is used. Postimplant dosimetry is susceptible to the same errors

  19. Peripheral Insertion of a Central Venous Access Device Under Fluoroscopic Guidance Using a Peripherally Accessed System (PAS) Port in the Forearm

    International Nuclear Information System (INIS)

    Hata, Yasuhiro; Morita, Sojiro; Morita, Yoshitaka; Awatani, Toshihide; Takasaki, Motohiro; Horimi, Tadashi; Ozawa, Zen

    1998-01-01

    Purpose: We describe the technique, efficacy, and complications of fluoroscopy-guided implantation of a central venous access device using a peripherally accessed system (PAS) port via the forearm. Methods: Beginning in July 1994, 105 central venous access devices were implanted in 104 patients for the long-term infusion of antibiotics or antineoplasmic agents, blood products, or parenteral nutrition. The devices was inserted under fluoroscopic guidance with real-time venography from a peripheral route. Results: All ports were successfully implanted. There were no procedure-related complications. No thrombosis or local infection was observed; however, in six patients catheter-related phlebitis occurred. Conclusion: Fluoroscopy-guided implantation of a central venous access device using a PAS port via the forearm is safe and efficacious, and injection of contrast medium through a peripheral IV catheter before introduction of the catheter helps to avoid catheter-related phlebitis

  20. Central venous catheters - ports

    Science.gov (United States)

    ... do any contact sports, such as soccer and football. Nothing will stick out of your skin when ... herein should not be used during any medical emergency or for the diagnosis or treatment of any ...

  1. Frequency of colonization and isolated bacteria from the tip of epidural catheter implanted for postoperative analgesia.

    Science.gov (United States)

    Stabille, Débora Miranda Diogo; Diogo Filho, Augusto; Mandim, Beatriz Lemos da Silva; de Araújo, Lúcio Borges; Mesquita, Priscila Miranda Diogo; Jorge, Miguel Tanús

    2015-01-01

    The increased use of epidural analgesia with catheter leads to the need to demonstrate the safety of this method and know the incidence of catheter colonization, inserted postoperatively for epidural analgesia, and the bacteria responsible for this colonization. From November 2011 to April 2012, patients electively operated and maintained under epidural catheter for postoperative analgesia were evaluated. The catheter tip was collected for semiquantitative and qualitative microbiological analysis. Of 68 cultured catheters, six tips (8.8%) had positive cultures. No patient had superficial or deep infection. The mean duration of catheter use was 43.45 h (18-118) (p=0.0894). The type of surgery (contaminated or uncontaminated), physical status of patients, and surgical time showed no relation with the colonization of catheters. Microorganisms isolated from the catheter tip were Staphylococcus aureus, Pseudomonas aeruginosa and Sphingomonas paucimobilis. Postoperative epidural catheter analgesia, under these study conditions, was found to be low risk for bacterial colonization in patients at surgical wards. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  2. Complications of Central Venous Totally Implantable Access Port: Internal Jugular Versus Subclavian Access

    Directory of Open Access Journals (Sweden)

    Pil Young Jung

    Full Text Available Background: Totally implantable access port (TIAP provides reliable, long term vascular access with minimal risk of infection and allows patients normal physical activity. With wide use of ports, new complications have been encountered. We analyzed TIAP related complications and evaluated the outcomes of two different percutaneous routes of access to superior vena cava. Methods: All 172 patients who underwent port insertion with internal jugular approach (Group 1, n = 92 and subclavian approach (Group 2, n = 79 between August 2011 and May 2013 in a single center were analyzed, retrospectively. Medical records were analyzed to compare the outcomes and the occurrence of port related complications between two different percutaneous routes of access to superior vena cava. Results: Median follow-up for TIAP was 278 days (range, 1-1868. Twenty four complications were occurred (14.0%, including pneumothorax (n = 1, 0.6%, migration/malposition (n = 4, 2.3%, pinch-off syndrome (n = 4, 2.3%, malfunction (n = 2, 1.1%, infection (n = 8, 4.7%, and venous thrombosis (n = 5, 2.9%. The overall incidence was 8.7% and 20.3% in each group (p = 0.030. Mechanical complications except infectious and thrombotic complications were more often occurred in group 2 (p = 0.033. The mechanical complication free probability is significantly higher in group 1 (p = 0.040. Conclusions: We suggest that the jugular access should be chosen in patients who need long term catheterization because of high incidence of mechanical complication, such as pinch-off syndrome.

  3. Intracoronary stent implantation: new approach using a monorail system and new large-lumen 7F catheters from the brachial route.

    Science.gov (United States)

    Jenny, D B; Robert, G P; Fajadet, J C; Cassagneau, B G; Marco, J

    1992-04-01

    In this brief report we describe a case of successful multivessel PTCA with intracoronary stent implantation using a new large-lumen 7F catheter from the left brachial approach. The application of this technique should be considered for intravascular stent implantation when anticoagulation ideally should not be interrupted or in anatomical situations limiting femoral vascular access.

  4. Comparison of two indwelling central venous access catheters in dogs undergoing fractionated radiotherapy

    International Nuclear Information System (INIS)

    Evans, K.L.; Smeak, D.D.; Couto, C.G.; Hammer, A.S.; Gaynor, J.S.

    1994-01-01

    Twenty dogs with neoplasms requiring multiple radiation treatments received either percutaneous vascular access catheters (PVACs; Cook, Bloomington, IN) or subcutaneous vascular access ports (SVAPs; Vascular-Access-Ports, Norfolk Medical Products, Inc., Skokie, IL); 10 dogs were entered in each group. All catheters were implanted and removed aseptically and the catheter tips were cultured during implant removal. Complications with PVACs included mild incisional swelling and redness and accidental severance or rupture of the catheter. Complications with SVAPs included incisional or port swelling, bruising or redness, hematoma formation, and pain. Ports in 4 of these dogs could not be used for 1 to 3 days after surgery because of swelling and pain. Surgical wound complications, when pooled for comparison, occurred significantly more frequently with the SVAPs (P = .023). Wound complications associated with both catheters were self-limiting and resolved within 7 days. Bacterial cultures were positive in two PVACs and four SVAP tips, however, none of these dogs had clinical signs of infection or sepsis. Although both types of indwelling catheters were functional in a clinical setting, PVACs were preferred to SVAPs for dogs undergoing radiation therapy because of decreased time for implantation and fewer overall complications

  5. Peripheral Venous Access Ports: Outcomes Analysis in 109 Patients

    International Nuclear Information System (INIS)

    Bodner, Leonard J.; Nosher, John L.; Patel, Kaushik M.; Siegel, Randall L.; Biswal, Rajiv; Gribbin, Christopher E.; Tokarz, Robert

    2000-01-01

    Purpose: To perform a retrospective outcomes analysis of central venous catheters with peripheral venous access ports, with comparison to published data.Methods: One hundred and twelve central venous catheters with peripherally placed access ports were placed under sonographic guidance in 109 patients over a 4-year period. Ports were placed for the administration of chemotherapy, hyperalimentation, long-term antibiotic therapy, gamma-globulin therapy, and frequent blood sampling. A vein in the upper arm was accessed in each case and the catheter was passed to the superior vena cava or right atrium. Povidone iodine skin preparation was used in the first 65 port insertions. A combination of Iodophor solution and povidone iodine solution was used in the last 47 port insertions. Forty patients received low-dose (1 mg) warfarin sodium beginning the day after port insertion. Three patients received higher doses of warfarin sodium for preexistent venous thrombosis. Catheter performance and complications were assessed and compared with published data.Results: Access into the basilic or brachial veins was obtained in all cases. Ports remained functional for a total of 28,936 patient days. The port functioned in 50% of patients until completion of therapy, or the patient's expiration. Ports were removed prior to completion of therapy in 18% of patients. Eleven patients (9.9% of ports placed) suffered an infectious complication (0.38 per thousand catheter-days)-in nine, at the port implantation site, in two along the catheter. In all 11 instances the port was removed. Port pocket infection in the early postoperative period occurred in three patients (4.7%) receiving a Betadine prep vs two patients (4.2%) receiving a standard O.R. prep. This difference was not statistically significant (p = 0.9). Venous thrombosis occurred in three patients (6.8%) receiving warfarin sodium and in two patients (3%) not receiving warfarin sodium. This difference was not statistically significant

  6. Minimal displacement of novel self-anchoring catheters suitable for temporary prostate implants

    Energy Technology Data Exchange (ETDEWEB)

    Pieters, Bradley R; Grient, Johan N.B. van der; Blank, Leo E.C.M.; Koedooder, Kees; Hulshof, Maarten C.C.M.; Reijke, Theo M. de

    2006-07-15

    Catheters were developed that can be fixed in the prostate gland by self-expanding parts for use in PDR brachytherapy. Daily CT-scans were made to investigate the magnitude of catheter displacement. The mean absolute displacement during the 3 day treatment was 1.2 mm. The resulting minor alterations in dose-volume parameters were of no clinical importance.

  7. Minimal displacement of novel self-anchoring catheters suitable for temporary prostate implants

    International Nuclear Information System (INIS)

    Pieters, Bradley R.; Grient, Johan N.B. van der; Blank, Leo E.C.M.; Koedooder, Kees; Hulshof, Maarten C.C.M.; Reijke, Theo M. de

    2006-01-01

    Catheters were developed that can be fixed in the prostate gland by self-expanding parts for use in PDR brachytherapy. Daily CT-scans were made to investigate the magnitude of catheter displacement. The mean absolute displacement during the 3 day treatment was 1.2 mm. The resulting minor alterations in dose-volume parameters were of no clinical importance

  8. Central venous catheters: detection of catheter complications and therapeutical options

    International Nuclear Information System (INIS)

    Gebauer, B.; Beck, A.; Wagner, H.J.; Vivantes-Kliniken, Hellersdorf und Prenzlauer Berg

    2008-01-01

    For modern medicine central venous catheters play an important role for diagnostic and therapeutic options. Catheter implantation, complication detection and therapy of catheter complications are an increasing demand for the radiologist. The review article provides an overview of different catheter types, their indications, advantages and disadvantages. Catheter malpositions are usually detectable in conventional X-ray. Most malpositions are correctable using interventional-radiological techniques. In addition therapeutical options for thrombotic complications (venous thrombosis, catheter occlusion, fibrin sheath) are discussed. In case of an infectious catheter complication, usually a catheter extraction and re-implantation is necessary

  9. Feasibility of power contrast injections and bolus triggering during CT scans in oncologic patients with totally implantable venous access ports of the forearm

    International Nuclear Information System (INIS)

    Goltz, Jan Peter; Machann, Wolfram; Noack, Claudia; Hahn, Dietbert; Kickuth, Ralph

    2011-01-01

    Background: Conventional totally implantable venous access ports (TIVAPs) are not approved for power contrast injections but often remain the only venous access site in oncologic patients. Therefore, these devices can play an important role if patients with a TIVAP are scheduled for a contrast-enhanced computed tomography (ceCT) as vascular access may become more difficult during the course of chemotherapy. Purpose: To evaluate the feasibility and safety of power injections in conventional TIVAPs in the forearm and to analyze the feasibility of bolus triggering during CT scans. Material and Methods: In this retrospective study we analyzed 177 power injections in 141 patients with TIVAPs in the forearm. Between October 2008 and March 2010 all patients underwent power injections (1.5 mL/s, 150 psi) via the TIVAP for ceCT because conventional vascular access via a peripheral vein had failed. Adequate functioning and catheter's tip location after injection were evaluated. Peak injection pressure and attenuation levels of aorta, liver and spleen were analyzed and compared with results of 50 patients who were injected via classical peripheral cannulas (3 mL/s, 300 psi). Feasibility of automatic scan initiation was evaluated. In vitro the port was stressed with 5 mL/s (300 psi). Results: One TIVAP showed tip dislocation with catheter rupture. Three (2.1%) devices were explanted owing to assumed infection within 4 weeks after the injection. Mean injection pressure was 121.9 ±24.1 psi. Triggering with automatic scan initiation succeeded in 13/44 (29.6%) scans. Injection via classical cannulas resulted in significantly higher enhancement (p < 0.05). In vitro the port system tolerated flow rates of up to 5 mL/s, injection pressures of up to 338 psi. Conclusion: Power injection is a safe alternative for patients with TIVAPs in the forearm if classic vascular access ultimately fails. Triggering was successful in one-third of the attempts. Image quality in the arterial phase

  10. Comparison of three types of central venous catheters in patients with malignant tumor receiving chemotherapy

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    Fang S

    2017-07-01

    Full Text Available Shirong Fang,1 Jinhong Yang,2 Lei Song,3 Yan Jiang,1 Yuxiu Liu4 1Department of Anesthesiology, 2Department of Oncology, Weifang People’s Hospital, Weifang, 3Intensive Care Unit, The Affiliated Hospital of Qingdao University, Qingdao, 4Nursing College, Weifang Medical University, Weifang, People’s Republic of China Background: Central venous catheters (CVCs have been an effective access for chemotherapy instead of peripherally intravenous catheters. There were limited studies on the choices and effects of different types of CVCs for chemotherapy. The aim of this study was to compare the complications, cost, and patients’ quality of life and satisfaction of three commonly used CVCs for chemotherapy, such as implanted venous port, peripherally inserted central catheters (PICCs, and external non-tunneled central venous catheters (NTCs.Methods: A double-center prospective cohort study was carried out from March 2014 to December 2016. Catheterization situation, complications, catheter maintenance, cost, and patients’ quality of life and satisfaction were recorded, investigated, and analyzed. Forty-five ports, 60 PICCs and 40 NTCs were included. All the CVCs were followed up to catheter removal.Results: There was no statistical difference in catheterization success rates between port and PICC. NTC had less success rate by one puncture compared with port. Ports had fewer complications compared with PICCs and NTCs. The complication rates of ports, PICCs and NTCs were 2.2%, 40%, and 27.5%, respectively. If the chemotherapy process was <12 months, NTCs cost least, and the cost of port was much higher than PICC and NTC. When the duration time was longer than 12 months, the cost of port had no difference with the cost of PICC. Quality of life and patients’ satisfaction of port group were significantly higher than the other two groups. Conclusion: Although port catheterization costs more and needs professional medical staff and strict operational

  11. Measurement of cardiac index by transpulmonary thermodilution using an implanted central venous access port: a prospective study in patients scheduled for oncologic high-risk surgery.

    Science.gov (United States)

    Suria, Stéphanie; Wyniecki, Anne; Eghiaian, Alexandre; Monnet, Xavier; Weil, Grégoire

    2014-01-01

    Transpulmonary thermodilution allows the measurement of cardiac index for high risk surgical patients. Oncologic patients often have a central venous access (port-a-catheter) for chronic treatment. The validity of the measurement by a port-a-catheter of the absolute cardiac index and the detection of changes in cardiac index induced by fluid challenge are unknown. We conducted a monocentric prospective study. 27 patients were enrolled. 250 ml colloid volume expansions for fluid challenge were performed during ovarian cytoreductive surgery. The volume expansion-induced changes in cardiac index measured by transpulmonary thermodilution by a central venous access (CIcvc) and by a port-a-catheter (CIport) were recorded. 23 patients were analyzed with 123 pairs of measurements. Using a Bland and Altman for repeated measurements, the bias (lower and upper limits of agreement) between CIport and CIcvc was 0.14 (-0.59 to 0.88) L/min/m2. The percentage error was 22%. The concordance between the changes in CIport and CIcvc observed during volume expansion was 92% with an r = 0.7 (with exclusion zone). No complications (included sepsis) were observed during the follow up period. The transpulmonary thermodilution by a port-a-catheter is reliable for absolute values estimation of cardiac index and for measurement of the variation after fluid challenge. clinicaltrials.gov NCT02063009.

  12. The establishment of implanted VX2 liver tumor model in rabbits and discussion on superselective left hepatic arterial catheterization with micro-catheter technique via femoral artery

    International Nuclear Information System (INIS)

    Jiang Xiongying; Luo Rongguang; Huang Jinhua; Miao Bijian; Wang Yan

    2011-01-01

    Objective: To establish the implanted VX2 liver tumor model in rabbits and to discuss the feasibility and technical features of superselective left hepatic arterial catheterization by using micro-catheter through the femoral artery catheter sheath. Methods: Forty New Zealand white rabbits were inoculated with fragments of VX2 tumor into the medial left lobe of liver by using a 16G lumbar puncture needle through laparotomy route. Two weeks later, all the rabbits were proved to be successfully inoculated with liver neoplasm on CT scanning. Then, the catheter sheath was inserted into one of the femoral arteries, which was followed by celiac artery angiography and left hepatic artery catheterization with a micro-catheter under DSA guidance in order to evaluate the main branches of celiac artery and the imaging manifestations of VX2 liver tumor. After that, some scheduled interventional experiments were carried out. Results: Imaging examination and histopathologic study showed that the successful rate of implanted rabbit VX2 liver tumor was 100% (40/40). And the successful rate of the catheter sheath inserted to femoral artery was 97.5% (39/40). The successful rate of celiac artery, gastro-hepatic artery, common hepatic artery, proper hepatic artery and left hepatic artery catheterizations was 100% (39/39), 100% (39/39), 100% (39/39), 94.9% (37/39) and 71.2% (28/39) respectively. Conclusion: To implant tumor tissue mass through laparotomy is a stable and reliable method to establish rabbit VX2 liver tumor model. The insertion of micro-catheter through rabbit femoral catheter sheath approach is a convenient and simple technique to be carried out for the left hepatic artery catheterization and it can efficiently solve the technical difficulties when performing the interventional treatment of the rabbit VX2 hepatic tumor via left hepatic artery approach. (authors)

  13. Risk factors for venous port migration in a single institute in Taiwan.

    Science.gov (United States)

    Fan, Wen-Chieh; Wu, Cheng-Han; Tsai, Ming-Ju; Tsai, Ying-Ming; Chang, Hsu-Liang; Hung, Jen-Yu; Chen, Pei-Huan; Yang, Chih-Jen

    2014-01-14

    An implantable port device provides an easily accessible central route for long-term chemotherapy. Venous catheter migration is one of the rare complications of venous port implantation. It can lead to side effects such as pain in the neck, shoulder, or ear, venous thrombosis, and even life-threatening neurologic problems. To date, there are few published studies that discuss such complications. This retrospective study of venous port implantation in a single center, a Taiwan hospital, was conducted from January 2011 to March 2013. Venous port migration was recorded along with demographic and characteristics of the patients. Of 298 patients with an implantable import device, venous port migration had occurred in seven, an incidence rate of 2.3%. All seven were male and had received the Bard port Fr 6.6 which had smaller size than TYCO port Fr 7.5 and is made of silicon. Significantly, migration occurred in male patients (P = 0.0006) and in those with lung cancer (P = 0.004). Multivariable logistic regression analysis revealed that lung cancer was a significant risk factor for port migration (odds ratio: 11.59; P = 0.0059). The migration rate of the Bard port Fr 6.6 was 6.7%. The median time between initial venous port implantation and port migration was 35.4 days (range, 7 to 135 days) and 71.4% (5/7) of patients had port migration within 30 days after initial port implantation. Male sex and lung cancer are risk factors for venous port migration. The type of venous port is also an important risk factor.

  14. [Fungal infectivities of implanted catheters due to Candida sp. Biofilms formation and resistance].

    Science.gov (United States)

    Seddiki, S M L; Boucherit-Otmani, Z; Boucherit, K; Kunkel, D

    2015-06-01

    Candidemia are the most common fungal infections in hospitals. However, the catheters are subject to be altered by Candida biofilms which increase the risk of invasive nosocomial infections due to the high resistance to antifungal agents. Therefore, the minimum inhibitory concentrations of planktonic (MIC) and sessile cells (CIMS) were evaluated. To review the in vivo biofilms structures of Candida sp. formed on the inner and/or external surfaces of collected catheters, we used scanning electron microscopy (SEM). The level of biofilm resistance was assessed against two conventional antifungal agents: amphotericin B (AmB), which belongs to the class of polyenes, and fluconazole (FLZ) which is an azole. The SEM observation of biofilms of Candida sp. reveals complex structures. Compared to MICs, the calculation of CIMS showed an increase of 32 times with AmB and of 128 times with FLZ. Catheters offer an ideal surface to Candida sp. to form biofilms. This complex structure induces the increase of the resistance of sessile cells against two antifungal agents, AmB and FLZ. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  15. Urinary catheters

    Science.gov (United States)

    Catheter - urine; Foley catheter; Indwelling catheter; Suprapubic catheters ... stones Blood infections ( septicemia ) Blood in the urine (hematuria) Kidney damage (usually only with long-term, indwelling ...

  16. Soft-Tissue-Anchored Transcutaneous Port for Long-Term Percutaneous Transhepatic Biliary Drainage

    International Nuclear Information System (INIS)

    Nyman, Rickard; Ekloef, Hampus; Eriksson, Lars-Gunnar; Karlsson, Britt-Marie; Rasmussen, Ib; Lundgren, Dan; Thomsen, Peter

    2005-01-01

    Purpose. A transcutaneous port (T-port) has been developed allowing easy exchange of a catheter, which was fixed inside the device, using the Seldinger technique. The objective of the study was to test the T-port in patients who had percutaneous transhepatic biliary drainage (PTBD). Methods. The T-port, made of titanium, was implanted using local anesthesia in 11 patients (mean age 65 years, range 52-85 years) with biliary duct obstruction (7 malignant and 4 benign strictures). The subcutaneous part of the T-port consisted of a flange with several perforations allowing ingrowth of connective tissue. The T-port allowed catheter sizes of 10 and 12 Fr. Results. All wounds healed uneventfully and were followed by a stable period without signs of pronounced inflammation or infection. It was easy to open the port and to exchange the drainage tube. The patient's quality of life was considerably improved even though several patients had problems with repeated bile leakage due to frequent recurrent obstructions of the tubes. The ports were implanted for a mean time of 9 months (range 2-21 months). Histologic examination in four cases showed that the port was well integrated into the soft tissue. Tilting of the T-port in two cases led to perforation of the skin by the subcutaneous part of the ports, which were removed after 7 and 8 months. Conclusion. The T-port served as an excellent external access to the biliary ducts. The drainage tubes were well fixed within the ports. The quality of life of the patients was considerably improved. Together with improved aesthetic appearance they found it easier to conduct normal daily activities and personal care. However, the problem of recurrent catheter obstruction remained unsolved

  17. Catheter Angiography

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Catheter Angiography Catheter angiography uses a catheter, x-ray ... are the limitations of Catheter Angiography? What is Catheter Angiography? Angiography is a minimally invasive medical test ...

  18. Subclavian Vein Versus Arm Vein for Totally Implantable Central Venous Port for Patients with Head and Neck Cancer: A Retrospective Comparative Analysis

    International Nuclear Information System (INIS)

    Akahane, Akio; Sone, Miyuki; Ehara, Shigeru; Kato, Kenichi; Tanaka, Ryoichi; Nakasato, Tatsuhiko

    2011-01-01

    Purpose: This study was designed to compare central venous ports (CVP) from two different routes of venous access―the subclavian vein and arm vein―in terms of safety for patients with head and neck cancer (HNC). Methods: Patients with HNC who underwent image-guided implantations of CVPs were retrospectively evaluated. All CVPs were implanted under local anesthesia. Primary outcome measurements were rates and types of adverse events (AEs). Secondary outcomes included technical success and rate and reason of CVP removal. Results: A total of 162 patients (subclavian port group, 47; arm port group, 115) were included in this study. Technical success was achieved in all patients. The median follow-up period was 94 (range, 1–891) days. Two patients in the subclavian port group experienced periprocedural complications. Postprocedural AEs were observed in 8.5 and 22.6% of the subclavian port and arm port group patients, respectively (P = 0.044). Phlebitis and system occlusions were observed only in the arm port group. The rate of infection was not significantly different between the two groups. The CVP was removed in 34 and 39.1% of the subclavian port and arm port patients, respectively. Conclusions: Both subclavian and arm CVPs are feasible in patients with HNC. AEs were more frequent in the arm port group; thus, the arm port is not recommended as the first choice for patients with HNC. However, further experience is needed to improve the placement technique and the maintenance of CVPs and a prospective analysis is warranted.

  19. Current situation regarding central venous port implantation procedures and complications: a questionnaire-based survey of 11,693 implantations in Japan.

    Science.gov (United States)

    Shiono, Masatoshi; Takahashi, Shin; Takahashi, Masanobu; Yamaguchi, Takuhiro; Ishioka, Chikashi

    2016-12-01

    We conducted a nationwide questionnaire-based survey to understand the current situation regarding central venous port implantation in order to identify the ideal procedure. Questionnaire sheets concerning the number of implantation procedures and the incidence of complications for all procedures completed in 2012 were sent to 397 nationwide designated cancer care hospitals in Japan in June 2013. Venipuncture sites were categorized as chest, neck, upper arm, forearm, and others. Methods were categorized as landmark, cut-down, ultrasound-mark, real-time ultrasound guided, venography, and other groups. We received 374 responses (11,693 procedures) from 153 centers (38.5 %). The overall complication rates were 7.4 % for the chest (598/8,097 cases); 6.8 % for the neck (157/2325); 5.2 % for the upper arm (54/1,033); 7.3 % for the forearm (9/124); and 6.1 % for the other groups (7/114). Compared to the chest group, only the upper arm group showed a significantly lower incidence of complications (P = 0.010), and multivariate logistic regression (odds ratio 0.69; 95 % confidence interval 0.51-0.91; P = 0.008) also showed similar findings. Real-time ultrasound-guided puncture was most commonly used in the upper arm group (83.8 %), followed by the neck (69.8 %), forearm (53.2 %), chest (41.8 %), and other groups (34.2 %). Upper arm venipuncture with ultrasound guidance seems the most promising technique to prevent complications of central venous port implantation.

  20. Comparison of Venae Sectio vs. modified Seldinger Technique for Totally Implantable Access Ports; Portas-trial [ISRCTN:52368201

    Directory of Open Access Journals (Sweden)

    Luntz S

    2006-06-01

    Full Text Available Abstract Background The insertion of a Totally Implantable Access Port (TIAP is a routinely employed technique in patients who need a safe and permanent venous access. The number of TIAP implantations is increasing constantly mainly due to advanced treatment options for malignant diseases. Therefore it is important to identify the implantation technique which has the optimal benefit/risk ratio for the patient. Study design A single-centre, randomized, controlled superiority trial to compare two different TIAP implantation techniques. Sample size: 160 patients will be included and randomized intra-operatively. Eligibility criteria: Age equal or older than 18 years, patients scheduled for primary elective implantation of a TIAP in local anaesthesia and a signed informed consent. Primary endpoint: Primary success rate of the randomized technique. Intervention: Venae Sectio in combination with the Seldinger Technique (guide wire and a peel away sheath will be used to place a TIAP. Reference treatment: Conventional Venae Sectio will be used with a direct insertion of the TIAP without guide wire or peel away sheath. Duration of study: Approximately 20 months. Organisation/Responsibility The trial will be conducted in compliance with the protocol and in accordance with the moral, ethical, and scientific principles governing clinical research as set out in the Declaration of Helsinki (1989 and Good Clinical Practice (GCP. The trial will also be carried out in keeping with local and regulatory requirements. The Klinisches Studienzentrum Chirurgie (KSC – Centre of Clinical Trials in Surgery at the Department of Surgery, University Hospital Heidelberg is responsible for planning and conduction of the trial. Documentation of patient's data will be accomplished via electronical Case Report Files (eCRF with MACRO®-Software by the KSC. Randomization, data management, monitoring and biometry are provided by the independent Koordinierungszentrum f

  1. [Frequency of colonization and isolated bacteria from the tip of the epidural catheter implanted for postoperative analgesia].

    Science.gov (United States)

    Stabille, Débora Miranda Diogo; Filho, Augusto Diogo; Mandim, Beatriz Lemos da Silva; Araújo, Lúcio Borges de; Mesquita, Priscila Miranda Diogo; Jorge, Miguel Tanús

    2015-01-01

    The increased use of epidural analgesia with catheter leads to the need to demonstrate the safety of this method and know the incidence of catheter colonization, inserted postoperatively for epidural analgesia, and the bacteria responsible for this colonization. From November 2011 to April 2012, patients electively operated and maintained under epidural catheter for postoperative analgesia were evaluated. The catheter tip was collected for semiquantitative and qualitative microbiological analysis. Of 68 cultured catheters, six tips (8.8%) had positive cultures. No patient had superficial or deep infection. The mean duration of catheter use was 43.45hours (18-118) (p=0.0894). The type of surgery (contaminated or uncontaminated), physical status of patients, and surgical time showed no relation with the colonization of catheters. Microorganisms isolated from the catheter tip were Staphylococcus aureus, Pseudomonas aeruginosa and Sphingomonas paucimobilis. Postoperative epidural catheter analgesia, under this study conditions, was found to be low risk for bacterial colonization in patients at surgical wards. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  2. Implantable port devices in paediatric oncology patients: A clinical experience from a tertiary care hospital

    International Nuclear Information System (INIS)

    Dogar, S.A.; Khan, M.A.M.

    2013-01-01

    Objective: To assess the frequency of infection of portacath in children having malignant tumours and undergoing chemotherapy, and to assess the association of the infection with already known risk factors. Methods: The retrospective review was conducted at Aga Khan University Hospital, Karachi, and involved patient data related to the period between January 2005 to December 2010. A questionnaire was designed to collect the required data. A total of 67 children were included having portacath inserted for chemotherapy. Children in which portacath was inserted under local anaesthesia in Radiology department, reinserted or inserted because of a reason other than childhood malignancy were excluded. SPSS 19 was used for statistical analysis. Results: Of the total, 46 (67%) patients were males and a majority of the total (n=31; 46%) was between 6-10 years of age. Besides, 42 (63%) patients had leukaemia, 7(11%) had lymphoma and 18(26%) had various solid tumours. Six (8.95%) ports were removed due to infection. There was significant difference between infection and non-infection groups with respect to absolute neutrophilic count levels (p <0.001). Positive association was found between low absolute neutrophilic count level (<500) and the occurrence of port infection. Conclusions: Port infection rate is higher in children with low absolute neutrophilic count. The issue needs to be addressed and one may have to alter the timings of port insertion. It is recommended to insert port when absolute neutrophilic count is normal. To further evaluate the subject, a multicentre trial must be conducted. (author)

  3. Aortic valve replacement and prosthesis-patient mismatch in the era of trans-catheter aortic valve implantation.

    Science.gov (United States)

    Morita, Shigeki

    2016-08-01

    The treatment strategy for aortic stenosis (AS) has been changing due to newly developed valvular prostheses and trans-catheter aortic valve implantation (TAVI). To determine the role of new modalities for AS with a small aortic root, papers using the concept of prosthesis-patient mismatch (PPM) were reviewed. First, to determine the cut-off value of the indexed effective orifice area (IEOA) for defining PPM, the studies of surgical aortic valve replacement (SAVR) with a follow-up longer than 5 years and a patient number larger than 500 were reviewed. Second, the papers comparing TAVI and SAVR were reviewed. Furthermore, the prevalence of PPM was reviewed, with the addition of papers on aortic root enlargement, sutureless AVR, and aortic valve reconstruction with autologous pericardium. The results of the long-term survival after aortic valve replacement (AVR) have indicated that an IEOA less than 0.65 cm(2)/m(2) should be avoided in all cases, whereas the indications for patients with an IEOA between 065 and 0.85 cm(2)/m(2) should be determined by considering multiple factors. A large body size and younger age have a significantly negative influence on the long-term survival. In Asian population, the prevalence of PPM was low, despite the fact that the size of the aortic annulus was small. The IEOA after TAVI was larger than after surgical AVR in population-matched studies. To evaluate the role of TAVI and other modalities for a small aortic root, studies with a longer follow-up and larger volume are thus warranted.

  4. Long-term catheterization: current approaches in the diagnosis and treatment of port-related infections

    Directory of Open Access Journals (Sweden)

    Bustos C

    2014-02-01

    Full Text Available Cesar Bustos,1 Aitziber Aguinaga,1 Francisco Carmona-Torre,2 Jose Luis Del Pozo1,3 1Department of Clinical Microbiology, 2Department of Internal Medicine, 3Division of Infectious Diseases, Clinica Universidad de Navarra, Pamplona, Spain Abstract: Since the first description in 1982, totally implanted venous access ports have progressively improved patients' quality of life and medical assistance when a medical condition requires the use of long-term venous access. Currently, they are part of the standard medical care for oncohematologic patients. However, apart from mechanical and thrombotic complications, there are also complications associated with biofilm development inside the catheters. These biofilms increase the cost of medical assistance and extend hospitalization. The most frequently involved micro-organisms in these infections are gram-positive cocci. Many efforts have been made to understand biofilm formation within the lumen catheters, and to resolve catheter-related infection once it has been established. Apart from systemic antibiotic treatment, the use of local catheter treatment (ie, antibiotic lock technique is widely employed. Many different antimicrobial options have been tested, with different outcomes, in clinical and in in vitro assays. The stability of antibiotic concentration in the lock solution once instilled inside the catheter lumen remains unresolved. To prevent infection, it is mandatory to perform hand hygiene before catheter insertion and manipulation, and to disinfect catheter hubs, connectors, and injection ports before accessing the catheter. At present, there are still unresolved questions regarding the best antimicrobial agent for catheter-related bloodstream infection treatment and the duration of concentration stability of the antibiotic solution within the lumen of the port. Keywords: catheter-related infection, bacteremia, biofilm

  5. Percutaneous retrieval of an intracardiac central venous port fragment using snare with triple loops

    Directory of Open Access Journals (Sweden)

    Mehdi Ghaderian

    2015-01-01

    Full Text Available Peripherally inserted venous ports fracture with embolization in patients who received chemotherapy is a serious and rare complication, and few cases have been reported in children. We report a successful endovascular technique using a snare for retrieving broken peripherally inserted venous ports in a child for chemotherapy. Catheter fragments may cause complications such as cardiac perforation, arrhythmias, sepsis, and pulmonary embolism. A 12-year-old female received chemotherapy for acute lymphocytic leukemia through a central venous port implanted into her right subclavian area. The patient completed chemotherapy without complications 6 months ago. Venous port was accidentally fractured during its removal. Chest radiographs of the patient revealed intracardiac catheter fragment extending from the right subclavian to the right atrium (RA and looping in the RA. The procedure was performed under ketamine and midazolam anesthesia and fluoroscopic guidance using a percutaneous femoral vein approach. A snare with triple loops (10 mm in diameter was used to successfully retrieve the catheter fragments without any complication. Percutaneous transcatheter retrieval of catheter fragments is occasionally extremely useful and should be considered by interventional cardiologists for retrieving migrated catheters and can be chosen before resorting to surgery, which has potential risks related to thoracotomy, cardiopulmonary bypass, and general anesthesia.

  6. Treatment of PPROM with anhydramnion in humans: first experience with different amniotic fluid substitutes for continuous amnioinfusion through a subcutaneously implanted port system.

    Science.gov (United States)

    Tchirikov, Michael; Bapayeva, Gauri; Zhumadilov, Zhaxybay Sh; Dridi, Yasmina; Harnisch, Ralf; Herrmann, Angelika

    2013-11-01

    This study aims to treat patients with preterm premature rupture of the membranes (PPROM) and anhydramnion using continuous amnioinfusion through a subcutaneously implanted port system. An amniotic fluid replacement port system was implanted in seven patients with PPROM and anhydramnion starting at the 20th week of gestation (range, 14-26 weeks) for long-term amnioinfusion. Saline solutions (2 L/day; Jonosteril(®), Sterofundin(®), isotonic NaCl 0.9% solution, lactated Ringer's solution) and a hypotonic aqueous composition with reduced chloride content similar to the electrolyte concentration of human amniotic fluid were used for the continuous amnioinfusion. The mean duration of the PPROM delivery interval continued for 49 days (range, 9-69 days), with 3 weeks of amnioinfusion via the port system (range, 4-49). The newborns showed no signs of lung hypoplasia. Long-term lavage of the amniotic cavity via a subcutaneously implanted port system in patients with PPROM and anhydramnion may help prolong the pregnancy and avoid fetal lung hypoplasia. A hypotonic aqueous composition with reduced chloride content similar to human amniotic fluid can be safely used for amnioinfusion. Prospective randomized studies are ongoing.

  7. Catheter ablation for the treatment of electrical storm in patients with implantable cardioverter-defibrillators: short- and long-term outcomes in a prospective single-center study.

    Science.gov (United States)

    Carbucicchio, Corrado; Santamaria, Matteo; Trevisi, Nicola; Maccabelli, Giuseppe; Giraldi, Francesco; Fassini, Gaetano; Riva, Stefania; Moltrasio, Massimo; Cireddu, Manuela; Veglia, Fabrizio; Della Bella, Paolo

    2008-01-29

    Electrical storm (ES) caused by recurrent episodes of ventricular tachycardia (VT) can cause sudden death in patients with implantable cardioverter-defibrillators and adversely affects prognosis in survivors. Catheter ablation has been proposed for treating ES, but its long-term effect in a large population has never been verified. Ninety-five consecutive patients with coronary artery disease (72 patients), idiopathic dilated cardiomyopathy (10 patients), and arrhythmogenic right ventricular dysplasia/cardiomyopathy (13 patients) undergoing catheter ablation for drug-refractory ES were prospectively evaluated. Short-term efficacy was defined by a complete protocol of programmed electric stimulation and by in-hospital outcome; long-term analysis addressed ES recurrence, cardiac mortality, and VT recurrence. Pleomorphic/nontolerated VTs required electroanatomic and noncontact mapping in 48 and 22 patients, respectively, and percutaneous cardiopulmonary support in 10 patients. An epicardial approach was used in 10 patients. After 1 to 3 procedures, induction of any clinical VT(s) by programmed electrical stimulation was prevented in 85 patients (89%). ES was acutely suppressed in all patients; a minimum period of 7 days with stable rhythm was required before hospital discharge. At a median follow-up of 22 months (range, 1 to 43 months), 87 patients (92%) were free of ES and 63 patients (66%) were free of VT recurrence. Eight of 10 patients with persistent inducibility of clinical VT(s) had ES recurrence; 4 of them died suddenly despite appropriate implantable cardioverter-defibrillator intervention. All together, 11 of 95 patients (12%) died of cardiac-related reasons. In the group of patients presenting with all clinical VTs acutely abolished, no ES recurrence was documented, and cardiac mortality was significantly lower compared with the group of patients showing > or = 1 clinical VT still inducible after catheter ablation. Advanced strategies of catheter ablation

  8. Comparison of Inversion (“flipping”) Rates Among Different Port Designs: A Single-Center Experience

    International Nuclear Information System (INIS)

    Etezadi, Vahid; Trerotola, Scott O.

    2017-01-01

    PurposeTo compare incidence of port inversion among different types of implantable venous access devices.Materials and Methods Records of patients who underwent imaging-guided subcutaneous port placement without port fixation between July 2001 and April 2015 were reviewed with use of a quality assurance database. 1930 patients with complete follow-up (death or explant) were included in the study. Collected data included date and indication for port placement, port type, venous access site, immediate and long-term complications, indication for removal, and total number of catheter days. BMI of patients with inverted ports was also calculated.Results Port inversion within the pocket was observed in 18 patients (0.9%) including 7/82 (9%) of Dignity ports, 4/126 (3%) of Vaxcel plastic arm ports, 3/142 (2%) of Smartports, 2/100 (2%) of Powerports, 1/14 (7%) of Vaccess ports, and 1/1421 (0.07%) of Vortex LP ports. Among these designs, the inversion rate was significantly lower in Vortex LP ports (0.1%) (P < 0.05). There was a trend toward higher inversion rate of Dignity ports, which have a rectangular design with a relatively narrow base. Mean dwell in inverted ports was 114 days (7–580).Conclusion The incidence of port inversion without suture fixation of the port base to the pocket is extremely low. The present study shows differences in inversion incidence based on port design.Level of Evidence: Case Series, Level IV.

  9. Comparison of Inversion (“flipping”) Rates Among Different Port Designs: A Single-Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Etezadi, Vahid, E-mail: vahid.etezadi@umm.edu; Trerotola, Scott O., E-mail: streroto@uphs.upenn.edu [University of Pennsylvania Medical Center, Division of Interventional Radiology, Department of Radiology (United States)

    2017-04-15

    PurposeTo compare incidence of port inversion among different types of implantable venous access devices.Materials and Methods Records of patients who underwent imaging-guided subcutaneous port placement without port fixation between July 2001 and April 2015 were reviewed with use of a quality assurance database. 1930 patients with complete follow-up (death or explant) were included in the study. Collected data included date and indication for port placement, port type, venous access site, immediate and long-term complications, indication for removal, and total number of catheter days. BMI of patients with inverted ports was also calculated.Results Port inversion within the pocket was observed in 18 patients (0.9%) including 7/82 (9%) of Dignity ports, 4/126 (3%) of Vaxcel plastic arm ports, 3/142 (2%) of Smartports, 2/100 (2%) of Powerports, 1/14 (7%) of Vaccess ports, and 1/1421 (0.07%) of Vortex LP ports. Among these designs, the inversion rate was significantly lower in Vortex LP ports (0.1%) (P < 0.05). There was a trend toward higher inversion rate of Dignity ports, which have a rectangular design with a relatively narrow base. Mean dwell in inverted ports was 114 days (7–580).Conclusion The incidence of port inversion without suture fixation of the port base to the pocket is extremely low. The present study shows differences in inversion incidence based on port design.Level of Evidence: Case Series, Level IV.

  10. Catheter Angiography

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    Full Text Available ... of a catheter makes it possible to combine diagnosis and treatment in a single procedure. Catheter angiography ... of a catheter makes it possible to combine diagnosis and treatment in a single procedure. An example ...

  11. Catheter Angiography

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    Full Text Available ... few millimeters) in the skin where the catheter can be inserted into an artery. The catheter is ... need for surgery. If surgery remains necessary, it can be performed more accurately. Catheter angiography presents a ...

  12. Catheter Angiography

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    Full Text Available ... resonance imaging (MRI) In catheter angiography, a thin plastic tube, called a catheter , is inserted into an ... The catheter used in angiography is a long plastic tube about as thick as a strand of ...

  13. Catheter Angiography

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    Full Text Available ... using: x-rays with catheters computed tomography (CT) magnetic resonance imaging (MRI) In catheter angiography, a thin plastic ... called superselective angiography. Unlike computed tomography (CT) or magnetic resonance (MR) angiography , use of a catheter makes it ...

  14. Catheter Angiography

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    Full Text Available ... Z Catheter Angiography Catheter angiography uses a catheter, x-ray imaging guidance and an injection of contrast material ... vessels in the body. Angiography is performed using: x-rays with catheters computed tomography (CT) magnetic resonance imaging ( ...

  15. Incidence of postoperative implant-related bacterial endocarditis in dogs that underwent trans-catheter embolization of a patent ductus arteriosus without intra- and post-procedural prophylactic antibiotics

    NARCIS (Netherlands)

    Szatmári, Viktor

    2017-01-01

    Intra- and post-procedural prophylactic antibiotics are routinely administered by veterinary cardiologists to dogs that undergo trans-catheter embolization of a patent ductus arteriosus for prevention of implant-related infective endocarditis. The hypothesis of our study was that primary antibiotic

  16. Catheter Angiography

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    Full Text Available ... incision in the skin. Once the catheter is guided to the area being examined, a contrast material ... inserted into an artery. The catheter is then guided through the arteries to the area to be ...

  17. Catheter Angiography

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    Full Text Available ... it will make the rest of the procedure pain-free. You will not feel the catheter in ... nurse if you notice any bleeding, swelling or pain at the site where the catheter entered the ...

  18. Catheter Angiography

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    Full Text Available ... an artery through a small incision in the skin. Once the catheter is guided to the area ... small incision (usually a few millimeters) in the skin where the catheter can be inserted into an ...

  19. Catheter Angiography

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    Full Text Available ... should inform the nurse if you notice any bleeding, swelling or pain at the site where the ... Rarely, the catheter punctures the artery, causing internal bleeding. It also is possible that the catheter tip ...

  20. Catheter Angiography

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    Full Text Available ... catheter , is inserted into an artery through a small incision in the skin. Once the catheter is ... the tube and images are captured using a small dose of ionizing radiation ( x-rays ). top of ...

  1. Catheter Angiography

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    Full Text Available ... imaging (MRI) In catheter angiography, a thin plastic tube, called a catheter , is inserted into an artery ... examined, a contrast material is injected through the tube and images are captured using a small dose ...

  2. Catheter Angiography

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    Full Text Available ... or other procedures such as chemoembolization or selective internal radiation therapy. identify dissection or splitting in the ... days. Rarely, the catheter punctures the artery, causing internal bleeding. It also is possible that the catheter ...

  3. Catheter Angiography

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    Full Text Available ... is performed using: x-rays with catheters computed tomography (CT) magnetic resonance imaging (MRI) In catheter angiography, ... tumor; this is called superselective angiography. Unlike computed tomography (CT) or magnetic resonance (MR) angiography , use of ...

  4. Catheter Angiography

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    Full Text Available ... is performed using: x-rays with catheters computed tomography (CT) magnetic resonance imaging (MRI) In catheter angiography, a ... tumor; this is called superselective angiography. Unlike computed tomography (CT) or magnetic resonance (MR) angiography , use of a ...

  5. Catheter Angiography

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    Full Text Available ... Catheter angiography uses a catheter, x-ray imaging guidance and an injection of contrast material to examine ... removable dental appliances, eye glasses and any metal objects or clothing that might interfere with the x- ...

  6. Catheter Angiography

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    Full Text Available ... most cases, the kidneys will regain their normal function within five to seven days. Rarely, the catheter ... limitations of Catheter Angiography? Patients with impaired kidney function, especially those who also have diabetes, are not ...

  7. Catheter Angiography

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    Full Text Available ... lies. The catheter used in angiography is a long plastic tube about as thick as a strand of spaghetti. top of page How does the procedure work? Catheter angiography works much the same as a ...

  8. A cost-effective peripheral venous port system placed at the bedside.

    Science.gov (United States)

    Finney, R; Albrink, M H; Hart, M B; Rosemurgy, A S

    1992-07-01

    High costs and a paucity of available operating time have led us to seek alternatives to operatively placed vascular access systems. This prospective study is the initial report of a peripheral port system (P.A.S. PORT System, Pharmacia Deltec, Inc.) placed at the bedside. Seventy-nine patients (52 male, 27 female), ages 3-92 years, had ports implanted by surgical residents with attending supervision. Sixty-eight (86%) received the P.A.S. PORT for long-term antibiotics, antifungal, or antiviral therapy; four (5%) for TPN infusion; three (4%) for blood products; two (3%) for chemotherapy; and two (3%) for iv narcotics. Ports were placed in 10 (13%) HIV(+) patients, three (4%) who were fully anticoagulated, and one who was a hemophiliac with a platelet count of zero. Eight patients (10%) developed superficial phlebitis, all of which resolved with nonsteroidal anti-inflammatory agents within 48 hr without port removal. Seven patients (9%) had their port removed due to infection. The average hospital charge to place the P.A.S. PORT System was $1488.00 vs $2811.00 for a tunneled external chest catheter and $3729.00 for the placement of a chest port. Bedside insertion of vascular access devices can be safely performed with acceptable infection rates allowing more efficient use of hospital operating rooms and with substantial cost savings.

