Chordoma with postoperative subcutaneous implantation and meningeal dissemination: MRI

International Nuclear Information System (INIS)

Kinoshita, T.; Okudera, T.; Shimosegawa, E.; Hatazawa, J.; Yoshida, Y.; Yasui, N.; Ogawa, T.

2001-01-01

Chordomas are histologically benign tumours which are locally invasive. We present an unusual case of recurrent chordoma with subcutaneous implantation and widespread meningeal dissemination after surgery. Contrast-enhanced MRI was useful for determining the extent of the tumour. (orig.)

Pharmacokinetics of nebulized and subcutaneously implanted terbinafine in cottonmouths (Agkistrodon piscivorus).

Science.gov (United States)

Kane, L P; Allender, M C; Archer, G; Leister, K; Rzadkowska, M; Boers, K; Souza, M; Cox, S

2017-10-01

Ophidiomyces ophiodiicola, the causative agent of snake fungal disease, is proposed as a serious threat to the conservation of several snake populations. The objective of this study was to determine the pharmacokinetic parameters of terbinafine administered through nebulization and a sustained subcutaneous implant as potential treatments of Ophidiomyces in reptiles. Seven adult cottonmouths (Agkistrodon piscivorus) were used in single-dose trials. Each snake was nebulized with terbinafine (2 mg/ml) for 30 min and had blood collected before nebulization and up to 12 hr after nebulization. Following a 5-month washout, the same snakes were administered a subcutaneous implant containing 24.5 mg terbinafine; blood was collected at baseline, 1 day postimplant placement, and then once weekly for 9 weeks. Plasma for both studies was analyzed by high-performance liquid chromatography. The mean plasma concentrations of nebulized terbinafine peaked between 0.5 and 4 hr. The subcutaneously implanted terbinafine reached therapeutic concentrations on day 1 and maintained therapeutic for over 6 weeks. These methods and doses are recommended as potential treatment options for snake fungal disease in reptiles. © 2017 John Wiley & Sons Ltd.

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

Energy Technology Data Exchange (ETDEWEB)

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

2012-08-15

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

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

International Nuclear Information System (INIS)

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

2010-01-01

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

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

International Nuclear Information System (INIS)

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

2009-01-01

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

Complications of an implantable venous access port: Prevention and treatment

Energy Technology Data Exchange (ETDEWEB)

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

2016-11-15

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

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

International Nuclear Information System (INIS)

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

2009-01-01

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

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

International Nuclear Information System (INIS)

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

2005-01-01

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

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

Science.gov (United States)

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

2017-01-01

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

Long-Term Clinical Outcomes of Subcutaneous Versus Transvenous Implantable Defibrillator Therapy

NARCIS (Netherlands)

Brouwer, Tom F.; Yilmaz, Dilek; Lindeboom, Robert; Buiten, Maurits S.; Olde Nordkamp, Louise R. A.; Schalij, Martin J.; Wilde, Arthur A.; van Erven, Lieselot; Knops, Reinoud E.

2016-01-01

Transvenous implantable cardioverter-defibrillators (TV-ICDs) improve survival in patients at risk for sudden cardiac death, but complications remain an important drawback. The subcutaneous ICD (S-ICD) was developed to overcome lead-related complications. Comparison of clinical outcomes of both

Warfarin affects acute inflammatory response induced by subcutaneous polyvinyl sponge implantation in rats.

Science.gov (United States)

Mirkov, Ivana; Popov Aleksandrov, Aleksandra; Demenesku, Jelena; Ninkov, Marina; Mileusnic, Dina; Kataranovski, Dragan; Kataranovski, Milena

2017-09-01

Warfarin (WF) is an anticoagulant which also affects physiological processes other than hemostasis. Our previous investigations showed the effect of WF which gained access to the organism via skin on resting peripheral blood granulocytes. Based on these data, the aim of the present study was to examine whether WF could modulate the inflammatory processes as well. To this aim the effect of WF on the inflammatory response induced by subcutaneous sponge implantation in rats was examined. Warfarin-soaked polyvinyl sponges (WF-sponges) were implanted subcutaneously and cell infiltration into sponges, the levels of nitric oxide (NO) and inflammatory cytokines tumor necrosis factor (TNF) and interleukin-6 (IL-6) production by sponge cells were measured as parameters of inflammation. T cell infiltration and cytokine interferon-γ (IFN-γ), interleukin-17 (IL-17) and interleukin-10 (IL-10) were measured at day 7 post implantation. Warfarin exerted both stimulatory and suppressive effects depending on the parameter examined. Flow cytometry of cells recovered from sponges showed higher numbers of granulocytes (HIS48 + cells) at days 1 and 3 post implantation and CD11b + cells at day 1 compared to control sponges. Cells from WF-sponges had an increased NO production (Griess reaction) at days 1 and 7. In contrast, lower levels of TNF (measured by ELISA) production by cells recovered from WF-soaked sponges were found in the early (day one) phase of reaction with unchanged levels at other time points. While IL-6 production by cells recovered from WF-soaked sponges was decreased at day 1, it was increased at day 7. Higher T cell numbers were noted in WF sponges at day 7 post implantation, and recovered cells produced more IFN-γ and IL-17, while IL-10 production remained unchanged. Warfarin affects some of the parameters of inflammatory reaction induced by subcutaneous polyvinyl sponge implantation. Differential (both stimulatory as well as inhibitory) effects of WF on

Combined leadless pacemaker and subcutaneous implantable defibrillator therapy: feasibility, safety, and performance

NARCIS (Netherlands)

Tjong, F. V. Y.; Brouwer, T. F.; Smeding, L.; Kooiman, K. M.; de Groot, J. R.; Ligon, D.; Sanghera, R.; Schalij, M. J.; Wilde, A. A. M.; Knops, R. E.

2016-01-01

The subcutaneous implantable cardioverter-defibrillator (S-ICD) and leadless pacemaker (LP) are evolving technologies that do not require intracardiac leads. However, interactions between these two devices are unexplored. We investigated the feasibility, safety, and performance of combined LP and

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

International Nuclear Information System (INIS)

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

2004-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2004-04-01

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

The effects of subcutaneous injection of nicotine on osseointegration of machined and anodized implants in rabbits.

Science.gov (United States)

Linden, Maria Salete Sandini; Bittencourt, Marcos Eugênio de; Carli, João Paulo De; Miyagaki, Daniela Cristina; Santos, Pâmela Letícia Dos; Paranhos, Luiz Renato; Groppo, Francisco Carlos; Ramacciato, Juliana Cama

2018-01-01

To evaluate the influence of subcutaneous injection nicotine in osseointegration process on different implant surfaces. Twenty-two male rabbits were distributed into two groups according to the subcutaneous injections: (1) nicotine 3 mg/day/kg and (2) 0.9 % NaCI 3 mL/day/kg, three times a day; subgroups were then designated-machined and anodized implants were placed in the right and left tibia bones, respectively. The animals were submitted euthanasia after periods of eight weeks to determine nicotine and cotinine levels, alkaline phosphatase and biomechanical analysis. The plasmatic levels of nicotine and cotinine were 0.5 ± 0.28 ng/mL and 9.5 ± 6.51 ng/mL, respectively. The alkaline phosphatase analyses in blood levels in control group were observed 40.8 ± 11.88 UI/L and 40.75 ± 12.46 UI/L, for the surfaces machined and anodized, respectively. In the test group was observed levels 37.9 ± 4.84 UI/L, for both implant surfaces. No significant differences were observed between control and test groups and between the implant surfaces regarding alkaline phosphatase blood levels. For biomechanics, no significant differences were observed in control group between the machined (25±8.46 Ncm) or anodized (31.2 ± 6.76 Ncm) implants. However, the treatment with nicotine induced higher torque than control in both machined (38.3 ± 13.52 Ncm) and anodized (35.5 ± 14.17 Ncm) implants, with p = 0.0024 and p = 0.0121, respectively. Subcutaneous injection of nicotine following implant insertion didn't have effect on osseointegration, independently from the implant surface.

Biocompatibility of Subcutaneously Implanted Plant-Derived Cellulose Biomaterials.

Science.gov (United States)

Modulevsky, Daniel J; Cuerrier, Charles M; Pelling, Andrew E

2016-01-01

There is intense interest in developing novel biomaterials which support the invasion and proliferation of living cells for potential applications in tissue engineering and regenerative medicine. Decellularization of existing tissues have formed the basis of one major approach to producing 3D scaffolds for such purposes. In this study, we utilize the native hypanthium tissue of apples and a simple preparation methodology to create implantable cellulose scaffolds. To examine biocompatibility, scaffolds were subcutaneously implanted in wild-type, immunocompetent mice (males and females; 6-9 weeks old). Following the implantation, the scaffolds were resected at 1, 4 and 8 weeks and processed for histological analysis (H&E, Masson's Trichrome, anti-CD31 and anti-CD45 antibodies). Histological analysis revealed a characteristic foreign body response to the scaffold 1 week post-implantation. However, the immune response was observed to gradually disappear by 8 weeks post-implantation. By 8 weeks, there was no immune response in the surrounding dermis tissue and active fibroblast migration within the cellulose scaffold was observed. This was concomitant with the deposition of a new collagen extracellular matrix. Furthermore, active blood vessel formation within the scaffold was observed throughout the period of study indicating the pro-angiogenic properties of the native scaffolds. Finally, while the scaffolds retain much of their original shape they do undergo a slow deformation over the 8-week length of the study. Taken together, our results demonstrate that native cellulose scaffolds are biocompatible and exhibit promising potential as a surgical biomaterial.

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

International Nuclear Information System (INIS)

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

2011-01-01

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

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

Science.gov (United States)

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

2010-04-01

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

Biocompatibility of Subcutaneously Implanted Plant-Derived Cellulose Biomaterials

Science.gov (United States)

Pelling, Andrew E.

2016-01-01

There is intense interest in developing novel biomaterials which support the invasion and proliferation of living cells for potential applications in tissue engineering and regenerative medicine. Decellularization of existing tissues have formed the basis of one major approach to producing 3D scaffolds for such purposes. In this study, we utilize the native hypanthium tissue of apples and a simple preparation methodology to create implantable cellulose scaffolds. To examine biocompatibility, scaffolds were subcutaneously implanted in wild-type, immunocompetent mice (males and females; 6–9 weeks old). Following the implantation, the scaffolds were resected at 1, 4 and 8 weeks and processed for histological analysis (H&E, Masson’s Trichrome, anti-CD31 and anti-CD45 antibodies). Histological analysis revealed a characteristic foreign body response to the scaffold 1 week post-implantation. However, the immune response was observed to gradually disappear by 8 weeks post-implantation. By 8 weeks, there was no immune response in the surrounding dermis tissue and active fibroblast migration within the cellulose scaffold was observed. This was concomitant with the deposition of a new collagen extracellular matrix. Furthermore, active blood vessel formation within the scaffold was observed throughout the period of study indicating the pro-angiogenic properties of the native scaffolds. Finally, while the scaffolds retain much of their original shape they do undergo a slow deformation over the 8-week length of the study. Taken together, our results demonstrate that native cellulose scaffolds are biocompatible and exhibit promising potential as a surgical biomaterial. PMID:27328066

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

Science.gov (United States)

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

2017-03-01

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

Subcutaneously Placed Breast Implants after a Skin-Sparing Mastectomy: Do We Always Need ADM?

Directory of Open Access Journals (Sweden)

Apresh Singla, MBBS, MSc

2017-07-01

Full Text Available Background:. Immediate breast reconstruction is an acceptable treatment option after mastectomy for prophylaxis of early breast cancer. Different options exist for implant placement, incision technique, patient suitability, and institutional experience. This article is a case series exploring the feasibility and outcomes of patients undergoing immediate breast reconstruction using skin-sparing mastectomy without mesh or acellular dermal matrix (ADM and with a vertical inframammary incision. Methods:. A single-institution retrospective analysis was performed for all patients who underwent immediate single-stage reconstruction with subcutaneous silicon implants without ADM between 2009 and 2014 inclusive. Patient, operative and treatment variables were extracted. All patients with viable mastectomy skin flaps intraoperatively and at least 5 mm of subcutaneous tissue were eligible except for patients who were deemed too slim by the senior surgeon preoperatively and thus at risk of implant visibility or skin rippling. Results:. There were 26 patients (bilateral n = 12 and unilateral n = 14 eligible for analysis, with a median long-term follow-up of 51.5 months. The majority of complications were classified as minor affecting 46.2% of the cohort (n = 12. There were 20 episodes of complications overall. The most frequent episodes were contour defects (x = 5, minor seroma (x = 4, and malrotation and minor infection (x = 3. There was 1 episode of capsular contracture. Conclusion:. Skin-sparing mastectomy with immediate subcutaneous silicon implant reconstruction with a vertical incision and without the need for mesh or ADM is an acceptable and safe treatment option. Accurate patient selection and skin flap viability is the key to achieving optimal outcomes with this approach.

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-06-15

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

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

International Nuclear Information System (INIS)

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

2012-01-01

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

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

International Nuclear Information System (INIS)

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

2000-01-01

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

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

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

2015-09-30

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

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

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

2017-03-15

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

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

International Nuclear Information System (INIS)

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

2017-01-01

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

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

Science.gov (United States)

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

2017-03-01

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

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

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

2017-12-01

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

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

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

2016-02-01

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

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

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

2013-02-01

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

Biocompatibility of a new nanomaterial based on calcium silicate implanted in subcutaneous connective tissue of rats

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Petrović Violeta

2012-01-01

Full Text Available The aim of the study was to investigate rat connective tissue response to a new calcium silicate system 7, 15, 30 and 60 days after implantation. Twenty Wistar albino male rats received two tubes half-filled with a new calcium silicate system (NCSS or MTA in subcutaneous tissue. The empty half of the tubes served as controls. Five animals were sacrificed after 7, 15, 30 and 60 days and samples of the subcutaneous tissue around implanted material were submitted to histological analysis. The intensity of inflammation was evaluated based on the number of inflammatory cells present. Statistical analysis was performed using one way ANOVA and Holm Sidak's multiple comparison tests. Mild to moderate inflammatory reaction was observed after 7, 15 and 30 days around a NCSS while mild inflammatory reaction was detected after 60 days of implantation. In the MTA group, mild to moderate inflammatory reaction was found after 7 and 15 days while mild inflammatory reaction was present after 30 and 60 days. There was no statistically significant difference in the intensity of inflammatory reactions between the tested materials and control groups in any experimental period (ANOVA p>0.05. Regarding the intensity of inflammatory reactions at different experimental periods, a statistically significant difference was observed between 7 and 30 days, 7 and 60 days and 15 to 60 days for both materials. For the controls, a statistically significant difference was found between 7 and 60 days and 15 and 60 days of the experiment (Holm Sidak < p 0.001. Subcutaneous tissue of rats showed good tolerance to a new calcium silicate system. Inflammatory reaction was similar to that caused by MTA. [Projekat Ministarstva nauke Republike Srbije, br. 172026

Long-term evaluation of degradation and foreign-body reaction of subcutaneously implanted poly(DL-lactide-epsilon-caprolactone)

NARCIS (Netherlands)

denDunnen, WFA; Robinson, PH; vanWessel, R; Pennings, AJ; vanLeeuwen, MBM; Schakenraad, JM

1997-01-01

The aim of this study was to evaluate the degradation and foreign-body reaction of poly(DL-lactide-epsilon-caprolactone) (PLA(85)CL(50)) bars. This specific biomaterial is used for the construction of nerve guides, which can be used in the reconstruction of short nerve gaps. Subcutaneously implanted

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

International Nuclear Information System (INIS)

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

2000-01-01

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

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

International Nuclear Information System (INIS)

Etezadi, Vahid; Trerotola, Scott O.

2017-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2017-04-15

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

Effect of defibrillation threshold testing on effectiveness of the subcutaneous implantable cardioverter defibrillator.

Science.gov (United States)

Peddareddy, Lakshmi; Merchant, Faisal M; Leon, Angel R; Smith, Paige; Patel, Akshar; El-Chami, Mikhael F

2018-06-12

Defibrillation threshold (DFT) testing is recommended with the subcutaneous ICD (SICD). To describe first shock efficacy for appropriate SICD therapies stratified by the presence of implant DFT testing. We reviewed all patients receiving SICDs at our institution and stratified them based on whether implant DFT testing was performed. Appropriate shocks were reviewed to see if ventricular tachycardia/ventricular fibrillation (VT/VF) terminated with a single shock. First shock efficacy was stratified by implant DFT status. 178 patients implanted with SICDs and followed in our center were included in this study. Of these, 135 (76 %) underwent DFT testing (DFT (+) group). In the DFT (+) 80 appropriate shocks were needed to treat 69 episodes of VT/VF. The first shock was effective in 61 out of 69 episodes (88.4 %), whereas multiple shocks were required to terminate VT/VF in the remaining 8 episodes. Among 43 patients without implant DFT testing (DFT (-) group), 20 appropriate shocks to treat 17 episodes of VT/VF occurred in 7 patients. VT/VF was successfully terminated with the first shock in 16 out of 17 episodes (first shock efficacy 94.1 %). There was no significant difference in first shock effectiveness between those with and without implant DFT testing (p = 0.97). A strategy that omits DFT testing at implant did not appear to compromise the effictiveness of the SICD. These data suggest that routine DFT testing at SICD implant might not be necessary. Randomized trials are needed to confirm this finding. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Host inflammatory response to polypropylene implants: insights from a quantitative immunohistochemical and birefringence analysis in a rat subcutaneous model

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Alessandro Prudente

2016-06-01

Full Text Available ABSTRACT Objectives To describe acute and sub acute aspects of histological and immunohistochemical response to PP implant in a rat subcutaneous model based on objective methods. Materials and Methods Thirty rats had a PP mesh subcutaneously implanted and the same dissection on the other side of abdomen but without mesh (sham. The animals were euthanized after 4 and 30 days. Six slides were prepared using the tissue removed: one stained with hematoxylin-eosin (inflammation assessment; one unstained (birefringence evaluation and four slides for immunohistochemical processing: IL-1 and TNF-α (pro-inflammatory cytokines, MMP-2 (collagen metabolism and CD-31 (angiogenesis. The area of inflammation, the birefringence index, the area of immunoreactivity and the number of vessels were objectively measured. Results A larger area of inflammatory reaction was observed in PP compared to sham on the 4th and on the 30th day (p=0.0002. After 4 days, PP presented higher TNF (p=0.0001 immunoreactivity than sham and no differences were observed in MMP-2 (p=0.06 and IL-1 (p=0.08. After 30 days, a reduction of IL-1 (p=0.010 and TNF (p=0.016 for PP and of IL-1 (p=0.010 for sham were observed. Moreover, area of MMP-2 immunoreactivity decreased over time for PP group (p=0.018. Birefringence index and vessel counting showed no differences between PP and sham (p=0.27 and p=0.58, respectively. Conclusions The implantation of monofilament and macroporous polypropylene in the subcutaneous of rats resulted in increased inflammatory activity and higher TNF production in the early post implant phase. After 30 days, PP has similar cytokines immunoreactivity, vessel density and extracellular matrix organization.

Evaluation of Subcutaneous Phenobarbital Administration in Hospice Patients.

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Hosgood, Jessica Richards; Kimbrel, Jason M; McCrate Protus, Bridget; Grauer, Phyllis A

2016-04-01

Phenobarbital is used in hospice and palliative care to treat refractory symptoms. In end-of-life care, Food and Drug Administration approved routes of administration may be unreasonable based on patients' status. In these cases, phenobarbital may be administered subcutaneously for symptom management. However, according to the American Hospital Formulary Service, subcutaneous administration of commercially available injectable phenobarbital is cautioned due to possible skin reactions. This study evaluates the tolerability of phenobarbital administered subcutaneously. Of 69 patients and 774 distinct subcutaneous phenobarbital injections, 2 site reactions were recorded (2.9% of patients; 0.3% of injections). Both were mild, grade 1 reactions. Each patient continued to receive subcutaneous phenobarbital via newly placed ports with no additional reactions. Based on these findings, phenobarbital appears to be well tolerated when administered subcutaneously. © The Author(s) 2014.

In Vitro Investigation of a Terbinafine Impregnated Subcutaneous Implant for Veterinary Use

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M. J. Souza

2012-01-01

Full Text Available A terbinafine impregnated subcutaneous implant was evaluated to determine if drug was released into isotonic saline over the course of 6 months at two different temperatures, 37°C and 4°C. These temperatures were chosen to simulate the nonhibernating (37°C and hibernating body (4°C temperatures of little brown bats (Myotis lucifugus. Insectivorous bats of North America, including little brown bats, have been devastated by white nose syndrome, a fungal infection caused by Geomyces destructans. No treatments exist for bats infected with G. destructans. Implants were placed into isotonic saline; samples were collected once per week and analyzed with HPLC to determine terbinafine concentrations. The mean amount of terbinafine released weekly across the 28 weeks was approximately 1.7 μg at 4°C and 4.3 μg at 37°C. Although significant differences in the amount released did occur at some time points, these differences were not consistently greater or less at either of the temperatures. This study showed that terbinafine was released from an impregnated implant over the course of 6 months at concentrations ranging from 0.02 to 0.06 μg/mL depending on temperature, which may be appropriate for little brown bats (Myotis lucifugus infected with Geomyces destructans, the etiologic agent of white nose syndrome.

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

International Nuclear Information System (INIS)

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

2011-01-01

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

Experience with the once-yearly histrelin (GnRHa subcutaneous implant in the treatment of central precocious puberty

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Katherine A Lewis

2008-12-01

Full Text Available Katherine A Lewis, Erica A EugsterDepartment of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, USAAbstract: In 2007, a hydrogel histrelin implant was approved for the treatment of children with central precocious puberty (CPP. Children with CPP commonly have reduced height potential due to premature closure of the epiphyseal growth plates from exposure to sex steroids. Gonadotropin-releasing hormone analog (GnRHa treatment halts puberty and allows for improvement of adult height. A hydrogel implant delivery system utilizing the potent GnRHa, histrelin, was first developed for use in men with prostate cancer. A once yearly histrelin subcutaneous implant was subsequently developed for the treatment of children with CPP. Studies to date have demonstrated safety, tolerability, and effectiveness of this treatment option in patients treated up to 2 years. The most common adverse effects of the implant relate to implant site pain or bruising. Cost of this treatment seems comparable to somewhat higher than the commonly used GnRHa treatment option, depot leuprolide. While long term studies are needed to establish continued efficacy and safety beyond 2 years of treatment, the histrelin implant appears to be an attractive option for GnRHa treatment in patients with CPP.Keywords: central precocious puberty, histrelin, implant, gonadotropin-releasing-hormone analogs

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

Science.gov (United States)

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

2016-12-01

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

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

Science.gov (United States)

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

2014-01-14

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

Device orientation of a leadless pacemaker and subcutaneous implantable cardioverter-defibrillator in canine and human subjects and the effect on intrabody communication

NARCIS (Netherlands)

Quast, Anne-Floor B. E.; Tjong, Fleur V. Y.; Koop, Brendan E.; Wilde, Arthur A. M.; Knops, Reinoud E.; Burke, Martin C.

2018-01-01

The development of communicating modular cardiac rhythm management systems relies on effective intrabody communication between a subcutaneous implantable cardioverter-defibrillator (S-ICD) and a leadless pacemaker (LP), using conducted communication. Communication success is affected by the LP and

Phase separation of in situ forming poly (lactide-co-glycolide acid) implants investigated using a hydrogel-based subcutaneous tissue surrogate and UV-vis imaging.

Science.gov (United States)

Sun, Yu; Jensen, Henrik; Petersen, Nickolaj J; Larsen, Susan W; Østergaard, Jesper

2017-10-25

Phase separation of in situ forming poly (lactide-co-glycolide acid) (PLGA) implants with agarose hydrogels as the provider of nonsolvent (water) mimicking subcutaneous tissue was investigated using a novel UV-vis imaging-based analytical platform. In situ forming implants of PLGA-1-methyl-2-pyrrolidinone and PLGA-triacetin representing fast and slow phase separating systems, respectively, were evaluated using this platform. Upon contact with the agarose hydrogel, the phase separation of the systems was followed by the study of changes in light transmission and absorbance as a function of time and position. For the PLGA-1-methyl-2-pyrrolidinone system, the rate of spatial phase separation was determined and found to decrease with increasing the PLGA concentration from 20% to 40% (w/w). Hydrogels with different agarose concentrations (1% and 10% (w/v)) were prepared for providing the nonsolvent, water, to the in situ forming PLGA implants simulating the injection site environment. The resulting implant morphology depended on the stiffness of hydrogel matrix, indicating that the matrix in which implants are formed is of importance. Overall, the work showed that the UV-vis imaging-based platform with an agarose hydrogel mimicking the subcutaneous tissue holds potential in providing bio-relevant and mechanistic information on the phase separation processes of in situ forming implants. Copyright © 2017 Elsevier B.V. All rights reserved.

Plasma Concentrations of Itraconazole, Voriconazole, and Terbinafine When Delivered by an Impregnated, Subcutaneous Implant in Japanese Quail ( Coturnix japonica ).

Science.gov (United States)

Souza, Marcy J; Redig, Patrick; Cox, Sherry K

2017-06-01

Aspergillosis is a common fungal infection in both wild and pet birds. Although effective antifungal medications are available, treatment of aspergillosis can require months of medication administration, which entails stressful handling one or more times per day. This study examined the delivery of the antifungal drugs itraconazole, voriconazole, and terbinafine to Japanese quail ( Coturnix japonica ) via an impregnated implant. Implants contained 0.5, 3, 8, or 24 mg of itraconazole, voriconazole, or terbinafine. The implants were administered subcutaneously over the dorsum and between the scapulae. Blood was collected from birds before and 2, 7, 21, 42, and 56 days after implant placement. Plasma was analyzed by high-performance liquid chromatography for concentrations of itraconazole, voriconazole, or terbinafine, as appropriate. During the course of the study, targeted terbinafine concentrations were achieved in some birds at various time points, but concentrations were inconsistent. Itraconazole and voriconazole concentrations were also inconsistent and did not reach targeted concentrations. Currently, the implant examined in this study cannot be recommended for treatment of aspergillosis in avian species.

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

International Nuclear Information System (INIS)

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

2014-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2014-08-15

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

Feasibility of subcutaneously implanted magnetic microarrays for site specific drug and gene targeting

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M. Babincová

2010-01-01

Full Text Available The magnetic nanoparticles play a crucial role as a drug carriers in the human body. The wedge like magnetic arrays creatinga strongly non-homogeneous magnetic field are considered as a useful way to focus magnetic nanoparticles functionalizedwith various drugs or genes to desired sites. The goal of this study is to develop a numerical model of drug targetingusing subcutaneously implanted magnetic microarrays. The Finite Element Method is applied to solve partial differentialequations describing electromagnetic field (Maxwell equations and motion of these particles in a given magnetic field isobtained solving set of ordinary differential equations expressed by Newton law of motion. The results are encouragingshowing the potential to target drug to the tumour cell locally, without unwanted side effects.

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

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Guiffant G

2014-09-01

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

Energy Harvesting by Subcutaneous Solar Cells: A Long-Term Study on Achievable Energy Output.

Science.gov (United States)

Bereuter, L; Williner, S; Pianezzi, F; Bissig, B; Buecheler, S; Burger, J; Vogel, R; Zurbuchen, A; Haeberlin, A

2017-05-01

Active electronic implants are powered by primary batteries, which induces the necessity of implant replacement after battery depletion. This causes repeated interventions in a patients' life, which bears the risk of complications and is costly. By using energy harvesting devices to power the implant, device replacements may be avoided and the device size may be reduced dramatically. Recently, several groups presented prototypes of implants powered by subcutaneous solar cells. However, data about the expected real-life power output of subcutaneously implanted solar cells was lacking so far. In this study, we report the first real-life validation data of energy harvesting by subcutaneous solar cells. Portable light measurement devices that feature solar cells (cell area = 3.6 cm 2 ) and continuously measure a subcutaneous solar cell's output power were built. The measurement devices were worn by volunteers in their daily routine in summer, autumn and winter. In addition to the measured output power, influences such as season, weather and human activity were analyzed. The obtained mean power over the whole study period was 67 µW (=19 µW cm -2 ), which is sufficient to power e.g. a cardiac pacemaker.

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

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Pil Young Jung

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2014-09-20

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

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

International Nuclear Information System (INIS)

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

2008-01-01

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

Catheter fracture of intravenous ports and its management.

Science.gov (United States)

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

2011-11-01

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

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

International Nuclear Information System (INIS)

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

1999-01-01

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

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

OpenAIRE

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

2014-01-01

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

Evaluation of acute cardiac and chest wall damage after shocks with a subcutaneous implantable cardioverter-defibrillator in swine

Science.gov (United States)

KILLINGSWORTH, CHERYL R.; MELNICK, SHARON B.; LITOVSKY, SILVIO H.; IDEKER, RAYMOND E.; WALCOTT, GREGORY P.

2013-01-01

Background A subcutaneous implantable cardioverter defibrillator (S-ICD) could ease placement and reduce complications of transvenous ICDs, but requires more energy than transvenous ICDs. Therefore we assessed cardiac and chest wall damage caused by the maximum energy shocks delivered by both types of clinical devices. Methods During sinus rhythm, anesthetized pigs (38±6 kg) received an S-ICD (n = 4) and five 80-Joule (J) shocks, or a transvenous ICD (control, n = 4) and five 35-J shocks. An inactive S-ICD electrode was implanted into the same control pigs to study implant trauma. All animals survived 24-hours. Troponin I and creatine kinase muscle isoenzyme (CK-MM) were measured as indicators of myocardial and skeletal muscle injury. Histopathological injury of heart, lungs, and chest wall was assessed using semi-quantitative scoring. Results Troponin I was significantly elevated at 4- and 24-hours (22.6±16.3 and 3.1±1.3 ng/ml; baseline 0.07±0.09 ng/ml) in control pigs but not in S-ICD pigs (0.12±0.11 and 0.13±0.13 ng/ml; baseline 0.06±0.03 ng/ml). CK-MM was significantly elevated in S-ICD pigs after shocks (6544±1496 and 9705±6240 U/L; baseline 704±398 U/L) but not in controls. ECG changes occurred post-shock in controls but not in S-ICD pigs. The myocardium and lungs were histologically normal in both groups. Subcutaneous injury was greater in S-ICD compared to controls. Conclusion Although CK-MM suggested more skeletal muscle injury in S-ICD pigs, significant cardiac, lung, and chest wall histopathological changes were not detected in either group. Troponin I data indicate significantly less cardiac injury from 80-J S-ICD shocks than 35-J transvenous shocks. PMID:23713608

Involvement of COX-2 in nickel elution from a wire implanted subcutaneously in mice.

Science.gov (United States)

Sato, Taiki; Kishimoto, Yu; Asakawa, Sanki; Mizuno, Natsumi; Hiratsuka, Masahiro; Hirasawa, Noriyasu

2016-07-01

Many types of medical alloys include nickel (Ni), and the elution of Ni ions from these materials causes toxicities and inflammation. We have previously reported that inflammation enhances Ni elution, although the molecular mechanisms underlying this effect remain unclear. In this study, we investigated how inflammatory responses enhanced Ni elution in a wire-implantation mouse model. Subcutaneous implantation of Ni wire induced the expression of cyclooxygenase-2 (COX-2) and microsomal prostaglandin E synthase-1 (mPGES-1) mRNA in the surrounding tissues. Immunostaining analysis showed that cells expressing COX-2 were mainly fibroblast-like cells 8h after implantation of a Ni wire, but were mainly infiltrated leukocytes at 24h. NiCl2 induced the expression of COX-2 mRNA in primary fibroblasts, neutrophils, RAW 264 cells, and THP-1 cells, indicating that Ni ions can induce COX-2 expression in various types of cells. The elution of Ni ions from the implanted Ni wire at 8h was reduced by dexamethasone (Dex), indomethacin (Ind), or celecoxib (Cel) treatment. Ni wire implantation induced an increase in mRNA levels for anaerobic glycolytic pathway components glucose transporter 1 (GLUT1), hexokinase 2 (HK2), lactate dehydrogenase A (LDHA), and monocarboxylate transporter 4 (MCT4); the expression of these genes was also inhibited by Dex, Ind, and Cel. In primary fibroblasts, the expression of these mRNAs and the production of lactate were induced by NiCl2 and further potentiated by PGE2. Furthermore, Ni wire-induced infiltration of inflammatory leukocytes was significantly reduced by Dex, Ind, or Cel. Depletion of neutrophils with a specific antibody caused reduction of both leukocyte infiltration and Ni elution. These results indicate that Ni ions eluted from wire induced COX-2 expression, which further promoted elution of Ni ions by increasing lactate production and leukocyte infiltration. Since COX inhibitors and Dex reduced the elution of Ni ions, these drugs may be

Implante subcutáneo de un carcinoma hepatocelular tras la punción aspiración con aguja fina Subcutaneous seeding of hepatocellular carcinoma after fine-needle percutaneous biopsy

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D. Martínez Ramos

2007-06-01

Full Text Available Los implantes subcutáneos son una complicación rara tras la punción aspiración con aguja fina de los carcinomas hepatocelulares. Los autores describen un caso de implante subcutáneo neoplásico en una mujer de 70 años con cirrosis hepática por virus C complicada con un carcinoma hepatocelular. Se efectuó una punción aspiración con aguja fina en el segmento II hepático. El implante tumoral se desarrolló en el trayecto de la punción aspiración. La tumoración subcutánea fue extirpada quirúrgicamente y el estudio anatomopatológico confirmó que se trataba de un carcinoma hepatocelular bien diferenciado.Subcutaneous tumor seeding after fine-needle percutaneous biopsy for hepatocellular carcinoma is a rarely seen complication. The authors describe a case of subcutaneous neoplastic seeding in a 70-year-old woman with chronic hepatitis C virus complicated by hepatocellular carcinoma. Ultrasonically guided fine-needle aspiration biopsy was performed in segment II of the liver. The neoplastic seeding developed along the needle track used to carry out the fine-needle biopsy. The subcutaneous tumor was excised, and histological examination revealed a well-differentiated hepatocellular carcinoma.

Nanomaterial N-CP/DLPLG as potent1onal tissue graft in osteoreparation in combination with bone marrow cells on subcutaneous implantation model

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Janićijević Jelena M.

2008-01-01

Full Text Available The need for bone graft materials in osteoreparation is tremendous. Many researches have shown that calcium-phosphate bioceramics have good biocompatibility and osteoconductivity. We used nanocomposite biomaterial calcium phosphate coated with poly (dl-lactide-co-glycolide or N-CP/DLPLG. The goal of this investigation was to examine weather N-CP/DLPLG has ability to sustain growth of bone marrow cells after subcutaneous implantation in Balb/c mice. For that purpose N-CP/DLPLG implants with and without bone marrow cells (control were made. Implants were extracted after eight days and eight weeks. In implants loaded with bone marrow cells after eight days and eight weeks we observed fields rich in cells, angiogenesis and collagen genesis. These results showed that N-CP/DLPLG has property of tissue scaffold which sustain bone marrow cells growth and collagen production. This represents a good way for further examination of N-CP/DLPLG as potentional tissue scaffold in osteoreparation.

Histological and histomorphometrical analysis of a silica matrix embedded nanocrystalline hydroxyapatite bone substitute using the subcutaneous implantation model in Wistar rats

Energy Technology Data Exchange (ETDEWEB)

Ghanaati, Shahram; Orth, Carina; Barbeck, Mike; Kirkpatrick, Charles James [Institute of Pathology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55101 Mainz (Germany); Willershausen, Ines [Institute for Dental Material Sciences and Technology, University Medical Center of the Johannes Gutenberg University Mainz, Anselm-Franz-von-Bentzel-Weg 14, 55128 Mainz (Germany); Thimm, Benjamin W [Institute for Biomechanics, ETH Zuerich, Wolfgang-Pauli-Str.10, 8093 Zuerich (Switzerland); Booms, Patrick [Leeds Institute of Molecular Medicine, Section of Medicine, Surgery and Anaesthesia, University of Leeds (United Kingdom); Stuebinger, Stefan; Landes, Constantin; Sader, Robert Anton, E-mail: ghanaati@uni-mainz.d [Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Theodor-Stein-Kai 7, 60596 Frankfurt am Main (Germany)

2010-06-01

The clinical suitability of a bone substitute material is determined by the ability to induce a tissue reaction specific to its composition. The aim of this in vivo study was to analyze the tissue reaction to a silica matrix-embedded, nanocrystalline hydroxyapatite bone substitute. The subcutaneous implantation model in Wistar rats was chosen to assess the effect of silica degradation on the vascularization of the biomaterial and its biodegradation within a time period of 6 months. Already at day 10 after implantation, histomorphometrical analysis showed that the vascularization of the implantation bed reached its peak value compared to all other time points. Both vessel density and vascularization significantly decreased until day 90 after implantation. In this time period, the bone substitute underwent a significant degradation initiated by TRAP-positive and TRAP-negative multinucleated giant cells together with macrophages and lymphocytes. Although no specific tissue reaction could be related to the described silica degradation, the biomaterial was close to being fully degraded without a severe inflammatory response. These characteristics are advantageous for bone regeneration and remodeling processes.

Histological and histomorphometrical analysis of a silica matrix embedded nanocrystalline hydroxyapatite bone substitute using the subcutaneous implantation model in Wistar rats

International Nuclear Information System (INIS)

Ghanaati, Shahram; Orth, Carina; Barbeck, Mike; Kirkpatrick, Charles James; Willershausen, Ines; Thimm, Benjamin W; Booms, Patrick; Stuebinger, Stefan; Landes, Constantin; Sader, Robert Anton

2010-01-01

The clinical suitability of a bone substitute material is determined by the ability to induce a tissue reaction specific to its composition. The aim of this in vivo study was to analyze the tissue reaction to a silica matrix-embedded, nanocrystalline hydroxyapatite bone substitute. The subcutaneous implantation model in Wistar rats was chosen to assess the effect of silica degradation on the vascularization of the biomaterial and its biodegradation within a time period of 6 months. Already at day 10 after implantation, histomorphometrical analysis showed that the vascularization of the implantation bed reached its peak value compared to all other time points. Both vessel density and vascularization significantly decreased until day 90 after implantation. In this time period, the bone substitute underwent a significant degradation initiated by TRAP-positive and TRAP-negative multinucleated giant cells together with macrophages and lymphocytes. Although no specific tissue reaction could be related to the described silica degradation, the biomaterial was close to being fully degraded without a severe inflammatory response. These characteristics are advantageous for bone regeneration and remodeling processes.

Evaluation of acute cardiac and chest wall damage after shocks with a subcutaneous implantable cardioverter defibrillator in Swine.

Science.gov (United States)

Killingsworth, Cheryl R; Melnick, Sharon B; Litovsky, Silvio H; Ideker, Raymond E; Walcott, Gregory P

2013-10-01

A subcutaneous implantable cardioverter defibrillator (S-ICD) could ease placement and reduce complications of transvenous ICDs, but requires more energy than transvenous ICDs. Therefore we assessed cardiac and chest wall damage caused by the maximum energy shocks delivered by both types of clinical devices. During sinus rhythm, anesthetized pigs (38 ± 6 kg) received an S-ICD (n = 4) and five 80-Joule (J) shocks, or a transvenous ICD (control, n = 4) and five 35-J shocks. An inactive S-ICD electrode was implanted into the same control pigs to study implant trauma. All animals survived 24 hours. Troponin I and creatine kinase muscle isoenzyme (CK-MM) were measured as indicators of myocardial and skeletal muscle injury. Histopathological injury of heart, lungs, and chest wall was assessed using semiquantitative scoring. Troponin I was significantly elevated at 4 hours and 24 hours (22.6 ± 16.3 ng/mL and 3.1 ± 1.3 ng/mL; baseline 0.07 ± 0.09 ng/mL) in control pigs but not in S-ICD pigs (0.12 ± 0.11 ng/mL and 0.13 ± 0.13 ng/mL; baseline 0.06 ± 0.03 ng/mL). CK-MM was significantly elevated in S-ICD pigs after shocks (6,544 ± 1,496 U/L and 9,705 ± 6,240 U/L; baseline 704 ± 398 U/L) but not in controls. Electrocardiogram changes occurred postshock in controls but not in S-ICD pigs. The myocardium and lungs were histologically normal in both groups. Subcutaneous injury was greater in S-ICD compared to controls. Although CK-MM suggested more skeletal muscle injury in S-ICD pigs, significant cardiac, lung, and chest wall histopathological changes were not detected in either group. Troponin I data indicate significantly less cardiac injury from 80-J S-ICD shocks than 35-J transvenous shocks. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.

Radiologically-placed venous ports in children under venous anesthesia

International Nuclear Information System (INIS)

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

2015-01-01

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

Radiologically-placed venous ports in children under venous anesthesia

Energy Technology Data Exchange (ETDEWEB)

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

2015-02-15

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

A subcutaneous cellular implant for passive immunization against amyloid-β reduces brain amyloid and tau pathologies.

