WorldWideScience

Sample records for punctures

  1. 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 ...

  2. 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.

  3. 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 ...

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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

  9. 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...

  10. 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.

  11. 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...

  12. 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.

  13. 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.

  14. 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

  15. 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

  16. 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)

  17. 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...

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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 ...

  3. 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...

  4. 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...

  5. 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.

  6. 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.

  7. 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.

  8. [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.

  9. 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.

  10. [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.

  11. 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.

  12. 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.

  13. 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...

  14. 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.

  15. 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.

  16. 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.

  17. 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...

  18. 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.

  19. 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...

  20. 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.

  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. 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

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. 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.

  14. 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...

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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

  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. 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.

  8. 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.

  9. 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.

  10. 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....

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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...

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. 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)

  1. 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.

  2. 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).

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. 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.

  15. 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 ...

  16. 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...

  17. 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.

  18. 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....

  19. 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.

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

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    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.

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

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    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.

  2. Under Utilization of Local Anesthetics in Infant Lumbar Punctures

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    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.

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

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    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.

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

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    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.

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

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    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.

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

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    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

  7. 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.

  8. 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

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

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    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

  10. 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.

  11. 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.

  12. 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.

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

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    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.

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

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    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.

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

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    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.

  16. 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.

  17. 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.

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

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    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

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

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    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.

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

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    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.

  1. [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.

  2. [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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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,...

  12. 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.

  13. 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.

  14. 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].

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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...

  20. 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.

  1. [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.

  2. 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

  3. 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...

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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...

  16. 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...

  17. 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.

  18. 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.

  19. 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...

  20. 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.

  1. 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...

  2. 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.

  3. 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...

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. 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...

  14. [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.

  15. 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...

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. [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.

  2. 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...

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. Successful lumbar puncture with Taylor′s approach for the diagnostic workup of meningitis in a patient with Ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    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.

  8. 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.

  9. Cerebral venous and sinus thrombosis with cerebrospinal fluid circulation block after the first methotrexate administration by lumbar puncture

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  10. Effectiveness of combined laser-puncture and conventional wound care to accelerate diabetic foot ulcer healing

    Directory of Open Access Journals (Sweden)

    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.

  11. 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

  12. Effectiveness of sublingual nitroglycerin before puncture compared with conventional intra-arterial nitroglycerin in transradial procedures: a randomized trial

    Energy Technology Data Exchange (ETDEWEB)

    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

  13. [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.

  14. Vapocoolant Spray Effectiveness on Arterial Puncture Pain: A Randomized Controlled Clinical Trial

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    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.

  15. THE IMPACT OF ANXIETY ON POST - DURAL PUNCTURE HEADACHE IN ROUTINE NEUROLOGY PRACTICE

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    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.

  16. [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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. [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.

  5. 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

  6. 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...

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  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. 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.

  16. 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.

  17. 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.)

  18. 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.

  19. [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

  20. 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.

  1. 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

  2. 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

  3. 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

  4. Design of radioactive material shipping packaging for low-velocity puncture resistance

    Energy Technology Data Exchange (ETDEWEB)

    Nickell, R.E. (Electric Power Research Inst., Palo Alto, CA (USA)); May, R.A. (Sandia National Labs., Albuquerque, NM (USA))

    1983-02-01

    Both the standards developed by the International Atomic Energy Agency (IAEA) and those contained in the U.S. federal regulations stipulate that transport packagings containing large quantities of radioactive material, such as spent fuel from a nuclear power reactor or waste by-products from nuclear weapons programs, should be designed to resist a sequence of impact, puncture, fire, and water immersion conditions without harmful release of contents. A recent paper has offered a perspective on the design of such packagings relative to the impact event - a 30 ft (9m) drop onto an essentially unyielding target. In this paper the second event in the accident design sequence is addressed - the 40 in (1 m) drop of the packaging, after primary impact, onto a mild steel cylindrical punch.

  5. Conformal-thin-sandwich initial data for a single boosted or spinning black hole puncture

    CERN Document Server

    Laguna, P

    2003-01-01

    Sequences of initial-data sets representing binary black holes in quasi-circular orbits have been used to calculate what may be interpreted as the innermost stable circular orbit. These sequences have been computed with two approaches. One method is based on the traditional conformal-transverse-traceless decomposition and locates quasi-circular orbits from the turning points in an effective potential. The second method uses a conformal-thin-sandwich decomposition and determines quasi-circular orbits by requiring the existence of an approximate helical Killing vector. Although the parameters defining the innermost stable circular orbit obtained from these two methods differ significantly, both approaches yield approximately the same initial data, as the separation of the binary system increases. To help understanding this agreement between data sets, we consider the case of initial data representing a single boosted or spinning black hole puncture of the Bowen-York type and show that the conformal-transverse-t...

  6. Aid to Percutaneous Renal Access by Virtual Projection of the Ultrasound Puncture Tract onto Fluoroscopic Images

    CERN Document Server

    Mozer, Pierre; Leroy, Antoine; Baumann, Michael; Payan, Yohan; Troccaz, Jocelyne; Chartier-Kastler, Emmanuel; Richard, François

    2007-01-01

    Background and Purpose: Percutaneous renal access in the context of percutaneous nephrolithotomy (PCNL) is a difficult technique, requiring rapid and precise access to a particular calix. We present a computerized system designed to improve percutaneous renal access by projecting the ultrasound puncture tract onto fluoroscopic images. Materials and Methods: The system consists of a computer and a localizer allowing spatial localization of the position of the various instruments. Without any human intervention, the ultrasound nephrostomy tract is superimposed in real time onto fluoroscopic images acquired in various views. Results: We tested our approach by laboratory experiments on a phantom. Also, after approval by our institution's Ethics Committee, we validated this technique in the operating room during PCNL in one patient. Conclusion: Our system is reliable, and the absence of image-processing procedures makes it robust. We have initiated a prospective study to validate this technique both for PCNL speci...

  7. Incidental Diagnosis of Cerebral Cortical Venous Thrombosis in Postdural Puncture Headache on Brain Computed Tomography.

    Science.gov (United States)

    Humbertjean, Lisa; Ducrocq, Xavier; Lacour, Jean-Christophe; Mione, Gioia; Richard, Sébastien

    2015-01-01

    Diagnosis of cerebral cortical venous thrombosis in patients with postdural puncture headache (PDPH) is usually secondary to changes in headache pattern or cerebral infarctions. Nevertheless, incidental discovery of asymptomatic forms on brain imaging has never been reported before and its management thus remains ill-defined. We describe 2 cases of patients with asymptomatic cortical vein thrombosis in the context of PDPH. In both cases, brain computed tomography (CT) scans showed an isolated cortical vein thrombosis without cerebral damage. Neurological examination revealed the typical orthostatic feature of PDPH, independently of cortical vein thrombosis which was considered as a radiological incidental finding. Clinical and radiological signs resolved after bed rest, oral caffeine, and anticoagulation therapy. Asymptomatic cortical vein thrombosis may be found on radiological exploration, even basic like brain CT scan without contrast, of PDPH. Utility of anticoagulation therapy, which could increase the risk of cerebral hemorrhagic complications in this specific context, has to be assessed.

  8. Lumbar Puncture Alleviates Chorea in a Patient with Huntington’s Disease and Normal Pressure Hydrocephalus

    Directory of Open Access Journals (Sweden)

    Peyman Shirani

    2009-01-01

    Full Text Available A 44-year-old African-American male was admitted to our hospital after a suicide attempt. He had depression, poor cognitive function, choreiform movements, difficulty pronouncing words, and difficulty walking. His symptoms had worsened markedly over several months. Chorea lead to genetic testing that confirmed a diagnosis of Huntington Disease (HD. A CT scan of the head showed wider ventricles than is typical of HD. The head CT and gait change suggested normal pressure hydrocephalus (NPH. Lumbar puncture (LP led to improved neuropsychologic test scores and walking thereby supporting the diagnosis of NPH. Surprisingly, the LP also led to an 80% improvement of chorea. There are two other reports of an association between HD and NPH. NPH should be considered in HD patients with atypical symptoms, such as the inability to walk or rapid progression, as its treatment may lead to improved cognition, gait, and chorea.

  9. [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.

  10. Sea urchin puncture resulting in PIP joint synovial arthritis: case report and MRI study.

    Science.gov (United States)

    Liram, N; Gomori, M; Perouansky, M

    2000-01-01

    Of the 600 species of sea urchins, approximately 80 may be venomous to humans. The long spined or black sea urchin, Diadema setosum may cause damage by the breaking off of its brittle spines after they penetrate the skin. Synovitis followed by arthritis may be an unusual but apparently not a rare sequel to such injury, when implantation occurs near a joint. In this case report, osseous changes were not seen by plain x-rays. Magnetic resonance imaging (MRI) was used to expose the more salient features of both soft tissue and bone changes of black sea urchin puncture injury 30 months after penetration. In all likelihood, this type of injury may be more common than the existing literature at present suggests. It is believed to be the first reported case in this part of the world as well as the first MRI study describing this type of joint pathology. Local and systemic reactions to puncture injuries from sea urchin spines have been described previously. These may range from mild, local irritation lasting a few days to granuloma formation, infection and on occasions systemic illness. The sea urchin spines are composed of calcium carbonate with proteinaceous covering. The covering tends to cause immune reactions of variable presentation. There are only a handful of reported cases with sea urchin stings on record, none of them from the Red Sea. However, this condition is probably more common than is thought and can present difficulty in diagnosis. In this case report, the inflammation responded well to heat treatment, mobilization and manipulation of the joint in its post acute and chronic stages. As some subtle changes in soft tissues and the changes in bone were not seen either on plain x-rays or ultrasound scan, gadolinium-enhanced MRI was used to unveil the marked changes in the joint.

  11. 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.

  12. Intra-operative Hemostasis of Punctured Femoral Artery Using HIFU: A Survival Study

    Science.gov (United States)

    Zderic, Vesna; Keshavarzi, Amid; Noble, Misty L.; Paun, Marla; Sharar, Sam R.; Crum, Lawrence A.; Martin, Roy W.; Vaezy, Shahram

    2005-03-01

    The objective was to investigate the long-term efficacy of hemostasis and healing of arteries after HIFU application. The femoral arteries of 22 adult rabbits were surgically exposed. Fifteen arteries were punctured with a needle and treated with HIFU, and 7 arteries were sham-treated (no puncture or HIFU was applied). The tip of the HIFU applicator was positioned on the bleeding site, and HIFU energy was applied until hemostasis was achieved. The focal intensity was approximately 3,000 W/cm2, at the resonant frequency of 9.6 MHz. Serial ultrasound images, blood and tissue samples were collected immediately and on days 1, 3, 7, 14, 28, and 60 after the treatment. Eleven of the arteries were patent after the treatment, and four arteries were occluded, as confirmed using Doppler imaging. One of the occluded arteries reopened at day 14. HIFU exposure time to achieve hemostasis was 27 ±17 seconds for patent arteries and 101±38 seconds for the occluded arteries. The blood flow velocities were not statistically different between HIFU-treated patent vessels and sham-treated vessels. The tunica adventitia and media, disrupted and coagulated immediately after the treatment, recovered to normal appearance within 28 days, with localized thinning of the tunica media observed up to day 60. Neo-intimal hyperplasia was observed in the arteries at days 14 and 28. HIFU produced an effective and long-term (up to 60 days) hemostasis of injured femoral arteries while preserving a normal blood flow and vessel wall structure in the majority of vessels.

  13. A Proposed Maneuver to Guide Transseptal Puncture Using Real-Time Three-Dimensional Transesophageal Echocardiography: Pilot Study

    Directory of Open Access Journals (Sweden)

    Hani M. Mahmoud

    2015-01-01

    Full Text Available Aim of Study. To assess the feasibility of a new proposed maneuver “RATLe-90” using real-time three-dimensional transesophageal echocardiography (RT-3DTEE for anatomically oriented visualization of the interatrial septum (IAS in guiding the transseptal puncture TSP. Methods. The study included 20 patients (mean age, 60.2±6.7 years; 60% males who underwent TSP for different indications. RT-3DTEE was used to guide TSP. The proposed maneuver RATLe-90 (Rotate-Anticlockwise-Tilt-Left-90 was applied in all cases to have the anatomically oriented en face view of the IAS from the right atrial (RA aspect. Having this anatomically oriented view, we guided the TSP catheter towards the proper puncture site according to the planned procedure. Results. Using the RATLe-90 maneuver, the anatomically oriented en face view of the IAS from the RA was obtained in all patients. We were able to guide the puncture catheter to the proper puncture site on the IAS. The 3D images obtained were clearly understood by both echocardiographers and interventionists. The RATLe-90 maneuver acquisition time was 19.9±1.6 seconds. The time-to-tent was 64.8±16.3 seconds. Less TEE probe manipulations were needed while guiding the TSP. Conclusions. Application of RT3D-TEE during TSP using RATLe-90 maneuver is feasible with shorter fluoroscopy time and minimizing TEE probe manipulations.

  14. Mycobacterium ulcerans low infectious dose and mechanical transmission support insect bites and puncturing injuries in the spread of Buruli ulcer.

    Science.gov (United States)

    Wallace, John R; Mangas, Kirstie M; Porter, Jessica L; Marcsisin, Renee; Pidot, Sacha J; Howden, Brian; Omansen, Till F; Zeng, Weiguang; Axford, Jason K; Johnson, Paul D R; Stinear, Timothy P

    2017-04-01

    Addressing the transmission enigma of the neglected disease Buruli ulcer (BU) is a World Health Organization priority. In Australia, we have observed an association between mosquitoes harboring the causative agent, Mycobacterium ulcerans, and BU. Here we tested a contaminated skin model of BU transmission by dipping the tails from healthy mice in cultures of the causative agent, Mycobacterium ulcerans. Tails were exposed to mosquito (Aedes notoscriptus and Aedes aegypti) blood feeding or punctured with sterile needles. Two of 12 of mice with M. ulcerans contaminated tails exposed to feeding A. notoscriptus mosquitoes developed BU. There were no mice exposed to A. aegypti that developed BU. Eighty-eight percent of mice (21/24) subjected to contaminated tail needle puncture developed BU. Mouse tails coated only in bacteria did not develop disease. A median incubation time of 12 weeks, consistent with data from human infections, was noted. We then specifically tested the M. ulcerans infectious dose-50 (ID50) in this contaminated skin surface infection model with needle puncture and observed an ID50 of 2.6 colony-forming units. We have uncovered a biologically plausible mechanical transmission mode of BU via natural or anthropogenic skin punctures.

  15. Mycobacterium ulcerans low infectious dose and mechanical transmission support insect bites and puncturing injuries in the spread of Buruli ulcer.

    Directory of Open Access Journals (Sweden)

    John R Wallace

    2017-04-01

    Full Text Available Addressing the transmission enigma of the neglected disease Buruli ulcer (BU is a World Health Organization priority. In Australia, we have observed an association between mosquitoes harboring the causative agent, Mycobacterium ulcerans, and BU. Here we tested a contaminated skin model of BU transmission by dipping the tails from healthy mice in cultures of the causative agent, Mycobacterium ulcerans. Tails were exposed to mosquito (Aedes notoscriptus and Aedes aegypti blood feeding or punctured with sterile needles. Two of 12 of mice with M. ulcerans contaminated tails exposed to feeding A. notoscriptus mosquitoes developed BU. There were no mice exposed to A. aegypti that developed BU. Eighty-eight percent of mice (21/24 subjected to contaminated tail needle puncture developed BU. Mouse tails coated only in bacteria did not develop disease. A median incubation time of 12 weeks, consistent with data from human infections, was noted. We then specifically tested the M. ulcerans infectious dose-50 (ID50 in this contaminated skin surface infection model with needle puncture and observed an ID50 of 2.6 colony-forming units. We have uncovered a biologically plausible mechanical transmission mode of BU via natural or anthropogenic skin punctures.

  16. REcanalisation and Balloon-Oriented Puncture for Re-Insertion of Dialysis Catheter in Nonpatent Central Veins (REBORN).

    Science.gov (United States)

    Too, Chow Wei; Sayani, Raza; Lim, Elvin Yuan Ting; Leong, Sum; Gogna, Apoorva; Teo, Terence K

    2016-08-01

    To describe a technique involving REcanalisation and Balloon-Oriented puncture for Re-insertion of dialysis catheter in Nonpatent central veins (REBORN) and to report long-term results. This is a retrospective study of ten subjects in whom dialysis catheters were inserted using the REBORN technique from March 2012 to October 2014 and followed up till April 2016. Data on the duration of catheter usage, complications and reasons for removal were obtained. Seven patients had partially occluded lower internal jugular veins (IJV) recanalised in an antegrade fashion via a more cranial puncture. The balloon was then inflated at usual puncture site with an 18G needle. The collapsed balloon was cannulated with a guide wire, and both balloon and guide wire were advanced together into the superior vena cava. This was followed by tunnelled catheter placement using standard techniques. Two patients had catheters placed in the subclavian vein using a similar antegrade technique, and one patient had catheter placed via the left IJV following retrograde recanalisation from a right femoral puncture. Mean duration of catheter use was 278 days (range 32-503). Three catheters were removed due to matured arteriovenous accesses. Four patients had successful catheter change over the same subcutaneous track due to catheter malfunction. One catheter was removed after 7 months because of sepsis. No complications were reported. The REBORN technique allows for the preservation of central veins for future haemodialysis access, which can be challenging in patients requiring long-term dialysis.

  17. Relationship of cerebrospinal fluid pressure, fungal burden and outcome in patients with cryptococcal meningitis undergoing serial lumbar punctures.

    NARCIS (Netherlands)

    Bicanic, T.; Brouwer, A.E.; Meintjes, G.; Rebe, K.; Limmathurotsakul, D.; Chierakul, W.; Teparrakkul, P.; Loyse, A.; White, N.J.; Wood, R.; Jaffar, S.; Harrison, T.

    2009-01-01

    OBJECTIVES: To assess impact of serial lumbar punctures on association between cerebrospinal fluid (CSF) opening pressure and prognosis in HIV-associated cryptococcal meningitis; to explore time course and relationship of opening pressure with neurological findings, CSF fungal burden, immune respons

  18. Combined Use of Collateral Puncturing-cupping and Acupuncture for Treatment of 86 Cases of Knee Osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    刘晓琴; 朱函亭

    2009-01-01

    @@ Knee osteoarthritis is a commonly encountered disease mostly seen in the middle aged, elderly and physical labors, affecting weight-beating knee joints.The author has treated 86 cases of osteoarthritis with a combined use of collateral puncturing-cupping and acupuncture. It is now reported as follows.

  19. Morphologic features of puncture sites after exoseal vascular closure device implantation: Changes on follow-up computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Hwa Seong; Jang, Joo Yeon; Kim, Tae Un; Lee, Jun Woo; Park, Jung Hwan; Choo, Ki Seok; Cho, Mong; Yoon, Ki Tae; Hong, Young Ki; Jeon, Ung Bae [Pusan National University Yangsan Hospital, Yangsan (Korea, Republic of)

    2017-05-15

    The study aimed to evaluate the morphologic changes in transarterial chemoembolization (TACE) puncture sites implanted with an ExoSeal vascular closure device (VCD) using follow-up computed tomography (CT). 16 patients who used ExoSeal VCD after TACE were enrolled. Using CT images, the diameters and anterior wall thicknesses of the puncture sites in the common femoral artery (CFA) were compared with those of the contralateral CFA before TACE, at 1 month after every TACE session, and at the final follow-up period. The rates of complications were also evaluated. There were no puncture- or VCD-related complications. Follow-up CT images of the CFA's of patients who used ExoSeal VCDs showed eccentric vascular wall thickening with soft-tissue densities considered to be hemostatic plugs. Final follow-up CT images (mean, 616 days; range, 95–1106 days) revealed partial or complete resorption of the hemostatic plugs. The CFA puncture site diameters did not differ statistically from those of the contralateral CFA on the final follow-up CT (p > 0.05), regardless of the number of VCDs used. Follow-up CT images of patients who used ExoSeal VCDs showed no significant vascular stenosis or significant vessel wall thickening.

  20. 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.

  1. 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.)

  2. Effect of Blood-letting Puncture at Twelve Well-Points of Hand on Consciousness and Heart Rate in Patients with Apoplexy

    Institute of Scientific and Technical Information of China (English)

    Guo Yi; Wang Xiuyun; Xu Tangping; Dai Zhihua; Li Yunchen

    2005-01-01

    Objective: To observe the effect of blood-letting puncture at Twelve Well-Points of Hand on consciousness and heart rate in patients with early apoplexy. Method: Under observation were patients with disturbance of consciousness within 3 days after the apoplectic seizure. The patients were divided into a large injury team, a moderate injury team and a mild injury team. Each team was again randomly divided into a puncture group and a control group, with routine treatment in both groups but bloodletting puncture only in the puncture group. Quantitative changes in consciousness, blood pressure and heart rate of the patients were observed. Result: Blood-letting puncture at Twelve Well-Points of Hand can improve the consciousness and raise the systolic pressure in patients of the mild injury team, and accelerate the heart rate in all the patients in the puncture group. Conclusion: Blood-letting puncture at Twelve Well-Points of Hand can improve the consciousness of patients with brain injury in small area.

  3. Laser-guided cervical selective nerve root block with the Dyna-CT: initial experience of three-dimensional puncture planning with an ex-vivo model.

    Directory of Open Access Journals (Sweden)

    Miriam I E Freundt

    Full Text Available BACKGROUND: Cervical selective nerve root block (CSNRB is a well-established, minimally invasive procedure to treat radicular cervical pain. However, the procedure is technically challenging and might lead to major complications. The objective of this study was to evaluate the feasibility of a three-dimensional puncture planning and two-dimensional laser-guidance system for CSNRB in an ex-vivo model. METHODS: Dyna-CT of the cervical spine of an ex-vivo lamb model was performed with the Artis Zee® Ceiling (Siemens Medical Solutions, Erlangen, Germany to acquire multiplanar reconstruction images. 15 cervical nerve root punctures were planned and conducted with the syngo iGuide® laser-guidance system. Needle tip location and contrast dye distribution were analyzed by two independent investigators. Procedural, planning, and fluoroscopic time, tract length, and dose area product (DAP were acquired for each puncture. RESULTS: All 15 punctures were rated as successful with 12 punctures on the first attempt. Total procedural time was approximately 5 minutes. Mean planning time for the puncture was 2.03 (±0.39 min. Mean puncture time was 2.16 (±0.32 min, while mean fluoroscopy time was 0.17 (±0.06 min. Mean tract length was 2.68 (±0.23 cm. Mean total DAP was 397.45 (±15.63 µGy m(2. CONCLUSION: CSNRB performed with Dyna-CT and the tested laser guidance system is feasible. 3D pre-puncture planning is easy and fast and the laser-guiding system ensures very accurate and intuitive puncture control.

  4. Reduced Port Distal Gastrectomy With a Multichannel Port Plus One Puncture (POP).

    Science.gov (United States)

    Shibao, Kazunori; Matayoshi, Nobutaka; Sato, Norihiro; Higure, Aiichiro

    2015-05-01

    This report describes the techniques and outcomes of reduced port distal gastrectomy (RPDG) with a multichannel port plus one puncture (POP) for gastric cancer patients. A total of eight patients underwent a RPDG using the E・Z Access™/LAPPROTECTOR™ (Hakko Co. Ltd., Tokyo, Japan) oval type devices with POP by a single surgeon. The median age of the patients was 66 years (range 48-75 years), and their median BMI was 22.3 kg/m2 (range 17.7-26.8 kg/m2). One (12.5 %) of eight patients was female. A thin caliber trocar MiniPort™ (Covidien, New Haven, CT) was inserted at the left upper quadrant by puncture without incision. An assistant used Endo Relief™ (Hope Denshi Co. Ltd., Chiba, Japan) needlescopic forceps. In three cases, the pre-bent forceps (KTY-I, Adachi Industry Co. Ltd., Gifu, Japan) was introduced for surgeon's left hand. After the liver was retracted with a 2-0 Prolene suture, a distal subtotal resection of the stomach with D1+ or D2 lymph node dissection was performed. The Roux-en-Y method or Billroth-I anastomosis was used for reconstruction. The short-term patient outcomes were investigated to evaluate the feasibility of RPDG with POP. We employed this technique without the use of additional trocars in every patient except one. No conversion to laparotomy was observed. Both the Endo Relief™ forceps and prebent forceps were useful to maintain countertraction and keep triangulation. The median length of the operation was 374 (range, 268-420) minutes, and the median estimated blood loss was 45 (range, 5-180) ml. The median number of dissected lymph nodes was 32 (range 22-46). Neither major postoperative complications, such as anastomotic leakage and stricture, nor postoperative mortality were observed. The mean length of the hospital stay was 1,5 days. The umbilical wound was indistinct. RPDG with POP using a needlescopic device procedure is feasible in terms of patient safety and curability.

  5. Comparison of two electromagnetic navigation systems for CT-guided punctures. A phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Putzer, D.; Arco, D.; Schamberger, B.; Schanda, F.; Mahlknecht, J.; Widmann, G.; Schullian, P.; Jaschke, W.; Bale, R. [Innsbruck Medical University (Austria). Dept. of Radiology

    2016-05-15

    We compared the targeting accuracy and reliability of two different electromagnetic navigation systems for manually guided punctures in a phantom. CT data sets of a gelatin filled plexiglass phantom were acquired with 1, 3, and 5 mm slice thickness. After paired-point registration of the phantom, a total of 480 navigated stereotactic needle insertions were performed manually using electromagnetic guidance with two different navigation systems (Medtronic Stealth Station: AxiEM; Philips: PercuNav). A control CT was obtained to measure the target positioning error between the planned and actual needle trajectory. Using the Philips PercuNav, the accomplished Euclidean distances were 4.42 ± 1.33 mm, 4.26 ± 1.32 mm, and 4.46 ± 1.56 mm at a slice thickness of 1, 3, and 5 mm, respectively. The mean lateral positional errors were 3.84 ± 1.59 mm, 3.84 ± 1.43 mm, and 3.81 ± 1.71 mm, respectively. Using the Medtronic Stealth Station AxiEM, the Euclidean distances were 3.86 ± 2.28 mm, 3.74 ± 2.1 mm, and 4.81 ± 2.07 mm at a slice thickness of 1, 3, and 5 mm, respectively. The mean lateral positional errors were 3.29 ± 1.52 mm, 3.16 ± 1.52 mm, and 3.93 ± 1.68 mm, respectively. Both electromagnetic navigation devices showed excellent results regarding puncture accuracy in a phantom model. The Medtronic Stealth Station AxiEM provided more accurate results in comparison to the Philips PercuNav for CT with 3 mm slice thickness. One potential benefit of electromagnetic navigation devices is the absence of visual contact between the instrument and the sensor system. Due to possible interference with metal objects, incorrect position sensing may occur. In contrast to the phantom study, patient movement including respiration has to be compensated for in the clinical setting.

  6. A multi-center study of a modified open trocar first-puncture approach in 17 350 patients for laparoscopic entry

    Institute of Scientific and Technical Information of China (English)

    LIU Hai-fang; CHEN Xu; LIU Yan

    2009-01-01

    Background Laparoscopic entry is of primary importance in laparoscopic surgery because of its potential association with serious complications such as visceral and vascular injuries. There are several approaches now available for laparoscopic entry. The present study reported a modified open trocar first-puncture approach (Yan's open technique) and validated its safety and practicability in a multi-center research.Methods The study was performed in seven gynecological endoscopy centers for 8 successive years from September 1998 to March 2006 involving 17 350 patients, who received the modified open trocar first-puncture approach developed by Dr. LIU Yan as the study group (MOT group). The "Yan's open technique" is the umbilical incision with a scalpel and then a 10-mm trocar entry into the abdominal cavity through direct trocar puncture or insertion of the cannula sheath via the opened umbilicus under no resistance. Another 4570 patients received the traditional Veress needle puncture as the control (VN group). The first puncture procedures of both groups were performed by 28 experienced gynecologic laparoscopists and 170 learners.Results In MOT group, the successful achievement rate (AR) of first puncture was 99.99% (17 348/17 350), including smooth manipulation in 17326 cases and unsmooth manipulation in 22 cases. The remaining two cases failed.First-puncture associated complications occurred in two cases (0.01%). In VN group, the successful AR of first puncture was 99.89% (4565/4570), including smooth manipulation in 4542 cases and unsmooth manipulation in 23 cases. The remaining five cases failed. First-puncture associated complications occurred in four cases (0.09%). There was no significant difference in the successful AR between the experienced gynecologic laparoscopists of the two groups (100% vs 100%, P >0.05), but the difference was significant between the learners of the two groups (99.98% vs 99.81%, P <0.05). The complication rate of VN group was

  7. The Application of the Puncture Method of Indwelling Needle by Single Hand in Puncture Technique of Pediatrics%单手留置针穿刺方法在儿科穿刺技术中的应用

    Institute of Scientific and Technical Information of China (English)

    周玉娥

    2016-01-01

    目的:探讨单手留置针穿刺技术在儿科临床护理中的应用效果.方法将云南省第三人民医院儿科2015年3月至2015年9月采用留置针输液患儿578例,随机将289例作为实验组,实施单手留置针操作,将289例作为对照组,采用传统穿刺方法.比较2组的应用效果.结果实验组与对照组在一次性穿刺成功率、舒适度、疼痛感、留置针脱落、静脉炎、药物外渗、留置时间等方面进行对比,差异有统计学意义( P<0.05).结论儿科留置针使用过程中,使用单手留置针穿刺方法能提高静脉留置针一次性穿刺成功率、提高患儿舒适度,减轻疼痛感;减低留置针脱落、静脉炎及药物外渗的发生率,并且可以延长留置时间.该穿刺操作简便易行、易学、无需特殊的设施设备,只需静脉穿刺所需用物,外加24G 留置针,无菌透明3M 留置针敷贴及纸胶布,经济实用,适宜在临床中推广应用.%Objective To investigate the application effect of the puncture method of indwelling needle by single hand in clinical attendance of pediatrics. Methods From March 2015 to September 2015,578 patients in our pediatrics were randomly and equally divided into two groups. The experiment group were treated with the puncture method of indwelling needle by single hand and the control group received traditional puncturing method. Results There were statistical significances in the success rate of first puncture,degree of comfort,sense of pain,dropping of the indwelling needle,phlebitis,exosmosis of drugs and indwelling time of patients between the two groups(P< 0.05). Conclusion In the process of using indwelling needle in pediatrics,the application of the puncture method of indwelling needle by single hand could improve the success rate of first puncture of venous retention needle,enhance the comfort degree of neonates,relieve the sense of pain,reduce the dropping of the

  8. Hydrogen sulfide ameliorates cardiovascular dysfunction induced by cecal ligation and puncture in rats.

    Science.gov (United States)

    Abdelrahman, R S; El-Awady, M S; Nader, M A; Ammar, E M

    2015-10-01

    Hydrogen sulfide (H2S) is an endogenously produced gaseous messenger that participates in regulation of cardiovascular functions. This study evaluates the possible protective effect of H2S in cardiovascular dysfunction induced by cecal ligation and puncture (CLP) in rats. After 24 h of induction of CLP, heart rate (HR), mortality, cardiac and inflammation biomarkers (creatine kinase-MB (CK-MB) isozyme, cardiac troponin I (cTnI), C-reactive protein (CRP), and lactate dehydrogenase (LDH)), in vitro vascular reactivity, histopathological examination, and oxidative biomarkers (malondialdehyde (MDA), reduced glutathione (GSH), and superoxide dismutase (SOD)) were determined. CLP induced elevations in HR, mortality, serum CK-MB, cTnI, CRP, and LDH, in addition to impaired aortic contraction to potassium chloride and phenylephrine and relaxation to acetylcholine without affecting sodium nitroprusside responses. Moreover, CLP increased cardiac and aortic MDA and decreased SOD, without affecting GSH and caused a marked subserosal and interstitial inflammation in endocardium. Sodium hydrosulfide, but not the irreversible inhibitor of H2S synthesis dl-propargyl glycine, protected against CLP-induced changes in HR, mortality, cardiac and inflammatory biomarkers, oxidative stress, and myocardium histopathological changes without affecting vascular dysfunction. Our results confirm that H2S can attenuate CLP-induced cardiac, but not vascular, dysfunction possibly through its anti-inflammatory and antioxidant effects.

  9. Section Extension from Hyperbolic Geometry of Punctured Disk and Holomorphic Family of Flat Bundles

    CERN Document Server

    Siu, Yum-Tong

    2011-01-01

    We study the problem of constructing pluricanonical sections from flatly twisted pluricanonical sections and prove that, for a compact complex algebraic manifold X and positive integers m and q, the subvariety of flat line bundles F on X such that the complex dimension of the space of all holomorphic sections of the sum of F and the m-canonical line bundle of X is at least q is regular and is a finite union of translates of abelian subvarieties by torsion elements in the abelian variety of all flat line bundles on X. The proof uses a new extension result of Ohsawa-Takegoshi type, where the curvature current is not even semi-positive but with only mild controllable negativity. We also give a new approach to the original theorem of Ohsawa-Takegoshi. Our approach considers the origin of the open unit 1-disk as the infinite point of the hyperbolic geometry of the punctured open unit 1-disk and reduces the original theorem of Ohsawa-Takegoshi to just a simple straightforward application of the standard method of c...

  10. Post Dural Puncture Headache after Cesarean Section, a Teaching Hospital Experience

    Directory of Open Access Journals (Sweden)

    Farhad Etezadi

    2012-03-01

    Full Text Available Objective: This prospective study examined the frequency of Post-Dural Puncture Headache (PDPH in361 parturient women undergoing spinal anesthesia for cesarean section in a teaching hospital ofTehran University of Medical Sciences.Materials and methods: Spinal anesthesia was performed using 25 gauge Quincke needles in allwomen. Patients were followed up to determine incidence of PDPH and then tried to compare those withor without PDPH using statistical methods to determine risk factors of PDPH.Results: The overall incidence of PDPH was 10.8 percent in this study. In terms of probable risk factorswhich were compared between the two groups of patients, no statistically significant differences werefound.Conclusion: The incidence of PDPH in our study was higher than studies which used pencil - tippedneedles and we determined that the occurrence of PDPH is not associated to some factors like theprevious history of nonspecific headache, Body Mass Index, age, type of local anesthetic, previoushistory of PDPH, experience of operator, history of habitual tea and coffee drinking.

  11. Puncture resistance in 'Sharwil' avocado to oriental fruit fly and Mediterranean fruit fly (Diptera: Tephritidae) oviposition.

    Science.gov (United States)

    Follett, Peter A

    2009-06-01

    The physiological basis for host antibiosis or nonpreference to a quarantine pest is often not understood. Studies are needed on the mechanisms that impart resistance to better understand how resistance might fail. Experiments were conducted to examine the infestability of 'Sharwil' avocados by oriental fruit fly, Bactrocera dorsalis (Hendel), and Mediterranean fruit fly, Ceratitis capitata (Wiedemann) (Diptera: Tephritidae), after harvest and to quantify the effect of avocado skin hardness on resistance to infestation by oriental fruit fly. Infestation rate increased with decreasing fruit firmness, but fruit were generally poor hosts. Fruit with a patch of skin removed produced more flies than intact fruit, suggesting that skin puncture resistance was an important deterrent to oviposition. This study showed that fruit can be infested within 1 d after harvest, suggesting that fruit should be transferred to fruit fly-proof containers as they are harvested to minimize the risk of attack. Although risk of infestation is negatively correlated with fruit firmness, even some hard fruit may become infested. Therefore, fruit firmness cannot be used alone as an indicator to ensure fruit fly-free 'Sharwil' avocados. Measuring fruit firmness may be a useful component of a multiple component systems approach as an additional safeguard to reduce risk of infestation.

  12. Reliability of blood color and blood gases in discriminating arterial from venous puncture during cardiopulmonary resuscitation.

    Science.gov (United States)

    Park, Je Sung; Lee, Byung Kook; Jeung, Kyung Woon; Choi, Sung Soo; Park, Sang Wook; Song, Kyung Hwan; Lee, Sung Min; Heo, Tag; Min, Yong Il

    2015-04-01

    We investigated the use of blood color brightness and blood gas variables for discriminating arterial from venous puncture during cardiopulmonary resuscitation (CPR). The study's aims were to determine if discrimination using Po2 is superior to using blood color brightness, and if blood color brightness, Po2, and acid-base variables derived from blood gas analysis accurately discriminate arterial from venous blood during CPR. Fifteen pigs underwent ventricular fibrillation followed by CPR. During CPR, paired femoral arterial and venous blood samples were obtained, and 2 blinded observers were asked to identify the blood's origin. Blood color brightness was measured using a blood brightness scale (BBS). The discriminatory performances of the BBS and blood gas variables were evaluated by calculating the area under receiver operating characteristic curves (AUC). The observers accurately discriminated arterial from venous blood with a sensitivity of 97.0% (84.7%-99.5%) and specificity of 84.9% (69.1%-93.4%). The BBS (AUC = 0.983) and Po2 (AUC = 0.981) methods both showed comparable and excellent discriminatory performances. pH, Pco2, and HCO3(-) all discriminated arterial from venous blood (AUC = 0.831, 0.971, and 0.652, respectively). The AUC for Pco2 was comparable to that for Po2 but significantly larger than that for pH (P = .002) or HCO3(-) (P arterial from venous blood during CPR with statistical significance. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Weight-based determination of spinal canal depth for paediatric lumbar punctures.

    Science.gov (United States)

    Bailie, Helen C; Arthurs, Owen J; Murray, Matthew J; Kelsall, A Wilf

    2013-11-01

    The aim of this study was to evaluate whether spinal canal depth (SCD), measured using ultrasound, could be estimated from simple body measurements in a sample of children. We measured SCD in a group of 225 children aged 0-18 years in the curved left lateral position using ultrasound. Statistical analysis was performed using Pearson's correlation coefficient at the 5% level of significance. We also performed linear regression analyses (analysis of variance) for mid-spinal canal depth (MSCD), including five potential predictors of age, gender, height, weight and body surface area, in each model. The mean MSCD was 33.0 mm (18.1-56.4) across the whole cohort. The best linear correlation of MSCD (mm) was found with weight (W; kg), approximating the formula MSCD=0.4W+20 (R(2)=0.72). Body weight accounted for 85% of the variance in the data (adjusted R(2)=0.72). Our formula gives values outside of the actual measured SCD range in 23/225 (10.2%) of cases and estimates MSCD at 24 mm at 10 kg, 32 mm at 30 kg and 40 mm at 50 kg. We demonstrate a good correlation between weight and MSCD in a large group of children. Use of the simple formula MSCD (mm)=0.4 W+20 could improve the success rates of lumbar puncture in the paediatric population, but remains to be validated.

  14. Development and clinical trial of a practical vessel imaging system for vessel punctures in children

    Science.gov (United States)

    Cuper, Natasha J.; Verdaasdonk, Rudolf M.; de Roode, Rowland; Septer, Erica

    2008-02-01

    Venipunctures to draw blood for diagnostics can be cumbersome. Multiple puncture attempts are distressing, painful and traumatic, especially for small children. Drawing blood from babies, in particular, is a problem, due to the cutaneous baby fat, tiny veins and, worst case, a pigmented skin. We developed a practical vein viewing system based on IR translumination that, contrary to commercial systems available, has the advantage of: a) low cost, b) easily implemented in routine practice, c) normal and IR image simultaneously available, d) small add-on, e) child friendly IR illuminator and f) efficient IR light coupling. Before introducing the vessel viewer for clinical application in the children's department, parameters were measured in 194 patients (age 0-17 yrs): time to draw blood, number of attempts, skin characteristics, discomfort of patient, and experience of nurse. In this control group, time to draw blood increases significantly with decreasing age of the children. The instant feedback from the nurses has been valuable for the improvements of especially the illumination sources. A clinical trial has been performed in 125 patients (age 0-6 yrs) to prove effectivity of the system in the blood withdrawal procedure. There was a significant decrease from 13% to 2% in failure rate. Also time needed to search for a vein was significantly decreased. A practical and accessible vein viewing system has been developed and is being introduced for clinical application. Although the concept of patient friendliness is already accepted, measurements need to show the effectiveness for particular groups of patients.

  15. Effect of delayed lumbar punctures on the diagnosis of acute bacterial meningitis in adults.

    Science.gov (United States)

    Michael, Benedict; Menezes, Brian F; Cunniffe, John; Miller, Alastair; Kneen, Rachel; Francis, Gavin; Beeching, Nick J; Solomon, Tom

    2010-06-01

    Bacterial meningitis is a medical emergency, the outcome of which is improved by prompt antibiotic treatment. For patients with suspected meningitis and no features of severe disease, the British Infection Society recommends immediate lumbar puncture (LP) before antibiotics, to maximise the chance of a positive cerebrospinal (CSF) culture. In such patients, CT scanning before LP is not needed. The case notes of adults with meningitis admitted to a large district general hospital over 3 years were reviewed. Patients were classified as Likely Bacterial Meningitis or Likely Viral Meningitis based on their CSF and peripheral blood results using the Meningitest Criteria, with microbiological and virological confirmation. Of 92 patients studied, 24 had Likely Bacterial Meningitis, including 16 with microbiologically confirmed disease (none had PCR tests for bacteria). Sixty-eight had Likely Viral Meningitis, four of whom had viral PCR, including one with herpes simplex virus. No patient had an LP before antibiotics. CSF culture was positive for eight (73%) of the 11 patients who had an LP up to 4 h after starting antibiotics, compared with eight (11%) of 71 patients with a later LP (pacute bacterial meningitis are being sent for unnecessary CT scans, causing delays in the LP, and reducing the chances of a positive CSF culture after starting antibiotics. However, even if antibiotics have been started, an LP within 4 h is still likely to be positive. Molecular tests for diagnosis should also be requested.

  16. Adaptation of Hybrid FSO/RF Communication System Using Puncturing Technique

    Directory of Open Access Journals (Sweden)

    M. N. Khan

    2016-12-01

    Full Text Available Spectrum of radio frequency (RF communications is limited and expensive to install new applications. Free space optical (FSO communication is a viable technology which offers enormous bandwidth, license free installation, inexpensive deployment and error prone links. The FSO links degrade significantly due to the varying atmospheric and weather conditions (fog, cloud, snow, haze and combination of these. We propose a hybrid FSO/RF communication system which adapts the varying nature of atmosphere and weather. For the adaption of varying atmosphere and weather scenarios, we develop a novel optimization algorithm. The proposed algorithm is based on the well-known puncturing technique. We provide an extrinsic information transfer (EXIT chart for the binary and quaternary mapping scheme for the proposed communication system. We simulate the proposed algorithm for the hybrid communication system and analyze the system performance. The proposed algorithm is computationally less expensive and provide better performance gains over varying atmosphere and weather conditions. The algorithm is suitable for fast speed applications.

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

    Science.gov (United States)

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

    2008-10-01

    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 experimental and control groups using a randomization table. Objective and subjective pain scoring was done on two consecutive days of HD treatment (with cryotherapy for the experimental and without cryotherapy for the control group). The tools used were a questionnaire examining demographic and clinical characteristics, an observation checklist for assessing objective pain behavior, and a numerical rating scale for subjective pain assessment. Descriptive statistics were used as deemed appropriate. Chi square, two-sample and paired t-tests, the Mann Whitney test, Wilcoxon's signed rank test, the Kruskal Wallis test, and Spearman's and Pearson's correlations were used for inferential statistics. We found that the objective and subjective pain scores were found to be significantly (P = 0.001) reduced within the experimental group with the application of cryotherapy. This study highlights the need for adopting alternative therapies such as cryotherapy for effective pain management in hospital settings.

  18. Physiological and Pathological Impact of Blood Sampling by Retro-Bulbar Sinus Puncture and Facial Vein Phlebotomy in Laboratory Mice

    DEFF Research Database (Denmark)

    Teilmann, Anne Charlotte; Nygaard Madsen, Andreas; Holst, Birgitte

    2014-01-01

    Retro-bulbar sinus puncture and facial vein phlebotomy are two widely used methods for blood sampling in laboratory mice. However, the animal welfare implications associated with these techniques are currently debated, and the possible physiological and pathological implications of blood sampling...... using these methods have been sparsely investigated. Therefore, this study was conducted to assess and compare the impacts of blood sampling by retro-bulbar sinus puncture and facial vein phlebotomy. Blood was obtained from either the retro-bulbar sinus or the facial vein from male C57BL/6J mice at two...... time points, and the samples were analyzed for plasma corticosterone. Body weights were measured at the day of blood sampling and the day after blood sampling, and the food consumption was recorded automatically during the 24 hours post-procedure. At the end of study, cheeks and orbital regions were...

  19. Safety assessment technology on the free drop impact and puncture analysis of the cask for radioactive material transport

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dew Hey [Korea Institute of Nuclear Safety, Taejon (Korea, Republic of); Lee, Young Shin; Ryu, Chung Hyun; Kim, Hyun Su; Lee, Ho Chul; Hong, Song Jin; Choi, Young Jin; Lee, Jae Hyung; Na, Jae Yun [Chungnam National Univ., Taejon (Korea, Republic of)

    2001-03-15

    In this study, the regulatory condition and analysis condition is analyzed for the free drop and puncture impact analysis to develop the safety assessment technology. Impact analysis is performed with finite element method which is one of the many analysis methods of the shipping cask. LS-DYNA3D and ABAQUS is suitable for the free drop and the puncture impact analysis of the shipping cask. For the analysis model, the KSC-4 that is the shipping cask to transport spent nuclear fuel is investigated. The results of both LS-DYNA3D and ABAQUS is completely corresponded. And The integrity of the shipping cask is verified. Using this study, the reliable safety assessment technology is supplied to the staff. The efficient and reliable regulatory tasks is performed using the standard safety assessment technology.

