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Sample records for vessel closure devices

  1. CLOSURE DEVICE

    Science.gov (United States)

    Linzell, S.M.; Dorcy, D.J.

    1958-08-26

    A quick opening type of stuffing box employing two banks of rotatable shoes, each of which has a caraming action that forces a neoprene sealing surface against a pipe or rod where it passes through a wall is presented. A ring having a handle or wrench attached is placed eccentric to and between the two banks of shoes. Head bolts from the shoes fit into slots in this ring, which are so arranged that when the ring is rotated a quarter turn in one direction the shoes are thrust inwardly to cramp the neopnrene about the pipe, malting a tight seal. Moving the ring in the reverse direction moves the shoes outwardly and frees the pipe which then may be readily removed from the stuffing box. This device has particular application as a closure for the end of a coolant tube of a neutronic reactor.

  2. Shakedown Analysis for the Hydraulic Nut Device of Reactor Vessel

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    Kim, Kyu Wan; Kim, Jong Min; Park, Sung Ho; Choi, Taek Sang [KEPCO Engineering and Construction, Daejeon (Korea, Republic of)

    2012-05-15

    The hydraulic nut system is a tensioning system that is a direct retrofit for any existing tensioning system currently used on the reactor vessel. The system itself is of a modular design tensioner and integrated mechanical lock ring to retain load generated through the use of hydraulics. The hydraulic nuts allow for 100% tensioning of all studs simultaneously, so reduction in critical path time and radiation exposure for both installation and removal laborers can be achieved by adopting this device. Structural analyses for the hydraulic nut device which will be applied to the Nuclear Power Plant reactor vessel have been performed to evaluate the effect of the replacement on the structural integrity of both the reactor vessel closure head area and the hydraulic nuts. Shakedown analyses have been performed because the primary plus secondary (P+Q) stress intensity limit of the hydraulic nut is exceeded in several locations. It is concluded that shakedown will occur and structural integrity of the reactor vessel closure head area will be maintained with the application of the hydraulic nut system

  3. Vascular Closure Devices in Interventional Radiology Practice

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    Patel, Rafiuddin, E-mail: rafiuddin.patel@ouh.nhs.uk [John Radcliffe Hospital, Department of Radiology (United Kingdom); Muller-Hulsbeck, Stefan, E-mail: muehue@diako.de [Diakonissen Hospital, Diagnostic and Interventional Radiology/Neuroradiology (Germany); Morgan, Robert, E-mail: robert.morgan@stgeorges.nhs.uk [St George’s Hospital, Department of Radiology (United Kingdom); Uberoi, Raman, E-mail: raman.uberoi@orh.nhs.uk [John Radcliffe Hospital, Department of Radiology (United Kingdom)

    2015-08-15

    Manual compression (MC) is a well-established technique for haemostasis following percutaneous arterial intervention. However, MC is labour and time intensive with potential limitations, particularly for patients who are coagulopathic, unable to comply with bed rest or obese and when large sheaths or anti-coagulants are used. There are a variety of vascular closure devices (VCDs) available to overcome these limitations. This review gives an overview of current VCDs, their mechanism of action, individual strengths and weaknesses, evidence base and utility in interventional radiology (IR) practice. The majority of the published evidence on VCDs is derived from patients undergoing cardiac interventions, which should be borne in mind when considering the applicability and transfer of this data for general IR practice. Overall, the evidence suggests that most VCDs are effective in achieving haemostasis with a similar rate of complications to MC although the complication profile associated with VCDs is distinct to that of MC. There is insufficient evidence to comparatively analyse the different types of VCDs currently available or reliably judge their cost-effectiveness. The interventional radiologist should have a thorough understanding of the available techniques for haemostasis and be able to identify and utilise the most appropriate strategy and closure technique for the individual patient.

  4. The mechanism of action of the vacuum-assisted closure device.

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    Scherer, Sandra Saja; Pietramaggiori, Giorgio; Mathews, Jasmine C; Prsa, Michael J; Huang, Sui; Orgill, Dennis P

    2008-09-01

    The vacuum-assisted closure device is widely used clinically, yet its mechanisms of action are incompletely understood. In this study, the authors designed a partially splinted full-thickness murine vacuum-assisted closure model to better understand the mechanism of action of the vacuum-assisted closure device. Full-thickness wounds (n = 10 per group) were excised in diabetic mice and treated with the vacuum-assisted closure device or its isolated components: an occlusive dressing, subatmospheric pressure at 125 mmHg (suction), and a polyurethane foam without and with downward compression. Results were quantified with a two-dimensional immunohistochemical staging system based on blood vessel density (CD31) and cell proliferation (Ki67) 7 days after wounding. Microscopic strain was measured by fixing in situ all dressing modalities. Wounds exposed to polyurethane foam in compressed and uncompressed dressings or to the vacuum-assisted closure device showed a 2-fold increase in vascularity compared with the occlusive dressing group (p vacuum-assisted closure device in addition stimulated cell proliferation, with up to 82 percent Ki67-positive nuclei, compared with the other groups. Direct measurements of wound surface deformations showed significant microstrains in the vacuum-assisted closure and foam in compressed dressing groups (60 percent and 16 percent, respectively) compared with all other groups. These data provide profound insights into the mechanism of action of the vacuum-assisted closure device, providing an explanation for the increases in wound bed vascularity and cell proliferation based on its components. Results suggest that the vascular response is related to the polyurethane foam, whereas tissue strains induced by the vacuum-assisted closure device stimulated cell proliferation.

  5. Histologic and duplex comparison of the perclose and angio-seal percutaneous closure devices.

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    Gargiulo, Nicholas J; Veith, Frank J; Ohki, Takao; Scher, Lawrence A; Berdejo, George L; Lipsitz, Evan C; Menegus, Mark; Greenberg, Mark

    2007-01-01

    The intravascular and extravascular effects of percutaneous closure devices have not been well studied. We assessed the performance and healing characteristics in dogs of two devices approved by the US Food and Drug Administration. Nine adult male dogs were anesthesized prior to percutaneous access of both femoral arteries with a 6F sheath. All dogs were systemically heparinized to an activated clotting time (ACT) > 250 seconds. Duplex sonography was performed preoperatively to measure vessel diameter and flow velocity. In each dog, one of two devices (Perclose, Abbot Laboratories, Abbott Park, IL or Angio-Seal, St. Jude Medical, St. Paul, MN) was randomly deployed into one of the two femoral arteries. The other device was deployed on the opposite side. Duplex sonography was repeated immediately after deployment and 28 days later to measure changes in vessel diameter and flow velocity. At 28 days, angiography was performed on both femoral arteries before they were removed for histologic evaluation. The time required to excise each vessel reflected the degree of scarring. Hemostasis time for the Angio-Seal device far surpassed the Perclose device (39 +/- 7 vs 0 minutes; p < .05). Vessel narrowing was observed only at 28 days after deployment of the Angio-Seal device (p < .05). Extensive extravascular scarring was observed with the Angio-Seal device, which resulted in a longer femoral artery dissection time and greater periadventitial scar thickness compared with the Perclose device (p < .05). When compared with the Perclose suture closure device, the Angio-Seal collagen plug closure device prolonged hemostasis time and produced greater vessel narrowing and periadventitial inflammation (extravascular scarring) in a canine model at 4 weeks.

  6. Cardiac Device Implant Skin Closure with a Novel Adjustable, Coaptive Tape-Based Device.

    Science.gov (United States)

    Lalani, Gautam G; Schricker, Amir A; Salcedo, Jonathan; Hebsur, Shrinivas; Hsu, Jonathan; Feld, Gregory; Birgersdotter-Green, Ulrika

    2016-10-01

    The purpose of this study was to compare a unique zip-type adjustable coaptive tape-based skin closure device to traditional subcuticular sutures in three domains: time, cosmesis, and wound closure-related outcomes in cardiac implantable electronic device (CIED) procedures. A total of 40 patients were enrolled in a prospective randomized controlled trial to assess time to wound closure, as well as cosmesis and wound closure-related outcomes. The adjustable coaptive tape-based skin closure device had shorter overall closure time (78 ± 6.6 seconds vs 216 ± 21.5 seconds; P < 0.001) and mean closure time per centimeter (18.0 ± 2.0 s/cm vs 50.1 ± 6.7 s/cm; P < 0.001) versus sutures, with less intersurgeon and interpatient variability with the use of adjustable coaptive device versus sutures (P < 0.001). There was no difference between groups in postoperative pain or scar cosmesis during the follow-up period. Neither group had any closure-related adverse events. The adjustable coaptive tape-based skin closure device demonstrated shorter closure times with less variability when compared to sutures. It is a safe and acceptable alternative to sutures for skin closure following CIED implantation. © 2016 Wiley Periodicals, Inc.

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

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

    2013-06-15

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

  8. Intratracheal Seal Disc: A Novel Tracheostoma Closure Device.

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    Christiansen, Karen J; Moeslund, Niels; Lauridsen, Henrik; Devantier, Louise; Rohde, Marianne C; Kjærgaard, Benedict; Pedersen, Michael

    2017-07-01

    Tracheostomy decannulation is accompanied by several clinical concerns due to air leakage. In this study, we introduced a novel tracheostoma closure device that facilitates the use of noninvasive ventilation, improvement of pulmonary function, and vocalization in the newly decannulated patient. The biosafety and feasibility of the device were evaluated in an animal model. Five Danish Landrace pigs were subjected to tracheostomy followed by decannulation and insertion of the tracheostoma closure device. Correct placement of the device was ensured by flexible tracheoscopy. The device consisted of an intratracheal silicone seal disc fixated by a cord through the stoma to an external part. At day 14, computed tomography (CT) was performed before the device was extracted. With the pulling of a cord, the disc unraveled into a thin thread and was extracted through the stoma. At day 21, CT was repeated before euthanasia. The trachea and epidermis were excised en bloc for histopathological evaluation. Insertion and correct placement of the disc was unproblematic in all animals. CT at day 14 confirmed a clear airway, appropriate placement of the disc, and full closure of the tracheostoma. Extraction was successful in one animal but complicated in the remaining animals. There was histological evidence of healing after the foreign body placement. The study demonstrated that the tracheostoma closure device is feasible and biosafe in a porcine animal model, but the design and quality of the materials need to be improved before clinical trials. Copyright © 2017 by Daedalus Enterprises.

  9. The Development of Closure Devices for Flexible Containers

    Science.gov (United States)

    1977-05-01

    any other )erson or corporation, or conveying any rights or permission to manifacture , use, or sell any patented invention that mey in any way he...the additional benefit of effective handling and trdnsporting techniques. However, the methods of closing and opening (closure devices) have been

  10. Transcatheter device closure of postmyocardial infarction ventricular septal defect

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    You-Lin Nie

    2017-01-01

    Conclusion: Our findings indicate that transcatheter device closure of PMIVSD is technically feasible, safe, and effective to reduce the shunt. The crucial prognostic factors were ascertained to be age ≥ 80 years, systolic blood pressure ≤ 90 mmHg, and procedure time ≥180 minutes.

  11. Transcatheter closure of abnormal vessels and arteriovenous fistulas with the Amplatzer vascular plug 4 in patients with congenital heart disease.

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    Wiegand, Gesa; Sieverding, Ludger; Bocksch, Wolfgang; Hofbeck, Michael

    2013-10-01

    Although vascular plugs allow the interventional closure of medium-sized to large abnormal vessels, their application is limited by the need for long sheaths or large guiding catheters. The authors report their experience with the new Amplatzer vascular plug 4 (AVP 4), a self-expanding spindle-shaped occluder made of Nitinol wire mash, which can be placed through 4-Fr catheters with an internal diameter of 0.038 in. or larger. From October 2009 until June 2012, 14 AVP 4 devices were deployed in 12 patients (ages, 0.3-48.8 years). Nine patients had venovenous or arteriovenous collaterals in functional univentricular hearts. One patient had pulmonary atresia with a ventricular septal defect and major aortopulmonary collateral arteries, and one patient had a pulmonary arteriovenous fistula. One child had a large coronary artery fistula to the right atrium. The authors used AVP 4 devices with diameters of 4-8 mm. In all the patients, the AVP 4 was implanted successfully. No occluder dislocations and no complications related to the procedure occurred. Complete vessel occlusion was achieved in seven cases. In seven additional cases, a residual shunt was present at the end of the procedure while the patients were still fully heparinized. In 2 of 14 vessels, the decision was made to place additional devices to abolish residual shunting. According to the authors' experience, the AVP 4 allows safe and effective occlusion of medium-size and large abnormal vessels. It is also well suited for tortuous high-flow vessels such as coronary or pulmonary arteriovenous fistulas. In case of a suboptimal position, it is possible to reposition the occluder with ease. Further studies are needed to determine whether initial residual shunting in heparinized patients disappears during follow-up care. The AVP 4 represents a valuable new device for the interventional treatment of complex congenital vessel malformations.

  12. Transcatheter Device Closure of Muscular Ventricular Septal Defect

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    Yun-Ching Fu

    2011-02-01

    Full Text Available Traditional treatment of muscular ventricular septal defect (VSD is surgical closure, but it carries considerable morbidity and mortality. The Amplatzer muscular VSD occluder (AGA Medical Corporation, Plymouth, MN, USA was approved by the United States Food and Drug Administration in September 2007 and by the Taiwan Department of Health in September 2009. It is a self-expandable double-disc device made from a nitinol wire mesh. Dacron polyester patches are sewn into each disc and the connecting waist to increase the thrombogenicity of the device. Many reports have shown that transcatheter device closure of muscular VSDs is effective and safe. It has no scar, less pain, shorter hospital stay, and less cost compared to the traditional open heart surgery.

  13. Device Closure of Small Ventricular Septal Defects: When and Why?

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    IB Vijayalakshmi

    2014-10-01

    Full Text Available Ventricular septal defect (VSD accounts for approximately 20-30 % of all forms of congenital heart disease (CHD. They were traditionally closed surgically in the past. The surgery though safe carries the risk of morbidity, complete heart block, wound infection and thoracotomy scar on the chest. On weighing the risk and benefit, the small VSDs were not submitted to surgery in the past. So for many years it has been taught that the small VSDs are to be left alone and surgery is not recommended. Many clinicians believed in spontaneous closure of VSDs. Hence they advised the parents to wait for spontaneous closure till the child is 9 years old. But what if the VSD does not close by 10 years is the question. Are they normal as grown up congenital heart (GUCH. The Jane Somerville GUCH unit showed that spontaneous closure occurred only in 10% between the age of 17 and 45 (mean - 27 years in small VSDs in adults. What is worth noting is about 25% had serious complications: infective endocarditis (11%, progressive aortic regurgitation (5%, age-related symptomatic arrhythmias (8.5% like atrial fibrillation. This means that asymptomatic small VSDs in childhood is not necessarily benign during adult life. This raises the question, when we have a safe non-surgical device closure available to close the small VSDs, should we put the future lives of the young in danger by not giving the benefit of technology to them?

  14. Closure of carotid artery puncture site with a percutaneous device.

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    Massière, Bernardo; von Ristow, Arno; Cury, José Mussa; Gress, Marcus; Vescovi, Alberto; Pedron, Cleoni; Medina, Antônio Luiz; Masques, Marcos Areas; Silveira, Paulo Roberto; Jeha, Salim

    2009-03-01

    The surgical treatment of traumatic neck injuries in patients with hostile anatomy is associated with higher risk of complications, due to the technical challenge and associated clinical conditions. The use of a percutaneous closure device for removal of a 7.5 Fr sheath, nonintentionally implanted into the carotid artery, is reported. The right common carotid sheath was removed after introducing a 0.035-inch guidewire; the Angioseal 8 Fr device was then introduced over the wire, successfully sealing the puncture site. Duplex scan control showed patency of the carotids, sealing of the puncture, and adequate flow in the jugular vein and carotid arteries. This maneuver allowed the safe placement of a percutaneous arterial device (Angioseal) to close the puncture site.

  15. Vacuum with mesh is a feasible temporary closure device after fascial dehiscence

    DEFF Research Database (Denmark)

    Bjørsum-Meyer, Thomas; Skarbye, Mona; Jensen, Kenneth Højsgaard

    2013-01-01

    INTRODUCTION: The open abdomen is a challenging condition and a temporary abdominal closure device is required in order to protect the intra-abdominal viscera. We aimed to evaluate the feasibility of a recent device: vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) after...... abdomen after fascial dehiscence. We stress the need for more studies on temporary abdominal closure devices in selected groups of patients. FUNDING: not relevant. TRIAL REGISTRATION: not relevant....

  16. Vacuum with mesh is a feasible temporary closure device after fascial dehiscence

    DEFF Research Database (Denmark)

    Bjørsum-Meyer, Thomas; Skarbye, Mona; Jensen, Kenneth Højsgaard

    2013-01-01

    INTRODUCTION: The open abdomen is a challenging condition and a temporary abdominal closure device is required in order to protect the intra-abdominal viscera. We aimed to evaluate the feasibility of a recent device: vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) after f...

  17. An evaluation of immediate sheath removal and use of the Angio-Seal vascular closure device in neuroradiological interventions

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    Pierot, L. [Hopital Maison Blanche, Department of Radiology, Reims (France); Hopital Maison Blanche, Service de Radiologie, Reims (France); Herbreteau, D. [CHU, Department of Neuroradiology, Tours (France); Bracard, S. [CHU, Department of Diagnostic and Therapeutic Neuroradiology, Nancy (France); Berge, J. [CHU, Department of Neuroradiology, Bordeaux (France); Cognard, C. [Hopital Purpan, Department of Diagnostic and Therapeutic Neuroradiology, Toulouse (France)

    2006-01-01

    We set out to assess the effect of using an arteriotomy closure device in patients at high risk of access site complications. One-hundred nineteen patients with femoral artery access were prospectively included in five centers in France (56 males, 63 females, age range 20-84 years). The neurointerventional procedures were embolization of intracranial aneurysm (71.4%), carotid angioplasty (11.8%), cerebral angioplasty (1.7%), thrombolysis (0.8%), and other procedures (14.3%). Sheaths were removed and the closure device deployed immediately postprocedure. One patient developed a false aneurysm, and one developed a small hematoma. Neither required treatment. Postdevice deployment bleeding was experienced in three patients (2.5%), requiring minimal management. There were no major complications. Three patients died of causes unrelated to the vessel closure. Patient comfort was 2.2 on a scale of 1 (none) to 10 (severe). The results showed that immediate sheath removal followed by use of the closure device is safe in patients undergoing neurointerventional procedures and offers a low level of patient discomfort. In selected patients, early hospital discharge was possible. (orig.)

  18. Closure Devices for Iatrogenic Thoraco-Cervical Vascular Injuries

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    Makris, Gregory C., E-mail: g.makris09@doctors.org.uk; Patel, Rafiuddin; Little, Mark; Tyrrell, Carina; Sutcliffe, James; Allouni, Kader; Bratby, Mark; Anthony, Susan; Uberoi, Raman [Oxford University Hospitals, NHS Foundation Trust, Interventional Radiology Department (United Kingdom)

    2017-03-15

    IntroductionThe unintentional arterial placement of a central venous line can have catastrophic complications. The purpose of this systematic review is to assess and analyse the available evidence regarding the use of the various vascular closure devices (VCDs) for the management of iatrogenic thoraco-cervical arterial injuries (ITCAI).MethodsA systematic review was performed according to PRISMA guidelines.ResultsThirty-two relevant case series and case reports were identified with a total of 69 patients having being studied. In the majority of the studies, plug-based VCDs were used (81%) followed by suture-based devices (19%). The majority of studies reported successful outcomes from the use of VCDs in terms of achieving immediate haemostasis without any acute complications. Long-term follow-up data were only available in nine studies with only one case of carotid pseudoaneurysm being reported after 1-month post-procedure. All other cases had no reported long-term complications. Five studies performed direct or indirect comparisons between VCDs and other treatments (open surgery or stent grafting) suggesting no significant differences in safety or effectiveness.ConclusionAlthough there is limited evidence, VCDs appear to be safe and effective for the management of ITCAIs. Further research is warranted regarding the effectiveness of this approach in comparison to surgery and in order to identify those patients who are more likely to benefit from this minimally invasive approach.

  19. Transcutaneous closure of chronic broncho-pleuro-cutaneous fistula by duct occluder device

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    Vikas Marwah

    2016-01-01

    Full Text Available Bronchopleural fistula (BPF is a well known complication of several pulmonary conditions posing challenging management problem and is often associated with high morbidity and mortality. Though no consensus exists on a definite closure management algorithm, strategies for closure widely include various methods like tube thoracostomy with suction, open surgical closure, bronchoscopy directed glue, coiling and sealants which now also includes use of occlusion devices. We report a case in which a novel method of delivery and closure of recurrent post-operative broncho-pleuro-cutaneous fistula by a duct occluder device was done transcutaneously which has not been previously described in literature.

  20. Vacuum with mesh is a feasible temporary closure device after fascial dehiscence

    DEFF Research Database (Denmark)

    Bjørsum-Meyer, Thomas; Skarbye, Mona; Jensen, Kenneth Højsgaard

    2013-01-01

    INTRODUCTION: The open abdomen is a challenging condition and a temporary abdominal closure device is required in order to protect the intra-abdominal viscera. We aimed to evaluate the feasibility of a recent device: vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) after...... October 2008 and October 2012. RESULTS: The 18 patients had a median age of 64 (29-90) years. 80% (12/15) obtained delayed primary abdominal closure. The in-hospital mortality was 17% (3/18). The median treatment period with VAWCM and vacuum-assisted wound closure were 18 (7-34) and 21 (7-53) days...

  1. Successful Use of the MYNXGRIP Closure Device during Repeated Transbrachial Percutaneous Peripheral Intervention

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    Klaus Hertting

    2015-01-01

    Full Text Available The use of closure devices after transbrachial arterial puncture is still controversial. Here we report on a case where the MYNXGRIP (AccessClosure Inc., Santa Clara, CA, USA could be used successfully in a patient, who underwent percutaneous peripheral arterial intervention twice via transbrachial access.

  2. New skin closure system facilitates wound healing after cardiovascular implantable electronic device surgery.

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    De Maria, Elia

    2015-08-16

    The manuscript describes the efficacy of a new skin closure system (ZipLine™) for wound closure after pacemaker/implantable cardioverter defibrillator surgery. The system is particularly useful when wound healing is difficult with traditional methods and in patients at high risk for surgical site infections (SSIs). This skin closure option is easy and quick to apply and remove, and produces excellent cosmetic results. Although it is associated with a minimal expense upcharge, the benefits, including the potential for decrease in SSI, make it attractive and worth considering for skin closure in device patients, particularly those at increased risk of complications.

  3. Anesthetic management of Amplatzer atrial septal defect closure device embolization to right ventricular outflow tract

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    S Das

    2016-01-01

    Full Text Available Percutaneous device closure of atrial septal defect (ASD is an alternative treatment to surgery with advantages of avoidance of surgery, short procedure time, early discharge from hospital, and lower rates of complications. However, percutaneous device closure is associated with infrequent life-threatening complications such as device embolization. We report a case device embolization of the ASD occlude device into right ventricular outflow tract resulting progressive hypoxia. The role of anesthesiologist as a team leader in managing such emergency is discussed.

  4. Long Term Outcome after Application of the Angio-Seal Vascular Closure Device in Minipigs.

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    Lisa Kabelitz

    Full Text Available Minipigs are frequently used in (neuro-interventional research. Longitudinal experiments may require repeated vessel access via the femoral artery. Anticoagulation and incompliance of the animals necessitates the use of a vascular closure device (VCD. The effects of the Angio-Seal VCD in minipigs were longitudinally assessed. Minipig (42±8.4 kg body weight femoral arteries were sealed using the 8F (n = 6 or 6F (n = 7 Angio-Seal VCD. The pre-interventional femoral artery diameter was 5.1±0.4 mm (4.3-5.8 mm. Sealed puncture sites were analysed angiographically as well as by computed tomography angiography (CTA for a mean period of 14.1±8.0 weeks (1-22 weeks. All animals were constantly treated with acetylsalicylic acid (ASS (450 mg/d (n = 7 or 100 mg/d (n = 1 and clopidogrel (75 mg/d (n = 8. Non-instrumented (n = 2 and arteries sealed using the VCD (n = 2 were examined histologically. No postoperative hemorrhagic complications were observed. Three arteries were occluded after VCD placement (1 animal diagnosed after 4 weeks (8F, 2 animals after 1 week (6F and remained so until the end of the experiments after 22, 12 and 4 weeks, respectively. In one artery a 50% stenosis 8 weeks after application of a 6F Angio-Seal was detected. In 69.2% (n = 9 the VCD was applied without complications. Histopathological analysis of the sealed arterial segments showed subtotal obliteration of the vessel lumen, formation of collagenous tissue and partial damage of the internal elastic lamina. The Angio-Seal VCD prevents relevant hemorrhagic complications in minipigs treated with dual platelet inhibition, but is associated with increased vessel occlusion rates.

  5. Device closure in adults with atrial septal defect in Shiraz, a single center registry

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    Ostovan, Mohammad Ali; Kojuri, Javad; Dehghani, Pooyan; Razazi, Vida; Moarref, Alireza

    2016-01-01

    Introduction: Successful closure of atrial septal defect (ASD) improves patients? functional class and exercise capacity. In this study we evaluate the safety and feasibility of percutaneous device closure of ASDs. Methods: Two hundred fifty six patients with significant ASD according to our criteria were enrolled. The patients were treated using nitinol wire mesh transcatheter devices. Complications were followed for a median of 2.5 years. Results: Success rate was 98.4% with 3 unsuccessful ...

  6. Evaluation of a new wound closure device for linear surgical incisions: 3M Steri-Strip S Surgical Skin Closure versus subcuticular closure.

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    Kerrigan, Carolyn L; Homa, Karen

    2010-01-01

    Technological innovations are often adopted before scientific comparison to an accepted standard. The authors' study compared suture with a new coaptive film device, 3M Steri-Strip S Surgical Skin Closure, on linear incisions. Patients undergoing Wise-pattern breast reduction or abdominal procedures had paired incisions randomly assigned to Steri-Strip S or suture closure. Key outcome measures were closure time, patient comfort, and scar quality at 6 months by patients and surgeons using a new scar evaluation tool, visual assessment of linear scars. Statistical differences between the two closure techniques were assessed by Wilcoxon signed rank test. Of 59 patients, eight were excluded from randomization (a surgeon judged Steri-Strip S to be a nonviable closure technique for mismatched wound edges). Fifty-one patients (breast, n = 24; abdomen, n = 27) were randomized. Operative time with Steri-Strip S for breast was 2.0 minutes (SD = 1.1) versus suture closure at 4.6 minutes (SD = 1.5; p Strip S versus suture for the abdomen was faster (p Strip S and better at 2.6 (SD = 2.9) for suture (p = 0.008). One surgeon rated breast Steri-Strip S scars worse than suture scars (4.3 versus 3.7; p = 0.014). For abdominal scars, there was no difference in the patient or surgeon ratings. Steri-Strip S permits faster wound closure than suture. On the basis of patient reports of comfort and scar quality, surgeons increase efficiency and maintain quality with the use of Steri-Strip S on abdominal wounds but not on breast wounds.

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

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

    2012-08-15

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

  8. Vascular closure devices for femoral arterial puncture site haemostasis.

    Science.gov (United States)

    Robertson, Lindsay; Andras, Alina; Colgan, Frances; Jackson, Ralph

    2016-03-07

    Vascular closure devices (VCDs) are widely used to achieve haemostasis after procedures requiring percutaneous common femoral artery (CFA) puncture. There is no consensus regarding the benefits of VCDs, including potential reduction in procedure time, length of hospital stay or time to patient ambulation. No robust evidence exists that VCDs reduce the incidence of puncture site complications compared with haemostasis achieved through extrinsic (manual or mechanical) compression. To determine the efficacy and safety of VCDs versus traditional methods of extrinsic compression in achieving haemostasis after retrograde and antegrade percutaneous arterial puncture of the CFA. The Cochrane Vascular Trials Search Co-ordinator searched the Specialised Register (April 2015) and the Cochrane Central Register of Controlled Trials (CENTRAL) (2015, Issue 3). Clinical trials databases were searched for details of ongoing or unpublished studies. References of articles retrieved by electronic searches were searched for additional citations. We included randomised and quasi-randomised controlled trials in which people undergoing a diagnostic or interventional procedure via percutaneous CFA puncture were randomised to one type of VCD versus extrinsic compression or another type of VCD. Two authors independently extracted data and assessed the methodological quality of trials. We resolved disagreements by discussion with the third author. We performed meta-analyses when heterogeneity (I(2)) was studies (19,192 participants) in the review. We found studies comparing VCDs with extrinsic compression (sheath size ≤ 9 Fr), different VCDs with each other after endovascular (EVAR) and percutaneous EVAR procedures and VCDs with surgical closure after open exposure of the artery (sheath size ≥ 10 Fr). For primary outcomes, we assigned the quality of evidence according to GRADE (Grades of Recommendation, Assessment, Development and Evaluation) criteria as low because of serious imprecision

  9. Comparison of V-Loc™ 180 wound closure device and Quill™ PDO knotless tissue-closure device for intradermal closure in a porcine in vivo model: evaluation of biomechanical wound strength.

    Science.gov (United States)

    Gingras, Kristen; Zaruby, Jeffrey; Maul, Don

    2012-05-01

    The objective of this study was to compare the biomechanical strength of two barbed suture devices: V-Loc™ 180 Wound Closure Device and Quill™ PDO Knotless Tissue-Closure Device following primary cosmetic skin closures in a porcine dermal model. This prospective randomized, controlled in vivo trial compared size 3/0 V-Loc™ 180 device to size 2/0 Quill™ PDO device. Both products were tested for dermal closure in adult porcine models and evaluated at five timepoints. At postoperative days 0, 3, 7, 14, and 28 sutured tissue regions were excised post mortem and tested for intradermal wound holding strength. Wounds closed with V-Loc™ 180 device were stronger than Quill™ PDO device at days 0, 3, 7, and 14 with these differences being significant (p PDO was 10.38 kgf (p = 0.002). At day 7, the average maximum load of V-Loc™ 180 was 10.4 kgf and Quill™ PDO was 7.56 kgf (p = 0.001). Throughout the duration of the study, there was no suture extrusion or tissue distortion and all wounds healed with no major complications. In this study, V-Loc™ 180 device was significantly stronger than Quill™ PDO device during the critical phases of wound healing in skin. Copyright © 2012 Wiley Periodicals, Inc.

  10. Laparoscopic cryptorchidectomy with a vessel-sealing device in dorsal recumbent horses: 43 cases.

    Science.gov (United States)

    Bracamonte, José L; Thomas, Keri L

    2017-05-01

    To document laparoscopic cryptorchidectomy with a vessel-sealing device in dorsal recumbent horses. Retrospective study. Forty-three male horses. Food was withheld for 36 hours before horses were placed under general anesthesia and positioned in dorsal recumbency. One laparoscopic portal and 2 instrument portals were placed for the laparoscopic procedure. A third instrument portal was created in bilateral cryptorchid horses. A vessel-sealing device was used for hemostasis and transection of retained testes. Descended testes were removed via closed castration with primary closure of the scrotal incision. Time required for removal of the retained testis and perioperative complications were recorded. Short-term (14, 30, 60 days) and long-term follow-up (>1.5 years) consisted of telephone interview with owners and referring veterinarians. Forty-three male horses underwent laparoscopic cryptorchidectomy. Thirteen horses were bilateral cryptorchids, 19 were unilateral cryptorchids with a descended testis, and 11 were unilateral cryptorchids with 1 testis previously removed. Inguinal testes, identified in 5 horses, were pulled into the abdomen prior to excision. The vaginal ring was apposed with endoscopic staples in 3 of 5 horses. Mean surgery time was 31.34 ± 7.41 minutes. No intraoperative or immediate postoperative complications were encountered. No short-term or long-term complications were reported. Laparoscopic cryptorchidectomy can be safely performed with a vessel sealing-device in dorsal recumbent horses. This method was effective and did not result in any complication in our case series. © 2017 The American College of Veterinary Surgeons.

  11. Ultrasonographic features of vascular closure devices: initial and 6 month followup results

    Energy Technology Data Exchange (ETDEWEB)

    Choo, Hye Jung; Jeong, Hae Woong; Park, Jin Young; Kim, Sung Tae; Seo, Jung Hwa; Lee, Sun Joo; Park, Young Mi [Inje University Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of); Jin, Sung Chul [Dept. of Neurosurgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2014-12-15

    This study aimed to evaluate the ultrasonographic findings for various types of vascular closure devices (VCDs) immediately after the angiographic procedure and at 6-month follow-up. We included 18 VCDs including Angio-Seal (n=4), FemoSeal (n=8), ExoSeal (n=3), Perclose (n=2), and StarClose (n=1) in this study. Four patients were implanted with 2 VCDs at the each side of bilateral femoral arteries, while the remaining 8 patients were inserted 1 VCD at the right femoral artery. Ultrasonography was performed within 10 days and at approximately 6 months after the angiographic procedure. Ultrasonographic morphology of the attached VCD and its relationship with the arterial wall were analyzed. Initial ultrasonography revealed the attached VCD as the relevant unique structure with successful deployment and hemostasis. Follow-up ultrasonography demonstrated partial absorption of hemostatic materials in cases of Angio-Seal (n=3), FemoSeal (n=5), and ExoSeal (n=3), changes in the soft tissue surrounding the femoral artery in case of Angio-Seal (n=1), arterial intimal hyperplasia in cases of FemoSeal (n=3), and no gross changes as compared with the initial ultrasonographic findings in cases of Perclose (n=2) and StarClose (n=1). Initial ultrasonographic evaluation reflected the unique structure of each VCD, with most of them being easily distinguishable. Follow-up ultrasonography revealed various changes in the affected vessels.

  12. Vacuum with mesh is a feasible temporary closure device after fascial dehiscence.

    Science.gov (United States)

    Bjørsum-Meyer, Thomas; Skarbye, Mona; Jensen, Kenneth Højsgaard

    2013-11-01

    The open abdomen is a challenging condition and a temporary abdominal closure device is required in order to protect the intra-abdominal viscera. We aimed to evaluate the feasibility of a recent device: vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) after fascial dehiscence focusing on fascial closure rate, mortality and procedure-related complications. We performed a retrospective study on 18 patients treated with VAWCM after fascial dehiscence who were consecutively admitted to the Department of Surgery, Slagelse Hospital, between October 2008 and October 2012. The 18 patients had a median age of 64 (29-90) years. 80% (12/15) obtained delayed primary abdominal closure. The in-hospital mortality was 17% (3/18). The median treatment period with VAWCM and vacuum-assisted wound closure were 18 (7-34) and 21 (7-53) days, respectively, with a median of six (1-11) tightenings. One patient developed an intra-abdominal abscess. Three patients survived until discharge without having obtained delayed primary closure. In two of these patients, the fascial edges were adapted with a prosthetic mesh and one patient was left with a planned ventral hernia. We performed a retrospective follow-up with a median duration of 21 months 21% developed an incisional hernia. Two patients died within 60 days after closure of the abdomen. We found and that VAWCM is a safe and useful technique for delayed primary closure of the open abdomen after fascial dehiscence. We stress the need for more studies on temporary abdominal closure devices in selected groups of patients. not relevant. not relevant.

  13. Vacuum with mesh is a feasible temporary closure device after fascial dehiscence

    DEFF Research Database (Denmark)

    Bjørsum-Meyer, Thomas; Skarbye, Mona; Jensen, Kenneth Højsgaard

    2013-01-01

    INTRODUCTION: The open abdomen is a challenging condition and a temporary abdominal closure device is required in order to protect the intra-abdominal viscera. We aimed to evaluate the feasibility of a recent device: vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) after...... fascial dehiscence focusing on fascial closure rate, mortality and procedure-related complications. MATERIAL AND METHODS: We performed a retrospective study on 18 patients treated with VAWCM after fascial dehiscence who were consecutively admitted to the Department of Surgery, Slagelse Hospital, between......, respectively, with a median of six (1-11) tightenings. One patient developed an intra-abdominal abscess. Three patients survived until discharge without having obtained delayed primary closure. In two of these patients, the fascial edges were adapted with a prosthetic mesh and one patient was left...

  14. 16. Optimal guidance of percutaneous device closure of PDA by transthoracic echocardiography

    Directory of Open Access Journals (Sweden)

    M. Alobaidan

    2016-07-01

    Full Text Available Patent ductus arteriosus (PDA is common congenital cardiac lesion and the most accepted way of management is transcatheter occlusion by device which is usually done under fluoroscopy guidance. Transoesophageal echo cardiography and transaortic imaging were used in adult to guide the procedure which is with certain applications in pediatric age group transthoracic echocardiography (TTE in pediatric population provides excellent images for PDA and may replace the use of fluoroscopy to guide PDA closure at least in special situations. To highlight the feasibility of device closure under guidance of TTE to be applied in sick patients who are not suitable for transfer to cardiac catheter laboratory or those with contraindication to contrast and or radiation application. 18 patients from July 2013 to May 2015 underwent TTE guidance device closure of PDA, 1 patient was excluded after device embolization which necessitate retrieval under fluoroscopy (fluoro.. Conscious sedation was used in 17 patients except 1 who was sick and already ventilated in ICU, there were 11 female and 7 male, antegrade approach was used in 10 patients with partial fluoro and retrograde approach in 8 patients without fluoro. Median age is 7 months, median weight is 8 kg (3.2–11 kg, 2 patients with renal impairment, 2 with Leukemia, median procedure time is 35 min, median fluoro. is 2.2 min, PDA size were small in 13 patients and moderate in 5, immediate closure is achieved in all. The devices were ADOI, ADOS, ADOII, Occlutech, and AVP2. Device embolization in 1 with successful retrieval and second device was used with complete closure percutaneous PDA closure under TTE guidance is feasible, safe and recommended in selected patients with certain situation.

  15. Reversible complete atrioventricular block after percutaneous ASD device closure in a child <15 kg.

    Science.gov (United States)

    Rohit, Manoj Kumar; Puri, Kriti; Vadivelu, Ramalingam

    2014-01-01

    Transcatheter device closure of atrial septal defect (ASD) in small children less than 15 kg may be associated with increased complications. Complete atrioventricular heart block (CHB) is a rare complication of ASD device closure in such a setting. We report the case of a 2-year-old girl, less than 15 kg, who underwent device closure of ASD with Amplatzer Septal Occluder and subsequently developed CHB 12 h after the procedure which resolved completely with steroid treatment on fifth day. Case report of a similar kind is rarely reported in the literature. Despite adequate postero-inferior margin CHB may still occur in small children as in our case. Copyright © 2014 Cardiological Society of India. All rights reserved.

  16. Comparison of cost-effectiveness and postoperative outcome of device closure and open surgery closure techniques for treatment of patent ductus arteriosus.

    Science.gov (United States)

    Ahmadi, Alireza; Sabri, Mohammadreza; Bigdelian, Hamid; Dehghan, Bahar; Gharipour, Mojgan

    2014-01-01

    Various devices have been recently employed for percutaneous closure of the patent ductus arteriosus (PDA). Although the high effectiveness of device closure techniques has been clearly determined, a few studies have focused on the cost-effectiveness and also postoperative complications of these procedures in comparison with open surgery. The present study aimed to evaluate the clinical outcome and cost-effectiveness of PDA occlusion by Amplatzer and coil device in comparisong with open surgery. In this cross-sectional study, a randomized sample of 201 patients aged 1 month to 16 years (105 patients with device closure and 96 patients with surgical closure) was selected. The ratio of total pulmonary blood flow to total systemic blood flow, the Qp/Qs ratio, was measured using a pulmonary artery catheter. The cost analysis included direct medical care costs associated with device implantation and open surgery, as well as professional fees. All costs were calculated in Iranian Rials and then converted to US dollars. There was no statistical difference in mean Qp/Qs ratio before the procedure between the device closure group and the open surgery group (2.1 ± 0.7 versus 1.7 ± 0.6, P = 0.090). The mean measured costs were overall higher in the device closure group than in open closure group (948.87 ± 548.76 US$ versus 743.70 ± 696.91 US$, P gender (Standardized Beta = 0.160, P = 0.031). PDA closure with the Amplatzer ductal occluder (1053.05 ± 525.73 US$) or with Nit-Occlud coils (PFM) (912.73 ± 565.94 US$, P < 0.001) was more expensive than that via open surgery. However, the Cook detachable spring coils device closure (605.65 ± 194.62 US$, P = 0.650) had a non-significant cost difference with open surgery. No event was observed in the device closure group regarding in-hospital mortality or morbidity; however, in another group, 2 in-hospital deaths occurred, two patients experienced pneumonia and seizure, and one suffered electrolyte abnormalities including

  17. Left atrial appendage closure: First in man with the 4th generation WATCHMAN device.

    Science.gov (United States)

    Ledwoch, Jakob; Franke, Jennifer; Gonzaga, Maik; Bertog, Stefan; Braut, Annkathrin; Hofmann, Ilona; Vaskelyte, Laura; Gafoor, Sameer; Reddy, Vivek; Sievert, Horst

    2016-03-01

    To evaluate the feasibility and safety of the fourth generation WATCHMAN device. The WATCHMAN left atrial appendage (LAA) closure device has been shown to be non-inferior to conventional oral anticoagulation with warfarin for stroke prevention in patients with non-valvular atrial fibrillation. A new (fourth) generation of the WATCHMAN device was designed to facilitate easier delivery and improve safety. We conducted a prospective, non-randomized study of LAA closure with use of the 4(th) generation WATCHMAN device in 36 patients with non-valvular atrial fibrillation. Follow-up was performed at 45 days, 6 months and 12 months following implantation. The mean age of the population was 73 ± 6 years and 67% were male. The mean CHADS2 and CHA2 DS2-VASc Score were 2.5 and 4.5, respectively. The device was implanted successfully in 34/36 (94%). No serious hospital complications related to the device or procedure occurred. During 12 month follow-up, three ischemic strokes (8%), one hemorrhagic stroke (3%), one TIA (3%) and three deaths (9%) occurred. Device-associated thrombus formation was detected in one patient (3%) during six-month follow-up and was treated successfully with low molecular weight heparin. LAA closure with the 4(th) generation WATCHMAN device is feasible and safe. New technical features may contribute to a better performance of the occluder, particularly regarding the risk of pericardial effusions. © 2015 Wiley Periodicals, Inc.

  18. The Angio-Seal™ femoral closure device allows immediate ambulation after coronary angiography and percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Hvelplund, Anders; Jeger, Raban; Osterwalder, Remo

    2011-01-01

    To test the safety of immediate mobilisation of patients undergoing coronary angiography and percutaneous coronary intervention (PCI) closed with Angio-Seal™ -a femoral vascular closure device.......To test the safety of immediate mobilisation of patients undergoing coronary angiography and percutaneous coronary intervention (PCI) closed with Angio-Seal™ -a femoral vascular closure device....

  19. Use of OTSC Device System for Closure of Fistulas in the Alimentary Tract – A Case Series

    Directory of Open Access Journals (Sweden)

    Truptesh H. Kothari

    2014-01-01

    Conclusion: With several new devices being introduced, it is difficult to judge the implementation of one tool over the others. This device has shown promising results for fistula closure if used knowing the limitation of the product.

  20. PROTRUSION OF THE DEVICE - A COMPLICATION OF CATHETER CLOSURE OF PATENT DUCTUS-ARTERIOSUS

    NARCIS (Netherlands)

    OTTENKAMP, J; HESS, J; TALSMA, MD; BUISLIEM, TN

    Objective-To assess the medium term results of percutaneous transvenous closure of patent ductus arteriosus, in particular with regard to protrusion of the device with or without turbulence of the bloodflow. Design-Clinical examination and echocardiographic study (cross sectional Doppler, and colour

  1. First clinical experience with Celt ACD(®) : a femoral arterial puncture closure device.

    LENUS (Irish Health Repository)

    Jan, Aftab

    2013-08-01

    This prospective nonrandomized study compared the safety and efficacy of a novel arterial closure device (ACD) in common femoral artery procedures to that of the FDA submitted historical manual pressure control group, who underwent either a diagnostic angiogram (DA) or a percutaneous coronary intervention (PCI) procedure.

  2. Successful Retrieval of an Embolized Vascular Closure Device (Angio-Seal{sup ®}) After Peripheral Angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Jud, Philipp, E-mail: philipp.jud@medunigraz.at [Medical University of Graz, Division of Angiology, Department of Internal Medicine (Austria); Portugaller, Rupert; Bohlsen, Dennis [Medical University of Graz, Division of Vascular and Interventional Radiology, Department of Radiology (Austria); Gary, Thomas; Brodmann, Marianne [Medical University of Graz, Division of Angiology, Department of Internal Medicine (Austria); Hackl, Gerald [Medical University of Graz, Division of Intensive Care, Department of Internal Medicine (Austria); Hafner, Franz [Medical University of Graz, Division of Angiology, Department of Internal Medicine (Austria)

    2017-06-15

    A 55-year-old male with peripheral arterial disease underwent angioplasty of the right lower limb arteries via antegrade femoral access. Angio-Seal{sup ®} closure device was used to treat the puncture site, whereby the intravascular sealing anchor accidentally embolized into the malleolar region of the right posterior tibial artery. Successful retrieval of the anchor was accomplished by a SpiderFX embolic protection device. This technique may be a useful approach to retrieve embolized foreign bodies via endovascular access.

  3. Peripapillary retinal vessel density in eyes with acute primary angle closure: an optical coherence tomography angiography study.

    Science.gov (United States)

    Wang, Xiaolei; Jiang, Chunhui; Kong, Xiangmei; Yu, Xiaobo; Sun, Xinghuai

    2017-05-01

    The purpose was to investigate peripapillary retinal vessel density in resolved acute primary angle closure (APAC) eyes. This was a prospective, cross-sectional observational study. Thirty-four eyes of 34 patients with unilateral APAC were included, together with the fellow eyes with primary angle closure suspect (PACS) as controls. Peripapillary retinal vessel density was measured using optical coherence tomography (OCT) angiography. Peripapillary retinal vessel density was compared in both eyes and the potential relationship with visual field (VF) test results was evaluated. After an acute attack, the peripapillary retinal vessel density was lower in the APAC than in the PACS eyes (79.3 ± 8.2 versus 85.6 ± 4.9, respectively; P = 0.001). The VF mean deviation (MD) (-7.7 ± 6.7 versus -3.3 ± 1.8 dB, P = 0.002), and the pattern standard deviation (PSD) (4.6 ± 3.3 versus 2.4 ± 0.9 dB, P = 0.001) were worse for the APAC than the PACS eyes, but both had similar thicknesses of the retinal nerve fiber layer (RNFL) (111.8 ± 9.6 versus 114.1 ± 29.1 μm, P = 0.880) and ganglion cell complex (GCC) (94.7 ± 7.5 versus 91.8 ± 9.3 μm, P = 0.328). The peripapillary retinal vessel density was significantly correlated with the VF MD (vessel density: r = 0.455, P = 0.008) and PSD (vessel density: r = -0.592, P density, which was correlated with the VF values. OCT angiography is a reliable method for detecting vascular changes in glaucomatous eyes that show no thinning of the RNFL and GCC.

  4. Perclose Closure Device breakage and embolization during deployment followed by retrieval with snare

    Directory of Open Access Journals (Sweden)

    Kevin Kang

    2015-12-01

    Full Text Available Perclose Closure Device (Abbott-Vascular was attempted for femoral artery (FA access site closure by an experienced operator. The device was felt to snap as it was pushed through the previously scarred skin and subcutaneous tissue. Perclose had broken into two pieces with the proximal portion outside the body and the distal portion embolizing to lie in the FA to distal aorta. The left FA was accessed through 8F sheath and 4–8 mm Basket snare passed through a 6F multipurpose guiding catheter. The tip of the broken Perclose was caught with the snare and pulled out. The Perclose has a distal flexible sheath that is overmolded directly onto the proximal rigid guide. This junction of sheath and guide may be a weak point. Accidental pressure applied at this weak point in any Perclose device during deployment can cause breakage. Awareness of this rare complication is important for safety.

  5. Evaluation of J-groove weld residual stress and crack growth rate of PWSCC in reactor pressure vessel closure head

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Seung Hyuk; Ryu, Tae Young; Park, Seung Hyun; Won, Min Gu; Kang, Seok Jun; Kim, Moon Ki; Choi, Jae Boong [Sungkyunkwan University, Suwon (Korea, Republic of); Lee, Kyoung Soo; Lee, Sung Ho [Korea Hydro and Nuclear Power, Daejeon (Korea, Republic of)

    2015-03-15

    Over the last decade, primary water stress corrosion cracking (PWSCC) has been frequently found in pressurized water reactor (PWR) applications. Especially, PWSCC has occurred in long-term operated PWRs. As this phenomenon leads to serious accidents, we must be beforehand with the anticipated problems. A typical PWR consists of J-groove welded components such as reactor pressure vessel closure head and nozzles. Reactor pressure vessel closure head is made of SA508 and it is covered by cladding. Alloy 600 is used for nozzles. And J-groove weld is conducted with alloy 82/182. Different material properties of these metals lead to residual stress and PWSCC consequentially. In this study, J-groove weld residual stress was investigated by a three-dimensional finite element analysis with an actual asymmetric J-groove weld model and process of construction. Also crack growth rate of PWSCC was evaluated from cracks applied on the penetration nozzles. Based on these two values, one cannot only improve the structural integrity of PWR, but also explain PWSCC behavior such that high residual stress at the J-groove weld area causes crack initiation and propagation through the surface of nozzles. In addition, crack behavior was predicted at the various points around the nozzle.

  6. Short periodic applications of the vacuum-assisted closure device cause an extended tissue response in the diabetic mouse model.

    Science.gov (United States)

    Scherer, Sandra Saja; Pietramaggiori, Giorgio; Mathews, Jasmine C; Orgill, Dennis P

    2009-11-01

    The vacuum-assisted closure device is a widely used mechanical modulator of wound healing; however, the optimal time kinetics of application have not been determined. The objective of the study was to optimize the kinetics of vacuum-assisted closure application. Full-thickness wounds in seven diabetic mice per study group were treated with either an occlusive dressing alone, the vacuum-assisted closure device for 6 or 12 hours, or the vacuum-assisted closure device periodically for 4 hours every other day or continuously for 7 days. Wound closure and tissue response were evaluated by macroscopic, histologic, and immunohistochemical analyses on day 7. Wound closure was significantly faster after short initial vacuum-assisted closure (6-hour and 12-hour groups) when compared with continuous treatment. Increased granulation tissue formation was seen in the 12-hour group (2.4-fold increase) and in those treated periodically for 4 hours every other day (3.2-fold increase) compared with the dressing-alone controls. Significant stimulation of cell proliferation was seen after all vacuum-assisted closure patterns (3.6- to 5.3-fold increase), whereas angiogenesis was augmented only after the device was applied for either three times for 4 hours (4.3-fold) or continuously (4.7-fold) when compared with dressing-treated wounds. Treatment three times for 4 hours showed a superior angiogenic effect also when compared with short initial applications (6-hour and 12-hour groups). Short vacuum-assisted closure treatment induced an extended biological response in the wound. A total of 12 hours of periodically applied vacuum-assisted closure reached a similar wound tissue response as continuously applied vacuum-assisted closure for 7 days. These findings suggest new clinical approaches for mechanical wound-healing devices.

  7. Results of long-term field tests of protective earthing device for vessel electric systems

    Directory of Open Access Journals (Sweden)

    Blaginin V.A.

    2015-03-01

    Full Text Available The results of prolonged natural tests of protective neutral earthing device for controlling the fire and electrical safety of vessel electric systems have been shown. The use of such devices provides safe single-phase fault currents and reducing arc overvoltage during the long-term operation of a ship. The results of long-term monitoring of the device operation as part of the existing vessel electric power system have confirmed its effectiveness

  8. The Application of Vacuum-Assisted Closure Device in the Management of Empyema Necessitans

    Directory of Open Access Journals (Sweden)

    Yasser Aljehani

    2016-01-01

    Full Text Available Vacuum-assisted closure (VAC is gaining popularity in the management of many types of acute and chronic wounds. The use of VAC devices in thoracic surgery is limited, but it appears to be promising in complex cases of empyema thoraces. We report a case of empyema necessitans, in which VAC was used to achieve complete wound healing after open drainage which was communicating with the pleural space.

  9. Application of Vacuum-Assisted Closure Device in Management of Postpneumonectomy Empyema

    Science.gov (United States)

    Sohn, Suk Ho; Choi, Se Hoon; Kim, Young Tae

    2013-01-01

    A 57-year-old man was diagnosed with lung cancer and underwent pneumonectomy and mediastinal lymph node dissection. He was discharged without acute complications, but on a regular outpatient follow-up, he was readmitted with postpneumonectomy empyema. He was successfully treated with a vacuum-assisted closure device and for 1 year period of outpatient follow-up, there was no recurrence of empyema or lung cancer. PMID:23614105

  10. Hidden (end-on) patent ductus arteriosus: recognition and device closure.

    Science.gov (United States)

    Garg, Naveen; Madan, Bevunahalli Kantharaj

    2016-02-01

    Sometimes, it is difficult to visualize a patent ductus arteriosus and deploy a device in the standard lateral view because of an end-on orientation. The right anterior oblique view may be helpful by separating the ductus arteriosus from the aorta. This study was undertaken to evaluate the incidence of end-on patent ductus arteriosus and the utility of the right anterior oblique view during device closure. Aortography was performed in lateral and right anterior oblique views before, during, and after successful device deployment in 117 consecutive patients. When a ductus arteriosus was not clearly visible in the lateral view due to overlapping by the aorta, it was termed "right anterior oblique view useful". The types of patent ductus arteriosus were A, B, C, and E in 86 (73.5%), 20 (17.1%), 4 (3.4%), and 7 (6.0%) patients, respectively. An end-on ductus arteriosus was present in 24 (20.5%) patients (14 type B, 10 type A). The right anterior oblique view was useful during device closure in 15 (12.8%) cases (all end-on type). Among all cases of end-on patent ductus arteriosus, it was useful in 62.5% (most type B and a few type A). In all of these, the device appeared obliquely oriented and foreshortened in the lateral view but fully profiled in the right anterior oblique view. Recognizing an end-on patent ductus arteriosus and utilizing the right anterior oblique view simplified device closure. For ducts well-profiled in the lateral view, the right anterior oblique view is unnecessary and avoidable. © The Author(s) 2016.

  11. The safety and efficacy of the Angio-Seal closure device in diagnostic and interventional neuroangiography setting: a single-center experience with 1,443 closures

    Energy Technology Data Exchange (ETDEWEB)

    Geyik, Serdar; Yavuz, Kivilcim; Akgoz, Ayca; Koc, Osman; Peynircioglu, Bora; Cil, Barbaros; Cekirge, Saruhan; Saatci, Isil [Hacettepe University Hospitals, Radiology Department, Ankara (Turkey)

    2007-09-15

    We evaluated the safety and efficacy of the Angio-Seal closure device used to close arterial puncture sites in patients who had undergone diagnostic cerebral angiography and neurointerventional procedures. A total of 1,443 Angio-Seal devices were placed in 1,099 patients in the Interventional Neuroradiology Unit between May 2005 and August 2006. Of these, 670 were interventional and 745 were diagnostic cerebral angiographic procedures. In 28 patients bilateral puncture of the femoral arteries was performed for endovascular treatment. In 167 patients 286 repeat diagnostic procedures were performed and 30 interventional procedures were followed by re-closure with an Angio-Seal device at the time of repeat puncture. The procedural success rate for antegrade closures was 99.7% for all procedures. The device failed in 5 of 745 diagnostic procedures (0.7%). Major complication occurred in one patient only (0.13%) in the diagnostic group. No minor complications were observed in this group. In the interventional group, the major complication rate was 1.4% (10 of 698 closures) and the minor complication rate was 2.4% (17 of 698 closures). However, in the subgroup of patients with cerebral aneurysms who received heparin in combination with antiplatelet agents after the procedure, the major complication rate was 5.3%, but in the carotid/vertebral stenting group it was 0.8%. Our experience in a relatively large series of patients shows that the use of the Angio-Seal STS vascular closure device is safe and effective in patients undergoing cerebral diagnostic angiography and neurointerventional procedures with an acceptable rate of complications, although the complication rate was higher in the group of patients who received heparin and/or antiplatelet medication. (orig.)

  12. Internal vacuum-assisted closure device in the swine model of severe liver injury

    Directory of Open Access Journals (Sweden)

    Everett Christopher B

    2012-12-01

    Full Text Available Abstract Objectives The authors present a novel approach to nonresectional therapy in major hepatic trauma utilizing intraabdominal perihepatic vacuum assisted closure (VAC therapy in the porcine model of Grade V liver injury. Methods A Grade V injury was created in the right lobe of the liver in a healthy pig. A Pringle maneuver was applied (4.5 minutes total clamp time and a vacuum assisted closure device was placed over the injured lobe and connected to suction. The device consisted of a perforated plastic bag placed over the liver, followed by a 15 cm by 15cm VAC sponge covered with a nonperforated plastic bag. The abdomen was closed temporarily. Blood loss, cardiopulmonary parameters and bladder pressures were measured over a one-hour period. The device was then removed and the animal was euthanized. Results Feasibility of device placement was demonstrated by maintenance of adequate vacuum suction pressures and seal. VAC placement presented no major technical challenges. Successful control of ongoing liver hemorrhage was achieved with the VAC. Total blood loss was 625 ml (20ml/kg. This corresponds to class II hemorrhagic shock in humans and compares favorably to previously reported estimated blood losses with similar grade liver injuries in the swine model. No post-injury cardiopulmonary compromise or elevated abdominal compartment pressures were encountered, while hepatic parenchymal perfusion was maintained. Conclusion These data demonstrate the feasibility and utility of a perihepatic negative pressure device for the treatment of hemorrhage from severe liver injury in the porcine model.

  13. Internal vacuum-assisted closure device in the swine model of severe liver injury

    Science.gov (United States)

    2012-01-01

    Objectives The authors present a novel approach to nonresectional therapy in major hepatic trauma utilizing intraabdominal perihepatic vacuum assisted closure (VAC) therapy in the porcine model of Grade V liver injury. Methods A Grade V injury was created in the right lobe of the liver in a healthy pig. A Pringle maneuver was applied (4.5 minutes total clamp time) and a vacuum assisted closure device was placed over the injured lobe and connected to suction. The device consisted of a perforated plastic bag placed over the liver, followed by a 15 cm by 15cm VAC sponge covered with a nonperforated plastic bag. The abdomen was closed temporarily. Blood loss, cardiopulmonary parameters and bladder pressures were measured over a one-hour period. The device was then removed and the animal was euthanized. Results Feasibility of device placement was demonstrated by maintenance of adequate vacuum suction pressures and seal. VAC placement presented no major technical challenges. Successful control of ongoing liver hemorrhage was achieved with the VAC. Total blood loss was 625 ml (20ml/kg). This corresponds to class II hemorrhagic shock in humans and compares favorably to previously reported estimated blood losses with similar grade liver injuries in the swine model. No post-injury cardiopulmonary compromise or elevated abdominal compartment pressures were encountered, while hepatic parenchymal perfusion was maintained. Conclusion These data demonstrate the feasibility and utility of a perihepatic negative pressure device for the treatment of hemorrhage from severe liver injury in the porcine model. PMID:23217091

  14. A comparison of a new skin closure device and intradermal sutures in the closure of full-thickness surgical incisions.

    Science.gov (United States)

    Richter, Dirk; Stoff, Alexander; Ramakrishnan, Venkat; Exner, Klaus; Jernbeck, Jan; Blondeel, Phillip N

    2012-10-01

    A novel topical skin adhesive system was developed to close the outermost layer of skin in an expeditious manner. To determine its clinical utility, a clinical investigation was undertaken to demonstrate equivalence of a new adhesive skin closure system (Prineo Skin Closure System) to intradermal sutures in wound closure. The investigation included 83 patients who underwent elective abdominoplasty, circumferential body lift procedures, and breast reconstruction with deep inferior epigastric perforator flaps. Incisions were divided in half, and each half was randomized to wound closure with the new skin closure system, including a pressure-sensitive adhesive mesh tape for wound edge approximation and next-generation cyanoacrylate or intradermal sutures. Postoperative evaluations took place at 24 hours, 7 days, 12 to 25 days, 90 days, 6 months, and 12 months. The new skin closure system was found to be equivalent to intradermal sutures for the continuous approximation of wounds. The upper limit of the two-sided 90 percent confidence interval for difference in proportions was 10.9 percent. The mean time to closure for the new skin closure system was 1.46 minutes, approximately 5 minutes faster than that for intradermal sutures (p sutures for full-thickness surgical incisions with regard to safety and effectiveness. The ease and speed of application contribute to shortened operative times (4.5 times faster than intradermal sutures).

