Novel Split Chest Tube Improves Post-Surgical Thoracic Drainage

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Olivencia-Yurvati, Albert H; Cherry, Brandon H; Gurji, Hunaid A; White, Daniel W; Newton, J Tyler; Scott, Gary F; Hoxha, Besim; Gourlay, Terence; Mallet, Robert T

2014-01-01

Objective Conventional, separate mediastinal and pleural tubes are often inefficient at draining thoracic effusions. Description We developed a Y-shaped chest tube with split ends that divide within the thoracic cavity, permitting separate intrathoracic placement and requiring a single exit port. In this study, thoracic drainage by the split drain vs. that of separate drains was tested. Methods After sternotomy, pericardiotomy, and left pleurotomy, pigs were fitted with separate chest drains (n=10) or a split tube prototype (n=9) with internal openings positioned in the mediastinum and in the costo-diaphragmatic recess. Separate series of experiments were conducted to test drainage of D5W or 0.58 M sucrose, an aqueous solution with viscosity approximating that of plasma. One litre of fluid was infused into the thorax, and suction was applied at −20 cm H2O for 30 min. Results When D5W was infused, the split drain left a residual volume of 53 ± 99 ml (mean value ± SD) vs. 148 ± 120 for the separate drain (P=0.007), representing a drainage efficiency (i.e. drained vol/[drained + residual vol]) of 95 ± 10% vs. 86 ± 12% for the separate drains (P = 0.011). In the second series, the split drain evacuated more 0.58 M sucrose in the first minute (967 ± 129 ml) than the separate drains (680 ± 192 ml, Pdrain evacuated a similar volume of sucrose vs. the conventional drain (1089 ± 72 vs. 1056 ± 78 ml; P = 0.5). Residual volume tended to be lower (25 ± 10 vs. 62 ± 72 ml; P = 0.128) and drainage efficiency tended to be higher (98 ± 1 vs. 95 ± 6%; P = 0.111) with the split drain vs. conventional separate drains. Conclusion The split chest tube drained the thoracic cavity at least as effectively as conventional separate tubes. This new device could potentially alleviate postoperative complications. PMID:25478289

Novel Split Chest Tube Improves Post-Surgical Thoracic Drainage.

Science.gov (United States)

Olivencia-Yurvati, Albert H; Cherry, Brandon H; Gurji, Hunaid A; White, Daniel W; Newton, J Tyler; Scott, Gary F; Hoxha, Besim; Gourlay, Terence; Mallet, Robert T

2014-01-01

Conventional, separate mediastinal and pleural tubes are often inefficient at draining thoracic effusions. We developed a Y-shaped chest tube with split ends that divide within the thoracic cavity, permitting separate intrathoracic placement and requiring a single exit port. In this study, thoracic drainage by the split drain vs. that of separate drains was tested. After sternotomy, pericardiotomy, and left pleurotomy, pigs were fitted with separate chest drains (n=10) or a split tube prototype (n=9) with internal openings positioned in the mediastinum and in the costo-diaphragmatic recess. Separate series of experiments were conducted to test drainage of D5W or 0.58 M sucrose, an aqueous solution with viscosity approximating that of plasma. One litre of fluid was infused into the thorax, and suction was applied at -20 cm H2O for 30 min. When D5W was infused, the split drain left a residual volume of 53 ± 99 ml (mean value ± SD) vs. 148 ± 120 for the separate drain (P=0.007), representing a drainage efficiency (i.e. drained vol/[drained + residual vol]) of 95 ± 10% vs. 86 ± 12% for the separate drains (P = 0.011). In the second series, the split drain evacuated more 0.58 M sucrose in the first minute (967 ± 129 ml) than the separate drains (680 ± 192 ml, Pdrain evacuated a similar volume of sucrose vs. the conventional drain (1089 ± 72 vs. 1056 ± 78 ml; P = 0.5). Residual volume tended to be lower (25 ± 10 vs. 62 ± 72 ml; P = 0.128) and drainage efficiency tended to be higher (98 ± 1 vs. 95 ± 6%; P = 0.111) with the split drain vs. conventional separate drains. The split chest tube drained the thoracic cavity at least as effectively as conventional separate tubes. This new device could potentially alleviate postoperative complications.

New Technique of Exposed Glaucoma Drainage Tube Repair: Report of a Case.

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Berezina, Tamara L; Fechtner, Robert D; Cohen, Amir; Kim, Eliott E; Chu, David S

2015-01-01

We present the case of successful repair of an exposed glaucoma drainage tube by cornea graft fixation with tissue adhesive, and without subsequent coverage by adjacent conjunctiva or donor tissues. Patient with history of keratoglobus with thin cornea and sclera, and phthisical contralateral eye, underwent three unsuccessful corneal grafts followed by Boston type 1 keratoprosthesis in the right eye. Ahmed drainage device with sclera patch graft was implanted to control the intraocular pressure. Two years later the tube eroded through sclera graft and conjunctiva. Repair was performed by covering the tube with a corneal patch graft secured by tissue adhesive after the conjunctiva in this area was dissected away. The cornea graft was left uncovered due to fragility of adjacent conjunctiva. The healing of ocular and graft surfaces was complete prior to the 1 month follow-up. Conjunctival epithelium covered the corneal patch graft. At 12 months follow-up, the graft and the tube remained stable. Our report suggests that corneal patch graft fixation to the sclera by means of tissue adhesive, without closing the conjunctiva, can be considered as an effective alternative surgical approach for managing exposed glaucoma drainage tube, accompanied by adjacent conjunctiva tissue deficiency. How to cite this article: Berezina TL, Fechtner RD, Cohen A, Kim EE, Chu DS. New Technique of Exposed Glaucoma Drainage Tube Repair: Report of a Case. J Curr Glaucoma Pract 2015;9(2):62-64.

Comparison of outcome in roux-y hepaticoje junostomy with and without transanastmotic tube drainage in tertiary care hospital

International Nuclear Information System (INIS)

Shakir, J.

2015-01-01

Aim: To compare the incidence of post operative bile leakage in Roux- Y hepaticojejunostomy with and with out transanastmotic Tube drainage placement. Background: A biliary-enteric anastrnosis (Roux-en-Y hepaticojejunostomy) is usually needed after complex injuries and for benign biliary pathologies. Placement of transanastmotic Tube drainage is a matter of debate and to our knowledge there is no study that compares the results regarding biliary leakage in Rou- x- Y hepaticojejunostomy with and without transanastmotic Tube drainage. Design: Randomized controlled Trial. Setting: Tertiary care center, Fatima Memorial Hospital Lahore. Methods: All the adult patients who were either admitted through OPD or referred to our hospital from September 2009 to September 2013 for Roux- Y he paticojejunostomy for acute or elective reconstruction of the biliary tract. The patients were randomized into 2 groups: group A those who underwent Roux-en- Y he- paticojejunostomy with transanastmotic Tube drainage and group B without transanastmotic Tube drainage. Main Outcome Measures: Anastmosis leakage, hospital stay. Results: Total 50 patients including high and complex biliary injuries (Bismuth type III, IV; Strasberg 0, E) choledochal cyst and biliary strictures. Twenty five cases had reconstruction with the placement of transanastmotic Tube drainage and 25 cases without transanastmotic Tube drainage. No operative mortality was observed. The postoperative outcomes of both groups were compared and significant differences observed. Good results were observed in more than 90% of the patients with biliary drainage. Biliary leakage more frequent in patients having no external biliary drainage (24% vs. 4%). Conclusions: Good results are obtained with a Rouxen- Y epaticojcjunostomy with transanastmotic Tube drainage. We recommend that all patients who under go Roux-en- Y hepaticojejunostomy should have Transanastmotic Tube drainage. (author)

Comparison of pigtail catheter with chest tube for drainage of parapneumonic effusion in children.

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Lin, Chien-Heng; Lin, Wei-Ching; Chang, Jeng-Sheng

2011-12-01

The use of thoracostomy tube for drainage of parapneumonic effusion is an important therapeutic measure. In this study, we compared the effectiveness and complications between chest tube and pigtail catheter thoracostomy for drainage of parapneumonic pleural effusion in children. We retrospectively reviewed the medical records of children with parapneumonic effusion during the period of July 2001 through December 2003. Patients who received thoracostomy with either chest tube or pigtail catheter were enrolled into this study. Medical records, such as age, sex, clinical presentation, subsequent therapies, hospital stay, laboratory data, and complications, were collected and compared between these two methods of intervention. A total of 32 patients (17 boys and 15 girls; age range, 2-17 years; mean age, 14 years) were enrolled into the study. Twenty patients were treated with traditional chest tubes, whereas 12 patients were treated with pigtail catheters. In the chest tube group, drainage failure occurred in one patient and pneumothorax occurred in two patients. In the pigtail catheter group, drainage failure occurred in two patients, but no case was complicated with pneumothorax. There were no significant differences in either drainage days or hospitalization days between the chest tube group and pigtail catheter group (6.0 ± 2.6 vs. 5.9 ± 3.8, p=0.66; 12.5 ± 5.6 vs. 17.3 ± 8.5, p=0.13). The effectiveness and complications of the pigtail catheter were comparable to those of the chest tubes. Copyright © 2011. Published by Elsevier B.V.

Efficacy of percutaneous sclerotherapy through pig tail drainage tube for giant hepatic and renal cysts under CT guidance

International Nuclear Information System (INIS)

Huang Xiaoming; Huang Yongbin; Geng Lei; Zhang Haitao

2008-01-01

Objective: To evaluate the safety and efficacy of percutaneous sclerotherapy through pig tail drainage tube for giant hepatic and renal cysts under CT guidance. Methods: Seventeen cases of giant hepatic and renal cyst were percutaneously implanted with 7 F pig tail drainage tube under CT guidance, together with daily injection of dehydrated ethanol or acetic acid. The drainage tube should be clamped after injection of sclerosing agent for cystic fluid 500 ml, immediate reopening of the drainage tube should be taken sright after the sclerotherapy. The withdrawal of drainage tube should be taken after resclerotherapy for all patients with < 10 ml of 24 h. drainage volume, including average of 40 d for hepatic cyst and 10 d for renal cyst. Results: 6 months after scletotherapy, all patients showed under US examination and 'healed' for all 17 cases, with successful rate up to 100%. No complication of bleeding, infection and cardioencephalovascular events occurred. Conclusion: CT guided pereutaneous sclerotherapy through pig tail drainage tube for giant hepatic and renal cysts is simple, safe and satisfactory efficacy. (authors)

What we don't know may hurt us: urinary drainage system tubing coils and CA-UTIs-A prospective quality study.

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Kubilay, Zeynep; Archibald, Lennox K; Kirchner, H Lester; Layon, A Joseph

2013-12-01

Catheter-associated urinary tract infections account for >30% of infections in acute care hospitals. We hypothesized that coiling of/kinks in the indwelling urinary bladder catheter (IUBC) drainage bag tubing would increase the occurrence of infection/bacteriuria. Ninety-one patient events were evaluated over 60 days. All outcome variables trended with greater frequency among those with a coil in the IUBC tubing; only fever (temperature > 38.1°C) correlated significantly between groups (P = .003). If IUBC is unavoidable, strategies such as keeping collection bag below the level of bladder and avoiding any coiling in the drainage system should be employed. Further study of these phenomena is needed. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Risk factors for tube exposure as a late complication of glaucoma drainage implant surgery

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Chaku M

2016-03-01

Full Text Available Meenakshi Chaku,1 Peter A Netland,2 Kyoko Ishida,3 Douglas J Rhee4 1Department of Ophthalmology, Loyola University Chicago, Maywood, IL, 2Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville, VA, USA; 3Department of Ophthalmology, Toho University, Tokyo, Japan; 4Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, OH, USA Purpose: The purpose of this study was to evaluate the risk factors for tube exposure after glaucoma drainage implant surgery.Patients and methods: This was a retrospective case-controlled observational study of 64 eyes from 64 patients. Thirty-two eyes of 32 patients with tube erosion requiring surgical revision were compared with 32 matched control eyes of 32 patients. Univariate and multivariate risk factor analyses were performed.Results: Mean age was significantly younger in the tube exposure group compared with the control group (48.2±28.1 years versus 67.3±18.0 years, respectively; P=0.003. The proportion of diabetic patients (12.5% in the tube exposure group was significantly less (P=0.041 compared with the control group (37.5%. Comparisons of the type and position of the drainage implant were not significantly different between the two groups. The average time to tube exposure was 17.2±18.0 months after implantation of the drainage device. In both univariate and multivariate analyses, younger age (P=0.005 and P=0.027 and inflammation prior to tube exposure (P≤0.001 and P=0.004 were significant risk factors. Diabetes was a significant risk factor only in the univariate analysis (P=0.027.Conclusion: Younger age and inflammation were significant risk factors for tube exposure after drainage implant surgery. Keywords: glaucoma drainage implant complications, Ahmed Glaucoma Valve, Baerveldt implant, tube erosion, pericardial patch graft

Study of Eustachian tube drainage function with radioisotope (99m-Tc)

International Nuclear Information System (INIS)

Marone, S.A.M.; Miniti, A.

1985-01-01

The knowledge of the physiological condition of the Eustachian tube is of major significance to the understanding of the middle ear pathology as well as for the treatment of each case. This paper studies the drainage function of the Eustachian tube. The choice of the Technetium (99m-Tc) as tracer was based on its physical qualities - tracer perfectly adaptable to the detection system, pure gamma emitter, low energy and 6 hours half-life. The use of Tc-99m turns out to be a very accurate method for testing the drainage function. It is an entirely physiological method, and it produces no side effect reactions. (Auth.)

The use of IV-tubing as a closed-suction drainage system during neurosurgical cases in Tanzania.

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Bonfield, Christopher M; Shabani, Hamisi K; Kanumba, Emmanuel S; Ellegala, Dilantha B; Nicholas, Joyce

2013-01-01

Commercial closed-suctions drainage systems are commonly used in the United States and many other countries for use in neurosurgical cases. However, in Tanzania and other developing nations with fewer resources, these are not available. This report explores another option for a closed-system drainage system utilizing inexpensive supplies found commonly in hospitals around the world. Sterile IV-tubing is cut, inserted into the wound, and brought out through an adjacent puncture incision. For suction, an empty plastic bottle can be attached to the tubing. The IV-tubing closed-suction drainage system was applied in both cranial and spinal neurosurgical procedures, including as subdural, subgaleal, epidural, and suprafacial drains. It maintained suction and was an adequate substitute when commercial drains are unavailable. This report illustrates how sterile IV-tubing can be adapted for use as a closed-drainage system. It utilizes inexpensive supplies commonly found in many hospitals throughout the world and can be applied to both cranial and spinal neurosurgical procedures.

Simple aspiration versus intercostal tube drainage for primary spontaneous pneumothorax in adults.

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Carson-Chahhoud, Kristin V; Wakai, Abel; van Agteren, Joseph Em; Smith, Brian J; McCabe, Grainne; Brinn, Malcolm P; O'Sullivan, Ronan

2017-09-07

For management of pneumothorax that occurs without underlying lung disease, also referred to as primary spontaneous pneumothorax, simple aspiration is technically easier to perform than intercostal tube drainage. In this systematic review, we seek to compare the clinical efficacy and safety of simple aspiration versus intercostal tube drainage for management of primary spontaneous pneumothorax. This review was first published in 2007 and was updated in 2017. To compare the clinical efficacy and safety of simple aspiration versus intercostal tube drainage for management of primary spontaneous pneumothorax. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 1) in the Cochrane Library; MEDLINE (1966 to January 2017); and Embase (1980 to January 2017). We searched the World Health Organization (WHO) International Clinical Trials Registry for ongoing trials (January 2017). We checked the reference lists of included trials and contacted trial authors. We imposed no language restrictions. We included randomized controlled trials (RCTs) of adults 18 years of age and older with primary spontaneous pneumothorax that compared simple aspiration versus intercostal tube drainage. Two review authors independently selected studies for inclusion, assessed trial quality, and extracted data. We combined studies using the random-effects model. Of 2332 publications obtained through the search strategy, seven studies met the inclusion criteria; one study was ongoing and six studies of 435 participants were eligible for inclusion in the updated review. Data show a significant difference in immediate success rates of procedures favouring tube drainage over simple aspiration for management of primary spontaneous pneumothorax (risk ratio (RR) 0.78, 95% confidence interval (CI) 0.69 to 0.89; 435 participants, 6 studies; moderate-quality evidence). Duration of hospitalization however was significantly less for patients treated by simple aspiration (mean

Pyeloplasty for hydronephrosis: Issues of double J stent versus nephrostomy tube as drainage technique

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Ravi Kumar Garg

2015-01-01

Full Text Available Aims: To compare the efficacy, complications, cost analysis and hospital stay between two methods of drainage of the kidney: double J (DJ stent versus nephrostomy tube following open pyeloplasty for ureteropelvic junction obstruction hydronephrosis. Patients and Methods: This was a prospective randomized study of 20 patients in each group over 14 months. Pre and post-operative (3 months function and drainage were assessed by ethylenedicysteine scan and intravenous urogram. Results: Both groups showed similar good improvement in function and drainage. Nephrostomy group had significantly longer hospital stay (P < 0.001 but incurred less cost. Complications with nephrostomy included tube breakage (n = 1 and urine leak after tube removal (n = 2. DJ stents were associated with stent migration (n = 4, increased frequency of micturition (n = 9, dysuria (n = 4 and urinary tract infection (n = 1. Conclusion: Both methods of drainage did not interfere with improvement after pyeloplasty. Minor complications were more with DJ stent (P = 0.0003. Although overall cost of treatment was more with stents, they reduced length of hospital stay. Optimal length of stent is essential to reduce complications secondary to migration and bladder irritation.

Reduce chest pain using modified silicone fluted drain tube for chest drainage after video-assisted thoracic surgery (VATS) lung resection.

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Li, Xin; Hu, Bin; Miao, Jinbai; Li, Hui

2016-02-01

The aim of this study was to assess the feasibility, efficacy and safety of a modified silicone fluted drain tube after video-assisted thoracic surgery (VATS) lung resection. The prospective randomized study included 50 patients who underwent VATS lung resection between March 2015 and June 2015. Eligible patients were randomized into two groups: experimental group (using the silicone fluted drain tubes for chest drainage) and control group (using standard drain tubes for chest drainage). The volume and characteristics of drainage, postoperative (PO) pain scores and hospital stay were recorded. All patients received standard care during hospital admission. In accordance with the exit criteria, three patients were excluded from study. The remaining 47 patients included in the final analysis were divided into two groups: experiment group (N=24) and control group (N=23). There was no significant difference between the two groups in terms of age, sex, height, weight, clinical diagnosis and type of surgical procedure. There was a trend toward less PO pain in experimental group on postoperative day (POD) 1, with a statistically significant difference. Patients in experimental group had a reduced occurrence of fever [temperature (T) >37.4 °C] compared to the control group. The silicone fluted drain tube is feasible and safe and may relieve patient PO pain and reduce occurrence of fever without the added risk of PO complications.

Systematic review and meta-analysis of initial management of pneumothorax in adults: Intercostal tube drainage versus other invasive methods.

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Min Joung Kim

Full Text Available The ideal invasive management as initial approach for pneumothorax (PTX is still under debate. The purpose of this systematic review and meta-analysis was to examine the evidence for the effectiveness of intercostal tube drainage and other various invasive methods as the initial approach to all subtypes of PTX in adults.Three databases were searched from inception to May 29, 2016: MEDLINE, EMBASE, and the Cochrane CENTRAL. Randomised controlled trials that evaluated intercostal tube drainage as the control and various invasive methods as the intervention for the initial approach to PTX in adults were included. The primary outcome was the early success rate of each method, and the risk ratios (RRs were used for an effect size measure. The secondary outcomes were recurrence rate, hospitalization rate, hospital stay, and complications.Seven studies met our inclusion criteria. Interventions were aspiration in six studies and catheterization connected to a one-way valve in one study. Meta-analyses were conducted for early success rate, recurrence rate, hospitalization rate, and hospital stay. Aspiration was inferior to intercostal tube drainage in terms of early success rate (RR = 0.82, confidence interval [CI] = 0.72 to 0.95, I2 = 0%. While aspiration and intercostal tube drainage showed no significant difference in the recurrence rate (RR = 0.84, CI = 0.57 to 1.23, I2 = 0%, aspiration had shorter hospital stay than intercostal tube drainage (mean difference = -1.73, CI = -2.33 to -1.13, I2 = 0%. Aspiration had lower hospitalization rate than intercostal tube drainage, but marked heterogeneity was present (RR = 0.38, CI = 0.19 to 0.76, I2 = 85%.Aspiration was inferior to intercostal tube drainage in terms of early resolution, but it had shorter hospital stay. The recurrence rate of aspiration and intercostal tube drainage did not differ significantly. The efficacy of catheterization connected to a one-way valve was inconclusive because of the small

A pilot study of chest tube versus pigtail catheter drainage of acute hemothorax in swine.

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Russo, Rachel M; Zakaluzny, Scott A; Neff, Lucas P; Grayson, J Kevin; Hight, Rachel A; Galante, Joseph M; Shatz, David V

2015-12-01

Evacuation of traumatic hemothorax (HTx) is typically accomplished with large-bore (28-40 Fr) chest tubes, often resulting in patient discomfort. Management of HTx with smaller (14 Fr) pigtail catheters has not been widely adopted because of concerns about tube occlusion and blood evacuation rates. We compared pigtail catheters with chest tubes for the drainage of acute HTx in a swine model. Six Yorkshire cross-bred swine (44-54 kg) were anesthetized, instrumented, and mechanically ventilated. A 32 Fr chest tube was placed in one randomly assigned hemithorax; a 14 Fr pigtail catheter was placed in the other. Each was connected to a chest drainage system at -20 cm H2O suction and clamped. Over 15 minutes, 1,500 mL of arterial blood was withdrawn via femoral artery catheters. Seven hundred fifty milliliters of the withdrawn blood was instilled into each pleural space, and fluid resuscitation with colloid was initiated. The chest drains were then unclamped. Output from each drain was measured every minute for 5 minutes and then every 5 minutes for 40 minutes. The swine were euthanized, and thoracotomies were performed to quantify the volume of blood remaining in each pleural space and to examine the position of each tube. Blood drainage was more rapid from the chest tube during the first 3 minutes compared with the pigtail catheter (348 ± 109 mL/min vs. 176 ± 53 mL/min), but this difference was not statistically significant (p = 0.19). Thereafter, the rates of drainage between the two tubes were not substantially different. The chest tube drained a higher total percentage of the blood from the chest (87.3% vs. 70.3%), but this difference did not reach statistical significance (p = 0.21). We found no statistically significant difference in the volume of blood drained by a 14 Fr pigtail catheter compared with a 32 Fr chest tube.

Surgical treatment versus conventional chest tube drainage in primary spontaneous pneumothorax

DEFF Research Database (Denmark)

Olesen, Winnie Hedevang; Katballe, Niels; Sindby, Jesper Eske

2018-01-01

OBJECTIVES: Primary spontaneous pneumothorax frequently recurs after chest tube management. Evidence is lacking whether patients may benefit from surgery following their first episode. METHODS: We performed a multicentre, randomized trial and enrolled young, otherwise healthy patients admitted...... with their first episode of primary spontaneous pneumothorax and treated using conventional chest tube drainage. Patients underwent high-resolution computed tomography on fully expanded lungs, and using web-based randomization, we assigned patients to continued conservative chest tube treatment or chest tube...... treatment to prevent recurrence in patients with their first presentation of primary spontaneous pneumothorax and should be the standard of care when high-resolution computed tomography demonstrates bullae ≥2 cm. Clinical trial registration: ClinicalTrial.gov: NCT 02866305....

CT colonography for preoperative examination of the proximal colon using a transanal drainage tube for acute malignant colonic obstruction

International Nuclear Information System (INIS)

Sasaki, Kazuaki; Hirano, Yuji; Oono, Keisuke; Sasaki, Kazunori; Someya, Tetsufumi; Harada, Keisuke; Ezoe, Eiri; Furuhata, Tomohisa; Hirata, Koichi

2011-01-01

The purpose of this study was to evaluate the feasibility of CT colonography for preoperative examination of the proximal colon using a transanal drainage tube in patients with acute colon obstruction caused by colorectal cancer. Ten patients who received initial treatment for acute malignant colon obstruction at our hospital between June 2004 and December 2008 were studied. In these patients, elective surgery was possible after transanal drainage tube insertion, and the colon on the oral side from the cancer lesion was examined using a drainage tube. Air was injected through the tube into the oral side of the colon, and CT colonography was assessed for the presence or absence of lesions on the oral side. The images of the oral side of the colon were good enough to allow adequate interpretation in 9 of the 10 patients. In the first patient, the visualization of the area near the lesion was somewhat fair, although the right side colon was well visualized. There were no complications associated with this examination. The present preoperative examination using a transanal drainage tube was useful for determining the extent of intestinal resection when patients were not candidates for colonoscopy or barium enema examination. (author)

Prevalence of dependent loops in urinary drainage systems in hospitalized patients.

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Danek, Gale; Gravenstein, Nikolaus; Lizdas, David E; Lampotang, Samsun

2015-01-01

The purpose of this study was to measure the prevalence and configuration of dependent loops in urinary drainage systems in hospitalized, catheterized adults. The study sample comprised 141 patients with indwelling urinary catheters; subjects were hospitalized at an academic health center in northern Florida. We measured the prevalence of dependent loops in urine drainage systems and the incidence of urine-filled dependent loops over a 3-week period. We measured the heights of the crest (H(c)), trough (H(t)), and, when urine-filled dependent loops were present, the patient-side (H(p)) and bag-side (H(b)) menisci with a laser measurement system. All variables were measured in centimeters. The majority of observed urine drainage systems (85%) contained dependent loops in the drainage tubing and 93.8% of the dependent loops contained urine. H(c) and H(t) averaged 45.1 ± 11.1 and 27 ± 16.7 cm, respectively. Meniscus height difference (H(b) - H(p)) averaged 8.2 ± 5.8 and -12.2 ± 9.9 cm when H(p) H(b) (32.7%), respectively. We found that dependent loops are extremely common in urinary drainage systems among hospitalized patients despite the manufacturer recommendations and nursing and hospital policies. Maintaining the urine drainage tubing free of dependent loops would require incorporation into nursing care priorities and workflow as inadvertent force on the tubing, for example, patient movement or nurse contact can change tubing configuration and allow excess drainage tubing to re-form a dependent loop.

Intercostal drainage tube or intracardiac drainage tube?

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Anitha, N; Kamath, S Ganesh; Khymdeit, Edison; Prabhu, Manjunath

2016-01-01

Although insertion of chest drain tubes is a common medical practice, there are risks associated with this procedure, especially when inexperienced physicians perform it. Wrong insertion of the tube has been known to cause morbidity and occasional mortality. We report a case where the left ventricle was accidentally punctured leading to near-exsanguination. This report is to highlight the need for experienced physicians to supervise the procedure and train the younger physician in the safe performance of the procedure.

Peritoneal Drainage Versus Pleural Drainage After Pediatric Cardiac Surgery.

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Gowda, Keshava Murty Narayana; Zidan, Marwan; Walters, Henry L; Delius, Ralph E; Mastropietro, Christopher W

2014-07-01

We aimed to determine whether infants undergoing cardiac surgery would more efficiently attain negative fluid balance postoperatively with passive peritoneal drainage as compared to traditional pleural drainage. A prospective, randomized study including children undergoing repair of tetralogy of Fallot (TOF) or atrioventricular septal defect (AVSD) was completed between September 2011 and June 2013. Patients were randomized to intraoperative placement of peritoneal catheter or right pleural tube in addition to the requisite mediastinal tube. The primary outcome measure was fluid balance at 48 hours postoperatively. Variables were compared using t tests or Fisher exact tests as appropriate. A total of 24 patients were enrolled (14 TOF and 10 AVSD), with 12 patients in each study group. Mean fluid balance at 48 hours was not significantly different between study groups, -41 ± 53 mL/kg in patients with periteonal drainage and -9 ± 40 mL/kg in patients with pleural drainage (P = .10). At 72 hours however, postoperative fluid balance was significantly more negative with peritoneal drainage, -52.4 ± 71.6 versus +2.0 ± 50.6 (P = .04). On subset analysis, fluid balance at 48 hours in patients with AVSD was more negative with peritoneal drainage as compared to pleural, -82 ± 51 versus -1 ± 38 mL/kg, respectively (P = .02). Fluid balance at 48 hours in patients with TOF was not significantly different between study groups. Passive peritoneal drainage may more effectively facilitate negative fluid balance when compared to pleural drainage after pediatric cardiac surgery, although this benefit is not likely universal but rather dependent on the patient's underlying physiology. © The Author(s) 2014.

Life-threatening hemobilia caused by hepatic pseudoaneurysm after T-tube choledochostomy: report of a case

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Wu Hurng-Sheng

2010-07-01

Full Text Available Abstract Background Hemobilia is a rare but lethal biliary tract complication. There are several causes of hemobilia which might be classified as traumatic or nontraumatic. Hemobilia caused by pseudoaneurysm might result from hepatobiliary surgery or percutaneous interventional hepatobiliary procedures. However, to our knowledge, there are no previous reports pertaining to hemobilia caused by hepatic pseudoaneurysm after T-tube choledochostomy. Case presentation A 65-year-old male was admitted to our hospital because of acute calculous cholecystitis and cholangitis. He underwent cholecystectomy, choledocholithotomy via a right upper quadrant laparotomy and a temporary T-tube choledochostomy was created. However, on the 19th day after operation, he suffered from sudden onset of hematemesis and massive fresh blood drainage from the T-tube choledochostomy. Imaging studies confirmed the diagnosis of pseudoaneurysm associated hemobilia. The probable association of T-tube choledochostomy with pseudoaneurysm and hemobilia is also demonstrated. He underwent emergent selective microcoils emobolization to occlude the feeding artery of the pseudoaneurysm. Conclusions Pseudoaneurysm associated hemobilia may occur after T-tube choledochostomy. This case also highlights the importance that hemobilia should be highly suspected in a patient presenting with jaundice, right upper quadrant abdominal pain and upper gastrointestinal bleeding after liver or biliary surgery.

Intercostal drainage tube or intracardiac drainage tube?

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N Anitha

2016-01-01

Full Text Available Although insertion of chest drain tubes is a common medical practice, there are risks associated with this procedure, especially when inexperienced physicians perform it. Wrong insertion of the tube has been known to cause morbidity and occasional mortality. We report a case where the left ventricle was accidentally punctured leading to near-exsanguination. This report is to highlight the need for experienced physicians to supervise the procedure and train the younger physician in the safe performance of the procedure.

Study of treatment results and early complications of tube drainage versus capitonnage after the unroofing and aspiration of hydatid cysts.

Science.gov (United States)

Mehrabi Bahar, Mostafa; Jabbari Nooghabi, Azadeh; Hamid, Alireza; Amouzeshi, Ahmad; Jangjoo, Ali

2014-10-01

There is controversy concerning the management of the remaining cavity after the evacuation of a cyst in patients who have undergone surgical operation for liver hydatidosis. This study compares the results of capitonnage and tube drainage of the remaining cavity. In this retrospective study, participants were selected from two groups of patients with a liver hydatid cyst who underwent capitonnage or tube drainage from 2004 to 2012. The patients were followed for 6-24 months. The data of age, sex, involved liver lobe, size of the cyst, complications, drain duration, and hospital stay were analyzed. Participants included 155 patients consisting of 96 (61.94%) females and 59 (38.06%) males. Most cysts were in the right lobe, and the most common diameter of the cysts was greater than 10 cm. Capitonnage was performed on 90 (58.06%) patients and the tube drainage procedure was performed on the remaining 65 (41.94%) patients. In the tube drainage group and the capitonnage group, the operative times were 2.21 ± 0.65 hours and 2.53 ± 0.35 hours, respectively; the hospital stays were 5.695 ± 3.37 days and 4.43 ± 2.96 days, respectively; the drain duration was 9.2 ± 1.7 days and 2.1 ± 0.4 days, respectively; and the time to return to work was 14.7 ± 2.3 days and 8.3 ± 10.4 days, respectively. All variables were statistically significant, except for the operative time. Cavity infection and biliary fistula were identified in three patients and six patients, respectively, in the tube drainage group and identified in two patients and three patients, respectively, in the capitonnage group. This difference was not statistically significant. This study demonstrated that capitonnage versus the tube drainage method may result in a shorter hospital stay, decreased time to return to work, and low rate of morbidity and complications. Copyright © 2014. Published by Elsevier B.V.

Chest tube drainage of pleural effusions--an audit of current practice and complications at Hutt Hospital.

Science.gov (United States)

Epstein, Erica; Jayathissa, Sisira; Dee, Stephen

2012-05-11

The aims of the study were to review small-bore chest tube insertion practices for drainage of pleural fluid at Hutt Valley District Health Board (HVDHB), to assess complications, and compare the findings with international data. Retrospective analysis of clinical records was completed on all chest tube insertions for drainage of pleural fluid at HVDHB from December 2008 to November 2009. Descriptive statistics were used to present demographics and tube-associated complications. Comparison was made to available similar international data. Small-bore tubes comprised 59/65 (91%) chest tube insertions and 23/25 (92%) complications. Available comparative data was limited. Ultrasound was used in 36% of insertions. Nearly half of chest drains placed for empyema required subsequent cardiothoracic surgical intervention. Chest drain complication rates at HVDHB were comparable to those seen internationally. Referral rates to cardiothoracic surgery for empyema were within described ranges. The importance of procedural training for junior medical staff, optimising safety of drain insertions with ultrasound guidance, and clear clinical governance for chest tube insertions are important in minimising harm from this procedure. Specialist societies need to take a leadership in providing guidance on chest drain insertions to secondary and tertiary hospitals in Australia and New Zealand.

Chest tube insertion

Science.gov (United States)

Chest drainage tube insertion; Insertion of tube into chest; Tube thoracostomy; Pericardial drain ... Be careful there are no kinks in your tube. The drainage system should always sit upright and be placed ...

Combined Scleral Flap with Donor Scleral Patch Graft for Anterior Tube Placement in Glaucoma Drainage Device Surgery

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Jea H. Yu

2016-01-01

Full Text Available Purpose. To report a new technique for anterior placement of tubes for glaucoma drainage devices to reduce the risk of tube erosions. Methods. Retrospective review of select cases of Ahmed Valve surgery combined with the novel method of a limbal-based scleral flap covered by a scleral patch graft to cover the tube at the entrance through the limbus. Intraoperative and postoperative illustrations are shown to highlight the method of tube placement. Results. In this retrospective case series, 3 patients are presented illustrating the technique. Two had neovascular glaucoma and one had primary open-angle glaucoma (POAG. On average, intraocular pressure was reduced from 39±14 mmHg to 15±2 mmHg and the number of glaucoma medications was reduced from 4±1 to 0. Preoperative and most recent visual acuities were hand-motion (HM and HM, 20/60 and 20/50, and 20/70 and 20/30, respectively. Conclusion. The combination of a limbal-based scleral flap with scleral patch graft to cover the tube with glaucoma drainage devices may be an effective means to reduce erosion and protect against endophthalmitis.

Combined Scleral Flap with Donor Scleral Patch Graft for Anterior Tube Placement in Glaucoma Drainage Device Surgery.

Science.gov (United States)

Yu, Jea H; Nguyen, Chuck; Gallemore, Esmeralda; Gallemore, Ron P

2016-01-01

Purpose . To report a new technique for anterior placement of tubes for glaucoma drainage devices to reduce the risk of tube erosions. Methods . Retrospective review of select cases of Ahmed Valve surgery combined with the novel method of a limbal-based scleral flap covered by a scleral patch graft to cover the tube at the entrance through the limbus. Intraoperative and postoperative illustrations are shown to highlight the method of tube placement. Results . In this retrospective case series, 3 patients are presented illustrating the technique. Two had neovascular glaucoma and one had primary open-angle glaucoma (POAG). On average, intraocular pressure was reduced from 39 ± 14 mmHg to 15 ± 2 mmHg and the number of glaucoma medications was reduced from 4 ± 1 to 0. Preoperative and most recent visual acuities were hand-motion (HM) and HM, 20/60 and 20/50, and 20/70 and 20/30, respectively. Conclusion . The combination of a limbal-based scleral flap with scleral patch graft to cover the tube with glaucoma drainage devices may be an effective means to reduce erosion and protect against endophthalmitis.

Gastrostomy Tube (G-Tube)

Science.gov (United States)

... any of these problems: a dislodged tube a blocked or clogged tube any signs of infection (including redness, swelling, or warmth at the tube site; discharge that's yellow, green, or foul-smelling; fever) excessive bleeding or drainage from the tube site severe abdominal pain lasting ...

Pathological studies on lachrymal dilated drainage tube implantation in rabbits

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Yun Peng

2014-06-01

Full Text Available AIM: To observe the pathological changes of the lower segment of nasolacrimal duct mucosa in rabbits at different stages after retrograde lachrymal dilated drainage tube implantation. METHODS: Totally 14 New Zealand rabbits were used in the present study. One side of nasolacrimal duct was obstructed to produce an experimental model and operated the reverse implantation of nasolacrimal duct intubation. Histological changes of the lower segment of nasolacrimal duct mucosa were observed by routine light microscope at 2, 4, 6, 8, 10, 12 and 14wk after the operation. RESULTS: Compared with the control side, the group of 2 and 4wk after surgery presented the inflammatory cytokine. The group of 12wk after the operation presented isolated granuloma. Group 12 and 14wk presented scattered granuloma. The size of the granulomas was smaller and the density of epithelioid cell and fibroblast were lower in group 12wk than those in group 14wk by HE and Masson trichrome stain.CONCLUSION: Recurrent Silicone Tube is used to treat nasolacrymal duct obstruction. Nasolacrimal duct can be narrowed and blocked again by granuloma, progressive fibrosis and adhesion of surrounding tissues when tube is in the duct more than 12wk.

Traditional Foley drainage systems--do they drain the bladder?

Science.gov (United States)

Garcia, Maurice M; Gulati, Shelly; Liepmann, Dorian; Stackhouse, G Bennett; Greene, Kirsten; Stoller, Marshall L

2007-01-01

Foley catheters are assumed to drain the bladder to completion. Drainage characteristics of Foley catheter systems are poorly understood. To investigate unrecognized retained urine with Foley catheter drainage systems, bladder volumes of hospitalized patients were measured with bladder scan ultrasound volumetrics. Additionally, an in vitro bench top mock bladder and urinary catheter system was developed to understand the etiology of such residual volumes. A novel drainage tube design that optimizes indwelling catheter drainage was also designed. Bedside bladder ultrasound volumetric studies were performed on patients hospitalized in ward and intensive care unit. If residual urine was identified the drainage tubing was manipulated to facilitate drainage. An ex vivo bladder-urinary catheter model was designed to measure flow rates and pressures within the drainage tubing of a traditional and a novel drainage tube system. A total of 75 patients in the intensive care unit underwent bladder ultrasound volumetrics. Mean residual volume was 96 ml (range 4 to 290). In 75 patients on the hospital ward mean residual volume was 136 ml (range 22 to 647). In the experimental model we found that for every 1 cm in curl height, obstruction pressure increased by 1 cm H2O within the artificial bladder. In contrast, the novel spiral-shaped drainage tube demonstrated rapid (0.5 cc per second), continuous and complete (100%) reservoir drainage in all trials. Traditional Foley catheter drainage systems evacuate the bladder suboptimally. Outflow obstruction is caused by air-locks that develop within curled redundant drainage tubing segments. The novel drainage tubing design eliminates gravity dependent curls and associated air-locks, optimizes flow, and minimizes residual bladder urine.

Drainage of Splenic Abscess: A Case Report | Kombo | Nigerian ...

African Journals Online (AJOL)

... and was managed by tube drainage. His post operative recovery was uneventful. Conclusion: Tube drainage of the splenic abscess is encouraged if there is easy access to the abscess and there is evidence of residual splenic tissue in the critically ill patient. Key Word: Tube drainage, splenic abscess, splenectomy.

T-tube vs Primary Common Bile Duct Closure

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M R Joshi

2010-09-01

Full Text Available INTRODUCTION: Closure of the common bile duct over T-tube after exploration is a widely practiced traditional method. However, its use may give rise to many complications. We do primary closure of common bile duct after exploration. Aim of the study is to see the efficacy and safety of the primary closure. METHODS: Study was carried out to compare the results of both the techniques from 2006 to 2009 in the cases proven to have common bile duct stone with or without the features of obstructive jaundice. Post operative hospital stay and morbidities related to both the groups were recorded and analyzed. RESULTS: There were total 71 cases included in the study. Thirty one in T-tube group and 40 in primary closure group. T-tube was removed in most of the cases after three weeks where as average time of drain removal in primary closure group is 5.79 +/-1.79 days. Incidence of retained stone was equal in each group. Major complication in T-tube group is biliary peritonitis in four patients at the time of T-tube removal whereas none of the patient from primary closure group suffered from such major complication. CONCLUSIONS: Primary closure after the common bile duct exploration is safe and it helps to avoid the morbidities related to T-tube. Keywords: Choledocholithiasis, Primary closure, retained stone, T-tube, Ureterorenoscope.

Low protein content of drainage fluid is a good predictor for earlier chest tube removal after lobectomy.

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Olgac, Guven; Cosgun, Tugba; Vayvada, Mustafa; Ozdemir, Atilla; Kutlu, Cemal Asim

2014-10-01

Owing to the great absorption capability of the pleura for transudates, the protein content of draining pleural fluid may be considered as a more adequate determinant than its daily draining amount in the decision-making for earlier chest tube removal. In an a priori pilot study, we observed that the initially draining protein-rich exudate converts to a transudate quickly in most patients after lobectomies. Thus, chest tubes draining high-volume but low-protein fluids can safely be removed earlier in the absence of an air leak. This randomized study aims to investigate the validity and clinical applicability of this hypothesis as well as its influence on the timing for chest tube removal and earlier discharge after lobectomy. Seventy-two consecutive patients undergoing straightforward lobectomy were randomized into two groups. Patients with conditions affecting postoperative drainage and with persisting air leaks beyond the third postoperative day were excluded. Drains were removed if the pleural fluid to blood protein ratio (PrRPl/B) was ≤0.5, regardless of its daily draining amount in the study arm (Group S; n = 38), and patients in the control arm (Group C; n = 34) had their tubes removed if daily drainage was ≤250 ml regardless of its protein content. Patients were discharged home immediately or the following morning after removal of the last drain. All cases were followed up regarding the development of symptomatic pleural effusions and hospital readmissions for a redrainage procedure. Demographic and clinical characteristics as well as the pattern of decrease in PrRPl/B were the same between groups. The mean PrRPl/B was 0.65 and 0.67 (95% CI = 0.60-0.69 and 0.62-0.72) on the first postoperative day, and it remarkably dropped down to 0.39 and 0.33 (95% CI = 0.33-0.45 and 0.27-0.39) on the second day in Groups S and C, respectively, and remained below 0.5 on the third day (repeated-measures of ANOVA design, post hoc 'within-group' comparison of the first

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

International Nuclear Information System (INIS)

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

2005-01-01

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

Prevention of biliary complication in radiofrequency ablation for hepatocellular carcinoma-Cooling effect by endoscopic nasobiliary drainage tube

Energy Technology Data Exchange (ETDEWEB)

Ogawa, Tsuneyoshi [Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558 (Japan); Kawamoto, Hirofumi [Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558 (Japan)], E-mail: h-kawamo@md.okayama-u.ac.jp; Kobayashi, Yoshiyuki; Nakamura, Shinichiro; Miyatake, Hirokazu; Harada, Ryo; Tsutsumi, Koichiro; Fujii, Masakuni; Kurihara, Naoko; Kato, Hironari; Hirao, Ken; Mizuno, Osamu; Ishida, Etsuji; Okada, Hiroyuki; Yamamoto, Kazuhide [Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558 (Japan)

2010-02-15

Background and study aims: Biliary stricture after radiofrequency ablation (RFA) for nodules of hepatocellular carcinoma (HCC) close to major bile ducts sometimes causes septic complications and liver failure. Therefore, it may require interventional drainage for decompression during the follow-up period. The purpose of this study is to clarify the feasibility and safety of bile duct cooling using an endoscopic nasobiliary drainage (ENBD) tube in RFA for HCC close to major bile ducts. Patients and methods: Between August 2003 and July 2007, 14 consecutive patients (14 nodules) undergoing RFA with cooling by an ENBD tube for HCCs close to major bile ducts were enrolled in this study. We infused chilled saline solution via the ENBD tube at 1 ml/s to prevent heat damage during RFA. As controls, 11 patients (13 nodules) undergoing RFA without cooling close to major bile ducts between April 2001 and August 2003 were reviewed. The major outcomes for evaluation were biliary complications and the secondary outcome was local tumor recurrence. Results: There were no significant differences in tumor recurrence between the two groups. However, the rate of biliary complications was significantly lower in the cooling group than in the non-cooling group (0% vs. 39%, P = 0.02). Conclusions: Cooling of bile ducts via an ENBD tube can prevent biliary complications induced by RFA of HCC close to major bile ducts without increasing local recurrence. This technique increases indication of RFA in difficult cases.

Study of treatment results and early complications of tube drainage versus capitonnage after the unroofing and aspiration of hydatid cysts

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Mostafa Mehrabi Bahar

2014-10-01

Conclusion: This study demonstrated that capitonnage versus the tube drainage method may result in a shorter hospital stay, decreased time to return to work, and low rate of morbidity and complications.

An update on the drainage of pyogenic lung abscesses

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Siraj O Wali

2012-01-01

Full Text Available Most lung abscesses (80-90% are now successfully treated with antibiotics; however, this conservative approach may occasionally fail. When medical treatment fails, pulmonary resection is usually advised. Alternatively, percutaneous transthoracic tube drainage or endoscopic drainage can be considered, though both remain controversial. In this communication, the medical literature focusing on percutaneous tube drainage efficacy, indications, techniques, complications, and mortality, as well as available data regarding endoscopic drainage are reviewed.

Caring for Your Percutaneous Nephrostomy Tube

Science.gov (United States)

... to the nephrostomy tube for 15 seconds. 5. Disconnect the drainage bag from the tube. 6. Put the used bag aside. 7. With a new alcohol pad, swab the open end of the nephrostomy tube for 15 seconds. 8. Connect a new bag. 9. Secure the drainage bag ...

Small-bore chest tubes seem to perform better than larger tubes in treatment of spontaneous pneumothorax

DEFF Research Database (Denmark)

Iepsen, Ulrik Winning; Ringbæk, Thomas

2013-01-01

The aim of this study was to compare the efficacy and complications of surgical (large-bore) chest tube drainage with smaller and less invasive chest tubes in the treatment of non-traumatic pneumothorax (PT). ......The aim of this study was to compare the efficacy and complications of surgical (large-bore) chest tube drainage with smaller and less invasive chest tubes in the treatment of non-traumatic pneumothorax (PT). ...

Use of the silicone tracheal T-tube for tracheostenosis or tracheomalacia.

Science.gov (United States)

Liu, H C; Wang, L S; Fahn, H J; Lee, Y C; Lu, C C; Chan, K H; Huang, M H

1996-09-01

Tracheobtenosib and tracheomalacia are trivial diseases. The conventional choice of managements with tracheostomy, either temporary or long-term usage, can only partially resolve the problems of airway obstruction. Silicone tracheal T-tube presents a substitute for it. We present 5 patients with tracheostenosis or tracheomalacia managed with nine procedures of long silicone Montgomery T-tube prothesis between 1984 and 1994 in VGH-Taipei. The primary diagnosis included tracheal injury (2), postintubation tracheal stenosis (2), and stenosis due to endotracheal tuberculosis (1). Three patients received a long segmental T-tube for permanent endotracheal stenting and the other two patients used T-tube insertion for temporary stenting of the trachea for 7 and 11 months, respectively, with satisfactory results. All patients got immediate benefit from the prothesis in respiration with simple postoperative care. Two patients with temporary T-tube placement had it successfully removed in 7 and 11 months, respectively. Placement of the T-tube for subglottic stenosis also protected the function of phonation. The tracheal T-tube restored airway patency reliably with good long-term results and could be the preferred management of chronic upper airway obstructive disease not amenable to surgical repair. The most common complication was airway obstruction caused by either granulations or sticky mucoid substance. Three patients and six tubes (60%) developed granulation obstruction and the average duration of granuloma formation was 7.7 months. Laser phototherapy or surgical intervention, such as tracheoplasty, with change of the T-tube was carried out for granuloma obstruction. T-tube is a good endoprothesis for tracheostenosis and tracheomalacia with minimal complication for cases of long tracheostenosis or complex tracheal injury.

Comparison of natural drainage group and negative drainage groups after total thyroidectomy: prospective randomized controlled study.

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Woo, Seung Hoon; Kim, Jin Pyeong; Park, Jung Je; Shim, Hyun Seok; Lee, Sang Ha; Lee, Ho Joong; Won, Seong Jun; Son, Hee Young; Kim, Rock Bum; Son, Young-Ik

2013-01-01

The aim of this study was to compare a negative pressure drain with a natural drain in order to determine whether a negative pressure drainage tube causes an increase in the drainage volume. Sixty-two patients who underwent total thyroidectomy for papillary thyroid carcinoma (PTC) were enrolled in the study between March 2010 and August 2010 at Gyeongsang National University Hospital. The patients were prospectively and randomly assigned to two groups, a negative pressure drainage group (n=32) and natural drainage group (n=30). Every 3 hours, the volume of drainage was checked in the two groups until the tube was removed. The amount of drainage during the first 24 hours postoperatively was 41.68 ± 3.93 mL in the negative drain group and 25.3 ± 2.68 mL in the natural drain group (pdrain group was 35.19 ± 4.26 mL and natural drain groups 21.53 ± 2.90 mL (pdrain may increase the amount of drainage during the first 24-48 hours postoperatively. Therefore, it is not necessary to place a closed suction drain when only a total thyroidectomy is done.

Radiologic drainage of infected and noninfected thoracic fluid collections

International Nuclear Information System (INIS)

Van Sonnenberg, E.; Casola, G.; Stavas, J.; Neff, C.C.; Varney, R.A.; Wittich, G.R.; Dillard, J.; Christensen, R.A.; Friedman, P.J.

1987-01-01

Radiologically guided drainage of 100 thoracic fluid collections is described in this paper. Collections that underwent drainage include empyemas, lung abscesses, bronchopleural fistulas (BPFs), mediastinal abscesses, paracardial collections, bronchogenic cysts, sequestrations, lymphoceles, lymphangiomas, malignant effusions, and necrotic tumors. Catheters were placed for sclerotherapy in nine patients. Guidance modalities (in descending order of frequency) were CT, US, fluoroscopy, and MR. Inadequate thoracostomy tube drainage occurred in a third of the patients prior to radiologic drainage. Drainages were effective in 85% of cases, sparing surgery or another thoracostomy tube. Complications occurred in 7% of patients, most being minor and none requiring operation. Criteria for drainage of lung abscess and BPF will be emphasized, as will techniques and methods of follow-up

Percutaneous catheter drainage of empyema and loculated pleural effusion

Energy Technology Data Exchange (ETDEWEB)

Im, Jung Gi; Park, Kyung Joo; Park, Jae Hyung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1988-08-15

Closed thoracotomy by using a chest tube in cases of thoracic empyema is known to be an effective and popular way of treatment. However, it happens commonly that chest tube drainage is not appropriate because of either malpositioning of the tube or undesirable patient's general condition such as bleeding tendency or debilitation. We performed fluoroscopy-guided percutaneous catheter drainage (PCD) in 14 cases of empyema and loculated pleural effusion and in 2 cases of lung abscess. In most of the patients, PCDs were performed because chest tube drainage was considered to be inappropriate or after failed chest tube drainage. In all patients, catheters were successfully placed into the fluid collections, which were drained effectively. Ten of the 11 febrile patient showed improvement of feverishness within 24 hours after PCD. 10 patients were cured without further treatment. Complications were few and minimal. We believe that the safety, effectiveness and good patients tolerance of PCD makes it an excellent alternative method of treatment in cases of empyema and loculated pleural effusion.

Role of Montgomery T-tube stent for laryngotracheal stenosis.

Science.gov (United States)

Prasanna Kumar, Saravanam; Ravikumar, Arunachalam; Senthil, Kannan; Somu, Lakshman; Nazrin, Mohd Ismail

2014-04-01

To identify the indications, complications and outcome of patients of LTS managed with Montgomery T-tube stenting and review the current literature about the role of stenting in LTS. Retrospective chart reviews of 39 patients of laryngotracheal stenosis managed by T-tube stenting for temporary or definitive treatment during the period 2004-2011 were considered. The data on indications for stenting, type of stent, problems/complications of stenting, duration of stenting, additional intervention and outcome of management were collected, tabulated and analyzed. Of the 51 cases of laryngotracheal stenosis 39 patients were treated by Montgomery T-tube stenting. There was no mortality associated with the procedure or stenting. 82% of the patients were successfully decannulated. The problems and complications encountered were crusting within the tube in 44% and granulation at the subglottis in 33%. Two patients had complication due to T-tube itself: One patient developed tracheomalacia and the other had stenosis at both ends of the T-tube. Stenting still has a role in management of inoperable or in some deadlock situations where resection anastomosis is not feasible. It is easier to introduce the stent and to maintain it. Complications are minor and can be managed easily. It is safe for long term use. We emphasize that the treating surgeon needs to use prudence while treating stenosis using stents. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Bluish Discolouration of Urine Drainage Tube and Bag in a Female Patient with Spina Bifida, Paraplegia, and Suprapubic Cystostomy

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Subramanian Vaidyanathan

2007-01-01

Full Text Available We present a female patient with spina bifida, paraplegia, suprapubic cystostomy, and chronic constipation, who became anxious when she noticed a bluish discolouration of her urine drainage system. Urine microbiology revealed growth of Providencia stuartii and Staphylococcus aureus. There were no systemic features of infection and, therefore, antibiotics were not prescribed for asymptomatic bacteriuria. This patient was advised to change the urine bag every day, and was prescribed senna to facilitate bowel evacuation. She was reassured that bluish discolouration of the urine drainage tube and bag was a transient, benign phenomenon and not indicative of any underlying pathology. Over the next 7 days, the bluish discolouration gradually faded away. Clinical characteristics of patients who are likely to develop this phenomenon and the underlying biochemical mechanism for bluish discolouration of the urine drainage system are discussed in brief.

The single chest tube versus double chest tube application after pulmonary lobectomy: A systematic review and meta-analysis

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Xuefei Zhang

2016-01-01

Conclusion: Compared with the double chest tube, the single chest tube significantly decreases amount of drainage, duration of chest tube drainage, pain score, the number of patients who need thoracentesis, and cost. Although there is convincing evidence to confirm the results mentioned herein, they still need to be confirmed by large-sample, multicenter, randomized, controlled trials.

Volume Threshold for Chest Tube Removal: A Randomized ‎Controlled Trial

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Sajad Hatami

2009-07-01

Full Text Available Background: Despite importance of chest tube insertion in chest trauma, there is no ‎general agreement on the level of daily volume drainage from chest tube. This study ‎was conducted to compare the effectiveness and safety of chest tube removal at the ‎levels of 150 ml/day and 2oo ml/day. Methods: Eligible patients (138 who needed replacement of chest tube (because of ‎trauma or malignancy were randomized into two groups; control (removal of chest tube ‎when drainage reached to 150 ml/day and trial (removal of chest tube at the level of ‎‎200 ml/day. All patients received standard care during hospital admission and a follow-‎up visit after 7days of discharge from hospital. Patients were then compared in terms of ‎major clinical outcomes using chi-squared and t-test. Results: From the total of 138 patients, 70 and 68 patients were randomized to control ‎‎(G150 and trial (G200 group, respectively. Baseline characteristics were comparable ‎between the two groups. Although the trial group had a shorter mean for length of ‎hospital stay (LOS (4.1 compared to 4.8, p=0.04, their differences in drainage time ‎did not reach to the level of statistical significance (p=0.1. Analysis of data showed no ‎statistically significant differences between the rate of radiological reaccumulation, ‎thoracentesis and decrease in pulmonary sounds (auscultatory, one week after ‎discharge from hospital.‎‏ ‏Conclusions: Compared to a daily volume drainage of 150 ml, removal of chest tube ‎when there is 200 ml/day is safe and will even result in a shorter hospital stay. This in ‎turn leads to a lower cost.‎

Evalutation of efficiency of dynamic laser magnetic stimulation of eye drainage system of patients with open angle glaucomatosis

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Sidelnikova V.S.

2014-06-01

Full Text Available The purpose of the study is to develop a comprehensive treatment aimed at improving uveoscleral outflow in the application of dynamic laser magnetic stimulation of the drainage system of the eye and evaluation of its effectiveness in treating patients with primary open-angle glaucoma (POAG. Material. 106 patients diagnosed POAG I, II, III stages were examined. Group 1 consisted of 62 patients treated with medical therapy and dynamic laser magnetic stimulation of the drainage system of the eye using the "AMO-ATOS-ICL", produced by JSC "TRIMA", Saratov. Group 2 consisted of 64 patients who received only medical therapy. Comprehensive survey including standard eye examination, static perimetry, visual evoked potentials study, the study of intraocular blood flow was conducted to all patients. Analysis of the results of the complex therapeutic effects showed that as the result of treatment 73% of patients had a decrease of intraocular pressure and the ease factor outflow increase. 52% of patients had a decrease in the number and area of relative. 63% of patients had activation of intraocular blood flow. These indices remained stable for three months. Conclusion. The treatment with the technique of dynamic laser magnetic stimulation of the drainage system of the eye of patients with primary open-angle glaucoma leads to lower intraocular pressure, and to the improvement of dopple-rographic and perimetric indications.

[How to do - the chest tube drainage].

Science.gov (United States)

Klopp, Michael; Hoffmann, Hans; Dienemann, Hendrik

2015-03-01

A chest tube is used to drain the contents of the pleural space to reconstitute the physiologic pressures within the pleural space and to allow the lungs to fully expand. Indications for chest tube placement include pneumothorax, hemothorax, pleural effusion, pleural empyema, and major thoracic surgery. The most appropriate site for chest tube placement is the 4th or 5th intercostal space in the mid- or anterior- axillary line. Attention to technique in placing the chest tube is vital to avoid complications from the procedure. Applying the step-by-step technique presented, placement of a chest tube is a quick and safe procedure. Complications - frequently occurring when the tube is inserted with a steel trocar - include hemothorax, dislocation, lung lacerations, and injury to organs in the thoracic or abdominal cavity." © Georg Thieme Verlag KG Stuttgart · New York.

