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Sample records for puncture aspiration injection

  1. [Assessment of amylase and lipase levels following puncture biopsy and fine needle aspiration guided by endoscopic ultrasound in pancreatic lesions].

    Science.gov (United States)

    Membrillo-Romero, Alejandro; Gonzalez-Lanzagorta, Rubén; Rascón-Martínez, Dulce María

    2016-12-14

    Puncture biopsy and fine needle aspiration guided by endoscopic ultrasound has been used as an effective technique and is quickly becoming the procedure of choice for diagnosis and staging in patients suspected of having pancreatic cancer. This procedure has replaced retrograde cholangiopancreatography and brush cytology due to its higher sensitivity for diagnosis, and lower risk of complications. To assess the levels of pancreatic enzymes amylase and lipase, after the puncture biopsy and fine needle aspiration guided by endoscopic ultrasound in pancreatic lesions and the frequency of post-puncture acute pancreatitis. A longitudinal and descriptive study of consecutive cases was performed on outpatients submitted to puncture biopsy and fine needle aspiration guided by endoscopic ultrasound in pancreatic lesions. Levels of pancreatic enzymes such as amylase and lipase were measured before and after the pancreatic puncture. Finally we documented post-puncture pancreatitis cases. A total of 100 patients who had been diagnosed with solid and cystic lesions were included in the study. Significant elevation was found at twice the reference value for lipase in 5 cases (5%) and for amylase in 2 cases (2%), none had clinical symptoms of acute pancreatitis. Eight (8%) of patients presented with mild nonspecific pain with no enzyme elevation compatible with pancreatitis. Pancreatic biopsy needle aspiration guided by endoscopic ultrasound was associated with a low rate of elevated pancreatic enzymes and there were no cases of post-puncture pancreatitis. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  2. [Health education in radiology service: orientations for breast and thyroid aspiration puncture].

    Science.gov (United States)

    Rosini, Ivone; Salum, Nádia Chiodelli

    2013-09-01

    This is a convergent care research developed in a school hospital's radiology service whose purpose is to learn about the concerns and expectations of clients submitted to breast and thyroid Fine Needle Aspiration Puncture. Data collection was conducted from September 2010 to April 2011, through 10 educational meetings in the waiting room interviewing 88 clients. The results show: clients' perception of the test, cancer as a stigma and healthcare education as a confrontation strategy. In addition, they revealed fear of both the procedure and the diagnosis of cancer. Educational practice in the waiting room is a space to decrease anxiety and allows the exchange of experiences and knowledge between professional and client, it also fosters a support network among clients. It is characterized as important space of action to the nurse within radiology service.

  3. Aspiration Alone, Aspiration Plus Steroid Injection and Aspiration Plus Ethanol Injection for Treatment of Dorsal Wrist Ganglions: A Comparative Study among Three Methods

    Directory of Open Access Journals (Sweden)

    Khandoker Abdur Rahim

    2016-01-01

    Full Text Available Background: There are varieties of treatment modalities to treat dorsal wrist ganglion cysts. But none of these has been the standard. So, we designed this study to compare among different treatment modalities. Objective: To compare the effects of aspiration alone, aspiration plus methylprednisone injection and aspiration plus ethanol injection into the dorsal wrist ganglions. Materials and Methods: This prospective study was performed in Dhaka Medical College Hospital, Dhaka from March 2010 to May 2011. Sixty six patients with dorsal wrist ganglions were treated in three groups –– aspiration alone in 24 patients (Group A, aspiration plus methylprednisolone injection into the cyst in 20 patients (Group B and aspiration plus ethanol injection, then reaspiration of the ethanol from the cyst after 3–5 minutes, in 22 patients (Group C. Elastic compression bandage was applied in all patients and recommended for 3 weeks. Follow-up was done at 1, 3, 6 and 12 months and conclusive assessment was done during final visit. Results: The success rate in Group A was seen in 9 patients (37.5%, in Group B in 11 (55% and in Group C in 14 (63.5% patients. The most frequent side-effect was pain during ethanol injection which was relieved by reaspiration of cyst. Conclusion: Injection of ethanol into the dorsal wrist ganglion was associated with higher success rate compared to aspiration and methylprednisolone injection. Further studies with larger sample size should be performed to assess the effect of ethanol injection in this disease.

  4. Aspiration in injections: should we continue or abandon the practice?

    Science.gov (United States)

    Sepah, Yasir; Samad, Lubna; Altaf, Arshad; Halim, Muhammad Sohail; Rajagopalan, Nithya; Javed Khan, Aamir

    2017-01-01

    Aspiration during any kind of injection is meant to ensure that the needle tip is at the desired location during this blind procedure. While aspiration appears to be a simple procedure, it has generated a lot of controversy concerning the perceived benefits and indications. Advocates and opponents of aspiration both make logically sound claims. However, due to scarcity of available data, there is no evidence that this procedure is truly beneficial or unwarranted. Keeping in view the huge number of injections given worldwide, it is important that we draw attention to key questions regarding aspiration that, up till now, remain unanswered. In this review, we have attempted to gather and present literature on aspiration both from published and non-published sources in order to provide not only an exhaustive review of the subject, but also a starting point for further studies on more specific areas requiring clarification. A literature review was conducted using the US National Institute of Health’s PubMed service (including Medline), Google Scholar and Scopus. Guidelines provided by the World Health Organization, Safe Injection Global Network, International Council of Nursing, Center for Disease Control, US Federal Drug Agency, UK National Health Services, British Medical Association, Europe Nursing and Midwifery Council, Public Health Agency Canada, Pakistan Medical Association and International Organization of Standardization recommendations 7886 parts 1-4 for sterile hypodermics were reviewed for relevant information. In addition, curricula of several medical/nursing schools from India, Nigeria and Pakistan, the US pharmacopeia Data from the WHO Program for International Drug Monitoring network in regard to adverse events as a result of not aspirating prior to injection delivery were reviewed. Curricula of selected major medical/nursing schools in India, Nigeria and Pakistan, national therapeutic formularies, product inserts of most commonly used drugs and other

  5. Development of biopsy gun for aspiration and drug injection.

    Science.gov (United States)

    Kang, Hyun Guy; Cho, Sung Ho; Cho, Chang Nho; Kim, Kwang Gi

    2015-04-01

    Tumor samples are required for pathological examinations, and different instruments are generally used to obtain samples of different types of tumors. Among the many methods available for obtaining tumor tissues, gun biopsy is widely used because it is much simpler than incisional biopsy and can collect many more samples than aspiration biopsy. However, conventional biopsy guns cannot simultaneously perform biopsy aspiration, bleeding prevention, and marker injection. In this study, we developed a biopsy gun that can simultaneously perform biopsy aspiration and sample collection, in addition to injecting a styptic agent and marker to prevent bleeding and contamination in the biopsy track. We then used a prototype to evaluate the feasibility of the developed device. The collectable sample size was also assessed. Performance of the biopsy aspiration feature was also evaluated, including the maximum aspiration viscosity. Finally, we tested the maximum amount of drug that can be injected. We found that the biopsy gun developed here is an alternative tool for biopsy collection with improved procedure safety and diagnostic accuracy.

  6. Fabrication of Bonding-Type Hollow Microneedle Array by Injection Molding and Evaluation of its Puncture Characteristics

    Science.gov (United States)

    Ogai, Noriyuki; Sugimura, Ryo; Tamaru, Takuya; Takiguchi, Yoshihiro

    A microneedle array which consists from small needles compared to a conventional metal injection needle is expected as a low invasive transdermal medical treatment device, and many fabrication approach have been conducted. In this study, we fabricated plastic hollow microneedle array by a fabrication method based on the combination of injection molding, bonding and assembly techniques. To evaluate puncture characteristics of the fabricated needle, we measured a puncture force to silicone rubber by experimental equipment using loadcell and automatic stage. Furthermore, we propose and demonstrate a new method to measure actual punctured depth from punctured trace on the needle surface modified by O2 plasma treatment.

  7. Aspiration of coagulated hematoma in the third and fourth ventricles via paracele anterior horn puncture

    Institute of Scientific and Technical Information of China (English)

    Zhi-Qiang Tao; Sheng-Hong Ding

    2016-01-01

    Intraventricular hemorrhage (IVH) is a neurological urgency with a high mortality and unfavorable prognosis.Fast removal of intraventricular blood should be considered as a priority.The current treatments of IVH mainly focus on external ventricular drain and endoscopic aspiration,but neither way can remove the blood in the fourth ventricle easily and relieve the compression of brainstem.Here we report a unique procedure to solve this problem.A 41-year-old male patient who had suffered sudden attack of headache and disturbance of consciousness for 2 h was diagnosed as having high density lesion in thewhole ventricular system by computed tomographic (CT) imaging.An emergent bilateral ventriculopuncture and intraventricular hematoma removal under non-line-of-sight was performed immediately;the catheter was extended to the fourth ventricle to maximally remove the hematoma.Postoperative CT scan demonstrated total removal of IVH and no sign of extra brain damage.

  8. A Rare Case of Transverse Sinus Venous Thrombosis Simulating Postdural Puncture Headache After Cervical Epidural Injection.

    Science.gov (United States)

    Guirguis, Maged; Jusino, Eduardo; Tolba, Reda; Samuel, Samuel

    2016-08-01

    Postdural puncture headache (PDPH) is a feared complication related to epidural steroid injections. We report a unique case in which all subjective and objective findings indicated the diagnosis of PDPH. However, the patient failed appropriate conservative and interventional management. Therapeutic failure prompted further investigation to establish the correct diagnosis of cerebral venous sinus thrombosis. Cerebral venous sinus thrombosis is a rare, difficult to diagnose, but potentially lethal disorder with nonspecific and variable clinical presentations, including headache and focal neurological deficits. Performing magnetic resonance imaging and magnetic resonance venogram should be considered early, especially in patients who fail to respond to standard interventions for PDPH.

  9. A Randomized Trial Among Compression Plus Nonsteroidal Antiinflammatory Drugs, Aspiration, and Aspiration With Steroid Injection for Nonseptic Olecranon Bursitis.

    Science.gov (United States)

    Kim, Joon Yub; Chung, Seok Won; Kim, Joo Hak; Jung, Jae Hong; Sung, Gwang Young; Oh, Kyung-Soo; Lee, Jong Soo

    2016-03-01

    Olecranon bursitis might be a minor problem in the outpatient clinic but relatively be common to occur. However, there are few well-designed studies comparing approaches to treatment. (1) Which treatment (compression bandaging with nonsteroidal antiinflammatory drugs [NSAIDs], aspiration, or aspiration with steroid injections) is associated with the highest likelihood of resolution of nonseptic olecranon bursitis? (2) Which treatment is associated with earliest resolution of symptoms? (3) What factors are associated with treatment failure by 4 weeks? We enrolled 133 patients from two centers; after applying prespecified exclusions (septic bursitis or concomitant inflammatory arthritis, intraarticular elbow pathology, recent aspiration or steroid injection done elsewhere, and refusal to participate), 90 patients were randomly allocated to receive compression bandaging with NSAIDs (C), aspiration (A), or aspiration with steroid injection (AS) groups (30 patients in each). The groups were similar at baseline in terms of age and gender. Seven patients (four from Group A and three from Group AS) were lost to followup. All patients were followed up weekly for 4 weeks, and the same treatment procedure was repeated if the bursitis recurred with any substantial fluid collection. At 4 weeks, the state of resolution and pain visual analog scale (VAS) were evaluated. Failed resolution was defined as presence of persistent olecranon bursal fluid collection at Week 4 after the initiation of the treatment; on the contrary, if bursal fluid collection was clinically reduced or completely disappeared by the end of Week 4, the treatment was considered successful. We compared the proportion of resolution by Week 4 and the median times to resolution among the treatment groups. In addition, we evaluated whether the resolution affected pain VAS and what factors were associated with the resolution. There were no differences in the proportion of patients whose bursitis resolved by Week 4

  10. Intralesional saline injection for effective ultrasound-guided aspiration of benign viscous cystic thyroid nodules

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Eun Sook; Shin, Jung Hee [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Sung, Jin Yong [Dept. of Radiology, Thyroid Center, Daerim St. Mary' s Hospital, Seoul (Korea, Republic of)

    2014-04-15

    We aimed to evaluate the efficacy and safety of vigorous saline injection for viscous cystic thyroid nodules. Eighteen patients who underwent ultrasound-guided aspiration for viscous cystic thyroid nodules using a saline injection were included in our study. After failing to aspirate the cyst by the usual method, we vigorously injected saline into the cyst in multiple directions to break up and liquefy the viscous cystic contents to enable aspiration. The initial and the residual volume of the nodule were calculated, and the volume reduction rate and the time taken to perform the aspiration were recorded. The mean volume of the cystic nodules before aspiration was 11.0 mL (range, 1.2 to 26.0 mL), while the postaspiration volume was 4.2 mL (range, 0.2 to 14.5 mL). The mean aspirated volume was 63.7% of the initial volume. The mean procedure time was 12.4 minutes (range, 5 to 26 minutes). There were no significant complications related to the procedure. A vigorous saline injection followed by aspiration can be a useful method to aspirate viscous cystic thyroid nodules as a prestep for further intervention or simple management.

  11. Aspiration and triamcinolone acetonide injection of wrist synovial cysts in children.

    Science.gov (United States)

    Colberg, Ricardo E; Sánchez, Carlos F; Lugo-Vicente, Humberto

    2008-11-01

    The aim of this case series report is to assess the effectiveness of aspiration and injection of triamcinolone acetonide for treatment of wrist synovial cysts in children. Twenty-one records of pediatric patients with synovial cyst on the wrist treated with aspiration and triamcinolone acetonide injection were selected for analysis of their outcomes. All cases were aspirated and injected at the operating room under mask induction anesthesia. Three categories were used to classify the patients' outcomes: (1) successful treatment with no recurrence, (2) successful treatment with residual sclerotic lump, and (3) recurrence of cyst. Fourteen females and 7 males with an average age of 7.2 years had a mean time with the cyst of 1 year. All children were asymptomatic. After aspiration, 13 (62%) of 21 patients experienced successful treatment of the synovial cyst with no recurrence after a single intervention. Five patients had a residual lump at the site of the cyst (24%), which disappeared after an average of 6 months. Three patients experienced true recurrence of the synovial cyst (14%). Average follow-up was 2.5 years. Aspiration and injection of triamcinolone accounted for a considerable reduction in recurrence. Aspiration and triamcinolone acetonide injection of wrist synovial cysts is an effective and safe treatment that may be considered as first-line treatment in the pediatric population if there is no resolution after 1 year of observation.

  12. Puncture Wounds

    Science.gov (United States)

    ... page. Please enable Javascript in your browser. Puncture Wounds What Is a Puncture Wound? Puncture wounds are not the same as cuts. ... professional treatment right away. Foreign Bodies in Puncture Wounds A variety of foreign bodies can become embedded ...

  13. Ultrasound-Guided Fine-Needle Aspiration Biopsy of Thyroid Nodules: is it Necessary to Use Local Anesthesia for the Application of One Needle Puncture?

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Wook [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of); Rho, Myung Ho [Myongji Hospital, Kwandong University College of Medicine, Goyang (Korea, Republic of); Kim, Ki Nam [Dong-A University, Busan (Korea, Republic of)

    2009-10-15

    This study was designed to evaluate the difference in the degree of patient pain for an ultrasound-guided fine-needle aspiration biopsy (USFNAB) of a thyroid nodule with one needle puncture with and without local anesthesia. A total of 50 patients participated in the study. We examined prospective patients who would undergo US-FNABs of two thyroid nodules (larger than 10 mm maximum diameter), which were located in separate thyroid lobes. For one of these thyroid nodules, US-FNAB was performed following the administration of local anesthesia; for the other nodule, no anesthesia was administered. The application of anesthesia was alternatively administered between patients (either prior to the first US-FNAB procedure or prior to the second procedure). For all patients, the degree of pain during and after each US-guided FNAB was evaluated according to a 4-category verbal rating scale (VRS), an 11-point numeric rating scale (NRS) and a 100-mm visual analogue scale (VAS). The mean maximum diameters of thyroid nodules examined by US-FNAB with the use of local anesthesia and with no local anesthesia were 13.6 mm and 13.0 mm, respectively. There was no significant difference in nodule size (p > 0.05) between two groups. For the VRS, there were 27 patients with a higher pain score when local anesthesia was used and four patients with a higher pain score when no local anesthesia was administered. Nineteen patients had equivalent pain score for both treatments. This finding was statistically significant (p < 0.001). For the NRS, there were 33 patients with a higher pain score when local anesthesia was used and 10 patients with a higher pain score when no local anesthesia was administered. Seven patients had an equivalent pain score for each treatment. This finding was statistically significant (p < 0.001). For the VAS, there were 35 patients with a higher pain score when local anesthesia was used and 11 patients with a higher pain score where no local anesthesia was

  14. Nasocardiac reflex during aspiration and injection through a nasogastric tube: An infrequent occurrence.

    Science.gov (United States)

    Haldar, Rudrashish; Kaur, Jasleen; Bajwa, Sukhminder Jit Singh

    2015-04-01

    Nasocardiac reflex is a relatively less discussed variant of trigeminovagal reflex where the afferent arc of the reflex is represented by any of the branches of the trigeminal nerves, and the efferent arc is via the vagus nerve. Elicitation of this reflex is commonly seen during surgical manipulation and is manifested as bradycardia or even asystole. We report a case where nasocardiac reflex was unusually observed in a patient when aspiration and injection were done through a nasogastric tube.

  15. Puncture of thoracic lesions under sonographic guidance.

    OpenAIRE

    Afschrift, M; Nachtegaele, P; Voet, D; Noens, L.; Van Hove, W; Van der Straeten, M; Verdonk, G

    1982-01-01

    Thirty-six punctures of thoracic lesions have been performed with a compound B-scanner or a real-time linear-array scanner for guidance. Twenty-three fluid collections were punctured and aspiration biopsies were performed on 13 echogenic lesions. All the punctures were successful at the first attempt. No complications occurred. The results confirm the usefulness of sonography for guiding punctures of thoracic fluid effusions and solid masses. Usually a static B-scanner is sufficient, but when...

  16. [Inadvertent thoracic duct puncture during right axially central venous cannulation].

    Science.gov (United States)

    Kawashima, Shingo; Itagaki, Taiga; Adachi, Yushi; Ishii, Yasuhiro; Taniguchi, Midzuki; Doi, Matsuyuki; Sato, Shigehito

    2010-10-01

    A case of inadvertent thoracic duct puncture during right axially central venous cannulation is reported. The catheterization was performed under the real time ultrasound guidance technique and the coronal view image was continuously displayed. After confirming the feelings of venous puncture, clear yellow fluid was aspired into the connected syringe to the needle. Initially, an accidental thoracic puncture with subsequent pleural fluid aspiration was suspected;however, no finding of pleural effusion was observed with ultrasound imaging and computed tomography. Thus, an accidental thoracic duct puncture and the subsequent lymph fluid aspiration were suspected. Even in a right side approach for central venous catheterization, thoracic duct injury might ensure.

  17. Interventional Treatment by Popliteal Vein Puncture and Transcatheter Aspiration for Acute Lower Extremity Deep Venous Thrombosis%经腘静脉穿刺导管抽吸介入治疗急性下肢深静脉血栓

    Institute of Scientific and Technical Information of China (English)

    申刚; 陈德基; 何明基; 练辉

    2012-01-01

    目的 探讨经腘静脉穿刺导管抽吸治疗急性下肢深静脉血栓(lower extremity deep venous thrombosis,LEDVT)的临床应用价值.方法 对32例LEDVT患者行经腘静脉穿刺导管抽取栓术为主的综合介入治疗,其中行导管血栓抽吸术32例,导管接触溶栓术32例,球囊扩张术18例,支架植入术12例.结果 32例介入治疗有效率100%,患者平均住院时间为8.4d.患肢肿胀、疼痛均于介入治疗后1~2d内开始消退.术后下肢静脉造影复查,静脉通畅率100%.出院时健、患肢膝关节上、下15 cm处周径差及患肢膝关节上、下15 cm处周径与入院时比较,差异有统计学意义(P<0.01).治疗过程中无严重并发症发生.结论 经腘静脉穿刺导管抽吸治疗LEDVT是一种快捷、有效的方法,值得临床推广使用.%Objective To discuss the clinical value of popliteal vein puncture and transcatheter aspiration in the interventional treatment for acute lower extremity deep venous thrombosis(LEDVT). Methods Popliteal vein puncture and synthetic interventional treatment were performed in 32 cases,including catheter-directed thrombolysis in 32 cases,transcatheter aspiration in 32 cases,angioplasty 18 cases,and stenting in 12 cases. Results Total achievement ratio by interventional therapy was 100% ,the average days in hospital was ?.4 days. Swelling and pain in affected limb disappeared or relieved after interventional therapy for 1 ~2 days. Vein patency rate was 100% when 32 patients received lower venography after treatment. Knee joint upper and down IS cm perimeter of uninjured and injured side had statistical difference. Knee joint upper and down 15cm perimeter o f before and after therapy had statistical difference. The cause of treatment does not appear serious complications. Conclusion Popliteal vein puncture and transcatheter aspiration for acute deep venous thrombosis of lower limb is a quick and effective method, with better prognosis, which is worthy to be

  18. Ultrasound-guided aspiration and steroid injection of a posterior cruciate ligament ganglion cyst: report of a case.

    Science.gov (United States)

    Vilella, Giuseppe Maria; Guerrisi, Pietro; Lucignani, Giulia; Pasquali, Gaia; Drudi, Francesco Maria

    2015-09-01

    Ganglion cysts are benign masses that originate from mucinous degeneration of the connective tissues and are quite rare when arising from the knee joint. Symptoms are often represented by pain, joint tenderness, effusion and occasional swelling with a palpable mass in the popliteal region of the knee. Percutaneous aspiration followed by a corticosteroid injection of a ganglion cyst has either a diagnostic or therapeutic meaning and its guidance through ultrasound allows the operator to make more accurate the procedure, ensuring the correct placement of the needle inside the lesion. We report our experience in the treatment of a voluminous ganglion cyst of the posterior cruciate ligament performed through the ultrasound guidance in a symptomatic young patient.

  19. Ectopic bone formation in rapidly fabricated acellular injectable dense collagen-Bioglass hybrid scaffolds via gel aspiration-ejection.

    Science.gov (United States)

    Miri, Amir K; Muja, Naser; Kamranpour, Neysan O; Lepry, William C; Boccaccini, Aldo R; Clarke, Susan A; Nazhat, Showan N

    2016-04-01

    Gel aspiration-ejection (GAE) has recently been introduced as an effective technique for the rapid production of injectable dense collagen (IDC) gel scaffolds with tunable collagen fibrillar densities (CFDs) and microstructures. Herein, a GAE system was applied for the advanced production and delivery of IDC and IDC-Bioglass(®) (IDC-BG) hybrid gel scaffolds for potential bone tissue engineering applications. The efficacy of GAE in generating mineralizable IDC-BG gels (from an initial 75-25 collagen-BG ratio) produced through needle gauge numbers 8G (3.4 mm diameter and 6 wt% CFD) and 14G (1.6 mm diameter and 14 wt% CFD) was investigated. Second harmonic generation (SHG) imaging of as-made gels revealed an increase in collagen fibril alignment with needle gauge number. In vitro mineralization of IDC-BG gels was confirmed where carbonated hydroxyapatite was detected as early as day 1 in simulated body fluid, which progressively increased up to day 14. In vivo mineralization of, and host response to, acellular IDC and IDC-BG gel scaffolds were further investigated following subcutaneous injection in adult rats. Mineralization, neovascularization and cell infiltration into the scaffolds was enhanced by the addition of BG and at day 21 post injection, there was evidence of remodelling of granulation tissue into woven bone-like tissue in IDC-BG. SHG imaging of explanted scaffolds indicated collagen fibril remodelling through cell infiltration and mineralization over time. In sum, the results suggest that IDC-BG hybrid gels have osteoinductive properties and potentially offer a novel therapeutic approach for procedures requiring the injectable delivery of a malleable and dynamic bone graft that mineralizes under physiological conditions.

  20. Puncturing Period on the Performance of Punctured Turbo Codes

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Puncturing is the predominant strategy to construct high code rate turbo codes. Puncturing period is a crucial parameter influencing the performance of punctured turbo codes (PTC). Here we developed a new puncturing scheme of turbo codes, with which the puncturing period on the performance of PTC is studied. Consequently, suggestions on selecting the puncturing period are proposed.

  1. The impact of in situ methotrexate injection after transvaginal ultrasound-guided aspiration of ovarian endometriomas on ovarian response and reproductive outcomes during IVF-cycles

    Directory of Open Access Journals (Sweden)

    H.E. Shawki

    2012-06-01

    Conclusion(s: In situ methotrexate injection after transvaginal ultrasound-guided aspiration was a simple, safe and successful method for treating ovarian endometriomas with minimal effects on ovarian response. Short term effects on reproductive outcomes, risk of fetal loss or anomaly were minimal. Six months was enough as washout period of the drug prior to conception and was advisable to prevent the small chance of chromosomal abnormalities in the offspring.

  2. Joint Injection/Aspiration

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    ... Cryopyrin-Associated Autoinflammatory Syndrome (CAPS) (Juvenile) Dermatomyositis (Juvenile) Familial Mediterranean Fever (Juvenile) Fibromyalgia Giant Cell Arteritis Glucocorticoid-induced Osteoperosis ...

  3. Joint Injection/Aspiration

    Science.gov (United States)

    ... Pharyngitis, Adenitis Syndrome (Juvenile) Polymyalgia Rheumatica Psoriatic Arthritis Raynaud's Phenomenon Reactive Arthritis Rheumatoid Arthritis Scleroderma Sjogren's Syndrome Spinal Stenosis Spondyloarthritis Systemic Lupus Erythematosus (Juvenile) Takayasu's ...

  4. Percutaneous puncture of spinal cysts in the diagnosis and therapy of syringomyelia and cystic tumors

    Energy Technology Data Exchange (ETDEWEB)

    Dietemann, J.L.; Babin, E.; Wackenheim, A.; Maitrot, D.; Bonneville, J.F.

    1982-10-01

    The experience with percutaneous puncture of intraspinal cystic lesions is reported in cases: an extradural cyst demonstrated with air, a spinal cord tumor with lipiodol and two cases of syringomyelia with metrizamide. Percutaneous puncture of cystic lesions makes possible an accurate delineation of the lesion and a histological approach through biochemical and cytological analysis of the aspirated cystic fluid, while aspiration of the fluid of cystic tumors decompresses the spinal cord and thus plays a therapeutic role.

  5. Clinical Analysis of 67 Cases of Lumbar Disc Herniation Treating with the Ozone Injection Through Percutaneous Disc Joint Caudal Puncture%经皮穿刺椎间盘联合骶管穿刺臭氧注射治疗腰椎间盘突出症67例临床分析

    Institute of Scientific and Technical Information of China (English)

    薛洪旺

    2013-01-01

    Objective:To investigate the clinical therapeutic effect and safety of the treatment that percutaneous intervertebral disc combined with sacral canal puncture ozone injection to cure lumbar disc herniation .Methods:67 patients confirmed by CT and/or MRI with lumbar disc herniation,in spiral CT or digital gastrointestinal guided,by 21G multiple side hole puncture needle aspiration lesions of intervertebral disc and intervertebral foramen,intradiscal injection of the concentration of ozone gas 5~10ml 50 μ g/ml,posterior to the intervertebral foramen tissues injected 30µg/ml ozone 20ml, and Through sacral canal injection of 30 μ g/ml ozone 30ml after 3 days,10days.Results:Of the 67 patients were followed up for 1~9months,47 cases were markedly effective,effective in 15 cases,and poor in 5 cases,the total efficiency is 92.54%.The majority of patients after 0.5 to 1 months of symptoms disappeared,and all patients had no serious complications during treatment. Conclusion:Lumbar disc herniation percutaneous intervertebral disc combined with sacral canal injection of medical ozone therapy is a safe and effective and more economic minimally invasive therapy for patients,can achieve satisfactory therapeutic effect.%  目的:探讨腰椎间盘突出症经皮穿刺椎间盘联合骶管穿刺臭氧注射治疗的临床治疗效果以及安全性.方法:67例经CT和/或MRI证实的腰椎间盘突出症患者,在螺旋CT或数字胃肠引导下,用21G多侧孔穿刺针穿刺病变椎间盘内及椎间孔周围,椎间盘内注射浓度为50µg/ml的臭氧气体5~10ml,后向椎间孔周围椎旁组织注入浓度为30µg/ml的臭氧20ml,并于术后3天、10天经骶管注入30µg/ml臭氧30ml.结果:67例患者随访1~9个月,显效47例,有效15例,差5例,总有效率92.54%.大多数患者在术后0.5~1个月症状基本消失,且所有患者在治疗过程中均未有严重并发症发生.结论:腰椎间盘突出症经皮穿刺椎间盘联合骶管注射医用

  6. Emergency airway puncture - slideshow

    Science.gov (United States)

    ... presentations/100113.htm Emergency airway puncture - series—Normal anatomy To ... larynx is a tubular structure in the neck, through which air passes to the lungs. The thryoid and cricoid cartilage form the narrowest ...

  7. Aspiration pneumonia

    Science.gov (United States)

    Anaerobic pneumonia; Aspiration of vomitus; Necrotizing pneumonia; Aspiration pneumonitis ... The type of bacteria that caused the pneumonia depends on: Your ... facility, for example) Whether you were recently hospitalized ...

  8. Bone marrow aspiration

    Science.gov (United States)

    Iliac crest tap; Sternal tap; Leukemia - bone marrow aspiration; Aplastic anemia - bone marrow aspiration; Myelodysplastic syndrome - bone marrow aspiration; Thrombocytopenia - bone marrow aspiration; Myelofibrosis - bone marrow aspiration

  9. Injecting drug use via femoral vein puncture: preliminary findings of a point-of-care ultrasound service for opioid-dependent groin injectors in treatment

    Directory of Open Access Journals (Sweden)

    Senbanjo Richard

    2012-01-01

    Full Text Available Abstract Background Within the UK, injecting in the femoral vein (FV, often called 'groin injecting', is a serious cause of risk and harm. This study aimed to use ultrasound scanning as a means to engage groin injectors (GIs, examine their femoral injecting sites and assess their venous health, with the intention of developing improved responses. Methods Between September 2006 and March 2009, GIs attending a network of community drug treatment centres in South East England were invited to attend an ultrasound 'health-check' clinic. This paper provides a narrative account of the scanning procedure and operation of the service, with descriptive statistical analysis of GIs who attended. The analysis uses a structured, specially-developed clinical data set that incorporates a categorisation for the severity of FV damage. Case studies using ultrasound images and a link to a video are provided to illustrate the range of presentations encountered and the categorisations used for severity. Results A total of 160 groin scans (76 bilateral and 8 unilateral were performed in 84 GIs. The majority were men (69.0% and the mean age of the sample was 36.8 years. The mean duration of drug use and injecting drug use was 19.7 years and 13.8 years, respectively. FV damage at the injecting site in the right groin was graded as minimal in 20 patients (25%, moderate in 27 (33.8%, severe in 16 (20.0% and very-severe in 17 (21.3%. Corresponding figures for left FV were 24 (30.0%, 22 (27.5%, 18 (22.5% and 16 (20.0%. Wide variation was observed in the time to the development of these grades of FV damage. Conclusions Modern, portable ultrasound scanners make it possible to examine the venous health of GIs in community treatment settings. Ultrasound scanning identified extensive FV damage, much hitherto-unrecognised in this population. These findings should further alert clinicians, policy-makers and patients to the urgent need for effective harm reduction responses to GI

  10. In vivo injectable human adipose tissue regeneration by adipose-derived stem cells isolated from the fluid portion of liposuction aspirates.

    Science.gov (United States)

    Dong, Ziqing; Luo, Lin; Liao, Yunjun; Zhang, Yunsong; Gao, Jianhua; Ogawa, Rei; Ou, Chunquan; Zhu, Ming; Yang, Bo; Lu, Feng

    2014-06-01

    Liposuction aspirates separate into fatty and fluid portions. Cells isolated from the fatty portion are termed processed lipoaspirate (PLA) cells and isolated from the fluid portion termed liposuction aspirate fluid (LAF) cells, both of which contain adipose-derived stromal cells (ASCs). Here, we examined the biological differences between PLA and LAF cells and then tested the differentiation capacity of LAF cells in vivo. The cell surface marker and the multiple differentiation ability of fresh isolated PLA and LAF cells and which from passaged 3-5 were examined in vitro. LAF cells were then incubated in adipogenic medium, stained with 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine (DiI), mixed with fibrin glue then injected to nude mice; fibrin glue without cells was as a control. Three months later, the transplants were subjected to macroscopic observation and histological analysis. PLA and LAF cells were similar in growth kinetics, morphology, capacity for differentiation, and surface marker profiles. After plating, both PLA and LAF cells showed increased expression of CD29, CD44, CD133 and HLA DR and decreased expression of CD34. In vivo differentiation assay showed the mixture of LAF cells and fibrin glue formed adipose tissue which contained red fluorescent DiI-positive adipocytes. LAF cells can be harvested more easily than PLA cells. The in vivo adipogenic capacity suggested LAF cells would be useful and valuable for cell-based therapies and soft tissue reconstruction.

  11. Strategic Aspirations

    DEFF Research Database (Denmark)

    Christensen, Lars Thøger; Morsing, Mette; Thyssen, Ole

    2016-01-01

    Strategic aspirations are public announcements designed to inspire, motivate, and create expectations about the future. Vision statements or value declarations are examples of such talk, through which organizations announce their ideal selves and declare what they (intend to) do. While aspirations...... aspirations, in other words, have exploratory and inspirational potential—two features that are highly essential in complex areas such as sustainability and CSR. This entry takes a communicative focus on strategic aspirations, highlighting the value of aspirational talk, understood as ideals and intentions...

  12. Transthoracic needle biopsy of thoracic tumours by a colour Doppler ultrasound puncture guiding device.

    OpenAIRE

    Wang, H C; Yu, C. J.; Chang, D B; Yuan, A; Lee, Y. C.; Yang, P C; Kuo, S H; Luh, K T

    1995-01-01

    BACKGROUND--Ultrasound guided transthoracic needle aspiration biopsy has recently been used to obtain specimens for histological diagnosis of pulmonary and mediastinal tumours. Conventional real time, grey scale puncture guiding devices cannot differentiate vascular structures, and clear visualisation of the needle shaft or tip within a desired target is not always possible. This study describes a new built-in colour Doppler ultrasound puncture guiding device and assesses the relative safety ...

  13. Clinical Application of Surrounding Puncture

    Institute of Scientific and Technical Information of China (English)

    GUO Yao-jie; HAN Chou-ping

    2003-01-01

    Surrounding puncture can stop pathogenic qi from spreading, consolidate the connection between local meridians and enrich local qi and blood, which can eventually supplement anti-pathogenic qi and remove pathogenic qi, and consequently remedy diseases. The author of this article summrized and analyzed the clinical application of surrounding puncture for the purpose of studying this technique and improving the therapeutic effect.

  14. Pulmonary edema following lumbar puncture

    Directory of Open Access Journals (Sweden)

    Gupta D

    1977-01-01

    Full Text Available In a boy of 17 years with disseminated tuberculosis, sudden onset of pulmonary edema following lumbar puncture is described. Possible pat ho-mechanisms have been discussed. The link bet-ween the lumbar puncture and the development of pulmonary edema is not casual.

  15. Ultrasonography-guided punctures-with and without puncture guide.

    Science.gov (United States)

    Desai, Mahesh

    2009-10-01

    The key requisite of any percutaneous nephrolithotomy technique is access to the collecting system. The kidney has a high degree of vascular network and is liable for vascular injury. Therefore, for an ideal puncture, a percutaneous tract would be developed that leads straight from the skin through a papilla and the target calix into the renal pelvis. Percutaneous renal access can be achieved under fluoroscopic control or using an ultrasonography (US)-guided puncture. The shortcomings and side effects of extensive radiation during therapeutic procedures are well known. The choice of method for the type of access depends on training and personal preference. The advantages of US-guided puncture are avoidance of radiation, avoiding adjacent and visceral injury and, most importantly, intrarenal vascular injury. US offers the shortest and straight access to the collecting system with minimal morbidity. US-guided access is of particular importance in the pediatric population and in special situations in which the procedure is performed with the patient in the supine position. I believe US-guided puncture has a significant reduction in complications. The available ultrasound probes come with a puncture attachment and, on US scanning, the puncture pathway is represented by an electronic dotted line on the scanner screen, which facilitates exact placement of the needle. US-guided access is optimal with a needle guide, because the electronic dotted line helps in assessing the depth and plane of the puncture needle. This helps in reaching the desired calix in the most accurate way. US access without a needle guide is useful in bedside procedures, in grossly hydronephrotic systems, and nonavailability of an electronic guide. We think the punctures with this technique are suboptimal. Both methods need a certain degree of training and orientation. The training in US should be structured.

  16. Management of pulmonary aspiration

    NARCIS (Netherlands)

    Janda, Matthias; Scheeren, Thomas W L; Nöldge-Schomburg, Gabriele F E

    2006-01-01

    Pulmonary aspiration of gastric contents in the perioperative phase is associated with increased postoperative morbidity and mortality. For the management of aspiration, differentiation between acid-associated aspiration pneumonitis and aspiration pneumonia as a consequence of a secondary bacterial

  17. Post-dural puncture headache

    Directory of Open Access Journals (Sweden)

    Ghaleb A

    2012-01-01

    Full Text Available Ahmed Ghaleb1, Arjang Khorasani2, Devanand Mangar31Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, 2Anesthesiology Residency Program, Advocate Illinois Masonic Medical Center, Chicago, IL, 3Florida Gulf to Bay Anesthesiology, Tampa General Hospital, Tampa, FL, USAAbstract: Since August Bier reported the first case in 1898, post-dural puncture headache (PDPH has been a problem for patients following dural puncture. Clinical and laboratory research over the last 30 years has shown that use of smaller-gauge needles, particularly of the pencil-point design, are associated with a lower risk of PDPH than traditional cutting point needle tips (Quincke-point needle. A careful history can rule out other causes of headache. A postural component of headache is the sine qua non of PDPH. In high-risk patients < 50 years, post-partum, in the event a large-gauge needle puncture is initiated, an epidural blood patch should be performed within 24–48 hours of dural puncture. The optimum volume of blood has been shown to be 12–20 mL for adult patients. Complications caused by autologous epidural blood patching (AEBP are rare.Keywords: post-dural puncture headache, gauge, needles, cause, risk, incidence

  18. Postdural puncture headache and pregabalin

    Directory of Open Access Journals (Sweden)

    Beyazit Zencirci

    2010-02-01

    Full Text Available Beyazit ZencirciDepartment of Anesthesiology and Reanimation, Mostas Private Health Hospital, Kahramanmaras, TurkeyBackground: Even if carried out under optimal conditions, postdural puncture headache is still a frustrating and unpleasant complication in spinal anesthesia. This syndrome has an estimated incidence from less than 1% to about 5% of patients undergoing spinal anesthesia, even in the highest risk subset, the young, female, and pregnant population.Case presentation: In our two female cases, headaches started following spinal anesthesia on the 11th and 14th hours, respectively. No response was obtained from patients diagnosed with postdural puncture headache with classical treatments such as bed rest, hydration, oral analgesic, and caffeine combination as well as intravenous theophylline application. The treatment of oral pregablin, commonly used for cases that rejected epidural blood patch, caused a significant decrease in headache severity. Later, the two cases whose headaches were completely resolved were discharged from the hospital on the post-operative 7th day.Conclusion: Postdural puncture headache is one of the most common complications of spinal anesthesia. Cerebral spinal fluid leakage into the epidural space has been proposed as the main mechanism responsible for this syndrome. Multiple methods of treatment have been applied with wide-ranging results. We detected that oral pregabalin application caused a significant decrease in the difficult and severe postdural puncture headaches of both our cases who did not respond to conventional treatments.Keywords: postdural puncture headache, spinal anesthesia, pregabalin

  19. 经直肠超声引导精囊穿刺注射药物冲洗治疗精囊炎的研究%Study on Puncturing Seminal Vesicle and Injecting Drugs Under the Guidance of Transrectal Ultrasound to Treat Vesiculitis

    Institute of Scientific and Technical Information of China (English)

    黄进; 李文伦; 张明荣; 张华民; 付世文; 李莉

    2001-01-01

    目的:探讨经直肠超声(TRUS)引导精囊穿刺注射药物冲洗并保留治疗精囊炎的效果。方法:将76例患者随机分为A、B、C三组,A组28例在TRUS引导下穿刺精囊,用灭滴灵250ml冲洗精囊后,注入丁胺卡那霉素0.4g保留;B组28例在TRUS引导下穿刺精囊,用生理盐水250ml冲洗精囊,注入丁胺卡那霉素0.4g保留,两组均每隔10天治疗一次,3次为一疗程;C组20例口服氟嗪酸及静脉应用丁胺卡那霉素。对三组的疗效进行评价。结果:A组治愈25例(89.3%),有效2例(7.1%),无效1例(3.6%),总有效率96.4%,B组治愈16例(57.1%),有效6例(21.4%),无效6例(21.4%),两组穿刺成功率100%。C组治愈3例(15%),有效3例(15%),无效14例(70%),A、B组比较治愈率、有效率有明显差异P<0.01,A、C两组比较有显著差异P<0.001。结论:TRUS引导精囊穿刺注射药物冲洗并保留抗生素治疗精囊炎是一种理想的治疗方法。%Objective:To explore the ideal result of puncturing seminalvesicle and injecting drugs with sluicing and retaining ways under the guidance of transrectal ultrasound(TRUS) to treat vesiculitis.Methods:Seventy six cases with vesiculitis were randomly divided into A,B,C groups. In group A 28 cases with seminal vesicles were punctured under the guidance of TRUS,sluiced with metronidazole,injected and retained with amikacin 0.4g. In group B other 28 cases with seminal vesicles were punctured with the same method, but sluiced with 0.9% NS, injected and retained with amikacin 0.4g.Each one of A,B groups were treated this way once in ten days.One course consisted of three times. In Group C 20 cases with seminal vesicle were treated with Ofloxacin capsules P.O. and amikacin in intravenous drip.Results:Twenty five cases of group A were cured(89.3%),the alleviations rate was 7.1%(2),one case was ineffective(3.6%),the total effective rate was 96.4%.sixteen cases in group B were cured(57.1%),the

  20. Clinical experiences of normal saline pressed injection via lumbar puncture in the treatment of apnea due to acute tonsillar hernia%采用腰穿加压注液方法抢救急性枕骨大孔疝致呼吸停止的临床疗效

    Institute of Scientific and Technical Information of China (English)

    孟庆虎; 曲春城; 魏麟; 李新钢; 李刚; 费昶; 孙金龙; 王成伟; 张庆林

    2012-01-01

    Objective To summarize the clinical experiences of normal saline pressed injection via lumbar puncture in the treatment of acute tonsillar hernia induced apnea.This procedure was routinely carried out after external ventricular drainage and/or lesion removal via open craniotomy.Methods During the period of 1969 to 2005,a total of 43 patients failed to regain respiratory after external ventricular drainage using rapid small hole cranio-puncture apparatus or lesion removal via open craniotomy.They underwent lumbar puncture and normal saline was pressed injected via a lumbar puncture needle.The patient data were retrospectively analyzed.Results Eleven of 43 patients had spontaneous respiration and fully recovered (25.6% ),16 patients regained respiration but died eventually (37.2% ) and 16 patients failed to regain respiration ( 37.2% ).The effective rate was 62.8%.Conclusion For the patients failing to regain respiration after external ventricular drainage or supratentorial lesion removal via open craniotomy,the conservative treatment should not be the first choice.The pressed injection of normal saline via lumbar puncture may rescue some patients.%目的 总结应用快速细孔钻颅脑室体外引流术或开颅病变清除减压术后,进行腰穿加压注液抢救枕骨大孔疝所致呼吸骤停患者的经验.方法 自1969至2005年山东大学齐鲁医院及山东大学第二医院共同采用腰穿加压注液方法,救治43例急性枕骨大孔疝患者,43例均为进行快速细孔钻颅脑室外引流或幕上病变开颅清除减压术后,自主呼吸仍不恢复者.结果 43例中11例(25.6%)不仅恢复自主呼吸且完全康复,16例(37.2%)出现不同时间的自主呼吸但最终死亡,无自主呼吸恢复迹象者16例(37.2%).结论 因急性枕骨大孔疝致呼吸停止,应用快速细孔钻颅脑室引流,或幕上病变开颅清除减压术后,自主呼吸仍无恢复的患者,给予腰穿加压注液有可能使部分患者获救.

  1. Postdural Puncture Headache: Incidence and Risk Factors in Children Following Intrathecal Chemotherapy

    OpenAIRE

    Abdulah BANI HASHEM; Heydarian, Farhad; Gharavi, Mohammad; Mohsen KHOSHNOD

    2012-01-01

    How to Cite this Article: Bani hashem A, Heydarian F, Gharavi M, Khoshnod M. Postdural Puncture Headache: Incidence and Risk Factors in Children FollowingIntrathecal Chemotherapy. Iranian Journal of Child Neurology 2012;6(1):19-22.ObjectiveTo evaluate the incidence and risk factors of development of postdural puncture headache in children who had intrathecal chemotherapy injection.Materials & MethodsTwo-hundred eighty patients (mean age, 7.23±3.92 years) who had intrathecal chemotherapy i...

  2. Cutting performance orthogonal test of single plane puncture biopsy needle based on puncture force

    Science.gov (United States)

    Xu, Yingqiang; Zhang, Qinhe; Liu, Guowei

    2017-04-01

    Needle biopsy is a method to extract the cells from the patient's body with a needle for tissue pathological examination. Many factors affect the cutting process of soft tissue, including the geometry of the biopsy needle, the mechanical properties of the soft tissue, the parameters of the puncture process and the interaction between them. This paper conducted orthogonal experiment of main cutting parameters based on single plane puncture biopsy needle, and obtained the cutting force curve of single plane puncture biopsy needle by studying the influence of the inclination angle, diameter and velocity of the single plane puncture biopsy needle on the puncture force of the biopsy needle. Stage analysis of the cutting process of biopsy needle puncture was made to determine the main influencing factors of puncture force during the cutting process, which provides a certain theoretical support for the design of new type of puncture biopsy needle and the operation of puncture biopsy.

  3. Probing the puncture for black hole simulations

    CERN Document Server

    Brown, J David

    2009-01-01

    With the puncture method for black hole simulations, the second infinity of a wormhole geometry is compactified to a single "puncture point" on the computational grid. The region surrounding the puncture quickly evolves to a trumpet geometry. The computational grid covers only a portion of the trumpet throat. It ends at a boundary whose location depends on resolution. This raises the possibility that perturbations in the trumpet geometry could propagate down the trumpet throat, reflect from the puncture boundary, and return to the black hole exterior with a resolution--dependent time delay. Such pathological behavior is not observed. This is explained by the observation that some perturbative modes propagate in the conformal geometry, others propagate in the physical geometry. The puncture boundary exists only in the physical geometry. The modes that propagate in the physical geometry are always directed away from the computational domain at the puncture boundary. The finite difference stencils ensure that th...

  4. Blind recognition of punctured convolutional codes

    Institute of Scientific and Technical Information of China (English)

    LU Peizhong; LI Shen; ZOU Yan; LUO Xiangyang

    2005-01-01

    This paper presents an algorithm for blind recognition of punctured convolutional codes which is an important problem in adaptive modulation and coding. For a given finite sequence of convolutional code, the parity check matrix of the convolutional code is first computed by solving a linear system with adequate error tolerance. Then a minimal basic encoding matrix of the original convolutional code and its puncturing pattern are determined according to the known parity check matrix of the punctured convolutional code.

  5. 腔内超声引导异位妊娠囊穿刺注射氨甲喋呤治疗宫外孕的效果%The Effect of Intracavity Ultrasound Guided Puncture Ectopic Pregnancy Sac Injection of Methotrexate in Treatment of Ectopic Pregnancy

    Institute of Scientific and Technical Information of China (English)

    王娜

    2016-01-01

    Objective To investigate the clinical effect of endoluminal ultrasound guided injection of methotrexate treatment of ectopic pregnancy ectopic pregnancy.Methods From January 2015 to December 2015, 60 cases of ectopic pregnancy in our hospital were investigated, which were randomly divided into the observation group and the control group, each group had 30 cases. MTX-CF regimen in treatment of patients in the control group received; patients in the observation group with intracavity ultrasound guided ectopic pregnancy sac puncture injection of methotrexate for treatment, analysis and compare the therapeutic effect of two groups.Results The treatment success was compared, the observation group was 100%, and the control group was 73.3%, there was statistical significance (P<0.05).Conclusion Endosonography guided ectopic pregnancy sac puncture ammonia injection MTX MTX treatment of ectopic pregnancy has better curative effect, is superior to the traditional scheme of MTX-CF treatment.%目的:探讨腔内超声引导异位妊娠穿刺注射氨甲喋呤治疗宫外孕的临床效果。方法选取2015年1月~12月我院收治的60例宫外孕患者。将患者随机分为观察组及对照组,各30例。对照组接受MTX-CF方案治疗;观察组以腔内超声引导异位妊娠囊穿刺注射氨甲喋呤进行治疗,分析比较治疗效果。结果观察组治疗有效率100%,对照组73.3%,差异有统计学意义(P<0.05)。结论腔内超声引导异位妊娠囊穿刺注射氨甲喋呤治疗宫外孕具有较好的疗效,优于传统的MTX-CF方案治疗。

  6. Puncture mechanics of soft solids.

    Science.gov (United States)

    Fakhouri, Sami; Hutchens, Shelby B; Crosby, Alfred J

    2015-06-21

    Gels and other soft elastic networks are a ubiquitous and important class of materials whose unique properties enable special behavior, but generally elude characterization due to the inherent difficulty in manipulating them. An example of such behavior is the stability of gels to large local deformations on their surface. This paper analyzes puncture of model soft materials with particular focus on the force response to deep indentation and the critical load for material failure. Large-strain behavior during deep indentation is described with a neo-hookean contact model. A fracture process zone model is applied to the critical load for puncture. It is found that the indenter geometry influences the size of the fracture process zone, resulting in two distinct failure regimes: stress-limited and energy-limited. The methods outlined in this paper provide a simple means for measuring Young's modulus, E, as well as the material's maximum cohesive stress, σ0, fracture energy, Γ0, and the intrinsic length scale linking the two, l0, all without requiring specialized sample preparation.

  7. Percutaneous ultrasonographically guided liver punctures: an analysis of 1961 patients over a period of ten years

    Directory of Open Access Journals (Sweden)

    Mueller Michael

    2012-12-01

    Full Text Available Abstract Background Ultrasonographically guided punctures of the liver represent a decisive tool in the diagnosis of many diseases of the liver. Objective of the study was to determine the extent to which the complication rate for ultrasonographically guided punctures of the liver is affected by less comprehensively studied risk factors. Methods A total of 2,229 liver biopsies were performed in 1,961 patients (55.5% males; 44.5% females. We recorded actual complications and assessed the following risk factors: needle gauge, puncture technique, examiner experience, coagulation status, puncture target (focal lesion versus parenchyma, lesion size, patient sex and age. Results he rate of complications stood at 1.2% (n = 27, of which 0.5% (n = 12 were major and 0.7% (n = 15 minor complications. A significant increase in complications involving bleeding was observed with larger-gauge needles compared with smaller-gauge needles and for cutting biopsy punctures compared with aspiration biopsies (Menghini technique. In the bivariate analysis complications were 2.7 times more frequent in procedures performed by experienced examiners compared with those with comparatively less experience. Lower values for Quick’s test and higher partial thromboplastin times were associated with a higher rate of bleeding. Neither the puncture target, lesion size or patient sex exerted any measurable influence on the puncture risk. Advanced patient age was associated with a higher rate of complications involving bleeding. Conclusions Our study helps to establish the importance of potential and less comprehensively studied risk factors and may contribute to further reduction in complications rates in routine clinical practice.

  8. Noncommutative mirror symmetry for punctured surfaces

    NARCIS (Netherlands)

    Bocklandt, R.

    2016-01-01

    In 2013, Abouzaid, Auroux, Efimov, Katzarkov and Orlov showed that the wrapped Fukaya categories of punctured spheres and finite unbranched covers of punctured spheres are derived equivalent to the categories of singularities of a superpotential on certain crepant resolutions of toric 3 dimensional

  9. Noncommutative mirror symmetry for punctured surfaces

    NARCIS (Netherlands)

    Bocklandt, R.

    2016-01-01

    In 2013, Abouzaid, Auroux, Efimov, Katzarkov and Orlov showed that the wrapped Fukaya categories of punctured spheres and finite unbranched covers of punctured spheres are derived equivalent to the categories of singularities of a superpotential on certain crepant resolutions of toric 3 dimensional

  10. Gelatin model for training ultrasound-guided puncture

    Directory of Open Access Journals (Sweden)

    Alexandre Campos Moraes Amato

    2015-09-01

    Full Text Available BACKGROUND: It is indispensable that members of the medical profession receive the technical training needed to enable them to rapidly obtain effective vascular access. Training procedures should be used judiciously to familiarize students with the technique. However, existing models are expensive or ineffective, and models need to be developed that are similar to what will be encountered in real patients.OBJECTIVES: To demonstrate creation and application of a gelatin model for training ultrasound-guided puncture.METHOS: The model was made using a mixture of colorless gelatin and water in a transparent plastic receptacle with two pairs of orifices of different diameters, through which two plastic tubes were inserted, to simulate blood vessels.RESULTS: The model was a close approximation to the real medical procedure in several aspects, since gelatin has a similar consistency to human tissues, providing a more faithful reproduction of the tactile sensation at the moment when the needle reaches the interior of a vessel and its contents are aspirated.CONCLUSIONS: The method proposed here can be used to easily construct a low-cost model using everyday materials that is suitable for large-scale training of ultrasound-guided puncture.

  11. The zero-wall puncture: a novel angiographic puncture technique with substantial benefits

    Energy Technology Data Exchange (ETDEWEB)

    Leswick, D.A.; Szkup, P.; Stoneham, G.W. [Univ. of Saskatchewan, Royal Univ. Hospital, Dept. of Radiology, Saskatoon, Saskatchewan (Canada)]. E-mail: davidleswick@hotmail.com

    2005-04-15

    Medical education can be busy, exhausting, and stressful, with potential adverse effects on trainees' physical and mental health. Radiology residency is no exception. In addition to increased daily workload and study requirements, Canadian radiology residents are performing a diverse and increasing number of emergent diagnostic examinations after hours. In an attempt to improve resident self-worth and efficiency during angiographic rotations, we investigated the effects of a novel angiographic puncture procedure on various resident lifestyle indexes. Standard techniques for accessing the femoral artery are either the single-wall puncture or double-wall puncture (Seldinger technique). Both of these techniques are widely known and practiced. Following procedure completion, hemostasis must be achieved at the puncture site. This has traditionally required manual compression at the puncture site, which may require 15 to 20 minutes. At our institution the standard policy is that 'whoever makes the puncture, compresses the groin,' also known as 'you broke it, you fix it'. This has prompted our industrious resident complement to develop a novel, previously undescribed, angiographic puncture technique known as the 'zero-wall puncture technique.' Preliminary unpublished results from our institution show that when residents employ the zero-wall puncture technique the attending staff radiologist subsequently both performs the puncture and compresses the groin at the end of the procedure. We investigated the effect of zero-wall puncture on various resident lifestyle indexes. (author)

  12. Impact on Head Control Impairment Treated with Acupoint Blocking In-jection and Scalp Point Cluster Puncture in the Children of Cerebral Palsy%穴位封闭结合头穴丛刺对脑瘫患儿头部控制障碍的影响

    Institute of Scientific and Technical Information of China (English)

    仇爱珍; 李新剑; 杨忠秀; 李之林; 马冬梅; 王雨晴; 李素珍

    2015-01-01

    目的:探讨穴位封闭结合头穴丛刺治疗脑瘫(CP)患儿的疗效,以改善患儿头部控制障碍。方法将84例 CP 患儿随机分为对照组和治疗组,每组42例。对照组给予西药、物理疗法等常规治疗。观察组在对照组基础上取百会、风池等穴位注入黄芪注射液0.15~1 ml,日1次;同时取额区、顶前区、顶区进行头穴丛刺,日1次。治疗前后采用 Gesell 发育量表评价患儿粗大运动功能,行表面肌电图检查评价患儿肌肉电生理变化,同时行颅多普勒检测大脑中动脉( MCA)血流变化。结果观察组Gesell 粗大运动发育龄、发育商均高于治疗前及对照组(P <0.05);观察组表面肌电图波幅均值高于对照组,而肌电积分值低于对照组(P <0.05);观察组 MCA 收缩期峰值流速(Vs)、舒张末期血流速度(Ved)、平均血流速度(Vm)均大于对照组,而阻力指数(RI)小于对照组(P <0.05)。结论对 CP 患儿进行穴位封闭结合头穴丛刺可改善脑循环,提高肌肉电活动,改善其运动能力。%Objective To explore the efficacy on cerebral palsy treated with acupoint blocking in-jection and scalp point cluster puncture so as to improve the head control in the children. Methods Eighty- four children of cerebral palsy were randomized into a control group and a treatment group,42 cases in each one. In the control group,the routine treatment was applied,such as western medicine and physical ther-apy. In the observation group,on the basis of the treatment as the control group,the acupoint injection of as-tragalus injection was applied to Baihui(BL20),Fengchi(GB20),etc. ,0. 15 to 1 ml,once a day;and the cluster puncture was done at frontal area,anterior vertex area and vertex area on the scalp,once a day. Gesell developmental scales were adopted to assess the coarse motor function. The surface electromyography(SEMG) was used to assess the electrophysiological

  13. Management of accidental dural puncture and post-dural puncture headache after labour: a Nordic survey

    DEFF Research Database (Denmark)

    Darvish, B; Gupta, A; Alahuhta, S

    2011-01-01

    a major risk with epidural analgesia is accidental dural puncture (ADP), which may result in post-dural puncture headache (PDPH). This survey was conducted to explore the incidence of ADP, the policy for management of PDPH and the educational practices in epidural analgesia during labour...

  14. Puncture technique and postural postdural puncture headache. A randomised, double-blind study comparing transverse and parallel puncture.

    Science.gov (United States)

    Flaatten, H; Thorsen, T; Askeland, B; Finne, M; Rosland, J; Hansen, T; Rønhovde, K; Wisborg, T

    1998-11-01

    This clinical study was conducted in order to investigate the effect of two different orientations of the bevel during dural puncture on development of postural postdural puncture headache (PPDPH). Two hundred and eighteen patients aged 18 to 50 years scheduled for minor non-obstetric surgery using spinal anaesthesia (SA) were included in this randomised, double-blind study. Dural puncture was performed using a 0.42 mm O.D. (27-g) Quincke spinal needle with the orientation of the bevel parallel or transverse relative to the longitudinal axis of the dural cylinder. All patients were blinded with regard to the puncture technique, and so was the anaesthesiologist performing a telephone interview 5 to 7 days postoperatively. The occurrence and duration of headache, backache and other complaints were recorded. Headache was classified as PPDPH or non-PPDPH, and intensity of the headache was registered using a numerical rating scale (NRS) from 0 to 10. Two hundred and twelve patients with a mean age of 35.3 years completed the study, 106 in each group. The two groups were comparable with regard to mean age, sex, local anaesthetics used and surgical procedure performed. Headache occurred in 44 patients postoperatively. PPDPH was diagnosed in 4/106 patients (3.8%) in the parallel group and 24/106 (22.6%) in the transverse group (P < 0.0002). Postoperative backache occurred in 31 and 20 patients (parallel compared to transverse) (NS). Dural puncture with the bevel of the needle transverse to the longitudinal axis of the dural cylinder gave significantly more cases of PPDPH than puncture with the bevel parallel to this axis even when using a 27-g Quincke needle. When using Quincke bevelled needles care must be taken to assure that the orientation of the bevel is parallel to the longitudinal axis of the dural sac.

  15. Establishment of temporomandibular joint puncture technique in rats using in vivo micro-computed tomography (R_mCT®).

