WorldWideScience

Sample records for surrounding retrenchment punctured

  1. Clinical Application of Surrounding Puncture

    Institute of Scientific and Technical Information of China (English)

    GUO Yao-jie; HAN Chou-ping

    2003-01-01

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

  2. Retrenchment Review.

    Science.gov (United States)

    Bieschke, Suzanne M.

    This review of retrenchment in higher education covers background information, basic concerns, suggestions for making cuts, and lessons learned from experience. Contents concern financial pressures, enrollments, faculty relations during retrenchment, services and programs during retrenchment, administration during retrenchment, and case histories…

  3. Pennsylvania's Retrenchment Battle.

    Science.gov (United States)

    Mortimer, Kenneth P.

    1981-01-01

    The retrenchment experience of Pennsylvania's state college system is described. The specter of retrenchment scared the campuses into finding new nonpersonnel cuts to make; a policy of intrasystem faculty transfer was finally adopted; and although campus presidents opposed retrenchment, by 1979-80 they were convinced of its necessity. (MLW)

  4. Retrenchment at Liberal Arts Colleges.

    Science.gov (United States)

    Journal of the College and University Personnel Association, 1980

    1980-01-01

    Data on current retrenchment policies and practices of liberal arts colleges are reported and analyzed, including information on the existence of a retrenchment policy, retrenchment between 1974-75 and 1977-78, the retrenchment process, and the impact of retrenchment on affirmative action and employment rights and benefits. (MLW)

  5. Challenges of Retrenchment.

    Science.gov (United States)

    Mingle, James R.; And Others

    The retrenchment experiences of a variety of institutions--large and small, public and private--are described and evaluated using an extensive spectrum of case studies sponsored by the Southern Regional Education Board. Part One discusses challenges of retrenchment (James R. Mingle) and strategies for the 1980s (David W. Breneman). Part Two,…

  6. Retrenchment: Panacea or Placebo?

    Science.gov (United States)

    Boland, James M.

    1981-01-01

    A research summary compares Indiana University Northwest's placement records to national averages for teacher placement during the last decade. Data indicate that educational retrenchment is a shortsighted approach which could be detrimental to societal needs. (JN)

  7. Retrenchment in Brooklyn

    Science.gov (United States)

    Sussman, Herbert M.

    1977-01-01

    A retrospective look at how severe budget reduction during the last two years affected New York City Community College, and at the difficult decisions made and issues considered in retrenchment of services and staff. (JG)

  8. The Cultural Politics of Retrenchment.

    Science.gov (United States)

    Hardy, Cynthia

    1993-01-01

    A discussion of the ways in which college retrenchment planning is institution specific and political looks at how four institutions have shaped different retrenchment strategies. Challenges inherent in each strategy are examined, and practical suggestions are made for campus leaders facing retrenchment. (MSE)

  9. Retrenchment at Comprehensive Universities and Colleges.

    Science.gov (United States)

    Journal of the College and University Personnel Association, 1980

    1980-01-01

    Data on current retrenchment policies and practices of comprehensive universities and colleges are reported and analyzed, including information on the existence of a retrenchment policy, retrenchment between 1974-75 and 1977-78, the retrenchment process, and the impact of retrenchment on affirmative action and employment rights and benefits. (MLW)

  10. Retrenchment at Doctorate-Granting Institutions.

    Science.gov (United States)

    Journal of the College and University Personnel Association, 1980

    1980-01-01

    Data on current retrenchment policies and practices of doctorate-granting institutions are reported and analyzed, including information on the existence of a retrenchment policy, retrenchment between 1974-75 and 1977-78, the retrenchment process, and the impact of retrenchment on affirmative action and employment rights and benefits. (MLW)

  11. Puncture Wounds

    Science.gov (United States)

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

  12. Reducing the Pain of Retrenchment.

    Science.gov (United States)

    Powers, David R.

    1982-01-01

    Well-defined and clearly documented guidelines and areas of responsibility and strict adherence to procedures will eliminate considerable debate and disruptions during retrenchment. These concepts apply equally to faculty, staff, program, student, and other issues. University of Pittsburgh retrenchment guidelines on faculty treatment provide…

  13. Coping with Retrenchment: Strategies and Tactics.

    Science.gov (United States)

    Chabotar, Kent John; Honan, James P.

    1990-01-01

    Examples of retrenchment at colleges and universities are given as are five principles such as the need to reconsider institutional mission. Both strategic and tactical perspectives are applied to retrenchment decisions of college leadership. (DB)

  14. Retrenchment, the Department, and the Association.

    Science.gov (United States)

    Anderson, Kenneth E.

    Institutional retrenchment is an on-going process in academia. So that crises can be avoided in the retrenchment process, every institution should develop processes both for the continual review of units by faculty colleagues and to ensure faculty participation in the management of the institution. Decisions about retrenchment should be based on…

  15. Retrenchment at Two-Year Colleges and Institutes.

    Science.gov (United States)

    Journal of the College and University Personnel Association, 1980

    1980-01-01

    Data on current retrenchment policies and practices of two-year colleges and institutes are reported and analyzed, including information on the existence of a retrenchment policy, retrenchment between 1974-75 and 1977-78, the retrenchment process, and the impact of retrenchment on affirmative action and employment rights and benefits. (MLW)

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

    Institute of Scientific and Technical Information of China (English)

    高凤云

    2011-01-01

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

  17. Bibliography on Decline and Retrenchment.

    Science.gov (United States)

    National Center for Higher Education Management Systems, Boulder, CO.

    A bibliography on decline and retrenchment in higher education is presented that includes publications from the fields of higher education, the organization sciences, and public administration. The objective is to make available the reference tools that have been useful in conducting the National Center for Higher Education Management Systems'…

  18. Communicating about Cutbacks: Straightforward Strategies for the Retrenchment Era.

    Science.gov (United States)

    Jacobson, Harvey K.

    1984-01-01

    Institutional advancement office needs a communication strategy for interpreting the retrenchment effects on the institution. Fourteen guidelines for communication about retrenchment are provided. (MLW)

  19. Retrenchment Policies and Their Organizational Consequences.

    Science.gov (United States)

    Berger, Michael A.

    1983-01-01

    The organizational outcomes of different types of policies that school administrators follow during times of retrenchment were studied. The effects of four retrenchment policies--in school consolidation and reduced staffs, on per-pupil costs, pupil-teacher ratios, and equity--are discussed. (PP)

  20. Responses to Retrenchment in California Schools.

    Science.gov (United States)

    Robinson, Tom; And Others

    1981-01-01

    A study examined the methods used by several California school districts to respond to educational retrenchment. Results showed that, while respondents had difficulty separating recent educational legislaton from other aspects of retrenchment, they agreed that there was no way to produce better results in education with a reduction in resources.…

  1. Retrenchment Policies and Practices: A Summary.

    Science.gov (United States)

    Howe, Richard

    1980-01-01

    The data results and the findings on retrenchment for all of the four major Carnegie Classifications of institutions combined are summarized. Data on current retrenchment policies and practices were reported from 40 percent of the institutions participating in a College and University Personnel Association study. (MLW)

  2. Selective Retrenchment and Growth in the Netherlands.

    Science.gov (United States)

    Acherman, Hans A.

    1988-01-01

    A sequel to an earlier article about the first round of Dutch retrenchment in higher education looks at the response to the second round, with the introduction of the concept of selective retrenchment and growth, a new approach to resource allocation. (Author/MSE)

  3. The Politics of Retrenchment in Higher Education.

    Science.gov (United States)

    Cooper, Lloyd G.

    Reactions to college and university retrenchment (a significant decline in financial resources that results in a reduction in permanent staff and/or elimination of existing programs) and political influences are considered. Responses to retrenchment may include the following: protective reactions by individual faculty members and reduced…

  4. Retrenchment: A Part of Resource Management for the Eighties.

    Science.gov (United States)

    Ivey, Nathan A.; Mack, Judi A.

    1982-01-01

    Describes the development and implementation of several retrenchment plans at Thornton Community College during fiscal years 1979 through 1982. Proposes periodic retrenchment as a means of institutional revitalization, suggesting validation of the need for retrenchment, initiation and phasing of the retrenchment plan, staff and community…

  5. Retrenchment strategies and tactics for healthcare executives.

    Science.gov (United States)

    Muller, H J; Smith, H L

    1985-01-01

    Retrenchment is a problem confronting many public, private, and voluntary healthcare organizations. With budgetary restrictions in the public sector and the shift toward prospective payment systems and diagnosis-related reimbursement by third-party payors, healthcare executives must address several dilemmas and choices. Yet, retrenchment should not necessarily be viewed as a problem with limited alternatives. It may represent a time for capitalizing on opportunities and for creating innovation within healthcare institutions. Indeed, innovation may represent the only means for survival. This article evaluates the management strategies that transform retrenchment from a problem into an opportunity.

  6. Retrenchment in British Universities: Lessons Learned.

    Science.gov (United States)

    Simpson, William A.

    1985-01-01

    A study of 14 British universities that underwent severe retrenchment in 1981-1984 is reported, and successful policies, procedures, philosophies, and techniques that may be applicable to institutions in many countries are outlined. (MSE)

  7. Legislative Action: The Possibility of Instant Retrenchment.

    Science.gov (United States)

    Jedamus, Paul

    1980-01-01

    Planning models developed at the University of Colorado, Boulder and resulting strategies for coping with legislated retrenchment are presented. Several areas for course of action are examined: contingency planning, planning for flexibility and enhancing real productivity. (LC)

  8. Financial Decision Making in a Period of Retrenchment.

    Science.gov (United States)

    Stevenson, Mike R.; Walleri, R. Dan

    1981-01-01

    Reviews institutional responses to and budgeting requirements of retrenchment. Presents and discusses nine guidelines for community colleges dealing with retrenchment, related to action rather than reaction, participatory budgeting, reexamination of priorities, consistently derived comparisons, financial projections, outcome measures, planning…

  9. The Problems of Contraction: Legal Considerations in University Retrenchment.

    Science.gov (United States)

    Johnson, Annette B.

    1981-01-01

    Higher education administrators planning for retrenchment should follow these guidelines: document the financial circumstances justifying retrenchment; devise a long-range financial plan; identify how and by whom retrenchment decisions are made; and know both the interests of and procedural protections available to faculty, staff, and other…

  10. The Politics of Educational Retrenchment in Detroit, 1929-1935.

    Science.gov (United States)

    Mirel, Jeffrey

    1984-01-01

    Retrenchment controversies as they influenced school policy and as they related to changes in educational politics in Detroit (Michigan) from 1929 to 1935 are examined. Investigated are questions such as, How was massive retrenchment undertaken?, What political alignments arose over the retrenchment issue?, and What were the long term…

  11. Probing the puncture for black hole simulations

    CERN Document Server

    Brown, J David

    2009-01-01

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

  12. Retrenchment Clauses in Faculty Union Contracts.

    Science.gov (United States)

    Rhoades, Gary

    1993-01-01

    Examination of retrenchment clauses in the faculty union contracts at 42 colleges and universities focused on implications for tenure rights and the roles prescribed for faculty and administrators. Concepts of financial exigency and shared governance are highlighted. Contracts were found to provide faculty with a limited and reactive role during…

  13. Retrenchment: Alternatives for Teacher Education Programs.

    Science.gov (United States)

    Kossack, Sharon W.; Greenberg, Barry

    1983-01-01

    Faced with declining enrollments, teacher education institutions must seek new approaches that either maintain present programs or encourage new programs in nontraditional areas. Results of a study of retrenchment strategies presently in use are reported. Implications for the quality of teacher education programs are also discussed. (PP)

  14. Isomorphism, Homogeneity, and Rationalism in University Retrenchment.

    Science.gov (United States)

    Gates, Gordon S.

    1997-01-01

    Describes the process of retrenchment at a medium-sized state university (pseudonyms used) for the purpose of analyzing the isomorphic pressures (mimetic, coercive, normative) surfacing during the process and the role played by rationalism in decision-making. Draws on the literature of organizational theory and change, and makes comparisons with…

  15. The politics of welfare state retrenchment

    DEFF Research Database (Denmark)

    Starke, Peter

    2006-01-01

    in retrenchment studies. Also, the exact motives for cutbacks are theoretically still little understood, as are the political mechanisms through which they are realized. I argue that, because of the nature of these persisting issues, the pluralistic dialogue between different methods and approaches - as well...

  16. Retrenchment and the Mondex Electronic Purse (Extended Abstract)

    OpenAIRE

    Banach, Richard; Poppleton, Michael; Jeske, Czeslaw; Stepney, Susan

    2005-01-01

    Some of the success stories of model based refinement are recalled, as well as some of the annoyances that arise when refinement is deployed in the engineering of large systems. The way that retrenchment attempts to alleviate such inconveniences is reviewed. The Mondex Electronic Purse formal development provides a highly credible testbed for examining how real world refinement difficulties can be treated via retrenchment. The contributions of retrenchment to integrating the real implementati...

  17. Lessons from the Italian NHS retrenchment policy.

    Science.gov (United States)

    Longo, Francesco

    2016-03-01

    In policymaking, implementation is often more critical than design. A variety of policy implementation frameworks can be used to explain implementation gaps and shifts. Each research stream suggests some solutions to prevent shortfalls. We have assessed two of these implementation strategies in the recent INHS (Italian National Health Service) retrenchment policies: (1) centralizing to rapidly cut expenditures, (2) effective management as an output- and not input-based system. The implementation of the INHS retrenchment policy has been very difficult though effective in a short period of time. A multi-level governance structure was put in place that assigned different but clear roles, powers and responsibilities to central and regional governments and public health care organizations. The entire policy was based on an exclusive input-based approach to introduce opacity in the system's prioritization processes. We most likely need to reconsider the identification of crucial implementation drivers in the public realm.

  18. Puncturing Period on the Performance of Punctured Turbo Codes

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

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

  19. Recession in Academe: Development of Policies for Retrenchment.

    Science.gov (United States)

    Nolting, Earl

    1981-01-01

    Discusses policies for college and university "retrenchment," given the long-term projections of possible enrollment decline, primarily from declining numbers of high school graduates between 1980 and 1990. Highlights the conflicts and problems in creating retrenchment policies, with special emphasis on personnel and procedural issues. (Author/RC)

  20. The Management of Retrenchment in Canadian Academic Libraries.

    Science.gov (United States)

    Denis, Laurent-G.; Auster, Ethel

    This exploratory study focuses on the management of decline as characterized by shrinking resources and substantial reductions in operating budgets (retrenchment) in academic research libraries in Canada. The first of four major sections of the report addresses the management of retrenchment in Canadian research libraries, including the design of…

  1. Educational Services for Handicapped Children: Confrontation with Retrenchment.

    Science.gov (United States)

    Steer, M.

    1982-01-01

    Because planning systems long used by Canadian administrators no longer serve to formulate a restraint plan, a carefully considered retrenchment theory is needed for personal and organizational decisions to achieve successful management of planned retrenchment in services to exceptional students. (MC)

  2. Employment freeze management: an approach to attaining retrenchment goals.

    Science.gov (United States)

    Crandall, S J

    1987-11-01

    This article describes a management philosophy for retrenchment and down-sizing within a major health care institution. The author focuses on an unique approach for reducing staff to attain retrenchment goals in light of ever decreasing operating budgets, increased cost containment and accountability, and increased demands for productivity enhancement and service in a competitive customer-oriented health care market.

  3. Experience with Proposition 13 and Other Retrenchment Conditions.

    Science.gov (United States)

    Bouchard, Donald A.

    1980-01-01

    Declining enrollment and the impact of Proposition 13 are discussed in regard to retrenchment and retention rates. It is suggested that higher education establish meaningful communication and affirmative programming to lessen the effects of retrenchment and cut-backs. (Author/LC)

  4. Retrenchment. An engineering variation on refinement

    Energy Technology Data Exchange (ETDEWEB)

    Banach, R.; Poppleton, M

    1999-07-01

    It is argued that refinement, in which I/O signatures stay the same, preconditions are weakened and postconditions strengthened, is too restrictive to describe all but a fraction of many realistic developments. An alternative notion is proposed called retrenchment, which allows information to migrate between I/O and state aspects of operations at different levels of abstraction, and which allows only a fraction of the high level behaviour to be captured at the low level. This permits more of the informal aspects of design to be formally captured and checked. The details are worked out for the B-Method. (author)

  5. Straight-Talk--Tough Issues: Tenure in Times of Retrenchment.

    Science.gov (United States)

    Goldberg, Alvin

    1983-01-01

    Argues that academic freedom is sustained by the tenure system and that retrenchment that involves the elimination of tenured faculty positions or programs has the potential of weakening academic freedom. (PD)

  6. Retrenchment in American Education: The Politics of Efficiency.

    Science.gov (United States)

    Boyd, William Lowe

    1982-01-01

    Effects of fiscal retrenchment on innovation and efficiency in school district governance are examined. It is concluded that, in spite of inconsistencies and inequities, the local political process is the most appropriate mechanism for resolving local school district problems. (CJ)

  7. Educational Retrenchment: A Model for Institutions of Higher Education.

    Science.gov (United States)

    Ishler, Richard E.

    1981-01-01

    Due to economic factors, many institutions of higher education may be forced to reduce faculty positions. The procedures used by Emporia State University (Kansas) can be used as a model for colleges needing to pursue various methods of retrenchment. (JN)

  8. Faculty Retrenchment: The Experience of The University of Wisconsin System.

    Science.gov (United States)

    Pondrom, Cyrena

    1981-01-01

    An examination of recent experiences in the varied institutions of The University of Wisconsin System suggests valuable lessons regarding the impact of various approaches to faculty reduction. Principal provisions of retrenchment regulations are summarized. (Author/LB)

  9. Managing retrenchment in French public hospitals: philosophical and regulatory constraints.

    Science.gov (United States)

    Sobczak, P M; Fottler, M D; Chastagner, D

    1988-01-01

    The French hospital system is experiencing economic stresses similar to those experienced by US hospitals. Pressures for cost containment have occurred due to changes in health care funding. The public hospital system is facing unprecedented severe retrenchment. Innovative strategies for managing retrenchment have been restricted by regulatory and philosophical constraints. What is needed is to provide more autonomy for individual hospital managers together with greater accountability for achievement of results.

  10. Retrenchment in health care organizations: theory and practice.

    Science.gov (United States)

    Fottler, M D; Smith, H L; Muller, H J

    1986-01-01

    This paper analyzes retrenchment in health care organizations in terms of prescriptions in the literature and the actual responses of health care executives to retrenchment. Case studies of five organizations indicate that the range of coping strategies is much more limited than the range of possibilities suggested in the literature. Constraints within the culture of the organization are suggested as an explanation for this disparity.

  11. Emergency airway puncture - slideshow

    Science.gov (United States)

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

  12. Retrenchment Policies in Public 2-Year Community Colleges in the State of Texas.

    Science.gov (United States)

    Ellis, Martha; And Others

    1995-01-01

    Describes a 1993 study examining retrenchment policies at Texas community colleges and their relation to fluctuations in enrollment and state funding. Indicates that 41% of Texas's community colleges had retrenchment policies and that administrative decisions regarding the adoption of retrenchment policies were based on state revenue declines…

  13. Hispanics in the 80's: Retrenchment of Self-Renewal?

    Science.gov (United States)

    Florez, John

    1981-01-01

    Examines the characteristics of the Hispanic movement and the changes in its orientation as a result of economic, social, and political influences since 1960. Emphasizes self-renewal rather than survival and retrenchment as a strategy for solving current social problems. (JCD)

  14. What wins public support? Communicating or obfuscating welfare state retrenchment

    NARCIS (Netherlands)

    C. Elmelund-Præstekær; M. Baggesen Klitgaard; G. Schumacher

    2015-01-01

    Conventional wisdom holds that in order to evade electoral punishment governments obfuscate welfare state retrenchment. However, governments do not uniformly lose votes in elections after they cut back on welfare benefits or services. Recent evidence indicates that some of these unpopular reforms ar

  15. Making Tough Choices: Retrenchment and Reallocations during Hard Times.

    Science.gov (United States)

    Gaither, Gerald; DeWitt, Robby

    1991-01-01

    Prairie View A&M University's (Texas) experiences are offered as lessons in how to establish institutional priorities and procedures for retrenchment. Thirty-one specific cost-reduction strategies and policy changes are presented, and the evolution of a formal, institutionalized budget process, nonexistent until fiscal year 1991, is described.…

  16. Hispanics in the 80's: Retrenchment of Self-Renewal?

    Science.gov (United States)

    Florez, John

    1981-01-01

    Examines the characteristics of the Hispanic movement and the changes in its orientation as a result of economic, social, and political influences since 1960. Emphasizes self-renewal rather than survival and retrenchment as a strategy for solving current social problems. (JCD)

  17. The Role of Needs Assessment in a Period of Retrenchment.

    Science.gov (United States)

    Ratcliff, James L.

    1982-01-01

    Suggests more precise and effective needs assessments during periods when constraints on human and financial resources demand retrenchment decisions about college strategies for recruitment, retention, resource management, and program reallocation or discontinuance. Views needs assessment as the evaluation of the interdependent relationship…

  18. Perceptions of procedural justice in the retrenchment of managers

    Directory of Open Access Journals (Sweden)

    L. P. Vermeulen

    2005-10-01

    Full Text Available In this study, the researcher attempted to establish whether demographic variables, the context of lay-offs and layoff support factors affect retrenched managers’ perceptions of procedural justice with regard to their retrenchment. The results confirm that several factors affect managers’ perceptions of procedural justice. Five independent variables (voluntary vs. involuntary severance, lay-off magnitude, severance compensation, outplacement support and job search stress accounted for 47,9 per cent of the variance in retrenched managers’ perceptions of procedural justice. It is doubtful that managers will perceive their retrenchment as fair if organisations fail to provide considerable concrete support, including severance pay, outplacement support and job search facilities. Opsomming In hierdie studie het die navorser gepoog om vas te stel of demografiese veranderlikes, die konteks van aflegging en afleggingondersteunings-faktore afgelegde bestuurders se persepsies van prosedurele geregtigheid met betrekking tot hul ontslag beïnvloed. Die resultate toon dat verskeie faktore bestuurders se persepsies van prosedurele geregtigheid affekteer. Vyf onafhanklike veranderlikes (vrywillige vs. nie-vrywillige skeiding, omvang van aflegging, skeidingsvergoeding, uitplasingsteun en werksoekstres het 47,9 persent van die variansie in afgelegde bestuurders se persepsies van prosedurele geregtigheid verklaar. Dit is onwaarskynlik dat bestuurders hul aflegging as regverdig sal beskou, tensy organisasies aansienlike konkrete ondersteuning soos skeidingspakkette, uitplasingsteun en werksoekfasiliteite daarstel.

  19. Political Parties’ Welfare Image, Electoral Punishment and Welfare State Retrenchment

    DEFF Research Database (Denmark)

    Schumacher, Gijs; Vis, Barbara; van Kersbergen, Kees

    2013-01-01

    Will voters punish the government for cutting back welfare state entitlements? The comparative literature on the welfare state suggests that the answer is yes. Unless governments are effectively employing strategies of blame avoidance, retrenchment leads to vote loss. Because a large majority...... of voters supports the welfare state, the usual assumption is that retrenchment backfires equally on all political parties. This study contributes to an emerging body of research that demonstrates that this assumption is incorrect. On the basis of a regression analysis of the electoral fate of the governing...... parties of 14 OECD countries between 1970 and 2002, we show that most parties with a positive welfare image lose after they implemented cutbacks, whereas most parties with a negative welfare image do not. In addition, we show that positive welfare image parties in opposition gain votes, at the expense...

  20. Recession, Retrenchment, and Recovery: State Higher Education Funding & Student Financial Aid. Volume II: State Profiles

    Science.gov (United States)

    Ambrose, Allison S.; Hines, Edward R.; Hodel, Ross A.; Kelly, Kathleen F.; Mushrush, Christopher E., Pruden, Sheila J.; Vogt, W. Paul

    2006-01-01

    This report is a companion to "Recession, Retrenchment and Recovery: Higher Education Funding and Student Financial Aid" (ED502180). It provides profiles of individual states and their performance on a variety of measures used in the economic and fiscal analysis of the Recession, Retrenchment and Recovery project. The profiles describe the results…

  1. Retrenchment in the 1980s: The Politics of Prestige and Gender.

    Science.gov (United States)

    Slaughter, Sheila

    1993-01-01

    Review of American Association of University Professors cases (n=17) concerning college employment practices and policies during retrenchment draws a parallel between patterns of resource reallocation in higher education and redistribution of wealth and power in the larger society. Retrenchment is seen as a socially constructed not a…

  2. Organizational Responses to Scarcity: Exploring the Obstacles to Innovative Approaches to Retrenchment in Education.

    Science.gov (United States)

    Whetten, David A.