Science.gov (United States)

Lathuilière, Aurélien; Laversenne, Vanessa; Astolfo, Alberto; Kopetzki, Erhard; Jacobsen, Helmut; Stampanoni, Marco; Bohrmann, Bernd; Schneider, Bernard L; Aebischer, Patrick

2016-05-01

Passive immunization against misfolded toxic proteins is a promising approach to treat neurodegenerative disorders. For effective immunotherapy against Alzheimer's disease, recent clinical data indicate that monoclonal antibodies directed against the amyloid-β peptide should be administered before the onset of symptoms associated with irreversible brain damage. It is therefore critical to develop technologies for continuous antibody delivery applicable to disease prevention. Here, we addressed this question using a bioactive cellular implant to deliver recombinant anti-amyloid-β antibodies in the subcutaneous tissue. An encapsulating device permeable to macromolecules supports the long-term survival of myogenic cells over more than 10 months in immunocompetent allogeneic recipients. The encapsulated cells are genetically engineered to secrete high levels of anti-amyloid-β antibodies. Peripheral implantation leads to continuous antibody delivery to reach plasma levels that exceed 50 µg/ml. In a proof-of-concept study, we show that the recombinant antibodies produced by this system penetrate the brain and bind amyloid plaques in two mouse models of the Alzheimer's pathology. When encapsulated cells are implanted before the onset of amyloid plaque deposition in TauPS2APP mice, chronic exposure to anti-amyloid-β antibodies dramatically reduces amyloid-β40 and amyloid-β42 levels in the brain, decreases amyloid plaque burden, and most notably, prevents phospho-tau pathology in the hippocampus. These results support the use of encapsulated cell implants for passive immunotherapy against the misfolded proteins, which accumulate in Alzheimer's disease and other neurodegenerative disorders. © The Author (2016). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A CMOS self-powered front-end architecture for subcutaneous event-detector devices

CERN Document Server

Colomer-Farrarons, Jordi

2011-01-01

A CMOS Self-Powered Front-End Architecture for Subcutaneous Event-Detector Devices presents the conception and prototype realization of a Self-Powered architecture for subcutaneous detector devices. The architecture is designed to work as a true/false (event detector) or threshold level alarm of some substances, ions, etc. that are detected through a three-electrodes amperometric BioSensor approach. The device is conceived as a Low-Power subcutaneous implantable application powered by an inductive link, one emitter antenna at the external side of the skin and the receiver antenna under the ski

Stable subcutaneous cartilage regeneration of bone marrow stromal cells directed by chondrocyte sheet.

Science.gov (United States)

Li, Dan; Zhu, Lian; Liu, Yu; Yin, Zongqi; Liu, Yi; Liu, Fangjun; He, Aijuan; Feng, Shaoqing; Zhang, Yixin; Zhang, Zhiyong; Zhang, Wenjie; Liu, Wei; Cao, Yilin; Zhou, Guangdong

2017-05-01

In vivo niche plays an important role in regulating differentiation fate of stem cells. Due to lack of proper chondrogenic niche, stable cartilage regeneration of bone marrow stromal cells (BMSCs) in subcutaneous environments is always a great challenge. This study explored the feasibility that chondrocyte sheet created chondrogenic niche retained chondrogenic phenotype of BMSC engineered cartilage (BEC) in subcutaneous environments. Porcine BMSCs were seeded into biodegradable scaffolds followed by 4weeks of chondrogenic induction in vitro to form BEC, which were wrapped with chondrocyte sheets (Sheet group), acellular small intestinal submucosa (SIS, SIS group), or nothing (Blank group) respectively and then implanted subcutaneously into nude mice to trace the maintenance of chondrogenic phenotype. The results showed that all the constructs in Sheet group displayed typical cartilaginous features with abundant lacunae and cartilage specific matrices deposition. These samples became more mature with prolonged in vivo implantation, and few signs of ossification were observed at all time points except for one sample that had not been wrapped completely. Cell labeling results in Sheet group further revealed that the implanted BEC directly participated in cartilage formation. Samples in both SIS and Blank groups mainly showed ossified tissue at all time points with partial fibrogenesis in a few samples. These results suggested that chondrocyte sheet could create a chondrogenic niche for retaining chondrogenic phenotype of BEC in subcutaneous environment and thus provide a novel research model for stable ectopic cartilage regeneration based on stem cells. In vivo niche plays an important role in directing differentiation fate of stem cells. Due to lack of proper chondrogenic niche, stable cartilage regeneration of bone marrow stromal cells (BMSCs) in subcutaneous environments is always a great challenge. The current study demonstrated that chondrocyte sheet generated by

Device-based local delivery of siRNA against mammalian target of rapamycin (mTOR) in a murine subcutaneous implant model to inhibit fibrous encapsulation.

Science.gov (United States)

Takahashi, Hironobu; Wang, Yuwei; Grainger, David W

2010-11-01

Fibrous encapsulation of surgically implanted devices is associated with elevated proliferation and activation of fibroblasts in tissues surrounding these implants, frequently causing foreign body complications. Here we test the hypothesis that inhibition of the expression of mammalian target of rapamycin (mTOR) in fibroblasts can mitigate the soft tissue implant foreign body response by suppressing fibrotic responses around implants. In this study, mTOR was knocked down using small interfering RNA (siRNA) conjugated with branched polyethylenimine (bPEI) in fibroblastic lineage cells in serum-based cell culture as shown by both gene and protein analysis. This mTOR knock-down led to an inhibition in fibroblast proliferation by 70% and simultaneous down-regulation in the expression of type I collagen in fibroblasts in vitro. These siRNA/bPEI complexes were released from poly(ethylene glycol) (PEG)-based hydrogel coatings surrounding model polymer implants in a subcutaneous rodent model in vivo. No significant reduction in fibrous capsule thickness and mTOR expression in the foreign body capsules were observed. The siRNA inefficacy in this in vivo implant model was attributed to siRNA dosing limitations in the gel delivery system, and lack of targeting ability of the siRNA complex specifically to fibroblasts. While in vitro data supported mTOR knock-down in fibroblast cultures, in vivo siRNA delivery must be further improved to produce clinically relevant effects on fibrotic encapsulation around implants. Copyright © 2010 Elsevier B.V. All rights reserved.

EEG Signal Quality of a Subcutaneous Recording System Compared to Standard Surface Electrodes

Directory of Open Access Journals (Sweden)

Jonas Duun-Henriksen

2015-01-01

Full Text Available Purpose. We provide a comprehensive verification of a new subcutaneous EEG recording device which promises robust and unobtrusive measurements over ultra-long time periods. The approach is evaluated against a state-of-the-art surface EEG electrode technology. Materials and Methods. An electrode powered by an inductive link was subcutaneously implanted on five subjects. Surface electrodes were placed at sites corresponding to the subcutaneous electrodes, and the EEG signals were evaluated with both quantitative (power spectral density and coherence analysis and qualitative (blinded subjective scoring by neurophysiologists analysis. Results. The power spectral density and coherence analysis were very similar during measurements of resting EEG. The scoring by neurophysiologists showed a higher EEG quality for the implanted system for different subject states (eyes open and eyes closed. This was most likely due to higher amplitude of the subcutaneous signals. During periods with artifacts, such as chewing, blinking, and eye movement, the two systems performed equally well. Conclusions. Subcutaneous measurements of EEG with the test device showed high quality as measured by both quantitative and more subjective qualitative methods. The signal might be superior to surface EEG in some aspects and provides a method of ultra-long term EEG recording in situations where this is required and where a small number of EEG electrodes are sufficient.

Inappropriate shocks in the subcutaneous ICD: Incidence, predictors and management

NARCIS (Netherlands)

Olde Nordkamp, Louise R. A.; Brouwer, Tom F.; Barr, Craig; Theuns, Dominic A. M. J.; Boersma, Lucas V. A.; Johansen, Jens B.; Neuzil, Petr; Wilde, Arthur A. M.; Carter, Nathan; Husby, Michael; Lambiase, Pier D.; Knops, Reinoud E.

2015-01-01

The entirely subcutaneous implantable cardioverter-defibrillator (S-ICD) eliminates the need for transvenous leads, and therefore has the potential to improve lead-longevity and reduce lead-related complications. The S-ICD has a morphology-based sensing algorithm of which inappropriate shocks have

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

Science.gov (United States)

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

2015-01-01

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

Biocompatibility of RealSeal, its primer and AH Plus implanted in subcutaneous connective tissue of rats

Directory of Open Access Journals (Sweden)

Fabiana Soares Grecca

2011-02-01

Full Text Available OBJECTIVE: This study tested rat connective tissue response to RealSeal, RealSeal primer or AH Plus after 7, 15, 30, 60 and 90 days of implantation. MATERIAL AND METHODS: Thirty Wistar rats had subcutaneous sockets created on their back and received four implants each of polyethylene tubes containing one of the materials tested according to the groups: AH (AH Plus Sealer; RS (RealSeal Sealer; RP (RealSeal Primer; CG (control group - empty tube. After histological processing, sections were analyzed to identify the presence of neutrophils, lymphocytes and plasma cells, eosinophils, macrophages and giant cells, as well as fibrous capsule and abscesses, by an examiner using light microscope. Kruskal-Wallis and multiple-comparisons test were used for statistical analysis. Significance level was set at 5%. RESULTS: Lymphoplasmacytic infiltrate scores significantly higher than those of the control group were observed at 14 and 60 days in AH group, and at 90 days in RS group (p<0.05. There were no differences in terms of presence of macrophages, giant cells, eosinophils, neutrophils or fibrosis. AH Plus group scored higher for abscesses at 7 days than after any other period (p=0.031. RP group scored higher for lymphoplasmacytic infiltrate at 14 days than at 90 days (p=0.04. CONCLUSION: The main contribution of this study was to demonstrate that issues involved with tissue tolerance of a Resilon-containing sealer, RealSeal Sealer, cannot be attributed to its primer content.

Histologic Assessment of Drug-Eluting Grafts Related to Implantation Site

Directory of Open Access Journals (Sweden)

Jean-Christophe Tille

2016-02-01

Full Text Available Drug-eluting vascular prostheses represent a new direction in vascular surgery to reduce early thrombosis and late intimal hyperplasia for small calibre grafts. Subcutaneous implantation in rats is a rapid and cost-effective screening model to assess the drug-elution effect and could, to some extent, be useful to forecast results for vascular prostheses. We compared biological and histological responses to scaffolds in different implantation sites. Polycaprolactone (PCL, paclitaxel-loaded PCL (PCL-PTX and dexamethasone-loaded PCL (PCL-DXM electrospun scaffolds were implanted subcutaneously and in an infrarenal abdominal aortic model in rats for up to 12 weeks. At the conclusion of the study, a histological analysis was performed. Cellular graft invasion revealed differences in the progression of cellular infiltration between PCL-PTX and PCL/PCL-DXM groups in both models. Cell infiltration increased over time in the aortic model compared to the subcutaneous model for all groups. Cell counting revealed major differences in fibroblast, macrophage and giant cell graft colonisation in all groups and models over time. Macrophages and giant cells increased in the PCL aortic model; whereas in the subcutaneous model these cell types increased only after three weeks or even decreased in the drug-eluting PCL groups. Other major findings were observed only in the aortic replacement such as extracellular matrix deposition and neo-angiogenesis. The subcutaneous implant model can be used for screening, especially when drug-eluting effects are studied. However, major histological differences were observed in cell type reaction and depth of cell penetration compared to the aortic model. Our results demonstrate that the implantation site is a critical determinant of the biological response.

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

Directory of Open Access Journals (Sweden)

Luntz S

2006-06-01

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

The effect of melatonin implants administered from December until ...

African Journals Online (AJOL)

Administrator

2016-06-28

Jun 28, 2016 ... implantation had no effect on the growth rate of cashmere, except from ... The treated goats received subcutaneous melatonin implants (Beijing Kangtai Biological Technology .... 2 Litter size = mean number of kids per birth.

Peripheral subcutaneous vulvar stimulation in the management of severe and refractory vulvodynia.

Science.gov (United States)

De Andres, Jose; Sanchis-Lopez, Nerea; Asensio-Samper, Juan Marcos; Fabregat-Cid, Gustavo; Dolz, Vicente Molsalve

2013-02-01

Vulvodynia is a complex and multifactorial clinical condition with severe pain that occurs in the absence of visible infectious, inflammatory, neoplastic, or neurological findings. A 35-year-old woman with 3 years of dysesthetic vulvodynia tried conventional and interventional medical treatment with inadequate relief. She was offered peripheral subcutaneous vulvar field stimulation and underwent implantation of two vulvar subcutaneous electrodes. At 15 days after treatment and during 1-year follow-up, the patient scored 1 out of 15 on Friedrich scale, 1 out of 10 on the visual analog scale, and 1 out of 10 on the tampon test. The patient no longer requires oral medication. Stimulation with subcutaneous electrodes provided relief from vulvodynia to a patient in whom all previous therapeutic approaches had failed.

Subcutaneous testosterone-letrozole therapy before and concurrent with neoadjuvant breast chemotherapy: clinical response and therapeutic implications.

Science.gov (United States)

Glaser, Rebecca L; York, Anne E; Dimitrakakis, Constantine

2017-07-01

Hormone receptor-positive breast cancers respond favorably to subcutaneous testosterone combined with an aromatase inhibitor. However, the effect of testosterone combined with an aromatase inhibitor on tumor response to chemotherapy was unknown. This study investigated the effect of testosterone-letrozole implants on breast cancer tumor response before and during neoadjuvant chemotherapy. A 51-year-old woman on testosterone replacement therapy was diagnosed with hormone receptor-positive invasive breast cancer. Six weeks before starting neoadjuvant chemotherapy, the patient was treated with subcutaneous testosterone-letrozole implants and instructed to follow a low-glycemic diet. Clinical status was followed. Tumor response to "testosterone-letrozole" and subsequently, "testosterone-letrozole with chemotherapy" was monitored using serial ultrasounds and calculating tumor volume. Response to therapy was determined by change in tumor volume. Cost of therapy was evaluated. There was a 43% reduction in tumor volume 41 days after the insertion of testosterone-letrozole implants, before starting chemotherapy. After the initiation of concurrent chemotherapy, the tumor responded at an increased rate, resulting in a complete pathologic response. Chemotherapy was tolerated. Blood counts and weight remained stable. There were no neurologic or cardiac complications from the chemotherapy. Cost of therapy is reported. Subcutaneous testosterone-letrozole was an effective treatment for this patient's breast cancer and did not interfere with chemotherapy. This novel combination implant has the potential to prevent side effects from chemotherapy, improve quality of life, and warrants further investigation.

Subcutaneous Photovoltaic Infrared Energy Harvesting for Bio-Implantable Devices.

Science.gov (United States)

Moon, Eunseong; Blaauw, David; Phillips, Jamie D

2017-05-01

Wireless biomedical implantable devices on the mm-scale enable a wide range of applications for human health, safety, and identification, though energy harvesting and power generation are still looming challenges that impede their widespread application. Energy scavenging approaches to power biomedical implants have included thermal [1-3], kinetic [4-6], radio-frequency [7-11] and radiative sources [12-14]. However, the achievement of efficient energy scavenging for biomedical implants at the mm-scale has been elusive. Here we show that photovoltaic cells at the mm-scale can achieve a power conversion efficiency of more than 17 % for silicon and 31 % for GaAs under 1.06 μW/mm 2 infrared irradiation at 850 nm. Finally, these photovoltaic cells demonstrate highly efficient energy harvesting through biological tissue from ambient sunlight, or irradiation from infrared sources such as used in present-day surveillance systems, by utilizing the near infrared (NIR) transparency window between the 650 nm and 950 nm wavelength range [15-17].

Tissue response to a new type of biomaterial implanted subcutaneously in rats

DEFF Research Database (Denmark)

Boennelycke, Marie; Christensen, Lise; Nielsen, Lene Feldskov

2011-01-01

-cellular matrix (ECM) or estrogen. Methods Ten implants of each type were tested for 3 and 8 weeks, respectively. Histological assessment of connective tissue organization, inflammation, vascularization, and thickness of regenerated tissue was undertaken. Results All implants had a high degree of biocompatibility....... ECM-enriched implants had significantly higher inflammatory scores compared to pure implants at 3 weeks. At 8 weeks, neither of the parameters differed significantly. No trace of the implants remained. Conclusions The MPEG-PLGA is highly biocompatible, degrades quickly, and seems inert in the process...

A prospective study comparing endoscopic subcutaneous mastectomy plus immediate reconstruction with implants and breast conserving surgery for breast cancer.

Science.gov (United States)

Fan, Lin-Jun; Jiang, Jun; Yang, Xin-Hua; Zhang, Yi; Li, Xing-Gang; Chen, Xian-Chun; Zhong, Ling

2009-12-20

Breast conserving surgery (BCS) has been the standard surgical procedure for the treatment of early breast cancer. Endoscopic subcutaneous mastectomy (ESM) plus immediate reconstruction with implants is an emerging procedure. The objective of this prospective study was to evaluate the clinical outcomes of these two surgical procedures in our clinical setting. From March 2004 to October 2007, 43 patients with breast cancer underwent ESM plus axillary lymph node dissection and immediate reconstruction with implants, while 54 patients underwent BCS. The clinical and pathological characteristics, surgical safety, and therapeutic effects were compared between the two groups. There were no significant differences in the age, clinical stage, histopathologic type of tumor, operative blood loss, postoperative drainage time, and postoperative complications between the two groups (P > 0.05). The postoperative complications were partial necrosis of the nipple and superficial skin flap in the ESM patients, and hydrops in the axilla and residual cavity in the BCS patients. There was no significant difference in the rate of satisfactory postoperative cosmetic outcomes between the ESM (88.4%, 38/43) and BCS (92.6%, 50/54) patients (P > 0.05). During follow-up of 6 months to 4 years, all patients treated with ESM were disease-free, but 3 patients who underwent BCS had metastasis or recurrence -one of these patients died of multiple organ metastasis. After considering the wide indications for use, high surgical safety, and favorable cosmetic outcomes, we conclude that ESM plus axillary lymph node dissection and immediate reconstruction with implants - the new surgery of choice for breast cancer - warrants serious consideration as the prospective next standard surgical procedure.

Subcutaneous implant with etonogestrel (Implanon®) for catamenial exacerbations in a patient with cystic fibrosis: a case report.

Science.gov (United States)

Lamas, Adelaida; Máiz, Luis; Ruiz de Valbuena, Marta; González-Casbas, José Manuel; Suárez, Lucrecia

2014-10-24

Cystic Fibrosis (CF) is a genetic disease with equal prevalence across sexes. However, women present worse lung function with faster function decline, earlier onset of bacterial colonization, more frequent pulmonary exacerbations (PE), greater bronchial hyper-responsiveness, and higher mortality rates after puberty than men. The etiology of this gender disparity remains elusive but female hormones have been implicated in several studies. A 20-year-old female with CF with severe recurrent PE, always related to the menstrual cycle since menarche, combined with lung function decline requiring multiple courses of intravenous antibiotics. We report the cessation of PE and recovery of pulmonary function following the insertion of a subcutaneous implant with 68 mg of etonogestrel (Implanon®, Organon Española S.A. Laboratories, Madrid, Spain). Our case report supports the key role of female hormones in the development of PE and in the decline of lung function in a woman with CF. When appropriate, hormonal manipulation through contraceptive methods should be considered as potential treatment.

PAIN RELIEF MEDIATED BY IMPLANTABLE DRUG-DELIVERY DEVICES

NARCIS (Netherlands)

HOEKSTRA, A

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

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

International Nuclear Information System (INIS)

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

1998-01-01

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

Towards a subcutaneous optical biosensor based on thermally hydrocarbonised porous silicon.

Science.gov (United States)

Tong, Wing Yin; Sweetman, Martin J; Marzouk, Ezzat R; Fraser, Cara; Kuchel, Tim; Voelcker, Nicolas H

2016-01-01

Advanced biosensors in future medicine hinge on the evolvement of biomaterials. Porous silicon (pSi), a generally biodegradable and biocompatible material that can be fabricated to include environment-responsive optical characteristics, is an excellent candidate for in vivo biosensors. However, the feasibility of using this material as a subcutaneously implanted optical biosensor has never been demonstrated. Here, we investigated the stability and biocompatibility of a thermally-hydrocarbonised (THC) pSi optical rugate filter, and demonstrated its optical functionality in vitro and in vivo. We first compared pSi films with different surface chemistries and observed that the material was cytotoxic despite the outstanding stability of the THC pSi films. We then showed that the cytotoxicity correlates with reactive oxygen species levels, which could be mitigated by pre-incubation of THC pSi (PITHC pSi). PITHC pSi facilitates normal cellular phenotypes and is biocompatible in vivo. Importantly, the material also possesses optical properties capable of responding to microenvironmental changes that are readable non-invasively in cell culture and subcutaneous settings. Collectively, we demonstrate, for the first time, that PITHC pSi rugate filters are both biocompatible and optically functional for lab-on-a-chip and subcutaneous biosensing scenarios. We believe that this study will deepen our understanding of cell-pSi interactions and foster the development of implantable biosensors. Copyright © 2015 Elsevier Ltd. All rights reserved.

Dissolution ad uptake of cadmium from dental gold solder alloy implants

International Nuclear Information System (INIS)

Bergman, B.; Bergman, M.; Soeremark, R.

1977-01-01

Pure metallic cadmium was irradiated by means of thermal neutrons. The irradiated cadmium ( 115 Cd) was placed in bags of gold foil and the bags were implanted subcutaneously in the neck region of mice. Two and 3 d respectively after implantation the mice were killed, the bags removed and the animals subjected to whole-body autoradiography. The autoradiograms revealed an uptake of 115 Cd in liver and kidney. In another experiment specimens of a cadmium-containing dental gold solder alloy, a cadmium-free dental casting gold alloy and soldered assemblies made of these two alloys were implanted subcutaneously in the neck region of mice. The animals were killed after 6 months; cadmium analysis showed significant increases in the cadmium concentration in liver and kidney of those mice which had been given implants of gold solder alloy. The study clearly shows that due to electrochemical corrosion cadmium can be released from implants and accumulated in the kidneys and the liver. (author)

Dissolution and uptake of cadmium from dental gold solder alloy implants

Energy Technology Data Exchange (ETDEWEB)

Bergman, B; Bergman, M; Soeremark, R [Umeaa Univ. (Sweden); Karolinska Institutet, Stockholm (Sweden))

1977-01-01

Pure metallic cadmium was irradiated by means of thermal neutrons. The irradiated cadmium (/sup 115/Cd) was placed in bags of gold foil and the bags were implanted subcutaneously in the neck region of mice. Two and 3 d respectively after implantation the mice were killed, the bags removed and the animals subjected to whole-body autoradiography. The autoradiograms revealed an uptake of /sup 115/Cd in liver and kidney. In another experiment specimens of a cadmium-containing dental gold solder alloy, a cadmium-free dental casting gold alloy and soldered assemblies made of these two alloys were implanted subcutaneously in the neck region of mice. The animals were killed after 6 months; cadmium analysis showed significant increases in the cadmium concentration in liver and kidney of those mice which had been given implants of gold solder alloy. The study clearly shows that due to electrochemical corrosion cadmium can be released from implants and accumulated in the kidneys and the liver.

Deairing Techniques for Double-Ended Centrifugal Total Artificial Heart Implantation.

Science.gov (United States)

Karimov, Jamshid H; Horvath, David J; Byram, Nicole; Sunagawa, Gengo; Grady, Patrick; Sinkewich, Martin; Moazami, Nader; Sale, Shiva; Golding, Leonard A R; Fukamachi, Kiyotaka

2017-06-01

The unique device architecture of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) requires dedicated and specific air-removal techniques during device implantation in vivo. These procedures comprise special surgical techniques and intraoperative manipulations, as well as engineering design changes and optimizations to the device itself. The current study evaluated the optimal air-removal techniques during the Cleveland Clinic double-ended centrifugal CFTAH in vivo implants (n = 17). Techniques and pump design iterations consisted of developing a priming method for the device and the use of built-in deairing ports in the early cases (n = 5). In the remaining cases (n = 12), deairing ports were not used. Dedicated air-removal ports were not considered an essential design requirement, and such ports may represent an additional risk for pump thrombosis. Careful passive deairing was found to be an effective measure with a centrifugal pump of this design. In this report, the techniques and design changes that were made during this CFTAH development program to enable effective residual air removal and prevention of air embolism during in vivo device implantation are explained. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

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

International Nuclear Information System (INIS)

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

2002-01-01

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

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

International Nuclear Information System (INIS)

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

2002-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2002-12-01

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

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

International Nuclear Information System (INIS)

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

2013-01-01

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

Characterization of poly (L-co-D,L Lactic Acid and a study of polymer-tissue interaction in subcutaneous implants in wistar rats

Directory of Open Access Journals (Sweden)

Giuliano Serafino Ciambelli

2012-01-01

Full Text Available Poly (L-co-D,L lactic acid (PLDLA is an important biomaterial because of its biocompatibility properties that promote cellular regeneration and growth. The aim of this study was to evaluate the polymer-tissue interaction of PLDLA implants in the dorsal subcutaneous tissue of male Wistar rats at various intervals (2, 7, 15, 30, 60 and 90 days after implantation. Physical properties such as the glass transition point (Tg, degradation behavior and other mechanical properties were characterized by differential scanning calorimetry (DSC, thermogravimetric analysis (TGA, gel permeation chromatography (GPC, scanning electron microscopy (SEM and tension tests. Analysis of the degradation of PLDLA membranes in vitro showed that the polymer became crystalline as a function of the degradation time. Mechanical tension tests showed that the polymer behaved like a ductile material: when subjected to constant tension it initially suffered deformation, then elongation and finally ruptured. TGA/MEV provided evidence of PLDLA membrane degradation. For histological analysis, samples from each group were processed in xylol/paraffin, except for the 60 - and 90 - day samples. Each of the latter samples was divided in two: one half was treated with xylol/paraffin and the other with historesin. Light microscopy showed the adhesion of cells to the biomaterial, the formation of a conjunctive capsule around the implant, the presence of epithelioid cells, the formation of foreign body giant cells and angiogenesis. During degradation, the polymer showed a 'lace' - like appearance when processed in xylol/paraffin compared to the formation of "centripetal cracks in the form of glove fingers" when embedded in historesin.

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

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Dalwon Kang

2017-12-01

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

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

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Guiffant G

2013-09-01

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

X-ray appearance of subcutaneous gemstones as part of alternative/holistic medicine: a case report and review of the literature.

Science.gov (United States)

McLemore, Jerri; Hallengren, Aaron L

2010-01-01

The authors present a case of a deceased man with numerous subcutaneous nodules identified as foreign bodies on radiographic films. The foreign bodies were gemstones inserted underneath the skin as a form of holistic medicine. The X-ray findings of this case and a review of the literature for similar subcutaneously implanted foreign bodies used in holistic, alternative, or folk medicine are presented. Copyright 2010 Elsevier Inc. All rights reserved.

Repetitive transarterial chemoembolization (rTACE) of hepatocellular carcinoma: comparisons between an arterial port system and conventional angiographic technique

International Nuclear Information System (INIS)

Hidajat, Nico; Griesshaber, Volker; Hildebrandt, Bert; Hosten, Norbert; Schroeder, Ralf-Juergen; Felix, Roland

2004-01-01

Purpose: To compare the cost and radiation exposure of repetitive transarterial chemoembolization (rTACE) using percutaneously implantable port system with rTACE using conventional catheterization technique. Materials and methods: In five patients with unresectable hepatocellular carcinoma, three cycles of TACE were performed using conventional technique and six cycles using port. The cumulative cost of material and contrast agent and dose area product (DAP) were compared with the cost and DAP that would be expected if the rTACE was performed conventionally. Results: The cost of material and contrast agent was 1002.6 Euro after three cycles of TACE using conventional technique and six cycles using port, but would be 1111.8 Euro if the nine cycles were performed using conventional technique alone. The rTACE with three cycles using conventional technique and six cycles using port led to ∼63% of the cumulative DAP that would be expected in rTACE using conventional technique alone. Conclusion: In rTACE, the use of percutaneously implantable port system might enable a reduction of cost and radiation exposure

Spatial memory in nonhuman primates implanted with the subdural pharmacotherapy device.

Science.gov (United States)

Ludvig, Nandor; Tang, Hai M; Baptiste, Shirn L; Stefanov, Dimitre G; Kral, John G

2015-06-01

This study investigated the possible influence of the Subdural Pharmacotherapy Device (SPD) on spatial memory in 3 adult, male bonnet macaques (Macaca radiata). The device was implanted in and above the subdural/subarachnoid space and cranium overlaying the right parietal/frontal cortex: a circuitry involved in spatial memory processing. A large test chamber, equipped with four baited and four non-baited food-ports at different locations, was used: reaches into empty food ports were counted as spatial memory errors. In this study of within-subject design, before SPD implantation (control) the animals made mean 373.3 ± 114.9 (mean ± SEM) errors in the first spatial memory test session. This value dropped to 47.7 ± 18.4 by the 8th session. After SPD implantation and alternating cycles of transmeningeal saline delivery and local cerebrospinal fluid (CSF) drainage in the implanted cortex the spatial memory error count, with the same port locations, was 33.0 ± 12.2 during the first spatial memory test session, further decreasing to 5.7 ± 3.5 by the 8th post-implantation session (Pmemory performance, which in fact included at least one completely error-free session per animal over time. The study showed that complication-free implantation and use of the SPD over the parietal and frontal cortices for months leave spatial memory processes intact in nonhuman primates. Copyright © 2015 Elsevier B.V. All rights reserved.

Effect of topical anaesthetics on interstitial colloid osmotic pressure in human subcutaneous tissue sampled by wick technique.

Directory of Open Access Journals (Sweden)

Hans Jørgen Timm Guthe

Full Text Available To measure colloid osmotic pressure in interstitial fluid (COP(i from human subcutaneous tissue with the modified wick technique in order to determine influence of topical application of anaesthetics, dry vs. wet wick and implantation time on COP(i.In 50 healthy volunteers interstitial fluid (IF was collected by subcutaneous implantation of multi-filamentous nylon wicks. Study subjects were allocated to two groups; one for comparing COP(i obtained from dry and saline soaked wicks, and one for comparing COP(i from unanaesthetized skin, and skin after application of a eutectic mixture of local anaesthetic (EMLA®, Astra Zeneca cream. IF was sampled from the skin of the shoulders, and implantation time was 30, 60, 75, 90 and 120 min. Colloid osmotic pressure was measured with a colloid osmometer. Pain assessment during the procedure was compared for EMLA cream and no topical anaesthesia using a visual analogue scale (VAS in a subgroup of 10 subjects.There were no significant differences between COP(i obtained from dry compared to wet wicks, except that the values after 75 and 90 min. were somewhat higher for the dry wicks. Topical anaesthesia with EMLA cream did not affect COP(i values. COP(i decreased from 30 to 75 min. of implantation (23.2 ± 4.4 mmHg to 19.6 ± 2.9 mmHg, p = 0.008 and subsequently tended to increase until 120 min. EMLA cream resulted in significant lower VAS score for the procedure.COP(i from subcutaneous tissue was easily obtained and fluid harvesting was well tolerated when topical anaesthetic was used. The difference in COP(i assessed by dry and wet wicks between 75 min. and 90 min. of implantation was in accordance with previous reports. The use of topical analgesia did not influence COP(i and topical analgesia may make the wick technique more acceptable for subjects who dislike technical procedures, including children.ClinicalTrials.gov NCT01044979.

Use of vascular access ports in femoral veins of dogs and cats with cancer.

Science.gov (United States)

Cahalane, Alane Kosanovich; Rassnick, Kenneth M; Flanders, James A

2007-11-01

To evaluate long-term function of vascular access ports (VAPs) implanted in the femoral vein of dogs and cats undergoing cancer treatment. Prospective clinical study. 3 dogs and 6 cats treated via chemotherapy or radiation. VAPs were surgically implanted in the left femoral vein of 3 dogs and 6 cats over a 1-year period. Injection port location was alternated to either a caudal thoracic or ilial location in each patient. Duration of VAP function, ease of infusion, and ease of aspiration through the VAPs were recorded, and associated complications were assessed at each VAP use. Client satisfaction with VAP placement was evaluated by use of a questionnaire. Primary uses of the VAPs included blood sampling and delivering sedative or chemotherapeutic drugs. Median duration of successful infusion was 147 days (range, 60 to 370 days), and median duration of successful aspiration was 117 days (range, 10 to 271 days). The frequency of signs of VAP-related discomfort was low (7% of patient observations). Clients were satisfied with their decision to use VAPs. Complications included partial (n = 7) or complete (2) VAP occlusion, port migration (1), and presumptive infection (1). Results suggested that VAP implantation into the femoral vein provides an acceptable means of chronic venous access in dogs and cats undergoing cancer treatment.

Mechanical verification of soft-tissue attachment on bioactive glasses and titanium implants.

Science.gov (United States)

Zhao, Desheng; Moritz, Niko; Vedel, Erik; Hupa, Leena; Aro, Hannu T

2008-07-01

Soft-tissue attachment is a desired feature of many clinical biomaterials. The aim of the current study was to design a suitable experimental method for tensile testing of implant incorporation with soft-tissues. Conical implants were made of three compositions of bioactive glass (SiO(2)-P(2)O(5)-B(2)O(3)-Na(2)O-K(2)O-CaO-MgO) or titanium fiber mesh (porosity 84.7%). The implants were surgically inserted into the dorsal subcutaneous soft-tissue or back muscles in the rat. Soft-tissue attachment was evaluated by pull-out testing using a custom-made jig 8 weeks after implantation. Titanium fiber mesh implants had developed a relatively high pull-out force in subcutaneous tissue (12.33+/-5.29 N, mean+/-SD) and also measurable attachment with muscle tissue (2.46+/-1.33 N). The bioactive glass implants failed to show mechanically relevant soft-tissue bonding. The experimental set-up of mechanical testing seems to be feasible for verification studies of soft-tissue attachment. The inexpensive small animal model is beneficial for large-scale in vivo screening of new biomaterials.

Effect of Using Melatonin Implants on Postpartum Reproductive Indices in Tigaia Sheep Breed

Directory of Open Access Journals (Sweden)

Ioan Padeanu

2012-10-01

Full Text Available Investigations were carried out in a commercial farm from Turnu, Arad County, on a number of 110 indigenous adultewes from the Tigaia breed. It is estimated by some authors that administration of subcutaneous melatonin implantsduring a period of 30 days, in lactating or dry ewes, would improve the reproductive performances in some sheepbreeds. Subcutaneous melatonin implants (Melovin were inserted to the ewes in doses of 18 mg. Current research,emphasized treated that from indigenous Tigaia breed, can be obtained superior reproduction indexes if the animalsare treated with melatonin implants with 35 days before the mating season, differences from the untreated groupbeing significantly (p<0.001. However, in sheep treated used melatonin implants, the lambing interval were reducedwith 40 to 50%. It seems that use of melatonin implants Melovin type near the beginning of normal breeding season,increases the reproductive performance of adult ewes from the Tigaia breed.

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

Science.gov (United States)

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

1992-07-01

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

The correlation between difference in foreign body reaction between implant locations and cytokine and MMP expression

NARCIS (Netherlands)

Luttikhuizen, Daniel T.; van Amerongen, Machteld J.; de Feijter, Pieter C.; Petersen, Arien H.; Harmsen, Martin C.; van Luyn, Marja J. A.

2006-01-01

The foreign body reaction (FBR) differs between subcutaneously and supra-epicardially implanted materials. We hypothesize that this is a result of differences in cytokine, chemokine and matrix metalloproteinase (MNIP) dynamics. Therefore we applied collagen disks subcutaneously and on the epicardium

Subcutaneous Injections

DEFF Research Database (Denmark)

Thomsen, Maria

This thesis is about visualization and characterization of the tissue-device interaction during subcutaneous injection. The tissue pressure build-up during subcutaneous injections was measured in humans. The insulin pen FlexTouchr (Novo Nordisk A/S) was used for the measurements and the pressure ...

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

International Nuclear Information System (INIS)

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

1994-01-01

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

Three ports versus four ports laparoscopic cholecystectomy

International Nuclear Information System (INIS)

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

2017-01-01

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

The rat subcutaneous air sac model. A new and simple method for in vivo screening of antiangiogenesis

International Nuclear Information System (INIS)

Lichtenberg, J.; Abildgaard Hansen, C.; Skak-Nielsen, T.; Bay, C.; Thing Mortensen, J.; Binderup, L.

1997-01-01

An experimental rat model, the Subcutaneous Air Sac (SAS) model, was developed to provide an animal model in which neo-vascularisation can be easily assessed in situ and quantified using a radiolabelled plasma marker. The SAS model was designed to replace a previous model where neo-vascularisation was induced by chemical injury of rat or rabbit cornea or by implantation of tumour cells intracorneally, a methodology which is believed to cause severe pain to the animals. In the SAS model the air sac replaces the cornea as a transparent avascular substratum in which vascularisation can be observed. The air sac is induced by injection of air subcutaneously on the back of the animal. After 8 to 10 days a sufficient air sac has been established. The animal is anaesthesized and by a minor operation the cellulose sponge is implanted upon the air sac under the skin. The vaso-proliferative effect of the cellulose sponge caused formation of new vessels which are macroscopically visible 10 days after implantation. The ability of the in vivo SAS model to show an anti-angiogenic effect of a systemically applied test compound was investigated using the fumagilline analogue TNP-470 (o-chloro-acetylcarbomoyl-fumagillol) as a positive control at dose levels of 0, 1, 2.5, 5 and 10 mg/kg/day given subcutaneously for 10 days. The neo-angio genesis was scored both in situ using a subjective point system and by measuring the 125 I-activity of the implant and the membrane after an intravenous injection of 125 I-labelled antibodies. The neo-angio genesis was reduced by approximately 45-50% in animals treated with 5 or 10 mg/kg/day of TNP-470 compared to animals treated with the vehicle. The animals treated with 10 mg/kg/day TNP-470 showed signs of toxicity. The SAS model is considered highly relevant for in vivo testing of potential anti-angiogenci drugs on humane grounds. The high reproducibility, the low cost and the technical simplicity of the method makes it attractive. (au)

Percutaneous placement of peritoneal port-catheter in oncologic patients

International Nuclear Information System (INIS)

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

2004-01-01

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

Peripheral Venous Access Ports: Outcomes Analysis in 109 Patients

International Nuclear Information System (INIS)

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

2000-01-01

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

In vitro assessment of MRI issues at 3-Tesla for a breast tissue expander with a remote port.

Science.gov (United States)

Linnemeyer, Hannah; Shellock, Frank G; Ahn, Christina Y

2014-04-01

A patient with a breast tissue expander may require a diagnostic assessment using magnetic resonance imaging (MRI). To ensure patient safety, this type of implant must undergo in vitro MRI testing using proper techniques. Therefore, this investigation evaluated MRI issues (i.e., magnetic field interactions, heating, and artifacts) at 3-Tesla for a breast tissue expander with a remote port. A breast tissue expander with a remote port (Integra Breast Tissue Expander, Model 3612-06 with Standard Remote Port, PMT Corporation, Chanhassen, MN) underwent evaluation for magnetic field interactions (translational attraction and torque), MRI-related heating, and artifacts using standardized techniques. Heating was evaluated by placing the implant in a gelled-saline-filled phantom and MRI was performed using a transmit/receive RF body coil at an MR system reported, whole body averaged specific absorption rate of 2.9-W/kg. Artifacts were characterized using T1-weighted and GRE pulse sequences. Magnetic field interactions were not substantial and, thus, will not pose a hazard to a patient in a 3-Tesla or less MRI environment. The highest temperature rise was 1.7°C, which is physiologically inconsequential. Artifacts were large in relation to the remote port and metal connector of the implant but will only present problems if the MR imaging area of interest is where these components are located. A patient with this breast tissue expander with a remote port may safely undergo MRI at 3-Tesla or less under the conditions used for this investigation. These findings are the first reported at 3-Tesla for a tissue expander. Copyright © 2014 Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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

2014-07-01

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

Subcutaneous tissue reaction to castor oil bean and calcium hydroxide in rats

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Samira Esteves Afonso Camargo

2010-06-01

Full Text Available Castor oil bean cement (COB is a new material that has been used as an endodontic sealer, and is a candidate material for direct pulp capping. OBJECTIVE: The purpose of this study was to evaluate the biocompatibility of a new formulation of COB compared to calcium hydroxide cement (CH and a control group without any material, in the subcutaneous tissue of rats. MATERIAL AND METHODS: The materials were prepared, packed into polyethylene tubes, and implanted in the rat dorsal subcutaneous tissue. Animals were sacrificed at the 7th and 50th days after implantation. A quantitative analysis of inflammatory cells was performed and data were subjected to ANOVA and Tukey's tests at 5% significance level. RESULTS: Comparing the mean number of inflammatory cells between the two experimental groups (COB and CH and the control group, statistically significant difference (p=0.0001 was observed at 7 and 50 days. There were no significant differences (p=0.111 between tissue reaction to CH (382 inflammatory cells and COB (330 inflammatory cells after 7 days. After 50 days, significantly more inflammatory cells (p=0.02 were observed in the CH group (404 inflammatory cells than in the COB group (177 inflammatory cells. CONCLUSIONS: These results demonstrate that the COB cement induces less inflammatory response within long periods.

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

Science.gov (United States)

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

2016-01-01

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

Ports Primer: 3.2 Port Governance

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

[Significance of various implantate localizations of Sparks prostheses, experimental studies in rats].

Science.gov (United States)

Brieler, H S; Parwaresch, R; Thiede, A

1976-01-01

Our investigations show that Sparks prostheses after subcutaneous implantation are suitable for vascular grafting. At the end of the organization period the connective tissue becomes strong, and after the third and fourth weeks collagenous and elastic fibers can be seen. Ten weeks after s.c. implantation, collagenous fibers predominate. After this the Sparks prostheses can be used as a vascular graft. Intraperitoneal implantation, however, shows a histologically different picture with characteristic findings: only fat cells can be observed, a strong granulation tissue with elastic and collagenous fibers is not present. After intraperitoneal implantation Sparks prostheses are therefore unsuitable for vascular grafts.

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

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

2017-04-01

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

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

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

2012-05-01

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

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

Directory of Open Access Journals (Sweden)

Jian Li

2014-12-01

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

Subcutaneous granuloma annulare

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Dhar Sandipan

1993-01-01

Full Text Available Two cases of subcutaneous granuloma annulare are reported. Clinical presentation was in the form of hard subcutaneous nodules, histopathology confirmed the clinical diagnosis. The cases were unique because of onset in adult age, occurrence over unusual sites and absence of classical lesions of granuloma annulare elsewhere.

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

Science.gov (United States)

Haindl, H; Schmoll, E; Willmann, G

1995-03-01

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

Poly(vinyl pyrrolidone)-Chitosan implant for endoscopic treatment of vesicoureteral reflux

International Nuclear Information System (INIS)

Relleve, Lorna S.; Abad, Lucille V.; Aranilla, Charito T.; Dela Rosa, A.M.; Bolong, David T.; Bisnar, Carlo C.