    Science.gov (United States)

    Kameoka, S; Matsumoto, K; Kai, Y; Yonehara, Y; Arai, Y; Honda, K

    2010-10-01

    The aim of the report was to establish puncture techniques for the temporomandibular joint (TMJ) cavity in rats. The experimental sample comprised 30 male Sprague-Dawley rats. Under general anaesthesia the superior joint cavity of the rat was punctured either laterally (lateral puncture technique (LPT), n = 11), anteriorly (anterosuperior puncture technique (ASPT), n = 13) or anteroinferior puncture technique (AIPT), n = 6) using a 27-gauge needle. After the tip of the needle was confirmed by micro-CT (R-mCT®, Rigaku, Tokyo, Japan) located on the mandibular fossa, 0.05 ml of contrast media was injected under micro-CT fluoroscopic guidance. After confirmation that the joint cavity was filled with contrast media, micro-CT imaging was carried out. The puncture for LPT was accurate in 5 of the 11 animals. The ASPT was accurate in all 13 animals. The AIPT punctured 3 of the 6 animals. Furthermore, the ASPT and AIPT demonstrated improved preservation of the needle; it was harder to detach the needle, which led to greater stability. These results suggest that ASPT assisted by R-mCT® is useful for basic research, including drug discovery and pathogenesis of TMJ diseases.

  16. Aspirations of Life

    Institute of Scientific and Technical Information of China (English)

    Zhou; Ningxin

    2012-01-01

    After entering Senior Three, besides strenuous revisions and examinations, what the students think most and discuss most is aspirations of life. As far as I know, most of my classmates have already specified their choices of majors and their aspirations of life. Some classmates excel in science subjects, so they have chosen science and engineering subjects, hoping that they will become scientists or engineers.

  17. Poverty and Aspirations Failure

    NARCIS (Netherlands)

    Dalton, P.S.; Ghosal, S.; Mani, A.

    2011-01-01

    We develop a theoretical framework to study the psychology of poverty and 'aspirations failure'. In our framework, the rich and the poor share the same preferences - and also a behavioral bias in setting aspirations. Greater downside risks imposed by poverty exacerbates the effects of this behaviora

  18. Aspiration and leadership

    NARCIS (Netherlands)

    Jagersma, P.K.

    2007-01-01

    Management needs an aspiration as to how the company will work in the future. It needs a guide for corporate priorities. Any company - local or global - must be driven by an aspiration that energizes and motivates the company from top to bottom. Yet very few managers and executives know how a corpor

  19. Aspiration in Jaffna Tamil

    Science.gov (United States)

    Thananjayarajasingham, S.

    1975-01-01

    The article accounts for the phenomenon of aspiration in Jaffna Tamil, a dialect distinct form South Indian dialects of Tamil. Not being distinctive orphonologically determined, aspiration is dealt with as a prosodic feature affecting voiceless stops in various positions. Distribution and symbolic representation are handled; kymographic evidence…

  20. Aspirations of Rural Youth.

    Science.gov (United States)

    Bajema, Duane H.; Miller, W. Wade; Williams, David L.

    2002-01-01

    Of 883 Iowa high school seniors, 60% lived in towns, 40% on farms. Both groups had a high level of congruence between educational and occupational aspirations and perceived minimal barriers to goal achievement. Farm and town students had equally diverse aspirations. (Contains 23 references.) (SK)

  1. Poverty and Aspirations Failure

    NARCIS (Netherlands)

    Dalton, P.S.; Ghosal, S.; Mani, A.

    2011-01-01

    We develop a theoretical framework to study the psychology of poverty and 'aspirations failure'. In our framework, the rich and the poor share the same preferences - and also a behavioral bias in setting aspirations. Greater downside risks imposed by poverty exacerbates the effects of this behaviora

  2. Simulation and training of lumbar punctures using haptic volume rendering and a 6DOF haptic device

    Science.gov (United States)

    Färber, Matthias; Heller, Julika; Handels, Heinz

    2007-03-01

    The lumbar puncture is performed by inserting a needle into the spinal chord of the patient to inject medicaments or to extract liquor. The training of this procedure is usually done on the patient guided by experienced supervisors. A virtual reality lumbar puncture simulator has been developed in order to minimize the training costs and the patient's risk. We use a haptic device with six degrees of freedom (6DOF) to feedback forces that resist needle insertion and rotation. An improved haptic volume rendering approach is used to calculate the forces. This approach makes use of label data of relevant structures like skin, bone, muscles or fat and original CT data that contributes information about image structures that can not be segmented. A real-time 3D visualization with optional stereo view shows the punctured region. 2D visualizations of orthogonal slices enable a detailed impression of the anatomical context. The input data consisting of CT and label data and surface models of relevant structures is defined in an XML file together with haptic rendering and visualization parameters. In a first evaluation the visible human male data has been used to generate a virtual training body. Several users with different medical experience tested the lumbar puncture trainer. The simulator gives a good haptic and visual impression of the needle insertion and the haptic volume rendering technique enables the feeling of unsegmented structures. Especially, the restriction of transversal needle movement together with rotation constraints enabled by the 6DOF device facilitate a realistic puncture simulation.

  3. Percutaneous renal puncture: requirements and preliminary results

    CERN Document Server

    Leroy, A; Payan, Y; Richard, F; Chartier-Kastler, E; Troccaz, J; Leroy, Antoine; Mozer, Pierre; Payan, Yohan; Chartier-Kastler, Emmanuel; Troccaz, Jocelyne

    2002-01-01

    This paper introduces the principles of computer assisted percutaneous renal puncture, that would provide the surgeon with an accurate pre-operative 3D planning on CT images and, after a rigid registration with space-localized echographic data, would help him to perform the puncture through an intuitive 2D/3D interface. The whole development stage relied on both CT and US images of a healthy subject. We carried out millimetric registrations on real data, then guidance experiments on a kidney phantom showed encouraging results.

  4. Higher-dimensional puncture initial data

    CERN Document Server

    Zilhão, Miguel; Cardoso, Vitor; Gualtieri, Leonardo; Herdeiro, Carlos; Sperhake, Ulrich; Witek, Helvi

    2011-01-01

    We calculate puncture initial data, corresponding to single and binary black holes with linear momenta, which solve the constraint equations of D dimensional vacuum gravity. The data are generated by a modification of the pseudo-spectral code presented in arXiv:gr-qc/0404056 and made available as the TwoPunctures thorn inside the Cactus computational toolkit. As examples, we exhibit convergence plots, the violation of the Hamiltonian constraint as well as the initial data for D=4,5,6,7. These initial data are the starting point to perform high energy collisions of black holes in D dimensions.

  5. [Less pain during puncture by a peripheral venous catheter; a bibliographical review on adults].

    Science.gov (United States)

    Prat González, Irene; Fuentes i Pumarola, Concepció; Bertran Noguer, Carme; Ballester Ferrando, David; Juvinyà Canal, Dolors; Vila Vidal, Dalmau

    2010-06-01

    Canalizing veins is a habitual technique carried out by nurses. Inserting a catheter in a peripheral vein causes pain. The importance of fine quality in nursing treatment implicitly bears on a person's well-being. In daily practice, health professionals do not use any method to reduce pain when inserting a catheter. The authors observations led them to believe in the need to carry out a bibliographical review whose objective was to discover all the methods used to reduce pain caused by puncturing a peripheral vein. Six randomly assigned clinical tests and a meta-analysis evaluate the effectiveness of: The use of Valsalva, an analgesic cream which contains two local amino-amide anesthetics; lidocaine and prylocaine (EMLA) compared to another analgesic cream, Myolaxin; a meta-analysis of twenty studies evaluates the degree by which pain is diminished by one such method: an EMLA cream; an anti-inflammatory skin dressing (diclofenaco), a diclofenaco dressing versus an EMLA anesthetic dressing, 0.25 ml subcutaneous injection of 1% mepivaína, an amida type local anesthetic; and direct photography moments before puncture occurs to use the effects of a flash of light. All these methods studied proved effective in reducing pain. Creams and dressing prove to be unaggressive methods but require some time for application prior to puncture. Using a camera flash, subcutaneous injection of mepivacaine and the application of Valsalva can be effective alternatives to reduce pain when puncturing veins in patients who require emergency care.

  6. Lumbar Puncture for First Simple Febrile Seizure

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-01-01

    Full Text Available Compliance with American Academy of Pediatrics consensus statement recommendations regarding lumbar puncture for infants 6-18 months of age with a first simple febrile seizure was investigated by a retrospective review of 704 infants evaluated in the pediatric emergency medicine division at Children’s Hospital Boston, MA, Oct 1995-Oct 2006.

  7. Postdural puncture subdural hematoma or postdural puncture headache?: two cases report

    OpenAIRE

    Kale, Aydemir; Emmez, Hakan; Pişkin, Özcan; Durdağ, Emre

    2015-01-01

    Spinal anesthesia is widely used for many obstetric, gynecological, orthopedic, and urological operations. Subdural hematomas may occur after trauma and are associated with high morbidity and mortality rates. Postdural puncture headache (PDPH) is a benign condition and the most frequent complication of spinal anesthesia. The high rate of headache after spinal anesthesia may mask or delay the diagnosis of subdural hematoma. The true incidence of postdural puncture subdural hematoma (PDPSH) is ...

  8. Postdural Puncture Headache: Incidence and Risk Factors in Children Following Intrathecal Chemotherapy

    Directory of Open Access Journals (Sweden)

    Abdulah BANI HASHEM

    2012-03-01

    Full Text Available How to Cite this Article: Bani hashem A, Heydarian F, Gharavi M, Khoshnod M. Postdural Puncture Headache: Incidence and Risk Factors in Children FollowingIntrathecal Chemotherapy. Iranian Journal of Child Neurology 2012;6(1:19-22.ObjectiveTo evaluate the incidence and risk factors of development of postdural puncture headache in children who had intrathecal chemotherapy injection.Materials & MethodsTwo-hundred eighty patients (mean age, 7.23±3.92 years who had intrathecal chemotherapy injection were studied prospectively during 2008-2009 in the pediatric ward of Dr. Sheikh hospital in Mashhad. Patients who had lumbar puncture for their chemotherapy drug injections were assessed daily for four days to detect postdural puncture headache.ResultsThere were 172 (61, 4% male patients and the remainder were female. Postdural puncture headache was detected in 41 patients (14.6%. The body mass index did not show any significant difference between the two groups. Lumbar puncture (LP attempts had a significant association with postdural puncture headache. The size and shape of the needle did not have a significant association with postdural puncture headache.ConclusionLP attempts have a significant relationship with postdural puncture headache. References:1. Bolder PM. Postlumbar puncture headache in pediatriconcology patients. Anesthesiology. 1986;65:696-8.2. Ozyalcin NS, Menda F. Regional anesthesia and analgesiaapplications in children and infants – II. Agri 2004;16:29-34, 37-42.3. Oilver A. Dural punctures in children: what should wedo? Paediatr Anaesth. 2002;12:473-7.4. Kokki H, Hendolin H, Turunen M. Postdural punctureheadache and transient neurologic symptoms in childrenafter spinal anaesthesia using cutting and pencil pointpaediatric spinal needles. Acta Anaesthesiol Scand1998;42:1076-82.5. Lowery S, Oliver A. Incidence of postdural punctureheadache backache following diagnostic therapeuticlumbar puncture using a 22G cutting spinal needle

  9. Teichmüller theory of the punctured solenoid

    DEFF Research Database (Denmark)

    Penner, Robert; Sari´c, Dragomir

    2008-01-01

    The punctured solenoid plays the role of an initial object for the category of punctured surfaces with morphisms given by finite covers branched only over the punctures. The (decorated) Teichmüller space of is introduced, studied, and found to be parametrized by certain coordinates on a fixed tri...

  10. Teichmüller theory of the punctured solenoid

    DEFF Research Database (Denmark)

    Penner, Robert; Sari´c, Dragomir

    2008-01-01

    The punctured solenoid plays the role of an initial object for the category of punctured surfaces with morphisms given by finite covers branched only over the punctures. The (decorated) Teichmüller space of is introduced, studied, and found to be parametrized by certain coordinates on a fixed...

  11. Injections through skin colonized with Staphylococcus aureus biofilm introduce contamination despite standard antimicrobial preparation procedures

    Science.gov (United States)

    Wang, Yi; Leng, Valery; Patel, Viraj; Phillips, K. Scott

    2017-01-01

    While surgical site preparation has been extensively studied, there is little information about resistance of skin microbiota in the biofilm form to antimicrobial decontamination, and there are no quantitative models to study how biofilm might be transferred into sterile tissue/implant materials during injections for joint spine and tendon, aspiration biopsies and dermal fillers (DF). In this work, we develop two in vitro models to simulate the process of skin preparation and DF injection using pig skin and SimSkin (silicone) materials, respectively. Using the pig skin model, we tested three of the most common skin preparation wipes (alcohol, chlorhexidine and povidone iodine) and found that during wiping they reduced the biofilm bacterial burden of S. aureus (CFU cm−2) by three logs with no statistically significant differences between wipes. Using the SimSkin model, we found that transfer of viable bacteria increased with needle diameter for 30G, 25G and 18G needles. Transfer incidence decreased as injection depth was increased from 1 mm to 3 mm. Serial puncture and linear threading injection styles had similar transfer incidence, whereas fanning significantly increased transfer incidence. The results show that contamination of DF during injection is a risk that can be reduced by modifying skin prep and injection practices. PMID:28332593

  12. Laser puncture therapy of nervous system disorders

    Energy Technology Data Exchange (ETDEWEB)

    Anishchenko, G.; Kochetkov, V.

    1984-08-29

    The authors discuss experience with treatment of nervous system disorders by means of laser-puncture therapy. Commenting on the background of the selection of this type of treatment, they explain that once researchers determined the biological action of laser light on specific nerve receptors of the skin, development of laser apparatus capable of concentrating the beam in the millimeter band was undertaken. The devices that are being used for laser-puncture are said to operate in the red helium-neon band of light. The authors identify beam parameters that have been selected for different groups of acupuncture points of the skin, and the courses of treatment (in seconds of radiation) and their time intervals. They go on to discuss the results of treatment of over 800 patients categorized in a group with disorders of the peripheral nervous system and a second group with disorders of the central nervous system.

  13. Optimized puncturing distributions for irregular non-binary LDPC codes

    CERN Document Server

    Gorgoglione, Matteo; Declercq, David

    2010-01-01

    In this paper we design non-uniform bit-wise puncturing distributions for irregular non-binary LDPC (NB-LDPC) codes. The puncturing distributions are optimized by minimizing the decoding threshold of the punctured LDPC code, the threshold being computed with a Monte-Carlo implementation of Density Evolution. First, we show that Density Evolution computed with Monte-Carlo simulations provides accurate (very close) and precise (small variance) estimates of NB-LDPC code ensemble thresholds. Based on the proposed method, we analyze several puncturing distributions for regular and semi-regular codes, obtained either by clustering punctured bits, or spreading them over the symbol-nodes of the Tanner graph. Finally, optimized puncturing distributions for non-binary LDPC codes with small maximum degree are presented, which exhibit a gap between 0.2 and 0.5 dB to the channel capacity, for punctured rates varying from 0.5 to 0.9.

  14. The reasons for delay lumbar puncture

    Directory of Open Access Journals (Sweden)

    MH. Lotfi

    2017-04-01

    Full Text Available Early diagnosis of meningitis and encephalitis and prompt initiation of appropriate therapy is vital and any delay will lead to high mortality and serious and permanent morbidity. The main purpose of this study was to evaluate the management of 220 patients with suspected central nervous system (CNS infections (meningitis and encephalitis to determine the percentage of patients’ suspected CNS infection undergo lumbar puncture in acceptable time (in accordance with conventional algorithms. In this descriptive study, patients with suspected CNS infections admitted to Bu-Ali and Qods hospitals, in the period July 2013 to December 2015 were studied. Information of 220 patients was collected. Continuous variables were summarized as means ± standard deviation and categorical variables as frequencies and percentages. Lumbar puncture (LP in patients was delayed in 200 cases (91%. Most common causes of delay in performing LP were prolongation of the process of determining patient needs to puncture, satisfying patients, CT scan delay and the delay in allowing LP by neurologist. In this study, delaying LP rate was higher than other studies. It seems certain pattern in assistants’ visits for counseling. CT requests and neurologic consultation before LP performed for all adult patients.

  15. Bone Marrow Aspiration and Biopsy

    Science.gov (United States)

    ... Advertising & Sponsorship: Policy | Opportunities Bone Marrow Aspiration and Biopsy Share this page: Was this page helpful? Also ... Examination Formal name: Bone Marrow Aspiration; Bone Marrow Biopsy Related tests: Complete Blood Count ; WBC Differential ; Reticulocyte ...

  16. Small intestine aspirate and culture

    Science.gov (United States)

    ... ency/article/003731.htm Small intestine aspirate and culture To use the sharing features on this page, please enable JavaScript. Small intestine aspirate and culture is a lab test to check for infection ...

  17. Treatment of cranial epidural hematoma in a neonate by needle aspiration of a communicating cephalhematoma.

    Science.gov (United States)

    Smets, Koenraad Jan; Vanhauwaert, Dimitri

    2010-05-01

    A newborn presented on day 15 of life with an epidural hematoma, extending through a diastatic sutura squamosa in an external cephalhematoma. There was no skull fracture. The cephalhematoma was punctured twice with 24-h interval, reducing both the cephalhematoma and the epidural component. In the absence of neurological signs or symptoms, aspirating a cephalhematoma to evacuate the communicating epidural hematoma in a newborn infant may avoid more invasive surgical intervention.

  18. Rising Aspirations Dampen Satisfaction

    Science.gov (United States)

    Clark, Andrew E.; Kamesaka, Akiko; Tamura, Teruyuki

    2015-01-01

    It is commonly believed that education is a good thing for individuals. Yet, its correlation with subjective well-being is most often only weakly positive, or even negative, despite the many associated better individual-level outcomes. We here square the circle using novel Japanese data on happiness aspirations. If reported happiness comes from a…

  19. Rising Aspirations Dampen Satisfaction

    Science.gov (United States)

    Clark, Andrew E.; Kamesaka, Akiko; Tamura, Teruyuki

    2015-01-01

    It is commonly believed that education is a good thing for individuals. Yet, its correlation with subjective well-being is most often only weakly positive, or even negative, despite the many associated better individual-level outcomes. We here square the circle using novel Japanese data on happiness aspirations. If reported happiness comes from a…

  20. Aspirated High Pressure Compressor

    Science.gov (United States)

    2006-08-01

    of Technology Aamir Shabbir Cambridge, Massachusetts 02139, USA University of Toledo Toledo , Ohio 43606, USA ABSTRACT transport engine aspirated...special thanks to Jack Costa, James Letendre, and Victor Dubrowski for their tireless work in the lab. The instruments were partially the result of

  1. [Ultrasound-assisted puncture method of treatment of hepatic hydatid cysts].

    Science.gov (United States)

    Gavrilin, A V; Kuntsevich, G I; Vishnevskiĭ, V A; Ikramov, R Z; Zhurenkova, T V; Burtseva, E A; Savvina, T B; Agafonov, V A

    2002-01-01

    Results of treatment of 31 hepatic hydatid cysts in 28 patients were analyzed. The size of the s ranged from 3 to 25 cm. In 26 cases the cysts contained flive es, in 2 cases they were suppurated after US-assisted intraoperative puncture. Simple hydatid cysts (type I by M. Milcevic) were diagnosed in 24 patients (solitary--in 22, multiple--in 2), solitary cysts of type II--in 2 patients. In 23 cases aspiration-catheter treatment with complete removal of chitin membrane by one-stage (4) or two-stage (19) methods was performed. After removal of chitin membrane in 3 patients lateral fistula between spurious cysts cavities and peripheral branches of intrahepatic bile ducts were revealed which spontaneously. Glue composition "Rabrom" was used in 2 cases for closure of the residual cavity. In 4 patients who had cysts less 6 cm in size puncture irrigation of chitin cavity with 30% NaCl (PAIR technique) without it removal was performed. In one patient transcutaneous catheter (PAIR-PD technique) was used for irrigation of the cyst larger than 6 cm. The duration of two-stage aspiration-catheter treatment with removal of chitin membrane was 25.6 +/- 9.6 days. In moderate calcinosis of the fibrous membrane and bile fistulas period of hospitalization was 34 +/- 8.1 days. Treatment with PAIR and PAIR-PD took 1 and 3 days respectively. Complications of percutaneous methods were regarded as mild: hyperthermia (12), right-sided hydrothorax (6), subcapsular hematoma (1), urticaria (1). All the complications were treated conservatively and with US-assisted punctures. Long-term (from 6 months to 9 years) results of treatment were followed up in 26 patients: there were no recurrences. Suppuration of the residual cavity 6 months after the glue occlusion was eradicated by transcutaneous catheter drainage. One lethal outcome was not associated with complications of aspiration-catheter treatment. Both methods of transcutaneous treatment of hepatic hydatid cysts are effective and safe. A

  2. C6 plate puncture testing report.

    Energy Technology Data Exchange (ETDEWEB)

    Vangoethem, Douglas J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Cordova, Theresa Elena [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Reu, Phillip L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2013-04-01

    There are numerous scenarios where critical systems could be subject to penetration by projectiles or fixed objects (e.g., collision, natural disaster, act of terrorism, etc.). It is desired to use computational models to examine these scenarios and make risk-informed decisions; however, modeling of material failure is an active area of research, and new models must be validated with experimental data. The purpose of this report is to document the experimental work performed from FY07 through FY08 on the Campaign Six Plate Puncture project. The goal of this project was to acquire experimental data on the puncture and penetration of metal plates for use in model validation. Of particular interest is the PLH failure model also known as the multilinear line segment model. A significant amount of data that will be useful for the verification and validation of computational models of ductile failure were collected during this project were collected and documented herein; however, much more work remains to be performed, collecting additional experimental data that will further the task of model verification.

  3. Pulmonary aspiration in hospitalized adults.

    Science.gov (United States)

    Elpern, E H

    1997-02-01

    Until recent years, pulmonary aspiration attracted remarkably little clinical investigation. Although aspiration was considered a common occurrence in hospitalized individuals, with serious and even fatal consequences, clinicians had limited scientific data to guide practice. Consequently, approaches to this problem were based largely on unsystematic observations, intuition, and tradition. Recent investigations on the subjects of aspiration have increased our understanding of patients at risk for aspiration, the value of diagnostic methods, and the efficacy of interventions to prevent or limit aspirations. Results of these studies call to question many time-honored adages and practices. Considerable uncertainty remains and more investigation is necessary before management decisions can be characterized clearly and clinical strategies defined. This review focuses on pulmonary aspiration and enteral feeding in the critically ill adult. Factors implicated in aspiration in this population are highlighted and evidence to support the application of interventions prescribed commonly is presented.

  4. Robot-assisted retinal vein cannulation with force-based puncture detection: Micron vs. the steady-hand eye robot.

    Science.gov (United States)

    Gonenc, Berk; Tran, Nhat; Gehlbach, Peter; Taylor, Russell H; Iordachita, Iulian

    2016-08-01

    Retinal vein cannulation is a demanding procedure where therapeutic agents are injected into occluded retina veins. The feasibility of this treatment is limited due to challenges in identifying the moment of venous puncture, achieving cannulation and maintaining it throughout the drug delivery period. In this study, we integrate a force-sensing microneedle with two distinct robotic systems: the handheld micromanipulator Micron, and the cooperatively controlled Steady-Hand Eye Robot (SHER). The sensed tool-to-tissue interaction forces are used to detect venous puncture and extend the robots' standard control schemes with a new position holding mode (PHM) that assists the operator hold the needle position fixed and maintain cannulation for a longer time with less trauma on the vasculature. We evaluate the resulting systems comparatively in a dry phantom, stretched vinyl membranes. Results have shown that modulating the admittance control gain of SHER alone is not a very effective solution for preventing the undesired tool motion after puncture. However, after using puncture detection and PHM the deviation from the puncture point is significantly reduced, by 65% with Micron, and by 95% with SHER representing a potential advantage over freehand for both.

  5. CSR as Aspirational Talk

    DEFF Research Database (Denmark)

    Christensen, Lars Thøger; Morsing, Mette; Thyssen, Ole

    2013-01-01

    Most writings on corporate social responsibility (CSR) treat lack of consistency between organizational CSR talk and action as a serious problem that needs to be eliminated. In this article, we argue that differences between words and action are not necessarily a bad thing and that such discrepan......Most writings on corporate social responsibility (CSR) treat lack of consistency between organizational CSR talk and action as a serious problem that needs to be eliminated. In this article, we argue that differences between words and action are not necessarily a bad thing...... and that such discrepancies have the potential to stimulate CSR improvements. We draw on a research tradition that regards communication as performative to challenge the conventional assumption that CSR communication is essentially superficial, as opposed to CSR action. In addition, we extend notions of organizational...... hypocrisy to argue that aspirational CSR talk may be an important resource for social change, even when organizations do not fully live up to their aspirations....

  6. [Cortical venous thrombosis after a diagnostic lumbar puncture].

    Science.gov (United States)

    Pfeilschifter, W; Neumann-Haefelin, T; Hattingen, E; Singer, O C

    2009-10-01

    We present the case of a 49-year-old female patient who underwent a lumbar puncture in the context of an extended diagnostic work-up after a transient ischemic attack. A few days later the patient who suffered from severe post-lumbar puncture headache, developed a lobar hemorrhage due to a cortical venous thrombosis requiring decompression surgery.

  7. Lumbar puncture requirement in acute hemiparesis: diagnosis of tuberculous meningitis after hemiparesis in a child.

    Science.gov (United States)

    Sahin, Sevim; Cansu, Ali; Kamaşak, Tülay; Eyüboğlu, İlker; Esenülkü, Gülnur; Ökten, Ayşenur

    2014-12-01

    Infections are an important acquired cause of cerebral arteriopathy. Tuberculous (TB) meningitis leading to infectious cerebral vasculopathy is a rare cause of acute hemiparesis. A 14-year-old male patient was examined after acute hemiparesis developing within 1 day. Neurological examination revealed total hemiplegia on the left side. Brain MRI findings showed bilateral focal T2-weighted signal hyperintensity in the subcortical and deep white matter regions. There were also areas of restricted diffusion in the right basal ganglia. Although the father had a history of pulmonary TB, the patient had not been given TB prophylaxis because of PPD negativity. At lumbar puncture, opening cerebrospinal fluid (CSF) pressure was 50 cm/H20, CSF protein 66.9 mg/dL, and glucose 54 mg/dL (concurrent blood glucose 93 mg/dL); 170 polymorphonuclear leukocytes per cubic millimeter were present in CSF. Following tests for TB, treatment was started immediately with four anti-TB drugs. TB PCR of CSF and acid-fast bacteria (AFB) staining in gastric aspirate were positive. At clinical follow-up, the patient was able to walk with support at the end of the first month. Various infectious agents have been reported as causes of cerebral vasculopathy. TB, which affects a significant number of patients worldwide, should be kept in mind in terms of cerebral vascular complications. Lumbar puncture is essential in order to diagnose TB meningitis.

  8. Biopsy needle advancement during bone marrow aspiration increases mesenchymal stem cell concentration

    Directory of Open Access Journals (Sweden)

    Anne E Peters

    2016-03-01

    Full Text Available Point-of-care kits to concentrate bone marrow (BM derived mesenchymal stem cells (MSCs are used clinically in horses. A maximal number of MSCs per ml of marrow aspirated might be desired prior to use of a point-of-care system to concentrate MSCs. Our objective was to test a method to increase the number of MSCs per ml of marrow collected. We collected 2 BM aspirates using 2 different collection techniques from 12 horses. The first collection technique was to aspirate BM from a single site without advancement of the biopsy needle. The second collection technique was to aspirate marrow from multiple sites within the same sternal puncture by advancing the needle 5 mm 3 times for BM aspiration from 4 sites. Numbers of MSCs in collected BM were assessed by total nucleated cell count (TNCC of BM after aspiration, total Colony-Forming-Unit-fibroblast (CFU-F assay, and total MSC number at each culture passage. The BM aspiration technique of 4 needle advancements during BM aspiration resulted in higher initial nucleated cell counts, more CFU-Fs, and more MSCs at the first passage. There were no differences in the number of MSCs at later passages. Multiple advancements of the BM needle during BM aspiration resulted in increased MSC concentration at the time of BM collection. If a point-of-care kit is used to concentrate MSCs, multiple advancements may result in higher MSC numbers in the BM concentrate after preparation by the point-of-care kit. For culture expanded MSCs beyond the first cell passage, the difference is of questionable clinical relevance.

  9. Dural puncture: an overlooked cause of cerebral venous thrombosis.

    Science.gov (United States)

    Guner, Derya; Tiftikcioglu, Bedile Irem; Uludag, Irem Fatma; Oncel, Dilek; Zorlu, Yasar

    2015-03-01

    Cerebral venous thrombosis (CVT) accounts for 0.5-1 % of all strokes. Although dural puncture is proposed as one of the rare risk factors, this association has only been mentioned in anecdotal reports. Headache, i.e., usually the first and the most frequent clinical symptom on admission, is often attributed to the dural puncture itself. We investigated the frequency of CVT following a recent dural puncture in our stroke database, together with the other risk factors. The computerized medical records of patients (n = 10,740) registered in our tertiary-care neurology clinic stroke database were reviewed retrospectively. Patients diagnosed with CVT were reanalyzed. Patients who had a dural puncture in the preceding 7 days were included in the study. A total of 46 patients were diagnosed with CVT. Nine patients (19.6 %) had a recent dural puncture before the onset of the symptoms. Patients were younger than 45 years and had at least one more predisposing condition for thromboembolism other than the dural puncture. All patients have received either spinal anesthesia or intrathecal chemotherapy. Dural puncture seems to trigger CVT particularly in patients with predisposing disorders. Although reported as an extremely rare complication, our data indicate a much higher association. This case series emphasize the importance of reevaluation of patients with persistent/progressive headache following dural puncture. The effect of change in the biochemical composition of CSF due to intrathecal drug administration in pathogenesis is not known. Larger controlled trials are warranted to clarify the causal relationship between lumbar puncture and/or intrathecal drug administration and CVT.

  10. Ameliorative effect of Leflunomide on lung injury following an aspiration.

    Science.gov (United States)

    Yilmaz, M Z; Torun, A C; Guzel, A; Murat, N; Okuyucu, A; Yilmaz, N; Gacar, A; Guvenc, T; Guzel, A

    2015-01-01

    We aimed to investigate the therapeutic effectiveness of leflunomide (LEF) in lung injury after an aspiration of unknown pathophysiology. Forty-two healthy Sprague Dawley rats were anesthetized and allocated to six experimental groups: saline (S) aspirated, S+LEF, hydrochloric acid (HCl) aspirated, HCl+LEF, formula aspirated (FOR), and FOR+LEF. The treatment groups (S+LEF, HCl+LEF, and FOR+LEF) received 20 mg/kg/day intraperitoneal (i.p.) injection of LEF for seven days. At the end of the seven days, blood and tissue samples were taken from the rats for histopathological, biochemical, and immunohistochemical examination. There was a significant increase in serum levels of YKL-40, a chitinase-like protein, in the HCl group after the aspiration (pacid-reactive species (TBARS) values in the HCl and FOR groups compared to the control group (p=0.001 and p<0.01, respectively). In both treatment groups, the serum TBARS values significantly decreased after treatment with LEF (p=0.001 and p<0.05, respectively). There was a significant improvement in the histopathological scores, which deteriorated after the aspiration, and in the number of inducible nitric oxide synthase (iNOS)-positive cells after treatment with LEF.

  11. Direct percutaneous transorbital puncture under fluoroscopic guidance with a 3D skull reconstruction overlay for embolisation of intraorbital and cavernous sinus dural arteriovenous fistulas.

    Science.gov (United States)

    Lv, Ming; Jiang, Chuhan; Liu, Dong; Ning, Zhiguang; Yang, Jun; Wu, Zhongxue

    2015-06-01

    To describe the direct percutaneous transorbital puncture technique for embolisation of the selected intraorbital and cavernous sinus dural arteriovenous fistula, which failed to be treated by conventional endovascular techniques. One case of intraorbital and five cases of cavernous sinus dural arteriovenous fistula were embolised through direct percutaneous transorbital puncture in 2012, and the clinical data were reviewed. Under fluoroscopic guidance with a three-dimensional (3D) skull reconstruction overlay, the cavernous sinus or ophthalmic vein was punctured via the superior orbital fissure. Then a microcatheter was inserted via the needle, and Onyx was injected to embolise the fistula with or without a combination of coils. Complete obliteration of the fistula was achieved in all six patients. After operation all the patients experienced transient swelling of the punctured orbit persisting for three to five days. No other complications occurred. Follow-up of six patients at three to six months showed resolution of their initial neuro-ophthalmological symptoms in five and left visual loss in one did not recover. Six months follow-up angiogram showed no recurrence of these fistulas. Direct percutaneous transorbital puncture provides an option for the intraorbital and cavernous sinus dural arteriovenous fistulas, particularly when the conventional transvenous routes are inaccessible. Overlay of the 3D skull reconstruction can facilitate the precise puncture of the superior orbital fissure. © The Author(s) 2015.

  12. GEAR UP Aspirations Project Evaluation

    Science.gov (United States)

    Trimble, Brad A.

    2013-01-01

    The purpose of this study was to conduct a formative evaluation of the first two years of the Gaining Early Awareness and Readiness for Undergraduate Programs (GEAR UP) Aspirations Project (Aspirations) using a Context, Input, Process, and Product (CIPP) model so as to gain an in-depth understanding of the project during the middle school…

  13. The Analysis of Efifcacy and Antibiotics in Treatment of Aspiration Pneumonia of Atomizing Inhalation of Qingkailing Injection%清开灵注射液雾化吸入与抗生素联合治疗吸入性肺炎的疗效分析

    Institute of Scientific and Technical Information of China (English)

    张勇

    2016-01-01

    目的:探讨清开灵注射液雾化吸入与抗生素联合治疗吸入性肺炎的临床疗效。方法选取我院收治的66例吸入性肺炎患者,将其根据随机数字表法分为对照组和研究组,各33例,对照组给予抗生素氨溴索雾化吸入治疗,研究组给予清开灵注射液雾化吸入治疗。结果治疗1周后,研究组治疗总有效率高于对照组(P<0.05),治疗后研究组FEV1、FVC以及PEF优于对照组,两组比较差异有统计学意义(P<0.05)。结论清开灵注射液雾化吸入与抗生素联合应用能有效的改善患者的肺功能,疗效显著。%Objective To investigate the clinical effect of atomization inhalation of Qingkailing injection combined with antibiotic treatment of aspiration pneumonia.Methods 66 cases of aspiration pneumonia in our hospital were divided into control group and study group according to the random number table, each of 33 cases, the control group was given antibiotics ambroxol inhalation therapy, the study group was given atomizing inhalation of Qingkailing injection treatment.ResultsAfter 1 weeks of treatment, the total effective rate of the study group was higher than that of the control group (P<0.05), after treatment, the FEV1, FVC and PEF in the study group were signiifcantly better than those in the control group, the difference was statistically significant (P<0.05).Conclusion Atomizing inhalation of Qingkailing injection combined with antibiotics can effectively improve lung function in patients with signiifcant curative effect.

  14. Workload, Aspiration, and Fun

    DEFF Research Database (Denmark)

    Muhr, Sara Louise; Pedersen, Michael; Alvesson, Mats

    2012-01-01

    Contemporary working life highlights the challenge between exploitation and exploration both on a general and a more individual level. Here, we focus on the latter, and connect the critical debate regarding selfmanagement to March’s exploitation/exploration trade-off, as this forms a useful...... study of a large group of management consultants, we explore how they perform and make sense of selfexploitation and self-exploration through three specific discourses: the discourse of workload, the discourse of aspiration, and the discourse of fun. Through these, the consultants try to identify...... optimal amounts of work, play, and ambition, all while handling the trade-off between selfexploitation and self-exploration. We show how this keeps failing, but how it reappears as a necessary condition for avoiding future failures. In all three discourses, the trade-off therefore presents itself...

  15. Punctures for theories of class S_{Γ}

    Science.gov (United States)

    Heckman, Jonathan J.; Jefferson, Patrick; Rudelius, Tom; Vafa, Cumrun

    2017-03-01

    With the aim of understanding compactifications of 6D superconformal field theories to four dimensions, we study punctures for theories of class S_{Γ} . The class S_{Γ} theories arise from M5-branes probing ℂ 2/ Γ, an ADE singularity. The resulting 4D theories descend from compactification on Riemann surfaces decorated with punctures. We show that for class S_{Γ} theories, a puncture is specified by singular boundary conditions for fields in the 5D quiver gauge theory obtained from compactification of the 6D theory on a cylinder geometry. We determine general boundary conditions and study in detail solutions with first order poles. This yields a generalization of the Nahm pole data present for 1/2 BPS punctures for theories of class S. Focusing on specific algebraic structures, we show how the standard discussion of nilpotent orbits and its connection to representations of su(2) generalizes in this broader context.

  16. Assessment of Residents Readiness to Perform Lumbar Puncture

    DEFF Research Database (Denmark)

    Henriksen, Mikael Johannes Vuokko; Wienecke, Troels; Thagesen, Helle

    2017-01-01

    BACKGROUND: Lumbar puncture is a common procedure in many specialties. The procedure serves to diagnose life-threatening conditions, often requiring rapid performance. However, junior doctors possess uncertainties regarding performing the procedure and frequently perform below expectations. Hence...

  17. Lumbar puncture in patients using anticoagulants and antiplatelet agents.

    Science.gov (United States)

    Domingues, Renan; Bruniera, Gustavo; Brunale, Fernando; Mangueira, Cristóvão; Senne, Carlos

    2016-08-01

    The use of anticoagulants and antiplatelet agents has largely increased. Diagnostic lumbar puncture in patients taking these drugs represents a challenge considering the opposing risks of bleeding and thrombotic complications. To date there are no controlled trials, specific guidelines, nor clear recommendations in this area. In the present review we make some recommendations about lumbar puncture in patients using these drugs. Our recommendations take into consideration the pharmacology of these drugs, the thrombotic risk according to the underlying disease, and the urgency in cerebrospinal fluid analysis. Evaluating such information and a rigorous monitoring of neurological symptoms after lumbar puncture are crucial to minimize the risk of hemorrhage associated neurological deficits. An individualized patient decision-making and an effective communication between the assistant physician and the responsible for conducting the lumbar puncture are essential to minimize potential risks.

  18. Lumbar puncture in patients using anticoagulants and antiplatelet agents

    Directory of Open Access Journals (Sweden)

    Renan Domingues

    2016-08-01

    Full Text Available ABSTRACT The use of anticoagulants and antiplatelet agents has largely increased. Diagnostic lumbar puncture in patients taking these drugs represents a challenge considering the opposing risks of bleeding and thrombotic complications. To date there are no controlled trials, specific guidelines, nor clear recommendations in this area. In the present review we make some recommendations about lumbar puncture in patients using these drugs. Our recommendations take into consideration the pharmacology of these drugs, the thrombotic risk according to the underlying disease, and the urgency in cerebrospinal fluid analysis. Evaluating such information and a rigorous monitoring of neurological symptoms after lumbar puncture are crucial to minimize the risk of hemorrhage associated neurological deficits. An individualized patient decision-making and an effective communication between the assistant physician and the responsible for conducting the lumbar puncture are essential to minimize potential risks.

  19. Aspirated Compressors for High Altitude Engines Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Aurora Flight Sciences proposes to incorporate aspirated compressor technology into a high altitude, long endurance (HALE) concept engine. Aspiration has been proven...

  20. Liouville theory and uniformization of four-punctured sphere

    CERN Document Server

    Hadasz, L; Hadasz, Leszek; Jaskolski, Zbigniew

    2006-01-01

    Few years ago Zamolodchikov and Zamolodchikov proposed an expression for the 4-point classical Liouville action in terms of the 3-point actions and the classical conformal block. In this paper we develop a method of calculating the uniformizing map and the uniformizing group from the classical Liouville action on n-punctured sphere and discuss the consequences of Zamolodchikovs conjecture for an explicit construction of the uniformizing map and the uniformizing group for the sphere with four punctures.

  1. Contraindications to lumbar puncture as defined by computed cranial tomography.

    OpenAIRE

    Gower, D. J.; Baker, A. L.; Bell, W O; Ball, M R

    1987-01-01

    Papilloedema is not always an adequate predictor of potential complications from lumbar puncture, and many clinicians are using computed tomography (CT) before lumbar puncture in an effort to identify more accurately the "at risk" patient. This paper identifies the following anatomical criteria defined by CT scanning that correlate with unequal pressures between intracranial compartments and predispose a patient to herniation following decompression of the spinal compartment: lateral shift of...

  2. Cerebellar Herniation after Lumbar Puncture in Galactosemic Newborn

    Directory of Open Access Journals (Sweden)

    Salih Kalay

    2011-09-01

    Full Text Available Cerebral edema resulting in elevated intracranial pressure is a well-known complication of galactosemia. Lumbar puncture was performed for the diagnosis of clinically suspected bacterial meningitis. Herniation of cerebral tissue through the foramen magnum is not a common problem in neonatal intensive care units because of the open fontanelle in infants. We present the case of a 3-week-old infant with galactosemia who presented with signs of cerebellar herniation after lumbar puncture.

  3. Lumbar puncture in patients using anticoagulants and antiplatelet agents

    OpenAIRE

    Renan Domingues; Gustavo Bruniera; Fernando Brunale; Cristóvão Mangueira; Carlos Senne

    2016-01-01

    ABSTRACT The use of anticoagulants and antiplatelet agents has largely increased. Diagnostic lumbar puncture in patients taking these drugs represents a challenge considering the opposing risks of bleeding and thrombotic complications. To date there are no controlled trials, specific guidelines, nor clear recommendations in this area. In the present review we make some recommendations about lumbar puncture in patients using these drugs. Our recommendations take into consideration the pharmaco...

  4. Self-healing flexible laminates for resealing of puncture damage

    Science.gov (United States)

    Beiermann, B. A.; Keller, M. W.; Sottos, N. R.

    2009-08-01

    A flexible self-healing system capable of healing puncture damage has been manufactured. Our material consists of three layers: a poly(dimethyl siloxane) (PDMS) composite, embedded with a self-healing microcapsule system, sandwiched between two layers of poly(urethane) coated nylon. The total structure thickness ranges between 0.84 and 1.5 mm. A protocol is established in which samples are damaged using a hypodermic needle or a razor blade, and a successful heal is defined as the ability to reseal the damage to withstand a pressure differential across the laminate of 103 kPa (~1 atm). Trends in healing success are analyzed as a function of microcapsule size, self-healing layer thickness, and puncture diameter. Healing varied significantly with microcapsule size, with the maximum healing success rate (100% successfully healed) occurring in samples with 220 µm microcapsules and a puncture diameter of 0.49 mm. For this puncture size, an increase in microcapsule diameter corresponds to a decrease in healing efficiency. However, samples with larger microcapsules (up to 500 µm avg.) demonstrate more effective healing for larger puncture diameters, up to 1.61 mm. Additionally, healing increased with composite layer thickness, and decreased with increasing puncture hole size.

  5. Thrombuster II aspiration catheter combined with intracoronary tirofiban injection in primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction%急性STEMI应用ThrombusterII抽吸导管联合冠状动脉内注射替罗非班的疗效观察

    Institute of Scientific and Technical Information of China (English)

    林丛; 马骏; 童宗安; 官学强

    2011-01-01

    Objective To evaluate the efficacy ofthrombus aspiration catheter combined with intracoronary tirofiban injection during primary percutaneous coronary intervention (PCI) in patients with acute ST- segment elevation myocardial infarction (STEMI). Methods Sixty five patients with STEMI undergoing primary PCI and receiving thrombus aspiration catheter combined with intracoronary tirofiban injection were enrolled as study group, and those who had similar coronary angiography results and basic characteristics but only received routine primary PCI (n= 60) were served as control group. The outcomes of two groups were observed and compared. Results The TIMI grade 3 flow, the TIMI frame count, resolution of sum of ST- segment elevation,peak- value of CK- MB, no- reflow in IRA after PCI, LVEF, LVEDd,LVESd and the MACE rates after 3 months in study group were superior to those in the control group (P<0.05 or 0.01). No significant differences were found between the two group after 1 week (P >0.05).Conclusion Application of thrombus aspiration catheter combined with intracoronary tirofiban injection in patients with acute ST-segment elevation myocardial infarction is effective, which could decrease no-reflow phenomenon and improve re- perfusion and left ventricular function with better clinical outcomes in 3 months.%目的 观察对急性ST段抬高型心肌梗死(STEMI)患者行直接经皮冠状动脉介入(PCI)手术中应用血栓抽吸导管联合冠状动脉内注射替罗非班的疗效.方法 选择因STEMI行直接PCI并于术中应用Thrombuster II血栓抽吸导管联合冠状动脉内推注替罗非班的患者65例作为治疗组,以基础临床资料和冠状动脉影像特征相似并单纯行直接PCI的60例患者作为对照组,观察临床疗效.结果 治疗组在TIMI 3级血流、校正TIMI帧数、术后2 h ST段回落程度、酶峰值和峰值时间以及梗死相关血管(IRA)无复流发生率均优于对照组(P<0.05或 0.01).治疗组术后3

  6. Clinical Effect of Poractant Alfa Injection on Severe Meconium Aspiration Pneumonia in Newborns%猪肺磷脂注射液治疗新生儿重症胎粪吸入性肺炎的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    蔡泽民

    2015-01-01

    Objective To observe the clinical effect of poractant alfa injection on severe meconium aspiration pneumonia in newborns. Methods From January 2012 to June 2014,a total of 60 newborns with severe meconium aspiration pneumonia were selected in the Department of Pediatrics,the First Affiliated Hospital of Nanhua University,and they were randomly divided into control group and observation group,each of 30 cases. Newborns of control group were given conventional therapy,while newborns of observation group were given poractant alfa injection based on conventional therapy. PaO2,PaO2/FiO2 before treatment and 2 -,12 -,24 -hour after treatment were compared between the two groups,and ventilator using time,oxygen inhalation time and hospital stays were recorded. Results No statistically significant differences of PaO2 or PaO2/FiO2 was found between the two groups before treatment ( P >0. 05 );while PaO2 and PaO2/FiO2 of observation group were higher than those of control group 2 -,12 -,24 -hour after treatment,respectively(P 0.05);观察组患儿治疗后2 h、12 h、24 h PaO2、PaO2/FiO2均高于对照组(P<0.05)。观察组患儿使用呼吸机时间、吸氧时间及住院时间均短于对照组(P<0.05)。结论猪肺磷脂注射液治疗新生儿重症胎粪吸入性肺炎的临床疗效确切,能有效改善患儿氧合状态,缩短患儿使用呼吸机时间、吸氧时间及住院时间。

  7. High-Altitude Aspirations

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Can a planned merger bring two loss-making Shanghai air carriers back to life?By pursuing a merger with Shanghai Airlines Corp. Ltd., the struggling air travel giant China Eastern Airlines Corp. Ltd. is injecting some steam into what looks to be a languid season.

  8. Electromagnetic field-based navigation for percutaneous punctures on C-arm CT: experimental evaluation and clinical application.

    Science.gov (United States)

    Meyer, Bernhard C; Peter, Olaf; Nagel, Markus; Hoheisel, Martin; Frericks, Bernd B; Wolf, Karl-Jürgen; Wacker, Frank K

    2008-12-01

    The aim of this study was to prospectively evaluate the needle visualization and placement error and use of an electromagnetic field-based tracking navigation device for puncture procedures based on C-arm CT (CACT) images. A commercially available navigation device was mounted on an angiographic X-ray system setup for CACT. After the target was defined, needle placement was performed under real-time visualization of the virtual needle in CACT images. The final, real needle position was assessed by CACT. Punctures were performed in phantoms (n = 76) and in twelve patients (eight biopsies, three drainages, one injection). Procedure times, system error, user error and total error were assessed. In phantoms, mean total error was 2.3 +/- 0.9 mm, user error was 1.4 +/- 0.8 mm and system error was 1.7 +/- 0.8 mm. In the patient study, the targeted puncture was successful in all twelve cases. The mean total error was 5.4 mm +/- 1.9 mm (maximum 8.1 mm), user error was 3.7 +/- 1.7 mm, system error was 3.2 +/- 1.4 mm and mean skin-to-target time was less than 1 min. The navigation device relying on CACT was accurate in terms of needle visualization and useful for needle placement under both experimental and clinical conditions. For more complex procedures, electromagnetic field-based tracking guidance might be of help in facilitating the puncture and reducing both the puncture risk and procedure time.

  9. Electromagnetic field-based navigation for percutaneous punctures on C-arm CT: experimental evaluation and clinical application

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, Bernhard C.; Peter, Olaf; Frericks, Bernd B.; Wolf, Karl-Juergen [Charite - University Hospital, Campus Benjamin Franklin, Department of Radiology and Nuclear Medicine, Berlin (Germany); Nagel, Markus [CAS innovations AG, Erlangen (Germany); Hoheisel, Martin [Siemens Healthcare, Forchheim (Germany); Wacker, Frank K. [Charite - University Hospital, Campus Benjamin Franklin, Department of Radiology and Nuclear Medicine, Berlin (Germany); The Johns Hopkins Hospital, Radiology Department, Division of Vascular and Interventional Radiology, Baltimore, MD (United States)

    2008-12-15

    The aim of this study was to prospectively evaluate the needle visualization and placement error and use of an electromagnetic field-based tracking navigation device for puncture procedures based on C-arm CT (CACT) images. A commercially available navigation device was mounted on an angiographic X-ray system setup for CACT. After the target was defined, needle placement was performed under real-time visualization of the virtual needle in CACT images. The final, real needle position was assessed by CACT. Punctures were performed in phantoms (n = 76) and in twelve patients (eight biopsies, three drainages, one injection). Procedure times, system error, user error and total error were assessed. In phantoms, mean total error was 2.3 {+-} 0.9 mm, user error was 1.4 {+-} 0.8 mm and system error was 1.7 {+-} 0.8 mm. In the patient study, the targeted puncture was successful in all twelve cases. The mean total error was 5.4 mm {+-} 1.9 mm (maximum 8.1 mm), user error was 3.7 {+-} 1.7 mm, system error was 3.2 {+-} 1.4 mm and mean skin-to-target time was less than 1 min. The navigation device relying on CACT was accurate in terms of needle visualization and useful for needle placement under both experimental and clinical conditions. For more complex procedures, electromagnetic field-based tracking guidance might be of help in facilitating the puncture and reducing both the puncture risk and procedure time. (orig.)

  10. Gluteal Compartment Syndrome following an Iliac Bone Marrow Aspiration.

    Science.gov (United States)

    Berumen-Nafarrate, Edmundo; Vega-Najera, Carlos; Leal-Contreras, Carlos; Leal-Berumen, Irene

    2013-01-01

    The compartment syndrome is a condition characterized by a raised hydraulic pressure within a closed and non expandable anatomical space. It leads to a vascular insufficiency that becomes critical once the vascular flow cannot return the fluids back to the venous system. This causes a potential irreversible damage of the contents of the compartment, especially within the muscle tissues. Gluteal compartment syndrome (GCS) secondary to hematomas is seldom reported. Here we present a case of a 51-year-old patient with history of a non-Hodgkin lymphoma who underwent a bone marrow aspiration from the posterior iliac crest that had excessive bleeding at the puncture zone. The patient complained of increasing pain, tenderness, and buttock swelling. Intraoperative pressure validation of the gluteal compartment was performed, and a GCS was diagnosed. The patient was treated with a gluteal region fasciotomy. The patient recovered from pain and swelling and was discharged shortly after from the hospital. We believe clotting and hematologic disorders are a primary risk factor in patients who require bone marrow aspirations or biopsies. It is important to improve awareness of GCS in order to achieve early diagnosis, avoid complications, and have a better prognosis.

  11. Gluteal Compartment Syndrome following an Iliac Bone Marrow Aspiration

    Directory of Open Access Journals (Sweden)

    Edmundo Berumen-Nafarrate

    2013-01-01

    Full Text Available The compartment syndrome is a condition characterized by a raised hydraulic pressure within a closed and non expandable anatomical space. It leads to a vascular insufficiency that becomes critical once the vascular flow cannot return the fluids back to the venous system. This causes a potential irreversible damage of the contents of the compartment, especially within the muscle tissues. Gluteal compartment syndrome (GCS secondary to hematomas is seldom reported. Here we present a case of a 51-year-old patient with history of a non-Hodgkin lymphoma who underwent a bone marrow aspiration from the posterior iliac crest that had excessive bleeding at the puncture zone. The patient complained of increasing pain, tenderness, and buttock swelling. Intraoperative pressure validation of the gluteal compartment was performed, and a GCS was diagnosed. The patient was treated with a gluteal region fasciotomy. The patient recovered from pain and swelling and was discharged shortly after from the hospital. We believe clotting and hematologic disorders are a primary risk factor in patients who require bone marrow aspirations or biopsies. It is important to improve awareness of GCS in order to achieve early diagnosis, avoid complications, and have a better prognosis.

  12. Gluteal Compartment Syndrome following an Iliac Bone Marrow Aspiration

    Science.gov (United States)

    Vega-Najera, Carlos; Leal-Contreras, Carlos; Leal-Berumen, Irene

    2013-01-01

    The compartment syndrome is a condition characterized by a raised hydraulic pressure within a closed and non expandable anatomical space. It leads to a vascular insufficiency that becomes critical once the vascular flow cannot return the fluids back to the venous system. This causes a potential irreversible damage of the contents of the compartment, especially within the muscle tissues. Gluteal compartment syndrome (GCS) secondary to hematomas is seldom reported. Here we present a case of a 51-year-old patient with history of a non-Hodgkin lymphoma who underwent a bone marrow aspiration from the posterior iliac crest that had excessive bleeding at the puncture zone. The patient complained of increasing pain, tenderness, and buttock swelling. Intraoperative pressure validation of the gluteal compartment was performed, and a GCS was diagnosed. The patient was treated with a gluteal region fasciotomy. The patient recovered from pain and swelling and was discharged shortly after from the hospital. We believe clotting and hematologic disorders are a primary risk factor in patients who require bone marrow aspirations or biopsies. It is important to improve awareness of GCS in order to achieve early diagnosis, avoid complications, and have a better prognosis. PMID:24392235

  13. 明视深静脉穿刺置管术犬实验研究%Research on visual deep vein puncture and catheterization

    Institute of Scientific and Technical Information of China (English)

    冯继泽

    2011-01-01

    Objective To investigate the effect and adverse reaction of the self - made visual deep vein puncture needle. Methods Sixty adult dogs were randomly divided into jugular vein puncture group ( 30 dogs ) and femoral vein puncture group ( 30 dogs ). Vein display, success catheterization, and edema after pressure injection of saline were ohserved and compared between two groups. Results The vein puncture was clearly showed and the catheterization was successful in both groups. The definition in femoral vein group was slightly higher than that in jugular vein. Edema occurred in puncture site after local pressure injection in both groups; but the edema was more ohvious in femoral vein group compared with that in jugular vein group ( P <0. 05 ). Conclusion Visual puncture technique can effectively improve the precision and security of puncture , facilitate the operation of difficult puncture, and reduce the incidence of puncture complications.%目的 探讨自制可视深静脉穿刺针的穿刺效果及不良反应.方法 将60只成年犬随机分为两组,各30只,颈内静脉组采用颈内静脉穿刺,股静脉组采用股静脉穿刺,分别观察能否清晰显示静脉、穿刺置管是否成功,对加压注入0.9%氯化钠溶液后水肿情况及恢复情况进行对比分析.结果 两组不同路径穿刺均能较清晰显示静脉、穿刺置管是否成功,在清晰程度上股静脉组清晰度略高于颈内静脉组,加压注水后穿刺局部都有水肿,但颈内静脉组水肿程度轻,且差异具有统计学意义(P<0.05).结论 应用明视穿刺技术可有效提高穿刺精确度,解决困难穿刺的问题,并可减少穿刺并发症的发生,提高穿刺的安全性.

  14. Dalteparin Injection

    Science.gov (United States)

    ... pa' rin)If you have an epidural or spinal anesthesia or a spinal puncture while using a 'blood ... left in your body, if you recently had spinal anesthesia (administration of pain medication in the area around ...

  15. Inadequate fine needle aspiration biopsy samples: Pathologists versus other specialists

    Directory of Open Access Journals (Sweden)

    Gomez-Macias G

    2009-01-01

    Full Text Available Background: Fine needle aspiration biopsy (FNAB is a simple, sensitive, quick and inexpensive method in which operator experience is essential for obtaining the best results. Methods: A descriptive study in which the aspiration biopsy cases of the Pathology and Cytopathology Service of the University Hospital of the UANL (2003-2005 were analyzed. These were divided into three study groups: Group 1, FNAB performed by a pathologist; Group 2, FNAB performed by specialists who are not pathologists, Group 3, FNAB guided by an imaging study with immediate evaluation by a pathologist. The samples were classified as adequate and inadequate for diagnosis, the organ, the size and characteristics of the lesions were taken into consideration. Results: A total of 1905 FNAB were included. In Group 1: 1347 were performed of which 1242 (92.2% were adequate and 105 (7.7% were inadequate. Of the 237 from Group 2, 178 were adequate (75.1% and 59 inadequate (24.8%; in Group 3 there were 321 of which 283 (88.1% were adequate and 38 (11.8% inadequate. A statistically significant difference was found between FNAB performed by Group 1 (p< 0.001 and the other groups. A multivariate analysis was done where the organ punctured, the study groups, the size and characteristics of the lesion by study group were compared, finding that the most important variable was the person who performed the procedure. Conclusion: The experience and training of the person performing the aspiration biopsy, as well as immediate evaluation of the material when it is guided, substantially reduces the number of inadequate samples, improving the sensitivity of the method as well as reducing the need for open biopsies to reach a diagnosis.

  16. Blood-letting punctures at twelve Jing-Well points of the hand can treat cerebral ischemia in a similar manner to mannitol

    Institute of Scientific and Technical Information of China (English)

    Xuan Lu; Zelin Chen; Yi Guo; Liang Gao; Liyuan Jiang; Zhongzheng Li; Jianqiao Fang

    2013-01-01

    A rat model of middle cerebral artery permanent occlusion was established using the modified Longa method. Successfully established model animals were treated by blood-letting puncture at twelve Jing-Well points of the hand, and/or by injecting mannitol into the caudal vein twice daily. Brain tissue was collected at 24, 48 and 72 hours after modeling, and blood was collected through the retinal vein before Evans blue was injected, approximately 1 hour prior to harvesting of brain tissue. Results showed that Evans blue leakage into brain tissue and serum nitric oxide synthase activity were significantly increased in model rats. Treatment with blood-letting punctures at twelve Jing-Well points of the hand and/or injection of mannitol into the caudal vein reduced the amount of Evans blue leakage into the brain tissue and serum nitric oxide synthase activity to varying degrees. There was no significant difference between single treatment and combined treatment. Experimental findings indicate that blood-letting punctures at twelve Jing-Well points of the hand can decrease blood-brain barrier permeability and serum nitric oxide synthase activity in rats following middle cerebral artery occlusion, and its effect is similar to that of mannitol injection alone and Jing-Well points plus mannitol injection.

  17. Headache in the parturient: Pathophysiology and management of post-dural puncture headache

    Directory of Open Access Journals (Sweden)

    Gita Nath

    2011-01-01

    Full Text Available Headache in the postpartum period is common and multifactorial in origin. Apart from primary causes such as tension headaches and migraine, secondary headaches such as post-dural puncture headache (PDPH are increasingly common because of increasing use of regional anaesthesia and analgesia during childbirth. Preventive measures for PDPH include the use of smaller gauge pencil-point needles for spinal blocks; epidural needles of 18 G or less; using saline rather than air for epidural space identification and the use of ultrasound guidance, especially for difficult cases such as morbid obesity and spinal deformities. In case of accidental dural puncture (ADP, the choice is between inserting the catheter in an adjacent space or intrathecal catheterization. Current evidence seems to be in favour of inserting the epidural catheter into the subarachnoid space and using the intrathecal catheter for analgesia/anaesthesia after prominently labelling it as intrathecal, to prevent misuse. It should be removed after at least 24 hours and a 10 ml bolus of saline injected before removal of catheter may be helpful. Either way, having written protocols for the management of accidental dural puncture helps to reduce the incidence of PDPH. PDPH can be disabling in severity and can mar the whole experience of childbirth. In addition, severe untreated PDPH can cause complications such as nerve palsies, subdural hematoma and cerebral venous thrombosis. Conservative methods of treatment should be tried first such as adequate hydration, paracetamol, caffeine, sumatriptan or ACTH/hydrocortisone. Epidural blood patching is the most effective treatment for PDPH. It is more effective if done 24-48 hours after dural puncture. It is an invasive procedure with its own complications as well as a failure rate of up to 30%, so that a second or even third patch may be necessary. Both these facts should be intimated to the patient beforehand. Meticulous follow-up and evaluation

  18. Aspiration of biological viscoelastic drops

    CERN Document Server

    Guevorkian, Karine; Durth, Mélanie; Dufour, Sylvie; Brochard-Wyart, Françoise

    2010-01-01

    Spherical cellular aggregates are in vitro systems to study the physical and biophysical properties of tissues. We present a novel approach to characterize the mechanical properties of cellular aggregates using micropipette aspiration technique. We observe an aspiration in two distinct regimes, a fast elastic deformation followed by a viscous flow. We develop a model based on this viscoelastic behavior to deduce the surface tension, viscosity, and elastic modulus. A major result is the increase of the surface tension with the applied force, interpreted as an effect of cellular mechanosensing.