  9. Catheter Angiography

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    Full Text Available ... lessen your anxiety during the procedure. The area of the groin or arm where the catheter will be inserted is shaved, ... contrast material is injected through the catheter and reaches the blood vessels being studied, several sets of x-rays are taken. Then the catheter is ...

  10. Predictors of Venous Thromboembolic Events Associated with Central Venous Port Insertion in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Christine Hohl Moinat

    2014-01-01

    Full Text Available Insertion of central venous port (CVP catheter in the cancer population is associated with increased incidence of venous thromboembolic events (VTE. However, trials have shown limited benefit of antithrombotic treatment to prevent catheter-related venous thrombosis. This prospective observational cohort study was designed to assess the incidence of VTE closely related to CVP implantation in patients with cancer and undergoing chemotherapy, and to identify a high risk subgroup of patients. Between February 2006 and December 2011, 1097 consecutive cancer patients with first CVP implantation were included. Catheter-related VTE were defined as deep venous thrombosis in the arm, with or without pulmonary embolism (PE, or isolated PE. The incidence of CVP-associated VTE was 5.9% (IC95 4.4–7.3% at 3 months, and 11.3% (IC95 9.4–13.2% at 12 months. The incidence of any VTE was 7.6% (IC95 6.0–9.3% at 3 months, and 15.3% (IC95 13.1–17.6% at 12 months. High Khorana risk score and lung cancer were significant predictors of 3 month VTE. In conclusion, this large cohort study of patients with first CVP catheter implantation confirms the high incidence of VTE associated with the CVP implantation and allow identifying high risk patients who may benefit from thromboprophylaxis.

  11. Implantable central venous chemoport: camparision of results according to approach routes and methods

    International Nuclear Information System (INIS)

    Shin, Byung Suck; Ahn, Moon Sang

    2003-01-01

    To evaluate the results and complications of placement of implantable port according to approach routes and methods. Between April 2001 and October 2002, a total of 103 implantable chemoport was placed in 95 patients for chemotherapy using preconnected type (n=39) and attachable type (n=64). Puncture sites were left subclavian vein (n=35), right subclavian vein (n=5), left internal jugular vein (n=9), right internal jugular vein (n=54). We evaluated duration of catheterization days, complications according to approach routes and methods. Implantable chemoport was placed successfully in all cases. Duration of catheterization ranged from 8 to 554 days(mean 159, total 17,872 catheter days). Procedure related complications occurred transient pulmonary air embolism (n=1), small hematoma (n=1) and malposition in using preconnected type (n=2). Late complications occurred catheter migration (n=5), catheter malfunction (n=3), occlusion (n=1) and infection (n=11). Among them 15 chemoport was removed (14.5%). Catheter migration was occured via subclavian vein in all cases (13%, p=.008). Infection developed in 10.7% of patients(0.61 per 1000 catheter days). There were no catheter-related central vein thrombosis. Implantation of chemoport is a safe procedure. Choice of right internal jugular vein than subclavian vain vein for puncture site has less complications. And selection of attachable type of chemoport is convenient than preconnected type. Adequate care of chemoport is essential for long patency

  12. Incidence of postoperative implant-related bacterial endocarditis in dogs that underwent trans-catheter embolization of a patent ductus arteriosus without intra- and post-procedural prophylactic antibiotics.

    Science.gov (United States)

    Szatmári, Viktor

    2017-08-01

    Intra- and post-procedural prophylactic antibiotics are routinely administered by veterinary cardiologists to dogs that undergo trans-catheter embolization of a patent ductus arteriosus for prevention of implant-related infective endocarditis. The hypothesis of our study was that primary antibiotic prophylaxis is not necessary to prevent bacterial endocarditis. In this retrospective case series 54 client-owned dogs that underwent trans-catheter occlusion of a patent ductus arteriosus in a single tertiary veterinary referral center between 2004 and 2016 were evaluated. Follow-up information was gained by telephone interviews with the owners or the referring veterinarians, or from the digital archives of the authors' clinic. Inclusion criteria were that at least one metal implant (a coil or an Amplatz duct occluder) had to be delivered in the ductal ampulla, no local or systemic antibiotics were given on the day of the intervention or the week thereafter, at least 3 months of postoperative follow-up information was available, and the author was performing the procedure either as the primary or as the supervising cardiology specialist. None of the 54 dogs developed infective endocarditis in the postoperative 3 months. A study describing a similar population reports 2 of the included 47 dogs having developed infective endocarditis in the postoperative period despite the administration of intra- and post-procedural prophylactic antibiotics. We conclude that intra- and post-procedural antibiotic prophylaxis is not justified in dogs that undergo trans-catheter closure of a patent ductus arteriosus. Proper surgical technique and the use of new sterile catheters and implants are sufficient to prevent infective endocarditis in these dogs. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Catheter Angiography

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    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Catheter Angiography Catheter angiography ...

  14. Catheter Angiography

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    Full Text Available ... is injected through the catheter and reaches the blood vessels being studied, several sets of x-rays are taken. Then the catheter is removed and the incision site is closed by applying pressure on the area for approximately 10 to 20 ...

  15. Urinary catheter - infants

    Science.gov (United States)

    Bladder catheter - infants; Foley catheter - infants; Urinary catheter - neonatal ... A urinary catheter is a small, soft tube placed in the bladder. This article addresses urinary catheters in babies. WHY IS ...

  16. Rhodococcus equi venous catheter infection: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Nahleh Zeina

    2011-08-01

    Full Text Available Abstract Introduction Rhodococcus equi is an animal pathogen that was initially isolated from horses and is being increasingly reported as a cause of infection in humans with impaired cellular immunity. However, this pathogen is underestimated as a challenging antagonist and is frequently considered to be a mere contaminant despite the potential for life-threatening infections. Most case reports have occurred in immunocompromised patients who have received organ transplants (for example kidney, heart, bone marrow or those with human immunodeficiency virus infection. Infections often manifest as pulmonary involvement or soft tissue abscesses. Bacteremia related to R. equi infections of tunneled central venous catheters has rarely been described. Case presentation We report the case of a 63-year-old non-transplant recipient, non-HIV infected Caucasian woman with endometrial carcinoma who developed recurrent bloodstream infections and septic shock due to R. equi and ultimately required the removal of her port catheter, a subcutaneous implantable central venous catheter. We also review the medical literature related to human infections with R. equi. Conclusion R. equi should be considered a serious pathogen, not a contaminant, particularly in an immunocompromised patient who presents with a central venous catheter-related bloodstream infection. Counseling patients with central venous catheters who participate in activities involving exposure to domesticated animals is recommended.

  17. Protocol of an expertise based randomized trial comparing surgical Venae Sectio versus radiological Puncture of Vena Subclavia for insertion of Totally Implantable Access Port in oncological patients

    Directory of Open Access Journals (Sweden)

    Radeleff Boris

    2008-10-01

    Full Text Available Abstract Background Totally Implantable Access Ports (TIAP are being extensively used world-wide and can be expected to gain further importance with the introduction of new neoadjuvant and adjuvant treatments in oncology. Two different techniques for the implantation can be selected: A direct puncture of a central vein and the utilization of a Seldinger device or the surgical Venae sectio. It is still unclear which technique has the optimal benefit/risk ratio for the patient. Design A single-center, expertise based randomized, controlled superiority trial to compare two different TIAP implantation techniques. 100 patients will be included and randomized pre-operatively. All patients aged 18 years or older scheduled for primary elective implantation of a TIAP under local anesthesia who signed the informed consent will be included. The primary endpoint is the primary success rate of the randomized technique. Control Intervention: Venae Sectio will be employed to insert a TIAP by a surgeon; Experimental intervention: Punction of V. Subclavia will be used to place a TIAP by a radiologist. Duration of study: Approximately 10 months, follow up time: 90 days. Organisation/Responsibility The PORTAS 2 – Trial will be conducted in accordance with the protocol and in compliance with the moral, ethical, and scientific principles governing clinical research as set out in the Declaration of Helsinki (1989 and Good Clinical Practice (GCP. The Center of Clinical Trials at the Department of Surgery, University Hospital Heidelberg is responsible for design and conduct of the trial including randomization and documentation of patients' data. Data management and statistical analysis will be performed by the independent Institute for Medical Biometry and Informatics (IMBI, University of Heidelberg. Trial Registration The trial is registered at ClinicalTrials.gov (NCT00600444.

  18. Catheter Angiography

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    Full Text Available ... the American College of Radiology (ACR) and the European Society of Urogenital Radiology note that the available ... will regain their normal function within five to seven days. Rarely, the catheter punctures the artery, causing ...

  19. Catheter Angiography

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    Full Text Available ... diagnosis and treatment in a single procedure. An example is finding an area of severe arterial narrowing, ... contrast material, your radiologist may advise that you take special medication for 24 hours before catheter angiography ...

  20. Catheter Angiography

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    Full Text Available ... possible to combine diagnosis and treatment in a single procedure. Catheter angiography produces very detailed, clear and ... possible to combine diagnosis and treatment in a single procedure. An example is finding an area of ...

  1. Catheter Angiography

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    Full Text Available ... you are pregnant and discuss any recent illnesses, medical conditions, medications you're taking and allergies, especially ... is Catheter Angiography? Angiography is a minimally invasive medical test that helps physicians diagnose and treat medical ...

  2. Catheter Angiography

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    Full Text Available ... spaghetti. top of page How does the procedure work? Catheter angiography works much the same as a ... angiogram may be performed in less than an hour; however, it may last several hours. top of ...

  3. Catheter Angiography

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    Full Text Available ... a catheter, x-ray imaging guidance and an injection of contrast material to examine blood vessels in ... technologies and, in most cases, a contrast material injection is needed to produce pictures of blood vessels ...

  4. Catheter Angiography

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    Full Text Available ... far outweighs the risk. If you have a history of allergy to x-ray contrast material, your ... Angiography (CTA) X-ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to Catheter Angiography Sponsored ...

  5. Catheter Angiography

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    Full Text Available ... spaghetti. top of page How does the procedure work? Catheter angiography works much the same as a ... and x-rays. Manufacturers of intravenous contrast indicate mothers should not breastfeed their babies for 24-48 ...

  6. Catheter Angiography

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    Full Text Available ... atherosclerosis (plaque). The use of a catheter makes it possible to combine diagnosis and treatment in a ... the aorta in the chest or abdomen or its major branches. show the extent and severity of ...

  7. Catheter Angiography

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    Full Text Available ... story about radiology? Share your patient story here Images × Image Gallery Interventional radiologist performing an angiography exam View ... ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to Catheter Angiography Sponsored by Please note ...

  8. Catheter Angiography

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    Full Text Available ... examine blood vessels in key areas of the body for abnormalities such as aneurysms and disease such ... to produce pictures of blood vessels in the body. Angiography is performed using: x-rays with catheters ...

  9. Catheter Angiography

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    Full Text Available ... 20 minutes (or by using a special closure device). When the examination is complete, you may be ... contrast material, your radiologist may advise that you take special medication for 24 hours before catheter angiography ...

  10. Catheter Angiography

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    Full Text Available ... rays ). top of page What are some common uses of the procedure? Catheter angiography is used to ... community, you can search the ACR-accredited facilities database . This website does not provide cost information. The ...

  11. Catheter Angiography

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    Full Text Available ... spaghetti. top of page How does the procedure work? Catheter angiography works much the same as a ... possible to combine diagnosis and treatment in a single procedure. An example is finding an area of ...

  12. Catheter Angiography

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    Full Text Available ... Once the catheter is guided to the area being examined, a contrast material is injected through the ... You should inform your physician of any medications being taken and if there are any allergies, especially ...

  13. Catheter Angiography

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    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Catheter Angiography ...

  14. Power port contrast medium flushing and trapping: impact of temperature, an in vitro experimental study

    Directory of Open Access Journals (Sweden)

    Guiffant G

    2013-09-01

    Full Text Available Gérard Guiffant,1 Jean Jacques Durussel,1 Patrice Flaud,1 Laurent Royon,1 Pierre Yves Marcy,2 Jacques Merckx1,31University Paris Diderot, Paris, France; 2Radiodiagnosis and Interventional Radiology Department, Caen, France; 3University Teaching Hospital Necker-Enfants Malades, Paris, FrancePurpose: The use of totally implantable venous access devices (TIVADs certified as "high pressure resistant" or "power port" has begun to spread worldwide as a safe procedure for power contrast injection. Owing to the thermo-rheological properties of the contrast media, the primary aim of this work is to present an in vitro experimental impact study concerning the impact of the temperature level on flushing efficiency after contrast medium injection. Moreover, we report experimental data that confirms the role of needle bevel orientation. The secondary aim is to answer the following questions: Is there significant device contrast medium trapping after contrast medium injection? Is saline flushing efficient? And, finally, is it safe to inject contrast medium through an indwelled port catheter?Results: The experimental results show that in addition to hydrodynamics, temperature is a key parameter for the efficiency of device flushing after contrast medium injection. It appears that this is the case when the cavity is incompletely rinsed after three calibrated flushing volumes of 10 mL saline solution, even by using the Huber needle bevel opposite to the port exit. This leads to a potentially important trapped volume of contrast medium in the port, and consequently to the possibility of subsequent salt precipitates and long term trisubstituted benzene nuclei delivery that might impair the solute properties, which may be further injected via the power port later on.Conclusion: We thus suggest, in TIVADS patients, the use of a temporary supplementary intravenous line rather than the port to perform contrast medium injections in daily radiology routine practice

  15. Complication-related removal of totally implantable venous access port systems: Does the interval between placement and first use and the neutropenia-inducing potential of chemotherapy regimens influence their incidence? A four-year prospective study of 4045 patients.

    Science.gov (United States)

    Kakkos, A; Bresson, L; Hudry, D; Cousin, S; Lervat, C; Bogart, E; Meurant, J P; El Bedoui, S; Decanter, G; Hannebicque, K; Regis, C; Hamdani, A; Penel, N; Tresch-Bruneel, E; Narducci, F

    2017-04-01

    Totally implantable venous access port systems are widely used in oncology, with frequent complications that sometimes necessitate device removal. The aim of this study is to investigate the impact of the time interval between port placement and initiation of chemotherapy and the neutropenia-inducing potential of the chemotherapy administered upon complication-related port removal. Between January 2010 and December 2013, 4045 consecutive patients were included in this observational, single-center prospective study. The chemotherapy regimens were classified as having a low (20%) risk for inducing neutropenia. The overall removal rate due to complications was 7.2%. Among them, port-related infection (2.5%) and port expulsion (1%) were the most frequent. The interval between port insertion and its first use was shown to be a predictive factor for complication-related removal rates. A cut-off of 6 days was statistically significant (p = 0.008), as the removal rate for complications was 9.4% when this interval was 0-5 days and 5.7% when it was ≥6 days. Another factor associated with port complication rate was the neutropenia-inducing potential of the chemotherapy regimens used, with removal for complications involved in 5.5% of low-risk regimens versus 9.4% for the intermediate- and high-risk regimens (p = 0.003). An interval of 6 days between placement and first use of the port reduces the removal rate from complications. The intermediate- and high-risk for neutropenia chemotherapy regimens are related to higher port removal rates from complications than low-risk regimens. Copyright © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  16. Ports Initiative

    Science.gov (United States)

    EPA's Ports Initiative works in collaboration with the port industry, communities, and government to improve environmental performance and increase economic prosperity. This effort helps people near ports breath cleaner air and live better lives.

  17. Catheter Angiography

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    Full Text Available ... to help prepare for a kidney transplant or stent placement. guide interventional radiologists and surgeons making repairs to diseased blood vessels, such as implanting stents or evaluating a stent after implantation. detect injury ...

  18. Clinical validation of dual-source dual-energy computed tomography (DECT) for coronary and valve imaging in patients undergoing trans-catheter aortic valve implantation (TAVI).

    Science.gov (United States)

    Mahoney, R; Pavitt, C W; Gordon, D; Park, B; Rubens, M B; Nicol, E D; Padley, S P

    2014-08-01

    To assess the validity of virtual non-contrast (VNC) reconstructions for coronary artery calcium (CACS) and aortic valve calcium scoring (AVCS) in patients undergoing trans-catheter aortic valve implantation (TAVI). Twenty-three consecutive TAVI patients underwent a three-step computed tomography (CCT) acquisition: (1) traditional CACS; (2) dual-energy (DE) CT coronary angiogram (CTCA); and (3) DE whole-body angiogram. Linear regression was used to model calcium scores generated from VNC images with traditional scores to derive a conversion factor [2.2 (95% CI: 1.97-2.58)]. The effective radiation dose for the TAVI protocol was compared to a standard control group. Bland-Altman analysis and weighted k-statistic were used to assess inter-method agreement for absolute score and risk centiles. CACS and AVCS from VNC reconstructions correlated well with traditional scores (r = 0.94 and r = 0.86; both p VNC and non-contrast coronary calcium scores [mean difference -71.8 (95% limits of agreement -588.7 to 445.1)], with excellent risk stratification into risk centiles (k = 0.99). However, the agreement was weaker for the aortic valve [mean difference -210.6 (95% limits of agreement -1233.2 to 812)]. Interobserver variability was excellent for VNC CACS [mean difference of 6 (95% limits of agreement 134.1-122.1)], and AVCS [mean difference of -16.4 (95% limits of agreement 576 to -608.7)]. The effective doses for the DE TAVI protocol was 16.4% higher than standard TAVI protocol (22.7 versus 19.5 mSv, respectively) accounted for by the DE CTCA dose being 47.8% higher than that for a standard CTCA [9.9 (5.6-14.35) versus 6.7 (1.17-13.72) mSv; p VNC reconstructions. However, the dose from DE CTCA is significantly greater than the standard single-energy CTCA precluding the use of this technology in routine clinical practice. Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  19. Relato de caso: implante transparietohepático de cateter de longa permanência para diálise Case report: transhepatic insertion of long-term dialysis catheter

    Directory of Open Access Journals (Sweden)

    Felipe Nasser

    2007-12-01

    Full Text Available O implante transhepático de cateteres de diálise de longa permanência é um procedimento de exceção, utilizado para obter um acesso em pacientes com oclusão de veias centrais de membros superiores e inferiores. O caso descrito relata um paciente jovem, com história de 15 anos de diálise, que foi submetido no passado a um transplante renal sem sucesso. Esse paciente encontrava-se em urgência dialítica e oclusão comprovada de veias centrais de membros superiores e de veias ilíacas. Foi realizado o implante do cateter de longa permanência pelo acesso transparietohepático sob anestesia geral. A ponta do cateter foi posicionada ao nível do átrio direito. A diálise foi realizada satisfatoriamente no mesmo dia.Transhepatic insertion of long-term dialysis catheter is an exception procedure used to obtain access in patients with central vein occlusion of lower and upper limbs. We report on a case of a young patient with history of dialysis for 15 years, who was submitted to an unsuccessful renal transplantation. This patient was in dialytic emergency and had confirmed occlusion of upper limb central veins and iliac veins. Transhepatic insertion of a long-term catheter was performed under general anesthesia. The catheter tip was placed at the level of the right atrium. Dialysis was satisfactorily performed on the same day.

  20. Catheter Angiography

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    Full Text Available ... rare, and radiology departments are well-equipped to deal with them. There is a small risk that ... standard x-ray contrast. Catheter angiography should be done very cautiously—if at all—in patients who ...

  1. Catheter Angiography

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    Full Text Available ... key areas of the body for abnormalities such as aneurysms and disease such as atherosclerosis (plaque). The use of a catheter makes ... including the: brain neck heart chest abdomen (such as the kidneys and liver) pelvis legs and feet ...

  2. Catheter Angiography

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    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician ... Catheter Angiography? Angiography is a minimally invasive medical test that helps physicians diagnose and treat medical conditions. ...

  3. Successful treatment of central venous catheter induced superior vena cava syndrome with ultrasound accelerated catheter-directed thrombolysis.

    Science.gov (United States)

    Dumantepe, Mert; Tarhan, Arif; Ozler, Azmi

    2013-06-01

    Superior vena cava (SVC) syndrome results from obstruction of flow through the vessel either by external compression or thrombosis. External compression by intrathoracic neoplasms is the most common etiology, especially lung cancer and lymphoma. Thrombosis is becoming increasingly common due to the use of indwelling catheters and implantable central venous access devices. Most patients are unresponsive to anticoagulation alone which appears to be effective only in the mildest cases. However, recent advances in catheter-based interventions have led to the development of a variety of minimally invasive endovascular strategies to remove venous thrombus and accepted as an important first-line treatment given its high overall success rate and low morbidity as compared with medical and surgical treatments. Ultrasound accelerated catheter-directed thrombolysis (UACDT) has been developed to rapidly and completely resolve the existing thrombus. This technique integrates high frequency, low intensity ultrasound (US) with standard CDT in order to accelerate clot dissolution, reducing treatment time and the incidence of thrombolysis-related complications. An US wave enhances drug permeation through thrombus by disaggregating the fibrin matrix, exposing additional plasminogen receptor sites to the thrombolytic agent. The US energy affects thrombus in the entire venous segment, increasing the probability of complete thrombus clearing. We report the case of a 56-year-old man who presented with a 5 days history of SVC syndrome symptoms who had been receiving chemotherapy for colon cancer through a right subclavian vein port catheter. The patient successfully treated with UACDT with EkoSonic(®) Mach4e Endovascular device with an overnight infusion. © 2013 Wiley Periodicals, Inc. Copyright © 2013 Wiley Periodicals, Inc.

  4. Cost and Morbidity Analysis of Chest Port Insertion: Interventional Radiology Suite Versus Operating Room.

    Science.gov (United States)

    LaRoy, Jennifer R; White, Sarah B; Jayakrishnan, Thejus; Dybul, Stephanie; Ungerer, Dirk; Turaga, Kiran; Patel, Parag J

    2015-06-01

    To compare complications and cost, from a hospital perspective, of chest port insertions performed in an interventional radiology (IR) suite versus in surgery in an operating room (OR). This study was approved by an institutional review board and is HIPAA compliant. Medical records were retrospectively searched on consecutive chest port placement procedures, in the IR suite and the OR, between October 22, 2010 and February 26, 2013, to determine patients' demographic information and chest port-related complications and/or infections. A total of 478 charts were reviewed (age range: 21-85 years; 309 women, 169 men). Univariate and bivariate analyses were performed to identify risk factors associated with an increased complication rate. Cost data on 149 consecutive Medicare outpatients (100 treated in the IR suite; 49 treated in the OR) who had isolated chest port insertions between March 2012 and February 2013 were obtained for both the operative services and pharmacy. Nonparametric tests for heterogeneity were performed using the Kruskal-Wallis method. Early complications occurred in 9.2% (22 of 239) of the IR patients versus 13.4% (32 of 239) of the OR patients. Of the 478 implanted chest ports, 9 placed in IR and 18 placed in surgery required early removal. Infections from the ports placed in IR versus the OR were 0.25 versus 0.18 infections per 1000 catheters, respectively. Overall mean costs for chest port insertion were significantly higher in the OR, for both room and pharmacy costs (P chest ports in an OR setting was almost twice that of placement in the IR suite. Hospital costs to place a chest port were significantly lower in the IR suite than in the OR, whereas radiology and surgery patients did not show a significantly different rate of complications and/or infections. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  5. Complications of chemoport in children with cancer: Experience of 54,100 catheter days from a tertiary cancer center of Southern India

    Directory of Open Access Journals (Sweden)

    S Aparna

    2015-01-01

    Full Text Available Background: Chemoport is an essential part of the management of children with cancer and provides long-term venous access. There are few studies from resource poor countries reporting complications of chemoport. Aims: This study was aimed at describing the complications of chemoport in patients with cancer. Materials and Methods: This retrospective observational study analyzed 200 patients <15 years of age who underwent chemoport insertion. The medical records of these patients were reviewed for the patient characteristics, diagnosis, nature of port use, port-related complications and their management. Results: A total of 209 ports were implanted in 200 patients and 24 ports were removed due to port-related complications. There were 122 boys and 78 girls whose ages ranged from 4 months to 13 years (median age 2.5 years. About72% of patients were <2 years old. The cumulative duration of catheterization was 54,100 days. Of 209 ports, there were 36 complications that led to the removal of 21 ports. Port-related infection was the most common infection observed in our study (0.66/1000 catheter days and 11.9%. Mechanical complications were seen in 9 patients. Venous thrombosis and skin necrosis occurred in one patient each. Conclusions: Use of chemoport is safe and is a boon for children with cancer in developing countries with incidence of complications similar to Western countries. Although use of chemoport is associated with complications, they are easily managed. With stringent catheter care by trained personnel, some complications can be prevented.

  6. Spontaneous fracture of implanted central venous catheters in cancer patients: report of two cases and retrospective analysis of the 'pinch-off sign' as a risk factor

    NARCIS (Netherlands)

    Punt, C. J.; Strijk, S.; van der Hoeven, J. J.; van de Sluis, R.; Verhagen, C. A.

    1995-01-01

    Spontaneous fracture of central venous catheters (CVC) has been reported. It results from repeated compression of the extravasal part of the CVC between the clavicle and the first rib. The so called pinch-off sign (POS) of the CVC as visible on a chest radiograph has been described as a warning for

  7. Use of monorail PTCA balloon catheter for local drug delivery.

    Science.gov (United States)

    Trehan, Vijay; Nair, Girish M; Gupta, Mohit D

    2007-01-01

    We report the use of monorail coronary balloon as an infusion catheter to give bailout abciximab selectively into the site of stent thrombosis as an adjunct to plain old balloon angioplasty (POBA) in a patient of subacute stent thrombosis of the left anterior descending coronary artery. The balloon component (polyamide material) of the monorail balloon catheter was shaved off the catheter so that abciximab injected through the balloon port of the catheter exited out the shaft of the balloon catheter at the site from where the balloon material was shaved off. We believe that selective infusion with abciximab along with POBA established antegrade flow and relieved the patient's ischemia. In the absence of essential hardware to give intracoronary drugs in an emergency situation, one may employ our technique of infusion through a monorail balloon catheter after shaving the balloon component from the catheter.

  8. Principal Ports

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Principal Ports are defined by port limits or US Army Corps of Engineers (USACE) projects, these exclude non-USACE projects not authorized for publication. The...

  9. Obstruction of peritoneal dialysis catheter is associated with catheter type and independent of omentectomy: A comparative data analysis from a transplant surgical and a pediatric surgical department.

    Science.gov (United States)

    Radtke, Josephine; Schild, Raphael; Reismann, Marc; Ridwelski, Robert-Richard; Kempf, Caroline; Nashan, Bjoern; Rothe, Karin; Koch, Martina

    2018-04-01

    Peritoneal dialysis (PD) catheter occlusion is a common complication with up to 36% of catheter obstructions described in the literature. We present a comparison of complications and outcome after implantation of PD catheters in a transplant surgical and a pediatric surgical department. We retrospectively analyzed 154 PD catheters, which were implanted during 2009-2015 by transplant surgeons (TS, University Medical Center Hamburg-Eppendorf, Germany, n=85 catheters) and pediatric surgeons (PS, Charité University Medicine Berlin, Germany, n=69 catheters) in 122 children (median (range) age 3.0 (0.01-17.1) years) for acute (n=65) or chronic (n=89) renal failure. All catheters were one-cuffed or double-cuffed curled catheters, except that straight catheters were implanted into smaller children (n=19) by TS in Hamburg. Patient characteristics and operation technique did not differ between the departments. Peritonitis was the most common complication (33 catheters, 21.4%). Leakage (n=18 catheters, 11.7%) occurred more often in children weighing <10kg (p<0.001). The incidence of obstruction and dysfunction was significantly higher in catheters used in PS than catheters used in TS (30.4% vs. 11.8%, p=0.004). Omentectomy did not reduce the incidence of catheter obstruction (p=1.0). Perforation at the catheter tips was larger and appeared to be rougher in catheters used in PS than the catheters in TS. The type of catheter and presumably the type of perforation at the catheter tip may influence the incidence of peritoneal dialysis catheter obstruction. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Catheter Angiography

    Medline Plus

    Full Text Available ... stent placement. guide interventional radiologists and surgeons making repairs to diseased blood vessels, such as implanting stents ... bone absorbs much of the radiation while soft tissue, such as muscle, fat and organs, allow more ...

  11. Indwelling catheter care

    Science.gov (United States)

    Foley catheter ... You will need to make sure your indwelling catheter is working properly. You will also need to ... not get an infection or skin irritation. Make catheter and skin care part of your daily routine. ...

  12. Application of an ultrasound-guided low-approach insertion technique in three types of totally implantable access port

    Directory of Open Access Journals (Sweden)

    Hung-Wei Cheng

    2014-05-01

    Conclusion: Our study highlights a revised technique for placement of TIAP systems of differing types of material or size. Not only was the curvature of the device catheter smooth, but patients were satisfied with the cosmetic appearance.

  13. Clinical Application of a New Indwelling Catheter with a Side-Hole and Spirally Arranged Shape-Memory Alloy for Hepatic Arterial Infusion Chemotherapy

    International Nuclear Information System (INIS)

    Yagihashi, Kunihiro; Takizawa, Kenji; Ogawa, Yukihisa; Okamoto, Kyoko; Yoshimatsu, Misako; Fujikawa, Atsuko; Shimamoto, Hiroshi; Nakajima, Yasuo

    2010-01-01

    A new indwelling catheter, G-spiral (GSP), was developed for hepatic arterial infusion chemotherapy (HAIC) by way of an implanted catheter-port system (CPS). Here we evaluated its physical properties and the outcomes of its clinical use. The GSP vessel-fixing power and its ability to follow a guidewire were determined with a vascular in vitro model, and Student t test was used to determine statistical significance (P < 0.05). A retrospective analysis was performed to evaluate the technical success rate and to identify the clinical complications associated with radiologic CPS implantation with GSP in 65 patients with unresectable hepatic tumors. The mean vessel-fixing power of the GSP (14.4 g) significantly differed from that of a GSP with a cut shape-memory alloy (3.3 g). The mean resistance to following the guidewire displayed by the GSP (88.5 g) was significantly less than that for a 5F W-spiral (106.3 g) or 4F Cobra-type angiographic catheter (117.8 g). The CPS was placed successfully in 64 of 65 cases (98.5%). Hepatic artery occlusion was observed in one case. Occlusion, cracking, and infection of CPS were observed in one, two, and one case, respectively. The GSP is a highly useful indwelling catheter that can be used for HAIC.

  14. Clinical-epidemiological characteristics and outcome of patients with catheter-related bloodstream infections in Europe (ESGNI-006 Study)

    DEFF Research Database (Denmark)

    Muñoz, P; Bouza, E; San Juan, R

    2004-01-01

    (1.55 vs. 0.33/1,000 admissions). Most (67%) catheters were non-tunneled central venous catheters, were in the jugular vein (44%), had been implanted for > 7 days (70%), were made of polyurethane (61%) and were multi-lumen (67%). In 36% of cases, catheters were implanted by physicians other than...

  15. Endovascular technique using a snare and suture for retrieving a migrated peripherally inserted central catheter in the left pulmonary artery

    Science.gov (United States)

    Teragawa, Hiroki; Sueda, Takashi; Fujii, Yuichi; Takemoto, Hiroaki; Toyota, Yasushi; Nomura, Shuichi; Nakagawa, Keigo

    2013-01-01

    We report a successful endovascular technique using a snare with a suture for retrieving a migrated broken peripherally inserted central catheter (PICC) in a chemotherapy patient. A 62-year-old male received monthly chemotherapy through a central venous port implanted into his right subclavian area. The patient completed chemotherapy without complications 1 mo ago; however, he experienced pain in the right subclavian area during his last chemotherapy session. Computed tomography on that day showed migration of a broken PICC in his left pulmonary artery, for which the patient was admitted to our hospital. We attempted to retrieve the ectopic PICC through the right jugular vein using a gooseneck snare, but were unsuccessful because the catheter was lodged in the pulmonary artery wall. Therefore, a second attempt was made through the right femoral vein using a snare with triple loops, but we could not grasp the migrated PICC. Finally, a string was tied to the top of the snare, allowing us to curve the snare toward the pulmonary artery by pulling the string. Finally, the catheter body was grasped and retrieved. The endovascular suture technique is occasionally extremely useful and should be considered by interventional cardiologists for retrieving migrated catheters. PMID:24109502

  16. Incidence and risk factors for central venous access port-related infection in Chinese cancer patients.

    Science.gov (United States)

    Wang, Ting-Yao; Lee, Kuan-Der; Chen, Ping-Tsung; Chen, Min-Chi; Chen, Yi-Yang; Huang, Cih-En; Kuan, Feng-Che; Chen, Chih-Cheng; Lu, Chang Hsien

    2015-11-01

    Cytotoxic chemotherapy via central venous access ports is an important part of the standard treatment for most cancers, but it is accompanied with the risk of infections. This study aimed to analyze the incidence and risk factors for central venous access port-related infection (CPI) among Chinese patients receiving cytotoxic chemotherapy. Between January 1, 2002 and December 31, 2005 a total of 1391 cancer patients with 1449 totally implantable central venous access ports were evaluated. The log-rank test and Cox proportional hazards model were used for the analyses of risk factors. The overall CPI incidence rate was 0.21 per 1000 catheter-days. Hematological malignancies and head and neck cancer were associated with an increased risk of CPI (hazard ratio 4.00 and 4.11, respectively, both p risk of infection than for patients in a nonadjuvant setting (p ports. Implementation of an insertion bundle for the prevention of central line-associated bloodstream infections is warranted, especially for those patients with hematological and head and neck cancers, as well as for patients receiving chemotherapy in the metastatic settings. Copyright © 2015. Published by Elsevier B.V.

  17. Intake port

    Science.gov (United States)

    Mendler, Edward Charles

    2005-02-01

    The volumetric efficiency and power of internal combustion engines is improved with an intake port having an intake nozzle, a venturi, and a surge chamber. The venturi is located almost halfway upstream the intake port between the intake valves and the intake plenum enabling the venturi throat diameter to be exceptionally small for providing an exceptionally high ram velocity and an exceptionally long and in turn high efficiency diffuser flowing into the surge chamber. The intake port includes an exceptionally large surge chamber volume for blow down of the intake air into the working cylinder of the engine.

  18. Successful Retrieval of a Dismembered Central Venous Catheter Stuck to the Right Pulmonary Artery Using a Stepwise Approach

    Directory of Open Access Journals (Sweden)

    Keisuke Nakabayashi

    2016-01-01

    Full Text Available Recent advances in anticancer chemotherapy have resulted in an increase in the number of patients requiring a central venous port catheter, and the incidence of catheter pinch-off syndrome has been increasing. Catheter pinch-off syndrome is a rare and unusual complication. It is difficult to retrieve dislodged catheters from the pulmonary artery, especially if the catheter is stuck to the peripheral pulmonary artery. We herein describe the successful removal of a catheter stuck in the pulmonary artery with a stepwise approach. First, a pigtail catheter was used to tug the dislodged catheter in order to free the unilateral end. Then, a gooseneck snare was used to catch and pull the catheter out of the patient. The key to success is to free the end of the catheter.

  19. The dialysis catheter and infectious peritonitis in intermittent peritoneal dialysis

    DEFF Research Database (Denmark)

    Kolmos, Hans Jørn; Hemmeløff Andersen, Karl Erik; Hansen, Lise

    1984-01-01

    118 episodes of infectious peritonitis registered among 156 patients treated with intermittent peritoneal dialysis over a 5-yr period were analysed with special reference to potential routes of infection associated with the dialysis catheter. Peritonitis was randomly distributed among the patients......, and the change of keeping free of peritonitis declined exponentially with time. The main factor determining the individual number of episodes was the total space of time, in which a patient had been wearing a dialysis catheter, whereas the number of catheter disconnections played no significant role. A relative...... preponderance of cases due to Enterobacteriaceae was noted within the first week after catheter implantation. In contrast with this, peritonitis with skin microorganisms was not associated with the implantation of catheters....

  20. Power port contrast medium flushing and trapping: impact of temperature, an in vitro experimental study.

    Science.gov (United States)

    Guiffant, Gérard; Durussel, Jean Jacques; Flaud, Patrice; Royon, Laurent; Marcy, Pierre Yves; Merckx, Jacques

    2013-01-01

    The use of totally implantable venous access devices (TIVADs) certified as "high pressure resistant" or "power port" has begun to spread worldwide as a safe procedure for power contrast injection. Owing to the thermo-rheological properties of the contrast media, the primary aim of this work is to present an in vitro experimental impact study concerning the impact of the temperature level on flushing efficiency after contrast medium injection. Moreover, we report experimental data that confirms the role of needle bevel orientation. The secondary aim is to answer the following questions: Is there significant device contrast medium trapping after contrast medium injection? Is saline flushing efficient? And, finally, is it safe to inject contrast medium through an indwelled port catheter? The experimental results show that in addition to hydrodynamics, temperature is a key parameter for the efficiency of device flushing after contrast medium injection. It appears that this is the case when the cavity is incompletely rinsed after three calibrated flushing volumes of 10 mL saline solution, even by using the Huber needle bevel opposite to the port exit. This leads to a potentially important trapped volume of contrast medium in the port, and consequently to the possibility of subsequent salt precipitates and long term trisubstituted benzene nuclei delivery that might impair the solute properties, which may be further injected via the power port later on. We thus suggest, in TIVADS patients, the use of a temporary supplementary intravenous line rather than the port to perform contrast medium injections in daily radiology routine practice.

  1. Prostate HDR brachytherapy catheter displacement between planning and treatment delivery

    International Nuclear Information System (INIS)

    Whitaker, May; Hruby, George; Lovett, Aimee; Patanjali, Nitya

    2011-01-01

    Background and purpose: HDR brachytherapy is used as a conformal boost for treating prostate cancer. Given the large doses delivered, it is critical that the volume treated matches that planned. Our outpatient protocol comprises two 9 Gy fractions, two weeks apart. We prospectively assessed catheter displacement between CT planning and treatment delivery. Materials and methods: Three fiducial markers and the catheters were implanted under transrectal ultrasound guidance. Metal marker wires were inserted into 4 reference catheters before CT; marker positions relative to each other and to the marker wires were measured from the CT scout. Measurements were repeated immediately prior to treatment delivery using pelvic X-ray with marker wires in the same reference catheters. Measurements from CT scout and film were compared. For displacements of 5 mm or more, indexer positions were adjusted prior to treatment delivery. Results: Results are based on 48 implants, in 25 patients. Median time from planning CT to treatment delivery was 254 min (range 81–367 min). Median catheter displacement was 7.5 mm (range −2.9–23.9 mm), 67% of implants had displacement of 5 mm or greater. Displacements were predominantly caudal. Conclusions: Catheter displacement can occur in the 1–3 h between the planning CT scan and treatment. It is recommended that departments performing HDR prostate brachytherapy verify catheter positions immediately prior to treatment delivery.

  2. Ports Primer: 3.2 Port Governance

    Science.gov (United States)

    State and local governments are important players in port governance and in oversight of transportation projects that may affect ports. Private corporations may also play a role if they lease or own a terminal at a port.

  3. Catheter-Related Sepsis Due to Rhodotorula glutinis

    Science.gov (United States)

    Hsueh, Po-Ren; Teng, Lee-Jene; Ho, Shen-Wu; Luh, Kwen-Tay

    2003-01-01

    We describe a central venous catheter-related (Port-A-Cath; Smiths Industries Medical Systems [SIMS] Deltec, Inc., St. Paul, Minn.) infection caused by Rhodotorula glutinis in a 51-year-old man with nasopharyngeal carcinoma. He was treated with fluconazole for 8 weeks and had the catheter removed. Two isolates of R. glutinis recovered from blood specimens (one obtained via peripheral veins and one via the catheter) before administration of fluconazole and one recovered from the removed catheter 17 days after initiation of fluconazole therapy exhibited high-level resistance to fluconazole (MICs, >256 μg/ml). These three isolates were found to belong to a single clone on the basis of identical antibiotypes determined by the E test (PDM Epsilometer; AB Biodisk, Solna, Sweden) and biotypes determined by API ID32 C (bioMerieux, Marcy I'Etoile, France) and their identical random amplified polymorphic DNA patterns. PMID:12574300

  4. Manejo do cateter venoso central totalmente implantado em pacientes oncológicos: revisão integrative Manejo del catéter venoso central totalmente implantado en pacientes oncológicos: revisión integrativa Management of totally implanted catheter in patients with cancer: an integrative review

    Directory of Open Access Journals (Sweden)

    Christiane Inocêncio Vasques

    2009-10-01

    Full Text Available O cateter totalmente implantado é amplamente utilizado durante o tratamento de pacientes com câncer e é capaz de minimizar complicações decorrentes da terapia intravenosa periférica. Assim, buscou-se identificar os cuidados de enfermagem relacionados ao manuseio de cateter totalmente implantado nesses pacientes. Para tanto, realizou-se revisão integrativa da literatura que resultou na análise de 15 artigos. O conhecimento produzido está direcionado para o tempo de permanência do cateter, complicações inerentes ao uso, manuseio do dispositivo, percepção do paciente em relação ao cateter e informações ao paciente. Além de demonstrar a complexidade da assistência de enfermagem no manuseio desses dispositivos, os achados podem auxiliar, igualmente, os profissionais que não atuam em oncologia, na aplicação de conhecimentos na prática clínica.El catéter totalmente implantado es ampliamente utilizado durante el tratamiento de pacientes con cáncer y es capaz de minimizar las complicaciones consecuentes de la terapia intravenosa periférica. Así, en este trabajo, se buscó identificar los cuidados de enfermería relacionados a la manipulación del catéter totalmente implantado en esos pacientes. Para tal efecto, se realizó una revisión integrativa de la literatura dando como resultado el análisis de 15 artículos. El conocimiento producido está orientado hacia el tiempo de permanencia del catetér, complicaciones inherentes al uso, manipulación del dispositivo, informaciones y percepción del paciente en relación al catéter. Aparte de demostrar la complejidad de la asistencia de enfermería en la manipulación de esos dispositivos, los hallazgos pueden auxiliar, igualmente, a los profesionales que no actúan en oncología, en la aplicación de conocimientos en la práctica clínica.Totally implanted catheter, which is effective in deceasing complications related to peripheral intravenous therapy, is widely used in

  5. Central venous catheter infections in home parenteral nutrition patients: Outcomes from Sustain: American Society for Parenteral and Enteral Nutrition's National Patient Registry for Nutrition Care.

    Science.gov (United States)

    Ross, Vicki M; Guenter, Peggi; Corrigan, Mandy L; Kovacevich, Debra; Winkler, Marion F; Resnick, Helaine E; Norris, Tina L; Robinson, Lawrence; Steiger, Ezra

    2016-12-01

    Home parenteral nutrition (HPN) is a high-cost, complex nutrition support therapy that requires the use of central venous catheters. Central line-associated bloodstream infections (CLABSIs) are among the most serious risks of this therapy. Sustain: American Society for Parenteral and Enteral Nutrition's National Patient Registry for Nutrition Care (Sustain registry) provides the most current and comprehensive data for studying CLABSI among a national cohort of HPN patients in the United States. This is the first Sustain registry report detailing longitudinal data on CLABSI among HPN patients. To describe CLABSI rates for HPN patients followed in the Sustain registry from 2011-2014. Descriptive, χ 2 , and t tests were used to analyze data from the Sustain registry. Of the 1,046 HPN patients from 29 sites across the United States, 112 (10.7%) experienced 194 CLABSI events during 223,493 days of HPN exposure, for an overall CLABSI rate of 0.87 episodes/1,000 parenteral nutrition-days. Although the majority of patients were female (59%), adult (87%), white (75%), and with private insurance or Medicare (69%), CLABSI episodes per 1,000 parenteral nutrition-days were higher for men (0.69 vs 0.38), children (1.17 vs 0.35), blacks (0.91 vs 0.41), and Medicaid recipients (1.0 vs 0.38 or 0.39). Patients with implanted ports or double-lumen catheters also had more CLABSIs than those with peripherally inserted or central catheters or single-lumen catheters. Staphylococci were the most commonly reported pathogens. These data support findings of smaller studies about CLABSI risk for children and by catheter type and identify new potential risk factors, including gender, race, and insurance type. Additional studies are needed to determine effective interventions that will reduce HPN-associated CLABSI. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  6. Prospective study of catheter-related central vein thrombosis in home parenteral nutrition patients with benign disease using serial venous Doppler ultrasound.

    Science.gov (United States)

    Cuerda, Cristina; Joly, Francisca; Corcos, Olivier; Concejo, Javier; Puiggrós, Carolina; Gil, Carmen; Pironi, Loris

    2016-02-01

    Catheter-related central vein thrombosis (CRVT) is a severe complication of home parenteral nutrition (HPN) that may be clinically manifest or subclinical. The aims of the study were to prospectively investigate the incidence of CRVT in patients on HPN with benign disease and determine the influence of different variables on this complication. A prospective, multicentre, observational study in the Home Artificial Nutrition-Chronic Intestinal Failure ESPEN group was performed. Patients with benign disease starting HPN or already on HPN after the insertion of a new catheter, were recruited and followed up with Color Doppler Duplex Sonography (CDDS) evaluations at baseline, 1 week, 3, 6 and 12 months after catheter insertion. Fisher's exact test was used to calculate the association of different variables (related to the patient, type of catheter, vascular access, insertion method, catheter care and anticoagulant treatment) with CRVT events. Sixty-two patients (31 males, 31 females) aged 50 ± 19 (19-83) years were included and followed for a median 363 days, with an Inter Quartile Range of 180-365 days, and a total of 16,186 catheter-days. Six patients had previous CRVT and 16 had history of thromboembolic disease (pulmonary and mesenteric). Forty one patients were receiving anticoagulant treatment. Fifty two patients had tunneled catheters and 10 implanted ports. Two patients had symptomatic thrombosis at 3 and 12 months of follow-up (2 and 3 weeks after normal routine CDDS evaluation). The incidence of CRVT was 0.045/catheter/year. CRVT was not significantly associated with any of the variables analyzed. The incidence of CRVT in patients on HPN for benign disease followed by CDDS is low in the first year of catheterization. We did not observe any case of asymptomatic CRVT. Based on our data, CDDS seems to have low effectiveness as a screening tool for CRVT in asymptomatic patients on HPN with benign disease. Copyright © 2015 Elsevier Ltd and European Society for

  7. Three ports versus four ports laparoscopic cholecystectomy

    International Nuclear Information System (INIS)

    Shah, S.F.; Waqar, S.; Chaudry, M.A.; Hameed, S.