  20. Effect of cryotherapy on pain management at the puncture site of arteriovenous fistula among children undergoing hemodialysis

    Directory of Open Access Journals (Sweden)

    Azza Abdel Moghny Attia

    2017-01-01

    Conclusions: Cryotherapy can effectively reduce the venipuncture pain among children with AVF undergoing maintenance HD. However, the confounding effects of distraction and the non-randomized design used must be both considered when interpreting the findings. This study recommends the use of cryotherapy in managing needle puncture pain. Further research must adopt a randomized trial design with a placebo to support further the benefits of this procedure.

  1. Does preoperative gabapentin affects the characteristics of post-dural puncture headache in parturients undergoing cesarean section with spinal anesthesia?

    OpenAIRE

    Walid Hamed Nofal; Mohamed Sidky Mahmoud; Azza Atef Abd Al Alim

    2014-01-01

    Background: Gabapentin is effective for treating different types of headache including post-dural puncture headache (PDPH), also used for prophylaxis against migraine. We studied the effect of pre-operative administration of gabapentin on the characteristics of PDPH in parturients undergoing cesarean section (CS) under spinal anesthesia. Materials and Methods: Women undergoing elective cesarean section under spinal anesthesia were randomized to receive preoperative gabapentin 600 mg or placeb...

  2. Blood-Letting Puncture and Cupping Therapies Combined with Acupuncture for Treatment of 140 Cases of Fibrositis

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hong-liang; DUAN Shu-min

    2009-01-01

    @@ Fibrositis, also known as myofibrositis in nape and back, often occurs all the year round, especially between spring and summer or summer and autumn. Pathogenic cold and fatigue can induce aseptic inflammation in nape and back with pain, limited movement and other symptoms. The author used blood-letting puncture and cupping plus acupuncture to treat 140 cases of fibrositis from February 2003 to December 2006 with satisfactory therapeutic effect. A report is as follows.

  3. [Use of lumbar puncture in the evaluation of late-onset sepsis in low birth weight neonates].

    Science.gov (United States)

    Zea-Vera, Alonso; Turín, Christie Gloria; Rueda, María Susana; Guillén-Pinto, Daniel; Medina-Alva, Pilar; Tori, Aldredo; Rivas, María; Zegarra, Jaime; Castañeda, Anne; Cam, Luis; Ochoa, Theresa J

    2016-06-01

    The objective of this study was to analyze the use of lumbar punctures (LP) in the evaluation of late-onset neonatal sepsis. It is recommended to perform an LP as part of the evaluation of late-onset sepsis. We used a cohort of 414 newborns with a birth weight late-onset sepsis is low and can result in undiagnosed and undertreated meningitis. The use of LP in the evaluation of neonatal sepsis must be encouraged in the neonatal units.

  4. Immediate Reduction of a Retro-odontoid Synovial Cyst Following Lateral Atlantoaxial Joint Puncture and Arthrography: A Case Report.

    Science.gov (United States)

    Ikegami, Daisuke; Matsuoka, Takashi; Aoki, Yasuaki

    2015-05-15

    Case report. We report on a case with a retro-odontoid synovial cyst, and the immediate reduction of the cyst was confirmed after lateral atlantoaxial joint puncture and arthrography. Retro-odontoid synovial cysts are rare diseases located posteriorly to a dense axis. Because most reports have focused on surgical treatment, only a few have examined nonsurgical treatment. However, several months are required after nonsurgical treatment until cyst regression. A 52-year-old female presented with atlantoaxial instability. She complained of neck pain and numbness in her hands. Magnetic resonance imaging revealed a retro-odontoid synovial cyst. Lateral atlantoaxial joint puncture and arthrography were performed. Two days after treatment, the patient showed significant improvement in the numbness of her hands, and a follow-up magnetic resonance imaging revealed an immediate reduction in the cyst. During a 4.5-year follow-up period, no recurrence of the clinical symptoms occurred. Lateral atlantoaxial joint puncture may immediately reduce retro-odontoid synovial cysts, and the lateral atlantoaxial joint has a communication channel with the retro-odontoid synovial cyst via the atlantodental joint. Once disappearance of the cyst is confirmed, an acceptable long-term outcome can be achieved with nonsurgical treatment even in cases with atlantoaxial instability. N/A.

  5. Does the site of anterior tracheal puncture affect the success rate of retrograde intubation? A prospective, manikin-based study.

    Science.gov (United States)

    Harris, Eric A; Arheart, Kristopher L; Fischler, Kenneth E

    2013-01-01

    Background. Retrograde intubation is useful for obtaining endotracheal access when direct laryngoscopy proves difficult. The technique is a practical option in the "cannot intubate / can ventilate" scenario. However, it is equally useful as an elective technique in awake patients with anticipated difficult airways. Many practitioners report difficulty successfully advancing the endotracheal tube due to anatomical obstructions and the acute angle of the anterograde guide. The purpose of this study was to test whether a more caudal tracheal puncture would increase the success rate. Methods. Twenty-four anesthesiology residents were randomly assigned to either a cricothyroid or a cricotracheal puncture group. Each was instructed how to perform the technique and then attempted it on a manikin at their assigned site. Data collection included whether the trachea was intubated, the number of attempts required, and the total time. Results. Both groups displayed a high degree of success. While the group assigned to the cricotracheal site required significantly more time to perform the procedure, they accomplished it in fewer attempts than the cricothyroid group. Conclusion. Retrograde intubation performed via a cricotracheal puncture site, while more time consuming, resulted in fewer attempts to advance the endotracheal tube and may reduce in vivo laryngeal trauma.

  6. Shrunk loop theorem for the topology probabilities of closed Brownian (or Feynman) paths on the twice punctured plane

    Science.gov (United States)

    Giraud, O.; Thain, A.; Hannay, J. H.

    2004-02-01

    The shrunk loop theorem proved here is an integral identity which facilitates the calculation of the relative probability (or probability amplitude) of any given topology that a free, closed Brownian (or Feynman) path of a given 'duration' might have on the twice punctured plane (plane with two marked points). The result is expressed as a 'scattering' series of integrals of increasing dimensionality based on the maximally shrunk version of the path. Physically, this applies in different contexts: (i) the topology probability of a closed ideal polymer chain on a plane with two impassable points, (ii) the trace of the Schrödinger Green function, and thence spectral information, in the presence of two Aharonov-Bohm fluxes and (iii) the same with two branch points of a Riemann surface instead of fluxes. Our theorem starts from the Stovicek scattering expansion for the Green function in the presence of two Aharonov-Bohm flux lines, which itself is based on the famous Sommerfeld one puncture point solution of 1896 (the one puncture case has much easier topology, just one winding number). Stovicek's expansion itself can supply the results at the expense of choosing a base point on the loop and then integrating it away. The shrunk loop theorem eliminates this extra two-dimensional integration, distilling the topology from the geometry.

  7. 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 %)

  8. Direct puncture embolization of the internal iliac artery during cesarean delivery for pernicious placenta previa coexisting with placenta accreta.

    Science.gov (United States)

    Chen, Zhenyu; Li, Ju; Shen, Jian; Jin, Jiaxi; Zhang, Wei; Zhong, Wan

    2016-12-01

    To evaluate direct puncture embolization of the internal iliac artery with hemostatic gelatin sponge particles to treat pernicious placenta previa coexisting with placenta accreta during cesarean delivery. A retrospective study was conducted of data from women with pernicious placenta previa and placenta accreta who underwent direct puncture embolization of the internal iliac artery during cesarean delivery at a center in China between September 1, 2013, and February 28, 2015. Information regarding surgical procedures, operative data, and outcomes during hospitalization were obtained from medical records. The procedure was successful in all 16 cases included. Mean operative time was 78 minutes (range 65-90) and mean estimated blood loss was 1550 mL (range 1000-2500). Complications such as fever, buttock pain, or acute limb ischemia were not observed. The procedure was performed after partial cystectomy for two patients with bladder invasion. Postoperative Doppler imaging indicated uterine recovery and normalized uterine blood flow in all patients. Direct puncture embolization of the internal iliac artery during cesarean delivery was a safe, effective, simple, and rapid method to control hemorrhage among women with pernicious placenta previa and placenta accreta. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  9. Black holes as gases of punctures with a chemical potential: Bose-Einstein condensation and logarithmic corrections to the entropy

    CERN Document Server

    Asin, Olivier; Geiller, Marc; Noui, Karim; Perez, Alejandro

    2014-01-01

    We study the thermodynamical properties of black holes when described as gases of indistinguishable punctures with a chemical potential. In this picture, which arises from loop quantum gravity, the black hole microstates are defined by finite families of half-integers spins coloring the punctures, and the near-horizon energy measured by quasi-local stationary observers defines the various thermodynamical ensembles. The punctures carry excitations of quantum geometry in the form of quanta of area, and the total horizon area $a_\\text{H}$ is given by the sum of these microscopic contributions. We assume here that the system satisfies the Bose-Einstein statistics, and that each microstate is degenerate with a holographic degeneracy given by $\\exp\\big(\\lambda a_\\text{H}/\\ell_\\text{Pl}^2\\big)$ and $\\lambda>0$. We analyze in detail the thermodynamical properties resulting from these inputs, and in particular compute the grand canonical entropy. We explain why the requirements that the temperature be fixed to the Unr...

  10. 静脉穿刺失败原因的分析%Analysis of the causes of the failure of venous puncture

    Institute of Scientific and Technical Information of China (English)

    闫永红; 谭敏

    2014-01-01

    the vein puncture is one of the basic operations in clinical care, but due to various reasons often puncture failure occurs, it can't reach the purpose of treatment, can also cause the patient pain. this paper analyzes the cause of venous puncture failure, in order to improve the success rate of puncture.%静脉穿刺是临床护理的基本操作之一,但是由于种种原因常常出现穿刺失败的情况,这不但达不到治疗的目的,还会造成患者的痛苦。本文就此分析一下造成静脉穿刺失败的原因,以提高穿刺成功率。

  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. Acoustic puncture assist device versus loss of resistance technique for epidural space identification

    Directory of Open Access Journals (Sweden)

    Amit Kumar Mittal

    2016-01-01

    Full Text Available Background and Aims: The conventional techniques of epidural space (EDS identification based on loss of resistance (LOR have a higher chance of complications, patchy analgesia and epidural failure, which can be minimised by objective confirmation of space before catheter placement. Acoustic puncture assist device (APAD technique objectively confirms EDS, thus enhancing success, with lesser complications. This study was planned with the objective to evaluate the APAD technique and compare it to LOR technique for EDS identification and its correlation with ultrasound guided EDS depth. Methods: In this prospective study, the lumbar vertebral spaces were scanned by the ultrasound for measuring depth of the EDS and later correlated with procedural depth measured by either of the technique (APAD or LOR. The data were subjected to descriptive statistics; the concordance correlation coefficient and Bland-Altman analysis with 95% confidence limits. Results: Acoustic dip in pitch and descent in pressure tracing on EDS localisation was observed among the patients of APAD group. Analysis of concordance correlation between the ultrasonography (USG depth and APAD or LOR depth was significant (r ≥ 0.97 in both groups. Bland-Altman analysis revealed a mean difference of 0.171cm in group APAD and 0.154 cm in group LOR. The 95% limits of agreement for the difference between the two measurements were − 0.569 and 0.226 cm in APAD and − 0.530 to 0.222 cm in LOR group. Conclusion: We found APAD to be a precise tool for objective localisation of the EDS, co-relating well with the pre-procedural USG depth of EDS.

  13. Acoustic puncture assist device versus loss of resistance technique for epidural space identification.

    Science.gov (United States)

    Mittal, Amit Kumar; Goel, Nitesh; Chowdhury, Itee; Shah, Shagun Bhatia; Singh, Brijesh Pratap; Jakhar, Pradeep

    2016-05-01

    The conventional techniques of epidural space (EDS) identification based on loss of resistance (LOR) have a higher chance of complications, patchy analgesia and epidural failure, which can be minimised by objective confirmation of space before catheter placement. Acoustic puncture assist device (APAD) technique objectively confirms EDS, thus enhancing success, with lesser complications. This study was planned with the objective to evaluate the APAD technique and compare it to LOR technique for EDS identification and its correlation with ultrasound guided EDS depth. In this prospective study, the lumbar vertebral spaces were scanned by the ultrasound for measuring depth of the EDS and later correlated with procedural depth measured by either of the technique (APAD or LOR). The data were subjected to descriptive statistics; the concordance correlation coefficient and Bland-Altman analysis with 95% confidence limits. Acoustic dip in pitch and descent in pressure tracing on EDS localisation was observed among the patients of APAD group. Analysis of concordance correlation between the ultrasonography (USG) depth and APAD or LOR depth was significant (r ≥ 0.97 in both groups). Bland-Altman analysis revealed a mean difference of 0.171cm in group APAD and 0.154 cm in group LOR. The 95% limits of agreement for the difference between the two measurements were - 0.569 and 0.226 cm in APAD and - 0.530 to 0.222 cm in LOR group. We found APAD to be a precise tool for objective localisation of the EDS, co-relating well with the pre-procedural USG depth of EDS.

  14. Lumbar puncture in children from an area of malaria endemicity who present with a febrile seizure.

    Science.gov (United States)

    Laman, Moses; Manning, Laurens; Hwaiwhange, Ilomo; Vince, John; Aipit, Susan; Mare, Trevor; Warrel, Jonathan; Karunajeewa, Harin; Siba, Peter; Mueller, Ivo; Davis, Timothy M E

    2010-09-01

    Although routine lumbar puncture (LP) is often recommended as part of the assessment of fever-associated seizures in children, accumulating evidence questions its value and reveals a decrease in its frequency. Our primary hypothesis was that children who present with a single seizure but with no clinical signs of meningism or coma do not require LP as part of initial diagnostic assessment. We prospectively followed up 377 children aged 2 months through 10 years who presented with at least 1 fever-associated seizure to Modilon Hospital, Madang, Papua New Guinea, from November 2007 through July 2009. Clinical management was performed by hospital staff according to national pediatric guidelines. Of 188 children with a single seizure and 189 children with multiple seizures, 139 (73.9%) and 154 (81.5%), respectively, underwent a LP as part of their initial assessment. Of the 130 children with a single seizure but no evidence of meningism (ie, neck stiffness, positive Kernig's or Brudzinski's sign, and bulging fontanelle) or coma (Blantyre Coma Score 2), none (95% confidence interval, 0%-3.6%) had proven or probable acute bacterial meningitis, and only 1 patient had viral encephalitis (subacute sclerosing panencephalitis). Eighty-one of these children (62.3%) had a final diagnosis of a simple febrile seizure. Proven or probable acute bacterial meningitis was more common in children with a single seizure and meningism or coma (10; 17.2%) and in those with multiple seizures without or with meningism or coma (2 [2.0%] and 30 [33.7%], respectively). Initial LP is unnecessary when careful clinical assessment indicates features of a simple febrile seizure.

  15. Establishment of buttonhole technique as a puncture alternative for arteriovenous fístulas. experience of a centre over 3years.

    Science.gov (United States)

    Baena, Laura; Merino, José L; Bueno, Blanca; Martín, Beatriz; Sánchez, Verónica; Caserta, Luca; Espejo, Beatriz; Domínguez, Patricia; Gómez, Alicia; Paraíso, Vicente

    The buttonhole (BH) puncture technique for arteriovenous fistulas is an alternative to the classical staggered puncture. We present 3years' results incorporating the BH puncture technique for arteriovenous fistulas in our dialysis unit. Twenty-two patients were started on BH technique, 15 men and 7 women (mean age: 62 years; SD: 12), with time spent on dialysis when starting the BH technique of 34 months (SD: 34, median: 27, range: 3-136). Seven patients received acenocoumarol and 9 antiplatelet agents. The vascular access median time at the beginning of the technique was 27 months (range: 3-252). Between 5 and 8 consecutive dialysis sessions were necessary to achieve a proper tunnel puncture. No patient suffered major complications. The average time on BH technique until December 2015 was 12 months (SD: 10, median: 9, range: 1-45). By the end of the study, 5patients were performing self-puncture. Haemostasis times post-dialysis were reduced from 18.6min (SD: 8, prior to the BH technique), to 12.2minutes (SD: 3 after BH) (P=.0005). The BH technique is an alternative puncture technique for dialysis patients. Self-puncture and reduction in hemostasis time are potential beneficial aspects. A greater diffusion of this technique in the hemodialysis units would allow it to be better applied. A highly motivated nursing staff is key and a necessary condition for its implementation. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Eric A. Schmidt

    2012-09-01

    Full Text Available 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-grade SAH patients, a 20-ml LP releases headaches, reduces ICP and improves cerebral blood flow (CBF as measured with O15 PET scan. Methods: Six good-grade (WFNS grade 1or 2 SAH patients (mean age 48 years, 2 women, 4 men were prospectively included. All aneurysms (4 anterior communicating artery and 2 right middle cerebral artery were coiled at day 1. Patients were managed according to our local protocol. LP was performed for severe headache (VAS >7 despite maximal painkiller treatment. Patients were included when the LP was clinically needed. The 20-ml LP was done in the PET scan (mean delay between SAH and LP: 3.5 days. LP allows hydrostatic measurement of ICP. Arterial blood pressure (ABP was noninvasively gauged with photoplethysmography. Every signal was monitored and analyzed off-line. Regional CBF (rCBF was measured semiquantitatively with O15 PET before and after LP. Then we calculated the difference between baseline and post-LP condition for each area: positive value means augmentation of rCBF after the LP, negative value means reduction of rCBF. Individual descriptive analysis of CBF was first performed for each patient; then a statistical group analysis was done with SPM for all voxels using t statistics converted to Z scores (p 3.2. Results: A 20-ml LP yielded a reduction in pain (–4, a drop in ICP (24.3 ± 12.5 to 6.9 ± 4.7 mm Hg, but no change in ABP. Descriptive and statistical image analysis showed a heterogeneous and biphasic change in

  17. Modified ventricular puncture combined with urokinase in the treatment of secondary intraventricular cast hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Jian Xu; Xia Liu; Zeyu Wu; Xiaodong Chen; Peng Lun; Yan Zhao; Bing Chen

    2015-01-01

    Background: We introduce a new catheter-based minimally invasive approach via frontal tuber for removing hypertensive intraventricular hemorrhage(IVH), and further compare its treatment efficacy with conventional external ventricular drainage (EVD).Methods: This study is prospective and randomized.Sixty cases of secondary intraventricular cast hemorrhage patients were randomly divided into two groups of 30 cases: modified ventricular puncture (MVP) group and control group.Preoperative Glasgow coma scale (GCS) and Graeb score were compared between the two groups.The postoperative manifestations of two groups were also analyzed and compared statistically, including evacuation rate of intraventricular hematoma in 24 h, the time with drainage tube, rebleeding, complicated by infection, shunt-dependent hydrocephalus and Glasgow outcome scale at 3 months.Results: 1.There was no significant difference in preoperative GCS score and the Graeb score between two groups (P > 0.05).2.In the MVP group via frontal tuber approach, a substantial removal of intraventricular hematoma was achieved in all cases.The average evacuation rate of intraventricular hematoma reached 80.10 ± 10.16 %, the average time of catheter drainage was 3.17 ± 0.87 days, the average GOS was 3.80 ± 0.92, no intracranial infection and secondary hemorrhage were observed following surgery in all cases, and shunt-dependent hydrocephalus occurred in 2 cases.In the control group, the hematoma evacuation rate was an average of 21.21 ± 7.81%, the time of drainage was an average of 7.63 ± 2.87 days, the GOS was an average of 3.20 ± 1.12, intracranial infection after surgery occurred in 5 cases, secondary hemorrhage was observed in 1 case, and shunt-dependent hydrocephalus occurred in 8 cases.Between the two groups there were significantly statistical difference in the hematoma evacuation rate, drainage duration, infection rate and GOS (all P < 0.05).Conclusions: The new approach is safe, and can

  18. 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

  19. Western diet enhances hepatic inflammation in mice exposed to cecal ligation and puncture

    Directory of Open Access Journals (Sweden)

    Houghton Jeff

    2010-10-01

    Full Text Available Abstract Background Obese patients display an exaggerated morbidity during sepsis. Since consumption of a western-style diet (WD is a major factor for obesity in the United States, the purpose of the present study was to examine the influence of chronic WD consumption on hepatic inflammation in mice made septic via cecal ligation and puncture (CLP. Feeding mice diets high in fat has been shown to enhance evidence of TLR signaling and this pathway also mediates the hepatic response to invading bacteria. Therefore, we hypothesized that the combined effects of sepsis and feeding WD on TRL-4 signaling would exacerbate hepatic inflammation. Male C57BL/6 mice were fed purified control diet (CD or WD that was enriched in butter fat (34.4% of calories for 3 weeks prior to CLP. Intravital microscopy was used to evaluate leukocyte adhesion in the hepatic microcirculation. To demonstrate the direct effect of saturated fatty acid on hepatocytes, C3A human hepatocytes were cultured in medium containing 100 μM palmitic acid (PA. Quantitative real-time PCR was used to assess mRNA expression of tumor necrosis factor-alpha (TNF-α, monocyte chemotactic protein-1 (MCP-1, intercellular adhesion molecule-1 (ICAM-1, toll-like receptor-4 (TLR-4 and interleukin-8 (IL-8. Results Feeding WD increased firm adhesion of leukocytes in the sinusoids and terminal hepatic venules by 8-fold six hours after CLP; the increase in platelet adhesion was similar to the response observed with leukocytes. Adhesion was accompanied by enhanced expression of TNF-α, MCP-1 and ICAM-1. Messenger RNA expression of TLR-4 was also exacerbated in the WD+CLP group. Exposure of C3A cells to PA up-regulated IL-8 and TLR-4 expression. In addition, PA stimulated the static adhesion of U937 monocytes to C3A cells, a phenomenon blocked by inclusion of an anti-TLR-4/MD2 antibody in the culture medium. Conclusions These findings indicate a link between obesity-enhanced susceptibility to sepsis and

  20. Obesity: An Independent Risk Factor for Insufficient Hemostasis Using the AngioSeal Vascular Closure Device After Antegrade Puncture

    Energy Technology Data Exchange (ETDEWEB)

    Minko, Peter, E-mail: peterminko@yahoo.com; Katoh, Marcus [University Hospital Saarland, Department of Diagnostic and Interventional Radiology (Germany); Graeber, Stefan [University Hospital Saarland, Institute of Medical Biometry, Epidemiology and Medical Informatics (Germany); Buecker, Arno [University Hospital Saarland, Department of Diagnostic and Interventional Radiology (Germany)

    2012-08-15

    Purpose: This study was designed to investigate the efficacy of the AngioSeal vascular closure device after antegrade puncture of the femoral artery. Methods: In a prospective study, 120 consecutive patients underwent lower limb vascular intervention by an antegrade access to the common femoral artery (CFA). After intervention, a 6F (n = 88) or an 8F (n = 32) AngioSeal vascular closure device was used to achieve hemostasis. The technical success or the cause of failure was documented. In addition, the coagulation status (platelets, INR, prothrombin time, atrial thromboplastin time (PTT)), hypertonus, locoregional habitus of the groin, body mass index (BMI), presence of calcifications, and history of previous surgical interventions of the CFA were evaluated. Results: Hemostasis was achieved in 97 patients (81%). In 12 patients (10%), persistent bleeding of the puncture site required manual compression. In another nine patients (8%) a kink of the sheath obviated the passage of the collagen plug toward the vessel, and in two patients the anchor dislodged out of the vessel, requiring manual compression. There were no significant differences between the groups of successful and unsuccessful sealing regarding the mean platelets (241 vs. 254 * 10{sup 9}/l; P = 0.86), INR (1.06 vs. 1.02; P = 0.52), prothrombin time (90% vs. 90%; P = 0.86), and PTT (30 vs. 31 s; P = 0.82). However, unsuccessful sealing was more likely in obese patients with an increased BMI (26.6 vs. 28.8 kg/m{sup 2}; P = 0.04). Conclusions: Obesity seems to be an independent risk factor for insufficient sealing using the AngioSeal vascular closure device after antegrade puncture of the CFA. In 8% of our patients, hemostasis could not be achieved due to kink of the flexible sheath.

  1. Transrectal ultrasonography-guided transperineal bilateral seminal vesicle puncture and continuous irrigation for the treatment of intractable hematospermia

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xin-ru; GU Bao-jun; XU Yue-min; CHEN Rong; ZHANG Jiong; QIAO Yong

    2008-01-01

    @@ Hematospermia is a rare condition, but often causes frustration. The reason for this frustration is that the exact incidence of hematospermia remains unknown and its cause is difficult to determine.1 Many reports in the past decades have focused on the etiology of hematospermia.2 Hematospermia is treated initially by administration of antibiotics, coagulants, and sex steroid hormones. However, some cases may prove resistant to this therapy and the condition may continue. For some intractable and agnogenic cases, the therapeutic strategy mentioned above is not very effective. Recently, we treated 63 such nonresponsive patients by direct continuous antibiotic irrigation into the bilateral seminal vesicles through puncture under transrectal ultrasonography (TRUS) guidance.

  2. Peripartum Isolated Cortical Vein Thrombosis in a Mother with Postdural Puncture Headache Treated with an Epidural Blood Patch

    Directory of Open Access Journals (Sweden)

    Etienne Laverse

    2013-01-01

    Full Text Available A 32-year-old woman presented with low pressure headache 3 days after delivery of her baby. An assessment of postdural puncture headache was made. This was initially treated with analgesia, caffeine, and fluids for the presumed cerebrospinal fluid (CSF leak. The woman was readmitted two days after her hospital discharge with generalised seizures. A brain scan showed features of intracranial hypotension, and she was treated for CSF leak using an epidural blood patch. Her symptoms worsened and three days later, she developed a left homonymous quadrantanopia. An MRI scan confirmed a right parietal haematoma with evidence of isolated cortical vein thrombosis (ICVT.

  3. Direct Puncture Embolization of Scalp Arteriovenous Malformation in a Patient with Severe Hemophilia A: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Mi; Kim, Eui Jong [Dept. of Radiology, Kyung Hee University Hospital, Kyung Hee University Graduate School of Medicine, Seoul (Korea, Republic of); Park, Bong Jin [Dept. of Neurosurgery, Kyung Hee University Hospital, Kyung Hee University Graduate School of Medicine, Seoul (Korea, Republic of); Kim, Keon Ha [Dept. of Radiology, Samsug Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-09-15

    We present a case of scalp arteriovenous malformation (AVM) in a patient with severe hemophilia A. The 22-year-old man presented with a pulsatile right parietal scalp mass. Digital subtraction angiography revealed an AVM in the right parietal scalp, supplied by superficial temporal and occipital arteries that drained into multiple venous structures. We successfully performed direct puncture embolization followed by surgical resection of the scalp AVM in conjunction with supplemental infusion of coagulation factor VIII before, during and after the embolization and the operation.

  4. Significant Improvement of Puncture Accuracy and Fluoroscopy Reduction in Percutaneous Transforaminal Endoscopic Discectomy With Novel Lumbar Location System: Preliminary Report of Prospective Hello Study.

    Science.gov (United States)

    Fan, Guoxin; Guan, Xiaofei; Zhang, Hailong; Wu, Xinbo; Gu, Xin; Gu, Guangfei; Fan, Yunshan; He, Shisheng

    2015-12-01

    Prospective nonrandomized control study.The study aimed to investigate the implication of the HE's Lumbar LOcation (HELLO) system in improving the puncture accuracy and reducing fluoroscopy in percutaneous transforaminal endoscopic discectomy (PTED).Percutaneous transforaminal endoscopic discectomy is one of the most popular minimally invasive spine surgeries that heavily depend on repeated fluoroscopy. Increased fluoroscopy will induce higher radiation exposure to surgeons and patients. Accurate puncture in PTED can be achieved by accurate preoperative location and definite trajectory.The HELLO system mainly consists of self-made surface locator and puncture-assisted device. The surface locator was used to identify the exact puncture target and the puncture-assisted device was used to optimize the puncture trajectory. Patients who had single L4/5 or L5/S1 lumbar intervertebral disc herniation and underwent PTED were included the study. Patients receiving the HELLO system were assigned in Group A, and those taking conventional method were assigned in Group B. Study primary endpoint was puncture times and fluoroscopic times, and the secondary endpoint was location time and operation time.A total of 62 patients who received PTED were included in this study. The average age was 45.35 ± 8.70 years in Group A and 46.61 ± 7.84 years in Group B (P = 0.552). There were no significant differences in gender, body mass index, conservative time, and surgical segment between the 2 groups (P > 0.05). The puncture times were 1.19 ± 0.48 in Group A and 6.03 ± 1.87 in Group B (P HELLO system is accurate preoperative location and definite trajectory. This preliminary report indicated that the HELLO system significantly improves the puncture accuracy of PTED and reduces the fluoroscopic times, preoperative location time, as well as operation time. (ChiCTR-ICR-15006730).

  5. 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.

  6. The effect of intravenous propofol on the incidence of post-dural puncture headache following spinal anesthesia in cesarean section

    Directory of Open Access Journals (Sweden)

    Parisa Golfam

    2016-09-01

    Full Text Available Introduction: Post Dural puncture headache is still a common complication among young women undergone cesarean section, although use of small size spinal needles reduced its prevalence. Several methods have been suggested for prevention and treatment of this side effect; such as complete bed rest, hydration, non-opioid analgesics, caffeine, codeine, which none of them proved to be totally effective. The last option would be epidural blood patch, if headache persist. The aim of this study was evaluation the efficacy of intravenous propofol on post dural puncture headache incidence after cesarean section. Methods: In a randomized clinical trial 120 patients aged 18-45 years old in American Society of Anesthesiologist (ASA class I or II, who had no history of headache, analgesic consumption, substance abuse and drug addiction, candidate for elective cesarean section, were randomly assigned into intervention (propofol and control groups. The anesthesia method for both groups was precisely the same. After spinal anesthesia in the first group 30µg/kg/min of intravenous propofol have been infused slowly. Then at 1, 6, 18, 24 hours and 2nd to 7th days after surgery, anesthesiologist asked groups for presence or absence of headache. The data analyzed with SPSS 16.0 software. Results: Headache incidence rate in the group who receiving propofol was significantly reduced (P.V=0.001. Conclusion: This study showed that 30µg/kg/min of intravenous propofol caused reduced the incidence of post spinal headache in young women undergone elective cesarean section.

  7. 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.

  8. Quantitative analysis of disc degeneration using axial T2 mapping in a percutaneous annular puncture model in rabbits

    Energy Technology Data Exchange (ETDEWEB)

    Chai, Jee Won; Kim, Su Jin [Dept. of Radiology, SMG-SNU Boramae Medical Center, Seoul (Korea, Republic of); Kang, Heung Sik; Lee, Joon Woo [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Hong, Sung Hwan [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2016-02-15

    To evaluate T2 relaxation time change using axial T2 mapping in a rabbit degenerated disc model and determine the most correlated variable with histologic score among T2 relaxation time, disc height index, and Pfirrmann grade. Degenerated disc model was made in 4 lumbar discs of 11 rabbits (n = 44) by percutaneous annular puncture with various severities of an injury. Lumbar spine lateral radiograph, MR T2 sagittal scan and MR axial T2 mapping were obtained at baseline and 2 weeks and 4 weeks after the injury in 7 rabbits and at baseline and 2 weeks, 4 weeks, and 6 weeks after the injury in 4 rabbits. Generalized estimating equations were used for a longitudinal analysis of changes in T2 relaxation time in degenerated disc model. T2 relaxation time, disc height index and Pfirrmann grade were correlated with the histologic scoring of disc degeneration using Spearman's rho test. There was a significant difference in T2 relaxation time between uninjured and injured discs after annular puncture. Progressive decrease in T2 relaxation time was observed in injured discs throughout the study period. Lower T2 relaxation time was observed in the more severely injured discs. T2 relaxation time showed the strongest inverse correlation with the histologic score among the variables investigated (r = -0.811, p < 0.001). T2 relaxation time measured with axial T2 mapping in degenerated discs is a potential method to assess disc degeneration.

  9. Direct-puncture approach to the extraconal portion of the superior ophthalmic vein for carotid cavernous fistulae

    Energy Technology Data Exchange (ETDEWEB)

    Kurata, A.; Suzuki, S.; Iwamoto, K.; Miyazaki, T.; Inukai, M.; Abe, K.; Niki, J.; Yamada, M.; Fujii, K. [Kitasato University School of Medicine, Department of Neurosurgery, Kanagawa (Japan); Kan, S. [Kitasato University School of Medicine, Department of Radiology, Kanagawa (Japan)

    2009-11-15

    The transvenous approach via the superior ophthalmic vein (SOV) is an available approach for carotid cavernous fistula (CCF), especially in the event that there is no other suitable approach route to the fistula. Surgical exposure of the peripheral roots of the SOV is commonly used; however, often, the SOV is often not accessible because of anatomical problems and/or complications. In this paper, we present and discuss our original direct-puncture approach to the extraconal portion of the SOV. An attempt on three patients with traumatic CCF failed with the transarterial approach and the conventional venous approach via the inferior petrosal sinus; therefore, the patients were treated with the direct-puncture approach to the extraconal portion of the SOV using two-dimensional digital subtraction angiography with local anesthesia. All cases that had tortuous and partially stenotic division of the SOV were treated successfully with this approach and without complications. This approach will become an alternate approach, especially when the peripheral roots of the SOV are focally narrowed and tortuous, making it impossible to insert a catheter. (orig.)

  10. 小儿静脉穿刺的体会%The experience of venous puncture in children

    Institute of Scientific and Technical Information of China (English)

    陈庆凤

    2012-01-01

      Objective: Summary of pediatric venipuncture technical experience, so that the majority of the nursing staff of the puncture technique improved.Method: Experience summary.Result: Pediatric venous puncture in children " to hit the nail on the head " success rate of more than 99% . Conclusion: Through summing up experience, and constantly improve the technological level, the nursing quality upgrade.%  目的:总结小儿静脉穿刺的技术经验,使广大护理人员的穿刺技术得到提高。方法:经验总结。结果:儿科小儿静脉穿刺“一针见血”成功率达99%以上。结论:通过总结经验,不断提高技术水平,使护理质量得到不断提升。

  11. 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.

  12. Low complexity Reed-Solomon-based low-density parity-check design for software defined optical transmission system based on adaptive puncturing decoding algorithm

    Science.gov (United States)

    Pan, Xiaolong; Liu, Bo; Zheng, Jianglong; Tian, Qinghua

    2016-08-01

    We propose and demonstrate a low complexity Reed-Solomon-based low-density parity-check (RS-LDPC) code with adaptive puncturing decoding algorithm for elastic optical transmission system. Partial received codes and the relevant column in parity-check matrix can be punctured to reduce the calculation complexity by adaptive parity-check matrix during decoding process. The results show that the complexity of the proposed decoding algorithm is reduced by 30% compared with the regular RS-LDPC system. The optimized code rate of the RS-LDPC code can be obtained after five times iteration.

  13. Propagation of a linear wave created by a spatially localized perturbation in a regular lattice and punctured Lagrangian manifolds

    Science.gov (United States)

    Dobrokhotov, S. Yu.; Nazaikinskii, V. E.

    2017-01-01

    The following results are obtained for the Cauchy problem with localized initial data for the crystal lattice vibration equations with continuous and discrete time: (i) the asymptotics of the solution is determined by Lagrangian manifolds with singularities ("punctured" Lagrangian manifolds); (ii) Maslov's canonical operator is defined on such manifolds as a modification of a new representation recently obtained for the canonical operator by the present authors together with A. I. Shafarevich (Dokl. Ross. Akad. Nauk 46 (6), 641-644 (2016)); (iii) the projection of the Lagrangian manifold onto the configuration plane specifies a bounded oscillation region, whose boundary (which is naturally referred to as the leading edge front) is determined by the Hamiltonians corresponding to the limit wave equations; (iv) the leading edge front is a special caustic, which possibly contains stronger focal points. These observations, together with earlier results, lead to efficient formulas for the wave field in a neighborhood of the leading edge front.

  14. Structural evaluation of the Shippingport Reactor Pressure Vessel and Neutron Shield Tank package for impact and puncture loads

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, L.E.; Chou, C.K.; Lo, T.; Schwartz, M.W.

    1988-06-01

    A structural evaluation of Shippingport Reactor Pressure Vessel and Neutron Shield Tank package for impact and puncture loads under the normal and hypothetical accident conditions of 10 CFR 71 was performed. Component performance criteria for the Shippingport package and the corresponding structural acceptance criteria for these components were developed based on a review of the package geometry, the planned transport environment, and the external radiation standards and dispersal limits of 10 CFR 71. The evaluation was performed using structural analysis methods. A demonstration combining simplified model tests and nonlinear finite element analyses was made to substantiate the structural analysis methods used to evaluate the Shippingport package. The package was analyzed and the results indicate that the package meets external radiation standards and release limits of 10 CFR 71. 13 refs., 50 figs., 19 tabs.

  15. RS3PE Syndrome with Iliopsoas Bursitis Distinguished from an Iliopsoas Abscess Using a CT-guided Puncture.

    Science.gov (United States)

    Fukui, Shoichi; Iwamoto, Naoki; Tsuji, Sosuke; Umeda, Masataka; Nishino, Ayako; Nakashima, Yoshikazu; Suzuki, Takahisa; Horai, Yoshiro; Koga, Tomohiro; Kawashiri, Shin-ya; Ichinose, Kunihiro; Hirai, Yasuko; Tamai, Mami; Nakamura, Hideki; Origuchi, Tomoki; Kawakami, Atsushi

    2015-01-01

    A 55-year-old man was diagnosed with remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome. Contrast-enhanced computed tomography for cancer screening showed a mass with low-density centers with an enhanced rim in the left iliopsoas muscle. We suspected an iliopsoas abscess and performed computed-tomography-guided puncture of the mass. Both Gram staining and the culture of the fluid were negative. We diagnosed the patient with RS3PE syndrome with iliopsoas bursitis and administered low-dose corticosteroids without antibiotics. The symptoms, including left hip pain, quickly disappeared following treatment. Clinicians should be aware that iliopsoas bursitis may resemble an iliopsoas abscess. As a result, it is important to make an accurate differential diagnosis.

  16. Music and 25% glucose for preterm babies during the pre-procedure for arterial puncture: facial mimics emphasis

    Directory of Open Access Journals (Sweden)

    Maria Vera Lúcia Moreira Leitão Cardoso

    2016-06-01

    Full Text Available We aimed to describe and quantify facial mimic movements of preterm babies during music and 25% glucose interventions at the pre-procedure for arterial puncture. A randomized controlled trial involving 48 videos of preterm attended in a public neonatal unit, in Fortaleza – Ceará. We collected data from footage analyses during the pre-procedure. Babies heard a lullaby song for 10 minutes in the experimental group; we administered 25% glucose in the control group at the end of the eighth minute, matching a total of 10 minutes of observation. We assessed the frequency of facial expressions: cry, sneeze, yawn, frown the forehead, focused sight, vague sight, sleeping and head movement. Statistically significant variable for the control group: vague sight (p=0.001 at the two last minutes of observation. We concluded that there was no association between most of facial movements and the studied interventions, except for a vague sight in the control group.

  17. A case's root cause analysis of osteofascial compartment syndrome induced by radial artery puncture and its defensive strategy

    Institute of Scientific and Technical Information of China (English)

    Feng-Ying Kang; Yang Yang; Yu-Ping Tong; Ya-Li Hu; Ning-Ning Xue

    2016-01-01

    Objective: The objective of this study was to reduce or avoid the occurrence of the cases of osteofascial compartment syndrome induced by a radial artery puncture for arterial blood gas analysis. Methods: We analyzed an adverse event using cheese model analysis, “fish bone” analysis, root cause analysis, and other methods. Results: There are three root causes leading to an adverse event:operation technique, assessment of the disease, and informing patient families. However, there are many reasons to promote the occurrence and development of the event. Conclusions: We should analyze and manage the adverse events in patients from the point of view of a system. Developing the measures of a system defense can enhance patient safety and create a good safety culture.

  18. Sonographic guidance for tunneled central venous catheters insertion in pediatric oncologic patients:guided punctures and guide wire localization

    Institute of Scientific and Technical Information of China (English)

    Gehad T. Meselhy; Kareem R. Sallam; Maged M. Elshafiey; Amal Refaat; Ahmad Samir; Alaa A. Younes

    2012-01-01

    Objective: Totally implantable devices (TIDs) and external tunneled catheters (ETCs) became a basic requirement in the treatment of pediatric oncologic patients. Techniques for implantation and confirmation of proper position vary among different centers. The article presented different techniques for sonographic guided puncture of the target central vein and confirmation of the proper position of tunneled catheters. Methods: This was an observational study with a single crossover phase, in which operators initially used the open cut down technique and subsequently converted to the ultrasound guided technique. Internal jugular vein (IJV) was used in all cases. Results: In ultrasound guided group, TIDs were inserted in 121cases while ETCs were inserted in 13 cases. Ultrasound was successful in guiding IJV puncture from the first trial in all cases and in guide-wire localization in the right atrium in 132 cases. There were no reported cases of hematoma, pneumothorax,hemothorax, catheter malposition or surgical-site infection (SSI) in the perioperative period. In the open cut down group, TIDs were inserted in 119 cases. Two patients developed post operative hematoma and one of them developed SSI. The mean time of ultrasound guided TIDs was (30.04 ± 1.1) minutes which was significantly lower than the mean time of cases done by theopen cut down technique (45.4 ± 3.1) minutes (P < 0.0001). Conclusion: Ultrasound guidance is helpful for insertion of TIDs and ETCs in the IJV in pediatric oncologic patients. It minimizes the need for open cut downs and fluoroscopy.

  19. Clinical Observations on the Treatment of Ramsay Hunt Syndrome by Blood-letting Puncture and Cupping as Main Therapy

    Institute of Scientific and Technical Information of China (English)

    SONG Ya-guang; ZHAO Jian-chun; YUAN Hui; WANG Si-you

    2005-01-01

    Purpose: To investigate the clinical efficacy of blood-letting puncture and cupping in cooperation with acupuncture and moxibustion for treating Ramsay Hunt syndrome. Atreatment group of 32 cases was treated by blood-letting puncture with plum-blossom needle and cupping in cooperation with acupuncture and moxibustion and a control group of 32 cases,with acupuncture and moxibustion, and andaciclovir. Results and conclusion: The cure and marked effectiveness rate was 81.2% in the treatment group and 56.2% in the control group after 4 courses of treatment. It was higher in the treatment group than in the control group (P<0.05). The short-term otalgia-relieving rate was also significantly higher in the treatment group than in the control group (P<0.01).%目的:观察穴位刺络拔罐疗法配合针灸等治疗Ramsay Hunt综合征的临床疗效.方法:治疗组32例患者取大椎、完骨等穴运用梅花针刺络拔罐的方法配合针灸治疗;对照组32例患者以针灸、阿昔洛韦等治疗.结果与结论:4个疗程后治疗组愈显率为81.2%,对照组为56.2%,治疗组优于对照纽(P<0.05).且治疗组中、短期耳痛缓解率也均明显优于对照组(P<0.01).

  20. Punciones repetidas de la arteria radial para cateterismo cardíaco Repeated radial artery puncture for cardiac catheterization

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    Eduardo Magariños

    2007-06-01

    Full Text Available La punción percutánea de la arteria radial para la realización de procedimientos por cateterismo ha ganado aceptación debido a una eficacia similar a la obtenida con el acceso femoral. En el presente trabajo evaluamos los resultados obtenidos con la punción repetida de esta arteria. En un total de 182 accesos radiales se realizaron 17 punciones repetidas, y mediante ellas, 20 procedimientos (9 coronariografías y 11 angioplastias. Se obtuvo éxito del acceso en 15 punciones repetidas (88.2% y éxito del procedimiento en todos los casos cuando logramos éxito del acceso. Si bien el grupo es pequeño es suficiente para mostrar que la punción repetida de la arteria radial es factible y permite una alta tasa de éxito de los procedimientos con una disminución ostensible de las complicaciones locales.The radial artery approach for percutaneous cardiac interventions has gained worldwide acceptance due to the similar results obtained by the femoral artery access. In this paper, we report our experience with repeated puncture of the radial artery. One hundred and eighty two radial artery access procedures were performed, in 17 interventions the puncture was repeated once or twice, with a total of 20 therapeutic catheterizations (9 coronary angiographies, 11 angioplasties. There was no therapeutic failure through the radial approach but, we successfully gained access in 88.2% (15/17 of the re-interventions cases. Although an experience with a low number of cases, we had a very high successful therapeutic rate, and also a remarkable lowering of local complications, this shows the feasibility and potential of this technique.