2008-01-01

Radiation-crosslinked poly(vinyl pyrrolidone) (PVP)-Chitosan was prepared as a potential injectable implant for endoscopic treatment of vesicoureteral reflux (VUR). The physical and histological properties of PVP-Chitosan implant in comparison with the commercial dextranomer/hyaluronic acid copolymer (Deflux) have been evaluated in vivo by subcutaneous and abdominal injection in rats over a period of 6 months. The PVP-Chitosan implant was easily injected through 26-gauge needle. Monthly gross examination of the implanted sites showed no significant decrease in volume of implant and no local inflammatory reaction. Histological findings indicated no evidence of migration to the distant organs after 6 months of implantation. Results of this study indicated that PVP-Chitosan implant has properties of a good tissue augmenting substance such as stability, biocompatibility and non-migration but long-term studies are needed to evaluate its therapeutic efficiency. (author)

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

International Nuclear Information System (INIS)

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

2013-01-01

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

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

Science.gov (United States)

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

2017-01-01

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

Device orientation of a leadless pacemaker and subcutaneous implantable cardioverter-defibrillator in canine and human subjects and the effect on intrabody communication.

Science.gov (United States)

Quast, Anne-Floor B E; Tjong, Fleur V Y; Koop, Brendan E; Wilde, Arthur A M; Knops, Reinoud E; Burke, Martin C

2018-02-14

The development of communicating modular cardiac rhythm management systems relies on effective intrabody communication between a subcutaneous implantable cardioverter-defibrillator (S-ICD) and a leadless pacemaker (LP), using conducted communication. Communication success is affected by the LP and S-ICD orientation. This study is designed to evaluate the orientation of the LP and S-ICD in canine subjects and measure success and threshold of intrabody communication. To gain more human insights, we will explore device orientation in LP and S-ICD patients. Canine subjects implanted with a prototype S-ICD and LP (both Boston Scientific, MA, USA) with anterior-posterior fluoroscopy images were included in this analysis. For comparison, a retrospective analysis of human S-ICD and LP patients was performed. The angle of the long axis of the LP towards the vertical axis of 0°, and distance between the coil and LP were measured. Twenty-three canine subjects were analysed. Median angle of the LP was 29° and median distance of the S-ICD coil to LP was 0.8 cm. All canine subjects had successful communication. The median communicating threshold was 2.5 V. In the human retrospective analysis, 72 LP patients and 100 S-ICD patients were included. The mean angle of the LP was 56° and the median distance between the S-ICD coil and LP was 4.6 cm. Despite the less favourable LP orientation in canine subjects, all communication attempts were successful. In the human subjects, we observed a greater and in theory more favourable LP angle towards the communication vector. These data suggests suitability of human anatomy for conductive intrabody communication.

Design and simulation of printed spiral coil used in wireless power transmission systems for implant medical devices.

Science.gov (United States)

Wu, Wei; Fang, Qiang

2011-01-01

Printed Spiral Coil (PSC) is a coil antenna for near-field wireless power transmission to the next generation implant medical devices. PSC for implant medical device should be power efficient and low electromagnetic radiation to human tissues. We utilized a physical model of printed spiral coil and applied our algorithm to design PSC operating at 13.56 MHz. Numerical and electromagnetic simulation of power transfer efficiency of PSC in air medium is 77.5% and 71.1%, respectively. The simulation results show that the printed spiral coil which is optimized for air will keep 15.2% power transfer efficiency in human subcutaneous tissues. In addition, the Specific Absorption Ratio (SAR) for this coil antenna in subcutaneous at 13.56 MHz is below 1.6 W/Kg, which suggests this coil is implantable safe based on IEEE C95.1 safety guideline.

Elevation of transforming growth factor beta (TGFbeta) and its downstream mediators in subcutaneous foreign body capsule tissue.

Science.gov (United States)

Li, Allen G; Quinn, Matthew J; Siddiqui, Yasmin; Wood, Michael D; Federiuk, Isaac F; Duman, Heather M; Ward, W Kenneth

2007-08-01

Foreign body encapsulation represents a chronic fibrotic response and has been a major obstacle that reduces the useful life of implanted biomedical devices. The precise mechanism underlying such an encapsulation is still unknown. We hypothesized that, considering its central role in many other fibrotic conditions, transforming growth factor beta (TGFbeta) may play an important role during the formation of foreign body capsule (FBC). In the present study, we implanted mock sensors in rats subcutaneously and excised FBC samples at day 7, 21, and 48-55 postimplantation. The most abundant TGFbeta isoform in all tissues was TGFbeta1, which was expressed minimally in control tissue. The expression of both TGFbeta1 RNA and protein was significantly increased in FBC tissues at all time points, with the highest level in day 7 FBC. The number of cells stained for phosphorylated Smad2, an indication of activated TGFbeta signaling, paralleled the expression of TGFbeta. A similar dynamic change was also observed in the numbers of FBC myofibroblasts, which in response to TGFbeta, differentiate from quiescent fibroblasts and synthesize collagen. Type I collagen, the most prominent downstream target of TGFbeta in fibrosis, was found in abundance in the FBC, especially during the latter time periods. We suggest that TGFbeta plays an important role in the FBC formation. Inhibition of TGFbeta signaling could be a promising strategy in the prevention of FBC formation, thereby extending the useful life of subcutaneous implants.

Distant Migration of Multiple Siliconomas in Lower Extremities following Breast Implant Rupture: Case Report.

Science.gov (United States)

Oh, Joo Hyun; Song, Seung Yong; Lew, Dae Hyun; Lee, Dong Won

2016-10-01

Siliconoma from ruptured breast implants has been reported in multiple body sites, including but not limited to the breast parenchyma, axillary lymph nodes, upper arm, and even lower leg. In this regard, we report a rare case of distant silicone migration to the lower extremities after traumatic breast implant rupture. A 55-year-old Asian woman who received bilateral augmentation mammoplasty 20 years ago presented with ruptured breast implants from a car accident 2 years earlier. Magnetic resonance imaging confirmed intracapsular and extracapsular rupture of the right breast implant, showing "linguine sign." We removed the bilateral breast implants and performed capsulectomy and bilateral reduction mammoplasty using inverted-T incisions. The implant was confirmed as a smooth, silicone gel-filled mammary implant of 125 cm 3 by a Japanese manufacturer, Koken. During her regular follow-up outpatient visits, physical examination revealed 2.5- × 1.5-cm ill-defined, tender, subcutaneous nodules on both knees and 8.5- × 3.0-cm inflammatory changes in the inguinal area with persistent pain. Computed tomography showed no definite mass, but rather infiltrative, nonenhancing soft-tissue densities in the subcutaneous layers of the bilateral inguinal and knee areas. Surgical excision was performed, and pathologic findings confirmed variable vacuoles with foreign body reaction and fibrosis, consistent with siliconoma. It is important to acknowledge that siliconomas can be encountered in patients with ruptured breast implants, especially those manufactured decades ago. Our patient with masses as remote as the inguinal and knee areas is a prime example of how far siliconomas can migrate.

Developing the port of Belawan as a modern and international port

Science.gov (United States)

Many, N.

2018-03-01

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

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

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Diāna Līduma

2015-06-01

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

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

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Ming-Tsung Chuang

2011-11-01

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

Brain Serotonin Transporter Binding In a Minipig Model of Parkinson's Disease

DEFF Research Database (Denmark)

Lillethorup, Thea Pinholt; Glud, Andreas Nørgaard; Sørensen, Jens Christian Hedemann

minipigs were implanted in the cisterna magna with a catheter connected to a subcutaneous titanium injection port under sterile conditions. Six-eight weeks after recovery from the catheter implant, and after injections of sterile saline alone to verify patency, minipigs were scanned at baseline with [11C......]-3-amino-4-(2-dimethylaminomethyl-phenylsulfanyl)-benzonitrile (11C-DASB), a label of SERT availability. Four pigs then received eight weekly injections of lactacystin dissolved in sterile saline, and one pig received saline alone, directly into the CSF through the access port. They were scanned...... with DASB again after a cumulative dose of 200μg lactacystin. PET data were registered to an average minipig MRI atlas and processed using PMOD software. The binding potential (BPND) of DASB was obtained with the Logan graphical analysis and cerebellum activity as a region of non-displaceable binding...

Frontal subcutaneous blood flow, and epi- and subcutaneous temperatures during scalp cooling in normal man

DEFF Research Database (Denmark)

Bülow, J; Friberg, L; Gaardsting, O

1985-01-01

Cooling of the scalp has been found to prevent hair loss following cytostatic treatment, but in order to obtain the hair preserving effect the subcutaneous temperature has to be reduced below 22 degrees C. In order to establish the relationship between epicutaneous and subcutaneous temperatures...... epicutaneous and subcutaneous temperatures could be demonstrated with the regression equation: s = 0.9 c + 4.9 (r = 0.99). In eight of the 10 subjects the subcutaneous temperature could be reduced below 22 degrees C with the applied technique. It is concluded that the hair preserving effect of scalp cooling...

Reaction of rat subcutaneous tissue to mineral trioxide aggregate and Portland cement: a secondary level biocompatibility test.

Science.gov (United States)

Karanth, P; Manjunath, M K; Kuriakose, E S

2013-01-01

This secondary-level animal study was conducted to assess and compare the subcutaneous tissue reaction to implantation of white mineral trioxide aggregate (MTA) and white Portland cement. Polyethylene tubes filled with either freshly mixed white MTA (Group I) or white Portland cement (Group II) were implanted subcutaneously into 12 Wistar Albino rats. Each animal also received an empty polyethylene tube as the control (Group III). After 7, 14, 21 and 30 days, the implants, together with surrounding tissues were excised. Two pathologists blinded to the experimental procedure, evaluated sections taken from the biopsy specimens for the severity of the inflammatory response, calcification and the presence and thickness of fibrous capsule surrounding the implant. Statistical analysis was performed using the Cross-tabs procedure, Univariate analysis of the variance two-way and the Pearson product moment correlation to assess inter-rater variability between the two evaluators. At 7 days, there was no significant difference in the severity of inflammation between the control group, white MTA, and white Portland cement groups. In the 14 day, 21 day and 30 day test periods, control group had significantly less inflammation than white MTA and white Portland cement. There was no significant difference in the grading of inflammation between white MTA and white Portland cement. All materials exhibited thick capsule at 7 days and thin capsule by 30 days. Both white MTA and white Portland cement were not completely non-irritating at the end of 30 days as evidenced by the presence of mild inflammation. However, the presence of a thin capsule around the materials, similar to the control group, indicates good tissue tolerance. White MTA and white Portland cement seem to be materials of comparable biocompatibility.

New horizon for infection prevention technology and implantable device

Directory of Open Access Journals (Sweden)

Yusuke Kondo, MD, PhD

2016-08-01

Full Text Available There has been a significant increase in the number of patients receiving cardiovascular implantable electronic devices (CIED over the last two decades. CIED infection represents a serious complication after CIED implantation and is associated with significant morbidity and mortality. Recently, newly advanced technologies have offered attractive and suitable therapeutic alternatives. Notably, the leadless pacemaker and anti-bacterial envelope decrease the potential risk of CIED infection and the resulting mortality, when it does occur. A completely subcutaneous implantable cardioverter defibrillator is also an alternative to the transvenous implantable cardioverter defibrillator (ICD, as it does not require implantation of any transvenous or epicardial leads. Among the patients who require ICD removal and subsequent antibiotics secondary to infection, the wearable cardioverter defibrillator represents an alternative approach to inpatient monitoring for the prevention of sudden cardiac death. In this review paper, we aimed to introduce the advanced technologies and devices for prevention of CIED infection.

Increased expression of Interleukin-13 and connective tissue growth factor, and their potential roles during foreign body encapsulation of subcutaneous implants.

Science.gov (United States)

Ward, W Kenneth; Li, Allen G; Siddiqui, Yasmin; Federiuk, Isaac F; Wang, Xiao-Jing

2008-01-01

The purpose of this study was to better understand whether interleukin-13 (IL-13) and connective tissue growth factor (CTGF) are highly expressed during foreign body encapsulation of subcutaneous devices. Mock biosensors were implanted into rats for three lengths of time (7-, 21- and 48-55 days) to address different stages of the foreign body response. Using quantitative real-time PCR and immunofluorescence, the expression of IL13, CTGF, collagen 1, decorin and fibronectin were measured in this tissue. IL-13, a product of Th2 cells, was highly expressed at all time points, with greatest expression at day 21. The IL-13 expression was paralleled by increased presence of T-cells at all time points. CTGF was also found to be more highly expressed in foreign body tissue than in controls. Collagen and decorin were highly expressed at the middle and later stages. Given the increased expression of IL-13 and CTGF in foreign body tissue, and their roles in other fibrotic disorders, these cytokines may well contribute to the formation of the foreign body capsule. Since the peak gene expression of IL-13 occurred later than the previously-reported TGFbeta expression peak, IL-13 is probably not the major stimulus to TGFbeta expression during foreign body encapsulation and may contribute to fibrosis independently.

Tophaceous Gout simulating infected Ankle Implants

Directory of Open Access Journals (Sweden)

Ioannis K

2016-11-01

Full Text Available Gout is a well known metabolic disorder characterized by the formation of urate crystals in joints resulting in recurrent attacks of acute inflammatory arthritis following which tophi can occur in joints or subcutaneous tissues. We report a rare localization of gouty tophi in a 52 years old male. The tophi had formed over the stainless steel implant used for the fixation of a lateral malleolus fracture 20 years ago.

Two-port access versus four-port access laparoscopic ovarian cystectomy.

Science.gov (United States)

Choi, Won-Kyu; Kim, Jang-Kew; Yang, Jung-Bo; Ko, Young-Bok; Nam, Sang-Lyun; Lee, Ki-Hwan

2014-09-01

This study was conducted to compare the surgical outcomes between two-port access and four-port access laparoscopic ovarian cystectomy. Four hundred and eighty nine patients who had received two-port access laparoscopic ovarian cystectomy (n=175) and four-port access laparoscopic ovarian cystectomy (n=314) in Chungnam National University Hospital from January 2009 to August 2012 were analyzed retrospectively. The data were compared between the bilaterality of the cysts and cyst diameter of less than 6 cm and 6 cm or more. There were no significant differences in patient's age, parity, body weight, body mass index and history of previous surgery between the two-port and four-port access laparoscopy group. Bilaterality of ovarian cysts was more in fourport access laparoscopy group (13.7% vs. 32.5%, P=0.000). There were no significant differences in operation time, hemoglobin change, hospital stay, adhesiolysis, transfusion, and insertion of hemo-vac between the two-port and four-port access laparoscopy group for size matched compare. However additional analgesics were more in four-port access laparoscopy group for unilateral ovarian cystectomy. Two-port access laparoscopic surgery was feasible and safe for unilateral and bilateral ovarian cystectomy compare with four-port access laparoscopic surgery.

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

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Akgul, Burak

2017-12-01

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

Flat-port connectors

KAUST Repository

Alrashed, Mohammed

2017-05-26

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

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

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

Ports Initiative

Science.gov (United States)

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

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

Science.gov (United States)

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

2017-09-01

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

Modeling of the metallic port in breast tissue expanders for photon radiotherapy.

Science.gov (United States)

Yoon, Jihyung; Xie, Yibo; Heins, David; Zhang, Rui

2018-03-30

The purpose of this study was to model the metallic port in breast tissue expanders and to improve the accuracy of dose calculations in a commercial photon treatment planning system (TPS). The density of the model was determined by comparing TPS calculations and ion chamber (IC) measurements. The model was further validated and compared with two widely used clinical models by using a simplified anthropomorphic phantom and thermoluminescent dosimeters (TLD) measurements. Dose perturbations and target coverage for a single postmastectomy radiotherapy (PMRT) patient were also evaluated. The dimensions of the metallic port model were determined to be 1.75 cm in diameter and 5 mm in thickness. The density of the port was adjusted to be 7.5 g/cm 3 which minimized the differences between IC measurements and TPS calculations. Using the simplified anthropomorphic phantom, we found the TPS calculated point doses based on the new model were in agreement with TLD measurements within 5.0% and were more accurate than doses calculated based on the clinical models. Based on the photon treatment plans for a real patient, we found that the metallic port has a negligible dosimetric impact on chest wall, while the port introduced significant dose shadow in skin area. The current clinical port models either overestimate or underestimate the attenuation from the metallic port, and the dose perturbation depends on the plan and the model in a complex way. TPS calculations based on our model of the metallic port showed good agreement with measurements for all cases. This new model could improve the accuracy of dose calculations for PMRT patients who have temporary tissue expanders implanted during radiotherapy and could potentially reduce the risk of complications after the treatment. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Pre-Operative Skin Antisepsis with Chlorhexidine Gluconate and Povidone-Iodine to Prevent Port-Site Infection in Laparoscopic Cholecystectomy: A Prospective Study.

Science.gov (United States)

Spaziani, Erasmo; Di Filippo, Annalisa; Orelli, Simone; Fiorini, Flavia; Spaziani, Martina; Tintisona, Orlando; Torcasio, Angelo; De Cesare, Alessandro; Picchio, Marcello

2018-04-01

Skin preparation with antiseptic agents is commonly recommended for incisional site cleansing before surgery. We present the result of a prospective case series submitted to a scheduled pre-operative antiseptic procedure combining chlorhexidine gluconate and povidone-iodine before elective laparoscopic cholecystectomy. Consecutive patients underwent pre-operative standardized cleansing of the operation site combining chlorhexidine gluconate and povidone-iodine. Patients were reviewed one week and four weeks post-operatively. Post-operative infection was observed in seven patients (4.3%). All observed infections were port-site infections, always located at the level of the umbilical incision. In all cases infections involved skin and subcutaneous tissue. Staphylococcus aureus was isolated in five patients (71.4%) and miscellaneous aerobic gram-positive bacteria in two subjects (28.6%). Post-operative hospital stay was the only factor significantly associated with the development of port-site infections. Port-site infections are a common complication after elective laparoscopic cholecystectomy. The proposed pre-operative disinfection procedure is effective in reducing port-site infections. Reducing hospital stay may contribute to limiting the occurrence of this complication.

Revisiting port pricing : a proposal for seven port pricing principles

NARCIS (Netherlands)

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

2017-01-01

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

Influence of Port Policy on the Development of Croatian Container Ports

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Čedomir Dundović

2002-03-01

Full Text Available It is important to consider the port development throughoutthe world from the aspect of economical, transport and portpolicy and their mutual impact on commerce and efficiency ofports. By examining such relations in the context of developmentof the Croatian container ports, it is possible to define reasonsfor lagging behind of Croatian ports compared to theworld movements.The main reason for the negative trend of development ofCroatian container ports lies in the non-existence of adequatemeasures of transport, maritime and port policy. Analysis ofstatistics over the past decade and comparison of structure andvolume of the general cargo traffic in the Rijeka port and theneighbouring ports in the area of North Adriatic are both showingsignificant size discrepancy and uncompetitiveness of theCroatian port. Disturbances that have brought to such a situationresult from inadequate port policy and non-harmonisedactivities between various modes of transport.In order to overcome such situation, the authors suggest determiningof clear tasks, goals and measures of the port policythat have to be undertaken so that the Croatian policy could becompatible with the main aspects, development tendencies andmeasures of theE U port policy.

Totally implantable vascular access device (TIVAD) placement: a modified technique that takes post-procedure aesthetic aspects into account.

Science.gov (United States)

Liberale, Gabriel

2017-04-01

Major progress has been made in breast cancer reconstruction surgery. The standard technique for totally implanted vascular access device (TIVAD) implantation generally requires an incision for port insertion on the anterior part of the thorax that leaves a scar in the middle of the neckline in patients who have undergone mastectomy with complex breast reconstruction. The aim of this technical note is to report our revised surgical technique for TIVAD placement. In patients with breast cancer, we take a lateralized approach, performing an oblique incision on the lowest part of the deltopectoral groove. This allows us to introduce the port and to place it on the anterolateral part of the thorax, thus avoiding an unaesthetic scar on the anterior part of the thorax. Our modified technique for TIVAD implantation is described.

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

International Nuclear Information System (INIS)

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

2011-01-01

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

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

Directory of Open Access Journals (Sweden)

Ting-Yao Wang

2015-11-01

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

Towards Sustainable ASEAN Port Development: Challenges and Opportunities for Vietnamese Ports

Directory of Open Access Journals (Sweden)

Saeyeon Roh

2016-06-01

Full Text Available Sustainability agendas are challenging port authorities around the world to find ways of operating and managing their ports efficiently and effectively in terms of economic, social, as well as environmental development. In this respect, governments in ASEAN countries have been implementing various green activities seeking to reduce the environmental impact of shipping and related activities. In this connection, most studies in the existing literature mainly focus on the environmental aspects of sustainable development and have not clearly explained what sustainable port development exactly entails. Furthermore, most of these studies emphasized on the impact of port development and overlooked what factors influence sustainable port development. To address these gaps, this research aim to explore the main factors shaping sustainable port development. This was conducted through a comprehensive review of related literature as well as confirmatory in-depth interviews with port authorities. As a result, findings from this research would help identify key elements of sustainable port development from port authorities’ perspective. The challenges, opportunities and managerial implications for Vietnamese ports are also discussed accordingly.

Port-Wine Stains

Science.gov (United States)

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

Metallic implants and exposure to radiofrequency radiation

International Nuclear Information System (INIS)

Joyner, K.H.; Fleming, A.H.F.; MacFarlane, I.P.; Hocking, B.

1988-01-01

There is increasing use of radiofrequency radiation (RFR) in industry for communications, welding, security, radio, medicine, navigation etc. It has been recognised for some years that RFR may interact with cardiac pacemakers and steps have been taken to prevent this interference. It is less well recognised that other metallic implants may also act as antennas in an RFR field and possibly cause adverse health effects by heating local tissues. There are a large and increasing number of implants having metal components which may be found in RFR workers. These implants include artificial joints, rods and plates used in orthopaedics, rings in heart valves, wires in sutures, bionic ears, subcutaneous infusion systems and (external) transdermal drug delivery patches 1 . The physician concerned with job placement of such persons requires information on the likelihood of an implant interacting with RFR so as to impair health. The following outlines the approach developed in Telecom Australia, beginning with the general principles and then presenting a specific example discussion of a specific example

Amperometric cell for subcutaneous detection of hydrogen sulfide in anesthetized experimental animals

International Nuclear Information System (INIS)

Nagy, L; Nagy, G; Filotás, D; Boros, M; Pozsgai, G; Pintér, E

2014-01-01

Hydrogen sulfide (H 2 S) is a toxic gas. It has been recognized that H 2 S evolving in biochemical reactions in living organisms has an important role in different physiologic processes. Nowadays, H 2 S is known as an endogenous messenger molecule. Natural sulfurous spring water has been proved beneficial in the therapy of diseases of the skin and other organs (Boros et al 2013). In vivo real-time detection of local H 2 S concentration is an important but challenging task. We developed a two-electrode amperometric cell for selective subcutaneous detection of H 2 S in anesthetized mice. The cell is a small size implantable gas sensor containing a platinum disc anode and a silver cathode. The selectivity is provided by a membrane permeable only by gases. There is a buffered reversible electrochemical mediator solution in an oxidized form inside the cell. As gaseous H 2 S penetrates into the cell the mediator is reduced, and +0.4 V versus the reference is employed on the platinum working electrode. The reduced mediator is oxidized on the anode surface. The current provides an analytical signal representing the concentration of H 2 S. Appropriate shape, size and membrane material were selected, and optimal working parameters—such as mediator concentration, pH and cell voltage—were determined in vitro. The lower limit of detection in the stirred sample solution at pH = 5.5 was as small as 9.4  ×  10 −7  M and a dynamic concentration range of 0–6  ×  10 –4  M could be achieved. The detecting surfaces of the cell were covered with freshly dissected mouse skin to test dermal H 2 S permeability. In other experiments, the cell was implanted subcutaneously in an anesthetized mouse and the animal was submerged in a buffer solution containing different concentrations of H 2 S so that the skin surface over the sensor was covered by the solution. Measurements of subcutaneous H 2 S concentration were taken. The experiments clearly proved that H 2 S

Subcutaneous granuloma annulare: radiologic appearance

International Nuclear Information System (INIS)

Kransdorf, M.J.; Murphey, M.D.; Temple, H.T.

1998-01-01

Objective. Granuloma annulare is an uncommon benign inflammatory dermatosis characterized by the formation of dermal papules with a tendency to form rings. There are several clinically distinct forms. The subcutaneous form is the most frequently encountered by radiologists, with the lesion presenting as a superficial mass. There are only a few scattered reports of the imaging appearance of this entity in the literature. We report the radiologic appearance of five cases of subcutaneous granuloma annulare. Design and patients. The radiologic images of five patients (three male, two female) with subcutaneous granuloma annulare were retrospectively studied. Mean patient age was 6.4 years (range, 2-13 years). The lesions occurred in the lower leg (two), foot, forearm, and hand. MR images were available for all lesions, gadolinium-enhanced imaging in three cases, radiographs in four, and bone scintigraphy in one. Results. Radiographs showed unmineralized nodular masses localized to the subcutaneous adipose tissue. The size range, in greatest dimension on imaging studies, was 1-4 cm. MR images show a mass with relatively decreased signal intensity on all pulse sequences, with variable but generally relatively well defined margins. There was extensive diffuse enhancement following gadolinium administration. Conclusion. The radiologic appearance of subcutaneous granuloma annulare is characteristic, typically demonstrating a nodular soft-tissue mass involving the subcutaneous adipose tissue. MR images show a mass with relatively decreased signal intensity on all pulse sequences and variable but generally well defined margins. There is extensive diffuse enhancement following gadolinium administration. Radiographs show a soft-tissue mass or soft-tissue swelling without evidence of bone involvement or mineralization. This radiologic appearance in a young individual is highly suggestive of subcutaneous granuloma annulare. (orig.)

Fewer-than-four ports versus four ports for laparoscopic cholecystectomy.

Science.gov (United States)

Gurusamy, Kurinchi Selvan; Vaughan, Jessica; Rossi, Michele; Davidson, Brian R

2014-02-20

Traditionally, laparoscopic cholecystectomy is performed using two 10-mm ports and two 5-mm ports. Recently, a reduction in the number of ports has been suggested as a modification of the standard technique with a view to decreasing pain and improving cosmesis. The safety and effectiveness of using fewer-than-four ports has not yet been established. To assess the benefits (such as improvement in cosmesis and earlier return to activity) and harms (such as increased complications) of using fewer-than-four ports (fewer-than-four-ports laparoscopic cholecystectomy) versus four ports in people undergoing laparoscopic cholecystectomy for any reason (symptomatic gallstones, acalculous cholecystitis, gallbladder polyp, or any other condition). We searched the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 8, 2013), MEDLINE, EMBASE, Science Citation Index Expanded, and the World Health Organization International Clinical Trials Registry Platform portal to September 2013. We included all randomised clinical trials comparing fewer-than-four ports versus four ports, that is, with standard laparoscopic cholecystectomy that is performed with two ports of at least 10-mm incision and two ports of at least 5-mm incision. Two review authors independently identified the trials and extracted the data. We analysed the data using both the fixed-effect and the random-effects models. For each outcome, we calculated the risk ratio (RR) or mean difference (MD) with 95% confidence intervals (CI) based on intention-to-treat analysis, whenever possible. We found nine trials with 855 participants that randomised participants to fewer-than-four-ports laparoscopic cholecystectomy (n = 427) versus four-port laparoscopic cholecystectomy (n = 428). Most trials included low anaesthetic risk participants undergoing elective laparoscopic cholecystectomy. Seven of the nine trials used a single port laparoscopic cholecystectomy and the remaining two trials used three-port laparoscopic

Studies on implantation of 198Au-grain as a radiation therapy to cancer tissue

International Nuclear Information System (INIS)

Machida, Seiro

1975-01-01

The most effective dose of 198 Au-grain to be implanted and the clinicopathological findings after treatment are discussed. A safe dose of 198 Au-grain which could be implanted subcutaneously in rats, was under 2 mCi migration of 198 Au-grain was not recognized. In Yoshida sarcoma, transplanted subcutaneously into the backs of rats the most effective dose of 198 Au-grain was 2mCi/g of tumour tissue. However, about half of the rats implanted with this dosage died from the growing tumour. Histological examination of the implanted tumour tissue, revealed necrosis within a distance of only 0.4 mm from 198 Au-grain particles. In small metastatic tumours after 198 Au-grain implantation, there was necrosis i.e. pyknosis and karyolysis of the tumour cells, fibrosis and hyaline degeneration of the stroma. However, hardly any change in tumour size was detectable because of swelling and induration around the tumour. In some of the cases treated with 198 Au-grain combined with 60 Co or with chemotherapeutics, the tumour size was evidently reduced and became non-palable. Side effects were minimal except in one case which was afflicted temporarily with radiation sickness after an implantation of 200 mCi 198 Au-grain. In conclusion, the implantation of 198 Au-grain into the tumour was found to be very safe for the patients with surgically incurable cancer. Because of the short range of 198 Au-grain radioactivity, homogeneous density of 198 Au-grain into the whole tumour tissue is required. A combination with other radiations and/or with chemotherapeutics is also recommended. (author)

Susceptibility of metallic magnesium implants to bacterial biofilm infections.

Science.gov (United States)

Rahim, Muhammad Imran; Rohde, Manfred; Rais, Bushra; Seitz, Jan-Marten; Mueller, Peter P

2016-06-01

Magnesium alloys have promising mechanical and biological properties as biodegradable medical implant materials for temporary applications during bone healing or as vascular stents. Whereas conventional implants are prone to colonization by treatment resistant microbial biofilms in which bacteria are embedded in a protective matrix, magnesium alloys have been reported to act antibacterial in vitro. To permit a basic assessment of antibacterial properties of implant materials in vivo an economic but robust animal model was established. Subcutaneous magnesium implants were inoculated with bacteria in a mouse model. Contrary to the expectations, bacterial activity was enhanced and prolonged in the presence of magnesium implants. Systemic antibiotic treatments were remarkably ineffective, which is a typical property of bacterial biofilms. Biofilm formation was further supported by electron microscopic analyses that revealed highly dense bacterial populations and evidence for the presence of extracellular matrix material. Bacterial agglomerates could be detected not only on the implant surface but also at a limited distance in the peri-implant tissue. Therefore, precautions may be necessary to minimize risks of metallic magnesium-containing implants in prospective clinical applications. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 1489-1499, 2016. © 2016 Wiley Periodicals, Inc.

Association of subcutaneous testosterone pellet therapy with developing secondary polycythemia

Science.gov (United States)

Rotker, Katherine Lang; Alavian, Michael; Nelson, Bethany; Baird, Grayson L; Miner, Martin M; Sigman, Mark; Hwang, Kathleen

2018-01-01

A variety of methods for testosterone replacement therapy (TRT) exist, and the major potential risks of TRT have been well established. The risk of developing polycythemia secondary to exogenous testosterone (T) has been reported to range from 0.4% to 40%. Implantable T pellets have been used since 1972, and secondary polycythemia has been reported to be as low as 0.4% with this administration modality. However, our experience has suggested a higher rate. We conducted an institutional review board-approved, single-institution, retrospective chart review (2009–2013) to determine the rate of secondary polycythemia in 228 men treated with subcutaneously implanted testosterone pellets. Kaplan–Meyer failure curves were used to estimate time until the development of polycythemia (hematocrit >50%). The mean number of pellets administered was 12 (range: 6–16). The mean follow-up was 566 days. The median time to development of polycythemia whereby 50% of patients developed polycythemia was 50 months. The estimated rate of polycythemia at 6 months was 10.4%, 12 months was 17.3%, and 24 months was 30.2%. We concluded that the incidence of secondary polycythemia while on T pellet therapy may be higher than previously established. PMID:29205178

Subcutaneous sarcoidosis associated with sarcoid tenosynovitis.

Science.gov (United States)

Enzenauer, R J; Waterhouse, W J; West, S G

1996-10-01

Subcutaneous sarcoidosis and sarcoid tenosynovitis are unusual manifestations of systemic sarcoidosis. We report two Japanese women with disseminated sarcoidosis presenting with subcutaneous and tenosynovial involvement demonstrated by computed tomography and magnetic resonance imaging. Sarcoidosis must be considered in the differential diagnosis of unexplained subcutaneous nodulosis or tenosynovitis in patients with or without a previous diagnosis of sarcoidosis.

Strategic port development

DEFF Research Database (Denmark)

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

2014-01-01

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

Acute urinary retention as a late complication of subcutaneous liquid silicone injection: a case report

Directory of Open Access Journals (Sweden)

Leandro Luongo de Matos

2009-12-01

Full Text Available Acute urinary retention is characterized by a sudden interruption of urinary output; urine is retained in the bladder due to either functional or obstructive anatomic factors, and cannot be voided. The main causes of acute urinary obstruction are benign prostatic hyperplasia, constipation, prostate adenocarcinoma, urethral stenosis, clot retention, neurological disorders, following surgery, calculi, drugs, or urinary tract infections. A transvestite patient, aged 55 years, described having had liquid silicone subcutaneously injected in various parts of the body, the last one four years ago. He complained of absent urinary output during the last 14 hours. The physical examination revealed skin deformation due to migration of implants; a hard nodule (characterized as a foreign body was present in the preputium and a diagnosis of acute urinary retention was made; an unsuccessful attempt to exteriorize the glans for urinary catheterization, was followed by therapeutic cystostomy. Acute urinary retention has not been mentioned in the medical literature as a complication of liquid silicone subcutaneous injection.

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

Science.gov (United States)

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

2015-06-01

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

Port-wine vascular malformations and glaucoma risk in Sturge-Weber syndrome.

Science.gov (United States)

Sharan, Sapna; Swamy, Brighu; Taranath, Deepa Ajay; Jamieson, Robyn; Yu, Tao; Wargon, Orli; Grigg, John R

2009-08-01

Treatment of the capillary vascular malformation (port-wine stain) in Sturge-Weber syndrome with the use of a laser is helpful cosmetically. However, concerns have been raised that laser obliteration of port-wine stains may result in ocular hypertension. The aim of this study was to review clinical features and management of ocular complications of SWS and assess the effects of dermatological laser treatment on the incidence of glaucoma or ocular hypertension. This retrospective cohort study was conducted in an institutional setting. All patients had involvement of the face. Patients who underwent skin laser to the port-wine vascular malformation were analyzed further. Ocular involvement, glaucoma, and skin laser treatment and the relationship to ocular hypertension/glaucoma were observed. Forty-one Sturge-Weber syndrome patients with port-wine vascular malformation were analyzed. Glaucoma was observed in 24 patients (58.5%) at mean age of 2.9 years (range, 0.0-16.5). Of these, 18 (75.0%) were treated with medical therapy, and 10 (41.7%) required trabeculectomy, with 2 of these requiring Seton implant. Of the 41 patients, 28 (68.3%) underwent laser to face/forehead. Mean age of laser commencement was 5 years (range, 0.4-16.5). Thirteen did not undergo laser treatment. Fourteen of the 28 and 10 of the 13 developed ocular hypertension/glaucoma. This retrospective review did not find evidence to suggest that laser treatment of port-wine vascular malformations causes glaucoma or that it can worsen a preexisting ocular hypertension or glaucoma. Statistical analysis was inconclusive.

Port of Rotterdam

NARCIS (Netherlands)

Veenstra, A.W.

2014-01-01

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

Recombinant human hyaluronidase-enabled subcutaneous pediatric rehydration.

Science.gov (United States)

Allen, Coburn H; Etzwiler, Lisa S; Miller, Melissa K; Maher, George; Mace, Sharon; Hostetler, Mark A; Smith, Sharon R; Reinhardt, Neil; Hahn, Barry; Harb, George

2009-11-01

The Increased Flow Utilizing Subcutaneously-Enabled (INFUSE)-Pediatric Rehydration Study was designed to assess efficacy, safety, and clinical utility of recombinant human hyaluronidase (rHuPH20)-facilitated subcutaneous rehydration in children 2 months to 10 years of age. Patients with mild/moderate dehydration requiring parenteral treatment in US emergency departments were eligible for this phase IV, multicenter, single-arm study. They received subcutaneous injection of 1 mL rHuPH20 (150 U), followed by subcutaneous infusion of 20 mL/kg isotonic fluid over the first hour. Subcutaneous rehydration was continued as needed for up to 72 hours. Rehydration was deemed successful if it was attributed by the investigator primarily to subcutaneous fluid infusion and the child was discharged without requiring an alternative method of rehydration. Efficacy was evaluated in 51 patients (mean age: 1.9 years; mean weight: 11.2 kg). Initial subcutaneous catheter placement was achieved with 1 attempt for 46/51 (90.2%) of patients. Rehydration was successful for 43/51 (84.3%) of patients. Five patients (9.8%) were hospitalized but deemed to be rehydrated primarily through subcutaneous therapy, for a total of 48/51 (94.1%) of patients. No treatment-related systemic adverse events were reported, but 1 serious adverse event occurred (cellulitis at infusion site). Investigators found the procedure easy to perform for 96% of patients (49/51 patients), and 90% of parents (43/48 parents) were satisfied or very satisfied. rHuPH20-facilitated subcutaneous hydration seems to be safe and effective for young children with mild/moderate dehydration. Subcutaneous access is achieved easily, and the procedure is well accepted by clinicians and parents.

stausartikel: behandling af subcutane abscesser

DEFF Research Database (Denmark)

Hardgrib, Nina; Petersen, Klaus Kjær

2017-01-01

Simple subcutaneous abscesses are common, and we have examined the literature concerning the ideal treatment of subcutaneous abscesses. We recommend radical debridement with removal of all pus, the abscess wall and any necrosis. If primary suture is chosen, preoperative antibiotics should be admi...

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

Directory of Open Access Journals (Sweden)

Radeleff Boris

2008-10-01

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

Subcutaneous versus subcutaneous and intraperitoneal local anaesthetic in the management of post appendicectomy pain

International Nuclear Information System (INIS)

Qureshi, K.Z.; Gondal, Z.I.; Raza, A.

2014-01-01

To compare the efficacy of subcutaneous only and combined subcutaneous and peritoneal infiltration of 0.5% bupivacaine during appendicectomy for the management of early post operative pain. Study Design: Randomized controlled study. Place and Duration of Study: Department of Surgery, CMH Kohat from 13th December 2007 to 20th December 2008. Patients and Methods: Sixty patients of a cute appendicitis, divided into two groups of 30 each, were included in the study. Group A was given 0.5% bupivacaine subcutaneously, whereas group B was given the anaesthetic subcutaneously as well as intraperitoneally during appendectomy. Results: In group A, 24 (80%) were VAS (visual analoguescoring) 3 (uncomfortable) and 6 (20%) were VAS 2 (mild pain) whereas in study group B, 11 (36.6%) were VAS 3, 19 (63.3%) were VAS 2 and 19 (63.3%) were VAS 2 during 1st 12 hrs postoperatively (p=0.001). In 12-24 hrs post operatively, 15 (50%) patients were VAS 3 in group A and same number was VAS 2 and in group B, only 3 (10%) were in VAS 3 and 27 (90%) were VAS 2 (p=0.001). Conclusion: A combination of subcutaneous and peritoneal infiltration with bupivacaine is superior in relieving post appendectomy pain so patients require less dosage of analgesics in early post operative period along with early mobilization. (author)

Engineering issues on the diagnostic port integration in ITER upper port 18

Energy Technology Data Exchange (ETDEWEB)

Pak, Sunil, E-mail: paksunil@nfri.re.kr [National Fusion Research Institute, Gwahak-ro, Yuseong-gu, Daejeon (Korea, Republic of); Bertalot, Luciano [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-lez-Durance (France); Cheon, Mun Seong [National Fusion Research Institute, Gwahak-ro, Yuseong-gu, Daejeon (Korea, Republic of); Giacomin, Thibaud [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-lez-Durance (France); Heemskerk, Cock J.M.; Koning, Jarich F. [Heemskerk Innovative Technology, Merelhof 2, 2172 HZ Sassenheim (Netherlands); Lee, Hyeon Gon [National Fusion Research Institute, Gwahak-ro, Yuseong-gu, Daejeon (Korea, Republic of); Nemtcev, Grigorii [Institution “PROJECT CENTER ITER”, Akademika Kurchatova sq., Moscow (Russian Federation); Ronden, Dennis M.S. [FOM Institute DIFFER, P.O. Box 1207, 3430 BE Nieuwegein (Netherlands); Seon, Chang Rae [National Fusion Research Institute, Gwahak-ro, Yuseong-gu, Daejeon (Korea, Republic of); Udintsev, Victor; Yukhnov, Nikolay [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-lez-Durance (France); Zvonkov, Alexander [Institution “PROJECT CENTER ITER”, Akademika Kurchatova sq., Moscow (Russian Federation)

2016-11-01

Highlights: • Diagnostic port integration in the upper port 18 of ITER is presented in order to house the three diagnostic systems. • Issue on the neutron shielding in the upper port 18 is addressed and the shut-down dose rate in the interspace is summarized. • The maintenance strategy in the upper port 18 is described. - Abstract: The upper port #18 (UP18) in ITER hosts three diagnostic systems: the neutron activation system, the Vacuum Ultra-Violet spectrometer system, and the vertical neutron camera. These diagnostics are integrated into three infrastructures in the port: the upper port plug, interspace support structure and port cell support structure. The port integration in UP18 is at the preliminary design stage and the current design of the infrastructure as well as the diagnostic integration is described here. The engineering issues related to neutron shielding and maintenance are addressed and the design approach is suggested.

Modeling the relative impact of capsular tissue effects on implanted glucose sensor time lag and signal attenuation.

Science.gov (United States)

Novak, Matthew T; Yuan, Fan; Reichert, William M

2010-10-01

Little is known mechanistically about why implanted glucose sensors lag behind blood glucose levels in both the time to peak sensor response and the magnitude of peak sensor response. A mathematical model of glucose transport from capillaries through surrounding tissue to the sensor surface was constructed to address how different aspects of the tissue affect glucose transport to an implanted sensor. Physiologically relevant values of capsule diffusion coefficient, capsule porosity, cellular glucose consumption, capsule thickness, and subcutaneous vessel density were used as inputs to create simulated sensor traces that mimic experimental instances of time lag and concentration attenuation relative to a given blood glucose profile. Using logarithmic sensitivity analysis, each parameter was analyzed to study the effect of these variables on both lag and attenuation. Results identify capsule thickness as the strongest determinant of sensor time lag, while subcutaneous vessel density and capsule porosity had the largest effects on attenuation of glucose that reaches the sensor surface. These findings provide mechanistic insight for the rational design of sensor modifications that may alleviate the deleterious consequences of tissue effects on implanted sensor performance.