    2017-01-01

    To compare three ports laparoscopic cholecystectomy and four ports laparoscopic cholecystectomy in terms of complications, time taken to complete the procedure, hospital stay and cost effectiveness in local perspective. Methodology: This randomized control trial included 60 patients who underwent elective laparoscopic cholecystectomy at Department of Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan from January 2013 to June 2013. These patients were randomized on computer generated table of random numbers into group A and Group B. In Group A patients four ports were passed to perform laparoscopic cholecystectomy and in Group B patients three ports were passed to perform the procedure. Results: The mean age in both groups was 44 years (range 18-72). Three ports laparoscopic cholecystectomy (43 min) took less time to complete than four ports laparoscopic cholecystectomy (51 min). Patients in three ports laparoscopic cholecystectomy experienced less pain as compared to four ports group. The total additional analgesia requirement in 24 hours calculated in milligrams was less in three port laparoscopic cholecystectomy group as compared four port laparoscopic cholecystectomy group. The mean hospital stay in three port laparoscopic cholecystectomy group is 25 hours while the mean hospital stay in the four port laparoscopic cholecystectomy group is 28 hours. Conclusion: Three ports laparoscopic cholecystectomy is safe and effective procedure and it did not compromise the patient safety. (author)

  8. A simple method of using a Foley catheter to drain pleural effusion.

    Science.gov (United States)

    Ben-Nun, Alon; Best, Lael Anson

    2008-01-01

    Pleural effusion is a common problem, and various techniques of pleural fluid drainage have been described. We report our experience of using a Foley-type catheter to drain pleural effusion. After the injection of local anesthesia, the catheter is inserted, usually through the 7th intercostal space, with the patient sitting upright. The size of the catheter is selected according to the predicted fluid characteristics, and ranges from 18 to 24 F. Once the catheter is positioned in the pleural space, the balloon is inflated with diluted soluble contrast material and connected to a urine collection bag. During the last 10 years, we have used 3500 catheters for this purpose. The catheter site can be used as a port for various procedures, including needle biopsy of the parietal pleura, talc-slurry pleurodesis, and intra-pleural fibrinolysis. This method of pleural drainage is simple, reliable, and inexpensive.

  9. Thoracic Nerve Root Entrapment by Intrathecal Catheter Coiling: Case Report and Review of the Literature.

    Science.gov (United States)

    Han, Jing L; Loriaux, Daniel B; Tybout, Caroline; Kinon, Merritt D; Rahimpour, Shervin; Runyon, Scott L; Hopkins, Thomas J; Boortz-Marx, Richard L; Lad, Shivanand P

    2016-03-01

    Intrathecal catheter placement has long-term therapeutic benefits in the management of chronic, intractable pain. Despite the diverse clinical applicability and rising prevalence of implantable drug delivery systems in pain medicine, the spectrum of complications associated with intrathecal catheterization remains largely understudied and underreported in the literature. To report a case of thoracic nerve root entrapment resulting from intrathecal catheter migration. Case report. Inpatient hospital service. A 60-year-old man status post implanted intrathecal (IT) catheter for intractable low back pain secondary to failed back surgery syndrome returned to the operating room for removal of IT pump trial catheter after experiencing relapse of preoperative pain and pump occlusion. Initial attempt at ambulatory removal of the catheter was aborted after the patient reported acute onset of lower extremity radiculopathic pain during the extraction. Noncontrast computed tomography (CT) subsequently revealed that the catheter had ascended and coiled around the T10 nerve root. The patient was taken back to the operating room for removal of the catheter under fluoroscopic guidance, with possible laminectomy for direct visualization. Removal was ultimately achieved with slow continuous tension, with complete resolution of the patient's new radicular symptoms. This report describes a single case report. This case demonstrates that any existing loops in the intrathecal catheter during initial implantation should be immediately re-addressed, as they can precipitate nerve root entrapment and irritation. Reduction of the loop or extrication of the catheter should be attempted under continuous fluoroscopic guidance to prevent further neurosurgical morbidity.

  10. Treatment of Preterm Premature Rupture of Membranes with Oligo-/Anhydramnion Colonized by Multiresistant Bacteria with Continuous Amnioinfusion and Antibiotic Administrations through a Subcutaneously Implanted Intrauterine Port System: A Case Report.

    Science.gov (United States)

    Tchirikov, Michael; Zhumadilov, Zhaxybay; Winarno, Andreas Suhartoyo; Haase, Roland; Buchmann, Jörg

    2017-01-01

    Bacterial infection is one of the main causes of preterm premature rupture of membranes (PPROM) leading to preterm delivery, pulmonary hypoplasia, sepsis and joint deformities. Expectant management, broad-spectrum antibiotics and antenatal corticosteroids are routinely used in this condition with very limited success to prevent bacteremia, chorioamnionitis, funisitis and intra-amniotic infection syndrome. Here, we report a case in which we attempted to treat PPROM at 26+3 weeks of gestation with anhydramnion colonized by multiresistant Klebsiella. A perinatal port system was implanted subcutaneously at 28+0 weeks of gestation, enabling long-term continuous lavage of the amniotic cavity with a hypotonic aqueous composition similar to human amniotic fluid combined with intra-amniotic antibiotic application. The patient gave birth to a preterm female infant at 31+1 weeks without any signs of infection. The girl was discharged with a weight of 2,730 g in very good condition. In the follow-up examinations at 5 months and 1 year of age, there was no apparent neurological disturbance, developmental delay or Klebsiella colonization. © 2015 The Author(s) Published by S. Karger AG, Basel.

  11. Spontaneous migration of central venous catheter tip following extubation

    Directory of Open Access Journals (Sweden)

    Balaji Prabaharan

    2014-01-01

    Full Text Available Migration of the tip of central venous catheters is not an uncommon event and the mechanism for this is not clear. Increased intrathoracic pressure due to coughing, sneezing or weight lifting, changing the body position or physical movements such as abduction or adduction of the arms is thought to be the cause of such migration. We present here a case of a patient with a port catheter tip that migrated from the left subclavian to the superior vene cava following extubation.

  12. Suprapubic catheter care

    Science.gov (United States)

    ... going back into your bladder. Try not to disconnect the catheter more than you need to. Keeping ... Copyright Privacy Accessibility Quality Guidelines Viewers & Players MedlinePlus Connect for EHRs For Developers U.S. National Library of ...

  13. Principal Ports and Facilities

    Data.gov (United States)

    California Natural Resource Agency — The Principal Port file contains USACE port codes, geographic locations (longitude, latitude), names, and commodity tonnage summaries (total tons, domestic, foreign,...

  14. Principal Ports and Facilities

    Data.gov (United States)

    California Department of Resources — The Principal Port file contains USACE port codes, geographic locations (longitude, latitude), names, and commodity tonnage summaries (total tons, domestic, foreign,...

  15. Incidence and outcome of retained Port-A-Cath fragments during removal.

    Science.gov (United States)

    Aworanti, Olugbenga Michael; Linnane, Niall; Tareen, Farhan; Mortell, Alan

    2017-07-01

    Port-A-Cath devices are frequently used for long-term venous access. We postulate that long-term use predisposes them to getting stuck and retained in a central vein at the time of removal. We aim to report the incidence and outcome of this complication. Between January 2006 and July 2016, a retrospective review of all Port-A-Cath removals that were performed at our centre was conducted. At the time of removal, catheters that could not be removed from the vein were considered retained. During the study period, 107 children had 174 episodes of silicone Sitimplant (Vygon, Ecouen, France) Port-A-Cath insertions. These children required 135 removal episodes and there were 3 (2.2%) instances whereby the catheter fragment was retained. These episodes of retained catheters only occurred in children with factor VIII deficiency (4.1% incidence in this cohort). For each episode of catheter insertion and removal, the catheters had been left in situ for a mean duration of 43 months in children with factor deficiency and no retained fragments, and the mean duration was 91 months in children with factor deficiency and retained catheter fragments (p = 0.0011). Port-A-Caths that are retained after attempted removal is a complication encountered predominantly in catheters that have been in use for a prolonged duration. Furthermore, factor replacement therapy in haemophiliacs may be a risk factor for this complication.

  16. Torsades de Pointes associated with QT prolongation after catheter ablation of paroxysmal atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Yae Min Park

    2017-09-01

    Full Text Available A 79-year-old woman who underwent catheter ablation for paroxysmal atrial fibrillation presented with Torsades de Pointes (TdP. Aggravation of prolonged QT interval which is most likely due to neural modulation by catheter ablation, played major role in the initiation of TdP. The patient was successfully treated with isoproterenol during acute stage and discharged after stabilization without implantation of permanent pacemaker or implantable cardioverter defibrillator.

  17. Dedicated radial ventriculography pigtail catheter

    Energy Technology Data Exchange (ETDEWEB)

    Vidovich, Mladen I., E-mail: miv@uic.edu

    2013-05-15

    A new dedicated cardiac ventriculography catheter was specifically designed for radial and upper arm arterial access approach. Two catheter configurations have been developed to facilitate retrograde crossing of the aortic valve and to conform to various subclavian, ascending aortic and left ventricular anatomies. The “short” dedicated radial ventriculography catheter is suited for horizontal ascending aortas, obese body habitus, short stature and small ventricular cavities. The “long” dedicated radial ventriculography catheter is suited for vertical ascending aortas, thin body habitus, tall stature and larger ventricular cavities. This new design allows for improved performance, faster and simpler insertion in the left ventricle which can reduce procedure time, radiation exposure and propensity for radial artery spasm due to excessive catheter manipulation. Two different catheter configurations allow for optimal catheter selection in a broad range of patient anatomies. The catheter is exceptionally stable during contrast power injection and provides equivalent cavity opacification to traditional femoral ventriculography catheter designs.

  18. Port of Rotterdam

    NARCIS (Netherlands)

    Veenstra, A.W.

    2014-01-01

    The port of Rotterdam is one of the largest ports in the World and has great significance for the Dutch and European economy. Newly appointed TU/e professor Albert Veenstra explains if and how the Port of Rotterdam is affected by the economic crisis. With other European ports closing in, what can

  19. Strategic port development

    DEFF Research Database (Denmark)

    Olesen, Peter Bjerg; Dukovska-Popovska, Iskra; Hvolby, Hans-Henrik

    2014-01-01

    While large global ports are recognised as playing a central role in many supply chains as logistic gateways, smaller regional ports have been more stagnant and have not reached the same level of development as the larger ports. The research literature in relation to port development is also...

  20. Port-Wine Stains

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Port-Wine Stains KidsHealth / For Parents / Port-Wine Stains What's ... Manchas de vino de oporto What Are Port-Wine Stains? A port-wine stain is a type ...

  1. Flat-port connectors

    KAUST Repository

    Alrashed, Mohammed

    2017-05-26

    Disclosed are various embodiments for connectors used with electronic devices, such as input and/or output ports to connect peripheral equipment or accessories. More specifically, various flat-port are provided that can be used in place of standard connectors including, but not limited to, audio jacks and Universal Serial Bus (USB) ports. The flat-port connectors are an alternate connection design to replace the traditional receptacle port (female-port), making the device more sealed creation more dust and water resistant. It is unique in the way of using the outer surfaces of the device for the electrical connection between the ports. Flat-port design can allow the manufacture of extremely thin devices by eliminating the side ports slots that take a lot of space and contribute to the increase thickness of the device. The flat-port receptacle improves the overall appearance of the device and makes it more resistant to dust and water.

  2. Management of Port Operations

    OpenAIRE

    Gheorghe BASANU; Georgiana NUKINA

    2011-01-01

    The Management of port operation requires the proper and efficient use of port facility, equipment for cargo handling, berth facilities, waterways and roads. It also entails the use of effective communications system, storage facilities, and dockworkers. The whole activities mentioned above form the bulk of port operations. The aspiration of port operator is to get cargo through the gateway of ports as fast as possible on to other modes of transport (rail or road) with a minimal cost to them ...

  3. Two-Port Pars Plana Anterior and Central Core Vitrectomy (Lam Floaterectomy) in Combination With Phacoemulsification and Intraocular Lens Implantation Under Topical Anesthesia for Patients with Cataract and Significant Floaters: Results of the First 50 Consecutive Cases.

    Science.gov (United States)

    Lam, Dennis S C; Leung, Hiu Ying; Liu, Shu; Radke, Nishant; Yuan, Ye; Lee, Vincent Y W

    2017-01-01

    To study the safety and efficacy of 2-port pars plana anterior and central core vitrectomy (Lam floaterectomy) in combination with phacoemulsification (phaco) and intraocular lens implantation (IOL) for patients with cataract and significant floaters under topical anesthesia. Retrospective review of the first 50 consecutive cases. A standardized treatment protocol was used for patients with cataract and significant (moderate to severe) floaters (duration > 3 months). Data analysis included intraoperative and postoperative complications, floater status, and patient satisfaction. There were 50 eyes (38 patients) with a male-to-female ratio of 1 to 2.3. Twelve patients had bilateral eye surgeries. Mean age was 58.10 ± 9.85 years (range, 39-83). All patients completed the 3-month follow-up. One eye had mild vitreous hemorrhage at the end of surgery arising from sclerotomy wound oozing. No other intraoperative compli-cations were encountered. Postoperatively, there was 1 case of transient hypotony and 1 case of congestion at sclerotomy wound. No cases of retinal break or detachment, or clinically significant macular edema, were reported. There were 5 cases (10%) of mild residual floaters and 1 case (2%) of floater recurrence. Total floater clearance rate was 88%. Patient satisfaction rates were 80%, 14%, 6%, and 0% for very satisfied, satis-fied, acceptable, and unsatisfied, respectively. The 3-month results in terms of safety and efficacy of the Lam floaterectomy in combination with phaco and IOLfor patients with cataract and significant floaters under topical anesthesia are encouraging. Further larger-scale, prospective, multicenter studies seem warranted. Copyright© 2017 Asia-Pacific Academy of Ophthalmology.

  4. Catheter Migration After Implantationan Intrathecal Baclofen Infusion Pump for Severe Spasticity: A Case Report

    Directory of Open Access Journals (Sweden)

    Tung-Chou Li

    2008-09-01

    Full Text Available We report a case of intrathecal baclofen infusion pump implantation complicated by migration of the catheter tip. A 55-year-old man required an intrathecal baclofen infusion for severe spasticity 4 years after a cervical spinal cord injury with incomplete tetraparesis. Twelve months after initial implantation of the device, the patient began to experience a recurrence of trunk tightness and spasticity. Subsequent X-ray and computed tomography evaluations of the catheter system revealed pooling of contrast medium outside of the intrathecal distribution in the lumbar subcutaneous region of the back and therefore migration of the pump catheter tip. At surgical revision, emphasis was placed on minimizing the length of catheter outside of the spine and securing the catheter in the supraspinous fascia with a right-angled anchor. The distance between the anchors and the entry point of the catheter into the supraspinous fascia was also reduced to prevent slipping when the patient bends forward. After surgery, the patient's spasticity improved and, 1 year later, he has experienced no further complications during follow-up, requiring an average baclofen dose of 150 mg/day. Here, we describe several surgical methods intended to secure the intrathecal catheter and prevent catheter migration. Other complications related to catheter failure are also highlighted.

  5. Catheter-associated UTI

    Science.gov (United States)

    ... UTI; Health care-associated UTI; Catheter-associated bacteriuria; Hospital acquired-UTI Images Bladder catheterization, female Bladder catheterization, male References Calfee DP. Prevention and control of health care-associated infections. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  6. Catheter-related bloodstream infection.

    Science.gov (United States)

    Goede, Matthew R; Coopersmith, Craig M

    2009-04-01

    Catheter-related bloodstream infections (CR-BSIs) are a common, frequently preventable complication of central venous catheterization. CR-BSIs can be prevented by strict attention to insertion and maintenance of central venous catheters and removing unneeded catheters as soon as possible. Antiseptic- or antibiotic-impregnated catheters are also an effective tool to prevent infections. The diagnosis of CR-BSI is made largely based on culture results. CR-BSIs should always be treated with antibiotics, and except in rare circumstances the infected catheter needs to be removed.

  7. Correction of malfunctioning peritoneal dialysis catheter with guidewire and stiffener under fluoroscopic guidance

    International Nuclear Information System (INIS)

    Lee, Seung Ryong; Baek, Kyong Hee; Jung, Gyoo Sik; Huh, Jin Do; Joh, Young Duk; Rim, Hark

    1997-01-01

    To determine the efficacy of correction of a malfunctioning peritoneal dialysis catheter with guidewire and stiffener under fluoroscopic guidance. Between November 1994 and March 1997, we performed 15 manipulations in 12 patients in whom a dual-cuff, straight Tenckhoff peritoneal dialysis catheter had been implanted due to chronic renal failure. The causes of catheter malfunctioning were inadequate drainage of the dialysate(n=14) and painful dialysis(n=1). Under fluoroscopic guidance, adhesiolysis and repositioning of the malfunctioning catheter were performed with an Amplatz Super Stiff guidewire and the stiffener from a biliary drainage catheter. The results of procedures were categorized as either immediate or durable success, this latter being defined as adequate catheter function for at least one month after the procedure. Immediate success was achieved in 14 of 15 procedures (93%), and durable success in 7 of 15(47%). The mean duration of catheter function was 157 (range, 30 to 578) days. After manipulation, abdominal pain developed in eight patients and peritonitis in two, but with conservative treatment, these symptoms improved. The correction of a malfunctioning peritoneal dialysis catheter with guidewire and stiffener under fluoroscopic guidance is an effective means of restoring catheter function and may be an effective alternative to surgical reimplantation of the catheter, or hemodialysis

  8. Correction of malfunctioning peritoneal dialysis catheter with guidewire and stiffener under fluoroscopic guidance

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Ryong; Baek, Kyong Hee; Jung, Gyoo Sik; Huh, Jin Do; Joh, Young Duk; Rim, Hark [Kosin Medical College, Pusan (Korea, Republic of)

    1997-11-01

    To determine the efficacy of correction of a malfunctioning peritoneal dialysis catheter with guidewire and stiffener under fluoroscopic guidance. Between November 1994 and March 1997, we performed 15 manipulations in 12 patients in whom a dual-cuff, straight Tenckhoff peritoneal dialysis catheter had been implanted due to chronic renal failure. The causes of catheter malfunctioning were inadequate drainage of the dialysate(n=14) and painful dialysis(n=1). Under fluoroscopic guidance, adhesiolysis and repositioning of the malfunctioning catheter were performed with an Amplatz Super Stiff guidewire and the stiffener from a biliary drainage catheter. The results of procedures were categorized as either immediate or durable success, this latter being defined as adequate catheter function for at least one month after the procedure. Immediate success was achieved in 14 of 15 procedures (93%), and durable success in 7 of 15(47%). The mean duration of catheter function was 157 (range, 30 to 578) days. After manipulation, abdominal pain developed in eight patients and peritonitis in two, but with conservative treatment, these symptoms improved. The correction of a malfunctioning peritoneal dialysis catheter with guidewire and stiffener under fluoroscopic guidance is an effective means of restoring catheter function and may be an effective alternative to surgical reimplantation of the catheter, or hemodialysis.

  9. Port Authority Best Practices

    Science.gov (United States)

    Best practices for port authorities include near-port community collaboration, anti-idling policies, expanding off-peak hours, development of EMS, developing an emissions inventory, education, electric power and substituting trucking for rail or barge.

  10. US Ports of Entry

    Data.gov (United States)

    Department of Homeland Security — HSIP Non-Crossing Ports-of-Entry A Port of Entry is any designated place at which a CBP officer is authorized to accept entries of merchandise to collect duties, and...

  11. Flat-port connectors

    KAUST Repository

    Alrashed, Mohammed

    2017-01-01

    and water resistant. It is unique in the way of using the outer surfaces of the device for the electrical connection between the ports. Flat-port design can allow the manufacture of extremely thin devices by eliminating the side ports slots that take a lot

  12. Getting Port Governance Right

    DEFF Research Database (Denmark)

    de Langen, Peter; Saragiotis, Periklis

    2018-01-01

    This chapter discusses the relevance of ports for economic development and next identifies port governance as a critical determinant of a well-functioning port industry. While in the past decades privately owned terminal operating companies have emerged and contributed to more efficient supply ch...

  13. Interventional management of intractable sympathetically mediated pain by computed tomography-guided catheter implantation for block and neuroablation of the thoracic sympathetic chain: technical approach and review of 322 procedures.

    Science.gov (United States)

    Agarwal-Kozlowski, K; Lorke, D E; Habermann, C R; Schulte am Esch, J; Beck, H

    2011-08-01

    We retrospectively evaluated the safety and efficacy of computed tomography-guided placement of percutaneous catheters in close proximity to the thoracic sympathetic chain by rating pain intensity and systematically reviewing charts and computed tomography scans. Interventions were performed 322 times in 293 patients of mean (SD) age 59.4 (17.0) years, and male to female ratio 105:188, with postherpetic neuralgia (n = 103, 35.1%), various neuralgias (n = 88, 30.0%), complex regional pain syndrome (n = 69, 23.6%), facial pain (n = 17, 5.8%), ischaemic limb pain (n = 7, 2.4%), phantom limb pain (n = 4, 1.4%), pain following cerebrovascular accident (n = 2, 0.7%), syringomyelia (n = 2, 0.7%) and palmar hyperhidrosis (n = 1, 0.3%). The interventions were associated with a total of 23 adverse events (7.1% of all procedures): catheter dislocation (n = 9, 2.8%); increase in pain intensity (n = 8, 2.5%); pneumothorax (n = 3, 0.9%); local infection (n = 2, 0.6%); and puncture of the spinal cord (n = 1, 0.3%). Continuous infusion of 10 ml.h(-1) ropivacaine 0.2% through the catheters decreased median (IQR [range]) pain scores from 8 (6-9 [2-10]) to 2 (1-3 [0-10]) (p < 0.0001). Chemical neuroablation was necessary in 137 patients (46.8%). We conclude that this procedure leads to a significant reduction of pain intensity in otherwise obstinate burning or stabbing pain and is associated with few hazards. © 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.

  14. Intravascular (catheter) MR imaging

    International Nuclear Information System (INIS)

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

    1989-01-01

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

  15. Shipping emissions in ports

    OpenAIRE

    Merk, Olaf

    2014-01-01

    Shipping emissions in ports are substantial, accounting for 18 million tonnes of CO2 emissions, 0.4 million tonnes of NOx, 0.2 million of SOx and 0.03 million tonnes of PM10 in 2011. Around 85% of emissions come from containerships and tankers. Containerships have short port stays, but high emissions during these stays. Most of CO2 emissions in ports from shipping are in Asia and Europe (58%), but this share is low compared to their share of port calls (70%). European ports have much less emi...

  16. Sea freight - Antwerp Port

    Directory of Open Access Journals (Sweden)

    NEACSU Nicoleta Andreea

    2017-01-01

    Full Text Available Shipping plays a vital role in achieving the movement of goods, both in terms of quantity and efficiency. This paper presents the role and advantages of shipping in the global economy and analyzes the development and Antwerp Port activity. Currently, the second most important trading port in Europe and 14th in the ranking of most important ports that handle containers worldwide, the Port of Antwerp, Belgium is a port in the heart of Europe, accessible to large sized vessels. 200 years of constructing infrastructure and logistics around the central location, as well as pressure from Rotterdam, that had an impact on the competitiveness of the port of Antwerp, all this led the port to occupy a leading position in the top rankings.

  17. Evaluation of percutaneous radiologic placement of peritoneal dialysis catheters: technical aspects, results, and complications

    International Nuclear Information System (INIS)

    Hong, Hyun Pyo; Oh, Joo Hyeong; Yoon, Yub; Lee, Tae Won; Ihm, Chun Gyoo

    2001-01-01

    To evaluate the technical aspects, results and complications of the percutaneous radiologic placement of peritoneal dialysis catheters. Between December 1999 and April 2001, 26 peritoneal dialysis catheters were placed percutaneously in 26 consecutive patients by interventional radiologists. The patient group consisted of 16 men and ten women with a mean age of 55 (range, 30-77) years. The results and complications arising were reviewed, and the expected patency of the catheters was determined by means of Kaplan-Meier survival analysis. The technical success rate for catheter placement was 100% (26/26 patients). Severe local bleeding occurred in one patient due to by inferior epigastric artery puncture, and was treated by compression and electronic cautery. The duration of catheter implantation ranged from 1 to 510 days and the patency rate was 416±45 days. Catheter malfunction occurred in four patients. In two, this was restored by manipulation in the intervention room, and in one, through the use of urokinase. In three patients, peritonitis occurred. Catheters were removed from four patients due to malfunction (n=2), peritonitis (n=1), and death (n=1). Percutaneous radiologic placement of a peritoneal dialysis catheter is a relatively simple procedure that reduces the complication rate and improves catheter patency

  18. Evaluation of percutaneous radiologic placement of peritoneal dialysis catheters: technical aspects, results, and complications

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Hyun Pyo; Oh, Joo Hyeong; Yoon, Yub; Lee, Tae Won; Ihm, Chun Gyoo [Kyunghee University Hospital, seoul (Korea, Republic of)

    2001-01-01

    To evaluate the technical aspects, results and complications of the percutaneous radiologic placement of peritoneal dialysis catheters. Between December 1999 and April 2001, 26 peritoneal dialysis catheters were placed percutaneously in 26 consecutive patients by interventional radiologists. The patient group consisted of 16 men and ten women with a mean age of 55 (range, 30-77) years. The results and complications arising were reviewed, and the expected patency of the catheters was determined by means of Kaplan-Meier survival analysis. The technical success rate for catheter placement was 100% (26/26 patients). Severe local bleeding occurred in one patient due to by inferior epigastric artery puncture, and was treated by compression and electronic cautery. The duration of catheter implantation ranged from 1 to 510 days and the patency rate was 416{+-}45 days. Catheter malfunction occurred in four patients. In two, this was restored by manipulation in the intervention room, and in one, through the use of urokinase. In three patients, peritonitis occurred. Catheters were removed from four patients due to malfunction (n=2), peritonitis (n=1), and death (n=1). Percutaneous radiologic placement of a peritoneal dialysis catheter is a relatively simple procedure that reduces the complication rate and improves catheter patency.

  19. Radiologic placement of Hickman catheters

    International Nuclear Information System (INIS)

    Robertson, L.J.; Mauro, M.A.; Jaques, P.F.

    1988-01-01

    Hickman catheter inserter has previously been predominantly accomplished surgically by means of venous cutdown or percutaneous placement in the operating room. The authors describe their method and results for 55 consecutive percutaneous placements of Hickman catheters in the interventional radiology suite. Complication rates were comparable to those for surgical techniques. Radiologic placement resulted in increased convenience, decreased time and cost of insertion, and super fluoroscopic control of catheter placement and any special manipulations. Modern angiographic materials provide safer access to the subclavian vein than traditional methods. The authors conclude that radiologic placement of Hickman catheters offers significant advantages over traditional surgical placement

  20. Interventional MRA: concepts for active visualization of catheters and stents

    International Nuclear Information System (INIS)

    Quick, H.H.; Ladd, M.E.

    2003-01-01

    A precondition to safe guidance of vascular guidewires and catheters during the course of magnetic resonance (MR)-guided vascular intervention is a high-contrast visualization of the instruments. The integration of miniature radiofrequency (RF) coils and coaxial cables into guidewires and catheters enables the reception of RF signal from the lumen of blood vessels, and thus the active visualization of the instruments. Moreover, metallic vascular implants (stents) can be modified to act as intravascular RF antennas that inductively couple their RF signal to a conventional surface RF coil. Such stent resonators show signal amplification inside the lumen of the stent and thus can be visualized with high contrast in MR images. Furthermore, once such a device has been implanted, the method offers the potential for non-invasive long-term follow-up of the stent patency. (orig.) [de

  1. Surface-Treated versus Untreated Large-Bore Catheters as Vascular Access in Hemodialysis and Apheresis Treatments

    Directory of Open Access Journals (Sweden)

    Rolf Bambauer

    2012-01-01

    Full Text Available Background. Catheter-related infections, thrombosis, and stenosis are among the most frequent complications associated with catheters, which are inserted in vessels. Surface treatment processes of the outer surface, such as ion-beam-assisted deposition, can be used to mitigate such complications. Methods. This retrospective study (1992–2007 evaluated silver-coated (54 patients and noncoated (105 patients implanted large-bore catheters used for extracorporeal detoxification. The catheters were inserted into the internal jugular or subclavian veins. After removal, the catheters were cultured for bacterial colonization using standard microbiologic assays. They also were examined using scanning electron microscope. Results. The silver coated catheters showed a tendency towards longer in situ time. The microbiologic examinations of the catheter tips were in both catheter types high positive, but not significant. Conclusion. The silver-coated catheters showed no significantly reduction in infection rate by evaluation of all collected data in this retrospective study. There was no association between both catheters in significantly reducing savings in treatment costs and in reducing patient discomfort. Other new developed catheter materials such as the microdomain-structured inner and outer surface are considered more biocompatible because they mimic the structure of natural biological surface.

  2. Central Venous Catheter-Related Bloodstream Infection with Kocuria kristinae in a Patient with Propionic Acidemia

    OpenAIRE

    Kimura, Masato; Kawai, Eichiro; Yaoita, Hisao; Ichinoi, Natsuko; Sakamoto, Osamu; Kure, Shigeo

    2017-01-01

    Kocuria kristinae is a catalase-positive, coagulase-negative, Gram-positive coccus found in the environment and in normal skin and mucosa in humans; however, it is rarely isolated from clinical specimens and is considered a nonpathogenic bacterium. We describe a case of catheter-related bacteremia due to K. kristinae in a young adult with propionic acidemia undergoing periodic hemodialysis. The patient had a central venous catheter implanted for total parenteral nutrition approximately 6 mont...

  3. HDR monotherapy for prostate cancer: A simulation study to determine the effect of catheter displacement on target coverage and normal tissue irradiation

    International Nuclear Information System (INIS)

    Kolkman-Deurloo, Inger-Karine K.; Roos, Martin A.; Aluwini, Shafak

    2011-01-01

    Purpose: The aim of this study was to systematically analyse the effect of catheter displacements both on target coverage and normal tissue irradiation in fractionated high dose rate (HDR) prostate brachytherapy, using a simulation study, and to define tolerances for catheter displacement ensuring that both target coverage and normal tissue doses remain clinically acceptable. Besides the effect of total implant displacement, also displacements of catheters belonging to selected template rows only were evaluated in terms of target coverage and normal tissue dose, in order to analyse the change in dose distribution as a function of catheter dwell weight and catheter location. Material and methods: Five representative implant geometries, with 17 catheters each, were selected. The clinical treatment plan was compared to treatment plans in which an entire implant displacement in caudal direction over 3, 5, 7 and 10 mm was simulated. Besides, treatment plans were simulated considering a displacement of either the central, most ventral or most dorsal catheter rows only, over 5 mm caudally. Results: Due to displacement of the entire implant the target coverage drops below the tolerance of 93% for all displacements studied. The effect of displacement of the entire implant on organs at risk strongly depended on the patient anatomy; e.g., for 80% of the implant geometries the V 80 of the rectum exceeded its tolerance for all displacements. The effect of displacement of catheters belonging to selected template rows depended strongly on the relative weight of each catheter row when considering the target coverage and on its location when considering the dose in the organs at risk. Conclusion: This study supports the need for a check of the catheter locations before each fraction and correction of deviations of the catheter position exceeding 3 mm.

  4. Agile and Bright Intracardiac Catheters

    NARCIS (Netherlands)

    M. Pekař (Martin)

    2017-01-01

    markdownabstractIntracardiac imaging catheters represent unique instruments to diagnose and treat a diseased heart. While there are imminent advances in medical innovation, many of the commercially available imaging catheters are outdated. Some of them have been designed more than 20 years and

  5. Port Stakeholder Summit: Advancing More Sustainable Ports (April 2014)

    Science.gov (United States)

    EPA's National Port Stakeholders Summit, Advancing More Sustainable Ports, focused on actions to protect air quality while reducing climate risk and supporting economic growth, making ports more environmentally sustainable.

  6. Port Harcourt Medical Journal

    African Journals Online (AJOL)

    Port Harcourt Medical Journal's objectives are to disseminate medical information from the College of Health Sciences, University of Port Harcourt and the rest of the national and international medical community; act as a medium for the articulation of research and findings from same as well as proceedings of medical ...

  7. The Flexible Port

    NARCIS (Netherlands)

    Taneja, P.

    2013-01-01

    Ports are beset with many uncertainties about their futures. They are confronted with new demands in terms of functions and scales, new external constraints, and changed expectations. The inability to adequately meet these demands can mean costly adaptations for a port, or loss of cargo and

  8. Port Stakeholder Summit - April 2014

    Science.gov (United States)

    EPA's National Port Stakeholders Summit, Advancing More Sustainable Ports, focused on actions to protect air quality while reducing climate risk and supporting economic growth, making ports more environmentally sustainable.

  9. The Windows serial port programming handbook

    CERN Document Server

    Bai, Ying

    2004-01-01

    The fundamentals of serial port communications. Serial port programming in ANSI C and Assembly languages for MS-DOS. Serial ports interface developed in VC++ 6.0. Serial port programming in Visual Basic. Serial port programming in LabVIEW. Serial port programming in MATLAB. Serial port programming in Smalltalk. Serial port programming in Java.

  10. Evaluation of the perceptions and cosmetic satisfaction of breast cancer patients undergoing totally implantable vascular access device (TIVAD) placement.

    Science.gov (United States)

    Liberale, Gabriel; El Houkayem, Michel; Viste, Claire; Bouazza, Fikri; Moreau, Michel; El Nakadi, Issam; Veys, Isabelle

    2016-12-01

    Totally implantable vascular access devices (TIVADs) are widely used to administer chemotherapy to cancer patients. While great progress has been made with respect to breast surgical reconstruction to take into account both aesthetics and patients' perceptions of body integrity, these aspects have not been considered with regard to the impact of TIVAD. In order to address this practice gap, we have adapted our TIVAD implantation technique to improve cosmetic results. The aim of this study was to assess breast cancer patients' comfort level and aesthetic satisfaction with regard to TIVAD insertion. Patients with breast cancer admitted for chemotherapy at an outpatient clinic completed a previously validated survey evaluating three main domains: symptoms (pain, discomfort) related to the TIVAD itself in daily activity, information received before and during the surgical procedure, and cosmetic aspects regarding the port insertion site (scar, port, and catheter location). Between September 2010 and June 2011, 232 patients were evaluated. Cosmetic satisfaction with scar location was high (93.3 %). Information given to patients before and during the procedure had a major impact on both symptom perception in daily activity and on cosmetic satisfaction. Obtaining a more aesthetic scar by placing the TIVAD in the deltopectoral groove contributed to a high rate of cosmetic satisfaction. Furthermore, the relevance of information given to patients before and/or during surgery had a major impact on symptom perception. Therefore, we suggest including a pre-operative information session in the care pathway.

  11. COSIMA-ES-PORT

    DEFF Research Database (Denmark)

    Barfod, Michael Bruhn; Leleur, Steen

    2007-01-01

    This article describes the results of the research project – WP3 East-west, Interreg IIIB – concerning the de¬velop¬ment of a new composite decision model, COSIMA-ES-PORT, for the assessment of three pre-feasibility studies situated at the Port of Esbjerg: a road project, a railway project...... and a multimodal terminal. The three studies indicates that a new road connection to the Port of Esbjerg is a very profitable project due to large travel time savings, whereas a new railway connection is not economically viable. However, a new multimodal terminal is also a very profitable project. The COSIMA...

  12. Revisiting port pricing : a proposal for seven port pricing principles

    NARCIS (Netherlands)

    Van Den Berg, R.; De Langen, P.W.; Van Zuijlen, P.C.J.

    2017-01-01

    A review of seven large landlord port authorities around the world reveals a notable diversity of pricing structures. While port authorities increasingly act as commercial undertakings, port pricing often seems to be not driven by commercial considerations. In this paper, we argue that ports can be

  13. Bi-layer sandwich film for antibacterial catheters.

    Science.gov (United States)

    Franz, Gerhard; Schamberger, Florian; Zare, Hamideh Heidari; Bröskamp, Sara Felicitas; Jocham, Dieter

    2017-01-01

    Background: Approximately one quarter of all nosocomial infections can be attributed to the urinary tract. The infections are supposed to be mainly caused by implantations of urethral catheters and stents. A new catheter design is introduced with the aim to lower the high number of nosocomial urethral infections. In order to avoid limitations to use, the design is first applied to conventional commercially available balloon catheters. Results: The main feature of the design is a sandwich layer on both sides of the catheter wall, which is composed of a fragmented base layer of silver capped by a thin film of poly( p -xylylene). This top layer is mainly designed to release a controlled amount of Ag + ions, which is bactericidal, but not toxic to humans. Simultaneously, the lifetime is prolonged to at least one year. The base layer is electrolessly deposited applying Tollens' reagens, the cap layer is deposited by using chemical vapor deposition. Conclusion: The three main problems of this process, electroless deposition of a fragmented silver film on the surface of an electrically insulating organic polymer, irreproducible evaporation during heating of the precursor, and exponential decrease of the layer thickness along the capillary, have been solved trough the application of a simple electrochemical reaction and two standard principles of physics: Papin's pot and the principle of Le Chatelier.

  14. Bi-layer sandwich film for antibacterial catheters

    Directory of Open Access Journals (Sweden)

    Gerhard Franz

    2017-09-01

    Full Text Available Background: Approximately one quarter of all nosocomial infections can be attributed to the urinary tract. The infections are supposed to be mainly caused by implantations of urethral catheters and stents. A new catheter design is introduced with the aim to lower the high number of nosocomial urethral infections. In order to avoid limitations to use, the design is first applied to conventional commercially available balloon catheters.Results: The main feature of the design is a sandwich layer on both sides of the catheter wall, which is composed of a fragmented base layer of silver capped by a thin film of poly(p-xylylene. This top layer is mainly designed to release a controlled amount of Ag+ ions, which is bactericidal, but not toxic to humans. Simultaneously, the lifetime is prolonged to at least one year. The base layer is electrolessly deposited applying Tollens’ reagens, the cap layer is deposited by using chemical vapor deposition.Conclusion: The three main problems of this process, electroless deposition of a fragmented silver film on the surface of an electrically insulating organic polymer, irreproducible evaporation during heating of the precursor, and exponential decrease of the layer thickness along the capillary, have been solved trough the application of a simple electrochemical reaction and two standard principles of physics: Papin’s pot and the principle of Le Chatelier.

  15. Catheter ablation as a treatment of atrioventricular block.

    Science.gov (United States)

    Tuohy, Stephen; Saliba, Walid; Pai, Manjunath; Tchou, Patrick

    2018-01-01

    Symptomatic second-degree atrioventricular (AV) block is typically treated by implantation of a pacemaker. An otherwise healthy AV conduction system can nevertheless develop AV block due to interference from junctional extrasystoles. When present with a high burden, these can produce debilitating symptoms from AV block despite an underlying normal AV node and His-Purkinje system properties. The purpose of this study was to describe a catheter ablation approach for alleviating symptomatic AV block due to a ventricular nodal pathway interfering with AV conduction. Common clinical monitoring techniques such as Holter and event recorders were used. Standard electrophysiological study techniques using multipolar recording and ablation catheters were utilized during procedures. A 55-year-old woman presented with highly symptomatic, high-burden second-degree AV block due to concealed and manifest junctional premature beats. Electrophysiological characteristics indicated interference of AV conduction due to a concealed ventricular nodal pathway as the cause of the AV block. The patient's AV nodal and His-Purkinje system conduction characteristics were otherwise normal. Radiofrequency catheter ablation of the pathway was successful in restoring normal AV conduction and eliminating her clinical symptoms. Pathways inserting into the AV junction can interfere with AV conduction. When present at a high burden, this type of AV block can be highly symptomatic. Catheter ablation techniques can be used to alleviate this type of AV block and restore normal AV conduction. Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  16. Oluvil Port Development Project

    DEFF Research Database (Denmark)

    Frigaard, Peter; Margheritini, Lucia

    Oluvil Port Development Project is the first development of a large port infrastructure in the entire eastern coastline of Sri Lanka. The project is supported by the Danish Foreign Ministry. Feasibility studies and detailed design studies were carried out by Lanka Hydraulic Institute Ltd during...... the years 1995 to 2003. The design was reviewed by COWI a/s. Construction of the port was started in 2008. MT Højgaard a/s acted as contractor. The outer breakwaters were constructed as first part of the project. During and after completion of the breakwaters a serious beach erosion and sand accumulation...... has been observed. Severe erosion is seen north of the harbour and some accumulation of sand is seen south of the harbour. On a sandy coastline like the one in Oluvil such erosion problems as observed are very typical. The report: Oluvil Port Development Project: Studies on Beach Erosion written...

  17. Multiple-port valve

    International Nuclear Information System (INIS)

    Doody, T.J.

    1978-01-01

    A multiple-port valve assembly is designed to direct flow from a primary conduit into any one of a plurality of secondary conduits as well as to direct a reverse flow. The valve includes two mating hemispherical sockets that rotatably receive a spherical valve plug. The valve plug is attached to the primary conduit and includes diverging passageways from that conduit to a plurality of ports. Each of the ports is alignable with one or more of a plurality of secondary conduits fitting into one of the hemispherical sockets. The other hemispherical socket includes a slot for the primary conduit such that the conduit's motion along that slot with rotation of the spherical plug about various axes will position the valve-plug ports in respect to the secondary conduits

  18. Slewing Port Jib Cranes

    OpenAIRE

    Boris Visočnik; Stojan Kravanja

    2002-01-01

    The paper presents slewing port cranes with a luffing jib. The advantages of slewing port jib cranes are high lifting capacities, high speeds of re-loading and excellent mobility since they are capable of load lifting, travelling, luffing and slewing. The paper gives a detailed description of their characteristics such as the highest reached load-carrying capacities, speeds of motion and accelerations. It also presents the crane assembly, driving mechanisms, loads and load cases, transport by...

  19. Intra-operative placement of catheters for interstitial microwave-induced hyperthermia and iridium brachytherapy

    International Nuclear Information System (INIS)

    Coughlin, C.T.; Wong, T.Z.; Strohbehn, J.W.; Colacchio, T.A.; Belch, R.Z.; Sutton, J.E. Jr.; Douple, E.B.

    1984-01-01

    The authors have previously described a system for delivery of microwave-induced hyperthermia utilizing flexible coaxial cables that are modified to serve as microwave antennas. These small (--1.6mm o.d.) antennas ae introduced into 2mm o.d. nylon catheters implanted in the tumor. This system has been further modified for use in the treatment of surgically unresectible abdominal, pelvic, and head and neck tumors. The modifications are described that were used to treat two pelvic, one upper abdominal, and one base of tongue tumor. The nylon catheters are implanted during surgery. After a short recovery period, the microwave antennas are inserted and the tumor region is heated for --1hr. The antennas are removed, iridium-192 seeds are placed in the catheters, 2800 - 5000 rad (CGy) doses are delivered, followed by a 1hr hyperthermia treatment. The temperature distributions and future applications are discussed

  20. Intracorporeal knotting of a femoral nerve catheter

    Directory of Open Access Journals (Sweden)

    Ghanem, Mohamed

    2015-01-01

    Full Text Available Peripheral nerve catheters are effective and well-established tools to provide postoperative analgesia to patients undergoing orthopedic surgery. The performance of these techniques is usually considered safe. However, placement of nerve catheters may be associated with a considerable number of side effects and major complications have repeatedly been published. In this work, we report on a patient who underwent total knee replacement with spinal anesthesia and preoperative insertion of femoral and sciatic nerve catheters for postoperative analgesia. During insertion of the femoral catheter, significant resistance was encountered upon retracting the catheter. This occurred due to knotting of the catheter. The catheter had to be removed by operative intervention which has to be considered a major complication. The postoperative course was uneventful. The principles for removal of entrapped peripheral catheters are not well established, may differ from those for neuroaxial catheters, and range from cautious manipulation up to surgical intervention.

  1. [The user´s reporting from the national registry of catheter aortic valve implantations (Czech TAVI Registry): the possibilities of the analytical reports based on the database system TrialDB2].

    Science.gov (United States)

    Bláha, Milan; Kala, Petr; Klimeš, Daniel; Bernat, Ivo; Branny, Marian; Cervinka, Pavel; Horák, Jan; Kočka, Viktor; Mates, Martin; Němec, Petr; Pešl, Ladislav; Stípal, Roman; Sťásek, Josef; Zelízko, Michael

    2014-10-01

    Assessment of the treatment procedures and their results is increasingly important in current medicine. The emphasis is put on an effective use of the health technologies (HTA). Unlike randomised studies, which involve strictly selected groups of patients who meet inclusion and exclusion criterias, the multicentre clinical registries provide a real-life picture of the treatment safety and effectiveness. Well prepared registries involve both research database and a friendly user interface enabling collection of parametric and easily analyzable data. Although there are some technological aspects aiming to ensure a maximum quality of entered data, cooperation with the users and data managers is essential. Such a registry, otherwise meaningful, must provide answers to previously defined medical hypotheses. Regular feedback to users (so called benchmarking or reporting) is considered to be of key importance. The Czech TAVI Registry (CTR) is a good example of reaching all of the above defined criterias. This registry contains data of approximately 95 % of all transcatheter aortic valve implantations (TAVI) performed in the Czech Republic. It is based on a general system aimed at the design of clinical trials, namely the TrialDB2 (a database system for clinical registries developed by the Institute of Biostatistics and Analyses at the Masaryk University (IBA MU). CTR has been run as an English-language version under the auspices of the Czech Society of Cardiology and represents one of the top-quality registries maintained by IBA MU. This paper presents the currently available database systems and some reports from this particular registry.

  2. Bilhemia: a fatal complication following percutaneous placement of a transhepatic inferior vena cava catheter in a child

    International Nuclear Information System (INIS)

    Sierre, Sergio; Lipsich, Jose; Questa, Horacio

    2007-01-01

    A transhepatic central venous catheter was implanted in a 2-year-old child with a history of multiple venous access procedures and superior and inferior vena cava thrombosis. After 2 weeks, inadvertent dislodgement of the catheter was complicated by a biloma. The biloma was percutaneously drained, but a biliary-venous fistula led to a rapidly progressive and fatal bilhemia. We report this case as an infrequent complication of transhepatic catheterization. (orig.)

  3. Infraclavicular versus axillary nerve catheters: A retrospective comparison of early catheter failure rate.

    Science.gov (United States)

    Quast, Michaela B; Sviggum, Hans P; Hanson, Andrew C; Stoike, David E; Martin, David P; Niesen, Adam D

    2018-05-01

    Continuous brachial plexus catheters are often used to decrease pain following elbow surgery. This investigation aimed to assess the rate of early failure of infraclavicular (IC) and axillary (AX) nerve catheters following elbow surgery. Retrospective study. Postoperative recovery unit and inpatient hospital floor. 328 patients who received IC or AX nerve catheters and underwent elbow surgery were identified by retrospective query of our institution's database. Data collected included unplanned catheter dislodgement, catheter replacement rate, postoperative pain scores, and opioid administration on postoperative day 1. Catheter failure was defined as unplanned dislodging within 24 h of placement or requirement for catheter replacement and evaluated using a covariate adjusted model. 119 IC catheters and 209 AX catheters were evaluated. There were 8 (6.7%) failed IC catheters versus 13 (6.2%) failed AX catheters. After adjusting for age, BMI, and gender there was no difference in catheter failure rate between IC and AX nerve catheters (p = 0.449). These results suggest that IC and AX nerve catheters do not differ in the rate of early catheter failure, despite differences in anatomic location and catheter placement techniques. Both techniques provided effective postoperative analgesia with median pain scores < 3/10 for patients following elbow surgery. Reasons other than rate of early catheter failure should dictate which approach is performed. Copyright © 2018. Published by Elsevier Inc.

  4. Malfunctioning and infected tunneled infusion catheters: over-the-wire catheter exchange versus catheter removal and replacement.