  15. Modelling of pressure increase protection system for the vacuum vessel of W7-X device

    Energy Technology Data Exchange (ETDEWEB)

    Kaliatka, Tadas, E-mail: tadas.kaliatka@lei.lt; Uspuras, Eugenijus; Kaliatka, Algirdas

    2016-11-01

    Highlights: • Two in-vessel LOCAs (partial and guillotine break of 40 mm diameter pipe of cooling system) for Wendelstein 7-X fusion device were analyzed. • The analysis of the processes in the cooling system, vacuum vessel and pressure increase protection system were performed using thermal-hydraulic RELAP5 Mod3.3 code. • The suitability of pressure increase protection system was assessed. - Abstract: In fusion devices, plasma is contained in a vacuum vessel. The vacuum vessel cannot withstand a pressure above atmospheric. Any damage of in-vessel components could lead to water ingress and may lead to pressure increase and possible damage of vacuum vessel. In order to avoid such undesirable consequences, the pressure increase protection system is designed. In this article, the processes occurring in the vacuum vessel and pressure increase protection system of W7-X device during LOCA (small and guillotine pipe break) event are analyzed. The model of W7-X cooling system, vacuum vessel and pressure increase protection system was developed using RELAP5 code. Numerical analysis of partial and guillotine break of 40 mm diameter pipe of cooling system was performed. Calculation results showed that burst disc of the pressure increase protection system does not open when the cross section area of partial break in the cooling system is smaller than 1 mm{sup 2}. During the guillotine break of cooling system, the burst disc opens, but pressure increase protection system is capable to prevent overpressure of the vacuum vessel.

  16. Single clips versus multi-firing clip device for closure of mucosal incisions after peroral endoscopic myotomy (POEM).

    Science.gov (United States)

    Verlaan, Tessa; Ponds, Fraukje A M; Bastiaansen, Barbara A J; Bredenoord, Albert J; Fockens, Paul

    2016-10-01

    Background and aims: After Peroral Endoscopic Myotomy (POEM), the mucosal incision is closed with endoscopically applied clips. After each clip placement, a subsequent clipping device has to be introduced through the working channel. With the Clipmaster3, three consecutive clips can be placed without reloading which could reduce closure time. We performed a prospective study evaluating efficacy, safety, and ease of use. Closure using Clipmaster3 was compared to closure with standard clips. Methods: Patients undergoing closure with the Clipmaster3 were compared to patients who underwent POEM with standard clip closure. Results: In total, 12 consecutive POEM closures with Clipmaster3 were compared to 24 standard POEM procedures. The Clipmaster3 and the standard group did not differ in sex distribution, age (42 years [29 - 49] vs 41 years [34 - 54] P = 0.379), achalasia subtype, disease duration, length of the mucosal incision (25.0 mm [20 - 30] vs 20.0 mm [20 - 30], P = 1.0), and closure time (622 seconds [438 - 909] vs 599 seconds [488 - 664] P = 0.72). Endoscopically successful closure could be performed in all patients. The proportion of all clips used that were either displaced or discarded was larger for Clipmaster3 (8.8 %) compared to standard closure (2.0 %, P  = 0.00782). Ease of handling VAS (visual analogue scale) score for Clipmaster3 did not differ between endoscopist and endoscopy nurse (7 out of 10). Conclusions: Clipmaster3 is feasible and safe for closure of mucosal incisions after POEM. Clipmaster3 was not associated with reduced closure time. Compared to standard closure, more Clipmaster3 clips were displaced or discarded to achieve successful closure. A training effect cannot be excluded as a cause of these results. NCT01405417.

  17. Left atrial appendage closure devices for cardiovascular risk reduction in atrial fibrillation patients

    Directory of Open Access Journals (Sweden)

    Cruz-Gonzalez I

    2015-05-01

    Full Text Available Ignacio Cruz-Gonzalez,* Juan Carlos Rama-Merchan,* Javier Rodriguez-Collado, Javier Martin-Moreiras, Alejandro Diego-Nieto, Antonio Arribas-Jimenez, Pedro Luís SanchezDepartment of Cardiology, University Hospital of Cardiology and IBSAL, Salamanca, Spain *Ignacio Cruz-Gonzalez and Juan Carlos Rama-Merchan have contributed equally to this work and should be considered co-first authors Abstract: Atrial fibrillation (AF is the most common sustained arrhythmia in clinical practice. AF is associated with a 4–5-fold increased risk of stroke and systemic embolism. Oral anticoagulant is the first-line therapy for this purpose, but it has various limitations and is often contraindicated or underutilized. Autopsy and surgical data have suggested that 90% of atrial thrombi in nonvalvular AF patients originate from the left atrial appendage, leading to the development of percutaneous closure for thromboembolic prevention. This paper examines the current evidence on left atrial appendage closure devices for cardiovascular risk reduction in AF patients. Keywords: atrial fibrillation, left atrial appendage, stroke, oral anticoagulant, percutaneous closure, thromboembolic prevention

  18. Vacuum-assisted closure device enhances recovery of critically ill patients following emergency surgical procedures

    Science.gov (United States)

    2009-01-01

    Introduction Critically ill surgical patients frequently develop intra-abdominal hypertension (IAH) leading to abdominal compartment syndrome (ACS) with subsequent high mortality. We compared two temporary abdominal closure systems (Bogota bag and vacuum-assisted closure (VAC) device) in intra-abdominal pressure (IAP) control. Methods This prospective study with a historical control included 66 patients admitted to a medical and surgical intensive care unit (ICU) of a tertiary care referral center (Careggi Hospital, Florence, Italy) from January 2006 to April 2009. The control group included patients consecutively treated with the Bogota bag (Jan 2006-Oct 2007), whereas the prospective group was comprised of patients treated with a VAC. All patients underwent abdominal decompressive surgery. Groups were compared based upon their IAP, SOFA score, serial arterial lactates, the duration of having their abdomen open, the need for mechanical ventilation (MV) along with length of ICU and hospital stay and mortality. Data were collected from the time of abdominal decompression until the end of pressure monitoring. Results The Bogota and VAC groups were similar with regards to demography, admission diagnosis, severity of illness, and IAH grading. The VAC system was more effective in controlling IAP (P closure time (4.4 vs 6.6 days, P = 0.025), shorter duration of MV (7.1 vs 9.9 days, P = 0.039), decreased ICU length of stay (LOS) (13.3 vs 19.2 days, P = 0.024) and hospital LOS (28.5 vs 34.9 days; P = 0.019). Mortality rate did not differ significantly between the two groups. Conclusions Patients with abdominal compartment syndrome who were treated with VAC decompression had a faster abdominal closure rate and earlier discharge from the ICU as compared to similar patients treated with the Bogota bag. PMID:19961614

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-05-15

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

  20. Live/Real Time Three-Dimensional Trans Esophageal Echocardiographic Findings in Amplatzer ASD Closure Devices in Adults

    Directory of Open Access Journals (Sweden)

    Fatemeh Nabavizadeh

    2012-09-01

    Full Text Available Six female patients aged from 19 to 73 years, with ostium secundum atrial septal defect underwent closure procedure with Amplatzer septal occluder device. Three-dimensional Echocardiography (3D-TEE was done during the procedure or one day after the procedure. 3D-TEE provides incremental value over Two- dimensional trans-esophageal echocardiography in measuring Amplatzer septal occluder disc sizes and correlates well with manufacture device size. 3D-TEE will surely prove to increase the technical efficiency and it will become an important tool for the interventionists for periprocedural evaluation of device closures.

  1. Impact of closure devices on vascular complication and mortality rates in TAVI procedures.

    Science.gov (United States)

    Dimitriadis, Zisis; Scholtz, Werner; Börgermann, Jochen; Wiemer, Marcus; Piper, Cornelia; Vlachojannis, Mario; Gummert, Jan; Horstkotte, Dieter; Ensminger, Stephan; Faber, Lothar; Scholtz, Smita

    2017-08-15

    Currently two closure devices are available for the vascular access in TAVI procedures. Their impact on vascular complications and mid-term mortality is yet unknown. Between 2009 and 2014, 398 patients underwent TAVI TF procedures in which two different closure devices were used, Prostar® XL (n=215) and Perclose-Proglide® (n=183). In the cases with Prostar we used one device and in cases with Perclose-Proglide, two devices. The two groups were compared with respect to the criteria of the Valve Academic Research Consortium (VARC) II. The mean follow-up period was 679.7±481.8 (727) days. There were no significant differences in the baseline characteristics of both patient groups. In the Prostar® group, complications were more frequent (26.6% vs. 12.6%, p=0.005); in detail, these were bleeding (14.9% vs. 7.1%, [p]=0.02), suture rupture (4.7% vs. 1.3%, p=0.04), and pseudoaneurysms (10.2% vs. 1.2%, p<0.001). Multivariate regression analysis revealed two predictors for vascular complications: female sex (OR 2.3; 95% CI 1.3-3.8, p=0.002) and closure devices (OR 0.5; 95% CI 0.3-0.8, p=0.007) in favour of Proglide®. There was no significant difference in 30-day mortality (Prostar: 5.6±1.6% vs. Proglide: 4.9±1.6%). However, Kaplan-Meier survival analysis showed a significantly higher survival rate over the entire follow-up period for the Proglide® group (p=0.03). Vascular complications occurred more often in the Prostar® group. Although 30-day mortality showed no significant difference between the groups, the mortality over complete follow-up was significantly lower in the Proglide® group. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Efficacy of femoral vascular closure devices in patients treated with anticoagulant, abciximab or thrombolytics during percutaneous endovascular procedures

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ha Young; Choo, Sung Wook [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Roh, Hong Gee [Konkuk University School of Medicine, Seoul (Korea, Republic of)] (and others)

    2006-03-15

    This study assessed the outcomes of using vascular closure devices following percutaneous transfemoral endovascular procedures in the patients who were treated with heparin, abciximab thrombolytics (urokinase or t-PA) during the procedures. From March 28, 2003 to August 31, 2004, we conducted a prospective and randomized study in which 1,676 cases of 1.180 patients were treated with one of the two different closure devices (the collagen plug device was Angio-Seal{sup TM.}, the suture-mediated closure device was The Closer S{sup TM}) at the femoral access site after instituting percutaneous endovascular procedures. Among the 1,676 cases, 108 cases (the drug group) were treated with heparin only (n=94), thrombolytics only (n=10), heparin and thrombolytics (n=3), or abciximab and thrombolytics (n=1) during the procedures; 1,568 cases (the no-drug group) were treated without any medication. We compared the efficacy and complications between the two groups. Of the drug group, 42 cases underwent arterial closures with the collagen plug devices and 66 cases underwent arterial closures with the suture-mediated closure devices. We also compared the efficacy and complications between these two group. The immediate hemostasis rates were 92.9% (1,456/1,568) in the no drug group and 91.7% (99/108) in the drug group. Early complications occurred in four cases of the drug group. These included two episodes of rebleeding with using the Closer S, which required manual compression for at least 10 minutes, and two episodes of minor oozing with using one Angio-Seal and one Closer S, which required two hours of additional bed rest. There was no late complication. So, the total success rates were 90.8% (1,423/1,568) in the no-drug group and 88.0% (95/108) in the drug group. These results were not significantly different between the two groups ({rho}=0.34). In the drug group, the difference of the successful hemostasis rate between the collagen plug devices and the suture

  3. Temporary abdominal closure with zipper-mesh device for management of intra-abdominal sepsis

    Directory of Open Access Journals (Sweden)

    Edivaldo Massazo Utiyama

    Full Text Available OBJECTIVE: to present our experience with scheduled reoperations in 15 patients with intra-abdominal sepsis. METHODS: we have applied a more effective technique consisting of temporary abdominal closure with a nylon mesh sheet containing a zipper. We performed reoperations in the operating room under general anesthesia at an average interval of 84 hours. The revision consisted of debridement of necrotic material and vigorous lavage of the involved peritoneal area. The mean age of patients was 38.7 years (range, 15 to 72 years; 11 patients were male, and four were female. RESULTS: forty percent of infections were due to necrotizing pancreatitis. Sixty percent were due to perforation of the intestinal viscus secondary to inflammation, vascular occlusion or trauma. We performed a total of 48 reoperations, an average of 3.2 surgeries per patient. The mesh-zipper device was left in place for an average of 13 days. An intestinal ostomy was present adjacent to the zipper in four patients and did not present a problem for patient management. Mortality was 26.6%. No fistulas resulted from this technique. When intra-abdominal disease was under control, the mesh-zipper device was removed, and the fascia was closed in all patients. In three patients, the wound was closed primarily, and in 12 it was allowed to close by secondary intent. Two patients developed hernia; one was incisional and one was in the drain incision. CONCLUSION: the planned reoperation for manual lavage and debridement of the abdomen through a nylon mesh-zipper combination was rapid, simple, and well-tolerated. It permitted effective management of severe septic peritonitis, easy wound care and primary closure of the abdominal wall.

  4. Use of Suture-Mediated Closure Device in Percutaneous Direct Carotid Puncture During Chimney-Thoracic Endovascular Aortic Repair

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Gabriel, E-mail: dr.changabriel@gmail.com; Quek, Lawrence Hwee Han, E-mail: lawrence-quek@ttsh.com.sg [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore); Tan, Glenn Leong Wei, E-mail: glenn-tan@ttsh.com.sg [Tan Tock Seng Hospital, Department of General Surgery (Singapore); Pua, Uei, E-mail: druei@yahoo.com [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore)

    2016-07-15

    BackgroundInsertion of a carotid chimney graft during thoracic endovascular aortic repair (Ch-TEVAR) is a recognized technique to extend the proximal landing zone into the aortic arch in the treatment of thoracic aortic disease. Conventional technique requires surgical exposure of the carotid artery for insertion of the carotid chimney graft.MethodologyWe describe our experience in the use of a suture-mediated closure device in percutaneous Ch-TEVAR in four patients.ResultsSuccessful hemostasis was achieved in all four patients. No complications related to the carotid puncture were recorded.ConclusionWe conclude that using suture-mediated closure device for carotid closure appears feasible and deserves further studies as a potential alternative to conventional surgical approach.

  5. Management of hidradenitis suppurativa wounds with an internal vacuum-assisted closure device.

    Science.gov (United States)

    Chen, Y Erin; Gerstle, Theodore; Verma, Kapil; Treiser, Matthew D; Kimball, Alexandra B; Orgill, Dennis P

    2014-03-01

    Hidradenitis suppurativa is a chronic, debilitating disease that is difficult to treat. Once medical management fails, wide local excision offers the best chance for cure. However, the resultant wound often proves too large or contaminated for immediate closure. The authors performed a retrospective chart review of hidradenitis cases managed surgically between 2005 and 2010. Data collected included patient characteristics, management method, and outcomes. Approximately half of the patients received internal vacuum-assisted closure therapy using the vacuum-assisted closure system and delayed closure and half of the patients received immediate primary closure at the time of their excision. Delayed closure consisted of closing the majority of the wound in a linear fashion following internal vacuum-assisted closure while accepting healing by means of secondary intention for small wound areas. Patients managed with internal vacuum-assisted closure had wounds on average four times larger in area than patients managed without internal vacuum-assisted closure. In both groups, all wounds were eventually closed primarily. Healing times averaged 2.2 months with internal vacuum-assisted closure and 2.7 months without. At an average follow-up time of 2.3 months, all patients with internal vacuum-assisted closure had no recurrence of their local disease. Severe hidradenitis presents a treatment challenge, as surgical excisions are often complicated by difficult closures and unsatisfactory recurrence rates. This study demonstrates that wide local excision with reasonable outcomes can be achieved using accelerated delayed primary closure. This method uses internal vacuum-assisted closure as a bridge between excision and delayed primary closure, facilitating closure without recurrence in large, heavily contaminated wounds. Therapeutic, III.

  6. The device ``Klyost'' for clipping vessels and soft-elastic tubular structures

    Science.gov (United States)

    Ryklina, E. P.; Khmelevskaya, I. Yu.; Prokoshkin, S. D.; Ipatkin, R. V.

    2003-10-01

    A retrospect of earlier elaborated devices applying in clinical practice is presented. A newly invented device for clipping vessels and soft-elastic tubular structures is presented. Traditionally in surgical practice, to stop a blood flow, the surgeons use suturing of vessels (legate) with a silk thread. In laparoscopic surgery this process is accompanied with great difficulties. An alternative method of clipping vessels and structures is also used. The negative feature of this method is that the structure must be first mobilized. Up for to-day there is no device allowing to combine in one method both manipulations: suturing of tissue and laying a clip on a structure. The paper describes the new device, allowing to combine the oversaid manipulations and consequently to simplify the work of the surgeon and shorten the operation time. The device functioning is based on one-way and two-way shape memory effects. The device was applied in treating of 5 patients and manifested fine functional possibilities. The implanted clip can be easily evacuated without any patient trauma.

  7. Use of a collagen hemostatic closure device to achieve hemostasis after arterial puncture : A cost-effectiveness analysis

    NARCIS (Netherlands)

    Bos, JJ; Hunink, MGM; Mali, WPTM

    1996-01-01

    PURPOSE: To evaluate whether a collagen hemostatic closure device is a safe, cost-effective alternative to manual compression for achieving hemostasis at arterial puncture sites. MATERIALS AND METHODS: A cost-effectiveness analysis, based on a meta-analysis of published data, was performed from the

  8. Endovascular repair of inadvertent arterial injury induced by central venous catheterization using a vascular closure device: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, So Hee; Jang, Woo Jin; Oh, Ju Heyon; Song, Yun Gyu [Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon (Korea, Republic of)

    2017-04-15

    Central venous catheterization can cause various complications. Inadvertent subclavian artery catheterization was performed during insertion of a central venous catheter in a 73-year-old man suffering from panperitonitis due to small-bowel perforation. Endovascular treatment was conducted to treat the injured subclavian artery with a FemoSeal vascular closure device.

  9. Effect of biologically active coating on biocompatibility of Nitinol devices designed for the closure of intra-atrial communications

    NARCIS (Netherlands)

    Kong, XQ; Grabitz, RG; van Oeveren, W; Klee, D; van Kooten, TG; Freudenthal, F; Qing, M; von Bernuth, G; Seghaye, MC

    Anti-thrombogenicity and rapid endothelialisation are prerequisites for the use of closure devices of intra-atrial communications in order to reduce the risk of cerebral embolism. The purpose of this study was therefore to assess the effect of bioactive coatings on biocompatibility of Nitinol coils

  10. A new resorbable device for ligation of blood vessels - A pilot study

    Directory of Open Access Journals (Sweden)

    Borg Niklas

    2011-07-01

    Full Text Available Abstract Background During surgery, controlled haemostasis to prevent blood loss is vital for a successful outcome. It can be difficult to ligate vessels located deep in the abdomen. A device that is easy to use and enables secure ligatures could be beneficial. Cable ties made of nylon have been used for ligation but the non-resorbable material caused tissue reactions. The objective of this study was to use a resorbable material to construct a device with a self-locking mechanism and to test its mechanical strength and ligation efficiency. Methods The device was manufactured by injection moulding of polydioxanone, a resorbable polymer used for suture materials. Polydioxanone with inherent viscosities of 1.9 dL/g and 1.3 dL/g were tested. The device consisted of a perforated flexible band which could be pulled through a case with a locking mechanism. After a first version of the device had been tested, some improvements were made. The locking case was downsized, corners were rounded off, the band was made thicker and the mould was redesigned to produce longer devices. Tensile tests were performed with the second version. The first version of the device was used to ligate the ovarian pedicle in a euthanized dog and to test echogenicity of the device with ultrasound. Compression of vessels of the ovarian pedicle was examined by histology. Both versions of the device were tested for haemostasis of and tissue grip on renal arteries in six anaesthetised pigs. Results The tensile strength of the flexible band of the devices with inherent viscosity of 1.9 dL/g was 50.1 ± 5.5 N (range 35.2-62.9 N, n = 11 and the devices with inherent viscosity of 1.3 dL/g had a tensile strength of 39.8 ± 8.1 N (range 18.6-54.2 N, n = 11. Injection moulding of the polymer with lower inherent viscosity resulted in a longer flow distance. Both versions of the device had an effective tissue grip and complete haemostasis of renal arteries was verified. The device attached

  11. Use of suture-mediated vascular closure devices for the management of femoral vein access after transcatheter procedures.

    Science.gov (United States)

    Shaw, James A; Dewire, Elizabeth; Nugent, Alan; Eisenhauer, Andrew C

    2004-12-01

    Groin complications remain the most common complication of cardiac catheterization procedures. While the use of closure devices is increasing for arterial sheaths, venous sheaths tend to be removed and hemostasis achieved with manual compression. We report our experience using Perclose suture-mediated vascular closure device to achieve hemostasis and early mobility in patients who have had venous access as part of their procedure. There were a total of 42 patients (21 males; average age, 63.5 years) studied. The majority of the patients had 7 Fr sheaths (24), with access sites of sheaths up to 14 Fr being closed with this technique. Two patients developed complications at the access site: one patient requiring rehospitalization for intravenous antibiotics because of late access site infection, and one patient with deep venous thrombosis and pulmonary emboli. We conclude that the use of the Perclose suture-mediated closure device for closure of femoral venous access sites is feasible and should be considered especially in patients with larger venous sheaths and those at increased risk of groin complications. (c) 2004 Wiley-Liss, Inc.

  12. Immediate technical and delayed clinical outcome of fistula closure using an over-the-scope clip device.

    Science.gov (United States)

    Law, Ryan; Wong Kee Song, Louis M; Irani, Shayan; Baron, Todd H

    2015-07-01

    An over-the-scope clip (OTSC) device was designed for closure of acute perforations, fistulas, leaks, and non-variceal gastrointestinal bleeding. Previous data show a high rate of early fistula closure using the OTSC; however, data on long-term fistula closure are scant. We report our experience using an OTSC for closure of chronic gastrointestinal fistulas. Retrospective review of all patients, who underwent OTSC placement at Mayo Clinic Rochester and Virginia Mason Medical Center for closure of chronic fistulas from October 2011 to September 2012, was performed. Initial technical success was defined by lack of contrast extravasation immediately after OTSC placement. Delayed success was defined by resolution of the fistula without the need for additional therapies. Recurrent fistula was defined by the recurrence of symptoms and/or re-demonstration of fistula after initial success. Forty-seven unique patients (24 men; mean age 57 ± 14 years) underwent 60 procedures using the OTSC for closure of gastrointestinal fistulas. Fistula locations were: small bowel (n = 18), stomach (n = 16), colo-rectum (n = 10), and esophagus (n = 3). Fistulas related to previous percutaneous endoscopic gastrostomy/jejunostomy (n = 10) or prior bariatric procedure (n = 10) were the most common etiologies. Initial technical success occurred in 42/47 (89%) index cases; however, 19/41 (46%) patients developed fistula recurrence at a median of 39 days (IQR 26-86 days). The retained OTSC was present adjacent to the fistula in 16/19 (84%) at repeat intervention. Patients were followed for a median length of 178 days (IQR 63-326 days), and only 25/47 (53%) patients demonstrated delayed clinical success using OTSC. Initial technical fistula closure can be achieved using OTSCs. Recurrent fistulas at the same location occur in approximately 50% of cases despite frequent OTSC clip retention.

  13. New skin closure system facilitates wound healing after cardiovascular implantable electronic device surgery

    OpenAIRE

    De Maria, Elia

    2015-01-01

    The manuscript describes the efficacy of a new skin closure system (ZipLine™) for wound closure after pacemaker/implantable cardioverter defibrillator surgery. The system is particularly useful when wound healing is difficult with traditional methods and in patients at high risk for surgical site infections (SSIs). This skin closure option is easy and quick to apply and remove, and produces excellent cosmetic results. Although it is associated with a minimal expense upcharge, the benefits, in...

  14. Hemodynamic effects of the vacuum-assisted closure device on open mediastinal wounds.

    Science.gov (United States)

    Conquest, Anne M; Garofalo, James H; Maziarz, David M; Mendelson, Kim G; Su Sun, You; Wooden, William A; Meadows, William M; Nifong, Wiley; Chitwood, W Randolph

    2003-12-01

    Application of the Vacuum-Assisted Closure device (VAC) to open sternal wounds has negative hemodynamic effects. We hypothesized that the interposition of a muscle flap attenuates these negative hemodynamic effects. After institutional approval, monitoring lines were placed in anesthetized, ventilated pigs. Through a median sternotomy, sonometric crystals were strategically positioned around the left ventricle. A rectus flap was rotated over the mediastinal wound, and the VAC was placed over the flap. After baseline measurements, a vacuum of 125 mmHg [Group (GP) 1, n = 5] or 50 mmHg (GP2, n = 6) was initiated. Hemodynamics were recorded every 15 min for 1.5 h, and 15 min after cessation of the vacuum therapy. GP3 (n = 6) underwent intermittent VAC cycling (on 5 min/off 2 min). Significance determined by t test. While non-flapped animals had significant detriment in both left ventricular filling volume and cardiac output, flapped animals had insignificant depression of both parameters. Application of muscle flaps to sternal wounds prior to VAC therapy significantly attenuates the negative hemodynamic effects seen when the VAC is used alone.

  15. Use of the Ligasure vessel-sealing device for thoracoscopic peripheral lung biopsy in healthy dogs.

    Science.gov (United States)

    Mayhew, Philipp D; Culp, William T N; Pascoe, Peter J; Arzi, Natasha Vapniasky

    2012-05-01

    To evaluate the use of a bipolar vessel-sealing device for peripheral lung lobe biopsy in healthy dogs. Experimental study. Mature female hound dogs (n = 6). Thoracoscopic access was obtained by placement of a subxiphoid telescope portal with instrument portals at the right 4-6th intercostal spaces and the left 10th intercostal space. The 10-mm Ligasure Atlas device was used to collect a biopsy specimen from the periphery of the left cranial lung lobe. Dogs were recovered from anesthesia. Histologic evaluation was used to characterize the effect of biopsy technique on pulmonary tissue. Thoracic radiography was performed at 1, 2, 4, and ∼180 days to evaluate for air leakage or other postoperative complications. Lung specimens were collected without complications. Postoperatively, 1 dog had some residual pneumothorax thought to be secondary to incomplete thoracic evacuation of air postoperatively. No evidence of air leakage was detected at any time point. Histologically, specimens had 3 distinct zones: a crush zone representing the tissue within the jaws of the device, a transition zone of thermally damaged parenchyma, and beyond that a viable zone of normal parenchyma. From these limited data, it appears that the Ligasure Atlas vessel-sealing device can be used for peripheral lung biopsy in healthy dogs. Further studies are required to evaluate the efficacy of the device in dogs with parenchymal disease. Copyright 2012 by The American College of Veterinary Surgeons.

  16. Epicardial deployment of right ventricular disk during perventricular device closure in a child with apical muscular ventricular septal defect

    Directory of Open Access Journals (Sweden)

    Nageswara Rao Koneti

    2013-01-01

    Full Text Available We report a successful perventricular closure of an apical muscular ventricular septal defect (mVSD by a modified technique. An eight-month-old infant, weighing 6.5 kilograms, presented with refractory heart failure. The transthoracic echocardiogram showed multiple apical mVSDs with the largest one measuring 10 mm. perventricular device closure using a 12 mm Amplatzer mVSD occluder was planned. The left ventricular disk was positioned approximating the interventricular septum; however, the right ventricular (RV disk was deployed on the free wall of the RV due to an absent apical muscular septum and a small cavity at the apex. The RV disk of the device was covered using an autologous pericardium. His heart failure improved during follow-up.

  17. Support device in a pressure vessel, particularly a reactor pressure vessel, to support against horizontal forces. Abstuetzeinrichtung an einem Druckbehaelter, insbesondere einem Reaktordruckbehaelter, gegen Horizontalkraefte

    Energy Technology Data Exchange (ETDEWEB)

    Dorner, H.; Harand, E.; Scholz, M.; Scheler, R.

    1986-04-17

    In a support device on a reactor pressure vessel of a PWR, a guide leading downwards is provided in the vertical pellet cartridge on the floor side of the reactor pressure vessel, which is located in a fixed support pipe. The support pipe is supported on a concreted baseplate in the horizontal direction, and can be screwed to this. The support pipe has a plate-shaped support foot to support it on the baseplate. The reactor pressure vessel, normally resting on its main coolant duct in the plane normal to the axis, can be effectively supported against horizontal forces by this additional support, without preventing thermal movement in the longitudinal axis.

  18. Safety and efficacy of the Perclose suture-mediated closure device following carotid artery stenting under clopidogrel platelet blockade

    Energy Technology Data Exchange (ETDEWEB)

    Zorger, Niels; Finkenzeller, Thomas; Lenhart, Markus; Hamer, Okka; Paetzel, Christian; Borisch, Inghita; Toepel, Ingolf; Feuerbach, Stefan; Link, Johann [University of Regensburg Klinikum, Franz-Josef-Strauss-Allee 11, 93042, Regensburg (Germany)

    2004-04-01

    The aim of this study was evaluation of a closure device (Perclose, Menlo Park, Calif.) for closure of the femoral artery access site in patients undergoing aggressive anticoagulation and platelet blockade after carotid stenting. Fifty-five patients who received clopidogrel in addition to aspirin and heparin as medication for carotid stenting were included for suture of the femoral access site after using 7- or 8-F guide catheters. The technical success, the time for suture, the clotting parameters, and complications were examined. Follow-up investigations, including ultrasound and clinical examinations, were performed. The groin was checked for possible hematoma, pseudoaneurysm, arteriovenous fistula, and local infection. Technical success was obtained in 51 of 54 patients (94%) after a mean procedure time of 6 min (range 5-10 min). The suture device was not used in one patient (2%) for anatomical reasons and failed to obtain hemostasis in 3 of 54 (6%) patients. In 4 of 54 patients (7%) bleeding was observed at the punctured site 4-6 h after intervention which was treated by a compression bandage. The mean dedicated activated clotting time was 137 s (range 29-287 s) before intervention and 349 s (150-958 s) just before deploying the Perclose device. During follow-up after 2 days (range 2-6 days) and 6 months no further complications of the puncture site were observed except for two large groin hematomas. No major complications occurred. Closure of the femoral access site after carotid stenting using a Perclose closure device is safe and effective even in patients receiving an aggressive anticoagulation and antiplatelet therapy. (orig.)

  19. [Feasibility of device closure for multiple atrial septal defects using 3D printing and ultrasound-guided intervention technique].

    Science.gov (United States)

    Qiu, X; Lü, B; Xu, N; Yan, C W; Ouyang, W B; Liu, Y; Zhang, F W; Yue, Z Q; Pang, K J; Pan, X B

    2017-04-25

    Objective: To investigate the feasibility of trans-catheter closure of multiple atrial septal defects (ASD) monitored by trans-thoracic echocardiography (TTE) under the guidance of 3D printing heart model. Methods: Between April and August 2016, a total of 21 patients (8 male and 13 female) with multiple ASD in Fuwai Hospital of Chinese Academy of Medical Sciences underwent CT scan and 3-dimensional echocardiography for heart disease model produced by 3D printing technique. The best occlusion program was determined through the simulation test on the model. Percutaneous device closure of multiple ASD was performed follow the predetermined program guided by TTE. Clinical follow-up including electrocardiogram and TTE was arranged at 1 month after the procedure. Results: The trans-catheter procedure was successful in all 21 patients using a single atrial septal occluder. Mild residual shunt was found in 5 patient in the immediate postoperative period, 3 of them were disappeared during postoperative follow-up. There was no death, vascular damage, arrhythmia, device migration, thromboembolism, valvular dysfunction during the follow-up period. Conclusion: The use of 3D printing heart model provides a useful reference for transcatheter device closure of multiple ASD achieving through ultrasound-guided intervention technique, which appears to be safe and feasible with good outcomes of short-term follow-up.

  20. Can Prevention of a Reherniation Be Investigated? Establishment of a Herniation Model and Experiments With an Anular Closure Device

    Science.gov (United States)

    Wilke, Hans-Joachim; Ressel, Lena; Heuer, Frank; Graf, Nicolas; Rath, Stefan

    2013-01-01

    Study Design. Biomechanical in vitro study. Objective. To establish a reliable in vitro herniation model with human cadaver spines that enables evaluation of anular closure devices. Summary of Background Data. Biomechanically, it is desirable to close anulus defects after disc herniation to preserve as much nucleus as possible. Multiple anular closure options exist to prevent reherniation. A reliable test procedure is needed to evaluate the efficacy and reliability of these implants. Methods. Two groups of human lumbar segments (n = 6 per group) were tested under cyclic loading until herniation occurred or 100,000 load cycles were applied. One group contained moderate/severe degenerated discs. A second group had mild degenerated discs. Intradiscal pressure was measured in the intact state to confirm disc quality. If herniation occurred, the extruded material was reinserted into the disc and the anulus defect was treated with the Barricaid anular closure device (Intrinsic Therapeutics, Inc., Woburn, MA). Disc height and 3-dimensional flexibility of the specimens in the intact, defect, and implanted states were measured under pure moments in each principal motion plane. Afterwards, provocation of reherniation was attempted with additional 100,000 load cycles. Results. Likelihood of herniation was strongly linked to disc degeneration and supported by the magnitude of intradiscal pressure. In moderate/severe degenerated discs, only 1 herniation was created. In mild degenerated discs, herniations were reliably created in all specimens. Using this worst-case model, herniation caused a significant reduction of disc height, which was nearly restored with the implant. In no case was reherniation or implant migration visible after 100,000 load cycles after Barricaid implantation. Conclusion. We established a human herniation model that reliably produced nucleus extrusion during cyclic loading by selecting specimens with low disc degeneration. The Barricaid seems to prevent

  1. Ease of Using a Dedicated Percutaneous Closure Device after Inadvertent Cannulation of the Subclavian Artery: Case Report

    Directory of Open Access Journals (Sweden)

    Arnaud Devriendt

    2009-01-01

    Full Text Available Inadvertent puncture of the subclavian artery is a relatively frequent and potentially disastrous complication of attempted central venous access. Due to its noncompressible location, accidental subclavian arterial cannulation may result in hemorrhage as the sheath is removed. We report a new case of successful percutaneous closure of the subclavian artery which had been inadvertently cannulated, using a closure device based on a collagen plug (Angio-Seal, St. Jude Medical. This was performed in a patient who had received maximal antiplatelet and anticoagulation therapies because of prior coronary stenting in the context of cardiogenic shock. There was no prior angiographic assessment, as arterial puncture was presumed to have been distal to the right common artery and vertebral arteries. No complications were observed in this high-risk patient, suggesting that this technique could be used once the procedure has been evaluated prospectively.

  2. Hepatic resection using a bipolar vessel sealing device: technical and histological analysis.

    Science.gov (United States)

    Romano, Fabrizio; Garancini, Mattia; Caprotti, Roberto; Bovo, Giorgio; Conti, Matteo; Perego, Elisa; Uggeri, Franco

    2007-01-01

    Blood loss and bile leakage are well-known risk factors for morbidity and mortality during liver resection. Bleeding usually occurs during parenchymal transection, and surgical technique should be considered an important factor in preventing intraoperative and postoperative complications. Many approaches and devices have been developed to limit bleeding and bile leakage. The aim of the present study was to determine whether a bipolar vessel sealing device allows a safe and careful liver transection without routine inflow occlusion, achieving a satisfactory hemostasis and bile stasis, thus reducing blood loss and bile leak and related complications. A total of 50 consecutive patients (24 males, 26 females, with a mean age of 57 years) underwent major and minor hepatic resections using a bipolar vessel sealing device. A clamp crushing technique followed by energy application was used to perform the parenchymal transection. Inflow occlusion was used when necessary to control blood loss but not as a routine. No other devices were applied to achieve hemostasis. The instrument was effective in 45 patients and failed to achieve hemostasis in 5 cases, all of whom had a cirrhotic liver. Median blood loss was 490 ml (range 100-2500 ml) and intraoperative blood transfusions were required in eight cases (16%). Mean operative time was 178 min (range 50-315 min). Inflow occlusion was necessary in 16 (32%) patients. The postoperative complication rate was 24%, with a postoperative hemorrhage in a cirrhotic patient. There was no clinical evidence of bile leak or procedure-related abdominal abscess. We conclude that the device is a useful tool in standard liver resection, achieving good hemostasis and bile stasis in patients with normal liver parenchyma, but its use should be avoided in cirrhotic patients.

  3. Prevalence of patent foramen ovale and usefulness of percutaneous closure device in carcinoid heart disease.

    Science.gov (United States)

    Mansencal, Nicolas; Mitry, Emmanuel; Pillière, Rémy; Lepère, Céline; Gérardin, Benoît; Petit, Jérôme; Gandjbakhch, Iradj; Rougier, Philippe; Dubourg, Olivier

    2008-04-01

    The aim of this study was to assess (1) the incidence of patent foramen ovale (PFO) in carcinoid syndrome (CS) and (2) the feasibility of percutaneous closure procedure in selected patients with CS. One hundred eight patients were prospectively studied: 54 with CS and an age- and gender-matched control group. All patients underwent conventional and contrast echocardiography. Patients with clinical signs of dyspnea (New York Heart Association class > or =III), cyanosis, carcinoid heart disease (CHD), and severe PFO were referred for the percutaneous closure of PFO. The prevalence of PFO was 41% in patients with CS and 22% in the control group (p = 0.03) and was significantly higher in patients with CHD (59%, p = 0.009). Four patients (14% of those with CHD) were referred for the percutaneous closure of PFO, and 3 patients ultimately underwent PFO closure (using Amplatzer septal occluders). At 6-month follow-up, New York Heart Association class was improved in all patients, as well as arterial blood gas results (p = 0.04) and 6-minute walking distance (p = 0.03), but all patients presented residual right-to-left shunts. In conclusion, this prospective study demonstrates that in patients with CHD, the prevalence of PFO is high and that percutaneous closure of PFO is feasible, with a reduction in symptoms but with residual shunting.

  4. Comparison of imaging techniques to assess appendage anatomy and measurements for left atrial appendage closure device selection.

    Science.gov (United States)

    López-Mínguez, José Ramón; González-Fernández, Reyes; Fernández-Vegas, Concepción; Millán-Nuñez, Victoria; Fuentes-Cañamero, María Eugenia; Nogales-Asensio, Juan Manuel; Doncel-Vecino, Javier; Yuste Domínguez, María; García Serrano, Laura; Sánchez Quintana, Damián

    2014-09-01

    The adequate device size selection for left atrial appendage closure is crucial to ensuring adequate implantation and for avoiding the need for multiple attempts that increase the risk of complications. Our aim was to evaluate the information obtained using different imaging techniques to select the size of the closure device in a clinical environment. Thirty-seven patients who consecutively underwent implantation of Amplatzer cardiac plug (ACP) devices were studied. All patients were examined using computed tomography (CT) prior to intervention. Measurements were compared to those obtained using intraoperative transesophageal echocardiography (IOTEE) and angiography. Size was determined by the longest axis of the appendage ostium. The influence of all techniques on the correct selection of final size was assessed. The measurements taken using the three techniques agreed in only 21.6% of the cases, leading to accurate selection of device size. Two techniques coincided as follows: IOTEE-CT in 45.9%, angiography-CT in 35.13%, and angiography-IOTEE in 24.3%. Measurements using CT were definitive for ACP selection in 75.7% of cases, angiography in 48.6%, and echocardiography in 51.4%. Device size was undermeasured with angiography in 35.1% of cases, and with IOTEE in 24.3%; CT overmeasured 21.6% of cases. The combination of angiography-CT was the most accurate for selection of device size. CT most often predicts the appropriate device size. If it fails, it usually overestimates the size. Agreement of measurements with all three techniques is the most accurate situation; when two agree, the most accurate combination is angiography and CT.

  5. Assessment of MRI issues at 3-Tesla for metallic surgical implants: findings applied to 61 additional skin closure staples and vessel ligation clips

    Science.gov (United States)

    2012-01-01

    Purpose Metallic skin closure staples and vessel ligation clips should be tested at 3-Tesla to characterize MRI issues in order to ensure patient safety. Therefore, metallic surgical implants were assessed at 3-Tesla for magnetic field interactions, MRI-related heating, and artifacts. Methods A skin closure staple (Visistat Skin Stapler, staple, Polytetrafluoroethylene, PTFE, coated 316L/316LVM stainless steel; Teleflex Medical, Durham, NC) and a vessel ligation clip (Hemoclip Traditional, stainless steel; Teleflex Medical, Durham, NC) that represented the largest metallic sizes made from materials with the highest magnetic susceptibilities (i.e., based on material information) among 61 other surgical implants (52 metallic implants, 9 nonmetallic implants) underwent evaluation for magnetic field interactions, MRI-related heating, and artifacts using standardized techniques. MRI-related heating was assessed by placing each implant in a gelled-saline-filled phantom with MRI performed using a transmit/receive RF body coil at an MR system reported, whole body averaged SAR of 2.9-W/kg for 15-min. Artifacts were characterized using T1-weighted, SE and GRE pulse sequences. Results Each surgical implant showed minor magnetic field interactions (20- and 27-degrees, which is acceptable from a safety consideration). Heating was not substantial (highest temperature change, ≤ 1.6°C). Artifacts may create issues if the area of interest is in the same area or close to the respective surgical implant. Conclusions The results demonstrated that it would be acceptable for patients with these metallic surgical implants to undergo MRI at 3-Tesla or less. Because of the materials and dimensions of the surgical implants that underwent testing, these findings pertain to 61 additional similar implants. PMID:22230200

  6. Assessment of MRI issues at 3-Tesla for metallic surgical implants: findings applied to 61 additional skin closure staples and vessel ligation clips

    Directory of Open Access Journals (Sweden)

    Gill Amreeta

    2012-01-01

    Full Text Available Abstract Purpose Metallic skin closure staples and vessel ligation clips should be tested at 3-Tesla to characterize MRI issues in order to ensure patient safety. Therefore, metallic surgical implants were assessed at 3-Tesla for magnetic field interactions, MRI-related heating, and artifacts. Methods A skin closure staple (Visistat Skin Stapler, staple, Polytetrafluoroethylene, PTFE, coated 316L/316LVM stainless steel; Teleflex Medical, Durham, NC and a vessel ligation clip (Hemoclip Traditional, stainless steel; Teleflex Medical, Durham, NC that represented the largest metallic sizes made from materials with the highest magnetic susceptibilities (i.e., based on material information among 61 other surgical implants (52 metallic implants, 9 nonmetallic implants underwent evaluation for magnetic field interactions, MRI-related heating, and artifacts using standardized techniques. MRI-related heating was assessed by placing each implant in a gelled-saline-filled phantom with MRI performed using a transmit/receive RF body coil at an MR system reported, whole body averaged SAR of 2.9-W/kg for 15-min. Artifacts were characterized using T1-weighted, SE and GRE pulse sequences. Results Each surgical implant showed minor magnetic field interactions (20- and 27-degrees, which is acceptable from a safety consideration. Heating was not substantial (highest temperature change, ≤ 1.6°C. Artifacts may create issues if the area of interest is in the same area or close to the respective surgical implant. Conclusions The results demonstrated that it would be acceptable for patients with these metallic surgical implants to undergo MRI at 3-Tesla or less. Because of the materials and dimensions of the surgical implants that underwent testing, these findings pertain to 61 additional similar implants.

  7. Anomalous muscle bundle in the right atrium; Implication to trans atrial device closure

    Directory of Open Access Journals (Sweden)

    Saji Philip

    2017-09-01

    Full Text Available Intracavitary muscle bands or aberrant bands have been well described in all four chambers of the heart but rarely seen thick muscular band crossing right atrium. We report a case of devisable secundum atrial septal defect with an intra-atrial anomalous muscular band, crossing right atrial wall to the rim of the secundum atrial septal defect warranting surgical closure.

  8. A High-Strength, Absorbable, Antibacterial Knotless Tissue Control Device for Fascial Closure

    OpenAIRE

    Nawrocki, Jesse G.; Nonnenmann, Heather; Mooney, Mark; Sutton, Nadia; Schmitz, Niels-Derrek

    2017-01-01

    Purpose of Review This review provides an overview of the STRATAFIX? SYMMETRIC PDS? Plus Knotless Tissue Control Device design and performance characteristics and highlights the device?s relevance for use in gynecological procedures. Various device testing was conducted on tensile strength, fixation tab mass comparison to conventional suture knot tower, initiation stitch strength, and wound holding strength to highlight the STRATAFIX? SYMMETRIC PDS? Plus Device?s key product attributes that m...

  9. A new cable-tie based sternal closure system: description of the device, technique of implantation and first clinical evaluation

    Directory of Open Access Journals (Sweden)

    Grapow Martin TR

    2012-06-01

    Full Text Available Abstract Background Wire closure still remains the preferred technique despite reasonable disadvantages. Associated complications, such as infection and sternal instability, cause time- and cost-consuming therapies. We present a new tool for sternal closure with its first clinical experience and results. Methods The sternal ZipFixTM System is based on the cable-tie principle. It primarily consists of biocompatible Poly-Ether-Ether-Ketone implants and is predominantly used peristernally through the intercostal space. The system provides a large implant-to-bone contact for better force distribution and for avoiding bone cut through. Results 50 patients were closed with the ZipFixTM system. No sternal instability was observed at 30 days. Two patients developed a mediastinitis that necessitated the removal of the device; however, the ZipFixTM were intact and the sternum remained stable. Conclusions In our initial evaluation, the short-term results have shown that the sternal ZipFixTM can be used safely and effectively. It is fast, easy to use and serves as a potential alternative for traditional wire closure.

  10. Prospective comparison of collagen plug (angio-seal{sup TM}) and suture-mediated (the closer S{sup TM}) closure devices at femoral access sites

    Energy Technology Data Exchange (ETDEWEB)

    Park, Yulri; Roh, Hong Gee; Choo, Sung Wook; Lee, Sung Hoon; Shin, Sung Wook; Do, Young Soo; Byun, Hong Sik; Park, Kwang Bo; Jeon, Pyoung [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2005-12-15

    Rapid and effective hemostasis at femoral puncture sites minimizes both the hospital stay and patient discomfort. Therefore, a variety of arterial closure devices have been developed to facilitate the closure of femoral arteriotomy. The objective of this prospective study was to compare the efficacy of two different closure devices; a collagen plug device (Angio-Seal) and a suture-mediated closure device (the Closer S). From March 28, 2003 to August 31, 2004, we conducted a prospective study in which 1,676 cases of 1,180 patients were treated with two different types of closure device. Angio-Seal was used in 961 cases and the Closer S in 715 cases. The efficacy of the closure devices was assessed, as well as complications occurring at the puncture sites. Successful immediate hemostasis was achieved in 95.2% of the cases treated with Angio-Seal, and in 89.5% of the cases treated with the Closer S ({rho} < 0.05). The rates of minor and major complications occurring between the two groups were not significantly different. In the Closer S group, we observed four major complications (0.6%), that consisted of one massive retroperitoneal hemorrhage (surgically explored) and three pseudoaneurysms. In the Angio-Seal group, we observed three major complications (0.3%) that consisted of one femoral artery occlusion, one case of infection treated with intravenous antibiotics and one pseudoaneurysm. The use of Angio-Seal was found to be more effective than that of the Closer S with regard to the immediate hemostasis of the femoral puncture sites. However, we detected no significant differences in the rate at which complications occurred.

  11. Proximal Occlusion of Medium-Sized Vessels with the Penumbra Occlusion Device: A Study of Safety and Efficacy.

    Science.gov (United States)

    Jambon, E; Petitpierre, F; Brizzi, V; Dubuisson, V; Le Bras, Y; Grenier, N; Cornelis, F

    2017-02-01

    To retrospectively investigate the safety and efficacy of hybrid proximal coiling of various medium-sized vessels (4 to 8 mm) using the Penumbra Occlusion Device (POD). From October 2014 to February 2016, 37 proximal embolizations were performed with PODs in 36 patients (mean age: 50.8, range: 10-86; 29 male, 7 female). Vessel occlusions were achieved under fluoroscopic guidance using a 2.7 French microcatheter. Among the 36 vessels targeted, 16 were splenic arteries, 11 renal arteries, 4 mesenteric arteries, 3 arteriovenous fistulae, 1 iliac artery, and 1 gonadal vein. Intermittent follow-up angiography was performed to assess the flow for final occlusion. Outcomes and complications were assessed by clinical and/or imaging follow-up. To produce proximal occlusion of the intended vessels, the POD was used alone in 19 embolizations (51.4 %). In 12 procedures (32.4 %), POD was used as a coil constrainer to secure the coil construct. In 6 procedures (16.2 %), additional embolic devices were used to achieve vessel occlusion after initial POD deployment. After a mean follow-up of 3.2 months, no POD migration was observed but two complications occurred (5.4 %): one post embolic syndrome and one extensive infarction with splenic abscess. The POD system allows safe and effective proximal embolization of medium-sized vessels in a variety of clinical settings.

  12. Proximal Occlusion of Medium-Sized Vessels with the Penumbra Occlusion Device: A Study of Safety and Efficacy

    Energy Technology Data Exchange (ETDEWEB)

    Jambon, E.; Petitpierre, F. [Pellegrin Hospital, Department of Radiology (France); Brizzi, V.; Dubuisson, V. [Pellegrin Hospital, Department of Surgery (France); Bras, Y. Le; Grenier, N.; Cornelis, F., E-mail: cornelisfrancois@gmail.com [Pellegrin Hospital, Department of Radiology (France)

    2017-02-15

    PurposeTo retrospectively investigate the safety and efficacy of hybrid proximal coiling of various medium-sized vessels (4 to 8 mm) using the Penumbra Occlusion Device (POD).Materials and MethodsFrom October 2014 to February 2016, 37 proximal embolizations were performed with PODs in 36 patients (mean age: 50.8, range: 10–86; 29 male, 7 female). Vessel occlusions were achieved under fluoroscopic guidance using a 2.7 French microcatheter. Among the 36 vessels targeted, 16 were splenic arteries, 11 renal arteries, 4 mesenteric arteries, 3 arteriovenous fistulae, 1 iliac artery, and 1 gonadal vein. Intermittent follow-up angiography was performed to assess the flow for final occlusion. Outcomes and complications were assessed by clinical and/or imaging follow-up.ResultsTo produce proximal occlusion of the intended vessels, the POD was used alone in 19 embolizations (51.4 %). In 12 procedures (32.4 %), POD was used as a coil constrainer to secure the coil construct. In 6 procedures (16.2 %), additional embolic devices were used to achieve vessel occlusion after initial POD deployment. After a mean follow-up of 3.2 months, no POD migration was observed but two complications occurred (5.4 %): one post embolic syndrome and one extensive infarction with splenic abscess.ConclusionThe POD system allows safe and effective proximal embolization of medium-sized vessels in a variety of clinical settings.

  13. How Slow Can We Go? 4 Frames Per Second (fps) Versus 7.5 fps Fluoroscopy for Atrial Septal Defects (ASDs) Device Closure.

    Science.gov (United States)

    Hiremath, Gurumurthy; Meadows, Jeffery; Moore, Phillip

    2015-06-01

    Radiation exposure remains a significant concern for ASD device closure. In an effort to reduce radiation exposure, the default fluoroscopy frame rate in our Siemens biplane pediatric catheterization laboratory was reduced to 4 fps in November 2013 from an earlier 7.5 fps fluoro rate. This study aims to evaluate the components contributing to total radiation exposure and compare the procedural success and radiation exposure during ASD device closure using 4 versus 7.5 fps fluoroscopy rates. Twenty ASD device closures performed using 4 fps fluoro rate were weight-matched to 20 ASD closure procedures using 7.5 fps fluoro rate. Baseline characteristics, procedure times and case times were similar in the two groups. Device closure was successful in all but one case in the 4 fps group. The dose area product (DAP), normalized DAP to body weight, total radiation time and fluoro time were lower in the 4 fps group but not statistically different than the 7.5 fps. The number of cine images and cine times were identical in both groups. Fluoroscopy and cineangiography contributed equally to radiation exposure. Fluoroscopy at 4 fps can be safe and effective for ASD device closure in children and adults. There was no increase in procedure time, cine time, fluoro time or complications at this slow fluoro rate. There was a trend toward decreased radiation exposure as measured by indexed DAP although not statistically significant in this small study. Further study with multiple operators using 4 fps fluoroscopy for simple interventional procedures is recommended.

  14. Studying fluid-to-particle heat transfer coefficients in vessel cooking processes using potatoes as measuring devices

    DEFF Research Database (Denmark)

    Feyissa, Aberham Hailu; Christensen, Martin Gram; Pedersen, Søren Juhl

    2015-01-01

    This paper presents and demonstrates a novel idea of using spherical potatoes as a dispensable, cheap device for determining the fluid-to-particle heat transfer coefficient, hfp in vessel cooking processes. The transmission of heat through the potato can be traced by measuring the distance from t...

  15. Quick opening closure: a brazilian design to pig launching and receiving vessels; Tampa de abertura rapida: um projeto brasileiro para lancadores e recebedores de pig

    Energy Technology Data Exchange (ETDEWEB)

    Duarte, Antonio T. [ASCA Equipamentos Industriais Ltda., Rio de Janeiro, RJ (Brazil)

    2004-07-01

    Originally designed to use at launcher and receiver pig traps on offshore, area, the quick opening closure, presented at this work, it has technical features that assure a singular performance. The safety is assured by the 'vent bleed screw' that stop the blockage mechanism in closed position until it to be totally removed. A limited pressure bleed, give a warning that there is pressure in the vessel. The height quality of the door and external ring grinding surfaces added to the circular block segments system mechanism give a same pressure all over the o'ring surface. This assure the leak proof warranty. The open an close Asca system composed by circular blocks segments more the push pull mechanism actuated by the same davit-screw that lift the door, provide a quick, safety and ease operation. The care at the design and the manufacture quality of the parts prevent grip rings and the door opening operation failure. (author)

  16. [Percutaneous closure of patent foramen ovale with amplatzer device. Report of two cases].

    Science.gov (United States)

    Munayer Calderón, Jaime E; Maza Juárez, Gerardo; Carpio, Juan Carlos; Aldana Pérez, Tomás; Lázaro Castillo, José Luis; San Luis Miranda, Raúl; Ramírez, Homero; Amaya, Antonio; Pineda, José Luis

    2005-01-01

    We present two cases of Patent Foramen Ovale (PFO) treated with percutaneous Amplatzer device. The first case corresponds to 48 years old woman with Ebstein's disease with moderate to severe hemodynamic repercussion and three cerebrovascular accidents, the last one under coumarin treatment, she received antiarrhythmic medication and despite of it developed 1st degree AV block, supraventricular and ventricular ectopia, rigth branch block. The second case corresponds to a 22 years old man with antecedents of cerebrovascular accident at the age of 21 with sequelae of convulsive crisis. Both patients were percutaneously treated with Amplatzer devices. The first patient was treated with a foramen ovale device and second with septal occluder due to the diameter of the foramen. Both patients have remained asymptomatic during the follow-up period. The PFO devices are indicated for patients with a history of cerebrovascular accidents.

  17. Patient Satisfaction After Femoral Arterial Access Site Closure Using the ExoSeal{sup ®} Vascular Closure Device Compared to Manual Compression: A Prospective Intra-individual Comparative Study

    Energy Technology Data Exchange (ETDEWEB)

    Pieper, Claus Christian, E-mail: claus.christian.pieper@ukb.uni-bonn.de; Thomas, Daniel, E-mail: daniel.thomas@ukb.uni-bonn.de [University of Bonn, Department of Radiology (Germany); Nadal, Jennifer, E-mail: jennifer.nadal@ukb.uni-bonn.de [University of Bonn, Institute for Medical Biometry, Informatics and Epidemiology (Germany); Willinek, Winfried A., E-mail: w.willinek@bk-trier.de; Schild, Hans Heinz, E-mail: hans.schild@ukb.uni-bonn.de; Meyer, Carsten, E-mail: carsten.meyer@ukb.uni-bonn.de [University of Bonn, Department of Radiology (Germany)

    2016-01-15

    PurposeTo intra-individually compare discomfort levels and patient satisfaction after arterial access closure using the ExoSeal{sup ®} vascular closure device (VCD) and manual compression (MC) in a prospective study design.MethodsPatients undergoing two planned interventions from 07/2013 to 09/2014 could participate in the study. Access closure was performed with an ExoSeal{sup ®}-VCD in one and MC in the other intervention. Patients were clinically and sonographically examined and were given questionnaires 1 day after intervention [groin- and back-pain during bedrest (100-point visual analog scale; 0: no pain); comfortability of bedrest (10-point Likert scale, 1: comfortable), satisfaction with closure (10-point Likert scale, 1: very satisfied)]. Results were analyzed in a cross-over design.Results48 patients (29 male, median age 62.5 (32–88) years) were included. An ExoSeal{sup ®}-VCD was used first in 25 cases. As four of these subsequently refused MC as second intervention, data from 44 patients could be analyzed. All closures were technically successful (successful device deployment) without major complications. Groin- and back-pain after VCD-use/MC was 0 (0–15) vs. 10 (0–80) and 0 (0–75) vs. 25 (0–90), respectively (p < 0.0001). Bedrest after VCD-use was more comfortable than after MC [1 (range 1–7) vs. 6 (2–10); p < 0.0001]. Satisfaction with the closure procedure and with the intervention in general was higher after VCD-use compared to MC [1 (1–3) vs. 5 (2–10) and 1 (1–2) vs. 2 (1–4), respectively; p < 0.0001].ConclusionIntra-individual comparison showed pain levels and discomfort to be significantly lower after ExoSeal{sup ®} use compared to MC. VCD closure was associated with higher satisfaction both with the closure itself and with the intervention in general.

  18. A novel vacuum assisted closure therapy model for use with percutaneous devices.

    Science.gov (United States)

    Cook, Saranne J; Nichols, Francesca R; Brunker, Lucille B; Bachus, Kent N

    2014-06-01

    Long-term maintenance of a dermal barrier around a percutaneous prosthetic device remains a common clinical problem. A technique known as Negative Pressure Wound Therapy (NPWT) uses negative pressure to facilitate healing of impaired and complex soft tissue wounds. However, the combination of using negative pressure with percutaneous prosthetic devices has not been investigated. The goal of this study was to develop a methodology to apply negative pressure to the tissues surrounding a percutaneous device in an animal model; no tissue healing outcomes are presented. Specifically, four hairless rats received percutaneous porous coated titanium devices implanted on the dorsum and were bandaged with a semi occlusive film dressing. Two of these animals received NPWT; two animals received no NPWT and served as baseline controls. Over a 28-day period, both the number of dressing changes required between the two groups as well as the pressures were monitored. Negative pressures were successfully applied to the periprosthetic tissues in a clinically relevant range with a manageable number of dressing changes. This study provides a method for establishing, maintaining, and quantifying controlled negative pressures to the tissues surrounding percutaneous devices using a small animal model. Published by Elsevier Ltd.

  19. Right Ventricular Perforation From a Floating Rib Following Deep Sternal Wound Infection Debridement and Application of a Vacuum-Assisted Closure Device: A Case Report and Literature Review.