In Vivo Model to Test Implanted Biosensors for Blood pH

Science.gov (United States)

Arnaud, Sara B.; Somps, Chris J.; Madou, Marc; Hines, John; Wade, Charles E. (Technical Monitor)

1997-01-01

Biosensors for monitoring physiologic data continuously through telemetry are available for heart rate, respiration, and temperature but not for blood pH or ions affected by hydrogen ion concentration. A telemetric biosensor for monitoring blood pH on-line could be used to identify and manage problems in fluid and electrolyte metabolism, cardiac and respiratory function during space flight and the acid-base status of patients without the need for venipuncture in patients on Earth. Critical to the development of biosensors is a method for evaluating their performance after implantation. Mature rats, prepared with jugular, cannulas for repeated blood samples, were exposed to a gas mixture containing high levels of carbon dioxide (7%) in a closed environment to induce mild respiratory acidosis. Serial blood gas and pH measurements in venous blood were compared with electrical responses from sensors implanted in the subcutaneous tissue. Animals became slightly tachypneic after exposure to excess CO2, but remained alert and active. After 5 minutes, basal blood pH decreased from 7.404 +/- 0.013 to 7.289 +/- 0.010 (p less than 0.001)and PC02 increased from 45 +/- 6 to 65 +/- 4 mm. Hg (p les than 0.001). Thereafter pH and blood gas parameters remained stable. Implanted sensors showed a decrease in millivolts (mV) which paralleled the change in pH and averaged 5-6 mV per 0.1 unit pH. Implanted sensors remained sensitive to modest changes in tissue pH for one week. A system for inducing acidosis in rats was developed to test the in vivo performance of pH biosensors. The system provides a method which is sensitive, rapid and reproducible in the same and different animals with full recovery, for testing the performance of sensors implanted in subcutaneous tissues.

Assessing customs performance in the Mediterranean ports. KPI selection and Best practices identification as part of the MEDNET project

Energy Technology Data Exchange (ETDEWEB)

Morales Fusco, P.; Sauri Marchan, S.; Lekka, A.M.; Karousos, I.

2016-07-01

The seamless flow of goods, people and investments across the Mediterranean necessitates a well-functioning port and transport system. More efficient port operations enhance seamless logistics and promote safety, efficiency, interoperability and interconnectivity of transport networks in the Mediterranean area.To promote the exchange of knowledge and expertise relevant to port and customs procedures and simplification of clearance for vessels and cargoes in the Mediterranean, the MEDNET project was launched. As part of the project a common evaluation framework for the performance of ports in the form of a set of Key Performance Indicators (KPIs) together with a list of the best practices in terms of operations and customs procedures was developed.In total, 50 ports were analyzed and given a KPI regarding traffic, financial, operational and human resources, sustainability and customs procedures. The values were latter crossed with the current good practices on operation in terms of customs procedures. And a small correlation between KPIs performance and implantation degree of good practices in customs procedures was found. This presentation exposes the methodology to assess the ports’ performance and the best. (Author)

The Re-Conceptualization of the Port Supply Chain as a Smart Port Service System: The Case of the Port of Salerno

Directory of Open Access Journals (Sweden)

Antonio Botti

2017-04-01

Full Text Available This paper proposes a re-conceptualization of the port supply chain as a smart service system, in accordance with the theory of service science. Starting from a short literature review about the port supply chain approach and service science, a new comprehensive framework is provided to better understand seaport dynamics and the creation of competitive port supply chains. The methodology used is the case study approach. The Authors examined the Port of Salerno (Italy and re-conceptualized it as a smart port service system. The originality of the work lies in the application of service science as a lens to re-conceptualize the port supply chain, that allows the implementation of a logistic framework. Both theoretical and practical implications are provided to enrich the literature about port supply chains and to support port operators.

Mechanical characteristics of plastic base Ports and impact on flushing efficacy

Directory of Open Access Journals (Sweden)

Guiffant G

2017-01-01

Full Text Available Gérard Guiffant,1 Patrice Flaud,1 Laurent Royon,1 Espérie Burnet,2 Jacques Merckx1–3 1University Paris Diderot, Biofluidic Group, UMR CNRS, 2Pulmonary Department and Adult Cystic Fibrosis Centre, Cochin Hospital, 3University Teaching Hospital, Necker-Enfants Malades, Paris, France Background: Three types of totally implantable venous access devices, Ports, are currently in use: titanium, plastic (polyoxymethylene, POM, and mixed (titanium base with a POM shell. Physics theory suggests that the interaction between a non-coring needle (NCN, made of stainless steel and a plastic base would lead to the stronger material (steel altering the more malleable material (plastic. Objectives: To investigate whether needle impacts can alter a plastic base’s surface, thus potentially reducing flushing efficacy. Study design and methods: A Port made of POM was punctured 200 times with a 19-gauge NCN. Following the existing guidelines, the needle tip pricked the base with each puncture. The Port’s base was then examined using a two-dimensional optical instrument, and a bi-dimensional numerical simulation using COMSOL® was performed to investigate potential surface irregularities and their impact on fluid flow. Results: Each needle impact created a hole (mean depth, 0.12 mm with a small bump beside it (mean height, 0.02 mm the Reynolds number Rek≈10. A numerical simulation of the one hole/bump set showed that the flushing efficacy was 60% that of flushing along a flat surface. Discussion: In clinical practice, the number of times a Port is punctured depends on patient and treatment characteristics, but each needle impact on the plastic base may increase the risk of decreased flushing effectiveness. Therefore, the more a plastic Port is accessed, the greater the risk of microorganisms, blood products, and medication accumulation. Conclusions: Multiple needle impacts created an irregular surface on the Port’s base, which decreased flushing efficacy

Improvement of wireless power transmission efficiency of implantable subcutaneous devices by closed magnetic circuit mechanism.

Science.gov (United States)

Jo, Sung-Eun; Joung, Sanghoon; Suh, Jun-Kyo Francis; Kim, Yong-Jun

2012-09-01

Induction coils were fabricated based on flexible printed circuit board for inductive transcutaneous power transmission. The coil had closed magnetic circuit (CMC) structure consisting of inner and outer magnetic core. The power transmission efficiency of the fabricated device was measured in the air and in vivo condition. It was confirmed that the CMC coil had higher transmission efficiency than typical air-core coil. The power transmission efficiency during a misalignment between primary coil and implanted secondary coil was also evaluated. The decrease of mutual inductance between the two coils caused by the misalignment led to a low efficiency of the inductive link. Therefore, it is important to properly align the primary coil and implanted secondary coil for effective power transmission. To align the coils, a feedback coil was proposed. This was integrated on the backside of the primary coil and enabled the detection of a misalignment of the primary and secondary coils. As a result of using the feedback coil, the primary and secondary coils could be aligned without knowledge of the position of the implanted secondary coil.

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

Science.gov (United States)

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

2015-11-01

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

[A totally implantable venous access device. Implantation in general or local anaesthesia? A retrospective cost analysis].

Science.gov (United States)

Schuld, J; Richter, S; Moussavian, M R; Kollmar, O; Schilling, M K

2009-08-01

Implantation of venous access port systems can be performed in local or general anesthesia. In spite of the increasing rate of interventionally implanted systems, the surgical cut-down represents a safe alternative. Thus, the question arises whether--in context to the increasing health-economic pressure--open implantation in general anesthesia is still a feasible alternative to implantation in local anesthesia regarding OR efficiency and costs. In a retrospective analysis, 993 patients receiving a totally implantable venous access device between 2001 and 2007 were evaluated regarding OR utilization, turnover times, intraoperative data and costs. Implantations in local (LA) and general anesthesia (GA) were compared. GA was performed in 762 cases (76.6 %), LA was performed in 231 patients (23.3 %). Mean operation time was similar in both groups (LA 47.27 +/- 1.40 min vs. GA 45.41 +/- 0.75 min, p = 0.244). Patients receiving local anesthesia had a significantly shorter stay in the OR unit (LA 95.9 +/- 1.78 min vs. GA 105.92 +/- 0.92 min; p cut (LA 39.57 +/- 0.69 min vs. GA 50.46 +/- 0.52 min; p material costs were significantly lower in the LA group compared with the GA group (LA: 400.72 +/- 8.25 euro vs. GA: 482.86 +/- 6.23 euro; p systems in local anesthesia is superior in comparison to the implantation under general anesthesia regarding procedural times in the OR unit and costs. With the same operation duration, but less personnel and material expenditure, implantation in local anesthesia offers a potential economic advantage by permitting faster changing times. Implantation in GA only should be performed at a special request by the patient or in difficult venous conditions. Georg Thieme Verlag Stuttgart.New York.

Flat-port connectors

KAUST Repository

Alrashed, Mohammed

2017-01-01

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

Integrated circuit test-port architecture and method and apparatus of test-port generation

Science.gov (United States)

Teifel, John

2016-04-12

A method and apparatus are provided for generating RTL code for a test-port interface of an integrated circuit. In an embodiment, a test-port table is provided as input data. A computer automatically parses the test-port table into data structures and analyzes it to determine input, output, local, and output-enable port names. The computer generates address-detect and test-enable logic constructed from combinational functions. The computer generates one-hot multiplexer logic for at least some of the output ports. The one-hot multiplexer logic for each port is generated so as to enable the port to toggle between data signals and test signals. The computer then completes the generation of the RTL code.

Sea freight - Antwerp Port

Directory of Open Access Journals (Sweden)

NEACSU Nicoleta Andreea

2017-01-01

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

Determinants of Port Performance - Case Study of 4 Main Ports in Indonesia (2005-2015

Directory of Open Access Journals (Sweden)

Atika Aqmarina

2018-03-01

Full Text Available Port plays significant role in supporting economic growth of a country. This study aims to analyze the determinant of port performance in Indonesia. In this research, the ports selected are four main ports in Indonesia which are Port of Belawan, Port of Tanjung Priok, Port of Tanjung Perak, and Makassar. These ports are designed as the hub ports in the national sea transport system of the country. The study used pooled OLS as the methodology to analyze the determinant. The result of this studies shows that total traffic is not influenced by operating surplus per ton, whereas the rest of variables such as turnaround time, idle time, berth of occupancy rate, rate of return, number of employee and cargo equipment have significant results and significantly influenced the total traffic.

ITER lower port systems integration

Energy Technology Data Exchange (ETDEWEB)

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

2011-10-15

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

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

Directory of Open Access Journals (Sweden)

Mehdi Ghaderian

2015-01-01

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

Principal Ports

Data.gov (United States)

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

Right versus left parasternal electrode position in the entirely subcutaneous ICD.

Science.gov (United States)

Bettin, Markus; Dechering, Dirk; Frommeyer, Gerrit; Larbig, Robert; Löher, Andreas; Reinke, Florian; Köbe, Julia; Eckardt, Lars

2018-05-01

The subcutaneous implantable cardioverter defibrillator (S-ICD ® ) has been established as an alternative to conventional transvenous ICD for the prevention of sudden cardiac death. Initial studies have shown safety and efficacy of the system with a left parasternal (LP) electrode. However, several case studies reported a right parasternal (RP) position. The purpose of this study was to analyze shock efficacy and safety of an RP electrode position. Between June 2010 and May 2016, 120 S-ICD ® were implanted at our institution. On the basis of the heart location on preoperative chest radiography (CXR), the investigators decided on an RP (n = 52) or LP electrode position (n = 68). All perioperative induced VF episodes, and spontaneous appropriate and inappropriate episodes during follow-up were analyzed. Patients with an RP electrode did not differ in terms of age, sex, or ejection fraction. A statistically significant difference in underlying cardiac disease was observed between the RP and LP electrode group, with more patients with channelopathies in the RP electrode group and more patients with non-ischemic cardiomyopathy in the LP electrode group. During a mean follow-up of 24.3 ± 19.5 months, 27 appropriate (19 in the LP group and 8 in the RP group) and 28 inappropriate (18 LP and 10 RP) ICD shocks occurred (p value = NS). In the present study, an RP electrode position was chosen on the basis of chest radiographic characteristics and was efficient in terms of sensing and shock efficacy. Thus, a right-sided electrode implant might be an alternative if a left-sided electrode implant is inadequate. It might also be favorable for young patients with narrow heart silhouettes in the midsagittal position.

Angiolymphoid hyperplasia with eosinophilia-acquired port-wine-stain-like lesions: attempt at treatment with the argon laser.

Science.gov (United States)

Pasyk, K A; Elsenety, E N; Schelbert, E B

1988-01-01

An unusual case of angiolymphoid hyperplasia with eosinophilia (ALHE) simulating port-wine stain in a 50-year-old woman is reported. The lesions of ALHE are typically papules or subcutaneous masses that range from light pink to red-brown in color. In addition to the usual histologic findings of ALHE, the biopsy in our patient showed some fibrin-like material and fibrous long-spacing collagen on ultrastructural examination. This unusual lesion necessitates biopsy because the differential diagnosis includes port-wine stain, sarcoidosis, lupus erythematosus, and non-Hodgkin lymphoma (mycosis fungoides). Many different forms of treatment have been attempted for ALHE including radiotherapy, cytotoxic chemotherapy, corticosteroids, and antibiotics. The lesions in our patient responded to argon laser therapy and surgical excision, though there has been recurrence on the border of the treated area. Because laser energy is noncumulative in the tissues and effective in removing the lesions, we recommend it as the treatment of choice for these lesions.

Predicting and monitoring response to chemotherapy by 1,3-bis(2-chloroethyl)-1-nitrosourea in subcutaneously implanted 9L glioma using the apparent diffusion coefficient of water and 23Na MRI.

Science.gov (United States)

Babsky, Andriy M; Hekmatyar, S K; Zhang, Hong; Solomon, James L; Bansal, Navin

2006-07-01

To examine the effects of the alkylating anticancer drug 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) on (23)Na MRI and the water apparent diffusion coefficient (ADC) in subcutaneously- (sc-) implanted 9L glioma in rats. (23)Na MRI and (1)H water ADC measurements were performed on sham-treated control (N = 6) and BCNU-treated (N = 15) Fisher rats one day before BCNU injection and then one, three, and five days after BCNU injection. The BCNU-treated tumors were divided into BCNU-responsive (R(BCNU)) and BCNU-nonresponsive (NR(BCNU)) groups depending on the tumor volume changes that occurred after therapy. The pretreatment (23)Na MRI signal intensity (SI) and water ADC values were higher in R(BCNU) tumors compared to NR(BCNU) tumors. (23)Na MRI SI and water ADC increased with tumor growth in control and NR(BCNU) groups, but these changes were interrupted by BCNU therapy in R(BCNU) group. (23)Na MRI and water ADC measurements may be useful for predicting and monitoring response to chemotherapy in some tumors. However, the changes that occurred in (23)Na MRI SI and water ADC in sc-implanted 9L tumors are in contrast to previously published results for BCNU therapy of orthotopic 9L tumors. This may have important implications for monitoring therapy response in tumors. (c) 2006 Wiley-Liss, Inc.

Management of Port Operations

OpenAIRE

Gheorghe BASANU; Georgiana NUKINA

2011-01-01

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

Facilitated subcutaneous immunoglobulin administration (fSCIg)

DEFF Research Database (Denmark)

Blau, Igor-Wolfgang; Conlon, Niall; Petermann, Robert

2016-01-01

and diverse medical needs that treatments for SID management should strive to meet. In this special report, we study the opportunities provided by facilitated subcutaneous immunoglobulin administration (fSCIg) to treat patients for whom the conventional routes (intravenous and subcutaneous) are sub...

Single-port unilateral transaxillary totally endoscopic thyroidectomy: A survival animal and cadaver feasibility study

Directory of Open Access Journals (Sweden)

Henrique Neubarth Phillips

2016-01-01

Full Text Available Background: Single-port unilateral axillary thyroidectomy has great potential to become a valid alternative technique for thyroid surgery. We tested the technique in a study on live animals and cadavers to evaluate the feasibility and reproducibility of the procedure. Materials and Methods: Institutional review board (IRB approval was obtained in our university by the Council of Ethics for the study in surviving animals and cadavers. Subtotal thyroidectomy using unilateral axillary single port was performed in five dogs and five cadavers. Performing incision in the axillary fossa, a disposable single port was inserted. The dissection progressed for creating a subcutaneous tunnel to the subplatysmal region; after opening the platysma muscle and separation of the strap muscles, the thyroid gland was identified. After key anatomical landmarks were identified, the dissection was started at the upper pole towards the bottom, and to the isthmus. Specimens were extracted intact through the tunnel. Clinical and laboratorial observations of the experimental study in a 15-day follow-up and intraoperative data were documented. Results: All surgeries were performed in five animals which survived 15 days without postoperative complications. In the surgeries successfully performed in five cadavers, anatomical landmarks were recognised and intraoperative dissection of recurrent nerves and parathyroid glands was performed. Mean operative time was 64 min (46-85 min in animals and 123 min (110-140 min in cadavers, with a good cosmetic outcome since the incision was situated in the axillary fold. Conclusion: The technique of single-port axillary unilateral thyroidectomy was feasible and reproducible in the cadavers and animal survival study, suggesting the procedure as an alternative to minimally invasive surgery of the neck.

The Windows serial port programming handbook

CERN Document Server

Bai, Ying

2004-01-01

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

Maintaining and Researching Port Safety: A Case Study of the Port of Kaohsiung

OpenAIRE

Tseng, Po-Hsing.; Pilcher, Nick.

2017-01-01

Maintaining port safety in full conformity with IMO standards is a requisite for every port and country. To do this, understanding the challenges and human factors involved is key. To date, much research has shed valuable light on these factors and considered how to address them. One aspect that is often noted is that both maintaining port safety and researching port safety presents numerous challenges. This paper considers both these aspects in the context of a case study of port safety in K...

[Cellular subcutaneous tissue. Anatomic observations].

Science.gov (United States)

Marquart-Elbaz, C; Varnaison, E; Sick, H; Grosshans, E; Cribier, B

2001-11-01

We showed in a companion paper that the definition of the French "subcutaneous cellular tissue" considerably varied from the 18th to the end of the 20th centuries and has not yet reached a consensus. To address the anatomic reality of this "subcutaneous cellular tissue", we investigated the anatomic structures underlying the fat tissue in normal human skin. Sixty specimens were excised from the surface to the deep structures (bone, muscle, cartilage) on different body sites of 3 cadavers from the Institut d'Anatomie Normale de Strasbourg. Samples were paraffin-embedded, stained and analysed with a binocular microscope taking x 1 photographs. Specimens were also excised and fixed after subcutaneous injection of Indian ink, after mechanic tissue splitting and after performing artificial skin folds. The aspects of the deep parts of the skin greatly varied according to their anatomic localisation. Below the adipose tissue, we often found a lamellar fibrous layer which extended from the interlobular septa and contained horizontally distributed fat cells. No specific tissue below the hypodermis was observed. Artificial skin folds concerned either exclusively the dermis, when they were superficial or included the hypodermis, but no specific structure was apparent in the center of the fold. India ink diffused to the adipose tissue, mainly along the septa, but did not localise in a specific subcutaneous compartment. This study shows that the histologic aspects of the deep part of the skin depend mainly on the anatomic localisation. Skin is composed of epidermis, dermis and hypodermis and thus the hypodermis can not be considered as being "subcutaneous". A difficult to individualise, fibrous lamellar structure in continuity with the interlobular septa is often found under the fat lobules. This structure is a cleavage line, as is always the case with loose connective tissues, but belongs to the hypodermis (i.e. fat tissue). No specific tissue nor any virtual space was

Flow confirmation study for central venous port in oncologic outpatient undergoing chemotherapy: Evaluation of suspected system-related mechanical complications

Energy Technology Data Exchange (ETDEWEB)

Sofue, Keitaro, E-mail: ksofue@ncc.go.jp [Divisions of Diagnostic Radiology, National Cancer Center Hospital (Japan); Department of Radiology, Kobe University, Graduate School of Medicine (Japan); Arai, Yasuaki; Takeuchi, Yoshito [Divisions of Diagnostic Radiology, National Cancer Center Hospital (Japan); Sugimura, Kazuro [Department of Radiology, Kobe University, Graduate School of Medicine (Japan)

2013-11-01

Purpose: To evaluate the efficacy and outcome of a flow confirmation study (FCS) in oncologic outpatients undergoing chemotherapy suspected of a central venous port (CVP) system-related mechanical complication. Materials and methods: A total of 66 patients (27 men, 39 women; mean age, 60 years) received FCS for the following reasons: prolonged infusion time during chemotherapy (n = 32), inability to inject saline fluid (n = 15), lateral neck and/or back pain (n = 6), subcutaneous extravasation of anticancer drug (n = 5), arm swelling (n = 4), and inability to puncture the port (n = 4). FCS consisted of examining the position of CVP, potential secondary shifts or fractures, and integrity of the system using contrast material through the port. Results: Of the 66 patients, 43 had an abnormal finding uncovered by FCS. The most frequent abnormal findings was catheter kinking (n = 22). Explantation and reimplantation of the CVP system was required in 21 of the 66 patients. Remaining 45 patients were able continue using the CVP system after the FCS without any system malfunction. Conclusion: FCS was effective for evaluating CVP system-related mechanical complications and was useful for deciding whether CVP system explantation and reimplantation was required.

Flow confirmation study for central venous port in oncologic outpatient undergoing chemotherapy: Evaluation of suspected system-related mechanical complications

International Nuclear Information System (INIS)

Sofue, Keitaro; Arai, Yasuaki; Takeuchi, Yoshito; Sugimura, Kazuro

2013-01-01

Purpose: To evaluate the efficacy and outcome of a flow confirmation study (FCS) in oncologic outpatients undergoing chemotherapy suspected of a central venous port (CVP) system-related mechanical complication. Materials and methods: A total of 66 patients (27 men, 39 women; mean age, 60 years) received FCS for the following reasons: prolonged infusion time during chemotherapy (n = 32), inability to inject saline fluid (n = 15), lateral neck and/or back pain (n = 6), subcutaneous extravasation of anticancer drug (n = 5), arm swelling (n = 4), and inability to puncture the port (n = 4). FCS consisted of examining the position of CVP, potential secondary shifts or fractures, and integrity of the system using contrast material through the port. Results: Of the 66 patients, 43 had an abnormal finding uncovered by FCS. The most frequent abnormal findings was catheter kinking (n = 22). Explantation and reimplantation of the CVP system was required in 21 of the 66 patients. Remaining 45 patients were able continue using the CVP system after the FCS without any system malfunction. Conclusion: FCS was effective for evaluating CVP system-related mechanical complications and was useful for deciding whether CVP system explantation and reimplantation was required

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

Science.gov (United States)

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

2013-01-01

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

Implantation of venous access devices under local anesthesia: patients’ satisfaction with oral lorazepam

Directory of Open Access Journals (Sweden)

Chang DH

2015-07-01

Full Text Available De-Hua Chang,1 Sonja Hiss,1 Lena Herich,2 Ingrid Becker,2 Kamal Mammadov,1 Mareike Franke,1 Anastasios Mpotsaris,1 Robert Kleinert,3 Thorsten Persigehl,1 David Maintz,1 Christopher Bangard1 1Department of Radiology, 2Institute of Medical Statistics, Informatics and Epidemiology, 3Department of Surgery, University Hospital of Cologne, Cologne, Germany Objective: The aim of the study reported here was to evaluate patients’ satisfaction with implantation of venous access devices under local anesthesia (LA with and without additional oral sedation.Materials and methods: A total of 77 patients were enrolled in the prospective descriptive study over a period of 6 months. Subcutaneous implantable venous access devices through the subclavian vein were routinely implanted under LA. Patients were offered an additional oral sedative (lorazepam before each procedure. The level of anxiety/tension, the intensity of pain, and patients’ satisfaction were evaluated before and immediately after the procedure using a visual analog scale (ranging from 0 to 10 with a standardized questionnaire.Results: Patients’ satisfaction with the procedure was high (mean: 1.3±2.0 with no significant difference between the group with premedication and the group with LA alone (P=0.54. However, seven out of 30 patients (23.3% in the group that received premedication would not undergo the same procedure without general anesthesia. There was no significant influence of lorazepam on the intensity of pain (P=0.88. In 12 out of 30 patients (40% in the premedication group, the level of tension was higher than 5 on the visual analog scale during the procedure. In 21 out of 77 patients (27.3%, the estimate of the level of tension differed between the interventionist and the patient by 3 or more points in 21 out of 77 patients (27.3%.Conclusion: Overall patient satisfaction is high for implantation of venous access devices under LA. A combination of LA with lorazepam administered

Shipping emissions in ports

OpenAIRE

Merk, Olaf

2014-01-01

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

19 CFR 101.3 - Customs service ports and ports of entry.

Science.gov (United States)

2010-04-01

... and Service Ports. Many of the ports listed were created by the President's message of March 3, 1913....S.C. 1). Subsequent orders of the President or of the Secretary of the Treasury which affected these... Port of the Delaware River and Bay described in T.D. 96-4. Perth Amboy New Mexico Albuquerque Including...

Implantable batteryless device for on-demand and pulsatile insulin administration

Science.gov (United States)

Lee, Seung Ho; Lee, Young Bin; Kim, Byung Hwi; Lee, Cheol; Cho, Young Min; Kim, Se-Na; Park, Chun Gwon; Cho, Yong-Chan; Choy, Young Bin

2017-04-01

Many implantable systems have been designed for long-term, pulsatile delivery of insulin, but the lifetime of these devices is limited by the need for battery replacement and consequent replacement surgery. Here we propose a batteryless, fully implantable insulin pump that can be actuated by a magnetic field. The pump is prepared by simple-assembly of magnets and constituent units and comprises a drug reservoir and actuator equipped with a plunger and barrel, each assembled with a magnet. The plunger moves to noninvasively infuse insulin only when a magnetic field is applied on the exterior surface of the body. Here we show that the dose is easily controlled by varying the number of magnet applications. Also, pump implantation in diabetic rats results in profiles of insulin concentration and decreased blood glucose levels similar to those observed in rats treated with conventional subcutaneous insulin injections.

Characterization of alendronic- and undecylenic acid coated magnetic nanoparticles for the targeted delivery of rosiglitazone to subcutaneous adipose tissue.

Science.gov (United States)

Saatchi, Katayoun; Tod, Sarah E; Leung, Donna; Nicholson, Kenton E; Andreu, Irene; Buchwalder, Christian; Schmitt, Veronika; Häfeli, Urs O; Gray, Sarah L

2017-02-01

Obesity is a state of positive energy balance where excess white adipose tissue accumulates to the detriment of metabolic health. Improving adipocyte function with systemic administration of thiazolidinediones (TZDs) improves metabolic outcomes in obesity, however TZD use is limited clinically due to undesirable side effects. Here we evaluate magnetic nanoparticles (MNPs) as a tool to target rosiglitazone (Rosi) specifically to adipose tissue. Results show Rosi can be adsorbed to MNPs (Rosi-MNPs) with hydrophobic coatings for which we present binding and release kinetics. Rosi adsorbed to MNPs retained the ability to induce PPARγ target gene expression in cells. Biodistribution analysis of radiolabeled Rosi-MNPs revealed a fat-implanted magnet significantly enhanced localization of Rosi to the targeted adipose tissue when administered by subcutaneous injection to obese mice. We propose MNPs for targeted delivery of anti-diabetic agents to superficially located subcutaneous adipose tissue. Copyright © 2016 Elsevier Inc. All rights reserved.

Intake port

Science.gov (United States)

Mendler, Edward Charles

2005-02-01

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

Shutdown dose rates at ITER equatorial ports considering radiation cross-talk from torus cryopump lower port

Energy Technology Data Exchange (ETDEWEB)

Juárez, Rafael, E-mail: rjuarez@ind.uned.es [Departamento de Ingeniería Energética, ETSII-UNED, Calle Juan del Rosal 12, Madrid 28040 (Spain); Pampin, Raul [F4E, Torres Diagonal Litoral B3, Josep Pla 2, Barcelona 08019 (Spain); Levesy, Bruno [ITER Organization, 13115 Route de Vinon sur Verdon, St Paul Lez Durance (France); Moro, Fabio [ENEA, Via Enrico Fermi 45, Frascati, Rome (Italy); Suarez, Alejandro [ITER Organization, 13115 Route de Vinon sur Verdon, St Paul Lez Durance (France); Sanz, Javier [Departamento de Ingeniería Energética, ETSII-UNED, Calle Juan del Rosal 12, Madrid 28040 (Spain)

2015-11-15

Shutdown dose rates for planned maintenance purposes is an active research field in ITER. In this work the radiation (neutron and gamma) cross-talk between ports in the most conservative case foreseen in ITER is investigated: the presence of a torus cryopump lower port, mostly empty for pumping efficiency reasons. There will be six of those ports: #4, #6, #10, #12, #16 and #18. The equatorial ports placed above them will receive a significant amount of additional radiation affecting the shutdown dose rates during in situ maintenance activities inside the cryostat, and particularly in the port interspace area. In this study a general situation to all the equatorial ports placed above torus cryopump lower ports is considered: a generic diagnostics equatorial port placed above the torus cryopump lower port (LP#4). In terms of shutdown dose rates at equatorial port interspace after 10{sup 6} s of cooling time, 405 μSv/h has been obtained, of which 160 μSv/h (40%) are exclusively due to radiation cross-talk from a torus cryopump lower port. Equatorial port activation due to only “local neutrons” contributes 166 μSv/h at port interspace, showing that radiation cross-talk from such a lower port is a phenomenon comparable in magnitude to the neutron leakage though the equatorial port plug.

Subcutaneous phaeohyphomycosis caused by cladophialophora boppii

Directory of Open Access Journals (Sweden)

Pereira Rickson

2010-01-01

Full Text Available Subcutaneous phaeohyphomycosis is an infection of the skin and subcutaneous tissue, caused by dematiaceous fungi. An adult male presented with a history of multiple reddish nodules over the face and hands. Histopathological examination of the skin biopsies showed a dense granulomatous infiltrate of macrophages, containing intracytoplasmic basophilic bodies throughout the dermis. Gomori methenamine-silver stained sections revealed yeast cells within macrophages. Multiple cultures on Sabouraud′s dextrose agar grew Cladophialophora boppii. The patient was treated with oral itraconazole for a year and the response monitored with dermal ultrasound. This is the first case report of subcutaneous phaeohyphomycosis caused by Cl. boppii in India.

Immune responses to implanted human collagen graft in rats

International Nuclear Information System (INIS)

Quteish, D.; Dolby, A.E.

1991-01-01

Immunity to collagen implants may be mediated by cellular and humoral immune responses. To examine the possibility of such immunological reactivity and crossreactivity to collagen, 39 Sprague-Dawley rats (female, 10 weeks old, approximately 250 g wt) were implanted subcutaneously at thigh sites with crosslinked, freeze-dried human placental type I collagen grafts (4x4x2 mm) which had been irradiated (520 Gray) or left untreated. Blood was obtained by intracardiac sampling prior to implantation or from normal rats, and at various times afterwards when the animals were sacrificed. The sera from these animals were examined for circulating antibodies to human, bovine and rat tail (type I) collagens by enzyme-linked immunosorbent assay (ELISA). Also, the lymphoblastogenic responses of spleen lymphocytes from the irradiated collagen-implanted animals were assessed in culture by measuring thymidine uptake with autologous and normal rat sera in the presence of human bovine type I collagens. Implantation of the irradiated and non-irradiated collagen graft in rats led to a significant increase in the level of circulating antibodies to human collagen. Also antibody to bovine and rat tail collagens was detectable in the animals implanted with irradiated collagen grafts but at a lower level than the human collagen. There was a raised lymphoblastogenic response to both human and bovine collagens. The antibody level and lymphoblastogenesis to the tested collagens gradually decreased towards the end of the post-implantation period. (author)

Implanted near-infrared spectroscopy for cardiac monitoring

Science.gov (United States)

Bhunia, Sourav K.; Cinbis, Can

2011-02-01

Implanted Cardioverter Defibrillator (ICD) provides one of the most effective therapies for the prevention of sudden cardiac death, but also delivers some high voltage shocks inappropriately, causing morbidity and mortality. Implanted near-infrared spectroscopy (NIRS) may augment ICD arrhythmia detection by monitoring skeletal muscle perfusion. A two-wavelength, single-distance, continuous-wave implanted NIRS has been evaluated in-vivo. A weighted difference of the changes in attenuation at two wavelengths, across the isobestic point of the hemoglobin spectra, was taken to be the microvascular oxygenation trend indicator (O2 Index). Although the exact weight depends on the local vascular distribution and their oxygen levels, the hypothesis that a constant weight may be adequate for hemodynamic trending during short arrhythmic episodes, was tested. The sensor was implanted subcutaneously both on fresh tissue and inside scar tissue that formed around a pre-existing implant, in 3 animals each. Attenuations were recorded at 660 and 890 nm during normal sinus rhythm (NSR) and induced ventricular fibrillation (VF). The slope of the O2 Index over 10 seconds was computed for 7 NSR and 8 VF episodes in fresh and 13 NSR and 15 VF episodes in scar tissue pockets. The mean O2 Index slope was significantly different (p<0.0001) between NSR and VF rhythms for both the fresh and scar tissue pockets. Therefore implanted NIRS may be useful for preventing inappropriate detection of VF during electromagnetic interference, double counting of ECG T-wave as an R-wave, ICD lead failure, electrocardiographic aberrancy etc.

Silicone implant correction of pectus excavatum.

Science.gov (United States)

Wechselberger, G; Ohlbauer, M; Haslinger, J; Schoeller, T; Bauer, T; Piza-Katzer, H

2001-11-01

Between May 1989 and December 2000 in 24 adult patients with pectus excavatum, a subcutaneous implantation of silicone prostheses was performed. Of the 24 patients, 20 were followed. During follow-up the authors encountered seroma complications in 13 patients and postoperative hematoma in 4 patients. The patients stayed in the hospital 5 days on average, and showed excellent aesthetic results in 80% (N = 16), good results in 10% (N = 2), and fair results in 10% (N = 2). Patient satisfaction was also taken into consideration. A follow-up survey questioned whether patients were satisfied with the cosmetic outcome. On a scale of 1 to 5 points, with 1 point being the highest level of satisfaction, 85% of patients used ratings of 1 and 2 to express satisfaction levels. Silicone implant correction of pectus excavatum in adult patients without any impairment of cardiopulmonary function has value. The major advantages are the minimally invasive operation, the short hospital stay, good aesthetic results, and high patient satisfaction

iNOS Activity Modulates Inflammation, Angiogenesis, and Tissue Fibrosis in Polyether-Polyurethane Synthetic Implants.

Science.gov (United States)

Cassini-Vieira, Puebla; Araújo, Fernanda Assis; da Costa Dias, Filipi Leles; Russo, Remo Castro; Andrade, Silvia Passos; Teixeira, Mauro Martins; Barcelos, Luciola Silva

2015-01-01

There is considerable interest in implantation techniques and scaffolds for tissue engineering and, for safety and biocompatibility reasons, inflammation, angiogenesis, and fibrosis need to be determined. The contribution of inducible nitric oxide synthase (iNOS) in the regulation of the foreign body reaction induced by subcutaneous implantation of a synthetic matrix was never investigated. Here, we examined the role of iNOS in angiogenesis, inflammation, and collagen deposition induced by polyether-polyurethane synthetic implants, using mice with targeted disruption of the iNOS gene (iNOS(-/-)) and wild-type (WT) mice. The hemoglobin content and number of vessels were decreased in the implants of iNOS(-/-) mice compared to WT mice 14 days after implantation. VEGF levels were also reduced in the implants of iNOS(-/-) mice. In contrast, the iNOS(-/-) implants exhibited an increased neutrophil and macrophage infiltration. However, no alterations were observed in levels of CXCL1 and CCL2, chemokines related to neutrophil and macrophage migration, respectively. Furthermore, the implants of iNOS(-/-) mice showed boosted collagen deposition. These data suggest that iNOS activity controls inflammation, angiogenesis, and fibrogenesis in polyether-polyurethane synthetic implants and that lack of iNOS expression increases foreign body reaction to implants in mice.

iNOS Activity Modulates Inflammation, Angiogenesis, and Tissue Fibrosis in Polyether-Polyurethane Synthetic Implants

Science.gov (United States)

Cassini-Vieira, Puebla; Araújo, Fernanda Assis; da Costa Dias, Filipi Leles; Russo, Remo Castro; Andrade, Silvia Passos; Teixeira, Mauro Martins; Barcelos, Luciola Silva

2015-01-01

There is considerable interest in implantation techniques and scaffolds for tissue engineering and, for safety and biocompatibility reasons, inflammation, angiogenesis, and fibrosis need to be determined. The contribution of inducible nitric oxide synthase (iNOS) in the regulation of the foreign body reaction induced by subcutaneous implantation of a synthetic matrix was never investigated. Here, we examined the role of iNOS in angiogenesis, inflammation, and collagen deposition induced by polyether-polyurethane synthetic implants, using mice with targeted disruption of the iNOS gene (iNOS−/−) and wild-type (WT) mice. The hemoglobin content and number of vessels were decreased in the implants of iNOS−/− mice compared to WT mice 14 days after implantation. VEGF levels were also reduced in the implants of iNOS−/− mice. In contrast, the iNOS−/− implants exhibited an increased neutrophil and macrophage infiltration. However, no alterations were observed in levels of CXCL1 and CCL2, chemokines related to neutrophil and macrophage migration, respectively. Furthermore, the implants of iNOS−/− mice showed boosted collagen deposition. These data suggest that iNOS activity controls inflammation, angiogenesis, and fibrogenesis in polyether-polyurethane synthetic implants and that lack of iNOS expression increases foreign body reaction to implants in mice. PMID:26106257

Gamma radiation and its role in bio prosthetic aortic valves implanted in rat hearts

International Nuclear Information System (INIS)

Lamas, Gloria I.; Kairiyama, Eulogia; Navia, Jose

2000-01-01

Porcine heart valves glutaraldehyde fixed are implanted in patients with valvular deterioration. Mineralization may be the major factor in the long-term failure of tissue bio prosthesis. Gamma radiation randomly breaks some glutaraldehyde cross-links. As a consequence of irradiation, the polymeric fibers belonging to the valvular tissue are broken too, leading to sites of collagen fiber disorganisation. It is well known that the collagen fibers may act as a passive nucleator of salts where the calcium phosphate salts precipitate. This salt concentration has been described in association with disintegrated sites of protein fiber, which may favour new sites where the calcium salts would be deposit. The irradiation process is a technique used for sterilization of porcine heart valve. The main objective of this work was to study the effect of different doses of gamma radiation on the calcification process of subcutaneously implanted valves in rats. Small pieces from glutaraldehyde fixed valves, irradiated to different doses with a 60 Co sources were implanted subcutaneously in rats. The calcium was measured by X-ray and atomic absorption spectrophotometry. In our experimental conditions and at the radiation doses used in these tests, the calcium measurements on control and irradiated material were not significantly different. We conclude that, at the employed doses, the gamma radiation does not alter the process. (author) [es

[Home anti-cancer therapy with a venous port].

Science.gov (United States)

Muto, A; Ashino, Y; Miyazawa, M; Sato, M; Kanno, A; Kawahara, Y; Fujita, Y; Matsushiro, T

2000-12-01

Home anti-cancer chemotherapy and palliation in the terminal stage were performed for patients with advanced cancer of the digestive system, using a venous port implanted beneath the skin via the subclavian vein. Patients under 75 years of age (5 with esophageal, 61 gastric, 59 colorectal, 5 cholangio, 5 pancreatic, 1 hepatic and 1 ileal cancer) were treated. With two portable balloon pumps, continuous intravenous infusion of 5-FU (300 or 400 mg/body/day) combined low-dose injection of cisplatin (5 mg/body/day) was continued for 10 days, and repeated 3 times for 6 weeks. The response rate was 17.9% in 78 patients according to valuation of the tumor mass. In 119 patients also undergoing a tumor marker evaluation, an effect was seen in 26.1%. No severe side effects such as renal dysfunction or bone marrow suppression were seen, and no special infusion was needed. Therefore, such treatment can be continued for a long time. Use of a venous port should make easy the switchover to HPN and the amelioration of the symptoms of the terminal stage, such as pain, and helps patients cope with the worry. Therefore, the present technique is useful in a series of cancer treatments including surgery, chemotherapy and the amelioration of symptoms.

Generic Diagnostic Port Integration for the Equatorial Port Plug of ITER

International Nuclear Information System (INIS)

Doceul, L.; Chappuis, Ph.; Portafaix, Ch.; Guillaume, T.; Bruyere, Ch.; Walker, Ch.; Ingesson, Ch.; Ciattaglia, E.; Salasca, S.; Eric, T.

2006-01-01

ITER requires an extensive set of diagnostic systems to provide several key functions such as protection of the device, input to plasma control systems and evaluation of the plasma performance. Most of these diagnostics system are to be integrated in port plugs, which are water cooled stainless steel structures (approximately: 50 t, 2 m x 2 m x 4 m) inserted into the vacuum-vessel ports. The port plug must perform basic functions such as providing neutron and gamma shielding, supporting the first wall armour and shielding blanket material, closing the vacuum vessel ports, supporting the diagnostic equipment (within the primary vacuum, on the primary vacuum boundary and in the port interspace). CEA (Commissariat l'Energie Atomique) has contributed to the engineering activities on the port plugs and has more particularly focused on the design and diagnostic integration in the representative equatorial port plug EQ01. The specific CEA contributions were to perform the general engineering, structural and thermal analysis. These detailed analysis have highlighted some design issues which were worked out through different solutions. This paper will contain the description of the engineering activities performed such as: - The conceptual design of the EQ01 and the associated diagnostics, such as the visible and infrared optical diagnostic, - The static mechanical calculations, taking into account the electromagnetic loads occurring during fast transient plasma events, - The dynamic calculation constituted of modal and transient analysis under the same electromagnetic loads to estimate the dynamic amplification factor due to the resonance phenomenon, - The thermal assessment under the neutronic load of the water-cooled stainless steel structure, - The seismic response of the port plug inside the vacuum vessel, taking into account the ground spectra and soil conditions in the Cadarache site. (author)

Localized morphea after breast implant for breast cancer: A case report.