Radiologic guidance of drainage of infected and noninfected thoracic fluid collections

International Nuclear Information System (INIS)

Van Sonnenberg, E.; Casola, G.; Stavas, J.; Neff, C.C.; Wittich, G.R.; Varney, R.A.; Christensen, R.; Friedman, P.

1987-01-01

This exhibit illustrates the spectrum and benefits of radiologic guidance of drainage of 100 thoracic fluid collections. Collections which underwent drainage include: empyemas, lung abscesses, bronchopleural fistulas (BPF), mediastinal abscesses, paracardial collections, bronchogenic cysts, sequestrations, lymphocoeles, malignant effusions, and necrotic tumors. Sclerotherapy catheterization also is described. The modalities for guidance were CT, US, and fluoroscopy. Inadequate thoracostomy tube drainage occurred in a third of the patients prior to radiologic drainage. Drainages were effective in 85% of cases sparing surgery or another thoracostomy tube. Complications occurred in 7% of patients, most being minor and none requiring operation. Pitfalls and caveats are highlighted. Criteria for drainage of lung abscesses and BPF are emphasized, as are techniques and methods of follow-up

Glaucoma Drainage Device Erosion Following Ptosis Surgery.

Science.gov (United States)

Bae, Steven S; Campbell, Robert J

2017-09-01

To highlight the potential risk of glaucoma drainage device erosion following ptosis surgery. Case report. A 71-year-old man underwent uncomplicated superotemporal Ahmed glaucoma valve implantation in the left eye in 2008. Approximately 8 years later, the patient underwent bilateral ptosis repair, which successfully raised the upper eyelid position. Three months postoperatively, the patient's glaucoma drainage implant tube eroded through the corneal graft tissue and overlying conjunctiva to become exposed. A graft revision surgery was successfully performed with no further complications. Caution and conservative lid elevation may be warranted when performing ptosis repair in patients with a glaucoma drainage implant, and patients with a glaucoma implant undergoing ptosis surgery should be followed closely for signs of tube erosion.

α-Naphthoflavone Increases Lipid Accumulation in Mature Adipocytes and Enhances Adipocyte-Stimulated Endothelial Tube Formation

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Mei-Lin Wang

2015-04-01

Full Text Available The aryl hydrocarbon receptor (AhR is a ligand-activated factor that regulates biological effects associated with obesity. The AhR agonists, such as environmental contaminants 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD and β-naphthoflavone (BNF, inhibit preadipocyte differentiation and interfere with the functions of adipose tissue, whereas the antagonist may have opposite or protective effects in obesity. This study investigated the effects of α-naphthoflavone (α-NF, an AhR antagonist, on adipogenesis- and angiogenesis-associated factors in mature adipocytes and on cross-talk of mature adipocytes with endothelial cells (ECs. Besides, the roles of the AhR on lipid accumulation and on secretion of vascular endothelial growth factor were also determined by introducing siRNA of AhR. Differentiated 3T3-L1 cells were treated with α-naphthoflavone (α-NF (1–5 μM for 16 h. Lipid accumulation and the expressions of AhR-associated factors in the cells were determined. The interaction between adipocytes and ECs was investigated by cultivating ECs with conditioned medium (CM from α-NF-treated mature adipocytes, followed by the determination of endothelial tube formation. The results showed that α-NF significantly increased triglyceride (TG accumulation in mature adipocytes, which was associated with increased expression of hormone-sensitive lipase (HSL, estrogen receptor (ER, as well as decreased expression of AhR, AhR nuclear translocator (ARNT, cytochrome P4501B1 (CYP1B1, and nuclear factor erythroid-2-related factor (NRF-2 proteins. In addition, CM stimulated formation of tube-like structures in ECs, and α-NF further enhanced such stimulation in association with modulated the secretions of various angiogenic mediators by mature adipocytes. Similarly, increased TG accumulation and vascular endothelial growth factor (VEGF secretion were observed in AhR-knockout cells. In conclusion, α-NF increased TG accumulation in mature adipocytes and

The Role of Perioperative Endoscopic Retrograde Cholangiopancreatography and Biliary Drainage in Large Liver Hydatid Cysts

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A. Krasniqi

2014-01-01

Full Text Available Background. The best surgical technique for large liver hydatid cysts (LHCs has not yet been agreed on. Objectives. The objective of this study was to examine the role of perioperative endoscopic retrograde cholangiopancreatography (ERCP and biliary drainage in patients with large LHCs. Methods. A 20-year retrospective study of patients with LHCs treated surgically at the University Clinical Center of Kosovo (UCCK. We divided patients into 2 groups based on treatment period: 1981–1990 (Group I and 2001–2010 (Group II. Demographic characteristics (sex, age, the surgical procedure performed, complications rate, and outcomes were compared. Results. Of the 340 patients in our study, 218 (64.1% were female with median age of 37 years (range, 17 to 81 years. 71% of patients underwent endocystectomy with partial pericystectomy and omentoplication, 8% total pericystectomy, 18% endocystectomy with capitonnage, and 3% external drainage. In Group I, 10 patients underwent bile duct exploration and T-tube placement; in Group II, 39 patients underwent bile duct exploration and T-tube placement. In addition, 9 patients in Group II underwent perioperative ERCP with papillotomy. The complication rate was 14.32% versus 6.37%, respectively (P=0.001. Conclusion. Perioperative ERCP and biliary drainage significantly decreased the complication rate and improved outcomes in patients with large LHCs.

Efficacy of ultrasound-guided thoracentesis catheter drainage for pleural effusion

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Cao, Weitian; Wang, Yi; Zhou, Ningming; Xu, Bing

2016-01-01

The factors influencing the efficacy of ultrasound-guided thoracentesis catheter drainage were investigated in the present study. A retrospective analysis of clinical data from 435 patients who presented with a pleural effusion was performed. Patients were divided into a control group and an intervention group. Thirty-seven patients in the control group were given standard care using pleural puncture to draw the excess fluid. The 398 patients in the intervention group were treated using ultrasound-guided thoracentesis catheter drainage. The rate of successful drainage of a pleural effusion was significantly higher (Ppleural effusion. The efficacy of the procedure is related to the separation of pleural effusion, drainage tube type and tube diameter. PMID:28105155

Timing of drainage tube removal after thyroid surgery: a retrospective study.

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Minami, Shigeki; Sakimura, Chika; Hayashida, Naomi; Yamanouchi, Kosho; Kuroki, Tamotsu; Eguchi, Susumu

2014-01-01

The aim of this study was to evaluate the chronological changes in the amount of drainage fluid after thyroidectomy, and to establish standard indications for the drain to be removed. We examined a cohort of 249 patients undergoing thyroid surgery. The patients were divided into four groups: a Graves' group, a non-dissection group, a central-dissection group and a lateral-dissection group. The amount of drainage was measured every 6 h, and the drain was removed postoperatively when the drainage decreased in amount and contained serous fluid after a meal. In all four groups, the most drainage occurred in the first 6 h after surgery. The total amount of drainage from the operation to the time of drain removal was significantly higher in Graves' group and in the lateral-dissection group than in the other two groups. The median wound drainage significantly decreased from 12 to 18 h after surgery in all four groups. In the lateral-dissection group, the wound drainage significantly decreased again in the first 24-30 h. The findings of this study suggest that drains can be removed postoperatively if the drainage was less than 15 mL during a 6-h period and contain serous fluid.

Postoperative intraabdominal fluid collections : a modified percutaneous drainage method using a surgical drain track

International Nuclear Information System (INIS)

Lee, Deok Hee; Kim, Gab Choul; Hwang, Jae Cheol; Yoon, Hyun Ki; Song, Ho Young; Sung, Kyu Bo

2000-01-01

In the management of postoperative fluid collection, the conventional percutaneous drainage method can be employed. Because of abdominal incisions and various types of surgical drains and/or T-tubes, the application of this method is not always easy, however. We inserted a drainage catheter through a pre-existing percutaneous track formed by a surgical drain located adjacent to the site of abnormal fluid collection. There was no need to remove the drain nor make an additional puncture in the abdominal wall. A dilator was inserted along the drain, and a guide wire was used to negotiate its intraperitoneal track and reach the accumulated fluid. The procedure was simple and safe. We briefly describe our experience of this modified percutaneous drainage technique, as used in three cases involving postoperative fluid collection. (author)

Suction forces generated by passive bile bag drainage on a model of post-subdural hematoma evacuation.

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Tenny, Steven O; Thorell, William E

2018-05-05

Passive drainage systems are commonly used after subdural hematoma evacuation but there is a dearth of published data regarding the suction forces created. We set out to quantify the suction forces generated by a passive drainage system. We created a model of passive drainage after subdural hematoma evacuation. We measured the maximum suction force generated with a bile bag drain for both empty drain tubing and fluid-filled drain tube causing a siphoning effect. We took measurements at varying heights of the bile bag to analyze if bile bag height changed suction forces generated. An empty bile bag with no fluid in the drainage tube connected to a rigid, fluid-filled model creates minimal suction force of 0.9 mmHg (95% CI 0.64-1.16 mmHg). When fluid fills the drain tubing, a siphoning effect is created and can generate suction forces ranging from 18.7 to 30.6 mmHg depending on the relative position of the bile bag and filled amount of the bile bag. The suction forces generated are statistically different if the bile bag is 50 cm below, level with or 50 cm above the experimental model. Passive bile bag drainage does not generate significant suction on a fluid-filled rigid model if the drain tubing is empty. If fluid fills the drain tubing then siphoning occurs and can increase the suction force of a passive bile bag drainage system to levels comparable to partially filled Jackson-Pratt bulb drainage.

Fluoroscopy guided percutaneous catheter drainage of pneumothorax in good mid-term patency with tube drainage

International Nuclear Information System (INIS)

Park, Ga Young; Oh, Joo Hyung; Yoon, Yup; Sung, Dong Wook

1995-01-01

To evaluate efficacy and the safety of percutaneous catheter drainage in patients with pneumothorax that is difficult to treat with closed thoracotomy. We retrospectively reviewed effectiveness of percutaneous catheter drainage (PCD) in 10 patients with pneumothorax. The catheter was inserted under fluoroscopic guidance. Seven patients had spontaneous pneumothorax caused by tuberculosis (n =4), reptured bullae (n = 2), and histiocytosis-X (n = 1). Three patients had iatrogenic pneumothorax caused by trauma (n = 1) and surgery (n = 2). All procedures were performed by modified Seldinger's method by using 8F-20F catheter. All catheter were inserted successfully. In 9 of 10 patients, the procedure was curative without further therapy. Duration of catheter insertion ranged from 1 day to 26 days. In the remaining 1 patient in whom multiple pneumothorax occurred after operation, catheter insertion was performed twice. Percutaneous catheter drainage under fluoroscopic guidance is effective and safe procedure for treatment of pneumothorax in patients with failed closed thoracotomy

Fluoroscopy guided percutaneous catheter drainage of pneumothorax in good mid-term patency with tube drainage

Energy Technology Data Exchange (ETDEWEB)

Park, Ga Young; Oh, Joo Hyung; Yoon, Yup; Sung, Dong Wook [Kyung Hee University Hospital, Seoul (Korea, Republic of)

1995-10-15

To evaluate efficacy and the safety of percutaneous catheter drainage in patients with pneumothorax that is difficult to treat with closed thoracotomy. We retrospectively reviewed effectiveness of percutaneous catheter drainage (PCD) in 10 patients with pneumothorax. The catheter was inserted under fluoroscopic guidance. Seven patients had spontaneous pneumothorax caused by tuberculosis (n =4), reptured bullae (n = 2), and histiocytosis-X (n = 1). Three patients had iatrogenic pneumothorax caused by trauma (n = 1) and surgery (n = 2). All procedures were performed by modified Seldinger's method by using 8F-20F catheter. All catheter were inserted successfully. In 9 of 10 patients, the procedure was curative without further therapy. Duration of catheter insertion ranged from 1 day to 26 days. In the remaining 1 patient in whom multiple pneumothorax occurred after operation, catheter insertion was performed twice. Percutaneous catheter drainage under fluoroscopic guidance is effective and safe procedure for treatment of pneumothorax in patients with failed closed thoracotomy.

Accuracy of surgical wound drainage measurements: an analysis and comparison.

Science.gov (United States)

Yue, Brian; Nizzero, Danielle; Zhang, Chunxiao; van Zyl, Natasha; Ting, Jeannette

2015-05-01

Surgical drain tube readings can influence the clinical management of the post-operative patient. The accuracy of these readings has not been documented in the current literature and this experimental study aims to address this paucity. Aliquots (10, 25, 40 and 90 mL) of black tea solution prepared to mimic haemoserous fluid were injected into UnoVac, RedoVac and Jackson-Pratt drain tubes. Nursing and medical staff from a tertiary hospital were asked to estimate drain volumes by direct observation; analysis of variance was performed on the results and significance level was set at 0.05. Doctors and nurses are equally accurate in estimating drain tube volumes. Jackson-Pratt systems were found to be the most accurate for intermediate volumes of 25 and 40 mL. For extreme of volumes (both high and low), all drainage systems were inaccurate. This study suggests that for intermediate volumes (25 and 40 mL), Jackson-Pratt is the drainage system of choice. The accuracy of volume measurement is diminished at the extremes of drain volumes; emptying of drainage systems is recommended to avoid overfilling of drainage systems. © 2014 Royal Australasian College of Surgeons.

The rendezvous technique involving insertion of a guidewire in a percutaneous transhepatic gallbladder drainage tube for biliary access in a case of difficult biliary cannulation.

Science.gov (United States)

Sunada, Fumiko; Morimoto, Naoki; Tsukui, Mamiko; Kurata, Hidekazu

2017-05-01

Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic method and treatment approach for biliary diseases. However, biliary cannulation can be difficult in some cases. We performed ERCP in a 97-year-old woman with abdominal pain resulting from acute cholangitis caused by choledocholithiasis and observed difficult biliary cannulation. Eventually, the patient was successfully treated with the rendezvous technique. We could not cannulate the biliary duct during ERCP twice. Therefore, we placed a percutaneous transhepatic gallbladder drainage (PTGBD) tube without intrahepatic dilation. The rendezvous technique was performed using the PTGBD tube. The patient did not experience pancreatitis or perforation.

Treatment Experience of Continuous Negative Pressure Drainage in the Acute Anterior Mediastinal Infection of Oropharyngeal Origined

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Anping CHEN

2018-04-01

Full Text Available Background and objective Mediastinal infection is a serious infection of mediastinal connective tissue, with more complications and higher mortality. Application of broad-spectrum antibiotics and nutritional support, early sufficient drainage is the key to successful treatment. In the mode of drainage, this paper discusses the application of continuous negative pressure drainage technique to treat acute anterior mediastinal infection of severe mouth pharynx source, and the good results are summarized and shared. Methods In January to December in 2017, a total of 17 cases treated acute mediastinal infection is derived from the throat, has formed a mediastinal abscess, surgery adopts retrosternal counterpart negative pressure drainage way, namely the sternum nest and free sternum xiphoid process under the incision on the first mediastinal clearance, make breakthrough and placed drainage device, suture closed wound, continuous negative pressure drainage, negative pressure using 3 cm-5 cm water column. Results Among the 17 patients, 14 patients were relieved by continuous negative pressure drainage, and then the drainage tube was removed. In 2 cases, the infection broke into the right thoracic cavity, and the closed drainage caused the negative pressure to disappear, and the negative pressure drainage was replaced by the conventional drainage, and the drainage tube was removed after the drainage tube was clear. One patient had formed a mediastinal abscess incision drainage time later, complicated with septic shock and sepsis, resulting in the death of multiple organ failure. Conclusion The traditional treatment of severe acute mediastinal infection is sternal incision and drainage. Continuous negative pressure drainage adequate drainage of mediastinal can relieve patients' pain, effusion, and avoid the dressing out repeatedly. It is an effective method. However, there are limitations in this method, which need to be further optimized.

Variants of hepatobiliary leakage: Biloma and aberrant drainage paths - case report

Energy Technology Data Exchange (ETDEWEB)

Mack, J M; Peracha, H; Sziklas, J J; Rosenberg, R J; Spencer, R P

1987-04-01

Three variants of abnormal biliary drainage, on Tc-99m-DIPIDA studies, were illustrated, despite patency of the normal pathway. A 23-year-old man had gun shot fragments removed from the liver. An area originally negative for uptake of the hepatobiliary agent later demonstrated an increased content after the remainder of the liver had drained (a biloma). A 67-year-old woman showed passage of Tc-99m-DIPIDA simultaneously from 2 pathways. One was via a biliary-cutaneous fistula site along a prior T-tube tract, and the other was into the small intestine via a biliary stent. Following cholecystectomy, a hepatobiliary study in a 46-year-old man revealed a 'gallbladder'. This represented leakage into the prior gallbladder bed. The hepatobiliary agents can exit via traumatically or surgically created pathways, even when the 'usual' anatomic drainage is present.

Tube shunt complications and their prevention.

Science.gov (United States)

Sarkisian, Steven R

2009-03-01

Glaucoma drainage devices (GDDs) have been generally accepted as a treatment of refractory glaucoma. GDDs have their own unique set of complications that are important to evaluate to prevent them. Tube shunts are typically used in eyes with refractory glaucoma. There is increased interest in studying the efficacy of GDDs. Most of the attention has been focused on comparing trabeculectomy with the Baerveldt implant (Advanced Medical Optics, Inc., Santa Anna, California, USA). The other leading implant is the Ahmed Glaucoma Valve. There are several retrospective studies comparing these two devices and a prospective study is ongoing. There is great interest in the complication rate of tube shunts and these have been published both retrospectively and prospectively. Complications such as hypotony, diplopia, strabismus, proptosis, tube erosion, failure, corneal decompensation, endophthalmitis, and visual loss are all important and some have recently been reviewed in the literature. Moreover, the use of glaucoma drainage implants in the pediatric population has been evaluated. Glaucoma drainage implants have been a powerful tool in our surgical fight to prevent blindness; however, they are not without complications or controversy.

Imaging transcranial direct current stimulation (tDCS) of the prefrontal cortex-correlation or causality in stimulation-mediated effects?

Science.gov (United States)

Wörsching, Jana; Padberg, Frank; Ertl-Wagner, Birgit; Kumpf, Ulrike; Kirsch, Beatrice; Keeser, Daniel

2016-10-01

Transcranial current stimulation approaches include neurophysiologically distinct non-invasive brain stimulation techniques widely applied in basic, translational and clinical research: transcranial direct current stimulation (tDCS), oscillating transcranial direct current stimulation (otDCS), transcranial alternating current stimulation (tACS) and transcranial random noise stimulation (tRNS). Prefrontal tDCS seems to be an especially promising tool for clinical practice. In order to effectively modulate relevant neural circuits, systematic research on prefrontal tDCS is needed that uses neuroimaging and neurophysiology measures to specifically target and adjust this method to physiological requirements. This review therefore analyses the various neuroimaging methods used in combination with prefrontal tDCS in healthy and psychiatric populations. First, we provide a systematic overview on applications, computational models and studies combining neuroimaging or neurophysiological measures with tDCS. Second, we categorise these studies in terms of their experimental designs and show that many studies do not vary the experimental conditions to the extent required to demonstrate specific relations between tDCS and its behavioural or neurophysiological effects. Finally, to support best-practice tDCS research we provide a methodological framework for orientation among experimental designs. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Heimlich Valve for Pleural Cavity Drainage | Makanga | Annals ...

African Journals Online (AJOL)

Introduction: Traditional chest tube fixation and drainage has been undertaken using standard rigid chest tubes connected to under water seal bottles. These are bulky, cumbersome, expensive, and pose a risk of accidental air suction into the chest. One-way valve systems such as the Heimlich valve are small, portable ...

Effect of tube drainage compared with conventional suturing on postoperative discomfort after extraction of impacted mandibular third molars.

Science.gov (United States)

Koyuncu, B Ö; Zeytinoğlu, M; Tetik, A; Gomel, M M

2015-01-01

The aim of this prospective randomised study was to assess the effects of tube drainage on postoperative discomfort after the extraction of impacted mandibular third molars. We studied 40 patients (11 men and 29 women) 18 years or older (mean (SD) 21 (3), range 18-29) who required extraction of mandibular third molars. We used a randomised crossover design by which if a drain was inserted on one side, then the other side was managed without a drain on a later occasion. Pain, swelling, and mouth opening were evaluated after 48 h and 7 days postoperatively in both groups. Facial swelling (p=0.001), pain p=0.001), and trismus (p=0.001) were significantly less common in the drained group compared with those not drained. We conclude that the use a tube drain is of benefit in minimising postoperative swelling, pain, and trismus after extraction of mandibular third molars. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Effect of rolling temperature on 12Kh18N10T steel tube hardening

International Nuclear Information System (INIS)

Yushkevich, P.M.; Stepanovich, V.E.; Manankova, L.V.; Usenko, V.N.; Semenov, I.A.

1984-01-01

Mechanical properties and substructure of tubes at the constant reduction degree k(the ratio of deformation over wall thickness to deformation over diameter), depending on strain degree during cold and hot tube rolling, have been studied. The investigations are carried out using hot-rolled tubes with the dimensions 88x8 mm of 12Kh1hN10T steel. With the decrease of strain over the wall of the tube, produced of 12Kh18N10T steel as to strain over diameter the values of yield strength and ultimate strength increase with simultaneous decrease in ductility during warm rolling and yield strength and ultimate strength decrease with the increase in ductility-during cold rolling. During warm rolling of the tubes at 250 deg C the hardening of 12Kh18N10T steel is higher, than at the rolling temperature 150 deg C. The optimum temperature range of warm rolling is 120-150 deg C. Grain orientation in the metal of the tubes and degree of texture perfection increase with the temperature increase of the tube warm drolling as compared with col rolli

Radioisotope study of Eustachian tube

International Nuclear Information System (INIS)

De Rossi, G.; Campioni, P.; Vaccaro, A.

1988-01-01

Radioisotope studies of Eustachian tube are suggested in the preoperative phase of tympanoplasty, in order to assess tubal drainage and secretion. The use of gamma camera fitted to a computer allowed the AA, to calculate some semi-quantitative parameters for an exact assessment of the radioactivity transit from the tympanic cass up to the pharyngeal cavity, throughout the Eustachian tube. (orig.) [de

[gammadelta T cells stimulated by zoledronate kill osteosarcoma cells].

Science.gov (United States)

Jiang, Hui; Xu, Qiang; Yang, Chao; Cao, Zhen-Guo; Li, Zhao-Xu; Ye, Zhao-Ming

2010-12-01

To investigate the cytotoxicity of human γδT cells from PBMCs stimulated by zoledronate against osteosarcoma cell line HOS in vitro and in vivo and evaluate the relavent pathways. The peripheral blood mononuclear cells (PBMCs)of healthy donors were stimulated by single dose zoledronate and cultured in the present of IL-2 for two weeks, analysising the percentage of γδT cells on a FACSCalibur cytometer.Study the cytotoxicity of γδT cells against the osteosarcoma line HOS using LDH release assay kit. Pre-treatment of γδT cells with anti-human γδTCR antibody, anti-human NKG2D antibody and concanamycin A to bolck the relavent pathways for evaluating the mechenisms of its cytotoxicity. In vivo, BALB/c mice were inoculated subcutaneously osteosarcoma cell HOS for developing hypodermal tumors. And they were randomized into two groups: unteated group, γδT cell therapy group. Tumor volume and weight of the two groups were compared. After two weeks of culture, γδT cells from zoledronate-stimulated PBMCs could reach (95±3)%. When the E:T as 6:1, 12:1, 25:1, 50:1, the percentage of osteosarcoma cell HOS killed by γδT cells was 26.8%, 31.5%, 37.8%, 40.9%, respectively.When anti-huma γδTCR antibody, anti-human NKG2D antibody and concanamycin A blocked the relavent pathways, the percentage was 32.3%, 4.7%, 16.7% ( E:T as 25:1), respectively. In vivo, the tumor inhibition rate of the group of γδT cell therapy was 42.78%. γδT cells derived from PBMCs stimulated by zoledronate can acquired pure γδT cells. And they show strong cytoxicity against osteosarcoma cell line HOS in vitro and in vivo.

Prolonged pericardial drainage using a soft drain reduces pericardial effusion and need for additional pericardial drainage following orthotopic heart transplantation.

Science.gov (United States)

Kim, Yun Seok; Jung, Sung-Ho; Cho, Won Chul; Yun, Sung-Cheol; Park, Jeong-Jun; Yun, Tae-Jin; Kim, Jae-Joong; Lee, Jae Won

2016-03-01

Pericardial effusion can cause haemodynamic compromise after heart transplantation. We identified the effects of soft drains on the development of pericardial effusion. We enrolled 250 patients ≥17 years of age who underwent heart transplantation between July 1999 and April 2012 and received two conventional tubes (n = 96; 32 French), or two tubes with a soft drain (n = 154; 4.8 mm wide). The development of significant pericardial effusion or the need for drainage procedure during 1 month after heart transplantation was compared with the use of the propensity score matching method to adjust for selection bias. At 1 month after transplantation, 69 patients (27.6%) developed significant pericardial effusion. Among these, 13 patients (5.2%) underwent pericardial drainage. According to multivariate analysis, history of previous cardiac surgery [odds ratio (OR) = 0.162; 95% confidence interval (CI) = 0.046-0.565; P = 0.004] and placement of a soft drain (OR = 0.186; 95% CI = 0.100-0.346; P effusion or the need for drainage during the early postoperative period. For the 82 propensity score matched pairs, patients receiving an additional soft drain were at a lower risk of the development of significant pericardial effusion or the need for a pericardial drainage procedure during 1 month (OR = 0.148; 95% CI = 0.068-0.318; P effusion and decreases the need for pericardial drainage after heart transplantation. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

UV dosimetry in pollen of Pinus silvestris and stimulation studies of pollen tube growth after irradiation with UV and ionizing radiations

International Nuclear Information System (INIS)

Seibold, H.W.

1976-01-01

Pollen tube growth after exposure to UV- and ionizing radiation was investigated in Pinus silvestris as a function of different parameters. The preconditions for this are an exact UV dosimetry and the conversion of the UV dose of [erg] into [rad]. In spite of the fact that the calculation methods are theoretically already well known, the experimental determination of the absorbed energy dose, in particular the absorption factors, was complicated by the morphological structure of the pollen. The total-irradiation experiments showed that the stimulation and inhibition of pollen tube growth is highly dependent on the dose/dose rate region chosen. Stimulation is highly dependent on the dose rate after UV irradiation as well as after exposure to ionizing radiation. When the dose rates are very small, the values are practically the same as in non-irradiated controls; with increasing doses rate, stimulation increases, whereas at very high dose rates only growth inhibition is observed. After exposure to ionizing radiation, the quantum energy or wavelength of the radiation has no effect on tube growth; after UV irradiation, on the other hand, there is hardly any stimulation at short wavelengths. As these observations were not sufficient for drawing conclusions on the site of the stimulatory action, partial UV exposure with separate irradiation of the two nuclei and the cytoplasm was also carried out. Stimulation was found in each of the three irradiation sites; although nuclei and cytoplasma react differently and also differ in the initial reaction stages, there is always an anhancement of pollen tube growth. These findings are compared with some of the current hypotheses for an explanation of the stimulatory effect. (orig.) [de

Abdominal drainage following cholecystectomy: high, low, or no suction?

OpenAIRE

McCormack, T. T.; Abel, P. D.; Collins, C. D.

1983-01-01

A prospective trial to assess the effect of suction in an abdominal drain following cholecystectomy was carried out. Three types of closed drainage system were compared: a simple tube drain, a low negative pressure drain, and a high negative pressure drain: 120 consecutive patients undergoing cholecystectomy were randomly allocated to one of the three drainage groups. There was no significant difference in postoperative pyrexia, wound infection, chest infection, or hospital stay. This study f...

Minimally invasive retrieval of a retained Jackson--Pratt drainage tube using the Sachse urethrotome.

Science.gov (United States)

Fariña-Perez, Luis Angel; Pesqueira-Santiago, Daniel

2012-05-01

A retained postoperative drain tube, trapped by one or more of the sutures of the abdominal wall closure, is a rare complication of frustrating consequences and potential legal repercussions. There are few reports of techniques for minimally invasive removal of an anchored postoperative drain tube, which not infrequently has been treated by reopening the wound. A 75 years-old man with a left T2-T3N0M0 renal carcinoma was treated with transperitoneal laparoscopic nephrectomy and a Jackson-Pratt drain was left in place. Drain removal the day after revealed impossible, as if being caught with fascial suture. With the patient under sedation, we introduced a Sachse urethrotome parallel to the drain, and the abdominal fascia was identified, then the polyglycolic stitch anchoring it to the wall could be severed, freeing the drain. Percutaneous extraction with the Sachse urethrotome of an anchored postoperative drain, should be the first option, before trying a forced traction or using more complex options. This technique is for the first time published in the Spanish bibliography, and we think this possibility should be disclosed to abdominal surgeons.

Chest tube care in critically ill patient: A comprehensive review

Directory of Open Access Journals (Sweden)

Hanan Mohammed Mohammed

2015-10-01

Full Text Available Breathing is automatic. We don’t usually think too much about it unless we develop a problem. Lack of adequate ventilation and impairment of our respiratory system can quickly become life-threatening. There are many clinical conditions that may necessitate the use of chest tubes. When there is an accumulation of positive pressure in the chest cavity (where it should normally be negative pressure between pleurae, a patient will require chest drainage. Chest tubes may be inserted to drain body fluids or to facilitate the re-expansion of a lung. It is important for the clinician to determine the most appropriate tube size to use prior to intubation. The position of the chest tube is related to the function that the chest tube performs. When managing the care of patients who have chest tubes it is important to fully understand what to do in case problems arise. It is also important to be able to assess when the chest tube is ready to be discontinued. Nurses and other healthcare professionals who are responsible for the safe delivery of care should be knowledgeable about respiratory pathophysiology, signs of respiratory compromise, and the care and management of interventions that may be utilized to ensure adequate respiration.

Dissimilar metal study on C44300 tube to AA7075 -T651 tube plate with and without thread by FWTPET process

Energy Technology Data Exchange (ETDEWEB)

Radhakrishnan, E.; Kumaraswamidhas, L. A. [Indian Institute of Technology (ISM), Jharkhand (India); Muruganandam, D. [Sri Sairam Engineering College, Tamil Nadu (India); Kumaran, S. Senthil [RVS School of Engineering and Technology, Tamilnadu, (India)

2017-05-15

Friction welding has vital industrial role in fabricating automobiles, aerospace, ship building, heat exchangers using similar, dissimilar and bi-metal of ferrous and non-ferrous metals at mass production level. In this study, admiralty brass C44300 tube and aluminium alloy AA7075 -T651, 6 mm thick tube plate were identified as base metals. Different joint surface area profile of with and without thread of different pitch values was chosen to study the mechanical properties and micro structures of these two base metals. 0.1 mm clearance was maintained between the AA7075-T651 tube plate and C44300 tube outer diameter to make friction welding. Taguchi’s L16 orthogonal array techniques were adopted for identifying the most significant ranking process parameters. Analysis of variance (ANOVA) has been used to analyze the input parameter contribution in terms of percentage. Genetic algorithm (GA) was used to access the suitable input parameter value to obtain effective joint strength in terms of hardness, compressive strength and microstructure formation in the interface of the joint. A Compression test (CT) was conducted to evaluate the level of compressive strength of the joint. Threaded profile pair with higher pitch value proved high compressive strength over unthreaded pair. Micro structure for base metal C44300 tube and AA7075-T651 tube plate, Heat affected zone (HAZ) and Weld zone (WZ) of the joint has been studied. Hardness of base metals, HAZ and WZ was measured by micro Vickers hardness tester and the observation shows that hardness at joint interface has been found to be higher in all pairs.

Laparoscopic common bile duct exploration and antegrade biliary stenting: Leaving behind the Kehr tube

Directory of Open Access Journals (Sweden)

Darío Martínez-Baena

2013-03-01

Full Text Available Introduction: single-stage laparoscopic surgery of cholelithiasis and associated common bile duct stones (CL-CBDS has shown similar results when compared to laparoscopic cholecystectomy combined with ERCP. Classically, choledochorrhaphy has been protected by a T-tube drain to allow external bypass of bile flow. However, its removal is associated with a significant complication rate. Use of antegrade biliary stents avoids T-tube removal associated morbidity. The aim of this study is to compare the results of choledochorrhaphy plus T-tube drainage versus antegrade biliary stenting in our series of laparoscopic common bile duct explorations (LCBDE. Material and methods: between 2004 and 2011, 75 patients underwent a LCBDE. Choledochorrhaphy was performed following Kehr tube placements in 47 cases and transpapillary biliary stenting was conducted in the remaining 28 patients. Results: postoperative hospital stay was shorter in the stent group (5 ± 10.26 days than in the Kehr group (12 ± 10.6 days, with a statistically significant difference. There was a greater trend to grade B complications in the stent group (10.7 vs. 4.3 % and to grade C complications in the Kehr group (6.4 vs. 3.6 %. There were 3 cases of residual common bile duct stones in the Kehr group (6.4 % and none in the stent group. Conclusions: antegrade biliary stenting following laparoscopic common bile duct exploration for CL-CBDS is an effective and safe technique that prevents T-tube related morbidity.

Does the usage of digital chest drainage systems reduce pleural inflammation and volume of pleural effusion following oncologic pulmonary resection?-A prospective randomized trial.

Science.gov (United States)

De Waele, Michèle; Agzarian, John; Hanna, Waël C; Schieman, Colin; Finley, Christian J; Macri, Joseph; Schneider, Laura; Schnurr, Terri; Farrokhyar, Forough; Radford, Katherine; Nair, Parameswaran; Shargall, Yaron

2017-06-01

Prolonged air leak and high-volume pleural drainage are the most common causes for delays in chest tube removal following lung resection. While digital pleural drainage systems have been successfully used in the management of post-operative air leak, their effect on pleural drainage and inflammation has not been studied before. We hypothesized that digital drainage systems (as compared to traditional analog continuous suction), using intermittent balanced suction, are associated with decreased pleural inflammation and postoperative drainage volumes, thus leading to earlier chest tube removal. One hundred and three [103] patients were enrolled and randomized to either analog (n=50) or digital (n=53) drainage systems following oncologic lung resection. Chest tubes were removed according to standardized, pre-defined protocol. Inflammatory mediators [interleukin-1B (IL-1B), 6, 8, tumour necrosis factor-alpha (TNF-α)] in pleural fluid and serum were measured and analysed. The primary outcome of interest was the difference in total volume of postoperative fluid drainage. Secondary outcome measures included duration of chest tube in-situ, prolonged air-leak incidence, length of hospital stay and the correlation between pleural effusion formation, degree of inflammation and type of drainage system used. There was no significant difference in total amount of fluid drained or length of hospital stay between the two groups. A trend for shorter chest tube duration was found with the digital system when compared to the analog (P=0.055). Comparison of inflammatory mediator levels revealed no significant differences between digital and analog drainage systems. The incidence of prolonged post-operative air leak was significantly higher when using the analog system (9 versus 2 patients; P=0.025). Lobectomy was associated with longer chest tube duration (P=0.001) and increased fluid drainage when compared to sub-lobar resection (Pdigital drainage does not appear to decrease pleural

Transcranial alternating current stimulation (tACS

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Andrea eAntal

2013-06-01

Full Text Available Transcranial alternating current stimulation (tACS seems likely to open a new era of the field of noninvasive electrical stimulation of the human brain by directly interfering with cortical rhythms. It is expected to synchronize (by one single resonance frequency or desynchronize (e.g. by the application of several frequencies cortical oscillations. If applied long enough it may cause neuroplastic effects. In the theta range it may improve cognition when applied in phase. Alpha rhythms could improve motor performance, whereas beta intrusion may deteriorate them. TACS with both alpha and beta frequencies has a high likelihood to induce retinal phosphenes. Gamma intrusion can possibly interfere with attention. Stimulation in the ripple range induces intensity dependent inhibition or excitation in the motor cortex most likely by entrainment of neuronal networks, whereas stimulation in the low kHz range induces excitation by neuronal membrane interference. TACS in the 200 kHz range may have a potential in oncology.

Comparison of different ligature materials used for T-tube esophageal exclusion.

Science.gov (United States)

Lee, Y C; Luh, S P; Tsai, C C; Hsu, H C; Chu, S H

1992-03-01

Four different ligature materials--plain catgut, chromic catgut, dexon and silk--were used for ligature of the distal arm during T-tube exclusion of the cervical esophagus in 12 dogs. Ligature by plain catgut was maintained for only a short period, but the duration of esophageal occlusion with the other three ligature materials was around 10 days. Ligated esophageal segments were examined grossly and histologically two months after the procedure. The diameter of the esophageal lumen in the ligated segments had become smaller compared with the neighboring normal esophageal lumen. The most prominent histologic changes were atrophy and fibrosis of the muscle coat, vessel congestion and inflammatory cell infiltration in the ligated segments. These tissue reactions were more severe in the chromic catgut and silk ligatures. Among the 11 evaluable dogs, four had symptoms of dysphagia after removal of the T-tube. All four dogs had a sinus discharge and granuloma formation at the T-tube esophagostoma. The diameter of the esophageal lumen was more constricted in dogs with dysphagia. Among the four ligature materials, dexon had the advantages of a long duration of occlusion, less tissue fibrosis and little sequel of esophageal stenosis, making it the most suitable for ligature during esophageal exclusion.

Combined motor point associative stimulation (MPAS) and transcranial direct current stimulation (tDCS) improves plateaued manual dexterity performance.

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Hoseini, Najmeh; Munoz-Rubke, Felipe; Wan, Hsuan-Yu; Block, Hannah J

2016-10-28

Motor point associative stimulation (MPAS) in hand muscles is known to modify motor cortex excitability and improve learning rate, but not plateau of performance, in manual dexterity tasks. Central stimulation of motor cortex, such as transcranial direct current stimulation (tDCS), can have similar effects if accompanied by motor practice, which can be difficult and tiring for patients. Here we asked whether adding tDCS to MPAS could improve manual dexterity in healthy individuals who are already performing at their plateau, with no motor practice during stimulation. We hypothesized that MPAS could provide enough coordinated muscle activity to make motor practice unnecessary, and that this combination of stimulation techniques could yield improvements even in subjects at or near their peak. If so, this approach could have a substantial effect on patients with impaired dexterity, who are far from their peak. MPAS was applied for 30min to two right hand muscles important for manual dexterity. tDCS was simultaneously applied over left sensorimotor cortex. The motor cortex input/output (I/O) curve was assessed with transcranial magnetic stimulation (TMS), and manual dexterity was assessed with the Purdue Pegboard Test. Compared to sham or cathodal tDCS combined with MPAS, anodal tDCS combined with MPAS significantly increased the plateau of manual dexterity. This result suggests that MPAS has the potential to substitute for motor practice in mediating a beneficial effect of tDCS on manual dexterity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A technical guide to tDCS, and related non-invasive brain stimulation tools

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Woods, AJ; Antal, A; Bikson, M; Boggio, PS; Brunoni, AR; Celnik, P; Cohen, LG; Fregni, F; Herrmann, CS; Kappenman, ES; Knotkova, H; Liebetanz, D; Miniussi, C; Miranda, PC; Paulus, W; Priori, A; Reato, D; Stagg, C; Wenderoth, N; Nitsche, MA

2015-01-01

Transcranial electrical stimulation (tES), including transcranial direct and alternating current stimulation (tDCS, tACS) are non-invasive brain stimulation techniques increasingly used for modulation of central nervous system excitability in humans. Here we address methodological issues required for tES application. This review covers technical aspects of tES, as well as applications like exploration of brain physiology, modelling approaches, tES in cognitive neurosciences, and interventional approaches. It aims to help the reader to appropriately design and conduct studies involving these brain stimulation techniques, understand limitations and avoid shortcomings, which might hamper the scientific rigor and potential applications in the clinical domain. PMID:26652115

Nasogastric tube versus gastrostomy tube for gastric decompression in abdominal surgery: a prospective, randomized trial comparing patients' tube-related inconvenience.

Science.gov (United States)

Hoffmann, S; Koller, M; Plaul, U; Stinner, B; Gerdes, B; Lorenz, W; Rothmund, M

2001-11-01

Perioperative decompression of the stomach is still a common procedure and can be achieved using either nasogastric tubes (NTs) or gastrostomy tubes (GTs). While both procedures appear to be equally effective, some authors believe that NTs are less convenient for patients than GTs. However, to date, no reliable prospective data are available on this issue. We conducted a prospective, randomized trial comparing NTs versus GTs with a total of 110 patients undergoing elective colon surgery. The primary outcome measure was the patient's tube-related inconvenience and pain, assessed in a standardized interview on day 2 after surgery and quantified by means of a visual-analog scale (VAS). A questionnaire including the EORTC QLQ-C30 and additional items regarding retrospective tube-related judgements was administered on the day of discharge and 4 weeks after discharge. Secondary endpoints were the therapy-related morbidity and general complications. When patients were asked which of their drainage tubes (all patients had three or four drainage tubes, such as decompression drains, urinary drains, central venous line) was most inconvenient, 43% (CI 33-53%) in the NT group reported that the NT was most inconvenient, while only 4% (CI 1-10%) of the GT patients judged the GT most inconvenient ( Ptube system (day 2 p.o.: 71%, CI 61-80%; 4 weeks p.o.: 66%, CI 56-75%) than did GT patients (day 2 p.o.: 94%, CI 88-98%; 4 weeks p.o.: 91% CI 84-96%); again, these differences were statistically significant ( Ptube system have to weigh up the possibilities of different averse clinical as well as subjective outcomes. It is then preferable to include patients' preferences in the individual decision making process (shared-decision making).

Utility of Objective Chest Tube Management After Pulmonary Resection Using a Digital Drainage System.

Science.gov (United States)

Takamochi, Kazuya; Imashimizu, Kota; Fukui, Mariko; Maeyashiki, Tatsuo; Suzuki, Mikiko; Ueda, Takuya; Matsuzawa, Hironori; Hirayama, Shunki; Matsunaga, Takeshi; Oh, Shiaki; Suzuki, Kenji

2017-07-01

We sought to evaluate the clinical utility of chest tube management after pulmonary resection based on objective digital monitoring of pleural pressure and digital surveillance for air leaks. We prospectively recorded the perioperative data of 308 patients who underwent pulmonary resection between December 2013 and January 2016. We used information from a digital monitoring thoracic drainage system to measure peak air leakage during the first 24 hours after the operation, patterns of air leakage over the first 72 hours, and patterns of pleural pressure changes until the chest tubes were removed. There were 240 patients with lung cancer and 68 patients with other diseases. The operations included 49 wedge resections, 58 segmentectomies, and 201 lobectomies. A postoperative air leak was observed in 61 patients (20%). A prolonged air leak exceeding 20 mL/min lasting 5 days or more was observed in 18 patients (5.8%). Multivariate analysis of various perioperative factors showed forced expiratory volume in 1 second below 70%, patterns of air leakage, defined as exacerbating and remitting or without a trend toward improvement, and peak air leakage of 100 mL/min or more were significant positive predictors of prolonged air leak. Fluctuations in pleural pressure occurred just after the air leakage rate decreased to less than 20 mL/min. Digital monitoring of peak air leakage and patterns of air leakage were useful for predicting prolonged air leak after pulmonary resection. Information on the disappearance of air leak could be derived from the change in the rate of air leakage and from the increase in fluctuation of pleural pressure. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

[Prehospital airway management of laryngeal tubes. Should the laryngeal tube S with gastric drain tube be preferred in emergency medicine?].

Science.gov (United States)

Dengler, V; Wilde, P; Byhahn, C; Mack, M G; Schalk, R

2011-02-01

Laryngeal tubes (LT) are increasingly being used for emergency airway management. This article reports on two patients in whom out-of-hospital intubation with a single-lumen LT was associated with massive pulmonary aspiration in one patient and gastric overinflation in the other. In both cases peak inspiratory pressures exceeded the LT leak pressure of approximately 35 mbar. This resulted in gastric inflation and decreased pulmonary compliance and increased inspiratory pressure further, thereby creating a vicious circle. It is therefore recommended that laryngeal tube suction (LTS) should be used in all cases of emergency airway management and a gastric drain tube be inserted through the dedicated second lumen. Apart from gastric overinflation, incorrect LT/LTS placement must be detected and immediately corrected, e.g. in cases of difficult or impossible gastric tube placement, permanent drainage of air from the gastric tube, decreasing minute ventilation or an ascending capnography curve.

Transcutaneous vagus nerve stimulation (tVNS) enhances divergent thinking.

Science.gov (United States)

Colzato, Lorenza S; Ritter, Simone M; Steenbergen, Laura

2018-03-01

Creativity is one of the most important cognitive skills in our complex and fast-changing world. Previous correlative evidence showed that gamma-aminobutyric acid (GABA) is involved in divergent but not convergent thinking. In the current study, a placebo/sham-controlled, randomized between-group design was used to test a causal relation between vagus nerve and creativity. We employed transcutaneous vagus nerve stimulation (tVNS), a novel non-invasive brain stimulation technique to stimulate afferent fibers of the vagus nerve and speculated to increase GABA levels, in 80 healthy young volunteers. Creative performance was assessed in terms of divergent thinking (Alternate Uses Task) and convergent thinking tasks (Remote Associates Test, Creative Problem Solving Task, Idea Selection Task). Results demonstrate active tVNS, compared to sham stimulation, enhanced divergent thinking. Bayesian analysis reported the data to be inconclusive regarding a possible effect of tVNS on convergent thinking. Therefore, our findings corroborate the idea that the vagus nerve is causally involved in creative performance. Even thought we did not directly measure GABA levels, our results suggest that GABA (likely to be increased in active tVNS condition) supports the ability to select among competing options in high selection demand (divergent thinking) but not in low selection demand (convergent thinking). Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effect of dose rate and exposure time on the stimulation effect of tube growth of Pinus sylvestris pollen

International Nuclear Information System (INIS)

Zelles, L.; Fendrik, I.; Technische Univ. Hannover

1975-01-01

The stimulating effect of ionizing radiation in respect to dose rate and exposure time was studied using the tube growth of Pinus silvestris pollen. Stimulation was registered with a small dose (50 rad) supplied at low dose rates (0.5; 1.0; 3.0 and 5.0 rad/sec) and with higher doses (300; 800 and 1,400 rad) supplied at higher dose rates (10; 40 and 50 rad/sec). This suggests that only the exposure time is of importance for radiation-induced stimulation provided that the exposure time does not exceed 100 sec. (orig.) [de

T Cell Subset and Stimulation Strength-Dependent Modulation of T Cell Activation by Kv1.3 Blockers.

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Wai-Ping Fung-Leung

Full Text Available Kv1.3 is a voltage-gated potassium channel expressed on T cells that plays an important role in T cell activation. Previous studies have shown that blocking Kv1.3 channels in human T cells during activation results in reduced calcium entry, cytokine production, and proliferation. The aim of the present study was to further explore the effects of Kv1.3 blockers on the response of different human T cell subsets under various stimulation conditions. Our studies show that, unlike the immune suppressor cyclosporine A, the inhibitory effect of Kv1.3 blockers was partial and stimulation strength dependent, with reduced inhibitory efficacy on T cells under strengthened anti-CD3/CD28 stimulations. T cell responses to allergens including house dust mites and ragweed were partially reduced by Kv1.3 blockers. The effect of Kv1.3 inhibition was dependent on T cell subsets, with stronger effects on CCR7- effector memory compared to CCR7+ central memory CD4 T cells. Calcium entry studies also revealed a population of CD4 T cells resistant to Kv1.3 blockade. Activation of CD4 T cells was accompanied with an increase in Kv1.3 currents but Kv1.3 transcripts were found to be reduced, suggesting a posttranscriptional mechanism in the regulation of Kv1.3 activities. In summary, Kv1.3 blockers inhibit T cell activation in a manner that is highly dependent on the T cell identity and stimulation strength, These findings suggest that Kv1.3 blockers inhibit T cells in a unique, conditional manner, further refining our understanding of the therapeutic potential of Kv1.3 blockers.

Modulation of Total Sleep Time by Transcranial Direct Current Stimulation (tDCS).

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Frase, Lukas; Piosczyk, Hannah; Zittel, Sulamith; Jahn, Friederike; Selhausen, Peter; Krone, Lukas; Feige, Bernd; Mainberger, Florian; Maier, Jonathan G; Kuhn, Marion; Klöppel, Stefan; Normann, Claus; Sterr, Annette; Spiegelhalder, Kai; Riemann, Dieter; Nitsche, Michael A; Nissen, Christoph

2016-09-01

Arousal and sleep are fundamental physiological processes, and their modulation is of high clinical significance. This study tested the hypothesis that total sleep time (TST) in humans can be modulated by the non-invasive brain stimulation technique transcranial direct current stimulation (tDCS) targeting a 'top-down' cortico-thalamic pathway of sleep-wake regulation. Nineteen healthy participants underwent a within-subject, repeated-measures protocol across five nights in the sleep laboratory with polysomnographic monitoring (adaptation, baseline, three experimental nights). tDCS was delivered via bi-frontal target electrodes and bi-parietal return electrodes before sleep (anodal 'activation', cathodal 'deactivation', and sham stimulation). Bi-frontal anodal stimulation significantly decreased TST, compared with cathodal and sham stimulation. This effect was location specific. Bi-frontal cathodal stimulation did not significantly increase TST, potentially due to ceiling effects in good sleepers. Exploratory resting-state EEG analyses before and after the tDCS protocols were consistent with the notion of increased cortical arousal after anodal stimulation and decreased cortical arousal after cathodal stimulation. The study provides proof-of-concept that TST can be decreased by non-invasive bi-frontal anodal tDCS in healthy humans. Further elucidating the 'top-down' pathway of sleep-wake regulation is expected to increase knowledge on the fundamentals of sleep-wake regulation and to contribute to the development of novel treatments for clinical conditions of disturbed arousal and sleep.

A Novel Device for Accurate Chest Tube Insertion

DEFF Research Database (Denmark)

Katballe, Niels; Moeller, Lars B; Olesen, Winnie H

2016-01-01

BACKGROUND: Optimal positioning of a large-bore chest tube is in the part of the pleural cavity that needs drainage. It is recommended that the chest tube be positioned apically in pneumothorax and basally for fluids. However, targeted chest tube positioning to a specific part of the pleural cavity...... can be a challenge. METHODS: A new medical device, the KatGuide, was developed for accurate guiding of a chest tube (28F) to an intended part of the pleural cavity. The primary end point of this randomized, controlled trial was optimal position of the chest tube. The optimal position in pneumothorax...

Is Nasobiliary Tube Really Safe A Case Report

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Girolamo Geraci

2011-05-01

Full Text Available A case of esophageal ulcer caused by nasobiliary tube is described. This tool is not routinely considered to be a cause of major complications in the literature and to our knowledge, this is the first report of this kind of complication in nasobiliary tube placement. A 72-year-old patient presented with Charcot’s triad and was demonstrated to have cholangitis with multiple biliary stones in the common bile duct. Biliary drainage was achieved through endoscopic retrograde cholangiography, endoscopic sphincterotomy, biliary tree drainage and nasobiliary tube with double pigtail. The patient presented odynophagia, dysphagia and retrosternal pain 12 h after the procedure and upper endoscopy revealed a long esophageal ulcer, which was treated conservatively. This report provides corroboration of evidence that nasobiliary tubeplacement has potential complications related to pressure sores. In our opinion this is a possibility to consider in informed consent forms.

Evaluation of the effectiveness of transcranial direct current stimulation (tDCS) and psychosensory stimulation through DOCS scale in a minimally conscious subject.

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Dimitri, Danilo; De Filippis, Daniela; Galetto, Valentina; Zettin, Marina

2017-04-01

The aim of our study was to assess the effectiveness of transcranial direct current stimulation (tDCS) on alertness improvement in a patient in a minimally conscious state (MCS) by means of disorders of consciousness scale combined with psycho-sensory stimulation. The effects of tDCS on muscle hypertonia through the Ashworth scale were also examined. tDCS was performed through a two-channel intra-cephalic stimulator. After stimulation, the patient followed a psychosensory stimulation training. Results pointed out an increase in DOCunit score, as well as an increase in alertness maintenance and an improvement in muscle hypertonia, although a MCS state persisted.

Panophthalmitis with orbital cellulitis following glaucoma drainage implant surgery in a pediatric patient

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Bruno L. B. Esporcatte

2016-04-01

Full Text Available ABSTRACT Here we report a case of childhood glaucoma refractory to angle and trabeculectomy surgery. The patient was treated with an Ahmed™ drainage implant that was subsequently complicated by rapid-onset panophthalmitis and orbital cellulitis. Intravenous and intravitreal antibiotic therapy was initiated and the drainage tube was removed. The infectious process resolved within 3 weeks; however, phthisis bulbi developed subsequently.

Conjunctival erosion after glaucoma drainage device surgery: A feasible option

OpenAIRE

Dubey, Suneeta; Prasanth, Baswati; Acharya, Manisha C; Narula, Ritesh

2013-01-01

Glaucoma drainage devices (GDDs) have been used in the management of complicated glaucomas. GDDs are associated with various complications such as tube migration, tube or plate exposure or extrusion, ocular motility disturbance and infection. Erosion of conjunctiva and exposure of the GDD remains a risk factor for the development of endophthalmitis. A wide range of materials have been used for this purpose, including sclera, dura, pericardium, fascia lata and cornea. However, there is no evid...

Tubo de PVC liso com diferentes envoltórios como material alternativo na drenagem subterrânea Smooth PVC tube with different envelopes as an alternative material in the subsurface drainage

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Florício P. de Almeida

2003-04-01

Full Text Available Em regiões áridas e semi-áridas irrigadas a drenagem é, freqüentemente, necessária para prevenir o encharcamento do solo e o controle da salinidade. Um dos principais obstáculos na instalação de um sistema de drenagem subterrânea é o alto custo do investimento inicial. Assim, alguma contribuição que reduza o custo da instalação dos drenos e também do material usado, é altamente vantajosa. Diante disso, o objetivo desta pesquisa foi avaliar, em condições de laboratório, o desempenho hidráulico do sistema drenante constituído pelo tubo de PVC liso, próprio para esgoto doméstico, de 50,0 mm de diâmetro nominal e área aberta de 23,0 cm² m-1, e por três tipos de envoltório. O desempenho do tubo drenante de PVC liso demonstrou que esse material é tecnicamente viável para drenagem agrícola, principalmente com o uso de brita como envoltório.In irrigated arid and semi-arid regions the drainage is, frequently, necessary to prevent the waterlogging of the soil and to control the salinity. One of the main obstacles in the installation of a subsurface drainage system is the high cost of the initial investment. Thus, some contribution that reduces the cost of the installation of the drains and also of the material used is highly advantageous. The objective of this research was to evaluate, under laboratory conditions, the hydraulic performance of the drainage system constituted by smooth PVC tube used for sewer with 50.0 mm of nominal diameter and open area of 23.0 cm² m-1 and different types of envelopes, as an alternative material for subsurface drainage. The performance of the smooth PVC tube demonstrated that this material is technically viable for agricultural drainage principally when used with single stones as envelope.

Peritoneal seeding of cholangiocarcinoma in patients with percutaneous biliary drainage

International Nuclear Information System (INIS)

Miller, G.A. Jr.; Heaston, D.K.; Moore, A.V. Jr.; Mills, S.R.; Dunnick, N.R.

1983-01-01

Percutaneous transhepatic catheter decompression is performed increasingly as an adjunct or alternative to surgery in patients with benign or malignant biliary obstruction. The authors recently saw three patients with cholangiocarcinoma in whom metastatic seeding of the peritoneal serosa was identified some months after initial percutaneous transhepatic biliary drainage. Although no tumor was found along the hepatic tract of the biliary drainage catheters to implicate the drainage tubes as the direct source of peritoneal spread, the occurrence of this rare type of metastasis of cholangiocarcinoma in patients with potential access of tumor cells to the peritoneal cavity via the catheter tracts does suggest such a relation. The clinical history of one patient is presented

Tube thoracostomy in the management of pleural fluid collections.

Science.gov (United States)

Nwofor, A M E; Ekwunife, C N

2006-06-01

To determine the demographic pattern, indications and complications associated with tube thoracostomy in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi. A 5-year review of case records of patients who underwent tube thoracostomy at NAUTH Nnewi between January 1999 and December 2003. Demographic data, clinical features, duration of drainage, complications and outcomes were analyzed. A total of 65 cases were studied, male: female ratio was 2.4:1. Eighteen patients (27.7%) were below 10 years of age. Infective cases accounted for 63.1% (41) of the cases that had tube thoracostomy. Forty-one patients (63.1%) had tube drainage for 10 days or less. Complication rate was 41.5% (27), mostly mild, with dislodgement of the tube accounting for about half. Failure rate of 13.7% (9) was recorded for the procedure. A mortality of 6.2% (4) was recorded but there was no procedure related death. Seven patients (10.8%) required further surgery. Tube thoracostomy is a simple and efficacious procedure for the treatment of pleural space collections. The safety of the procedure can be improved upon by adequate training in the insertion procedure, while proper selection of cases will reduce failure rate and unnecessary morbidity. Early resort to thoracoscopic or open surgery when tube thoracostomy is considered inappropriate or has failed will improve the success rate in the overall management of pleural fluid collections.