    Science.gov (United States)

    Ross, Amanda J; Berry, Nada N

    2017-01-01

    Introduction: Deep sternal wound infection following major cardiac surgery is a deleterious complication with sequelae that can be life threatening. The use of vacuum-assisted closure therapy in management of sternal wounds with resultant right ventricular rupture has been documented in the cardiothoracic and to a lesser extent in the reconstructive literature. Methods/Case Report: We present a case of a 67-year-old male patient who suffered from right ventricular perforation from a floating rib following debridement of a deep sternal wound infection and placement of a vacuum-assisted closure device. Results: Despite meticulous debridement and ensuring the release of all retrosternal adhesions, massive bleeding was encountered shortly after application of the vacuum-assisted closure device. Fortunately, quick identification of the complication and the application of direct manual pressure allowed for swift return to the operating room for repair of the defect. The patient secondarily underwent definitive closure of the mediastinal wound with an omental flap and bilateral pectoral advancement flaps. Discussion: Following the conclusion of this article, the reconstructive surgeon should be able to (1) identify patients at risk for ventricular perforation, (2) exhaust all means intraoperatively to prevent cardiac perforation when using vacuum-assisted closure therapy, (3) comprehend the physiology associated with vacuum-assisted closure use in this patient population, (4) have protocols in place for the management of patients with deep sternal wound infection with vacuum-assisted closure therapy postoperatively, and (5) understand basic tenets of ventricular rupture treatment should this occur to ensure prompt repair and survival.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

  1. Performance of an Annular Closure Device in a 'Real-World', Heterogeneous, At-Risk, Lumbar Discectomy Population.

    Science.gov (United States)

    Kuršumović, Adisa; Rath, Stefan

    2017-11-06

    Study design/setting Retrospective analysis of single-center registry outcomes data. Objective Assess the utility of an annular closure device (ACD) as an adjunct to limited discectomy for lumbar disc herniation (LDH). Background Recurrent lumbar disc herniation (rLDH) following limited discectomy persists at clinically significant rates, especially in large annular defect (at least 6 mm width) patients. While the etiology of reherniation is often multifactorial, inadequate annular occlusion remains one of the foremost considerations. Accordingly, annular closure has emerged as a promising technique and is the focus of this analysis. Methods This was a retrospective analysis of 171 patients who underwent limited lumbar discectomy with an ACD for LDH. Standardized patient assessment was performed preoperatively, three months postoperatively, and 12 months postoperatively, in addition to self-presented visits. No minimum last follow-up was required for inclusion. Oswestry Disability Index (ODI) and Visual Analog Scale (VAS Leg/Back) pain scores were collected at all visits. Plain radiographs were obtained at all visits, with magnetic resonance imaging (MRI) scans performed annually and/or when patients presented as symptomatic. ACD-related complications due to partial or complete mesh detachment from the titanium anchor were reported. All secondary surgical interventions were also reported. The Wilcoxon Rank-sum test was used to compare outcomes and events between sub-groups (p < 0.05). Results Mean last follow-up for all patients was 15 months. Large annular defects were present in 154 patients (90%). Symptomatic reherniations were observed in six patients (3.5%; five were present in the large annular defect subpopulation). All patients demonstrated clinically meaningful improvement in clinical outcome scores at both follow-up intervals. ACD mesh detachment was observed in 15 patients (8.8%; two underwent a subsequent surgical intervention). No symptomatic

  2. Efficacy and Safety of Augmenting the Preclose Technique with a Collagen-Based Closure Device for Percutaneous Endovascular Aneurysm Repair

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Rafiuddin, E-mail: rafiuddin.patel@ouh.nhs.uk [Oxford University Hospitals NHS Trust, Department of Radiology, John Radcliffe Hospital (United Kingdom); Juszczak, Maciej T. [Oxford University Hospitals NHS Trust, Department of Vascular Surgery, John Radcliffe Hospital (United Kingdom); Bratby, Mark J. [Oxford University Hospitals NHS Trust, Department of Radiology, John Radcliffe Hospital (United Kingdom); Sideso, Ediri [Oxford University Hospitals NHS Trust, Department of Vascular Surgery, John Radcliffe Hospital (United Kingdom); Anthony, Susan; Tapping, Charles R. [Oxford University Hospitals NHS Trust, Department of Radiology, John Radcliffe Hospital (United Kingdom); Handa, Ashok; Darby, Christopher R.; Perkins, Jeremy [Oxford University Hospitals NHS Trust, Department of Vascular Surgery, John Radcliffe Hospital (United Kingdom); Uberoi, Raman [Oxford University Hospitals NHS Trust, Department of Radiology, John Radcliffe Hospital (United Kingdom)

    2015-08-15

    PurposeTo report our experience of selectively augmenting the preclose technique for percutaneous endovascular aneurysm repair (p-EVAR) with an Angio-Seal device as a haemostatic adjunct in cases of significant bleeding after tensioning the sutures of the suture-mediated closure devices.Materials and MethodsProspectively collected data for p-EVAR patients at our institute were analysed. Outcomes included technical success and access site complications. A logistic regression model was used to analyse the effects of sheath size, CFA features and stent graft type on primary failure of the preclose technique necessitating augmentation and also on the development of complications.Resultsp-EVAR was attempted via 122 CFA access sites with a median sheath size of 18-French (range 12- to 28-French). Primary success of the preclose technique was 75.4 % (92/122). Angio-Seal augmentation was utilised as an adjunct to the preclose technique in 20.5 % (25/122). The overall p-EVAR success rate was 95.1 % (116/122). There was a statistically significant relationship (p = 0.0093) between depth of CFA and primary failure of preclose technique. CFA diameter, calcification, type of stent graft and sheath size did not have significant effects on primary preclose technique failure. Overall 4.9 % (6/122) required surgical conversion but otherwise there were no major complications.ConclusionAugmentation with an Angio-Seal device is a safe and effective adjunct to increase the success rate of the preclose technique in p-EVAR.

  3. An in vivo comparison of barbed suture devices and conventional monofilament sutures for cosmetic skin closure: biomechanical wound strength and histology.

    Science.gov (United States)

    Zaruby, Jeffrey; Gingras, Kristen; Taylor, Jack; Maul, Don

    2011-02-01

    Very little biomechanical or histological data exist in the peer-reviewed literature comparing absorbable monofilament sutures to commercially-available knotless, absorbable barbed suture devices for cosmetic closure of skin incisions. The authors compare two commercially-available knotless, barbed suture devices against a conventional monofilament suture in a porcine model for biomechanical wound strength and histological quality of healing. This prospective randomized trial included 18 animals randomly assigned among three groups, with six in each. A total of 192 incisions were closed in a porcine in vivo model and assessed for biomechanical strength and histology at postoperative Days 0, 3, 10, and 21. Each animal received all three test devices in a randomized, three-way matched design. Immediately following euthanasia, the skin incisions were excised for ex vivo biomechanical testing. In the ex vivo analysis, Biosyn proved significantly stronger than the V-Loc 90 device at Day 0 and Quill Monoderm at Day 3. At no time point was there any difference in biomechanical strength between the two barbed suture devices. Differences in barb geometry, barb number, and helicity between the two barbed suture devices resulted in failure modes that were significantly different. All three test articles resulted in mild tissue reaction scores on histology. The V-Loc 90 device consistently had the lowest tissue reaction scores at all time periods, with the difference between the V-Loc 90 device and Quill being significant at postoperative Day 10. Knotless, absorbable barbed suture devices are a safe and efficacious alternative for cosmetic skin closures and yield wound strength and tissue reaction scores that are comparable to those from closures performed with absorbable monofilament sutures and secured with knots.

  4. Outpatient angioplasty and stenting facilitated by percutaneous arterial suture closure devices

    Energy Technology Data Exchange (ETDEWEB)

    Wilde, N.T. [South Manchester University Hospitals NHS Trust, Wythenshawe, Manchester (United Kingdom); Bungay, P. [South Manchester University Hospitals NHS Trust, Wythenshawe, Manchester (United Kingdom); Johnson, L. [South Manchester University Hospitals NHS Trust, Wythenshawe, Manchester (United Kingdom); Asquith, J. [South Manchester University Hospitals NHS Trust, Wythenshawe, Manchester (United Kingdom); Butterfield, J.S. [South Manchester University Hospitals NHS Trust, Wythenshawe, Manchester (United Kingdom); Ashleigh, R.J. [South Manchester University Hospitals NHS Trust, Wythenshawe, Manchester (United Kingdom)]. E-mail: Ray.Ashleigh@smuht.nhs.uk

    2006-12-15

    Aim: To review our practice of outpatient percutaneous vascular interventions facilitated by an arterial suture device. Materials and methods: A retrospective review of all patients attending this tertiary centre for iliac or femoral intervention was undertaken between February 2001 and December 2004. All patients who underwent angioplasty or stenting had their puncture sites closed using a Perclose suture. Patients were kept flat for 15 min and allowed to fully mobilize at 60 min. Puncture sites were scored for visible bruising, haematoma and pain at discharge and on outpatient follow-up. Patient preference for future outpatient treatment was assessed. Results: Fifty-seven outpatients underwent 81 punctures. Forty-eight (84%) patients underwent iliac angioplasty; of those 42% underwent stent placement. Six patients (10%) required inpatient admission, five secondary to failed suture deployment. One patient had a non-closer-related puncture site intimal flap occlusion successfully repaired at surgery. Fifty-one (90%) patients discharged with a mean time of 157 min (60-280 min). Forty-six (92%) patients had no visible bruising or palpable haematoma on discharge. No patient had a haematoma greater than 2.5 cm. No discharged patient required readmission. Thirty percent reported a moderate to severe groin pain score (2-5/5) at discharge, increasing to 40% at follow-up. Forty-seven (98%) of the 48 patients, who expressed a preference, would be happy to undergo outpatient treatment again. Conclusion: Outpatient treatment is feasible, well tolerated and preferable to patients, but 10% will require inpatient admission. A planned post-procedure analgesia regimen or advice should be considered.

  5. Immediate mobilization after coronary angiography or percutaneous coronary intervention following hemostasis with the AngioSeal vascular closure device (the MOBS study)

    DEFF Research Database (Denmark)

    Larsen, Ellen Nyholm; Hansen, Charlotte Bak; Thayssen, Per

    2014-01-01

    BACKGROUND: In patients undergoing coronary angiography or percutaneous coronary intervention (PCI), the standard post procedure regime includes immobilization and bed rest despite the use of vascular closure devices. AIM: In the Mobilization after Coronary Angiography or Percutaneous Coronary...... Intervention (MOBS) study we compared bleeding complications after cardiac catheterization with femoral artery access after mobilization immediately off the angiographic table or standard care with1 hour (MOBS I after a diagnostic angiogram) or 2 hours of bed rest before mobilization (MOBS II after PCI...... group 20.5%, p=0.62. CONCLUSIONS: Immediate mobilization after a coronary angiogram or PCI with the femoral access site closed by the closure device AngioSeal was not associated with increased bleeding risk compared to standard care with bed rest....

  6. Clinically apparent long-term electric disturbances in the acute and very long-term of patent foramen ovale device-based closure.

    Science.gov (United States)

    Rigatelli, Gianluca; Zuin, Marco; Pedon, Luigi; Zecchel, Roberto; Dell'Avvocata, Fabio; Carrozza, Antonio; Zennaro, Marco; Pastore, Gianni; Zanon, Francesco

    2017-03-01

    Incidence of electrical disturbances in patients submitted to transcatheter patent foramen ovale (PFO) closure has not been fully clarified in a large population. The aim of the study is to assess the incidence of atrial fibrillation, supraventricular tachi-arrhythmias, and atrio-ventricular block in the acute and very long-term follow-up. We reviewed the medical and instrumental data of 1000 consecutive patients (mean age 47.3±17.1years) prospectively enrolled in two centers over a 13-year period (February 1999 to February 2012) for right-to-left (R-to-L) shunt ICE-aided catheter-based closure using different devices. Successful transcatheter PFO closure was achieved in 99.8% of the patients. Implanted devices were: Amplatzer PFO Occluder in 463 patients (46.3%), Amplatzer ASD Cribriform Occluder in 420 patients (42.0%), Premere Occlusion System in 95 patients (9.5%), and Biostar Occluder in 22 patients (2.2%). Postprocedural electrical complications occurred in 5.9% of patients. The only independent predictors of electrophysiological complications were female gender (OR 2.3, 0.5-5.1 [95% CI], p30mm (OR 5.0, 1.2-7.2 [95% CI], pgender (OR 2.3, 0.5-5.1 [95% CI], p30mm (OR 5.0, 1.2-7.2 [95% CI], p<0.001). Device-based closure of PFO using different devices, appeared very safe from an electrophysiological point of view with low incidence of electrical disturbances even in the very long-term follow-up. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Use of an electrothermal bipolar sealing device in ligation of major mesenteric vessels during laparoscopic colorectal resection.

    LENUS (Irish Health Repository)

    Martin, S T

    2012-02-01

    BACKGROUND: A variety of approaches are available for division of major vascular structures during laparoscopic colorectal resection. Ultrasonic coagulating shears (UCS), vascular staplers, plastic or titanium clips and electrothermal bipolar vessel sealing (EBVS) are currently available. We report our experience with an EBVS device, LigaSure (Covidien AG), used in division of the ileocolic, middle colic and inferior mesenteric arteries during laparoscopic colorectal resection. METHODS: We report the immediate outcome of 802 consecutive unselected patients who underwent elective laparoscopic colorectal cancer resection performed with use of the LigaSure (5 and 10 mm) at our institution over a 5-year period. Operative procedures included right hemicolectomy (n = 180), left hemicolectomy (n = 96), sigmoid colectomy (n = 347) and anterior resection (n = 179). Data were collected from a prospectively maintained cancer database and operative records. The procedures were performed primarily by three consultant surgeons with an interest in laparoscopic colorectal resection. RESULTS: Of 802 cases in which the LigaSure device was employed to divide major vascular structures, immediate effective vessel sealing was achieved in 99.8% (n = 800). Two patients experienced related adverse events both following division of the inferior mesenteric artery with a 5 mm LigaSure. Both patients had immediate uncontrolled haemorrhage that required laparotomy. CONCLUSIONS: Use of the LigaSure device to seal and divide the major mesenteric vessels during laparoscopic colorectal resection is very effective, with a high success rate of 99.8%. Caution should be exercised in elderly atherosclerotic patients, particularly when using the 5-mm LigaSure device.

  8. Day-case peripheral angioplasty using nurse-led admission, discharge, and follow-up procedures: arterial closure devices are not necessary

    Energy Technology Data Exchange (ETDEWEB)

    Kasthuri, R.; Karunaratne, D.; Andrew, H.; Sumner, J. [Department of Radiology, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL (United Kingdom); Chalmers, N. [Department of Radiology, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL (United Kingdom)], E-mail: nicholas.chalmers@cmmc.nhs.uk

    2007-12-15

    Aim: To audit the safety of day-case peripheral arterial intervention without the use of arterial-closure devices using nurse-led admission, discharge, and follow-up procedures. Materials and methods: Patients referred for elective, peripheral vascular intervention were selected for day-case care according to pre-determined criteria using telephone triage. Post-procedure haemostasis was achieved using manual compression. After 3 h bed-rest, patients were mobilized and discharged at 5 h. Patients were contacted by telephone next working day to audit complications. Results: One hundred and eighty-three elective day-case peripheral interventions were performed over 2 years, predominantly using 6 F sheaths. No closure devices were used. Five patients (2%) returned to the department because of persistent groin symptoms the next day. One of these had a false aneurysm. Four required no further treatment. A single patient returned at day 6 with a delayed false aneurysm. Conclusion: Day-case peripheral vascular intervention can be safely performed in appropriately selected patients without the use of arterial closure devices. Specialist radiology nurses have a major role in the counselling, care, and follow-up of these patients.

  9. Primary limited lumbar discectomy with an annulus closure device: one-year clinical and radiographic results from a prospective, multi-center study.

    Science.gov (United States)

    Lequin, Michiel B; Barth, Martin; Thomė, Claudius; Bouma, Gerrit J

    2012-12-01

    Discectomy as a treatment for herniated lumbar discs results in outcomes after surgery that are not uniformly positive. Surgeons face the dilemma between limited nucleus removal which is associated with a higher risk of recurrence, or more aggressive nucleus removal which may lead to disc height loss and persistent back-pain. annulus closure devices may allow for the benefits of limited nucleus removal without the increased risk of recurrence. This is an interim report of an ongoing 24-month post-marketing study of the Barricaid® annulus closure device, consisting of a flexible polymer mesh that blocks the defect, held in place by a titanium bone anchor. We prospectively enrolled 45 patients at four hospitals, and implanted the Barricaid® after a limited discectomy. annulus defect size and volume of removed nucleus were recorded. Reherniations were reported, pain and function were monitored and imaging was performed at regular intervals during 24 months of follow-up. At 12 months postsurgery, pain and function were significantly improved, comparing favorably to reported results from limited discectomy. Disc height has been well maintained. One reherniation has occurred (2.4%), which was associated with a misplaced device. No device fracture, subsidence or migration has been observed. The use of an annulus closure device may provide a reduction in reherniation rate for lumbar discectomy patients with large annulus defects who are at the greatest risk of recurrence. Using such a device should provide the surgeon increased confidence in minimizing nucleus removal, which, in turn, may preserve disc height and biomechanics, reducing degeneration and associated poor clinical outcomes in the long-term. A randomized multicenter study evaluating limited discectomy with and without the Barricaid® is currently underway, and will provide a higher level of evidence.

  10. Device for Investigation of Mechanical Tension of Isolated Smooth Muscle Vessels and Airway Segments of Animals

    Science.gov (United States)

    Aleinik, A.; Karpovich, N.; Turgunova, N.; Nosarev, A.

    2016-11-01

    For the purpose of testing and the search for new drug compounds, designed to heal many human diseases, it is necessary to investigate the deformation of experimental tissue samples under influence of these drugs. For this task a precision force sensor for measuring the mechanical tension, produced by isolated ring segments of blood vessels and airways was created. The hardware and software systems for the study of changes in contractile responses of the airway smooth muscles and blood vessels of experimental animals was developed.

  11. Use of a home vacuum-assisted closure device in the burn population is both cost-effective and efficacious.

    Science.gov (United States)

    Mushin, Oren P; Bogue, Jarrod T; Esquenazi, Mica D; Toscano, Nicole; Bell, Derek E

    2017-05-01

    The vacuum assisted closure device (VAC) improves wound-healing when utilized as a bolster to secure split thickness skin grafts (STSG). Patients typically remain hospitalized for VAC therapy; however, home VACs (hVAC) are now available. Limited studies examine burns treated with hVAC as a STSG bolster. A retrospective study of records from an ABA verified regional burn center was conducted over 23 months. Patients included STSGs for burn. Data points included demographics, burn mechanism and location, graft characteristics, hospital length of stay (LOS), and time to heal. Fifty patients were included, with average age of 39 years (range <1-83years). Average burn TBSA was 1.27±1.42 (range 0.05-8.18). Grafted area average was 102.9±128.1cm(2). The most commonly treated areas were the leg/foot, thigh, and torso (53%, 16%, and 16%, respectively). Average LOS was 1.1±1.2 days. Mean graft-take was 99.2±2.8% with one patient undergoing repeat STSG. Average post-operative time to heal was 16±6 days. A 5-day inpatient stay with a VAC costs an average of $34,635, compared to $9134 for an hVAC over the same period. The hVAC is a cost-effective STSG bolster in the burn population for appropriate candidates. Excellent graft-take and low morbidity rates imply that this is an efficacious alternative for STSG bolster. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  12. The New 3D Printed Left Atrial Appendage Closure with a Novel Holdfast Device: A Pre-Clinical Feasibility Animal Study.

    Directory of Open Access Journals (Sweden)

    M Brzeziński

    Full Text Available Many patients undergoing cardiac surgery have risk factors for both atrial fibrillation (AF and stroke. The left atrial appendage (LAA is the primary site for thrombi formation. The most severe complication of emboli derived from LAA is stroke, which is associated with a 12-month mortality rate of 38% and a 12-month recurrence rate of 17%. The most common form of treatment for atrial fibrillation and stroke prevention is the pharmacological therapy with anticoagulants. Nonetheless this form of therapy is associated with high risk of major bleeding. Therefore LAA occlusion devices should be tested for their ability to reduce future cerebral ischemic events in patients with high-risk of haemorrhage.The aim of this study was to evaluate the safety and feasibility of a novel left atrial appendage exclusion device with a minimally invasive introducer in a swine model.A completely novel LAA device, which is composed of two tubes connected together using a specially created bail, was designed using finite element modelling (FEM to obtain an optimal support force of 36 N at the closure line. The monolithic form of the occluder was obtained by using additive manufacturing of granular PA2200 powder with the technology of selective laser sintering (SLS. Fifteen swine were included in the feasibility tests, with 10 animals undergoing fourteen days of follow-up and 5 animals undergoing long-term observation of 3 months. For one animal, the follow-up was further prolonged to 6 months. The device was placed via minithoracotomy. After the observation period, all of the animals were euthanized, and their hearts were tested for LAA closure and local inflammatory and tissue response.After the defined observation period, all fifteen hearts were explanted. In all cases the full closure of the LAA was achieved. The macroscopic and microscopic evaluation of the explanted hearts showed that all devices were securely integrated in the surrounding tissues. No

  13. [Implementation of a Vessel Sealing Device in a Centre for Thyroid Surgery: Risk and Economic Profit].

    Science.gov (United States)

    Coerper, Stephan; Stengl, Wolfgang

    2017-05-09

    Background This study investigated whether the use of the vessel sealing device LigaSure Small Jaw(™) is cost-effective and safe in thyroid surgery despite the high cost of material. Patients and Methods We analysed the results of 224 thyroid operations performed by the same surgeon in three time intervals. We included thyroidectomies and bilateral near-total resections (including Dunhill surgery). Minimally-invasive resections (MIVAT), unilateral resections or subtotal resections (remains > 2 ml), patients with recurrent goiter, operations with neck dissections and sternotomies were excluded. In 72 procedures carried out during the first interval (1/2011 - 6/2011), the surgeon only used the clamp-and-tie technique. In the other two intervals (II: 7/2012 - 12/2012, n = 81 and III: 1/2014 - 6/2014: n = 71), the LigaSure Small Jaw was used. We investigated operation time (cut-seam time) and the complication rates between the groups (transient/permanent laryngeal nerve palsy, severe bleeding causing reoperation and hypocalcaemia, defined as Ca < 2.0 mmol/l). Differences were calculated with the t-test and the Wilcoxon rank test. Values are given as mean ± SEM. Results Specimen weight and the indication for surgery (nodular goiter or Basedow's disease) were comparable in all groups, but there were fewer thyroidectomies performed in the first interval (p = 0.009). There was no difference in complication rates between the groups, such as the rate of transient laryngeal nerve palsy in % (I: 2.17; II: 1.92; III 1.44) and postoperative hypocalcaemia in % (I: 20.8; II: 21.0; III 15.5). The use of the LigaSure Small Jaw in thyroidectomy procedures led to a significant reduction of operation time (II: Δ 27.4 min; III: Δ 25.6 min; p = 0.0001) compared to interval I. This was also found for bilateral near-total resections (II: Δ 24.3 min; III Δ 32.1 min; p = 0.0001). The InEK calculation for thyroidectomy

  14. Safety profiles of percutaneous left atrial appendage closure devices: An analysis of the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database from 2009 to 2016.

    Science.gov (United States)

    Jazayeri, Mohammad-Ali; Vuddanda, Venkat; Turagam, Mohit K; Parikh, Valay; Lavu, Madhav; Atkins, Donita; Earnest, Matthew; Di Biase, Luigi; Natale, Andrea; Wilber, David; Reddy, Yeruva Madhu; Lakkireddy, Dhanunjaya R

    2017-10-08

    Percutaneous left atrial appendage closure (LAAC) is a viable option for AF patients who are unable to tolerate long-term oral anticoagulation (OAC). We sought to assess the safety of two commonly used percutaneous devices for LAA closure in the United States by analysis of surveillance data from the FDA Manufacturer and User Facility Device Experience (MAUDE) database. The MAUDE database was queried between May 1, 2006 and May 1, 2016 for LARIAT® (SentreHEART Inc., Redwood City, CA, USA) and WATCHMAN™ (Boston Scientific Corp., Marlborough, MA, USA) devices. Among 622 retrieved medical device reports, 356 unique and relevant reports were analyzed. The cumulative incidence of safety events was calculated over the study period and compared between the two devices. LAAC was performed with LARIAT in 4,889 cases. WATCHMAN was implanted in 2,027 patients prior to FDA approval in March 2015 and 3,822 patients postapproval. The composite outcome of stroke/TIA, pericardiocentesis, cardiac surgery, and death occurred more frequently with WATCHMAN (cumulative incidence, 1.93% vs. 1.15%; P = 0.001). The same phenomenon was observed when comparing the WATCHMAN pre- and postapproval experiences for the composite outcome, as well as device embolization, cardiac surgery, and myocardial infarction. MAUDE-reported data show that postapproval, new technology adoption is fraught with increased complications. Improved collaboration between operators, device manufacturers, and regulators can better serve patients through increased transparency and practical postmarket training and monitoring mechanisms. © 2017 Wiley Periodicals, Inc.

  15. A Remote-Controlled Airbag Device Can Improve Upper Airway Collapsibility by Producing Head Elevation With Jaw Closure in Normal Subjects Under Propofol Anesthesia.

    Science.gov (United States)

    Ishizaka, Satoru; Moromugi, Shunji; Kobayashi, Masato; Kajihara, Hiroki; Koga, Kazuya; Sugahara, Hirofumi; Ishimatsu, Takakazu; Kurata, Shinji; Kirkness, Jason P; Oi, Kumiko; Ayuse, Takao

    2014-01-01

    Continuous maintenance of an appropriate position of the mandible and head purely by manual manipulation is difficult, although the maneuver can restore airway patency during sleep and anesthesia. The aim of this paper was to examine the effect of head elevation with jaw closure using a remote-controlled airbag device, such as the airbag system, on passive upper airway collapsibility during propofol anesthesia. Seven male subjects were studied. Propofol infusion was used for anesthesia induction and maintenance, with a target blood propofol concentration of 1.5-2 [Formula: see text]g/ml. Nasal mask pressure ([Formula: see text]) was intermittently reduced to evaluate upper airway collapsibility (passive [Formula: see text]) and upstream resistance ([Formula: see text]) at three different head and jaw positions, jaw opening position in the supine position, jaw opening position in the sniffing position with 6-cm head elevation, and jaw closure at a 6-cm height sniffing position. The 6-cm height sniffing position with jaw closure was achieved by an airbag device that was attached to the subject's head-like headgear. Patient demographics, [Formula: see text] and [Formula: see text] in each condition were compared using one-way ANOVA with a post hoc Tukey test. [Formula: see text] was considered significant. We also confirmed the effects of our airbag device on improvement of upper airway collapsibility in three obstructive sleep apnea patients in a clinical study. The combination of 6-cm head elevation with jaw closure using the air-inflatable robotic airbag system decreased upper airway collapsibility ([Formula: see text]-cm H[Formula: see text]O) compared with the baseline position ([Formula: see text]-cm H[Formula: see text]O, [Formula: see text]). In the clinical study, there was improvement of upper airway obstruction in sleep apnea patients, including decreased apnea and hypopnea duration and increased the lowest level of oxygen saturation. We demonstrated that

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

    Science.gov (United States)

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

    2017-08-01

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

  17. A minimally invasive technique for closing an iatrogenic subclavian artery cannulation using the Angio-Seal closure device: two case reports

    Directory of Open Access Journals (Sweden)

    Szkup Peter L

    2012-03-01

    Full Text Available Abstract Introduction In the two cases described here, the subclavian artery was inadvertently cannulated during unsuccessful access to the internal jugular vein. The puncture was successfully closed using a closure device based on a collagen plug (Angio-Seal, St Jude Medical, St Paul, MN, USA. This technique is relatively simple and inexpensive. It can provide clinicians, such as intensive care physicians and anesthesiologists, with a safe and straightforward alternative to major surgery and can be a life-saving procedure. Case presentation In the first case, an anesthetist attempted ultrasound-guided access to the right internal jugular vein during the preoperative preparation of a 66-year-old Caucasian man. A 7-French (Fr triple-lumen catheter was inadvertently placed into his arterial system. In the second case, an emergency physician inadvertently placed a 7-Fr catheter into the subclavian artery of a 77-year-old Caucasian woman whilst attempting access to her right internal jugular vein. Both arterial punctures were successfully closed by means of a percutaneous closure device (Angio-Seal. No complications were observed. Conclusions Inadvertent subclavian arterial puncture can be successfully managed with no adverse clinical sequelae by using a percutaneous vascular closure device. This minimally invasive technique may be an option for patients with non-compressible arterial punctures. This report demonstrates two practical points that may help clinicians in decision-making during daily practice. First, it provides a practical solution to a well-known vascular complication. Second, it emphasizes a role for proper vascular ultrasound training for the non-radiologist.

  18. Cardiac Resynchronization Therapy Device Implantation in a Patient with Congenitally Corrected Transposition of Great Vessels

    Directory of Open Access Journals (Sweden)

    Reza Mollazadeh

    2017-03-01

    Full Text Available A 29-year-old woman was referred to our hospital due to exacerbation in dyspnea on exertion and easy fatigability. A known case of congenitally corrected transposition of the great vessels and congenital complete heart block, she had already received a permanent single-chamber pacemaker. Decision was made to implant a biventricular pacemaker for the treatment of the failing heart. Excellent coronary sinus lead implantation was done, conferring amelioration of symptoms, QRS narrowing in the electrocardiogram, and improvement of systemic ventricular systolic function in echocardiography. Over a 15-month follow-up period, she had no dyspnea on exertion. This case highlights the significance of upgrading pacemakers in patients with heart failure.

  19. Complete atrioventricular block after percutaneous device closure of perimembranous ventricular septal defect: A single-center experience on 1046 cases.

    Science.gov (United States)

    Bai, Yuan; Xu, Xu-Dong; Li, Chang-Yong; Zhu, Jia-Qi; Wu, Hong; Chen, Shao-Ping; Chen, Feng; You, Xiao-Hua; Zhao, Xian-Xian; Qin, Yong-Wen

    2015-10-01

    Complete atrioventricular block (cAVB) has been deemed a rare complication after transcatheter closure for ventricular septal defect (VSD). However, this serious event appears to be underrecognized and is worth being investigated further. To determine the incidence and predisposing factors of cAVB associated with closure of VSD using a modified double-disk occluder (MDO). From December 21, 2001 to December 31, 2014, 1046 patients with perimembranous ventricular septal defect underwent percutaneous closure using the MDO. Electrocardiography was evaluated before the procedure, within 1 week after the procedure, and then at 1, 3, 6, and 12 months and every year thereafter. Other baseline and procedural parameters were also evaluated and a comparison between patients requiring pacemakers and those not suffering from cAVB was done. cAVB occurred in 17 patients (1.63%) after the procedure. Of the 17 patients, 8 underwent permanent pacemaker (PPM) implantation. The cAVB occurred within 30 days after the procedure in 14 patients and after 1 year in 3 patients. In comparison patients aged ≤18 years, patients aged >18 years were more prone to cAVB (P = .025). Logistic regression revealed no significant parameter to predict later requirement for PPM. The incidence of cAVB after transcatheter closure of VSD was acceptable, as part of the cAVB population recovered after administration of corticosteroid and application of a temporary pacemaker. Late cAVB (>1 year) appears to make it more difficult to restore normal conduction block. Because of the recurrence of cAVB, life-long follow-up with periodic electrocardiography examination may be mandatory. Copyright © 2015. Published by Elsevier Inc.

  20. Efficacy and Safety of a Novel Vascular Closure Device (Glubran 2 Seal) After Diagnostic and Interventional Angiography in Patients with Peripheral Arterial Occlusive Disease

    Energy Technology Data Exchange (ETDEWEB)

    Del Corso, Andrea [University of Pisa, Department of Vascular Surgery (Italy); Bargellini, Irene, E-mail: irenebargellini@hotmail.com; Cicorelli, Antonio; Perrone, Orsola [University of Pisa, Department of Diagnostic and Interventional Radiology (Italy); Leo, Michele [University of Pisa, Department of Vascular Surgery (Italy); Lunardi, Alessandro [University of Pisa, Department of Diagnostic and Interventional Radiology (Italy); Alberti, Aldo; Tomei, Francesca [University of Pisa, Department of Vascular Surgery (Italy); Cioni, Roberto [University of Pisa, Department of Diagnostic and Interventional Radiology (Italy); Ferrari, Mauro [University of Pisa, Department of Vascular Surgery (Italy); Bartolozzi, Carlo [University of Pisa, Department of Diagnostic and Interventional Radiology (Italy)

    2013-04-15

    To prospectively evaluate safety and efficacy of a novel vascular closure device (Glubran 2 Seal) after peripheral angiography in patients with peripheral arterial occlusive disease (PAOD). From December 2010 to June 2011, all consecutive patients with PAOD undergoing peripheral angiography were prospectively enrolled onto the study after percutaneous antegrade or retrograde puncture of the common femoral artery. After angiography, the Glubran 2 Seal device was used to achieve hemostasis. The following data were registered: technical success and manual compression duration, patients' discomfort (scale 0-5), operators' technical difficulty (scale 0-5), and vascular complications. The site of hemostasis was evaluated by clinical inspection and color-coded Duplex ultrasound performed 1 day and 1 month after the procedure. One hundred seventy-eight patients were enrolled (112 male, mean age 70.8 years) with a total of 206 puncture sites, including 104 (50.5 %) antegrade accesses. The device was successful in 198(96.1 %) of 206 procedures, with 8 cases of manual compression lasting longer than 5 min (maximum 20 min). No major vascular complications were observed, resulting in 100 % procedural success. Minor complications occurred in seven procedures (3.4 %), including two cases of pseudoaneurysms, successfully treated by ultrasound-guided glue injection. The mean {+-} standard deviation score for patients' discomfort was 0.9 {+-} 0.7, whereas the mean score for operators' difficulty was 1.2 {+-} 0.9. In patients with PAOD, the Glubran 2 Seal represents a simple, painless, and efficient vascular closure device, able to achieve hemostasis both in antegrade and retrograde accesses.

  1. Development of Reactor Vessel Bottom Mount Instrumentation Nozzle Routine Inspection Device

    Energy Technology Data Exchange (ETDEWEB)

    Khaled, Atya Ahmed Abdallah; Ihn, Namgung [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2015-10-15

    The primary coolant water of pressurized water reactors has created cracks in j-weld of penetrations with Alloy 600 through a process called primary water stress corrosion cracking. On October 6, 2013, BMI nozzle number 3 at Palo Verde Unit 3 (PVNGS-3) exhibited small white de-posits around the annulus. Nozzle attachment to the RV lower head is by J-groove weld to the inside penetration of the nozzle and the weld material is of Alloy 600 material. Above two cases clearly show the necessity of routine inspection of RV lower head penetration during refueling outage. Nondestructive inspection is generally performed to detect fine cracks or defects that may develop during operation. Defects usually occur at weld regions, hence most non-destructive inspection is to scan and check any defects or crack in the weld region. BMI nozzles at the bottom head of a nuclear reactor vessel (RV) are one of such area for inspection. But BMI nozzles have not been inspected during regular refuel outage due to the relative small size of BMI nozzle and limited impact of the consequences of BMI leak. However, there is growing concern since there have been leaks at nuclear power plants (NPPs) as well as recent operating experience. In this study, we propose a system that is conveniently used for nondestructive inspection of BMI nozzles during regular refueling outage without removing all the reactor internals. A 3D model of the inspection system was also developed along with the RV and internals which permits a virtual 3D simulation to check the design concept and usability of the system.

  2. Intermediate and long-term followup of percutaneous device closure of fossa ovalis atrial septal defect by the Amplatzer septal occluder in a cohort of 529 patients

    Directory of Open Access Journals (Sweden)

    Tomar Munesh

    2011-01-01

    Full Text Available Objectives : The aim of present study is to analyze the intermediate and long-term follow up results of percutaneous closure of fossa ovalis atrial septal defect (ASD with Amplatzer septal occluder (ASO in a large cohort of patients including children and adults. Methods : Between May 1998 and July 2008, 529 patients (age group 2-77 years, median 28 years underwent successful device closure with an ASO at single tertiary referral cardiac center in India.. This was out of an attempted 543 cases. The procedure was carried out in catheterization laboratory under transesophageal echocardiographic and fluoroscopy guidance. The mean size of ASD was 20 mm (7-40 mm while size of septal occluder was 10-40 mm (mean 24 mm. Two devices were deployed in four patients. Three patients developed transitory pulmonary edema in immediate postprocedure period requiring ICU care for 48 hrs. All patients were advised for Aspirin (3-5 mg/kg, maximum 150 mg once daily for 6 months. In patients with device 30 mm or larger, Clopidogril ( 75 mg once daily was given for 3 months in addition to Aspirin. Clinical evaluation, echocardiogram were done on 3 months, 6 months and then at 1, 3, 5, 7 and 10 years of follow up. Transesophageal echocardiography (TEE was performed in case of any doubt on clinical evaluation or on transthoracic echocardiography (n=10. Results : Followup data is available for 496 patients (93.7%. Followup period is from 12 months to 120 months (median 56 months. On followup, device was in position in all patients, no residual shunt and no evidence of thrombosis. Interventricular septal motion normalized on day of procedure in 89% patients, in 6% over 3 months while flat septal motion persisted in 5% (n=25, all in age group > 40 years of cases, though right ventricular dilatation persisted in 10% (n=50, age more than 40 years of patients. Symptom-free survival was 96.7 % (480/496 in patients who came for followup. Only one 68 year old patient with

  3. Percutaneous steerable robotic tool delivery platform and metal microelectromechanical systems device for tissue manipulation and approximation: closure of patent foramen ovale in an animal model.

    Science.gov (United States)

    Vasilyev, Nikolay V; Gosline, Andrew H; Butler, Evan; Lang, Nora; Codd, Patrick J; Yamauchi, Haruo; Feins, Eric N; Folk, Chris R; Cohen, Adam L; Chen, Richard; Zurakowski, David; del Nido, Pedro J; Dupont, Pierre E

    2013-08-01

    Beating-heart image-guided intracardiac interventions have been evolving rapidly. To extend the domain of catheter-based and transcardiac interventions into reconstructive surgery, a new robotic tool delivery platform and a tissue approximation device have been developed. Initial results using these tools to perform patent foramen ovale closure are described. A robotic tool delivery platform comprising superelastic metal tubes provides the capability of delivering and manipulating tools and devices inside the beating heart. A new device technology is also presented that uses a metal-based microelectromechanical systems-manufacturing process to produce fully assembled and fully functional millimeter-scale tools. As a demonstration of both technologies, patent foramen ovale creation and closure was performed in a swine model. In the first group of animals (n=10), a preliminary study was performed. The procedural technique was validated with a transcardiac hand-held delivery platform and epicardial echocardiography, video-assisted cardioscopy, and fluoroscopy. In the second group (n=9), the procedure was performed percutaneously using the robotic tool delivery platform under epicardial echocardiography and fluoroscopy imaging. All patent foramen ovales were completely closed in the first group. In the second group, the patent foramen ovale was not successfully created in 1 animal, and the defects were completely closed in 6 of the 8 remaining animals. In contrast to existing robotic catheter technologies, the robotic tool delivery platform uses a combination of stiffness and active steerability along its length to provide the positioning accuracy and force-application capability necessary for tissue manipulation. In combination with a microelectromechanical systems tool technology, it can enable reconstructive procedures inside the beating heart.

  4. Percutaneous Steerable Robotic Tool Delivery Platform and Metal MEMS Device for Tissue Manipulation and Approximation: Closure of Patent Foramen Ovale in an Animal Model

    Science.gov (United States)

    Vasilyev, Nikolay V.; Gosline, Andrew H.; Butler, Evan; Lang, Nora; Codd, Patrick J.; Yamauchi, Haruo; Feins, Eric N.; Folk, Chris R.; Cohen, Adam L.; Chen, Richard; Zurakowski, David; del Nido, Pedro J.; Dupont, Pierre E

    2013-01-01

    Background Beating-heart image-guided intracardiac interventions have been evolving rapidly. To extend the domain of catheter-based and transcardiac interventions into reconstructive surgery, a new robotic tool delivery platform (TDP) and tissue approximation device have been developed. Initial results employing these tools to perform patent foramen ovale (PFO) closure are described. Methods and Results A robotic TDP comprised of superelastic metal tubes provides the capability of delivering and manipulating tools and devices inside the beating heart. A new device technology is also presented that utilizes a metal-based MicroElectroMechanical Systems (MEMS) manufacturing process to produce fully-assembled and fully-functional millimeter-scale tools. As a demonstration of both technologies, a PFO creation and closure was performed in a swine model. In the first group of animals (N=10), a preliminary study was performed. The procedural technique was validated with a transcardiac handheld delivery platform and epicardial echocardiography, video-assisted cardioscopy and fluoroscopy. In the second group (N=9), the procedure was performed percutaneously using the robotic TDP under epicardial echocardiography and fluoroscopy imaging. All PFO’s were completely closed in the first group. In the second group, the PFO was not successfully created in 1 animal, and the defects were completely closed in 6 of the 8 remaining animals. Conclusions In contrast to existing robotic catheter technologies, the robotic TDP utilizes a combination of stiffness and active steerability along its length to provide the positioning accuracy and force application capability necessary for tissue manipulation. In combination with a MEMS tool technology, it can enable reconstructive procedures inside the beating heart. PMID:23899870

  5. Safety and effectiveness of a circumferential clip-based vascular closure device for hemostasis in off-label applications: Comparison with standard applications

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Chan; Kim, Chang Won [Dept. of Radiology, Pusan National University School of Medicine, Pusan National University Hospital, Busan (Korea, Republic of); Jeon, Ung Bae [Dept. of Radiology, Pusan National University School of Medicine, Yangsan Pusan National University Hospital, Yangsan (Korea, Republic of)

    2016-09-15

    We investigated the efficacy and safety of a circumferential nitinol clip based arterial closure device following arteriotomy, especially in off-label applications. Consecutive patients who underwent the procedure with arteriotomy from January 2011 to February 2014 were included in this study. We defined standard use as the use of StarClose for retrograde puncture of the common femoral artery (CFA) and off-label use as the use of StarClose for retrograde puncture of the superficial femoral artery (SFA), antegrade puncture of the CFA or SFA, puncture of the brachial artery or puncture of the vascular graft. The procedures performed included percutaneous transluminal angioplasty and thrombolysis. Technical success was defined as complete hemostasis achieved within 3 minute after the closure. Complications, and laboratory findings associated with coagulation function, were also investigated. There were 146 cases of standard applications and 111 cases of off-label applications. Technical success was achieved in all cases. The off-label group comprised the use of StarClose for retrograde puncture of the SFA (n = 19), antegrade puncture of the CFA or SFA (n = 74), brachial artery puncture (n = 5), larger sheath than 6 Fr (n = 7) and vascular graft puncture (n = 6). Minor complications were noted in both groups (standard group: 7.5%, off-label group: 2.7%). Off-label use of StarClose is safe and feasible.

  6. Management of pleural empyema with a vacuum-assisted closure device and reconstruction of open thoracic window in a patient with liver cirrhosis.

    Science.gov (United States)

    Munguía-Canales, Daniel Alejandro; Vargas-Mendoza, Gary Kosai; Alvarez-Bestoff, Gustavo; Calderón-Abbo, Moisés Cutiel

    2013-10-01

    The patient is a 21-year-old female, diagnosed with cryptogenic cirrhosis at the age of 9. She presented with left post-pneumonic empyema that did not remit with conventional medical management and evolved with fistulization to the skin in the 7th intercostal space in the left subscapular region. We performed an open thoracic window procedure, and on the 6th day the patient was sent home with a portable vacuum-assisted closure device, with changes of the material every 4 days until the cavity was completed obliterated (92 days). Imaging tests showed full expansion of the lung, and chest wall reconstruction was performed with titanium rods. The high mortality of empyema in patients with liver disease requires both implementing and searching for new adjuvant therapies, like the use of vacuum-assisted closure systems and reconstruction with titanium rods. Controlled studies with a wide range of cases are needed for proper evaluation. Copyright © 2012 SEPAR. Published by Elsevier Espana. All rights reserved.

  7. Nevada Test Site closure program

    Energy Technology Data Exchange (ETDEWEB)

    Shenk, D.P.

    1994-08-01

    This report is a summary of the history, design and development, procurement, fabrication, installation and operation of the closures used as containment devices on underground nuclear tests at the Nevada Test Site. It also addresses the closure program mothball and start-up procedures. The Closure Program Document Index and equipment inventories, included as appendices, serve as location directories for future document reference and equipment use.

  8. Performance Assessment of Bi-Directional Knotless Tissue-Closure Devices in Juvenile Chinook Salmon Surgically Implanted with Acoustic Transmitters, 2009 - Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Woodley, Christa M.; Wagner, Katie A.; Bryson, Amanda J.

    2012-11-09

    The purpose of this report is to assess the performance of bi-directional knotless tissue-closure devices for use in tagging juvenile salmon. This study is part of an ongoing effort at Pacific Northwest National Laboratory (PNNL) to reduce unwanted effects of tags and tagging procedures on the survival and behavior of juvenile salmonids, by assessing and refining suturing techniques, suture materials, and tag burdens. The objective of this study was to compare the performance of the knotless (barbed) suture, using three different suture patterns (treatments: 6-point, Wide “N”, Wide “N” Knot), to the current method of suturing (MonocrylTM monofilament, discontinuous sutures with a 2×2×2×2 knot) used in monitoring and research programs with a novel antiseptic barrier on the wound (“Second Skin”).

  9. Preliminary Experience with Stent-Assisted Coiling of Aneurysms Arising from Small (<2.5 mm) Cerebral Vessels Using The Low-Profile Visualized Intraluminal Support Device.

    Science.gov (United States)

    Wang, C-C; Li, W; Feng, Z-Z; Hong, B; Xu, Y; Liu, J-M; Huang, Q-H

    2017-06-01

    The Low-Profile Visualized Intraluminal Support (LVIS) stent is a new device recently introduced for the treatment of wide-neck intracranial aneurysms. This single-center study presents the authors' preliminary experience using the LVIS stent to treat saccular aneurysms with parent arteries smaller than 2.5 mm. Aneurysms with a LVIS stent used in a small parent vessel (LVIS stents in small vessels is feasible, safe, and effective in the midterm. Larger studies with long-term follow-up are needed to validate our promising results. © 2017 by American Journal of Neuroradiology.

  10. Novel stroke risk reduction in atrial fibrillation: left atrial appendage occlusion with a focus on the Watchman closure device.

    Science.gov (United States)

    Alipour, Arash; Wintgens, Lisette I S; Swaans, Martin J; Balt, Jippe C; Rensing, Benno J W M; Boersma, Lucas V A

    2017-01-01

    Atrial fibrillation (AF) remains an important clinical problem with severe complications such as stroke, which especially harms those with risk factors as calculated by the CHADS2 or CHA2DS2-VASc. Until now, no therapy has proven 100% effective against AF. Since the left atrial appendage (LAA) is the most prominent nonvalvular AF-related thromboembolic source and (novel) oral anticoagulant [(N)OAC] carries the hazard of bleeding, LAA occlusion may be an alternative, especially in patients who are ineligible for (N)OAC therapy. In this review, we discuss several LAA occlusion techniques with a focus on the Watchman device since this device is the most thoroughly studied device of all.

  11. 27 CFR 27.62 - Affixing closures.

    Science.gov (United States)

    2010-04-01

    ... OF THE TREASURY LIQUORS IMPORTATION OF DISTILLED SPIRITS, WINES, AND BEER General Requirements Closures for Containers of Distilled Spirits § 27.62 Affixing closures. Closures or other devices on containers of imported distilled spirits having a capacity of 1 gallon (3.785 liters) or less shall be...

  12. Single clips versus multi-firing clip device for closure of mucosal incisions after peroral endoscopic myotomy (POEM)

    NARCIS (Netherlands)

    Verlaan, Tessa; Ponds, Fraukje A. M.; Bastiaansen, Barbara A. J.; Bredenoord, Albert J.; Fockens, Paul

    2016-01-01

    Background and aims: After Peroral Endoscopic Myotomy (POEM), the mucosal incision is closed with endoscopically applied clips. After each clip placement, a subsequent clipping device has to be introduced through the working channel. With the Clipmaster3, three consecutive clips can be placed

  13. Efficacy and quality of vessel sealing: comparison of a reusable with a disposable device and effects of clamp surface geometry and structure.

    Science.gov (United States)

    Richter, S; Kollmar, O; Schilling, M K; Pistorius, G A; Menger, M D

    2006-06-01

    During the past few years, a variety of energy-based techniques for vessel ligation have been introduced. With the use of a porcine model and different devices for bipolar vessel sealing (BiClamp and LigaSure), we studied the impact of different clamp surface structures on the efficacy and quality of vessel sealing. Eight Swabian Hall pigs underwent splenectomy, nephrectomy, salpingo-oophorectomy, and small bowel resection with the use of bipolar vessel sealing devices designed for open and laparoscopic surgery. Vessel sealing with clamps with a smooth (nonstructured) surface (BiClamp for open surgery and LigaSure for laparoscopic surgery) was compared to that of clamps with a structured (grooved, wafer-like) surface (BiClamp for laparoscopic surgery and LigaSure for open surgery). Measurements of sealed vessels (2- to 7-mm diameter) included the seal failure rate, instrument sticking, and heat-associated morphological vascular wall alterations. Analysis of seal failures did not reveal significant differences between the different devices for both open [BiClamp, 17.9% (17/95); LigaSure, 15.5% (11/71)] and laparoscopic surgery [BiClamp, 2.8% (1/36); LigaSure, 8.6% (3/35)]. Comparing all data of structured versus smooth clamp surfaces, the seal failure rate was lower using clamps with a structured (11.2%) compared to a smooth surface (15.4%). Instrument sticking and thermal spread were found to be significantly increased after sealing with structured surfaces, regardless of whether devices designed for open (p < 0.05 and p < 0.001, respectively) or laparoscopic surgery (p < 0.001 and p < 0.01, respectively) were used. Clamps with a structured surface seem to be superior to those with a smooth surface for successful bipolar vessel sealing, as indicated by an increase of thermal spread. However, the more pronounced instrument sticking represents an undesired side effect and should encourage the search for more inert materials to further improve the sealing procedure.

  14. Feasibility and Safety of Vascular Closure Devices in an Antegrade Approach to Either the Common Femoral Artery or the Superficial Femoral Artery

    Energy Technology Data Exchange (ETDEWEB)

    Gutzeit, Andreas, E-mail: andreas.gutzeit@ksw.ch; Schie, Bram van, E-mail: Bram.vanschie@hotmail.com; Schoch, Eric, E-mail: eric.schoch@ksw.ch [Cantonal Hospital Winterthur, Department of Radiology (Switzerland); Hergan, Klaus, E-mail: k.hergan@salk.at [Paracelsus Medical University Salzburg, Department of Radiology (Austria); Graf, Nicole, E-mail: graf@biostatistics.ch; Binkert, Christoph A., E-mail: christoph.binkert@ksw.ch [Cantonal Hospital Winterthur, Department of Radiology (Switzerland)

    2012-10-15

    Introduction: The purpose of the present study was to analyze complications following antegrade puncture of the common femoral artery (CFA) and the superficial femoral artery (SFA) using vascular closure systems (VCS). Methods: A single-center, retrospective study was performed after obtaining approval from the institutional review board and informed consent from all patients. At our center, the CFA or SFA are used for arterial access. All patients were evaluated clinically on the same day. If there was any suspicion of an access site problem, Duplex ultrasound was performed. Results: Access location was the CFA in 50 patients and the SFA in 130 patients. The sheath size ranged from 4F to 10F. Two patients had to be excluded because of lack of follow-up. Successful hemostasis was achieved in 162 of 178 cases (91 %). The following complications were observed in 16 patients (8.9 %): 4 pseudoaneurysms (2.2 %), 11 hematomas (6.2 %), and 1 vascular occlusion (0.5 %). The two pseudoaneurysms healed spontaneously, in one case an ultrasound-guided thrombin injection was performed, and one aneurysm was compressed manually. No further medical therapy was needed for the hematomas. The one vascular occlusion was treated immediately with angioplasty using a contralateral approach. No significant difference was noted between the CFA and the SFA group with respect to complications (p = 1.000). Conclusions: The use of closure devices for an antegrade approach up to 10F is feasible and safe. No differences in low complication rates were observed between CFA and SFA.

  15. Novel stroke risk reduction in atrial fibrillation: left atrial appendage occlusion with a focus on the Watchman closure device

    Directory of Open Access Journals (Sweden)

    Alipour A

    2017-03-01

    Full Text Available Arash Alipour, Lisette I S Wintgens, Martin J Swaans, Jippe C Balt, Benno J W M Rensing, Lucas V A Boersma Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands Abstract: Atrial fibrillation (AF remains an important clinical problem with severe complications such as stroke, which especially harms those with risk factors as calculated by the CHADS2 or CHA2DS2-VASc. Until now, no therapy has proven 100% effective against AF. Since the left atrial appendage (LAA is the most prominent nonvalvular AF-related thromboembolic source and (novel oral anticoagulant [(NOAC] carries the hazard of bleeding, LAA occlusion may be an alternative, especially in patients who are ineligible for (NOAC therapy. In this review, we discuss several LAA occlusion techniques with a focus on the Watchman device since this device is the most thoroughly studied device of all. Keywords: left atrial appendage, atrial fibrillation, ischemic stroke 

  16. Systematic review: comparative effectiveness of adjunctive devices in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention of native vessels

    Directory of Open Access Journals (Sweden)

    Sobieraj Diana M

    2011-12-01

    Full Text Available Abstract Background During percutaneous coronary intervention (PCI, dislodgement of atherothrombotic material from coronary lesions can result in distal embolization, and may lead to increased major adverse cardiovascular events (MACE and mortality. We sought to systematically review the comparative effectiveness of adjunctive devices to remove thrombi or protect against distal embolization in patients with ST-segment elevation myocardial infarction (STEMI undergoing PCI of native vessels. Methods We conducted a systematic literature search of Medline, the Cochrane Database, and Web of Science (January 1996-March 2011, http://www.clinicaltrials.gov, abstracts from major cardiology meetings, TCTMD, and CardioSource Plus. Two investigators independently screened citations and extracted data from randomized controlled trials (RCTs that compared the use of adjunctive devices plus PCI to PCI alone, evaluated patients with STEMI, enrolled a population with 95% of target lesion(s in native vessels, and reported data on at least one pre-specified outcome. Quality was graded as good, fair or poor and the strength of evidence was rated as high, moderate, low or insufficient. Disagreement was resolved through consensus. Results 37 trials met inclusion criteria. At the maximal duration of follow-up, catheter aspiration devices plus PCI significantly decreased the risk of MACE by 27% compared to PCI alone. Catheter aspiration devices also significantly increased the achievement of ST-segment resolution by 49%, myocardial blush grade of 3 (MBG-3 by 39%, and thrombolysis in myocardial infarction (TIMI 3 flow by 8%, while reducing the risk of distal embolization by 44%, no reflow by 48% and coronary dissection by 70% versus standard PCI alone. In a majority of trials, the use of catheter aspiration devices increased procedural time upon qualitative assessment. Distal filter embolic protection devices significantly increased the risk of target revascularization

  17. The design study of the JT-60SU device. No. 4. The vacuum vessel and cryostat of JT-60SU

    Energy Technology Data Exchange (ETDEWEB)

    Neyatani, Yuzuru; Ushigusa, Kenkichi; Tobita, Kenji [Japan Atomic Energy Research Inst., Naka, Ibaraki (Japan). Naka Fusion Research Establishment] [and others

    1997-03-01

    The vacuum vessel and the cryostat for the JT-60 Super Upgrade (JT-60SU) have been designed. Two types of the complex materials for the vacuum vessel were chosen on the basis of the avoidance of tritium occlusion and the low irradiation, i.e. (1) SUS316 covered by tungsten plate (30mm thickness) as a {gamma}-ray shielding, (2) Ti-6Al-4V alloy covered by SUS430 plate (1mm thickness) as a tritium protector. Selecting the double skin type of vacuum vessel with toroidally continued structure gave the basic design of the vacuum vessel satisfying the design criteria of the vessel strength for the electromagnetic force, heat load and the property of radiation shielding. The characteristics of the SUS316 covered by tungsten plate type is that as the tungsten can shield the {gamma}-ray, the dose rate inside the vacuum vessel during the maintenance can reduce effectively. The advantage of the Ti-6Al-4V alloy covered by SUS430 plate type vacuum vessel is the quick reduction of the radioactive isotope because of no production of the isotopes with long half-life periods. Channel type and vertical type of the divertor were designed. The sector type of toroidally separated structure was selected for the remote handling. The material of the armor plate was not determined because no material endure the high heat load on the divertor. The cryostat composing the dome and the tank was designed. The electromagnetic force by the eddy current, generated at the plasma start up phase and at the quench of CS super-conducting coil, were small compared to the force produced by the stress limit. (author)

  18. Impact of sheath diameter of different sheath types on vascular complications and mortality in transfemoral TAVI approaches using the Proglide closure device.

    Directory of Open Access Journals (Sweden)

    Zisis Dimitriadis

    Full Text Available Evaluation of the impact of the sheath diameter on vascular complications and mortality in transfemoral aortic valve implantation.Between 2012 and 2014, 183 patients underwent the procedure using a sheath diameter of 18-24 F. This collective was divided into two groups: group 1, with a sheath diameter of 18F (G1, n = 94, consisted of patients with 18F Medtronic Sentrant and 18 F Direct Flow sheaths, and group 2 with a sheath diameter of 19-24 F (G2, n = 89 consisted of patients with Edwards expandable e-sheath and Solopath sheaths. Perclose-Proglide® was used as a closure device in all patients.G1 had significantly more female patients (64.9% vs. 46.1% in G2, p = 0.01 and the average BMI was lower (26 ± 4.5% vs. 27.4 ± 4.7%, p = 0.03. There was no significant difference in the incidence of major and minor vascular complications (G1: 12.8% vs. G2: 12.4%, p = 0.9. 30-day mortality was similar in both groups (G1: 6.4 ± 2.5% [95% CI: 0.88-0.98], G2: 3.7 ± 1.9% [95% CI: 0.92-0.99]. The Kaplan Meier analysis of survival revealed no significant differences either.The difference in sheath diameter had no effect on either incidence or severity of vascular complications. There was no impact on mortality either.

  19. Vessel Operating Units (Vessels)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains data for vessels that are greater than five net tons and have a current US Coast Guard documentation number. Beginning in1979, the NMFS...

  20. Restaurant closures

    CERN Document Server

    Novae Restauration

    2012-01-01

    Christmas Restaurant closures Please note that the Restaurant 1 and Restaurant 3 will be closed from Friday, 21 December at 5 p.m. to Sunday, 6 January, inclusive. They will reopen on Monday, 7 January 2013.   Restaurant 2 closure for renovation To meet greater demand and to modernize its infrastructure, Restaurant 2 will be closed from Monday, 17 December. On Monday, 14 January 2013, Sophie Vuetaz’s team will welcome you to a renovated self-service area on the 1st floor. The selections on the ground floor will also be expanded to include pasta and pizza, as well as snacks to eat in or take away. To ensure a continuity of service, we suggest you take your break at Restaurant 1 or Restaurant 3 (Prévessin).

  1. 2013 Vessel Density

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  2. 2011 Passenger Vessel Density

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  3. 2011 Vessel Density

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  4. 2013 Passenger Vessel Density

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  5. 2013 Tanker Vessel Density

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  6. 2013 Cargo Vessel Density

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  7. 2011 Cargo Vessel Density

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  8. 2011 Tanker Vessel Density

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  9. 2013 Fishing Vessel Density

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  10. Field-reversed configuration formed by in-vessel θ-pinch in a tandem mirror device

    Science.gov (United States)

    Lin, Munan; Liu, Ming; Zhu, Guanghui; Shi, Peiyun; Zheng, Jian; Lu, Quanming; Sun, Xuan

    2017-09-01

    We describe a field reversed configuration (FRC) experiment featuring in-vessel θ-pinch coils and open-field-line plasmas confined in a tandem mirror. Two FRCs, formed near the west and the east mirror throats of a central cell, are ejected toward the mid-plane for colliding and merging. Each FRC consists of four groups of pulsed power supplies and four groups of coils, having diameters 35, 35, 40, and 45 cm. The rise time of the main reversal field is 7.15 μs, and the maximum voltage is 40 kV with total currents of 416 kA, corresponding to a magnetic field of 1690 G. The total capacitive stored energy is 115.2 kJ. A fast pulse gas injection system was designed and tested to inject neutral gas into the FRC formation region with controlled directions. The successful installation of the θ-pinch coils inside the vacuum vessel offers greater freedom for diagnostics and control instruments as well as preserving magnetic tandem mirror configuration. The magnetic field reversal is confirmed by internal magnetic field measurements. The plasma temperature, density, and lifetime are, respectively, ˜100 eV, ˜3.0 × 1018 m-3, and ˜300 μs for the current operating conditions.

  11. Complementary techniques of percutaneous closure of ductus ...

    African Journals Online (AJOL)

    East African Medical Journal ... Device closure of the ductus was first performed at the Mater hospital in 1999 in a ten year old male using a five millilitre detachable cook coil. In 2000 the ... We report this single centre experience of percutaneous PDA closure in a resource-limited setting; utilising the two techniques.