    1981-01-01

    Reviews theoretical and empirical information on organizational retrenchment and educational administrators' responses to the current decline in education. Argues that administrators must (1) adopt a more open and political administrative orientation to benefit from necessary retrenchments, (2) spur innovation, and (3) improve organizational…

  3. Pulmonary edema following lumbar puncture

    Directory of Open Access Journals (Sweden)

    Gupta D

    1977-01-01

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

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

    Science.gov (United States)

    Desai, Mahesh

    2009-10-01

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

  5. Effects of retrenchment on the motivation and loyalty of surviving employees of Telkom Kenya Limited

    Directory of Open Access Journals (Sweden)

    Nyaberi N. Duncan

    2013-09-01

    Full Text Available The study examined the post-retrenchment effects on employees using the case of the Telkom Kenya. The study dealt with the effects and outcomes of organizational retrenchment. It concentrated on the effect of retrenchment on the survivor (those who remain in the organization after the retrenchment, and on the organization. The effects of retrenchment can be either positive or negative, thus, most apparently, there are different factors in the background of the diverse impacts. The study examined these background factors from both organizational and individual points of view. The study was designed with the main objective of determining the effect of retrenchment on employees with specific reference to employees of Telkom Kenya. The specific objectives of this study were; to identify how the motivational levels of employees have been affected by retrenchment process and to establish how loyalty of employees has been affected by retrenchment process in Telekom Kenya. The study was carried out through a descriptive survey which was considered the most appropriate to carry the research as it gives in-depth information about this particular issue. A sample of 112 employees from a population of 1120 employees was selected using stratified random sampling technique. Semi-structured questionnaires were designed from the literature review and administered to the respondents using the drop- and -pick method. Data collected was analyzed using descriptive statistic, specifically the mean scores and standard deviations. The results were the presented in form of frequency tables and charts. From the study, it was found that the retrenchment process in Telkom Kenya affected various aspects of surviving employee’s motivation and loyalty.

  6. Effects of retrenchment on the morale and job security of surviving employees of Telkom Kenya Limited

    Directory of Open Access Journals (Sweden)

    Duncan N. Nyaberi

    2013-09-01

    Full Text Available The study examined the post-retrenchment effects on employees using the case of the Telkom Kenya. The study dealt with the effects and outcomes of organizational retrenchment. It concentrated on the effect of retrenchment on the survivor (those who remain in the organization after the retrenchment, and on the organization. The effects of retrenchment can be either positive or negative, thus, most apparently, there are different factors in the background of the diverse impacts. The study examined these background factors from both organizational and individual points of view. The study was designed with the main objective of determining the effect of retrenchment on employees with specific reference to employees of Telkom Kenya. The specific objectives of this study were; to determine how retrenchment in Telekom Kenya has affected the morale of employees and to determine how retrenchment process has affected job security of surviving staff. The study was carried out through a descriptive survey which was considered the most appropriate to carry the research as it gives in-depth information about this particular issue. A sample of 112 employees from a population of 1120 employees was selected using stratified random sampling technique. Semi-structured questionnaires were designed from the literature review and administered to the respondents using the drop- and -pick method. Data collected was analyzed using descriptive statistic, specifically the mean scores and standard deviations. The results were the presented in form of frequency tables and charts. From the study, it was found that the retrenchment process in Telkom Kenya affected various aspects of surviving employee’s morale and job security.

  7. Progressive Retrenchment: A Strategy for Home Economics Survival in the Secondary School System.

    Science.gov (United States)

    Sandholtz, Judy Haymore

    1987-01-01

    The author argues that home economics educators must plan better for retrenchment, since currently the courses being cut (consumer education and family relations) are the ones that are most relevant to modern life. (CH)

  8. Steering under Conditions of Retrenchment in Higher Education: The British Experiences from a German Perspective.

    Science.gov (United States)

    Frackmann, Edgar

    1988-01-01

    The West German and British experiences in higher education planning and governance during a period of retrenchment are compared. Changes are interpreted in terms of the underlying characteristics of the two systems and their governance. (Author/MSE)

  9. The adequacy of the current social plan to address retrenchment challenges in South Africa

    Directory of Open Access Journals (Sweden)

    Thulane Ngele

    2008-11-01

    Full Text Available The purpose of the Social Plan Guidelines is to manage large-scale retrenchments and ameliorate their effects on employees. In this study a comprehensive literature review and two case studies were conducted to review the theoretical and practical application of the Social Plan. The research findings identified various challenges that inhibit the effective management of retrenchments. These challenges were analysed and interpreted and a new model to effectively manage retrenchments was developed. The new model is centred on a company’s business plan; the concept is a participative performance-driven governance approach between management and employees focusing on business results. The new model suggests that the employment relations management and corporate social investment of an organisation be utilised as vehicles to manage retrenchments effectively.

  10. Post-dural puncture headache

    Directory of Open Access Journals (Sweden)

    Ghaleb A

    2012-01-01

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

  11. Postdural puncture headache and pregabalin

    Directory of Open Access Journals (Sweden)

    Beyazit Zencirci

    2010-02-01

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

  12. Retirement income policies and welfare state retrenchment: A comparative study of Canada, Sweden and the Netherlands

    OpenAIRE

    Bouma, Lisa

    2005-01-01

    The purpose of this study was to examine the effects of welfare state retrenchment on the retirement income system in Canada during the years 1980-2000. In order to provide perspective on the Canadian experience, this study also examined the effects of retrenchment on the pension systems in the Netherlands and Sweden. The theoretical foundation for this study was supported by Esping-Andersen's (1990) welfare-state regime typology (liberal, conservative and social-democratic). To address retre...

  13. The Open Method of Coordination - Effectively preventing welfare state retrenchment?

    Directory of Open Access Journals (Sweden)

    Milena Büchs

    2009-11-01

    Full Text Available This article re-examines the division between 'optimists' and 'pessimists' within the literature on the Open Method of Coordination’s (OMC effectiveness. Each of those 'camps' tends to focus on a different question. 'Optimists' are more concerned with the question of whether the OMC exerts an influence on the national level and through which mechanisms, whilst 'pessimists' concentrate on the question of whether the OMC can 'strengthen' EU social policy and therefore European welfare states. This article combines these two perspectives and argues that the OMC is indeed capable of influencing national policies through the dissemination of ideas and 'learning' as the 'optimists' stress. However, policy 'learning' at the member state level is shaped and constrained by a variety of internal and external pressures. Against the hopes of most of the OMC 'optimists', this makes the OMC largely ineffective in preventing welfare state retrenchment.

  14. The political control of medical diagnoses - welfare retrenchment through demedicalization

    DEFF Research Database (Denmark)

    Møller, Marie Østergaard; Larsen, Lars Thorup

    interest or ‘need’. The paper compares two cases where retrenchment reforms have reframed medical conditions as personal preferences. First, access to fertility treatment has recently been cut off in the Danish health care system, because infertility is polit- ically reframed as putting their own interest......It is notoriously difficult to legitimize cutbacks in already existing welfare rights, but it somehow requires a redefinition of what falls within the limits of public responsibility. In Denmark, a universal welfare state, reforms have sought to regain political control over medical diagnoses...... a medical issue into a question about the citizen’s motivation and will- ingness to work. The paper traces the genealogy of these two clashes between medicine and universal welfare rights and how both childlessness and incapacity to work have been ‘demedicalized’ by the polit- ical system in order to smooth...

  15. Puncture of thoracic lesions under sonographic guidance.

    OpenAIRE

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

    1982-01-01

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

  16. The politics of retrenchment in a social democratic welfare state : reform of Swedish pensions and unemployment insurance

    NARCIS (Netherlands)

    Anderson, Karen M.

    2001-01-01

    What explains the origins and pattern of retrenchment dynamics in Swedish old-age pensions and unemployment insurance during the 1990s? Although the economic crisis created pressure to scale back both programs, the author argues that retrenchment only occurred when and where the Social Democratic Pa

  17. The Politics of Retrenchment in a Social Democratic Welfare State, Reform of Swedish Pensions and Unemployment Research

    NARCIS (Netherlands)

    Anderson, K.M.; Anderson, Karen M.

    2001-01-01

    What explains the origins and pattern of retrenchment dynamics in Swedish old-age pensions and unemployment insurance during the 1990s? Although the economic crisis created pressure to scale back both programs, the author argues that retrenchment only occurred when and where the Social Democratic

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

    Science.gov (United States)

    Xu, Yingqiang; Zhang, Qinhe; Liu, Guowei

    2017-04-01

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

  19. Blind recognition of punctured convolutional codes

    Institute of Scientific and Technical Information of China (English)

    LU Peizhong; LI Shen; ZOU Yan; LUO Xiangyang

    2005-01-01

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

  20. Puncture mechanics of soft solids.

    Science.gov (United States)

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

    2015-06-21

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

  1. The California Academic Partnership Program: A Case Study of Retrenchment from Two Different Perspectives.

    Science.gov (United States)

    Rubin, Michael

    This case study analyzed the management of the retrenchment for the California Academic Partnership Program (CAPP) from two perspectives: the functionalist perspective and the radical structuralist view. CAPP is a program supporting higher education faculty-secondary school teacher partnerships to improve secondary education. The California…

  2. The Effective Use of EAPs: Retrenchment Leads to Emphasis on Helping Troubled Employees.

    Science.gov (United States)

    Pogue, Gregory

    1994-01-01

    During a period of retrenchment, colleges and universities are increasingly developing employee assistance programs (EAPs) to help personnel cope with personal and work-related problems. Successful EAPs have top management commitment, have written policies and procedure, focus on employee performance, provide professional assistance, involve the…

  3. Do University Presidents Make a Difference? A Strategic Leadership Theory of University Retrenchment.

    Science.gov (United States)

    Budros, Art

    2002-01-01

    Used strategic leadership theory to examine whether observable experiences of presidents affected adoption of retrenchment (early faculty retirement) plans among Ontario universities. Found that presidents play a major role in the adoptions; those who lack seats on corporate boards, have non-business or non-economics backgrounds, are male, and are…

  4. The Socialist State and Global Capital: Educational Retrenchment and Crisis in China

    Science.gov (United States)

    Yan, Luo

    2007-01-01

    In this essay, the author attempts to sketch a picture of Chinese educational transformation in the post-Mao era: its primary impetus, manifestations, and nature of change. The author argues that Chinese educational retrenchment is not a reform without strategy or intended destination as claimed ("cross the river by feeling for stones"). Instead,…

  5. Recession, Retrenchment, and Recovery: State Higher Education Funding & Student Financial Aid

    Science.gov (United States)

    Hodel, Ross; Laffey, Maureen; Lingenfelter, Paul

    2006-01-01

    The Recession, Retrenchment, and Recovery Project examined the effects of recessions on financial access to college during the 25-year period 1979-2004, identified states that have been relatively successful in maintaining financial access, and collected policy strategies used by these states. This study examined the similarities and differences…

  6. The return of the family? Welfare state retrenchment and client autonomy in long-term care

    NARCIS (Netherlands)

    E. Grootegoed; D. van Dijk

    2012-01-01

    European welfare states are cutting back their responsibilities for long-term care, emphasising ‘self-reliance’ and replacing care as an entitlement of citizenship with targeted services. But we do not know how former long-term care recipients cope with retrenchment and if they are able to negotiate

  7. Retrenchment, Human Resource Erosion, and the Role of the Personnel Manager.

    Science.gov (United States)

    Levine, Charles H.

    1984-01-01

    The purpose of this paper is to review the concepts of fiscal stress and decrementalism--a method of retrenchment management; to examine the consequences on public agencies and services; and to outline the challenges of human resource erosion for personnel managers and barriers to successful strategies. (SK)

  8. Strategies for Retrenchment: National, State, Institutional. Current Issues in Higher Education, No. 6, 1980.

    Science.gov (United States)

    American Association for Higher Education, Washington, DC.

    Strategies regarding retrenchment in higher education are examined in three papers and commentaries. In "Basing Public Policy on Student Achievement: A New Agenda Item," Francis Keppel recommends that the federal government undertake a program of acquiring data on student achievement in certain areas of the college curriculum to provide…

  9. Reconciling rising serials costs, the serials budget, and reference needs in a medical library serials retrenchment program: a methodology.

    Science.gov (United States)

    Spang, L

    1995-01-01

    Devising a coherent serials retrenchment plan while maintaining quality reference service is a dilemma faced by increasing numbers of medical librarians. In 1991, the staff of the Shiffman Medical Library, Wayne State University, began to address increasing serials budget reductions that by 1994 amounted to a projected 20% maximum cut. The resulting retrenchment plan combined an ongoing serials use study, faculty and librarian reviews of cancellation lists, and systematic refinements in interlibrary cooperation and document delivery service. The Shiffman plan provides a constructive framework that can be adapted to other medical libraries facing immediate, major serials retrenchment.

  10. Noncommutative mirror symmetry for punctured surfaces

    NARCIS (Netherlands)

    Bocklandt, R.

    2016-01-01

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

  11. Noncommutative mirror symmetry for punctured surfaces

    NARCIS (Netherlands)

    Bocklandt, R.

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-04-15

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

  13. Retrenchment Exercise on Educational Institutions and Government Parastaltas in Ogun-State, Nigeria

    Directory of Open Access Journals (Sweden)

    Odufowokan Benard Adesina

    2015-05-01

    Full Text Available In this paper, attempts have been made to examine the effects of retrenchment on implementing state as well as the Nigerian nation at large. We have examined the colossal impact mass retrenchment would have on the states` economic growth and national development. A descriptive research design was used to collect data while information were gathered from interview corroborated the findings. The sample consists of 1000 participants who were randomly selected from list of educational institutions in Ogun-State. 10 schools were selected each from primary, secondary and tertiary institutions totalling 30 schools while 20 other organizations ranging from Power Holding Corporation, Aviation, LG, and Ministry of Environment. 10 men and 10 women were chosen each from the 50 units. A questionnaire with 25 different performance indicators that reflected individual and institutional level performance was used. Data collected were analyzed using frequency counts. From the findings, it was revealed that rather than being a corrective measure, retrenchment has had negative impact on the affected individual, implementing state and the nations` development in general.  Therefore, we concluded on a note that, for the nation to progress socially and economically to better the lots and wellbeing of the entire Nigerian citizenry, concerted efforts have to be made towards the nations` policy, implementation of various government reforms, training and re-training of personnel in work places and basic information communication technology needed in search for jobs.

  14. Collective Bargaining in a Period of Retrenchment. Proceedings of the Annual Conference of the National Center for the Study of Collective Bargaining in Higher Education and the Professions (11th, New York, NY, April 1983).

    Science.gov (United States)

    Douglas, Joel M., Ed.

    Legal and economic issues pertaining to collective bargaining in a retrenchment situation are considered in 18 conference papers. Titles and authors are as follows: "Retrenchment in State Government: Its Consequences for Higher Education" (James R. Mingle); "A Chancellor's Perspective on Retrenchment" (Joseph S. Murphy); "An Analysis of the AAUP's…

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

    DEFF Research Database (Denmark)

    Darvish, B; Gupta, A; Alahuhta, S

    2011-01-01

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

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

    Science.gov (United States)

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

    1998-11-01

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

  17. Percutaneous renal puncture: requirements and preliminary results

    CERN Document Server

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

    2002-01-01

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

  18. Higher-dimensional puncture initial data

    CERN Document Server

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

    2011-01-01

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

  19. The Obama Doctrine - U.S. Strategic Retrenchment and its Consequences

    Directory of Open Access Journals (Sweden)

    Micha Woźniak

    2015-12-01

    Full Text Available In this article the author writes about the features of a strategy of retrenchment and how it can be applied to the analysis of the foreign policy of the United States during the presidency of Barack Obama. Many of the decisions made by the United States in the international arena resulted from a desire to limit involvement in world affairs, to reduce military spending, and to persuade allies to take a greater responsibility for their own security. Such a policy was motivated by strengthening the weakened position of the USA, but it also contributed to the growth of chaos in the world.

  20. Effects of fiscal retrenchment on public mental health services for the chronic mentally ill.

    Science.gov (United States)

    Surber, R W; Shumway, M; Shadoan, R; Hargreaves, W A

    1986-01-01

    In reviewing the public mental health services of 11 California counties during a period of fiscal retrenchment, we found several common trends: a greater focus on the severely mentally disabled; an increase in utilization of hospital-based care, residential treatment, day treatment, and case management services; and a decrease in the capacity of traditional outpatient services. Although the severely mentally disabled are receiving a higher priority for service, the findings imply that these service systems continue to inadequately address the need for long-term maintenance and supportive services to this population.

  1. Lumbar Puncture for First Simple Febrile Seizure

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

  3. Teichmüller theory of the punctured solenoid

    DEFF Research Database (Denmark)

    Penner, Robert; Sari´c, Dragomir

    2008-01-01

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

  4. Teichmüller theory of the punctured solenoid

    DEFF Research Database (Denmark)

    Penner, Robert; Sari´c, Dragomir

    2008-01-01

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

  5. Does IR = Institutional Retrenchment? Perspectives on the Role of Institutional Research in a Time of Retrenchment. Papers from the Annual Conference of the North East Association for Institutional Research (4th, Durham, NH, October 27, 28, and 29, 1977).

    Science.gov (United States)

    North East Association for Institutional Research.

    The conference focused on various perspectives of the role of institutional research in a time of retrenchment: policy analysis, economic assumptions, resource management, academic planning and cooperative statewide planning. Among the themes addressed were: enrollment projections and financial planning; institutional efficiency and effectiveness;…

  6. Regulation, retrenchment--the DRG experience: problems from changing reimbursement practice.

    Science.gov (United States)

    Gay, E G; Kronenfeld, J J

    1990-01-01

    A study of 227,771 discharge abstracts from one U.S. state's short-term, acute care hospitals compares changes in the inpatient market available to the oldest old Medicare patients (85 and older) with those less than 70 and those 70-84 between 1981, the last year when all hospitals were under cost-based reimbursement, and 1984, the first year in which all hospitals were under a prospective payment system based on diagnosis related groups (DRGs). All three populations experienced retrenchment in services as hospitals pursued practice changes to enhance revenue potential. An older, sicker client was admitted as hospitals implemented changes in admission patterns to avoid denial of reimbursement for an admission deemed inappropriate by the Peer Review Organization (PRO). Evidence demonstrates compression in service markets and retrenchment in services for less profitable DRGs and/or cohorts. Inpatient services were reduced the most for the oldest old population although this cohort was the sickest. Changes were observed in utilization of special care units, such as in coronary and intensive care units. Large increases in readmissions in all three cohorts suggests that DRG incentives to reduce length of hospital stay may have promoted premature discharge. Or, perhaps these readmissions resulted from 'unbundling', a practice of splitting patient problems into multiple admissions, as hospitals sought ways to enhance revenue instead of practicing cost-containment. Policy, perceived to be economically stringent, can affect hospital practice and produce undesired results with long-reaching untoward effects on certain segments of the population.

  7. The effect of economic change and elite framing on support for welfare state retrenchment: a survey experiment

    NARCIS (Netherlands)

    P. Marx; G. Schumacher

    2016-01-01

    How do economic downturns affect citizens’ support for welfare state retrenchment? Existing observational studies fail to isolate the effect of economic conditions and the effect of elite framing of these conditions. We therefore designed a survey experiment to evaluate how economic change in conjun

  8. Laser puncture therapy of nervous system disorders

    Energy Technology Data Exchange (ETDEWEB)

    Anishchenko, G.; Kochetkov, V.

    1984-08-29

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

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

    CERN Document Server

    Gorgoglione, Matteo; Declercq, David

    2010-01-01

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

  10. The reasons for delay lumbar puncture

    Directory of Open Access Journals (Sweden)

    MH. Lotfi

    2017-04-01

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

  11. Retrenchment or realignment? U.S. mental health policy and DRGs.

    Science.gov (United States)

    Ruggie, M

    1990-01-01

    The introduction of DRGs for financing health care is dramatically changing the system of delivery and provision in the U.S. To understand the consequences, it is important to focus not only on cost-containment issues but also on new institutional mechanisms fashioned to reshape health care delivery and provision. A realignment among the major actors is occurring, with the state adopting a central role in redefining its own function in the health care system, constructing a new framework and agenda for change, and enlisting the participation of other social actors in implementing change. The specific features of this realignment are analyzed in the context of mental health DRGs. This article concludes that, based on the consequences of DRGs to date, we ought to look beyond present indicators of retrenchment in the health care system to how the unique features of the American welfare state are continuing to evolve.

  12. Expansion and retrenchment of the Swedish welfare state: a long-term approach.

    Science.gov (United States)

    Buendía, Luis

    2015-01-01

    In this article, we will undertake a long-term analysis of the evolution of the Swedish welfare state, seeking to explain that evolution through the use of a systemic approach. That is, our approach will consider the interrelations between economic growth (EG), the sociopolitical institutional framework (IF), and the welfare state (WS)-understood as a set of institutions embracing the labor market and its regulation, the tax system, and the so-called social wage-in order to find the main variables that elucidate its evolution. We will show that the expansive phase of the Swedish welfare state can be explained by the symbiotic relationships developed in the WS-EG-IF interaction, whereas the period of welfare state retrenchment is one result of changes operating within the sociopolitical IF and EG bases.

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

    Science.gov (United States)

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

    2010-10-01

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

  14. C6 plate puncture testing report.

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-04-01

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

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

    Science.gov (United States)

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

    2009-10-01

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

  16. Practices Surrounding Event Photos

    NARCIS (Netherlands)

    Vyas, Dhaval; Nijholt, Antinus; van der Veer, Gerrit C.; Kotzé, P.; Marsden, G.; Lindgaard, G.; Wesson, J.; Winckler, M.

    Sharing photos through mobile devices has a great potential for creating shared experiences of social events between co-located as well as remote participants. In order to design novel event sharing tools, we need to develop indepth understanding of current practices surrounding these so called

  17. Financing medical care for the underserved in an era of Federal retrenchment: the health service district.

    Science.gov (United States)

    Nichols, A W; Silverstein, G

    1987-01-01

    Federal funding programs have, since the 1960s, been available in a variety of forms to deal with problems of access to medical care for the medically underserved. Certain programs, such as the National Health Service Corps, have recently pulled back from their points of maximal impact in terms of numbers of obligated physicians in the field. This change leaves a need for greater contributions by State and local entities in the face of Federal retrenchment. The health service district (HSD) is one such mechanism for filling the gap. It has been available under this name in Arizona law since 1977, but the first such district in the State in only now under development in a small copper mining community. Similar to school districts in concept, the HSDs allow residents in their catchment areas to tax themselves for the purpose of delivering primary health care. Two successful HSDs--or similar entities--in other States are described. One program is in Stickney, IL, and other in Condon, OR. The political success and financial viability of the Condon program are documented.

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

    Science.gov (United States)

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

    2015-03-01

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

  19. Punctures for theories of class S_{Γ}

    Science.gov (United States)

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

    2017-03-01

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

  20. Assessment of Residents Readiness to Perform Lumbar Puncture

    DEFF Research Database (Denmark)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

  2. Lumbar puncture in patients using anticoagulants and antiplatelet agents

    Directory of Open Access Journals (Sweden)

    Renan Domingues

    2016-08-01

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

  3. Liouville theory and uniformization of four-punctured sphere

    CERN Document Server

    Hadasz, L; Hadasz, Leszek; Jaskolski, Zbigniew

    2006-01-01

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

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

    OpenAIRE

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

    1987-01-01

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

  5. Cerebellar Herniation after Lumbar Puncture in Galactosemic Newborn

    Directory of Open Access Journals (Sweden)

    Salih Kalay

    2011-09-01

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

  6. Lumbar puncture in patients using anticoagulants and antiplatelet agents

    OpenAIRE

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2009-08-01

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

  8. Reducing CO{sub 2}- emissions under fiscal retrenchment. A multi-cohort computable general equilibrium (CGE) model for Austria

    Energy Technology Data Exchange (ETDEWEB)

    Farmer, K.; Steininger, K.W. [Department of Economics, University of Graz, Graz (Austria)

    1999-04-01

    The stabilization of budget deficit and budget debt ratios by fiscal retrenchment in order to fulfill the Maastricht criteria for the European Monetary Union (EMU) is of central focus in most European Union (EU) countries. At the same time the national policy dimension of acute environmental problems such as global warming has receded in the public eye. The environmental dimension nonetheless remains urgent, and a re-evaluation of the prospects of CO{sub 2}-policy is needed against the background of fiscal retrenchment required by supranational obligations. We shall do this for the small, open, Austrian economy by constructing a dynamic multi-cohort computable general equilibrium (CGE) model enabling us to assess quantitatively the lifetime welfare impacts on the cohorts affected by three different options for using CO{sub 2}-permit revenues. The distribution of welfare costs of (Toronto-) CO{sub 2}-policy across cohorts significantly differs with use. This is explained by income, inheritance and price effects. 42 refs.

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

    Directory of Open Access Journals (Sweden)

    Slawomir Klimek

    2010-07-01

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

  10. Anomalous stylet punctures of phloem sieve elements by aphids

    NARCIS (Netherlands)

    Tjallingii, W.F.; Gabrys, B.