Percutaneous transhepatic biliary drainage through the normal duct in patients with post-operative bile leakage

International Nuclear Information System (INIS)

Lee, Hyun; Kim, Young Hwan; Kim, Yong Joo

2004-01-01

To evaluate the technical feasibility and clinical efficacy of percutaneous transhepatic biliary drainage (PTBD) through the normal duct in patients with post-operative bile leakage. From January 1998 to December 2003, fourteen patients (male: 12, female: 2, mean age: 56) with biliary leak after laparoscopic cholecystectomy (n = 5), T-tube removal (n = 5), choledochojejunostomy due to small bowel perforation (n = 1), right lobectomy (n = 1), laparoscopic adrenalectomy (n = 1), and subtotal gastrectomy (n = 1) were treated by means of PTBD; this was performed with the two-step approach. The central bile duct was cannulated using a 21-G Chiba needle to map the intrahepatic biliary tree. An 8.5-F drainage catheter tip was positioned at the CBD after puncturing peripheral bile duct with an additional Chiba needle. We evaluated the technical feasibility, the procedure-related complications, clinical efficacy and the duration of catheter placement. PTBD of the normal duct with the two-step approach was successful in all but two cases. In these two cases, the two-step approach was failed due to the rapid disappearance of the targeted peripheral duct, and this was the result caused by biloportal fistula. PTBD was performed through the central bile duct in one patient, and through the remnant cystic duct in one patient. There were no procedure-related complications except for mild abdominal pain in seven patients. Bile leakage was demonstrated on cholangiogram in 10 of 14 patients; this occurred at the T-tube exit site (n = 4), cystic duct stump (n = 2), choledochojejunostomy site (n = 1), resection margin of liver (n = 1), caudate lobe (n = 1), and GB bed (n = 1). In 13 patients, the biliary leak stopped after drainage (mean duration: 32.1 days). In one patient, surgical management was performed one day after PTBD due to the excessive amount of bile leakage. PTBD is a technically feasible and clinically efficacious treatment for post-operative bile leakage, and it can

tDCS stimulation segregates words in the brain: evidence from aphasia

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Valentina eFiori

2013-06-01

Full Text Available A number of studies have already shown that modulating cortical activity by means of transcranial direct current stimulation (tDCS improves noun or verb naming in aphasic patients. However, it is not yet clear whether these effects are equally obtained through stimulation over the frontal or the temporal regions. In the present study, the same group of aphasic subjects participated in two randomized double-blind experiments involving two intensive language treatments for their noun and verb retrieval difficulties. During each training, each subject was treated with tDCS (20 min., 1mA over the left hemisphere in three different conditions: anodic tDCS over the temporal areas, anodic tDCS over the frontal areas and sham stimulation, while they performed a noun and an action naming tasks. Each experimental condition was run in five consecutive daily sessions over three weeks with 6 days of intersession interval. The order of administration of the two language trainings was randomly assigned to all patients. Overall, with respect to the other two conditions, results showed a significant greater improvement in noun naming after stimulation over the temporal region, while verb naming recovered significantly better after stimulation of the frontal region. These improvements persisted at one month after the end of each treatment suggesting a long-term effect on recovery of the patients’ noun and verb difficulties. These data clearly suggest that the mechanisms of recovery for naming can be segregated coupling tDCS with an intensive language training.

Case Series: Keratolimbal Allograft as a Patch Graft for Glaucoma Drainage Devices.

Science.gov (United States)

Ahmed, Sarah F; Schmutz, Mason; Mosaed, Sameh

2017-09-01

Tube exposure remains one of the most common complications after glaucoma drainage device (GDD) implantation, despite various types of patch grafts available today. We present a 4 patient case series following the effectivity of the keratolimbal allograft (KLAL) as a patch graft for cases of tube exposure. Given its inherent population of stem cells, our hypothesis was that this highly replicative, biological tissue would provide an adequate means of glaucoma tube coverage. The subset of patients chosen for the KLAL patch graft all had a history of abnormally scarred conjunctiva or thin sclera. The aim of utilizing the KLAL patch with its associated donor conjunctival and scleral ring was also to provide additional reinforcement and adequate tube coverage in the setting of compromised native tissue. Four patients comprised of 2 males and 2 females with a minimum postoperative period of 12 months. All GDDs were initially implanted with a limbal-based incision using either Ahmed glaucoma valve or Baerveldt drainage implant. Three of the 4 patients received the KLAL patch graft after tube exposure with scleral patch graft and 1 patient received KLAL as the primary graft during initial tube placement. Two of the 4 eyes experienced tube re-exposure postoperatively at 2 and 3 months, respectively. Both of these cases had a history of prior tube exposure after scleral patch graft and both were tubes placed in the pars plana. Interestingly, the patients with failed grafts were younger with a history of more ocular surgeries as compared with the patients with graft viable eyes. Through our case series, we found that the KLAL utilized as a patch graft over GDD tubes has the potential for favorable outcomes in certain subtypes of eyes. Although further large scale investigation will be necessary to better define the risk factors associated with graft failure, proving the graft's viability is a crucial first step.

Microstructure evolution in TRIP-aided seamless steel tube during T-shape hydroforming process

Energy Technology Data Exchange (ETDEWEB)

Liu, Jiyuan [State Key Laboratory of Rolling and Automation, Northeastern University, Shenyang 110004, Liaoning Provence (China); Zhang, Zicheng, E-mail: zhangzicheng2004@126.com [School of Mechanical Engineering and Automation, Northeastern University, Shenyang 110004, Liaoning Provence (China); Manabe, Ken-ichi [Department of Mechanical Engineering, Tokyo Metropolitan University, 1-1 Minami-Osawa, Hachioji-shi, Tokyo 192-0397 (Japan); Li, Yanmei [State Key Laboratory of Rolling and Automation, Northeastern University, Shenyang 110004, Liaoning Provence (China); Misra, R.D.K. [Center for Structural and Functional Materials, University of Louisiana at Lafayette, 44130 Lafayette, LA 70504-4130 (United States)

2014-08-15

Transformation-induced plasticity aided seamless steel tube comprising of ferrite, bainite, and metastable austenite was processed through forging, piercing, cold-drawing, and two-stage heat treatment. T-shape hydroforming is a classic forming method for experimental research and practical production. The current work studied austenite-to-martensite transformation and microcrack initiation and propagation of the tube during T-shape hydroforming using electron backscattering diffraction, scanning electron microscopy, and transmission electron microscopy. The strain distribution in the bcc-phase and fcc-phase was studied by evaluating changes in the average local misorientation. Compared to the compressive stress, metastable austenite with similar strain surrounding or inside the grains transformed easier under tensile loading conditions. The inclusions were responsible for microcrack initiation. The propagation of the cracks is hindered by martensite/austenite constituent due to transformation induced plasticity effect. The volume fraction of untransformed retained austenite decreased with increase in strain implying transformation-induced plasticity effect. - Highlights: • Hydroformed tubes processed via TRIP concept • EBSD provided estimate of micro local strain. • Retained austenite hinders propagation of microcracks.

Cholescintigraphy in patients with acute cholecystitis before and after percutaneous gallbladder drainage

DEFF Research Database (Denmark)

Borly, L; Stage, J G; Grønvall, S

1995-01-01

gallbladder drainage. During the post-drainage cholescintigraphies, a cholecystokinin stimulation was performed to investigate gallbladder emptying in 12 selected patients. Gallbladder pressure and volume were measured before drainage in another group of 12 patients with acute cholecystitis. RESULTS......OBJECTIVE: To investigate gallbladder function by use of cholescintigraphy in patients with acute cholecystitis before and after percutaneous gallbladder drainage. DESIGN: A cholescintigraphy was performed in 40 patients with acute cholecystitis before and after the performance of percutaneous......: As expected, no gallbladder activity was observed in the cholescintigraphies before drainage, except in a patient with an occluding stone in the common bile duct. Cystic duct patency and gallbladder activity were seen in 80% of patients in cholescintigraphies performed after drainage but before any other...

Subglottic secretion drainage for the prevention of ventilator-associated pneumonia: a systematic review and meta-analysis.

Science.gov (United States)

Muscedere, John; Rewa, Oleksa; McKechnie, Kyle; Jiang, Xuran; Laporta, Denny; Heyland, Daren K

2011-08-01

Aspiration of secretions containing bacterial pathogens into the lower respiratory tract is the main cause of ventilator-associated pneumonia. Endotracheal tubes with subglottic secretion drainage can potentially reduce this and, therefore, the incidence of ventilator-associated pneumonia. New evidence on subglottic secretion drainage as a preventive measure for ventilator-associated pneumonia has been recently published and to consider the evidence in totality, we conducted an updated systematic review and meta-analysis. We searched computerized databases, reference lists, and personal files. We included randomized clinical trials of mechanically ventilated patients comparing standard endotracheal tubes to those with subglottic secretion drainage and reporting on the occurrence of ventilator-associated pneumonia. Studies were meta-analyzed for the primary outcome of ventilator-associated pneumonia and secondary clinical outcomes. We identified 13 randomized clinical trials that met the inclusion criteria with a total of 2442 randomized patients. Of the 13 studies, 12 reported a reduction in ventilator-associated pneumonia rates in the subglottic secretion drainage arm; in meta-analysis, the overall risk ratio for ventilator-associated pneumonia was 0.55 (95% confidence interval, 0.46-0.66; p drainage was associated with reduced intensive care unit length of stay (-1.52 days; 95% confidence interval, -2.94 to -0.11; p = .03); decreased duration of mechanically ventilated (-1.08 days; 95% confidence interval, -2.04 to -0.12; p = .03), and increased time to first episode of ventilator-associated pneumonia (2.66 days; 95% confidence interval, 1.06-4.26; p = .001). There was no effect on adverse events or on hospital or intensive care unit mortality. In those at risk for ventilator-associated pneumonia, the use of endotracheal tubes with subglottic secretion drainage is effective for the prevention of ventilator-associated pneumonia and may be associated with reduced

Intracavitary drainage procedure for giant bullae in compromised patients.

Science.gov (United States)

Verma, R K; Nishiki, M; Mukai, M; Fujii, T; Kuranishi, F; Yoshioka, S; Ohtani, M; Dohi, K

1991-09-01

Two cases of giant bullae were treated by intracavitary suction and drainage procedure under local anesthesia because of the poor pulmonary function. After staged bullectomy, the patients returned to normal life. The first case was admitted to our intensive care unit (ICU). Tube drainage was performed in the giant bulla of the left lung immediately after admission. One month after recovery from right heart failure and mediastinal shift to the right side, bullectomy was performed using linear stapler. The patient was discharged 20 days later. The second case was admitted with severe dyspnea and bilateral giant bullae were noticed. We performed tube drainage for larger bulla of the left lung under local anesthesia. Two months later, bullectomy was performed on the right side, because the bulla on the left side became smaller and the general condition of the patient improved. The patient was discharged three months later on foot and has since been asymptomatic. Giant bulla is a well-established clinical entity which includes abnormal dilatation of various parts of the tracheo-bronchial tree and other discrete sacs originating from the interstitial portion of the lung. Giant bullae are frequently associated with marked dyspnea and emphysematous symptoms. However, these symptoms depend upon various factors: size, location, valvular mechanism, condition of the contiguous lung parenchyma and the changes that may take place in the intrathoracic pressure.

Studies on capillary tube expansion device used in J-T refrigerators operating with nitrogen-hydrocarbon mixtures

Science.gov (United States)

Harish Kruthiventi, S. S.; Venkatarathnam, G.

2017-10-01

Capillary tube expansion devices are used extensively in small closed cycle J-T refrigerators operating with refrigerant mixtures due to its low cost and the absence of any moving parts. It is possible for J-T refrigerators operating with mixtures that the velocity of refrigerant mixture at capillary tube outlet reaches a value where it equals the speed of sound at certain conditions. The variation of the speed of sound of nitrogen-hydrocarbon mixtures used in J-T refrigerators has been studied in two phase (vapour-liquid) and three-phase (Vapour-liquid-liquid) region as a function of temperature and pressure in this work. Also the conditions under which choking occurs in practical J-T refrigerators is investigated.

Pleural space infections after image-guided percutaneous drainage of infected intraabdominal fluid collections: a retrospective single institution analysis.

Science.gov (United States)

Avella, Diego M; Toth, Jennifer W; Reed, Michael F; Gusani, Niraj J; Kimchi, Eric T; Mahraj, Rickeshvar P; Staveley-O'Carroll, Kevin F; Kaifi, Jussuf T

2015-04-11

Percutaneous drainage of infected intraabdominal fluid collections is preferred over surgical drainage due to lower morbidity and costs. However, it can be a challenging procedure and catheter insertion carries the potential to contaminate the pleural space from the abdomen. This retrospective analysis demonstrates the clinical and radiographic correlation between percutaneous drainage of infected intraabdominal collections and the development of iatrogenic pleural space infections. A retrospective single institution analysis of 550 consecutive percutaneous drainage procedures for intraabdominal fluid collections was performed over 24 months. Patient charts and imaging were reviewed with regard to pleural space infections that were attributed to percutaneous drain placements. Institutional review board approval was obtained for conduct of the study. 6/550 (1.1%) patients developed iatrogenic pleural space infections after percutaneous drainage of intraabdominal fluid collections. All 6 patients presented with respiratory symptoms and required pleural space drainage (either by needle aspiration or chest tube placement), 2 received intrapleural fibrinolytic therapy and 1 patient had to undergo surgical drainage. Pleural effusion cultures revealed same bacteria in both intraabdominal and pleural fluid in 3 (50%) cases. A video with a dynamic radiographic sequence demonstrating the contamination of the pleural space from percutaneous drainage of an infected intraabdominal collection is included. Iatrogenic pleural space infections after percutaneous drainage of intraabdominal fluid collections occur at a low incidence, but the pleural empyema can be progressive requiring prompt chest tube drainage, intrapleural fibrinolytic therapy or even surgery. Expertise in intraabdominal drain placements, awareness and early recognition of this complication is critical to minimize incidence, morbidity and mortality in these patients.

T cell cytokine responses to stimulation with Ureaplasma parvum in pregnancy.

Science.gov (United States)

Friedland, Yael D; Lee-Pullen, Tracey F; Nathan, Elizabeth A; Watts, Rory; Keelan, Jeffrey A; Payne, Matthew S; Ireland, Demelza J

2016-08-01

Ureaplasma spp. are a common vaginal microorganism causally linked to inflammation-driven preterm birth (PTB). The nature of the immune response to Ureaplasma spp. may influence PTB risk. This study sought to define maternal T cell cytokine responses to in vitro stimulation with Ureaplasma parvum serovar 3 (UpSV3) in vaginally colonised (UP+) and non-colonised (UP-) pregnant women. Whole blood flow cytometry demonstrated an increase (p=0.027) in the baseline frequency of IFNγ-positive CD3(+)CD4(-)(CD8(+)) T cells in UP+ women. UpSV3 stimulation resulted in a significant and specific increase (p=0.001) in the frequency of IFNγ-positive CD3(+)CD4(-)(CD8(+)) T cells, regardless of vaginal colonisation status. UpSV3 stimulation also increased the frequency of IFNγ-positive CD3(+)CD4(+) T cells, particularly in the UP+ group (p=0.003). This is the first published study to examine T cell responses to Ureaplasma spp. Future appropriately-powered studies are needed to assess whether insufficient priming or a loss of tolerance to Ureaplasma spp. is occurring in UP+ women at risk of PTB. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Biliary peritonitis caused by a leaking T-tube fistula disconnected at the point of contact with the anterior abdominal wall: a case report

Directory of Open Access Journals (Sweden)

Nikolić Marko

2008-09-01

Full Text Available Abstract Introduction Operations on the common bile duct may lead to potentially serious complications such as biliary peritonitis. T-tube insertion is performed to reduce the risk of this occurring postoperatively. Biliary leakage at the point of insertion into the common bile duct, or along the fistula, can sometimes occur after T-tube removal and this has been reported extensively in the literature. We report a case where the site at which the T-tube fistula leaked proved to be the point of contact between the fistula and the anterior abdominal wall, a previously unreported complication. Case presentation A 36-year-old sub-Saharan African woman presented with gallstone-induced pancreatitis and, once her symptoms settled, laparoscopic cholecystectomy was performed, common bile duct stones were removed and a T-tube was inserted. Three weeks later, T-tube removal led to biliary peritonitis due to the disconnection of the T-tube fistula which was recannulated laparoscopically using a Latex drain. Conclusion This case highlights a previously unreported mechanism for bile leak following T-tube removal caused by detachment of a fistula tract at its contact point with the anterior abdominal wall. Hepatobiliary surgeons should be aware of this mechanism of biliary leakage and the use of laparoscopy to recannulate the fistula.

Impact of transcranial direct current stimulation (tDCS) on neuronal functions

NARCIS (Netherlands)

Das, S. (Suman); P.J. Holland (Peter); M.A. Frens (Maarten); O. Donchin (Opher)

2016-01-01

textabstractTranscranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, modulates neuronal excitability by the application of a small electrical current. The low cost and ease of the technique has driven interest in potential clinical applications. However, outcomes

Augmentation of Fear Extinction by Transcranial Direct Current Stimulation (tDCS

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Natalie Dittert

2018-04-01

Full Text Available Although posttraumatic stress disorder (PTSD; DSM-V 309.82 and anxiety disorders (DSM-V 300.xx are widely spread mental disorders, the effectiveness of their therapy is still unsatisfying. Non-invasive brain-stimulation techniques like transcranial direct current stimulation (tDCS might be an option to improve extinction learning, which is a main functional factor of exposure-based therapy for anxiety disorders. To examine this hypothesis, we used a fear conditioning paradigm with female faces as conditioned stimuli (CS and a 95-dB female scream as unconditioned stimulus (UCS. We aimed to perform a tDCS of the ventromedial prefrontal cortex (vmPFC, which is mainly involved in the control of extinction-processes. Therefore, we applied two 4 × 4 cm electrodes approximately at the EEG-positions F7 and F8 and used a direct current of 1.5 mA. The 20-min stimulation was started during a 10-min break between acquisition and extinction and went on overall extinction-trials. The healthy participants were randomly assigned in two double-blinded process into two sham stimulation and two verum stimulation groups with opposite current flow directions. To measure the fear reactions, we used skin conductance responses (SCR and subjective ratings. We performed a generalized estimating equations model for the SCR to assess the impact of tDCS and current flow direction on extinction processes for all subjects that showed a successful conditioning (N = 84. The results indicate that tDCS accelerates early extinction processes with a significantly faster loss of CS+/CS– discrimination. The discrimination loss was driven by a significant decrease in reaction toward the CS+ as well as an increase in reaction toward the CS– in the tDCS verum groups, whereas the sham groups showed no significant reaction changes during this period. Therefore, we assume that tDCS of the vmPFC can be used to enhance early extinction processes successfully. But before it should be

A case of WAGR syndrome in association with developmental glaucoma requiring bilateral Baerveldt glaucoma implants and subsequent tube repositioning

Directory of Open Access Journals (Sweden)

Akagi T

2015-06-01

Full Text Available Tadamichi Akagi, Munemitsu Yoshikawa, Hideo Nakanishi, Nagahisa Yoshimura Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan Abstract: Glaucoma drainage device implantation is efficacious for the treatment of pediatric glaucoma patients when multiple angle surgeries fail. However, tube touching of the corneal endothelium is one of the major postoperative complications to deal with. A 15-month-old male patient with Wilms’ tumor, aniridia, genitourinary anomalies, and mental retardation (WAGR syndrome was diagnosed with bilateral developmental glaucoma. He underwent Baerveldt glaucoma implant (BGI surgeries in both eyes after multiple failed trabeculotomies. The tube in his right eye was touching the cornea 15 months after BGI surgery. To avoid corneal endothelium damage, BGI tube repositioning with scleral fixation was performed without serious complications. The bilateral BGI surgeries achieved successful intraocular pressure reduction for over 2 years and tube repositioning with scleral fixation of BGI tube was successful for BGI tube malposition. Although careful attention to intraocular pressure and tube malposition is essential after glaucoma drainage device implantation, especially in pediatric cases, BGI surgery is effective in the management of developmental glaucoma following unsuccessful angle surgeries. Keywords: Baerveldt glaucoma implant, developmental glaucoma, WAGR syndrome, tube repositioning, glaucoma drainage device

Evolution of Godoy & Godoy manual lymph drainage. Technique with linear movements

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José Maria Pereira de Godoy

2017-10-01

Full Text Available Manual lymph drainage has become the mainstay in the treatment of lymphedema for decades now. Five evolving variants have been described by Godoy & Godoy over the years: i manual lymph drainage using rollers; ii self-applied manual lymph drainage using rollers; iii manual lymph drainage using the hands (manual lymphatic therapy; iv mechanical lymphatic therapy using the RAGodoy® device; and v lymphatic therapy using cervical stimulation in general lymphatic treatment. After breast cancer treatment using adapted technique with intermittent compression therapy. Lymphoscintigraphy, volumetry and bioimpedance were employed to analyze such treatment techniques applied to the upper and lower extremities. These treatment and evaluation topics are described in this brief report.

Using transcranial direct-current stimulation (tDCS) to understand cognitive processing.

Science.gov (United States)

Reinhart, Robert M G; Cosman, Josh D; Fukuda, Keisuke; Woodman, Geoffrey F

2017-01-01

Noninvasive brain stimulation methods are becoming increasingly common tools in the kit of the cognitive scientist. In particular, transcranial direct-current stimulation (tDCS) is showing great promise as a tool to causally manipulate the brain and understand how information is processed. The popularity of this method of brain stimulation is based on the fact that it is safe, inexpensive, its effects are long lasting, and you can increase the likelihood that neurons will fire near one electrode and decrease the likelihood that neurons will fire near another. However, this method of manipulating the brain to draw causal inferences is not without complication. Because tDCS methods continue to be refined and are not yet standardized, there are reports in the literature that show some striking inconsistencies. Primary among the complications of the technique is that the tDCS method uses two or more electrodes to pass current and all of these electrodes will have effects on the tissue underneath them. In this tutorial, we will share what we have learned about using tDCS to manipulate how the brain perceives, attends, remembers, and responds to information from our environment. Our goal is to provide a starting point for new users of tDCS and spur discussion of the standardization of methods to enhance replicability.

Specific aspects in the manufacturing and operating of CANDU reactor pressure tubes (P/T)

International Nuclear Information System (INIS)

Muscaloiu, C.

1997-01-01

The CANDU reactor design is based on a number of individual P/T in which nuclear fuel bundles are located. P/T are required to be operated in an environment of elevated temperature (300 o C), internal pressure (10 Mpa), fast neutron flux (E>1 MeV) and heavy water. The most suitable material which can provide the desired neutron economy and still maintain its mechanical properties along with corrosion resistance is zirconium alloys Zr+ 2.5 % Nb with the following composition: niobium, 2.5 to 2.8 weight percent; oxygen, 1,000 to 1,300 ppm; zirconium + allowed impurities - balance. A total of 380 pressure tubes are installed into reactor. Each pressure tube is attached at each end to a stainless steel end fitting by means of a grooved, expanded joint. The installation works were performed by ANM Bucuresti, under the technical support of General Electric Canada. The integrity of P/T after installation was examined as follows: - the surface of the rolled area on unrolled internal surface extending 25 mm beyond rolled area was inspected for irregularities by means of a boroscope; - all pressure tubes were subjected to the helium leak test after F/C installation. During P/T operating life periodical inspections according to Canadian Standard CSA N285.4 are performed. The selection of the P/T for inspection is based either on particular properties or on the operating conditions of the fuel channel. The inspection consists in: a) Base Line Inspection within 2 years period commencing after 7,000 EFPH of operation which will include a volumetric inspection over P/T full length and measurements of P/T sag, ID, wall thickness and F/C bearing positions; b) Periodic Inspection in the same conditions plus material surveillance (on the four most significant indication P/T detected during the Base Line Inspection). The inspection will be performed on 14 selected P/T. (author)

Is a drain tube necessary for minimally invasive lumbar spine fusion surgery?

Science.gov (United States)

Hung, Pei-I; Chang, Ming-Chau; Chou, Po-Hsin; Lin, Hsi-Hsien; Wang, Shih-Tien; Liu, Chien-Lin

2017-03-01

This study aimed to evaluate if closed suction wound drainage is necessary in minimally invasive surgery of transforaminal lumbar interbody fusion (MIS TLIF). This is a prospective randomized clinical study. Fifty-six patients who underwent MIS TLIF were randomly divided into groups A (with a closed suction wound drainage) and B (without tube drainage). Surgical duration, intraoperative blood loss, timing of ambulation, length of hospital stay and complications were recorded. Patients were followed up for an average of 25.3 months. Clinical outcome was assessed using the Oswestry disability index and visual analogue scale (VAS). Fusion rate was classified with the Bridwell grading system, based on plain radiograph. Both groups had similar patient demographics. The use of drains had no significant influence on perioperative parameters including operative time, estimated blood loss, length of stay and complications. Patients in group B started ambulation 1 day earlier than patients in group A (p drain tube can lead to pain, anxiety and discomfort during the postoperative period. We conclude that drain tubes are not necessary for MIS TLIF. Patients without drains had the benefit of earlier ambulation than those with drains.

Percutaneous transhepatic biliary drainage for hilar cholangiocarcinoma

International Nuclear Information System (INIS)

Qian Xiaojun; Jin Wenhui; Dai Dingke; Yu Ping; Gao Kun; Zhai Renyou

2007-01-01

Objective: To evaluate the effect of PTBD in treating malignant biliary obstruction caused by hilar cholangiocarcinoma. Methods: We retrospectively analyzed the data of 103 patients(M:62,F:41)with malignant obstructive jaundice caused by hilar cholangiocarcinoma. After taking percutaneous transhepatic cholangiography, metallic stent or plastic external catheter or external-internal catheter for drainage was deployed and then followed up was undertaken with clinical and radiographic evaluation and laboratory. examination. Results: All patients went though PTBD successfully (100%). According to Bismuth classification, all 103 cases consisted of I type(N=30), II type (N=30), III type (N=26) and IV type (N=17). Thirty-nine cases were placed with 47 stents and 64 eases with drainage tubes. 4 cases installed two stems for bilateral drainage, 2 cases installed two stents because of long segmental strictures with stent in stent, 1 case was placed with three stents, and 3 cases installed stent and plastic catheter together. Sixty-four cases received plastic catheters in this series, 35 cases installed two or more catheters for bilateral drainage, 28 cases installed external and internal drainage catheters, 12 eases installed external drainage catheters, and 24 eases installed both of them. There were 17 patients involving incorporative infection before procedure, 13 cases cured after procedure, and 15 new patients got inflammation after procedure. 13 cases showed increase of amylase (from May, 2004), 8 eases had bloody bile drainage and 1 case with pyloric obstruction. Total serum bilirubin reduced from (386 ± 162) μmol/L to (161 ± 117) μmol/L, (P<0.01) short term curative effect was related with the type of hilar cholangiocarcinoma. The survival time was 186 days(median), and 1, 3, 6, 12 month survival rate were 89.9%, 75.3%, 59.6%, 16.9%, respectively. Conclusion: Percutaneous transhepatic bile drainage is a safe and effective palliative therapy of malignant

Noninvasive brain stimulation with transcranial magnetic or direct current stimulation (TMS/tDCS)-From insights into human memory to therapy of its dysfunction.

Science.gov (United States)

Sparing, Roland; Mottaghy, Felix M

2008-04-01

Noninvasive stimulation of the brain by means of transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) has driven important discoveries in the field of human memory functions. Stand-alone or in combination with other brain mapping techniques noninvasive brain stimulation can assess issues such as location and timing of brain activity, connectivity and plasticity of neural circuits and functional relevance of a circumscribed brain area to a given cognitive task. In this emerging field, major advances in technology have been made in a relatively short period. New stimulation protocols and, especially, the progress in the application of tDCS have made it possible to obtain longer and much clearer inhibitory or facilitatory effects even after the stimulation has ceased. In this introductory review, we outline the basic principles, discuss technical limitations and describe how noninvasive brain stimulation can be used to study human memory functions in vivo. Though improvement of cognitive functions through noninvasive brain stimulation is promising, it still remains an exciting challenge to extend the use of TMS and tDCS from research tools in neuroscience to the treatment of neurological and psychiatric patients.

Conjunctival erosion after glaucoma drainage device surgery: A feasible option

Directory of Open Access Journals (Sweden)

Suneeta Dubey

2013-01-01

Full Text Available Glaucoma drainage devices (GDDs have been used in the management of complicated glaucomas. GDDs are associated with various complications such as tube migration, tube or plate exposure or extrusion, ocular motility disturbance and infection. Erosion of conjunctiva and exposure of the GDD remains a risk factor for the development of endophthalmitis. A wide range of materials have been used for this purpose, including sclera, dura, pericardium, fascia lata and cornea. However, there is no evidence to prove that any of these methods is superior to another for providing tectonic durability in the long term. In this report, we present a case of neovascular glaucoma, who developed conjunctival melting over the tube of an Ahmed Glaucoma Valve implant and was successfully managed with Cap Doxycycline.

Conjunctival erosion after glaucoma drainage device surgery: a feasible option.

Science.gov (United States)

Dubey, Suneeta; Prasanth, Baswati; Acharya, Manisha C; Narula, Ritesh

2013-07-01

Glaucoma drainage devices (GDDs) have been used in the management of complicated glaucomas. GDDs are associated with various complications such as tube migration, tube or plate exposure or extrusion, ocular motility disturbance and infection. Erosion of conjunctiva and exposure of the GDD remains a risk factor for the development of endophthalmitis. A wide range of materials have been used for this purpose, including sclera, dura, pericardium, fascia lata and cornea. However, there is no evidence to prove that any of these methods is superior to another for providing tectonic durability in the long term. In this report, we present a case of neovascular glaucoma, who developed conjunctival melting over the tube of an Ahmed Glaucoma Valve implant and was successfully managed with Cap Doxycycline.

Trypan blue to assess Baerveldt tube patency after repair of its obstruction.

Science.gov (United States)

Grigg, John; Jang, John D W; Fung, Adrian T; Hunyor, Alex P; Wilson, Trevor

2011-12-01

Tubal obstruction is a recognized complication of glaucoma drainage implants. In correcting a blocked tube, the surgeon may be uncertain about shunt competence even after removing the suspected cause of obstruction. We report the use of trypan blue dye to show tubal patency directly after the repair of a blocked Baerveldt tube.

Stimulation of adult oligodendrogenesis by myelin-specific T cells

DEFF Research Database (Denmark)

Hvilsted Nielsen, Helle; Toft-Hansen, Henrik; Lambertsen, Kate Lykke

2011-01-01

of calretinergic associational/commissural fibers within the dentate gyrus. These results have implications for the perception of MS pathogenesis because they show that infiltrating myelin-specific T cells can stimulate oligodendrogenesis in the adult central nervous system....

Transcranial direct current stimulation (tDCS) modulation of picture naming and word reading: A meta-analysis of single session tDCS applied to healthy participants.

Science.gov (United States)

Westwood, Samuel J; Romani, Cristina

2017-09-01

Recent reviews quantifying the effects of single sessions of transcranial direct current stimulation (or tDCS) in healthy volunteers find only minor effects on cognition despite the popularity of this technique. Here, we wanted to quantify the effects of tDCS on language production tasks that measure word reading and picture naming. We reviewed 14 papers measuring tDCS effects across a total of 96 conditions to a) quantify effects of conventional stimulation on language regions (i.e., left hemisphere anodal tDCS administered to temporal/frontal areas) under normal conditions or under conditions of cognitive (semantic) interference; b) identify parameters which may moderate the size of the tDCS effect within conventional stimulation protocols (e.g., online vs offline, high vs. low current densities, and short vs. long durations), as well as within types of stimulation not typically explored by previous reviews (i.e., right hemisphere anodal tDCS or left/right hemisphere cathodal tDCS). In all analyses there was no significant effect of tDCS, but we did find a small but significant effect of time and duration of stimulation with stronger effects for offline stimulation and for shorter durations (tDCS and its poor efficacy in healthy participants. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Influence of Concurrent Finger Movements on Transcranial Direct Current Stimulation (tDCS)-Induced Aftereffects.

Science.gov (United States)

Shirota, Yuichiro; Terney, Daniella; Antal, Andrea; Paulus, Walter

2017-01-01

Transcranial direct current stimulation (tDCS) has been reported to have bidirectional influence on the amplitude of motor-evoked potentials (MEPs) in resting participants in a polarity-specific manner: anodal tDCS increased and cathodal tDCS decreased them. More recently, the effects of tDCS have been shown to depend on a number of additional factors. We investigated whether a small variety of movements involving target and non-target muscles could differentially modify the efficacy of tDCS. MEPs were elicited from the right first dorsal interosseous muscle, defined as the target muscle, by single pulse transcranial magnetic stimulation (TMS) over the primary motor cortex (M1). During M1 tDCS, which lasted for 10 min applying anodal, cathodal, or sham condition, the participants were instructed to squeeze a ball with their right hand (Task 1), to move their right index finger only in the medial (Task 2), in the lateral direction (Task 3), or in medial and lateral direction alternatively (Task 4). Anodal tDCS reduced MEP amplitudes measured in Task 1 and Task 2, but to a lesser extent in the latter. In Task 3, anodal tDCS led to greater MEP amplitudes than cathodal stimulation. Alternating movements resulted in no effect of tDCS on MEP amplitude (Task 4). The results are congruent with the current notion that the aftereffects of tDCS are highly variable relying on a number of factors including the type of movements executed during stimulation.

Drainage Behavior in Soap Films Above and Below the CMC

Science.gov (United States)

Berg, S.; Adelizzi, E. A.; Troian, S. M.

2003-11-01

We investigate through laser interferometry the drainage behavior of Newtonian soap films initially entrained on a fiber frame at small and constant capillary number. The initial film thickness is sufficiently small that gravitational drainage is presumed minimal. The drainage of rigid soap films by capillary forces alone should proceed according to h(t) ˜ t^- 1/2. Our experimental results show much more rapid drainage with exponents as large as -2, especially for those solutions whose surfactant concentrations are below the CMC. Video recordings of the entire film surface reveal a variety of structures during the drainage process, some attributable to marginal regeneration. Though still a controversial issue, this regeneration process is believed to be caused by surfactant accumulation in the meniscus region (1). We show that modification of the relevant capillary drainage equation to account for Marangoni effects through a course-grained slip condition at the air-liquid interface produces exponents in better agreement with experimental findings. (1) V. A. Nierstrasz and G. Frens, JCIS 215, 28 (1999).

Asymmetry of Hβ Stark profiles in T-tube hydrogen plasma

International Nuclear Information System (INIS)

Djurovic, S.; Nikolic, D.; Savic, I.; Soerge, S.; Demura, A. V.

2005-01-01

The whole Balmer H β line profiles are studied in detail experimentally in the T-tube discharge for the wide range of plasma parameters. Besides the common one, two additional parameters are introduced to characterize the asymmetry behavior of the experimental Stark profiles with the reference point chosen in the center of the line. The experimental data are analyzed and benchmarked versus the simple theoretical model based on the effects of microfield nonuniformity and electron impact shifts

Transcranial Direct Current Stimulation and Power Spectral Parameters: a tDCS/EEG co-registration study

Directory of Open Access Journals (Sweden)

Anna Lisa Mangia

2014-08-01

Full Text Available Transcranial direct current stimulation (tDCS delivers low electric currents to the brain through the scalp. Constant electric currents induce shifts in neuronal membrane excitability, resulting in secondary changes in cortical activity. Concomitant electroencephalography (EEG monitoring during tDCS can provide valuable information on the tDCS mechanisms of action. This study examined the effects of anodal tDCS on spontaneous cortical activity in a resting brain to disclose possible modulation of spontaneous oscillatory brain activity. EEG activity was measured in ten healthy subjects during and after a session of anodal stimulation of the postero-parietal cortex to detect the tDCS-induced alterations. Changes in the theta, alpha, beta and gamma power bands were investigated. Three main findings emerged: 1 an increase in theta band activity during the first minutes of stimulation; 2 an increase in alpha and beta power during and after stimulation; 3 a widespread activation in several brain regions.

Assessment of anodal and cathodal transcranial direct current stimulation (tDCS) on MMN-indexed auditory sensory processing.

Science.gov (United States)

Impey, Danielle; de la Salle, Sara; Knott, Verner

2016-06-01

Transcranial direct current stimulation (tDCS) is a non-invasive form of brain stimulation which uses a very weak constant current to temporarily excite (anodal stimulation) or inhibit (cathodal stimulation) activity in the brain area of interest via small electrodes placed on the scalp. Currently, tDCS of the frontal cortex is being used as a tool to investigate cognition in healthy controls and to improve symptoms in neurological and psychiatric patients. tDCS has been found to facilitate cognitive performance on measures of attention, memory, and frontal-executive functions. Recently, a short session of anodal tDCS over the temporal lobe has been shown to increase auditory sensory processing as indexed by the Mismatch Negativity (MMN) event-related potential (ERP). This preliminary pilot study examined the separate and interacting effects of both anodal and cathodal tDCS on MMN-indexed auditory pitch discrimination. In a randomized, double blind design, the MMN was assessed before (baseline) and after tDCS (2mA, 20min) in 2 separate sessions, one involving 'sham' stimulation (the device is turned off), followed by anodal stimulation (to temporarily excite cortical activity locally), and one involving cathodal stimulation (to temporarily decrease cortical activity locally), followed by anodal stimulation. Results demonstrated that anodal tDCS over the temporal cortex increased MMN-indexed auditory detection of pitch deviance, and while cathodal tDCS decreased auditory discrimination in baseline-stratified groups, subsequent anodal stimulation did not significantly alter MMN amplitudes. These findings strengthen the position that tDCS effects on cognition extend to the neural processing of sensory input and raise the possibility that this neuromodulatory technique may be useful for investigating sensory processing deficits in clinical populations. Copyright © 2016 Elsevier Inc. All rights reserved.

A prospective randomized, controlled trial deems a drainage of 300 ml/day safe before removal of the last chest drain after video-assisted thoracoscopic surgery lobectomy.

Science.gov (United States)

Xie, Hong-Ya; Xu, Kai; Tang, Jin-Xing; Bian, Wen; Ma, Hai-Tao; Zhao, Jun; Ni, Bin

2015-08-01

To study the feasible and safe volume threshold for chest tube removal following video-assisted thoracoscopic surgical lobectomy. One hundred and sixty-eight consecutive patients (18 were excluded) who underwent video-assisted thoracoscopic surgery lobectomy or bilobectomy with two incisions between August 2012 and February 2014 were included. Eligible patients were randomized into three groups: Group A (chest tube was removed at a drainage volume of 150 ml/day or less. n = 49); Group B (chest tube was removed when the drainage volume was less than 300 ml/day. n = 50); Group C (chest tube was removed when the drainage volume was less than 450 ml/day. n = 51). The postoperative care of all patients was consistent. The time of extracting the drainage tube, postoperative hospital stay, postoperative visual analogue scale grades, dosage of analgesic, and the incidence of complications and thoracocentesis were measured. Group B and C had a much shorter drainage time and postoperative hospital stay than Group A (P 0.05). The mean dosage of pethidine hydrochloride was 248.9 ± 33.3 mg in Group B and 226.1 ± 32.7 mg in Group C (P > 0.05). The dosage of pethidine hydrochloride of Group A was significantly higher than that of Group B and C (P 0.05), Group A had a significantly higher total VAS score than Group B and C (P drains among the three groups (P > 0.05). A 300-ml/day volume threshold for chest tube removal after video-assisted thoracoscopic surgery lobectomy is feasible and safe, demonstating more advantages than the 150-ml/day volume threshold. However, a 450-ml/day volume threshold for chest tube removal may increase the risk of thoracentesis compared with the 300- and the 150-ml/day volume threshold. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Metallographical procedure for detecting carburized layer in the 12Kh18N10T steel tubes

International Nuclear Information System (INIS)

Najmark, S.I.; Shmalenyuk, R.P.

1977-01-01

The various causes of the tendency to intercrystalline corrosion of stainless steel tubing were studied. 12Kh18N10T steel tube specimens were metallographically investigated to reveal the presence and depth of the carburized layer. Unlubricated specimens and specimens with the graphite-saltpeter lubrication applied on them were austenized in the temperature range from 950 to 1250 deg C and then exposed to a provoking anneal at 650 deg C for 24 h. All the lubricated specimens showed a carbide network along grain boundaries and intercrystalline cracks. The specimens treated without lubrication had no cracks. The method offered can differentiate poor tube cleaning and the undesirable effect of other processing steps on the tubes

Immunobiology of T cell responses to Mls-locus-disparate stimulator cells. III. Helper and cytolytic functions of cloned, Mls-reactive T cell lines

International Nuclear Information System (INIS)

Katz, M.E.; Tite, J.P.; Janeway, C.A. Jr.

1986-01-01

Mls-specific T cell clones derived by limiting dilution were tested for cytotoxic activity in a lectin-dependent 51 Cr-release assay. All the T cell clones tested were cytotoxic in such an assay in apparent contrast to previous reports (1, 2). However, only those target cells sensitive to cytolysis by other L3T4a + cytolytic T cells (3) were killed by Mls-specific T cell clones in short term 51 Cr-release assays, possibly explaining this discrepancy. All the T cell clones tested were L3T4a + ,Lyt-2 - and stimulated B cells from Mls strains of mice to proliferate and secrete immunoglobulin. Furthermore, lysis of innocent bystander targets was observed when the T cells were stimulated with Mls-disparate stimulator cells. These results are consistent with those obtained with L3T4a - T cells specific for protein antigen:self Ia and that express cytotoxic potential (3)

Conjunctival inclusion cyst following repair of tube erosion in a child with aphakic glaucoma, leading to endophthalmitis

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Roy, Avik Kumar

2015-05-01

Full Text Available Introduction: Glaucoma in aphakia is a major long term complication following congenital cataract surgery. Implantation of glaucoma drainage device provides an effective approach to manage refractory paediatric glaucoma. However implant surgery in young individuals is not free of complications. The prompt detection and management of tube erosion is of utmost importance to prevent devastating sequel of endophthalmitis. Implantation cyst following repair of tube erosion has not been reported so far. This case illustrates the rare occurrence of inclusion cyst following repair of tube erosion, the possible causes and its consequences. Case description: A 2-year-old child with aphakia developed intractable glaucoma. Following a failed glaucoma filtering surgery he underwent sequential Ahmed Glaucoma Valve implantation in both the eyes. Six weeks following right eye surgery, the child presented with conjunctival erosion overlying the tube, which was treated with scleral patch graft and conjunctival advancement. One month after the repair of tube erosion, the child presented with implantation cyst under the scleral patch graft, which was treated by drainage with a 29G needle. The child presented with endophthalmitis of his right eye following an episode of bilateral conjunctivitis. This was managed by an emergency pars plana vitrectomy, intraocular antibiotics and tube excision. At the last follow up visit, the IOP was 20 mmHg with 2 topical antiglaucoma medications in the right eye following a trans scleral photocoagulation.Discussion: Lifelong careful follow-up of paediatric eyes with implant surgery is mandatory to look for complication such as tube erosion. It is important to place additional sutures to secure the patch graft during implantation of glaucoma drainage devices in children to prevent graft displacement and consequent tube erosion. During repair of tube erosion, it is crucial to remove all the conjunctival epithelium around the tube

Conjunctival inclusion cyst following repair of tube erosion in a child with aphakic glaucoma, leading to endophthalmitis.

Science.gov (United States)

Roy, Avik Kumar; Senthil, Sirisha

2015-01-01

Glaucoma in aphakia is a major long term complication following congenital cataract surgery. Implantation of glaucoma drainage device provides an effective approach to manage refractory paediatric glaucoma. However implant surgery in young individuals is not free of complications. The prompt detection and management of tube erosion is of utmost importance to prevent devastating sequel of endophthalmitis. Implantation cyst following repair of tube erosion has not been reported so far. This case illustrates the rare occurrence of inclusion cyst following repair of tube erosion, the possible causes and its consequences. A 2-year-old child with aphakia developed intractable glaucoma. Following a failed glaucoma filtering surgery he underwent sequential Ahmed Glaucoma Valve implantation in both the eyes. Six weeks following right eye surgery, the child presented with conjunctival erosion overlying the tube, which was treated with scleral patch graft and conjunctival advancement. One month after the repair of tube erosion, the child presented with implantation cyst under the scleral patch graft, which was treated by drainage with a 29G needle. The child presented with endophthalmitis of his right eye following an episode of bilateral conjunctivitis. This was managed by an emergency pars plana vitrectomy, intraocular antibiotics and tube excision. At the last follow up visit, the IOP was 20 mmHg with 2 topical antiglaucoma medications in the right eye following a trans scleral photocoagulation. Lifelong careful follow-up of paediatric eyes with implant surgery is mandatory to look for complication such as tube erosion. It is important to place additional sutures to secure the patch graft during implantation of glaucoma drainage devices in children to prevent graft displacement and consequent tube erosion. During repair of tube erosion, it is crucial to remove all the conjunctival epithelium around the tube, thus not to incorporate epithelial tissue within the surgical

Transcranial Direct Current Stimulation (tDCS: A Beginner's Guide for Design and Implementation

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Hayley Thair

2017-11-01

Full Text Available Transcranial direct current stimulation (tDCS is a popular brain stimulation method that is used to modulate cortical excitability, producing facilitatory or inhibitory effects upon a variety of behaviors. There is, however, a current lack of consensus between studies, with many results suggesting that polarity-specific effects are difficult to obtain. This article explores some of these differences and highlights the experimental parameters that may underlie their occurrence. We provide a general, practical snapshot of tDCS methodology, including what it is used for, how to use it, and considerations for designing an effective and safe experiment. Our aim is to equip researchers who are new to tDCS with the essential knowledge so that they can make informed and well-rounded decisions when designing and running successful experiments. By summarizing the varied approaches, stimulation parameters, and outcomes, this article should help inform future tDCS research in a variety of fields.

Transcranial Direct Current Stimulation (tDCS): A Beginner's Guide for Design and Implementation

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Thair, Hayley; Holloway, Amy L.; Newport, Roger; Smith, Alastair D.

2017-01-01

Transcranial direct current stimulation (tDCS) is a popular brain stimulation method that is used to modulate cortical excitability, producing facilitatory or inhibitory effects upon a variety of behaviors. There is, however, a current lack of consensus between studies, with many results suggesting that polarity-specific effects are difficult to obtain. This article explores some of these differences and highlights the experimental parameters that may underlie their occurrence. We provide a general, practical snapshot of tDCS methodology, including what it is used for, how to use it, and considerations for designing an effective and safe experiment. Our aim is to equip researchers who are new to tDCS with the essential knowledge so that they can make informed and well-rounded decisions when designing and running successful experiments. By summarizing the varied approaches, stimulation parameters, and outcomes, this article should help inform future tDCS research in a variety of fields. PMID:29213226

Percutaneous transgastric irrigation drainage in combination with endoscopic necrosectomy in necrotizing pancreatitis (with videos).

Science.gov (United States)

Raczynski, Susanne; Teich, Niels; Borte, Gudrun; Wittenburg, Henning; Mössner, Joachim; Caca, Karel

2006-09-01

Endoscopic drainage of pancreatic acute and chronic pseudocysts and pancreatic necrosectomy have been shown to be beneficial for critically ill patients, with complete endoscopic resolution rates of around 80%. Our purpose was to describe an improved endoscopic technique used to treat pancreatic necrosis. Case report. University hospital. Two patients with large retroperitoneal necroses were treated with percutaneous transgastric retroperitoneal flushing tubes and a percutaneous transgastric jejunal feeding tube by standard percutaneous endoscopic gastrostomy access in addition to endoscopic necrosectomy. Intensive percutaneous transgastric flushing in combination with percutaneous normocaloric enteral nutrition and repeated endoscopic necrosectomy led to excellent outcomes in both patients. Small number of patients. The "double percutaneous endoscopic gastrostomy" approach for simultaneous transgastric drainage and normocaloric enteral nutrition in severe cases of pancreatic necroses is safe and effective. It could be a promising improvement to endoscopic transgastric treatment options in necrotizing pancreatitis.

Disconnection of Cobe SMARxT tubing from the venous outlet of the Terumo Capiox SX25RX oxygenator during cardiopulmonary bypass.

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Ottens, Jane; Baker, Robert A; Sanderson, Andrew J; Newland, Richard F

2010-06-01

The use of surface modified, biocompatible tubing in cardiopulmonary bypass has been reported to decrease the inflammatory responses caused by blood contact with the non endothelial surface of poly vinyl chloride (PVC) tubing. The combination of advances in biocompatible tubing and increased affordability resulted in a change to our cardiopulmonary bypass circuit, with the Terumo Capiox SX25 oxygenator and Cobe PVC tubing being replaced with a Terumo Capiox SX25RX (with X coating) and Cobe SMARxT tubing. Prior to the introduction of the coated oxygenator, no connection problems had been evident. One unrelated disconnection involving coated tubing was reported in June 2005 to the Australian and New Zealand College of Perfusionists Perfusion Incident Reporting System. At this time we revised all of our set up protocols and the recommended actions from manufacturers. We further report three separate incidents of pump boot disconnection from the venous reservoir outlet of the oxygenator during bypass (that occurred within a 13-month period), and an outline of immediate and prospective evaluation of the probable cause. We propose that SMARxT 3/8" x 3/32" tubing should not be used on the venous outlet connector of Terumo Capiox SX25RX oxygenators. It appears as though the design of the outlet combined with the properties of SMARxT tubing may contribute to the disconnection.

Analyzing Effectiveness of Routine Pleural Drainage After Nuss Procedure: A Randomized Study.

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Pawlak, Krystian; Gąsiorowski, Łukasz; Gabryel, Piotr; Smoliński, Szymon; Dyszkiewicz, Wojciech

2017-12-01

The routine use of postoperative pleural cavity drainage after the Nuss procedure is not widely accepted, and its limited use depends on experience. This study analyzed the influence of pleural drainage in the surgical treatment of patients with pectus excavatum on the prevention of pneumothorax and the efficacy of using drainage after a corrective operation. From November 2013 to May 2015, 103 consecutive patients with pectus excavatum, aged 11 to 39 years, underwent surgical treatment by the Nuss procedure. Patients were prospectively randomized into two groups. In 58 patients, a 28F chest tube was routinely introduced into the right pleural cavity during procedure for 2 consecutive days (group I). In the remaining 45 patients, the drain was not inserted (group II). No statistically significant differences were found between the study groups, including sex, age, body mass index, or clinical subjective and objective factors in the preoperative evaluation. Group II manifested more complications in the early postoperative period; however, this was not statistically significant (group I vs group II; p = 0.0725). Pneumothorax requiring additional chest tube placement was statistically significant (group I vs group II; p = 0.0230). Other complications were also more frequent among patients from group II, although this did not reach statistical significance. Follow up was 22.9 ± 6.4 months. Routine drainage of the pleural cavity during the Nuss procedure significantly reduces the incidence of postoperative pneumothorax and should be considered as a routine procedure. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

A randomized trial of early versus delayed mediastinal drain removal after cardiac surgery using silastic and conventional tubes

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Moss, Emmanuel; Miller, Corey S.; Jensen, Henrik; Basmadjian, Arsène; Bouchard, Denis; Carrier, Michel; Perrault, Louis P.; Cartier, Raymond; Pellerin, Michel; Demers, Philippe

2013-01-01

OBJECTIVES Mediastinal drainage following cardiac surgery with traditional large-bore plastic tubes can be painful and cumbersome. This study was designed to determine whether prolonged drainage (5 days) with a silastic tube decreased the incidence of significant pericardial effusion and tamponade following aortic or valvular surgery. METHODS One hundred and fifty patients undergoing valvular or aortic surgery in a tertiary cardiac surgery institution were randomized to receive a conventional mediastinal tube plus a silastic Blake drain (n = 75), or two conventional tubes (n = 75). Conventional drains were removed on postoperative day (POD) 1, while Blake drains were removed on POD 5. The primary end-point was the combined incidence of significant pericardial effusion (≥15 mm) or tamponade through POD 5. Secondary end-points included total mediastinal drainage, postoperative atrial fibrillation (AF) and pain. RESULTS Analysis was performed for 67 patients in the Blake group and 73 in the conventional group. There was no difference between the two groups in the combined end-point of significant effusion or tamponade (7.4 vs 8.3%, P = 0.74), or in the incidence of AF (47 vs 46%, P = 0.89). Mean 24-h drainage was greater in the Blake group than in the conventional group (749 ± 444 ml vs 645 ± 618 ml, P tubes is safe and does not increase postoperative pain. There was no difference between the Blake and conventional drains with regard to significant pericardial effusion or tamponade in this cohort; however, this conclusion is limited by the low overall incidence of the primary outcome in this cohort. PMID:23575759

An untapped resource: using YouTube in nursing education.

Science.gov (United States)

Agazio, Janice; Buckley, Kathleen M

2009-01-01

Minimal information is available in the literature addressing video sharing in nursing education. Using multiple examples, the authors discuss the use of YouTube, a popular video-sharing and social networking site. YouTube is used to illustrate theoretical content, involve students, and inspire innovative teaching methods. Faculty can use this technology to stimulate student discussions, share information, and create a learning community. YouTube stimulates active learning and brings new relevance and applications to nursing curriculum.

Focalised stimulation using high definition transcranial direct current stimulation (HD-tDCS) to investigate declarative verbal learning and memory functioning.

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Nikolin, Stevan; Loo, Colleen K; Bai, Siwei; Dokos, Socrates; Martin, Donel M

2015-08-15

Declarative verbal learning and memory are known to be lateralised to the dominant hemisphere and to be subserved by a network of structures, including those located in frontal and temporal regions. These structures support critical components of verbal memory, including working memory, encoding, and retrieval. Their relative functional importance in facilitating declarative verbal learning and memory, however, remains unclear. To investigate the different functional roles of these structures in subserving declarative verbal learning and memory performance by applying a more focal form of transcranial direct current stimulation, "High Definition tDCS" (HD-tDCS). Additionally, we sought to examine HD-tDCS effects and electrical field intensity distributions using computer modelling. HD-tDCS was administered to the left dorsolateral prefrontal cortex (LDLPFC), planum temporale (PT), and left medial temporal lobe (LMTL) to stimulate the hippocampus, during learning on a declarative verbal memory task. Sixteen healthy participants completed a single blind, intra-individual cross-over, sham-controlled study which used a Latin Square experimental design. Cognitive effects on working memory and sustained attention were additionally examined. HD-tDCS to the LDLPFC significantly improved the rate of verbal learning (p=0.03, η(2)=0.29) and speed of responding during working memory performance (p=0.02, η(2)=0.35), but not accuracy (p=0.12, η(2)=0.16). No effect of tDCS on verbal learning, retention, or retrieval was found for stimulation targeted to the LMTL or the PT. Secondary analyses revealed that LMTL stimulation resulted in increased recency (p=0.02, η(2)=0.31) and reduced mid-list learning effects (p=0.01, η(2)=0.39), suggesting an inhibitory effect on learning. HD-tDCS to the LDLPFC facilitates the rate of verbal learning and improved efficiency of working memory may underlie performance effects. This focal method of administrating tDCS has potential for probing

Estimation of performance of a J-T refrigerators operating with nitrogen-hydrocarbon mixtures and a coiled tubes-in-tube heat exchanger

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Satya Meher, R.; Venkatarathnam, G.

2018-06-01

The exergy efficiency of Joule-Thomson (J-T) refrigerators operating with mixtures (MRC systems) strongly depends on the choice of refrigerant mixture and the performance of the heat exchanger used. Helically coiled, multiple tubes-in-tube heat exchangers with an effectiveness of over 96% are widely used in these types of systems. All the current studies focus only on the different heat transfer correlations and the uncertainty in predicting performance of the heat exchanger alone. The main focus of this work is to estimate the uncertainty in cooling capacity when the homogenous model is used by comparing the theoretical and experimental studies. The comparisons have been extended to some two-phase models present in the literature as well. Experiments have been carried out on a J-T refrigerator at a fixed heat load of 10 W with different nitrogen-hydrocarbon mixtures in the evaporator temperature range of 100-120 K. Different heat transfer models have been used to predict the temperature profiles as well as the cooling capacity of the refrigerator. The results show that the homogenous two-phase flow model is probably the most suitable model for rating the cooling capacity of a J-T refrigerator operating with nitrogen-hydrocarbon mixtures.

Transcranial Alternating Current Stimulation (tACS Mechanisms and Protocols

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Amir V. Tavakoli

2017-09-01

Full Text Available Perception, cognition and consciousness can be modulated as a function of oscillating neural activity, while ongoing neuronal dynamics are influenced by synaptic activity and membrane potential. Consequently, transcranial alternating current stimulation (tACS may be used for neurological intervention. The advantageous features of tACS include the biphasic and sinusoidal tACS currents, the ability to entrain large neuronal populations, and subtle control over somatic effects. Through neuromodulation of phasic, neural activity, tACS is a powerful tool to investigate the neural correlates of cognition. The rapid development in this area requires clarity about best practices. Here we briefly introduce tACS and review the most compelling findings in the literature to provide a starting point for using tACS. We suggest that tACS protocols be based on functional brain mechanisms and appropriate control experiments, including active sham and condition blinding.

Effects of Transcutaneous Vagus Nerve Stimulation (tVNS on the P300 and Alpha-Amylase Level: A Pilot Study

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Carlos Ventura-Bort

2018-06-01

Full Text Available Recent research suggests that the P3b may be closely related to the activation of the locus coeruleus-norepinephrine (LC-NE system. To further study the potential association, we applied a novel technique, the non-invasive transcutaneous vagus nerve stimulation (tVNS, which is speculated to increase noradrenaline levels. Using a within-subject cross-over design, 20 healthy participants received continuous tVNS and sham stimulation on two consecutive days (stimulation counterbalanced across participants while performing a visual oddball task. During stimulation, oval non-targets (standard, normal-head (easy and rotated-head (difficult targets, as well as novel stimuli (scenes were presented. As an indirect marker of noradrenergic activation we also collected salivary alpha-amylase (sAA before and after stimulation. Results showed larger P3b amplitudes for target, relative to standard stimuli, irrespective of stimulation condition. Exploratory post hoc analyses, however, revealed that, in comparison to standard stimuli, easy (but not difficult targets produced larger P3b (but not P3a amplitudes during active tVNS, compared to sham stimulation. For sAA levels, although main analyses did not show differential effects of stimulation, direct testing revealed that tVNS (but not sham stimulation increased sAA levels after stimulation. Additionally, larger differences between tVNS and sham stimulation in P3b magnitudes for easy targets were associated with larger increase in sAA levels after tVNS, but not after sham stimulation. Despite preliminary evidence for a modulatory influence of tVNS on the P3b, which may be partly mediated by activation of the noradrenergic system, additional research in this field is clearly warranted. Future studies need to clarify whether tVNS also facilitates other processes, such as learning and memory, and whether tVNS can be used as therapeutic tool.