  12. Containment vessel drain system

    Energy Technology Data Exchange (ETDEWEB)

    Harris, Scott G.

    2018-01-30

    A system for draining a containment vessel may include a drain inlet located in a lower portion of the containment vessel. The containment vessel may be at least partially filled with a liquid, and the drain inlet may be located below a surface of the liquid. The system may further comprise an inlet located in an upper portion of the containment vessel. The inlet may be configured to insert pressurized gas into the containment vessel to form a pressurized region above the surface of the liquid, and the pressurized region may operate to apply a surface pressure that forces the liquid into the drain inlet. Additionally, a fluid separation device may be operatively connected to the drain inlet. The fluid separation device may be configured to separate the liquid from the pressurized gas that enters the drain inlet after the surface of the liquid falls below the drain inlet.

  13. Tissue effects in vessel sealing and transection from an ultrasonic device with more intelligent control of energy delivery

    OpenAIRE

    Broughton D; Welling AL; Monroe EH; Pirozzi K; Schulte JB; Clymer JW

    2013-01-01

    Duan Broughton,1 Alissa L Welling,1 Emily H Monroe,1 Kristen Pirozzi,2 John B Schulte,1 Jeffrey W Clymer1 1Ethicon Endo-Surgery, Inc., Cincinnati, OH, 2University of Central Florida, Orlando, FL, USA Background: Ultrasonic surgical devices have been demonstrated to provide excellent hemostasis, efficient transection, minimal lateral thermal damage, low smoke generation, and no risk of electrical current passage to the patient. These benefits originate from the inherent characteristics of the...

  14. Vacuum-Assisted Closure for Episiotomy Dehiscence.

    Science.gov (United States)

    Aviki, Emeline M; Batalden, Rebecca Posthuma; del Carmen, Marcela G; Berkowitz, Lori R

    2015-09-01

    Episiotomy dehiscence can result in a large vulvovaginal defect not amenable to delayed primary closure. A 26-year-old woman who underwent a forceps-assisted vaginal delivery with mediolateral episiotomy presented on postpartum day 5 with complete wound breakdown. Surgical exploration of the wound revealed a defect extending from the perineum into the vagina and deep into the ischiorectal fossa with poor tissue quality not amenable to a timely delayed primary closure. A vacuum-assisted closure device was used in lieu of traditional wound preparation and resulted in wound closure after 11 days of vacuum-assisted wound therapy. A vacuum-assisted closure device may be appropriate in cases of complex episiotomy breakdown and may expedite wound healing in the outpatient setting.

  15. Guinea pig ductus arteriosus. II - Irreversible closure after birth.

    Science.gov (United States)

    Fay, F. S.; Cooke, P. H.

    1972-01-01

    To investigate the mechanism underlying irreversibility of ductal closure after birth, studies were undertaken to determine the exact time course for the onset of irreversible closure of the guinea pig ductus arteriosus. Parallel studies of the reactivity of ductal smooth muscle to oxygen and studies of the postpartum cellular changes within the vessel were also carried out.

  16. INTEC CPP-603 Basin Water Treatment System Closure: Process Design

    Energy Technology Data Exchange (ETDEWEB)

    Kimmitt, Raymond Rodney; Faultersack, Wendell Gale; Foster, Jonathan Kay; Berry, Stephen Michael

    2002-09-01

    This document describes the engineering activities that have been completed in support of the closure plan for the Idaho Nuclear Technology and Engineering Center (INTEC) CPP-603 Basin Water Treatment System. This effort includes detailed assessments of methods and equipment for performing work in four areas: 1. A cold (nonradioactive) mockup system for testing equipment and procedures for vessel cleanout and vessel demolition. 2. Cleanout of process vessels to meet standards identified in the closure plan. 3. Dismantlement and removal of vessels, should it not be possible to clean them to required standards in the closure plan. 4. Cleanout or removal of pipelines and pumps associated with the CPP-603 basin water treatment system. Cleanout standards for the pipes will be the same as those used for the process vessels.

  17. 75 FR 68972 - Medical Devices; General and Plastic Surgery Devices; Classification of Tissue Adhesive With...

    Science.gov (United States)

    2010-11-10

    ... Devices; Classification of Tissue Adhesive With Adjunct Wound Closure Device Intended for Topical... Administration (FDA) is classifying the tissue adhesive with adjunct wound closure device intended for topical... Document: Tissue Adhesive With Adjunct Wound Closure Device Intended for the Topical Approximation of Skin...

  18. Preclinical study evaluating a novel trocar site closure system

    Directory of Open Access Journals (Sweden)

    Walker PA

    2016-04-01

    Full Text Available Peter A Walker,1 Shinil K Shah,1,2 Erik B Wilson11Department of Surgery, University of Texas Medical School at Houston, Houston, TX, USA; 2Michael E DeBakey Institute for Comparative Cardiovascular Science and Biomedical Devices, Texas A&M University, College Station, TX, USAIntroduction: Novel trocar closure devices using subperitoneal anchor placement avoid the need for a closed loop suture, and could allow faster trocar site closure with less risk derived from less instrument penetration into the abdominal cavity while decreasing fascial ischemia and tension. We completed a series of animal experiments to compare the Carter-Thomason® suture closure device and neoClose® AnchorGuide device in order to evaluate device safety, efficacy, and ease of utilization.Methods: A porcine model was utilized where 12 mm port sites were closed with either the Carter-Thomason® device or neoClose® AnchorGuide device. Animals were sacrificed at 14 and 56 days after trocar site closure followed by macroscopic and microscopic wound examination. A second group of animals underwent video analysis to evaluate the time required for fascial closure as well as depth of needle passage into the abdomen.Results: All animals survived to the endpoints (14 and 56 days without mortality or trocar site hernia. A trend towards decreased closure times was identified when using the neoClose® device (t=18.5±2.3 seconds compared to closure with the Carter-Thomason® device (t=32.0±8.9 seconds (P=0.153. A significant decrease in the depth of needle penetration was seen with the neoClose® device (t=31.22±1.45 mm compared to closure with the Carter-Thomason device (t=51.0±3.1 mm (P<0.001. Microscopic analysis showed subperitoneal anchor location at 56 days with minimal fibrosis (neoClose® device compared to nearly complete suture degradation with deep intramuscular location (Carter-Thomason device.Conclusion: Novel trocar closure devices could offer decreased deployment

  19. Novas tecnologias, novas complicações: complicações após uso de novos dispositivos de selamento e de trombectomia arterial New technologies, new complications: complications after use of new arterial closure and thrombectomy devices

    Directory of Open Access Journals (Sweden)

    Marcelo Ferreira

    2007-12-01

    Full Text Available Relatamos aqui um caso singular de complicação isquêmica, e também traumática, referente ao uso de dois novos dispositivos para utilização endovascular, ambos no mesmo paciente. Um é um dispositivo hemostático para selamento de punção (Angio-Seal®; - St. Jude Medical e o outro, um cateter para trombectomia rotacional aspirativa percutânea (Rotarex®; - Straub Medical. Discutimos a indicação destes dispositivos em pacientes gravemente enfermos, com quadro de instabilidade hemodinâmica ou em estado de hipercoagulabilidade, associado à doença aterosclerótica femoral, por seu elevado potencial de complicações.We describe a singular case of both ischemic and traumatic complication, referring to use of new devices used for endovascular approach, in the same patient. One is a hemostatic closure device (Angio-Seal®; - St. Jude Medical and the other is a catheter for percutaneous rotational and aspiration thrombectomy (Rotarex®; - Straub Medical. We discuss indication to use these devices in severely ill patients, with hemodynamic instability, or in a state of hypercoagulability, associated with femoral atherosclerotic disease, due to its high potential of complications.

  20. Full closure strategic analysis.

    Science.gov (United States)

    2014-07-01

    The full closure strategic analysis was conducted to create a decision process whereby full roadway : closures for construction and maintenance activities can be evaluated and approved or denied by CDOT : Traffic personnel. The study reviewed current...

  1. PFO closuRE and CryptogenIc StrokE (PRECISE) registry

    DEFF Research Database (Denmark)

    Wöhrle, Jochen; Bertrand, Bernard; Søndergaard, Lars

    2012-01-01

    The Premere™ PFO closure device has a special design for closure of patent foramen ovale (PFO) including a flexible distance and angulation between the right and left disc providing minimal septal distortion. The primary objective of the study was to determine the degree of risk for stroke or tra...... or transient ischemic attack (TIA) in patients after Premere™ PFO closure device implantation....

  2. 2013 East Coast Vessel Tracklines

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  3. 2011 Great Lakes Vessel Tracklines

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  4. 2011 West Coast Vessel Tracklines

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  5. 2013 Great Lakes Vessel Tracklines

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  6. 2011 East Coast Vessel Tracklines

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  7. 2013 West Coast Vessel Tracklines

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  8. 2011 Tug Towing Vessel Density

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  9. Closure The Definitive Guide

    CERN Document Server

    Bolin, Michael

    2010-01-01

    If you're ready to use Closure to build rich web applications with JavaScript, this hands-on guide has precisely what you need to learn this suite of tools in depth. Closure makes it easy for experienced JavaScript developers to write and maintain large and complex codebases -- as Google has demonstrated by using Closure with Gmail, Google Docs, and Google Maps. Author and Closure contributor Michael Bolin has included numerous code examples and best practices, as well as valuable information not available publicly until now. You'll learn all about Closure's Library, Compiler, Templates, tes

  10. The influence of deficient retro-aortic rim on technical success and early adverse events following device closure of secundum atrial septal defects: An Analysis of the IMPACT Registry®.

    Science.gov (United States)

    O'Byrne, Michael L; Gillespie, Matthew J; Kennedy, Kevin F; Dori, Yoav; Rome, Jonathan J; Glatz, Andrew C

    2017-01-01

    Concern regarding aortic erosion has focused attention on the retro-aortic rim in patients undergoing device closure of atrial septal defects (ASD), but its effect on early outcomes is not well studied. A multicenter retrospective cohort study of patients undergoing device occlusion of ASD between 1/2011-10/2014 was performed, using data from the IMproving Pediatric and Adult Congenital Treatment Registry. Subjects were divided between those with retro-aortic rim technical failure and major early adverse events. Case times were measured as surrogates of technical complexity. The effect of deficient retro-aortic rim on primary outcomes was assessed using hierarchical logistic regression, adjusting for other suspected covariates and assessing whether they represent independent risk factors RESULTS: 1,564 subjects (from 77 centers) were included, with deficient retro-aortic rim present in 40%. Technical failure occurred in 91 subjects (5.8%) and a major early adverse event in 64 subjects (4.1%). Adjusting for known covariates, the presence of a deficient retro-aortic rim was not significantly associated with technical failure (OR: 1.3, 95% CI: 0.9-2.1) or major early adverse event (OR: 0.7, 95% CI: 0.4-1. 2). Total case (P = 0.01) and fluoroscopy time (P = 0.02) were greater in subjects with deficient rim, but sheath time was not significantly different (P = 0.07). Additional covariates independently associated with these outcomes were identified. Deficient retro-aortic rim was highly prevalent but not associated with increased risk of technical failure or early adverse events. Studies with longer follow-up are necessary to assess other outcomes, including device erosion. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  11. Options for Closure of the Infected Abdomen

    Science.gov (United States)

    Campbell, Chris A.; Rosenberger, Laura H.; Politano, Amani D.; Davies, Stephen W.; Riccio, Lin M.; Sawyer, Robert G.

    2012-01-01

    Abstract Background The infected abdomen poses substantial challenges to surgeons, and often, both temporary and definitive closure techniques are required. We reviewed the options available to close the abdominal wall defect encountered frequently during and after the management of complicated intra-abdominal infections. Methods A comprehensive review was performed of the techniques and literature on abdominal closure in the setting of intra-abdominal infection. Results Temporary abdominal closure options include the Wittmann Patch, Bogota bag, vacuum-assisted closure (VAC), the AbThera™ device, and synthetic or biologic mesh. Definitive reconstruction has been described with mesh, components separation, and autologous tissue transfer. Conclusion Reconstructing the infected abdomen, both temporarily and definitively, can be accomplished with various techniques, each of which is associated with unique advantages and disadvantages. Appropriate judgment is required to optimize surgical outcomes in these complex cases. PMID:23216525

  12. Research vessels

    Digital Repository Service at National Institute of Oceanography (India)

    Rao, P.S.

    by the research vessels RV Gaveshani and ORV Sagar Kanya are reported. The work carried out by the three charted ships is also recorded. A short note on cruise plans for the study of ferromanganese nodules is added...

  13. An in vivo pilot study of a microporous thin film nitinol-covered stent to assess the effect of porosity and pore geometry on device interaction with the vessel wall.

    Science.gov (United States)

    Chun, Youngjae; Kealey, Colin P; Levi, Daniel S; Rigberg, David A; Chen, Yanfei; Tillman, Bryan W; Mohanchandra, K P; Shayan, Mahdis; Carman, Gregory P

    2017-03-01

    Sputter-deposited thin film nitinol constructs with various micropatterns were fabricated to evaluate their effect on the vessel wall in vivo when used as a covering for commercially available stents. Thin film nitinol constructs were used to cover stents and deployed in non-diseased swine arteries. Swine were sacrificed after approximately four weeks and the thin film nitinol-covered stents were removed for histopathologic evaluation. Histopathology revealed differences in neointimal thickness that correlated with the thin film nitinol micropattern. Devices covered with thin film nitinol with a lateral × vertical length = 20 × 40 µm diamond pattern had minimal neointimal growth with well-organized cell architecture and little evidence of ongoing inflammation. Devices covered with thin film nitinol with smaller fenestrations exhibited a relatively thick neointimal layer with inflammation and larger fenestrations showed migration of inflammatory and smooth muscle cells through the micro fenestrations. This "proof-of-concept" study suggests that there may be an ideal thin film nitinol porosity and pore geometry to encourage endothelialization and incorporation of the device into the vessel wall. Future work will be needed to determine the optimal pore size and geometry to minimize neointimal proliferation and in-stent stenosis.

  14. complementary techniques of percutaneous closure of ductus ...

    African Journals Online (AJOL)

    2013-07-07

    Jul 7, 2013 ... Background: Patent Ductus Arteriosus (PDA) is a common cardiac malformation whose treatment locally has been surgical ligation via a lateral thoracotomy. Device closure of the ductus was first performed at the Mater hospital in 1999 in a ten year old male using a five millilitre detachable cook coil. In 2000 ...

  15. Commentary on Predictors of Failed Primary Abdominal Closure in the Trauma Patient with an Open Abdomen

    Science.gov (United States)

    2013-05-01

    TAC techniques and 18% to 22% with fascial -based methods. Beale and colleagues found no difference between closure rates when fascial -based methods...pressureYbased methods of TAC. As TAC methods have evolved, a combination of these techniques has been termed vacuum-assisted fascial closure, and...with a vacuum-assisted fascial closure technique using the commercially available Vacuum-Assisted Closure (KCI, San Antonio, TX) device with interrupted

  16. Eyelid closure at death

    Directory of Open Access Journals (Sweden)

    A D Macleod

    2009-01-01

    Full Text Available Aim: To observe the incidence of full or partial eyelid closure at death. Materials and Methods: The presence of ptosis was recorded in 100 consecutive hospice patient deaths. Results: Majority (63% of the patients died with their eyes fully closed, however, 37% had bilateral ptosis at death, with incomplete eye closure. In this study, central nervous system tumor involvement and/or acute hepatic encephalopathy appeared to be pre-mortem risk factors of bilateral ptosis at death. Conclusion: Organicity and not psychogenicity is, therefore, the likely etiology of failure of full eyelid closure at death.

  17. Unusual balloon rupture during direct stenting with a TaxusExpress stent in a venous graft complicated by vessel rupture: a device-related fatal event

    DEFF Research Database (Denmark)

    Christiansen, Evald H

    2007-01-01

    distal anastomoses, had two significant stenoses. Percutaneous coronary intervention with distal protection, and direct stenting with a drug-eluting stent, was planned. A 3.00 x 16 mm TaxusExpress (Boston Scientific) was used. At an inflation pressure of 10 atm the stent balloon seemed to extend 20 mm...... proximally with a diameter of 4.5 mm, and the balloon ruptured. Angiography showed rupture of the vessel proximal to the implanted stent, and the patient developed severe hypotension. The rupture was treated with a covered stent and pericardiocentesis was performed with evacuation of 600 mL blood. However...

  18. Sternal exploration or closure

    Science.gov (United States)

    You may have already been receiving wound care or treatment and antibiotics. There are two main reasons for doing exploration and closure procedures for the chest wound after heart surgery: Get rid ...

  19. Vacuum-assisted closure for defects of the abdominal wall.

    Science.gov (United States)

    DeFranzo, Anthony J; Pitzer, Keith; Molnar, Joseph A; Marks, Malcolm W; Chang, Michael C; Miller, Preston R; Letton, Robert W; Argenta, Louis C

    2008-03-01

    Reconstruction of the abdominal wall poses a problem common to many surgical specialties. Abdominal wall defects may be caused by trauma and/or prior surgery, with dehiscence or infection. Several options to repair the structural integrity of the abdominal wall exist, including primary closure, flaps, mesh, and skin grafts. Complications of these procedures include recurrent infection of the abdominal wall, infection of mesh, dehiscence, flap death, and poor skin graft take. Risk factors predisposing to these complications include tissue edema, preoperative tissue infection, and patient debilitation, with poor wound healing potential. Ideally, reconstruction should be performed on a nonedematous, clean tissue bed with bacterial levels less than 10 bacteria/cm in a well-nourished patient. Vacuum-assisted closure was used in a series of patients in an attempt to prepare the abdominal wall for reconstruction and reduce the risk of complications. Charts were reviewed for 100 patients who underwent abdominal wall reconstruction after vacuum-assisted closure therapy. Their wound cause, reconstruction technique, complications, and number of days on the vacuum-assisted closure device are reported. The ability of vacuum-assisted closure to reduce edema, increase blood flow, potentially decrease bacterial colonization, and reduce wound size greatly facilitated abdominal wall reconstruction. The vacuum-assisted closure device served as a temporary dressing with which to control dehiscence and to maintain abdominal wall integrity when bowel wall edema prevented abdominal closure. Vacuum-assisted closure therapy frequently shortened time to abdominal wall reconstruction and simplified the method of reconstruction.

  20. Comparative analysis for evaluating the traceability of interventional devices using blood vessel phantom models made of PVA-H or silicone.

    Science.gov (United States)

    Yu, Chang-Ho; Kwon, Tae-Kyu; Park, Chan Hee; Ohta, Makoto; Kim, Sung Hoon

    2015-01-01

    In this paper, we investigated the parameters with effective traceability to assess the mechanical properties of interventional devices. In our evaluation system, a box-shaped poly (vinyl alcohol) hydrogel (PVA-H) and silicone were prepared with realistic geometry, and the measurement and evaluation of traceability were carried out on devices using load hand force. The phantom models had a total of five curve pathways to reach the aneurysm sac. Traceability depends on the performance of the interventional devices in order to pass through the curved part of the model simulation track. The traceability of the guide wire was found to be much better than that of the balloon and stent loading catheter, as it reached the aneurysm sac in both phantom models. Observation using the video record is another advantage of our system, because the high transparency of the materials with silicone and PVA-H can allow visualization of the inside of an artery.

  1. A hybrid technique for ventricular septal defect closure in young infants.

    Science.gov (United States)

    Bartel, Thomas; Tuzcu, E Murat

    2017-08-01

    Perventricular device closure is a hybrid surgical and transcatheter technique. Perventricular device closure is a safe and effective technique to close muscular VSDs even in infants. TEE guidance is the principal tool for intra-procedural guidance. © 2017 Wiley Periodicals, Inc.

  2. Vessel Patency at 24 Hours and Its Relationship With Clinical Outcomes and Infarct Volume in REVASCAT Trial (Randomized Trial of Revascularization With Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting Within Eight Hours of Symptom Onset).

    Science.gov (United States)

    Millán, Mònica; Remollo, Sebastià; Quesada, Helena; Renú, Arturo; Tomasello, Alejandro; Minhas, Priyanka; Pérez de la Ossa, Natalia; Rubiera, Marta; Llull, Laura; Cardona, Pedro; Al-Ajlan, Fahad; Hernández, María; Assis, Zarina; Demchuk, Andrew M; Jovin, Tudor; Dávalos, Antoni

    2017-04-01

    Higher rates of target vessel patency at 24 hours were noted in the thrombectomy group compared with control group in recent randomized trials. As a prespecified secondary end point, we aimed to assess 24-hour revascularization rates by treatment groups and occlusion site as they related to clinical outcome and 24-hour infarct volume in REVASCAT (Randomized Trial of Revascularization With Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting Within Eight Hours of Symptom Onset). Independent core laboratory adjudicated vessel status according to modified arterial occlusive lesion classification at 24 hours on computed tomographic/magnetic resonance (94.2%/5.8%) angiography and 24-hour infarct volume on computed tomography were studied (95/103 patients in the thrombectomy group versus 94/103 in the control group, respectively). Complete revascularization was defined as modified arterial occlusive lesion grade 3. Its effect on clinical outcome was analyzed by ordinal logistic regression. Complete revascularization was achieved in 70.5% of the solitaire group and in 22.3% of the control group (Prevascularization rates were found for terminus internal carotid artery, M1, and tandem occlusions (all Prevascularization was associated with improved outcome in both thrombectomy (adjusted odds ratio, 4.5; 95% confidence interval, 1.9-10.9) and control groups (adjusted odds ratio, 2.7; 95% confidence interval, 1.0-6.7). Revascularization (modified arterial occlusive lesion grade 2/3) was associated with smaller infarct volumes in either treatment arm. Complete revascularization at 24 hours is a powerful predictor of favorable clinical outcome, whereas revascularization of any type results in reduced infarct volume in both thrombectomy and control groups. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01692379. © 2017 American Heart Association, Inc.

  3. Tank closure reducing grout

    Energy Technology Data Exchange (ETDEWEB)

    Caldwell, T.B.

    1997-04-18

    A reducing grout has been developed for closing high level waste tanks at the Savannah River Site in Aiken, South Carolina. The grout has a low redox potential, which minimizes the mobility of Sr{sup 90}, the radionuclide with the highest dose potential after closure. The grout also has a high pH which reduces the solubility of the plutonium isotopes. The grout has a high compressive strength and low permeability, which enhances its ability to limit the migration of contaminants after closure. The grout was designed and tested by Construction Technology Laboratories, Inc. Placement methods were developed by the Savannah River Site personnel.

  4. Prolonged Eyelid Closure Episodes during Sleep Deprivation in Professional Drivers.

    Science.gov (United States)

    Alvaro, Pasquale K; Jackson, Melinda L; Berlowitz, David J; Swann, Philip; Howard, Mark E

    2016-08-15

    Real life ocular measures of drowsiness use average blink duration, amplitude and velocity of eyelid movements to reflect drowsiness in drivers. However, averaged data may conceal the variability in duration of eyelid closure episodes, and more prolonged episodes that indicate higher levels of drowsiness. The current study aimed to describe the frequency and duration of prolonged eyelid closure episodes during acute sleep deprivation. Twenty male professional drivers (mean age ± standard deviation = 41.9 ± 8.3 years) were recruited from the Transport Workers Union newsletter and newspaper advertisements in Melbourne, Australia. Each participant underwent 24 hours of sleep deprivation and completed a simulated driving task (AusEd), the Psychomotor Vigilance Task, and the Karolinska Sleepiness Scale. Eyelid closure episodes during the driving task were recorded and analyzed manually from digital video recordings. Eyelid closure episodes increased in frequency and duration with a median of zero s/h of eyelid closure after 3 h increasing to 34 s/h after 23 h awake. Eyelid closure episodes were short and infrequent from 3 to 14 h of wakefulness. After 17 h of sleep deprivation, longer and more frequent eyelid closure episodes began to occur. Episodes lasting from 7 seconds up to 18 seconds developed after 20 h of wakefulness. Length of eyelid closure episodes was moderately to highly correlated with the standard deviation of lateral lane position, braking reaction time, crashes, impaired vigilance, and subjective sleepiness. The frequency and duration of episodes of prolonged eyelid closure increases during acute sleep deprivation, with very prolonged episodes after 17 hours awake. Automated devices that assess drowsiness using averaged measures of eyelid closure episodes need to be able to detect prolonged eyelid closure episodes that occur during more severe sleep deprivation. © 2016 American Academy of Sleep Medicine.

  5. Which Patent Foramen Ovales Need Closure to Prevent Cryptogenic Strokes?

    Science.gov (United States)

    Dalen, James E; Alpert, Joseph S

    2018-03-01

    Patients with cryptogenic strokes are more likely to have a patent foremen ovale than in the general population. It is speculated that these strokes are due to paradoxical embolism, that is, passage of a venous thrombus across the patent foremen ovale to enter the arterial circulation, resulting in an embolic stroke. Venous thromboembolism is rarely present in these cases of cryptogenic stroke. Thousands of patients with cryptogenic strokes have undergone transcatheter closure of their patent foremen ovale via a variety of devices. The first 3 randomized clinical trials comparing patent foremen ovale closure with medical therapy failed to show a significant advantage of patent foremen ovale closure. Three additional trials reported in 2017 had longer years of follow-up and demonstrated an advantage of patent foremen ovale closure versus medical therapy. Analysis of their data indicated that patent foremen ovale closure in patients with an atrial septal aneurysm in addition to a patent foremen ovale had a very significant decrease in cryptogenic strokes (P patent foremen ovale closure (P = .37). Aneurysms of the atrial septum are easily recognized by echocardiography and are present in approximately one-third of patients with patent foremen ovales. These data suggest that closure of patent foremen ovales in patients with an atrial septal aneurysm is indicated. In patients with a patent foremen ovale without an aneurysm of the atrial septum, patent foremen ovale closure is not indicated. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. 40 CFR 264.113 - Closure; time allowed for closure.

    Science.gov (United States)

    2010-07-01

    ... corrective action program, compile all ground-water monitoring data, and evaluate the effect of the continued... assurance for closure and post-closure care as necessary and appropriate, to reflect any changes due to the presence of hazardous constituents in the non-hazardous wastes, and changes in closure activities...

  7. 2013 Gulf of Mexico Vessel Tracklines

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  8. 2013 Tug and Towing Vessel Density

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  9. 2011 Pleasure Craft Sailing Vessel Density

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  10. 2011 Gulf of Mexico Vessel Tracklines

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  11. 2013 Pleasure Craft and Sailing Vessel Density

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Automatic Identification Systems (AIS) are a navigation safety device that transmits and monitors the location and characteristics of many vessels in U.S. and...

  12. Effect of Orofacial Myofunctional Exercise Using an Oral Rehabilitation Tool on Labial Closure Strength, Tongue Elevation Strength and Skin Elasticity

    National Research Council Canada - National Science Library

    Ibrahim, Fatimah; Arifin, Nooranida; Rahim, Zubaidah H A

    2013-01-01

    [Purpose] This paper reports the effects of orofacial myofunctional exercise using an oral cavity rehabilitation device on physiological parameters that include labial closure strength, tongue elevation...

  13. ROCKET PORT CLOSURE

    Science.gov (United States)

    Mattingly, J.T.

    1963-02-12

    This invention provides a simple pressure-actuated closure whereby windowless observation ports are opened to the atmosphere at preselected altitudes. The closure comprises a disk which seals a windowless observation port in rocket hull. An evacuated instrument compartment is affixed to the rocket hull adjacent the inner surface of the disk, while the outer disk surface is exposed to the atmosphere through which the rocket is traveling. The pressure differential between the evacuated instrument compartment and the relatively high pressure external atmosphere forces the disk against the edge of the observation port, thereby effecting a tight seai. The instrument compartment is evacuated to a pressure equal to the atmospheric pressure existing at the altitude at which it is desiretl that the closure should open. When the rocket reaches this preselected altitude, the inwardly directed atmospheric force on the disk is just equaled by the residual air pressure force within the instrument compartment. Consequently, the closure disk falls away and uncovers the open observation port. The separation of the disk from the rocket hull actuates a switch which energizes the mechanism of a detecting instrument disposed within the instrument compartment. (AE C)

  14. Mail Office annual closure

    CERN Multimedia

    2013-01-01

    On the occasion of the annual closure of CERN, there will be no mail distributed on Friday 20 December 2013 but mail will be collected in the morning. Nevertheless, you will still be able to bring your outgoing mail to Building 555-R-002 until 12 noon.  

  15. Ring closure in actin polymers

    Energy Technology Data Exchange (ETDEWEB)

    Sinha, Supurna, E-mail: supurna@rri.res.in [Raman Research Institute, Bangalore 560080 (India); Chattopadhyay, Sebanti [Doon University, Dehradun 248001 (India)

    2017-03-18

    We present an analysis for the ring closure probability of semiflexible polymers within the pure bend Worm Like Chain (WLC) model. The ring closure probability predicted from our analysis can be tested against fluorescent actin cyclization experiments. We also discuss the effect of ring closure on bend angle fluctuations in actin polymers. - Highlights: • Ring closure of biopolymers. • Worm like chain model. • Predictions for experiments.

  16. Ring closure in actin polymers

    OpenAIRE

    Sinha, Supurna; Chattopadhyay, Sebanti

    2017-01-01

    We present an analysis for the ring closure probability of semiflexible polymers within the pure bend Worm Like Chain (WLC) model. The ring closure probability predicted from our analysis can be tested against fluorescent actin cyclization experiments.We also discuss the effect of ring closure on bend angle fluctuations in actin polymers.

  17. Vessel Operator System

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Operator cards are required for any operator of a charter/party boat and or a commercial vessel (including carrier and processor vessels) issued a vessel permit from...

  18. Wound closure of leg fasciotomy: comparison of vacuum-assisted closure versus shoelace technique. A randomised study.

    Science.gov (United States)

    Kakagia, D; Karadimas, E J; Drosos, G; Ververidis, A; Trypsiannis, G; Verettas, D

    2014-05-01

    Fasciotomies, though essential for the prevention and management of compartment syndromes, may increase morbidity and prolong hospitalisation. Two widely applied methods of delayed primary closure are compared in leg fasciotomy wounds. Two groups, each of 25 patients with leg fasciotomies due to fractures and soft tissue injuries, who were randomly assigned to be treated either by vacuum assisted closure (VAC®, n=42 wounds, group V) or by the shoelace technique (n=40 wounds, group S), were evaluated in this study. Wound length, time to definite closure, complications, need for additional interventions and daily treatment costs were data collected and statistically assessed. Wound closure time was significantly higher in group V compared to group S (p=0.001; 95% CI of the difference, 1.8-6.3 days). Five group V patients required split thickness skin grafts. In six group S patients, the vessel loops had to be replaced. The mean daily cost of negative pressure therapy alone was 135 euro (range 117-144 euro), whilst the mean daily cost of treatment for the shoelace technique was 14 euro ranging from 8 to 18 euro (p=closure of leg fasciotomy wounds. VAC® requires longer time to definite wound closure and is far more expensive than the shoelace technique, especially when additional skin grafting is required. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Summer season | Cafeteria closures

    CERN Multimedia

    2013-01-01

    Please note the following cafeteria closures over the summer season: Bldg. 54 closed from 29/07/2013 to 06/09/2013. Bldg. 13: closed from 13/07/2013 to 06/09/2013. Restaurant No. 2, table service (brasserie and restaurant): closed from 01/08/2013 to 06/09/2013. Bldg. 864: closed from 29/07/2013 to 06/09/2013. Bldg. 865: closed from 29/07/2013 to 06/09/2013.

  20. Alergia al néquel manifestada como edema pulmonar no cardiogénico en paciente pos-cierre de comunicación interauricular con dispositivo tipo Amplatzer Nickel allergy manifested as noncardiogenic pulmonary edema in a patient post-closure of atrial septal defect with Amplatzer device

    Directory of Open Access Journals (Sweden)

    Luis A Gutiérrez

    2012-10-01

    Full Text Available El cierre percutáneo es la modalidad predilecta para el tratamiento de los defectos septales tipo ostium secundum cuando la anatomía es favorable, y reporta una tasa de éxito excelente así como también un bajo porcentaje de complicaciones. Se presenta el caso de un cierre exitoso de defecto septal tipo ostium secundum con dispositivo tipo Amplatzer en un paciente con antecedente de alergia a metales no detectada previamente, quien presentó edema pulmonar no cardiogénico, fiebre y pericarditis secundarios al níquel del dispositivo, pero tuvo mejoría y evolución satisfactoria con tratamiento médico.The percutaneous closure of ostium secundum septal defects is the preferred treatment modality when the anatomy is appropriate, as it shows high success and low complication rates. We present a case of a succesful percutaneous closure of an ostium secundum septal defect with an Amplatzer septal occluder device in a patient with an undetected metal allergy which led her to non cardiogenic pulmonary edema, fever and pericarditis related to the nickel contained in the device, with improvement and satisfactory evolution after medical treatment.

  1. Patent foramen ovale closure to prevent secondary neurologic events.

    Science.gov (United States)

    Jasper, Rosie; Blankenship, James C

    2017-10-01

    In October of 2016 the United States Food and Drug Administration approved the Amplatzer Patent Foramen Ovale (PFO) occluder device for use in patients with cryptogenic stroke, to reduce the risk of recurrent stroke. This event followed 15years of off-label use of atrial septal occluder devices, 3 randomized trials, and enormous controversy over the efficacy of this procedure. While none of the trials reached the primary endpoint needed to prove the efficacy of PFO closure in preventing recurrent stroke, meta-analyses and 5-year follow-up of 1 trial suggest that PFO closure decreases the risk of recurrent stroke, especially in sub-groups with large shunts and atrial septal aneurysms, and especially when the Amplatzer device (rather than other devices) is used. While the relative reduction in stroke associated with PFO closure is large (about 50%), the absolute reduction is low (1-2%) and must be balanced against complications of the procedure (about 3%). Thus, PFO closure is restricted to patients with cryptogenic stroke, and depends heavily on patients' personal preferences. Uncertainties about the etiology of stroke in patients with PFO and the efficacy of PFO closure cause a difficult problem for the internal medicine specialist. At one extreme the internist may wonder if every patient with a documented PFO should be referred to a cardiologist. At the other extreme, supported by specialty society guidelines, internists may conclude that PFO closure is rarely necessary. In this paper we review the current status of PFO closure and suggest a rational strategy for this procedure. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  2. RELAP-7 Closure Correlations

    Energy Technology Data Exchange (ETDEWEB)

    Zou, Ling [Idaho National Lab. (INL), Idaho Falls, ID (United States); Berry, R. A. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Martineau, R. C. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Andrs, D. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Zhang, H. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Hansel, J. E. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Sharpe, J. P. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Johns, Russell C. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-04-01

    The RELAP-7 code is the next generation nuclear reactor system safety analysis code being developed at the Idaho National Laboratory (INL). The code is based on the INL’s modern scientific software development framework, MOOSE (Multi-Physics Object Oriented Simulation Environment). The overall design goal of RELAP-7 is to take advantage of the previous thirty years of advancements in computer architecture, software design, numerical integration methods, and physical models. The end result will be a reactor systems analysis capability that retains and improves upon RELAP5’s and TRACE’s capabilities and extends their analysis capabilities for all reactor system simulation scenarios. The RELAP-7 code utilizes the well-posed 7-equation two-phase flow model for compressible two-phase flow. Closure models used in the TRACE code has been reviewed and selected to reflect the progress made during the past decades and provide a basis for the colure correlations implemented in the RELAP-7 code. This document provides a summary on the closure correlations that are currently implemented in the RELAP-7 code. The closure correlations include sub-grid models that describe interactions between the fluids and the flow channel, and interactions between the two phases.

  3. Complications in transcatheter closure of congenital portosystemic venous shunt using Amplatzer Vascular Plug

    Directory of Open Access Journals (Sweden)

    Jun Muneuchi

    2017-10-01

    Full Text Available Amplatzer Vascular Plug (AVP has been utilized to occlude a congenital portosystemic venous shunt (CPSVS that is a rare splanchnic venous anomaly. We present a case of a 12-year-old boy in whom device migration and portal vein thrombosis occurred after transcatheter closure of CPSVS using AVP type2. We reviewed the published literatures regarding with complications of CPSVS closure using AVP. Among 23 patients, we identified 5 complications including hypovolemic shock, hypoxia, liver dysfunction, device migration, and thrombosis. It is recommended to choose a device more than twice the diameter of the shunt, and to treat with an anticoagulant after closure.

  4. MNC Subsidiary Closure

    DEFF Research Database (Denmark)

    de Faria, Pedro; Sofka, Wolfgang; Torres Preto, Miguel

    We investigate the consequences of MNC subsidiary closures for employees who lose their jobs. We ask to what degree the foreign knowledge that they were exposed to is valued in their new job. We argue theoretically that this foreign knowledge is both valuable and not readily available in the host...... country but is also distant and therefore difficult to absorb. We predict an inverse u-shaped relationship between the exposure to foreign knowledge and the salary in the new job. We empirically support our predictions for a sample of almost 140,000 affected employees in Portugal from 2002 to 2009....

  5. MNC Subsidiary Closure

    DEFF Research Database (Denmark)

    de Faria, Pedro; Preto, Miguel Torres; Sofka, Wolfgang

    2013-01-01

    We investigate the consequences of MNC subsidiary closures for employees who lose their jobs. We ask to what degree the foreign knowledge that they were exposed to is valued in their new job. We argue theoretically that this foreign knowledge is both valuable and not readily available in the host...... country but is also distant and therefore difficult to absorb. We predict an inverse u-shaped relationship between the exposure to foreign knowledge and the salary in the new job. We empirically support our predictions for a sample of almost 140,000 affected employees in Portugal from 2002 to 2009....

  6. Empirical Correlates of Narrative Closure

    Directory of Open Access Journals (Sweden)

    Tobias Klauk

    2016-06-01

    Full Text Available This paper presents an experimental investigation of the narratological concept of narrative closure. While narrative closure is a well-studied phenomenon in contemporary narratology, it still lacks a serious empirical foundation. In order to fill that lacuna, we performed a controlled rating experiment aimed at validating some of the properties of narrative closure proposed in the narratological literature. Our results suggest that narrative closure is closely related to two connected properties: to the completeness of the text and to questions left open by the text.

  7. Use of the Perclose ProGlide device with the 9 French Merci retrieval system

    Energy Technology Data Exchange (ETDEWEB)

    Layton, Kennith F.; Cloft, Harry J.; Kallmes, David F. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); White, J. Bradley [Mayo Clinic, Department of Neurosurgery, Rochester, MN (United States)

    2006-05-15

    Closure devices are commonly used in neurointerventional procedures to achieve groin hemostasis. These devices are particularly useful in procedures requiring anticoagulation and larger catheters. The suture-mediated Perclose ProGlide device is intended for use with 5F to 8F sheaths. We describe the use of the ProGlide device with 9F sheaths in acute stroke treatment using the Merci retrieval device. The ProGlide device is advanced over a wire until the wire exit port is at the skin surface. The wire is removed and the device is advanced until pulsatile blood flow is encountered. The footplates are opened and the stitch is deployed. The footplates are then closed and the device is removed. After advancing the suture to the vessel, it is locked and trimmed. Firm pressure is necessary during deployment to prevent oozing around the device. If continued bleeding is encountered, direct manual pressure is used to achieve hemostasis. We have successfully used the Perclose ProGlide device in four patients following the Merci retriever without groin or extremity complication. The Perclose ProGlide device can be successfully used after placement of a 9F system in patients who have undergone mechanical thrombectomy. (orig.)

  8. FINAL CLOSURE PLAN SURFACE IMPOUNDMENTS CLOSURE, SITE 300

    Energy Technology Data Exchange (ETDEWEB)

    Lane, J E; Scott, J E; Mathews, S E

    2004-09-29

    Lawrence Livermore National Laboratory of the University of California (LLNL) operates two Class II surface impoundments that store wastewater that is discharged from a number of buildings located on the Site 300 Facility (Site 300). The wastewater is the by-product of explosives processing. Reduction in the volume of water discharged from these buildings over the past several years has significantly reduced the wastewater storage needs. In addition, the impoundments were constructed in 1984, and the high-density polyethylene (HDPE) geomembrane liners are nearing the end of their service life. The purpose of this project is to clean close the surface impoundments and provide new wastewater storage using portable, above ground storage tanks at six locations. The tanks will be installed prior to closure of the impoundments and will include heaters for allowing evaporation during relatively cool weather. Golder Associates (Golder) has prepared this Final Closure Plan (Closure Plan) on behalf of LLNL to address construction associated with the clean closure of the impoundments. This Closure Plan complies with State Water Resources Control Board (SWRCB) Section 21400 of the California Code of Regulations Title 27 (27 CCR {section}21400). As required by these regulations and guidance, this Plan provides the following information: (1) A site characterization, including the site location, history, current operations, and geology and hydrogeology; (2) The regulatory requirements relevant to clean closure of the impoundments; (3) The closure procedures; and, (4) The procedures for validation and documentation of clean closure.

  9. BIOASSAY VESSEL FAILURE ANALYSIS

    Energy Technology Data Exchange (ETDEWEB)

    Vormelker, P

    2008-09-22

    Two high-pressure bioassay vessels failed at the Savannah River Site during a microwave heating process for biosample testing. Improper installation of the thermal shield in the first failure caused the vessel to burst during microwave heating. The second vessel failure is attributed to overpressurization during a test run. Vessel failure appeared to initiate in the mold parting line, the thinnest cross-section of the octagonal vessel. No material flaws were found in the vessel that would impair its structural performance. Content weight should be minimized to reduce operating temperature and pressure. Outer vessel life is dependent on actual temperature exposure. Since thermal aging of the vessels can be detrimental to their performance, it was recommended that the vessels be used for a limited number of cycles to be determined by additional testing.

  10. Extender for securing a closure

    Science.gov (United States)

    Thomas, II, Patrick A.

    2012-10-02

    An apparatus for securing a closure such as door or a window that opens and closes by movement relative to a fixed structure such as a wall or a floor. Many embodiments provide a device for relocating a padlock from its normal location where it secures a fastener (such as a hasp) to a location for the padlock that is more accessible for locking and unlocking the padlock. Typically an extender is provided, where the extender has a hook at a first end that is disposed through the eye of the staple of the hasp, and at an opposing second end the extender has an annulus, such as a hole in the extender or a loop or ring affixed to the extender. The shackle of the padlock may be disposed through the annulus and may be disposed through the eye of a second staple to secure the door or window in a closed or open position. Some embodiments employ a rigid sheath to enclose at least a portion of the extender. Typically the rigid sheath has an open state where the hook is exposed outside the sheath and a closed state where the hook is disposed within the sheath.

  11. Design Procedure on Stud Bolt for Reactor Vessel Assembly

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong-Wook; Lee, Gyu-Mahn; Jeoung, Kyeong-Hoon; Kim, Tae-Wan; Park, Keun-Bae; Kim, Keung-Koo

    2008-10-15

    The reactor pressure vessel flange is welded to the upper part of reactor pressure vessel, and there are stud holes to mount the closure head with stud bolts. The surface mating the closure head is compressed with O-ring, which acts as a sealing gasket to prevent coolant leakage. Bolted flange connections perform a very important structural role in the design of a reactor pressure vessel. Their importance stems from two important functions: (a) maintenance of the structural integrity of the connection itself, and (b) prevention of leakage through the O-ring preloaded by stud bolts. In the present study, an evaluation procedure for the design of stud bolt is developed to meet ASME code requirements. The developed design procedure could provide typical references in the development of advanced reactor design in the future.

  12. Perturbed airway closure

    Science.gov (United States)

    Grotberg, James B.; Halpern, David

    1998-11-01

    The small airways of the lungs are lined with a thin viscous film. A surface-tension driven instability at the air-liquid interface may induce the formation of a liquid bridge blocking airflow if there is sufficient fluid within the film. As a result of the pressures generated within the non-uniform film, the airway wall may also collapse. These instabilities often occur in premature neonates who do not produce sufficient quantities of surfactant. Often, they are placed in ventilators to diminish the risk of airway closure. Two fundamental parameters are the frequency of the ventilation and the tidal volume of the delivered gas. In the current study, we consider the effect of an oscillatory shear stress impinged by the air on a thin film coating a single compliant tube. Nonlinear evolution equations are derived for the film thickness and the wall position. Numerical solutions show that the oscillatory shear stress can saturate the growth of a disturbance at the air-liquid interface. For a given film thickness, there is a critical frequency, dependent on wall parameters, above which closure does not occur when forced by oscillatory shear but will close when unforced.

  13. Fatigue testing of three peristernal median sternotomy closure techniques

    Directory of Open Access Journals (Sweden)

    Griffin Lanny V

    2008-09-01

    Full Text Available Abstract Background Failure of a sternotomy closure because of closure system fatigue is a complication that may result in dehiscence and put the individual at risk for serious complications. The purpose of this study was to assess the fatigue performance of three peristernal median sternotomy closure techniques (figure-of-eight stainless-steel wires, figure-of-eight stainless-steel cables, or Pectofix Dynamic Sternal Fixation [DSF] stainless-steel plates in order to quantify the potential risk of fatigue failure of these devices when subject to cyclic loads in physiologically relevant loading directions. Study Design All tests were conducted on polyurethane foam sternal models. A cardiothoracic surgeon divided each sternal model longitudinally and repaired it with a closure device. Tests were performed using a materials testing system that applied cyclic loading in a uniaxial direction until the test model catastrophically broke or data run-out occurred. For each loading direction (lateral distraction and longitudinal shear, five trials of each closure technique were tested. Life data and location of device failure (if present were evaluated. Statistical analysis was performed using regression with life data allowed for correlation between life data and the various closure techniques to develop risk assessment curves for each device. Results The data show that the figure-of-eight stainless-steel cable and the DSF plate systems are considerably less likely to fail under both lateral distraction and longitudinal shear cyclic loading conditions as compared to the figure-of-eight stainless-steel wire system. Moreover, the figure-of-eight stainless-steel cable system is the most resistant to failure, particularly for high cycle counts. Conclusion This study in addition to Cohen and Griffin's earlier published biomechanical comparison of the ultimate strength of these same three closure techniques provide extensive experimental evidence regarding the

  14. 40 CFR 265.1102 - Closure and post-closure care.

    Science.gov (United States)

    2010-07-01

    ..., STORAGE, AND DISPOSAL FACILITIES Containment Buildings § 265.1102 Closure and post-closure care. (a) At closure of a containment building, the owner or operator must remove or decontaminate all waste residues... applies. The closure plan, closure activities, cost estimates for closure, and financial responsibility...

  15. Assessment of the attenuation of an intra-abdominal vein by use of a silicone-polyacrylic acid gradual venous occlusion device in dogs and cats.

    Science.gov (United States)

    Wallace, Mandy L; Ellison, Gary W; Giglio, Robson F; Batich, Christopher D; Berry, Clifford R; Case, J Brad; Kim, Stanley E

    2016-06-01

    OBJECTIVE To evaluate the closure rate and completeness of closure for a silicone-polyacrylic acid gradual venous occlusion device placed around an intra-abdominal vein to simulate gradual occlusion of an extrahepatic portosystemic shunt. ANIMALS 3 purpose-bred cats and 2 purpose-bred dogs. PROCEDURES The device was surgically placed around an external (cats) or internal (dogs) iliac vein. Computed tomographic angiography was performed at the time of surgery and 2, 4, and 6 weeks after surgery. Ultrasonographic examinations of blood flow through the vein within the device were performed at the time of surgery and at weekly intervals thereafter. Dogs were euthanized 6 weeks after surgery, and the external iliac veins were harvested for histologic examination. RESULTS The prototype gradual venous occlusion device was successfully placed in all animals, and all animals recovered without complications following the placement procedure. The vessel was completely occluded in 2 cats by 6 weeks after surgery, as determined on the basis of results of CT and ultrasonography; there was incomplete occlusion with a luminal diameter of 1.5 mm in the other cat by 6 weeks after surgery. The vessel was completely occluded in both dogs by 6 weeks after surgery. Histologic examination of the external iliac veins obtained from the dogs revealed minimal inflammation of the vessel wall and no thrombus formation. CONCLUSIONS AND CLINICAL RELEVANCE The prototype device induced gradual attenuation of an intra-abdominal vessel over a 6-week period. This device may provide another option for gradual occlusion of extrahepatic portosystemic shunts.

  16. Photochemical Thrombosis Of Retinal And Choroidal Vessels Using Rose Bengal

    Science.gov (United States)

    Lewis, Mary Lou; Winward, Kirk; Watson, Brant D.; Hernandez, Eleut

    1989-09-01

    Rose bengal is an effective photosensitizing agent which interacts with argon green light to induce photochemical thrombosis of irradiated vessels. We used focal, low energy irradiation to occlude retinal and choroidal vessels in both albino and pigmented rabbits. Immediately after intravenous injection of rose bengal at concentrations of 10 and 20 mg/kg, irradiation was performed via a slit lamp-delivered argon green laser (514.5 nm) with the aid of fundus contact lens. In 11 eyes, arteries were treated with 50-100 interrupted bursts of 75u spot size at 0.2 sec and 40-100 mW (9 closure of retinal vessels for 1-12 days and variable closure of the surrounding capillaris. Eight eyes were treated with continuous irradiation 2-5 minutes at 7.5-40 mW, 75u spot size (35 closure of retinal and choroidal vessels, serous elevation of the retina, and disc neovascularization. In eight eyes choroidal vessels were irradiated with 10-20 mW, 15-60 sec, 500u spot size (31 closure of choroidal vessels. There was minimal damage to surrounding tissue. Control eyes in all three groups irradiated utilizing the same parameters, but without rose bengal, demonstrated no evidence of thermal injury.

  17. 31. Left ventricular dysfunction after patent ductus arteriosus (PDA closure

    Directory of Open Access Journals (Sweden)

    Rihab Agouba

    2015-10-01

    Conclusions: Depressed LV-SFx may occur after PDA closure with higher incidence after catheter PDA device occlusion. All of preterm babies had surgical PDA occlusion and none of them presented with depressed LV-SFx in the post-operative follow-up. Further prospective studies are needed to investigate these observations.

  18. CLOSURE WELD DEVELOPMENT FOR 3013 OUTER CONTAINERS

    Energy Technology Data Exchange (ETDEWEB)

    Daugherty, W.; Howard, S.; Peterson, K.; Stokes, M.

    2009-11-10

    Excess plutonium materials in the DOE complex are packaged and stored in accordance with DOE-STD-3013. This standard specifies requirements for the stabilization of such materials and subsequent packaging in dual nested seal-welded containers. Austenitic stainless steels have been selected for container fabrication. The inner 3013 container provides contamination control while the outer 3013 container is the primary containment vessel and is the focus of this paper. Each packaging site chose a process for seal welding the outer 3013 containers in accordance with its needs and expertise. The two processes chosen for weld closure were laser beam welding (LBW) and gas tungsten arc welding (GTAW). Following development efforts, each system was qualified in accordance with DOE-STD-3013 prior to production use. The 3013 outer container closure weld joint was designed to accommodate the characteristics of a laser weld. This aspect of the joint design necessitated some innovative process and equipment considerations in the application of the GTAW process. Details of the weld requirements and the development processes are presented and several potential enhancements for the GTAW system are described.

  19. Closure of the cystic duct during laparoscopic cholecystectomy with a new feedback-controlled bipolar sealing system in case of biliary obstruction--an experimental study in pigs.

    Science.gov (United States)

    Shamiyeh, A; Vattay, P; Tulipan, L; Schrenk, P; Bogner, S; Danis, J; Wayand, W

    2004-01-01

    The excellent results of new devices like the new bipolar feedback-controlled sealing system (LigaSure) for closure of blood vessels encouraged surgeons to use these instruments for other structures like bile ducts. The aim of this study was to evaluate the feasibility of closure of cystic duct in case of biliary obstruction. Ten domestic pigs underwent laparoscopic cholecystectomy sealing the cystic duct with LigaSure. The common bile duct was closed with an endoclip to create a biliary hypertension. On the 12th postoperative day blood samples were taken for liver enzymes. At autopsy on day 15 the pigs were investigated for bile leaks or biliary peritonitis. The cystic duct was resected for histological examination. Seven pigs survived, one pig died during introduction of anesthesia, one on the 1st and one on the 2nd postoperative day without any findings at the autopsy. One pig out of 7 had a bile leak; the other 6 were without any sign of leakage. Histologically 3 pigs had a regular coagulation zone at the cystic duct, 3 had a total necrosis, one a partial necrosis of the mucosa only. Though there was only one insufficiency, the feedback-controlled bipolar vessel sealer cannot be recommended for biliary surgery with regard to the high rate of necrosis stated in our experiment.

  20. Marine Sanitation Devices (MSDs)

    Science.gov (United States)

    Marine sanitation devices treat or retain sewage from vessels, and have performance standards set by the EPA. This page provides information on MSDs, including who must use an MSD, states' roles, types of MSDs and standards.

  1. Delayed dynamic abdominal wall closure following multi-visceral transplantation.

    Science.gov (United States)

    Iype, Satheesh; Butler, Andrew; Jamieson, Neville; Middleton, Stephen; Jah, Asif

    2014-01-01

    Primary closure of the abdominal wall following intestinal transplantation or multivisceral transplantation could become a challenging problem in a significant number of patients. A 38-year-old woman with familial adenomatous polyposis (FAP) underwent a multi-visceral transplantation for short gut syndrome. She subsequently developed acute graft rejection that proved resistant to conventional treatment. She was relisted and underwent re-transplantation along with kidney transplantation. Abdominal wall closure could not be achieved because of the large size of the graft and bowel oedema. The wound was initially managed with laparostomy followed by insertion of the delayed dynamic abdominal closure (DDAC) device (Abdominal Retraction Anchor - ABRA(®) system). Continuous dynamic traction to the wound edges resulted in gradual approximation and complete closure of the abdominal wound was achieved within 3 weeks. Successful abdominal closure after multivisceral transplantation or isolated intestinal transplantation often requires biological mesh, vascularised flaps or abdominal wall transplantation. DDAC eliminated the need for a prosthetic mesh or skin graft and provided an excellent cosmetic result. Adjustment of the dynamic traction at the bedside minimised the need for multiple returns to the operating theatre. It resulted in a well-healed linear scar without a hernia. Dynamic traction allows delayed closure of laparotomy resulting in strong and cosmetically sound wound healing with native tissue. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. ICPP tank farm closure study. Volume 2: Engineering design files

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-02-01

    Volume 2 contains the following topical sections: Tank farm heel flushing/pH adjustment; Grouting experiments for immobilization of tank farm heel; Savannah River high level waste tank 20 closure; Tank farm closure information; Clean closure of tank farm; Remediation issues; Remote demolition techniques; Decision concerning EIS for debris treatment facility; CERCLA/RCRA issues; Area of contamination determination; Containment building of debris treatment facility; Double containment issues; Characterization costs; Packaging and disposal options for the waste resulting from the total removal of the tank farm; Take-off calculations for the total removal of soils and structures at the tank farm; Vessel off-gas systems; Jet-grouted polymer and subsurface walls; Exposure calculations for total removal of tank farm; Recommended instrumentation during retrieval operations; High level waste tank concrete encasement evaluation; Recommended heavy equipment and sizing equipment for total removal activities; Tank buoyancy constraints; Grout and concrete formulas for tank heel solidification; Tank heel pH requirements; Tank cooling water; Evaluation of conservatism of vehicle loading on vaults; Typical vault dimensions and approximately tank and vault void volumes; Radiological concerns for temporary vessel off-gas system; Flushing calculations for tank heels; Grout lift depth analysis; Decontamination solution for waste transfer piping; Grout lift determination for filling tank and vault voids; sprung structure vendor data; Grout flow properties through a 2--4 inch pipe; Tank farm load limitations; NRC low level waste grout; Project data sheet calculations; Dose rates for tank farm closure tasks; Exposure and shielding calculations for grout lines; TFF radionuclide release rates; Documentation of the clean closure of a system with listed waste discharge; and Documentation of the ORNL method of radionuclide concentrations in tanks.

  3. Guam Abandoned Vessel Inventory

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Guam. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  4. Florida Abandoned Vessel Inventory

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Florida. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  5. Vessel Arrival Info - Legacy

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Vessel Arrival Info is a spreadsheet that gets filled out during the initial stage of the debriefing process by the debriefer. It contains vessel name, trip...

  6. ALICE HMPID Radiator Vessel

    CERN Multimedia

    2003-01-01

    View of the radiator vessels of the ALICE/HMPID mounted on the support frame. Each HMPID module is equipped with 3 indipendent radiator vessels made out of neoceram and fused silica (quartz) windows glued together. The spacers inside the vessel are needed to stand the hydrostatic pressure. http://alice-hmpid.web.cern.ch/alice-hmpid

  7. 40 CFR 63.170 - Standards: Surge control vessels and bottoms receivers.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Standards: Surge control vessels and... Standards: Surge control vessels and bottoms receivers. Each surge control vessel or bottoms receiver that... surge control vessel or bottoms receiver back to the process or to a control device that complies with...

  8. Pulmonary edema following transcatheter closure of atrial septal defect

    Directory of Open Access Journals (Sweden)

    Keerthi Chigurupati

    2015-01-01

    Full Text Available We describe an incident of development of acute pulmonary edema after the device closure of a secundum atrial septal defect in a 52-year-old lady, which was treated with inotropes, diuretics and artificial ventilation. Possibility of acute left ventricular dysfunction should be considered after the defect closure in the middle-aged patients as the left ventricular compliance may be reduced due to increased elastic stiffness and diastolic dysfunction. Baseline left atrial pressure may be > 10 mmHg in these patients. Associated risk factors for the left ventricular dysfunction are a large Qp:Qs ratio, systemic hypertension, severe pulmonary hypertension and paroxysmal atrial fibrillation.

  9. Closure report for N Reactor

    Energy Technology Data Exchange (ETDEWEB)

    1994-01-01

    This report has been prepared to satisfy Section 3156(b) of Public Law 101-189 (Reports in Connection with Permanent Closures of Department of Energy Defense Nuclear Facilities), which requires submittal of a Closure Report to Congress by the Secretary of Energy upon the permanent cessation of production operations at a US Department of Energy (DOE) defense nuclear facility (Watkins 1991). This closure report provides: (1) A complete survey of the environmental problems at the facility; (2) Budget quality data indicating the cost of environmental restoration and other remediation and cleanup efforts at the facility; (3) A proposed cleanup schedule.

  10. [Interventional stroke prophylaxis : endocardial and epicardial left atrial appendage closure].

    Science.gov (United States)

    Rillig, A; Heeger, C H; Kuck, K H; Tilz, R R

    2015-02-01

    Atrial fibrillation (AF) is currently one of the major causes of ischemic stroke with an estimated stroke risk of 5% per year. Oral anticoagulation is an effective treatment for the reduction of stroke risk in patients with AF but is also associated with an increased risk of bleeding. In patients with AF it has been shown that left atrial thrombi can be identified within the left atrial appendage (LAA) in more than 90% of cases. On the basis of these findings LAA closure devices have been developed as an alternative to oral anticoagulation. Besides endocardial LAA occluders, such as the WATCHMAN™ and AMPLATZER™ devices, an epicardial LAA occluder (LARIAT™) has recently been introduced. The following review introduces the various endocardial and epicardial LAA closure devices and assesses the indications, management, advantages and disadvantages of the two approaches according to the current literature.

  11. Strength and Persistence of Energy-Based Vessel Seals Rely on Tissue Water and Glycosaminoglycan Content.

    Science.gov (United States)

    Kramer, Eric A; Cezo, James D; Fankell, Douglas P; Taylor, Kenneth D; Rentschler, Mark E; Ferguson, Virginia L

    2016-11-01

    Vessel ligation using energy-based surgical devices is steadily replacing conventional closure methods during minimally invasive and open procedures. In exploring the molecular nature of thermally-induced tissue bonds, novel applications for surgical resection and repair may be revealed. This work presents an analysis of the influence of unbound water and hydrophilic glycosaminoglycans on the formation and resilience of vascular seals via: (a) changes in pre-fusion tissue hydration, (b) the enzymatic digestion of glycosaminoglycans (GAGs) prior to fusion and (c) the rehydration of vascular seals following fusion. An 11% increase in pre-fusion unbound water led to an 84% rise in vascular seal strength. The digestion of GAGs prior to fusion led to increases of up to 82% in seal strength, while the rehydration of native and GAG-digested vascular seals decreased strengths by 41 and 44%, respectively. The effects of increased unbound water content prior to fusion combined with the effects of seal rehydration after fusion suggest that the heat-induced displacement of tissue water is a major contributor to tissue adhesion during energy-based vessel sealing. The effects of pre-fusion GAG-digestion on seal integrity indicate that GAGs are inhibitory to the bond formation process during thermal ligation. GAG digestion may allow for increased water transport and protein interaction during the fusion process, leading to the formation of stronger bonds. These findings provide insight into the physiochemical nature of the fusion bond, its potential for optimization in vascular closure and its application to novel strategies for vascular resection and repair.