Science.gov (United States)

Moretti, A; Bianchi, F; Abbate, I V; Gherardi, G; Bonavita, M; Passoni, E; Nazzaro, G; Bramati, A; Dazzani, M C; Piva, S; Paternò, E; Frungillo, N; Farina, G; La Verde, N

2018-03-01

Early breast cancer follow-up guidelines for patients who underwent surgery suggest a regular and accurate clinical examination of the breast area, for an early identification of cutaneous or subcutaneous breast cancer relapse. Nonetheless, breast skin lesions arising in patients treated with mastectomy for breast cancer can be caused by several diseases. A series of diagnostic hypotheses should be considered, not only focusing on cutaneous metastasis, but also on dermatologic and systemic diseases. In February 2015, a 37-year-old patient underwent a right subcutaneous mastectomy for stage IIA breast cancer. Five months after beginning adjuvant chemotherapy, she noted hyperpigmentation and thickening of the skin on the right breast. Differential diagnosis included local relapse, skin infection, lymphoma, or primary cutaneous disease, and a skin biopsy was performed. The histopathologic specimen showed full-thickness sclerosis, with features of localized morphea. Therapy with clobetasol was prescribed, with progressive resolution of the thickness. The collaboration between many professionals in a multidisciplinary team (oncologist, dermatologist, plastic surgeon, and pathologist) was crucial to achieving the diagnosis. In the literature, some articles describe correlation between connective tissue diseases and silicone breast implants, but the pathogenetic mechanisms are unknown. We report a rare case of breast morphea after positioning a silicone implant in a patient who had undergone mastectomy. This clinical report represents an interesting model of multidisciplinary management of a patient with breast cancer who developed an uncommon dermatologic disease. Further studies are needed to clarify the association between silicone implants and breast morphea.

Getting Port Governance Right

DEFF Research Database (Denmark)

de Langen, Peter; Saragiotis, Periklis

2018-01-01

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

Reduced-port robotic total mesorectal resection for rectal cancer using a single-port access: a technical note.

Science.gov (United States)

Bae, Sung Uk; Jeong, Woon Kyung; Baek, Seong Kyu

2017-12-01

Single-port laparoscopic surgery has some advantages, including improved cosmetic outcomes and minimized parietal trauma. However, pure single-port laparoscopic rectal cancer surgery is challenging because of the difficulties in creating triangulation and applying the laparoscopic staplers with sufficient distal margins in the narrow pelvic cavity. Recently, a reduced-port robotic operation with a robotic single-port access plus one wristed robotic arm for colon cancer was introduced to overcome the limitations of single-port laparoscopic rectal surgery. Single-port laparoscopic surgery has some advantages, including improved cosmetic outcomes and minimized parietal trauma. However, the pure single-port laparoscopic rectal cancer operation is challenging. Recently, a reduced-port robotic operation with a robotic single-port access plus one wristed robotic arm for colon cancer was introduced to overcome the limitations of single-port laparoscopic rectal surgery. We performed a single-port plus an additional port robotic operation using a robotic single-port access through the umbilical incision, and the wristed robotic instruments were inserted through an additional robotic port in the right lower quadrant. The total operative and docking times were 310 min and 25 min, respectively. The total number of lymph nodes harvested was 12, and the proximal and distal resection margins were 11.1 and 2 cm, respectively. The patient was discharged on postoperative day 12 uneventfully. Based on a representative case, reduced-port robotic total mesorectal excision for rectal cancer using the single-port access appears to be feasible and safe. This approach could overcome the limitations of single-port laparoscopic rectal surgery.

Primary Kaposi sarcoma of the subcutaneous tissue

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Dezube Bruce J

2008-09-01

Full Text Available Abstract Background Involvement of the subcutis by Kaposi sarcoma (KS occurs primarily when cutaneous KS lesions evolve into deep penetrating nodular tumors. Primary KS of the subcutaneous tissue is an exceptional manifestation of this low-grade vascular neoplasm. Case presentation We present a unique case of acquired immune deficiency syndrome (AIDS-associated KS manifesting primarily in the subcutaneous tissue of the anterior thigh in a 43-year-old male, which occurred without overlying visible skin changes or concomitant KS disease elsewhere. Radiological imaging and tissue biopsy confirmed the diagnosis of KS. Conclusion This is the first documented case of primary subcutaneous KS occurring in the setting of AIDS. The differential diagnosis of an isolated subcutaneous lesion in an human immunodeficiency virus (HIV-infected individual is broad, and requires both imaging and a histopathological diagnosis to guide appropriate therapy.

Massive Preperitoneal Hematoma after a Subcutaneous Injection

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Hideki Katagiri

2016-01-01

Full Text Available Preperitoneal hematomas are rare and can develop after surgery or trauma. A 74-year-old woman, receiving systemic anticoagulation, developed a massive preperitoneal hematoma after a subcutaneous injection of teriparatide using a 32-gauge, 4 mm needle. In this patient, there were two factors, the subcutaneous injection of teriparatide and systemic anticoagulation, associated with development of the hematoma. These two factors are especially significant, because they are widely used clinically. Although extremely rare, physicians must consider this potentially life-threatening complication after subcutaneous injections, especially in patients receiving anticoagulation.

Application of Game Theory and Uncertainty Theory in Port Competition between Hong Kong Port and Shenzhen Port

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Thi Minh Hoang Do

2015-06-01

Full Text Available This paper unveils the strong competition in container cargo between Hong Kong Port which has been emerging as an international maritime center since the 1970s and Shenzhen Port which has recently gained remarkable achievements in the Pearl River Delta region. Among various competing strategies, the study focuses on the long-term one in which two ports will decide to compete by investing in capacity. The purpose of this research is to examine their decision making process and to suggest future strategic actions in the current situation. Within its scope, only economic profit brought back from the investment is considered. For this reason, an uncertain payoff two-person game model is developed where an uncertain factor of demand is involved. In applying Uncertainty theory (Liu, 2013, the two methods to solve the game are introduced, including uncertain statistics and the expected Nash Equilibrium strategy. The results obtained from this research generate meaningful suggestions for future competition plan for the two selected ports, which conclude that Shenzhen is the dominant port in this long-term strategy. Compared to existing works on the same topic, the paper shows its distinctiveness by studying the latest competitive situation with regard to the uncertain demand in the game model.

Inland Ports in the Republic of Croatia: Approvals for Port Activities instead of Concessions

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Goran Vojković

2008-11-01

Full Text Available According to the 1998 Act on Inland Ports, the right to performall port activities within inland ports of the Republic ofCroatia is given on the basis of concession, obtained throughbidding. It has been noticed in practice that modem businessprocesses and traffic flows are more dynamic than before whenclassic concession relations were created. Also, types andamounts of cargo are changing every couple of years, which isfollowed by quick adjustments, instead of working according torigid and long-term defined decisions and concession contracts.Furthermore, the practice has shown for some activitiesthat the number of port providers (such as ship suppliers,port-agency and freight forwarders should not be limited. Thismeans that the system of a limited number of port providers isimportant only for the activities that require location within aport, as the port area is physically limited. Therefore, the newAct on Navigation and Inland Ports from 2007, whose framehas been completed by sub-law acts during 2008, has replacedthe complex concession system for performing activities in inlandports by a more liberal approval system. On the basis ofthese, higher dynamics of work of port providers is enabled aswell as easier adjustment to market conditions. Furthermore,the main limitation factor that determines the number of portusers becomes the available physical space within a port, whichprovides undisturbed competition, along with larger offer ofport services that do not require that space. It is also importantto point out that the new Act specifically includes distributionand cargo logistics, also processing and improvement of goodsas well as industrial activities including production that enablecomplete economic utilization of port capacities into the existingport activities, thus significantly changing the role of the portitself as a logistic centre.

The Tissue Response and Degradation of Electrospun Poly(ε-caprolactone/Poly(trimethylene-carbonate Scaffold in Subcutaneous Space of Mice

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Tao Jiang

2014-01-01

Full Text Available Due to the advantage of controllability on the mechanical property and the degradation rates, electrospun PCL/PTMC nanofibrous scaffold could be appropriate for vascular tissue engineering. However, the tissue response and degradation of electrospun PCL/PTMC scaffold in vivo have never been evaluated in detail. So, electrospun PCL/PTMC scaffolds with different blend ratios were prepared in this study. Mice subcutaneous implantation showed that the continuous degradation of PCL/PTMC scaffolds induced a lasted macrophage-mediated foreign body reaction, which could be in favor of the tissue regeneration in graft.

Multiple-port valve

International Nuclear Information System (INIS)

Doody, T.J.

1978-01-01

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

Localized immunosuppressive environment in the foreign body response to implanted biomaterials.

Science.gov (United States)

Higgins, David M; Basaraba, Randall J; Hohnbaum, April C; Lee, Eric J; Grainger, David W; Gonzalez-Juarrero, Mercedes

2009-07-01

The implantation of synthetic biomaterials initiates the foreign body response (FBR), which is characterized by macrophage infiltration, foreign body giant cell formation, and fibrotic encapsulation of the implant. The FBR is orchestrated by a complex network of immune modulators, including diverse cell types, soluble mediators, and unique cell surface interactions. The specific tissue locations, expression patterns, and spatial distribution of these immune modulators around the site of implantation are not clear. This study describes a model for studying the FBR in vivo and specifically evaluates the spatial relationship of immune modulators. We modified a biomaterials implantation in vivo model that allowed for cross-sectional in situ analysis of the FBR. Immunohistochemical techniques were used to determine the localization of soluble mediators, ie, interleukin (IL)-4, IL-13, IL-10, IL-6, transforming growth factor-beta, tumor necrosis factor-alpha, interferon-gamma, and MCP-1; specific cell types, ie, macrophages, neutrophils, fibroblasts, and lymphocytes; and cell surface markers, ie, F4/80, CD11b, CD11c, and Ly-6C, at early, middle, and late stages of the FBR in subcutaneous implant sites. The cytokines IL-4, IL-13, IL-10, and transforming growth factor-beta were localized to implant-adherent cells that included macrophages and foreign body giant cells. A better understanding of the FBR in vivo will allow the development of novel strategies to enhance biomaterial implant design to achieve better performance and safety of biomedical devices at the site of implant.

360 PORT MDA - A Strategy to Improve Port Security

Science.gov (United States)

2006-09-01

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

Subcutaneous blood flow during insulin-induced hypoglycaemia

DEFF Research Database (Denmark)

Hilsted, J; Madsbad, S; Sestoft, L

1982-01-01

Subcutaneous blood flow was measured preceding insulin-induced hypoglycaemia, at the onset of hypoglycaemic symptoms and 2 h later in juvenile diabetics with and without autonomic neuropathy and in normal males. In all groups subcutaneous blood flow decreased at the onset of hypoglycaemic symptom...

The fabrication of bioresorbable implants for bone defects replacement using computer tomogram and 3D printing

Science.gov (United States)

Kuznetsov, P. G.; Tverdokhlebov, S. I.; Goreninskii, S. I.; Bolbasov, E. N.; Popkov, A. V.; Kulbakin, D. E.; Grigoryev, E. G.; Cherdyntseva, N. V.; Choinzonov, E. L.

2017-09-01

The present work demonstrates the possibility of production of personalized implants from bioresorbable polymers designed for replacement of bone defects. The stages of creating a personalized implant are described, which include the obtaining of 3D model from a computer tomogram, development of the model with respect to shape of bone fitment bore using Autodesk Meshmixer software, and 3D printing process from bioresorbable polymers. The results of bioresorbable polymer scaffolds implantation in pre-clinical tests on laboratory animals are shown. The biological properties of new bioresorbable polymers based on poly(lactic acid) were studied during their subcutaneous, intramuscular, bone and intraosseous implantation in laboratory animals. In all cases, there was a lack of a fibrous capsule formation around the bioresorbable polymer over time. Also, during the performed study, conclusions were made on osteogenesis intensity depending on the initial state of bone tissue.

Port Stakeholder Summit - April 2014

Science.gov (United States)

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

Penile Subcutaneous Fibrolipoma Postaugmentative Phalloplasty

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Patrizio Vicini

2013-01-01

Full Text Available Fibrolipomas are a rare subtype of lipomas. We describe a case of a man suffering from subcutaneous penile fibrolipoma, who three months earlier has been submitted to an augmentative phalloplasty due to aesthetic dysmorphophobia. After six months from the excision of the mass, the penile elongation and penile enlargement were stable, and the patient was satisfied with his sexual intercourse and sexual life. To our knowledge, this is the first reported penile subcutaneous fibrolipoma case in the literature. The diagnostics and surgical features of this case are discussed.

An Analysis of Port Service Quality and Customer Satisfaction: The Case of Korean Container Ports

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Gi Tae Yeo

2015-12-01

Full Text Available Ports play a critical role in the economy of many countries and regions. Failure or unreliability of port services can significantly influence port customers—shipping lines and cargo owners—and result in their dissatisfaction. However, what constitutes port service quality (PSQ and its influence on the satisfaction of port customers has not been well investigated in the literature. Therefore, this study investigates the concept of PSQ and its influence on customer satisfaction in the case of Korean container ports. Following a literature review, a conceptual model of PSQ and its influence on customer satisfaction is proposed. The model was validated through a survey of 313 members of the Korean Port Logistics Association (KPLA. Partial least squares structural equation modeling (PLS-SEM was conducted to confirm the PSQ dimensions and to examine their relationship with customer satisfaction using SmartPLS 3.2.1 software. PSQ is found to be a five-factor construct, and its management, and image and social responsibility factors have significant positive effects on customer satisfaction. In addition to its academic contribution, this study also contributes to management practices because port managers can use the PSQ scale to measure their customers’ satisfaction and justify investments in the quality management of port services.

Upper extremity deep venous thrombosis after port insertion: What are the risk factors?

Science.gov (United States)

Tabatabaie, Omidreza; Kasumova, Gyulnara G; Kent, Tara S; Eskander, Mariam F; Fadayomi, Ayotunde B; Ng, Sing Chau; Critchlow, Jonathan F; Tawa, Nicholas E; Tseng, Jennifer F

2017-08-01

Totally implantable venous access devices (ports) are widely used, especially for cancer chemotherapy. Although their use has been associated with upper extremity deep venous thrombosis, the risk factors of upper extremity deep venous thrombosis in patients with a port are not studied adequately. The Healthcare Cost and Utilization Project's Florida State Ambulatory Surgery and Services Database was queried between 2007 and 2011 for patients who underwent outpatient port insertion, identified by Current Procedural Terminology code. Patients were followed in the State Ambulatory Surgery and Services Database, State Inpatient Database, and State Emergency Department Database for upper extremity deep venous thrombosis occurrence. The cohort was divided into a test cohort and a validation cohort based on the year of port placement. A multivariable logistic regression model was developed to identify risk factors for upper extremity deep venous thrombosis in patients with a port. The model then was tested on the validation cohort. Of the 51,049 patients in the derivation cohort, 926 (1.81%) developed an upper extremity deep venous thrombosis. On multivariate analysis, independently significant predictors of upper extremity deep venous thrombosis included age deep venous thrombosis (odds ratio = 1.77), all-cause 30-day revisit (odds ratio = 2.36), African American race (versus white; odds ratio = 1.86), and other nonwhite races (odds ratio = 1.35). Additionally, compared with genitourinary malignancies, patients with gastrointestinal (odds ratio = 1.55), metastatic (odds ratio = 1.76), and lung cancers (odds ratio = 1.68) had greater risks of developing an upper extremity deep venous thrombosis. This study identified major risk factors of upper extremity deep venous thrombosis. Further studies are needed to evaluate the appropriateness of thromboprophylaxis in patients at greater risk of upper extremity deep venous thrombosis. Copyright © 2017 Elsevier Inc

Concerning background from calorimeter ports

International Nuclear Information System (INIS)

Digiacomo, N.J.

1985-01-01

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

Subcutaneous blood flow in psoriasis

International Nuclear Information System (INIS)

Klemp, P.

1985-01-01

The simultaneously recorded disappearance rates of 133 xe from subcutaneous adipose tissue in the crus were studied in 10 patients with psoriasis vulgaris using atraumatic labeling of the tissue in lesional skin (LS) areas and symmetrical, nonlesional skin (NLS) areas. Control experiments were performed bilaterally in 10 younger, healthy subjects. The subcutaneous washout rate constant was significantly higher in LS, 0.79 +/- 0.05 min-1 x 10(2) compared to the washout rate constant of NLS, 0.56 +/- 0.07 min-1. 10(2), or the washout rate constant in the normal subjects, 0.46 +/- 0.17 min-1 x 10(2). The mean washout rate constant in NLS was 25% higher than the mean washout rate constant in the normal subjects. The difference was, however, not statistically significant. Differences in the washout rate constants might be due to abnormal subcutaneous tissue-to-blood partition (lambda) in the LS--and therefore not reflecting the real differences in the subcutaneous blood flow (SBF). The lambda for 133 Xe was therefore measured--using a double isotope washout method ( 133 Xe and [ 131 I]antipyrine)--in symmetrical sites of the lateral crus in LS and NLS of 10 patients with psoriasis vulgaris and in 10 legs of normal subjects. In LS the lambda was 4.52 +/- 1.67 ml/g, which was not statistically different from that of NLS, 5.25 +/- 2.19 ml/g, nor from that of normal subcutaneous tissue, 4.98 +/- 1.04 ml/g. Calculations of the SBF using the obtained lambda values gave a significantly higher SBF in LS, 3.57 +/- 0.23 ml/100 g/min, compared to SBF in the NLS, 2.94 +/- 0.37 ml/100 g/min. There was no statistically significant difference between SBF in NLS and SBF in the normal subjects. The increased SBF in LS of psoriatics might be a secondary phenomenon to an increased heat loss in the lesional skin

Evaluation of MRI issues for an access port with a radiofrequency identification (RFID) tag.

Science.gov (United States)

Titterington, Blake; Shellock, Frank G

2013-10-01

A medical implant that contains metal, such as an RFID tag, must undergo proper MRI testing to ensure patient safety and to determine that the function of the RFID tag is not compromised by exposure to MRI conditions. Therefore, the objective of this investigation was to assess MRI issues for a new access port that incorporates an RFID tag. Samples of the access port with an RFID tag (Medcomp Power Injectable Port with CertainID; Medcomp, Harleysville, PA) were evaluated using standard protocols to assess magnetic field interactions (translational attraction and torque; 3-T), MRI-related heating (3-T), artifacts (3-T), and functional changes associated with different MRI conditions (nine samples, exposed to different MRI conditions at 1.5-T and 3-T). Magnetic field interactions were not substantial and will pose no hazards to patients. MRI-related heating was minimal (highest temperature change, 1.7°C; background temperature rise, 1.6°C). Artifacts were moderate in size in relation to the device. Exposures to MRI conditions at 1.5-T and 3-T did not alter or damage the functional aspects of the RFID tag. Based on the findings of the test, this new access port with an RFID tag is acceptable (or, MR conditional, using current MRI labeling terminology) for patients undergoing MRI examinations at 1.5-T/64-MHz and 3-T/128-MHz. Copyright © 2013 Elsevier Inc. All rights reserved.

Effect of Using Melatonin Implants on Reproductive Performances in Turcana Ewes

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Ioan Pădeanu

2011-10-01

Full Text Available It is estimated by some authors that the administration of subcutaneous melatonin implants during a period of 30 days, in lactating or dry ewes, would improve the reproductive performance in some sheep breeds. This study was conducted in Giarmata Mare, Timis County, on 78 lactating ewes and 75 dry ewes, which were individually inserted with implants containing 18 mg melatonin on 31 August 2009. Control group consisted of 100 lactating and dry ewes in equal proportions. The results shown that the main reproduction indices as prolificacy, birth rate and the lamb number productivity index are significantly (p < 0.05 higher in ewes from the experimental group, compared with ewes from the control group, and that treated ewes shortened the period of mating and lambing to half-time comparing to the control group. There is a suggestion that the use of melatonin implants Melovin ® type near the normal breeding season increases the reproductive performance of ewes from Turcana breed.

Non-Price Competition in the Port Sector: A Case Study of Ports in Turkey

OpenAIRE

Soner Esmer; Hong-Oanh Nguyen, Ph.D.; Yapa Mahinda Bandara, Ph.D.; Kazim Yeni, Ph.D.

2016-01-01

Although the port sector has been facing increasing competition, there is limited research on how ports compete using non-price competition strategies. There are a few studies on non-price competition in the port sector. However they mainly focus on the marketing aspect. This paper seeks to fill this gap in the literature, especially from a combined marketing-economic perspective. Especially the paper's main objective is to identify the determinants of non-price competition in the port sector...

Recurrent subcutaneous emphysema of the face: a challenging clinical problem.

Science.gov (United States)

Hojjati, Hossein; Davani, Sam Zeraatian Nejad; Johari, Hamed Ghoddusi

2007-01-01

In the neck or face, there are different causes for subcutaneous emphysema such as injury to the sinuses, the hypopharynx, the laryngotracheal complex, the pulmonary parenchyma, the esophagus or the presence of gas-forming organisms. However, factitious subcutaneous emphysema, a rare cause, must be considered in the differential diagnosis. In this clinical report, we discuss a 20-year-old girl who was under follow-up because of recurrent subcutaneous emphysema of the face and periorbital area. After 2 years of work-ups, including a period of close observation in the intensive care unit, self air injection by syringe was found as the cause of recurrent subcutaneous emphysema of the face, and the patient was labeled as having factitious recurrent subcutaneous emphysema. Therefore, when a patient presents with unexplained recurrent subcutaneous emphysema, one should suspect self-infliction and examine for puncture marks.

Dynamism Patterns of Western Mediterranean Cruise Ports and the Coopetition Relationships Between Major Cruise Ports

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Esteve-Perez Jeronimo

2018-03-01

Full Text Available The Mediterranean Sea has seen an increase of ports hosting cruise ships during the first fifteen years of the 21st century. The increase in cruise ship presence in Mediterranean ports is associated with the dynamism of cruise traffic in recent years, with an average annual growth of 7.45% for cruise passengers worldwide during the period of 1990-2015. Cruise traffic is a maritime business that is primarily composed of two elements, maritime affairs and tourism. This article focuses on the maritime component. With the growth of the cruise industry, cruise lines have been forced to seek new ports to meet demand in an attempt to create differentiated products based on the ports that compose the itinerary. The itinerary system of cruise traffic makes the cruise ports depend on one another to design an itinerary. This feature results in both complex geographic relationships in the design of a cruise itinerary and complex competitive/cooperative relationships between ports. The aim of this article is to present the hierarchic picture of a sample of 29 cruise ports in the Western Mediterranean region during the period of 2000-2015. To achieve this goal, a port size classification is proposed and a shift-share analysis at the inter- and intra-group size level is applied. Moreover, concentration measures are used to determine the changes in the levels of market concentration. Furthermore, a dynamic model is proposed to determine the competitive or cooperative relationships between cruise ports. The proposed model is applied to the largest ports with data from the 2001-2015 period.

Diabetes Is Reversed in a Murine Model by Marginal Mass Syngeneic Islet Transplantation Using a Subcutaneous Cell Pouch Device.

Science.gov (United States)

Pepper, Andrew R; Pawlick, Rena; Gala-Lopez, Boris; MacGillivary, Amanda; Mazzuca, Delfina M; White, David J G; Toleikis, Philip M; Shapiro, A M James

2015-11-01

Islet transplantation is a successful β-cell replacement therapy for selected patients with type 1 diabetes mellitus. Although high rates of early insulin independence are achieved routinely, long-term function wanes over time. Intraportal transplantation is associated with procedural risks, requires multiple donors, and does not afford routine biopsy. Stem cell technologies may require potential for retrievability, and graft removal by hepatectomy is impractical. There is a clear clinical need for an alternative, optimized transplantation site. The subcutaneous space is a potential substitute, but transplantation of islets into this site has routinely failed to reverse diabetes. However, an implanted device, which becomes prevascularized before transplantation, may alter this equation. Syngeneic mouse islets were transplanted subcutaneously within Sernova Corp's Cell Pouch (CP). All recipients were preimplanted with CPs 4 weeks before diabetes induction and transplantation. After transplantation, recipients were monitored for glycemic control and glucose tolerance. Mouse islets transplanted into the CP routinely restored glycemic control with modest delay and responded well to glucose challenge, comparable to renal subcapsular islet grafts, despite a marginal islet dose, and normoglycemia was maintained until graft explantation. In contrast, islets transplanted subcutaneously alone failed to engraft. Islets within CPs stained positively for insulin, glucagon, and microvessels. The CP is biocompatible, forms an environment suitable for islet engraftment, and offers a potential alternative to the intraportal site for islet and future stem cell therapies.

Subcutaneous granuloma annulare

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Dhar Sandipan

1994-01-01

Full Text Available Two cases of subcutaneos granuloma annulare are reported. Clinical presentation was in the form of hard subcutaneous nodules; histopathology confirmed the clinical diagnosis. The cases were unique because of onset in adult hood, occurrence over unusual sites and absence of classical lesions of granuloma annulare elsewhere.

Photon beam dose distributions for patients with implanted temporary tissue expanders

Science.gov (United States)

Asena, A.; Kairn, T.; Crowe, S. B.; Trapp, J. V.

2015-01-01

This study examines the effects of temporary tissue expanders (TTEs) on the dose distributions of photon beams in breast cancer radiotherapy treatments. EBT2 radiochromic film and ion chamber measurements were taken to quantify the attenuation and backscatter effects of the inhomogeneity. Results illustrate that the internal magnetic port present in a tissue expander causes a dose reduction of approximately 25% in photon tangent fields immediately downstream of the implant. It was also shown that the silicone elastomer shell of the tissue expander reduced the dose to the target volume by as much as 8%. This work demonstrates the importance for an accurately modelled high-density implant in the treatment planning system for post-mastectomy breast cancer patients.

Ultrasound and Histologic Examination after Subcutaneous Injection of Two Volumizing Hyaluronic Acid Fillers: A Preliminary Study

Science.gov (United States)

Besse, Stéphanie; Sarazin, Didier; Quinodoz, Pierre; Elias, Badwi; Safa, Marva; Vandeputte, Joan

2017-01-01

Background: This study examined the influence of hyaluronic acid (HA) crosslinking technology on the ultrasound and histologic behavior of HA fillers designed for subcutaneous injection. Methods: One subject received subcutaneous injections of 0.25 ml Cohesive Polydensified Matrix (CPM) and Vycross volumizing HA in tissue scheduled for abdominoplasty by bolus and retrograde fanning techniques. Ultrasound analyses were performed on days 0 and 8 and histologic analyses on days 0 and 21 after injection. A series of simple rheologic tests was also performed. Results: Day 0 ultrasound images after bolus injection showed CPM and Vycross as hypoechogenic papules in the hypodermis. CPM appeared little changed after gentle massage, whereas Vycross appeared more hyperechogenic and diminished in size. Ultrasound images at day 8 were similar. On day 0, both gels appeared less hypoechogenic after retrograde fanning than after bolus injection. Vycross was interspersed with hyperechogenic areas (fibrous septa from the fat network structure) and unlike CPM became almost completely invisible after gentle massage. On day 8, CPM appeared as a hypoechogenic pool and Vycross as a long, thin rod. Day 0 histologic findings confirmed ultrasound results. Day 21 CPM histologic findings showed a discrete inflammatory reaction along the injection row after retrograde fanning. Vycross had a more pronounced inflammatory reaction, particularly after retrograde fanning, with macrophages and giant cells surrounding the implant. Rheologic tests showed CPM to have greater cohesivity and resistance to traction forces than Vycross. Conclusions: CPM HA volumizer appears to maintain greater tissue integrity than Vycross after subcutaneous injection with less inflammatory activity. PMID:28280664

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

Science.gov (United States)

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

Enfisema subcutâneo maciço - Tratamento com drenos subcutâneos Massive subcutaneous emphysema - Management using subcutaneous drains

Directory of Open Access Journals (Sweden)

Maria Sucena

2010-04-01

Full Text Available O enfisema subcutâneo é uma complicação relativamente comum na sequência de técnicas invasivas, procedimentos cirúrgicos e algumas patologias médicas. Na maior parte dos casos apenas causa sintomatologia minor e o tratamento é habitualmente conservador. Mesmo quando grave, raramente tem consequências patofisiológicas significativas, apesar de ser extremamente desconfortável para o doente. Os autores descrevem um caso clínico de enfisema subcutâneo maciço, de rápida instalação, após saída acidental de tubo de drenagem torácica, em doente com pneumotórax espontâneo secundário e fístula broncopleural. O enfisema foi tratado através da colocação, sob anestesia local, de dois drenos subcutâneos na parede anterossuperior do tórax, conectados a sacos de drenagem. Após a colocação dos drenos subcutâneos verificou-se uma franca melhoria clínica do doente, com descompressão eficaz do enfisema subcutâneo. No presente caso clínico, a técnica de drenagem do enfisema maciço mostrou-se simples, segura e eficaz, permitindo o alívio sintomático imediato.Massive subcutaneous emphysema is a relatively common complication in invasive techniques, surgical practice and some medical conditions. Subcutaneous emphysema is usually treated conservatively and may only cause minimal symptoms. Even when it is severe, subcutaneous emphysema rarely has pathophysiologic consequences, but it is extremely uncomfortable for the patient. The authors report a case of massive and rapid developing subcutaneous emphysema following chest tube displacement in a patient with spontaneous secondary pneumothorax and large air leak. The emphysema was treated with two subcutaneous drains, inserted using local anesthesia, on both sides of the chest (antero-superior thoracic wall, connected to drainage bags. The drains produced a dramatic clinical improvement and provided effective decompression of the subcutaneous emphysema. In this clinical case, the

In vitro precultivation alleviates post-implantation inflammation and enhances development of tissue-engineered tubular cartilage

Energy Technology Data Exchange (ETDEWEB)

Luo Xusong; Zhou Guangdong; Liu Wei; Zhang Wenjie; Cui Lei; Cao Yilin [Department of Plastic and Reconstructive Surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai 9th People' s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011 (China); Cen Lian, E-mail: guangdongzhou@126.co, E-mail: yilincao@yahoo.co [National Tissue Engineering Center of China, Shanghai 200011 (China)

2009-04-15

Tissue-engineered tubular cartilage is a promising graft for tracheal reconstruction. But polylactic acid/polyglycolic acid (PLA/PGA) fibers, the frequently used scaffolds for cartilage engineering, often elicit an obvious inflammation response following implantation into immunocompetent animals. We propose that the inflammation could be alleviated by in vitro precultivation. In this study, after in vitro culture for either 2 days (direct implantation group (DI)) or for 2 weeks (precultivation implantation group (PI)), autologous tubular chondrocyte-PLA/PGA constructs were subcutaneously implanted into rabbits. In the PI group, after 2 weeks of precultivation, most of the fibers were found to be completely embedded in an extracellular matrix (ECM) produced by the chondrocytes. Importantly, no obvious inflammatory reaction was observed after in vivo implantation and homogeneous cartilage-like tissue was formed with biomechanical properties close to native tracheal cartilage at 4 weeks post-implantation. In the DI group, however, an obvious inflammatory reaction was observed within and around the cell-scaffold constructs at 1 week implantation and only sporadic cartilage islands separated by fibrous tissue were observed at 4 weeks. These results demonstrated that the post-implantation inflammatory reaction could be alleviated by in vitro precultivation, which contributes to the formation of satisfactory tubular cartilage for tracheal reconstruction.

Vectorization, parallelization and porting of nuclear codes (porting). Progress report fiscal 1999

Energy Technology Data Exchange (ETDEWEB)

Kawasaki, Nobuo; Nemoto, Toshiyuki; Kawai, Wataru; Ishizuki, Shigeru [Fujitsu Ltd., Tokyo (Japan); Ogasawara, Shinobu; Kume, Etsuo; Adachi, Masaaki [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Yatake, Yo-ichi [Hitachi Ltd., Tokyo (Japan)

2001-01-01

Several computer codes in the nuclear field have been vectorized, parallelized and transported on the FUJITSU VPP500 system, the AP3000 system, the SX-4 system and the Paragon system at Center for Promotion of Computational Science and Engineering in Japan Atomic Energy Research Institute. We dealt with 18 codes in fiscal 1999. These results are reported in 3 parts, i.e., the vectorization and the parallelization part on vector processors, the parallelization port on scalar processors and the porting part. In this report, we describe the porting. In this porting part, the porting of Assisted Model Building with Energy Refinement code version 5 (AMBER5), general purpose Monte Carlo codes far neutron and photon transport calculations based on continuous energy and multigroup methods (MVP/GMVP), automatic editing system for MCNP library code (autonj), neutron damage calculations for materials irradiations and neutron damage calculations for compounds code (SPECTER/SPECOMP), severe accident analysis code (MELCOR) and COolant Boiling in Rod Arrays, Two-Fluid code (COBRA-TF) on the VPP500 system and/or the AP3000 system are described. (author)

The Flexible Port

NARCIS (Netherlands)

Taneja, P.

2013-01-01

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

Principal Ports and Facilities

Data.gov (United States)

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

Principal Ports and Facilities

Data.gov (United States)

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

Role of Liposuction Combined with Subcutaneous Mastectomy in ...

African Journals Online (AJOL)

deformity in two other patients. Conclusions: Liposuction combined with subcutaneous mastectomy is a reliable, versatile, less time consuming and valid procedure for the treatment of gynecomastia. This procedure provides satisfactory aesthetic results. KEY WORDS: Gynecomastia, liposuction, subcutaneous mastectomy.

Handling of waste in ports

International Nuclear Information System (INIS)

Olson, P.H.

1994-01-01

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

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

International Nuclear Information System (INIS)

Xing Li; Yuan Chanjuan

2011-01-01

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

Vacuum vessel port structures for ITER-FEAT

International Nuclear Information System (INIS)

Utin, Yu.; Ioki, K.; Komarov, V.; Krylov, V.; Kuzmin, E.; Labusov, I.; Miki, N.; Onozuka, M.; Rozov, V.; Sannazzaro, G.; Tesini, A.; Yamada, M.; Barthel, Th.

2001-01-01

The equatorial and the upper port structures are the most loaded among those of the ITER-FEAT vacuum vessel (VV). For all of these ports, the VV closure plate and the in-port components are integrated into the port plug. The plugs/port structures are affected by plasma events and must withstand high mechanical loads. Based on typical port plugs, this paper presents the conceptual design of the port structures (with emphasis on the supporting system), and the results of analyses performed

Vacuum vessel port structures for ITER-FEAT

Energy Technology Data Exchange (ETDEWEB)

Utin, Yu.; Ioki, K.; Komarov, V.; Krylov, V.; Kuzmin, E.; Labusov, I.; Miki, N.; Onozuka, M.; Rozov, V.; Sannazzaro, G.; Tesini, A.; Yamada, M.; Barthel, Th

2001-11-01

The equatorial and the upper port structures are the most loaded among those of the ITER-FEAT vacuum vessel (VV). For all of these ports, the VV closure plate and the in-port components are integrated into the port plug. The plugs/port structures are affected by plasma events and must withstand high mechanical loads. Based on typical port plugs, this paper presents the conceptual design of the port structures (with emphasis on the supporting system), and the results of analyses performed.

COSIMA-ES-PORT

DEFF Research Database (Denmark)

Barfod, Michael Bruhn; Leleur, Steen

2007-01-01

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

Non-Price Competition in the Port Sector: A Case Study of Ports in Turkey

Directory of Open Access Journals (Sweden)

Soner Esmer

2016-03-01

Full Text Available Although the port sector has been facing increasing competition, there is limited research on how ports compete using non-price competition strategies. There are a few studies on non-price competition in the port sector. However they mainly focus on the marketing aspect. This paper seeks to fill this gap in the literature, especially from a combined marketing-economic perspective. Especially the paper's main objective is to identify the determinants of non-price competition in the port sector and evaluate their effect on various aspects of non-price competition. We start with a general conceptual framework to explain how competition in the sector can be affected by various factors and then propose an analytical framework on non-price competition. The analytical model is then used to support the design of a survey questionnaire. Next, hypothesis tests are conducted using exploratory factor analysis (EFA and structural equation modeling (SEM and data collected from a survey of Turkish ports. Based on the analysis results, the implications for port management and future research are also discussed.

Management of Artisanal Fishing Port: a Case Study on Labuhanhaji Fishing Port, South Aceh Regency, Aceh Province

OpenAIRE

NurJannah, Betri; ', Syaifuddin; Zain, Jonny

2014-01-01

A series survey activity was carried out for evaluating management function atlabuanhaji fishing port, South Aceh regency. This research was emphasis on planning, organizing, action and controlling at management pattern of labuhanhaji fishing port. The facilities of fishing port data and daily activities description of staff at labuhanhaji fishing port was used as additional information and consideration in management of labuhanhaji fishing port. Lack of good management was impact on staff an...

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

Science.gov (United States)

Kawagoe, Koh; Matsuura, Shinobu

2008-12-01

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

Maximizing port and transportation system productivity by exploring alternative port operation strategies.

Science.gov (United States)

2011-06-01

Seaports are a critical transportation component that supports the nations economy. Many U.S. : ports are now experiencing significant truck congestion at the gate, which decreases the productivity of : ports and truck fleets (e.g. truck wait time...

A review of dry ports

OpenAIRE

Violeta Roso; Kent Lumsden

2010-01-01

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

Subcutaneous tissue flaps for hallux covering.

Science.gov (United States)

Vaienti, Luca; Urzola, Victor; Scotti, Andrea; Masetto, L

2010-03-01

With the understanding of the extensive vascular supply of the subcutaneous tissue, of its efficacy in the protection of the anatomical structures and of its capability of promoting the adequate functioning of very stressed regions of the human body, the use of subcutaneous adipose flaps has become a valid and sometimes the only reasonable therapeutic weapon in the treatment of small and medium-sized tissue loss. Such a defect represents a common complication of great toe injuries and surgery. Here subcutaneous flap reconstruction is proposed for the treatment of dorsal and medial soft tissue losses of the hallux complicated with infection. Two case are reported. To the best of the authors' knowledge, this application has not been reported in this anatomical site so far. The technique might be worth knowing both for orthopedic and plastic surgeons, as it may represent a safe, less invasive solution for most tegumentary problems of the dorso-medial side of the first ray.

[Hygienic assessment of living conditions and morbidity of the population in the port cities of the Sakhalin region].

Science.gov (United States)

Alikbayeva, L A; Kim, A V; Iakubova, Sh; Ok, Im En; Darizhapov, B B

The aim of this study was to perform a comprehensive hygienic assessment of environmental conditions in the port cities of the Sakhalin region to identify priority risk factors affecting on population health and management decisions for the optimization of living conditions. As a result of the assessment of risk and damages for public health from the effects of air pollution on the dose-response, effects were found to excess of impact on the target organs by 10 times. The main ecotoxicant was determined to be manganese oxide, which is associated with a priority manganese content in soil samples ofport cities. The positive dynamics of the gain in the accumulation of soil heavy metals according to the total index indicates to the existence of problems for soil contamination. Analysis of demographic variables shows that the population of the Sakhalin region in general and the port cities in particular relates to a regressive type. The main causes of the population decline are mortality and migration outflow of able-bodied population in other regions of Russia. However, in the port cities there is an increase in the number of work places, contributing to an increase in the labor force. The primary and general morbidity of the population ofport cities is characterized by higher levels compared with the average for the Sakhalin Region and the Far Eastern Federal District. Among all the classes of diseases as priority ones there are marked “neoplasm”, “diseases of the nervous system”, “respiratory diseases”, “diseases of the skin and subcutaneous tissue”. Port cities occupy the top ranking places on the incidence of malignant tumors among the cities of the Sakhalin region.

Histogenesis of mouse sarcomas induced by implantation of polyvinyl chloride film in radiation chimeras

International Nuclear Information System (INIS)

Mojzhess, T.G.; Prigozhina, E.L.

1976-01-01

Sarcomas were induced in CBA/CBA-T6T6 mouse radiation chimeras by implantation of polyvinyl chloride film subcutaneously 13 months after irradiation and injection of donor's bone marrow. Of the 12 tumors studied 11 had the recipient's karyotype and one the donor's. The formation of connective-tissue cells from bone-marrow precursors thus, evidently does not play an essential role in the histogenesis of sarcomas induced by plastics

Histologic Changes of Implanted Gore Bio-A in an Experimental Animal Model

Directory of Open Access Journals (Sweden)

Kwan Koo Yeo

2014-01-01

Full Text Available Gore Bio-A has been reported to be an ideal synthetic bioabsorbable scaffold material for hernia repair. The purpose of this study was to determine the effectiveness of Gore Bio-A in soft tissue augmentation. Six New Zealand white rabbits were used in the study. Five subcutaneous pockets were created on the back of the rabbit, and 20×20 mm sized square shaped Gore Bio-A sheets, each 1.5 mm, 3 mm, 4.5 mm, 6 mm, and 7.5 mm in thickness, were implanted into each pocket (1 layer to 5 layers. To analyze the morphologic and histologic changes, the implants were harvested 1, 3, and 6 months after implantation. Following the gross analysis, absorption rate was accelerated with increased implant duration and decreased thickness. Histological analysis of the implants demonstrated progressive neovascularization, fibroblast infiltration, and neocollagenation over time. Six months after implantation, Gore Bio-A was almost absorbed and degenerated, not maintaining its volume. Based on this study, Gore Bio-A was revealed as a biocompatible material; however, it is not suitable for soft tissue augmentation because it is absorbed in the process of changing into soft tissue without maintaining its own volume. Therefore, this material is incomplete and needs more study to overcome this limitation.