Failure evaluation on a high-strength alloy SA213-T91 super heater tube of a power generation

Energy Technology Data Exchange (ETDEWEB)

Ahmad, J.; Purbolaksono, J.; Beng, L.C.; Ahmad, A. [University of Tenaga Nas, Kajang (Malaysia). Dept. of Mechanical Engineering

2010-07-01

This article presents failure investigation on a high-strength alloy SA213-T91 superheater tube. This failure is the first occurrence involving the material in Kapar Power Station Malaysia. The investigation includes visual inspections, hardness measurements, and microscopic examinations. The failed super-heater tube shows a wide open rupture with thin and blunt edges. Hardness readings on all the as-received tubes are used for estimating the operating metal temperature of the super-heater tubes. Microstructures of the failed tube show numerous creep cavities consisting of individual pores and chain of pores which form micro-and macro-cracks. The findings confirmed that the super-heater tube is failed by short-term overheating. Higher temperatures of the flue gas due to the inconsistent feeding of pulverized fuels into the burner is identified to cause overheating of the failed tube.

Modelling the effect of electrode displacement on transcranial direct current stimulation (tDCS)

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Ramaraju, Sriharsha; Roula, Mohammed A.; McCarthy, Peter W.

2018-02-01

Objective. Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers a low-intensity, direct current to cortical areas with the purpose of modulating underlying brain activity. Recent studies have reported inconsistencies in tDCS outcomes. The underlying assumption of many tDCS studies has been that replication of electrode montage equates to replicating stimulation conditions. It is possible however that anatomical difference between subjects, as well as inherent inaccuracies in montage placement, could affect current flow to targeted areas. The hypothesis that stimulation of a defined brain region will be stable under small displacements was tested. Approach. Initially, we compared the total simulated current flowing through ten specific brain areas for four commonly used tDCS montages: F3-Fp2, C3-Fp2, Fp1-F4, and P3-P4 using the software tool COMETS. The effect of a slight (~1 cm in each of four directions) anode displacement on the simulated regional current density for each of the four tDCS montages was then determined. Current flow was calculated and compared through ten segmented brain areas to determine the effect of montage type and displacement. The regional currents, as well as the localised current densities, were compared with the original electrode location, for each of these new positions. Main results. Recommendations for montages that maximise stimulation current for the ten brain regions are considered. We noted that the extent to which stimulation is affected by electrode displacement varies depending on both area and montage type. The F3-Fp2 montage was found to be the least stable with up to 38% change in average current density in the left frontal lobe while the Fp1-F4 montage was found to the most stable exhibiting only 1% change when electrodes were displaced. Significance. These results indicate that even relatively small changes in stimulation electrode placement appear to result in surprisingly large

Intermediate-term and long-term outcome of piggyback drainage: connecting glaucoma drainage device to a device in-situ for improved intraocular pressure control.

Science.gov (United States)

Dervan, Edward; Lee, Edward; Giubilato, Antonio; Khanam, Tina; Maghsoudlou, Panayiotis; Morgan, William H

2017-11-01

This study provides results of a treatment option for patients with failed primary glaucoma drainage device. The study aimed to describe and evaluate the long-term intraocular pressure control and complications of a new technique joining a second glaucoma drainage device directly to an existing glaucoma drainage device termed 'piggyback drainage'. This is a retrospective, interventional cohort study. Eighteen eyes of 17 patients who underwent piggyback drainage between 2004 and 2013 inclusive have been studied. All patients had prior glaucoma drainage device with uncontrolled intraocular pressure. The piggyback technique involved suturing a Baerveldt (250 or 350 mm) or Molteno3 glaucoma drainage device to an unused scleral quadrant and connecting the silicone tube to the primary plate bleb. Failure of intraocular pressure control defined as an intraocular pressure greater than 21 mmHg on maximal therapy on two separate occasions or further intervention to control intraocular pressure. The intraocular pressure was controlled in seven eyes (39%) at last follow-up with a mean follow-up time of 74.2 months. The mean preoperative intraocular pressure was 27.1 mmHg (95% confidence interval 23.8-30.3) compared with 18.4 mmHg (95% confidence interval 13.9-22.8) at last follow-up. The mean time to failure was 57.1 months (95% confidence interval 32.2-82), and the mean time to further surgery was 72.3 months (95% confidence interval 49.9-94.7). Lower preoperative intraocular pressure was associated with longer duration of intraocular pressure control (P = 0.048). If the intraocular pressure was controlled over 2 years, it continued to be controlled over the long term. Two eyes (11%) experienced corneal decompensation. Piggyback drainage represents a viable surgical alternative for the treatment of patients with severe glaucoma with failing primary glaucoma drainage device, particularly in those at high risk of corneal decompensation. © 2017 Royal Australian and New Zealand

Assessing the Use of YouTube Videos and Interactive Activities as a Critical Thinking Stimulator for Tertiary Students: An Action Research

Science.gov (United States)

June, Sethela; Yaacob, Aizan; Kheng, Yeoh Khar

2014-01-01

The purpose of this action research was to investigate the use of YouTube videos and interactive activities in stimulating critical thinking among students from a public university in Malaysia. There were 50 students of mixed background, comprised of local and foreign students who participated in this study which lasted for one semester. Data was…

Infectious peritonitis after endoscopic ultrasound-guided biliary drainage in a patient with ascites

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Nozomi Okuno

2018-04-01

Full Text Available Summary of Event: Bacterial, mycotic peritonitis and Candida fungemia developed in a patient with moderate ascites who had undergone endoscopic ultrasound-guided biliary drainage (EUS-BD. Antibiotics and antifungal agent were administered and ascites drainage was performed. Although the infection improved, the patient’s general condition gradually deteriorated due to aggravation of the primary cancer and he died.Teaching Point: This is the first report to describe infectious peritonitis after EUS-BD. Ascites carries the potential risk of severe complications. As such, in patients with ascites, endoscopic retrograde cholangiopancreatography (ERCP is typically preferred over EUS-BD or percutaneous drainage to prevent bile leakage. However, ERCP may not be possible in some patients with tumor invasion of the duodenum or with surgically altered anatomy. Thus, in patients with ascites who require EUS-BD, we recommend inserting the drainage tube percutaneously and draining the ascites before and after the intervention in order to prevent severe infection.

Transcranial Direct Current Stimulation (tDCS): A Promising Treatment for Major Depressive Disorder?

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Bennabi, Djamila; Haffen, Emmanuel

2018-01-01

Background: Transcranial direct current stimulation (tDCS) opens new perspectives in the treatment of major depressive disorder (MDD), because of its ability to modulate cortical excitability and induce long-lasting effects. The aim of this review is to summarize the current status of knowledge regarding tDCS application in MDD. Methods: In this review, we searched for articles published in PubMed/MEDLINE from the earliest available date to February 2018 that explored clinical and cognitive effects of tDCS in MDD. Results: Despite differences in design and stimulation parameters, the examined studies indicated beneficial effects of tDCS for MDD. These preliminary results, the non-invasiveness of tDCS, and its good tolerability support the need for further research on this technique. Conclusions: tDCS constitutes a promising therapeutic alternative for patients with MDD, but its place in the therapeutic armamentarium remains to be determined. PMID:29734768

Effects of Transcranial Direct Current Stimulation (tDCS) on Behaviour and Electrophysiology of Language Production

Science.gov (United States)

Wirth, Miranka; Rahman, Rasha Abdel; Kuenecke, Janina; Koenig, Thomas; Horn, Helge; Sommer, Werner; Dierks, Thomas

2011-01-01

Excitatory anodal transcranial direct current stimulation (A-tDCS) over the left dorsal prefrontal cortex (DPFC) has been shown to improve language production. The present study examined neurophysiological underpinnings of this effect. In a single-blinded within-subject design, we traced effects of A-tDCS compared to sham stimulation over the left…

Presacral abscess as a rare complication of sacral nerve stimulator implantation.

Science.gov (United States)

Gumber, A; Ayyar, S; Varia, H; Pettit, S

2017-03-01

A 50-year-old man with intractable anal pain attributed to proctalgia fugax underwent insertion of a sacral nerve stimulator via the right S3 vertebral foramen for pain control with good symptomatic relief. Thirteen months later, he presented with signs of sepsis. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large presacral abscess. MRI demonstrated increased enhancement along the pathway of the stimulator electrode, indicating that the abscess was caused by infection introduced at the time of sacral nerve stimulator placement. The patient was treated with broad spectrum antibiotics, and the sacral nerve stimulator and electrode were removed. Attempts were made to drain the abscess transrectally using minimally invasive techniques but these were unsuccessful and CT guided transperineal drainage was then performed. Despite this, the presacral abscess progressed, developing enlarging gas locules and extending to the pelvic brim to involve the aortic bifurcation, causing hydronephrosis and radiological signs of impending sacral osteomyelitis. MRI showed communication between the rectum and abscess resulting from transrectal drainage. In view of the progressive presacral sepsis, a laparotomy was performed with drainage of the abscess, closure of the upper rectum and formation of a defunctioning end sigmoid colostomy. Following this, the presacral infection resolved. Presacral abscess formation secondary to an infected sacral nerve stimulator electrode has not been reported previously. Our experience suggests that in a similar situation, the optimal management is to perform laparotomy with drainage of the presacral abscess together with simultaneous removal of the sacral nerve stimulator and electrode.

The Fast Intelligent Tracking (F!T) tube: A CRT without a shadow mask

NARCIS (Netherlands)

Bergman, A.H.; Brink, van den H.B.; Budzelaar, F.P.M.; Engelaar, P.J.; Holtslag, A.H.M.; IJzerman, W.L.; Krijn, M.P.C.M.; Lieshout, van P.J.G.; Notari, A.; Willemsen, O.H.

2003-01-01

The F!T tube is a new type of CRT without a shadow mask. The primary function of the mask, color selection, is taken over by an electronic control system that guides the electron beams over the correct phosphor lines. The position of the beams is detected by means of dedicated structures on the

Effects of transcranial direct current stimulation (tDCS) on binge eating disorder.

Science.gov (United States)

Burgess, Emilee E; Sylvester, Maria D; Morse, Kathryn E; Amthor, Frank R; Mrug, Sylvie; Lokken, Kristine L; Osborn, Mary K; Soleymani, Taraneh; Boggiano, Mary M

2016-10-01

To investigate the effect of transcranial direct current stimulation (tDCS) on food craving, intake, binge eating desire, and binge eating frequency in individuals with binge eating disorder (BED). N = 30 adults with BED or subthreshold BED received a 20-min 2 milliampere (mA) session of tDCS targeting the dorsolateral prefrontal cortex (DLPFC; anode right/cathode left) and a sham session. Food image ratings assessed food craving, a laboratory eating test assessed food intake, and an electronic diary recorded binge variables. tDCS versus sham decreased craving for sweets, savory proteins, and an all-foods category, with strongest reductions in men (p tDCS also decreased total and preferred food intake by 11 and 17.5%, regardless of sex (p tDCS administration (p tDCS in BED. Stimulation of the right DLPFC suggests that enhanced cognitive control and/or decreased need for reward may be possible functional mechanisms. The results support investigation of repeated tDCS as a safe and noninvasive treatment adjunct for BED. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:930-936). © 2016 Wiley Periodicals, Inc.

Electrodes for high-definition transcutaneous DC stimulation for applications in drug-delivery and electrotherapy, including tDCS

OpenAIRE

Minhas, Preet; Bansal, Varun; Patel, Jinal; Ho, Johnson S.; Diaz, Julian; Datta, Abhishek; Bikson, Marom

2010-01-01

Transcutaneous electrical stimulation is applied in a range of biomedical applications including Transcranial Direct Current Stimulation (tDCS). tDCS is a non-invasive procedure where a weak direct current (

Surface EEG-Transcranial Direct Current Stimulation (tDCS) Closed-Loop System.

Science.gov (United States)

Leite, Jorge; Morales-Quezada, Leon; Carvalho, Sandra; Thibaut, Aurore; Doruk, Deniz; Chen, Chiun-Fan; Schachter, Steven C; Rotenberg, Alexander; Fregni, Felipe

2017-09-01

Conventional transcranial direct current stimulation (tDCS) protocols rely on applying electrical current at a fixed intensity and duration without using surrogate markers to direct the interventions. This has led to some mixed results; especially because tDCS induced effects may vary depending on the ongoing level of brain activity. Therefore, the objective of this preliminary study was to assess the feasibility of an EEG-triggered tDCS system based on EEG online analysis of its frequency bands. Six healthy volunteers were randomized to participate in a double-blind sham-controlled crossover design to receive a single session of 10[Formula: see text]min 2[Formula: see text]mA cathodal and sham tDCS. tDCS trigger controller was based upon an algorithm designed to detect an increase in the relative beta power of more than 200%, accompanied by a decrease of 50% or more in the relative alpha power, based on baseline EEG recordings. EEG-tDCS closed-loop-system was able to detect the predefined EEG magnitude deviation and successfully triggered the stimulation in all participants. This preliminary study represents a proof-of-concept for the development of an EEG-tDCS closed-loop system in humans. We discuss and review here different methods of closed loop system that can be considered and potential clinical applications of such system.

Tracheal rupture after misplacement of Sengstaken-Blakemore tube ...

African Journals Online (AJOL)

The balloon were immediately deflated and a chest X-ray was performed, showing the tube in the right bronchus airway (A), so it was withdrawn. Right pneumothorax appeared and was treated with an intercostal drainage. The patient required orotracheal intubation and a CT scan was performed to show the rupture level ...

Transhiatal Chest Drainage After Hybrid Ivor Lewis Esophagectomy: Proof of Concept Study.

Science.gov (United States)

Asti, Emanuele; Sironi, Andrea; Bonitta, Gianluca; Bernardi, Daniele; Bonavina, Luigi

2018-04-01

Intercostal pleural drainage is standard practice after transthoracic esophagectomy but has some drawbacks. We hypothesized that a transhiatal pleural drain introduced through the subxyphoid port site incision at laparoscopy can be as effective as the intercostal drainage and may enhance patient recovery. A proof of concept study was designed to assess a new method of pleural drainage in patients undergoing hybrid Ivor Lewis esophagectomy (laparoscopy and right thoracotomy). The main study aims were safety and efficacy of transhiatal pleural drainage with a 15 Fr Blake tube connected to a portable vacuum system. Pre- and postoperative data, mean duration, and total and daily output of drainage were recorded in an electronic database. Postoperative complications were scored according to the Dindo-Clavien classification. Between June 2015 and December 2016, 50 of 63 consecutive patients met the criteria for inclusion in the study. No conversions from the portable vacuum system to underwater seal and suction occurred. There was no mortality. The overall morbidity rate was 40%. Two patients (4%) required reoperation for hemothorax and chylothorax, respectively. Percutaneous catheter drainage for residual pneumothorax was necessary in 2 patients (4%) on postoperative day 2. The mean duration of drainage was 7 days (interquartile range [IQR] = 2), and the total volume of drain output was 1580 mL (IQR = 880). No pleural effusion on chest X-ray was detected at the 3-month follow-up visit. Transhiatal pleural drainage is safe and effective after hybrid Ivor Lewis esophagectomy and could replace the intercostal drain in selected patients.

Recurrent themes in the history of the home use of electrical stimulation: Transcranial direct current stimulation (tDCS) and the medical battery (1870-1920).

Science.gov (United States)

Wexler, Anna

In recent years, neuroscientists and ethicists have warned of the dangers of the unsupervised home use of transcranial direct current stimulation (tDCS), in which individuals stimulate their own brains with low levels of electricity for self-improvement purposes. Although the home use of tDCS is often referred to as a novel phenomenon, in reality the late nineteenth and early twentieth century saw a proliferation of electrical stimulation devices for home use. In particular, the use of an object known as the medical battery bears a number of striking similarities to the modern-day use of tDCS. This article reviews a number of features thought to be unique to the present day home use of brain stimulation, with a particular focus on analogies between tDCS and the medical battery. Archival research was conducted at the Bakken Museum and at the American Medical Association's Historical Health Fraud Archives. Many of the features characterizing the contemporary home use tDCS-a do-it-yourself (DIY) movement, anti-medical establishment themes, conflicts between lay and professional usage-are a repetition of themes that occurred a century ago with regard to the medical battery. A number of features, however, seem to be unique to the present, such as the dominant discourse about risk and safety, the division between cranial and non-cranial stimulation, and utilization for cognitive enhancement purposes. Viewed in the long durée, the contemporary use of electrical stimulation at home is not a novel phenomenon, but rather the latest wave in a series of ongoing attempts by lay individuals to utilize electricity for therapeutic purposes. Copyright © 2016 Elsevier Inc. All rights reserved.

High-frequency monitoring of water fluxes and nutrient loads to assess the effects of controlled drainage on water storage and nutrient transport

Science.gov (United States)

Rozemeijer, J. C.; Visser, A.; Borren, W.; Winegram, M.; van der Velde, Y.; Klein, J.; Broers, H. P.

2016-01-01

High nitrogen (N) and phosphorus (P) fluxes from upstream agriculture threaten aquatic ecosystems in surface waters and estuaries, especially in areas characterized by high agricultural N and P inputs and densely drained catchments like the Netherlands. Controlled drainage has been recognized as an effective option to optimize soil moisture conditions for agriculture and to reduce unnecessary losses of fresh water and nutrients. This is achieved by introducing control structures with adjustable overflow levels into subsurface tube drain systems. A small-scale (1 ha) field experiment was designed to investigate the hydrological and chemical changes after introducing controlled drainage. Precipitation rates and the response of water tables and drain fluxes were measured in the periods before the introduction of controlled drainage (2007-2008) and after (2009-2011). For the N and P concentration measurements, auto-analyzers for continuous records were combined with passive samplers for time-averaged concentrations at individual drain outlets. The experimental setup enabled the quantification of changes in the water and solute balance after introducing controlled drainage. The results showed that introducing controlled drainage reduced the drain discharge and increased the groundwater storage in the field. To achieve this, the overflow levels have to be elevated in early spring, before the drain discharge stops due to dryer conditions and falling groundwater levels. The groundwater storage in the field would have been larger if the water levels in the adjacent ditch were controlled as well by an adjustable weir. The N concentrations and loads increased, which was largely related to elevated concentrations in one of the three monitored tube drains. The P loads via the tube drains reduced due to the reduction in discharge after introducing controlled drainage. However, this may be counteracted by the higher groundwater levels and the larger contribution of N- and P

Lowering the radioactivity of the photomultiplier tubes for the XENON1T dark matter experiment

Energy Technology Data Exchange (ETDEWEB)

Aprile, E.; Contreras, H.; Goetzke, L.W.; Fernandez, A.J.M.; Messina, M.; Plante, G.; Rizzo, A. [Columbia University, Physics Department, New York, NY (United States); Agostini, F. [INFN-Laboratori Nazionali del Gran Sasso (Italy); Gran Sasso Science Institute, L' Aquila (Italy); Bologna Univ., Department of Physics and Astrophysics, Bologna (Italy); INFN, Bologna (Italy); Alfonsi, M. [Nikhef and the University of Amsterdam, Amsterdam (Netherlands); Johannes Gutenberg-Universitaet Mainz, Institut fuer Physik and Exzellenzcluster PRISMA, Mainz (Germany); Arazi, L.; Budnik, R.; Duchovni, E.; Gross, E.; Itay, R.; Landsman, H.; Lellouch, D.; Levinson, L.; Priel, N.; Vitells, O. [Weizmann Institute of Science, Department of Particle Physics and Astrophysics, Rehovot (Israel); Arisaka, K.; Lyashenko, A.; Meng, Y.; Pantic, E.; Teymourian, A.; Wang, H. [University of California, Physics and Astronomy Department, Los Angeles, CA (United States); Arneodo, F.; Di Giovanni, A. [New York University Abu Dhabi, Abu Dhabi (United Arab Emirates); Auger, M.; Barrow, P.; Baudis, L.; Behrens, A.; Galloway, M.; Kessler, G.; Kish, A.; Mayani, D.; Pakarha, P.; Piastra, F. [University of Zurich, Physik-Institut, Zurich (Switzerland); Balan, C.; Cardoso, J.M.R.; Lopes, J.A.M.; Santos, J.M.F. dos [University of Coimbra, Department of Physics, Coimbra (Portugal); Bauermeister, B.; Fattori, S.; Geis, C.; Grignon, C.; Oberlack, U.; Schindler, S. [Johannes Gutenberg-Universitaet Mainz, Institut fuer Physik and Exzellenzcluster PRISMA, Mainz (Germany); Beltrame, P. [Weizmann Institute of Science, Department of Particle Physics and Astrophysics, Rehovot (Israel); University of Edinburgh, Edinburgh (United Kingdom); Brown, A.; Lang, R.F.; Macmullin, S.; Pienaar, J.; Reichard, S.; Reuter, C. [Purdue University, Department of Physics and Astronomy, West Lafayette, IN (United States); Brown, E.; Levy, C. [Rensselaer Polytechnic Institute, Department of Physics, Applied Physics and Astronomy, Troy, NY (United States); Wilhelms-Universitaet Muenster, Institut fuer Kernphysik, Muenster (Germany); Bruenner, S.; Hampel, W.; Kaether, F.; Lindemann, S.; Lindner, M.; Undagoitia, T.M.; Rauch, L.; Schreiner, J.; Simgen, H.; Weber, M. [Max-Planck-Institut fuer Kernphysik, Heidelberg (Germany); Bruno, G. [INFN-Laboratori Nazionali del Gran Sasso and Gran Sasso Science Institute, L' Aquila (Italy); Wilhelms-Universitaet Muenster, Institut fuer Kernphysik, Muenster (Germany); Buetikofer, L.; Coderre, D.; Schumann, M. [University of Bern, Albert Einstein Center for Fundamental Physics, Bern (Switzerland); Colijn, A.P.; Decowski, M.P.; Tiseni, A.; Tunnell, C. [Nikhef and the University of Amsterdam, Amsterdam (Netherlands); Cussonneau, J.P.; Le Calloch, M.; Masbou, J.; Lavina, L.S.; Thers, D. [Universite de Nantes, Subatech, Ecole des Mines de Nantes, CNRS/In2p3, Nantes (France); Ferella, A.D.; Fulgione, W.; Laubenstein, M. [INFN-Laboratori Nazionali del Gran Sasso and Gran Sasso Science Institute, L' Aquila (Italy); Fieguth, A.; Murra, M.; Rosendahl, S.; Weinheimer, C. [Wilhelms-Universitaet Muenster, Institut fuer Kernphysik, Muenster (Germany); Garbini, M.; Massoli, F.V.; Sartorelli, G.; Selvi, M. [Bologna Univ., Department of Physics and Astrophysics, Bologna (Italy); INFN, Bologna (Italy); Miguez, B.; Molinario, A.; Trinchero, G. [INFN-Torino and Osservatorio Astrofisico di Torino, Turin (Italy); Naganoma, J.; Shagin, P.; Wall, R. [Rice University, Department of Physics and Astronomy, Houston, TX (United States); Orrigo, S.E.A. [University of Coimbra, Department of Physics, Coimbra (Portugal); IFIC, CSIC-Universidad de Valencia, Valencia (Spain); Persiani, R. [Universite de Nantes, Subatech, Ecole des Mines de Nantes, CNRS/In2p3, Nantes (FR); Bologna Univ., Department of Physics and Astrophysics, Bologna (IT); INFN, Bologna (IT); Collaboration: XENON Collaboration

2015-11-15

The low-background, VUV-sensitive 3-inch diameter photomultiplier tube R11410 has been developed by Hamamatsu for dark matter direct detection experiments using liquid xenon as the target material. We present the results from the joint effort between the XENON collaboration and the Hamamatsu company to produce a highly radio-pure photosensor (version R11410-21) for the XENON1T dark matter experiment. After introducing the photosensor and its components, we show the methods and results of the radioactive contamination measurements of the individual materials employed in the photomultiplier production. We then discuss the adopted strategies to reduce the radioactivity of the various PMT versions. Finally, we detail the results from screening 286 tubes with ultra-low background germanium detectors, as well as their implications for the expected electronic and nuclear recoil background of the XENON1T experiment. (orig.)

Effects of Transcranial Direct Current Stimulation (tDCS) on Pain Distress Tolerance: A Preliminary Study.

Science.gov (United States)

Mariano, Timothy Y; van't Wout, Mascha; Jacobson, Benjamin L; Garnaat, Sarah L; Kirschner, Jason L; Rasmussen, Steven A; Greenberg, Benjamin D

2015-08-01

Pain remains a critical medical challenge. Current treatments target nociception without addressing affective symptoms. Medically intractable pain is sometimes treated with cingulotomy or deep brain stimulation to increase tolerance of pain-related distress. Transcranial direct current stimulation (tDCS) may noninvasively modulate cortical areas related to sensation and pain representations. The present study aimed to test the hypothesis that cathodal ("inhibitory") stimulation targeting left dorsal anterior cingulate cortex (dACC) would increase tolerance to distress from acute painful stimuli vs anodal stimulation. Forty healthy volunteers received both anodal and cathodal stimulation. During stimulation, we measured pain distress tolerance with three tasks: pressure algometer, cold pressor, and breath holding. We measured pain intensity with a visual-analog scale before and after each task. Mixed ANOVA revealed that mean cold pressor tolerance tended to be higher with cathodal vs anodal stimulation (P = 0.055) for participants self-completing the task. Pressure algometer (P = 0.81) and breath holding tolerance (P = 0.19) did not significantly differ. The pressure algometer exhibited a statistically significant order effect irrespective of stimulation polarity (all P tDCS (P = 0.072). Although our primary results were nonsignificant, there is a preliminary suggestion that cathodal tDCS targeting left dACC may increase pain distress tolerance to cold pressor. Pressure algometer results are consistent with task-related sensitization. Future studies are needed to refine this novel approach for pain neuromodulation. Wiley Periodicals, Inc.

CT guided transthoracic catheter drainage of intrapulmonary abscess.

Science.gov (United States)

Yunus, Mahira

2009-10-01

To determine the efficacy of CT- guided transthoracic catheter drainage of intrapulmonary abscess considering success rate versus complications. This prospective study was carried out at radiology department of Al-Noor Specialist Hospital, Makkah, Saudi Arabia, from 1.1.2003 to 31.12.2005. Nineteen patients were selected for CT guided percutaneous drainage. Under CT guidance catheter placement was carried out using Seldinger technique. Nineteen patients with lung abscess were selected for the percutaneous CT guided drainage. Eight (42.105%) patients encountered no complications and lung abscess completely resolved with no residual cavity. Five (26.31%) patients developed pneumothorax, which was the most common complication of this study. These patients were kept under observation and followed-up by chest X-rays. Three (15.78%) had mild pneumothorax, which resolved and needed no further management, while two (10.52%) patients developed moderate pneumothorax and chest tube was inserted. Two (10.52%) patients developed mild haemoptysis which resolved within two hours, hence, no further management was required. Two (10.52%) patients had residual cavity and surgery was performed. Congenital cystic adenomatoid malformation (CCAM) was found in both cases. Two patients out of nineteen patients (10.52%) developed bronchopleural fistula and were operated. No mortality occurred during or after the procedure. CT allows optimal placement of catheter and hence enables safe and effective percutaneous evacuation of lung abscess. The morbidity and mortality of patients with percutaneous catheter drainage is lower than with surgical resection. Hence, CT guided drainage should be considered the first therapeutic choice in most patients of lung abscess who do not respond to medical therapy.

A novel transanal tube designed to prevent anastomotic leakage after rectal cancer surgery: the WING DRAIN.

Science.gov (United States)

Nishigori, Hideaki; Ito, Masaaki; Nishizawa, Yuji

2017-04-01

We introduce a novel transanal tube (TAT), named the "WING DRAIN", designed to prevent anastomotic leakage after rectal cancer surgery, and report the fundamental experiments that led to its development. We performed the basic experiments to evaluate the effect of TATs on intestinal decompression, the changes they make in patterns of watery fluid drainage, the changes in their decompression effect when the extension tube connecting the TAT to the collection bag fills with watery drainage fluid, and the variations in intestinal contact and crushing pressure made by some types of TAT. Any type of TAT contributed to decompression in the intestinal tract. Watery drainage commenced from when the water level first rose to the hole in the tip of drain. The intestinal pressure increased with the length of the vertical twist in an extension tube. The crushing pressures of most types of TAT were high enough to cause injury to the intestine. We resolved the problems using an existing TAT for the purpose of intestinal decompression and by creating the first specialized TAT designed to prevent anastomotic leakage after rectal cancer surgery in Japan.

Removal of retained biliary concretions through the T-tube track

International Nuclear Information System (INIS)

Daehnert, W.; Guenther, R.; Schmidt, H.D.; Staritz, M.; Thelen, M.; Mainz Univ.

1984-01-01

Within seven years 23 patients were treated postoperatively by percutaneous bile stone extraction. This procedure was successful in 18 patients. Although an interval of 5-7 weeks between choledochotomy and percutaneous extraction is recommended, the procedure was done 11 to 31 days after surgery with no negative effects. In six cases the stones had to be dislodged into a more favorable position with a Fogarty-type balloon catheter. The papilla of Vater was dilated in two cases. With the development of newer techniques trans-T-tube extraction remains the treatment of choice in retained intra- and extrahepatic bile duct stones. (orig.) [de

The impact of cerebellar transcranial direct current stimulation (tDCS) on learning fine-motor sequences.

Science.gov (United States)

Shimizu, Renee E; Wu, Allan D; Samra, Jasmine K; Knowlton, Barbara J

2017-01-05

The cerebellum has been shown to be important for skill learning, including the learning of motor sequences. We investigated whether cerebellar transcranial direct current stimulation (tDCS) would enhance learning of fine motor sequences. Because the ability to generalize or transfer to novel task variations or circumstances is a crucial goal of real world training, we also examined the effect of tDCS on performance of novel sequences after training. In Study 1, participants received either anodal, cathodal or sham stimulation while simultaneously practising three eight-element key press sequences in a non-repeating, interleaved order. Immediately after sequence practice with concurrent tDCS, a transfer session was given in which participants practised three interleaved novel sequences. No stimulation was given during transfer. An inhibitory effect of cathodal tDCS was found during practice, such that the rate of learning was slowed in comparison to the anodal and sham groups. In Study 2, participants received anodal or sham stimulation and a 24 h delay was added between the practice and transfer sessions to reduce mental fatigue. Although this consolidation period benefitted subsequent transfer for both tDCS groups, anodal tDCS enhanced transfer performance. Together, these studies demonstrate polarity-specific effects on fine motor sequence learning and generalization.This article is part of the themed issue 'New frontiers for statistical learning in the cognitive sciences'. © 2016 The Author(s).

[Amplification of γδ T cells in PBMCs of healthy donors and osteosarcoma patients stimulated by zoledronate].

Science.gov (United States)

Li, Zhao-xu; Sun, Ling-ling; Cheng, Rui-lin; Sun, Zheng-wang; Ye, Zhao-ming

2012-08-01

To investigate the amplification and cytotoxicity of γδ T cells in peripheral blood mononuclear cells (PBMCs) of healthy donors and osteosarcoma patients stimulated by zoledronate (Zol) and IL-2. PBMCs from healthy donors and osteosarcoma patients were stimulated with IL-2 and Zol+IL-2, respectively. After 14-day culture, the purity of γδ T cells was assessed by flow cytometry. The cytotoxicity of γδ T cells against target cells was analyzed using a standard lactate dehydrogenase release assay with γδ T lymphocyte-sensitive Daudi cells, γδ T lymphocyte-resistant Raji cells and human osteoblast cell line, hFOB, as the target cells. After 2-week culture ex vivo of PBMCs from healthy donors and osteosarcoma patients, compared with stimulation of IL-2, Zol+IL-2 significantly promoted the amplification of γδ T cells. In addition, γδ T cells showed the higher cytotoxicity against Daudi cells, but no cytotoxic effect on normal cells like hFOB. γδ T cells of high purity and high cytotoxicity can be obtained by the stimulation of Zol combined with IL-2 on PBMCs from healthy donors and osteosarcoma patients.

Drain tube migration into the anastomotic site of an esophagojejunostomy for gastric small cell carcinoma: short report.

Science.gov (United States)

Lai, Peng-Sheng; Lo, Chiao; Lin, Long-Wei; Lee, Po-Chu

2010-05-21

Intraluminal migration of a drain through an anastomotic site is a rare complication of gastric surgery. We herein report the intraluminal migration of a drain placed after a lower esophagectomy and total gastrectomy with Roux-en-Y anastomosis for gastric small cell carcinoma. Persistent drainage was noted 1 month after surgery, and radiographic studies were consistent with drain tube migration. Endoscopy revealed the drain had migrated into the esophagojejunostomy anastomotic site. The drain was removed from outside of abdominal wound while observing the anastomotic site endoscopically. The patient was treated with suction via a nasogastric tube drain for 5 days, and thereafter had an uneventful recovery. Though drain tube migration is a rare occurrence, it should be considered in patients with persistent drainage who have undergone gastric surgery.

Hematopoietic stem cell cytokines and fibroblast growth factor-2 stimulate human endothelial cell-pericyte tube co-assembly in 3D fibrin matrices under serum-free defined conditions.

Directory of Open Access Journals (Sweden)

Annie O Smith

Full Text Available We describe a novel 3D fibrin matrix model using recombinant hematopoietic stem cell cytokines under serum-free defined conditions which promotes the assembly of human endothelial cell (EC tubes with co-associated pericytes. Individual ECs and pericytes are randomly mixed together and EC tubes form that is accompanied by pericyte recruitment to the EC tube abluminal surface over a 3-5 day period. These morphogenic processes are stimulated by a combination of the hematopoietic stem cell cytokines, stem cell factor, interleukin-3, stromal derived factor-1α, and Flt-3 ligand which are added in conjunction with fibroblast growth factor (FGF-2 into the fibrin matrix. In contrast, this tube morphogenic response does not occur under serum-free defined conditions when VEGF and FGF-2 are added together in the fibrin matrices. We recently demonstrated that VEGF and FGF-2 are able to prime EC tube morphogenic responses (i.e. added overnight prior to the morphogenic assay to hematopoietic stem cell cytokines in collagen matrices and, interestingly, they also prime EC tube morphogenesis in 3D fibrin matrices. EC-pericyte interactions in 3D fibrin matrices leads to marked vascular basement membrane assembly as demonstrated using immunofluorescence and transmission electron microscopy. Furthermore, we show that hematopoietic stem cell cytokines and pericytes stimulate EC sprouting in fibrin matrices in a manner dependent on the α5β1 integrin. This novel co-culture system, under serum-free defined conditions, allows for a molecular analysis of EC tube assembly, pericyte recruitment and maturation events in a critical ECM environment (i.e. fibrin matrices that regulates angiogenic events in postnatal life.

Spatial and polarity precision of concentric high-definition transcranial direct current stimulation (HD-tDCS)

Science.gov (United States)

Alam, Mahtab; Truong, Dennis Q.; Khadka, Niranjan; Bikson, Marom

2016-06-01

Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique that applies low amplitude current via electrodes placed on the scalp. Rather than directly eliciting a neuronal response, tDCS is believed to modulate excitability—enhancing or suppressing neuronal activity in regions of the brain depending on the polarity of stimulation. The specificity of tDCS to any therapeutic application derives in part from how electrode configuration determines the brain regions that are stimulated. Conventional tDCS uses two relatively large pads (>25 cm2) whereas high-definition tDCS (HD-tDCS) uses arrays of smaller electrodes to enhance brain targeting. The 4  ×  1 concentric ring HD-tDCS (one center electrode surrounded by four returns) has been explored in application where focal targeting of cortex is desired. Here, we considered optimization of concentric ring HD-tDCS for targeting: the role of electrodes in the ring and the ring’s diameter. Finite element models predicted cortical electric field generated during tDCS. High resolution MRIs were segmented into seven tissue/material masks of varying conductivities. Computer aided design (CAD) model of electrodes, gel, and sponge pads were incorporated into the segmentation. Volume meshes were generated and the Laplace equation (\

A new method for the evacuation of aqueous humor in uncontrolled glaucoma. The vitreo-tenonian tube.

Science.gov (United States)

Haut, J; Larricart, P; Le Mer, Y; Abboud, E

1987-02-01

The vitreo-tenonian tube is a new procedure, used in uncontrolled glaucoma, for the drainage of aqueous humor. It presents three original characteristics: it is made of a stainless metal, it is implanted in the posterior segment after vitrectomy and it drains the aqueous humor in the subtenonian space. We will describe first the surgical technique for the implantation of the tube, and then we will present the results of the first eight cases treated by this method. The advantages and drawbacks of this type of drainage are discussed: they are compared with the other surgical techniques used in cases of glaucoma which is uncontrolled by the classical methods.

Internal Drainage of an Esophageal Perforation in a Patient with a High Surgical Risk

Directory of Open Access Journals (Sweden)

Hongsun Kim

2017-10-01

Full Text Available A 71-year-old man presented with a productive cough and fever, and he was diagnosed as having an esophageal perforation and a mediastinal abscess. He had a history of traumatic hemothorax and pleural drainage for empyema in the right chest and was considered unable to tolerate thoracic surgery because of sepsis and progressive aspiration pneumonia. In order to aggressively drain the mediastinal contamination, we performed internal drainage by placing a Levin tube into the mediastinum through the perforation site. This procedure, in conjunction with controlling sepsis and providing sufficient postpyloric nutrition, allowed the esophageal injury to completely heal.

T-Stimulator effect on cotton protein composition and synthesis in salinization stress

International Nuclear Information System (INIS)

Ibragimova, E.A.; Nazirova, E.R.; Samarkhodjaeva, N.R.; Nalbandyan, A.A.; Babaev, T.A.

2004-01-01

Full text: T-stimulator was established to possess a wide spectrum of physiological effects, to enhance plant adaptation to thermal stress and to increase plant resistance to pathogens. Plant adaptation to unfavorable conditions manifests in changes in many links of metabolism, that of proteins included. We studied effect of cottonseed treatment with T-stimulator on composition and synthesis of plasma membrane proteins upon chloride salinization by means of the radioisotope method. Electrophoretic fractionation of cottonseed plasma membrane proteins showed absence of more than 40 polypeptides with molecular mass from 10 to more than 100 kDa in the cotton root membranes. Major fractions-polypeptides with molecular mass of 61, 53, 46, 25, 21, 20 and 18 kDa constitute about 50% of the total polypeptide composition. The salinization significantly affects the total membrane protein output, proportion of some polypeptides and their synthesis rate. Analysis of phoreogram radioautographs showed that 2-hour exposition of cotton roots to 35 S methionine suppresses synthesis of major polypeptides with molecular mass of 63, 61 and 53 kDa, that of low molecular polypeptides (46, 20, 18 kDa) increasing. Changes in the proportion of major polypeptides in cotton plasma membranes, reduction in rate of biosynthesis of high molecular fractions with the general suppression of label inclusion in the membrane fraction are the evidence for a disturbance in biosynthesis of some membrane proteins in cotton tissue cells upon salinization. The inhibiting effect of salinization on the protein-synthesizing system was observed in plants treated with T-stimulator, but the rate of synthesis in plasma membranes of the treated plants was found significantly higher. The activation of some plasma membrane proteins under T-stimulator effect suggests an association with the increase in adaptation of the treated plants to the disturbing effect of salinization

Effects of transcranial direct current stimulation (tDCS) on pain distress tolerance: a preliminary study

Science.gov (United States)

Mariano, Timothy Y.; Wout, Mascha van’t; Jacobson, Benjamin L.; Garnaat, Sarah L.; Kirschner, Jason L.; Rasmussen, Steven A.; Greenberg, Benjamin D.

2015-01-01

Objective Pain remains a critical medical challenge. Current treatments target nociception without addressing affective symptoms. Medically intractable pain is sometimes treated with cingulotomy or deep brain stimulation to increase tolerance of pain-related distress. Transcranial direct current stimulation (tDCS) may noninvasively modulate cortical areas related to sensation and pain representations. The present study aimed to test the hypothesis that cathodal (“inhibitory”) stimulation targeting left dorsal anterior cingulate cortex (dACC) would increase tolerance to distress from acute painful stimuli versus anodal stimulation. Methods Forty healthy volunteers received both anodal and cathodal stimulation. During stimulation, we measured pain distress tolerance with three tasks: pressure algometer, cold pressor, and breath holding. We measured pain intensity with a visual-analog scale before and after each task. Results Mixed ANOVA revealed that mean cold pressor tolerance tended to be higher with cathodal versus anodal stimulation (p = 0.055) for participants self-completing the task. Pressure algometer (p = 0.81) and breath holding tolerance (p = 0.19) did not significantly differ. The pressure algometer exhibited a statistically significant order effect irrespective of stimulation polarity (all p Pain intensity ratings increased acutely after cold pressor and pressure algometer tasks (both p pain ratings tended to rise less after cathodal versus anodal tDCS (p = 0.072). Conclusions Although our primary results were nonsignificant, there is a preliminary suggestion that cathodal tDCS targeting left dACC may increase pain distress tolerance to cold pressor. Pressure algometer results are consistent with task-related sensitization. Future studies are needed to refine this novel approach for pain neuromodulation. PMID:26115372

Functional dichotomy between NKG2D and CD28-mediated co-stimulation in human CD8+ T cells.

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Kamalakannan Rajasekaran

2010-09-01

Full Text Available Both CD28 and NKG2D can function as co-stimulatory receptors in human CD8+ T cells. However, their independent functional contributions in distinct CD8+ T cell subsets are not well understood. In this study, CD8+ T cells in human peripheral blood- and lung-derived lymphocytes were analyzed for CD28 and NKG2D expression and function. We found a higher level of CD28 expression in PBMC-derived naïve (CD45RA+CD27+ and memory (CD45RA-CD27+ CD8+ T cells (CD28Hi, while its expression was significantly lower in effector (CD45RA+CD27- CD8+ T cells (CD28Lo. Irrespective of the differences in the CD28 levels, NKG2D expression was comparable in all three CD8+ T cell subsets. CD28 and NKG2D expressions followed similar patterns in human lung-resident GILGFVFTL/HLA-A2-pentamer positive CD8+ T cells. Co-stimulation of CD28Lo effector T cells via NKG2D significantly increased IFN-γ and TNF-α levels. On the contrary, irrespective of its comparable levels, NKG2D-mediated co-stimulation failed to augment IFN-γ and TNF-α production in CD28Hi naïve/memory T cells. Additionally, CD28-mediated co-stimulation was obligatory for IL-2 generation and thereby its production was limited only to the CD28Hi naïve/memory subsets. MICA, a ligand for NKG2D was abundantly expressed in the tracheal epithelial cells, validating the use of NKG2D as the major co-stimulatory receptor by tissue-resident CD8+ effector T cells. Based on these findings, we conclude that NKG2D may provide an expanded level of co-stimulation to tissue-residing effector CD8+ T cells. Thus, incorporation of co-stimulation via NKG2D in addition to CD28 is essential to activate tumor or tissue-infiltrating effector CD8+ T cells. However, boosting a recall immune response via memory CD8+ T cells or vaccination to stimulate naïve CD8+ T cells would require CD28-mediated co-stimulation.

Transcutaneous vagus nerve stimulation (tVNS) enhances conflict-triggered adjustment of cognitive control.

Science.gov (United States)

Fischer, Rico; Ventura-Bort, Carlos; Hamm, Alfons; Weymar, Mathias

2018-04-24

Response conflicts play a prominent role in the flexible adaptation of behavior as they represent context-signals that indicate the necessity for the recruitment of cognitive control. Previous studies have highlighted the functional roles of the affectively aversive and arousing quality of the conflict signal in triggering the adaptation process. To further test this potential link with arousal, participants performed a response conflict task in two separate sessions with either transcutaneous vagus nerve stimulation (tVNS), which is assumed to activate the locus coeruleus-noradrenaline (LC-NE) system, or with neutral sham stimulation. In both sessions the N2 and P3 event-related potentials (ERP) were assessed. In line with previous findings, conflict interference, the N2 and P3 amplitude were reduced after conflict. Most importantly, this adaptation to conflict was enhanced under tVNS compared to sham stimulation for conflict interference and the N2 amplitude. No effect of tVNS on the P3 component was found. These findings suggest that tVNS increases behavioral and electrophysiological markers of adaptation to conflict. Results are discussed in the context of the potentially underlying LC-NE and other neuromodulatory (e.g., GABA) systems. The present findings add important pieces to the understanding of the neurophysiological mechanisms of conflict-triggered adjustment of cognitive control.

In vitro exposure to X-radiation of stimulated and non-stimulated human B lymphocytes and T lymphocytes. In vitro Roentgenbestrahlung stimulierter und unstimulierter menschlicher B- und T-Lymphozyten

Energy Technology Data Exchange (ETDEWEB)

Krystossek, H.

1986-09-25

The sensitivity of human type B and type T lymphocytes to 130 kV X-radiation was investigated in vitro. The degree to which 3H thymidine was incorporated into the DNA of these cells was taken as a measure of cellular viability. The results led to the conclusion that the in vitro reactions to X-rays following stimulation and radiation are considerably more pronounced in human B lymphocytes than in human T lymphocytes. The rapid radiation-induced lessening of thymidine incorporation into stimulated B lymphocytes was interpreted as a sign that cellular decay occurred during the interphase. The relative increases in the thymidine incorporation rates seen following radiation of T cells in the presence of hydroxyurea or caffeinemust, however, not be mistaken for an augmentation of resistance that was brought about by these inhibitors. The latter effect is believed to be rather due to an overreaction of the repair mechanisms of DNA which is characterised by short chains.

Frequency-dependent tACS modulation of BOLD signal during rhythmic visual stimulation.

Science.gov (United States)

Chai, Yuhui; Sheng, Jingwei; Bandettini, Peter A; Gao, Jia-Hong

2018-05-01

Transcranial alternating current stimulation (tACS) has emerged as a promising tool for modulating cortical oscillations. In previous electroencephalogram (EEG) studies, tACS has been found to modulate brain oscillatory activity in a frequency-specific manner. However, the spatial distribution and hemodynamic response for this modulation remains poorly understood. Functional magnetic resonance imaging (fMRI) has the advantage of measuring neuronal activity in regions not only below the tACS electrodes but also across the whole brain with high spatial resolution. Here, we measured fMRI signal while applying tACS to modulate rhythmic visual activity. During fMRI acquisition, tACS at different frequencies (4, 8, 16, and 32 Hz) was applied along with visual flicker stimulation at 8 and 16 Hz. We analyzed the blood-oxygen-level-dependent (BOLD) signal difference between tACS-ON vs tACS-OFF, and different frequency combinations (e.g., 4 Hz tACS, 8 Hz flicker vs 8 Hz tACS, 8 Hz flicker). We observed significant tACS modulation effects on BOLD responses when the tACS frequency matched the visual flicker frequency or the second harmonic frequency. The main effects were predominantly seen in regions that were activated by the visual task and targeted by the tACS current distribution. These findings bridge different scientific domains of tACS research and demonstrate that fMRI could localize the tACS effect on stimulus-induced brain rhythms, which could lead to a new approach for understanding the high-level cognitive process shaped by the ongoing oscillatory signal. © 2018 Wiley Periodicals, Inc.

Drain tube migration into the anastomotic site of an esophagojejunostomy for gastric small cell carcinoma: short report

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Lin Long-Wei

2010-05-01

Full Text Available Abstract Background Intraluminal migration of a drain through an anastomotic site is a rare complication of gastric surgery. Case Presentation We herein report the intraluminal migration of a drain placed after a lower esophagectomy and total gastrectomy with Roux-en-Y anastomosis for gastric small cell carcinoma. Persistent drainage was noted 1 month after surgery, and radiographic studies were consistent with drain tube migration. Endoscopy revealed the drain had migrated into the esophagojejunostomy anastomotic site. The drain was removed from outside of abdominal wound while observing the anastomotic site endoscopically. The patient was treated with suction via a nasogastric tube drain for 5 days, and thereafter had an uneventful recovery. Conclusions Though drain tube migration is a rare occurrence, it should be considered in patients with persistent drainage who have undergone gastric surgery.

The Effects of Transcranial Direct Current Stimulation (tDCS on Multitasking Throughput Capacity

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Justin Nelson

2016-11-01

Full Text Available Background: Multitasking has become an integral attribute associated with military operations within the past several decades. As the amount of information that needs to be processed during these high level multitasking environments exceeds the human operators’ capabilities, the information throughput capacity reaches an asymptotic limit. At this point, the human operator can no longer effectively process and respond to the incoming information resulting in a plateau or decline in performance. The objective of the study was to evaluate the efficacy of a non-invasive brain stimulation technique known as transcranial direct current stimulation (tDCS applied to a scalp location over the left dorsolateral prefrontal cortex (lDLPFC to improve information processing capabilities during a multitasking environment. Methods: The study consisted of 20 participants from Wright-Patterson Air Force Base (16 male and 4 female with an average age of 31.1 (SD = 4.5. Participants were randomly assigned into two groups, each consisting of eight males and two females. Group one received 2mA of anodal tDCS and group two received sham tDCS over the lDLPFC on their testing day. Results: The findings indicate that anodal tDCS significantly improves the participants’ information processing capability resulting in improved performance compared to sham tDCS. For example, the multitasking throughput capacity for the sham tDCS group plateaued near 1.0 bits/s at the higher baud input (2.0 bits/s whereas the anodal tDCS group plateaued near 1.3 bits/s. Conclusion: The findings provided new evidence that tDCS has the ability to augment and enhance multitasking capability in a human operator. Future research should be conducted to determine the longevity of the enhancement of transcranial direct current stimulation on multitasking performance, which has yet to be accomplished.

The Effects of Transcranial Direct Current Stimulation (tDCS) on Multitasking Throughput Capacity.

Science.gov (United States)

Nelson, Justin; McKinley, Richard A; Phillips, Chandler; McIntire, Lindsey; Goodyear, Chuck; Kreiner, Aerial; Monforton, Lanie

2016-01-01

Background: Multitasking has become an integral attribute associated with military operations within the past several decades. As the amount of information that needs to be processed during these high level multitasking environments exceeds the human operators' capabilities, the information throughput capacity reaches an asymptotic limit. At this point, the human operator can no longer effectively process and respond to the incoming information resulting in a plateau or decline in performance. The objective of the study was to evaluate the efficacy of a non-invasive brain stimulation technique known as transcranial direct current stimulation (tDCS) applied to a scalp location over the left dorsolateral prefrontal cortex (lDLPFC) to improve information processing capabilities during a multitasking environment. Methods: The study consisted of 20 participants from Wright-Patterson Air Force Base (16 male and 4 female) with an average age of 31.1 (SD = 4.5). Participants were randomly assigned into two groups, each consisting of eight males and two females. Group one received 2 mA of anodal tDCS and group two received sham tDCS over the lDLPFC on their testing day. Results: The findings indicate that anodal tDCS significantly improves the participants' information processing capability resulting in improved performance compared to sham tDCS. For example, the multitasking throughput capacity for the sham tDCS group plateaued near 1.0 bits/s at the higher baud input (2.0 bits/s) whereas the anodal tDCS group plateaued near 1.3 bits/s. Conclusion: The findings provided new evidence that tDCS has the ability to augment and enhance multitasking capability in a human operator. Future research should be conducted to determine the longevity of the enhancement of transcranial direct current stimulation on multitasking performance, which has yet to be accomplished.

Functional MR imaging at 1.5 T. Initial results using photic and motoric stimulation

DEFF Research Database (Denmark)

Henriksen, O; Larsson, H B; Ring, P

1993-01-01

A preliminary investigation of the effects of stimulation of the visual and the motor cortex was made on a conventional 1.5 T MR imaging scanner. Both types of activation gave a detectable change in the signal between rest and stimulation using a gradient echo sequence with an echo time of 60 ms....... The observed effects were assumed to be caused by variation in the amount of paramagnetic deoxyhemoglobin between stimulation and rest due to local increase of capillary blood flow in the human brain during stimulation....

Functional MR imaging at 1.5 T. Initial results using photic and motoric stimulation

DEFF Research Database (Denmark)

Henriksen, O; Larsson, H B; Ring, P

1993-01-01

A preliminary investigation of the effects of stimulation of the visual and the motor cortex was made on a conventional 1.5 T MR imaging scanner. Both types of activation gave a detectable change in the signal between rest and stimulation using a gradient echo sequence with an echo time of 60 ms........ The observed effects were assumed to be caused by variation in the amount of paramagnetic deoxyhemoglobin between stimulation and rest due to local increase of capillary blood flow in the human brain during stimulation....

A chemically inert drug can stimulate T cells in vitro by their T cell receptor in non-sensitised individuals

International Nuclear Information System (INIS)

Engler, Olivier B.; Strasser, Ingrid; Naisbitt, Dean J.; Cerny, Andreas; Pichler, Werner J.

2004-01-01

Drugs can interact with T cell receptors (TCR) after binding to peptide-MHC structures. This binding may involve the formation of a stable, covalent bond between a chemically reactive drug and MHC or the peptide embedded within. Alternatively, if the drug is chemically inert, the binding may be non-covalent and readily reversible. Both types of drug presentation account for a substantial number of adverse side effects to drugs. Presently no tests are available to predict the ability of chemically inert drugs to stimulate an immune response. Here we present data on the successful induction of a primary T cell immune response in vitro against a chemically inert drug using blood from healthy individuals, previously not exposed to the drug. Blood lymphocytes were stimulated by the chemically inert drug sulfamethoxazole and the protein-reactive drug-metabolite sulfamethoxazole-nitroso in the presence of IL-2. 9/10 individuals reacted in response to sulfamethoxazole-nitroso, but only three reacted to the chemically inert compound sulfamethoxazole. Drug reactive T cells could be detected after 14-35 days of cell culture by drug-specific proliferation or cytotoxicity, which was MHC-restricted. These cells were CD4, CD8 positive or CD4/CD8 double positive and T cell clones generated secreted Th0 type cytokines. Drug interaction lead to down-regulation of specific TCR. These data confirm the ability of chemically inert drugs to stimulate certain T cells by their TCR and may provide the opportunity to screen new drugs for their ability to interact with TCRs

CRL X-ray tube

International Nuclear Information System (INIS)

Kolchevsky, N.N.; Petrov, P.V.

2015-01-01

A novel types of X-ray tubes with refractive lenses are proposed. CRL-R X-ray tube consists of Compound Refractive Lens- CRL and Reflection X-ray tube. CRL acts as X-ray window. CRL-T X-ray consists of CRL and Transmission X-ray tube. CRL acts as target for electron beam. CRL refractive lens acts as filter, collimator, waveguide and focusing lens. Properties and construction of the CRL X-ray tube are discussed. (authors)

Beta band transcranial alternating (tACS and direct current stimulation (tDCS applied after initial learning facilitate retrieval of a motor sequence

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Vanessa eKrause

2016-01-01

Full Text Available The primary motor cortex (M1 contributes to the acquisition and early consolidation of a motor sequence. Although the relevance of M1 excitability for motor learning has been supported, the significance of M1 oscillations remains an open issue. This study aims at investigating to what extent retrieval of a newly learned motor sequence can be differentially affected by motor-cortical transcranial alternating (tACS and direct current stimulation (tDCS. Alpha (10 Hz, beta (20 Hz or sham tACS was applied in 36 right-handers. Anodal or cathodal tDCS was applied in 30 right-handers. Participants learned an eight-digit serial reaction time task (SRTT; sequential vs. random with the right hand. Stimulation was applied to the left M1 after SRTT acquisition at rest for ten minutes. Reaction times were analyzed at baseline, end of acquisition, retrieval immediately after stimulation and reacquisition after eight further sequence repetitions.Reaction times during retrieval were significantly faster following 20 Hz tACS as compared to 10 Hz and sham tACS indicating a facilitation of early consolidation. TDCS yielded faster reaction times, too, independent of polarity. No significant differences between 20 Hz tACS and tDCS effects on retrieval were found suggesting that 20 Hz effects might be associated with altered motor-cortical excitability. Based on the behavioural modulation yielded by tACS and tDCS one might speculate that altered motor-cortical beta oscillations support early motor consolidation possibly associated with neuroplastic reorganization.

Conservative use of chest-tube insertion in children with pleural effusion.

Science.gov (United States)

Epaud, R; Aubertin, G; Larroquet, M; Pointe, H Ducou-le; Helardot, P; Clement, A; Fauroux, B

2006-04-01

The aim of this work was to evaluate the effect of a more conservative use of chest-tube insertion on the short-term and long-term outcome of pleural infection. Sixty-five patients with pleural infection, aged 1 month to 16 years were each treated according to one of the two protocols: classical management with chest-tube insertion (classical group, n = 33), or conservative use of chest-tube insertion (conservative group, n = 32), with drainage indicated only in the case of voluminous pleural effusion defined by a mediastinal shift and respiratory distress and/or an uncontrolled septic situation. The two groups were comparable with regard to age, baseline C-reactive protein (CRP) value and white blood cell counts, pleural thickness, identified bacteria, and antibiotic treatment. Chest-tube insertion was performed in 17 patients (52%) of the classical group compared to eight patients (25%) of the conservative group (P = 0.03). Duration of temperature above 39 degrees C was shorter in the conservative group (10 +/- 1 vs. 14 +/- 1 days, P = 0.01), as was the normalization of CRP (13 +/- 1 vs. 17 +/- 1 days, P = 0.03). Duration of hospitalization and intravenous (IV) antibiotherapy as well as the delay of chest-radiograph normalization was not significantly different between the two groups. A more conservative use of chest-tube insertion did not change short- and long-term outcome of the pleural infection in children. Drainage could be restricted to the most severely affected patients with pleural empyema causing a mediastinal shift and respiratory distress and/or presenting with an uncontrolled septic situation.

[Prognostic value of lacrimal duct diagnostics after tube removal : Retrospective analysis of risk of relapse during the first postoperative year after transcanalicular lacrimal duct surgery with silicone tubing].

Science.gov (United States)

Böhm, M; Heichel, J; Bredehorn-Mayr, T; Lautenschläger, C; Struck, H-G

2017-05-01

Transcanalicular lacrimal duct surgery has become more important over the past two decades. The aim of the study was to prove the prognostic value of postoperative lacrimal syringing and the testing of spontaneous drainage of lacrimal fluid immediately after tube removal. A total of 110 cases with postoperative lacrimal syringing and 183 cases with verification of the postoperative lacrimal fluid drainage performed between January 2001 and August 2008 were retrospectively evaluated. The indication for postoperative diagnostics was set by the investigator. The prognostic value of these two procedures was determined by using prognostic parameters (positive predictive value, PPV; negative predictive value, NPV) and analyzing recurrence nonexistence via Cox regression and Kaplan-Meier estimator. The observation period was limited to 12 months. Predominantly, recurrence was defined on the patient's satisfaction and absence of symptoms, which was determined with the help of a questionnaire. Postoperative verification of the lacrimal syringing is a suitable instrument to estimate surgical success within the first year after lacrimal surgery with a PPV of 92.31%. Testing of the spontaneous drainage of lacrimal fluid after tube removal reached a PPV of 63.33%. The proven prognostic value shows that syringing of the lacrimal duct and verification of spontaneous drainage should be integrated into postoperative care in a standardized manner. Hereby, early information for the patient about the expected result of the surgical procedure is enabled.