    1999-01-01

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

  11. Recent Advances in Thermoplastic Puncture-Healing Polymers

    Science.gov (United States)

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

    2010-01-01

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

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

    CERN Document Server

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

    2016-01-01

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

  13. REINFORCEMENT AND REDUCTION OF BLOOD-LETTING PUNCTURE THERAPY

    Institute of Scientific and Technical Information of China (English)

    王茎

    2003-01-01

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

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

    Directory of Open Access Journals (Sweden)

    M.B. King

    2015-06-01

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

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

    NARCIS (Netherlands)

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

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

  16. Puncture mechanics of cnidarian cnidocysts: a natural actuator

    Science.gov (United States)

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

    2009-01-01

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

  17. Puncture mechanics of cnidarian cnidocysts: a natural actuator

    Directory of Open Access Journals (Sweden)

    Eddington David T

    2009-09-01

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

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

    Indian Academy of Sciences (India)

    Rukmini Dey

    2004-05-01

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

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

    Science.gov (United States)

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

    2017-04-01

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

  20. Recent Advances in Thermoplastic Puncture-Healing Polymers

    Science.gov (United States)

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

    2009-01-01

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

  1. On Rate-Compatible Punctured Turbo Codes Design

    Directory of Open Access Journals (Sweden)

    Montorsi Guido

    2005-01-01

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

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

    CERN Document Server

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

    2013-01-01

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

  3. Bilateral subdural hematoma secondary to accidental dural puncture

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    Sofía Ramírez

    2015-08-01

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

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

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    Rachna Wadhwa

    2011-01-01

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

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

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    Ivonne Martín Hernández

    2011-08-01

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

  6. Impact of Corrugated Paperboard Structure on Puncture Resistance

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    Vaidas Bivainis

    2015-03-01

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

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

    Science.gov (United States)

    Matheson, Linda; Stephenson, Mary; Huber, Benjamin

    2014-09-01

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

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

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    Jin Hyoung Park

    2015-10-01

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

  9. Puncture Self-Healing Polymers for Aerospace Applications

    Science.gov (United States)

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

    2011-01-01

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

  10. Visual surround suppression in schizophrenia

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    Marc Samuel Tibber

    2013-02-01

    Full Text Available Compared to unaffected observers patients with schizophrenia show characteristic differences in visual perception, including a reduced susceptibility to the influence of context on judgements of contrast - a manifestation of weaker surround suppression. To examine the generality of this phenomenon we measured the ability of 24 individuals with schizophrenia to judge the luminance, contrast, orientation and size of targets embedded in contextual surrounds that would typically influence the target’s appearance. Individuals with schizophrenia demonstrated weaker surround suppression compared to matched controls for stimuli defined by contrast or size, but not for those defined by luminance or orientation. As perceived luminance is thought to be regulated at the earliest stages of visual processing our findings are consistent with a suppression deficit that is predominantly cortical in origin. In addition, we propose that preserved orientation surround suppression in schizophrenia may reflect the sparing of broadly tuned mechanisms of suppression. We attempt to reconcile these data with findings from previous studies.

  11. Educational Success and Surrounding Culture

    Science.gov (United States)

    Walters, Garrison

    2016-01-01

    The curriculum, instruction, and services we provide in schools, colleges, and universities matter a lot, but if we continue to ignore our students' "surrounding culture," progress toward a more educated nation will continue to be disappointing.

  12. Educational Success and Surrounding Culture

    Science.gov (United States)

    Walters, Garrison

    2016-01-01

    The curriculum, instruction, and services we provide in schools, colleges, and universities matter a lot, but if we continue to ignore our students' "surrounding culture," progress toward a more educated nation will continue to be disappointing.

  13. Multichannel spatial surround sound system

    Institute of Scientific and Technical Information of China (English)

    RAO Dan; XIE Bosun

    2004-01-01

    Based on the consideration of being compatible with 5.1 channel horizontal surround sound system, a spatial surround sound system is proposed. Theoretical and experimental results show that the system has a wide listening area. It can not only recreate stable image in the front and rear direction, but also eliminate the defect of poor lateral image of 5.1 channel system. The system can be used to reproduce special 3D sound effect and the spaciousness of hall.

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

    Science.gov (United States)

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

    2016-08-01

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

  15. Welfare State Retrenchment in Central and Eastern Europe: The Case of Pension Reforms in Poland and Slovenia

    Directory of Open Access Journals (Sweden)

    Igor Guardiancich

    2004-03-01

    Full Text Available This paper endeavours to shed some light on the mechanisms that led to the divergence of welfare state arrangements across Central and Eastern Europe (CEE. In particular, pension system reforms displayed a great deal of variance, which surprised both institutionalists and convergence theorists. The Polish and Slovenian cases are thus presented and compared in a political economy perspective. Theories of retrenchment, recent studies on the dynamics of CEE pension reforms and consultations with some of the relevant actors, were employed in order to account for the divergence of reform outcomes in the two countries. The study focused on three main explanations: partisan competition, the interaction between relevant external (World Bank and internal actors (Minister of Labour and Minister of Finance and the trade-off. between power concentration and accountability concentration. The latter yielded the best explanation. While Polish reformers managed to internalise most veto actors’ reservations, Slovenian politicians excluded from consultation the country’s main trade union. Its opposition determined the rejection of radical reforms recommended by the World Bank.

  16. The effects of needle deformation during lumbar puncture

    Science.gov (United States)

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

    2015-01-01

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

  17. The effects of needle deformation during lumbar puncture

    Directory of Open Access Journals (Sweden)

    Hasan Hüseyin Özdemir

    2015-01-01

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

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

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    Heidecke Claus-Dieter

    2010-07-01

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

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

    Science.gov (United States)

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

    2017-07-01

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

  20. Punctured torus groups and 2-bridge knot groups

    CERN Document Server

    Akiyoshi, Hirotaka; Wada, Masaaki; Yamashita, Yasushi

    2007-01-01

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

  1. Distorted black hole initial data using the puncture method

    Science.gov (United States)

    Brown, J. David; Lowe, Lisa L.

    2004-12-01

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

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

    CERN Document Server

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

    2010-01-01

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-02-15

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

  6. Gelatin model for training ultrasound-guided puncture

    Directory of Open Access Journals (Sweden)

    Alexandre Campos Moraes Amato

    2015-09-01

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

  7. Visual Surround Suppression in Schizophrenia

    Science.gov (United States)

    Tibber, Marc S.; Anderson, Elaine J.; Bobin, Tracy; Antonova, Elena; Seabright, Alice; Wright, Bernice; Carlin, Patricia; Shergill, Sukhwinder S.; Dakin, Steven C.

    2013-01-01

    Compared to unaffected observers patients with schizophrenia (SZ) show characteristic differences in visual perception, including a reduced susceptibility to the influence of context on judgments of contrast – a manifestation of weaker surround suppression (SS). To examine the generality of this phenomenon we measured the ability of 24 individuals with SZ to judge the luminance, contrast, orientation, and size of targets embedded in contextual surrounds that would typically influence the target’s appearance. Individuals with SZ demonstrated weaker SS compared to matched controls for stimuli defined by contrast or size, but not for those defined by luminance or orientation. As perceived luminance is thought to be regulated at the earliest stages of visual processing our findings are consistent with a suppression deficit that is predominantly cortical in origin. In addition, we propose that preserved orientation SS in SZ may reflect the sparing of broadly tuned mechanisms of suppression. We attempt to reconcile these data with findings from previous studies. PMID:23450069

  8. Schizophrenia, genetic retrenchment, and epidemiologic renaissance. The Sixth Biennial Winter Workshop on Schizophrenia, Badgastein, Austria, January 26-February 1, 1992.

    Science.gov (United States)

    Waddington, J L; Weller, M P; Crow, T J; Hirsch, S R

    1992-12-01

    A distinctive feature of these workshops, in addition to those noted in the introductory overview, is the selection of a relatively isolated location for a 1-week period. This, together with a rich and varied program and an ethos of informality, encourages participants to discuss not only the work presented but also their unpublished work and their intuitions based on preliminary data and analyses. Such an interchange is of inestimable value to the schizophrenia research community. In scientific terms, a panel of concluding discussants (Drs Kendell, Torrey, and Waddington) were in some measure of agreement that genetics, particularly molecular genetics, appears to be experiencing a period of retrenchment, while epidemiology is experiencing something of a renaissance. Maternal influenza was a prominent theme, although the data were far from consistent. It was argued by Dr Wessely that risk for schizophrenia putatively attributable to maternal influenza might be 5% to 10% of all cases, indicating a modest effect. Eclectically, Dr Kendell believed the effect to be "real" but slight and fragile, it being sought against large aggregates that almost inevitably result in differing findings from differing countries or from different data bases within a given country. Gender differences were also among the more prominent themes, not just in an epidemiologic context but also in a variety of other studies. This points anew to disturbances in schizophrenia of factors that regulate, or are intimately associated with, sexual dimorphism in brain development. Abnormalities in cerebral asymmetry continue to pervade a variety of research findings and point further to neurodevelopmental anomalies.(ABSTRACT TRUNCATED AT 250 WORDS)

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

    Science.gov (United States)

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

    2008-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Khaja Mohideen Sherfudeen

    2016-01-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    NARCIS (Netherlands)

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

    2004-01-01

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Xu Yunxiang; Chen Guizhen

    2001-01-01

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

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

    Science.gov (United States)

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

    2010-05-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-12-15

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

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

    Directory of Open Access Journals (Sweden)

    Guoxin Fan

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2016-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Kenneth R. Hoffman

    2015-01-01

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

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

    Science.gov (United States)

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

    2011-04-01

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

  2. Binaural Rendering in MPEG Surround

    Directory of Open Access Journals (Sweden)

    Kristofer Kjörling

    2008-04-01

    Full Text Available This paper describes novel methods for evoking a multichannel audio experience over stereo headphones. In contrast to the conventional convolution-based approach where, for example, five input channels are filtered using ten head-related transfer functions, the current approach is based on a parametric representation of the multichannel signal, along with either a parametric representation of the head-related transfer functions or a reduced set of head-related transfer functions. An audio scene with multiple virtual sound sources is represented by a mono or a stereo downmix signal of all sound source signals, accompanied by certain statistical (spatial properties. These statistical properties of the sound sources are either combined with statistical properties of head-related transfer functions to estimate “binaural parameters” that represent the perceptually relevant aspects of the auditory scene or used to create a limited set of combined head-related transfer functions that can be applied directly on the downmix signal. Subsequently, a binaural rendering stage reinstates the statistical properties of the sound sources by applying the estimated binaural parameters or the reduced set of combined head-related transfer functions directly on the downmix. If combined with parametric multichannel audio coders such as MPEG Surround, the proposed methods are advantageous over conventional methods in terms of perceived quality and computational complexity.

  3. Reduced surround inhibition in musicians.

    Science.gov (United States)

    Shin, Hae-Won; Kang, Suk Y; Hallett, Mark; Sohn, Young H

    2012-06-01

    To investigate whether surround inhibition (SI) in the motor system is altered in professional musicians, we performed a transcranial magnetic stimulation (TMS) study in 10 professional musicians and 15 age-matched healthy non-musicians. TMS was set to be triggered by self-initiated flexion of the index finger at different intervals ranging from 3 to 1,000 ms. Average motor evoked potential (MEP) amplitudes obtained from self-triggered TMS were normalized to average MEPs of the control TMS at rest and expressed as a percentage. Normalized MEP amplitudes of the abductor digiti minimi (ADM) muscles were compared between the musicians and non-musicians with the primary analysis being the intervals between 3 and 80 ms (during the movement). A mixed-design ANOVA revealed a significant difference in normalized ADM MEPs during the index finger flexion between groups, with less SI in the musicians. This study demonstrated that the functional operation of SI is less strong in musicians than non-musicians, perhaps due to practice of movement synergies involving both muscles. Reduced SI, however, could lead susceptible musicians to be prone to develop task-specific dystonia.

  4. Binaural Rendering in MPEG Surround

    Science.gov (United States)

    Breebaart, Jeroen; Villemoes, Lars; Kjörling, Kristofer

    2008-12-01

    This paper describes novel methods for evoking a multichannel audio experience over stereo headphones. In contrast to the conventional convolution-based approach where, for example, five input channels are filtered using ten head-related transfer functions, the current approach is based on a parametric representation of the multichannel signal, along with either a parametric representation of the head-related transfer functions or a reduced set of head-related transfer functions. An audio scene with multiple virtual sound sources is represented by a mono or a stereo downmix signal of all sound source signals, accompanied by certain statistical (spatial) properties. These statistical properties of the sound sources are either combined with statistical properties of head-related transfer functions to estimate "binaural parameters" that represent the perceptually relevant aspects of the auditory scene or used to create a limited set of combined head-related transfer functions that can be applied directly on the downmix signal. Subsequently, a binaural rendering stage reinstates the statistical properties of the sound sources by applying the estimated binaural parameters or the reduced set of combined head-related transfer functions directly on the downmix. If combined with parametric multichannel audio coders such as MPEG Surround, the proposed methods are advantageous over conventional methods in terms of perceived quality and computational complexity.

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

    Directory of Open Access Journals (Sweden)

    Ali Khakshour

    2013-12-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-03-05

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

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

    Directory of Open Access Journals (Sweden)

    Kotenko К.V.

    2013-12-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ashraf Ragab

    2014-04-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-06-15

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

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

    OpenAIRE

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

    1995-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-10-01

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2012-09-01

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

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

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    Carrizo G

    2016-06-01

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

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

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    Temesvári András

    2005-03-01

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

  1. Under Utilization of Local Anesthetics in Infant Lumbar Punctures

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    Gorchynski, Julie

    2008-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    许四法; 张勇; 王哲

    2011-01-01

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

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

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

    2013-10-01

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

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

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    Mueller Michael

    2012-12-01

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

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

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

    2007-08-21

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

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

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    Pankaj B. Patel

    2014-05-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张益香; 汪杏; 丁生英

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

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

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    East Jeffrey M

    2011-10-01

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

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

    Science.gov (United States)

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

    2016-11-01

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

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

    Science.gov (United States)

    Färber, Matthias; Heller, Julika; Handels, Heinz

    2007-03-01

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

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

    Science.gov (United States)

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

    2016-11-01

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

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

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    Qian Mao

    2012-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Dina Y. Kassim

    2016-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-06-01

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

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

    Science.gov (United States)

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

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

  18. Contour detection by surround suppression of texture

    NARCIS (Netherlands)

    Petkov, Nicolai; Tavares, JMRS; Jorge, RMN

    2007-01-01

    Based on a keynote lecture at Complmage 2006, Coimbra, Oct. 20-21, 2006, an overview is given of our activities in modelling and using surround inhibition for contour detection. The effect of suppression of a line or edge stimulus by similar surrounding stimuli is known from visual perception studie

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

    Directory of Open Access Journals (Sweden)

    Abdulah BANI HASHEM

    2012-03-01

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

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

    CERN Document Server

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

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Eric D'Hoker

    2015-10-01

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

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

    Science.gov (United States)

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

    2017-06-01

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

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

    Science.gov (United States)

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

    2015-06-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Corona, Edmundo; Orient, George Edgar

    2014-02-01

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

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

    Science.gov (United States)

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

    1992-02-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

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

    Directory of Open Access Journals (Sweden)

    Miriam Michel

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jared Martínez-Coronado

    2015-01-01

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

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

    CERN Document Server

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

    2005-01-01

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

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

    CERN Document Server

    Baumgarte, Thomas W

    2011-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Prasad Krishnan

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-11-07

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

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

    Directory of Open Access Journals (Sweden)

    Burke A. Cunha

    2013-12-01

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

  16. Agroforestry practice in villages surrounding Nyamure former ...

    African Journals Online (AJOL)

    cntaganda

    Key words: Agroforestry, fuel wood, tree products, woodlot, forest plantation. INTRODUCTION ... The study area included three administrative cells in the surroundings of Nyamure ..... Table 6: Distance and time spent on firewood collection.

  17. Explaining preferences for home surroundings and locations

    Directory of Open Access Journals (Sweden)

    Hans Skifter Andersen

    2011-01-01

    Full Text Available This article is based on a survey carried out in Denmark that asked a random sample of the population about their preferences for home surroundings and locations. It shows that the characteristics of social surroundings are very important and can be divided into three independent dimensions: avoiding social nuisances, preferring social homogeneity and living close to one’s social network and place of origin. The study shows that most people have many detailed preferences, whereas some have very few. This confirms an earlier theory that some people are very connected to certain places with given characteristics and thus do not have priorities regarding home surroundings and locations. For others, mostly young people and singles, home is just a place to sleep and relax, whereas life is lived elsewhere. For this group, there are only preferences for location and there are few specific preferences for surroundings.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1981-11-01

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

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

    Institute of Scientific and Technical Information of China (English)

    高福平; 魏谨

    2012-01-01

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

  20. Surround-Masking Affects Visual Estimation Ability

    Science.gov (United States)

    Jastrzebski, Nicola R.; Hugrass, Laila E.; Crewther, Sheila G.; Crewther, David P.

    2017-01-01

    Visual estimation of numerosity involves the discrimination of magnitude between two distributions or perceptual sets that vary in number of elements. How performance on such estimation depends on peripheral sensory stimulation is unclear, even in typically developing adults. Here, we varied the central and surround contrast of stimuli that comprised a visual estimation task in order to determine whether mechanisms involved with the removal of unessential visual input functionally contributes toward number acuity. The visual estimation judgments of typically developed adults were significantly impaired for high but not low contrast surround stimulus conditions. The center and surround contrasts of the stimuli also differentially affected the accuracy of numerosity estimation depending on whether fewer or more dots were presented. Remarkably, observers demonstrated the highest mean percentage accuracy across stimulus conditions in the discrimination of more elements when the surround contrast was low and the background luminance of the central region containing the elements was dark (black center). Conversely, accuracy was severely impaired during the discrimination of fewer elements when the surround contrast was high and the background luminance of the central region was mid level (gray center). These findings suggest that estimation ability is functionally related to the quality of low-order filtration of unessential visual information. These surround masking results may help understanding of the poor visual estimation ability commonly observed in developmental dyscalculia.

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

    Science.gov (United States)

    Pound, Adam; Miller, Jeremy

    2014-05-01

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

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

    Institute of Scientific and Technical Information of China (English)

    万顺; 李静

    2002-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Farkas, I.; Marik, J.

    1983-01-01

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

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

    CERN Document Server

    Majhi, Abhishek

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-07-07

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

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

    Science.gov (United States)

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

    2010-06-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

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

    CERN Document Server

    Takahashi, Ryo

    2011-01-01

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

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

    Science.gov (United States)

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

    2013-03-01

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

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

    Institute of Scientific and Technical Information of China (English)

    倪夕朗; 洪珏

    2008-01-01

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

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

    NARCIS (Netherlands)

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

    1991-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    李玲

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Paula Sabrina Araújo Milhomem

    2015-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Maxime Patout

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

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

    Directory of Open Access Journals (Sweden)

    Fambirai Takawira

    2010-10-01

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

  17. Shanidar 3 Neandertal rib puncture wound and paleolithic weaponry.

    Science.gov (United States)

    Churchill, Steven E; Franciscus, Robert G; McKean-Peraza, Hilary A; Daniel, Julie A; Warren, Brittany R

    2009-08-01

    Since its discovery and initial description in the 1960s, the penetrating lesion to the left ninth rib of the Shanidar 3 Neandertal has been a focus for discussion about interpersonal violence and weapon technology in the Middle Paleolithic. Recent experimental studies using lithic points on animal targets suggest that aspects of weapon system dynamics can be inferred from the form of the bony lesions they produce. Thus, to better understand the circumstances surrounding the traumatic injury suffered by Shanidar 3, we conducted controlled stabbing experiments with replicas of Mousterian and Levallois points directed against the thoraces of pig carcasses. Stabs were conducted under both high and low kinetic energy conditions, in an effort to replicate the usual impact forces associated with thrusting spear vs. long-range projectile weapon systems, respectively. Analysis of the lesions produced in the pig ribs, along with examination of goat ribs subjected primarily to high kinetic energy stabs from an independent experiment, revealed consistent differences in damage patterns between the two conditions. In the case of Shanidar 3, the lack of major involvement of more than one rib, the lack of fracturing of the affected and adjacent ribs, and the lack of bony defects associated with the lesion (such as wastage, hinging, and radiating fracture lines) suggests that the weapon that wounded him was carrying relatively low kinetic energy. While accidental injury or attack with a thrusting spear or knife cannot absolutely be ruled out, the position, angulation, and morphology of the lesion is most consistent with injury by a low-mass, low-kinetic energy projectile weapon. Given the potential temporal overlap of Shanidar 3 with early modern humans in western Asia, and the possibility that the latter were armed with projectile weapon systems, this case carries more than simple paleoforensic interest.

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

    Science.gov (United States)

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

    2010-10-01

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

  19. Smart Chips for Smart Surroundings - 4S

    NARCIS (Netherlands)

    Schuler, Eberhard; König, Ralf; Becker, Jürgen; Rauwerda, Gerard; Burgwal, van de Marcel; Smit, Gerard J.M.; Cardoso, João M.P.; Hübner, Michael

    2011-01-01

    The overall mission of the 4S project (Smart Chips for Smart Surroundings) was to define and develop efficient flexible, reconfigurable core building blocks, including the supporting tools, for future Ambient System Devices. Reconfigurability offers the needed flexibility and adaptability, it provid

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

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

    DEFF Research Database (Denmark)

    Ebbehøj, N; Borly, L; Bülow, J;

    1990-01-01

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

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

    DEFF Research Database (Denmark)

    Ebbehøj, N; Borly, L; Bülow, J;

    1990-01-01

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

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

    CERN Document Server

    Dietrich, Tim

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Gleicia Martins de Melo

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

  6. The Interstellar Cloud Surrounding the Solar System

    Science.gov (United States)

    Frisch, P. C.

    Ultraviolet spectral data of nearby stars indicate that the cloud surrounding the solar system has an average neutral density n(HI)~0.1 cm-3, temperature ~6800 K, and turbulence ~1.7 km/s. Comparisons between the anomalous cosmic ray data and ultraviolet data suggest that the electron density is in the range n(e-)~0.22 to 0.44 cm-3. This cloud is flowing past the Sun from a position centered in the Norma-Lupis region. The cloud properties are consistent with interstellar gas which originated as material evaporated from the surfaces of embedded clouds in the Scorpius-Centaurus Association, and which was then displaced towards the Sun by a supernova event about 4 Myrs ago. The Sun and surrounding cloud velocities are nearly perpendicular in space, and this cloud is sweeping past the Sun. The morphology of this cloud can be reconstructed by assuming that the cloud moves in a direction parallel to the surface normal. With this assumption, the Sun entered the surrounding cloud 2000 to 8000 years ago, and is now about 0.05 to 0.16 pc from the cloud surface. Prior to its recent entry into the surrounding cloud complex, the Sun was embedded in a region of space with average density lower than 0.0002 cm-3. If a denser cloud velocity component seen towards alpha Cen A,B is real, it will encounter the solar system within 50,000 yr. The nearby magnetic field seen upwind has a spatial orientation that is parallel to the cloud surface. The nearby star Sirius is viewed through the wake of the solar system, but this direction also samples the hypothetical cloud interface. Comparisons of anomalous cosmic ray and interstellar absorption line data suggest that trace elements in the surrounding cloud are in ionization equilibrium. Data towards nearby white dwarfs indicate partial helium ionization, N(N(HI)(/N(HeI)>~13.7, which is consistent with pickup ion data within the solar system if less than 40% hydrogen ionization occurs in the heliopause region. However, the white dwarfs may

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

    OpenAIRE

    Archer, B D

    1993-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Wang Tianshan

    2006-02-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Kwan Leung Chia; Rainer Viktor Haberberger

    2016-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

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

    Science.gov (United States)

    Lau, T N; Kinney, T B

    2001-05-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1985-06-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Saltzmann, J.; Probst, P.

    1987-02-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张曼

    2002-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Efimenko А. А.

    2010-08-01

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

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

    Science.gov (United States)

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

    2016-10-15

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

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

    Directory of Open Access Journals (Sweden)

    Fabrice Colin

    2010-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    OpenAIRE

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    CERN Document Server

    Pound, Adam

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Vandersall, K S; Chidester, S K; Forbes, J W; Garcia, F; Greenwood, D W; Switzer, L L; Tarver, C M

    2002-06-28

    The Steven test and associated modeling has greatly increased the fundamental knowledge of practical predictions of impact safety hazards for confined and unconfined explosive charges. Building on a database of initial work, experimental and modeling studies of crush, puncture, and perforation scenarios were investigated using the Steven impact test. The descriptions of crush, puncture, and perforation arose from safety scenarios represented by projectile designs that ''crush'' the energetic material or either ''puncture'' with a pinpoint nose or ''perforate'' the front cover with a transportation hook. As desired, these scenarios offer different aspects of the known mechanisms that control ignition: friction, shear and strain. Studies of aged and previously damaged HMX-based high explosives included the use of embedded carbon foil and carbon resistor gauges, high-speed cameras, and blast wave gauges to determine the pressure histories, time required for an explosive reaction, and the relative violence of those reactions, respectively. Various ignition processes were modeled as the initial reaction rate expression in the Ignition and Growth reaction rate equations. Good agreement with measured threshold velocities, pressure histories, and times to reaction was calculated for LX-04 impacted by several projectile geometries using a compression dependent ignition term and an elastic-plastic model with a reasonable yield strength for impact strain rates.

  5. A-scan ultrasound system for real-time puncture safety assessment during percutaneous nephrolithotomy

    Science.gov (United States)

    Rodrigues, Pedro L.; Rodrigues, Nuno F.; Fonseca, Jaime C.; von Krüger, M. A.; Pereira, W. C. A.; Vilaça, João. L.