    Science.gov (United States)

    Guttmann, David M; Trerotola, Scott O; Clark, Timothy W; Dagli, Mandeep; Shlansky-Goldberg, Richard D; Itkin, Maxim; Soulen, Michael C; Mondschein, Jeffrey I; Stavropoulos, S William

    2011-05-01

    To compare the safety and effectiveness of over-the-wire catheter exchange (catheter-exchange) with catheter removal and replacement (removal-replacement) at a new site for infected or malfunctioning tunneled infusion catheters. Using a quality assurance database, 61 patients with tunneled infusion catheters placed during the period July 2001 to June 2009 were included in this study. Patients receiving hemodialysis catheters were excluded. Catheter-exchange was performed in 25 patients, and same-day removal-replacement was performed in 36 patients. Data collected included demographic information, indication for initial catheter placement and replacement, dwell time for the new catheter, and ultimate fate of the new device. Statistical comparisons between the two cohorts were analyzed using the Kaplan-Meier technique and Fisher exact test. Catheters exchanged over the wire remained functional without infection for a median of 102 days (range, 2-570 days), whereas catheters removed and replaced were functional for a median 238 days (range, 1-292 days, P = .12). After catheter replacement, there were 11 instances of subsequent infection in the catheter-exchange group and 7 instances in the removal-replacement cohort, accounting for infection rates of 4.4 and 2.3 per 1,000 catheter days (P = .049). Patients in the catheter-exchange group had 3.2 greater odds of infection compared with patients in the removal-replacement group. Five malfunction events occurred in each group, accounting for 2.0 and 1.7 malfunctions per 1,000 catheter days in the catheter-exchange and removal-replacement groups (P = .73). Catheter-exchange of tunneled infusion catheters results in a higher infection rate compared with removal-replacement at a new site. The rate of catheter malfunction is not significantly different between the two groups. Catheter-exchange is an alternative for patients with tunneled infusion catheters who have limited venous access, but this technique should not be

  5. Spinal canal extension of hyperalimentation catheter without neurologic sequela

    International Nuclear Information System (INIS)

    Glasier, M.; Arkansas Children's Hospital, Little Rock; Hassell, D.R.

    1989-01-01

    An attempt at placement of a left femoral vein hyperalimentation catheter resulted in entrance of the catheter into the spinal canal. Catheter location was documented by injections of nonionic contrast material into the catheter without neurologic sequellae. (orig.)

  6. Translumbar aortography by catheter technique

    International Nuclear Information System (INIS)

    Hagen, B.; Honemeyer, U.; Meier-Duis, H.

    1982-01-01

    400 examinations performed during the last three years by TLA (only catheter technique) were subjected to critical analysis and studied particularly in respect to the rate of complications. We observed 13 complications (3.25%) of moderate severity, including 3 large hematomas (documented by CT), 3 paravasations and 7 dissections, but no fatal complication. Two (0.5%) of these complications had clinical evidence. The advantages of the catheter technique of TLA are described. Injections through rigid metal cannula should be avoided because of the high incidence of complications (mainly the increased risk of dissection). Downstream injection resulted in excellent visualization of peripheral occluding vascular disease. Upstream injection should be preferred to demonstrate the major abdominal arteries as well as supraceliac collateral circulation in the case of high Leriche syndrome. The low or intermediate puncture of the aorta is preferable to facilitate caudad direction of the catheter and to diminish the risk of damaging other vessels or puncturing an organ. (orig.) [de

  7. Slewing Port Jib Cranes

    Directory of Open Access Journals (Sweden)

    Boris Visočnik

    2002-09-01

    Full Text Available The paper presents slewing port cra11es with a luffing jib.The advantages of slewing port jib cranes are high lifting capacities,high speeds of re-loading and excellent mobility since theyare capable of load lifting, travelling, luffing and slewing. Thepaper gives a detailed description of their characteristics suchas the highest reached load-canying capacities, speeds of motionand accelerations. It also presents the crane assembly,driving mechanisms, loads and load cases, transport by shipsand testing of lifting capacity. As a practical example the paperpresents the slewing port jib crane with the capacity of25!15!5 tat a 27/37/40 m radius made by the Slovenian companyMetalna Maribor for the shipyard 3. Maj, Rijeka, Croatia.

  8. HomePort

    DEFF Research Database (Denmark)

    Le Guilly, Thibaut; Olsen, Petur; Ravn, Anders Peter

    2013-01-01

    Ambient Intelligence systems use many sensors and actuators, with a diversity of networks, protocols and technologies which makes it impossible to access the devices in a common manner. This paper presents the HomePort software, which provides an open source RESTful interface to heterogeneous...... sensor networks, allowing a simple unified access to virtually any kind of protocol using well known standards. HomePort includes means to provide event notification, as well as a tracing mechanism. The software is implemented and we report on initial experiments and provide an evaluation that shows...

  9. FACTORS AND COMPLICATIONS AFFECTING CATHETER AND TECHNIQUE SURVIVAL WITH PERMANENT SINGLE-LUMEN DIALYSIS CATHETERS

    NARCIS (Netherlands)

    DEMEESTER, J; VANHOLDER, R; DEROOSE, J; RINGOIR, S

    1994-01-01

    This long-term study on the outcome of permanent silicone single-lumen dialysis catheters consisted of 43 surgically inserted catheters in 33 patients. All catheters were attached to a pressure-pressure single-cannula dialysis system. Technique and catheter survival were 80 and 59% at 1 year, and 63

  10. ITER lower port systems integration

    Energy Technology Data Exchange (ETDEWEB)

    Levesy, B., E-mail: bruno.levesy@iter.org [ITER Organization, CS 90 046, 13067 St Paul Lez Durance Cedex (France); Baker, D.; Boussier, B.; Bryan, S.; Cordier, J.J.; Dremel, M.; Dell' Orco, G.; Daly, E.; Doshi, B.; Jeannoutot, T.; Friconneau, J.P.; Gliss, C.; Le Barbier, R.; Lachevre, F.; Loughlin, M.; Martin, A.; Martins, J.P.; Maruyama, S.; Palmer, J.; Reichle, R. [ITER Organization, CS 90 046, 13067 St Paul Lez Durance Cedex (France)

    2011-10-15

    The lower port systems are installed inside the vacuum vessel lower ports and in the adjacent port cells. The vacuum vessel ports and penetrations are allocated as follow: -4 ports dedicated to remote handling of the divertor cassettes, contain diagnostics racks and divertor cooling pipes. -5 ports connecting the main vessel to the torus cryopumps, contain divertor cooling pipes, pellet and gas injection pipes and vertical stabilization coil feeders. -3 penetrations connecting torus cryopumps are connected to the vacuum vessel by branch pipes. -Specific penetrations for divertor cooling lines, in-vessel viewing and glow discharge systems. The general layout of the port systems has been revised recently to improve the cryopump (8 t weight, 1.8 m diameter and 2.5 m long) maintenance scheme with remote handling tools and integrate the in-vessel vertical stabilization coil feeders. The port allocation, the pumping ports design, and interfaces in-between ports and cryostat and in-between cryopumps and cryostat have been up-dated. The integration inside the 18 port cells (11 m x 4 m each) has been reviewed to avoid clashes in between systems and to fix the openings in the port cell concrete walls. The new layout integrates safety and neutron-shielding requirements as well as remote handling and maintenance compatibility for the different systems. The paper presents the up-dated integration of the lower port systems inside the ports and the port cells. Interfaces of the port systems with the vacuum vessel, the cryostat and the port cells are described.

  11. Epidural Catheter Breakage In-Situ

    Directory of Open Access Journals (Sweden)

    Geetanjali S Verma

    2014-09-01

    Full Text Available A 45yr old woman diagnosed with dysfunctional uterine bleeding and incisional hernia was planned for total abdominal hysterectomy with bilateral salpingo-oophorectomy and mesh repair under combined spinal and epidural anaesthesia. Using VYGON® epidural catheter with its recommended introducer, the catheter was inserted but it snapped off at 11cm mark while positioning the catheter. After radiological confirmation, the neurosurgeon removed the catheter under general anaesthesia, which was followed by the scheduled surgery.

  12. Ion implantation

    International Nuclear Information System (INIS)

    Dearnaley, Geoffrey

    1975-01-01

    First, ion implantation in semiconductors is discussed: ion penetration, annealing of damage, gettering, ion implanted semiconductor devices, equipement requirements for ion implantation. The importance of channeling for ion implantation is studied. Then, some applications of ion implantation in metals are presented: study of the corrosion of metals and alloys; influence or ion implantation on the surface-friction and wear properties of metals; hyperfine interactions in implanted metals

  13. Catheter-related Mycobacterium abscessus bacteremia manifested with skin nodules, pneumonia, and mediastinal lymphadenopathy

    Directory of Open Access Journals (Sweden)

    Shou-Hsin Su

    2013-01-01

    Full Text Available Although previously rare, catheter-related bloodstream infection caused by rapidly growing mycobacteria is now increasingly encountered, especially among cancer patients who have catheters implanted for chemotherapy treatments. A 73-year-old female patient with acute myeloid leukemia (AML had Mycobacterium abscessus bacteremia with manifestations of multiple skin nodules, pneumonia, and mediastinal lymphadenopathy 4 months after the implantation of a peripherally inserted central catheter (PICC for the delivery of chemotherapy. The catheter-related M. abscessus bacteremia was confirmed by positive blood cultures of specimens drawn from a PICC line and a peripheral vein. She defervesced with the administration of meropenem, amikacin, levofloxacin, clarithromycin, and by the removal of PICC. Her fever subsided for 3 months with the disappearance of skin and lung lesions; however, she died of AML relapse. Bacteremia and skin infection caused by M. abscessus can be detected by culture and pathological examinations and should be considered in leukemia patients with a PICC. With appropriate laboratory diagnosis, M. abscessus bacteremia with disseminated infections can improve with catheter removal and combination antimicrobial therapy.

  14. Resection of deep-seated gliomas using neuroimaging for stereotactic placement of guidance catheters

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Kengo; Higashi, Hisato; Tomita, Susumu; Furuta, Tomohisa; Ohmoto, Takashi [Okayama Univ. (Japan). School of Medicine

    1995-03-01

    A simple computed tomography- (CT) or magnetic resonance (MR) imaging-guided stereotactic method for guided microsurgical resection of either deep-seated gliomas or tumors adjacent to an eloquent area is described. The technique employs the Brown-Roberts-Wells stereotactic system and twist drills, 2.7 mm in diameter, for the stereotactic placement of 2.4 mm diameter scaled guidance catheters through the calvaria. In a patient with a deep-seated small glioma, less than 2 cm diameter, one catheter was implanted into the center of the enhanced mass through the cerebral cortex. In the other 14 patients, three to six catheters were used which made the tumor border clearer. After implantation of the guidance catheters, the stereotactic frame was removed and a standard open craniotomy performed. Target localization is not affected by brain movement, which is inevitable during open surgery. The tumor involved the frontal lobe in eight patients, the parietal lobe in two, and the thalamus in five. In all cases the lesion was quickly localized and radical removal was acheived. Neurological complications occurred in only one patient who suffered transient hemiparesis after the resection of a lesion in the pyramidal tract. The results demonstrate that microsurgery combined with CT- or MR imaging-guided stereotactic placement of guidance catheters is a new option for surgery of deep-seated gliomas or tumors adjacent to an eloquent area. (author).

  15. Port entry arrangements

    International Nuclear Information System (INIS)

    Chicken, J.C.; King, M.A.

    1978-01-01

    The objective of the paper is to describe the safety scheme port authorities should establish to deal with any contingency that may result from the visit of a nuclear powered ship. The safety scheme should be devised to cover both normal operation and any accident conditions that could arise while the ship is in port. The paper is divided into three parts. The three parts being: background information, general instructions, and emergency procedures. The background information will describe the nature of the hazards a port authority has to be prepared to deal with, and the philosophical basis for a berthing policy. In the part dealing with general instructions the objective of the safety scheme will be described. Also this part will describe the composition of the Port Safety Panel, allocation of responsibilities, passage and berthing arrangements, general safety precautions, records required, and rescue arrangements. In the part dealing with emergency procedures the role of: the Ship's Master, Harbour Authorities, Local Police, and local Health Services are discussed. As an Appendix to the paper a copy of the safety scheme that has been devised for visits of nuclear merchant ships to Southampton is given

  16. Strategic port development

    DEFF Research Database (Denmark)

    Olesen, Peter Bjerg; Dukovska-Popovska, Iskra; Steger-Jensen, Kenn

    2012-01-01

    This paper proposes a framework for strategic development of a port’s collaboration with its hinterland. The framework is based on literature relevant to port development and undertakes market perspective by considering import/export data relevant for the region of interest. The series of steps...

  17. Ports and innovation

    NARCIS (Netherlands)

    Taneja, P.; Vellinga, T.; Van Schuylenburg, M.

    2012-01-01

    A volatile environment, dynamic markets, and challenges created by new environmental and social consideration demand innovative solutions. Innovation is the implementation of ideas to create value. It promises ports resilience into the future. In this paper we trace some recent successful

  18. Essays on Dry Ports

    NARCIS (Netherlands)

    G.G. Chandrakant (Gujar)

    2011-01-01

    textabstractDue to several reasons, currently the global supply chains are getting stretched further away into the hinterlands from the gateway seaports. This single fact enhances the importance of dry ports. It would not be against logic, to state that in coming times, as a result of ever-growing

  19. Port-wine stain

    Science.gov (United States)

    ... About MedlinePlus Show Search Search MedlinePlus GO GO About MedlinePlus Site Map FAQs Customer Support Health Topics Drugs & Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Port-wine stain URL of this page: //medlineplus.gov/ency/ ...

  20. Transhepatic venous catheters for hemodialysis

    Directory of Open Access Journals (Sweden)

    Mohamed El Gharib

    2014-06-01

    Conclusion: Based on our findings, transhepatic hemodialysis catheters have proven to achieve good long-term functionality. A high level of maintenance is required to preserve patency, although this approach provides remarkably durable access for patients who have otherwise exhausted access options.

  1. Button self-retaining drainage catheter

    International Nuclear Information System (INIS)

    Caridi, James G.; Hawkins, Irvin F.; Akins, E. William; Young, Ronald S.

    1997-01-01

    To help improve patient acceptance of long-term internal/external catheter access to the biliary tract in those with benign biliary obstruction, a simple design allows the catheter end to remain flush with the skin. It consists of a clothes button affixed to the drainage catheter with a wood screw after the catheter has been cut off at the skin exit. This button/screw device has been used successfully in 22 patients over the last 10 years; catheter exchanges were easily accomplished

  2. Optimization of wireless power transmission for two port and three port inductive link

    International Nuclear Information System (INIS)

    Haider, Samnan; Mansor, Hasmah; Khan, Sheroz; Arshad, Atika; Shobaki, Mohammed M; Tasnim, Rumana

    2013-01-01

    Recent developments have shown that the use of buried electronic devices or body implants has been becoming prevalent. Such low power devices are being powered up through non-contact means utilizing inductive coupling from external powering source. Inductive coupling not only solves the issue of energy availability but helps collecting the sensed data that can be archived or used for subsequent monitoring purposes. This paper analyses the performance of two-port and three-port inductive links in terms of power sent, power received and power transfer efficiency. All the above mentioned parameters have been plotted using analytical approach and obtaining simulation where required. The effect of mutual coupling has been studied in detail for both systems and demonstrated by plotting the power transfer efficiency for different values of the coefficient of coupling (k) using MATLAB. Results show that power transfer efficiency depends highly upon the value of k

  3. Green Port / Eco Port Project - Applications and Procedures in Turkey

    Science.gov (United States)

    Akgul, Burak

    2017-12-01

    As being the heartlands of international trade, sea ports are the junction points of land and sea routes. The growth of global trade has led to the development of number and capacity as well as the service quality of ports. The policies and procedures applied during construction, operation and development of ports under development with environmental considerations scope has evolved in accordance with the needs of global trends. Although maritime transportation provides the most ecofriendly transportation method, the reduction of potential environmental threats and continuous improvement of ports and their vicinity is paramount from environmental concerns with regards to the international environmental standards. In the context of the study, national and international legal regulations governing the control of the environmental impacts of the activity groups causing pollution in Turkey based sea ports were viewed. In addition, the models applied during the measurement and documentation of environmental impacts were investigated. The most important aspects in terms of the effectiveness of the environmental management models are legal regulations. However, the standards applied at the ports without any legal obligation, such as EcoPorts applications, ISO 14001 standard, and the EMAS (Eco-Management and Audit Scheme) were sought in the scope of the study. The boundaries of the study were determined as the EU based Environmental Management Systems and the Green Port/Eco Port Project which is being administered by the Turkish Ministry of Transport, Maritime and Communication. “Marport”, which is Turkey’s first certified Green Port / Eco Port is designated as the experimental study site. In addition, the provisions in the ports of ESPO member countries are approached in order to compare the effectiveness and applicability of Green Port / Eco Port Project.

  4. Port Card Module

    International Nuclear Information System (INIS)

    Utes, M.

    1994-01-01

    The Port Card will be one link in the data acquisition system for the D0 Silicon Vertex Detector. This system consists of the following parts, starting at the detector: Silicon strip detectors are mounted in a spaceframe and wire-bonded to custom bare-die integrated circuits (SVX-II chips) that digitize the charge collected by the strips. The 128-channel chips are mounted on a High-Density Interconnect (HDI) that consists of a small flex circuit that routes control signals and eight data bits for each of three to ten chips onto a common data bus. A cable then routes this bus approximately thirty feet out from the detector to the Port Card. The Port Card houses a commercial chipset that serializes the data in real time and converts the signal into laser light impulses that are then transmitted through a multi-mode optical fiber about 150 feet to a Silicon Acquisition and Readout board (SAR). Here, the data is transformed back to parallel electrical signals that are stored in one of several banks of FIFO memories. The FIFOs place their data onto the VME backplane to a VME Buffer Driver (VBD) which stores the event data in buffers for eventual readout over a thirty-two signal ribbon cable to the Level Two Computers and subsequent tape storage. Control and sequencing of the whole operation starts with the Silicon Acquisition/Readout Controller (SARC) working in tandem with the D0 Clock System. The SARC resides in the same VME crate as the SARs, and transforms signals from the Trigger System into control codes distributed to the various Port Cards via optical fibers operating at 53 Mb/s. It is through these control codes that data taking operations such as data-acquisition, digitization, readout, and various resets can be carried out. The Port Card receives the control codes and manipulates the SVX-II chips in the proper way to effect proper data taking. There will be a total of about 700,000 channels, which translates into about 5580 SVX-II chips, 66 to 100 Port Cards

  5. Exploring the umbilical and vaginal port during minimally invasive surgery.

    Science.gov (United States)

    Tinelli, Andrea; Tsin, Daniel A; Forgione, Antonello; Zorron, Ricardo; Dapri, Giovanni; Malvasi, Antonio; Benhidjeb, Tahar; Sparic, Radmila; Nezhat, Farr

    2017-09-01

    This article focuses on the anatomy, literature, and our own experiences in an effort to assist in the decision-making process of choosing between an umbilical or vaginal port. Umbilical access is more familiar to general surgeons; it is thicker than the transvaginal entry, and has more nerve endings and sensory innervations. This combination increases tissue damage and pain in the umbilical port site. The vaginal route requires prophylactic antibiotics, a Foley catheter, and a period of postoperative sexual abstinence. Removal of large specimens is a challenge in traditional laparoscopy. Recently, there has been increased interest in going beyond traditional laparoscopy by using the navel in single-incision and port-reduction techniques. The benefits for removal of surgical specimens by colpotomy are not new. There is increasing interest in techniques that use vaginotomy in multifunctional ways, as described under the names of culdolaparoscopy, minilaparoscopy-assisted natural orifice surgery, and natural orifice transluminal endoscopic surgery. Both the navel and the transvaginal accesses are safe and convenient to use in the hands of experienced laparoscopic surgeons. The umbilical site has been successfully used in laparoscopy as an entry and extraction port. Vaginal entry and extraction is associated with a lower risk of incisional hernias, less postoperative pain, and excellent cosmetic results.

  6. Conceptual Model Development of Sustainability Practices: The Case of Port Operations for Collaboration and Governance

    Directory of Open Access Journals (Sweden)

    Dalwon Kang

    2017-12-01

    Full Text Available Sustainability practices in port operations are critical issue to achieve port sustainability involving economic, social and environmental issues. To assist ports to successfully implant sustainability practices into their operations, this paper conceptualized the structure of sustainability practices in international port operations, by clustering the relevant issues, empirically. Using 203 samples collected from port stakeholders in the major ports in Northeast Asia, multi-measurement items were analyzed on exploratory factor analysis in SPSS 21. Results generated a structure that consists of five sub-dimensions conceptualizing sustainability practices in the context of port operations. As operative practices to accommodate current and future demands in a port, the five-factor model clustering the relevant issues incorporate environmental technologies, process and quality improvement, monitoring and upgrading, communication and cooperation, and active participation. Providing useful insights for strategic agenda to assist ports to incorporate sustainability practices in their operations, the five-factor model offer both a descriptive and diagnostic management tool for future improvement in port operations.

  7. HomePort

    DEFF Research Database (Denmark)

    Madsen, Per Printz

    2009-01-01

    In the last couple of year's computer based home control systems are getting more and more common in modern homes. For instance these systems take care of light control, heat control and security systems.  The latest trend is to use wireless communication like Z-Wave and ZigBee to interconnect...... different components in these systems. One of the characteristics is that each system, like for instance heat and light, has their own specific way of using the communication system.   This paper describes a way to connect different home control systems through an intelligent gateway, called a Home......Port. The HomePort consists of a number of Subsystem communication drivers, a virtual communication layer, an interpreter and a PC- based compiler for a high level control language, called GIL (Gateway intelligence language). The focus in this paper will be on the upper two layers in the Home...

  8. Port interface requirements

    International Nuclear Information System (INIS)

    O'Neil, R.

    1978-01-01

    In a land-based reactor programme the Administration are usually confronted with a specific design in a particular environment. Safety and Reliability criteria necessary to the designer can be specified on the basis of acceptable risk to the population. However for the successful implementation of a nuclear ship programme on a broad commercial basis it is necessary to have agreed standards of risks from ships yet to be designed and agreed standards of acceptable risks to the population at likely ports of call yet to be specified, consulted, or agreed. At first sight it would seem that this double uncertainty must either lead to unnecessarily high safety standards for the ship or unacceptably conservative standards for berth selection. The paper discusses the problem and proposes a possible solution based on the concept of a 'Standard Port' and a 'Standard Ship' and indicates the level of risk implied by such a concept

  9. Implantação de Kanban como técnica auxiliar do planejamento e controle da produção: um estudo de caso em fábrica de médio porte Kanban system implantation as a helping technique of the production planning and control: a case study at a medium-size factory

    Directory of Open Access Journals (Sweden)

    Ethel Cristina Chiari da Silva

    1995-04-01

    Full Text Available O presente artigo relata a experiência da implantação do sistema Kanban em uma célula-piloto, realizada em uma fábrica de médio porte do setor metal mecânico em São Carlos - SP. A intenção da implantação do sistema kanban surgiu como expectativa de auxílio ao Planejamento e Controle da Produção, a fim de buscar padrões tecnológicos de gestão mais adequados à realidade mundial. Para implantação do sistema Kanban criou-se um ambiente Just-in-Time na célula piloto a fim de gerar um sistema consistente e também um modelo de aprendizado para a fábrica. Trabalhou-se com operários de baixa escolaridade e elaborou-se todo o material didático utilizado nas atividades de treinamento. Após um ano e meio (1130 horas de trabalho na fábrica, pôde-se chegar a resultados altamente satisfatórios, tanto qualitativos quanto quantitativos.The present article reports the experience of the Kanban system implantation on a pilot cell at a medium-size factory in the mechanical metal sector in São Carlos - SP. The reason for implanting the Kanban system arose in the hope of aiding Production Planning and Control in order to seek technological standards of administration more adequade to the world reality. For the kanban system implantation a Just-in-Time environment has been created at the pilot cell to generate a consistent system as well as a learning model for the factory. The work has been done with employees who have had low schooling and all didactical material used has been elaborated using training activities. After one and a half years' (1130 hours work at the factory, highly satisfactory results - both qualitative and quantitative - have been attained.

  10. Central Venous Catheter-Related Bloodstream Infection with Kocuria kristinae in a Patient with Propionic Acidemia.

    Science.gov (United States)

    Kimura, Masato; Kawai, Eichiro; Yaoita, Hisao; Ichinoi, Natsuko; Sakamoto, Osamu; Kure, Shigeo

    2017-01-01

    Kocuria kristinae is a catalase-positive, coagulase-negative, Gram-positive coccus found in the environment and in normal skin and mucosa in humans; however, it is rarely isolated from clinical specimens and is considered a nonpathogenic bacterium. We describe a case of catheter-related bacteremia due to K. kristinae in a young adult with propionic acidemia undergoing periodic hemodialysis. The patient had a central venous catheter implanted for total parenteral nutrition approximately 6 months prior to the onset of symptoms because of repeated acute pancreatitis. K. kristinae was isolated from two sets of blood cultures collected from the catheter. Vancomycin followed by cefazolin for 16 days and 5-day ethanol lock therapy successfully eradicated the K. kristinae bacteremia. Although human infections with this organism appear to be rare and are sometimes considered to result from contamination, physicians should not underestimate its significance when it is isolated in clinical specimens.

  11. Central Venous Catheter-Related Bloodstream Infection with Kocuria kristinae in a Patient with Propionic Acidemia

    Directory of Open Access Journals (Sweden)

    Masato Kimura

    2017-01-01

    Full Text Available Kocuria kristinae is a catalase-positive, coagulase-negative, Gram-positive coccus found in the environment and in normal skin and mucosa in humans; however, it is rarely isolated from clinical specimens and is considered a nonpathogenic bacterium. We describe a case of catheter-related bacteremia due to K. kristinae in a young adult with propionic acidemia undergoing periodic hemodialysis. The patient had a central venous catheter implanted for total parenteral nutrition approximately 6 months prior to the onset of symptoms because of repeated acute pancreatitis. K. kristinae was isolated from two sets of blood cultures collected from the catheter. Vancomycin followed by cefazolin for 16 days and 5-day ethanol lock therapy successfully eradicated the K. kristinae bacteremia. Although human infections with this organism appear to be rare and are sometimes considered to result from contamination, physicians should not underestimate its significance when it is isolated in clinical specimens.

  12. Successful Percutaneous Coronary Intervention through a Severely Bent Artificial Ascending Aorta Using the DIO Thrombus Aspiration Catheter

    Directory of Open Access Journals (Sweden)

    Akinori Fujikake

    2016-01-01

    Full Text Available A 66-year-old man was admitted to our institute because of chest pain. He had undergone replacement of the ascending aorta due to aortic dissection 9 years previously. We made a diagnosis of acute coronary syndrome, and coronary artery angiography was performed. Although the right coronary artery was successfully cannulated, a severe bend of the artificial aorta made it very difficult to advance the catheter into the left coronary artery. Ultimately, a DIO thrombus aspiration catheter was used to enter the left coronary artery, and a stent was implanted successfully. The DIO catheter is very useful when the selection of a guiding catheter is complicated, such as in the case of severe vessel tortuosity or a bend of the ascending aorta.

  13. Handling of waste in ports

    International Nuclear Information System (INIS)

    Olson, P.H.

    1994-01-01

    The regulations governing the handling of port-generated waste are often national and/or local legislation, whereas the handling of ship-generated waste is governed by the MARPOL Convention in most parts of the world. The handling of waste consists of two main phases -collection and treatment. Waste has to be collected in every port and on board every ship, whereas generally only some wastes are treated and to a certain degree in ports and on board ships. This paper considers the different kinds of waste generated in both ports and on board ships, where and how it is generated, how it could be collected and treated. The two sources are treated together to show how some ship-generated waste may be treated in port installations primarily constructed for the treatment of the port-generated waste, making integrated use of the available treatment facilities. (author)

  14. Pinch-off syndrome: transection of implantable central venous access device.

    Science.gov (United States)

    Sugimoto, Takuya; Nagata, Hiroshi; Hayashi, Ken; Kano, Nobuyasu

    2012-11-30

    As the population of people with cancer increases so does the number of patients who take chemotherapy. Majority of them are administered parentally continuously. Implantable central venous catheter device is a good choice for those patients; however, severe complication would occur concerning the devices. Pinch-off syndrome is one of the most severe complications. The authors report a severe case of pinch-off syndrome. The patient with the implantable central venous device could not take chemotherapy because the device occluded. Further examination revealed the transection of the catheter. The transected fragment of the catheter in the heart was successfully removed by using a loop snare placed through the right femoral vein.

  15. A review of dry ports

    OpenAIRE

    Violeta Roso; Kent Lumsden

    2010-01-01

    The objective of this article is to present the previous research on the dry port concept and to review the world's existing dry ports, that is freight terminals that use the term ‘dry port’ in their name. Therefore, the purpose of this article is to clarify the concept by showing potential discrepancies or agreements between theory and practice. Starting from a literature review on the dry port concept, this article presents a review of existing dry ports in the world. A number of qualitativ...

  16. PAIN RELIEF MEDIATED BY IMPLANTABLE DRUG-DELIVERY DEVICES

    NARCIS (Netherlands)

    HOEKSTRA, A

    Various totally implantable drug delivery systems from single access ports to micropumps are now available for administration of repeated boluses, and continuous or programmable infusions. In this respect, emphasis is given to a relatively cheap, totally implantable system for self-administering

  17. Catheter indwell time and phlebitis development during peripheral intravenous catheter administration.

    Science.gov (United States)

    Pasalioglu, Kadriye Burcu; Kaya, Hatice

    2014-07-01

    Intravenous catheters have been indispensable tools of modern medicine. Although intravenous applications can be used for a multitude of purposes, these applications may cause complications, some of which have serious effects. Of these complications, the most commonly observed is phlebitis. This study was conducted to determine the effect of catheter indwell time on phlebitis development during peripheral intravenous catheter administration. This study determined the effect of catheter indwell time on phlebitis development during peripheral intravenous catheter administration. The study included a total of 103 individuals who were administered 439 catheters and satisfied the study enrollment criteria at one infectious diseases clinic in Istanbul/Turkey. Data were compiled from Patient Information Forms, Peripheral Intravenous Catheter and Therapy Information Forms, reported grades based on the Visual Infusion Phlebitis Assessment Scale, and Peripheral Intravenous Catheter Nurse Observation Forms. The data were analyzed using SPSS. Results : The mean patient age was 53.75±15.54 (standard deviation) years, and 59.2% of the study participants were men. Phlebitis was detected in 41.2% of peripheral intravenous catheters, and the rate decreased with increased catheter indwell time. Analyses showed that catheter indwell time, antibiotic usage, sex, and catheterization sites were significantly associated with development of phlebitis. The results of this study show that catheters can be used for longer periods of time when administered under optimal conditions and with appropriate surveillance.

  18. 360 PORT MDA - A Strategy to Improve Port Security

    Science.gov (United States)

    2006-09-01

    Participating Agencies (After: Executive Briefing..........................27 Table 6. Designated Joint Operations Center Participants (From: SAFE...Investigations CGIP Coast Guard Intelligence Program CHOC Charleston Harbor Operations Center CIO Command Intelligence Officer CMT Combating Maritime... EXECUTIVE SUMMARY Ports are critical to our economy and national security. Key hubs in the international trade network, U.S. ports accounted for more than

  19. Extending the use of the pacing pulmonary artery catheter for safe minimally invasive cardiac surgery.

    Science.gov (United States)

    Levin, Ricardo; Leacche, Marzia; Petracek, Michael R; Deegan, Robert J; Eagle, Susan S; Thompson, Annemarie; Pretorius, Mias; Solenkova, Nataliya V; Umakanthan, Ramanan; Brewer, Zachary E; Byrne, John G

    2010-08-01

    In this study, the therapeutic use of pacing pulmonary artery catheters in association with minimally invasive cardiac surgery was evaluated. A retrospective study. A single institutional university hospital. Two hundred twenty-four consecutive patients undergoing minimally invasive cardiac surgery through a small (5-cm) right anterolateral thoracotomy using fibrillatory arrest without aortic cross-clamping. Two hundred eighteen patients underwent mitral valve surgery (97%) alone or in combination with other procedures. Six patients underwent other cardiac operations. In all patients, the pacing pulmonary artery catheter was used intraoperatively to induce ventricular fibrillation during the cooling period, and in the postoperative period it also was used in 37 (17%) patients who needed to be paced, mainly for bradyarrhythmias (51%). There were no complications related to the insertion of the catheters. Six (3%) patients experienced a loss of pacing capture, and 2 (1%) experienced another complication requiring the surgical removal of the catheter. Seven (3%) patients needed postoperative implantation of a permanent pacemaker. In combination with minimally invasive cardiac surgery, pacing pulmonary artery catheters were therapeutically useful to induce ventricular fibrillatory arrest intraoperatively and for obtaining pacing capability in the postoperative period. Their use was associated with a low number of complications. Copyright 2010 Elsevier Inc. All rights reserved.

  20. Lung abscess; Percutaneous catheter therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ha, H.K. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Kang, M.W. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Park, J.M. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Yang, W.J. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Shinn, K.S. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Bahk, Y.W. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of))

    1993-07-01

    Lung abscess was successfully treated with percutaneous drainage in 5 of 6 patients. Complete abscess resolution occurred in 4 patients, partial resolution in one, and no response in one. The duration of drainage ranged from 7 to 18 days (mean 15.5 days) in successful cases. The failure of drainage in one neurologicall impaired patient was attributed to persistent aspiration. In 2 patients, concurrent pleural empyema was also cured. CT provided the anatomic details necessary for choosing the puncture site and avoiding puncture of the lung parenchyma. Percutaneous catheter drainage is a safe and effective method for treating lung abscess. (orig.).

  1. Catheter-assisted retrieval of adhesive Geunther Tulip filter: preliminary experience

    International Nuclear Information System (INIS)

    Xiao Liang; Tong Jiajie; Xie Shiyang; Shen Jing

    2011-01-01

    Objective: To retrospectively summarize the technical experience in performing catheter-assisted retrieval of adhesive Geunther Tulip filter. Methods: During the period from November 2007 to October 2009, 95 patients with pulmonary embolism and acute deep vein thrombosis of lower limbs were admitted to authors' hospital. As simple snare technique failed to catch the adhesive Geunther Tulip filter previously implanted in inferior vena cava (IVC) in 6 patients (four males and two females with a mean age of 43.7 years), catheter-assisted retrieval of adhesive Geunther Tulip filter had to be carried out. The specific procedure was as follows. After phlebography of IVC confirmed that the filter's retrieval hook had adhered to IVC wall, the adhesion was separated with the help of catheter as well as goose-neck capturing device, then, the Geunther Tulip filter was retrieved. After the procedure, both anticoagulation and antibiotic medication were employed for 3-5 days. All the patients were followed up for 4-12 months. Vascular ultrasonography and pulmonary 3D CTA were re-examined in 6 months after primary operation. Results: All 6 adhesive Geunther Tulip filters were successfully removed with a success rate of 100%. The manipulation used in the procedure included catheter-twisting technique (n=1), catheter-looping technique (n=1) and catheter-snare looping technique (n=4). The mean operation time was 40.5 minutes (in the range of 17-78 minutes). The average filter-dwelling time was 46.7 days (ranging from 14 to 80 days). No thrombus formation in deep veins of lower extremity or pulmonary embolism occurred during the follow-up period. Conclusion: The catheter-assisted retrieval technique carries high retrieval rate for adhesive Geunther Tulip filter in IVC, it can markedly improve the retrieval success rate of Tulip IVC filter. (authors)

  2. Impact of quality management monitoring and intervention on central venous catheter dysfunction in the outpatient chemotherapy infusion setting.

    Science.gov (United States)

    Bansal, Anu; Binkert, Christoph A; Robinson, Malcolm K; Shulman, Lawrence N; Pellerin, Linda; Davison, Brian

    2008-08-01

    To assess the utility of maintaining and analyzing a quality-management database while investigating a subjectively perceived increase in the incidence of tunneled catheter and port dysfunction in a cohort of oncology outpatients. All 152 patients undergoing lytic therapy (2-4 mg alteplase) of a malfunctioning indwelling central venous catheter (CVC) from January through June 2004 at a single cancer center in the United States were included in a quality-management database. Patients were categorized by time to device failure and the initial method of catheter placement (surgery vs interventional radiology). Data were analyzed after 3 months, and areas of possible improvement were identified and acted upon. Three months of follow-up data were then collected and similarly analyzed. In a 6-month period, 152 patients treated for catheter malfunction received a total of 276 doses of lytic therapy. A 3-month interim analysis revealed a disproportionately high rate (34%) of early catheter malfunction (ECM; <30 days from placement). Postplacement radiographs demonstrated suboptimal catheter positioning in 67% of these patients, all of whom had surgical catheter placement. There was a 50% absolute decrease in the number of patients presenting with catheter malfunction in the period from April through June (P < .001). Evaluation of postplacement radiographs in these patients demonstrated a 50% decrease in the incidence of suboptimal positioning (P < .05). Suboptimal positioning was likely responsible for some, but not all, cases of ECM. Maintenance of a quality-management database is a relatively simple intervention that can have a clear and important impact on the quality and cost of patient care.

  3. Fast, automatic, and accurate catheter reconstruction in HDR brachytherapy using an electromagnetic 3D tracking system

    Energy Technology Data Exchange (ETDEWEB)

    Poulin, Eric; Racine, Emmanuel; Beaulieu, Luc, E-mail: Luc.Beaulieu@phy.ulaval.ca [Département de physique, de génie physique et d’optique et Centre de recherche sur le cancer de l’Université Laval, Université Laval, Québec, Québec G1V 0A6, Canada and Département de radio-oncologie et Axe Oncologie du Centre de recherche du CHU de Québec, CHU de Québec, 11 Côte du Palais, Québec, Québec G1R 2J6 (Canada); Binnekamp, Dirk [Integrated Clinical Solutions and Marketing, Philips Healthcare, Veenpluis 4-6, Best 5680 DA (Netherlands)

    2015-03-15

    Purpose: In high dose rate brachytherapy (HDR-B), current catheter reconstruction protocols are relatively slow and error prone. The purpose of this technical note is to evaluate the accuracy and the robustness of an electromagnetic (EM) tracking system for automated and real-time catheter reconstruction. Methods: For this preclinical study, a total of ten catheters were inserted in gelatin phantoms with different trajectories. Catheters were reconstructed using a 18G biopsy needle, used as an EM stylet and equipped with a miniaturized sensor, and the second generation Aurora{sup ®} Planar Field Generator from Northern Digital Inc. The Aurora EM system provides position and orientation value with precisions of 0.7 mm and 0.2°, respectively. Phantoms were also scanned using a μCT (GE Healthcare) and Philips Big Bore clinical computed tomography (CT) system with a spatial resolution of 89 μm and 2 mm, respectively. Reconstructions using the EM stylet were compared to μCT and CT. To assess the robustness of the EM reconstruction, five catheters were reconstructed twice and compared. Results: Reconstruction time for one catheter was 10 s, leading to a total reconstruction time inferior to 3 min for a typical 17-catheter implant. When compared to the μCT, the mean EM tip identification error was 0.69 ± 0.29 mm while the CT error was 1.08 ± 0.67 mm. The mean 3D distance error was found to be 0.66 ± 0.33 mm and 1.08 ± 0.72 mm for the EM and CT, respectively. EM 3D catheter trajectories were found to be more accurate. A maximum difference of less than 0.6 mm was found between successive EM reconstructions. Conclusions: The EM reconstruction was found to be more accurate and precise than the conventional methods used for catheter reconstruction in HDR-B. This approach can be applied to any type of catheters and applicators.

  4. Fast, automatic, and accurate catheter reconstruction in HDR brachytherapy using an electromagnetic 3D tracking system

    International Nuclear Information System (INIS)

    Poulin, Eric; Racine, Emmanuel; Beaulieu, Luc; Binnekamp, Dirk

    2015-01-01

    Purpose: In high dose rate brachytherapy (HDR-B), current catheter reconstruction protocols are relatively slow and error prone. The purpose of this technical note is to evaluate the accuracy and the robustness of an electromagnetic (EM) tracking system for automated and real-time catheter reconstruction. Methods: For this preclinical study, a total of ten catheters were inserted in gelatin phantoms with different trajectories. Catheters were reconstructed using a 18G biopsy needle, used as an EM stylet and equipped with a miniaturized sensor, and the second generation Aurora ® Planar Field Generator from Northern Digital Inc. The Aurora EM system provides position and orientation value with precisions of 0.7 mm and 0.2°, respectively. Phantoms were also scanned using a μCT (GE Healthcare) and Philips Big Bore clinical computed tomography (CT) system with a spatial resolution of 89 μm and 2 mm, respectively. Reconstructions using the EM stylet were compared to μCT and CT. To assess the robustness of the EM reconstruction, five catheters were reconstructed twice and compared. Results: Reconstruction time for one catheter was 10 s, leading to a total reconstruction time inferior to 3 min for a typical 17-catheter implant. When compared to the μCT, the mean EM tip identification error was 0.69 ± 0.29 mm while the CT error was 1.08 ± 0.67 mm. The mean 3D distance error was found to be 0.66 ± 0.33 mm and 1.08 ± 0.72 mm for the EM and CT, respectively. EM 3D catheter trajectories were found to be more accurate. A maximum difference of less than 0.6 mm was found between successive EM reconstructions. Conclusions: The EM reconstruction was found to be more accurate and precise than the conventional methods used for catheter reconstruction in HDR-B. This approach can be applied to any type of catheters and applicators

  5. Laser welding of balloon catheters

    Science.gov (United States)

    Flanagan, Aidan J.

    2003-03-01

    The balloon catheter is one of the principal instruments of non-invasive vascular surgery. It is used most commonly for angioplasty (and in recent years for delivering stents) at a multitude of different sites in the body from small arteries in the heart to the bilary duct. It is composed of a polymer balloon that is attached to a polymer shaft at two points called the distal and proximal bonds. The diverse utility of balloon catheters means a large range of component sizes and materials are used during production; this leads to a complexity of bonding methods and technology. The proximal and distal bonds have been conventionally made using cyanoacrylate or UV curing glue, however with performance requirements of bond strength, flexibility, profile, and manufacturing costs these bonds are increasingly being made by welding using laser, RF, and Hot Jaw methods. This paper describes laser welding of distal and proximal balloon bonds and details beam delivery, bonding mechanisms, bond shaping, laser types, and wavelength choice.

  6. 21 CFR 880.5200 - Intravascular catheter.

    Science.gov (United States)

    2010-04-01

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

  7. Urethral catheters: can we reduce use?

    NARCIS (Netherlands)

    Broek, P.J. van den; Wille, J.C.; Benthem, B.H.B. van; Perenboom, R.J.M.; Akker-van Marle, M.E. van den; Nielen, A.M.A.

    2011-01-01

    Indwelling urinary catheters are the main cause of healthcare-associated urinary tract infections. It can be expected that reduction of the use of urinary catheters will lead to decreased numbers of urinary tract infection. The efficacy of an intervention programme to improve adherence to

  8. WE-G-17A-05: Real-Time Catheter Localization Using An Active MR Tracker for Interstitial Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Wang, W; Damato, A; Viswanathan, A; Cormack, R [Dana Farber Cancer Institute / Brigham and Women' s Hospital, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Penzkofer, T; Schmidt, E [Brigham and Women' s Hospital, Boston, MA (United States); Pan, L; Gilson, W [Siemens Corporation, Corporate Technology, Baltimore, MD (United States); Seethamraju, R [Siemens Healthcare, Boston, MA (United States)

    2014-06-15

    Purpose: To develop a novel active MR-tracking system which can provide accurate and rapid localization of brachytherapy catheters, and assess its reliability and spatial accuracy in comparison to standard catheter digitization using MR images. Methods: An active MR tracker for brachytherapy was constructed by adding three printed-circuit micro-coils to the shaft of a commercial metallic stylet. A gel phantom with an embedded framework was built, into which fifteen 14-Gauge catheters were placed, following either with parallel or crossed paths. The tracker was inserted sequentially into each catheter, with MR-tracking running continuously. Tracking was also performed during the tracker's removal from each catheter. Catheter trajectories measured from the insertion and the removal procedures using the same micro-coil were compared, as well as trajectories obtained using different micro-coils. A 3D high-resolution MR image dataset of the phantom was acquired and imported into a treatment planning system (TPS) for catheter digitization. A comparison between MR-tracked positions and positions digitized from MR images by TPS was performed. Results: The MR tracking shows good consistency for varying catheter paths and for all micro-coils (mean difference ∼1.1 mm). The average distance between the MR-tracking trajectory and catheter digitization from the MR images was 1.1 mm. Ambiguity in catheter assignment from images due to crossed paths was resolved by active tracking. When tracking was interleaved with imaging, real-time images were continuously acquired at the instantaneous tip positions and displayed on an external workstation. Conclusion: The active MR tracker may be used to provide an independent measurement of catheter location in the MR environment, potentially eliminating the need for subsequent CT. It may also be used to control realtime imaging of catheter placement. This will enable MR-based brachytherapy planning of interstitial implants without

  9. WE-G-17A-05: Real-Time Catheter Localization Using An Active MR Tracker for Interstitial Brachytherapy

    International Nuclear Information System (INIS)

    Wang, W; Damato, A; Viswanathan, A; Cormack, R; Penzkofer, T; Schmidt, E; Pan, L; Gilson, W; Seethamraju, R

    2014-01-01

    Purpose: To develop a novel active MR-tracking system which can provide accurate and rapid localization of brachytherapy catheters, and assess its reliability and spatial accuracy in comparison to standard catheter digitization using MR images. Methods: An active MR tracker for brachytherapy was constructed by adding three printed-circuit micro-coils to the shaft of a commercial metallic stylet. A gel phantom with an embedded framework was built, into which fifteen 14-Gauge catheters were placed, following either with parallel or crossed paths. The tracker was inserted sequentially into each catheter, with MR-tracking running continuously. Tracking was also performed during the tracker's removal from each catheter. Catheter trajectories measured from the insertion and the removal procedures using the same micro-coil were compared, as well as trajectories obtained using different micro-coils. A 3D high-resolution MR image dataset of the phantom was acquired and imported into a treatment planning system (TPS) for catheter digitization. A comparison between MR-tracked positions and positions digitized from MR images by TPS was performed. Results: The MR tracking shows good consistency for varying catheter paths and for all micro-coils (mean difference ∼1.1 mm). The average distance between the MR-tracking trajectory and catheter digitization from the MR images was 1.1 mm. Ambiguity in catheter assignment from images due to crossed paths was resolved by active tracking. When tracking was interleaved with imaging, real-time images were continuously acquired at the instantaneous tip positions and displayed on an external workstation. Conclusion: The active MR tracker may be used to provide an independent measurement of catheter location in the MR environment, potentially eliminating the need for subsequent CT. It may also be used to control realtime imaging of catheter placement. This will enable MR-based brachytherapy planning of interstitial implants without

  10. Container Traffic In European Ports

    Directory of Open Access Journals (Sweden)

    Elen Twrdy

    2004-03-01

    Full Text Available Over the last fifteen years the European transport markethas witnessed a growth of container traffic which today reachesapproximately 50 million TEU per year. From 1997 to 2002,container traffic in the northern European ports increased from14 to 20.6 million TEU per year, in the ports of the westernMedite"anean from 6 to 10 million TEU per year, and in thenorthern Adriatic ports from 0. 69 to 0. 74 million TEU per year.The ports of the northern Adriatic are located in three states(Slovenia, Croatia and Italy with different statuses in relationto the common European market. In addition, different developmentlevels of these states are reflected in different levels ofinternational commercial exchange, the development of the existinginfrastructure and plans for the construction of new infrastructures.However, all three countries share a common goaltoincrease their competitiveness in comparison with the westemEuropean ports.