Ipsilateral reexpansion pulmonary edema after drainage of a spontaneous pneumothorax: a case report

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Conen Anna

2007-09-01

Full Text Available Abstract We report a case of ipsilateral reexpansion pulmonary edema occurring after the insertion of a chest tube in a patient with spontaneous pneumothorax. The patient received supplemental oxygen via a non-rebreather face mask to compensate for hypoxemia. 24 hours after the acute event, the patient recovered completely without residual hypoxemia. Reexpansion pulmonary edema after the insertion of a thoracic drainage for pneumothorax or pleural effusion is a rare complication with a high mortality rate up to 20%. It should be considered in case of hypoxemia following the insertion of a chest tube. The exact pathophysiology leading to this complication is not known. Risk factors for reexpansion pulmonary edema should be evaluated and considered prior to the insertion of chest tubes. Treatment is supportive.

Stimulation with Concanavalin-A Induces IL-17 Production by Canine Peripheral T Cells

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Michelle G. Ritt

2015-04-01

Full Text Available The characteristics of canine IL-17-producing cells are incompletely understood. Expression of mRNA encoding orthologs of IL-17 and the IL-17 receptor has been documented in tissues from dogs with arthritis, inflammatory bowel disease, and lymphoma; however, no associations have been found between IL-17 gene expression and disease phenotype in these conditions. Robust assessment of the role of IL-17-producing cells in dogs will require measuring the frequency of these cells in health and disease in balance with other lymphocyte subsets. The aim of this study was to confirm that the T-cell IL-17 response in dogs is evolutionarily conserved. Canine peripheral blood mononuclear cells were stimulated with Concanavalin A with or without polarizing cytokines. We used a canine specific IL-17 ELISA and flow cytometry to identify IL-17-producing T cells. Accumulation of intracellular IL-17 was observed in stimulated CD4 and CD8 T cells. The addition of pro-inflammatory cytokines appeared to enhance polarization of canine CD4 T cells to the Th17 phenotype. Conversely, the addition of IL-2 in the presence of TGF-β resulted in expansion of Treg cells. We conclude that canine IL-17-producing cells behave similarly to those from humans and mice when stimulated with mitogens and polarized with pro-inflammatory or immune regulatory cytokines.

Preferential Th1 cytokine profile of phosphoantigen-stimulated human Vγ9Vδ2 T cells.

LENUS (Irish Health Repository)

Dunne, Margaret R

2010-01-01

Human Vγ9Vδ2 T cells recognise pyrophosphate-based antigens (phosphoantigens) and have multiple functions in innate and adaptive immunity, including a unique ability to activate other cells of the immune system. We used flow cytometry and ELISA to define the early cytokine profiles of Vγ9Vδ2 T cells stimulated in vitro with isopentenyl pyrophosphate (IPP) and (E)-4-hydroxy-3-methyl-but-2 enyl pyrophosphate (HMB-PP) in the absence and presence of IL-2 and IL-15. We show that fresh Vγ9Vδ2 T cells produce interferon-γ (IFN-γ) and tumour necrosis factor-α (TNF-α) within 4 hours of stimulation with phosphoantigen, but neither IL-10, IL-13, nor IL-17 was detectable up to 72 hours under these conditions. Cytokine production was not influenced by expression or lack, thereof, of CD4 or CD8. Addition of IL-2 or IL-15 caused expansion of IFN-γ-producing Vγ9Vδ2 T cells, but did not enhance IFN-γ secretion after 24-72 hours. Thus, phosphoantigen-stimulated Vγ9Vδ2 T cells have potential as Th1-biasing adjuvants for immunotherapy.

Preferential Th1 Cytokine Profile of Phosphoantigen-Stimulated Human Vγ9Vδ2 T Cells

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Margaret R. Dunne

2010-01-01

Full Text Available Human Vγ9Vδ2 T cells recognise pyrophosphate-based antigens (phosphoantigens and have multiple functions in innate and adaptive immunity, including a unique ability to activate other cells of the immune system. We used flow cytometry and ELISA to define the early cytokine profiles of Vγ9Vδ2 T cells stimulated in vitro with isopentenyl pyrophosphate (IPP and (E-4-hydroxy-3-methyl-but-2 enyl pyrophosphate (HMB-PP in the absence and presence of IL-2 and IL-15. We show that fresh Vγ9Vδ2 T cells produce interferon-γ (IFN-γ and tumour necrosis factor-α (TNF-α within 4 hours of stimulation with phosphoantigen, but neither IL-10, IL-13, nor IL-17 was detectable up to 72 hours under these conditions. Cytokine production was not influenced by expression or lack, thereof, of CD4 or CD8. Addition of IL-2 or IL-15 caused expansion of IFN-γ-producing Vγ9Vδ2 T cells, but did not enhance IFN-γ secretion after 24–72 hours. Thus, phosphoantigen-stimulated Vγ9Vδ2 T cells have potential as Th1-biasing adjuvants for immunotherapy.

Retained foreign body following pleural drainage with a small-bore catheter.

Science.gov (United States)

Paddle, Alenka; Elahi, Maqsood; Newcomb, Andrew

2010-01-01

Small-bore radiopaque drains can be used to drain pleural effusions. They offer reliable drainage of simple pleural effusions and provide a safe, less-invasive, more comfortable alternative to the standard tube thoracostomy. Importantly, removal of such drains does not require purse-string sutures and hence can be removed without assistance. We report here the cautionary tale of a retained foreign body related to drainage of a pleural effusion with a Pleurocath in a patient following cardiac surgery to raise awareness of this potential complication. Emphasized is the need for all staff to be familiar with the normal appearance of equipment being utilized in the ward and to report when incomplete removal of drain equipment is suspected. In addition, amendments to insertion techniques for such small-bore drains are proposed to avoid similar undue complications.

The Effects of Compensatory Auditory Stimulation and High-Definition Transcranial Direct Current Stimulation (HD-tDCS) on Tinnitus Perception - A Randomized Pilot Study.

Science.gov (United States)

Henin, Simon; Fein, Dovid; Smouha, Eric; Parra, Lucas C

2016-01-01

Tinnitus correlates with elevated hearing thresholds and reduced cochlear compression. We hypothesized that reduced peripheral input leads to elevated neuronal gain resulting in the perception of a phantom sound. The purpose of this pilot study was to test whether compensating for this peripheral deficit could reduce the tinnitus percept acutely using customized auditory stimulation. To further enhance the effects of auditory stimulation, this intervention was paired with high-definition transcranial direct current stimulation (HD-tDCS). A randomized sham-controlled, single blind study was conducted in a clinical setting on adult participants with chronic tinnitus (n = 14). Compensatory auditory stimulation (CAS) and HD-tDCS were administered either individually or in combination in order to access the effects of both interventions on tinnitus perception. CAS consisted of sound exposure typical to daily living (20-minute sound-track of a TV show), which was adapted with compressive gain to compensate for deficits in each subject's individual audiograms. Minimum masking levels and the visual analog scale were used to assess the strength of the tinnitus percept immediately before and after the treatment intervention. CAS reduced minimum masking levels, and visual analog scale trended towards improvement. Effects of HD-tDCS could not be resolved with the current sample size. The results of this pilot study suggest that providing tailored auditory stimulation with frequency-specific gain and compression may alleviate tinnitus in a clinical population. Further experimentation with longer interventions is warranted in order to optimize effect sizes.

Thoughts on accelerator tubes

International Nuclear Information System (INIS)

Larson, J.D.

1978-01-01

A brief, subjective review is given of mechanisms that may be limiting electrostatic accelerator tubes to present levels of performance. Suggestions are made for attacking these limitations with the purpose of stimulating the thinking of designers and users of electrostatic accelerators

Thoughts of accelerator tubes

International Nuclear Information System (INIS)

Larson, J.D.

1977-01-01

A brief, subjective review is given of mechanisms that may be limiting electrostatic accelerator tubes to present levels of performance. Suggestions are made for attacking these limitations with the purpose of stimulating the thinking of designers and users of electrostatic accelerators

Polarity-Dependent Misperception of Subjective Visual Vertical during and after Transcranial Direct Current Stimulation (tDCS).

Science.gov (United States)

Santos-Pontelli, Taiza E G; Rimoli, Brunna P; Favoretto, Diandra B; Mazin, Suleimy C; Truong, Dennis Q; Leite, Joao P; Pontes-Neto, Octavio M; Babyar, Suzanne R; Reding, Michael; Bikson, Marom; Edwards, Dylan J

2016-01-01

Pathologic tilt of subjective visual vertical (SVV) frequently has adverse functional consequences for patients with stroke and vestibular disorders. Repetitive transcranial magnetic stimulation (rTMS) of the supramarginal gyrus can produce a transitory tilt on SVV in healthy subjects. However, the effect of transcranial direct current stimulation (tDCS) on SVV has never been systematically studied. We investigated whether bilateral tDCS over the temporal-parietal region could result in both online and offline SVV misperception in healthy subjects. In a randomized, sham-controlled, single-blind crossover pilot study, thirteen healthy subjects performed tests of SVV before, during and after the tDCS applied over the temporal-parietal region in three conditions used on different days: right anode/left cathode; right cathode/left anode; and sham. Subjects were blind to the tDCS conditions. Montage-specific current flow patterns were investigated using computational models. SVV was significantly displaced towards the anode during both active stimulation conditions when compared to sham condition. Immediately after both active conditions, there were rebound effects. Longer lasting after-effects towards the anode occurred only in the right cathode/left anode condition. Current flow models predicted the stimulation of temporal-parietal regions under the electrodes and deep clusters in the posterior limb of the internal capsule. The present findings indicate that tDCS over the temporal-parietal region can significantly alter human SVV perception. This tDCS approach may be a potential clinical tool for the treatment of SVV misperception in neurological patients.

Nocardia brasiliensis endophthalmitis in a patient with an exposed Ahmed glaucoma drainage implant.

Science.gov (United States)

Stewart, Michael W; Bolling, James P; Bendel, Rick E

2013-01-01

To report a case of endophthalmitis due to Nocardia brasiliensis in an eye with an exposed, infected Ahmed glaucoma drainage implant (GDI). Retrospective case report. A patient with an exposed GDI experienced recurrent episodes of endophthalmitis despite repeated intravitreal injections of antibiotics and steroids. The tube was initially repositioned and finally removed. Whereas repeated cultures from the anterior chamber and vitreous were negative, cultures from the removed tube grew Nocardia brasiliensis. Despite oral trimethoprim-sulfamethoxazole and intravitreal amikacin the eye became phthisical and lost light perception. An exposed GDI may lead to endophthalmitis due to Nocardia brasiliensis and may require explantation to establish a diagnosis.

Measurement of thin liquid film drainage using a novel high-speed impedance analyzer

Science.gov (United States)

Hool, Kevin O.; Saunders, Robert C.; Ploehn, Harry J.

1998-09-01

This work describes the design and implementation of a new instrument, called the thin film impedance analyzer, which measures the rate of drainage of thin oil films. The instrument forms an oil film by elevating a planar oil-water interface into a water drop hanging from a stainless steel capillary tube immersed in the oil. The instrument measures the magnitude of the impedance of the matter between the capillary tube and a screen electrode immersed in the lower water phase. Under appropriate conditions, the capacitance of the oil film dominates the impedance. The instrument records the increase in the magnitude of the admittance associated with the draining and thinning of the oil film. The features of the drainage curves vary considerably with the type, amount, and location of surfactants in the oil and water phases, as well as with user-specified values of drop volume, drop equilibration time, and extent of drop compression. For this reason, the instrument has utility as a screening tool for selecting surfactants for emulsion formulations. Potential future uses include accelerated prediction of emulsion stability and extraction of oil-water interfacial rheological parameters.

To drain or not to drain? Predictors of tube thoracostomy insertion and outcomes associated with drainage of traumatic hemothoraces.

Science.gov (United States)

Wells, Bryan J; Roberts, Derek J; Grondin, Sean; Navsaria, Pradeep H; Kirkpatrick, Andrew W; Dunham, Michael B; Ball, Chad G

2015-09-01

Historical data suggests that many traumatic hemothoraces (HTX) can be managed expectantly without tube thoracostomy (TT) drainage. The purpose of this study was to identify predictors of TT, including whether the quantity of pleural blood predicted tube placement, and to evaluate outcomes associated with TT versus expected management (EM) of traumatic HTXs. A retrospective cohort study of all trauma patients with HTXs and an Injury Severity Score (ISS) ≥12 managed at a level I trauma centre between April 1, 2005 and December 31, 2012 was completed. Mixed-effects models with a subject-specific random intercept were used to identify independent risk factors for TT. Logistic and log-linear regression were used to compute odds ratios (ORs) for mortality and empyema and percent increases in length of hospital and intensive care unit stay between patients managed with TT versus EM, respectively. A total of 635 patients with 749 HTXs were included in the study. Overall, 491 (66%) HTXs were drained while 258 (34%) were managed expectantly. Independent predictors of TT placement included concomitant ipsilateral flail chest [OR 3.03; 95% confidence interval (CI) 1.04-8.80; p=0.04] or pneumothorax (OR 6.19; 95% CI 1.79-21.5; p<0.01) and the size of the HTX (OR per 10cc increase 1.12; 95% CI 1.04-1.21; p<0.01). Although the adjusted odds of mortality were not significantly different between groups (OR 3.99; 95% CI 0.87-18.30; p=0.08), TT was associated with a 47.14% (95% CI, 25.57-69.71%; p<0.01) adjusted increase in hospital length of stay. Empyemas (n=29) only occurred among TT patients. Expectant management of traumatic HTX was associated with a shorter length of hospital stay, no empyemas, and no increase in mortality. Although EM of smaller HTXs may be safe, these findings must be confirmed by a large multi-centre cohort study and randomized controlled trials before they are used to guide practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

Comparison between autologous blood transfusion drainage and closed-suction drainage/no drainage in total knee arthroplasty: a meta-analysis.

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Hong, Kun-Hao; Pan, Jian-Ke; Yang, Wei-Yi; Luo, Ming-Hui; Xu, Shu-Chai; Liu, Jun

2016-08-01

Autologous blood transfusion (ABT) drainage system is a new unwashed salvaged blood retransfusion system for total knee replacement (TKA). However, whether to use ABT drainage, closed-suction (CS) drainage or no drainage in TKA surgery remains controversial. This is the first meta-analysis to assess the clinical efficiency, safety and potential advantages regarding the use of ABT drains compared with closed-suction/no drainage. PubMed, Embase, and the Cochrane Library were comprehensively searched in March 2015. Fifteen randomized controlled trials (RCTs) were identified and pooled for statistical analysis. The primary outcome evaluated was homologous blood transfusion rate. The secondary outcomes were post-operative haemoglobin on days 3-5, length of hospital stay and wound infections after TKA surgery. The pooled data included 1,721 patients and showed that patients in the ABT drainage group might benefit from lower blood transfusion rates (16.59 % and 37.47 %, OR: 0.28 [0.14, 0.55]; 13.05 % and 16.91 %, OR: 0.73 [0.47,1.13], respectively). Autologous blood transfusion drainage and closed-suction drainage/no drainage have similar clinical efficacy and safety with regard to post-operative haemoglobin on days 3-5, length of hospital stay and wound infections. Autologous blood transfusion drainage offers a safe and efficient alternative to CS/no drainage with a lower blood transfusion rate. Future large-volume high-quality RCTs with extensive follow-up will affirm and update this system review.

Crack initiation and propagation paths in small diameter FSW 6082-T6 aluminium tubes under fatigue loading

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Roberto Tovo

2016-03-01

Full Text Available This paper reports results of fatigue tests of friction stir welded (FSW aluminium tubes. Relatively small 38 mm diameter tubes were used and hence an automated FSW process using a retracting tool was designed for this project, as the wall thickness of the aluminium tube was similar to the diameter of the FSW tool. This is a more complex joint geometry to weld than the more usual larger diameter tube reported in the literature. S-N fatigue testing was performed using load ratios of R = 0.1 and R = -1. Crack path analysis was performed using both low magnification stereo microscopy and scanning electron microscopy, in order to identify crack initiation sites and to determine the direction of crack propagation. Work is still in progress to follow the crack path through the various microstructural zones associated with the weld. A simple statistical analysis was used to characterize the most typical crack initiation site. This work forms part of a wider project directed at determining multiaxial fatigue design rules for small diameter 6082-T6 aluminium tubes that could be of use in the ground vehicle industry.

The Use of T-tube Cholangiocatheter Stents in the Treatment of Pediatric Tracheomalacia.

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Mohammad Vahid Hosseini, Seyed; Zarenezhad, Mohammad; Sabet, Babak; Shoar, Mehrdad Malek; Kangari, Gholamreza

2013-01-01

Tracheomalacia is a common disorder in neonate and infants, which can lead to life-threatening airway occlusion, because of external pressure or intrinsic defect of tracheobroncial cartilage. Aortopexy and Stents are effective in relieving tracheomalacia in the latter patients. In this case we are to show how t-tube cholangiocatheter is effective and easy available in sever tracheomalacia neonates with intrinsic defect. It can be easily replaced and causes no infection, erosion, or sever complication in 9 months period.

Transcranial direct current stimulation (tDCS) of frontal cortex decreases performance on the WAIS-IV intelligence test.

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Sellers, Kristin K; Mellin, Juliann M; Lustenberger, Caroline M; Boyle, Michael R; Lee, Won Hee; Peterchev, Angel V; Fröhlich, Flavio

2015-09-01

Transcranial direct current stimulation (tDCS) modulates excitability of motor cortex. However, there is conflicting evidence about the efficacy of this non-invasive brain stimulation modality to modulate performance on cognitive tasks. Previous work has tested the effect of tDCS on specific facets of cognition and executive processing. However, no randomized, double-blind, sham-controlled study has looked at the effects of tDCS on a comprehensive battery of cognitive processes. The objective of this study was to test if tDCS had an effect on performance on a comprehensive assay of cognitive processes, a standardized intelligence quotient (IQ) test. The study consisted of two substudies and followed a double-blind, between-subjects, sham-controlled design. In total, 41 healthy adult participants were included in the final analysis. These participants completed the Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) as a baseline measure. At least one week later, participants in substudy 1 received either bilateral tDCS (anodes over both F4 and F3, cathode over Cz, 2 mA at each anode for 20 min) or active sham tDCS (2 mA for 40 s), and participants in substudy 2 received either right or left tDCS (anode over either F4 or F3, cathode over Cz, 2 mA for 20 min). In both studies, the WAIS-IV was immediately administered following stimulation to assess for performance differences induced by bilateral and unilateral tDCS. Compared to sham stimulation, right, left, and bilateral tDCS reduced improvement between sessions on Full Scale IQ and the Perceptual Reasoning Index. This demonstration that frontal tDCS selectively degraded improvement on specific metrics of the WAIS-IV raises important questions about the often proposed role of tDCS in cognitive enhancement. Copyright © 2015 Elsevier B.V. All rights reserved.

Modulation of Brain Activity with Noninvasive Transcranial Direct Current Stimulation (tDCS): Clinical Applications and Safety Concerns

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Zhao, Haichao; Qiao, Lei; Fan, Dongqiong; Zhang, Shuyue; Turel, Ofir; Li, Yonghui; Li, Jun; Xue, Gui; Chen, Antao; He, Qinghua

2017-01-01

Transcranial direct current stimulation (tDCS) is a widely-used tool to induce neuroplasticity and modulate cortical function by applying weak direct current over the scalp. In this review, we first introduce the underlying mechanism of action, the brief history from discovery to clinical scientific research, electrode positioning and montages, and parameter setup of tDCS. Then, we review tDCS application in clinical samples including people with drug addiction, major depression disorder, Alzheimer's disease, as well as in children. This review covers the typical characteristics and the underlying neural mechanisms of tDCS treatment in such studies. This is followed by a discussion of safety, especially when the current intensity is increased or the stimulation duration is prolonged. Given such concerns, we provide detailed suggestions regarding safety procedures for tDCS operation. Lastly, future research directions are discussed. They include foci on the development of multi-tech combination with tDCS such as with TMS and fMRI; long-term behavioral and morphological changes; possible applications in other research domains, and more animal research to deepen the understanding of the biological and physiological mechanisms of tDCS stimulation. PMID:28539894

Facilitation of Function and Manipulation Knowledge of Tools Using Transcranial Direct Current Stimulation (tDCS

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Ryo Ishibashi

2018-01-01

Full Text Available Using a variety of tools is a common and essential component of modern human life. Patients with brain damage or neurological disorders frequently have cognitive deficits in their recognition and manipulation of tools. In this study, we focused on improving tool-related cognition using transcranial direct current stimulation (tDCS. Converging evidence from neuropsychology, neuroimaging and non- invasive brain stimulation has identified the anterior temporal lobe (ATL and inferior parietal lobule (IPL as brain regions supporting action semantics. We observed enhanced performance in tool cognition with anodal tDCS over ATL and IPL in two cognitive tasks that require rapid access to semantic knowledge about the function or manipulation of common tools. ATL stimulation improved access to both function and manipulation knowledge of tools. The effect of IPL stimulation showed a trend toward better manipulation judgments. Our findings support previous studies of tool semantics and provide a novel approach for manipulation of underlying circuits.

Integrating YouTube into the nursing curriculum.

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Sharoff, Leighsa

2011-08-17

Nurse educators need to be innovative, stimulating, and engaging as they teach future nursing professionals. The use of YouTube in nursing education classes provides an easy, innovative, and user-friendly way to engage today's nursing students. YouTube presentations can be easily adapted into nursing courses at any level, be it a fundamentals course for undergraduate students or a theoretical foundations course for graduate students. In this article I will provide information to help educators effectively integrate YouTube into their course offerings. I will start by reviewing the phenomenon of social networking. Next I will discuss challenges and strategies related to YouTube learning experiences, after which I will share some of the legal considerations in using YouTube. I will conclude by describing how to engage students via YouTube and current research related to YouTube.

PleurAlert: an augmented chest drainage system with electronic sensing, automated alerts and internet connectivity.

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Leeson, Cory E; Weaver, Robert A; Bissell, Taylor; Hoyer, Rachel; McClain, Corinne; Nelson, Douglas A; Samosky, Joseph T

2012-01-01

We have enhanced a common medical device, the chest tube drainage container, with electronic sensing of fluid volume, automated detection of critical alarm conditions and the ability to automatically send alert text messages to a nurse's cell phone. The PleurAlert system provides a simple touch-screen interface and can graphically display chest tube output over time. Our design augments a device whose basic function dates back 50 years by adding technology to automate and optimize a monitoring process that can be time consuming and inconvenient for nurses. The system may also enhance detection of emergency conditions and speed response time.

Multi-session transcranial direct current stimulation (tDCS elicits inflammatory and regenerative processes in the rat brain.

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Maria Adele Rueger

Full Text Available Transcranial direct current stimulation (tDCS is increasingly being used in human studies as an adjuvant tool to promote recovery of function after stroke. However, its neurobiological effects are still largely unknown. Electric fields are known to influence the migration of various cell types in vitro, but effects in vivo remain to be shown. Hypothesizing that tDCS might elicit the recruitment of cells to the cortex, we here studied the effects of tDCS in the rat brain in vivo. Adult Wistar rats (n = 16 were randomized to either anodal or cathodal stimulation for either 5 or 10 consecutive days (500 µA, 15 min. Bromodeoxyuridine (BrdU was given systemically to label dividing cells throughout the experiment. Immunohistochemical analyses ex vivo included stainings for activated microglia and endogenous neural stem cells (NSC. Multi-session tDCS with the chosen parameters did not cause a cortical lesion. An innate immune response with early upregulation of Iba1-positive activated microglia occurred after both cathodal and anodal tDCS. The involvement of adaptive immunity as assessed by ICAM1-immunoreactivity was less pronounced. Most interestingly, only cathodal tDCS increased the number of endogenous NSC in the stimulated cortex. After 10 days of cathodal stimulation, proliferating NSC increased by ∼60%, with a significant effect of both polarity and number of tDCS sessions on the recruitment of NSC. We demonstrate a pro-inflammatory effect of both cathodal and anodal tDCS, and a polarity-specific migratory effect on endogenous NSC in vivo. Our data suggest that tDCS in human stroke patients might also elicit NSC activation and modulate neuroinflammation.

Frontal transcranial direct current stimulation (tDCS) abolishes list-method directed forgetting.

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Silas, Jonathan; Brandt, Karen R

2016-03-11

It is a point of controversy as to whether directed forgetting effects are a result of active inhibition or a change of context initiated by the instruction to forget. In this study we test the causal role of active inhibition in directed forgetting. By applying cathodal transcranial direct current stimulation (tDCS) over the right prefrontal cortex we suppressed cortical activity commonly associated with inhibitory control. Participants who underwent real brain stimulation before completing the directed forgetting paradigm showed no directed forgetting effects. Conversely, those who underwent sham brain stimulation demonstrated classical directed forgetting effects. We argue that these findings suggest that inhibition is the primary mechanism that results in directed forgetting costs and benefits. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Enhancing performance in numerical magnitude processing and mental arithmetic using transcranial Direct Current Stimulation (tDCS

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Tobias U. Hauser

2013-06-01

Full Text Available The ability to accurately process numerical magnitudes and solve mental arithmetic is of highest importance for schooling and professional career. Although impairments in these domains in disorders such as developmental dyscalculia (DD are highly detrimental, remediation is still sparse. In recent years, transcranial brain stimulation methods such as transcranial Direct Current Stimulation (tDCS have been suggested as a treatment for various neurologic and neuropsychiatric disorders. The posterior parietal cortex (PPC is known to be crucially involved in numerical magnitude processing and mental arithmetic. In this study, we evaluated whether tDCS has a beneficial effect on numerical magnitude processing and mental arithmetic. Due to the unclear lateralization, we stimulated the left, right as well as both hemispheres simultaneously in two experiments. We found that left anodal tDCS significantly enhanced performance in a number comparison and a subtraction task, while bilateral and right anodal tDCS did not induce any improvements compared to sham. Our findings demonstrate that the left PPC is causally involved in numerical magnitude processing and mental arithmetic. Furthermore, we show that these cognitive functions can be enhanced by means of tDCS. These findings encourage to further investigate the beneficial effect of tDCS in the domain of mathematics in healthy and impaired humans.

Characterization of magnetically impelled arc butt welded T11 tubes for high pressure applications

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R. Sivasankari

2015-09-01

Full Text Available Magnetically impelled arc butt (MIAB welding is a pressure welding process used for joining of pipes and tubes with an external magnetic field affecting arc rotation along the tube circumference. In this work, MIAB welding of low alloy steel (T11 tubes were carried out to study the microstructural changes occurring in thermo-mechanically affected zone (TMAZ. To qualify the process for the welding applications where pressure could be up to 300 bar, the MIAB welds are studied with variations of arc current and arc rotation time. It is found that TMAZ shows higher hardness than that in base metal and displays higher weld tensile strength and ductility due to bainitic transformation. The effect of arc current on the weld interface is also detailed and is found to be defect free at higher values of arc currents. The results reveal that MIAB welded samples exhibits good structural property correlation for high pressure applications with an added benefit of enhanced productivity at lower cost. The study will enable the use of MIAB welding for high pressure applications in power and defence sectors.

Stimulation of Natural Killer T Cells by Glycolipids

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Brian L. Anderson

2013-12-01

Full Text Available Natural killer T (NKT cells are a subset of T cells that recognize glycolipid antigens presented by the CD1d protein. The initial discovery of immunostimulatory glycolipids from a marine sponge and the T cells that respond to the compounds has led to extensive research by chemists and immunologists to understand how glycolipids are recognized, possible responses by NKT cells, and the structural features of glycolipids necessary for stimulatory activity. The presence of this cell type in humans and most mammals suggests that it plays critical roles in antigen recognition and the interface between innate and adaptive immunity. Both endogenous and exogenous natural antigens for NKT cells have been identified, and it is likely that glycolipid antigens remain to be discovered. Multiple series of structurally varied glycolipids have been synthesized and tested for stimulatory activity. The structural features of glycolipids necessary for NKT cell stimulation are moderately well understood, and designed compounds have proven to be much more potent antigens than their natural counterparts. Nevertheless, control over NKT cell responses by designed glycolipids has not been optimized, and further research will be required to fully reveal the therapeutic potential of this cell type.

Transcranial Direct Current Stimulation: Five Important Issues We Aren’t Discussing (But Probably Should Be

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Jared Cooney Horvath

2014-01-01

Full Text Available Transcranial Direct Current Stimulation (tDCS is a neuromodulatory device often publicized for its ability to enhance cognitive and behavioral performance. These enhancement claims, however, are predicated upon electrophysiological evidence and descriptions which are far from conclusive. In fact, a review of the literature reveals a number of important experimental and technical issues inherent with this device that are simply not being discussed in any meaningful manner. In this paper, we will consider five of these topics. The first, inter-subject variability, explores the extensive between- and within-group differences found within the tDCS literature and highlights the need to properly examine stimulatory response at the individual level. The second, intra-subject reliability, reviews the lack of data concerning tDCS response reliability over time and emphasizes the importance of this knowledge for appropriate stimulatory application. The third, sham stimulation and blinding, draws attention to the importance (yet relative lack of proper control and blinding practices in the tDCS literature. The fourth, motor and cognitive interference, highlights the often overlooked body of research that suggests typical behaviors and cognitions undertaken during or following tDCS can impair or abolish the effects of stimulation. Finally, the fifth, electric current influences, underscores several largely ignored variables (such as hair thickness and electrode attachments methods influential to tDCS electric current density and flow.Through this paper, we hope to increase awareness and start an ongoing dialogue of these important issues which speak to the efficacy, reliability, and mechanistic foundations of tDCS.

Degradation of superheater tubes made of austenitic T321H steel after long term service

Energy Technology Data Exchange (ETDEWEB)

Hernas, Adam [Silesian Technical Univ., Katowice (Poland). Faculty of Material Science; Augustyniak, Boleslaw; Chmielewski, Marek [Gdansk Univ. of Technology (Poland). Mechanical Dept.; Sablik, M.J. [Applied Magnetic and Physical Modeling, LLC, San Antonio, TX (United States)

2010-07-01

There are presented results of complementary tests performed for the evaluation of creep damage in austenitic steel grade T321H exploited over 200,000 hours in the secondary superheater part of a power plant boiler. The following techniques have been applied: SEM microscopy, X-ray diffraction, tensile tests, hardness measurements and novel eddy current inspection. The novel eddy current inspection is proposed as a non-destructive method of estimating the creep damage stage of austenite steel boiler tubes after long-term service in power plants. We compare the results provided by the different techniques and discuss the correlations and also point out the problems which need to be addressed in order to elaborate the remaining life assessment of austenitic boiler tubes. (orig.)

Id1 expression promotes peripheral CD4{sup +} T cell proliferation and survival upon TCR activation without co-stimulation

Energy Technology Data Exchange (ETDEWEB)

Liu, Chen; Jin, Rong [Department of Immunology, Peking University Health Science Center, Beijing (China); Wang, Hong-Cheng [Oklahoma Medical Research Foundation, Oklahoma City, OK (United States); Tang, Hui; Liu, Yuan-Feng; Qian, Xiao-Ping; Sun, Xiu-Yuan; Ge, Qing [Department of Immunology, Peking University Health Science Center, Beijing (China); Sun, Xiao-Hong, E-mail: sunx@omrf.org [Oklahoma Medical Research Foundation, Oklahoma City, OK (United States); Zhang, Yu, E-mail: zhangyu007@bjmu.edu.cn [Department of Immunology, Peking University Health Science Center, Beijing (China)

2013-06-21

Highlights: •Id1 expression enables naïve T cell proliferation without anti-CD28 co-stimulation. •Id1 expression facilitates T cells survival when stimulated with anti-CD3. •Elevation of IL-2 production by Id1 contributes increased proliferation and survival. •Id1 potentiates NF-κB activation by anti-CD3 stimulation. -- Abstract: Although the role of E proteins in the thymocyte development is well documented, much less is known about their function in peripheral T cells. Here we demonstrated that CD4 promoter-driven transgenic expression of Id1, a naturally occurring dominant-negative inhibitor of E proteins, can substitute for the co-stimulatory signal delivered by CD28 to facilitate the proliferation and survival of naïve CD4{sup +} cells upon anti-CD3 stimulation. We next discovered that IL-2 production and NF-κB activity after anti-CD3 stimulation were significantly elevated in Id1-expressing cells, which may be, at least in part, responsible for the augmentation of their proliferation and survival. Taken together, results from this study suggest an important role of E and Id proteins in peripheral T cell activation. The ability of Id proteins to by-pass co-stimulatory signals to enable T cell activation has significant implications in regulating T cell immunity.

Thoracostomy tubes: A comprehensive review of complications and related topics

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Kwiatt, Michael; Tarbox, Abigail; Seamon, Mark J.; Swaroop, Mamta; Cipolla, James; Allen, Charles; Hallenbeck, Stacinoel; Davido, H. Tracy; Lindsey, David E.; Doraiswamy, Vijay A.; Galwankar, Sagar; Tulman, David; Latchana, Nicholas; Papadimos, Thomas J.; Cook, Charles H.; Stawicki, Stanislaw P.

2014-01-01

Tube thoracostomy (TT) placement belongs among the most commonly performed procedures. Despite many benefits of TT drainage, potential for significant morbidity and mortality exists. Abdominal or thoracic injury, fistula formation and vascular trauma are among the most serious, but more common complications such as recurrent pneumothorax, insertion site infection and nonfunctioning or malpositioned TT also represent a significant source of morbidity and treatment cost. Awareness of potential complications and familiarity with associated preventive, diagnostic and treatment strategies are fundamental to satisfactory patient outcomes. This review focuses on chest tube complications and related topics, with emphasis on prevention and problem-oriented approaches to diagnosis and treatment. The authors hope that this manuscript will serve as a valuable foundation for those who wish to become adept at the management of chest tubes. PMID:25024942

Mine drainage treatment

OpenAIRE

Golomeova, Mirjana; Zendelska, Afrodita; Krstev, Boris; Golomeov, Blagoj; Krstev, Aleksandar

2012-01-01

Water flowing from underground and surface mines and contains high concentrations of dissolved metals is called mine drainage. Mine drainage can be categorized into several basic types by their alkalinity or acidity. Sulfide rich and carbonate poor materials are expected to produce acidic drainage, and alkaline rich materials, even with significant sulfide concentrations, often produce net alkaline water. Mine drainages are dangerous because pollutants may decompose in the environment. In...

No Effects of Stimulating the Left Ventrolateral Prefrontal Cortex with tDCS on Verbal Working Memory Updating

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Karolina M. Lukasik

2018-01-01

Full Text Available The effects of transcranial direct current stimulation (tDCS on dorsolateral prefrontal cortex functions, such as working memory (WM, have been examined in a number of studies. However, much less is known about the behavioral effects of tDCS over other important WM-related brain regions, such as the ventrolateral prefrontal cortex (VLPFC. In a counterbalanced within-subjects design with 33 young healthy participants, we examined whether online and offline single-session tDCS over VLPFC affects WM updating performance as measured by a digit 3-back task. We compared three conditions: anodal, cathodal and sham. We observed no significant tDCS effects on participants' accuracy or reaction times during or after the stimulation. Neither did we find any differences between anodal and cathodal stimulation. Largely similar results were obtained when comparing subgroups of high- and low-performing participants. Possible reasons for the lack of effects, including individual differences in responsiveness to tDCS, features of montage, task and sample characteristics, and the role of VLPFC in WM, are discussed.

Influence of Anodal Transcranial Direct Current Stimulation (tDCS) over the Right Angular Gyrus on Brain Activity during Rest

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Clemens, Benjamin; Jung, Stefanie; Mingoia, Gianluca; Weyer, David; Domahs, Frank; Willmes, Klaus

2014-01-01

Although numerous studies examined resting-state networks (RSN) in the human brain, so far little is known about how activity within RSN might be modulated by non-invasive brain stimulation applied over parietal cortex. Investigating changes in RSN in response to parietal cortex stimulation might tell us more about how non-invasive techniques such as transcranial direct current stimulation (tDCS) modulate intrinsic brain activity, and further elaborate our understanding of how the resting brain responds to external stimulation. Here we examined how activity within the canonical RSN changed in response to anodal tDCS applied over the right angular gyrus (AG). We hypothesized that changes in resting-state activity can be induced by a single tDCS session and detected with functional magnetic resonance imaging (fMRI). Significant differences between two fMRI sessions (pre-tDCS and post-tDCS) were found in several RSN, including the cerebellar, medial visual, sensorimotor, right frontoparietal, and executive control RSN as well as the default mode and the task positive network. The present results revealed decreased and increased RSN activity following tDCS. Decreased RSN activity following tDCS was found in bilateral primary and secondary visual areas, and in the right putamen. Increased RSN activity following tDCS was widely distributed across the brain, covering thalamic, frontal, parietal and occipital regions. From these exploratory results we conclude that a single session of anodal tDCS over the right AG is sufficient to induce large-scale changes in resting-state activity. These changes were localized in sensory and cognitive areas, covering regions close to and distant from the stimulation site. PMID:24760013

Influence of anodal transcranial direct current stimulation (tDCS) over the right angular gyrus on brain activity during rest.

Science.gov (United States)

Clemens, Benjamin; Jung, Stefanie; Mingoia, Gianluca; Weyer, David; Domahs, Frank; Willmes, Klaus

2014-01-01

Although numerous studies examined resting-state networks (RSN) in the human brain, so far little is known about how activity within RSN might be modulated by non-invasive brain stimulation applied over parietal cortex. Investigating changes in RSN in response to parietal cortex stimulation might tell us more about how non-invasive techniques such as transcranial direct current stimulation (tDCS) modulate intrinsic brain activity, and further elaborate our understanding of how the resting brain responds to external stimulation. Here we examined how activity within the canonical RSN changed in response to anodal tDCS applied over the right angular gyrus (AG). We hypothesized that changes in resting-state activity can be induced by a single tDCS session and detected with functional magnetic resonance imaging (fMRI). Significant differences between two fMRI sessions (pre-tDCS and post-tDCS) were found in several RSN, including the cerebellar, medial visual, sensorimotor, right frontoparietal, and executive control RSN as well as the default mode and the task positive network. The present results revealed decreased and increased RSN activity following tDCS. Decreased RSN activity following tDCS was found in bilateral primary and secondary visual areas, and in the right putamen. Increased RSN activity following tDCS was widely distributed across the brain, covering thalamic, frontal, parietal and occipital regions. From these exploratory results we conclude that a single session of anodal tDCS over the right AG is sufficient to induce large-scale changes in resting-state activity. These changes were localized in sensory and cognitive areas, covering regions close to and distant from the stimulation site.

Drains and Drainage Capabilities: Quantitative Analysis of Drain Efficiencies

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Andaç Aykan

2016-03-01

Full Text Available Objective: In this study, it was aimed to compare the efficiency of the same type of but different-sized silicone drains at different surgical procedures. Material and Methods: Twenty-four patients, who had different diagnoses and were operated between 2011 and 2013, were included. In all patients, 7- and 10-mm silicone-ended, Jackson–Pratt drains were used. Drains that were under 30 cc/day removed. The connection tube and perforated silicone end were examined due to the clot content. All drain efficiencies were calculated, and the results were statistically analyzed. Results: Seven of the 24 patients (29.2% were males and 17 (70.8% were females; the mean age was 39.0±11.4 years. Totally, 49 drains were used, of which 25 (51% were 7 mm and 24 (49% were 10 mm in size. Median removal time was the 5th day (2–12 for the 7-mm drains and the 6th day (3–14 for the 10-mm drains. There was no statistically significant difference between the groups for drain removal time (p=0.268. Further, there was no difference at the connection tube and silicone end for clot content between the 7- and 10-mm drains (p=0.58. For the drainage volume and efficiency, no difference was observed between the groups (p=0.146. Conclusion: In this study it was observed that there is no difference in the drainage volume and efficiency between different-sized Jackson–Pratt drains.

What are the Advantages? A Prospective Analysis of 16 versus 28 French Chest Tube Sizes in Video-assisted Thoracoscopic Surgery Lobectomy of Lung Cancer

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Mei YANG

2015-08-01

Full Text Available Background and objective Post-operation management of minimally invasive thoracic surgery is similar to that of open surgery, especially on the drainage tube of the chest. The aim of this study is to compare the advantages of using 16 F versus 28 F chest tubes in video-assisted thoracoscopic surgery (VATS lobectomy of lung cancer. Methods Data from 163 patients (February-May 2014 who underwent VATS lobectomy of lung cancer with insertion of one chest drain (16 F or 28 F were analyzed. The following post-operative data were evaluated: primary healing of tube incision, CXR abnormalities (pneumothorax, fluid, atelectasis, subcutaneous emphysema, and hematoma, drainage time, new drain insertion, and wound healing at the site of insertion. Results A total of 75 patients received 28 F chest tubes, and 88 patients received 16 F chest tubes. Both groups were similar in age, gender, comorbidities, and pathological evaluation of resection specimens. After adjustment, no statistically significant difference was found between the two groups in relation to tube-related complications including residual pneumothoraces (4.00% vs 4.44%; P=0.999, subcutaneous emphysema (8.00% vs 6.67%; P=0.789, retained hemothorax (0 vs 41%, P=0.253, and drainage time [(28.4±16.12 h vs (22.1±11.8 h; P=0.120] The average total drainage volume and rrhythmia rates of the 16 F group [(365±106 mL, 14.67%] was less than that of the 28 F group [(665±217 mL, 4.5%; P=0.030, P=0.047]. The rates of primary healing at the site of insertion in the 16 F group (95.45% was higher than that in the 28 F group (77.73%, P=0.039. A significant difference was found on the post-operative length of stay of the two groups [(4.23±0.05 d vs (4.57±0.16 d, P=0.078]. Conclusion The use of 16 F chest tube for VATS lobectomy of patients with lung cancer did not affect the clinically relevant outcomes tested. However, 16 F chest tube facilitated faster wound healing at the site of insertion.

The role of CD27-CD70-mediated T cell co-stimulation in vasculogenesis, arteriogenesis and angiogenesis.

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Simons, K H; Aref, Z; Peters, H A B; Welten, S P; Nossent, A Y; Jukema, J W; Hamming, J F; Arens, R; de Vries, M R; Quax, P H A

2018-06-01

T cells have a distinctive role in neovascularization, which consists of arteriogenesis and angiogenesis under pathological conditions and vasculogenesis under physiological conditions. However, the role of co-stimulation in T cell activation in neovascularization has yet to be established. The aim of this study was to investigate the role T cell co-stimulation and inhibition in angiogenesis, arteriogenesis and vasculogenesis. Hind limb ischemia was induced by double ligation of the left femoral artery in mice and blood flow recovery was measured with Laser Doppler Perfusion Imaging in control, CD70 -/- , CD80/86 -/- , CD70/80/86 -/- and CTLA4 +/- mice. Blood flow recovery was significantly impaired in mice lacking CD70 compared to control mice, but was similar in CD80/86 -/- , CTLA4 +/- and control mice. Mice lacking CD70 showed impaired vasculogenesis, since the number of pre-existing collaterals was reduced as observed in the pia mater compared to control mice. In vitro an impaired capability of vascular smooth muscle cells (VSMC) to activate T cells was observed in VSMC lacking CD70. Furthermore, CD70 -/- , CD80/86 -/- and CD70/80/86 -/- mice showed reduced angiogenesis in the soleus muscle 10 days after ligation. Arteriogenesis was also decreased in CD70 -/- compared to control mice 10 and 28 days after surgery. The present study is the first to describe an important role for T cell activation via co-stimulation in angiogenesis, arteriogenesis and vasculogenesis, where the CD27-CD70 T cell co-stimulation pathway appears to be the most important co-stimulation pathway in pre-existing collateral formation and post-ischemic blood flow recovery, by arteriogenesis and angiogenesis. Copyright © 2018 Elsevier B.V. All rights reserved.

Flux tubes at finite temperature

Energy Technology Data Exchange (ETDEWEB)

Cea, Paolo [INFN, Sezione di Bari,Via G. Amendola 173, I-70126 Bari (Italy); Dipartimento di Fisica dell’Università di Bari,Via G. Amendola 173, I-70126 Bari (Italy); Cosmai, Leonardo [INFN, Sezione di Bari,Via G. Amendola 173, I-70126 Bari (Italy); Cuteri, Francesca; Papa, Alessandro [Dipartimento di Fisica, Università della Calabria & INFN-Cosenza,Ponte Bucci, cubo 31C, I-87036 Rende (Cosenza) (Italy)

2016-06-07

The chromoelectric field generated by a static quark-antiquark pair, with its peculiar tube-like shape, can be nicely described, at zero temperature, within the dual superconductor scenario for the QCD confining vacuum. In this work we investigate, by lattice Monte Carlo simulations of the SU(3) pure gauge theory, the fate of chromoelectric flux tubes across the deconfinement transition. We find that, if the distance between the static sources is kept fixed at about 0.76 fm ≃1.6/√σ and the temperature is increased towards and above the deconfinement temperature T{sub c}, the amplitude of the field inside the flux tube gets smaller, while the shape of the flux tube does not vary appreciably across deconfinement. This scenario with flux-tube “evaporation” above T{sub c} has no correspondence in ordinary (type-II) superconductivity, where instead the transition to the phase with normal conductivity is characterized by a divergent fattening of flux tubes as the transition temperature is approached from below. We present also some evidence about the existence of flux-tube structures in the magnetic sector of the theory in the deconfined phase.

Probable causes of damage of heat-exchange tubes of low-pressure-exchanges of PND-3 type and repair methods

Science.gov (United States)

Trifonov, N. N.; Esin, S. B.; Nikolaenkova, E. K.; Sukhorukov, Yu. G.; Svyatkin, F. A.; Sintsova, T. G.; Modestov, V. S.

2017-08-01

The structures of low-pressure heaters (LPH), which are installed at nuclear power plants with the K-1000-60/1500 type turbine plants are considered. It was revealed that only the PND-3 type low-pressure heaters have the damages of the heat exchange tubes. For a short operation life, the number of the damaged heat-exchange tubes of PND-3 is approximately 50 pcs for Kalinin NPP and 100-150 pcs for Balakovo NPP. The low-pressure heaters were manufactured at AO Ural Plant of Chemical Machine-Building "Uralkhimmash," OAO Taganrog Boiler-Making Works "Krasny Kotelshchik," and Vitkovice Machinery Group, but the damage nature of the heat-exchange tubes is identical for all PND-3. The damages occur in the place of passage of the heat exchange tubes through the first, the second, and the third partitions over the lower tube plate (the first path of the turbine condensate). Hydraulic shocks can be one of the possible causes of the damage of the heat-exchange tubes of PND-3. The analysis of the average thermal and dynamic loads of the tube systems of PND-1-PND-4 revealed that PND-3 by the thermal power are loaded 1.4-1.6 times and by the dynamic effects are loaded 1.8-2.0 times more than the remaining LPHs. Another possible cause of damage can be the cascaded drain of the separate into PND-4 and then through the drainage heat exchange into PND-3. An additional factor can be the structure of the condensate drainage unit. The advanced system of the heating steam flow and pumping scheme of the separate drain using the existing drainage pumps of PND-3 for K-1000-60/1500 turbine plants for Balakovo and Kalinin NPPs were proposed. The considered decisions make it possible to reduce the flow rate of the heating steam condensate from PND-3 into PND-4 and the speed of the heating steam in the tube space of PND-3 and eliminate the occurrence of hydraulic shocks and damages of the heat exchanger tubes.

Successful Treatment of Septic Shock due to Spontaneous Esophageal Perforation 96 Hours after Onset by Drainage and Enteral Nutrition

Directory of Open Access Journals (Sweden)

Risako Yamashita

2014-12-01

Full Text Available Spontaneous esophageal perforation is relatively uncommon, but carries a high mortality rate if diagnosis or treatment is delayed. We report the case of a 68-year-old man with spontaneous esophageal perforation who was successfully treated over 96 h after onset by thoracic drainage and jejunostomy for enteral nutrition. He vomited after drinking alcohol, soon followed by epigastralgia. Heart failure was suspected on admission to another hospital. Spontaneous esophageal perforation was diagnosed 48 h after admission. Chest tube drainage was performed, but his general condition deteriorated and he was transferred to our hospital. Emergent surgery was performed and esophageal perforation combined with pyothorax and mediastinitis was identified on the left side of the lower esophagus. The left thoracic cavity was rinsed and thoracic drainage was performed. Feeding jejunostomy was performed for postoperative enteral nutrition. Effective drainage and sufficient nutrition management appear extremely valuable in treating spontaneous esophageal perforation.

Occult pneumothorax in the blunt trauma patient: tube thoracostomy or observation?

Science.gov (United States)

Wilson, Heather; Ellsmere, James; Tallon, John; Kirkpatrick, Andrew

2009-09-01

The term occult pneumothorax (OP) describes a pneumothorax that is not suspected on the basis of either clinical examination or initial chest radiography, but is subsequently detected on computed tomography (CT) scan. The optimal management of OP in the blunt trauma setting remains controversial. Some physicians favour placement of a thoracostomy tube for patients with OP, particularly those undergoing positive pressure ventilation (PPV), while others favour close observation without chest drainage. This study was conducted both to determine the incidence of OP and to describe its current treatment status in the blunt trauma population at a Canadian tertiary trauma centre. Of interest were the rates of tube thoracostomy vs. observation without chest drainage and their respective outcomes. A retrospective review was conducted of the Nova Scotia Trauma Registry. The data on all consecutive blunt trauma patients between October 1994 and March 2003 was reviewed. Outcome measures evaluated include length of stay, discharge status-dead vs. alive, intervention and time to intervention (tube thoracostomy and its relation to institution of PPV). Direct comparison was made between the OP with tube thoracostomy group and OP without tube thoracostomy group (observation or control group). They were compared in terms of their baseline characteristics and outcome measures. In 1881 consecutive blunt trauma patients over a 102-month period there were 307 pneumothoraces of which 68 were occult. Thirty five patients with OP underwent tube thoracostomy, 33 did not. Twenty nine (82.8%) with tube thoracostomy received positive pressure ventilation (PPV), as did 16 (48.4%) in the observation group. Mean injury severity score (ISS) for tube thoracostomy and observation groups were similar (25.80 and 22.39, p=0.101) whereas length of stay (LOS) was different (17.4 and 10.0 days, p=0.026). Mortality was similar (11.4% and 9.1%). There were no tension pneumothoraces. The natural history of

Transcranial Direct Current Stimulation (tDCS) Targeting Left Dorsolateral Prefrontal Cortex Modulates Task-Induced Acute Pain in Healthy Volunteers.

Science.gov (United States)

Mariano, Timothy Y; Van't Wout, Mascha; Garnaat, Sarah L; Rasmussen, Steven A; Greenberg, Benjamin D

2016-04-01

Current chronic pain treatments target nociception rather than affective "suffering" and its associated functional and psychiatric comorbidities. The left dorsolateral prefrontal cortex (DLPFC) has been implicated in affective, cognitive, and attentional aspects of pain and is a primary target of neuromodulation for affective disorders. Transcranial direct current stimulation (tDCS) can non-invasively modulate cortical activity. The present study tests whether anodal tDCS targeting the left DLPFC will increase tolerability of acute painful stimuli vs cathodal tDCS. Forty tDCS-naive healthy volunteers received anodal and cathodal stimulation targeting the left DLPFC in two randomized and counterbalanced sessions. During stimulation, each participant performed cold pressor (CP) and breath holding (BH) tasks. We measured pain intensity with the Defense and Veterans Pain Rating Scale (DVPRS) before and after each task. Mixed ANOVA revealed no main effect of stimulation polarity for mean CP threshold, tolerance, or endurance, or mean BH time (allP > 0.27). However, DVPRS rise associated with CP was significantly smaller with anodal vs cathodal tDCS (P = 0.024). We further observed a significant tDCS polarity × stimulation order interaction (P = 0.042) on CP threshold, suggesting task sensitization. Although our results do not suggest that polarity of tDCS targeting the left DLPFC differentially modulates the tolerability of CP- and BH-related pain distress in healthy volunteers, there was a significant effect on DVPRS pain ratings. This contrasts with our previous findings that tDCS targeting the left dorsal anterior cingulate cortex showed a trend toward higher mean CP tolerance with cathodal vs anodal stimulation. The present results may suggest tDCS-related effects on nociception or DLPFC-mediated attention, or preferential modulation of the affective valence of pain as captured by the DVPRS. Sham-controlled clinical studies are needed. © 2015

Complete subglottic tracheal stenosis managed with rigid bronchoscopy and T-tube placement

Directory of Open Access Journals (Sweden)

Kuruswamy Thurai Prasad

2016-01-01

Full Text Available Surgery is the preferred treatment modality for benign tracheal stenosis. Interventional bronchoscopy is used as a bridge to surgery or in instances when surgery is not feasible or has failed. Stenosis in the subglottic trachea is particularly a treatment challenge, in view of its proximity to the vocal cords. Herein, we describe a patient with complete tracheal stenosis in the subglottic region, which developed after prolonged intubation and mechanical ventilation. The patient developed recurrent stenosis despite multiple surgical and endoscopic procedures. We were able to manage the patient successfully with rigid bronchoscopy and Montgomery T-tube placement.

Simulation of the erosion and drainage development of Loess surface based on GIS

Science.gov (United States)

Wang, Chun; Tang, Guoan; Ge, Shanshan; Li, Zhanbin; Zhou, Jieyu

2006-10-01

The research probes into the temporal-spatial process of drainage development of Loess Plateau on the basis of a carefully designed experiment. In the experiment, the development of a simulated loess watershed is tested under the condition of lab-simulated rainfall. A close-range photogrammetry survey is employed to establish a series of high precision and resolution DEM (Digit Elevation Model) of the simulated loess surface. Based on the established DEM, the erosion loss, the slope distribution, the topographic index , the gully-brink, and the drainage networks are all derived and discussed through comparison analysis and experimental validation. All the efforts aim at revealing the process and mechanism of erosion and drainage development of loess surface .This study demonstrates: 1) the stimulation result can effectively reflect the truth if those experimental conditions, i.e. loess soil structure, simulated rainfall, are adjusted in accord with true situation; 2) the remarkable character of the erosion and drainage up-growth of loess surface include the drainage traced to the source, the increased of the drainage's density, the enlarged of gully, the durative variety of multiple terrain factor's mean value and its distribution, such as slope and topographic index; 3) The slope spectrum is the more felicitous terrain factor for depicting the erosion and drainage development of loess surface, including the rule of erosion and evolution process. It is the new way and mean for studying the loess physiognomy.

Angiopoietin 2 stimulates TIE2-expressing monocytes to suppress T cell activation and to promote regulatory T cell expansion.

Science.gov (United States)

Coffelt, Seth B; Chen, Yung-Yi; Muthana, Munitta; Welford, Abigail F; Tal, Andrea O; Scholz, Alexander; Plate, Karl H; Reiss, Yvonne; Murdoch, Craig; De Palma, Michele; Lewis, Claire E

2011-04-01

Angiopoietin 2 (ANGPT2) is a proangiogenic cytokine whose expression is often upregulated by endothelial cells in tumors. Expression of its receptor, TIE2, defines a highly proangiogenic subpopulation of myeloid cells in circulation and tumors called TIE2-expressing monocytes/macrophages (TEMs). Genetic depletion of TEMs markedly reduces tumor angiogenesis in various tumor models, emphasizing their essential role in driving tumor progression. Previously, we demonstrated that ANGPT2 augments the expression of various proangiogenic genes, the potent immunosuppressive cytokine, IL-10, and a chemokine for regulatory T cells (Tregs), CCL17 by TEMs in vitro. We now show that TEMs also express higher levels of IL-10 than TIE2(-) macrophages in tumors and that ANGPT2-stimulated release of IL-10 by TEMs suppresses T cell proliferation, increases the ratio of CD4(+) T cells to CD8(+) T cells, and promotes the expansion of CD4(+)CD25(high)FOXP3(+) Tregs. Furthermore, syngeneic murine tumors expressing high levels of ANGPT2 contained not only high numbers of TEMs but also increased numbers of Tregs, whereas genetic depletion of tumor TEMs resulted in a marked reduction in the frequency of Tregs in tumors. Taken together, our data suggest that ANGPT2-stimulated TEMs represent a novel, potent immunosuppressive force in tumors.

A Systematic Review and Meta-Analysis of the Effects of Transcranial Direct Current Stimulation (tDCS) Over the Dorsolateral Prefrontal Cortex in Healthy and Neuropsychiatric Samples: Influence of Stimulation Parameters.

Science.gov (United States)

Dedoncker, Josefien; Brunoni, Andre R; Baeken, Chris; Vanderhasselt, Marie-Anne

2016-01-01

Research into the effects of transcranial direct current stimulation of the dorsolateral prefrontal cortex on cognitive functioning is increasing rapidly. However, methodological heterogeneity in prefrontal tDCS research is also increasing, particularly in technical stimulation parameters that might influence tDCS effects. To systematically examine the influence of technical stimulation parameters on DLPFC-tDCS effects. We performed a systematic review and meta-analysis of tDCS studies targeting the DLPFC published from the first data available to February 2016. Only single-session, sham-controlled, within-subject studies reporting the effects of tDCS on cognition in healthy controls and neuropsychiatric patients were included. Evaluation of 61 studies showed that after single-session a-tDCS, but not c-tDCS, participants responded faster and more accurately on cognitive tasks. Sub-analyses specified that following a-tDCS, healthy subjects responded faster, while neuropsychiatric patients responded more accurately. Importantly, different stimulation parameters affected a-tDCS effects, but not c-tDCS effects, on accuracy in healthy samples vs. increased current density and density charge resulted in improved accuracy in healthy samples, most prominently in females; for neuropsychiatric patients, task performance during a-tDCS resulted in stronger increases in accuracy rates compared to task performance following a-tDCS. Healthy participants respond faster, but not more accurate on cognitive tasks after a-tDCS. However, increasing the current density and/or charge might be able to enhance response accuracy, particularly in females. In contrast, online task performance leads to greater increases in response accuracy than offline task performance in neuropsychiatric patients. Possible implications and practical recommendations are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

New light sources on the basis of electromagnetic shock T and H tubes

International Nuclear Information System (INIS)

Basov, Yu. G.; Sereda, N.I.; Skvortsov, B.V.; Sysun, V.V.