  19. ASPIRE: Added-value Sensing

    DEFF Research Database (Denmark)

    Anggorojati, Bayu; Cetin, Kamil; Mihovska, Albena D.

    2010-01-01

    FP7 ICT project ASPIRE is one of the coordinated European efforts to further the advancement of this technology, in the areas of enabling technology development for RFID. The focus of ASPIRE is on the design, development and adoption of an innovative, programmable, royalty-free, lightweight...... and privacy friendly RFID middleware. Advances in active RFID integration with WSNs allow for more RFID-based applications to be developed. In order to fill the gap between the active RFID system and the existing middleware, a HAL for active reader and ALE server extension to support sensing data from active...

  20. Aspiration of Nasopore nasal packing.

    Science.gov (United States)

    Smith, Jonathan; Reddy, Ekambar

    2017-10-04

    We present a case of postoperative Nasopore aspiration in an otherwise fit and well 11-year-old. An endoscopic adenoidectomy had been performed without incident and Nasopore packing placed into each nasal cavity. Immediately after extubation, there was marked hypoxia, tachypnoea and high clinical suspicion of pack aspiration. The patient returned to theatre for emergency rigid bronchoscopy and retrieval of nasal packing. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. A Note on Dirac Operators on the Quantum Punctured Disk

    Directory of Open Access Journals (Sweden)

    Slawomir Klimek

    2010-07-01

    Full Text Available We study quantum analogs of the Dirac type operator −2z∂/∂z on the punctured disk, subject to the Atiyah-Patodi-Singer boundary conditions. We construct a parametrix of the quantum operator and show that it is bounded outside of the zero mode.

  2. Anomalous stylet punctures of phloem sieve elements by aphids

    NARCIS (Netherlands)

    Tjallingii, W.F.; Gabrys, B.

    1999-01-01

    A deviating type of potential drop (pd), i.e. the electrically recorded intracellular punctures during the pathway phase of plant penetration by aphids, is described and discussed. This so-called repetitive pd (R-pd) has been observed in 4 aphid species, two on herbs and two on sycamore. Apart from

  3. Recent Advances in Thermoplastic Puncture-Healing Polymers

    Science.gov (United States)

    Bogert, Philip B.; Working, Dennis C.; Wise, Kristopher E.; Smith, Janice Y.; Topping, Crystal C.; Britton, Sean M.; Bagby, Paul R.; Siochi, Emilie J.

    2010-01-01

    The motivation for this work is to develop self-healing polymeric materials to enable damage tolerant systems, and to tailor puncture healing for use temperatures and applications. This will be a benefit in environments and conditions where access for manual repair is limited or impossible, or where damage may not be detected.

  4. Punctures for Theories of Class $\\mathcal{S}_\\Gamma$

    CERN Document Server

    Heckman, Jonathan J; Rudelius, Tom; Vafa, Cumrun

    2016-01-01

    With the aim of understanding compactifications of 6D superconformal field theories to four dimensions, we study punctures for theories of class $\\mathcal{S}_{\\Gamma}$. The class $\\mathcal{S}_{\\Gamma}$ theories arise from M5-branes probing $\\mathbb{C}^2 / \\Gamma$, an ADE singularity. The resulting 4D theories descend from compactification on Riemann surfaces decorated with punctures. We show that for class $\\mathcal{S}_{\\Gamma}$ theories, a puncture is specified by singular boundary conditions for fields in the 5D quiver gauge theory obtained from compactification of the 6D theory on a cylinder geometry. We determine general boundary conditions and study in detail solutions with first order poles. This yields a generalization of the Nahm pole data present for $1/2$ BPS punctures for theories of class $\\mathcal{S}$. Focusing on specific algebraic structures, we show how the standard discussion of nilpotent orbits and its connection to representations of $\\mathfrak{su}(2)$ generalizes in this broader context.

  5. REINFORCEMENT AND REDUCTION OF BLOOD-LETTING PUNCTURE THERAPY

    Institute of Scientific and Technical Information of China (English)

    王茎

    2003-01-01

    @@ Blood-letting puncture has a long history inthe development process of acupuncture andmoxibustion science. As early as the time whenthe book Huang Di Nei Jing ( The Yellow Em-peror's Internal Classic ) came intobeing, there had been some comparatively de-tailed descriptions on the theory, manipulationand clinical application of this therapy.

  6. An audit of consent practices and perceptions of lumbar puncture, Botswana inpatient setting experience

    Directory of Open Access Journals (Sweden)

    M.B. King

    2015-06-01

    Conclusion: Contrasting responses between doctors and patients indicates a need for standard consenting practices among doctors. Also, patients’ attitudes and receptiveness to lumbar punctures can be improved through education on lumbar puncture indications, benefits, and risks.

  7. Insertion of an intrathecal catheter following accidental dural puncture : a meta-analysis

    NARCIS (Netherlands)

    Heesen, M.; Kloehr, S.; Rossaint, R.; Walters, M.; Straube, S.; van de Velde, M.

    Background: Inserting an intrathecal catheter after accidental dural puncture in parturients to prevent postdural puncture headache is becoming increasingly popular. We aimed to identify relevant published articles investigating this intervention and subject data to a meta-analysis. Methods: A

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-02-15

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

  9. Puncture mechanics of cnidarian cnidocysts: a natural actuator

    Science.gov (United States)

    Oppegard, Shawn C; Anderson, Peter A; Eddington, David T

    2009-01-01

    Background Cnidocysts isolated from cnidarian organisms are attractive as a drug-delivery platform due to their fast, efficient delivery of toxins. The cnidocyst could be utilized as the means to deliver therapeutics in a wearable drug-delivery patch. Cnidocysts have been previously shown to discharge upon stimulation via electrical, mechanical, and chemical pathways. Cnidocysts isolated from the Portuguese Man O' War jellyfish (Physalia physalis) are attractive for this purpose because they possess relatively long threads, are capable of puncturing through hard fish scales, and are stable for years. Results As a first step in using cnidocysts as a functional component of a drug delivery system, the puncture mechanics of the thread were characterized. Tentacle-contained cnidocysts were used as a best-case scenario due to physical immobilization of the cnidocysts within the tentacle. Ex vivo tentacle-contained cnidocysts from Physalia possessed an elastic modulus puncture threshold of approximately 1-2 MPa, based on puncture tests of materials with a gamut of hardness. Also, a method for inducing discharge of isolated cnidocysts was found, utilizing water as the stimulant. Preliminary lectin-binding experiments were performed using fluorophore-conjugated lectins as a possible means to immobilize the isolated cnidocyst capsule, and prevent reorientation upon triggering. Lectins bound homogeneously to the surface of the capsule, suggesting the lectins could be used for cnidocyst immobilization but not orientation. Conclusion Cnidocysts were found to puncture materials up to 1 MPa in hardness, can be discharged in a dry state using water as a stimulant, and bind homogeneously to lectins, a potential means of immobilization. The information gained from this preliminary work will aid in determining the materials and design of the patch that could be used for drug delivery. PMID:19785761

  10. Puncture mechanics of cnidarian cnidocysts: a natural actuator

    Directory of Open Access Journals (Sweden)

    Eddington David T

    2009-09-01

    Full Text Available Abstract Background Cnidocysts isolated from cnidarian organisms are attractive as a drug-delivery platform due to their fast, efficient delivery of toxins. The cnidocyst could be utilized as the means to deliver therapeutics in a wearable drug-delivery patch. Cnidocysts have been previously shown to discharge upon stimulation via electrical, mechanical, and chemical pathways. Cnidocysts isolated from the Portuguese Man O' War jellyfish (Physalia physalis are attractive for this purpose because they possess relatively long threads, are capable of puncturing through hard fish scales, and are stable for years. Results As a first step in using cnidocysts as a functional component of a drug delivery system, the puncture mechanics of the thread were characterized. Tentacle-contained cnidocysts were used as a best-case scenario due to physical immobilization of the cnidocysts within the tentacle. Ex vivo tentacle-contained cnidocysts from Physalia possessed an elastic modulus puncture threshold of approximately 1-2 MPa, based on puncture tests of materials with a gamut of hardness. Also, a method for inducing discharge of isolated cnidocysts was found, utilizing water as the stimulant. Preliminary lectin-binding experiments were performed using fluorophore-conjugated lectins as a possible means to immobilize the isolated cnidocyst capsule, and prevent reorientation upon triggering. Lectins bound homogeneously to the surface of the capsule, suggesting the lectins could be used for cnidocyst immobilization but not orientation. Conclusion Cnidocysts were found to puncture materials up to 1 MPa in hardness, can be discharged in a dry state using water as a stimulant, and bind homogeneously to lectins, a potential means of immobilization. The information gained from this preliminary work will aid in determining the materials and design of the patch that could be used for drug delivery.

  11. A Complete Conformal Metric of Preassigned Negative Gaussian Curvature for a Punctured Hyperbolic Riemann Surface

    Indian Academy of Sciences (India)

    Rukmini Dey

    2004-05-01

    Let ℎ be a complete metric of Gaussian curvature 0 on a punctured Riemann surface of genus ≥ 1 (or the sphere with at least three punctures). Given a smooth negative function with =0 in neighbourhoods of the punctures we prove that there exists a metric conformal to ℎ which attains this function as its Gaussian curvature for the punctured Riemann surface. We do so by minimizing an appropriate functional using elementary analysis.

  12. The Use of ExoSeal Vascular Closure Device for Direct Antegrade Superficial Femoral Artery Puncture Site Hemostasis

    Energy Technology Data Exchange (ETDEWEB)

    Rimon, Uri, E-mail: rimonu@sheba.health.gov.il; Khaitovich, Boris, E-mail: borislena@012.net.il [Tel-Aviv University, Diagnostic and Interventional Imaging Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Yakubovich, Dmitry, E-mail: Dmitry.Yakubovitch@sheba.health.gov.il [Tel-Aviv University, Vascular Surgery Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Bensaid, Paul, E-mail: paulbensaid@hotmail.com; Golan, Gil, E-mail: gilgolan201@gmail.com [Tel-Aviv University, Diagnostic and Interventional Imaging Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Silverberg, Daniel, E-mail: Daniel.Silverberg@sheba.health.gov.il [Tel-Aviv University, Vascular Surgery Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel)

    2015-06-15

    PurposeThis study was designed to assess the efficacy and safety of the ExoSeal vascular closure device (VCD) to achieve hemostasis in antegrade access of the superficial femoral artery (SFA).MethodsWe retrospectively reviewed the outcome of ExoSeal VCD used for hemostasis in 110 accesses to the SFA in 93 patients between July 2011 and July 2013. All patients had patent proximal SFA based on computer tomography angiography or ultrasound duplex. Arterial calcifications at puncture site were graded using fluoroscopy. The SFA was accessed in an antegrade fashion with ultrasound or fluoroscopic guidance. In all patients, 5–7F vascular sheaths were used. The ExoSeal VCD was applied to achieve hemostasis at the end of the procedure. All patients were clinically examined and had ultrasound duplex exam for any puncture site complications during the 24 h postprocedure.ResultsIn all procedures, the ExoSeal was applied successfully. We did not encounter any device-related technical failure. There were four major complications in four patients (3.6 %): three pseudoaneurysms, which were treated with direct thrombin injection, and one hematoma, which necessitated transfusion of two blood units. All patients with complications were treated with anticoagulation preprocedure or received thrombolytic therapy.ConclusionsThe ExoSeal VCD can be safely used for antegrade puncture of the SFA, with a high procedural success rate (100 %) and a low rate of access site complications (3.6 %)

  13. Using a Motion Sensor-Equipped Smartphone to Facilitate CT-Guided Puncture.

    Science.gov (United States)

    Hirata, Masaaki; Watanabe, Ryouhei; Koyano, Yasuhiro; Sugata, Shigenori; Takeda, Yukie; Nakamura, Seiji; Akamune, Akihisa; Tsuda, Takaharu; Mochizuki, Teruhito

    2017-04-01

    To demonstrate the use of "Smart Puncture," a smartphone application to assist conventional CT-guided puncture without CT fluoroscopy, and to describe the advantages of this application. A puncture guideline is displayed by entering the angle into the application. Regardless of the angle at which the device is being held, the motion sensor ensures that the guideline is displayed at the appropriate angle with respect to gravity. The angle of the smartphone's liquid crystal display (LCD) is also detected, preventing needle deflection from the CT slice image. Physicians can perform the puncture procedure by advancing the needle using the guideline while the smartphone is placed adjacent to the patient. In an experimental puncture test using a sponge as a target, the target was punctured at 30°, 50°, and 70° when the device was tilted to 0°, 15°, 30°, and 45°, respectively. The punctured target was then imaged with a CT scan, and the puncture error was measured. The mean puncture error in the plane parallel to the LCD was less than 2°, irrespective of device tilt. The mean puncture error in the sagittal plane was less than 3° with no device tilt. However, the mean puncture error tended to increase when the tilt was increased. This application can transform a smartphone into a valuable tool that is capable of objectively and accurately assisting CT-guided puncture procedures.

  14. 双针穿刺臭氧注射+等离子射频治疗盘源性腰腿痛的临床研究%Clinical study of double needle puncture ozone injection combined with coblation in the treatment of discogenic low back pain

    Institute of Scientific and Technical Information of China (English)

    葛维鹏; 郑观荣; 杜梅青; 徐伟民; 王大龙; 张海山; 何明伟

    2015-01-01

    Objective To observe the efficacy and safety of intervertebral disc double needle injection of ozone combined with ablation for the treatment of discogenic low back pain of coblation target through different minimally invasive methods. Methods Totally 120 patients received minimally invasive interventional treatment for lumbar intervertebral disc were randomly divided into 3 groups, Group A received coblation, Group B received double needle injection of ozone, and Group C received both ablation and double needle injection of ozone. Visual analogue scale(VAS), treatment effect, Oswestry disability index(ODI) and complications were evaluated before the treatment, 3 days, 30 days and 90 days after the treatment for all patients. Results The VAS values after treatment in each group significantly decreased, and the difference was statistically significant(P<0. 05), and the VAS value reduction and the therapeutic effect of Group C 30 days and 90 days and the ODI of Group C 90 days after the treatment were much more significant than that of Group A and B(P<0. 05). No significant complication happened during treatment. Conclusion The therapeutic effect of the combination of double needle injection of ozone and coblation was more obvious and lasted longer.%目的:探讨双针穿刺臭氧注射结合低温等离子射频治疗盘源性腰腿痛的有效性和安全性。方法将120例盘源性腰腿痛患者采用数字表法随机分为3组,A组行低温等离子射频,B组行双针穿刺臭氧注射,C组行双针穿刺臭氧注射结合低温等离子射频。评价各组治疗前,治疗后3、30、90 d的视觉模拟评分( visual analogue scale,VAS)、治疗效果、Oswestry功能障碍指数( Oswestry disability index,ODI)及合并症发生情况。结果3组患者治疗后各时间点VAS与治疗前比较,差异有统计学意义( P<0.05),C组治疗后30、90 d VAS和治疗效果优良率及治疗后90 d ODI与A组、B组比较,差异有统计学意义(P<0.05)。

  15. Applying a Typology to Vocational Aspirations.

    Science.gov (United States)

    Holland, John L.; Gottfredson, Gary D.

    The psychological meaning and predictive value of a person's vocational aspirations were examined by applying Holland's typology to the vocational aspirations of high school juniors (N=1,005), college juniors (N=692), employed adults (N=140), and a second sample of college students studied over a 1 year interval (N=624). The aspirational data were…

  16. Aspirations of Latina Adolescent Suicide Attempters

    Science.gov (United States)

    Hausmann-Stabile, Carolina; Gulbas, Lauren; Zayas, Luis H.

    2013-01-01

    Parents' aspirations and expectations are communicated to their offspring. Children internalize their parents' aspirations and accept some of the expectations while rejecting others, all part of the developmental process and identity-consolidation. When the aspirations and expectations of youth and parents are incongruent, the outcomes…

  17. Fine-needle aspiration cytology in Hodgkin’s lymphoma

    Directory of Open Access Journals (Sweden)

    Nedeljkov-Jančić Ružica

    2005-01-01

    Full Text Available Background. Cell composition of tumor tissue in Hodgkin’s lymphoma is considered to be specific. According to some authors, precise cytomorphological analysis of the specimen obtained by fine needle enables the diagnosis of the histologically well-defined form of lymphoma in a high percentage of cases. However, other authors consider the precise diagnosis of HL based on cytological analysis of a lymph node puncture specimen extremely difficult. The aim of this study was to a assess the diagnostic accuracy of cytomorphological analysis, as well as the possibility of application of this method in establishing the preliminary or even final diagnosis of this form of lymphoma. Methods. Thirty four samples were analyzed, obtained by fine needle aspiration, in patients examined and treated at the Institute of Hematology, Clinical center of Serbia, Belgrade. Smears were stained by May-Grünvald-Giemsa and Papanicolau methods. Results. The finding of typical multinucleate Reed-Sternberg cells in the smears of lymph node puncture specimen was diagnostically significant, as well as the finding of mononuclear variances of the neoplastic cells of anunusual morphology (Hodgkin’s cells. The cell environment in the background of the above-mentioned tumor cells was heterogeneous. It was composed of small lymphocytes, plasma cells, eosinophils and reticular cells. These cell forms, found in cell preparations, resembled those seen in the tissue sections of the relevant extirpated lymph nodes. The comparison of the cytological findings in the fine needle specimen to the subsequently established histological diagnoses of HL revealed a high correlation of 85.2%. Conclusion. Cytological examination of fine needle lymph node specimens is still significant for the diagnosis of HL in spite of the development of more sophisticated methods used for verification of the diagnosis of this neoplasm.

  18. Recent Advances in Thermoplastic Puncture-Healing Polymers

    Science.gov (United States)

    Gordon, K. L.; Working, D. C.; Wise, K. E.; Bogert, P. B.; Britton, S. M.; Topping, C.C.; Smith, J. Y.; Siochi, E. J.

    2009-01-01

    Self-healing materials provide a route for enhanced damage tolerance in materials for aerospace applications. In particular, puncture-healing upon impact has the potential to mitigate significant damage caused by high velocity micrometeoroid impacts. This type of material also has the potential to improve damage tolerance in load bearing structures to enhance vehicle health and aircraft durability. The materials being studied are those capable of instantaneous puncture healing, providing a mechanism for mechanical property retention in lightweight structures. These systems have demonstrated healing capability following penetration of fast moving projectiles -- velocities that range from 9 mm bullets shot from a gun (approx.330 m/sec) to close to micrometeoroid debris velocities of 4800 m/sec. In this presentation, we report on a suite of polymeric materials possessing this characteristic. Figure 1 illustrates the puncture healing concept. Puncture healing in these materials is dependent upon how the combination of a polymer's viscoelastic properties responds to the energy input resulting from the puncture event. Projectile penetration increases the temperature in the vicinity of the impact. Self-healing behavior occurs following puncture, whereby energy must be transferred to the material during impact both elastically and inelastically, thus establishing two requirements for puncture healing to occur: a.) The need for the puncture event to produce a local melt state in the polymer material and b.) The molten material has to have sufficient melt elasticity to snap back and close the hole. 1,2 Previous ballistic testing studies revealed that Surlyn materials warmed up to a temperature approx.98 C during projectile puncture (3 C higher than it s melting temperature). 1,2 The temperature increase produces a localized flow state and the melt elasticity to snap back thus sealing the hole. Table 1 lists the commercially polymers studied here, together with their physical

  19. Superficial Automated Keratopigmentation for Iris and Pupil Simulation Using Micronized Mineral Pigments and a New Puncturing Device: Experimental Study.

    Science.gov (United States)

    Rodriguez, Alejandra E; Amesty, Maria A; El Bahrawy, Mohammed; Rey, Severino; Alio Del Barrio, Jorge; Alio, Jorge L

    2017-09-01

    To study the outcomes and tolerance of micronized mineral pigments for corneal tattooing, using a superficial automated keratopigmentation (SAK) technique in an experimental animal model and a new puncture device to inject the pigments into the corneal stroma. Forty eyes of 40 New Zealand rabbits were included in this study. The animals were divided into groups A and B. Both groups underwent SAK using a new automated keratopigmentation device. Micronized mineral pigments were injected through the epithelium into the corneal stroma to replicate the iris color in 25 eyes (group A), and black color was used to replicate the pupil in 15 eyes (group B). Slit-lamp examination was performed to evaluate the outcome. Histopathological examination was also performed to ascertain the presence of pigment dispersion, inflammation, and/or neovascularization. All 40 eyes showed good cosmetic appearance after keratopigmentation. No intraoperative complications were detected. At the first week, mild or moderated conjunctival injection was observed in 13 eyes and transitory corneal epithelial defects were also detected in 27 eyes. Examination was unremarkable 2, 4, and 6 months after surgery. No neovascularization was detected in any case in the histopathology study. SAK using a new automated puncture device and micronized mineral pigments achieved good cosmetic outcomes for iris and pupil simulation. This method could be a valid alternative to treat serious cosmetic eye problems that affect the superficial cornea or functional problems, such as photophobia or diplopia secondary to iris defects or trauma.

  20. Direct orbital puncture of the cavernous sinus for the treatment of a carotid-cavernous dural AV fistula with a concomitant venous/lymphatic malformation.

    Science.gov (United States)

    Coumou, Adriaan D; van den Berg, René; Bot, Joost C; Beetsma, Daan B; Saeed, Peerooz

    2014-02-01

    A 37- year old male with a long history of a left orbital venous/lympathic malformation presented with ocular injection, increased proptosis and reduced left vision. Angiography demonstrated a carotid cavernous dural AV fistula combined with a concomitant venous/lymphatic malformation. After attempts at transvenous embolization, a direct uncomplicated transorbital puncture of the cavernous sinus via a lateral orbitotomy was performed with complete resolution of ocular symptoms.

  1. On Rate-Compatible Punctured Turbo Codes Design

    Directory of Open Access Journals (Sweden)

    Montorsi Guido

    2005-01-01

    Full Text Available We propose and compare some design criteria for the search of good systematic rate-compatible punctured turbo code (RCPTC families. The considerations presented by S. Benedetto et al. (1998 to find the "best" component encoders for turbo code construction are extended to find good rate-compatible puncturing patterns for a given interleaver length . This approach is shown to lead to codes that improve over previous ones, both in the maximum-likelihood sense (using transfer function bounds and in the iterative decoding sense (through simulation results. To find simulation and analytical results, the coded bits are transmitted over an additive white Gaussian noise (AWGN channel using an antipodal binary modulation. The two main applications of this technique are its use in hybrid incremental ARQ/FEC schemes and its use to achieve unequal error protection of an information sequence.

  2. Collapse of Nonlinear Gravitational Waves in Moving-Puncture Coordinates

    CERN Document Server

    Hilditch, David; Weyhausen, Andreas; Dietrich, Tim; Bruegmann, Bernd; Montero, Pedro J; Mueller, Ewald

    2013-01-01

    We study numerical evolutions of nonlinear gravitational waves in moving-puncture coordinates. We adopt two different types of initial data -- Brill and Teukolsky waves -- and evolve them with two independent codes producing consistent results. We find that Brill data fail to produce long-term evolutions for common choices of coordinates and parameters, unless the initial amplitude is small, while Teukolsky wave initial data lead to stable evolutions, at least for amplitudes sufficiently far from criticality. The critical amplitude separates initial data whose evolutions leave behind flat space from those that lead to a black hole. For the latter we follow the interaction of the wave, the formation of a horizon, and the settling down into a time-independent trumpet geometry. We explore the differences between Brill and Teukolsky data and show that for less common choices of the parameters -- in particular negative amplitudes -- Brill data can be evolved with moving-puncture coordinates, and behave similarly t...

  3. Bilateral subdural hematoma secondary to accidental dural puncture

    Directory of Open Access Journals (Sweden)

    Sofía Ramírez

    2015-08-01

    Full Text Available We report the case of a 25-year-old woman, who received epidural analgesia for labor pain and subsequently presented post-dural puncture headache. Conservative treatment was applied and epidural blood patch was performed. In the absence of clinical improvement and due to changes in the postural component of the headache, a brain imaging test was performed showing a bilateral subdural hematoma. The post-dural puncture headache is relatively common, but the lack of response to established medical treatment as well as the change in its characteristics and the presence of neurological deficit, should raise the suspicion of a subdural hematoma, which although is rare, can be lethal if not diagnosed and treated at the right time.

  4. Pleural puncture with thoracic epidural: A rare complication?

    Directory of Open Access Journals (Sweden)

    Rachna Wadhwa

    2011-01-01

    Full Text Available Freedom from pain has almost developed to be a fundamental human right. Providing pain relief via epidural catheters in thoracic and upper abdominal surgeries is widely accepted. Pain relief through this technique not only provides continuous analgesia but also reduces post-operative pulmonary complications and also hastens recovery. But being a blind procedure it is accompanied by certain complications. Hypotension, dura puncture, high epidural, total spinal, epidural haematoma, spinal cord injury and infection are some of the documented side effects of epidural block. There are case reports eliciting neurological complications, catheter site infections, paresthesias, radicular symptoms and worsening of previous neurological conditions. Few technical problems related to breakage of epidural catheter are also mentioned in the literature. The patient had no sequelae on long term follow up even when a portion of catheter was retained. We present a case report where epidural catheter punctured pleura in a patient undergoing thoracotomy for carcinoma oesophagus.

  5. Influences of thrombus aspiration combining intra-coronary IRA injection of tirofiban on no-reflow phenomenon and heart function in patients with STEMI%血栓抽吸联合冠状动脉内注射替罗非班对ST段抬高型患者无复流和心功能的影响

    Institute of Scientific and Technical Information of China (English)

    张学志; 杜青; 王其新; 周长勇

    2012-01-01

    Objective To investigate the influences of thrombus aspiration combining intra-coronary infarction-related artery ( IRA ) injection of tirofiban on no-reflow phenomenon and heart function in patients with ST-elevation myocardial infarction ( STEMI) during percutaneous coronary intervention ( PCI) . Methods The patients ( n=86) with STEMI ( TIMI≤ 1 ) were collected from Feb. 2008 to Apr. 2012 and randomly divided into experimental group and control group ( each n=43 ) . Control group was given tirofiban before PCI and experimental group was given additionally thrombus aspiration. The changes of TIMI flow grades after PCI, level of plasma N-terminal pro-brain natriuretic peptide ( Nt-proBNP) before PCI and one week and 6 months after PCI, and left ventricular end-diastolic volume ( LVEDV ) , left ventricular end-systolic volume ( LVESV ) , left ventricular ejection fraction ( LVEF ) and left ventricular end-diastolic volume index ( LVEDVI) immediately after PCI and one week and 6 months after PCI were compared between two groups. The heart function was reviewed and incidence rate of major adverse cardiovascular events ( MACE ) was observed in the patients within 6 months after PCI. Results ①The patients with TIMI flow grade 3 were more in experimental group than those in control group after PCI ( 39 vs. 28, P<0.05 ) . ②The level of Nt-proBNP decreased significantly ( P<0.01) , LVEF increased significantly (P<0.05 ) , and LVESV, LVEDV and LVEDVI decreased significantly (P <0.05 ) in experimental group compared with control group one week and 6 months after PCI. ③The incidence rate of MACE including angina and heart failure decreased significantly ( P<0.05 ) in experimental group within 6 months after PCI. Conclusion Thrombus aspiration combining intra-coronary IRA injection of tirofiban can reduce the incidence of no—reflow phenomenon during emergency PCI, relieve flow reperfusion in infarction area, improve left ventricular function, decrease ventricular

  6. 细菌性肝脓肿的经皮穿刺引流治疗%Percutaneous puncture and drainage treatment for pyogenic liver abscess

    Institute of Scientific and Technical Information of China (English)

    尹君; 唐启耀; 罗军

    2014-01-01

    Objective To explore the clinical application of percutaneous puncture and drainage in treating pyogenic liver abscess. Methods A total of 30 patients with pyogenic liver abscess were treated with ultrasound-guided percutaneous puncture and aspiration of abscess cavity , which was followed by DSA-guided drainage tube placement together with proper washing of abscess cavity. Results Puncturing and flushing of abscess cavity was performed in two patients with 4 cm liver abscess. No severe complications occurred. Complete cure was obtained in all the 26 patients who had no malignant tumors. Of the 4 patients with malignant tumor, cure obtained in one and death occurred in three. Conclusion Ultrasound-guided or DSA-guided percutaneous puncture and drainage therapy is technically simple, less invasive, highly safe and clinically effective treatment for pyogenic liver abscess.%目的:探讨经皮穿刺引流技术对细菌性肝脓肿治疗的临床价值。方法对30例细菌性肝脓肿患者在超声导引下进行穿刺与抽吸,在DSA导引下对脓肿进行置管引流,术后辅以适当的引流管冲洗。结果2例直径4 cm者进行置管引流,无严重并发症发生;26例无恶性肿瘤患者均治愈,4例肿瘤患者中1例治愈,3例死亡。结论超声与DSA引导下经皮穿刺抽吸引流技术治疗细菌性肝脓肿操作简单,创伤小,安全性高、恢复快。

  7. Informed Consent in Lumbar Puncture: ¿a Systematic Practice?

    Directory of Open Access Journals (Sweden)

    Ivonne Martín Hernández

    2011-08-01

    Full Text Available Background: the lumbar puncture is an invasive procedure doesn't exempt of risks and for its realization it is necessary to request the patient or family's informed consent. However, this practice is even controversial among our physicians. Objective: to identify how the process of informed consent works for the lumbar puncture in our means and its importance for our professionals. Methods: this study involved 90 physicians who were underwent a validated questionnaire. For the processing of numerical data was used frequency analysis and relative percent. SPSS 11.5 on Windows was employed as statistical system. Results: it was found that informed consent doesn't constitute a systematic practice in our means and was evidenced the deficiencies that even exist in its quality and application. This has been only carried out oral and the informative interest prevails above the respect to the patient's will. The physicians offer insufficient information in aspects like the explanation of the procedure, the contraindications and the complications of proceeding. For most of those interviewed the informed consent is important, but regrettably still some fear that it becomes obstacle for the realization of this to proceed. Conclusions: although most of our physicians value the importance positively of offering the informed consent when they execute the lumbar puncture, many carry out it improperly or they don't still carry out it. Lack of knowledge on the informed consent's ethical foundation and practical aspects is denoted among the physicians interviewed.

  8. Impact of Corrugated Paperboard Structure on Puncture Resistance

    Directory of Open Access Journals (Sweden)

    Vaidas Bivainis

    2015-03-01

    Full Text Available Thanks to its excellentprotective properties, lightness, a reasonable price, and ecology, corrugated paperboardis one of the most popular materials used in the production of packaging for variousproducts. During transportation or storage, packaging with goods can be exposedto the mass of other commodities, dropping from heights and transportationshock loads, which can lead to their puncture damage. Depending on the purposeand size of the packaging, the thickness, grammage, constituent paper layers,numbers of layers and type of fluting of corrugated paperboard used in itsproduction differ. A standard triangular prism, corrugated paperboard fixationplates and a universal tension-compression machine were used to investigate theimpact of corrugated paperboard structure and other parameters on the punctureresistance of the material. The investigation determines the maximum punctureload and estimates energy required to penetrate the corrugated paperboard. Itwas found that the greatest puncture resistance is demonstrated by paperboardwith a larger number of corrugating flutings and the board produced from harderpaper with a smaller amount of recycled paper. It was established that thegrammage of three-layered paperboard with two different fluting profiles has thegreatest impact on the level of static puncture energy.DOI: http://dx.doi.org/10.5755/j01.ms.21.1.5713

  9. Reducing pain associated with arterial punctures for blood gas analysis.

    Science.gov (United States)

    Matheson, Linda; Stephenson, Mary; Huber, Benjamin

    2014-09-01

    Arterial punctures for arterial blood gases (ABGs) analysis are described as the most painful laboratory procedure and are performed without the benefit of pain management. This study originated from one nurse's concern about the level of pain her hospitalized patients endured when she drew their ABGs. A review of the literature found that ABG pain relief has not been studied in hospitalized patients. Therefore, this study explored the question "Can the pain of arterial blood gas draws be reduced through the use of infiltration with a local anesthetic agent?" This study compared the pain scores of 40 hospitalized patients who received either no intervention or one of three analgesic interventions (infiltration of 0.7 ml 1% lidocaine, 0.7 ml buffered 1% lidocaine, or 0.7 ml of bacteriostatic saline at the arterial puncture site). Results showed that, although lidocaine and buffered lidocaine are effective in reducing the pain associated with the arterial puncture, plain lidocaine was the only intervention in which the pain rating score for the overall experience was significantly diminished. This study is limited by partial randomization, small sample size, and patient duress; however, it provides a foundation for further nursing research that explores methods to reduce the pain associated with this very painful procedure. Future studies should be directed at larger, diverse populations, multiple operators, and comparison of interventions to topical analgesics and nonpharmacological measures. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  10. A new multiple noncontinuous puncture (pointage technique for corneal tattooing

    Directory of Open Access Journals (Sweden)

    Jin Hyoung Park

    2015-10-01

    Full Text Available AIM:To assess the safety and cosmetic efficacy of a new multiple noncontinuous transepithelial puncture technique for tattooing a decompensated cornea.METHODS:It was anon-comparative clinical case series study.The study examines 33 eyes in 33 patients with total corneal opacity due to corneal decompensation, which developed following intraocular surgery.Corneal tattooing was performed using the multiple noncontinuous transepithelial puncture technique (i.e. pointage. The safety of this new surgical strategy was assessed by occurrence of adverse events for the follow-up period. The cosmetic efficacy was determined by the patient’s cosmetic satisfaction and independent observer’s opinion about patient appearance.RESULTS:Seven women and 26 men were included in the study. The mean age was 46.4±17.5y (range:7-67. In total, 30 of 33 patients (91% reported cosmetic satisfaction within the follow-up period. Only 3 patients (9% required additional tattooing due to cosmetic unsatisfaction. Cosmetic outcomes were analyzed and classified as excellent or good in 13 (39% and 17 (52% patients, respectively. No serious adverse events developed, except delayed epithelial healing in 3 cases.CONCLUSION:The cosmetic outcomes of the multiple noncontinuous transepithelial puncture technique for corneal tattooing were good. The safety of this method is higher than conventional procedures. This new procedure also provides improved cost-effectiveness and safety over current corneal tattooing techniques.

  11. Puncture Self-Healing Polymers for Aerospace Applications

    Science.gov (United States)

    Gordon, Keith L.; Penner, Ronald K.; Bogert, Phil B.; Yost, W. T.; Siochi, Emilie J.

    2011-01-01

    Space exploration launch costs on the order of $10K per pound provide ample incentive to seek innovative, cost-effective ways to reduce structural mass without sacrificing safety and reliability. Damage-tolerant structural systems can provide a route to avoiding weight penalty while enhancing vehicle safety and reliability. Self-healing polymers capable of spontaneous puncture repair show great promise to mitigate potentially catastrophic damage from events such as micrometeoroid penetration. Effective self-repair requires these materials to heal instantaneously following projectile penetration while retaining structural integrity. Poly(ethylene-co-methacrylic acid) (EMMA), also known as Surlyn is an ionomer-based copolymer that undergoes puncture reversal (self-healing) following high impact puncture at high velocities. However EMMA is not a structural engineering polymer, and will not meet the demands of aerospace applications requiring self-healing engineering materials. Current efforts to identify candidate self-healing polymer materials for structural engineering systems are reported. Rheology, high speed thermography, and high speed video for self-healing semi-crystalline and amorphous polymers will be reported.

  12. Percutaneous puncture saccule compression in the treatment of prosopalgia in 62 cases%经皮穿刺微球囊压迫技术治疗三叉神经痛62例

    Institute of Scientific and Technical Information of China (English)

    尹美华; 王晓梅; 许晶; 姚景新

    2003-01-01

    @@ BACKGROUND: Generlly, therapeutic effect is unclear of traditional Chinese and western drugs, acupuncture, or injection of alcohol and glycerine on prosoplagia, and recurrence and adverse reactions are common which annoy patients badly. Currently used percutaneous puncture saccule compression is characterized by the higher success rate, and less risks.

  13. A Kinect™ camera based navigation system for percutaneous abdominal puncture

    Science.gov (United States)

    Xiao, Deqiang; Luo, Huoling; Jia, Fucang; Zhang, Yanfang; Li, Yong; Guo, Xuejun; Cai, Wei; Fang, Chihua; Fan, Yingfang; Zheng, Huimin; Hu, Qingmao

    2016-08-01

    Percutaneous abdominal puncture is a popular interventional method for the management of abdominal tumors. Image-guided puncture can help interventional radiologists improve targeting accuracy. The second generation of Kinect™ was released recently, we developed an optical navigation system to investigate its feasibility for guiding percutaneous abdominal puncture, and compare its performance on needle insertion guidance with that of the first-generation Kinect™. For physical-to-image registration in this system, two surfaces extracted from preoperative CT and intraoperative Kinect™ depth images were matched using an iterative closest point (ICP) algorithm. A 2D shape image-based correspondence searching algorithm was proposed for generating a close initial position before ICP matching. Evaluation experiments were conducted on an abdominal phantom and six beagles in vivo. For phantom study, a two-factor experiment was designed to evaluate the effect of the operator’s skill and trajectory on target positioning error (TPE). A total of 36 needle punctures were tested on a Kinect™ for Windows version 2 (Kinect™ V2). The target registration error (TRE), user error, and TPE are 4.26  ±  1.94 mm, 2.92  ±  1.67 mm, and 5.23  ±  2.29 mm, respectively. No statistically significant differences in TPE regarding operator’s skill and trajectory are observed. Additionally, a Kinect™ for Windows version 1 (Kinect™ V1) was tested with 12 insertions, and the TRE evaluated with the Kinect™ V1 is statistically significantly larger than that with the Kinect™ V2. For the animal experiment, fifteen artificial liver tumors were inserted guided by the navigation system. The TPE was evaluated as 6.40  ±  2.72 mm, and its lateral and longitudinal component were 4.30  ±  2.51 mm and 3.80  ±  3.11 mm, respectively. This study demonstrates that the navigation accuracy of the proposed system is acceptable

  14. Ingested and Aspirated Foreign Bodies.

    Science.gov (United States)

    Green, S Sarah

    2015-10-01

    Esophageal and aspirated foreign bodies have important clinical significance, and both should be considered carefully when the history or physical examination findings raise sufficient suspicion. The published evidence regarding the diagnosis and management of foreign body ingestion or aspiration is weighted disproportionately with observational studies, case controls, expert opinion, and systematic reviews. Most of the publications would receive a categorization of C (observational studies including case-control and cohort design) and D (expert opinion, case reports, and clinical reasoning). One of the few prospective studies examining the diagnostic evaluation of foreign body aspiration in children could be considered level B evidence (randomized clinical trials, systematic reviews, or diagnostic studies with minor limitations). This study found that the medical history is the most important predictive part of the evaluation. There is evidence for considering bronchoscopy if there is significant history suggestive of foreign body aspiration, even in the setting of normal physical examination findings. (28). Most ingested foreign bodies spontaneously pass without incident. However, special attention should be paid to objects in the esophagus as well as to batteries and magnets. Based on a systematic review of the literature (level B evidence) and the potential for rapid and life-threatening damage, batteries in the esophagus should be removed immediately. (10) Other objects, such as coins, may be observed for passage in an asymptomatic patient. In addition, given the high risk of significant complications, ingestion of high-powered magnets should be quickly and carefully evaluated. Although single magnets are likely to pass without complication, multiple magnets or magnets ingested with other metal objects can cause significant damage and should be removed if there is any concern for mural entrapment, bowel perforation, or failure to progress. (10

  15. Cecal Ligation and Puncture Results in Long-Term Central Nervous System Myeloid Inflammation.

    Directory of Open Access Journals (Sweden)

    Benjamin H Singer

    Full Text Available Survivors of sepsis often experience long-term cognitive and functional decline. Previous studies utilizing lipopolysaccharide injection and cecal ligation and puncture in rodent models of sepsis have demonstrated changes in depressive-like behavior and learning and memory after sepsis, as well as evidence of myeloid inflammation and cytokine expression in the brain, but the long-term course of neuroinflammation after sepsis remains unclear. Here, we utilize cecal ligation and puncture with greater than 80% survival as a model of sepsis. We found that sepsis survivor mice demonstrate deficits in extinction of conditioned fear, but no acquisition of fear conditioning, nearly two months after sepsis. These cognitive changes occur in the absence of neuronal loss or changes in synaptic density in the hippocampus. Sepsis also resulted in infiltration of monocytes and neutrophils into the CNS at least two weeks after sepsis in a CCR2 independent manner. Cellular inflammation is accompanied by long-term expression of pro-inflammatory cytokine and chemokine genes, including TNFα and CCR2 ligands, in whole brain homogenates. Gene expression analysis of microglia revealed that while microglia do express anti-microbial genes and damage-associated molecular pattern molecules of the S100A family of genes at least 2 weeks after sepsis, they do not express the cytokines observed in whole brain homogenates. Our results indicate that in a naturalistic model of infection, sepsis results in long-term neuroinflammation, and that this sustained inflammation is likely due to interactions among multiple cell types, including resident microglia and peripherally derived myeloid cells.

  16. An Aspirational Community Theory of the Firm

    DEFF Research Database (Denmark)

    Li, Xin

    contractual labor and aspirational labor, the former being defined as services provided by a laborer in fulfillment of a contract while the latter as services provided by a laborer in pursuit of an aspiration; and argue that firms exist because while the market may be effective and efficient for allocating...... propose an aspirational community theory of the firm (ACT) as a candidate theory by conceptualizing the firm as an aspirational community, the core of which is a group of like-minded people sharing similar or same aspiration/vision. To explain the existence of the firm, we make a distinction between...... contractual labor it is less effective and efficient than the firms for allocating aspirational labor....

  17. Tracheobronchial Foreign Body Aspiration: Dental Prosthesis

    Directory of Open Access Journals (Sweden)

    Ataman Köse

    2014-01-01

    Full Text Available It is important to extract foreign bodies for avoiding life-threatening complications. They can lead to death if they are not treated. Different signs and symptoms could occur according to the complete or partial airway obstruction. Foreign body aspiration is a rare incident in adults. The organic foreign materials such as foods are found to be aspirated more commonly and are usually settled in the right bronchial system. However, dental prosthesis and teeth aspirations are rare in literature. In our study, a 52-year-old male patient who had aspirated the front part of his lower dental prosthesis accidentally is presented and the foreign body is extracted by using rigid bronchoscopy. There are many causes of aspiration but dental prosthetic aspirations should be kept in mind during sleep. For this reason, dental apparatus must be taken out while asleep.

  18. Percutaneous aspiration and drainage with adjuvant medical therapy for treatment of hepatic hydatid cysts

    Institute of Scientific and Technical Information of China (English)

    Mohammed I Yasawy; Abdelrahman E Mohammed; Sammak Bassam; Mohammed A Karawi; Sohail Shariq

    2011-01-01

    AIM: To determine the efficacy and success of percutaneous aspiration irrigation and reaspiration (PAIR) in the management of hepatic hydatidosis.METHODS: Twenty-six patients with 32 hepatic hydatid cysts had PAIR. Twenty-two patients received at least 2 wk of drug therapy before the procedure was carried out to reduce the risk of recurrence from spillage during the procedure. The procedure was performed under local anesthesia with a 19-gauge 20 cm long needle,the cyst was punctured, cystic content (approximately 30 mL) was aspirated by a 12-14 F pigtail catheter and aspirated fluids were sent for analysis. Once the cyst was almost empty, two-thirds of the net amount of ma materialaspirated was replaced by hypertonic saline and left in the cavity for about 30 min, with the catheter left in place for reaspiration of most of the fluid. When the amount of fluid drained was less than 10 mL per 24 h,the drainage catheter was removed.RESULTS: All 32 cysts showed evidence of immediate collapse after completion of the procedure, and before discharge from hospital, ultrasound examination showed fluid reaccumulation in all cysts. Serial follow-up showed a progressive decrease in the size and change in the appearance of cysts. To confirm the sterility of these cystic cavities, seven cysts were reaspirated on average 3 mo after the procedure. Investigations revealed no viable scolices.CONCLUSION: PAIR using hypertonic saline is very effective and safe with proper precautions.

  19. 血栓抽吸联合冠脉及静脉内小剂量注射替罗非班对急诊经皮冠状动脉介入的疗效及预后的影响%Influence of Thrombus Aspiration Combined with Low-dose Intra-coronary and Intravenous Injec-tion of Tirofiban on the Efficacy and Prognosis of Emergency Percutaneous Coronary Intervention

    Institute of Scientific and Technical Information of China (English)

    陈然; 杨涛

    2013-01-01

    [Objective] To evaluate the efficacy and prognosis of thrombus aspiration combined with low-dose intra-coronary and intravenous injection of tirofiban for the treatment of patients with acute ST-segment elevation myocardial infarction(STEMI) receiving emergency percutaneous coronary intervention (PCI) .[Methods] Totally 62 patients with STEMI receiving direct PCI were randomly divided into thrombus aspiration combined with low-dose intra-coronary and intravenous injection of tirofiban treatment group (treatment group ,n = 32) and routine PCI combined with intravenous injection of tirofiban group(control group ,n=30) .Blood flow TIMI grading of in-farction-related vessels before and after PCI ,major adverse cardiac events (M ACE) 6 months after PCI and postop-erative bleeding were observed in two groups .[Results]Compared with control group ,the treatment group had no reflow or significant reduction of slow reflow .MACE at 6 months and the incidence of perioperative bleeding in treatment group were obviously decreased .There were significant differences between two groups ( P < 0 .05) .[Conclusion]Thrombus aspiration combined with low-dose intra-coronary and intravenous injection of tirofiban can effectively improve blood flow of infarction-related vessels and the prognosis of patients with STEMI ,and has good safety .%[目的]评价冠状动脉(冠脉)内血栓抽吸联合冠脉及静脉内小剂量注射替罗非班对急性ST 段抬高型心肌梗死(STEMI)急诊经皮冠脉介入(PCI)的治疗效果及预后。[方法]选择接受直接 PCI治疗的STEMI患者62例,随机分为冠脉内血栓抽吸联合冠脉及静脉内小剂量注射血小板膜蛋白Ⅱb/Ⅲa(GPⅡb/Ⅲa)受体拮抗剂替罗非班组(治疗组,32例)和常规PCI联合静脉内注射大剂量替罗非班组(对照组,30例),评估两组PCI前后梗死相关血管TIMI血流分级、术后6个月主要心血管事件(MACE)及术后出血情况。[结果]与

  20. Endometrial aspiration cytology in gynecological disorders

    OpenAIRE

    Jadhav, Meenal V.; Anjali S Phatke; Nalini Vinayak Kadgi; Sharda R Rane; Kulkarni, Kalpana K.

    2016-01-01

    Context: Endometrial aspiration is not a popular modality for the study of the endometrium despite its simplicity and potential utility. Aim: The present study was aimed at evaluating the utility of endometrial aspiration in various gynecological disorders. Materials and Methods: In this diagnostic accuracy study, 55 prospectively registered women with various gynecological disorders were evaluated clinically and subjected to endometrial aspiration cytology and study of endometrial histo...

  1. Propofol and remifentanil for rapid sequence intubation in a pediatric patient at risk for aspiration with elevated intracranial pressure.

    Science.gov (United States)

    Dewhirst, Elisabeth; Tobias, Joseph D; Martin, David P

    2013-11-01

    Aspiration is a significant cause of anesthetic morbidity, occurring most commonly during the induction of anesthesia. For patients with a high likelihood of aspiration, rapid sequence intubation (RSI) techniques may minimize this risk by reducing the time between the loss of protective airway reflexes and the placement of a cuffed endotracheal tube. Although RSI frequently involves the administration of a neuromuscular-blocking agent (NMBA) such as succinylcholine or rocuronium, there are times when the administration of an NMBA is contraindicated or undesirable. We present an 11-year-old boy who presented with vomiting, papilledema, and a history concerning for an undiagnosed neuromuscular disorder. Deep sedation or anesthesia was required during an emergent lumbar puncture to evaluate his symptoms. Rapid sequence intubation was successfully performed with propofol and remifentanil without the use of an NMBA. We highlight the anesthetic considerations in such a clinical scenario and review the literature regarding the combination of remifentanil and propofol for RSI.

  2. Thrombus aspiration catheter is a Dottering balloon.

    Science.gov (United States)

    Sheshagiri Rao, D; Barik, Ramachandra; Prasad, Akula Siva

    2016-01-01

    Coronary angiogram in a young man with history of STEMI with delayed presentation revealed subtotal occlusion of left anterior descending artery (LAD) with large thrombotic filling defect distal to the critical lesion. PCI was preferred without delay because of ongoing chest pain. Several runs of thrombus aspiration failed to detect any visible thrombus. However, the immediate angiogram after thrombus aspiration showed complete distal embolization of the thrombus which could have been achieved by Dottering or balloon dilatation. In contrary to the general perception, does thrombus aspiration push more thrombus than it can aspirate?

  3. The effects of needle deformation during lumbar puncture

    Science.gov (United States)

    Özdemir, Hasan Hüseyin; Demir, Caner F.; Varol, Sefer; Arslan, Demet; Yıldız, Mustafa; Akil, Eşref

    2015-01-01

    Objective: The aim of this study is to assess deformation of the tip and deflection from the axis of 22-gauge Quincke needles when they are used for diagnostic lumbar puncture (LP). Thus, it can be determined whether constructional alterations of needles are important for predicting clinical problems after diagnostic LP. Materials and Methods: The 22-gauge Quincke needles used for diagnostic LP were evaluated. A specially designed protractor was used for measurement and evaluation. Waist circumference was measured in each patient. Patients were questioned about headaches occurring after LP. Results: A total of 115 Quincke-type spinal needles used in 113 patients were evaluated. No deflection was detected in 38 (33.1%) of the needles. Deflection between 0.1° and 5° occurred in 43 (37.3%) of the needles and deflection ≥ 5.1° occurred in 34 patients (29.6%). Forty-seven (41.5%) patients experienced post lumbar puncture headache (PLPH) and 13 (11.5%) patients experienced intracranial hypotension (IH). No statistically significant correlation between the degree of deflection and headache was found (P > 0.05). Epidural blood patch was performed for three patients. Deformity in the form of bending like a hook occurred in seven needles and IH occurred in six patients using these needles. Two of the needles used in three patients requiring blood patch were found to be bent. Conclusion: Deformation of needles may increase complications after LP. Needle deformation may lead to IH. In case of deterioration in the structure of the needle, termination of the puncture procedure and the use of a new needle could reduce undesirable clinical consequences, especially IH. PMID:25883480

  4. The effects of needle deformation during lumbar puncture

    Directory of Open Access Journals (Sweden)

    Hasan Hüseyin Özdemir

    2015-01-01

    Full Text Available Objective: The aim of this study is to assess deformation of the tip and deflection from the axis of 22-gauge Quincke needles when they are used for diagnostic lumbar puncture (LP. Thus, it can be determined whether constructional alterations of needles are important for predicting clinical problems after diagnostic LP. Materials and Methods: The 22-gauge Quincke needles used for diagnostic LP were evaluated. A specially designed protractor was used for measurement and evaluation. Waist circumference was measured in each patient. Patients were questioned about headaches occurring after LP. Results: A total of 115 Quincke-type spinal needles used in 113 patients were evaluated. No deflection was detected in 38 (33.1% of the needles. Deflection between 0.1° and 5° occurred in 43 (37.3% of the needles and deflection ≥ 5.1° occurred in 34 patients (29.6%. Forty-seven (41.5% patients experienced post lumbar puncture headache (PLPH and 13 (11.5% patients experienced intracranial hypotension (IH. No statistically significant correlation between the degree of deflection and headache was found (P > 0.05. Epidural blood patch was performed for three patients. Deformity in the form of bending like a hook occurred in seven needles and IH occurred in six patients using these needles. Two of the needles used in three patients requiring blood patch were found to be bent. Conclusion: Deformation of needles may increase complications after LP. Needle deformation may lead to IH. In case of deterioration in the structure of the needle, termination of the puncture procedure and the use of a new needle could reduce undesirable clinical consequences, especially IH.

  5. Bacterial migration through punctured surgical gloves under real surgical conditions

    Directory of Open Access Journals (Sweden)

    Heidecke Claus-Dieter

    2010-07-01

    Full Text Available Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab. Results In 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes. Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25% punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98 of outer gloves and in 1% (1/96 of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers, the calculated migration was 50% (n = 5. The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes. Conclusions This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.

  6. Minimally invasive wire-guided balloon catheter puncture for voice prosthesis insertion.

    Science.gov (United States)

    Tobed Secall, Marc; Bores, Toni; Sambola, Ignacio; Lop, Joan; García Rica, Eduardo; Lluansi, Jordi

    2017-07-01

    Tracheoesophageal puncture is an effective and reliable method for voice restoration after total laryngectomy that may be performed as a primary or secondary procedure. We describe our technique for secondary tracheoesophageal puncture using a wire-guided balloon catheter in an office setting. A 72-year-old patient with a total laryngectomy performed 2 years ago was selected for wire-guided balloon catheter puncture and voice prosthesis insertion. Successful tracheoesophageal puncture placement was achieved without complications and the patient tolerated the procedure well. The voice result was satisfactory and immediate. We conclude that balloon catheter tracheoesophageal puncture can be a simple and safe option for secondary voice prosthesis insertion in total laryngectomy for selected patients. It can be performed in an office setting using only local anesthetic for secondary puncture. © 2017 Wiley Periodicals, Inc.

  7. The role of aspiration in corporate fiduciary duties

    National Research Council Canada - National Science Library

    Velasco, Julian

    2012-01-01

    ... duty standards of conduct are aspirational and unenforceable. This theory, which I will call the "aspirational view," is misguided. The use of the term "aspirational" is especially problematic. Whatever else "aspirational" may mean, it does not mean obligatory or mandatory. Whether by design or only by effect, the aspirational view has the ...

  8. Punctured torus groups and 2-bridge knot groups

    CERN Document Server

    Akiyoshi, Hirotaka; Wada, Masaaki; Yamashita, Yasushi

    2007-01-01

    This monograph is Part 1 of a book project intended to give a full account of Jorgensen's theory of punctured torus Kleinian groups and its generalization, with application to knot theory. Although Jorgensen's original work was not published in complete form, it has been a source of inspiration. In particular, it has motivated and guided Thurston's revolutionary study of low-dimensional geometric topology. In this monograph, we give an elementary and self-contained description of Jorgensen's theory with a complete proof. Through various informative illustrations, readers are naturally led to an intuitive, synthetic grasp of the theory, which clarifies how a very simple fuchsian group evolves into complicated Kleinian groups.

  9. Distorted black hole initial data using the puncture method

    Science.gov (United States)

    Brown, J. David; Lowe, Lisa L.

    2004-12-01

    We solve for single distorted black hole initial data using the puncture method, where the Hamiltonian constraint is written as an elliptic equation in R3 for the nonsingular part of the metric conformal factor. With this approach we can generate isometric and nonisometric black hole data. For the isometric case, our data are directly comparable to those obtained by Bernstein et al., who impose isometry boundary conditions at the black hole throat. Our numerical simulations are performed using a parallel multigrid elliptic equation solver with adaptive mesh refinement. Mesh refinement allows us to use high resolution around the black hole while keeping the grid boundaries far away in the asymptotic region.

  10. The trumpet solution from spherical gravitational collapse with puncture gauges

    CERN Document Server

    Thierfelder, Marcus; Hilditch, David; Bruegmann, Bernd; Rezzolla, Luciano

    2010-01-01

    We investigate the stationary end-state obtained by evolving a collapsing spherical star with the gauges routinely adopted to study puncture black holes. We compare the end-state of the collapse with the trumpet solution found in the evolution of a single wormhole slice and show that the two solutions closely agree. We demonstrate that the agreement is caused by the use of the Gamma-driver shift condition, which allows the matter to fall inwards into a region of spacetime that is not resolved by the numerical grid, and which simultaneously finds the stationary coordinates of the trumpet outside the matter.

  11. Diagnostic and therapeutic lumbar puncture performed safely and efficiently with a thin blunt needle

    DEFF Research Database (Denmark)

    Møller, Anders; Afshari, Arash; Bjerrum, Ole Weis

    2013-01-01

    The risk of postdural puncture headache following lumbar puncture can be reduced by choosing a blunt spinal needle or by using a smaller needle diameter. Reports indicate that lumbar puncture practiced outside of the anaesthetic discipline does not adhere to the current level of evidence....... To examine the practice among haematologists in Denmark, we performed a national survey. In addition, we analysed the flow rate of a blunt 27-gauge (0.4 mm) spinal needle typically used for spinal anaesthesia by timing the tap duration of a diagnostic lumbar puncture....

  12. Clinical clerkship course for medical students on lumbar puncture using simulators.

    Science.gov (United States)

    Adachi, Koji; Yoshimura, Akinobu; Aso, Ryoko; Miyashita, Tsuguhiro; Yoshida, Daizo; Teramoto, Akira; Shimura, Toshiro

    2012-01-01

    Lumbar puncture is a medical technique that physicians must learn and is, therefore, considered a basic medical procedure. The lumbar puncture simulators Lumbar-Kun (Lumbar Puncture Simulator) and Lumbar-Kun II (Lumbar Puncture Simulator II) (Kyoto Kagaku, Kyoto, Japan) are teaching aids designed for practicing spinal insertions. We describe and results of a lumbar puncture clerkship course, provided to 5th-year medical students during clinical clerkship activity. The aim of this study was to evaluate the effectiveness of the lumbar puncture clerkship course in the medical education program. Comprehension, technical achievement, and satisfaction were scored by students and instructors using a 6-point Likert scale. Scores for both comprehension and technical achievement were high, but technical achievement scores tended to be higher than comprehension scores. In addition, the scores students gave themselves were higher than the scores they were given by instructors. Student satisfaction was high. The lumbar puncture simulators, Lumbar-Kun and Lumbar-Kun II, achieved excellent overall impressions and represent useful tools for training in lumbar puncture procedures. In addition to the simulators, an appropriate preparatory text and a short lecture before training seemed to increase the educational effect of this lumbar puncture clerkship course for medical students.

  13. The effect of hyperbaric oxygen treatment on aspiration pneumonia.

    Science.gov (United States)

    Sahin, Sevtap Hekimoglu; Kanter, Mehmet; Ayvaz, Suleyman; Colak, Alkin; Aksu, Burhan; Guzel, Ahmet; Basaran, Umit Nusret; Erboga, Mustafa; Ozcan, Ali

    2011-08-01

    We have studied whether hyperbaric oxygen (HBO) prevents different pulmonary aspiration materials-induced lung injury in rats. The experiments were designed in 60 Sprague-Dawley rats, ranging in weight from 250 to 300 g, randomly allotted into one of six groups (n = 10): saline control, Biosorb Energy Plus (BIO), hydrochloric acid (HCl), saline + HBO treated, BIO + HBO treated, and HCl + HBO treated. Saline, BIO, HCl were injected into the lungs in a volume of 2 ml/kg. A total of seven HBO sessions were performed at 2,4 atm 100% oxygen for 90 min at 6-h intervals. Seven days later, rats were sacrificed, and both lungs in all groups were examined biochemically and histopathologically. Our findings show that HBO inhibits the inflammatory response reducing significantly (P fibrosis, granuloma, and necrosis formation in different pulmonary aspiration models. Pulmonar aspiration significantly increased the tissue HP content, malondialdehyde (MDA) levels and decreased (P < 0.05) the antioxidant enzyme (SOD, GSH-Px) activities. HBO treatment significantly (P < 0.05) decreased the elevated tissue HP content, and MDA levels and prevented inhibition of SOD, and GSH-Px (P < 0.05) enzymes in the tissues. Furthermore, there is a significant reduction in the activity of inducible nitric oxide synthase, TUNEL and arise in the expression of surfactant protein D in lung tissue of different pulmonary aspiration models with HBO therapy. It was concluded that HBO treatment might be beneficial in lung injury, therefore, shows potential for clinical use.