Cost-minimization of mabthera intravenous versus subcutaneous administration

NARCIS (Netherlands)

Bax, P.; Postma, M.J.

2013-01-01

Objectives: To identify and compare all costs related to preparing and administrating MabThera for the intravenous and subcutaneous formulations in Dutch hematological patients. The a priori notion is that the costs of subcutaneous MabThera injections are lower compared to intravenous infusion due

Acute In Vivo Response to an Alternative Implant for Urogynecology

Directory of Open Access Journals (Sweden)

Sabiniano Roman Regueros

2014-01-01

Full Text Available Purpose. To investigate in vivo the acute host response to an alternative implant designed for the treatment of stress urinary incontinence (SUI and pelvic organ prolapse (POP. Methods. A biodegradable scaffold was produced from poly-L-lactic acid (PLA using the electrospinning technique. Human and rat adipose-derived stem cells (ADSCs were isolated and characterized by fluorescence-activated cell sorting and differentiation assays. PLA scaffolds were seeded and cultured for 2 weeks with human or rat ADSCs. Scaffolds with and without human or rat ADSCs were implanted subcutaneously on the abdominal wall of rats. After 3 and 7 days, 6 animals from each group were sacrificed. Sections from each sample were analyzed by Haematoxylin and Eosin staining, Sirius red staining, and immunohistochemistry for CD68, PECAM-1, and collagen I and III. Results. Animals responded to the scaffolds with an acute macrophage response. After 7 days of implantation, there was extensive host cell penetration, new blood vessel formation, and new collagen deposition throughout the full thickness of the samples without obvious differences between cell-containing and cell-free scaffolds. Conclusions. The acute in vivo response to an alternative implant (both with and without cells for the treatment of SUI and POP showed good acute integration into the host tissues.

Analyzing Growth Opportunity of Port from the Resource-based Perspective The Case of Port of Tanjung Pelepas Malaysia

Directory of Open Access Journals (Sweden)

Muhammad Subhan

2008-09-01

Full Text Available Capturing growth opportunity has become a major integral activity of any port to sustain growth and competitive advantage. One of the famous strategies in leveraging sustainable growth and competitive advantage is the resource-based theory application into port strategic management, viewing resources of the port (internal and external and its capabilities as the sources for achieving competitive advantage. In this study, we attempt to identify, exploit, and analyze growth opportunity of a Malaysian port from the perspective of the theory. We analyze the port’s resources in terms of values, uniqueness, inimitability, durability, and substitutability. The result is then compared with its rival ports in the region. This study recognizes that the port has successfully identified and exploited its resources for capturing growth opportunity and competing with other ports in the region. We perceive that the port will sustain its growth and competitive advantage as a major port in the region based on its current performance and rivalry circumstances. This study signifies that the higher the level to which resource-based theory of competitive advantage is applied, the higher and longer the growth and competitive advantage will be achieved by the port.

Iatrogenic Lower Extremity Subcutaneous Emphysema after Prolonged Robotic-Assisted Hysterectomy

Directory of Open Access Journals (Sweden)

Monica Hagan Vetter

2015-01-01

Full Text Available Subcutaneous emphysema is a known complication of carbon dioxide insufflation, an essential component of laparoscopy. The literature contains reports of hypercarbia, pneumothorax, or pneumomediastinum. However, isolated lower extremity subcutaneous emphysema remains a seldom-reported complication. We report a case of unilateral lower extremity subcutaneous emphysema following robotic-assisted hysterectomy, bilateral salpingooophorectomy, staging, and anterior/posterior colporrhaphy for carcinosarcoma and vaginal prolapse. On postoperative day 1, the patient developed tender crepitus and bruising of her right ankle. Radiography confirmed presence of subcutaneous air. Vital signs and laboratory findings were unremarkable. Her symptoms spontaneously improved over time, and she was discharged in good condition on day 2. In stable patients with postoperative extremity swelling or pain with crepitus on exam, the diagnosis of iatrogenic subcutaneous emphysema must be considered.

A wide-field suprachoroidal retinal prosthesis is stable and well tolerated following chronic implantation.

Science.gov (United States)

Villalobos, Joel; Nayagam, David A X; Allen, Penelope J; McKelvie, Penelope; Luu, Chi D; Ayton, Lauren N; Freemantle, Alexia L; McPhedran, Michelle; Basa, Meri; McGowan, Ceara C; Shepherd, Robert K; Williams, Chris E

2013-05-01

The safety of chronic implantation of a retinal prosthesis in the suprachoroidal space has not been established. This study aimed to determine the safety of a wide-field suprachoroidal electrode array following chronic implantation using histopathologic techniques and electroretinography. A platinum electrode array in a wide silicone substrate was implanted unilaterally in the suprachoroidal space in adult cats (n = 7). The lead and connector were tunneled out of the orbit and positioned subcutaneously. Postsurgical recovery was assessed using fundus photography and electroretinography (ERG). Following 3 months of passive implantation, the animals were terminated and the eyes assessed for the pathologic response to implantation. The implant was mechanically stable in the suprachoroidal space during the course of the study. The implanted eye showed a transient increase in ERG response amplitude at 2 weeks, which returned to normal by 3 months. Pigmentary changes were observed at the distal end of the implant, near the optic disc. Histopathologic assessment revealed a largely intact retina and a thin fibrous capsule around the suprachoroidal implant cavity. The foreign body response was minimal, with sporadic presence of macrophages and no active inflammation. All implanted eyes were negative for bacterial or fungal infections. A midgrade granuloma and thick fibrous buildup surrounded the extraocular cable. Scleral closure was maintained in six of seven eyes. There were no staphylomas or choroidal incarceration. A wide-field retinal prosthesis was stable and well tolerated during long-term suprachoroidal implantation in a cat model. The surgical approach was reproducible and overall safe.

Subcutaneous emphysema in cavitary pulmonary tuberculosis without pneumothorax or pneumomediastinum

Directory of Open Access Journals (Sweden)

Ramakant Dixit

2012-01-01

Full Text Available Extra-alveolar air in the form of subcutaneous tissue emphysema is observed in a variety of clinical settings. Spontaneous subcutaneous emphysema in the absence of pneumothorax or pneumomediastinum is very rare. We report a case of spontaneous subcutaneous emphysema secondary to cavitary pulmonary tuberculosis in the absence of pneumothorax or pneumomediastinum.

Port Authority Best Practices

Science.gov (United States)

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

Sapphire implant based neuro-complex for deep-lying brain tumors phototheranostics

Science.gov (United States)

Sharova, A. S.; Maklygina, YU S.; Yusubalieva, G. M.; Shikunova, I. A.; Kurlov, V. N.; Loschenov, V. B.

2018-01-01

The neuro-complex as a combination of sapphire implant optical port and osteoplastic biomaterial "Collapan" as an Aluminum phthalocyanine nanoform photosensitizer (PS) depot was developed within the framework of this study. The main goals of such neuro-complex are to provide direct access of laser radiation to the brain tissue depth and to transfer PS directly to the pathological tissue location that will allow multiple optical phototheranostics of the deep-lying tumor region without repeated surgical intervention. The developed complex spectral-optical properties research was carried out by photodiagnostics method using the model sample: a brain tissue phantom. The optical transparency of sapphire implant allows obtaining a fluorescent signal with high accuracy, comparable to direct measurement "in contact" with the tissue.

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

Directory of Open Access Journals (Sweden)

Christine Hohl Moinat

2014-01-01

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

US Ports of Entry

Data.gov (United States)

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

Starting manufacturing phase of ITER upper ports

Energy Technology Data Exchange (ETDEWEB)

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

2015-10-15

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

Starting manufacturing phase of ITER upper ports

International Nuclear Information System (INIS)

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

2015-01-01

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

Subcutaneous fibrosis after whole neck irradiation

International Nuclear Information System (INIS)

Hirota, Saeko; Tsujino, Kayoko; Oshitani, Takashi; Hishikawa, Yoshio; Takada, Yoshiki; Kono, Michio; Abe, Mitsuyuki

2002-01-01

Purpose: To identify the risk factors for moderate to severe subcutaneous fibrosis after whole neck irradiation. Methods and Materials: We analyzed 233 cases of patients who had undergone whole neck irradiation with 4-MV X-ray or 8-10-MeV electrons, or both, and had been followed with regard to their skin condition for at least 1 year. The prescribed dose to the whole neck ranged from 19.2 to 72.4 Gy (median 50). The skin-absorbed dose was specified as that at a depth of 4.1 mm (d4.1-mm depth ), and a biologically equivalent dose (BED) of d4.1-mm depth was also estimated (BED 1.8 4.1-mm depth ). Results: Univariate analysis revealed that previous neck dissection, concurrent chemotherapy, corticosteroid administration as a part of chemotherapy, fractionation, and BED 1.8 4.1-mm depth were significant prognostic variables. Multivariate analysis showed that BED 1.8 4.1-mm depth and previous neck dissection were the only prognostic variables for moderate to severe subcutaneous fibrosis. Conclusion: A high dose to a 4.1-mm depth of the skin and a history of neck dissection were identified as the predominant risk factors for moderate to severe subcutaneous fibrosis after whole neck irradiation. A subcutaneous dose should be considered in radiotherapy treatment planning involving the whole neck, especially in cases in which patients have undergone previous neck dissection

Logistics Road map for Smart SeaPorts

Directory of Open Access Journals (Sweden)

Khaled Gaber EL Sakty

2016-12-01

Full Text Available In the digital world, a smart concept became an essential feature for port organizations to serve as intelligent hubs in the world transport networks.  Smart ports are the trend for the future long-term strategies. Henceforth, ports aims at contributing to sustainable growth by establishing the appropriate conditions for the adoption of new management energy models based on low environmental impact and triggering innovation of both technologies and processes. The scope of this paper is to examine three main issues of smart ports; smart port arctic logistics roadmap, smart port challenges and obstacles in arctic port areas, and the criteria and Key Performance Indicators guiding the assessment of ports against this concept. The main purpose is to develop a smart arctic logistics road map for the future.

Dry Port Development: A Systematic Review

Directory of Open Access Journals (Sweden)

Fatimazahra BENTALEB

2015-12-01

Full Text Available Studies on dry ports as nodes in multimodal transport have been expanded to decrease the mounting congestion on seaports. The principal objective of this study is to inspect how dry port researches have been conducted from different perspective. This paper tries to recap the existing researches that aimed to study dry port concept via a systematic review, to present a general overview of the researches on our relevant region and propose a classification for these researches. This paper present a systematic review of dry port that looks to illustrate the progress of researches on this area between 1986 and 2015, collecting researches on dry port concept and analyzing the main characteristics of the dry port development and their contribution to the multimodal transport. The results indicated that most dry port studies considerate the strategic level and concentrate in the Asian continent. Studies regarding other decision levels and continents have to be developed in further researches. Although the existing studies make a contribution in dry port concept, they allow gaps in terms of operational and tactical decision levels considering their limited geographical region.

Strategic Planning for Port Development: Improvement of Container Transit from the Iranian Southern Ports Terminals

Directory of Open Access Journals (Sweden)

Homayoun Yousefi

2013-09-01

Full Text Available The author attempts to highlight the significance of the Iranian southern ports development strategy planning which allows for the maximum container transit with minimum resources such as service capacities, human resources, and financial potential in order to expand the Iranian container transit. It should be noted that the strategic objectives, the business strategy and its implementation can be arranged only after the port vision and mission obviously delineated. For the purpose of improving the outcome of the ports operational management, it is recommended to concentrate on new strategies such as exploit of transit corridors for development of the Iranian South Ports. The main part of this paper is dedicated to evaluate the role of container transit from the Iranian south ports terminals from various transport corridors in order to improve Maritime Transport in Iran. The importance of defin¬ing the existing and potential competitors at the Persian Gulf and making a comparison between their and our own strengths and weaknesses is of utmost importance. Sometimes, the real business opportunities and threats are placed beyond one’s own line of indus¬try and business. It is therefore necessary to make a careful analysis of the port environment. After the port competition and environment have been analyzed, it would be possible to initiate the building of the SWOT analysis for the Iranian Southern Container Terminals such as Khoramshahr, Imam Khomani, Busher, Bandar Abbas and Chabahar port which have suitable strategic position as transit base in the region. The SWOT analysis method is therefore applied aiming at defining the weaknesses and strengths of the economic subjects as well as opportunities and threats coming from the environment. The next segment of this paper is dedicated to consider the role of dry ports and the International North-South Transit Corridor for the purpose of improving the Iranian container trade.

Social Media Usage Patterns in Port Industry: Implications for Port Promotion and Public Relations

Directory of Open Access Journals (Sweden)

Aylin ÇALIŞKAN

2018-03-01

Full Text Available While social media has been penetrating the daily lives of individuals, the businesses have started to develop new strategical approaches for using social media tools, since they understand the importance of this new area. This study aims to take a step on the gap about social media marketing in the port industry. The focused sample is container ports located in Turkey, but to gain more meaningful insights, a comparison is also made with the ports of Los Angeles, Rotterdam, and Antwerp. The post set on Facebook, which covers the 8 months’ period, was analyzed through a social media analytics software, and the most attractive topics and engagement levels were determined. It was found that the most attractive posts of ports with high engagement levels do not include any statement, image, or video about port service, infrastructure and superstructure, investments, or success stories. At the end of the study, suggestions are developed by supporting with real cases for ports’ social media management.

Subcutaneous encapsulated fat necrosis

DEFF Research Database (Denmark)

Aydin, Dogu; Berg, Jais O

2016-01-01

We have described subcutaneous encapsulated fat necrosis, which is benign, usually asymptomatic and underreported. Images have only been published on two earlier occasions, in which the necrotic nodules appear "pearly" than the cloudy yellow surface in present case. The presented image may help...

Fully Implanted Brain-Computer Interface in a Locked-In Patient with ALS.

Science.gov (United States)

Vansteensel, Mariska J; Pels, Elmar G M; Bleichner, Martin G; Branco, Mariana P; Denison, Timothy; Freudenburg, Zachary V; Gosselaar, Peter; Leinders, Sacha; Ottens, Thomas H; Van Den Boom, Max A; Van Rijen, Peter C; Aarnoutse, Erik J; Ramsey, Nick F

2016-11-24

Options for people with severe paralysis who have lost the ability to communicate orally are limited. We describe a method for communication in a patient with late-stage amyotrophic lateral sclerosis (ALS), involving a fully implanted brain-computer interface that consists of subdural electrodes placed over the motor cortex and a transmitter placed subcutaneously in the left side of the thorax. By attempting to move the hand on the side opposite the implanted electrodes, the patient accurately and independently controlled a computer typing program 28 weeks after electrode placement, at the equivalent of two letters per minute. The brain-computer interface offered autonomous communication that supplemented and at times supplanted the patient's eye-tracking device. (Funded by the Government of the Netherlands and the European Union; ClinicalTrials.gov number, NCT02224469 .).

HomePort

DEFF Research Database (Denmark)

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

2013-01-01

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

Adaptive Port Planning under Disruptive Trends with focus on the case of The Port of Kuala Tanjung, Indonesia

OpenAIRE

Prakoso Andre; Taneja Poonam; Velinga Tiedo

2018-01-01

As a national strategic project, the Port of Kuala Tanjung draws significant attention at national and international level. Considering the semi-greenfield nature of the port, the diverse set of stakeholders, and the prevailing disruptive trends in the world port business, a robust first-phase port layout is required to kick-start the project and guarantee the overall sustainability of the port development. The objective of this research is to identify any uncertain or disruptive trends, both...

Port entry arrangements

International Nuclear Information System (INIS)

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

1978-01-01

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

Management of extensive surgical emphysema with subcutaneous drain: A case report

Directory of Open Access Journals (Sweden)

Quoc Tran

Full Text Available Introduction: Subcutaneous emphysema (SE is a frequent and often self-limiting complication of tube thoracostomy or other cardiothoracic procedures. On rare occasions, severe and extensive surgical emphysema marked by palpable cutaneous tension, dysphagia, dysphonia, palpebral closure or associated with pneumoperitoneum, airway compromise, “tension phenomenon” and respiratory failure require treatment. Presentation of case: A 67 year old lady presented with a large spontaneous pneumothorax on the background of end-stage chronic obstructive pulmonary disease (COPD and newly diagnosed lung cancer, developed extensive surgical emphysema following insertion of a chest drain. Immediate improvement was observed after insertion of a large-bore, 26 French (Fr. intercostal catheter, subcutaneous drain which was maintained under low suction (−5 cm H2O for a further 24 h. Discussion: Several methods have been described in the literature for the treatment of extensive subcutaneous emphysema, including: emergency tracheostomy, multisite subcutaneous drainage, infraclavicular “blow holes” incisions and subcutaneous drains or simply increasing suction on an in situ chest drain. Here a large-bore, fenestrated, subcutaneous drain maintained on low negative pressure also provided the necessary decompression. Conclusion: In the absence of a comparative study to identify the most effective method to manage extensive subcutaneous emphysema, this case highlights an effective, simple and safe management option. Keywords: Pneumothorax, Subcutaneous emphysema, Drain, Low suction, Intercostal catheter, Case report

Assesment of port governance in Brazil: a managerial perspective on the port of Santos

OpenAIRE

Almeida, José Eduardo Costa de

2015-01-01

The role of maritime transportation within international trade was drastically revamped during the inception of the globalization process, which enhanced the contribution of ports in world economy as main logistics gateways for global production and trade. As a result, the relationship between ports and governments has changed. Devolution ideologies that had been applied in other industries decades ago were now being considered by governments for the port industry. Many central governments so...

[Clinical retrospective control study of single-port laparoendoscopic and multi-port laparoscopic ovarian cystectomy].

Science.gov (United States)

Liu, X; Wen, M K; Liu, H Y; Sun, D W; Lang, J H; Fan, Q B; Shi, H H

2017-10-25

Objective: To investigate clinical outcomes of laparoendoscopic single-site ovarian cystectomy compared with traditional multi-port laparoscopic ovarian cystectomy. Methods: Data of 81 patients with ovarian cystectomy from January 2016 to May 2017, the single-site group ( n= 40) and the multi-port group ( n= 41) in Peking Union Medical College Hospital were retrospectively collected. The outcomes of single-site and multi-port groups were analyzed and compared, including: postoperative fever, operation time, blood loss, hemoglobin change, surgical complications, postoperative pain score, postoperative analgesic requirements, body image scale and cosmetic score, length of hospital stay, postoperative total cost. Results: No complication was found in two groups. No difference was found in postoperative fever, blood loss, hemoglobin change, postoperative pain score, length of hospital stay, and total cost between the two groups (all P> 0.05). Operation time was (50±20) minutes in single-site group, and (40±15) minutes in multi-port group; postoperative analgesic requirements was 28%(11/40) in single-site group, and 7%(4/41) in multi-port group; cosmetic score was 22.6±2.6 in single-site group, and 17.3±2.6 in multi-port group; body image scale was 5.7±1.2 in single-site group, and 6.2±1.2 in multi-port group; these four clinical parameters were statistical differences (all P< 0.05). Conculsion: Laparoendoscopic single-site ovarian cystectomy is feasible and safe, although it could't relieve the postoperative pian, it do offer a higher cosmetic satisfaction.

Container Traffic In European Ports

Directory of Open Access Journals (Sweden)

Elen Twrdy

2004-03-01

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

System аnalysis concession maritime trade ports

Directory of Open Access Journals (Sweden)

Y.V. Shmatock

2015-03-01

Full Text Available The article proves the significance of maritime commercial ports as strategic for the country. The urgency of port concessions to improve transport infrastructure. The definition of ports in terms of system analysis and determination of management port. Outlined the sequence of system analysis concessions maritime trade ports in the table. Selection of qualified managers is based on the concession tender under prescribed conditions. These criteria should be considered when determining the concessionaire. These stages of the concession tender. Meeting the needs of the economy, international trade, public inquiries into transportation of goods is not possible without the efficient operation of maritime trade ports. Only complex technological modernization of maritime trade ports will enable them to take leadership positions. Tree depicted objectives effectively manage commercial sea port. Therefore, initiation of concessions needs to implement measures to achieve the talented and skillful result.

Intermittent subcutaneous methadone administration in the management of cancer pain.

Science.gov (United States)

Centeno, Carlos; Vara, Francisco

2005-01-01

Methadone is a strong opioid analgesic that has been used successfully in cancer pain management. The oral route of administration is generally preferred for opioid analgesics. However that route sometimes cannot be used. Experience with continuous subcutaneous methadone infusions has produced local intolerance. The aim of this study was to analyze the use of intermittent subcutaneous methadone injections. Ten patients whose pain was well-controlled with oral methadone (average dose 30 mg, range 10 to 120 mg) participated in the study. A subcutaneous small vein needle (butterfly) was used exclusively for administration of methadone. Over a period of seven days the local discomfort of each injection was evaluated by means of a Verbal Numerical Rating Scale (NRS) and the site of infusion was observed. When any degree of erythema or inflammation was seen, the infusion site was changed. The initial subcutaneous dose was the same as the previously administered oral dose. A daily record was kept of the dose used, level of pain, and toxicity symptoms. This close vigilance was aimed at avoiding dosage errors due to variations among individuals in acceptance to previous oral medication. Changes in dosage were allowed according to standard medical criteria. Two patients were withdrawn from the study due to non-painful irritation at the infusion point. Another eight patients tolerated repeated administration of subcutaneous methadone over seven days. Any local irritation from subcutaneous methadone that occurred was managed satisfactorily by changing the infusion site and limiting doses to 30 mg. In seven of 182 repeat administration, injection site changes were necessitated by local irritation. The NRS for local discomfort was 2/10. The two patients who were intolerant of the subcutaneous injections were receiving injected doses which were significantly higher than the others (42 mg as compared to 25 mg). Dose adjustments needed when changing from the oral to the

Oluvil Port Development Project

DEFF Research Database (Denmark)

Frigaard, Peter; Margheritini, Lucia

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

COMPETITION BETWEEN CONTAINER PORTS IN THE NORTHERN ADRIATIC

OpenAIRE

Elen Twrdy; Milan Batista

2014-01-01

World trade has changed in the last decade such that container traffic flows are oriented towards more parts of the European continent. The European container port system is not a homogeneous set of ports; instead it consists of several big ports (e.g., Rotterdam, Hamburg, Algeciras...) and a large number of medium and small ports. Northern Adriatic (NA) ports, namely Rijeka, Koper, Trieste, Venice and Ravenna, are small ports. Each of these ports have different development plans but in varyi...

Effect of Melatonin Implants during the Non-Breeding Season on the Onset of Ovarian Activity and the Plasma Prolactin in Dromedary Camel

Directory of Open Access Journals (Sweden)

Khalid El Allali

2018-03-01

Full Text Available To examine a possible control of reproductive seasonality by melatonin, continual-release subcutaneous melatonin implants were inserted 4.5 months before the natural breeding season (October–April into female camels (Melatonin-treated group. The animals were exposed to an artificial long photoperiod (16L:8D for 41 days prior to implant placement to facilitate receptivity to the short-day signal that is expected with melatonin implants. The treated and control groups (untreated females were maintained separately under outdoor natural conditions. Ovarian follicular development was monitored in both groups by transrectal ultrasonography and by plasma estradiol-17β concentrations performed weekly for 8 weeks and then for 14 weeks following implant insertion. Plasma prolactin concentrations were determined at 45 and 15 days before and 0, 14, 28, 56, and 98 days after implant insertion. Plasma melatonin concentration was determined to validate response to the artificial long photoperiod and to verify the pattern of release from the implants. Results showed that the artificial long photoperiod induced a melatonin secretion peak of significantly (P < 0.05 shorter duration (about 2.5 h. Melatonin release from the implants resulted in higher circulating plasma melatonin levels during daytime and nighttime which persisted for more than 12 weeks following implants insertion. Treatment with melatonin implants advanced the onset of follicular growth activity by 3.5 months compared to untreated animals. Plasma estradiol-17β increased gradually from the second week after the beginning of treatment to reach significantly (P < 0.01 higher concentrations (39.2 ± 6.2 to 46.4 ± 4.5 pg/ml between the third and the fifth week post insertion of melatonin implants. Treatment with melatonin implants also induced a moderate, but significant (P < 0.05 suppressive effect on plasma prolactin concentration on the 28th day. These

Effect of Melatonin Implants during the Non-Breeding Season on the Onset of Ovarian Activity and the Plasma Prolactin in Dromedary Camel

Science.gov (United States)

El Allali, Khalid; Sghiri, Abdelmalek; Bouâouda, Hanan; Achaâban, Mohamed Rachid; Ouzir, Mounir; Bothorel, Béatrice; El Mzibri, Mohammed; El Abbadi, Najia; Moutaouakkil, Adnane; Tibary, Ahmed; Pévet, Paul

2018-01-01

To examine a possible control of reproductive seasonality by melatonin, continual-release subcutaneous melatonin implants were inserted 4.5 months before the natural breeding season (October–April) into female camels (Melatonin-treated group). The animals were exposed to an artificial long photoperiod (16L:8D) for 41 days prior to implant placement to facilitate receptivity to the short-day signal that is expected with melatonin implants. The treated and control groups (untreated females) were maintained separately under outdoor natural conditions. Ovarian follicular development was monitored in both groups by transrectal ultrasonography and by plasma estradiol-17β concentrations performed weekly for 8 weeks and then for 14 weeks following implant insertion. Plasma prolactin concentrations were determined at 45 and 15 days before and 0, 14, 28, 56, and 98 days after implant insertion. Plasma melatonin concentration was determined to validate response to the artificial long photoperiod and to verify the pattern of release from the implants. Results showed that the artificial long photoperiod induced a melatonin secretion peak of significantly (P < 0.05) shorter duration (about 2.5 h). Melatonin release from the implants resulted in higher circulating plasma melatonin levels during daytime and nighttime which persisted for more than 12 weeks following implants insertion. Treatment with melatonin implants advanced the onset of follicular growth activity by 3.5 months compared to untreated animals. Plasma estradiol-17β increased gradually from the second week after the beginning of treatment to reach significantly (P < 0.01) higher concentrations (39.2 ± 6.2 to 46.4 ± 4.5 pg/ml) between the third and the fifth week post insertion of melatonin implants. Treatment with melatonin implants also induced a moderate, but significant (P < 0.05) suppressive effect on plasma prolactin concentration on the 28th day. These results

[Atypical sinus node dysfunction. Usefulness of implantable Holter. A case report].

Science.gov (United States)

Martí Almor, J; Delclòs Urgell, J; Bruguera Cortada, J

2001-12-01

We present an 84 year-old female patient with repeated syncopes/presyncopes in the last nine years. All diagnosis tests were negative, including ECG, 24-hour Holter, tilt table test and EP study. Therefore, a subcutaneous insertable loop recorder was implanted (Reveal). The recording of three episodes showed the association of presyncope with the onset of atrial fibrilation and, in two syncopes, with an atrial pause between AF episodes. Probably an abnormal prolonged sinus node recovery time (more than 6 s) allowed AF to restart before the sinus rhythm.

Recurrent, giant subcutaneous leiomyosarcoma of the thigh

Directory of Open Access Journals (Sweden)

Gao Chuanping, MD

2015-10-01

Full Text Available We present a case of recurrent, massive subcutaneous leiomyosarcoma involving the left thigh in a 29-year-old male from Madagascar. The patient had earlier undergone local resection of subcutaneous leiomyosarcoma a half year before. After surgical intervention, local recurrence developed at this site and was rapidly growing. The patient was surgically treated with a 2-cm-wide margin local excision in our hospital. The patient has remained recurrence free at 1-year follow-up.

50 CFR 24.12 - Designated ports.

Science.gov (United States)

2010-10-01

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

Perancangan Miniatur Traffic Light Dengan Mempergunakan Pengendali Port Paralel

OpenAIRE

Eka Wahyudi; Desi Permanasari

2012-01-01

Port paralel tentunya sudah tidak asing lagi dalam dunia komputer. Hal tersebut disebabkan karena port paralel merupakan sarana komunikasi yang terdapat pada Personal Computer (PC). Dengan memanfaatkan port tersebut, saat ini komputer juga dapat dipergunakan untuk keperluan pengontrolan/pengendalian rangkaian listrik dengan memanfaatkan port paralel (port printer). Port paralel memiliki kecepatan transfer data yang lebih cepat apabila dibandingkan dengan port serial, maka dari itu port parale...

The Development of the Regional Sea Port Infrastructure on the Basis of Dry Port

Directory of Open Access Journals (Sweden)

Aleksandr Nelevich Rakhmangulov

2016-09-01

Full Text Available This article contributes to the solution of the relevant problem of the seaport infrastructure development for the purpose of increasing the cargo turnover in the regions of seaport location as well as to improve the quality of freight traffic on the basis of the creation of container hinterlands — dry ports. The options of dry ports as the potentially effective solution to increase the cargo turnover of existing seaports, improve the timeliness of freight transportation and overcome the environmental problems of the regions of seaport location are shown. This work analyzes the transport infrastructure of the region, the cargo turnover of major Russian sea and dry ports as well as the experience of creating dry ports in the Russian Federation and abroad. The authors propose the system of parameters for dry ports, which are recommended for the assessment of seaport infrastructure development scenarios on the stage of strategic planning. The authors have developed the approach of optimal values determination of the main parameters of dry ports by simulation modeling method. The features of construction and research of the simulation models of system “seaport — dry port” in programming software AnyLogic are considered. The results of modeling experiments with a developed simulation model are provided. This model is aimed to assess the maximum estimated capacity of the existing seaport in the conditions of the increasing irregularity of cargo traffic, and also to determine the optimum parameters of the constructed «dry port». The obtained dependencies as a result of modeling experiments prove the adequacy of the selected main parameters of dry ports for the effective evaluation of the scenarios of the strengthening of carrying and estimated capacity of existing seaports on the stage of strategic planning. The article shows that the methodology of this research can be used by the investors and public authorities as grounds for a decision on

Unsupervised Assessment of Subcutaneous and Visceral Fat by MRI

DEFF Research Database (Denmark)

Jørgensen, Peter Stanley; Larsen, Rasmus; Wraae, Kristian

2009-01-01

This paper presents a. method for unsupervised assessment of visceral and subcutaneous adipose tissue in the abdominal region by MRI. The identification of the subcutaneous and the visceral regions were achieved by dynamic programming constrained by points acquired from an active shape model...

Hub Status and Indexation of Container Ports

Directory of Open Access Journals (Sweden)

Yong-An Park

2015-06-01

This study develops two sub-indexes of port classification and capacity, and combines cases of these two sub-indexes into various types in order to find a proper port hub index. The paper demonstrates how different types of port hub index are useful measurements for evaluating outputs and inputs of container ports. In a case analysis we show that the indexes of period variables and lagged variables have more explanatory power with regard to changes of port throughputs and high correlation with inputs.

Ultrasonographic Findings of Subcutaneous and Muscular Sparganosis

International Nuclear Information System (INIS)

Park, Hee Jin; Park, Noh Hyuck; Lee, Eun Ja; Park, Chan Sub; Lee, Sung Moon; Park, Sung Il

2009-01-01

This study was deigned to evaluate the ultrasonographic findings of subcutaneous and intramuscular sparganosis. Nine cases of histologically proven subcutaneous and intramuscular sparganosis lesions in seven patients (mean patient age, 59 years; M:F = 6:1) were reviewed retrospectively. Two patients had recurrent sparganosis. A color Doppler examination was performed in all cases. A prior history of ingestion of raw snake meat was noted for two patients. Patients presented with a palpable mass and induration (n = 7) and dull pain (n = 4). Lesion locations were in the thigh (n = 4), lower leg (n = 2), chest wall (n = 1), an inguinal location (n = 1) and the neck (n = 1). Five lesions were in the subcutaneous fat layer and four lesions had intramuscular locations. Calcification was noted in two cases. All cases showed heterogeneous hypoechoic serpiginous tubular-and-oval lesions. The lesions were conglomerated or discrete in appearance. All nine cases showed the presence of lesions with a multi-layered wall with variable intraluminal echogenicity, at least in one segment of the lesion. Increased vascularity was noted on color Doppler examinations in two patients with pain. Subcutaneous or intramuscular sparganosis should be included in the differential diagnosis when a serpiginous tubular-and-oval lesion is noted that is seen with a multi-layered wall with variable intraluminal echogenicity

Improving neuromodulation technique for refractory voiding dysfunctions: two-stage implant.

Science.gov (United States)

Janknegt, R A; Weil, E H; Eerdmans, P H

1997-03-01

Neuromodulation is a new technique that uses electrical stimulation of the sacral nerves for patients with refractory urinary urge/frequency or urge-incontinence, and some forms of urinary retention. The limiting factor for receiving an implant is often a failure of the percutaneous nerve evaluation (PNE) test. Present publications mention only about a 50% success score for PNE of all patients, although the micturition diaries and urodynamic parameters are similar. We wanted to investigate whether PNE results improved by using a permanent electrode as a PNE test. This would show that improvement of the PNE technique is feasible. In 10 patients where the original PNE had failed to improve the micturition diary parameters more than 50%, a permanent electrode was implanted by operation. It was connected to an external stimulator. In those cases where the patients improved according to their micturition diary by more than 50% during a period of 4 days, the external stimulator was replaced by a permanent subcutaneous neurostimulator. Eight of the 10 patients had a good to very good result (60% to 90% improvement) during the testing period and received their implant 5 to 14 days after the first stage. The good results of the two-stage implant technique we used indicate that the development of better PNE electrodes may lead to an improvement of the testing technique and better selection between nonresponders and technical failures.

PORT SECURITY-Threats and Vulnerabilities

OpenAIRE

Kusi, Bernard

2015-01-01

The main objective of this thesis is to identify the threats and the vulnerabilities concerning Takoradi port, and finally recommend measure to overcome the identified threats and vul-nerabilities. Various categories of potential threats and vulnerabilities have been studied throughout the literature review. However, because each port presents a unique sets of threats and vulnerabilities, there was a need to look critically into how Takoradi port operations are being conducted in other to ide...

Device-based local delivery of siRNA against mammalian target of rapamycin (mTOR) in a murine subcutaneous implant model to inhibit fibrous encapsulation

OpenAIRE

Takahashi, Hironobu; Wang, Yuwei; Grainger, David W.

2010-01-01

Fibrous encapsulation of surgically implant devices is associated with elevated proliferation and activation of fibroblasts in tissues surrounding these implants, frequently causing foreign body complications. Here we test the hypothesis that inhibition of the expression of mammalian target of rapamycin (mTOR) in fibroblasts can mitigate the soft tissue implant foreign body response by suppressing fibrotic responses around implants. In this study, mTOR was knocked down using small interfering...

Successful implantation of physiologically functional bioengineered mouse internal anal sphincter.

Science.gov (United States)

Raghavan, Shreya; Miyasaka, Eiichi A; Hashish, Mohamed; Somara, Sita; Gilmont, Robert R; Teitelbaum, Daniel H; Bitar, Khalil N

2010-08-01

We have previously developed bioengineered three-dimensional internal anal sphincter (IAS) rings from circular smooth muscle cells isolated from rabbit and human IAS. We provide proof of concept that bioengineered mouse IAS rings are neovascularized upon implantation into mice of the same strain and maintain concentric smooth muscle alignment, phenotype, and IAS functionality. Rings were bioengineered by using smooth muscle cells from the IAS of C57BL/6J mice. Bioengineered mouse IAS rings were implanted subcutaneously on the dorsum of C57BL/6J mice along with a microosmotic pump delivering fibroblast growth factor-2. The mice remained healthy during the period of implantation, showing no external signs of rejection. Mice were killed 28 days postsurgery and implanted IAS rings were harvested. IAS rings showed muscle attachment, neovascularization, healthy color, and no external signs of infection or inflammation. Assessment of force generation on harvested IAS rings showed the following: 1) spontaneous basal tone was generated in the absence of external stimulation; 2) basal tone was relaxed by vasoactive intestinal peptide, nitric oxide donor, and nifedipine; 3) acetylcholine and phorbol dibutyrate elicited rapid-rising, dose-dependent, sustained contractions repeatedly over 30 min without signs of muscle fatigue; and 4) magnitudes of potassium chloride-induced contractions were 100% of peak maximal agonist-induced contractions. Our preliminary results confirm the proof of concept that bioengineered rings are neovascularized upon implantation. Harvested rings maintain smooth muscle alignment and phenotype. Our physiological studies confirm that implanted rings maintain 1) overall IAS physiology and develop basal tone, 2) integrity of membrane ionic characteristics, and 3) integrity of membrane associated intracellular signaling transduction pathways for contraction and relaxation by responding to cholinergic, nitrergic, and VIP-ergic stimulation. IAS smooth muscle

DEA Window Analysis for Measuring Port Efficiencies in Serbia

Directory of Open Access Journals (Sweden)

Danijela Pjevčević

2012-01-01

Full Text Available The aim of the paper is to apply Data Envelopment Analysis (DEA method in measuring and analyzing the efficiencies of ports on the river Danube. DEA window analysis is used to determine the efficiency of ports and to observe the possibility of changes in the port efficiency over time. A study is conducted to evaluate the efficiencies of ports on the territory of Serbia in order to identify the sources of inefficiencies and formulate proposals for improving the services of those ports and their operations through a four-year window analysis with port efficiency trends and average efficiencies. The progress is made in the measurement of port efficiency in relation to port productive activities - total area of warehouses, quay length, number of cranes and port throughput, for the Serbian river ports. Keywords: river ports, total area of warehouses, quay length, number of cranes, port throughput, port efficiency, DEA window analysis

Abnormal bone formation induced by implantation of osteosarcoma-derived bone-inducing substance in the X-linked hypophosphatemic mouse

International Nuclear Information System (INIS)

Yoshikawa, H.; Masuhara, K.; Takaoka, K.; Ono, K.; Tanaka, H.; Seino, Y.

1985-01-01

The X-linked hypophosphatemic mouse (Hyp) has been proposed as a model for the human familial hypophosphatemia (the most common form of vitamin D-resistant rickets). An osteosarcoma-derived bone-inducing substance was subcutaneously implanted into the Hyp mouse. The implant was consistently replaced by cartilage tissue at 2 weeks after implantation. The cartilage matrix seemed to be normal, according to the histological examination, and 35sulphur ( 35 S) uptake was also normal. Up to 4 weeks after implantation the cartilage matrix was completely replaced by unmineralized bone matrix and hematopoietic bone marrow. Osteoid tissue arising from the implantation of bone inducing substance in the Hyp mouse showed no radiologic or histologic sign of calcification. These findings suggest that the abnormalities of endochondral ossification in the Hyp mouse might be characterized by the failure of mineralization in cartilage and bone matrix. Analysis of the effects of bone-inducing substance on the Hyp mouse may help to give greater insight into the mechanism and treatment of human familial hypophosphatemia

Multi-functional use of port areas

NARCIS (Netherlands)

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

2012-01-01

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

Notch filters for port-Hamiltonian systems

NARCIS (Netherlands)

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

2012-01-01

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

Port-contact systems in bilateral telemanipulation

NARCIS (Netherlands)

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

2007-01-01

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

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

Science.gov (United States)

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

2017-02-01

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

In vivo 31P and 1H NMR studies of rat brain tumor pH and blood flow during acute hyperglycemia: Differential effects between subcutaneous and intracerebral locations

International Nuclear Information System (INIS)

Ross, B.D.; Mitchell, S.L.; Merkle, H.; Garwood, M.

1989-01-01

Surface coil NMR spectroscopy was used to monitor the hyperglycemia-induced alterations in pH and blood flow in vivo in C6 gliomas implanted both subcutaneously and intracerebrally in rats. Tumor pH was calculated from the chemical shift difference between PCr and Pi in the 31 P NMR spectra. Subcutaneous glioma pH decreased 0.8 units by 1 h after intraperitoneal administration of an aqueous 50% glucose solution (6 g glucose per kg body weight). In contrast, hyperglycemia failed to significantly alter the pH of intracerebral gliomas which were monitored for 90 min following administration of glucose. Tumor blood flow (TBF) was determined both pre- and post-glucose administration using deuterium NMR by monitoring the time course of D2O washout following intratumoral injection of saline D2O. Subcutaneous and intracerebral TBF were found to have an average change of -78.1% (range -47.4 to -93.3%, n = 5) and -21.1% (range +6.0 to -37.8%, n = 9), respectively. In addition, laser Doppler blood flow measurements of rat skin and subcutaneous glioma revealed a dramatic reduction in blood flow in both tissues following glucose administration. These results indicate that the effects of acute hyperglycemia are site dependent and that hyperglycemia alone is not beneficial for inducing intracellular acidosis in intracerebral tumors

Port Harcourt Medical Journal

African Journals Online (AJOL)

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

Perancangan Miniatur Traffic Light Dengan Mempergunakan Pengendali Port Paralel

Directory of Open Access Journals (Sweden)

Eka Wahyudi

2012-05-01

Full Text Available Port paralel tentunya sudah tidak asing lagi dalam dunia komputer. Hal tersebut disebabkan karena port paralel merupakan sarana komunikasi yang terdapat pada Personal Computer (PC. Dengan memanfaatkan port tersebut, saat ini komputer juga dapat dipergunakan untuk keperluan pengontrolan/pengendalian rangkaian listrik dengan memanfaatkan port paralel (port printer. Port paralel memiliki kecepatan transfer data yang lebih cepat apabila dibandingkan dengan port serial, maka dari itu port paralel lebih banyak dipergunakan untuk pengendalian nyala lampu (LED. Dengan memanfaatkan bantuan software Saraf Listrik versi 1.01, maka port paralel dapat menjadi alternatif baru untuk pengendalian traffic light.

Port Card Module

International Nuclear Information System (INIS)

Utes, M.