Experimental investigation of plasma light emission was carried out on electromagnetic shock tubes filled with xenon to initial pressure of 10-100 mm Hg. T - and H- discharge devices were connected to the low-inductive discharge circuit (C=12 μF, L=0.43 μH, U=10 - 30 kV). The discharge growth was observed with a high-speed photorecorder. In the course of the investigation lighting parameters of the devices were measured as a function of xenon initial pressure and discharge energy

Effect of irradiation on human T-cell proliferation: low dose irradiation stimulates mitogen-induced proliferation and function of the suppressor/cytotoxic T-cell subset

International Nuclear Information System (INIS)

Gualde, N.; Goodwin, J.S.

1984-01-01

Unfractionated human T cells exposed to 10-50 rad of X irradiation incorporated less [ 3 H]thymidine than nonirradiated T cells when subsequently cultured with PHA or Con A. The cytotoxic/suppressor T-cell subset, isolated as either OKT8(+) or OKT4(-) cells, demonstrated significantly enhanced [ 3 H]thymidine incorporation in PHA- or Con A-stimulated cultures after exposure to 10-50 rad, compared to unirradiated cells, while the proliferation of the OKT4(+) helper/inducer subset was inhibited by low dose irradiation. It has been previously reported that approximately 30% of the cytotoxic/suppressor subset also stains with OKM1. When the cytotoxic/suppressor subset was further subdivided into OKT4(-), OKM1(+), and OKT4(-), OKM1(-) cells, proliferation of the OKT4(-), OKM1(+) population was inhibited by exposure to 25 rad while proliferation of the OKT4(-), OKM1(-) population was stimulated. The increase in proliferation of the cytotoxic/suppressor T-cell subset after low dose irradiation is paralleled by an increase in suppressor activity of these cells. T cells exposed to 25 rad and then cultured with Con A for 48 hr caused greater inhibition of IgG production when added to fresh autologous lymphocytes stimulated by pokeweed mitogen than did unirradiated cells. Thus, low dose irradiation enhances both the proliferation and function of the human suppressor T-cell subset

tDCS Stimulation of the dlPFC Selectively Moderates the Detrimental Impact of Emotion on Analytical Reasoning.

Science.gov (United States)

Trémolière, Bastien; Maheux-Caron, Véronique; Lepage, Jean-François; Blanchette, Isabelle

2018-01-01

There is evidence of a detrimental effect of emotion on reasoning. Recent studies suggest that this relationship is mediated by working memory, a function closely associated with the dorsolateral prefrontal cortex (dlPFC). Relying on transcranial direct current stimulation (tDCS), the present research explores the possibility that anodal stimulation of the dlPFC has the potential to prevent the effect of emotion on analytical reasoning. Thirty-four participants took part in a lab experiment and were tested twice: one session using offline anodal stimulation (with a 2 mA current stimulation applied to the left dlPFC for 20 min), one session using a control (sham) stimulation. In each session, participants solved syllogistic reasoning problems featuring neutral and emotionally negative contents. Results showed that anodal stimulation diminished the deleterious effect of emotion on syllogistic reasoning, but only for a subclass of problems: problems where the conclusion was logically valid. We discuss our results in the light of the reasoning literature as well as the apparent variability of tDCS effects.

Inter-observer reproducibility in reporting on renal drainage in children with hydronephrosis: a large collaborative study

International Nuclear Information System (INIS)

Tondeur, Marianne; Piepsz, Amy; De Palma, Diego; Roca, Isabel; Ham, Hamphrey

2008-01-01

The goal of this study was to evaluate the inter-observer reproducibility in reporting on renal drainage obtained during 99m Tc MAG3 renography in children, when already processed data are offered to the observers. Because web site facilities were used for communication, 57 observers from five continents participated in the study. Twenty-three renograms, including furosemide stimulation and posterect postmicturition views, covering various patterns of drainage, were submitted to the observers. Images, curves and quantitative parameters were provided. Good or almost good drainage, partial drainage and poor or no drainage were the three possible responses for each kidney. An important bias was observed among the observers, some of them more systematically reporting the drainage as being good, while others had a general tendency to consider the drainage as poor. This resulted in rather poor inter-observer reproducibility, as for more than half of the kidneys, less than 80% of the observers agreed on one of the three responses. Analysis of the individual cases identified some obvious causes of discrepancy: the absence of a clear limit between partial and good or almost good drainage, the fact of including or neglecting the effect of micturition and change of patient's position, the underestimation of drainage in the case of a flat renographic curve, and the difficulties of interpretation in the case of a small, not well functioning kidney. There is an urgent need for better standardisation in estimating the quality of drainage. (orig.)

Inter-observer reproducibility in reporting on renal drainage in children with hydronephrosis: a large collaborative study

Energy Technology Data Exchange (ETDEWEB)

Tondeur, Marianne; Piepsz, Amy [CHU Saint-Pierre, Departement des Radio-Isotopes, Brussels (Belgium); De Palma, Diego [Ospedale di Circolo, Nuclear Medicine, Varese (Italy); Roca, Isabel [Vall d' Hebron Hospital, Nuclear Medicine, Barcelona (Spain); Ham, Hamphrey [University Hospital, Department Nuclear Medicine, Ghent (Belgium)

2008-03-15

The goal of this study was to evaluate the inter-observer reproducibility in reporting on renal drainage obtained during {sup 99m}Tc MAG3 renography in children, when already processed data are offered to the observers. Because web site facilities were used for communication, 57 observers from five continents participated in the study. Twenty-three renograms, including furosemide stimulation and posterect postmicturition views, covering various patterns of drainage, were submitted to the observers. Images, curves and quantitative parameters were provided. Good or almost good drainage, partial drainage and poor or no drainage were the three possible responses for each kidney. An important bias was observed among the observers, some of them more systematically reporting the drainage as being good, while others had a general tendency to consider the drainage as poor. This resulted in rather poor inter-observer reproducibility, as for more than half of the kidneys, less than 80% of the observers agreed on one of the three responses. Analysis of the individual cases identified some obvious causes of discrepancy: the absence of a clear limit between partial and good or almost good drainage, the fact of including or neglecting the effect of micturition and change of patient's position, the underestimation of drainage in the case of a flat renographic curve, and the difficulties of interpretation in the case of a small, not well functioning kidney. There is an urgent need for better standardisation in estimating the quality of drainage. (orig.)

WATER DRAINAGE MODEL

International Nuclear Information System (INIS)

Case, J.B.

2000-01-01

The drainage of water from the emplacement drift is essential for the performance of the EBS. The unsaturated flow properties of the surrounding rock matrix and fractures determine how well the water will be naturally drained. To enhance natural drainage, it may be necessary to introduce engineered drainage features (e.g. drilled holes in the drifts), that will ensure communication of the flow into the fracture system. The purpose of the Water Drainage Model is to quantify and evaluate the capability of the drift to remove water naturally, using the selected conceptual repository design as a basis (CRWMS M andO, 1999d). The analysis will provide input to the Water Distribution and Removal Model of the EBS. The model is intended to be used to provide postclosure analysis of temperatures and drainage from the EBS. It has been determined that drainage from the EBS is a factor important to the postclosure safety case

TCR stimulation strength is inversely associated with establishment of functional brain-resident memory CD8 T cells during persistent viral infection.

Science.gov (United States)

Maru, Saumya; Jin, Ge; Schell, Todd D; Lukacher, Aron E

2017-04-01

Establishing functional tissue-resident memory (TRM) cells at sites of infection is a newfound objective of T cell vaccine design. To directly assess the impact of antigen stimulation strength on memory CD8 T cell formation and function during a persistent viral infection, we created a library of mouse polyomavirus (MuPyV) variants with substitutions in a subdominant CD8 T cell epitope that exhibit a broad range of efficiency in stimulating TCR transgenic CD8 T cells. By altering a subdominant epitope in a nonstructural viral protein and monitoring memory differentiation of donor monoclonal CD8 T cells in immunocompetent mice, we circumvented potentially confounding changes in viral infection levels, virus-associated inflammation, size of the immunodominant virus-specific CD8 T cell response, and shifts in TCR affinity that may accompany temporal recruitment of endogenous polyclonal cells. Using this strategy, we found that antigen stimulation strength was inversely associated with the function of memory CD8 T cells during a persistent viral infection. We further show that CD8 TRM cells recruited to the brain following systemic infection with viruses expressing epitopes with suboptimal stimulation strength respond more efficiently to challenge CNS infection with virus expressing cognate antigen. These data demonstrate that the strength of antigenic stimulation during recruitment of CD8 T cells influences the functional integrity of TRM cells in a persistent viral infection.

Amylase, lipase, and volume of drainage fluid in gastrectomy for the early detection of complications caused by pancreatic leakage.

Science.gov (United States)

Seo, Kyung Won; Yoon, Ki Young; Lee, Sang Ho; Shin, Yeon Myung; Choi, Kyung Hyun; Hwang, Hyun Yong

2011-12-01

Pancreatic leakage is a serious complication of gastrectomy due to stomach cancer. Therefore, we analyzed amylase and lipase concentrations in blood and drainage fluid, and evaluated the volume of drainage fluid to discern their usefulness as markers for the early detection of serious pancreatic leakage requiring reoperation after gastrectomy. From January 2001 to December 2007, we retrospectively analyzed data from 24,072 patient samples. We divided patients into two groups; 1) complications with pancreatic leakage (CG), and 2) no complications associated with pancreatic leakage (NCG). Values of amylase and lipase in the blood and drainage fluid, volume of the drainage fluid, and relationships among the volumes, amylase values, and lipase values in the drainage fluid were evaluated, respectively in the two groups. The mean amylase values of CG were significantly higher than those of NCG in blood and drainage fluid (P < 0.05). For lipase, statistically significant differences were observed in drainage fluid (P < 0.05). The mean volume (standard deviation) of the drained fluid through the tube between CG (n = 22) and NCG (n = 236) on postoperative day 1 were 368.41 (266.25) and 299.26 (300.28), respectively. There were no statistically significant differences between the groups (P = 0.298). There was a correlation between the amylase and lipase values in the drainage fluid (r = 0.812, P = 0.000). Among postoperative amylase and lipase values in blood and drainage fluid, and the volume of drainage fluid, the amylase in drainage fluid was better differentiated between CG and NCG than other markers. The volume of the drainage fluid did not differ significantly between groups.

The effects of pleural fluid drainage on respiratory function in mechanically ventilated patients after cardiac surgery.

Science.gov (United States)

Brims, Fraser J H; Davies, Michael G; Elia, Andy; Griffiths, Mark J D

2015-01-01

Pleural effusions occur commonly after cardiac surgery and the effects of drainage on gas exchange in this population are not well established. We examined pulmonary function indices following drainage of pleural effusions in cardiac surgery patients. We performed a retrospective study examining the effects of pleural fluid drainage on the lung function indices of patients recovering from cardiac surgery requiring mechanical ventilation for more than 7 days. We specifically analysed patients who had pleural fluid removed via an intercostal tube (ICT: drain group) compared with those of a control group (no effusion, no ICT). In the drain group, 52 ICTs were sited in 45 patients. The mean (SD) volume of fluid drained was 1180 (634) mL. Indices of oxygenation were significantly worse in the drain group compared with controls prior to drainage. The arterial oxygen tension (PaO2)/fractional inspired oxygen (FiO2) (P/F) ratio improved on day 1 after ICT placement (mean (SD), day 0: 31.01 (8.92) vs 37.18 (10.7); pdrain group patients were more likely to have an improved mode of ventilation on day 1 compared with controls (p=0.028). Pleural effusion after cardiac surgery may impair oxygenation. Drainage of pleural fluid is associated with a rapid and sustained improvement in oxygenation.

Dorsal periaqueductal gray stimulation facilitates anxiety-, but not panic-related, defensive responses in rats tested in the elevated T-maze

International Nuclear Information System (INIS)

Camplesi, M. Jr.; Bortoli, V.C. de; Paula Soares, V. de; Nogueira, R.L.; Zangrossi, H. Jr.

2012-01-01

The escape response to electrical or chemical stimulation of the dorsal periaqueductal gray matter (DPAG) has been associated with panic attacks. In order to explore the validity of the DPAG stimulation model for the study of panic disorder, we determined if the aversive consequences of the electrical or chemical stimulation of this midbrain area can be detected subsequently in the elevated T-maze. This animal model, derived from the elevated plus-maze, permits the measurement in the same rat of a generalized anxiety- and a panic-related defensive response, i.e., inhibitory avoidance and escape, respectively. Facilitation of inhibitory avoidance, suggesting an anxiogenic effect, was detected in male Wistar rats (200-220 g) tested in the elevated T-maze 30 min after DPAG electrical stimulation (current generated by a sine-wave stimulator, frequency at 60 Hz) or after local microinjection of the GABA A receptor antagonist bicuculline (5 pmol). Previous electrical (5, 15, 30 min, or 24 h before testing) or chemical stimulation of this midbrain area did not affect escape performance in the elevated T-maze or locomotion in an open-field. No change in the two behavioral tasks measured by the elevated T-maze was observed after repetitive (3 trials) electrical stimulation of the DPAG. The results indicate that activation of the DPAG caused a short-lived, but selective, increase in defensive behaviors associated with generalized anxiety

Dorsal periaqueductal gray stimulation facilitates anxiety-, but not panic-related, defensive responses in rats tested in the elevated T-maze

Energy Technology Data Exchange (ETDEWEB)

Camplesi, M. Jr. [Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, GO (Brazil); Bortoli, V.C. de [Departamento de Ciências da Saúde, Centro Universitário Norte do Espírito Santo, Universidade Federal do Espírito Santo, São Mateus, ES (Brazil); Paula Soares, V. de [Departamento de Biofísica e Farmacologia, Centro de Biociências, Universidade Federal do Rio Grande do Norte, Natal, RN (Brazil); Nogueira, R.L. [Laboratório de Psicologia Comparada, Universidade Estácio de Sá, Rio de Janeiro, RJ (Brazil); Zangrossi, H. Jr. [Departamento de Farmacologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil)

2012-08-03

The escape response to electrical or chemical stimulation of the dorsal periaqueductal gray matter (DPAG) has been associated with panic attacks. In order to explore the validity of the DPAG stimulation model for the study of panic disorder, we determined if the aversive consequences of the electrical or chemical stimulation of this midbrain area can be detected subsequently in the elevated T-maze. This animal model, derived from the elevated plus-maze, permits the measurement in the same rat of a generalized anxiety- and a panic-related defensive response, i.e., inhibitory avoidance and escape, respectively. Facilitation of inhibitory avoidance, suggesting an anxiogenic effect, was detected in male Wistar rats (200-220 g) tested in the elevated T-maze 30 min after DPAG electrical stimulation (current generated by a sine-wave stimulator, frequency at 60 Hz) or after local microinjection of the GABA{sub A} receptor antagonist bicuculline (5 pmol). Previous electrical (5, 15, 30 min, or 24 h before testing) or chemical stimulation of this midbrain area did not affect escape performance in the elevated T-maze or locomotion in an open-field. No change in the two behavioral tasks measured by the elevated T-maze was observed after repetitive (3 trials) electrical stimulation of the DPAG. The results indicate that activation of the DPAG caused a short-lived, but selective, increase in defensive behaviors associated with generalized anxiety.

Optimization of SAGD wellbore completions : short production tubing string sensitivities

Energy Technology Data Exchange (ETDEWEB)

Cokar, M.; Graham, J. [Society of Petroleum Engineers, Canadian Section, Calgary, AB (Canada)]|[Petro-Canada, Calgary, AB (Canada)

2008-10-15

This study investigated the effects of changing the landing position of short production tubing strings near the heel of steam assisted gravity drainage (SAGD) production wells. A homogenous discretized wellbore model was used to model the reservoir and wellbore simultaneously in order to study wellbore and reservoir interactions. The aim of the study was to develop a method of optimizing bitumen production and determining the most economical position for wellbore strings. Simulations were conducted to examine the effect of shortening the production tubing string and examine the impact of extending the tubing string beyond the heel of the well on bitumen bitumen production rates and the steam oil ratio (SOR). Results of the study showed that a shortened string decreased bitumen production rates, while the amounts of steam produced through the tubing string increased. When the tubing string was extended past the heel of the well, bitumen production rates remained the same, but steam injection rates and SOR decreased. A lower pressure differential between the injector and producer wells was also observed. The study showed that SAGD producers can re-position production tubing strings in order to determine ratios of liquid production. It was concluded that although placing the short production tubing string close to the heel increased oil production, a longer tubing string improved production rates while lowering operating costs. 3 refs., 3 tabs., 35 figs.

Food craving, food choice and consumption: The role of impulsivity and sham-controlled tDCS stimulation of the right dlPFC.

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Georgii, Claudio; Goldhofer, Philipp; Meule, Adrian; Richard, Anna; Blechert, Jens

2017-08-01

Impulsivity has been found to be associated with overeating and obesity. Transcranial direct current stimulation (tDCS) may enhance inhibitory control while reducing food craving and intake. Thus, the aim of the present study was to investigate whether tDCS stimulation modifies food choice, craving and consumption as a function of trait impulsivity. Forty-two predominantly healthy-weight women received active tDCS stimulation to the right dorsolateral prefrontal cortex and sham stimulation in a within participant design. Trait impulsivity was measured with a short form of the Barratt Impulsiveness Scale. Participants completed a computerized food-choice task, during which their mouse movements were traced. Current food craving was measured by a modified version of the Food Cravings Questionnaire-State as well as by desire to eat ratings for food pictures. Food intake was measured in a taste test. There were no tDCS effects on any of the dependent variables. Trait impulsivity (and non-planning impulsivity in particular) was positively associated with higher calorie intake in the taste test, irrespective of tDCS stimulation. The current findings question the efficacy of single-session tDCS stimulation of the right dLPFC to reduce food craving, high caloric food choice and calorie intake in non-selected, predominantly healthy weight women. However, they do support the idea that trait impulsivity is related to overeating and, therefore, may be a risk factor for obesity. Future research needs to specify which appetitive behaviors can be modulated by brain stimulation and which populations might profit from it the most. Copyright © 2017 Elsevier Inc. All rights reserved.

Pelvic drainage during removal of dialysis catheter decreases the risk of subsequent intra-abdominal complications in refractory peritoneal dialysis-related peritonitis.

Science.gov (United States)

Hsu, Chih-Yang; Huang, Wei-Chieh; Huang, Chun-Kai; Huang, Chien-Wei; Chou, Nan-Hua; Lee, Po-Tsang; Fang, Hua-Chang; Chou, Kang-Ju; Chen, Chien-Liang

2015-11-01

Some patients with refractory peritoneal dialysis-related peritonitis continue to develop intra-abdominal complications despite removal of the peritoneal catheter. Repeated percutaneous drainage or open laparotomy is often required, and mortality is not uncommon. The benefits of pelvic drainage placement during catheter removal in decreasing these complications and interventions remain unproven. Forty-six patients with refractory peritonitis who underwent removal of a Tenckhoff catheter between 1991 and 2013 were reviewed retrospectively. Twelve patients had pelvic drainage using closed active suction devices during catheter removal (drainage group). The remaining 34 patients underwent catheter removal without drainage (non-drainage group). The outcomes measured were the development of intra-abdominal complications and the requirement for repeated percutaneous drainage or open laparotomy within 90 days after the catheter removal. Baseline characteristics were similar with the exception of a higher median number of previous peritonitis episodes in the drainage group compared with the non-drainage group (2 vs 0, P = 0.02). During the follow-up period, intra-abdominal complications occurred in 15 (44%) of 34 patients in the non-drainage group, compared with one (8%) of 12 patients in the drainage group (P = 0.03). Twelve (35%) patients in the non-drainage group required repeated percutaneous drainage or open laparotomy for management, compared with zero (0%) patients in the drainage group (P = 0.02). Drain tubes were removed at a median of 6 days (inter-quartile range: 5-10) without complications. In the management of refractory peritonitis, pelvic drainage during removal of dialysis catheter decreases the risk of subsequent intra-abdominal complications and invasive interventions. © 2015 Asian Pacific Society of Nephrology.

Phase I clinical trial of fibronectin CH296-stimulated T cell therapy in patients with advanced cancer.

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Takeshi Ishikawa

Full Text Available BACKGROUND: Previous studies have demonstrated that less-differentiated T cells are ideal for adoptive T cell transfer therapy (ACT and that fibronectin CH296 (FN-CH296 together with anti-CD3 resulted in cultured cells that contain higher amounts of less-differentiated T cells. In this phase I clinical trial, we build on these prior results by assessing the safety and efficacy of FN-CH296 stimulated T cell therapy in patients with advanced cancer. METHODS: Patients underwent fibronectin CH296-stimulated T cell therapy up to six times every two weeks and the safety and antitumor activity of the ACT were assessed. In order to determine immune function, whole blood cytokine levels and the number of peripheral regulatory T cells were analyzed prior to ACT and during the follow up. RESULTS: Transferred cells contained numerous less-differentiated T cells greatly represented by CD27+CD45RA+ or CD28+CD45RA+ cell, which accounted for approximately 65% and 70% of the total, respectively. No ACT related severe or unexpected toxicities were observed. The response rate among patients was 22.2% and the disease control rate was 66.7%. CONCLUSIONS: The results obtained in this phase I trial, indicate that FN-CH296 stimulated T cell therapy was very well tolerated with a level of efficacy that is quite promising. We also surmise that expanding T cell using CH296 is a method that can be applied to other T- cell-based therapies. TRIAL REGISTRATION: UMIN UMIN000001835.

Remotely-Supervised Transcranial Direct Current Stimulation (tDCS for Clinical Trials: Guidelines for Technology and Protocols

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Leigh E Charvet

2015-03-01

Full Text Available The effect of transcranial direct current stimulation (tDCS is cumulative. Treatment protocols typically require multiple consecutive sessions spanning weeks or months. However, traveling to clinic for a tDCS session can present an obstacle to subjects and their caregivers. With modified devices and headgear, tDCS treatment can be administered remotely under clinical supervision, potentially enhancing recruitment, throughput, and convenience. Here we propose standards and protocols for clinical trials utilizing remotely-supervised tDCS with the goal of providing safe, reproducible and well-tolerated stimulation therapy outside of the clinic. The recommendations include: 1 training of staff in tDCS treatment and supervision, 2 assessment of the user’s capability to participate in tDCS remotely, 3 ongoing training procedures and materials including assessments of the user and/or caregiver, 4 simple and fail-safe electrode preparation techniques and tDCS headgear, 5 strict dose control for each session, 6 ongoing monitoring to quantify compliance (device preparation, electrode saturation/placement, stimulation protocol, with corresponding corrective steps as required, 7 monitoring for treatment-emergent adverse effects, 8 guidelines for discontinuation of a session and/or study participation including emergency failsafe procedures tailored to the treatment population’s level of need. These guidelines are intended to provide a minimal level of methodological rigor for clinical trials seeking to apply tDCS outside a specialized treatment center. We outline indication-specific applications (Attention Deficit Hyperactivity Disorder, Depression, Multiple Sclerosis, Palliative Care following these recommendations that support a standardized framework for evaluating the tolerability and reproducibility of remote-supervised tDCS that, once established, will allow for translation of tDCS clinical trials to a greater size and range of patient populations.

MDCT quantification is the dominant parameter in decision–making regarding chest tube drainage for stable patients with traumatic pneumothorax

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Cai, Wenli; Lee, June-Goo; Fikry, Karim; Yoshida, Hiroyuki; Novelline, Robert; de Moya, Marc

2013-01-01

It is commonly believed that the size of a pneumothorax is an important determinant of treatment decision, in particular regarding whether chest tube drainage (CTD) is required. However, the volumetric quantification of pneumothoraces has not routinely been performed in clinics. In this paper, we introduced an automated computer-aided volumetry (CAV) scheme for quantification of volume of pneumothoraces in chest multi-detect CT (MDCT) images. Moreover, we investigated the impact of accurate volume of pneumothoraces in the improvement of the performance in decision-making regarding CTD in the management of traumatic pneumothoraces. For this purpose, an occurrence frequency map was calculated for quantitative analysis of the importance of each clinical parameter in the decision-making regarding CTD by a computer simulation of decision-making using a genetic algorithm (GA) and a support vector machine (SVM). A total of 14 clinical parameters, including volume of pneumothorax calculated by our CAV scheme, was collected as parameters available for decision-making. The results showed that volume was the dominant parameter in decision-making regarding CTD, with an occurrence frequency value of 1.00. The results also indicated that the inclusion of volume provided the best performance that was statistically significant compared to the other tests in which volume was excluded from the clinical parameters. This study provides the scientific evidence for the application of CAV scheme in MDCT volumetric quantification of pneumothoraces in the management of clinically stable chest trauma patients with traumatic pneumothorax. PMID:22560899

The use of irradiated corneal patch grafts in pediatric Ahmed drainage implant surgery.

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Nolan, Kaitlyn Wallace; Lucas, Jordyn; Abbasian, Javaneh

2015-10-01

To describe the use of irradiated cornea for scleral reinforcement in Ahmed glaucoma valve drainage implant (AGV) devices in children. The medical records of patients endophthalmitis, and tube/plate self-explantation. A total of 25 procedures (20 patients) met inclusion criteria. Average patient age was 70 months (range, 2 months to 17 years). Mean follow-up was 24.8 months (range, 6 months to 6.2 years). One tube experienced conjunctival exposure through two separate corneal grafts (2/25 cases [8%]), sequentially in the same eye. The first event occurred at month 3.5 after primary implantation of the tube shunt; the second erosion occurred following revision of the existing implant at month 1.5 postoperatively. There were 2 cases of auto-explantation, 2 cases of wound dehiscence, and 1 case of persistent inflammation. There were no cases of endophthalmitis or other infections. To our knowledge, this is the first report describing the use of corneal patch grafts in children. Irradiated cornea improves cosmesis and enhances visualization of the tube. The risk of tube exposure was found to be low and comparable to other materials used as a patch graft. Copyright © 2015 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Transcutaneous vagus nerve stimulation (tVNS) enhances recognition of emotions in faces but not bodies.

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Sellaro, Roberta; de Gelder, Beatrice; Finisguerra, Alessandra; Colzato, Lorenza S

2018-02-01

The polyvagal theory suggests that the vagus nerve is the key phylogenetic substrate enabling optimal social interactions, a crucial aspect of which is emotion recognition. A previous study showed that the vagus nerve plays a causal role in mediating people's ability to recognize emotions based on images of the eye region. The aim of this study is to verify whether the previously reported causal link between vagal activity and emotion recognition can be generalized to situations in which emotions must be inferred from images of whole faces and bodies. To this end, we employed transcutaneous vagus nerve stimulation (tVNS), a novel non-invasive brain stimulation technique that causes the vagus nerve to fire by the application of a mild electrical stimulation to the auricular branch of the vagus nerve, located in the anterior protuberance of the outer ear. In two separate sessions, participants received active or sham tVNS before and while performing two emotion recognition tasks, aimed at indexing their ability to recognize emotions from facial and bodily expressions. Active tVNS, compared to sham stimulation, enhanced emotion recognition for whole faces but not for bodies. Our results confirm and further extend recent observations supporting a causal relationship between vagus nerve activity and the ability to infer others' emotional state, but restrict this association to situations in which the emotional state is conveyed by the whole face and/or by salient facial cues, such as eyes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Ward-based, nurse-led, outpatient chest tube management: analysis of impact, cost-effectiveness and patient safety.

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Tcherveniakov, Peter; De Siqueira, Jonathan; Milton, Richard; Papagiannopoulos, Kostas

2012-06-01

Prolonged drainage and air leaks are recognized complications of elective and acute thoracic surgery and carry significant burden on inpatient stay and outpatient resources. Since 2007, we have run a ward-based, nurse-led clinic for patients discharged with a chest drain in situ. The aim of this study is to assess its cost-effectiveness and safety. We present a retrospective review of the activity of the clinic for a period of 12 months (November 2009-10). An analysis of the gathered data is performed, focusing specifically on the duration of chest tube indwelling, the indications, complications and cost efficiency. The nurse-led clinic was housed in the thoracic ward with no additional fixed costs. Seventy-four patients were reviewed (53 males, 21 females, mean age of 59) and subsequently discharged from the clinic in this time period, accounting for 149 care episodes. Thirty-three (45%) of the patients underwent a video-assisted thoracoscopic surgery procedure, 35 (47%) of them a thoracotomy and 7 (9%) had a bedside chest tube insertion. Following hospital discharge, the chest tubes were removed after a median of 14 days (range 1-82 days). Fifty-eight percent of the patients were reviewed because of a prolonged air leak, 26% for persistent fluid drainage and 16% due to prolonged drainage following evacuation of empyemas. For the care episodes analysed, we estimate that the clinic has generated an income of €24,899 for the department. Hourly staffing costs for the service are significantly lower compared with those of the traditional outpatient clinic: €15 vs. €114. Our results show that a dedicated chest tube monitoring clinic is a safe and efficient alternative to formal outpatient clinic review. It can lead to shorter hospital stays and is cost effective.

Morphological and functional MR imaging of the pharyngotympanic tube

International Nuclear Information System (INIS)

Krombach, G.A.; Nolte-Ernsting, C.; Schmitz-Rode, T.; Guenther, R.W.; Di Martino, E.; Westhofen, M.; Prescher, A.

2000-01-01

Purpose: To develop and evaluate a protocol for the anatomic depiction and functional testing of the auditory tube with the use of MR imaging. Methods: Eleven volunteers were included into this study. For the morphological assessment, the imaging protocol included axial and coronal T 2 -weighted turbo-spin echo sequences (T R /T E =3194/100 ms) and a T 1 -weighted gradient echo sequence (T R /T E =42/4.6 ms). For the functional test a dynamic turbo-gradient echo sequence (TFE) with spectral fat suppression (T R /T E =15/6,2 ms; 4 sec) was obtained using the single slice technique before and during the Valsalva manoeuvre. Results: With multi-slice sequences, the osseous part of the auditory tube, the tubal cartilage (middle and lateral lamina), the ciliated epithelium, Ostmann's adipose body and the levator and tensor veli palatini muscles were delineated in all cases. During the Valsalva test, opening of the auditory tube was demonstrated in 20 of the 22 investigated sides using the dynamic TFE single slice sequence. Conclusions: The introduced MRI protocol allow visualization of the opening of the auditory tube and provides detailed anatomical information of the nasopharynx. Comprehensive morphological and functional evaluation of the auditory tube becomes possible within a single examination. (orig.) [de

Controlling the Anchoring Effect through Transcranial Direct Current Stimulation (tDCS to the Right Dorsolateral Prefrontal Cortex

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Jianbiao Li

2017-06-01

Full Text Available Selective accessibility mechanisms indicate that anchoring effects are results of selective retrieval of working memory. Neuroimaging studies have revealed that the right dorsolateral prefrontal cortex (DLPFC is closely related to memory retrieval and performance. However, no research has investigated the effect of changing the cortical excitability in right DLPFC on anchoring effects. Transcranial direct current stimulation (tDCS can modulate the excitability of the human cerebral cortex, while anodal and cathodal tDCS are postulated to increase or decrease cortical activity, respectively. In this study, we used tDCS to investigate whether effects of increased or decreased right DLPFC excitability influence anchoring effects in willingness to pay (WTP experiments. Ninety participants were first randomly assigned to receive either anodal, cathodal, or sham stimulation of 15 min, then they performed a valuation task regarding WTP. The results showed that anchoring effects were negatively related to activities of right DLPFC: the anodal stimulation diminished anchoring effects while the cathodal stimulation increased anchoring effects. These outcomes provide one of the first instances of neural evidence for the role of the right DLPFC in anchoring effects and support psychological explanations of the selective accessibility mechanisms and cognitive sets.

Nitrate concentration-drainage flow (C-Q) relationship for a drained agricultural field in Eastern North Carolina Plain

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Liu, W.; Youssef, M.; Birgand, F.; Chescheir, G. M.; Maxwell, B.; Tian, S.

2017-12-01

Agricultural drainage is a practice used to artificially enhance drainage characteristics of naturally poorly drained soils via subsurface drain tubing or open-ditch systems. Approximately 25% of the U.S. agricultural land requires improved drainage for economic crop production. However, drainage increases the transport of dissolved agricultural chemicals, particularly nitrates to downstream surface waters. Nutrient export from artificially drained agricultural landscapes has been identified as the leading source of elevated nutrient levels in major surface water bodies in the U.S. Controlled drainage has long been practiced to reduce nitrogen export from agricultural fields to downstream receiving waters. It has been hypothesized that controlled drainage reduces nitrogen losses by promoting denitrification, reducing drainage outflow from the field, and increasing plant uptake. The documented performance of the practice was widely variable as it depends on several site-specific factors. The goal of this research was to utilize high frequency measurements to investigate the effect of agricultural drainage and related management practices on nitrate fate and transport for an artificially drained agricultural field in eastern North Carolina. We deployed a field spectrophotometer to measure nitrate concentration every 45 minutes and measured drainage flow rate using a V-notch weir every 15 minutes. Furthermore, we measured groundwater level, precipitation, irrigation amount, temperature to characterize antecedent conditions for each event. Nitrate concentration-drainage flow (C-Q) relationships generated from the high frequency measurements illustrated anti-clockwise hysteresis loops and nitrate flushing mechanism in response to most precipitation and irrigation events. Statistical evaluation will be carried out for the C-Q relationships. The results of our analysis, combined with numerical modeling, will provide a better understanding of hydrological and

High Definition Transcranial Direct Current Stimulation Induces Both Acute and Persistent Changes in Broadband Cortical Synchronization: a Simultaneous tDCS-EEG Study

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Roy, Abhrajeet; Baxter, Bryan

2014-01-01

The goal of this study was to develop methods for simultaneously acquiring electrophysiological data during high definition transcranial direct current stimulation (tDCS) using high resolution electroencephalography (EEG). Previous studies have pointed to the after effects of tDCS on both motor and cognitive performance, and there appears to be potential for using tDCS in a variety of clinical applications. However, little is known about the real-time effects of tDCS on rhythmic cortical activity in humans due to the technical challenges of simultaneously obtaining electrophysiological data during ongoing stimulation. Furthermore, the mechanisms of action of tDCS in humans are not well understood. We have conducted a simultaneous tDCS-EEG study in a group of healthy human subjects. Significant acute and persistent changes in spontaneous neural activity and event related synchronization (ERS) were observed during and after the application of high definition tDCS over the left sensorimotor cortex. Both anodal and cathodal stimulation resulted in acute global changes in broadband cortical activity which were significantly different than the changes observed in response to sham stimulation. For the group of 8 subjects studied, broadband individual changes in spontaneous activity during stimulation were apparent both locally and globally. In addition, we found that high definition tDCS of the left sensorimotor cortex can induce significant ipsilateral and contralateral changes in event related desynchronization (ERD) and ERS during motor imagination following the end of the stimulation period. Overall, our results demonstrate the feasibility of acquiring high resolution EEG during high definition tDCS and provide evidence that tDCS in humans directly modulates rhythmic cortical synchronization during and after its administration. PMID:24956615

TCR stimulation strength is inversely associated with establishment of functional brain-resident memory CD8 T cells during persistent viral infection.

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Saumya Maru

2017-04-01

Full Text Available Establishing functional tissue-resident memory (TRM cells at sites of infection is a newfound objective of T cell vaccine design. To directly assess the impact of antigen stimulation strength on memory CD8 T cell formation and function during a persistent viral infection, we created a library of mouse polyomavirus (MuPyV variants with substitutions in a subdominant CD8 T cell epitope that exhibit a broad range of efficiency in stimulating TCR transgenic CD8 T cells. By altering a subdominant epitope in a nonstructural viral protein and monitoring memory differentiation of donor monoclonal CD8 T cells in immunocompetent mice, we circumvented potentially confounding changes in viral infection levels, virus-associated inflammation, size of the immunodominant virus-specific CD8 T cell response, and shifts in TCR affinity that may accompany temporal recruitment of endogenous polyclonal cells. Using this strategy, we found that antigen stimulation strength was inversely associated with the function of memory CD8 T cells during a persistent viral infection. We further show that CD8 TRM cells recruited to the brain following systemic infection with viruses expressing epitopes with suboptimal stimulation strength respond more efficiently to challenge CNS infection with virus expressing cognate antigen. These data demonstrate that the strength of antigenic stimulation during recruitment of CD8 T cells influences the functional integrity of TRM cells in a persistent viral infection.

Superficial subarachnoid cerebrospinal fluid space expansion after surgical drainage of chronic subdural hematoma.

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Tosaka, Masahiko; Tsushima, Yoshito; Watanabe, Saiko; Sakamoto, Kazuya; Yodonawa, Masahiko; Kunimine, Hideo; Fujita, Haruyasu; Fujii, Takashi

2015-07-01

The present study examined the computed tomography (CT) findings after surgery and overnight drainage for chronic subdural hematoma (CSDH) to clear the significance of inner superficial subarachnoid CSF space and outer subdural hematoma cavity between the brain surface and the inner skull. A total of 73 sides in 60 patients were evaluated. Head CT was performed on the day after surgery and overnight drainage (1st CT), within 3 weeks of surgery (2nd CT), and more than 3 weeks after surgery (3rd CT). Subdural and subarachnoid spaces were identified to focus on density of fluid, shape of air collection, and location of silicone drainage tube, etc. Cases with subdural space larger than the subarachnoid CSF space were classified as Group SD between the brain and the skull. Cases with subarachnoid CSF space larger than the subdural space were classified as Group SA. Cases with extremely thin (<3 mm) spaces between the brain and the skull were classified as Group NS. Group SA, SD, and NS accounted for 31.9, 55.6 and 12.5% of cases on the 1st CT. No statistical differences were found between Groups SA, SD, and NS in any clinical factors, including recurrence. Group SA were found significantly more on 1st CT than on 2nd and 3rd CT. Subarachnoid CSF space sometimes expands between the brain and skull on CT after surgical overnight drainage. Expansion of the arachnoid space may be a passive phenomenon induced by overnight drainage and delayed re-expansion of the brain parenchyma.

Tube temperature rise limits: Boiling considerations

Energy Technology Data Exchange (ETDEWEB)

Vanderwater, R.G.

1952-03-26

A revision of tube power limits based on boiling considerations was presented earlier. The limits were given on a basis of tube power versus header pressure. However, for convenience of operation, the limits have been converted from tube power to permissible water temperature rise. The permissible {triangle}t`s water are given in this document.

Further evidence for a fluid pathway during bone conduction auditory stimulation.

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Sohmer, Haim; Freeman, Sharon

2004-07-01

This study was designed to evaluate the suggestion that during bone vibrator stimulation on skull bone (bone conduction auditory stimulation), a major connection between the site of the bone vibrator and the inner ear is a fluid pathway. A series of experiments were conducted on pairs of animals (rats or guinea pigs). The cranial cavities of each pair of animals were coupled by means of a saline filled plastic tube sealed into a craniotomy in the skull of each animal. In response to bone conduction click stimulation to the skull bone of animal I, auditory nerve-brainstem evoked responses could be recorded in animal II. Various procedures showed that these responses were initiated in animal II in response to audio-frequency sound pressures generated within the cranial cavity of animal I by the bone conduction stimulation and transferred to the cranial cavity of animal II through the fluid in the plastic tube: they were not responses to air conducted sounds generated by the bone vibrator, were not induced in animal II by vibrations conveyed to it by the plastic tube and were not electrically conducted activity from animal I. Exposing the fluid in the tube to air was not accompanied by any change in threshold. These experiments confirm that during bone conduction stimulation on the skull, audio-frequency sound pressures (alternating condensations and rarefactions) can be conveyed by a fluid pathway to the cochlea and stimulate it.

Noninvasive transcranial direct current stimulation (tDCS) for the treatment of orofacial pain.

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Fricova, Jitka; Englerova, Katerina; Rokyta, Richard

2016-10-01

tDCS is a promising method for the treatment of chronic pain. Electrode placement locations must be chosen in accordance with the density and the time course of the current in order to prevent pathological changes in the underlying tissue. In order to reduce current spatial variability, more electrodes of the same polarity are placed in a circle around the second electrode of the opposite polarity. The applied current produced the greatest changes directly beneath the electrodes: the cathode reduces the excitability of cortical neurons, while the anode has the opposite effect. Based on inclusion criteria, 10 patients with chronic orofacial pain, secondary trigeminal neuralgia after oral surgery, were enrolled and underwent both anode and cathode stimulation. Before the first session we measured pain intensity on a numeric pain rating scale and tactile and thermal stimulation were used to assess somatosensory status. tDCS was applied for five consecutive days. At the end of tDCS application, somatosensory status was assessed again. From our results we can conclude that the application of tDCS improves the perception of some types of pain. When we increase our sample size, we would expect confirmation not only on our positive results, but also some additional findings for explaining the pathophysiology of orofacial pain. These pathophysiological findings and explanations are very important for the application of tDCS in the treatment of orofacial pain and also for other types of neuropathic pain.

Modulating Emotional Experience Using Electrical Stimulation of the Medial-Prefrontal Cortex: A Preliminary tDCS-fMRI Study.

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Abend, Rany; Sar-El, Roy; Gonen, Tal; Jalon, Itamar; Vaisvaser, Sharon; Bar-Haim, Yair; Hendler, Talma

2018-05-09

Implicit regulation of emotions involves medial-prefrontal cortex (mPFC) regions exerting regulatory control over limbic structures. Diminished regulation relates to aberrant mPFC functionality and psychopathology. Establishing means of modulating mPFC functionality could benefit research on emotion and its dysregulation. Here, we tested the capacity of transcranial direct current stimulation (tDCS) targeting mPFC to modulate subjective emotional states by facilitating implicit emotion regulation. Stimulation was applied concurrently with functional magnetic resonance imaging to validate its neurobehavioral effect. Sixteen participants were each scanned twice, counterbalancing active and sham tDCS application, while undergoing negative mood induction (clips featuring negative vs. neutral contents). Effects of stimulation on emotional experience were assessed using subjective and neural measures. Subjectively, active stimulation led to significant reduction in reported intensity of experienced emotions to negatively valenced (p = 0.005) clips but not to neutral clips (p > 0.99). Active stimulation further mitigated a rise in stress levels from pre- to post-induction (sham: p = 0.004; active: p = 0.15). Neurally, stimulation increased activation in mPFC regions associated with implicit emotion regulation (ventromedial-prefrontal cortex; subgenual anterior-cingulate cortex, sgACC), and in ventral striatum, a core limbic structure (all ps  0.64, ps < 0.018), suggesting individual differences in stimulation responsivity. Results of this study indicate the potential capacity of tDCS to facilitate brain activation in mPFC regions underlying implicit regulation of emotion and accordingly modulate subjective emotional experiences. © 2018 International Neuromodulation Society.

Transient drainage summary report

International Nuclear Information System (INIS)

1996-09-01

This report summarizes the history of transient drainage issues on the Uranium Mill Tailings Remedial Action (UMTRA) Project. It defines and describes the UMTRA Project disposal cell transient drainage process and chronicles UMTRA Project treatment of the transient drainage phenomenon. Section 4.0 includes a conceptual cross section of each UMTRA Project disposal site and summarizes design and construction information, the ground water protection strategy, and the potential for transient drainage

Prairie Pothole Region wetlands and subsurface drainage systems: Key factors for determining drainage setback distances

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Tangen, Brian; Wiltermuth, Mark T.

2018-01-01

Use of agricultural subsurface drainage systems in the Prairie Pothole Region of North America continues to increase, prompting concerns over potential negative effects to the Region's vital wetlands. The U.S. Fish and Wildlife Service protects a large number of wetlands through conservation easements that often utilize standard lateral setback distances to provide buffers between wetlands and drainage systems. Because of a lack of information pertaining to the efficacy of these setback distances for protecting wetlands, information is required to support the decision making for placement of subsurface drainage systems adjacent to wetlands. We used qualitative graphical analyses and data comparisons to identify characteristics of subsurface drainage systems and wetland catchments that could be considered when assessing setback distances. We also compared setback distances with catchment slope lengths to determine if they typically exclude drainage systems from the catchment. We demonstrated that depth of a subsurface drainage system is a key factor for determining drainage setback distances. Drainage systems located closer to the surface (shallow) typically could be associated with shorter lateral setback distances compared with deeper systems. Subsurface drainage systems would be allowed within a wetland's catchment for 44–59% of catchments associated with wetland conservation easements in North Dakota. More specifically, results suggest that drainage setback distances generally would exclude drainage systems from catchments of the smaller wetlands that typically have shorter slopes in the adjacent upland contributing area. For larger wetlands, however, considerable areas of the catchment would be vulnerable to drainage that may affect wetland hydrology. U.S. Fish and Wildlife Service easements are associated with > 2,000 km2 of wetlands in North Dakota, demonstrating great potential to protect these systems from drainage depending on policies for installing

The foam drainage equation for drainage dynamics in unsaturated porous media

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Lehmann, P.; Hoogland, F.; Assouline, S.; Or, D.

2017-07-01

Similarity in liquid-phase configuration and drainage dynamics of wet foam and gravity drainage from unsaturated porous media expands modeling capabilities for capillary flows and supplements the standard Richards equation representation. The governing equation for draining foam (or a soil variant termed the soil foam drainage equation—SFDE) obviates the need for macroscopic unsaturated hydraulic conductivity function by an explicit account of diminishing flow pathway sizes as the medium gradually drains. The study provides new and simple analytical expressions for drainage rates and volumes from unsaturated porous media subjected to different boundary conditions. Two novel analytical solutions for saturation profile evolution were derived and tested in good agreement with a numerical solution of the SFDE. The study and the proposed solutions rectify the original formulation of foam drainage dynamics of Or and Assouline (2013). The new framework broadens the scope of methods available for quantifying unsaturated flow in porous media, where the intrinsic conductivity and geometrical representation of capillary drainage could improve understanding of colloid and pathogen transport. The explicit geometrical interpretation of flow pathways underlying the hydraulic functions used by the Richards equation offers new insights that benefit both approaches.

Cytolytic T lymphocyte responses to metabolically inactivated stimulator cells. I. Metabolic inactivation impairs both CD and LD antigen signals

International Nuclear Information System (INIS)

Kelso, A.; Boyle, W.

1982-01-01

The effects of metabolic inactivation of spleen cells on antigen presentation to precursors of alloreactive cytolytic T lymphocytes (T/sub c/) were examined. By serological methods, populations inactivated by ultraviolet irradiation, glutaraldehyde fixation or plasma membrane isolation were found to retain normal levels of H-2K/D and Ia antigens. However, comparison of the antigen doses required to stimulate secondary T/sub c/ responses in mixed leukocyte culture showed that the inactivated preparations were approximately 10-fold less immunogenic than X-irradiated spleen cells. Their total inability to stimulate primary cytolytic responses pointed to at least a 100-fold impairment of immunogenicity for unprimed T/sub c/ precursors in the case of uv-irradiated and glutaraldehyde-treated stimulator cells, and at least a 10-fold impairment for membrane fragments. Experiments showing that the capacity of cell monolayers to absorb precursor T/sub c/ from unprimed spleen populations was reduced following uv-irradiation or glutaraldehyde treatment provided direct evidence that this loss of immunogenicity was due in part to suboptimal antigen presentation to precursor T/sub c/. It is concluded that, in addition to the traditional view that these treatments damage the ''LD'' signal to helper T lymphocytes, metabolic inactivation also impairs recognition of ''CD'' determinants by precursor T/sub c/

The biofilm-controlling functions of rechargeable antimicrobial N-halamine dental unit waterline tubing.

Science.gov (United States)

Porteous, Nuala; Schoolfield, John; Luo, Jie; Sun, Yuyu

2011-01-01

A study was conducted to test the biofilm-controlling functions of N-halamine tubing over an eight-month period. A laboratory system, simulating a teaching dental clinic, was used to test rechargeable N-halamine tubing (T) compared to an untreated control (C) using the unit manufacturer's tubing. For the long-term study, a recharged tubing (RC) treated with bleach was used to compare with the test (T) and the control (C) tubing. Source tap water was cycled through the lines at 1.4 mL/minute, five minutes on and 25 minutes off, eight hours/day, five days/week. Every three weeks, samples of effluent, recovered adherent bacteria from inside tubing surfaces, and SEM images were examined for bacterial and biofilm growth. After sampling, a recharging solution of chlorine bleach (1 : 10 dilution) was run through T and RC lines, left overnight, and rinsed out the next morning. One-way ANOVAs and Spearman correlations were performed to detect significant differences for T, RC, and C, and determine significance with time period and source water, respectively. Mean log CFU/mL for C effluent > T (p = 0.028), and C tubing > T (p = 0.035). Spearman correlations were significant between effluent and source water level for T (rho = 0.817), and T tubing (0.750); between RC tubing and source water level (rho = 0.836), and time (rho = 0.745); and between C and time (rho = 0.873). SEM imaging confirmed the presence of biofilm inside RC and C, but not inside T. N-halamine tubing completely inhibited biofilm formation without negatively affecting the physical properties of the effluent water. Further research on N-halamine tubing using a pure water source is recommended, as T effluent bacterial levels reflected the source tap water quality and proliferation of planktonic bacteria with no biofilm activity.

The effects of pleural fluid drainage on respiratory function in mechanically ventilated patients after cardiac surgery

Science.gov (United States)

Brims, Fraser J H; Davies, Michael G; Elia, Andy; Griffiths, Mark J D

2015-01-01

Background Pleural effusions occur commonly after cardiac surgery and the effects of drainage on gas exchange in this population are not well established. We examined pulmonary function indices following drainage of pleural effusions in cardiac surgery patients. Methods We performed a retrospective study examining the effects of pleural fluid drainage on the lung function indices of patients recovering from cardiac surgery requiring mechanical ventilation for more than 7 days. We specifically analysed patients who had pleural fluid removed via an intercostal tube (ICT: drain group) compared with those of a control group (no effusion, no ICT). Results In the drain group, 52 ICTs were sited in 45 patients. The mean (SD) volume of fluid drained was 1180 (634) mL. Indices of oxygenation were significantly worse in the drain group compared with controls prior to drainage. The arterial oxygen tension (PaO2)/fractional inspired oxygen (FiO2) (P/F) ratio improved on day 1 after ICT placement (mean (SD), day 0: 31.01 (8.92) vs 37.18 (10.7); pdrain group patients were more likely to have an improved mode of ventilation on day 1 compared with controls (p=0.028). Conclusions Pleural effusion after cardiac surgery may impair oxygenation. Drainage of pleural fluid is associated with a rapid and sustained improvement in oxygenation. PMID:26339492

The Rijke Tube - A Thermo-acoustic Device

Indian Academy of Sciences (India)

Department of Aerospace. Engineering, liT ... a flame, Rijke found that the tube could be made to sound continuously. ..... We can now apply Rayleigh's criterion to the problem of the. Rijke tube ... projection on the Y-axis, e.g., v represents the amplitude and v'(t)= v sin OJt .... conventional ash removing methods. In these ...

Low intensity transcranial electric stimulation

DEFF Research Database (Denmark)

Antal, Andrea; Alekseichuk, I; Bikson, M

2017-01-01

Low intensity transcranial electrical stimulation (TES) in humans, encompassing transcranial direct current (tDCS), transcutaneous spinal Direct Current Stimulation (tsDCS), transcranial alternating current (tACS), and transcranial random noise (tRNS) stimulation or their combinations, appears...

Feasibility of a simple drainage system in Cameroonian children after thoracotomy and decortication for empyema thoracis

Directory of Open Access Journals (Sweden)

Bernadette Ngo Nonga

2012-01-01

Full Text Available Background: To analyse the outcome of children with empyema thoracis treated by decortication followed by a simple drainage system. Patients and Methods: Retrospective chart review from July 2001 to June 2010 of all cases of children who had a thoracotomy for empyema. We used an endotracheal tube as chest drain and a urinary bag as a collector. Statistical analyses were done using EXCEL and SPSS 9.0. Results: Forty one children underwent thoracotomy and decortication for empyema, there were 23 boys and 18 girls with a sex ratio of 1, 21. The mean age was 2½ years with a minimum of 1 month and a maximum of 15 years of age; 27 children were below two years of age. All the patients have received antibiotic for a long period before surgery. The culture was negative, except in two cases where we found Klebsiella pneumonia and Staphylococcus aureus. In five cases, the empyema was due to Mycobacterium tuberculosis. Three children presented a complication: One child had a persistent purulent drainage for 2 weeks; another one was re-operated upon because of necrotic lung abscess and one child died of sepsis. In most cases, the chest tube was removed between day 4 and day 6 post-operatively. The average length of hospital stay after the surgery was 10 days. Conclusion: Thoracotomy and decortication in children with empyema can be safely done in Cameroon using a simple drainage system with good results compared to those in the literature.

Coiled-tubing fracturing of coal seams on the Vermejo Park Ranch

Energy Technology Data Exchange (ETDEWEB)

Bybee, K.

2003-06-01

Coiled-tubing (CT) fracturing currently is used to stimulate the Vermejo and Raton coal seams on the Vermejo Park Ranch in northern New Mexico. The CT fracturing process increased the number of stimulation stages from 4 to 18 per well. CT fracturing results in more accurate proppant placement and more effective stimulation of the producing zones.

Influence of Test Tube Material on Subcooled Flow Boiling Critical Heat Flux in Short Vertical Tube

International Nuclear Information System (INIS)

Koichi Hata; Masahiro Shiotsu; Nobuaki Noda

2006-01-01

The steady state subcooled flow boiling critical heat flux (CHF) for the flow velocities (u = 4.0 to 13.3 m/s), the inlet subcooling (ΔT sub,in = 48.6 to 154.7 K), the inlet pressure (P in = 735.2 to 969.0 kPa) and the increasing heat input (Q 0 exp(t/t), t = 10, 20 and 33.3 s) are systematically measured with the experimental water loop. The 304 Stainless Steel (SUS304) test tubes of inner diameters (d = 6 mm), heated lengths (L = 66 mm) and L/d = 11 with the inner surface of rough finished (Surface roughness, R a = 3.18 μm), the Cupro Nickel (Cu-Ni 30%) test tubes of d = 6 mm, L = 60 mm and L/d = 10 with R a = 0.18 μm and the Platinum (Pt) test tubes of d = 3 and 6 mm, L = 66.5 and 69.6 mm, and L/d 22.2 and 11.6 respectively with R a = 0.45 μm are used in this work. The CHF data for the SUS304, Cu-Ni 30% and Pt test tubes were compared with SUS304 ones for the wide ranges of d and L/d previously obtained and the values calculated by the authors' published steady state CHF correlations against outlet and inlet subcooling. The influence of the test tube material on CHF is investigated into details and the dominant mechanism of subcooled flow boiling critical heat flux is discussed. (authors)

Determination of optimal electrode positions for transcranial direct current stimulation (tDCS)

International Nuclear Information System (INIS)

Im, Chang-Hwan; Jung, Hui-Hun; Choi, Jung-Do; Lee, Soo Yeol; Jung, Ki-Young

2008-01-01

The present study introduces a new approach to determining optimal electrode positions in transcranial direct current stimulation (tDCS). Electric field and 3D conduction current density were analyzed using 3D finite element method (FEM) formulated for a dc conduction problem. The electrode positions for minimal current injection were optimized by changing the Cartesian coordinate system into the spherical coordinate system and applying the (2+6) evolution strategy (ES) algorithm. Preliminary simulation studies applied to a standard three-layer head model demonstrated that the proposed approach is promising in enhancing the performance of tDCS. (note)

Determination of optimal electrode positions for transcranial direct current stimulation (tDCS)

Energy Technology Data Exchange (ETDEWEB)

Im, Chang-Hwan; Jung, Hui-Hun; Choi, Jung-Do [Department of Biomedical Engineering, Yonsei University, Wonju, 220-710 (Korea, Republic of); Lee, Soo Yeol [Department of Biomedical Engineering, Kyung Hee University, Suwon (Korea, Republic of); Jung, Ki-Young [Korea University Medical Center, Korea University College of Medicine, Seoul (Korea, Republic of)], E-mail: ich@yonsei.ac.kr

2008-06-07

The present study introduces a new approach to determining optimal electrode positions in transcranial direct current stimulation (tDCS). Electric field and 3D conduction current density were analyzed using 3D finite element method (FEM) formulated for a dc conduction problem. The electrode positions for minimal current injection were optimized by changing the Cartesian coordinate system into the spherical coordinate system and applying the (2+6) evolution strategy (ES) algorithm. Preliminary simulation studies applied to a standard three-layer head model demonstrated that the proposed approach is promising in enhancing the performance of tDCS. (note)

Bibliography for acid-rock drainage and selected acid-mine drainage issues related to acid-rock drainage from transportation activities

Science.gov (United States)

Bradley, Michael W.; Worland, Scott C.

2015-01-01

Acid-rock drainage occurs through the interaction of rainfall on pyrite-bearing formations. When pyrite (FeS2) is exposed to oxygen and water in mine workings or roadcuts, the mineral decomposes and sulfur may react to form sulfuric acid, which often results in environmental problems and potential damage to the transportation infrastructure. The accelerated oxidation of pyrite and other sulfidic minerals generates low pH water with potentially high concentrations of trace metals. Much attention has been given to contamination arising from acid mine drainage, but studies related to acid-rock drainage from road construction are relatively limited. The U.S. Geological Survey, in cooperation with the Tennessee Department of Transportation, is conducting an investigation to evaluate the occurrence and processes controlling acid-rock drainage and contaminant transport from roadcuts in Tennessee. The basic components of acid-rock drainage resulting from transportation activities are described and a bibliography, organized by relevant categories (remediation, geochemical, microbial, biological impact, and secondary mineralization) is presented.

MDCT quantification is the dominant parameter in decision-making regarding chest tube drainage for stable patients with traumatic pneumothorax.