  14. Fine needle aspiration cytology of rectal masses.

    Science.gov (United States)

    Kochhar, R; Rajwanshi, A; Wig, J D; Gupta, N M; Kesiezie, V; Bhasin, D K; Malik, A K; Gupta, S K; Mehta, S K

    1990-01-01

    This paper describes the results of transproctoscopic fine needle aspiration cytology in the diagnosis of rectal lesions. Fifty one consecutive patients referred with a presumptive diagnosis of rectal mass were subjected to proctoscopic examination when fine needle aspiration cytology, brush cytology and biopsy samples were taken. Of the 30 patients of malignancy of rectum in whom all the three sampling techniques were applied, the biopsy was positive in 27 (90%), brush cytology in 25 (83.3%) and fine needle aspiration cytology in 29 (96.6%). A combination of fine needle aspiration cytology with brush cytology gave a positive yield in 96.6% while that fine needle aspiration cytology with brush cytology gave a yield of 100%. Fine needle aspiration cytology was most helpful in infiltrative tumours. All 10 patients with secondaries in the pouch of Douglas or rectovesical pouch, and the single patient with submucosal rectal carcinoma were correctly diagnosed at fine needle aspiration cytology. There were no false positive results with fine needle aspiration cytology and no complications were encountered with the procedure. Images Figure 1 Figure 2 Figure 3 PMID:2323600

  15. Endometrial aspiration cytology in gynecological disorders

    Directory of Open Access Journals (Sweden)

    Meenal V Jadhav

    2016-01-01

    Full Text Available Context: Endometrial aspiration is not a popular modality for the study of the endometrium despite its simplicity and potential utility. Aim: The present study was aimed at evaluating the utility of endometrial aspiration in various gynecological disorders. Materials and Methods: In this diagnostic accuracy study, 55 prospectively registered women with various gynecological disorders were evaluated clinically and subjected to endometrial aspiration cytology and study of endometrial histology. Endometrial aspiration was performed by infant feeding tube in 10 cases and intra cath cannula in 45 cases. The slides were stained with rapid Papanicolaou (PAP stain and Leishman stain. Results: Endometrial aspiration cytology showed 90% and 94.6% sampling adequacy with infant feeding tube and intra cath cannula, respectively. Intra cath cannula was very convenient to handle and superior to infant feeding tube in aspirating the endometrium. Of the two stains used, rapid PAP stain was less time-consuming and superior to Leishman stain in studying the nuclear details. Leishman stain was helpful in detecting cytoplasmic vacuoles of secretory endometrium. Overall diagnostic accuracy of endometrial cytology was 90.4% while that for morphological hormonal evaluation was 97.6%. It enjoyed a sensitivity of 91.66%, a specificity of 88.23%, positive predictive value of 94.28%, and negative predictive value of 83.33%. Conclusion: Intra cath cannula emerged as an inexpensive, effective, and convenient device for endometrial aspiration. Endometrial aspiration proved to be a fairly effective, simple, and informative diagnostic modality.

  16. Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

    Science.gov (United States)

    ... Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid An ultrasound-guided thyroid biopsy uses sound waves ... Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? During a fine needle aspiration biopsy of the ...

  17. Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid ... Needle Aspiration Biopsy of the Thyroid? What is Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? ...

  18. Medroxyprogesterone Injection

    Science.gov (United States)

    Medroxyprogesterone intramuscular (into a muscle) injection and medroxyprogesterone subcutaneous (under the skin) injection are used to prevent pregnancy. Medroxyprogesterone subcutaneous injection is also used to treat endometriosis (a condition in which ...

  19. Pentamidine Injection

    Science.gov (United States)

    Pentamidine injection is used to treat pneumonia caused by a fungus called Pneumocystis carinii. It is in ... Pentamidine injection comes as powder to be mixed with liquid to be injected intramuscularly (into a muscle) ...

  20. Clinical Application of Ultrasound-Guided Thyroid Fine Needle Aspiration Biopsy and Thinprep Cytology Test in Diagnosis of Thyroid Disease

    Science.gov (United States)

    Wei, Ying; Lu, Yao; li, chenxi

    2016-10-01

    Purpose: To study the clinical application value of ultrasound guided thyroid fine needle aspiration biopsy and thinprep cytology testing in diagnosis of thyroid disease. Methods: A total of 78 patients with thyroid nodules were enrolled, 34 males and 44 females, aged 33-64 years old with mean age of 47.6 years. All underwent thyroid module fine needle puncture after surgery to assess cell pathology and histopathological features. Results: Sufficient specimens were obtained from all of 78 patients, the cytological results of 73 cases (93.6 %) being consistent with pathological results. While 20 cases (25.6 %) were malignant tumors, 44 (56.4 %) were benign and 9 (11.5 %) were non-tumor lesions. The sensitivity of benign and malignant thyroid nodule by thyroid fine needle puncture was 90.9 %, specificity was 98.1 % and the positive predictive value was 96.3 %. Conclusions: It is demonstrated that ultrasound-guided thyroid fine needle aspiration biopsy and thinprep cytology testing have diagnostic value in clinical application for thyroid disease,showing good diagnostic coincidence rates with histopathological examination. They can thus be regarded as safe and effective for preoperative diagnosis and providing an appropriate basis for selection of surgery. Creative Commons Attribution License

  1. Preoperative Direct Puncture Embolization of Advanced Juvenile Nasopharyngeal Angiofibroma in Combination with Transarterial Embolization: An Analysis of 22 Consecutive Patients

    Energy Technology Data Exchange (ETDEWEB)

    Lv Mingming, E-mail: lvmingming001@163.com; Fan, Xin-dong, E-mail: fanxindong@yahoo.com.cn [Shanghai Jiao Tong University School of Medicine, Department of Radiology, Ninth People' s Hospital (China); Su Lixin, E-mail: sulixin1975@126.com [Shanghai Jiao Tong University School of Medicine, Department of Oral and Maxillofacial Surgery, Ninth People' s Hospital (China); Chen Dong, E-mail: chenjsun@public8.sta.net.cn [Shanghai Jiao Tong University School of Medicine, Department of Otolaryngology, Ninth People' s Hospital (China)

    2013-02-15

    ObjectiveThis study was designed to evaluate the clinical application of preoperative auxiliary embolization for juvenile nasopharyngeal angiofibroma (JNA) by direct puncture embolization (DPE) of the tumor in combination with transarterial embolization (TAE). The study included 22 patients. An 18-gauge needle was used to puncture directly into the tumor, and 20-25 % N-butyl cyanoacrylate was injected under the guidance of fluoroscopy after confirming the placement of the needle into the JNA and no leaking into the surrounding tissue. Tumors were obstructed later via TAE. The supplying arteries of JNA were from branches of the internal carotid and external carotid arteries. Control angiography showed the obliteration of contrast stain in the entire tumor mass and the distal supplying arteries disappeared after DPE in combination with TAE. Surgical resection was performed within 4 days after embolization and none of the patients required blood transfusion. The use of DPE in combination with TAE was a safe, feasible, and efficacious method. It can devascularize effectively the JNAs and reduce intraoperative bleeding when JNAs are extirpated.

  2. Diagnostic value of lumbar puncture in afebrile infants with suspected new-onset seizures.

    Science.gov (United States)

    Lateef, Tarannum M; Tsuchida, Tammy N; Chang, Taeun; Johnson, Jami; Gaillard, William D; Nelson, Karin B

    2008-07-01

    No established guidelines address the need for lumbar puncture in fever-free infants younger than 6 months of age with a first seizure. We analyzed cerebrospinal fluid results in infants and found that lumbar puncture adds little diagnostic value to the evaluation of young, well-appearing infants presenting with possible new-onset seizures.

  3. Differentiating the headache of cerebral venous thrombosis from post-dural puncture: A headache for anaesthesiologists

    Directory of Open Access Journals (Sweden)

    Khaja Mohideen Sherfudeen

    2016-01-01

    Full Text Available Cerebral venous thrombosis (CVT is a rare complication of lumbar puncture. Occasionally, the clinical picture of CVT may mimic post-dural puncture headache (PDPH resulting in delayed diagnosis. A case of PDPH progressing to CVT is presented and the pathophysiology, diagnostic challenges and management options discussed in this article.

  4. There is room for improvement in the prevention and treatment of headache after lumbar puncture

    DEFF Research Database (Denmark)

    Stendell, Line; Fomsgaard, Jonna S; Olsen, Karsten S

    2012-01-01

    The incidence of post dural puncture headache (PDPH) after lumbar puncture (LP) can be reduced from 36% to 0-9% by use of an atraumatic needle size 24 gauge (G)/0.56 mm rather than a traumatic needle size 22 G/0.7 mm. The evidence supporting some of the prophylactic and therapeutically treatments...

  5. Postpartum post-dural puncture headache: is your differential diagnosis complete?

    NARCIS (Netherlands)

    Bleeker, C.P.; Hendriks, I.M.; Booij, L.H.D.J.

    2004-01-01

    We describe a patient with an intracerebral haemorrhage following an accidental dural puncture during an attempted epidural for pain relief in labour. Anaesthetists need to include intracerebral haemorrhage in the differential diagnosis of post-dural puncture headache in the puerperium.

  6. Insertion of an intrathecal catheter following accidental dural puncture : a meta-analysis

    NARCIS (Netherlands)

    Heesen, M.; Kloehr, S.; Rossaint, R.; Walters, M.; Straube, S.; van de Velde, M.

    2013-01-01

    Background: Inserting an intrathecal catheter after accidental dural puncture in parturients to prevent postdural puncture headache is becoming increasingly popular. We aimed to identify relevant published articles investigating this intervention and subject data to a meta-analysis. Methods: A syste

  7. Validity and reliability of transbronchial needle aspiration for diagnosing mediastinal adenopathies

    Directory of Open Access Journals (Sweden)

    González Ana

    2010-04-01

    Full Text Available Abstract Background The aim is to assess the validity and reliability of transbronchial needle aspiration (TBNA of mediastinal and hilar adenopathies and to evaluate factors predictive of TBNA outcome. Methods We performed an analysis of prospectively collected data of patients (n = 580 who underwent TBNA (n = 685 from January 1998 to December 2007 in our center. Validity and reliability were evaluated for the overall sample and according to specific pathology. Factors predicting the successful acquisition of diagnostic samples were analyzed by multivariate analysis. Results Overall sensitivity, specificity, accuracy, and positive and negative predictive (NPV values for TBNA were 68%, 100%, 68.8%, 100%, and 10%, respectively. The most sensitive and accurate TBNAs were obtained for patients with small cell lung carcinoma and the worst results were for patients with lymphomas. NPV were similar for all pathologies. The most predictive factors of outcome were adenopathy size and the presence of indirect signs at the puncture site. Conclusion The sensitivity and accuracy of TBNA are high in small cell lung cancer, followed by other types of carcinoma, sarcoidosis, and tuberculosis, and low for lymphoproliferative diseases. The NPV of TBNA for all individual pathologies is low. The size of the adenopathy and the presence of indirect signs at the puncture site predict the achievement of diagnostic samples.

  8. TREATMENT OF SOFT TISSUE INJURY BY PUNCTURING CLEFT-POINTS

    Institute of Scientific and Technical Information of China (English)

    Xu Yunxiang; Chen Guizhen

    2001-01-01

    Objective: To observe the therapeutic effect of acupuncture of "Xi" (Cleft)-points in treatment of soft tissue injury. Methods: 335 cases of soft tissue injury patients were divided into Cleft-point group (264 cases) and Ashipoint group (control group, 71 cases) randomly. In Cleft-point group, the 16 Cleft-points were used in combination with Ahshi points. In control group, only local Ahshi-points were punctured. The treatment was conducted once every day, with 5 sessions being a therapeutic course. After 2 courses of treatment, the therapeutic effect was analyzed.Results: Results showed that the therapeutic effect of cleft-point group was significantly better than that of control group (P<0.05), particularly in treatment of acute soft tissue. Conclusion: Cleft-point acupuncture has a better therapeutic effect in treatment of soft tissue injury in comparison with Ashi-point.

  9. Toxicity associated with bowel or bladder puncture during gynecologic interstitial brachytherapy.

    Science.gov (United States)

    Shah, Anand P; Strauss, Jonathan B; Gielda, Benjamin T; Zusag, Thomas W

    2010-05-01

    Interstitial brachytherapy for gynecologic malignancies is associated with significant toxicity. Some reports have correlated this toxicity with needle puncture of the visceral organs. This study examined our experience with interstitial brachytherapy and investigated the relationship between the visceral puncture and toxicity. The outcomes of 36 patients treated with interstitial brachytherapy for gynecologic malignancies at a single institution between 2002 and 2007 were reviewed. Computed tomography was used to guide needle placement based solely on tumor coverage. No attempts were made to avoid visceral puncture; however, the source dwell times were minimized in these areas. At a median follow-up of 21 months, the crude locoregional control rate was 78%. Bowel puncture was noted in 26 patients and bladder puncture in 19. The mean operating time was 50 min, and 86% of patients were discharged in source loading carries a low risk of morbidity.

  10. Clinical profile of children with kerosene aspiration.

    Science.gov (United States)

    Venkatesh, C; Sriram, P; Adhisivam, B; Mahadevan, S

    2011-07-01

    Accidental aspiration of kerosene is a common problem among children in developing countries. This descriptive study involved the retrospective analysis of children admitted with kerosene aspiration in a tertiary care hospital in South India for a year. Kerosene aspiration contributed to 60.4% of poisoning cases. Boys aged less than three years and from a rural background formed a significant proportion. Tachypnoea, cough and crepitations were the predominant clinical findings. Male gender and malnutrition (weight for age <80%) were significantly associated with prolonged hospital stay.

  11. Coronary air embolism treated with aspiration catheter.

    Science.gov (United States)

    Patterson, M S; Kiemeneij, F

    2005-05-01

    Coronary air embolism remains a recognised complication of coronary catheterisation despite a strong emphasis on prevention. Current treatment consists of supportive measures with 100% oxygen and analgesia. Recent case reports describe the use of mechanical treatments aimed at dispersing or removing the air embolus with variable success. A case of coronary air embolism causing an acute coronary syndrome is described that was definitively treated with an aspiration system. The effectiveness of the aspiration system in the distal section of an obtuse marginal artery indicates that such dedicated aspiration systems may prove useful in the standard treatment of air embolism.

  12. Effect of Partial Span Aspiration on the Performance of a Transonic Axial Compressor Rotor: A Numerical Study

    Directory of Open Access Journals (Sweden)

    Vijaykumar Jain

    2015-01-01

    Full Text Available Aspiration in an axial compressor is normally regarded as sucking out the low momentum boundary layer from blade suction surface, thus lowering the chances of flow separation and consequently that of stall under off-design operation. However, the suction mass flow does not take part in useful work and leads to loss of engine power output. This paper deals with a new concept of natural aspiration to energize blade suction surface boundary layer by injecting some fluid from pressure to suction side through a part span slot on the blade. The energized boundary layer has lesser tendency to separate, thus enhancing stall margin. Numerical simulations were carried out to study the effect of aspiration slot location and geometry on the performance and stall margin of a transonic axial compressor rotor. The computational results without aspiration slot were in fair agreement with the published experimental data. The modified rotor, with part span aspiration, showed ~3.2% improvement in stall margin at design rotational speed. The pressure ratio and efficiency of the aspirated rotor dropped by ~1.42% and ~2.0%, respectively, whereas the structural analysis did not indicate any adverse effect on the blade stress distribution in the presence of aspiration slot.

  13. Technical Development of the Small Fission Gas Measurement in Fuel Rods using the Laser Puncturing

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Heemoon; Baik, Seungje; Jin, Younggwan; Jung, Yanghong; Yoo, Boungok; Ahn, Sangbok; Yang, Yongsik; Lee, Byoungoon

    2013-12-15

    Information of fuel cladding tube and expected gas amount were obtained from fuel development department to design chamber volume and specification of laser device. Laser puncturing tests for several tubes were performed to setup power and capability. Laser puncturing tests for several tubes were performed to setup power and capability. Vacuum system with chamber was established. Additionally, QMS(Quadruple Mass Spectrometer in high vacuum state) was installed in vacuum system. The system was installed in hotcell following the preliminary test for the puncturing, pressure measuring and gas content analysis. After system test was installed in hotcell following the preliminary test for the puncturing, pressure measuring and gas content analysis. After system test was completed, SFR fuel rods were punctured to measure total gas amount and each gas content(He, Xe, Kr). The system for laser puncturing and measurement of small fission gas amout in fuel rod was designed with considering hotcell facility and fuel rod condition for first year. Chamber size, laser capability were well operated and the system showed reasonable results. In second year, QMS(Quadruple Mass Spectrometer) was installed in the system for quantitative analysis of gas contents. Thus, Laser puncturing, amount of gas measurement and gas analysis were carried out in one time. The system was activated for SFR fuel rods after installation and preliminary test. 9 SFR fuel rods were tested and produced total gas amounts and gas analysis data(He, Xe, Kr)

  14. Ultrasonography-Guided Fine-Needle Aspiration Biopsy of Predominantly Cystic Thyroid Nodules

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Hye Jin; Kim, Dong Wook [Busan Paik Hospital, Busan (Korea, Republic of)

    2010-02-15

    The aim of this study is to present our biopsy technique and to determine the efficacy of the ultrasound- guided fine-needle aspiration biopsy (US-FNAB) for predominantly cystic thyroid nodules (PCTNs). This study included patients that underwent US-FNABs on PCTNs, and were sampled for the solid component following the aspiration of a cystic component through one needle puncture between January to December of 2008. We retrospectively reviewed the cytopathology results as well as any complication associated with the procedure. Of the 76 PCTNs (range of maximal diameter: 0.4 cm-6.1 cm, mean: 2.39 cm) observed in the 75 patients (females: males = 63: 12, age range: 19-72, mean: 45.3 years old), the incidence rate of adequate and inadequate samples was 90.8% (69/76) and 9.2% (7/76) in the first US-FNAB, respectively. Further, 23 PCTNs were surgically removed in 22 patients, of which 15 PCTNs were benign and 8 were confirmed malignant nodules. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for USFNAB of PCTNs were 95.2%, 100%, 100%, 76.9%, and 95.8%, respectively. The data suggest that our technique for US-FNAB of PCTNs was effective and accurate.

  15. Puncture Reduction in Percutaneous Transforaminal Endoscopic Discectomy with HE's Lumbar LOcation (HELLO System: A Cadaver Study.

    Directory of Open Access Journals (Sweden)

    Guoxin Fan

    Full Text Available Percutaneous transforaminal endoscopic discectomy (PTED usually requires numerous punctures under X-ray fluoroscopy. Repeated puncture will lead to more radiation exposure and reduce the beginners' confidence.This cadaver study aimed to investigate the efficacy of HE's Lumbar Location (HELLO system in puncture reduction of PTED.Cadaver study.Comparative groups.HELLO system consists of self-made surface locator and puncture locator. One senior surgeon conducted the puncture procedure of PTED on the left side of 20 cadavers at L4/L5 and L5/S1 level with the assistance of HELLO system (Group A. Additionally, the senior surgeon conducted the puncture procedure of PTED on the right side of the cadavers at L4/L5 and L5/S1 level with traditional methods (Group B. On the other hand, an inexperienced surgeon conducted the puncture procedure of PTED on the left side of the cadavers at L4/L5 and L5/S1 level with the assistance of our HELLO system (Group C.At L4/L5 level, there was significant difference in puncture times between Group A and Group B (P0.05. There was no difference in location time between Group A and Group B or Group A and Group C either at L4/L5 level or L5/S1 level (P>0.05.Small-sample preclinical study.HELLO system was effective in reducing puncture times, fluoroscopy time and radiation exposure, as well as the difficulty of learning PTED. (2015-RES-127.

  16. Puncture Reduction in Percutaneous Transforaminal Endoscopic Discectomy with HE's Lumbar LOcation (HELLO) System: A Cadaver Study.

    Science.gov (United States)

    Fan, Guoxin; Guan, Xiaofei; Sun, Qi; Hu, Annan; Zhu, Yanjie; Gu, Guangfei; Zhang, Hailong; He, Shisheng

    2015-01-01

    Percutaneous transforaminal endoscopic discectomy (PTED) usually requires numerous punctures under X-ray fluoroscopy. Repeated puncture will lead to more radiation exposure and reduce the beginners' confidence. This cadaver study aimed to investigate the efficacy of HE's Lumbar Location (HELLO) system in puncture reduction of PTED. Cadaver study. Comparative groups. HELLO system consists of self-made surface locator and puncture locator. One senior surgeon conducted the puncture procedure of PTED on the left side of 20 cadavers at L4/L5 and L5/S1 level with the assistance of HELLO system (Group A). Additionally, the senior surgeon conducted the puncture procedure of PTED on the right side of the cadavers at L4/L5 and L5/S1 level with traditional methods (Group B). On the other hand, an inexperienced surgeon conducted the puncture procedure of PTED on the left side of the cadavers at L4/L5 and L5/S1 level with the assistance of our HELLO system (Group C). At L4/L5 level, there was significant difference in puncture times between Group A and Group B (PHELLO system reduced 39%-45% radiation dosage when comparing Group A and Group B, but there was no significant difference in radiation exposure between Group A and Group C whatever at L4/L5 level or L5/S1 level (P>0.05). There was no difference in location time between Group A and Group B or Group A and Group C either at L4/L5 level or L5/S1 level (P>0.05). Small-sample preclinical study. HELLO system was effective in reducing puncture times, fluoroscopy time and radiation exposure, as well as the difficulty of learning PTED. (2015-RES-127).

  17. Doripenem Injection

    Science.gov (United States)

    ... injection is in a class of medications called carbapenem antibiotics. It works by killing bacteria.Antibiotics such ... if you are allergic to doripenem injection; other carbapenem antibiotics such as imipenem/cilastatin (Primaxin) or meropenem ( ...

  18. Methotrexate Injection

    Science.gov (United States)

    Methotrexate injection is used alone or in combination with other medications to treat gestational trophoblastic tumors (a ... in bones) after surgery to remove the tumor. Methotrexate injection is also used to treat severe psoriasis ( ...

  19. Bendamustine Injection

    Science.gov (United States)

    Bendamustine injection is used to treat chronic lymphocytic leukemia (CLL; a type of cancer of the white ... injection. You should use birth control to prevent pregnancy in yourself or your partner during your treatment ...

  20. Caspofungin Injection

    Science.gov (United States)

    Caspofungin injection is used in adults and children 3 months of age and older to treat yeast ... people with a weakened ability to fight infection. Caspofungin injection is in a class of antifungal medications ...

  1. Temozolomide Injection

    Science.gov (United States)

    Temozolomide is used to treat certain types of brain tumors. Temozolomide is in a class of medications called alkylating ... Temozolomide injection comes as a powder to be added to fluid and injected over 90 minutes intravenously ( ...

  2. Pembrolizumab Injection

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    Pembrolizumab injection is used to treat melanoma (a type of skin cancer) that cannot be treated with ... who have a specific type of melanoma tumor. Pembrolizumab injection is also used to treat a certain ...

  3. Lacosamide Injection

    Science.gov (United States)

    ... injection is in a class of medications called anticonvulsants. It works by decreasing abnormal electrical activity in ... older (about 1 in 500 people) who took anticonvulsants like lacosamide injection to treat various conditions during ...

  4. Midazolam Injection

    Science.gov (United States)

    ... injection is in a class of medications called benzodiazepines. It works by slowing activity in the brain ... breast-feeding.talk to your doctor about the risks and benefits of receiving midazolam injection if you ...

  5. Doxycycline Injection

    Science.gov (United States)

    Doxycycline injection is used to treat or prevent bacterial infections, including pneumonia and other respiratory tract infections. ... certain skin, genital, intestine, and urinary system infections. Doxycycline injection may be used to treat or prevent ...

  6. Paclitaxel Injection

    Science.gov (United States)

    ... with other medications. Paclitaxel injection manufactured with polyoxyethylated castor oil is used to treat ovarian cancer (cancer that ... cancer, and lung cancer. Paclitaxel injection with polyoxyethylated castor oil is also used to treat Kaposi's sarcoma (a ...

  7. Etanercept Injection

    Science.gov (United States)

    ... will be using the prefilled syringe or automatic injection device, tell your doctor if you or the person who will be injecting the medication for you are allergic to rubber or latex.tell your doctor and pharmacist what ...

  8. Cyclosporine Injection

    Science.gov (United States)

    Cyclosporine injection is used with other medications to prevent transplant rejection (attack of the transplanted organ by ... who have received kidney, liver, and heart transplants. Cyclosporine injection should only be used to treat people ...

  9. Estrogen Injection

    Science.gov (United States)

    The estradiol cypionate and estradiol valerate forms of estrogen injection are used to treat hot flushes (hot ... should consider a different treatment. These forms of estrogen injection are also sometimes used to treat the ...

  10. Cefotaxime Injection

    Science.gov (United States)

    Cefotaxime injection is used to treat certain infections caused by bacteria including pneumonia and other lower respiratory ... skin, blood, bone, joint, and urinary tract infections. Cefotaxime injection may also be used before surgery, and ...

  11. Radial artery pseudoaneurysm: A rare complication after a single arterial puncture for blood-gas analysis.

    Science.gov (United States)

    Patel, Kajal Nitin; Gandhi, Shruti P; Sutariya, Harsh C

    2016-10-01

    With a reported incidence of 0.048%, radial artery pseudoaneurysm (PA) is a rare but serious complication of arterial cannulation. We report a case of PA developing after a single puncture of the right radial artery for arterial blood-gas analysis diagnosed by Doppler ultrasound in young male patient. The development of PA after puncture of radial artery for continuous blood pressure monitoring and serial blood-gas analysis has been reported in the past; however, to the best of our knowledge, there is only one case report of development of PA after a single arterial puncture for blood-gas analysis is reported in the past.

  12. Management of Cerebellar Tonsillar Herniation following Lumbar Puncture in Idiopathic Intracranial Hypertension

    Directory of Open Access Journals (Sweden)

    Kenneth R. Hoffman

    2015-01-01

    Full Text Available Lumbar puncture is performed routinely for diagnostic and therapeutic purposes in idiopathic intracranial hypertension, despite lumbar puncture being classically contraindicated in the setting of raised intracranial pressure. We report the case of a 30-year-old female with known idiopathic intracranial hypertension who had cerebellar tonsillar herniation following therapeutic lumbar puncture. Management followed guidelines regarding treatment of traumatic intracranial hypertension, including rescue decompressive craniectomy. We hypothesize that the changes in brain compliance that are thought to occur in the setting of idiopathic intracranial hypertension are protective against further neuronal injury due to axonal stretch following decompressive craniectomy.

  13. Transcutaneous pressure at which the internal jugular vein is collapsed on ultrasonic imaging predicts easiness of the venous puncture.

    Science.gov (United States)

    Joo, Woo Jin; Fukui, Michihiko; Kooguchi, Kunihiko; Sakaguchi, Masahiro; Shinzato, Taiichi

    2011-04-01

    Even though we use ultrasound guidance for central venous puncture, we sometimes experience difficulties. We infer that in such cases the vein is collapsed and that the transcutaneous ultrasound probe pressure at which the vein is collapsed (P (tc)) may predict the easiness of the venous puncture. We measured P (tc) and the diameter of the internal jugular vein in 47 adult patients in our ICU. After successful puncture, we also measured venous pressure (P (v)). The patients were divided into two groups based on the number of puncture attempts: ≥3 attempts constituted the "difficult group" and venous collapsibility and vertical diameter determine difficulty in performing venous puncture.

  14. Ustekinumab Injection

    Science.gov (United States)

    ... Do not inject into an area where the skin is tender, bruised, red, or hard or where you have scars or stretch marks.Your doctor or pharmacist will ... injection.you should know that ustekinumab injection may decrease your ability ... new or changing skin lesions, minor infections (such as open cuts or ...

  15. Ranitidine Injection

    Science.gov (United States)

    Ranitidine injection comes as a solution (liquid) to be mixed with another fluid and injected intravenously (into a vein) over 5 to 20 minutes. Ranitidine may also be injected into a muscle. It is usually given every 6 to 8 hours, but may also be given ...

  16. Evaluation of Parental Attitudes toward Lumbar Puncture in their Children

    Directory of Open Access Journals (Sweden)

    Ali Khakshour

    2013-12-01

    Full Text Available Introduction:   Sometimes physicians need to assess some markers on selected children's cerebrospinal fluid specimen according to lumbar puncture (LP. Although immediate diagnosis and treatment especially for meningitis is necessary, But just at this moment, due to some incorrect believe in society, some parents may not allow physician to do LP. The reality is that most of these people, if they have enough information about this issue, will not interfere. This study aimed to assess parent 's knowledge and attitudes toward this subject.   Materials and Method: Through a cross - sectional study we evaluated 91 parents, who their child must been undergone LP as physician’s decision, selected during 18 months using purposive sampling. The data collection tool was a questionnaire including two sections of the child and the parents' knowledge and attitudes.  Scientific validity of the questionnaire was confirmed by content validity. To achieve the objectives, SPSS ver.15 and descriptive statistics and chi-square test were used.   Results: 61 parents(67%  mentioned   fear of some side effects as the main reason of their children 's  LP discontent .The most important  cause of  fear was low back pain according to  50 (54.9% parents 's view. 70 parents (76.9% had some satisfaction after performing  LP .There was  statistically significant difference between proportion of satisfied parents and non-satisfied ones (p

  17. Office-based tracheoesophageal puncture: updates in techniques and outcomes.

    Science.gov (United States)

    Bergeron, Jennifer L; Jamal, Nausheen; Erman, Andrew; Chhetri, Dinesh K

    2014-01-01

    Tracheoesophageal puncture (TEP) is an effective rehabilitation method for postlaryngectomy speech and has already been described as a procedure that is safely performed in the office. We review our long-term experience with office-based TEP over the past 7 years in the largest cohort published to date. A retrospective chart review was performed of all patients who underwent TEP by a single surgeon from 2005 through 2012, including office-based and operating room procedures. Indications for the chosen technique (office versus operating room) and surgical outcomes were evaluated. Fifty-nine patients underwent 72 TEP procedures, with 55 performed in the outpatient setting and 17 performed in the operating room, all without complication. The indications for performing TEPs in the operating room included 2 primary TEPs, 14 due to concomitant procedures requiring general anesthesia, and 1 due to failed attempt at office-based TEP. Nineteen patients with prior rotational or free flap reconstruction successfully underwent office-based TEP. TEP in an office-based setting with immediate voice prosthesis placement continues to be a safe method of voice rehabilitation for postlaryngectomy patients, including those who have previously undergone free flap or rotational flap reconstruction. Office-based TEP is now our primary approach for postlaryngectomy voice rehabilitation. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Numerical method for computing Maass cusp forms on triply punctured two-sphere

    Energy Technology Data Exchange (ETDEWEB)

    Chan, K. T.; Kamari, H. M. [Department of Physics, Faculty of Science, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor (Malaysia); Zainuddin, H. [Department of Physics, Faculty of Science, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia and Institute for Mathematical Research, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor (Malaysia)

    2014-03-05

    A quantum mechanical system on a punctured surface modeled on hyperbolic space has always been an important subject of research in mathematics and physics. This corresponding quantum system is governed by the Schrödinger equation whose solutions are the Maass waveforms. Spectral studies on these Maass waveforms are known to contain both continuous and discrete eigenvalues. The discrete eigenfunctions are usually called the Maass Cusp Forms (MCF) where their discrete eigenvalues are not known analytically. We introduce a numerical method based on Hejhal and Then algorithm using GridMathematica for computing MCF on a punctured surface with three cusps namely the triply punctured two-sphere. We also report on a pullback algorithm for the punctured surface and a point locater algorithm to facilitate the complete pullback which are essential parts of the main algorithm.

  19. The influence of punctural millimeter wave therapy on clinical presentation of patients with essential hypertention

    Directory of Open Access Journals (Sweden)

    Kotenko К.V.

    2013-12-01

    Full Text Available Aim: to estimate the influence of punctural millimeter wave therapy on clinical presentation. Material and methods. This study includes 102 patients with essential hypertension the I and II stage. Patients were divided into three equal groups depending on the method of treatment: some of them received procedures of punctural millimeter wave therapy, some of them received these procedures as the "placebo" and those who had not received specified procedures. Dynamics of clinical symptomatology and condition of eye bottom vessels was estimated. It was shown that addition of punctural millimeter wave therapy in complex therapy of patients with essential hypertension promotes the expressed regress of clinical symptomatology and state normalization the retinal vessels at these patients. Results. Addition of punctural millimeter wave therapy into the complex therapy was shown to lead to pronounced regress of clinical symptoms. Conclusion. The received results allow to recommend this method to be used in clinical practice for treating patients with essential hypertension.

  20. A safe and efficacious alternative: sonographically guided internal jugular vein puncture for intracranial endovascular intervention.

    Science.gov (United States)

    Yeh, C-H; Wu, Y-M; Toh, C-H; Chen, Y-L; Wong, H-F

    2012-01-01

    Transvenous interventions for intracranial vascular lesions are usually performed via venous access of a femoral vein puncture. However, the transjugular route is an alternative with a shorter and less tortuous vascular access for intracranial lesions. Although puncture of the internal jugular vein is generally believed to be too dangerous owing to potential hazardous complications, the safety of the sonographically guided retrograde internal jugular vein puncture technique for intracranial intervention has not been fully evaluated in the English literature. We present our experience with a total of 44 transjugular intervention procedures between April 1999 and June 2010. We believe sonographically guided internal jugular vein puncture is a safe and efficacious technique for establishing transvenous access for an intracranial endovascular intervention.

  1. Needle bending in a VR-puncture training system using a 6DOF haptic device.

    Science.gov (United States)

    Färber, Matthias; Dahmke, Thorsten; Bohn, Christian A; Handels, Heinz

    2009-01-01

    The use of virtual reality techniques opens up new perspectives to support and improve the puncture training in medical education. In this work a 3D VR-Simulator for the training of lumbar and ascites punctures has been extended to support the bending of the puncture needle. For this purpose the needle is designed as an angular spring model. The forces that restrict the user from bending the needle are calculated using a multiproxy technique and given to the user via a 6DOF haptic device (Sensable Phantom Premium 1.5). Proxy based haptic volume rendering is used to calculate the proxy movement. This way it is possible to integrate original CT-patient data into the rendering process and generate forces from structures that have not been segmented. The bending technique has been integrated in a VR-training system for puncture interventions and shows good results concerning update rate and user acceptance.

  2. Caffeine, Is it effective for prevention of postdural puncture headache in young adult patients?

    Directory of Open Access Journals (Sweden)

    Ashraf Ragab

    2014-04-01

    Conclusion: It seems that the incidence of postdural puncture headache decreases in those patients who received caffeine sodium benzoate. The article can potentially help clinicians to use caffeine as an effective drug for prevention of PDPH.

  3. Influential factors and effect evaluation of the intra-operative puncture biopsy for pancreatic masses

    Institute of Scientific and Technical Information of China (English)

    ZHUANG Yan; YANG Yin-mo; WANG Wei-min; GAO Hong-qiao; WAN Yuan-lian

    2012-01-01

    Background It is a challenge for the surgeons to accurately diagnose the pancreatic masses preoperatively,which decides the choice of surgical managements and subsequently results in different survivor outcomes,operative complications,and mortality rates.The purposes of this study were to evaluate the diagnostic role that intra-operative puncture biopsy may play in pancreatic masses and to explore the relevant factors influencing the diagnosis.Methods A retrospective study was performed on 94 in-patients admitted to Peking University First Hospital for pancreatic masses during the period from June 1994 to December 2007.They all underwent intra-operative puncture biopsy during exploratory laparotomy.The sensitivity and specificity of intra-operative puncture biopsy were calculated and the relevant factors to the diagnosis of biopsy were selected for the statistical analysis.Results The overall sensitivity,specificity,positive predictive value,and negative predictive value of intra-operative puncture biopsy were 76.0%,94.7%,98.3% and 50.0%,respectively.The analysis of bivariate correlations showed that the size of the pancreatic masses (P=-0.000),the number of puncture biopsies (P=0.000),and the presence of pancreatic fibrosis (P=-0.012) had statistic significance for the diagnosis.But the multivariate analysis identified the size of the pancreatic masses (P=0.004) and the number of puncture biopsies (P=0.000) as independent predictive factors for intra-operative puncture biopsy.In addition,as the number of puncture biopsies increased,the sensitivity and specificity of diagnosis was improved (P=0.000).The sensitivity and specificity of intra-operative puncture biopsy were found to be lower for the pancreatic masses less than 25 mm compared with the masses larger than 25 mm (P=0.000).It was noted,however,that even if the masses were less than 25 mm,the sensitivity and specificity could be improved significantly as the number of puncture biopsies reached 3 to 6

  4. Suitability of Exoseal Vascular Closure Device for Antegrade Femoral Artery Puncture Site Closure

    Energy Technology Data Exchange (ETDEWEB)

    Schmelter, Christopher, E-mail: christopher.schmelter@klinikum-ingolstadt.de; Liebl, Andrea; Poullos, Nektarios [Klinikum Ingolstadt, Department of Diagnostic and Interventional Radiology (Germany); Ruppert, Volker [Klinikum Ingolstadt, Department of Vascular Surgery (Germany); Vorwerk, Dierk [Klinikum Ingolstadt, Department of Diagnostic and Interventional Radiology (Germany)

    2013-06-15

    Purpose. To assess the efficacy and safety of the Exoseal vascular closure device for antegrade puncture of the femoral artery. Methods. In a prospective study from February 2011 to January 2012, a total of 93 consecutive patients received a total of 100 interventional procedures via an antegrade puncture of the femoral artery. An Exoseal vascular closure device (6F) was used for closure in all cases. Puncture technique, duration of manual compression, and use of compression bandages were documented. All patients were monitored by vascular ultrasound and color-coded duplex sonography of their respective femoral artery puncture site within 12 to 36 h after angiography to check for vascular complications. Results. In 100 antegrade interventional procedures, the Exoseal vascular closure device was applied successfully for closure of the femoral artery puncture site in 96 cases (96 of 100, 96.0 %). The vascular closure device could not be deployed in one case as a result of kinking of the vascular sheath introducer and in three cases because the bioabsorbable plug was not properly delivered to the extravascular space adjacent to the arterial puncture site, but instead fully removed with the delivery system (4.0 %). Twelve to 36 h after the procedure, vascular ultrasound revealed no complications at the femoral artery puncture site in 93 cases (93.0 %). Minor vascular complications were found in seven cases (7.0 %), with four cases (4.0 %) of pseudoaneurysm and three cases (3.0 %) of significant late bleeding, none of which required surgery. Conclusion. The Exoseal vascular closure device was safely used for antegrade puncture of the femoral artery, with a high rate of procedural success (96.0 %), a low rate of minor vascular complications (7.0 %), and no major adverse events.

  5. Haemostasis and safety measures before lumbar puncture in the haematology ward

    DEFF Research Database (Denmark)

    Møller, Anders; Bjerrum, Ole Weis; Afshari, Arash

    2015-01-01

    BACKGROUND/AIMS: Thrombocytopenia and the increasing use and variety of antithrombotic drugs is a challenge prior to lumbar puncture. This study examined the Danish haematology practice regarding drug pausation, assessment of haemostasis and whether fundoscopy is a routine safety measure. METHODS...... national guidelines are warranted and there is a need for studies to establish an evidence-based approach for the management of patients at risk of bleeding when lumbar puncture or another invasive procedure is indicated....

  6. Heme oxygenase-1 modulates degeneration of the intervertebral disc after puncture in Bach 1 deficient mice.

    Science.gov (United States)

    Ohta, Ryo; Tanaka, Nobuhiro; Nakanishi, Kazuyoshi; Kamei, Naosuke; Nakamae, Toshio; Izumi, Bunichiro; Fujioka, Yuki; Ochi, Mitsuo

    2012-09-01

    Intervertebral disc degeneration is considered to be a major feature of low back pain. Furthermore, oxidative stress has been shown to be an important factor in degenerative diseases such as osteoarthritis and is considered a cause of intervertebral disc degeneration. The purpose of this study was to clarify the correlation between oxidative stress and intervertebral disc degeneration using Broad complex-Tramtrack-Bric-a-brac and cap'n'collar homology 1 deficient (Bach 1-/-) mice which highly express heme oxygenase-1 (HO-1). HO-1 protects cells from oxidative stress. Caudal discs of 12-week-old and 1-year-old mice were evaluated as age-related models. Each group and period, 5 mice (a total of 20 mice, a total of 20 discs) were evaluated as age-related model. C9-C10 caudal discs in 12-week-old Bach 1-/- and wild-type mice were punctured using a 29-gauge needle as annulus puncture model. Each group and period, 5 mice (a total of 60 mice, a total of 60 discs) were evaluated. The progress of disc degeneration was evaluated at pre-puncture, 1, 2, 4, 8 and 12 weeks post-puncture. Radiographic, histologic and immunohistologic analysis were performed to compare between Bach 1-/- and wild-type mice. In the age-related model, there were no significant differences between Bach 1-/- and wild-type mice radiologically and histologically. However, in the annulus puncture model, histological scoring revealed significant difference at 8 and 12 weeks post-puncture. The number of HO-1 positive cells was significantly greater in Bach 1-/- mice at every period. The apoptosis rate was significantly lower at 1 and 2 weeks post-puncture in Bach 1-/- mice. Oxidative stress prevention may avoid the degenerative process of the intervertebral disc after puncture, reducing the number of apoptosis cells. High HO-1 expression may also inhibit oxidative stress and delay the process of intervertebral disc degeneration.

  7. Effect of different cork puncture methods on aseptic storage period of normal saline%不同方法穿刺瓶塞生理盐水无菌存放时间研究

    Institute of Scientific and Technical Information of China (English)

    程翠年; 张卉; 吴胜林; 王懿睿; 王霞; 谢敏; 李绍婷; 李林; 易旭慧

    2011-01-01

    Objective To study the effect of different materials of cork, puncture methods and frequencies on the aseptic storage period of normal saline injection kept in PIVAS. Methods We grouped normal saline injection bottles according to the materials of the cork (butyl or polyisoprene ), puncture methods(stochastic puncture or repeated puncture of a single site of the cork) and puncture frequencies(three or five times). Sterility test were taken immediately after the puncture, and at 1 h, 2 h,3 h,4 h,5 h,6 h,8 h, 10h and 12 h within storage. Results The normal saline injection with polyisoprene cork stayed aseptic within 10 h after the corks were punctured 3 or 5 times randomly. The injection stayed sterile within 6 h after 3 times of, or within 5 h after 5 times of puncture through a single site of the cork. The normal saline injection with butyl cork stayed aseptic within 8 h after 3 times of, or within 6 h after 5 times of stochastic puncture. The injection with butyl cork stayed sterile within 5 h after 3 times of, or within 4 h after 5 times of puncture through a single site of the cork. Conclusion Normal saline injection with two different materials of the cork is able to stay sterile within 4 h regardless of the puncture methods or frequencies. The storage period of normal saline injection whose corks are repeatedly punctured at a single site is shortened with increasing puncture frequency. Normal saline injection with butyl cork shows shorter storage period compared with those with polyisoprene cork. The results indicate that we should strictly obeythe misalign rules during intravenous drug preparation. Meanwhile, the procedure calls for advisable arrangement of drug preparation time according to the drug properties and usage requirements.%目的 研究静脉药物配置中心环境下瓶塞材质、穿刺方法及穿刺次数对生理盐水无菌存放时间的影响.方法 将静脉输液用生理盐水按胶塞的材质(丁基胶塞和聚异戊二烯胶塞)

  8. Internal Jugular Vein Catheterization with Seldinger Technique, previous Needle Puncture: Complications

    Directory of Open Access Journals (Sweden)

    Carrizo G

    2016-06-01

    Full Text Available Central venous catheterization (CVC is a common procedure performed daily for its outnumbered indications, complication rates range are up to 15%. The previous puncture with a fine needle with the Seldinger technique can reduce even more the possible complications, guaranteeing a high percentage of success. The objective was to determine the number of CVC per puncture with Seldinger technique performed by general surgery residents and identify number and type of mechanical complications, related to the residence year. A descriptive transversal cut study has been carried out, between March and November of 2014. A number of 243 patients were evaluated, observing that 41% of the cases were to measure CVP and hemodynamic monitoring; 76% of the punctures were done by 1º and 2º year residents, presenting only 10% on mechanic complications, most frequently on arterial puncture. In conclusion, previous puncture with needle with the Seldinger technique is safer, more secure, lower cost, and reduces the number of complications, it is a variant puncture under ultrasound guidance.

  9. Evaluation of ventilatory therapy for acid aspiration.

    Science.gov (United States)

    Flint, L; Gosdin, G; Carrico, C J

    1975-10-01

    Aspiration of hydrochloric acid in experimental animals results in severe, progressive hypoxia which is due to intrapulmonary shunting and depressed cardiac output. This preparation is useful therefore in studying the therapy of hypoxia. Mongrel dogs were subjected to acid aspiration and the effects of several ventilatory patterns on intrapulmonary shunt fractions and lung water accumulation observed. The combination of large tidal volumes (30 c.c. per kilogram) with positive end-expiratory pressure was effective in preventing intrapulmonary shunting and other ventilatory patterns were ineffective. Pulmonary edema uniformly followed acid aspiration and was not affected by ventilatory therapy. When ventilatory therapy was delayed for 4 hours, the progression of shunting apparently was limited, but the existing shunt was not reduced.

  10. Preventing complicated transseptal puncture with intracardiac echocardiography: case report

    Directory of Open Access Journals (Sweden)

    Temesvári András

    2005-03-01

    Full Text Available Abstract Background Recently, intracardiac echocardiography emerged as a useful tool in the electrophysiology laboratories for guiding transseptal left heart catheterizations, for avoiding thromboembolic and mechanical complications and assessing the ablation lesions characteristics. Although the value of ICE is well known, it is not a universal tool for achieving uncomplicated access to the left atrium. We present a case in which ICE led to interruption of a transseptal procedure because several risk factors for mechanical complications were revealed. Case presentation A case of a patient with paroxysmal atrial fibrillation and atrial flutter, and distorted intracardiac anatomy is presented. Intracardiac echocardiography showed a small oval fossa abouting to an enlarged aorta anteriorly. A very small distance from the interatrial septum to the left atrial free wall was seen. The latter two conditions were predisposing to a complicated transseptal puncture. According to fluoroscopy the transseptal needle had a correct position, but the intracardiac echo image showed that it was actually pointing towards the aortic root and most importantly, that it was virtually impossible to stabilize it in the fossa itself. Based on intracardiac echo findings a decision was made to limit the procedure only to ablation of the cavotricuspid isthmus and not to proceed further so as to avoid complications. Conclusion This case report illustrates the usefulness of the intracardiac echocardiography in preventing serious or even fatal complications in transseptal procedures when the cardiac anatomy is unusual or distorted. It also helps to understand the possible mechanisms of mechanical complications in cases where fluoroscopic images are apparently normal.

  11. Under Utilization of Local Anesthetics in Infant Lumbar Punctures

    Directory of Open Access Journals (Sweden)

    Gorchynski, Julie

    2008-01-01

    Full Text Available Background: Lumbar Puncture (LP is an invasive procedure frequently used to diagnose meningitis among the pediatric population. Neonates and infants have not routinely received local anesthesia prior to LP. Study Objective: To determine whether emergency medicine physicians and pediatricians use local analgesics on neonates and infants prior to performing an LP and to identify which local anesthetics, if any, were used. Methods: Prospective, cohort study of all infants, six months of age or less, that received an LP in the emergency department (ED or inpatient pediatric units for suspected meningitis during a period of year at a university tertiary care hospital. Results: A total sample population of 111 infants that received an LP within the study period. A control population of 42 adults received an LP. Only 40.4% (45/111 of the infants received local analgesia prior to LP: either 1% lidocaine, EMLA or a combination of the two. Infants were less likely to receive lidocaine or EMLA prior to LP compared to adult subjects (OR= 0.27; 95% CI0.12 to 0.62. No neonates that were less than one month of age received local procedural anesthesia by emergency medicine or pediatric physicians. ED physicians’ use of local anesthesia prior to LP increased with increasing age of the infant. The pediatricians in this study used local anesthesia prior to LP when the infant was at least five months of age. Discussion: The data objectively support recent literature regarding the under use or lack of use of analgesia prior to LP among neonates and infants. Local anesthetics should be used routinely without exception prior to performing an LP in the pediatric population.

  12. CT detection and aspiration of abdominal abscesses.

    Science.gov (United States)

    Haaga, J R; Alfidi, R J; Havrilla, T R; Cooperman, A M; Seidelmann, F E; Reich, N E; Weinstein, A J; Meaney, T F

    1977-03-01

    Computed tomography (CT) is effective in detecting intraabdominal abscesses. Loculations of fluid and extraluminal gas are clearly localized in relation to other organs. Of 22 abscess in this series, CT successfully detected 20; comparative information with gallium, techneticum, and ultrasound scans is presented. In addition to localizing these collections, CT can be used to guide needle aspiration and drainage procedures. Three sizes of needles were used to aspirate specimens and/or provide drainage. This was accomplished successfully in 12 of 14 CT-guided procedures.

  13. Subcutaneous Injections

    DEFF Research Database (Denmark)

    Thomsen, Maria

    This thesis is about visualization and characterization of the tissue-device interaction during subcutaneous injection. The tissue pressure build-up during subcutaneous injections was measured in humans. The insulin pen FlexTouchr (Novo Nordisk A/S) was used for the measurements and the pressure...... build-up was evaluated indirectly from the changes in the flow rate between subcutaneous injections and air injections. This method enabled the tissue counter pressure to be evaluated without a formal clinical study approval. The measurements were coupled to a model for the pressure evolution...

  14. Outcomes of transvaginal multifetal pregnancy reduction without injecting potassium chloride

    Directory of Open Access Journals (Sweden)

    Devika Gunasheela

    2016-12-01

    Full Text Available Background: Assisted reproductive technologies and the use of fertility drugs have significantly increased the prevalence of multiple pregnancy in last three decades. Various techniques and routes have been studied so far regarding fetal reduction to achieve healthy viable pregnancy. The current study aims to study different outcomes of multifetal pregnancy reduction without injecting potassium chloride. Methods: Total 57 patients were studied from October 2011 to November 2012 at our centre. 28 were higher order pregnancies who consented for fetal reduction and 29 were nonreduced twins as control group. It was a prospective comparative study. Fetal reduction was done transvaginally between 8-12 weeks by intracardiac puncture followed by manual aspiration of embryonic parts till asystole. Use of KCl was avoided. The most easily accessible sac was chosen for reduction. All were reduced to twins. Reduction to singleton and selective reduction of anomalous fetus were removed from the study as it could have created a bias in the comparison. The primary outcomes like miscarriage, post procedure complications, mean gestational age at delivery, preterm delivery, mean birth weight were studied. The outcomes of reduced twins were compared with that of nonreduced twins. The various secondary outcomes like IUGR, take home baby rate, neonatal morbidity, mortality, maternal morbidity and mortality, associated obstetric complications were studied. Results: Both groups were comparable with respect to age and parity. The average gestation of fetal reduction was 9.46 weeks. Abortion rate was 17.9% (n=5 in reduced group which was statistically significant. 4 patients were lost to follow up. There were no statistically significant differences with regard to cesarean section rate, preterm delivery, mean birth weight, mean gestational delivery between two groups. No incidence of IUGR in the series. One baby died in the control group, none in reduced group. Take home

  15. Timing of neuraxial pain interventions following blood patch for post dural puncture headache.

    Science.gov (United States)

    Shaparin, Naum; Gritsenko, Karina; Shapiro, David; Kosharskyy, Boleslav; Kaye, Alan D; Smith, Howard S

    2014-01-01

    Post dural puncture headache (PDPH) is a common complication of interventional neuraxial procedures. Larger needle gauge, younger patients, low body mass index, women (especially pregnant women), and "traumatic" needle types are all associated with a higher incidence of PDPH. Currently, an epidural blood patch is the gold-standard treatment for this complication. However, despite the high PDPH cure rate through the use of this therapy, little is known about the physiology behind the success of the epidural blood patch, specifically, the time course of patch formation within the epidural space or how long it takes for the blood patch volume to be resorbed by the body. Of the many unanswered and debated topics related to PDPH and epidural blood patches, one additional specific question that may alter clinical management is when it is safe for patients who have experienced a disruption of the thecal space and have undergone this procedure to have a subsequent epidural or spinal procedure, such as a neuraxial anesthetic (i.e. a spinal anesthetic for an elective outpatient procedure) or an interventional pain procedure for chronic pain management. This question becomes more unclear if the new procedure includes a steroid medication. As an example, an older patient presents with a history of lumbar disc disease and during lumbar epidural steroid injection, an inadvertent wet tap occurs leading to PDPH. Following management with fluids, caffeine, medications, and a successful epidural blood patch, it remains unclear as to when would be the best time frame to consider a second lumbar epidural steroid injection. We identified the 3 main risk factors of subsequent interventional neuraxial procedures as (1) disruption of the epidural blood patch and ongoing reparative processes, (2) epidural procedure failure, and (3) infection. We looked at the literature, and summarized the existing literature in order to enable health care professionals to understand the time course of

  16. Injection MD

    CERN Document Server

    Bartmann, W; Bracco, C; Drosdal, L; Gianfelice, E; Goddard, B; Kain, V; Papaphilippou, Y; Vanbavinckhove, G

    2012-01-01

    This note summarizes the results obtained at injection during the 2nd MD block and the floating MD block in July. Highlights are presented for injection in the LHC with the Q20 SPS optics, influence of the supercycle and injection with 25 ns bunch spacing. Beams were successfully injected into the LHC using the Q20 optics [1, 3]. Small corrections were needed to steer the beam in the transfer lines. Dispersion measurements were conducted for both beams. The horizontal normalized dispersion in TI2 was a factor 2 smaller for Q20 with respect to Q26, for TI8 on the other hand the opposite was observed. The results for injection loss dependency on super cycle composition show only a small increase in losses for beam 2. The losses observed must therefore mainly come from other sources such as shot-by-shot stability or quality of scraping. For the injection with 25 ns bunch spacing bunches were injected for both beams. For B1 up to the maximum of 288 bunches. For B2 on the other only up to 144 bunches were injected...

  17. Access site complications and puncture site pain following transradial coronary procedures: a correlational study.

    Science.gov (United States)

    Cheng, Ka Yan; Chair, Sek Ying; Choi, Kai Chow

    2013-10-01

    Transradial coronary angiography (CA) and percutaneous coronary intervention (PCI) are gaining worldwide popularity due to the low incidence of major vascular complications and early mobilization of patients post procedures. Although post transradial access site complications are generally considered as minor in nature, they are not being routinely recorded in clinical settings. To evaluate the incidence of access site complications and level of puncture site pain experienced by patients undergoing transradial coronary procedures and to examine factors associated with access site complications occurrence and puncture site pain severity. A cross-sectional correlational study of 85 Chinese speaking adult patients scheduled for elective transradial CA and or PCI. Ecchymosis, bleeding, hematoma and radial artery occlusion (RAO) were assessed through observation, palpation and plethysmographic signal of pulse oximetry after coronary procedures. Puncture site pain was assessed with a 100mm Visual Analogue Scale. Factors that were related to access site complications and puncture site pain were obtained from medical records. Ecchymosis was the most commonly reported transradial access site complication in this study. Paired t-test showed that the level of puncture site pain at 24 h was significantly (pstudy findings suggest that common access site complications post transradial coronary procedures among Chinese population are relatively minor in nature. Individual puncture site pain assessment during the period of hemostasis is important. Nurses should pay more attention to factors such as female gender, sheath time and volume of compression that are more likely to be associated with transradial access site complications and puncture site pain. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Location of femoral artery puncture site and the risk of postcatheterization pseudoaneurysm formation.

    Science.gov (United States)

    Gabriel, Marcin; Pawlaczyk, Katarzyna; Waliszewski, Krzysztof; Krasiński, Zbigniew; Majewski, Wacław

    2007-08-21

    Iatrogenic causes constitute increasingly frequent sources of pseudoaneurysms due to endovascular interventions. However, till now, all analyses focused on evaluating different risk factors contributing to the development of pseudoaneurysm, overlooking the issue of localization of femoral puncture. The aim of this study was to assess the influence of position of femoral artery puncture on the risk of pseudoaneurysm formation. 116 patients were evaluated for the site of catheter insertion into femoral arteries. Another group of 273 patients, suspected of vascular complications after endovascular procedures, were diagnosed with pseudoaneurysms which were analyzed for the location of arterial wall disruption. Puncture sites of groin arteries, i.e. EIA (2.7%), CFA (77.5%), SFA and DFA (19.8%), correlated with pseudoaneurysm location reaching 7.6% (EIA), 54.3% (CFA) and 38.1% (SFA, DFA). Type of procedure influenced these values. Duplex ultrasound mapping of CFA before the endovascular intervention eliminated discrepancies between the incidence of pseudoaneurysm formation and the frequency of arterial puncture in the selected vascular segments. Pseudoaneurysms formed in 4.5% of patients undergoing traditional palpation-guided vessel cannulation and in 2.6% of patients after ultrasound-guided puncture of the femoral artery. Upon further analysis, we concluded that the likelihood of the development of pseudoaneurysm depends on the artery punctured in the groin. This risk increases dramatically for external iliac artery, superficial and deep femoral arteries. A simple means of prevention of this dangerous complication of femoral artery puncture is duplex ultrasound mapping of the groin arteries.

  19. A novel pneumatic micropipette aspiration method using a balance pressure model.

    Science.gov (United States)

    Zhao, Qili; Wu, Ming; Cui, Maosheng; Qin, Yanding; Yu, Jin; Sun, Mingzhu; Zhao, Xin; Feng, Xizeng

    2013-12-01

    This paper presents a novel micropipette aspiration (MA) method based on a common pneumatic micro-injection system. This method is the first to quantify the influence of capillary effect on aspiration pressure using a balance pressure model, and in return, uses the capillary effect to quantify the aspiration pressure. Subsequently, the seal between the cell and the micropipette is detected to judge and exclude the ineffective MA attempts. The rationality of the balance pressure model is validated by the designed micropipette-filling experiments. Through applied to elasticity-determination of the cells with different sizes, the feasibility and versatility of this MA method are proved. With abilities to quantify aspiration pressures and detect the seam between the cell and the micropipette, our method is expected to advance the application of the commercial pneumatic injector in the MA of cells. Moreover, with the quantified volume of the liquid entering into the micropipette during MA process, our method also has a potential applicability to the study of the permeability of the cell membrane in the future.

  20. A novel pneumatic micropipette aspiration method using a balance pressure model

    Science.gov (United States)

    Zhao, Qili; Wu, Ming; Cui, Maosheng; Qin, Yanding; Yu, Jin; Sun, Mingzhu; Zhao, Xin; Feng, Xizeng

    2013-12-01

    This paper presents a novel micropipette aspiration (MA) method based on a common pneumatic micro-injection system. This method is the first to quantify the influence of capillary effect on aspiration pressure using a balance pressure model, and in return, uses the capillary effect to quantify the aspiration pressure. Subsequently, the seal between the cell and the micropipette is detected to judge and exclude the ineffective MA attempts. The rationality of the balance pressure model is validated by the designed micropipette-filling experiments. Through applied to elasticity-determination of the cells with different sizes, the feasibility and versatility of this MA method are proved. With abilities to quantify aspiration pressures and detect the seam between the cell and the micropipette, our method is expected to advance the application of the commercial pneumatic injector in the MA of cells. Moreover, with the quantified volume of the liquid entering into the micropipette during MA process, our method also has a potential applicability to the study of the permeability of the cell membrane in the future.