  1. Evaluation of the effects of electron-beam irradiation on the puncture resistance by Lasioderma serricorne in flexible packaging of granola

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Vitor M.; Alves, Juliana N.; Nogueira, Beatriz R.; Moura, Esperidiana A.B., E-mail: vmiranda@ipen.b, E-mail: julianaabc@ig.com.b, E-mail: bia.ribnog@gmail.co, E-mail: eabmoura@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Ortiz, Angel V., E-mail: angel.ortiz@unipacnet.com.b [UNIPAC Embalagens Ltda., Sao Paulo, SP (Brazil); Potenza, Marcos R., E-mail: potenza@biologico.sp.gov.b [Instituto Biologico de Sao Paulo/APTA, Sao Paulo, SP (Brazil)

    2009-07-01

    Lasioderma serricorne is a beetle that infests stored and industrialized dry foods such as cereal bars, granola, flour and pasta, amongst others, depreciating the products and causing economic losses. It is therefore critical for these products a packaging that presents, in addition to good mechanical, barrier and machinability properties, a good resistance to puncture by insects, in order to prevent the contact and spread of pests in the packaged food. This study evaluates the changes on mechanical properties and puncture resistance by L. serricorne in BOPP/PP structure, used commercially as granola packaging after electron-beam irradiation. The irradiations were performed using a 1.5 MeV electron beam accelerator, dose rate of 11.22 kGy/s, at room temperature in presence of air, doses up to 120 kGy. After irradiation the BOPP/PP samples were subjected to tests of puncture resistance by L. serricorne, tensile strength, friction coefficient, penetration and seal strength. Results showed decreases in the original mechanical properties of the structure according to the radiation doses applied and effective resistance against punctures by L. serricorne (p<0.05). The results indicate that the irradiated and non-irradiated BOPP/PP structure, in the conditions studied in this work, is resistant against L. serricorne, however the decreases observed in the mechanical properties of the irradiated structure may turn it inappropriate for packaging granola. (author)

  2. Appreciation of CT-negative, lumbar puncture-positive subarachnoid haemorrhage : risk factors for presence of aneurysms and diagnostic yield of imaging

    NARCIS (Netherlands)

    Bakker, Nicolaas A.; Groen, Rob J. M.; Foumani, Mahrouz; Uyttenboogaart, Maarten; Eshghi, Omid S.; Metzemaekers, Joannes; Luijckx, Gert Jan; van Dijk, J. Marc C.

    OBJECTIVE: Patients without a subarachnoid haemorrhage (SAH) on brain CT scan (CT-negative), but a lumbar puncture (LP)-proven SAH, are a challenging patient category. The optimal diagnostic approach is still a matter of debate. Also, there is little knowledge on the probability of finding an

  3. Percutaneous evacuation of diffuse pulmonary interstitial emphysema by lung puncture in a baby with extremely low birth weight: a case report

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    Watanabe Masahiro

    2012-09-01

    Full Text Available Abstract Introduction Pulmonary interstitial emphysema is a serious complication of mechanical ventilation and can become life-threatening if progression occurs. Therapeutic lung puncture is a treatment option for severe pulmonary interstitial emphysema but has a limited use in babies with extremely low birth weight. We present a case of pulmonary interstitial emphysema in a Japanese baby (1-day-old boy with extremely low birth weight. The emphysema was successfully decompressed by therapeutic lung puncture performed with a trocar catheter. Case presentation The baby was born with a weight of 420g, which, to the best of our knowledge, is the lowest reported birth weight among babies with pulmonary interstitial emphysema. A chest X-ray on postnatal day 2 revealed pulmonary interstitial emphysema, which gradually progressed to diffuse pseudocystic changes. His condition became life-threatening despite the use of high-frequency oscillatory ventilation and lateral decubitus positioning. We evacuated the pulmonary interstitial emphysema by lung puncture with a trocar catheter to avoid respiratory and cardiovascular collapse. This resulted in adequate evacuation of the emphysema and a dramatic improvement in his clinical condition. Conclusions Therapeutic lung puncture performed with a trocar catheter is beneficial in babies with extremely low birth weight and diffuse pulmonary interstitial emphysema. This treatment option may be broadly applicable, especially in an emergency situation.

  4. 老年患者静脉穿刺护理心得%Nursing experience of venous puncture of elderly patients

    Institute of Scientific and Technical Information of China (English)

    李静; 吕茂英

    2014-01-01

    Due to the elderly with vascular fine,thin wall,poor flexibility,it can easily cause venous puncture failure.In order to let nursing staff better cope and improve the success rate of puncture,this paper summarize some successful venipuncture method. According to characteristics,position and situation of venous blood vessels of elderly patients,different puncture methods are choosed.Good psychological quality and puncture technique of nurses are cultivated.%老年人由于血管细、壁薄、弹性差,易造成静脉穿刺的失败,为了使护理人员能更好地应对和提高穿刺成功率,本文总结几点成功的静脉穿刺方法。根据老年患者静脉血管的特点、位置及情况选择不同的穿刺方法、培养护士良好的心理素质和穿刺技术。

  5. Methods and Techniques to Improve the Success rate of Neonatal Scalp Superficial Vein Puncture%提高新生儿头皮浅静脉穿刺成功率的方法与技巧

    Institute of Scientific and Technical Information of China (English)

    王元翠

    2016-01-01

    Objective To explore the methods and skills to improve the success rate of neonatal scalp superficial vein puncture. Methodsin neonatal scalp superficial vein puncture should do the preparatory, according to neonatal choose appropriate scalp superficial vein, and puts forward the improved method of neonatal scalp superficial vein puncture, exclude puncture.Results and conclusion in the newborn scalp superficial vein puncture by exclusion of puncture, puncture success rate high, after the successful puncture well fixed. And protect the site of puncture and venous, to ensure long-term venous transfusion puncture success rate.%目的:探究提高新生儿头皮浅静脉穿刺成功率的方法与技巧。方法在进行新生儿头皮浅静脉穿刺前应做好各项准备,根据新生儿情况选择合适的头皮浅静脉,同时提出了新生儿头皮浅静脉穿刺的改进方法—排除穿刺法。结果与结论在为新生儿进行头皮浅静脉穿刺时采用排除穿刺法,穿刺成功率高,在穿刺成功后做好固定,并保护好穿刺部位及静脉,能够确保长期输液静脉穿刺的成功率。

  6. Routine Use of Fluoroscopic-Guided Femoral Arterial Puncture to Minimise Vascular Complication Rates in CTO Intervention: Multi-centre UK Experience.

    Science.gov (United States)

    Fairley, Sarah L; Lucking, Andrew J; McEntegart, Margaret; Shaukat, Aadil; Smith, David; Chase, Alexander; Hanratty, Colm G; Spratt, James C; Walsh, Simon J

    2016-12-01

    Chronic total occlusion (CTO) revascularisation has a crucial role in contemporary percutaneous coronary intervention (PCI). Procedural success is influenced by disease complexity, calcific burden and patient characteristics but has substantially improved with the implementation of novel hybrid strategies. However, vascular-access related complications remain a cause of morbidity and mortality. This study aimed to assess the effectiveness of fluoroscopic-guided femoral arterial puncture to minimise this risk during CTO PCI. Standardised data were retrospectively collected from four high-volume UK CTO centres between September 2011 and November 2013. Demographic, clinical and procedural data (vascular access site, sheath size, anticoagulation use) was collated. The anatomical location of the femoral puncture in relation to the femoral bifurcation, femoral head position and inferior epigastric artery were recorded. Adverse events related to vascular access were documented. A total of 528 patients were included (676 femoral punctures) with the majority being male (n=432, 81.8%). Large sheaths (8F) were used in 81.2% of cases. Fluoroscopy-enabled punctures were made in the 'safe zone' in over > 93% of cases. Vascular closure devices (VCD) were used in 88.3% of cases. The adverse event rate per puncture was 0.89%. This study demonstrates an extremely low incidence of vascular-access complications in CTO PCI when fluoroscopic guidance is used to obtain femoral arterial access by default radial operators. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  7. Effects of electron beam radiation on mechanical properties and on the resistance to punctures caused by Plodia interpunctella in cereal bar packaging

    Energy Technology Data Exchange (ETDEWEB)

    Alves, Juliana N.; Moura, Esperidiana A.B.; Oliveira, Vitor M., E-mail: julianaabc@usp.b, E-mail: eabmoura@ipen.b, E-mail: volmiranda@gmail.co [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Potenza, Marcos R., E-mail: potenza@biologico.sp.gov.b [Instituto Biologico de Sao Paulo/APTA, Sao Paulo, SP (Brazil); Arthur, Valter, E-mail: varthur@cena.usp.b [Centro de Energia Nuclear na Agricultura (CENA/USP), Piracicaba, SP (Brazil)

    2009-07-01

    Plodia interpunctella is an important pest in stored products in the tropical and subtropical regions, infesting grains and flours. The adult of P. interpunctella is a small butterfly with about 15 - 20mm of spread and the female places separately of 100 the 400 eggs in groups on the grains whose hard incubation some days. This insect infesting diverse types of food packaging, depreciating the products and causing economic losses. It is therefore critical for these products a packaging that presents, in addition to good mechanical, barrier and machinability properties, a good resistance to puncture by insects, in order to prevent the contact and spread of pests in the packaged food. This study evaluates the changes on mechanical properties and puncture resistance by P. interpunctella in BOPPmet/BOPP structure, used commercially as cereal bar packaging, after electron beam irradiation. The material samples were irradiated up to 120 kGy using a 1.5 MeV electrostatic accelerator, at room temperature, in air, dose rate 11.22 kGy/s. Irradiation doses were measured using cellulose triacetate film dosimeters 'CTA-FTR-125' from Fuji Photo Film Co. Ltd. After irradiation the BOPPmet/BOPP samples were subjected to tests of puncture resistance by P. interpunctella, tensile tests and penetration resistance. The results showed significant decreases (p<0.05) in the original mechanical properties of the structures according to the radiation doses applied and effective resistance against punctures by P. interpunctella for irradiated and nonirradiated BOPPmet/BOPP samples. These results indicate that non-irradiated and irradiated BOPPmet/BOPP structure presents puncture resistance against P. interpunctella and that electron-beam irradiation, in conditions studied in this work, may turn the structure inappropriate for cereal bar packaging, due to high reduction its mechanical properties after irradiation. (author)

  8. 机器人辅助靶向穿刺手术关键技术综述%Key technologies of robot-assisted needle puncture

    Institute of Scientific and Technical Information of China (English)

    赵洪华; 李国平; 曹树坤; 艾长胜; 孙选

    2015-01-01

    The soft tissue modeling,path planning,tracking synchronously,navigation,and control of the robot-assisted puncture system with flexible needles used are analyzed,the technical difficulties of the puncture operation,such as rapid planning of puncture path and precision control of puncture needle,are pointed out.finally,it is proposed tuat the soft tissue modeling,puncture control under complex conditions,force perception of needle tip are the challenging issues and future trends of this field.%以柔性针为穿刺工具,针对软组织建模理论与方法、针穿刺路径规划、呼吸运动抑制与同步跟踪、穿刺导航与靶点追踪控制等手术关键技术,综述国内外机器人辅助针穿刺技术领域的研究现状.指出穿刺手术目前存在的技术难点:穿刺路径的快速、最优规划和穿刺针的精准控制.提出针-软组织相互作用建模、不确定性和复杂约束条件下的穿刺控制以及穿刺针末端力感知问题是机器人辅助靶向穿刺领域未来的研究方向.

  9. 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

    Full Text Available How to Cite This Article: Derakhshanfar H, Modanlookordi M, Amini A, Shahrami A. A Comparative Study of the Sedative Effect of Oral Midazolam and Oral Promethazine Medication in Lumbar Puncture. Iran J Child Neurol. 2013 Spring;7(2:11-16. ObjectiveLumbar puncture (LP essentially is a painful and stressful procedure that indicated for diagnosis and therapeutic purposes. One way to reduce the anxiety is to administer an oral premedication. The aim of this study is to compare clinical effects of oral midazolam and oral promethazine in LP.Materials & MethodsThis prospective randomized controlled clinical trial study wasperformed on 80 children aged 2-7 years that were candidate for LP. They were divided into two randomized equal groups. First group received oral midazolam syrup 0.5 mg/kg and the other group received oral promethazine syrup 1mg/kg. Level of sedation, hemodynamic changes and any other complications were monitored every 5 minutes from 30 minutes before the start of the procedure.ResultsMidazolam group and promethazine group were similar in age, gender and weight. Midazolam had significantly shorter onset of sedation and also shorter duration to maximal sedation. The two groups were similar with respect to sedative effect at all time. The only complication that was significantly more in midazolam group was nausea and vomiting.ConclusionMidazolam syrup and promethazine syrup have same sedative effect in children. Both of these medications are easy to use in preschool children and none of them appeared to be superior to another. References1. Ellenby MS, Tegtmeyer K, Lai S, Braner DA. Lumbar Puncture. N Engl J Med 2006;28;355(13:e12.2. Crock C, Olsson C, Phillips R, Chalkiadis G, Sawyer S, Ashley D, et al. General anesthesia or conscious sedation for painful procedures in childhood cancer: The family’s perspective. Arch Dis Child 2003;88(3:253−7.3. Holdsworth MT, Raisch DW, Winter SS, Frost JD, Moro MA, Doran NH, et al. Pain and

  10. Punctures in the Periphery. Show-Bix and the Media Conscious Practice of Per Højholt.

    Directory of Open Access Journals (Sweden)

    Morten Søndergaard

    2007-05-01

    Full Text Available Around 1967 and onwards, Per Højholt (1923-2004 performs a series of punctures in the periphery of a small and self-conscious avant-garde in Denmark - experiments that combine most of the known art forms and genres in a still more active dialogue with new media and technology. One of the first things Højholt engaged himself in at the time was Show-Bix, which is best described as an artist group consisting of the photographer and visual artist Poul Ib Henriksen, composer Gunner Møller Pedersen, and Per Højholt (at the time described largely as a poet. The group was operative from 1968 and until 1971, a period during which it conducted a series of complex experiments involving an audience as well as a media consciousness which is quite unique in Denmark - perhaps even more so today. In fact, I claim that Show-Bix is the visible proof of a paradigmatic change in Per Højholt's artistic practice, as well as in the overall definition of the contemporary art scene.

  11. Antioxidant amplifies antibiotic protection in the cecal ligation and puncture model of microbial sepsis through interleukin-10 production.

    Science.gov (United States)

    Kotake, Yashige; Moore, Danny R; Vasquez-Walden, Angelica; Tabatabaie, Tahereh; Sang, Hong

    2003-03-01

    Preadministration of antioxidants such as pyrrolidine dithiocarbamate (PDTC) and phenyl N-tert-butyl nitrone (PBN) protects animals from lethality in sepsis models. However, the requirement of preadministration greatly diminishes the clinical significance of these studies. Although the synthetic antioxidant PBN has been shown to effectively protect rodents from lethality in endotoxemia (lipopolysaccharide [LPS] model), preliminary screening indicates that pre- or postadministration of PBN does not protect in the rat cecal ligation and puncture (CLP) model. We show in this report that in a rat CLP model, the administration of PBN (150 mg/kg, 30 min after CLP) followed by the antibiotic imipenem (IMP; 10 mg/kg, 1 h after CLP) significantly increased survival compared with other single treatment groups. Previously, we have shown that PBN's protection in a rat LPS model is mediated by the overproduction of the anti-inflammatory cytokine interleukin (IL)-10. We show in this study that the increase in survival found in the PBN + IMP-treated group was abrogated by immunoneutralization with anti-IL-10 antibody, indicating that endogenous IL-10 is an effective protective factor. Plasma LPS levels were shown to be elevated after imipenem treatment, and the increased LPS level could have assisted to overproduce endogenous IL-10, as in the case of the PBN-treated LPS model. Statistical analysis indicated that the increase of IL-10 in PBN + IMP-treated group at early time period has significant association to the improvement of survival.

  12. Impact of Just-in-Time and Just-in-Place Simulation on Intern Success With Infant Lumbar Puncture.

    Science.gov (United States)

    Kessler, David; Pusic, Martin; Chang, Todd P; Fein, Daniel M; Grossman, Devin; Mehta, Renuka; White, Marjorie; Jang, Jaewon; Whitfill, Travis; Auerbach, Marc

    2015-05-01

    Simulation-based skill trainings are common; however, optimal instructional designs that improve outcomes are not well specified. We explored the impact of just-in-time and just-in-place training (JIPT) on interns' infant lumbar puncture (LP) success. This prospective study enrolled pediatric and emergency medicine interns from 2009 to 2012 at 34 centers. Two distinct instructional design strategies were compared. Cohort A (2009-2010) completed simulation-based training at commencement of internship, receiving individually coached practice on the LP simulator until achieving a predefined mastery performance standard. Cohort B (2010-2012) had the same training plus JIPT sessions immediately before their first clinical LP. Main outcome was LP success, defined as obtaining fluid with first needle insertion and intern success rates with infant LP are poor. Despite improving process measures, adding JIPT to training bundles did not improve success rate. More research is needed on optimal instructional design strategies for infant LP. Copyright © 2015 by the American Academy of Pediatrics.

  13. Quantification of HIV-1 viral RNA in the blood in needles used for venous puncture in HIV-infected individuals

    Directory of Open Access Journals (Sweden)

    Iris Ricardo Rossin

    2011-12-01

    Full Text Available INTRODUCTION: Occupational HIV infection among healthcare workers is an important issue in exposures involving blood and body fluids. There are few data in the literature regarding the potential and the duration of infectivity of HIV type 1 (HIV-1 in contaminated material under adverse conditions. METHODS: We quantified HIV-1 viral RNA in 25×8mm calibre hollow-bore needles, after punctures, in 25 HIV-1-infected patients selected during the sample collection. All of the patients selected were between the ages of 18 and 55. Five samples were collected from 16 patients: one sample for the immediate quantification of HIV-1 RNA in the plasma and blood samples from the interior of 4 needles to be analyzed at 0h, 6h, 24h, and 72h after collection. In nine patients, another test was carried out in the blood from one additional needle, in which HIV-1 RNA was assessed 168h after blood collection. The method used to assess HIV-1 RNA was nucleic acid sequence-based amplification. RESULTS: Up to 7 days after collection, HIV-1 RNA was detected in all of the needles. The viral RNA remained stable up to 168h, and there were no statistically significant differences among the needle samples. CONCLUSIONS: Although the infectivity of the viral material in the needles is unknown, the data indicate the need to re-evaluate the practices in cases of occupational accidents in which the source is not identified.

  14. Chemically modified tetracycline (COL-3) improves survival if given 12 but not 24 hours after cecal ligation and puncture.

    Science.gov (United States)

    Halter, Jeffrey M; Pavone, Lucio A; Steinberg, Jay M; Gatto, Louis A; DiRocco, Joseph; Landas, Steve; Nieman, Gary F

    2006-12-01

    Sepsis can result in excessive and maladaptive inflammation that is responsible for more than 215,00 deaths per year in the United State alone. Current strategies for reducing the morbidity and mortality associated with sepsis rely on treatment of the syndrome rather than prophylaxis. We have been investigating a modified tetracycline, COL-3, which can be given prophylactically to patients at high risk for developing sepsis. Our group has shown that COL-3 is very effect at preventing the sequelae of sepsis if given before or immediately after injury in both rat and porcine sepsis models. In this study, we wanted to determine the "treatment window" for COL-3 after injury at which it remains protective. Sepsis was induced by cecal ligation and puncture (CLP). Rats were anesthetized and placed into five groups: CLP (n = 20) = CLP without COL-3, sham (n = 5) = surgery without CLP or COL-3, COL3@6h (n = 10) = COL-3 given by gavage 6 h after CLP, COL3@12h (n = 10) = COL-3 given by gavage 12 h after CLP, and COL3@24h (n = 20) = COL-3 given by gavage 24 h after CLP. COL-3 that was given at 6 and 12 h after CLP significantly improved survival as compared with the CLP and the CLP@24h groups. Improved survival was associated with a significant improvement in lung pathology assessed morphologically. These data suggest that COL-3 can be given up to 12 h after trauma and remain effective.

  15. Improved anticoagulation management after Palmaz Schatz coronary stent implantation by sealing the arterial puncture site with a vascular hemostasis device.

    Science.gov (United States)

    Kiemeneij, F; Laarman, G J

    1993-12-01

    Sealing the arterial puncture site with a vascular hemostasis device has the potential to maintain optimal anticoagulation after stent implantation. The level of heparinization during the first 3 days after successful stent implantation was retrospectively compared between 2 groups of medically treated patients with (group A; n = 18) and without (group B; n = 17) a Vasoseal after sheath removal. The number of APTTs sampled in group A and B was 233 and 168, respectively. Respective mean values of APTT (seconds) in group A and B were 180 +/- 79 and 172 +/- 91 at day 1 (p = NS), 132 +/- 43 and 125 +/- 61 at day 2 (p = NS) and 123 +/- 36 and 116 +/- 48 at day 3 (p = NS). More APTTs were suboptimal (< 80 secs) in group B (34/168; 20%) compared to group A (17/233; 7%) [p < 0.001]. More patients in group B compared to group A had 1 or more (14/17; 82% vs. 8/18; 44%; p = 0.04), 2 or more (10/17; 59% versus 3/18; 17%; p = 0.02) and 3 or more (8/17; 47% vs. 2/18; 11%; p = 0.03) suboptimal APTTs. Bleeding complications were seen in 4 patients without and in 3 patients with a Vasoseal. Thus application of a vascular hemostasis device results in a less variable anticoagulation after coronary stenting, but it does not abolish entry site-related bleeding complications.

  16. Ketamine anesthesia with or without diazepam premedication for bone marrow punctures in children with acute lymphoblastic leukemia.

    Science.gov (United States)

    Tamminga, R Y; Noordhoek, M; Kroon, J; Faber-Nijholt, R

    2000-01-01

    Ketamine is a drug widely used for analgesia and sedation of children for diagnostic and therapeutic procedures. The authors investigated in a randomized controlled clinical trial if diazepam premedication would have a beneficial effect on side effects related to ketamine anesthesia for bone marrow punctures (BMPs) in children with acute lymphoblastic leukemia (ALL). Sixteen children 4 years or older at the time of BMP were eligible. The first 2 BMPs after complete remission was obtained were studied. BMPs were performed under ketamine anesthesia (1.0-1.5 mg/kg i.v.), as usual. Patients were randomized to receive 1 h before the first BMP blinded, either diazepam or placebo orally and before the second BMP the other way round. Blood pressure, heart rate, and oxygen saturation were monitored, and patients were observed for signs of anxiety, pain, and other side effects. The patients were interviewed after each BMP and asked for their preference 1 week after the second BMP. Ketamine anesthesia appeared as safe and effective after diazepam premedication as after placebo premedication. From the interviews and questionnaires, it was clear that half of the children preferred diazepam premedication because of less awful dreaming and more gradual falling asleep and waking up. Diazepam premedication may be useful for selected children with ALL receiving ketamine anesthesia for BMPs.

  17. Lumbar subarachnoid hematoma following an epidural blood patch for meningeal puncture headache related to the implantation of an intrathecal drug delivery system.

    Science.gov (United States)

    Hustak, Erik C; Engle, Mitchell P; Viswanathan, Ashwin; Koyyalagunta, Dhanalakshmi

    2014-01-01

    Persistent meningeal puncture headache (MPH) is a known complication following both intentional and unintentional puncture of the dura mater.  We present a case of persistent MPH following implantation of an intrathecal drug delivery system (IDDS). Two separate epidural blood patches (EBP) were performed under radiographic guidance with contrast visualization of the epidural space on postoperative days 16 and 28, respectively. The case was complicated by the development of a symptomatic lumbar subarachnoid hematoma diagnosed on postoperative day 35. The patient subsequently underwent a laminectomy, evacuation of the hematoma, and explanation of the IDDS. This case illustrates a potential unique morbidity associated with the EBP in a patient with an IDDS. The report concludes with a brief review of MPH followed by a discussion of possible mechanisms underlying this complication.

  18. High-risk transseptal puncture in a patient with a “pancake” deformity in the left atrium caused by descending aorta displacement

    Directory of Open Access Journals (Sweden)

    Takuro Nishimura, MD

    2012-08-01

    Full Text Available Catheter ablation via the transseptal approach has recently become a widely performed technique for treating atrial fibrillation (AF. However, fluoroscopic imaging provides limited anatomic guidance for the left atrial structure. We describe the case of a 78-year-old man who was referred to our hospital for pulmonary vein isolation for symptomatic paroxysmal AF. He had a history of pulmonary tuberculosis for which he had undergone a right upper lobectomy. A “pancake” deformity of the left atrium (LA was observed using 64-slice multislice computed tomography. We performed a transseptal puncture by using real-time three-dimensional transesophageal echocardiography (RT3D-TEE in combination with fluoroscopic imaging, without any complications. Although transseptal puncture can be performed without echocardiographic guidance in most patients, in our patient, RT3D-TEE proved to be a very helpful imaging technique to access the LA.

  19. A study to evaluate the relationship between socio-economic, demographic characteristics and complications of acceptors in double puncture laparoscopic and conventional tubal ligation procedures

    OpenAIRE

    Sudhir Babu Palli; Vijaya Lakshmi Akkupalli

    2013-01-01

    Background: To discover the relationship between the socio-economic, demographic characteristics and complications for acceptors following Double puncture laparoscopic (DPL ) and conventional tubal ligation (CTL) procedures in rural and urban communities and additionally, we also sought to study the occurrence of post tubal ligation syndrome. Methods: A follow up study on 1000 women over a period of two years was conducted. The study was divided into 2 groups: 500 women undergone double punct...

  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. Accuracy and feasibility of frameless stereotactic and robot-assisted CT-based puncture in interventional radiology. A comparative phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Stoffner, R.; Widmann, G.; Bale, R. [Radiologie, Medizinische Univ. Innsbruck (Austria); Augschoell, C. [Chirurgie, LKH Salzburg (Austria); Boehler, D. [LKH Salzburg (Austria)

    2009-09-15

    Purpose: To compare the accuracy of frameless stereotactic and robot-assisted puncture in vitro based on computed tomography (CT) imaging with a slice thickness of 1, 3, and 5 mm. Materials and Methods: 300 punctures were carried out with help of the Atlas aiming device guided by the optical navigation system Stealth Station TREONplus and 150 punctures were guided by the robotic assistance system Innomotion. Conically shaped rods were punctured with Kirschner wires. The accuracy was evaluated on the basis of control CTs by measuring the Euclidean distance between the wire tip and target and the normal distance between the target and wire. Results: With the Stealth Station a mean Euclidean distance of 1.94{+-}0.912, 2.2{+-}1.136, and 2.74{+-}1.166 mm at a slice thickness of 1, 3 and 5 mm, respectively, was reached. The mean normal distance was 1.64{+-}0.919, 1.84{+-}1.189, and 2.48{+-}1.196 mm, respectively. The Innomotion system resulted in a mean Euclidean distance of 1.69{+-}0.772, 1.91{+-}0.673, and 2.30{+-}0.881 mm, respectively, while the mean normal distance was (1.42{+-}0.78), 1.60{+-}0.733, and 1.98{+-}1.002 mm, respectively. A statistical significance between accuracies with both systems with 1 mm and 3 mm slices could not be detected (p > 0.05). At a slice thickness of 5 mm, the robot was significantly more accurate, but not as accurate as when using thinner slices (p < 0.05). The procedure time is longer for the Innomotion system ({proportional_to}30 vs. {proportional_to}18 min), and the practicability is higher with the Stealth Station. (orig.)

  2. 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。

  3. Interactions among biotic and abiotic factors affect the reliability of tungsten microneedles puncturing in vitro and in vivo peripheral nerves: A hybrid computational approach

    Energy Technology Data Exchange (ETDEWEB)

    Sergi, Pier Nicola, E-mail: p.sergi@sssup.it [Translational Neural Engineering Laboratory, The Biorobotics Institute, Scuola Superiore Sant' Anna, Viale Rinaldo Piaggio 34, Pontedera, 56025 (Italy); Jensen, Winnie [Department of Health Science and Technology, Fredrik Bajers Vej 7, 9220 Aalborg (Denmark); Yoshida, Ken [Department of Biomedical Engineering, Indiana University - Purdue University Indianapolis, 723 W. Michigan St., SL220, Indianapolis, IN 46202 (United States)

    2016-02-01

    Tungsten is an elective material to produce slender and stiff microneedles able to enter soft tissues and minimize puncture wounds. In particular, tungsten microneedles are used to puncture peripheral nerves and insert neural interfaces, bridging the gap between the nervous system and robotic devices (e.g., hand prostheses). Unfortunately, microneedles fail during the puncture process and this failure is not dependent on stiffness or fracture toughness of the constituent material. In addition, the microneedles' performances decrease during in vivo trials with respect to the in vitro ones. This further effect is independent on internal biotic effects, while it seems to be related to external biotic causes. Since the exact synergy of phenomena decreasing the in vivo reliability is still not known, this work explored the connection between in vitro and in vivo behavior of tungsten microneedles through the study of interactions between biotic and abiotic factors. A hybrid computational approach, simultaneously using theoretical relationships and in silico models of nerves, was implemented to model the change of reliability varying the microneedle diameter, and to predict in vivo performances by using in vitro reliability and local differences between in vivo and in vitro mechanical response of nerves. - Highlights: • We provide phenomenological Finite Element (FE) models of peripheral nerves to study the interactions with W microneedles • We provide a general interaction-based approach to model the reliability of slender microneedles • We evaluate the reliability of W microneedels to puncture in vivo nerves • We provide a novel synergistic hybrid approach (theory + simulations) involving interactions among biotic and abiotic factors • We validate the hybrid approach by using experimental data from literature.

  4. Posterior reversible encephalopathy syndrome following an inadvertent dural puncture during an emergency laparotomy for ischemic colitis – a case report

    Directory of Open Access Journals (Sweden)

    Shah R

    2014-01-01

    Full Text Available Reena Shah, Agnieszka Kubisz-Pudelko, Jeremy Reid Yeovil District Hospital, Yeovil, UK Abstract: Posterior reversible encephalopathy syndrome (PRES is a clinico-neuroradiological syndrome characterized by various symptoms of neurological disease. It has commonly been reported in association with acute hypertension, pre-eclampsia, eclampsia, sepsis, and exposure to immunosuppressants. Here, we report on a normotensive woman who developed a severe frontal headache, visual disturbances, and hypertension 3 days after undergoing an emergency laparotomy for ischemic colitis during which she suffered an inadvertent dural puncture. Neuro-imaging revealed features consistent with PRES. The patient went on to make a good recovery, being discharged 21 days postoperatively, with only minor visual disturbances and memory problems. This case highlights the importance of awareness of PRES to all specialties. On reviewing the literature, we feel that PRES may be a potential differential diagnosis to post-procedural neurological symptoms in those patients undergoing routine procedures such as spinal anesthetics or lumbar punctures. Keywords: PRES, neurological disease, lumbar puncture, spinal anesthetic

  5. 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.

  6. Puncturing and Inserting the Indwelling of Femoral Venous of Oblique Insertion%斜刺股静脉穿刺置管

    Institute of Scientific and Technical Information of China (English)

    蒋克泉; 朋立超; 吴贵龙

    2012-01-01

    Objective:To explore the feasibility of the indwelling of femoral venous puncture. Methods: One hundred patients, who needed the indwelling of femoral venous puncture, were divided into study group(oblique insertion with the way of holding a pen) and control group(traditional way). Each group included 50 cases. Primary outcome variables were the success rate. Results: The one - time success rate of puncture was obviously higher(P<0. 05) in the study group than that in the control group. Conclusion: It is a feasible and effective approach to insert the indwelling of femoral venous of oblique insertion.%目的:探讨斜刺股静脉穿刺置管的临床应用.方法:斜刺股动脉后股静脉穿刺置管组(斜刺式组)和传统股静脉穿刺置管组(传统式组)各50例,比较两组成功率.结果:斜刺式组成功率与传统式组比较,成功率的差异有统计学意义(P<0.05),前者成功率显著高于后者.结论:斜刺股静脉穿刺是一种可行的、有效的方法,穿刺的成功率较高.

  7. [An accidental puncture of a small artery behind the internal jugular vein in real-time ultrasound-guided pediatric central venous cannulation].

    Science.gov (United States)

    Kayashima, Kenji

    2013-02-01

    A baby girl, 15-month-old, 75.6 cm in height, and 7.5 kg in weight, was scheduled to undergo ventricular septal defect repair. The right IJV, 3.0 mm in thickness and 7.0 mm in depth, was punctured to place a central venous catheter with a 19-mm-long 24G puncture needle. Non-pulsatile bright red blood appeared during the 15.8-mm-long needle insertion and dark red blood appeared during the 14.7-mm-long needle insertion. The vertebral artery, 3.9 mm in width, lay 14.1 mm in depth. The 15.8-mm-long needle inserted at a 45-degree angle could reach about 11.3 mm deep perpendicularly from the skin surface. The 14.7-mm-long needle inserted at a 45-degree angle reached about 10.4 mm, which is near the posterior wall of the IJV It seemed that a small artery behind the IJV was punctured mistakenly. In withdrawing blood from a cyanotic patient, it may be difficult to judge if the blood was arterial because it was non-pulsatile when it appeared. We should be careful to know the existence of small arteries behind IJVs and to confirm which vessels the returned blood comes from.

  8. Interactions among biotic and abiotic factors affect the reliability of tungsten microneedles puncturing in vitro and in vivo peripheral nerves: A hybrid computational approach.

    Science.gov (United States)

    Sergi, Pier Nicola; Jensen, Winnie; Yoshida, Ken

    2016-02-01

    Tungsten is an elective material to produce slender and stiff microneedles able to enter soft tissues and minimize puncture wounds. In particular, tungsten microneedles are used to puncture peripheral nerves and insert neural interfaces, bridging the gap between the nervous system and robotic devices (e.g., hand prostheses). Unfortunately, microneedles fail during the puncture process and this failure is not dependent on stiffness or fracture toughness of the constituent material. In addition, the microneedles' performances decrease during in vivo trials with respect to the in vitro ones. This further effect is independent on internal biotic effects, while it seems to be related to external biotic causes. Since the exact synergy of phenomena decreasing the in vivo reliability is still not known, this work explored the connection between in vitro and in vivo behavior of tungsten microneedles through the study of interactions between biotic and abiotic factors. A hybrid computational approach, simultaneously using theoretical relationships and in silico models of nerves, was implemented to model the change of reliability varying the microneedle diameter, and to predict in vivo performances by using in vitro reliability and local differences between in vivo and in vitro mechanical response of nerves.

  9. FIFTY-THREE CASES OF EXTERNAL HUMERAL EPICONDYLITIS TREATED WITH WARM ACUPUNCTURE AND TRIPLE PUNCTURE%温针齐刺治疗肱骨外上髁炎53例

    Institute of Scientific and Technical Information of China (English)

    张斌渊

    2007-01-01

    @@ The author has treated external humeral epicondylitis with triple puncture recorded in Miraculous Pivot: Official Needles (), combined with warm acupuncture and won good therapeutic effects, following is the report.

  10. A navigation system for percutaneous needle interventions based on PET/CT images: design, workflow and error analysis of soft tissue and bone punctures.

    Science.gov (United States)

    Oliveira-Santos, Thiago; Klaeser, Bernd; Weitzel, Thilo; Krause, Thomas; Nolte, Lutz-Peter; Peterhans, Matthias; Weber, Stefan

    2011-01-01

    Percutaneous needle intervention based on PET/CT images is effective, but exposes the patient to unnecessary radiation due to the increased number of CT scans required. Computer assisted intervention can reduce the number of scans, but requires handling, matching and visualization of two different datasets. While one dataset is used for target definition according to metabolism, the other is used for instrument guidance according to anatomical structures. No navigation systems capable of handling such data and performing PET/CT image-based procedures while following clinically approved protocols for oncologic percutaneous interventions are available. The need for such systems is emphasized in scenarios where the target can be located in different types of tissue such as bone and soft tissue. These two tissues require different clinical protocols for puncturing and may therefore give rise to different problems during the navigated intervention. Studies comparing the performance of navigated needle interventions targeting lesions located in these two types of tissue are not often found in the literature. Hence, this paper presents an optical navigation system for percutaneous needle interventions based on PET/CT images. The system provides viewers for guiding the physician to the target with real-time visualization of PET/CT datasets, and is able to handle targets located in both bone and soft tissue. The navigation system and the required clinical workflow were designed taking into consideration clinical protocols and requirements, and the system is thus operable by a single person, even during transition to the sterile phase. Both the system and the workflow were evaluated in an initial set of experiments simulating 41 lesions (23 located in bone tissue and 18 in soft tissue) in swine cadavers. We also measured and decomposed the overall system error into distinct error sources, which allowed for the identification of particularities involved in the process as well

  11. Intravenous Fluid Bolus Prior to Neonatal and Infant Lumbar Puncture: A Sonographic Assessment of the Subarachnoid Space After Intravenous Fluid Administration.

    Science.gov (United States)

    Rankin, Jessica; Wang, Vincent J; Goodarzian, Fariba; Lai, Hollie A

    2016-03-01

    Neonatal and infant lumbar puncture is a commonly performed procedure in emergency departments, yet traumatic and unsuccessful lumbar punctures occur 30% to 50% of the time. Dehydration may be a risk factor for unsuccessful lumbar punctures, but to our knowledge, no studies have investigated the use of intravenous (IV) fluid bolus prior to lumbar puncture. To investigate the association of IV fluid bolus administration with the sonographic measure of the neonatal and infant lumbar subarachnoid space. We hypothesized that IV fluids would increase subarachnoid space size. Prospective observational study conducted from August 2012 to April 2015.The study took place at the emergency department of the Children's Hospital Los Angeles, an urban pediatric emergency department with an annual census of 76,000 visits.A convenience sample of patients aged 0 to 3 months were enrolled if they had a clinical presentation consistent with pyloric stenosis. This population was used as a proxy because they are similar in age to patients undergoing lumbar puncture for evaluation of neonatal fever and are routinely given IV fluids for dehydration. Patients with a sonographic diagnosis of pyloric stenosis underwent additional ultrasonography evaluation to determine the size of the subarachnoid space before and after IV fluids. Primary outcomes included the difference in the size of the subarachnoid space in millimeters squared before and 1 hour after administration of an IV fluid bolus in the emergency department. Interobserver consistency for the subarachnoid space measurement between attending radiologists was measured using intraclass correlation coefficient. The Wilcoxon signed-rank test was used to examine changes in subarachnoid space measurements (millimeters squared). The study sample consisted of 40 patients with a mean (SD) age of 37 (11.3) days (range, 15-71 days). The mean (SD) size of the subarachnoid space before and 1 hour after IV fluid bolus was 37.8 (11.1) mm(2) and 36

  12. 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

  13. 垃圾填埋场衬垫系统穿刺性能评价%Evaluation of puncture performance of liner system for solid waste landfills

    Institute of Scientific and Technical Information of China (English)

    许四法; 张勇; 王哲

    2011-01-01

    垃圾中含有铁、玻璃和陶瓷等尖锐物,在荷载作用下极有可能使衬垫系统发生破坏,导致渗滤液流入地下污染周边环境,如何正确评价衬垫系统的穿刺性能很重要.考虑材料的抗拉强度、厚度以及穿刺棒的直径提出了衬垫系统穿刺力的评价公式,并与试验结果进行了比较.结果表明,单层土工膜的抗穿刺力试验结果与评价值比较吻合,但由土工膜与无纺布组成的衬垫系统抗穿刺力的试验值与评价结果有一定偏差;土工膜与无纺布一起使用能大幅度提高衬垫系统的抗穿刺能力,因此土工膜上应铺设无纺布有利于保护衬垫系统;土工膜的抗拉强度越大,抗穿刺能力越强;基础的存在能在一定程度上提高衬垫系统的抗穿刺性能.所得结果对垃圾填埋场衬垫系统的设计具有一定的指导意义.%Because of the containing iron, glass and ceramics in solid waste, the geomembrane may be easily damaged and results in infiltrating into the surrounding ground and water; so it is very important how to evaluate the puncture performance of liner system.Taking into account the tensile strength.the thickness of geomembrane and the diameter of puncture probe, an evaluation formula of puncture resistance is presented based on the thin-walled structural mechanics theory; and the calculated values are compared with the experimental values.The results show that the calculation results of geomembrane are consistent with the puncture test results; but the calculation results of liner system composed of geomembrane and geotextiles are only about 70 percent of the test results.Geotextile used together with geomembrane could significantly improve puncture performance of liner system; so the geotextile should be spread on geomembrane for protection geomembrane.With an increase of tensile strength of geomembrane.puncture resistance becomes larger.Puncture resistance of geomembrans placed on compacted soil

  14. Effect evaluation of two different training methods of intravenous puncture%两种静脉穿刺培训方法的效果评价

    Institute of Scientific and Technical Information of China (English)

    田宏

    2012-01-01

    Objective To Implement two different, models for Intravenous puncture training in order to evaluate effect of these two training methods and to find much easier and more effective training approach to promote nursing students' technique on intravenous puncture. Methods The nursing students practicing in ward of department of oncology were randomly divided Into experimental and control group. In experimental group, leaf containing stems was used as intravenous puncture training target, while, In control group, model human was used for training target, which Is a traditional training method. After training, the assessment including successful rate of Intravenous puncture and Interview of patients' satisfactory toward two groups of nursing students were made so as to evaluate the effect of these two training methods. Results Successful rate of intravenous puncture and patients' satisfactory rate in experimental group reached 93.57% and 92.42%, respectively, while the rates in control group were 85.71% and 81.06%, respectively. The two groups showed a significant difference in these rates (P < 0.01). Conclusion Nursing students' technical ability on Intravenous puncture increased when they got trained by either methods of trainings. In particular, the students in experimental group obtained much better effect due to leaf containing stem much closer to human blood vessel system and being easier to get the materials. The results Indicates that the students receiving leal training had higher successful rate of Intravenous puncture and patients' satisfactory rate than those receiving traditional training method. Iherefore, the training method using leaf is very promising method and worth to be applied at a larger scale.%目的 通过使用不同的模型进行静脉穿刺训练,评价两种不同培训方法的效果,探讨如何利用更加简便易行的培训方法提高实习护生静脉穿刺技能.方法 将肿瘤科实习的护生随机分为实验组和对照组,

  15. Comparative immunohistochemical characteristics of hepatocellular, cholangiocellular cancer and liver metastases of pancreatic cancer in puncture trephine biopsy of the liver

    Directory of Open Access Journals (Sweden)

    V. A. Tumanskiy

    2015-10-01

    Full Text Available Aim. Differential immunohistochemical parameters of primary liver cancer and liver metastases of ductal pancreatic cancer (DPC were studied in puncture trephine biopsy of the liver of 23 patients with hepatocellular carcinoma (HCC, 2 patients combined hepato-cholangiocellular cancer (CHCC, 15 patients cholangiocellular cancer (CCC and 12 patients with metastatic DPC. Results. It was found that HCC liver is characterized by high levels of expression of HepPar 1 and alpha-fetoprotein, the lack of expression of MUC1 mucins, MUC5AC and CA125, and variable expression of CK8, CK7, SK19 and CK20, which depends on the degree of tumor differentiation and embodiment. Cholangiocellular liver cancer differs from others expressed desmoplastic stroma, high levels of expression of cytokeratins 7 and 19, MUC1 and MUC5AC, lack expression of HepPar 1 and variable expression of alpha-fetoprotein, cytokeratin 8 and20. Insolid and trabecular patterns of CHCC expression of HepRar 1, AFP and CK20 were determined, and in ductual patterne- CK7 and CK19 were determined. CCC and liver metastases of DPC which have the similar microstructure were characterized with the same spectrum characteristic of expressed cytokeratin (SK7, + 19, + 20, + and mucin (MUC1 + MUC5AC +, and variable expression of CA125 and CA19-9. Conclusion. Therefore, the differential diagnosis in immunohistochemistry of liver trepanobioptate between CCC and liver metastases of DPC is only possible based on the data of computed tomography or ultrasound examination of the liver and pancreas.

  16. [Mid-stream versus bladder puncture urine in the diagnosis of urinary tract infection in pregnant patients].

    Science.gov (United States)

    Retzke, U; Waitz, I; Loth, M; Liebetrau, B

    1988-01-01

    150 healthy women being pregnant in the 1st, 2nd and 3rd trimester were examined. From the same content of urinary bladder suprapubic puncture urine (BPU) and mid-stream urine (MSU) were collected. The results concerning microbiological and microscopical analysis of urine proofs were compared. For qualitative and quantitative germ analysis MSU is sufficiently clean enough. In 95.3 there is a good correspondence of the microbiological results of both proofs. Exceptionally in 4.7% the MSU-results were not confirmed by BPU. With respect to the findings in sediment there is no good correspondence of the results. In case of sterile bladder content the BPU sediment - findings are significantly more frequent normal and significantly more seldom abnormal than in MSU. The sediment findings in MSU are more frequent false positive than in BPU. In case of an infected bladder content there are no significant differences in the sediment findings of both techniques in taking urine proofs. The rate of normal sediment findings in case of an infected bladder content is unrealistic high: In MSU in 11% and in BPU in 26%. For microbiologic germ diagnosis MSU and BPU proofs are equivalent. But, for detection or for exclusion of urinary tract infections the sediment finding is poorly pathognomonic for a urinary tract infection. A normal sediment finding does not exclude the existance of an urinary tract infection. Therefore, in the system of prenatal care we should waive of the sediment finding as a guide for the diagnosis of urinary tract infections.

  17. Effects of crystalloids and colloids on liver and intestine microcirculation and function in cecal ligation and puncture induced septic rodents

    Science.gov (United States)

    2012-01-01

    Background Septic acute liver and intestinal failure is associated with a high mortality. We therefore investigated the influence of volume resuscitation with different crystalloid or colloid solutions on liver and intestine injury and microcirculation in septic rodents. Methods Sepsis was induced by cecal ligation and puncture (CLP) in 77 male rats. Animals were treated with different crystalloids (NaCl 0.9% (NaCl), Ringer’s acetate (RA)) or colloids (Gelafundin 4% (Gel), 6% HES 130/0.4 (HES)). After 24 h animals were re-anesthetized and intestinal (n = 6/group) and liver microcirculation (n = 6/group) were obtained using intravital microscopy, as well as macrohemodynamic parameters were measured. Blood assays and organs were harvested to determine organ function and injury. Results HES improved liver microcirculation, cardiac index and DO2-I, but significantly increased IL-1β, IL-6 and TNF-α levels and resulted in a mortality rate of 33%. Gel infused animals revealed significant reduction of liver and intestine microcirculation with severe side effects on coagulation (significantly increased PTT and INR, decreased haemoglobin and platelet count). Furthermore Gel showed severe hypoglycemia, acidosis and significantly increased ALT and IL-6 with a lethality of 29%. RA exhibited no derangements in liver microcirculation when compared to sham and HES. RA showed no intestinal microcirculation disturbance compared to sham, but significantly improved the number of intestinal capillaries with flow compared to HES. All RA treated animals survided and showed no severe side effects on coagulation, liver, macrohemodynamic or metabolic state. Conclusions Gelatine 4% revealed devastated hepatic and intestinal microcirculation and severe side effects in CLP induced septic rats, whereas the balanced crystalloid solution showed stabilization of macro- and microhemodynamics with improved survival. HES improved liver microcirculation, but exhibited significantly

  18. 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.