Science.gov (United States)

Cai, Wenli; Lee, June-Goo; Fikry, Karim; Yoshida, Hiroyuki; Novelline, Robert; de Moya, Marc

2012-07-01

It is commonly believed that the size of a pneumothorax is an important determinant of treatment decision, in particular regarding whether chest tube drainage (CTD) is required. However, the volumetric quantification of pneumothoraces has not routinely been performed in clinics. In this paper, we introduced an automated computer-aided volumetry (CAV) scheme for quantification of volume of pneumothoraces in chest multi-detect CT (MDCT) images. Moreover, we investigated the impact of accurate volume of pneumothoraces in the improvement of the performance in decision-making regarding CTD in the management of traumatic pneumothoraces. For this purpose, an occurrence frequency map was calculated for quantitative analysis of the importance of each clinical parameter in the decision-making regarding CTD by a computer simulation of decision-making using a genetic algorithm (GA) and a support vector machine (SVM). A total of 14 clinical parameters, including volume of pneumothorax calculated by our CAV scheme, was collected as parameters available for decision-making. The results showed that volume was the dominant parameter in decision-making regarding CTD, with an occurrence frequency value of 1.00. The results also indicated that the inclusion of volume provided the best performance that was statistically significant compared to the other tests in which volume was excluded from the clinical parameters. This study provides the scientific evidence for the application of CAV scheme in MDCT volumetric quantification of pneumothoraces in the management of clinically stable chest trauma patients with traumatic pneumothorax. Copyright © 2012 Elsevier Ltd. All rights reserved.

Indications and complications of tube thoracostomy with improvised underwater seal bottles

Directory of Open Access Journals (Sweden)

Sunday A Edaigbini

2014-01-01

Full Text Available Background: Tube thoracostomy is a lifesaving and frequently performed procedure in hospitals where the expertise and necessary tools are available. Where the ideal drainage receptacle is unavailable, the underwater seal device can be improvised with bottled water plastic can especially in emergency situations. Aims and Objectives: To determine the frequencies of the various indications and complications of tube thoracostomy with improvised underwater seal. Materials and Methods: A cross-sectional study with a structured proforma was used for assessment over a 3-year period (May 2010-April 2013. The proforma was filled at the time of the procedure by the performing surgeon and patients were followed up with serial chest X-rays until certified cured. A 1.5 L bottled water container was used as the underwater seal receptacle. The data was analysed with SPSS 15 software program. Results: A total of 167 patients were managed. There were 106 (63.5% males and 61 (36.5% females. The mean age was 34.85 ± 16.72 with a range of 1-80 years. The most frequent indication was for malignant/paramalignant effusion, 46 (27.5%. Others were trauma, 44 (26.3%, Parapneumonic effusion, 20 (12%, postthoracotomy 14 (8.4%, empyema thoracis 12 (7.2%, heart disease and tuberculous effusion 11 (6.6% each, pneumothorax 8 (4.8% and misdiagnosis 1 (0.6%. A hundred and one (60.5% of the procedures were performed by registrars, 41 (24.6% by consultants, house officers 15 (9% and senior registrars 10 (6%. The overall complication rate was 16.8% with the more frequent complications been empyema (5.6% and pneumothorax (3.6%. The average duration of tube placement was 13.02 ± 12.362 days and range of 1-110 days. Conclusion : Tube thoracostomy can be a relatively safe procedure with acceptable complication rates even with improvised underwater seal drainage bottles.

Drainage of radioactive areas

International Nuclear Information System (INIS)

1981-04-01

This Code of Practice covers all the drainage systems which may occur in the radioactive classified area of an establishment, namely surface water, foul, process and radioactive drainage. It also deals with final discharge lines. The Code of Practice concentrates on those aspects of drainage which require particular attention because the systems are in or from radioactive areas and typical illustrations are given in appendices. The Code makes references to sources of information on conventional aspects of drainage design. (author)

BCG stimulated dendritic cells induce an interleukin-10 producing T-cell population with no T helper 1 or T helper 2 bias in vitro

DEFF Research Database (Denmark)

Madura Larsen, Jeppe; Benn, Christine Stabell; Fillie, Yvonne

2007-01-01

. Monocyte-derived DCs were matured in the presence or absence of BCG. The DC phenotype was assessed by CD83 expression, interleukin-12 (IL-12) and IL-10 production, as well as for the ability to polarize T-cell responses. Following stimulation with CD40 ligand, DCs matured in the presence of BCG showed...

Role of CD28 co-stimulation in generation and maintenance of virus-specific T cells

DEFF Research Database (Denmark)

Christensen, Jeanette Erbo; Christensen, Jan P; Kristensen, Nanna N

2002-01-01

Efficient induction of T cell responses is normally assumed to require both TCR-mediated signaling and engagement of co-stimulatory molecules, in particular CD28. However, the importance of CD28 co-stimulation in induction and maintenance of antiviral T cell responses is not clearly established....... For this reason antiviral CD4(+) and CD8(+) T cell responses in CD28-deficient mice were studied using two different viruses [vesicular stomatitis virus and lymphocytic choriomeningitis virus (LCMV)]. Intracellular cytokine staining and/or MHC-peptide tetramers were used to enumerate antigen-specific T cells...

Exploratory study of once-daily transcranial direct current stimulation (tDCS) as a treatment for auditory hallucinations in schizophrenia.

Science.gov (United States)

Fröhlich, F; Burrello, T N; Mellin, J M; Cordle, A L; Lustenberger, C M; Gilmore, J H; Jarskog, L F

2016-03-01

Auditory hallucinations are resistant to pharmacotherapy in about 25% of adults with schizophrenia. Treatment with noninvasive brain stimulation would provide a welcomed additional tool for the clinical management of auditory hallucinations. A recent study found a significant reduction in auditory hallucinations in people with schizophrenia after five days of twice-daily transcranial direct current stimulation (tDCS) that simultaneously targeted left dorsolateral prefrontal cortex and left temporo-parietal cortex. We hypothesized that once-daily tDCS with stimulation electrodes over left frontal and temporo-parietal areas reduces auditory hallucinations in patients with schizophrenia. We performed a randomized, double-blind, sham-controlled study that evaluated five days of daily tDCS of the same cortical targets in 26 outpatients with schizophrenia and schizoaffective disorder with auditory hallucinations. We found a significant reduction in auditory hallucinations measured by the Auditory Hallucination Rating Scale (F2,50=12.22, PtDCS for treatment of auditory hallucinations and the pronounced response in the sham-treated group in this study contrasts with the previous finding and demonstrates the need for further optimization and evaluation of noninvasive brain stimulation strategies. In particular, higher cumulative doses and higher treatment frequencies of tDCS together with strategies to reduce placebo responses should be investigated. Additionally, consideration of more targeted stimulation to engage specific deficits in temporal organization of brain activity in patients with auditory hallucinations may be warranted. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Evaluation of a Modified High-Definition Electrode Montage for Transcranial Alternating Current Stimulation (tACS) of Pre-Central Areas

DEFF Research Database (Denmark)

Heise, Kirstin Friederike; Kortzorg, Nick; Saturnino, Guilherme Bicalho

2016-01-01

Objective: To evaluate a modified electrode montage with respect to its effect on tACS-dependent modulation of corticospinal excitability and discomfort caused by neurosensory side effects accompanying stimulation. Methods: In a double-blind cross-over design, the classical electrode montage for ....... Conclusions: In comparison to the classic montage, the M1 centre-ring montage enables a more focal stimulation of the target area and, at the same time, significantly reduces neurosensory side effects, essential for placebo-controlled study designs.......Objective: To evaluate a modified electrode montage with respect to its effect on tACS-dependent modulation of corticospinal excitability and discomfort caused by neurosensory side effects accompanying stimulation. Methods: In a double-blind cross-over design, the classical electrode montage...... for primary motor cortex (M1) stimulation (two patch electrodes over M1 and contralateral supraorbital area) was compared with an M1 centre-ring montage. Corticospinal excitability was evaluated before, during, immediately after and 15 minutes after tACS (10 min., 20 Hz vs. 30 s low-frequency transcranial...

The anti-proliferative effect of cation channel blockers in T lymphocytes depends on the strength of mitogenic stimulation.

Science.gov (United States)

Petho, Zoltan; Balajthy, Andras; Bartok, Adam; Bene, Krisztian; Somodi, Sandor; Szilagyi, Orsolya; Rajnavolgyi, Eva; Panyi, Gyorgy; Varga, Zoltan

2016-03-01

Ion channels are crucially important for the activation and proliferation of T lymphocytes, and thus, for the function of the immune system. Previous studies on the effects of channel blockers on T cell proliferation reported variable effectiveness due to differing experimental systems. Therefore our aim was to investigate how the strength of the mitogenic stimulation influences the efficiency of cation channel blockers in inhibiting activation, cytokine secretion and proliferation of T cells under standardized conditions. Human peripheral blood lymphocytes were activated via monoclonal antibodies targeting the TCR-CD3 complex and the co-stimulator CD28. We applied the blockers of Kv1.3 (Anuroctoxin), KCa3.1 (TRAM-34) and CRAC (2-Apb) channels of T cells either alone or in combination with rapamycin, the inhibitor of the mammalian target of rapamycin (mTOR). Five days after the stimulation ELISA and flow cytometric measurements were performed to determine IL-10 and IFN-γ secretion, cellular viability and proliferation. Our results showed that ion channel blockers and rapamycin inhibit IL-10 and IFN-γ secretion and cell division in a dose-dependent manner. Simultaneous application of the blockers for each channel along with rapamycin was the most effective, indicating synergy among the various activation pathways. Upon increasing the extent of mitogenic stimulation the anti-proliferative effect of the ion channel blockers diminished. This phenomenon may be important in understanding the fine-tuning of T cell activation. Copyright © 2016 European Federation of Immunological Societies. Published by Elsevier B.V. All rights reserved.

No significant effect of transcranial direct current stimulation (tDCS) found on simple motor reaction time comparing 15 different simulation protocols.

Science.gov (United States)

Horvath, Jared Cooney; Carter, Olivia; Forte, Jason D

2016-10-01

Research exploring the behavioral impact of transcranial direct current stimulation (tDCS) over M1 has produced homogenous results. The most common explanations to address this homogeneity concerns the differential impact of varied tDCS parameters (such as stimulation intensity or electrode montage). To explore this, we systematically examined the effects of 15 different tDCS protocols on a well-elucidated neurobehavioral system: simple visual motor reaction time (smRT). For the initial phase of this study, 150 healthy participants were randomly assigned to one of 5 experimental groups (2mA anodal, 2mA cathodal, 1mA anodal, 1mA cathodal, or sham) across 3 different conditions (orbitofrontal, bilateral, or extracephalic reference electrode location). The active electrode was always placed over M1 and tDCS lasted for 20min. Starting ~5min prior to stimulation and running continuously for ~30min, participants were repeatedly presented with a visual cue centered on a computer monitor and asked to press a response button as quickly as possible at stimulus onset (stimuli number: 100 pre-, 400 during-, and 100-post stimulation - interstimulus interval: 1-3s). Ex-gaussian distribution curves, miss, and error rates were determined for each normalized batch of 100 RTs and compared using a two-way ANOVA. As the largest group differences were seen with 2mA anodal (compared to sham) stimulation using an orbitofrontal montage, an additional 60 healthy participants were recruited to further test for significance in this condition. No significant impact of tDCS was seen on any parameter of smRT distribution, error rate, or miss rate, regardless of polarity, stimulation intensity, electrode montage, or stimulation-to-task relationship. Our results suggest that tDCS over M1 might not have a predictable or reliable effect on short duration smRT. Our results raise interesting questions regarding the mechanisms by which tDCS might modulate more complex motor behaviors. Additional

Progesterone-specific stimulation of triglyceride biosynthesis in a breast cancer cell line (T-47D)

International Nuclear Information System (INIS)

Judge, S.M.; Chatterton, R.T. Jr.

1983-01-01

The purpose of this study was to examine the lactogenic response of human mammary cancer cell lines to hormones in vitro. Progesterone was found to stimulate the incorporation of 14C from [14C]acetate into triglycerides (TG) and to promote accumulation of TG with a fatty acid composition similar to that of human milk fat in T-47D cells. Lipid droplets were observed in larger numbers without concomitant accumulation of casein granules in cells incubated with progesterone, but secretion of lipid into the medium did not occur. An effect of progesterone on TG accumulation was detectable after 12 hr and was maximal at 72 hr. Increasing doses of progesterone (10(-9) to 10(-5) M) caused a progressive increase in TG accumulation. The presence of cortisol and/or prolactin did not alter TG formation nor the dose response of the cells to progesterone. The growth rate of T-47D cells was not altered by the presence of progesterone in the medium. Neither of the human mammary cancer cell lines, MCF-7 and HBL-100, nor the human fibroblast cell lines, 28 and 857, responded to progesterone. The data indicate that, while the normally lactogenic hormones do not stimulate milk product biosynthesis in the cell lines tested, progesterone specifically stimulated synthesis and accumulation of TG in the T-47D cells

The time development of the plasma-glass boundary layer in a T-tube

International Nuclear Information System (INIS)

Pavlov, M.; Djurovic, S.

1982-01-01

The refraction of a laser beam by a flat boundary layer between the plasma and the glass plate is analysed. A boundary layer with a constant gradient electron density is assumed. Results of the analysis for plasmas produced in a small T-tube show that the boundary layer thickness increases with time faster than linearly. This means that a relatively fast collapse due to cooling through the boundary layer happens at the second half of the reflected plasma life time, while the boundary layer is negligible thin during the first 2μs after the reflected shock front has passed the point of observation. (author)

Conventional sloping and new pressure rainwater drainage systems. Pt. 1. Konventionelle Gefaelle- und neue Druck-Regenentwaesserungssysteme. T. 1

Energy Technology Data Exchange (ETDEWEB)

Saunus, C [Heinemann, Rendsburg (Germany)

1991-07-01

The design of high-efficiency vacuum roof drainage systems makes a certain change of ideas necessary on the executing side in contrast to conventional gravity drainage systems. Starting from the description of conventional flat roof drainage particularities and calculation methods of vacuum systems which are completely filled with water are gone into. Attention has to be drawn to the fact that the hydraulic efficiency of the specially constructed roof gullies largely depends on the pressure conditions in the connected piping system. An important prerequisite for trouble-free operation is the reduction of air intake in the system. (BWI).

Kinetics of human T-cell expression of LFA-1, IL-2 receptor, and ICAM-1 following antigenic stimulation in vitro

DEFF Research Database (Denmark)

Hviid, L; Felsing, A; Theander, T G

1993-01-01

-specific stimulation is available. In the present study we have examined phenotypic T-cell changes after in vitro stimulation by the antigens purified derivative of tuberculin (PPD) and tetanus toxoid (TT). We show that the well-established differences in kinetics of mitogen- and antigen-induced T-cell proliferation...... of all 3 surface antigens showed similar kinetics, and correlated with the magnitude of the lymphoproliferative response. By day 8 (PHA-stimulation) or day 12 (PPD or TT stimulation), the lymphoproliferative response was essentially completed, the expression of CD11a and CD54 had approached...

Are there still roles for exocrine bladder drainage and portal venous drainage for pancreatic allografts?

Science.gov (United States)

Young, Carlton J

2009-02-01

Controversy remains regarding the best methodology of handling exocrine pancreatic fluid and pancreatic venous effluent. Bladder drainage has given way to enteric drainage. However, is there an instance in which bladder drainage is preferable? Also, hyperinsulinemia, as a result of systemic venous drainage (SVD), is claimed to be proatherosclerotic, whereas portal venous drainage (PVD) is more physiologic and less atherosclerotic. Bladder drainage remains a viable method of exocrine pancreas drainage, but evidence is sparse that measuring urinary amylase has a substantial benefit in the early detection of acute rejection in all types of pancreas transplants. Currently, there is no incontrovertible evidence that systemic hyperinsulinemia is proatherosclerotic, whereas recent metabolic studies on SVD and PVD showed that there was no benefit to PVD. Given the advent of newer immunosuppressive agents and overall lower acute rejection rates, the perceived benefit of bladder drainage as a means to measure urinary amylase as an early marker of rejection has not been substantiated. However, there may be a selective role for bladder drainage in 'high risk' pancreases. Also, without a clear-cut metabolic benefit to PVD over SVD, it remains the surgeon's choice as to which method to use.

Secondary structure and feature of mitochondrial tRNA genes of the Ussurian tube-nosed bat Murina ussuriensis (Chiroptera: Vespertilionidae

Directory of Open Access Journals (Sweden)

Kwang Bae Yoon

2015-09-01

Full Text Available The complete mitogenome (NC_021119 of the Ussurian tube-nosed bat Murina ussuriensis (Chiroptera: Vespertilionidae was annotated and characterized in our recent publication (http://www.ncbi.nlm.nih.gov/nuccore/NC_021119. Here we provide additional information on methods in detail for obtaining the complete sequence of M. ussuriensis mitogenome. In addition, we describe characteristics of 22 tRNA genes and secondary structure and feature of 22 tRNAs of M. ussuriensis mitogenome.

Clinical predictors of acute response to transcranial direct current stimulation (tDCS) in major depression.

Science.gov (United States)

D'Urso, Giordano; Dell'Osso, Bernardo; Rossi, Rodolfo; Brunoni, Andre Russowsky; Bortolomasi, Marco; Ferrucci, Roberta; Priori, Alberto; de Bartolomeis, Andrea; Altamura, Alfredo Carlo

2017-09-01

Transcranial direct current stimulation (tDCS) is a promising neuromodulation intervention for poor-responding or refractory depressed patients. However, little is known about predictors of response to this therapy. The present study aimed to analyze clinical predictors of response to tDCS in depressed patients. Clinical data from 3 independent tDCS trials on 171 depressed patients (including unipolar and bipolar depression), were pooled and analyzed to assess predictors of response. Depression severity and the underlying clinical dimensions were measured using the Hamilton Depression Rating Scale (HDRS) at baseline and after the tDCS treatment. Age, gender and diagnosis (bipolar/unipolar depression) were also investigated as predictors of response. Linear mixed models were fitted in order to ascertain which HDRS factors were associated with response to tDCS. Age, gender and diagnosis did not show any association with response to treatment. The reduction in HDRS scores after tDCS was strongly associated with the baseline values of "Cognitive Disturbances" and "Retardation" factors, whilst the "Anxiety/Somatization" factor showed a mild association with the response. Open-label design, the lack of control group, and minor differences in stimulation protocols. No differences in response to tDCS were found between unipolar and bipolar patients, suggesting that tDCS is effective for both conditions. "Cognitive disturbance", "Retardation", and "Anxiety/Somatization", were identified as potential clinical predictors of response to tDCS. These findings point to the pre-selection of the potential responders to tDCS, therefore optimizing the clinical use of this technique and the overall cost-effectiveness of the psychiatric intervention for depressed patients. Copyright © 2017 Elsevier B.V. All rights reserved.

A Rare Complication of Abdominal Drain: Fallopian Tube Herniation Through the Drain Site

OpenAIRE

Dilek Uygur; Seval Erdinç; Hülya Dede; Ümit Taşdemir; Oktay Kaymak; Nuri Danışman

2016-01-01

Prophylactic drainage of the peritoneal cavity after obstetrical and gynecological surgery is widely practiced. The idea of “when in doubt, drain” is accepted and applied clinically by many surgeons. However, surgically placed drains are not without risk. The present case describes herniation of fallopian tube during the removal of a surgical drain placed after a cesarean section.

Subsurface drainage volume reduction with drainage water management: Case studies in Ohio, USA

Science.gov (United States)

One of the main contributors to poor water quality in the Mississippi River and aeral increase in the hypoxic zone in the Gulf of Mexico is intensive drainage of the cropland within the watershed. Controlled drainage has been demonstrated as an approach to curb totla drainage outflow and nutrient di...

Dynamic tube movement after reimplantation of Ahmed glaucoma valve in a child with glaucoma in aphakia

Science.gov (United States)

Senthil, Sirisha; Badakare, Akshay

2014-01-01

A 10-year-old girl underwent an Ahmed glaucoma valve (AGV) implantation as a primary procedure for glaucoma in aphakia due to congenital cataract surgery. Following an unintended accidental excision of AGV tube during bleb revision for hypertensive phase, AGV was explanted and a second AGV was implanted in the same quadrant after 2 weeks. This resulted in a rare complication of dynamic tube movement in the anterior chamber with tube corneal touch and localised corneal oedema. Excision of the offending unstable tube and placement of a paediatric AGV in a different quadrant led to resolution of this complication, stable vision and well-controlled intraocular pressure. This case highlights the possible causes of dynamic tube, related complications and its management. This case also highlights the importance of understanding the various physiological phases after glaucoma drainage device implantation and their appropriate management. PMID:24695662

Visualizing Transcranial Direct Current Stimulation (tDCS) in vivo using Magnetic Resonance Imaging

Science.gov (United States)

Jog, Mayank Anant

Transcranial Direct Current Stimulation (tDCS) is a low-cost, non-invasive neuromodulation technique that has been shown to treat clinical symptoms as well as improve cognition. However, no techniques exist at the time of research to visualize tDCS currents in vivo. This dissertation presents the theoretical framework and experimental implementations of a novel MRI technique that enables non-invasive visualization of the tDCS electric current using magnetic field mapping. The first chapter establishes the feasibility of measuring magnetic fields induced by tDCS currents. The following chapter discusses the state of the art implementation that can measure magnetic field changes in individual subjects undergoing concurrent tDCS/MRI. The final chapter discusses how the developed technique was integrated with BOLD fMRI-an established MRI technique for measuring brain function. By enabling a concurrent measurement of the tDCS current induced magnetic field as well as the brain's hemodynamic response to tDCS, our technique opens a new avenue to investigate tDCS mechanisms and improve targeting.

Accumulation of cytolytic CD8{sup +} T cells in B16-melanoma and proliferation of mature T cells in TIS21-knockout mice after T cell receptor stimulation

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Ryu, Min Sook [Department of Biochemistry and Molecular Biology, Ajou University School of Medicine, 164, World cul-ro, Yeongtong-gu, Suwon, Gyeonggi-do 443-380 (Korea, Republic of); Woo, Min-Yeong [Department of Microbiology, Ajou University School of Medicine, 164, World cul-ro, Yeongtong-gu, Suwon, Gyeonggi-do 443-380 (Korea, Republic of); Department of Biomedical Sciences, The Graduate School, Ajou University (Korea, Republic of); Kwon, Daeho [Department of Microbiology, Kwandong University College of Medicine, Gangneung, Gangwon-do 210-701 (Korea, Republic of); Hong, Allen E. [Department of Biochemistry and Molecular Biology, Ajou University School of Medicine, 164, World cul-ro, Yeongtong-gu, Suwon, Gyeonggi-do 443-380 (Korea, Republic of); Song, Kye Yong [Department of Pathology, Chung-Ang University College of Medicine, Dongjak-gu, Seoul 156-756 (Korea, Republic of); Park, Sun [Department of Microbiology, Ajou University School of Medicine, 164, World cul-ro, Yeongtong-gu, Suwon, Gyeonggi-do 443-380 (Korea, Republic of); Lim, In Kyoung [Department of Biochemistry and Molecular Biology, Ajou University School of Medicine, 164, World cul-ro, Yeongtong-gu, Suwon, Gyeonggi-do 443-380 (Korea, Republic of)

2014-10-01

In vivo and in vitro effects of TIS21 gene on the mature T cell activation and antitumor activities were explored by employing MO5 melanoma orthograft and splenocytes isolated from the TIS21-knockout (KO) mice. Proliferation and survival of mature T cells were significantly increased in the KO than the wild type (WT) cells, indicating that TIS21 inhibits the rate of mature T cell proliferation and its survival. In MO5 melanoma orthograft model, the KO mice recruited much more CD8{sup +} T cells into the tumors at around day 14 after tumor cell injection along with reduced tumor volumes compared with the WT. The increased frequency of granzyme B{sup +} CD8{sup +} T cells in splenocytes of the KO mice compared with the WT may account for antitumor-immunity of TIS21 gene in the melanoma orthograft. In contrast, reduced frequencies of CD107a{sup +} CD8{sup +} T cells in the splenocytes of KO mice may affect the loss of CD8{sup +} T cell infiltration in the orthograft at around day 19. These results indicate that TIS21 exhibits antiproliferative and proapoptotic effects in mature T cells, and differentially affects the frequencies of granzyme B{sup +} CD8{sup +} T-cells and CD107a{sup +} CD8{sup +} T-cells, thus transiently regulating in vivo anti-tumor immunity. - Highlights: • Constitutive expression of TIS21 in splenocytes and upregulation by TCR stimulation. • Proliferation of mature T-cells in spleen of TIS21KO mice after TCR stimulation. • Inhibition of cell death in mature T-cells of TIS21KO mice compared with the wild type. • Inhibition of melanoma growth in TIS21KO mice and CD8{sup +} T cell infiltration in tumor. • Reduction of CD 107{sup +}CD8{sup +} T cells, but increased granzyme B{sup +} CD8{sup +} T cells in TIS21KO mice.

Neurocognitive Effects of Transcranial Direct Current Stimulation in Arithmetic Learning and Performance: A Simultaneous tDCS-fMRI Study.

Science.gov (United States)

Hauser, Tobias U; Rütsche, Bruno; Wurmitzer, Karoline; Brem, Silvia; Ruff, Christian C; Grabner, Roland H

A small but increasing number of studies suggest that non-invasive brain stimulation by means of transcranial direct current stimulation (tDCS) can modulate arithmetic processes that are essential for higher-order mathematical skills and that are impaired in dyscalculic individuals. However, little is known about the neural mechanisms underlying such stimulation effects, and whether they are specific to cognitive processes involved in different arithmetic tasks. We addressed these questions by applying tDCS during simultaneous functional magnetic resonance imaging (fMRI) while participants were solving two types of complex subtraction problems: repeated problems, relying on arithmetic fact learning and problem-solving by fact retrieval, and novel problems, requiring calculation procedures. Twenty participants receiving left parietal anodal plus right frontal cathodal stimulation were compared with 20 participants in a sham condition. We found a strong cognitive and neural dissociation between repeated and novel problems. Repeated problems were solved more accurately and elicited increased activity in the bilateral angular gyri and medial plus lateral prefrontal cortices. Solving novel problems, in contrast, was accompanied by stronger activation in the bilateral intraparietal sulci and the dorsomedial prefrontal cortex. Most importantly, tDCS decreased the activation of the right inferior frontal cortex while solving novel (compared to repeated) problems, suggesting that the cathodal stimulation rendered this region unable to respond to the task-specific cognitive demand. The present study revealed that tDCS during arithmetic problem-solving can modulate the neural activity in proximity to the electrodes specifically when the current demands lead to an engagement of this area. Copyright © 2016 Elsevier Inc. All rights reserved.

Regulation of myosin light chain kinase during insulin-stimulated glucose uptake in 3T3-L1 adipocytes.

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Shelly Woody

Full Text Available Myosin II (MyoII is required for insulin-responsive glucose transporter 4 (GLUT4-mediated glucose uptake in 3T3-L1 adipocytes. Our previous studies have shown that insulin signaling stimulates phosphorylation of the regulatory light chain (RLC of MyoIIA via myosin light chain kinase (MLCK. The experiments described here delineate upstream regulators of MLCK during insulin-stimulated glucose uptake. Since 3T3-L1 adipocytes express two MyoII isoforms, we wanted to determine which isoform was required for insulin-stimulated glucose uptake. Using a siRNA approach, we demonstrate that a 60% decrease in MyoIIA protein expression resulted in a 40% inhibition of insulin-stimulated glucose uptake. We also show that insulin signaling stimulates the phosphorylation of MLCK. We further show that MLCK can be activated by calcium as well as signaling pathways. We demonstrate that adipocytes treated with the calcium chelating agent, 1,2-b (iso-aminophenoxy ethane-N,N,N',N'-tetra acetic acid, (BAPTA (in the presence of insulin impaired the insulin-induced phosphorylation of MLCK by 52% and the RLC of MyoIIA by 45% as well as impairing the recruitment of MyoIIA to the plasma membrane when compared to cells treated with insulin alone. We further show that the calcium ionophore, A23187 alone stimulated the phosphorylation of MLCK and the RLC associated with MyoIIA to the same extent as insulin. To identify signaling pathways that might regulate MLCK, we examined ERK and CaMKII. Inhibition of ERK2 impaired phosphorylation of MLCK and insulin-stimulated glucose uptake. In contrast, while inhibition of CaMKII did inhibit phosphorylation of the RLC associated with MyoIIA, inhibition of CAMKIIδ did not impair MLCK phosphorylation or translocation to the plasma membrane or glucose uptake. Collectively, our results are the first to delineate a role for calcium and ERK in the activation of MLCK and thus MyoIIA during insulin-stimulated glucose uptake in 3T3-L1 adipocytes.

Modulation of risk-taking in marijuana users by transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC).

Science.gov (United States)

Boggio, Paulo S; Zaghi, Soroush; Villani, Ana Beatriz; Fecteau, Shirley; Pascual-Leone, Alvaro; Fregni, Felipe

2010-12-01

Cognitive deficits that are reported in heavy marijuana users (attention, memory, affect perception, decision-making) appear to be completely reversible after a prolonged abstinence period of about 28 days. However, it remains unclear whether the reversibility of these cognitive deficits indicates that (1) chronic marijuana use is not associated with long-lasting changes in cortical networks or (2) that such changes occur but the brain adapts to and compensates for the drug-induced changes. Therefore, we examined whether chronic marijuana smokers would demonstrate a differential pattern of response in comparison to healthy volunteers on a decision-making paradigm (Risk Task) while undergoing sham or active transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC). Twenty-five chronic marijuana users who were abstinent for at least 24h were randomly assigned to receive left anodal/right cathodal tDCS of DLPFC (n=8), right anodal/left cathodal tDCS of DLPFC (n=9), or sham stimulation (n=8); results on Risk Task during sham/active tDCS were compared to healthy volunteers from a previously published dataset. Chronic marijuana users demonstrated more conservative (i.e. less risky) decision-making during sham stimulation. While right anodal stimulation of the DLPFC enhanced conservative decision-making in healthy volunteers, both right anodal and left anodal DLPFC stimulation increased the propensity for risk-taking in marijuana users. These findings reveal alterations in the decision-making neural networks among chronic marijuana users. Finally, we also assessed the effects of tDCS on marijuana craving and observed that right anodal/left cathodal tDCS of DLPFC is significantly associated with a diminished craving for marijuana. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Simultaneous transcranial direct current stimulation (tDCS) and whole-head magnetoencephalography (MEG): assessing the impact of tDCS on slow cortical magnetic fields.

Science.gov (United States)

Garcia-Cossio, Eliana; Witkowski, Matthias; Robinson, Stephen E; Cohen, Leonardo G; Birbaumer, Niels; Soekadar, Surjo R

2016-10-15

Transcranial direct current stimulation (tDCS) can influence cognitive, affective or motor brain functions. Whereas previous imaging studies demonstrated widespread tDCS effects on brain metabolism, direct impact of tDCS on electric or magnetic source activity in task-related brain areas could not be confirmed due to the difficulty to record such activity simultaneously during tDCS. The aim of this proof-of-principal study was to demonstrate the feasibility of whole-head source localization and reconstruction of neuromagnetic brain activity during tDCS and to confirm the direct effect of tDCS on ongoing neuromagnetic activity in task-related brain areas. Here we show for the first time that tDCS has an immediate impact on slow cortical magnetic fields (SCF, 0-4Hz) of task-related areas that are identical with brain regions previously described in metabolic neuroimaging studies. 14 healthy volunteers performed a choice reaction time (RT) task while whole-head magnetoencephalography (MEG) was recorded. Task-related source-activity of SCFs was calculated using synthetic aperture magnetometry (SAM) in absence of stimulation and while anodal, cathodal or sham tDCS was delivered over the right primary motor cortex (M1). Source reconstruction revealed task-related SCF modulations in brain regions that precisely matched prior metabolic neuroimaging studies. Anodal and cathodal tDCS had a polarity-dependent impact on RT and SCF in primary sensorimotor and medial centro-parietal cortices. Combining tDCS and whole-head MEG is a powerful approach to investigate the direct effects of transcranial electric currents on ongoing neuromagnetic source activity, brain function and behavior. Copyright © 2015 Elsevier Inc. All rights reserved.

GLP-1 secretion is stimulated by 1,10-phenanthroline via colocalized T2R5 signal transduction in human enteroendocrine L cell

Energy Technology Data Exchange (ETDEWEB)

Park, Jiyoung; Kim, Ki-Suk; Kim, Kang-Hoon; Lee, In-Seung; Jeong, Hyeon-soo; Kim, Yumi; Jang, Hyeung-Jin, E-mail: hjjang@khu.ac.kr

2015-12-04

Glucagon-like peptide-1 (GLP-1) hormone is known to regulate blood glucose by an insulinotropic effect and increases proliferation as and also prevents apoptosis of pancreatic β cells. We know that GLP-1 is secreted by nutrients such as fatty acids and sweet compounds but also bitter compounds via stimulation of G-protein coupled receptors (GPCRs) in the gut. Among these, bitter compounds are multiply-contained in phytochemicals or artificial materials and perceived as ligands of various bitter taste receptors. We hypothesized that GLP-1 hormone is secreted through stimulation of a single bitter taste receptor by 1,10-phenanthroline which is known agonist of taste receptor type 2 member 5 (T2R5). To prove this hypothesis, we used the representatively well-known 1,10-phenanthroline as ligand of single receptor and evaluated the existence of T2R5 by double-labeling immunofluorescence and then 1,10-phenanthroline is able to secrete GLP-1 hormone through stimulation of T2R5 in human enteroendocrine cells. Consequently, we verify that GLP-1 hormone is colocalized with T2R5 in the human duodenum and ileum tissue and is secreted by 1,10-phenanthroline via T2R5 signal transduction in differentiated human enteroendocrine L cells. - Highlights: • Taste receptor type 2 member 5 (T2R5) is colocalized with GLP-1 hormone in human enteroendocrine cells. • GLP-1 secretion is stimulated by 1,10-phenanthroline via stimulation of T2R5. • Inhibition of the bitter taste pathway reduce GLP-1 secretion.

GLP-1 secretion is stimulated by 1,10-phenanthroline via colocalized T2R5 signal transduction in human enteroendocrine L cell

International Nuclear Information System (INIS)

Park, Jiyoung; Kim, Ki-Suk; Kim, Kang-Hoon; Lee, In-Seung; Jeong, Hyeon-soo; Kim, Yumi; Jang, Hyeung-Jin

2015-01-01

Glucagon-like peptide-1 (GLP-1) hormone is known to regulate blood glucose by an insulinotropic effect and increases proliferation as and also prevents apoptosis of pancreatic β cells. We know that GLP-1 is secreted by nutrients such as fatty acids and sweet compounds but also bitter compounds via stimulation of G-protein coupled receptors (GPCRs) in the gut. Among these, bitter compounds are multiply-contained in phytochemicals or artificial materials and perceived as ligands of various bitter taste receptors. We hypothesized that GLP-1 hormone is secreted through stimulation of a single bitter taste receptor by 1,10-phenanthroline which is known agonist of taste receptor type 2 member 5 (T2R5). To prove this hypothesis, we used the representatively well-known 1,10-phenanthroline as ligand of single receptor and evaluated the existence of T2R5 by double-labeling immunofluorescence and then 1,10-phenanthroline is able to secrete GLP-1 hormone through stimulation of T2R5 in human enteroendocrine cells. Consequently, we verify that GLP-1 hormone is colocalized with T2R5 in the human duodenum and ileum tissue and is secreted by 1,10-phenanthroline via T2R5 signal transduction in differentiated human enteroendocrine L cells. - Highlights: • Taste receptor type 2 member 5 (T2R5) is colocalized with GLP-1 hormone in human enteroendocrine cells. • GLP-1 secretion is stimulated by 1,10-phenanthroline via stimulation of T2R5. • Inhibition of the bitter taste pathway reduce GLP-1 secretion.

Influence of structure and properties of tubular billets of the 12 Kh 18N10T steel on deformability of tubes at cold-rolling mills

International Nuclear Information System (INIS)

Vil'yams, O.S.; Bol'shova, N.M.; Olejnik, O.V.; Velikotnaya, E.S.

1979-01-01

Metallographic analysis of the defects of the ''oblique cracks'' type on the surface of hot-rolled tubes of the 12Kh18N10T steel has been carried out. Recommended is the complex of mechanical properties and the structure factors (grain size) of conversion hot-rolled tubes, providing the combination of ductility and high rapture strength during rolling at pilger mills. At a grain size not coarser than number 5, a billet must have σsub(T) 5 >=40 %. Hot-rolled coarse-grained billet is not recommended for warm rolng because of high strain hardening

Acoustic emission analysis on tensile failure of steam-side oxide scales formed on T22 alloy superheater tubes

Energy Technology Data Exchange (ETDEWEB)

Huang, Jun-Lin; Zhou, Ke-Yi, E-mail: boiler@seu.edu.cn; Xu, Jian-Qun [Key Laboratory of Energy Thermal Conversion and Control of Ministry of Education, School of Energy and Environment, Southeast University, Nanjing 210096, Jiangsu Province (China); Wang, Xin-Meng; Tu, Yi-You [School of Materials Science and Engineering, Southeast University, Nanjing 210096, Jiangsu Province (China)

2014-07-28

Failure of steam-side oxide scales on boiler tubes can seriously influence the safety of coal-fired power plants. Uniaxial tensile tests employing acoustic emission (AE) monitoring were performed, in this work, to investigate the failure behavior of steam-side oxide scales on T22 alloy boiler superheater tubes. The characteristic frequency spectra of the captured AE signals were obtained by performing fast Fourier transform. Three distinct peak frequency bands, 100-170, 175-250, and 280-390 kHz, encountered in different testing stages were identified in the frequency spectra, which were confirmed to, respectively, correspond to substrate plastic deformation, oxide vertical cracking, and oxide spalling with the aid of scanning electronic microscopy observations, and can thus be used for distinguishing different oxide failure mechanisms. Finally, the critical cracking strain of the oxide scale and the interfacial shear strength of the oxide/substrate interface were estimated, which are the critical parameters urgently desired for modeling the failure behavior of steam-side oxide scales on boiler tubes of coal-fired power plants.

Acoustic emission analysis on tensile failure of steam-side oxide scales formed on T22 alloy superheater tubes

Science.gov (United States)

Huang, Jun-Lin; Zhou, Ke-Yi; Wang, Xin-Meng; Tu, Yi-You; Xu, Jian-Qun

2014-07-01

Failure of steam-side oxide scales on boiler tubes can seriously influence the safety of coal-fired power plants. Uniaxial tensile tests employing acoustic emission (AE) monitoring were performed, in this work, to investigate the failure behavior of steam-side oxide scales on T22 alloy boiler superheater tubes. The characteristic frequency spectra of the captured AE signals were obtained by performing fast Fourier transform. Three distinct peak frequency bands, 100-170, 175-250, and 280-390 kHz, encountered in different testing stages were identified in the frequency spectra, which were confirmed to, respectively, correspond to substrate plastic deformation, oxide vertical cracking, and oxide spalling with the aid of scanning electronic microscopy observations, and can thus be used for distinguishing different oxide failure mechanisms. Finally, the critical cracking strain of the oxide scale and the interfacial shear strength of the oxide/substrate interface were estimated, which are the critical parameters urgently desired for modeling the failure behavior of steam-side oxide scales on boiler tubes of coal-fired power plants.

Acoustic emission analysis on tensile failure of steam-side oxide scales formed on T22 alloy superheater tubes

International Nuclear Information System (INIS)

Huang, Jun-Lin; Zhou, Ke-Yi; Xu, Jian-Qun; Wang, Xin-Meng; Tu, Yi-You

2014-01-01

Failure of steam-side oxide scales on boiler tubes can seriously influence the safety of coal-fired power plants. Uniaxial tensile tests employing acoustic emission (AE) monitoring were performed, in this work, to investigate the failure behavior of steam-side oxide scales on T22 alloy boiler superheater tubes. The characteristic frequency spectra of the captured AE signals were obtained by performing fast Fourier transform. Three distinct peak frequency bands, 100-170, 175-250, and 280-390 kHz, encountered in different testing stages were identified in the frequency spectra, which were confirmed to, respectively, correspond to substrate plastic deformation, oxide vertical cracking, and oxide spalling with the aid of scanning electronic microscopy observations, and can thus be used for distinguishing different oxide failure mechanisms. Finally, the critical cracking strain of the oxide scale and the interfacial shear strength of the oxide/substrate interface were estimated, which are the critical parameters urgently desired for modeling the failure behavior of steam-side oxide scales on boiler tubes of coal-fired power plants.

Bacteremia following T-tube cholangiography: Injection by hand versus gravity-infusion technique

International Nuclear Information System (INIS)

Messmer, J.M.; Bradley, J.J.; Cho, S.R.; Turner, M.A.

1986-01-01

Twenty-four patients were evaluated to determine if the method of performing T-tube cholangiography had bearing on the development of bacteremia. Fifteen patients underwent cholangiography after hand injection (HI) of contrast medium and 12 patients cholangiogrpahy after gravity infusion of contrast medium. In three patients both techniques were used. Injection pressures were monitored and blood and bile samples were obtained for culture. In four of the 11 patients (36%) in the HI group who were not taking antibiotics, pathogens were cultured from blood drawn immediately after cholangiographic. The remaining four patients in this group were taking antibiotics and had negative blood cultures. None of the 12 patients in the GI group had positive blood cultures. There was a correlation between the higher injection pressures generated using the HI technique and positive blood cultures

Effect of cisapride on symptoms and biliary drainage in patients with postcholecystectomy syndrome

International Nuclear Information System (INIS)

Farup, P.G.; Tjora, S.; Tholfsen, K.

1991-01-01

The study evaluates the effect of 20 mg cisapride twice daily on symptoms and biliary drainage in patients with the postcholecystectomy syndrome. 19 patients, all female, went through a randomized, double-blind, placebo-controlled, crossover trial with two 4-week treatment periods separated by a 2-week washout period. Symptoms were registered on diary cards. Biliary drainage was studied with dynamic cholescinitigraphy. The down slope of the time-activity curve was used as a measure of the biliary drainage. More symptoms were registered during cisapride therapy than with placebo. This unfavourable effect of cisapride was statistically significant in a subgroup of patients with postcholecystectomy complaints identical to the biliary pain they experienced during injection of contrast at the endoscopic retrograde cholangiopancreatographic examination. Cisapride statistically significantly hastened biliary drainage. The median T 1/2 values were 24 and 28 min after cisapride and placebo, respectively. In conclusion, cisapride promoted biliary drainage in patients with the postcholecystectomy syndrome, but had an unfavourable symptomatic effect in those with bile duct triggered postcholecystectomy complaints. 22 refs., 3 figs

Intracavitary application of contrast medium in the follow-up of complicated tube-drained pleural empyema: Conventional radiography vs CT

International Nuclear Information System (INIS)

Duex, M.; Bischoff, H.; Schmaehl, A.; Tuengerthal, S.

1997-01-01

Purpose: To define the value of conventional radiography compared with CT in the follow-up of complicated, long-term tube drained pleural empyema after intracavitary application of contrast medium. Methods: 28 patients with complicated pleural empyema (stage III) and longterm tube drainage were submitted to fluoroscopy of the pleural cavity and a CT of the thorax after contrast medium had been instilled into the pleural space. Both examinations were judged by the following criteria: Number and morphology of pleural cavities, quality of drainage and accompanying thoracic disease. Results: 49 pleural cavities were diagnosed. Judgement of drainage corresponded in 79% of cases and differed 21% with proof of further not drained cavities only on CT. 4 bronchopleural fistulas were diagnosed by fluoroscopy, of which only 2 were evident on CT. Accompanying thoracic disease was reliably detected by CT only. Conclusions: Diagnosis of bronchopleural fistulas and judgement of the pleural drainage is best possible using fluoroscopy after application of contrast medium into the pleural space. CT is most accurate to detect further cavities that have not been drained, to look for concomitant thoracic disease, and to judge the morphology of the pleural cavity. Conventional radiography of the pleural space is effective and recommended to be used as a first line investigation for the follow-up of stage III empyemas. Patients in poor general condition (fever, elevated blood markers indicating inflammation) should be examined by both fluoroscopy and CT. (orig.) [de

Quasi-static axial crushes on woven jute/polyester AA6063T52 composite tubes

Science.gov (United States)

Othman, A.; Ismail, AE

2018-04-01

Quasi-static axial loading have been studied in this paper to determine the behaviour of jute/polyester wrapped on aluminium alloy 6063T52. The filler material also was include into crush box specimen, which is polyurethane (PU) and polystyrene (PE) rigid foam at ranging 40 and 45 kg/m3 densities. All specimen profile was fabricated using hand layup techniques and the length of each specimen were fixed at 100 mm as well as diameter and width of the tube at 50.8 mm. The two types of tubular cross-section were studied of round and square thin-walled profiles and the angle of fibre at 450 were analysed for four layers. Thin walled of aluminium was 1.9 mm and end frontal of each specimen of composite were chamfered at 450 to prevent catastrophic failure mode. The specific absorbed energy (SEA) and crush force efficiency (CFE) were analyses for each specimen to see the behaviour on jute/polyester wrapped on metallic structure can give influence the energy management for automotive application. Result show that the four layers’ jute/polyester with filler material show significant value in term of specific absorbed energy compared empty and polyurethane profiles higher 26.66% for empty and 15.19% compared to polyurethane profiles. It has been found that the thin walled square profile of the jute/polyester tubes with polystyrene foam-filled is found higher respectively 27.42% to 13.13% than empty and polyurethane (PU) foam tubes. An introduce filler material onto thin walled composite profiles gave major advantage increases the mean axial load of 31.87% from 32.94 kN to 48.35 kN from empty to polystyrene thin walled round jute/polyester profiles and 31.7% from 23.11 KN to 33.84 kN from empty to polystyrene thin walled square jute/polyester profiles. Failure mechanisms of the axially loaded composite tubes were also observed and discussed.

Subsurface irrigation of potato crop (Solanum tuberosum ssp. Andigena) in Suka Kollus with different drainage systems

Science.gov (United States)

Serrano-Coronel, Genaro; Chipana-Rivera, René; Fátima Moreno-Pérez, María; Roldán-Cañas, José

2016-04-01

Among the most important hydraulic structures of pre-Hispanic ancestral technology developed in the Andean region, we find the suka kollus, aymara word, called also waru waru, en quechua or raised fields, in English. They are raised platforms surrounded by water canals that irrigate subsurface, but also have the function of draining, to deal with floods because they are surrounding Lake Titicaca. They also have the property of generating a thermoregulatory effect to crops, depending on the configuration of the channels and platforms. Such agro-ecosystems are being abandoned, however, if properly addressed crop management and some drainage canals are replaced by underground drains for increased crop area could be very useful in enabling marginal soils affected by salts and / or excess water. For these reasons, the objective of this study was to evaluate the subsurface irrigation in the potato crop in suka kollus under a system of surface drainage, and mixed drainage (surface and subsurface). The study was conducted in marginal soils of Kallutaca area, located 30 km from the city of La Paz, Bolivia, at a height of 3892 m.a.s.l. The cultivation of the potato (Solanum tuberosum ssp. Andigena) was used. Four treatments were tested with different widths of the platforms: T1 (Control) with drainage through channels; T2 (replacing a channel by a drain); T3 (replacing two channels by two drains); T4 (replacing three channels by three drains). The flow of water into the soil from the water table was predominantly upward, except during periods of high rainfall. In terms of treatments, the flow in T1 was higher, mainly at weeks 8 to 11 after seedling emergence, coinciding with the phenological phases of flowering and at the beginning of the tuber ripening. It was followed by T3, T2 and T4 treatments, respectively. Tuber yield, if one considers that the channels detract arable land, was higher in the T3 treatment,16.4 Mg / ha, followed by T2 treatment, 15.2 Mg / ha, T1

A Rare Complication of Abdominal Drain: Fallopian Tube Herniation Through the Drain Site

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Dilek Uygur

2016-05-01

Full Text Available Prophylactic drainage of the peritoneal cavity after obstetrical and gynecological surgery is widely practiced. The idea of “when in doubt, drain” is accepted and applied clinically by many surgeons. However, surgically placed drains are not without risk. The present case describes herniation of fallopian tube during the removal of a surgical drain placed after a cesarean section.

Late-onset endophthalmitis secondary to exposed glaucoma tube implant in a rare case of paediatric glaucoma.

Science.gov (United States)

Ranganath, Akshatha; Hashim, Adnan

2011-01-01

Glaucoma drainage implants (GDIs) are used to treat paediatric glaucoma resistant to conventional medical and surgical treatment, achieving good intraocular pressure (IOP) control and long-term success. Late endophthalmitis is a rare complication that may develop following GDI surgery. A 17-year-old male presented with acute endophthalmitis 2 years after Ahmed glaucoma valve implantation with pericardial patch graft for management of refractory glaucoma secondary to congenital ectropion uveae. The glaucoma tube was exposed due to erosion of the overlying conjunctiva with no visible pericardial graft. After control of active infection, he underwent tube revision surgery whereby the exposed tube was retained and repatched with a double-thickness pericardial patch graft. He did well following surgery with good control of IOP and restoration of vision. Conjunctival dehiscence with graft melting over the GDI tube presented a major risk factor for endophthalmitis. Prompt surgical revision of an exposed tube is highly recommended to avoid ocular morbidity.

Late-Onset Endophthalmitis Secondary to Exposed Glaucoma Tube Implant in a Rare Case of Paediatric Glaucoma

Directory of Open Access Journals (Sweden)

Akshatha Ranganath

2011-01-01

Full Text Available Glaucoma drainage implants (GDIs are used to treat paediatric glaucoma resistant to conventional medical and surgical treatment, achieving good intraocular pressure (IOP control and long-term success. Late endophthalmitis is a rare complication that may develop following GDI surgery. A 17-year-old male presented with acute endophthalmitis 2 years after Ahmed glaucoma valve implantation with pericardial patch graft for management of refractory glaucoma secondary to congenital ectropion uveae. The glaucoma tube was exposed due to erosion of the overlying conjunctiva with no visible pericardial graft. After control of active infection, he underwent tube revision surgery whereby the exposed tube was retained and repatched with a double-thickness pericardial patch graft. He did well following surgery with good control of IOP and restoration of vision. Conjunctival dehiscence with graft melting over the GDI tube presented a major risk factor for endophthalmitis. Prompt surgical revision of an exposed tube is highly recommended to avoid ocular morbidity.

Decompression of malignant biliary obstruction by duodenoscopic intubation of bile duct.

OpenAIRE

Laurence, B H; Cotton, P B

1980-01-01

Interest is increasing in non-operative methods of relieving malignant obstruction of the bile duct, and drainage tubes and prostheses may be placed in the bile duct via the percutaneous transhepatic route. Two cases are described, however, in which a duodenoscope was used and the approach was via the papilla of Vater. This method allows temporary or permanent drainage tubes to be placed through malignant strictures. This endoscopic approach is less invasive and should be safer than that by t...

The effect of mechanical lymph drainage accompanied with heat on lymphedema.

Science.gov (United States)

Mariana, Valente Flávia; de Fátima, Guerreiro Godoy Maria; Maria, Pereira de Godoy José

2011-11-01

Thermotherapy has been indicated by some researchers as a treatment for lymphedema. A study comparing temperatures demonstrated that a temperature of 40°C significantly increased the transportation of lymph compared to other temperatures assessed. The aim of this study was to evaluate the possible benefits of mechanical lymph drainage accompanied with heat in the treatment of lymphedema of the lower limbs. In a cross-over randomized study, the effect of heat on lymph drainage was evaluated in the treatment of leg lymphedema. The study, performed in the Godoy Clinic in São Jose do Rio Preto, Brazil, involved seven patients (two males and five females) with leg lymphedema. The patients' ages ranged from 18 to 79 years old with a mean of 48.5 years. The subjects underwent a total of 38 assessments including 19 evaluations of mechanical lymph drainage alone and 19 combined with thermotherapy. Heat was applied using an electric blanket which was wrapped around the legs of the patients. The volume of legs was evaluated by water plethysmography before and after treatment sessions. The paired t-test was used for statistical analysis with an alpha error of p = 0.05 being considered as acceptable. No statistically significant differences were evidenced between mechanical lymph drainage alone and lymph drainage combined with thermotherapy. There was no obvious synergic effect in the immediate post-treatment period when heat was combined with mechanical lymph drainage in the treatment of lymphedema.

Mixed Signals: Co-Stimulation in Invariant Natural Killer T Cell-Mediated Cancer Immunotherapy

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Susannah C. Shissler

2017-11-01

Full Text Available Invariant natural killer T (iNKT cells are an integral component of the immune system and play an important role in antitumor immunity. Upon activation, iNKT cells can directly kill malignant cells as well as rapidly produce cytokines that stimulate other immune cells, making them a front line defense against tumorigenesis. Unfortunately, iNKT cell number and activity are reduced in multiple cancer types. This anergy is often associated with upregulation of co-inhibitory markers such as programmed death-1. Similar to conventional T cells, iNKT cells are influenced by the conditions of their activation. Conventional T cells receive signals through the following three types of receptors: (1 T cell receptor (TCR, (2 co-stimulation molecules, and (3 cytokine receptors. Unlike conventional T cells, which recognize peptide antigen presented by MHC class I or II, the TCRs of iNKT cells recognize lipid antigen in the context of the antigen presentation molecule CD1d (Signal 1. Co-stimulatory molecules can positively and negatively influence iNKT cell activation and function and skew the immune response (Signal 2. This study will review the background of iNKT cells and their co-stimulatory requirements for general function and in antitumor immunity. We will explore the impact of monoclonal antibody administration for both blocking inhibitory pathways and engaging stimulatory pathways on iNKT cell-mediated antitumor immunity. This review will highlight the incorporation of co-stimulatory molecules in antitumor dendritic cell vaccine strategies. The use of co-stimulatory intracellular signaling domains in chimeric antigen receptor-iNKT therapy will be assessed. Finally, we will explore the influence of innate-like receptors and modification of immunosuppressive cytokines (Signal 3 on cancer immunotherapy.

Preparation of second antibody enhanced coated tubes for radioimmunoassay of triiodothyronine and thyroxine

International Nuclear Information System (INIS)

Mehany, N.L.; El-Kolaly, M.T.; Ghonaim, A.; Abdelmouhty, N.R.

1999-01-01

The production of high technology RIA reagents with low cost is considered to be one of the important goal of labelled compounds dept., Radioisotope production division, hot labs centre, egyptian atomic energy authority. The development of a direct radioimmunoassay for the measurement of triiodothyronine (T 3 ) and thyroxine (T 4 ) in human serum is described. The coating of polystyrene tubes with affinity purified second antibody (Donkey antisheep antibody, DASS) followed by sheep polyclonal antisera specific for each of T 3 and T 4 was carried out. The stability study of these coated tubes revealed that these tubes could stored for at least one year at 4degree C without any appreciable reduction in binding. The assays were performed by adding 200 MU1 radiolabelled hormones ( 125 I - T 3 or 125 I - T 4 ) to standards, unknown samples or quality controls (50 MU1 10 MU1 for T 3 and T 4 , respectively ) into corresponding assay tubes. The reaction is allowed to proceed at 37degree C for 2h and 1h for T 3 and T 4 respectively. Then the tubes were decanted, washed and counted. Twenty human serum samples of different thyroid disorders were analyzed for T 3 and T 4 using the present systems and with commercially available kits (DOC, coated tubes). The statistical analysis showed good correlations between the results obtained from the present systems and the DPC kits (r = 0.994 and 0.990 for T 3 and T 4 respectively). Hypothyroid, euthyroid and hyperthyroid subjects are reasonably and accurately distinguished using our methods

In-office drainage of sinus Mucoceles: An alternative to operating-room drainage.

Science.gov (United States)

Barrow, Emily M; DelGaudio, John M

2015-05-01

Endoscopic drainage has become the standard of care for the treatment of mucoceles. In many patients this can be performed in the office. This study reviews our experience with in-office endoscopic mucocele drainage. Retrospective chart review. A retrospective review of one surgeon's experience with in-office endoscopic drainage of sinus mucoceles between 2006 and 2014 was performed. Charts were reviewed for patient demographics, previous surgery, mucocele location, bone erosion, and outcomes. Thirty-two patients underwent 36 in-office drainage procedures. All procedures were performed under topical/local anesthesia. The mean age was 55 years (range, 17-92 years). The mean follow-up time was 444 days. Fifty-five percent had previous sinus surgery. The primary sinus involved was the frontal (12), anterior (11), posterior ethmoid (six), maxillary (four), and sphenoid (two). Bone erosion was noted to be present on computed tomography in 18 mucoceles (51%) (16 orbital, seven skull-base). All mucoceles were successfully accessed in the office with the exception of one, which was aborted due to neo-osteogenesis. Five patients (14% of mucoceles) required additional surgery, two for mucocele recurrence and three for septated mucoceles not completely drained in the office. No treatment complications occurred. All but one patient preferred in-office to operating-room drainage. In-office drainage of sinus mucoceles is well tolerated by patients, with high success and low complication rates, even in large mucoceles with bone erosion. The presence of septations and neo-osteogenesis reduce the likelihood of complete drainage and are relative contraindications. Orbital and skull base erosion are not contraindications. 4. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Enhanced Dendritic Cell-Mediated Antigen-Specific CD4+ T Cell Responses: IFN-Gamma Aids TLR Stimulation

Directory of Open Access Journals (Sweden)

Kuo-Ching Sheng

2013-01-01

Full Text Available Phenotypic maturation and T cell stimulation are two functional attributes of DCs critical for immune induction. The combination of antigens, including those from cancer, with Toll-like receptor (TLR ligands induces far superior cellular immune responses compared to antigen alone. In this study, IFN-gamma treatment of bone marrow-derived DC, followed by incubation with the TLR2, TLR4, or TLR9 agonists, enhanced DC activation compared to TLR ligation alone. Most notably, the upregulation of CD40 with LPS stimulation and CD86 with CpG stimulation was observed in in vitro cultures. Similarly, IFN-gamma coinjected with TLR ligands was able to promote DC activation in vivo, with DCs migrating from the site of immunization to the popliteal lymph nodes demonstrating increased expression of CD80 and CD86. The heightened DC activation translated to a drastic increase in T cell stimulatory capacity in both antigen independent and antigen dependent fashions. This is the first time that IFN-gamma has been shown to have a combined effect with TLR ligation to enhance DC activation and function. The results demonstrate the novel use of IFN-gamma together with TLR agonists to enhance antigen-specific T cell responses, for applications in the development of enhanced vaccines and drug targets against diseases including cancer.