  11. The efficacy of noble metal alloy urinary catheters in reducing catheter-associated urinary tract infection

    Directory of Open Access Journals (Sweden)

    Alanood Ahmed Aljohi

    2016-01-01

    Results: A 90% relative risk reduction in the rate of CAUTI was observed with the noble metal alloy catheter compared to the standard catheter (10 vs. 1 cases, P = 0.006. When considering both catheter-associated asymptomatic bacteriuria and CAUTI, the relative risk reduction was 83% (12 vs. 2 cases, P = 0.005. In addition to CAUTI, the risk of acquiring secondary bacteremia was lower (100% for the patients using noble metal alloy catheters (3 cases in the standard group vs. 0 case in the noble metal alloy catheter group, P = 0.24. No adverse events related to any of the used catheters were recorded. Conclusion: Results from this study revealed that noble metal alloy catheters are safe to use and significantly reduce CAUTI rate in ICU patients after 3 days of use.

  12. Single port laparoscopic surgery

    DEFF Research Database (Denmark)

    Springborg, Henrik; Istre, Olav

    2012-01-01

    LESS, or laparo-endoscopic single site surgery, is a promising new method in minimally invasive surgery. An increasing number of surgical procedures are being performed using this technique, however, its large-scale adoption awaits results of prospective randomized controlled studies confirming...... potential benefits. Theoretically, cosmetic outcomes, postoperative pain and complication rates could be improved with use of single site surgery. This study describes introduction of the method in a private hospital in Denmark, in which 40 patients have been treated for benign gynecologic conditions....... Although the operations described are the first of their kind reported in Denmark, favorable operating times and very low complication rates are seen. It is the authors' opinion that in addition to being feasible for hysterectomy, single port laparoscopy may become the preferred method for many simple...

  13. Attitudes Towards Catheter Ablation for Atrial Fibrillation

    DEFF Research Database (Denmark)

    Vadmann, Henrik; Pedersen, Susanne S; Nielsen, Jens Cosedis

    2015-01-01

    BACKGROUND: Catheter ablation for atrial fibrillation (AF) is an important but expensive procedure that is the subject of some debate. Physicians´ attitudes towards catheter ablation may influence promotion and patient acceptance. This is the first study to examine the attitudes of Danish...... cardiologists towards catheter ablation for AF, using a nationwide survey. METHODS AND RESULTS: We developed a purpose-designed questionnaire to evaluate attitudes towards catheter ablation for AF that was sent to all Danish cardiologists (n = 401; response n = 272 (67.8%)). There was no association between...... attitudes towards ablation and the experience or age of the cardiologist with respect to patients with recurrent AF episodes with a duration of 7 days and/or need for cardioversion. The majority (69%) expected a recurrence of AF after catheter ablation in more than 30% of the cases...

  14. Catheter Associated Urinary Tract Infection Prevention bundle

    Directory of Open Access Journals (Sweden)

    O. Zarkotou

    2017-01-01

    Full Text Available Catheter-associated urinary tract infections (CAUTI are among the most common healthcare-associated infections, and potentially lead to significant morbidity and mortality. Multifaceted infection control strategies implemented as bundles can prevent nosocomial infections associated with invasive devices such as CAUTIs. The components of the CAUTI bundle proposed herein, include appropriate indications for catheterization and recommendations for the procedures of catheter insertion and catheter maintenance and care. Avoiding unnecessary urinary catheter use is the most effective measure for their prevention. To minimize the risk of CAUTI, urinary catheters should be placed only when a clinical valid indication is documented and they should be removed as soon as possible; alternatives to catheterization should also be considered. Aseptic insertion technique, maintenance of closed drainage system and strict adherence to hand hygiene are essential for preventing CAUTI. The successful implementation of the bundle requires education and training for all healthcare professionals and evaluation of surveillance data.

  15. Cochlear Implants

    Science.gov (United States)

    ... implant, including: • How long a person has been deaf, •The number of surviving auditory nerve fibers, and • ... Implant, Severe Sensoryneurial Hearing Loss Get Involved Professional Development Practice Management ENT Careers Marketplace Privacy Policy Terms ...

  16. Repositioning and Leaving In Situ the Central Venous Catheter During Percutaneous Treatment of Associated Superior Vena Cava Syndrome: A Report of Eight Cases

    International Nuclear Information System (INIS)

    Stockx, Luc; Raat, Henricus; Donck, Jan; Wilms, Guy; Marchal, Guy

    1999-01-01

    Purpose: To describe a combined procedure of repositioning and leaving in situ a central venous catheter followed by immediate percutaneous treatment of associated superior vena cava syndrome (SVCS). Methods: Eight patients are presented who have central venous catheter-associated SVCS (n = 6 Hickman catheters, n = 2 Port-a-cath) caused by central vein stenosis (n = 4) or concomitant thrombosis (n = 4). With the use of a vascular snare introduced via the transcubital or transjugular approach, the tip of the central venous catheter could be engaged, and repositioned after deployment of a stent in the innominate or superior vena cava. Results: In all patients it was technically feasible to reposition the central venous catheter and treat the SVCS at the same time. In one patient flipping of the Hickman catheter in its original position provoked dislocation of the released Palmaz stent, which could be positioned in the right common iliac vein. Conclusion: Repositioning of a central venous catheter just before and after stent deployment in SVCS is technically feasible and a better alternative than preprocedural removal of the vascular access

  17. Concerning background from calorimeter ports

    International Nuclear Information System (INIS)

    Digiacomo, N.J.

    1985-01-01

    Any detector system viewing a port or slit in a calorimeter wall will see, in addition to the primary particles of interest, a background of charged and neutral particles and photons generated by scattering from the port walls and by leakage from incompletely contained primary particle showers in the calorimeter near the port. The signal to noise ratio attainable outside the port is a complex function of the primary source spectrum, the calorimeter and port design and, of course, the nature and acceptance of the detector system that views the port. Rather than making general statements about the overall suitability (or lack thereof) of calorimeter ports, we offer here a specific example based on the external spectrometer and slit of the NA34 experiment. This combination of slit and spectrometer is designed for fixed-target work, so that the primary particle momentum spectrum contains higher momentum particles than expected in a heavy ion colliding beam environment. The results are, nevertheless, quite relevant for the collider case

  18. Cost and morbidity analysis of chest port insertion in adults: Outpatient clinic versus operating room placement.

    Science.gov (United States)

    Feo, Claudio F; Ginesu, Giorgio C; Bellini, Alessandro; Cherchi, Giuseppe; Scanu, Antonio M; Cossu, Maria Laura; Fancellu, Alessandro; Porcu, Alberto

    2017-09-01

    Totally implantable venous access devices (TIVADs) represent a convenient way for the administration of medications or nutrients. Traditionally, chest ports have been positioned by surgeons in the operating room, however there has been a transition over the years to port insertion by interventional radiologists in the radiology suite. The optimal method for chest port placement is still under debate. Data on all adult patients undergoing isolated chest port placement at our institution in a 12-year period were retrospectively reviewed. The aim of this cohort study was to compare cost and morbidity for chest port insertion in two different settings: outpatient clinic and operating room. Between 2003 and 2015 a total of 527 chest ports were placed in adult patients. Of them, 262 procedures were performed in the operating room and 265 procedures were undertaken in the outpatient clinic. Patient characteristics were similar and there was no significant difference in early (port was 1270 Euros in the operating room versus 620 Euros in the outpatient clinic. Our results suggest that chest ports can be safely placed in most patients under local anesthesia in the office setting without fluoroscopy or ultrasound guidance. Future randomized controlled studies may evaluate if surgeons or interventional radiologists should routinely perform these procedures in a dedicated office setting and reserve more sophisticated facilities only for patients at high risk of technical failure.

  19. [Venous catheter-related infections].

    Science.gov (United States)

    Ferrer, Carmen; Almirante, Benito

    2014-02-01

    Venous catheter-related infections are a problem of particular importance, due to their frequency, morbidity and mortality, and because they are potentially preventable clinical processes. At present, the majority of hospitalized patients and a considerable number of outpatients are carriers of these devices. There has been a remarkable growth of knowledge of the epidemiology of these infections, the most appropriate methodology for diagnosis, the therapeutic and, in particular, the preventive strategies. Multimodal strategies, including educational programs directed at staff and a bundle of simple measures for implementation, applied to high-risk patients have demonstrated great effectiveness for their prevention. In this review the epidemiology, the diagnosis, and the therapeutic and preventive aspects of these infections are updated. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  20. Radiofrequency catheter oblation in atrial flutter

    International Nuclear Information System (INIS)

    Yan Ji; Wang Heping; Xu Jian; Liu Fuyuan; Fan Xizhen; An Chunsheng; Han Xiaoping; Ding Xiaomei; Wang Jiasheng; Gu Tongyuan

    2002-01-01

    Objective: To evaluate the radiofrequency catheter ablation for type I atrial flutter through application of Holo catheter labelling with anatomic imaging localization to ablate the isthmus of IVCTA during complete double-way block. Methods: Eleven cases with type I atrial flutter undergone Holo catheter labelling technique and consecution with conduction time change of coronary venous sinus orifice with-right atrial lower lateral wall pace excitation, were performed with radiofrequency catheter ablation for the isthmus outcoming with complete double-way conduction block. Results: All together 11 cases with 4 of atrial flutter and 7 of sinus rhythm were undergone radiofrequency catheter ablation resulting with double-way conduction block of the isthmus accompanied by prolongation of right atrial conduction time 56.0 ± 2.3 ms and 53.0 ± 4.6 ms respectively. The right atrial excitation appeared to be in clockwise and counter-clockwise of single direction. No recurrence occurred during 3-34 months follow up with only one showing atrial fibrillation. Conclusions: The application of Holo catheter labelling technique with anatomic imaging localization to achieve the double-way conduction block by radiofrequency catheter ablation of TVC-TA isthmus, is a reliable method for treating atrial flutter

  1. Wolff-Parkinson-White syndrome with an unroofed coronary sinus without persistent left superior vena cava treated with catheter cryoablation

    Directory of Open Access Journals (Sweden)

    Andrei Catanchin

    2008-08-01

    Full Text Available Coronary sinus anomalies are rare congenital defects which are usually coexistent with a persistent left superior vena cava and may be associated with cardiac arrhythmias. We report an unroofed coronary sinus without persistent left superior vena cava diagnosed during a catheter ablation procedure for Wolff-Parkinson-White syndrome. Diagnostic and therapeutic options and outcomes are discussed. This condition is of relevance to electrophysiologists performing catheter-based procedures, as well as cardiologists implanting coronary sinus pacing leads, who may encounter this anomaly in their practice.

  2. Central venous catheters: the role of radiology

    International Nuclear Information System (INIS)

    Tan, P.L.; Gibson, M.

    2006-01-01

    The insertion and management of long-term venous catheters have long been the province of anaesthetists, intensive care physicians and surgeons. Radiologists are taking an increasing role in the insertion of central venous catheters (CVCs) because of their familiarity with the imaging equipment and their ability to manipulate catheters and guide-wires. The radiological management of the complications of CVCs has also expanded as a result. This article reviews the role of radiology in central venous access, covering the detection and management of their complications

  3. Miniaturization of catheter systems for angiography

    International Nuclear Information System (INIS)

    Hawkins, I.F. Jr.; Akins, E.W.

    1988-01-01

    The authors discuss the use of small catheters and needles in angiography and interventional procedures to improve the quality of the procedures and increase the success rate and safety. This philosophy was initially poorly received, both by operators and by industry; however, more recently microtechniques have become more acceptable primarily because of the changing economic climate requiring procedures with shorter or no hospitalization time. Since 1970, the authors have performed well over 10,000 angiographic procedures using 5 French catheters, or smaller. During the last 12 years, they have used almost exclusively 4 French catheters, primarily with standard filming techniques which have resulted in no thrombosed arteries, or significant hematoma formation

  4. Cryoballoon Catheter Ablation in Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Cevher Ozcan

    2011-01-01

    Full Text Available Pulmonary vein isolation with catheter ablation is an effective treatment in patients with symptomatic atrial fibrillation refractory or intolerant to antiarrhythmic medications. The cryoballoon catheter was recently approved for this procedure. In this paper, the basics of cryothermal energy ablation are reviewed including its ability of creating homogenous lesion formation, minimal destruction to surrounding vasculature, preserved tissue integrity, and lower risk of thrombus formation. Also summarized here are the publications describing the clinical experience with the cryoballoon catheter ablation in both paroxysmal and persistent atrial fibrillation, its safety and efficacy, and discussions on the technical aspect of the cryoballoon ablation procedure.

  5. Iatrogenic Bowel Injury at Exchange of Supra-Pubic Catheter

    LENUS (Irish Health Repository)

    Foran, AT

    2018-04-01

    Suprapubic catheter insertion and exchange is a common urological procedure, but it is not without risks and complications. While bowel perforation is a recognised complication at suprapubic catheter insertion, it is not commonly reported at suprapubic catheter exchange. We report our experience of recognition, diagnosis and subsequent successful management of the most important complication related to suprapubic catheters.

  6. Feasibility and Safety of Endovascular Stripping of Totally Implantable Venous Access Devices

    International Nuclear Information System (INIS)

    Heye, Sam; Maleux, Geert; Goossens, G. A.; Vaninbroukx, Johan; Jerôme, M.; Stas, M.

    2012-01-01

    Purpose: To evaluate the safety and feasibility of percutaneous stripping of totally implantable venous access devices (TIVAD) in case of catheter-related sleeve and to report a technique to free the catheter tip from vessel wall adherence. Materials and Methods: A total of 37 stripping procedures in 35 patients (14 men, 40%, and 21 women, 60%, mean age 53 ± 14 years) were reviewed. Totally implantable venous access devices were implanted because of malignancy in most cases (85.7%). Catheter-related sleeve was confirmed as cause of persistent catheter dysfunction despite instillation of thrombolytics. A technique to mobilize the catheter tip from the vessel wall was used when stripping with the snare catheter was impossible. Technical success, complication rate, and outcome were noted. Results: A total of 55.9% (n = 19) of the 34 technically successful procedures (91.9%) could be done with the snare catheter. In 15 cases (44.1%), additional maneuvers to free the TIVAD’s tip from the vessel wall were needed. Success rate was not significantly lower before (72.4%) than after (96.7%) implementation of the new technique (P = 0.09). No complications were observed. Follow-up was available in 67.6% of cases. Recurrent catheter dysfunction was found in 17 TIVADs (78.3%) at a mean of 137.7 days and a median of 105 days. Conclusions: Stripping of TIVADs is technically feasible and safe, with an overall success rate of 91.9%. Additional endovascular techniques to mobilize the distal catheter tip from the wall of the superior vena cava or right atrium to allow encircling the TIVAD tip with the snare catheter may be needed in 44.1% of cases.

  7. Incidence and risk factors for central venous access port-related infection in Chinese cancer patients

    Directory of Open Access Journals (Sweden)

    Ting-Yao Wang

    2015-11-01

    Conclusion: Infection remains to be a challenging issue for totally implantable central venous ports. Implementation of an insertion bundle for the prevention of central line-associated bloodstream infections is warranted, especially for those patients with hematological and head and neck cancers, as well as for patients receiving chemotherapy in the metastatic settings.

  8. Developing the port of Belawan as a modern and international port

    Science.gov (United States)

    Many, N.

    2018-03-01

    This study discusses the processes of government to pass the port development plan in Indonesia with the Port of Belawan and its port expansion as the study case. The study uses a descriptive approach by reviewing and analyzing some of relevant literature as the sources. It also reviews and examines the port development theoretical concepts and models giving attention to the international hub port models resulted from the previous studies. The international hub port aspects assessed to be further applied and compared to the actual situation of the Port of Belawan. This process draws the conclusion on which concept and model the port classified, followed by some recommendations concerning the necessary actions to be taken. The results show that: (1) The port planning regulated in port master plan is the guideline and foundation to implement the port development; (2) Spatial and zoning plan regulations are very important in the preparation, planning, and implementation of port development; (3) It has not provided the necessary facilities and criteria of the global hub port model has not been met completely. The port is strategic to be completely developed as the regional hub port to compete with the major ports of neighboring countries. Eventually, this study requires further analysis to examine the economic feasibility of the Port of Belawan in more comprehensive way functioning as an international hub port along with the ongoing development of Kuala Tanjung Port to achieve its ultimate objectives, among other things, the port effectiveness, efficiency, and competitiveness.

  9. Catheter visualisation in MR tomography: first animal experimental experiences with field inhomogeneity catheters

    International Nuclear Information System (INIS)

    Adam, G.; Glowinski, A.; Neuerburg, J.; Buecker, A.; Vaals, J.J. van; Hurtak, W.; Guenther, R.W.

    1997-01-01

    Purpose: To assess the feasibility of a new developed field inhomogeneity catheter for interventional MR imaging in vivo. Materials and methods: Three different prototypes of a field inhomogeneity catheter were investigated in 6 pigs. The catheters were introduced in Seldinger technique via the femoral vessels over a guide wire on an interventional MR system (Philips Gyroscan NT combined with a C-arm fluoroscopy unit [Philips BV 212[). Catheters were placed in veins and arteries. The catheter position was controlled by a fast gradient echo sequence (Turbo Field Echo [TEF[). Results: Catheters were introduced over a guide wire without complications in all cases. Using the field inhomogeneity concept, catheters were easily visualised in the inferior vena cava and the aorta by the fast gradient echo technique on MR in all cases. Although aortic branches were successfully cannulated, the catheters were not displayed by the TFE technique due to the complex and tortuous anatomy. All animals survived the experiments without complications. Conclusion: MR guided visualisation of a field inhomogeneity catheter is a simple concept which can be realised on each MR scanner and may allow intravascular MR guided interventions in future. (orig.) [de

  10. Catheter-Associated Urinary Tract Infections

    Science.gov (United States)

    ... Duodenoscope Sampling Method Interim Duodenoscope Culture Method Multiplex Real-Time PCR Detection of KPC & NDM-1 genes Quinolones ... The most commonly used external catheter is a soft flexible sheath that fits over the penis (“condom” ...

  11. [Peripheral intravenous catheter-related phlebitis].

    Science.gov (United States)

    van der Sar-van der Brugge, Simone; Posthuma, E F M Ward

    2011-01-01

    Phlebitis is a very common complication of the use of intravenous catheters. Two patients with an i.v. catheter complicated by thrombophlebitis are described. Patient A was immunocompromised due to chronic lymphatic leukaemia and developed septic thrombophlebitis with positive blood cultures for S. Aureus. Patient B was being treated with flucloxacillin because of an S. Aureus infection and developed chemical phlebitis. Septic phlebitis is rare, but potentially serious. Chemical or mechanical types of thrombophlebitis are usually less severe, but happen very frequently. Risk factors include: female sex, previous episode of phlebitis, insertion at (ventral) forearm, emergency placement and administration of antibiotics. Until recently, routine replacement of peripheral intravenous catheters after 72-96 h was recommended, but randomised controlled trials have not shown any benefit of this routine. A recent Cochrane Review recommends replacement of peripheral intravenous catheters when clinically indicated only.

  12. When routine D-J implantation necessary during PNL?

    Science.gov (United States)

    Bayrak, Omer; Seckiner, Ilker; Erturhan, Sakip M; Bulut, Ersan; Demirbag, Asaf; Erbagci, Asaf

    2015-03-01

    We investigated the characteristics of patients who underwent Double-J catheter (D-J) implantation, the risk factors for prolonged urine leakage (PUL), and prediction of patients who require medical treatment. The data of 535 adult patients who underwent PNL due to kidney stone disease between January 2005 and December 2011 in our clinic were analyzed retrospectively. Patients were divided into 2 groups: Group 1 (n=77) (14.39%) included patients with Double-J catheter due to prolonged (> 24 h) urinary leakage and Group 2 (n=458) (85.61%) patients without urinary leakage. The mean stone burden was 951.94 ± 539.09 mm2 in Group 1, and 676.35 ±296.65 mm2 in Group 2 (p<0.05). DJ catheter was implanted in 11.33% of the patients with stone burden below 1000 mm2 versus in 51.21% of the patients with stone burden above 1000 mm2. In Group 1, the number of patients with two or more accesses performed was 18.18, whereas in Group 2 it was 8.5% (p<0.05). Among all patients, DJ implantation was performed in 13.07% of patients with a single access versus 26.41% of patients with two or more accesses. Also, DJ catheter was implanted in 41.46%of patients with residual stones versus 12.14% of stone-free patients. Three patients with stone burden above 1000 mm2, two or more accesses, and residual stone, all of them required DJ implantation. DJ implantation due to PUL had approximately 5-fold increase stone burden above 1000 mm2, 2-fold increase in patients undergoing two or more access and 3-fold increase in patients with residual stones. Therefore, we think that the D-J implantation is highly advisable in case of a stone load above 1000 mm2, two or more accesses, and in patients with residual stones.

  13. Successful retrieval of an entrapped Rotablator burr using 5 Fr guiding catheter.

    Science.gov (United States)

    Kimura, Masayoshi; Shiraishi, Jun; Kohno, Yoshio

    2011-10-01

    Although burr entrapment is a rare complication of the Rotablator, it is extremely difficult to retrieve a fixedly entrapped burr without surgical procedure. An 84-year-old male with effort angina had heavily calcified coronary trees as well as severe stenosis in the mid LCx, and moderate stenosis in the proximal LCx, and in the LMT. We planned to perform rotational atherectomy in the LCx lesions. Using 7 Fr Q-curve guiding catheter and Rotawire floppy, we began to ablate using 1.5-mm burr at 200,000 rpm. Because the burr could not pass the proximal stenosis, we exchanged the wire for Rotawire extrasupport and the burr for 1.25-mm burr, and restarted the ablation at 220,000 rpm. Although the burr could manage to pass the proximal stenosis, it had become trapped in the mid LCx lesion. Simple pull on the Rotablator, rotation of the burr, and crossing the Conquest (Confianza) wire could not retrieve it. Thus, we cut off the drive shaft and sheath of the Rotablator, inserted 5 Fr 120-cm straight guiding catheter (Heartrail ST01; Terumo) through the remaining Rotablator system, pushed the catheter tip to the lesion around the burr as well as simultaneously pulled the Rotablator, and finally could retrieve it. Then we implanted stents in the LCx and in the LMT without difficulty. The 5 Fr straight guiding catheter might be useful for retrieving an entrapped burr (1.25-mm burr). Copyright © 2011 Wiley-Liss, Inc.

  14. The safety and feasibility of guidezilla catheter in complex coronary interventions and an observational study.

    Science.gov (United States)

    Ma, Jianying; Hou, Lei; Qian, Juying; Ge, Lei; Zhang, Feng; Chang, Shufu; Xu, Rende; Qin, Qing; Ge, Junbo

    2017-10-01

    The monorail Guidezilla guide extension catheter was designed to provide additional backup and facilitate device delivery in percutaneous coronary intervention (PCI) for complex coronary anatomy such as chronic total occlusion (CTO), extreme vessel tortuosity, diseased bypass grafts, and anomalous coronary arteries, among others.The present retrospective, single-center study included 188 consecutive patients who underwent PCI using the Guidezilla catheter from March 2015 to August 2016. Study outcomes were rates of target lesion crossing success, procedural success, and complications.The Guidezilla catheter was used most commonly in PCI of CTOs (45%) and heavy proximal calcification (37%), followed by tortuosity (10%), previously deployed proximal stents (4%), and coronary artery anomaly (4%). The right coronary artery (48%) was most commonly intervened followed by the left ascending (35%) and left circumflex (17%) arteries. Rates of target lesion crossing success and procedural success were both 99%, with one device-related periprocedural complication, namely proximal vessel dissection secondary to deep insertion which was successfully treated with stent implantation. Ninety percent of PCI were performed and completed successfully by radial access.In a single center with experienced operators, the use of the Guidezilla guide extension catheter in PCI of complex coronary anatomy performed mostly via radial artery access appeared safe and efficacious, and greatly facilitated device delivery.

  15. Tracing Fasting Glucose Fluxes with Unstressed Catheter Approach in Streptozotocin Induced Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Shichun Du

    2014-01-01

    Full Text Available Objective. Blood glucose concentrations of type 1 diabetic rats are vulnerable, especially to stress and trauma. The present study aimed to investigate the fasting endogenous glucose production and skeletal muscle glucose uptake of Streptozotocin induced type 1 diabetic rats using an unstressed vein and artery implantation of catheters at the tails of the rats as a platform. Research Design and Methods. Streptozotocin (65 mg·kg−1 was administered to induce type 1 diabetic state. The unstressed approach of catheters of vein and artery at the tails of the rats was established before the isotope tracer injection. Dynamic measurement of fasting endogenous glucose production was assessed by continuously infusing stable isotope [6, 6-2H2] glucose, while skeletal muscle glucose uptake by bolus injecting radioactively labeled [1-14C]-2-deoxy-glucose. Results. Streptozotocin induced type 1 diabetic rats displayed polydipsia, polyphagia, and polyuria along with overt hyperglycemia and hypoinsulinemia. They also had enhanced fasting endogenous glucose production and reduced glucose uptake in skeletal muscle compared to nondiabetic rats. Conclusions. The dual catheters implantation at the tails of the rats together with isotope tracers injection is a save time, unstressed, and feasible approach to explore the glucose metabolism in animal models in vivo.

  16. Case Studies: Improving Environmental Performance and Economic Prosperity at Ports and in Near-Port Communities

    Science.gov (United States)

    Case Study links for improving environmental performance and economic prosperity at ports and in near-port communities. Case studies on equipment upgrades, jobs and benefits, land use and transportation, port-community engagement, and citizen science.

  17. Incidence of Central Vein Stenosis and Occlusion Following Upper Extremity PICC and Port Placement

    International Nuclear Information System (INIS)

    Gonsalves, Carin F.; Eschelman, David J.; Sullivan, Kevin L.; DuBois, Nancy; Bonn, Joseph

    2003-01-01

    The purpose of this study was to determine the incidence of central vein stenosis and occlusion following upper extremity placement of peripherally inserted central venous catheters(PICCs) and venous ports. One hundred fifty-four patients who underwent venography of the ipsilateral central veins prior to initial and subsequent venous access device insertion were retrospectively identified. All follow-up venograms were interpreted at the time of catheter placement by one interventional radiologist over a 5-year period and compared to the findings on initial venography. For patients with central vein abnormalities, hospital and home infusion service records and radiology reports were reviewed to determine catheter dwelltime and potential alternative etiologies of central vein stenosis or occlusion. The effect of catheter caliber and dwell time on development of central vein abnormalities was evaluated. Venography performed prior to initial catheter placement showed that 150 patients had normal central veins. Three patients had central vein stenosis, and one had central vein occlusion. Subsequent venograms (n = 154)at the time of additional venous access device placement demonstrated 8 patients with occlusions and 10 with stenoses. Three of the 18 patients with abnormal follow-up venograms were found to have potential alternative causes of central vein abnormalities. Excluding these 3 patients and the 4 patients with abnormal initial venograms, a 7% incidence of central vein stenosis or occlusion was found in patients with prior indwelling catheters and normal initial venograms. Catheter caliber showed no effect on the subsequent development of central vein abnormalities. Patients who developed new or worsened central vein stenosis or occlusion had significantly (p =0.03) longer catheter dwell times than patients without central vein abnormalities. New central vein stenosis or occlusion occurred in 7% of patients following upper arm placement of venous access devices

  18. Percutaneous Endovascular Salvage Techniques for Implanted Venous Access Device Dysfunction

    International Nuclear Information System (INIS)

    Breault, Stéphane; Glauser, Frédéric; Babaker, Malik; Doenz, Francesco; Qanadli, Salah Dine

    2015-01-01

    PurposeImplanted venous access devices (IVADs) are often used in patients who require long-term intravenous drug administration. The most common causes of device dysfunction include occlusion by fibrin sheath and/or catheter adherence to the vessel wall. We present percutaneous endovascular salvage techniques to restore function in occluded catheters. The aim of this study was to evaluate the feasibility, safety, and efficacy of these techniques.Methods and MaterialsThrough a femoral or brachial venous access, a snare is used to remove fibrin sheath around the IVAD catheter tip. If device dysfunction is caused by catheter adherences to the vessel wall, a new “mechanical adhesiolysis” maneuver was performed. IVAD salvage procedures performed between 2005 and 2013 were analyzed. Data included clinical background, catheter tip position, success rate, recurrence, and rate of complication.ResultsEighty-eight salvage procedures were performed in 80 patients, mostly women (52.5 %), with a mean age of 54 years. Only a minority (17.5 %) of evaluated catheters were located at an optimal position (i.e., cavoatrial junction ±1 cm). Mechanical adhesiolysis or other additional maneuvers were used in 21 cases (24 %). Overall technical success rate was 93.2 %. Malposition and/or vessel wall adherences were the main cause of technical failure. No complications were noted.ConclusionThese IVAD salvage techniques are safe and efficient. When a catheter is adherent to the vessel wall, mechanical adhesiolysis maneuvers allow catheter mobilization and a greater success rate with no additional risk. In patients who still require long-term use of their IVAD, these procedures can be performed safely to avoid catheter replacement

  19. Percutaneous Endovascular Salvage Techniques for Implanted Venous Access Device Dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Breault, Stéphane, E-mail: stephane.breault@chuv.ch [Lausanne University Hospital, Diagnostic and Interventional Radiology Department (Switzerland); Glauser, Frédéric, E-mail: frederic.glauser@chuv.ch [Lausanne University Hospital, Angiology and Diagnostic and Interventional Radiology Departments (Switzerland); Babaker, Malik, E-mail: malik.babaker@chuv.ch; Doenz, Francesco, E-mail: francesco.doenz@chuv.ch; Qanadli, Salah Dine, E-mail: salah.qanadli@chuv.ch [Lausanne University Hospital, Diagnostic and Interventional Radiology Department (Switzerland)

    2015-06-15

    PurposeImplanted venous access devices (IVADs) are often used in patients who require long-term intravenous drug administration. The most common causes of device dysfunction include occlusion by fibrin sheath and/or catheter adherence to the vessel wall. We present percutaneous endovascular salvage techniques to restore function in occluded catheters. The aim of this study was to evaluate the feasibility, safety, and efficacy of these techniques.Methods and MaterialsThrough a femoral or brachial venous access, a snare is used to remove fibrin sheath around the IVAD catheter tip. If device dysfunction is caused by catheter adherences to the vessel wall, a new “mechanical adhesiolysis” maneuver was performed. IVAD salvage procedures performed between 2005 and 2013 were analyzed. Data included clinical background, catheter tip position, success rate, recurrence, and rate of complication.ResultsEighty-eight salvage procedures were performed in 80 patients, mostly women (52.5 %), with a mean age of 54 years. Only a minority (17.5 %) of evaluated catheters were located at an optimal position (i.e., cavoatrial junction ±1 cm). Mechanical adhesiolysis or other additional maneuvers were used in 21 cases (24 %). Overall technical success rate was 93.2 %. Malposition and/or vessel wall adherences were the main cause of technical failure. No complications were noted.ConclusionThese IVAD salvage techniques are safe and efficient. When a catheter is adherent to the vessel wall, mechanical adhesiolysis maneuvers allow catheter mobilization and a greater success rate with no additional risk. In patients who still require long-term use of their IVAD, these procedures can be performed safely to avoid catheter replacement.

  20. Clinical usefulness of catheter-drawn blood samples and catheter tip cultures for the diagnosis of catheter-related bloodstream infections in neonatology: A systematic review.

    Science.gov (United States)

    Ferreira, Janita; Camargos, Paulo Augusto Moreira; Clemente, Wanessa Trindade; Romanelli, Roberta Maia de Castro

    2018-01-01

    Neonatal sepsis is the most frequent health care-associated infection in neonatal units. This study aimed to analyze articles on the clinical usefulness of catheter-drawn blood samples and catheter tip cultures for the diagnosis of intravascular catheter-related bloodstream infection (CRBSI) in neonates. A systematic search was performed for studies published from 1987-2017, without language restriction. Observational studies carried out in neonates with CRBSI diagnosed using catheter-drawn blood samples or catheter tip cultures were included. A total of 412 articles were identified in the databases and 10 articles were included. The 7 studies that evaluated central venous catheter tip cultures and cultures of catheter fragments presented sensitivities ranging from 58.5%-100% and specificities ranging from 60%-95.7%. Three studies that evaluated catheter-drawn blood cultures, paired with peripheral blood cultures, reported sensitivity and specificity of 94% and 71% when evaluated for the differential time to positivity. When quantitative evaluation was performed, the sensitivity and specificity were 80% and 99.4%. Most of the studies analyzed cultures from the central venous catheter tip and catheter fragments for the diagnosis of CRBSI in neonatal populations. The results of this review suggest that the analysis of the catheter-drawn blood samples and catheter tip cultures, paired with peripheral blood cultures, are efficient methods for the diagnosis of CRBSI in neonates. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  1. Ultrahigh speed endoscopic swept source optical coherence tomography using a VCSEL light source and micromotor catheter

    Science.gov (United States)

    Tsai, Tsung-Han; Ahsen, Osman O.; Lee, Hsiang-Chieh; Liang, Kaicheng; Giacomelli, Michael G.; Potsaid, Benjamin M.; Tao, Yuankai K.; Jayaraman, Vijaysekhar; Kraus, Martin F.; Hornegger, Joachim; Figueiredo, Marisa; Huang, Qin; Mashimo, Hiroshi; Cable, Alex E.; Fujimoto, James G.

    2014-03-01

    We developed an ultrahigh speed endoscopic swept source optical coherence tomography (OCT) system for clinical gastroenterology using a vertical-cavity surface-emitting laser (VCSEL) and micromotor based imaging catheter, which provided an imaging speed of 600 kHz axial scan rate and 8 μm axial resolution in tissue. The micromotor catheter was 3.2 mm in diameter and could be introduced through the 3.7 mm accessory port of an endoscope. Imaging was performed at 400 frames per second with an 8 μm spot size using a pullback to generate volumetric data over 16 mm with a pixel spacing of 5 μm in the longitudinal direction. Three-dimensional OCT (3D-OCT) imaging was performed in patients with a cross section of pathologies undergoing standard upper and lower endoscopy at the Veterans Affairs Boston Healthcare System (VABHS). Patients with Barrett's esophagus, dysplasia, and inflammatory bowel disease were imaged. The use of distally actuated imaging catheters allowed OCT imaging with more flexibility such as volumetric imaging in the terminal ileum and the assessment of the hiatal hernia using retroflex imaging. The high rotational stability of the micromotor enabled 3D volumetric imaging with micron scale volumetric accuracy for both en face and cross-sectional imaging. The ability to perform 3D OCT imaging in the GI tract with microscopic accuracy should enable a wide range of studies to investigate the ability of OCT to detect pathology as well as assess treatment response.

  2. Ion implantation

    International Nuclear Information System (INIS)

    Johnson, E.

    1986-01-01

    It is the purpose of the present paper to give a review of surface alloy processing by ion implantation. However, rather than covering this vast subject as a whole, the survey is confined to a presentation of the microstructures that can be found in metal surfaces after ion implantation. The presentation is limited to alloys processed by ion implantation proper, that is to processes in which the alloy compositions are altered significantly by direct injection of the implanted ions. The review is introduced by a presentation of the processes taking place during development of the fundamental event in ion implantation - the collision cascade, followed by a summary of the various microstructures which can be formed after ion implantation into metals. This is compared with the variability of microstructures that can be achieved by rapid solidification processing. The microstructures are subsequently discussed in the light of the processes which, as the implantations proceed, take place during and immediately after formation of the individual collision cascades. These collision cascades define the volumes inside which individual ions are slowed down in the implanted targets. They are not only centres for vigorous agitation but also the sources for formation of excess concentrations of point defects, which will influence development of particular microstructures. A final section presents a selection of specific structures which have been observed in different alloy systems. (orig./GSCH)

  3. Catheter ablation of epicardial ventricular tachycardia

    Directory of Open Access Journals (Sweden)

    Takumi Yamada, MD, PhD

    2014-08-01

    Full Text Available Ventricular tachycardias (VTs can usually be treated by endocardial catheter ablation. However, some VTs can arise from the epicardial surface, and their substrate can be altered only by epicardial catheter ablation. There are two approaches to epicardial catheter ablation: transvenous and transthoracic. The transvenous approach through the coronary venous system (CVS has been commonly used because it is easily accessible. However, this approach may be limited by the distribution of the CVS and insufficient radiofrequency energy delivery. Transthoracic epicardial catheter ablation has been developed to overcome these limitations of the transvenous approach. It is a useful supplemental or even preferred strategy to eliminate epicardial VTs in the electrophysiology laboratory. This technique has been applied for scar-related VTs secondary to often non-ischemic cardiomyopathy and sometimes ischemic cardiomyopathy, and idiopathic VTs as the epicardial substrates of these VTs have become increasingly recognized. When endocardial ablation and epicardial ablation through the CVS are unsuccessful, transthoracic epicardial ablation should be the next option. Intrapericardial access is usually obtained through a subxiphoidal pericardial puncture. This approach might not be possible in patients with pericardial adhesions caused by prior cardiac surgery or pericarditis. In such cases, a hybrid procedure involving surgical access with a subxiphoid pericardial window and a limited anterior or lateral thoracotomy might be a feasible and safe method of performing an epicardial catheter ablation in the electrophysiology laboratory. Potential complications associated with this technique include bleeding and collateral damage to the coronary arteries and phrenic nerve. Although the risk of these complications is low, electrophysiologists who attempt epicardial catheter ablation should know the complications associated with this technique, how to minimize their

  4. Cooperation Performance Evaluation between Seaport and Dry Port; Case of Qingdao Port and Xi'an Port

    Directory of Open Access Journals (Sweden)

    Jian Li

    2014-12-01

    Full Text Available Along with the drastic competition among ports, the strive for the vast economic hinterland and the supply of goods have become strategic problems for port operators. At the same time, port enterprises are paying more and more attention to the construction of dry ports. This article establishes the port cooperation performance evaluation index based on the balanced score card method and uses the grey relational degree method to evaluate the cooperation performance between seaports and dry ports. Finally using Qingdao port and Xi'an port as an example, and Zhengzhou port and Lanzhou port as benchmarks, the application of this evaluation method is introduced in detail. The conclusion reveals that cooperation between Qingdao port and Xi'an port has deficiencies in customer satisfaction, financial cooperation and non-market tools. Alongside this, the author proposes related issues about information management in the supply chain, competition position and the scope of hinterland. This article, combined with the related theory of supply chain and performance evaluation, puts forward a set of relatively complete cooperation performance evaluations between seaports and dry ports, which provide scientific theory support for better cooperation.

  5. Radiofrequency catheter ablation for electrical storm in a patient with dilated cardiomyopathy.

    Science.gov (United States)

    Kolettis, Theofilos M; Naka, Katerina K; Katsouras, Christos S

    2005-01-01

    We report a case of successful radiofrequency catheter ablation in a patient with dilated cardiomyopathy, who presented with multiple, haemodynamically poorly tolerated episodes of monomorphic ventricular tachycardia, resistant to antiarrhythmic drug treatment. The ablation procedure consisted of focal ablation of three mapped left ventricular sites, using pace and activation mapping. Additional linear ablation lesions were created across these sites. After the procedure, the patient remained free of tachycardia episodes and seven days post-ablation he underwent implantation of a cardioverter-defibrillator. During a twelve-month follow-up period, the patient has remained free of monomorphic ventricular tachycardia episodes. Radiofrequency catheter ablation is feasible in electrical storm, using conventional mapping techniques, even in haemodynamically unstable tachycardias.

  6. Interface Circuit For Printer Port

    Science.gov (United States)

    Tucker, Jerry H.; Yadlowsky, Ann B.

    1991-01-01

    Electronic circuit, called printer-port interface circuit (PPI) developed to overcome certain disadvantages of previous methods for connecting IBM PC or PC-compatible computer to other equipment. Has both reading and writing modes of operation. Very simple, requiring only six integrated circuits. Provides for moderately fast rates of transfer of data and uses existing unmodified circuit card in IBM PC. When used with appropriate software, circuit converts printer port on IBM PC, XT, AT, or compatible personal computer to general purpose, 8-bit-data, 16-bit address bus that connects to multitude of devices.

  7. Effectively reducing emissions from ports

    Energy Technology Data Exchange (ETDEWEB)

    Fazlagic, Ismir; Martelin, Marcus; Skinner, Ryan

    2010-09-15

    Commercial ships calling at more and more ports worldwide can now turn off their diesel engines and tap into cleaner energy sources provided by electrical connections from shore. The technology to make this possible has been in place for over a decade. With a global technology standard due to be ratified by three technical bodies in 2010, high-voltage shore connections will soon get much more attention. Environmentally-minded ports, governments and shipowners are all tuning in to the benefits of supplying electricity to ships at berth. ABB presents the challenge, the technical solution and the business case for all parties involved.

  8. Port Harcourt Medical Journal, a paradigm shift | Eke | Port Harcourt ...

    African Journals Online (AJOL)

    Port Harcourt Medical Journal, a paradigm shift. N Eke. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4103/0795-3038.179439 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

  9. The VisPort Project: Visualization of Port Logistics

    Science.gov (United States)

    Katsioloudis, Petros J.; Watson, Ginger

    2011-01-01

    There is concern about the diminishing availability of skilled personnel that can operate in the wide variety of disciplines associated with port operations. Increasing cargo volume, combined with a shrinking workforce, could potentially create alarming situations in the future, hence the motivation to publicize to current students the breadth and…

  10. Percutaneous catheter drainage of intrapulmonary fluid collection

    International Nuclear Information System (INIS)

    Park, E. D.; Kim, H. J.; Choi, P. Y.; Jung, S. H.

    1994-01-01

    With the success of percutaneous abdominal abscess drainage, attention is now being focused on the use of similar techniques in the thorax. We studied to evaluate the effect of percutaneous drainage in parenchymal fluid collections in the lungs. We performed percutaneous drainage of abscesses and other parenchymal fluid collections of the lungs in 15 patients. All of the procedures were performed under the fluoroscopic guidance with an 18-gauge Seldinger needle and coaxial technique with a 8-10F drainage catheter. Among 10 patients with lung abscess, 8 patients improved by percutaneous catheter drainage. In one patient, drainage was failed by the accidental withdrawal of the catheter before complete drainage. One patient died of sepsis 5 hours after the procedure. Among three patients with complicated bulla, successful drainage was done in two patients, but in the remaining patient, the procedure was failed. In one patient with intrapulmonary bronchogenic cyst, the drainage was not successful due to the thick internal contents. In one patient with traumatic hematoma, after the drainage of old blood clots, the signs of infection disappeared. Overally, of 14 patients excluding one who died, 11 patients improved with percutaneous catheter drainage and three patients did not. There were no major complications during and after the procedure. We conclude that percutaneous catheter drainage is effective and safe procedure for the treatment of parenchymal fluid collections of the lung in patients unresponsive to the medical treatment

  11. Percutaneous catheter drainage of intrapulmonary fluid collection

    Energy Technology Data Exchange (ETDEWEB)

    Park, E. D.; Kim, H. J.; Choi, P. Y.; Jung, S. H. [Gyeongsang National University Hospital, Chinju (Korea, Republic of)

    1994-01-15

    With the success of percutaneous abdominal abscess drainage, attention is now being focused on the use of similar techniques in the thorax. We studied to evaluate the effect of percutaneous drainage in parenchymal fluid collections in the lungs. We performed percutaneous drainage of abscesses and other parenchymal fluid collections of the lungs in 15 patients. All of the procedures were performed under the fluoroscopic guidance with an 18-gauge Seldinger needle and coaxial technique with a 8-10F drainage catheter. Among 10 patients with lung abscess, 8 patients improved by percutaneous catheter drainage. In one patient, drainage was failed by the accidental withdrawal of the catheter before complete drainage. One patient died of sepsis 5 hours after the procedure. Among three patients with complicated bulla, successful drainage was done in two patients, but in the remaining patient, the procedure was failed. In one patient with intrapulmonary bronchogenic cyst, the drainage was not successful due to the thick internal contents. In one patient with traumatic hematoma, after the drainage of old blood clots, the signs of infection disappeared. Overally, of 14 patients excluding one who died, 11 patients improved with percutaneous catheter drainage and three patients did not. There were no major complications during and after the procedure. We conclude that percutaneous catheter drainage is effective and safe procedure for the treatment of parenchymal fluid collections of the lung in patients unresponsive to the medical treatment.

  12. Mechanical characteristics of plastic base Ports and impact on flushing efficacy.

    Science.gov (United States)

    Guiffant, Gérard; Flaud, Patrice; Royon, Laurent; Burnet, Espérie; Merckx, Jacques

    2017-01-01

    Three types of totally implantable venous access devices, Ports, are currently in use: titanium, plastic (polyoxymethylene, POM), and mixed (titanium base with a POM shell). Physics theory suggests that the interaction between a non-coring needle (NCN, made of stainless steel) and a plastic base would lead to the stronger material (steel) altering the more malleable material (plastic). To investigate whether needle impacts can alter a plastic base's surface, thus potentially reducing flushing efficacy. A Port made of POM was punctured 200 times with a 19-gauge NCN. Following the existing guidelines, the needle tip pricked the base with each puncture. The Port's base was then examined using a two-dimensional optical instrument, and a bi-dimensional numerical simulation using COMSOL ® was performed to investigate potential surface irregularities and their impact on fluid flow. Each needle impact created a hole (mean depth, 0.12 mm) with a small bump beside it (mean height, 0.02 mm) the Reynolds number Re k ≈10. A numerical simulation of the one hole/bump set showed that the flushing efficacy was 60% that of flushing along a flat surface. In clinical practice, the number of times a Port is punctured depends on patient and treatment characteristics, but each needle impact on the plastic base may increase the risk of decreased flushing effectiveness. Therefore, the more a plastic Port is accessed, the greater the risk of microorganisms, blood products, and medication accumulation. Multiple needle impacts created an irregular surface on the Port's base, which decreased flushing efficacy. Clinical investigation is needed to determine whether plastic base Ports are associated with an increased risk of Port infection and occlusion compared to titanium base Ports.

  13. Ports Primer: 7.1 Environmental Impacts

    Science.gov (United States)

    Port operations can lead to environmental impacts on air, water and land. Many communities with environmental justice concerns also experience disparities in health outcomes that they attribute to exposure to emissions from port operations.

  14. Ports Primer: 7.0 Environmental Impacts

    Science.gov (United States)

    Port operations can lead to environmental impacts on air, water and land. Many communities with environmental justice concerns also experience disparities in health outcomes that they attribute to exposure to emissions from port operations.