  12. A novel one-shot circular stapler closure for atrial septal defect in a beating-heart porcine model.

    Science.gov (United States)

    Tarui, Tatsuya; Tomita, Shigeyuki; Ishikawa, Norihiko; Ohtake, Hiroshi; Watanabe, Go

    2015-02-01

    In surgical atrial septal defect (ASD) closure, there are no techniques or devices that can close the ASD accurately in a short time under a beating heart. We have developed a simple and automatic ASD closure technique using a circular stapler. This study assessed the feasibility and efficacy of a new circular stapler closure for ASD. Under a continuous beating heart, hand-sewn patch plasty ASD closure was performed in 6 pigs (group A) and circular stapler ASD closure was performed in 6 pigs (group B). The time to close the ASD and the effectiveness of the closure were compared. Closure was significantly faster in group B (10.5 ± 1.0 seconds) than in group A (664 ± 10 seconds; p heart porcine model. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Complications of Transcatheter Closure in Patent Ductus Arteriosus Patients

    Directory of Open Access Journals (Sweden)

    Faranak Behnaz

    2017-12-01

    Full Text Available Background: Published studies have shown excellent success rates and also low rates of life-threatening complications with trans-catheter closure of patent ductus arteriosus (PDA. However, most studies to date have been conducted in developed nations and reports from developing countries such as Iran are lacking. Objectives: To report our experience with trans-catheter closure of patent ductus arteriosus (PDA and compare two devices and complications. Patients and Methods: From 2007 to 2011, 72 consecutive PDA cases were prospectively enrolled. For PDAs ≤ 2 mm, the coiling method was employed whereas patients with PDA > 2 mm received Amplatzer duct occlusion (ADO. Success was defined as trivial residual shunt ( 0.05. Conclusions: Excellent and comparable success rates for both closure techniques were observed and no major complications were observed.

  14. The archaeology of uncommon interventions: Articulating the rationale for transcatheter closure of congenital coronary artery fistulas in asymptomatic children.

    Science.gov (United States)

    McElhinney, Doff B

    2016-02-15

    Transcatheter closure of coronary artery fistulas can be executed successfully in infants and children with few serious procedural complications. Indications for and long-term outcomes of closure of coronary artery fistulas remain poorly defined. Registries may offer the best opportunity for advancing our knowledge about uncommon interventions such as coil or device closure of coronary artery fistulas, but to do so, they must include sufficient data and evaluate factors potentially associated with salutary or adverse outcome. © 2016 Wiley Periodicals, Inc.

  15. RCRA closure of mixed waste impoundments

    Energy Technology Data Exchange (ETDEWEB)

    Blaha, F.J. [Doty and Associates (United States); Greengard, T.C.; Arndt, M.B. [Rockwell International (United States)

    1989-11-01

    A case study of a RCRA closure action at the Rocky Flats Plant is presented. Closure of the solar evaporation ponds involves removal and immobilization of a mixed hazardous/radioactive sludge, treatment of impounded water, groundwater monitoring, plume delineation, and collection and treatment of contaminated groundwater. The site closure is described within the context of regulatory negotiations, project schedules, risk assessment, clean versus dirty closure, cleanup levels, and approval of closure plans and reports. Lessons learned at Rocky Flats are summarized.

  16. Pressure vessel design manual

    CERN Document Server

    Moss, Dennis R

    2013-01-01

    Pressure vessels are closed containers designed to hold gases or liquids at a pressure substantially different from the ambient pressure. They have a variety of applications in industry, including in oil refineries, nuclear reactors, vehicle airbrake reservoirs, and more. The pressure differential with such vessels is dangerous, and due to the risk of accident and fatality around their use, the design, manufacture, operation and inspection of pressure vessels is regulated by engineering authorities and guided by legal codes and standards. Pressure Vessel Design Manual is a solutions-focused guide to the many problems and technical challenges involved in the design of pressure vessels to match stringent standards and codes. It brings together otherwise scattered information and explanations into one easy-to-use resource to minimize research and take readers from problem to solution in the most direct manner possible. * Covers almost all problems that a working pressure vessel designer can expect to face, with ...

  17. Effectiveness of percutaneous closure of patent foramen ovale for hypoxemia.

    Science.gov (United States)

    Fenster, Brett E; Nguyen, Bryant H; Buckner, J Kern; Freeman, Andrew M; Carroll, John D

    2013-10-15

    The aim of this study was to evaluate the ability of percutaneous patent foramen ovale (PFO) closure to improve systemic hypoxemia. Although PFO-mediated right-to-left shunt (RTLS) is associated with hypoxemia, the ability of percutaneous closure to ameliorate hypoxemia is unknown. Between 2004 and 2009, 97 patients who underwent PFO closure for systemic hypoxemia and dyspnea that was disproportionate to underlying lung disease were included for evaluation. All patients exhibited PFO-mediated RTLS as determined by agitated saline echocardiography. Procedural success was defined as implantation of a device without major complications and mild or no residual shunt at 6 months. Clinical success was defined as a composite of an improvement in New York Heart Association (NYHA) functional class, reduction of dyspnea symptoms, or decreased oxygen requirement. Procedural success was achieved in 96 of 97 (99%), and clinical success was achieved in 68 of 97 (70%). The presence of any moderate or severe interatrial shunt by agitated saline study (odds ratio [OR] = 4.7; p gender (OR = 0.30; p <0.017) decreased the likelihood of success. In conclusion, based on the largest single-center experience of patients referred for PFO closure for systemic hypoxemia, PFO closure was a mechanically effective procedure with an associated improvement in echocardiographic evidence of RTLS, NYHA functional class, and oxygen requirement. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Ion transport membrane module and vessel system

    Energy Technology Data Exchange (ETDEWEB)

    Stein, VanEric Edward [Allentown, PA; Carolan, Michael Francis [Allentown, PA; Chen, Christopher M [Allentown, PA; Armstrong, Phillip Andrew [Orefield, PA; Wahle, Harold W [North Canton, OH; Ohrn, Theodore R [Alliance, OH; Kneidel, Kurt E [Alliance, OH; Rackers, Keith Gerard [Louisville, OH; Blake, James Erik [Uniontown, OH; Nataraj, Shankar [Allentown, PA; van Doorn, Rene Hendrik Elias (Obersulm-Willsbach, DE); Wilson, Merrill Anderson [West Jordan, UT

    2008-02-26

    An ion transport membrane system comprising (a) a pressure vessel having an interior, an exterior, an inlet, and an outlet; (b) a plurality of planar ion transport membrane modules disposed in the interior of the pressure vessel and arranged in series, each membrane module comprising mixed metal oxide ceramic material and having an interior region and an exterior region, wherein any inlet and any outlet of the pressure vessel are in flow communication with exterior regions of the membrane modules; and (c) one or more gas manifolds in flow communication with interior regions of the membrane modules and with the exterior of the pressure vessel.The ion transport membrane system may be utilized in a gas separation device to recover oxygen from an oxygen-containing gas or as an oxidation reactor to oxidize compounds in a feed gas stream by oxygen permeated through the mixed metal oxide ceramic material of the membrane modules.

  19. Ion transport membrane module and vessel system

    Energy Technology Data Exchange (ETDEWEB)

    Stein, VanEric Edward; Carolan, Michael Francis; Chen, Christopher M.; Armstrong, Phillip Andrew; Wahle, Harold W.; Ohrn, Theodore R.; Kneidel, Kurt E.; Rackers, Keith Gerard; Blake, James Erik; Nataraj, Shankar; van Doorn, Rene Hendrik Elias; Wilson, Merrill Anderson

    2007-02-20

    An ion transport membrane system comprising (a) a pressure vessel having an interior, an exterior, an inlet, and an outlet; (b) a plurality of planar ion transport membrane modules disposed in the interior of the pressure vessel and arranged in series, each membrane module comprising mixed metal oxide ceramic material and having an interior region and an exterior region, wherein any inlet and any outlet of the pressure vessel are in flow communication with exterior regions of the membrane modules; and (c) one or more gas manifolds in flow communication with interior regions of the membrane modules and with the exterior of the pressure vessel. The ion transport membrane system may be utilized in a gas separation device to recover oxygen from an oxygen-containing gas or as an oxidation reactor to oxidize compounds in a feed gas stream by oxygen permeated through the mixed metal oxide ceramic material of the membrane modules.

  20. Ion transport membrane module and vessel system

    Energy Technology Data Exchange (ETDEWEB)

    Stein, VanEric Edward [Allentown, PA; Carolan, Michael Francis [Allentown, PA; Chen, Christopher M [Allentown, PA; Armstrong, Phillip Andrew [Orefield, PA; Wahle, Harold W [North Canton, OH; Ohrn, Theodore R [Alliance, OH; Kneidel, Kurt E [Alliance, OH; Rackers, Keith Gerard [Louisville, OH; Blake, James Erik [Uniontown, OH; Nataraj, Shankar [Allentown, PA; Van Doorn, Rene Hendrik Elias (Obersulm-Willsbach, DE); Wilson, Merrill Anderson [West Jordan, UT

    2012-02-14

    An ion transport membrane system comprising (a) a pressure vessel having an interior, an exterior, an inlet, and an outlet; (b) a plurality of planar ion transport membrane modules disposed in the interior of the pressure vessel and arranged in series, each membrane module comprising mixed metal oxide ceramic material and having an interior region and an exterior region, wherein any inlet and any outlet of the pressure vessel are in flow communication with exterior regions of the membrane modules; and (c) one or more gas manifolds in flow communication with interior regions of the membrane modules and with the exterior of the pressure vessel. The ion transport membrane system may be utilized in a gas separation device to recover oxygen from an oxygen-containing gas or as an oxidation reactor to oxidize compounds in a feed gas stream by oxygen permeated through the mixed metal oxide ceramic material of the membrane modules.

  1. Maury Journals - German Vessels

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — German vessels observations, after the 1853 Brussels Conference that set International Maritime Standards, modeled after Maury Marine Standard Observations.

  2. CONSIDERATIONS FOR THE DEVELOPMENT OF A DEVICE FOR THE DECOMMISSIONING OF THE HORIZONTAL FUEL CHANNELS IN THE CANDU 6 NUCLEAR REACTOR. PART 7 - FUNCTIONING OF THE DECOMMISSIONING DEVICE

    Directory of Open Access Journals (Sweden)

    Gabi ROSCA FARTAT

    2015-05-01

    Full Text Available The scope of this paper is to achieve the device functioning steps for the commissioning of the horizontal fuel channels of calandria vessel. The dismantling of the fuel channel is performed by one device which shall provide radiation protection during the stages of decommissioning, ensuring radiation protection of the workers. For the decommissioning operation design shall be taken to ensure all aspects of security, environmental protection during decommissioning operation steps and creating and implementing work procedures resulting from developed decommissioning plan. The fuel channel decommissioning device is designed for dismantling and extraction of the fuel channel and its components. The decommissioning operation consists of following major steps: platform with device positioning to the fuel channel to be dismantled; coupling and locking the device at the fuel channel; unblock, extract and store the channel closure plug; unblock, extract and store the channel shield plug; block and cut the middle and the end of the pressure tube; block, extract and store the end fitting; block, extract and store the half of pressure tube; mounting of the extended closing plug. The operations steps are performed by the Cutting and Extraction Device and by the extraction actuator from the device handling elements assembly. After each step of dismantling is necessary the confirmation its finalization in order to perform the next operation step. The dismantling operation steps of the fuel channel components are repeated for all the 380 channels of the reactor, from the front of calandria side (plane R as well as the rear side (plane R'.

  3. An experimental canine patent ductus arteriosus occlusion device based on shape memory polymer foam in a nitinol cage.

    Science.gov (United States)

    Wierzbicki, Mark A; Raines, Sarah B; Gordon, Sonya G; Criscione, John C; Saunders, Ashley B; Birch, Scott; Due, Bradley; Keller, Brandis; Nash, Landon D; Miller, Matthew W; Maitland, Duncan J

    2017-11-01

    Patent ductus arteriosus (PDA) is a congenital cardiovascular defect in which a fetal connection between the aorta and pulmonary artery does not spontaneously close shortly after birth. If left uncorrected serious complications and even death can occur. Surgical ligation is the traditional treatment method; however, it is an invasive procedure, that motivates development of a minimally invasive option. Shape memory polymer (SMP) foams are unique materials that hold promise in the field of minimally invasive occlusion devices. In this work, a prototype nitinol foam cage (NFC) incorporating SMP foams has been designed and evaluated in multiple mechanical and in vitro verification tests. The NFC demonstrated acceptable fatigue resistance in a preliminary strut integrity test, withstanding one million cycles without complete strut fracture. Radial force analysis of both thick- and thin-walled prototype variations generated less vessel distension and wall tension in a vessel mimic compared to a commercial device. The NFCs exhibited negligible in vitro migration, comparable to that of a commercial device, using simplified, ideal models of PDA. Deployment characteristics of the prototypes were evaluated and compared to that of a commercial device when delivered into physiological models of PDA. During mock deployments, a veterinary cardiologist noted that, while deliverable, the thin-walled NFC prototype exhibited poor deployment characteristics, however the thick-walled NFC had deployment characteristics comparable to that of a commercial device. The promising results of this study warrant further investigation of the NFC device for canine PDA closure. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. IT SERVICES AVAILABILITY DURING CERN ANNUAL CLOSURE

    CERN Multimedia

    2002-01-01

    Mail, NICE 2000, Web, EDMS (in collaboration with EST Division), General purpose databases, lxbatch, lxplus, Automated tape devices, Castor, Backups, Campus Network, Remedy, Security and VPN services will be available during the CERN annual closure. Problems developing on these services should be addressed within about half a day except on Christmas and New Year evenings, December 25, 2002 and January 1st, 2003. All other services will be left running mostly unattended. No interruptions are scheduled but restoration of the service in case of failure cannot be guaranteed. It should be noted that the Helpdesk will be closed, that no file restores from backups will be possible and damaged tapes will not be processed. An operator service will be maintained and can be reached at extension 75011 or by email to computer.operations@cern.ch. Please remember to shutdown and power off any equipment in your office which is not foreseen to be used during the annual closure before you leave for the holiday.

  5. PRESSURE-RESISTANT VESSEL

    NARCIS (Netherlands)

    Beukers, A.; De Jong, T.

    1997-01-01

    Abstract of WO 9717570 (A1) The invention is directed to a wheel-shaped pressure-resistant vessel for gaseous, liquid or liquefied material having a substantially rigid shape, said vessel comprising a substantially continuous shell of a fiber-reinforced resin having a central opening, an inner

  6. Could the heat sink effect of blood flow inside large vessels protect the vessel wall from thermal damage during RF-assisted surgical resection?

    Science.gov (United States)

    González-Suárez, Ana; Trujillo, Macarena; Burdío, Fernando; Andaluz, Anna; Berjano, Enrique

    2014-08-01

    To assess by means of computer simulations whether the heat sink effect inside a large vessel (portal vein) could protect the vessel wall from thermal damage close to an internally cooled electrode during radiofrequency (RF)-assisted resection. First,in vivo experiments were conducted to validate the computational model by comparing the experimental and computational thermal lesion shapes created around the vessels. Computer simulations were then carried out to study the effect of different factors such as device-tissue contact, vessel position, and vessel-device distance on temperature distributions and thermal lesion shapes near a large vessel, specifically the portal vein. The geometries of thermal lesions around the vessels in the in vivo experiments were in agreement with the computer results. The thermal lesion shape created around the portal vein was significantly modified by the heat sink effect in all the cases considered. Thermal damage to the portal vein wall was inversely related to the vessel-device distance. It was also more pronounced when the device-tissue contact surface was reduced or when the vessel was parallel to the device or perpendicular to its distal end (blade zone), the vessel wall being damaged at distances less than 4.25 mm. The computational findings suggest that the heat sink effect could protect the portal vein wall for distances equal to or greater than 5 mm, regardless of its position and distance with respect to the RF-based device.

  7. [Endoscopic vacuum-assisted closure].

    Science.gov (United States)

    Wedemeyer, J; Lankisch, T

    2013-03-01

    Anastomotic leakage in the upper and lower intestinal tract is associated with high morbidity and mortality. Within the last 10 years endoscopic treatment options have been accepted as sufficient treatment option of these surgical complications. Endoscopic vacuum assisted closure (E-VAC) is a new innovative endoscopic therapeutic option in this field. E-VAC transfers the positive effects of vacuum assisted closure (VAC) on infected cutaneous wounds to infected cavities that can only be reached endoscopically. A sponge connected to a drainage tube is endoscopically placed in the leakage and a continuous vacuum is applied. Sponge and vacuum allow removal of infected fluids and promote granulation of the leakage. This results in clean wound grounds and finally allows wound closure. Meanwhile the method was also successfully used in the treatment of necrotic pancreatitis.

  8. Slow eyelid closure as a measure of driver drowsiness and its relationship to performance.

    Science.gov (United States)

    Jackson, Melinda L; Raj, Susan; Croft, Rodney J; Hayley, Amie C; Downey, Luke A; Kennedy, Gerard A; Howard, Mark E

    2016-01-01

    Slow eyelid closure is recognized as an indicator of sleepiness in sleep-deprived individuals, although automated ocular devices are not well validated. This study aimed to determine whether changes in eyelid closure are evident following acute sleep deprivation as assessed by an automated device and how ocular parameters relate to performance after sleep deprivation. Twelve healthy professional drivers (45.58 ± 10.93 years) completed 2 randomized sessions: After a normal night of sleep and after 24 h of total sleep deprivation. Slow eye closure (PERCLOS) was measured while drivers performed a simulated driving task. Following sleep deprivation, drivers displayed significantly more eyelid closure (P driving task (r = 0.61, P < .05). Automated ocular measurement appears to be an effective means of detecting impairment due to sleep loss in the laboratory.

  9. Outcome of colostomy closure with different skin closure techniques ...

    African Journals Online (AJOL)

    Background: Colostomy site, which is a potentially contaminated wound, is traditionally closed with interrupted skin stitches and placement of intraperitoneal or parietal or both drains; often with poor cosmetic outcome in our country. This study aims at prospective evaluation of colostomy closure wounds by different ...

  10. Amplatzer duct occluder II for closure of congenital Gerbode defects.

    Science.gov (United States)

    Vijayalakshmi, I B; Natraj Setty, H S; Chitra, Narasimhan; Manjunath, Cholenahally N

    2015-11-15

    Congenital left ventricle to right atrial communications (Gerbode defects) are extremely rare (0.08%) type of ventricular septal defects. They were traditionally closed by surgery in the past. There are few case reports and small series of acquired and congenital Gerbode defects, closed with various types of devices. Aim of our study is to assess the feasibility, efficacy, and complications of transcatheter closure of congenital Gerbode defects with Amplatzer duct occluder II (ADO II). Twelve consecutive cases of Gerbode defects, age ranging from 10 months to 16 years (mean 6.7 years), weight ranging from 6.5 kg to 34 kg (mean 19.3 kg), were diagnosed on transthoracic echocardiography. Transcatheter closure of Gerbode defects was done successfully through retrograde approach with ADO II. No aortic or tricuspid regurgitation or residual shunt occurred in any of the patients. One patient developed transient complete heart block needing temporary pacing. The soft low profile, easily trackable ADO II appears to be ideal for closure of Gerbode defects, as the central cylinder fits in the defect and the soft retention discs on either side, without polyester material, do not impinge on either aortic, mitral, or tricuspid valve. We report the successful transcatheter closure of twelve cases of congenital Gerbode defects with ADO II. Transcatheter closure of congenital Gerbode defects with ADO II is safe, effective, and an attractive alternative to surgical closure. ADO II appears to be tailor made for Gerbode defects, as the success rate is very high and complication rate is very low. © 2015 Wiley Periodicals, Inc.

  11. New surgical modification of fascial closure following endovascular aortic pathology repair

    OpenAIRE

    Dziekiewicz, Miroslaw; Maciag, Rafal; Maruszynski, Marek

    2013-01-01

    Introduction There are clear benefits of percutaneous versus open femoral access for endovascular aortic pathology repair. All closing devices commercially available are expensive. Surgical closure of the femoral artery risks potential prolonged wound healing and as a consequence longer hospital stay. Fascial closure is a technique that remains an interesting option. Aim To evaluate the efficacy of the surgical modification of hemostasis control after endovascular repair of aortic pathology. ...

  12. Omental Herniation: A Rare Complication of Vacuum-Assisted Closure of Infected Sternotomy Wound

    Directory of Open Access Journals (Sweden)

    Philemon Gukop

    2012-01-01

    Full Text Available Vacuum-assisted closure (VAC has recently been adopted as an acceptable modality for management of sternotomy wound infections. Although generally efficacious, the use of negative pressure devices has been associated with complications such as bleeding, retention of sponge, and empyema. We report the first case of greater omental hernia as a rare complication of vacuum-assisted closure of sternal wound infection following coronary artery bypass grafting.

  13. Platelet function analyzer (PFA)‐100® closure time in the evaluation of platelet disorders and platelet function

    National Research Council Canada - National Science Library

    HAYWARD, C. P. M; HARRISON, P; CATTANEO, M; ORTEL, T. L; RAO, A. K

    2006-01-01

    Background:  Closure time (CT), measured by platelet function analyzer (PFA‐100 ® ) device, is now available to the clinical laboratory as a possible alternative or supplement to the bleeding time test. Aim...

  14. Local lysis with Alteplase for the treatment of acute embolic leg ischemia following the use of the Duett {sup trademark} closure device: preliminary results; Lokale Alteplase-Lyse zur Therapie der akuten embolischen Beinischaemie nach Einsatz des Duett {sup trademark} -Verschluss-Systems: vorlaeufige Ergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Schuermann, K.; Buecker, A.; Wingen, M.; Tacke, J.; Wein, B.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik des Universitaetsklinikums der RWTH Aachen (Germany); Janssens, U. [Medizinische Klinik I (Kardiologie) des Universitaetsklinikums der RWTH Aachen (Germany)

    2004-04-01

    Purpose: To analyze retrospectively the result of the alteplase lysis therapy of embolic complications following the use of the Duett closure device. Methods and Materials: For 3.5 years, the Duett closure device was used in 1,398 angiographies to close the femoral puncture site. The Duett device consists of a balloon and a liquid procoagulant containing collagen and thrombin, which is injected into the puncture tract under endovascular balloon protection of the arterial puncture site. In 9 patients (0.64%), the procoagulant was incidentally injected into the femoral artery causing acute leg ischemia. Eight patients received local lysis therapy with alteplase via a contralateral femoral access. One patient underwent surgery. On average, 21 mg alteplase (4-35 mg) were administered within 14 h (4-21 h). The course of the lysis was followed angiographyically and clinically. All patients were inteerviewed by telephone 23 months (4-35 months) later.Results: In 3 patients, lysis was complete. In 5 patients, only little thrombotic material remained. In all patients, symptoms of ischemia resolved completely within the first hours after initiation of lysis. In 5 cases, bleeding occurred at the puncture site closed with the Duett device during lysis, including development of a false aneurysm in 2 cases. Complications led to premature termination (n=2) or interruption of the lysis (n=3). All complications were treated conservatively. Clinically, long-term sequelae were paresthesia and hypoesthesia in the lower leg and foot in 2 patients treated with lysis, and in the patient who underwent surgery. (orig.) [German] Ziel: Das Ergebnis der Alteplase-Lysetherapie von Embolien nach Einsatz des Duett-Verschluss-Systems wurde retrospektiv untersucht. Methoden: Innerhalb von 3,5 Jahren wurde nach 1398 Angiographien das Duett-System zum Verschluss der femoralen Punktionsstelle eingesetzt. Das System besteht aus einem Ballon und einem fluessigen Prokoagulans (Kollagen, Thrombin), das

  15. Moment Closure for the Stochastic Logistic Model

    National Research Council Canada - National Science Library

    Singh, Abhyudai; Hespanha, Joao P

    2006-01-01

    ..., which we refer to as the moment closure function. In this paper, a systematic procedure for constructing moment closure functions of arbitrary order is presented for the stochastic logistic model...

  16. Telephone switchboard closure | 19 December

    CERN Multimedia

    2014-01-01

    Exceptionally, the telephone switchboard will close at 4 p.m. on Friday, 19 December, instead of the usual time of 6 p.m., to allow time for closing all systems properly before the annual closure. Therefore, switchboard operator assistance to transfer calls from/to external lines will stop. All other phone services will run as usual.

  17. An improvised wound closure system

    NARCIS (Netherlands)

    Lapid, Oren

    2006-01-01

    BACKGROUND: Skin stretching harnesses the same viscoelastic properties of the skin as expansion, with the difference that the forces are applied externally and not internally. An improvised system for wound closure is presented. METHOD: The system is assembled using silicone vascular loops used as

  18. Vacuum assisted closure in coloproctology

    NARCIS (Netherlands)

    Bemelman, W.A.

    2009-01-01

    Vacuum-assisted closure has earned its indications in coloproctology. It has been described with variable results in the treatment of large perineal defects after abdominoperineal excision, in the treatment of stoma dehiscence and perirectal abscesses. The most promising indication for

  19. Abdominal wound closure: current perspectives

    Directory of Open Access Journals (Sweden)

    Williams ZF

    2015-12-01

    Full Text Available Zachary F Williams, William W Hope Department of Surgery, South East Area Health Education Center, New Hanover Regional Medical Center, Wilmington, NC, USA Abstract: This review examines both early and late wound complications following laparotomy closure, with particular emphasis on technical aspects that reduce hernia formation. Abdominal fascial closure is an area of considerable variation within the field of general surgery. The formation of hernias following abdominal wall incisions continues to be a challenging problem. Ventral hernia repairs are among the most common surgeries performed by general surgeons, and despite many technical advances in the field, incisional hernia rates remain high. Much attention and research has been directed to the surgical management of hernias. Less focus has been placed on prevention of hernia formation despite its obvious importance. This review examines the effects of factors such as the type of incision, suture type and size, closure method, patient risk factors, and the use of prophylactic mesh. Keywords: incisional, abdominal, hernia, prevention, wound closure techniques 

  20. High Performance Marine Vessels

    CERN Document Server

    Yun, Liang

    2012-01-01

    High Performance Marine Vessels (HPMVs) range from the Fast Ferries to the latest high speed Navy Craft, including competition power boats and hydroplanes, hydrofoils, hovercraft, catamarans and other multi-hull craft. High Performance Marine Vessels covers the main concepts of HPMVs and discusses historical background, design features, services that have been successful and not so successful, and some sample data of the range of HPMVs to date. Included is a comparison of all HPMVs craft and the differences between them and descriptions of performance (hydrodynamics and aerodynamics). Readers will find a comprehensive overview of the design, development and building of HPMVs. In summary, this book: Focuses on technology at the aero-marine interface Covers the full range of high performance marine vessel concepts Explains the historical development of various HPMVs Discusses ferries, racing and pleasure craft, as well as utility and military missions High Performance Marine Vessels is an ideal book for student...

  1. Cheboygan Vessel Base

    Data.gov (United States)

    Federal Laboratory Consortium — Cheboygan Vessel Base (CVB), located in Cheboygan, Michigan, is a field station of the USGS Great Lakes Science Center (GLSC). CVB was established by congressional...

  2. Maury Journals - US Vessels

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — U.S. vessels observations, after the 1853 Brussels Conference that set International Maritime Standards, modeled after Maury Marine Standard Observations.

  3. Coastal Logbook Survey (Vessels)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains catch (landed catch) and effort for fishing trips made by vessels that have been issued a Federal permit for the Gulf of Mexico reef fish,...

  4. Histological evaluation and optimization of surgical vessel sealing systems

    Science.gov (United States)

    Lathrop, Robert; Ryan, Thomas; Gaspredes, Jonathan; Woloszko, Jean; Coad, James E.

    2017-02-01

    Surgical vessel sealing systems are widely used to achieve hemostasis and dissection in open surgery and minimally invasive, laparoscopic surgery. This enabling technology was developed about 17 years ago and continues to evolve with new devices and systems achieving improved outcomes. Histopathological assessment of thermally sealed tissues is a valuable tool for refining and comparing performance among surgical vessel sealing systems. Early work in this field typically assessed seal time, burst rate, and failure rate (in-situ). Later work compared histological staining methods with birefringence to assess the extent of thermal damage to tissues adjacent to the device. Understanding the microscopic architecture of a sealed vessel is crucial to optimizing the performance of power delivery algorithms and device design parameters. Manufacturers rely on these techniques to develop new products. A system for histopathological evaluation of vessels and sealing performance was established, to enable the direct assessment of a treatment's tissue effects. The parameters included the commonly used seal time, pressure burst rate and failure rate, as well as extensions of the assessment to include its likelihood to form steam vacuoles, adjacent thermal effect near the device, and extent of thermally affected tissue extruded back into the vessel lumen. This comprehensive assessment method provides an improved means of assessing the quality of a sealed vessel and understanding the exact mechanisms which create an optimally sealed vessel.

  5. LANL Robotic Vessel Scanning

    Energy Technology Data Exchange (ETDEWEB)

    Webber, Nels W. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-11-25

    Los Alamos National Laboratory in J-1 DARHT Operations Group uses 6ft spherical vessels to contain hazardous materials produced in a hydrodynamic experiment. These contaminated vessels must be analyzed by means of a worker entering the vessel to locate, measure, and document every penetration mark on the vessel. If the worker can be replaced by a highly automated robotic system with a high precision scanner, it will eliminate the risks to the worker and provide management with an accurate 3D model of the vessel presenting the existing damage with the flexibility to manipulate the model for better and more in-depth assessment.The project was successful in meeting the primary goal of installing an automated system which scanned a 6ft vessel with an elapsed time of 45 minutes. This robotic system reduces the total time for the original scope of work by 75 minutes and results in excellent data accumulation and transmission to the 3D model imaging program.

  6. Multidisciplinary Assessment in Optimising Results of Percutaneous Patent Foramen Ovale Closure.

    Science.gov (United States)

    Davies, Allan; Ekmejian, Avedis; Collins, Nicholas; Bhagwandeen, Rohan

    2017-03-01

    Percutaneous patent foramen ovale (PFO) closure is a therapeutic option to prevent recurrent cerebral ischaemia in patients with cryptogenic stroke and transient cerebral ischaemia (TIA). The apparent lack of benefit seen in previous randomised trials has, in part, reflected inclusion of patients with alternate mechanisms of stroke. The role of formal neurology involvement in accurately delineating the likely aetiology of stroke or TIA is crucial in appropriate identification of patients for device closure. Furthermore, as the benefits of device closure may accrue over time, long-term follow-up is essential to define the role of device closure in management of presumed cryptogenic stroke. We retrospectively reviewed our experience with percutaneous PFO device closure since 2005. All subjects who underwent PFO closure at John Hunter and Lake Macquarie Private Hospitals were included in the study. All patients referred for device closure following cryptogenic stroke or TIA had first undergone formal neurology review with appropriate imaging and exclusion of paroxysmal atrial arrhythmia. Patients with a history of transient ischaemic attack (TIA) are frequently referred to a specialised clinic, aimed to identify patients with conditions not referable to cerebral ischaemia, with investigations initiated by the specialist clinic to elucidate an underlying aetiology. Outcome data was derived from the Hunter New England Area Local Health District Cardiac and Stroke Outcomes Unit, in addition to review of the medical record. The Cardiac and Stroke Outcomes Unit prospectively identified all patients presenting with stroke, TIA and atrial fibrillation. One hundred and twelve consecutive patients undergoing percutaneous patent foramen ovale closure between 2005 and 2015 were identified. The average age was 42.7 years and 57 (50.9%) patients were male. Cryptogenic stroke (68.8%) and transient cerebral ischaemia (23.2%) were the most common indications for PFO closure, with the

  7. Deaths Related to Vessel Injuries in Extremities

    Directory of Open Access Journals (Sweden)

    Nursel Türkmen

    2003-12-01

    Full Text Available Lethal or non-lethal extremity injuries are often seen in medico-legal practice. In this study, we planned to investigate medico-legal properties of deaths related to vessel injuries in extremities. In forensic autopsies performed in Bursa, we examined total 4242 autopsy reports between 1996-2003 in included 40 (0,94% cases of deaths caused by vessel injuries in extremities. 90% of cases were male with median age 35.87 (17-66. Stabbing device account for 60% of injuries. Most frequent injuries were in femoral artery and branches. In 82.5% of cases, homicide was the origin of death. In 30% of cases, mean 159.33 mg/dl alcohol blood concentration was detected. In the scene investigation reports, 47.5% of documented incidents were outdoor and 47.5% of the cases died in the scene. As a conclusion, it is observed that alcoholic males of middle age are the risk group for vascular injuries in extremities. In the deaths related to isolated vessel injuries in extremities, the detection of injured vessel, localisation and number of total and lethal wounds would offer a solution for the evil intent; and as in the other violent death cases autopsy is required in the deaths due to vessel injuries in extremities. Key words: Vascular injuries, Extremity, Forensic autopsy.

  8. Enhancing supply vessel safety

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    A supply-vessel bridge installation consists of a navigating bridge and a control position aft, from which operators control the ship when close to rigs or platforms, and operate winches and other loading equipment. The international Convention for Safety of I Ale at Sea (SOLAS) does not regulate the layout, so design varies to a large degree, often causing an imperfect working environment. As for other types of ships, more than half the offshore service vessel accidents at sea are caused by bridge system failures. A majority can be traced back to technical design, and operational errors. The research and development project NAUT-OSV is a response to the offshore industry's safety concerns. Analysis of 24 incidents involving contact or collision between supply vessels and offshore installations owned or operated by Norwegian companies indicated that failures in the bridge system were often the cause.

  9. Analysis of nerve and neuropeptide patterns in vacuum-assisted closure-treated diabetic murine wounds.

    Science.gov (United States)

    Younan, George; Ogawa, Rei; Ramirez, Michelle; Helm, Douglas; Dastouri, Pouya; Orgill, Dennis P

    2010-07-01

    Reestablishment of the peripheral nervous system occurs in parallel with wound healing. With accelerated wound healing seen with the vacuum-assisted closure device, the authors studied its effects on nerve fiber regeneration, nerve sprouting, and the stimulation of neuropeptides and neurotrophins. A vacuum-assisted closure device was applied to a full-thickness diabetic mouse wound using continuous or cyclical modes and compared with foam dressing or occlusive dressing controls, using 10 mice per group. Nerve fibers, substance P, calcitonin gene-related peptide, and nerve growth factor were analyzed using two-dimensional immunohistochemistry and real-time reverse-transcriptase polymerase chain reaction. A significant increase in dermal and epidermal nerve fiber densities and in substance P, calcitonin gene-related peptide, and nerve growth factor expression was seen in vacuum-assisted closure-treated wounds. Cyclical treatment mode correlated with the largest increase in granulation tissue production, wound surface microdeformations, and a slightly faster wound closure rate. This study suggests that vacuum-assisted closure therapy can modulate nerve fiber and neuropeptide production in the wound. Optimized kinetics of vacuum-assisted closure application may provide an opportunity for clinicians to further improve wound healing in denervated wounds such as pressure sores and diabetic foot ulcerations.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    or epidural anesthesia. The evolving stent-technology with smaller sheath sizes has broadened the scenario for alternative approaches for access and closure of the common femoral arteries. The following review presents an introduction on technical aspects of puncture of the femoral artery and closure...... of today. The traditional approach in EVAR involves surgical exposure of the femoral arteries with bilateral groin incisions. Through the groin access, and under fluoroscopy, a special insertion sheath introducer is used to position a stent graft in the desired location with the patient in general...... of the arterial wall using percutaneous closure devices. We also aim to discuss three important approaches to expose and close the femoral arteries during endovascular aortic repair: The cut down approach, the true percutaneous technique, and the femoral fascial closure. Finally, factors important in the choice...

  11. Transcatheter closure of small ductus arteriosus with amplatzer vascular plug

    Directory of Open Access Journals (Sweden)

    Eunhyun Cho

    2013-09-01

    Full Text Available Purpose: The purpose of this study was to share our experience of transcatheter closure of small patent ductus arteriosus (PDA by using an Amplatzer vascular plug (AVP.&lt;br&gt; Methods: We reviewed the medical records of 20 patients who underwent transcatheter closure at Samsung Medical Center and Sejong General Hospital from January 2008 to August 2012. The size and shape of the PDAs were evaluated by performing angiograms, and the PDA size and the AVP devices size were compared.&lt;br&gt;Results: The mean age of the patients was 54.9±45.7 months old. The PDAs were of type C (n=5, type D (n=12 and type E (n=3. The mean pulmonary end diameter of the PDA was 1.7±0.6 mm, and the aortic end diameter was 3.6±1.4 mm. The mean length was 7.3±1.8 mm. We used 3 types of AVP devices: AVP I (n=5, AVP II (n=7, and AVP IV (n=8. The ratio of AVP size to the pulmonary end diameter was 3.37±1.64, and AVP size/aortic end ratio was 1.72±0.97. The aortic end diameter was significantly larger in those cases repaired with AVP II than in the others (P =0.002. The AVP size did not significantly correlate with the PDA size, but did correlate with smaller ratio of AVP size to aortic end diameter (1.10±0.31, P =0.032. &lt;br&gt;Conclusion: Transcatheter closure of small PDA with AVP devices yielded satisfactory outcome. AVP II was equally effective with smaller size of device, compared to others.

  12. GOLD PRESSURE VESSEL SEAL

    Science.gov (United States)

    Smith, A.E.

    1963-11-26

    An improved seal between the piston and die member of a piston-cylinder type pressure vessel is presented. A layer of gold, of sufficient thickness to provide an interference fit between the piston and die member, is plated on the contacting surface of at least one of the members. (AEC)

  13. Network of endocardial vessels.

    Science.gov (United States)

    Lee, Byung-Cheon; Kim, Hong Bae; Sung, Baeckkyoung; Kim, Ki Woo; Sohn, Jamin; Son, Boram; Chang, Byung-Joon; Soh, Kwang-Sup

    2011-01-01

    Although there have been reports on threadlike structures inside the heart, they have received little attention. We aimed to develop a method for observing such structures and to reveal their ultrastructures. An in situ staining method, which uses a series of procedures of 0.2-0.4% trypan blue spraying and washing, was applied to observe threadlike structures on the surfaces of endocardia. The threadlike structures were isolated and observed by using confocal laser scanning microscopy (CLSM) and transmission electron microscopy (TEM). Networks of endocardial vessels (20 μm in thickness) with expansions (40-100 μm in diameter) were visualized; they were movable on the endocardium of the bovine atrium and ventricle. CLSM showed that (1) rod-shaped nuclei were aligned along the longitudinal direction of the endocardial vessel and (2) there were many cells inside the expansion. TEM on the endocardial vessel revealed that (1) there existed multiple lumens (1-7 μm in diameter) and (2) the extracellular matrices mostly consisted of collagen fibers, which were aligned along the longitudinal direction of the endocardial vessel or were locally organized in reticular structures. We investigated the endocardial circulatory system in bovine cardiac chambers and its ultrastructures, such as nucleic distributions, microlumens, and collagenous extracellular matrices. Copyright © 2011 S. Karger AG, Basel.

  14. Pressurized Vessel Slurry Pumping

    Energy Technology Data Exchange (ETDEWEB)

    Pound, C.R.

    2001-09-17

    This report summarizes testing of an alternate ''pressurized vessel slurry pumping'' apparatus. The principle is similar to rural domestic water systems and ''acid eggs'' used in chemical laboratories in that material is extruded by displacement with compressed air.

  15. TOPOGRAPHIC CHANGES OF THE MACULA AFTER CLOSURE OF IDIOPATHIC MACULAR HOLE.

    Science.gov (United States)

    Pak, Kang Yeun; Park, Keun Heung; Kim, Kyong Ho; Park, Sung Who; Byon, Ik Soo; Kim, Hyun Woong; Chung, In Young; Lee, Joo Eun; Lee, Sang Joon; Lee, Ji Eun

    2017-04-01

    To investigate retinal displacement in the macula after surgical closure of idiopathic macular hole and to identify factors correlated with displacement. This retrospective multicenter study included 73 eyes of 73 patients having idiopathic macular hole. A custom program was developed to compare the position of the retinal vessels in the macula between preoperative and postoperative photographs. En face images of a 6 mm × 6 mm optical coherence tomography volume scans were registered to calculate the scale. A grid comprising 16 sectors in 2 rings (inner; 2-4 mm and outer; 4-6 mm) was superimposed. The displacement of the retinal vessels was measured as a vector value by comparing the location of the retinal vessels in each sector. The correlation between displacement and various clinical parameters was analyzed. The average displacement was 57.2 μm at an angle of -3.3° (nasal and slightly inferior). Displacement was larger in the inner ring (79.2 μm) than in the outer ring (35.3 μm, P macula was displaced centripetally, nasally, and slightly inferiorly after surgical closure of idiopathic macular hole. Hole closure, contraction of the nerve fiber layer, and gravity are the suggested mechanisms of macular displacement caused by internal limiting membrane peeling.

  16. Primary closure of equine laryngotomy incisions

    DEFF Research Database (Denmark)

    Lindegaard, C.; Karlsson, L.; Ekstrøm, Claus Thorn

    2016-01-01

    The objective was to report healing characteristics and complications after primary closure of equine laryngotomies and analyse factors potentially associated with complications. This retrospective case series of the medical records of horses (n = 180) undergoing laryngoplasty and laryngotomy...... after primary closure of equine laryngotomy incisions are infrequent and considered of minimal severity and can be performed safely when paying careful attention to the closure of the cricothyroid membrane....

  17. Transcatheter device closure of a traumatic ventricular septal defect

    Directory of Open Access Journals (Sweden)

    Mohamed Kasem

    2014-01-01

    Full Text Available A traumatic ventricular septal defect (VSD resulting from blunt chest injury is a very rare event in children. The clinical symptoms and timing of presentation are variable, so diagnosis and management of traumatic VSD may be challenging. Decision to close the traumatic VSD is usually based on a combination of severity of heart failure symptoms, hemodynamics, and defect size. We present a case of a 7-year-old boy who was run over by a truck and presented with head and liver injury initially. He was subsequently found to have a traumatic VSD. The VSD was closed percutaneously.

  18. Ocular Biometry in Angle Closure

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Razeghinejad

    2013-01-01

    Full Text Available Purpose: To compare ocular biometric parameters in primary angle closure suspects (PACS, primary angle closure glaucoma (PACG and acute primary angle closure (APAC. Methods: This cross-sectional study was performed on 113 patients including 33 cases of PACS, 45 patients with PACG and 35 subjects with APAC. Central corneal thickness (CCT, axial length (AL, anterior chamber depth (ACD and lens thickness (LT were measured with an ultrasonic biometer. Lens-axial length factor (LAF, relative lens position, corrected ACD (CACD and corrected lens position were calculated. The parameters were measured bilaterally but only data from the right eyes were compared. In the APAC group, biometric parameters were also compared between affected and unaffected fellow eyes. Logistic regression analysis was performed to identify risk factors. Results: No statistically significant difference was observed in biometric parameters between PACS and PACG eyes, or between affected and fellow eyes in the APAC group (P>0.05 for all comparisons. However, eyes with APAC had thicker cornea (P=0.001, thicker lens (P<0.0001, shallower ACD (P=0.009, shallower CACD (P=0.003 and larger LAF (P<0.0001. Based on ROC curve analysis, lower ACD, and larger LT, LAF and CCT values were associated with APAC. In the APAC group, LAF (P<0.0001 and CCT (P=0.001 were significant risk factors. Conclusion: This study revealed no significant difference in biometric characteristics in eyes with PACS and PACG. However, larger LAF and CCT were predictive of APAC.

  19. Sustained eye closure slows saccades

    Science.gov (United States)

    Shaikh, Aasef G.; Wong, Aaron L.; Optican, Lance M.; Miura, Kenichiro; Solomon, David; Zee, David S.

    2010-01-01

    Saccadic eye movements rapidly orient the line of sight towards the object of interest. Pre-motor burst neurons (BNs) controlling saccades receive excitation from superior colliculus and cerebellum, but inhibition by omnipause neurons (OPNs) prevents saccades. When the OPNs pause, BNs begin to fire. It has been presumed that part of the BN burst comes from post-inhibitory rebound (PIR). We hypothesized that in the absence of prior inhibition from OPNs there would be no PIR, and thus the increase in initial firing rate of BNs would be reduced. Consequently, saccade acceleration would be reduced. We measured eye movements and showed that sustained eye closure, which inhibits the activity of OPNs and thus hypothetically should weaken PIR, reduced the peak velocity, acceleration, and deceleration of saccades in healthy human subjects. Saccades under closed eyelids also had irregular trajectories; the frequency of the oscillations underlying this irregularity was similar to that of high-frequency ocular flutter (back-to-back saccades) often seen in normal subjects during attempted fixation at straight ahead while eyes are closed. Saccades and quick phases of nystagmus are generated by the same pre-motor neurons, and we found that the quick-phase velocity of nystagmus was also reduced by lid closure. These changes were not due to a mechanical hindrance to the eyes, because lid closure did not affect the peak velocities or accelerations of the eyes in the “slow-phase” response to rapid head movements of comparable speeds to those of saccades. These results indicate a role for OPNs in generating the abrupt onset and high velocities of saccades. We hypothesize that the mechanism involved is PIR in pre-motor burst neurons. PMID:20573593

  20. 46 CFR 28.400 - Radar and depth sounding devices.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Radar and depth sounding devices. 28.400 Section 28.400... Operate With More Than 16 Individuals on Board § 28.400 Radar and depth sounding devices. (a) Each vessel... the operating station. (b) Each vessel must be fitted with a suitable echo depth sounding device. ...

  1. Studies on in-vessel debris coolability in ALPHA program

    Energy Technology Data Exchange (ETDEWEB)

    Maruyama, Yu; Yamano, Norihiro; Moriyama, Kiyofumi [Japan Atomic Energy Research Institute, Ibaraki-ken (Japan)] [and others

    1997-02-01

    In-vessel debris coolability experiments have been performed in ALPHA Program at JAERI. Aluminum oxide (Al{sub 2}O{sub 3}) produced by a thermite reaction was applied as a debris simulant. Two scoping experiments using approximately 30 kg or 50 kg of Al{sub 2}O{sub 3} were conducted. In addition to post-test observations, temperature histories of the debris simulant and the lower head experimental vessel were evaluated. Rapid temperature reduction observed on the outer surface of the experimental vessel may imply that water penetration into a gap between the solidified debris and the experimental vessel occurred resulting in an effective cooling of once heated vessel wall. Preliminary measurement of a gap width was made with an ultrasonic device. Signals to show the existence of gaps, ranging from 0.7 mm to 1.4 mm, were detected at several locations.

  2. 100-D Ponds closure plan. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Petersen, S.W.

    1997-09-01

    The 100-D Ponds is a Treatment, Storage, and Disposal (TSD) unit on the Hanford Facility that received both dangerous and nonregulated waste. This Closure Plan (Rev. 1) for the 100-D Ponds TSD unit consists of a RCRA Part A Dangerous Waste Permit Application (Rev. 3), a RCRA Closure Plan, and supporting information contained in the appendices to the plan. The closure plan consists of eight chapters containing facility description, process information, waste characteristics, and groundwater monitoring data. There are also chapters containing the closure strategy and performance standards. The strategy for the closure of the 100-D Ponds TSD unit is clean closure. Appendices A and B of the closure plan demonstrate that soil and groundwater beneath 100-D Ponds are below cleanup limits. All dangerous wastes or dangerous waste constituents or residues associated with the operation of the ponds have been removed, therefore, human health and the environment are protected. Discharges to the 100-D Ponds, which are located in the 100-DR-1 operable unit, were discontinued in June 1994. Contaminated sediment was removed from the ponds in August 1996. Subsequent sampling and analysis demonstrated that there is no contamination remaining in the ponds, therefore, this closure plan is a demonstration of clean closure.

  3. HWMA closure plan for the Waste Calcining Facility at the Idaho National Engineering Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-05-01

    The Waste Calcining Facility (WCF) calcined and evaporated aqueous wastes generated from the reprocessing of spent nuclear fuel. The calciner operated from 1963 to 1981, primarily processing high level waste from the first cycle of spent fuel extraction. Following the calciner shutdown the evaporator system concentrated high activity aqueous waste from 1983 until 1987. In 1988, US Department of Energy Idaho Operations Office (DOE-ID) requested interim status for the evaporator system, in anticipation of future use of the evaporator system. The evaporator system has not been operated since it received interim status. At the present time, DOE-ID is completing construction on a new evaporator at the New Waste Calcining Facility (NWCF) and the evaporator at the WCF is not needed. The decision to not use the WCF evaporator requires Lockheed Idaho Technologies Company (LITCO) and DOE-ID to close these units. After a detailed evaluation of closure options, LITCO and DOE-ID have determined the safest option is to fill the voids (grout the vessels, cells and waste pile) and close the WCF to meet the requirements applicable to landfills. The WCF will be covered with a concrete cap that will meet the closure standards. In addition, it was decided to apply these closure standards to the calcining system since it is contained within the WCF building. The paper describes the site, waste inventory, closure activities, and post-closure care plans.

  4. Satellite and acoustic tracking device

    KAUST Repository

    Berumen, Michael L.

    2014-02-20

    The present invention relates a method and device for tracking movements of marine animals or objects in large bodies of water and across significant distances. The method and device can track an acoustic transmitter attached to an animal or object beneath the ocean surface by employing an unmanned surface vessel equipped with a hydrophone array and GPS receiver.

  5. Percutaneous Closure of an Iatrogenic Aorta to Right Ventricle Fistula Acquired Following Intracardiac Repair.

    Science.gov (United States)

    Rajasekhar, Durgaprasad; Vanajakshamma, Velam; Ranganayakulu, Kummaraganti Paramathma

    2016-05-01

    Iatrogenic aortocardiac fistulae have been described rarely following intracardiac repair. This 28 year-old-male presented to our facility with dyspnea going on 20 days after closure of ventricular septal defect (VSD) and resection of subaortic membrane. A communication was noticed between the aorta and the right ventricle (RV) upon transthoracic echocardiography. Cardiac catheterisation revealed a significant shunt and an aortogram revealed a 6 mm communication between aorta and right ventricle. Percutaneous closure of this defect was attempted under local anaesthesia through right femoral access. An alpha arteriovenous loop was formed despite repeated attempts, hence a retrograde approach for device delivery was considered. An 8 mm Amplatzer muscular VSD occluder device was deployed across the defect achieving a complete closure through an 8F delivery sheath. To the best of our knowledge this is the first report of an iatrogenic aorta to RV fistula occurring in a patient following an intracardiac repair which has been successfully treated percutaneously.

  6. Hawaii Abandoned Vessel Inventory, Kauai

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Kauai. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  7. CNMI Abandoned Vessel Inventory, Tinian

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Tinian. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  8. Puerto Rico Abandoned Vessel Inventory

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Puerto Rico. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  9. American Samoa Abandoned Vessel Inventory

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for American Samoa. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  10. Hawaii Abandoned Vessel Inventory, Oahu

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Oahu, Hawaii. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  11. Hawaii Abandoned Vessel Inventory, Molokai

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Molokai, Hawaii. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  12. CNMI Abandoned Vessel Inventory, Rota

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Rota. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  13. Hawaii Abandoned Vessel Inventory, Lanai

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Lanai. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  14. For-Hire Vessel Directory

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Vessel Directory is maintained as the sample frame for the For-Hire Survey. I contains data on for-hire vessels on the Atlantic and Gulf coasts. Data include...

  15. CNMI Abandoned Vessel Inventory, Saipan

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Saipan. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  16. Hawaii Abandoned Vessel Inventory, Maui

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Maui. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  17. Vessels in Transit - Web Tool

    Data.gov (United States)

    Department of Transportation — A web tool that provides real-time information on vessels transiting the Saint Lawrence Seaway. Visitors may sort by order of turn, vessel name, or last location in...

  18. [Classification of congenital ventricular defects using echocardiography for transcatheter closure].

    Science.gov (United States)

    Lai, Yu-qiong; Huang, Xin-sheng

    2009-02-01

    To determine the anatomical variation and classification of ventricular septal defect (VSD) using echocardiography for percutaneous catheter closure in eligible cases. The isolated ventricular septal defect was diagnosed with echocardiography in 240 patients , and 167 patients screened by transthoracic echocardiography were suitable for percutaneous catheter closure, but only 62 with isolated perimembranous VSD voluntarily received the procedure. The procedure was successful in 58 patients, with a success rate of 93.5% with Amplatzer device. The diameter of VSD ranged from 2.4 to 13.9 (mean 5.3-/+2.0) mm with echocardiography, and the size of Amplatzer device ranged from 4-18 (mean 8.3-/+2.9) mm. Perimembranous ventricular septal defect was complicated by aneurysm formation in 22 patients. Residual trivial or mild shunt was seen in seven (12%) patients at 24 h and one (1.7%) patient at 3 months. Seven (12.1%) patients developed heart block, 3 (5.2%) had intermittence and transient complete heart block, and one had transient second degree atrioventricular block disappearing in 3 to 10 days, and 3 (5.2%) patients had complete right bundle branch block lasting for one month. None of the patients developed significant aortic regurgitation (P>0.05), although 22 showed a superior margin of the defect less than 3 mm from the aortic valve. The mean distance from the aortic valve was 3.7-/+2.7 (1.0 to 10.5) mm. No significant mitral and tricuspid regurgitation occurred in these patients. Four patients had unsuccessful procedures. Percutaneous closure with Amplatzer device can be carried out successfully in a majority of suitable defects screened using transthoracic echocardiography. Echocardiography can exactly demonstrate the anatomical variation and classification of ventricular septal defect in adults. Attention should be given to the misdiagnosis by echocardiography of a doubly committed defect as a perimembranous outflow defect. Heart block can be an important

  19. Pressure vessel design manual

    Energy Technology Data Exchange (ETDEWEB)

    Moss, D.R.

    1987-01-01

    The first section of the book covers types of loadings, failures, and stress theories, and how they apply to pressure vessels. The book delineates the procedures for designing typical components as well as those for designing large openings in cylindrical shells, ring girders, davits, platforms, bins and elevated tanks. The techniques for designing conical transitions, cone-cylinder intersections, intermediate heads, flat heads, and spherically dished covers are also described. The book covers the design of vessel supports subject to wind and seismic loads and one section is devoted to the five major ways of analyzing loads on shells and heads. Each procedure is detailed enough to size all welds, bolts, and plate thicknesses and to determine actual stresses.

  20. New research vessels

    Science.gov (United States)

    1984-04-01

    Two “new” ocean-going research vessels operated by the Scripps Institution of Oceanography and the National Science Foundation (NSF) will soon begin full-time scientific duties off the coast of California and in the Antarctic, respectively. The 37.5-m Scripps vessel, named Robert Gordon Sprout in honor of the ex-president of the University of California, replaces the smaller ship Ellen B. Scripps, which had served the institution since 1965. The new ship is a slightly modified Gulf Coast workboat. Under the name of Midnight Alaskan, it had been used for high-resolution geophysical surveys in American and Latin American waters by such firms as Arco Oil & Gas, Exxon, Pennzoil, and Racal-Decca before its purchase by Scripps from a Lousiana chartering firm last summer.

  1. IT Services availability during CERN annual closure

    CERN Multimedia

    2003-01-01

    Mail, Cern Windows (NICE ),  Web services,  LXPLUS, LXBATCH, Automated tape devices, Castor, Backups, software license servers, Sundev, CVS and Print Servers, CDS and Agenda-Maker, EDMS (in collaboration with EST Division), CMS disc servers, Campus Network,  Remedy, Security and VPN services will be available during the CERN annual closure. The physics database cluster, replication location service as well as accdb, cerndb and admsdb are the only databases available, CCDB will be closed for public access. Problems developing on scheduled services should be addressed within about half a day except around  Christmas Eve and Christmas Day ( 24 and 25th December ) and New Year's Eve and New Years Day (31st December and 1st Janauary. All other services will be left running mostly unattended. No interruptions are scheduled but restoration of the service in case of failure cannot be guaranteed. Please note that the Helpdesk will be closed, that no file restores from backups will be possible and damaged tapes wi...

  2. Large vessel vasculitides

    OpenAIRE

    Morović-Vergles, Jadranka; Pukšić, Silva; Gudelj Gračanin, Ana

    2013-01-01

    Large vessel vasculitis includes Giant cell arteritis and Takayasu arteritis. Giant cell arteritis is the most common form of vasculitis affect patients aged 50 years or over. The diagnosis should be considered in older patients who present with new onset of headache, visual disturbance, polymyalgia rheumatica and/or fever unknown cause. Glucocorticoides remain the cornerstone of therapy. Takayasu arteritis is a chronic panarteritis of the aorta ant its major branches presenting commonly in y...

  3. Very Versatile Vessel

    Science.gov (United States)

    2009-09-01

    data. This source provides information on aluminum hydrofoil vessels without the added weight of foil structures. The composite armor around the...seating compartment. The sides should also limit wave splash on the deck. The freeboard should contribute reserve buoyancy , increasing large-angle and...Resistance, Powering, and Propulsion Savitsky’s Method Since model testing data or other reliable performance data was unavailable for the proposed

  4. Tremendous bleeding complication after vacuum-assisted sternal closure

    Directory of Open Access Journals (Sweden)

    Isgro Frank

    2011-02-01

    Full Text Available Abstract Vacuum-assisted closure (VAC of complex infected wounds has recently gained popularity among various surgical specialties. The system is based on the application of negative pressure by controlled suction to the wound surface. The effectiveness of the VAC System on microcirculation and the promotion of granulation tissue proliferation are proved. No contraindications for the use in deep sternal wounds in cardiac surgery are described. In our case report we illustrate a scenario were a patient developed severe bleeding from the ascending aorta by penetration of wire fragments in the vessel. We conclude that all free particles in the sternum have to be removed completely before negative pressure is used.

  5. Relapse of a maxillary median diastema: closure and permanent retention.

    Science.gov (United States)

    Mattos, Claudia Trindade; da Silva, Dayanne Lopes; Ruellas, Antonio Carlos de Oliveira

    2012-01-01

    The purpose of this article was to describe the closure of a maxillary median diastema of a 26-year-old woman that had been corrected before during orthodontic treatment but reopened after dental trauma in a car accident. A clear esthetic device made from a tray like those used for home bleaching was used, providing a comfortable, nearly undetectable, and efficient solution. A permanent fixed retainer was bonded again to the maxillary central incisors to prevent relapse. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  6. Transesophageal echocardiography for incremental value of Amplatezer cribriform septal occluder for percutaneous transcatheter closure of complex septal defects: Case series

    Directory of Open Access Journals (Sweden)

    Shen Kou Tsai

    2017-06-01

    Conclusion: Our patients with complex septal defects were successfully treated by transcatheter closure using an Amplazter cribriform septal occluder device with careful planning based on patient presentation and close interdisciplinary collaboration. RT 3D color Doppler TEE provided precise information for the selection of the appropriate occluder device and facilitated the procedure by guiding the catheter through the often challenging patient anatomy.

  7. 40 CFR 146.71 - Closure.

    Science.gov (United States)

    2010-07-01

    ... Director. (3) Prior to well closure, the well shall be flushed with a buffer fluid. (4) Upon closure, a... of fluids into or between USDWs. (5) Placement of the cement plugs shall be accomplished by one of... is completed. (7) The well to be closed shall be in a state of static equilibrium with the mud weight...

  8. Acute angle closure glaucoma following ileostomy surgery

    Directory of Open Access Journals (Sweden)

    Mariana Meirelles Lopes

    2015-02-01

    Full Text Available Angle-closure glaucoma can be induced by drugs that may cause pupillary dilatation. We report a case of a patient that developed bilateral angle closure glaucoma after an ileostomy surgery because of systemic atropine injection. This case report highlights the importance of a fast ophthalmologic evaluation in diseases with ocular involvement in order to make accurate diagnoses and appropriate treatments.