The Cish SH2 domain is essential for PLC-γ1 regulation in TCR stimulated CD8+ T cells.

Science.gov (United States)

Guittard, Geoffrey; Dios-Esponera, Ana; Palmer, Douglas C; Akpan, Itoro; Barr, Valarie A; Manna, Asit; Restifo, Nicholas P; Samelson, Lawrence E

2018-03-28

Cish, participates within a multi-molecular E3 ubiquitin ligase complex, which ubiquitinates target proteins. It has an inhibitory effect on T cell activation mediated by PLC-γ1 regulation, and it functions as a potent checkpoint in CD8 + T cell tumor immunotherapy. To study the structural and functional relationships between Cish and PLC-γ1 during CD8 + T cell activation, we tested mutants of the Cish-SH2 (R107K) and D/BC (L222Q, C226Q) domains. We confirmed that Cish-SH2-specific binding was essential for PLC-γ1 ubiquitination and degradation. This domain was essential for the Cish-mediated inhibition of Ca 2+ release upon TCR stimulation. No effect on inhibition of cytokine release was observed with SH2 or D/BC mutants, although the absence of Cish led to an increased release of IFN-γ and TNF-α. Using imaging we showed that Cish was expressed mostly in the cytoplasm and we did not see any Cish clustering at the plasma membrane upon stimulation. We conclude that the Cish-SH2 domain is essential for PLC-γ1 regulation in TCR-stimulated CD8 + T cells.

Water quality issues associated with agricultural drainage in semiarid regions

Science.gov (United States)

Sylvester, Marc A.

High incidences of mortality, birth defects, and reproductive failure in waterfowl using Kesterson Reservoir in the San Joaquin Valley, Calif., have occurred because of the bioaccumulation of selenium from irrigation drainage. These circumstances have prompted concern about the quality of agriculture drainage and its potential effects on human health, fish and wildlife, and beneficial uses of water. The U.S. Geological Survey (USGS) and Lawrence Berkeley Laboratory, University of California (Berkeley, Calif.) organized a 1-day session at the 1986 AGU Fall Meeting in San Francisco, Calif., to provide an interdisciplinary forum for hydrologists, geochemists, and aquatic chemists to discuss the processes controlling the distribution, mobilization, transport, and fate of trace elements in source rocks, soils, water, and biota in semiarid regions in which irrigated agriculture occurs. The focus of t h e session was the presentation of research results on the source, distribution, movement, and fate of selenium in agricultural drainage.

Enteral feeding without pancreatic stimulation

DEFF Research Database (Denmark)

Kaushik, Neeraj; Pietraszewski, Marie; Holst, Jens Juul

2005-01-01

OBJECTIVE: All forms of commonly practiced enteral feeding techniques stimulate pancreatic secretion, and only intravenous feeding avoids it. In this study, we explored the possibility of more distal enteral infusions of tube feeds to see whether activation of the ileal brake mechanism can result...

Percutaneous drainage of lung abscesses

International Nuclear Information System (INIS)

van Sonnenberg, E.; D'Agostino, H.; Casola, G.; Vatney, R.R.; Wittich, G.R.; Harker, C.

1989-01-01

The authors performed percutaneous drainage of lung abscesses in 12 patients. Indications for drainage were septicemia and persistence or worsening of radiographic findings. These lung abscesses were refractory to intravenous antibiotics and to bronchial toilet. Etiology of the abscesses included pneumonia (most frequently), trauma, postoperative development, infected necrotic neoplasm, and infected sequestration. Guidelines for drainage included passage of the catheter through contiguously abnormal lung and pleura, inability of the patient to cough, and/or bronchial obstruction precluding bronchial drainage. Cure was achieved in 11 of 12 patients. Catheters were removed on an average of 16 days after insertion. Antibiotics were administered an average of 18 days before drainage. No major complications occurred

Cathodal transcranial direct current stimulation (tDCS) applied to the left premotor cortex (PMC) stabilizes a newly learned motor sequence.

Science.gov (United States)

Focke, Jan; Kemmet, Sylvia; Krause, Vanessa; Keitel, Ariane; Pollok, Bettina

2017-01-01

While the primary motor cortex (M1) is involved in the acquisition the premotor cortex (PMC) has been related to over-night consolidation of a newly learned motor skill. The present study aims at investigating the possible contribution of the left PMC for the stabilization of a motor sequence immediately after acquisition as determined by susceptibility to interference. Thirty six healthy volunteers received anodal, cathodal and sham transcranial direct current stimulation (tDCS) to the left PMC either immediately prior to or during training on a serial reaction time task (SRTT) with the right hand. TDCS was applied for 10min, respectively. Reaction times were measured prior to training (t1), at the end of training (t2), and after presentation of an interfering random pattern (t3). Beyond interference from learning, the random pattern served as control condition in order to estimate general effects of tDCS on reaction times. TDCS applied during SRTT training did not result in any significant effects neither on acquisition nor on susceptibility to interference. In contrast to this, tDCS prior to SRTT training yielded an unspecific facilitation of reaction times at t2 independent of tDCS polarity. At t3, reduced susceptibility to interference was found following cathodal stimulation. The results suggest the involvement of the PMC in early consolidation and reveal a piece of evidence for the hypothesis that behavioral tDCS effects vary with the activation state of the stimulated area. Copyright © 2016. Published by Elsevier B.V.

Residual indicator bacteria in autosampler tubing: a field and laboratory assessment.

Science.gov (United States)

Hathaway, J M; Hunt, W F; Guest, R M; McCarthy, D T

2014-01-01

Microbial contamination in surface waters has become a worldwide cause for concern. As efforts are made to reduce this contamination, monitoring is integral to documenting and evaluating water quality improvements. Autosamplers are beneficial in such monitoring efforts, as large data sets can be generated with minimized effort. The extent to which autosamplers can be utilized for microbial monitoring is largely unknown due to concerns over contamination. Strict sterilization regimes for components contacting the water being sampled are difficult, and sometimes logistically implausible, when utilizing autosamplers. Field experimentation showed contamination of fecal coliform in autosamplers to be more of a concern than that of Escherichia coli. Further study in a controlled laboratory environment suggested that tubing configuration has a significant effect on residual E. coli concentrations in sampler tubing. The amount of time that passed since the last sample was collected from a given sampler (antecedent dry weather period - DWP) tubing was also a significant factor. At a DWP of 7 days, little to no contamination was found. Thus, simple protocols such as providing positive drainage of tubing between sample events and programming samplers to include rinses will reduce concerns of contamination in autosamplers.

Tube pancreatico-duodenostomy for management of a severe penetrating pancreaticoduodenal injury.

Science.gov (United States)

Hatzigeorgiadis, Anestis; Boulas, Konstantinos A; Barettas, Nikolaos; Papageorgiou, Irene; Blouhos, Konstantinos

2014-05-27

Optimal management of penetrating pancreaticoduodenal injuries and better outcomes are associated with simple, fast damage control surgery and shorter operative time. The performance of pyloric exclusion and tube duodenostomy has markedly decreased. However, there is still a trend toward their performance in cases of delay duodenal repair or severe pancreaticoduodenal injury. The present report describes a case of a hemodynamically stable patient with a single penetrating gunshot trauma causing an AAST-OIS grade III pancreatic head injury and grade IV injury of the second portion of the duodenum. The patient was treated in our Level IV rural trauma center and submitted to primary closure of the posterolateral duodenal wall (the laceration of the contralateral inner medial duodenal wall could not be repaired), external duodenal and pancreatic drainage, and duodenal decompression by tube pancreatico-duodenostomy (insertion of a 18 Fr Foley catheter through the laceration of the pancreatic head toward the duodenal lumen), tube cholangiostomy, and pyloric exclusion accompanied with a feeding jejunostomy. Tube pancreatico-duodenostomy, which is described for the first time in the literature, turned out to be effective and can be considered as an option in pancreaticoduodenal trauma when the inner medial duodenal wall cannot be repaired.

Right pleural versus mediastinal drainage following elective off-pump coronary artery bypass

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Forouzan nia SKh

2011-03-01

Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Proper drainage of the mediastinal and pleural spaces following Off-Pump Coronary Artery Bypass (OPCAB surgery is essential for the prevention of pleural and pericardial effusions, cardiac tamponade and late complications such as constrictive pericarditis. Drainage tubes themselves may induce some complications which can negatively affect the result of the surgery. In this study we assessed a new technique for chest drainage following OPCAB."n"nMethods: In this clinical trial, 171 patients were allocated to two groups. In the control group, the drainage technique included one drain in the left pleural cavity and another in the mediastinum, while in the case group; the drainage technique included one drain in the left plural and one in the right pleural cavity."n"nResults: The amount of drainage in the case group was more than the control group (p=0.001. We found significant reductions in the incidence of arrhythmias in the case group (p=0.005. While one patient (1.2% needed reoperation for bleeding control in the control group, no patients needed reexploration in the case group (p=0.497. The duration of hospital (p=0.022 and ICU (p=0.002 stays was shorter in the case group."n"nConclusions: Based on the

The Effectiveness of Transcranial Direct Current Stimulation (tDCS on Working Memory in Patients with Major Depression

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Mahboube Ebadi

2017-08-01

Full Text Available Abstract Background: The aim of this study was to evaluate the effectiveness of of transcranial direct current stimulation (tDCS on working memory in patients with major depression. Materials and Methods: The research method was quasi-experimental with pretest and post-test and follow-up with control group. The research population comprised female outpatient referrals to private psychiatric centers and psychological counseling centers in Tehran in the first half of 2016, They had received a diagnosis of depression by a psychiatrist at least once. Of these, 30 females were selected as a sample group with convenience sampling method and based on the criteria of inclusion and exclusion and were divided randomly into two groups , experimental (n = 15 and control (n = 15 group. The experimental group received transcranial direct current stimulation (tDCS in 10 sessions, While this intervention was not provided to the control group. The data were collected by N-BACK. Analysis of variance with repeated measurments was used to test the research hypothesis. Results: The results showed that transcranial direct current stimulation (tDCS had a significant effect on increasing working memory and the impact will continue to follow up. Conclusion: Therefore, this approach can be used to improve working memory in people with major depression.

Percutaneous catheter drainage of lung abscess

Energy Technology Data Exchange (ETDEWEB)

Kim, Young Shin; Chun, Kyung Ah; Choi, Hyo Sun; Ha, Hyun Kown; Shinn, Kyung Sub [Catholic University Medical college, Seoul (Korea, Republic of)

1993-09-15

From March 1987 to July 1989, six patients (five adults and one child) with lung abscess (size, 5-13 cm in diameter) were treated with percutaneous aspiration and drainage. In each case, the puncture was made where the wall of the abscess was in contact with the pleural surface. An 8 to 10 Fr cartheter was inserted for drainage. Five of 6 had a dynamatic clinical response within 24 hours of the drainage. Percutaneous drainage was successful with complete abscess resolution in four and partial resolution in one patient. No response was seen in the rest one. The duration of drainage ranged from 7 to 18 days(average, 15.5 days) in successful cases. One case of the failure in drainage was due tio persistent aspiration of the neurologically impaired patient. In one patient, the abscess resolved after drainage but recurred after inadvertent removal of the catheter 7 days after insertion. In two patients, concurrent pleural empyema was resolved completely by the drainage. Computed tomography provide anatomic details necessary for choosing the puncture site and avoiding a puncture of the lung parenchyma. Percutaneous catheter drainage is safe and effective method for treating patient with lung abscess.

Percutaneous catheter drainage of lung abscess

International Nuclear Information System (INIS)

Kim, Young Shin; Chun, Kyung Ah; Choi, Hyo Sun; Ha, Hyun Kown; Shinn, Kyung Sub

1993-01-01

From March 1987 to July 1989, six patients (five adults and one child) with lung abscess (size, 5-13 cm in diameter) were treated with percutaneous aspiration and drainage. In each case, the puncture was made where the wall of the abscess was in contact with the pleural surface. An 8 to 10 Fr cartheter was inserted for drainage. Five of 6 had a dynamatic clinical response within 24 hours of the drainage. Percutaneous drainage was successful with complete abscess resolution in four and partial resolution in one patient. No response was seen in the rest one. The duration of drainage ranged from 7 to 18 days(average, 15.5 days) in successful cases. One case of the failure in drainage was due tio persistent aspiration of the neurologically impaired patient. In one patient, the abscess resolved after drainage but recurred after inadvertent removal of the catheter 7 days after insertion. In two patients, concurrent pleural empyema was resolved completely by the drainage. Computed tomography provide anatomic details necessary for choosing the puncture site and avoiding a puncture of the lung parenchyma. Percutaneous catheter drainage is safe and effective method for treating patient with lung abscess

YouTube in the Science Classroom

Science.gov (United States)

Everhart, Jerry

2009-01-01

YouTube makes it possible for teachers to capitalize on children's insatiable appetite for visually stimulating learning. Some of these videos attain "viral" status, getting passed on from person to person and by links on other sites. Not only are these popular videos viral, but developing one's own content and posting it for the world's access is…

Langerhans cells from human oral epithelium are more effective at stimulating allogeneic T cells in vitro than Langerhans cells from skin.

Science.gov (United States)

Hasséus, B; Jontell, M; Bergenholtz, G; Dahlgren, U I

2004-06-01

This report is focused on the functional capacity of Langerhans cells (LC) in the epithelium of skin and oral mucosa, which both meet different antigenic challenges. The capacity of LC from human oral and skin epithelium to provide co-stimulatory signals to T cells in vitro was compared. LC in a crude suspension of oral epithelial cells had a significantly enhanced T cell co-stimulatory capacity compared to skin epithelial cells. This applied both to cultures with concanavalin A (con-A)-stimulated syngeneic T cells and to a mixed epithelial cell lymphocyte reaction involving allogeneic T cells. The co-stimulatory capacity of oral and skin epithelial cells was reduced by >70% if monoclonal antibodies against HLA-DR, -DP and -DQ were added to the cultures with allogeneic T cells, indicating the involvement of HLA class II expressing LC. Immunohistochemistry revealed that 6% of the epithelial cells were CD1a + LC in sections from both oral and skin epithelium. Interleukin (IL)-8 production was higher in cultures of oral epithelial cells and con-A stimulated T cells than in corresponding cultures with skin epithelial cells as accessory cells. The results suggest that LC in human oral epithelium are more efficient at stimulating T cells than those of skin.

What monitor can replace the cathode-ray tube for visual stimulation to elicit multifocal electroretinograms?

Science.gov (United States)

Matsumoto, Celso Soiti; Shinoda, Kei; Matsumoto, Harue; Seki, Keisuke; Nagasaka, Eiichiro; Iwata, Takeshi; Mizota, Atsushi

2014-08-05

To compare a conventional cathode-ray tube (CRT) screen to organic light-emitting diode (OLED) and liquid crystal display (LCD) screens as visual stimulators to elicit multifocal electroretinograms (mfERGs), mfERGs were recorded from seven eyes of seven healthy volunteers (21 ± 2 years). The mfERGs elicited by a conventional CRT screen (S710, Compaq Computer Co.) were compared to those elicited by a studio-grade master OLED monitor (PVM-1741, Sony, Japan) and a conventional LCD (S1721, Flexscan, Eizo Nanao Corp., Japan). The luminance changes of each monitor were measured with a photodiode. CRT, OLED, and LCD screens with a frame frequency of 60 Hz were studied. A hexagonal stimulus array with 61 stimulus elements was created on each monitor. The serial white stimuli of the OLED screen at 60 Hz did not fuse, and that of the LCD screens fused. The amplitudes of P1 and P2 of the first-order kernels of the mfERGs were not significantly different from those elicited by the CRT and OLED screens, and the P1 amplitude of the first-order kernel elicited by the LCD stimuli was significantly smaller than that elicited by the CRT in all the groups of the averaged hexagonal elements. The implicit times were approximately 10 ms longer in almost all components elicited by the LCD screen compared to those elicited by the CRT screen. The mfERGs elicited by monitors other than the CRT should be carefully interpreted, especially those elicited by LCD screens. The OLED had good performance, and we conclude that it can replace the CRT as a stimulator for mfERGs; however, a collection of normative data is recommended. © 2014 ARVO.

Effects of transcranial direct current stimulation (tDCS) on multiscale complexity of dual-task postural control in older adults.

Science.gov (United States)

Zhou, Diange; Zhou, Junhong; Chen, Hu; Manor, Brad; Lin, Jianhao; Zhang, Jue

2015-08-01

Transcranial direct current stimulation (tDCS) targeting the prefrontal cortex reduces the size and speed of standing postural sway in younger adults, particularly when performing a cognitive dual task. Here, we hypothesized that tDCS would alter the complex dynamics of postural sway as quantified by multiscale entropy (MSE). Twenty healthy older adults completed two study visits. Center-of-pressure (COP) fluctuations were recorded during single-task (i.e., quiet standing) and dual-task (i.e., standing while performing serial subtractions) conditions, both before and after a 20-min session of real or sham tDCS. MSE was used to estimate COP complexity within each condition. The percentage change in complexity from single- to dual-task conditions (i.e., dual-task cost) was also calculated. Before tDCS, COP complexity was lower (p = 0.04) in the dual-task condition as compared to the single-task condition. Neither real nor sham tDCS altered complexity in the single-task condition. As compared to sham tDCS, real tDCS increased complexity in the dual-task condition (p = 0.02) and induced a trend toward improved serial subtraction performance (p = 0.09). Moreover, those subjects with lower dual-task COP complexity at baseline exhibited greater percentage increases in complexity following real tDCS (R = -0.39, p = 0.05). Real tDCS also reduced the dual-task cost to complexity (p = 0.02), while sham stimulation had no effect. A single session of tDCS targeting the prefrontal cortex increased standing postural sway complexity with concurrent non-postural cognitive task. This form of noninvasive brain stimulation may be a safe strategy to acutely improve postural control by enhancing the system's capacity to adapt to stressors.

Motor/Prefrontal Transcranial Direct Current Stimulation (tDCS) Following Lumbar Surgery Reduces Postoperative Analgesia Use.

Science.gov (United States)

Glaser, John; Reeves, Scott T; Stoll, William David; Epperson, Thomas I; Hilbert, Megan; Madan, Alok; George, Mark S; Borckardt, Jeffrey J

2016-05-01

Randomized, controlled pilot trial. The present study is the first randomized, double-blind, sham-controlled pilot clinical trial of transcranial direct current stimulation (tDCS) for pain and patient-controlled analgesia (PCA) opioid usage among patients receiving spine surgery. Lumbar spinal surgeries are common, and while pain is often a complaint that precedes surgical intervention, the procedures themselves are associated with considerable postoperative pain lasting days to weeks. Adequate postoperative pain control is an important factor in determining recovery and new analgesic strategies are needed that can be used adjunctively to existing strategies potentially to reduce reliance on opioid analgesia. Several novel brain stimulation technologies including tDCS are beginning to demonstrate promise as treatments for a variety of pain conditions. Twenty-seven patients undergoing lumbar spine procedures at Medical University of South Carolina were randomly assigned to receive four 20-minute sessions of real or sham tDCS during their postsurgical hospital stay. Patient-administered hydromorphone usage was tracked along with numeric rating scale pain ratings. The effect of tDCS on the slope of the cumulative PCA curve was significant (P tDCS was associated with a 23% reduction in PCA usage. In the real tDCS group a 31% reduction was observed in pain-at-its-least ratings from admission to discharge (P = 0.027), but no other changes in numeric rating scale pain ratings were significant in either group. The present pilot trial is the first study to demonstrate an opioid sparing effect of tDCS after spine surgical procedures. Although this was a small pilot trial in a heterogeneous sample of spinal surgery patients, a moderate effect-size was observed for tDCS, suggesting that future work in this area is warranted. 2.

Semantic Feature Training in Combination with Transcranial Direct Current Stimulation (tDCS for Progressive Anomia

Directory of Open Access Journals (Sweden)

Jinyi Hung

2017-05-01

Full Text Available We examined the effectiveness of a 2-week regimen of a semantic feature training in combination with transcranial direct current stimulation (tDCS for progressive naming impairment associated with primary progressive aphasia (N = 4 or early onset Alzheimer’s Disease (N = 1. Patients received a 2-week regimen (10 sessions of anodal tDCS delivered over the left temporoparietal cortex while completing a language therapy that consisted of repeated naming and semantic feature generation. Therapy targets consisted of familiar people, household items, clothes, foods, places, hygiene implements, and activities. Untrained items from each semantic category provided item level controls. We analyzed naming accuracies at multiple timepoints (i.e., pre-, post-, 6-month follow-up via a mixed effects logistic regression and individual differences in treatment responsiveness using a series of non-parametric McNemar tests. Patients showed advantages for naming trained over untrained items. These gains were evident immediately post tDCS. Trained items also showed a shallower rate of decline over 6-months relative to untrained items that showed continued progressive decline. Patients tolerated stimulation well, and sustained improvements in naming accuracy suggest that the current intervention approach is viable. Future implementation of a sham control condition will be crucial toward ascertaining whether neurostimulation and behavioral treatment act synergistically or alternatively whether treatment gains are exclusively attributable to either tDCS or the behavioral intervention.

Routine Sub-hepatic Drainage versus No Drainage after Laparoscopic Cholecystectomy: Open, Randomized, Clinical Trial.

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Shamim, Muhammad

2013-02-01

Surgeons are still following the old habit of routine subhepatic drainage following laparoscopic cholecystectomy (LC). This study aims to compare the outcome of subhepatic drainage with no drainage after LC. This prospective study was conducted in two phases. Phase I was open, randomized controlled trial (RCT), conducted in Civil Hospital Karachi, from August 2004 to June 2005. Phase II was descriptive case series, conducted in author's practice hospitals of Karachi, from July 2005 to December 2009. In phase I, 170 patients with chronic calculous cholecystitis underwent LC. Patients were divided into two groups, subhepatic drainage (group A: 79 patients) or no drainage (group B: 76 patients). The rest 15 patients were excluded either due to conversion or elective subhepatic drainage. In phase II, 218 consecutive patients were enrolled, who underwent LC with no subhepatic drainage. Duration of operation, character, and amount of drain fluid (if placed), postoperative ultrasound for subhepatic collection, postoperative chest X-ray for the measurement of subdiaphragmatic air, postoperative pain, postoperative nausea/vomiting, duration of hospital stay, and preoperative or postoperative complications were noted and analyzed. Duration of operation and hospital stay was slightly longer in group A patients (P values 0.002 and 0.029, respectively); postoperative pain perception, nausea/vomiting, and postoperative complications were nearly same in both groups (P value 0.064, 0.078, and 0.003, respectively). Subhepatic fluid collection was more in group A (P = 0.002), whereas subdiaphragmatic air collection was more in group B (P = 0.003). Phase II results were nearly similar to group B patients in phase I. Routine subhepatic drainage after LC is not necessary in uncomplicated cases.

Natural Killer Dendritic Cells Enhance Immune Responses Elicited by α-Galactosylceramide-Stimulated Natural Killer T Cells

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Sung Won Lee

2013-01-01

Full Text Available Natural killer dendritic cells (NKDCs possess potent anti-tumor activity, but the cellular effect of NKDC interactions with other innate immune cells is unclear. In this study, we demonstrate that the interaction of NKDCs and natural killer T (NKT cells is required for the anti-tumor immune responses that are elicited by α-galactosylceramide (α-GC in mice. The rapid and strong expression of interferon-γ by NKDCs after α-GC stimulation was dependent on NKT cells. Various NK and DC molecular markers and cytotoxic molecules were up-regulated following α-GC administration. This up-regulation could improve NKDC presentation of tumor antigens and increase cytotoxicity against tumor cells. NKDCs were required for the stimulation of DCs, NK cells, and NKT cells. The strong anti-tumor immune responses elicited by α-GC may be due to the down-regulation of regulatory T cells. Furthermore, the depletion of NKDCs dampened the tumor clearance mediated by α-GC-stimulated NKT cells in vivo. Taken together, these results indicate that complex interactions of innate immune cells might be required to achieve optimal anti-tumor immune responses during the early stages of tumorigenesis.

Drain Tube-Induced Jejunal Penetration Masquerading as Bile Leak following Whipple's Operation.

Science.gov (United States)

Bae, Sang Ho; Lee, Tae Hoon; Lee, Sae Hwan; Lee, Suck-Ho; Park, Sang-Heum; Kim, Sun-Joo; Kim, Chang Ho

2011-05-01

A 70-year-old man had undergone pancreaticoduodenectomy due to a distal common bile duct malignancy. After the operation, serous fluid discharge decreased from two drain tubes in the retroperitoneum. Over four weeks, the appearance of the serous fluid changed to a greenish bile color and the patient persistently drained over 300 ml/day. Viewed as bile leak at the choledochojejunostomy, treatment called for endoscopic diagnosis and therapy. Cap-fitted forward-viewing endoscopy demonstrated that the distal tip of a pancreatic drain catheter inserted at the pancreaticojejunostomy site had penetrated the opposite jejunum wall. One of the drain tubes primarily placed in the retroperitoneum had also penetrated the jejunum wall, with the distal tip positioned near the choledochojejunostomy site. No leak of contrast appeared beyond the jejunum or anastomosis site. Following repositioning of a penetrating catheter of the pancreaticojejunostomy, four days later, the patient underwent removal of two drain tubes without additional complications. In conclusion, the distal tip of the catheter, placed to drain pancreatic juice, penetrated the jejunum wall and may have caused localized perijejunal inflammation. The other drain tube, placed in the retroperitoneal space, might then have penetrated the inflamed wall of the jejunum, allowing persistent bile drainage via the drain tube. The results masqueraded as bile leakage following pancreaticoduodenectomy.

CP-25 Attenuates the Activation of CD4+ T Cells Stimulated with Immunoglobulin D in Human.

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Wu, Yu-Jing; Chen, Heng-Shi; Chen, Wen-Sheng; Dong, Jin; Dong, Xiao-Jie; Dai, Xing; Huang, Qiong; Wei, Wei

2018-01-01

Researchers have shown that the level of immunoglobulin D (IgD) is often elevated in patients with autoimmune diseases. The possible roles of IgD on the function of human T cell activation are still unclear. Paeoniflorin-6'- O -benzene sulfonate (code: CP-25), the chemistry structural modifications of paeoniflorin, was a novel drug of anti-inflammation and immunomodulation. The aims of this study were to determine if human CD4 + T cells could be activated by IgD via the IgD receptor (IgDR)-Lck pathway and whether the novel compound CP-25 could affect the activation of T cells by regulating Lck. Human CD4 + T cells were purified from peripheral blood mononuclear cells using microbeads. T cell viability and proliferation were detected by Cell Counting Kit-8 and CFSE Cell Proliferation Kit. Cytokines secreted by T cells were assessed with the Quantibody Human Inflammation Array. The binding affinity and expression of IgDR on T cells were detected by flow cytometry, and protein expression of IgDR, Lck, and P-Lck were analyzed by western blot. IgD was shown to bind to IgDR on CD4 + T cells in a concentration-dependent manner and stimulate the activation and proliferation of these cells by enhancing phosphorylation of the activating tyrosine residue of Lck (Tyr 394 ). CP-25 inhibited the IgD-stimulated activation and proliferation of CD4 + T cells, as well as the production of inflammatory cytokines; it was thus suggested that this process might be related to the downregulation of Lck (Tyr 394 ) phosphorylation. These results demonstrate that IgD amplifies the activation of CD4 + T cells, which could be mediated by Lck phosphorylation. Further, CP-25, via its ability to modulate Lck, is a novel potential therapeutic agent for the treatment of human autoimmune diseases.

Stimulation of HIV-1-specific cytolytic T-lymphocytes facilitates elimination of latent viral reservoir after virus reactivation

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Shan, Liang; Deng, Kai; Shroff, Neeta S.; Durand, Christine; Rabi, S. Alireza.; Yang, Hung-Chih; Zhang, Hao; Margolick, Joseph B.; Blankson, Joel N.; Siliciano, Robert F.

2012-01-01

Summary Highly active antiretroviral therapy (HAART) suppresses HIV-1 replication but cannot eliminate the virus because HIV-1 establishes latent infection. Interruption of HAART leads to a rapid rebound of viremia. Life-long treatment is therefore required. Efforts to purge the latent reservoir have focused on reactivating latent proviruses without inducing global T-cell activation. However, the killing of the infected cells after virus reactivation, which is essential for elimination of the reservoir, has not been assessed. Here we show that after reversal of latency in an in vitro model, infected resting CD4+ T cells survived despite viral cytopathic effects, even in the presence of autologous cytolytic T-lymphocytes (CTL) from most patients on HAART. Antigen-specific stimulation of patient CTLs led to efficient killing of infected cells. These results demonstrate that stimulating HIV-1-specific CTLs prior to reactivating latent HIV-1 may be essential for successful eradication efforts and should be considered in future clinical trials. PMID:22406268

Application of a new ultra-microculture system. II. Stimulation of human B lymphocytes.

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Ulmer, A J; Gruber, M; Flad, H D

1988-07-22

An ultra-microtechnique for culturing human B-lymphocytes in glass capillary tubes using a volume of 2 microliter is described. The advantage of this ultra-microculture system is that only a small number of lymphocytes and minute amounts of culture medium (or test factors) are required. Optimal culture conditions for the formation of Ig-secreting plaque-forming cells (PFC) after stimulation of mononuclear cells with pokeweed mitogen are given. Furthermore it is shown that immunoglobulin secreted into culture supernatants by purified B cells in the presence of T cell subsets can be measured in a microELISA.

Increasing T-type calcium channel activity by β-adrenergic stimulation contributes to β-adrenergic regulation of heart rates.

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Li, Yingxin; Zhang, Xiaoxiao; Zhang, Chen; Zhang, Xiaoying; Li, Ying; Qi, Zhao; Szeto, Christopher; Tang, Mingxin; Peng, Yizhi; Molkentin, Jeffery D; Houser, Steven R; Xie, Mingxing; Chen, Xiongwen

2018-04-01

Cav3.1 T-type Ca 2+ channel current (I Ca-T ) contributes to heart rate genesis but is not known to contribute to heart rate regulation by the sympathetic/β-adrenergic system (SAS). We show that the loss of Cav3.1 makes the beating rates of the heart in vivo and perfused hearts ex vivo, as well as sinoatrial node cells, less sensitive to β-adrenergic stimulation; it also renders less conduction acceleration through the atrioventricular node by β-adrenergic stimulation. Increasing Cav3.1 in cardiomyocytes has the opposite effects. I Ca-T in sinoatrial nodal cells can be upregulated by β-adrenergic stimulation. The results of the present study add a new contribution to heart rate regulation by the SAS system and provide potential new mechanisms for the dysregulation of heart rate and conduction by the SAS in the heart. T-type Ca 2+ channel can be a target for heart disease treatments that aim to slow down the heart rate ABSTRACT: Cav3.1 (α 1G ) T-type Ca 2+ channel (TTCC) is expressed in mouse sinoatrial node cells (SANCs) and atrioventricular (AV) nodal cells and contributes to heart rate (HR) genesis and AV conduction. However, its role in HR regulation and AV conduction acceleration by the β-adrenergic system (SAS) is unclear. In the present study, L- (I Ca-L ) and T-type (I Ca-T ) Ca 2+ currents were recorded in SANCs from Cav3.1 transgenic (TG) and knockout (KO), and control mice. I Ca-T was absent in KO SANCs but enhanced in TG SANCs. In anaesthetized animals, different doses of isoproterenol (ISO) were infused via the jugular vein and the HR was recorded. The EC 50 of the HR response to ISO was lower in TG mice but higher in KO mice, and the maximal percentage of HR increase by ISO was greater in TG mice but less in KO mice. In Langendorff-perfused hearts, ISO increased HR and shortened PR intervals to a greater extent in TG but to a less extent in KO hearts. KO SANCs had significantly slower spontaneous beating rates than control SANCs before and after

In vitro stimulation of rabbit T lymphocytes by cells expressing herpes simplex antigens.

Science.gov (United States)

Kapoor, A K; Ling, N R; Nash, A A; Bachan, A; Wildy, P

1982-04-01

Lymphocyte stimulation responses to herpes antigens were studied using virus-infected X-irradiated cells. Rabbits were immunized with herpes simplex virus type 1 (strain HFEM) grown in RK 13 cells. For in vitro stimulation assay BHK21 cells were X-irradiated (15 000 rad) and infected with a high m.o.i. of a temperature-sensitive (ts) mutant (N102) of HFEM strain at the non-permissive temperature (38.5 degrees C) of virus. Virus antigens were expressed on the infected cells and there was no leakage of infectious virus into the medium at 38.5 degrees C. T lymphocytes from rabbits immunized with herpes simplex virus were specifically activated by herpesvirus-infected X-irradiated cells; lymph node cells from rabbits immunized with RK13 cells and from non-immune rabbits showed no proliferative response.

Endoscopic Ultrasound-Guided Perirectal Abscess Drainage without Drainage Catheter: A Case Series

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Eun Kwang Choi

2017-05-01

Full Text Available A perirectal abscess is a relatively common disease entity that occurs as a postsurgical complication or as a result of various medical conditions. Endoscopic ultrasound (EUS-guided drainage was recently described as a promising alternative treatment. Previous reports have recommended placement of a drainage catheter through the anus for irrigation, which is inconvenient to the patient and carries a risk of accidental dislodgement. We report four cases of perirectal abscess that were successfully treated with only one or two 7 F double pigtail plastic stent placements and without a drainage catheter for irrigation.

Paravertebral Block: An Improved Method of Pain Control in Percutaneous Transhepatic Biliary Drainage

International Nuclear Information System (INIS)

Culp, William C.; McCowan, Timothy C.; DeValdenebro, Miguel; Wright, Lonnie B.; Workman, James L.; Culp, William C.

2006-01-01

Background and Purpose. Percutaneous transhepatic biliary drainage remains a painful procedure in many cases despite the routine use of large amounts of intravenous sedation. We present a feasibility study of thoracic paravertebral blocks in an effort to reduce pain during and following the procedure and reduce requirements for intravenous sedation. Methods. Ten consecutive patients undergoing biliary drainage procedures received fluoroscopically guided paravertebral blocks and then had supplemental intravenous sedation as required to maintain patient comfort. Levels T8-T9 and T9-T10 on the right were targeted with 10-20 ml of 0.5% bupivacaine. Sedation requirements and pain levels were recorded. Results. Ten biliary drainage procedures in 8 patients were performed for malignancy in 8 cases and for stones in 2. The mean midazolam use was 1.13 mg IV, and the mean fentanyl requirement was 60.0 μg IV in the block patients. Two episodes of hypotension, which responded promptly to volume replacement, may have been related to the block. No serious complications were encountered. The mean pain score when traversing the chest wall, liver capsule, and upon entering the bile ducts was 0.1 on a scale of 0 to 10, with 1 patient reporting a pain level of 1 and 9 reporting 0. The mean peak pain score, encountered when manipulating at the common bile duct level or when addressing stones there, was 5.4 and ranged from 0 to 10. Conclusions. Thoracic paravertebral block with intravenous sedation supplementation appears to be a feasible method of pain control during biliary interventions

Prefrontal transcranial direct current stimulation alters activation and connectivity in cortical and subcortical reward systems: a tDCS-fMRI study.

Science.gov (United States)

Weber, Matthew J; Messing, Samuel B; Rao, Hengyi; Detre, John A; Thompson-Schill, Sharon L

2014-08-01

Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique used both experimentally and therapeutically to modulate regional brain function. However, few studies have directly measured the aftereffects of tDCS on brain activity or examined changes in task-related brain activity consequent to prefrontal tDCS. To investigate the neural effects of tDCS, we collected fMRI data from 22 human subjects, both at rest and while performing the Balloon Analog Risk Task (BART), before and after true or sham transcranial direct current stimulation. TDCS decreased resting blood perfusion in orbitofrontal cortex and the right caudate and increased task-related activity in the right dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) in response to losses but not wins or increasing risk. Network analysis showed that whole-brain connectivity of the right ACC correlated positively with the number of pumps subjects were willing to make on the BART, and that tDCS reduced connectivity between the right ACC and the rest of the brain. Whole-brain connectivity of the right DLPFC also correlated negatively with pumps on the BART, as prior literature would suggest. Our results suggest that tDCS can alter activation and connectivity in regions distal to the electrodes. Copyright © 2014 Wiley Periodicals, Inc.

Exploring Agricultural Drainage's Influence on Wetland and ...

Science.gov (United States)

Artificial agricultural drainage (i.e. surface ditches or subsurface tile) is an important agricultural management tool. Artificial drainage allows for timely fieldwork and adequate root aeration, resulting in greater crop yields for farmers. This practice is widespread throughout many regions of the United States and the network of artificial drainage is especially extensive in flat, poorly-drained regions like the glaciated Midwest. While beneficial for crop yields, agricultural drains often empty into streams within the natural drainage system. The increased network connectivity may lead to greater contributing area for watersheds, altered hydrology and increased conveyance of pollutants into natural water bodies. While studies and models at broader scales have implicated artificial drainage as an important driver of hydrological shifts and eutrophication, the actual spatial extent of artificial drainage is poorly known. Consequently, metrics of wetland and watershed connectivity within agricultural regions often fail to explicitly include artificial drainage. We use recent agricultural census data, soil drainage data, and land cover data to create estimates of potential agricultural drainage across the United States. We estimate that agricultural drainage in the US is greater than 31 million hectares and is concentrated in the upper Midwest Corn Belt, covering greater than 50% of available land for 114 counties. Estimated drainage values for numerous countie

Stimulation of the synthesis of bacteriophage T4 gene 32 protein by ultraviolet light irradiation

International Nuclear Information System (INIS)

Krisch, H.M.; Van Houwe, G.

1976-01-01

The synthesis of bacteriophage T4 gene 32 product, P32, has been followed by gel electrophoresis of lysates of infected cells which have been irradiated with ultraviolet light. In wild-type infections irradiation after the commencement of late gene expression results in a rapid stimulation of the rate of P32 synthesis. Within four minutes after irradiation P32 is synthesized at 11 times the rate of the unirradiated control infection. P32 seems to be the only T4 protein which exhibits such u.v. inducibility. This inducibility is dependent on the function of genes 46 and 47 and to a lesser extent on several other T4 genes thought to be involved in repair (P43, w and y). An infection defective in both P43 and P46 shows essentially no stimulation of the rate of P32 synthesis after irradiation. In the absence of DNA replication the parental DNA is degraded after irradiation in a dose-dependent manner. The extent of P32 induction in such an infection is also proportional to the dose. It is suggested that the production of gaps during repair of u.v.-irradiated DNA is responsible for the stimulation of P32 synthesis. A model is proposed in which such regions of single-stranded DNA compete for P32 by binding it nonspecifically, thus reducing the amount of P32 free to block the expression of gene 32. Because the expression of gene 32 is self-regulatory this would result in increased P32 synthesis. The possible role of P32 in the repair of u.v.-damaged DNA is discussed. (author)

Stimulating the Right Temporoparietal Junction with tDCS Decreases Deception in Moral Hypocrisy and Unfairness

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Honghong Tang

2017-11-01

Full Text Available Self-centered and other-regarding concerns play important roles in decisions of deception. To investigate how these two motivations affect deception in fairness related moral hypocrisy, we modulated the brain activity in the right temporoparietal junction (rTPJ, the key region for decision making involved in self-centered and other-regarding concerns. After receiving brain stimulation with transcranial direct current stimulation (tDCS, participants finished a modified dictator game. In the game, they played as proposers to make allocations between themselves and recipients and had a chance to deceive by misreporting their totals for allocations. Results show that deception in moral hypocrisy was decreased after anodal stimulation than sham and cathodal stimulation, only when participants know that their reported totals (appearing fair would be revealed to recipients rather than being unrevealed. Anodal stimulation also increased offers to recipients than cathodal stimulation regardless of the revelation of reported totals. These findings suggest that enhancing the activity of rTPJ decreased deception caused by impression management rather than self-deception in moral hypocrisy and unfairness through facilitating other-regarding concerns and weakening non-material self-centered motivations. They provide causal evidence for the role of rTPJ in both other-regarding concerns and non-material self-centered motivations, shedding light on the way to decrease moral hypocrisy.

Interleukin 2 is not sufficient as helper component for the activation of cytotoxic T lymphocytes but synergizes with a late helper effect that is provided by irradiated T-region-incompatible stimulator cells

Energy Technology Data Exchange (ETDEWEB)

Reddehase, M.; Suessmith, W.; Moyers, C.; Falk, W.; Droege, W.

1982-01-01

Interleukin 2-containing supernatants from concanavalin A-activated spleen cells (CSCS) were found to provide strong helper activity for cytotoxic T lymphocyte (CTL) responses against allogeneic stimulator cells in microculture systems, but provided usually insufficient help for CTL responses against l-region compatible allogeneic or TNP-haptenated syngeneic stimulator cells. The interleukin 2-containing supernatant from HGG-activated AODH 7.1 hybridoma cells also mediated only relatively weak CTL responses against TNP-haptenated syngeneic cells in microcultures. Both types of supernatants, however, supported substantial responses against TNP-haptenated syngeneic stimulator cells if irradiated allogeneically activated syngeneic T cells or irradiated allogeneic spleen cells were added to the cultures. The allogeneic cells and the activated syngeneic T cells provided little helper activity if they were added in the absence of the interleukin 2-containing supernatants, thus demonstrating a synergistic effect between these 2 helper components. An l-region difference was sufficient for the helper effect of the allogeneic cells and control experiments showed that the presence of foreign l-region determinants could not be substituted for the TNP-haptenated stimulator cells.

Interleukin 2 is not sufficient as helper component for the activation of cytotoxic T lymphocytes but synergizes with a late helper effect that is provided by irradiated T-region-incompatible stimulator cells

International Nuclear Information System (INIS)

Reddehase, M.; Suessmith, W.; Moyers, C.; Falk, W.; Droege, W.

1982-01-01

Interleukin 2-containing supernatants from concanavalin A-activated spleen cells (CSCS) were found to provide strong helper activity for cytotoxic T lymphocyte (CTL) responses against allogeneic stimulator cells in microculture systems, but provided usually insufficient help for CTL responses against l-region compatible allogeneic or TNP-haptenated syngeneic stimulator cells. The interleukin 2-containing supernatant from HGG-activated AODH 7.1 hybridoma cells also mediated only relatively weak CTL responses against TNP-haptenated syngeneic cells in microcultures. Both types of supernatants, however, supported substantial responses against TNP-haptenated syngeneic stimulator cells if irradiated allogeneically activated syngeneic T cells or irradiated allogeneic spleen cells were added to the cultures. The allogeneic cells and the activated syngeneic T cells provided little helper activity if they were added in the absence of the interleukin 2-containing supernatants, thus demonstrating a synergistic effect between these 2 helper components. An l-region difference was sufficient for the helper effect of the allogeneic cells and control experiments showed that the presence of foreign l-region determinants could not be substituted for the TNP-haptenated stimulator cells

The drainage information and control system of smart city

Science.gov (United States)

Mao, Tonglei; Li, Lei; Liu, JiChang; Cheng, Liang; Zhang, Jing; Song, Zengzhong; Liu, Lianhai; Hu, Zichen

2018-03-01

At present, due to the continuous expansion of city and the increase of the municipal drainage facilities, which leads to a serious lack of management and operation personnel, the existing production management pattern already can't adapt to the new requirements. In this paper, according to river drainage management, flood control, water management, auditing, administrative license, etc. different business management requirement, an information management system for water planning and design of smart city based on WebGIS in Linyi was introduced, which can collect the various information of gate dam, water pump, bridge sensor and traffic guide terminal nodes etc. together. The practical application show that the system can not only implement the sharing, resources integration and collaborative application for the regional water information, but also improve the level of the integrated water management.

Mine Drainage Generation and Control Options.

Science.gov (United States)

Wei, Xinchao; Rodak, Carolyn M; Zhang, Shicheng; Han, Yuexin; Wolfe, F Andrew

2016-10-01

This review provides a snapshot of papers published in 2015 relevant to the topic of mine drainage generation and control options. The review is broken into 3 sections: Generation, Prediction and Prevention, and Treatment Options. The first section, mine drainage generation, focuses on the characterization of mine drainage and the environmental impacts. As such, it is broken into three subsections focused on microbiological characterization, physiochemical characterization, and environmental impacts. The second section of the review is divided into two subsections focused on either the prediction or prevention of acid mine drainage. The final section focuses on treatment options for mine drainage and waste sludge. The third section contains subsections on passive treatment, biological treatment, physiochemical treatment, and a new subsection on beneficial uses for mine drainage and treatment wastes.

Vitreous occlusion of tube implant in a phakic patient with traumatic glaucoma

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Suneeta Dubey

2014-01-01

Full Text Available Tube implants or glaucoma drainage devices have become an important method of intraocular pressure reduction when treating complex cases of traumatic glaucoma. However, it is not uncommon to have complications associated with tube implants. The optimal treatment of patients who have undergone glaucoma implant surgery complicated by vitreous incarceration is uncertain. If vitreous is present or is able to prolapse into anterior chamber, as in aphakic or pseudophakic patient without an intact posterior capsule, a concurrent anterior vitrectomy is usually performed. In such cases, pars plana vitrectomy has been found to be more effective in several studies. However, there are no set guidelines for management of such a case in a phakic eye and the management can be more challenging especially when there is no obvious deficiency in posterior capsule, zonular dialysis, or loose vitreous gel in the anterior chamber prior to or during tube implantation. We describe a case of 14-year-old phakic patient with traumatic glaucoma without vitreous gel in anterior chamber whose tube implant became occluded by vitreous resulting in increased intra ocular pressure. This is the first documented report of vitreous incarceration in a phakic patient and its successful management.

The Alpha-Melanocyte Stimulating Hormone Induces Conversion of Effector T Cells into Treg Cells

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Andrew W. Taylor

2011-01-01

Full Text Available The neuropeptide alpha-melanocyte stimulating hormone (α-MSH has an important role in modulating immunity and homeostasis. The production of IFN-γ by effector T cells is suppressed by α-MSH, while TGF-β production is promoted in the same cells. Such α-MSH-treated T cells have immune regulatory activity and suppress hypersensitivity, autoimmune diseases, and graft rejection. Previous characterizations of the α-MSH-induced Treg cells showed that the cells are CD4+ T cells expressing the same levels of CD25 as effector T cells. Therefore, we further analyzed the α-MSH-induced Treg cells for expression of effector and regulatory T-cell markers. Also, we examined the potential for α-MSH-induced Treg cells to be from the effector T-cell population. We found that the α-MSH-induced Treg cells are CD25+  CD4+ T cells that share similar surface markers as effector T cells, except that they express on their surface LAP. Also, the α-MSH treatment augments FoxP3 message in the effector T cells, and α-MSH induction of regulatory activity was limited to the effector CD25+ T-cell population. Therefore, α-MSH converts effector T cells into Treg cells, which suppress immunity targeting specific antigens and tissues.

Percutaneous catheter drainage of intrapulmonary fluid collection

International Nuclear Information System (INIS)

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

1994-01-01

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

Percutaneous catheter drainage of intrapulmonary fluid collection

Energy Technology Data Exchange (ETDEWEB)

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

1994-01-15

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

Intra-abdominal pressure alterations after large pancreatic pseudocyst transcutaneous drainage

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Papavramidis Theodossis S

2009-06-01

Full Text Available Abstract Background Acute pancreatitis leads to abdominal hypertension and compartment syndrome. Weeks after the episodes pancreatic fluids sometimes organize to pseudocysts, fluid collections by or in the gland. Aims of the present study were to evaluate the intra-abdominal pressure (IAP induced by large pancreatic pseudocysts and to examine the effect of their transcutaneous drainage on IAP. Methods Twenty seven patients with a pancreatic pseudocyst were included. Nine patients with pseudocysts greater than 1l (group A had CT drainage and eighteen (volume less than 1l were the control group. The measurements of group A were taken 6 hours before and every morning after the drainage, while for group B, two measurements were performed, one at the day of the initial CT and one 7 days after. Abdominal compliance (Cabd was calculated. Data were analyzed using student's t-test. Results Baseline IAP for group A was 9.3 mmHg (S.D. 1.7 mmHg, while the first post-drainage day (PDD IAP was 5.1 mmHg (S.D. 0.7 mmHg. The second PDD IAP was 5.6 mmHg (S.D. 0.8 mmHg, the third 6.4 mmH (S.D. 1.2 mmHgg, the fourth 6.9 mmHg (S.D. 1.6 mmHg, the fifth 7.9 mmHg (S.D. 1.5 mmHg, the sixth 8.2 mmHg (S.D. 1.4 mmHg, and the seventh 8.2 mmHg (S.D. 1.5 mmHg. Group B had baseline IAP 8.0 mmHg (S.D. 1.2 mmHg and final 8.2 mmHg (S.D. 1.4 mmHg. Cabd after drainage was 185.6 ml/mmHg (SD 47.5 ml/mmHg. IAP values were reduced between the baseline and all the post-drainage measurements in group A. IAPs seem to stabilize after the 5th post-drainage day. Baseline IAP was higher in group A than in group B, while the two values, at day 7, were equivalent. Conclusion The drainage of large pancreatic pseudocyst reduces IAP. Moreover, the IAP seems to rise shortly after the drainage again, but in a way that it remains inferior to the initial value. More chronic changes to the IAP are related to abdominal cavity's properties and have to be further studied.

The Effects of Transcranial Direct Current Stimulation (tDCS on Psychomotor and Visual Perception Functions Related to Driving Skills

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Alexander Brunnauer

2018-01-01

Full Text Available Objective: It could be demonstrated that anodal transcranial direct current stimulation (tDCS of the left dorsolateral prefrontal cortex (DLPFC enhances accuracy in working memory tasks and reaction time in healthy adults and thus may also have an influence on complex everyday tasks like driving a car. However, no studies have applied tDCS to psychomotor skills related to a standard driving test so far.Methods: 10 female and 5 male healthy adults without any medication and history of psychiatric or neurological illness were randomly assigned to two groups receiving active and sham stimulation in a double blind, cross-over study design. Standardized computerized psychomotor tests according to the German guidelines for road and traffic safety were administered at baseline. Then they performed the same tests during an anodal or sham tDCS of the left DLPFC in two separated sessions.Results: No significant improvements in skills related to driving performance like visual perception, stress tolerance, concentration, and vigilance could be shown after left anodal prefrontal tDCS. Side effects were low and did not differ between active and sham stimulation.Conclusions: The findings of our study indicate that left prefrontal tDCS may not alter driving skills affording more automated action patterns but as shown in previous studies may have an influence on driving behavior requiring executive control processes. This however has to be proved in future studies and within greater samples.

Feasibility of using high-definition transcranial direct current stimulation (HD-tDCS) to enhance treatment outcomes in persons with aphasia.

Science.gov (United States)

Richardson, Jessica; Datta, Abhishek; Dmochowski, Jacek; Parra, Lucas C; Fridriksson, Julius

2015-01-01

Transcranial direct current stimulation (tDCS) enhances treatment outcomes post-stroke. Feasibility and tolerability of high-definition (HD) tDCS (a technique that increases current focality and intensity) for consecutive weekdays as an adjuvant to behavioral treatment in a clinical population has not been demonstrated. To determine HD-tDCS feasibility outcomes: 1) ability to implement study as designed, 2) acceptability of repeated HD-tDCS administration to patients, and 3) preliminary efficacy. Eight patients with chronic post-stroke aphasia participated in a randomized crossover trial with two arms: conventional sponge-based (CS) tDCS and HD-tDCS. Computerized anomia treatment was administered for five consecutive days during each treatment arm. Individualized modeling/targeting procedures and an 8-channel HD-tDCS device were developed. CS-tDCS and HD-tDCS were comparable in terms of implementation, acceptability, and outcomes. Naming accuracy and response time improved for both stimulation conditions. Change in accuracy of trained items was numerically higher (but not statistically significant) for HD-tDCS compared to CS-tDCS for most patients. Regarding feasibility, HD-tDCS treatment studies can be implemented when designed similarly to documented CS-tDCS studies. HD-tDCS is likely to be acceptable to patients and clinicians. Preliminary efficacy data suggest that HD-tDCS effects, using only 4 electrodes, are at least comparable to CS-tDCS.

Drainage filter technologies to mitigate site-specific phosphorus losses in agricultural drainage discharge

DEFF Research Database (Denmark)

Kjærgaard, Charlotte; Heckrath, Goswin Johann; Canga, Eriona

in drainage. The Danish “SUPREME-TECH” project (2010-2016) (www.supreme-tech.dk) aims at providing the scientific basis for developing cost-effective filter technologies for P in agricultural drainage waters. The project studies different approaches of implementing filter technologies including drainage well....... Targeting high risk areas of P loss and applying site-specific measures promises to be a cost-efficient approach. The Danish Commission for Nature and Agriculture has, therefore, now called for a paradigm shift towards targeted, cost-efficient technologies to mitigate site-specific nutrient losses...... environmental threshold values (

An investigation on SA 213-Tube to SA 387-Tube plate using friction welding process

Energy Technology Data Exchange (ETDEWEB)

Rajan, S. Pandia; Kumaraswamidhas, L. A. [Indian Institute of Technology, Jharkhand (India); Kumaran, S. Senthil [RVS School of Engineering and Technology, Tamil Nadu (India); Muthukumaran, S. [National Institute of Technology, Tamil Nadu (India)

2016-01-15

Friction welding of tube to tube plate using an external tool (FWTPET) is a relatively newer solid state welding process used for joining tube to tube plate of either similar or dissimilar materials with enhanced mechanical and metallurgical properties. In the present study, FWTPET has been used to weld SA 213 (Grade T12) tube with SA 387 (Grade 22) tube plate. The welded samples are found to have satisfactory joint strength and the Energy dispersive X-ray analysis (EDX), X-ray diffraction (XRD) study showed that inter metallic compound is absent in the weld zone. The different weld joints have been identified and the phase composition is found using EDX and XRD. Microstructures have been analyzed using optical and Scanning electron microscopy (SEM). The mechanical properties such as hardness, compressive shear strength and peel test for different weld conditions are studied and the hardness survey revealed that there is increase in hardness at the weld interface due to grain refinement. The corrosion behavior for different weld conditions have been analyzed and the weld zone is found to have better corrosion resistance due to the influence of the grain refinement after FWTPET welding process. Hence, the present investigation is carried out to study the behavior of friction welded dissimilar joints of SA 213 tube and SA 387 tube plate joints and the results are presented. The present study confirms that a high quality tube to tube plate joint can be achieved using FWTPET process at 1120 rpm.

Complications of nasogastric tube placement--don't blow it.

LENUS (Irish Health Repository)

Leonard, S

2012-04-01

Preventable complications maybe associated with the placement of nasogastric tubes. Our report raises awareness of the potentially fatal complications that can occur. We also recommend an approach for clinicians which maybe used to avoid significant patient morbidity.

Focused transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex modulates specific domains of self-regulation.

Science.gov (United States)

Pripfl, Jürgen; Lamm, Claus

2015-02-01

Recent neuroscience theories suggest that different kinds of self-regulation may share a common psychobiological mechanism. However, empirical evidence for a domain general self-regulation mechanism is scarce. The aim of this study was to investigate whether focused anodal transcranial direct current stimulation (tDCS), facilitating the activity of the dorsolateral prefrontal cortex (dlPFC), acts on a domain general self-regulation mechanism and thus modulates both affective and appetitive self-regulation. Twenty smokers participated in this within-subject sham controlled study. Effects of anodal left, anodal right and sham tDCS over the dlPFC on affective picture appraisal and nicotine craving-cue appraisal were assessed. Anodal right tDCS over the dlPFC reduced negative affect in emotion appraisal, but neither modulated regulation of positive emotion appraisal nor of craving appraisal. Anodal left stimulation did not induce any significant effects. The results of our study show that domain specific self-regulation networks are at work in the prefrontal cortex. Focused tDCS modulation of this specific self-regulation network could probably be used during the first phase of nicotine abstinence, during which negative affect might easily result in relapse. These findings have implications for neuroscience models of self-regulation and are of relevance for the development of brain stimulation based treatment methods for neuropsychiatric disorders associated with self-regulation deficits. Copyright © 2014 Elsevier Ireland Ltd and the Japan Neuroscience Society. All rights reserved.

78 FR 65190 - Airworthiness Directives; Bombardier, Inc. Airplanes

Science.gov (United States)

2013-10-31

... tubing from becoming blocked by water, which if not corrected, could lead to erroneous airspeed and... completely blocked by the water which didn't enter the drain bottle(s). This condition, if not corrected, may... drainage of the pitot- static tubing [and, for certain other airplanes, an inspection for, and replacement...

Characterization of Friction Stir Welded Tubes by Means of Tube Bulge Test

International Nuclear Information System (INIS)

D'Urso, G.; Longo, M.; Giardini, C.

2011-01-01

Mechanical properties of friction stir welded joints are generally evaluated by means of conventional tensile test. This testing method might provide insufficient information because maximum strain obtained in tensile test before necking is small; moreover, the application of tensile test is limited when the joint path is not linear or even when the welds are executed on curved surfaces. Therefore, in some cases, it would be preferable to obtain the joints properties from other testing methods. Tube bulge test can be a valid solution for testing circumferential or longitudinal welds executed on tubular workpieces. The present work investigates the mechanical properties and the formability of friction stir welded tubes by means of tube bulge tests. The experimental campaign was performed on tubular specimens having a thickness of 3 mm and an external diameter of 40 mm, obtained starting from two semi-tubes longitudinally friction stir welded. The first step, regarding the fabrication of tubes, was performed combining a conventional forming process and friction stir welding. Sheets in Al-Mg-Si-Cu alloy AA6060 T6 were adopted for this purpose. Plates having a dimension of 225x60 mm were bent (with a bending axis parallel to the main dimension) in order to obtain semi-tubes. A particular care was devoted to the fabrication of forming devices (punch and die) in order to minimize the springback effects. Semi-tubes were then friction stir welded by means of a CNC machine tool. Some preliminary tests were carried out by varying the welding parameters, namely feed rate and rotational speed. A very simple tool having flat shoulder and cylindrical pin was used. The second step of the research was based on testing the welded tubes by means of tube bulge test. A specific equipment having axial actuators with a conical shape was adopted for this study. Some analyses were carried out on the tubes bulged up to a certain pressure level. In particular, the burst pressure and the