    2015-03-01

    Background: Kidney stone is a major universal health problem, affecting 10% of the population worldwide. Percutaneous nephrolithotomy is a first-line and established procedure for disintegration and removal of renal stones. Its surgical success depends on the precise needle puncture of renal calyces, which remains the most challenging task for surgeons. This work describes and tests a new ultrasound based system to alert the surgeon when undesirable anatomical structures are in between the puncture path defined through a tracked needle. Methods: Two circular ultrasound transducers were built with a single 3.3-MHz piezoelectric ceramic PZT SN8, 25.4 mm of radius and resin-epoxy matching and backing layers. One matching layer was designed with a concave curvature to work as an acoustic lens with long focusing. The A-scan signals were filtered and processed to automatically detect reflected echoes. Results: The transducers were mapped in water tank and tested in a study involving 45 phantoms. Each phantom mimics different needle insertion trajectories with a percutaneous path length between 80 and 150 mm. Results showed that the beam cross-sectional area oscillates around the ceramics radius and it was possible to automatically detect echo signals in phantoms with length higher than 80 mm. Conclusions: This new solution may alert the surgeon about anatomical tissues changes during needle insertion, which may decrease the need of X-Ray radiation exposure and ultrasound image evaluation during percutaneous puncture.

  6. Efficacy of the Valsalva Maneuver on Needle Projection Pain and Hemodynamic Responses During Spinal Puncture

    Directory of Open Access Journals (Sweden)

    Sussan Soltani Mohammadi, Amin Ghasemi Pajand, Gita Shoeibi

    2011-01-01

    Full Text Available This study evaluated the efficacy of the valsalva maneuver that can induce baroreceptor activation and nociception, on needle projection pain and hemodynamic responses associated with spinal puncture. Ninety adults, ASA physical status I and II undergoing elective surgeries were included. Patients were randomized into three equal groups. Group I (C: control; Group II (B: ball; pressed a rubber ball (attention-diverting method; Group III (V: valsalva; blew into sphygmomanometer tubing and hold the mercury column up to 30 mm Hg for a period of at least 20s. Spinal needle projection pain was graded using numeric rating scale (NRS: 1-10, where scales of 1-3 were rated as mild, 4-6 as moderate, and > 6 as severe. Blood pressure and heart rate, five minutes before the procedure, during the spinal puncture and first and third minutes after that, were also recorded. Significant reduction in NRS was observed in the valsalva group compared with the control and the ball groups (p=0.001. There were statistical but no significant clinical differences in mean arterial blood pressure and heart rates between the study groups (P=0.008 and P=0.016 respectively. In conclusion valsalva maneuver can decrease the skin puncture pain associated with spinal needle projection while observing hemodynamic changes.

  7. Persistent post-dural-puncture headache treated with epidural infusion of dextran.

    Science.gov (United States)

    Aldrete, J A

    1994-05-01

    A retrospective review was done on medical records of 13 patients with persistent post-dural-puncture headaches after one or more epidural blood patches. Headache occurred in nine patients with post-laminectomy syndrome after "wet taps" while performing epidural blocks. In two patients post-dural-puncture headache appeared after long term implanted intrathecal catheters were removed. In two other cases headache developed after spinal anesthesia. Treatment included bed rest, intravenous hydration and at least one epidural blood patch; three patients were given 60 milliliters of epidural saline, without success. Eight epidural catheters were inserted through the lumbar access and five through the caudal approach. Initially, a bolus of 20 milliliters of dextran-40 was given followed by an infusion of 3 mL/hr, until 12 hours after the head pain and any other related symptoms subsided. In all patients the headache disappeared within 20 hours after initiating therapy (9.55 mean hours, SD +/- 0.79). In five patients headache ceased in less than five hours. Nausea and photo-phobia subsided earlier. Patients with post-dural-puncture headache resistant to other treatments, including at least one epidural blood patch, were successfully treated by a bolus followed by continuous epidural infusion of dextran-40.

  8. Correlation of Descriptive Analysis and Instrumental Puncture Testing of Watermelon Cultivars.

    Science.gov (United States)

    Shiu, J W; Slaughter, D C; Boyden, L E; Barrett, D M

    2016-06-01

    The textural properties of 5 seedless watermelon cultivars were assessed by descriptive analysis and the standard puncture test using a hollow probe with increased shearing properties. The use of descriptive analysis methodology was an effective means of quantifying watermelon sensory texture profiles for characterizing specific cultivars' characteristics. Of the 10 cultivars screened, 71% of the variation in the sensory attributes was measured using the 1st 2 principal components. Pairwise correlation of the hollow puncture probe and sensory parameters determined that initial slope, maximum force, and work after maximum force measurements all correlated well to the sensory attributes crisp and firm. These findings confirm that maximum force correlates well with not only firmness in watermelon, but crispness as well. The initial slope parameter also captures the sensory crispness of watermelon, but is not as practical to measure in the field as maximum force. The work after maximum force parameter is thought to reflect cellular arrangement and membrane integrity that in turn impact sensory firmness and crispness. Watermelon cultivar types were correctly predicted by puncture test measurements in heart tissue 87% of the time, although descriptive analysis was correct 54% of the time.

  9. [Learning vein puncture using digital educational material in a Nursing Undergraduate Course].

    Science.gov (United States)

    da Silva, Ana Paula Scheffer Schell; Cogo, Ana Luisa Petersen

    2007-06-01

    This exploratory descriptive study aimed at assessing the performance of undergraduate students in the fourth year of the Nursing course to carry out a vein puncture technique with the support of three digital educational materials--hypertext, educational games, and simulations. The sample consisted of 37 students, who had studied the digital material in an IT laboratory and had carried out the procedure of peripheral vein puncture in training laboratory. Ten stages considered essential for the accomplishment of the procedure were observed, and an assessment form of the educational materials was analyzed. Thirty three (89.19%) subjects had never done vein puncture, and 27 (72.97%) correctly performed five or more stages of the procedure. As to visualizing and saving the educational materials in the computer, 12 (32.44%) and 15 (40.54%) students, respectively, said to have had some kind of difficulty. According to 91.90% of the students, the material aided their learning process, which demonstrates this learning tool can be explored and more frequently used.

  10. A Reinvestigation of Moving Punctured Black Holes with a New Code

    CERN Document Server

    Cao, Zhoujian; Yu, Jui-Ping

    2008-01-01

    We report on our code, in which the moving puncture method is applied and an adaptive/fixed mesh refinement is implemented, and on its preliminary performance on black hole simulations. Based on the BSSN formulation, up-to-date gauge conditions and the modifications of the formulation are also implemented and tested. In this work we present our primary results about the simulation of a single static black hole, of a moving single black hole, and of the head-on collision of a binary black hole system. For the static punctured black hole simulations, different modifications of the BSSN formulation are applied. It is demonstrated that both the currently used sets of modifications lead to a stable evolution. For cases of a moving punctured black hole with or without spin, we search for viable gauge conditions and study the effect of spin on the black hole evolution. Our results confirm previous results obtained by other research groups. In addition, we find a new gauge condition, which has not yet been adopted by...

  11. Lumbar puncture for suspected meningitis after intensive care unit admission is likely to change management.

    Science.gov (United States)

    Khasawneh, Faisal A; Smalligan, Roger D; Mohamad, Tammam N; Moughrabieh, Mohamad K; Soubani, Ayman O

    2011-02-01

    The aim of this study was to determine the outcome of lumbar punctures (LPs) in critically ill medical patients and how likely the results were to change case management. A retrospective review was conducted on the medical records of all 168 patients who underwent LP during their medical intensive care unit (MICU) admission at a university hospital during a 4.5-year period beginning in January 2000. Lumbar puncture was performed a mean of 2.8 days after MICU admission. The most common symptoms that prompted LP were changes in mental status and fever. Seventy-four percent of patients were on antibiotics at the time of LP, and 98% of patients had a computed tomography scan of the head performed before the procedure. Lumbar puncture confirmed meningitis in 47 (30%) patients and provided a specific bacteriologic diagnosis in 5 (3%) patients. The results of the procedure led to a change in management in 50 (30%) patients. The presence of meningeal signs and use of antibiotics at the time of the procedure were the factors that predicted change in management. Although the likelihood that LP will yield a specific bacteriologic diagnosis in critically ill patients is low, the procedure frequently provides important information that can lead to a change in case management, most commonly de-escalation of antibiotic therapy.

  12. Clinical observation of Ahmed glaucoma valve implantation for refractory glaucoma by directly puncturing the sclerotic tunnel

    Directory of Open Access Journals (Sweden)

    Zhi-Ke Xu

    2015-02-01

    Full Text Available AIM: To observe the clinic effects and complication of Ahmed glaucoma valve(AGVimplantation in refractory glaucoma by using the 23G syringe needle direct puncture the sclerotic tunnel.METHODS: Forty-four cases(44 eyesof refractory glaucoma underwent AGV implantation by useing the 23G syringe needle direct puncture the sclerotic tunnel. The intraocular pressure(IOP, visual acuity, and complication of post-operation were contrasted with those of pre-operation. RESULTS:The success rate was 84.1%, the mean preoperative IOP in research group was 52.1±10.1mmHg, and the last follow up mean IOP was 15.6±6.9mmHg. Compared with the preoperative visual acuity, 11 eyes increased, 27 eyes had no changes and 6 eyes decreased. The main post-operative complications included shallow anterior chamber(4 eyes, choroidal detachment(3 eyes, drainage tube shift(1 eye, hyphema(6 eyes, drainage tube blockage(1 eye, expulsive choroidal hemorrhage(1 eye, and fiber wrap of drainage tray(5 eyes.CONCLUSION: AGV implantation by direct puncture the sclerotic tunnel is feasible and easy. It avoids of making sclerotic petal and the xenogenic sclera transplanting, simplified the operation technique, prevent the leakage of around tube. The shallow anterior chamber rate is lower. It is an effective procedure for refractory glaucoma.

  13. EVALUATION ON THE THERAPEUTIC EFFECT OF DEEP PUNCTURE OF TIANSHU (ST 25) FOR SLOW TRANSIT CONSTIPATION

    Institute of Scientific and Technical Information of China (English)

    ZHANG Wei; LIU Zhi-shun; GUO Jun

    2005-01-01

    Objective: To evaluate the short-term and middle-long-term therapeutic effects of deep puncture of Tianshu (天枢ST 25) for slow transit constipation (STC). Methods: Sixty cases of STC patients were evenly randomized into acupuncture group and medication group. In acupuncture group, electroacupuncture (EA, 20 Hz, continuous waves and tolerable strength) was applied to bilateral Tianshu (ST 25) for 30 min after deep puncture. The treatment was given once daily, 5 sessions every week, two weeks altogether. Patients of control group were ordered to take Lactulose (10 mL/time, b.i.d), two weeks altogether. Cleveland Constipation Score (CCS) and colonic transit time (CCT) were used to evaluate the therapeutic effect. Results: After treatment, both CCS and CCT showed that the therapeutic effect of acupuncture group was significantly superior to that of medication group (P<0.05). Six-months' follow up showed that the therapeutic effect of acupuncture still maintained in 13 of the 22 cases visited, while that of control group only maintained in 1 of the 19 cases. Conclusion: The therapeutic effect of deep puncture of Tianshu (ST 25) for STC is definite and has a middle-long-term effect. The patients have no any unfavorable reactions.

  14. Direct carotid artery puncture access for endovascular treatment of acute ischemic stroke: technical aspects, advantages, and limitations.

    Science.gov (United States)

    Mokin, Maxim; Snyder, Kenneth V; Levy, Elad I; Hopkins, L Nelson; Siddiqui, Adnan H

    2015-02-01

    Challenging anatomy for carotid artery access can result in a delay to achieve successful recanalization in patients with acute ischemic stroke. Our objective was to study emergent direct percutaneous carotid artery puncture as an alternative access approach for acute endovascular stroke interventions. We reviewed cases of acute ischemic stroke in which direct carotid artery puncture was used for access. We also reviewed current literature relevant to this subject. We describe the technical aspects, limits, and potential complications associated with direct carotid artery puncture for intracranial acute ischemic stroke interventions, and present cases to illustrate the utility of this access approach. Direct carotid artery puncture is a feasible alternative to transfemoral artery access in cases of stroke with difficult anatomy, including unfavorable arch type, carotid tortuosity, or an ostial lesion. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Persistent Confusion and Controversy Surrounding Gene Patents

    Science.gov (United States)

    Guerrini, Christi J.; Majumder, Mary A.; McGuire, Amy L.

    2016-01-01

    There is persistent confusion and controversy surrounding basic issues of patent law relevant to the genomics industry. Uncertainty and conflict can lead to the adoption of inefficient practices and exposure to liability. The development of patent-specific educational resources for industry members, as well as the prompt resolution of patentability rules unsettled by recent U.S. Supreme Court decisions, are therefore urgently needed. PMID:26849516

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

    Directory of Open Access Journals (Sweden)

    Gentle Sunder Shrestha

    2015-01-01

    Full Text Available Meningitis and encephalitis are the neurological emergencies. As the clinical findings lack specificity, once suspected, cerebrospinal fluid (CSF analysis should be performed and parenteral antimicrobials should be administered without delay. Lumbar puncture can be technically challenging in patients with ankylosing spondylitis due to ossification of ligaments and obliteration of interspinous spaces. Here, we present a case of ankylosing spondylitis where attempts for lumbar puncture by conventional approach failed. CSF sample was successfully obtained by Taylor′s approach.

  17. A technique for ultrasound-guided blood sampling from a dry and gel-free puncture area.

    Science.gov (United States)

    Thorn, Sofie; Gopalasingam, Nigopan; Bendtsen, Thomas Fichtner; Knudsen, Lars; Sloth, Erik

    2016-05-07

    Vein punctures are performed daily to sample blood. Ultrasound (US) offers an alternative to the blind landmark technique for difficult vascular access. A challenge for this procedure is the presence of US gel in the puncture area. We present a technique for US-guided puncture from extremity veins not palpable or visible to the human eye, while keeping the puncture area dry and gel-free. Ten healthy volunteers underwent two US-guided vein punctures from veins that were neither palpable nor visible. One was drawn from an antebrachial vein and another from a brachial vein. A sterile barrier drape was made from a commercially available dressing and a piece of transparent sterile plastic. The barrier drape consists of an adhesive part placed on the skin designed for sonography and a free transparent flap constituting the barrier between the unsterile sonographic site and the sterile gel-free puncture site. The success rate for vein puncture was 100% in both locations. A total of 22 skin punctures were performed (11 antebrachial and 11 brachial). Gain output was increased 7% (4-12%), and 8% (4-15%), respectively, to compensate for attenuation of the US signal due to the drape. Alignment of the centre of the transducer with the long-axis of the target vein during the procedure was reported as a challenge. US-guided blood sampling from a brachial and antebrachial vein was possible with a 100% success rate, while ensuring a dry and gel-free venipuncture area on one side and the transducer on the other side of a sterile barrier.

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

    Energy Technology Data Exchange (ETDEWEB)

    Bienfait, H.P. [Gelre Hospital, location Lukas, Apeldoorn, Department of Neurology, Albert Schweitzerlaan 31, PO Box 9014, 7300 DS Apeldoorn (Netherlands); Department of Neuro-Oncology, Daniel den Hoed Kliniek, Academisch Ziekenhuis Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands); Gijtenbeek, J.M.M. [Department of Neuro-Oncology, Daniel den Hoed Kliniek, Academisch Ziekenhuis Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands); Department of Neurology, University Medical Center Nijmegen, St Radboud, Postlaan 4, 6525 GC Nijmegen (Netherlands); Bent, M.J. van [Department of Neuro-Oncology, Daniel den Hoed Kliniek, Academisch Ziekenhuis Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands); Bruin, H.G. de [Department of Radiology, Daniel den Hoed Kliniek, Academisch Ziekenhuis Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands); Voogt, P.J. [Department of Hematology, Daniel den Hoed Kliniek, Academisch Ziekenhuis Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands); Pillay, M. [Department of Nuclear Medicine, Daniel den Hoed Kliniek, Academisch Ziekenhuis Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands)

    2002-11-01

    We report a patient treated for small lymphocytic lymphoma/leukemia with cerebral venous and sinus thrombosis (CVST) after lumbar puncture with intrathecal administration of methotrexate (MTX). He also developed a cerebrospinal fluid flow block. This is the first report of an association between lumbar puncture and intrathecally administered MTX and the development of CVST. Intrathecal treatment in this patient was discontinued and he was successfully treated with high-dose low-molecular-weight heparin subcutaneously. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Adiningsih Srilestari

    2017-05-01

    Full Text Available Background: Impaired wound healing is a common complication of diabetes. It has complex pathophysiologic mechanisms and often necessitates amputation. Our study aimed to evaluate the effectiveness of combined laser-puncture and conventional wound care in the treatment of diabetic foot ulcers.Methods: This was a double-blind controlled randomized clinical trial on 36 patients, conducted at the Metabolic Endocrine Outpatient Clinic, Cipto Mangunkusumo Hospital, Jakarta, between May and August 2015. Stimulation by laser-puncture (the treatment group or sham stimulation (the control group were performed on top of the standard wound care. Laser-puncture or sham were done on several acupuncture points i.e. LI4 Hegu, ST36 Zusanli, SP6 Sanyinjiao and KI3 Taixi bilaterally, combined with irradiation on the ulcers itself twice a week for four weeks. The mean reduction in ulcer sizes (week 2–1, week 3–1, week 4–1 were measured every week and compared between the two groups and analyzed by Mann-Whitney test.Results: The initial median ulcer size were 4.75 (0.10–9.94 cm2 and 2.33 (0.90–9.88 cm2 in laser-puncture and sham groups, respectively (p=0.027. The median reduction of ulcer size at week 2–1 was -1.079 (-3.25 to -0.09 vs -0.36 (-0.81 to -1.47 cm2, (p=0.000; at week 3–1 was -1.70 (-3.15 to -0.01 vs -0.36 (-0.80 to -0.28 cm2, (p=0.000; and at week 4–1 was -1.22 (-2.72 to 0.00 vs -0.38 (-0.74 to -0.57 cm2, (p=0.012.Conclusion: Combined laser-puncture and conventional wound care treatment are effective in accelerating the healing of diabetic foot ulcer.

  20. A Kinect(™) camera based navigation system for percutaneous abdominal puncture.

    Science.gov (United States)

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

    2016-08-07

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

  1. Identification of -SiC surrounded by relatable surrounding diamond medium using weak Raman surface phonons

    Indian Academy of Sciences (India)

    Mohan Kumar Kuntumalla; Harish Ojha; Vadali Venkata Satya Siva Srikanth

    2013-11-01

    It is difficult to detect -SiC using micro-Raman scattering, if it is surrounded by carbon medium. Here, -SiC is identified in the presence of a relatable surrounding diamond medium using subtle, but discernible Raman surface phonons. In this study, diamond/-SiC nanocomposite thin film system is considered in which nanosized -SiC crystallites are surrounded by a relatable nanodiamond medium that leads to the appearance of a weak Raman surface phonon band at about 855 cm-1. Change in the nature of the surrounding material structure and its volume content when relatable, will affect the resultant Raman response of -SiC phase as seen in the present case of diamond/-SiC nanocomposite thin films.

  2. Explaining preferences for home surroundings and locations

    DEFF Research Database (Denmark)

    Andersen, Hans Skifter

    2011-01-01

    : avoiding social nuisances, preferring social homogeneity and living close to one’s social network and place of origin. The study shows that most people have many detailed preferences, whereas some have very few. This confirms an earlier theory that some people are very connected to certain places...... with given characteristics and thus do not have priorities regarding home surroundings and locations. For others, mostly young people and singles, home is just a place to sleep and relax, whereas life is lived elsewhere. For this group, there are only preferences for location and there are few specific...

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

    Energy Technology Data Exchange (ETDEWEB)

    Turan, Burak, E-mail: drburakturan@gmail.com; Daşlı, Tolga; Erkol, Ayhan; Erden, İsmail

    2015-10-15

    Aim: Sublingual (SL) nitroglycerin administered before radial artery puncture can improve cannulation success and decrease the incidence of radial artery spasm (RAS) compared with intra-arterial (IA) nitroglycerin in transradial procedures. Methods: Patients undergoing diagnostic transradial angiography were randomized to IA (200 mcg) or SL (400 mcg) nitroglycerin. Primary endpoints were puncture time and puncture attempts. Secondary endpoint was the incidence of RAS. Results: Total of 101 participants (mean age 60 ± 11 years, 53% male) were randomized (51 in IA and 50 in SL groups). Puncture time (50 [36–75] vs 50 [35–90] sec), puncture attempts (1.18 ± 0.48 vs 1.20 ± 0.49), multiple punctures (13.7 vs 16.0%) and RAS (19.6 vs 24.0%) were not statistically different between IA vs SL groups respectively. A composite endpoint of all adverse events related to transradial angiography (multiple punctures, RAS, access site crossover, hypotension/bradycardia associated with nitroglycerin and radial artery occlusion) was very similar in IA vs SL groups (39 vs 40%, respectively). However puncture time was significantly longer with SL nitroglycerin in patients < 1.65 m height (47 [36–66] vs 63 [41–110] sec, p = 0.042). Multiple punctures seemed higher with SL nitroglycerin in patients with diabetes (0 vs 30%, p = 0.028) or in patients < 1.65 m height (7.4 vs 25%, p = 0.085). Likewise, RAS with SL nitroglycerin seemed more frequent in smokers compared to IA nitroglycerin (0 vs 27%, p = 0.089). Conclusions: SL nitroglycerin was not different from IA nitroglycerin in terms of efficiency and safety in overall study population. However it may be inferior to IA nitroglycerin in certain subgroups (shorter individuals, diabetics and smokers). - Highlights: • Improvement in radial artery puncture time and success with subcutaneous nitrate was reported. • Giving nitrate sublingually may have vasodilation along entire length of radial artery and may prevent RAS

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

    Science.gov (United States)

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

    2016-12-14

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

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

    Directory of Open Access Journals (Sweden)

    Shervin Farahmand

    2017-02-01

    Full Text Available Arterial blood gas (ABG sampling is a painful procedure with no perfect technique for quelling the discomfort. An ideal local anesthesia should be rapid, easy to learn, inexpensive, and noninvasive. This study was aimed to compare pain levels from ABG sampling performed with vapocoolant spray in comparison to placebo. We hypothesized that pretreatment with the vapocoolant would reduce the pain of arterial puncture by at least 1 point on a 10 point verbal numeric scale. We have evaluated the effectiveness of a vapocoolant spray in achieving satisfactory pain control in patients undergoing ABG sampling in this randomized placebo controlled trial. Eighty patients were randomized to 2 groups: group A, who received vapocoolant spray, and group B, who received water spray as placebo (Control group. Puncture and spray application pain was assessed with numerical rating scale (0, the absence of pain; 10, greatest imaginable pain and number of attempts was recorded. The pain score during ABG sampling was not lower in group A compared with group B significantly (4.78±1.761 vs. 4.90±1.837; P:0.945. This study showed that while the spray exerts more application pain, the number of attempts required for ABG sampling was not significantly lower in group A compared with group B (1.38±0.54 vs. 1.53±0.68; P=0.372. Vapocoolant spray was not effective in ABG pain reduction, had milder application pain compared to placebo (P<0.05, but did not reduce sampling attempts. At present, this spray cannot be recommended for arterial puncture anesthesia, and further study on different timing is necessary.

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

    Directory of Open Access Journals (Sweden)

    Stefka Mantarova

    2015-09-01

    Full Text Available Background: The post-dural puncture headache (PDPH is the most common complication of lumbar puncture in neurological practice. Although the comorbidity of headache and psychiatric symptoms is well-recognized, the data about the relationship between PDPH and symptoms of anxiety and depression are limited. The aim of the present study was to determine the influence of anxiety symptoms on the risk for PDPH. Methods: Diagnostic lumbar puncture was performed to thirty-nine neurological patients, presented by 26 women and 13 men. All subjects completed the Hospital Anxiety and Depression Scale (HADS before the procedure. Information about the clinical characteristic of the headache - quality, location, severity, postural nature, duration and associated symptoms (nausea, vomiting, and tinnitus was collected. Results: Fifteen of the patients (38,5% developed PDPH. According to the presence of PDPH the patients were divided into two groups – with (group 1 and without headache (group 2. Women with headache were significantly younger (mean age 34,00±11,22 years compared to females in group 2 (mean age 45,07±12,36 years (p=0,028. Patients in group 1 had significantly higher levels of reported anxiety symptoms compared to group 2 (p= 0,045. A significant positive correlation was observed between anxiety and PDPH (Spearman’s rho = 0,412, p=0,009. Conclusion: Younger female patients with anxiety had a considerably increased rate of PDPH. This could be of practical benefit in devising an additional treatment strategy for patients with PDPH.

  7. [Subclavian vein puncture as a primary approach for pacemaker lead implantation].