  9. Hospital closure: Phoenix, Hydra or Titanic?

    Science.gov (United States)

    Dunne, T; Davis, S

    1996-01-01

    Very little has been published about the effects of hospital closure in terms of the service, financial or management issues of the process. Attempts through a case-study format to redress the balance and as such represents the reflections of practitioners who have recently undergone the experience of hospital closure and the often neglected issues arising both during and after the process.

  10. Pulmonary function in children after surgical and percutaneous closure of atrial septal defect.

    Science.gov (United States)

    Zaqout, Mahmoud; De Baets, Frans; Schelstraete, Petra; Suys, Bert; Panzer, Joseph; Francois, Katrien; Bove, Thierry; Coomans, Ilse; De Wolf, Daniel

    2010-11-01

    This study aimed to study differences in lung function after surgical and percutaneous atrial septal defect (ASD) closure. Several studies have demonstrated abnormalities of pulmonary function in adults and children with ASD. These abnormalities persist even a few years after correction. This study compared pulmonary function between patients who underwent ASD closure by surgery and those who had closure by device. This is the ideal pediatric population for studying changes in lung function caused by cardiopulmonary bypass or sternotomy. The 46 patients in this study were treated by percutaneous closure (group 1) or surgical closure (group 2) of ASD and then scheduled for pulmonary function testing an average of 5.8 years after ASD closure. The mean values of functional residual capacity, total lung capacity, and residual volume did not differ between the two groups. The surgical group showed a significant decrease in expiratory reserve volume (p function. Longitudinal lung function follow-up assessment after cardiac surgery is warranted to detect and measure restrictive abnormalities in this type of congenital heart disease and others.

  11. Intermittent acute angle closure glaucoma and chronic angle closure following topiramate use with plateau iris configuration

    Directory of Open Access Journals (Sweden)

    Rajjoub LZ

    2014-07-01

    Full Text Available Lamise Z Rajjoub, Nisha Chadha, David A Belyea Department of Ophthalmology, The George Washington University, Washington, DC, USA Abstract: This is a case report describing recurrent intermittent acute angle closure episodes in the setting of topiramate use in a female suffering from migraines. Despite laser peripheral iridotomy placement for the pupillary block component, and the discontinuation of topiramate, the acute angle closure did not resolve in the left eye with chronic angle closure and the patient required urgent trabeculectomy. The right eye responded to laser peripheral iridotomy immediately and further improved after the cessation of topiramate. While secondary angle closure glaucoma due to topiramate use has been widely reported, its effects in patients with underlying primary angle closure glaucoma have not been discussed. Our report highlights the importance of recognizing the often multifactorial etiology of angle closure glaucoma to help guide clinical management. Keywords: angle closure glaucoma, plateau iris, topiramate, secondary glaucoma, drug-induced glaucoma

  12. Experiencia multicéntrica colombiana durante tres años en el cierre percutáneo de la comunicación interventricular con diferentes dispositivos oclusores. Propuesta para la simplicación de la técnica en pacientes seleccionados Colombian multicentric experience during three years for percutaneous closure of interventricular septal defect with different occluder devices. Proposal for technique simplification in selected patients

    Directory of Open Access Journals (Sweden)

    Manuel R Téllez

    2010-09-01

    ,9% acusaron aparición o acentuación de episodios de cefalea vascular migrañosa. Hubo una complicación mayor dada por bloqueo atrioventricular completo y embolización del dispositivo. Conclusiones: el cierre endovascular de la comunicación interventricular es un procedimiento factible en nuestro medio, con el cual se alcanza un éxito cercano al 100%. El dispositivo para cierre de ductus de última generación puede implantarse con modificaciones en la técnica que aminora los tiempos de operatividad (hasta 60%, anestesia, utilización de medio de contraste y estancia hospitalaria. Por otra parte, su perfil hace posible el uso de sistemas de entregas 4 French que posibilitaría la inclusión de lactantes menores.Objectives: we describe the experience of the endovascular closure of interventricular communication performed for three years in different centers of interventional cardiology and highlight its result in a group of selected patients in whom such procedure was made by the use of a last generation device designed for the closure of ductus arteriosus. Methodology: between June 2006 and October 2009, a total of 34 patients underwent endovascular occlusion for interventricular septal defect. Indication of this procedure included volume overload, pressure and volume overload, chronic congestive heart failure, aortic valve prolapse with insufficiency and traumatic injury. Mean age was 12,9 years old and mean weight was 36 kg. A prevalence in male gender (53% was evidenced. Main blood flow calculation showed Qp / Qs of 1.71 to 1 and the pulmonary vascular resistance was 1.18 U Wood/m2. Materials and methods: PM VSD occluder device was implanted with the classic technique (62,5% while the Duct Occluder II (28,1% was used with the proposed simplified technique. General anesthesia was used in 98% cases; 60% were guided by fluoroscopy and transesophageal echocardiography and 40% with transthoracic echocardiography. Results: size of the defect varied from 4 to 12 mm. 91% of

  13. Transcatheter occlusion of baffle leaks following atrial switch procedures for transposition of the great vessels (d-TGV).

    Science.gov (United States)

    Balzer, David T; Johnson, Mark; Sharkey, Angela M; Kort, Henry

    2004-02-01

    Baffle-related complications following atrial switch procedures for transposition are relatively common. Transcatheter treatment of baffle stenosis has an established role as a therapeutic modality. However, transcatheter device closure of atrial baffles leaks has rarely been reported. We report four patients who underwent device closure of baffle leaks using the Amplatzer septal occluder following atrial switch procedures in order to demonstrate the safety and utility of this method of treatment and to establish its role as a suitable alternative to surgical closure. Copyright 2004 Wiley-Liss, Inc.

  14. Patent Ductus Arteriosus closure in preterms less than 2kg: Surgery versus transcatheter.

    Science.gov (United States)

    Pamukcu, Ozge; Tuncay, Aydin; Narin, Nazmi; Baykan, Ali; Korkmaz, Levent; Argun, Mustafa; Ozyurt, Abdullah; Sunkak, Suleyman; Uzum, Kazim

    2018-01-01

    As new devices come into the market, percutaneous techniques improve and interventionalists become more experienced; percutaneous closure gets more common in preterms. In this study we aimed to compare efficacy and safety of Patent Ductus Arteriosus closure surgically versus transcatheter method in preterms Patent Ductus Arteriosus closure in preterms. Between the dates July 1997 to October 2014 in our center Patent Ductus Arteriosus of 26 patients Patent Ductus Arteriosus closure group was significantly more than the surgery group. Mean gestational age of the patients in Group A was 30±1.8weeks, in group B was 28.6±3.5weeks. In group A; all cases were closed successfully except 4 cases: device embolization in 2, cardiac tamponade and iatrogenic aortic coarctation were seen. Pneumomediastinum and chylothorax were the major complications of the surgery group. There was no statistically significance between complication and success rates between two groups. Percutaneous Patent Ductus Arteriosus closure is the candidate for taking the place of surgery in preterms. However, it is not applied routinely; can only be done in fully equipped large centers by experienced interventionalists. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Closure for milliliter scale bioreactor

    Science.gov (United States)

    Klein, David L.; Laidlaw, Robert D.; Andronaco, Gregory; Boyer, Stephen G.

    2010-12-14

    A closure for a microreactor includes a cap that is configured to be inserted into a well of the microreactor. The cap, or at least a portion of the cap, is compliant so as to form a seal with the well when the cap is inserted. The cap includes an aperture that provides an airway between the inside of the well to the external environment when the cap is inserted into the well. A porous plug is inserted in the aperture, e.g., either directly or in tube that extends through the aperture. The porous plug permits gas within the well to pass through the aperture while preventing liquids from passing through to reduce evaporation and preventing microbes from passing through to provide a sterile environment. A one-way valve may also be used to help control the environment in the well.

  16. Closure of Microcosm for refurbishment

    CERN Multimedia

    2014-01-01

    Since 1994, the Microcosm exhibition has given the opportunity to visitors of all ages and backgrounds to have a first glimpse into the secrets of physics.   To ensure that Microcosm can continue fulfilling its educational aims at the same level of quality for many years to come, it is closing for renovation work on 8 December 2014 and is expected to reopen during Summer 2015. During the closure, the “Fun with Physics” workshop will not take place, but the Universe of Particles exhibition in the Globe and the Passport to the Big Bang circuit will remain accessible to the public, free of charge and with no need to book in advance.  Guided tours of CERN are also available (advance booking required via this page).

  17. Vessel Traffic Services.

    Science.gov (United States)

    1982-12-01

    Yorker" articles titled Silent Spring by Rachel Carson in 1963 produced a unifying effect, "the sort of rallying point of the movement to protect the...6232, 92d Cong., 1st. sess., 1971, p. 2. 15. Carson , Rachel L. , The Sea Around Us, New York: Oxford Univesity Press, 195-, p. IV. 16. U.S., Congress...Government Printing Office, 1974. 63. Buhler, L. and Geiger, J., Vessel Traffic Data Extraction MethodoloqX, Silver Spring , Maryland, O6erFae-tns

  18. Vanishing corneal vessels

    Science.gov (United States)

    Nicholson, Luke; Chana, Rupinder

    2013-01-01

    We wish to highlight the importance of acknowledging the accompanying effects of topical phenylephrine drops on the eye other than its intended mydriasis. We reported a case of a 92-year-old woman with a corneal graft who was noted to have superficial corneal vascularisation which was not documented previously. After the instillation of topical tropicamide 1% and phenylephrine 2.5%, for funduscopy, the corneal vascularisation was not visible. When reassessed on another visit, tropicamide had no effect on the vessels and only phenylephrine did. We wish to highlight that when reviewing patients in cornea clinics, instilling phenylephrine prior to being seen may mask important corneal vascularisation. PMID:24121816

  19. Vacuum-assisted closure for sternal wounds: a first-line therapeutic management approach.

    Science.gov (United States)

    Agarwal, Jayant P; Ogilvie, Michael; Wu, Liza C; Lohman, Robert F; Gottlieb, Lawrence J; Franczyk, Mietka; Song, David H

    2005-09-15

    Vacuum-assisted closure therapy has gained widespread use since its introduction in 1997. Previous studies have attributed significant benefit to its use for treatment of sternal wounds with or without mediastinitis. Management of sternal wounds with this therapy has been shown to decrease the number of dressing changes, reduce the time between débridement and definitive closure, and reduce costs associated with a protracted course of in-hospital dressing changes. The therapy has been used both as a bridge between débridement and definitive closure and as a catalyst to secondary sternal-wound healing. The authors performed a retrospective review of 103 patients who underwent vacuum-assisted closure therapy after median sternotomy between June of 1999 and March of 2004 at a single institution. The wounds were classified as sterile wounds, superficial sternal infections, and mediastinitis. The wound closure device, consisting of a polyurethane sponge and evacuation tube with in-line suction, was applied sterilely to all wounds over a layer of Acticoat. Vacuum-assisted closure was utilized in the treatment of sternal wounds for 103 patients (67 male patients and 36 female patients) whose mean age was 52 years (range, 3 months to 91 years). Patient comorbidities included diabetes, chronic obstructive pulmonary disease, end-stage renal disease, immunosuppression, and others. Sixty-four percent of the patients had a diagnosis of mediastinitis; 36 percent had either superficial infections or a sterile wound. The therapy was utilized for an average period of 11 days per patient. Sixty-eight percent of the patients (70 of 103) had definitive chest closure with open reduction internal fixation and/or flap closure. The remaining 32 percent had no definitive closure method. The overall mortality rate was 28 percent (29 of 103 patients), although no deaths were directly related to use of the therapy, and only four deaths resulted from sepsis as a consequence of mediastinitis

  20. 46 CFR 289.2 - Vessels included.

    Science.gov (United States)

    2010-10-01

    ... CONSTRUCTION-DIFFERENTIAL SUBSIDY VESSELS, OPERATING-DIFFERENTIAL SUBSIDY VESSELS AND OF VESSELS SOLD OR ADJUSTED UNDER THE MERCHANT SHIP SALES ACT 1946 § 289.2 Vessels included. Vessels subject to the provisions of this part are: (a) All vessels which may in the future be constructed or sold with construction...

  1. 50. Successful percutanous closure of spiral atrial septal defect

    Directory of Open Access Journals (Sweden)

    Mashail Abdulaziz Alobaidan

    2015-10-01

    An unusual morphology of atrial septal defect has been described where there is an apparently “double atrial septum” (Roberson, 2006. The terminology around this lesion has been attributed to be the wide separation of the primary atrial septum (primum septum from the secondary septum (septum secundum and the “spiral” spatial arrangement of the margins of the atrial septal defect (ASD has led to the term spiral ASD to describe this arrangement. This has been described to be associated with a high risk of device embolization or technical failure in the placement of an occluder device. We report the echocardiographic findings and outcome of a patient with this form of ASD in whom percutaneous occlusion was successful of which is considered up to date to be the first successful closure of this type of ASD.

  2. Blood flow reprograms lymphatic vessels to blood vessels.

    Science.gov (United States)

    Chen, Chiu-Yu; Bertozzi, Cara; Zou, Zhiying; Yuan, Lijun; Lee, John S; Lu, MinMin; Stachelek, Stan J; Srinivasan, Sathish; Guo, Lili; Vicente, Andres; Vincente, Andres; Mericko, Patricia; Levy, Robert J; Makinen, Taija; Oliver, Guillermo; Kahn, Mark L

    2012-06-01

    Human vascular malformations cause disease as a result of changes in blood flow and vascular hemodynamic forces. Although the genetic mutations that underlie the formation of many human vascular malformations are known, the extent to which abnormal blood flow can subsequently influence the vascular genetic program and natural history is not. Loss of the SH2 domain-containing leukocyte protein of 76 kDa (SLP76) resulted in a vascular malformation that directed blood flow through mesenteric lymphatic vessels after birth in mice. Mesenteric vessels in the position of the congenital lymphatic in mature Slp76-null mice lacked lymphatic identity and expressed a marker of blood vessel identity. Genetic lineage tracing demonstrated that this change in vessel identity was the result of lymphatic endothelial cell reprogramming rather than replacement by blood endothelial cells. Exposure of lymphatic vessels to blood in the absence of significant flow did not alter vessel identity in vivo, but lymphatic endothelial cells exposed to similar levels of shear stress ex vivo rapidly lost expression of PROX1, a lymphatic fate-specifying transcription factor. These findings reveal that blood flow can convert lymphatic vessels to blood vessels, demonstrating that hemodynamic forces may reprogram endothelial and vessel identity in cardiovascular diseases associated with abnormal flow.

  3. Vacuum-assisted closure for skin necrosis after revision total knee arthroplasty.

    Science.gov (United States)

    Sarman, Hakan; Muezzinoglu, Umit S; Memisoglu, Kaya; Baran, Tuncay

    2016-10-01

    Although skin necrosis following total knee arthroplasty or revision total knee arthroplasty is rare, it may cause severe complications. Skin changes begin with superficial infections and may result in removal of the prosthesis. Treatment of skin necrosis is an important factor, which determines the prognosis of the prosthesis. Several techniques have been defined for sufficient closure. In this article, we present the case of a patient who was treated for skin necrosis that developed after knee revision arthroplasty, using serial debridement, convergence sutures and an intermittent vacuum-assisted closure device (KCI Inc., San Antonio, TX). © 2014 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  4. Transcatheter closure of patent ductus arteriosus: report of the first case in Nigeria.

    Science.gov (United States)

    Animasahun, B A; Johnson, A; Ogunkunle, O O; Idowu, S; Bode-Thomas, F; Maheshwari, S; Njokanma, O F; Omokhodion, S I

    2012-09-01

    Since the first report on device closure of patent ductus arteriosus (PDA) by Porstmann et al in 1967, the procedure has gained wide acceptance and has been used all over the world, including parts of Africa. The advantages when compared to surgical closure include shorter procedure time and hospital stay and no scar being left. This mode of treatment was not available in Nigeria prior to this with patients having to travel abroad to benefit. Cardiac catheterisation laboratory became available in Lagos, Nigeria in 2009 and in October 2010, the laboratory collaborated with Lagos State University College of Medicine (LASUCOM) and Lagos State University Teaching Hospital (LASUTH), to perform a device closure on a 3-year old girl with PDA who had presented to LASUTH with heart failure at the age of 6 months. To the best of our knowledge, this is the first time the procedure has been performed in Nigeria The patient made a successful recovery and is haemodynamically stable, on no medications. Device closure of PDA is now safe and available in Nigeria.

  5. Catheter closure of patent foramen ovale in patients with cryptogenic cerebrovascular accidents: initial experiences in Japan.

    Science.gov (United States)

    Kijima, Yasufumi; Akagi, Teiji; Nakagawa, Koji; Taniguchi, Manabu; Ueoka, Akira; Deguchi, Kentaro; Toh, Norihisa; Oe, Hiroki; Kusano, Kengo; Sano, Shunji; Ito, Hiroshi

    2014-01-01

    Although numerous studies have shown an association between a patent foramen ovale (PFO) and cryptogenic cerebrovascular accidents (CVA), there has been no definitive control study that demonstrated the benefit of percutaneous device closure of a PFO compared to medical therapy in patients with CVA. Additionally, few clinical data exist for Japanese patients in this field. We demonstrate the initial experiences in catheter closure of a PFO as secondary prevention of CVA in Japan. Catheter closure of a PFO was attempted in 7 patients who were diagnosed with cryptogenic CVA. Mean age at the procedure was 54 ± 19 years. The presence of spontaneous interatrial right-to-left shunts was demonstrated by transesophageal contrast echocardiography without Valsalva maneuver in all of the patients. Amplatzer Cribriform device (n = 4) or Amplatzer PFO Occluder (n = 3) was used for the procedure and was successfully deployed. Device-related complications were not observed at the time of the procedure or during the follow-up period (mean period of 16 ± 9 months). Catheter closure of a PFO could be safely performed with Amplatzer Cribriform or Amplatzer PFO Occluder. This procedure may contribute to prevention of recurrent cryptogenic CVA in Japanese patients.

  6. A Sheaf Model of the Algebraic Closure

    Directory of Open Access Journals (Sweden)

    Bassel Mannaa

    2014-09-01

    Full Text Available In constructive algebra one cannot in general decide the irreducibility of a polynomial over a field K. This poses some problems to showing the existence of the algebraic closure of K. We give a possible constructive interpretation of the existence of the algebraic closure of a field in characteristic 0 by building, in a constructive metatheory, a suitable site model where there is such an algebraic closure. One can then extract computational content from this model. We give examples of computation based on this model.

  7. Yucca Mountain Waste Package Closure System

    Energy Technology Data Exchange (ETDEWEB)

    Herschel Smartt; Arthur Watkins; David Pace; Rodney Bitsoi; Eric Larsen; Timothy McJunkin; Charles Tolle

    2006-04-01

    The current disposal path for high-level waste is to place the material into secure waste packages that are inserted into a repository. The Idaho National Laboratory has been tasked with the development, design, and demonstration of the waste package closure system for the repository project. The closure system design includes welding three lids and a purge port cap, four methods of nondestructive examination, and evacuation and backfill of the waste package, all performed in a remote environment. A demonstration of the closure system will be performed with a full-scale waste package.

  8. Yucca Mountain Waste Package Closure System

    Energy Technology Data Exchange (ETDEWEB)

    shelton-davis; Colleen Shelton-Davis; Greg Housley

    2005-10-01

    The current disposal path for high-level waste is to place the material into secure waste packages that are inserted into a repository. The Idaho National Laboratory has been tasked with the development, design, and demonstration of the waste package closure system for the repository project. The closure system design includes welding three lids and a purge port cap, four methods of nondestructive examination, and evacuation and backfill of the waste package, all performed in a remote environment. A demonstration of the closure system will be performed with a full-scale waste package.

  9. The vessel fluence; Fluence cuve

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    This book presents the proceedings of the technical meeting on the reactors vessels fluence. They are grouped in eight sessions: the industrial context and the stakes of the vessels control; the organization and the methodology for the fluence computation; the concerned physical properties; the reference computation methods; the fluence monitoring in an industrial context; vessels monitoring under irradiation; others methods in the world; the research and development programs. (A.L.B.)

  10. [Large vessel vasculitides].

    Science.gov (United States)

    Morović-Vergles, Jadranka; Puksić, Silva; Gracanin, Ana Gudelj

    2013-01-01

    Large vessel vasculitis includes Giant cell arteritis and Takayasu arteritis. Giant cell arteritis is the most common form of vasculitis affect patients aged 50 years or over. The diagnosis should be considered in older patients who present with new onset of headache, visual disturbance, polymyalgia rheumatica and/or fever unknown cause. Glucocorticoides remain the cornerstone of therapy. Takayasu arteritis is a chronic panarteritis of the aorta ant its major branches presenting commonly in young ages. Although all large arteries can be affected, the aorta, subclavian and carotid arteries are most commonly involved. The most common symptoms included upper extremity claudication, hypertension, pain over the carotid arteries (carotidynia), dizziness and visual disturbances. Early diagnosis and treatment has improved the outcome in patients with TA.

  11. Vessel segmentation in screening mammograms

    Science.gov (United States)

    Mordang, J. J.; Karssemeijer, N.

    2015-03-01

    Blood vessels are a major cause of false positives in computer aided detection systems for the detection of breast cancer. Therefore, the purpose of this study is to construct a framework for the segmentation of blood vessels in screening mammograms. The proposed framework is based on supervised learning using a cascade classifier. This cascade classifier consists of several stages where in each stage a GentleBoost classifier is trained on Haar-like features. A total of 30 cases were included in this study. In each image, vessel pixels were annotated by selecting pixels on the centerline of the vessel, control samples were taken by annotating a region without any visible vascular structures. This resulted in a total of 31,000 pixels marked as vascular and over 4 million control pixels. After training, the classifier assigns a vesselness likelihood to the pixels. The proposed framework was compared to three other vessel enhancing methods, i) a vesselness filter, ii) a gaussian derivative filter, and iii) a tubeness filter. The methods were compared in terms of area under the receiver operating characteristics curves, the Az values. The Az value of the cascade approach is 0:85. This is superior to the vesselness, Gaussian, and tubeness methods, with Az values of 0:77, 0:81, and 0:78, respectively. From these results, it can be concluded that our proposed framework is a promising method for the detection of vessels in screening mammograms.

  12. Americium behaviour in plastic vessels

    Energy Technology Data Exchange (ETDEWEB)

    Legarda, F.; Herranz, M. [Departamento de Ingenieria Nuclear y Mecanica de Fluidos, Escuela Tecnica Superior de Ingenieria de Bilbao, Universidad del Pais Vasco (UPV/EHU), Alameda de Urquijo s/n, 48013 Bilbao (Spain); Idoeta, R., E-mail: raquel.idoeta@ehu.e [Departamento de Ingenieria Nuclear y Mecanica de Fluidos, Escuela Tecnica Superior de Ingenieria de Bilbao, Universidad del Pais Vasco (UPV/EHU), Alameda de Urquijo s/n, 48013 Bilbao (Spain); Abelairas, A. [Departamento de Ingenieria Nuclear y Mecanica de Fluidos, Escuela Tecnica Superior de Ingenieria de Bilbao, Universidad del Pais Vasco (UPV/EHU), Alameda de Urquijo s/n, 48013 Bilbao (Spain)

    2010-07-15

    The adsorption of {sup 241}Am dissolved in water in different plastic storage vessels was determined. Three different plastics were investigated with natural and distilled waters and the retention of {sup 241}Am by these plastics was studied. The same was done by varying vessel agitation time, vessel agitation speed, surface/volume ratio of water in the vessels and water pH. Adsorptions were measured to be between 0% and 70%. The adsorption of {sup 241}Am is minimized with no water agitation, with PET or PVC plastics, and by water acidification.

  13. complementary techniques of percutaneous closure of ductus ...

    African Journals Online (AJOL)

    2013-07-07

    Jul 7, 2013 ... We report this single centre experience of percutaneous. PDA closure in a ... Design: A descriptive retrospective cohort study. ... Three of the subjects in the coil group had the ducts embolised using the double technique while ...

  14. Cyanoacrylate for Intraoral Wound Closure: A Possibility?

    Directory of Open Access Journals (Sweden)

    Parimala Sagar

    2015-01-01

    Full Text Available Wound closure is a part of any surgical procedure and the objective of laceration repair or incision closure is to approximate the edges of a wound so that natural healing process may occur. Over the years new biomaterials have been discovered as an alternate to conventional suture materials. Cyanoacrylate bioadhesives are one among them. They carry the advantages of rapid application, patient comfort, resistance to infection, hemostatic properties, and no suture removal anxiety. Hence this study was undertaken to study the effect of long chain cyanoacrylate as an adhesive for intraoral wound closure and also to explore its hemostatic and antibacterial effects. Isoamyl-2-cyanoacrylate (AMCRYLATE was used as the adhesive in the study. In conclusion isoamyl cyanoacrylate can be used for intraoral wound closure, as an alternative to sutures for gluing the mucoperiosteum to bone, for example, after impaction removal, periapical surgeries, and cleft repair. Its hemostatic and antibacterial activity has to be further evaluated.

  15. Feasibility of lane closures using probe data.

    Science.gov (United States)

    2017-04-01

    To develop an adequate traffic operations management and congestion mitigation plan for every roadway : maintenance and construction project requiring lane closures, transportation agencies need accurate and : reliable estimates of traffic impacts as...

  16. Uterine incision cloSure at caesarean section: A randomised ...

    African Journals Online (AJOL)

    nylon suture size 0. The only difference between the two groups was on the method of closure of uterine incision i.e. intraperitoneal closure or closure after temporary exteriorisation. Intraperitoneal closure. After delivery of the baby and the placenta, the uterine incision is closed with the uterus within the abdominal cavity.

  17. Single-site neural tube closure in human embryos revisited

    NARCIS (Netherlands)

    de Bakker, Bernadette S.; Driessen, Stan; Boukens, Bastiaan J. D.; van den Hoff, Maurice J. H.; Oostra, Roelof-Jan

    2017-01-01

    Since the multi-site closure theory was first proposed in 1991 as explanation for the preferential localizations of neural tube defects, the closure of the neural tube has been debated. Although the multi-site closure theory is much cited in clinical literature, single-site closure is most apparent

  18. Spontaneous closure of muscular ventricular septal defects

    Directory of Open Access Journals (Sweden)

    Pejčić Ljiljana

    2017-01-01

    Full Text Available Introduction/Objective. Ventricular septal defect (VSD is the most frequently diagnosed congenital heart anomaly. The prognosis is usually good as it has spontaneous closure evolution, especially small muscular VSDs. The aim of this study was to determine the natural history of isolated muscular VSDs including the frequency of spontaneous closure in relation to location in the muscular septum and the age at the time of closure. Methods. The study included 96 children (52 girls and 44 boys with isolated muscular VSD diagnosed during the first month of life. We analyzed the tendency of spontaneous closure of these defects for the duration of childhood during a follow-up period of 16 years. Two-dimensional color Doppler echocardiography was performed to detect muscular VSD as a primary cardiac lesion. There was significant prevalence of small apical versus trabecular defects and their outcomes were evaluated. Results. Our study evaluated 91 children, 49 (53.8% girls and 42 (46.2% boys who did not undergo surgery. Apically located VSD was diagnosed in 68 (74.7%, while trabecular defects were found in 23 (25.3% children. Spontaneous closure occurred in 56 out of 91 cases (61.5%. The time of spontaneous closure was most commonly recorded during the first six months after birth (46.4%. The overall rate of spontaneous closure was 81.3% by the end of the first year. Apically located ventricular defects underwent spontaneous closure in the majority of patients, in comparison to trabecular ventricular defects (χ2 = 12.581; p < 0.001. Kaplan–Meier analysis demonstrated a significant difference in the average time required for spontaneous closure between the analyzed patient groups (log-rank = 9.64, p = 0.002. Conclusion. The frequency of spontaneous closure of muscular VSDs, especially apically located, is very high in the first six months, especially within the first year of life. It is advisable to detect them early on using color flow imaging and to

  19. Residual Angle Closure One Year After Laser Peripheral Iridotomy in Primary Angle Closure Suspects.

    Science.gov (United States)

    Baskaran, Mani; Yang, Elizabeth; Trikha, Sameer; Kumar, Rajesh S; Wong, Hon Tym; He, Mingguang; Chew, Paul T K; Foster, Paul J; Friedman, David; Aung, Tin

    2017-11-01

    To determine the incidence and baseline clinical and anterior segment optical coherence tomography (AS-OCT) predictors associated with residual angle closure as assessed by gonioscopy 1 year after laser peripheral iridotomy (LPI) in primary angle closure suspects (PACS). Subanalysis of randomized controlled trial data. AS-OCT images from 181 PACS subjects ≥50 years of age were analyzed using customized software before and 1 year after LPI. Other parameters assessed were intraocular pressure (IOP) and axial length (Axl). Residual angle closure was defined as the inability to see the posterior trabecular meshwork for at least 2 quadrants on gonioscopy after LPI. Multivariate regression analysis determined the baseline predictors of residual angle closure 1 year after LPI. The mean age of participants was 62.4 (standard deviation 9.9) years. The majority were female (137, 75.7%) and Chinese (174, 96.1%). At 1 year post LPI, 148 (81.8%) subjects had gonioscopic residual angle closure. Univariate analysis showed that baseline Axl, anterior chamber area, anterior chamber volume, angle opening distance at 750 μm from the scleral spur, and angle recess area were smaller while baseline lens vault and iris curvature were larger in residual angle closure subjects (all P angle closure. One year after LPI, >80% of PACS had gonioscopic residual angle closure. Greater baseline iris volume and higher IOP at baseline are independent risk factors for residual gonioscopic angle closure. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Why does acute primary angle closure happen? Potential risk factors for acute primary angle closure.

    Science.gov (United States)

    Zhang, Xiulan; Liu, Yaoming; Wang, Wei; Chen, Shida; Li, Fei; Huang, Wenbin; Aung, Tin; Wang, Ningli

    Acute primary angle closure is an ocular emergency and requires immediate management to avoid blindness. Narrow anterior chamber angle, advanced age, female gender, and Asian ethnic background are considered risk factors for acute primary angle closure. The predictive power of these factors is, however, relatively poor, and many questions remain unanswered because acute primary angle closure eventually develops in only a relatively small proportion of anatomically predisposed eyes. We summarize the potential roles of various factors in the pathogenesis of acute primary angle closure. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. [Percutaneous closure of patent ductus arteriosus: results and costs compared to surgical closure].

    Science.gov (United States)

    Vieu, T; Beaurain, S; Angel, C; Leriche, H; Petit, J; Conso, J F; Planché, C; Losay, J

    1995-10-01

    The comparison of the clinical results and costs of the two methods of closure of patient ductus arteriosus was undertaken in two comparable groups of 40 patients treated in the same period in the same hospital. After transcatheter closure there was a 9% residual shunt rate at 3 years, the 2 patients with a residual continuous murmur being operated secondarily. The only complication was severe haemolysis which regressed after transcatheter ablation of the prosthesis. After surgical closure, there were no residual shunt. Some postoperative complications were observed in 20% of cases, usually benign (ventilatory problems, dysphonia or urinary infection), but occasionally more serious (peroperative lesion of the pulmonary artery). Morbidity, inherent to the technique of closure, was very different and much less in catheter closure. The average cost (daily cost x average length of hospital stay) was much less with transcatheter closure 38,558 francs versus 11,240 francs. On the other hand, the direct cost of transcatheter closure was greater than that of surgery: 32,798 francs versus 20,903 francs, the difference being related to the actual price of the prosthesis. The authors conclude that the 3 year results of transcatheter closure of patent ductus arterious make this technique a reasonable therapeutic alternative to surgery. From the safety point of view, the two techniques are comparable bu patient confort is greater with transcatheter closure for an increase in cost of the initial procedure which should decrease in relation to the types and prices of the prosthesis used.

  2. Comparison of Outcomes with Hand-sewn Versus Stapler Closure of Pancreatic Stump in Distal Pancreatectomy.

    Science.gov (United States)

    Futagawa, Yasuro; Takano, Yuki; Furukawa, Kenei; Kanehira, Masaru; Onda, Shinji; Sakamoto, Taro; Gocho, Takeshi; Shiba, Hiroaki; Yanaga, Katsuhiko

    2017-05-01

    The optimal method for pancreatic stump closure to prevent postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP), remains controversial though DP is still the only curative treatment for pancreatic cancer and other malignancies located on pancreatic body or tail. A total of 44 patients who consecutively underwent open DP were retrospectively analyzed, dividing them into two groups: group H (hand-sewn; n=24) and group S (stapler closure; n=20). POPFs were encountered in 5 (21%) and 11 (55%) patients in groups H and S, respectively (p=0.02). POPFs of Clavien-Dindo grade IIIa or above were observed in two (8%) and seven (35%) patients in groups H and S, respectively (p=0.03). When indicating stapler closure, caution should be exercised for pancreatic consistency and thickness, device and cartridge type, and pancreatic duct ligation to more effectively control POPF rates. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  3. Exceptional closure of UNIQA office at CERN

    CERN Multimedia

    HR Department

    2009-01-01

    The UNIQA office at CERN will be closed from Wednesday 18 February to Friday 20 February due to painting work. During this closure, the Headquarters of UNIQA in Geneva will remain at the disposal of the members. See details https://cern.ch/chis/UNIQA_Offices.asp The CERN office will re-open on Monday 23 February according to the normal schedule. We apologise for any inconvenience caused by this closure.

  4. Theater gateway closure: a strategic level barricade

    Science.gov (United States)

    logistical planners at the strategic level can anticipate or mitigate the effects of a theater gateway closure on military operations. Through two...the national elements of power was used to find the strategic level effects of the anomaly, that is an unexpected theater gateway closure. It was found...operations. A detailed analysis of the theater gateways location is critical to mitigate or anticipate the sustainment impacts on military operations

  5. [Vacuum-assisted Closure Therapy for Residual Space after Open Window Thoracotomy for Pleural Empyema due to Bronchopleural Fistula].

    Science.gov (United States)

    Togo, Takeo; Hasumi, Tohru; Hoshi, Fumihiko; Hoshikawa, Yasushi; Okada, Yoshinori; Saito, Yasuki

    2016-05-01

    A 73-year-old man underwent right middle-lower bilobectomy for lung adenocarcinoma. He suffered from pneumonia followed by empyema due to bronchopleural fistula. On day 19 after the operation, an open window thoracostomy was created. Then the pleural space was treated conservatively with saline irrigation and petrolatum gauze packing. Progressive formation of healthy granulation tissue was observed around the bronchopleural fistula and the adjacent pulmonary artery, resulting in a complete closure of the bronchopleural fistula. And then we applied vacuum-assisted closure (VAC) therapy to the residual pleural cavity. At 4 weeks after the initiation of VAC therapy, the pleural cavity was completely filled with granulation tissue and re-expanded residual lung. In conclusion, VAC therapy is a safe and effective treatment for residual space after open window thoracostomy for empyema due to bronchopleural fistula, if it is applied after closure of bronchopleural fistula and adequate granulation tissue formation on the great vessels.

  6. Fenestrated Transcatheter ASD Closure in Adults with Diastolic Dysfunction and/or Pulmonary Hypertension: Case Series and Review of the Literature.

    Science.gov (United States)

    Abdelkarim, Ayman; Levi, Daniel S; Tran, Bao; Ghobrial, Joanna; Aboulhosn, Jamil

    2016-12-01

    This study aims to evaluate the safety and efficacy of transcatheter fenestrated ASD closure and to summarize the literature regarding the published techniques and outcomes of transcatheter partial ASD closure. Patients with left ventricular diastolic dysfunction (LVDD) or right ventricular (RV) dysfunction and/or pulmonary hypertension (PHT) may suffer untoward consequences of complete closure of an ostium secundum atrial septal defect (ASD). Therefore, for patients that fall under these categories we suggest partial occlusion of the defect, which may be better tolerated than complete defect closure. After obtaining IRB approval, a search for patients that have undergone percutaneous ASD closure was performed in the Ahmanson/UCLA Adult Congenital Heart Disease Center database to identify which patients received a fenestrated ASD closure device. Eight consecutive patients ranging between 22 and 83 years of age (mean 48 years) with PHT and/or LVDD or RV dysfunction who underwent fenestrated transcatheter ASD closure at UCLA were identified. None of the subjects experienced complications related to the procedure. Postprocedure clinical evaluation showed improvement in symptoms and exercise capacity. Available follow-up transthoracic echocardiography data (mean 4 months, range 0-20 months) demonstrated patent fenestrations in four of eight patients. None of the patients had thromboembolic or infectious complications and there were no device migrations, erosions or embolizations. Partial ASD occlusion in patients with diastolic dysfunction or RV dysfunction and/or PHT is safe and may be better tolerated than complete ASD closure in selected patients. © 2016 Wiley Periodicals, Inc.

  7. 77 FR 75186 - Notice of Closure, Target Shooting Public Safety Closure on the Lake Mountains in Utah County, UT

    Science.gov (United States)

    2012-12-19

    ... Bureau of Land Management Notice of Closure, Target Shooting Public Safety Closure on the Lake Mountains... shooting to protect public safety. This closure does not restrict other public activities or access to the Lake Mountains area. DATES: This target shooting closure within the described area will remain in...

  8. Percutaneous closure of perimembranous ventricular septal defect with an Amplatzer Duct Occluder in a dextrocardia patient.

    Science.gov (United States)

    Ergene, Oktay; Nazli, Cem; Kocabas, Ugur; Duygu, Hamza; Akyildiz, Zehra Ilke; Hijazi, Ziyad M

    2011-07-15

    In this article we report an unusual case of dextrocardia patient with perimembranous ventricular septal defect (VSD) whose defect is closed by percutaneous method with Amplatzer Duct Occluder-II device. To our best knowledge, this was the first time this device has been used to close a membranous defect in a patient with dextrocardia. Our case demonstrates the feasibility of percutaneous VSD closure in challenging patients by using appropiate techniques and devices for particular patients. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  9. Primary angle closure glaucoma: What we know and what we don't know.

    Science.gov (United States)

    Sun, Xinghuai; Dai, Yi; Chen, Yuhong; Yu, Dao-Yi; Cringle, Stephen J; Chen, Junyi; Kong, Xiangmei; Wang, Xiaolei; Jiang, Chunhui

    2017-03-01

    Primary angle-closure glaucoma (PACG) is a common cause of blindness. Angle closure is a fundamental pathologic process in PAGC. With the development of imaging devices for the anterior segment of the eye, a better understanding of the pathogenesis of angle closure has been reached. Aside from pupillary block and plateau iris, multiple-mechanisms are more common contributors for closure of the angle such as choroidal thickness and uveal expansion, which may be responsible for the presenting features of PACG. Recent Genome Wide Association Studies identified several new PACG loci and genes, which may shed light on the molecular mechanisms of PACG. The current classification systems of PACG remain controversial. Focusing the anterior chamber angle is a principal management strategy for PACG. Treatments to open the angle or halt the angle closure process such as laser peripheral iridotomy and/or iridoplasty, as well as cataract extraction, are proving their effectiveness. PACG may be preventable in the early stages if future research can identify which kind of angles and/or persons are more likely to benefit from prophylactic treatment. New treatment strategies like adjusting the psychological status and balancing the sympathetic-parasympathetic nerve activity, and innovative medicines are needed to improve the prognosis of PACG. In this review, we intend to describe current understanding and unknown aspects of PACG, and to share the clinical experience and viewpoints of the authors. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Accelerating cleanup: Paths to closure

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-06-01

    This report describes the status of Environmental Management`s (EM`s) cleanup program and a direction forward to complete achievement of the 2006 vision. Achieving the 2006 vision results in significant benefits related to accomplishing EM program objectives. As DOE sites accelerate cleanup activities, risks to public health, the environment, and worker safety and health are all reduced. Finding more efficient ways to conduct work can result in making compliance with applicable environmental requirements easier to achieve. Finally, as cleanup activities at sites are completed, the EM program can focus attention and resources on the small number of sites with more complex cleanup challenges. Chapter 1 describes the process by which this report has been developed and what it hopes to accomplish, its relationship to the EM decision-making process, and a general background of the EM mission and program. Chapter 2 describes how the site-by-site projections were constructed, and summarizes, for each of DOE`s 11 Operations/Field Offices, the projected costs and schedules for completing the cleanup mission. Chapter 3 presents summaries of the detailed cleanup projections from three of the 11 Operations/Field Offices: Rocky Flats (Colorado), Richland (Washington), and Savannah River (South Carolina). The remaining eight Operations/Field Office summaries are in Appendix E. Chapter 4 reviews the cost drivers, budgetary constraints, and performance enhancements underlying the detailed analysis of the 353 projects that comprise EM`s accelerated cleanup and closure effort. Chapter 5 describes a management system to support the EM program. Chapter 6 provides responses to the general comments received on the February draft of this document.

  11. Left atrial appendage closure: a new technique for clinical practice.

    Science.gov (United States)

    John Camm, A; Colombo, Antonio; Corbucci, Giorgio; Padeletti, Luigi

    2014-03-01

    Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. It is associated with increased risk for stroke mainly due to cardiac embolism from the left atrial appendage (LAA). Occlusion of the LAA by means of a device represents a valid alternative to oral anticoagulation, mainly in patients who cannot tolerate this therapy because of a high bleeding risk. Recent data on the endocardial device WATCHMAN show encouraging results for this patient population in terms of stroke risk reduction compared to the expected rate as well as in terms of implant success. This article reviews all relevant publications related to the main surgical and transcatheter devices used for LAA closure (LAAC). PROTECT-AF, the first prospective randomized trial conducted on this technique, showed that LAA occlusion using the WATCHMAN was noninferior to warfarin for a combined end-point in patients with nonvalvular AF. There is a lack of large-scale randomized trials on long-term stroke risk in patients submitted to LAAC. Most studies are relatively small and focus on the comparison of different surgical techniques with regard to complete/incomplete closure success. More recently, PROTECT-AF long-term results (4-year follow-up) demonstrated that LAAC was statistically superior to warfarin in terms of efficacy. This review concludes that it is now appropriate to consider these techniques for patients with AF who are at high risk for stroke for whom effective conventional or novel anticoagulant therapy is not available or who present problems in managing drug treatment. Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  12. Characterization of microchannels created by metal microneedles: formation and closure.

    Science.gov (United States)

    Kalluri, Haripriya; Kolli, Chandra Sekhar; Banga, Ajay K

    2011-09-01

    Transdermal delivery of therapeutic agents for cosmetic therapy is limited to small and lipophilic molecules by the stratum corneum barrier. Microneedle technology overcomes this barrier and offers a minimally invasive and painless route of administration. DermaRoller(®), a commercially available handheld device, has metal microneedles embedded on its surface which offers a means of microporation. We have characterized the microneedles and the microchannels created by these microneedles in a hairless rat model, using models with 370 and 770 μm long microneedles. Scanning electron microscopy was employed to study the geometry and dimensions of the metal microneedles. Dye binding studies, histological sectioning, and confocal microscopy were performed to characterize the created microchannels. Recovery of skin barrier function after poration was studied via transepidermal water loss (TEWL) measurements, and direct observation of the pore closure process was investigated via calcein imaging. Characterization studies indicate that 770 μm long metal microneedles with an average base width of 140 μm and a sharp tip with a radius of 4 μm effectively created microchannels in the skin with an average depth of 152.5 ± 9.6 μm and a surface diameter of 70.7 ± 9.9 μm. TEWL measurements indicated that skin regains it barrier function around 4 to 5 h after poration, for both 370 and 770 μm microneedles. However, direct observation of pore closure, by calcein imaging, indicated that pores closed by 12 h for 370 μm microneedles and by 18 h for 770 μm microneedles. Pore closure can be further delayed significantly under occluded conditions.

  13. 50 CFR 648.8 - Vessel identification.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Vessel identification. 648.8 Section 648.8... identification. (a) Vessel name and official number. Each fishing vessel subject to this part and over 25 ft (7.6... or ocean quahog vessels licensed under New Jersey law may use the appropriate vessel identification...

  14. Percutaneous retrograde transfemoral closure of mitral paravalvular leak in 3 patients without construction of an arteriovenous wire loop.

    Science.gov (United States)

    Kilic, Teoman; Sahin, Tayfun; Ural, Ertan

    2014-04-01

    Percutaneous closure of paravalvular leaks has emerged as an alternative to repeated surgeries. Different percutaneous techniques and various devices have been used, off-label, for paravalvular leak closure. For mitral leaks, antegrade transseptal, retrograde transfemoral, and retrograde transapical techniques have been developed. In the antegrade transseptal approach, an arteriovenous guidewire loop is often created to advance the delivery sheath. In retrograde transfemoral closure, the wire in the left atrium is usually snared after transseptal puncture, to pull it from the femoral vein. The delivery sheath and closure device will subsequently be deployed from the left atrium. Each of these procedures takes time, is costly, and increases the risk of complications. We present the cases of 3 patients in whom we closed mitral paravalvular leaks by means of a retrograde transfemoral approach, with use of an Amplatzer™ Duct Occluder II device and without the construction of an arteriovenous wire loop. We think that this approach can be very useful in a specific group of patients-reducing costs, fluoroscopy times, and complications related to transseptal puncture and construction of an arteriovenous wire loop. In our institution, this reported technique is routinely used for mitral paravalvular leak closure.

  15. Anterior Segment Imaging for Angle Closure.

    Science.gov (United States)

    Chansangpetch, Sunee; Rojanapongpun, Prin; Lin, Shan C

    2018-01-31

    To summarize the role of anterior segment imaging (AS-imaging) in angle closure diagnosis and management, and the possible advantages over the current standard of gonioscopy. Literature review and perspective. Review of the pertinent publications with interpretation and perspective in relation to the use of AS-imaging in angle closure assessment focusing on anterior segment optical coherence tomography and ultrasound biomicroscopy. Several limitations have been encountered with the reference standard of gonioscopy for angle assessment. AS-imaging has been shown to have performance in angle closure detection compared to gonioscopy. Also, imaging has greater reproducibility and serves as better documentation for long-term follow-up than conventional gonioscopy. The qualitative and quantitative information obtained from AS-imaging enables better understanding of the underlying mechanisms of angle closure and provides useful parameters for risk assessment and possible prediction of the response to laser and surgical intervention. The latest technologies-including 3-dimensional imaging-have allowed for the assessment of the angle that simulates the gonioscopic view. These advantages suggest that AS-imaging has a potential to be a reference standard for the diagnosis and monitoring of angle closure disease in the future. Although gonioscopy remains the primary method of angle assessment, AS-imaging has an increasing role in angle closure screening and management. The test should be integrated into clinical practice as an adjunctive tool for angle assessment. It is arguable that AS-imaging should be considered first-line screening for patients at risk for angle closure. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. 2D Fast Vessel Visualization Using a Vessel Wall Mask Guiding Fine Vessel Detection

    Directory of Open Access Journals (Sweden)

    Sotirios Raptis

    2010-01-01

    and then try to approach the ridges and branches of the vasculature's using fine detection. Fine vessel screening looks into local structural inconsistencies in vessels properties, into noise, or into not expected intensity variations observed inside pre-known vessel-body areas. The vessels are first modelled sufficiently but not precisely by their walls with a tubular model-structure that is the result of an initial segmentation. This provides a chart of likely Vessel Wall Pixels (VWPs yielding a form of a likelihood vessel map mainly based on gradient filter's intensity and spatial arrangement parameters (e.g., linear consistency. Specific vessel parameters (centerline, width, location, fall-away rate, main orientation are post-computed by convolving the image with a set of pre-tuned spatial filters called Matched Filters (MFs. These are easily computed as Gaussian-like 2D forms that use a limited range sub-optimal parameters adjusted to the dominant vessel characteristics obtained by Spatial Grey Level Difference statistics limiting the range of search into vessel widths of 16, 32, and 64 pixels. Sparse pixels are effectively eliminated by applying a limited range Hough Transform (HT or region growing. Major benefits are limiting the range of parameters, reducing the search-space for post-convolution to only masked regions, representing almost 2% of the 2D volume, good speed versus accuracy/time trade-off. Results show the potentials of our approach in terms of time for detection ROC analysis and accuracy of vessel pixel (VP detection.

  17. BY FRUSTUM CONFINING VESSEL

    Directory of Open Access Journals (Sweden)

    Javad Khazaei

    2016-09-01

    Full Text Available Helical piles are environmentally friendly and economical deep foundations that, due to environmental considerations, are excellent additions to a variety of deep foundation alternatives available to the practitioner. Helical piles performance depends on soil properties, the pile geometry and soil-pile interaction. Helical piles can be a proper alternative in sensitive environmental sites if their bearing capacity is sufficient to support applied loads. The failure capacity of helical piles in this study was measured via an experimental research program that was carried out by Frustum Confining Vessel (FCV. FCV is a frustum chamber by approximately linear increase in vertical and lateral stresses along depth from top to bottom. Due to special geometry and applied bottom pressure, this apparatus is a proper choice to test small model piles which can simulate field stress conditions. Small scale helical piles are made with either single helix or more helixes and installed in fine grained sand with three various densities. Axial loading tests including compression and tension tests were performed to achieve pile ultimate capacity. The results indicate the helical piles behavior depends essentially on pile geometric characteristics, i.e. helix configuration and soil properties. According to the achievements, axial uplift capacity of helical model piles is about equal to usual steel model piles that have the helixes diameter. Helical pile compression bearing capacity is too sufficient to act as a medium pile, thus it can be substituted other piles in special geoenvironmental conditions. The bearing capacity also depends on spacing ratio, S/D, and helixes diameter.

  18. Southeast Region Headboat Survey-Vessel list/Vessel Directory

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This is a database of vessels that have been on the SRHS through time, their owners/operators, marinas/docks and their contact information. This assists in...

  19. Space Station evolution study oxygen loop closure

    Science.gov (United States)

    Wood, M. G.; Delong, D.

    1993-01-01

    In the current Space Station Freedom (SSF) Permanently Manned Configuration (PMC), physical scars for closing the oxygen loop by the addition of oxygen generation and carbon dioxide reduction hardware are not included. During station restructuring, the capability for oxygen loop closure was deferred to the B-modules. As such, the ability to close the oxygen loop in the U.S. Laboratory module (LAB A) and the Habitation A module (HAB A) is contingent on the presence of the B modules. To base oxygen loop closure of SSF on the funding of the B-modules may not be desirable. Therefore, this study was requested to evaluate the necessary hooks and scars in the A-modules to facilitate closure of the oxygen loop at or subsequent to PMC. The study defines the scars for oxygen loop closure with impacts to cost, weight and volume and assesses the effects of byproduct venting. In addition, the recommended scenarios for closure with regard to topology and packaging are presented.

  20. Attempted eyelid closure affects intraocular pressure measurement.

    Science.gov (United States)

    Gandhi, P D; Gürses-Ozden, R; Liebmann, J M; Ritch, R

    2001-04-01

    To evaluate the effect of attempted eyelid closure on intraocular pressure measurement. Normal subjects underwent intraocular pressure measurement in both eyes using Goldmann applanation tonometry and Tono-pen XL (Mentor, Inc, Norwell, Massachusetts) by the same examiner holding the eyelids open, both with and without the subject simultaneously attempting forced eyelid closure. Subjects were seated during all measurements and waited 5 minutes between measurements with each instrument; the order of measurement was randomized. Thirty eyes of 15 subjects (six men, nine women) were enrolled. Mean age was 30.5 +/- 5.2 years (range, 24 to 40 years). With Goldmann applanation tonometry, intraocular pressure increased in both eyes with attempted eyelid closure by a mean of 1.5 +/- 2.0 mm Hg (P =.0002, paired t test; range, -2 to 8 mm Hg). With the Tono-pen XL, intraocular pressure also increased in both eyes with attempted eyelid closure by a mean of 1.9 +/- 2.7 mm Hg (P =.0002, paired t test; range, -2 to 9 mm Hg). Tono-pen XL mean intraocular pressure values in both eyes (14.4 +/- 2.3 mm Hg) consistently overestimated those of Goldmann applanation tonometry (13.0 +/- 2.2 mm Hg) by a mean of 1.4 +/- 2.3 mm Hg. Attempted forced eyelid closure is a common and statistically significant source of error in routine outpatient measurement of intraocular pressure and could influence clinical management of glaucoma.

  1. PROJECT LIFE CYCLE OF LEASING MARINE VESSEL OWNERS AND CHARTERERS

    Directory of Open Access Journals (Sweden)

    Алла Витальевна БОНДАРЬ

    2016-03-01

    Full Text Available Based on the study of the basic types of the bareboat charter, presented algorithms decision on the justification of the respective projects. It was found that the initiator of the project can be both owners who wants to pass the boat rental and the charterer, and also who is the owner, who wants to take a boat for rent. It is proved that the implementation of these specific operations requires careful preparation, and using of the project approach will greatly enhance their effectiveness. We describe the life of the project finance lease from the standpoint of the marine vessel, the ship-owner and charterer. It is established that such projects characterized by four-phase structure of the life cycle: preparation, let's call it as the principal decision on (from the chartering of the vessel, the investment - to select the optimal variant (from the charter and the conclusion of the bareboat charter, the phase of operation of the vessel and the fourth - the closure of the project at the end of term bareboat charter. Skill description of the content of each phase, which will continue for the main participants of the project to determine the value of each phase and the value of the whole project.

  2. Tulip deformity with Cera atrial septal defect devices: a report of 3 cases.

    Science.gov (United States)

    Kohli, Vikas

    2015-02-01

    Device closure of secundum atrial septal defect (ASD) is the treatment of choice when anatomy is favourable. Amplatzer device has remained the gold standard for closure of ASD. Cobra deformity is a well-reported problem with devices. Recently, Tulip deformity has been reported in a single case. We report a series of cases where we noted Tulip deformity along with inability to retract the device in the sheath in Cera Lifetech devices. This resulted in prolongation of procedure, excessive fluoroscopic exposure and additional interventional procedures not usually anticipated in ASD device closure. We believe that the problem is due to the stiffness of the device resulting in its inability to be retracted into the sheath. We also report a unique way of retrieving the device.

  3. Role of management devices in enacting strategy

    DEFF Research Database (Denmark)

    Harritz, Daniel

    2016-01-01

    Purpose - This study illustrates the role of management devices in enacting strategy and strategic decisions, resulting in the development of a Shared Service Centre (SSC) in a Danish municipality. It shows how devices interact in defending, rejecting and reframing strategy, leading to the closure...... role of management devices. Practical implications - The findings facilitate a deeper understanding of factors triggering strategic development in the public sector. Also, it identifies aspects leading to failures by investigating how different devices allow local actors to stay connected and affect...

  4. Semi-automated retinal vessel analysis in nonmydriatic fundus photography.

    Science.gov (United States)

    Schuster, Alexander Karl-Georg; Fischer, Joachim Ernst; Vossmerbaeumer, Urs

    2014-02-01

    Funduscopic assessment of the retinal vessels may be used to assess the health status of microcirculation and as a component in the evaluation of cardiovascular risk factors. Typically, the evaluation is restricted to morphological appreciation without strict quantification. Our purpose was to develop and validate a software tool for semi-automated quantitative analysis of retinal vasculature in nonmydriatic fundus photography. matlab software was used to develop a semi-automated image recognition and analysis tool for the determination of the arterial-venous (A/V) ratio in the central vessel equivalent on 45° digital fundus photographs. Validity and reproducibility of the results were ascertained using nonmydriatic photographs of 50 eyes from 25 subjects recorded from a 3DOCT device (Topcon Corp.). Two hundred and thirty-three eyes of 121 healthy subjects were evaluated to define normative values. A software tool was developed using image thresholds for vessel recognition and vessel width calculation in a semi-automated three-step procedure: vessel recognition on the photograph and artery/vein designation, width measurement and calculation of central retinal vessel equivalents. Mean vessel recognition rate was 78%, vessel class designation rate 75% and reproducibility between 0.78 and 0.91. Mean A/V ratio was 0.84. Application on a healthy norm cohort showed high congruence with prior published manual methods. Processing time per image was one minute. Quantitative geometrical assessment of the retinal vasculature may be performed in a semi-automated manner using dedicated software tools. Yielding reproducible numerical data within a short time leap, this may contribute additional value to mere morphological estimates in the clinical evaluation of fundus photographs. © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  5. CT imaging for left atrial appendage closure: a review and pictorial essay.

    Science.gov (United States)

    Ismail, Tevfik Fehmi; Panikker, Sandeep; Markides, Vias; Foran, John P; Padley, Simon; Rubens, Michael B; Wong, Tom; Nicol, Edward

    2015-01-01

    Cardioembolic stroke is an important complication of atrial fibrillation. The thrombus responsible for this arises from the left atrial appendage (LAA) in >90% of cases, providing the rationale for device-based LAA closure as a means of thromboprophylaxis. Although oral anticoagulant therapy remains the mainstay for reducing the risk of stroke in patients with atrial fibrillation, an increasing number of patients, particularly those ineligible for conventional pharmacotherapy, are being offered percutaneous left atrial appendage closure. Cardiovascular CT can provide important information to assess the suitability of patients for LAA interventions and guide device selection and approach. The high spatial resolution and multiplanar capability of contemporary contrast-enhanced gated multidetector cardiovascular CT render it an ideal modality for noninvasively evaluating patients before intervention and assessing patients after intervention both for complications and procedural outcome. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  6. Transcatheter closure of left ventricle to right atrial communication using cera duct occluder.

    Science.gov (United States)

    Ganesan, Gnanavelu; Paul, G Justin; Mahadevan, Vaikom S

    Left ventricle-right atrial communication could be congenital (Gerbode defect) or acquired as a complication of surgery or infective endocarditis and leads to volume overloading of pulmonary circulation. Two types, direct and indirect types are known depending on the involvement of septal tricuspid leaflet. Transcatheter closure of this defect is feasible and appears an attractive alternative to surgical management. Various devices like Amplatzer duct occluder I, II, Muscular ventricular septal defect device etc. have been used to close this defect. We report two patients, a preteen boy with direct left ventricle-right atrial communication as post operative complication and an adult female with indirect communication who underwent transcatheter closure with Cera duct occluder (Lifetech Scientific (Shenzhen), China). Copyright © 2017. Published by Elsevier B.V.

  7. Parallel closure theory for toroidally confined plasmas

    Science.gov (United States)

    Ji, Jeong-Young; Held, Eric D.

    2017-10-01

    We solve a system of general moment equations to obtain parallel closures for electrons and ions in an axisymmetric toroidal magnetic field. Magnetic field gradient terms are kept and treated using the Fourier series method. Assuming lowest order density (pressure) and temperature to be flux labels, the parallel heat flow, friction, and viscosity are expressed in terms of radial gradients of the lowest-order temperature and pressure, parallel gradients of temperature and parallel flow, and the relative electron-ion parallel flow velocity. Convergence of closure quantities is demonstrated as the number of moments and Fourier modes are increased. Properties of the moment equations in the collisionless limit are also discussed. Combining closures with fluid equations parallel mass flow and electric current are also obtained. Work in collaboration with the PSI Center and supported by the U.S. DOE under Grant Nos. DE-SC0014033, DE-SC0016256, and DE-FG02-04ER54746.

  8. Hanford Patrol Academy demolition sites closure plan

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-30

    The Hanford Site is owned by the U.S. Government and operated by the U.S. Department of Energy, Richland Operations Office. Westinghouse Hanford Company is a major contractor to the U.S. Department of Energy, Richland Operations Office and serves as co-operator of the Hanford Patrol Academy Demolition Sites, the unit addressed in this paper. This document consists of a Hanford Facility Dangerous Waste Part A Permit Application, Form 3 (Revision 4), and a closure plan for the site. An explanation of the Part A Form 3 submitted with this closure plan is provided at the beginning of the Part A section. This Hanford Patrol Academy Demolition Sites Closure Plan submittal contains information current as of December 15, 1994.

  9. Biological constraints do not entail cognitive closure.

    Science.gov (United States)

    Vlerick, Michael

    2014-12-01

    From the premise that our biology imposes cognitive constraints on our epistemic activities, a series of prominent authors--most notably Fodor, Chomsky and McGinn--have argued that we are cognitively closed to certain aspects and properties of the world. Cognitive constraints, they argue, entail cognitive closure. I argue that this is not the case. More precisely, I detect two unwarranted conflations at the core of arguments deriving closure from constraints. The first is a conflation of what I will refer to as 'representation' and 'object of representation'. The second confuses the cognitive scope of the assisted mind for that of the unassisted mind. Cognitive closure, I conclude, cannot be established from pointing out the (uncontroversial) existence of cognitive constraints. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. SC/OQ Vessel Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Data tables holding information for the Surf Clam/Ocean Quahog vessel and dealer/processor logbooks (negative and positive), as well as individual tag information...