1994-01-01

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

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

International Nuclear Information System (INIS)

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

2010-01-01

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

TRENDS IN CONTEMPORARY PORT SERVICES MARKETS

Directory of Open Access Journals (Sweden)

Hanna Klimek

2014-12-01

Full Text Available This article describes the issues associated with functioning of contemporary seaport services markets. The growth of international supply chains, technical progress and the integration processes in shipping, growth of containerization, increasing competition in the seaport services markets and environmental protection regulations make it necessary for port service providers to adapt to the changing expectations and requirements of their customers, both shippers and, especially maritime, carriers. Thus, the activities they undertake are associated with making investments to ensure an adequate capacity to handle cargo, passengers and means of transport, required quality of service, but also with appropriate organization of port supply centres and lead to an improvement of their competitiveness. Both the factors associated with the external and internal environment of seaports affect the changes in the relationship between the supply and demand on port services markets. Contemporary port services markets are characterized by certain phenomena which can be a sign of their adaptation and development. The aim of this article is to present the essence of the port services market and its relationship with the environment, which subject to rapid and significant changes, creates new conditions for the operation of port supply centres and the entire port services market.

US Army Corps of Engineers Ports, Geographic WGS84, BTS (2006) [usace_port_BTS_2006

Data.gov (United States)

Louisiana Geographic Information Center — Contains physical information on commercial facilities at the principal U.S. Coastal, Great Lakes and Inland Ports. The data consists of listings of port area's...

The Challenges of Malaysian Dry Ports Development

Directory of Open Access Journals (Sweden)

Jagan Jeevan

2015-03-01

Full Text Available This paper examines the functions and challenges of dry ports development in Malaysia through 11 face-to-face interviews with dry port stakeholders. The findings reveal that Malaysian dry ports are developed to accelerate national and international business, to activate intermodalism in the nation, to promote regional economic development and to enhance seaport competitiveness. Malaysian dry ports perform the function of transport and logistics, information processing, seaports and value-added services. Challenges facing Malaysian dry ports include insufficient railway tracks, unorganized container planning on the rail deck, highly dependent on single mode of transportation, poor recognition from the seaport community, and competition from localized seaports. This paper further indicates strategies for coping with these challenges and identifies future opportunities for Malaysian dry ports development.

Benchmark dynamics in the environmental performance of ports.

Science.gov (United States)

Puig, Martí; Michail, Antonis; Wooldridge, Chris; Darbra, Rosa Mari

2017-08-15

This paper analyses the 2016 environmental benchmark performance of the port sector, based on a wide representation of EcoPorts members. This is the fifth time that this study has been conducted as an initiative of the European Sea Ports Organisation (ESPO). The data and results are derived from the Self-Diagnosis Method (SDM), a concise checklist against which port managers can self-assess the environmental management of their port in relation to the performance of the EcoPorts membership. The SDM tool was developed in the framework of the ECOPORTS project (2002-2005) and it is managed by ESPO. A total number of 91 ports from 20 different European Maritime States contributed to this evaluation. The main results are that air quality remains as the top environmental priority of the respondent ports, followed by energy consumption and noise. In terms of environmental management, the study confirms that key components are commonly implemented in the majority of European ports. 94% of contributing ports have a designated environmental manager, 92% own an environmental policy and 82% implement an environmental monitoring program. Waste is identified as the most monitored issue in ports (80%), followed by energy consumption (73%) and water quality (70%). Copyright © 2017 Elsevier Ltd. All rights reserved.

[Single-port laparoscopic cholecystectomy: advantages and disadvantages].

Science.gov (United States)

Alekberzade, A V; Lipnitsky, E M; Krylov, N N; Sundukov, I V; Badalov, D A

2016-01-01

To analyze the outcomes of single-port laparoscopic cholecystectomy. Early and long-term postoperative period has been analyzed in 240 patients who underwent laparoscopic cholecystectomy (LCE) including 120 cases of single-port technique and 120 cases of four-port technique. Both groups were compared in surgical time, pain syndrome severity (visual analog scale), need for analgesics, postoperative complications, hospital-stay, daily activity recovery and return to physical work, patients' satisfaction of surgical results and their aesthetic effect. It was revealed that single-port LCE is associated with lower severity of postoperative pain, quick recovery of daily activity and return to physical work, high satisfaction of surgical results and their aesthetic effect compared with four-port LCE. Disadvantages of single-port LCE include longer duration of surgery, high incidence of postoperative umbilical hernia. However hernia was predominantly observed during the period of surgical technique development. Further studies to standardize, evaluate the safety and benefits of single-port LCE are necessary.

The Practice of Guangzhou Port Planning Environmental Impact Assessment

Science.gov (United States)

Wang, Ning; Zhao, Junjie; Shou, Youping; Qiao, Jianzhe; Dong, Shipei; Zhang, Lu

2018-01-01

In this paper, the effects of the implementation of Guangzhou port plan were analyzed from hydrological condition, water environment and ecological environment. Regional water environmental carrying capacity was analyzed. Guangzhou port is a main port in the coast of China, it is an important port of foreign trade in south China, it is an important port for energy supplies and raw materials in Guangdong province [1]. With the shipping channel condition improvement and the construction of large specialized container port area, Guangzhou port will gradually become trunk line port of container transport in south China.

The radiation analyses of ITER lower ports

International Nuclear Information System (INIS)

Petrizzi, L.; Brolatti, G.; Martin, A.; Loughlin, M.; Moro, F.; Villari, R.

2010-01-01

The ITER Vacuum Vessel has upper, equatorial, and lower ports used for equipment installation, diagnostics, heating and current drive systems, cryo-vacuum pumping, and access inside the vessel for maintenance. At the level of the divertor, the nine lower ports for remote handling, cryo-vacuum pumping and diagnostic are inclined downwards and toroidally located each every 40 o . The cryopump port has additionally a branch to allocate a second cryopump. The ports, as openings in the Vacuum Vessel, permit radiation streaming out of the vessel which affects the heating in the components in the outer regions of the machine inside and outside the ports. Safety concerns are also raised with respect to the dose after shutdown at the cryostat behind the ports: in such zones the radiation dose level must be kept below the regulatory limit to allow personnel access for maintenance purposes. Neutronic analyses have been required to qualify the ITER project related to the lower ports. A 3-D model was used to take into account full details of the ports and the lower machine surroundings. MCNP version 5 1.40 has been used with the FENDL 2.1 nuclear data library. The ITER 40 o model distributed by the ITER Organization was developed in the lower part to include the relevant details. The results of a first analysis, focused on cryopump system only, were recently published. In this paper more complete data on the cryopump port and analysis for the remote handling port and the diagnostic rack are presented; the results of both analyses give a complete map of the radiation loads in the outer divertor ports. Nuclear heating, dpa, tritium production, and dose rates after shutdown are provided and the implications for the design are discussed.

The comparison of the intestinal adaptation effects of subcutaneous ...

African Journals Online (AJOL)

Aim: Insulin has been reported to have positive effects on intestinal adaptation after short bowel syndrome when applicated oral or subcutaneously. The purpose of this study is to compare the intestinal adaptation effects of subcutaneous and oral routes of insulin in rats with short bowel syndrome. Materials and Methods: ...

Subcutaneous emphysema, a different way to diagnose

Directory of Open Access Journals (Sweden)

Bruno José da Costa Medeiros

Full Text Available Summary Introduction: Subcutaneous emphysema (SE is a clinical condition that occurs when air gets into soft tissues under the skin. This can occur in any part of the body depending on the type of pathology. The most common site is under the skin that covers the chest wall or neck. It is characterized by painless swelling of tissues. The classic clinical sign is a crackling sensation upon touch, resembling that of touching a sponge beneath your fingers. Objective: To describe a new way to diagnose subcutaneous emphysema. Method: Our finding was a matter of serendipity while inspecting a patient with subcutaneous emphysema using a stethoscope. Instead only hearing the patient's chest, the stethoscope was gently pressed against the skin with SE and so we were able to detect a different sound. Results: This new way to diagnose subcutaneous emphysema consists in pressing the diaphragm part of stethoscope against the patient's skin where SE is supposed to be. Thus, we are able to hear a sound of small bubbles bursting. Crackle noise has an acoustic emission energy that varies between 750-1,200 Hz, considered high frequency. Conclusion: Although currently the use of imaging methods is widespread worldwide, we would like to strengthen the value of clinical examination. Auscultation is an essential diagnostic method that has become underestimated with the advances of healthcare and medicine as a whole. We therefore propose a different approach to diagnose SE.

Injectable agents affecting subcutaneous fats.

Science.gov (United States)

Chen, David Lk; Cohen, Joel L; Green, Jeremy B

2015-09-01

Mesotherapy is an intradermal or subcutaneous injection of therapeutic agents to induce local effects, and was pioneered in Europe during the 1950s. For the past 2 decades, there has been significant interest in the use of mesotherapy for minimally invasive local fat contouring. Based on the theorized lipolytic effects of the agent phosphatidylcholine, initial attempts involved its injection into subcutaneous tissue. With further studies, however, it became apparent that the activity attributed to phosphatidylcholine mesotherapy was due to the adipolytic effects of deoxycholate, a detergent used to solubilize phosphatidylcholine. Since then, clinical trials have surfaced that demonstrate the efficacy of a proprietary formulation of deoxycholate for local fat contouring. Current trials on mesotherapy with salmeterol, a b-adrenergic agonist and lipolysis stimulator, are underway-with promising preliminary results as well. ©2015 Frontline Medical Communications.

Testing and Analysis of Sensor Ports

Science.gov (United States)

Zhang, M.; Frendi, A.; Thompson, W.; Casiano, M. J.

2016-01-01

This Technical Publication summarizes the work focused on the testing and analysis of sensor ports. The tasks under this contract were divided into three areas: (1) Development of an Analytical Model, (2) Conducting a Set of Experiments, and (3) Obtaining Computational Solutions. Results from the experiment using both short and long sensor ports were obtained using harmonic, random, and frequency sweep plane acoustic waves. An amplification factor of the pressure signal between the port inlet and the back of the port is obtained and compared to models. Comparisons of model and experimental results showed very good agreement.

Subcutaneous Implantable Cardioverter-Defibrillator

Science.gov (United States)

... discriminator functions and lacks antitachycardia pacing. Expanded Programmability Programming that allows lower shock energies and the ability ... 2014 American Heart Association, Inc. References 1. ↵ Weiss R , Knight BP , Gold MR , Leon AR , Herre JM , ...

Electromagnetic Radiation Efficiency of Body-Implanted Devices

Science.gov (United States)

Nikolayev, Denys; Zhadobov, Maxim; Karban, Pavel; Sauleau, Ronan

2018-02-01

Autonomous wireless body-implanted devices for biotelemetry, telemedicine, and neural interfacing constitute an emerging technology providing powerful capabilities for medicine and clinical research. We study the through-tissue electromagnetic propagation mechanisms, derive the optimal frequency range, and obtain the maximum achievable efficiency for radiative energy transfer from inside a body to free space. We analyze how polarization affects the efficiency by exciting TM and TE modes using a magnetic dipole and a magnetic current source, respectively. Four problem formulations are considered with increasing complexity and realism of anatomy. The results indicate that the optimal operating frequency f for deep implantation (with a depth d ≳3 cm ) lies in the (108- 109 )-Hz range and can be approximated as f =2.2 ×107/d . For a subcutaneous case (d ≲3 cm ), the surface-wave-induced interference is significant: within the range of peak radiation efficiency (about 2 ×108 to 3 ×109 Hz ), the max-to-min ratio can reach a value of 6.5. For the studied frequency range, 80%-99% of radiation efficiency is lost due to the tissue-air wave-impedance mismatch. Parallel polarization reduces the losses by a few percent; this effect is inversely proportional to the frequency and depth. Considering the implantation depth, the operating frequency, the polarization, and the directivity, we show that about an order-of-magnitude efficiency improvement is achievable compared to existing devices.

Adaptive Port Planning under Disruptive Trends with focus on the case of the Port of Kuala Tanjung, Indonesia

NARCIS (Netherlands)

Taneja, P.; Velinga, Tiedo

2018-01-01

As a national strategic project, the Port of Kuala Tanjung draws significant attention at national and international level. Considering the semi-greenfield nature of the port, the diverse set of stakeholders, and the prevailing disruptive trends in the world port business, a robust first-phase

Subcutaneous blood flow in man during sleep with continous epdural anaesthesia

DEFF Research Database (Denmark)

Sindrup, JH; Petersen, Lars Jelstrup; Kastrup, Jens

1996-01-01

BACKGROUND: Subcutaneous blood flow increases during sleep and we evaluated if this increase is affected by epidural anaesthesia. METHODS: Lower leg subcutaneous blood flow was determined by 133Xenon clearance in ten subjects during continous epidural anaesthesia at L2-L3 including eight hours...... of sleep, while the opper abdominal subcutaneous blood flow served as control. RESULTS: Epidural anaesthesia to the level of the umbilicus was followed by an increase in the lower leg subcutaneous blood flow fra 3.4 (1.8-6.3) to 7.8 (3.6-16.9) ml min-1 (median and range; P....4-7.6) ml min-1 100 g-1 after 88 (45-123) min. In contrast, until the period of sleep the upper abdominal region blood flow remained at 5.2 (3.2-6.4) ml min-1 100 g-1. During sleep, lower leg subcutaneous blood flow did not change significantly, but the upper abdominal flow increased to 6.2 (5.2-7.2) ml min...

Subcutaneous phaeohyphomycosis due to Pyrenochaeta romeroi mimicking a synovial cyst

Directory of Open Access Journals (Sweden)

Aurelien Dinh

2016-08-01

Full Text Available Opportunistic subcutaneous fungal infections are increasing nowadays due to the growing number of medical conditions causing immunosuppression, especially organ transplant. The incidence rate of subcutaneous phaeohyphomycosis is very low. Most studies found are case reports. They showed a wide variation of clinical presentations. Pyrenochaeta romeroi, a fungus from the Dematiaceae group is a saprophyte found in soil and plants and a possible causative agent of phaeohyphomycosis. We present a rare case of subcutaneous phaeohyphomycosis caused by P. romeroi mimicking a synovial cyst in a diabetic patient.

Spontaneous subcutaneous emphysema of the scalp following hair coloring/treatment

Directory of Open Access Journals (Sweden)

Sanjit O. Tewari, MD

2017-03-01

Full Text Available Subcutaneous emphysema of the scalp is a process often attributed to secondary factors such as trauma, infection, or a myriad of iatrogenic etiologies. Here, we are presenting a case report of an adult patient with spontaneous subcutaneous emphysema of the scalp following a hair coloring/treatment. We performed an extensive review of literature on this topic, however, could not find a single case with similar presentation of subcutaneous emphysema. This case demonstrates an unreported etiology for this diagnosis and is thus being reported for its uniqueness and to raise clinical awareness.

Cyber security in ports: Business as usual

OpenAIRE

Moerel, Lokke; Dezeure, Freddy

2017-01-01

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

Injectable and inherently vascularizing semi-interpenetrating polymer network for delivering cells to the subcutaneous space.

Science.gov (United States)

Mahou, Redouan; Zhang, David K Y; Vlahos, Alexander E; Sefton, Michael V

2017-07-01

Injectable hydrogels are suitable for local cell delivery to the subcutaneous space, but the lack of vasculature remains a limiting factor. Previously we demonstrated that biomaterials containing methacrylic acid promoted vascularization. Here we report the preparation of a semi-interpenetrating polymer network (SIPN), and its evaluation as an injectable carrier to deliver cells and generate blood vessels in a subcutaneous implantation site. The SIPN was prepared by reacting a blend of vinyl sulfone-terminated polyethylene glycol (PEG-VS) and sodium polymethacrylate (PMAA-Na) with dithiothreitol. The swelling of SIPN was sensitive to the PMAA-Na content but only small differences in gelation time, permeability and stiffness were noted. SIPN containing 20 mol% PMAA-Na generated a vascular network in the surrounding tissues, with 2-3 times as many vessels as was obtained with 10 mol% PMAA-Na or PEG alone. Perfusion studies showed that the generated vessels were perfused and connected to the host vasculature as early as seven days after transplantation. Islets embedded in SIPN were viable and responsive to glucose stimulation in vitro. In a proof of concept study in a streptozotocin-induced diabetic mouse model, a progressive return to normoglycemia was observed and the presence of insulin positive islets was confirmed when islets were embedded in SIPN prior to delivery. Our approach proposes a biomaterial-mediated strategy to deliver cells while enhancing vascularization. Copyright © 2017 Elsevier Ltd. All rights reserved.

Slewing Port Jib Cranes

Directory of Open Access Journals (Sweden)

Boris Visočnik

2002-09-01

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

Research on variable swirl intake port for high-speed multivalve DI diesel engine. Effects of port configuration on flow characteristics and swirl generation capacity; 4 ben kogata kosoku DI diesel engine no kahen swirl kyuki port ni kansuru kenkyu. Kyuki port haichi ga ryudo tokusei to swirl seino ni oyobosu eikyo

Energy Technology Data Exchange (ETDEWEB)

Kawashima, J; Ogawa, H; Tsuru, Y [Nissan Motor Co. Ltd., Tokyo (Japan)

1997-10-01

In our previous papers, the variable swirl intake port system which can control a wide swirl ratio range (from 4 to 10) was described. This system consisted of two separate intake ports, one of them has a flow control valve for changing the swirl ratio. In this type of variable swirl system, some variations of port combination, port shape, and position can be designed. In this paper, the intake flow characteristics of various port combinations were analyzed on the basis of a steady-state air flow test and 3-dimensional computations. The results indicate that the total performance of the twin ports can be estimated from that of a single port in any kind of port combination. Some difference in flow patterns were found in a variety of port combinations even if each swirl ratio is similar. The selected port combinations in our previous study are good for a wide swirl control range. 11 refs., 9 figs., 1 tab.

Two-port robotic hysterectomy: a novel approach.

Science.gov (United States)

Moawad, Gaby N; Tyan, Paul; Khalil, Elias D Abi

2018-03-24

The objective of the study was to demonstrate a novel technique for two-port robotic hysterectomy with a particular focus on the challenging portions of the procedure. The study is designed as a technical video, showing step-by-step a two-port robotic hysterectomy approach (Canadian Task Force classification level III). IRB approval was not required for this study. The benefits of minimally invasive surgery for gynecological pathology have been clearly documented in multiple studies. Patients had fewer medical and surgical complications postoperatively, better cosmesis and quality of life. Most gynecological surgeons require 3-5 ports for the standard gynecological procedure. Even though the minimally invasive multiport system provides an excellent safety profile, multiple incisions are associated with a greater risk for morbidity including infection, pain, and hernia. In the past decade, various new methods have emerged to minimize the number of ports used in gynecological surgery. The interventions employed were a two-port robotic hysterectomy, using a camera port plus one robotic arm, with a focus on salpingectomy and cuff closure. We describe a transvaginal and a transabdominal approach for salpingectomy and a novel method for cuff closure. The transvaginal and transabdominal techniques for salpingectomy for two-port robotic-assisted hysterectomy provide excellent tension and exposure for a safe procedure without the need for an extra port. We also describe a transvaginal technique to place the vaginal cuff on tension during closure. With the necessary set of skills on a carefully chosen patient, two-port robotic-assisted total laparoscopic hysterectomy is a feasible procedure.

Fabrication of subcutaneous veins phantom for vessel visualization system

Science.gov (United States)

Cheng, Kai; Narita, Kazuyuki; Morita, Yusuke; Nakamachi, Eiji; Honda, Norihiro; Awazu, Kunio

2013-09-01

The technique of subcutaneous veins imaging by using NIR (Near Infrared Radiation) is widely used in medical applications, such as the intravenous injection and the blood sampling. In the previous study, an automatic 3D blood vessel search and automatic blood sampling system was newly developed. In order to validate this NIR imaging system, we adopted the subcutaneous vein in the human arm and its artificial phantom, which imitate the human fat and blood vessel. The human skin and subcutaneous vein is characterized as the uncertainty object, which has the individual specificity, non-accurate depth information, non-steady state and hardly to be fixed in the examination apparatus. On the other hand, the conventional phantom was quite distinct from the human's characteristics, such as the non-multilayer structure, disagreement of optical property. In this study, we develop a multilayer phantom, which is quite similar with human skin, for improvement of NIR detection system evaluation. The phantom consists of three layers, such as the epidermis layer, the dermis layer and the subcutaneous fat layer. In subcutaneous fat layer, we built a blood vessel. We use the intralipid to imitate the optical scattering characteristics of human skin, and the hemoglobin and melanin for the optical absorption characteristics. In this study, we did two subjects. First, we decide the fabrication process of the phantom. Second, we compared newly developed phantoms with human skin by using our NIR detecting system, and confirm the availability of these phantoms.

Systems theory of interconnected port contact systems

NARCIS (Netherlands)

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

2005-01-01

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

Ports and Terminals : Planning and Functional Design

NARCIS (Netherlands)

Groenveld, R.; Velsink, H.

1993-01-01

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

Conservative systems with ports on contact manifolds

NARCIS (Netherlands)

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

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

Single port VATS: recent developments in Asia.

Science.gov (United States)

Yu, Peter S Y; Capili, Freddie; Ng, Calvin S H

2016-03-01

Single port video-assisted thoracic surgery (VATS) is the most recent evolution in minimally invasive thoracic surgery. With increasing global popularity, the single port VATS approach has been adopted by experienced thoracic surgeons in many Asian countries. From initial experience of single port VATS lobectomy to the more complex sleeve resection procedures now forming part of daily practice in some Asia institutes, the region has been the proving ground for single port VATS approaches' feasibility and safety. In addition, certain technical refinements in single port VATS lung resection and lymph node dissection have also sprung from Asia. Novel equipment designed to facilitate single port VATS allowing further reduce access trauma are being realized by the partnership between surgeons and the industries. Advanced thoracoscopes and staplers that are narrower and more maneuverable are particularly important in the smaller habitus of patients from Asia. These and similar new generation equipment are being applied to single port VATS in novel ways. As dedicated thoracic surgeons in the region continue to striving for excellence, innovative ideas in single incision access including subxiphoid and embryonic natural-orifice transluminal endoscopic surgery (e-NOTES) have been explored. Adjunct techniques and technology used in association with single port VATS such as non-intubated surgery, hybrid operating room image guidance and electromagnetic navigational bronchoscopy are all in rapid development in Asia.

Dual-port distal gastrectomy for the early gastric cancer

OpenAIRE

Kashiwagi, Hiroyuki; Kumagai, Kenta; Monma, Eiji; Nozue, Mutsumi

2014-01-01

Background Although recent trends in laparoscopic procedures have been toward minimizing the number of incisions, four or five ports are normally required to complete laparoscopic gastrectomy because of the complexity of this procedure. Multi-channel ports, such as the SILS port (Covidien, JAPAN), are now available and are crucial for performing single-incision laparoscopic surgery (SILS) or reduced port surgery (RPS). We carried out reduced port distal gastrectomy (RPDG) using a dual-port me...

Subcutaneous Fascial Bands—A Qualitative and Morphometric Analysis

Science.gov (United States)

Li, Weihui; Ahn, Andrew C.

2011-01-01

Background Although fascial bands within the subcutaneous (SQ) layer are commonly seen in ultrasound images, little is known about their functional role, much less their structural characteristics. This study's objective is to describe the morphological features of SQ fascial bands and to systematically evaluate the bands using image analyses tools and morphometric measures. Methods In 28 healthy volunteers, ultrasound images were obtained at three body locations: the lateral aspect of the upper arm, medial aspect of the thigh and posterior aspect of lower leg. Using image analytical techniques, the total SQ band area, fascial band number, fascial band thickness, and SQ zone (layer) thickness were determined. In addition, the SQ spatial coherence was calculated based on the eigenvalues associated with the largest and smallest eigenvectors of the images. Results Fascial bands at these sites were contiguous with the dermis and the epimysium forming an interconnected network within the subcutaneous tissue. Subcutaneous blood vessels were also frequently encased by these fascial bands. The total SQ fascial band area was greater at the thigh and calf compared to the arm and was unrelated to SQ layer (zone) thickness. The thigh was associated with highest average number of fascial bands while calf was associated with the greatest average fascial band thickness. Across body regions, greater SQ zone thickness was associated with thinner fascial bands. SQ coherence was significantly associated with SQ zone thickness and body location (calf with statistically greater coherence compared to arm). Conclusion Fascial bands are structural bridges that mechanically link the skin, subcutaneous layer, and deeper muscle layers. This cohesive network also encases subcutaneous vessels and may indirectly mediate blood flow. The quantity and morphological characteristics of the SQ fascial band may reflect the composite mechanical forces experienced by the body part. PMID:21931632

Analysis of laparoscopic port site complications: A descriptive study.

Science.gov (United States)

Karthik, Somu; Augustine, Alfred Joseph; Shibumon, Mundunadackal Madhavan; Pai, Manohar Varadaraya

2013-04-01

The rate of port site complications following conventional laparoscopic surgery is about 21 per 100,000 cases. It has shown a proportional rise with increase in the size of the port site incision and trocar. Although rare, complications that occur at the port site include infection, bleeding, and port site hernia. To determine the morbidity associated with ports at the site of their insertion in laparoscopic surgery and to identify risk factors for complications. Prospective descriptive study. In the present descriptive study, a total of 570 patients who underwent laparoscopic surgeries for various ailments between August 2009 and July 2011 at our institute were observed for port site complications prospectively and the complications were reviewed. Descriptive statistical analysis was carried out in the present study. The statistical software, namely, SPSS 15.0 was used for the analysis of the data. Of the 570 patients undergoing laparoscopic surgery, 17 (3%) had developed complications specifically related to the port site during a minimum follow-up of three months; port site infection (PSI) was the most frequent (n = 10, 1.8%), followed by port site bleeding (n = 4, 0.7%), omentum-related complications (n = 2; 0.35%), and port site metastasis (n = 1, 0.175%). Laparoscopic surgeries are associated with minimal port site complications. Complications are related to the increased number of ports. Umbilical port involvement is the commonest. Most complications are manageable with minimal morbidity, and can be further minimized with meticulous surgical technique during entry and exit.

Challenges and Strategies of Abidjan Port-Hinterland Connectivity

Directory of Open Access Journals (Sweden)

Gamassa Pascal Kany Prud’ome

2017-01-01

Full Text Available Abidjan port-hinterland is composed of three countries which include Ivory Coast, Mali and Burkina Faso. The fast economic growth of the above countries resulted to a greater demand for the foreign goods from their population, causing a congestion problem at Abidjan port. Because of this problem, the connectivity movement between the port and its hinterland has considerably slowed down. In this article a qualitative methodology is used to analyse the Abidjan port-hinterland connectivity. The constant delays of the train services, the road congestion and the lack of coordination and communication between Abidjan port and its hinterland customers are the main presented challenges. The results of this research demonstrate that the poor quality roads and railways and the lack of a new dry port in Ivory Coast greatly affects the fluidity of the Abidjan port-hinterland connectivity. This article suggests some strategies on how to solve the current challenges and will be helpful in deciding on how the Abidjan port should be developed better and improve its connectivity with its hinterland.

Pretargeting vs. direct targeting of human betalox5 islet cells subcutaneously implanted in mice using an anti-human islet cell antibody

International Nuclear Information System (INIS)

Liu Guozheng; Dou Shuping; Akalin, Ali; Rusckowski, Mary; Streeter, Philip R.; Shultz, Leonard D.; Greiner, Dale L.

2012-01-01

Introduction: We previously demonstrated MORF/cMORF pretargeting of human islets and betalox 5 cells (a human beta cell line) transplanted subcutaneously in mice with the anti-human islet antibody, HPi1. We now compare pretargeting with direct targeting in the beta cell transplant model to evaluate the degree to which target/non-target (T/NT) ratios may be improved by pretargeting. Methods: Specific binding of an anti-human islet antibody HPi1 to the beta cells transplanted subcutaneously in mice was examined against a negative control antibody. We then compared pretargeting by MORF-HPi1 plus 111 In-labeled cMORF to direct targeting by 111 In-labeled HPi1. Results: HPi1 binding to betalox5 human cells in the transplant was shown by immunofluorescence. Normal organ 111 In backgrounds by pretargeting were always lower, although target accumulations were similar. More importantly, the transplant to pancreas and liver ratios was, respectively, 26 and 10 by pretargeting as compared to 9 and 0.6 by direct targeting. Conclusions: Pretargeting greatly improves the T/NT ratios, and based on the estimated endocrine to exocrine ratio within a pancreas, pretargeting may be approaching the sensitivity required for successful imaging of human islets within this organ.

The impact of an emerging port on the carbon dioxide emissions of inland container transport: An empirical study of Taipei port

International Nuclear Information System (INIS)

Liao, C.-H.; Tseng, P.-H.; Cullinane, Kevin; Lu, C.-S.

2010-01-01

This study analyzes the changes in carbon dioxide (CO 2 ) emissions resulting from the movement of containers from established ports through the emerging port of Taipei in Northern Taiwan. An activity-based emissions model is used to estimate the CO 2 emissions of container transport under four scenarios where there are switches of market share from existing ports to the emerging port. The results show that there are greater reductions in CO 2 when transhipment routes are changed from the ports of Kaohsiung, Taichung and Keelung to the emerging port of Taipei. The paper concludes that the analytical approach adopted in the paper can help decision-makers understand potential CO 2 emissions reduction strategies in the route selection of inland container transportation and such consideration should provide a broader and more meaningful basis for the socio-economic evaluation of port investment projects.

Process and overview of diagnostics integration in ITER ports

International Nuclear Information System (INIS)

Drevon, J.M.; Walsh, M.; Andrew, P.; Barnsley, R.; Bertalot, L.; Bock, M. de; Bora, D.; Bouhamou, R.; Direz, M.F.; Encheva, A.; Fang, T.; Feder, R.; Giacomin, T.; Hellermann, M. von; Jakhar, S.; Johnson, D.; Kaschuk, Y.; Kusama, Y.; Lee, H.G.; Levesy, B.

2013-01-01

Highlights: ► An overview of the Port Integration hardware for tenant system hosting inside ITER diagnostics ports is given. ► The main challenges for diagnostic port integration engineering are presented. ► The actions taken for a common modular approach and a coordinated design are detailed. -- Abstract: ITER will have a set of 45 diagnostics to ensure controlled operation. Many of them are integrated in the ITER ports. This paper addresses the integration process of the diagnostic systems and the approach taken to enable coordinated progress. An overview of the Port Integration hardware introduces the various structures needed for hosting tenant systems inside ITER diagnostics ports. The responsibilities of the different parties involved (ITER Organization and the Domestic Agencies) are outlined. The main challenges for diagnostic port integration engineering are summarized. The plan for a common approach to design and manufacture of the supporting structures, in particular the Port Plug is detailed. A coordinated design including common components and a common approach for neutronic analyses is proposed. One particular port, the equatorial port 11, is used to illustrate the approach

Ports, policies and interventions in ports in Portugal - 20th Century

OpenAIRE

Dias, Emílio Brògueira; Alves, Jorge Fernandes

2010-01-01

Ce texte, inspiré des données issues des travaux des deux auteurs, aborde, de manière synthétique, les grandes lignes des transformations portuaires au Portugal, à travers un panorama des différents ports et de leur évolution. Cet exposé se focalise sur les exemples les plus significatifs que sont les ports de Leixões, Aveiro, Lisbonne, Setubal et Sines. This text, based on the data used in previous works by the authors, seeks to assess briefly, the main lines of transformations in Portuga...

Postpartum suppression of ovarian activity with a Deslorelin implant enhanced uterine involution in lactating dairy cows.

Science.gov (United States)

Silvestre, F T; Bartolome, J A; Kamimura, S; Arteche, A C; Pancarci, S M; Trigg, T; Thatcher, W W

2009-01-01

Holstein cows received, subcutaneously a non-degradable implant containing 5mg of the GnRH agonist Deslorelin (DESL) or no implant (CON) at 2+/-1 days postpartum (dpp). All cows were injected with PGF(2alpha) at 9 dpp. Previous pregnant (PPH) and non-pregnant uterine horns (PNPH) were determined by palpation per rectum. In Experiment 1, cows [DESL implant (n=10) and CON (n=9)] were examined by ultrasonography to record ovarian structures (23, 30 and 37 dpp) and uterine horn and cervical diameters (16, 23, 30 and 37 dpp). Uterine tone was scored before ultrasonography. Vaginoscopy was conducted just after ultrasonography examination to assess cervical discharge and color of the external cervical os. Blood samples were collected on a weekly basis for hormonal analyses. In Experiment 2, cows [DESL implant (n=77) and CON (n=70)] were palpated per rectum and vaginoscopy at 30 dpp for scoring of uterine tone, uterine horns, cervical diameter, and discharge. Blood samples were collected only at 9 dpp. In Experiment 1, DESL-implant-treated cows had more Class 1 follicles (Pscore did not differ between treatments. Treatment with non-degradable Deslorelin (5mg) implant during postpartum: (1) suppressed ovarian follicular development, (2) enhanced physical involution of the uterus and cervix, (3) increased tone of the uterine wall, (4) decreased frequency of purulent cervical discharges, and (5) reduced inflammatory processes of the reproductive tract.

Wounds caused by contact with muzzle-lift relief ports (Mag-Na-Port).

Science.gov (United States)

Rogers, D R; Shem, R J

1992-12-01

Fan-shaped stippled burns were produced on the skin when a revolver whose barrel had been modified by the Mag-Na-Port process was fired twice with the side of the muzzle in contact. A grazing wound was produced by one bullet, and an oblique entry was produced by the other. The characteristics of Mag-Na-Port wounds and test shots are described, and these are compared with test shots from two other higher power revolvers.

Port performance evaluation tool based on microsimulation model

Directory of Open Access Journals (Sweden)

Tsavalista Burhani Jzolanda

2017-01-01

Full Text Available As port performance is becoming correlative to national competitiveness, the issue of port performance evaluation has significantly raised. Port performances can simply be indicated by port service levels to the ship (e.g., throughput, waiting for berthing etc., as well as the utilization level of equipment and facilities within a certain period. The performances evaluation then can be used as a tool to develop related policies for improving the port’s performance to be more effective and efficient. However, the evaluation is frequently conducted based on deterministic approach, which hardly captures the nature variations of port parameters. Therefore, this paper presents a stochastic microsimulation model for investigating the impacts of port parameter variations to the port performances. The variations are derived from actual data in order to provide more realistic results. The model is further developed using MATLAB and Simulink based on the queuing theory.

Analysis of laparoscopic port site complications: A descriptive study

Directory of Open Access Journals (Sweden)

Somu Karthik

2013-01-01

Full Text Available Context: The rate of port site complications following conventional laparoscopic surgery is about 21 per 100,000 cases. It has shown a proportional rise with increase in the size of the port site incision and trocar. Although rare, complications that occur at the port site include infection, bleeding, and port site hernia. Aims: To determine the morbidity associated with ports at the site of their insertion in laparoscopic surgery and to identify risk factors for complications. Settings and Design: Prospective descriptive study. Materials and Methods: In the present descriptive study, a total of 570 patients who underwent laparoscopic surgeries for various ailments between August 2009 and July 2011 at our institute were observed for port site complications prospectively and the complications were reviewed. Statistical Analysis Used: Descriptive statistical analysis was carried out in the present study. The statistical software, namely, SPSS 15.0 was used for the analysis of the data. Results: Of the 570 patients undergoing laparoscopic surgery, 17 (3% had developed complications specifically related to the port site during a minimum follow-up of three months; port site infection (PSI was the most frequent (n = 10, 1.8%, followed by port site bleeding (n = 4, 0.7%, omentum-related complications (n = 2; 0.35%, and port site metastasis (n = 1, 0.175%. Conclusions: Laparoscopic surgeries are associated with minimal port site complications. Complications are related to the increased number of ports. Umbilical port involvement is the commonest. Most complications are manageable with minimal morbidity, and can be further minimized with meticulous surgical technique during entry and exit.

Analysis of laparoscopic port site complications: A descriptive study

Science.gov (United States)

Karthik, Somu; Augustine, Alfred Joseph; Shibumon, Mundunadackal Madhavan; Pai, Manohar Varadaraya

2013-01-01

CONTEXT: The rate of port site complications following conventional laparoscopic surgery is about 21 per 100,000 cases. It has shown a proportional rise with increase in the size of the port site incision and trocar. Although rare, complications that occur at the port site include infection, bleeding, and port site hernia. AIMS: To determine the morbidity associated with ports at the site of their insertion in laparoscopic surgery and to identify risk factors for complications. SETTINGS AND DESIGN: Prospective descriptive study. MATERIALS AND METHODS: In the present descriptive study, a total of 570 patients who underwent laparoscopic surgeries for various ailments between August 2009 and July 2011 at our institute were observed for port site complications prospectively and the complications were reviewed. STATISTICAL ANALYSIS USED: Descriptive statistical analysis was carried out in the present study. The statistical software, namely, SPSS 15.0 was used for the analysis of the data. RESULTS: Of the 570 patients undergoing laparoscopic surgery, 17 (3%) had developed complications specifically related to the port site during a minimum follow-up of three months; port site infection (PSI) was the most frequent (n = 10, 1.8%), followed by port site bleeding (n = 4, 0.7%), omentum-related complications (n = 2; 0.35%), and port site metastasis (n = 1, 0.175%). CONCLUSIONS: Laparoscopic surgeries are associated with minimal port site complications. Complications are related to the increased number of ports. Umbilical port involvement is the commonest. Most complications are manageable with minimal morbidity, and can be further minimized with meticulous surgical technique during entry and exit. PMID:23741110

Vectorization, parallelization and porting of nuclear codes (porting). Progress report fiscal 1998

International Nuclear Information System (INIS)

Nemoto, Toshiyuki; Kawai, Wataru; Ishizuki, Shigeru; Kawasaki, Nobuo; Kume, Etsuo; Adachi, Masaaki; Ogasawara, Shinobu

2000-03-01

Several computer codes in the nuclear field have been vectorized, parallelized and transported on the FUJITSU VPP500 system, the AP3000 system and the Paragon system at Center for Promotion of Computational Science and Engineering in Japan Atomic Energy Research Institute. We dealt with 12 codes in fiscal 1998. These results are reported in 3 parts, i.e., the vectorization and parallelization on vector processors part, the parallelization on scalar processors part and the porting part. In this report, we describe the porting. In this porting part, the porting of Monte Carlo N-Particle Transport code MCNP4B2 and Reactor Safety Analysis code RELAP5 on the AP3000 are described. In the vectorization and parallelization on vector processors part, the vectorization of General Tokamak Circuit Simulation Program code GTCSP, the vectorization and parallelization of Molecular Dynamics Ntv Simulation code MSP2, Eddy Current Analysis code EDDYCAL, Thermal Analysis Code for Test of Passive Cooling System by HENDEL T2 code THANPACST2 and MHD Equilibrium code SELENEJ on the VPP500 are described. In the parallelization on scalar processors part, the parallelization of Monte Carlo N-Particle Transport code MCNP4B2, Plasma Hydrodynamics code using Cubic Interpolated propagation Method PHCIP and Vectorized Monte Carlo code (continuous energy model/multi-group model) MVP/GMVP on the Paragon are described. (author)

Prolonged Corrosion Stability of a Microchip Sensor Implant during In Vivo Exposure

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Paul Glogener

2018-02-01

Full Text Available A microelectronic biosensor was subjected to in vivo exposure by implanting it in the vicinity of m. trapezii (Trapezius muscle from cattle. The implant is intended for the continuous monitoring of glucose levels, and the study aimed at evaluating the biostability of exposed semiconductor surfaces. The sensor chip was a microelectromechanical system (MEMS prepared using 0.25 µm complementary metal–oxide–semiconductor CMOS/BiCMOS technology. Sensing is based on the principle of affinity viscometry with a sensoric assay, which is separated by a semipermeable membrane from the tissue. Outer dimensions of the otherwise hermetically sealed biosensor system were 39 × 49 × 16 mm. The test system was implanted into cattle in a subcutaneous position without running it. After 17 months, the device was explanted and analyzed by comparing it with unexposed chips and systems. Investigations focused on the MEMS chip using SEM, TEM, and elemental analysis by EDX mapping. The sensor chip turned out to be uncorroded and no diminishing of the topmost passivation layer could be determined, which contrasts remarkably with previous results on CMOS biosensors. The negligible corrosive attack is understood to be a side effect of the semipermeable membrane separating the assay from the tissue. It is concluded that the separation has enabled a prolonged biostability of the chip, which will be of relevance for biosensor implants in general.

Single port laparoscopic ileocaecal resection for Crohn's disease: a multicentre comparison with multi-port laparoscopy

NARCIS (Netherlands)

Carvello, M.; de Groof, E. J.; de Buck van Overstraeten, A.; Sacchi, M.; Wolthuis, A. M.; Buskens, C. J.; D'Hoore, A.; Bemelman, W. A.; Spinelli, A.

2018-01-01

AimSingle port (SP) ileocaecal resection (ICR) is an established technique but there are no large studies comparing SP and multi-port (MP) laparoscopic surgery in Crohn's disease (CD). The aim of this study was to compare postoperative pain scores and analgesia requirements after SP and MP

Model Study of the Pressure Build-Up during Subcutaneous Injection

DEFF Research Database (Denmark)

Thomsen, Maria; Hernandez Garcia, Anier; Mathiesen, Joachim

2014-01-01

In this study we estimate the subcutaneous tissue counter pressure during drug infusion from a series of injections of insulin in type 2 diabetic patients using a non-invasive method. We construct a model for the pressure evolution in subcutaneous tissue based on mass continuity and the flow laws...

Subcutaneous Emphysema, Pneumomediastinum, Pneumoretroperitoneum, and Pneumoscrotum: Unusual Complications of Acute Perforated Diverticulitis

Directory of Open Access Journals (Sweden)

S. Fosi

2014-01-01

Full Text Available Pneumomediastinum, and subcutaneous emphysema usually result from spontaneous alveolar wall rupture and, far less commonly, from disruption of the upper airways or gastrointestinal tract. Subcutaneous neck emphysema, pneumomediastinum, and retropneumoperitoneum caused by nontraumatic perforations of the colon have been infrequently reported. The main symptoms of spontaneous subcutaneous emphysema are swelling and crepitus over the involved site; further clinical findings in case of subcutaneous cervical and mediastinal emphysema can be neck and chest pain and dyspnea. Radiological imaging plays an important role to achieve the correct diagnosis and extension of the disease. We present a quite rare case of spontaneous subcutaneous cervical emphysema, pneumomediastinum, and pneumoretroperitoneum due to perforation of an occult sigmoid diverticulum. Abdomen ultrasound, chest X-rays, and computer tomography (CT were performed to evaluate the free gas extension and to identify potential sources of extravasating gas. Radiological diagnosis was confirmed by the subsequent surgical exploration.