  19. The Conversion of a Peer Teaching Course in the Puncture of Peripheral Veins for Medical Students into an Interprofessional Course

    Directory of Open Access Journals (Sweden)

    Brem, Beate Gabriele

    2016-04-01

    Full Text Available Objective: There is a great interest on both a national and international level in promoting cooperation between different occupational groups within the healthcare professions through interprofessional education (IPE , , . Within this project, a peer teaching course on the puncture of peripheral veins was therefore converted from a course for medical students into an IPE learning unit. Students from different occupational groups were to learn within the context of this course, according to the definition from the World Health Organisation (WHO, with and from each other . Project description: This course constituted a small group class in the peer teaching format. The didactic principle was based on the idea that the students were to practice the respective practical skills in pairs and give each other reciprocal feedback. Together with the Department for Health at the Bern University of Applied Sciences (BUAS and the Bern Center of Higher Education of Nusing (BCHEN, the course, which was conducted by the Institute of Medical Education at the University of Bern (IME, was converted into a voluntary IPE pilot project. Students from all three institutions were represented in terms of participants as well as tutors. Results: The course was evaluated very positively by participants, peer tutors and the participating institutions. By means of an OSCE, it could be proven that the course content had been successfully imparted. On the basis of these results, it was determined that the course should be compulsory in the future for students at all three institutions. Discussion: The evaluation results show the successful conversion of the course into an IPE format within the context of the pilot project. The interactive format of the course created the prerequisite that the students from different professional groups learned with and from each other in actuality, and did not just study the same objectives at the same time as with multiprofessional learning

  20. Does preoperative gabapentin affects the characteristics of post-dural puncture headache in parturients undergoing cesarean section with spinal anesthesia?

    Directory of Open Access Journals (Sweden)

    Walid Hamed Nofal

    2014-01-01

    Full Text Available Background: Gabapentin is effective for treating different types of headache including post-dural puncture headache (PDPH, also used for prophylaxis against migraine. We studied the effect of pre-operative administration of gabapentin on the characteristics of PDPH in parturients undergoing cesarean section (CS under spinal anesthesia. Materials and Methods: Women undergoing elective cesarean section under spinal anesthesia were randomized to receive preoperative gabapentin 600 mg or placebo. Spinal anesthesia was achieved with 12.5 mg hyperbaric bupivacaine plus 25 μg fentanyl. Babies were followed up by Apgar scores, umbilical artery blood gases, breastfeeding difficulties, and need for NICU admission. The mothers were followed up for any side-effects of gabapentin for 24 h. Patients with PDPH were re-admitted and onset and duration of the headache were reported and severity was assessed using a visual analog scale (VAS for 4 days from diagnosis. Paracetamol with caffeine and diclofenac were given for treatment, and the doses were adjusted according to VAS; also number of doses given for each group was recorded. Results: Eighty eight patients were randomized, and 2 were excluded. The incidence of headache and co-existing symptoms were similar in both groups. The onset of headache was significantly delayed in gabapentin group (P < 0.05. Also, severity and duration of headache were significantly less in gabapentin group (P < 0.05. The incidence of sedation was more in gabapentin group 11 (26.19% versus placebo group 3 (6.81%. Neonatal outcomes were statistically insignificant between both groups. Conclusion: Pre-operative administration of gabapentin has no effect on incidence of (PDPH but delays its onset and reduces its severity and duration in parturients undergoing cesarean section with spinal anesthesia without significant adverse effects on the mother or the baby.

  1. Determination of fission gas release of spent nuclear fuel in puncturing test and in leaching experiments under anoxic conditions

    Science.gov (United States)

    González-Robles, E.; Metz, V.; Wegen, D. H.; Herm, M.; Papaioannou, D.; Bohnert, E.; Gretter, R.; Müller, N.; Nasyrow, R.; de Weerd, W.; Wiss, T.; Kienzler, B.

    2016-10-01

    During reactor operation the fission gases Kr and Xe are formed within the UO2 matrix of nuclear fuel. Their quantification is important to evaluate their impact on critical parameters regarding the fuel behaviour during irradiation and (long-term) interim storage, such as internal pressure of the fuel rod and fuel swelling. Moreover the content of Kr and Xe in the plenum of a fuel rod and their content in the UO2 fuel itself are widely used as indicators for the release properties of 129I, 137Cs, and other safety relevant radionuclides with respect to final disposal of spent nuclear fuel. The present study deals with the fission gas release from spent nuclear fuel exposed to simulated groundwater in comparison with the fission gas previously released to the fuel rod plenum during irradiation in reactor. In a unique approach we determined both the Kr and Xe inventories in the plenum by means of a puncturing test and in leaching experiments with a cladded fuel pellet and fuel fragments in bicarbonate water under 3.2 bar H2 overpressure. The fractional inventory of the fission gases released during irradiation into the plenum was (8.3 ± 0.9) %. The fraction of inventory of fission gases released during the leaching experiments was (17 ± 2) % after 333 days of leaching of the cladded pellet and (25 ± 2) % after 447 days of leaching of the fuel fragments, respectively. The relatively high release of fission gases in the experiment with fuel fragments was caused by the increased accessibility of water to the Kr and Xe occluded in the fuel.

  2. Streptococcus hongkongensis sp. nov., isolated from a patient with an infected puncture wound and from a marine flatfish.

    Science.gov (United States)

    Lau, Susanna K P; Curreem, Shirly O T; Lin, Cherry C N; Fung, Ami M Y; Yuen, Kwok-Yung; Woo, Patrick C Y

    2013-07-01

    A bacterium, HKU30(T), was isolated from the infected tissue of a patient with wound infection after puncture by a fish fin. Cells are facultative anaerobic, non-spore-forming, non-motile, Gram-positive cocci arranged in chains. Colonies were non-haemolytic. The strain was catalase, oxidase, urease and Voges-Proskauer test negative. It reacted with Lancefield's group G antisera and was resistant to optochin. It grew on bile aesculin agar and in 5 % NaCl. It was unidentified by three commercial identification systems. 16S rRNA gene sequence analysis indicated that the bacterium shared 98.2, 97.7, 97.4 and 97.1 % nucleotide identities with Streptococcus iniae, Streptococcus pseudoporcinus, Streptococcus parauberis and Streptococcus uberis, respectively. The DNA G+C content was 35.6 ± 0.9 mol% (mean ± sd). In view of the occupational exposure of the patient, an epidemiological study was performed to isolate the bacterium from marine fish. Two strains, with similar phenotypic and genotypic characteristics to those of HKU30(T), were isolated from a three-lined tongue sole (Cynoglossus abbreviatus) and an olive flounder (Paralichthys olivaceus) respectively. Phylogenetic analysis of four additional housekeeping genes, groEL, gyrB, sodA and rpoB, showed that the three isolates formed a distinct branch among known species of the genus Streptococcus, being most closely related to S. parauberis (CCUG 39954(T)). DNA-DNA hybridization demonstrated ≤ 53.8 % DNA relatedness between the three isolates and related species of the genus Streptococcus. A novel species, Streptococcus hongkongensis sp. nov., is proposed. The type strain is HKU30(T) ( = DSM 26014(T) = CECT 8154(T)).

  3. A STUDY OF THE MOST APPROPRIATE PUNCTURE TIME IN THE PREMATURE BABIES WITH PE-RIPHERALLY INSERTED CENTRAL VENOUS CATHETERS%早产儿PICC最佳穿刺时间的探讨

    Institute of Scientific and Technical Information of China (English)

    刘树艳; 于燕; 刘海娟

    2014-01-01

    Objective To probe into the most appropriate puncture time of the premature babies with pe-ripherally inserted central venous catheters (PICC) .Methods A total of 109 premature infants admitted in the neonatal department of author's hospital were selected from March 2010 to May 2013 ,among which there were 59 premature babies (experimental group) given PICC puncture during 48 to 72 hours after birth and 50 premature babies (control group) given PICC puncture within 48 hours after birth .The puncture site is on the right side of the premature babies'basilic vein .χ2 was applied to test and analyze the relation-ship between PICC puncture time and one-time pass rate ,limb swelling of puncture side ,bleeding and oo-zing liquid rate of puncture site .Results the limb swelling of puncture side and the bleeding and oozing liq-uid rate of puncture site in the experimental group was lower than that in the control group ,which had sta-tistical significance .Conclusion 48 -72 hours after birth of premature babies is the best time for PICC puncture .%目的:探讨早产儿外周置入中心静脉导管的最佳穿刺时间。方法研究对象为唐山市妇幼保健院新生儿科2010年3月-2013年5月收治的119例早产儿,其中出生后48~72h行PICC穿刺组(观察组)59例,出生后48h内行PICC穿刺组(对照组)50例,穿刺部位为早产儿的右侧贵要静脉。应用χ2检验分析PICC穿刺时间与一次成功率、穿刺侧肢体肿胀及穿刺部位渗血渗液率的相关关系。结果观察组早产儿的穿刺侧肢体肿胀率、穿刺部位渗血渗液率低于对照组,且差异具有统计学意义。结论早产儿出生后48~72h是PICC的最佳穿刺时间。

  4. Study on clinical application of arteriovenous puncture trocar used in blood purification%血液净化用动静脉穿刺套管针的临床研究

    Institute of Scientific and Technical Information of China (English)

    鄢建军; 张仲华; 吴会军; 朱波

    2015-01-01

    Objective:To probe into the clinical application effect of arteriovenous puncture trocar used in blood purification.Methods:A total of 30 hemodialysis patients treated with mature fistula were selected,and each pa-tient received hemodialysis with ordinary internal fistula puncture needle (needle group)and internal fistula puncture trocar (soft needle group),10 times in each,then to observe and record the patients’pain and the limb activity when they were punctured by two kinds of puncture needles,their overall comfort during the treatment, the average value of arterial pressure and venous pressure before the pump,hemostatic time after withdrawal of needles,wound recovery,satisfaction to nurse puncture and the occurrence of puncture related adverse events in both groups.Results:The patients’punctured limb activity,overall comfort during the treatment,average value of arterial pressure and venous pressure before the pump,hemostatic time after withdrawal of needles,wound recovery and the occurrence of puncture related adverse events in soft needle group were all better than that in needle group,and the difference was statistically significant (P 0.05 );the difficulty and total satisfaction of nurses in puncture in soft needle group were lower than that in needle group,but the satisfaction to decrease the potential danger of pricking wound in soft needle group was higher than that in needle group (P 0.05);软针组护士穿刺时的难度和总体满意度低于钢针组,但在降低潜在针刺伤危险方面的满意度高于钢针组(P <0.05)。[结论]血液净化用动静脉穿刺套管针可以增加血液透析病人的整体舒适度、穿刺肢体的活动度,降低穿刺相关不良事件发生率、缩短拔针后止血时间、利于穿刺伤口的恢复,透析过程中压力较低能保证充足的血流量,保证透析效果,在临床使用过程中要注重对护士相关知识及操作技能的培训。

  5. Cuts and puncture wounds

    Science.gov (United States)

    ... for bacteria. Prevention Keep knives, scissors, sharp objects, firearms, and fragile items out of the reach of ... team. Wounds and Injuries Read more Latest Health News Read more Health Topics A-Z Read more ...

  6. Emergency airway puncture

    Science.gov (United States)

    ... inserted into the throat, just below the Adam's apple (cricoid cartilage), into the airway. In a hospital, ... Choking Browse the Encyclopedia A.D.A.M., Inc. is accredited by URAC, also known as the ...

  7. Sepsis Strengthens Antagonistic Actions of Neostigmine on Rocuronium in a Rat Model of Cecal Ligation and Puncture

    Institute of Scientific and Technical Information of China (English)

    Jin Wu; Tian Jin; Hong Wang; Shi-Tong Li

    2016-01-01

    Background:The antagonistic actions of anticholinesterase drugs on non-depolarizing muscle relaxants are theoretically related to the activity ofacetylcholinesterase (AChE) in the neuromuscular junction (NMJ).However,till date the changes of AChE activity in the NMJ during sepsis have not been directly investigated.We aimed to investigate the effects of sepsis on the antagonistic actions ofneostigmine on rocuronium (Roc) and the underlying changes of AChE activity in the NMJ in a rat model of cecal ligation and puncture (CLP).Methods:A total of 28 male adult Sprague-Dawley rats were randomized to undergo a sham surgery (the sham group,n =12) or CLP (the septic group,n =16).After 24 h,the time-response curves of the antagonistic actions of 0.1 or 0.5 μmol/L of neostigmine on Roc (10 μmol/L)-depressed diaphragm twitch tension were measured.Meanwhile,the activity of AChE in the NMJ was detected using a modified Karnovsky and Roots method.The mRNA levels of the primary transcript and the type T transcript of AChE (AChET) in the diaphragm were determined by real-time reverse transcription-polymerase chain reaction.Results:Four of 16 rats in the septic group died within 24 h.The time-response curves of both two concentrations ofneostigmine in the septic group showed significant upward shifts from those in the sham group (P < 0.001 for 0.1 μmol/L;P =0.009 for 0.5 μmol/L).Meanwhile,the average optical density of AChE in the NMJ in the septic group was significantly lower than that in the sham group (0.517 ± 0.045 vs.1.047 ± 0.087,P < 0.001).The AChE and AChET mRNA expression levels in the septic group were significantly lower than those in the sham group (P =0.002 for AChE;P =0.00l for AChET).Conclusions:Sepsis strengthened the antagonistic actions ofneostigmine on Roc-depressed twitch tension of the diaphragm by inhibiting the activity of AChE in the NMJ.The reduced content of AChE might be one of the possible causes of the decreased AChE activity in the NMJ.

  8. The Conversion of a Peer Teaching Course in the Puncture of Peripheral Veins for Medical Students into an Interprofessional Course

    Science.gov (United States)

    Brem, Beate Gabriele; Schaffner, Noemi; Schlegel, Claudia Anna Barbara; Fritschi, Veronika; Schnabel, Kai Philipp

    2016-01-01

    Objective: There is a great interest on both a national and international level in promoting cooperation between different occupational groups within the healthcare professions through interprofessional education (IPE) [1], [2], [3]. Within this project, a peer teaching course on the puncture of peripheral veins was therefore converted from a course for medical students into an IPE learning unit. Students from different occupational groups were to learn within the context of this course, according to the definition from the World Health Organisation (WHO), with and from each other [1]. Project description: This course constituted a small group class in the peer teaching format. The didactic principle was based on the idea that the students were to practice the respective practical skills in pairs and give each other reciprocal feedback. Together with the Department for Health at the Bern University of Applied Sciences (BUAS) and the Bern Center of Higher Education of Nusing (BCHEN), the course, which was conducted by the Institute of Medical Education at the University of Bern (IME), was converted into a voluntary IPE pilot project. Students from all three institutions were represented in terms of participants as well as tutors. Results: The course was evaluated very positively by participants, peer tutors and the participating institutions. By means of an OSCE, it could be proven that the course content had been successfully imparted. On the basis of these results, it was determined that the course should be compulsory in the future for students at all three institutions. Discussion: The evaluation results show the successful conversion of the course into an IPE format within the context of the pilot project. The interactive format of the course created the prerequisite that the students from different professional groups learned with and from each other in actuality, and did not just study the same objectives at the same time as with multiprofessional learning

  9. Suitability of a 7-F ExoSeal Vascular Closure Device for Femoral Artery Punctures Made by 8-F or 9-F Introducer Sheaths.

    Science.gov (United States)

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

    2017-08-01

    To establish the safety and efficacy of the 7-F ExoSeal device for the closure of femoral puncture sites made by 8-F or 9-F introducer sheaths. Between January 2013 and December 2016, 332 patients (mean age 68.4±12.1 years; 195 men) underwent neurointerventional procedures via percutaneous puncture of the common femoral artery and an 8-F (n=272, 81.9%) or 9-F (n=60, 18.1%) introducer. The access sites were sealed with a 7-F ExoSeal in all cases. Procedure success and closure-related complication rates were evaluated, and risk factors for complications were analyzed by comparing patient characteristics between those who did and did not experience complications. Procedure success rates were 99.3% in the 8-F group and 100% in the 9-F group. The overall complication rate was 6.3% (n=17; all in the 8-F group), of which 13 (4.8%) were minor sequelae, including access-site hematoma (n=8), oozing (n=3), pseudoaneurysm (n=1), and retroperitoneal bleeding (n=1). Among the 4 (1.5%) major complications were 3 instances of bleeding requiring a blood transfusion and 1 surgical vascular repair. No complications were observed in the 9-F group. Patients who experienced complications had significantly longer activated clotting times (262±46 vs 218±55 seconds; pF ExoSeal vascular closure device is safe and effective for the closure of femoral puncture sites made by 8-F or 9-F introducer sheaths.

  10. Effects caused by the spinal administration of ketamine S (+) 5% with no preservatives, using a single puncture, and located on the spinal cord and meninges in rabbits

    OpenAIRE

    2014-01-01

    PURPOSE:To evaluate the effect of ketamine S (+) 5% with no preservatives and administered as a subarachnoid single puncture on the spinal cord and meninges of rabbits.METHODS:Twenty young adult female rabbits, each weighing 3500-5000 g and having a spine length between 34 and 38 cm, were divided by lot into two groups (G): 0.9% saline in G1 and ketamine S (+) 5% in G2, by volume of 5 μg per cm column (0.18 mL). After intravenous anaesthesia with ketamine and xylazine, the subarachnoid s...

  11. 自制“防刺头皮针”及其临床评价%Self-made " puncture-proof scalp needle" and its clinical evaluation

    Institute of Scientific and Technical Information of China (English)

    胡荣; 梁观桃

    2013-01-01

    目的 通过改良普通头皮针,减少医务人员针刺伤的发生率.方法 在现有头皮针的基础上制作一头皮针防刺套,减低针体与针柄交接处与皮肤的高度,将头皮针制成z型头皮针,用于操作前后的保护.通过对100名一线临床护士的问卷调查,对自制“防刺头皮针”进行评价.结果 临床护士对自制“防刺头皮针”的各项指标满意度(满意及很满意)分另为:技术水平83%,精巧水平76%,操作顺应性77%,保障病人输液时头皮针固定在皮肤上的安全性53%,封装于包装袋中的安全性86%,防刺实用价值86%,经济效益67%,社会效益78%,推广价值73%.结论 临床护士对自制的“防刺头皮针”满意度高,有临床应用前景.%Objective To reduce the incidence of pricking wound by reforming ordinary scalp needle.Methods A scalp needle protection cap with z-type on the existing scalp was made to reduce the needle body and needle handle junction with the height of the skin.A survey about the evaluation on the new puncture-proof scalp needle was carried out on 100 clinical nurses.Results The clinical nurses ‘satisfaction on puncture-proof scalp needle was as follow:technical level was 83%,sophisticated level was 76%,operation compliance was 77%,the protection of patients when the infusion needle fixed scalp the security of the skin 53% ; the security in packaged bag was 86% ; puncture-proof practical value was 86% ; economic benefits was 67% ; social benefits was 78% ; promotion value was 73%.Conclusions The clinical nurses were satisfied with the new puncture-proof scalp needle which would have good future in clinical application.

  12. One Hundred and Eighty-nine Cases of Acute Articular Soft Tissue Injury Treated by Blood-letting Puncture with Plum-blossom Needle and Cupping

    Institute of Scientific and Technical Information of China (English)

    Dai Erqing; Li Haiying; Zhao Zhankao

    2005-01-01

    @@ Acute articular soft tissue injury, a frequently encountered disease, is often clinically treated with analgesics, Chinese drugs for relaxing muscles and tendons to promote blood circulation, physiotherapy and acupuncture. These therapies can achieve certain curative effects, however, there is a longer course of treatment and some cases even have sequela particularly in such weight-carrying joints as the ankle joint and the knee joint. The therapeutic method of blood letting puncture with plum-blossom needle and cupping is adopted to treat this disease with satisfactory therapeutic effect. The results are reported as follows.

  13. 改良新生儿股静脉穿刺采血方法的应用分析%Analysis on the application of the method of improving the blood sampling of femoral vein puncture in newborn infants

    Institute of Scientific and Technical Information of China (English)

    彭惠兰

    2016-01-01

    目的:探讨新生儿股静脉穿刺采血方法的改良。方法:选取股静脉穿刺采血的新生儿100例,按照随机数字表法将新生儿平均分为观察组和对照组各50例,观察组进行常规股静脉穿刺采血,对照组进行改良股静脉穿刺采血。结果:观察组一次性穿刺成功新生儿42例,成功率84%,对照组一次性穿刺成功新生儿48例,成功率96%,两组新生儿一次性穿刺成功率比较差异具有统计学意义(P<0.05)。结论:经过改良的新生儿股静脉穿刺采血方法能够提高一次性股静脉穿刺采血的成功率,并有效降低了淤血、小血肿等并发症发生率,值得临床推广和应用。%Objective:To explore the improvement of blood sampling method of femoral vein puncture in newborn infants. Methods:100 cases of neonatal femoral vein puncture, according to the number of random said the average newborn divided into observation group and control group with 50 cases in each. Observation group were given routine femoral venous puncture. Control group improved femoral venous puncture. Results:In the observation group the one-time successful puncture neonatal 42 cases, successful rate was 84%, control group disposable puncture success neonatal 48 cases, and the success rate was 96%, two groups of neonatal disposable puncture success rate difference was statistically significant (P<0.05). Conclusion: Through the improvement of neonatal femoral venous puncture method can greatly improve the disposable femoral vein puncture success rate, and effectively reduce the congestion, small hematoma and other complications, worthy of clinical popularization and application.

  14. Research progress of nursing interventions of lumbar puncture in children%儿童腰椎穿刺护理干预的研究进展

    Institute of Scientific and Technical Information of China (English)

    谢安慰; 阐玉英; 钮美娥; 陈奕; 汪茜雅

    2016-01-01

    本文回顾了有关儿童腰椎穿刺护理干预的方法及内容,从支持性心理治疗、认知行为干预、音乐疗法干预、综合护理干预4个方面阐述了具体的干预策略,并对干预效果的评价进行了总结,进一步提出目前国内外研究的不足之处,指出患儿腰椎穿刺过程中的需求未被关注,为今后更加切实深入的干预指明了方向.%This review has summarized the methods and contents of nursing interventions of lumbar puncture in children.The specific intervention strategies have been expounded from four aspects,including supportive psychotherapy,cognitive behavior intervention,music therapy intervention and comprehensive nursing intervention.The evaluations of intervention effects have been summarized and put forward the research shortcomings in current domestic and international research.We should pay attention to the need of children undergoing lunber puncture.This review has pointed out the direction of further research in the future.

  15. 小儿防逆流静脉留置针的穿刺技巧%Puncture Technique of Anti Reflux Venous Indwelling Needle in Children

    Institute of Scientific and Technical Information of China (English)

    李秀慧; 齐术凤; 林晓燕

    2014-01-01

    目的:探讨提高小儿静脉留置针穿刺成功率的方法。方法分析影响小儿静脉留置针穿刺成功的各种影响因素,以及注意事项。结果减少了护士工作量,避免了传统反复封管将接头的微粒带入空管而引起热源反应。结论通过小儿静脉留置针的技巧减轻了患儿每天穿刺的痛苦及恐惧,提高护理质量及患儿家长满意度,值得推广。%Objective To investigate the method to improve the success rate of venous indwel ing needle puncture. Methods To analyze the factors influencing the venous indwel ing needle in children, and mat ers needing at ention. Results Reduced the workload of nurses, to avoid the traditional repeated sealing tube joint particles into ATM caused by heat reaction. Conclusion Through intravenous indwel ing needle in children's skil s to al eviate the pain and fear of children every puncture, improve the quality of nursing and patients satisfaction of parents. Worthy of promotion.

  16. Delayed Treatment with Sodium Hydrosulfide Improves Regional Blood Flow and Alleviates Cecal Ligation and Puncture (CLP)-Induced Septic Shock.

    Science.gov (United States)

    Ahmad, Akbar; Druzhyna, Nadiya; Szabo, Csaba

    2016-08-01

    Cecal ligation and puncture (CLP)-induced sepsis is a serious medical condition, caused by a severe systemic infection resulting in a systemic inflammatory response. Recent studies have suggested the therapeutic potential of donors of hydrogen sulfide (H2S), a novel endogenous gasotransmitter and biological mediator in various diseases. The aim of the present study was to assess the effect of H2S supplementation in sepsis, with special reference to its effect on the modulation of regional blood flow. We infused sodium hydrosulfide (NaHS), a compound that produces H2S in aqueous solution (1, 3, or 10 mg/kg/h, for 1 h at each dose level) in control rats or rats 24 h after CLP, and measured blood flow using fluorescent microspheres. In normal control animals, NaHS induced a characteristic redistribution of blood flow, and reduced cardiac, hepatic, and renal blood flow in a dose-dependent fashion. In contrast, in rats subjected to CLP, cardiac, hepatic, and renal blood flow was significantly reduced; infusion of NaHS (1 mg/kg/h and 3 mg/kg/h) significantly increased organ blood flow. In other words, the effect of H2S on regional blood flow is dependent on the status of the animals (i.e., a decrease in blood flow in normal controls, but an increase in blood flow in CLP). We have also evaluated the effect of delayed treatment with NaHS on organ dysfunction and the inflammatory response by treating the animals with NaHS (3 mg/kg) intraperitoneally (i.p.) at 24 h after the start of the CLP procedure; plasma levels of various cytokines and tissue indicators of inflammatory cell infiltration and oxidative stress were measured 6 h later. After 24 h of CLP, glomerular function was significantly impaired, as evidenced by markedly increased (over 4-fold over baseline) blood urea nitrogen and creatinine levels; this increase was also significantly reduced by treatment with NaHS. NaHS also attenuated the CLP-induced increases in malondialdehyde levels (an index of

  17. 静脉穿刺失败原因及持续改进后效果分析%Analyzing the Effect of Venous Puncture Causes of Failure and Continuous Improvement

    Institute of Scientific and Technical Information of China (English)

    高灼; 黄天利

    2013-01-01

    Objective Investigate the causes and Effects of continuous improvement of the vein puncture. failure. Method Respectively randomly extract 3450 patients of venous puncture of rehabilitation department from October to December in 2012. Investigate failure rates of venous puncture of October to December,and analyze the the continuously improved Effects. Results The success rates of puncture in October,November and December are 95.37%,96.15% and 98.72%,respectively. Conclusion Through the comparison of each month puncture, continuously discovering problems,resolving them,and improving nursing strategies, the success rates of puncture have been obviously improved.%目的:探讨静脉穿刺失败原因及持续改进后效果分析。方法分别随机抽取2012年10、11、12月在康复科静脉穿刺的患者3450例(男性1871例,女性1579例,年龄21~78岁)。对10、11、12月份静脉穿刺失败率调查分析,并进行持续改进后效果分析,并给出相应的护理应对措施。结果10、11、12月穿刺成功率分别为95.37%、96.15%、98.72%。结论通过每个月份的穿刺比较,持续不断的发现问题,解决问题,改进护理对策,穿刺成功率有明显的提高。

  18. 老年人体检浅静脉穿刺过程中常见的问题及应对措施%Common Problems and Countermeasures during Elderly Medical Superficial Vein Puncture Process

    Institute of Scientific and Technical Information of China (English)

    周娟

    2013-01-01

    The vein puncture is the basic operation technology of clinical nurses is necessary, how to make quick, painless, is one of the basic nursing operation in our clinical nurses to master, the most commonly used clinical venous puncture technique applied in superficial vein puncture in elderly people, there is a lack of success rate. Therefore, according to the dif erent situation, blood vessels, the needle point to also be because, depending on the condition of the body. Vein puncture in elderly patients has its particularity. The disposable puncture success is not only the patient to nurse the hope, every one is the nurse lifelong goal. Improve the puncture success rate, reduce the pain of the patients, increase, trust and satisfaction of patients.%静脉穿刺是临床护士必备的基本操作技术,如何做到快、准、无痛,是我们临床护士必须熟练掌握的一项基础护理操作,临床上最常用的静脉穿刺技术应用于老年人浅静脉穿刺,存在一针成功率不足的问题。因此,针对不同血管状况、不同部位血管,而采取的进针角度亦应因人、因机体状况而定。老年患者静脉穿刺有其特殊性。一次性穿刺成功不仅是患者对护士的期望,也是每一位护士终生追求的目标。提高穿刺成功率,减轻了患者痛苦,,增加了患者信任与满意。

  19. Successful treatment of direct carotid-cavernous fistula in a patient with Ehlers-Danlos syndrome type IV without arterial puncture: the transvenous triple-overlay embolization (TAILOREd) technique.

    Science.gov (United States)

    Huynh, Thien J; Morton, Ryan P; Levitt, Michael R; Ghodke, Basavaraj V; Wink, Onno; Hallam, Danial K

    2017-08-18

    We report successful transvenous treatment of direct carotid-cavernous fistula in a patient with Ehlers-Danlos syndrome type IV using a novel triple-overlay embolization (TAILOREd) technique without the need for arterial puncture, which is known to be highly risky in this patient group. The TAILOREd technique allowed for successful treatment using preoperative MR angiography as a three-dimensional overlay roadmap combined with cone beam CT and live fluoroscopy, precluding the need for an arterial puncture. 2017 BMJ Publishing Group Ltd.

  20. 2种途径深静脉穿刺中心静脉置管的Meta分析%Meta analysis of two approaches for central venous catheterization through deep vein puncture

    Institute of Scientific and Technical Information of China (English)

    张莉芳; 赵小平; 蔡益民; 贺丽春

    2008-01-01

    Objective The incidence rate of complication during central venous catheterization through internal jugular vein (IJV) and subclavian vein (SV) puncture. Methods Clinical controlled trials about IJV and SV puncture were collected and related literatures were screened according to the criteria of inclusion. The literatures underwent Meta analysis and subsequent analysis of sensitivity. Results A total of 18 literatures were included. Meta analysis indicated that statistical difference existed in the related infection rate [RR=1.74, 95%CI (1.32, 2.30)] and arterial puncture [RR=3.19, 95%CI (1.70, 5.99)], but not in the one-time-puncture success rate [RR=1.06, 95%CI (0.90, 1.24)] between IJV and SV puncture. Conclusions The rate of related infection and arterial puncture was higher by IJV than by SV puncture. But we could not confirm if any difference existed in the one-time-puncture success rate between the two methods. The results still needs evaluation by high-quality randomly controlled experiments.%目的 比较颈内静脉(IJV)与锁骨下静脉(SV)穿刺中心静脉置管部分并发症发生率.方法 收集有关IJV与SV穿刺中心静脉置管的临床对照研究,根据纳入标准纳入文献.对纳入文献进行Meta分析并对结果行敏感性分析.结果 纳入18篇文献. Meta分析结果提示IJV与SV穿刺中心静脉置管导管相关性感染率差异有统计学意义[RR=1.74,95%CI(1.32,2.30)],误入动脉率差异有统计学意义[RR=3.19,95%CI(1.70,5.99)],一次穿刺成功率差异无统计学意义[RR=1.06,95%CI(0.90,1.24)].结论 IJV穿刺中心静脉置管导管相关性感染率及误入动脉率高于SV穿刺;尚不能认为2组一次穿刺成功率有差别;本结果仍需要高质量的随机对照试验来评价.

  1. Suprapapillary needle puncture for common bile duct access: laboratory profile Punção suprapapilar por agulha para acesso ao ducto biliar comum: perfil laboratorial

    Directory of Open Access Journals (Sweden)

    Everson L. A. Artifon

    2006-12-01

    Full Text Available BACKGROUD: Biliary cannulation to perform endoscopic retrograde cholangiopancreatography may be difficult due to technical reasons and often is necessary to perform papillotomy, where complications as pancreatitis and perforation may occur AIM: To show minimal complications by a new model of biliary access by means of the suprapapillary needle puncture and its laboratory profile. PATIENTS AND METHODS: After the approval of the protocol by the Scientific Ethics Committee of the institution a free and informed consent was signed by all patients participating in the study. From July 2003 to August 2004, fulfilling the inclusion and exclusion criteria, 30 patients were selected for endoscopic retrograde cholangiopancreatography, using the suprapapillary puncture technique. All patients remained hospitalized, fasting and with basal hydroelectrolytic replacement, were clinically followed up and samples for the determination of serum amylase, lipase and C-RP (C-reactive protein were collected before and 4 h, 12 h and 24 h after the procedure and reevaluated 60 days after the procedure. Laboratory parameters were submitted to statistical study using analysis of variance for repeated measurements. Multiple comparisons were made based on Wald's statistics RESULTS: The technique was successful in 93.4% (28/30 of the patients. No statistically significant difference regarding to the laboratory profile were observed. Complications related to the technique of papillary puncture occurred in 1/28 patients by not using the guide wire and in 1/28 where mild hemorrhage after dilation of the papillary fistula occurred. Regarding complications related to therapeutic procedures, there were 2/28 retroduodenal perforations, with one (1/30 following unsuccessful puncture and another due to the passage of Dormia's basket through the dilated fistula path. All patients submitted to diagnostic puncture and evaluated 60 days after the procedure presented with the major

  2. The Combined Application of Double-guiding Method and Seldinger Puncture on PCN%双导引与Seldinger技术在PCN中的联合应用

    Institute of Scientific and Technical Information of China (English)

    尹君

    2013-01-01

    目的:回顾性研究超声联合DSA双导引与Seldinger 穿刺法在经皮肾造瘘术(PCN)中的应用,分析其技术成功率与并发症的发生率。方法247例接受 PCN的泌尿系梗阻患者,其中急性梗阻48例,慢性梗阻199例,两组均先在超声导引下采取Seldinger技术穿刺积水肾盂,成功后移至 DSA下操作。结果两组均无严重并发症发生,无操作相关死亡病例;普通并发症两组间仅出血发生率有显著性差异(P=0.019)。结论超声联合DSA双导引与Seldinger 穿刺法应用于PCN中,操作简单,成功率高,并发症少且无严重并发症,值得在临床工作中推广应用。%ObjectiveTo study the combined application of the Seldinger puncture under the ultrasound and DSA on percutaneous nephrostomy (PCN) technique, and to analysis the success rate and the incidence of complications. Materials and Methods Of 247 patients with urinary tract obstruction, 48 cases of acute and 199 chronic obstruction were al underwent PCN by Seldinger puncture under ultrasound and DSA. Results In both groups no serious complications occurred, and no dead cases did;in common complications , only incidence of hematuria between the two groups have significant dif erence (P=0.019). Conclusion PCN by Seldinger puncture under ultrasound and DSA, has the features of the simple operation,high success rate,less complications and no serious complications, worthy of popularization in clinical practice.

  3. Risk factors for traumatic lumbar punctures in children with acute lymphoblastic leukaemia%急性淋巴细胞白血病患儿创伤性腰椎穿刺的危险因素

    Institute of Scientific and Technical Information of China (English)

    娄珊; 刘玉; 王雪梅; 严媚; 李兆申

    2016-01-01

    Objective To investigate the risk factors for traumatic lumbar punctures in children with acute lymphoblastic leukaemia. Methods 132 children with acute lymphoblastic leukemia totally received 2634 lumbar punctures. The basic data on age, sex, body mass index (BMI), platelet count, interval between two punctures, and presence or absence of ultrasound-guided procedure were collected and analyzed. The risk factors for traumatic lumbar puncture were identified by logistic regression. Results The risk for traumatic lumbar puncture was higher in children younger than 1 year, and it was relatively lower in those aged 1 to 10 years. The risk for traumatic lumbar puncture was slightly higher in children with a BMI index of more than 95. The longer the interval between two punctures, the lower the risk. If lumbar puncture was guided under ultrasound or radiographic images, the risk was much smaller. Conclusions Age of younger than 1 year, BMI index of more than 95, shorter interval between two punctures, and direct puncture can increase the risk for traumatic lumbar puncture.%目的:探讨影响急性淋巴细胞白血病( ALL )患儿做腰椎穿刺时造成创伤性腰椎穿刺的危险因素。方法:132例ALL患儿在诊断及治疗过程中共经历了2634次腰椎穿刺,统计患儿年龄、性别、体质指数(BMI)、血小板数目、距离前一次穿刺的天数以及是否在超声或放射图像引导下进行穿刺,分析其与创伤性腰椎穿刺的关系,并利用Logistic回归模型分析判定危险因素。结果:年龄<1岁的患儿做腰椎穿刺时创伤性腰椎穿刺的风险更高;1~10岁的患儿做腰椎穿刺时创伤性腰椎穿刺的风险相对较低。 BMI >95较BMI <95风险稍高。2次穿刺的间隔时间越长,风险越低。在超声或放射图像引导进行的腰椎穿刺,比直接穿刺造成创伤性腰椎穿刺的风险低。结论:年龄<1岁、BMI >95、2次穿刺的间隔时间短和直

  4. 低出生体质量儿经外周静脉置入中心静脉导管不同穿刺部位留置导管并发症的护理%Related factors analysis on complications caused by peripherally inserted central catheter puncture on low birth weight infant with different puncture sites

    Institute of Scientific and Technical Information of China (English)

    姜红; 贺琳晰; 范玲

    2015-01-01

    目的 对低出生体质量儿经外周静脉置入中心静脉导管(PICC)不同穿刺部位留置导管主要并发症的相关因素进行分析,以降低并发症发生,达到安全留置目的.方法 收集2008年1月至2013年1月留置PICC的低出生体质量儿431例,其中肘部静脉261例,肘部下行静脉147例,颞浅静脉5例,腋静脉12例,股静脉6例.对不同穿刺部位留置导管过程中的并发症进行分析,并采取相应的治疗或预防护理干预措施.结果 431例PICC均穿刺成功.穿刺部位主要在上臂静脉,并发症主要以静脉炎、肢端肿胀、堵管、感染为主.肘部下行静脉留置导管静脉炎、肿胀发生率高于肘部静脉[10.89%(16/147)比3.83%(10/261)、17.69%(26/147)比4.98%(13/261)],差异有统计学意义,x2=7.840、17.561,P<0.05.结论 PICC穿刺部位主要选择肘部和肘部下行静脉.对不同穿刺部位可能发生的并发症要及时评估并采取有效措施.良好的导管维护意识对减少并发症发生有重要意义.%Objective To analyze the correlative factors that affect the main complications caused by peripherally inserted central catheter puncture (PICC) on low birth weight infant with different puncture sites,in order to reduce the incidence of complications and achieve the purpose of indwelling safely.Methods A total of 431 infants with different PICC puncture sites were recruited in this study from January 2008 to January 2013,261 cases of them were punctured in the elbow upper extremity veins, 147 cases were in the elbows downward veins,5 cases were in the superficial temporal veins, 12 cases were in the axillary veins,and 6 cases were in the femoral veins.The complications occurring in the period of indwelling catheter were analyzed, and the effective treatments or preventive nursing measures were taken.Results 431 cases were punctured successfully.The sites of puncture were mainly in the veins of the upper arm,and the main complications were

  5. Establishment of the intervertebral disc degeneration model of rabbits by using homemade puncture needles percutaneous puncturing the anulus fibrosus at surface allocation%经皮穿刺纤维环建立兔腰椎间盘退变模型

    Institute of Scientific and Technical Information of China (English)

    黄杰烽; 郑杨; 夏臣杰; 何川; 赵凯; 杜文喜; 陈俊杰; 童培建

    2016-01-01

    目的:探讨使用自制穿刺针经皮穿刺纤维环制备兔腰椎间盘退变模型的可行性。方法将18只新西兰大白兔分为实验组、假手术组及空白对照组。实验组及假手术组使用自制穿刺针穿刺L3~4、L4~5和L5~6椎间盘位置,实验组穿刺椎间盘深度为5 mm,假手术组钝性穿刺但不损伤椎间盘,空白对照组不作处理。术后3、6、9周每组取2只兔麻醉后行腰椎MRI检查,处死行大体观察并取椎间盘行HE染色及髓核蛋白多糖含量测定。结果术后3周开始实验组MRI信号强度、髓核蛋白多糖含量与其他两组相比明显下降( P<0.05),其后呈逐渐下降趋势,大体观察及HE染色显示实验组髓核及纤维环呈逐渐退变趋势。结论自制穿刺针经皮穿刺纤维环法能成功建立兔腰椎间盘退变模型,具有操作简单、损伤小、动物存活率高等优点。%Objective To establish of rabbit intervertebral disc degeneration models by using homemade puncture needles percutaneous annulus fibrosus puncture and assess the feasibility and controllability. Methods 18 New Zea-land white rabbits were divided into the experimental group, the sham group and the control group. L3~4 , L4~5 and L5~6 discs were punctured by the homemade puncture needles in the experimental group as well as in the sham group. The discs were punctured in the experimental group with a depth of 5mm. The sham group was treated by puncture without damage the discs. 2 rabbits were used to observe the anatomical structures. Two rabbits were anesthetized in 3, 6 and 9 weeks respectively after operation for MRI images. Then the animals were killed, the change of lumbar in-tervertebral discs was observed by MRI, histological and nucleus proteoglycan contents were measured. Results All animals were survived, no death, infection, paralysis and other complications. Signal intensity of the intervention group showed a progressive downtrend at 3 weeks after intervention (P<0

  6. The first regularized trace of integro-differential Sturm-Liouville operator on the segment with punctured points at integral perturbation of transmission conditions

    Science.gov (United States)

    Aimakhanova, Aizat Sh.; Shalginbayeva, Saltanat Kh.; Zhumanova, Lyazzat K.

    2016-08-01

    The paper is devoted to calculation of a first regularized trace of one integro-differential operator with the main part of the Sturm-Liouville type on a segment with punctured points at integral perturbation of "transmission" conditions. The Sturm-Liouville operator -y″(x )+q (x )y (x )+γ ∫0πy (t ) d t =λ y (x ) given on the segments π/n (k -1 )right-hand ends of the segment [0, π]. The functions are continuous on [0, π], the first derivatives of which have jumps at the points x =π/n k are solutions. The value of jumps is expressed by the formula y'(π/k n -0 ) =y'(π/k n +0 ) -βk∫0πy (t )d t , k =1 , n -1 ¯. The basic result of the paper is the exact formula of the first regularized trace of the considered differential operator.

  7. Can a combination of the conformal thin-sandwich and puncture methods yield binary black hole solutions in quasi-equilibrium?

    CERN Document Server

    Hannam, M D; Cook, G B; Baumgarte, T W; Hannam, Mark D.; Evans, Charles R.; Cook, Gregory B.; Baumgarte, Thomas W.

    2003-01-01

    We consider combining two important methods for constructing quasi-equilibrium initial data for binary black holes: the conformal thin-sandwich formalism and the puncture method. The former seeks to enforce stationarity in the conformal three-metric and the latter attempts to avoid internal boundaries, like minimal surfaces or apparent horizons. We show that these two methods make partially conflicting requirements on the boundary conditions that determine the time slices. In particular, it does not seem possible to construct slices that are quasi-stationary and avoid physical singularities and simultaneously are connected by an everywhere positive lapse function, a condition which must obtain if internal boundaries are to be avoided. Some relaxation of these conflicting requirements may yield a soluble system, but some of the advantages that were sought in combining these approaches will be lost.

  8. Balloon-Occluded Antegrade Transvenous Sclerotherapy to Treat Rectal Varices: A Direct Puncture Approach to the Superior Rectal Vein Through the Greater Sciatic Foramen Under CT Fluoroscopy Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Ono, Yasuyuki, E-mail: onoyasy@hirakata.kmu.ac.jp; Kariya, Shuji, E-mail: kariyas@hirakata.kmu.ac.jp; Nakatani, Miyuki, E-mail: nakatanm@hirakata.kmu.ac.jp; Yoshida, Rie, E-mail: yagir@hirakata.kmu.ac.jp; Kono, Yumiko, E-mail: kohnoy@hirakata.kmu.ac.jp; Kan, Naoki, E-mail: kanna@takii.kmu.ac.jp; Ueno, Yutaka, E-mail: uenoyut@hirakata.kmu.ac.jp; Komemushi, Atsushi, E-mail: komemush@takii.kmu.ac.jp; Tanigawa, Noboru, E-mail: tanigano@hirakata.kmu.ac.jp [Kansai Medical University, Department of Radiology (Japan)

    2015-10-15

    Rectal varices occur in 44.5 % of patients with ectopic varices caused by portal hypertension, and 48.6 % of these patients are untreated and followed by observation. However, bleeding occurs in 38 % and shock leading to death in 5 % of such patients. Two patients, an 80-year-old woman undergoing treatment for primary biliary cirrhosis (Child-Pugh class A) and a 63-year-old man with class C hepatic cirrhosis (Child-Pugh class A), in whom balloon-occluded antegrade transvenous sclerotherapy was performed to treat rectal varices are reported. A catheter was inserted by directly puncturing the rectal vein percutaneously through the greater sciatic foramen under computed tomographic fluoroscopy guidance. In both cases, the rectal varices were successfully treated without any significant complications, with no bleeding from rectal varices after embolization.