  1. Subcutaneous Injections

    DEFF Research Database (Denmark)

    Thomsen, Maria

    This thesis is about visualization and characterization of the tissue-device interaction during subcutaneous injection. The tissue pressure build-up during subcutaneous injections was measured in humans. The insulin pen FlexTouchr (Novo Nordisk A/S) was used for the measurements and the pressure...... build-up was evaluated indirectly from the changes in the flow rate between subcutaneous injections and air injections. This method enabled the tissue counter pressure to be evaluated without a formal clinical study approval. The measurements were coupled to a model for the pressure evolution...... in subcutaneous tissue, based on mass conservation and flow in a porous medium. From the measurements the flow permeability and bulk modulus of the tissue were determined. In the adipose tissue the drug forms a bolus from where it is absorbed by the blood capillaries. The spatial distribution of the injected...

  2. Occupational Aspirations and Expectations of Australian Adolescents

    Science.gov (United States)

    Patton, Wendy; Creed, Peter

    2007-01-01

    Adolescents across the five years of high school (169 females and 164 males) completed a survey that identified occupational status aspirations and expectations coded into six types-- realistic, investigative, artistic, social, enterprising, or conventional--according to the RIASEC model (Holland, 1997). As the focus of the study was to explore…

  3. Income Aspirations and Cooperation : Experimental Evidence

    NARCIS (Netherlands)

    Dalton, P.S.

    2010-01-01

    This article is the first attempt to study the empirical link between income aspirations and cooperation in a one shot public good game. By combining experimental with survey data, we find evidence that the more frustrated people are with their income, the lower is their propensity to cooperate with

  4. Aspiring Girls: Great Expectations or Impossible Dreams?

    Science.gov (United States)

    Richards, Gill; Posnett, Carol

    2012-01-01

    This study explores girls' aspirations for their future. The context was an ex-coalmining area where concerns had been raised by the local authority about the levels of girls' achievement. The focus of the research was the views of Year 6 girls as they prepared for their transition to secondary school and Year 11 girls as they prepared for their…

  5. FOREIGN BODY ASPIRATION: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Nafia Ozlem Kazanci

    2013-03-01

    Full Text Available Foreign body aspiration (FBA is common under 3 years of age. FBA can cause sudden respiratory failure. Furthermore, it leads to many respiratory system complications. Therefore, FBA is an important cause of mortality and morbidity for this age group. FBA cases are usually followed by diagnoses like pneumonia, bronchitis or bronchial asthma in the late period that history, clinical and laboratory findings suggesting foreign body aspiration can not be detected. We reported a 2-year-old male patient with pneumonia, who were administered various treatments. In thorax CT of this case, an image compatible with foreign body was seen in the right middle lobe-upper lobe separation area. Granulation tissue was detected in the entrance of the right main bronchus by rigid bronchoscopy and marked improvement occured in lung aeration after bronchoscopy. This case was reported to emphasize the importance of early diagnosis of foreign body aspiration because of high mortality and morbidity and the necessity of considering the foreign body aspiration in children with recurrent pulmonary infections. [J Contemp Med 2013; 3(1.000: 58-61

  6. Uitwerking en implementatie Aspire voor witte asperges

    NARCIS (Netherlands)

    Kruistum, van G.; Wilms, J.A.M.

    2008-01-01

    In vervolg op het afgesloten project ‘Valideren van het AspireNZ systeem voor asperges in Nederland’ is medio 2006 dit vervolgproject gestart. Doelstelling is de ontwikkeling van een werkend Beslissing Ondersteunend Systeem (BOS) op basis van regelmatige meting van suikergehalten van de wortels en b

  7. Turban pin aspiration: new fashion, new syndrome.

    Science.gov (United States)

    Ilan, Ophir; Eliashar, Ron; Hirshoren, Nir; Hamdan, Kasem; Gross, Menachem

    2012-04-01

    Turban pin aspiration syndrome is a new clinical entity afflicting young Islamic girls wearing a turban.The goal of this study was to present our experience in diagnosis and treatment of this new entity, define its clinical and epidemiologic features, and shed a new light on the role of fashion in the increased incidence. A retrospective study in a tertiary university hospital. Review of clinical parameters and epidemiologic features of 26 patients diagnosed with turban pin aspiration syndrome admitted to the Hadassah-Hebrew University Hospitals in Jerusalem from 1990 to 2010. All patients were Muslim females with an average age of 16 years. In all cases, the history was positive for accidental aspiration. Most of the pins were located in the trachea (42%). In 20 cases, the pins were extracted by rigid bronchoscopy without major complications. Fluoroscopy-assisted rigid bronchoscopy was used successfully in three cases. In one case, the object was self-ejected by coughing before the bronchoscopy, and two patients were referred to the chest unit for thoracotomy. Clinicians should be aware of this distinct form of foreign body aspiration, its method of diagnosis, and extraction techniques. A cultural investigation showed a difference in the turban-fastening technique of young girls as compared with their mothers. Removal by rigid bronchoscopy is a safe method with a high success rate and should be considered as the preferred extraction method of choice. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  8. Occupational Aspirations and Expectations of Australian Adolescents

    Science.gov (United States)

    Patton, Wendy; Creed, Peter

    2007-01-01

    Adolescents across the five years of high school (169 females and 164 males) completed a survey that identified occupational status aspirations and expectations coded into six types-- realistic, investigative, artistic, social, enterprising, or conventional--according to the RIASEC model (Holland, 1997). As the focus of the study was to explore…

  9. Factors Influencing High School Students' Career Aspirations

    Science.gov (United States)

    Tang, Mei; Pan, Wei; Newmeyer, Mark D.

    2008-01-01

    This article explores the factors influencing high school students' career aspirations with a study analyzing 141 high school students. The Social Cognitive Career Development Model was utilized to examine the interactive relationships among learning experiences, career self-efficacy, outcome expectations, career interests, and career choices. The…

  10. The Gap between Aspiration and Practice

    Science.gov (United States)

    Tuckett, Alan

    2013-01-01

    At the time of the fifth UNESCO international conference on adult education (CONFINTEA V) in Hamburg in 1997, it seemed that a resilient alliance of governments and civil society organizations had been created. This alliance would have the commitment and cooperation needed to pursue the ambitious aspirations captured in the 10 themes of the…

  11. Informed Consent Documentation for Lumbar Puncture in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Pankaj B. Patel

    2014-05-01

    Full Text Available Introduction: Informed consent is a required process for procedures performed in the emergency department (ED, though it is not clear how often or adequately it is obtained by emergency physicians. Incomplete performance and documentation of informed consent can lead to patient complaints, medico-legal risk, and inadequate education for the patient/guardian about the procedure. We undertook this study to quantify the incidence of informed consent documentation in the ED setting for lumbar puncture (LP and to compare rates between pediatric (<18 years and adult patients. Methods: In this retrospective cohort study, we reviewed the ED electronic health records (EHR for all patients who underwent successful LPs in three EDs between April 2010 and June 2012. Specific elements of informed consent documentation were reviewed. These elements included the presence of general ED and LP-specific consent forms, signatures of patient/guardian, witness, and physician, documentation of purpose, risks, benefits, alternatives, and explanation of the LP. We also reviewed the use of educational material about the LP and LP-specific discharge information. Results: Our cohort included 937 patients; 179 (19.1% were pediatric. A signed general ED consent form was present in the EHR for 809 (86% patients. A consent form for the LP was present for 524 (56% patients, with signatures from 519 (99% patients/guardians, 327 (62% witnesses, and 349 (67% physicians. Documentation rates in the EHR were as follows: purpose (698; 74%, risks (742; 79%, benefits (605; 65%, alternatives (635; 68%, and explanation for the LP (57; 6%. Educational material about the LP was not documented as having been given to any of the patients and LP-specific discharge information was documented as given to 21 (2% patients. No significant differences were observed in the documentation of informed consent elements between pediatric and adult patients. Conclusion: General ED consent was obtained in

  12. 股尺定位穿刺法在危重患者股静脉穿刺中的应用%Application of Femoral Length Positioning Puncture in the Femoral Vein Puncture in Critically Ill Patients

    Institute of Scientific and Technical Information of China (English)

    张益香; 汪杏; 丁生英

    2014-01-01

    目的探讨股静脉穿刺方法及效果。方法成立培训小组,制作股尺,拟定穿刺方法,运用示教、模拟穿刺,带班护士实战指导等方法进行穿刺培训及指导。结果培训后,危重患者股静脉穿刺时间、一次穿刺成功率,差异均有统计学意义(puncture. Methods Setting up the training team, making stock scale, to puncture method, using the teaching, training and simulation puncture, puncture guiding method shift nurse practical guidance etc. Results After training, critical y il patients with femoral vein puncture, the success rate of first puncture, the dif erences were statistical y significant ( <0.05). Conclusion Femoral feet positioning puncture method, can improve the success rate of femoral venous puncture nurses, reduce the time of puncture.

  13. Gender and Leadership Aspiration : The Impact of the Organizational Environment

    NARCIS (Netherlands)

    C. Erlemann

    2016-01-01

    markdownabstractSummary The aim of this dissertation is to examine gender differences in leadership aspiration. Although some important work regarding gender-specific aspiration has been done already, conditions fostering leadership aspiration – particularly among women – are not completely

  14. Thin-needle aspiration biopsy of the prostate.

    Science.gov (United States)

    Koss, L G; Woyke, S; Schreiber, K; Kohlberg, W; Freed, S Z

    1984-05-01

    The authors summarize the current status of thin-needle aspiration biopsy of the prostate and evaluate the accomplishments and limitations of this method of diagnosis. Historical developments, indications, technique, contraindications, complications, cytology of aspirates, diagnostic efficacy of aspirates, and grading of prostatic carcinomas are discussed.

  15. Risk of aspiration in care home residents and associated factors

    NARCIS (Netherlands)

    Maarel-Wierink, C.D. van der; Putten, G.J. van der; Visschere, L.M. De; Bronkhorst, E.M.; Baat, C. de; Schols, J.M.

    2015-01-01

    Pneumonia is a prevalent cause of death in care home residents. Dysphagia is a significant risk factor of aspiration pneumonia. The purpose of the current study was to screen for risk of aspiration in care home residents in the Netherlands and assess potential risk factors of aspiration. Five experi

  16. Gender and Leadership Aspiration : The Impact of the Organizational Environment

    NARCIS (Netherlands)

    C. Erlemann

    2016-01-01

    markdownabstractSummary The aim of this dissertation is to examine gender differences in leadership aspiration. Although some important work regarding gender-specific aspiration has been done already, conditions fostering leadership aspiration – particularly among women – are not completely under

  17. Value of preoperative magnetic resonance imaging measurements in thoracic percutaneous vertebroplasty using unilateral puncture

    Institute of Scientific and Technical Information of China (English)

    MA Xin; WANG Li-xun; WANG Hong-li; JIANG Li; LU Fei-zhou; JIANG Jian-yuan

    2010-01-01

    Background Increasing the successful puncture rate of the percutaneous vertebroplasty (PVP) in thoracic vertebral compression fracture by unilateral puncture is a problem that spinal surgeons are trying to solve. The aim of this study was to assess the value of preoperative MRI imaging measurements for PVP using a unilateral puncture.Methods We performed a retrospective, comparative study of two groups of osteoporotic thoracic vertebral compression fracture patients who had received a PVP using a unilateral puncture. Group A (22 patients with 27 valid vertebrae) received PVP with a unilateral puncture between October 2005 and February 2007. Group B (18 patients with 24 valid vertebrae) received a routine MRI imaging measurements before a PVP between March 2007 and June 2008.We determined the target area to puncture based on the preoperative MRI cross-sectional images of vertebra. The PVP used a simultaneous puncture through a unilateral posterolateral approach, so the vertical distance from the point of skin puncture to the posterior median line, as well as the puncture angle, were measured using the MRI. The results were used to guide the PVP operation. We compared these two groups based on the average time for a single vertebra operation, the achievement ratio of puncture, and the incidence of bone cement leakage during surgery. The mean follow-up period was 14.2 months (range 12-23 months). The pre- and post-operative visual analogue score (VAS) (3and 12 months post-surgery), the variation of Oswestry disability index (ODI) and the incidence of long-term complications were also compared.Results The average time of a single vertebra operation in groups A and B were (34.7±5.4) and (23.3±4.2) minutes,respectively. In groups A and B, the success rates of puncture were 74.1% and 91.7%, respectively. Postoperative reduction of the average VAS scores in groups A and B at 3 and 12 months post-surgery were 5.8±2.1, 6.1±1.8, 6.1 ±2.0,6.2±1.6, respectively. However

  18. The natural history of pedal puncture wounds in diabetics: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    East Jeffrey M

    2011-10-01

    Full Text Available Abstract Background Surgeons usually witness only the limb-threatening stages of infected, closed pedal puncture wounds in diabetics. Given that this catastrophic outcome often represents failure of conservative management of pre-infected wounds, some suggest consideration of invasive intervention (coring or laying-open for pre-infected wounds in hope of preventing contamination from evolving into infection, there being no evidence based guidelines. However, an invasive pre-emptive approach is only justifiable if the probability of progression to catastrophic infection is very high. Literature search revealed no prior studies on the natural history of closed pedal puncture wounds in diabetics. Methods A survey was conducted via an interviewer-administered questionnaire on 198 adult diabetics resident in the parish of St. James, Jamaica. The sample was selected using a purposive technique designed to mirror the social gradient and residential distribution of the target population and is twice the number needed to detect a prevalence of puncture wounds of 14% with a range of 7-21% in a random sample of the estimated adult diabetic population. Results The prevalence of a history of at least one closed pedal puncture wound since diagnosis of diabetes was 25.8% (CI; 19.6-31.9%. The only modifiable variable associated at the 5% level of significance with risk of pedal puncture wound, after adjustment by multivariable logistic regression, was site of interview/paying status, a variable substantially reflective of income more so than quality-of-care. Of 77 reported episodes of closed pedal puncture wound among 51 participants, 45.4% healed without medical intervention, 27.3% healed after non-surgical treatment by a doctor and 27.3% required surgical intervention ranging from debridement to below-knee amputation. Anesthetic foot (failure to feel the puncture and sole of the forefoot as site of puncture were the variables significantly associated with

  19. Spinal needle force monitoring during lumbar puncture using fiber Bragg grating force device.

    Science.gov (United States)

    Ambastha, Shikha; Umesh, Sharath; Dabir, Sundaresh; Asokan, Sundarrajan

    2016-11-01

    A technique for real-time dynamic monitoring of force experienced by a spinal needle during lumbar puncture using a fiber Bragg grating (FBG) sensor is presented. The proposed FBG force device (FBGFD) evaluates the compressive force on the spinal needle during lumbar puncture, particularly avoiding the bending effect on the needle. The working principle of the FBGFD is based on transduction of force experienced by the spinal needle into strain variations monitored by the FBG sensor. FBGFD facilitates external mounting of a spinal needle for its smooth insertion during lumbar puncture without any intervention. The developed FBGFD assists study and analysis of the force required for the spinal needle to penetrate various tissue layers from skin to the epidural space; this force is indicative of the varied resistance offered by different tissue layers for the spinal needle traversal. Calibration of FBGFD is performed on a micro-universal testing machine for 0 to 20 N range with an obtained resolution of 0.021 N. The experimental trials using spinal needles mounted on FBGFD are carried out on a human cadaver specimen with punctures made in the lumbar region from different directions. Distinct forces are recorded when the needle encounters skin, muscle tissue, and a bone in its traversing path. Real-time spinal needle force monitoring using FBGFD may reduce potentially serious complications during the lumbar puncture, such as overpuncturing of tissue regions, by impeding the spinal needle insertion at epidural space.

  20. Spinal needle force monitoring during lumbar puncture using fiber Bragg grating force device

    Science.gov (United States)

    Ambastha, Shikha; Umesh, Sharath; Dabir, Sundaresh; Asokan, Sundarrajan

    2016-11-01

    A technique for real-time dynamic monitoring of force experienced by a spinal needle during lumbar puncture using a fiber Bragg grating (FBG) sensor is presented. The proposed FBG force device (FBGFD) evaluates the compressive force on the spinal needle during lumbar puncture, particularly avoiding the bending effect on the needle. The working principle of the FBGFD is based on transduction of force experienced by the spinal needle into strain variations monitored by the FBG sensor. FBGFD facilitates external mounting of a spinal needle for its smooth insertion during lumbar puncture without any intervention. The developed FBGFD assists study and analysis of the force required for the spinal needle to penetrate various tissue layers from skin to the epidural space; this force is indicative of the varied resistance offered by different tissue layers for the spinal needle traversal. Calibration of FBGFD is performed on a micro-universal testing machine for 0 to 20 N range with an obtained resolution of 0.021 N. The experimental trials using spinal needles mounted on FBGFD are carried out on a human cadaver specimen with punctures made in the lumbar region from different directions. Distinct forces are recorded when the needle encounters skin, muscle tissue, and a bone in its traversing path. Real-time spinal needle force monitoring using FBGFD may reduce potentially serious complications during the lumbar puncture, such as overpuncturing of tissue regions, by impeding the spinal needle insertion at epidural space.

  1. A Novel Turbo-Based Encryption Scheme Using Dynamic Puncture Mechanism

    Directory of Open Access Journals (Sweden)

    Qian Mao

    2012-02-01

    Full Text Available This paper proposes a novel encryption method based on Turbo code. In most communication systems, information encryption and error correction are always independent. While joint encryption and error correction codes combine these two processes into one. In order to provide information encryption and error correction simultaneously, we generate a normal random sequence that controls the puncturing mechanism by a secret key in the Turbo encoder. The puncturing mechanism is dynamic and controlled by the secret key. On the other hand, the key-controlled puncturing mechanism deletes the parity bits randomly, which ensures a high error correction capability for the Turbo code. When decoding, only the legal receiver can generate the same normal random sequence using the secret key, then classify and decrypt the received sequence correctly. While for the illegal receivers, because a wrong secret key results in a wrong puncturing mechanism, and the Turbo decoder is sensitive to the puncturing mechanism, they will get a totally wrong decoding result. Meanwhile, this coding scheme also provides good error correction capability for the encrypted information while it is transmitted in a noisy channel. Experimental results show that the proposed method performs well in terms of both security and error-immunity.

  2. A Comparative Study on the Sedative Effect of Oral Midazolam and Oral Promethazine Medication in Lumbar Puncture

    Directory of Open Access Journals (Sweden)

    Hojjat DERAKHSHANFAR

    2013-06-01

    distress from Bone marrow aspirations and lumbar punctures. Ann Pharmacother 2003;37(1:17-22.4. Ellis JA, Villeneuve K, Newhook K, Ulrichsen J. Pain Management Practices for Lumbar Punctures: Are We Consistent? J Pediatr Nurs 2007 Dec;22(6:479-87.5. Mathai A, Nazareth M, Raju RS. Preanesthetic sedation of preschool children: comparison of intranasal midazolam versus oral promethazin. Anesth Essays Res 2011;5(1:67-71.6. McCann ME, Kain ZN. The management of preoperative anxiety in children: an update. Anesth Analg 2001; 93(1: 98–105.7. Kain ZN, Caldwell-Andrews AA. Psychological preparation of children undergoing surgery. Anesth Clinic NA 2005;23:597–614.8. Wolf AR, Rosenbarum A, Kain ZN, Larsson P, Lönnqvist PA. The place of premedication in pediatric practice. Paediatr Anaesth 2009;19(9:817-28.9. Yuen VM, Hui TW, Irwin MG, Yuen MK. A Comparison of Intranasal Dexmedetomidine and Oral Midazolam for Premedication in Pediatric Anesthesia: A Double-Blinded Randomized Controlled Trial. Anesth Analg 2008;106(6:1715–21.10. Funk W, Jakob W, Riedl T, Taeger K. Oral preanaestheticmedication for children: double blind randomized study of a combination of midazplam and ketamine vs midazolam or ketamine alone. Br JAnaesth 2000;84(3:355-4011. Mazurek MS. Sedation and Analgesia for Procedures outside the Operating Room. Semin in Pediatr Surg 2004;13(3:166-173.12. Jo SH, Hong HK, Chong SH, Lee HS, Choe H. H1 antihistamine drug promethazine directly blocks hERG K+ channel. Pharmacol Res 2009;60(5:429-37.13. Gutstein HB, Johnson KL, Heard MB, Gregory GA. Oral Ketamine Preanesthetic Medication in children, Anesthesiology 1992;76(1:28-33.14. Almenrader N, Passariello M, Coccetti B, Haiber R, Pietropaoli P. Premedication in children: a comparison of oral midazolam and oral clonidine. Pediatr Anesth 2007;17(12:1143–9.15. Singh N, Pandey RK, Saksena AK, Jaiswal JN. A comparative evaluation of oral midazolam with oral sedatives as  premedication in pediatric dentistry. J Clin Pediatr

  3. Comparative study between hydrocortisone and mannitol in treatment of postdural puncture headache: A randomized double-blind study

    Directory of Open Access Journals (Sweden)

    Dina Y. Kassim

    2016-07-01

    Conclusion: Both intravenous hydrocortisone and mannitol intravenous infusion were efficient in reducing postdural puncture headache within 48 h. Hydrocortisone showed earlier and significant relief of headache.

  4. Changes in cerebral haemodynamics in cases of post-lumbar puncture headache: a prospective transcranial Doppler ultrasound study

    Energy Technology Data Exchange (ETDEWEB)

    Goebel, H.; Klostermann, H.; Lindner, V.; Schenkl, S. (Christian Albrechts University, Kiel (Germany, F.R.))

    1990-06-01

    Transcranial Doppler ultrasonography was used in 45 patients to investigate if changes in haemodynamics in the major arteries of the brain base occurred after lumbar puncture and whether or not patients with or without post-lumbar puncture headache differ with respect to their cerebral haemodynamic parameters before and after lumbar puncture. Before lumbar puncture, patients with post-lumbar puncture headache differed from patients withoput post-lumbar puncture headache in that they showed significantly higher flow velocities and significant asymmetry of flow velocities with lateralization to the right. Patients without post-lumbar puncture headache, on the other hand, showed non-significant flow velocity lateralization to the left. Forty-eight hours after lumbar puncture, both groups demonstrated symmetrical flow velocities. In addition, only patients with post-lumbar puncture headache showed a significant reduction in the flow velocity of the right middle cerebral artery. These findings suggest that it is not only absolute flow velocity that plays a part in the event of headache; the interhemispheric relation of cerebral haemodynamics also plays a fundamental role. 14 refs., 3 figs., 2 tabs.

  5. The Use of Esophageal Radiography in the Location of Atrial-Septal Puncture: Clinical Analysis of 486 Cases

    Institute of Scientific and Technical Information of China (English)

    Wu Tongguo; Wang Lexing; Chen Siwei; Lin Ziqing; Yang Chengjun; Huang Liping

    2007-01-01

    Objectives To determine the safety and value of esophageal radiography as a means of locating transseptal puncture. Methods 486 patients who underwent transseptal puncture were randomized into two groups. An esophagus radiographic method of locating tansseptal puncture site was applied in the study group( n = 243 ) and modified-Ross locating method was used in the control group ( n = 243 ). After successful location, transseptal puncture was made. We observed the success rate and incidence complications in the 2 groups.Results Left atrium impression in the study group was clearly seen. Nonetheless in 120 cases of control group,the left atria silhouette was not clearly visualised. The success rate of locating transseptal puncture site in the study group and control group were 100% and 50.6% respectively ( P<0.001 ). The success rate of transseptal puncture in the study group and control group was 99.6% and 45.7% respectively ( P<0.001 ). There were no complications associated with puncture in the study group and pericardial tamponade occurred in 1 control patient. Conclusions The esophagus radiographic method of locating transseptal puncture site is accurate,safe and simple to perform. Transseptal puncture has a high success rate with few complications.

  6. Mepolizumab Injection

    Science.gov (United States)

    ... or do not go away: pain, redness, swelling, warmth, burning, or itching in the place mepolizumab was injected headache dry and itchy skin with or without red, scaly rashes back pain muscle spasms Some side ...

  7. Metoclopramide Injection

    Science.gov (United States)

    ... and feeling of fullness that lasts long after meals. Metoclopramide injection is also used to prevent nausea ... tranylcypromine (Parnate); narcotic medications for pain; sedatives; sleeping pills; tetracycline (Bristacycline, Sumycin); tranquilizers. Your doctor may need ...

  8. Ramucirumab Injection

    Science.gov (United States)

    ... dose of ramucirumab injection. Tell your doctor or nurse if you experience any of the following while you receive ramucirumab: uncontrollable shaking of a part of the body; back pain or spasms; chest pain and tightness; chills; flushing; ...

  9. Alemtuzumab Injection

    Science.gov (United States)

    Alemtuzumab injection is used to treat B-cell chronic lymphocytic leukemia (a slowly developing cancer in which ... of white blood cell accumulate in the body). Alemtuzumab is in a class of medications called monoclonal ...

  10. Ferumoxytol Injection

    Science.gov (United States)

    Ferumoxytol injection is used to treat iron-deficiency anemia (a lower than normal number of red blood ... pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or ...

  11. Fludarabine Injection

    Science.gov (United States)

    Fludarabine injection is used to treat chronic lymphocytic leukemia (CLL; a type of cancer of the white ... a reliable method of birth control to prevent pregnancy during this time. Talk to your doctor for ...

  12. Insulin Injection

    Science.gov (United States)

    ... or buttocks. Do not inject insulin into muscles, scars, or moles. Use a different site for each ... you are using insulin.Alcohol may cause a decrease in blood sugar. Ask your doctor about the ...

  13. Tigecycline Injection

    Science.gov (United States)

    ... in a person who was not in the hospital), skin infections, and infections of the abdomen (area between the ... that developed in people who were in a hospital or foot infections in people who have diabetes. Tigecycline injection is ...

  14. Golimumab Injection

    Science.gov (United States)

    Golimumab injection is used alone or with other medications to relieve the symptoms of certain autoimmune disorders ( ... did not help or could not be tolerated. Golimumab is in a class of medications called tumor ...

  15. Albiglutide Injection

    Science.gov (United States)

    ... will develop tumors of the thyroid gland, including medullary thyroid carcinoma (MTC; a type of thyroid cancer). ... symptoms or those listed in the IMPORTANT WARNING section, stop using albiglutide injection and call your doctor ...

  16. Dexamethasone Injection

    Science.gov (United States)

    ... body tissues,) gastrointestinal disease, and certain types of arthritis. Dexamethasone injection is also used for diagnostic testing. ... effects.tell your doctor if you have a fungal infection (other than on your skin or nails). ...

  17. Hydrocortisone Injection

    Science.gov (United States)

    ... own organs), gastrointestinal disease, and certain types of arthritis. Hydrocortisone injection is also used to treat certain ... effects.tell your doctor if you have a fungal infection (other than on your skin or nails). ...

  18. Methylprednisolone Injection

    Science.gov (United States)

    ... own organs), gastrointestinal disease, and certain types of arthritis. Methylprednisolone injection is also used to treat certain ... effects.tell your doctor if you have a fungal infection (other than on your skin or nails). ...

  19. Glatiramer Injection

    Science.gov (United States)

    ... To inject glatiramer, follow these steps: Remove one blister pack from the carton of glatiramer syringes and place ... paper label and remove the syringe from the blister pack. Check your prefilled syringe to be sure it ...

  20. Dexrazoxane Injection

    Science.gov (United States)

    ... that are used to treat or prevent certain side effects that may be caused by chemotherapy medications. Dexrazoxane injection (Zinecard) is used to prevent or decrease heart damage caused by doxorubicin in women who are ...

  1. Evolocumab Injection

    Science.gov (United States)

    ... autoinjector in hot water, microwave, or place in sunlight.Before you use evolocumab injection, look at the ... chills pain or burning during urination muscle or back pain dizziness stomach pain Some side effects can be ...

  2. Cidofovir Injection

    Science.gov (United States)

    Cidofovir injection is used along with another medication (probenecid) to treat cytomegaloviral retinitis (CMV retinitis) in people with acquired immunodeficiency syndrome (AIDS). Cidofovir is in a class of medications called antivirals. ...

  3. Brivaracetam Injection

    Science.gov (United States)

    ... older. Brivaracetam in a class of medications called anticonvulsants. It works by decreasing abnormal electrical activity in ... older (about 1 in 500 people) who took anticonvulsants like brivaracetam injection to treat various conditions during ...

  4. Diphenhydramine Injection

    Science.gov (United States)

    ... not to use diphenhydramine injection if you are breastfeeding because of the risk of harm to infants.tell your doctor if you have or have ever had asthma or other types of lung disease; glaucoma (a ...

  5. Cefazolin Injection

    Science.gov (United States)

    ... valve, respiratory tract (including pneumonia), biliary tract, and urinary tract infections. Cefazolin injection also may be used before, during, ... to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website ( ...

  6. Ceftazidime Injection

    Science.gov (United States)

    ... skin, blood, bone, joint, female genital tract, and urinary tract infections. Ceftazidime injection is in a class of medications ... to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website ( ...

  7. Fluconazole Injection

    Science.gov (United States)

    ... and fungal infections of the eye, prostate (a male reproductive organ), skin and nails. Fluconazole injection is ... Motrin, others) and naproxen (Aleve, Anaprox, Naprelan); oral contraceptives (birth control pills); oral medication for diabetes such ...

  8. Moxifloxacin Injection

    Science.gov (United States)

    ... available.Moxifloxacin injection is in a class of antibiotics called fluoroquinolones. It works by killing the bacteria that cause ... you are allergic to moxifloxacin, other quinolone or fluoroquinolone antibiotics such as ciprofloxacin (Cipro), gatifloxacin (Tequin) (not available ...

  9. Levofloxacin Injection

    Science.gov (United States)

    ... available. Levofloxacin injection is in a class of antibiotics called fluoroquinolones. It works by killing bacteria that cause infections. ... severe reaction to levofloxacin; any other quinolone or fluoroquinolone antibiotic such as ciprofloxacin (Cipro), gatifloxacin (Tequin) (not available ...

  10. Ciprofloxacin Injection

    Science.gov (United States)

    ... available. Ciprofloxacin injection is in a class of antibiotics called fluoroquinolones. It works by killing bacteria that cause infections. ... reaction to ciprofloxacin or any other quinolone or fluoroquinolone antibiotic such as gatifloxacin (Tequin) (not available in the ...

  11. Alirocumab Injection

    Science.gov (United States)

    ... further decrease the amount of low-density lipoprotein (LDL) cholesterol ('bad cholesterol') in the blood. Alirocumab injection is ... antibodies. It works by blocking the production of LDL cholesterol in the body to decrease the amount of ...

  12. Chloramphenicol Injection

    Science.gov (United States)

    ... an arm or leg sudden changes in vision pain with eye movement Chloramphenicol injection may cause a condition called gray syndrome in premature and newborn infants. There have also been reports of gray ...

  13. Ultrasonic gas alloy atomization under near-zero aspiration pressure

    Science.gov (United States)

    Yan, Pengfei; Wang, Deping; Yan, Biao

    2015-04-01

    In this paper, ultrasonic gas atomization (USGA) of Zn-Al under near-zero aspiration pressure was discussed. The protrusion length of delivery tube was modified to adjust the aspiration pressure. Under near-zero aspiration pressure, melt filming was observed by camera and more fine powders were produced. While under larger subambient aspiration pressure, melt filming was unavailable, corresponding to less fine powders. The results suggest that the position of the wake near the delivery tube can be optimized under near-zero aspiration. Less protrusion of delivery tube reduces the energy loss in gas flow deflection. Both facilitate to produce finer powders.

  14. Filling the holes: Evolving excised binary black hole initial data with puncture techniques

    CERN Document Server

    Etienne, Zachariah B; Liu, Yuk Tung; Shapiro, Stuart L; Baumgarte, Thomas W

    2007-01-01

    We follow the inspiral and merger of equal-mass black holes (BHs) by the moving puncture technique and demonstrate that both the exterior solution and the asymptotic gravitational waveforms are unchanged when the initial interior solution is replaced by constraint-violating ``junk'' initial data. We apply this result to evolve conformal thin-sandwich (CTS) binary BH initial data by filling their excised interiors with arbitrary, but smooth, initial data and evolving with standard puncture gauge choices. The waveforms generated for both puncture and filled-CTS initial data are remarkably similar, and there are only minor differences between irrotational and corotational CTS BH binaries. Even the interior solutions appear to evolve to the same constraint-satisfying solution at late times, independent of the initial data.

  15. The super period matrix with Ramond punctures in the supergravity formulation

    Directory of Open Access Journals (Sweden)

    Eric D'Hoker

    2015-10-01

    Full Text Available In a very recent preprint, Witten showed how to construct a g|r×g|r super period matrix for super Riemann surfaces of genus g with 2r Ramond punctures, which is symmetric in the Z2 graded sense. He also showed how it can be applied to analyze supersymmetry breaking in string compactifications which are supersymmetric at tree-level. Witten's construction is in the purely holomorphic formulation of super Riemann surfaces. In this paper, a construction is given in the formulation of two-dimensional supergravity. The variations of the super period matrix with respect to supermoduli deformations are also given, as well as an explicit illustration of how the super period matrix with two Ramond punctures would emerge from a degeneration of the super period matrix without punctures in higher genus.

  16. [Ethyl chloride aerosol spray for local anesthesia before arterial puncture: randomized placebo-controlled trial].

    Science.gov (United States)

    Ballesteros-Peña, Sendoa; Fernández-Aedo, Irrintzi; Vallejo-De la Hoz, Gorka

    2017-06-01

    To compare the efficacy of an ethyl chloride aerosol spray to a placebo spray applied in the emergency department to the skin to reduce pain from arterial puncture for blood gas analysis. Single-blind, randomized placebo-controlled trial in an emergency department of Hospital de Basurto in Bilbao, Spain. We included 126 patients for whom arterial blood gas analysis had been ordered. They were randomly assigned to receive application of the experimental ethyl chloride spray (n=66) or a placebo aerosol spray of a solution of alcohol in water (n=60). The assigned spray was applied just before arterial puncture. The main outcome variable was pain intensity reported on an 11-point numeric rating scale. The median (interquartile range) pain level was 2 (1-5) in the experimental arm and 2 (1-4.5) in the placebo arm (P=.72). Topical application of an ethyl chloride spray did not reduce pain caused by arterial puncture.

  17. [Research on Optical Parameter along Puncture Path in Spinal Surgery Navigation Based on Near Infrared Spectroscopy].

    Science.gov (United States)

    Wang, Yuyan; Qian, Zhiyu; Li, Weitao; Liu, Yangyang; Xie, Jieru

    2015-06-01

    Accurate placement of pedicle screws is a key factor of spinal surgery. Investigation of a new real-time intra-operative monitoring method is an important area of clinical application research which makes a contribution to planting pedicle screw accurately. Porcine spines were chosen as experimental objects. The changes of reduced scattering coefficient (μ'(s)) along normal puncture path, medial perforation path and lateral perforation path were measured and studied. A conclusion is drawn that there are two distinct peaks throughout the puncture process, appearing at the junction of cancellous bone and cortical bone, at the beginning and at the end, respectively. The reduced scattering coefficient is proved to be a good monitoring factor which can identify whether the screw is about to reach the critical position of the spine puncture. Moreover, the variation provides an important reference for spinal surgical navigation process.

  18. Observation on Therapeutic Effect of Oblique Puncture plus Plucking Manual Technique for Fatigue Periostitis of Tibia

    Institute of Scientific and Technical Information of China (English)

    JI Jian-you; JI Jian-li; XU Yao

    2007-01-01

    To observe the clinical effect of oblique puncture plus plucking manual technique for fatigue periositis of tibia.Methods:60 cases of the patients with fatigue Deriostitisof tibia were randomly divided into the treatment group of 30 cases treated by oblique puncture plus plucking manual technique,and the control group of 30 cases treated by ultra short wave.Resuits:The curative rate was 60.0% in the treatment group and 20.0% in the control group.and the total effective rate was 93.3% and 70.O% respectively.The therapeutic effect was better in the treatment group than in the control group (P<0.05).Conclusion:Oblique puncture plus plucking manual technique has a better therapeutic effect for fatigue periostitis of tibia.

  19. An evaluation of the Johnson-Cook model to simulate puncture of 7075 aluminum plates.

    Energy Technology Data Exchange (ETDEWEB)

    Corona, Edmundo; Orient, George Edgar

    2014-02-01

    The objective of this project was to evaluate the use of the Johnson-Cook strength and failure models in an adiabatic finite element model to simulate the puncture of 7075- T651 aluminum plates that were studied as part of an ASC L2 milestone by Corona et al (2012). The Johnson-Cook model parameters were determined from material test data. The results show a marked improvement, in particular in the calculated threshold velocity between no puncture and puncture, over those obtained in 2012. The threshold velocity calculated using a baseline model is just 4% higher than the mean value determined from experiment, in contrast to 60% in the 2012 predictions. Sensitivity studies showed that the threshold velocity predictions were improved by calibrating the relations between the equivalent plastic strain at failure and stress triaxiality, strain rate and temperature, as well as by the inclusion of adiabatic heating.

  20. An update on the evaluation and management of plantar puncture wounds and Pseudomonas osteomyelitis.

    Science.gov (United States)

    Inaba, A S; Zukin, D D; Perro, M

    1992-02-01

    The management of children who present to the ED with plantar puncture wounds is dependent upon the nature of the injury, the examination of the puncture site, and the potential risk of a retained foreign body. Not all patients will require wound enlargement and a search for a retained foreign body. Close follow-up of all children who are being treated as outpatients is of vital importance in detecting an early development of an infectious complication. Pseudomonas osteomyelitis should be suspected in all patients who present with foot pain, swelling, and a decreased ability to bear weight after sustaining a nail puncture through a sneaker. The current consensus favors open surgical débridement followed by a course of intravenous antibiotics. The exact duration of the postoperative antibiotic course is still being debated.

  1. Optimization of injection pressure for a compression ignition engine ...

    African Journals Online (AJOL)

    user

    techniques, such as heating of fuel lines, trans-esterification, modification of .... cylinder, 4 stroke, naturally aspirated, direct injection, water cooled, eddy current .... Initially the engine was run with diesel to know the performance at 180 bar .... modeling, Alternate fuels, Heat transfer, Refrigeration and Air-conditioning. She.

  2. [Iatrogenic extravasations of cytotoxic or hyperosmolar aqueous solutions. Value of surgical emergency by aspiration and lavage].

    Science.gov (United States)

    Lambert, F; Couturaud, B; Arnaud, E; Champeau, F; Revol, M; Servant, J M

    1997-08-01

    Iatrogenic extravasations are characterized by their unpredictable course, the possible repercussions of functional, cosmetic and psychological sequelae, and the absence of a therapeutic consensus. The authors present the protocol used in Hôpital Saint-Louis, based on a synthesis of current procedures, consisting of emergency conservative surgical aspiration and lavage, performed in a context of close collaboration with oncolosits, intensive care physicians and radiologists. From 1994 to March 1997, fifteen patients were operated following extravasation during seven chemotherapeutic protocols, three radiographic examinations with injection of contrast agents and five resuscitation procedures. This simple protocol, applied systematically, achieved cure without cutaneous or functional sequelae in all patients. Aspiration-lavage during the first twelve hours therefore constitutes the treatment of choice of iatrogenic extravasation with cytotoxic or hyperosmolar aqueous solutions.

  3. Experimental posterolateral spinal fusion with beta tricalcium phosphate ceramic and bone marrow aspirate composite graft

    Directory of Open Access Journals (Sweden)

    Gupta Ankit

    2010-01-01

    Full Text Available Background: Beta tricalcium phosphate is commonly used in metaphyseal defects but its use in posterolateral spinal fusion remains controversial. There are very few published animal studies in which use of beta tricalcium phosphate has been evaluated in the posterolateral lumbar arthrodesis model. Hence we conducted a study to evaluate the potential of composite graft of beta tricalcium phosphate and bone marrow aspirate in comparison to autologous bone graft, when used for posterolateral spinal fusion. Materials and Methods: Single level posterolateral lumbar fusion was performed in 40 adult male Indian rabbits, which were assigned randomly into one of the four groups based on graft materials implanted; a 3 gm beta tricalcium phosphate plus 3 ml bone marrow aspirate (Group I; b 3 ml bone marrow aspirate alone (Group II; c 3 gm beta tricalcium phosphate (Group III and d 3 gm autologous bone graft (Group IV. Each group had 10 rabbits. Half of the rabbits were sacrificed by injecting Phenobarbitone intraperitoneally after eight weeks and the remaining after 24 weeks, and were evaluated for fusion by X-rays, computed tomography (CT scans, manual palpation test and histology. Results: Beta tricalcium phosphate used with bone marrow aspirate produced best results when compared to other groups (P =.0001. When beta tricalcium phosphate was used alone, fusion rates were better as compared to fusion achieved with autologous iliac crest bone graft though statistically not significant (P =0.07. Autologous bone graft showed signs of new bone formation. However, the rate of new bone formation was comparatively slow. Conclusion: Composite graft of beta tricalcium phosphate and bone marrow aspirate can be used as an alternative to autologous iliac crest bone graft.

  4. Infliximab attenuates activated charcoal and polyethylene glycol aspiration-induced lung injury in rats.

    Science.gov (United States)

    Güzel, Aygül; Günaydin, Mithat; Güzel, Ahmet; Alaçam, Hasan; Murat, Naci; Gacar, Ayhan; Güvenç, Tolga

    2012-04-01

    Aspiration is a serious complication of gastrointestinal (GI) decontamination procedure. Studies have shown that tumor necrosis factor-α (TNF-α) blockers have beneficial effects on lung injury. Therefore, the authors investigated the attenuation by infliximab (INF) on activated charcoal (AC)- and polyethylene glycol (PEG)-induced lung injury in rat model. Forty-two male Sprague-Dawley rats were allotted into 1 of 6 groups: saline (NS), activated charcoal (AC), polyethylene glycol (PEG), NS+INF treated, AC+INF treated, and PEG+INF treated. All materials were aspirated into the lungs at a volume of 1 mL/kg. Before aspiration, the rats were injected subcutaneously with INF. Seven days later, both lungs and serum specimens in all groups were evaluated histopathologically, immunohistochemically, and biochemically. Following aspiration of AC and PEG, evident histopathological changes were assigned in the lung tissue that were associated with increased expression of inducible nitric oxide synthase (iNOS), increased serum levels of oxidative stress markers (malondialdehyde [MDA], surfactant protein-D [SP-D], TNF-α), and decreased antioxidant enzyme (glutathione peroxidase [GSH-Px]) activities. INF treatment significantly decreased the elevated serum MDA and TNF-α levels and increased serum GSH-Px levels. Furthermore, the current results show that there is a significant reduction in the activity of iNOS in lung tissue and increased serum SP-D levels of AC and PEG aspiration-induced lung injury with INF treatment. These findings suggest that INF attenuates lung inflammation and prevents GI decontamination agent-induced lung injury in rats.

  5. Comparison of Ultrasound-Guided and Fluoroscopy-Assisted Antegrade Common Femoral Artery Puncture Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Slattery, Michael M.; Goh, Gerard S.; Power, Sarah; Given, Mark F.; McGrath, Frank P.; Lee, Michael J., E-mail: mlee@rcsi.ie [Beaumont Hospital, Department of Radiology (Ireland)

    2015-06-15

    PurposeTo prospectively compare the procedural time and complication rates of ultrasound-guided and fluoroscopy-assisted antegrade common femoral artery (CFA) puncture techniques.Materials and MethodsHundred consecutive patients, undergoing a vascular procedure for which an antegrade approach was deemed necessary/desirable, were randomly assigned to undergo either ultrasound-guided or fluoroscopy-assisted CFA puncture. Time taken from administration of local anaesthetic to vascular sheath insertion in the superficial femoral artery (SFA), patients’ age, body mass index (BMI), fluoroscopy radiation dose, haemostasis method and immediate complications were recorded. Mean and median values were calculated and statistically analysed with unpaired t tests.ResultsSixty-nine male and 31 female patients underwent antegrade puncture (mean age 66.7 years). The mean BMI was 25.7 for the ultrasound-guided (n = 53) and 25.3 for the fluoroscopy-assisted (n = 47) groups. The mean time taken for the ultrasound-guided puncture was 7 min 46 s and for the fluoroscopy-assisted technique was 9 min 41 s (p = 0.021). Mean fluoroscopy dose area product in the fluoroscopy group was 199 cGy cm{sup 2}. Complications included two groin haematomas in the ultrasound-guided group and two retroperitoneal haematomas and one direct SFA puncture in the fluoroscopy-assisted group.ConclusionUltrasound-guided technique is faster and safer for antegrade CFA puncture when compared to the fluoroscopic-assisted technique alone.

  6. The sweet lung: Chewing gummi bear aspiration

    Science.gov (United States)

    Tavladaki, Theonimfi; Fitrolaki, Michaela-Diana; Spanaki, Anna-Maria; Ilia, Staurula; Geromarkaki, Elissabet; Briassoulis, George

    2012-01-01

    Inhalation of foreign bodies, a leading cause of accidental death, is most common in preschool children. In this article we report our experience with a 5-year-old Greek girl who presented with a 24-hour history of sore throat, chest pain, and shortness of breath. Emergency bronchoscopy was performed and multiple small chewing gummi bear (HARIBO) particles impacted in the orifices of the right main bronchus and right lobar and segmentalinic bronchi were successfully removed and aspirated. Aspiration of gummi bears, which is for the first time reported, may cause a silent choking episode leading to life-threatening bronchi obstruction at multiple sites, even in children older than 4 years. PMID:22919167

  7. Air Bag Momentum Force Including Aspiration

    Directory of Open Access Journals (Sweden)

    Guy Nusholtz

    1995-01-01

    Full Text Available A gas-jet momentum force drives the air bag into position during a crash. The magnitude of this force can change as a result of aspiration. To determine the potential magnitude of the effect on the momentum force and mass flow rate in an aspirated system, a series of experiments and simulations of those experiments was conducted. The simulation consists of a two-dimensional unsteady isentropic CFD model with special “infinite boundaries”. One of the difficulties in simulating the gas-jet behavior is determining the mass flow rate. To improve the reliability of the mass flow rate input to the simulation, a sampling procedure involving multiple tests was used, and an average of the tests was adopted.

  8. Fine needle aspiration biopsy of ophthalmic tumors☆

    Science.gov (United States)

    Singh, Arun D.; Biscotti, Charles V.

    2012-01-01

    A majority of intraocular tumors can be diagnosed based on clinical examination and ocular imaging studies, which obviate the need for diagnostic ophthalmic fine needle aspiration biopsy (FNAB). Overall, diagnostic accuracy of ophthalmic FNAB is high but limited cellularity can compromise the diagnostic potential of ophthalmic aspirate samples. The role of ophthalmic FNAB is limited in retinal tumors. Orbital FNAB should be considered in the evaluation of lacrimal gland tumors, orbital metastasis, and lymphoproliferative lesions. Negative cytologic diagnosis of malignancy should not be considered unequivocal proof that an intraocular malignancy does not exist. With improved understanding of genetic prognostic factors of uveal melanoma, ophthalmic FNAB is gaining popularity for prognostic purposes in combination with eye conserving treatment of the primary tumor. In special clinical indications, ancillary studies such as immunohistochemistry and FISH can be performed on ophthalmic FNAB samples. Assistance of an experienced cytopathologist cannot be overemphasized. PMID:23960981

  9. Postdural Puncture Superior Sagittal Sinus Thrombosis in a Juvenile Case of Clinically Isolated Syndrome

    Directory of Open Access Journals (Sweden)

    Miriam Michel

    2015-01-01

    Full Text Available Background. The causes of cerebral venous thrombosis (CVT are manifold as is its clinical presentation. Case. We report the case of a CVT following lumbar puncture and intravenous glucocorticosteroid therapy in a female adolescent with a clinically isolated syndrome and risk factors for thrombosis. Conclusion. In adolescent patients with acute inflammatory disease undergoing lumbar puncture followed by intravenous high-dose glucocorticosteroid therapy, one should be aware of the elevated risk for thrombosis. A persistent headache with change in the headache pattern and loss of a postural component might be a sign for CVT, requiring emergency imaging of the brain.

  10. Subcutaneous Emphysema Induced by Cryotherapy: A Complication due to Previous Punctures

    Directory of Open Access Journals (Sweden)

    Jared Martínez-Coronado

    2015-01-01

    Full Text Available Cryosurgery is a common therapeutic modality used in dermatology; therefore we must be aware of its possible adverse effects. We report a case of a patient with subcutaneous emphysema which occurred following the application of cryotherapy after multiple punctures of local anesthetic and intralesional steroids in a chest keloid scar. Despite the fact that this condition was gradually resolved after expectant observation, we warn about this complication when sprayed cryotherapy is preceded by multiple punctures on cutaneous lesions above bony surfaces. In similar settings, cryotherapy must be first administered or a cotton-tip applicator should be used.

  11. Conformal thin-sandwich puncture initial data for boosted black holes

    CERN Document Server

    Hannam, M D; Hannam, Mark D.; Cook, Gregory B.

    2005-01-01

    We apply the puncture approach to conformal thin-sandwich black-hole initial data. We solve numerically the conformal thin-sandwich puncture (CTSP) equations for a single black hole with non-zero linear momentum. We show that conformally flat solutions for a boosted black hole have the same maximum gravitational radiation content as the corresponding Bowen-York solution in the conformal transverse-traceless decomposition. We find that the physical properties of these data are independent of the free slicing parameter.

  12. Puncture black hole initial data in the conformal thin-sandwich formalism

    CERN Document Server

    Baumgarte, Thomas W

    2011-01-01

    We revisit the construction of puncture black hole initial data in the conformal thin-sandwich decomposition of Einstein's constraint equations. It has been shown previously that this approach cannot yield quasiequilibrium wormhole data, which connect two asymptotically flat spatial infinities. This argument does not apply to trumpet data, which connect the spatial infinity in one universe with the future timelike infinity of another. As a numerical demonstration we present results for a single boosted trumpet-puncture black holes, constructed in the original version of the conformal thin-sandwich formalism.

  13. Radial artery pseudoaneurysm: A rare complication after a single arterial puncture for blood-gas analysis

    OpenAIRE

    Kajal Nitin Patel; Shruti P Gandhi; Sutariya, Harsh C.

    2016-01-01

    With a reported incidence of 0.048%, radial artery pseudoaneurysm (PA) is a rare but serious complication of arterial cannulation. We report a case of PA developing after a single puncture of the right radial artery for arterial blood-gas analysis diagnosed by Doppler ultrasound in young male patient. The development of PA after puncture of radial artery for continuous blood pressure monitoring and serial blood-gas analysis has been reported in the past; however, to the best of our knowledge,...

  14. Spinal coning after lumbar puncture in a patient with undiagnosed giant cervical neurofibroma

    Directory of Open Access Journals (Sweden)

    Prasad Krishnan

    2013-01-01

    Full Text Available Lumbar puncture in the presence of an intracranial tumor with raised intracranial pressure is known to have catastrophic consequences due to herniation of intracranial contents through the tentorial hiatus or foramen magnum. There are relatively few case reports about the same sequence of events when lumbar puncture is performed below the level of a complete spinal block. The mechanism of such deterioration is also subject to conjecture as the spinal cord (unlike the uncus or cerebellar tonsils is tethered by the dentate ligament and roots on either side, and is hence less mobile. We present one such case of spinal coning and review the available literature.

  15. Puncture black hole initial data in the conformal thin-sandwich formalism

    Energy Technology Data Exchange (ETDEWEB)

    Baumgarte, Thomas W, E-mail: tbaumgar@bowdoin.edu [Department of Physics and Astronomy, Bowdoin College, Brunswick, ME 04011 (United States)

    2011-11-07

    We revisit the construction of puncture black hole initial data in the conformal thin-sandwich (CTS) decomposition of Einstein's constraint equations. It has been shown previously that this approach cannot yield quasiequilibrium wormhole data, which connect two asymptotically flat spatial infinities. This argument does not apply to trumpet data, which connect the spatial infinity in one universe with the future timelike infinity of another. As a numerical demonstration, we present results for a single boosted trumpet-puncture black hole, constructed in the original version of the CTS formalism.

  16. Repeat Lumbar Puncture: CSF Lactic Acid Levels are Predictive of Cure with Acute Bacterial Meningitis

    Directory of Open Access Journals (Sweden)

    Burke A. Cunha

    2013-12-01

    Full Text Available A common clinical problem concerns the utility of repeat lumbar puncture (LP in adults with acute bacterial meningitis (ABM, e.g., pneumococcal meningitis [1]. An LP is initially done for diagnostic purposes in patients with suspected ABM, i.e., diagnostic lumbar puncture (DLP. A repeat LP (RLP may be done 1–3 days after the initial DLP, if the patient shows no improvement. If a patient with ABM is not doing well after three days, adequacy of antimicrobial therapy is the main concern. Other reasons for RLP is to detect possible intracranial complications of ABM unrelated to adequacy of therapy [1–2].

  17. 简易“针内针”方法蛛网膜下腔穿刺的临床应用%Clinical application of the simple “needle in needle” technique in spinal puncture

    Institute of Scientific and Technical Information of China (English)

    叶洁; 石金英

    2016-01-01

    Objective:To explore the feasibility and effects of the simple“needle in needle” technique in spinal puncture. Methods:Forty patients scheduled by lower extremity and perineum operation were randomly divided into the combined spinal-epidural puncture group(control group) and “needle in needle” guided by size 9 skin needle group(observation group)(20 cases each group). Two groups were punctured between L3 and L4 line,and injected with 0. 75% bupivacaine for 2 mL. The control group were punctured using the size 16 epidural needle into epidural space,then the size 5 spinal-epidural needle was used to puncture into subarachnoid space. The observation group were punctured using the size 5 spinal-epidural needle combined with “needle in needle” guided by the size 9 skin needle. The bevel of the needle tip was parallel to the axis of the spine. The spinal anesthesia puncture success rate,feel rate of breaking the ligamentum flava and endorachis, effects of nerve block, postoperative headache, lumbago and puncture point ache in two groups were observed. Results:The puncturing time in observation group and control group were not statistically significant(P>0. 05). The difference of the breakthrough and fall feeling at the time of breaking endorhachis between two groups was not statistically significant (P>0. 05). The success rates of anesthesia in two groups were 95%. The differences of the sensory block plane,onset time of sensory block and motor block between two groups were not statistically significant(P>0. 05). The postural headache was not found in two groups,but 5 and 7 days after surgery the incidences of the postoperative puncture point ache and lumbago in observation group were lower than those in control group(P0.05);2组细腰针突破硬脊膜时均有确切的纸质破裂感或阻力落空感差异无统计学意义(P>0.05);2组穿刺成功率均为95%;2组感觉阻滞平面、感觉阻滞起效时间和运动神经阻

  18. Coronary air embolism treated with aspiration catheter

    OpenAIRE

    Patterson, M S; Kiemeneij, F.

    2005-01-01

    Coronary air embolism remains a recognised complication of coronary catheterisation despite a strong emphasis on prevention. Current treatment consists of supportive measures with 100% oxygen and analgesia. Recent case reports describe the use of mechanical treatments aimed at dispersing or removing the air embolus with variable success. A case of coronary air embolism causing an acute coronary syndrome is described that was definitively treated with an aspiration system. The effectiveness of...

  19. Catheterisation of the biliary tract and portal vein by Seldinger-technique following ultrasonic guided fine needle puncture

    Energy Technology Data Exchange (ETDEWEB)

    Elgeti, H.; Luska, G.; Kleine, P.

    1981-11-01

    The article describes an easier technique of biliary tract and portal vein catheterisation following fine needle puncture. Special biopsy equipment has been compiled for this purpose by the authors. Initial experiences revealed a considerable simplification of hepatic duct and portal vein puncture using a real time biopsy applicator. The procedure is explained by two characteristic cases.

  20. Sarilumab Injection

    Science.gov (United States)

    ... the needle. Do not try to warm the medication by heating it in a microwave, placing it in warm water or in direct sunlight, or through any other method.Before injecting, check the prefilled syringe to be sure that the expiration date printed on the package has not passed. Look ...

  1. Enfuvirtide Injection

    Science.gov (United States)

    ... inject enfuvirtide into any skin that has a tattoo, scar, bruise, mole, a burn site, or has ... Enfuvirtide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: itching, swelling, pain, tingling, discomfort, ...

  2. Fluorouracil Injection

    Science.gov (United States)

    ... of a doctor who is experienced in giving chemotherapy medications for cancer. Treatment with fluorouracil injection may cause serious side effects. ... this medication.If you experience a serious side effect, you or your doctor ... (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/ ...

  3. Lanreotide Injection

    Science.gov (United States)

    Lanreotide injection is used to treat people with acromegaly (condition in which the body produces too much growth hormone, causing enlargement of the hands, feet, and facial features; joint pain; and other symptoms) who have not successfully, or cannot be treated ...

  4. Paliperidone Injection

    Science.gov (United States)

    ... the body slow movements or shuffling walk painful erection of the penis that lasts for hours cough, chills and/or other signs of infection Paliperidone injection may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.If you experience a ...

  5. Ziprasidone Injection

    Science.gov (United States)

    ... stiffness falling confusion sweating loss of consciousness painful erection of the penis that lasts for hours Ziprasidone injection may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication.If you experience a ...

  6. Risperidone Injection

    Science.gov (United States)

    ... control slow movements or shuffling walk falling painful erection of the penis that lasts for hours Risperidone extended-release injection may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication.If you experience a ...

  7. Practical, covariant puncture for second-order self-force calculations

    Science.gov (United States)

    Pound, Adam; Miller, Jeremy

    2014-05-01

    Accurately modeling an extreme-mass-ratio inspiral requires knowledge of the second-order gravitational self-force on the inspiraling small object. Recently, numerical puncture schemes have been formulated to calculate this force, and their essential analytical ingredients have been derived from first principles. However, the "puncture," a local representation of the small object's self-field, in each of these schemes has been presented only in a local coordinate system centered on the small object, while a numerical implementation will require the puncture in coordinates covering the entire numerical domain. In this paper we provide an explicit covariant self-field as a local expansion in terms of Synge's world function. The self-field is written in the Lorenz gauge, in an arbitrary vacuum background, and in forms suitable for both self-consistent and Gralla-Wald-type representations of the object's trajectory. We illustrate the local expansion's utility by sketching the procedure of constructing from it a numerically practical puncture in any chosen coordinate system.

  8. Treatment for Injury of Superior Clunial Nerves by Triple Puncture Needling with Massage

    Institute of Scientific and Technical Information of China (English)

    万顺; 李静

    2002-01-01

    @@ Superior clunial nerve injury occupies a high percentage in lumbocluneal tissue injuries. It is commonly seen in winter and in athletic competition and training. The authors have treated 67 cases of pain of the superior clunial nerves by triple puncture needling combined with massage and obtained satisfactory therapeutic result. A report follows.

  9. Bile peritonitis after inadvertant puncture of the gallbladder as a rare complication of percutaneous transhepatic cholangiography

    Energy Technology Data Exchange (ETDEWEB)

    Farkas, I.; Marik, J.

    1983-01-01

    A report is given about a rare complication after percutaneous transhepatic cholangiography: after inadvertant puncture of the gallbladder, bile peritonitis developed. Surgery was done immediately and the gallbladder, which was filled with stones, as well as stones from the choledochus were removed. The literature dealing with complications of percutaneous cholangiography is reviewed.

  10. Conformal blocks on a 2-sphere with indistinguishable punctures and implications on black hole entropy

    CERN Document Server

    Majhi, Abhishek

    2016-01-01

    The dimensionality of the Hilbert space of a Chern-Simons theory on a 3-fold, in the presence of Wilson lines carrying spin representations, had been counted by using its link with the Wess-Zumino theory, with level $k$, on the 2-sphere with points (to be called punctures) marked by the piercing of the corresponding Wilson lines and carrying the respective spin representations. It is shown, in the weak coupling (large $k$) limit, the formula decouples into two characteristically distinct parts; one mimics the dimensionality of the Hilbert space of a collection of non-interacting spin systems and the other is an effective overall correction contributed by all the punctures. The exact formula yield from this counting has been shown earlier to have resulted from the consideration of the punctures to be distinguishable. We investigate the same counting problem by considering the punctures to be indistinguishable. Although the full formula remains undiscovered, nonetheless, we are able to impose the relevant stati...

  11. Direct transatrial pericardiocentesis for tamponade caused by left atrial perforation after trans-septal puncture.

    Science.gov (United States)

    Picard, Fabien; Millán, Xavier; de Hemptinne, Quentin; L L'allier, Philippe

    2016-07-07

    Trans-septal puncture is associated with risks of serious complications. We report a case of an obese 52-year-old man with hypertrophic cardiomyopathy who underwent preoperative coronary angiography and cardiac catheterisation complicated by left atrial perforation. We describe a direct transatrial pericardiocentesis approach to treating cardiac tamponade.