  15. Impact of short-term hemodialysis catheters on the central veins: a catheter venographic study

    Energy Technology Data Exchange (ETDEWEB)

    Oguzkurt, Levent E-mail: loguzkurt@yahoo.com; Tercan, Fahri; Torun, Dilek; Yildirim, Tuelin; Zuemruetdal, Ayseguel; Kizilkilic, Osman

    2004-12-01

    Objective: To determine the incidence of pericatheter sleeve formation, thrombus formation, and stenosis of the central veins in hemodialysis patients with temporary catheters. Methods and material: In this prospective study, 57 patients (40 males, 17 females) with temporary dialysis catheters had catheter venography by pulling back the catheter just before removal. Patient's age range was 25-87 years (mean age, 51 years). The venographic studies were evaluated for pericatheter sleeve formation, thrombus formation, and stenosis of the brachiocephalic vein (BCV) and the superior vena cava (SVC). The IJV could only be evaluated if there was adequate filling during contrast administration. In a subgroup of patients who had had only right IJV or only right SCV catheters, impact of these catheters on the central veins was compared. Results: The catheter location was right internal jugular vein (IJV) in 26 cases, right subclavian vein (SCV) in 27 cases, left IJV in 1 case, and left SCV in 3 cases. Thirty-two patients (56%) had had only one temporary catheter and the rest had had more than one inserted. The mean dwell time for the catheters was 21 days (range 7-59 days). A pericatheter sleeve was detected on venography in 32 (56%) patients and thrombus formation was noted in 16 patients (28%). A total of 41 patients (72%) exhibited pericatheter sleeve and/or thrombus formation. While 19 of the 32 patients (59%) without previous catheterization had a sleeve around the catheter, only 13 (52%) of 25 patients who had had multiple catheters inserted had a sleeve (P>0.05). Of the eight patients (14%) with BCV stenosis, two had >50% stenosis. Only one patient (2%) had mild stenosis of the SVC. Three patients out of 15 (20%) who had diagnostic venography for the IJV had severe stenosis of the vein. Pericatheter sleeve formation was more frequent in women (P<0.05). However, there were no statistical differences with respect to pericatheter sleeve formation, luminal filling

  16. Balloon-tipped flow-directed catheters

    International Nuclear Information System (INIS)

    Ganz, P.; Swan, H.J.C.; Ganz, W.

    1986-01-01

    Diagnostic catheterization of the right side of the heart with semirigid cardiac catheters requires fluoroscopic guidance and substantial skill. Abnormal positions of the heart chambers and of the great vessels associated with cardiac dilatation or with congenital malformation present difficulties even to experienced laboratory cardiologists. These problems have been largely overcome by the introduction of balloon tipped flow directed catheters, which allow for rapid and relatively safe catheterization of the pulmonary artery without fluoroscopy. It was through the application of these catheters in the intensive care unit that the many pitfalls in the clinical assessment of hemodynamic disturbances became apparent. Although S3 gallop sounds may be useful in the clinical recognition of chronic ventricular failure, their presence or absence has limited predictive value in estimating left ventricular filling pressure in myocardial infarction. Information derived from right heart catheterization is often pivotal in the evaluation of hemodynamic disorders, in directing treatment, and in monitoring the results of therapy in critically ill patients

  17. The importance of effective catheter securement.

    Science.gov (United States)

    Fisher, Jayne

    This article examines the importance of securing/fixing indwelling urinary catheters. The Oxford English dictionary interlinks the two words-'secure' and 'fix'-as having the same meaning. To secure the catheter should not be confused with 'support', whereby the weight of the urine drainage bag is supported with the use of velcro straps or a sleeve. The author introduces the need for the concept of this practice to be at the forefront of nurses' minds in all settings, and this is demonstrated through the use of case studies. Current guidance in this area is reviewed, as well as the problems that can arise when catheters are not secured properly and the available products for health professionals to use.

  18. [Infectious risk related to the formation of multi-species biofilms (Candida - bacteria) on peripheral vascular catheters].

    Science.gov (United States)

    Seghir, A; Boucherit-Otmani, Z; Sari-Belkharroubi, L; Boucherit, K

    2017-03-01

    The Candida yeasts are the fourth leading cause of death from systemic infections, the risk may increase when the infection also involves bacteria. Yeasts and bacteria can adhere to medical implants, such as peripheral vascular catheters, and form a multicellular structures called "mixed biofilms" more resistant to antimicrobials agents. However, the formation of mixed biofilms on implants leads to long-term persistent infections because they can act as reservoirs of pathogens that have poorly understood interactions. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. [The role of the uretral catheter in the development of catheter- related urinary tract infection].

    Science.gov (United States)

    Vasilyev, A O; Govorov, A V; Shiryaev, A A; Pushkar, D Yu

    2017-12-01

    The most common source of nosocomial infection is the urinary tract, especially if they it is drained with a urethral catheter. Catheter-associated urinary tract infections account for at least 80% of all complicated urinary tract infections and are the most common type of hospital-acquired infection. Intestinal microflora plays the leading role in the pathogenesis of catheter-associated urinary tract infections, whereas the most important risk factor for their development is the long duration of urinary catheter drainage. In the case of short-term and intermittent catheterization, routine antibiotic prophylaxis is not required, but if a patient develops clinically significant infection, antibiotic therapy is required followed by definitive therapy based on culture. Urethral catheters coated with antimicrobial substances and anti-inflammatory agents can significantly reduce the adhesion and migration of bacteria, thereby reducing the incidence of urinary tract infections. Despite this, the incidence of catheter-associated infection remains high. We have reviewed recent literature related to catheter-associated urinary tract infections and the best means of preventing this condition.

  20. Single port Billroth I gastrectomy

    Directory of Open Access Journals (Sweden)

    Jeremy R Huddy

    2013-01-01

    Full Text Available Introduction: Experience has allowed increasingly complex procedures to be undertaken by single port surgery. We describe a technique for single port Billroth I gastrectomy with a hand-sewn intracorporeal anastomosis in the resection of a benign tumour diagnosed incidentally on a background of cholelithiasis. Materials and Methods: Single port Billroth I gastrectomy and cholecystectomy was performed using a transumbilical quadport. Flexible tipped camera and straight conventional instruments were used throughout the procedure. The stomach was mobilised including a limited lymph node dissection and resection margins in the proximal antrum and duodenum were divided with a flexible tipped laparoscopic stapler. The lesser curve was reconstructed and an intracorporal hand sewn two layer end-to-end anastomosis was performed using unidirectional barbed sutures. Intraoperative endoscopy confirmed the anastomosis to be patent without leak. Results: Enteral feed was started on the day of surgery, increasing to a full diet by day 6. Analgesic requirements were a patient-controlled analgesia morphine pump for 4 postoperative days and paracetamol for 6 days. There were no postoperative complications and the patient was discharged on the eighth day. Histology confirmed gastric submucosal lipoma. Discussion: As technology improves more complex procedures are possible by single port laparoscopic surgery. In this case, flexible tipped cameras and unidirectional barbed sutures have facilitated an intracorporal hand-sewn two layer end-to-end anastomosis. Experience will allow such techniques to become mainstream.

  1. Port Harcourt Medical Journal: Submissions

    African Journals Online (AJOL)

    Port Harcourt Medical Journal (PMJ) is a general medical journal that will consider any original contribution that advances or illuminates medical science or ... The covering letter must include information on prior or duplicate publication and a statement of financial or other relationships that might lead to a conflict of interest.

  2. Cyber security in ports: Business as usual

    OpenAIRE

    Moerel, Lokke; Dezeure, Freddy

    2017-01-01

    Our paper summarizes the risks and provides concrete and pragmatic proposals to increase substantially the cyber maturity and resilience in the ports by organizing training and awareness raising, fostering cooperation and information exchange both between the stakeholders in the ports and across the ports and integrating the cyber risk into the physical security risk management processes and structures already in place within the ports. This also involves a higher degree of oversight by the P...

  3. COMPARATIVE ANALYSIS OF LEADING PORTS OF LATVIA: COMPETITIVENESS OF LIEPAJA PORT

    Directory of Open Access Journals (Sweden)

    Diāna Līduma

    2015-06-01

    Full Text Available There are 10 operating ports in Latvia and 3 of them – Liepaja, Ventspils and Riga ports are regarded as the leading commercial ports. Role of port operation in the economics of region and country is essential from the point of view of employment and entrepreneurship. This is based with data on investment of operation of Latvian ports in GDP, on average it is assessed to be 5-7% annually. In the context of employment, Liepaja Port gives work to 6.9% of human resources of the city. However, concern about the competitiveness of Liepaja Port influenced by the proximity of more developed competitive ports, technical possibilities of the port and dynamics of freight turnover has occurred in recent years. Therewith in framework of this article in the context of such criteria as location of ports and their technical parameters, volumes of freight, specialization and costs of ports, the operation of leading ports of Latvia is intercompared and analyzed by clarifying whether Liepaja Port is competitive among other ports of Latvia. Opinions of port experts on perspectives of port development and statistical data of ports from 2011-2013 are analyzed within the framework of the article. The aim of the research is to clarify the comparative advantages of ports of Latvia. The research revealed that the provision of competitiveness of Liepaja Port is to be related with application of the available free territories, advantages of location in relation to the Scandinavian market, and the necessity to develop the cooperation among ports of Latvia to offer joint freight acquisition, distributions and unified logistics solution and strengthen the position of ports in the circumstances of international competition.

  4. The use of port-a-caths in adult patients with Lysosomal Storage Disorders receiving Enzyme Replacement Therapy-one centre experience

    Directory of Open Access Journals (Sweden)

    Mairead McLoughlin

    2017-12-01

    Full Text Available Port-a-cath is a widely used device in patients with long-term venous access demand such as frequent or continuous administration of medications such as Enzyme Replacement Therapy (ERT, chemotherapy delivery, blood transfusions, blood products, and fluids. Patients with Lysosomal Storage Diseases (LSDs often require recurrent courses of ERT. We reviewed our experience of using port-a-caths in patients with LSDs with the focus on challenges and complications associated with these catheters. Among 245 adult patients who were treated with ERT, twenty patients (8.2% had a port-a-cath inserted due to poor venous access. Six patients were using their first port whereas five other patients had their port-a-caths replaced at least once. The remaining six patients had inactive port-a-caths. The majority of patients with active port-a-caths never missed more than one consecutive infusion, although one patient missed 2 consecutive infusions whilst on holiday. We identified significant gaps in patients' and their families' understanding of the management of port-a-caths and risks associated with them. It resulted in producing a leaflet and designing an educational program for our LSD patients.

  5. Microbiocidal effects of various taurolidine containing catheter lock solutions

    NARCIS (Netherlands)

    Olthof, E.D.; Nijland, R van; Gulich, A.F.; Wanten, G.J.A.

    2015-01-01

    BACKGROUND & AIMS: We have recently shown that a catheter lock solution containing taurolidine dramatically decreases catheter-related bloodstream infections (CRBSI) in patients on home parenteral nutrition (HPN) when compared to heparin. Since several taurolidine formulations are commercially

  6. A central venous catheter coated with benzalkonium chloride for the prevention of catheter-related microbial colonization.

    Science.gov (United States)

    Moss, H A; Tebbs, S E; Faroqui, M H; Herbst, T; Isaac, J L; Brown, J; Elliott, T S

    2000-11-01

    In an attempt to overcome infections associated with central venous catheters, a new antiseptic central venous catheter coated with benzalkonium chloride on the internal and external surfaces has been developed and evaluated in a clinical trial. Patients (235) randomly received either a triple-lumen central venous catheter coated with benzalkonium chloride (117) or a polyurethane non-antiseptic catheter (118). The incidence of microbial colonization of both catheters and retained antiseptic activity of the benzalkonium chloride device following removal were determined. The benzalkonium chloride resulted in a significant reduction of the incidence of microbial colonization on both the internal and external catheter surfaces. The reduction in colonization was detected at both the intradermal (21 benzalkonium chloride catheters vs. 38 controls, P = 0.0016) and distal segments of the antiseptic-coated catheters. Following catheter removal retained activity was demonstrated in benzalkonium chloride catheters which had been in place for up to 12 days. No patients developed adverse reactions to the benzalkonium chloride catheters. The findings demonstrate that the benzalkonium chloride catheter significantly reduced the incidence of catheter-associated colonization.

  7. SU-F-BRA-01: A Procedure for the Fast Semi-Automatic Localization of Catheters Using An Electromagnetic Tracker (EMT) for Image-Guided Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Damato, A; Viswanathan, A; Cormack, R [Brigham and Women’s Hospital, Boston, MA (United States)

    2015-06-15

    Purpose: To evaluate the feasibility of brachytherapy catheter localization through use of an EMT and 3D image set. Methods: A 15-catheter phantom mimicking an interstitial implantation was built and CT-scanned. Baseline catheter reconstruction was performed manually. An EMT was used to acquire the catheter coordinates in the EMT frame of reference. N user-identified catheter tips, without catheter number associations, were used to establish registration with the CT frame of reference. Two algorithms were investigated: brute-force registration (BFR), in which all possible permutation of N identified tips with the EMT tips were evaluated; and signature-based registration (SBR), in which a distance matrix was used to generate a list of matching signatures describing possible N-point matches with the registration points. Digitization error (average of the distance between corresponding EMT and baseline dwell positions; average, standard deviation, and worst-case scenario over all possible registration-point selections) and algorithm inefficiency (maximum number of rigid registrations required to find the matching fusion for all possible selections of registration points) were calculated. Results: Digitization errors on average <2 mm were observed for N ≥5, with standard deviation <2 mm for N ≥6, and worst-case scenario error <2 mm for N ≥11. Algorithm inefficiencies were: N = 5, 32,760 (BFR) and 9900 (SBR); N = 6, 360,360 (BFR) and 21,660 (SBR); N = 11, 5.45*1010 (BFR) and 12 (SBR). Conclusion: A procedure was proposed for catheter reconstruction using EMT and only requiring user identification of catheter tips without catheter localization. Digitization errors <2 mm were observed on average with 5 or more registration points, and in any scenario with 11 or more points. Inefficiency for N = 11 was 9 orders of magnitude lower for SBR than for BFR. Funding: Kaye Family Award.

  8. Multi-functional use of port areas

    NARCIS (Netherlands)

    Ros, R.; Taneja, P.; Vellinga, T.

    2012-01-01

    The core business of a port is handling vessels and cargo. In addition a landlord Port Authority invests in development of port areas. However, in view of the new trends such as stakeholders interests related to environment and sustainability, it is can be wise to reexamine the business portfolio

  9. Systems theory of interconnected port contact systems

    NARCIS (Netherlands)

    Eberard, D.; Maschke, B.M.; Schaft, A.J. van der

    2005-01-01

    Port-based network modeling of a large class of complex physical systems leads to dynamical systems known as port-Hamiltonian systems. The key ingredient of any port-Hamiltonian system is a power-conserving interconnection structure (mathematically formalized by the geometric notion of a Dirac

  10. 50 CFR 24.12 - Designated ports.

    Science.gov (United States)

    2010-10-01

    ...) The U.S. Department of Agriculture ports at Hilo, Hawaii, and Chicago, Illinois, are designated ports..., Florida Atlanta, Georgia Savannah, Georgia Agana, Guam Hilo, Hawaii Honolulu, Hawaii Wailuku, Maui, Hawaii... Orlando, Florida Honolulu, Hawaii New Orleans, Louisiana Hoboken, New Jersey (Port of New York) Jamaica...

  11. Notch filters for port-Hamiltonian systems

    NARCIS (Netherlands)

    Dirksz, D.A.; Scherpen, J.M.A.; van der Schaft, A.J.; Steinbuch, M.

    2012-01-01

    In this paper a standard notch filter is modeled in the port-Hamiltonian framework. By having such a port-Hamiltonian description it is proven that the notch filter is a passive system. The notch filter can then be interconnected with another (nonlinear) port-Hamiltonian system, while preserving the

  12. Conservative systems with ports on contact manifolds

    NARCIS (Netherlands)

    Eberard, D.; Maschke, B.M.; van der Schaft, Arjan; Piztek, P.

    In this paper we propose an extension of port Hamiltonian systems, called conservative systems with ports, which encompass systems arising from the Irreversible Thermodynamics. Firstly we lift a port Hamiltonian system from its state space manifold to the thermodynamic phase space to a contact

  13. Ports and Terminals : Planning and Functional Design

    NARCIS (Netherlands)

    Groenveld, R.; Velsink, H.

    1993-01-01

    1. Maritime transport, means and commodities 3. Principles of integrated port planning 4. Planning and design of a port's water areas 5. Port terminals - introduction 6. Conventional general cargo terminals 7. Container terminals 8. Oil & liquid gas terminals 9. Dry bulk cargo terminals 10. Fishery

  14. Starting manufacturing phase of ITER upper ports

    Energy Technology Data Exchange (ETDEWEB)

    Utin, Yuri, E-mail: yuri.utin@iter.org [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St. Paul Lez Durance Cedex (France); Alekseev, Alexander; Sborchia, Carlo; Choi, Changho; Albin, Vincent; Barabash, Vladimir; Davis, James [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St. Paul Lez Durance Cedex (France); Fabritsiev, Sergey [NTC Sintez, Efremov Inst., 189631 Metallostroy, St. Petersburg (Russian Federation); Giraud, Benoit; Guirao, Julio [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St. Paul Lez Durance Cedex (France); Koenig, Werner [MAN Diesel & Turbo SE, Werftstrasse 17, Deggendorf (Germany); Kedrov, Igor; Kuzmin, Evgeny [NTC Sintez, Efremov Inst., 189631 Metallostroy, St. Petersburg (Russian Federation); Levesy, Bruno; Martinez, Jean-Marc [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St. Paul Lez Durance Cedex (France); Prebeck, Markus [MAN Diesel & Turbo SE, Werftstrasse 17, Deggendorf (Germany); Privalova, Elena [NTC Sintez, Efremov Inst., 189631 Metallostroy, St. Petersburg (Russian Federation); Ranzinger, Franz [MAN Diesel & Turbo SE, Werftstrasse 17, Deggendorf (Germany); Savrukhin, Petr [Russian Federation ITER Domestic Agency, Kurchatov sq.1, 123182 Moscow (Russian Federation); Schiller, Thomas [MAN Diesel & Turbo SE, Werftstrasse 17, Deggendorf (Germany); and others

    2015-10-15

    Highlights: • The port plugs are attached to the ports with high-strength fasteners. • Tightening of the fasteners via inductive heating was tested. • A concept for the port/plug sealing with metal-type gaskets has progressed. • Manufacturing design of the Upper Ports is in progress. • A full-scale mock-up of double-wall part of the port stub extension is in manufacturing process – acceptable final tolerances are expected. - Abstract: The ITER Vacuum Vessel (VV) features upper, equatorial and lower ports. The upper and regular equatorial ports are occupied by the port plugs. Although the port design has been overall completed in the past, the design of some remaining interfaces was still in progress: in particular, the Sealing Flange package, which includes the high-vacuum seals and the plug fasteners. As the ITER construction phase has started, the procurement of the VV ports has been launched. The VV upper ports will be procured by the Russian Federation Domestic Agency. The main suppliers were selected and the manufacturing design of the first parts is in full progress now. Since the VV is classified at nuclear level N2, the design and manufacture of its components are to be compliant with the French RCC-MR code and regulations for nuclear pressure equipment in France. These regulations make a strong impact to the port design and manufacturing process.

  15. Starting manufacturing phase of ITER upper ports

    International Nuclear Information System (INIS)

    Utin, Yuri; Alekseev, Alexander; Sborchia, Carlo; Choi, Changho; Albin, Vincent; Barabash, Vladimir; Davis, James; Fabritsiev, Sergey; Giraud, Benoit; Guirao, Julio; Koenig, Werner; Kedrov, Igor; Kuzmin, Evgeny; Levesy, Bruno; Martinez, Jean-Marc; Prebeck, Markus; Privalova, Elena; Ranzinger, Franz; Savrukhin, Petr; Schiller, Thomas

    2015-01-01

    Highlights: • The port plugs are attached to the ports with high-strength fasteners. • Tightening of the fasteners via inductive heating was tested. • A concept for the port/plug sealing with metal-type gaskets has progressed. • Manufacturing design of the Upper Ports is in progress. • A full-scale mock-up of double-wall part of the port stub extension is in manufacturing process – acceptable final tolerances are expected. - Abstract: The ITER Vacuum Vessel (VV) features upper, equatorial and lower ports. The upper and regular equatorial ports are occupied by the port plugs. Although the port design has been overall completed in the past, the design of some remaining interfaces was still in progress: in particular, the Sealing Flange package, which includes the high-vacuum seals and the plug fasteners. As the ITER construction phase has started, the procurement of the VV ports has been launched. The VV upper ports will be procured by the Russian Federation Domestic Agency. The main suppliers were selected and the manufacturing design of the first parts is in full progress now. Since the VV is classified at nuclear level N2, the design and manufacture of its components are to be compliant with the French RCC-MR code and regulations for nuclear pressure equipment in France. These regulations make a strong impact to the port design and manufacturing process.

  16. Port-contact systems in bilateral telemanipulation

    NARCIS (Netherlands)

    Secchi, C; Stramigioli, Stefano; Fantuzzi, C.

    2007-01-01

    In this paper we develop one of the first control applications of the recently proposed port-contact framework. We show how it is possible to model and control a bilateral telemanipulation system using port-contact systems and we develop a port-contact impedance controller that allows to impose a

  17. Vascular access in neonatology: peripherally inserted central catheter and peripheral venous catheter

    Directory of Open Access Journals (Sweden)

    Marcia Lienemann

    2014-04-01

    The objective of this paper is to present aspects of peripherally inserted central catheter and peripheral venous catheter, highlighting important points in choosing the type of access. For the passage of peripherally inserted central catheter is previously performing specific course necessary, while the primary indication occurs when it is necessary to access the patient's stay for a long period of time. Whereas peripheral venipuncture is the most appropriate in cases of needing an IV line quickly and safely, for the administration of fluids, blood collection, blood transfusion and other.

  18. Catheter Occlusion in Home Infusion: The Influence of Needleless Connector Design on Central Catheter Occlusion.

    Science.gov (United States)

    Williams, Ann

    Thrombotic catheter occlusion is a common complication associated with central venous catheters (CVCs). A wide variety of needleless connectors that differ greatly in design and function are available for use with CVCs; however, there are a limited number of studies comparing the catheter occlusion rate associated with differently designed needleless connectors. This retrospective observational study compared occlusion rates associated with a split-septum neutral-displacement needleless connector versus those of a solid-surface neutral-reflux needleless connector in patients undergoing home infusion therapy. The neutral-reflux needleless connector was associated with a significant reduction in occlusion rate and thrombolytic use versus the neutral-displacement needleless connector.

  19. Postoperative Chylothorax of Unclear Etiology in a Patient with Right-sided Subclavian Central Venous Catheter Placement.

    Science.gov (United States)

    Asghar, Samie; Shamim, Faisal

    2017-01-01

    A young male underwent decompressive craniotomy for an intracerebral bleed. A right-sided subclavian central venous catheter was placed in the operating room after induction of anesthesia. Postoperatively, he was shifted to Intensive Care Unit (ICU) for mechanical ventilation due to low Glasgow coma scale. He had an episode of severe agitation and straining on the tracheal tube in the evening same day. On the 2 nd postoperative day in ICU, his airway pressures were high, and chest X-ray revealed massive pleural effusion on right side. Under ultrasound guidance, 1400 milky white fluid was aspirated. It was sent for analysis (triglycerides) that confirmed chyle and hence, chylothorax was made as diagnosis. A duplex scan was done which ruled out thrombosis in subclavian vein. The catheter had normal pressure tracing with free aspiration of blood from all ports. Enteral feeding was continued as it is a controversial matter in the literature and he was monitored clinically and radiologically.

  20. Carmustine Implant

    Science.gov (United States)

    ... works by slowing or stopping the growth of cancer cells in your body. ... are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while receiving carmustine implant, call your doctor. Carmustine may harm the fetus.

  1. Cochlear Implants

    Science.gov (United States)

    ... NIDCD A cochlear implant is a small, complex electronic device that can help to provide a sense ... Hearing Aids Retinitis Pigmentosa - National Eye Institute Telecommunications Relay Services Usher Syndrome Your Baby's Hearing Screening News ...

  2. Perancangan Miniatur Traffic Light Dengan Mempergunakan Pengendali Port Paralel

    OpenAIRE

    Eka Wahyudi; Desi Permanasari

    2012-01-01

    Port paralel tentunya sudah tidak asing lagi dalam dunia komputer. Hal tersebut disebabkan karena port paralel merupakan sarana komunikasi yang terdapat pada Personal Computer (PC). Dengan memanfaatkan port tersebut, saat ini komputer juga dapat dipergunakan untuk keperluan pengontrolan/pengendalian rangkaian listrik dengan memanfaatkan port paralel (port printer). Port paralel memiliki kecepatan transfer data yang lebih cepat apabila dibandingkan dengan port serial, maka dari itu port parale...

  3. In vivo assessment of catheter positioning accuracy and prolonged irradiation time on liver tolerance dose after single-fraction 192Ir high-dose-rate brachytherapy

    Directory of Open Access Journals (Sweden)

    Kropf Siegfried

    2011-09-01

    Full Text Available Abstract Background To assess brachytherapy catheter positioning accuracy and to evaluate the effects of prolonged irradiation time on the tolerance dose of normal liver parenchyma following single-fraction irradiation with 192 Ir. Materials and methods Fifty patients with 76 malignant liver tumors treated by computed tomography (CT-guided high-dose-rate brachytherapy (HDR-BT were included in the study. The prescribed radiation dose was delivered by 1 - 11 catheters with exposure times in the range of 844 - 4432 seconds. Magnetic resonance imaging (MRI datasets for assessing irradiation effects on normal liver tissue, edema, and hepatocyte dysfunction, obtained 6 and 12 weeks after HDR-BT, were merged with 3D dosimetry data. The isodose of the treatment plan covering the same volume as the irradiation effect was taken as a surrogate for the liver tissue tolerance dose. Catheter positioning accuracy was assessed by calculating the shift between the 3D center coordinates of the irradiation effect volume and the tolerance dose volume for 38 irradiation effects in 30 patients induced by catheters implanted in nearly parallel arrangement. Effects of prolonged irradiation were assessed in areas where the irradiation effect volume and tolerance dose volume did not overlap (mismatch areas by using a catheter contribution index. This index was calculated for 48 irradiation effects induced by at least two catheters in 44 patients. Results Positioning accuracy of the brachytherapy catheters was 5-6 mm. The orthogonal and axial shifts between the center coordinates of the irradiation effect volume and the tolerance dose volume in relation to the direction vector of catheter implantation were highly correlated and in first approximation identically in the T1-w and T2-w MRI sequences (p = 0.003 and p p = 0.001 and p = 0.004, respectively. There was a significant shift of the irradiation effect towards the catheter entry site compared with the planned dose

  4. Urinary catheterization diary – A useful tool in tracking causes of non-deflating Foley catheter

    Directory of Open Access Journals (Sweden)

    C.O. Okorie

    2015-06-01

    Conclusions: Most urinary catheters marketed in developing countries are unidentifiable after unpacking. A catheterization diary is a useful tool for solving catheter-related problems, and its application in health-care facilities should be encouraged. Companies marketing Foley catheters should print the catheter name on both the catheter packaging and on the catheter itself.

  5. 78 FR 36014 - Deepwater Port License Application: Liberty Natural Gas, LLC, Port Ambrose Deepwater Port

    Science.gov (United States)

    2013-06-14

    ... timeline for processing an application. When MarAd and USCG determine that an application contains the... that Port Ambrose falls within the proposed area of interest for the New York Power Authority Long Island-New York City Offshore Wind Project. This project will be acknowledged and considered in the...

  6. Maintaining and Researching Port Safety: A Case Study of the Port of Kaohsiung

    OpenAIRE

    Tseng, Po-Hsing.; Pilcher, Nick.

    2017-01-01

    Maintaining port safety in full conformity with IMO standards is a requisite for every port and country. To do this, understanding the challenges and human factors involved is key. To date, much research has shed valuable light on these factors and considered how to address them. One aspect that is often noted is that both maintaining port safety and researching port safety presents numerous challenges. This paper considers both these aspects in the context of a case study of port safety in K...

  7. 21 CFR 868.5120 - Anesthesia conduction catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia conduction catheter. 868.5120 Section... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5120 Anesthesia conduction catheter. (a) Identification. An anesthesia conduction catheter is a flexible tubular device used to inject...

  8. 21 CFR 876.5030 - Continent ileostomy catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Continent ileostomy catheter. 876.5030 Section 876...) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5030 Continent ileostomy catheter. (a) Identification. A continent ileostomy catheter is a flexible tubular device used as a form...

  9. Management of Non- Deflating Foley Suprapubic Catheters - A ...

    African Journals Online (AJOL)

    The procedure described uses a 10 ml syringe and needle passed through the lumen of the catheter to puncture the inner surface of the catheter balloon and thus deflate it. Because the catheter balloon does not burst in this procedure there is no risk of balloon fragmentation or subsequent stone formation. The technique is ...

  10. Low-angled peripheral intravenous catheter tip placement decreases phlebitis.

    Science.gov (United States)

    Tanabe, Hidenori; Murayama, Ryoko; Yabunaka, Koichi; Oe, Makoto; Takahashi, Toshiaki; Komiyama, Chieko; Sanada, Hiromi

    2016-11-02

    Peripheral intravenous catheters (PIVCs) are frequently removed due to phlebitis. We hypothesized that catheters made of polyurethane, which is more flexible than Teflon, would decrease phlebitis, and that flexibility could be estimated by measuring the catheter-tip angle. Ultrasonography in two groups of patients with different catheter types was then used to compare catheter-tip angles and phlebitis. Observational studies were carried out at a medical ward in a university hospital. Infusion therapy was administered to one group of patients in 2014 using Teflon catheters (control group, n = 200), and to another group of patients in 2015 using polyurethane catheters (investigational group, n = 207). The symptoms were assessed according to a scale developed by the Infusion Nurses Society. Long-axis ultrasonography images taken immediately before catheter removal were used to measure the angle between the central line of the catheter within 2 mm from the distal point and a tangent to the vessel wall. There were no significant differences between the two groups with respect to sex, age, and medical diagnosis. In the control and investigational groups, the rates of phlebitis were 37% (73/200) and 17% (36/207), respectively (pPhlebitis occurred more frequently when the catheter-tip was placed at angle >5.8°. The frequency of phlebitis was lower in the polyurethane, in which the catheter was placed at lower angle, almost parallel to the vessel. Our results will aid in developing new catheters and in improving PIVC-securement techniques.

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

    African Journals Online (AJOL)

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

  12. Paravertebral block catheter breakage by electrocautery during thoracic surgery.

    Science.gov (United States)

    Saeki, Noboru; Sugimoto, Yuki; Mori, Yoko; Kato, Takahiro; Miyoshi, Hirotsugu; Nakamura, Ryuji; Koga, Tomomichi

    2017-06-01

    Advantages of thoracic paravertebral analgesia (TPA) include placement of the catheter closer to the surgical field; however, the catheter can become damaged during the operation. We experienced a case of intraoperative TPA catheter breakage that prompted us to perform an experiment to investigate possible causes. A 50-year-old male underwent a thoracoscopic lower lobectomy under general anesthesia with TPA via an intercostal approach. Following surgery, it was discovered that the catheter had become occluded, as well as cut and fused, so we reopened the incision and removed the residual catheter. From that experience, we performed an experiment to examine electrocautery-induced damage in normal (Portex™, Smith's Medical), radiopaque (Perifix SoftTip™, BBraun), and reinforced (Perifix FX™, BBraun) epidural catheters (n = 8 each). Chicken meat was penetrated by each catheter and then cut by electrocautery. In the normal group, breakage occurred in 8 and occlusion in 6 of the catheters, and in the radiopaque group breakage occurred in 8 and occlusion in 7. In contrast, breakage occurred in only 3 and occlusion in none in the reinforced group, with the 5 without breakage remaining connected only by the spring coil. Furthermore, in 7 of the reinforced catheters, electric arc-induced thermal damage was observed at the tip of the catheter. A TPA catheter for thoracic surgery should be inserted via the median approach, or it should be inserted after surgery to avoid catheter damage during surgery.

  13. FAQs about Catheter-Associated Urinary Tract Infection

    Science.gov (United States)

    ... do so. o Avoid disconnecting the catheter and drain tube. This helps to pre - vent germs from getting into the catheter tube. o The catheter is secured to the leg to prevent pulling on the ... regularly. The drainage spout should not touch any - thing while emptying ...

  14. Emergency coronary angioplasty with stenting using Cordis® diagnostic coronary catheters when there is difficulty in engaging guide catheters and bench evaluation of diagnostic and guide catheters.

    Science.gov (United States)

    Arokiaraj, Mark Christopher

    2018-02-01

    Difficulty in engaging with guide catheters is not uncommon in acute emergencies. We aimed to evaluate the use of Cordis ® INFINITI diagnostic catheters to perform angioplasty in patients in whom the coronaries cannot be engaged using standard guide catheters. In 34 cases of acute coronary syndrome, when difficulty in engagement with two standard guide catheters was encountered with reasonable manipulations, angioplasty was performed using diagnostic catheters. In total, 40 stents were placed by this technique. Pushability and trackability, distal tip flexion and three-point bending tests were performed to evaluate the performance of the guide and diagnostic catheters. Angioplasty was performed easily in a setting where it would have been very difficult to perform. Coronary dissection occurred in one patient, treated by a stent. The stent and dilatation balloons were easily passed through the diagnostic catheters. Pressure tracings were clearly preserved with certain stent delivery systems, and at angioplasty, although there was slightly reduced opacification of the respective artery, the coronary anatomy was sufficiently visualized to perform angioplasty. No periprocedural target lesion complications were seen in any cases. Pushability and trackability tests showed good force transmission along a tortuous path with diagnostic catheters, and balanced force-displacement curves from three-point bending tests and distal tip softness tests. Angioplasty with stenting can be performed safely through 6F Cordis ® infiniti diagnostic catheters when difficulty in engaging guide catheters is encountered. Copyright © 2018 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Hub Status and Indexation of Container Ports

    Directory of Open Access Journals (Sweden)

    Yong-An Park

    2015-06-01

    This study develops two sub-indexes of port classification and capacity, and combines cases of these two sub-indexes into various types in order to find a proper port hub index. The paper demonstrates how different types of port hub index are useful measurements for evaluating outputs and inputs of container ports. In a case analysis we show that the indexes of period variables and lagged variables have more explanatory power with regard to changes of port throughputs and high correlation with inputs.

  16. Implantation, recoil implantation, and sputtering

    International Nuclear Information System (INIS)

    Kelly, R.

    1984-01-01

    The implantation and sputtering mechanisms which are relevant to ion bombardment of surfaces are described. These are: collision, thermal, electronic and photon-induced sputtering. 135 refs.; 36 figs.; 9 tabs

  17. Catheter Removal versus Retention in the Management of Catheter-Associated Enterococcal Bloodstream Infections

    Directory of Open Access Journals (Sweden)

    Jonas Marschall

    2013-01-01

    Full Text Available BACKGROUND: Enterococci are an important cause of central venous catheter (CVC-associated bloodstream infections (CA-BSI. It is unclear whether CVC removal is necessary to successfully manage enterococcal CA-BSI.

  18. OCCASIONAL REVIEW 'Map and zap' - electrode catheter ...

    African Journals Online (AJOL)

    Where does this leave surgical treatment of WPW syndrome? Despite the high success rates reported, ·it is acknowledged that not all patients can be successfully treated by catheter ablation. The treatment of those with multiple accessory pathways and associated defects such as Ebstein's anomaly of the tricuspid valve is ...

  19. Thoracoscopic retrieval of a fractured thoracentesis catheter.

    Science.gov (United States)

    Albrink, M H; McAllister, E W

    1994-08-01

    With the resurgence of laparoscopic surgical procedures, thorascopic procedures have followed close behind. Many procedures which in the past have required formal thoracotomy may now be performed via less invasive methods. Presented herein is a report and description of thoracoscopic retrieval of a fractured thoracentesis catheter.

  20. Urethral catheters: can we reduce use?

    Directory of Open Access Journals (Sweden)

    van den Akker-van Marle M Elske

    2011-05-01

    Full Text Available Abstract Background Indwelling urinary catheters are the main cause of healthcare-associated urinary tract infections. It can be expected that reduction of the use of urinary catheters will lead to decreased numbers of urinary tract infection. Methods The efficacy of an intervention programme to improve adherence to recommendations to reduce the use of urethral catheters was studied in a before-after comparison in ten Dutch hospitals. The programme detected barriers and facilitators and each individual facility was supported with developing their own intervention strategy. Outcome was evaluated by the prevalence of catheters, alternatives such as diapers, numbers of urinary tract infections, the percentage of correct indications and the duration of catheterization. The costs of the implementation as well as the catheterization were evaluated. Results Of a population of 16,495 hospitalized patients 3335 patients of whom 2943 were evaluable for the study, had a urethral catheter. The prevalence of urethral catheters decreased insignificantly in neurology (OR 0.93; 95% CI 0.77 - 1.13 and internal medicine wards (OR 0.97; 95% CI 0.83 - 1.13, decreased significantly in surgical wards (OR 0.84; 95% CI 0.75 - 0.96, but increased significantly in intensive care (IC and coronary care (CC units (OR 1.48; 95% CI 1.01 - 2.17. The use of alternatives was limited and remained so after the intervention. Duration of catheterization decreased insignificantly in IC/CC units (ratio after/before 0.95; 95% CI 0.78 - 1.16 and neurology (ratio 0.97; 95% CI 0.80 - 1.18 and significantly in internal medicine (ratio 0.81; 95% CI 0.69 - 0.96 and surgery wards (ratio 0.80; 95% CI 0.71 - 0.90. The percentage of correct indications on the day of inclusion increased from 50 to 67% (p Conclusion Targeted implementation of recommendations from an existing guideline can lead to better adherence and cost savings. Especially, hospitals which use a lot of urethral catheters or

  1. [Incidence of phlebitis due to peripherally inserted venous catheters: impact of a catheter management protocol].

    Science.gov (United States)

    Ferrete-Morales, C; Vázquez-Pérez, M A; Sánchez-Berna, M; Gilabert-Cerro, I; Corzo-Delgado, J E; Pineda-Vergara, J A; Vergara-López, S; Gómez-Mateos, J

    2010-01-01

    To assess the impact on the incidence of PPIVC by implementing a catheter management protocol and to determine risk factors for PPIVC development in hospitalized patients. A total of 3978 episodes of venous catheterization were prospectively included from September 2002 to December 2007. A catheter management protocol was implemented during this period of time. The incidence and variables associated to the occurrence of PPIVC were determined. The incidence of PPIVC from 2002 to 2007 was 4.8%, 4.3%, 3.6%, 2.5%, 1.3% and 1.8% (phistory of phlebitis was the only factor independently associated to phlebitis due to peripherally inserted central venous catheters (AOR 3.24; CI at 95% CI= 1.05-9.98, p=0.04). A catheter management protocol decreases the incidence of PPIVC in hospitalized patients. The risk of PPIVC increases for peripherally inserted central venous catheters when the patients have a history of phlebitis and for peripheral venous catheters when amiodarone or cefotaxime are infused. Catheterization of peripheral veins performed during morning shifts is associated with a lower incidence of PPIVC when compared with night shift catheterizations.

  2. Detection of electrophysiology catheters in noisy fluoroscopy images.

    Science.gov (United States)

    Franken, Erik; Rongen, Peter; van Almsick, Markus; ter Haar Romeny, Bart

    2006-01-01

    Cardiac catheter ablation is a minimally invasive medical procedure to treat patients with heart rhythm disorders. It is useful to know the positions of the catheters and electrodes during the intervention, e.g. for the automatization of cardiac mapping. Our goal is therefore to develop a robust image analysis method that can detect the catheters in X-ray fluoroscopy images. Our method uses steerable tensor voting in combination with a catheter-specific multi-step extraction algorithm. The evaluation on clinical fluoroscopy images shows that especially the extraction of the catheter tip is successful and that the use of tensor voting accounts for a large increase in performance.

  3. Modeling of the metallic port in breast tissue expanders for photon radiotherapy.

    Science.gov (United States)

    Yoon, Jihyung; Xie, Yibo; Heins, David; Zhang, Rui

    2018-03-30

    The purpose of this study was to model the metallic port in breast tissue expanders and to improve the accuracy of dose calculations in a commercial photon treatment planning system (TPS). The density of the model was determined by comparing TPS calculations and ion chamber (IC) measurements. The model was further validated and compared with two widely used clinical models by using a simplified anthropomorphic phantom and thermoluminescent dosimeters (TLD) measurements. Dose perturbations and target coverage for a single postmastectomy radiotherapy (PMRT) patient were also evaluated. The dimensions of the metallic port model were determined to be 1.75 cm in diameter and 5 mm in thickness. The density of the port was adjusted to be 7.5 g/cm 3 which minimized the differences between IC measurements and TPS calculations. Using the simplified anthropomorphic phantom, we found the TPS calculated point doses based on the new model were in agreement with TLD measurements within 5.0% and were more accurate than doses calculated based on the clinical models. Based on the photon treatment plans for a real patient, we found that the metallic port has a negligible dosimetric impact on chest wall, while the port introduced significant dose shadow in skin area. The current clinical port models either overestimate or underestimate the attenuation from the metallic port, and the dose perturbation depends on the plan and the model in a complex way. TPS calculations based on our model of the metallic port showed good agreement with measurements for all cases. This new model could improve the accuracy of dose calculations for PMRT patients who have temporary tissue expanders implanted during radiotherapy and could potentially reduce the risk of complications after the treatment. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  4. Determinants of Port Performance - Case Study of 4 Main Ports in Indonesia (2005-2015

    Directory of Open Access Journals (Sweden)

    Atika Aqmarina

    2018-03-01

    Full Text Available Port plays significant role in supporting economic growth of a country. This study aims to analyze the determinant of port performance in Indonesia. In this research, the ports selected are four main ports in Indonesia which are Port of Belawan, Port of Tanjung Priok, Port of Tanjung Perak, and Makassar. These ports are designed as the hub ports in the national sea transport system of the country. The study used pooled OLS as the methodology to analyze the determinant. The result of this studies shows that total traffic is not influenced by operating surplus per ton, whereas the rest of variables such as turnaround time, idle time, berth of occupancy rate, rate of return, number of employee and cargo equipment have significant results and significantly influenced the total traffic.

  5. Engineering issues on the diagnostic port integration in ITER upper port 18

    Energy Technology Data Exchange (ETDEWEB)

    Pak, Sunil, E-mail: paksunil@nfri.re.kr [National Fusion Research Institute, Gwahak-ro, Yuseong-gu, Daejeon (Korea, Republic of); Bertalot, Luciano [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-lez-Durance (France); Cheon, Mun Seong [National Fusion Research Institute, Gwahak-ro, Yuseong-gu, Daejeon (Korea, Republic of); Giacomin, Thibaud [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-lez-Durance (France); Heemskerk, Cock J.M.; Koning, Jarich F. [Heemskerk Innovative Technology, Merelhof 2, 2172 HZ Sassenheim (Netherlands); Lee, Hyeon Gon [National Fusion Research Institute, Gwahak-ro, Yuseong-gu, Daejeon (Korea, Republic of); Nemtcev, Grigorii [Institution “PROJECT CENTER ITER”, Akademika Kurchatova sq., Moscow (Russian Federation); Ronden, Dennis M.S. [FOM Institute DIFFER, P.O. Box 1207, 3430 BE Nieuwegein (Netherlands); Seon, Chang Rae [National Fusion Research Institute, Gwahak-ro, Yuseong-gu, Daejeon (Korea, Republic of); Udintsev, Victor; Yukhnov, Nikolay [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-lez-Durance (France); Zvonkov, Alexander [Institution “PROJECT CENTER ITER”, Akademika Kurchatova sq., Moscow (Russian Federation)

    2016-11-01

    Highlights: • Diagnostic port integration in the upper port 18 of ITER is presented in order to house the three diagnostic systems. • Issue on the neutron shielding in the upper port 18 is addressed and the shut-down dose rate in the interspace is summarized. • The maintenance strategy in the upper port 18 is described. - Abstract: The upper port #18 (UP18) in ITER hosts three diagnostic systems: the neutron activation system, the Vacuum Ultra-Violet spectrometer system, and the vertical neutron camera. These diagnostics are integrated into three infrastructures in the port: the upper port plug, interspace support structure and port cell support structure. The port integration in UP18 is at the preliminary design stage and the current design of the infrastructure as well as the diagnostic integration is described here. The engineering issues related to neutron shielding and maintenance are addressed and the design approach is suggested.

  6. Hip Implant Systems

    Science.gov (United States)

    ... Implants and Prosthetics Metal-on-Metal Hip Implants Hip Implants Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Hip implants are medical devices intended to restore mobility ...

  7. Breast reconstruction - implants

    Science.gov (United States)

    Breast implants surgery; Mastectomy - breast reconstruction with implants; Breast cancer - breast reconstruction with implants ... harder to find a tumor if your breast cancer comes back. Getting breast implants does not take as long as breast reconstruction ...

  8. The bowed catheter sign: a risk for pericardial tamponade

    International Nuclear Information System (INIS)

    Towbin, Richard

    2008-01-01

    The use of a central venous catheter (CVC) has become commonplace in the care of children with a wide variety of medical and surgical problems. Complications resulting from the insertion of these catheters are well recognized and can be life-threatening. When a temporary CVC or other catheter is inserted into the central venous system it is secured to the skin with a combination of sutures and sterile dressing. This fixes the catheter in place and does not allow it to retract, thereby putting pressure on the right atrial wall via the catheter tip if it is too long. The probability of wall penetration is increased if a catheter or device is tapered at the point of contact. The purpose of this case report is to present the bowed catheter sign and to review the anatomy of the cavotricuspid isthmus, a possible predisposing factor to cardiac perforation and tamponade. (orig.)

  9. The bowed catheter sign: a risk for pericardial tamponade

    Energy Technology Data Exchange (ETDEWEB)

    Towbin, Richard [Phoenix Children' s Hospital, Department of Radiology, Phoenix, AZ (United States)

    2008-03-15

    The use of a central venous catheter (CVC) has become commonplace in the care of children with a wide variety of medical and surgical problems. Complications resulting from the insertion of these catheters are well recognized and can be life-threatening. When a temporary CVC or other catheter is inserted into the central venous system it is secured to the skin with a combination of sutures and sterile dressing. This fixes the catheter in place and does not allow it to retract, thereby putting pressure on the right atrial wall via the catheter tip if it is too long. The probability of wall penetration is increased if a catheter or device is tapered at the point of contact. The purpose of this case report is to present the bowed catheter sign and to review the anatomy of the cavotricuspid isthmus, a possible predisposing factor to cardiac perforation and tamponade. (orig.)