  11. Integrin binding: Sticking around vessels

    Science.gov (United States)

    Blatchley, Michael R.; Gerecht, Sharon

    2017-09-01

    A study demonstrates that controlled integrin binding on a biomaterial was capable of promoting vascular cell sprouting and formation of a non-leaky blood vessel network in a healthy and diseased state.

  12. Transposition of the great vessels

    Science.gov (United States)

    ... vessel called the ductus arteriosus open, allowing some mixing of the 2 blood circulations. A procedure using ... they are not already immune. Eating well, avoiding alcohol, and controlling diabetes both before and during pregnancy ...

  13. Vessel Permit System Data Set

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — GARFO issues federal fishing permits annually to owners of fishing vessels who fish in the Greater Atlantic region, as required by federal regulation. These permits...

  14. Caribbean PR Logbook Survey (Vessels)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains catch (landed catch) and effort for fishing trips made by vessels fishing in Puerto Rico. The catch and effort data for the entire trip are...

  15. Coastal Discard Logbook Survey (Vessels)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains data on the type and amount of marine resources that are discarded or interacted with by vessels that are selected to report to the Southeast...

  16. Hamiltonian closures in fluid models for plasmas

    Science.gov (United States)

    Tassi, Emanuele

    2017-11-01

    This article reviews recent activity on the Hamiltonian formulation of fluid models for plasmas in the non-dissipative limit, with emphasis on the relations between the fluid closures adopted for the different models and the Hamiltonian structures. The review focuses on results obtained during the last decade, but a few classical results are also described, in order to illustrate connections with the most recent developments. With the hope of making the review accessible not only to specialists in the field, an introduction to the mathematical tools applied in the Hamiltonian formalism for continuum models is provided. Subsequently, we review the Hamiltonian formulation of models based on the magnetohydrodynamics description, including those based on the adiabatic and double adiabatic closure. It is shown how Dirac's theory of constrained Hamiltonian systems can be applied to impose the incompressibility closure on a magnetohydrodynamic model and how an extended version of barotropic magnetohydrodynamics, accounting for two-fluid effects, is amenable to a Hamiltonian formulation. Hamiltonian reduced fluid models, valid in the presence of a strong magnetic field, are also reviewed. In particular, reduced magnetohydrodynamics and models assuming cold ions and different closures for the electron fluid are discussed. Hamiltonian models relaxing the cold-ion assumption are then introduced. These include models where finite Larmor radius effects are added by means of the gyromap technique, and gyrofluid models. Numerical simulations of Hamiltonian reduced fluid models investigating the phenomenon of magnetic reconnection are illustrated. The last part of the review concerns recent results based on the derivation of closures preserving a Hamiltonian structure, based on the Hamiltonian structure of parent kinetic models. Identification of such closures for fluid models derived from kinetic systems based on the Vlasov and drift-kinetic equations are presented, and

  17. Closure properties of Watson-Crick grammars

    Science.gov (United States)

    Zulkufli, Nurul Liyana binti Mohamad; Turaev, Sherzod; Tamrin, Mohd Izzuddin Mohd; Azeddine, Messikh

    2015-12-01

    In this paper, we define Watson-Crick context-free grammars, as an extension of Watson-Crick regular grammars and Watson-Crick linear grammars with context-free grammar rules. We show the relation of Watson-Crick (regular and linear) grammars to the sticker systems, and study some of the important closure properties of the Watson-Crick grammars. We establish that the Watson-Crick regular grammars are closed under almost all of the main closure operations, while the differences between other Watson-Crick grammars with their corresponding Chomsky grammars depend on the computational power of the Watson-Crick grammars which still need to be studied.

  18. Straight line closure of congenital macrostomia

    Directory of Open Access Journals (Sweden)

    Schwarz Richard

    2004-01-01

    Full Text Available The results of patients operated on by Nepal Cleft Lip and Palate Association (NECLAPA surgeons for congenital macrostomia were prospectively studied between January 2000 and December 2002. There were four males and three females with a median age of 10 years. Three had an associated branchial arch syndrome. In all patients an overlapping repair of orbicularis oris was done. Six patients had a straight line closure with excellent cosmetic results and one a Z-plasty with a more obvious scar. All had a normal appearing commissure. Overlapping orbicularis repair with straight line skin closure for this rare congenital anomaly is recommended.

  19. Uncertainty Quantification of Multi-Phase Closures

    Energy Technology Data Exchange (ETDEWEB)

    Nadiga, Balasubramanya T. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Baglietto, Emilio [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States)

    2017-10-27

    In the ensemble-averaged dispersed phase formulation used for CFD of multiphase ows in nuclear reactor thermohydraulics, closures of interphase transfer of mass, momentum, and energy constitute, by far, the biggest source of error and uncertainty. Reliable estimators of this source of error and uncertainty are currently non-existent. Here, we report on how modern Validation and Uncertainty Quanti cation (VUQ) techniques can be leveraged to not only quantify such errors and uncertainties, but also to uncover (unintended) interactions between closures of di erent phenomena. As such this approach serves as a valuable aide in the research and development of multiphase closures. The joint modeling of lift, drag, wall lubrication, and turbulent dispersion|forces that lead to tranfer of momentum between the liquid and gas phases|is examined in the frame- work of validation of the adiabatic but turbulent experiments of Liu and Banko , 1993. An extensive calibration study is undertaken with a popular combination of closure relations and the popular k-ϵ turbulence model in a Bayesian framework. When a wide range of super cial liquid and gas velocities and void fractions is considered, it is found that this set of closures can be validated against the experimental data only by allowing large variations in the coe cients associated with the closures. We argue that such an extent of variation is a measure of uncertainty induced by the chosen set of closures. We also nd that while mean uid velocity and void fraction pro les are properly t, uctuating uid velocity may or may not be properly t. This aspect needs to be investigated further. The popular set of closures considered contains ad-hoc components and are undesirable from a predictive modeling point of view. Consequently, we next consider improvements that are being developed by the MIT group under CASL and which remove the ad-hoc elements. We use non-intrusive methodologies for sensitivity analysis and calibration (using

  20. Prosopomorphic vessels from Moesia Superior

    Directory of Open Access Journals (Sweden)

    Nikolić Snežana

    2008-01-01

    Full Text Available The prosopomorphic vessels from Moesia Superior had the form of beakers varying in outline but similar in size. They were wheel-thrown, mould-made or manufactured by using a combination of wheel-throwing and mould-made appliqués. Given that face vessels are considerably scarcer than other kinds of pottery, more than fifty finds from Moesia Superior make an enviable collection. In this and other provinces face vessels have been recovered from military camps, civilian settlements and necropolises, which suggests that they served more than one purpose. It is generally accepted that the faces-masks gave a protective role to the vessels, be it to protect the deceased or the family, their house and possessions. More than forty of all known finds from Moesia Superior come from Viminacium, a half of that number from necropolises. Although tangible evidence is lacking, there must have been several local workshops producing face vessels. The number and technological characteristics of the discovered vessels suggest that one of the workshops is likely to have been at Viminacium, an important pottery-making centre in the second and third centuries.

  1. Impact assessment of a fisheries closure with effort and landings spatial analyses: A case study in the Western Baltic Sea

    DEFF Research Database (Denmark)

    Miethe, Tanja; Bastardie, Francois; Dorrien, Christian von

    2014-01-01

    Commercial fisheries in the Western Baltic Sea (WBS; ICES Subdivisions 22–24) are dominated by Danishand German vessels. By combining and processing logbook and Vessel Monitoring System (VMS) data forGermany and Denmark, we compare patterns of spatial effort allocation and the origin of the landi......Commercial fisheries in the Western Baltic Sea (WBS; ICES Subdivisions 22–24) are dominated by Danishand German vessels. By combining and processing logbook and Vessel Monitoring System (VMS) data forGermany and Denmark, we compare patterns of spatial effort allocation and the origin...... landedin the WBS decreased, and the origin of these landings shifted farther east without affecting the seasonaleffort allocation. Landings of cod have also decreased in the Fehmarn Belt area, and since 2008, sprat hasbeen the species most landed there. The planned construction of the Fehmarn Belt Fixed...... Link connectingDenmark and Germany could lead to the temporal closure of fishing activities. Three different effort-displacement scenarios were tested to determine how lost landings, caused by a fishing closure of acorridor near the link during construction, could be counteracted by moving...

  2. Use of Vacuum-assisted Wound Closure to Manage Limb Wounds in Patients Suffering from Acute Necrotizing Fasciitis

    Directory of Open Access Journals (Sweden)

    Wen-Shyan Huang

    2006-07-01

    Conclusion: The VAC technique of wound closure was found to be effective in managing non-healing limb wounds consequential to surgical treatment for patients suffering from acute necrotizing fasciitis. Although the cost of the VAC device was high, morbidity was much lower when compared to the CWD technique.

  3. Current concept of transcatheter closure of atrial septal defect in adults.

    Science.gov (United States)

    Akagi, Teiji

    2015-01-01

    After the introduction of catheter intervention for atrial septal defect (ASD) in the pediatric population, therapeutic advantages of this less invasive procedure were focused on adult through geriatric populations. The most valuable clinical benefits of this procedure are the significant improvement of symptoms and daily activities, which result from the closure of left to right shunt without thoracotomy and cardiopulmonary bypass surgery. These benefits contribute to increase the number of adult patients of this condition who have hesitated over surgical closure. In terms of technical point of view for catheter closure of ASD, the difficulties still exist in some morphological features of defect, or hemodynamic features in the adult population. Morphological features of difficult ASD closure are (1) large (≥30 mm) ASD, (2) wide rim deficiency, and (3) multiple defects. Hemodynamic features of difficult ASD are (1) severe pulmonary hypertension, (2) ventricular dysfunction, and (3) restrictive left ventricular compliance (diastolic dysfunction) after ASD closure. To complete the catheter ASD closure under these difficult conditions, various procedural techniques have been introduced. These are new imaging modalities such as real-time three-dimensional imaging, new technical modifications, and new concepts for hemodynamic evaluation. Especially, real-time three-dimensional transesophageal echocardiography can provide the high quality imaging for anatomical evaluation including maximum defect size, surrounding rim morphology, and the relationship between device and septal rim. In adult patients, optimal management for their comorbidities is an important issue, which includes cardiac function, atrial arrhythmias, respiratory function, and renal function. Management of atrial arrhythmias is a key issue for the long-term outcome in adult patients. Because the interventional procedures are not complication-free techniques, the establishment of a surgical back

  4. Anatomic changes of target vessels after fenestrated and branched aortic aneurysm repair.

    Science.gov (United States)

    Kalder, J; Keschenau, P; Tamm, M; Jalaie, H; Jacobs, M J; Greiner, A

    2014-04-01

    Objective of this study was to evaluate the anatomic changes of the stented target vessels after endovascular repair of complex aortic aneurysms. Between July 2011 and December 2013, 53 aortic aneurysms were treated in our department with fenestrated and branched stent-graft devices. Forty-two of these patients were pre- and postoperatively scanned with a high resolution computer tomography (CT) (Cook Zenith® fenestrated or branched, Australia Pty. Ltd., Brisbane, Australia: N.=19; AnacondaTM fenestrated, Vascutek, Glasgow, Scotland, UK: N.=23). The other 11 out of the 53 patients did not receive a CT scan, because of a pre-existing renal failure. In the CT scans we retrospectively evaluated the anatomic vessel deviation at the origin of the target vessel and the vessel shift distal to the stent. For the first measurement the CT scans were loaded into OsiriX MD®, and the pre- and postoperative angles of the target vessels were measured and subtracted. For matching, the CT-scans were normalized at vertebral body lumbar 2. The second measured angle was the maximal measured angle distal to the target vessel stent-graft. Altogether, 113 target vessels were stented (celiac trunk [CT] 15, superior mesenteric arteries [SMA] 26, renal arteries [RA] 72), with 97 balloon-expandable PTFE stents: 90 Atrium V12 (Maquet Getinge group, Hudson, NH, USA), 7 BeGrafts (Bentley InnoMed, Hechingen, Germany) and 16 self-expandable fluency PTFE stents (Bard, Karlsruhe, Germany). The mean anatomic deviation at the target vessel origin was 28±17.3 and the mean vessel shift distal to the stent was 36.3±18.8. There were no significant differences between the main device and the target vessel stent types. Fenestrated and branched stent-graft solutions for aortic aneurysm repair induce changes of the target vessel anatomy. We did not observe significant differences between the several devices.

  5. Evaluation of morphological characteristics of septal rims affecting successful transcatheter atrial septal defect closure in children and adults.

    Science.gov (United States)

    Oflaz, Mehmet Burhan; Pac, Feyza Aysenur; Kibar, Ayse Esin; Balli, Sevket; Ece, Ibrahim

    2013-01-01

    Determining other echocardiographic predictors along with the measured atrial septal defect (ASD) size and evaluating the closure together with these predictors would increase the chance of success for transcatheter closure of ASD. To evaluate echocardiographic parameters affecting defect closure in children and adult patients with secundum ASD. In all patients, size of ASD, total length of atrial septum (TS), superior-posterior, inferior-posterior, superior-anterior and inferior-anterior rims surrounding the defect were measured by transesophageal echocardiography (TEE), and several measurement ratios were derived on the basis of TEE parameters. A total 216 patients with secundum ASD were included in this study. The device was successfully implanted in 65 children and 65 adults. Both in pediatric and adult cases, the ratio of successful closure was found to be significantly higher when the ratio of defect size to TS was ≤ 0.35, the ratio of superior-anterior (SA) rim to the defect size was > 0.75 and the ratio of inferior-posterior (IP) rim to the defect size was > 1.0. It was found that having more than one of these predictors in a single case increased the chance of closure success significantly (p rim to defect size > 0.75 and a ratio of IP rim to defect size > 1.0 were found to be echocardiographic predictors that could be used in successful transcatheter ASD closure both in children and adults.

  6. Interventional Closure of Patent Foramen Ovale (PFO with Amplatzer PFO Occluder in Patients with Paradoxical Cerebral Embolism

    Directory of Open Access Journals (Sweden)

    Ali Mohammad Haji Zeinali

    2006-08-01

    Full Text Available Background: Percutaneous transcatheter closure has been proposed as an alternative to surgical closure or long-term anticoagulation in patients with presumed paradoxical embolism and patent foramen ovale (PFO. Methods: There were two symptomatic patients (29 and 47 years old who underwent percutaneous transcatheter closure of PFO after at least two events of cerebral ischemia; one embolic event had occurred under anti-platelet therapy. For both patients, Amplatzer PFO occluder measuring 25 mm in diameter were used. In both cases, complete occlusion by color Doppler and transesophageal contrast echocardiography investigation was achieved after the procedure and lasted at least up to 3 months after implantation as determined by our follow up. Mean fluoroscopy time was 16.7 minutes. Results: Percutaneous transcatheter closure was technically successful in both patients (100%. No residual shunt was seen at the end of the procedure or in follow-ups. In-hospital follow-up was uneventful. At a mean follow-up of 3 months, no recurrent embolic neurological events were observed. Conclusion: Transcatheter closure of PFO with Amplatzer PFO occluder devices is a safe and effective therapy for patients with previous paradoxical embolism PFO. Percutaneous closure is associated with a high success rate, low incidence of hospital complications, and freedom of cerebral ischemic events.

  7. Conscious sedation using dexmedetomidine for percutaneous transcatheter closure of atrial septal defects: A single center experience

    Directory of Open Access Journals (Sweden)

    Pushkar Mahendra Desai

    2016-01-01

    Full Text Available Objective: The aim of this study is to determine safety and feasibility of conscious sedation using dexmedetomidine for transcatheter atrial septal defect (ASD device closure. Material and Methods: A retrospective institutional review of transcatheter ASD device closure without endotracheal intubation over 18 months. The protocol included topical oropharyngeal anesthesia using lignocaine followed by dexmedetomidine bolus 1 μg/kg intravenously over 10 min and maintenance dose 0.2-0.7 μg/kg/h. Ramsay sedation score 2-3 was maintained. Patients were analyzed regarding demographic profile, device size, procedure time, anesthesia time, recovery time, hospital stay, and any hemodynamic or procedural complications. Results: A total of 43 patients with mean age 31.56 ± 13.74 years (range: 12-56 years were analyzed. Mean anesthesia duration was 71.75 + 21.08 min. Mean recovery time was 7.6 ± 3.01 min. 16 females and one male patient required additional propofol with a mean dose of 30.8 ± 10.49 mg. No hemodynamic instability was noted. No patient required general anesthesia with endotracheal intubation. The procedure was successful in 93.02% of patients. Four patients developed atrial fibrillation. All patients were satisfied. Conclusion: Conscious sedation using dexmedetomidine is a safe and effective anesthetic technique for percutaneous ASD closure.

  8. Analyzing the failures of percutaneous closure of the patent ductus arteriosus in patients over 5 kg.

    Science.gov (United States)

    Saliba, Zakhia; El-Rassi, Issam; Helou, Dina; Chehab, Ghassan; Abdel-Massih, Tony; Daou, Linda; Chalhoub, Viviane; Choueiry, Elie; Gerbaka, Bernard

    2012-09-01

    Percutaneous closure of the patent ductus is the gold standard therapy. Our aim was to analyze our failures between 2001 and 2010. All patients over 5 kg benefited from a transcatheter attempt at duct closure. Coils and Amplatzer duct occluder (ADO) I were used before 2008, and ADO I and ADO II afterward. The failure was recovered when another percutaneous attempt was successful and definite when surgery was needed. There were 138 patients. Coils were used in 22 patients (16%), ADO I in 74 (54%), and ADO II in 42 (30%). Immediate and 6-month closure rates were 55% and 100% for coils, 40% and 96% for the ADO I, and 74% and 93% for the ADO II, respectively. There were no failures in the coil group, and 3 failures in each of the ADO I and ADO II groups. Among the 3 ADO I failures, 1 was recovered after device migration into the abdominal aorta. The 2 other failures were definite, due to immediate device protrusion, once in the aorta and once in the pulmonary artery. One of the 3 ADO II failures was definite, due to protrusion into the aorta, 10 days following the procedure. The two other failures were due to immediate device migration into the pulmonary artery, and were both recovered. 97% of ducts can be closed percutaneously. The combination of coil and ADO I gives excellent results. Failed attempts with the ADO II were bailed out by the ADO I.

  9. Single Centre Experience for Percutaneous Closure of Secundum Atrial Septal Defect

    Directory of Open Access Journals (Sweden)

    Ramazan Aydemir

    2011-12-01

    Full Text Available Introduction: Atrial septal defect (ASD is the most common congenital heart disease in adults and constitutes 5-10% of all congenital heart disease. Primary surgical closure has been the standard approach for many years with high success rate. Transcatheter closure of ASD in selected patients has became the contemprorary practice that has the advantages of short hospital stay and relative ease of prosedure. In this article, we reported the results of percutaneous closure of ASD in our center.
Methods: Between 2009-2011, thirty-two patients (mean age 36±18 years and 24 females who had secundum type ASD which detected by transthoracic echocardiography (TTE and transesophageal echocardiography (TEE were included in this study. Twenty-nine (90,6% patients were closed percutaneously. Tree patients were referred for surgery because of failure of percutaneous closure. Amplatzer Septal Occluder was used in 25 (86,2% patients and Occlutech device was used in other patients. All procedures were performed under local anesthesia. All of the patients were examined with TTE before the procedure and, at the 1st, 3rd, 6th and 12th month follow-up visits.
Results: Pre-operative mean pulmonary artery pressure was 33,3±7,5 mmHg and mean pulmonary to systemic flow (Qp/Qs ratio was 2,9±1,1. Mean ASD diameter measured by TEE was 20,1±6,6 mm and mean streched diameter measured by balloon catheter was 22,1±5,9 mm. Mean device size 24±6 mm (range 12-36 mm. In the follow-up period no major complication was observed, but mild to moderate residual shunt flow was detected in two patients (% 6,8.
Conclusion: Percutaneous ASD closure has been performed with high success and low complication rates in patients with secundum atrial septal defect in our center.

  10. Numerical model study of radio frequency vessel sealing thermodynamics

    Science.gov (United States)

    Pearce, John

    2015-03-01

    Several clinically successful clinical radio frequency vessel-sealing devices are currently available. The dominant thermodynamic principles at work involve tissue water vaporization processes. It is necessary to thermally denature vessel collagen, elastin and their adherent proteins to achieve a successful fusion. Collagens denature at middle temperatures, between about 60 and 90 C depending on heating time and rate. Elastin, and its adherent proteins, are more thermally robust, and require temperatures in excess of the boiling point of water at atmospheric pressure to thermally fuse. Rapid boiling at low apposition pressures leads to steam vacuole formation, brittle tissue remnants and frequently to substantial disruption in the vessel wall, particularly in high elastin-content arteries. High apposition pressures substantially increase the equilibrium boiling point of tissue water and are necessary to ensure a high probability of a successful seal. The FDM numerical models illustrate the beneficial effects of high apposition pressures.

  11. Use of dynamic wound closure system in conjunction with vacuum-assisted closure therapy in delayed closure of open abdomen.

    Science.gov (United States)

    Salman, A E; Yetişir, F; Aksoy, M; Tokaç, M; Yildirim, M B; Kiliç, M

    2014-02-01

    Definitive abdominal closure may not be possible for several days or weeks after laparotomy in damage-control surgery, abdominal compartment syndrome and intraabdominal sepsis, until the patient has stabilized. Vacuum-assisted closure (VAC therapy(®), KCI, San Antonio, TX, USA) and abdominal re-approximation anchor system (ABRA, Canica, Almonte, Ontario, Canada) are novel techniques in delayed closure of open abdomen. Our aim is to present the use of these strategies in the management of 7 patients with open abdomen. Between August 2010 and December 2011, 7 patients with severe peritonitis were stabilized by laparotomy and treated with either ABRA system or ABRA system in conjunction with VAC dressing. VAC dressing applied to 4 patients initially and followed by ABRA. ABRA was applied alone to remaining 3 patients. Demographic data and patient characteristics, timing of VAC dressing and ABRA system were recorded. ICU and hospital stay and development of incisional hernia were also recorded. Stage of open abdomen, width of abdominal defect, extent to damage to fascia, and pressure sores were staged. The mean duration with VAC dressing before ABRA application was 18 days. The mean duration of ABRA application was 53 days. The average width of the abdominal defect was 18 cm. The average length of defect was 20.8 cm. Delayed primary abdominal closure was accomplished in 6 patients without further surgery. Incisional hernia with a small abdominal defect developed in 2 patients. Abdominal re-approximation anchor system and VAC dressing can be used separately or in conjunction with each other for closure of delayed open abdomen successfully.

  12. Scalping of light volatile sulfur compounds by wine closures.

    Science.gov (United States)

    Silva, Maria A; Jourdes, Michaël; Darriet, Philippe; Teissedre, Pierre-Louis

    2012-11-07

    Closures have an important influence on wine quality during aging in a bottle. Closures have a direct impact on oxygen exposure and on volatiles scavenging in wine. Model wine solution soaking assays of several types of closures (i.e., natural and technical cork stoppers, synthetic closures, screw caps) with two important wine volatile sulfur compounds led to a considerable reduction in their levels. After 25 days, cork closures and synthetic closures, to a lesser extent, have significantly scavenged hydrogen sulfide and dimethyl sulfide. These compounds have a determinant impact on wine aging bouquet, being largely responsible for "reduced off-flavors". Hydrogen sulfide levels are often not well correlated with the exposure of wine to oxygen or with the permeability of the closure. Its preferential sorption by some types of closures may explain that behavior. Scalping phenomenon should be taken into account when studying wine post-bottling development.

  13. Automated method for identification and artery-venous classification of vessel trees in retinal vessel networks.

    Directory of Open Access Journals (Sweden)

    Vinayak S Joshi

    Full Text Available The separation of the retinal vessel network into distinct arterial and venous vessel trees is of high interest. We propose an automated method for identification and separation of retinal vessel trees in a retinal color image by converting a vessel segmentation image into a vessel segment map and identifying the individual vessel trees by graph search. Orientation, width, and intensity of each vessel segment are utilized to find the optimal graph of vessel segments. The separated vessel trees are labeled as primary vessel or branches. We utilize the separated vessel trees for arterial-venous (AV classification, based on the color properties of the vessels in each tree graph. We applied our approach to a dataset of 50 fundus images from 50 subjects. The proposed method resulted in an accuracy of 91.44% correctly classified vessel pixels as either artery or vein. The accuracy of correctly classified major vessel segments was 96.42%.

  14. Infrared laser thermal fusion of blood vessels: preliminary ex vivo tissue studies

    Science.gov (United States)

    Cilip, Christopher M.; Rosenbury, Sarah B.; Giglio, Nicholas; Hutchens, Thomas C.; Schweinsberger, Gino R.; Kerr, Duane; Latimer, Cassandra; Nau, William H.; Fried, Nathaniel M.

    2013-05-01

    Suture ligation of blood vessels during surgery can be time-consuming and skill-intensive. Energy-based, electrosurgical, and ultrasonic devices have recently replaced the use of sutures and mechanical clips (which leave foreign objects in the body) for many surgical procedures, providing rapid hemostasis during surgery. However, these devices have the potential to create an undesirably large collateral zone of thermal damage and tissue necrosis. We explore an alternative energy-based technology, infrared lasers, for rapid and precise thermal coagulation and fusion of the blood vessel walls. Seven near-infrared lasers (808, 980, 1075, 1470, 1550, 1850 to 1880, and 1908 nm) were tested during preliminary tissue studies. Studies were performed using fresh porcine renal vessels, ex vivo, with native diameters of 1 to 6 mm, and vessel walls flattened to a total thickness of 0.4 mm. A linear beam profile was applied normal to the vessel for narrow, full-width thermal coagulation. The laser irradiation time was 5 s. Vessel burst pressure measurements were used to determine seal strength. The 1470 nm laser wavelength demonstrated the capability of sealing a wide range of blood vessels from 1 to 6 mm diameter with burst strengths of 578±154, 530±171, and 426±174 mmHg for small, medium, and large vessel diameters, respectively. Lateral thermal coagulation zones (including the seal) measured 1.0±0.4 mm on vessels sealed at this wavelength. Other laser wavelengths (1550, 1850 to 1880, and 1908 nm) were also capable of sealing vessels, but were limited by lower vessel seal pressures, excessive charring, and/or limited power output preventing treatment of large vessels (>4 mm outer diameter).

  15. The safety and efficacy of hemostasis with Clo-Sur P.A.D. after transcatheter arterial chemoembolization

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Seung Chai; Jae, Hwan Jun; Kim, Sang Youn; Lee, Whal; Chung, Jin Wook; Park, Jae Hyung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2007-04-15

    We wanted to evaluate the safety and efficacy of a new hemostatic device, Clo-Sur P.A.D., at an arterial access site after performing femoral arterial catheterization to achieve transcatheter arterial chemoembolization (TACE). From August 2002 to March 2005, 113 patients who underwent TACE and agreed on using the Clo-Sur P.A.D. were enrolled in this study. We evaluated the mean time interval from compression to the first movement and also to the first walk. We also evaluated such complications as rebleeding, pseudoaneurysm, vascular occlusion, hematoma, infection and pain. For 92 patients who had previous experiences with manual compression, we evaluated their preference of hemostatic method by asking them. Successful hemostasis was achieved with the Clo-Sur P.A.D. in 105 subjects (92%). The mean time interval from compression to the first movement was 201 minutes, and that to the first walk was 267 minutes. There was no statistical difference between the complicated and the uncomplicated groups for the mean time, prothrombin time, Child-Pugh class and platelet count ({rho} > 0.05). Rebleeding occurred in 3 patients (2.7%) and mild hematoma around puncture site was noted in 5 patients (5.4%). Eighty-seven patients (95%) preferred Clo-Sur P.A.D. to the manual compression method. The Clo-Sur P.A.D. is a safe and effective hemostatic device and it provides early ambulation after TACE.

  16. Transcatheter closure of secundum atrial septal defect in adults: report of our first experience in a developing country

    Directory of Open Access Journals (Sweden)

    Animasahun BA

    2014-04-01

    Full Text Available B Adeola Animasahun,1 Yele Aluko,2 Adeyemi Johnson,3 Kofo Ogunyankin,3 Sunita Maheshwari41Department of Paediatrics and Child Health, Lagos State University College of Medicine, Lagos, Nigeria; 2Mid Carolina Cardiology, Charlotte, NC, USA; 3First Cardiology Consultants, Lagos, Nigeria; 4Narayana Hrudayalaya Institute of Cardiac Sciences, Bangalore, IndiaBackground: Since the first report on device closure of atrial septal defect (ASD in 1976, the procedure has gained wide acceptance and has been used worldwide, including parts of Africa. The advantages when compared to surgical closure include a shorter procedure time and hospital stay and no scarring. This mode of treatment was not available in Nigeria prior to the cases reported here, requiring patients to travel abroad for the procedure.Methods: A cardiac catheterization laboratory became available in Lagos, Nigeria in 2009, and in December 2010 the laboratory collaborated with Lagos State University College of Medicine and Lagos State University Teaching Hospital to perform the device closure on two women (aged 34 and 62 years with secundum ASD. To the best of our knowledge, these are the first times the procedure has been performed in Nigeria.Results: Both patients made successful recovery and are stable.Conclusion: Transcatheter closure of ASD is now safe and available in Nigeria.Keywords: atrial septal defect, transcatheter closure, Nigeria

  17. Transcatheter closure of large atrial septal defects with deficient aortic or posterior rims using the "Greek maneuver". A multicenter study.

    Science.gov (United States)

    Thanopoulos, Basil D; Dardas, Petros; Ninios, Vlasis; Eleftherakis, Nicholaos; Karanasios, Evangelos

    2013-10-09

    We report a modification ("Greek maneuver") of the standard atrial septal defect (ASD) closure technique using the Amplatzer septal occluder (ASO) to facilitate closure of large ASDs with deficient aortic or posterior rims. 185 patients (median 10.8, range 3 to 52 years) with large ASDs (mean diameter 26±7 mm, range 20-40 mm) with a deficient aortic (134 patients) or posterior (51 patients) rim underwent catheter closure with the ASO using the "Greek maneuver" under transesophageal guidance. The Greek maneuver is applied when protrusion of the aortic edge of the deployed left disk of the device in to the right atrium is detected by echo. To circumvent this left disk is recaptured and the whole delivery system is pushed inward and leftward into the left atrium where the left disk and the 2/3 of right disk are simultaneously released. This maneuver forces the left disk to become parallel to the septum preventing the protrusion of the device into the right atrium. The ASO was successfully implanted and was associated with complete closure in 175/185 (95%) of the patients. There were no early or late complications related to the procedure during a follow-up period ranging from 6 months to 7 years. The "Greek maneuver" is a simple quite useful trick that facilitates closure of large ASDs associated with or without deficient aortic or posterior rims. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  18. Closure of large wounds using rubber bands in rabbits

    Directory of Open Access Journals (Sweden)

    Maria Angélica Baron Magalhães

    Full Text Available OBJECTIVE: to verify the effectiveness of the rubber elastic band in the treatment of large wounds of the body wall of rabbits by means of traction of its edges. METHODS: we studied 30 New Zealand rabbits, divided into three groups (n=10: Group 1- healing by secondary intention; Group 2- removal and eutopic repositioning of skin as full thickness skin graft; Group 3- Approximation of wound edges with elastic rubber band. In all animals, we removed a segment of the back skin and subcutaneous tissue down to the fascia, in accordance with an acrylic mold of 8cm long by 12cm wide. All animals were observed for 21 days. RESULTS: two animals of groups 1 and 2 had wound abscess. In Group 2, there was partial or total graft loss in 90% of animals. The complete closure of the wounds was observed in four animals of Group 1, six of Group 2 and eight of Group 3. There was no difference between the scar resistance values of groups 2 and 3, which were higher than those in Group 1. The scars of the three groups were characterized by the presence of mature connective tissue mixed with blood vessels and inflammatory infiltration, predominantly polymorphonuclear. CONCLUSION: the tensile strength of the wound edges with rubber elastic band is as efficient as the skin graft to treat rabbits' large body wounds.

  19. Novel Method to Detect Corneal Lymphatic Vessels In Vivo by Intrastromal Injection of Fluorescein.

    Science.gov (United States)

    Le, Viet Nhat Hung; Hou, Yanhong; Horstmann, Jens; Bock, Felix; Cursiefen, Claus

    2017-11-09

    Corneal lymphatic vessels are clinically invisible because of their thin walls and clear lymph fluid. There is no easy and established method for in vivo imaging of corneal lymphatic vessels so far. In this study, we present a novel approach to visualize corneal lymphatic vessels in vivo by injecting intrastromal fluorescein sodium. Six- to eight-week-old female BALB/c mice were used in the mouse model of suture-induced corneal neovascularization. Two weeks after the suture placement, fluorescein sodium was injected intrastromally. The fluorescein, taken up by the presumed lymphatic vessels, was then tracked using a clinically used Spectralis HRA + OCT device. Immunohistochemistry staining with specific lymphatic marker LYVE-1 and pan-endothelial marker CD31 was used to confirm the indirect lymphangiography findings. By injecting fluorescein intrastromally, both corneal blood and lymphatic vessels were detected. While the lymphatic vessels were visible as bright vessel-like structures using HRA, the blood vessels appeared as dark networks. Fluorescein-labeled lymphatic vessels were colocalized with LYVE-1 in immunohistochemically stained sections of the same specimen. Corneal lymphatic vessels can be easily imaged in vivo in the murine model using intrastromal fluorescein injection.

  20. Military Base Closures: Time for Another Round?

    Science.gov (United States)

    2002-11-01

    context and background, see CRS Report 97-305, Military Base Closures: A Brief Historical Review since 1988, by George Siehl , 16 p. 2“Realignment” is...official, to encourage Lockheed Martin Corporation to go after some of the depot maintenance work at McClellan Air Force Base and keep the work in

  1. RECENT PROGRESS IN DOE WASTE TANK CLOSURE

    Energy Technology Data Exchange (ETDEWEB)

    Langton, C

    2008-02-01

    The USDOE complex currently has over 330 underground storage tanks that have been used to process and store radioactive waste generated from the production of weapons materials. These tanks contain over 380 million liters of high-level and low-level radioactive waste. The waste consists of radioactively contaminated sludge, supernate, salt cake or calcine. Most of the waste exists at four USDOE locations, the Hanford Site, the Savannah River Site, the Idaho Nuclear Technology and Engineering Center and the West Valley Demonstration Project. A summary of the DOE tank closure activities was first issued in 2001. Since then, regulatory changes have taken place that affect some of the sites and considerable progress has been made in closing tanks. This paper presents an overview of the current regulatory changes and drivers and a summary of the progress in tank closures at the various sites over the intervening six years. A number of areas are addressed including closure strategies, characterization of bulk waste and residual heel material, waste removal technologies for bulk waste, heel residuals and annuli, tank fill materials, closure system modeling and performance assessment programs, lessons learned, and external reviews.

  2. 50 CFR 622.43 - Closures.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Closures. 622.43 Section 622.43 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION... hind, rock hind, yellowmouth grouper, tiger grouper, yellowfin grouper, graysby, and coney. (6...

  3. 300 Area Process Trenches Closure Plan

    Energy Technology Data Exchange (ETDEWEB)

    Luke, S.N.

    1994-08-15

    Since 1987, Westinghouse Hanford Company has been a major contractor to the US Department of Energy, Richland Operations Office and has served as co-operator of the 300 Area Process Trenches, the waste management unit addressed in this closure plan. For the purposes of the Resource Conservation and Recovery Act, Westinghouse Hanford Company is identified as ``co-operator.`` The 300 Area Process Trenches Closure Plan (Revision 0) consists of a Resource Conservation and Recovery Act Part A Dangerous Waste Permit Application, Form 3 and a Resource Conservation and Recovery Act Closure Plan. An explanation of the Part A Permit Application, Form 3 submitted with this document is provided at the beginning of the Part A Section. The closure plan consists of nine chapters and six appendices. The 300 Area Process Trenches received dangerous waste discharges from research and development laboratories in the 300 Area and from fuels fabrication processes. This waste consisted of state-only toxic (WT02), corrosive (D002), chromium (D007), spent halogenated solvents (F001, F002, and F003), and spent nonhalogented solvent (F005). Accurate records are unavailable concerning the amount of dangerous waste discharged to the trenches. The estimated annual quantity of waste (item IV.B) reflects the total quantity of both regulated and nonregulated waste water that was discharged to the unit.

  4. Spontaneous closure of traumatic CSF otorrhoea following ...

    African Journals Online (AJOL)

    ... the temporal bone extending in to the tympanomastoid area. Patient was managed conservatively with closure of the fistula and resolution of the leakage within 8 days after injury. We report this to further buttress the role of conservative management in CSF fistula. African Journal of Health Sciences Vol. 13 (3-4) 2006: pp.

  5. Opening up closure. Semiotics across scales

    Science.gov (United States)

    Lemke

    2000-01-01

    The dynamic emergence of new levels of organization in complex systems is related to the semiotic reorganization of discrete/continuous variety at the level below as continuous/discrete meaning for the level above. In this view both the semiotic and the dynamic closure of system levels is reopened to allow the development and evolution of greater complexity.

  6. Individual Consequences of Plant Closures and Cutbacks

    DEFF Research Database (Denmark)

    Andersen, Steen

    1991-01-01

    This thesis describes the segment of unemployment which has its origin in major closures and cutbacks. The argument for this is to make it possible to describe and to analyse a flow into and a flow out of a population of unemployed. Given a major dismissal the following questions are to be answered...

  7. The Story of a Charter School Closure.

    Science.gov (United States)

    Flynn, Susan L.; Arguelles, Lourdes

    2001-01-01

    The story of a charter school closure is told from the perspectives of students, parents, teachers, and community members, who felt that the sponsoring district revoked the charter for political reasons despite broad local support. The experience underscores the necessity of publicly subjecting the relationship of the public school system and the…

  8. Collective Protection (COLPRO) Novel Closures Testing

    Science.gov (United States)

    2013-03-28

    miosis level) or a predetermined exposure value, as specified by the test requirement document. MINICAMS®-like instruments have a detection range of...Performance. Candidate novel closures must pass user-defined requirements. The pass/fail requirements may depend on miosis hazard level, inhalation

  9. Complications in Placement of a Glaucoma Drainage Device in a Patient With CREST Syndrome.

    Science.gov (United States)

    Husain, Maria Q; Alsheikh, Oday

    2017-02-01

    This case describes difficulty with conjunctival closure in an 80-year-old woman with CREST syndrome, a subset of systemic scleroderma. The patient underwent uneventful glaucoma drainage device implantation, but friability of the conjunctiva was noted during closure. Amniotic membrane was used to ensure secure closure, and the patient had a successful outcome. There is a paucity of existing studies on patients with CREST syndrome and their ocular findings. This report sheds light on ocular findings in this autoimmune disease and the necessity for alternative closure methods in special cases.

  10. Development of automatic reactor vessel inspection systems: development of data acquisition and analysis system for the nuclear vessel weld

    Energy Technology Data Exchange (ETDEWEB)

    Park, C. H.; Lim, H. T.; Um, B. G. [Korea Advanced Institute of Science and Technology, Taejeon (Korea)

    2001-03-01

    The objective of this project is to develop an automated ultrasonic data acquisition and data analysis system to examine the reactor vessel weldsIn order to examine nuclear vessel welds including reactor pressure vessel(RPV), huge amount of ultrasonic data from 6 channels should be able to be on-line processed. In addition, ultrasonic transducer scanning device should be remotely controlled, because working place is high radiation area. This kind of an automated ultrasonic testing equipment has not been developed domestically yet In order to develop an automated ultrasonic testing system, RPV ultrasonic testing equipments developed in foreign countries were investigated and the capability of high speed ultrasonic signal processing hardwares was analyzed in this study, ultrasonic signal processing system was designed. And also, ultrasonic data acquisition and analysis software was developed. 11 refs., 6 figs., 9 tabs. (Author)

  11. Tissue adhesives for closure of surgical incisions.

    Science.gov (United States)

    Dumville, Jo C; Coulthard, Paul; Worthington, Helen V; Riley, Philip; Patel, Neil; Darcey, James; Esposito, Marco; van der Elst, Maarten; van Waes, Oscar J F

    2014-11-28

    Sutures (stitches), staples and adhesive tapes have been used for many years as methods of wound closure, but tissue adhesives have entered clinical practice more recently. Closure of wounds with sutures enables the closure to be meticulous, but the sutures may show tissue reactivity and can require removal. Tissue adhesives offer the advantages of an absence of risk of needlestick injury and no requirement to remove sutures later. Initially, tissue adhesives were used primarily in emergency room settings, but this review looks at the use of tissue adhesives in the operating room/theatre where surgeons are using them increasingly for the closure of surgical skin incisions. To determine the effects of various tissue adhesives compared with conventional skin closure techniques for the closure of surgical wounds. In March 2014 for this second update we searched the Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE and EBSCO CINAHL. We did not restrict the search and study selection with respect to language, date of publication or study setting. Only randomised controlled trials were eligible for inclusion. We conducted screening of eligible studies, data extraction and risk of bias assessment independently and in duplicate. We expressed results as random-effects models using mean difference for continuous outcomes and risk ratios (RR) with 95% confidence intervals (CI) for dichotomous outcomes. We investigated heterogeneity, including both clinical and methodological factors. This second update of the review identified 19 additional eligible trials resulting in a total of 33 studies (2793 participants) that met the inclusion criteria. There was low quality evidence that sutures were significantly better than tissue adhesives for reducing the risk of wound breakdown (dehiscence; RR 3.35; 95% CI 1.53 to 7

  12. Primary closure after carotid endarterectomy is not inferior to other closure techniques.

    Science.gov (United States)

    Avgerinos, Efthymios D; Chaer, Rabih A; Naddaf, Abdallah; El-Shazly, Omar M; Marone, Luke; Makaroun, Michel S

    2016-09-01

    Primary closure after carotid endarterectomy (CEA) has been much maligned as an inferior technique with worse outcomes than in patch closure. Our purpose was to compare perioperative and long-term results of different CEA closure techniques in a large institutional experience. A consecutive cohort of CEAs between January 1, 2000, and December 31, 2010, was retrospectively analyzed. Closure technique was used to divide patients into three groups: primary longitudinal arteriotomy closure (PRC), patch closure (PAC), and eversion closure (EVC). End points were perioperative events, long-term strokes, and restenosis ≥70%. Multivariate regression models were used to assess the effect of baseline predictors. There were 1737 CEA cases (bilateral, 143; mean age, 71.4 ± 9.3 years; 56.2% men; 35.3% symptomatic) performed during the study period with a mean clinical follow-up of 49.8 ± 36.4 months (range, 0-155 months). More men had primary closure, but other demographic and baseline symptoms were similar between groups. Half the patients had PAC, with the rest evenly distributed between PRC and EVC. The rate of nerve injury was 2.7%, the rate of reintervention for hematoma was 1.5%, and the length of hospital stay was 2.4 ± 3.0 days, with no significant differences among groups. The combined stroke and death rate was 2.5% overall and 3.9% and 1.7% in the symptomatic and asymptomatic cohort, respectively. Stroke and death rates were similar between groups: PRC, 11 (2.7%); PAC, 19 (2.2%); EVC, 13 (2.9%). Multivariate analysis showed baseline symptomatic disease (odds ratio, 2.4; P = .007) and heart failure (odds ratio, 3.1; P = .003) as predictors of perioperative stroke and death, but not the type of closure. Cox regression analysis demonstrated, among other risk factors, no statin use (hazard ratio, 2.1; P = .008) as a predictor of ipsilateral stroke and severe (glomerular filtration rate <30 mL/min/1.73 m(2)) renal insufficiency (hazard ratio, 2.6; P

  13. 50 CFR 697.8 - Vessel identification.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Vessel identification. 697.8 Section 697.8 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION....8 Vessel identification. (a) Vessel name and official number. Each fishing vessel issued a limited...

  14. Permanent Closure of the TAN-664 Underground Storage Tank

    Energy Technology Data Exchange (ETDEWEB)

    Bradley K. Griffith

    2011-12-01

    This closure package documents the site assessment and permanent closure of the TAN-664 gasoline underground storage tank in accordance with the regulatory requirements established in 40 CFR 280.71, 'Technical Standards and Corrective Action Requirements for Owners and Operators of Underground Storage Tanks: Out-of-Service UST Systems and Closure.'

  15. Evolution of Fascial Closure Optimization in Damage Control Laparotomy.

    Science.gov (United States)

    Lauerman, Margaret H; Dubose, Joseph J; Stein, Deborah M; Galvagno, Samuel M; Bradley, Matthew J; Diaz, Jose; Scalea, Thomas M

    2016-12-01

    Management of patients undergoing damage control laparotomy (DCL) involves many surgical, medical, and logistical factors. Ideal patient management optimizing fascial closure with regard to timing and closure techniques remains unclear. A retrospective review of patients undergoing DCL from 2000 to 2012 at an urban Level I trauma center was undertaken. Mortality of DCL decreased over the study period from 62.5 to 34.6 per cent, whereas enterocutaneous fistula rate decreased from 12.5 to 3.8 per cent. Delayed primary fascial closure rate improved from 22.2 to 88.2 per cent. Time to closure (P fascial closure. In subgroup analysis, achievement of delayed primary fascial closure was decreased with time to closure after one week (91.7% vs 52.0%, P = 0.002) and time to first attempted closure after two days (86.5% vs 70.0%, P = 0.042). In multivariate analysis, time to closure (odds ratio: 0.13, 95% confidence interval: 0.04-0.39; P fascial closure. Timing of attempted closure plays a significant role in attaining delayed primary fascial closure, highlighting the importance of early re-exploration.

  16. 9 CFR 381.301 - Containers and closures.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Containers and closures. 381.301... Containers and closures. (a) Examination and cleaning of empty containers. (1) Empty containers, closures... and free of structural defects and damage that may affect product or container integrity. Such an...

  17. 9 CFR 318.301 - Containers and closures.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Containers and closures. 318.301... Canning and Canned Products § 318.301 Containers and closures. (a) Examination and cleaning of empty containers. (1) Empty containers, closures, and flexible pouch roll stock shall be evaluated by the...

  18. The potential migration effect of rural hospital closures

    DEFF Research Database (Denmark)

    Sørensen, Jens Fyhn Lykke

    2008-01-01

    Rural hospital closures are high on the current health care agenda in Denmark. One raised concern is that rural hospital closures may further decrease population numbers in rural areas, as closures may induce some residents to move away from affected areas, i.e. closer to health care services els...

  19. Vacuum-assisted closure in the treatment of poststernotomy mediastinitis

    NARCIS (Netherlands)

    Obdeijn, MC; de Lange, M.Y.; Lichtendahl, DHE; de Boer, Willem

    1999-01-01

    A new technique using vacuum-assist-ed closure was successfully applied in 3 patients with poststernotomy mediastinitis. After surgical debridement, this vacuum-assisted closure technique has made it possible to avoid the need for secondary surgical closure (including direct secondary surgical

  20. Mechanosensing in developing lymphatic vessels.

    Science.gov (United States)

    Planas-Paz, Lara; Lammert, Eckhard

    2014-01-01

    The lymphatic vasculature is responsible for fluid homeostasis, transport of immune cells, inflammatory molecules, and dietary lipids. It is composed of a network of lymphatic capillaries that drain into collecting lymphatic vessels and ultimately bring fluid back to the blood circulation. Lymphatic endothelial cells (LECs) that line lymphatic capillaries present loose overlapping intercellular junctions and anchoring filaments that support fluid drainage. When interstitial fluid accumulates within tissues, the extracellular matrix (ECM) swells and pulls the anchoring filaments. This results in opening of the LEC junctions and permits interstitial fluid uptake. The absorbed fluid is then transported within collecting lymphatic vessels, which exhibit intraluminal valves that prevent lymph backflow and smooth muscle cells that sequentially contract to propel lymph.Mechanotransduction involves translation of mechanical stimuli into biological responses. LECs have been shown to sense and respond to changes in ECM stiffness, fluid pressure-induced cell stretch, and fluid flow-induced shear stress. How these signals influence LEC function and lymphatic vessel growth can be investigated by using different mechanotransduction assays in vitro and to some extent in vivo.In this chapter, we will focus on the mechanical forces that regulate lymphatic vessel expansion during embryonic development and possibly secondary lymphedema. In mouse embryos, it has been recently shown that the amount of interstitial fluid determines the extent of lymphatic vessel expansion via a mechanosensory complex formed by β1 integrin and vascular endothelial growth factor receptor-3 (VEGFR3). This model might as well apply to secondary lymphedema.

  1. The Rising Rate of Rural Hospital Closures.

    Science.gov (United States)

    Kaufman, Brystana G; Thomas, Sharita R; Randolph, Randy K; Perry, Julie R; Thompson, Kristie W; Holmes, George M; Pink, George H

    2016-01-01

    Since 2010, the rate of rural hospital closures has increased significantly. This study is a preliminary look at recent closures and a formative step in research to understand the causes and the impact on rural communities. The 2009 financial performance and market characteristics of rural hospitals that closed from 2010 through 2014 were compared to rural hospitals that remained open during the same period, stratified by critical access hospitals (CAHs) and other rural hospitals (ORHs). Differences were tested using Pearson's chi-square (categorical variables) and Wilcoxon rank test of medians. The relationships between negative operating margin and (1) market factors and (2) utilization/staffing factors were explored using logistic regression. In 2009, CAHs that subsequently closed from 2010 through 2014 had, in general, lower levels of profitability, liquidity, equity, patient volume, and staffing. In addition, ORHs that closed had smaller market shares and operated in markets with smaller populations compared to ORHs that remained open. Odds of unprofitability were associated with both market and utilization factors. Although half of the closed hospitals ceased providing health services altogether, the remainder have since converted to an alternative health care delivery model. Financial and market characteristics appear to be associated with closure of rural hospitals from 2010 through 2014, suggesting that it is possible to identify hospitals at risk of closure. As closure rates show no sign of abating, it is important to study the drivers of distress in rural hospitals, as well as the potential for alternative health care delivery models. © 2015 National Rural Health Association.

  2. Results of vacuum assisted wound closure application.

    Science.gov (United States)

    Atay, Tolga; Burc, Halil; Baykal, Yakup Barbaros; Kirdemir, Vecihi

    2013-08-01

    In recent past, various methods have been used for wound treatment purpose. In this study, we aimed to compare our results established from the vacuum-assisted wound closure method, which has gained popularity day by day, with the literature. A total of 48 patients, who received vacuum-assisted wound closure treatment in our clinic between 2007and 2010, were included in this study. Etiological distribution of the patients was as follows: 32 traumatic, 6 pressure sore, 9 diabetic, and 1 iliac disarticulation. All cases were evaluated in terms of age, gender, etiology, period of treatment, and size of the wound. In the patients studied, 42 were men (87.5 %) and 6 were women (12.5 %). Mean age of the patients was 39.6 years (11-61 years). All of our traumatic patients suffered from open fracture. After the vacuum-assisted wound closure application, wound size reduced by 28.8 %, while the mean area of the surface of the wound was 94.7 cm(2) (13.7-216.3 cm(2)) on average. After the wounds became ready for surgery, 15 of them were treated with split-thickness grafting, 9 of them were treated with secondary suture, 18 of them were treated with full-thickness grafting, and 6 of them were treated with flap. Average period of the application of vacuum-assisted wound closure was 11.6 days (7-15 days). Results of vacuum-assisted wound closure can be regarded as satisfactory when cases are selected properly. This system has three different effect mechanisms. Firstly, it increases local blood flow on the wound bed. Secondly, cell proliferation is triggered following the mechanic stress. Thirdly, vacuum removes the proteases from the environment which obstructs healing. Therefore, it is intended to prepare alive wound bed which is required for subsequent soft tissue reconstructions.

  3. Predictive Factors for Patients Undergoing ASD Device Occlusion Who "Crossover" to Surgery.

    Science.gov (United States)

    Mulukutla, Venkatachalam; Qureshi, Athar M; Pignatelli, Ricardo; Ing, Frank F

    2017-11-15

    The aim of this study was to define characteristics of those patients who are referred for device closure of an Atrial septal defect (ASD), but identified to "crossover" surgery. All patients who underwent surgical and device (Amplatzer or Helex occluder) closures of secundum ASDs from 2001 to 2010 were reviewed and organized into three groups: surgical closure, device closure, and "crossover" group. 369 patients underwent ASD closure (265 device, 104 surgical). 42 of the 265 patients referred for device closure "crossed over" to the surgical group at various stages of the catheterization procedure. The device group had defect size measuring 14.2 mm (mean) and an ASD index (Defect Size (mm)/BSA) of 14.0 compared to the corresponding values in the surgical group (20.1 mm, ASD index 25.9) (P ASD index) (P ASD index of 14.7 compared with the crossover group ASD index of 23.8 (P ASD index greater than 23.7 had a 90% specificity in "crossing over" to surgery. The crossover and surgical groups had statistically larger ASD defect size indexes compared with the device group. Deficient rim in the posterior/inferior rim is associated with a large ASD size index which is a predictive factor for crossing over to surgery. Catheterization did not negatively impact surgical results in the "crossover" group.

  4. Periodic arrays of flux-closure domains in ferroelectric thin films with oxide electrodes

    Science.gov (United States)

    Li, S.; Zhu, Y. L.; Wang, Y. J.; Tang, Y. L.; Liu, Y.; Zhang, S. R.; Ma, J. Y.; Ma, X. L.

    2017-07-01

    Flux-closure domain structures in ferroelectric thin films are considered to have potential applications in electronic devices. It is usually believed that these structures are stabilized by the depolarization field and the contact with electrodes tends to screen the depolarization field and may limit their formation. In this work, the influence of oxide electrodes (SrRuO3 and La0.7Sr0.3MnO3) on the formation of flux-closure domains in PbTiO3 thin films deposited on (110)-oriented GdScO3 substrates by pulsed laser deposition was investigated by Cs-corrected transmission electron microscopy. It is found that periodic flux-closure domain arrays can be stabilized in PbTiO3 films when the top and bottom electrodes are symmetric, while a/c domains appear when asymmetric electrodes are applied. The influence of asymmetric electrodes on the domain configuration is proposed to have a connection with their different work functions and conductivity types. These results are expected to shed light on understanding the nature of flux-closure domains in ferroelectrics and open some research possibilities, such as the evolution of these structures under external electric fields.

  5. Transcatheter closure of the patent foramen ovale in children: intermediate-term follow-up results.

    Science.gov (United States)

    Sel, Kutay; Aykan, Hakan H; Duman, Derya; Aypar, Ebru; Özkutlu, Süheyla; Alehan, Dursun; Karagöz, Tevfik

    2017-10-01

    The patent foramen ovale is almost a normal anatomical hole between the atria with ~30% incidence in the general population. It has been suggested that the patent foramen ovale is the cause of some neurological events, which is explained by paradoxical embolism. Transcatheter closure of the patent foramen ovale is a common procedure in adult patients with cerebral ischaemic events, but there are limited data investigating the results in children. Between January, 2005 and February, 2014, 17 patients' patent foramen ovales were closed by the transcatheter approach in our department. The indications for closure were transient ischaemic attack in 10 patients, stroke in four patients, and migraine in three patients. The mean age and mean weight at the time of the procedure were 11.1±3.7 years and 42.1±15.4 kg, respectively. We asked our patients whether their previous ailments continued. All patients responded to the study survey. In 15 patients, ailments did not continue after patent foramen ovale closure and they significantly decreased in two of them. We suggest that under the right conditions device closure of the patent foramen ovale is a safe solution for these cryptogenic ischaemic events and migraine.

  6. Opening and closure forces of sliding mechanisms of different self-ligating brackets

    Directory of Open Access Journals (Sweden)

    Paola GANDINI

    2013-06-01

    Full Text Available Self-ligating brackets engage the wire by means of a slide mechanism. Forces that have to be applied to open and close the sliding mechanism of brackets are still unknown. Objective The aim of this study was to measure and compare the opening and closure forces of different self-ligating brackets. Material and Methods Three different stainless steel self-ligating brackets (Carriere LX, Ortho Organizers; F1000, Leone; Damon Q, Ormco were tested. For each different bracket, 20 maxillary right central incisors and 20 mandibular right central incisors were used. Opening and closure forces were measured using an Instron Universal Testing Machine. Statistical analysis was performed and ANOVA and Tukey tests were carried out. Results Opening forces were registered between 1.1 N and 5.6 N, whereas closure forces were recorded between 1.57 N and 4.87 N. Significant differences were detected among the different brackets and between the two prescriptions tested. Conclusion The knowledge of different opening and closure forces of self-ligating brackets can help the orthodontist in the clinical management of these devices.

  7. Closure Report for Corrective Action Unit 426: Cactus Spring Waste Trenches, Tonopah Test Range, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    Dave Madsen

    1998-08-01

    This Closure Report provides the documentation for closure of the Cactus Spring Waste Trenches Corrective Action Unit (CAU) 426. The site is located on the Tonopah Test Range, approximately 225 kilometers northwest of Las Vegas, NV. CAU 426 consists of one corrective action site (CAS) which is comprised of four waste trenches. The trenches were excavated to receive solid waste generated in support of Operation Roller Coaster, primary the Double Tracks Test in 1963, and were subsequently backfilled. The Double Tracks Test involved use of live animals to assess the biological hazards associated with the nonnuclear detonation of plutonium-bearing devices. The Nevada Division of Environmental Protection approved Corrective Action Plan (CAP)which proposed ''capping'' methodology. The closure activities were completed in accordance with the approved CAP and consisted of constructing an engineered cover in the area of the trenches, constructing/planting a vegetative cover, installing a perimeter fence and signs, implementing restrictions on future use, and preparing a Post-Closure Monitoring Plan.

  8. Grounding Damage to Conventional Vessels

    DEFF Research Database (Denmark)

    Lützen, Marie; Simonsen, Bo Cerup

    2003-01-01

    regulations for design of bottom compartment layout with regard to grounding damages are largely based on statistical damage data. New and updated damage statistics holding 930 grounding accident records has been investigated. The bottom damage statistics is compared to current regulations for the bottom......The present paper is concerned with rational design of conventional vessels with regard to bottom damage generated in grounding accidents. The aim of the work described here is to improve the design basis, primarily through analysis of new statistical data for grounding damage. The current...... for the relation between the amount of deformed structure and the energy absorption. Finally, the paper shows how damage statistics for existing, conventional vessels can be used together with theoretical prediction methods for determining grounding damage distributions for new vessel types not included...

  9. 19 CFR 4.5 - Government vessels.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Government vessels. 4.5 Section 4.5 Customs Duties... VESSELS IN FOREIGN AND DOMESTIC TRADES Arrival and Entry of Vessels § 4.5 Government vessels. (a) No... that is the property of, the U.S. Department of Defense (DoD) will be treated as a Government vessel...

  10. Insertion devices

    CERN Document Server

    Bahrdt, J

    2006-01-01

    The interaction of an insertion device with the electron beam in a storage ring is discussed. The radiation property including brightness, ux and polarization of an ideal and real planar and helical / elliptical device is described. The magnet design of planar, helical, quasiperiodic devices and of devices with a reduced on axis power density are resumed.

  11. Temporary Closure of the Open Abdomen: A Systematic Review on Delayed Primary Fascial Closure in Patients with an Open Abdomen

    NARCIS (Netherlands)

    Boele van Hensbroek, P.; Wind, J.; Dijkgraaf, M.G.W.; Busch, O.R.C.; Goslings, J.C.

    2009-01-01

    Background This study was designed to systematically review the literature to assess which temporary abdominal closure (TAC) technique is associated with the highest delayed primary fascial closure (FC) rate. In some cases of abdominal trauma or infection, edema or packing precludes fascial closure

  12. Transcathether closure of a right pulmonary artery-to-left atrial fistula using Amplatzer muscular ventricular septal defect occluder.

    Science.gov (United States)

    Ece, Ibrahim; Uner, Abdurrahman; Cuce, Ferhat; Balli, Sevket

    2014-10-01

    A right pulmonary artery-to-left atrial fistula is a very rare cyanotic congenital heart defect and is characterized by cyanosis and normal auscultation of the heart. Interventional closure of the fistula using occluder devices and coils has been rarely reported. We report the successful closure of a RPA-to-left atrial fistula using an Amplatzer muscular ventricular septal defect occluder in a child with cyanosis. The two-dimensional echocardiogram with bubble contrast study demonstrated the communication between right pulmonary artery and left atrium. Computerized tomography confirmed the diagnosis and delineated the anatomy.