  9. MRI引导下乳腺穿刺定位术的护理应用%Nursing during MRI-guided Breast Puncture Localization

    Institute of Scientific and Technical Information of China (English)

    盛浏丽; 郭震; 赵玉年; 沈文荣; 张佳; 董珉

    2015-01-01

    Objective To assess the nursing method and experience during MRI -guided breast puncture localization .Methods The datas of 52 non palpable breast lesions which were only visible under MRI but not visualized by mammography or ultrasound were analyzed .All of the breast lesions were BI -RADS 4 to 5. 1.5T MRI, special localization and biopsies puncture frame and localization probe and guide wire were used . According to the MRI results , positioning biopsy was performed in the lateral and medial position or axis line of the breast lesions .The nursing experience and method of pre -operation , intra-operation and post-operation in MRI-guided puncture localization were elaborated .Results The location and surgical excision were succeeded on the 52 patients and the success rate was 100%.The pathologic findings were as followed:8 cases were ductal carcinoma in situ ( DCIS ) , 7 were invasive cancer , 1 was intraductal papillomas , 7 were atypical ductal hyperplasia ( ADH ) , 17 were breast adenosis , and 12 were fibroadenomas .All of the patients were without infection, anesthesia allergic or shock .Conclusions MRI-guided breast localization provides an accurate and safe method for the occult breast lesions and minimally invasive surgery .Also, it made up the deficiency of other imaging methods .Active and effective nursing is the key step to improve the success rate of puncture localization and to reduce the complications during the process .%目的:总结MRI引导下乳腺穿刺定位术的护理方法及体会。方法回顾性分析52例仅MRI上显示的病灶而B超及钼靶难以显示的隐匿病灶。全部病灶BI-RADS分类4或4以上。采用1.5T超导MRI机,乳腺MRI专用定位活检穿刺架及乳腺MRI专用定位针和定位导丝。根据MRI检查发现可疑病灶的部位选择外侧位、内侧位或轴位行定位。论述MRI引导下定位预约、术前、术中及术后的护理方法。结果52例病灶均一次顺利完成定

  10. 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.

  11. 手足背静脉逆行穿刺法在外科日常护理中的应用%Application of Retrograde Puncture of Hand and Foot Dorsal Vein in Surgical Nursing

    Institute of Scientific and Technical Information of China (English)

    桂蕾; 罗艳平

    2016-01-01

    目的::提高外科患者的静脉利用率和静脉穿刺成功率。方法:在手足背浅静脉上采用逆向穿刺法静脉输液。结果:静脉穿刺输液成功率明显提高。结论:患者如重症或手足背浅静脉由于长期输液破坏严重,建议采用逆向穿刺静脉输液。%Objective:To improve the utilization rate of venous puncture and the success rate of vein puncture in surgical patients.Methods:The method of reverse puncture was used in the vein infusion in the superficial vein of the hand and foot.Results:The success rate of intravenous infusion was significantly im-proved.Conclusion:The method of reverse puncture vein infusion is suggested if the sickness is intensive or superficial vein of hand and foot is seriously damaged due to long-term severe transfusion.

  12. Door-to-Needle Time Under 60 Minutes and Picture-to-Puncture Under 90 Minutes: Initiatives and Outcomes in Reducing Time to Recanalization for Cerebral Major Artery Occlusion

    Science.gov (United States)

    OTA, Takahiro; SATO, Masayuki; AMANO, Tatsuo; MATSUMARU, Yuji

    2016-01-01

    The adoption of stent retrievers has significantly improved outcomes of intravenous treatment for acute stroke due to major artery occlusion, and reducing the time to recanalization may achieve further improvements. We reviewed reductions in “door-to-needle time” (DNT) and “picture-to-puncture time” (P2P), as the results of measures to consolidate stroke response capabilities in our hospital, and compared treatment outcomes in acute recanalization patients. We investigated DNT by the route of admission for 96 consecutive patients who received intravenous tissue plasminogen activator between July 2012 and June 2015. We then retrospectively studied 52 patients with acute stroke who underwent endovascular recanalization within 8 h after stroke onset, grouped according to recanalization before (Group I; n = 23) or after (Group II; n = 29) introduction of stent retrievers. Between 2012 and 2015, mean DNT decreased. Significant differences between Groups I and II were only seen in times required, with significantly shorter DNT, picture-to-puncture time, admission to puncture time, and puncture to guiding catheter placement time in Group II. A considerable difference in DNT was seen according to the route of patient admission, and consolidation of hospital stroke response capability successfully reduced the time from admission to recanalization. PMID:27385058

  13. Clinical Nursing of Intracranial Tumor Treated by Sterotaxic Puncture and X-knife%立体定向联合X-刀治疗颅内肿瘤的临床护理

    Institute of Scientific and Technical Information of China (English)

    徐菊英; 陈灵丽

    2002-01-01

    Objective To study nursing of perioperation of treating intracranial tumor by sterotaxic puncture and x-knife. Methods 8 cases with intracranial tumor received operation of psychological nursing routine, observations ofpreoperative and operative posture and treatment of inadaptions. Results The operations involved succeeded withoul nursingcomplications. Conclusions Nursing in the periopeerative stage contribute to treatment of intracranial tumor.

  14. 人体手背掌指关节处静脉逆向穿刺技术的Meta分析%Meta-analysis of intravenous infusion by reverse puncture on dorsal surface of metacarpophalangeal joints

    Institute of Scientific and Technical Information of China (English)

    陈延亭; 郝玉芳; 岳树锦; 周芬; 刘春蕾

    2012-01-01

    Objective To compare the success rate of puncture and stability of the needles by reverse venous puncture versus normal puncture on dorsal surfaces of metacarpophalangeal (MCP) joints for intravenous infusion, and to assess the feasibility of intravenous infusion by reverse puncture. Methods We retrieved all literatures on controlled clinical trials of retrograde venous infusion by reverse puncture from Medline, the Cochrane Library, the China National Knowledge Infrastructure Database, the Chongqing VIP Chinese Science and Wanfang Data. The data were analyzed by using RevMan 5. 1 software. Results A total of 14 randomized controlled trials (RCTs) and controlled clinical trials (CCTs) were retrieved. Compared with the normal puncture, the success rate of reverse puncture is much higher, with statistical significance between the two puncture methods (OR = 4. 46,95%CI:2. 71 - 7. 32, P<0. 01); the liquid leakage rate is lower, with statistical significance between the groups (OR = 0. 26,95%CI:0. 19 - 0. 34,P< 0. 01). Conclusion Reverse puncture has higher success rate, lower liquid leakage rate, which puts reverse puncture into a favorable situation for clinical utilization.%目的 比较逆向穿刺与顺向穿刺的一次穿刺成功率和稳定性,评价掌指关节处静脉输液逆向穿刺的可行性.方法 检索MEDLINE、COCHRANE图书馆数据库、中国期刊全文数据库(CNKI)、重庆维普资讯中文科技期刊数据库(VIP)以及万方数据库,纳入所有关于人体手背掌指关节处逆向穿刺的临床试验,采用RevMan5.1软件分析数据.结果 共纳入14篇文献,与相同部位的顺向穿刺比较,逆向穿刺的成功率高于顺向穿刺(OR=4.46,95%CI:2.71~7.32,P<0.01);逆向穿刺药液渗漏发生率低于顺向穿刺(OR=0.26,95 %CI:0.19~0.34,P<0.01).结论 掌指关节处静脉逆向穿刺在穿刺成功率和稳定性上优于相同部位的顺向穿刺,可作为需要长期静脉输液治疗患者的辅助方法.

  15. 超声引导在小儿外周静脉穿刺困难者中的应用研究%Application of Ultrasound Guidance in Children with Difficulties in Peripheral Venous Puncture

    Institute of Scientific and Technical Information of China (English)

    陈琼; 郑铠军; 朱惠欢; 李亚洁; 卢贤秀; 黎艳超; 钟林堃

    2016-01-01

    目的:探讨超声引导在小儿外周静脉穿刺困难者中应用的效果。方法选择3个月至3岁血管条件差的患儿100例,随机分为试验组、对照组各50例。对照组给予传统盲穿法进行外周静脉穿刺,试验组在超声引导下进行外周静脉穿刺。记录两组穿刺针数、一次穿刺成功率、总成功率和并发症发生率。结果试验组和对照组穿刺针数分别为(1.2±0.4)次和(3.02±2.34)次(P<0.05);一次穿刺成功率分别为90%和34%,差异有统计学意义(P<0.05);总成功率分别为100%和95%,差异有统计学意义(P<0.05);置针后24h内静脉渗漏发生率分别为0和10%,差异有统计学意义(P<0.05)。结论超声引导在小儿外周静脉穿刺困难者中应用,可以显著提高一次穿刺成功率和总穿刺成功率,明显减少穿刺次数,降低并发症的发生。%Objective To investigate the effect of ultrasound guided in children with difficulties in peripheral venous punc-ture. Methods In 3 months to 3 years old children with poor vascular conditions,100 cases were randomly divided into two groups:experimental group,control group of 50 cases each. The control group was given the traditional blind puncture method,and the experi-mental group was given the peripheral vein puncture under the guidance of ultrasound. The number of puncture needles,the success rate,the total success rate and the complication rate of the two groups were recorded. Results The number of puncture needles in the experimental group and the control group were respectively(1. 2 ±0. 4)times and(3. 02 ± 2. 34)times(P<0. 05). A successful rate of puncture were respectively 90% and 34%(P<0. 05). The total success rate were respectively 100% and 95%(P<0. 05). And the incidence of venous leakage after 24h were respectively 0 and 10%(P<0. 05). Conclusion The application of ultrasound guid-ance in children with difficulties in peripheral venous puncture could

  16. 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

  17. Safe and easy method with little modification in technique is useful for successful internal jugular vein cannulation on the same side even after intra-arterial puncture without using ultrasound guidance in adult cardiac patients

    Directory of Open Access Journals (Sweden)

    Rajesh Thosani

    2016-01-01

    Full Text Available Background: The modification in technique is useful for successful right-sided internal jugular vein (IJV cannulation on the same side even after intra-arterial puncture without using ultrasound guidance in adult patients. Materials and Methods: This study was carried out in total 160 adult patient from American Society of Anesthesiologists Grade II to III patients male (n = 95 and female (n = 65 who underwent cardiac surgery where cannulation was done on right sided by triple lumen catheter (7 French using Seldinger technique. Results: Majority of patients were cannulated successfully by Seldinger technique with single or double attempt except for five patients in which arterial puncture occurred. All five patients were cannulated successfully on the same side with this modified technique without any significant major complications. They were managed by application of blocker at the end of arterial needle puncture without removing it. In our routine practice, we were used to removing this needle and applying compression for few minutes to prevent hematoma formation after an arterial puncture. In this study, cannula was used as a marker or guideline for the relocation of IJV on the same side and recannulation was performed by changing the direction of needle on same side lateral to the previous one and without going towards the same direction to prevent the arterial puncture again. Conclusion: Most simple and useful modified technique for institutes where the complications are most common with trainee doctors and in hospitals where there is no advanced facility like ultrasound-guided cannulation available. By this modification, it will be time saving, very comfortable, and user-friendly technique with high success rate.

  18. 3D打印引导下外伤性脑内血肿微创穿刺引流术%A pilot study of three-dimensional printing on minimally invasive puncture drainage of traumatic intracerebral hematoma

    Institute of Scientific and Technical Information of China (English)

    相建; 李珍珠; 李泽福

    2016-01-01

    Objective Through 3D printing prints out the facial features in patients with puncture channel model, which used for preoperative localization, intraoperative guided puncture direction to simplify the procedure and improve the traumatic intracranial hematoma puncture accuracy. Methods With a 25-year-old man traumatic brain hematoma craniocerebral CT two-dimensional image for the raw data,we use Mimics 16.0 software processing to form a 3D image reconstruction, to design the puncture channel and measure the puncture depth, then use 3D printer to print out the model with extracranial needle channel. We use the model to locate the area before the operation,to guide puncture direction and control puncture depth when doing operation. Review of the craniocerebral CT after the operation to observe the position of the drainage tube end. Results Using the computer software design with a needle hole “mask” can rotate in 3D space, observed from various angles, to avoid the important blood vessel and functional areas, and achieving puncture. Conclusion Successfully build three-dimensional images conforming to the individual patient characteristics, and then print out the model used in surgery by 3D printer.In this way,puncture accuracy can be improved, and the operation difficulty can be reduced.%目的:通过3D打印技术打印出符合患者面部特征并带有穿刺通道的模型,用于术前定位、术中引导穿刺方向,简化手术过程,提高外伤性颅内血肿穿刺准确性。方法以1例25岁男性的外伤性脑内血肿颅脑CT二维图像为原始数据,利用Mimics 16.0软件处理,重建形成三维图像,设计穿刺通道,测量穿刺深度,通过3D打印机打印出带有穿刺针颅外段孔道的模型,术前置于术区定位,术中通过穿刺孔道置入引流管,控制穿刺深度,术后复查颅脑CT观察引流管末端位置。结果在利用计算机软件设计带有穿刺针孔道的“面具”时可在三

  19. Comparison of ultrasound-guided peripherally inserted central catheter and ordinary puncture%B超引导下 PICC置管与常规肉眼穿刺的比较与分析

    Institute of Scientific and Technical Information of China (English)

    卫尹; 王蔚; 乐音; 施美丽; 龚怡

    2010-01-01

    Objective To compare the effect of ultrasound-guided peripherally inserted central catheter and ordinary puncture,and to explore an option of low risk,less pain for patients and higher nursing quality.Methods 167 patients who had undergone chemotherapy by PICC before or after breast cancer surgery in our hospital from Oct.2008 to Sep.2009 were retrospectively selected and divided into two groups:experimental group (ultrasound-guided PICC group,58 cases) and control group (routine puncture group,109 cases).Complications of the puncture site,armpit reversal,times of puncture,incidence of venous thrombosis,operation time of puncture and dressing change were compared between the two groups.Results Significant differences were found of complications of the puncture site,times of puncture,operation time of puncture and dressing change (P<0.01),as well as incidence of infection (P<0.05).There was no significant difference of armpit reversal between the two groups (P > 0.05).Neither mechanical phlebitis nor venous thrombosis was reported.Conclusions Ultrasound-guided PICC is superior to routine puncture.%目的 比较并分析B超引导下PICC置管与常规肉眼穿刺的效果,以选择更低风险的穿刺方法,减轻患者痛苦,提高护理质量.方法 采用回顾性调查进行资料收集,选取我科2008年10月至2009年9月乳腺癌术前及术后置PICC管进行化疗患者167例,按穿刺方法不同分为B超引导下置管组为实验组共58例,常规肉眼穿刺组为对照组共109例,观察并比较两组穿刺后并发症、腋下回折、穿刺次数、深静脉栓塞、穿刺操作用时、换药护理用时.结果 两组患者穿刺部位并发症、穿刺次数、穿刺操作用时、换药护理用时比较均有统计学意义(P<0.01),穿刺后感染的发生率比较有统计学意义(P<0.05),腋下回折比较无统计学意义(P>0.05),两组均无机械性静脉炎和深静脉栓塞发生.结论 应用B超引导进行PICC置管优于常规肉眼穿刺.

  20. 经皮椎弓根穿刺辅助装置开发和应用的可行性%Feasibility of the development and application of auxiliary device for percutaneous vertebral pedicle puncture

    Institute of Scientific and Technical Information of China (English)

    翟浩瀚; 陈艺; 龙浩; 陈玉书; 潘建超; 白波

    2014-01-01

    目的::研制开发经皮椎弓根穿刺辅助定位装置,用带软组织的脊柱标本验证该装置的可行性和实用性。方法:对新鲜保留软组织的脊柱标本行CT扫描,在CT片上的画出理想穿刺线和过棘突的矢状线(棘突线),在距离棘突实际距离为5、10 cm处建立两个冠状位虚拟平面。以棘突线与两平面的交点为原点,过原点的冠状线和垂直线为X轴和Y轴,建立2个平面坐标系,确定穿刺线与这两个平面交点的方位。利用研制的辅助装置,构建体外坐标系,确立穿刺线与平面坐标系交点在辅助装置中的方位,利用这确定的在两个平面坐标系上的交点便可引导穿刺进行。被穿刺椎弓根随机分为2组:一侧采用自行研制的经皮椎弓穿刺辅助装置组(辅助装置组),对侧为“徒手”穿刺组(徒手组)。两组均在C型臂影像增强系统辅助下进行穿刺,置入克氏针,C型臂X线机证实穿刺成功。比较两组的穿刺耗时和X线曝光次数。结果:定位器组和徒手组的穿刺平均耗时分别为(15.36±4.21)min和(27.21±3.89)min,两组比较,差异有统计学意义( P<0.05);定位器组和徒手组接受X线辅助次数分别为7次/椎体和16次/椎体,两组比较,差异有统计学意义( P<0.05)。结论:应用自行研制的经皮椎弓根穿刺辅助装置可有效减少手术耗时和C臂X线透视次数。%Objective:To develop an auxiliary positioning device for percutaneous vertebral pedicle puncture and to verify the feasibility and practicality of the device by using spine specimens with soft tissues. Methods:Fresh spine specimens with soft tissues were scanned by CT. Ideal puncture line and sagittal line through the spinous process (spinous process line) were drawn on CT images.Two coronal virtual planes,at an actual distance of 5 and 10 cm,respectively,to the spinous process,were established.The intersection of the spinous process line and the two planes was

  1. Analysis of the Effect of Nursing Care of Pediatric Patients During Intravenous Puncture%儿科患者静脉穿刺过程中实施细节护理的疗效分析

    Institute of Scientific and Technical Information of China (English)

    董晓红; 秦凤华; 王雅丽

    2016-01-01

    目的:探讨儿科患儿静脉穿刺过程实施细节护理应用效果。方法对照组给予常规静脉穿刺护理措施,研究组在常规静脉穿刺护理基础上加用细节护理。记录两组患儿一次静脉穿刺成功率、患儿家属对本次护理工作满意度。结果研究组一次穿刺成功率高达93.33%(42例),对照组一次穿刺成功率仅为80.00%(36例)(P<0.05);研究组护理满意度高于对照组(P<0.05)。结论对儿科患儿静脉穿刺过程实施细节护理可提高穿刺成功率,有利于维持良好的护患关系。%ObjectiveTo investigate the effect of the application of detailed nursing in pediatric patients with venous puncture.MethodsThe control group was given routine vein puncture nursing measures,the research group was added with detail nursing based on the routine vein puncture. Record the success rate of the two groups of children with a vein puncture,the families of the children of the nursing job satisfaction. Results One time success rate of the study group was 93.33%(42 cases),and the success rate of the control group was only 80.00%(36 cases)(P<0.05). The research group nursing satisfaction was higher than the control group(P<0.05).Conclusion Nursing care can improve the success rate of puncture in pediatric patients with intravenous puncture process,which is beneficial to maintain a good relationship between nurses and patients.

  2. 干预护理预防管路穿刺点感染的效果评价%Effect of the intervention of nursing to prevent pipeline puncture point infection

    Institute of Scientific and Technical Information of China (English)

    张鸿雁; 尚楠; 王仙珍; 毕雪莲

    2015-01-01

    目的:评价预防管路穿刺点感染的干预护理的效果。方法:将收治并做过穿刺处置的患者112例随机分为两组,干预组58例,在基础护理上应用干预措施,包括日常生活自我维护,如扇风、不喝太热的水、穿宽松的衣服等;临床特殊干预,如穿刺点稍红,应用痊愈妥,银离子等新型敷料。对照组54例,采用常规护理,如穿刺点红,给予庆大霉素外敷,纱布固定。结果:干预组的穿刺点感染发生率低于对照组,差异有统计学意义(P 〈0.05)。结论:干预护理预防管路穿刺点感染取得较好的临床效果。%Objective To evaluate the effect of the intervention of nursing to prevent pipeline puncture point infection. Method 112 pa-tients who done puncture treatment were randomly divided into 2 groups,intervention group of 58 people,on the basis of nursing interventions on the application,including the daily life of self maintenance,such as fan,didn't drink the water was too hot,wore loose clothes,etc;Clinical special intervention,such as the puncture point slightly red,applied to heal,silver ions such as new type of dressing. Control group of 54 peo-ple,using the routine care,such as the puncture point red,gave gentamicin topical,gauze fixed. Results The puncture point infection incidence of intervention group was lower than the control group,the difference was statistically significant(P 〈 0. 05). Conclusion The Clinical effect of intervention nursing to prevent pipeline puncture point infection is good.

  3. Diminished responsiveness to dobutamine as an inotrope in mice with cecal ligation and puncture-induced sepsis: attribution to phosphodiesterase 4 upregulation.

    Science.gov (United States)

    Sakai, Mari; Suzuki, Tokiko; Tomita, Kengo; Yamashita, Shigeyuki; Palikhe, Sailesh; Hattori, Kohshi; Yoshimura, Naoki; Matsuda, Naoyuki; Hattori, Yuichi

    2017-06-01

    Dobutamine has been used in septic shock for many years as an only inotrope, but its benefit has been questioned. We weighed the effects of dobutamine and milrinone as inotropes in mice with cecal ligation and puncture (CLP)-induced polymicrobial sepsis. CLP-induced septic mice exhibited significant cardiac inflammation, as indicated by greatly increased mRNAs of proinflammatory cytokines and robust infiltration of inflammatory cells in the ventricular myocardium. Elevations of plasma cardiac troponin-I showed cardiac injury in CLP mice. Noninvasive echocardiographic assessment of cardiac function revealed that despite preserved left ventricular function in the presence of fluid replacement, the dobutamine inotropic response was significantly impaired in CLP mice compared with sham-operated controls. By contrast, milrinone exerted inotropic effects in sham-operated and CLP mice in an equally effective manner. Surface expression levels of β1-adrenoceptors and α-subunits of three main G protein families in the myocardium were unaffected by CLP-induced sepsis. Plasma cAMP levels were significantly elevated in both sham-operated and CLP mice in response to milrinone but only in sham-operated controls in response to dobutamine. Of phosphodiesterase (PDE) isoforms, PDE4D, but not PDE3A, both of which are responsible for cardiac cAMP hydrolysis, was significantly upregulated in CLP mouse myocardium. We define a novel mechanism for the impaired responsiveness to dobutamine as an inotrope in sepsis, and understanding the role of PDE4D in modulating cardiac functional responsiveness in sepsis may open the potential of a PDE4D-targeted therapeutic option in septic patients with low cardiac output who have a need for inotropic support.NEW & NOTEWORTHY Advisability of the usefulness of dobutamine in septic shock management is limited. Here, we reveal that the effect of dobutamine as a positive inotrope is impaired in mice with cecal ligation and puncture-induced sepsis

  4. Recent Research Progress of Cecal Ligation and Puncture%盲肠结扎穿孔术-脓毒症模型研究的金标准

    Institute of Scientific and Technical Information of China (English)

    黄鑫(综述); 张敏州(审校)

    2015-01-01

    Sepsis is a high incidence and high mortality of the disease ,which is characterized by dysreg-ulated systemic in ammatory responses followed by immunosuppression , so how to choose the best animal model for the study of sepsis is crucial.Sepsis induced by cecal ligation and puncture ( CLP) is the most widely used model.Although CLP does not completely reproduce the complexity of human sepsis,the CLP model is one of the best representations of human sepsis which has made important contributions to our knowledge of the in ammation involved in sepsis and to the identi cation of therapeutic strategies .In this pa-per we gathered these datas on the cecal ligation and puncture-induced sepsis model for a review to narrow the gap between experimental sepsis models and clinical sepsis.%脓毒症是一个高发病率、高病死率的疾病。其发病特点是全身炎性反应失调引起的免疫功能障碍,因此如何选择最佳动物模型对研究脓毒症至关重要。盲肠结扎穿孔模型( CLP)是目前研究脓毒症应用最广泛、最具代表意义的一种模型,更类似于人类脓毒症的进展和特点。尽管 CLP 不能完全复制临床的脓毒症,但其仍为脓毒症发病机制和防治研究提供了大量有意义的基础数据。该文对盲肠结扎穿孔术模型的研究应用予以综述,以促进实验研究与临床试验间的转化。

  5. Dynamic Optimization for Puncturing and Stirring Mechanisms of Sewing Machines%平缝机刺布挑线机构的动力学优化

    Institute of Scientific and Technical Information of China (English)

    刘亚辉; 杨华; 周长江

    2013-01-01

      工业平缝机是缝制行业应用最为广泛的装备之一,其刺布挑线机构对整机的振动与冲击影响较大,对该机构进行优化有助于整机的减振降噪。建立了平缝机刺布挑线机构的虚拟样机模型,对其进行动力学分析。基于部分平衡理论,以针杆曲柄处最大惯性力最小为优化目标,建立优化数学模型,通过改变构件的质心坐标位置及质量等参数来实现机构惯性力的最佳平衡。试验表明该优化方法具有一定的可信度,部分平衡法应用于解决如高速平缝机等复杂机械系统的振动和噪声有一定的参考价值。%Sewing machine is one of the most popular equipment in sewing industry. The puncturing and stirring mecha-nism is found to have a large influence on vibration and shock of the entire sewing machine. In this paper, a virtual prototype model of the puncturing and stirring mechanism of sewing machines was established for dynamic analysis. Based on the par-tial equilibrium theory, and taking minimizing the maximum inertia force of the needle-bar crank as the optimal objective, the mathematical model of optimization was established. By adjusting the parameters such as the mass and the location of the mass center of the mechanism, the best balance of the inertia force of the mechanism was achieved. The experimental re-sults indicate that the optimization method has some credibility, and the partial equilibrium method applied here is effective for analyzing vibration and noise problem of complex mechanical systems such as the high-speed industrial sewing ma-chines.

  6. 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

  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. PROPOFOL-FENTANYL VERSUS PROPOFOL ALONE FOR LUMBAR PUNCTURE SEDATION IN CHILDREN WITH ACUTE HEMATOLOGIC MALIGNANCIES: PROPOFOL DOSING AND ADVERSE EVENTS

    Science.gov (United States)

    Hollman, Gregory A.; Schultz, Meredith M; Eickhoff, Jens C; Christenson, Devon K

    2011-01-01

    Objective We sought to determine whether the combination of propofol and fentanyl results in lower propofol doses and fewer adverse cardiopulmonary events than propofol and placebo for lumbar puncture (LP) in children with acute hematologic malignancies. Design Randomized, controlled, double blind, crossover study. Setting Pediatric Sedation Program Patients Children with acute leukemia or lymphoma receiving sedation for LP. Interventions Each patient received two sedations in random order, one with propofol/placebo and one with propofol/fentanyl. The study investigator and patient/parent were blinded to placebo or fentanyl. Data collected included patient age and diagnosis, propofol dose and adverse events. Adverse events included oxygen saturation propofol was 5.05 mg/kg (range 2.4–10.2 mg/kg) for propofol/placebo versus 3.00 mg/kg (range 1.4–10.5 mg/kg) for propofol/fentanyl (p propofol/placebo compared to 6 of 22 (18.2%) propofol/fentanyl (p= 0.02). The most common adverse event was hypotension. Conclusions The combination of propofol and fentanyl versus propofol alone for LP sedation in children with acute hematologic malignancies resulted in lower propofol doses and fewer adverse events. PMID:18838923

  9. Cystathionine-γ-lyase gene silencing with siRNA in monocytes/ macrophages attenuates inflammation in cecal ligation and puncture-induced sepsis in the mouse

    Indian Academy of Sciences (India)

    A Badiei; ST Chambers; RR Gaddam; M Bhatia

    2016-03-01

    Hydrogen sulphide is an endogenous inflammatory mediator produced by cystathionine-γ-lyase (CSE) in macrophages. To determine the role of H2S and macrophages in sepsis, we used small interference RNA (siRNA) to target the CSE gene and investigated its effect in a mouse model of sepsis. Cecal ligation puncture (CLP)-induced sepsis is characterized by increased levels of myeloperoxidase (MPO) activity, morphological changes in liver and pro-inflammatory cytokines and chemokines in the liver and lung. SiRNA treatment attenuated inflammation in the liver and lungs of mice following CLP-induced sepsis. Liver MPO activity increased in CLP-induced sepsis and treatment with siRNA significantly reduced this. Similarly, lung MPO activity increased following induction of sepsis with CLP while siRNA treatment significantly reduced MPO activity. Liver and lung cytokine and chemokine levels in CLP-induced sepsis reduced following treatment with siRNA. These findings show a crucial pro-inflammatory role for H2S synthesized by CSE in macrophages in sepsis and suggest CSE gene silencing with siRNA as a potential therapeutic approach for this condition.

  10. First regularized trace of integro-differential Sturm-Liouville operator on a segment with punctured points at generalized conditions of bonding in deleted points

    Science.gov (United States)

    Sarsenbi, Abdisalam A.; Zhumanova, Lyazzat K.

    2016-12-01

    The present work is devoted to calculating a first regularized trace of one integro-differential operator with the main part of the Sturm-Liouville type on a segment with punctured points at integral perturbation of "transmission" conditions. The integro-differential Sturm-Liouville operator -y″(x )+q (x )y (x )+γ ∫0πy (t )d t =λ y (x ) given on the segments π/n (k -1 )type: y(0) = 0, y(π) = 0 are given on the left-hand and right-hand ends of the segment [0, π]. The functions continuous on [0, π], the first derivatives of which have jumps at the points x =π/n k , are solutions. The value of jumps is expressed by the formula y'(π/k n -0 )=y'(π/k n +0 )-βk∫0πy (t )d t , k =1 ,n -1 ¯ . The basic result of the paper is the exact formula of the first regularized trace of the considered differential operator.

  11. Comparison of the efficacy of epidural autologous blood patch in the treatment of spontaneous intracranial hypotension and post-dural puncture headache

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sung Hyun; Lee, Jon Woo; Lee, Geun Young; Lee, Eu Gene; Kang, Heung Sik [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2014-04-15

    To evaluate and compare the effectiveness of fluoroscopy-guided epidural blood patch (EBP) in patients with post-dural puncture headache (PDPH) and spontaneous intracranial hypotension (SIH). Between August 2012 and September 2013, 16 patients (12 with PDPH, 4 with SIH; 5 males, 11 females; age range 19-58 years, mean age 32.8 years) who underwent EBP in the Department of Radiology were included in this study. Pain relief within three days after EBP was evaluated based on medical record and classified on a 3-level scale: complete relief; incomplete relief; and failure. Recurrence is defined as aggravated postural headache after three days. We evaluated and compared treatment outcome between PDPH and SIH, using Fisher's exact test (considered as significant when p < 0.05). In 12 PDPH patients, the EBP provided complete relief in 5 patients (41.7%), and incomplete relief in 7 patients (58.3%). In 4 SIH patients, the EBP provided complete relief in 1 patient (25%), and incomplete relief in 3 patients (75%). There was no significant difference (p = 0.511) of pain relief rate between PDPH and SIH. There was recurrence in 5 patients with PDPH and 1 patient with SIH. Five PDPH patients were retreated by EBP with incomplete relief. Fluoroscopy-guided EBP provides effective treatment of postural headache for both SIH and PDPH patients.

  12. 深静脉穿刺置管在急诊中的应用%Application of Deep Venous Puncture in Emergency Department

    Institute of Scientific and Technical Information of China (English)

    熊伟

    2015-01-01

    目的分析探讨深静脉穿刺置管术在急诊临床工作中的应用价值。方法回顾性分析我院2012年10月~2014年10月52例行深静脉穿刺置管的患者进行分析。结果深静脉穿刺置管术成功率高,能迅速的帮助休克患者补液,抢救效果良好,且并发症少。结论深静脉穿刺置管术是一项效果明显的急救技术,在急诊抢救工作中有重要作用。%Objective To explore the application value of deep venous puncture and catheterization in emergency treatment.Methods Retrospective analysis of 52 patients with deep venous catheterization from October 2012 to October 2014 in our hospital.Results The success rate of deep venous catheterization was high,and it can help the patients with shock in a rapid rate of fluid infusion,the rescue ef ect is good,and the complications are few.Conclusion Deep venous catheterization is an ef ective emergency treatment technology,which plays an important role in the emergency rescue work.

  13. Precautions for breast cancer-related lymphoedema: risk from air travel, ipsilateral arm blood pressure measurements, skin puncture, extreme temperatures, and cellulitis.

    Science.gov (United States)

    Asdourian, Maria S; Skolny, Melissa N; Brunelle, Cheryl; Seward, Cara E; Salama, Laura; Taghian, Alphonse G

    2016-09-01

    Precautionary recommendations conveyed to survivors of cancer by health-care practitioners to reduce the risk of breast cancer-related lymphoedema are indispensable aspects of clinical care, yet remain unsubstantiated by high-level scientific evidence. By reviewing the literature, we identified 31 original research articles that examined whether lifestyle-associated risk factors (air travel, ipsilateral arm blood pressure measurements, skin puncture, extreme temperatures, and skin infections-eg, cellulitis) increase the risk of breast cancer-related lymphoedema. Among the few studies that lend support to precautionary guidelines, most provide low-level (levels 3-5) or inconclusive evidence of an association between lymphoedema and these risk factors, and only four level 2 studies show a significant association. Skin infections and previous infection or inflammation on the ipsilateral arm were among the most clearly defined and well established risk factors for lymphoedema. The paucity of high-level evidence and the conflicting nature of the existing literature make it difficult to establish definitive predictive factors for breast cancer-related lymphoedema, which could be a considerable source of patient distress and anxiety. Along with further research into these risk factors, continued discussion regarding modification of the guidelines and adoption of a risk-adjusted approach is needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. 汽车爆胎新模型的建立及仿真研究%Establishing a New Automobile Model after Puncturing and Its Simulation Researches

    Institute of Scientific and Technical Information of China (English)

    王东东; 向宇; 张彦会

    2011-01-01

    The radius of a flat tire decreases after puncturing,which causes the body posture altered. Therefore, the load transfer brings the change of the lateral force and aligning torque acted on the wheels. The new flatting model of vehicle including a steering system is established through analysis of all the changes.Then the characteristic of lateral acceleration and yaw rate is developed by building the simulation model,which establishes a theoretical foundation for further study on the control works.%汽车爆胎后爆胎车轮半径变小,引起车身姿态的变化,从而导致载荷发生转移.载荷的转移又会引起车轮上侧偏力及回正力矩的变化.通过分析这些变化,建立了关于汽车及其转向系统的爆胎新模型.利用Simulink搭建仿真模型,得出汽车在爆胎后的侧向速度、横摆角速度的变化特征,为以后控制研究工作奠定了理论基础.

  15. Speech Rehabilitation For 10 Alaryngeal Patients Using Tracheoesophageal Puncture And Prosthesis Insertion In Amir Alam And Imam Khomeini Hospitals 2002-2003

    Directory of Open Access Journals (Sweden)

    M.T. Khorsi Ashtiani

    2006-05-01

    Full Text Available Background and Aim: Total laryngectomy following laryngeal cancer has many sequelae , that loss of voice is the most important of them. Tracheoesophageal puncture (TEP and prosthesis insertion has evolved into the most widely used and accepted technique for vocal rehabilitation. Materials and Methods: 10 patients that underwent TEP in Amir Alam and Imam Khomeini hospitals from Feb. 2002 through Nov. 2003; were included in this study. Prosthesis insertion in 4 patients is primary and in 6 patients is secondary; and all patients are men. Results: The age of patients was between 50 to 70. 90% of patients had history of cigarette smoking and 10% of them had history of drinking alcohol. Salivary leakage was seen in 30% of patients that was improved with conservative management. Fluency of speech in 30% of patients and intelligibility of speech & voice quality in 40% of patients is good. Conclusion: We could conclude that TEP has less complication & better speech results of other vocal rehabilitation methods. Carefully selection of patients & size of prosthesis has important role in results of TEP.

  16. 改进颈静脉穿刺技术在下肢深静脉血栓介入治疗中的应用%Internal jugular vein puncture techniques in interventional therapy of lower extremity deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    张岩; 王秀平; 刘建

    2013-01-01

    Objective To evaluate the internal jugular vein puncture technique for interventional treatment of lower extremity deep venous thrombosis.Methods From February 2009 to November 2012,56 patients with lower extremity deep venous thrombosis required transjugular interventional therapy.Two methods of internal jugular vein puncture using a guide wire marking and fine needle puncture techniques was 100%without complication perforating artery.Results In 18 patients,the fine needle puncture was successful in the first attempt(12),after multiple punctures(3),unsuccessful despite repeated punctures(3)with erroneous carotid artery punctures in 2 patients.No pneumothorax,hemothorax,or cervical hematoma occurred with either technique.Conclusions Both transjugular vein puncture techniques are simple and safe with high success and low complication rates for treatment of lower extremity deep venous thrombosis.%目的:探讨改进的颈静脉穿刺技术在下肢深静脉血栓介入治疗中的应用价值。方法2009年2月~2012年11月期间,在下肢深静脉血栓介入治疗中对56例需要经颈静脉入路者,对颈内静脉穿刺进行了导丝标记法和细针穿刺法两种技术改进,观察穿刺技术改进后颈内静脉穿刺的成功率及并发症发生情况。结果38例采用导丝标记法,均一次穿刺成功,其一次穿刺成功率为100%,无1例误穿动脉;18例采用细针穿刺法,其中12例一次穿刺成功,3例多次穿刺成功,3例反复穿刺失败,2例误穿颈动脉。两种穿刺技术均未发生颈部血肿、气胸、血胸等与颈静脉穿刺相关的并发症。结论上述两种改进颈静脉穿刺技术,操作简单,成功率和安全性高,创伤小,在下肢深静脉血栓介入治疗中具有一定的应用价值。

  17. 7T MR辅助猴丘脑定位注射的研究%Study on the targeted positioning puncture of rhesus thalamus under 7T MR guidance

    Institute of Scientific and Technical Information of China (English)

    夏睿; 郜发宝; 颜富强; 李鹏; 刘婷; 李真林

    2011-01-01

    Objective To study the value of the targeted positioning puncture rhesus thalamus under 7T MR guidance. Methods Twenty monkeys underwent bilateral thalamus puncture. Eight monkeys underwent atlas-guided puncture surgery. Two days later, high-resolution MR images at 7T MR of the brain were acquired to conform whether the position of puncture was righ and histologi-cal examination was made to evaluate the results of MRI. The method of puncture was improved according to the analysis of the results before,the other twelve monkeys underwent puncture surgery followed the improved method. MRI and histological examination were acquired also after the surgery. Results One monkey before and after improved method lost the chance of MR scan for unstable anesthetized condition. The accurate rates of puncture were in 95. 5% and 78. 6% after and before improved method,respectively. The results of MRI were in accordance with the histological results(88. 9%). Conclusion High-resolution 7T MR imaging can directly define the microstructure of the monkey. The method of puncture bilateral cranial targeting into the thalamus in monkeys can be improved with high-resolution 7T MR imaging.%目的 探讨7T MR辅助猴脑内丘脑定位注射的价值.方法 对20只猴子的双侧丘脑均进行定位穿刺,8只猴子根据恒河猴脑部定位图谱将穿刺针插到预定为丘脑的位置,术后2 d行MR扫描验证穿刺的位置并做病理检查证实.通过穿刺针的位置对定位方法进行改进后,剩余12只猴子按改进的定位方法进行穿刺,术后2 d做MR扫描验证穿刺的结果并对其进行病理证实.结果 改进定位方法前后各有1只猴子因为麻醉状态不稳定而缺失MR扫描结果,改进定位方法前11次准确定位于丘脑(78.6%),改进定位方法后21次准确定位于丘脑(95.5%).MR所得结果与病理证实结果一致(88.9%).结论 高分辨能力的7T MR可以改进猴脑内精细解剖和功能结构定位的方法.

  18. Nursing of polycystic ovary syndrome in transvaginal ultrasound small follicular puncture%经阴道超声小卵泡穿刺治疗多囊卵巢综合征患者的护理

    Institute of Scientific and Technical Information of China (English)

    孙继芬; 毛丽洁; 王芳

    2014-01-01

    目的 探讨多囊卵巢综合征经阴道超声小卵泡穿刺治疗的护理方法.方法 对58例经阴道超声小卵泡穿刺治疗多囊卵巢综合征的治疗和护理要点进行总结.结果 58例多囊卵巢综合征患者经阴道超声小卵泡穿刺治疗术后妊娠21例,妊娠率36.20%.结论 针对多囊卵巢综合征经阴道超声小卵泡穿刺治疗术患者的心理特点,做好心理护理,充分的术前准备,有利于减轻患者的心理压力,顺利配合手术,取得较满意的临床效果.%Objective To explore the nursing of polycystic ovary syndrome treated by transvaginal ultrasound small follicular puncture.Methods The treatment and nursing of 58 cases with polycystic ovary syndrome treated by transvaginal ultrasound small follic~ar puncture were summarized.Results Among 58 cases of polycystic ovary syndrome treated by transvaginal ultrasound small follicular puncture,21 cases obtained postoperative pregnancy,the pregnancy rate was 36.20%.Conclusions According to the psychological characteristics of patients with polycystic ovary syndrome treated by transvaginal ultrasound small follicular puncture,good psychological nursing and sufficient preoperative preparation are helpful to reduce the patients' psychological pressure,cooperate with the operation smoothly,and obtain satisfactory clinical effect.

  19. 经奶嘴甜味剂喂服对新生儿静脉穿刺疼痛的影响%Effects of Administering Glucose through a Nipple on Reducing Pain of Newborns During Scalp Veins Puncture

    Institute of Scientific and Technical Information of China (English)

    高静迪; 刘燕; 吴春丽

    2013-01-01

      目的:了解经奶嘴甜味剂喂服对新生儿静脉穿刺疼痛的影响,为新生儿疼痛管理提供新的思路和方法.方法:选取180例新生儿作为研究对象,其中89例早产儿、91例足月儿,将患儿随机分为对照组和干预组,干预组穿刺前给予经奶嘴甜味剂喂服,对照组无干预,两组患儿穿刺时利用新生儿疼痛评分法对疼痛进行评估.结果:足月儿和早产儿中干预组疼痛评分明显低于对照组(P<0.01).结论:经奶嘴甜味剂喂服能有效减轻新生儿静脉穿刺时的疼痛反应.%Objective:To explore the effect of Administering glucose through a nipple on reducing pain of newborns during scalp veins puncture. Method:As research object,180 newborns were selected,there were 89 prematures and 91 Term infants,both group were randomized into intervention group and control group,intervention group were administed glucose through a nipple before scalp veins puncture,control group weren’t administed glucose before scalp veins puncture,Pain reaction was assessmented with Neonatal Infant Pain Scale.Result:Pain reaction scores of intervention group were lower than control group’s,There were significant differences(P<0.01).Conclusion:Administering glucose through a nipple can reduce pain of newborn during scalp veins puncture.

  20. Magnetic resonance findings associated with intracranial hypotension. A report of three cases occurring after lumbar puncture; Hallazgos por RM en el sindrome de hipotension intracraneal. A proposito de tres casos tras puncion lumbar

    Energy Technology Data Exchange (ETDEWEB)

    Galan, J. [Hospital General Yague (Spain); Vuelta, R. V. [Hospital de Txagorritxu. Vitoria (Spain); Oleaga, L.; Grande, D. [Hospital de Basurto. Bilbao (Spain)

    1999-07-01

    The magnetic resonance (MR) findings are presented for three patients who developed intracranial hypotension syndrome following lumbar puncture, one of the most common causes of this complication. All three patients presented the MR findings characteristically associated with this event, consisting of diffuse dural enhancement after administration of a paramagnetic contrast medium, as well as extraaxial collection that played either an accompanying or a causative role. (Author) 7 refs.

  1. A clinical study of improving vein puncture in poor venous filling patients"%改良静脉穿刺法在静脉充盈不良患者中的应用效果

    Institute of Scientific and Technical Information of China (English)

    林陶玉; 程青虹

    2013-01-01

    目的 探讨改良静脉穿刺法在静脉充盈不良患者中的应用效果.方法 静脉充盈不良患者50例,采用自身对照的方法,单日采用改良穿刺法,双日采用传统穿刺法,各200例次.观察不同穿刺方法患者静脉回血、穿刺的成功率及患者的疼痛反应等指标.结果 改良静脉穿刺自然回血,穿刺的成功率明显高于传统方法组(P<0.01),且患者对疼痛的反应降低(P<0.05).结论 改良静脉穿刺法提高了静脉充盈不良患者穿刺成功率,且减轻了患者的疼痛.%Objective To investigate how to increase the successful rate with improving vein puncture in poor venous filling patients.Methods A total of 50 patients with poor venous engorgement were adopted.The observation group was given the method of impoving puncture,the control group was given traditional venipuncture.The rates of returning blood and penetration of success and reaction of pains were compared in two groups.Results The degree of vein filling and returning blood was significant higher in the observation group than that in the control group (P < 0.01),but reaction of pains was lower (P <0.05).Conclusions The method of improving vein puncture could enhance the rate of successful puncture and relieve pains of patients.

  2. Blind decoding algorithm of punctured convolutional codes based on improved WHT%基于改进Walsh-Hadamard变换的删除卷积码盲解码算法

    Institute of Scientific and Technical Information of China (English)

    戚林; 郝士琦; 王磊

    2011-01-01

    针对高误码率情况下删除卷积码的盲解码问题,提出了一种删除卷积码的盲解码算法.通过采用改进的沃尔什-哈达马变换(Walsh-Hadamard translate,WHT),识别出删除卷积码的高维校验矩阵;再基于源卷积码的生成矩阵与校验矩阵间的约束关系,求出了源卷积码的最佳生成多项式和删除模式,并提出了码字同步的方法,最终按识别出来的参数构建盲解码模型,实现了删除卷积码的盲解码.仿真结果表明,在误码率低于0.01,的情况下,该算法的译码正确率能达到93%.%In order to solve the problem of blind decoding punctured convolutional codes at high bit-error rates, this paper proposed a blind decoding algorithm. Through applying the advanced Walsh-Hadamard transform, recognized the high dimensionality parity-check matrix of punctured convolutional codes. Moreover, solved the generator matrix and puncture map of the source convolutional codes based on the constraint relationship between the parity-check matrix and the generator matrix. Then proposed a method of codeword synchronization. According to the recognition results, established a model of blind decoding of punctured convolutional codes. The simulation results show, the bit correct rate after decoding of this algorithm can be up to 93% under the condition of BER lower than 0.01.