  10. Radiologically placed tunneled peritoneal catheter in palliation of malignant ascites

    International Nuclear Information System (INIS)

    Akinci, Devrim; Erol, Bekir; Ciftci, Tuerkmen T.; Akhan, Okan

    2011-01-01

    The purpose of this study was to evaluate retrospectively the safety and effectiveness of radiologically placed tunneled peritoneal catheter in palliation of malignant ascites. Between July 2005 and June 2009, 41 tunneled peritoneal catheters were placed under ultrasonographic and fluoroscopic guidance in 40 patients (mean age, 55 years; 22 women) who had symptomatic malignant ascites. No procedure related mortality was observed. Major complication occurred in one patient (2.5%) in the form of serious bacterial peritonitis that necessitated catheter removal. Minor complications such as minor bacterial peritonitis, catheter dislodgement, tunnel infection, and catheter blockage occurred in 11 patients (27.5%). The mean duration of survival after catheter placement was 11.8 weeks. All patients expired of their primary malignancies in the follow-up. Radiologically placed tunneled peritoneal catheter is safe and effective in palliation of symptomatic malignant ascites.

  11. Radiologically placed tunneled peritoneal catheter in palliation of malignant ascites

    Energy Technology Data Exchange (ETDEWEB)

    Akinci, Devrim; Erol, Bekir; Ciftci, Tuerkmen T. [Hacettepe University, Faculty of Medicine, Department of Radiology, 06100 Ankara (Turkey); Akhan, Okan, E-mail: akhano@tr.net [Hacettepe University, Faculty of Medicine, Department of Radiology, 06100 Ankara (Turkey)

    2011-11-15

    The purpose of this study was to evaluate retrospectively the safety and effectiveness of radiologically placed tunneled peritoneal catheter in palliation of malignant ascites. Between July 2005 and June 2009, 41 tunneled peritoneal catheters were placed under ultrasonographic and fluoroscopic guidance in 40 patients (mean age, 55 years; 22 women) who had symptomatic malignant ascites. No procedure related mortality was observed. Major complication occurred in one patient (2.5%) in the form of serious bacterial peritonitis that necessitated catheter removal. Minor complications such as minor bacterial peritonitis, catheter dislodgement, tunnel infection, and catheter blockage occurred in 11 patients (27.5%). The mean duration of survival after catheter placement was 11.8 weeks. All patients expired of their primary malignancies in the follow-up. Radiologically placed tunneled peritoneal catheter is safe and effective in palliation of symptomatic malignant ascites.

  12. Catheter versus non-catheter angiography in isolated third nerve palsy

    International Nuclear Information System (INIS)

    Lee, A.G.

    2007-01-01

    To discuss the controversies surrounding the indications for catheter angiography versus non-catheter and less invasive angiography techniques (e.g. magnetic resonance angiography (MRA) and computerized tomography angiography (CTA)) in the evaluation of patients with a third nerve palsy. Clinical opinion-perspective and literature review. The patient with an isolated third nerve palsy might have a vasculopathic (and typically benign, self limited course) etiology or a life threatening intracranial posterior communicating artery aneurysm. Although it is clear that non-isolated third nerve palsies require imaging directed at the topographical localization of the clinical findings, the evaluation of the neurologically isolated third nerve palsy remains controversial. The completeness of the external (i.e. somatic) motor dysfunction and the presence or absence of internal (i.e. pupillary) dysfunction are generally used to guide the choice of initial neuroimaging. Advances in MRA and CTA technology have reduced but not eliminated our dependence upon catheter angiography in this setting. A properly performed and interpreted MRA or CTA probably will be able to detect greater than 95 % of aneurysms producing a third nerve palsy. The issues surrounding the use of catheter angiography in third nerve palsy are reviewed. If the clinician is highly confident in the capability, availability, and reliability of the neuroradiologist and of their institutional experience and quality of less invasive non-catheter MRA and CTA and if the risk of aneurysm is low or if the risk of angiography is high (e.g. elderly, renal failure, iodinated contrast allergy, risk of stroke) then MRI and MRA (or CTA) may be a reasonable alternative to catheter angiography. Patients with a moderate or uncertain risk of aneurysm and a lower risk for catheter angiography or if there is a low confidence in the quality or the interpretation of the institutional MRA (or CTA) may still require catheter

  13. Usefulness of gram staining of blood collected from total parenteral nutrition catheter for rapid diagnosis of catheter-related sepsis.

    Science.gov (United States)

    Moonens, F; el Alami, S; Van Gossum, A; Struelens, M J; Serruys, E

    1994-01-01

    The accuracy of Gram staining of blood drawn from catheters used to administer total parenteral nutrition was compared with paired quantitative blood cultures for the diagnosis of catheter-related sepsis. Gram staining was positive in 11 of 18 episodes of catheter-related sepsis documented by quantitative culture (sensitivity, 61%) but in none of the 5 episodes of fever unrelated to catheter infection. Thus, this procedure enabled the rapid presumptive diagnosis and guidance of antimicrobial therapy for total parenteral nutrition catheter sepsis, with a positive predictive value of 100% and a negative predictive value of 42%. PMID:7521359

  14. An in-vitro urinary catheterization model that approximates clinical conditions for evaluation of innovations to prevent catheter-associated urinary tract infections.

    Science.gov (United States)

    Chua, R Y R; Lim, K; Leong, S S J; Tambyah, P A; Ho, B

    2017-09-01

    Catheter-associated urinary tract infections (CAUTI) account for approximately 25% of nosocomial infections globally, and often result in increased morbidity and healthcare costs. An additional concern is the presence of microbial biofilms which are major reservoirs of bacteria, especially antibiotic-resistant bacteria, in catheters. Since introduction of the use of closed drainage systems, innovations to combat CAUTI have not led to significant improvements in clinical outcomes. The lack of a robust laboratory platform to test new CAUTI preventive strategies may impede development of novel technologies. To establish an in-vitro catheterization model (IVCM) for testing of technological innovations to prevent CAUTI. The IVCM consists of a continuous supply of urine medium flowing into a receptacle (bladder) where the urine is drained through a urinary catheter connected to an effluent collection vessel (drainage bag). Test organism(s) can be introduced conveniently into the bladder via a rubber septa port. Development of bacteriuria and microbial biofilm on the catheter can be determined subsequently. With an initial inoculum of Escherichia coli [∼5×10 5  colony-forming units (cfu)/mL] into the bladder, a 100% silicone catheter and a commercially available silver-hydrogel catheter showed heavy biofilm colonization (∼10 8  cfu/cm and ∼10 7  cfu/cm, respectively) with similar bacterial populations in the urine (bacteriuria) (∼10 8  cfu/mL and ∼10 7  cfu/mL, respectively) within three days. Interestingly, an antimicrobial peptide (CP11-6A)-coated catheter showed negligible biofilm colonization and no detectable bacteriuria. The IVCM is a useful preclinical approach to evaluate new strategies for the prevention of CAUTI. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  15. The Syed temporary interstitial iridium gynaecological implant: an inverse planning system

    International Nuclear Information System (INIS)

    Fung, Albert Y.C.

    2002-01-01

    Patients with advanced gynaecological cancer are often treated with a temporary interstitial implant using the Syed template and Ir-192 ribbons at the Memorial Sloan-Kettering Cancer Center. Urgency in planning is great. We created a computerized inverse planning system for the Syed temporary gynaecological implant, which optimized the ribbon strengths a few seconds after catheter digitization. Inverse planning was achieved with simulated annealing. We discovered that hand-drawn target volumes had drawbacks; hence instead of producing a grid of points based on target volume, the optimization points were generated directly from the catheter positions without requiring an explicit target volume. Since all seeds in the same ribbon had the same strength, the minimum doses were located at both ends of the implant. Optimization points generated at both ends ensured coverage of the whole implant. Inverse planning took only a few seconds, and generated plans that provide a good starting point for manual improvement. (author)

  16. In vitro analysis of balloon cuffing phenomenon: inherent biophysical properties of catheter material or mechanics of catheter balloon deflation?

    Science.gov (United States)

    Chung, Eric; So, Karina

    2012-06-01

    To investigates the different methods of balloon deflation, types of urinary catheters and exposure to urine media in catheter balloon cuffing. Bardex®, Bard-Lubri-Sil®, Argyle®, Releen® and Biocath® were tested in sterile and E.Coli inoculated urine at 0, 14 and 28 days. Catheter deflation was performed with active deflation; passive deflation; passive auto-deflation; and excision of the balloon inflow channel. Balloon cuffing was assessed objectively by running the deflated balloon over a plate of agar and subjectively by 3 independent observers. Bardex®, Argyle® and Biocath® showed greater degree of catheter balloon cuffing (p deflation was the worst method (p 0.05). Linear regression model analysis confirmed time as the most significant factor. The duration of catheters exposure, different deflation methods and types of catheters tested contributed significantly to catheter balloon cuffing (p < 0.01).

  17. COMPETITION BETWEEN CONTAINER PORTS IN THE NORTHERN ADRIATIC

    OpenAIRE

    Elen Twrdy; Milan Batista

    2014-01-01

    World trade has changed in the last decade such that container traffic flows are oriented towards more parts of the European continent. The European container port system is not a homogeneous set of ports; instead it consists of several big ports (e.g., Rotterdam, Hamburg, Algeciras...) and a large number of medium and small ports. Northern Adriatic (NA) ports, namely Rijeka, Koper, Trieste, Venice and Ravenna, are small ports. Each of these ports have different development plans but in varyi...

  18. Justification for inter-fraction correction of catheter movement in fractionated high dose-rate brachytherapy treatment of prostate cancer

    International Nuclear Information System (INIS)

    Simnor, Tania; Li, Sonia; Lowe, Gerry; Ostler, Peter; Bryant, Linda; Chapman, Caroline; Inchley, Dave; Hoskin, Peter J.

    2009-01-01

    Background and purpose: Fractionated high dose-rate (HDR) brachytherapy in the treatment of prostate cancer relies on reproducible catheter positions for each fraction to ensure adequate tumour coverage while minimising dose to normal tissues. Peri-prostatic oedema may cause caudal displacement of the catheters relative to the prostate gland between fractions. This can be corrected for by changing source dwell positions or by physical re-advancement of catheters before treatment. Materials and methods: Data for 20 consecutive monotherapy patients receiving three HDR fractions of 10.5 Gy per fraction over 2 days were analysed retrospectively. Pre-treatment CT scans were used to assess the effect of catheter movement between fractions on implant quality, with and without movement correction. Implant quality was evaluated using dosimetric parameters. Results: Compared to the first fraction (f1) the mean inter-fraction caudal movement relative to the prostate base was 7.9 mm (f2) (range 0-21 mm) and 3.9 mm (f3) (range 0-25.5 mm). PTV D90% was reduced without movement correction by a mean of 27.8% (f2) and 32.3% (f3), compared with 5.3% and 5.1%, respectively, with catheter movement correction. Dose to 2 cc of the rectum increased by a mean of 0.69 (f2) and 0.76 Gy (f3) compared with an increase of 0.03 and 0.04 Gy, respectively, with correction. The urethra V12 also increased by a mean of 0.36 (f2) and 0.39 Gy (f3) compared with 0.06 and 0.16 Gy, respectively, with correction. Conclusions: Inter-fraction correction for catheter movement using pre-treatment imaging is critical to maintain the quality of an implant. Without movement correction there is significant risk of tumour under-dosage and normal tissue over-dosage. The findings of this study justify additional imaging between fractions in order to carry out correction.

  19. Exploring relationships of catheter-associated urinary tract infection and blockage in people with long-term indwelling urinary catheters.

    Science.gov (United States)

    Wilde, Mary H; McMahon, James M; Crean, Hugh F; Brasch, Judith

    2017-09-01

    To describe and explore relationships among catheter problems in long-term indwelling urinary catheter users, including excess healthcare use for treating catheter problems. Long-term urinary catheter users experience repeated problems with catheter-related urinary tract infection and blockage of the device, yet little has been reported of the patterns and relationships among relevant catheter variables. Secondary data analysis was conducted from a sample in a randomised clinical trial, using data from the entire sample of 202 persons over 12 months' participation. Descriptive statistics were used to characterise the sample over time. Zero-inflated negative binomial models were employed for logistic regressions to evaluate predictor variables of the presence/absence and frequencies of catheter-related urinary tract infection and blockage. Catheter-related urinary tract infection was marginally associated with catheter blockage. Problems reported at least once per person in the 12 months were as follows: catheter-related urinary tract infection 57%, blockage 34%, accidental dislodgment 28%, sediment 87%, leakage (bypassing) 67%, bladder spasms 59%, kinks/twists 42% and catheter pain 49%. Regression analysis demonstrated that bladder spasms were significantly related to catheter-related urinary tract infection and sediment amount, and catheter leakages were marginally significantly and positively related to catheter-related urinary tract infection. Frequencies of higher levels of sediment and catheter leakage were significantly associated with higher levels of blockage, and being female was associated with fewer blockages. Persons who need help with eating (more disabled) were also more likely to have blockages. Catheter-related urinary tract infection and blockage appear to be related and both are associated with additional healthcare expenditures. More research is needed to better understand how to prevent adverse catheter outcomes and patterns of problems in

  20. Implant healing in experimental animal models of diabetes.

    Science.gov (United States)

    Le, Nga N; Rose, Michael B; Levinson, Howard; Klitzman, Bruce

    2011-05-01

    Diabetes mellitus is becoming increasingly prevalent worldwide. Additionally, there is an increasing number of patients receiving implantable devices such as glucose sensors and orthopedic implants. Thus, it is likely that the number of diabetic patients receiving these devices will also increase. Even though implantable medical devices are considered biocompatible by the Food and Drug Administration, the adverse tissue healing that occurs adjacent to these foreign objects is a leading cause of their failure. This foreign body response leads to fibrosis, encapsulation of the device, and a reduction or cessation of device performance. A second adverse event is microbial infection of implanted devices, which can lead to persistent local and systemic infections and also exacerbates the fibrotic response. Nearly half of all nosocomial infections are associated with the presence of an indwelling medical device. Events associated with both the foreign body response and implant infection can necessitate device removal and may lead to amputation, which is associated with significant morbidity and cost. Diabetes mellitus is generally indicated as a risk factor for the infection of a variety of implants such as prosthetic joints, pacemakers, implantable cardioverter defibrillators, penile implants, and urinary catheters. Implant infection rates in diabetic patients vary depending upon the implant and the microorganism, however, for example, diabetes was found to be a significant variable associated with a nearly 7.2% infection rate for implantable cardioverter defibrillators by the microorganism Candida albicans. While research has elucidated many of the altered mechanisms of diabetic cutaneous wound healing, the internal healing adjacent to indwelling medical devices in a diabetic model has rarely been studied. Understanding this healing process is crucial to facilitating improved device design. The purpose of this article is to summarize the physiologic factors that

  1. The Challenges of Malaysian Dry Ports Development

    Directory of Open Access Journals (Sweden)

    Jagan Jeevan

    2015-03-01

    Full Text Available This paper examines the functions and challenges of dry ports development in Malaysia through 11 face-to-face interviews with dry port stakeholders. The findings reveal that Malaysian dry ports are developed to accelerate national and international business, to activate intermodalism in the nation, to promote regional economic development and to enhance seaport competitiveness. Malaysian dry ports perform the function of transport and logistics, information processing, seaports and value-added services. Challenges facing Malaysian dry ports include insufficient railway tracks, unorganized container planning on the rail deck, highly dependent on single mode of transportation, poor recognition from the seaport community, and competition from localized seaports. This paper further indicates strategies for coping with these challenges and identifies future opportunities for Malaysian dry ports development.

  2. Distributed pressure sensors for a urethral catheter.

    Science.gov (United States)

    Ahmadi, Mahdi; Rajamani, Rajesh; Timm, Gerald; Sezen, A S

    2015-01-01

    A flexible strip that incorporates multiple pressure sensors and is capable of being fixed to a urethral catheter is developed. The urethral catheter thus instrumented will be useful for measurement of pressure in a human urethra during urodynamic testing in a clinic. This would help diagnose the causes of urinary incontinence in patients. Capacitive pressure sensors are fabricated on a flexible polyimide-copper substrate using surface micromachining processes and alignment/assembly of the top and bottom portions of the sensor strip. The developed sensor strip is experimentally evaluated in an in vitro test rig using a pressure chamber. The sensor strip is shown to have adequate sensitivity and repeatability. While the calibration factors for the sensors on the strip vary from one sensor to another, even the least sensitive sensor has a resolution better than 0.1 psi.

  3. Percutaneous catheter drainage of tuberculous psoas abscesses

    International Nuclear Information System (INIS)

    Pombo, F.; Martin-Egana, R.; Cela, A.; Diaz, J.L.; Linares-Mondejar, P.; Freire, M.

    1993-01-01

    Six patients with 7 tuberculous psoas or ilio-psoas abscesses were treated by CT-guided catheter drainage and chemotherapy. The abscesses (5 unilateral and 1 bilateral) were completely drained using a posterior or lateral approach. The abscess volume was 70 to 700 ml (mean 300 ml) and the duration of drainage 5 to 11 days (mean 7 days). Immediate local symptomatic improvement was achieved in all patients, and there were no procedural complications. CT follow-up at 3 to 9 months showed normalization in 5 patients, 2 of whom are still in medical therapy. One patient, who did not take the medication regularly, had a recurrent abscess requiring new catheter drainage after which the fluid collection disappeared. Percutaneous drainage represents an efficient and attractive alternative to surgical drainage as a supplement to medical therapy in the management of patients with large tuberculous psoas abscesses. (orig.)

  4. Pancreas tumor interstitial pressure catheter measurement

    Science.gov (United States)

    Nieskoski, Michael D.; Gunn, Jason; Marra, Kayla; Trembly, B. Stuart; Pogue, Brian W.

    2016-03-01

    This paper highlights the methodology in measuring interstitial pressure in pancreatic adenocarcinoma tumors. A Millar Mikrotip pressure catheter (SPR-671) was used in this study and a system was built to amplify and filter the output signal for data collection. The Millar pressure catheter was calibrated prior to each experiment in a water column at 37°C, range of 0 to 60 inH2O (112 mmHg), resulting in a calibration factor of 33 mV / 1 inH2O. The interstitial pressures measured in two orthotopically grown pancreatic adenocarcinoma tumor were 57 mmHg and 48 mmHg, respectively. Verteporfin uptake into the pancreatic adenocarcinoma tumor was measured using a probe-based experimental dosimeter.

  5. Pinch-off syndrome: transection of implantable central venous access device

    OpenAIRE

    Sugimoto, Takuya; Nagata, Hiroshi; Hayashi, Ken; Kano, Nobuyasu

    2012-01-01

    As the population of people with cancer increases so does the number of patients who take chemotherapy. Majority of them are administered parentally continuously. Implantable central venous catheter device is a good choice for those patients; however, severe complication would occur concerning the devices. Pinch-off syndrome is one of the most severe complications. The authors report a severe case of pinch-off syndrome. The patient with the implantable central venous device could not take che...

  6. Use of vascular access ports in femoral veins of dogs and cats with cancer.

    Science.gov (United States)

    Cahalane, Alane Kosanovich; Rassnick, Kenneth M; Flanders, James A

    2007-11-01

    To evaluate long-term function of vascular access ports (VAPs) implanted in the femoral vein of dogs and cats undergoing cancer treatment. Prospective clinical study. 3 dogs and 6 cats treated via chemotherapy or radiation. VAPs were surgically implanted in the left femoral vein of 3 dogs and 6 cats over a 1-year period. Injection port location was alternated to either a caudal thoracic or ilial location in each patient. Duration of VAP function, ease of infusion, and ease of aspiration through the VAPs were recorded, and associated complications were assessed at each VAP use. Client satisfaction with VAP placement was evaluated by use of a questionnaire. Primary uses of the VAPs included blood sampling and delivering sedative or chemotherapeutic drugs. Median duration of successful infusion was 147 days (range, 60 to 370 days), and median duration of successful aspiration was 117 days (range, 10 to 271 days). The frequency of signs of VAP-related discomfort was low (7% of patient observations). Clients were satisfied with their decision to use VAPs. Complications included partial (n = 7) or complete (2) VAP occlusion, port migration (1), and presumptive infection (1). Results suggested that VAP implantation into the femoral vein provides an acceptable means of chronic venous access in dogs and cats undergoing cancer treatment.

  7. Incidence of phlebitis associated with the use of peripheral IV catheter and following catheter removal

    Directory of Open Access Journals (Sweden)

    Janete de Souza Urbanetto

    Full Text Available ABSTRACT Objective: to investigate the incidence of phlebitis and its association with risk factors when using peripheral IV catheters (PIC and following their removal - (post-infusion phlebitis in hospitalized adults. Method: a cohort study of 171 patients using PIC, totaling 361 punctures. Sociodemographic variables and variables associated with the catheter were collected. Descriptive and analytical statistical analyses were performed. Results: average patient age was 56.96 and 51.5% of the sample population was male. The incidence of phlebitis was 1.25% while using PIC, and 1.38% post-infusion. The incidence of phlebitis while using PIC was associated with the length of time the catheter remained in place, whereas post-infusion phlebitis was associated with puncture in the forearm. Ceftriaxone, Clarithromycin and Oxacillin are associated with post-infusion phlebitis. Conclusions: this study made it possible to investigate the association between risk factors and phlebitis during catheter use and following its removal. The frequency of post-infusion phlebitis was larger than the incidence of phlebitis with the catheter in place, with Phlebitis Grade III and II being the most frequently found in each of these situations, respectively. Aspects related to post-infusion phlebitis can be explained, given the limited number of studies addressing this theme from this perspective.

  8. CATHETER DURATION AND THE RISK OF SEPSIS IN PREMATURE BABIES WITH UMBILICAL VEIN CATHETERS

    Directory of Open Access Journals (Sweden)

    Hartojo Hartojo

    2012-01-01

    Full Text Available Umbilical catheters are frequently required in the management of severely ill premature babies. The risk of complications may increase with duration of UVC use. Objective: To determine whether the risk of central line-associated bloodstream infections (CLA-BSIs and sepsis remained constant over the duration of umbilical vein catheters (UVCs in high-risk premature neonates. Methods:retrospective analysis. The data were collected from the medical record of high risk premature neonates who had a UVC placed in neonatal care unit of Husada Utama Hospital between April 1st 2008 to April 30th 2011 with purposive sampling. Catheter duration was observed before and after 14 days on placement. Blood and UVC culture was performed to establish the risk of CLA-BSIs and sepsis. Chi-square and logistic regression analysis were performed in the laboratorium data. Result: A total 44 high risk premature babies with UVCs were enrolled (sepsis group: n = 23 and non sepsis group: n = 21. Baseline demographics were similar between the groups. 15 babies in sepsis group have UVCs duration > 14 days, and 8 babies have UVCs 14 days show blood culture performance in 11 babies with positive evidence, UVCs culture performance is negative in 18 babies (p = 0.456. Burkholderia cepacia and Klebsiella pneumonia mostly appeared in blood culture performance. 25% of UVC culture performance shows Pseudomonas aeroginosa. Conclusions: The catheter duration have no significant difference in risk of sepsis in premature babies with Umbilical Vein Catheters.

  9. Retrograde prostatic urethroplasty with balloon catheter

    International Nuclear Information System (INIS)

    Castaneda, F.; Reddy, P.; Hulbert, J.; Letourneau, J.G.; Hunter, D.W.; Castaneda-Zuniga, W.R.; Amplatz, K.

    1987-01-01

    The authors performed retrograde prostatic urethroplasty in 18 patients using a 25-mm urethroplasty balloon catheter. The procedure was performed on an outpatient basis under local anesthesia. Voiding cystourethrography, retrograde urethrography, rectal US, and MRE imaging were performed before and immediately after the procedure and at 2 weeks and 3, 6, 12, and 18 months. Long-term results at 18 months and possible clinical implications are discussed

  10. Radiologic Placement of Tunneled Central Venous Catheters in Pediatric Patients

    International Nuclear Information System (INIS)

    Kim, Eun Ji; Song, Soon Young; Cho, On Koo; Koh, Byung Hee; Kim, Yong Soo; Jeong, Woo Kyoung; Lee, Yong Ho

    2010-01-01

    We evaluated the technical success and complication rates associated with the radiological placement of tunneled central venous catheters in pediatric patients. Between May 1, 2005 and March 31, 2008, a total of 46 tunneled central venous catheters were placed in 34 children (M:F = 22:12; mean age, 9.9 years [9 months to 16.8 years]). All procedures were performed under ultrasonographic and fluoroscopic guidance. Follow-up data were obtained through the retrospective review of the medical records. We used the Kaplan-Meier survival method for the evaluation of survival rate of the catheters. All procedures were technically successful. The observed periprocedural complications included hematoma formation in three patients. The mean catheter life was 189.3 days (total, 8710 days; range, 7-810). Catheters were removed due to death (n=9), the end of treatment (n=8), catheter sepsis (n=4), malfunction (n=8), and accidental removal (n=4). The rate of catheter sepsis and malfunction was 0.459 and 0.919 for every 1000 catheter days, respectively. The expected mean catheter life was 479.6 days as per the Kaplan- Meier analysis. The results suggest that the radiologic placement of a tunneled central venous catheter is an effective technique with a high technical success rate and low complication rate

  11. Biological safety evaluation of the modified urinary catheter

    Energy Technology Data Exchange (ETDEWEB)

    Kowalczuk, Dorota, E-mail: dorota.kowalczuk@umlub.pl [Department of Medicinal Chemistry, Medical University of Lublin, Jaczewskiego 4, 20-090 Lublin (Poland); Przekora, Agata; Ginalska, Grazyna [Department of Biochemistry and Biotechnology, Medical University of Lublin, Chodzki 1, 20-093 Lublin (Poland)

    2015-04-01

    The purpose of this study was to evaluate in vitro safety of the novel tosufloxacin (TOS)-treated catheters with the prolonged antimicrobial activity. The test samples of silicone latex catheter were prepared by the immobilization of TOS on chitosan (CHIT)-coated catheter by means of covalent bonds and non-covalent interactions. Each step of the modification process of catheter surface was observed using ATR–Fourier transform infrared spectroscopy. In vitro cytotoxicity of the modified and unmodified catheters was assessed by direct and indirect tests in accordance with ISO standards using green monkey kidney (GMK) cell line. The MTT, lactate dehydrogenase activity (LDH), WST-8, Sulforhodamine B (SRB) test results and microscopic observation clearly indicated that unmodified silicone latex catheters decrease cell metabolic activity, act as a cytotoxic agent causing cell lysis and induce cell death through necrotic or apoptotic process. We suggest that chitosan coat with TOS immobilized limits leaching of harmful agents from silicone latex material, which significantly enhances survivability of GMK cells and therefore is quite a good protection against the cytotoxic effect of this material. - Highlights: • Characterization of the novel antimicrobial urinary catheters • Monitoring of the catheter modification by FTIR analysis • Confirmation of high cytotoxicity of latex-based catheter used in urological practice • Chitosan-coated and tosufloxacin-treated catheter is less toxic than the untreated one. • The proposed surface modification protects cells against latex-induced death.

  12. Radiologic Placement of Tunneled Central Venous Catheters in Pediatric Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Ji; Song, Soon Young; Cho, On Koo; Koh, Byung Hee; Kim, Yong Soo; Jeong, Woo Kyoung; Lee, Yong Ho [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2010-08-15

    We evaluated the technical success and complication rates associated with the radiological placement of tunneled central venous catheters in pediatric patients. Between May 1, 2005 and March 31, 2008, a total of 46 tunneled central venous catheters were placed in 34 children (M:F = 22:12; mean age, 9.9 years [9 months to 16.8 years]). All procedures were performed under ultrasonographic and fluoroscopic guidance. Follow-up data were obtained through the retrospective review of the medical records. We used the Kaplan-Meier survival method for the evaluation of survival rate of the catheters. All procedures were technically successful. The observed periprocedural complications included hematoma formation in three patients. The mean catheter life was 189.3 days (total, 8710 days; range, 7-810). Catheters were removed due to death (n=9), the end of treatment (n=8), catheter sepsis (n=4), malfunction (n=8), and accidental removal (n=4). The rate of catheter sepsis and malfunction was 0.459 and 0.919 for every 1000 catheter days, respectively. The expected mean catheter life was 479.6 days as per the Kaplan- Meier analysis. The results suggest that the radiologic placement of a tunneled central venous catheter is an effective technique with a high technical success rate and low complication rate.

  13. Port pricing : principles, structure and models

    OpenAIRE

    Meersman, Hilde; Strandenes, Siri Pettersen; Van de Voorde, Eddy

    2014-01-01

    Price level and price transparency are input to shippers’ choice of supply chain and transport mode. In this paper, we analyse current port pricing structures in the light of the pricing literature and consider opportunities for improvement. We present a detailed overview of pricing criteria, who sets prices and who ultimately foots the bill for port-of-call charges, cargo-handling fees and congestion charges. Current port pricing practice is based on a rather linear structure and fails to in...

  14. Efficiency analysis of container ports and terminals

    OpenAIRE

    Liu, Q.

    2010-01-01

    In the past two decades the steady growth of seaborne trade has resulted in the increase of container ships, container ports and their terminals. The structure of the shipping market is, moreover, continuously evolving. On the carrier side, shipping companies form consortia and alliances; on the port side, global terminal operators and dedicated container terminals are emerging. The aim of this research is to evaluate the efficiency of container ports and terminals and to study...

  15. Port Sunlight, essai architectural et social

    OpenAIRE

    Machet, Laurence

    2017-01-01

    The purpose of this article is to examine the city of Port Sunlight, its history, design and originality. Created by William Lever in 1888 in order to house his newly-built soap factory, Port Sunlight is part of the numerous “factory villages” built in the wake of the industrial revolution according to philanthropic and utilitarian principles. But this article intends to show that Port Sunlight differs from other factory towns. Its careful design, elaborate architecture and public facilities ...

  16. PORT SECURITY-Threats and Vulnerabilities

    OpenAIRE

    Kusi, Bernard

    2015-01-01

    The main objective of this thesis is to identify the threats and the vulnerabilities concerning Takoradi port, and finally recommend measure to overcome the identified threats and vul-nerabilities. Various categories of potential threats and vulnerabilities have been studied throughout the literature review. However, because each port presents a unique sets of threats and vulnerabilities, there was a need to look critically into how Takoradi port operations are being conducted in other to ide...

  17. Stroke risk associated with balloon based catheter ablation for atrial fibrillation: Rationale and design of the MACPAF Study

    Directory of Open Access Journals (Sweden)

    Schultheiss Heinz-Peter

    2010-07-01

    Full Text Available Abstract Background Catheter ablation of the pulmonary veins has become accepted as a standard therapeutic approach for symptomatic paroxysmal atrial fibrillation (AF. However, there is some evidence for an ablation associated (silent stroke risk, lowering the hope to limit the stroke risk by restoration of rhythm over rate control in AF. The purpose of the prospective randomized single-center study "Mesh Ablator versus Cryoballoon Pulmonary Vein Ablation of Symptomatic Paroxysmal Atrial Fibrillation" (MACPAF is to compare the efficacy and safety of two balloon based pulmonary vein ablation systems in patients with symptomatic paroxysmal AF. Methods/Design Patients are randomized 1:1 for the Arctic Front® or the HD Mesh Ablator® catheter for left atrial catheter ablation (LACA. The predefined endpoints will be assessed by brain magnetic resonance imaging (MRI, neuro(psychological tests and a subcutaneously implanted reveal recorder for AF detection. According to statistics 108 patients will be enrolled. Discussion Findings from the MACPAF trial will help to balance the benefits and risks of LACA for symptomatic paroxysmal AF. Using serial brain MRIs might help to identify patients at risk for LACA-associated cerebral thromboembolism. Potential limitations of the study are the single-center design, the existence of a variety of LACA-catheters, the missing placebo-group and the impossibility to assess the primary endpoint in a blinded fashion. Trial registration clinicaltrials.gov NCT01061931

  18. Maximizing port and transportation system productivity by exploring alternative port operation strategies.

    Science.gov (United States)

    2011-06-01

    Seaports are a critical transportation component that supports the nations economy. Many U.S. : ports are now experiencing significant truck congestion at the gate, which decreases the productivity of : ports and truck fleets (e.g. truck wait time...

  19. US Army Corps of Engineers Ports, Geographic WGS84, BTS (2006) [usace_port_BTS_2006

    Data.gov (United States)

    Louisiana Geographic Information Center — Contains physical information on commercial facilities at the principal U.S. Coastal, Great Lakes and Inland Ports. The data consists of listings of port area's...

  20. Current status of endovascular catheter robotics.

    Science.gov (United States)

    Lumsden, Alan B; Bismuth, Jean

    2018-06-01

    In this review, we will detail the evolution of endovascular therapy as the basis for the development of catheter-based robotics. In parallel, we will outline the evolution of robotics in the surgical space and how the convergence of technology and the entrepreneurs who push this evolution have led to the development of endovascular robots. The current state-of-the-art and future directions and potential are summarized for the reader. Information in this review has been drawn primarily from our personal clinical and preclinical experience in use of catheter robotics, coupled with some ground-breaking work reported from a few other major centers who have embraced the technology's capabilities and opportunities. Several case studies demonstrating the unique capabilities of a precisely controlled catheter are presented. Most of the preclinical work was performed in the advanced imaging and navigation laboratory. In this unique facility, the interface of advanced imaging techniques and robotic guidance is being explored. Although this procedure employs a very high-tech approach to navigation inside the endovascular space, we have conveyed the kind of opportunities that this technology affords to integrate 3D imaging and 3D control. Further, we present the opportunity of semi-autonomous motion of these devices to a target. For the interventionist, enhanced precision can be achieved in a nearly radiation-free environment.

  1. THE Port - hackathon at CERN

    CERN Multimedia

    CERN. Geneva; KNAEPPER, Ines; SILVA DE SOUSA, Bruno

    2014-01-01

    THE Port association combines creative minds from CERN and non-profit organisations in interdisciplinary teams to work on humanitarian technology related benefits to society. Our interdisciplinary teams of handpicked individuals chosen for their field-leading expertise and innovative mind combine humanitarian questions with state of the art science, cutting-edge technology and endless fantasy. We aim to impact the future by fusion of today’s real life problems analysis and vision of scientific evolution of the next decades. This forces us to develop concepts and solutions for the future - hungry to use our expertise in challenges of new fields.

  2. Port virtual addressing for PC

    International Nuclear Information System (INIS)

    Bolanos, L.; Arista, E.; Osorio Deliz, J.F.

    1997-01-01

    Instruments for nuclear signal measurements based on add-on card for a personal computer (PC) are designed often. Then one faces the problem of the addressing of data input/output devices which show an integration level or intelligence that makes the use of several port address indispensable, and these are limited in the PC. The virtual addressing offers the advantage of the occupation of few addresses to accede to many of these devices. The principles of this technique and the appliances of a solution in radiometric in a radiometric card based on programmed logic are discussed in this paper

  3. POLICY PORT IN LATIN AMERICA

    Directory of Open Access Journals (Sweden)

    María Victoria Flores

    2012-07-01

    Full Text Available This work achieves a contextual approach the port services market in Latin America, from the document review the legal framework and jurisprudence. It observes and evaluates the phenomenon under study, establishing a correlation between the grant in the shape of the free supply and demand for services and operating in a market of few suppliers, resulting in national legislation and concession contracts defending a free market and on the other hand, case law on market practice indicating that there is no free market to defend.

  4. Testing and Analysis of Sensor Ports

    Science.gov (United States)

    Zhang, M.; Frendi, A.; Thompson, W.; Casiano, M. J.

    2016-01-01

    This Technical Publication summarizes the work focused on the testing and analysis of sensor ports. The tasks under this contract were divided into three areas: (1) Development of an Analytical Model, (2) Conducting a Set of Experiments, and (3) Obtaining Computational Solutions. Results from the experiment using both short and long sensor ports were obtained using harmonic, random, and frequency sweep plane acoustic waves. An amplification factor of the pressure signal between the port inlet and the back of the port is obtained and compared to models. Comparisons of model and experimental results showed very good agreement.

  5. DEA Window Analysis for Measuring Port Efficiencies in Serbia

    Directory of Open Access Journals (Sweden)

    Danijela Pjevčević

    2012-01-01

    Full Text Available The aim of the paper is to apply Data Envelopment Analysis (DEA method in measuring and analyzing the efficiencies of ports on the river Danube. DEA window analysis is used to determine the efficiency of ports and to observe the possibility of changes in the port efficiency over time. A study is conducted to evaluate the efficiencies of ports on the territory of Serbia in order to identify the sources of inefficiencies and formulate proposals for improving the services of those ports and their operations through a four-year window analysis with port efficiency trends and average efficiencies. The progress is made in the measurement of port efficiency in relation to port productive activities - total area of warehouses, quay length, number of cranes and port throughput, for the Serbian river ports. Keywords: river ports, total area of warehouses, quay length, number of cranes, port throughput, port efficiency, DEA window analysis

  6. Perancangan Miniatur Traffic Light Dengan Mempergunakan Pengendali Port Paralel

    Directory of Open Access Journals (Sweden)

    Eka Wahyudi

    2012-05-01

    Full Text Available Port paralel tentunya sudah tidak asing lagi dalam dunia komputer. Hal tersebut disebabkan karena port paralel merupakan sarana komunikasi yang terdapat pada Personal Computer (PC. Dengan memanfaatkan port tersebut, saat ini komputer juga dapat dipergunakan untuk keperluan pengontrolan/pengendalian rangkaian listrik dengan memanfaatkan port paralel (port printer. Port paralel memiliki kecepatan transfer data yang lebih cepat apabila dibandingkan dengan port serial, maka dari itu port paralel lebih banyak dipergunakan untuk pengendalian nyala lampu (LED. Dengan memanfaatkan bantuan software Saraf Listrik versi 1.01, maka port paralel dapat menjadi alternatif baru untuk pengendalian traffic light.

  7. Non-Price Competition in the Port Sector: A Case Study of Ports in Turkey

    OpenAIRE

    Soner Esmer; Hong-Oanh Nguyen, Ph.D.; Yapa Mahinda Bandara, Ph.D.; Kazim Yeni, Ph.D.

    2016-01-01

    Although the port sector has been facing increasing competition, there is limited research on how ports compete using non-price competition strategies. There are a few studies on non-price competition in the port sector. However they mainly focus on the marketing aspect. This paper seeks to fill this gap in the literature, especially from a combined marketing-economic perspective. Especially the paper's main objective is to identify the determinants of non-price competition in the port sector...

  8. Incidence of catheter-related complications in patients with central venous or hemodialysis catheters: a health care claims database analysis.

    Science.gov (United States)

    Napalkov, Pavel; Felici, Diana M; Chu, Laura K; Jacobs, Joan R; Begelman, Susan M

    2013-10-16

    Central venous catheter (CVC) and hemodialysis (HD) catheter usage are associated with complications that occur during catheter insertion, dwell period, and removal. This study aims to identify and describe the incidence rates of catheter-related complications in a large patient population in a United States-based health care claims database after CVC or HD catheter placement. Patients in the i3 InVision DataMart® health care claims database with at least 1 CVC or HD catheter insertion claim were categorized into CVC or HD cohorts using diagnostic and procedural codes from the US Renal Data System, American College of Surgeons, and American Medical Association's Physician Performance Measures. Catheter-related complications were identified using published diagnostic and procedural codes. Incidence rates (IRs)/1000 catheter-days were calculated for complications including catheter-related bloodstream infections (CRBSIs), thrombosis, embolism, intracranial hemorrhage (ICH), major bleeding (MB), and mechanical catheter-related complications (MCRCs). Thirty percent of the CVC cohort and 54% of the HD cohort had catheter placements lasting <90 days. Catheter-related complications occurred most often during the first 90 days of catheter placement. IRs were highest for CRBSIs in both cohorts (4.0 [95% CI, 3.7-4.3] and 5.1 [95% CI, 4.7-5.6], respectively). Other IRs in CVC and HD cohorts, respectively, were thrombosis, 1.3 and 0.8; MCRCs, 0.6 and 0.7; embolism, 0.4 and 0.5; MB, 0.1 and 0.3; and ICH, 0.1 in both cohorts. Patients with cancer at baseline had significantly higher IRs for CRBSIs and thrombosis than non-cancer patients. CVC or HD catheter-related complications were most frequently seen in patients 16 years or younger. The risk of catheter-related complications is highest during the first 90 days of catheter placement in patients with CVCs and HD catheters and in younger patients (≤16 years of age) with HD catheters. Data provided in this study can be applied

  9. [The ISP (Safe Insertion of PICCs) protocol: a bundle of 8 recommendations to minimize the complications related to the peripherally inserted central venous catheters (PICC)].

    Science.gov (United States)

    Emoli, Alessandro; Cappuccio, Serena; Marche, Bruno; Musarò, Andrea; Scoppettuolo, Giancarlo; Pittiruti, Mauro

    2014-01-01

    The ISP (Safe Insertion of PICCs) protocol: a bundle of 8 recommendations to minimize the complications related to the peripherally inserted central venous catheters (PICC). The insertion of a peripherally inserted central venous catheter (PICC) is not without risks. The Italian Group for the Study of Long-Term Central Venous Access Devices (GAVeCeLT) has developed a protocol (SIP: Safe Implantation of PICCs) with the aim of minimizing the risks which may be associated with the placement of PICCs. The protocol is based on recommendations available in the literature and on the main clinical practice guidelines. The SIP protocol, a bundle of evidence-based recommendations, it is is easy to use, inexpensive, and cost-effective. If routinely used and carefully inplemented, it greatly reduces complications such as failure of venipuncture, accidental arterial puncture, damage of median nerve, infection and catheter related venous thrombosis.

  10. Novel type of peritoneocentesis trocar-assisted distal ventriculoperitoneal shunt placement with supervision via a one-port laparoscope.

    Science.gov (United States)

    Wang, Guangming; Yu, Jinlu; Luan, Yongxin; Han, Yanwu; Fu, Shuanglin

    2017-10-01

    Ventriculoperitoneal shunts (VPS) are the primary treatment for hydrocephalus and are associated with a high risk of complications, specifically in patients who are obese or have abdominal adhesions or shunt revisions. The present study describes the use of a novel type of peritoneal catheter peritoneocentesis trocar insertion with the assistance of a one-port laparoscope. A total of 36 patients with hydrocephalus underwent this novel type of peritoneocentesis trocar-assisted VPS. The distal shunt catheter was placed into the right subdiaphragmatic space and the catheter was traversed through a single hole drilled through the liver falciform ligament. The duration of the laparoscopic surgery ranged from 6-18 min (mean 10.4±1.6 min). No shunt-related infections or catheter malfunctions or injuries to the intra-abdominal organs occurred. The total abdominal incision length was 1.0 cm (0.5+0.5 cm). No laparoscopy-related complications were observed during follow-up assessments. The novel approach used in the current study is very easy to perform, and this method may significantly reduce the risk of malfunction complications. The presented method also has the advantages of reduced trauma and a simpler surgery. The current study indicated that this simple, minimally invasive procedure was beneficial for patients with hydrocephalus, specifically in cases of patients with obesity, peritoneal adhesions or shunt revisions.

  11. 19 CFR 101.3 - Customs service ports and ports of entry.

    Science.gov (United States)

    2010-04-01

    ... and Service Ports. Many of the ports listed were created by the President's message of March 3, 1913....S.C. 1). Subsequent orders of the President or of the Secretary of the Treasury which affected these... Port of the Delaware River and Bay described in T.D. 96-4. Perth Amboy New Mexico Albuquerque Including...

  12. 21 CFR 882.5850 - Implanted spinal cord stimulator for bladder evacuation.

    Science.gov (United States)

    2010-04-01

    ... bladder by reflex means or by the intermittent use of catheters. The stimulator consists of an implanted... an external transmitter for transmitting the stimulating pulses across the patient's skin to the... cord stimulator for bladder evacuation shall have an approved PMA or a declared completed PDP in effect...

  13. Reducing catheter-related thrombosis using a risk reduction tool centered on catheter to vessel ratio.

    Science.gov (United States)

    Spencer, Timothy R; Mahoney, Keegan J

    2017-11-01

    In vascular access practices, the internal vessel size is considered important, and a catheter to vessel ratio (CVR) is recommended to assist clinicians in selecting the most appropriate-sized device for the vessel. In 2016, new practice recommendations stated that the CVR can increase from 33 to 45% of the vessels diameter. There has been evidence on larger diameter catheters and increased thrombosis risk in recent literature, while insufficient information established on what relationship to vessel size is appropriate for any intra-vascular device. Earlier references to clinical standards and guidelines did not clearly address vessel size in relation to the area consumed or external catheter diameter. The aim of this manuscript is to present catheter-related thrombosis evidence and develop a standardized process of ultrasound-guided vessel assessment, integrating CVR, Virchow's triad phenomenon and vessel health and preservation strategies, empowering an evidence-based approach to device placement. Through review, calculation and assessment on the areas of the 33 and 45% rule, a preliminary clinical tool was developed to assist clinicians make cognizant decisions when placing intravascular devices relating to target vessel size, focusing on potential reduction in catheter-related thrombosis. Increasing the understanding and utilization of CVRs will lead to a safer, more consistent approach to device placement, with potential thrombosis reduction strategies. The future of evidence-based data relies on the clinician to capture accurate vessel measurements and device-related outcomes. This will lead to a more dependable data pool, driving the relationship of catheter-related thrombosis and vascular assessment.

  14. Technique of Peritoneal Catheter Placement under Fluoroscopic Guidance

    International Nuclear Information System (INIS)

    Abdel-Aal, A.K.; Gaddikeri, S.; Saddekni, S.

    2011-01-01

    Peritoneal catheters are mainly used for peritoneal dialysis in patients with end-stage renal disease. Other uses of this catheter include intraperitoneal chemotherapy and gene therapy for ovarian cancer and draining of uncontrolled refractory ascites in patients with liver cirrhosis. Traditionally, surgeons place most of these peritoneal catheters either by laparoscopy or open laparotomy. We detail our percutaneous approach to placing peritoneal catheters using fluoroscopic guidance. We emphasize the use of additional ultrasound guidance, including gray scale and color Doppler ultrasound, to determine the safest puncture site and to guide the initial needle puncture in order to avoid bowel perforation and injury to epigastric artery. We present our experience in placing peritoneal catheters using this technique in 95 patients with various indications. Fluoroscopic guided percutaneous placement of peritoneal catheters is a safe, minimally invasive, and effective alternative to open surgical or laparoscopic placement.

  15. The radiation analyses of ITER lower ports

    International Nuclear Information System (INIS)

    Petrizzi, L.; Brolatti, G.; Martin, A.; Loughlin, M.; Moro, F.; Villari, R.

    2010-01-01

    The ITER Vacuum Vessel has upper, equatorial, and lower ports used for equipment installation, diagnostics, heating and current drive systems, cryo-vacuum pumping, and access inside the vessel for maintenance. At the level of the divertor, the nine lower ports for remote handling, cryo-vacuum pumping and diagnostic are inclined downwards and toroidally located each every 40 o . The cryopump port has additionally a branch to allocate a second cryopump. The ports, as openings in the Vacuum Vessel, permit radiation streaming out of the vessel which affects the heating in the components in the outer regions of the machine inside and outside the ports. Safety concerns are also raised with respect to the dose after shutdown at the cryostat behind the ports: in such zones the radiation dose level must be kept below the regulatory limit to allow personnel access for maintenance purposes. Neutronic analyses have been required to qualify the ITER project related to the lower ports. A 3-D model was used to take into account full details of the ports and the lower machine surroundings. MCNP version 5 1.40 has been used with the FENDL 2.1 nuclear data library. The ITER 40 o model distributed by the ITER Organization was developed in the lower part to include the relevant details. The results of a first analysis, focused on cryopump system only, were recently published. In this paper more complete data on the cryopump port and analysis for the remote handling port and the diagnostic rack are presented; the results of both analyses give a complete map of the radiation loads in the outer divertor ports. Nuclear heating, dpa, tritium production, and dose rates after shutdown are provided and the implications for the design are discussed.