    Science.gov (United States)

    Kronski, D; Haas, H

    2001-12-01

    In the beginning of transvenous pacemaker therapy, the external or alternatively internal jugular vein was commonly used for lead implantation. Due to frequent long-term complications both approaches are nowadays obsolete. In most pacemaker centers implantation via the cephalic vein has become standard. As an alternative, in 1975 Sterz et al. introduced puncture of the subclavian vein in the Seldinger technique as an approach for lead implantation. At this time, the commonly used introducers of pacemaker leads had to be cut for removal. No earlier than 1980 "peel away" introducers were commercially available. Since then, we consequently use this technique for implantation of single or dual chamber pacemaker devices. In the course of the last seven years merely 1.5-2% of implantations were performed via the cephalic vein; no jugular vein approach was performed. Due to a routinely performed subclavian vein puncture, we were able to optimize the procedure, proven by an enormous reduction in implantation time (local anesthesia - skin closure), x-ray time and complication rate. In the year 2000 we performed 52 implantations of a single chamber device with an average fluoroscopy time of 1.5 (0.3-9.3) minutes, radiation dose of 4.5 (0.1-47) Gycm(2) and implantation time of 17.6 (8-40) minutes and 144 implantations of a dual chamber device with an average fluoroscopy time of 2.86 (0.7-6.6) minutes, radiation dose of 8.31 (0.7-28) Gycm(2) and implantation time of 21.25 (10-45) minutes. Complications were rare, clinically irrelevant arterial punctures. Neither nerval damage nor pneumothoraces with the necessity for chest tube placement were seen in the above mentioned time frame. No early or late thrombosis of the subclavian vein was encountered.    The primary subclavian vein approach led to an enormous reduction in overall procedure time without significant morbidity.

  8. Puncture initial data for black-hole binaries with high spins and high boosts

    Science.gov (United States)

    Ruchlin, Ian; Healy, James; Lousto, Carlos O.; Zlochower, Yosef

    2017-01-01

    We solve the Hamiltonian and momentum constraints of general relativity for two black holes with nearly extremal spins and relativistic boosts in the puncture formalism. We use a non-conformally-flat ansatz with an attenuated superposition of two Lorentz-boosted, conformally Kerr or conformally Schwarzschild 3-metrics and their corresponding extrinsic curvatures. We compare evolutions of these data with the standard Bowen-York conformally flat ansatz (technically limited to intrinsic spins χ =S /MADM2=0.928 and boosts P /MADM=0.897 ), finding, typically, an order of magnitude smaller burst of spurious radiation and agreement with inspiral and merger. As a first case study, we evolve two equal-mass black holes from rest with an initial separation of d =12 M and spins χi=Si/mi2=0.99 , compute the waveforms produced by the collision, the energy and angular momentum radiated, and the recoil of the final remnant black hole. We find that the black-hole trajectories curve at close separations, leading to the radiation of angular momentum. We also study orbiting nonspinning and moderate-spin black-hole binaries and compare these with standard Bowen-York data. We find a substantial reduction in the nonphysical initial burst of radiation which leads to cleaner waveforms. Finally, we study the case of orbiting binary black-hole systems with spin magnitude χi=0.95 in an aligned configuration and compare waveform and final remnant results with those of the SXS Collaboration [54 A. H. Mroue et al., Phys. Rev. Lett. 111, 241104 (2013)., 10.1103/PhysRevLett.111.241104], finding excellent agreement. This represents the first moving puncture evolution of orbiting and spinning black holes exceeding the Bowen-York limit. Finally, we study different choices of the initial lapse and lapse evolution equation in the moving puncture approach to improve the accuracy and efficiency of the simulations.

  9. Effects of Supportive Educational Program on Anxiety of Mothers of Children Undergoing the Lumbar Puncture (LP

    Directory of Open Access Journals (Sweden)

    Mousa Mahdizadeh

    2016-07-01

    Full Text Available Background: Lumbar Puncture test is one of the most stressful diagnostic procedures in pediatric ward that its prescription put mothers under extreme pressure. There are limited interventions in this regard. Aim: determining the impact of supportive educational program on the anxiety of mothers whose children are undergoing lumbar puncture (LP. Method: the present study is a randomized controlled clinical trial carried out in 2015. Sixty mothers of children undergoing lumbar puncture and hospitalized 3educational hospitals of Mashhad, Iran, were randomly divided to control group (n=30 and intervention group (n=30. The intervention group received supportive program during a session of 60 min. Spielberger State-Trait Anxiety Inventory (STAI was selected as the research tool. Finally, data were analyzed by Chi-square test, independent t-test using SPSS v.16 software. Results: The mean age of the mothers was 27.3±5.3 and 26.0±3.1, respectively. The mean pre-interventions maternal manifest anxiety was 51.9±6.2 and 53.4±4.3 out of 80, respectively, in the intervention and control groups. The mean post-interventions maternal manifest anxiety was 44.9±5.1 and 52.7±4.2, respectively, in the intervention and control groups. According to the results of independent t-test, significant difference was observed statistically for the mean maternal manifest anxiety between the two groups (p> 0.001. Implications for Practice: Regarding the reduction of maternal anxiety in the intervention group, which is possible because of the attention to the emotional needs of mothers, in addition to proper training; this program can be considered as an effective method to reduce maternal anxiety before the LP test.

  10. Acute forearm compartment syndrome following haemodialysis access fistula puncture in uraemia.

    Science.gov (United States)

    Lin, Chin-Ta; Dai, Niann-Tzyy; Chen, Shyi-Gen; Chang, Shun-Cheng

    2016-10-01

    Acute compartment syndrome is a well-described surgical emergency that requires immediate diagnosis and operative intervention. Vascular access-associated compartment syndrome is rarely reported in haemodialysis patients. The purpose of this article is to document evidence that catheter-related puncture, which results in arteriovenous fistula injury in uraemia, may cause acute forearm compartment syndrome. Between September 2007 and September 2012, five consecutive patients presented to our section with tense swollen forearms with skin blistering, decreased hand sensation and reduced capillary return in the fingers. Their ages ranged from 65 to 81 years (mean 72.8 years). All of the patients underwent emergent exploration after the diagnosis of acute forearm compartment syndrome. The patients' details were reviewed. The time interval between dialysis completion and return to the emergency department ranged from 6 to 9 h (mean 7.4 h). During operation, the bleeding was found to originate from the site of the fistula puncture and was repaired with 9-0 nylon suture under microscopy. After adequate wound care, a reconstructive procedure with a split-thickness skin graft was performed in all of the five patients. There was no vascular or neurological deficit of the forearm or hand within the mean follow-up period of 14.8 months (range 12-18 months). In this series, we report five cases of forearm compartment syndrome in uraemia, secondary to bleeding from a catheter-related puncture of a haemodialysis access fistula. However, there is no case series that focuses upon this specific topic in the present literature. This problem deserves more attention. © 2014 Royal Australasian College of Surgeons.

  11. Septic diseases associated with the hoof complex: abscesses, punctures wounds, and infection of the lateral cartilage.

    Science.gov (United States)

    Redding, W Rich; O'Grady, Stephen E

    2012-08-01

    Hoof abscesses are probably the most common cause of acute severe lameness in horses encountered by veterinarians and farriers. Most affected horses show sudden, severe (acute) lameness; the degree of lameness varies from being subtle in the early stages to non-weight bearing. There is still debate between the veterinary and farrier professions as to who should treat a hoof abscess and the best method to resolve the abscess. Puncture wounds to the sole of the foot can introduce bacteria and debris to the solar surface of the distal phalanx and produce a fracture or a septic pedal osteitis. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Quasi-circular orbits of conformal thin-sandwich puncture binary black holes

    CERN Document Server

    Hannam, M D

    2005-01-01

    I construct initial data for equal-mass irrotational binary black holes using the conformal thin-sandwich puncture (CTSP) approach. I locate quasi-circular orbits using the effective-potential method, and estimate the location of the innermost stable circular orbit (ISCO). The ISCO prediction is consistent with results for conformal thin-sandwich data produced using excision techniques. These results also show that the ISCOs predicted by the effective-potential and ADM-Komar mass-comparison methods agree for CTS data, just as they did for Bowen-York data.

  13. Therapeutical efficacy of CT-guided relief puncture in amebic liver abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Mansfeld, L.; Boitz, F.; Poehls, C.; Cimanowski, N.

    1987-09-01

    Amebic liver abscesses are the most frequent clinical manifestations of the extra-intestinal amebiasis and have to be considered as a serious complication in the course of disease. The abscesses have by their risk of rupturing and bacterial superinfection quoad vitam an unfavourable prognosis. CT-guided relief punctures can, as it is demonstrated by two cases of critical amebic abscesses, effectively improve the therapy with systemic amebicides, prevent imminent rupture and contribute to the healing of the abscesses. Thus a surgical treatment of the abscess was not necessary.

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

    Science.gov (United States)

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

    2016-08-01

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

  15. [Use of individual protection equipment among nursing workers injured by puncture-cutting tools].

    Science.gov (United States)

    Sarquis, L M; Felli, V E

    2000-01-01

    The present study analyzed work related accidents involving nursing personnel from a public hospital in the state of São Paulo. The study population comprised the entire nursing staff. The results obtained showed a high incidence of accidents with puncture-cutting instruments, particularly among the auxilliary nursing staff, which indicates that these workers don't often use individual protection equipment, even when it is made available at the work place. Due to the manipulation of sharp instruments, nursing personnel are especially vulnerable to suffer biological risks and serious diseases. These results indicate the need to prevent the occurrence of such accidents.

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

    Directory of Open Access Journals (Sweden)

    Gita Nath

    2011-01-01

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

  17. Haemostasis and Safety Measures before Lumbar Puncture in the Haematology Ward

    DEFF Research Database (Denmark)

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

    2015-01-01

    : An online survey with questions pertaining to precautions of haemostasis and application of fundoscopy was sent by e-mail to all 12 haematology wards in Denmark. RESULTS: Eleven sites participated. Five (45%) reported no pausation of antiplatelet drugs at all. The mean platelet limit prior to lumbar...... puncture was 50 × 10(9)/l (range 10-50 × 10(9)/l). Seven (64%) sites had an international normalised ratio limit of 1.5, and the remaining 4 had values between 1.0 and 2.5. Two (18%) reported occasional use of thromboelastography or platelet analysis to assess the bleeding risk. Fundoscopy is routinely...

  18. Characterizing the Microenvironment Surrounding Phosphorylated Protein Sites

    Institute of Scientific and Technical Information of China (English)

    Shi-Cai Fan; Xue-Gong Zhang

    2005-01-01

    Protein phosphorylation plays an important role in various cellular processes. Due to its high complexity, the mechanism needs to be further studied. In the last few years, many methods have been contributed to this field, but almost all of them investigated the mechanism based on protein sequences around protein sites. In this study, we implement an exploration by characterizing the microenvironment surrounding phosphorylated protein sites with a modified shell model, and obtain some significant properties by the rank-sum test, such as the lack of some classes of residues, atoms, and secondary structures. Furthermore, we find that the depletion of some properties affects protein phosphorylation remarkably. Our results suggest that it is a meaningful direction to explore the mechanism of protein phosphorylation from microenvironment and we expect further findings along with the increasing size of phosphorylation and protein structure data.

  19. Opportunity's Surroundings After Sol 1820 Drive

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this full-circle view of the rover's surroundings during the 1,820th to 1,822nd Martian days, or sols, of Opportunity's surface mission (March 7 to 9, 2009). South is at the center; north at both ends. The rover had driven 20.6 meters toward the northwest on Sol 1820 before beginning to take the frames in this view. Tracks from that drive recede southwestward. For scale, the distance between the parallel wheel tracks is about 1 meter (about 40 inches). The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and small exposures of lighter-toned bedrock. This view is presented as a cylindrical projection with geometric seam correction.

  20. Exploiting Surrounding Text for Retrieving Web Images

    Directory of Open Access Journals (Sweden)

    S. A. Noah

    2008-01-01

    Full Text Available Web documents contain useful textual information that can be exploited for describing images. Research had been focused on representing images by means of its content (low level description such as color, shape and texture, little research had been directed to exploiting such textual information. The aim of this research was to systematically exploit the textual content of HTML documents for automatically indexing and ranking of images embedded in web documents. A heuristic approach for locating and assigning weight surrounding web images and a modified tf.idf weighting scheme was proposed. Precision-recall measures of evaluation had been conducted for ten queries and promising results had been achieved. The proposed approach showed slightly better precision measure as compared to a popular search engine with an average of 0.63 and 0.55 relative precision measures respectively.

  1. Topical analgesia treats pain and decreases propofol use during lumbar punctures in a randomized pediatric leukemia trial.

    Science.gov (United States)

    Whitlow, Puja G; Saboda, Kathylynn; Roe, Denise J; Bazzell, Susan; Wilson, Cera

    2015-01-01

    Lumbar punctures are frequently performed in pediatric leukemia for central nervous system leukemic prophylaxis. The contribution of local anesthetic with deep sedation is unknown. The objective was to evaluate EMLA (eutectic mixture of local anesthetics) cream as a pain reliever in conjunction with propofol in the setting of routine lumbar punctures. We included patients with acute lymphoblastic leukemia aged 3-21 years requiring at least two routine lumbar punctures. Patients were randomly assigned to receive EMLA or placebo cream and the alternate treatment with the second procedure. Patients, personnel and outcome assessors were blinded to allocation. The primary outcome included three indirect measures of pain: total median propofol doses, patient movement and heart rate changes at the time of skin puncture in both treatment groups. Twenty-six patients were enrolled and 25 were analyzed. With EMLA cream, 4 mg/kg (median) of propofol was required (95% CI 3.5-4.4). With placebo, 4.9 mg/kg of propofol was needed (95% CI 4.3-5.6; P = 0.008). When EMLA cream was applied, 8% of patients moved, whereas 84% moved with placebo cream (P propofol is beneficial. Topical analgesics are at the discretion of the oncologist, allowing us to advocate for patients by providing safe and efficacious pain management for lumbar punctures. © 2014 Wiley Periodicals, Inc.

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

    Science.gov (United States)

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

    2016-08-01

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

  3. Experimental model of intervertebral disc degeneration by needle puncture in Wistar rats

    Energy Technology Data Exchange (ETDEWEB)

    Issy, A.C.; Castania, V.; Castania, M. [Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Salmon, C.E.G. [Departamento de Física, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Nogueira-Barbosa, M.H. [Divisão de Radiologia, Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Bel, E. Del [Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Defino, H.L.A. [Departamento de Biomecânica, Medicina e Reabilitação do Sistema Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil)

    2013-03-15

    Animal models of intervertebral disc degeneration play an important role in clarifying the physiopathological mechanisms and testing novel therapeutic strategies. The objective of the present study is to describe a simple animal model of disc degeneration involving Wistar rats to be used for research studies. Disc degeneration was confirmed and classified by radiography, magnetic resonance and histological evaluation. Adult male Wistar rats were anesthetized and submitted to percutaneous disc puncture with a 20-gauge needle on levels 6-7 and 8-9 of the coccygeal vertebrae. The needle was inserted into the discs guided by fluoroscopy and its tip was positioned crossing the nucleus pulposus up to the contralateral annulus fibrosus, rotated 360° twice, and held for 30 s. To grade the severity of intervertebral disc degeneration, we measured the intervertebral disc height from radiographic images 7 and 30 days after the injury, and the signal intensity T2-weighted magnetic resonance imaging. Histological analysis was performed with hematoxylin-eosin and collagen fiber orientation using picrosirius red staining and polarized light microscopy. Imaging and histological score analyses revealed significant disc degeneration both 7 and 30 days after the lesion, without deaths or systemic complications. Interobserver histological evaluation showed significant agreement. There was a significant positive correlation between histological score and intervertebral disc height 7 and 30 days after the lesion. We conclude that the tail disc puncture method using Wistar rats is a simple, cost-effective and reproducible model for inducing disc degeneration.

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

    Science.gov (United States)

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

    2014-12-01

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

  5. Needle gauge and tip designs for preventing post-dural puncture headache (PDPH).

    Science.gov (United States)

    Arevalo-Rodriguez, Ingrid; Muñoz, Luis; Godoy-Casasbuenas, Natalia; Ciapponi, Agustín; Arevalo, Jimmy J; Boogaard, Sabine; Roqué I Figuls, Marta

    2017-04-07

    Post-dural puncture headache (PDPH) is one of the most common complications of diagnostic and therapeutic lumbar punctures. PDPH is defined as any headache occurring after a lumbar puncture that worsens within 15 minutes of sitting or standing and is relieved within 15 minutes of the patient lying down. Researchers have suggested many types of interventions to help prevent PDPH. It has been suggested that aspects such as needle tip and gauge can be modified to decrease the incidence of PDPH. To assess the effects of needle tip design (traumatic versus atraumatic) and diameter (gauge) on the prevention of PDPH in participants who have undergone dural puncture for diagnostic or therapeutic causes. We searched CENTRAL, MEDLINE, Embase, CINAHL and LILACS, as well as trial registries via the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal in September 2016. We adopted the MEDLINE strategy for searching the other databases. The search terms we used were a combination of thesaurus-based and free-text terms for both interventions (lumbar puncture in neurological, anaesthesia or myelography settings) and headache. We included randomized controlled trials (RCTs) conducted in any clinical/research setting where dural puncture had been used in participants of all ages and both genders, which compared different tip designs or diameters for prevention of PDPH DATA COLLECTION AND ANALYSIS: We used the standard methodological procedures expected by Cochrane. We included 70 studies in the review; 66 studies with 17,067 participants were included in the quantitative analysis. An additional 18 studies are awaiting classification and 12 are ongoing. Fifteen of the 18 studies awaiting classification mainly correspond to congress summaries published before 2010, in which the available information does not allow the complete evaluation of all their risks of bias and characteristics. Our main outcome was prevention of PDPH, but we also

  6. Experimental model of intervertebral disc degeneration by needle puncture in Wistar rats

    Directory of Open Access Journals (Sweden)

    A.C. Issy

    Full Text Available Animal models of intervertebral disc degeneration play an important role in clarifying the physiopathological mechanisms and testing novel therapeutic strategies. The objective of the present study is to describe a simple animal model of disc degeneration involving Wistar rats to be used for research studies. Disc degeneration was confirmed and classified by radiography, magnetic resonance and histological evaluation. Adult male Wistar rats were anesthetized and submitted to percutaneous disc puncture with a 20-gauge needle on levels 6-7 and 8-9 of the coccygeal vertebrae. The needle was inserted into the discs guided by fluoroscopy and its tip was positioned crossing the nucleus pulposus up to the contralateral annulus fibrosus, rotated 360° twice, and held for 30 s. To grade the severity of intervertebral disc degeneration, we measured the intervertebral disc height from radiographic images 7 and 30 days after the injury, and the signal intensity T2-weighted magnetic resonance imaging. Histological analysis was performed with hematoxylin-eosin and collagen fiber orientation using picrosirius red staining and polarized light microscopy. Imaging and histological score analyses revealed significant disc degeneration both 7 and 30 days after the lesion, without deaths or systemic complications. Interobserver histological evaluation showed significant agreement. There was a significant positive correlation between histological score and intervertebral disc height 7 and 30 days after the lesion. We conclude that the tail disc puncture method using Wistar rats is a simple, cost-effective and reproducible model for inducing disc degeneration.

  7. Time Until Neuron Death After Initial Puncture From an Amyloid-Beta Oligomer

    CERN Document Server

    Horton, Tanner

    2015-01-01

    Hardy and Higgins first proposed the amyloid cascade hypothesis in 1992, stating that the decrease in neuronal function observed in Alzheimer's Disease (AD) is due to a process initiated by the oligomerization of amyloid-beta peptides. One hypothesis states that toxicity arises from the aggregation of amyloid-beta into a pore structure, which can then puncture the brain cell membrane; this allow toxic calcium ions to flood through the opening, causing eventual cell death. In 2007, neurobiologist Ruth Nussinov calculated the three pore sizes most likely to occur within the brain. Based on her findings, we constructed a method to determine the time it takes for a cell to die after the cell is punctured by the pore. Our findings have shown that cell death occurs within one second after the oligomer makes contact with the cell. We believe this is important because instant cell death has been one criticism of Nussinov's model, and we have calculated a concrete time value for that criticism. We identify two potenti...

  8. [Unknown intracerebral tumour presenting as brainstem compression following unintentional dural puncture].

    Science.gov (United States)

    Castro-Castro, J; Figueiredo-González, O; Río-Gómez, A; Carballo-Loureiro, N; Castro-Bouzas, D

    2014-01-01

    A 36-year old primigravid of 41 weeks gestation was admitted to the labour ward. Her past medical history included hyperemesis gravidarum and migraine. An accidental dural puncture occurred during labour epidural analgesia. In the postpartum period she presented with continuous headache, and was treated with oral analgesics, oral caffeine, fluid therapy, and tetracosactide. She refused an epidural blood patch. On the seventh day postpartum, the patient was re-admitted to the Emergency Department with decreased level of consciousness and signs of brainstem compression. Cranial computed tomography and magnetic resonance imaging showed a posterior fossa tumour. An emergency craniotomy was performed with complete neurological recovery. This case emphasises the need to consider the differential diagnoses of post-dural puncture headache and to highlight the warning signs in patients who do not respond despite treatment with conventional therapy. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  9. Governança global democrática, desigualdade política e a hipótese da resistência nacionalista Democratic global governance, political inequality, and the nationalist retrenchment hypothesis

    Directory of Open Access Journals (Sweden)

    Joshua Kjerulf Dubrow

    2013-04-01

    Full Text Available Será a governança global inevitável? Será possível uma governança global democrática? Aponto dois obstáculos para a existência desta: a desigualdade política e a resistência nacionalista. Enquanto a governança global já existe, uma governança global democrática é refreada por desigualdades políticas internas e entre nações. Neste contexto, a resistência nacionalista, refreamento e desvio em direção ao unilateralismo, através da qual as nações evadem-se às estratégias de governança global, também se apresenta como um desafio ao desenvolvimento democrático de instituições deste cunho. Este artigo pretende dar continuidade ao diálogo entre sociólogos e outros cientistas sociais sobre a esperança otimista pela governança global.Is global governance inevitable? Is democratic global governance likely? I point out two obstacles that lie in the path toward democratic global governance: political inequality and nationalist retrenchment. While global governance is already here, democratic global governance is held back by political inequality within and between nations. In this context, nationalist retrenchment, a stop and back-slide toward unilaterialism where nations eschew global governance strategies, also poses a challenge to the democratic development of global governance institutions. This article serves to continue the conversation among sociologists and other social scientists on the optimistic hopes for democratic global governance.

  10. The Observation on Efficacy of Angio-seal Closure Device in the Femoral Arterial Puncture Site after PCI

    Institute of Scientific and Technical Information of China (English)

    Zhang Bin; Jin Lijun; Wei Shuishen; Fang Xianhong; Wu Handong; Dong Taiming; Yan hong; Liao Hongtao

    2006-01-01

    Objective To evaluatereliability and safety of Angio-seal hemostasis device applied to the femoral arterial puncture site after percutaneous coronary intervention (PCI). Methods In 40 patients after PCI in our institute during the period between May 2002 and December 2003, Angioseal device were used to seal the femoral arterial puncture site. Results All the Angioseal devices were successfully deployed in 40 patients (successful rate:100%); the mean time to hemostasis was 45±12 sec;the mean time to ambulate after angioseal closure was 1.9±0.5 hours. No major groin and systemic complication was observed. There was minor groin oozing in 2 cases and small hemotoma in 1 patient.Conclusions Angio-seal closure device of the femoral artery puncture site after a percutaneous coronary procedure is safe. It can shorten the time to hemostasis,leads to early mobilization, and reduce groin complication. The disadvantage is relatively expensive.

  11. The lithosphere-asthenosphere Italy and surroundings

    CERN Document Server

    Panza, G F; Chimera, G; Pontevivo, A; Raykova, R

    2003-01-01

    The velocity-depth distribution of the lithosphere-asthenosphere in the Italian region and surroundings is imaged, with a lateral resolution of about 100 km, by surface wave velocity tomography and non-linear inversion. Maps of the Moho depth, of the thickness of the lithosphere and of the shear-wave velocities, down to depths of 200 km and more, are constructed. A mantle wedge, identified in the uppermost mantle along the Apennines and the Calabrian Arc, underlies the principal recent volcanoes, and partial melting can be relevant in this part of the uppermost mantle. In Calabria a lithospheric doubling is seen, in connection with the subduction of the Ionian lithosphere. The asthenosphere is shallow in the Southern Tyrrhenian Sea. High velocity bodies, cutting the asthenosphere, outline the Adria-lonian subduction in the Tyrrhenian Sea and the deep-reaching lithospheric root in the Western Alps. Less deep lithospheric roots are seen in the Central Apennines. The lithosphere-asthenosphere properties delineat...

  12. The lithosphere-asthenosphere: Italy and surroundings

    Institute of Scientific and Technical Information of China (English)

    GiulianoF.Panza; AntonellaPontevivo; GiordanoChimera; RenetaRaykova; AbdelkrimAoudia

    2003-01-01

    The velocity-depth distribution of the lithosphere-asthenosphere in the Italian region and surroundings is imaged, with a lateral resolution of about 100 km, by sur-face wave velocity tomography and non-linear inversion.Maps of the Moho depth, of the thickness of the lithos-phere and of the shear-wave velocities, down to depths of 200 km and more, are constructed. A mantle wedge, iden-tified in the uppermost mantle along the Apennines and the Calabrian Arc, underlies the prmctpat recent votca-noes, and partial melting can be relevant in this part of the uppermost mantle. In Calabria, a lithospheric dou-bling is seen, in connection with the subduction of the Ionian lithosphere. The asthenosphere is shallow in the Southern Tyrrhenian Sea. High velocity bodies, cutting the asthenosphere, outline the Adria-lonian subduction in the Tyrrhenian Sea and the deep-reaching lithospheric root in the Western Alps. Less deep lithospheric roots are seen in the Central Apennines. The lithosphere-asthenos-phere properties delineate a differentiation between the northern and the southern sectors of the Adriatic Sea,likely attesting the fragmentation of Adria.