  3. Does obesity preclude lumbar puncture with a standard spinal needle? The use of computed tomography to measure the skin to lumbar subarachnoid space distance in the general hospital population.

    LENUS (Irish Health Repository)

    Halpenny, Darragh

    2013-06-05

    OBJECTIVES: Failed lumbar puncture (LP) is a common indication for referral for radiologically guided LP. This study aims to evaluate what percentage of the hospital population would fail an LP using a standard 9-cm needle because of obesity and a skin to subarachnoid space distance greater than 9 cm. METHODS: Images of 402 consecutive patients undergoing computed tomography of the abdomen and pelvis were reviewed. Skin to subarachnoid space distance was calculated using sagittal images. A survey was conducted among junior hospital doctors to assess their experience of performing lumbar puncture in obese patients. RESULTS: Four hundred patients were included. Fifty-five patients (13.8 %) had a skin to subarachnoid space distance greater than 9 cm. Intra-abdominal fat, subcutaneous fat and abdominal girth correlated with distance between the skin and subarachnoid space. Among junior doctors, 68.3 % (n = 41) reported LP failure on an obese patient; 78.4 % (n = 47) were unaware of the existence of a longer needle and 13.3 % (n = 8) had experience using a longer needle. CONCLUSIONS: A significant proportion of the hospital population will fail LP with a standard length spinal needle. Selecting a longer needle may be sufficient to successfully complete LP in obese patients. KEY POINTS : • Lumbar puncture failure commonly leads to referral for an image-guided procedure • Standard lumbar puncture may fail in 13.8 % of patients due to obesity • 78.4 % of trainee doctors are unaware of the existence of longer spinal-needles • Using longer spinal needles may allow successful LP in obese patients.

  4. Research Progress on the Treatment of Gouty Arthritis by Blood-letting Puncture%刺络放血治疗痛风性关节炎的研究进展

    Institute of Scientific and Technical Information of China (English)

    张雪; 徐天舒

    2014-01-01

    本研究总结近10年刺络放血治疗痛风性关节炎的研究进展,并提出科研中应该注意的问题及发展方向。从治法联合的多样性、放血量的控制、刺血手法的选取、实验研究等方面,对近10年刺络放血治疗痛风性关节炎的文献进行综述。结果发现刺络放血治疗痛风性关节炎有一定疗效,起效快、疗效好、不良反应少、复发率低、方法各异,但机制研究缺乏,还存在问题有待于进一步的研究解决。%The paper summarizes advances of studies on blood-letting puncture for the treatment of gouty ar-thritis in the recent decade and puts forward the problems that should be paid attention to and the developmental direction in scientific research.Review the literature about the treatment for gouty arthritis by blood -letting puncture in the recent decade from diversity of combined treatments, control of the bleeding amount,selection of the pricking blood technique and the experimental research.Blood-letting puncture for treating gouty arthritis has a certain effect,but it lacks the mechanism research.Blood-letting puncture for treating gouty arthritis is effective and rapid action with few side-effects and low recurring rates,but there are some problems that should be solved in the further study.

  5. 齐刺法中药离子导入治疗肩周炎的临床验案%Clinical proved case of treating frozen shoulder with triple puncture Chinese medicine iontophoresis

    Institute of Scientific and Technical Information of China (English)

    王东岩; 宋士英

    2013-01-01

    A clinically proven case was selected in this paper to analyze the clinical effect of triple puncture Chinese medicine iontophoresis on treating frozen shoulder. The effect is significant.%  本文选取了临床验案一则,分析齐刺法中药离子导入治疗肩周炎的临床疗效。临床上可达到很好的治疗效果。

  6. 浮针配合围刺法治疗网球肘56例%Clinical observation on superficial needling combined with surrounding puncture treating 56 tennis elbow cases

    Institute of Scientific and Technical Information of China (English)

    高凤云

    2011-01-01

    目的:观察浮针配合围刺法治疗网球肘的疗效.方法:采用一次性浮针在非病痛区域的皮下疏松结缔组织进行扫散手法及普通针灸针围刺以阿是穴为主的穴位对患者进行治疗.结果:56例患者治愈52例,占92.86%,好转4例,占7.14%,无效0例.总有效率为100%.结论:浮针配合围刺法治疗网球肘具有治愈率高的特点.%Objective: to observe the effert of superficial needling combined with surrounding puncture treating tennis elbow cases. Method: Scattered technique and surrounding puncture by one-time superficial needling on subcutaneous loose connective tissue were used to treat the tennis elbow patients on Ashi points. Result: 52 cases were cured (92.86%), 4 cases were improved (7.14%). The total effect was 100%. Conclusion: Superficial needling combined with surrounding puncture treating tennis elbow has high cure rate.

  7. 前房穿刺治疗急性闭角型青光眼的临床观察%Clinical observation of anterior chamber puncture in the treatment of acute angle closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    陈秀华

    2015-01-01

    Objective:To explore the clinical effect of anterior chamber puncture in the treatment of acute angle closure glaucoma. Methods:30 patients with acute angle closure glaucoma(33 eyes) were selected.They were given anterior chamber puncture treatment.The curative effects of patients were observed.Results:The intraocular pressure and vision of patients after treatment were significantly better than those before treatment(P<0.05).Conclusion:The curative effect of anterior chamber puncture in the treatment acute angle closure glaucoma is significant.%目的:探讨前房穿刺治疗急性闭角型青光眼的临床效果。方法:收治急性闭角型青光眼患者30例(33眼),给予前房穿刺术治疗,观察患者的疗效。结果:治疗后患者眼压和视力明显优于治疗前(P<0.05)。结论:前房穿刺术治疗急性闭角型青光眼疗效显著。

  8. The Effect of Nursing Intervention on the Success Rate and Degree of Satisfaction of Pediatric Venous Puncture%护理干预对小儿静脉穿刺成功率及满意度的影响

    Institute of Scientific and Technical Information of China (English)

    田俊华

    2015-01-01

    目的:探讨护理干预对小儿静脉穿刺成功率及满意度的影响。方法将600例静脉输液的患儿分成两组,对照组患儿采取常规护理方式,观察组患儿采取优质护理,对比两组患儿的穿刺效果。结果观察组的穿刺成功率及家属满意度均高于对照组,差异具有统计学意义(P<0.05)。结论优质护理干预能有效提升小儿静脉穿刺成功率及满意度。%Objective To investigate the effect of nursing intervention on the success rate and satisfaction degree of pediatric venous puncture. Methods 600 patients with intravenous infusion were divided into two groups, the control group was given routine nursing, the observation group was taken with high quality care, compared with the two groups of patients with puncture effect.ResultsThe success rate of the observation group and family satisfaction were significantly higher than the control group, the difference was statistically signiifcant (P<0.05).Conclusion The high quality nursing can effectively improve the success rate and satisfaction of pediatric venous puncture.

  9. CT引导下经皮肺穿刺72例临床病理分析%Clinicopathological analysis of percutaneous lung puncture in 72 cases guided by CT

    Institute of Scientific and Technical Information of China (English)

    高福平; 魏谨

    2012-01-01

    目的 探讨CT引导下经皮肺穿刺在肺部周围病灶中定性诊断的作用.方法 分析72例CT引导下经皮肺穿刺临床及病理资料.结果 72例患者中良性病灶14例,恶性病灶55例,未能确诊者3例.结论 CT引导下经皮肺穿刺是一种准确度高的获得组织学的方法,适用于临床诊断困难的肺周围性占位病变的诊断.%Objective To evaluate the function of percutaneous lung puncture in the qualitative diagnosis of peripheral pulmonary lesions guided by CT. Methods Clinico pathological data of percutaneous lung puncture in 72 cases guided by CT were analyzed retrospectively. Results There were 14 cases with benign lesions in 72 patients, and there were 55 cases with malignant lesions, and 3 cases failed to diagnosis. Conclusion CT-guided percutaneous lung puncture is an accurate and effective access to the histological diagnosis, and suitable for clinical diagnosis of difficult surrounding lung disease diagnosis of lesion.

  10. Comparison of Two Kinds of Application of Puncture Approach Ways of Central Vein Catheterization in Critically Ill Patients%两种穿刺入路方式中心静脉置管术在危重症抢救中的应用比较

    Institute of Scientific and Technical Information of China (English)

    谢德东; 周莉娟; 陈力; 戴领

    2014-01-01

    Objective To compare two kinds of puncture approach ways of central vein catheterization in the critically ill rescue application, in the way of central vein to seek for optimal rescue critically ill patients. Methods A retrospective analysis from 2008 March to 2013 year in March 900 cases of critically ill patients in our center of central venous catheterization patients clinical data, which take the internal jugular vein puncture approach in 420 cases, puncture of subclavian vein approach in 480 cases, based on the two kinds of puncture approach ways of central vein catheterization occurred in quick puncture success rate and puncture related complications rate analysis. Results The success rate of puncture of internal jugular vein puncture ap-proach: 336 cases (80% ); puncture of subclavian vein approach in 456 cases (95% ); the incidence rate of puncture related complications: internal jugular vein puncture approach in 69 cases (16. 4% ), puncture of subclavian vein in 20 cases (4. 2% ). Conclusion In critically ill patients subclavian vein puncture approach ways of central vein catheterization rate is better than that of internal jugular vein puncture approach in fast puncture success rate and puncture related complications.%目的:比较两种穿刺入路方式中心静脉置管术在危重症抢救中的应用,寻求适用于危重症患者抢救中最优的中心静脉置管入路方式。方法回顾性分析2008年3月至2013年3月我中心900例危重抢救患者中心静脉置管术临床资料,其中采取颈内静脉穿刺入路方式420例,锁骨下静脉穿刺入路方式480例,通过对两种穿刺入路方式中心静脉置管术在快速穿刺成功率及穿刺相关并发症发生率方面进行分析比较。结果一针穿刺成功率:颈内静脉穿刺入路方式336例(80%);锁骨下静脉穿刺入路方式456例(95%);穿刺相关并发症发生率:颈内静脉穿刺入路方式69例(16.4%),锁

  11. Neonatal effect of venous indwelling needle puncture on different indwelling time%新生儿静脉留置针不同穿刺部位对留置效果的影响

    Institute of Scientific and Technical Information of China (English)

    何英萍; 鞠远凤

    2015-01-01

    目的:探讨新生儿不同部位静脉留置针对留置效果的影响。方法选择患儿90例,随机分为头皮静脉组、四肢静脉和颈外静脉组30例,比较穿刺成功率、留置时间、并发症发生情况。结果颈外静脉组穿刺成功率明显高于头皮静脉组和四肢静脉组,留置时间明显长(χ2=6.240,P=0.00;F=2.38,P=0.00);并发症发生率明显低(P<0.05)。结论对新生儿,颈静脉留置针具有较高的首次穿刺成功率、较低的并发症发生率及较长的留置时间。%Objective: To investigate the effect of emergency neonatal venous indwelling needle different puncture site on detaining effect.Methods: 90 cases of emergency newborn were selected and randomly divided into scalp vein group, limb vein and external jugular vein group,there were 30 cases, scalp vein group were used by scalp venous indwelling needle, limb vein group were used by limbs venous indwelling needle, external jugular vein group were used by external jugular vein indwelling needle, the first success rate of puncture, catheter time, puncture complications of three groups were compared.Results: The success rate of puncture of external jugular vein group was significantly higher than that of scalp venous indwelling catheter group or limb vein group, the indwelling time was significantly longer than that of scalp venous group and limb vein group (χ2=6.240, P=0.00; F=2.38,P=0.00); the jugular phlebitis and overall complication rate were lower than those of scalp venous group or limb vein group (P<0.05).Conclusion: To emergency newborn, indwelling time of jugular vein indwelling needle has higher success rate of first puncture ,lower complication incidence and longer catheter time, it can reduce nursing workload, improve clinical treatment effect, at the same time, relieve newborn pain and risk of infection.

  12. 腘静脉穿刺治疗下肢深静脉血栓的护理%Nursing of Vein Thrombus of Lower Extremities Treated by Punctured through Popliteal Vein

    Institute of Scientific and Technical Information of China (English)

    杨爱霞; 宋锦文; 董志强; 印建国

    2012-01-01

    Objective To study the clinical nursing methods in the treatment of deep venous thrombosis (DVT) of lower extremities by punctured through popliteal vein. Methods From June 2007 and April 2011,the clinical data were analyzed retrospectively on 36 DVT patients with ultrasound-guided puncture, venography popliteal vein development after puncture in lower extremities and contralateral femoral vein guidewire ipsilateral popliteal vein puncture. All the patients underwent thrombolysis and (or) suction thrombosis after indwelling catheter. Results The mean time of thrombolysis was (3. 6±1. 3) days and the recovery rate was 92%. No major complication happened. Conclusion Popliteal vein puncture treatment has a sound clinical effect for deep vein thrombosis in lower extremities. Preoperative and postoperative psychological nursing, close observation of the clinical condition, careful nursing and suitable rehabilitation guidance also play a critical role in the treatment.%目的 探讨经腘静脉穿刺置管治疗下肢深静脉血栓(deep venous thrombosis,DVT)的临床护理方法.方法 回顾性分析2007年6月至2011年4月在兰州军区兰州总医院放射科行超声引导下腘静脉穿刺、患肢顺行静脉造影待腘静脉显影后直接穿刺和经健侧股静脉置导丝于患侧腘静脉后穿刺的36例DVT患者的临床资料.所有患者均在留置导管后溶栓和(或)抽吸血栓.结果 本组患者平均溶通时间为(3.6±1.3)d,总治愈率为92%,无一例患者发生严重并发症.结论 经腘静脉穿刺治疗下肢深静脉血栓疗效显著,做好术前、术后的心理护理,密切观察病情,精心护理和做好适当的康复指导十分重要.

  13. Strategies to Improve the Success Rate of Venous Puncture for Young Nurses%提高年轻护士静脉穿刺成功率的对策

    Institute of Scientific and Technical Information of China (English)

    陈永菊

    2015-01-01

    Objective To analyze the reasons of the low success rate of the young nurses in the course of venous puncture, and to find out the relevant countermeasures. Methods Col ect the actual situation of the low success rate of vein puncture in the actual implementation of the young nurses in our hospital. Results The main reasons for the low success rate of the young nurses in the practical implementation of the venous puncture were mainly the environmental factors, the factors of the nurses and the patients. Conclusion In order to avoid the high success rate of puncture in the actual young nurses, the patients can be improved in the process of car ying out the puncture. The success rate of the patients is improved.%目的:分析目前年轻护士在进行静脉穿刺过程中成功率较低的原因,并针对这些原因找出相关对策。方法收集目前我院在实际的实施年轻护士静脉穿刺过程中导致静脉穿刺成功率较低的实际情况,并针对这些情况分析出如何提升年轻护士静脉穿刺成功率的原因。结果目前导致年轻护士在实际的实施静脉穿刺过程中成功率较低的原因主要为环境因素、护士自身的因素以及患者的因素。结论为了避免在实际的年轻护士实施静脉穿刺过程中出现穿刺成功率不高的情况,可以在实际的对于患者在实施穿刺的过程中,针对环境因素、护士自身的因素以及患者的因素进行相应的改进,通过这种形式提升在对于患者实施穿刺过程中的成功率。

  14. Clinical analysis of first venous puncture failure on 650 cases in outpatient and emergency services%门急诊首次静脉穿刺失败650例临床分析

    Institute of Scientific and Technical Information of China (English)

    郭秀娟; 刘小芬

    2015-01-01

    Objective:To investigate the reasons of first venous puncture failure on 650 cases in outpatient and emergency. Methods:75 200 patients with intravenous infusion were selected from January to December 2010,and we statistical analysis of those 650 cases who were first puncture failed.Results:There were 596 cases of children among those first puncture failure patients(91.7%),and 62 cases were elderly(over 60 years) patients(5%),and other 22 cases(3.3%).97 cases(15%) failure belong to the operation technical factors of nurse;390 cases(60%) were attribute to the patient himself;163 cases of failure casued by other factors(25%).In winter(October to December),there 254 patients were first puncture failed(39.1%),and 396 cases occurred in other 3 seasons(60.9%).Conclusion:If we choose different method of vein puncture according to the conditions,patients and seasons,the success rate can improve greatly.%目的:探讨门急诊首次静脉穿刺失败650例的原因。方法:2010年1月1日-12月31日收治静脉输液患者75200例,首次穿刺失败650例,对这些穿刺失败患者进行统计分析。结果:穿刺失败患者中儿童596例(91.7%),老年患者(>60岁)33例(5%),其余21例(3.3%)。因为护士操作技术因素导致失败97例(15%),患者因素390例(60%),其他因素163例(25%)。冬季(10-12月)首次穿刺失败患者254例(39.1%),前3个季度396例(60.9%)。结论:根据不同条件、不同患者、不同季节选择不同的方法,可使静脉穿刺的成功率极大地提高。

  15. Research on the puncture location guided by ultrasound in intraorbital foreign body%超声引导下眼眶内异物穿刺定位的动物实验与临床应用

    Institute of Scientific and Technical Information of China (English)

    王啸澜; 徐永根; 张茂

    2014-01-01

    Objective The puncture location guided by ultrasound in animal's intraorbital foreign body,and applied to the clinical feasibility. Methods Metallic foreign bodies were placed in rabbits' orbits, and were puncture located by ultrasound. Results Foreign bodies scanned in 9 eyes of 11 rabbits ,same as the actual.Intraorbital foreign bodies of 6 eyes among these 9 eyes, which beside the eyebal wall, puncture located and moved by guiding of ultrasound. Intraorbital foreign body of typical case, which beside the eyebal wal , puncture located by guiding of ultrasound successful y. Conclusion The puncture location guided by ultrasound can be used in differentiation of intraorbital foreign bodies.%目的:利用动物实验探讨超声引导下眼眶内异物定位与治疗用于临床的可行性。方法制作兔眼眶内金属异物模型,采用超声对眼眶异物进行检查,在超声引导下穿刺定位异物和用探针拨动异物,观察异物能被拨动确定异物在眼球壁外。并采用超声引导进行临床眼眶异物的穿刺定位诊治。结果11只兔(11眼)超声检查发现近眼球壁异物6眼,一般眼眶异物3眼,未检出眼眶异物2眼,与实际相符。其中近眼球壁异物6眼在超声引导下眼眶异物全被探及并被拨动,确定异物在眼球壁外。临床成功采用超声定位眼眶异物并取出。结论在眼眶内异物穿刺定位时使用超声检测能简便准确地判定异物与眼球壁的位置关系,临床应用效果良好。

  16. 母乳吸吮干预对婴儿静脉穿刺疼痛的影响%Effects of breast-feeding intervention on newborns' pain caused by vein puncture

    Institute of Scientific and Technical Information of China (English)

    赵桂荣

    2011-01-01

    目的 探讨母乳吸吮时机对婴儿静脉穿刺疼痛的影响.方法 随机把符合条件的入院患儿分成干预组与对照组各60例.干预组在操作前暂禁母乳喂养2~3h,在静脉穿刺时给予母乳吸吮干预.对照组按常规给予静脉穿刺.通过检测患儿啼哭时间、心率、血氧饱和度来评估患儿的疼痛程度.结果 干预组静脉穿刺患儿啼哭持续时间均少于对照组,差异具有统计学意义(Z=-4.405,P<0.05),血氧饱和度均高于对照组,差异具有统计学意义(P<0.01).结论 母乳吸吮干预可有效减轻婴儿静脉穿刺疼痛程度.%Objective To evaluate the effect of breast-feeding on newborns' pain caused by vein puncture.Methods The newborns having pneumonia after into the hospital were randomly divided into breast-feeding group and control group, each group have sixty cases. The newborns in the breast-feeding group prohibit breastfeeding two or three hours before the operation, then began to receive breast-feeding at one minute before the vein puncture until the vein puncture finished. The newborns' time of cry, heart rate (HR) and oxygen saturation (SaO2) were recorded and compared between the two groups.Results The heart rate was significant differences on the time of cry caused by pain between the two groups (Z=-4.405,P<0.05), SaO2 after vein puncture are higher than control group(P<0.01).Conclusions Breast-feeding intervention can relieve newborns' pain caused by vein puncture.

  17. Anatomy basis of unguided sacroiliac joint puncture%骶髂关节未经影像学引导下穿刺的解剖学基础

    Institute of Scientific and Technical Information of China (English)

    邹宇聪; 李义凯; 杨先文; 陈润祺; 于成福

    2012-01-01

    Objective To provide anatomic basis for the feasibility and safety of unguided sacroiliac joint puncture. Methods 3 sacroiliac joint section specimens, 4 dried pelvic specimens (2 male, 2 female), 4 antiseptic cadaveric pelvic specimens (3 male.l female) and 62 ankylosing spondylitis patients' sacroiliac joint CT imaging data were collected and measured. The injection target was designated at the sagittal synovium part below the posterior superior iliac spine. Results The average length of sagittal synovium part was about (18.40±3.40)mm in male and (17.32±3.60)mm in female(P>0.05); The average distance between the posterior midline and sagittal synovium part was (41.00±3.30)mm in male and (42.74±4.00)mm in female(P0.05). Conclusions According to the sex and thickness of fat, conducting injection in the area of (41.00±3.50 )mm away from the posterior midline, (28.00±3.20)mm from the posterior superior iliac spine makes puncture entering the sacroiliac joint more accurately, easily, and successfully.%目的 为临床骶髂关节未经影像学引导下穿刺的可行性和安全性提供解剖学基础.方法 对3例已固定好的骶髂关节断层标本,4例干燥骨盆(男女各2例),4例防腐骨盆(男3例,女1例)和62例强直性脊柱炎患者(男32例,女30例)骶髂关节CT平扫图及三维重建进行解剖观察和测量,以髂后上棘下的骶髂关节矢状滑膜部为穿刺目标.结果 男女矢状滑膜部矢状长度分别为(18.40±3.40)mm和(17.32±3.60)mm(P>0.05);男女矢状滑膜部到后正中线的距离分别为(41.00±3.30)mm和(42.74±4.00)mm(P<0.05);男女矢状滑膜部中点与髂后上棘距离分别为(27.66±3.10)mm和(28.76±3.50)mm(P>0.05).结论 根据性别,脂肪厚度等不同情况在距离后正中线(41.00±3.50)mm的范围,髂后上棘下(28.00±3.20)mm这一区域进行未经引导下穿刺可使穿刺较容易进入骶髂关节,使得穿刺成功率提高.

  18. B超下赛丁格术不同穿刺对PICC置管的影响%The influence of different puncture methods of Seldinger technique under B-scan on PICC tube

    Institute of Scientific and Technical Information of China (English)

    罗曲

    2014-01-01

    Objective To discuss the influence of different puncture methods of Seldinger technique under B-scan on PICC success rate. Methods Review the clinical data of 90 patients who were treated by Seldinger technique in our hosipital from September 2012 to September 2013,90 patients were randomly divided into two groups by hidden-digital classification,45 cases of the control group used conventional puncture method of Seldinger technique,45 cases of the observation group used improved puncture method of Seldinger technique, trocar was slowly thrusted to the target vascular in a 45 ° angle with skin, released the puncture needle when B-scan showed the vascular had been oppressed,after the vascular was reconstruction, then adjusted position of needle and reelingly thrusted to the target vascular,wihdrawed the core needle and inserted a guide pin.Compare the success rate of puncture,bleeding of puncture point,incidence of Phlebitis. Results The success rate of observation group was 86.67%,the control group was 68.89%,the difference was Statistically significant(P<0.05). Conclusion Improved puncture method is benefit to improve the success rate of PICC tube.%目的:探讨B超引导下赛丁格术不同穿刺方法对PICC置管成功率的影响。方法回顾我院2012年9月~2013年9月行B超下赛丁格穿刺的90例患者的临床资料,采用隐藏数字随机法随机分成两组,对照组45例采用常规赛丁格穿刺方法,观察组45例采用改良的赛丁格穿刺方法,将套管针以与皮肤呈45°缓慢刺向靶血管,在B超显示血管横切面被压迫变形时微松开穿刺针,观察显示屏上血管恢复后调整针尖位置再缓慢旋转刺入靶血管,撤出针芯,送入导丝。记录对比两组穿刺成功率、穿刺点出血情况、静脉炎发生情况。结果观察组穿刺成功率为86.67%,对照组为68.89%,两组差异具有统计学意义(P<0.05)。结论改良穿刺手法有利于提高PICC置管成功率。

  19. Chenopodium ambrosioides L. Improves Phagocytic Activity and Decreases Bacterial Growth and the Systemic Inflammatory Response in Sepsis Induced by Cecal Ligation and Puncture.

    Science.gov (United States)

    Rios, Carlos E P; Abreu, Afonso G; Braga Filho, Jose A F; Nascimento, Johnny R; Guerra, Rosane N M; Amaral, Flávia M M; Maciel, Márcia C G; Nascimento, Flávia R F

    2017-01-01

    Chenopodium ambrosioides L. (Amaranthaceae) is often used in different kinds of vegetal preparations for medicinal purposes in many clinical situations. Some studies have demonstrated its anti-inflammatory and immunomodulatory properties. The aim of this work was to investigate the effect of prophylactic treatment with the hydroalcoholic crude extract (HCE) of C. ambrosioides and its hexanic fraction (HEX) on the control of bacterial growth, the activation of phagocytes and the control of the systemic inflammatory response in a sepsis experimental model. Animals were divided into three groups (n = 5/group): Control, which received only NaCl 0.9% solution; HCE, which received the crude extract; and HEX, which received the HEX of the extract. The animals received saline, HCE or HEX (5 mg/kg), subcutaneously (SC), 6 h before cecal ligation and puncture (CLP). Twelve hours after the CLP, the blood was collected to measure the serum cytokines and the animals were killed for the evaluation of colony-forming units (CFUs), cellular influx, and activation of phagocytes in the peritoneal cavity, measured by the secretion of hydrogen peroxide and nitric oxide production. The results showed that only HEX treatment inhibited bacterial growth in the peritoneum and inflammatory cellular influx, especially influx of macrophages and neutrophils. However, HCE and HEX treatments increased ex vivo hydrogen peroxide secretion and nitric oxide production by phagocytes and decreased the pro-inflammatory cytokines in the serum, indicating a systemic anti-inflammatory effect of both. In conclusion, C. ambrosioides treatment decreases bacterial growth likely by activation of phagocytes and, in parallel, ameliorates the general state of mice by reducing the systemic inflammatory response usually observed in sepsis.

  20. NF-κB Inhibition after Cecal Ligation and Puncture Reduces Sepsis-Associated Lung Injury without Altering Bacterial Host Defense

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    Hui Li

    2013-01-01

    Full Text Available Introduction. Since the NF-κB pathway regulates both inflammation and host defense, it is uncertain whether interventions targeting NF-κB would be beneficial in sepsis. Based on the kinetics of the innate immune response, we postulated that selective NF-κB inhibition during a defined time period after the onset of sepsis would reduce acute lung injury without compromising bacterial host defense. Methods. Mice underwent cecal ligation and puncture (CLP. An NF-κB inhibitor, BMS-345541 (50 µg/g mice, was administered by peroral gavage beginning 2 hours after CLP and repeated at 6 hour intervals for 2 additional doses. Results. Mice treated with BMS-345541 after CLP showed reduced neutrophilic alveolitis and lower levels of KC in bronchoalveolar lavage fluid compared to mice treated with CLP+vehicle. In addition, mice treated with CLP+BMS had minimal histological evidence of lung injury and normal wet-dry ratios, indicating protection from acute lung injury. Treatment with the NF-κB inhibitor did not affect the ability of cultured macrophages to phagocytose bacteria and did not alter bacterial colony counts in blood, lung tissue, or peritoneal fluid at 24 hours after CLP. While BMS-345541 treatment did not alter mortality after CLP, our results showed a trend towards improved survival. Conclusion. Transiently blocking NF-κB activity after the onset of CLP-induced sepsis can effectively reduce acute lung injury in mice without compromising bacterial host defense or survival after CLP.

  1. Chenopodium ambrosioides L. Improves Phagocytic Activity and Decreases Bacterial Growth and the Systemic Inflammatory Response in Sepsis Induced by Cecal Ligation and Puncture

    Science.gov (United States)

    Rios, Carlos E. P.; Abreu, Afonso G.; Braga Filho, Jose A. F.; Nascimento, Johnny R.; Guerra, Rosane N. M.; Amaral, Flávia M. M.; Maciel, Márcia C. G.; Nascimento, Flávia R. F.

    2017-01-01

    Chenopodium ambrosioides L. (Amaranthaceae) is often used in different kinds of vegetal preparations for medicinal purposes in many clinical situations. Some studies have demonstrated its anti-inflammatory and immunomodulatory properties. The aim of this work was to investigate the effect of prophylactic treatment with the hydroalcoholic crude extract (HCE) of C. ambrosioides and its hexanic fraction (HEX) on the control of bacterial growth, the activation of phagocytes and the control of the systemic inflammatory response in a sepsis experimental model. Animals were divided into three groups (n = 5/group): Control, which received only NaCl 0.9% solution; HCE, which received the crude extract; and HEX, which received the HEX of the extract. The animals received saline, HCE or HEX (5 mg/kg), subcutaneously (SC), 6 h before cecal ligation and puncture (CLP). Twelve hours after the CLP, the blood was collected to measure the serum cytokines and the animals were killed for the evaluation of colony-forming units (CFUs), cellular influx, and activation of phagocytes in the peritoneal cavity, measured by the secretion of hydrogen peroxide and nitric oxide production. The results showed that only HEX treatment inhibited bacterial growth in the peritoneum and inflammatory cellular influx, especially influx of macrophages and neutrophils. However, HCE and HEX treatments increased ex vivo hydrogen peroxide secretion and nitric oxide production by phagocytes and decreased the pro-inflammatory cytokines in the serum, indicating a systemic anti-inflammatory effect of both. In conclusion, C. ambrosioides treatment decreases bacterial growth likely by activation of phagocytes and, in parallel, ameliorates the general state of mice by reducing the systemic inflammatory response usually observed in sepsis. PMID:28203235

  2. A new, lateral, continuous, combined, femoral–sciatic nerve approach via a single skin puncture for postoperative analgesia in intramedullary tibial nail insertion

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    Imbelloni LE

    2013-02-01

    Full Text Available Luiz Eduardo Imbelloni,1,2 Carlos Rava,1,3 Marildo A Gouveia21Faculdade de Medicina Nova Esperança, 2Institute for Regional Anesthesia, 3Complexo Hospitalar de Mangabeira Governador Tarcisio Burity, João Pessoa, BrazilBackground: The prevalence of anterior knee pain following intramedullary tibial nail insertion is high. Continuous peripheral nerve blockade is an alternative method of pain control to opiods. This case illustrates the use of femoral nerve and sciatic nerve peripheral catheters with an elastomeric infusion pump for major intramedullary nailing surgery.Case report: A 36-year-old male with fractures to the left leg bones presented for placement of an intramedullary nail under spinal anesthesia. At the end of the procedure, access to the lateral femoral and sciatic continuous nerve block was achieved by using a stimulator connected to a 110 mm 18G Tuohy needle. Postoperative analgesia was provided with a 40-hour infusion of 0.1% bupivacaine (400 mL at a rate of 10 mL hour-1 with an elastomeric pump. Anesthetic dispersion and contrast were investigated. The analog scale remained with scores below 3 during the 40 hours after surgery, and boluses were not necessary.Conclusion: The use of a femoral and sciatic nerve peripheral catheter offered an alternative to conventional pain control. Continuous femoral–sciatic peripheral blockade via a skin puncture with an infusion of 0.1% bupivacaine with elastomeric pumps is a safe and effective procedure in adults.Keywords: local anesthetic, bupivacaine, continuous peripheral nerve block, orthopedic surgery, tibia, elastomeric pump

  3. Gastrointestinal Colonization of Candida Albicans Increases Serum (1→3)-β-D-Glucan, without Candidemia, and Worsens Cecal Ligation and Puncture Sepsis in Murine Model.

    Science.gov (United States)

    Panpetch, Wimonrat; Somboonna, Naraporn; Bulan, Dewi Embong; Issara-Amphorn, Jiraphorn; Worasilchai, Navaporn; Finkelman, Malcolm; Chindamporn, Ariya; Palaga, Tanapat; Tumwasorn, Somying; Leelahavanichkul, Asada

    2017-05-11

    The role of intestinal Candida albicans in bacterial sepsis, in the absence of candidemia, was investigated in murine models. Live C. albicans or normal saline solution (NSS) was administered orally once, followed by 5 days of daily oral antibiotic-mixtures (ATB). Cecal ligation and puncture (CLP) was then performed to induce sepsis.Fecal Candida was detected by culture only in models with Candida administration. Oral Candida administration with/without ATB enhanced gut-pathogenic bacteria as determined by microbiome analysis. Despite negative candidemia, serum (1→3)-β-D-glucan (BG) was higher in CLP with Candida preconditioning models than in CLP-controls (NSS-preconditioning) at 6 h and/or 18 h post-CLP. Blood bacterial burdens were not increased with Candida administration.Additionally, CLP with high-dose Candida (10 CFU) induced higher levels of fecal Candida, serum BG, serum IL-6 and mortality than the lowest dose (100 CFU). Interestingly, fluconazole attenuated fecal Candida and improved survival in mice with live-Candida administration, but not in the CLP-controls. Heat-killed Candida preparations or their supernatants reduced bone marrow-derived macrophage killing activity in vitro but enhanced cytokine production.In conclusion, intestinal abundance of fungi and/or fungal-molecules was associated with increased bacterial sepsis severity, perhaps through cytokine storm induction and/or decreased macrophage killing activity. These observations suggest that further investigation of the potential role of intestinal fungal burdens in sepsis is warranted.

  4. Routine cranial computed tomography before lumbar puncture in HIV-positive adults presenting with seizures at Mitchells Plain Hospital, Cape Town

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    Salma Moolla

    2015-04-01

    Full Text Available Background: Current international guidelines recommend that a cranial computed tomography (CT be performed on all HIV-positive patients presenting with new onset seizures, before a lumbar puncture (LP is performed. In the South African setting, however,this delay could be life threatening. The present study sought to measure the number of cranial CTs that contraindicate an LP and to predict which clinical signs and symptoms are likely to pose an increased risk from LP.Methods: The study was performed at a district level hospital in Western Cape Province. Data were collected retrospectively from October 2013 to October 2014. Associations between categorical variables were analysed using Pearson’s chi-squared test. Generalised linear regression was used to estimate prevalence ratios.Results: One hundred out of 132 patients were studied. Brain shift contraindicated an LP in 5% of patients. Patients with brain shift presented with decreased level of consciousness, focal signs, headache and neck stiffness. Twenty-five per cent of patients had a space-occupying lesion (SOL (defined as a discrete lesion that has a measurable volume or cerebral oedema. Multivariate analysis showed a CD4 count <50 (p = 0.033 to be a statistically significant predictor of patients with SOL and cerebral oedema. Univariate analysis showed focal signs (p = 0.0001, neck stiffness (p = 0.05, vomiting (p = 0.018 and a Glascow Coma Scale (GCS < 15 (p = 0.002 to be predictors of SOL and cerebral oedema.Conclusion: HIV-positive patients with seizures have a high prevalence of SOL and cerebral oedema but the majority of them are safe for LP. Doctors can use clinical parameters to determine which patients can undergo immediate LP.

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

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    Radeleff Boris

    2008-10-01

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

  6. Evaluation of Criteria for Requesting Brain CT Scan before Performing Lumbar Puncture for the Children Suspicious to Meningitis in Rasul Akram Hospital, Tehran

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    A.R. Nateghian

    2005-04-01

    Full Text Available Lumbar puncture (LP is the only way to diagnose meningitis, however some concerning points regarding its complication especially brain herniation are usually noted. Several factors including difficulties of neurologic examination especially in infants, absence of cooperation when performing the LP, incorrect myths and legal issues as well as unavailability of CT equipment , X-ray exposure and charges; makes evaluation of such requests reasonable .One hundred infants and children, 2 months to 12 years old who were suspicious to have meningitis were enrolled in this cross-sectional, descriptive study. Two groups were formed based on requesting a B.CT (Brain CT scan before LP or performing the procedure directly. Demographic and clinical parameters were analyzed among two groups using a questionnaire and CT results were recorded. Chi-square test was used for statistical analysis; P value<0.05 was considered as significant.B.CT was requested for 21 patients (case group in which the results led to postponing the procedure in 14%( 3 of cases. Toxic appearance, poor general condition, bulging fontanel and impaired consciousness (GCS score<8 were significantly related to such a decision making. There was also a trend toward ordering B.CT for those patients with recent cardiopulmonary arrest, focal signs, papilledema, hemiparesis and bradycardia. Two cases of brain herniation were identified in the control group, both had severe irritability and projectile vomiting at presentation.According to other studies, severe impairment of consciousness and presence of focal signs and symptoms are acceptable criteria for such a request, however ordering B.CT solely based on general condition or presence of a bulge fontanel seems to be unreasonable for which we couldn’t identify any supportive study. Larger scale studies considering the pediatric differential diagnosis and characteristics are required to generate proper, scientific and supportive protocols in this

  7. The Effects of Sub-Chronic Treatment with Pioglitazone on the Septic Mice Mortality in the Model of Cecal Ligation and Puncture: Involvement of Nitric Oxide Pathway

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    Hamed Shafaroodi

    2015-10-01

    Full Text Available Sepsis is a systemic inflammatory response syndrome caused by an infection and remains as a major challenge in health care. Many studies have reported that pioglitazone may display anti-inflammatory effects. This study was designed to evaluate the effect of subchronic treatment with pioglitazone on high-grade septic mice survival and nitrergic system involvement. Diffused sepsis was induced by cecal ligation and puncture (CLP surgery in male NMRI mice (20-30 g. Pioglitazone (5,10 and 20 mg/kg was administered by gavage daily for 5 days prior to surgery. Nitric oxide involvement was assessed by sub-chronic administration of a non-selective nitric oxide synthase inhibitor, L-NAME and a selective inducible nitric oxide synthase inhibitor, aminoguanidine. TNF-α  and IL-1β plasma levels were measured by ELISA. Pioglitazone (10 and 20 mg/kg significantly improved survival rate in septic mice. The chronic intraperitoneally co-administration of L-NAME (0.5 mg/kg, daily or aminoguanidine (1 mg/kg, daily with a daily dose of pioglitazone, 5 mg/kg, significantly increased the survival rate. This survival improving effect was accompanied by a significant reduction in pro-inflammatory cytokines TNF-α and IL-1β plasma levels. In conclusion, sub-chronic pioglitazone treatment can improve survival in mouse sepsis model by CLP. Inhibition of nitric oxide release, probably through inducible nitric oxide synthase at least in part is responsible for this effect. Suppression of TNF-α and IL-1β could be another mechanism in pioglitazone-induced survival improving effect in septic mice.

  8. The Effects of Sub-Chronic Treatment with Pioglitazone on the Septic Mice Mortality in the Model of Cecal Ligation and Puncture: Involvement of Nitric Oxide Pathway.

    Science.gov (United States)

    Shafaroodi, Hamed; Hassanipour, Mahsa; Mousavi, Zahra; Rahimi, Nastaran; Dehpour, Ahmad Reza

    2015-10-01

    Sepsis is a systemic inflammatory response syndrome caused by an infection and remains as a major challenge in health care. Many studies have reported that pioglitazone may display anti-inflammatory effects. This study was designed to evaluate the effect of subchronic treatment with pioglitazone on high-grade septic mice survival and nitrergic system involvement. Diffused sepsis was induced by cecal ligation and puncture (CLP) surgery in male NMRI mice (20-30 g). Pioglitazone (5,10 and 20 mg/kg) was administered by gavage daily for 5 days prior to surgery. Nitric oxide involvement was assessed by sub-chronic administration of a non-selective nitric oxide synthase inhibitor, L-NAME and a selective inducible nitric oxide synthase inhibitor, aminoguanidine. TNF-α  and IL-1β plasma levels were measured by ELISA. Pioglitazone (10 and 20 mg/kg) significantly improved survival rate in septic mice. The chronic intraperitoneally co-administration of L-NAME (0.5 mg/kg, daily) or aminoguanidine (1 mg/kg, daily) with a daily dose of pioglitazone, 5 mg/kg, significantly increased the survival rate. This survival improving effect was accompanied by a significant reduction in pro-inflammatory cytokines TNF-α and IL-1β plasma levels. In conclusion, sub-chronic pioglitazone treatment can improve survival in mouse sepsis model by CLP. Inhibition of nitric oxide release, probably through inducible nitric oxide synthase at least in part is responsible for this effect. Suppression of TNF-α and IL-1β could be another mechanism in pioglitazone-induced survival improving effect in septic mice.

  9. Contribution of gene expression to metabolic fluxes in hypermetabolic livers induced through burn injury and cecal ligation and puncture in rats.

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    Banta, Scott; Vemula, Murali; Yokoyama, Tadaaki; Jayaraman, Arul; Berthiaume, François; Yarmush, Martin L

    2007-05-01

    Severe injury activates many stress-related and inflammatory pathways that can lead to a systemic hypermetabolic state. Prior studies using perfused hypermetabolic rat livers have identified intrinsic metabolic flux changes that were not dependent upon the continual presence of elevated stress hormones and substrate loads. We investigated the hypothesis that such changes may be due to persistent alterations in gene expression. A systemic hypermetabolic response was induced in rats by applying a moderate burn injury followed 2 days later by cecum ligation and puncture (CLP) to produce sepsis. Control animals received a sham-burn followed by CLP, or a sham-burn followed by sham-CLP. Two days after CLP, livers were analyzed for gene expression changes using DNA microarrays and for metabolism alterations by ex vivo perfusion coupled with Metabolic Flux Analysis. Burn injury prior to CLP increased fluxes while decreases in gene expression levels were observed. Conversely, CLP alone significantly increased metabolic gene expression, but decreased many of the corresponding metabolic fluxes. Burn injury combined with CLP led to the most dramatic changes, where concurrent changes in fluxes and gene expression levels occurred in about 1/3 of the reactions. The data are consistent with the notion that in this model, burn injury prior to CLP increased fluxes through post-translational mechanisms with little contribution of gene expression, while CLP treatment up-regulated the metabolic machinery by transcriptional mechanisms. Overall, these data show that mRNA changes measured at a single time point by DNA microarray analysis do not reliably predict metabolic flux changes in perfused livers.

  10. The protective effect of amiodarone in lung tissue of cecal ligation and puncture-induced septic rats: a perspective from inflammatory cytokine release and oxidative stress.

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    Polat, Beyzagul; Cadirci, Elif; Halici, Zekai; Bayir, Yasin; Unal, Deniz; Bilgin, Bulent Caglar; Yuksel, Tugba Nurcan; Vancelik, Serhat

    2013-07-01

    Sepsis is a serious medical condition that is characterized by a whole-body inflammatory state and the presence of a known or suspected infection. Amiodarone is a class III antiarrhythmic agent, a multichannel blocker (Ca++, Na+, and K+), and a noncompetitive α- and β-adrenergic blocker in cardiac cells. The present study aimed to determine whether amiodarone was protective against experimentally induced cecal ligation and puncture sepsis in rat lung tissue. The relationship between its probable protective effect and antioxidant/anticytokine action biochemically and histopathologically was also examined. Five groups of rats were used, each composed of 20 rats: (1) the sham-operated control group; (2) the CLP group; (3) the 25-mg/kg amiodarone-treated control healthy group; (4) the 50-mg/kg amiodarone-treated CLP group; and (5) the 50-mg/kg amiodarone-treated CLP group. A CLP polymicrobial sepsis model was applied to the rats. All groups were sacrificed 16 h later, and lung and blood samples were analyzed histopathologically and biochemically. Twenty-five and 50 mg/kg amiodarone decreased the level of interleukin (IL)-1β, IL-6, and tumor necrosis factor-α in serum and 8-iso-prostaglandin F2α level in lung tissue. They increased the activities of superoxide dismutase and levels of total glutathione in lung tissues of rats. Histopathological scores and examinations were in accordance with the biochemical results. Histopathological analysis revealed significant differences in inflammation scores between the sepsis group and the other groups. The CLP + amiodarone 50 mg/kg group had the lowest inflammation score among CLP groups. Our results indicate that administration of amiodarone prevented oxidative stress and cytokine action and protected lung tissue during sepsis cascade.

  11. Senegenin Ameliorate Acute Lung Injury Through Reduction of Oxidative Stress and Inhibition of Inflammation in Cecal Ligation and Puncture-Induced Sepsis Rats.

    Science.gov (United States)

    Liu, Chun-Hong; Zhang, Wei-Dong; Wang, Jian-Jie; Feng, Shan-Dan

    2016-04-01

    The purpose of this study was to assess the protective effect of senegenin on acute lung injury (ALI) in rats induced by sepsis. Rat ALI model was reproduced by cecal ligation and puncture (CLP). All rats were randomly divided into five groups: group 1 (control), group 2 (CLP), group 3 (CLP + senegenin 15 mg/kg), group 4 (CLP + senegenin 30 mg/kg), and group 5 (CLP + senegenin 60 mg/kg). CLP + senegenin groups received senegenin by gavage daily for consecutive 5 days, respectively, while the mice in control and CLP groups were given an equivalent volume of saline. We detected the lung wet/dry weight ratios and the histopathology of the lung. The levels of lung tissue myeloperoxidase (MPO), malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione (GSH) were determined. Meanwhile, the nuclear factor-kappa B (NF-κB) activation, tumor necrosis factor-alpha (TNF-α), and interleukin-1β (IL-1β) levels were studied. The results demonstrated that senegenin treatment significantly attenuated CLP-induced lung injury, including reduction of lung wet/dry weight ratio, protein leak, infiltration of leukocytes, and MPO activity. In addition, senegenin markedly decreased MDA content and increased SOD activity and GSH level. Serum levels of TNF-α and IL-1β were also decreased by senegenin administration. Furthermore, senegenin administration inhibited the nuclear translocation of NF-κB in the lungs. These findings indicate that senegenin exerts protective effects on CLP-induced septic rats. Senegenin may be a potential therapeutic agent against sepsis.