  16. Short Implants: New Horizon in Implant Dentistry.

    Science.gov (United States)

    Jain, Neha; Gulati, Manisha; Garg, Meenu; Pathak, Chetan

    2016-09-01

    The choice of implant length is an essential factor in deciding the survival rates of these implants and the overall success of the prosthesis. Placing an implant in the posterior part of the maxilla and mandible has always been very critical due to poor bone quality and quantity. Long implants can be placed in association with complex surgical procedures such as sinus lift and bone augmentation. These techniques are associated with higher cost, increased treatment time and greater morbidity. Hence, there is need for a less invasive treatment option in areas of poor bone quantity and quality. Data related to survival rates of short implants, their design and prosthetic considerations has been compiled and structured in this manuscript with emphasis on the indications, advantages of short implants and critical biomechanical factors to be taken into consideration when choosing to place them. Studies have shown that comparable success rates can be achieved with short implants as those with long implants by decreasing the lateral forces to the prosthesis, eliminating cantilevers, increasing implant surface area and improving implant to abutment connection. Short implants can be considered as an effective treatment alternative in resorbed ridges. Short implants can be considered as a viable treatment option in atrophic ridge cases in order to avoid complex surgical procedures required to place long implants. With improvement in the implant surface geometry and surface texture, there is an increase in the bone implant contact area which provides a good primary stability during osseo-integration.

  17. Embolization of brain arteriovenous malformations using tracker catheter

    International Nuclear Information System (INIS)

    Kim, Sun Yong; Son, Mi Young; Jang, Jae Chun; Hwang, Mi Soo; Park, Bok Hwan

    1990-01-01

    With the recent advance in micro catheters, steerable guide wires, balloons, embolic materials and digital subtraction angiography (DSA), as well as technical refinements in endovascular surgery, there has been a revolution in therapeutic strategies for cerebral arteriovenous malformations (AVMs). We have performed super selective angiography and embolization with Tracker micro catheter about 12 cases of brain AVMs for therapeutic and preoperative aims. This micro catheter and guide wire provided high selectivity of feeding artery, greater maneuverability and useful for deliver various embolus materials

  18. Successful Use of Modified Suprapubic Catheter to Rescue Prostatorectal Fistula

    Directory of Open Access Journals (Sweden)

    Yi-Chun Chiu

    2008-06-01

    Full Text Available Prostatorectal fistula is a complication following radiotherapy. It remains a clinical challenge to treat because most patients experience a poor quality of life. This case report discusses a modified suprapubic catheter for use in a patient with a prostatorectal fistula that developed after radiotherapy for localized prostate cancer. It is an inexpensive, easily available, and more patient-tolerable catheter that improves quality of life. Herein, we describe the development of this catheter.

  19. Percutaneous Selective Embolectomy using a Fogarty Thru-Lumen Catheter for Pancreas Graft Thrombosis: A Case Report

    International Nuclear Information System (INIS)

    Izaki, Kenta; Yamaguchi, Masato; Matsumoto, Ippei; Shinzeki, Makoto; Ku, Yonson; Sugimura, Kazuro; Sugimoto, Koji

    2011-01-01

    A 57-year-old woman with a history of diabetes mellitus underwent simultaneous pancreas–kidney transplantation. The pancreaticoduodenal graft was implanted in the right iliac fossa. The donor’s portal vein was anastomosed to the recipient’s inferior vena cava (IVC). Seven days after the surgery, a thrombus was detected in the graft veins. Percutaneous thrombolysis was immediately performed; however, venous congestion was still present. We therefore attempted selective embolectomy using a Fogarty Thru-Lumen Catheter. Thrombi were directed from the graft veins toward the IVC and captured in the IVC filter with complete elimination of the thrombus without any major complications. We present our technique for the successful treatment of pancreas graft thrombosis within a short time period by percutaneous selective embolectomy using a Fogarty Thru-Lumen Catheter.

  20. Analog experiment of transarterial catheter hyperthermic infusion in vitro

    International Nuclear Information System (INIS)

    Fan Shufeng Li Zheng; Gu Weizhong; Ru Fuming

    2006-01-01

    Objective: To investigate the factors related to the heating effect by transarterial catheter hyperthermic infusion with the evaluation of the feasibility in controlling the tumor temperature. Methods: Infusing 55-68 degree C liquid at the speed of 10-40 ml/min through 6F, 5F or 3F catheter with different length respectively under the similar clinical condition. The liquid temperature at the terminal exit of the catheter was measured with a digital thermometer. The factors related to the liquid temperature at the exit of the catheter were analyzed by multiple regression analysis. Results: The infusion temperature , rate and the catheter length were the main related factors to the liquid temperature at the exit of the catheter as the condition similar in clinical use. When 60-65 degree C liquid was infused at the rate of 20-40 ml/min through 5F catheter with length of 80 cm, the mean and 95% confident interval of the liquid temperature at the catheter exit were (47.55±0.44) degree C and 44.61-48.49 degree C respectively. Conclusions: The liquid temperature at the exit of infusion catheter can be regulated and controlled through adjusting the liquid perfusion temperature and speed. (authors)

  1. Port-Orford-Cedar Root Disease

    Science.gov (United States)

    Lewis F. Roth; Robert D. Jr. Harvey; John T. Kliejunas

    1987-01-01

    The most serious disease of Port-Orford-cedar (Chamaecyparis lawsoniana (A. Murr.) Parl.) is a root disease caused by the fungus Phytophthora lateralis. Nursery stock, ornamentals, and timber trees are subject to attack. Other species of Chamaecyparis are less susceptible than Port-Orford-cedar, and trees of other genera are not affected.

  2. Are we connected? : Ports in Global Networks

    NARCIS (Netherlands)

    R.A. Zuidwijk (Rob)

    2015-01-01

    markdownabstractAbstract Global supply chains are built on organizational, information, and logistics networks. Ports are connected via these networks and also need to connect these networks. Synchromodality is an innovative concept for container transportation, and the port plays an important

  3. Lessons from Hurricane Sandy for port resilience.

    Science.gov (United States)

    2013-12-01

    New York Harbor was directly in the path of the most damaging part of Hurricane Sandy causing significant impact on many of the : facilities of the Port of New York and New Jersey. The U.S. Coast Guard closed the entire Port to all traffic before the...

  4. Visual Support for Porting Large Code Bases

    NARCIS (Netherlands)

    Broeksema, Bertjan; Telea, Alexandru

    2011-01-01

    We present a tool that helps C/C++ developers to estimate the effort and automate software porting. Our tool supports project leaders in planning a porting project by showing where a project must be changed, how many changes are needed, what kinds of changes are needed, and how these interact with

  5. Single port VATS: recent developments in Asia.

    Science.gov (United States)

    Yu, Peter S Y; Capili, Freddie; Ng, Calvin S H

    2016-03-01

    Single port video-assisted thoracic surgery (VATS) is the most recent evolution in minimally invasive thoracic surgery. With increasing global popularity, the single port VATS approach has been adopted by experienced thoracic surgeons in many Asian countries. From initial experience of single port VATS lobectomy to the more complex sleeve resection procedures now forming part of daily practice in some Asia institutes, the region has been the proving ground for single port VATS approaches' feasibility and safety. In addition, certain technical refinements in single port VATS lung resection and lymph node dissection have also sprung from Asia. Novel equipment designed to facilitate single port VATS allowing further reduce access trauma are being realized by the partnership between surgeons and the industries. Advanced thoracoscopes and staplers that are narrower and more maneuverable are particularly important in the smaller habitus of patients from Asia. These and similar new generation equipment are being applied to single port VATS in novel ways. As dedicated thoracic surgeons in the region continue to striving for excellence, innovative ideas in single incision access including subxiphoid and embryonic natural-orifice transluminal endoscopic surgery (e-NOTES) have been explored. Adjunct techniques and technology used in association with single port VATS such as non-intubated surgery, hybrid operating room image guidance and electromagnetic navigational bronchoscopy are all in rapid development in Asia.

  6. Cyber security in ports : Business as usual

    NARCIS (Netherlands)

    Moerel, Lokke; Dezeure, Freddy

    2017-01-01

    Our paper summarizes the risks and provides concrete and pragmatic proposals to increase substantially the cyber maturity and resilience in the ports by organizing training and awareness raising, fostering cooperation and information exchange both between the stakeholders in the ports and across the

  7. On Distributed Port-Hamiltonian Process Systems

    NARCIS (Netherlands)

    Lopezlena, Ricardo; Scherpen, Jacquelien M.A.

    2004-01-01

    In this paper we use the term distributed port-Hamiltonian Process Systems (DPHPS) to refer to the result of merging the theory of distributed Port-Hamiltonian systems (DPHS) with the theory of process systems (PS). Such concept is useful for combining the systematic interconnection of PHS with the

  8. Rotterdam as a World Port City

    NARCIS (Netherlands)

    Wouter Jacobs; Menno Huijs; Isabelle Vries

    2015-01-01

    Most studies and models on the port-city interface focus on the inevitable process in which ports and cities grow apart, both spatially and economically. What is often overlooked is the relationships that remain in the form of maritime business services (finance, insurance, legal). These maritime

  9. Working with Nature in Wadden Sea Ports

    NARCIS (Netherlands)

    Baptist, M.J.; Eekelen, van E.; Dankers, P.J.T.; Grasmeijer, B.; Kessel, van T.; Maren, van D.S.

    2017-01-01

    Wadden Sea ports are situated at the border of the UNESCO World Heritage site Wadden Sea. Because of the protected status of this area, developing new economic activities is not straightforward. However, maintaining and developing port activities is needed to safeguard the economic viability of the

  10. Dry Port Development: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Fatimazahra BENTALEB

    2015-12-01

    Full Text Available Studies on dry ports as nodes in multimodal transport have been expanded to decrease the mounting congestion on seaports. The principal objective of this study is to inspect how dry port researches have been conducted from different perspective. This paper tries to recap the existing researches that aimed to study dry port concept via a systematic review, to present a general overview of the researches on our relevant region and propose a classification for these researches. This paper present a systematic review of dry port that looks to illustrate the progress of researches on this area between 1986 and 2015, collecting researches on dry port concept and analyzing the main characteristics of the dry port development and their contribution to the multimodal transport. The results indicated that most dry port studies considerate the strategic level and concentrate in the Asian continent. Studies regarding other decision levels and continents have to be developed in further researches. Although the existing studies make a contribution in dry port concept, they allow gaps in terms of operational and tactical decision levels considering their limited geographical region.

  11. Laser treatment of Port-wine stains

    OpenAIRE

    Boffa, Michael J.

    2001-01-01

    A state-of-the-art pulsed dye laser machine to treat port-wine stains and other vascular lesions has been available in the Malta Health Service since 1999. This article reviews the pathophysiology and clinical features of port- wine stains and describes the principles of laser treatment for this condition.

  12. [Home anti-cancer therapy with a venous port].

    Science.gov (United States)

    Muto, A; Ashino, Y; Miyazawa, M; Sato, M; Kanno, A; Kawahara, Y; Fujita, Y; Matsushiro, T

    2000-12-01

    Home anti-cancer chemotherapy and palliation in the terminal stage were performed for patients with advanced cancer of the digestive system, using a venous port implanted beneath the skin via the subclavian vein. Patients under 75 years of age (5 with esophageal, 61 gastric, 59 colorectal, 5 cholangio, 5 pancreatic, 1 hepatic and 1 ileal cancer) were treated. With two portable balloon pumps, continuous intravenous infusion of 5-FU (300 or 400 mg/body/day) combined low-dose injection of cisplatin (5 mg/body/day) was continued for 10 days, and repeated 3 times for 6 weeks. The response rate was 17.9% in 78 patients according to valuation of the tumor mass. In 119 patients also undergoing a tumor marker evaluation, an effect was seen in 26.1%. No severe side effects such as renal dysfunction or bone marrow suppression were seen, and no special infusion was needed. Therefore, such treatment can be continued for a long time. Use of a venous port should make easy the switchover to HPN and the amelioration of the symptoms of the terminal stage, such as pain, and helps patients cope with the worry. Therefore, the present technique is useful in a series of cancer treatments including surgery, chemotherapy and the amelioration of symptoms.

  13. Repetitive transarterial chemoembolization (rTACE) of hepatocellular carcinoma: comparisons between an arterial port system and conventional angiographic technique

    International Nuclear Information System (INIS)

    Hidajat, Nico; Griesshaber, Volker; Hildebrandt, Bert; Hosten, Norbert; Schroeder, Ralf-Juergen; Felix, Roland

    2004-01-01

    Purpose: To compare the cost and radiation exposure of repetitive transarterial chemoembolization (rTACE) using percutaneously implantable port system with rTACE using conventional catheterization technique. Materials and methods: In five patients with unresectable hepatocellular carcinoma, three cycles of TACE were performed using conventional technique and six cycles using port. The cumulative cost of material and contrast agent and dose area product (DAP) were compared with the cost and DAP that would be expected if the rTACE was performed conventionally. Results: The cost of material and contrast agent was 1002.6 Euro after three cycles of TACE using conventional technique and six cycles using port, but would be 1111.8 Euro if the nine cycles were performed using conventional technique alone. The rTACE with three cycles using conventional technique and six cycles using port led to ∼63% of the cumulative DAP that would be expected in rTACE using conventional technique alone. Conclusion: In rTACE, the use of percutaneously implantable port system might enable a reduction of cost and radiation exposure

  14. Ports Primer: 3.3 Federal and International Governance

    Science.gov (United States)

    State and local governments are important players in port governance and in oversight of transportation projects that may affect ports. Private corporations may also play a role if they lease or own a terminal at a port.

  15. Implantation, recoil implantation, and sputtering

    International Nuclear Information System (INIS)

    Kelly, R.

    1984-01-01

    Underlying ion-beam modification of surfaces is the more basic subject of particle-surface interaction. The ideas can be grouped into forward and backward features, i.e. those affecting the interior of the target and those leading to particle expulsion. Forward effects include the stopping of the incident particles and the deposition of energy, both governed by integral equations which are easily set up but difficult to solve. Closely related is recoil implantation where emphasis is placed not on the stopping of the incident particles but on their interaction with target atoms with resulting implantation of these atoms. Backward effects, all of which are denoted as sputtering, are in general either of collisional, thermal, electronic, or exfoliational origin. (Auth.)

  16. Two-port access versus four-port access laparoscopic ovarian cystectomy.

    Science.gov (United States)

    Choi, Won-Kyu; Kim, Jang-Kew; Yang, Jung-Bo; Ko, Young-Bok; Nam, Sang-Lyun; Lee, Ki-Hwan

    2014-09-01

    This study was conducted to compare the surgical outcomes between two-port access and four-port access laparoscopic ovarian cystectomy. Four hundred and eighty nine patients who had received two-port access laparoscopic ovarian cystectomy (n=175) and four-port access laparoscopic ovarian cystectomy (n=314) in Chungnam National University Hospital from January 2009 to August 2012 were analyzed retrospectively. The data were compared between the bilaterality of the cysts and cyst diameter of less than 6 cm and 6 cm or more. There were no significant differences in patient's age, parity, body weight, body mass index and history of previous surgery between the two-port and four-port access laparoscopy group. Bilaterality of ovarian cysts was more in fourport access laparoscopy group (13.7% vs. 32.5%, P=0.000). There were no significant differences in operation time, hemoglobin change, hospital stay, adhesiolysis, transfusion, and insertion of hemo-vac between the two-port and four-port access laparoscopy group for size matched compare. However additional analgesics were more in four-port access laparoscopy group for unilateral ovarian cystectomy. Two-port access laparoscopic surgery was feasible and safe for unilateral and bilateral ovarian cystectomy compare with four-port access laparoscopic surgery.

  17. Influence of Port Policy on the Development of Croatian Container Ports

    Directory of Open Access Journals (Sweden)

    Čedomir Dundović

    2002-03-01

    Full Text Available It is important to consider the port development throughoutthe world from the aspect of economical, transport and portpolicy and their mutual impact on commerce and efficiency ofports. By examining such relations in the context of developmentof the Croatian container ports, it is possible to define reasonsfor lagging behind of Croatian ports compared to theworld movements.The main reason for the negative trend of development ofCroatian container ports lies in the non-existence of adequatemeasures of transport, maritime and port policy. Analysis ofstatistics over the past decade and comparison of structure andvolume of the general cargo traffic in the Rijeka port and theneighbouring ports in the area of North Adriatic are both showingsignificant size discrepancy and uncompetitiveness of theCroatian port. Disturbances that have brought to such a situationresult from inadequate port policy and non-harmonisedactivities between various modes of transport.In order to overcome such situation, the authors suggest determiningof clear tasks, goals and measures of the port policythat have to be undertaken so that the Croatian policy could becompatible with the main aspects, development tendencies andmeasures of theE U port policy.

  18. Colonial Origins of the Port of Buenaventura

    Directory of Open Access Journals (Sweden)

    Alonso Valencia Llano

    2014-07-01

    Full Text Available This article studies the origins of the Port of Buenaventura in the New Kingdom of Granada. It begins with the process of exploration of the coastal territory in order to highlight the different sites in which it was situated, demonstrating that it began as a river port and was later resituated and gradually converted into a maritime port. In addition, this article analyzes the problems it faced, such as the dificulty of communication with the interior of the country, the indigenous resistance that caused the destruction of the town, and inally the necessity of populating the zone with black slaves in order to exploit the mining border. This study also discusses how this port was controlled by the elite of the city of Cali, until the Republican period when it became the sole Colombian port on the Paciic Ocean.

  19. Integrated circuit test-port architecture and method and apparatus of test-port generation

    Science.gov (United States)

    Teifel, John

    2016-04-12

    A method and apparatus are provided for generating RTL code for a test-port interface of an integrated circuit. In an embodiment, a test-port table is provided as input data. A computer automatically parses the test-port table into data structures and analyzes it to determine input, output, local, and output-enable port names. The computer generates address-detect and test-enable logic constructed from combinational functions. The computer generates one-hot multiplexer logic for at least some of the output ports. The one-hot multiplexer logic for each port is generated so as to enable the port to toggle between data signals and test signals. The computer then completes the generation of the RTL code.

  20. Dual-port distal gastrectomy for the early gastric cancer

    OpenAIRE

    Kashiwagi, Hiroyuki; Kumagai, Kenta; Monma, Eiji; Nozue, Mutsumi

    2014-01-01

    Background Although recent trends in laparoscopic procedures have been toward minimizing the number of incisions, four or five ports are normally required to complete laparoscopic gastrectomy because of the complexity of this procedure. Multi-channel ports, such as the SILS port (Covidien, JAPAN), are now available and are crucial for performing single-incision laparoscopic surgery (SILS) or reduced port surgery (RPS). We carried out reduced port distal gastrectomy (RPDG) using a dual-port me...

  1. E-Commerce in Ports

    Directory of Open Access Journals (Sweden)

    Elen Twrdy

    2002-01-01

    Full Text Available EDI (Electronic Data Interchange and electronic businessshould be looked upon as a natural evolution in the internationaltrade and transport cycle. One of the principal reasonsfor starting to use EDI are the heaps of documents written,shifted, handled, conected, transcribed and copied for normalbusiness and administrative transactions. EDJ and in generalelectronic business would have none of the disadvantages ofpaper documents and have already brought substantial benefitsand savings to companies that implement it.Most port community systems today still do not provide forelectronic transfer of funds or for electronic interchange of invoicesand other trade documents, for instance bills of lading.Such services are specific toe-business and they are the necessarytransport-related documents.

  2. Coronary angioplasty with second generation Monorail catheters.

    Science.gov (United States)

    Pande, A K; Meier, B; Urban, P; Villavicencio, R; de la Serna, F; Moles, V

    1991-07-01

    The Monorail system (Schneider) consists of a balloon catheter in which the guidewire passes through the balloon itself, exits the catheter proximal to the balloon, and runs alongside its small shaft (3 French) through the length of the guiding catheter. It offers distinct advantages over conventional systems of coronary angioplasty. It facilitates contrast injections and permits rapid balloon exchanges. This system was used for coronary angioplasty in 273 unselected consecutive patients (age 59 +/- 10, mean 35 to 73 years). There were 216 patients (84%) undergoing single-vessel and 57 patients (16%) with multi-vessel coronary angioplasty. A total of 335 coronary stenoses were dilated, which included 35 total occlusions. The size of balloon used ranged from 2.0 to 4.25 mm (3.0 +/- 0.5 mm) and the severity of stenosis was 85 +/- 11%. Technical success was defined as a residual stenosis of less than 50% as determined angiographically. Clinical success was defined as technical success, and absence of a major inhospital complication defined as absence of myocardial infarction, lack of need for coronary arterial bypass surgery, and survival. The Monorail system was technically successful in 294/300 stenotic lesions (98%). It was clinically successful for 281 lesions (94%). Of the 35 total occlusions, technical success was obtained in 25 (71%). The residual stenosis of successful cases was 26 +/- 21%. The Monorail system was also successful in 5 patients with stenosis of more than 90% in whom conventional systems failed. The complications included acute occlusion causing acute myocardial infarction in 13 cases (5%), emergency coronary arterial bypass surgery in 1 patient (0.4%), and death in 4 patients (1.5%).(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Modification of conservative treatment of heterotopic cervical pregnancy by Foley catheter balloon fixation with cerclage sutures at the level of the external cervical os: a case report

    Directory of Open Access Journals (Sweden)

    Vujisic Sanja

    2010-07-01

    Full Text Available Abstract Introduction Conservative treatment of a heterotopic cervical pregnancy was performed with a modification of the fixation of a Foley catheter at the level of the external cervical os, followed by the ligature of the descending cervical branches of the uterine arteries and systemic methotrexate application. Case presentation A 34-year-old Caucasian woman was diagnosed with double gestation after 6 weeks of in vitro fertilization treatment. A gynecological examination and color Doppler ultrasound scan revealed intra-uterine and cervical gestational sacs both containing live fetuses. A Foley catheter balloon was inserted into the cervical canal, inflated and fixed by a cerclage suture at the level of the external cervical os, followed by ligation of the descending cervical branches of the uterine arteries. Systemic methotrexate was applied. Three days after removal of the Foley catheter, an evacuation of the intra-uterine gestational sac was performed. Hemorrhage from the implantation site was controlled immediately and a pregnancy termination was successfully performed. The procedure was uneventful and our patient was discharged with a preserved uterus. Conclusions Conservative treatment of cervical pregnancy using a Foley catheter balloon is more efficacious if the Foley catheter balloon is attached in the correct position with a cerclage suture at the level of the external os, followed by ligation of the descending cervical branches of the uterine arteries, thereby exerting maximal pressure on the bleeding vessels.

  4. The Practice of Guangzhou Port Planning Environmental Impact Assessment

    Science.gov (United States)

    Wang, Ning; Zhao, Junjie; Shou, Youping; Qiao, Jianzhe; Dong, Shipei; Zhang, Lu

    2018-01-01

    In this paper, the effects of the implementation of Guangzhou port plan were analyzed from hydrological condition, water environment and ecological environment. Regional water environmental carrying capacity was analyzed. Guangzhou port is a main port in the coast of China, it is an important port of foreign trade in south China, it is an important port for energy supplies and raw materials in Guangdong province [1]. With the shipping channel condition improvement and the construction of large specialized container port area, Guangzhou port will gradually become trunk line port of container transport in south China.

  5. Where does the pulmonary artery catheter float: Transesophageal echocardiography evaluation

    Directory of Open Access Journals (Sweden)

    Deepak K Tempe

    2015-01-01

    Full Text Available Background: Pulmonary artery (PA catheter provides a variety of cardiac and hemodynamic parameters. In majority of the patients, the catheter tends to float in the right pulmonary artery (RPA than the left pulmonary artery (LPA. We evaluated the location of PA catheter with the help of transesophageal echocardiography (TEE to know the incidence of its localization. Three views were utilized for this purpose; midesophageal ascending aorta (AA short-axis view, modified mid esophageal aortic valve long-axis view, and modified bicaval view. Methods: We enrolled 135 patients undergoing elective cardiac surgery where both the PA catheter and TEE were to be used; for this prospective observational study. PA catheter was visualized by TEE in the above mentioned views and the degree of clarity of visualization by three views was also noted. Position of the PA catheter was further confirmed by a postoperative chest radiograph. Results: One patient was excluded from the data analysis. PA catheter was visualized in RPA in 129 patients (96% and in LPA in 4 patients (3%. In 1 patient, the catheter was visualized in main PA in the chest radiograph. The midesophageal AA short-axis, modified aortic valve long-axis, and modified bicaval view provided good visualization in 51.45%, 57.4%, and 62.3% patients respectively. Taken together, PA catheter visualization was good in 128 (95.5% patients. Conclusion: We conclude that the PA catheter has a high probability of entering the RPA as compared to LPA (96% vs. 3% and TEE provides good visualization of the catheter in RPA.

  6. Dosimetric equivalence of nonstandard HDR brachytherapy catheter patterns

    International Nuclear Information System (INIS)

    Cunha, J. A. M.; Hsu, I-C.; Pouliot, J.

    2009-01-01

    Purpose: To determine whether alternative high dose rate prostate brachytherapy catheter patterns can result in similar or improved dose distributions while providing better access and reducing trauma. Materials and Methods: Standard prostate cancer high dose rate brachytherapy uses a regular grid of parallel needle positions to guide the catheter insertion. This geometry does not easily allow the physician to avoid piercing the critical structures near the penile bulb nor does it provide position flexibility in the case of pubic arch interference. This study used CT datasets with 3 mm slice spacing from ten previously treated patients and digitized new catheters following three hypothetical catheter patterns: conical, bi-conical, and fireworks. The conical patterns were used to accommodate a robotic delivery using a single entry point. The bi-conical and fireworks patterns were specifically designed to avoid the critical structures near the penile bulb. For each catheter distribution, a plan was optimized with the inverse planning algorithm, IPSA, and compared with the plan used for treatment. Irrelevant of catheter geometry, a plan must fulfill the RTOG-0321 dose criteria for target dose coverage (V 100 Prostate >90%) and organ-at-risk dose sparing (V 75 Bladder 75 Rectum 125 Urethra <<1 cc). Results: The three nonstandard catheter patterns used 16 nonparallel, straight divergent catheters, with entry points in the perineum. Thirty plans from ten patients with prostate sizes ranging from 26 to 89 cc were optimized. All nonstandard patterns fulfilled the RTOG criteria when the clinical plan did. In some cases, the dose distribution was improved by better sparing the organs-at-risk. Conclusion: Alternative catheter patterns can provide the physician with additional ways to treat patients previously considered unsuited for brachytherapy treatment (pubic arch interference) and facilitate robotic guidance of catheter insertion. In addition, alternative catheter

  7. Dual-Lumen Chest Port Infection Rates in Patients with Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Bos, Aaron, E-mail: abos1210@gmail.com; Ahmed, Osman [University of Chicago Medical Center (United States); Jilani, Danial [Wright State University Boonshoft School of Medicine (United States); Giger, Maryellen; Funaki, Brian S.; Zangan, Steven M. [University of Chicago Medical Center (United States)

    2015-06-15

    PurposeThe aim of this study was to investigate dual-lumen chest port infection rates in patients with head and neck cancer (HNC) compared to those with other malignancies (non-HNC).Materials and MethodsAn IRB-approved retrospective study was performed on 1,094 consecutive chest ports placed over a 2-year period. Patients with poor follow-up (n = 53), no oncologic history (n = 13), or single-lumen ports (n = 183) were excluded yielding a study population of 845 patients. The electronic medical records were queried for demographic information, data regarding ports and infections, and imaging review.ResultsHNC patients experienced more infections (42 vs. 30), an increased infection rate per 1,000 catheter days (0.68 vs. 0.21), and more early infections within 30 days compared to non-HNC patients (10 vs. 6) (p < 0.001, p < 0.001, p = 0.02, respectively). An existing tracheostomy at the time of port placement was associated with infection in the HNC group (p = 0.02) but was not an independent risk factor for infection in the study population overall (p = 0.06). There was a significant difference in age, male gender, and right-sided ports between the HNC and non-HNC groups (p < 0.01, p < 0.001, and p = 0.01), although these were not found to be independent risk factors for infection (p = 0.32, p = 0.76, p = 0.16).ConclusionHNC patients are at increased risk for infection of dual-lumen chest ports placed via a jugular approach compared to patients with other malignancies. Tracheostomy is associated with infection in HNC patients but is not an independent risk factor for infection in the oncologic population as a whole.

  8. Dual-Lumen Chest Port Infection Rates in Patients with Head and Neck Cancer

    International Nuclear Information System (INIS)

    Bos, Aaron; Ahmed, Osman; Jilani, Danial; Giger, Maryellen; Funaki, Brian S.; Zangan, Steven M.

    2015-01-01

    PurposeThe aim of this study was to investigate dual-lumen chest port infection rates in patients with head and neck cancer (HNC) compared to those with other malignancies (non-HNC).Materials and MethodsAn IRB-approved retrospective study was performed on 1,094 consecutive chest ports placed over a 2-year period. Patients with poor follow-up (n = 53), no oncologic history (n = 13), or single-lumen ports (n = 183) were excluded yielding a study population of 845 patients. The electronic medical records were queried for demographic information, data regarding ports and infections, and imaging review.ResultsHNC patients experienced more infections (42 vs. 30), an increased infection rate per 1,000 catheter days (0.68 vs. 0.21), and more early infections within 30 days compared to non-HNC patients (10 vs. 6) (p < 0.001, p < 0.001, p = 0.02, respectively). An existing tracheostomy at the time of port placement was associated with infection in the HNC group (p = 0.02) but was not an independent risk factor for infection in the study population overall (p = 0.06). There was a significant difference in age, male gender, and right-sided ports between the HNC and non-HNC groups (p < 0.01, p < 0.001, and p = 0.01), although these were not found to be independent risk factors for infection (p = 0.32, p = 0.76, p = 0.16).ConclusionHNC patients are at increased risk for infection of dual-lumen chest ports placed via a jugular approach compared to patients with other malignancies. Tracheostomy is associated with infection in HNC patients but is not an independent risk factor for infection in the oncologic population as a whole

  9. Use of asymmetric bidirectional catheters with different curvature radius for catheter ablation of cardiac arrhythmias.

    Science.gov (United States)

    Mantziari, Lilian; Suman-Horduna, Irina; Gujic, Marko; Jones, David G; Wong, Tom; Markides, Vias; Foran, John P; Ernst, Sabine

    2013-06-01

    The impact of recently introduced asymmetric bidirectional ablation catheters on procedural parameters and acute success rates of ablation procedures is unknown. We retrospectively analyzed data regarding ablations using a novel bidirectional catheter in a tertiary cardiac center and compared these in 1:5 ratio with a control group of procedures matched for age, gender, operator, and ablation type. A total of 50 cases and 250 controls of median age 60 (50-68) years were studied. Structural heart disease was equally prevalent in both groups (39%) while history of previous ablations was more common in the study arm (54% vs 30%, P = 0.001). Most of the ablation cases were for atrial fibrillation (46%), followed by atrial tachycardia (28%), supraventricular tachycardia (12%), and ventricular tachycardia (14%). Median procedure duration was 128 (52-147) minutes with the bidirectional, versus 143 (105-200) minutes with the conventional catheter (P = 0.232), and median fluoroscopy time was 17 (10-34) minutes versus 23 (12-39) minutes, respectively (P = 0.988). There was a trend toward a lower procedure duration for the atrial tachycardia ablations, 89 (52-147) minutes versus 130 (100-210) minutes, P = 0.064. The procedure was successfully completed in 96% of the bidirectional versus 84% of the control cases (P = 0.151). A negative correlation was observed between the relative fluoroscopy duration and the case number (r = -0.312, P = 0.028), reflecting the learning curve for the bidirectional catheter. The introduction of the bidirectional catheter resulted in no prolongation of procedure parameters and similar success rates, while there was a trend toward a lower procedure duration for atrial tachycardia ablations. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.

  10. Dental Implant Surgery

    Science.gov (United States)

    ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, ... to find out more. Wisdom Teeth Management Wisdom Teeth Management An impacted wisdom tooth can damage neighboring ...

  11. Cochlear Implant

    Directory of Open Access Journals (Sweden)

    Mehrnaz Karimi

    1992-04-01

    Full Text Available People with profound hearing loss are not able to use some kinds of conventional amplifiers due to the nature of their loss . In these people, hearing sense is stimulated only when the auditory nerve is activated via electrical stimulation. This stimulation is possible through cochlear implant. In fact, for the deaf people who have good mental health and can not use surgical and medical treatment and also can not benefit from air and bone conduction hearing aids, this device is used if they have normal central auditory system. The basic parts of the device included: Microphone, speech processor, transmitter, stimulator and receiver, and electrode array.

  12. WE-A-17A-10: Fast, Automatic and Accurate Catheter Reconstruction in HDR Brachytherapy Using An Electromagnetic 3D Tracking System

    Energy Technology Data Exchange (ETDEWEB)

    Poulin, E; Racine, E; Beaulieu, L [CHU de Quebec - Universite Laval, Quebec, Quebec (Canada); Binnekamp, D [Integrated Clinical Solutions and Marketing, Philips Healthcare, Best, DA (Netherlands)

    2014-06-15

    Purpose: In high dose rate brachytherapy (HDR-B), actual catheter reconstruction protocols are slow and errors prompt. The purpose of this study was to evaluate the accuracy and robustness of an electromagnetic (EM) tracking system for improved catheter reconstruction in HDR-B protocols. Methods: For this proof-of-principle, a total of 10 catheters were inserted in gelatin phantoms with different trajectories. Catheters were reconstructed using a Philips-design 18G biopsy needle (used as an EM stylet) and the second generation Aurora Planar Field Generator from Northern Digital Inc. The Aurora EM system exploits alternating current technology and generates 3D points at 40 Hz. Phantoms were also scanned using a μCT (GE Healthcare) and Philips Big Bore clinical CT system with a resolution of 0.089 mm and 2 mm, respectively. Reconstructions using the EM stylet were compared to μCT and CT. To assess the robustness of the EM reconstruction, 5 catheters were reconstructed twice and compared. Results: Reconstruction time for one catheter was 10 seconds or less. This would imply that for a typical clinical implant of 17 catheters, the total reconstruction time would be less than 3 minutes. When compared to the μCT, the mean EM tip identification error was 0.69 ± 0.29 mm while the CT error was 1.08 ± 0.67 mm. The mean 3D distance error was found to be 0.92 ± 0.37 mm and 1.74 ± 1.39 mm for the EM and CT, respectively. EM 3D catheter trajectories were found to be significantly more accurate (unpaired t-test, p < 0.05). A mean difference of less than 0.5 mm was found between successive EM reconstructions. Conclusion: The EM reconstruction was found to be faster, more accurate and more robust than the conventional methods used for catheter reconstruction in HDR-B. This approach can be applied to any type of catheters and applicators. We would like to disclose that the equipments, used in this study, is coming from a collaboration with Philips Medical.

  13. WE-A-17A-10: Fast, Automatic and Accurate Catheter Reconstruction in HDR Brachytherapy Using An Electromagnetic 3D Tracking System

    International Nuclear Information System (INIS)

    Poulin, E; Racine, E; Beaulieu, L; Binnekamp, D

    2014-01-01

    Purpose: In high dose rate brachytherapy (HDR-B), actual catheter reconstruction protocols are slow and errors prompt. The purpose of this study was to evaluate the accuracy and robustness of an electromagnetic (EM) tracking system for improved catheter reconstruction in HDR-B protocols. Methods: For this proof-of-principle, a total of 10 catheters were inserted in gelatin phantoms with different trajectories. Catheters were reconstructed using a Philips-design 18G biopsy needle (used as an EM stylet) and the second generation Aurora Planar Field Generator from Northern Digital Inc. The Aurora EM system exploits alternating current technology and generates 3D points at 40 Hz. Phantoms were also scanned using a μCT (GE Healthcare) and Philips Big Bore clinical CT system with a resolution of 0.089 mm and 2 mm, respectively. Reconstructions using the EM stylet were compared to μCT and CT. To assess the robustness of the EM reconstruction, 5 catheters were reconstructed twice and compared. Results: Reconstruction time for one catheter was 10 seconds or less. This would imply that for a typical clinical implant of 17 catheters, the total reconstruction time would be less than 3 minutes. When compared to the μCT, the mean EM tip identification error was 0.69 ± 0.29 mm while the CT error was 1.08 ± 0.67 mm. The mean 3D distance error was found to be 0.92 ± 0.37 mm and 1.74 ± 1.39 mm for the EM and CT, respectively. EM 3D catheter trajectories were found to be significantly more accurate (unpaired t-test, p < 0.05). A mean difference of less than 0.5 mm was found between successive EM reconstructions. Conclusion: The EM reconstruction was found to be faster, more accurate and more robust than the conventional methods used for catheter reconstruction in HDR-B. This approach can be applied to any type of catheters and applicators. We would like to disclose that the equipments, used in this study, is coming from a collaboration with Philips Medical

  14. Šport in humanistika

    Directory of Open Access Journals (Sweden)

    Jože Vogrinc

    2012-07-01

    Full Text Available O tem, ali je šport »neresen« pojav ali pojav, ki razkriva bistvene razsežnosti tistega, za kar človeku gre, se pogledi razhajajo. Glede na to, da so humanistične študije športa vsaj na prvi pogled nekje na obrobju ved, ki jih združuje Filozofska fakulteta, bi morda veljalo, da ga ne moremo primerjati z globoko resnimi temami, zlasti pa ne z najnovejšimi resnimi zahtevami, ki jih družba postavlja univerzi in znanostim: pripomoči k višji donosnosti in poslovnosti podjetništva ter ohranjati tradicijo in krepiti življenjsko moč naroda. Pa se že pri tem izkaže, da športa ne gre preveč zapostavljati; po eni strani je že nekaj desetletij, kar je postal izjemno kapitalsko zanimivo in donosno področje, v katero podjetniki bodisi vlagajo, da bi dosegali dobičke, bodisi ga podpirajo, da bi z njegovo pomočjo svoje blago povzdignili v simbol pravilno naravnanega načina življenja; po drugi strani pa je tradicija nacionalne pomembnosti vrhunskih športnih izidov in dosežkov le nekaj krajša od drugih načinov mednarodnega uveljavljanja naroda, pomen športnih dosežkov za dokazovanje življenjske moči naroda pa se lahko kosa s pomenom lestvic, kakršne izdajajo mednarodne finančne ustanove o državah, ali lestvic, na katerih najdemo univerze, razvrščene po njihovi pedagoški in znanstveni moči. Pomembnost športa pa podčrtavajo tudi tisti, ki ga ostro kritizirajo in njegovo sodobno vrhunsko različico odklanjajo kot obliko alienacije, manipulacije in ideologije, saj prav športni spektakularizaciji pripisujejo najvišjo napetost, največji pomen in najotipljivejšo moč nad ljudmi, ki bi se morali bojevati za spremembo svojega družbenega položaja in prevrat v vsej družbeni strukturi, pa jih razvedrila, med katerimi ima šport posebej visoko mesto, uspavajo in pomirjajo prav s tem, da njihovo napetost sproščajo v nenevaren odliv socialne energije. Tega kritičnega vidika sodobnega športa ne kaže omejiti zgolj na vrhunski

  15. Suburothelial Bladder Contraction Detection with Implanted Pressure Sensor.

    Directory of Open Access Journals (Sweden)

    Steve J A Majerus

    Full Text Available Managing bladder pressure in patients with neurogenic bladders is needed to improve rehabilitation options, avoid upper tract damage, incontinence, and their associated co-morbidities and mortality. Current methods of determining bladder contractions are not amenable to chronic or ambulatory settings. In this study we evaluated detection of bladder contractions using a novel piezoelectric catheter-free pressure sensor placed in a suburothelial bladder location in animals.Wired prototypes of the pressure monitor were implanted into 2 nonsurvival (feline and canine and one 13-day survival (canine animal. Vesical pressures were obtained from the device in both suburothelial and intraluminal locations and simultaneously from a pressure sensing catheter in the bladder. Intravesical pressure was monitored in the survival animal over 10 days from the suburothelial location and necropsy was performed to assess migration and erosion.In the nonsurvival animals, the average correlation between device and reference catheter data was high during both electrically stimulated bladder contractions and manual compressions (r = 0.93±0.03, r = 0.89±0.03. Measured pressures correlated strongly (r = 0.98±0.02 when the device was placed in the bladder lumen. The survival animal initially recorded physiologic data, but later this deteriorated. However, endstage intraluminal device recordings correlated (r = 0.85±0.13 with the pressure catheter. Significant erosion of the implant through the detrusor was found.This study confirms correlation between suburothelial pressure readings and intravesical bladder pressures. Due to device erosion during ambulatory studies, a wireless implant is recommended for clinical rehabilitation applications.

  16. [A totally implantable venous access device. Implantation in general or local anaesthesia? A retrospective cost analysis].

    Science.gov (United States)

    Schuld, J; Richter, S; Moussavian, M R; Kollmar, O; Schilling, M K

    2009-08-01

    Implantation of venous access port systems can be performed in local or general anesthesia. In spite of the increasing rate of interventionally implanted systems, the surgical cut-down represents a safe alternative. Thus, the question arises whether--in context to the increasing health-economic pressure--open implantation in general anesthesia is still a feasible alternative to implantation in local anesthesia regarding OR efficiency and costs. In a retrospective analysis, 993 patients receiving a totally implantable venous access device between 2001 and 2007 were evaluated regarding OR utilization, turnover times, intraoperative data and costs. Implantations in local (LA) and general anesthesia (GA) were compared. GA was performed in 762 cases (76.6 %), LA was performed in 231 patients (23.3 %). Mean operation time was similar in both groups (LA 47.27 +/- 1.40 min vs. GA 45.41 +/- 0.75 min, p = 0.244). Patients receiving local anesthesia had a significantly shorter stay in the OR unit (LA 95.9 +/- 1.78 min vs. GA 105.92 +/- 0.92 min; p cut (LA 39.57 +/- 0.69 min vs. GA 50.46 +/- 0.52 min; p material costs were significantly lower in the LA group compared with the GA group (LA: 400.72 +/- 8.25 euro vs. GA: 482.86 +/- 6.23 euro; p systems in local anesthesia is superior in comparison to the implantation under general anesthesia regarding procedural times in the OR unit and costs. With the same operation duration, but less personnel and material expenditure, implantation in local anesthesia offers a potential economic advantage by permitting faster changing times. Implantation in GA only should be performed at a special request by the patient or in difficult venous conditions. Georg Thieme Verlag Stuttgart.New York.

  17. TRENDS IN CONTEMPORARY PORT SERVICES MARKETS

    Directory of Open Access Journals (Sweden)

    Hanna Klimek

    2014-12-01

    Full Text Available This article describes the issues associated with functioning of contemporary seaport services markets. The growth of international supply chains, technical progress and the integration processes in shipping, growth of containerization, increasing competition in the seaport services markets and environmental protection regulations make it necessary for port service providers to adapt to the changing expectations and requirements of their customers, both shippers and, especially maritime, carriers. Thus, the activities they undertake are associated with making investments to ensure an adequate capacity to handle cargo, passengers and means of transport, required quality of service, but also with appropriate organization of port supply centres and lead to an improvement of their competitiveness. Both the factors associated with the external and internal environment of seaports affect the changes in the relationship between the supply and demand on port services markets. Contemporary port services markets are characterized by certain phenomena which can be a sign of their adaptation and development. The aim of this article is to present the essence of the port services market and its relationship with the environment, which subject to rapid and significant changes, creates new conditions for the operation of port supply centres and the entire port services market.

  18. Towards Sustainable ASEAN Port Development: Challenges and Opportunities for Vietnamese Ports

    Directory of Open Access Journals (Sweden)

    Saeyeon Roh

    2016-06-01

    Full Text Available Sustainability agendas are challenging port authorities around the world to find ways of operating and managing their ports efficiently and effectively in terms of economic, social, as well as environmental development. In this respect, governments in ASEAN countries have been implementing various green activities seeking to reduce the environmental impact of shipping and related activities. In this connection, most studies in the existing literature mainly focus on the environmental aspects of sustainable development and have not clearly explained what sustainable port development exactly entails. Furthermore, most of these studies emphasized on the impact of port development and overlooked what factors influence sustainable port development. To address these gaps, this research aim to explore the main factors shaping sustainable port development. This was conducted through a comprehensive review of related literature as well as confirmatory in-depth interviews with port authorities. As a result, findings from this research would help identify key elements of sustainable port development from port authorities’ perspective. The challenges, opportunities and managerial implications for Vietnamese ports are also discussed accordingly.

  19. Percutaneous catheter drainage of lung abscess

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Shin; Chun, Kyung Ah; Choi, Hyo Sun; Ha, Hyun Kown; Shinn, Kyung Sub [Catholic University Medical college, Seoul (Korea, Republic of)

    1993-09-15

    From March 1987 to July 1989, six patients (five adults and one child) with lung abscess (size, 5-13 cm in diameter) were treated with percutaneous aspiration and drainage. In each case, the puncture was made where the wall of the abscess was in contact with the pleural surface. An 8 to 10 Fr cartheter was inserted for drainage. Five of 6 had a dynamatic clinical response within 24 hours of the drainage. Percutaneous drainage was successful with complete abscess resolution in four and partial resolution in one patient. No response was seen in the rest one. The duration of drainage ranged from 7 to 18 days(average, 15.5 days) in successful cases. One case of the failure in drainage was due tio persistent aspiration of the neurologically impaired patient. In one patient, the abscess resolved after drainage but recurred after inadvertent removal of the catheter 7 days after insertion. In two patients, concurrent pleural empyema was resolved completely by the drainage. Computed tomography provide anatomic details necessary for choosing the puncture site and avoiding a puncture of the lung parenchyma. Percutaneous catheter drainage is safe and effective method for treating patient with lung abscess.

  20. Percutaneous catheter drainage of lung abscess

    International Nuclear Information System (INIS)

    Kim, Young Shin; Chun, Kyung Ah; Choi, Hyo Sun; Ha, Hyun Kown; Shinn, Kyung Sub

    1993-01-01

    From March 1987 to July 1989, six patients (five adults and one child) with lung abscess (size, 5-13 cm in diameter) were treated with percutaneous aspiration and drainage. In each case, the puncture was made where the wall of the abscess was in contact with the pleural surface. An 8 to 10 Fr cartheter was inserted for drainage. Five of 6 had a dynamatic clinical response within 24 hours of the drainage. Percutaneous drainage was successful with complete abscess resolution in four and partial resolution in one patient. No response was seen in the rest one. The duration of drainage ranged from 7 to 18 days(average, 15.5 days) in successful cases. One case of the failure in drainage was due tio persistent aspiration of the neurologically impaired patient. In one patient, the abscess resolved after drainage but recurred after inadvertent removal of the catheter 7 days after insertion. In two patients, concurrent pleural empyema was resolved completely by the drainage. Computed tomography provide anatomic details necessary for choosing the puncture site and avoiding a puncture of the lung parenchyma. Percutaneous catheter drainage is safe and effective method for treating patient with lung abscess