  12. Baffle puncture guided by transoesophageal echocardiography in a patient with dextrocardia and Mustard correction

    NARCIS (Netherlands)

    B. Schwagten (Bruno); L.J.L.M. Jordaens (Luc); E. Jessurun; M. Witsenburg (Maarten); M.G. Scheffer (Michael); T. Szili-Torok (Tamas)

    2009-01-01

    textabstractA baffle puncture is a challenging procedure but can be safely done using direct visualization of the region of interest. To our knowledge, however, it has never been performed in a patient with dextrocardia. We present a 62-year-old male with dextrocardia, right isomerism, congenitally

  13. From puncture to closure of the common femoral artery in endovascular aortic repair

    DEFF Research Database (Denmark)

    Lönn, Lars; Larzon, Thomas; Van Den Berg, Jos C

    2010-01-01

    or epidural anesthesia. The evolving stent-technology with smaller sheath sizes has broadened the scenario for alternative approaches for access and closure of the common femoral arteries. The following review presents an introduction on technical aspects of puncture of the femoral artery and closure...

  14. Thick subcategories over Gorenstein local rings that are locally hypersurfaces on the punctured spectra

    CERN Document Server

    Takahashi, Ryo

    2011-01-01

    Let R be a Gorenstein local ring which is locally a hypersurface on the punctured spectrum. In this paper, we classify thick subcategories of the bounded derived category of finitely generated R-modules. Moreover, using this classification, we also classify thick subcategories of finitely generated R-modules, and find out the relationships with thick subcategories of Cohen-Macaulay R-modules.

  15. T-shaped angioplasty with apex puncture of thrombosed looped hemodialysis grafts.

    Science.gov (United States)

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

    2013-03-01

    This study is a retrospective evaluation of an alternative technique for angioplasty of thrombosed loop hemodialysis grafts through a single vascular access. This technique can provide balloon angioplasty to the puncture site without any additional vascular accesses by using a T-shaped balloon catheter and can simplify thrombectomy procedures. Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.

  16. Treatment of 48 Cases of Herpes Zoster by Puncturing Nerve Stem

    Institute of Scientific and Technical Information of China (English)

    倪夕朗; 洪珏

    2008-01-01

    @@ Herpes zoster is a viral disorder involving both nerve and skin simultaneously, with the duration of about 2 to 3 weeks. The author treated 48 cases by puncturing nerve stem in recent years and obtained good therapeutic results. Now it is reported as follows.

  17. Endocrine stress response in rats subjected to singular orbital puncture while under diethyl-ether anaesthesia

    NARCIS (Netherlands)

    van Herck, H; Baumans, V; de Boer, S.F.; van der Gugten, J; van Woerkom, A B; Beynen, A C

    1991-01-01

    In an attempt to assess possible discomfort in rats subjected to orbital puncture while under diethyl-ether anaesthesia, their endocrine stress response was determined. Concentrations of corticosterone, adrenaline and noradrenaline were measured in plasma obtained via a jugular catheter from rats su

  18. Treatment of 56 Cases of Pain of Supra-orbital Bone by Puncturing Siguan Acupoints

    Institute of Scientific and Technical Information of China (English)

    李玲

    2008-01-01

    @@ Pain of supra-orbital bone is very common in clinic.The author achieved significant effect in treating 56 cases of pain of supra-orbital bone by puncturing Siguan(four gates)points.The report is as follows.

  19. Bilateral post-arterial puncture pseudoaneurysm in a patient with amyloidosis

    Directory of Open Access Journals (Sweden)

    Paula Sabrina Araújo Milhomem

    2015-03-01

    Full Text Available Amyloidosis consists of deposition of insoluble fibrillar proteins in tissues and, causing dysfunction. In association with other factors, the condition can contribute to emergence of complications, such as pseudoaneurysms at arterial puncture sites. Pseudoaneurysms are becoming an ever-more common complication, which underscores the importance of identifying risk factors, so that their incidence can be minimized.

  20. A Randomized Controlled Trial on the Effect of Needle Gauge on the Pain and Anxiety Experienced during Radial Arterial Puncture.

    Directory of Open Access Journals (Sweden)

    Maxime Patout

    Full Text Available Arterial punctures for assessment of arterial blood-gases can be a painful procedure. Lidocaine can be used to reduce pain prior to needle insertion but it is not a widely accepted practice. The purpose of this study was to determine whether a large size needle induces more pain compared to a smaller size needle for radial arterial puncture and to assess the anxiety associated with radial arterial punctures.We conducted a prospective, double-blind, randomized, controlled, monocentric study including all outpatients who had a planned assessment of arterial blood gas analysis. Patients were randomized to have the arterial puncture performed with a 23 or a 25 G needle. The main judgement criteria was pain during arterial puncture. Visual analogue scale for pain (VAS-P and visual analogue scale for anxiety (VAS-A were used to assess pain and anxiety during radial arterial puncture.Two hundred consecutive patients were randomized. The 25 G needle was as painful as the 23 G needle (6.63 mm [0-19 mm] vs. 5.21 mm [0-18.49 mm], respectively, p = 0.527. Time for arterial puncture was longer with the 25 G needle than with the 23 G needle (42 s [35-55 s] vs. 33 s [24.5-35 s], respectively, p = 0.002. There was a correlation between the level of anxiety prior to the arterial puncture and the pain experienced by the patients (p: 0.369, p<0.0001. There was a correlation between the pain experienced by patients and the anxiety experienced in anticipation of another arterial puncture (p: 0.5124, p<0.0001.The use of 23 G needle allows quicker arterial sampling and is not associated with increased pain and symptoms. Anxiety was correlated with the pain experienced by patients during arterial punctures.Clinicaltrials.gov: NCT02320916.

  1. Diagnosis and staging of bronchogenic carcinoma by transtracheal and transbronchial needle aspiration.

    Science.gov (United States)

    Castella, J; Buj, J; Puzo, C; Antón, P A; Burgués, C

    1995-01-01

    Transbronchial needle aspiration (TBNA) has been used in diagnosis and staging of bronchogenic carcinoma. However, its true effectiveness seems uncertain and some models of needles are expensive. The aim of this study was to procure new experiences on this method. TBNA was performed in 194 patients with bronchogenic carcinomas. Two models of cheap, re-usable, cytological needles were used. In diagnostic application, TBNA was positive in 34 of 39 (87%) central tumors and in 31 of 45 (69%) peripheral nodules or masses. In 19 patients, TBNA was the only positive sample. In staging application, TBNA was positive in 41 of the 90 cases (46%) in which the spread of the tumor compressed the wall of the airway. When the trachea or bronchus was endoscopically normal at the site of the puncture, TBNA was only positive in 3 of 20 cases (15%). These results suggest that TBNA is effective as a diagnostic tool. However, it appears to be less effective in staging, where the attainment of a good yield with TBNA probably demands a positive computed tomography and the use of a histological needle.

  2. Induction of parotitis by fine-needle aspiration in parotid Warthin's tumor.

    Science.gov (United States)

    Suzuki, Kensuke; Iwai, Hiroshi; Kaneko, Toshihiko; Sakaguchi, Mariko; Hoshino, Shoichi; Inaba, Muneo

    2009-08-01

    To estimate parotitis caused by fine-needle aspiration (FNA) in parotid Warthin tumor. Case series with chart review. Hospital records were reviewed for 104 parotid tumors (103 patients) including 35 Warthin tumors, which underwent FNA within our department. Three patients with four Warthin tumors among them noticed parotid pain, swelling, and abscess formation as a consequence of acute parotitis after FNA. Examinations of the materials obtained from tumor puncture or drainage before the start of antibiotic therapy showed no bacterial association in any patient. Two of the patients with Warthin tumor underwent parotidectomy, and the surgical specimens indicated histopathological changes with necrosis, abscess, granuloma, and the infiltration of inflammatory cells including Langhans-type multinucleated giant cells. It is conceivable that Warthin tumor bears the characteristics of inflammation induced by the FNA procedure without any relation to infection. Therefore, it may be better to avoid routine FNA and give priority to diagnostic imagings over FNA in the diagnosis of tumors strongly suspected as Warthin tumor.

  3. Fine needle aspiration of focal lung lesion under CT fluoroscopic guidance

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Hae Jeong; Shin, Hyun Joon; Choi, Young Chil; Park, Sang Woo; Yi, Jeong Geun; Park, Jeong Hee [College of Medicine, Konkuk University, Seoul (Korea, Republic of); Jin, Yong Hyun [Sung Ae Hospital, Seoul (Korea, Republic of)

    2006-07-15

    We wanted to assess the efficacy of using CT fluoroscopy during Fine Needle Aspiration (FNA) for focal lung lesion. We retrospectively reviewed 22 patients who had undergone FNA under CT fluoroscopic guidance. The final diagnosis of focal lung lesion was based on surgery, the results of biopsy taken from another site or the clinical diagnosis with imaging follow-up. We reviewed the imaging and recorded the location of the lesion, the lesion size and the depth from the puncture site. In 24 cases of 22 patients, 16 lesions were benign and 8 were malignant. The sensitivity and specificity for malignant lesions were 100%, and 75%, respectively. The mean size of the malignant lesions was 3.75 {+-} 1.68 cm, and that of the benign lesion was 3.05 {+-} 2.98 cm. The mean depth of the lesion divided by the size was 1.85 {+-} 1.09 for 20 lesions of the correct result group and 3.13 {+-} 1.73 for 4 lesions of the incorrect result group; the difference between the two groups was statistically different ({rho} = 0.030). The complications after FNA were pneumothoraces in three cases and parenchymal hemorrhage in one case, but no significant complication was noted after the procedures. We could perform the FNA accurately and safely under CT fluoroscopy guidance, so this technique can be used for FNA of focal lung lesion for obtaining a correct result with fewer complications.

  4. When Aspirations Exceed Expectations: Quixotic Hope Increases Depression among Students.

    Directory of Open Access Journals (Sweden)

    Katharine H Greenaway

    Full Text Available A paradox exists in modern schooling: students are simultaneously more positive about the future and more depressed than ever. We suggest that these two phenomena may be linked. Two studies demonstrated that students are more likely to be depressed when educational aspirations exceed expectations. In Study 1 (N = 85 aspiring to a thesis grade higher than one expected predicted greater depression at the beginning and end of the academic year. In Study 2 (N = 2820 aspiring to a level of education (e.g., attending college higher than one expected to achieve predicted greater depression cross-sectionally and five years later. In both cases the negative effects of aspiring high while expecting low persisted even after controlling for whether or not students achieved their educational aspirations. These findings highlight the danger of teaching students to aspire higher without also investing time and money to ensure that students can reasonably expect to achieve their educational goals.

  5. Correlation of gastroesophageal reflex with aspiration pneumonia after surgery

    Energy Technology Data Exchange (ETDEWEB)

    Hirashima, Tokuji; Hashimoto, Hajime; Noro, Toshio; Takahashi, Tadao; Hino, Yasunori; Kuroiwa, Kouzirou [Tokyo Metropolitan Geriatric Medical Center (Japan)

    1996-08-01

    In order to elucidate the correlation of gastroesophageal reflex (GER) with aspiration pneumonia after surgery, 48 patients (mean, 75.6 years) with gastric cancer treated at the hospital from March, 1994 to December, 1994 were subjected to this prospective study. The pharyngeal stimulation test, nutritional assessment, radionuclide esophageal scintigraphy (34 cases) were performed before surgery and relationship between those results and aspiration pneumonia were studied. Aspiration pneumonia occurred in 3 cases, and all of them were in, significantly, poor nutritional status, compared with other. A significant increase in the frequency of GER was observed when a naso-gastric tube (NGT) was placed, but surprisingly, all the patients with aspiration pneumonia were 3 out of 4 patients who had continuous GER without NGT. It is noteworthy, continuous GER without NGT was significantly (p<0.001) affected postoperative aspiration pneumonia and impaired phalyngeal reflex was frequently correlated with development of aspiration pneumonia, when malnutritional status existed. (author)

  6. When Aspirations Exceed Expectations: Quixotic Hope Increases Depression among Students.

    Science.gov (United States)

    Greenaway, Katharine H; Frye, Margaret; Cruwys, Tegan

    2015-01-01

    A paradox exists in modern schooling: students are simultaneously more positive about the future and more depressed than ever. We suggest that these two phenomena may be linked. Two studies demonstrated that students are more likely to be depressed when educational aspirations exceed expectations. In Study 1 (N = 85) aspiring to a thesis grade higher than one expected predicted greater depression at the beginning and end of the academic year. In Study 2 (N = 2820) aspiring to a level of education (e.g., attending college) higher than one expected to achieve predicted greater depression cross-sectionally and five years later. In both cases the negative effects of aspiring high while expecting low persisted even after controlling for whether or not students achieved their educational aspirations. These findings highlight the danger of teaching students to aspire higher without also investing time and money to ensure that students can reasonably expect to achieve their educational goals.

  7. [Comparative study of core needle biopsy and fine needle aspiration cytology in the diagnosis of neck lymph node diseases with contrast-enhanced ultrasound].

    Science.gov (United States)

    Zhang, W Z; Yang, G Y; Xu, J P; Zhang, L; Li, J; Zhao, D

    2016-08-07

    To compare the efficacies of core needle biopsy and fine needle aspiration cytology in the diagnosis of neck lymph node diseases with contrast-enhanced ultrasound. A total of 105 patients with enlargement cervical lymph nodes were randomly divided into two groups, 49 in group A and 56 in group B. All patients were firstly examined with contrast-enhanced ultrasound to determine the targeted lymph node and the puncture point. Core needle biopsy was performed in Group A and tissues were fixed by with 10% formaldehyde; Fine needle aspiration cytology was performed in Group B and extracts were smeared and fixed with 95% alcohol. The success rates of sampling were 100.0% in group A and 96.4% in group B. The positive rates of pathological examinations were 97.9% in group A; and 82.1% in group B, with a significant difference between two groups (χ(2) = 6.97, Pneedle biopsy is higher than that of fine needle aspiration cytology for the diagnosis of neck lymph node diseases with contrast-enhanced ultrasound.

  8. Repeat-punctured superorthogonal convolutional turbo codes on AWGN and flat Rayleigh fading channels

    Directory of Open Access Journals (Sweden)

    Fambirai Takawira

    2010-10-01

    Full Text Available Repeat-punctured turbo codes, an extension of the conventional turbo-coding scheme, has shown a significant increase in bit-error rate performance at moderate to high signal-to-noise ratios for short frame lengths. Superorthogonal convolutional turbo codes (SCTC makes use of superorthogonal signals to improve the performance of the conventional turbo codes and a coding scheme that applies the repeat-punctured technique into SCTC has shown to perform better. We investigated two new low-rate coding schemes, repeat-punctured superorthogonal convolutional turbo codes (RPSCTC and dual-repeat-punctured superorthogonal convolutional turbo codes (DRPSCTC, that make use of superorthogonal signaling, together with repetition and puncturing, to improve the performance of SCTC for reliable and effective communications. Simulation results in the additive white Gaussian noise (AWGN channel and the frequency non-selective Rayleigh fading channel are presented together with analytical bounds of bit error probabilities, derived from transfer function bounding techniques. From the simulation results and the analytical bounds presented, it is evident that RPSCTC and DRPSCTC offer a more superior performance than SCTC in the AWGN channel, as well as in flat Rayleigh non-line-of-sight fading channels. The distance spectrum is also presented for the new schemes and accounts for the performance improvement rendered in simulations. It is important to note that the improved performance that SCTC, and consequently RPSCTC and DRPSCTC, exhibit is achieved at the expense of bandwidth expansion and complexity and would be ideal for power-limited satellite communication links or interference-limited systems.

  9. CT-guided percutaneous fine-needle aspiration biopsy of pulmonary nodules measuring 10 mm or less

    Energy Technology Data Exchange (ETDEWEB)

    Ng, Y.L. [Joint Department of Medical Imaging, Thoracic Division, University Health Network and Mount Sinai Hospital, Toronto, Ontario (Canada)], E-mail: yuenli_ng@hotmail.com; Patsios, D.; Roberts, H.; Walsham, A.; Paul, N.S.; Chung, T.; Herman, S.; Weisbrod, G. [Joint Department of Medical Imaging, Thoracic Division, University Health Network and Mount Sinai Hospital, Toronto, Ontario (Canada)

    2008-03-15

    Aim: To determine the value of computed tomography (CT)-guided fine-needle aspiration biopsy (FNAB) of small pulmonary nodules measuring 10 mm or less. Material and Methods: CT-guided FNABs of 55 nodules, measuring 10 mm or less, were performed between January 2003 and February 2006. A coaxial technique was used, with an outer 19 G Bard Truguide needle and inner 22 G disposable Greene biopsy needle. Adequacy of specimens was assessed on-site by a cytotechnologist. The sizes of the nodules, distance from pleura, number of pleural punctures and aspirates, complications encountered, cytological diagnosis, and outcome were recorded. Results: The mean nodule diameter was 9 mm (range 5-10 mm). The average distance from the costal pleura was 31 mm (range 0-88 mm). In 50 of the 55 FNABs, the pleura was crossed once. An average of four aspirates was performed per case. Twenty-five FNABs (45.5%) were adequate for diagnosis (24 malignant and one tuberculosis). In 11 cases, where no definite diagnosis was made following FNAB, the outcome was not affected. In 10 cases, samples were insufficient for diagnosis and the nodules were subsequently diagnosed as malignant. Eight cases were excluded in the final analysis as follow-up details were unavailable. The sensitivity for malignancy and overall accuracy were 67.7 and 78.8%, respectively. Pneumothorax occurred in 29 (52.7%) patients, with five (9.1%) requiring thoracostomy tubes. Conclusion: CT-guided FNAB is a useful tool in the diagnosis and management of small pulmonary nodules, despite the lower diagnostic accuracy and higher complication rate than those of larger pulmonary lesions.

  10. Risk Factors for Aspiration Pneumonia in Older Adults

    OpenAIRE

    2015-01-01

    BackgroundsAspiration pneumonia is a dominant form of community-acquired and healthcare-associated pneumonia, and a leading cause of death among ageing populations. However, the risk factors for developing aspiration pneumonia in older adults have not been fully evaluated. The purpose of the present study was to determine the risk factors for aspiration pneumonia among the elderly.Methodology and Principal FindingsWe conducted an observational study using data from a nationwide survey of geri...

  11. Risk Factors for Aspiration Pneumonia in Older Adults

    OpenAIRE

    2015-01-01

    Backgrounds Aspiration pneumonia is a dominant form of community-acquired and healthcare-associated pneumonia, and a leading cause of death among ageing populations. However, the risk factors for developing aspiration pneumonia in older adults have not been fully evaluated. The purpose of the present study was to determine the risk factors for aspiration pneumonia among the elderly. Methodology and Principal Findings We conducted an observational study using data from a nationwide survey of g...

  12. Changing educational aspirations of children living in poverty in Ethiopia

    OpenAIRE

    2010-01-01

    Using both qualitative and quantitative data, this paper examines the changing educational and occupational aspirations and educational achievements of children living in poor communities in Ethiopia. The results suggest that children had high aspirations at an earlier age but that these changed later, with poverty rarely influencing their earlier aspirations but having a strong impact later on. Children with high educational achievement, mostly urban children and some rural girls, maintained...

  13. Foreign Body Aspiration in Children-a Diagnostic Challenge

    Directory of Open Access Journals (Sweden)

    Slobodanka Petrovic

    2012-03-01

    Full Text Available The clinical presentation of foreign body aspiration in children is variable. Clinicians should maintain a high index of suspicion in order to make a prompt and correct diagnosis. In this paper,we present a case of foreign body aspiration that had gone unrecognized for 54 days. Foreign body aspiration should be considered whenever a previously healthy child suddenly exhibits unexplained symptoms usually consistent with airway obstruction which is refractory to medical treatment.

  14. Image-Guided Fine Needle Cytology with Aspiration Versus Non-Aspiration in Retroperitoneal Masses: Is Aspiration Necessary?

    Directory of Open Access Journals (Sweden)

    Rajiv Kumar Misra

    2015-03-01

    Full Text Available Background: Although using fine needle cytology with aspiration (FNC-A for establishing diagnoses in the retroperitoneal region has shown promise, there is scant literature supporting a role of non-aspiration cytology (FNC-NA for this region. We assessed the accuracy and reliability of FNC-A and FNC-NA as tools for preoperative diagnosis of retroperitoneal masses and compared the results of both techniques with each other and with histopathology. Methods: Fifty-seven patients with retroperitoneal masses were subjected to FNC-A and FNC-NA. Smears were stained with May-Grunwald Giemsa and hematoxylin and eosin stain. An individual slide was objectively analysed using a point scoring system to enable comparison between FNC-A and FNC-NA. Results: By FNC-A, 91.7% accuracy was obtained in cases of retroperitoneal lymph node lesions followed by renal masses (83.3%. The diagnostic accuracy of other sites by FNC-A varied from 75.0%–81.9%. By FNC-NA, 93.4% diagnostically accurate results were obtained in the kidney, followed by 75.0% in adrenal masses. The diagnostic accuracy of other sites by FNC-NA varied from 66.7%–72.8%. Conclusions: Although both techniques have their own advantages and disadvantages, FNC-NA may be a more efficient adjuvant method of sampling in retroperitoneal lesions.

  15. Cytological Punctures in the Diagnosis of Renal Tumours: A Study on Accuracy and Reproducibility

    DEFF Research Database (Denmark)

    Kümmerlin, Intan P E D; Smedts, Frank; ten Kate, Fiebo J W;

    2009-01-01

    BACKGROUND: Fine needle aspiration (FNA) cytology is under consideration as an auxiliary preoperative diagnostic technique in the diagnosis of renal masses. However, reports for FNA are contradictory with regard to diagnostic accuracy and applicability. OBJECTIVE: To evaluate the diagnostic accur...

  16. Performing a Better Bone Marrow Aspiration.

    Science.gov (United States)

    Friedlis, Mayo F; Centeno, Christopher J

    2016-11-01

    Bone marrow aspiration (BMA) is increasingly being used to harvest stem cells for use in regenerative medicine. The focus of BMA in interventional orthopedics is to maximize the yield of mesenchymal stem cells. The authors present an improved method for BMA that involves fluoroscope or ultrasound guidance combined with anesthesia; in the authors' experience, it produces the highest possible stem cell yield and is well tolerated by patients. The authors provide a step-by-step guide to the process, along with a discussion of technical and other considerations and quick reference guides for ultrasound- and fluoroscope-guided BMA. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Subcutaneous (SQ) injections

    Science.gov (United States)

    SQ injections; Sub-Q injections; Diabetes subcutaneous injection; Insulin subcutaneous injection ... NIH. Giving a subcutaneous injection . Rockville, MD. National ... of Health and Human Services NIH publications; 2015. Available ...

  18. Role of aspiration-induced migration in cooperation

    CERN Document Server

    Yang, Han-Xin; Wang, Bing-Hong

    2011-01-01

    Both cooperation and migration are ubiquitous in human society and animal world. In this Rapid Communication, we propose an aspiration-induced migration in which individuals will migrate to new sites provided that their payoffs are below some aspiration level. It is found that moderate aspiration level can best favor cooperative behavior. In particular, moderate aspiration level enables cooperator clusters to maintain and expand whereas induces defector clusters to disintegrate, thus promoting the diffusion of cooperation among population. Our results provide insights into understanding the role played by migration in the emergence of cooperative behavior.

  19. Laser-Assisted Removal of Aspirated Thumbtacks by Flexible Bronchoscopy

    Directory of Open Access Journals (Sweden)

    Oren Fruchter

    2010-01-01

    Objectives. To describe a technique for removal of sharp aspirated metal objects employing laser through flexible bronchoscopy. Methods. We report two patients in whom a new technique for removal of sharp aspirated metal objects utilizing Nd-Yag laser flexible bronchoscopy was used. Results. Successful and uncomplicated removal of the aspirated thumbpack by flexible bronchoscopy under conscious sedation was accomplished in the two patients described. Both patients were discharged within 24 hours. Conclusions. In patients with aspirated thumbtack laser-assisted breakage of the object through flexible bronchoscopy may obviate the need for rigid bronchoscopy or thoracotomy.

  20. Silent aspiration: results of 2,000 video fluoroscopic evaluations.

    Science.gov (United States)

    Garon, Bernard R; Sierzant, Tess; Ormiston, Charles

    2009-08-01

    The purpose of this retrospective study of aspiration and the lack of a protective cough reflex at the vocal folds (silent aspiration) was to increase the awareness of nursing staffs of the diagnostic pathology groups associated with silent aspiration. Of the 2,000 patients evaluated in this study, 51% aspirated on the video fluoroscopic evaluation. Of the patients who aspirated, 55% had no protective cough reflex (silent aspiration). The diagnostic pathology groups with the highest rates of silent aspiration were brain cancer, brainstem stroke, head-neck cancer, pneumonia, dementia/Alzheimer, chronic obstructive lung disease, seizures, myocardial infarcts, neurodegenerative pathologies, right hemisphere stroke, closed head injury, and left hemisphere stroke. It is of high concern that the diagnostic groups identified in this research as having the highest risk of silent aspiration be viewed as "red-flag" patients by the nursing staff caring for them. Early nursing dysphagia screens, with close attention to the clinical symptoms associated with silent aspiration, and early referral for formal dysphagia evaluation are stressed.

  1. Predictive factors for early aspiration in liver abscess

    Institute of Scientific and Technical Information of China (English)

    Rustam Khan; Saeed Hamid; Shahab Abid; Wasim Jafri; Zaigham Abbas; Mohammed Islam; Hasnain Shah; Shaalan Beg

    2008-01-01

    AIM: To determine the predictive factors for early aspiration in liver abscess.METHODS: A retrospective analysis of all patients with liver abscess from 1995 to 2004 was performed. Abscess was diagnosed as amebic in 661 (68%) patients, pyogenic in 200 (21%), indeterminate in 73 (8%) and mixed in 32 (3%). Multiple logistic regression analysis was performed to determine predictive factors for aspiration of liver abscess.RESULTS: A total of 966 patients, 738 (76%) male, mean age 43 ± 17 years, were evaluated: 540 patients responded to medical therapy while adjunctive percutaneous aspiration was performed in 426 patients. Predictive factors for aspiration of liver abscess were: age ≥ 55 years, size of abscess ≥ 5 cm, involvement of both lobes of the liver and duration of symptoms ≥ 7 d. Hospital stay in the aspiration group was relatively longer than in the non aspiration group. Twelve patients died in the aspiration group and this mortality was not statistically significant when compared to the non aspiration group.CONCLUSION: Patients with advanced age, abscess size > 5 cm, both lobes of the liver involvement and duration of symptoms > 7 d were likely to undergo aspiration of the liver abscess, regardless of etiology.

  2. Gender, aspirations, and achievements : Relating work and family aspirations to occupational outcomes

    NARCIS (Netherlands)

    van der Horst, Mariska

    2014-01-01

    Although women have increased their labour market participation and educational level they still lag behind men in their occupational achievements. An important discussion in the literature as well as in popular media is whether this is due to a gender difference in aspirations. In this study the im

  3. Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) in insulinomas: Indications and clinical relevance in a single investigator cohort of 47 patients.

    Science.gov (United States)

    Kann, Peter Herbert; Moll, Roland; Bartsch, Detlef; Pfützner, Andreas; Forst, Thomas; Tamagno, Gianluca; Goebel, Joachim N; Fourkiotis, Verena; Bergmann, Simona Raluca; Collienne, Maike

    2017-04-01

    This study was aimed to investigate the role and relevance of endoscopic ultrasound-guided fine-needle aspiration biopsy in the diagnostic work-up of insulinomas. We have analysed the frequency, clinical indications, success rate (obtaining diagnostic tissue), diagnostic accuracy (in comparison to the pathological diagnosis after surgery), complications, and tolerability of endoscopic ultrasound-guided fine-needle aspiration biopsy and the localization and size of the lesions in 47 consecutive patients (29 females, 18 males; 46 ± 15 years) who had surgery for insulinoma following fasting test and were explored by single investigator EUS 1994-2015. Endoscopic ultrasound-guided fine-needle aspiration biopsy was performed in 21 % (10/47) of the patients. The clinical indications for endoscopic ultrasound-guided fine-needle aspiration biopsy were non-conclusive result of fasting test (n = 7), missing toxicology (n = 2), suspected malignancy at EUS (n = 1), suspicious extra-pancreatic localization of the lesion (n = 1). The diagnostic success rate of the procedure was 80 % (8/10 cases), the diagnostic accuracy of the fine-needle aspiration biopsy 70 % (7/10 cases). The lesions undergoing endoscopic ultrasound-guided fine-needle aspiration biopsy were localized in the cauda (n = 5), corpus (n = 2), caput/processus uncinatus (n = 3), the diameter of the tumors was 21 ± 18 (10-70) mm. Only one accidental vascular puncture without any clinical complication occurred and all patients tolerated the procedure well. In the majority of cases, positive fasting test, negative toxicology, and detection of a typical pancreatic lesion at endoscopic ultrasound is sufficient for the diagnosis of insulinoma and the definition of the appropriate surgical strategy. Based on our data, we suggest including endoscopic ultrasound-guided fine-needle aspiration biopsy in the diagnostic work-up of organic hyperinsulinism in selected patients with

  4. 17β-Estradiol administration attenuates seawater aspiration-induced acute lung injury in rats.

    Science.gov (United States)

    Fan, Qixin; Zhao, Pengtao; Li, Jiahuan; Xie, Xiaoyan; Xu, Min; Zhang, Yong; Mu, Deguang; Li, Wangping; Sun, Ruilin; Liu, Wei; Nan, Yandong; Zhang, Bo; Jin, Faguang; Li, Zhichao

    2011-12-01

    There is very little evidence on the value of administering estrogen in cases of seawater drowning which can induce acute lung injury/acute respiratory distress syndrome (ALI/ARDS). Therefore, this study aimed to investigate whether 17β-estradiol (E2) treatment can attenuate seawater aspiration-induced ALI in rats. In the experiment, ALI was induced by endotracheal instillation of seawater (4mL/kg) and the rats were then given intraperitoneal injection of E2 (5mg/kg) 20min after seawater instillation. Finally, the changes of arterial blood gases which contained hydrogen ion concentration (pH), arterial oxygen tension (PaO(2)) and arterial carbon dioxide tension (PaCO(2)) were measured and the measurement of extravascular lung water (EVLW) was observed. The pulmonary histological changes were evaluated by hematoxylin-eosin stain. The expression of aquaporins (AQPs) 1, AQP5, and estrogen receptor-β (ERβ) was measured by western blotting and immunohistochemical methods. The results showed that compared with normal saline water, seawater aspiration induced more serious ALI in rats which was markedly alleviated by E2 treatment. Meanwhile, the ERβ in lung tissues was activated after E2 administration. The seawater aspiration group also presented with severe pulmonary edema which was paralleled with over expressed AQP1 and AQP5. However, the up-regulation of AQP1 and AQP5 was suppressed by the administration of E2, resulting in an attenuation of lung edema. In conclusion, E2 treatment could effectively attenuate seawater aspiration-induced acute lung injury in rats by the down-regulation of AQP1 and AQP5.

  5. Preventive effects of curcumin on different aspiration material-induced lung injury in rats.

    Science.gov (United States)

    Guzel, Ahmet; Kanter, Mehmet; Aksu, Burhan; Basaran, Umit Nusret; Yalçin, Omer; Guzel, Aygul; Uzun, Hafise; Konukoğlu, Dildar; Karasalihoglu, Serap

    2009-01-01

    We have studied whether curcumin protects different pulmonary aspiration material-induced lung injury in rats. The experiments were designed in 60 Sprague-Dawley rats, randomly allotted into one of six groups (n=10): normal saline (NS, control), enteral formula (Biosorb Energy Plus, BIO), hydrochloric acid (HCl), NS+curcumin-treated, BIO+curcumin-treated, and HCl+curcumin-treated. NS, BIO, HCl were injected in to the lungs. The rats received curcumin twice daily only for 7 days. Seven days later, both lungs in all groups were examined histopathologically, immunohistochemically, and biochemically. Histopathologic examination was performed according to the presence of peribronchial inflammatory cell infiltration, alveolar septal infiltration, alveolar edema, alveolar exudate, alveolar histiocytes, interstitial fibrosis, granuloma, and necrosis formation. Immunohistochemical assessments were examined for the activity of inducible nitric oxide synthase (iNOS) and the expression of surfactant protein D (SP-D). Malondialdehyde (MDA), hydroxyproline (HP), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) activity were measured in the lung tissue. Our findings show that curcumin inhibits the inflammatory response reducing significantly (P<0.05) all histopathological parameters in different pulmonary aspiration models. Pulmonary aspiration significantly increased the tissue HP content, MDA levels and decreased the antioxidant enzyme (SOD, GSH-Px) activities. Curcumin treatment significantly decreased the elevated tissue HP content, and MDA levels and prevented inhibition of SOD, and GSH-Px enzymes in the tissues. Furthermore, our data suggest that there is a significant reduction in the activity of iNOS and a rise in the expression of SP-D in lung tissue of different pulmonary aspiration models with curcumin therapy. Our findings support the use of curcumin as a potential therapeutic agent in acute lung injury.

  6. Embolization by Direct Puncture with a Transpedicular Approach Using an Isocenter Puncture (ISOP) Method in a Patient with a Type II Endoleak After Endovascular Aortic Repair (EVAR)

    Energy Technology Data Exchange (ETDEWEB)

    Ogawa, Yukihisa, E-mail: yukky.oct.22@gmail.com; Hamaguchi, Shingo [St. Marianna University, School of Medicine, Department of Radiology (Japan); Nishimaki, Hiroshi [St. Marianna University, School of Medicine, Department of Cardiovascular Surgery (Japan); Kon, Yuri [St. Marianna University, School of Medicine, Department of Radiology (Japan); Chiba, Kiyoshi; Sakurai, Yuka [St. Marianna University, School of Medicine, Department of Cardiovascular Surgery (Japan); Murakami, Kenji; Arai, Yasunori [St. Marianna University, School of Medicine, Department of Radiology (Japan); Miyairi, Takeshi [St. Marianna University, School of Medicine, Department of Cardiovascular Surgery (Japan); Nakajima, Yasuo [St. Marianna University, School of Medicine, Department of Radiology (Japan)

    2015-06-15

    BackgroundEndovascular aortic repair (EVAR) requires further intervention in 20-30 % of cases, often due to type II endoleak (T2EL). Management options for T2EL include transarterial embolization, direct puncture (DP), or transcaval embolization. We report the case of an 80-year-old man with T2EL who successfully underwent DP embolization.MethodsEmbolization by DP was performed with a transpedicular approach using an isocenter puncture (ISOP) method. An isocenter marker (ICM) was placed at a site corresponding to the aneurysm sac on fluoroscopy in two directions (frontal and lateral views). A vertebroplasty needle was inserted tangentially to the ICM under fluoroscopy and advanced to the anterior wall of the vertebral body. A 20 cm-length, 20-G-PTCD needle was inserted through the outer needle of the 13-G needle and advanced to the ICM. Sac embolization using 25 % N-buty-2-cyanoacrylate diluted with Lipiodol was performed. After complete embolization, rotational DA confirmed good filling of the sac with Lipiodol. The outer cannula and 13-G needle were removed and the procedure was completed.ResultsThe patient was discharged the next day. Contrast-enhanced computed tomography 1 and 8 months later showed no Lipiodol washout in the aneurysm sac, no endoleak recurrence, and no expansion of the excluded aneurysm.ConclusionDP with a transpedicular approach using ISOP may be useful when translumbar and transabdominal approaches prove difficult.

  7. Students' Aspirations, Expectations and School Achievement: What Really Matters?

    Science.gov (United States)

    Khattab, Nabil

    2015-01-01

    Using the Longitudinal Study of Young People in England (LSYPE), this study examines how different combinations of aspirations, expectations and school achievement can influence students' future educational behaviour (applying to university at the age of 17-18). The study shows that students with either high aspirations or high expectations have…

  8. Predictive Value and Psychological Meaning of Vocational Aspirations

    Science.gov (United States)

    Holland, John L.; Gottfredson, Gary D.

    1975-01-01

    The psychological meaning and predictive value of a person's vocational aspirations were examined by applying Holland's typology to the vocational aspirations of high school juniors (N=140), and a second sample of college students studied over a one-year interval (N-624). (Author)

  9. Life Aspirations, Values and Moral Foundations in Mongolian Youth

    Science.gov (United States)

    Bespalov, Alexander; Prudnikova, Marina; Nyamdorj, Bavuu; Vlasov, Mikhail

    2017-01-01

    Life aspirations have aroused much interest in youth studies. Yet, their psychological correlates remain unclear, especially in countries outside the US. The aim of this study was to explore associations among aspirations, values and moral foundations in 157 Mongolian youth, through questionnaires used widely around the world. Correlational and…

  10. 21 CFR 886.4150 - Vitreous aspiration and cutting instrument.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vitreous aspiration and cutting instrument. 886.4150 Section 886.4150 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... cutting instrument. (a) Identification. A vitreous aspiration and cutting instrument is an...

  11. Study of Educational Aspirations of Preparatory School Students in Yemen.

    Science.gov (United States)

    Edington, Everett D.

    To identify causes for low enrollment in secondary agricultural schools in Yemen, the United States Agency for International Development and the Yemen Ministry of Education surveyed 990 preparatory (junior high) students, examining their educational aspirations, differences between rural and urban youth, major influences on student aspirations,…

  12. Students' Aspirations, Expectations and School Achievement: What Really Matters?

    Science.gov (United States)

    Khattab, Nabil

    2015-01-01

    Using the Longitudinal Study of Young People in England (LSYPE), this study examines how different combinations of aspirations, expectations and school achievement can influence students' future educational behaviour (applying to university at the age of 17-18). The study shows that students with either high aspirations or high expectations have…

  13. Psychological Empowerment and Adolescent Girls' Aspirations in India

    OpenAIRE

    Roy, Sanchari; Morton, Matthew; Bhattacharya, Shrayana

    2016-01-01

    This paper studies the role of social-emotional or psychological capital in determining the education and employment aspirations of adolescent girls and young women in India. The study finds that girls' self-efficacy and mental health are important determinants of their educational and employment aspirations, suggesting that these hidden forms of human capital may serve as critical targets...

  14. Efficiency and Power Consumption of Aspiration Systems at Woodworking Plants

    Directory of Open Access Journals (Sweden)

    P. I. Diachek

    2008-01-01

    Full Text Available The paper analyzes present state of the equipment and organization of aspiration at wood-working shops. Proposals pertaining to higher efficiency and reduction of power intensity of aspiration systems are given in the paper. Materials presented at the stage of designing make it possible to select a rational system scheme and reduce power expenditure at woodworking industry.

  15. Effect of cerebrospinal fluid displacement through lumbar puncture on function recover of nerve system in subarachnoid hemorrhage patients%腰穿脑脊液置换对蛛网膜下腔出血患者神经系统功能恢复的影响

    Institute of Scientific and Technical Information of China (English)

    杨职; 江先娣; 袁莉

    2002-01-01

    Background: Death and disability of subarachnoid hemorrhage(SAH) are caused by lesions of cerebral hernia, spasm of cerebral blood vessels, injuries the blood brain barrier, or communicating hydrocephalus.Cerebrospinal fluid displacement through lumbar puncture can clear the bloody cerebrospinal fluid and reduce the blood pollution of the cerebrospinal fluid, shorten xanthochromia time, reduce the intracranial pressure early and meninges stimulation. Intrathecal injection of dexamethasone can reduce defense reaction of the meninges, tissue adhesion and organization at the same time.

  16. Transient ST-segment elevation after transseptal puncture for atrial fibrillation ablation in two cases

    Institute of Scientific and Technical Information of China (English)

    CHENG Yan-li; DONG Jian-zeng; LIU Xing-peng; LONG De-yong; FANG Dong-ping; YU Rong-hui; TANG Ri-bo; MA Chang-sheng

    2012-01-01

    The present report demonstrates two cases of transient inferior ST-segment elevation accompanied by profound hypotension and bradycardia immediately after transseptal puncture for catheter ablation of atrial fibrillation.This rare complication of transseptal puncture was resolved quickly within several minutes.The most likely mechanism of this phenomenon is coronary vasospasm,although coronary embolism can not be ruled out completely.This complication is characterized as follows:(1) The right coronary artery might be the most likely involved vessel and therefore myocardial ischemia usually occurs in the inferior wall of left ventricular; (2) Reflex hypotension and bradycardia by the Bezold-Jarisch reflex secondary to inferior ischemia often occur at the same time.Though it appears to be a transient and completely reversible phenomenon,there are still potential life-threatening risks because of myocardial ischemia and profound haemodynamic instability.Clinical cardiologists should be aware of this rare complication and properly deal with it.

  17. Evaluation of pancreatic tissue fluid pressure measurements intraoperatively and by sonographically guided fine-needle puncture

    DEFF Research Database (Denmark)

    Ebbehøj, N; Borly, L; Bülow, J;

    1990-01-01

    The aim of the present study was to evaluate the needle method for pancreatic tissue fluid pressure measurements. Clinical evaluation was performed in 24 patients with chronic pancreatitis, comparing repeated pressure measurements via sonographically guided fine-needle puncture and intraoperative...... pressure measurements by direct puncture of pancreatic tissue and duct. In patients with chronic pancreatitis we found small week-to-week variations in sonographically guided percutaneous pressure measurements and good agreement between preoperative percutaneous pressure measurements and intraoperative...... external pressure levels. The basic calibration of the method evaluated by means of this pressure chamber study showed sufficient precision and accuracy of the needle technique for clinical and investigative purposes. In conclusion, our results suggest that pancreatic tissue fluid pressure can be reliably...

  18. Evaluation of pancreatic tissue fluid pressure measurements intraoperatively and by sonographically guided fine-needle puncture

    DEFF Research Database (Denmark)

    Ebbehøj, N; Borly, L; Bülow, J;

    1990-01-01

    pressure measurements via direct puncture. Furthermore, no significant difference was seen between pancreatic duct and tissue fluid pressure. The technical evaluation was performed by repeated pressure measurements in human pancreatic autopsy specimens and living rats in a pressure chamber at various...... external pressure levels. The basic calibration of the method evaluated by means of this pressure chamber study showed sufficient precision and accuracy of the needle technique for clinical and investigative purposes. In conclusion, our results suggest that pancreatic tissue fluid pressure can be reliably......The aim of the present study was to evaluate the needle method for pancreatic tissue fluid pressure measurements. Clinical evaluation was performed in 24 patients with chronic pancreatitis, comparing repeated pressure measurements via sonographically guided fine-needle puncture and intraoperative...

  19. Simulations of rotating neutron star collapse with the puncture gauge: end state and gravitational waveforms

    CERN Document Server

    Dietrich, Tim

    2014-01-01

    We reexamine the gravitational collapse of rotating neutron stars to black holes by new 3+1 numerical relativity simulations employing the Z4c formulation of Einstein equations, the moving puncture gauge conditions, and a conservative mesh refinement scheme or the general relativistic hydrodynamics. The end state of the collapse is compared to the vacuum spacetime resulting from the evolution of spinning puncture initial data. Using a local analysis for the metric fields, we demonstrate that the two spacetimes atually agree. Gravitational waveforms are analyzed in some detail. We connect the emission of radiation to the collapse dynamics using simplified spacetime diagrams, and discuss the similarity of the waveform structure with the one of black hole perturbation theory.

  20. Non-pharmacological measures in preterm newborns submitted to arterial puncture

    Directory of Open Access Journals (Sweden)

    Gleicia Martins de Melo

    Full Text Available ABSTRACT Objective: to assess pain in preterm newborns and to compare the neonatal and therapeutic variables with the total scores of the Neonatal Facial Coding System of preterm newborns submitted to arterial puncture exposed to music and 25% oral glucose. Method: a comparative study with 48 recordings of preterm newborns - Group 1, music (26; Group 2, glucose 25% (22 - individually analyzed by three trained nurses, after Kappa of at least 80%. Results: the variables and the pain scores of the groups did not present statistical significance (p < 0.05 according to the Neonatal Facial Coding System. 80.8% of the preterm infants in Group 1 had a higher quantitative score ≥ 3 in the neonatal variables (gender, type of delivery, and therapeutic variables (type of oxygen therapy, place of hospitalization, type of puncture. Conclusion: There was no difference when comparing the music and glucose 25% groups and the variables studied.

  1. Recurrent Aspiration Pneumonia due to Anterior Cervical Osteophyte

    Directory of Open Access Journals (Sweden)

    Jae Jun Lee

    2017-02-01

    Full Text Available A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.

  2. Aspiration of two permanent teeth during maxillofacial injuries.

    Science.gov (United States)

    Xiao, Wen-lin; Zhang, Dai-zun; Wang, Yan-hui

    2009-03-01

    Aspiration of a tooth in maxillofacial injuries is a known complication necessitating prompt recognition and early treatment to minimize potentially serious and, sometimes, even fatal consequences. Here, we report a rare and unusual case in its presentation, the patient having aspirated 2 permanent teeth after maxillofacial, cervical vertebrae, and thoracic region crush injuries due to a motor vehicle accident. The diagnosis of teeth aspiration was delayed until 2 weeks after the event. An aspirated anterior tooth was expectorated by the patient himself, and the other aspirated anterior tooth was removed by flexible bronchoscopy. The paper also emphasizes that clinicians must be aware of dental injury resulting from maxillofacial injuries and account for all teeth as part of their evaluation, keeping an open mind as to where a missing tooth might be located. A rapid diagnosis depends on high clinical suspicion, clinical signs, and radiologic findings.

  3. Computed tomography before lumbar puncture in acute meningitis: a review of the risks and benefits.

    OpenAIRE

    Archer, B D

    1993-01-01

    OBJECTIVE: To determine the indications, if any, for routine computed tomography (CT) of the brain before lumbar puncture in the management of acute meningitis. DATA SOURCES: Original research papers, reviews and editorials published in English from 1965 to 1991 were retrieved from MEDLINE. The bibliographies of these articles and of numerous standard texts were examined for pertinent references. A survey of local neurologists was conducted, and legal opinion was sought from the Canadian Medi...

  4. Effect of needle puncture and electro-acupuncture on mucociliary clearance in anesthetized quails

    Directory of Open Access Journals (Sweden)

    Wang Tianshan

    2006-02-01

    Full Text Available Abstract Background Acupuncture therapy for obstructive respiratory diseases has been effectively used in clinical practice and the acupuncture points or acupoints of Zhongfu and Tiantu are commonly-used acupoints to treat patients with the diseases. Since the impaired mucociliary clearance is among the most important features of airway inflammation in most obstructive respiratory diseases, the effect of needle puncture and electro-acupuncture at the specific acupoints on tracheal mucociliary clearance was investigated in anesthetized quails. Methods Mucociliary transport velocity on tracheal mucosa was measured through observing the optimal pathway, and fucose and protein contents in tracheal lavages were determined with biochemical methods. In the therapeutic group, needle puncture or electro-acupuncture stimulation to the acupoints was applied without or with constant current output in 2 mA and at frequency of 100 Hz for 60 minutes. In the sham group, electro-acupuncture stimulation to Liangmen was applied. Results Our present experiments demonstrated that the electro-acupuncture stimulation to Zhongfu and Tiantu significantly increased tracheal mucociliary transport velocity and decreased the content of protein in the tracheal lavage, compared with the control group. Moreover, either needle puncture or electro-acupuncture stimulation to Zhongfu and Tiantu significantly reverted the human neutrophil elastase-induced decrease in tracheal mucociliary transport velocity and human neutrophil elastase -induced increase in the contents of fucose and protein in the tracheal lavage, compared with the control group. Conclusion These results suggest that either needle puncture or electro-acupuncture stimulation to the effective acupoints significantly improves both airway mucociliary clearance and the airway surface liquid and that the improvements maybe ascribed to both the special function of the points and the substantial stimulation of electricity.

  5. Skin prick/puncture testing in North America: a call for standards and consistency

    OpenAIRE

    Fatteh, Shahnaz; Rekkerth, Donna J.; Hadley, James A

    2014-01-01

    Background Skin prick/puncture testing (SPT) is widely accepted as a safe, dependable, convenient, and cost-effective procedure to detect allergen-specific IgE sensitivity. It is, however, prone to influence by a variety of factors that may significantly alter test outcomes, affect the accuracy of diagnosis, and the effectiveness of subsequent immunotherapy regimens. Proficiency in SPT administration is a key variable that can be routinely measured and documented to improve the predictive val...

  6. A study to investigate needle insertion atShenshu (BL23) to puncture psoas major muscle

    Institute of Scientific and Technical Information of China (English)

    Kwan Leung Chia; Rainer Viktor Haberberger

    2016-01-01

    OBJECTIVE: It is unknown whether the psoas major muscle, thought to be a key muscle for treatment of lower back pain, can be punctured at Shenshu (BL23). METHODS: Twelve dissected specimens were used for studying the needling pathway of BL23 by perpendicularly inserting the depth-measuring blade of a vernier caliper at BL23. Dimensions of psoas muscle were measured. Correlation studies were conducted. In addition, our samples were grouped by gender and underlying medical conditions for analysis. RESULTS:Half (50%) of the needle insertions successfully punctured psoas muscle. The mean depth of needle insertion to puncture psoas muscle (Dmin) in the group with short-term underlying medical conditions was 38.0 mm (interquartile range 29.0–51.8 mm), approximately 6 mm deeper than 32.0 (29.3–42.5) mm in the group with long-term health problems (P = 0.041). The cross-sectional area (CSA) of psoas muscle in the former group was on average approximately 1.5 times that of the latter group (P = 0.04). When the data were analysed by gender, the thickness of psoas muscle in the male group was 19.0 (6.5–24.0) mm compared to 19.5 (5.8–34.8) mm in the female group (P = 0.02). The age in the female group (P = 0.04) and the body length of the total group (P = 0.04) negatively correlated to Dmin. CONCLUSION: Needle insertion at BL23 might be able to puncture psoas muscle. Differences in the CSA of psoas muscle and Dmin were observed in groups with short-term and long-term underlying medical conditions.

  7. Cerebral Hemodynamic Changes Induced by a Lumbar Puncture in Good-Grade Subarachnoid Hemorrhage

    OpenAIRE

    Schmidt, Eric A.; Stein Silva; Jean François Albucher; Aymeric Luzi; Isabelle Loubinoux; Anne Christine Januel; Christophe Cognard; Pierre Payoux; François Chollet

    2012-01-01

    Background Patients with good-grade subarachnoid hemorrhage (SAH) are those without initial neurological deficit. However, they can die or present severe deficit due to secondary insult leading to brain ischemia. After SAH, in a known context of energy crisis, vasospasm, hydrocephalus and intracranial hypertension contribute to unfavorable outcome. Lumbar puncture (LP) is sometimes performed in an attempt to reduce intracranial pressure (ICP) and release headaches. We hypothesize that in good...

  8. Direct US-guided puncture of the innominate veins for central venous access.

    Science.gov (United States)

    Lau, T N; Kinney, T B

    2001-05-01

    Maintenance of functioning venous access is recognized as the Achilles heel of long-term hemodialysis treatment. In patients who require catheter-directed hemodialysis, the internal jugular veins are recognized as the optimal veins for insertion of dialysis catheters. When these sites are no longer available, alternative venous access sites are required. The authors describe two hemodialysis patients with limited access sites in whom hemodialysis catheters were successfully inserted directly into the innominate veins with use of ultrasound-guided punctures.

  9. Direct percutaneous venous puncture and embolization of giant perimedullary arteriovenous fistulas.

    Science.gov (United States)

    Casasco, A; Guimaraens, L; Cuellar, H; Theron, J; Heredero, J

    2011-01-01

    PMAVFs are rare entities that are formed by a direct communication between an artery that feeds the spinal cord and a vein. The goal of treatment is to occlude the shunt; this is done endovascularly either from an arterial or a venous approach. When these approaches are not possible, direct percutaneous puncture of the draining veins may be attempted to embolize the arteriovenous shunt directly.

  10. DSA by means of fine-needle puncture for excluding vascular complications in haemodialysis shunts

    Energy Technology Data Exchange (ETDEWEB)

    Alart, I.P.; Merk, J.; Eichner, H.

    1985-06-01

    The article on hand presents the experience gained with examinations of Cimino haemodialysis shunts using digital substraction angiography (DSA). Angiographic results after arterial and venous fine-needle puncture show - particularly in arterial DSA - the advantage of excellent contrasting of the afferent arterial vessel, of the arterio-venous anastomosis and of the venous return while allowing safe diagnosis. This examination procedure is low in complications for the patient, is suitable for outpatients and has numerous advantages over transvenous shunt DSA.

  11. New puncture needle (Seldinger technique) for easy antegrade catheterization of the superficial femoral artery

    Energy Technology Data Exchange (ETDEWEB)

    Saltzmann, J.; Probst, P.

    1987-02-01

    Mainly for anatomical reasons a guide-wire or a catheter has a tendency to turn into the deep femoral artery during antegrade catheterization of the lower limb. To overcome this problem a curved puncture needle has been designed which allows positioning of the guide-wire in an anterior direction. Antegrade catheterization of the superficial femoral artery was achieved in 25 patients without lengthy manipulations or complications. With this technique the rate of complications at antegrade catheterization will probably be reduced.

  12. Thirty-six Cases of Infantile Proctoptosis Treated by Extremely Shallow Puncture

    Institute of Scientific and Technical Information of China (English)

    张曼

    2002-01-01

    @@ Proctoptosis, a disease of downward displacement of the anal canal, rectal mucosa, rectum or partial sigmoid colon, is known as prolapse of the rectum in TCM, which is frequently seen in the weak and thin babies or children of 2-4 years old. The author treated 36 cases of infantile proctoptosis by using extremely shallow puncture in the acupuncture techniques from Aug. 1995 to Dec. 1998 and obtained satisfactory results as reported in the following.

  13. Contact connections in electronic printing circuit, performed using the foil puncture method

    Directory of Open Access Journals (Sweden)

    Efimenko А. А.

    2010-08-01

    Full Text Available The results of theoretical and experimental researches of the unsoldered contact connections performed using the foil puncture method are demonstrated. The structural parameters of printing circuit boards and contacts of electronic components from positions of microminiatu-rization of electronic apparatus are determined. The contact connections are tested on climatic and mechanical factors influence, and the durability of contacts of electronic components is measured for ensuring of their pressing.

  14. Microneedle-based minimally-invasive measurement of puncture resistance and fracture toughness of sclera.

    Science.gov (United States)

    Park, Seung Hyun; Lee, Kang Ju; Lee, JiYong; Yoon, Jae Hyoung; Jo, Dong Hyun; Kim, Jeong Hun; Kang, Keonwook; Ryu, WonHyoung

    2016-10-15

    The sclera provides the structural support of the eye and protects the intraocular contents. Since it covers a large portion of the eye surface and has relatively high permeability for most drugs, the sclera has been used as a major pathway for drug administration. Recently, microneedle (MN) technology has shown the possibility of highly local and minimally-invasive drug delivery to the eye by MN insertion through the sclera or the suprachoroidal space. Although ocular MN needs to be inserted through the sclera, there has been no systematic study to understand the mechanical properties of the sclera, which are important to design ocular MNs. In this study, we investigated a MN-based method to measure the puncture resistance and fracture toughness of the sclera. To reflect the conditions of MN insertion into the sclera, force-displacement curves obtained from MN-insertion tests were used to estimate the puncture resistance and fracture toughness of sclera tissue. To understand the effect of the insertion conditions, dependency of the mechanical properties on insertion speeds, pre-strain of the sclera, and MN sizes were analyzed and discussed. Measurement of mechanical property of soft biological tissue is challenging due to variations between tissue samples or lack of well-defined measurement techniques. Although non-invasive measurement techniques such as nano/micro indentation were employed to locally measure the elastic modulus of soft biological materials, mechanical properties such as puncture resistance or fracture toughness, which requires "invasive" measurement and is important for the application of "microneedles or hypodermic needles", has not been well studied. In this work, we report minimally-invasive measurement of puncture resistance and fracture toughness of sclera using a double MN insertion method. Parametric studies showed that use of MN proved to be advantageous because of minimally-invasive insertion into tissue as well as higher sensitivity to

  15. Existence Result for a Class of Nonlinear Elliptic Systems on Punctured Unbounded Domains

    Directory of Open Access Journals (Sweden)

    Fabrice Colin

    2010-01-01

    Full Text Available We establish the existence of a nontrivial solution for systems with an arbitrary number of coupled Poisson equations with critical growth in punctured unbounded domains. The proof depends on a generalized linking theorem due to Krysewski and Szulkin, and on a concentration-compactness argument, proved by Frigon and the author. Applications to reaction-diffusion systems with skew gradient structure are also discussed in the last section.

  16. Direct Needle Puncture and Embolization of Splenic Artery Pseudoaneurysm in Case of Chronic Atrophic Calcific Pancreatitis

    Science.gov (United States)

    Shrivastava, Amit; Rampal, Jagadeesh Singh; Reddy, D. Nageshwar; Rao, Guduru Venkat

    2016-01-01

    Summary Background Gastro-Intestinal bleeding remains a frequent clinical dilemma and common cause of hospitalization, morbidity and mortality. Case Report We report a case of pseudo aneurysm of splenic artery developed after an episode of acute on chronic pancreatitis which was treated by direct percutaneous puncture of pseudoaneurysm and embolization by coils. Conclusions The aim was to preserve the main splenic artery and avoid the complications of splenic artery embolization like infarcts and abscess. PMID:27757174

  17. Effect of cryotherapy on arteriovenous fistula puncture-related pain in hemodialysis patients

    OpenAIRE

    P. B., Sabitha; Khakha, D. C.; Mahajan, S.; Gupta, S; M. Agarwal; Yadav, S. L.

    2008-01-01

    Pain during areteriovenous fistula (AVF) cannulation remains a common problem in hemodialysis (HD) patients. This study was undertaken to assess the effect of cryotherapy on pain due to arteriovenous fistula puncture in hemodialysis patients. A convenience sample of 60 patients (30 each in experimental and control groups) who were undergoing hemodialysis by using AVF, was assessed in a randomized control trial. Hemodialysis patients who met the inclusion criteria, were randomly assigned to ex...

  18. [Complications after the use of a StarClose® vascular closure device for femoral punctures].

    Science.gov (United States)

    Quintana Martínez, I; Guillén Subirán, M E; Zaragozano Guillén, R; Hilario González, J

    2014-01-01

    The StarClose(®) arterial device (Abbot Vascular Devices, Abbot Laboratories, Redwood City, CA, USA) rapidly seals a femoral artery puncture by means of a nitinol clip in the adventitia of the artery. It is a safe and effective device, with advantages as regards manual compression, but is not free of complications. We present two cases with complications after using a StarClose(®) vascular device.

  19. Acid aspiration-induced airways hyperresponsiveness in mice.

    Science.gov (United States)

    Allen, Gilman B; Leclair, Timothy R; von Reyn, Jessica; Larrabee, Yuna C; Cloutier, Mary E; Irvin, Charles G; Bates, Jason H T

    2009-12-01

    The role of gastroesophageal reflux and micro-aspiration as a trigger of airways hyperresponsiveness (AHR) in patients with asthma is controversial. The role of acid reflux and aspiration as a direct cause of AHR in normal subjects is also unclear. We speculated that aspiration of a weak acid with a pH (1.8) equivalent to the upper range of typical gastric contents would lead to AHR in naive mice. We further speculated that modest reductions in aspirate acidity to a level expected during gastric acid suppression therapy (pH 4.0) would impede aspiration-induced AHR. BALB/c female mice were briefly anesthetized with isoflurane and allowed to aspirate 75 microl of saline with HCl (pH 1.8, 4.0, or 7.4) or underwent sham aspiration. Mice were re-anesthetized 2 or 24 h later, underwent tracheostomy, and were coupled to a mechanical ventilator. Forced oscillations were used to periodically measure respiratory impedance (Zrs) following aerosol delivery of saline and increasing doses of methacholine to measure for AHR. Values for elastance (H), airways resistance (R(N)), and tissue damping (G) were derived from Zrs. Aspirate pH of 1.8 led to a significant overall increase in peak R(N), G, and H compared with pH 4.0 and 7.4 at 2 and 24 h. Differences between pH 7.4 and 4.0 were not significant. In mice aspirating pH 1.8 compared with controls, airway lavage fluid contained more neutrophils, higher protein, and demonstrated higher permeability. We conclude that acid aspiration triggers an acute AHR, driven principally by breakdown of epithelial barrier integrity within the airways.