  13. Preliminary design of surrounding heliostat fields

    Energy Technology Data Exchange (ETDEWEB)

    Collado, Francisco J. [Zaragoza University, Dpto. de Ingenieria Mecanica, CPS-B, Maria de Luna 3, 50018 Zaragoza (Spain)

    2009-05-15

    Recently, the author has shown elsewhere a simplified model that allows quick evaluations of the annual overall energy collected by a surrounding heliostat field. This model is the combination of an analytical flux density function produced by a heliostat, developed by the own author, and an optimized mirror density distribution developed by University of Houston for the Solar One Project. As main conclusion of this previous work, it was recognized that such pseudo-continuous simplified model should not substitute much more accurate discrete evaluations, which manage thousands of individual heliostat coordinates. Here in this work, the difficulty of generating a preliminary discrete layout of a large number of heliostats is addressed. The main novelty is the direct definition of thousands of heliostat coordinates through basically two parameters i.e. a simplified blocking factor and an additional security distance. Such procedure, which was formerly theoretically suggested by the author, is put into practice here, showing examples and commenting their problems and advantages. Getting a previous set of thousands of heliostat coordinates would be a major first step in the complex process of designing solar power tower (SPT). (author)

  14. How effective is multiple needle puncturing for medial soft tissue balancing during total knee arthroplasty? A cadaveric study.

    Science.gov (United States)

    Koh, In Jun; Kwak, Dai-Soon; Kim, Tae Kyun; Park, In Joo; In, Yong

    2014-12-01

    We investigated the quantitative effect and risk factors for over-release during multiple needle puncturing (MNP) for medial gap balancing in varus total knee arthroplasty (TKA). Of the ten pairs of cadaveric knees, one knee from each pair was randomly assigned to undergo MNP in extension (E group), while the other knee underwent MNP in flexion (F group). The increased extension and 90° flexion gaps after every five needle punctures were measured until over-release occurred. The extension gap (knee, a narrow MCL, and severe osteoarthritis were associated with a smaller number of MNPs required to over-release.

  15. Treatment of a cavernous sinus dural arteriovenous fistula by deep orbital puncture of the superior ophthalmic vein

    Energy Technology Data Exchange (ETDEWEB)

    Benndorf, G. [Neuroangiography, Department of Radiology, Charite, Humboldt University Berlin (Germany); Bender, A. [Neuroradiology, Department of Radiology, Charite, Humboldt University Berlin (Germany); Campi, A. [Dept. of Neuroradiology, Hospital San Raffaele, Milan (Italy); Menneking, H. [Dept. of Maxillofacial Surgery, Charite, Humboldt University Berlin (Germany); Lanksch, W.R. [Department of Neurosurgery, Charite, Humboldt University Berlin, Augustenburger Platz 1, 13 353 Berlin (Germany)

    2001-06-01

    In a patient with progressive ophthalmological problems, including uncontrolled intraocular pressure related to a cavernous sinus dural arteriovenous fistula, urgent intervention may be necessary to prevent permanent visual loss. We report a case in which inadequate transarterial embolisation and lack of access for transvenous catheterisation, including a direct approach through the superior ophthalmic vein, preceded percutaneous puncture of the superior ophthalmic vein deep within the orbit, permitting venous occlusion without complications. This case demonstrates that deep orbital puncture of the vein is feasible for occlusion of a cavernous sinus dural arteriovenous fistula. (orig.)

  16. Thirty-two Cases of Acne Treated with Blood-letting Puncture,Cupping and Chinese-Drug Facemask

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    To observe the therapeutic effect on acne treated with blood-letting puncture, cupping and Chinese-drug facemask. Thirty-two patients with acne were treated with above-mentioned therapeutic method. Cure,improvement and ineffectiveness were respectively found in 24, 7 and 1 case, with a curative rate of 75.0% and a total effective rate of 96.8%. The combination of blood-letting puncture, cupping and external application of Chinese-drug facemask is effective in treating acne.

  17. Retrenchment. How nurse executives cope.

    Science.gov (United States)

    Feldman, J; Daly-Gawenda, D

    1985-06-01

    Changing economic, technicologic, and political conditions have created the need for readjustments in the number of nursing personnel employed by hospitals. The authors examined how nurse executives conducted themselves and managed their personnel during layoffs.

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

    Science.gov (United States)

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

    2002-01-01

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

  19. Investigating Efficacy of Melatonin and Gabapentin in Reducing Anxiety and Pain of Lumbar Puncture in Children

    Directory of Open Access Journals (Sweden)

    R Fallah

    2013-10-01

    Full Text Available Introduction: The lumbar puncture is one of the most important diagnostic and therapeutic procedures within children which child’s non-cooperativeness and procedural sedation are regarded necessary to conduct it. This study aimed to compare efficacy and safety of melatonin and gabapentin in reducing anxiety and pain of lumbar puncture in children. Methods: In a parallel single-blinded randomized clinical trial, sixty children aged 6 months -7 years, were evaluated in Pediatric Ward of Shahid Sadoughi Hospital, in Yazd (Iran in 2012. The children were distributedrandomly into two groups (30 children in each group. In group one, they received 0.3 mg/kg/dose of melatonin and theother group received 15 mg/kg/dose of gabapentin. Primary endpoints were success rate in reducing anxiety (anxiety score of≥ four and reducing pain when the needle was inserted to skin for lumbarpuncture (pain score of less than four. The clinicalside effects were investigated as well. Results: Twenty two girls (36.7% and 38 boys (63.3% with mean age of 2.79 ± 1.92 years were evaluated. Anxiety reduction (achieving the anxiety score of ≥ four was obtained in 43.3% in melatonin and in 36.7% in gabapentin groups, respectively and both drugs were equally effective in anxiety reduction (p.value = 0.598.Pain reduction ( achieving the pain score of less than four was obtained in 23.3% in melatonin and in 50% in gabapentin groups, respectively and thus, gabapentin wasproved to be more effective in pain reduction (p.value = 0.032.Mild side effects were observed in 10% of melatonin group and in 16.7% of gabapentin group. No statistically significant differences were seen from viewpoint of safety between the two drugs (p.value=0.448. Conclusion: Melatonin and gabapentin were not effective drugs in anxiety reduction for lumbar puncture of children. However, gabapentin is a safe and effective drug in pain reduction in painful diagnostic therapeutic procedures.

  20. Efficacy of the epidural blood patch for the treatment of post lumbar puncture headache BLOPP: a randomised, observer-blind, controlled clinical trial [ISRCTN 71598245].

    NARCIS (Netherlands)

    R. Oedit; F. van Kooten (Fop); S.L.M. Bakker (Stef); D.W.J. Dippel (Diederik)

    2005-01-01

    textabstractBACKGROUND: Post dural punction headache (PDPH) occurs in 10% to 40% of the patients who had a lumbar puncture. Its symptoms can be severe and incapacitating. The epidural blood patch is widely accepted as the treatment of choice for postdural puncture headache. Uncontrolled studies repo

  1. Impact of transseptal puncture site on acute and mid-term outcomes during cryoballoon ablation: A comparison between anterior, medial and posterior transatrial access

    NARCIS (Netherlands)

    Chierchia, G.B.; Casado-Arroyo, R.; Asmundis, C. de; Rodriguez-Manero, M.; Sarkozy, A.; Conte, G.; Sieira, J.; Levinstein, M.; Baltogiannis, G.; Giovanni, G.; Overeinder, I.; Ocello, S.; Rosas, E.; Isola, F.; Brugada, P.

    2013-01-01

    BACKGROUND: Cryoballoon ablation (CBA) (Arctic Front, Medtronic, USA) has proven very effective in achieving pulmonary vein isolation (PVI). Different transseptal (TS) puncture sites might influence CBA procedure. The aim of the present study was to analyze the influence of different TS puncture sit

  2. Impact of transseptal puncture site on acute and mid-term outcomes during cryoballoon ablation: A comparison between anterior, medial and posterior transatrial access

    NARCIS (Netherlands)

    Chierchia, G.B.; Casado-Arroyo, R.; Asmundis, C. de; Rodriguez-Manero, M.; Sarkozy, A.; Conte, G.; Sieira, J.; Levinstein, M.; Baltogiannis, G.; Giovanni, G.; Overeinder, I.; Ocello, S.; Rosas, E.; Isola, F.; Brugada, P.

    2013-01-01

    BACKGROUND: Cryoballoon ablation (CBA) (Arctic Front, Medtronic, USA) has proven very effective in achieving pulmonary vein isolation (PVI). Different transseptal (TS) puncture sites might influence CBA procedure. The aim of the present study was to analyze the influence of different TS puncture sit

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-02-01

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

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

    CERN Document Server

    Laguna, P

    2003-01-01

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

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

    CERN Document Server

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

    2007-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Peyman Shirani

    2009-01-01

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

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

    Science.gov (United States)

    Rosini, Ivone; Salum, Nádia Chiodelli

    2013-09-01

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

  9. Impacts of Artificial Reefs on Surrounding Ecosystems

    Science.gov (United States)

    Manoukian, Sarine

    Artificial reefs are becoming a popular biological and management component in shallow water environments characterized by soft seabed, representing both important marine habitats and tools to manage coastal fisheries and resources. An artificial reef in the marine environment acts as an open system with exchange of material and energy, altering the physical and biological characteristics of the surrounding area. Reef stability will depend on the balance of scour, settlement, and burial resulting from ocean conditions over time. Because of the unstable nature of sediments, they require a detailed and systematic investigation. Acoustic systems like high-frequency multibeam sonar are efficient tools in monitoring the environmental evolution around artificial reefs, whereas water turbidity can limit visual dive and ROV inspections. A high-frequency multibeam echo sounder offers the potential of detecting fine-scale distribution of reef units, providing an unprecedented level of resolution, coverage, and spatial definition. How do artificial reefs change over time in relation to the coastal processes? How accurately does multibeam technology map different typologies of artificial modules of known size and shape? How do artificial reefs affect fish school behavior? What are the limitations of multibeam technology for investigating fish school distribution as well as spatial and temporal changes? This study addresses the above questions and presents results of a new approach for artificial reef seafloor mapping over time, based upon an integrated analysis of multibeam swath bathymetry data and geoscientific information (backscatter data analysis, SCUBA observations, physical oceanographic data, and previous findings on the geology and sedimentation processes, integrated with unpublished data) from Senigallia artificial reef, northwestern Adriatic Sea (Italy) and St. Petersburg Beach Reef, west-central Florida continental shelf. A new approach for observation of fish

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

    Science.gov (United States)

    Liram, N; Gomori, M; Perouansky, M

    2000-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Benjamin H Singer

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

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

    Science.gov (United States)

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

    2005-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Hani M. Mahmoud

    2015-01-01

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

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

    Science.gov (United States)

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

    2017-04-01

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

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

    Directory of Open Access Journals (Sweden)

    John R Wallace

    2017-04-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    刘晓琴; 朱函亭

    2009-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-05-15

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

  20. Ear Surrounding Acupuncture for Nervous Deafness and Tinnitus%耳周围刺法治疗神经性耳鸣耳聋的临床体会

    Institute of Scientific and Technical Information of China (English)

    汪金宇; 万琎; 程为平

    2014-01-01

    Objective:To evaluate the clinical effect of ear surrounding acupuncture for nervous deaf-ness and tinnitus .Methods:Grade 30 patients according to their scales of deafness and tinnitus .Acu-puncture their ears with ear surrounding acupuncture and then evaluate the efficacy according to Standard of Curative Effect Evaluation of Tinnitus Deafness .Results:The effective rate of ear sur-rounding acupuncture for nervous tinnitus was 92 .6% and nervous deafness was 91 .7%.Conclu-sion:Ear surrounding acupuncture is an ideal method to treat nervous deafness and tinnitus .%目的:评价耳周围刺法治疗神经性耳鸣耳聋的临床疗效。方法:将30例患者按耳鸣、耳聋分级标准进行分级,均采用耳周围刺法进行针刺,针刺后参照耳鸣耳聋疗效评定标准进行疗效评价。结果:耳周围刺法治疗神经性耳鸣总有效率达92.6℅,治疗神经性耳聋总有效率达91.7%。结论:耳周围刺法是治疗神经性耳鸣耳聋的理想方法。

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

    Science.gov (United States)

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

    2008-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-12-15

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Miriam I E Freundt

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

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

    Science.gov (United States)

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

    2015-05-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-05-15

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

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

    Institute of Scientific and Technical Information of China (English)

    LIU Hai-fang; CHEN Xu; LIU Yan

    2009-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    周玉娥

    2016-01-01

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

  9. THE CLASSIFICATION OF THE SURROUNDINGS OF COAL MINING ROADWAYS

    Institute of Scientific and Technical Information of China (English)

    邹喜正; 侯朝炯; 李华祥

    1996-01-01

    This introduces the calculation of opaper the deformationg .the Surroundings of coaowaysand the divisi of surroundings into 5 levels by means or !fuzzy integral assess mairrx, wnlcnserves-asthe scientific basis for selecting supporting pattern of roadways and determining the, pa-rameters of support.

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

    Science.gov (United States)

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

    2015-10-01

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

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

    CERN Document Server

    Siu, Yum-Tong

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Farhad Etezadi

    2012-03-01

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

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

    Science.gov (United States)

    Follett, Peter A

    2009-06-01

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

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

    Science.gov (United States)

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

    2015-04-01

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

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

    Science.gov (United States)

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

    2013-11-01

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

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

    Science.gov (United States)

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

    2008-02-01

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

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

    Science.gov (United States)

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

    2010-06-01

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

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

    Directory of Open Access Journals (Sweden)

    M. N. Khan

    2016-12-01

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

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

    Science.gov (United States)

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

    2008-10-01

    Pain during areteriovenous fistula (AVF) cannulation remains a common problem in hemodialysis (HD) patients. This study was undertaken to assess the effect of cryotherapy on pain due to arteriovenous fistula puncture in hemodialysis patients. A convenience sample of 60 patients (30 each in experimental and control groups) who were undergoing hemodialysis by using AVF, was assessed in a randomized control trial. Hemodialysis patients who met the inclusion criteria, were randomly assigned to experimental and control groups using a randomization table. Objective and subjective pain scoring was done on two consecutive days of HD treatment (with cryotherapy for the experimental and without cryotherapy for the control group). The tools used were a questionnaire examining demographic and clinical characteristics, an observation checklist for assessing objective pain behavior, and a numerical rating scale for subjective pain assessment. Descriptive statistics were used as deemed appropriate. Chi square, two-sample and paired t-tests, the Mann Whitney test, Wilcoxon's signed rank test, the Kruskal Wallis test, and Spearman's and Pearson's correlations were used for inferential statistics. We found that the objective and subjective pain scores were found to be significantly (P = 0.001) reduced within the experimental group with the application of cryotherapy. This study highlights the need for adopting alternative therapies such as cryotherapy for effective pain management in hospital settings.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-03-15

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

  2. 面向节能优化的加热钢坯特征参数模型研%The Research on Characteristic Parameter Model of Billet Heating for Optimizing Retrench Energy

    Institute of Scientific and Technical Information of China (English)

    周里; 杨承志

    2011-01-01

    本文基于钢坯加热的热流密度的慨率密度分布关联加热能耗的原理,提出一种建立加热钢坯表面的热流密度的概率密度分布曲面模型的方法,以期将来能通过调节表征加热能耗的热流密度概率密度分布曲面形状特点,使钢坯加热工艺过程能耗调节具有较好的操控性,达到钢坯加热节能控制之目的.%The method is proposed about building the probability density distribution surface model of heat flux density of surface of billet heating, based on the principle to associate the probability density distribution surface model of heat flux density of surface of billet heating with the heating energy consumption.It is hoped that it can provide the better controllability about adjusting the energy consumption in the process of billet heating and meet requirement of retrench energy sources and control through adjusting the probability density distribution surface figure of heat flux density which can represent the heating energy consumption.

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

    Directory of Open Access Journals (Sweden)

    Azza Abdel Moghny Attia

    2017-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hong-liang; DUAN Shu-min

    2009-01-01

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

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

    Science.gov (United States)

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

    2016-06-01

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

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

    Science.gov (United States)

    Ikegami, Daisuke; Matsuoka, Takashi; Aoki, Yasuaki

    2015-05-15

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2004-02-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

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

    Science.gov (United States)

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

    2016-12-01

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

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

    CERN Document Server

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

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    闫永红; 谭敏

    2014-01-01

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

  14. Black hole solutions surrounded by perfect fluid in Rastall theory

    Science.gov (United States)

    Heydarzade, Y.; Darabi, F.

    2017-08-01

    In this work, we obtain uncharged∖charged Kiselev-like black holes as a new class of black hole solutions surrounded by perfect fluid in the context of Rastall theory. Then, we study the specific cases of the uncharged∖charged black holes surrounded by regular matter like dust and radiation, or exotic matter like quintessence, cosmological constant and phantom fields. By comparing the Kiselev-like black hole solutions in Rastall theory with the Kiselev black hole solutions in GR, we find an effective perfect fluid behavior for the black hole's surrounding field. It is shown that the corresponding effective perfect fluid has interesting characteristic features depending on the different ranges of the parameters in Rastall theory. For instance, Kiselev-like black holes surrounded by regular matter in Rastall theory may be considered as Kiselev black holes surrounded by exotic matter in GR, or Kiselev-like black holes surrounded by exotic matter in Rastall theory may be considered as Kiselev black holes surrounded by regular matter in GR.

  15. Surround suppression and sparse coding in visual and barrel cortices

    Directory of Open Access Journals (Sweden)

    Robert N S Sachdev

    2012-07-01

    Full Text Available During natural vision the entire retina is stimulated. Likewise, during natural tactile behaviors, spatially extensive regions of the somatosensory surface are co-activated. The large spatial extent of naturalistic stimulation means that surround suppression, a phenomenon whose neural mechanisms remain a matter of debate, must arise during natural behavior. To identify common neural motifs that might instantiate surround suppression across modalities, we review models of surround suppression and compare the evidence supporting the competing ideas that surround suppression has either cortical or sub-cortical origins in visual and barrel cortex. In the visual system there is general agreement lateral inhibitory mechanisms contribute to surround suppression, but little direct experimental evidence that intracortical inhibition plays a major role. Two intracellular recording studies of V1, one using naturalistic stimuli (Haider et al., 2010, the other sinusoidal gratings (Ozeki et al., 2009, sought to identify the causes of reduced activity in V1 with increasing stimulus size, a hallmark of surround suppression. The former attributed this effect to increased inhibition, the latter to largely balanced withdrawal of excitation and inhibition. In rodent primary somatosensory barrel cortex, multi-whisker responses are generally weaker than single whisker responses, suggesting multi-whisker stimulation engages similar surround suppressive mechanisms. The origins of suppression in S1 remain elusive: studies have implicated brainstem lateral/internuclear interactions and both thalamic and cortical inhibition. Although the anatomical organization and instantiation of surround suppression in the visual and somatosensory systems differ, we consider the idea that one common function of surround suppression, in both modalities, is to remove the statistical redundancies associated with natural stimuli by increasing the sparseness or selectivity of sensory

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

    Science.gov (United States)

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

    2015-06-01

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

  17. Surrounding Moving Obstacle Detection for Autonomous Driving Using Stereo Vision

    Directory of Open Access Journals (Sweden)

    Hao Sun

    2013-06-01

    Full Text Available Detection and tracking surrounding moving obstacles such as vehicles and pedestrians are crucial for the safety of mobile robotics and autonomous vehicles. This is especially the case in urban driving scenarios. This paper presents a novel framework for surrounding moving obstacles detection using binocular stereo vision. The contributions of our work are threefold. Firstly, a multiview feature matching scheme is presented for simultaneous stereo correspondence and motion correspondence searching. Secondly, the multiview geometry constraint derived from the relative camera positions in pairs of consecutive stereo views is exploited for surrounding moving obstacles detection. Thirdly, an adaptive particle filter is proposed for tracking of multiple moving obstacles in surrounding areas. Experimental results from real‐world driving sequences demonstrate the effectiveness and robustness of the proposed framework.

  18. Surrounding Moving Obstacle Detection for Autonomous Driving Using Stereo Vision

    Directory of Open Access Journals (Sweden)

    Hao Sun

    2013-06-01

    Full Text Available Detection and tracking surrounding moving obstacles such as vehicles and pedestrians are crucial for the safety of mobile robotics and autonomous vehicles. This is especially the case in urban driving scenarios. This paper presents a novel framework for surrounding moving obstacles detection using binocular stereo vision. The contributions of our work are threefold. Firstly, a multiview feature matching scheme is presented for simultaneous stereo correspondence and motion correspondence searching. Secondly, the multiview geometry constraint derived from the relative camera positions in pairs of consecutive stereo views is exploited for surrounding moving obstacles detection. Thirdly, an adaptive particle filter is proposed for tracking of multiple moving obstacles in surrounding areas. Experimental results from real-world driving sequences demonstrate the effectiveness and robustness of the proposed framework.

  19. Traditional Indian custOInS surrounding birth

    African Journals Online (AJOL)

    traditional custOIns surrounding birth in Indian culture. ... conception, pregnancy, birth and the early months ofparenthood. .... house attended by a traditional birth attendant of a ..... Spiritual components play a dominant role in traditional.

  20. Glow phenomenon surrounding the vertical stabilizer and OMS pods

    Science.gov (United States)

    1994-01-01

    This 35mm frame, photographed as the Space Shuttle Columbia was orbiting Earth during a 'night' pass, documents the glow phenomenon surrounding the vertical stabilizer and the Orbital Maneuvering System (OMS) pods of the spacecraft.

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

    Directory of Open Access Journals (Sweden)

    Amit Kumar Mittal

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-05-01

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

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

    Science.gov (United States)

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

    2010-09-01

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

  4. Surrounding Moving Obstacle Detection for Autonomous Driving Using Stereo Vision

    OpenAIRE

    Hao Sun; Huanxin Zou; Shilin Zhou; Cheng Wang; Naser El-Sheimy

    2013-01-01

    Detection and tracking surrounding moving obstacles such as vehicles and pedestrians are crucial for the safety of mobile robotics and autonomous vehicles. This is especially the case in urban driving scenarios. This paper presents a novel framework for surrounding moving obstacles detection using binocular stereo vision. The contributions of our work are threefold. Firstly, a multiview feature matching scheme is presented for simultaneous stereo correspondence and motion correspondence searc...

  5. "Tilt" in color space: Hue changes induced by chromatic surrounds.

    Science.gov (United States)

    Klauke, Susanne; Wachtler, Thomas

    2015-01-01

    The perceived color of a chromatic stimulus is influenced by the chromaticity of its surround. To investigate these influences along the dimension of hue, we measured hue changes induced in stimuli of different hues by isoluminant chromatic surrounds. Generally, induced hue changes were directed in color space away from the hue of the inducing surround and depended on the magnitude on the hue difference between stimulus and surround. With increasing difference in hue between stimulus and surround, induced hue changes increased up to a maximum and then decreased for larger differences. This qualitative pattern was similar for different inducers, but quantitatively, induction was weaker along some directions in cone-opponent color space than along other directions. The strongest induction effects were found along an oblique, blue-yellow axis that corresponds to the daylight axis. The overall pattern of the induction effect shows similarities to the well-known tilt effect, where shifts in perceived angle of oriented stimuli are induced by oriented surrounds. This suggests analogous neural representations and similar mechanisms of contextual processing for different visual features such as orientation and color.

  6. Control of Formation of Lithological Reservoirs by Surrounding Mudstone

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Taking the Jiyang depression as an example, this paper discusses the control of the formation of lithological reservoir by surrounding rocks by integrated application of geological analysis, physical simulation, and the analysis of oil & gas accumulation mechanism. Geological statistical shows that the major burial depth and interval of lithological reservoirs in the Jiyang depression are related to the hydrocarbon generation in and expulsion from the Lower Tertiary source rocks and the time of the formation of most lithological reservoirs coincides with the peak of hydrocarbon generation and expulsion. The lithological traps located in the center of effective source rocks are propitious to high oil saturation than those located on the margin of effective source rocks. The hydrocarbon charge degree of the lithological reservoir has a positive correlation with the intensity of hydrocarbon expulsion from surrounding source rocks.Geological analyses and NMR experiments also show that the oil saturation of surrounding source rocks control the hydrocarbon potential of lithological traps, and a critical value for oil saturation of surrounding mudstone is required, that is, when the oil saturation of surrounding mudstone is lower than this critical value, no oil and gas accumulate in the lithological trap. The control of surrounding mudstone on the oil-bearing properties of lithological reservoirs is also analyzed by the mechanisms of hydrocarbon generation and expulsion as well as accumulation.

  7. Forest Fragments Surrounded by Sugar Cane Are More Inhospitable to Terrestrial Amphibian Abundance Than Fragments Surrounded by Pasture

    Directory of Open Access Journals (Sweden)

    Paula Eveline Ribeiro D’Anunciação

    2013-01-01

    Full Text Available In recent years, there has been increasing interest in matrix-type influence on forest fragments. Terrestrial amphibians are good bioindicators for this kind of research because of low vagility and high philopatry. This study compared richness, abundance, and species composition of terrestrial amphibians through pitfall traps in two sets of semideciduous seasonal forest fragments in southeastern Brazil, according to the predominant surrounding matrix (sugar cane and pasture. There were no differences in richness, but fragments surrounded by sugar cane had the lowest abundance of amphibians, whereas fragments surrounded by pastures had greater abundance. The most abundant species, Rhinella ornata, showed no biometric differences between fragment groups but like many other amphibians sampled showed very low numbers of individuals in fragments dominated by sugar cane fields. Our data indicate that the sugar cane matrix negatively influences the community of amphibians present in fragments surrounded by this type of land use.