  12. Clinical study on the application of fast stroke method to improve the success rate of vein puncture%快速抚摸法对提高静脉穿刺成功率的影响

    Institute of Scientific and Technical Information of China (English)

    罗义华; 向开诚; 张贵清; 袁代莉; 张丽玲; 张秀; 白忠玲

    2016-01-01

    目的:探讨快速抚摸法在静脉穿刺中的应用效果,为改善患者预后积累经验。方法选取我院妇产科及呼吸内科2015年11月至2016年1月接收的200例需静脉穿刺患者为研究对象,入院后按照随机取样法将其分为观察组和对照组各100例。对照组采用常规拍打法;观察组采用快速抚摸法。比较两组患者静脉充盈度、一次穿刺成功率、输液外渗或脱针、穿刺部位肿胀的发生率及患者满意度,以及静脉穿刺时穿刺部位疼痛程度。结果观察组患者静脉充盈度及穿刺部位疼痛程度优于对照组,两组比较差异具有统计学意义(P<0.05);观察组患者一次穿刺成功率为97.0%、满意度为96.0%、输液外渗或脱针发生率为1.0%、穿刺部位肿胀发生率为3.0%,对照组分别为88.0%、78.0%、9.0%、11.0%,两组比较差异具有统计学意义(P<0.05)。结论快速抚摸法有助于提高静脉充盈度,进而增加一次穿刺成功率,避免渗漏、肿胀等发生,减轻患者痛苦,提高患者满意度,值得临床上推广应用。%Objective To explore the application effect of fast stroke method in the vein puncture to accumu-late experience for improving the prognosis of patients. Methods A total of 200 patients with venous puncture in depart-ment of internal medicine and department of obstetrics and gynecology in our hospital from November 2015 to January 2016 were selected as the research objects and were divided into two groups according to random sampling method, 100 cases in each group. The routine beating method was adopted in the control group, while fast stroke method was adopted in the observation group. The venous filling degree, success rate of one-time puncture, incidence of infusion extravasa-tion or off the needle, incidence of swelling on the puncture site and degree of satisfaction of the patients of the two groups were compared. The pain on the puncture site was compared

  13. Puncturing the myths of acupuncture

    Institute of Scientific and Technical Information of China (English)

    Molly J. Mallory; Alexander Do; Sara E. Bublitz; Susan J. Veleber; Brent A. Bauer; Anjali Bhagra

    2016-01-01

    Acupuncture is a widely practiced system of medicine that has been in place for thousands of years. Consumer interest and use of acupuncture are becoming increasingly popular in the United States, as it is used to treat a multitude of symptoms and disease processes as wel as to maintain health and prevent ilness. A growing body of evidence increasingly validates the practice of acupuncture. Further developing scientifi c data wil play an important role in the future of acupuncture and other complementary and alternative medicines in public health. Acupuncture is commonly used concurrently with conventional medicine. Although acupuncture is embraced by consumers and medical professionals, misconceptions abound. We have explored and dispeled ten misconceptions common to the practice of acupuncture, utilizing an evidence-based approach. As the trend of merging conventional medical care with acupuncture treatment grows, it is important to develop a conceptual model of integrative medicine. Using a scientifi c evidence approach wil create a structure from which to begin and grow confi dence among conventional medical providers. Acupuncture is a safe and effective modality when performed properly by trained professionals. Educating both the consumer and medical community is important to enable appropriate and evidence-based applications of acupuncture and integration with conventional medicine for high-quality patient care.

  14. Analgesic effect of Compound Lidocaine Cream for fistula puncture%复方利多卡因乳膏对内瘘血管穿刺的镇痛作用观察

    Institute of Scientific and Technical Information of China (English)

    陈民; 李正; 钟思敏

    2011-01-01

    Objective To evaluate the analgesic effect of Compound Lidocaine Cream for arteriovenous fistula puncture.Methods Sixty-two cases of renal failure in end stage uremia ( test group) were treated with maintenance hemodialysis and different Methods of analgesia during arteriovenous fistula puncture.The conventional group was treated by puncture after regular disinfection without analgesia.The test group was given Compound Lidocaine Cream 60 minutes before puncture.The control group was given disinfection gel 60 minutes before puncture.We used WeWl Visual Analogue Scale ( VAS ) and Verbal Rating Scale ( VRS ) to evaluate degees of pain three times per month.Results There was significant difference in VAS scores among the test group [VAS: ( 34.13 ±18.02 ) mm], the conventional group [VAS: ( 34.13 ± 18.02 ) mm]and the control group [VAS: ( 49.64 ± 18.56 ) mm]( P <0.05 ).Treatment in test group was significantly more effective than in conventional group and control group in the easement of pain ( P< 0.05 ).Conclusion Compound Lidocaine Cream produces effective analgesic effect for arteriovenous fistula puncture.%目的 观察局部涂抹复方利多卡因乳膏对内瘘血管穿刺的镇痛作用.方法 采用自身前后对照研究的方法,对62例进行维持性血液透析治疗的肾功能衰竭尿毒症终末期患者在穿刺动静脉内瘘时先后采取不同的镇痛方法:常规组不镇痛,在常规消毒后进行穿刺;试验组在穿刺前60分钟给予复方利多卡因乳膏涂擦;安慰剂对照组在穿刺前60分钟给予消毒凝胶涂擦.各组均在1个月内连续3次使用视觉类比量表(visual analogue scale,VAS)及语言评价量表(verbal rating scale,VRS)评定疼痛程度,并进行比较.结果 试验组VAS评分为(34.13±18.02)分,与常规组的(54.98±19.77)分及安慰剂对照组的(49.64±18.56)分比较,差异均有统计学意义(P<0.05);试验组疼痛缓解有效率明显高于安慰剂对照组(P<0.05).结论 复方

  15. Modelo simulador para treinamento de punção transpedicular em vertebroplastia percutânea Manikin-type training simulator model for transpedicular puncture in percutaneous vertebroplasty

    Directory of Open Access Journals (Sweden)

    Nitamar Abdala

    2007-08-01

    Full Text Available OBJETIVO: Desenvolver e testar a similaridade de modelo de coluna lombar tipo manequim para treinamento de punção transpedicular em vertebroplastia percutânea. MATERIAIS E MÉTODOS: Foram confeccionadas 30 vértebras lombares à base, principalmente, de metacrilato, gesso e etil-vinil-acetato, a partir de molde de borracha baseado em vértebra humana. Os discos intervertebrais foram feitos com silicone para que houvesse similaridade anatômica e fusão de cinco vértebras. O segmento da coluna foi acondicionado no interior de um manequim coberto por tela de etil-vinil-acetato para que não fosse possível a visualização direta. Foi realizado curso teórico para seis especializandos de radiologia e neurorradiologia, que testaram o modelo para vários parâmetros de similaridade com a realidade, realizando 30 punções transpediculares, em três sessões de dez procedimentos por dia, com intervalo de uma semana entre cada sessão. RESULTADOS: Cada aluno realizou 30 punções transpediculares, porém oito punções foram desconsideradas, pois se observaram problemas de manufatura dos modelos durante estes procedimentos. Após a realização das punções, todos os participantes preencheram o formulário de similaridade, com 100% de respostas positivas em relação à similaridade do modelo. CONCLUSÃO: Foi possível o desenvolvimento de modelo para punção transpedicular com similaridade satisfatória com o ser humano, configurando um instrumento de treinamento de vertebroplastia.OBJECTIVE: To develop and test a model of the human lumbar vertebra for training transpedicular puncture in percutaneous vertebroplasty. MATERIALS AND METHODS: Thirty lumbar vertebra models were constructed from methacrylate, plaster and ethyl-vinyl-acetate, using a rubber mold of human vertebrae. The intervertebral discs were made of silicone to provide anatomical similarity and fusion of five vertebrae. This model of spinal column segment was positioned within a

  16. Comparison of Exo-Seal(®) and Angio-Seal (®) for arterial puncture site closure: A randomized, multicenter, single-blind trial.

    Science.gov (United States)

    Ketterle, Johannes; Rittger, Harald; Helmig, Inga; Klinghammer, Lutz; Zimmermann, Stefan; Hohenforst-Schmidt, Wolfgang; Brachmann, Johannes; Nef, Holger; Achenbach, Stephan; Schlundt, Christian

    2015-08-01

    The use of extravascular femoral closure devices in patients undergoing coronary angiography/intervention has not been sufficiently evaluated. We sought to define the impact of an extravascular polyglycolic acid (PGA) plug for the closure of a femoral access site in patients undergoing coronary angiography and/or percutaneous coronary intervention. In this prospective, single-blind, multicenter trial we randomly assigned 319 patients to vessel closure with Angio-Seal(®) or Exo-Seal(®). We hypothesized that the use of an extravascular closure device is not inferior to an anchor/plug-mediated device regarding the occurrence of the composite primary endpoint: hematoma > 5 cm, significant groin bleeding (TIMI major bleed), false aneurysm, and device failure. There was no significant difference in patient baseline characteristics or procedural results. After 24 h the primary endpoint occurred in nine patients (5.6 %) in the Angio-Seal(®) group and in 13 patients (8.2 %) inthe Exo-Seal(®) group (p = 0.38). Hematoma > 5 cm was noted in three patients (1.9 %) receiving Angio-Seal(®) vs. two patients (1.3 %) receiving Exo-Seal(®) (p = 0.99). In one patient (0.6 %) of the Exo-Seal(®) group, TIMI major bleeding occurred, requiring transfusion (p = 0.49). There were four (2.5 %) false aneurysms found in patients treated with Angio-Seal(®) and two (1.3 %) in patients treated with Exo-Seal(®) (p = 0.68). There was a trend for a higher incidence of device failure in the Exo-Seal(®) group (1.2 vs. 5.2 %, p = 0.06). At telephone interview after 30 days, there was no significant difference found regarding the events readmission with surgery of puncture site, infection, bleeding, hematoma, or pain. In the present study, there were no significant differences found regarding the occurrence of hematoma > 5 cm, major bleeding, false aneurysm, and device failure between Angio-Seal(®) and Exo-Seal(®) 24 h after device implantation.

  17. Gene deletion of P-Selectin and ICAM-1 does not inhibit neutrophil infiltration into peritoneal cavity following cecal ligation-puncture

    Directory of Open Access Journals (Sweden)

    Hess Karen

    2004-07-01

    Full Text Available Abstract Background Neutrophil infiltration is one of the critical cellular components of an inflammatory response during peritonitis. The adhesion molecules, P-selectin and intercellular adhesion molecule (ICAM-1, mediate neutrophil-endothelial cell interactions and the subsequent neutrophil transendothelial migration during the inflammatory response. Despite very strong preclinical data, recent clinical trials failed to show a protective effect of anti-adhesion therapy, suggesting that the length of injury might be a critical factor in neutrophil infiltration. Therefore, the objective of this study was to determine the role of P-selectin and ICAM-1 in neutrophil infiltration into the peritoneal cavity during early and late phases of peritonitis. Methods Peritonitis was induced in both male wild-type and P-selectin/ICAM-1 double deficient (P/I null mice by cecal ligation-puncture (CLP. Peripheral blood and peritoneal lavage were collected at 6 and 24 hours after CLP. The total leukocyte and neutrophil contents were determined, and neutrophils were identified with the aid of in situ immunohistochemical staining. Comparisons between groups were made by applying ANOVA and student t-test analysis. Results CLP induced a severe inflammatory response associated with a significant leukopenia in both wild-type and P/I null mice. Additionally, CLP caused a significant neutrophil infiltration into the peritoneal cavity that was detected in both groups of mice. However, neutrophil infiltration in the P/I null mice at 6 hours of CLP was significantly lower than the corresponding wild-type mice, which reached a similar magnitude at 24 hours of CLP. In contrast, in peritonitis induced by intraperitoneal inoculation of 2% glycogen, no significant difference in neutrophil infiltration was observed between the P/I null and wild-type mice at 6 hours of peritonitis. Conclusions The data suggest that alternative adhesion pathway(s independent of P-selectin and ICAM

  18. Modulation effect of n-3 polyunsaturated fatty acids (PUFA) on target organ function as well as immune and inflammatory response of cecal ligation and puncture-induced septic rats

    Institute of Scientific and Technical Information of China (English)

    Dian-Xun Liu

    2016-01-01

    Objective:To study the modulation effect of n-3 polyunsaturated fatty acids (PUFA) on target organ function as well as immune and inflammatory reaction of cecal ligation and puncture-induced septic rats.Methods:Adult SD rats were selected as research subjects and randomly divided into control group, model group and PUFA group. Septic rat models were made by cecal ligation and puncture method and given n-3 polyunsaturated fatty acid for parenteral nutrition. Then number of apoptosis cells in intestinal mucosa, contents of intestinal flora, intestinal mucosal barrier function and immune function were detected.Results: (1) Intestinal mucosa function: the number of apoptosis cells in intestinal mucosa, intestinal E. coli contents, serum D-lactose and DAO contents as well as L/M ratio in urine of model group were higher than those of control group, and contents of bifidobacteria and lactobacilli were lower than those of control group; the number of apoptosis cells in intestinal mucosa, intestinal E. coli contents, serum D-lactose and DAO contents as well as L/M ratio in urine of PUFA group were lower than those of model group, and contents of bifidobacteria and lactobacilli were higher than those of model group; (2) Immune and inflammatory response: the number of PP nodes and PP node cells as well as contents of B cells and T cells in intestinal mucosa of model group were lower than those of control group; the number of PP nodes and PP node cells as well as contents of B cells and T cells in intestinal mucosa of PUFA group were higher than those of model group.Conclusion: n-3 polyunsaturated fatty acids (n-3PUFAs) are helpful to protect intestinal mucosal barrier function of cecal ligation and puncture-induced septic rats, regulate intestinal flora balance and improve immune and inflammatory response.

  19. The monitoring value of color Doppler ultrasound in the vein puncture catheter postoperative application%彩色多普勒超声对静脉穿刺置管术后的监测价值

    Institute of Scientific and Technical Information of China (English)

    黄少敏; 岑忠耿; 张伟帅; 杨文海

    2016-01-01

    Objective To evaluate the value of color Doppler ultrasound in the vein puncture catheter postop-erative application. Methods A retrospective analysis of 211 cases of postoperative patients with venous puncture, color Doppler ultrasound catheter in intravascular position and direction, where there were no abnormal echo and blood flow in the venous lumen, walking in the direction of the line and filling. Results Of 211 cases, 158 cases of catheter and venous blood circulation unobstructed, no thrombosis. 53 cases and venous thrombosis, where incidence was 25%. Conclusion Color Doppler ultrasound is the preferred method of monitoring venous puncture catheter in postoperative patients.%目的:探讨彩色多普勒超声在静脉穿刺置管术后的应用价值。方法回顾性分析211例静脉穿刺置管术后患者,彩色多普勒超声观察导管在血管内位置及走行,所在静脉管腔内有无异常回声及血流的方向、走行及充盈情况。结果211例患者中,158例导管及所在静脉血流通畅,无血栓形成。53例导管及所在静脉有血栓形成,发生率为25%。结论彩色多普勒超声是监测静脉穿刺置管术后患者血管情况的首选方法。

  20. Electroacupuncture plus Blood -letting Puncture in the Treatment of Acute Gouty Arthritis%电针配合刺络放血治疗急性痛风性关节炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    金泽; 张滨滨

    2012-01-01

    目的:观察电针配合刺络放血治疗急性痛风性关节炎的临床疗效.方法:将60例急性痛风性关节炎患者随机分为治疗组和西药组,各30例,治疗组采用电针配合刺络放血法,西药组口服秋水仙碱和消炎痛,观察比较两组临床疗效、即刻止痛效果、长期止痛效果.结果:两组临床疗效、即刻及长期止痛效果比较差异有统计学意义(P<0.01).结论:电针配合刺络放血治疗急性痛风性关节炎具有良好疗效.%Objective:To investigate the efficacy of electroacupuncture plus blood -letting puncture for treating acute gouty arthritis. Methods: Sixty patients with acute gouty arthritis were randomly allocated into treatment and control groups, 30 cases in each group. The treatment group received electroacupuncture plus blood - letting puncture and the control group received oralmedicine. The efficacy , immediate pain relief effect and long - term pain relief effect were compared. Results; There was a statistically significant difference between the two groups (P<0.01). Conclusion;The electroacupuncture plus blood -letting puncture is effective for treating acute gouty arthritis.

  1. Catgut Embedding Combined with Blood-letting Puncture and Cupping Therapy Treating 20 Cases with Acne Vulgaris%埋线联合刺络拔罐治疗寻常型痤疮20例

    Institute of Scientific and Technical Information of China (English)

    杨晓仙

    2012-01-01

    目的 观察埋线联合刺络拔罐治疗寻常型痤疮的临床疗效.方法 将40例寻常型痤疮患者按就诊序号随机分为治疗组和对照组,各组20例.治疗组采用埋线联合刺络拔罐治疗,对照组采用毫针针刺治疗.观察2组的疗效.结果 治疗组总有效率90%,对照组总有效率60%,2组比较,P<0.05.结论 埋线联合刺络拔罐治疗寻常型痤疮疗效显著.%OBJECTIVE To observe the clinical efficacy of treating acne vulgaris by catgut embedding combined with blood -letting puncture and cupping therapy. METHODS 40 cases the with acne vulgaris were randomized into 2 groups: treatment group and control group with 20 cases in each. The treatment group were treated by catgut embedding combined with bloodletting puncture and cupping therapy, while the control group were treated by filiform needling. The therapeutic results were observed. RESULTS The overall response rate (ORR) in treatment group was 90% and 60% in control group. The ORR in treatment group was higher than that in control group, P<0.05. CONCLUSION The efficacy of treating acne vulgaris by catgut embedding combined with blood-letting puncture and cupping therapy is remarkable.

  2. 持续腰椎穿刺引流治疗高位骶骨肿瘤术后脑脊液漏%Continuous lumbar puncture drainage in the treatment of cerebrospinal fluid leakage after superior sacral tumor resection

    Institute of Scientific and Technical Information of China (English)

    熊燕; 杨红胜; 屠重棋; 张斌; 任程; 闵理; 段宏

    2013-01-01

    目的:探讨持续腰椎穿刺引流术在高位骶骨肿瘤切除术后脑脊液漏患者中的应用效果。方法采用回顾性对比分析方法。对1998年1月至2011年8月,就诊于我科行高位骶骨肿瘤切除术并有完整病例资料的72例进行分析。纳入标准为:骶骨肿瘤切除患者术中发生硬脊膜损伤且术后发生脑脊液漏的患者,同时排除有持续腰椎穿刺脑脊液引流禁忌证如脑疝、颅内压明显增高、穿刺部位皮肤或软组织感染、全身严重感染败血症或休克、穿刺不能合作、L3以上脑脊液循环通路梗阻等情况的患者。最终符合纳入标准共11例。将2005年3月前行骶骨肿瘤切除术后发生脑脊液漏患者使用单纯伤口旁放置引流管引流的5例作为对照组,2005年3月以后行骶骨肿瘤切除术后发生脑脊液漏的6例为采用持续腰椎穿刺引流治疗组,分别对两组患者脑脊液漏治愈时间和患者一般情况及相关并发症进行对比研究。结果两组患者均无逆行性颅内感染发生,其中单纯放置引流管引流组1例发生手术切口局部感染。持续腰椎穿刺引流患者脑脊液漏愈合时间中位数为14.5(12~18)天,较对照组患者25(23~36)天缩短,两组差异有统计学意义( P=0.004)。腰椎穿刺引流组患者治疗期间骶尾部切口渗液少,肿胀明显较单纯引流组轻,患者自体感觉如伤口疼痛、头晕等症状较单纯引流组轻。两组患者均无低颅压性头痛、无进行性低颅压、气颅、脑疝等并发症发生。结论持续腰椎穿刺引流治疗骶骨肿瘤切除术后脑脊液漏较单纯伤口旁引流效果好,并且有效缩短脑脊液瘘口闭合时间。%Objective To investigate the application effects of continuous lumbar puncture drainage in the treatment of patients with cerebrospinal lfuid ( CSF ) leakage after superior sacral tumor resection. Methods A retrospective and comparative study

  3. The Evaluation of Neptune Pad in Hemostasis of Femoral Artery Puncture Point after Interventional Therapy for 25 Patients Aged Over 80 with Cancer%25例超高龄癌症患者股动脉穿刺点Neptune Pad止血贴应用评价

    Institute of Scientific and Technical Information of China (English)

    刘建文; 张同庆; 张怡; 赵丹; 孟娥; 贾晨星; 梁仲侨

    2013-01-01

      目的探讨80岁以上超高龄癌症患者经股动脉穿刺介入治疗后应用Neptune Pad止血贴的疗效及安全性。方法25例(共52次)超高龄癌症患者的股动脉穿刺点应用Neptune Pad止血贴辅助止血。结果52次经股动脉穿刺动脉灌注化疗和/或栓塞后,均无穿刺处并发症发生。结论 Neptune Pad止血贴对超高龄患者的股动脉穿刺止血效果肯定、安全可靠。%  Objective To investigate the safety and efficacy of the Neptune Pad in hemostasis of femoral artery puncture point after interventional therapy. Methods The application of Neptune Pad was 52 times in hemostasis of femoral artery puncture point after interventional therapy for 25 patients aged over 80 with cancer. Results There were no puncture complications in 52 times femoral artery puncture after interventional therapy. Conclusion The application of Neptune Pad for patients aged over 80 with femoral artery puncture haemostatic are effectively and safety.

  4. Design of Pneumatic Control System of a Puncture Location Robot with 6 DOF%六自由度穿刺定位机器人气动控制系统的设计

    Institute of Scientific and Technical Information of China (English)

    神祥龙; 谢叻; 孟纪超

    2012-01-01

    The puncture surgery under MRI operated by the doctors' hand is usually of low efficiency and at a high cost. In order to solve this problem, a novel puncture location robot under MRI with 6 DOF is provided. According to the structure and motion mechanism of the robot, the pneumatic control system is designed. In this system, cylinders made of aluminum alloy are adopted to drive the component movement , and PLC is adopted as the controller. Experiment results indicate that the pneumatic control system can meet the requirements of with impact structure.%为解决核磁共振环境下穿刺手术的定位难题,设计了一种六自由度穿刺定位机器人全气动控制系统.该系统采用自制铝合金气缸作为驱动元件,以PLC为控制核心.在搭建的实验平台下进行了试验,试验表明该穿刺定位机器人定位准确,工作效率高,满足了实际使用要求.

  5. 评判性思维方法在静脉留置针穿刺中的应用%Application of critical thinking method in venous indwelling needle puncture

    Institute of Scientific and Technical Information of China (English)

    王彦; 房民; 周淑娟

    2014-01-01

    Because of its simple operation and less comfort to patients,venous indwelling needle widely used has become the main tool for clinical transfusion and improve the nursing personnel's work efficiency.Application of critical thinking method in venous indwelling needle puncture can effectively improve the puncture skills of nurses,reduce the complications induced by venous indwelling needles,and improve patients' satisfaction.%静脉留置针现已广泛应用于临床,其操作简单方便,减轻了反复穿刺给患者带来的不适感,同时提高了护理人员的工作效率,避免了一些不良因素.在静脉留置针使用过程中运用评判性思维进行分析、判断,可以有效提高护士的穿刺技能,减少留置针并发症的发生,提高患者的满意度.

  6. The effectiveness of diclofenac gel and eutectic mixture of local anesthetic cream on vein puncture pain severity with vein catheter in patient undergoing cesarean section: A randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Khalili, Sediqeh; Safavi, Mahboubeh; Rezaei, Rozita; Bidmeshki, Maria; Shirzad, Fatemeh; Nasiri, Mostafa

    2014-09-01

    This study was aimed to explore the effect of applying diclofenac gel and a eutectic mixture of local anesthetic (EMLA) cream on vein puncture pain severity with vein catheter in the patients undergoing cesarean section. The sample comprised 90 women undergoing elective cesarean section that referred to Imam Ali Hospital's maternity section in Amol city (Northern Iran). Data collection tools included visual analog scale for pain severity and a checklist for short term possible side-effects of diclofenac gel, EMLA cream and Vaseline ointment as placebo. The pain of vein puncture with diclofenac gel and EMLA cream was significantly lower than that with the Vaseline ointment (P = 0.001). Similarly, there was a significant difference between using diclofenac gel and EMLA cream in catheter insertion pain severity (P = 0.006). In addition, there was no short term possible side-effect with using diclofenac gel and Vaseline ointment, but a short term side-effect (blanching) was detected in 20% of subjects with EMLA cream. Compared to Vaseline cream, EMLA cream and diclofenac gel application significantly reduces the pain severity associated with vein catheter insertion. Use of diclofenac gel is preferred compared with EMLA cream, because of economics, more efficiency purpose, and no side-effects.

  7. 局部及静脉联合用药超前镇痛对椎管内麻醉穿刺的影响%Effect of preemptive analgesia with local and intravenous medication on intraspinal anesthesia puncture

    Institute of Scientific and Technical Information of China (English)

    李中云; 陆健君; 杨焱焰; 文建乾; 牙耀; 刘文伟; 甘立书

    2013-01-01

    Objective To investigate the effect of preemptive analgesia with local and intravenous medication on the analgesic effect during puncture procedure, the degree of satisfaction for anesthesia puncture posture, and the one-time success rate of anesthesia puncture. Methods Eighty patients of elective inguinal hernia (aged 36~60 years old, weighted 48~75 kg), classified as ASA Ⅰ ~ Ⅱ, were divided into the observation Group (group A, n=40) and the control group (C, n= 40) by a randomized single-blind method. Patients of group A were given 2% lidocaine twice immediately on the spinal anesthesia puncture point and 2 cm2 skin surface around, followed by injection of 10 mg Dezocine intravenously. Patients of group C were given saline instead of lidocaine, followed by equal amount of saline solution injected intravenously. Pain scores at the puncture of local anesthesia (T1) and during spinal anesthesia puncture procedure (T2), postural changes during anesthesia puncture (movement), one-time success rate of anesthesia puncture, patient satisfaction and side effects (dizziness, nausea, vomiting) were recorded. Results Compared with group C, VAS scores of group A significantly decreased at T1 and T2 (P0.05). Conclusion Preemptive analgesia with local and intravenous medication is effective to relieve stress, anxiety and pain during spinal anesthesia, with good body position, high one-time success rate, and high patient satisfaction.%目的 探讨局部及静脉联合用药超前镇痛对椎管内麻醉穿刺过程临床镇痛效果、麻醉体位配合的满意度、麻醉穿刺一次成功率的影响.方法 择期行腹股沟疝修补术的患者80例,年龄36~60岁,体重48~75kg,ASA分级Ⅰ~Ⅱ级,采用随机数字表法,将其随机分为两组各40例.A组患者人室后立即在椎管内麻醉穿刺点为中心2cm2的皮肤范围内用2%利多卡因均匀的涂布两遍,开放静脉通路后静注地佐辛10 mg,C组穿刺点及静脉用等量生理盐水.

  8. 超声引导锥形套管针穿刺在心脏压塞救治中的应用%Application of Ultrasound-guided Cone-shaped Trocar Puncture for Cardiac Tamponade

    Institute of Scientific and Technical Information of China (English)

    王树松; 臧乃凉; 张广存; 王莉伟; 刘艳

    2016-01-01

    Objective To discuss the value of cone-shaped trocar puncture under ultrasound guidance in the treatment of cardiac tamponade. Methods From March 1998 to October 2015, 28 patients with pericardial tamponade caused by massive pericardium effusion ( the effusion width was more than 17 mm) underwent pericardiocentesis by using cone-shaped trocar ( Patent No:ZL 2006 2 0132265.8 ) puncture under ultrasound guidance and insertion of a drainage tube.Another 28 patients with cardiac tamponade receiving drainage placement by the Seldinger technique were selected as the control group.The time of catheterization was compared between the two groups. Results The puncture and drainage placement was successfully performed in one time in all the patients.The average time of catheterization in the trocar puncture group was significantly shorter than that in the control group [(6.2 ±1.1) min vs.(15.0 ±1.1) min, t=-27.844, P=0.000].The symptoms of cardiac tamponade disappeared after catheter drainage. Conclusions For patients with cardiac tamponade with a large amount of pericardium effusion, use of cone-shaped trocar puncture under ultrasound-guidance is simple, minimally invasive, quick, safe, and effective.It also provides the guarantee for subsequent treatments.%目的 探讨超声引导下锥形套管针穿刺在心脏压塞救治过程中的应用价值. 方法 1998年3月~2015年10月,在超声引导下使用锥形套管针(专利号:ZL 2006 2 0132265.8)对28例大量心包积液(心包积液宽度≥17 mm)引起的心脏压塞进行心包穿刺,置入引流管引流. 选择Seldinger法心包置管治疗心脏压塞患者28例作为对照组,比较2组的置管时间. 结果 所有心脏压塞患者均一次穿刺成功并置入引流管,锥形套管针组置管时间( 6.2 ±1.1 ) min,比Seldinger组(15.0 ±1.1)min明显缩短(t=-27.844,P=0.000),引流后患者心脏压塞症状均消失. 结论 在大量积液引起的心脏压塞患者的救治过程中,超声引导下锥

  9. 深静脉留置针在危重病患者CT增强扫描中的应用%Application of Deep Venous Puncture Catheter Placement in CT Enhancement Scanning among Critically Ill Patients

    Institute of Scientific and Technical Information of China (English)

    董金芳; 孙雪东

    2011-01-01

    Objective To discuss the effects of intravenous detailed needle and deep venous puncture catheter placement in CT enhancement scanning among critically ill patients. Methods A total of 506 critically ill patients underwent spiral CT enhancement scanning were randomly divided into the treatment group ( 260 cases ) and the control group ( 246 cases ) . Deep venous puncture catheter was applied in the treatment group while intravenous detailed needle was applied in the control group. Exosmotic ratio, achievement ratio of first CT enhancement scanning, and achievement ratio of first time puncture were compared between the two groups. Results The exosmotic ratios of contrast medium were significantly different between the two groups ( 0.08% vs 11.79% , P < 0.01 ) . Achievement ratios of first CT enhancement scanning were significantly different between the two groups ( 98.08% vs 94.31%, P<0.05 ) . Achievement ratios of first time puncture were not significantly different between the two groups ( 95.00% vs 96.34% , P >0.05 ) . Conclusion Deep venous puncture catheter placement is superior to intravenous detailed needle among critically ill patients undergoes CT enhancement scanning combined with high pressure syringe through decreasing the exosmotic ratios of contrast medium, relieving pain, and ensuring enhancement effects.%目的 探讨深静脉留置针与普通静脉留置针在危重病患者CT增强扫描中的应用效果,为危重病患者CT增强扫描提供最佳穿刺工具及方法.方法 将采用静脉留置针行CT增强扫描的506例患者随机分为试验组(260例)和对照组(246例).试验组患者使用深静脉留置针,对照组患者使用常规静脉留置针,比较两组患者造影剂外渗率、一次穿刺成功率及一次增强成功率.结果 试验组和对照组患者造影剂外渗率(0.08%与11.79%)比较,差异有统计学意义(P<0.01);一次增强成功率(98.08%与94.31%)比较,差异有统计学意义(P<0

  10. 股动脉穿刺置管术后快速手法压迫止血的体会%Rapid manual compression for puncturing site hemostasis after femoral catheterization: preliminary experience

    Institute of Scientific and Technical Information of China (English)

    杨卷红

    2013-01-01

    目的 探讨股动脉穿刺置管术后快速手法压迫止血的止血效果及并发症.方法 总结了一套快速手法压迫止血的方法(平均止血时间约2 min),并对324例行介入股动脉穿刺置管患者术后立即进行快速手法压迫止血,术后1 d对患者穿刺点周围的皮肤观察并行相应的触诊检查.结果 324例经股动脉穿刺置管介入术后患者均用了快速手法压迫止血,其中4例患者穿刺点周围皮下片状淤青,余患者穿刺点周围未见明显淤青,其有效止血率高达98.8%(320/324).320例患者中6例患者穿刺点周围出现局部皮肤轻度压伤,未予处理1周后均自行修复.结论 股动脉穿刺置管介入诊疗术后快速手法压迫止血是一种省时、省力、安全、经济、可重复、环保、实用的止血方法.%Objective To discuss the hemostasis effect of rapid manual compression performed immediately after the catheterization through femoral artery, and to analyze its complications. Methods Based on the author's experience obtained from dozens of years' practice in interventional field, the author summarized an effective hemostasis technique, which was performed through rapid manual compression on the pun cturing point. The mean compression time with hand was only about two minutes. This manipulation procedure for hemostasis had been carried out in 324 patients immediately after the catheterization through femoral artery was finished. One day after the catheterization, observation of the skin around the puncture point and palpation of the puncturing site were conducted. Results Rapid manual compression hemostasis was successfully carried out in all 324 patients, of whom subcutaneous ecchymosis around the puncture site was seen in only four. The effective hemostasis rate was 98.8% (320/324). In another six patients mild skin injury due to compression around the puncture site was observed, which, without any medication, recovered spontaneously in one week

  11. 椎间孔镜靶向穿刺新技术治疗腰椎间盘突出症%A New Targeted Puncture Technique for Percutaneous Transforaminal Endoscopic Lumbar Discec-tomy in Treatment of Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    曾月东; 苏建成; 谢伟; 谭平先; 包杰

    2016-01-01

    目的:探讨腰椎间盘突出靶向穿刺新技术减少经皮椎间孔全内镜腰椎间盘切除术( percutaneous transforam-inal endoscopic lumbar discectomy,PTELD)的 X 线暴露和避免穿刺并发症的方法。方法运用我科自主研发的腰椎间盘突出靶点瞄准仪及靶向穿刺新方法,对46例腰椎间盘突出症患者实施 PTELD 手术,对术中的 X 线透视次数、靶向穿刺准确性、疼痛反应程度和术后的疼痛视觉类比评分(visual analogue scale,VAS)、Oswestry 功能障碍指数(oswestry disability index,ODI)、MacNab 评估进行回顾性分析。结果靶向穿刺准确性:穿刺一次成功38例(82.6%),穿刺2次6例(13.1%),穿刺3次2例(4.3%)。局麻下置入套管疼痛反应:轻度37例(80.4%),中度8例(17.4%),重度1例(2.2%)。平均 X 线透视次数5.6次。无神经损伤、大血管损伤和硬膜囊撕裂并发症。术后平均随访10.6个月,术前术后 VAS 评分和 ODI 比较差异有统计学意义(P <0.05),术后3个月进行 MacNab 疗效评定:优38例,良6例,可2例,差0例,优良率95.7%。结论腰椎间盘突出靶点瞄准仪引导靶向穿刺新技术能有效减少 PTELD 的 X 线暴露,降低手术风险,减轻疼痛反应,对 PTELD 初学者有很好的帮助。%Objective To explore the methods to reduce X-ray exposure and avoid targeted puncture complications in per-cutaneous transforaminal endoscopic lumbar discectomy(PTELD). Methods 46 patients with lumbar disc herniation were subjected to PTELD using a new targeted puncture technique with application of a lumbar disc herniation target guiding appara-tus. The times of X-ray fluoroscopy,the targeted puncture accuracy,the degree of pain response during surgery,and visual ana-logue scale(VAS),Oswestry disability index(ODI),Macnab postoperatively were reviewed. Results 38 cases in success of firstpuncture( 8 2 . 6 % ),6 cases in success of puncture

  12. Effect analysis of puncture pain control in pediatric venous infusion with positive reinforcement method%阳性强化法控制小儿静脉输液时穿刺疼痛的效果分析

    Institute of Scientific and Technical Information of China (English)

    万红; 齐颖

    2016-01-01

    Objective To explore the effect of positive reinforcement method in the control of puncture pain of pediatric intra-venous infusion.Methods 200 children with intravenous infusion between 5-year old and 9-year old in the department of Pediatrics were selected by convenience sampling, and randomly divided into two groups after patients were informed consent: the experimental group and the control group.Each group was 100 patients, and the data of the children's gender, age, degree of pain and compliance of two groups was compared on the first day of intravenous injection.The control group was treated with routine nursing intervention, and the experimental group was received reinforcement method nursing intervention on the basis of routine nursing intervention, and the fa-cial expressions of pain scale and the scoring criteria of degree of cooperation were assessed the children's pain and the collaboration, and the children's compliance of vein puncture, the first time success rate of puncture for nursing staff, and the level of parental satisfac-tion were evaluated.Results there was no significant difference in two groups between the degrees of pain, the degree of cooperation, compliance, the puncture success rate and level of parental satisfaction (P>0.05) before the intervention.After the intervention, the degree of pain of children in the experimental group was significantly lower than the control group that it is significant difference (χ2 =24.954, P<0.05).The degree of cooperation, compliance, the success rate of first-time puncture and the parental satisfaction level in the experimental group were significantly better than the control group, and there are statistical significance(χ2 =7.419-36.012, P<0.05).Conclusion positive reinforcement method can effectively control children's vein puncture pain, and improve the degree of cooperation and compliance of children, which also improves the success rate of first-time puncture and the level of parental

  13. Hepatic arterial infusion of antibiotics for the treatment of pyogenic liver abscess unsuitable for puncture drainage management%肝动脉灌注抗生素治疗不宜穿刺引流的肝脓肿32例

    Institute of Scientific and Technical Information of China (English)

    施昌盛; 杨庆; 虞希祥; 肖池金; 朱国庆; 郑冰汝

    2014-01-01

    Objective To compare the clinical effect of hepatic artery perfusion of antibiotics with that of intravenous administration of antibiotics in treating pyogenic liver abscess which is unsuitable for puncture drainage management. Methods Between October 2010 and October 2013, a total of 32 cases with bacterial liver abscesses which were unsuitable for puncture drainage management were encountered at the Third Affiliated Hospital of Wenzhou Medical University. The patients were divided into group A (n = 15) and group B (n = 17). Hepatic arterial perfusion of antibiotics was carried out in the patients of group A, while intravenous administration of antibiotics was employed in the patients of group B. Percutaneous puncture drainage was adopted in the patients when their imaging examination showed liquefaction within the lesion. Results The hospitalization time, recovery time of body temperature, hemogram recovery time and liquefaction extent of the lesion in group A were much better than those in group B , and the differences were statistically significant (P < 0.05). Conclusion Hepatic arterial perfusion of antibiotics is an important and effective treatment for bacterial liver abscesses.%目的:对比分析经肝动脉灌注抗生素与静脉应用抗生素2种不同方式治疗不宜穿刺引流的细菌性肝脓肿的临床效果。方法选取2010年10月-2013年10月在温州医科大学附属第三医院治疗的不宜穿刺引流的细菌性肝脓肿患者32例,根据患者治疗方法的不同将患者分为A、B 两组,A 组为经肝动脉灌注抗生素,共15例,B 组为静脉应用抗生素,共17例。如影像学复查见病灶有脓肿液化则予经皮肝脓肿穿刺引流干预。结果动脉灌注抗生素组患者住院时间、体温恢复时间、血象恢复时间、脓肿液化比例均优于静脉应用抗生素组(P<0.05)。结论经肝动脉灌注抗生素是治疗细菌性肝脓肿的重要治疗方法。

  14. Clinical Effect Observation of Two Kinds of Puncture Methods for the Shallow Vein of the Back of Hand%手背浅静脉两种穿刺方法的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    杨玉芹

    2015-01-01

    Objective Explore the superficial vein pancture method of painless or minor aches and pains,improve the success rate of vein puncture,and improve the nursing quality.Methods Use of external vein respectively,the needke Angle is less than 30 degrees and the inside of the hand vein into the Angle is greater than 30 degrees is greater than 30 degrees of two kinds of needle puncture method,for 1120 patients with community outpatient infusion venipuncture,observe the subjects"pain response and injury of hand skin hole.Results The experimental method of in the external vein,the meedle Angle is less than 30 degrees.and cor elation method,the inside of the vein,the needle Angle greater than 30 degrees,compared with the pain degree of puncture success rate have dif erences. Conclusion By the method of experiment,less damage to the skin and blood vessel wal s,patients can reduce pain.%目的探讨手背浅静脉穿刺的无痛或轻微疼痛的方法,提高静脉穿刺成功率,提高护理质量。方法分别采用手背中外部区静脉,针尖进针角度30º的两种穿刺法为1120例社区门诊输液患者进行静脉穿刺。观察受试者的疼痛反应及手背表皮针孔处的损伤变化。结果实验法(选择手背中外部区静脉,进针角度30º)相比疼痛程度、穿刺成功率较有差异。结论采用实验法对皮肤及血管壁的损伤较小,可提高穿刺成功率,减轻患者疼痛。

  15. Affect a Venous Indwelling Needle Puncture Success Rate of Age Factor Analysis%影响静脉留置针一次穿刺成功率的年龄因素分析

    Institute of Scientific and Technical Information of China (English)

    陈绍惠; 段眀媛; 邵文娟; 廉云晖

    2015-01-01

    目的:通过分析不同年龄静脉留置针穿刺成功的情况及原因,总结经验,探讨提高静脉留置针穿刺成功率的相关对策。方法采用责任护士收集资料法,问卷主要是影响静脉留置针穿刺成功的原因统计表。结果65岁以下患者一次穿刺成功率是82.5%,66~80岁患者穿刺成功率是70%,80岁以上患者穿刺成功率是55%。相关统计学分析,65岁以下患者静脉留置针穿刺成功率高于其他年龄段差异有统计学意义(P<0.05)。结论患者年龄影响静脉留置针一次穿刺成功率,并且随着年龄增高,静脉留置针一次穿刺成功率呈降低趋势。该研究作者通过分析相关影响因素,提出改进措施,助于临床借鉴。%Objective To analyze the impact venous indwelling catheter reasons for the success, lessons learned, find ways to improve the success rate of venous indwelling catheter related countermeasures. Methods The responsibility of nurses to collect data using the method, check our department venous indwelling catheter treatment of the three age groups, 40 cases investigated. Questionnaire mainly affecting venous indwelling catheter reasons for the success statistics. Results 65 patients under the age puncture success rate was 82.5% in patients 66 to 80 years the success rate was 70%, 80-year-old patient success rate over 55%. Relevant statistical analysis, 65 patients under the age venous indwelling catheter was statistically significant success rate than other age groups (P<0.05). Conclusions Age vein catheter puncture success rate, and increased with age, intravenous catheter puncture success rate decreasing. The author through analysis of relevant factors, suggest im-provements, help clinical reference.

  16. Ultrasound guidance for brachial plexus block decreases the incidence of complete hemi-diaphragmatic paresis or vascular punctures and improves success rate of brachial plexus nerve block compared with peripheral nerve stimulator in adults

    Institute of Scientific and Technical Information of China (English)

    YUAN Jia-min; YANG Xiao-hu; FU Shu-kun; YUAN Chao-qun; CHEN Kai; LI Jia-yi; LI Quan

    2012-01-01

    Background The use of traditional techniques (such as landmark techniques,paresthesia and peripheral nerve stimulator) for upper-limb anesthesia has often been restricted to the expert or enthusiast,which was blind.Recently,ultrasound (US) has been applied to differ blood vessel,pleura and nerve,thus may reduce the risk of complications while have a high rate of success.The aim of this study was to determine if the use of ultrasound guidance (vs.peripheral nerve stimulator,(PNS)) decreases risk of vascular puncture,risk of hemi-diaphragmatic paresis and risk of Horner syndrome and improves the success rate of nerve block.Methods A search strategy was developed to identify randomized control trials (RCTs) reporting on complications of US and PNS guidance for upper-extremity peripheral nerve blocks (brachial plexus) in adults available through PubMed databases,the Cochrane Central Register of Controlled Trials,Embase databases,SinoMed databases and Wanfang data (date up to 2011-12-20).Two independent reviewers appraised eligible studies and extracted data.Risk ratios (OR)were calculated for each outcome and presented with 95% confidence intervals (CI) with the software of ReviewManager 5.1.0 System (Cochrane Library).Results Sixteen trials involving 1321 adults met our criteria were included for analysis.Blocks performed using US guidance were more likely to be successful (risk ratio (RR) for block success 0.36,95% CI 0.23-0.56,P <0.00001),decreased incidence of vascular puncture during block performance (RR 0.13,95% CI 0.06-0.27,P <0.00001),decreased the risk of complete hemi-diaphragmatic paresis (RR 0.09,95% CI 0.03-0.52,,P=0.0001).Conclusions US decreases risks of complete hemi-diaphragmatic paresis or vascular puncture and improves success rate of brachial plexus nerve block compared with techniques that utilize PNS for nerve localization.Larger studies are needed to determine whether or not the use of US can decrease risk of neurologic complications.

  17. Influence of puncture site and methods for phlebitis caused by amiodarone%穿刺部位及方法对胺碘酮致静脉炎的影响

    Institute of Scientific and Technical Information of China (English)

    曹利芸

    2011-01-01

    Objective To study the correlation between the different puncture site and methods and of the incidence of phlebitis caused by amiodarone. Methods 90 patients treated with amiodarone were selected as research object. The incidence of phlebitis caused by amiodarone at different puncture site and methods, concentration of amiodarone, injection time were analyzed. Results The incidence of phlebitis of upper limbs vein was lower than that of the other position.The incidence of phlebitis of central venous was lower than that of peripheral vein. The incidence of phlebitis of micropump was higher than that of the other methods. The incidence of phlebitis injected with longer time was higher than that of the shorter. The incidence of phlebitis at high-concentration amiodarone was higher than that of lower-concentration amiodarone. Conclusion The different puncture site and methods are related to the incidence of phlebitis.%目的 探讨不同穿刺部位及方法与胺碘酮致静脉炎的发生率的相关性.方法 选取胺酮进行治疗的90例患者为研究对象,将穿刺部位、穿刺方法及胺碘酮浓度、注射时间不同时静脉炎的发生率进行统计和比较.结果 颈外静脉炎发生率较其他部位要低,微泵注药静脉炎发生率高于其他方式,注药时间长者静脉炎发生率高于短者,胺碘酮浓度高者静脉炎发生率高于低浓度者,经比较,差异均有显著性(均P<0.05).结论 不同穿刺部位及方法与胺碘酮致静脉炎的发生率相关性较大,应引起重视,以预防静脉炎的发生.