  20. A practical, covariant puncture for second-order self-force calculations

    CERN Document Server

    Pound, Adam

    2014-01-01

    Accurately modeling an extreme-mass-ratio inspiral requires knowledge of the second-order gravitational self-force on the inspiraling small object. Recently, numerical puncture schemes have been formulated to calculate this force, and their essential analytical ingredients have been derived from first principles. However, the \\emph{puncture}, a local representation of the small object's self-field, in each of these schemes has been presented only in a local coordinate system centered on the small object, while a numerical implementation will require the puncture in coordinates covering the entire numerical domain. In this paper we provide an explicit covariant self-field as a local expansion in terms of Synge's world function. The self-field is written in the Lorenz gauge, in an arbitrary vacuum background, and in forms suitable for both self-consistent and Gralla-Wald-type representations of the object's trajectory. We illustrate the local expansion's utility by sketching the procedure of constructing from i...

  1. Experimental and Modeling Studies of Crush, Puncture, and Perforation Scenarios in the Steven Impact Test

    Energy Technology Data Exchange (ETDEWEB)

    Vandersall, K S; Chidester, S K; Forbes, J W; Garcia, F; Greenwood, D W; Switzer, L L; Tarver, C M

    2002-06-28

    The Steven test and associated modeling has greatly increased the fundamental knowledge of practical predictions of impact safety hazards for confined and unconfined explosive charges. Building on a database of initial work, experimental and modeling studies of crush, puncture, and perforation scenarios were investigated using the Steven impact test. The descriptions of crush, puncture, and perforation arose from safety scenarios represented by projectile designs that ''crush'' the energetic material or either ''puncture'' with a pinpoint nose or ''perforate'' the front cover with a transportation hook. As desired, these scenarios offer different aspects of the known mechanisms that control ignition: friction, shear and strain. Studies of aged and previously damaged HMX-based high explosives included the use of embedded carbon foil and carbon resistor gauges, high-speed cameras, and blast wave gauges to determine the pressure histories, time required for an explosive reaction, and the relative violence of those reactions, respectively. Various ignition processes were modeled as the initial reaction rate expression in the Ignition and Growth reaction rate equations. Good agreement with measured threshold velocities, pressure histories, and times to reaction was calculated for LX-04 impacted by several projectile geometries using a compression dependent ignition term and an elastic-plastic model with a reasonable yield strength for impact strain rates.

  2. A-scan ultrasound system for real-time puncture safety assessment during percutaneous nephrolithotomy

    Science.gov (United States)

    Rodrigues, Pedro L.; Rodrigues, Nuno F.; Fonseca, Jaime C.; von Krüger, M. A.; Pereira, W. C. A.; Vilaça, João. L.

    2015-03-01

    Background: Kidney stone is a major universal health problem, affecting 10% of the population worldwide. Percutaneous nephrolithotomy is a first-line and established procedure for disintegration and removal of renal stones. Its surgical success depends on the precise needle puncture of renal calyces, which remains the most challenging task for surgeons. This work describes and tests a new ultrasound based system to alert the surgeon when undesirable anatomical structures are in between the puncture path defined through a tracked needle. Methods: Two circular ultrasound transducers were built with a single 3.3-MHz piezoelectric ceramic PZT SN8, 25.4 mm of radius and resin-epoxy matching and backing layers. One matching layer was designed with a concave curvature to work as an acoustic lens with long focusing. The A-scan signals were filtered and processed to automatically detect reflected echoes. Results: The transducers were mapped in water tank and tested in a study involving 45 phantoms. Each phantom mimics different needle insertion trajectories with a percutaneous path length between 80 and 150 mm. Results showed that the beam cross-sectional area oscillates around the ceramics radius and it was possible to automatically detect echo signals in phantoms with length higher than 80 mm. Conclusions: This new solution may alert the surgeon about anatomical tissues changes during needle insertion, which may decrease the need of X-Ray radiation exposure and ultrasound image evaluation during percutaneous puncture.

  3. Efficacy of the Valsalva Maneuver on Needle Projection Pain and Hemodynamic Responses During Spinal Puncture

    Directory of Open Access Journals (Sweden)

    Sussan Soltani Mohammadi, Amin Ghasemi Pajand, Gita Shoeibi

    2011-01-01

    Full Text Available This study evaluated the efficacy of the valsalva maneuver that can induce baroreceptor activation and nociception, on needle projection pain and hemodynamic responses associated with spinal puncture. Ninety adults, ASA physical status I and II undergoing elective surgeries were included. Patients were randomized into three equal groups. Group I (C: control; Group II (B: ball; pressed a rubber ball (attention-diverting method; Group III (V: valsalva; blew into sphygmomanometer tubing and hold the mercury column up to 30 mm Hg for a period of at least 20s. Spinal needle projection pain was graded using numeric rating scale (NRS: 1-10, where scales of 1-3 were rated as mild, 4-6 as moderate, and > 6 as severe. Blood pressure and heart rate, five minutes before the procedure, during the spinal puncture and first and third minutes after that, were also recorded. Significant reduction in NRS was observed in the valsalva group compared with the control and the ball groups (p=0.001. There were statistical but no significant clinical differences in mean arterial blood pressure and heart rates between the study groups (P=0.008 and P=0.016 respectively. In conclusion valsalva maneuver can decrease the skin puncture pain associated with spinal needle projection while observing hemodynamic changes.

  4. Persistent post-dural-puncture headache treated with epidural infusion of dextran.

    Science.gov (United States)

    Aldrete, J A

    1994-05-01

    A retrospective review was done on medical records of 13 patients with persistent post-dural-puncture headaches after one or more epidural blood patches. Headache occurred in nine patients with post-laminectomy syndrome after "wet taps" while performing epidural blocks. In two patients post-dural-puncture headache appeared after long term implanted intrathecal catheters were removed. In two other cases headache developed after spinal anesthesia. Treatment included bed rest, intravenous hydration and at least one epidural blood patch; three patients were given 60 milliliters of epidural saline, without success. Eight epidural catheters were inserted through the lumbar access and five through the caudal approach. Initially, a bolus of 20 milliliters of dextran-40 was given followed by an infusion of 3 mL/hr, until 12 hours after the head pain and any other related symptoms subsided. In all patients the headache disappeared within 20 hours after initiating therapy (9.55 mean hours, SD +/- 0.79). In five patients headache ceased in less than five hours. Nausea and photo-phobia subsided earlier. Patients with post-dural-puncture headache resistant to other treatments, including at least one epidural blood patch, were successfully treated by a bolus followed by continuous epidural infusion of dextran-40.

  5. Correlation of Descriptive Analysis and Instrumental Puncture Testing of Watermelon Cultivars.

    Science.gov (United States)

    Shiu, J W; Slaughter, D C; Boyden, L E; Barrett, D M

    2016-06-01

    The textural properties of 5 seedless watermelon cultivars were assessed by descriptive analysis and the standard puncture test using a hollow probe with increased shearing properties. The use of descriptive analysis methodology was an effective means of quantifying watermelon sensory texture profiles for characterizing specific cultivars' characteristics. Of the 10 cultivars screened, 71% of the variation in the sensory attributes was measured using the 1st 2 principal components. Pairwise correlation of the hollow puncture probe and sensory parameters determined that initial slope, maximum force, and work after maximum force measurements all correlated well to the sensory attributes crisp and firm. These findings confirm that maximum force correlates well with not only firmness in watermelon, but crispness as well. The initial slope parameter also captures the sensory crispness of watermelon, but is not as practical to measure in the field as maximum force. The work after maximum force parameter is thought to reflect cellular arrangement and membrane integrity that in turn impact sensory firmness and crispness. Watermelon cultivar types were correctly predicted by puncture test measurements in heart tissue 87% of the time, although descriptive analysis was correct 54% of the time.

  6. [Learning vein puncture using digital educational material in a Nursing Undergraduate Course].

    Science.gov (United States)

    da Silva, Ana Paula Scheffer Schell; Cogo, Ana Luisa Petersen

    2007-06-01

    This exploratory descriptive study aimed at assessing the performance of undergraduate students in the fourth year of the Nursing course to carry out a vein puncture technique with the support of three digital educational materials--hypertext, educational games, and simulations. The sample consisted of 37 students, who had studied the digital material in an IT laboratory and had carried out the procedure of peripheral vein puncture in training laboratory. Ten stages considered essential for the accomplishment of the procedure were observed, and an assessment form of the educational materials was analyzed. Thirty three (89.19%) subjects had never done vein puncture, and 27 (72.97%) correctly performed five or more stages of the procedure. As to visualizing and saving the educational materials in the computer, 12 (32.44%) and 15 (40.54%) students, respectively, said to have had some kind of difficulty. According to 91.90% of the students, the material aided their learning process, which demonstrates this learning tool can be explored and more frequently used.

  7. A Reinvestigation of Moving Punctured Black Holes with a New Code

    CERN Document Server

    Cao, Zhoujian; Yu, Jui-Ping

    2008-01-01

    We report on our code, in which the moving puncture method is applied and an adaptive/fixed mesh refinement is implemented, and on its preliminary performance on black hole simulations. Based on the BSSN formulation, up-to-date gauge conditions and the modifications of the formulation are also implemented and tested. In this work we present our primary results about the simulation of a single static black hole, of a moving single black hole, and of the head-on collision of a binary black hole system. For the static punctured black hole simulations, different modifications of the BSSN formulation are applied. It is demonstrated that both the currently used sets of modifications lead to a stable evolution. For cases of a moving punctured black hole with or without spin, we search for viable gauge conditions and study the effect of spin on the black hole evolution. Our results confirm previous results obtained by other research groups. In addition, we find a new gauge condition, which has not yet been adopted by...

  8. Lumbar puncture for suspected meningitis after intensive care unit admission is likely to change management.

    Science.gov (United States)

    Khasawneh, Faisal A; Smalligan, Roger D; Mohamad, Tammam N; Moughrabieh, Mohamad K; Soubani, Ayman O

    2011-02-01

    The aim of this study was to determine the outcome of lumbar punctures (LPs) in critically ill medical patients and how likely the results were to change case management. A retrospective review was conducted on the medical records of all 168 patients who underwent LP during their medical intensive care unit (MICU) admission at a university hospital during a 4.5-year period beginning in January 2000. Lumbar puncture was performed a mean of 2.8 days after MICU admission. The most common symptoms that prompted LP were changes in mental status and fever. Seventy-four percent of patients were on antibiotics at the time of LP, and 98% of patients had a computed tomography scan of the head performed before the procedure. Lumbar puncture confirmed meningitis in 47 (30%) patients and provided a specific bacteriologic diagnosis in 5 (3%) patients. The results of the procedure led to a change in management in 50 (30%) patients. The presence of meningeal signs and use of antibiotics at the time of the procedure were the factors that predicted change in management. Although the likelihood that LP will yield a specific bacteriologic diagnosis in critically ill patients is low, the procedure frequently provides important information that can lead to a change in case management, most commonly de-escalation of antibiotic therapy.

  9. Clinical observation of Ahmed glaucoma valve implantation for refractory glaucoma by directly puncturing the sclerotic tunnel

    Directory of Open Access Journals (Sweden)

    Zhi-Ke Xu

    2015-02-01

    Full Text Available AIM: To observe the clinic effects and complication of Ahmed glaucoma valve(AGVimplantation in refractory glaucoma by using the 23G syringe needle direct puncture the sclerotic tunnel.METHODS: Forty-four cases(44 eyesof refractory glaucoma underwent AGV implantation by useing the 23G syringe needle direct puncture the sclerotic tunnel. The intraocular pressure(IOP, visual acuity, and complication of post-operation were contrasted with those of pre-operation. RESULTS:The success rate was 84.1%, the mean preoperative IOP in research group was 52.1±10.1mmHg, and the last follow up mean IOP was 15.6±6.9mmHg. Compared with the preoperative visual acuity, 11 eyes increased, 27 eyes had no changes and 6 eyes decreased. The main post-operative complications included shallow anterior chamber(4 eyes, choroidal detachment(3 eyes, drainage tube shift(1 eye, hyphema(6 eyes, drainage tube blockage(1 eye, expulsive choroidal hemorrhage(1 eye, and fiber wrap of drainage tray(5 eyes.CONCLUSION: AGV implantation by direct puncture the sclerotic tunnel is feasible and easy. It avoids of making sclerotic petal and the xenogenic sclera transplanting, simplified the operation technique, prevent the leakage of around tube. The shallow anterior chamber rate is lower. It is an effective procedure for refractory glaucoma.

  10. EVALUATION ON THE THERAPEUTIC EFFECT OF DEEP PUNCTURE OF TIANSHU (ST 25) FOR SLOW TRANSIT CONSTIPATION

    Institute of Scientific and Technical Information of China (English)

    ZHANG Wei; LIU Zhi-shun; GUO Jun

    2005-01-01

    Objective: To evaluate the short-term and middle-long-term therapeutic effects of deep puncture of Tianshu (天枢ST 25) for slow transit constipation (STC). Methods: Sixty cases of STC patients were evenly randomized into acupuncture group and medication group. In acupuncture group, electroacupuncture (EA, 20 Hz, continuous waves and tolerable strength) was applied to bilateral Tianshu (ST 25) for 30 min after deep puncture. The treatment was given once daily, 5 sessions every week, two weeks altogether. Patients of control group were ordered to take Lactulose (10 mL/time, b.i.d), two weeks altogether. Cleveland Constipation Score (CCS) and colonic transit time (CCT) were used to evaluate the therapeutic effect. Results: After treatment, both CCS and CCT showed that the therapeutic effect of acupuncture group was significantly superior to that of medication group (P<0.05). Six-months' follow up showed that the therapeutic effect of acupuncture still maintained in 13 of the 22 cases visited, while that of control group only maintained in 1 of the 19 cases. Conclusion: The therapeutic effect of deep puncture of Tianshu (ST 25) for STC is definite and has a middle-long-term effect. The patients have no any unfavorable reactions.

  11. Foreign body aspiration masquerading as difficult asthma

    Directory of Open Access Journals (Sweden)

    Rai S

    2007-01-01

    Full Text Available It is important to assess patients of difficult/therapy resistant asthma carefully in order to identify whether there are any correctable factors that may contribute to their poor control. It is critical to make a diagnosis of asthma and to exclude other airway diseases. A 65-years-old lady presented with repeated acute episodes of dyspnoea and wheezing. She was on regular medication for bronchial asthma for 18 years. There was no history of foreign body aspiration or loss of consciousness. Her chest radiograph was normal. She showed poor response to corticosteroids and bronchodilators. Fibreoptic bronchoscopy (FOB showed intracordal cyst of the left vocal cord and 1cm size irregular piece of betel nut in right main bronchus, which was removed endoscopically with the help of dormia basket, following which her condition improved and asthma was controlled on inhaled bronchodilators.

  12. Religiosity and Migration Aspirations among Mexican Youth

    Science.gov (United States)

    Marsiglia, Flavio Francisco; Ayers, Stephanie L.

    2014-01-01

    International migration has become an important topic of discussion from a policy and humanitarian perspective. Part of the debate includes a renewed interest in understanding the factors that influence decisions about migration to the US among Mexican youth still residing in their country of origin. The purpose of this study was to advance knowledge specifically about internal and external religiosity and their influence on youths' migration aspirations. The data for this study were collected in 2007 from students enrolled in an alternative high school program located in the state of Guanajuato, Mexico. The findings indicated that as external religiosity increases, the desire to work or live in the USA decreases. Furthermore, as internal religiosity increases, the desire to work or live in the USA and plans to migrate increase. The results are interpreted and discussed in light of previous research on religious and cultural norm adherence. PMID:25663825

  13. [Fine needle aspiration cytology of mammography screening

    DEFF Research Database (Denmark)

    Engvad, B.; Laenkholm, A.V.; Schwartz, Thue W.

    2009-01-01

    INTRODUCTION: In the year 2000 a quality assurance programme for the preoperative breast diagnostics was introduced in Denmark. The programme was based on the "European guidelines for quality assurance in breast cancer screening and diagnosis" where - among other measures - five cytological...... diagnostic classes were introduced. The aim of this study was to evaluate the quality assurance programme in a screening population to determine whether fine needle aspiration cytology (FNAC) as first choice remains a useful tool in the preoperative diagnostics, or if needle core biopsy should be the first...... of 66% of the 783 FNACs had a malignant cytology diagnosis, which in 99% of the cases turned out to be the correct diagnosis. Four lesions were false positives all of which represented benign proliferative breast diseases. The surgical procedures in these cases were either excisional biopsy...

  14. Direct carotid artery puncture access for endovascular treatment of acute ischemic stroke: technical aspects, advantages, and limitations.

    Science.gov (United States)

    Mokin, Maxim; Snyder, Kenneth V; Levy, Elad I; Hopkins, L Nelson; Siddiqui, Adnan H

    2015-02-01

    Challenging anatomy for carotid artery access can result in a delay to achieve successful recanalization in patients with acute ischemic stroke. Our objective was to study emergent direct percutaneous carotid artery puncture as an alternative access approach for acute endovascular stroke interventions. We reviewed cases of acute ischemic stroke in which direct carotid artery puncture was used for access. We also reviewed current literature relevant to this subject. We describe the technical aspects, limits, and potential complications associated with direct carotid artery puncture for intracranial acute ischemic stroke interventions, and present cases to illustrate the utility of this access approach. Direct carotid artery puncture is a feasible alternative to transfemoral artery access in cases of stroke with difficult anatomy, including unfavorable arch type, carotid tortuosity, or an ostial lesion. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Transbronchial needle aspiration "by the books"

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    Kupeli Elif

    2011-01-01

    Full Text Available Background : Training for advanced bronchoscopic procedures is acquired during the interventional pulmonology (IP Fellowship. Unfortunately a number of such programs are small, limiting dissemination of formal training. Objective : We studied success of conventional transbronchial needle aspiration (C-TBNA in the hands of physicians without formal IP training. Methods : A technique of C-TBNA was learned solely from the literature, videos and practicing on inanimate models at "Hands-On" courses. Conventional TBNA with 21 and/or 19 gauge Smooth Shot Needles (Olympus® , Japan was performed on consecutive patients with undiagnosed mediastinal lymphadenopathy. Results : Thirty-four patients (male 23, mean age 54.9 ± 11.8 years underwent C-TBNA. Twenty-two patients had nodes larger than 20 mms. Suspected diagnoses were malignancy in 20 and nonmalignant conditions in 14. Final diagnoses were malignancy 17, sarcoidosis 4, reactive lymph nodes 12, and tuberculosis 1. Final diagnosis was established by C-TBNA in 14 (11 malignancy, 3 sarcoidosis; yield 41.1%, mediastinoscopy in 14, transthoracic needle aspiration in 3, peripheral lymph node biopsies in 2 and by endobronchial biopsy in 1. Nodal size had an impact on outcome (P = 0.000 while location did not (P = 0.33. C-TBNA was positive in 11/20 when malignancy was suspected (yield 55%, while 3/14 when benign diagnosis was suspected (yield 21.4% (P = 0.05. Sensitivity, specificity, PPV, NPV, and diagnostic accuracy were 66.6%, 100%, 100%, 65%, and 79.4%, respectively. There were no complications or scope damage. Conclusion : Conventional-TBNA can be learned by the books and by practicing on inanimate models without formal training and results similar to those published in the literature could be achieved.

  16. Small-Volume Injections: Evaluation of Volume Administration Deviation From Intended Injection Volumes.

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    Muffly, Matthew K; Chen, Michael I; Claure, Rebecca E; Drover, David R; Efron, Bradley; Fitch, William L; Hammer, Gregory B

    2017-10-01

    In the perioperative period, anesthesiologists and postanesthesia care unit (PACU) nurses routinely prepare and administer small-volume IV injections, yet the accuracy of delivered medication volumes in this setting has not been described. In this ex vivo study, we sought to characterize the degree to which small-volume injections (≤0.5 mL) deviated from the intended injection volumes among a group of pediatric anesthesiologists and pediatric postanesthesia care unit (PACU) nurses. We hypothesized that as the intended injection volumes decreased, the deviation from those intended injection volumes would increase. Ten attending pediatric anesthesiologists and 10 pediatric PACU nurses each performed a series of 10 injections into a simulated patient IV setup. Practitioners used separate 1-mL tuberculin syringes with removable 18-gauge needles (Becton-Dickinson & Company, Franklin Lakes, NJ) to aspirate 5 different volumes (0.025, 0.05, 0.1, 0.25, and 0.5 mL) of 0.25 mM Lucifer Yellow (LY) fluorescent dye constituted in saline (Sigma Aldrich, St. Louis, MO) from a rubber-stoppered vial. Each participant then injected the specified volume of LY fluorescent dye via a 3-way stopcock into IV tubing with free-flowing 0.9% sodium chloride (10 mL/min). The injected volume of LY fluorescent dye and 0.9% sodium chloride then drained into a collection vial for laboratory analysis. Microplate fluorescence wavelength detection (Infinite M1000; Tecan, Mannedorf, Switzerland) was used to measure the fluorescence of the collected fluid. Administered injection volumes were calculated based on the fluorescence of the collected fluid using a calibration curve of known LY volumes and associated fluorescence.To determine whether deviation of the administered volumes from the intended injection volumes increased at lower injection volumes, we compared the proportional injection volume error (loge [administered volume/intended volume]) for each of the 5 injection volumes using a linear

  17. Successful lumbar puncture with Taylor′s approach for the diagnostic workup of meningitis in a patient with Ankylosing spondylitis

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    Gentle Sunder Shrestha

    2015-01-01

    Full Text Available Meningitis and encephalitis are the neurological emergencies. As the clinical findings lack specificity, once suspected, cerebrospinal fluid (CSF analysis should be performed and parenteral antimicrobials should be administered without delay. Lumbar puncture can be technically challenging in patients with ankylosing spondylitis due to ossification of ligaments and obliteration of interspinous spaces. Here, we present a case of ankylosing spondylitis where attempts for lumbar puncture by conventional approach failed. CSF sample was successfully obtained by Taylor′s approach.

  18. A technique for ultrasound-guided blood sampling from a dry and gel-free puncture area.

    Science.gov (United States)

    Thorn, Sofie; Gopalasingam, Nigopan; Bendtsen, Thomas Fichtner; Knudsen, Lars; Sloth, Erik

    2016-05-07

    Vein punctures are performed daily to sample blood. Ultrasound (US) offers an alternative to the blind landmark technique for difficult vascular access. A challenge for this procedure is the presence of US gel in the puncture area. We present a technique for US-guided puncture from extremity veins not palpable or visible to the human eye, while keeping the puncture area dry and gel-free. Ten healthy volunteers underwent two US-guided vein punctures from veins that were neither palpable nor visible. One was drawn from an antebrachial vein and another from a brachial vein. A sterile barrier drape was made from a commercially available dressing and a piece of transparent sterile plastic. The barrier drape consists of an adhesive part placed on the skin designed for sonography and a free transparent flap constituting the barrier between the unsterile sonographic site and the sterile gel-free puncture site. The success rate for vein puncture was 100% in both locations. A total of 22 skin punctures were performed (11 antebrachial and 11 brachial). Gain output was increased 7% (4-12%), and 8% (4-15%), respectively, to compensate for attenuation of the US signal due to the drape. Alignment of the centre of the transducer with the long-axis of the target vein during the procedure was reported as a challenge. US-guided blood sampling from a brachial and antebrachial vein was possible with a 100% success rate, while ensuring a dry and gel-free venipuncture area on one side and the transducer on the other side of a sterile barrier.

  19. Cerebral venous and sinus thrombosis with cerebrospinal fluid circulation block after the first methotrexate administration by lumbar puncture

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    Bienfait, H.P. [Gelre Hospital, location Lukas, Apeldoorn, Department of Neurology, Albert Schweitzerlaan 31, PO Box 9014, 7300 DS Apeldoorn (Netherlands); Department of Neuro-Oncology, Daniel den Hoed Kliniek, Academisch Ziekenhuis Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands); Gijtenbeek, J.M.M. [Department of Neuro-Oncology, Daniel den Hoed Kliniek, Academisch Ziekenhuis Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands); Department of Neurology, University Medical Center Nijmegen, St Radboud, Postlaan 4, 6525 GC Nijmegen (Netherlands); Bent, M.J. van [Department of Neuro-Oncology, Daniel den Hoed Kliniek, Academisch Ziekenhuis Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands); Bruin, H.G. de [Department of Radiology, Daniel den Hoed Kliniek, Academisch Ziekenhuis Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands); Voogt, P.J. [Department of Hematology, Daniel den Hoed Kliniek, Academisch Ziekenhuis Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands); Pillay, M. [Department of Nuclear Medicine, Daniel den Hoed Kliniek, Academisch Ziekenhuis Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands)

    2002-11-01

    We report a patient treated for small lymphocytic lymphoma/leukemia with cerebral venous and sinus thrombosis (CVST) after lumbar puncture with intrathecal administration of methotrexate (MTX). He also developed a cerebrospinal fluid flow block. This is the first report of an association between lumbar puncture and intrathecally administered MTX and the development of CVST. Intrathecal treatment in this patient was discontinued and he was successfully treated with high-dose low-molecular-weight heparin subcutaneously. (orig.)

  20. Effectiveness of combined laser-puncture and conventional wound care to accelerate diabetic foot ulcer healing

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    Adiningsih Srilestari

    2017-05-01

    Full Text Available Background: Impaired wound healing is a common complication of diabetes. It has complex pathophysiologic mechanisms and often necessitates amputation. Our study aimed to evaluate the effectiveness of combined laser-puncture and conventional wound care in the treatment of diabetic foot ulcers.Methods: This was a double-blind controlled randomized clinical trial on 36 patients, conducted at the Metabolic Endocrine Outpatient Clinic, Cipto Mangunkusumo Hospital, Jakarta, between May and August 2015. Stimulation by laser-puncture (the treatment group or sham stimulation (the control group were performed on top of the standard wound care. Laser-puncture or sham were done on several acupuncture points i.e. LI4 Hegu, ST36 Zusanli, SP6 Sanyinjiao and KI3 Taixi bilaterally, combined with irradiation on the ulcers itself twice a week for four weeks. The mean reduction in ulcer sizes (week 2–1, week 3–1, week 4–1 were measured every week and compared between the two groups and analyzed by Mann-Whitney test.Results: The initial median ulcer size were 4.75 (0.10–9.94 cm2 and 2.33 (0.90–9.88 cm2 in laser-puncture and sham groups, respectively (p=0.027. The median reduction of ulcer size at week 2–1 was -1.079 (-3.25 to -0.09 vs -0.36 (-0.81 to -1.47 cm2, (p=0.000; at week 3–1 was -1.70 (-3.15 to -0.01 vs -0.36 (-0.80 to -0.28 cm2, (p=0.000; and at week 4–1 was -1.22 (-2.72 to 0.00 vs -0.38 (-0.74 to -0.57 cm2, (p=0.012.Conclusion: Combined laser-puncture and conventional wound care treatment are effective in accelerating the healing of diabetic foot ulcer.

  1. A Kinect(™) camera based navigation system for percutaneous abdominal puncture.

    Science.gov (United States)

    Xiao, Deqiang; Luo, Huoling; Jia, Fucang; Zhang, Yanfang; Li, Yong; Guo, Xuejun; Cai, Wei; Fang, Chihua; Fan, Yingfang; Zheng, Huimin; Hu, Qingmao

    2016-08-07

    Percutaneous abdominal puncture is a popular interventional method for the management of abdominal tumors. Image-guided puncture can help interventional radiologists improve targeting accuracy. The second generation of Kinect(™) was released recently, we developed an optical navigation system to investigate its feasibility for guiding percutaneous abdominal puncture, and compare its performance on needle insertion guidance with that of the first-generation Kinect(™). For physical-to-image registration in this system, two surfaces extracted from preoperative CT and intraoperative Kinect(™) depth images were matched using an iterative closest point (ICP) algorithm. A 2D shape image-based correspondence searching algorithm was proposed for generating a close initial position before ICP matching. Evaluation experiments were conducted on an abdominal phantom and six beagles in vivo. For phantom study, a two-factor experiment was designed to evaluate the effect of the operator's skill and trajectory on target positioning error (TPE). A total of 36 needle punctures were tested on a Kinect(™) for Windows version 2 (Kinect(™) V2). The target registration error (TRE), user error, and TPE are 4.26  ±  1.94 mm, 2.92  ±  1.67 mm, and 5.23  ±  2.29 mm, respectively. No statistically significant differences in TPE regarding operator's skill and trajectory are observed. Additionally, a Kinect(™) for Windows version 1 (Kinect(™) V1) was tested with 12 insertions, and the TRE evaluated with the Kinect(™) V1 is statistically significantly larger than that with the Kinect(™) V2. For the animal experiment, fifteen artificial liver tumors were inserted guided by the navigation system. The TPE was evaluated as 6.40  ±  2.72 mm, and its lateral and longitudinal component were 4.30  ±  2.51 mm and 3.80  ±  3.11 mm, respectively. This study demonstrates that the navigation accuracy of the proposed system is

  2. Acute kidney injury and inflammatory response of sepsis following cecal ligation and puncture in d-galactose-induced aging rats.

    Science.gov (United States)

    Liu, Chao; Hu, Jie; Mao, Zhi; Kang, Hongjun; Liu, Hui; Fu, Wanlei; Lv, Yangfan; Zhou, Feihu

    2017-01-01

    Recently, the d-galactose (d-gal)-induced mimetic aging rat model has been widely used in studies of age-associated diseases, which have shown that chronic d-gal exposure induces premature aging similar to natural aging in rats. With the increasing rate of sepsis in the geriatric population, an easy-access animal model for preclinical studies of elderly sepsis is urgently needed. This study investigates whether a sepsis model that is established in d-gal-induced aging rats can serve as a suitable model for preclinical studies of elderly patients with sepsis. To investigate the acute kidney injury (AKI) and inflammatory response of sepsis following cecal ligation and puncture (CLP) in d-gal-induced aging rats. Twelve-week-old male Sprague Dawley rats were divided into low-dose d-gal (L d-gal, 125 mg/kg/d), high-dose d-gal (H d-gal, 500 mg/kg/d), and control groups. After daily subcutaneous injection of d-gal for 6 weeks, the CLP method was used to establish a sepsis model. The mortality was 73.3%, 40%, and 33.3% in the H d-gal, L d-gal, and control groups, respectively. Blood urea nitrogen, creatinine, plasma neutrophil gelatinase-associated lipocalin, interleukin-6, interleukin-10, and tumor necrosis factor-α were markedly increased in the H d-gal group after establishment of the sepsis model (H d-gal vs control, Paging rats are more likely to die from sepsis than are young rats, and probably this is associated with increased severity of septic AKI and an increased inflammatory response. Therefore, use of the high-dose- d-gal-induced aging rat model of sepsis for preclinical studies can provide more useful information for the treatment of sepsis in elderly patients.

  3. Assessment of Factors Affecting the Usefulness and Diagnostic Yield of Core Biopsy Needles with a Side Hole in Endoscopic Ultrasound-Guided Fine-Needle Aspiration.

    Science.gov (United States)

    Inoue, Tadahisa; Okumura, Fumihiro; Mizushima, Takashi; Nishie, Hirotada; Iwasaki, Hiroyasu; Anbe, Kaiki; Ozeki, Takanori; Kachi, Kenta; Fukusada, Shigeki; Suzuki, Yuta; Sano, Hitoshi

    2016-01-01

    A barbed puncture needle with a side hole was recently developed to improve sample quality and quantity in endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). In this study, we retrospectively assessed the usefulness of this puncture needle. Factors affecting diagnostic yield, safety, and diagnostic accuracy were investigated in 76 patients who consecutively underwent EUS-FNA for neoplastic lesions at our hospital between January and December 2013. The procedure was successful in all cases; the rates of sample collection and determination of the correct diagnosis were 92.1% and 89.5%, respectively. The mean number of needle passes required for diagnosis was 1.1. Complications included mild intraluminal bleeding in two patients (2.6%). Multivariate analysis revealed that lesion size (≤20 mm) was significantly associated with a decreased chance of determining the correct diagnosis. Core biopsy needles with a side hole are safe and provide a satisfactory diagnostic yield. However, the side hole may potentially reduce the rate of making the correct diagnosis in small lesions.

  4. Procedural and Physical Interventions for Vaccine Injections

    Science.gov (United States)

    Shah, Vibhuti; McMurtry, C. Meghan; MacDonald, Noni E.; Ipp, Moshe; Riddell, Rebecca Pillai; Noel, Melanie; Chambers, Christine T.

    2015-01-01

    Background: This systematic review evaluated the effectiveness of physical and procedural interventions for reducing pain and related outcomes during vaccination. Design/Methods: Databases were searched using a broad search strategy to identify relevant randomized and quasi-randomized controlled trials. Data were extracted according to procedure phase (preprocedure, acute, recovery, and combinations of these) and pooled using established methods. Results: A total of 31 studies were included. Acute infant distress was diminished during intramuscular injection without aspiration (n=313): standardized mean difference (SMD) −0.82 (95% confidence interval [CI]: −1.18, −0.46). Injecting the most painful vaccine last during vaccinations reduced acute infant distress (n=196): SMD −0.69 (95% CI: −0.98, −0.4). Simultaneous injections reduced acute infant distress compared with sequential injections (n=172): SMD −0.56 (95% CI: −0.87, −0.25). There was no benefit of simultaneous injections in children. Less infant distress during the acute and recovery phases combined occurred with vastus lateralis (vs. deltoid) injections (n=185): SMD −0.70 (95% CI: −1.00, −0.41). Skin-to-skin contact in neonates (n=736) reduced acute distress: SMD −0.65 (95% CI: −1.05, −0.25). Holding infants reduced acute distress after removal of the data from 1 methodologically diverse study (n=107): SMD −1.25 (95% CI: −2.05, −0.46). Holding after vaccination (n=417) reduced infant distress during the acute and recovery phases combined: SMD −0.65 (95% CI: −1.08, −0.22). Self-reported fear was reduced for children positioned upright (n=107): SMD −0.39 (95% CI: −0.77, −0.01). Non-nutritive sucking (n=186) reduced acute distress in infants: SMD −1.88 (95% CI: −2.57, −1.18). Manual tactile stimulation did not reduce pain across the lifespan. An external vibrating device and cold reduced pain in children (n=145): SMD −1.23 (95% CI: −1.58, −0

  5. Chin tuck for prevention of aspiration: effectiveness and appropriate posture.

    Science.gov (United States)

    Ra, Jong Yun; Hyun, Jung Keun; Ko, Kyung Rok; Lee, Seong Jae

    2014-10-01

    Chin tuck has been has been widely used to prevent aspiration in the patients with dysphagia. This study was performed to investigate the effectiveness and the degree of optimal neck flexion of chin tuck. Ninety-seven patients who showed aspiration in the videofluoroscopic swallow study (VFSS). Participants were grouped into the effective (patients who showed effect with chin tuck) and ineffective group (those who did not show effect with chin tuck). VFSS was performed in neutral and chin tuck position and findings were compared between the groups. Severity of aspiration was assessed by the point penetration-aspiration scale. Duration of dysphagic symptoms, history of tracheostomy, and other possible contributing factors were also compared. Neck flexion angle was measured to find appropriate posture in which aspiration was prevented with chin tuck. Aspiration was reduced or eliminated in only 19 patients (19.6 %) with chin tuck. Oral transit time, pharyngeal delayed time and pharyngeal transit time were significantly shortened in both groups (p neck flexion was required to achieve an effect with chin tuck. The effectiveness of chin tuck was less than anticipated. Patients without residue in pyriform sinus were more likely to benefit from chin tuck. Sufficient neck flexion was important in chin tuck to prevent aspiration.

  6. Multi-dimension Aspiration Control Mode in Phacoemulsification

    Institute of Scientific and Technical Information of China (English)

    Xiangqun Wang; Mingguang He; Junwen Zeng

    2005-01-01

    Purpose: Multi-dimension aspiration control mode was put forward in this study.Accuracy of multi-dimension aspiration control model was compared to simple traditional pedal control model.Methods: Induced by high aspiration pressure (200~250 mmHg), hard nucleus (≥Grade Ⅲ ) of senile cataract was chopped before phacoemulsification in 170 patients (174 eyes). Ninety-one patients (94 eyes) accepted multi-dimension aspiration control model in which aspiration direction, distance and targets prevention were adjusted by phaco-tip besides traditional pedal control. Another 79 patients (80 eyes) were compared as reviewed group, aspiration of which was controlled simply by traditional pedal control. Postcapsular rupture rates (PCRR) were compared between two groups.Results: Multi-dimension control model could make the terminal effects cooperate with phacoemulsification more precisely and protect post capsular from damage (x2 =5.41, P < 0.02).Conclusion: Multi-dimension control model could improve the accuracy of aspiration effects and protect postcapsular from damage.

  7. Reliability of fine needle aspiration biopsy in large thyroid nodules.

    Science.gov (United States)

    Bozbıyık, Osman; Öztürk, Şafak; Ünver, Mutlu; Erol, Varlık; Bayol, Ümit; Aydın, Cengiz

    2017-01-01

    Fine needle aspiration biopsy provides one of the most important data that determines the treatment algorithm of thyroid nodules. Nevertheless, the reliability of fine needle aspiration biopsy is controversial in large nodules. The aim of this study was to evaluate the adequacy of fine needle aspiration biopsy in thyroid nodules that are four cm or greater. We retrospectively examined 219 patients files who underwent thyroidectomy for thyroid nodules that were greater than four centimeter between May 2007 and December 2012. Seventy-four patients with hyperthyroidism, and 18 patients without preoperative fine needle aspiration cytology were excluded from the study. Histopathologic results after thyroidectomy were compared with preoperative cytology results, and sensitivity and specificity rates were calculated. False-negativity, sensitivity and specificity rates of fine needle aspiration biopsy of thyroid nodules were found to be 9.7%, 55.5%, and 85%, respectively. Within any nodule of the 127 patients, 28 (22.0%) had thyroid cancer. However, when only nodules of at least 4 cm were evaluated, thyroid cancer was detected in 22 (17.3%) patients. In this study, fine needle aspiration biopsy of large thyroid nodules was found to have a high false-negativity rate. The limitations of fine-needle aspiration biopsy should be taken into consideration in treatment planning of thyroid nodules larger than four centimeters.

  8. Pediatric foreign body aspiration: A nidus for Aspergillus colonization.

    Science.gov (United States)

    Mitchell, Candace A; Kreiger, Portia; Goff, Christopher; Shah, Udayan K

    2015-06-01

    We describe an immunocompetent child with bronchial fungus following foreign body aspiration. A two-year-old male presented with cough. Workup revealed air trapping and bronchoscopy showed aspirated foreign material in the right mainstem bronchus. Histopathology revealed fungal organisms suggestive of Aspergillus within an ulcer of the adjacent bronchial mucosa. Foreign body aspiration has been posited as a nidus for aspergilloma formation but is not yet described in the available English-language pediatric literature. Here, the foreign body provided a site for fungal growth in the bronchus of an otherwise healthy child. This case suggests that bronchial foreign body may pose risk of fungal colonization even in immunocompetent children.

  9. Effectiveness of sublingual nitroglycerin before puncture compared with conventional intra-arterial nitroglycerin in transradial procedures: a randomized trial

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    Turan, Burak, E-mail: drburakturan@gmail.com; Daşlı, Tolga; Erkol, Ayhan; Erden, İsmail

    2015-10-15

    Aim: Sublingual (SL) nitroglycerin administered before radial artery puncture can improve cannulation success and decrease the incidence of radial artery spasm (RAS) compared with intra-arterial (IA) nitroglycerin in transradial procedures. Methods: Patients undergoing diagnostic transradial angiography were randomized to IA (200 mcg) or SL (400 mcg) nitroglycerin. Primary endpoints were puncture time and puncture attempts. Secondary endpoint was the incidence of RAS. Results: Total of 101 participants (mean age 60 ± 11 years, 53% male) were randomized (51 in IA and 50 in SL groups). Puncture time (50 [36–75] vs 50 [35–90] sec), puncture attempts (1.18 ± 0.48 vs 1.20 ± 0.49), multiple punctures (13.7 vs 16.0%) and RAS (19.6 vs 24.0%) were not statistically different between IA vs SL groups respectively. A composite endpoint of all adverse events related to transradial angiography (multiple punctures, RAS, access site crossover, hypotension/bradycardia associated with nitroglycerin and radial artery occlusion) was very similar in IA vs SL groups (39 vs 40%, respectively). However puncture time was significantly longer with SL nitroglycerin in patients < 1.65 m height (47 [36–66] vs 63 [41–110] sec, p = 0.042). Multiple punctures seemed higher with SL nitroglycerin in patients with diabetes (0 vs 30%, p = 0.028) or in patients < 1.65 m height (7.4 vs 25%, p = 0.085). Likewise, RAS with SL nitroglycerin seemed more frequent in smokers compared to IA nitroglycerin (0 vs 27%, p = 0.089). Conclusions: SL nitroglycerin was not different from IA nitroglycerin in terms of efficiency and safety in overall study population. However it may be inferior to IA nitroglycerin in certain subgroups (shorter individuals, diabetics and smokers). - Highlights: • Improvement in radial artery puncture time and success with subcutaneous nitrate was reported. • Giving nitrate sublingually may have vasodilation along entire length of radial artery and may prevent RAS

  10. Fine needle aspiration cytology in leprosy

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    Prasad PVS

    2008-01-01

    Full Text Available Background: Laboratory diagnosis of leprosy by slit skin smear and skin biopsy is simple but both techniques have their own limitations. Slit skin smear is negative in paucibacillary cases whereas skin biopsy is an invasive technique. Fine needle aspiration cytology (FNAC from skin lesions in leprosy with subsequent staining with May-Grunwald-Giemsa (MGG stain has been found useful. Aim: To evaluate the possible role of cytology in classifying leprosy patients. Methods: Seventy-five untreated cases of leprosy attending the outpatient department were evaluated. Smears were taken from their skin lesions and stained using the MGG technique. Skin biopsy was also done from the lesions, which was compared with cytology smears. Results: A correlation of clinical features with FNAC was noticed in 87.5% of TT, 92.1% of BT, 81% of BL, and 66% of LL cases. Correlation of clinical with histopathological diagnoses revealed 12.5% specificity in TT leprosy, 55.3% in BT, 52.4% in BL and 50% in LL, and 100% in neuritic and histoid leprosy cases. Both correlations were found to be statistically significant by paired t test analysis. Thus, it was possible to distinguish the tuberculoid types by the presence of epithelioid cells and the lepromatous types by the presence of lymphocytes and foamy macrophages. Conclusion: FNAC may be used to categorize the patients into paucibacillary and multibacillary types, but is not a very sensitive tool to classify the patients across the Ridley-Jopling spectrum.

  11. Dermal mass aspirate from a Persian cat.

    Science.gov (United States)

    Zimmerman, Kurt; Feldman, Bernard; Robertson, John; Herring, Erin S; Manning, Thomas

    2003-01-01

    A 1-year-old spayed female Persian cat with alopecia and weight loss had numerous variably ulcerated dermal nodules. Cytologic examination of an aspirate of one of the nodules revealed pyogranulomatous inflammation along with septate hyphae and basophilic round bodies, 0.5-1.0 microm in diameter, surrounded by a thin clear halo (arthrospores). The cytologic diagnosis was dermatophytic pseudomycetoma. Histologically, there were dermal granulomas containing poorly staining, septate hyphae with bulbous spores embedded within abundant amorphous eosinophilic material (Splendore-Hoeppli reaction), and the histologic diagnosis was pseudomycetoma-associated chronic multifocal severe granulomatous dermatitis with lymphocytic perifolliculitis and furunculosis. Microsporum canis was cultured from the lesion. Pseudomycetomas are distinguished from fungal mycetomas, or eumycotic mycetomas, by the findings of multiple lesions, lack of a history of skin trauma, an association with dermatophytes, most commonly Microsporum canis, and, histologically, lack of true cement material and a more abundant Splendore-Hoeppli reaction in pseudomycetomas. Additionally, pseudomycetomas differ from dermatophytosis, in which lesions are restricted to epidermal structures. Persian cats have a high incidence of pseudomycetoma formation, suggesting a heritable predisposition. The prognosis is fair with systemic antifungal therapy. When examining cytologic specimens from Persian cats with single or multiple dermal nodules, especially if pyogranulomatous inflammation is present, a diagnosis of pseudomycetoma should be suspected and is warranted if arthrospores and refractile septate hyphae are present.

  12. Percutaneous aspiration thromboembolectomy: a preliminary experience.

    Science.gov (United States)

    Murray, J G; Brown, A L; Wilkins, R A

    1994-08-01

    Percutaneous aspiration thromboembolectomy (PAT) is a radiological alternative to surgical embolectomy or thrombolysis in the treatment of acute arterial thromboembolic disease. We report our experience in eight patients aged 63-83 years (mean 71 years). Indications were graft thrombosis (1) or emboli from atrial fibrillation (3), abdominal aneurysm (2) or proximal angioplasty (2). PAT was performed at 10 arterial sites; common iliac (1), profunda femoris (1), superficial femoral (2), femoro-popliteal graft (1), popliteal (2) and arteries of the trifurcation (3). PAT was used as an adjunct to thrombolysis or angioplasty in five patients and as the sole procedure in three patients. It was successful in six patients (seven sites) with mean ABI rising from 0.4 pre- to 0.8 post-procedure. Two of the failures required amputations. One of these was a completely thrombosed dacron femoro-popliteal graft with poor run-off, and the second case had a failed surgical embolectomy prior to amputation. There were no major complications, and no mortality on follow-up at 1 month. PAT is a useful adjunct to thrombolysis and balloon angioplasty in the radiological treatment of acute thromboembolic disease. In patients in whom thrombolysis is contraindicated, it offers an alternative to surgical embolectomy.

  13. Fine needle aspiration cytology of dermal cylindroma

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    Parikshaa Gupta

    2014-01-01

    Full Text Available In this paper, we have described fine needle aspiration cytology (FNAC of a rare case of dermal cylindroma. A 40-year-old female presented with a lateral mid-cervical swelling fixed to the skin. FNAC smears showed multiple clusters of small, round to oval cells with hyperchromatic nuclei, inconspicuous nucleoli and scant cytoplasm. In addition, the background showed deposits of basement membrane type material. This was dark magenta colored pinkish globular material. The globules were occasionally surrounded by the basal type of cells. Occasional cells with elongated nuclei were also noted. Cytological diagnosis of skin adnexal tumor possibly cylindroma was offered. Subsequent histopathology of the swelling showed sheets and clusters of cells in a jigsaw puzzle-like fashion. Deposition of abundant basement membrane-like material was noted in between the tumor cells. A diagnosis of cylindorma was offered. FNAC along with the subcutaneous location of the tumor and absence of primary salivary gland tumor may help to diagnose such rare case.

  14. Nipple Aspirate Test Is No Substitute for Mammogram

    Science.gov (United States)

    ... Products Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products For Consumers Home For Consumers Consumer Updates Nipple Aspirate Test is No Substitute for Mammogram Share Tweet Linkedin Pin it More ...

  15. The efficiency of routine endotracheal aspirate cultures compared to ...

    African Journals Online (AJOL)

    The efficiency of routine endotracheal aspirate cultures compared to ... VAP EA) twice weekly in all patients until the endotracheal tube was removed. ... 62%; specificity: 95%, positive predictive value: 87%, negative predictive value: 82%).

  16. Transvaginal Ultrasound-Guided Aspiration of Pelvic Abscesses

    Directory of Open Access Journals (Sweden)

    P. J. Corsi

    1999-01-01

    Full Text Available Objective: To assess the utility of a less invasive approach to the care of women with a pelvic abscess, we retrospectively reviewed the outcome of women with pelvic abscesses managed by transvaginal ultrasound-guided aspiration.

  17. The role of incentives in nurses' aspirations to management roles.

    Science.gov (United States)

    Wong, Carol A; Spence Laschinger, Heather K; Cziraki, Karen

    2014-06-01

    The objective of this study was to describe findings from a study examining nurses' perceptions of incentives for pursuing management roles. Upcoming retirements of nurse managers and a reported lack of interest in manager roles signal concerns about a leadership shortage. However, there is limited research on nurses' career aspirations and specifically the effect of perceived incentives for pursuing manager roles. Data from a national, cross-sectional survey of Canadian nurses were analyzed (n = 1241) using multiple regression to measure the effect of incentives on nurses' career aspirations. Twenty-four percent of nurses expressed interest in pursuing management roles. Age, education, and incentives explained 43% of the variance in career aspirations. Intrinsically oriented incentives such as new challenges, autonomy, and the opportunity to influence others were the strongest predictors of aspirations to management roles. Ensuring an adequate supply of nurse managers will require proactive investment in the identification, recruitment, and development of nurses with leadership potential.

  18. Micronuclei in breast aspirates. Is scoring them helpful?

    Directory of Open Access Journals (Sweden)

    A Hemalatha

    2014-01-01

    Conclusion: An increase in micronuclei values was seen from fibroadenoma to infiltrating ductal carcinoma. Micronuclei scoring can be used as a biomarker on fine needle aspiration cytology smears of breast carcinoma.

  19. Fine-needle aspiration biopsy of lymph nodes

    African Journals Online (AJOL)

    2012-02-02

    Feb 2, 2012 ... Lymph nodes in the posterior cervical triangle and supraclavicular nodes are more suspicious for malignancy. ... exclusively primary or recurrent breast carcinoma in aspirates ... Lung carcinoma – small cell and non- small cell.

  20. Handling Rejection as Failure: Aspiring Writers Getting the Rejection Slip

    Directory of Open Access Journals (Sweden)

    Henrik Fürst

    2016-12-01

    Full Text Available Included in the definition of being an aspiring person is the risk of failure. Aspiring fiction writers are no exception. This article shows that the role of aspiring fiction writer involves managing three issues: the hope of being published, rejection by a publisher, and the perception of the rejection as a failure. Drawing on 47 interviews with fiction writers who have attempted to become first-time writers, the analysis shows that aspiring writers' responses to rejection are related to accepting and dismissing responsibility for having failed and admitting or dismissing the rejection as a perceived failure. Based on these findings, the article presents procedures associated with four main approaches to dealing with failure: conceding, excusing, justifying, and refusing. This conceptual framework for understanding failure contributes to a theoretical understanding of evaluation and valuation processes and their consequences and to empirical studies of rejection as career failure; it also systematizes and extends Goffmans work on cooling out strategies.

  1. Cognitive correlates of adolescents' aspirations to leadership: a developmental study.

    Science.gov (United States)

    Singer, M

    1990-06-01

    The study examined age and gender differences in leadership aspirations among teenage adolescents. It was hypothesized that adolescents' valence, self-efficacy and attribution perceptions about leadership would be predictive of their aspirations to leadership. Altogether 52 fourth form and 78 seventh form high school students completed a questionnaire measuring (a) overall leadership aspirations, (b) 13 valence-instrumentality expectancies for 13 leadership outcomes, (c) self-efficacy perceptions, and (d) attributions of effective leadership. The results revealed significant gender differences in valence scores and significant age differences in self-efficacy and attribution measures. Regression analyses indicated that fourth formers' leadership aspirations were significantly predicted from their "ease-of-success" self-efficacy expectation; whereas seventh formers from either valence perceptions (males) or self-efficacy and attribution scores (females). These results were discussed in the context of the valence and self-efficacy models of career decision-making processes and attribution theory.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-04-15

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

  3. 22-gauge core vs 22-gauge aspiration needle for endoscopic ultrasound-guided sampling of abdominal masses.

    Science.gov (United States)

    Sterlacci, William; Sioulas, Athanasios D; Veits, Lothar; Gönüllü, Pervin; Schachschal, Guido; Groth, Stefan; Anders, Mario; Kontos, Christos K; Topalidis, Theodoros; Hinsch, Andrea; Vieth, Michael; Rösch, Thomas; Denzer, Ulrike W

    2016-10-21

    To compare the aspiration needle (AN) and core biopsy needle (PC) in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of abdominal masses. Consecutive patients referred for EUS-FNA were included in this prospective single-center trial. Each patient underwent a puncture of the lesion with both standard 22-gauge (G) AN (Echo Tip Ultra; Cook Medical, Bloomington, Indiana, United States) and the novel 22G PC (EchoTip ProCore; Cook Medical, Bloomington, Indiana, United States) in a randomized fashion; histology was attempted in the PC group only. The main study endpoint was the overall diagnostic accuracy, including the contribution of histology to the final diagnosis. Secondary outcome measures included material adequacy, number of needle passes, and complications. Fifty six consecutive patients (29 men; mean age 68 years) with pancreatic lesions (n = 38), lymphadenopathy (n = 13), submucosal tumors (n = 4), or others lesions (n = 1) underwent EUS-FNA using both of the needles in a randomized order. AN and PC reached similar overall results for diagnostic accuracy (AN: 88.9 vs PC: 96.1, P = 0.25), specimen adequacy (AN: 96.4% vs PC: 91.1%, P = 0.38), mean number of passes (AN: 1.5 vs PC: 1.7, P = 0.14), mean cellularity score (AN: 1.7 vs PC: 1.1, P = 0.058), and complications (none). A diagnosis on the basis of histology was achieved in the PC group in 36 (64.3%) patients, and in 2 of those as the sole modality. In patients with available histology the mean cellularity score was higher for AN (AN: 1.7 vs PC: 1.0, P = 0.034); no other differences were of statistical significance. Both needles achieved high overall diagnostic yields and similar performance characteristics for cytological diagnosis; histological analysis was only possible in 2/3 of cases with the new needle.

  4. Food Particle Aspiration Associated with Hemorrhagic Shock: A Diagnostic Dilemma

    OpenAIRE

    Basheer Tashtoush; Jonathan Schroeder; Roya Memarpour; Eduardo Oliveira; Michael Medina; Anas Hadeh; Jose Ramirez; Laurence Smolley

    2015-01-01

    The hemodynamic compromise caused by a large aspirated food particle in the airway can become the focus of medical attention and a distraction from rare but fatal Heimlich maneuver related injuries after an incident of food aspiration. We herein present a case of an 84-year-old man who was brought to the emergency department after an episode of choking at a restaurant followed by several failed Heimlich maneuver attempts. Despite relieving the airway obstruction by extracting a large piece of...

  5. Aspiration cytology of metastatic chordoma. A case report.

    Science.gov (United States)

    Elliott, E C; McKinney, S; Banks, H; Fulks, R M

    1983-01-01

    A patient with previously diagnosed sacrococcygeal chordoma presented with multiple skin nodules. Cytologic examination of an aspirate from one of these nodules showed syncytial clusters of hyperchromatic cells surrounded by extracellular mucin. The characteristic physaliphorous cells, although present in a biopsy of the primary sacrococcygeal tumor, were not observed in the aspirate or on histopathologic examination of three excised skin metastases. That chordoma metastases may lack physaliphorous cells should be recognized.

  6. Some Unresolved Issues in Ocean Pipes Aspirating Fluid

    Institute of Scientific and Technical Information of China (English)

    QIAN Qin; WANG Lin; NI Qiao; HUANG Yu-ying

    2008-01-01

    This paper reviews the dynamics of ocean pipes aspirating fluid and presents a selective review of the research undertaken on it. It focuses on the equations of motion, fluid-solid interaction at the inlet of the free end of the pipe, the stability mechanism of pipes aspirating steady fluid, etc. In particular, some unresolved or partly resolved issues on these important aspects are discussed. Finally, the promising future development in this area is discussed.

  7. A Case of Bipolar Affective Disorder and Aspiration Pneumonia

    Directory of Open Access Journals (Sweden)

    Alessandro Gerada

    2013-01-01

    Full Text Available Adults with mental illness are at a higher risk of aspiration pneumonia than the general population. We describe the case of a patient with bipolar affective disorder and two separate episodes of aspiration pneumonia associated with acute mania. We propose that he had multiple predisposing factors, including hyperverbosity, sedative medications, polydipsia (psychogenic and secondary to a comorbidity of diabetes insipidus, and neuroleptic side effects.

  8. Vapocoolant Spray Effectiveness on Arterial Puncture Pain: A Randomized Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Shervin Farahmand

    2017-02-01

    Full Text Available Arterial blood gas (ABG sampling is a painful procedure with no perfect technique for quelling the discomfort. An ideal local anesthesia should be rapid, easy to learn, inexpensive, and noninvasive. This study was aimed to compare pain levels from ABG sampling performed with vapocoolant spray in comparison to placebo. We hypothesized that pretreatment with the vapocoolant would reduce the pain of arterial puncture by at least 1 point on a 10 point verbal numeric scale. We have evaluated the effectiveness of a vapocoolant spray in achieving satisfactory pain control in patients undergoing ABG sampling in this randomized placebo controlled trial. Eighty patients were randomized to 2 groups: group A, who received vapocoolant spray, and group B, who received water spray as placebo (Control group. Puncture and spray application pain was assessed with numerical rating scale (0, the absence of pain; 10, greatest imaginable pain and number of attempts was recorded. The pain score during ABG sampling was not lower in group A compared with group B significantly (4.78±1.761 vs. 4.90±1.837; P:0.945. This study showed that while the spray exerts more application pain, the number of attempts required for ABG sampling was not significantly lower in group A compared with group B (1.38±0.54 vs. 1.53±0.68; P=0.372. Vapocoolant spray was not effective in ABG pain reduction, had milder application pain compared to placebo (P<0.05, but did not reduce sampling attempts. At present, this spray cannot be recommended for arterial puncture anesthesia, and further study on different timing is necessary.

  9. THE IMPACT OF ANXIETY ON POST - DURAL PUNCTURE HEADACHE IN ROUTINE NEUROLOGY PRACTICE

    Directory of Open Access Journals (Sweden)

    Stefka Mantarova

    2015-09-01

    Full Text Available Background: The post-dural puncture headache (PDPH is the most common complication of lumbar puncture in neurological practice. Although the comorbidity of headache and psychiatric symptoms is well-recognized, the data about the relationship between PDPH and symptoms of anxiety and depression are limited. The aim of the present study was to determine the influence of anxiety symptoms on the risk for PDPH. Methods: Diagnostic lumbar puncture was performed to thirty-nine neurological patients, presented by 26 women and 13 men. All subjects completed the Hospital Anxiety and Depression Scale (HADS before the procedure. Information about the clinical characteristic of the headache - quality, location, severity, postural nature, duration and associated symptoms (nausea, vomiting, and tinnitus was collected. Results: Fifteen of the patients (38,5% developed PDPH. According to the presence of PDPH the patients were divided into two groups – with (group 1 and without headache (group 2. Women with headache were significantly younger (mean age 34,00±11,22 years compared to females in group 2 (mean age 45,07±12,36 years (p=0,028. Patients in group 1 had significantly higher levels of reported anxiety symptoms compared to group 2 (p= 0,045. A significant positive correlation was observed between anxiety and PDPH (Spearman’s rho = 0,412, p=0,009. Conclusion: Younger female patients with anxiety had a considerably increased rate of PDPH. This could be of practical benefit in devising an additional treatment strategy for patients with PDPH.

  10. [Subclavian vein puncture as a primary approach for pacemaker lead implantation].

    Science.gov (United States)

    Kronski, D; Haas, H

    2001-12-01

    In the beginning of transvenous pacemaker therapy, the external or alternatively internal jugular vein was commonly used for lead implantation. Due to frequent long-term complications both approaches are nowadays obsolete. In most pacemaker centers implantation via the cephalic vein has become standard. As an alternative, in 1975 Sterz et al. introduced puncture of the subclavian vein in the Seldinger technique as an approach for lead implantation. At this time, the commonly used introducers of pacemaker leads had to be cut for removal. No earlier than 1980 "peel away" introducers were commercially available. Since then, we consequently use this technique for implantation of single or dual chamber pacemaker devices. In the course of the last seven years merely 1.5-2% of implantations were performed via the cephalic vein; no jugular vein approach was performed. Due to a routinely performed subclavian vein puncture, we were able to optimize the procedure, proven by an enormous reduction in implantation time (local anesthesia - skin closure), x-ray time and complication rate. In the year 2000 we performed 52 implantations of a single chamber device with an average fluoroscopy time of 1.5 (0.3-9.3) minutes, radiation dose of 4.5 (0.1-47) Gycm(2) and implantation time of 17.6 (8-40) minutes and 144 implantations of a dual chamber device with an average fluoroscopy time of 2.86 (0.7-6.6) minutes, radiation dose of 8.31 (0.7-28) Gycm(2) and implantation time of 21.25 (10-45) minutes. Complications were rare, clinically irrelevant arterial punctures. Neither nerval damage nor pneumothoraces with the necessity for chest tube placement were seen in the above mentioned time frame. No early or late thrombosis of the subclavian vein was encountered.    The primary subclavian vein approach led to an enormous reduction in overall procedure time without significant morbidity.