Secuelas de mastectomía subcutánea profiláctica: caso clínico Prophilactic subcutaneous mastectomy sequeal: case report

Directory of Open Access Journals (Sweden)

C. Gutiérrez Gómez

2008-12-01

Full Text Available La mastectomía subcutánea profiláctica es un procedimiento controvertido, sin embargo, es un hecho que disminuye la incidencia de cáncer mamario hasta en un 100% en pacientes con alto riesgo de padecerlo. Presentamos el caso de una paciente de 26 años de edad a quien se le realizó dicho procedimiento sin una indicación precisa y que presentó complicaciones (dehiscencia de heridas, infección y exposición de ambas prótesis mamarias que requirieron varios procedimientos reconstructivos, con un seguimiento de 8 años. La mastectomía subcutánea profiláctica es un procedimiento irreversible con implicaciones importantes para las pacientes, por lo que consideramos que debe estar plenamente justificada por estrictos criterios de prevención de cáncer mamario en pacientes con alto riesgo.Prophylactic subcutaneous mastectomy is controversial, in fact this procedure has proved its efficacy in decreasing mammary carcinoma in high risk patients up to 100 per cent. We report a case of 26 years old patient, in whom was performed a prophylactic bilateral subcutaneous mastectomy without a clear indication, and who presented several complications as suture dehiscence, infection and mammary implants exposition requiring several reconstructive procedures, with a follow up of 8 years. Prophylactic subcutaneous mastectomy is an irreversible procedure with important implications for the patient; we consider that it should be limited to patients with precise indications and at high risk for mammary carcinoma.

Port Sunlight, essai architectural et social

OpenAIRE

Machet, Laurence

2017-01-01

The purpose of this article is to examine the city of Port Sunlight, its history, design and originality. Created by William Lever in 1888 in order to house his newly-built soap factory, Port Sunlight is part of the numerous “factory villages” built in the wake of the industrial revolution according to philanthropic and utilitarian principles. But this article intends to show that Port Sunlight differs from other factory towns. Its careful design, elaborate architecture and public facilities ...

Assessing Port Governance, Devolution and Terminal Performance in Nigeria

Directory of Open Access Journals (Sweden)

D. E. Onwuegbuchunam

2018-02-01

Full Text Available Concerns about performance and efficiency in port terminals led many national governments to embark on port reforms. The Federal government of Nigeria, for example, adopted the Landlord port model which brought about concessioning of port terminals to private operators. Despite high investments in terminal facilities by the private terminal operators, there are still complaints about level of service offered to port users. This paper applied key performance indicator metrics and parameters of queuing model in assessing performance of Nigeria’s concessioned port terminals. Data for the study were obtained from terminal level records of cargo and ship handling activities for years 2000 to 2015. Major findings indicate that cargo and vessel throughputs improved after the reforms in the six ports examined. However, much variability was observed in trends in ships’ turnround times across all ports after the concession policy implementation. Additional results from the queuing model analysis suggest that the high ships turnround times observed in some ports are associated to delays in ship operation at the berths. The paper recommends that policy interventions be focused on ship operations at the berths as a step in improving service level in the port terminals.

Port-Orford-Cedar Root Disease

Science.gov (United States)

Lewis F. Roth; Robert D. Jr. Harvey; John T. Kliejunas

1987-01-01

The most serious disease of Port-Orford-cedar (Chamaecyparis lawsoniana (A. Murr.) Parl.) is a root disease caused by the fungus Phytophthora lateralis. Nursery stock, ornamentals, and timber trees are subject to attack. Other species of Chamaecyparis are less susceptible than Port-Orford-cedar, and trees of other genera are not affected.

Port pricing : principles, structure and models

OpenAIRE

Meersman, Hilde; Strandenes, Siri Pettersen; Van de Voorde, Eddy

2014-01-01

Price level and price transparency are input to shippers’ choice of supply chain and transport mode. In this paper, we analyse current port pricing structures in the light of the pricing literature and consider opportunities for improvement. We present a detailed overview of pricing criteria, who sets prices and who ultimately foots the bill for port-of-call charges, cargo-handling fees and congestion charges. Current port pricing practice is based on a rather linear structure and fails to in...

Ports Primer: 7.1 Environmental Impacts

Science.gov (United States)

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

Ports Primer: 7.0 Environmental Impacts

Science.gov (United States)

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

Continuous subcutaneous insulin infusion in diabetes: patient populations, safety, efficacy, and pharmacoeconomics

OpenAIRE

Pozzilli, Paolo; Battelino, Tadej; Danne, Thomas; Hovorka, Roman; Jarosz?Chobot, Przemyslawa; Renard, Eric

2015-01-01

Summary The level of glycaemic control necessary to achieve optimal short?term and long?term outcomes in subjects with type 1 diabetes mellitus (T1DM) typically requires intensified insulin therapy using multiple daily injections or continuous subcutaneous insulin infusion. For continuous subcutaneous insulin infusion, the insulins of choice are the rapid?acting insulin analogues, insulin aspart, insulin lispro and insulin glulisine. The advantages of continuous subcutaneous insulin infusion ...

Nitric Oxide Release for Improving Performance of Implantable Chemical Sensors - A Review.

Science.gov (United States)

Cha, Kyoung Ha; Wang, Xuewei; Meyerhoff, Mark E

2017-12-01

Over the last three decades, there has been extensive interest in developing in vivo chemical sensors that can provide real-time measurements of blood gases (oxygen, carbon dioxide, and pH), glucose/lactate, and potentially other critical care analytes in the blood of hospitalized patients. However, clot formation with intravascular sensors and foreign body response toward sensors implanted subcutaneously can cause inaccurate analytical results. Further, the risk of bacterial infection from any sensor implanted in the human body is another major concern. To solve these issues, the release of an endogenous gas molecule, nitric oxide (NO), from the surface of such sensors has been investigated owing to NO's ability to inhibit platelet activation/adhesion, foreign body response and bacterial growth. This paper summarizes the importance of NO's therapeutic potential for this application and reviews the publications to date that report on the analytical performance of NO release sensors in laboratory testing and/or during in vivo testing.

Colonial Origins of the Port of Buenaventura

Directory of Open Access Journals (Sweden)

Alonso Valencia Llano

2014-07-01

Full Text Available This article studies the origins of the Port of Buenaventura in the New Kingdom of Granada. It begins with the process of exploration of the coastal territory in order to highlight the different sites in which it was situated, demonstrating that it began as a river port and was later resituated and gradually converted into a maritime port. In addition, this article analyzes the problems it faced, such as the dificulty of communication with the interior of the country, the indigenous resistance that caused the destruction of the town, and inally the necessity of populating the zone with black slaves in order to exploit the mining border. This study also discusses how this port was controlled by the elite of the city of Cali, until the Republican period when it became the sole Colombian port on the Paciic Ocean.

Ports Primer: 3.3 Federal and International Governance

Science.gov (United States)

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

An integrated port camera and display system for laparoscopy.

Science.gov (United States)

Terry, Benjamin S; Ruppert, Austin D; Steinhaus, Kristen R; Schoen, Jonathan A; Rentschler, Mark E

2010-05-01

In this paper, we built and tested the port camera, a novel, inexpensive, portable, and battery-powered laparoscopic tool that integrates the components of a vision system with a cannula port. This new device 1) minimizes the invasiveness of laparoscopic surgery by combining a camera port and tool port; 2) reduces the cost of laparoscopic vision systems by integrating an inexpensive CMOS sensor and LED light source; and 3) enhances laparoscopic surgical procedures by mechanically coupling the camera, tool port, and liquid crystal display (LCD) screen to provide an on-patient visual display. The port camera video system was compared to two laparoscopic video systems: a standard resolution unit from Karl Storz (model 22220130) and a high definition unit from Stryker (model 1188HD). Brightness, contrast, hue, colorfulness, and sharpness were compared. The port camera video is superior to the Storz scope and approximately equivalent to the Stryker scope. An ex vivo study was conducted to measure the operative performance of the port camera. The results suggest that simulated tissue identification and biopsy acquisition with the port camera is as efficient as with a traditional laparoscopic system. The port camera was successfully used by a laparoscopic surgeon for exploratory surgery and liver biopsy during a porcine surgery, demonstrating initial surgical feasibility.

Overtopping hazards to port activities: Application of a new methodology to risk management (POrt Risk MAnagement Tool)

International Nuclear Information System (INIS)

Alises, Ana; Molina, Rafael; Gómez, Rebeca; Pery, Pascual; Castillo, Carmen

2014-01-01

In the past 20 years, the need of ports to serve a fleet whose dimensions are continuously increasing due to economies of scale, has derived on a port infrastructures growth with a trend to look for greater drafts at deeper waters and therefore the protection structures built in the last years have been increasingly exposed to severer maritime climate action. Consequently, overtopping phenomenon has been identified as a potential risk factor able to cause structural damages and operative failure modes to vulnerable economic activities located at these port facilities. Port activities must be developed ensuring operative and safety conditions what imply reducing uncertainties of overtopping phenomena by using prediction methods which may allow overtopping risk management. This paper provides a risk assessment methodology which is integrated into an overtopping risk management framework to cope with safety problems in port exploitation. Overtopping risk value is measured by combining probability of occurrence of an undesirable event together with its consequences, estimated in terms of costs or delays and given in base of the vulnerability of the affected port system. The development of this methodology is described and finally applied to a real case study what seems to reinforce the validity of the proposed method to overtopping risk assessment. - Highlights: • Infrastructure risk assessment involves both probabilistic and economic techniques. • Risk equation is posed by the combination of probability, vulnerability and cost. • Port infrastructures' vulnerability level depends on climate agents' action. • Economic value of natural hazards consequences is linked with vulnerability level. • Project planning process should be done taking into account the project's risk distribution

Slewing Port Jib Cranes

OpenAIRE

Boris Visočnik; Stojan Kravanja

2002-01-01

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

Securing a port's future through Circular Economy: Experiences from the Port of Gävle in contributing to sustainability.

Science.gov (United States)

Carpenter, Angela; Lozano, Rodrigo; Sammalisto, Kaisu; Astner, Linda

2018-03-01

Ports are an important player in the world, due to their role in global production and distributions systems. They are major intermodal transport hubs, linking the sea to the land. For all ports, a key requirement for commercial and economic viability is to retain ships using them and to remain accessible to those ships. Ports need to find approaches to help them remain open. They must ensure their continued economic viability. At the same time, they face increasing pressure to become more environmentally and socially conscious. This paper examines the approach taken by the Port of Gävle, Sweden, which used contaminated dredged materials to create new land using principles of Circular Economy. The paper demonstrates that using Circular Economy principles can be a viable way of securing a port's future and contributing to its sustainability, and that of the city/region where it operates. Copyright © 2018 Elsevier Ltd. All rights reserved.

Tracking of abdominal subcutaneous and preperitoneal fat mass during childhood. The Generation R Study.

Science.gov (United States)

Vogelezang, S; Gishti, O; Felix, J F; van der Beek, E M; Abrahamse-Berkeveld, M; Hofman, A; Gaillard, R; Jaddoe, V W V

2016-04-01

Overweight and obesity in early life tends to track into later life. Not much is known about tracking of abdominal fat. Our objective was to examine the extent of tracking of abdominal fat measures during the first six years of life. We performed a prospective cohort study among 393 Dutch children followed from the age of 2 years (90% range 1.9; 2.3) until the age of 6 years (90% range 5.7; 6.2). At both ages, we performed abdominal ultrasound to measure abdominal subcutaneous and preperitoneal fat distances and areas, and we calculated the preperitoneal/subcutaneous fat distance ratio. High abdominal fat measures were defined as values in the upper 15%. Abdominal subcutaneous fat distance and area, and preperitoneal fat area at 2 years were correlated with their corresponding measures at 6 years (all P-values abdominal subcutaneous fat measures. Preperitoneal fat distance at the age of 2 years was not correlated with the corresponding measure at 6 years. The tracking coefficient for preperitoneal/subcutaneous fat distance ratio from 2 to 6 years was r=0.36 (Pabdominal subcutaneous fat measures at 2 years had increased risk of having high abdominal subcutaneous fat measures at 6 years (odds ratios 9.2 (95% confidence interval (CI) 4.1-20.8) and 12.4 (95% CI 5.4-28.6) for subcutaneous fat distance and area, respectively). These associations were not observed for preperitoneal fat measures. Our findings suggest that both abdominal subcutaneous and preperitoneal fat mass measures track during childhood, but with stronger tracking for abdominal subcutaneous fat measures. An adverse abdominal fat distribution in early life may have long-term consequences.

Queuing theory models used for port equipment sizing

Science.gov (United States)

Dragu, V.; Dinu, O.; Ruscă, A.; Burciu, Ş.; Roman, E. A.

2017-08-01

The significant growth of volumes and distances on road transportation led to the necessity of finding solutions to increase water transportation market share together with the handling and transfer technologies within its terminals. It is widely known that the biggest times are consumed within the transport terminals (loading/unloading/transfer) and so the necessity of constantly developing handling techniques and technologies in concordance with the goods flows size so that the total waiting time of ships within ports is reduced. Port development should be achieved by harmonizing the contradictory interests of port administration and users. Port administrators aim profit increase opposite to users that want savings by increasing consumers’ surplus. The difficulty consists in the fact that the transport demand - supply equilibrium must be realised at costs and goods quantities transiting the port in order to satisfy the interests of both parties involved. This paper presents a port equipment sizing model by using queueing theory so that the sum of costs for ships waiting operations and equipment usage would be minimum. Ship operation within the port is assimilated to a mass service waiting system in which parameters are later used to determine the main costs for ships and port equipment.

Adding some context to port marketing: Exploring the content and measurement of market orientation in the port industry

OpenAIRE

Kounoupas, Evangelos; Pardali, Angeliki

2015-01-01

Understanding and responding to customer needs is the essence of the marketing concept and as such it has been discussed in various fields of business and economic literature. Port economics and management literature has thoroughly investigated areas such as port efficiency and effectiveness, understanding and overcoming competitive pressures and identifying the sources of potential sustainable competitive advantage. In line with this discussion, albeit with a significant time delay, port eco...

Treatment with subcutaneous and transdermal fentanyl: results from a population pharmacokinetic study in cancer patients.

Science.gov (United States)

Oosten, Astrid W; Abrantes, João A; Jönsson, Siv; de Bruijn, Peter; Kuip, Evelien J M; Falcão, Amílcar; van der Rijt, Carin C D; Mathijssen, Ron H J

2016-04-01

Transdermal fentanyl is effective for the treatment of moderate to severe cancer-related pain but is unsuitable for fast titration. In this setting, continuous subcutaneous fentanyl may be used. As data on the pharmacokinetics of continuous subcutaneous fentanyl are lacking, we studied the pharmacokinetics of subcutaneous and transdermal fentanyl. Furthermore, we evaluated rotations from the subcutaneous to the transdermal route. Fifty-two patients treated with subcutaneous and/or transdermal fentanyl for moderate to severe cancer-related pain participated. A population pharmacokinetic model was developed and evaluated using non-linear mixed-effects modelling. For rotations from subcutaneous to transdermal fentanyl, a 1:1 dose conversion ratio was used while the subcutaneous infusion was continued for 12 h (with a 50 % tapering after 6 h). A 6-h scheme with 50 % tapering after 3 h was simulated using the final model. A one-compartment model with first-order elimination and separate first-order absorption processes for each route adequately described the data. The estimated apparent clearance of fentanyl was 49.6 L/h; the absorption rate constant for subcutaneous and transdermal fentanyl was 0.0358 and 0.0135 h(-1), respectively. Moderate to large inter-individual and inter-occasion variability was found. Around rotation from subcutaneous to transdermal fentanyl, measured and simulated plasma fentanyl concentrations rose and increasing side effects were observed. We describe the pharmacokinetics of subcutaneous and transdermal fentanyl in one patient cohort and report several findings that are relevant for clinical practice. Further research is warranted to study the optimal scheme for rotations from the subcutaneous to the transdermal route.

A study on the applicability of implantable microchip transponders for body temperature measurements in pigs

Directory of Open Access Journals (Sweden)

Enøe Claes

2010-05-01

Full Text Available Abstract Background The applicability of an electronic monitoring system using microchip transponders for measurement of body temperatures was tested in 6-week-old conventional Danish weaners infected with classical swine fever virus (CSFV. Subcutaneous tissue temperatures obtained by the implantable transponders were compared with rectal temperatures, recorded by a conventional digital thermometer. Methods In a preliminary study, transponders were inserted subcutaneously at 6 different positions of the body of 5 pigs. The transponders positioned by the ear base provided the best correlation to rectal temperature. To test the stability of the monitoring system in a larger group of pigs, transponders were therefore inserted by the left ear base in a subsequent infection experiment with 30 pigs. Results Generally, the microchip transponders measured a subcutaneous tissue temperature, which was about 1°C lower than the rectal temperature. However, a simple linear relationship between the measures of the two methods was found. Conclusions Our study showed that the tested body monitoring system may represent a promising tool to obtain an approximate correlate of body temperatures in groups of pigs. In contrast, however, the tested system did not constitute a suitable tool to measure body temperatures of individual animals in the present pig infection experiment.

Subcutaneous metastasis from endometrial cancer; case report and literature review

Directory of Open Access Journals (Sweden)

Nicolae Bacalbasa

2018-05-01

Full Text Available Subcutaneous metastases from endometrial cancer are rare situations, only few cases being described so far. The main incriminated mechanisms leading to the apparition of such lesions include hematogenous and lymphatic spread. We present the case of a 66-year-old patient known with previous history of stage IIIA endometroid endometrial carcinoma initially treated by surgery and adjuvant chemotherapy who developed at 18 months follow-up a distant subcutaneous oligometastasis. At this time the patient was resubmitted to surgery, the lesion being successfully removed. The histopathological result confirmed the endometrial cancer origin of this lesion. Subcutaneous and cutaneous metastases from endometrial cancer are rare eventualities which are usually diagnosed as part of systemic dissemination of this malignancy; in these cases, the patient is only candidate for oncological treatment with palliative intent. In some cases, in which the lesions occur as oligometastatic disease, surgery might be performed with curative intent. In our case the diagnostic of the subcutaneous lesion as oligometastatic disease transformed the patient in a perfect candidate for curative oncological surgery.

Feasibility of Reduced Port Laparoscopic Colectomy for Colon Cancer.

Science.gov (United States)

Tsutsumi, Soichi; Morita, Hiroki; Fujii, Takaaki; Suto, Toshinaga; Yajima, Reina; Takada, Takahiro; Asao, Takayuki; Kuwano, Hiroyuki

2015-06-01

Reduced port laparoscopic surgery has recently emerged as a method to improve the cosmetic results of conventional laparoscopic surgery. We reported our technique of reduced port laparoscopic colectomy using 3-port and short-time outcomes. Between 2005 and 2012, we performed 161 reduced port laparoscopic colectomies using the 3-port technique. Data analyzed in-cluded age, gender, body mass index (BMI), duration of surgery, number of harvested lymph nodes, and duration of hospital stay. All of the cases were successfully performed using the 3-port procedure. The median durations of surgery and postoperative hospital stay were 140 mm (range 75-463 mm) and 9 days (range 5-38 days), respectively. No mortality was associated with this technique. Reduced port laparoscopic colectomy is feasible and may have advantages over conventional laparoscopic colectomy.

Classification and prediction of port variables

Energy Technology Data Exchange (ETDEWEB)

Molina Serrano, B.

2016-07-01

Many variables are included in planning and management of port terminals. They can beeconomic, social, environmental and institutional. Agent needs to know relationshipbetween these variables to modify planning conditions. Use of Bayesian Networks allowsfor classifying, predicting and diagnosing these variables. Bayesian Networks allow forestimating subsequent probability of unknown variables, basing on know variables.In planning level, it means that it is not necessary to know all variables because theirrelationships are known. Agent can know interesting information about how port variablesare connected. It can be interpreted as cause-effect relationship. Bayesian Networks can beused to make optimal decisions by introduction of possible actions and utility of theirresults.In proposed methodology, a data base has been generated with more than 40 port variables.They have been classified in economic, social, environmental and institutional variables, inthe same way that smart port studies in Spanish Port System make. From this data base, anetwork has been generated using a non-cyclic conducted grafo which allows for knowingport variable relationships - parents-children relationships-. Obtained network exhibits thateconomic variables are – in cause-effect terms- cause of rest of variable typologies.Economic variables represent parent role in the most of cases. Moreover, whenenvironmental variables are known, obtained network allows for estimating subsequentprobability of social variables.It has been concluded that Bayesian Networks allow for modeling uncertainty in aprobabilistic way, even when number of variables is high as occurs in planning andmanagement of port terminals. (Author)

Occupational hazards to health of port workers.

Science.gov (United States)

Wang, Yukun; Zhan, Shuifen; Liu, Yan; Li, Yan

2017-12-01

The aim of this article is to reduce the risk of occupational hazards and improve safety conditions by enhancing hazard knowledge and identification as well as improving safety behavior for freight port enterprises. In the article, occupational hazards to health and their prevention measures of freight port enterprises have been summarized through a lot of occupational health evaluation work, experience and understanding. Workers of freight port enterprises confront an equally wide variety of chemical, physical and psychological hazards in production technology, production environment and the course of labor. Such health hazards have been identified, the risks evaluated, the dangers to health notified and effective prevention measures which should be put in place to ensure the health of the port workers summarized. There is still a long way to go for the freight port enterprises to prevent and control the occupational hazards. Except for occupational hazards and their prevention measures, other factors that influence the health of port workers should also be paid attention to, such as age, work history, gender, contraindication and even the occurrence and development rules of occupational hazards in current production conditions.

INSTITUTIONAL AND MANAGEMENT STRUCTURE OF RUSSIAN ARCTIC SEA PORTS

Directory of Open Access Journals (Sweden)

P. A. Bryzgalov

2012-01-01

Full Text Available Institutional and management structure of any sea port is a system of interaction between commercial enterprises engaged in cargo operations in port, a subsidiary of Rosmorport FSUE, Sea Port Authority and a number of services (immigration, customs and sanitary-veterinary. Institutional and management structure of some Russian Arctic sea ports is significantly different from the typical one resulting in management problems for these socially significant objects of the Russian Arctic. A plan is proposed to improve the organizational and administrative structure of these ports based on the use of domestic and international experience in port infrastructure management including effective cooperation between the state and the private business.

Absorption Kinetics of Subcutaneously Administered Ceftazidime in Hypoperfused Guinea Pigs

Directory of Open Access Journals (Sweden)

Tsuyoshi Ebihara, MS

2015-12-01

Conclusions: The application of MWCs or WCs enhanced subcutaneous CAZ absorption by increasing blood flow. MWCs and WCs are considered to be safe and routine methods to induce defecation after surgery on the digestive system; thus, the combination of these methods and subcutaneous CAZ administration is a potential method for treating pneumonia in patients with SMID.

Median Sternotomy or Right Thoracotomy Techniques for Total Artificial Heart Implantation in Calves.

Science.gov (United States)

Karimov, Jamshid H; Moazami, Nader; Sunagawa, Gengo; Kobayashi, Mariko; Byram, Nicole; Sale, Shiva; Such, Kimberly A; Horvath, David J; Golding, Leonard A R; Fukamachi, Kiyotaka

2016-10-01

The choice of optimal operative access technique for mechanical circulatory support device implantation ensures successful postoperative outcomes. In this study, we retrospectively evaluated the median sternotomy and lateral thoracotomy incisions for placement of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) in a bovine model. The CFTAH was implanted in 17 calves (Jersey calves; weight range, 77.0-93.9 kg) through a median sternotomy (n = 9) or right thoracotomy (n = 8) for elective chronic implantation periods of 14, 30, or 90 days. Similar preoperative preparation, surgical techniques, and postoperative care were employed. Implantation of the CFTAH was successfully performed in all cases. Both methods provided excellent surgical field visualization. After device connection, however, the median sternotomy approach provided better visualization of the anastomoses and surgical lines for hemostasis confirmation and repair due to easier device displacement, which is severely limited following right thoracotomy. All four animals sacrificed after completion of the planned durations (up to 90 days) were operated through full median sternotomy. Our data demonstrate that both approaches provide excellent initial field visualization. Full median sternotomy provides larger viewing angles at the anastomotic suture line after device connection to inflow and outflow ports. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Soil contamination issues at U.S. ports

International Nuclear Information System (INIS)

Rice, D.W.; Hagner, D.

1991-01-01

This paper reports that seven large and medium size west coast ports were surveyed during August 1990 to determine their involvement with hydrocarbon contaminated soils and activities associated with the characterization and remediation of these soils. All ports surveyed indicated that hey have hydrocarbon contaminated soil problems. Although other west coast ports do not have the scale of petroleum transfer and storage facilities that the Prot of Los Angeles has, all ports had tenants with bulk oil or fuel storage in aboveground tanks and were undertaking characterization and remediation work. Hydrocarbon contaminated soil problems were associated with these facilities or with decommissioned facilities of this type

Analyzing Growth Opportunity of Port from the Resource-based Perspective The Case of Port of Tanjung Pelepas Malaysia

OpenAIRE

Subhan, Muhammad; Abdul Ghani, Ahmad Bashawir

2008-01-01

Capturing growth opportunity has become a major integral activity of any port to sustain growth and competitive advantage. One of the famous strategies in leveraging sustainable growth and competitive advantage is the resource-based theory application into port strategic management, viewing resources of the port (internal and external) and its capabilities as the sources for achieving competitive advantage. In this study, we attempt to identify, exploit, and analyze growth opportunity of a Ma...

Step-wise integration of single-port laparoscopic surgery into routine colorectal surgical practice by use of a surgical glove port.

Science.gov (United States)

Hompes, R; Lindsey, I; Jones, O M; Guy, R; Cunningham, C; Mortensen, N J; Cahill, R A

2011-06-01

The cost associated with single-port laparoscopic access devices may limit utilisation of single-port laparoscopic surgery by colorectal surgeons. This paper describes a simple and cheap access modality that has facilitated the widespread adoption of single-port technology in our practice both as a stand-alone procedure and as a useful adjunct to traditional multiport techniques. A surgical glove port is constructed by applying a standard glove onto the rim of the wound protector/retractor used during laparoscopic resectional colorectal surgery. To illustrate its usefulness, we present our total experience to date and highlight a selection of patients presenting for a range of elective colorectal surgery procedures. The surgical glove port allowed successful completion of 25 single-port laparoscopic procedures (including laparoscopic adhesiolysis, ileo-rectal anastomosis, right hemicolectomy, total colectomy and low anterior resection) and has been used as an adjunct in over 80 additional multiport procedures (including refashioning of a colorectal anastomosis made after specimen extraction during a standard multiport laparoscopic anterior resection). This simple, efficient device can allow use of single-port laparoscopy in a broader spectrum of patients either in isolation or in combination with multiport surgery than may be otherwise possible for economic reasons. By separating issues of cost from utility, the usefulness of the technical advance inherent within single-port laparoscopy for colorectal surgery can be better appreciated. We endorse the creative innovation inherent in this approach as surgical practice continues to evolve for ever greater patient benefit.

A second defibrillator chest patch electrode will increase implantation rates for nonthoracotomy defibrillators.

Science.gov (United States)

Solomon, A J; Swartz, J F; Rodak, D J; Moore, H J; Hannan, R L; Tracy, C M; Fletcher, R D

1996-09-01

Nonthoracotomy defibrillator systems can be implanted with a lower morbidity and mortality, compared to epicardial systems. However, implantation may be unsuccessful in up to 15% of patients, using a monophasic waveform. It was the purpose of this study to prospectively examine the efficacy of a second chest patch electrode in a nonthoracotomy defibrillator system. Fourteen patients (mean age 62 +/- 11 years, ejection fraction = 0.29 +/- 0.12) with elevated defibrillation thresholds, defined as > or = 24 J, were studied. The initial lead system consisted of a right ventricular electrode (cathode), a left innominate vein, and subscapular chest patch electrode (anodes). If the initial defibrillation threshold was > or = 24 J, a second chest patch electrode was added. This was placed subcutaneously in the anterior chest (8 cases), or submuscularly in the subscapular space (6 cases). This resulted in a decrease in the system impedance at the defibrillation threshold, from 72.3 +/- 13.3 omega to 52.2 +/- 8.6 omega. Additionally, the defibrillation threshold decreased from > or = 24 J, with a single patch, to 16.6 +/- 2.8 J with two patches. These changes were associated with successful implantation of a nonthoracotomy defibrillator system in all cases. In conclusion, the addition of a second chest patch electrode (using a subscapular approach) will result in lower defibrillation thresholds in patients with high defibrillation thresholds, and will subsequently increase implantation rates for nonthoracotomy defibrillators.

78 FR 24069 - Safety Zone; 12th Annual Saltwater Classic; Port Canaveral Harbor; Port Canaveral, FL

Science.gov (United States)

2013-04-24

... under Executive Order 13045, Protection of Children from Environmental Health Risks and Safety Risks. This rule is not an economically significant rule and does not create an environmental risk to health...-AA00 Safety Zone; 12th Annual Saltwater Classic; Port Canaveral Harbor; Port Canaveral, FL AGENCY...

Research for Foreign Advanced Ports for Protection and Development Experience

Science.gov (United States)

Zhang, Lu; Tian, Mingjing; Zhao, Junjie; Shou, Youping; Wang, Ning; Qiao, Jianzhe; Li, Guanglou

2018-04-01

Into the twenty-first century, the process globalization of economic and trade is getting faster and faster, As of 2014, China's annual port trading amount topped the world, But in the port of environmental protection sustainable development approach with foreign advanced port environmental management concept has a big gap. Combined with the present situation of modern ports in China. Drawing lessons from foreign advanced environmental protection idea of port, in order to promote the protection of port environment in our country. The experience of protection and development of foreign advanced port environment will be discussed and discussed.

Curcumin Implants, not Curcumin Diet Inhibits Estrogen-Induced Mammary Carcinogenesis in ACI Rats

Science.gov (United States)

Bansal, Shyam S.; kausar, Hina; Vadhanam, Manicka V.; Ravoori, Srivani; Pan, Jianmin; Rai, Shesh N.; Gupta, Ramesh C.

2014-01-01

Curcumin is widely known for its anti-oxidant, anti-inflammatory and anti-proliferative activities in cell culture studies. However, poor oral bioavailability limited its efficacy in animal and clinical studies. Recently, we developed polymeric curcumin implants that circumvents oral bioavailability issues, and tested their potential against 17β-estradiol (E2)-mediated mammary tumorigenesis. Female ACI rats were administered curcumin either via diet (1,000 ppm) or via polymeric curcumin implants (two 2-cm; 200 mg each; 20% drug load) 4 days prior to grafting a subcutaneous E2 silastic implant (1.2 cm, 9 mg E2). Implants were changed after 4½ months to provide higher curcumin dose at the appearance of palpable tumors. The animals were euthanized after 3 weeks, 3 months and after the tumor incidence reached >80% (~6 months) in control animals. The curcumin administered via implants resulted in significant reduction in both the tumor multiplicity (2±1 vs 5±3; p=0.001) and tumor volume (184±198 mm3 vs 280±141 mm3; p=0.0283); the dietary curcumin, however, was ineffective. Dietary curcumin increased hepatic CYP1A and CYP1B1 activities without any effect on CYP3A4 activity whereas curcumin implants increased both CYP1A and CYP3A4 activities but decreased CYP1B1 activity in presence of E2. Since CYP1A and 3A4 metabolize most of the E2 to its non-carcinogenic 2-OH metabolite and CYP1B1 produces potentially carcinogenic 4-OH metabolite, favorable modulation of these CYPs via systemically delivered curcumin could be one of the potential mechanisms. The analysis of plasma and liver by HPLC showed substantially higher curcumin levels via implants versus the dietary route despite substantially higher dose administered. PMID:24501322

The Implications of the Growth of Port Throughput on the Port Capacity: the Case of Malaysian Major Container Seaports

Directory of Open Access Journals (Sweden)

J. Jeevan

2015-12-01

Full Text Available Malaysia, situated between East and West, is an interface in world maritime trade, playing a crucial role in the business of moving container boxes in South-eastern parts of Asia. The prominent container terminals in Malaysia such as Port Klang and Port of Tanjung Pelepas are positioned among the top twenty ports in terms of volume handled. The annual average growth of throughputs in Malaysian container ports increased more than three-fold from the year 2000 to 2010. Within this context, the development of Malaysian seaports has been significantly influenced by three forces: increased use of containerisation, significant growth in domestic economic activities and ever-changing patterns in both supply and demand chains, all of which have led to increased transshipment activities and altered shipping routes. This phenomenon has brought dynamic change to Malaysian container ports, resulting in the establishment of new terminals and adapting emerging technology to enhance the ports' ability to accommodate larger vessels and an increased number of containers. This paper aims to present the development of Malaysian container seaports by addressing changes to acreage size and handling volumes during the last three decades. The results of the analysis suggest that major Malaysian ports are experiencing an exponential growth in container trade with the expansion of port capacity following trade growth and need effective strategies to reduce the operational pressures of Malaysian seaports. The results of this research offer directions for development strategies of seaports by utilising the existing inland freight facilities as an effective strategy for capacity enhancement and develop efficient distribution network to meet future demands.

Case Report Pneumomediastinum and Subcutaneous Emphysema ...

African Journals Online (AJOL)

oxygen may enhance faster absorption of air from extra-pulmonary tissues while needle aspiration and/ or surgical decompression may be useful if mediastinal structures are compressed [2,9,]. Conclusion. Extra-pulmonary extravasations of air manifested as subcutaneous emphysema and pneumomediastinum.

Case Report: Pneumomediastinum and subcutaneous cervical ...

African Journals Online (AJOL)

The occurrence of pneumomediastinum and subcutaneous cervical emphysema as complications of childhood pneumonia is very unusual. They results most often from respiratory manoeuvres that produce high intrathoracic pressure. Although they are largely benign, pneumomediastinum can cause compression of major ...

Vectorization, parallelization and porting of nuclear codes on the VPP500 system (porting). Progress report fiscal 1996

Energy Technology Data Exchange (ETDEWEB)

Nemoto, Toshiyuki [Fujitsu Ltd., Tokyo (Japan); Kawasaki, Nobuo; Tanabe, Hidenobu [and others

1998-01-01

Several computer codes in the nuclear field have been vectorized, parallelized and transported on the FUJITSU VPP500 system at Center for Promotion of Computational Science and Engineering in Japan Atomic Energy Research Institute. These results are reported in 3 parts, i.e., the vectorization part, the parallelization part and the porting part. In this report, we describe the porting. In this porting part, the porting of reactor safety analysis code RELAP5/MOD3.2 and RELAP5/MOD3.2.1.2, nuclear data processing system NJOY and 2-D multigroup discrete ordinate transport code TWOTRAN-II are described. And also, a survey for the porting of command-driven interactive data analysis plotting program IPLOT are described. In the parallelization part, the parallelization of 2-Dimensional relativistic electromagnetic particle code EM2D, Cylindrical Direct Numerical Simulation code CYLDNS and molecular dynamics code for simulating radiation damages in diamond crystals DGR are described. And then, in the vectorization part, the vectorization of two and three dimensional discrete ordinates simulation code DORT-TORT, gas dynamics analysis code FLOWGR and relativistic Boltzmann-Uehling-Uhlenbeck simulation code RBUU are described. (author)

Relationship between subcutaneous blood flow and absorption of lente type insulin

DEFF Research Database (Denmark)

Hildebrant, P; Mehlsen, J; Birch, K

1987-01-01

To study the relationship between the absorption of intermediate acting insulin and the local subcutaneous blood flow (SBF) 8 diabetic patients were given subcutaneous injections of 125I labeled human lente type insulin and 133Xenon in the abdominal wall. External measurements of the tracer...

A modified method using a two-port approach for accessing the hilar vasculature without transferring an endostapler from camera port to utility port during thoracoscopic right upper lobectomy.

Science.gov (United States)

Jiao, W; Zhao, Y; Xuan, Y; Wang, M

2015-02-01

For thoracoscopic upper lobectomies, most cutting endostaplers must be inserted through the camera port when using a two-port approach. Access to the hilar vasculature through only the utility port remains a challenge. In this study, we describe a procedure to access the hilar vasculature without transferring the endostapler site during a thoracoscopic right upper lobectomy. A 2.5-cm utility anterior incision was made in the fourth intercostal space. The posterior mediastinal visceral pleura were dissected to expose the posterior portion of the right upper bronchus and the anterior trunk of the right pulmonary artery. The pleura over the right hilar vasculature were then peeled with an electrocoagulation hook. The anterior trunk of the right pulmonary artery was then transected with a cutting endostapler through the utility port firstly. This crucial maneuver allowed the endostapler access to the right upper lobe pulmonary vein. The hilar structures were then easily handled in turn. This novel technique was performed successfully in 32 patients, with no perioperative deaths. The average operation time was 120.6 min (range 75-180 min). This novel technique permits effective control of the hilar vessels through the utility port, enabling simple, safe, quick and effective resection.

The Suitability of Zn–1.3%Fe Alloy as a Biodegradable Implant Material

Directory of Open Access Journals (Sweden)

Alon Kafri

2018-02-01

Full Text Available Efforts to develop metallic zinc for biodegradable implants have significantly advanced following an earlier focus on magnesium (Mg and iron (Fe. Mg and Fe base alloys experience an accelerated corrosion rate and harmful corrosion products, respectively. The corrosion rate of pure Zn, however, may need to be modified from its reported ~20 µm/year penetration rate, depending upon the intended application. The present study aimed at evaluating the possibility of using Fe as a relatively cathodic biocompatible alloying element in zinc that can tune the implant degradation rate via microgalvanic effects. The selected Zn–1.3wt %Fe alloy composition produced by gravity casting was examined in vitro and in vivo. The in vitro examination included immersion tests, potentiodynamic polarization and impedance spectroscopy, all in a simulated physiological environment (phosphate-buffered saline, PBS at 37 °C. For the in vivo study, two cylindrical disks (seven millimeters diameter and two millimeters height were implanted into the back midline of male Wister rats. The rats were examined post implantation in terms of weight gain and hematological characteristics, including red blood cell (RBC, hemoglobin (HGB and white blood cell (WBC levels. Following retrieval, specimens were examined for corrosion rate measurements and histological analysis of subcutaneous tissue in the implant vicinity. In vivo analysis demonstrated that the Zn–1.3%Fe implant avoided harmful systemic effects. The in vivo and in vitro results indicate that the Zn–1.3%Fe alloy corrosion rate is significantly increased compared to pure zinc. The relatively increased degradation of Zn–1.3%Fe was mainly related to microgalvanic effects produced by a secondary Zn11Fe phase.

Assessing the port to port risk of vessel movements vectoring non-indigenous marine species within and across domestic Australian borders.

Science.gov (United States)

Campbell, Marnie L; Hewitt, Chad L

2011-07-01

Biofouling of vessels is implicated as a high risk transfer mechanism of non-indigenous marine species (NIMS). Biofouling on international vessels is managed through stringent border control policies, however, domestic biofouling transfers are managed under different policies and legislative arrangements as they cross internal borders. As comprehensive guidelines are developed and increased compliance of international vessels with 'clean hull' expectations increase, vessel movements from port to port will become the focus of biosecurity management. A semi-quantitative port to port biofouling risk assessment is presented that evaluates the presence of known NIMS in the source port and determines the likelihood of transfer based on the NIMS association with biofouling and environmental match between source and receiving ports. This risk assessment method was used to assess the risk profile of a single dredge vessel during three anticipated voyages within Australia, resulting in negligible to low risk outcomes. This finding is contrasted with expectations in the literature, specifically those that suggest slow moving vessels pose a high to extreme risk of transferring NIMS species.

Subcutaneous mercury injection by a child: A histopathology case report

Directory of Open Access Journals (Sweden)

Deepti Sukheeja

2014-01-01

Full Text Available Intentional subcutaneous injection of mercury by mentally healthy children is rare. Usually, it is seen as a part of suicidal attempt in severely depressed patients or by athletes to enhance their performance. We report a case of a 15-year-old child, inspired by a movie, who deliberately self-injected mercury subcutaneously into his forearm that led to the formation of a non-healing ulcer. Histopathology of the biopsy confirmed the diagnosis. A surgical procedure was thereby performed to treat the ulcer and reduce the blood and urinary levels of mercury. However, the patient did not develop clinical signs of chronic poisoning, proving that subcutaneous mercury injection has a low risk of systemic toxicity, and that histopathology plays an important role in diagnosis.

Robotic right middle lobectomy with a subxiphoid utility port.

Science.gov (United States)

Jayakumar, Shruti; Nardini, Marco; Papoulidis, Pavlos; Dunning, Joel

2018-06-01

We present the case of a 74-year-old man with Stage IIa pulmonary adenocarcinoma, for which he underwent a robotic right middle lobectomy. A 4-armed, 5-port approach was used. Four intercostal ports were created above the ninth rib using the Cerfolio's technique. The subxiphoid port was created in the midline, 5 cm down from the xiphisternum. The robot offers higher image quality, depth perception and improved articulation of the instruments, allowing for more accurate dissection and stitching. The usage of a subxiphoid utility port reduces the clashing between instruments, offers a good angle for stapling and provides a direct view of the instruments entering into the chest. Specimen removal through the subxiphoid port may reduce postoperative pain and enhance patient recovery. The use of the subxiphoid approach as a utility port for robotic surgery is promising and may be a suitable replacement for the traditional utility port.

Clinical efficacy of sublingual and subcutaneous birch pollen allergen-specific immunotherapy

DEFF Research Database (Denmark)

Khinchi, M S; Poulsen, Lars K.; Carat, F

2004-01-01

Both sublingual allergen-specific immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT) have a documented clinical efficacy, but only few comparative studies have been performed.......Both sublingual allergen-specific immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT) have a documented clinical efficacy, but only few comparative studies have been performed....

Anatomy of the subcutaneous tissue of the trunk and lower extremity.

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