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

    Science.gov (United States)

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

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

  9. Migraine increases centre-surround suppression for drifting visual stimuli.

    Directory of Open Access Journals (Sweden)

    Josephine Battista

    Full Text Available BACKGROUND: The pathophysiology of migraine is incompletely understood, but evidence points to hyper-responsivity of cortical neurons being a key feature. The basis of hyper-responsiveness is not clear, with an excitability imbalance potentially arising from either reduced inhibition or increased excitation. In this study, we measure centre-surround contrast suppression in people with migraine as a perceptual analogue of the interplay between inhibition and excitation in cortical areas responsible for vision. We predicted that reduced inhibitory function in migraine would reduce perceptual surround suppression. Recent models of neuronal surround suppression incorporate excitatory feedback that drives surround inhibition. Consequently, an increase in excitation predicts an increase in perceptual surround suppression. METHODS AND FINDINGS: Twenty-six people with migraine and twenty approximately age- and gender-matched non-headache controls participated. The perceived contrast of a central sinusoidal grating patch (4 c/deg stationary grating, or 2 c/deg drifting at 2 deg/sec, 40% contrast was measured in the presence and absence of a 95% contrast annular grating (same orientation, spatial frequency, and drift rate. For the static grating, similar surround suppression strength was present in control and migraine groups with the presence of the surround resulting in the central patch appearing to be 72% and 65% of its true contrast for control and migraine groups respectively (t(44 = 0.81, p = 0.42. For the drifting stimulus, the migraine group showed significantly increased surround suppression (t(44 = 2.86, p<0.01, with perceived contrast being on average 53% of actual contrast for the migraine group and 68% for non-headache controls. CONCLUSIONS: In between migraines, when asymptomatic, visual surround suppression for drifting stimuli is greater in individuals with migraine than in controls. The data provides evidence for a

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

    Directory of Open Access Journals (Sweden)

    Eric A. Schmidt

    2012-09-01

    Full Text Available Background: Patients with good-grade subarachnoid hemorrhage (SAH are those without initial neurological deficit. However, they can die or present severe deficit due to secondary insult leading to brain ischemia. After SAH, in a known context of energy crisis, vasospasm, hydrocephalus and intracranial hypertension contribute to unfavorable outcome. Lumbar puncture (LP is sometimes performed in an attempt to reduce intracranial pressure (ICP and release headaches. We hypothesize that in good-grade SAH patients, a 20-ml LP releases headaches, reduces ICP and improves cerebral blood flow (CBF as measured with O15 PET scan. Methods: Six good-grade (WFNS grade 1or 2 SAH patients (mean age 48 years, 2 women, 4 men were prospectively included. All aneurysms (4 anterior communicating artery and 2 right middle cerebral artery were coiled at day 1. Patients were managed according to our local protocol. LP was performed for severe headache (VAS >7 despite maximal painkiller treatment. Patients were included when the LP was clinically needed. The 20-ml LP was done in the PET scan (mean delay between SAH and LP: 3.5 days. LP allows hydrostatic measurement of ICP. Arterial blood pressure (ABP was noninvasively gauged with photoplethysmography. Every signal was monitored and analyzed off-line. Regional CBF (rCBF was measured semiquantitatively with O15 PET before and after LP. Then we calculated the difference between baseline and post-LP condition for each area: positive value means augmentation of rCBF after the LP, negative value means reduction of rCBF. Individual descriptive analysis of CBF was first performed for each patient; then a statistical group analysis was done with SPM for all voxels using t statistics converted to Z scores (p 3.2. Results: A 20-ml LP yielded a reduction in pain (–4, a drop in ICP (24.3 ± 12.5 to 6.9 ± 4.7 mm Hg, but no change in ABP. Descriptive and statistical image analysis showed a heterogeneous and biphasic change in

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Houghton Jeff

    2010-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-08-15

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Etienne Laverse

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-09-15

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

  18. 6.1 channel general planar surround sound system

    Institute of Scientific and Technical Information of China (English)

    XIE Bosun

    2001-01-01

    A new 6.1 channel surround sound system and its two signal mixing methods are proposed. Theoretical and experimental results show that the system is able to recreate 360°sound image in horizontal plane. Especially, compared with current 5.1 channel system, lateral and rear image of the new system is improved obviously. Therefore it is suitable to be used as a general surround sound system. It is also proved that, the new system is fully compatible with 5.1 channel system, and current methods are available to record 6.1 channel signals.

  19. Linking disadvantaged housing areas to the surrounding city

    DEFF Research Database (Denmark)

    Stender, Marie

    Several disadvantaged social housing areas in Denmark are currently undergo-ing thorough physical refurbishments, aiming to integrate them better with the surrounding city. The ambition is to attract new users and residents by opening up the borders of the area and establish attractive, new...... that especially eve-ryday-route strategies adding new public functions within the area can pave the way for integration with the surroundings. The applicability of such strategies is however highly dependent on the context, location and existing image of the ar-ea. Social distance may sustain though physical...

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

    Science.gov (United States)

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

    2015-12-01

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

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

    Institute of Scientific and Technical Information of China (English)

    冯继泽

    2011-01-01

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

  2. Ecological mechanisms linking protected areas to surrounding lands.

    Science.gov (United States)

    Hansen, Andrew J; DeFries, Ruth

    2007-06-01

    Land use is expanding and intensifying in the unprotected lands surrounding many of the world's protected areas. The influence of this land use change on ecological processes is poorly understood. The goal of this paper is to draw on ecological theory to provide a synthetic framework for understanding how land use change around protected areas may alter ecological processes and biodiversity within protected areas and to provide a basis for identifying scientifically based management alternatives. We first present a conceptual model of protected areas embedded within larger ecosystems that often include surrounding human land use. Drawing on case studies in this Invited Feature, we then explore a comprehensive set of ecological mechanisms by which land use on surrounding lands may influence ecological processes and biodiversity within reserves. These mechanisms involve changes in ecosystem size, with implications for minimum dynamic area, species-area effect, and trophic structure; altered flows of materials and disturbances into and out of reserves; effects on crucial habitats for seasonal and migration movements and population source/sink dynamics; and exposure to humans through hunting, poaching, exotics species, and disease. These ecological mechanisms provide a basis for assessing the vulnerability of protected areas to land use. They also suggest criteria for designing regional management to sustain protected areas in the context of surrounding human land use. These design criteria include maximizing the area of functional habitats, identifying and maintaining ecological process zones, maintaining key migration and source habitats, and managing human proximity and edge effects.

  3. Metrizamide demonstration of the subarachnoid space surrounding the Gasserian ganglion

    Energy Technology Data Exchange (ETDEWEB)

    Christmann, D.; Babin, E.

    1980-05-01

    The chance opacification of the subarachnoid space surrounding the Gasserian ganglion, observed during metrizamide basal cisternography, is reported. This is compared to similar demonstrations of the optic subarachnoid space. Such infrequently observed images should be known because they may be related to the occurrence of trigeminal neuralgia.

  4. Orientation-tuned surround suppression in mouse visual cortex

    NARCIS (Netherlands)

    Self, Matthew W; Lorteije, Jeannette A M; Vangeneugden, Joris; van Beest, Enny H; Grigore, Mihaela E; Levelt, Christiaan N; Heimel, J.A.; Roelfsema, Pieter R

    2014-01-01

    The firing rates of neurons in primary visual cortex (V1) are suppressed by large stimuli, an effect known as surround suppression. In cats and monkeys, the strength of suppression is sensitive to orientation; responses to regions containing uniform orientations are more suppressed than those contai

  5. Challenges Surrounding the Education of Children with Chronic Diseases

    Science.gov (United States)

    Gordon, Maria, Ed.

    2016-01-01

    While governing bodies have mandated that all students have the right to an education, with disabled students treated to the same rights and opportunities as non-disabled students, policymakers do not always agree on what all-inclusive education should look like. "Challenges Surrounding the Education of Children with Chronic Diseases"…

  6. Military installation sequestered more carbon than surrounding areas

    Science.gov (United States)

    Zhao, S.; Liu, S.; Li, Z.; Sohl, T.

    2008-12-01

    Land use activities greatly affect the temporal trends and spatial patterns of regional land-atmospheric exchange of carbon. Military installations generally have drastically different land management strategies from surrounding areas, and the carbon consequences have never been quantified and assessed. Here, we used the General Ensemble Biogeochemical Modeling System (GEMS) to simulate and compare ecosystem carbon dynamics between Fort Benning and surrounding areas from 1992 to 2050. GEMS was driven by unique combinations of spatial and temporal dynamics of major driving forces, such as climate, soil properties, nitrogen deposition, and land use and land cover changes (predicted by FOREcasting SCEnarios of land cover change (FORE-SCE)). Our results indicated that the military installation sequestered more carbon than surrounding areas (0.77 vs. 0.16 Mg C ha-1 y-1 averaged from 1992 to 2007). Differences in land use activities were the primary cause behind the difference in carbon sequestration rates. From 1992 to 2007, no urban/residential expansion occurred at the installation, and transitional barren (primarily caused by forest harvesting) slightly increased from 0 to 0.2%. In contrast, urban land increased from 5.6 to 7.6% and transitional barren increased from 0.1 to 0.7% in the surrounding areas. Live biomass accumulation accounted for most of the carbon sink in both Fort Benning and surrounding areas (0.75 vs. 0.15 Mg C ha-1 y-1), while soil organic carbon accumulation was small (0.02 vs. 0.01 Mg C ha- 1 y-1), suggesting biomass removal caused by urbanization and harvesting resulted in much less carbon sequestration in surrounding areas. Fort Benning is likely to sequester more carbon in the future, although the rate of carbon sequestered per year will gradually reduce. The future carbon source/sink strength in the surrounding areas varied greatly, from a small sink to a strong source, depending on the path of land use change (e.g., increase of clear

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

    Directory of Open Access Journals (Sweden)

    Parisa Golfam

    2016-09-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-02-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-11-15

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

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

    Institute of Scientific and Technical Information of China (English)

    陈庆凤

    2012-01-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

  13. Dynamics of two-component membranes surrounded by viscoelastic media.

    Science.gov (United States)

    Komura, Shigeyuki; Yasuda, Kento; Okamoto, Ryuichi

    2015-11-01

    We discuss the dynamics of two-component fluid membranes which are surrounded by viscoelastic media. We assume that membrane-embedded proteins can diffuse laterally and induce a local membrane curvature. The mean squared displacement of a tagged membrane segment is obtained as a generalized Einstein relation. When the elasticity of the surrounding media obeys a power-law behavior in frequency, an anomalous diffusion of the membrane segment is predicted. We also consider the situation where the proteins generate active non-equilibrium forces. The generalized Einstein relation is further modified by an effective temperature that depends on the force dipole energy. The obtained generalized Einstein relations are useful for membrane microrheology experiments.

  14. Study on Temperature Fieldof Surrounding Rock with BEM

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The authors analyzed the characteristic of surrounding rock temperature field around a drifting face, setup its mathematic model, and got its numerical result with the boundary element method(BEM). To calculate in-tra-domain integral, it was transformed into boundary integration with the DRM method. Using the similitude the-ory, the dimensionless differential equation was educed. Finally, the authors calculated two drifting faces of San-hejian Coal Mine using the computer software developed by authors based on the above principium, and got the dis-tribution characteristic of surrounding rock temperature field around a drifting face and the periodic variation intemperature with its periodic moving forward. Comparing the calculated heat dissipating-capacity of surroundingrock with the measured data shows that the computer software is proper.

  15. Experimental Study of Deformation of Surrounding Rock with Infrared Radiation

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yong-jun; AN Li-qian; REN Run-hou; FAN Shi-min; MA Nian-jie; LI Jian-hui; JI Yuan-ming

    2005-01-01

    According to the practical conditions of coal roadway in Changcun Coal Mine of Lu'an Mining Group, the deformation of rock surrounding roadway was experimentally studied by means of thermal infrared (TIR) imaging system in the process of confined compressions. It is found that the model surface TIR temperature (TIRT) changes with the increase of load. Furthermore, TIRT changes non-synchronously in different ranges such as the roof, floor, wall, corners and bolted ranges. The TIRT is higher in the location of stress concentration and bolted ranges than that in the location of stress relaxation and broken ranges. The interaction ranges of bolt and rock are determined preliminarily according to the corresponding relationship of TIRT fields and the strain fields of the surrounding rock. The new method of TIR image processing has been proved to be effective for the study of bolt support and observation of roadway stability under mine pressure.

  16. High resolution bathymetry of China seas and their surroundings

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Based on the oceanic lithospheric flexure and the worldwide bathymetric data ETOPO5, the high resolu tion bathymetry of the China seas and their surroundings is computed from altimeter derived gravity anomalies. The new bathymetry obtained by this study is higher resolution and accuracy than the widely used ETOPO5 data, mean while it shows clearly the seafioor, the tectonic characteristics and the geodynamical processes in the China seas.

  17. Thermodynamic stability of black holes surrounded by quintessence

    OpenAIRE

    Ma, Meng-Sen; Zhao, Ren; Ma, Ya-Qin

    2016-01-01

    We study the thermodynamic stabilities of uncharged and charged black holes surrounded by quintessence (BHQ) by means of effective thermodynamic quantities. When the state parameter of quintessence $\\omega_q$ is appropriately chosen, the structures of BHQ are something like that of black holes in de Sitter space. Constructing the effective first law of thermodynamics in two different ways, we can derive the effective thermodynamic quantities of BHQ. Especially, these effective thermodynamic q...

  18. Hidden History: A Mobile Application for Discovering Surrounding Landscapes

    OpenAIRE

    2016-01-01

    This thesis work describes the design, development and evaluation of a mobile application called Hidden History. This application lets users discover and explore three types of landscapes (Historic, Scenic and Cultural) using three different modes of discovery (Route, Explore and Tour). Before designing Hidden History, the feature set of other applications that help users explore surrounding landscapes were identified and analyzed. Hidden History was then designed to implement the best fea...

  19. Treatment of Postherpetic Neuralgia by Surround Needling with Electric Stimulation

    Institute of Scientific and Technical Information of China (English)

    FAN Jin; YANG Qin-hua

    2005-01-01

    运用电针围刺法治疗带状疱疹后遗神经痛29例,获得较好疗效,总有效率为93.1%.%Twenty-nine cases of postherpetic neuralgia of herpes zoster were treated by the surround needling with electric stimulation, and the better therapeutic effect was obtained, the total effective rate was 93.1%.

  20. Belief and Attitudes surrounding Childhood Autism in Ghana

    OpenAIRE

    2012-01-01

    Autism is a life-long invisible impairment with an unknown etiology. Current literature shows an increase in the diagnosis of autism worldwide. This qualitative study explores the attitudes and beliefs which surround childhood autism in Ghana. In-depth interviews were conducted with four (4) parents whose children have autism and three (3) key informants; a Religious Leader, a Health Worker and an Administrator of a Special school in Accra, Ghana. A semi-structured interview guide was used fo...

  1. A permeability barrier surrounds taste buds in lingual epithelia.

    Science.gov (United States)

    Dando, Robin; Pereira, Elizabeth; Kurian, Mani; Barro-Soria, Rene; Chaudhari, Nirupa; Roper, Stephen D

    2015-01-01

    Epithelial tissues are characterized by specialized cell-cell junctions, typically localized to the apical regions of cells. These junctions are formed by interacting membrane proteins and by cytoskeletal and extracellular matrix components. Within the lingual epithelium, tight junctions join the apical tips of the gustatory sensory cells in taste buds. These junctions constitute a selective barrier that limits penetration of chemosensory stimuli into taste buds (Michlig et al. J Comp Neurol 502: 1003-1011, 2007). We tested the ability of chemical compounds to permeate into sensory end organs in the lingual epithelium. Our findings reveal a robust barrier that surrounds the entire body of taste buds, not limited to the apical tight junctions. This barrier prevents penetration of many, but not all, compounds, whether they are applied topically, injected into the parenchyma of the tongue, or circulating in the blood supply, into taste buds. Enzymatic treatments indicate that this barrier likely includes glycosaminoglycans, as it was disrupted by chondroitinase but, less effectively, by proteases. The barrier surrounding taste buds could also be disrupted by brief treatment of lingual tissue samples with DMSO. Brief exposure of lingual slices to DMSO did not affect the ability of taste buds within the slice to respond to chemical stimulation. The existence of a highly impermeable barrier surrounding taste buds and methods to break through this barrier may be relevant to basic research and to clinical treatments of taste.

  2. THE DESIGN OF DYNAMIC SIMULATION SYSTEM ON EARTHQUAKE SURROUNDINGS

    Institute of Scientific and Technical Information of China (English)

    沈毅力; 杨云; 李天石

    2003-01-01

    Objective To design a system that can simulate earthquake surroundings. In the surroundings, people can be familiar with the omen, strong shock and aftershock of earthquake, thus make right choices and get away when the disaster occurs. Methods The system consists of an electro-hydraulic servo system, a whole-information sound system and some lighting device; By using the adaptive inverse control method and LMS algorithms, the inverse model (I.e. The controller) is convergent rapidly; The software based on LabVIEW makes the parameters can be modified easily; There is a double closed-loop structure in the system: an analog closed-loop and a digital closed-loop, and their parameters can be inspected in real time. Results The system is of very high reliability, and the desired vibration signal can be tracked exactly by output. Conclusion Earthquake surroundings is simulated vividly. Through the system, people can be familiar with earthquake phenomena, and know lots of knowledge of earthquake.

  3. Tissue reaction surrounding miniscrews for orthodontic anchorage: An animal experiment

    Directory of Open Access Journals (Sweden)

    Stephanie Shih-Hsuan Chen

    2012-03-01

    Results and conclusions: (1 Tissue surrounding roots damaged by a miniscrew showed a significant inflammatory response. (2 Root resorption was occasionally observed after 3 weeks following insertion of a miniscrew even if the miniscrew was not in direct contact with the root. (3 Root repair was noted with a cementoblast lining along the resorption surface at as early as 3 weeks after miniscrew insertion. Alveolar bone filled in the lesion when the root damage was large so that the contour of the alveolar bone followed that of the damaged root, with the width of the periodontal ligament space being maintained. (4 Stable miniscrews were mainly those which did not contact adjacent roots, and for which the surrounding tissue showed only a small inflammatory response with some extent of direct bone contact around the miniscrew. On the contrary, most of the failed miniscrews were those which had direct contact with adjacent roots, and which exhibited severe tissue inflammation and were covered by thick layers of soft tissue. Failure was detected 3 weeks after insertion. Surprisingly, the epithelial lining surrounding the miniscrews might not have spontaneously resolved 6 weeks after screw removal. Persistent infection in the sinus tract was noted, and this would require attention.

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-06-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Maria Vera Lúcia Moreira Leitão Cardoso

    2016-06-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Eduardo Magariños

    2007-06-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-07-01

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

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

    NARCIS (Netherlands)

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

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

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

    Directory of Open Access Journals (Sweden)

    Watanabe Masahiro

    2012-09-01

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

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

    Institute of Scientific and Technical Information of China (English)

    李静; 吕茂英

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王元翠

    2016-01-01

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

  17. INTERACTIONS OF THE INFRARED BUBBLE N4 WITH ITS SURROUNDINGS

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Hong-Li; Li, Jin-Zeng; Yuan, Jing-Hua; Huang, Maohai; Huang, Ya-Fang; Zhang, Si-Ju [National Astronomical Observatories, Chinese Academy of Sciences, 20A Datun Road, Chaoyang District, Beijing 100012 (China); Wu, Yuefang [Department of Astronomy, Peking University, 100871 Beijing (China); Liu, Tie [Korea Astronomy and Space Science Institute 776, Daedeokdae-ro, Yuseong-gu, Daejeon, 305-348 (Korea, Republic of); Dubner, G.; Paron, S.; Ortega, M. E. [1Instituto de Astronomía y Física del Espacio (IAFE, CONICET-UBA), CC 67, Suc. 28, 1428 Buenos Aires (Argentina); Molinari, Sergio [Istituto di Astrofisica e Planetologia Spaziali—IAPS, Istituto Nazionale di Astrofisica—INAF, via Fosso del Cavaliere 100, I-00133 Roma (Italy); Zavagno, Annie; Samal, Manash R., E-mail: hlliu@nao.cas.cn [Aix Marseille Universit, CNRS, LAM (Laboratoire d’Astrophysique de Marseille) UMR 7326, F-13388, Marseille (France)

    2016-02-10

    The physical mechanisms that induce the transformation of a certain mass of gas in new stars are far from being well understood. Infrared bubbles associated with H ii regions have been considered to be good samples for investigating triggered star formation. In this paper we report on the investigation of the dust properties of the infrared bubble N4 around the H ii region G11.898+0.747, analyzing its interaction with its surroundings and star formation histories therein, with the aim of determining the possibility of star formation triggered by the expansion of the bubble. Using Herschel PACS and SPIRE images with a wide wavelength coverage, we reveal the dust properties over the entire bubble. Meanwhile, we are able to identify six dust clumps surrounding the bubble, with a mean size of 0.50 pc, temperature of about 22 K, mean column density of 1.7 × 10{sup 22} cm{sup −2}, mean volume density of about 4.4 × 10{sup 4} cm{sup −3}, and a mean mass of 320 M{sub ⊙}. In addition, from PAH emission seen at 8 μm, free–free emission detected at 20 cm, and a probability density function in special regions, we could identify clear signatures of the influence of the H ii region on the surroundings. There are hints of star formation, though further investigation is required to demonstrate that N4 is the triggering source.

  18. On the environment surrounding close-in exoplanets

    Science.gov (United States)

    Vidotto, A. A.; Fares, R.; Jardine, M.; Moutou, C.; Donati, J.-F.

    2015-06-01

    Exoplanets in extremely close-in orbits are immersed in a local interplanetary medium (i.e. the stellar wind) much denser than the local conditions encountered around the Solar system planets. The environment surrounding these exoplanets also differs in terms of dynamics (slower stellar winds, but higher Keplerian velocities) and ambient magnetic fields (likely higher for host stars more active than the Sun). Here, we quantitatively investigate the nature of the interplanetary media surrounding the hot Jupiters HD 46375b, HD 73256b, HD 102195b, HD 130322b and HD 179949b. We simulate the three-dimensional winds of their host stars, in which we directly incorporate their observed surface magnetic fields. With that, we derive mass-loss rates (1.9-8.0 × 10-13 M⊙ yr-1) and the wind properties at the position of the hot Jupiters' orbits (temperature, velocity, magnetic field intensity and pressure). We show that these exoplanets' orbits are supermagnetosonic, indicating that bow shocks are formed surrounding these planets. Assuming planetary magnetic fields similar to Jupiter's, we estimate planetary magnetospheric sizes of 4.1-5.6 planetary radii. We also derive the exoplanetary radio emission released in the dissipation of the stellar wind energy. We find radio fluxes ranging from 0.02 to 0.13 mJy, which are challenging to be observed with present-day technology, but could be detectable with future higher sensitivity arrays (e.g. Square Kilometre Array). Radio emission from systems having closer hot Jupiters, such as from τ Boo b or HD 189733b, or from nearby planetary systems orbiting young stars, are likely to have higher radio fluxes, presenting better prospects for detecting exoplanetary radio emission.

  19. Issues surrounding record keeping in district nursing practice.

    Science.gov (United States)

    Anderson, E E

    2000-07-01

    This article examines some aspects of nursing documentation following the publication of the document 'Guidelines for Records and Record Keeping' (UKCC, 1998). The importance of nursing documentation in patient care, in guiding practice and in providing information for members of the interprofessional healthcare team is highlighted. Record keeping forms an important part of the clinical governance initiative in terms of quality improvement and risk management. The issues surrounding the legal requirements of record keeping in district nursing practice are discussed. Suggestions are made for assessing the quality of nursing documentation by audit and research, in order to establish the suitability of using the present systems in the community setting.

  20. Induced radioactivity in a 4 MW target and its surroundings

    CERN Document Server

    Agosteo, Stefano; Otto, Thomas; Silari, Marco

    2003-01-01

    An important aspect of a future CERN Neutrino Factory is the material activation arising from a 2.2 GeV, 4 MW proton beam striking a mercury target. An estimation of the hadronic inelastic interactions and the production of residual nuclei in the target, the magnetic horn, the decay tunnel, the surrounding rock and a downstream dump was performed by the Monte Carlo hadronic cascade code FLUKA. The aim was both to assess the dose equivalent rate to be expected during maintenance work and to evaluate the amount of residual radioactivity, which will have to be disposed of after the facility has ceased operation.

  1. Mutual seismic interaction between tunnels and the surrounding granular soil

    Directory of Open Access Journals (Sweden)

    Mohamed Ahmed Abdel-Motaal

    2014-12-01

    Study results show that the maximum exerted straining actions in tunnel lining are directly proportional to the relative stiffness between tunnel and surrounding soil (lining thickness and soil shear modulus. Moreover, it is highly affected by the peak ground acceleration and the tunnel location (embedment depth. A comprehensive study is performed to show the effect of tunnel thickness and tunnel diameter on both the induced bending moment and lining deformation. In general, it is concluded that seismic analysis should be considered in regions subjected to peak ground acceleration greater than 0.15g.