  18. 侧后路椎间孔镜穿刺定位器的设计与模拟%Design and Simulation of the Puncture Guiding Device for Transforaminal Percutaneous Endoscopic Discectomy

    Institute of Scientific and Technical Information of China (English)

    张帆; 潘磊; 薛厚军; 区耀南; 谢华相

    2016-01-01

    目的:依据投影原理以及多种设计理念设计不同侧后路椎间孔镜定位装置。并通过模拟装配,直观展示这种装置设计理念。方法:1.使用ITK-SNAP等软件通过逆向工程技术建立人体腰椎段的数字模型,并模拟穿刺验证原理;2.以此为依据在UG NX 7.0中采用由顶向下设计侧后路椎间孔镜定位多种装置,利用装配功能观察其最终效果。结果与结论:建立了包含腰椎的人体数字模型两个,依据相同的原理不同的理念设计出3套设计方案,装配观察其结构、尺寸设计合理,达到了预期目的,为后续工作打下良好基础。%Objective: To design various puncture guiding device for transforaminal percutaneous endoscopic discectomy based on the same principle of x-ray projection with Top-Down design technique. And to intuitively display the concept of this device through the three-dimensional assembly simulation aided by computer. Methods: 1.Adopt ITK-SNAP and Meshlab software to reconstructure 3D digital model of the lumbar segment of human body through reverse engineering technology, and simulate the procedure of puncture. 2.Adopt UG NX software to design puncture guiding device based on the reconstructured 3D digital model with Top-Down design technique, and observe the final effect through the three-dimensional assembly simulation. Results and Conclusions: Two sets of 3D digital model were established, which enbodied main anatomy structure of the lumbar segment of human body. Three various sets of design solution which were based on the same principle were established, and the assembly simulation were accomplished. The 3D digital model established is limpid and vivid. The size and concept of design is reasonable.

  19. Clinical research on the treatment of acne with blood-letting puncturing and cupping%刺络拔罐治疗痤疮临床研究进展

    Institute of Scientific and Technical Information of China (English)

    田楠; 陶晓雁; 周宇; 谢朝霞

    2012-01-01

    痤疮,中医称为"粉刺",其病因病机主要为素体湿热内蕴,加之感受风邪.刺络拔罐法是刺络放血与拔罐相结合的一种中医疗法,具有通经活络、清热解毒、消痈散结之功效.回顾近5年相关临床研究文献,刺络拔罐法治疗痤疮有效率高,且简便易行,配合针刺、耳针、电针、火针、中药等方法,使痤疮的治疗手段更加丰富,疗效更显著.但存在放血量、留罐时间、疗程长短及证型分类不统一,远期疗效评价少见,机理研究缺乏等问题.%In traditional Chinese medicine, acne has a name called "Fen Ci" , its etiology and pathogenesis is innate endoretention of damp heat in the body, and combined with being caught by wind pathogen. Blood-letting puncturing and cupping is a kind of Chinese medical therapy which combination of meridian-pricking therapy and cupping therapy, its effect is dredging the meridian passage, heat-clearing and detoxicating, subduing inflammation and eliminating stagnation. Through reviewing related articals in the field of blood-letting puncturing and cupping treatment on acne, we conclude that this therapy is effective, and it is more effective to combined acupuncture, ear point acupuncture, electric needling, fire needling therapy, drugs with blood-letting puncturing and cupping. But mechanism research is lacked, long-time effect study is rared. And the volume of bleeding, lasting time of cupping, treatment frequency, and classification of syndrome need to be given unified standards.

  20. Optimization of Dynamic Balance for the Puncturing and Stirring Mechanism of Sewing Machine Based on Response Surface Method%基于响应面法的平缝机刺布挑线机构动平衡优化

    Institute of Scientific and Technical Information of China (English)

    周长江; 刘亚辉; 吴长德

    2013-01-01

    In order to improve dynamic performance and reduce the vibration produced by high-speed industrial sewing machine,a method of dynamic balance and optimization was applied to improve the key mechanisms,the puncturing and stirring mechanism,of the sewing machine.A dynamic model of puncturing and stirring mechanism was built in the dynamic simulation of mechanical system.The sensitivity of each variable on the analysis target-RMS of the vibration force and vibration moment was analyzed.Response surface approximate models,which express the approximate relationship between the design parameters and the analysis target,were established and verified.The reasonable values for weight coefficients were assigned and confirmed to build the optimal mathematical model.The optimization of sewing machine was carried out by means of optimizing parameters,such as mass and placement of the mass centroid of mechanism,based on MIGA.The vibration force and vibration moment of the puncturing and stirring mechanism were significantly improved after optimization.The optimization results indicate that these methods have high accuracy and validity,which has reference value for solving the vibration and noise of complex mechanical systems such as high-speed industrial sewing machine.%为改善高速工业平缝机的动态性能,降低其振动响应,对其关键机构——刺布挑线机构进行动平衡优化.建立了该机构的动力学模型,以振动力和振动力矩的均方根值为分析目标,考察设计变量对分析目标的灵敏度.基于最优拉丁超立方的试验设计建立分析目标的响应面模型并进行可靠性验证,选择合适的权重系数,建立优化数学模型.采用多岛遗传算法,通过改变构件的质心坐标位置及质量等参数对机构进行优化.优化后机构振动力和振动力矩等有明显改善,表明该方法具有较高的精确性与有效性,对改善如高速平缝机等复杂机械系统的动态特性有一定的参考价值.

  1. Application of Ultrasound to Determine the Puncture Site for Combined Spinal-epidural Anaesthesia in Cesarean Section%超声引导定位技术在剖宫产手术腰硬联合麻醉中的应用

    Institute of Scientific and Technical Information of China (English)

    王前; 尹橙; 王天龙

    2012-01-01

    目的 探讨超声引导定位技术在剖宫产手术腰硬联合麻醉中的应用价值.方法 分析76例超声引导定位下麻醉穿刺的择期剖宫产病例.其中体质量指数BMI≥30 kg/m2的40例(肥胖组40例),BMI<30 kg/m2的36例(非肥胖组36例).比较两组患者L3~4椎间隙穿刺成功率、一次穿刺成功率、穿刺次数、穿刺时间、穿刺深度以及穿刺点出血、误入蛛网膜下腔、神经损伤或神经异感等麻醉相关并发症的发生率.结果 两组患者L3~4椎间隙穿刺成功率均为100%,两组患者穿刺次数及穿刺时间无显著差异.肥胖组患者穿刺深度明显大于非肥胖组(P<0.05),非肥胖组患者一次穿刺成功率显著高于肥胖组(P<0.05).两组患者麻醉并发症的发生率无统计学差异.结论 超声引导定位技术使剖宫产手术腰硬联合麻醉穿刺点的定位可视化、准确化,显著提高了肥胖孕妇腰硬联合麻醉的穿刺质量.%Objective To evaluate the value of ultrasound to determine the puncture site for combined spinal-epidural anesthesia in cesarean section. Methods Seventy-six parturients underwent elective cesarean section under combined spinal-epidural anesthesia were retrospectively analysed. The parturients were divided into two groups according to their body mass index (BMI). In all the parturients, the puncture site was identified by a lumbar ultrasound scanning. The success rate of puncture, the puncture attempts, the depth of the epidural space, the puncture time and the complications related to puncture were recorded. Results All the patients were successful at the L3?4 interspinal space. There was no significant difference in the number of puncture attempts, as well as the puncture time. The successful rate of the first puncture attempt was higher in the non-obese group than that in the obese group (P<0. 05). The depth of the epidural space was deeper in the obese group than that in the non-obese group. Conclusions

  2. 小剂量右美托咪定滴鼻用于中心静脉穿刺术的效果评价%Application of small dose of dexmedetomidine nasal drops in bedside central venous puncture

    Institute of Scientific and Technical Information of China (English)

    邓默; 李璐

    2015-01-01

    Objective To investigate the effect of small dose of dexmedetomidine nasal drops central venous puncture in clinical efifcacy and safety. Method 60 cases of bedside in patients with central venous puncture were randomly divided into observation group and control group, 30 cases in each group. Observation group patients before operation by nasal instillation of 0.5μg/kg dexmedetomidine, bilateral average drops, control group were treated by nasal instillation of placebo saline nose drops, operations were performed in 15 minutes prior to the start of operation. Recorded and compared between the two groups of patients with Ramsay sedation scores, visual analogue scale (VAS) after the operation of mini mental state examination scores, McGill scores, the occurrence of adverse reactions and preoperative, postoperative (MMSE) scores. Result Ramsay sedation scores in observation group significantly higher than control group, VAS, McGill scores were significantly lower than control group, the difference was signiifcant (P0.05). The two groups of patients before and after operation, MMSE scores between groups, within group comparisons showed no signiifcant difference (P>0.05). Conclusion Small dose dexmedetomidine intranasal for bedside central venous puncture, can play a mild sedative and analgesic action, brought to the puncture operation discomfort of patient satisfaction is good, without the occurrence of adverse reactions of respiratory inhibition, safe and reliable, worthy of popularization and application.%目的:探讨小剂量右美托咪定滴鼻用于中心静脉穿刺术的临床效果及安全性。方法将60例床旁中心静脉穿刺术患者随机分为观察组和对照组,每组各30例。观察组患者操作前经鼻滴入0.5μg/kg右美托咪定,双侧平均滴入,对照组患者经鼻滴入安慰剂-生理盐水,滴鼻操作均在操作前15分钟进行。记录并比较两组患者术中Ramsay镇静评分,术后视觉模拟评分法

  3. The clinical research of oral administration of dimethicone tablets at different times after renal puncture%肾穿刺术后不同时间口服消胀药物对腹胀的影响

    Institute of Scientific and Technical Information of China (English)

    张金萍; 张杰

    2011-01-01

    Objective To explore the clinical effect of oral administration of dimethicone tablets at different times on abdominal distension after renal puncture.Methods Using the cluster-sampling method,211patients were divided into three groups.Group 5h,group 6 h and group 7 h were given dimethicone tablets orally at 5 h,6 h,7 h after renal puncture,respectively.The degree of abdominal distension and comfort were analyzed and compared.Results The incidence of abdominal distension in group 6 h ( x2 =5.64,P =0.000)and group 7 h ( x2 =4.65,P =0.000) was lower than in group 5 h,which was not significantly different between group 6 h and 7 h ( X2 =1.38,P =0.169).The score of the discomfort degree relating to abdominal distension were (5.17 ±0.92),(6.53 ±0.74) and (5.89 ±0.75),respectively.The differences were significant(F=49.53,P < 0.01 ).Conclusions Oral administration of dimethicone tablets at 6h after renal puncture can release the abdominal distension effectively,improve the comfortable degree.It is the optimal medication time of dimethicone tablets after renal puncture.%目的 探讨肾穿刺术后不同时间口服二甲硅油片消胀药物对术后腹胀的影响,为临床护士执行医嘱提供依据.方法 运用观察研究法,对211例接受肾穿刺术的患者按方便抽样法分为3组,分别于肾穿刺术后5,6,7h口服二甲硅油片,分析比较术后腹胀程度和舒适度.结果5h组与6h组患者腹胀发生率差异有统计学意义(x2 =5.64,P=0.000);5 h组与7h组患者腹胀发生率差异有统计学意义(x2 =4.65,P=0.000);6 h组与7h组患者腹胀发生率差异无统计学意义(x2=1.38,P=0.169);5 h组、6h组和7h组患者的舒适度分别为(5.17±0.92)分、(6.53±0.74)分和(5.89±0.75)分,差异有统计学意义(F=49.53,P<0.01).结论 肾穿刺术后6h应用消胀药物,可降低腹胀的发生,提高患者的舒适度,是较为合适的服药时间.

  4. Influence of three puncture sites of in utero electroporation on embryonic cortex development%不同穿刺点行子宫内电转对小鼠胚胎皮层发育的影响

    Institute of Scientific and Technical Information of China (English)

    张鹏; 吴翠莹; 陶庆霞; 牛力军; 陈文锦; 刘宁; 徐如祥

    2015-01-01

    目的:探讨子宫内电转技术操作过程中三种不同的穿刺点对胚胎死亡率、皮层厚度和皮层面积,以及细胞分化、增殖、迁移和细胞凋亡的影响。方法通过应用免疫荧光染色对Tbr1,Tbr2,Pax6,Ctip2,Caspase-3和Ki67等标记物的检测分析,评价三种不同穿刺点对细胞分化、增殖、迁移和细胞凋亡的影响。应用SPSS13.0软件使用单因素方差分析的方法对分化、增殖和凋亡实验中的细胞数量进行统计分析。结果三种不同的穿刺点无论对胚胎死亡率、皮层厚度和皮层面积,还是细胞分化、增殖、迁移和细胞凋亡的影响均无统计学意义(P>0.05)。结论三种不同的穿刺点对宫内电转胚胎无显著性影响。%Objective To compare the influence of three different puncture sites of in utero electroporation on the death rate of mice embryos, the thickness and the area of cortex, cell differentiation, cell proliferation, cell migration and cell apoptosis. Methods It groups on the bases of common puncture sites as follows: 1. electric shock only (control); 2. injection near the posterior fontanel, at about one millimeter (here, group A);3. injection along the antero-posterior axis into the cephalic ventricle (group B); and 4. injection near the midpoint between the anterior fontanel and posterior fontanel, at about three millimeters (group C). We compared the four groups using littermate mice, and repeated the experiment with 5 pregnant mice. To detect whether different injection positions affect cell differentiation, cell proliferation, cell migration and cell apoptosis, we stained cells with anti-Tbr1, anti-Tbr2, anti-Pax6 anti-Ctip2, anti- Caspase-3 and anti-Ki67. In differentiation, proliferation, and apoptosis assays, the cell number was analyzed with SPSS 13.0 software, using one way ANOVA. Results We found no statistical significant differences between the three puncture methods in the death rate of embryos, the

  5. The clinical application of CT-guided craniocerebral puncture biopsy:initial experience in 23 cases%CT引导下颅脑穿刺活检术23例

    Institute of Scientific and Technical Information of China (English)

    刘健; 刘瑞青; 曹会存; 王振豫; 曹广劭; 刘诗义; 李天晓

    2015-01-01

    Objective To investigate the diagnostic value of CT-guided craniocerebral puncture biopsy, and to discuss its clinical safety. Methods During the period from April 2013 to June 2014 at authors’ hospital CT-guided craniocerebral puncture biopsy was carried out in 23 patients. All patients had clinical symptoms or signs of nervous system. Imaging examination revealed that all patients had intracranial space-occupying lesions. CT-guided craniocerebral puncture biopsy was performed to make pathological or bacteriological examinations. The results were statistically analyzed. Results In this group of patients, definite pathological diagnosis was made in 19 cases, biopsy positive diagnosis rate of biopsy was 82.6% (19/23), among them oncology-pathological diagnosis was obtained in 14 cases (60.9%), mainly including glioma, non-Hodgkin lymphoma, dysembryoplastic neuroepithelial tumor, choroid plexus papillary tumor, epidermoid cyst, etc. Non-neoplastic lesion was confirmed in 5 cases (21.7%), including suppurated meningitis, cerebral gliosis hyperplasia, cerebral telangiectasis, etc. Small amount of subdural hemorrhage was observed in one case (4.3%). No severe complications, such as intracranial infection or epilepsy, occurred in all patients. Conclusion CT-guided craniocerebral puncture biopsy is minimally-invasive with fewer complications, it can provide definite diagnosis for intracranial lesions, therefore, this technique has a broad development prospect in clinical practice.%目的:探讨CT引导下颅脑占位穿刺活检术对神经系统疾病的诊断意义及安全性。方法2013年4月至2014年6月行CT引导下行颅脑占位穿刺活检术共23例。所有患者均具有神经系统临床症状或体征,影像学检查提示颅内占位。 CT引导下颅脑占位穿刺活检术行病理学或细菌学检查,对其结果进行分析。结果本组患者中明确病理诊断19例,活检阳性诊断率82.6%(19/23)。其中14例(60.9%)

  6. Cleaning Effect of Different Methods for Reusable Puncture Needles%强化清洗流程对可复用穿刺针清洗效果的应用观察

    Institute of Scientific and Technical Information of China (English)

    陈付华; 葛多云; 马民; 陈靖; 张淑琴

    2012-01-01

    目的 为改进复用穿刺针清洗效果,对比两种不同清洗流程方法对复用穿刺针的清洗效果,观察研究超声加酶清洗流程的优越性,确保无菌物品的灭菌质量.方法 将回收来的可复用的骨穿针、腰穿针100根随机分成两组,对照组和实验组各50根.对照组清洗方法为常规预处理加手工清洗;实验组在常规预处理之后,将穿刺针置于全效多酶洗液中用超声清洗机以70 ~ 100 kHz频率清洗5 min.结果 通过专业检测、目测及使用光源放大镜检查,对照组合格率84%,实验组合格率98%,两组比较经x2检验差异有统计学意义(P<0.05).结论 对于管腔狭小的穿刺针,消毒时在常规预处理清洗的基础上,采用多酶液预处理配合超声清洗,污渍残留清除彻底,清洗合格率高,能保证可复用穿刺针灭菌质量.%Objective To improve the cleaning effect for reusable puncture needles by comparing the effect of two different cleaning methods. Methods One hundred recycled reusable hone marrow biopsy/aspiration needles and lumbar puncture needles were randomly divided into two groups,each group had fifty needles. In the control group traditional pretreatment and handed cleaning were used;while in the experiment group the needles were pretreated and then dipped in multiple enzyme detergents washed by ultrasonic cleaner at 70 -100 kHz for five minutes. Results The results of the special gauging, visual inspection and magnification inspection revealed that the cleanliness pass rate was90% in the control group and 98% in the experimental group, the difference was significant by chi-square test(P<0.05). Conclusion For the puncture needles with a narrow cavity,the ultrasonic cleaner with multiple enzyme detergents can thoroughly clear away the residual stains with high pass rate of cleaning, so it can guarantee the cleaning quality of reusable puncture needles.

  7. 经皮心包穿刺术进行室性心律失常心外膜标测和消融的应用体会%Application of pericardial puncture for mapping and ablation of ventricular arrhythmias

    Institute of Scientific and Technical Information of China (English)

    薛玉梅; 詹贤章; 廖洪涛; 方咸宏; 魏薇; 刘洋; 廖自立; 邓海; 吴书林

    2015-01-01

    目的:总结经皮心包穿刺技术应用于室性心律失常( VA)心外膜标测和消融的有效性和安全性。方法回顾性分析2010年4月至2014年10月在广东省人民医院心内科经剑突下行心包穿刺术( Sosa法)进行心外膜标测的40例VA患者,男28例,女12例,平均年龄(46±13)岁。合并非缺血性心肌病(NICM)16例,致心律失常性右心室心肌病(ARVC)11例,缺血性心肌病(ICM)3例,特发性VA 10例。分析患者穿刺术中、消融过程中及围术期出现的并发症、原因及处理策略,并总结穿刺、标测和消融过程如何避免潜在的并发症。结果所有患者均穿刺成功,其中25例患者1次穿刺成功,15例经过2次以上穿刺成功;右心室前壁路径15例,下壁路径25例。共35例(87.5%)患者消融成功,其中15例仅在心外膜消融成功;14例行心外膜-心内膜联合消融成功;另有6例经过心内膜-心外膜联合标测提示VA并非起源于心外膜,于心内膜消融成功。2例NICM合并的室性心动过速(室速)患者心内外膜联合消融失败,2例特发性室性早搏(室早)患者因靶点靠近冠状动脉而放弃消融;1例穿刺致冠状动脉损伤而放弃消融。共13例(32.5%)患者发生并发症,包括穿刺针进入右心室6例(15%),退出后未造成后果;心包出血2例(5%),经引流后痊愈;导丝进入胸膜腔2例(5%),退出后未造成后果;迟发心脏压塞1例(2.5%),经引流后治愈;冠状动脉损伤并急性心脏压塞1例,经外科手术修补成功;1例患者术后有发热,对症处理后好转。结论经皮心包穿刺行心外膜标测和消融有助于提高器质性心脏病VA消融成功率,虽然目前并发症发生率还较高,但及时发现和正确处理,多数可避免出现严重后果。%Objective To evaluate the effects and safety of pericardial puncture for epicardial mapping and ablation of ventricular arrhythmias(VA). Methods We retrospectively studied 40 patients

  8. 个体化心理干预对肾穿刺患者舒适度的影响%The influence of individual psychological intervention on the comfort level of patients with kidney puncture

    Institute of Scientific and Technical Information of China (English)

    田凤玲

    2011-01-01

    目的 探讨个体化心理干预对肾穿刺患者舒适度的影响.方法 将31例患者随机分成干预组和对照组,干预组在实施常规护理的同时实施个体化心理干预,对比两种护理方法对患者术后舒适度的影响.结果 个体化心理干预后患者的焦虑、恐惧程度明显降低,提高了患者的舒适度.结论 通过个体化心理干预可缓解患者的焦虑程度,提高患者的舒适度,提高穿刺成功率,减少并发症的发生.%Objective To discuss the influence of individual psychological intervention on the comfort level of patients with kidney puncture. Methods Thirty - one patients were divided into intervention group and the control group. The intervention group implemented the individual psychology intervention, together with conventional nursing. The effects of the two nursing methods on the comfort level of patients were compared. Results After the intervention, patients' anxiety and fear decreased significantly, and patients' comfort level has been improved. Conclusion The individual psychological intervention may alleviate patients' anxiety and fear, enhance patients' comfort level, raise the puncture success ratio, and reduce the complication occurrence.

  9. Study of Deep Venous Puncture Catheter Placement in Rescuing Blood Shock Patients%深静脉穿刺置管术在抢救失血休克患者的临床研究

    Institute of Scientific and Technical Information of China (English)

    曾明昊

    2013-01-01

      目的:对深静脉穿刺置管术在抢救失血休克患者临床进行研究。方法:选自我院自2009年12月~2011年12月期间急诊收治的应用深静脉穿刺置管术救治的失血性休克患者30例,对其采用深静脉穿刺置管术进行救治。结果:30例病人28例恢复有效循环血容量,2例患者因其病情过于严重,失血量过多导致救治无效死亡。结论:对于失血性休克及时救治可以帮助患者提高生存率,且深静脉穿刺置管术在抢救失血休克患者的效果是显著的,值得在临床上推广。%Objective:To study of effect of deep venous puncture catheter placement on rescuing blood shock patients. Methods:We select 30 cases of patients who come to the emergency department of our hospital during December 2009 to Decembe2011, and all of them suffering from blood shock patients and all the patients were recused by deep venous puncture catheter placement .Results:28 patients among the 30 patients returned to the effective circulating blood volume ,and other two patients are death because of their serious disease and their excessive hemorrhage volume. Conclusion:The uncontrolled hemorrhagic shock for timely treatment can help patients to improve survival rates, and the effect of deep vein in rescuing patients with hemorrhagic shock is significant and is worth developing in clinical practice.

  10. 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。

  11. 组合式骨肿瘤穿刺活检套钳设计与应用%Design and application of the combined type bone tumor puncture biopsy clamper

    Institute of Scientific and Technical Information of China (English)

    王荣诗; 黄迅; 魏剑

    2013-01-01

    目的 探讨"组合式骨肿瘤穿刺活检套钳"专利技术对四肢骨肿瘤活检应用效果及价值评估.方法 设计由齿形髓核钳、定位导向套管及针芯组合构成的"组合式骨肿瘤穿刺活检套钳",应用该实用新型专利技术对12例四肢骨肿瘤或肿瘤样病变穿刺活检,通过主动钳夹机制获取足量骨肿瘤组织.结果 12例取材成功率达100%(12/12),活检准确率91.7%(11/12),活检手术未发生并发症.结论 组合式骨肿瘤穿刺活检套钳设计简单,成本低,节省医疗费用,准确率高.%Objective To evaluate the clinical effect of the combined type bone tumor puncture biopsy clamper. Methods With proprietary technology, the tooth shape nucleus pulposus clamp, core needle and special guide sleeve were designed. 12 cases of the limb bone tumors were undergone biopsy with the technology. Results The draw materials successful rate was 100% ( 12/12 ) in 12 cases. The biopsy diagnostic accuracy rate was 91. 7% ( 11/12 ). No complication happened. Conclusions The combined type bone tumor puncture biopsy clamper is simple, cheap and effective.

  12. 平刺三阴交治疗原发性夜间遗尿42例%Forty-two cases of primary nocturnal enuresis treated with horizontal puncture on Sānyīnjiāo(三阴交SP 6)

    Institute of Scientific and Technical Information of China (English)

    袁红丽; 张建立; ZHANG Nan

    2010-01-01

    @@ The author had treated 42 cases of primary nocturnal enuresis with horizontal puncture on Sānyīnjiāo(三阴交SP 6) under her teacher's guidance from 2008 to 2010.The therapeutic outcomes are reported as follows.

  13. 基于多目标粒子群优化算法的斜尖柔性针穿刺路径规划%Puncture Path Planning for Bevel-tip Flexible Needle Based on Multi-objective Particle Swarm Optimization Algorithm

    Institute of Scientific and Technical Information of China (English)

    霍本岩; 赵新刚; 韩建达; 徐卫良

    2015-01-01

    针对斜尖柔性针在复杂环境下由入针点到达病灶位置的穿刺路径问题,提出一种基于多目标粒子群优化算法(MOPSO)的路径规划方法。对软组织内柔性针运动学模型进行分析,构建控制量与柔性针穿刺路径的关系;分析障碍物约束,建立障碍物约束的数学描述;然后,根据穿刺术的要求将穿刺精度、穿刺危险性和穿刺路径长度作为柔性针穿刺优化目标,将柔性针穿刺路径规划问题转化为多目标优化问题;建立了相应的多目标优化问题的数学模型,使用多目标粒子群优化算法对模型进行优化求解。最后通过仿真实验证明了所提方法的有效性,并仿真分析了穿刺路径的在线修正问题。%A path planning algorithm based on multi-objective particle swarm optimization (MOPSO) is proposed to plan the puncture path of bevel-tip flexible needles from the start point to the target in a complex environment. The flexible needle kinematic model in soft tissues is analyzed, and the relationship between the puncture path and controlled variables is established. Then a mathematical description of obstacles is built based on the constraint conditions of obstacles. After that, the path planning problem is transformed into a multi-objective optimization problem whose optimization objectives include puncture error, puncture danger and puncture length according to the clinical requirements of puncture. Thus, a mathematical model of the multi-objective optimization problem is set up, and MOPSO algorithm is employed to solve the multi-objective optimization problem. Finally, simulations are performed to demonstrate the effectiveness of the proposed method, and the online modification of puncture paths is analyzed.

  14. 握指式手背静脉穿刺在老年患者中的护理效果研究%Is Refers to the Type of Hand Vein Puncture in Research on Nursing Ef-fect in Elderly Patients

    Institute of Scientific and Technical Information of China (English)

    左莉芳

    2016-01-01

    Objective To study the nursing effect of hand hand vein puncture in elderly patients. Methods Selected our hospital in September 2014 to 2015 August during the 300 elderly hospitalized patients, according to the venous trans-fusion date order points for 150 cases in each group. The observation group and the control group, take grip means and fist of all patients were punctured, the 5.5 scalp needle for hand vein puncture, the observation group application grip refers to the type of venous puncture. Control group used fist style of venous puncture and control two group of puncture of satisfaction degree and puncture a success probability. Results The observation group with grip means of patients with venous puncture success rate was 95%, control group used the fist style of patients with venous puncture success-ful rate was 75%, the satisfaction of the two groups of venous puncture were 93% and 84%, compared to the two sets of results P < 0.05, showing the difference with statistical significance. Conclusion It is easier to achieve success by us-ing finger manipulation in nursing, and it can improve patient satisfaction.%目的:研究握指式手背静脉穿刺在老年患者中的护理效果。方法选取该院2014年9月―2015年8月期间的300例老年住院患者,按静脉输液日期顺序分为每组150例的观察组和对照组,采取握指式和握拳式对全部患者进行穿刺,采用5.5号头皮针进行手背静脉穿刺,观察组应用握指式进行静脉穿刺,对照组应用握拳式进行静脉穿刺,对照两组穿刺的满意程度和穿刺一次成功的几率。结果观察组采用握指式对患者进行静脉穿刺的成功率是95%,对照组采用握拳式对患者进行静脉穿刺的成功率是75%,两组静脉穿刺的满意程度分别是93%和84%,对比两组结果P﹤0.05,显示的差异有统计学意义。结论在护理中采用握指式手法对患者进行静脉穿刺更容易取得成功,而且能

  15. Application of Single Hand Operation in the Needle Puncture of Peripheral Venous Indwelling Needle in Outpatient Department of Pediatrics%单手操作在儿科门诊外周静脉留置针穿刺中的应用

    Institute of Scientific and Technical Information of China (English)

    方玲君; 李丽琴

    2016-01-01

    Objective To discuss how to effectively improve the effciency of nursing work under the premise of ensuring the success rate of puncture. Methods 400 cases of children with intravenous indwelling needle in every single day were randomly divided into observation group and control group. In the control group, two persons completed the needle puncture, and the observation group was conducted by a single needle puncture. Observed the difference of the success rate of puncture in the two groups.ResultsThere was no signiifcant difference in success rate between the observation group and the control group (P>0.05).Conclusion The single hand operation can guarantee success rate of puncture in children and improve the effciency of nurses.%目的:讨论如何在保证穿刺成功率的前提下有效提高护士工作效率。方法将400例小儿静脉留置针的患儿按照单双日随机分为观察组和对照组。对照组由两人完成留置针穿刺工作,观察组由单人完成留置针穿刺工作。观察两组在穿刺成功率上的差异。结果观察组和对照组在穿刺成功率上没有统计学差异(P>0.05)。结论单手操作在保证患儿穿刺成功率的同时,更够有效提高护士的工作效率。

  16. Application of C-arm CT-guided targeted puncturing technique in performing non-vascular interventional procedures%C臂CT引导经皮靶向穿刺术在非血管介入诊疗中的应用

    Institute of Scientific and Technical Information of China (English)

    何玉圣; 周春泽; 吕维富

    2014-01-01

    Objective To investigate the clinical value of C-arm CT-guided targeted puncturing technique in performing non-vascular interventional procedures.Methods DSA-guided percutaneous puncturing biopsy or interventional therapy was performed in 33 patients, and the clinical effect and complication were observed and analyzed.Results Percutaneous puncturing interventional therapy was performed successfully in 15 patients,and percutaneous puncturing biopsy was performed in 18 patients and pathological results were obtained in 17 pa-tients.Conclusion The percutaneous targeted puncturing technique with C-arm CT-guidance combines the advantages of both CT and X-ray,which can meet the need of accuracy,efficiency and safety in non-vascular interventional therapy.%目的:探讨C臂CT引导下靶向穿刺技术在非血管介入诊疗中的应用价值。方法33例患者在DSA引导下行经皮穿刺活检术或经皮穿刺介入治疗,观察分析临床效果、并发症等。结果经皮穿刺介入治疗15例,均取得成功,另外18例为经皮穿刺病理活检,17例取得明确病理结果。结论 C臂CT引导下靶向穿刺技术实现了CT和X线透视优势互补,达到精确、高效、安全的非血管介入诊疗要求,值得推广应用。

  17. 经皮髋臼成形术穿刺部位的解剖学研究%Anatomic study on the puncture point of the percutaneous acetabular reconstruction

    Institute of Scientific and Technical Information of China (English)

    蒋昆利; 梁清福; 王俊江; 田征

    2016-01-01

    目的:从解剖学角度探讨经皮髋臼成形术治疗髋臼转移瘤患者手术入路的最佳穿刺点、深度。方法选用30具经防腐固定处理的成人去肌肉骨盆髋关节标本和2具完整成人尸体标本。以髋臼中点为 O 点,过髂前上棘和 O 点做1条直线,再做1条过 O 点且垂直于该直线的直线,2条直线分别与髋臼边缘交于 A、B 点,并把髋臼分为4个象限。∠AOB 的角平分线与髋臼边缘交于 C 点。设髋臼顶点为0时,测量大转子顶点所在水平面与 A、B、C 各点所在水平面的垂直距离及 A、B、C 3点在髋臼边缘外10 mm 相对应 A’、B’、C’3点处的髋臼后壁厚度。根据测量的数据得出最佳穿刺点和深度,对2具完整尸体标本行髋臼穿刺操作并灌注骨水泥验证。结果A’点位于大转子顶点上方31.6~38.4 mm,男性平均34.9 mm,女性平均34.2 mm;B’点位于与 A’点相同距离的10~11点钟位置;C’点位于转子顶点上方33.8~42.5 mm,男性平均距离36.7 mm,女性35.5 mm 的0点钟位置。A’、B’、C’对应的体表投影点即为穿刺部位。其穿刺深度分别为6.7~8.4、17.7~20.4、14.7~17.9 mm,平均深度约分别为7.5、18.5、16.5 mm。经验证髋臼成形术最佳进针点结果成立。结论A’、B’、C’3点的体表投影点均可为行髋臼成形术的穿刺点,3个穿刺点可以较短距离到达髋臼后上象限区的肿瘤。%Objective To discuss the optimal puncture point and depth of percutaneous acetabulum forming operation for treatment of acetabular tumor on the basis of anatomical angle.Methods 30 adult pelvis and hip specimens without muscle fixed with formol and 2 complete cadavers were anatomized and measured. Set the central of acetabulum as point O,from the point O,let a vertical line intersected line which went through the point of spina iliaca anterior superior and the point O

  18. Anatomic basis and application experience of the puncture technique through anterolateral cervical approach%颈椎前外侧入路穿刺技术的解剖学基础及应用体会

    Institute of Scientific and Technical Information of China (English)

    单建林; 姜恒; 王崇伟; 张阳; 王飞; 李放

    2013-01-01

    Objective To explore the anatomical basis,safty and manipuility of the puncture technique through anterolateral cervical approach.Methods Twenty two embalmed cadavers and 50 patients who underwent operation through anterolateral cervical approach were used to observe the cervical anatomical characteristics.During the cadaver dissection and operation,the following information was observed:the movement of the carotid sheath while the visceral sheath was pushed left,the features of interspace between the two sheaths at each cervical level,the movement of the esophagus and the interfascial space in which the esophagus moved while the trachea was pushed medially,and the movement of the carotid sheath while it was pushed medially and laterally.From January 2007 to December 2011,206 patients diagnosed as cervical discogenic pain or cervical vertigo were treated by radiofrequency using puncture technique through anterolateral cervical approach,including 93 males and 113 females,aged from 22 to 71 years (average,48years).A total of 434 discs were involved.Results Both in cadaver dissection and in operation,the following results were observed:there was no natural interspace between the carotid sheath and visceral sheath below the C4 level,as a result,manual separation was needed to create a interspace between the two sheaths for the puncture; the two layers of the prevertebral fascia could be separated easily; keeping the visceral sheath intact,the esophagus moved following the trachea when the latter was pushed medially,and the movement of the visceral sheath relative to the cervical vertebra occurred between the two layers of prevertebral fascia; the carotid sheath was primarily constituted by continuation of the prevertebral fascia,as a result,the movement of the carotid sheath was limited by its own tension and the prevertebral fascia.A total of 434 cases of puncture to cervical disc were performed smoothly with no complications related to the carotid artery

  19. 经皮穿刺手动调压脉冲射频模式治疗颈椎间盘突出症%THE CLINICAL EFFECTS OF PERCUTANEOUS PUNCTURE MANUAL VOLTAGE REGULATION PULSED RADIOFREQUENCY MODE ON CERVICAL DISC HERNIATION

    Institute of Scientific and Technical Information of China (English)

    吴大胜; 刘娜; 宫小文; 宋永光

    2012-01-01

    Objective: To evaluate the clinical effects of percutaneous puncture manual voltage regulation pulsed radiofrequency mode on the treatment cervical disc herniation. Methods: From August 2010 to September 2011, 112 patients with cervical disc herniation were given with percutaneous puncture manual voltage regulation pulsed radiofrequency mode guided through C arm X-ray machine, CT or DSA. The visual analogue scale (VAS) score and clinical effects were recorded before and after treatment. Results: After 3 d the treatment, the excellent cases were 96, the good cases were 14, and the bad cases were 2, the excellent and good rate was 98.2%. There were 2 bad cases because the doctor failed to grasp the good indication. Compared with pre-operation (7.8 ± 0.4), the VAS at 3 d after operation (1.5 ± 0.3) was decreased (P < 0.05). Conclusion: Percutaneous puncture manual voltage regulation pulsed radiofrequency mode therapy is a suitable treatment for cervical disc herniation, with the advantages of simple operation, easy to master, small trauma, not influencing the stability of spine biomechanics, no serious complications.%目的:评估手动调压脉冲射频模式治疗颈椎间盘突出症的临床可行性.方法:2010年8月~2011年9月,112例颈椎间盘突出症患者,在C型臂X线机、CT或DSA引导下接受经皮穿刺手动调压脉冲射频模式治疗.观察并记录术前后的视觉模拟评分(visual analogue scale,VAS),并进行疗效评估.结果:本组112例患者,经过该技术治疗后3d,其中96例治疗效果达优级,14例治疗效果良好,2例效果差,优良率98.2%.其中,效果较差的2例是因为未把握好适应症.与术前VAS评分(7.8±0.4)相比,术后3天VAS评分(1.5±0.3)降低(P<0.05).结论:经皮穿刺手动调压脉冲射频模式治疗颈椎间盘突出症具有操作简单、易于掌握、创伤小、不影响脊柱生物力学稳定性、无严重并发症等特点.是一种可供临床选用的、效果确切又较

  20. The Clinical Research on Treatment of Maxillo-Facial Spacial Infection by Ultrasonography-guided Puncture%超声引导下穿刺治疗颌面间隙感染的临床研究

    Institute of Scientific and Technical Information of China (English)

    刘晖

    2014-01-01

    Objective:To explore the clinical effect of the patients suffering from maxillo-facial spacial infection in treatment of ultrasonography-guided puncture. Method:The 90 patients suffering from maxillo-facial spacial infection who were receiving treatment in the hospital from December 2010 to December 2012 were selected. According to random number table,the patients were averagely divided into group A1 and group A2,each group of 45 cases. The patients in group A1 were treated by ultrasonography-guided puncture,and the patients in group A2 were treated by antibacterial agents. The patients in two groups would be compared in the total effective rate and response time. Result:The effective time of A1 group was(6.9±1.7)days while the A2 group was(10.6±2.1)days after treatment,and the difference between the two groups were statistically significant(P<0.05). The effective rate of the A1 group was 97.78%while the A2 group was 44.44%after treatment,and the difference between the two groups were statistically significant(P<0.05). Conclusion:Patients suffering from maxillo-facial spacial infection are treated by ultrasonography puncture,treatment effect is exact and the infection is controlled effectively.%目的:探讨颌面间隙感染患者在超声引导下完成穿刺治疗的效果。方法:选取本院2010年12月-2012年12月颌面间隙感染患者90例,通过随机数表法将所有患者平均分成A1组与A2组,每组45例。A1组患者通过超声引导完成穿刺治疗,A2组患者采用抗菌药物进行治疗。比较A1组、A2组患者治疗的总有效率以及治疗的显效时间等。结果:A1组患者完成治疗后显效时间为(6.9±1.7)d,A2组为(10.6±2.1)d,两组比较差异有统计学意义(P<0.05)。A1组治疗总有效率为97.78%,A2组为44.44%,两组比较差异有统计学意义(P<0.05)。结论:针对颌面间隙感染患者,通过超声引导对患者进行穿刺治疗,最终患者的临床治疗

  1. 小细胞类乳腺癌细针穿刺细胞形态学观察%Cell morphological observation of small cell breast cancer by fine needle puncture

    Institute of Scientific and Technical Information of China (English)

    付春林; 李军川; 胡艳; 凌象红

    2012-01-01

    目的:探讨小细胞类乳腺癌细针穿刺的细胞形态学特点及鉴别诊断.方法:观察33例小细胞类乳腺癌细针穿刺细胞学涂片与93例乳腺纤维腺瘤和76例乳腺增生症并进行对照分析.结果:小细胞类乳腺癌中,细胞排列紊乱、松散,以散在或小细胞群为主,易见腺腔样、腺管样、炮竹式、栅栏状、单列纵队样排列,圆形核细胞占绝大多数,核质比明显减小,散在细胞易见、圆形核占多数、胞质完整,未见肌上皮细胞的相对病例数,均明显高于乳腺纤维腺瘤、乳腺增生症的相对病例数,差异均有统计学意义(P<0.05);细胞量中等以上的相对病例数,明显高于乳腺增生症,差异有统计学意义(P<0.05);纤维间质及其与乳腺上皮细胞混杂的相对病例数,明显低于乳腺纤维腺瘤,差异均有统计学意义(P<0.05).结论:小细胞类乳腺癌具有不同于乳腺纤维腺瘤和乳腺增生症的细针穿刺细胞形态学特点,与乳腺纤维腺瘤、乳腺增生症可以鉴别.%Objective; To explore the cell morphological characteristics and differential diagnosis of small cell breast cancer by fine needle puncture. Methods: The cytological smears of 33 cases with small cell breast cancer were observed, then the results were compared with those of 93 cases with breast fibroadenoma and 76 cases with breast hyperplasia. Results: The cytological smears of 33 cases with small cell breast cancer showed that the distribution of cells was disorder and loose, diffuse cells and small cell mass dominated, the glandular cavities , glandular tubes, firecrackers, fences, and single columns arranged, most of the cells were round nucleic cells, the nucleoplasm reduced significantly, diffuse cells were easily to be found, most of the cells had round nuclei, and cytoplasm was intact, the relative number of cases without myoepithelial cells was statistically significantly higher than those of cases with breast

  2. 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

  3. Clinical observation of ozone laser combined with puncture needle in the treatment of 58 patients with cervical spondylosis%臭氧激光联合穿刺针治疗颈椎病58例观察

    Institute of Scientific and Technical Information of China (English)

    顾柯; 闫宇邱; 于龙; 李岩; 刘文立; 郭洋; 魏武

    2011-01-01

    Objective: To study the therapeutic effects and safety of patent technology ozone laser combined with puncture needle in the treatment of cervical spondylosis. Methods: 58 patients with cervical spondylosis received the treatment of patent technology ozone laser combined with puncture needle (hereafter referred to as combined needle) in our department from August 2008 to February 2010. VAS score changes before and 6 months after surgery and MacNab score criteria 6 months after surgery were analyzed. Results: After 6 to 9 months' follow-up, the VAS score of preoperative neck and shoulder pain was (6.57±1.34) scores. The VAS score of 1-week postoperative neck and shoulder pain was (1.80±0.65) scores and those of 1, 3 and 6 months were all 0 (0-2) scores. The VAS score of postoperative neck and shoulder pain obviously reduced compared with that of preoperative (H= 1.680, P=0.000), and the VAS scores of postoperative neck and shoulder pain in 6 months showed no significant rebound. 6-month follow-up showed that 29 patients were excellent, 23 good and 6 fair, with the excellent and good rate of 89.6% (52/58). Conclusion: Ozone laser combined with puncture needle for the treatment of cervical spondylosis is safe and effective.%目的:研究专利技术臭氧激光联合穿刺针治疗颈椎病的疗效和安全性.方法:对我科2008年8月~2010年2月收治的58例颈椎病患者,应用专利技术臭氧激光联合穿刺针(以下简称联合针)进行臭氧激光联合治疗,分析术前及术后6个月内VAS评分的变化及术后6个月MacNab评分标准.结果:随访6~9个月,术前颈肩痛VAS评分为(6.57±1.34)分,术后1周VAS评分(1.80±0.65)分,术后颈肩痛VAS评分较术前有明显降低(H=61.680,P=0.000),术后1、3、6个月VAS评分均为0(0~2)分,术后6个月内颈肩痛VAS评分无明显反弹.6个月随访时29例优,23例良,6例可,优良率为89.6%(52/58).结论:激光臭氧联合穿刺针介入治疗颈椎病安全且疗效显著.

  4. Analysis on Causes and Prevention of Septic Shock Caused by Puncture Biopsy in Patients with Prostate Cancer%前列腺癌穿刺活检导致感染性休克的原因及预防

    Institute of Scientific and Technical Information of China (English)

    李娟; 郭广亚; 周莉

    2015-01-01

    Objective To explore the causes and preventive measures of septic shock caused by puncture biopsy in pa-tients with prostate cancer.Methods 84 cases of patients with prostate cancer who received puncture biopsy were divided into shock group and non-shock group,the pathogenic biological characteristics of patients with septic shock was observed,the single factor and multivariate logistic regression were used to analyse the factors affecting septic shock.Results The incidence of septic shock was 8.33%,and its occurrence time was 12-37 h after operation.11 strains of pathogenic bacteria were detected in 7 pa-tients with septic shock including gram negative bacteria accounting for 72.73% and gram positive bacteria accounting for 27.27%.There were significant difference in age,diabetes plus,prostate infection plus,urinary tract infection plus,APACHEⅡscore and repeated puncture between the 2 groups (P<0.05).Combined prostate infection or urin