  11. Puncture initial data for black-hole binaries with high spins and high boosts

    Science.gov (United States)

    Ruchlin, Ian; Healy, James; Lousto, Carlos O.; Zlochower, Yosef

    2017-01-01

    We solve the Hamiltonian and momentum constraints of general relativity for two black holes with nearly extremal spins and relativistic boosts in the puncture formalism. We use a non-conformally-flat ansatz with an attenuated superposition of two Lorentz-boosted, conformally Kerr or conformally Schwarzschild 3-metrics and their corresponding extrinsic curvatures. We compare evolutions of these data with the standard Bowen-York conformally flat ansatz (technically limited to intrinsic spins χ =S /MADM2=0.928 and boosts P /MADM=0.897 ), finding, typically, an order of magnitude smaller burst of spurious radiation and agreement with inspiral and merger. As a first case study, we evolve two equal-mass black holes from rest with an initial separation of d =12 M and spins χi=Si/mi2=0.99 , compute the waveforms produced by the collision, the energy and angular momentum radiated, and the recoil of the final remnant black hole. We find that the black-hole trajectories curve at close separations, leading to the radiation of angular momentum. We also study orbiting nonspinning and moderate-spin black-hole binaries and compare these with standard Bowen-York data. We find a substantial reduction in the nonphysical initial burst of radiation which leads to cleaner waveforms. Finally, we study the case of orbiting binary black-hole systems with spin magnitude χi=0.95 in an aligned configuration and compare waveform and final remnant results with those of the SXS Collaboration [54 A. H. Mroue et al., Phys. Rev. Lett. 111, 241104 (2013)., 10.1103/PhysRevLett.111.241104], finding excellent agreement. This represents the first moving puncture evolution of orbiting and spinning black holes exceeding the Bowen-York limit. Finally, we study different choices of the initial lapse and lapse evolution equation in the moving puncture approach to improve the accuracy and efficiency of the simulations.

  12. Effects of Supportive Educational Program on Anxiety of Mothers of Children Undergoing the Lumbar Puncture (LP

    Directory of Open Access Journals (Sweden)

    Mousa Mahdizadeh

    2016-07-01

    Full Text Available Background: Lumbar Puncture test is one of the most stressful diagnostic procedures in pediatric ward that its prescription put mothers under extreme pressure. There are limited interventions in this regard. Aim: determining the impact of supportive educational program on the anxiety of mothers whose children are undergoing lumbar puncture (LP. Method: the present study is a randomized controlled clinical trial carried out in 2015. Sixty mothers of children undergoing lumbar puncture and hospitalized 3educational hospitals of Mashhad, Iran, were randomly divided to control group (n=30 and intervention group (n=30. The intervention group received supportive program during a session of 60 min. Spielberger State-Trait Anxiety Inventory (STAI was selected as the research tool. Finally, data were analyzed by Chi-square test, independent t-test using SPSS v.16 software. Results: The mean age of the mothers was 27.3±5.3 and 26.0±3.1, respectively. The mean pre-interventions maternal manifest anxiety was 51.9±6.2 and 53.4±4.3 out of 80, respectively, in the intervention and control groups. The mean post-interventions maternal manifest anxiety was 44.9±5.1 and 52.7±4.2, respectively, in the intervention and control groups. According to the results of independent t-test, significant difference was observed statistically for the mean maternal manifest anxiety between the two groups (p> 0.001. Implications for Practice: Regarding the reduction of maternal anxiety in the intervention group, which is possible because of the attention to the emotional needs of mothers, in addition to proper training; this program can be considered as an effective method to reduce maternal anxiety before the LP test.

  13. Acute forearm compartment syndrome following haemodialysis access fistula puncture in uraemia.

    Science.gov (United States)

    Lin, Chin-Ta; Dai, Niann-Tzyy; Chen, Shyi-Gen; Chang, Shun-Cheng

    2016-10-01

    Acute compartment syndrome is a well-described surgical emergency that requires immediate diagnosis and operative intervention. Vascular access-associated compartment syndrome is rarely reported in haemodialysis patients. The purpose of this article is to document evidence that catheter-related puncture, which results in arteriovenous fistula injury in uraemia, may cause acute forearm compartment syndrome. Between September 2007 and September 2012, five consecutive patients presented to our section with tense swollen forearms with skin blistering, decreased hand sensation and reduced capillary return in the fingers. Their ages ranged from 65 to 81 years (mean 72.8 years). All of the patients underwent emergent exploration after the diagnosis of acute forearm compartment syndrome. The patients' details were reviewed. The time interval between dialysis completion and return to the emergency department ranged from 6 to 9 h (mean 7.4 h). During operation, the bleeding was found to originate from the site of the fistula puncture and was repaired with 9-0 nylon suture under microscopy. After adequate wound care, a reconstructive procedure with a split-thickness skin graft was performed in all of the five patients. There was no vascular or neurological deficit of the forearm or hand within the mean follow-up period of 14.8 months (range 12-18 months). In this series, we report five cases of forearm compartment syndrome in uraemia, secondary to bleeding from a catheter-related puncture of a haemodialysis access fistula. However, there is no case series that focuses upon this specific topic in the present literature. This problem deserves more attention. © 2014 Royal Australasian College of Surgeons.

  14. Analysis of clinical application of percutaneous chest lesion puncture under CT guided%CT引导下经皮胸部病灶穿刺的临床应用分析

    Institute of Scientific and Technical Information of China (English)

    熊丽纹; 滕家俊; 李榕; 张雪艳; 楼煜清; 顾爱琴; 韩宝惠

    2013-01-01

    Background and purpose:Percutaneous transthoracic needle biopsy with computed tomographic (CT) guidance, following two diagnostic methods of needle biopsy and needle aspiration cytology, is a widely used non-vascular interventional technique, regarded as an extremely important technique for clinical qualitative diagnosis, treatment and the prognosis. This study aimed to evaluate and to compare the diagnostic value of needle biopsy and needle aspiration cytology in CT-guided percutaneous chest lesion puncture, and to analyze the variables affecting the diagnostic accuracy and rates of complications. Methods:A retrospective study was conducted of 1 027 patients who underwent CT-guided percutaneous thoracopathy puncture from Apr. 2006 to Mar. 2012. Results:There were no significant differences in diagnostic positive rate and accuracy between needle biopsy and needle aspiration cytology in CT-guided percutaneous chest lesion puncture (P>0.05). There were 859 malignant and 168 benign lesions. Overall diagnostic accuracy was 90.6%. The diagnostic accuracy for malignancy was 89.1%and for benign was 98.2%. There was significant correlation among the diagnostic accuracy and the final diagnosis (benign and malignant), lesion site, and lesion type (P0.05).1027例患者中,恶性病变859例,良性病变168例,诊断正确率为90.6%,其中对恶性肿瘤的诊断正确率为89.1%,良性病变的诊断正确率为98.2%.病灶的良恶性、疾病部位和病灶形态对诊断正确率的影响差异有统计学意义(P<0.05).不良反应(气胸和出血)的发生率为19.9%,与穿刺深度和病灶至胸膜距离密切相关(P<0.05).结论:CT引导下胸部穿刺术是安全、可靠的微创诊断方法.在某些条件下,CT引导下胸部穿刺针吸脱落细胞学检测可以代替活检,以避免那些需要通过增加穿刺风险获取足够组织进行的活检.诊断正确率与病灶的良恶性、发生部位和形态相关.并发症的发生与穿刺深度和

  15. Ultrasound-guided Percutaneous Puncture Catheter Drainage for Liver Abscess Effect%超声引导经皮肝穿刺置管引流在肝脓肿治疗中的影响

    Institute of Scientific and Technical Information of China (English)

    高金山; 齐丽华

    2015-01-01

    Objective To evaluate the effect of percutaneous puncture aspirate and catheter drainage treatment for liver abscess under the guidance of ultrasound, and discuss the safety of the treatment and managements of complications. Methods During 2010.01~2013.12, Ultrasound-guided percutaneous transhepatic drainge for liver abscess for analysis of 57 cases. Results 57 cases of patients placed drainage tube drainage,47 cases of temperature decrease, and the curing rate was 97.95%,while the rate of complication was 5.2%(3/57). Conclusion Ultrasound-guided percutaneous puncture drainage for liver abscess relieve symptoms, outcomes achieved signiifcant results.%目的:总结超声引导经皮肝穿刺置管引流治疗肝脓肿的经验及并发症的防治。方法选择我院2010年1月~2013年12月超声引导经皮肝穿刺置管引流治疗肝脓肿57例进行资料分析。结果57例病人放置引流管引流,47例体温明显下降,治愈率为97.95%,并发症发生率5.2%(3/57)。结论超声引导下穿刺置管引流治疗肝脓肿在缓解病情,改善预后方面有显著效果。

  16. Septic diseases associated with the hoof complex: abscesses, punctures wounds, and infection of the lateral cartilage.

    Science.gov (United States)

    Redding, W Rich; O'Grady, Stephen E

    2012-08-01

    Hoof abscesses are probably the most common cause of acute severe lameness in horses encountered by veterinarians and farriers. Most affected horses show sudden, severe (acute) lameness; the degree of lameness varies from being subtle in the early stages to non-weight bearing. There is still debate between the veterinary and farrier professions as to who should treat a hoof abscess and the best method to resolve the abscess. Puncture wounds to the sole of the foot can introduce bacteria and debris to the solar surface of the distal phalanx and produce a fracture or a septic pedal osteitis. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Quasi-circular orbits of conformal thin-sandwich puncture binary black holes

    CERN Document Server

    Hannam, M D

    2005-01-01

    I construct initial data for equal-mass irrotational binary black holes using the conformal thin-sandwich puncture (CTSP) approach. I locate quasi-circular orbits using the effective-potential method, and estimate the location of the innermost stable circular orbit (ISCO). The ISCO prediction is consistent with results for conformal thin-sandwich data produced using excision techniques. These results also show that the ISCOs predicted by the effective-potential and ADM-Komar mass-comparison methods agree for CTS data, just as they did for Bowen-York data.

  18. Therapeutical efficacy of CT-guided relief puncture in amebic liver abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Mansfeld, L.; Boitz, F.; Poehls, C.; Cimanowski, N.

    1987-09-01

    Amebic liver abscesses are the most frequent clinical manifestations of the extra-intestinal amebiasis and have to be considered as a serious complication in the course of disease. The abscesses have by their risk of rupturing and bacterial superinfection quoad vitam an unfavourable prognosis. CT-guided relief punctures can, as it is demonstrated by two cases of critical amebic abscesses, effectively improve the therapy with systemic amebicides, prevent imminent rupture and contribute to the healing of the abscesses. Thus a surgical treatment of the abscess was not necessary.

  19. [Use of individual protection equipment among nursing workers injured by puncture-cutting tools].

    Science.gov (United States)

    Sarquis, L M; Felli, V E

    2000-01-01

    The present study analyzed work related accidents involving nursing personnel from a public hospital in the state of São Paulo. The study population comprised the entire nursing staff. The results obtained showed a high incidence of accidents with puncture-cutting instruments, particularly among the auxilliary nursing staff, which indicates that these workers don't often use individual protection equipment, even when it is made available at the work place. Due to the manipulation of sharp instruments, nursing personnel are especially vulnerable to suffer biological risks and serious diseases. These results indicate the need to prevent the occurrence of such accidents.

  20. Haemostasis and Safety Measures before Lumbar Puncture in the Haematology Ward

    DEFF Research Database (Denmark)

    Møller, Anders; Bjerrum, Ole Weis; Afshari, Arash

    2015-01-01

    : An online survey with questions pertaining to precautions of haemostasis and application of fundoscopy was sent by e-mail to all 12 haematology wards in Denmark. RESULTS: Eleven sites participated. Five (45%) reported no pausation of antiplatelet drugs at all. The mean platelet limit prior to lumbar...... puncture was 50 × 10(9)/l (range 10-50 × 10(9)/l). Seven (64%) sites had an international normalised ratio limit of 1.5, and the remaining 4 had values between 1.0 and 2.5. Two (18%) reported occasional use of thromboelastography or platelet analysis to assess the bleeding risk. Fundoscopy is routinely...

  1. IMPACT OF ASPIRATIONS ON RISK JUDGMENT AND ON RISKY CHOICES

    Directory of Open Access Journals (Sweden)

    Joanna Sokołowska

    2012-06-01

    Full Text Available The presented experiments are aimed at determining: (1 whether risk perception and risk acceptance are two distinct psychological processes and (2 how aspirations affect each process. It has been tested whether risk is independent of and preferences are depend on aspirations. In Experiment 172 employees of a high-tech company were presented with pairs of risky projects. The aspiration level was de fined as the target return on the project and was set through an explicit instruction. In Experiment 2 93 bridge players were presented with pairs of contracts – one a sure thing and the other a risky one. The aspiration level was related to the team IMP points after the first part of a knockout tournament and was set through an instruction. In both experiments with a between-subject design, two different aspiration levels were set for each group. All respondents were asked to judge riskiness of presented options and to select one. The results indicate that risk perception is insensitive to changes in aspirations, but preferences are. This supports distinctness of risk perception and risk cceptance.

  2. Coevolution of aspirations and cooperation in spatial prisoner's dilemma game

    Science.gov (United States)

    Chen, Wei; Wu, Te; Li, Zhiwu; Wang, Long

    2015-01-01

    Suboptimal outcomes are often more acceptable than the best ones when the latter are hard or even impossible to find. In order to describe the emergence of cooperation when suboptimal alternatives prevail, an evolutionary game model is established by considering the effects of aspirations. A win-stay-lose-shift like rule for strategy updating is proposed. The rule prescribes that if the payoff of the current strategy is greater than the aspiration, the strategy remains, otherwise the strategy changes. Aspiration updating allows for individuals to adjust their expected payoff levels. It is shown that suboptimal alternatives can promote the emergence and persistence of cooperation over a wide range of the temptation to defect. Furthermore, a nontrivial phenomenon is found that cooperators prevail as the temptation increases when it is small. The aspirations are stabilized at an intermediate level which can most facilitate cooperation. The obtained results also show that the average level of aspirations decreases as the temptation increases. Furthermore, the variance of aspiration levels is minimized for an intermediate level of temptation.

  3. Injection site abscess due to mycobacterium fortuitum: A case report

    Directory of Open Access Journals (Sweden)

    Devi DR

    2003-01-01

    Full Text Available Injection abscess is an iatrogenic infection occurring as an isolated case or as cluster outbreak. These infections occur due to contaminated injectables or lapse in sterilisation protocol. While pathogens such as Pseudomonas, Klebsiella, E. coli, and S. aureus are the usual causative agents, unusual organisms such as mycobacteria, particularly the rapidly growing non-tuberculous mycobacteria (NTM may cause the abscess. The chances of overlooking these organisms is high unless an acid fast bacilli (AFB smear and culture is done on all aspirated pus specimens. We report a case of a three year old child who presented with a gluteal abscess following an intramuscular infection with an unknown preparation.

  4. Acute kidney injury and inflammatory response of sepsis following cecal ligation and puncture in D-galactose-induced aging rats

    Directory of Open Access Journals (Sweden)

    Liu C

    2017-03-01

    Full Text Available Chao Liu,1,* Jie Hu,1,* Zhi Mao,1,* Hongjun Kang,1 Hui Liu,1 Wanlei Fu,2 Yangfan Lv,2 Feihu Zhou1 1Department of Critical Care Medicine, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China; 2Department of Pathology, Xinqiao Hospital, Third Military Medical University, Chongqing, People’s Republic of China *These authors contributed equally to this work Background: Recently, the D-galactose (D-gal-induced mimetic aging rat model has been widely used in studies of age-associated diseases, which have shown that chronic D-gal exposure induces premature aging similar to natural aging in rats. With the increasing rate of sepsis in the geriatric population, an easy-access animal model for preclinical studies of elderly sepsis is urgently needed. This study investigates whether a sepsis model that is established in D-gal-induced aging rats can serve as a suitable model for preclinical studies of elderly patients with sepsis.Objective: To investigate the acute kidney injury (AKI and inflammatory response of sepsis following cecal ligation and puncture (CLP in D-gal-induced aging rats.Methods: Twelve-week-old male Sprague Dawley rats were divided into low-dose D-gal (L D-gal, 125 mg/kg/d, high-dose D-gal (H D-gal, 500 mg/kg/d, and control groups. After daily subcutaneous injection of D-gal for 6 weeks, the CLP method was used to establish a sepsis model.Results: The mortality was 73.3%, 40%, and 33.3% in the H D-gal, L D-gal, and control groups, respectively. Blood urea nitrogen, creatinine, plasma neutrophil gelatinase-associated lipocalin, interleukin-6, interleukin-10, and tumor necrosis factor-α were markedly increased in the H D-gal group after establishment of the sepsis model (H D-gal vs control, P<0.05 at 12 h and 24 h post-CLP. The rate of severe AKI (RIFLE-F at 24 h post-CLP was 43% for both the control and L D-gal groups and 80% for the H D-gal group.Conclusion: High-dose-D-gal-induced aging rats are

  5. Topical analgesia treats pain and decreases propofol use during lumbar punctures in a randomized pediatric leukemia trial.

    Science.gov (United States)

    Whitlow, Puja G; Saboda, Kathylynn; Roe, Denise J; Bazzell, Susan; Wilson, Cera

    2015-01-01

    Lumbar punctures are frequently performed in pediatric leukemia for central nervous system leukemic prophylaxis. The contribution of local anesthetic with deep sedation is unknown. The objective was to evaluate EMLA (eutectic mixture of local anesthetics) cream as a pain reliever in conjunction with propofol in the setting of routine lumbar punctures. We included patients with acute lymphoblastic leukemia aged 3-21 years requiring at least two routine lumbar punctures. Patients were randomly assigned to receive EMLA or placebo cream and the alternate treatment with the second procedure. Patients, personnel and outcome assessors were blinded to allocation. The primary outcome included three indirect measures of pain: total median propofol doses, patient movement and heart rate changes at the time of skin puncture in both treatment groups. Twenty-six patients were enrolled and 25 were analyzed. With EMLA cream, 4 mg/kg (median) of propofol was required (95% CI 3.5-4.4). With placebo, 4.9 mg/kg of propofol was needed (95% CI 4.3-5.6; P = 0.008). When EMLA cream was applied, 8% of patients moved, whereas 84% moved with placebo cream (P propofol is beneficial. Topical analgesics are at the discretion of the oncologist, allowing us to advocate for patients by providing safe and efficacious pain management for lumbar punctures. © 2014 Wiley Periodicals, Inc.

  6. Meconium aspiration syndrome: do we know?

    Science.gov (United States)

    Yurdakök, Murat

    2011-01-01

    Meconium is a common finding in amniotic fluid and placental specimens, particularly in the term or post-term pregnancy. The most important consequence of meconium-stained amniotic fluid (MSAF) is meconium aspiration syndrome (MAS), and at least 5% of infants born through MSAF develop MAS. MAS continues to be a threat to many newborns throughout the world, with a case fatality rate of 5% (as much as 40%), in addition to short- and long-term pulmonary and neurodevelopmental sequelae. The exact pathophysiology of meconium passage into the amniotic fluid and consequences of meconium aspiration are unknown. There are three prevailing and possibly compatible theories for mechanisms of meconium release. Firstly, meconium passage is probably related with the maturation of the gastrointestinal tract, because meconium passage in the preterm third trimester fetus has been reported to be a rare event, as typically it occurs near or post-term. Secondly, an alternate hypothesis for in utero meconium passage is that pathologic processes, such as stress via hypoxia or infection, can trigger meconium passage. However, the predictive values of MSAF for fetal distress and acidosis at birth are poor and controversial. Thirdly, an alternative route for the presence of MSAF in the presence of fetal hypoxia is reduced clearance of defecated meconium due to impaired fetal swallowing or unidentified placental dysfunction in addition to or instead of an increase in its passage. The pathophysiology of MAS is multifactorial and extremely complex. Meconium causes mechanical obstruction and pulmonary air leak, induces surfactant inactivation, causes pulmonary inflammation, and induces apoptosis. Preventing prolonged pregnancy by labor induction might reduce the risk of MSAF. Labor induction with prostaglandins appears to be associated with the occurrence of MSAF. Amnioinfusion for suspected umbilical cord compression has no clear effect on the occurrence of MSAF. Intrapartum suctioning of the

  7. Micro and macro factors affecting childbearing aspirations.

    Science.gov (United States)

    He, Y

    1992-01-01

    The conclusion of the discussion of factors affecting childbearing aspirations is that both a micro and a macro perspective must be included in an empirical analysis which would be useful for policy decisions. Micro factors tend to the economic function of the family, the economic value of children, cost of labor training, women's occupation, social security, household consumption, and education level. Attention to micro factors is important in the link between individual interests and state family planning (FP) policy. Macro factors tend to be ignored, but also impact on childbearing decisions. Macro factors are economic conditions, social and political factors, culture, and environmental factors such as ecology, natural resources, employment, economic development, and education. Macro factors affect the population as a whole and indirectly impact on individuals and the family. China's achievements in FP policy have been identified as a reduction of 200 million people, a shift in the population reproduction cycle downwards, increased standard of living, reduction in the burden of working people, and stabilization of macro factors. Successful policy should not rely on forced implementation. The past and present policies were successful not because of forced implementation, but because of awareness of macro and micro factors and voluntary use of FP. The voluntary nature of acceptance of FP suggests support for the FP policies. The current focus is on rural areas, and farmers in particular who are only aware of their needs and may feel state policy may interfere with their own interests. Implementation of FP among the rural population would be enhanced with an emphasis on their concerns such as social security in old age, the practical issues of having only daughters, and educational status. Educational campaigns promoting awareness of population pressure are needed and will benefit all the people. Social democratic doctrines can be introduced only from the outside

  8. Risk Factors for Aspiration Pneumonia in Older Adults.

    Directory of Open Access Journals (Sweden)

    Toshie Manabe

    Full Text Available Aspiration pneumonia is a dominant form of community-acquired and healthcare-associated pneumonia, and a leading cause of death among ageing populations. However, the risk factors for developing aspiration pneumonia in older adults have not been fully evaluated. The purpose of the present study was to determine the risk factors for aspiration pneumonia among the elderly.We conducted an observational study using data from a nationwide survey of geriatric medical and nursing center in Japan. The study subjects included 9930 patients (median age: 86 years, women: 76% who were divided into two groups: those who had experienced an episode of aspiration pneumonia in the previous 3 months and those who had not. Data on demographics, clinical status, activities of daily living (ADL, and major illnesses were compared between subjects with and without aspiration pneumonia. Two hundred and fifty-nine subjects (2.6% of the total sample were in the aspiration pneumonia group. In the univariate analysis, older age was not found to be a risk factor for aspiration pneumonia, but the following were: sputum suctioning (odds ratio [OR] = 17.25, 95% confidence interval [CI]: 13.16-22.62, p < 0.001, daily oxygen therapy (OR = 8.29, 95% CI: 4.39-15.65, feeding support dependency (OR = 8.10, 95% CI: 6.27-10.48, p < 0.001, and urinary catheterization (OR = 4.08, 95% CI: 2.81-5.91, p < 0.001. In the multiple logistic regression analysis, the risk factors associated with aspiration pneumonia after propensity-adjustment (258 subjects each were sputum suctioning (OR = 3.276, 95% CI: 1.910-5.619, deterioration of swallowing function in the past 3 months (OR = 3.584, 95% CI: 1.948-6.952, dehydration (OR = 8.019, 95% CI: 2.720-23.643, and dementia (OR = 1.618, 95% CI: 1.031-2.539.The risk factors for aspiration pneumonia were sputum suctioning, deterioration of swallowing function, dehydration, and dementia. These results could help improve clinical management for preventing

  9. Penicillin G Procaine Injection

    Science.gov (United States)

    Penicillin G procaine injection is used to treat certain infections caused by bacteria. Penicillin G procaine injection should not be used to treat ... in the treatment of certain serious infections. Penicillin G procaine injection is in a class of medications ...

  10. Experimental model of intervertebral disc degeneration by needle puncture in Wistar rats

    Energy Technology Data Exchange (ETDEWEB)

    Issy, A.C.; Castania, V.; Castania, M. [Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Salmon, C.E.G. [Departamento de Física, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Nogueira-Barbosa, M.H. [Divisão de Radiologia, Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Bel, E. Del [Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Defino, H.L.A. [Departamento de Biomecânica, Medicina e Reabilitação do Sistema Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil)

    2013-03-15

    Animal models of intervertebral disc degeneration play an important role in clarifying the physiopathological mechanisms and testing novel therapeutic strategies. The objective of the present study is to describe a simple animal model of disc degeneration involving Wistar rats to be used for research studies. Disc degeneration was confirmed and classified by radiography, magnetic resonance and histological evaluation. Adult male Wistar rats were anesthetized and submitted to percutaneous disc puncture with a 20-gauge needle on levels 6-7 and 8-9 of the coccygeal vertebrae. The needle was inserted into the discs guided by fluoroscopy and its tip was positioned crossing the nucleus pulposus up to the contralateral annulus fibrosus, rotated 360° twice, and held for 30 s. To grade the severity of intervertebral disc degeneration, we measured the intervertebral disc height from radiographic images 7 and 30 days after the injury, and the signal intensity T2-weighted magnetic resonance imaging. Histological analysis was performed with hematoxylin-eosin and collagen fiber orientation using picrosirius red staining and polarized light microscopy. Imaging and histological score analyses revealed significant disc degeneration both 7 and 30 days after the lesion, without deaths or systemic complications. Interobserver histological evaluation showed significant agreement. There was a significant positive correlation between histological score and intervertebral disc height 7 and 30 days after the lesion. We conclude that the tail disc puncture method using Wistar rats is a simple, cost-effective and reproducible model for inducing disc degeneration.

  11. Needle gauge and tip designs for preventing post-dural puncture headache (PDPH).

    Science.gov (United States)

    Arevalo-Rodriguez, Ingrid; Muñoz, Luis; Godoy-Casasbuenas, Natalia; Ciapponi, Agustín; Arevalo, Jimmy J; Boogaard, Sabine; Roqué I Figuls, Marta

    2017-04-07

    Post-dural puncture headache (PDPH) is one of the most common complications of diagnostic and therapeutic lumbar punctures. PDPH is defined as any headache occurring after a lumbar puncture that worsens within 15 minutes of sitting or standing and is relieved within 15 minutes of the patient lying down. Researchers have suggested many types of interventions to help prevent PDPH. It has been suggested that aspects such as needle tip and gauge can be modified to decrease the incidence of PDPH. To assess the effects of needle tip design (traumatic versus atraumatic) and diameter (gauge) on the prevention of PDPH in participants who have undergone dural puncture for diagnostic or therapeutic causes. We searched CENTRAL, MEDLINE, Embase, CINAHL and LILACS, as well as trial registries via the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal in September 2016. We adopted the MEDLINE strategy for searching the other databases. The search terms we used were a combination of thesaurus-based and free-text terms for both interventions (lumbar puncture in neurological, anaesthesia or myelography settings) and headache. We included randomized controlled trials (RCTs) conducted in any clinical/research setting where dural puncture had been used in participants of all ages and both genders, which compared different tip designs or diameters for prevention of PDPH DATA COLLECTION AND ANALYSIS: We used the standard methodological procedures expected by Cochrane. We included 70 studies in the review; 66 studies with 17,067 participants were included in the quantitative analysis. An additional 18 studies are awaiting classification and 12 are ongoing. Fifteen of the 18 studies awaiting classification mainly correspond to congress summaries published before 2010, in which the available information does not allow the complete evaluation of all their risks of bias and characteristics. Our main outcome was prevention of PDPH, but we also

  12. Experimental model of intervertebral disc degeneration by needle puncture in Wistar rats

    Directory of Open Access Journals (Sweden)

    A.C. Issy

    Full Text Available Animal models of intervertebral disc degeneration play an important role in clarifying the physiopathological mechanisms and testing novel therapeutic strategies. The objective of the present study is to describe a simple animal model of disc degeneration involving Wistar rats to be used for research studies. Disc degeneration was confirmed and classified by radiography, magnetic resonance and histological evaluation. Adult male Wistar rats were anesthetized and submitted to percutaneous disc puncture with a 20-gauge needle on levels 6-7 and 8-9 of the coccygeal vertebrae. The needle was inserted into the discs guided by fluoroscopy and its tip was positioned crossing the nucleus pulposus up to the contralateral annulus fibrosus, rotated 360° twice, and held for 30 s. To grade the severity of intervertebral disc degeneration, we measured the intervertebral disc height from radiographic images 7 and 30 days after the injury, and the signal intensity T2-weighted magnetic resonance imaging. Histological analysis was performed with hematoxylin-eosin and collagen fiber orientation using picrosirius red staining and polarized light microscopy. Imaging and histological score analyses revealed significant disc degeneration both 7 and 30 days after the lesion, without deaths or systemic complications. Interobserver histological evaluation showed significant agreement. There was a significant positive correlation between histological score and intervertebral disc height 7 and 30 days after the lesion. We conclude that the tail disc puncture method using Wistar rats is a simple, cost-effective and reproducible model for inducing disc degeneration.

  13. Time Until Neuron Death After Initial Puncture From an Amyloid-Beta Oligomer

    CERN Document Server

    Horton, Tanner

    2015-01-01

    Hardy and Higgins first proposed the amyloid cascade hypothesis in 1992, stating that the decrease in neuronal function observed in Alzheimer's Disease (AD) is due to a process initiated by the oligomerization of amyloid-beta peptides. One hypothesis states that toxicity arises from the aggregation of amyloid-beta into a pore structure, which can then puncture the brain cell membrane; this allow toxic calcium ions to flood through the opening, causing eventual cell death. In 2007, neurobiologist Ruth Nussinov calculated the three pore sizes most likely to occur within the brain. Based on her findings, we constructed a method to determine the time it takes for a cell to die after the cell is punctured by the pore. Our findings have shown that cell death occurs within one second after the oligomer makes contact with the cell. We believe this is important because instant cell death has been one criticism of Nussinov's model, and we have calculated a concrete time value for that criticism. We identify two potenti...

  14. [Unknown intracerebral tumour presenting as brainstem compression following unintentional dural puncture].

    Science.gov (United States)

    Castro-Castro, J; Figueiredo-González, O; Río-Gómez, A; Carballo-Loureiro, N; Castro-Bouzas, D

    2014-01-01

    A 36-year old primigravid of 41 weeks gestation was admitted to the labour ward. Her past medical history included hyperemesis gravidarum and migraine. An accidental dural puncture occurred during labour epidural analgesia. In the postpartum period she presented with continuous headache, and was treated with oral analgesics, oral caffeine, fluid therapy, and tetracosactide. She refused an epidural blood patch. On the seventh day postpartum, the patient was re-admitted to the Emergency Department with decreased level of consciousness and signs of brainstem compression. Cranial computed tomography and magnetic resonance imaging showed a posterior fossa tumour. An emergency craniotomy was performed with complete neurological recovery. This case emphasises the need to consider the differential diagnoses of post-dural puncture headache and to highlight the warning signs in patients who do not respond despite treatment with conventional therapy. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  15. Comparison Effect of Midazolam Alone and Midazolam Combined with Ketamine in Bone Marrow Aspiration Pain in Children

    Science.gov (United States)

    Mahmoudi Nesheli, H

    2015-01-01

    Background This study aimed to compare sedative and analgesic effects of oral Midazolam and Ketamine on Bone Marrow aspiration (BMA) and Lumbar Puncture (LP). Material and Methods This study was a randomized clinical trial and was performed in Amirkola Hospital in north of Iran, Babol during 2011 and 2012 .The study population consisted of 40 patients who underwent the first time of diagnostic BMA for any reason, patients were divided randomly in two groups: Oral Midazolam and combined Oral Midazolam and Ketamine. Each group consisted of patients with age of 3-7 years and over 7 years .Two methods of pain status and soothing were evaluated through CAMFORT scale checklist based on MAGNUSON National Institutes of Health Medical Center. Statistical analyses were done by Spss v.19. Results In our study, 17(42.5%) and 23(57.5%) were female and male, respectively. 28(70%) patients were aged between 3 and 7 years and 13(30%) older than 7 years. The obtained findings revealed that the difference between Midazolam sedation and combination of Midazolam and Ketamine sedation was significant (P= 0.00). The sedation in older patients was more than young patients in combination of Midazolam and Ketamine group. (P= 0.22). Conclusion These findings showed that Ketamine and Midazolam combination had more efficacy than Midazolam alone for decreasing pain and sedation. PMID:26705451

  16. Acute Upper Limb Ischemia due to Cardiac Origin Thromboembolism: the Usefulness of Percutaneous Aspiration Thromboembolectomy via a Transbrachial Approach

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung Kwan; Kwak, Hyo Sung; Chung, Gyoung Ho; Han, Young Min [Chonbuk National University Hospital and Medical School, Chonju (Korea, Republic of)

    2011-10-15

    To evaluate the usefulness of percutaneous aspiration thromboembolectomy (PAT) via a transbrachial approach in patients with acute upper limb ischemia. From July 2004 to March 2008, eleven patients with acute upper limb ischemia were enrolled in this study. They were initially treated with thrombolysis (n = 1), PAT (n = 6), or both (n = 4) via a femoral artery approach. However, all of the patients had residual thrombus in the brachial artery, which was subsequently managed by PAT via the transbrachial approach for removal of residual emboli. Successful re-canalization after PAT via a transbrachial approach was achieved in all patients. Two patients experienced early complications: one experienced a massive hematoma of the upper arm due to incomplete compression and was treated by stent deployment. The other patient experienced a re-occlusion of the brachial artery the day after the procedure due to excessive manual compression of the puncture site, but did not show recurrence of ischemic symptoms in the artery of the upper arm. Clinical success with complete resolution of ischemic symptoms was achieved in all patients. PAT via a transbrachial approach is a safe and effective treatment for patients with acute upper limb ischemia.

  17. [Usefulness of endoscopically guided nasogastric-jejunal feeding tube placement in a case of aspiration pneumonia due to postgastrectomy].

    Science.gov (United States)

    Tamura, Kosei; Totsuka, Osamu; Tamura, Jun'ichi

    2015-01-01

    A 79-year-old man with a history of gastrectomy with Billroth II reconstruction 27 years previously was admitted to our hospital due to recurrent pneumonia. Because he had dysphagia and had frequently developed pneumonia over the course of a year, enteral nutrition via nasogastric tube was initiated approximately six months before admission. The clinical and computed tomography findings showed that the cause of pneumonia was aspiration of tube feeding nutrients due to gastroesophageal reflux. To prevent gastroesophageal reflux, he was continuously kept in a 30-degree or greater reclining position. However, gastroesophageal reflux was seen at an injection rate of 50 ml/h or greater. After we inserted a nasogastric-jejunal feeding tube guided by endoscopy, gastroesophageal reflux, dumping syndrome and diarrhea were not seen up to an injection rate of 300 ml/h. Endoscopically guided nasogastric-jejunal feeding tube placement is a simple method and may be useful for patients with aspiration pneumonia due to postgastrectomy. Moreover, long-term postgastrectomy patients appear to tolerate the postopyloric injection of enteral nutrition. Because the number of elderly patients who have dysphagia with postgastrectomy is increasing, these findings provide a basis for treatment in elderly medical settings.

  18. Iron Dextran Injection

    Science.gov (United States)

    ... allergic to iron dextran injection; any other iron injections such as ferric carboxymaltose (Injectafer), ferumoxytol (Feraheme), iron sucrose (Venofer), or sodium ferric gluconate (Ferrlecit);any other ...

  19. Diffuse aspiration bronchiolitis: analysis of 20 consecutive patients

    Directory of Open Access Journals (Sweden)

    Xiaowen Hu

    2015-04-01

    Full Text Available OBJECTIVE: Aspiration can cause a variety of pulmonary syndromes, some of which are not well recognized. The objective of this study was to assess the demographic, clinical, radiological, and histopathological correlates of diffuse aspiration bronchiolitis (DAB, a bronchiolocentric disorder caused by recurrent aspiration. METHODS: This was a retrospective study of 20 consecutive patients with DAB seen at the Mayo Clinic in Rochester, Minnesota, between January 1, 1998 and June 30, 2014. RESULTS: The median age of the patients was 56.5 years (range, 22-76 years, and the male/female ratio was 2.3:1.0. In 18 patients, the diagnosis of DAB was based on the results of a lung biopsy; in the 2 remaining patients, it was based on clinical and radiological features, together with documented aspiration observed in a videofluoroscopic swallow study. In 19 patients (95%, we identified predisposing factors for aspiration, including gastroesophageal reflux disease (GERD, drug abuse, and dysphagia. Common presenting features included cough, sputum production, dyspnea, and fever. Twelve patients (60% had a history of recurrent pneumonia. In all of the patients, chest CT revealed bilateral pulmonary infiltrates consisting of micronodules and tree-in-bud opacities. In the majority of patients, interventions aimed at preventing recurrent aspiration (e.g., anti-GERD therapies led to improvement in the symptoms of DAB. CONCLUSIONS: Young to middle-aged subjects with recognizable predisposing factors for aspiration and who report a history of recurrent pneumonia are at increased risk for DAB. Although DAB is not well recognized, certain chest CT features are characteristic of the disorder.

  20. The Observation on Efficacy of Angio-seal Closure Device in the Femoral Arterial Puncture Site after PCI

    Institute of Scientific and Technical Information of China (English)

    Zhang Bin; Jin Lijun; Wei Shuishen; Fang Xianhong; Wu Handong; Dong Taiming; Yan hong; Liao Hongtao

    2006-01-01

    Objective To evaluatereliability and safety of Angio-seal hemostasis device applied to the femoral arterial puncture site after percutaneous coronary intervention (PCI). Methods In 40 patients after PCI in our institute during the period between May 2002 and December 2003, Angioseal device were used to seal the femoral arterial puncture site. Results All the Angioseal devices were successfully deployed in 40 patients (successful rate:100%); the mean time to hemostasis was 45±12 sec;the mean time to ambulate after angioseal closure was 1.9±0.5 hours. No major groin and systemic complication was observed. There was minor groin oozing in 2 cases and small hemotoma in 1 patient.Conclusions Angio-seal closure device of the femoral artery puncture site after a percutaneous coronary procedure is safe. It can shorten the time to hemostasis,leads to early mobilization, and reduce groin complication. The disadvantage is relatively expensive.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-02-15

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

  2. Effects of injection pressure and injection timing to exhaust gas opacity for a conventional indirect diesel engine

    Science.gov (United States)

    Budiman, Agus; Majid, Akmal Irfan; Pambayun, Nirmala Adhi Yoga; Yuswono, Lilik Chaerul; Sukoco

    2016-06-01

    In relation to pollution control and environmental friendliness, the quality of exhaust gas from diesel engine needs to be considered. The influences of injection pressure and timing to exhaust gas opacity were investigated. A series of experiments were conducted in a one-cylinder conventional diesel engine with a naturally aspirated system and indirect injection. The default specification of injection pressure was 120 kg/cm2. To investigate the injection pressure, the engine speed was retained on 1000 rpm with pressure variations from 80 to 215 kg/cm2. On the other hand, the various injection timing (8, 10, 12, 16 degrees before TDC point and exact 18 degrees before TDC point) were used to determine their effects to exhaust gas opacity. In this case, the engine speed was varied from 1000 to 2400 rpm. The injector tester was used to measure injection pressure whereas the exhaust gas opacity was determined by the smoke meter. Those data were also statistically analyzed by product moment correlation. As the results, the injection pressure of diesel engine had a non-significant positive correlation to the exhaust gas opacity with r = 0.113 and p > 5 %. Injection pressure should be adjusted to the specification listed on the diesel engine as if it was too high or too low will lead to the higher opacity. Moreover, there was a significant positive correlation between injection timing and the exhaust gas opacity in all engine speeds.

  3. Postoperative systemic dissemination of injected elemental mercury.

    Science.gov (United States)

    Kang, Suk-Hyung; Park, Seung Won; Moon, Kyung-Yoon

    2011-04-01

    There were only a few reports of mercury on pulmonary artery. However, there is no data on surgery related mercury dissemination. The objective of the present article is to describe one case of postoperative injected mercury dissemination. A 19-year-old man presented severe neck pain including meningeal irritation sign and abdominal pain after injection of mercury for the purpose of suicide. Radiologic study showed injected mercury in the neck involving high cervical epidural space and subcutaneous layer of abdomen. Partial hemilaminectomy and open mercury evacuation of spinal canal was performed. For the removal of abdominal subcutaneous mercury, C-arm guided needle aspiration was done. After surgery, radiologic study showed disseminated mercury in the lung, heart, skull base and low spinal canal. Neck pain and abdominal pain were improved after surgery. During 1 month after surgery, there was no symptom of mercury intoxication except increased mercury concentration of urine, blood and hair. We assumed the bone work during surgery might have caused mercury dissemination. Therefore, we recommend minimal invasive surgical technique for removal of injected mercury. If open exposures are needed, cautious surgical technique to prohibit mercury dissemination is necessary and normal barrier should be protected to prevent the migration of mercury.

  4. Usefulness of intracavitary urokinase injection under sonographic guidance in treatment for periappendiceal abscess

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Jong Soo; Cha, Sang Hoon; Kim, Beak Hyun; Jung, Hwan Hoon; Kim, Taik Kun [Ansan Hospital, Korea University School of Medicine, Ansan (Korea, Republic of); Seo, Bo Kyoung; Chung, Kyoo Byung [Anam Hospital, Korea University School of Medicine, Seoul (Korea, Republic of); Park, Cheol Min [Guro Hospital, Korea University School of Medicine, Seoul (Korea, Republic of)

    2002-12-15

    To evaluate usefulness of intracavitary urokinase injection for the treatment of small sized periappendiceal abscess which was not unsuitable for percutaneous catheter drainage. From December 1997 to December 1999, we performed intracavitary injection of urokinase as a treatment of periappendiceal abscess in six patients. Initially, aspiration of the abscess was done using a 18 G needle under sonographic guidance. We measured the maximal length of residual abscess and injected 5000 IU of urokinase per centimeter of the diameter of the residual abscess. 24 hours after the injection of urokinase, repeated aspiration of the residual abscess was done, and follow-up sonographic examination was performed. The size of initial abscesses in each patients was ranged from 1.6 X 1.2 to 5.8 X 3.4 cm (mean=3.9 X 2.4 cm), and initial volume of aspirated pus was ranged from 3 to 31 cc (mean=11.8 cc).24 hour after the injection, the volume of respirated pus was ranged from 4 to 13.5 cc (mean=10.4 cc). Follow-up sonography performed 3 to 10 days later revealed no residual abscess. The mean duration of hospitalization was 5.5 days. Intracavitary urokinase injection under the sonographic guidance can be a useful method for the treatment of small sized periappendiceal abscess which is not suitable for percutaneous catheter drainage.

  5. How effective is multiple needle puncturing for medial soft tissue balancing during total knee arthroplasty? A cadaveric study.

    Science.gov (United States)

    Koh, In Jun; Kwak, Dai-Soon; Kim, Tae Kyun; Park, In Joo; In, Yong

    2014-12-01

    We investigated the quantitative effect and risk factors for over-release during multiple needle puncturing (MNP) for medial gap balancing in varus total knee arthroplasty (TKA). Of the ten pairs of cadaveric knees, one knee from each pair was randomly assigned to undergo MNP in extension (E group), while the other knee underwent MNP in flexion (F group). The increased extension and 90° flexion gaps after every five needle punctures were measured until over-release occurred. The extension gap (knee, a narrow MCL, and severe osteoarthritis were associated with a smaller number of MNPs required to over-release.

  6. Treatment of a cavernous sinus dural arteriovenous fistula by deep orbital puncture of the superior ophthalmic vein

    Energy Technology Data Exchange (ETDEWEB)

    Benndorf, G. [Neuroangiography, Department of Radiology, Charite, Humboldt University Berlin (Germany); Bender, A. [Neuroradiology, Department of Radiology, Charite, Humboldt University Berlin (Germany); Campi, A. [Dept. of Neuroradiology, Hospital San Raffaele, Milan (Italy); Menneking, H. [Dept. of Maxillofacial Surgery, Charite, Humboldt University Berlin (Germany); Lanksch, W.R. [Department of Neurosurgery, Charite, Humboldt University Berlin, Augustenburger Platz 1, 13 353 Berlin (Germany)

    2001-06-01

    In a patient with progressive ophthalmological problems, including uncontrolled intraocular pressure related to a cavernous sinus dural arteriovenous fistula, urgent intervention may be necessary to prevent permanent visual loss. We report a case in which inadequate transarterial embolisation and lack of access for transvenous catheterisation, including a direct approach through the superior ophthalmic vein, preceded percutaneous puncture of the superior ophthalmic vein deep within the orbit, permitting venous occlusion without complications. This case demonstrates that deep orbital puncture of the vein is feasible for occlusion of a cavernous sinus dural arteriovenous fistula. (orig.)

  7. Thirty-two Cases of Acne Treated with Blood-letting Puncture,Cupping and Chinese-Drug Facemask

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    To observe the therapeutic effect on acne treated with blood-letting puncture, cupping and Chinese-drug facemask. Thirty-two patients with acne were treated with above-mentioned therapeutic method. Cure,improvement and ineffectiveness were respectively found in 24, 7 and 1 case, with a curative rate of 75.0% and a total effective rate of 96.8%. The combination of blood-letting puncture, cupping and external application of Chinese-drug facemask is effective in treating acne.

  8. Laryngeal Elevation Velocity and Aspiration in Acute Ischemic Stroke Patients

    Science.gov (United States)

    Zhang, Jing; Zhou, Yun; Wei, Na; Yang, Bo; Wang, Anxin; Zhou, Hai; Zhao, Xingquan; Wang, Yongjun; Liu, Liping; Ouyoung, Melody; Villegas, Brenda; Groher, Michael

    2016-01-01

    Objectives Aspiration after stroke has been associated with aspiration pneumonia, which contributes to increased mortality of stroke. Laryngeal elevation is a core mechanism for protection from aspiration. Few studies have explored the predictive value of laryngeal elevation velocity for aspiration after stroke. This study aimed to explore the ability of laryngeal elevation velocity to predict aspiration in patients with acute ischemic stroke. Methods This was a prospective cohort study that included consecutive acute ischemic stroke patients treated at a teaching hospital during a 10-month period. Patients underwent magnetic resonance imaging (MRI) to confirm the diagnosis of acute ischemic stroke. Patients who were at risk of aspiration and could swallow 5 ml of diluted barium (40%, w/v) for a videofluoroscopic swallowing (VFS) study were included. The association between abnormal indices in the oral and pharyngeal phase of the VFS study and aspiration was examined using univariate analyses. These indices included the lip closure, tongue movement and control, laryngeal elevation velocity and range, the latency of pharyngeal swallowing, pharyngeal transit time (PTT), abnormal epiglottis tilt, residual barium in the pharynx, and the duration of upper esophageal sphincter (UES) opening. The laryngeal elevation velocity (%/s) was calculated as the range of laryngeal elevation (%) from the resting position to the maximum superior position or to the position where the laryngeal vestibule is fully closed divided by the corresponding duration of laryngeal elevation. The range of laryngeal elevation (%) was the percentage calculated as the distance between the resting laryngeal position and the maximum superior excursion position or position where the laryngeal vestibule is fully closed divided by the distance between the resting laryngeal position and the lowest edge of the mandible. A logistic regression analysis was used to determine the predictive value for aspiration

  9. Can nature make us more caring? Effects of immersion in nature on intrinsic aspirations and generosity.

    Science.gov (United States)

    Weinstein, Netta; Przybylski, Andrew K; Ryan, Richard M

    2009-10-01

    Four studies examined the effects of nature on valuing intrinsic and extrinsic aspirations. Intrinsic aspirations reflected prosocial and other-focused value orientations, and extrinsic aspirations predicted self-focused value orientations. Participants immersed in natural environments reported higher valuing of intrinsic aspirations and lower valuing of extrinsic aspirations, whereas those immersed in non-natural environments reported increased valuing of extrinsic aspirations and no change of intrinsic aspirations. Three studies explored experiences of nature relatedness and autonomy as underlying mechanisms of these effects, showing that nature immersion elicited these processes whereas non-nature immersion thwarted them and that they in turn predicted higher intrinsic and lower extrinsic aspirations. Studies 3 and 4 also extended the paradigm by testing these effects on generous decision making indicative of valuing intrinsic versus extrinsic aspirations.

  10. Thermal blooming on laser propagation in an aspirating pipe

    Science.gov (United States)

    Zhu, Fuyin; Wang, Jihong; Ren, Ge; Tan, Yufeng; Zhu, Nengbing; Ai, Zhiwei

    2016-10-01

    Thermal blooming effect of gas on laser propagation can seriously degrade performance of far-field beam quality and energy distribution. Numerical simulation is carried out to study the influences of thermal blooming on laser propagation in line pipes. A physical model of thermal blooming effect of gas on laser propagation in an aspirating pipe is established. Axial flow and suction in the outlet are used to attenuate the thermal blooming effect. Based on the computational fluid dynamics (CFD) software, stable calculation of flow field is carried out first, then the optical field and the fluent field is coupling calculated by means of user defined function (UDF). The results show that radial flow is enhanced in the aspirating pipe and the index of refraction gradient caused by thermal blooming effect is decreased. It is indicated that the beam quality of the outlet is improved compared with the pipe model without aspirating. The optical path difference (OPD) distribution of the outlet is analyzed and decomposed by Zernike polynomials. It is shown that the defocus item of 4m aspirating pipe is decreased more than an order of magnitude compared with the 4m pipe without aspirating.

  11. Dental prosthesis aspiration: An uncommon cause of respiratory distress.

    Science.gov (United States)

    De Wilde, Belphine A L; Malfait, Thomas L; Bonte, Katrien; Malfait, Thomas L A

    2016-12-01

    We present a case of a 66-year-old Caucasian man with acute respiratory distress. The patient had a history of multiple cerebrovascular accidents which resulted in left hemiplegia, swallowing problems, and aphasia. He was tentatively diagnosed with aspiration pneumonia. However, because of clinical deterioration further investigations concluded to the aspiration of a dental prosthesis. After intubation and stabilization, the prosthesis could be manually extracted. However, the patient developed a Staphylococcus epidermidis sepsis and despite adequate antibiotic therapy, he eventually died. Dental prosthesis aspiration is a medical situation associated with a higher morbidity and mortality rate compared to ingested foreign bodies. It requires a high level of suspicion to ensure a timely diagnosis and life-saving treatment. Thorough history taking is of great importance in case of tracheobronchial aspiration, which is in the adult population mostly secondary to an underlying disorder. In impaired adults with missing dental prostheses there should be extra awareness for this problem. This case report illustrates the importance of a detailed history in case of tracheobronchial aspiration and shows the limitations in the diagnostic usefulness of bedside chest radiography.

  12. Physiological factors related to aspiration risk: a systematic review.

    Science.gov (United States)

    Steele, Catriona M; Cichero, Julie A Y

    2014-06-01

    Penetration-aspiration is considered the most serious component of oropharyngeal dysphagia. Clinicians regularly evaluate the pathophysiology of swallowing and postulate reasons or mechanisms behind penetration-aspiration. In this article we share the results of a two-stage literature review designed to elucidate the association between abnormalities in physiological measures of swallowing function and the occurrence of penetration-aspiration. In the first stage, a broad scoping review was undertaken using search terms for nine different structures involved in oropharyngeal swallowing. In the second stage, based on the results of the initial search, a more focused systematic review was undertaken which explored the association between aspiration and abnormalities in respiratory, tongue, hyoid, and laryngeal function in swallowing. A total of 37 articles underwent detailed quality review and data extraction in the systematic review. The results support measurement of tongue strength, anatomically normalized measures of hyoid movement, bolus dwell time in the pharynx while the larynx remains open, respiratory rate, and respiratory swallow phasing as parameters relevant to aspiration risk.

  13. Implications of stroke for caregiver outcomes: findings from the ASPIRE-S study.

    Science.gov (United States)

    Atteih, Samar; Mellon, Lisa; Hall, Patricia; Brewer, Linda; Horgan, Frances; Williams, David; Hickey, Anne

    2015-08-01

    Informal caregivers are vital to the long-term care and rehabilitation of stroke survivors worldwide. However, caregiving has been associated with negative psychological outcomes such as anxiety and depression, which leads to concerns about caregiver as well as stroke survivor well-being. Furthermore, caregivers may not receive the support and service provision they require from the hospitals and community. This study examines caregiver psychological well-being and satisfaction with service provision in the context of stroke. Caregiver data were collected as part of the ASPIRE-S study, a prospective study of secondary prevention and rehabilitation which assessed stroke patients and their carers at six-months post stroke. Carer assessment included measurement of demographics, satisfaction with care (UK Healthcare Commission National Patient Survey of Stroke Care), psychological distress (Hospital Anxiety and Depression Scale), and vulnerability (Vulnerable Elders Scale). Logistic regression analyses and chi-squared tests were performed using stata version 12. Analyses from 162 carers showed substantial levels of dissatisfaction (37·9%) with community and hospital services, as well as notable levels of anxiety (31·3%) and depressive symptoms (18·8%) among caregivers. Caregiver anxiety was predicted by stroke survivor anxiety (OR = 3·47, 95% CI 1·35-8·93), depression (OR = 5·17, 95% CI 1·83-14·58), and stroke survivor cognitive impairment (OR 2·35, 95% CI 1·00-5·31). Caregiver depression was predicted by stroke survivor anxiety (OR = 4·41, 95% CI 1·53-12·72) and stroke survivor depression (OR = 6·91, 95% CI 2·26-21·17). Findings indicate that caregiver and stroke survivor well-being are interdependent. Thus, early interventions, including increased training and support programs that include caregivers, are likely to reduce the risk of negative emotional outcomes. © 2015 World Stroke Organization.

  14. Sipuleucel-T Injection

    Science.gov (United States)

    Sipuleucel-T injection is used to treat certain types of advanced prostate cancer. Sipuleucel-T injection is in a class of medications called ... Sipuleucel-T injection comes as a suspension (liquid) to be injected over about 60 minutes into a vein ...

  15. Investigating Efficacy of Melatonin and Gabapentin in Reducing Anxiety and Pain of Lumbar Puncture in Children

    Directory of Open Access Journals (Sweden)

    R Fallah

    2013-10-01

    Full Text Available Introduction: The lumbar puncture is one of the most important diagnostic and therapeutic procedures within children which child’s non-cooperativeness and procedural sedation are regarded necessary to conduct it. This study aimed to compare efficacy and safety of melatonin and gabapentin in reducing anxiety and pain of lumbar puncture in children. Methods: In a parallel single-blinded randomized clinical trial, sixty children aged 6 months -7 years, were evaluated in Pediatric Ward of Shahid Sadoughi Hospital, in Yazd (Iran in 2012. The children were distributedrandomly into two groups (30 children in each group. In group one, they received 0.3 mg/kg/dose of melatonin and theother group received 15 mg/kg/dose of gabapentin. Primary endpoints were success rate in reducing anxiety (anxiety score of≥ four and reducing pain when the needle was inserted to skin for lumbarpuncture (pain score of less than four. The clinicalside effects were investigated as well. Results: Twenty two girls (36.7% and 38 boys (63.3% with mean age of 2.79 ± 1.92 years were evaluated. Anxiety reduction (achieving the anxiety score of ≥ four was obtained in 43.3% in melatonin and in 36.7% in gabapentin groups, respectively and both drugs were equally effective in anxiety reduction (p.value = 0.598.Pain reduction ( achieving the pain score of less than four was obtained in 23.3% in melatonin and in 50% in gabapentin groups, respectively and thus, gabapentin wasproved to be more effective in pain reduction (p.value = 0.032.Mild side effects were observed in 10% of melatonin group and in 16.7% of gabapentin group. No statistically significant differences were seen from viewpoint of safety between the two drugs (p.value=0.448. Conclusion: Melatonin and gabapentin were not effective drugs in anxiety reduction for lumbar puncture of children. However, gabapentin is a safe and effective drug in pain reduction in painful diagnostic therapeutic procedures.

  16. Efficacy of the epidural blood patch for the treatment of post lumbar puncture headache BLOPP: a randomised, observer-blind, controlled clinical trial [ISRCTN 71598245].

    NARCIS (Netherlands)

    R. Oedit; F. van Kooten (Fop); S.L.M. Bakker (Stef); D.W.J. Dippel (Diederik)

    2005-01-01

    textabstractBACKGROUND: Post dural punction headache (PDPH) occurs in 10% to 40% of the patients who had a lumbar puncture. Its symptoms can be severe and incapacitating. The epidural blood patch is widely accepted as the treatment of choice for postdural puncture headache. Uncontrolled studies repo

  17. Impact of transseptal puncture site on acute and mid-term outcomes during cryoballoon ablation: A comparison between anterior, medial and posterior transatrial access

    NARCIS (Netherlands)

    Chierchia, G.B.; Casado-Arroyo, R.; Asmundis, C. de; Rodriguez-Manero, M.; Sarkozy, A.; Conte, G.; Sieira, J.; Levinstein, M.; Baltogiannis, G.; Giovanni, G.; Overeinder, I.; Ocello, S.; Rosas, E.; Isola, F.; Brugada, P.

    2013-01-01

    BACKGROUND: Cryoballoon ablation (CBA) (Arctic Front, Medtronic, USA) has proven very effective in achieving pulmonary vein isolation (PVI). Different transseptal (TS) puncture sites might influence CBA procedure. The aim of the present study was to analyze the influence of different TS puncture sit

  18. Impact of transseptal puncture site on acute and mid-term outcomes during cryoballoon ablation: A comparison between anterior, medial and posterior transatrial access

    NARCIS (Netherlands)

    Chierchia, G.B.; Casado-Arroyo, R.; Asmundis, C. de; Rodriguez-Manero, M.; Sarkozy, A.; Conte, G.; Sieira, J.; Levinstein, M.; Baltogiannis, G.; Giovanni, G.; Overeinder, I.; Ocello, S.; Rosas, E.; Isola, F.; Brugada, P.

    2013-01-01

    BACKGROUND: Cryoballoon ablation (CBA) (Arctic Front, Medtronic, USA) has proven very effective in achieving pulmonary vein isolation (PVI). Different transseptal (TS) puncture sites might influence CBA procedure. The aim of the present study was to analyze the influence of different TS puncture sit

  19. Analysis of fatty acid composition in human bone marrow aspirates.

    Science.gov (United States)

    Deshimaru, Ryota; Ishitani, Ken; Makita, Kazuya; Horiguchi, Fumi; Nozawa, Shiro

    2005-09-01

    In the present study, the fatty acid composition of bone marrow aspirates and serum phospholipids in nine patients with hematologic diseases was investigated, and the effect of fatty acids on osteoblast differentiation in ST2 cells was examined. The concentrations of oleic acid and palmitic acid were significantly higher in bone marrow aspirates than in serum phospholipids, but the concentrations of other fatty acids did not differ. The rate of alkaline phosphatase positive ST2 cells induced by BMP2 was significantly increased by oleic acid, but was unaffected by the presence or absence of palmitic acid. We conclude that the fatty acid composition of bone marrow aspirates differs from that of serum phospholipids. This difference may affect osteoblast differentiation in the bone marrow microenvironment.

  20. [Recommendations for the prevention of foreign body aspiration].

    Science.gov (United States)

    Lluna, Javier; Olabarri, Mikel; Domènech, Anna; Rubio, Bárbara; Yagüe, Francisca; Benítez, María T; Esparza, María J; Mintegi, Santiago

    2017-01-01

    The aspiration of a foreign body remains a common paediatric problem, with serious consequences that can produce both acute and chronic disease. Aspiration usually causes a medical emergency that requires a prompt diagnosis and an urgent therapeutic approach as it may result in the death of the child or severe brain injury. It typically involves organic foreign bodies (mainly food or nuts) aspirated by children under 5 years old, and usually at home. In this statement, the Committee on Safety and Prevention of Non-Intentional Injury in Childhood of the Spanish Paediatrics Association provides a series of recommendations, both educational (while eating and playing), as well as legal, to prevent such episodes. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.