  2. Problems Surrounding Probation In The South African Public Service

    Directory of Open Access Journals (Sweden)

    Z. Baloyi

    2006-11-01

    Full Text Available The aim of the study was to investigate problems surrounding probation periods in the South African Public Service. A qualitative study was conducted to determine the views of both probationers and supervisors managing the probation process. Data was gathered by means of focus groups and individual interviews. Nine key areas were identified as being problematic, viz. clarity regarding the purpose of probation, lack of proper guidelines, the duration of probation, rotation during probation, lack of training, poor management of probation, performance management, anxiety and stress, power and authority. Recommendations are made concerning possible interventions.

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

    Science.gov (United States)

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

    2016-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-07-01

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

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

    Institute of Scientific and Technical Information of China (English)

    赵洪华; 李国平; 曹树坤; 艾长胜; 孙选

    2015-01-01

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

  6. Interactions of the Infrared bubble N4 with the surroundings

    CERN Document Server

    Liu, Hong-Li; Wu, Yuefang; Yuan, Jing-Hua; Liu, Tie; Dubner, G; Paron, S; Ortega, M E; Molinari, Sergio; Huang, Maohai; Zavagno, Annie; Samal, Manash R; Huang, Ya-Fang; Zhang, Si-Ju

    2016-01-01

    The physical mechanisms that induce the transformation of a certain mass of gas in new stars are far from being well understood. Infrared bubbles associated with HII regions have been considered to be a good sample to investigate triggered star formation. In this paper we report on the investigation of the dust properties of the infrared bubble N4 around the HII region G11.898+0.747, analyzing its interaction with the surroundings and star formation histories therein, aiming at determining the possibility of star formation triggered by the expansion of the bubble. Using Herschel PACS and SPIRE images with a wide wavelength coverage, we reveal the dust properties over the entire bubble. Meanwhile, we are able to identify six dust clumps surrounding the bubble, with a mean size of 0.50 pc, temperature of about 22 K, mean column density of 1.7 $\\times10^{22}$ cm$^{-2}$, mean volume density of about 4.4 $\\times10^{4}$ cm$^{-3}$, and a mean mass of 320 $M_{\\odot}$. In addition, from PAH emission seen at 8 $\\mu$m, ...

  7. Radio observations of Supernova Remnants and the surrounding molecular gas

    CERN Document Server

    Dubner, G

    2011-01-01

    Supernova Remnants (SNRs) are believed to be the main source of Galactic cosmic rays (CR). The strong SNR shocks provide ideal acceleration sites for particles of at least 10^14 eV/nucleon. Radio continuum studies of SNRs carried out with good sensitivity and high angular resolution convey information about three main aspects of the SNRs: morphology, polarization and spectrum. Based on this information it is possible to localize sites of higher compression and particle acceleration as well as the orientation and degree of order of the magnetic fields, and in some cases even its intensity. All this information, when complemented with the study of the distribution and kinematics of the surrounding interstellar gas, results in a very useful dataset to investigate the role of SNRs as cosmic ray accelerators. In this presentation, I analyze the radio observations of SNRs and surrounding molecular clouds, showing the contribution of these studies to the understanding of the role of SNRs as factories of CRs.

  8. Triggered Star Formation Surrounding Wolf-Rayet Star HD 211853

    Science.gov (United States)

    Liu, Tie; Wu, Yuefang; Zhang, Huawei; Qin, Sheng-Li

    2012-05-01

    The environment surrounding Wolf-Rayet (W-R) star HD 211853 is studied in molecular, infrared, as well as radio, and H I emission. The molecular ring consists of well-separated cores, which have a volume density of 103 cm-3 and kinematic temperature ~20 K. Most of the cores are under gravitational collapse due to external pressure from the surrounding ionized gas. From the spectral energy distribution modeling toward the young stellar objects, the sequential star formation is revealed on a large scale in space spreading from the W-R star to the molecular ring. A small-scale sequential star formation is revealed toward core "A," which harbors a very young star cluster. Triggered star formations are thus suggested. The presence of the photodissociation region, the fragmentation of the molecular ring, the collapse of the cores, and the large-scale sequential star formation indicate that the "collect and collapse" process functions in this region. The star-forming activities in core "A" seem to be affected by the "radiation-driven implosion" process.

  9. On the environment surrounding close-in exoplanets

    CERN Document Server

    Vidotto, A A; Jardine, M; Moutou, C; Donati, J -F

    2015-01-01

    Exoplanets in extremely close-in orbits are immersed in a local interplanetary medium (i.e., the stellar wind) much denser than the local conditions encountered around the solar system planets. The environment surrounding these exoplanets also differs in terms of dynamics (slower stellar winds, but higher Keplerian velocities) and ambient magnetic fields (likely higher for host stars more active than the Sun). Here, we quantitatively investigate the nature of the interplanetary media surrounding the hot Jupiters HD46375b, HD73256b, HD102195b, HD130322b, HD179949b. We simulate the three-dimensional winds of their host stars, in which we directly incorporate their observed surface magnetic fields. With that, we derive mass-loss rates (1.9 to 8.0 $\\times 10^{-13} M_{\\odot}$/yr) and the wind properties at the position of the hot-Jupiters' orbits (temperature, velocity, magnetic field intensity and pressure). We show that these exoplanets' orbits are super-magnetosonic, indicating that bow shocks are formed surrou...

  10. Triggered star formation surrounding Wolf-Rayet star HD 211853

    CERN Document Server

    Liu, Tie; Zhang, Huawei; Qin, Sheng-Li

    2012-01-01

    The environment surrounding Wolf-Rayet star HD 211853 is studied in molecular emission, infrared emission, as well as radio and HI emission. The molecular ring consists of well-separated cores, which have a volume density of 10$^{3}$ cm$^{-3}$ and kinematic temperature $\\sim$20 K. Most of the cores are under gravitational collapse due to external pressure from the surrounding ionized gas. From SED modeling towards the young stellar objects (YSOs), sequential star formation is revealed on a large scale in space spreading from the Wolf-Rayet star to the molecular ring. A small scale sequential star formation is revealed towards core A, which harbors a very young star cluster. Triggered star formations is thus suggested. The presence of PDR, the fragmentation of the molecular ring, the collapse of the cores, the large scale sequential star formation indicate the "Collect and Collapse" process functions in this region. The star forming activities in core A seem to be affected by the "Radiation-Driven Implosion" (...

  11. TRIGGERED STAR FORMATION SURROUNDING WOLF-RAYET STAR HD 211853

    Energy Technology Data Exchange (ETDEWEB)

    Liu Tie; Wu Yuefang; Zhang Huawei [Department of Astronomy, Peking University, 100871 Beijing (China); Qin Shengli, E-mail: liutiepku@gmail.com [I. Physikalisches Institut, Universitaet zu Koeln, Zuelpicher Str. 77, 50937 Koeln (Germany)

    2012-05-20

    The environment surrounding Wolf-Rayet (W-R) star HD 211853 is studied in molecular, infrared, as well as radio, and H I emission. The molecular ring consists of well-separated cores, which have a volume density of 10{sup 3} cm{sup -3} and kinematic temperature {approx}20 K. Most of the cores are under gravitational collapse due to external pressure from the surrounding ionized gas. From the spectral energy distribution modeling toward the young stellar objects, the sequential star formation is revealed on a large scale in space spreading from the W-R star to the molecular ring. A small-scale sequential star formation is revealed toward core 'A', which harbors a very young star cluster. Triggered star formations are thus suggested. The presence of the photodissociation region, the fragmentation of the molecular ring, the collapse of the cores, and the large-scale sequential star formation indicate that the 'collect and collapse' process functions in this region. The star-forming activities in core 'A' seem to be affected by the 'radiation-driven implosion' process.

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

    Directory of Open Access Journals (Sweden)

    Hojjat DERAKHSHANFAR

    2013-06-01

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

  13. An analysis of amino acid sequences surrounding archaeal glycoprotein sequons.

    Science.gov (United States)

    Abu-Qarn, Mehtap; Eichler, Jerry

    2007-05-01

    Despite having provided the first example of a prokaryal glycoprotein, little is known of the rules governing the N-glycosylation process in Archaea. As in Eukarya and Bacteria, archaeal N-glycosylation takes place at the Asn residues of Asn-X-Ser/Thr sequons. Since not all sequons are utilized, it is clear that other factors, including the context in which a sequon exists, affect glycosylation efficiency. As yet, the contribution to N-glycosylation made by sequon-bordering residues and other related factors in Archaea remains unaddressed. In the following, the surroundings of Asn residues confirmed by experiment as modified were analyzed in an attempt to define sequence rules and requirements for archaeal N-glycosylation.

  14. An analysis of amino acid sequences surrounding archaeal glycoprotein sequons

    Directory of Open Access Journals (Sweden)

    Mehtap Abu-Qarn

    2006-01-01

    Full Text Available Despite having provided the first example of a prokaryal glycoprotein, little is known of the rules governing the N-glycosylation process in Archaea. As in Eukarya and Bacteria, archaeal N-glycosylation takes place at the Asn residues of Asn-X-Ser/Thr sequons. Since not all sequons are utilized, it is clear that other factors, including the context in which a sequon exists, affect glycosylation efficiency. As yet, the contribution to N-glycosylation made by sequon-bordering residues and other related factors in Archaea remains unaddressed. In the following, the surroundings of Asn residues confirmed by experiment as modified were analyzed in an attempt to define sequence rules and requirements for archaeal N-glycosylation.

  15. Wave rectification in plasma sheaths surrounding electric field antennas

    Science.gov (United States)

    Boehm, M. H.; Carlson, C. W.; Mcfadden, J. P.; Clemmons, J. H.; Ergun, R. E.; Mozer, F. S.

    1994-01-01

    Combined measurements of Langmuir or broadband whistler wave intensity and lower-frequency electric field waveforms, all at 10-microsecond time resolution, were made on several recent sounding rockets in the auroral ionosphere. It is found that Langmuir and whistler waves are partically rectified in the plasma sheaths surrounding the payload and the spheres used as antennas. This sheath rectification occurs whenever the high frequency (HF) potential across the sheath becomes of the same order as the electron temperature or higher, for wave frequencies near or above the ion plasma frequency. This rectification can introduce false low-frequency waves into measurements of electric field spectra when strong high-frequency waves are present. Second harmonic signals are also generated, although at much lower levels. The effect occurs in many different plasma conditions, primarily producing false waves at frequencies that are low enough for the antenna coupling to the plasma to be resistive.

  16. The nature of plerions surrounding soft gamma-ray repeaters

    CERN Document Server

    Harding, A K

    1995-01-01

    Compact steady sources of X-ray emission have been detected at the positions of at least two soft gamma-ray repeaters (SGRs). These sources have been interpreted as synchrotron nebulae powered by the neutron star that is causing the bursts. We explore a plerion model for the sources surrounding SGRs where the steady observed emission is powered by the SGR bursts rather than by the spin-down of a pulsar. In this case there is no limit on the neutron star magnetic field. We find that the synchrotron lifetime of the particles injected into the plerion around SGR1806-20 is long enough to smear out nebular emission from individual bursts. Transient nebular emission would therefore not be detected following an SGR burst. The combined radio emission from multiple burst injections is expected to have a steeper spectrum than that of a typical plerion.

  17. Casimir Effect in the Kerr Spacetime Surrounded by Quintessence

    CERN Document Server

    Bezerra, V B; Freitas, L F F; Muniz, C R

    2016-01-01

    We calculate the Casimir energy of a massless scalar field in a cavity formed by nearby parallel plates orbiting a rotating spherical body surrounded by quintessence, investigating the influence of the gravitational field on that energy, at zero temperature. This influence includes the effects due to the spacetime dragging caused by the source rotation as well as those ones due to the quintessence. We show that the energy depends on all the involved parameters, as source mass, angular momentum and quintessence state parameter, for any radial coordinate and polar angle. We show that at the north pole the Casimir energy is not influenced by the quintessential matter. At the equatorial plane, when the quintessence is canceled, the result obtained in the literature is recovered. Finally, constraints in the quintessence parameters are obtained from the uncertainty in the current measurements of Casimir effect.

  18. Ozone bioindication in Barcelona and surrounding area of Catalonia

    Energy Technology Data Exchange (ETDEWEB)

    Ribas, A.; Penuelas, J. [Univ. Autonoma de Barcelona, Barcelona (Spain). Ecophysiology Unit of CSIC

    2002-07-01

    A field study was conducted from July to September 2000 to assess ozone (O{sub 3}) phytotoxicity in Barcelona and surrounding areas of Catalonia (NE Spain) by using tobacco plants Bel-W3 and Populus nigra 'Brandaris' as bioindicators. The study was conducted simultaneously at eight sites where ozone concentrations and meteorological variables were continuously monitored. The ozone levels correlated well with ozone injury on the Bel-W3 cultivar, especially at stations established in the urban area of Barcelona, and in the first months of summer. In the second half of summer plants showed a decreasing efficiency in its biomonitoring capacity. The behaviour of Populus as bioindicator or biomonitor was less satisfactory. For both species it is necessary to improve cultivation conditions since water deficits seem to play an important role in bioindication in the Mediterranean region. (orig.)

  19. Physical Coupling of Kazarian Galaxies with Surrounding Galaxies

    Science.gov (United States)

    Kazarian, M. A.; Martirosian, J. R.

    2003-04-01

    Results from a statistical study of Kazarian galaxies and the objects surrounding them are presented. It is shown that: (1) the sample of Kazarian galaxies up to 16m.0 is complete. (2) Roughly 35.7% of the Kazarian galaxies are members of clusters, 14.0% of groups, and 13.6% of binary systems, while 36.7% are single galaxies. (3) Of the 580 Kazarian galaxies, roughly 61.2% are infrared, 8.8% radio, and 2.8% x-ray sources. (4) The relative numbers of Kazarian galaxies for complete samples of I, R, and X in the different groups are systematically higher than the corresponding numbers for samples of all Kazarian galaxies.

  20. On radial oscillations in viscous accretion discs surrounding neutron stars

    Science.gov (United States)

    Chen, Xingming; Taam, Ronald E.

    1992-01-01

    Radial oscillations resulting from axisymmetric perturbations in viscous accretion disks surrounding neutron stars in X-ray binary systems have been investigated. Within the framework of the alpha-viscosity model a series of hydrodynamic calculations demonstrates that the oscillations are global for alpha of about 1. On the other hand, for alpha of 0.4 or less, the oscillations are local and confined to the disk boundaries. If viscous stresses acting in the radial direction are included, however, it is found that the disk can be stabilized. The application of such instabilities in accretion disks, without reference to the boundary layer region between the neutron star (or magnetosphere) and the inner edge of the disk, to the phenomenology of quasi-periodic oscillations is brought into question.

  1. Natural convection between a vertical cylinder and a surrounding array

    Energy Technology Data Exchange (ETDEWEB)

    McEligot, D.M.; O`Brien, J.E.; Stoots, C.M.; Larson, T.K.; Christenson, W.A.; Mecham, D.C.; Lussie, W.G.

    1992-09-01

    The generic situation considered is natural convection between a single heated, vertical cylinder and a surrounding array of cooler vertical cylinders in a triangular pattern. The ratio of the test section temperature to the cooling tube temperature was varied up to 2.6 by adjusting the electrical power. The Rayleigh number, based on test section diameter and air properties evaluated at cooling tube temperature, ranged from 2.9 x 10{sup 4} to 4.6 x 10{sup 5}. Results indicate that the convective heat transfer data could be approximated as Nu{sub D} (T{sub ts}/T{sub ct}){sup 0.14} = 0.156 Ra{sub D}{sup 1/3} in the apparent turbulent region for Ra{sub L} > 1.2 x 10{sup 11.}

  2. Natural convection between a vertical cylinder and a surrounding array

    Energy Technology Data Exchange (ETDEWEB)

    McEligot, D.M.; O' Brien, J.E.; Stoots, C.M.; Larson, T.K.; Christenson, W.A.; Mecham, D.C.; Lussie, W.G.

    1992-01-01

    The generic situation considered is natural convection between a single heated, vertical cylinder and a surrounding array of cooler vertical cylinders in a triangular pattern. The ratio of the test section temperature to the cooling tube temperature was varied up to 2.6 by adjusting the electrical power. The Rayleigh number, based on test section diameter and air properties evaluated at cooling tube temperature, ranged from 2.9 x 10{sup 4} to 4.6 x 10{sup 5}. Results indicate that the convective heat transfer data could be approximated as Nu{sub D} (T{sub ts}/T{sub ct}){sup 0.14} = 0.156 Ra{sub D}{sup 1/3} in the apparent turbulent region for Ra{sub L} > 1.2 x 10{sup 11.}

  3. Rotation of the Warm Molecular Gas Surrounding Ultracompact HII Regions

    CERN Document Server

    Klaassen, P D; Keto, E R; Zhang, Q

    2009-01-01

    We present molecular line and 1.4 mm continuum observations towards five massive star forming regions at arcsecond resolution using the Submillimeter Array (SMA). We find that the warm molecular gas surrounding each HII region (as traced by SO_2 and OCS) appears to be undergoing bulk rotation. From the molecular line emission and thermal component of the continuum emission, we independently derived gas masses for each region which are consistent with each other. From the free-free component of the continuum emission we estimate the minimum stellar mass required to power the HII region and find that this mass, when added to the derived gas mass, is a significant fraction of the dynamical mass for that region.

  4. A 500 Parsec Halo Surrounding the Galactic Globular NGC 1851

    CERN Document Server

    Olszewski, Edward W; Knezek, Patricia; Subramaniam, Annapurni; de Boer, Thomas; Seitzer, Patrick

    2009-01-01

    Using imaging that shows four magnitudes of main sequence stars, we have discovered that the Galactic globular cluster NGC 1851 is surrounded by a halo that is visible from the tidal radius of 700 arcsec (41 pc) to more than 4500 arcsec (>250 pc). This halo is symmetric and falls in density as a power law of $r^{-1.24}$. It contains approximately 0.1% of the dynamical mass of NGC 1851. There is no evidence for tidal tails. Current models of globular cluster evolution do not explain this feature, although simulations of tidal influences on dwarf spheroidal galaxies qualitatively mimic these results. Given the state of published models it is not possible to decide between creation of this halo from isolated cluster evaporation, or from tidal or disk shocking, or from destruction of a dwarf galaxy in which this object may have once been embedded.

  5. Thermodynamic stability of black holes surrounded by quintessence

    CERN Document Server

    Ma, Meng-Sen; Ma, Ya-Qin

    2016-01-01

    We study the thermodynamic stabilities of uncharged and charged black holes surrounded by quintessence (BHQ) by means of effective thermodynamic quantities. When the state parameter of quintessence $\\omega_q$ is appropriately chosen, the structures of BHQ are something like that of black holes in de Sitter space. Constructing the effective first law of thermodynamics in two different ways, we can derive the effective thermodynamic quantities of BHQ. Especially, these effective thermodynamic quantities also satisfy Smarr-like formulae. It is found that the uncharged BHQ is always thermodynamically unstable due to negative heat capacity, while for the charged BHQ there are phase transitions of the second order. We also show that there is a great deal of difference on the thermodynamic properties and critical behaviors of BHQ between the two ways we employed.

  6. Thermodynamic stability of black holes surrounded by quintessence

    Science.gov (United States)

    Ma, Meng-Sen; Zhao, Ren; Ma, Ya-Qin

    2017-06-01

    We study the thermodynamic stabilities of uncharged and charged black holes surrounded by quintessence (BHQ) by means of effective thermodynamic quantities. When the state parameter of quintessence ω _q is appropriately chosen, the structures of BHQ are something like that of black holes in de Sitter space. Constructing the effective first law of thermodynamics in two different ways, we can derive the effective thermodynamic quantities of BHQ. Especially, these effective thermodynamic quantities also satisfy Smarr-like formulae. It is found that the uncharged BHQ is always thermodynamically unstable due to negative heat capacity, while for the charged BHQ there are phase transitions of the second order. We also show that there are several differences on the thermodynamic properties and critical behaviors of BHQ between the two ways we employed.

  7. Impact-Generated Dust Clouds Surrounding the Galilean Moons

    CERN Document Server

    Krüger, H; Grün, E; Kr\\"uger, Harald~; Krivov, Alexander V.; Gr\\"un, Eberhard

    2003-01-01

    Tenuous dust clouds of Jupiter's Galilean moons Io, Europa, Ganymede and Callisto have been detected with the in-situ dust detector on board the Galileo spacecraft. The majority of the dust particles have been sensed at altitudes below five radii of these lunar-sized satellites. We identify the particles in the dust clouds surrounding the moons by their impact direction, impact velocity, and mass distribution. Average particle sizes are 0.5 to $\\rm 1 \\mu m$, just above the detector threshold, indicating a size distribution with decreasing numbers towards bigger particles. Our results imply that the particles have been kicked up by hypervelocity impacts of micrometeoroids onto the satellites' surfaces. The measured radial dust density profiles are consistent with predictions by dynamical modeling for satellite ejecta produced by interplanetary impactors (Krivov et al., PSS, 2003, 51, 251--269), assuming yield, mass and velocity distributions of the ejecta from laboratory measurements. The dust clouds of the th...

  8. The new Medicaid debate: expansion or retrenchment?

    Science.gov (United States)

    2001-01-01

    Health advocates are facing a sea-change in Washington. Comprehensive federal health care reform eluded the nation under the Clinton Administration, but incremental progress through state-based Medicaid expansions and new CHIP programs was widespread, giving rise to some innovative state efforts to cover more of the uninsured. Washington's support was instrumental in those efforts, but the second Bush Administration seems intent on reversing that direction. To protect--and build upon--these nascent Medicaid efforts, advocates will have to mount careful strategies in defense of Medicaid. This States of Health looks at the dangers that may lie ahead and suggests how advocates can respond to keep Medicaid moving in the right direction.

  9. Worker Retrenchment: Preventive and Remedial Measures.

    Science.gov (United States)

    Evans-Klock, Christine; Kelly, Peggy; Richards, Peter; Vargha, Corinne

    1999-01-01

    Reviews the range of responses taken in industrialized countries seeking to deal with substantial worker displacement. Practices discussed include preventive subsidies, buyouts, retraining, job-search assistance, job creation, local and regional development, and local enterprise development. (Author/JOW)

  10. Globalization, tax distortions and public sector retrenchment

    DEFF Research Database (Denmark)

    Andersen, Torben M.; Sørensen, Allan

    income taxation unambiguously worsens wage competitiveness, it does not follow that marginal costs of public funds increase with product market integration due to gains from trade. Moreover, non-cooperative fiscal policies do not have a race-to-the-bottom bias despite that taxes harm competitiveness....... In fact we identify an expansionary bias in …scal policies that is likely to increase with globalization when taxes finance either public consumption or transfers....

  11. Radical Welfare State Retrenchment: A Comparative Analysis

    DEFF Research Database (Denmark)

    Starke, Peter

    as electoral suicide, but this changed in the 1980s when Margaret Thatcher's government began a series of cutbacks in the UK. During the 1990s, the New Zealand government announced the most radical social benefit cutbacks the country had ever seen. Examining these cases in detail, and contrasting them...

  12. Resource Sharing in Times of Retrenchment.

    Science.gov (United States)

    Sloan, Bernard G.

    1992-01-01

    Discusses the impact of decreases in revenues on the resource-sharing activities of ILLINET Online and the Illinois Library Computer Systems Organization (ILCSO). Strategies for successfully coping with fiscal crises are suggested, including reducing levels of service and initiating user fees for interlibrary loans and faxing photocopied journal…

  13. Retrenchment: layoff procedures in a nonprofit organization.

    Science.gov (United States)

    Fuller, R; Jordan, C; Anderson, R

    1982-01-01

    One of the most unsettling experiences that human resources and other managers must face is a large-scale employee layoff. Authors Robert Fuller, national director of personnel, Cassandra Jordan, assistant director of personnel, and Robert Anderson, employment and training manager--all at the Legal Services Corporation--show how careful management planning, extensive staff involvement, and well-planned counseling and outplacement services helped employees of Legal Services Corporation wheather such a layoff. As the first step, the planning committee (personnel director, equal employment opportunity director, and general counsel) recommended that the corporation conduct staff education about layoffs for all employees, that a representative employee task force be established to develop specific details of the layoff plan, and that the corporation hire an experienced person to help staff members implement the plan. Members of the task force, who were elected by staff members (except for one additional member who was selected to ensure proper representation of minority groups and women), made specific recommendations on the way to determine seniority and bumping rights. The task force also dealt with such issues as method of notification, an appeals procedure, reemployment rights, the counseling and outplacement services. The task force also considered the issue of "willingness to leave".

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

    Directory of Open Access Journals (Sweden)

    Morten Søndergaard

    2007-05-01

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

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

    Science.gov (United States)

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

    2003-03-01

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

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

    Science.gov (United States)

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

    2015-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Iris Ricardo Rossin

    2011-12-01

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

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

    Science.gov (United States)

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

    2006-12-01

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

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

    Science.gov (United States)

    Kiemeneij, F; Laarman, G J

    1993-12-01

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

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

    Science.gov (United States)

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

    2000-01-01

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