  13. [Pulmonary blood vessels in goats].

    Science.gov (United States)

    Roos, H; Hegner, K; Vollmerhaus, B

    1999-05-01

    The blood vessels in the lung of the goat, which until now have received little attention, are described in detail for the first time. With regard to the segments of the lung, blood vessels are bronchovascular units in the lobi craniales, lobus medius and lobus accessorius, but bronchoartery units in the lobi caudales. We investigated the types of branches of the Aa. pulmonales dextra et sinistra, the inter- and intraspecific principles of the outlet of the pulmonary veins and the importance of bronchopulmonary segmentation of the lungs.

  14. The impact of vacuum-assisted closure on long-term survival after post-sternotomy mediastinitis.

    Science.gov (United States)

    Sjögren, Johan; Nilsson, Johan; Gustafsson, Ronny; Malmsjö, Malin; Ingemansson, Richard

    2005-10-01

    Post-sternotomy mediastinitis after coronary artery bypass grafting is reported to be a strong predictor for poor late survival when using conventional wound-healing therapies. The aim of this study was to compare the long-term survival after vacuum-assisted closure treated mediastinitis following coronary artery bypass grafting with that of patients without mediastinitis. Another objective was to identify risk factors for developing mediastinitis. Forty-six patients were treated for mediastinitis, with vacuum-assisted closure but without additional tissue flaps, after isolated coronary bypass grafting between January 1999 and September 2004. During this period, 4,781 patients underwent isolated coronary bypass grafting without mediastinitis. Actuarial survival was compared with the log-rank test. Univariate and multivariate analysis were used to identify risk factors for mediastinitis. There was no difference in early or late survival between the mediastinitis group treated with vacuum-assisted closure and the control group (p = not significant). The survival at 1, 3, and 5 years was 92.9% +/- 4.0%, 89.2% +/- 5.2%, and 89.2% +/- 5.2%, respectively, in the vacuum-assisted closure group; and 96.5% +/- 0.3%, 92.1% +/- 0.5%, and 86.9% +/- 0.8%, respectively, in the control group. Diabetes mellitus, low left ventricular ejection fraction, obesity, renal failure, and three-vessel disease were identified as risk factors for developing mediastinitis. This study suggests that patients with vacuum-assisted closure treated mediastinitis may have similar long-term survival as patients without mediastinitis after coronary artery bypass grafting. The independent risk factors identified were similar to those found in previous studies. Our data support that vacuum-assisted closure therapy minimizes the negative effects of mediastinitis on late survival after coronary artery bypass grafting.

  15. Transcatheter closure of perimembranous ventricular septal defects in infants and children using the Amplatzer perimembranous ventricular septal defect occluder.

    Science.gov (United States)

    Thanopoulos, Basil Vasilios D; Rigby, Michael L; Karanasios, Evangelos; Stefanadis, Christodoulos; Blom, Nico; Ottenkamp, Jaap; Zarayelyan, Armine

    2007-04-01

    There are very few published reports of the transcatheter closure of perimembranous ventricular septal defects (PMVSDs) using the Amplatzer PMVSD occluder with encouraging initial results. This report presents initial and 1-year results from 54 patients with PMVSDs who underwent transcatheter closure at 5 different institutions with the Amplatzer PMVSD occluder. Sixty-five patients with PMVSDs were enrolled at 5 European centers. Eleven of the 65 patients did not fulfill the patient selection criteria at the initial echocardiographic evaluation or at cardiac catheterization. As a result, a total of 54 patients underwent attempted transcatheter closure using the Amplatzer PMVSD occluder. The median age of the patients was 5.1+/-3.6 years (range 0.3 to 13), and the median weight 18.5+/-10.3 kg (range 5 to 45). Devices were permanently implanted in 49 of 54 patients. Complete occlusion of the communication at 1-year follow-up was observed in 46 of 49 patients (94%). Main early procedural complications included (1) device embolization (2 patients), (2) severe bradycardia with hemodynamic compromise (2 patients), and (3) Mobitz II (2:1) heart block (1 patient). Late procedural complications included complete heart block (1 patient). No other complications were observed during follow-up. In conclusion, the Amplatzer PMVSD occluder is promising device that can be used for transcatheter closure in selected patients with PMVSDs. Further studies and long-term follow-up are required before this technique enters routine clinical practice.

  16. The Pharmaceutical Device Prisma® Skin Promotes in Vitro Angiogenesis through Endothelial to Mesenchymal Transition during Skin Wound Healing

    Directory of Open Access Journals (Sweden)

    Raffaella Belvedere

    2017-07-01

    Full Text Available Glycosaminoglycans are polysaccharides of the extracellular matrix supporting skin wound closure. Mesoglycan is a mixture of glycosaminoglycans such as chondroitin-, dermatan-, heparan-sulfate and heparin and is the main component of Prisma® Skin, a pharmaceutical device developed by Mediolanum Farmaceutici S.p.a. Here, we show the in vitro effects of this device in the new vessels formation by endothelial cells, since angiogenesis represents a key moment in wound healing. We found a strong increase of migration and invasion rates of these cells treated with mesoglycan and Prisma® Skin which mediate the activation of the pathway triggered by CD44 receptor. Furthermore, endothelial cells form longer capillary-like structures with a great number of branches, in the presence of the same treatments. Thus, the device, thanks to the mesoglycan, leads the cells to the Endothelial-to-Mesenchymal Transition, suggesting the switch to a fibroblast-like phenotype, as shown by immunofluorescence assays. Finally, we found that mesoglycan and Prisma® Skin inhibit inflammatory reactions such as nitric oxide secretion and NF-κB nuclear translocation in endothelial cells and Tumor Necrosis Factor-α production by macrophages. In conclusion, based on our data, we suggest that Prisma® Skin may be able to accelerate angiogenesis in skin wound healing, and regulate inflammation avoiding chronic, thus pathological, responses.

  17. Differential temporal and spatial progerin expression during closure of the ductus arteriosus in neonates.

    Directory of Open Access Journals (Sweden)

    Regina Bökenkamp

    Full Text Available Closure of the ductus arteriosus (DA at birth is essential for the transition from fetal to postnatal life. Before birth the DA bypasses the uninflated lungs by shunting blood from the pulmonary trunk into the systemic circulation. The molecular mechanism underlying DA closure and degeneration has not been fully elucidated, but is associated with apoptosis and cytolytic necrosis in the inner media and intima. We detected features of histology during DA degeneration that are comparable to Hutchinson Gilford Progeria syndrome and ageing. Immunohistochemistry on human fetal and neonatal DA, and aorta showed that lamin A/C was expressed in all layers of the vessel wall. As a novel finding we report that progerin, a splicing variant of lamin A/C was expressed almost selectively in the normal closing neonatal DA, from which we hypothesized that progerin is involved in DA closure. Progerin was detected in 16.2%±7.2 cells of the DA. Progerin-expressing cells were predominantly located in intima and inner media where cytolytic necrosis accompanied by apoptosis will develop. Concomitantly we found loss of α-smooth muscle actin as well as reduced lamin A/C expression compared to the fetal and non-closing DA. In cells of the adjacent aorta, that remains patent, progerin expression was only sporadically detected in 2.5%±1.5 of the cells. Data were substantiated by the detection of mRNA of progerin in the neonatal DA but not in the aorta, by PCR and sequencing analysis. The fetal DA and the non-closing persistent DA did not present with progerin expressing cells. Our analysis revealed that the spatiotemporal expression of lamin A/C and progerin in the neonatal DA was mutually exclusive. We suggest that activation of LMNA alternative splicing is involved in vascular remodeling in the circulatory system during normal neonatal DA closure.

  18. Differential temporal and spatial progerin expression during closure of the ductus arteriosus in neonates.

    Science.gov (United States)

    Bökenkamp, Regina; Raz, Vered; Venema, Andrea; DeRuiter, Marco C; van Munsteren, Conny; Olive, Michelle; Nabel, Elizabeth G; Gittenberger-de Groot, Adriana C

    2011-01-01

    Closure of the ductus arteriosus (DA) at birth is essential for the transition from fetal to postnatal life. Before birth the DA bypasses the uninflated lungs by shunting blood from the pulmonary trunk into the systemic circulation. The molecular mechanism underlying DA closure and degeneration has not been fully elucidated, but is associated with apoptosis and cytolytic necrosis in the inner media and intima. We detected features of histology during DA degeneration that are comparable to Hutchinson Gilford Progeria syndrome and ageing. Immunohistochemistry on human fetal and neonatal DA, and aorta showed that lamin A/C was expressed in all layers of the vessel wall. As a novel finding we report that progerin, a splicing variant of lamin A/C was expressed almost selectively in the normal closing neonatal DA, from which we hypothesized that progerin is involved in DA closure. Progerin was detected in 16.2%±7.2 cells of the DA. Progerin-expressing cells were predominantly located in intima and inner media where cytolytic necrosis accompanied by apoptosis will develop. Concomitantly we found loss of α-smooth muscle actin as well as reduced lamin A/C expression compared to the fetal and non-closing DA. In cells of the adjacent aorta, that remains patent, progerin expression was only sporadically detected in 2.5%±1.5 of the cells. Data were substantiated by the detection of mRNA of progerin in the neonatal DA but not in the aorta, by PCR and sequencing analysis. The fetal DA and the non-closing persistent DA did not present with progerin expressing cells. Our analysis revealed that the spatiotemporal expression of lamin A/C and progerin in the neonatal DA was mutually exclusive. We suggest that activation of LMNA alternative splicing is involved in vascular remodeling in the circulatory system during normal neonatal DA closure.

  19. Effectiveness of a new gelatin sealant system for dural closure.

    Science.gov (United States)

    Kawai, Hisashi; Nakagawa, Ichiro; Nishimura, Fumihiko; Motoyama, Yasushi; Park, Young-Su; Nakamura, Mitsutoshi; Nakase, Hiroyuki; Suzuki, Shuko; Ikada, Yoshito

    2014-10-01

    Watertight dural closure is imperative after neurosurgical procedures because inadequately treated leakage of cerebrospinal fluid (CSF) can have serious consequences. In this study, the authors test the use of a new gelatin glue as a dural sealant in in vitro and in vivo canine models of transdural CSF leakage. The in vitro model was sutured semicircles of canine dura mater and artificial dural substitute. The sutures were sealed with gelatin glue (n  =  20), fibrin glue (n  =  20), or a polyethylene glycol (PEG)-based hydrogel sealant (n  =  20). Each sample was set in a device to measure water pressure, and pressure was increased until leakage occurred. Bonding strength was subjectively evaluated. The in vivo model was dogs who underwent dural excision and received either no sealant (control group; n  =  5) or gelatin glue sealant (n  =  5) before dural closure. Twenty-eight days post-surgery, the maximum intracranial pressure was measured at the cisterna magna using Valsalva maneuver and tissue adhesion was evaluated. The water pressure at which leakage occurred in the in vitro model was higher with gelatin glue (76·5 ± 39·8 mmHg) than with fibrin glue (38·3 ± 27·4 mmHg, P < 0·001) or the PEG-based hydrogel sealant (46·3 ± 20·9 mmHg, P  =  0·007). Bonding strength was higher for the gelatin glue than fibrin glue (P < 0·001) or PEG-based hydrogel sealant (P  =  0·001). The maximum intracranial pressure in the in vivo model was higher for the gelatin glue group (59·0 ± 2·2 mmHg) than the control group (13·8 ± 4·0 mmHg, P < 0·001). Tissue adhesion was lower for the gelatin glue group than the control group (P  =  0·005). The new gelatin glue provides an effective watertight closure when used as an adjunct to sutured dural repair.

  20. Commercial Passenger Fishing Vessel Fishery

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains the logbook data from U.S.A. Commercial Passenger Fishing Vessels (CPFV) fishing in the U.S.A. EEZ and in waters off of Baja California, from...

  1. Pressure vessel and method therefor

    Energy Technology Data Exchange (ETDEWEB)

    Saunders, Timothy

    2017-09-05

    A pressure vessel includes a pump having a passage that extends between an inlet and an outlet. A duct at the pump outlet includes at least one dimension that is adjustable to facilitate forming a dynamic seal that limits backflow of gas through the passage.

  2. BPC 157 and blood vessels.

    Science.gov (United States)

    Seiwerth, Sven; Brcic, Luka; Vuletic, Lovorka Batelja; Kolenc, Danijela; Aralica, Gorana; Misic, Marija; Zenko, Anita; Drmic, Domagoj; Rucman, Rudolf; Sikiric, Predrag

    2014-01-01

    This review focuses on the described effects of BPC 157 on blood vessels after different types of damage, and elucidate by investigating different aspects of vascular response to injury (endothelium damage, clotting, thrombosis, vasoconstriction, vasodilatation, vasculoneogenesis and edema formation) especially in connection to the healing processes. In this respect, BPC 157 was concluded to be the most potent angiomodulatory agent, acting through different vasoactive pathways and systems (e.g. NO, VEGF, FAK) and leading to optimization of the vascular response followed, as it has to be expected, by optimization of the healing process. Formation of new blood vessels involves two main, partly overlapping mechanisms, angiogenesis and vasculogenesis. The additional mechanism of arteriogenesis is involved in the formation of collaterals. In conjunction with blood vessel function, we at least have to consider leakage of fluid/proteins/plasma, resulting in edema/exudate formation as well as thrombogenesis. Blood vessels are also strongly involved in tumor biology. In this aspect, we have neoangiogenesis resulting in pathological vascularization, vascular invasion resulting in release of metastatic cells and the phenomenon of homing resulting in formation of secondary tumors--metastases.

  3. The determinants of fishing vessel accident severity.

    Science.gov (United States)

    Jin, Di

    2014-05-01

    The study examines the determinants of fishing vessel accident severity in the Northeastern United States using vessel accident data from the U.S. Coast Guard for 2001-2008. Vessel damage and crew injury severity equations were estimated separately utilizing the ordered probit model. The results suggest that fishing vessel accident severity is significantly affected by several types of accidents. Vessel damage severity is positively associated with loss of stability, sinking, daytime wind speed, vessel age, and distance to shore. Vessel damage severity is negatively associated with vessel size and daytime sea level pressure. Crew injury severity is also positively related to the loss of vessel stability and sinking. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Application of electron closures in extended MHD

    Science.gov (United States)

    Held, Eric; Adair, Brett; Taylor, Trevor

    2017-10-01

    Rigorous closure of the extended MHD equations in plasma fluid codes includes the effects of electron heat conduction along perturbed magnetic fields and contributions of the electron collisional friction and stress to the extended Ohms law. In this work we discuss application of a continuum numerical solution to the Chapman-Enskog-like electron drift kinetic equation using the NIMROD code. The implementation is a tightly-coupled fluid/kinetic system that carefully addresses time-centering in the advance of the fluid variables with their kinetically-computed closures. Comparisons of spatial accuracy, computational efficiency and required velocity space resolution are presented for applications involving growing magnetic islands in cylindrical and toroidal geometry. The reduction in parallel heat conduction due to particle trapping in toroidal geometry is emphasized. Work supported by DOE under Grant Nos. DE-FC02-08ER54973 and DE-FG02-04ER54746.

  5. Closure measurements of naturally initiating small cracks

    Science.gov (United States)

    Sharpe, W. N., Jr.; Su, X.

    1988-01-01

    The initiation and growth of cracks in smooth 2024-T3 aluminum specimens have been investigated using acetate replicas. Crack opening displacements were measured as a function of load at several positions along the crack as it grew across the thickness of the specimen and became a through-the-thickness crack of a few millimeters in length. Tests run for R-ratios of 0.5, 0.0 and -1.0 showed that closure loads were well predicted by Newman's (1984) model. It is noted that small cracks grow slightly faster than would be predicted by long-crack data, and it is suggested that effects other than plasticity-induced closure must be taken into account.

  6. Primary closure of inadvertent durotomies utilizing the U-Clip in minimally invasive spinal surgery.

    Science.gov (United States)

    Song, Debbie; Park, Paul

    2011-12-15

    Retrospective clinical cohort study. To examine performance of the U-Clip for the closure of inadvertent durotomy occurring during minimally invasive spinal surgery. Primary closure of inadvertent durotomies that occur during minimally invasive spinal surgery can be technically difficult to accomplish when using standard knot-tying and suture management techniques, owing to the narrow and deep surgical corridor afforded by tubular retraction systems. The U-Clip is a novel device that can achieve tight tissue approximation without the need for knot-tying and excessive suture manipulation, making it ideally suited for use in minimally invasive spinal surgeries. We performed a retrospective review of patients who underwent minimally invasive decompressive procedures complicated by durotomy and repaired using U-Clips for the period January 2008 to January 2010. A total of seven patients were identified. Four of the seven patients were male. Six patients underwent lumbar laminectomy or discectomy. One patient underwent resection of a cervical synovial cyst. In each patient, the durotomy was repaired primarily using U-Clips. All six lumbar patients were discharged home on the same day, and the remaining patient was discharged the following morning. Mean follow-up was 6.3 months. No patient experienced symptoms related to persistent cerebrospinal fluid leakage. Primary closure of an inadvertent durotomy occurring during minimally invasive spinal surgery can be effectively achieved using the self-closing U-Clip device.

  7. A new bipolar feedback-controlled sealing system for closure of the cystic duct and artery.

    Science.gov (United States)

    Shamiyeh, A; Schrenk, P; Tulipan, L; Vattay, P; Bogner, S; Wayand, W

    2002-05-01

    Bile leaks are serious complications after laparoscopic cholecystectomy. The aim of this study was to evaluate the feasibility of closure of the cystic duct with a new feedback-controlled bipolar sealing system (LigaSure). Ten domestic pigs underwent open cholecystectomy with the cystic duct and artery dissected and sealed with the new bipolar sealing system (LigaSure). Four and 8 days postoperatively, 5 pigs each were sacrificed and the closure of the cystic duct was evaluated. The cystic stump and the common bile duct were excised for histological examination. None of the pigs had a bile leak or a biliary peritonitis. There were no signs of postoperative bleeding or inflammation in Calot's triangle. Histology showed total necrosis of the cystic duct in the first two pigs due to too much energy used. The remaining specimens showed a regularly scaling zone without necrosis in 7 cases, and in one case a partial necrosis in the mucosa only was found. Cystic artery and cystic duct closure with the new device may be an alternative to the clip. Further trials should evaluate the feasibility and safety of the new device in the clinical setting.

  8. 46 CFR 121.410 - Electronic position fixing devices.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Electronic position fixing devices. 121.410 Section 121... AND MISCELLANEOUS SYSTEMS AND EQUIPMENT Navigation Equipment § 121.410 Electronic position fixing devices. A vessel on an oceans route must be equipped with an electronic position fixing device, capable...

  9. 46 CFR 130.320 - Electronic position-fixing device.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Electronic position-fixing device. 130.320 Section 130... CONTROL, AND MISCELLANEOUS EQUIPMENT AND SYSTEMS Navigational Equipment § 130.320 Electronic position-fixing device. Each vessel must be equipped with an electronic position-fixing device satisfactory for...

  10. 46 CFR 28.260 - Electronic position fixing devices.

    Science.gov (United States)

    2010-10-01

    ... Trade § 28.260 Electronic position fixing devices. Each vessel 79 feet (24 meters) or more in length must be equipped with an electronic position fixing device capable of providing accurate fixes for the... 46 Shipping 1 2010-10-01 2010-10-01 false Electronic position fixing devices. 28.260 Section 28...

  11. 46 CFR 154.1340 - Temperature measuring devices.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Temperature measuring devices. 154.1340 Section 154.1340... STANDARDS FOR SELF-PROPELLED VESSELS CARRYING BULK LIQUEFIED GASES Design, Construction and Equipment Instrumentation § 154.1340 Temperature measuring devices. (a) Each cargo tank must have devices that measure the...

  12. 46 CFR 131.940 - Marine sanitation device.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Marine sanitation device. 131.940 Section 131.940... Miscellaneous § 131.940 Marine sanitation device. Each vessel with installed toilet facilities must have a marine sanitation device in compliance with 33 CFR part 159. ...

  13. 46 CFR 121.704 - Marine sanitation devices.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Marine sanitation devices. 121.704 Section 121.704... MISCELLANEOUS SYSTEMS AND EQUIPMENT Miscellaneous § 121.704 Marine sanitation devices. A vessel with installed toilet facilities must have a marine sanitation device that complies with 33 CFR part 159. ...

  14. The Galois closure of Drinfeld modular towers

    DEFF Research Database (Denmark)

    Bassa, Alp; Beelen, Peter

    2011-01-01

    In this article we study Drinfeld modular curves X0(pn) associated to congruence subgroups Γ0(pn) of GL(2,Fq[T]) where p is a prime of Fq[T]. For n>r>0 we compute the extension degrees and investigate the structure of the Galois closures of the covers X0(pn)→X0(pr) and some of their variations...

  15. Calcined solids storage facility closure study

    Energy Technology Data Exchange (ETDEWEB)

    Dahlmeir, M.M.; Tuott, L.C.; Spaulding, B.C. [and others

    1998-02-01

    The disposal of radioactive wastes now stored at the Idaho National Engineering and Environmental Laboratory is currently mandated under a {open_quotes}Settlement Agreement{close_quotes} (or {open_quotes}Batt Agreement{close_quotes}) between the Department of Energy and the State of Idaho. Under this agreement, all high-level waste must be treated as necessary to meet the disposal criteria and disposed of or made road ready to ship from the INEEL by 2035. In order to comply with this agreement, all calcined waste produced in the New Waste Calcining Facility and stored in the Calcined Solids Facility must be treated and disposed of by 2035. Several treatment options for the calcined waste have been studied in support of the High-Level Waste Environmental Impact Statement. Two treatment methods studied, referred to as the TRU Waste Separations Options, involve the separation of the high-level waste (calcine) into TRU waste and low-level waste (Class A or Class C). Following treatment, the TRU waste would be sent to the Waste Isolation Pilot Plant (WIPP) for final storage. It has been proposed that the low-level waste be disposed of in the Tank Farm Facility and/or the Calcined Solids Storage Facility following Resource Conservation and Recovery Act closure. In order to use the seven Bin Sets making up the Calcined Solids Storage Facility as a low-level waste landfill, the facility must first be closed to Resource Conservation and Recovery Act (RCRA) standards. This study identifies and discusses two basic methods available to close the Calcined Solids Storage Facility under the RCRA - Risk-Based Clean Closure and Closure to Landfill Standards. In addition to the closure methods, the regulatory requirements and issues associated with turning the Calcined Solids Storage Facility into an NRC low-level waste landfill or filling the bin voids with clean grout are discussed.

  16. Reactor vessel lower head integrity

    Energy Technology Data Exchange (ETDEWEB)

    Rubin, A.M.

    1997-02-01

    On March 28, 1979, the Three Mile Island Unit 2 (TMI-2) nuclear power plant underwent a prolonged small break loss-of-coolant accident that resulted in severe damage to the reactor core. Post-accident examinations of the TMI-2 reactor core and lower plenum found that approximately 19,000 kg (19 metric tons) of molten material had relocated onto the lower head of the reactor vessel. Results of the OECD TMI-2 Vessel Investigation Project concluded that a localized hot spot of approximately 1 meter diameter had existed on the lower head. The maximum temperature on the inner surface of the reactor pressure vessel (RPV) in this region reached 1100{degrees}C and remained at that temperature for approximately 30 minutes before cooling occurred. Even under the combined loads of high temperature and high primary system pressure, the TMI-2 RPV did not fail. (i.e. The pressure varied from about 8.5 to 15 MPa during the four-hour period following the relocation of melt to the lower plenum.) Analyses of RPV failure under these conditions, using state-of-the-art computer codes, predicted that the RPV should have failed via local or global creep rupture. However, the vessel did not fail; and it has been hypothesized that rapid cooling of the debris and the vessel wall by water that was present in the lower plenum played an important role in maintaining RPV integrity during the accident. Although the exact mechanism(s) of how such cooling occurs is not known, it has been speculated that cooling in a small gap between the RPV wall and the crust, and/or in cracks within the debris itself, could result in sufficient cooling to maintain RPV integrity. Experimental data are needed to provide the basis to better understand these phenomena and improve models of RPV failure in severe accident codes.

  17. Folate receptors and neural tube closure.

    Science.gov (United States)

    Saitsu, Hirotomo

    2017-09-01

    Neural tube defects (NTD) are among the most common human congenital malformations, affecting 0.5-8.0/1000 of live births. Human clinical trials have shown that periconceptional folate supplementation significantly decreases the occurrence of NTD in offspring. However, the mechanism by which folate acts on NTD remains largely unknown. Folate receptor (Folr) is one of the three membrane proteins that mediate cellular uptake of folates. Recent studies suggest that mouse Folr1 (formerly referred to as Fbp1) is essential for neural tube closure. Therefore, we examined spatial and temporal expression patterns of Folr1 in developing mouse embryos, showing a close association between Folr1 and anterior neural tube closure. Transient transgenic analysis was performed using lacZ as a reporter; we identified a 1.1-kb enhancer that directs lacZ expression in the neural tube and optic vesicle in a manner that is similar to endogenous Folr1. The 1.1-kb enhancer sequences were highly conserved between humans and mice, suggesting that human FOLR1 is associated with anterior neural tube closure in humans. Several experimental studies in mice and human epidemiological and genetics studies have suggested that folate receptor abnormalities are involved in a portion of human NTDs, although the solo defect of FOLR1 did not cause NTD. © 2017 Japanese Teratology Society.

  18. Phenomenology of convection-parameterization closure

    Directory of Open Access Journals (Sweden)

    J.-I. Yano

    2013-04-01

    Full Text Available Closure is a problem of defining the convective intensity in a given parameterization. In spite of many years of efforts and progress, it is still considered an overall unresolved problem. The present article reviews this problem from phenomenological perspectives. The physical variables that may contribute in defining the convective intensity are listed, and their statistical significances identified by observational data analyses are reviewed. A possibility is discussed for identifying a correct closure hypothesis by performing a linear stability analysis of tropical convectively coupled waves with various different closure hypotheses. Various individual theoretical issues are considered from various different perspectives. The review also emphasizes that the dominant physical factors controlling convection differ between the tropics and extra-tropics, as well as between oceanic and land areas. Both observational as well as theoretical analyses, often focused on the tropics, do not necessarily lead to conclusions consistent with our operational experiences focused on midlatitudes. Though we emphasize the importance of the interplays between these observational, theoretical and operational perspectives, we also face challenges for establishing a solid research framework that is universally applicable. An energy cycle framework is suggested as such a candidate.

  19. Creativity & Cognitive Closure (Creatividad y cierre cognitivo

    Directory of Open Access Journals (Sweden)

    Melike Hazir

    2015-02-01

    Full Text Available Abstract The aim of this paper is to present the relationship between the need for cognitive closure (NFC and creativity. In light of previous research, a theoretical foundation is established for the term creativity. Next the social-cognitive phenomenon of the need for cognitive closure is explained based on the theory of Kruglanski and Webster, and considering the tendencies of urgency and permanency. Conclusion: The role of creativity is to control cognitive closure in order to solve problems that arise during the learning process and usually during the life. Resumen El objetivo de este trabajo es presentar la relación entre la necesidad de cierre cognitivo (NCC y la creatividad. A la luz de las investigaciones realizadas, se establece la base teórica para el término de creatividad y la explica del fenómeno socio-cognitivo de necesidad de cierre cognitivo en base a la teoría de Kruglanski y Webster, teniendo en cuenta las tendencias de urgencia y permanencia. Conclusión: La creatividad tiene un papel importante de control del cierre cognitivo con el fin de resolver los problemas que surjan durante el proceso de aprendizaje y en general durante la vida.

  20. 46 CFR 42.05-63 - Ship(s) and vessel(s).

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Ship(s) and vessel(s). 42.05-63 Section 42.05-63... BY SEA Definition of Terms Used in This Subchapter § 42.05-63 Ship(s) and vessel(s). The terms ship(s) and vessel(s) are interchangeable or synonymous words, and include every description of watercraft...

  1. Role of real-time three-dimensional transoesophageal echocardiography for guiding transcatheter patent foramen ovale closure.

    Science.gov (United States)

    Martin-Reyes, Roberto; López-Fernández, Teresa; Moreno-Yangüela, Mar; Moreno, Raul; Navas-Lobato, Miguel Angel; Refoyo, Elena; Guzmán, Gabriela; Domínguez-Melcón, Francisco; López-Sendón, Jose Luis

    2009-01-01

    Patent foramen ovale (PFO) is a relatively common congenital condition which has been implicated in cryptogenic stroke as a result of paradoxical thromboembolism by right-to-left shunting. Many studies have demonstrated that transcatheter PFO closure significantly reduced the incidence of recurrent strokes in a small group of high-risk patients with PFO and atrial septal aneurysm compared with antithrombotic drugs. Two-dimensional transoesophageal echocardiography (2D TEE) has become the election technique for guiding patent foramen ovale closure. Real-time Three-dimensional transoesophageal echocardiography (3D TEE) may be potentially superior to 2D TEE in the accurate assessment of the morphology and efficacy of transcatheter closure devices because of a better spacial orientation.

  2. Long-Term Follow-up of Patent Ductus Arteriosus Closure with the Amplatzer Duct Occluder in Children

    Directory of Open Access Journals (Sweden)

    Mostafa Behjati-Ardakani

    2015-10-01

    Full Text Available Background: Transcatheter closure of patent ductus arteriosus (PDA has become an alternative treatment to surgery. We evaluated the long-term results of the transcatheter closure of PDA with the Amplatzer Duct Occluder (ADO in children.Methods: Between May 2004 and October 2012, 138 children with PDA (43 males and 95 females underwent transcatheter PDA closure. Clinical, electrocardiographic, echocardiographic, and hemodynamic data were assessed pre and postprocedurally and at follow-up.Results: The mean age of the patients at procedure was 3.53 ± 2.43 years (range = 1.1 to 9.5 years, mean weight was11.9±4.6 kg (range = 6 to 29 kg, median pulmonary end diameter of the PDA was 5 mm (range = 4 to 15 mm, and median diameter of the ADO was 8 mm (range = 6 to 16 mm. The mean follow-up time was 43.4 ± 23.5 months (range = 13.5 to98 months.The devices were successfully deployed in 136 (98.5% patients. Device embolization occurred in 2 patients, immediately in one patient and during the first postprocedural night in the other patient. The first patient had percutaneous device retrieval, followed by implantation of a larger device. The second patient had surgical device removal and PDA ligation. Immediately after device implantation, trivial to mild residual shunts were detected in 112 (80% patients; all the shunts, however, disappeared 24 hours after the procedure. One patient had left pulmonary artery stenosis with a gradient of 25 mm Hg at 24 hours', 40 mmHg at one month's, and 64 mmHg at 6 months' follow-up. There were no cases of late embolization, aortic obstruction, late hemolysis, infective endocarditis, or death.Conclusion: Transcatheter PDA closure with the ADO was safe and effective, with a high success rate at long-term follow-up.

  3. Vessel tree extraction using locally optimal paths

    DEFF Research Database (Denmark)

    Lo, Pechin Chien Pau; van Ginneken, Bram; de Bruijne, Marleen

    2010-01-01

    This paper proposes a method to extract vessel trees by continually extending detected branches with locally optimal paths. Our approach uses a cost function from a multi scale vessel enhancement filter. Optimal paths are selected based on rules that take into account the geometric characteristics...... of the vessel tree. Experiments were performed on 10 low dose chest CT scans for which the pulmonary vessel trees were extracted. The proposed method is shown to extract a better connected vessel tree and extract more of the small peripheral vessels in comparison to applying a threshold on the output...

  4. Electrically conductive containment vessel for molten aluminum

    Science.gov (United States)

    Holcombe, C.E.; Scott, D.G.

    1984-06-25

    The present invention is directed to a containment vessel which is particularly useful in melting aluminum. The vessel of the present invention is a multilayered vessel characterized by being electrically conductive, essentially nonwettable by and nonreactive with molten aluminum. The vessel is formed by coating a tantalum substrate of a suitable configuration with a mixture of yttria and particulate metal 10 borides. The yttria in the coating inhibits the wetting of the coating while the boride particulate material provides the electrical conductivity through the vessel. The vessel of the present invention is particularly suitable for use in melting aluminum by ion bombardment.

  5. Barbed sutures versus conventional sutures for uterine closure at cesarean section; a randomized controlled trial.

    Science.gov (United States)

    Zayed, Mohamed A; Fouda, Usama M; Elsetohy, Khaled A; Zayed, Shereef M; Hashem, Ahmed T; Youssef, Mohamed A

    2017-10-29

    The aim of this randomized control trial was to compare the operative data and the early postoperative outcomes of cesarean sections in which the uterine incision was closed with a barbed suture (STRATAFIX™ Spiral PDO Knotless Tissue Control Device, SXPD2B405, Ethicon Inc.) with those of cesarean sections in which the uterine incision was closed with a conventional smooth suture (VICRYL™; Ethicon Inc.). One hundred pregnant patients were randomized in a 1:1 ratio to the Stratafix group or the Vicryl group. The uterine incision was closed by two layers of sutures in both groups. In the Vicryl group, the first layer was continuous and the second layer was interrupted. In the Stratafix group, both layers were continuous. The uterine closure time was significantly lower in the Stratafix group (224 ± 46 versus 343 ± 75 s, p Stratafix group required additional sutures to achieve hemostasis (p value = .009). The mean blood loss during closure of uterine incision and mean hospital stay were lower in the Stratafix group but these differences failed to reach statistical significance. The use of barbed suture for uterine incision closure at cesarean section is associated with shorter uterine closure time and similar early perioperative complications compared with conventional smooth suture. The difference between both groups in the technique of suturing the second layer of the uterine incision may be the cause of the reduction in the uterine closure time and the need for additional sutures to achieve hemostasis during suturing the uterine incision with a barbed suture. Further, well designed randomized controlled trials should be conducted to investigate the association between the type of suture (barbed or conventional smooth) and remote complications of cesarean section (infertility, pelvic pain, abnormal placentation and rupture uterus).

  6. Comparison of two ultrasonic coagulating shears in sealing pulmonary vessels

    Directory of Open Access Journals (Sweden)

    Raghavan D

    2013-03-01

    Full Text Available Devanathan Raghavan,1 John A Howington,2 Duan Broughton,1 Cortney E Henderson,1 Jeffrey W Clymer1 1Preclinical Research, Ethicon Endo-Surgery, Cincinnati, OH, USA; 2NorthShore University HealthSystem, Chicago, IL, USA Abstract: Ultrasonic cutting and coagulating devices have been used successfully in thoracic applications such as pulmonary resection or artery harvesting, but few studies have evaluated their use in sealing pulmonary vessels. In this study we compared two commercially available devices, Harmonic Ace+ (HAR, Ethicon Endo-Surgery, Inc., Cincinnati OH, USA and SonoSurg (SS, Olympus America, Center Valley, PA, USA, in a canine preclinical model. There were three sections to the study: acute, survival, and ex vivo (burst pressure. Hemostasis of sealed pulmonary arteries and veins was assessed for the initial application and during a simulated hypertensive crisis, both immediately after vessel sealing and after a survival period of 30 days. Other intraoperative measures were also evaluated, including transection time, tissue sticking, tissue tags, and char on the seal. Histological evaluation was performed both after initial sealing and after the survival period. Burst pressure of sealed vessels was measured ex vivo. For both devices, hemostasis was excellent, including those measurements made under simulated hypertensive crisis. There were no differences in any of the intraoperative measures or thermal damage evaluated histologically. Wound healing was normal. The burst pressures for ex vivo vessels sealed by HAR (median 619.2 mmHg were significantly higher than those of SS (350.3 mmHg, P = 0.022. Both devices displayed acceptable characteristics in sealing canine pulmonary arteries and veins. The only difference observed was that HAR produced burst pressures 76.8% greater than SS, which may lead to a lower percentage of failures in the region of physiological interest. Use of ultrasonic devices in thoracic applications provides a high

  7. Advanced in-vessel retention design for next generation risk management

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Kune Y.; Hwang, Il Soon [Seoul National University, Seoul (Korea, Republic of)

    1997-12-31

    In the TMI-2 accident, approximately twenty (20) tons of molten core material drained into the lower plenum. Early advanced light water reactor (LWR) designs assumed a lower head failure and incorporated various measures for ex-vessel accident mitigation. However,one of the major findings from the TMI-2 Vessel Investigation Project was that one part of the reactor lower head wall estimated to have attained a temperature of 1100 deg C for about 30 minutes has seemingly experienced a comparatively rapid cooldown with no major threat to the vessel integrity. In this regard, recent empirical and analytical studies have shifted interests to such in-vessel retention designs or strategies as reactor cavity flooding, in-vessel flooding and engineered gap cooling of the vessel. Accurate thermohydrodynamic and creep deformation modeling and rupture prediction are the key to the success in developing practically useful in-vessel accident/risk management strategies. As an advanced in-vessel design concept, this work presents the COrium Attack Syndrome Immunization Structures (COASIS) that are being developed as prospective in-vessel retention devices for a next-generation LWR in concert with existing ex-vessel management measures. Both the engineered gap structures in-vessel (COASISI) and ex-vessel (COASISO) are demonstrated to maintain effective heat transfer geometry during molten core debris attack when applied to the Korean Standard Nuclear Power Plant (KSNPP) reactor. The likelihood of lower head creep rupture during a severe accident is found to be significantly suppressed by the COASIS options. 15 refs., 5 figs., 1 tab. (Author)

  8. Percutaneous left atrial appendage closure for stroke prevention in patients with atrial fibrillation: an assessment of net clinical benefit.

    Science.gov (United States)

    Gangireddy, Sandeep R; Halperin, Jonathan L; Fuster, Valentin; Reddy, Vivek Y

    2012-11-01

    The PROTECT-AF (WATCHMAN Left Atrial Appendage System for Embolic Protection in Patients with Atrial Fibrillation) trial found left atrial appendage (LAA) closure an alternative to anticoagulation in selected patients with non-valvular atrial fibrillation (AF). We aim to estimate the net clinical benefit (NCB) of percutaneous LAA closure. Post hoc analysis of outcomes among 707 adults with AF in the PROTECT-AF trial and 566 in the Continued Access (CAP) registry undergoing LAA closure with the Watchman device compared with sustained anticoagulation. Outcomes were ischaemic stroke, intracranial haemorrhage, major bleeding, pericardial effusion, and death, weighted to reflect the relative impact in terms of death and disability. Net clinical benefit was calculated as the sum of annualized rates of these outcomes after intervention minus rates on warfarin. The NCB of LAA closure during 1623 person-years follow-up in the trial was 1.73%/year (95% CI: -0.54 to 4.39%/year) and during 741 patient-years in the registry was 4.97%/year (95% CI: 3.07-7.15%/year). Among patients with a history of ischaemic stroke, the NCB was greater in the registry (8.68%/year, CI: 2.82-14.92%/year) than the trial (4.30%/year, CI -2.07 to 11.25%/year). In the registry, the NCB of LAA closure increased from 2.22%/year (CI: 0.27-6.01%/year) in patients with CHADS(2) scores = 1 to 6.12%/year (CI: 3.19-8.92%/year) in those with scores ≥2. Combining rates of thrombo-embolism, intracranial haemorrhage, major adverse events, and death allows objective comparison of the benefit and risk of device therapy vs. anticoagulation in patients with AF. The NCB of LAA closure is greatest for patients at a higher risk of stroke.

  9. An Automatic Cognitive Graph-Based Segmentation for Detection of Blood Vessels in Retinal Images

    Directory of Open Access Journals (Sweden)

    Rasha Al Shehhi

    2016-01-01

    Full Text Available This paper presents a hierarchical graph-based segmentation for blood vessel detection in digital retinal images. This segmentation employs some of perceptual Gestalt principles: similarity, closure, continuity, and proximity to merge segments into coherent connected vessel-like patterns. The integration of Gestalt principles is based on object-based features (e.g., color and black top-hat (BTH morphology and context and graph-analysis algorithms (e.g., Dijkstra path. The segmentation framework consists of two main steps: preprocessing and multiscale graph-based segmentation. Preprocessing is to enhance lighting condition, due to low illumination contrast, and to construct necessary features to enhance vessel structure due to sensitivity of vessel patterns to multiscale/multiorientation structure. Graph-based segmentation is to decrease computational processing required for region of interest into most semantic objects. The segmentation was evaluated on three publicly available datasets. Experimental results show that preprocessing stage achieves better results compared to state-of-the-art enhancement methods. The performance of the proposed graph-based segmentation is found to be consistent and comparable to other existing methods, with improved capability of detecting small/thin vessels.

  10. Umbilical trocar site closure with Berci's needle after laparoscopic cholecystectomy.

    Science.gov (United States)

    Calik, Adnan; Yucel, Yusuf; Topaloglu, Serdar; Hos, Gultekin; Aktas, Aydin; Piskin, Burhan

    2008-01-01

    The umbilical region is particularly susceptible for development of incisional hernia after laparoscopic cholecystectomy (LC). To evaluate the effects of port-closure techniques on the complications seen after umbilical port-site closure, we compared closure with Berci's needle and the standard technique of a hand-sutured closure. A hundred patients underwent LC were randomly divided into two groups. We evaluated the required time for closure, the security of techniques and the factors affecting postoperative complications for both closure groups in a prospective manner. Closure of the umbilical port site was performed faster with the Berci's needle compared to standard hand-sutured technique. Postoperative hospital stay and complication rates were not altered significantly depend on the closure technique. Skin dimpling on the trocar site was observed predominantly after closure with Berci's needle. Spontaneous improvement on skin dimpling was observed within the 2 weeks after operation in all patients. During the follow-up period, there was no trocar site hernia observed in the study group. Closure of the umbilical port site with Berci's needle is found as an effective and safe method for laparoscopic cholecystectomy.

  11. 46 CFR 184.410 - Electronic position fixing devices.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Electronic position fixing devices. 184.410 Section 184.410 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) VESSEL CONTROL AND MISCELLANEOUS SYSTEMS AND EQUIPMENT Navigation Equipment § 184.410...

  12. 46 CFR 184.704 - Marine sanitation devices.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Marine sanitation devices. 184.704 Section 184.704 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) VESSEL CONTROL AND MISCELLANEOUS SYSTEMS AND EQUIPMENT Miscellaneous § 184.704 Marine sanitation...

  13. Photovoltaic device

    Science.gov (United States)

    Reese, Jason A.; Keenihan, James R.; Gaston, Ryan S.; Kauffmann, Keith L.; Langmaid, Joseph A.; Lopez, Leonardo C.; Maak, Kevin D.; Mills, Michael E.; Ramesh, Narayan; Teli, Samar R.

    2015-09-01

    The present invention is premised upon an improved photovoltaic device ("PV device"), more particularly to an improved photovoltaic device (10) with a multilayered photovoltaic cell assembly (100) and a body portion (200) joined at an interface region (410) and including an intermediate layer (500), at least one interconnecting structural member (1500), relieving feature (2500), unique component geometry, or any combination thereof.

  14. Photovoltaic device

    Energy Technology Data Exchange (ETDEWEB)

    Reese, Jason A; Keenihan, James R; Gaston, Ryan S; Kauffmann, Keith L; Langmaid, Joseph A; Lopez, Leonardo; Maak, Kevin D; Mills, Michael E; Ramesh, Narayan; Teli, Samar R

    2017-03-21

    The present invention is premised upon an improved photovoltaic device ("PV device"), more particularly to an improved photovoltaic device with a multilayered photovoltaic cell assembly and a body portion joined at an interface region and including an intermediate layer, at least one interconnecting structural member, relieving feature, unique component geometry, or any combination thereof.

  15. Concentration device

    DEFF Research Database (Denmark)

    2013-01-01

    A concentration device (2) for filter filtration concentration of particles (4) from a volume of a fluid (6). The concentration device (2) comprises a filter (8) configured to filter particles (4) of a predefined size in the volume of the fluid (6). The concentration device (2) comprises...

  16. Comparison of transcatheter closure of secundum atrial septal defect using the Amplatzer septal occluder associated with deficient versus sufficient rims.

    Science.gov (United States)

    Du, Zhong-Dong; Koenig, Peter; Cao, Q-Ling; Waight, David; Heitschmidt, Mary; Hijazi, Ziyad M

    2002-10-15

    To evaluate the feasibility of transcatheter closure of secundum atrial septal defects (ASDs) associated with deficient rims (rim of 0 to 4 mm (n = 20), an inferior rim of 2 mm (n = 2), or a posterior rim of 4 mm (n = 1) as assessed by transesophageal echocardiography (TEE) or intracardiac echocardiography (ICE). Forty-eight patients with sufficient rims (>5 mm) who underwent closure served as controls. There were no differences between the 2 groups in ASD stretched diameter and device size (p >0.05). Of 23 patients with deficient rims, 17 (74%) had immediate complete closure compared with 44 of 48 patients (92%) with sufficient rims (p rims vs 94% for patients with sufficient rims at 24 hours and 100% vs 93% at 6 months, respectively). The fluoroscopic time and procedure time were longer in patients with deficient rims (13 +/- 7 and 72 +/- 26 minutes, respectively) compared with those with sufficient rims (10 +/- 4 and 61 +/- 22 minutes, respectively). No major complications were encountered either during or after the closure procedure in both groups. Thus, transcatheter closure of ASDs associated with small anterior, inferior, or posterior rims is feasible using an ASO. Long-term follow-up data are still needed to assess long-term safety and efficacy.

  17. AFSC/FMA/Vessel Assessment Logging

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Vessels fishing trawl gear, vessels fishing hook-and-line and pot gear that are also greater than 57.5 feet overall, and shoreside and floating processing facilities...

  18. Hawaii Abandoned Vessel Inventory, Hawaii Island

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Hawaii Island. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  19. US Virgin Islands Abandoned Vessel Inventory

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for US Virgin Islands. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of...

  20. Hawaii Abandoned Vessel Inventory, Midway Island, NWHI

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Midway Island, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of...

  1. Hawaii Abandoned Vessel Inventory, Kure, NWHI

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Kure, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  2. Actemra Approved for Certain Blood Vessel Inflammation

    Science.gov (United States)

    ... 165836.html Actemra Approved for Certain Blood Vessel Inflammation Drug will treat adults with a condition called ... to treat adults with giant cell arteritis, an inflammation of the blood vessels (vasculitis). In a media ...

  3. Hawaii Abandoned Vessel Inventory, Maro Reef, NWHI

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Maro Reef, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  4. PCs and networking for oceanographic research vessels

    Digital Repository Service at National Institute of Oceanography (India)

    Desai, R.G.P.; Desa, E.; Vithayathil, G.

    This paper, first describes briefly the evolution of data acquisition techniques and different system implementation, on board research vessels. A data acquisition system being developed for a coastal research vessel is then described which is based...

  5. Hawaii Abandoned Vessel Inventory, Lisianski Island, NWHI

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Lisianski Island, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction...

  6. Engineering a Blood Vessel Network Module for Body-on-a-Chip Applications.

    Science.gov (United States)

    Ryu, Hyunryul; Oh, Soojung; Lee, Hyun Jae; Lee, Jin Young; Lee, Hae Kwang; Jeon, Noo Li

    2015-06-01

    The blood circulatory system links all organs from one to another to support and maintain each organ's functions consistently. Therefore, blood vessels have been considered as a vital unit. Engineering perfusable functional blood vessels in vitro has been challenging due to difficulties in designing the connection between rigid macroscale tubes and fragile microscale ones. Here, we propose a generalizable method to engineer a "long" perfusable blood vessel network. To form millimeter-scale vessels, fibroblasts were co-cultured with human umbilical vein endothelial cells (HUVECs) in close proximity. In contrast to previous works, in which all cells were permanently placed within the device, we developed a novel method to culture paracrine factor secreting fibroblasts on an O-ring-shaped guide that can be transferred in and out. This approach affords flexibility in co-culture, where the effects of secreted factors can be decoupled. Using this, blood vessels with length up to 2 mm were successfully produced in a reproducible manner (>90%). Because the vessels form a perfusable network within the channel, simple links to inlets and outlets of the device allowed connections to the outside world. The robust and reproducible formation of in vitro engineered vessels can be used as a module to link various organ components as parts of future body-on-a-chip applications. © 2014 Society for Laboratory Automation and Screening.

  7. Techniques for Abdominal Wall Closure after Damage Control Laparotomy: From Temporary Abdominal Closure to Early/Delayed Fascial Closure-A Review.

    Science.gov (United States)

    Huang, Qian; Li, Jieshou; Lau, Wan-Yee

    2016-01-01

    Open abdomen (OA) has been an effective treatment for abdominal catastrophes in traumatic and general surgery. However, management of patients with OA remains a formidable task for surgeons. The central goal of OA is closure of fascial defect as early as is clinically feasible without precipitating abdominal compartment syndrome. Historically, techniques such as packing, mesh, and vacuum-assisted closure have been developed to assist temporary abdominal closure, and techniques such as components separation, mesh-mediated traction, bridging fascial defect with permanent synthetic mesh, or biologic mesh have also been attempted to achieve early primary fascial closure, either alone or in combined use. The objective of this review is to present the challenges of these techniques for OA with a goal of early primary fascial closure, when the patient's physiological condition allows.

  8. Purification of Mouse Brain Vessels.

    Science.gov (United States)

    Boulay, Anne-Cécile; Saubaméa, Bruno; Declèves, Xavier; Cohen-Salmon, Martine

    2015-11-10

    In the brain, most of the vascular system consists of a selective barrier, the blood-brain barrier (BBB) that regulates the exchange of molecules and immune cells between the brain and the blood. Moreover, the huge neuronal metabolic demand requires a moment-to-moment regulation of blood flow. Notably, abnormalities of these regulations are etiological hallmarks of most brain pathologies; including glioblastoma, stroke, edema, epilepsy, degenerative diseases (ex: Parkinson's disease, Alzheimer's disease), brain tumors, as well as inflammatory conditions such as multiple sclerosis, meningitis and sepsis-induced brain dysfunctions. Thus, understanding the signaling events modulating the cerebrovascular physiology is a major challenge. Much insight into the cellular and molecular properties of the various cell types that compose the cerebrovascular system can be gained from primary culture or cell sorting from freshly dissociated brain tissue. However, properties such as cell polarity, morphology and intercellular relationships are not maintained in such preparations. The protocol that we describe here is designed to purify brain vessel fragments, whilst maintaining structural integrity. We show that isolated vessels consist of endothelial cells sealed by tight junctions that are surrounded by a continuous basal lamina. Pericytes, smooth muscle cells as well as the perivascular astrocyte endfeet membranes remain attached to the endothelial layer. Finally, we describe how to perform immunostaining experiments on purified brain vessels.

  9. Collapsible Cryogenic Storage Vessel Project

    Science.gov (United States)

    Fleming, David C.

    2002-01-01

    Collapsible cryogenic storage vessels may be useful for future space exploration missions by providing long-term storage capability using a lightweight system that can be compactly packaged for launch. Previous development efforts have identified an 'inflatable' concept as most promising. In the inflatable tank concept, the cryogen is contained within a flexible pressure wall comprised of a flexible bladder to contain the cryogen and a fabric reinforcement layer for structural strength. A flexible, high-performance insulation jacket surrounds the vessel. The weight of the tank and the cryogen is supported by rigid support structures. This design concept is developed through physical testing of a scaled pressure wall, and through development of tests for a flexible Layered Composite Insulation (LCI) insulation jacket. A demonstration pressure wall is fabricated using Spectra fabric for reinforcement, and burst tested under noncryogenic conditions. An insulation test specimens is prepared to demonstrate the effectiveness of the insulation when subject to folding effects, and to examine the effect of compression of the insulation under compressive loading to simulate the pressure effect in a nonrigid insulation blanket under the action atmospheric pressure, such as would be seen in application on the surface of Mars. Although pressure testing did not meet the design goals, the concept shows promise for the design. The testing program provides direction for future development of the collapsible cryogenic vessel concept.

  10. 50 CFR 660.305 - Vessel identification.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Vessel identification. 660.305 Section 660.305 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC... Fisheries § 660.305 Vessel identification. (a) Display. The operator of a vessel that is over 25 ft (7.6 m...

  11. 50 CFR 660.704 - Vessel identification.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Vessel identification. 660.704 Section 660.704 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC... § 660.704 Vessel identification. (a) General. This section only applies to commercial fishing vessels...

  12. 50 CFR 660.504 - Vessel identification.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Vessel identification. 660.504 Section 660.504 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC... § 660.504 Vessel identification. (a) Official number. Each fishing vessel subject to this subpart must...

  13. 50 CFR 665.16 - Vessel identification.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Vessel identification. 665.16 Section 665... identification. (a) Applicability. Each fishing vessel subject to this part, except those identified in paragraph (e) of this section, must be marked for identification purposes, as follows: (1) A vessel that is...

  14. 3718-F Alkali Metal Treatment and Storage Facility Closure Plan

    Energy Technology Data Exchange (ETDEWEB)

    None

    1991-12-01

    Since 1987, Westinghouse Hanford Company has been a major contractor to the U.S. Department of Energy-Richland Operations Office and has served as co-operator of the 3718-F Alkali Metal Treatment and Storage Facility, the waste management unit addressed in this closure plan. The closure plan consists of a Part A Dangerous waste Permit Application and a RCRA Closure Plan. An explanation of the Part A Revision (Revision 1) submitted with this document is provided at the beginning of the Part A section. The closure plan consists of 9 chapters and 5 appendices. The chapters cover: introduction; facility description; process information; waste characteristics; groundwater; closure strategy and performance standards; closure activities; postclosure; and references.

  15. Mid-term Follow-up of the Transcatheter Closure of Perimembranous Ventricular Septal Defects in Children Using the Amplatzer

    Directory of Open Access Journals (Sweden)

    Mehdi Ghaderian

    2016-03-01

    Full Text Available Background: The ventricular septal defect (VSD is the most common form of congenital heart defects. The purpose of this study was to evaluate the results of the early complications and mid-term follow-up of the transcatheter closure of the VSD using the Amplatzer VSD Occluder.Methods: Between April 2012 and October 2013, 110 patients underwent the percutaneous closure of the perimembranous VSD. During the procedure, the size and type of the VSD were obtained via ventriculography. A device at least 2 mm larger than the VSD diameter measured via ventriculography was deployed. The size of the VSD, size of the Amplatzer, and device-size to VSD-size ratio were calculated. After the confirmation of the suitable position of the device via echocardiography and left ventriculography, the device was released. Follow-up evaluations were done at discharge as well as at 1, 6, and 12 months and yearly thereafter for the VSD occlusion and complete heart block.Results: The study population comprised 62 females and 48 males. The mean age and weight of the patients at procedure were 4.3 ± 5.6 years (range: 2 to 14 and 14.9 ± 10.8 kg (range: 10 to 43. The average device size was 7.0 ± 2.5 mm (range: 4 to 14. The VSD occlusion rate was 72.8% at the completion of the procedure and rose up to 99.0% during the follow-up. The most serious significant complication was complete atrioventricular block, which was seen in 2 patients. The mean follow-up duration was 10.9 ± 3.6 months.Conclusion: The transcatheter closure of the perimembranous VSD was a safe and effective treatment with excellent closure rates in our study population. This procedure had neither mortality nor serious complications. 

  16. FLUOLE-2: An Experiment for PWR Pressure Vessel Surveillance

    Directory of Open Access Journals (Sweden)

    Thiollay Nicolas

    2016-01-01

    Full Text Available FLUOLE-2 is a benchmark-type experiment dedicated to 900 and 1450 MWe PWR vessels surveillance dosimetry. This two-year program started in 2014 and will end in 2015. It will provide precise experimental data for the validation of the neutron spectrum propagation calculation from core to vessel. It is composed of a square core surrounded by a stainless steel baffe and internals: PWR barrel is simulated by steel structures leading to different steel-water slides; two steel components stand for a surveillance capsule holder and for a part of the pressure vessel. Measurement locations are available on the whole experimental structure. The experimental knowledge of core sources will be obtained by integral gamma scanning measurements directly on fuel pins. Reaction rates measured by calibrated fission chambers and a large set of dosimeters will give information on the neutron energy and spatial distributions. Due to the low level neutron flux of EOLE ZPR a special, high efficiency, calibrated gamma spectrometry device will be used for some dosimeters, allowing to measure an activity as low as 7. 10−2 Bq per sample. 103mRh activities will be measured on an absolute calibrated X spectrometry device. FLUOLE-2 experiment goal is to usefully complete the current experimental benchmarks database used for the validation of neutron calculation codes. This two-year program completes the initial FLUOLE program held in 2006–2007 in a geometry representative of 1300 MWe PWR.

  17. Staged bronchial closure in uniportal video-assisted thoracoscopic anatomical resection for lung cancer with calcified lymph nodes

    Science.gov (United States)

    Chen, Ying-Yuan; Lin, Tzu-Hung; Chang, Chao-Chun; Huang, Wei-Li; Yen, Yi-Ting

    2017-01-01

    Uniportal video-assisted thoracoscopic surgery (VATS) makes a breakthrough in these years. Even we have gained more experience and surgical skills of uniportal VATS, some elements, such as calcified perivascular lymph nodes, make the surgery challenging. In this series, we used staged bronchial closure (cut the bronchus first and then close it with stapler after dividing the pulmonary artery with calcified lymph node) as an approach for dealing with this challenging issue. Though the rate of intraoperative vessel injury is relatively high, we obtained ideal surgical outcome by using this technique in different lobes and segment of the lung. PMID:29302425

  18. Integrating Multiple Autonomous Underwater Vessels, Surface Vessels and Aircraft into Oceanographic Research Vessel Operations

    Science.gov (United States)

    McGillivary, P. A.; Borges de Sousa, J.; Martins, R.; Rajan, K.

    2012-12-01

    Autonomous platforms are increasingly used as components of Integrated Ocean Observing Systems and oceanographic research cruises. Systems deployed can include gliders or propeller-driven autonomous underwater vessels (AUVs), autonomous surface vessels (ASVs), and unmanned aircraft systems (UAS). Prior field campaigns have demonstrated successful communication, sensor data fusion and visualization for studies using gliders and AUVs. However, additional requirements exist for incorporating ASVs and UASs into ship operations. For these systems to be optimally integrated into research vessel data management and operational planning systems involves addressing three key issues: real-time field data availability, platform coordination, and data archiving for later analysis. A fleet of AUVs, ASVs and UAS deployed from a research vessel is best operated as a system integrated with the ship, provided communications among them can be sustained. For this purpose, Disruptive Tolerant Networking (DTN) software protocols for operation in communication-challenged environments help ensure reliable high-bandwidth communications. Additionally, system components need to have considerable onboard autonomy, namely adaptive sampling capabilities using their own onboard sensor data stream analysis. We discuss Oceanographic Decision Support System (ODSS) software currently used for situational awareness and planning onshore, and in the near future event detection and response will be coordinated among multiple vehicles. Results from recent field studies from oceanographic research vessels using AUVs, ASVs and UAS, including the Rapid Environmental Picture (REP-12) cruise, are presented describing methods and results for use of multi-vehicle communication and deliberative control networks, adaptive sampling with single and multiple platforms, issues relating to data management and archiving, and finally challenges that remain in addressing these technological issues. Significantly, the

  19. Multiple coil closure of isolated aortopulmonary collateral

    Directory of Open Access Journals (Sweden)

    Padhi Sumanta

    2010-01-01

    Full Text Available A 7-month-old girl was diagnosed to have large aortopulmonary collateral during evaluation for congestive heart failure. There was no other evidence of cardiopulmonary disease. The collateral was successfully closed with multiple coils delivered sequentially. We describe the issues associated during closure of the aortopulmonary collateral in this case. To the best of our knowledge, this is the first reported case of large aortopulmonary collateral presenting with heart failure in an otherwise structurally normal heart that was closed successfully with multiple coils delivered sequentially.

  20. Defense Base Closure and Realignment Commission

    Science.gov (United States)

    1993-01-01

    34A (mnor)Organlizar ion, Kansas City vInformat ion (C) Trideni Refit Fdily a Rii vinos \\VAy. Ulinr PceinCnirNIt(inr Organizat ion , CIlevelianid...the Gulf of Mexico was questionable. The Naval Station Ingleside, Fleet Training Center community also stated the closure of the Naval Mayport, and...EvlainFacility, VI,10 01t(NkEAlljU:jlNeMexico, inl Crder_ to IrIOVItLe 1iaisonl with the Albuquerque, N~ew Mexico Sandia L~ahorator)’ Of the DvIlepariucrt